STPAN 121 Metropolitan Borough of St. Pancras. REPORT of the MEDICAL OFFICER OF HEALTH FOR THE YEAR 1917. T. SHADICK HIGGINS, M.D., B.Sc,, Lond., D.P.H. Cantab. 3 CONTENTS. page. Public Health Committee 6 Introduction 7 Part I. - General Statistics— Population 9 Marriages 9 Births 10 Illegitimacy 10 Notification of Births 10 Deaths 10 Infantile Mortality 11 Infectious Diseases 1 1 Part II.—Special Subjfcts— Maternity and Infant Welfare 15 Work of Public Health Department 15 Payment for Medical Help to Midwives 16 Maternity and Child Welfare Sub-Committee 17 Dental treatment of Mothers and Young Children 18 Work of Voluntary Institutions 20 Midwifery 22 Government Grants 23 Infantile Diarrhœa 23 Ophthalmia Neonatorum 24 Puerperal Fever 24 Tuberculosis 25 Work Done 28 Treatment of Tuberculosis 28 Scarlet Fever 30 Diphtheria 30 After-care of Scarlet Fever and Diphtheria 32 4 CONTENTS—continued. page. Typhoid Fever 32 Anterior Poliomyelitis 33 Epidemic Cerebrospinal Meningitis 33 Measles and German Measles 34 Other Notifiable Infectious Diseases 36 Whooping Cough 36 Diarrhoea and Enteritis 36 Syphilis 37 Cancer 37 Dwelling Houses 38 Inspection of Dwelling Houses 38 Underground Rooms 38 Houses unfit for Habitation 38 Inhabited House Duty 39 Canal Boats Acts 39 Factories, Workshops and Workplaces: Bakehouses, Restaurant- kitchens, Laundries 40 Index of Factories, Workshops and Workplaces 42 Inspection of Food and Food Places 44 Sale of Food and Drugs Acts 44 Summonses 44 Public Health (Milk and Cream) Regulations, 1912 46 Inspection of Food 46 Dairies, Cowsheds and Milkshops 46 Ice Cream Premises 47 Fried Fish and Fish Curing Premises 47 Other Food Premises 47 Slaughterhouses 47 Rag Flock Act, 1911 47 General Sanitary Work 47 Inspections 47 5 CONTENTS — continued. page. Intimation Notices 48 Summonses 48 Smoke Prevention 49 Regulated Trades 49 Constructional Drain Work 49 Drainage Register 50 Water Service 50 Disinfection and Cleansing Station 50 Disinfection 50 Cleansing Station 51 Public Mortuary and Coroner's Court 52 Bacteriological Examinations 52 Staff 52 Administration of the Orders of the Food Controller 53 Appendix— Table No. 1.—Vital Statistics of the whole District for 1917 and previous years required by the Local Government Board 56 Table No. 2.—Showing registered Deaths classified for Causes, Age and Sex 57 Table No. 3.—Summary of above 61 Table No. 4.—Meteorology 62 Table No. 5.—Showing Inspections made by the District Inspectors, Temporary Women Inspectors and Factory and Workshop Male Inspector 6:i Table No. 6.—Showing Inspections and other work of the Food Inspectors 64 Table No. 7.—Showing Visits, &c., made by Women Inspectors 65 Table No. 8.—Showing Inspections and Re-inspections made by individual Inspectors 66 Tables Nos. 9, 10, 11 and 12.—Showing detiils of Intimation Notices served 67 6 St. Pattrras Bornugh Council. PUBLIC HEALTH COMMITTEE, 1917. CHAIRMAN. Councillor James Mansell Swift (Ward 7). DEPUTY-CHAIRMAN. Councillor Abraham Davis (Ward 8). EX-OFFICIO. The Right Worshipful the Mvyok. (Alderman C. W. Matthews, J.P.) ALDERMEN. Bryan, James Thomas. Hicklixg, George, J.P. Davies, David, J.P., L.C.C. Williams, Charles. COUNCILLORS. Ward 6 Bayly, Christopher Hodgson. 5 Blount, George. 3 Bolsom, Sidney. 2 Brown, Henky Joseph, J.P. 1 Carrington, Thomas. 1 Coggan, Cornish Arthur. 3 Cooke, Joseph John. 2 Cosburn, George Frederick, J.P. 4 Escott, Arthur. 2 Gardner, George. 8 Hensman, William. 4 Lloyd-Taylor, William, J.P. 5 Mayfs, Henry Arthur. 8 Newton, William. 3 Rollks, Harry. 5 Saunders, James. 1 Shearing, Arthur George. 8 Stoney, Rev. Ralph Sadleir, M.A. 7 Wood, William Charles. 7 Public Health Department, Town Hall, Pancras Road, N.W. 1. July, 1918. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of St. Pancras. Gentlemen, I have the honour to present to you the Sixty-second Annual Report on the vital statistics and sanitary condition of the Sanitary District of St. Pancras, including particulars of the year's work of the Public Health Department, ihis is the fifth annual report that it has been my duiy to submit. It has again been considerably abridged with a view to economy. The fear 4 that were expressed by many a the outbreak of the war that there would be a serious increa e in disease and mortality amongst the civil population have up to the present time proved groundless. The mortali v statistics have never been more satisfactory than during the « ar. The figures for 1917 are not quite so good as in 1916 either as regards total deaths or deaths of infants, but are better than in 1915. In regard to infectious diseases the most striking feature has been the remarkable decline in Scarlet Fever. Only 246 cases of this disease were notified during the year, amongst which there were but 4 deaths. Contrasting with this, the average annual number of cases notified in the 10 years 1890-99 was 1112, and the average annual number of deaths reported was 46, while the corresponding figures for the ten years 1900-09 were 867 and 26. The other infectious diseases were of about the usual prevalence, while ihere was a continuance of the outbreak of cerebrospinal meningitis which had occurred during the two previous years. The most serious effect of the war upon the population is thj great decrease which has occurred in the births. In 1917 there were born in St Pancras 1721 fewer babies than in 1913, the last year of peace, a decrease of 31 per cent. In the face of this loss of population the need for taking all possible steps to prevent infant and other mortality is more obvious than ever. The work in connection with the prevention of infant mortality has occupied much attention during the year. Two additional health visitors were appointed for visiting in connection with notified births and began work early in the year. The activity of the voluntary centres increased greatly, and new centres were opened in Falkland Road and Grafton Road, the latter in premises at the Public Ba'hs lent for the purpose by your Council. More complete co-ordination of their work with that of the Public Health Department has been secured, and a Maternity and Child Welfare Committee, on which is represented all the voluntary centres, formed as a sub-committee of the Public Health Committee, to advise on all questions concerning the welfare of mothers and young children. In this connection, ulso, the Public Health Department co- operated in the successful efforts made in St. Pancra-s during the first National Baby Week which was held in the summer, 8 It cannot be too strongly urged that the health of mothers and infants depends not only upon the proper provision of good midwifery, maternity and child welfare centres, and the other services which are now being provided, but still more upon general social and economic improvement in the lower working classes and upon the supply of proper housing for them. As has been pointed out in former reports the housing accommodation at present available in the borough for the working classes is most defective and urgently calls for improvement. In the latter half of the year, in accordance with the suggestion of the Local Government Board, the male sanitary inspectors undertook work in connection with the enforcement of the Orders of the Food Controller. This was done during their ordinary working hours, but at the end of the j ear an alteration was made whereby it was done mainly after their usual working hours, and special remuneration was paid them. It is with great regret that I have to record the death during the year of Mr. II. Riches, first clerk in the department. He had been in the Council's employment for 26 years, and his loss was greatly deplored by all. Owing to several \acaneies due to death and resignation, and to the absence of members of the staff with His Majesty's Forces, the work of the department has had to be carried on very largely with the help of temporary assistants, and 1 desire to express my hearty thanks to all the staff for their constant help in these difficult times. I would also like to tender my thanks to your Public Health Committee for the support they have given me ; and to your Council for the pers mal consideration they have invariably shown me. I am, Gentlemen, Your obedient Servant, Medical Officer of Health. Metropolitan Borough of St. Pancras. REPORT of the MEDICAL OFFICER OF HEALTH For the Year 1917. Part I.—GENERAL STATISTICS. For the purposes of this Report the year 1917 consists of the 52 weeks ended 29th December, 1917. POPULATION. The Registrar-General estimates the civilian population for St. Pancras for 1917, at 186,600, and the total population, including men on service, as 208,006. The former rate is used in this report in estimating death rates, and the latter in estimating birth rates. In previous years an estimate of the population has been made by the Medical Officer of Health, based on the census figures of 1911, but in view of the difficulty in estimating owing to the changes brought about by the war, the Registrar-General's figures are this year taken for the purpose of this Report. MARRIAGES. The number of marriages celebrated in St. Pancras during 1917 was 1979 (including marriages of soldiers and sailors). This is equal to a rate of 9*5 per 1,000 total population. BIRTHS. The number of births registered in the borough during 1917 was 3,635. From information received from the Registrar-General, the excess of births to parishioners occurring outside the borough over births to non-parishioners occurring inside the borough was 161. The net number of births for St. Pancras registered during 1917 was, therefore, 3,796, making an annual birth-rate of 18.2 per 1,000 total population, 10 In Table 1 (page 56), the corresponding rates for the past ten years will be found. It will be seen that the fall in the birth-rate, which has gone on during the war, has continued during 1917 at a greater rate than ever. The birth rate in 1917 was only 18.2 per 1,000, while in 1913, the year before the war, it was 24'7 per 1,000. 543 births occurred in Public Institutions in the borough, equal to 14.9 percent. of the total births which took place in the borough. Illegitimacy. Of the 3,635 births which were registered in the borough 229, or 6.3 per cent., were returned as illegitimate. Of the 3,796 births to parishioners within and without the borough, 275, or 7'2 per cent., were registered as illegitimate. The corresponding figures for 1916, 1915, 1914 and 1913 were 7.0, 5.4, 4.4 and 4.7 per cent, respectivelv. Notification of Births. Notifications were received during the year of 3,471 births, including 3,355 live births, or 95'5 per cent, of the number of births registered. In the table below the notified births are also classified (in Registration SubDistricts and Wards) according to the person in attendance upon the mother in her confinement. Births. W. S. E. N. Total 4 5 7 8 3 6 1 2 Attended in their own homes by— Private Doctors 105 104 24 74 218 33 259 125 942 Private Mid wives 149 17 3 34 86 5 219 244 757 Doctors from New Hospital for Women 16 9 2 22 27 8 9 20 113 Medical Students from— University College Hospital 65 180 2 11 148 248 4 16 674 „ Middlesex Hospital — 32 73 4 — — — — 109 Royal Free Hospital — — — 25 — — — — 25 „ St. Bartholomew's Hospital — — — 5 — — — — 5 M idwives from— University College Hospital 1 6 20 95 1 24 — — 147 „ Maternity Nursing Association, Myddleton Square — — 33 33 „ Maternity Nursing Association, Oakley Square Branch 14 37 7 1 39 23 2 — 123 Attended in Institutions— University College Hospital — — 151 — — — — — 151 New Hospital for Women — — — — — 29 — — 29 Duchess of Marlborough's Maternity Hospital — — 258 — — — — — 25S Homes of Hope, Regent's Square — — — 6 — — — — 6 Lying-inWard of Workhouse — — — — — 99 — — 99 11 Certain of the notified births set out in the above table as having taken place in St. Pancras institutions were of infants of mothers not resident in St. Pancras. On the other hand a number of St. Pancras mothers were confined in institutions outside the Borough. On page 23 will be found a table showing the number of births to St. Pancras mothers which took place in institutions within and without the borough. DEATHS. Deaths of members of His Majesty's Forces are not included in the following figures. The number of deaths of civilians that were registered during the year as having taken place in the borough was 3,032. Of these, 608 were of persons whose residence was not in St. Pancras (nonparishioners), 500 dying in St. Pancras institutions, and 108 in other places in the borough. There were also reported by the Registrar-General 675 deaths of St. Pancras parishioners who died in institutions in other parts of the County of London, and 43 who died in other parts of England and Wales. This correction gives ths net number of civil deaths for St. Pancras registered during the years as 3,142, making an annual death-rate of 16*8 per 1,000 civil population. (The death-rate, calculated upon the estimated total population, would be 15'1 per 1,000). In Table 1 (page 56), the corresponding rates for the past ten years will be found. It will be seen that this year's rate compares favourably with that of previous years. 1,496 deaths occurred in Public Institutions in the borough. Taking from these the number which were of non-parishioners (500), and adding the number of deaths of St. Pancras parishioners in Public Institutions outside the borough (703)—both from the Registrar-General's figures), the number of St. Pancras deaths which took place in Public Institutions is shown to be 1,699 or 54-l per cent, of the total deaths. The deaths are fully classified for causes, sex and age periods in table 2, fpp. 57-60). Infantile Mortality. 402 deaths of St. Pancras infants under one year of age took place during the year. This is equal to a rate of infantile mortality of 106 per 1,000 births. In table 1 (page 55) the corresponding rate for the past ten years will be found, 12 The table required by the Local Government Board, showing the causes of deaths amongst these infants, is set out below:— 1917. Next 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 4 weeks. 4 weeks & under 3 months. 3 months & under 6 months. 6 months & under 9 months. 9 months & under 12 months. Total Deaths under 1 year. All causes Certified 63 25 22 11 126 71 82 56 67 402 Uncertified — — — — — — — — — — Small-pox — — — — — — — — — — Chicken-pox — — — — — — — — — — Measles — — — — — — 4 5 21 30 Scarlet Fever — — — — — — — — — — Whooping-Cough — — — — — 3 4 6 1 14 Diphtheria and Croup — — — — — — — — 1 1 Erysipelas — — — — — 1 — — — 1 Tuberculous Meningitis — — — — — 1 1 — 2 4 Abdominal Tuberculosis — — — — — — 1 1 — 2 Other Tuberculous Diseases — — — — — — — 5 2 7 Meningitis (not Tuberculous) — — — — — — 2 4 4 10 Convulsions 4 — — — 4 1 — — — 5 Laryngitis — — — — — — 1 — — 1 Bronchitis 2 2 1 1 6 12 18 12 15 63 Pneumonia (all forms) — — 1 — 1 4 2 2 4 13 Diarrhœa — 2 — — 2 1 2 1 2 8 Enteritis — — 4 1 5 14 24 6 3 52 Gastritis — — — — — 2 — 1 1 4 Syphilis — 1 5 1 7 4 1 4 — 16 Rickets — — — — — 1 — — 1 2 Suffocation (overlying) 1 1 — 3 5 4 2 1 1 13 Injury at birth 1 2 — — 3 — — — — 3 Atelectasis 8 — — — 8 — — — 1 9 Congenital Malformations 6 3 1 2 12 3 3 — 1 19 Premature birth 40 8 6 2 56 4 1 — — 61 Atrophy, Debility and Marasmus 4 4 2 — 10 13 12 4 5 44 Other causes 2 2 2 1 7 3 4 4 2 20 Totals 68 25 22 11 126 71 82 56 67 402 Nett Births in the year legitimate 3796 Nett Death in the year of legitimate 333 illegitimate 275 illegitimate infents 64 13 The work that is being done in regard to the prevention of infant mortality is described elsewhere in this report (pages 15-23). INFECTIOUS DISEASES. The number of cases of the compulsorily notifiable infectious diseases that have been notified during 1917 is shown in the table below, where they are also classified according to ages. The figures have not been corrected for subsequent revision of diagnosis. DISEASES. At all Ages. At Ages—Years. Under 1. I and under 5. 5 and under 10. 10 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. 1. Variola or Small-pox — — — — — — — — 2. Scarlatina or Scarlet Fever 246 2 66 106 43 22 7 — 3. Diphtheria and Membranous Croup 451 12 114 179 70 50 25 1 4. Typhus Fever — — — — — — — — 5. Enteric or Typhoid Fever 24 — — 4 4 2 13 1 6. Fever, Simple or Continued — — — — — — — 7. Relapsing Fever — — — — — — — — 8. Puerperal Fever 9 — — — — 2 7 — 9. Erysipelas 126 6 8 2 8 16 67 19 10. Cholera — — — — — - — — 11. Plague — — — — — — — — 12. Anthrax — — — — — — — 13. Glanders — — — — — — — 14. Hydrophobia — — — — — — — — 15. Cerebrospinal Meningitis 25 9 3 4 2 3 4 — 16. Poliomyelitis 1 — 1 — — — — — 17, Ophthalmia Neonatorum 31 31 — — — — — — Total under Public Health (London) Act, 1891, Sec. 55 913 60 192 295 127 95 123 21 Tuberculosis—Public Health (Tuberculosis) Regulations, 1912, Primary Notifications on Forms "A," "B," "C" & "D": Pulmonary 825 3 21 81 53 115 516 36 Do. other Forms 169 5 17 48 39 22 36 2 Public Health (Measles and German Measles) Regulations, 1915— Measles 3681 241 1971 109; 110 178 88 — German Measles 6c 9 22 123 168 61 129 106 — 14 The notifications of, unci deaths from, the notifiable infectious diseases, are classified in the following table according to their Wards and Registration Sub-Districts:— INFECTIOUS DISEASES. notifications. deaths. West. Ward South Ward East. Ward North. Ward No Address. vv hole Borough. West. W ard South. Ward East. Ward North. Ward no Address. Whole Borough 4 5 7 8 3 6 1 2 4 5 7 8 3 6 1 2 1. Variola or Small-pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2. Scarlatina or Scarlet Fever 49 23 16 32 20 12 55 39 .. 246 .. .. .. 1 .. .. 2 1 .. 4 3. Diphtheria and M embranous Croup 59 79 31 41 47 53 77 64 .. 451 2 3 2 1 4 2 6 5 .. 25 4. Typhus Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5. Entericor Typhoid Fever 1 3 4 5 3 3 2 3 .. 24 .. .. 1 2 .. 2 .. 1 .. 6 6. Fever, Simple and Continued .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 7. lielapsing Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 8. Puerperal Fever 1 1 1 .. 1 .. 4 1 .. 9 .. .. 1 .. 2 .. 2 .. .. 5 9. Erysipelas 13 15 11 17 13 14 34 9 .. 12 7 .. .. 1 .. .. 1 .. .. 3 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 11. Plague .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 12. Anthrax .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 13. Glanders .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 14. Hydrophobia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 15. Cerebrospinal Meningitis* 3 4 1 4 6 2 4 1 .. 25 1 1 2 2 .. 2 2 1 .. 16 16. Anterior Poliomyelitis .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. 17. Ophthalmia Neonatorum 3 3 6 3 3 5 7 1 .. 31 .. .. .. .. .. .. .. .. .. .. Total under Public Health (London) Act, 1891, Section 55 129 128 70 102 94 89 183 118 .. 913 4 4 6 7 11 6 13 8 .. 59 Tuberculosis—Public Health (Tuber culosis) Regulations 1912, Primary notifications on Forms "A" "B" "C"and "D" Pulmonary 8o 118 71 113 110 90 78 71 94 825 31 48 22 51 46 54 42 34 25 353 „ other forms 21 22 7 25 29 26 15 16 8 169 12 18 .. 11 13 13 10 12 2 91 Public Health (Measles and German Measles) Regulations, 1915— Measles 443 568 215 362 706 509 582 296 .. 3681 11 24 1 16 11 21 18 15 1 118 German Measles 86 70 78 95 72 20 135 53 .. 600 .. .. .. 1 .. .. .. .. .. 1 * This figure includes 3 deaths from Posterior Basic Meningitis. 15 PART II.—SPECIAL SUBJECTS. MATERNITY AND CHILD WELFARE. The annual statistics in regard to births and deaths of infants are given on pages 9-11 and 11-12 of this report. A great deal of work in connection with maternity and child welfare is performed by various voluntary organisations in the borough, and the following sections set out the work done by the Public Health Department and the voluntary bodies respectively. Work of the Public Health Department. In January, 1917, as reported in the last annual report, two more health \isitors were appointed, which brought up the Council's staff of women health wor ers to seven ; viz: one sanitary inspector, two ladies who are sanitary inspectors as to half their time and health visitors as to half, two health visitors, and two temporary sanitary inspectors who are taking the place of men inspectors now with the forces. The work of the women sanitary inspectors in connection with tuberculosis and infectious diseases is valuable from the health visiting point of view although it comes under the heading of sanitary inspection. The amount of visiting which the health \isitors are able to do in connection with the notification of births is very much curtailed by the time they have to give up to other work, especially the visiting of notified cases of measles. As in previous years cards of advice have been posted to the mothers of all infants whose births have been notified, and as much visiting to them has been done as the health visitors have had time for. Some visits have also been made to expectant mothers whose names have been obtained from University College Hospital and the Middlesex Hospital, and cards of advice to expectant mothers have been supplied to these hospitals and the Maternity Nursing Association, one card being given to every St. Pancras woman who attends there to arrange for her confinement. The visiting work to infants and expectant mothers has been considerably supplemented by the work of the paid visitors from the various centres to which reference is made later. 16 "the work done during 1917 by the departmental staff is indicated by the following figures : — Total births (excluding still-births) notified 3355 Advice cards sent to cases notified (on receipt of notification) 3355 Advice cards sent to cases registered but not notified 257 Cautionary letters sent to cases registered but not notified 257 Expectant mothers reported from hospitals 1157 „ „ „ to local maternity centres 577 Advice cards for expectant mothers supplied to maternity hospitals, etc. 1350 Number of births visited 1308 Additional visits 1563 Total visits to mothers with infants (by Council's visitors) 2871 Number of expectant mothers visited 155 Additional visits 63 Total visits to expectant mothers (by Council's visitors) 218 Extra visits (to Centres, Hospitals, Midwives, etc.) 499 Payment for Medical Help to Midwives. On 25th July, 1917, the Council approved of a report from the Medical Officer of Health providing for payment being made to medical practitioners upon a fixed scale when they are called in by midwives to mothers or infants, and the family are unable to pay the medical fees. It was pointed out that midwives attend about one third of the births in the borough (excluding institutions), and it was estimated, judging from the statements of midwives, that, upon the scale mentioned below, the whole cost of this would be about £100 per annum of which one half would be repaid by the Local Government Board. It was felt that in the interests of the patient the midwife should be free to call in a doctor without any hesitation on the score of payment, and in order that there might be no doubt whatever in the mind of the doctor that he would obtain his fee it was arranged that he should be paid upon his own statement that tne patient in his opinion was unable to pay hu fee. No abuse of this privilege has occurred, and although enquiries have always been made in no case has it being considered necessary to call upon the patient to repay to the Council any part of the fee. It is evident that after paying the fees of the midwife, the woman to look after the house, and the other expenses connected with the confinement, a poor family has little left to pay the doctor, even after the receipt of the 30s. maternity benefit; and the Local Government Board have made it clear that they prefer that payment to medi 'al practitioners in such cases should be made by the Sanitary Authorities rather than through the Poor Law. The scale of payment decided u: on was as follows:— One guinea for a normal confinement and two guineas for a confinement presenting special difficulty or requiring operative interference, including in 17 each case the necessary subsequent attendances, and for calls not for the confinement itself, but before or after confinement 5s. for the first visit (10s. 6d. if between 9 p.m. and 9 a.m.) and 2s. 6d. for each subsequent visit. Subsequently a fee of one guinea to a doctor called in to administer an anaesthetic was added to the scale. The following applications were received during 1917, the first coming in on 7th November:— Mother or Infant. Nature of emergency. Fee paid. £ s. d. Infant Incomplete expansion of lungs 0 7 6 Mother Abortion with profuse haemorrhage 2 2 0 Infant Incomplete expansion of lungs 0 7 6 Mother Severe lacerated perineum 0 17 6 Infant Prematurity and ophthalmia neonatorum 0 12 6 Mother Secondary haemorrhage 1 3 0 Formation of Maternity and Child Welfare Advisory Sub-Committee. During 1917 an invitation was issued by the Council to the different Maternity and Child Welfare Centres in the borough to appoint representatives to a committee upon which the Council were also to be represented. The committee was subsequently appointed as a sub-committee of the Public Health Committee under the title Maternity and Child Welfare Advisory Sub-Committee and with the following membership:— Representing. Name. Borough Council The Mayor (Alderman C. W. Matthews, J.P.).' The Chairman of the Public Health Committee (Councillor M. J. Swift). The Vice-Chairman of the Public Health Committee (Councillor A. Davis). Councillor A. Escott {Chairman). Alderman C. Williams. Councillor C. A. Coggan. Councillor G. F Cosburn, J.P. Councillor H. Rolles. St. Pancras School for Mothers Lady Meyer. Mrs. Hopkins. Dr. Matilda Hunt. North St. Pancras School for Motheis (Three Centres) Counte-s Grey. Viscountess Wolmer. Mrs. Mia'l Smith. Passmore Edwards Settlement School for Mothers Mrs. E. R. Thouless. Camden Town Mothers and Infants Welfare Centre — 18 Representing. Name. Argyle Square Mothers and Infants Weliare Centre (Two Centres') Miss de Pass. Miss M. Landel Jones Maternity Nursing Association Miss Hilda Blunt. St. Paneras Dispensary Dr. F. L. Provis. University College Hospital Dr. G. F. Blacker. Dr. E. A. Barton. Royal Free Hospital Lady Barrett, M D. The object of the Sub-Committee is to complete the co-ordination of the Borough Council with the voluntary welfare Centres, and to deal with problems of maternity and child welfare from the point of view of the borough as a whole. The first meeting was held on 29th November, 1917, and they have since made recom nendations to the Council in respect of the many important matters con erning this subject, including; dental treatment and the supply of food for mothers and young children, and have been given executive as well as advisory functions. Dental Treatment of Mothers and Young Children. This was one of the first matters considered by the Maternity and Child Welfare Advisory Sub-Committee. Towards the end of the year they asked for a report on the subject from the Medical Officer of Health, which was submitted to them in the following terms at their first meeting in the New Year. 9th January, 1918. To the Chairman and Members of the Maternity and Child Welfare Advisory Sub-Committee. Ladies and Gentlemen, At the first meeting of your Suli-Committee the question of the provision of dental treatment for mothers and children attending the various Maternity and Child Welfare Centres in the Borough was discussed, and I was asked to submit a report on the subject, which I now do. The Need.—Of the urgency of the need for such treatment there is no doubt. The experience of physicians at the Centres show s that the majority of expectant and nursing mothers attending there are suffering from dental decay and its consequences. A great deal of ill-health is caused to the mothers by these conditions, and there is very good evidence that the infants in some cases suffer owing to the dental condition of the mothers. In regard to the children's own teeth, the bad dental state of children entering the public elementary schools is notorious, only a very small percentage having sound teeth. The affected teeth in children below school age are "temporary" teeth, but the dental decay is not negligible on that account, for in addition to immediate ill-health it is held by those who have studied the question that damage to the permanent teeth may be caused by it. The decay seen in the teeth of school children begins while they are still of an age to atten.d the infant welfare centres, and it is then that proper treatment would save the teeth and perhaps prevent life-long injury. Existing Facilities.—In dental treatment a distinction must be made between (a) extractions, (b) conservative treatment ("stoppings"), and (c) the provision of dentures (artificial teeth). 19 The facilities at present existing in the Borough apart from private dental practice are very scanty. Extractions are done at most of tlie out-patient departments, but so far as I can ascertain the only hospital where the general public can obtain other dental treatment is the British Dentists' Hospital, Camden Road, where the patients are required to pay for the work done. The dental departu ent of University College Hospital (the National Dental Hospital, Great Portland Street), which also provides all kiuds of dental treatment and requires certain payments or the production of subscribers' letters, is outside the Borough. Dental treatment for school children is provided by the London County Council at their Treatment Centres. The St. Pancras School for Mothers, 1, Amptliill Square, has for some years provided dental treatment at their Centre for mothers and children attending there. Much credit is due to the Centre and to the dentist (Mr. George Thomson, l.d.s.) for this pioneer work. A charge is made, except for extractions. None of the other 11 Maternity and Child Welfare Centres in the Borough have any dental facilities, except the Centre at University College Hospital. Even when extractions and fillings are done without charge, there still remains the difficult question of artificial teeth. When many teeth are extracted these are essential, and seeing that the hospital charge for a complete set is £4, the difficulty of supplying them to people who cannot pay is obvious. Certain societies give assistance in this direction, and these are mentioned in the last paragraph of this report, where the matter is further considered. Recommendations.—Arrangements ought to be made at once for mothers and children attending all the Centres in the Borough to have proper dental attention. It would be convenient if each Centre could have this done on its own premises, but in most cases the premises are not suitable for the purpose. The most practical scheme for the present would be the institution of a central dental clinic to which the patients could be sent from all the Centres. The number of cases to be dealt with is not determined by the number of mothers and children requiring attention, but by the number attending the Centres wJio are willing to undergo treatment. It would be further limited if artificial teeth cannot be provided. The work to be done immediately is for this reason likely to be only moderate in amount, though there are undoubtedly mothers and children who would be glad to accept treatment if it were offered. The St. Pancras School for Mothers are able to meet the dental needs of their cases by one afternoon's dentistry per week, and in this way they dealt with the teeth of 150 mothers (making about 260 attendances) at the 36 dental clinics held in the year ended 31st March, 191", in addition to attention given to the children. The other Centres in the Borough (not counting that at University College Hospital) are dealing with from two to three times as many cases as the St. Pancras School for Mothers, and at the same rate these should need two or three half-day dental clinics per week; but I am inclined to think that for a time one such clinic per wfeek would go far towards meeting their needs so far as extractions and fillings are concerned. The British Dentists' Hospital, 81, Camden Road, is fully equipped for such a clinic, is conveniently situated, and I understand that the use of the premises and fittings, including the services of an attendant, could be secured here for one half-day a week for a suitable payment, which I am informed is likely to be about £65 per annum. The services of a dentist could be secured for a fee of one guinea per half day aticndance. and in addition a doctor would be required for administering anaesthetics (say) once a month, and could probably be obtained also for a fee of one guinea per attendance. The cost of materials would be small, and I estimate that such a weekly clinic for extractions and fillings (not dentures), which would involve no capital expenditure, could be maintained at a cost not exceeding .£150 ptr annum, one-lialf of which would be repayable by the Local Government Board. If the work inert ased so that more than one clinic per week were required, the expenditure would, of course, be proportionately increased. 20 The responsibility for Maternity and Child Welfare rests upon the Borough Council as the Sanitary Authority. The Centres in the Borough involve an expenditure exceeding two thousand pounds per annum, which is met entirely out of voluntary subscriptions and Government grants, and the provision of the dental centre might well be a contribution from the Council to their work. The Local Government Board have stated in a letter dated 20th December, 1917, that they will repay to the Council 50 per cent, of the cost of the work. If this provision is made by the Council, its administration might well be undertaken by your SubCommittee. This recommendation in regard to a dental clinic refers only to extractions and fillings, and not to the question of artificial teeth. The women attending the Centres are ill able to pay for dental treatment, and this is one of the reasons why they do not secure it. Moreover any charge would tend to add to their natural reluctance to undergo treatment, and I would therefore suggest that, like the other attention they receive at the Centres, it should be provided free, as far as concerns extractions and stoppings. There remains the important question of the provision of artificial teeth. This is an essential part of the problem and in many cases it is impossible to remove the bad teeth until it is certain that the patient will be able to get new ones. They are expensive and at present the Local Government Board exclude dentures from the expenditure towards which they will make a grant." It would therefore seem desirable that poor women who need dentures which they clearly cannot afford, should be helped from funds provided wholly or partially from voluntary sources. The matter is, however, one which cannot be neglected in a complete scheme, and the provision of dentures is essential to the most effective working of a dental clinic. At present a certain amount of help for poor patients in this direction is obtainable from various funds, including the Sunday Hospital Fund, the Surgical Aid Society, the Charity Organisation Society, and the Ivory Cross, but this is not sufficient to meet our needs. The Sub-Committee should therefore consider the possibility of raising a special voluntary fund for helping necessitous mothers in paying for artificial teeth, and it would be most valuable if a nucleus of the fund could be obtained from the Mayor's Local Charities Fund and other established local charitable agencies. It is only by such co-operation between the local authority and voluntary effort that the best results can be obtained. I am, etc., T. Shadick Higgins, Medical Officer of Health. A municipal dental clinic for expectant and nursing mothers and young children on the lines indicated in the report was opened early in 1918 at the British Dentists' Hospital, 31, Camden Road. * Since this was written the Board have extended their grant to the provision of dentures in necessitous cases. Work of the Voluntary Institutions. The work done during 1917 at the 11 voluntary centres (and by the Borough Health Visitors) is shewn in the following table:— 21 Attendances. Visits by Trained Visitors. No. of infant consultations held. No. of consultations for expectant mothers only. No. of trained visitors.‡ Expectant Mothers. Children. Expectant Mothers. Children. New cases. Total attendances New cases. Total attendances. First visits. Total visits. First visits. Total Visits. Under 1 year. Over 1 year. Total. Under 1 year. Over 1 year. Total. Borough Health Visitors — — — — — — — — 155 218 1252 2925 — — 2 (whole time). 2 (half time). St. Pancras School for Mothers 64 147 227 83 310 — — 2988 — 499 — 1688 135 47 2 (whole time). 1(half time). North St. Pancras School for Mothers:— Rhyl Street Centre 34 86 263 15 278 3336 550 3886 19 149 62 1986 97 23 2 (whole time). Winscombe Street Centre — — 43 — 43 543 76 619 — — 78 515 50 — 1 (3 days per week). Grafton Road Centre — — 59 13 72 560 100 660 — — 141 798 42 — *Passmore Edwards Settlement School for Mothers 5 5 59 28 87 401 195 596 30 50 91 538 50 — 1 (3 half days per week). Camden Town Mothers' and Infants' Welfare Centre 16 41 87 22 109 1051 505 1556 11 28 98 778 47 — 1 (2 days per week). Argyle Square Mothers' and Infants' Welfare Centre 49 124 112 37 149 1391 37 1428 99 146 376 1323 51 24 1 (whole time, paid). Falkland Road Mothers' and Infants' Welfare Centre — — 123 — 123 1084 — 1084 51 — 1 (whole time, unpaid). Maternity Nursing Association, 73, Oakley Square 105 372 334 — 334 864 96 960 203 288 354 677 26 12 visiting done by midwives. †University College Hospital — — — — 542 — — 1560 — — 639 1917 — 51 1 (whole time). †Royal Free Hospital 257 610 139 12 151 I 681 39 720 241 1285 198 2931 47 — 1 (whole time). *South HampsteaJ Centre, Lisburne Road — — 35 7 42 180 12 192 — — — 52 — * Counting St. Pancras cases only. †Including cases living outside St. Pancras. ‡These assist at the consultations besides visiting. 22 The Four Boroughs Maternity Scheme has supplied the Medical Officer for the pre-natal consultations (twice monthly) at the Bhyl Street and Argyle Square Centres. The Grafton Road Centre is held in rooms in the Public Baths, Prince of Wales Road, lent by the Borough Council. Lists of expectant mothers (from University College and Middlesex Hospitals) and of recently notified births have been supplied from time to time to certain of the centres, in order that visits might be paid to the homes from the centres. The number of names supplied was as follows:— Centres. Expectant Mothers. Births. St. Pancras School for Mothers 447 — 40, Argyle Square 87 180 Passmore Edwards Settlement 37 136 Winscombe Street — 85 Falkland Road 6 179 Grafton Road — 169 Infants' Clinic.—The special clinic for sick children under school age has been continued at the St. Pancras Dispensary, 39, Oakley Square. The infants are referred to the clinic from the various infant welfare centres and other sources. During 1917, 402 new cases under five years of age were treated at the dispensary, of which 103 were visited by the dispensary doctor in their own homes. The total number of attendances of these children was 1446, and the total number of the doctor's home visits 362. The dispensary also attended 44 women for illness associated with pregnancy or the puerperium, who made 120 attendances. In February, 1917, a half-time visiting nurse was appointed at the Dispensary for the home visiting and nursing of sick children, half the salary being repaid to the Dispensary by the Mayoress of St. Pancras Nursing Fund for Sick Poor Children. To the end of 1917 the Nurse paid 771 visits to children under 5. Home Helps.—The need for domestic assistance for women in sickness and childbirth had long been felt, and at the end of 1917 a small fund kindly collected for the purpose by ladies of the South St. Pancras War Pensions Committee, was put at the disposal of Miss Bibby, and a committee was formed of which the Medical Officer of Health was made Chairman and Miss Bibby Hon. Secretary, for the purpose of putting a scheme into operate n. The work done by the committee belongs more properly to 1918. Midwifery Work. "Extern" Midwifery.—The number of St. Pancras mothers attended gratuitously at their confinements in their own homes during 1917, according to the birth notifications, was as follows:— * New Hospital for Women (doctors) 113 University College Hospital (medical students) 674 „ „ „ (midwives) 147 Middlesex Hospital (medical students) 109 Royal Free Hospital (medical students) 25 St. Bartholomew's Hospital (medical students) 5 * Maternity Nursing Association, Myddleton Square and Oakley Square (midwives) 156 1229 (or one-third of the total number of births). *In some of these cases the women were charged reduced fees. 23 "Intern" Midwifery.—The number of St. Pancras births which took place in hospitals were as follows:— University College Hospital 92 Middlesex Hospital 114 Queen Charlotte's Lying-in Hospital 198 City of London Lying-in Hospital 74 *Duchess of Marlborough's Maternity Hospital, 21, Endsleigh St. 68 St. Pancras House 74 Other hospitals 42 662 (or one sixth of the total number of births). *Including paying patients. Government Grants. Government Grants were made during the year ended March 31st, 1918, in respect of Maternity and Child Welfare work as follows:— From the Lon,al Government Board:— £ s. d. St. Pancras Borough Council 115 0 4 North St. Pancras School for Mothers (and branches) 176 18 5 *Passmore Edwards Settlement School for Mothers 40 8 1 Camden Town Centre, Greenland Street 31 14 11 Centres at Argyle Square and Falkland Road 206 I 10 Maternity Nursing Association (for Infant Welfare Centre) 61 13 11 *The Four Boroughs Maternity Centres 127 7 6 *Maternity Nursing Association (for extern Midwifery and Maternity Nursing) 200 8 3 *University College Hospital (fur extern Midwifery and Infant Welfare Centre) 907 11 4 *Royal Free Hospital (for extern Midwifery and Infant Welfare Centre) 272 5 0 St. Pancras Dispensary (Infant Clinic) 52 10 0 From the Bt ard of Education:— St. Pancras School for Mothers 479 18 1 * Including expenditure on work amongst residents ontside of Sl. P ireras. INFANTILE DlARHHEA. 61 deaths of infants under one year of age from diarrhoea and enteritis were registered during 1917. The number of such deaths in each quarter of the year was as follows :— First quarter 17 Second ,, 11 Third ,, 17 Fourth „ 16 The number of deaths of children under 5 years of ago from diarrhoea and enteritis was 80. 24 OPHTHALMIA NEONATORUM. 31 cases were notified during 1917, 27 by doctors and 4 by midwives. Of these, 3 were found to have begun after the age of 3 weeks, and 1 was in a St. Pancras institution in the person of an infant whose mother's home was out of London. The corrected number of notified cases was therefore 27, equal to an incidence rate of 7.1 per 1,000 births. Other numerical details will be found on pages 13.14. 4 cases were regarded by the visitor as grave, 11 as moderate, and 12 as slight. 7 of the cases have since died. 8 were illegitimate. The cases are classified below according as the mothers were attended in their confinement by doctors, midwives, or medical students (in their own homes), or were delivered in hospital. Attended a birth by Cases of Ophthalmia Neonatorum. Total number of births notified. No. of cases per 1000 births notified. Doctors 6 1055 5-7 Medical Students 1 813 1-2 Midwives from Institutions 3 303 1-0 Private Midwives 5 757 6-6 Delivered in Hospitals and Institutions 12 A visiting nurse was called in in 11 cases, 5 cases were removed to hospital, and 2 cases died in the institutions where they were born. The other 9 cases were nursed by their own families. The results of treatment were as follows:— Complete recovery (including 5 who afterwards died) 21 Blind 1 Sight damaged, but improving 1 Died before recovery 2 Cases lost sight of 2 PUERPERAL FEVER. 9 cases were notified during 1917, equal to an incidence rate of 2"4 per 1,000 births. 4 deaths occurred amongst these, giving a case mortality of 44 per cent. One other death was registered (in an institution outside St. Pancras), the total number of deaths for the year being 5. No particulars were available as to 1 case, and the following figures apply to the remaining 8:— 4 followed the birth of live-born infants, 1 a dead viable infant, and 3 abortions. 25 6 of the patients were primiparse (i.e., women who had not previously borne children), and 2 multiparae. In 3 cases "instruments" were used at the confinement. In no case was there any obvious source of infection in the home. In the following table the cases are classified according to the manner in which the patients were a'tended in their confinements : Confinement attended by No. of cases of Puerperal Fever. Total number of births notified. No. of cases per 1000 births. Doctors 7 1055 6.6 In Hospital 1 No Medical assistance 1 There were no cases reported in the practice of midwives or medical students. TUBERCULOSIS. The number of notifications of civilian cases of tuberculosis received during the year are set out in the form suggested by the Local Government Board in the table on the next page. The total number of primary notifications (civilian) received during the year on forms A, B, C, and D, was 994 (825 pulmonary, 169 non-pulmonary), equal to a notification rate of 5'33 (4.42 pulmonary, 0.91 non-pulmonary) per per 1000 civilian population. The deaths from tuberculosis during the year numbered 444, of which 353 (215 males, 138 females) were from phthisis, and 91 (44 males, 47 females) from other forms of tuberculosis. 26 Public Health (Tuberculosis) Regulations, 1912. Summary of Notifications during the period from 31st December, 1916, to the 29th December, 1917 (inclusive). Age Periods. Number of Notifications on Form A. Number of Notifications on Form B. Number of Notifications on Form C. Number of Notifications on Form D. Primary Notifications. Total Notifications (i.e., including cases previously notified by other Doctors). Primary Notifications. Total Notifications i.e., including cases previously notified by other Doctors). Poor L aw Institutions. Sanatoria. Poor Law Institutions. Sanatoria. 0 to 1 1 to 5 5 to to 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. Under 5 5 to 10 10 to 15 Total. Pulmonary—Males 1 8 25 18 13 23 64 75 58 38 18 341 389 1 9 3 13 14 191 102 112 107 ,, Females 1 8 24 24 20 29 64 49 22 14 7 262 288 — 11 3 14 15 73 67 35 68 Non-pulmonary—Males 1 6 14 12 7 1 5 2 5 3 1 57 63 — 10 3 13 15 13 4 7 6 „ Females 4 9 10 12 7 4 9 5 3 — 1 64 72 — 9 8 17 20 15 5 7 4 Totals 7 31 73 66 47 57 142 131 88 55 27 724 812 1 39 17 57 64 292 178 161 185 Age Periods. Number of Primary Notifications on Form C. included in above. Number of Primary Notifications on Form D. included in above. 0 to 1 1 to 5 5 to 10 10 to 15 15 to 20 20 to 25 25 to 35 35 to 4S 45 to 55 55 to 65 65 and upwards. Total. 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. Pulmonary—Males 1 2 5 2 5 6 19 18 18 13 6 95 — — — — 1 2 9 9 6 6 3 36 ,, Females — 2 5 2 4 6 10 9 4 3 2 47 — — 2 — 2 4 6 1 1 1 — 17 Non-pulmonary—Males — 1 1 1 — 1 3 — — — — 7 — — 2 — — — — — — — — 2 ,, Females — 1 1 2 1 — — 1 — — - 6 — — 1 1 — 1 — — — — — 3 Totals 1 6 12 7 10 13 32 28 10 8 155 — — 5 1 3 7 15 10 7 l7 3 58 27 This is equal to a death-rate of 2.38 (l.89 pulmonary, 0.49 non-pulmonary) for 1000 civilian population. The deaths are classified in the following table:— 0-1 1-5 5—15 15—25 25—35 35—45 45—55 55—05 65—75 75—85 85 up. Total Males. 0-1 1-3 5—15 15—25 25—35 35—45 45—55 55-65 65-75 75—85 85 up. Total Female. Total Persons. Pulmonary Tuberculosis 1 2 4 17 25 47 55 27 n 3 — 192 - 2 6 22 25 29 15 15 3 — — 117 309 Phthisis (not defined as tuberculous) - - - 1 8 4 4 4 1 1 - 23 - 3 7 4 1 2 4 - - - 21 14 Total Pulmonary Tuberculosis 1 2 4 18^33 1 51 59 3' 12 4 215 r 2 9 29 29 30 3 - 138 353 Acute Phthisis — — — 1 1 1 1 1 — — — 5 — — — — — 1 — — — — — 1 6 Acute Miliary Tuberculosis 2 1 — — — 1 — — — — — 4 1 — — 1 — — — — — — — 2 6 Tuberculous Meningitis 3 8 3 — - — — — — — — 14 3 12 7 — — — — — — — — .22 36 Tabes Mesenterica — — — — — — — — — — — — — — — — — — — — — — — 2 2 Other Peritoneal and Intestinal Tubercle 2 — — — — 1 — — — 4 1 4 3 1 — — 1 — — — — 10 14 Tuberculosis of Spinal Column — — 1 1 — 1 1 — — — — 4 — 1 — — — — 1 — — — — 2 6 Tuberculosis of Joints — — 2 3 — — — 1 — — — 6 — — 1 — — — — — — — — 1 7 Lupus — — — — — — — — — — — — — — — — — — — — — — — — — Scrofula — — — — — — — — — — — — —— ——— ——— — — — — — — — — — — Tuberculosis of other Organs _ — — 1 — — 1 — — — — 2 — 1 1 — — — — 1 1 — — 4 6 Disseminated Tuberculosis - 2 — 1 2 — — — - - — 5 1 1 1 — — — — — — — — 3 8 Total Non-Pulmonary Tuberculosis 6 13 6 7 3 3 3 3 — - - 44 6 21 13 2 — 1 2 1 1 - - 47 91 Total all forms of Tuberculosis 7 15 10 25 36 54 62 34 12 4 — 259 6 23 22 31 29 31 19 20 4 - - 185 444 In the next table the new cases notified during 1917 are similarly classified. 28 Location of Disease. Ages. Total. 0-5 5-15 15 and upwards. Males. Females. Males. Females. Males. Females. Pulmonary Tuberculosis 13 22 62 60 410 258 825 Bones and Joints — 1 12 13 12 11 49 Meninges 2 6 1 5 — 1 15 Glands 4 5 21 22 6 10 68 Abdominal 1 — 3 2 1 — ly 7 Genito-U rinary — — — — — — — General 1 1 — — — — 2 Other Organs — 1 6 3 10 8 28 Total Non-pulmonary Tuberculosis 8 14 43 45 29 30 169 Total all forms of Tuberculosis 21 36 105 105 439 288 994 Work Done. The visiting work done during 1917 by the female visiting staff is indicated in the following table:- Number of visits to homes of notified cases— (a) First visits 1224 (b) Subsequent visits 249 Number of cases in which disinfection was carried out 102 Attendances of inspector or visitor at the dispensaries 71 Other visits made for various purposes 120 Treatment of Tuberculosis. The work done during 1917 at the approved tuberculosis dispensaries, which are completely subsidised by the Borough Council and through them by the Local Government Board, the London County Council and the London Insurance Committee, is shown in the following table based on returns supplied by the dispensaries:— 29 Tuberculosis Dispensary at University College Hospital. Tuberculosis Dispensary at StPancras Dispensary 39, Oakley Square Branch Tuberculosis Dispensary of St. Pancras Dispensary at 182, Maiden Road. Insured persons. Uninsured persons. Total. Insured persons. Uninsured persons. Total. Insured persons. Uninsured persons. Total. No. of new cases 86 97 183 231 251 482 18 71 89 No. found to be suffering from pulmonary tuberculosis 53 33 86 163 98 261 14 18 32 Ditto non-pulmonary do. 2 8 10 8 27 35 1 5 6 Ditto non-tuberculous 6 10 16 10 32 4 2 2 18 20 No. in whom diagnosis was found to be doubtful 25 46 71 50 94 144 1 30 31 Total attendances 666 669 1335 711 1769 2480 57 551 608 No. of above attendances at which physical examinations and records were m de 165 214 379 360 592 952 26 184 210 Home visits by Tuberculosis Officer 2 1 3 50 30 80 3 2 5 Ditto by Dispensary Nurse 118 195 313 181 491 672 131 292 423 No. of persons referred to the hospital to which this Dispensary is affiliated 0 4 4 24 42 66 11 15 26 No. of consultations with Medical Practitioners 1 1 2 0 0 0 0 0 0 No. of written reports to:— (a) Public Authorities 58 55 113 208 187 395 24 36 60 (b) Practitioners 36 26 62 74 30 104 9 17 26 No. of Specimens of sputum examined 40 30 70 46 35 81 Included under Oakley Square Residential Institutions. —Institutional treatment (sanatorium and hospital) is provided by the London Insurance Committee and the London County Council, and not by the Borough Council. A very conside able amount of work is clou by the Borough Medical Officer of Health (as Administrative Tuberculosis Officer) and the approved dispensaries in selecting suitable cases for such treatment, and recommending them to these providing authorities, and also in assisting them in their researches into the after-history of the cases. This division of responsibility between authorities lea Is to a very large amount of correspondence and cross-reference which would be avoided if the administration of all matters concerning tuberculosis patients in the Borough were in the hands of the Borough Medical Officer of Health including the selection of cases to be admitted for institutional treatment. Many tuberculous poor are dealt with by the Guardians in the Infirmaries, and charitable societies send away a certain number of cases. 30 The institutional treatment of pulmonary tuberculosis is very unsatisfactory for the reason that it is necessary in the majority of cases for the patient to return subsequently to bad social conditions at, home, and with our present knowledge the only really satisfactory w ay of dealing with the patients is to place them permanently in the surroundings best suited to the nature of their illness. This can only be done by the provision of a sufficient number of industrial or farm colonies, sanatorium schools, hospitals for advanced cases, &c. SCARLET FEVER. 246 St. Pancras (civil) patients were notified during 1917 as suffering from scarlet fever. Of these, 22 were afterwards found not to be (suffering from scarlet lever by Medical Superintendents of the Metropolitan Asylums Board Hospitals. This gives the net number of cases of scarlet fever notified during the year as 224, equal to an incidence rate of 1.08 per 1,000 population, and 1.20 per 1,000 civil popu'ation. The number of cases of this disease notified during the year was very much less than any other year since ! 889, when the disease was made notifiable. The number of deaths from scarlet fever cerified during the year was 4, equal to a death-rate of 0.02 per 1,000 population, and a case mortality of 1.8 per cent, of cases notified. Other statistical facts in regard to the disease will be found on pages 13 14. Of the notified cases of scarlet fever, 238 (or 96.7 per cent.) were removed to hospital, as follows:— To Metropolitan Asylums Board Hospitals 236 To other hospitals 2 288 Return Cases.—Only 3 return cases (in 3 houses) of scarlet fever were recorded in 1917. In each instance the return case was in the same family as the infecting (?) case. The intervals between the return of the first case and the onset of the second were 2, 5, and 23 days respectively. Two of the infecting (?) cases showed no signs of infectiousness and one had a nasal discharge. There were no cases of scarlet fever recorded as following upon the return of cases of diphtheria. On page 32 will be found a reference to after-care work amongst scarlet fever and diphtheria patients. DIPHTHERIA. 451 St. Pancras (civil) patients were notified during 1917 as suffering from diphtheria or membranous croup. Of these, 70 were afterwards found not to be suffering from diphtheria, 69 by Medical Superintendents of the 31 Metropolitan Asylums Board hospitals, and 1 by other medical practitioners. This gives the net number of cases of diphtheria notified during the year as 381, equal to an incidence rate of T83 per 1,000 population, and 2.04 per 1,000 civil population. The number of deaths from diphtheria certified during the year was 25, equal to a drath-rate of 0.12 per 1,000 population, and 0.13 per 1,000 civil population, and a case mortality of 5.5 per cent, of cases notified. Other statistical facts in regard to diphtheria will be found on pages 13-14. Of the notified cases of diphtheria 415 (or 98.7 per cent.) were removed to hospital as follows:— To Metropolitan Asylum Board hospitals 441 To other hospitals 4 445 Return Cases.—In 5 instances (in 5 houses) cases of diphtheria occurred within 28 days of the return from hospital to the same house of previous cases of the same disease, in 4 instances in the same family, and in one instance in a different family. The intervals between the return of the infecting (?) case and the onset of the return case were 6, 18, 19, 19, and 24 days respectively. In 2 of the infecting (?) cases there were no apparent signs of infectiousness, and in another there was s ight nasal catarrh. In the 2 other cases there was nasal discharge, which showed the 13. diphtheriae on swabbing: these were re-admitted to hospital. In one of these instances (24 days: separate family) there were 2 other cases of diphtheria, taking their onset 4 and 7 days respectively after the first return case. There were also 2 other cases of diphtheria (in 2 houses) occurring within 6 weeks of the return of previous cases in the same family. In one of these, the infecting (?) case had nasal discharge and otorrhœa, gave a positive swab from the nose, and was re-admitted to hospital. Thera was one case of diphtheria occurring 5 weeks after the return from hospital of a brother who ha 1 suffered from scarlet fever. The first case had slight nasal catarrh. In one house there was a somewhat remarkable series s of return-cases (included in those mentioned above). In February 3 cases of diphtheria occurred in the T. family 24, 28, and 31 days after the return of an earlier case of diphtheria in the same house (C family). Two of these caught scarlet fever in hospital, and a few days after they returned home in April another brother (C.T.J developed scarlet fever. After a long stay in hospital he returned home, and 5 weeks later (in September) one of the earlier cases developed diphtheria again. 18 days after the return of the latter the boy (C.T.), who had had scarlet fever in April, developed diphtheria. 32 After-care of Casus of Diphtheria and Scarlet Fever.—An investigation has been made into the condition of eases of Diphtheria and Scarlet Fever after their discharge from hospital, and for this purpose Miss Payne and Miss MacKenzie have visited a considerable number of the cases which were notified in 1917 within about 3 months of their discharge from hospital. The cases visited were children in poor circumstances, adults and other children being left. Where the children appeared to have completely recovered no further action was taken, but where they were suffering from weakness or ill-health steps were taken to obtain the necessary treatment. The results of the investigation are set out below:— Diphtheria. Cases notified, less revisions of diagnosis and deaths 356 Children visited for after-care 237 Children who appeared to have recovered completely 181 (or 77 per cent.) Children who required treatment 56 (or 23 per cent.) Of the 56 cases needing further treatment 22 were treated at the St. Pancras Dispensary, 18 at hospitals, and 10 by private doctors. Seven of these were sent to convalescent homes, and the remaining 6 children were sent away by their parents for convalescence. In 48 cases the visitors obtained some information as to the conditions for which treatment was required. These were as follows: -Debility 14, "chest trouble " 10, heart trouble 4, paralysis 7, "eyes" 2, rheumatism 3, arthritis 1, whooping cough 1, tonsils 3, nasal discharge 1, teeth 1, gastric trouble 1. Scarlet Fever. Cases notified, less revisions of diagnosis and deaths 220 Children visited for after-care 150 Children who appeared to have recovered completely 124 (or 83 per cent.) Children who required treatment 26 (or 17 per cent.) Of the 26 cases needing further treatment 12 were treated at the St. Pancias Dispensary (one being sent to convalescent home), 2 at hospitals, and 6 by private doctors, 3 were sent away by their parents for convalescence, and 3 were not treated. In 20 cases the visitors obtained some information as to the conditions for which treatment was required. These were as follewsDebility 7, ear discharge 6, " chest trouble" 3, rheumatism 2, whooping cough 1, scabies 1. TYPHOID FEVER. 24 cases (all civilian) were notified as suffering from typhoid fever during 1917. Of these, 7 proved not to be true cases, the number of actual cases notified being therefore 17, equal to an incidence rate of 0.09 per 1,000 civil population. 33 Of the 17 cases, 5 died, the case mortality being 29.4 per cent. One other death was registered (in an institution outside St. Pancras), the total number of deaths for the year being 6, equal to a death rate of 0.03 per 1000 civil population. Other statistical facts in regard to the disease will be found on pages 13-14. The 24 persons notified were treated as follows:— Cases notified. Not Typhoid. Diagnosis not contradicted. In hospitals of the M.A.B. 11 6 5 In other public hospitals 8 0 8 In their own homes 5 1 4 The cases were all in different houses except for two children in one family, aged 10 and 5 respectively, who fell ill early in November. Both children died, and the infection was attributed to the earlier illness of a sister aged 8, who fell ill early in October a few days after returning from "hopping" in Kent, and suffered for a few weeks from anaemia, diarrhoea, and intermittent fever, the diarrhoea appearing again early in December. The latter case was never notified, and at the end of December while under observation in hospital, was found to present no symptoms, but to give a positive Widal reaction to B. typhosus complete at 1 in 30 and 1 in 60 and slightly at 1 in 100. Two cases (adults) taking their Onset about 21st October and 14th November respectively were attributed to the eating of oysters a few days before the onset of symptoms. There were at this time a number of cases in London attributed to this cause. In the other cases no source of infection was traced. One of them was a hospital nurse. ACUTE ANTERIOR POLIOMYELITIS. Only one case of this disease was notified in 1917. The patient was a girl aged If in Ward 3 (E 2): onset 25th November, 1916: notified 1st January, 1917. The muscles of the left leg were affected, and the paralysis persists. EPIDEMIC CEREBROSPINAL MENINGITIS. The incidence of this disease, which was abnormally high in 1915 and 1916, when there were 37 and 20 true cases reported respectively, continued so in 1917. 25 persons were reported as suffering from the disease, of whom 6 were found to be wrongly diagnosed. In addition, two others, not notified, were reported after death, so that the total number of actual cases reported during the year was 21, equal to an incidence rate of 0.11 per 1,000 civil population. Of the 21 cases, 16 died (one in 1918), making a case mortality of 76 per cent. One other death was registered in 1917 (in an institution outside St. Pancras), the number of deaths for the year being 16, equal to a death rate of 0.09 per 1,000 civil population. 34 The 5 patients who survived recovered completely, except for one man who still suffers from pains in the back, giddiness and nervousness. One case took its onset in December (1916), 6 in January, 1 in February, 1 in March, 6 in April, 2 in May, 1 in October, 2 in November, and 1 in December. 12 cases were in females and 9 in males. 9 of the cases (7 fatal) were under 1 year of age, 4 (all fatal) between 1 and 5, 4 (3 fatal) between 5 and 15, and 4 (2 fatal) over 15. In 14 of the 21 cases the diagnosis was confirmed by identification of the meningococcus (in at least 6 cases grown in pure culture) in the cerebrospinal fluid during life (13) or from the brain post mortem (1). In 3 cases the germ was not found, in 3 there was no examination, and in 1 ease there is no information. No connection between the cases and no source of infection was traced, and in no intance was there more than one case in a house. No part of the borough was specially affected. All the patients were of the working class. MEASLES AND GERMAN MEASLES. All cases of these diseases are notifiable by parents and guardians, but only the first case occurring in an outbreak in a household or institution is notifiable by medical practitioners, an interval of two months since the last case constituting a new outbreak. Subject to correction for diagnosis in certain instances, 3,681 civil cases of measles, and 609 of german measles were notified or otherwise discovered in 1917. This represents an incidence rate of 19.7 per 1,000 civil population for measles and 3.3 for german measles. 118 deaths from measles were registered during the year, equal to a deathrate of 0.63 per 1,000 civil population, and a case mortality rate of 3.2 per cent, amongst the notified cases. There was one death certified as due to german measles. The cases were notified or reported as follows:— Measles. German measles. Notified by medical practitioners 2619 535 ,, parents and guardians 736 51 Discovered otherwise 326 23 3681 609 Further statistical facts in regard to the cases will be found on pages 13-14. Practically every case has been visited without delay by one of the women visitors, and this has much reduced the amount of ordinary infant visiting that they have been able to do. In every case, also, a card of advice and a printed postcard form of notification (unstamped) have been sent to the parent's home. 35 By reason of facilities placed at the disposal of the Medical Officer of Health by the Mayoress' Nursing Fund for Sick Poor Children it has been possible to send a visiting nurse once or twice a day to all cases where the visitor reported that such help was necessary, and where arrangements were not made for the removal of the patient to hospital. Milk, eggs, and coal were also paid for out of the fund in certain cases. The amount of this work is indicated in the following paragraph:— 784 patients (in 579 families) were nursed, and 2,906 visits were paid by the nurses, the average number of visits per family being 5. 1 patient nursed in each of 429 families. 2 patients ,, ,, ,, ,, 109 „ 3 ,, ,, ,, ,, ,, 34 ,, 4 ,, ,, ,, ,, ,, 7 ,, (7 patients belonged to families counted in the 1916 figures). 174 families received milk, and 9 coal. In the annual report for 1916 a somewhat exhaustive analysis will be found of the measles records for that year. In the following table are set out the deaths and death-rates from measles for the past 10 years for the whole borough and the four registration subdistricts. Year. Deaths. Rate per 1,000 population. West. South. East. North. No address Whole Borough West. South. East. North. Whole Borough 1907 37 5 33 16 .. 91 0.60 0.08 0.55 0.27 0.40 1908 9 13 5 19 .. 46 0.14 0.23 008 0.31 0.19 1909 30 9 30 33 .. 102 0.48 0.16 0.50 0 55 0.43 1910 39 21 60 23 .. 143 0.65 0.37 1.00 0.38 0 60 1911 26 28 19 40 .. 113 0.42 0.50 0.32 0.68 0.47 1912 25 11 33 25 .. 94 0.41 0.24 0 58 0.43 0.42 1913 8 5 6 17 .. 36 0.13 0.10 0.10 0.29 0.16 1914 10 10 21 12 .. 53 0.17 0.22 0 36 0.19 0.24 1915 20 14 14 15 .. 63 0.54 0.31 0.24 0.26 0.29 1916 12 6 8 16 .. 49 0.20 0.13 0.14 0.28 0.19 1917 35 17 32 33 1 118 0.60 0.38 0.56 0.57 0.54* * Based on census population. Of the 118 deaths, 30 were in children under one year of age, and 110 in children under five years of age. 36 OTHER NOTIFIABLE INFECTIOUS DISEASES. No cases of smallpox, typbus, cholera, plague or human glanders, anthrax or hydrophobia were reported in St. Pancras during the year. As usual, persons who had been in contact with smallpox and other exotic diseases (mostly on shipboard) were reported and were kept under observation, with negative results in all cases. A number of soldiers were reported as having returned to St. Pancras after suffering from dysentery, enteric and paratyphoid fever. No cases of these diseases were caused by their return. An outbreak of glanders in the horses in a St. Pancras stable was reported. The usual precautions were taken and there was no spread of the disease to human beings. WHOOPING COUGH. In the following table will be found the deaths and death-rates from whooping cough for the past ten years for the whole borough and for the four registration sub-districts:— Year. Deaths. Rate per 1,000 population. West south East. North No address Whole Borough West. South. East. North. Whole Borough 1907 17 19 22 18 .. 76 0.27 0.34 0.37 0.30 0.32 1908 22 12 16 17 .. 67 0.35 0.21 0.26 0.28 0.28 1909 2 6 9 10 .. 27 0.03 010 0.15 0.16 0.11 1910 31 5 41 15 .. 92 0.50 0.08 0.68 0.25 0.38 1911 13 7 12 16 .. 48 0.22 0.12 0.20 0.26 0.20 1912 6 14 22 5 .. 47 0.10 0.30 0.38 0.09 0.21 1913 8 3 8 17 .. 36 0.13 0.06 0.13 0.29 0.16 1914 11 1 16 21 .. 49 0.19 0.02 0.27 0.36 0.22 1915 10 13 15 12 2 52 0.17 0.29 0 26 0.21 0.24 1916 13 17 9 .. 39 0.22 • • 0.36 0.16 0.18 1917 6 3 10 8 .. 27 0.10 0.07 0.17 0.147 0.12* * Based on census population. Of the 27 deaths, 14 were of children under one year of age and 27 of children under five years of age. DIARRHCEA AND ENTERITIS. 97 deaths from diarrhoea and enteritis were registered during 1917; equal to a death-rate of 0.5 per 1,000 population. 37 Of these, 80 were in children under five years of age, and 61 in babies under one. Reference is made on page 23 to infantile diarrhoea. SYPHILIS. In the following table are given the age and sex distribution of deaths certified during 1917 as due to (a) declared syphilis, (b) locomotor ataxy and general paralysis of the insane, which are believed by most experts to be late manifestat ons of the disease, and (c) aortic aneurysm, which many authorities now consider to be at any rate frequently caused by it:— 0—1 1-5 5-15 15—25 26—85 35—45 45—55 55—65 65—75 75—85 85 up. Total Males. 0-1 1-5 _ 5-15 15—25 25 -35 35-45 45—55 55—65 65—75 75—85 85 up. Total Females. Total Persons. Syphilis 11 2 1 — - 1 1 1 1 — — 18 5 - — — — 1 - — — — — 6 24 Locomotor ataxy — — — — — 1 1 3 1 — — 6 - - — - - — - — — — — 6 General paralysis of the insane — — — — 3 6 13 1 1 — — 24 — - — — — 2 3 1 — — — 6 30 Aortic aneurysm — — — — — — 4 4 - — — 8 - — — — — — - 1 — — — 1 9 To assist the educational campaign of the London and Home Counties Branch of the National Council for Combating Venereal Diseases a Local Committee was formed in 1917 by the St Pancras Public Welfare Association, the Medical Officer of Health being Chairman and Miss Edith Neville, Hon. Secretary. During the .year there were arranged by the Committee a public meeting and conference add essed by Dr. Mary Scharlieb, a course of three lectures for women, and one of two lectures for men. CANCER. 281 deaths were registered during 1917 as due to cancer, under the various names of cancer, carcinoma, epithelioma, scirrhus, rodent ulcer, sarcoma, &c. This is equal to a death-rate of 1.35 per 1,000 population, and 151 per 1,000 civil population. The sex distribution of the deaths and death-rates is shown in the following table:— [##]Sex. No. of Deaths. Death-rates per 1,000 males or females living (based on 1911 Census). Males 135 1.27 Females 146 1.31 Doth Sexes 281 1.29 38 DWELLING HOUSES. Reference has been made in several previous annual reports as to the extremely defective housing accommodation provided for the working classes in the tenement houses of this part of London. The following paragraphs appeared in last year's report:— "Very commonly the houses consist of four floors, each containing two rooms, "and each floor is let to a separate family. Sometimes, however, the tenant has a "single room; or on the other hand, may be able to afford three or four rooms. In "the latter case he may occupy the whole of two floors. In parts of the borough "some of the tenement houses have three rooms on each floor. "It is quite usual to lind such a sub-let house provided with only one w.c.— "generally in the yard—and with no scullery accommodation or separate sinks for "the various tenants, though frequently there are one or more water-taps for the "common use of the tenants on the staircase. It is thus brought about that in "many tenement houses families have to live in one, two or more rooms, with no "proper separate accommodation in the way of w.c., scullery, sink, water supply, "yard (or balcony) &c., and frequently separated from the common w.c. or water "tap by several flights of stairs. "It cannot be doubted that grave injury rosults to the public health from these "evils. They are not confined to the ' slums,' but are endured by many respectable "working-class people who pay rents which would in many other towns provide "them with good separate cottages." The problem presented by these tenement houses is of the greatest importance, and it cannot be too strongly urged that measures ought to be taken at the earli'st opportunity to replace them by tenements offering sufficient accommodation for the families inhabiting them. In some cases this could be done by suitable reconstruction of the existing houses, while in others extensive schemes of demolition and re-building are required. Inspection of Dwelling-houses. The inspections of dwelling houses made duri g the year will be seen in table 5 on page 63, where they are divided into those following infectious disease, those made upon complaint, those carried out under the Housing, Town Planning, etc., Act, 1909, inspection of registered tenement houses other than the preceding, and other house to-house inspections. Underground Rooms. During the year letters were sent in respect of 19 underground rooms (in 17 houses) which did not comply with the requirements of the Housing, Town Planning, etc., Act, 1909, and the regulations made thereunder. 4 closing orders in respect of underground rooms (in 3 houses) were made. In addition 5 intimation notices were served in regard to underground rooms illegally occupied as dwellings. Houses unfit for Human Habitation. 4 houses (6, 7, 11 and 15, Redhill Street), were represented during 1917 as unfit (September 19th) and Closing Orders were made by the Council in respect of them. 39 In accordance with the Housing (Inspection of District) Regulations, 1910, the following table is submitted for the year 1917:— The number of dwelling-houses inspected under and for the purposes of Section 17— Totals. First routine inspections 85 Subsequent „ 1540 1625 The number of dwelling-houses, which, on inspection, were considered to be in a state so dangerous or injurious to health as to be unfit for human habitation— As regards the whole house 4 ,, underground rooms (19 rooms) 17 21 The number of representations made with a view to the making of closing orders— As regards the whole house 4 „ underground rooms (4 rooms) 3 7 The number of closing orders made — As regards the whole house 4 ,, underground rooms (4 rooms) 3 7 The number of dwelling-houses, the defects in which were remedied without the making of closing- orders 1621 The number of dwelling-houses which, alter the making of closing orders, were put into a fit state for human habitation Inhabited House Duty. Applications for certificates under Section 11 of the Inland Revenue Act, 1903, were received during 1917 in respect of 12 houses comprising 30 tenements. In 4 cases (12 tenements) the applications were granted, in 5 cases (12 tenements) refused, and in 3 cases (6 tenements) held over to 1918. Canal Boat* Acts. During the year Inspector Auger inspected 4 boats, registered to carry 16 adults and actually canying 7 adults and 4 children. 40 FACTORY AND WORKSHOP ACTS. The following five tables are those asked for by the Home Secretary:— 1.—Inspections made by Male and Female Sanitary Inspectors. Premises. Number of Inspections. Written Notices. Prosecutions. (i) ( ) (3) (4) Factories (including factory laundries) 509 96 — Workshops (including workshop laundries) Workplaces (other than Outworkers' 1078 167 — premises included in Part 3 of this Report) 176 16 — Total 1763 279 — 2.—Defects Found. Particulars. Number of Defects. Number of Prosecutions. Found. Remedied. Referred to h. m. Inspectors. (1) (2) (3) (4) (5) Nuisances under the Public Health Acta*:— Want of cleanliness 87 84 Want of ventilation 1 1 Overcrowding — — Want of drainage of floors 2 1 Other nuisances 28 25 Sanitary accommodation Insufficient 5 4 Unsuitable or defective 79 72 Not separate for sexes 3 2 Nil. Offences under the Factory and Workshop Act:— Illegal occupation of underground bakehouses (s. 101) Breach of special sanitary requirements for bakehouses (ss. 97 to 100) 72 71 Other offences (Excluding offences relating to outwork which are included in Part 3 of this Report) 2 1 Total 279 261 2 — # Including those specified in sections 2, 3, 7 & 8 of the Factory and Workshop Act, 1901, as remediable under the Public Health A.cts, 41 3.— Home Work. The only matter to report under this heading is the receipt of the following lists of outworkers for employers sending twice in the year:—18 in respect of the making, etc., of wearing aopnrel, comprising the name of 29 out-workers (contractors) and 94 outworkers (workmen), and 1 in respect of brushmaking, containing the name of 1 outworker (contractor). 4.—Registered Workshops. Workshops on the Register (See. 131) at the end of the year. Numbers. (1) (2) Bakehouses 139 Restaurant kitchens 385 Laundries 35 Domestic workshops — Other workshops where women are employed 321 Other workshops 741 Total number of workshops on Register 1621 5.—OtherMatters. Class (1) Number (2) Matters notified to IT, HI. Inspectors of Factories:— Failure to affix Abstract of the Factory and Workshop Act (s. 133) — Action taken in matters referred by H.M. Inspector as remediable under the Public Health Notified by H.M. Inspector 10 Reports (of action taken) sent to H.M. Inspector 10 Acts, but not under the Factory and Workshop Act (s. 5) Other — Underground bakehouses (s. 101):— Certificates granted during the year — In use at the end of the year 76 In 1914 Mr. West was appointed as factory and workshop inspector and commenced a routine inspection of all factories, workshops and workp'aces in the borough, in the course of which he undertook the preparation of a new cardindex register of these places. This work was completed towards the end of 1917, and in the following table are set out certain particulars in regard to these premises, classified in trades. The difference between the figures for workshops and those set out in table 4 is due to the fact that the latter includes a certain number of workshops where no labour was employed at the time of visit. 42 It will be understood that the figures represent the position at the time of the inspector's visits. Changes will have occurred between that time and the completion of the new register, particularly in munition works. TRADE. Factories. Workshops or Workplaces. No. of Factories. Males Employed. Females Employed. No. of Workshops. Males Employed. Females Employed Over 18 Under 18 Over 18 Under 18 Cabinet and Furniture Makers 41 1274 741 142 765 61 131 5 Pianoforte and Musical Instrument Makers 46 2211 263 36 333 38 36 6 Wood Workers 41 372 34 1 1 ... ... ... Timber Merchants ... ... ... 11 44 ... ... ... Toy and Basket Makers ... ... ... 10 23 4 39 43 Pipe Makers 6 108 26 2 8 ... ... ... Motor Body and Van Builders, Wheelwrights 16 466 15 18 66 2 ... ... Building Trade 10 116 3 41 108 3 ... ... Sculptors and Plaster Workers ... ... ... 28 142 3 6 ... China and Glass Trades, Stained Glass Windows 11 54 33 11 79 3 6 ... Scientific Instrument Makers 21 694 143 12 34 13 5 2 Dentistry 8 110 381 18 36 12 2 1 Jewellery Trade 9 107 15 15 35 4 9 3 Photography 3 11 45 12 41 1 40 ... Makers of Drugs, Chemicals, Patent 11 93 293 6 16 13 42 ... Foods, Toilet Preparations, &c. Penc 1 Makers, Artists' Colourmen, and Paint Makers 6 229 237 2 15 5 6 12 Metal Workers, Engineers, and Smiths (including Motor Engineers' Factories) 161 2895 1186 71 234 29 44 15 Brass Founders 10 232 19 5 19 5 ... ... Electro Platers 7 74 4 ... ... ... ... ... Lamp Makers 5 49 70 1 1 ... ... ... Motor Trade (excluding Motor Engineers' Factories) and Garage ... ... ... 62 285 42 9 ... Tailors, Hatters, Dressmakers, Milliners, Clothworkers, and Needleworkers 21 98 799 241 491 32 1346 142 Bootmakers and Repairers 12 23 2 48 109 3 1 ... Printers, Bookbinders,Card Markers 48 957 837 ... ... ... ... ... Bakers, Confectioners, Hotel and Restaurant Kitchens 34 497 251 379 380 12 609 12 Beer aud Wine Bottlers and Merchants 14 338 391 4 41 3 ... ... Mineral Water Manufacturers 5 107 121 ... ... ... ... ... Curriers, Harness Makers, and other Leather Workers 3 85 10 17 65 7 25 14 Tent, Blind, and Tarpaulin Makers 5 27 87 1 ... ... 4 ... Laundries 12 28 321 30 ... ... 96 ... Job Masters and Carriers ... ... ... 15 250 15 ... ... Railway Carriage Cleaners ... ... ... 1 190 ... ... ... Other trades 47 368 165 85 190 17 77 9 Totals 616 11623 6492 1325 4001 327 2533 264 43 The number of factories, workshops and workplaces aided to and remove:! from the register during 1917 was as follows:— Added to register. Removed from register. Bake' houses— Workshop 0 1 Factory 0 0 Laundries— Workshop 3 43 Factory 1 0 Restaurant kitchens 76 3 Other workshops and workplaces 58 182 Other factories 44 20 The number of inspections that were made during 1917 were as follows:— Factory and Workshop Inspector. Woman Sanitary Inspector. Total. Inspections. Re-inspections. Inspections. Re-inspections. Inspections. Re-inspections. Bakehouses 348 304 — — 348 304 Restaurant kitchens 65 35 — — 65 35 Laundries 67 17 — — 17 17 Domestic workshops — — — — — — Other work shops 335 166 — 335 166 Other workplaces 31 43 — — 33 43 Other factories 172 178 5 1 177 179 Total 1020 743 5 1 1025 744 Bakehouses.—At the end of the year there were 175 bakehouses on the register including 36 factory bakehouses. 128 of these were underground bakehouses, of which 52 were unoccupied. Restaurant Kitchens.—At the end of 1917, 388 restaurant kitchens were en the register. 44 INSPECTION OF FOOD AND FOOD-PLACES. Sale of Food and Drugs Acts. 742 samples have been taken under these Acts, and 666 of these proved to be genuine and 76, or 10.2 per cent., adulterated. The details are given in the following table:— Articles of food of which samples have been taken. Total number samples. Genuine. Adulterated. Baking Powder l l Butter 144 126 18 Cheese 7 7 — Cocoa 37 37 — Coffee 14 14 — Cream 12 10 2 Dripping 21 20 1 Jam 3 3 — Lard 37 35 2 Margarine 5 3 2 Milk 373 329 44 Mustard 10 10 — Olive Oil 13 12 1 Pepper 11 11 — Preserved Beans 2 1 1 Preserved Pears 3 1 2 Self Raising Flour 41 39 2 White Mixture 1 1 — Vinegar 7 7 — Total 742 666 76 The 742 include 6 informal samples of milk (5 adulterated) and 18 of butter (7 adulterated). Prosecutions were undertaken in respect of 35 of the 64 formal samples which were reported as being adulterated. In 2 other cases proceedings were instituted in respect of other offences under the Sale of Food and Drugs Acts. These are set out in the following table:— 45 Summonses—Under the Sale of Food and Drugs Acts. No. of Sample. Article. Result of Analysis Date of Hearing of Summons. Result of Proceedings. Penalty. Costs. 1917. £ s. d. £ s. d. C. 1 Milk Added water, 27 8 per cent. 23rd Feb. 3 0 0 including costs A. 7 Butter Foreign fat, other than the fat of butter, 30 per cent. 27th „ 2 0 0 0 10 6 A. 9 ,, 50 27th „ 2 0 0 0 10 6 C. 12 Milt Added water, 8.5 per cent. 16th March 0 15 0 0 10 6 A. 26 ,, 10.0 16th „ — 1 1 0 A. 29 ,, 11.1 23rd „ 0 15 0 0 10 6 C. 42 ,, ,, 7.4 ,, 13th April 2 0 0 0 10 6 C. 55 Butter Foreign fat, other than the fat of butter, 70 per cent. 13th „ 30 0 0 0 10 6 C. 74 Milk Added water, 9.2 per cent. 11th May 0 10 0 1 8 0 C. 76 ,, ,, 5.5 ,, 11th „ 0 10 0 — C. 93 Butter Foreign fat, other than the fat of butter, 86 per cent. 22nd ,, 3 0 0 1 1 0 A. 105 Milk Deficient in milk fat, 18.6 per cent. 24th „ 4 0 0 — A. 104 ,, Added water, 7 4 per cent, and deficient in milk fat, 19 per cent 25tb „ 1 0 0 0 10 6 A. 176 ,, Deficient in milk fat, 10.3 per cent. 20th July — 0 12 6 C. 155 ,, 10.0 20th „ — 0 12 6 C. 170 ,, 183 27th ,, 1 0 0 0 12 6 A. 190 Butter Foreign fat. other than the fat of butter, 84 per cent. 10th August 20 0 0 — Selling margarine in an unstamped wrapper 10th „ With drawn A. 237 ,, Foreign fat, other than the fat of butter, 30 per cent. 27th Sept. 10 0 0 0 10 6 A. 225 Olive Oil Oil other than olive oil, 50 per cent. 28th ,, 0 10 0 0 10 6 C. 234 Milk Added water. 91 per cent. 2nd Nov. 1 10 0 0 10 6 A. 253 ,, Deficient in milk fat, 13 3 per cent. 16th „ Summons dismissed Warranty proved A. 275 Butter Foreign fat, other than the fat of butter, 80 per cent. 30th „ 10 0 0 0 10 6 A. 284 Milk Added water, 20.4 per cent. 22nd Dec. 5 0 0 0 16 6 C. 293 ,, ,, 17.2 ,, 14th „ 8 0 0 0 10 6 C. 304 Self-raising Flour Flour other than self-raising flour, 100 per cent. 28th ,, 1918. 10 0 0 2 0 0 A. 301 Lard Foreign fat, other than the fat of lard, 90.5 per cent. 4th Jan. 5 0 0 0 10 6 A. 309 Milk Added water, 8 7 per cent. 4th „ 2 0 0 0 10 6 A. 311 ,, ,, 124 ,, 4th ,, Summons dismissed Warranty proved C. 333 Lard Foreign fat. other than the fat of lard, 100 per cent. 4th „ 5 0 0 0 10 6 A. 316 Milk Added water, 6 0 per cent. 7th ,, Summons dismissed Warranty proved 0. 326 ,, 10.4 ,, nth „ 20 0 0 0 10 6 C. 321 Self-raising Flour Flour, other than self-raising, 100 per cent. 18th „ 5 0 0 — A. 339 Milk Added water, 11.1 per cent. 22nd ,, — 2 2 0 A. 351 Dripping 50 per cent, cotton seed oil 25th ,, 10 0 0 — A. 335 Milk Deficient in milk fat, 7.0 per cent 28th „ 1917 — 2 2 0 C. 23 Margarine Exposing for sale and not being properly labelled 20th March 5 0 0 — C. 24 ,, ,, ,, ,, Milk Wilful obstruction of Inspector 5th October 5 0 0 — 46 Public Health (Milk and Cream) Regulations, 1912. The,following is a report of the work done under the regulations during the year ended '29 th December, 1917:— 373 samples of milk and 9 of cream not sold as preserved cream were taken, and in two cases (cream) preservatives were reported to be present. Warning letters were issued in these cases. Three sarpples of cream sold as preserved cream were taken, and were found to be in order No other contraventions of the regulations were discovered. Inspection of Food Public Health (London) Act, 1891, Sec. 47]. The Food-Inspectors have kept under regular inspection food exposed or deposited for gale in slaughterhouses, shops (especially butchers', cooked meat and fishmongers' shops), stalls, and market places. Three seizures of unsound food have been made during 1917, as follows:— Date. Division and Sub Division. Description of Article. Prosecution and Result. 1917. May 4 East-Ossulston 107 oranges Fined £1 costs £1 1s. July 21 ,, ,, 172 lbs. strawberries Fined £5 Sept. 11 North—Gospel Oak 8 lbs. apples (cautioned) On 40 occasions during the year unsound food has been surrendered by the owners to the food inspectors and destroyed as trade refuse. Dairies, Cowsheds, and Milkshops. Cowsheds.—7'here were at the end of 1917 five licensed cowsheds in the borough, as in the previous year. The-e are registered for 110 cows. One of these changed hands during the year, the new occupier being licensed. Tbey have befen kept under inspection by the food inspectors, 64 inspections having been made during the year. Milkshops and Dairies.—13 applications for registration under the Dairies, Cowsheds, and Milkshops Orders were considered during 1917. They were all acceded to. The figures in regard to registration of milkshops are set out below : — No. of purveyors of milk at retail milkshops on register at end of 1916 242 Deduct No. of purveyors removed from register during 1917 32 Add No. of purveyors added to register by resolution of Council during 1917 13 No. of purveyors of milk at retail milkshops on register at end of 1917 223 47 At the end of 1917 there were on the register in addition to these 223 retail milkshops and 5 cowsheds (of which 4 are attached to retail milkshops included in the 223), 2 persons in respect of premises where only a wholesale milk trade is done, and 3 itinerant vendors without milkshops. Three other itinerant vendors were removed from the register during the year. Legal Proceedings.—No prosecutions were undertaken under the Dairies, Cowsheds, and Milkshops Order of 1885 and 1886 in respect of the sale of milk by unregistered persons. Ice-Cream Premises. Ill visits were paid to these premises by the food inspectors during 1917. No legal proceedings were taken in respect of the manufacture or sale of ice cream. Fried Fish and Fish Curing Premises. At the end of 1917 there were 49 fried fish vendors' premises in the borough, at 2 of which fish curing was also carried on. There were 14 fish curers' premises, including these two. 150 visits were made by the food inspectors to these premises during the year. A large number of these premises are not in compliance with the by-laws as regards the structure of their premises and apparatus, but as practically all of them have been in use for some years they are exempt from the operations of the by-laws in this respect. Other Food Premises. The number of inspections made of butchers' and fishmongers' shops, premises where prepared meats (such as sausages, pies, tripe, cooked meat, &c.) are made, marketing places, &c,, will be found in table 6 on page 64. Bakehouses and restaurant kitchens are referred to under the heading of Workshops (see pages -3 0-43.) Slaughter-Houses. There were 11 licensed slaughter-houses in the borough at the end of 1917. 163 visits to slaughter-houses were made by the food inspectors during the year. The Rag Flock Act, 1911. No samples were taken under this Act during 1917. GENERAL SANITARY WORK. In this section reference is made to sanitary work carried out during the year by the staff. Some of this is mentioned in the foregoing parts of the report. Total Inspections. Altogether 46,664 inspections, including 2,081 Food Control inspections, w re made during 1917 by the staff of Inspectors'. These consisted of 48 28,969 inspections, including 1,647 Food Control inspections and 17,695 reinspections, including 434 Food Control re-inspections. Of these inspectionsl22,043 were made by the Distri t Inspectors, 2,651 by the Factories and Workshops Inspector, 5,901 by the Inspectors of Food and Food-places, and 16,069 by the Women Inspectors and Visitors. The inspections actually made by each individual Inspector are shown in table 8 on page 66. The work of the District Inspectors, Factories and Workshops Inspector, Women Inspectors, and Food Inspectors is set out in detail in tables 5 to 8 on pages 63 to 66. Intimation Notices. 2,079 intimation notices (comprising 3,733 items) were served by the Sanitary Inspectors during 1917. These were made up as follows — District Inspectors. Factory & Workshop Inspector. Temporary Women Inspectors. Total. In respect of Nuisances 2132 11 440 2583 In respect of Breaches of the Tenement House By-laws 237 — — 237 In respect of Breaches of Statutes in Factories, Workshops and Workplaces 3 276 — 279 In respect of other Breaches of Statutes and By-laws 504 2 128 634 2876 289 568 3733 These intimation notices are classified in tables 9, 10, 1 & 12 on pages 67 and 68. Summonses. The following prosecutions were undertaken in respect of general Sanitary work:— Situation of Property. Offence. Date of Hearing of Summons. Result of Proceedings. 55, Chalk Farm Road Failing to give notice before carrying out drainage work 1917. Feb. 16th Fined £.2. 5, ,, Failing to deposit plans ,, Fined £2. 33, Balmore Street Water-closet basin and dustbin defective April 2nd Fined £2 2s. 6, St. Mark's Crescent Drain defective June 21st Abatement Order, costs £1 3s, 26, Charlton King's Road ,, „ 29th Abatement Order, costs £1 3s. 69, Euston Street ,, Nov. 2nd Abatement Order, costs £1 3s. 77, ,, ,, , 13th Abatement Order, cost £1 3s, 83, Queen's Crescent Offensive accumulation in disused cistern. Insufficient supply of water to w.c. Dec. 7th Summons withdrawn, costs £,2 2s. (work completed). 49 Smoke-Prevention. During the year 4 observations of smoke shafts were made. There were no prosecutions. Regulated Trades. Offensive Trades.-— There are two licensed premises for such trades in St. Pancras, viz., a tripe-dresser's in Kentish Town Road, and a tallow-melter's in Tudor Place. 46 visits were paid to these premises, a number of these being special night observations of the tallow-melting premises, made in consequence ot a complaint made to the Council under Sec. 21 of the J ublic Health (London) Act, 1891. No legal proceedings were taken during the year. constructional, drain work. The construction of, and repairs to, house drains are supervised by the sanitary inspectors. During the year the following work has been done under this heading:— First inspections. Consequent re-inspections. Drainage work done under notice 243 2126 Voluntary drainage work 615 1946 Drains of new buildings 31 195 889 4267 The tests which have been applied to drains during 1917 are shown in the following table:— After Infectious Disease. Upon Complaint. Upon systematic 1 nspection Old Buildings. New Buildings at completion of work. Total. At commence ment of work. At completion of work. By Grenade. 1. Defects found 3 26 — — 3 — 32 2. No result 6 63 1 — 12 — 82 3. Total 9 89 1 — 15 — 114 By Smoke. 1. Defects localised — — — — — — — 2. No result — — — — — — — 3. Total — — — — — — — By Water. 1. Not found water-tight — — — — 18 — 18 2. Found water-tight — — — — 217 1 218 3. Total — — — — 235 1 236 Total 3 26 — — 21 — 50 6 63 1 — 229 1 300 9 89 1 — 250 1 350 50 Drainage Register.—The following is an analysis of the Drainage Registelduring 1917:— Plans deposited—Old Buildings under Notice 68 „ ,, —Old Buildings, Voluntary 76 ,, ,, — New Buildings and Additions 12 156 Applications without Plans 83 Total number of Applications and Plans 239 Water Service. The following notices have been received from the Metropolitan Water Board as to houses from which water has been cut off:— 1.—Demolition — 2. Empty 12 3 - Leakage 12 4. - Non-payment of Rates 2 5.—No statement (Withdrawals) — 6.—By request — 7.—Broken Supply Pipe 2 28 DISINFECTING AND CLEANSING STATION. Disinfection. The work done during the year by the disinfecting staff is shown in the following table:— Disease. No. of Cases. No. of Houses. No of Rooms Contents Disinfected or Destroyed. No. of Rooms Sprayed and Fumigated. Scarlet Fever 281 227 25 229 Diphtheria 420 413 436 4 84 Enteric Fever 22 22 22 1 Erysipelas 73 73 73 1 Puerperal Fever 6 6 6 — Cerebro-spinal Meningitis 21 21 23 22 Consumption 102 102 90 79 Measles 148 148 151 96 Cancer 35 35 33 24 Vermin and Scabies 98 93 93 — Other Diseases 56 56 55 16 Totals 1207 1196 1223 902 51 Below is shown the number of articles destroyed or disinfected during the year on account of infectious disease and verminousness Infectious Disease Verminousness. Destroyed. Disinfected. Destroyed. Disinfected Beds, mattresses and palliasses 56 1408 5 22 Bolsters and pillows 18 2759 4 30 Sheets, blankets and counterpanes 13 4459 4 251 Rugs, mats, cushions, carpets, covers, and curtains 17 763 1 30 Wearing apparel 39 2663 2 572 Books — 99 — — Sundries 46 854 1 11 Total 189 13005 17 916 These figures include 389 blankets, 5 rugs, 19 covers, and 538 articles of wearing apparel and sundries which were disinfected on account of verminousness for the military authorities, or for voluntary bodies (such as the Y.M.C.A.) who provide accommodation for soldiers. The following table shows the number of persons cleansed and disinfected after having been in contact with infectious disease : — Males. Females. Children urder 10. Scarlet Fever 1 3 — Puerperal Fever — 4 — Measles 6 — — Diphtheria — 1 — Cleansing Station. The amount of work done here during the year is indicated in the following table. The figures represent the number of attendances. At each attendance the person receives a bath, and his or her clothes are stored. Men. Women. Children under 15. Total. St. Pancras Cases Vermin 3.12 17 1328 *1657 Scabies 38 21 2034 *2093 Cases from outside St. Pancras Vermin 19 2 216 237 Scabies 4 — 520 524 Total 331 1.9 1544 1894 42 21 2554 2617 373 40 4098 4511 * Includes 126 males and 3 females who had no home address. 52 The school children included in the above table have in the main been brought to the cleansing station from the Public Elementary Schools by officials of the London County Council as the Education Authority under the powers conferred upon them by their General Powers Act, 1901, Sec. 36, and the Children Act, 1908, Sec. 122. A sum of one shilling per bath is paid by the County Council to the Borough Council, according to an agreement between the two Authorities, and 1628 baths were paid for on this scale during the year. 17 verminous persons from common lodging houses outside the borough were paid for by the London County Council at the rate of 1s. per attendance, and also 3 persons from Finsbury paid for by the Finsbury Borough Council at the same rate. PUBLIC MORTUARIES AND CORONER'S COURT. Number of bodies deposited in the General Mortuary during 1917 419 „ „ Infectious „ „ 4 Total 423 Inquests held during 1917— In the Coroner's Court —General Cases 400 ,, „ Poor Law „ 30 Elsewhere in St. Pancras — Total 430 BACTERIOLOGICAL EXAMINATIONS. The following work has been done by the Lister Institute of Preventive Medicine, Chelsea Gardens, S.W.. at the expense of the borough in respect of St. Pancras persons : — Total. Positive. Negative. Examinations of swabs for B. diphtheriae 178 60 118 ,, sputum for B. tuberculosis 213 56 187 „ blood for Widal reaction (typhoid) 11 8 3 THE STAFF. At the beginning of 1917 the working staff of the department was depleted by 5 male sanitary inspectors and 3 clerks serving with H..M. Forces, and by one other vacancy amongst the sanitary inspectors caused by death in 1914 not having been filled. The department suffered a great loss by the death on 11th April, 1917, of Mr. H. Riches, First Clerk. Mr. Riches had been in the Council's service for 26 years, and his loss was greatly mourned by his colleagues. 53 Additional temporary Clerks were appointed in the persons of Miss H. Henderson and Miss A. West, on 6th March and 7th May respectively. On 20th March Mr. E. J. Dillon, Sanitary Inspector, returned from the Army, and on 25th April Mr. E. J. Holmes, Sanitary Inspector, left the Council's service owing to resignation. Mr. M. Jaffa was appointed as temporary Sanitary Inspector, beginning work on 3rd December. At the end of the year the normal staff of 15 male and one full-time and 2 half-time female Sanitary Inspectors was represented by 10 male and 3 fulltime and 2 half-time female Sanitary Inspectors. Mrs. A. Hunter and Miss F. A. Anderson were appointed as Health Visitors, beginning work on 5th February and 5th March, respectively. ADMINISTRATION OF THE ORDERS OF THE FOOD CONTROLLER. On May 8th the L cal Government Board issued the Local Authorities (Food Control) Order (No. 1) 1917, which imposed upon the -Borough Council, and upon such of their officers as they should appoint for the purpose, the duty of enforcing certain of the Orders of the Food Controller. At the same time the Board suggested that the Sanitary Inspectors should be appointed to carry out this work in the course of their other duties. The Council accordingly on May 23rd instructed the Sanitary Inspectors to make the necessary inspections, and on June 27th they empowered and instructed the Medical Officer of Health and the Sanitary Inspectors to take the necessary steps for the enforcement of the Orders. This arrangement was left undisturbed when the Local Food Committee was constituted, the Sanitary Inspectors continuing, under the direction of the Medical Officer of Health, to carry out the necessary inspections and the purchase of samples, and to institute legal proceedings in respect of contravention of the Orders. The work was suitably allotted fo the Food Inspectors, the Factory and Workshop Inspector (male), and the District Inspectors respectively. The work done by the Sanitary Inspectors in this connection is indicated in the table on the next page. 54 Inspections Made and Samples Taken under the Orders of the Food Controller. Samples. Mr. Rackham. Mr. Brown. Mr. Dillon, Mr. Akers. Mr. Walker. Mr. Landen. Mr. Jaffa. Mr. West. Mr. Auger. Mr. Child. All Inspections. In accordance with order. In contravention of order. Warning letters sent. No. of prosecutions. Result of Proceedings Fines. Costs. £. s. d. £ s. d. Sweet and Chocolates — 5 5 4 — 2 — — 1 — 17 13 4 4 — — — Beans 18 13 13 10 14 25 3 — 1 3 100 78 22 12 10 23 13 0 6 5 6 Peas — 3 1 4 4 9 2 — — 1 24 20 3 3 — — — Lentils 2 10 5 4 2 3 1 — — — 27 23 4 2 2 0 10 0 0 5 0 Oat Products 31 30 51 24 20 22 1 — — 1 180 148 32 28 4 0 2 6 0 2 0 Maize Products 8 10 17 7 2 4 — — 1 49 39 10 8 2 12 5 0 2 2 0 Sugar 13 3 2 1 2 — — — — 20 21 — — — — — Jams and Jellies 38 29 47 33 27 17 2 — — 16 209 170 39 31 8 36 9 6 5 7 6 Flour 31 63 72 45 30 28 3 — 68 28 368 298 70 51 19 35 6 0 18 7 6 Bread — — — — — — — — 58 20 78 73 5 4 1 1 2 6 — Cakes — — — — — — — 1 4 7 12 5 7 4 — — — Tea 33 27 20 20 14 13 2 — — 4 133 127 6 6 — — — Coffee — 1 6 4 — — — — — — 11 7 4 3 1 10 0 0 2 2 0 Potatoes 8 10 5 5 8 11 — — — 9 56 34 22 22 — — — Meat — — — — — — — — 7 2 9 5 4 — 4 20 7 6 8 8 0 Meals (Restaurant) — — — — — — — 7 — — 7 2 5 3 1 1 1 0 1 1 0 Total samples bought 182 204 244 161 123 134 14 8 139 92 1301 1064 237 181 Total visits made 131 192 127 182 110 163 13 844 157 162 2081 Other prosecutions :— Re potato register 1 2 2 0 2 2 0 Re imposing a condition in respect of a sale 2 5 2 6 2 2 0 Re sale of bread 6 2 5 0 3 3 0 61 150 6 6 51 7 6 APPENDIX. 56 Table No. 1. VITAL STATISTICS OF WHOLE DISTRICT OF ST. PANCRAS DURING 1917 AND PREVIOUS YEARS. Year. Population estimated to middle of each Year. Civil Population. Births. Total Deaths Registered in the District. Transferable Deaths Nett Deaths belonging to the District. Uncorrected Number. Nett. of Nonresidents registered in the District. of Residents not registered in the District. Under 1 Year of Age. At all Ages. Number. Rate per l,000Nett Births. Number. Rate. Number. Rate. Number; Rate. 1907 237173 — 5484 — 23.1 — — — — 624 114 3532 15.0 1908 237158 — 5546 — 23.4 — — — — 638 115 3555 15.0 1909 237247 — 5238 — 22.1 3688 15.4 738 591 570 108 3521 14.8 1910 237178 — 5385 — 22.7 3415 14.4 710 562 580 107 3267 13.8 1911 237129 — 5135 5555 23.4 3418 14.4 673 611 623 112 3356 14.1 1912 220353 — 5008 5367 24.4 3147 14.3 595 605 472 88 3157 14.3 1913 218387 — 5167 5517 24.7 3409 15.6 728 662 512 93 3343 15.0 1914 218387 — 4945 5225 23.9 3386 15.5 721 677 481 92 3342 15.3 1915 218387 200322 4458 4751 21.8* 3523 17.6† 672 692 497 105 3543 17.7† 1916 214135 196813 4310 4530 21.2* 2991 15.2† 565 619 385 85 3045 15.5† 1917 208006 186600 3635 3796 18.2* 3099 16.6† 608 718 402 106 3142 16.8† Area of district in acres (land and inland water), 2694.4; total population at all ages, 218,387; number of inhabited houses, 22,246; average number of persons per house, 9.82; at Census, 1911 (cf. Census, Vol. V.). * Based oil total population. † Based on Civil population. 57 Table No. 2. Deaths Registered from all Causes for the Year 1917. Note.—The Deaths of Non-Residents occurring in Public Institutions situated in the Borough are excluded, and the Deaths of Residents occurring in Public Institutions situated beyond the limits of the Borough are included. Cause of Death. ages. 0 to 1 1 to 2 2 to 6 Total under 5 5 to 10 10 to 15 15 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 to 85 85 and upwards. Totals. m. f. m. f. m. f. m f. m f. m f. m f. m f. m f. M. f. M. f. M. F. M. f. M. f. m. f. SONS 1.—General Diseases. 1. Enteric Fever _ _ _ _ _ _ _ _ _ _ _ 1 _ _ 1 1 1 1 _ _ _ _ _ _ _ _ 3 3 6 2. Typhus ,, _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 3. Relapsing Fever _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 4. Malaria _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ _ _ _ _ _ _ _ _ _ _ 1 _ 1 5. Small Pox- fa) Vaccinated _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ (b) Not Vaccinated _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ (c) Doubtful _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 6. Measles 15 15 18 19 26 17 59 51 5 3 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 64 54 118 7. Scarlet Fever _ _ _ _ 3 _ 3 _ _ 1 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 3 1 4 8. Whooping Cough 8 6 3 3 1 6 12 15 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 12 15 27 9, (a) Diphtheria _ 1 1 1 7 5 8 7 3 7 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 11 14 25 (b) Croup _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 10. Influenza _ _ _ _ _ _ _ _ _ 1 _ _ _ _ _ _ 3 1 1 1 _ 4 _ _ _ 4 _ _ 8 13 21 11. Miliary Fever _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 12. Asiatic Cholera _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 13. Cholera Nostras _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 14. Dysentery _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 2 1 1 3 1 2 2 2 4 _ 2 _ 1 9 13 22 15. Plague _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 16. Yellow Fever _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 17. Leprosy _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 18. Erysipelas _ 1 _ _ _ _ _ 1 _ _ _ _ _ _ _ _ _ _ 1 _ _ 1 _ _ _ _ _ _ 1 2 3 19. (a) Mumps _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ (b) German Measles 1 _ _ _ 1 _ 1 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ 1 (c) Varicella _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ (d) Other Epidemic Diseases _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ 20. (a) Pyœmia _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ (b) Septieœmia 1 _ _ _ _ _ 1 _ _ 1 _ _ _ _ _ 1 1 _ _ _ _ _ _ _ _ _ _ _ 2 2 4 (c) Vaccinia _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 21. Glanders _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 22. Anthrax (Splenic Fever) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 23. Rabies _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 24. Tetanus _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 25. Mycoses _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 1 26. Pellagra _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 27. Beri-Ber _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 28. (a) Pulmonary Tuberculosis 1 _ 1 1 1 1 3 2 1 2 3 4 17 22 25 25 47 29 55 15 27 15 11 3 3 _ _ _ 192 117 309 (b) Phthisis (not' defined as tuberculous) _ _ _ _ _ _ _ _ _ 1 _ 2 1 7 8 4 4 1 4 2 4 4 1 _ 1 _ _ _ 23 21 44 29. (a) Acute Phthisis _ _ _ _ _ _ _ _ _ _ _ _ 1 _ 1 _ 1 1 1 _ 1 _ _ _ _ _ _ _ 5 1 6 (b) Acute Miliary Tuberculosis 2 1 _ _ 1 _ 3 1 _ _ _ _ _ 1 _ _ 1 _ _ _ _ _ _ _ __ _ _ _ 4 2 6 30. Tuberculous Meningitis 3 3 2 4 6 8 11 15 1 5 2 2 _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ 14 22 36 31. (a) Tabes Mesenterica _ _ _ 1 _ 1 _ 2 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 2 2 (b) Other peritoneal & intestinal tubercle 1 1 _ 1 2 3 3 5 _ 2 _ 1 _ 1 _ _ _ _ _ 1 1 _ _ _ _ _ _ _ 4 10 14 32. Tuberculosis of Spinal Column _ _ _ _ _ 1 _ 1 1 _ _ _ 1 _ _ _ 1 _ 1 1 _ _ _ _ _ _ _ _ 4 2 6 33. Tuberculosis of Joints _ _ _ _ _ _ _ _ _ _ 2 1 3 _ _ _ _ _ _ _ 1 _ _ _ _ _ _ _ 6 1 7 34. (a) Lupus _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ (b) Scrofula _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ (c) Tuberculosis of other Organs _ _ _ _ _ 1 _ 1 _ _ _ 1 1 _ _ _ _ _ 1 _ _ 1 _ 1 _ _ _ _ 2 4 6 35. Disseminated Tuberculosis _ 1 _ _ 2 1 2 2 _ _ _ 1 1 _ 2 _ _ _ _ _ _ _ _ _ _ _ _ _ 5 3 8 36. Rickets, Softening of Bones 1 1 2 _ _ _ 3 1 _ _ _ 1 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 3 2 5 37. Syphilis 11 5 1 _ 1 _ 13 5 _ _ 1 _ _ _ _ _ 1 1 1 _ 1 _ 1 _ _ _ _ _ 18 6 24 38. Other Venereal Diseases _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 39. Cancer of the Buccal Cavity _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 6 _ 6 _ 8 1 1 _ _ _ 21 1 22 40. ,, Stomach, Liver, &c. _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ 3 _ 6 4 17 12 16 12 1 7 _ _ 43 35 78 41. ,, Peritoneum, Intestines, and Rectum _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 2 1 2 3 7 10 12 7 4 5 _ _ 27 27 54 42. „ Female Genital Organs _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 2 _ 5 _ 12 _ 9 _ 5 _ 1 _ _ _ 34 34 43. ,, Breast _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ 1 _ 9 1 11 _ 6 _ 4 _ _ 1 32 33 44. ,, Skin _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ l _ _ _ 3 _ 2 _ _ 1 _ _ 6 1 7 45. Cancer of other or unspecified Organs _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 2 _ 8 2 9 4 14 5 4 3 _ 2 37 16 53 46. Other Tumours (situation undefined) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ 1 1 _ _ _ _ _ _ _ 1 2 3 47. Rheumatic Fever _ _ _ _ _ _ _ _ _ _ 2 _ _ _ _ _ _ _ _ 1 1 2 _ 1 _ _ _ _ 3 4 7 48. (a) Chronio Rheumatism _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ (b) Osteo-Arthritis _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ 2 _ _ _ _ _ _ _ 3 _ 3 (c) Gout _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ _ _ _ _ _ 1 _ _ 1 1 2 49. Scurvy _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 58 Deaths Registered from all Causes for the Year, 1917—continued. Cause of Death. AGES. 0 to 1 1 to 2 2 to 5 Total under 5 5 to 10 10 to 15 15 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 to 85 85 and upwards Totals m. F. m. F. m. F. M. F. m. F. m. F. m. F. m. F. m • F. m. F. m. F. M. F. m. F. m, F. m f. SONS 1. General Diseases—con. 50. Diabetes _ _ _ _ _ 1 _ 1 _ _ _ _ 2 _ 1 1 2 3 1 2 4 2 2 _ 1 1 _ _ 13 10 23 51. Exophthalmic Goitre _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ _ _ _ _ _ _ _ _ _ _ 1 1 52. Addison's Disease _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 53. Leucocythæmia Lymphadenoma _ _ _ _ _ _ _ _ _ 1 1 _ _ _ _ _ _ 1 _ 1 _ _ _ 1 _ _ _ _ 1 4 5 54-. Ancemia, Chlorosis — — — — — — - — — — — — 1 — i — 1 1 1 _ 2 — 1 — - 6 9 55. (a) Diabetes insipidus _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ (b) Purpura 2 _ _ _ _ _ 2 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 2 _ 2 (c) Haemophilia _ _ _ _ 1 _ 1 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ 1 (d) Other General Diseases _ 1 _ _ _ _ _ 1 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ 1 1 2 56. Alcoholism (acute or chronic) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ _ _ _ _ _ _ _ _ _ _ _ _ 1 1 57. (a) Occupational Lead Poisoning _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ (b) Non-occupational Lead Poisoning _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 58. Other Chronic Occupational Poisonings _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 59. Other Chronic Poisonings _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ _ _ _ _ _ _ _ _ _ _ 1 _ 1 2. Diseases of the Nervous System and of the Organs of Special Sense. 60. Encephalitis _ _ _ _ _ _ _ _ _ _ _ 2 _ _ _ _ 1 _ 1 _ _ _ _ _ _ _ _ _ 2 2 4 61. (a) Cerebrospinal Fever 2 5 2 _ _ 1 4 6 1 _ _ 1 _ _ _ _ _ _ 1 _ _ _ _ _ _ _ _ _ 6 7 13 (b) Posterior Basal Meningitis _ 1 _ _ _ _ _ 1 _ _ _ _ _ _ _ _ _ _ 1 _ _ _ 1 _ _ _ _ _ 2 1 3 (c) Meningitis, other forms 2 _ _ _ _ 1 2 1 2 2 1 _ 1 1 _ l _ _ _ 2 1 _ _ _ _ _ _ _ 7 7 14 62. Locomotor Ataxy _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ 1 _ 3 _ 1 _ _ _ _ _ 6 0 6 63. (a) Anterior Poliomyelitis _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 2 2 _ _ _ _ _ 2 2 4 (b) Other Diseases of the Spinal Cord _ _ _ _ _ _ _ _ _ _ _ _ 1 _ _ _ _ _ 2 1 1 1 1 _ _ _ _ 5 3 8 64. Cerebral Hæmorrhage, Apoplexy 1 _ _ _ _ _ 1 _ _ _ _ _ 1 _ _ 1 1 _ 7 9 10 9 23 9 5 10 2 2 50 40 90 65. Softening of Brain _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ _ _ 1 1 _ _ _ _ _ 1 _ _ 2 2 4 66. Paralysis without specified cause _ _ _ _ _ 1 _ 1 _ _ _ _ _ _ _ _ 1 _ 1 _ 1 1 _ 5 1 3 _ 2 4 12 16 67. General Paralysis of the Insape _ _ _ _ _ _ _ _ _ _ _ _ _ _ 3 _ 6 2 13 3 1 1 1 _ _ _ _ _ 24 6 30 68. Other forms of Mental Alienation _ _ _ _ _ _ _ _ _ _ _ _ _ _ l 1 _ 2 4 _ _ _ _ 1 _ 1 _ _ 5 5 10 69. Epilepsy _ _ _ _ _ _ _ _ _ _ _ _ 2 3 2 _ 2 _ _ _ 2 1 _ _ _ _ _ 9 4 13 70. Convulsions (Non-puerperal; 5 years and over) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ _ _ 1 _ _ _ _ _ _ _ _ _ 2 2 71. Infantile Convulsions (under 5 years) 2 3 _ _ _ _ 2 3 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 2 3 5 72. Chorea _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 73. Hysteria, Neuralgia, Neuritis _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 74. Other Diseases of the Nervous System 1 _ 1 _ _ _ 2 _ 1 1 _ _ _ 1 2 _ _ _ 1 _ 1 _ _ 1 _ _ _ _ 7 3 10 75. Diseases of the Eyes and Annexa _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 76. (a) Mastoid Disease 1 _ _ _ 1 _ 2 _ 1 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 3 _ 3 (b) Other Diseases of the Ears _ _ _ 1 _ _ _ 1 _ _ 1 _ 1 1 _ 1 _ _ _ _ _ _ _ _ _ _ _ _ 2 3 5 3. Diseases of the Circulatory System. 77. Pericarditis _ _ _ _ _ _ _ _ 1 _ _ 1 _ 2 _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 3 4 78. Acute Myocarditis and Endocarditis 1 _ _ _ _ _ 1 _ _ 2 _ _ 1 1 1 2 1 1 1 _ _ _ _ _ _ _ _ _ 5 6 11 79. (a) Valvular Disease _ _ _ _ _ _ _ _ 1 _ 1 1 1 6 _ 3 3 3 9 13 18 16 22 28 9 7 1 3 6 80 145 (6) Fatty Degeneration of the Heart _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 2 2 2 2 7 3 3 3 1 _ _ 1 15 25 (c) Other Organic Disease of the Heart 1 _ _ _ 1 _ 2 _ _ _ _ 1 1 2 1 3 6 3 15 5 20 21 43 34 31 27 3 5 122 101 223 80, Angina Pectoris _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 1 _ 1 1 _ _ 3 2 5 81. (a) Aneurysm _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 4 _ 4 1 _ _ _ _ _ _ 8 1 9 (b) Arterial Sclerosis _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 2 1 4 8 10 5 4 3 1 _ 2 17 38 (c) Other Diseases of Arteries _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 2 _ _ 1 _ _ 2 2 4 82. (a) Cerebral Embolism and Thrombosis _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 3 1 2 7 2 5 _ 4 1 1 8 18 26 (b) Other Embolism and Thrombosis _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ 1 1 _ 1 _ 2 1 1 _ _ _ 5 3 8 83. Diseases of the Veins (Varices. Haemorrhoids Phlebitis, etc.) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 84. (a) Status Lymphaticus _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ (b) Other Diseases of the Lymphatic System _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 85. Hæmorrhage; other Diseases of the Circu latory System _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ _ _ _ _ _ 1 _ _ 1 _ _ 1 2 3 4. Diseases of the Respiratory System. 86. Diseases of the Nasal Fossæ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 87. Diseases of the Larynx 1 _ 1 _ _ _ 2 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 2 _ 2 88. Diseases of the Thyroid Body _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ _ _ _ _ 1 1 89. & 90. Bronchitis 11 5 8 1 3 1 22 7 _ _ _ _ 1 _ 2 2 6 _ 20 6 28 16 28 40 23 37 2 10 132 118 250 91. Broncho-Pneumonia 30 17 16 8 10 4 56 29 _ 2 _ _ _ _ 1 1 1 4 _ 1 2 5 4 8 1 3 _ 1 65 54 119 92. (a) Lobar Pneumonia 2 2 1 3 5 2 8 7 2 1 _ 1 1 1 3 _ 9 2 5 4 4 3 _ 5 _ 1 _ 1 32 26 58 (b) Pneumonia (type not stated) 5 4 4 3 4 1 13 8 1 _ _ _ _ _ l 1 6 3 5 3 12 4 4 6 1 6 2 1 45 32 77 93. Pleurisy _ _ _ _ _ _ _ _ _ _ _ _ _ _ l 1 2 _ _ _ 2 _ 1 2 1 _ _ _ 7 3 10 59 Deaths Registered from all Causes for the Year, 1917—continued. Cause of Death. AGES. 0 to 1 1 to 2 2 to 5 Total under 5 5 to 10 10 to 15 15 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 to 85 85 and upwards Totals. M. F. M. f. m. f. M. F. M. F. m. F. M. F. M. F. M. f. m. F. m. f. m. f. M. f. m. f. M. F. SONS 4. Diseases of the Respiratory System - con. 94. Pulmonary Congestion,Pulmonary Apoplexy 1 1 _ _ _ _ 1 1 _ _ _ _ _ _ _ _ _ _ 1 1 1 _ 4 2 _ 1 _ _ 7 5 12 95. Gangrene of the Lung _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 96. Asthma _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ l _ 1 1 _ 1 _ _ _ _ 3 2 5 97- Pulmonary Emphysema _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ 1 _ _ _ _ _ 2 2 98. (a) Fibroid Disease of the Lung _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ (b) Other Diseases of the Respiratory System _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 2 _ _ _ _ _ _ _ _ _ 2 _ 2 5. Diseases of the Digestive System. 99. (a) Diseases of the Teeth and Gums _ _ 1 _ _ _ 1 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ 1 (b) Other Diseases of the Mouth and Annexa _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 100. Diseases of Pharynx, Tonsillitis _ _ _ _ _ _ __ _ 1 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ 1 101. Diseases of Œsophagus _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ _ _ _ _ 1 _ 1 102. Perforating Ulcer of Stomach _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ 1 6 5 _ _ 2 1 1 1 _ _ 9 8 17 103. (a) Inflammation of Stomach 1 2 _ _ _ _ 1 2 1 _ _ _ _ _ _ _ _ 1 _ _ _ _ _ _ _ _ _ _ 2 3 5 (b) Other Diseases of Stomach _ 2 _ _ _ _ _ 2 _ _ _ _ __ _ 1 _ _ _ _ _ _ 1 _ 1 1 _ _ _ 2 4 6 104 & 105. (a) Infective Enteritis 3 9 2 _ _ _ 5 9 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 5 9 14 (b) Diarrhœa (not returned as infective) 5 3 _ 1 1 2 6 6 _ _ _ _ _ _ _ _ _ _ _ _ _ 1 2 1 _ _ _ _ 8 8 16 (c) Enteritis (not returned as infective) 15 8 4 1 _ _ 19 9 _ _ _ _ _ _ _ _ _ 1 _ 1 1 _ _ 2 _ _ _ _ 20 13 33 (d) Gastro-Enteritis (not returned as infective) 12 6 3 2 2 1 17 9 1 1 _ _ _ _ _ _ _ _ _ _ _ 1 2 _ 1 2 _ _ 21 13 34 (e) Dyspepsia (under 2 years of age) _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ (f) Colic _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ (g) Ulceration of Intestines _ _ 1 _ _ _ 1 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ 1 (h) Duodenal Ulcer _ _ _ _ _ _ _ _ _ _ _ _ 1 _ _ _ _ 1 1 _ _ _ _ _ _ _ _ _ 2 1 3 106. Ankylostomiasis _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 107. Other Intestinal Earasites _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 108. Appendicitis _ _ _ _ _ 1 _ 1 _ _ _ 1 _ _ 1 1 _ _ 1 _ _ 2 _ _ _ _ _ _ 2 5 7 109. (a) Hernia _ _ _ _ _ _ _ _ 1 _ _ _ _ _ _ _ _ _ 1 5 2 _ 3 2 _ 3 _ 1 7 11 18 (b) Intestinal Obstruction _ 3 _ _ 1 _ 1 3 _ _ 1 _ l 1 _ 2 _ 2 _ 1 1 2 2 2 1 1 _ _ 7 14 21 110. Other Diseases of the Intestines _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ 1 _ _ _ _ _ _ _ _ 1 _ 1 2 3 111. Acute Yellow Atrophy of Liver _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 112. Hydatid of Liver _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 113. (a.) Cirrhosis of the Liver (not returned as alcoholic) _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ 3 1 3 1 3 2 3 _ 1 2 _ _ 14 6 20 (b) Cirrhosis of the Liver (returned as alcoholic) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ _ 1 _ _ _ _ _ _ _ _ 1 1 2 (c) Diseases formerly classed to "Other Diseases of Liver and Gall Bladder" _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 114. Biliary Calculi _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 1 _ _ _ _ 1 1 2 115. Other Diseases of the Liver _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ _ _ _ _ 1 _ 1 116. Diseases of the Spleen _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 117. Peritonitis (cause unstated) _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ 1 _ _ _ _ 1 2 _ _ _ _ _ _ 1 4 5 118. Other Diseases of the Digestive System _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ 2 _ _ _ _ _ _ _ 3 _ 3 6. Non-Venereal Diseases of the Genito-Urinary System and Annexa119. Acute Nephritis _ _ _ _ _ _ _ _ _ _ __ 1 1 _ _ _ 2 _ _ _ 1 1 _ _ __ _ _ _ 4 2 6 120. Bright's Disease _ _ _ _ _ _ _ _ 1 _ _ _ 3 _ _ 1 3 6 8 5 15 15 16 9 9 6 1 _ 56 42 98 121. Chyluria _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 122. Other Diseases of the Kidney and Annexa _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ _ 1 _ _ _ 1 1 2 123. Calculi of the Urinary Passages _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 124. Diseases of the Bladder _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ 1 _ 1 _ _ _ 2 _ 2 125. Diseases of the Urethra, Urinary Abscess &c. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ 2 _ _ _ _ _ 1 _ 4 _ 4 126. Diseases of the Prostate _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ 1 _ 6 _ _ _ 1 _ 9 _ 9 127. Non-Venereal Diseases of Mole Genital Orgrans _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 2 _ _ __ _ _ 2 _ 2 128. Uterine Hæmorrhage (Non-puerperal) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ _ _ _ _ _ _ _ _ 1 1 129. Uterine Tumour (Non-cancerous) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 130. Other Diseases of the Uterus _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 131. Ovariancyss, Tumour (Non-Cancerous) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ _ _ _ _ _ _ 1 1 132. Other Diseases of the Female Genital Organs _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ _ _ _ _ _ _ _ _ _ _ _ _ 1 1 133. Non-puerperal Diseases of the Breast (Non-cancerous) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ _ _ _ _ _ _ _ _ _ _ _ _ 1 1 60 Deaths Registered from all Causes for the Year, 1917—continued. Cause of Death. ages. 0 to 1 1 to 2 2 to 5 Total under 5 5 to 10 10 to 15 15 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 to 85 85 and upwards Totals. m. f. m. f. m. f. m. f. m. f. M. f. m, f. m. f. m. f. M. f. m. f. m. f. M. f. M. f. m. f. SONS 7. The Puerperal State. 134. Accidents of Pregnancy _ _ _ _ _ _ _ _ _ _ _ __ _ 2 _ 2 _ _ _ _ _ _ _ _ _ _ _ _ _ 4 4 135. Puerperal Hæmorrhage _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 3 _ _ _ _ _ _ _ _ _ _ _ 3 3 136. Other Accidents of Childbirth _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 137. Puerperal Fever _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ 3 _ 1 _ _ _ _ _ _ _ _ _ _ _ 5 5 138. ,, Albuminuria and Convulsions _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ 1 _ 1 _ _ _ _ _ _ _ _ _ _ _ 3 3 139. ,, Phlegmasia Alba Dolens, Embolism and sudden death _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 2 _ _ _ _ _ _ _ _ _ _ _ 2 2 140. ,, Insanity _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 141. ,, Diseases of the Breast _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 8. Diseases of the Skin and of the Cellular Tissue 142. (a) Senile Gangrene ... _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 2 1 _ _ 2 _ _ 2 4 6 (b) Gangrene (other types) _ _ _ _ 1 _ 1 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ 1 143. Carbuncle, Boil _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 144. Phlegmon, Acute Abscess 1 _ _ _ _ _ 1 _ _ 1 _ _ _ _ 1 _ _ _ _ _ _ 1 _ _ _ _ _ _ 2 2 4 145. Diseases of the Integumentary System _ 2 _ _ _ _ _ 2 _ _ _ _ _ _ _ _ _ _ _ _ 1 _ _ _ _ 2 _ _ 1 4 5 9. Diseases of the Bones and of the Organs of Locomotion. 146. Diseases of the Bones _ _ _ _ 1 _ 1 _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ _ _ _ _ _ 1 1 2 147. Diseases of the Joints _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ _ _ _ _ 1 _ ] 148. Amputations _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 149. O^.her Diseases of Locomotor System _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 10. Malformations. 150. Congenital Malformations 8 11 _ _ 2 _ 10 11 1 1 1 1 _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ _ 12 14 26 11. Diseases of Early Infancy 151. (a) Premature Birth 30 31 _ _ _ _ 30 31 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 30 31 61 (b) Infantile Debility, Icterus, and Sclerema 26 18 1 _ _ _ 27 18 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 27 18 45 152. Other Diseases peculiar to early Infancy 6 6 _ _ _ _ 6 6 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 6 6 12 153. Lack of Care _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 12. Old Age. 154. (a) Senile Dementia _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ 2 _ _ _ 3 3 (b) Senile Decay _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 2 23 20 36 48 9 23 69 93 162 13. Affections Produced by External Causes. 155 to 163. Suicides _ _ _ _ _ _ _ _ _ _ _ _ _ 1 12 2 1 _ _ _ 2 1 1 _ _ _ _ _ 6 4 10 164. Poisoning by Food _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ _ _ _ _ _ _ _ 1 1 165. Other Acute Poisonings _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ 1 _ _ _ _ _ _ _ 2 _ 2 166. Conflagration _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 167. Burns (Conflagration excepted) 1 _ _ 1 _ 4 1 5 _ _ _ _ _ 1 _ _ _ _ _ _ __ _ _ _ 1 _ _ _ 2 6 8 168. Absorption of Deleterious Gases (Conflagration excepted) 4 9 1 _ _ _ 5 9 _ _ _ _ _ _ 1 _ 1 _ _ 2 1 _ 1 _ _ _ _ 1 9 12 21 169. Accidental Drowning _ _ _ _ _ _ _ _ _ _ 1 _ _ _ _ _ _ _ 1 1 _ _ _ _ _ _ _ _ 2 1 3 170 to 176. Injuries _ _ _ _ 1 1 1 1 3 1 1 _ 2 2 _ 1 1 3 6 2 9 2 8 6 1 10 _ 2 32 30 62 177. Starvation _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ _ _ _ _ _ _ _ _ 1 _ 1 178. Excessive Cold _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 179. Effects of Heat _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 180. Lightning _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 181. Electricity (Lightning excepted) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 182 to 184. Homicide _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ _ _ _ _ _ _ _ _ _ _ _ _ 1 1 85 Fractures (cause not specified) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ _ _ _ 1 1 186. (a) Other Violence _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ _ _ _ 1 1 _ _ _ _ _ _ _ 2 1 3 (b) ,, ,, through Hostile Aircraft _ _ _ _ _ 1 _ 1 _ 1 _ _ _ _ 2 1 _ _ _ 2 _ _ _ _ _ _ _ _ 5 6 11 (c) ,, ,, ,, Submarine _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ 1 14. Ill-defined Causes. 187. Dropsy _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ 1 _ _ _ _ _ 2 2 188. (a) Syncope (aged 1 year and under 70) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ (6) Sudden death (not otherwise defined) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 189. (a) Heart Failure (aged 1 year and under 70) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ _ 1 _ _ _ _ _ 1 1 2 (b) Atrophy, Debility, Marasmus (aged 1 year and under 70) _ _ _ _ _ 1 _ 1 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 1 (c) Teething _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ (d) Pyrexia _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ (e) Other ill-defined Deaths _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ (f) Cause not specified _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 61 Table No. 3. Summary of Ages. 0 to 1 1 to 2 2 to 5 Total under 5 years 5 to 10 10 to 15 15 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 to 85 85 and upwards Totals. General Diseases 81 58 97 236 37 24 60 79 122 151 167 122 45 4 1047 Diseases of the Nervous System and of the Organs of Special Sense 18 4 4 26 8 5 12 14 16 50 35 47 21 6 240 Diseases of the Circulatory 2 _ 1 3 4 4 14 12 21 59 113 162 94 15 501 Diseases of the Respiratory System 79 45 30 8 154 6 1 3 13 31 49 80 107 74 17 538 Diseases of the Digestive 69 15 92 5 2 4 8 12 27 21 27 14 2 214 Non-Venereal Diseases of the Genito-Urinary System and Annexa _ _ _ _ 1 1 4 3 11 16 37 34 17 3 127 The Puerperal State _ _ _ _ _ _ 4 6 7 _ _ _ _ _ 17 Diseases of the Skin and of the Cellular Tissue 8 _ 1 4 1 _ _ 1 _ _ 4 1 5 _ 16 Diseases of the Bones and of the Organs of Locomotion _ _ 1 1 _ _ _ _ _ _ 1 1 _ 3 Malformations 19 _ 2 21 2 2 _ _ _ _ _ _ 1 _ 26 Diseases of Early Infancy 117 1 _ 118 _ _ _ _ _ _ _ _ _ _ 118 Old Age _ _ _ _ _ _ _ _ _ _ 3 44 86 32 165 Affections produced by External Causes 11 2 7 23 5 2 7 12 7 20 17 17 12 3 125 Ill-defined Causes _ _ 1 1 _ _ _ _ _ 1 1 2 _ _ 5 Totals 402 125 152 679 69 41 108 148 230 373 479 564 369 82 3142 62 Table No. 4. METEOROLOGICAL TABLE FOR SAINT PANCRAS, 1917. (Extracted from the Monthly Returns of the Metorological Office.) Deduced from Observations at Camden Square, n.w., under the Superintendence of H. Robert Mill, d.sc., ll.d. January. February. March. April. May. June. July. August. September. October. November. December. Barometer. Mean Pressure at 320 F. at Station Level* (Bar 123 ft. above M.S L.) 29.752 30.024 29.722 29.782 29.881 29.92 29.949 29.623 29.952 29.665 29.994 30.084 Air Temperature. Mean of Maximum A. 38.3 40.7 45.2 52.6 71.4 760 75.2 71.4 69.8 55.9 52.1 41.1 Minimum B. 32.7 30.7 32.8 34.6 48.5 54.2 54.7 55.6 51.9 40.3 41.8 31.3 Mean of A. and B 35.5 35.7 39.0 43.6 60.0 651 65.0 63.5 60.8 48.1 47.0 36.2 Difference from Average † —3.3 -4.3 -3.9 -1.8 -4.9 +4.1 +0.7 +0.3 +2.2 -2.6 +2.7 -4.3 Humidity—Morning 89% 88% 83% 72% 66% 64% 71% 78% 80% 91% 88% 90% Earth Temperature at 4 ft. depth 42.8 39.3 4.02 41.0 48.7 56.3 58.5 59.6 58.3 54.3 48.3 45.4 Bright Sunshine. Total Observed (Daily mean) Hours 0.55 1.36 2.25 4.97 6.43 6.16 6.14 5.16 4.52 3.74 1.25 1.26 Per cent. of total possible 7 14 19 36 44 38 39 36 36 36 14 16 Difference from Average † Hours — — — — — — — — — — — — Rain and other forms of Precipita tion. Number of Days 5 20 11 2 20 16 30 27 5 12 26 8 Total Fall Inches 1.3 0.9 1.7 2.2 2.0 5.3 4.1 4.0 2.3 3.3 1.8 1.1 Difference from Average † ,, +0.6 +0.8 +0.1 -0.7 -0.3 -3.3 -1.7 -1.8 -0.4 -0.6 +0.6 + 1.3 * The hoars of observation are 9 a.m. and 9 p.m., local time. † The averages used are obtained from observations extending over 35 years for Rainfall and Temperature and 25 years for Sunshine, 63 Table No. 5. Inspections and Re-inspections made by District Inspectors and temporary Women Inspectors and by Factory and Workshop (Male) Inspector during the year 1917. DUTIES AND PREMISES. Male Inspectors. Temporary Women Inspectors Total. Inspections. Re-inspections. Inspections. Re-inspections. Inspections. Re-inspections. DISTRICT INSPECTORS. Infectious Diseases—Inquiry, removal, disinfection, etc. 2 2 1498 59 10500 61 Subsequent sanitary inspection, etc. 8 74 8n 730 819 804 Complaints 1637 4986 145 16 1782 5002 Drainage—Under notice. Plans, supervision, etc. 243 2126 — — 243 2126 Voluntary 615 1946 — — 615 1946 New Buildings 31 195 — — 31 195 Yards of Mews and Stables 2701 40 — — 2701 40 House-to-House Inspections — Housing, Town Planning, etc., Act, 1909: 17 (1). First Inspections . 85 638 — 85 638 Subsequent routine Inspections 1540 2914 — — 1540 2914 Inspections of registered tenement houses other than above 125 40 — — 125 410 Other house-to house Inspections 6 12 — — 6 12 Visits to closed underground rooms 147 40 — — 147 40 Smoke Shafts observed 4 — — — 4 — Regulated Trades. Offensive Trades 45 1 — — 45 1 Rag and Bone dealers — — — — — — Other effluvia businesses 1 2 — — 1 2 Inspections of Market Streets : 22 1 — — 22 1 Other Duties 436 34 — — 436 134 Food Control 911 7 — — 911 7 Totals 8559 13528 2454 805 11013 14333 FACTORY & WORKSHOP (MALE) INSPECTOR. Factories (including Factory Laundries) 179 181 — 179 181 Laundries 60 14 — — 60 14 Bakehouses (Factories and Workshops) 348 304 — — 348 304 Restaurant Kitchens 65 35 — — 65 35 Other Workshops 335 166 — — 335 166 33 43 — — 33 43 — — — — — — Food Control 417 427 — — 417 427 Totals 1437 1170 — — 1437 1170 64 Table No. 6. Inspections and Re-Inspections and other work of the Food Inspectors during 1917. DUTIES AND PREMISES. Visits and Inspections. Re-Inspections after Intimation Notices. Mr. Auger. Mr. Child. Totals. Mr. Auger. Mr. Child. Totals. Milkshops 84 397 48 — — — Dairies 83 9 92 — — — Cowsheds — 30 30 — — — Other Premises of Milk Purveyors — 9 9 — — — Margarine Factories — — — — — — Butter Factories — — — — — — Ice Cream Premises 19 92 111 — — — Slaughter Houses 3 160 163 — — — Premises where Prepared Meats are made (sausages, pies tripe cooked meat, &c.) 33 177 210 — — — Butchers' Shops 5 204 209 — — — Fishmongers' Shops 62 175 237 1 — — Fried Fish Shops and Fish Curer's premises 23 127 150 — — — Marketing Places 1653 1241 2894 — — — Other Premises where Food or Drugs are sold 8 — 8 — — — Other Visits 41 149 190 — — — Food Control 157 102 319 — — — Total 2171 2932 5103 1 — 1 SAMPLES, &c., TAKEN. Formal Samples Informal Samples No, of Milk samples 184 183 367 — 6 6 ,, Cream samples 5 7 12 — — ,, Batter and Margarine samples 60 71 131 12 6 18 ,, Other samples (specified below)— Lard 18 19 37 — — — Coffee 8 6 14 — — — Self Raising Flour 24 17 41 — — — Vinegar — 7 7 — — — Cheese 1 6 7 — — — Dripping 12 9 21 — — — Mustard 7 3 10 — — — Preserved Beans 2 — 2 — — — ,, Peas 3 — 3 — — — Olive Oil 11 2 13 — — — Pepper 6 5 11 — — — Jam — 3 3 — — — Cocoa 20 17 37 — — — White Mixture 1 — 1 — — — Baking Powder — — — — — 1 Total 362 355 717 13 12 25 UNSOUND FOOD. No, of surrenders and seizures :— Surrendered Seized Meat — 2 2 — — — Fish 4 8 12 — — — Shellfish — 2 2 — — — Cheese 2 4 6 — — — Margarine 1 — 1 — — — Bread — 1 1 — — — Flour — 2 2 — — — Fruit 3 3 6 — 3 3 Vegetables 5 11 16 — Total 15 33 48 — 3 3 Inspections of Registered Canal Boats 4 — 4 — — — 65 Table No. 7. Visits, etc., made by Women Inspectors during 1917. DUTIES. First Visits. Re-Visits. Miss Bibby. Miss Smith Miss Giles. * Miss Payne. * Miss MacKenzie. Mrs. Hunter. Miss Anderson. Whole Borough. Miss Bibby. Miss Smith. Miss Giles. *Miss Pavne. *Miss MacKenzie. Mrs. Hunter. Miss Anderson. Whole Borough. Births visited — 369 13 2 — 488 436 1308 — 326 2 3 — 244 192 767 Other visits re births where admission not obtained — 400 7 — — 42 166 615 — 1 — 8 — 7 165 18 Visits re verminous persons — 5 — 121 182 20 1 329 — 1 — 82 43 — — 126 Other ,, where admission not obtained — 32 — — — — — 32 — — — — — — — — Visits re Ophthalmia Neonatorum — 26 5 — 24 — — 55 — 52 5 — 8 — — 65 Visits re Puerperal Fever — 9 5 — — — — 14 — 4 — — — — — — Visits re other cases of illness, &c. 183 594 863 516 8 2 1226 940 5144 — 118 12 93 247 135 103 70??? Visits re Tuberculosis notifications 10 3 852 97 162 4 — 1128 — — 70 49 130 — — 249 Other „ ,, where admission not obtained — — 61 — — 35 — 96 — — — — — — — — For other purposes „ ,, — 44 111 59 82 12 — 308 — 1 — 7 57 — — 65 Visits to Hospitals and other voluntary institutions 30 44 35 — — 48 37 863 — — 6 10 — — — 16 Factories 4 1 — — — — — 5 — — — 1 — — — 1 Domestic Workshops — — — — — — — — — — — — — — — — Home Workplaces — — — — — — — — — — — — — — — — Laundries — — — — — — — — — — — — — — — — Restaurant Kitchens — — — — — — — — — — — — — — — — Other Workshops — — — — — — — — — — — — — — — — Other Workplaces — — — — — — — — — — — — — — — — Other Visits, Inspections and Committees 248 44 286 — — 108 36 722 — 2 — — — 6 1 9 Total 747 1968 2238 8-5 1252 1983 1616 10619 — 505 95 253 485 392 461 2191 * Exclusive of those shown in Table 5, 66 Table No. 8. Total Number of Inspections and Re-inspections made by individual Inspectors during the year 1917. Inspector. Inspections. Re-inspections. " Food Control." Total. Inspections. Re-inspections. 1. Mr. Rackham 777 1770 131 — 2678 2. „ Brown 1095 2472 187 5 3759 3 ,, * Thompson — — — — — „ *Pottier (Temporary Inspector) — — — — — 4. „ ‡Dillon 474 1775 127 — 2376 ,, Auger (District Inspections) 232 497 — — 729 5. „ *James — — — — — 6. „ Akers 1713 986 182 — 2881 7. „ *Lonnon — — — — — 8. ,, *Adkins — — — — — 9. ,, †Holmes 262 781 — — 1043 10. „ § Jaffa (Temporary Inspector) 131 47 13 — 191 11. „ Walker 1240 2703 108 2 4053 12. ,, Landen 1689 2481 163 — 4333 13. „ West (Factories & Workshops)... 1055 752 417 427 2651 14. „ Auger (Food and Food premises) 2408 1 157 — 2566 15. „ Child 3173 — 162 — 3335 16. Miss Bibby 747 — — — 747 17. „ Smith 1968 505 — — 2473 18. „ Giles 2238 95 — — 2333 19. „ Payne (Temporary Inspector) 2250 610 — — 2860 20. „ MacKenzie Ditto 2271 933 — — 3204 21. Mrs. Hunter 1983 392 — — 2375 22. Miss Anderson 1616 461 — — 2077 Totals 27322 17261 1647 434 46664 * Away on Active Service during whole of 1917. † Resigned April 24, 1917. ‡ Returned from Active Service March 26, 1917. § Appointed 21st November, 1917. 67 Table No. 9. Intimations as to Nuisances and Breaches of Statutes and By-laws served by the Sanitary Inspectors during 1917. Schedule of Nuisances. Whole Borough. 1 Part of the house in a dirty condition 427 2 „ „ damp „ 110 3 Roof defective 550 4 Guttering defective 55 5 Water fittings defective 191 6 Water-closet apartment with absence of external ventilation 12 7 ,, ,, so foul as to be a nuisance or dangerous to health 45 8 Water-closet basin foul 56 9 „ ,, defective 70 10 „ ,, choked 114 11 Urinal in a foul condition — 12 Privy in a foul condition 1 13 Soil pipe defective 17 14 ,, unventilated 3 15 ,, improperly ventilated 6 16 Absence of waste pipe to sink, lavatory or bath 2 17 Waste pipe of sink, lavatory, or bath connected with drain 3 18 ,, ,, „ ,, defective 51 19 ,, ,, „ ,, foul 10 20 Inlet of drain improperly trapped 5 21 Drain defective 79 22 ,, stopped 129 23 ,, ventilating pipe defective 15 24 Rain-water pipe in direct communication with drain 9 25 ,, ,, defective 77 26 Unpaved condition of roadway — 27 Undrained ,, ,, — 28 Area or part unpaved 1 29 ,, undrained 4 30 Yard or space unpaved 2 31 ,, ,, undrained 2 32 Defective condition of washhouse paving 22 33 Dust-bin defective 70 34 ,, in an improper position — 35 Accumulation of stagnant water which is a nuisance dangerous to health 27 36 Accumulation or deposit which is a nuisance dangerous to health 102 37 Animals kept in such a manner as to be a nuisance dangerous to health 10 38 Part of the house so overcrowded as to be dangerous to health 28 39 Space below floor in basement or ground floor insufficiently ventilated 7 40 Issuing of black smoke in such a quantity as to be a nuisance — 41 Discharging smoke in such a manner as to cause part of a building to be a nuisance dangerous to health 2 42 Tent, van, shed, or similar structure used as a human habitation which is in such a state as to be injurious or dangerous to the health of the inmates — 43 Other nuisances 269 Total 2583 Table No. 10. Registered Tenement Houses—Breaches of By-Laws. Whole Borough. 1 Overcrowding 10 2 Inadequate water supply — 3 Contaminated water supply — 4 Foul closet, basin or trap 2 5 Want of means of ventilation — 6 Want of annual cleansing 2 7 Want of cleansing of the part or parts of premises used in common 88 8 ,, ,, ,, in sole use 109 9 Want of cleansing of the room or part of the dwelling 24 10 Animals improperly kept — 11 Other breaches 2 Total 237 68 Table No. 11. Factories, Workshops aid Work Places—Breaches of Statutes. Whole Borough. 1 Want of cleanliness 87 2 Want of ventilation 1 3 Want of air space, overcrowding — 4 Sanitary accommodation, absent or insufficient 5 5 ,, ,, unsuitable or defective 79 6 ,, not separate for sexes 3 7 Want of drainage of floors ... 2 8 Other nuisances 28 9 Illegal occupation of underground bakehouse — 10 Breach of special sanitary requirements for bakehouses 72 11 Failure as regards list of outworkers — 12 Giving out work to be done in premises which are unwholesome — 13 ,, ,, ,, infected — 14 Allowing wearing apparel to be made in premises infected by scarlet fever or small-pox — 15 Other contraventions 2 Total 279 Table No. 12. Breaches of other Statutes and Statutory By-laws. Whole Borough. 1a An occupied house without a proper and sufficient supply of water (1907 Act, Sec.78) 26 1b ,, ., ,, ,, (other than above) — 2 Water supply used for domestic purposes connected with cistern which is used for flushing the water-closet — 3 Water-closet not supplied w th a sufficient quantity of water for securing its effective action 200 4 Tank, cistern, or other receptacle for storing of water used or likely to be used by man for drinking purposes—dirty condition of 16 5 Tank, cistern, or other receptacle for storing water used or likely to be used by man for drinking purposes—absence of a proper cover to 14 6 Tank, cistern, or other receptacle for storing water used or likely to be used by man for drinking purposes placed in an improper position — 7 Animals so kept as to be likely to pollute the water supply — 8 Offensive matters not deposited in manure receptacle — 9 Manure not removed at proper intervals — 10 Mauure—absence of proper receptacle for — 11 Manure receptacle not properly constructed — 12 Sufficiant drain to stables or cowshed—absence of a — 13 Receptacle for house refuse—absence of a proper 128 14 Receptacle for house refuse—absence of a proper cover for 5 15 Yard or open space unpaved — 16 ,, paving defective 38 17 Insufficient water-closet accommodation to "lodging house" 11 18 A furnace improperly constructed or negligently used — 19 Effluvia arising from premises used for trade, business, or manufacture which is a nuisance dangerous to the inhabitants of the district — 20 Offensive matters suffered to run out of trade premises into an uncovered place — 21 Dairies and cowsheds—breach of By-laws as to — 22 Slaughterhouses—breach of By-laws as to — 23 Steam whistle—use of a, without authority — 24 Parts of houses infested with vermin requiring stripping, purifying, and cleansing 171 25 Articles in an unwholesome condition requiring to be purified or destroyed — 26 Underground room illegally occupied as a dwelling 5 27 Other breaches 25 Total 634