AC 4355 STPAN 84 Metropolitan Borough of Saint Pacras. REPORT of the MEDICAL OFFICER OF HEALTH FOR THE YEAR 1926. G. SOWDEN, M.D., D.P.H., M.R.C S,, L.R.C.P., Barrister-at-Law, Fellow of the Royal Institute of Public Health Printed by F. P. Lewingrion, 26 and 27, Eversholt Street. London N.W. 1. Metropolitan Borough of Saint Pancras With the Medical Officer of Health's Compliments. Public Health Department, Town Hall, Pancras Road, N.W. I. S. 335. 1000 12-26. Metropolitan Borough of Saint Pancras REPORT of the MEDICAL OFFICER OF HEALTH FOR THE YEAR 1926. G. SOWDEN, M.D., D.P.H., M.R.C.S., L.R.C.P., Barrister-at-Law, Fellow of the Royal Institute of Public Health. 3 CONTENTS. PAGE Map of Borough, showing statistics by Wards 2 Public Health Committee 5 Staff of Public Health Department 6 Introduction 8 Summary of Report 10 Section I.—Statistics, and Social Conditions of the Area. Population and General Statistics 11 Principal occupations of the inhabitants of the Borough 11 Economic Conditions 12 Marriages 12 Births 12 Illegitimacy 13 Notification of Births 13 Deaths 14 Inquests 16 Infantile Mortality 16 Section II.—General Provision of Health Services. Hospital Accommodation 19 Institutional Provision for Unmarried Mothers 20 Ambulance Facilities 20 Clinics, Treatment Centres, &c. 20 Maternity and Child Welfare 22 Advice Cards 22 Home Visiting 22 Centres 25 Artificial Light Treatment 27 Dental Clinic 30 Day Nurseries 31 Clinic for Sick Mothersand Children 31 Convalescent Home Treatment 32 Home for Sick Poor Children 32 Supply of Milk to Mothers and Children 32 Public Health Officers of the Local Authority 33 Professional Nursing 33 Home Helps 34 Midwives 34 Health Week 35 Legislation in force 36 page Section III.—Sanitary Circumstances of the Area. Water Supply 38 Drainage 38 Refuse Collection and Disposal 39 Mortuary 39 Sanitary Inspections 40 Notices served and result of service 40 Nuisances—Legal Proceedings 41 Smoke Abatement 42 Factory and Workshop Acts 42 Inspections 42 & 45 Defects found 43 Home Work 43 Outwork in Infected or Insanitary Premises 44 Factories, Workshops and Workplaces on Register 44 Other matters 44 Premises and Occupations controlled by by-laws or regulations 45 Offensive Trades 45 Rag and Bone Dealers 45 Houses Let in Lodgings 45 Underground Rooms 45 Canal Boats Acts 45 Rent and Mortgage Restrictions Act, 1923 45 Medical Examination of School Children 46 Section IV.—Housing. Statistics 48 Overcrowding 49 Housing Schemes 49 Work of the Estates Committee 49 Section V.—Inspection and Supervision of Food. (a) Milk Supply 51 Cowsheds, Dairies and Milkshops 51 Registration of Dairies and Dairymen 51 Milk (Special Designations) Order, 1923 53 4 CONTENTS—continued. page (i) Meat and Other Foods 54 Unsound and diseased food condemned and destroyed 55 Slaughter-houses 55 Fried Fish and Fish Curing Premises 55 Ice Cream Premises 55 Bakehouses and Restaurant Kitchens 55 Chemical Work 56 Arsenic in Apples 56 Strawberry Jam 56 (c) Sale of Food and Drugs Acts,— Samples taken 57 Prosecutions:— (a) Sale of Food and Drugs Acts 58 (b) Milk and Dairies solidation) Act, 1915 58 (c) Dairies, Cowsheds and Milkshops (Amending) Order, 1886 58 Milk and Cream Regulations 59 Section VI.—Prevalence of, and control over, Infectious Diseases. Notifications and Deaths from notifiable diseases by ages 60 Do. by Wards 61 Smallpox 62 Vaccination 62 Scarlet Fever 63 Diphtheria 63 Enteric (Typhoid) Fever 64 Puerperal Fever 64 Puerperal Pyrexia 65 Erysipelas 65 Anthrax 65 Cerebrospinal Meningitis 65 Anterior Poliomyelitis and Polioencephalitis 65 Ophthalmia Neonatorum 65 Encephalitis Lethargica 66 Pneumonia 66 Page Malaria 66 Dysentery 66 Measles and German Measles 66 Tuberculosis— New Cases and Deaths 67 Notifications 69 Prevalence and fatality for 10 years 70 Notifications and Deaths by Wards 70 Public Health (Tuberculosis) Regulations, 1924 71 Public Health (Prevention of Tuberculosis) Regulations, 1925 71 Boarding-out of Children 71 Care Committee 72 Dispensary 72 Report by Tuberculosis Officer 72 Summary of work carried out 73 Section VII.—Other Services. Disinfecting and Cleansing Station 74 Disinfecting Vans 75 Bacteriological Work 75 Appendix. Table No. 1. Vital Statistics for 11 years 78 Do. 2. Deaths Classified for all causes 79 Do. 3. Summary of above 83 Do. 4. Births and Deaths in Wards 84 Do. 5. Do., certain large towns and Metropolitan Boroughs 85 Do. 6. Meteorology 86 Do. 7. Inspections and reinspections District & Factory Inspectors) 87 Do. 8. Do. (Food Inspectors) 88 Do. 9. Visits by Women Inspectors 90 Tables Nos. 10, 1 i, 12 and 13. Details of Intimation Notices served and resulting Statutory Notices 91 5 Metropolitan Borough of Saint Pancras PUBLIC HEALTH COMMITTEE. Nor ember, 1925, to October, 1926. CHAIRMAN. Alderman Mansell James Swift. DEPUTY-CHAIRMAN. Alderman Alfred Solomon, J.P. EX-OFF1CIO. The Bight Worshipful The Mayor (Alderman Dr. Edward Andrew Gregg, .T.P.). ALDERMEN. Davies, David, J.P., L.C.C. Rolles, Harry. COUNCILLORS. Ward 3 Allan, Mrs. Isabella Menzies. 4 Alliston, Mrs. Evelyn. 6 Bambridgu, Mrs. Mary Winifred. 1 Bateman, William Edward. 2 Bland, Mrs. Violet. 8 Campion, John Sissons. 8 Crosby, Miss Ada, M.B.E. 8 Evans, Evan. 3 Hewson, Frederick. 7 Jenkins, Edwin. 4 Johnson, Job, J.P. 5 Kemp, Frederick William Isaac. 6 Martin, Arthur Henry. 3 Mop.rell, Rev. Roger Conyers, M.A. 5 Paterson, Mrs. Louisa Sophia. 2 Salmon-Brunsdon, Mrs. Elizabeth. 5 Saundf.rs, Edward John. 1 Spry, William Palmer. 5 Williams, Lt.-Col. Charles. 7 Wood, William Charles. November, 1926, to October, 1927. CHAIRMAN. Alderman Alfred Solomon, J.P. DEPUTY-CHAIRMAN. Councillor Evan Evans. EX-OFFICIO. The Right Worshipful The Mayor (Councillor Rev. R. Conyers Morrell, M.A., J.P.). ALDERMEN. Gregg, Dr. Edward Andrew. Rolles, Harry. Swift, Mansell James, F.R.M.S. COUNCILLORS. Ward 3 Allan, Mrs. Isabella Menzies. 4 Alliston, Mrs. Evelyn. 6 Bambridge, Mrs. Mary Winifred. 1 Bateman, William Edward. 2 Bland, Mrs. Violet. 8 Campion, John Sissons. 8 Crosby, Miss Ada, M.B.E. 1 Davies, John William. 5 Escott, Arthur, M.A.B. 3 Hewson, Frederick. 7 Jenkins, Edwin. 4 Johnson, Job, J.P. 5 Kemp, Frederick William Isaac. 6 Martin, Arthur Henry. 7 Mathews, William Lee. 5 Paterson, Mrs. Louisa Sophia. 2 Salmon-Brunsdon, Mrs. Elizabeth. 1 Spry, William Palmer. 5 Williams, Lt.-Col. Charles. 6 STAFF OF THE PUBLIC HEALTH DEPARTMENT at end of 1926. MEDICAL OFFICER OF HEALTH AND ADMINISTRATIVE TUBERCULOSIS 0FFICE1 G. Sowden, M.D., D.P.H., M.R.C.S., L.R.C.P. TUBERCULOSIS OFFICER. A. Viney, M.R.C.S., L.R.C.P., P.P.H. ASSISTANT MEDICAL OFFICER. G. A. Back, B.A., M.R.C.S., L.R.C.P., D.P.H. PUBLIC ANALYST. J. Kear Coi.wei.t,, F.I.C. SANITARY INSPECTORS AND HEALTH VISITORS. Inspector* of Food and Food Place*. §HW. G. Auger. §1|H. R. Child. Inspector of Workshops and Factories ,‡§B. H. Thompson. District Inspectors. §G. Rackham. ‡§fJ. I. Lonnon. +§W. L. Brown. §E. M. Dillon. ‡§HA. H. Walker J§R. E. James. ‡G. W. Adkins. ‡R. C. Akers. ‡M. Jaffa. ‡¶S. W. Capel. JfH. K. Nixon. §H. G. West. Senior Woman Sanitary Inspector. JMiss M. E. Bibby, B.A. (Lond.). Women Sanitaru Inspectors and Health Visitors. ‡||Miss C. Smith. ‡§||Miss F. A. Anderson. ‡§Mrs. A. Hunter. ‡||Miss V. K. Blaxland. ||+**Miss J. A. J. Camman. ‡||Miss A. Holland. CLERICAL STAFF. Chief Clerk First Clerk Second Clerk Clerk ,, ,, ,, Junior Clerk ,, ,, A. D. Corrick. A. G. Capel. A. Carpenter. G. N. Cove (attached to the Estates Dept.). J. D. Holiday. T. H. Hague. Miss A. Andrews. W. C. Mansfield. H. G. Avril. R. Wakren. * Cert. Municipal and County Engineers. ‡Cert. San. Insp. Examination Board. § San. Insp. Cert. Royal San. Inst. ¶Cert. Meat and other Foods. || Health Visitor's Certificate. + C.M.B. ** Certificate, Queen Charlotte's Hospital, 7 BOROUGH COUNCIL STAFF AT THE CENTRES AND CLINICS. Medical Officers. No. of Consultations per month Dr. Margaret E. Alden 1 Dr. Chas. H. A. Alderton 4 Dr. H. Searle Baker 4 Dr. B. Marion Cockerell 15 Dh. P. Ruth Elliott 1 Dr. A. Gertrude Grogan 8 Dr. J. Finch Haines 12 Dr. Janie Lorimer Hawthorne 6 Dr. Ethel F. Iredell 4 Dr. Kathleen F. Lander 2 Dr. Lydia A. Leney 8 Dr. Jessie S. Muir 9 Dr. J. Balfour Neill 8 Dr. Martin Oldershaw 1 Dr. Margaret R. Paterson 4 Dr. Mary J. Pirret 13 Dr. Francis L. Provis 13 Dental Clinic. Mrs. W. A. Murch, L.D.S., Dentist 10 Dr. Jas. Maughan, Anmthetht. 2 Artificial Light Clinic. Dr. William Beaumont 12 Dentists at Tuberculosis Dispensary. Mr. Southcomb May. L.D.S. Mr. A. J. Maurice, Ull.tS. (The above are nart-time officers.) Superintendents of Maternity and Child Welfare Centres. senior. UMiss K. L. Allfrf.y. •JMiss G. R. Bristow. £§Mrs. E. Crockart. JSMiss M. H. Landel Jones. ^Miss M. Smyth. Junior. †§Miss M. L. Blair. ‡§Mrs. S. C. Chapman. §Miss M. Manger. ‡§Miss E. M. Robinson. §Miss M. Thmpleton. Health Visitors at Maternity and Child Welfare Centres. SUM iss E. B. Bagnall. SMrs. E. E. Bruce. •JMiss M. A. Clarke. J^Miss B. M. Harris. iMiss A. M. U. Harrop. MRS. E. LURIE. *‡§Mrs. J. Lynn. ‡§Mrs. M. A. Smith. *§Miss Y. B. Woodruff. Tuberculosis Disnensaries Nurse Visitor, *5 Miss S. A. Long. Clerical and General Assistant. Miss Margaret Deed. DISINFECTING AND CLEANSING STAFF. Foreman of Disinfecting Station Disinfector .. .. - . . Motor Driver and Disinfector if f* • • • • Matron of Personal Cleansing Station Assistant at „ „ ty y 9 • • Resident Caretaker, Mortuaries and Coroner's Court (The above are full-time officers.) T. Bartholomew. A. J. Dibben. J. Stanley. C. Browne. Mrs. E. Mace. Mrs. A. Styles. Mrs. L. Blaby. J. Root. * Cert. San. Insp. Examination Board, f San. Insp. Cert. Royal San. Inst. X Health visitor's Certificate. § C.M.B. •[ Midwifery Certificate, Queen Charlotte's Hospital. 8 Public Health Department, Town Hall, Pancras Road, N.W. 1. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of St. Pancras. Mr. Mayor, Ladies and Gentlemen. I have the honour to present the 71st Annual Report on the vital statistics and sanitary condition of the Borough, including particulars of the work carried out during the the year by the staff of the Public Health Department. This is the fourth Annual Report which it has been my duty to submit to the Members of the Council. The Minister of Health has intimated that the Annual Report for 1926 should be an ordinary report, that is, a report of a more simple character than the full Survey Report, which was required to be furnished for the preceding year. A summary of the principal statistics for 1926 is given on page 10. It will be seen that the general death-rate of the Borough was 12.4 per 1000 of population, being slightly lower than the corresponding rate of the previous year. There was a decrease in the number of deaths from Cancer, Tuberculosis, Pneumonia, Bronchitis and Diphtheria, but deaths from Heart Disease, Measles, Nephritis, and from Accidents were more numerous than in the preceding year. The rate of Infantile Mortality, which is measured by the number deaths under 1 year of age per 1000 registered births, was 76, as compared with a rate of 72 for the year 1925, This increase was chiefly due to an epidemic of Measles, of a severe type, which occurred in the early part of the year. This disease was responsible for the death of 25 infants under 1 year of age, which represents an Infantile Mortality rate of no less than 7 per 1000 from this cause alone. The birth-rate again shewed a decrease, the rate being only 16.7 per 1000 of population. A lower birth-rate has never been recorded in the Borough. Notifiable Infectious diseases were very much less prevalent than during the previous year, with the exception of Measles. A rather severe epidemic of this disease occurred during the first four months of the year, resulting in 65 deaths. With two exceptions these deaths were all of children under 5 years of age. The most urgent and important Public Health question in the Borough—Housing—still remains in a very unsatisfactory condition and overcrowding is very prevalent. 9 Although an enomous number of houses have been erected in and around London during the past few years, the greater portion have been designed for the use of what may be termed the middle classes, and the majority of these houses have been built for sale only—not to be let. It is probable that the supply of houses of this character is now almost equal to the demand, but accommodation for what is usually called the working class still remains deplorably inadequate—the deficiency being particularly acute for that section of the community whose wages are the lowest and whose families, unfortunately, are usually the largest. The provision of suitable accommodation which can be let, at rents such tenants can afford to pay, appears to be an economic problem almost impossible to solve. The cost of building is so high that private enterprise appears to be unable to supply what is required, even when omitting practically everything in the nature of architectural embellishment. It would appear that the necessary accommodation can only be provided by Local Authorities at a loss, and consequent charge on the rates. The London County Council's Scheme for erecting large blocks of flats on the Ossulston Street area will probably commence at an early date, but the development of such schemes is always difficult owing to the necessity of finding accommodation for the people displaced. Practical]}' the only large vacant site in the Borough available for building purposes is the Foundling Hospital site. Here accommodation could be provided for some thousands of persons without encountering the difficulty of housing displaced tenants. If the Foundling estate could be developed for this purpose, the Ossulston Street area and adjoining parts of Somers Town, much of which is insanitary and ripe for condemnation, could then be cleared. As this area is adjacent to three great railway termini, it would appear to be an admirable site for industrial purposes, such as, for instance, Covent Garden Market, if the removal of this is still contemplated. It may be urged that the Foundling Hospital site is too central or too expensive, or that the amenities of the district would be destroyed by the erection of working-class dwellings. The reply to the first objection is, that owing to the exigencies of their work, many persons cannot live in the outskirts of London, but must be near their work. Eighteen per cent. of the adult male population of St. Pancras are employed in Railway or other forms of transport, and the majority of these must live adjacent to their employment. The other objections to the proposal appear to be inadequate when contrasted with the amount of physical deterioration and moral degradation caused by existing housing conditions. In conclusion, I should like to express my thanks to the Members of the Public Health Committee for the consideration they have so invariably accorded to me, and to the staff of the Department for their very loyal co-operation. I am, Ladies and Grentlemen, Your obedient Servant Medical Officer of Health. March, 1927, 10 SUMMARY OF REPORT FOR 1926. Area of Borough, 2,694 acres. Area of various open spaces, 501 acres. Soil and Situation.—Practically the whole of the Borough is situated on London clay. There are a few superficial deposits of gravel in the south, and lower Bagshot sands in the extreme north. The altitude varies from 48 feet above ordnance datum, the lowest point, which is situated in the south of the Borough in the neighbourhood of Ampton Street, King's Cross Road, to 427 feet above ordnance datum, the highest point, which is in Pond Square in the extreme north of the Borough. The Borough is about four miles long, extending from near Oxford Street in the south to Highgate in the north, and averages about a mile in width. Population (1921 Census), 211,366. Population (1926) Civilian, 216,400. Total, 216,800. Number of persons per acre, 80. Number of inhabited houses (1921 Census), 24,660. Number of families or separate occupiers (1921 Census) 56,603. Births. Males, 1,831; females, 1,781. Total, 3,612. Legitimate births, 3,386; illegitimate births, 226. Birth-rate, 16.7 per 1,000 of population. Excess of births over deaths, 932. Deaths. Males, 1,454; females, 1,226. Total, 2,680. Death-rate, 12.4 per 1,000 of population. Infantile Mortality Rate. Legitimate, 73; illegitimate, 119. Total, 76 per 1,000 births. Maternal Mortality. Number of women dying in, or in consequence of child-birth : From Sepsis, 1; from other causes, 9. Maternal death-rate per 1,000 births, 2.8. Deaths from Measles (all ages), 65. „Whooping Cough (all ages), 24. ,,Diarrhœa and Enteritis (under 2 years of age), 52. Tuberculosis. Pulmonary. Deaths, 175; death-rate, 0.81 per 1,000 of population. All forms. Deaths, 212; death-rate, 0.98 per 1,000 of population. Rateable value, £2,069,948. Sum produced by a penny rate, £8,515. Total rainfall during the year (recorded at Camden Square), 27.23 inches. Comparative Statistics. Rate per 1,000 of Population. Rate per 1,000 Births. Birth-rate. Death-rate. Infant Mortality. St. Pancras 16.7 12.4 76 England and Wales 17.8 11.6 70 105 Great Towns 18.2 11.6 73 County of London 17.1 11.4 61 11 Metropolitan Borough of Saint Pancras. REPORT of the MEDICAL OFFICER OF HEALTH For the Year 1926. For the purpose of this Report, the year consists of the 52 weeks ended 1 st January, 1927. Section 1.-STATISTICS AND SOCIAL CONDITIONS OF THE AREA. POPULATION AND GENERAL STATISTICS. The population of the Borough at the Census of 1921 was 211,366. The total population of St. Pancras for the year 1926, as estimated by the Registrar-General, was 216,800, the civilian population being estimated at 216,400. The latter estimate (civilian population) has been used in calculating the death-rates in this report, and the former (total population) in calculating the marriage and birth-rates. I am of opinion that the Registrar-General has somewhat under-estimated the population of the Borough, thus causing the various rates which are based on this estimate to appear unduly high. PRINCIPAL OCCUPATIONS OF THE INHABITANTS OF THE BOROUGH. There are no particular industries carried on in the Borough which to any extent affect the public health prejudicially. The following table gives for each sex the principal occupations as ascertained at the last Census. The number and percentage engaged in the various occupations mentioned are also given: — Total Population (over 12 years of age): Males, 78,036; Females, 90,616. Males. Occupations. Number. Percentage. Transport Workers (Railways, &c.) 13714 18 % Commercial and Financial (Shop Assistants, &c.) 7612 10 ,, Personal Service (Waiters, Hairdressers, &c.) 5676 7 ,, Metal Workers 5158 7 ,, Clerks and Typists 4643 6 ,, Wood and Furniture Workers 4282 5 „ Public Administration and Defence 3156 4 ,, Unoccupied and Retired 9669 12 „ All other Occupations 24126 31 „ Total 78036 100 „ 12 Females. Occupation. Number. Percentage. Personal Service (Domestic, Waitresses, &c.) 13350 15 % Makers of Textiles 5523 6 „ Clerks and Typists 4928 5 „ Commercial and Financial 3003 3 „ Unoccupied and Retired (married) 35263 39 „ „ (unmarried) 10406 12 „ ,, (widowed or divorced) 6424 7 ,, All other Occupations 11719 13 „ Total 90616 100 „ Economic Conditions. The amount of out-relief granted during the past 10 years is indicated in the following table (kindly supplied by Mr. Bernard Chapman, Clerk to the St. Pancras Guardians), which gives for half-yearly periods the amount spent on out door relief, and the number chargeable in this respect in the middle week of each half-year: — Half-Year ending Amount spent in the half-year. Numbers chargeable in the middle week of the half-year. Michaelmas, 1917 £ 3079 871 Lady day, 1918 3382 852 Michaelmas, 1918 3461 771 Lady day, 1919 3814 754 Michaelmas, 1919 4557 823 Lady day, 1920 6146 899 Michaelmas, 1920 8161 1079 Lady day, 1921 13081 1660 Michaelmas, 1921 21400 3529 Lady day, 1922 40081 6429 Michaelmas, 1922 34591 6325 Lady day, 1923 34193 6425 Michaelmas, 1923 28312 5489 Lady day, 1924 31690 5290 Michaelmas, 1924 26607 4723 Lady day, 1925 26766 4319 Michaelmas, 1925 31290 4267 Lady day, 1926 36061 5427 Michaelmas, 1926 43351 6242 MARRIAGES. The number of marriages celebrated in 1926 was 1,895. This is equal to a rate of 8.7 per 1,000 of total population. BIRTHS. The number of births registered during the year belonging to St. Pancras was 3,612, making an annual birth-rate of 16.7 per 1,000 of population. The total number of births actually registered as having taken place in the Borough was 4,129. This figure has to be corrected by deducting the births of non-residents which occurred in various public institutions in the Borough—these numbered 1,095, and adding the births of parishioners which occurred outside the Borough—these numbered 578. The corrected figure is therefore as stated above, 3,612. 13 The corresponding figures for previous years will be seen in Table 1, on page *8. The following table gives the number of births and the birth-rate in each ward 01 the Borough for the past year. For comparison the figures for the previous year are also given:— Ward Births and Birth Rates. Ward. Number of Births. Birth Bate. 1925. 1926. 1925. 1920. I 597 489 16.5 13.5 2 444 427 19.9 19.1 3 671 612 18.4 16.8 4 480 454 18.2 17.1 5 591 566 19.2 18.3 6 467 448 22.2 21.2 7 164 164 10.6 10.6 8 466 452 16.9 16.3 Borough 3880 3612 17.9 16.7 1,551 births occurred in Public Institutions, equal to 37.6 per cent. of the total births which took place in the Borough. Table 5, on page 85, shows for 1926 the birth-rate of England and Wales, the County of London, the Metropolitan Boroughs, and certain of the large towns having populations exceeding 125,000. Illegitimacy. Of the 3,012 net St. Pancras births, 226 were returned as illegitimate. This equals 6.3 per cent. of the total births. The corresponding figures for the preceding 10 years were as follows :— Year. Rate. Year. Rate. 1916 7.0 per cent. 1921 5.5 per cent. 1917 7.2 „ 1922 5.6 „ 1918 9.5 „ 1923 5.7 „ 1919 8.4 „ 1924 5.9 „ 1920 5.6 „ 1925 6.3 „ Notification of Births. 4,097 notifications of births were received during the year: this includes 138 stillbirths and 3,959 live births, and represents 96 per cent. of the births registered as having taken place in the Borough. The Notification of Births Act (1907) states: "information with regard to the event shall be given to the Medical Officer of Health within 36 hours of the occurrence of the birth of a child, alive or dead, which has issued forth from its mother after the twenty-eighth week of pregnancy." This notification is in addition to, and not in substitution for, registration of birth, which must be carried out at a Registry Office within forty-two days of the birth. 14 DEATHS. The net number of St. Pancras deaths registered during the year was 2,680; this equals an annual death-rate of 12.4 per 1,000 of population. The average yearly death-rate of the Borough during the previous five years was 13.1 per 1,000 of population. The actual number of deaths registered as having occurred in the Borough during the year 1926 was 2,992. This figure has to be corrected by the exclusion of 855 deaths which occurred in the Borough of persons who were not St. Pancras residents, and by the inclusion of 543 deaths of residents which occurred and were registered outside the Borough. The corrected figure of 2,680 is used in calculating the death-rates in this report. In Table 1, on page 78, will be found details of the corresponding figures for previous years. Cause of Death. The principal causes of death during the year are stated in the following table, and, for comparison, the figures and averages for the previous 10 years are also given: — Diseases. 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 Average for 10 years. 1926 Heart Disease 375 404 389 370 442 435 461 394 398 381 405 388 Cancer 267 281 269 245 299 290 302 319 298 324 289 301 Bronchitis 290 25° 228 301 236 276 308 223 3°4 274 269 239 Tuberculosis—all forms 423 444 485 3H 312 304 315 272 27! 231 340 212 Pneumonia 232 254 376 179 197 >73 265 201 200 204 228 155 Injuries 112 125 119 108 92 88 127 113 114 118 112 142 Premature Birth, Debility and Congenital Defects 176 144 132 162 201 149 134 134 118 105 146 114 Cerebral Hemorrhage, Embolism, and Apoplexy 119 116 131 91 98 126 120 112 118 123 115 110 Nephritis and Bright's Disease 103 104 98 61 95 60 67 79 75 75 82 89 Measles 42 118 75 15 65 23 107 5 74 3 53 65 Diarrhœa and Enteritis 72 97 56 68 54 98 47 61 63 55 6" 63 Influenza 35 21 700 260 46 57 142 24 So 41 141 29 Whooping Cough 39 27 80 7 60 38 29 28 46 7i 42 24 Diphtheria and Croup 23 25 31 21 33 51 44 20 22 34 30 12 Rheumatic Fever 7 7 8 7 6 16 15 8 5 18 10 10 Erysipelas 3 3 11 9 12 3 12 4 4 12 7 8 Pleurisy 3 10 14 9 12 7 10 8 8 10 11 5 Scarlet Fever 8 4 7 5 11 7 20 3 12 — 8 2 Enteric Fever 5 6 5 2 1 3 1 3 2 3 3 1 Puerperal Fever 4 5 2 9 8 4 4 9 4 4 5 1 15 The deaths which occurred during the year are fully classified for causes, age and sei in Table 2 on page 79. For purpose of comparison, the death-rates for England and Wales, the County of London, the Metropolitan Boroughs, and certain of the large towns are given in Table 5 on page 85. It will be noted that 22 Metropolitan Boroughs had a lower and 6 a higher general death-rate than St. Pancras, Of the total 2,680 St. Pancras deaths which occurred during the year, no less than 1,661 took place in public institutions, either within or outside the Borough ; this equals a proportion of 62 per cent. of the total deaths. Ward Deaths and Death-Rates. The number of deaths and the death-rates per 1,000 of population for each of the Wards during the past year were as follows, the figures for the preceding year being also given for comparison:— Ward. Number of Deaths. Death-rate per 1000 of population. 1925 1926 1925 1926 l 435 397 12.0 10.9 2 258 257 11.6 11.5 3 443 459 12.2 12.6 4 341 317 12.9 12.0 5 434 414 14.1 13.4 6 292 253 13.9 12.0 7 181 187 11.7 12.1 8 333 352 12.0 12.8 Homeless 28 44 — — Borough 2745 2680 12.7 12.4 u Inquests. In the following table will be found the causes of death, as certified by the Coroner; they are also further classified into age-periods: — Causes. Under 1 year. 1—5 years. 5—15 years. 15—25 years. 25—65 years. 65 and over. Totals. Natural— Heart Disease 3 — 1 — 29 26 59 Pneumonia 6 1 — — 3 3 13 Cerebral Haemorrhage — — — _ 9 2 11 Tuberculosis — — — 1 4 1 6 Other causes 14 3 1 1 19 11 49 Accidents— Street Vehicles — 2 11 5 20 8 49 Burns and Scalds — 2 — 2 — 1 5 Railway — — — — 1 1 2 Falls 1 2 — 2 16 12 33 Other causes 5 6 — 3 14 2 30 Suicides† — — — 3 26 5 34 Murder* — — 1 1 — 2 Manslaughter — — — — — 1 1 Open Verdict‡ 2 — — 1 4 — 7 Totals 31 16 17 19 145 73 301 * Includes 1 case of coal gas poisoning. † „ 14 cases ,, ,, ‡ ,, 2 ,, ,, ,, Infantile Mortality. 274 deaths of infants under 1 year of age occurred in the Borough during the year. This is equal to a rate of 76 per thousand births, and is somewhat higher than that of the previous year. This increase was almost entirely due to the prevalence of measles, and to a lesser degree of whooping cough, together with the complications arising from these diseases. The deaths from diarrhoea and enteritis were about the average, and there was practically no change in those due to premature birth, debility and congenital defects as compared with the previous year. In Table 1, on page 78, the corresponding rates for previous years are given, and in Table 4, on page 84, the figures will be found for the different wards and registration subdistricts. Table 5, on page 85, gives the infant mortality rates for England and Wales, the County of London, the Metropolitan Boroughs, and certain of the large towns with populations exceeding 125,000. In the tables on the next two pages are shown: — 1. The causes of death of all children under 12 months of age during 1026, classified according to age at death. 2. The causes of death of children under 12 months of age during the ten previous years. In this table the number of births in each year is also given for reference. 17 1926. Nett Deaths from stated causes at various Ages under 1 Year of Age. cause of death. Under 1 week. 1—2 weeks. 2—3 weeks. 3—4 weeks. Total under 4 weeks. 4 weeks and under 3 months. 3 months and under 6 months. 6 months and under 9 months. 9 months and under 12 months. Total Deaths under 1 year. Measles — — — — — — 3 10 12 25 Whooping-Cough — — — — — 1 3 5 2 11 Diphtheria and Croup — — — — — 1 — 1 Influenza — — — — — — 1 — — 1 Tuberculous Meningitis — — — — — — — 2 1 3 Other Tuberculous Diseases — — — — — — — — 1 1 Meningitis (not Tuberculous) — — — — — 1 1 — 1 3 Convulsions — — 1 1 2 — — — 2 Laryngitis — — — — — — 1 — — 1 Bronchitis — — — — — 3 6 3 2 14 Broncho-pneumonia 1 1 3 2 7 7 0 7 6 36 Lobar-pneumonia — — — — — — 1 1 — 2 Pneumonia (type not stated) — — — — — — — 1 — 1 Diarrhœa — — 1 — 1 1 3 2 — 7 Enteritis — 1 — — 1 6 14 14 3 38 Syphilis — — — — — — 1 — — 1 Suffocation (overlying) 1 1 — 1 3 — — — — 3 Injury at Birth 3 — — — 3 — — — — 3 Atelectasis 6 — — — 6 — — — — 6 Congenital Malformations 6 3 — 7 16 3 6 — — 25 Premature Birth 36 3 3 7 49 5 3 — — 57 Atrophy, Debility and Marasmus 3 — 4 — 7 7 4 — — 18 Other causes 1 1 1 — 3 5 2 3 2 15 Totals 57 10 13 18 98 39 58 49 30 274 Nett Births in the year legitimate 3386 illegitimate 226 Nett Deaths in the year of legitimate infants 247 illegitimate infants 27 18 Deaths from Stated Causes under 1 Year of Age for 1926 and 10 preceding Years. CAUSE OF DEATH. 1916 1917 1918 1919 1920 1921 1922 1923 1921 1925 Average for 10 years 1926 Measles 14 30 16 4 21 7 15 1 15 2 12 25 Scarlet Fever — — — 1 — — 3 — — — — — Whooping Cough 15 14 27 2 18 18 11 8 13 29 15 11 Diphtheria and Croup 2 1 1 — 2 2 — — — 1 1 1 Erysipelas — 1 1 — — — 1 1 2 2 1 — Influenza 1 — 18 11 2 2 7 — 6 2 5 1 Tuberculous Meningitis 5 4 8 4 6 1 3 4 3 2 4 3 Abdominal Tuberculosis 1 2 1 1 — 1 1 1 — — 1 — Other Tuberculous Diseases 5 7 3 2 2 3 7 2 — 1 3 1 Meningitis (not Tuberculous) 7 10 3 6 7 3 2 3 5 4 5 3 Convulsions 9 5 3 6 7 8 8 5 4 4 6 2 Laryngitis — 1 — — — — — 1 — — — 1 Bronchitis 17 16 17 23 27 13 21 12 12 19 13 14 Broncho-pneumonia 40 47 29 24 60 39 54 34 51 34 41 36 Lobar-pneumonia 4 4 6 1 5 1 3 1 3 4 3 2 Pneumonia (type not stated) 6 9 9 8 4 3 6 1 3 — 5 1 Diarrhœa 6 8 6 10 11 11 4 6 6 9 8 7 Enteritis 35 52 31 37 26 63 27 37 46 36 39 38 Gastritis 2 — 1 3 2 2 — 1 — 2 2 — Syphilis 14 16 13 11 15 14 8 5 2 5 10 1 Rickets 4 2 — 1 1 1 — — — 1 — Suffocation (overlying) 9 13 6 1 2 2 5 1 1 4 4 3 Injury at Birth 4 3 2 6 5 3 3 6 4 7 4 3 Atelectasis 9 9 8 7 10 8 4 9 7 2 7 6 Congenital Malformations 34 19 17 31 33 25 31 27 23 20 26 25 Premature Birth 75 61 50 68 105 75 61 70 59 57 68 57 Atrophy, Debility and Marasmus 43 44 46 45 40 34 28 21 24 17 34 18 Other causes 24 20 18 24 24 18 23 15 14 17 20 15 Totals 385 402 340 336 435 360 337 272 303 280 345 274 Nett Births 4530 6796 3318 3824 5934 4764 4559 4348 4112 3880 4306 3612 19 Section II.—GENERAL PROVISION OF HEALTH SERVICES. Hospital Accommodation. A. Fever and Smallpox.—Hospital accommodation is provided by the Metropolitan Asylums Board. B. Tuberculosis.—For patients suffering from this disease Institutional accommodation is provided through the London County Council. C. Maternity, Children's and other Hospitals— The following are situated in the Borough, but with the exception of the two hospitals of the St. Pancras Guardians, the use of these hospitals is by no means confined to residents of the Borough. On the other hand, hospitals situated outside the Borough are largely used by St. Pancras residents. Hospitals. Number of Beds. St. Pancras Poor Law Hospitals. St. Pancras Hospital, King's Road 404 Highgate Hospital, Dartmouth Park Hill 554 Metropolitan Asylums Board Hospital. St. Margaret's Hospital, Leighton Road (for ophthalmia neonatorum) 51 General and Special Voluntary Hospitals. University College Hospital, Gower Street 414 Royal Free Hospital, Gray's Inn Road 240 London Temperance Hospital, Hampstead Road 120 Elizabeth Garrett Anderson Hospital, Euston Road 75 West End Hospital for Nervous Diseases, Regent's Park 80 Hospital for Tropical Diseases, Endsleigh Gardens 58 Central London Throat, Nose and Ear Hospital, Gray's Inn Road 43 Central London Ophthalmic Hospital, Judd Street 40 Metropolitan Ear, Nose and Throat Hospital, Fitzroy Square 22 St. Saviour's Hospital, Osnaburgh Street 21 North-West London, Bayham Street — St. Pancras Dispensary, Oakley Square — London Skin Hospital, Fitzroy Square — Western Skin Hospital, Hampstead Road — British Dentists' Hospital, Camden Road — London Foot Hospital, Charlotte Street — The Borough Council pays a subsidy to certain hospitals, some of which are situated outside the Borough, for the admission of necessitous or abnormal cases to their Maternity wards. A subsidy is also paid to the Maternity Nursing Association for cases attended in the patients' own homes. 20 The following table gives the names of the hospitals, etc., and the amount of subsidy paid during the past year:— £ S. d. Royal Free Hospital 7 0 0 Elizabeth Garrett Anderson Hospital 48 15 0 Maternity Nursing Association 23 10 0 Queen Charlotte's Maternity Hospital 59 0 0 City of London Maternity Hospital 30 0 0 Middlesex Hospital 48 0 0 £216 5 0 The corresponding grants for the three previous years were £'275 10s. 0d., £412 5s. 0d., and £705. Institutional Provision for Unmarried Mothers. The Main Memorial Home, 49, Cartwright Gardens, W.C. 1, provides accommodation for young unmarried women expecting for the first time to become mothers. The Home is maintained by funds obtained from voluntary sources, but a grant is made by the Ministry of Health. Ambulance Facilities. For infectious cases ambulances arc provided by the Metropolitan Asylums Board. For non-infectious cases The Metropolitan Asylums Board have special ambulances. For accident cases the London County Council provide ambulances, and those of the St. John's Ambulance Association are also available. The St. Pancras Guardians also have three motor ambulances, which may be hired when available. Clinics, Treatment Centres, etc. For purpose of reference these are given in tabular form; details concerning the work carried out will be found on succeeding pages. Situation. By whom provided. A. Artificial Light Clinic. Raydon Street, South Highgate The Borough Council. B. Maternity and Child Welfare Centres. St. Pancras School for Mothers, Ampthill Square and Chalton Street Centres The Borough Council, with assistance from the Voluntary Committee. North St. Pancras School for Mothers, Queen's Crescent ,, South Highgate Centre, Raydon Street ,, Grafton Road Centre ,, * Mary Ward Settlement School for Mothers ,, Camden Town Centre, Camden Road ,, Argyle Square Centre ,, Caversham Road Centre ,, Oakley Square Centre ,, University College Hospital Centre The Hospital Authorities. † Royal Free Hospital Centre ,, * Amalgamated with Argyle Square Centre on April 1, 1926. † A grant is made by the Borough Council in respect of the Visitor's Salary, 21 Situation. By whom provided. C.— Bay Nurseries. Kentish Town Day Nursery, Gospel Oak Grove The Voluntary Committee, with a subsidy from the Borough Council. Margaret Day Nursery (Illegitimate children only), 44, Ampthill Square ,, VVhitfieid Street Day Nursery, 53, Whitfield Street ,, D. Dental Climes. Argyle Square: For mothers and children who attend the Maternity and Child Welfare Centres The Borough Council. Ampthill Square: For mothers and children who attend the Centre at 1, Ampthill Square The Voluntary Committee. St. Pancras Dispensary: For Tuberculosis cases The Borough Council. „ For ordinary cases The Dispensary Committee. E. School Clinics. Highgate New Town : Chester Road Voluntary Committees working under agreement with the St. Pancras Centre, Prince of Wales Road Lancing Street Centre, Churchway London County Council. F. Tuberculosis Dispensaries. St. Pancras Dispensary, Oakley Square The Borough Council. University College Hospital The Hospital Authorities. G. Venereal Disease Clinics. These are provided at various Voluntary Hospitals under agreements made with the London County Council. The undermentioned are situated within the Borough, but many others in the Metropolis are available for St. Pancras residents:— The Royal Free Hospital, Gray's Inn Road (for women and children only). University College Hospital, (lower Street (for male and female patients). H. Clinic for Sick Mothers and Young Children. St. Pancras Dispensary, 39, Oakley Square I. Convalescent Homes for Sick Poor Children. The Mayoress of St. Pancras Home, "Avalon," St. Alban's Road Invalid Children's Aid Association (for various homes) Medical Officer paid by Borough Council; other expenses paid by Dispensary Committee. By Voluntary Committee, with grant from Borough Council. Subsidy from Borough Council. 22 MATERNITY AND CHILD WELFARE. The statistics for the year in regard to births and deaths of infants will be found on pages 12, 13 and 16 to 18 of this report. The Borough scheme for Maternity and Child Welfare includes the following activities:— (а) The dispatch by post of cards of advice to the individual mothers immediately after the receipt of the notification of birth required by law. (b) The visiting of expectant and nursing mothers and babies by the Council's staff of health visitors, who work (a) from the Town Hall and (b) from the Centres. (c The provision and maintenance of Maternity and Child Welfare Centres. Those Centres are partly maintained on a voluntary basis; but the whole of the professional staff (medical officers and health visitors) are paid and controlled by the Council, who also pay the rent, rates and taxes of the Centre premises. (d) The provision of a clinic for ailing mothers and young children, the expenses being borne partly by municipal and partly by voluntary funds. (e) The provision of a municipal dental clinic for mothers and young children. (f) The subsidisation of a Home for sick poor children. (g) The supply of milk, free or at reduced price, for necessitous mothers (nursing or expectant) and young children; and the subsidisation of a voluntary fund for the provision of dinners for nursing and expectant mothers. (h) The subsidisation of a voluntary fund for the provision of Home Helps. (i) The subsidisation of four voluntary Day Nurseries. (j) The subsidisation of voluntary agencies providing, either free or at a reduced rate, in hospital or at home, midwifery attendance for necessitous St. Pancras women. (k) The payment for the homo nursing of sick infants in certain cases. (l) A Centre for Artificial Light treatment. (m) The visiting and supervision of necessitous children under 5 years of age upon discharge from the Borough Poor Law Hospitals. (n) The provision of convalescent home treatment by subsidy to voluntary agencies. Advice Cards.—Besides the posting of cards of advice to the mothers of all infants whose births have been notified, cards of advice to expectant mothers have been distributed through University College Hospital, Middlesex Hospital, the Maternity Nursing Association, and other agencies. Home Visiting. —The Council's visitors at the Infant Welfare Centres, 19 in number, are full-time workers, who divide their time between the necessary work at the Centres and visiting the homes of the mothers and children. In addition there was one full-time trained worker, not paid by the Council, at the Caversham Road Centre, and one part-time 23 trained voluntary (unpaid) worker at the Chalton Street and Grafton Road Centres. There were also two trained visitors at the University College Hospital Centre, who worked in neighbouring boroughs as well as in St. Pancras, and whose salaries were paid by the hospital authorities, and not by the Council. During 1926 the Council's staff at the various Centres made 36,527 visits to 3,355 children, and 3,324 to 1,436 expectant mothers; the trained workers not, paid by the Council made 12,031 visits to 595 children, and 324 visits to 179 expectant mothers. The visiting work is set out in detail on the next page, and is summarised in the following statement: — — No. of Expectant Mothers Visited. Total Visits to Expectant Mothers. No. of Children Visited. Total Visits to Children. Town Hall Health Visitors 3 3 80 128 Centre Staff, paid by Council 1436 3324 3355 36527 Trained Centre staff, not paid by Council 179 324 595 12031 Total of all trained workers 1618 3651 4030 48686 Corresponding totals for 5 previous years — 1925 2007 4979 4542 55547 1924 1921 4621 4571 53884 1923 2084 4953 5401 52759 1922 2342 4770 6194 50347 1921 2547 5730 7200 53547 24 Centre. Attendances at Consultations. Visits by Trained Visitors. Consultations. Number of Visitors. Expectant Mothers. Children. . Expectant Mothers. Children. Infants, Expectant Mothers. New cases. Total attendances. New cases. Total attendances. First visits. Total visits. First visits. Total visits. iUnder 1 year. Over 1 year. Total. Under 1 year. Over 1 year. Total. Visitors paid by Borough Council. Trained workers not paid by Borough Council. Visitors paid by Borough Council. Trained workers not paid by Borough Council. Visitors paid by Boron gh Council. Trained workers. not paid by Borough Council. Visitors paid by Borough Council. Trained workers not paid by Borough Council. Per month. Total. Per month. Total. Town Hall, Health Visitors _ — — — — — — — 3 — 3 — 80 — 128 — — — — — — St. Pancras School for Mothers— Ampthill Square ... 163 764 326 70 396 3831 1942 5773 389 — 594 — 663 — 6775 — 18 215 4 50 3 Chalton Street 58 150 189 34 223 2324 2069 4393 189 — 444 £8 306 — 4201 1351 12 146 1 12 2 (1) North St. Pancras School for Mothers, Queen's Crescent 60 166 329 32 361 1503 3159 7662 72 — 231 — 527 — 1733 — 18 213 2 24 3 South Highgate Centre — — 82 12 91 1251 1025 2276 19 — 42 — 124 — 1301 — 8 98 — — 1 Grafton Road Centre ... 56 162 194 33 227 2215 2132 4347 123 — 343 — 341 39 4638 1015 13 157 1 12 2 (1) Mary Ward Settlement School for Mothers — — 22 4 26 353 391 744 23 — 40 59 — 482 — 12 29 — — 1 Camden Town Centre, Camden Road 99 262 310 45 355 3601 1997 5598 239 — 702 — 519 — 5314 — 16 200 2 24 3 Argyle Square Centre... 41 86 260 10 270 2701 1080 3784 142 — 358 — 379 — 4494 — 13 175 1 12 2 Caversham Road Centre 96 571 266 32 298 3907 1410 5317 66 7 312 31 186 168 2502 3160 12 140 4 48 2(2) (f) Maternity Nursing Association, Oakley Square 119 131 149 5 154 2237 1550 3787 — 172 — 235 103 110 1263 584 8 95 1 12 1 University College Hos- 825 3468 — — 616 — — 3068 — — — — — 278 — 5921 8 100 — (3) 68 — Royal Free Hospital, Gray's Inn Road 283 1062 62 77 139 612 374 986 174 — 255 — 148 — 824 — 8 101 16 202 — Totals 1S03 6822 — — 3159 — — 47735 1439 179 3327 324 3435 595 36655 12031 146 1669 _ 464 20 * Closed March 31st, 1926. Year ended 31st March, 1927. (1) In addition to 1 part-time voluntary trained worker. (2) In addition to 1 full-time trained voluntary worker. (3) January to August, 4; September to December, 8. 25 Maternity and Child Welfare Centres. These are 11 in number. Each Centre is managed by a Committee, the members of which not only give valuable help at the various consultations, but also piovide additional funds for the maintenance of many other useful activities associated with the work of each Centre. The Council has representatives on each Committee, and each Committee sends one representative to the Council's Maternity and Child Welfare Sub-Committee. The Centres at University College Hospital and the Royal Free Hospital are not subsidised by the Council. The table 011 page 24 gives statistics concerning the work of all the Centres during 1926. It will be seen that 1,669 infant consultations and 464 ante-natal consultations were held during the year. The children who attended for the first time numbered 3,159. The total attendances of all children was 47,735, as compared with 49,470 in 1925, and 51,292 in 1924. The total attendances of expectant mothers numbered 6,822, as compared with 6,736 and 8,653 in the two preceding years. Details concerning the work, together with some of the special activities of the individual Centres, are given in the following paragraphs: — St. Pancras School for Mothers, 1, Amvthill Square. In addition to the consultations provided by the Council, the Medical Officers have held voluntary consultations for children from two to five years of age. Classes for Mothers. At infant care classes there were 399 attendances; ante-natal care, 310 attendances; and at needlework, etc., classes, 630 attendances. Dinners for Mothers and Children. These are supplied at a very small charge for necessitous cases. 3,046 dinners were supplied to nursing and expectant mothers, and 3,092 to young children. Observation Day Nursery. This is for children needing special care. There were 1,848 attendances during the year, of which 1,031 were made by infants under one year of age, and 817 by children over one year. Massage Clinic. 48 consultations were held, at which 396 attendances were recorded. This clinic was discontinued on June 30th. Dental Clinic. This is provided out of funds from voluntary sources. The Dental Surgeon is Mr. George Thomson, L.D.S. During the year 36 consultations were held, at which 455 attendances were made. Details of the work done are given in the following table :— Mothers. Children. Extractions with anaesthetics 61 26 „ without anaesthetics — 9 Fillings 53 121 Scalings 21 — Impressions and fitting dentures, etc. 46 — Examinations 62 56 Totals 243 212 26 Camden Road Centre. The number of new cases at the ante-natal consultations again shows an increase. 48 massage clinics were held, the attendances at which numbered 362. This clinic was discontinued at the end of July. A needlework class was held on alternate weeks during the months of January to April (inclusive), but was not very well attended. Chalton Street Centre. In addition to the usual consultations, 48 massage clinics were held, the attendances at which numbered 198. This clinic was suspended on June 30th. Attendances at sewing, etc., classes were 364. Interviews with parents by the Superintendent, other than at classes or clinics, numbered 3,020. Voluntary trained workers made 58 visits to expectant mothers and 1,351 visits to children. Grafton Road Centre. A voluntary consultation for children from 2 to 5 years of age is held monthly. 10 Mothers and 16 children requiring change were sent away to convalescent homes. 639 Free Dinners were given to nursing or expectant mothers, with the assistance of members of the Voluntary Committee. A large number of suitable woollen garments were supplied at cost price to necessitous mothers. 1,015 visits were paid to children by a Voluntary Trained worker. The Argyle Square Centre and the Mary Ward Settlement School for Mothers. These were amalgamated on March 31st. They were small centres in fairly close proximity, and the combination should tend to promote efficiency and economy. North St. Pancras School for Mothers, Queen's Crescent. In addition to the consultations provided by the Borough Council, two voluntary consultations for older children have been held during each month by Dr. J. Finch Haines. Health talks for mothers have also beeu held fortnightly by the Superintendent of the Centre. Other activities include Holiday and Clothing Funds. As a result of the energy and enthusiasm of the members of the Voluntary Committee, funds have been raised for the purchase of a seaside cottage, to which necessitous and ailing mothers and children attending the Centre will be sent for short periods. This is expected to come into use at an early date. Caversham Road Centre. Classes have been held in the following subjects:—Needlework, Cookery, Home Nursing and First Aid. The number of mothers who attended the various classes averaged from 6 to 17. A full-time and also a part-time Health Visitor are provided from funds from voluntary sources. A certain number of additional consultations are also provided from this fund. 27 South Highgate Centre. The work of the Artificial Light Clinic occupies a considerable amount of the time of the Superintendent of this Centre. In addition to the consultations, a needlework class was held on alternate Tuesdays during the three months January to March, the average attendance being 8. A Home Nursing Class was held on Tuesday evenings during the autumn, the lecturer being provided by the kind permission of the London County Council. The average attendance at these classes was 12. Artificial Light Treatment. The clinic for providing this treatment was opened in February, 1925. The patients are selected bv the Medical Officers of the various Welfare Centres from the children who are in attendance under their care. Medical practitioners can also recommend suitable St. Pancras cases. The treatment is free, the cost beindefraved bv the Borough Council. Three consultations, each of two hours' duration, are hold weekly. Staff.—The Medical Officer carrying out the treatment is Dr. Wm. Beaumont, m.r.c.s., l.r.c.r. The Superintendent of the Centre is Miss G. P. Bristow, who is assisted at the consultations by two Health Visitors from other Centres. Lamps, etc.—Three in number: 1 Westminster Single Arc Lamp, 2 Alpine Sun Four Arc Lamps. The current is direct, and voltage at main 220. Cases treated.—The total number of cases treated during the year was 180. The number of new patients being 149. The total number of attendances was 4,583. The number of Consultations held, 113. Average attendance per Consultation, 40. Average number of attendances per child, 25. Cost. £ s. d. Electric current 13 15 10 Cleaning 8 4 0 Consultation fees 177 19 6 Miscellaneous 5 14 5 £ 205 13 9 Treatment.—The conditions for which this treatment was given included: — Rickets, 85 cases Bronchial Affection, 23 cases Incipient Tubercidosis, 3 cases Delayed Development, 16 cases Other conditions, 7 cases, Debility, 27 cases Underweight, 5 cases Enlarged Glands, 5 cases Nervous Instability, 7 cases 28 The following clinical notes on the cases treated have been supplied by Dr. Beaumont, who is responsible for the opinions expressed:— Clinical Observations. (a) Skin re-action. No attempt has been made to group children according to any classification of skin texture and colour of hair, chiefly because, up to the present, it has not been practical to make any useful classification. Certain features have, however, been noted. (i) That the primary skin re-action (resulting from the red rays) do not necessarily indicate the body's re-action to the ultra-violet rays. (ii) That the secondary re-action usually occurs, as far as can be gathered, six hours after the primary, and there appears to be some connection between the primary and secondary skin re-actions. (iii) That pigmentation is an individual characteristic and not the criterion of general benefit. (iv) That some skins re-act only slightly to the red rays, and as far as can be gathered show no secondary re-action, and yet these children materially benefit by the treatment. (b) Weight. These are taken once each week by the same nurse under the same conditions before treatment. Observations show — (i) That a child whose weight has remained stationary for some weeks before treatment will gain weight after a few treatments, and continue this as long as treatment is given. (ii) That a child who lias been losing weight will continue to lose for three or four treatments and will then increase. (iii) That no child under treatment puts on an abnormal amount. Treatment is not continued should the child lose weight steadily. (r) Temperature and Pulse. These are taken before and after treatment. The only useful observation about temperature is that children who had sub-normal temperatures when they started treatment showed a gradual tendency to approximate to the normal during a course of treatment. Very few cases of rise of temperature immediately after treatment have occurred. Blood pressure, Photographic records, Radiographs. None of these have been undertaken, owing to lack of necessary equipment and facilities. Effectiveness and value of the Treatment for the different types of cases. (i) Enlarged Glands of Neck, irrespective of cause, show a most marked response to treatment. (ii) Cases of early bone manifestations of rickets where the anterior fontanelle has not closed at 18 months invariably respond quickly. (iii) Cases of Bronchitis (a) those associated with teething, (b) those with history of parental respiratory trouble. All these groups have given most satisfactory results. 29 (iv) Debility. Cases associated w ith poverty and unhygicnic conditions resulting in malnutrition and where the parents are not of robust type. These cases have shown very definite improvement under Light treatment, even when cod liver oil in some form had already been given. These undoubtedly are the cases where Light treatment should be supplemented with cod liver oil. (v) Nervous Instability. Condition marked by sleeplessness, fitful appetite, irritability of temper; these cases are usually only children; these children respond quickly, but require extended treatment. (vi) Late Rickets. There have been one or two outstanding successes. These were cases with marked genu valgum or genu varum; they, however, necessitated prolonged uninterrupted treatment. In spite of these, which seem to be exceptions, rickets with any marked bony changes in the limbs are very obstinate and never completely approximate to normal, even after months of treatment. These cases really should have artificial light only as an adjunct to more specialised treatment. (vii) Backward Children. This group of cases, of which there have been 16 treated, should not include cases of defective development. Where it is a case of true backward development with no history of birth injury or general disease, but resulting from severe illness in the early weeks of life, the result is very definite and marked improvement is early. There have been five cases treated which were unable to sit or stand at 12 months, and these showed great improvement. A few individual and isolated cases have been treated, including the following :— Chorea.—2 cases. These two cases very quickly responded and were apparently completely cured. One case of Impetigo which developed in a child being treated for Asthma. Both the Impetigo and the Asthma, but particularly the former, very strikingly responded to treatment. Several cases, where the only abnormal feature was the child's weight, remained stationary over a period of weeks, no cause being apparent. In every instance the child increased in weight after a few exposures, and maintained a steady increase while under treatment. One other observation—not truly clinical, but very marked—is the effect on the morale of both mothers and children, the dirty, untidy and uncarcd-for gradually becoming the clean, tidy and cared-for. The use of cod liver oil in some form along with the treatment is of value in cases where there is evidence of dietetic deficiency; but it has been found that the administration of some calcium preparation has tended to give better and quicker results. Conclusion. Artificial Sunlight is passing from the experimental stage to its rightful place in medicine, and its wide-spread and increasing popularity as an adjunct to treatment is unquestionably based on results, such as have been obtained at this Clinic and in private and hospital practice. The medical officer would like to draw attention to two salient features, startling in their unexpectedness. In the first place the effect on morale. It is known that disease lowers moral tone, but it is only a recent observation that sunlight holds the balance between these two. 30 The remarkable value of artificial sunlight in this respect is proved by the transformation already mentioned above among people upon whom many other methods of reformation have been tried without success. Secondly comes the devotion of the mothers. They have attended with regularity, often at great sacrifice and inconvenience, and the undoubted success of the clinic is in very large measure due to their willing co-operation—a sure sign of their belief in the efficacy of the treatment—and a belief not easily brought into existence. These two outstanding facts are full of unlimited possibilities and of hope for the future. WM. BEAUMONT, M.R.C.S., L.E..C.P. The Borough Council's Dental Clinic, 40, Arygle Square. At this clinic dental treatment is provided for mothers and children who attend the various Maternity and Child Welfare Centres in the Borough. Consultations have been held every Monday and Wednesday, and on alternate Fridays. No charge is made for extractions, fillings or scaling, but the patients are expected to contribute what they can reasonably afford towards the cost of dentures. The work done during the year is summarised in the following table, the figures for the previous year also being given for comparison:— Work carried out at the Dental Clinic. 1925. 1926. Number of new cases Mothers 233 213 Children 213 205 Total 446 418 Number of Attendances For extractions under nitrous oxide (gas) 369 358 „ „ local anaesthesia 100 117 „ fillings and dressings 301 311 „ scaling 47 61 ,, impressions and fitting dentures 571 530 „ examination and advice 634 628 Total attendances 2022 2005 Total number of clinics held 111 110 Number of clinics with nitrous oxide anæsthesia 24 23 The following table shows the number and cost of the dentures supplied during the year:— Number of Patients supplied with dentures 80. Total cost £269 0s. 0d. Amount paid by mothers £193 5s. 0d. Amount paid by Borough Council £21 15s. 0d. Amount paid by various Societies £54 0s. 0d. 23 mothers paid the entire cost of two dentures each. 22 mothers paid the entire cost of one denture each. 31 The Societies who made contributions towards the cost of dentures were the Metropolitan Hospital Sunday Fund, £24 5s. 0d.; the Metropolitan Hospital Saturday Fund, £8 0s. 0d.; Insurance Societies, £5 5s. 0d.; and various other societies (chiefly through the Charity Organisation Society), £16 10s. 0d. The general supervision of the work as regards attendances, collection of contributions, etc., continues to be efficiently carried out by Miss C. Smith, one of the Council's Women Inspectors. Dental treatment is also provided at the voluntary clinic, which is held at the St. Pancras School for Mothers, see page 25. The Centres held ia connection with the University College and Royal Free Hospitals are also able to refer cases needing dental treatment to the Dental Departments of their own Hospitals. Day Nurseries. The Council assists three approved day nurseries in the Borough by the payment of one-quarter of the net expenditure, as approved by the Ministry of Health, after the deduction of the payments made by the mothers. The effect of this is that the total expenses are shared, as to one-half by the Ministry of Health, one quarter by the Council, and one quarter by voluntary funds. Particulars in regard to the day nurseries for the year ended 31st March, 1927, are as follows :— —— Grant paid by Borough Council. No. of Days Open. Attendances. Average per Day. Whitetield Day Nursery £ 154 s. 10 d. 11 231 6444 27.9 Kentish Tn. DayNursery 144 3 10 226 7862 34.8 Margaret Day Nursery 139 13 8 245 4803 19.6 The Council also made a contribution of £50 to the Hampstead and North St. Pancras Day Nursery, 27.29, Pond Street, N.W. 3. Although this institution is situated in Ilampstead, it is used to a considerable extent by St. Pancras mothers who reside in the north of the Borough. Clinic for Sick Mothers, and Children under School Age. A weekly clinic is held by Dr. F. L. Provis at the St. Pancras Dispensary, 39, Oakley Square. To this patients are referred from the Town Hall, from the Welfare Centres, by the health visitors, etc. During 1926 new cases under five years of age numbered 174, ailing mothers 30, and expectant mothers (new cases) 78. The total attendances at this clinic were 492 of children under five, 159 of ailing mothers, and 109 of expectant mothers. The corresponding figures for the Dispensary as a whole (including Dr. Provis' clinic, but not the tuberculosis department) were:—children under five: new cases, 917; attendances, 3056; ailing mothers and expectant mothers: new cases 128; attendances 352. 32 The Dispensary Resident Medieal Officer also made 332 home visits to sick children under five. The Medical Officer of the above-mentioned Special Clinic is paid by the Borough Council. He is assisted by a Nurse (half-time), who is paid from voluntary funds. During the year the Nurse made 984 visits to the homes of children under five. The other work of the Dispensary amongst women and young children is supported by funds from voluntary sources, and is also subsidised by the Ministry of Health. Convalescent Home Treatment. (a) The Mayoress of St. Pancras Home for Sick Poor Children.—This is situated at "Avalon," 1, St. Alban's Road, and accommodates 18 children. The Borough Council make an annual grant of £350. The cases admitted are children from 2 to 5 years of age who are either convalescent after illness, or who are weakly, badly nourished, ctc., and need good food, fresh air and special care. At the beginning of the year 14 children were in residence, and during the year 104 were admitted. ll8 were discharged after an average stay in the Home of 32¾ days; of this number, 57 were in good health, 45 were much improved; 16 showed no marked improvement; but owing to the occurrence of infectious disease, several of these were discharged earlier than would otherwise have been the case. The chief conditions for which the children were admitted included—General debility, antcmia, convalescence after measles, bronchitis, pneumonia, etc. (b) Children requiring a longer period of convalescence than can be obtained at "Avalon" are sent to various homes by the Invalid Children's Aid Association, and a contribution to the cost is made by the Borough Council. Under this scheme 16 children were sent away during the year. Supply of Milk to Mothers, and Children under School Age. The Council continued during 1926 to make grants of milk, either free or at halfprice, for the use of nursing and expectant mothers, and children under school age. As a rule the grants were restricted to the last three months of pregnancy, and to children under three years of age. The extent of the distribution of milk in 1926 is shown in the following figures:— Pints of Milk Granted Free. Pints of Milk Granted Half-price. Cost to Council. 1926. £ s. d. January 7520 778 115 6 9 February 7565 793 116 3 5 March 7522 1188 118 10 8 April 5703 1119 78 7 0 May 6961 1007 108 1 8 June 7481 932 98 19 6 July 8510 801 111 7 3 August 7546 741 98 17 6 September 7377 607 111 19 5 October 8389 773 127 19 11 November 9072 1095 140 10 9 December 9804 1236 151 12 2 Totals 93450 11070 1377 16 0 33 At the end of 1925 there were 178 families in receipt of milk through the Council's scheme. 388 new families were added to the list of recipients during 1926, and at the end of 1926 there were 251 families in receipt of milk. As will be seen from the table above, there were supplied in 1926, 93,450 pints of milk free and 11,070 pints at half-price, at a cost to the Council of £1,377 16s., half of which sum is repayable by the Ministry of Health. This figure does not include the cost of administration. Inquiries are made by the Women Sanitary Inspectors and Health Visitors, if there is any doubt as to the circumstances of the families. The scale in use was based on weekly income, as follows:— Number in Family. After deduction of rent. Free. Half Cost. £ s. d. £ s. d. 1 0 13 0 0 15 0 2 1 0 0 1 5 0 3 1 4 0 1 10 0 4 1 8 0 1 14 0 5 1 12 6 2 0 0 6 1 16 0 2 5 0 Families in receipt of less income than that indicated in the table would be entitled to receive milk. The working of the scheme has been fully indicated in previous annual reports. Public Health Officers of the Local Authority. A complete list of these, including both whole and part-time officers is given on pages 6 and 7. Professional Nursing in the Home. This is provided by the staff of the following District Nursing Associations :— Central St. Pancras, Hampstead, Metropolitan, and North London. The Borough includes the whole of the area of the Central St. Pancras District Nursing Association and large portions of the areas of the other three Associations. The Borough Council has an arrangement with all the above Associations for the Home Nursing, at the request of the medical practitioner in attendance, of cases of Measles, Whooping Cough, Ophthalmia Neonatorum, Infective Enteritis and Pneumonia. Since October 1, 1926, an arrangement has also been made with the Central St. Pancras and Metropolitan District Associations for the nursing of cases of Puerperal Fever and Puerperal Pyrexia. A uniform fee of 1s. 6d. per visit is paid by the Borough Council. The following table gives the number of cases dealt with and visits made during 1926:- Nursing Associations. No. of cases. No. of visits. Central St. Pancras District 165 1143 Metropolitan 67 811 Hampstead District 45 319 North London 27 302 34 Home Help's. The St. tancras Home Helps Committee provides domestic assistance for families when the mother is incapacitated through sickness or child-birth. The Borough Council makes an annual grant to the Committee of £150 for use in respect of maternity cases only. During the past year 70 cases were dealt with, 33 being sickness and 37 maternity cases. Midwives. The supervising authority is the London County Council. According to figures supplied by that authority the total number of midwives who in 1926 had notified their intention to practise in St. Pancras was 31. Private midwives are not subsidised by the Borough Council, but midwives on the staff of certain hospitals and those employed by the Maternity Nursing Association arc paid a subsidy for each approved necessitous case attended at the patient's home (see page 19). Midwifery. In the following tables the figures are given for 1926 relating to all St. Pancras women who were attended in their confinements, either at home or as in-patients, by the staff of various institutions situated either within or outside the Borough. Attended at Home. Cases. Elizabeth Garrett Anderson Hospital (doctors) 145 University College Hospital (medical students) 658 „ „ „ (midwives) 140 Middlesex Hospital (midwives) 67 Royal Free Hospital (medical students) 23 St. Bartholomew's Hospital (medical students) 3 Maternity Nursing Association, Oakley Square and Mvddleton Square (midwives) 299 1335 (or 37 per cent, of the total number of births). Admitted as In-patients. Cases. University College Hospital 290 Royal Free Hospital 112 Elizabeth Garrett Anderson Hospital 21 St. Pancras House 158 Middlesex Hospital 110 Queen Charlotte's Maternity Hospital 165 City of London Maternity Hospital 73 Royal Northern Hospital 31 Other hospitals 38 998 (or 28 per cent, of the total number of births). It will be seen from the above tables that there are a large number of institutions available for midwifery for St. Pancras women, and that considerable use is made of them. 35 The majority of these institutions are situated in the south of the Borough, and in this area a very large proportion of the cases accept this treatment as out-patients. In the north of the Borough the out-patient hospital service is not so available, the result being that the majority of the cases are attended by medical practitioners or midwives. Health Week. This was observed during the period October 3rd to 9th. The object of Health Week is to focus public attention upon matters appertaining to health, and to arouse a sense of personal responsibility in connection with its attainment and maintenance. The following methods were adopted in an endeavour to achieve this purpose : — 1. A series of articles on Health subjects were written and published in the form of a booklet containing about fifty pages. In order to reduce the rather heavy expenditure a number of approved advertisements were included. Fifty thousand copies of the booklet were distributed. The receipts from the advertisements more than covered the cost of production. 2. A letter was sent to the Clergy and Ministers of all denominations, requesting them to co-operate in the movement, and to draw attention to the subject on Health Week Sunday, October 3rd. 3. A Special Open Meeting of the Tuberculosis Care Committee was held on Monday, October 4th, the Chair being taken by His Worship the Mayor. There was a good attendance, including representatives of many official and voluntary social activities in the Borough. 4. On Tuesday, October 5th, all the medical practitioners in the Borough were invited to a Special Meeting, at which the Mayor again presided. In addition to discussing subjects of mutual interest to Public Health Authorities and general practitioners, an address on The "Schick Test" and " Diphtheria Immunisation" was given by Dr. R. A. O'Brien, c.b.e., m.d. 5. On Wednesday, October fith, a meeting arranged by the Social Hygiene Council was held at the Aldenham Street Schools. An interesting address was given, followed by an appropriate film. 6. On Thursday, October 7th, the Public Health Department of the London County Council invited the Medical Officers of all the Metropolitan Boroughs to the Bedford Music Hall, Camden Town. A film was shown illustrating the "Schick" Test and Diphtheria Prevention. This film is, at present, the only one in the Country dealing with this subject. It will be ready for exhibition to the public at an early date. 7. On Friday, October 8th, the boys and girls in the senior classes of all the public elementary schools in the Borough were invited to write essays on subjects selected by the Medical Officer of Health from the Health Week Booklet. This competition was arranged in order to stimulate interest and ensure publicity in connection with subjects discussed in the booklet. The essays were judged and prizes awarded to the successful competitors. The London County Council Education Department gave their consent and support, and the teachers their cordial co-operation and assistance. This particular procedure was very successful, aud should prove to be of great value, as many thousands of essays were written. 36 Legislation in Force. A.—Local Acts, By-Laws, and Regulations in force in the Borough 1. St. Pancras (Measles and German Measles) Regulations, 1920. 2. By-laws made by the Borough Council, 1893 : — (a) For the prevention of nuisances. (4) With reference to w.c. cisterns. (c) Relating to Mortuaries. (d) For securing the cleanliness of drinking water tanks and cisterns. 3. Regulations concerning use of Post Mortem rooms, 1893. 4. By-laws made by the London County Council, bul enforced by the Borough Council:— (a) With reference to the removal of offensive matter, 1893. (b) „ ,, closets, ashpits, etc. (c) „ „ offensive trades. (d) ,, ,, drainage construction and accessories thereof. (e) ,, „ Rag and bone dealers, 1923. (J) ,, ,, Houses let in lodgings, 1926. B.—New (Public Health) legislation which came into force in 1926:— 1. London County Council (General Powers) Act, 1926. Sec. 42 authorises expenditure upon public education on matters reliting to health or disease. Sec. 44 gives the Council power to deal with verminous articles which are deposited, offered or exposed for sale, etc. 2. By-laws with reference to tenement houses came into force 5th March, 1926. 3. Public Health (Imported Milk) Regulations, 1926. 4. Milk and Dairies Order, 1926. This abolishes all previous Dairies, Cowsheds and Milkshops Orders. The new order is very comprehensive and deals with various matters, including the Registration of dairies and dairymen, the health and inspection of cattle, the cleanliness of dairies and the protection of milk against infection and contamination. 6. Public Health (Ophthalmia Neonatorum) Regulations, 1926:— Midwives are no longer required to notify cases of the above-mentioned disease, this duty being now placed solely upon the medical practitioner in attendance. 37 0. Public Health (Notification of Puerperal Fever and Puerperal Pyrexia) Regulations, 1926:— These Regulations came into force on October 1st. Puerperal Pyrexia is defined as any febrile condition (other than Puerperal Fever) occurring in a woman within 21 days after childbirth or miscarriage, in which a temperature of 100.4 deg. or more has been sustained during a period of 24 hours or has recurred during that period. The Borough Council are required to enforce the Regulations, and must notify medical practitioners resident or practising within the Borough of the duties imposed upon them. The Council must provide each doctor with a supply of notification forms. The Medical Officer of Health must forward a copy of every notification to the County Medical Officer of Health within 24 hours of its receipt, and to the Metropolitan Asylums Board within 12 hours. Puerperal Fever has been notifiable throughout the country since 1899. Experience has shown that for several reasons this notification has been incomplete, with the result that statistics are inaccurate. The main reason for the failure to notify is the fact that Puerperal Fever is somewhat ill-defined. It is not a definite specific disease like Diphtheria or Measles, so that in some cases there may be a genuine doubt as to diagnosis. There is also a widespread belief that if Puerperal Fever occurs there has been some want of care on the part of the doctor or nurse, and this may act as a deterrent to notification in mild or doubtful cases. In view of these circumstances, the Minister of Health has decided that in future prompt notification must be made as soon as symptoms suggesting septic infection become apparent. New forms have been provided for this notification and, in addition, the Regulations also require notification of all cases of Pyrexia arising during the Puerperal period (21 days) irrespective of the cause to which the fever may be attributed. The Minister of Health has doubtless been prompted to take this course owing to the fact that for a number of years maternal mortality has not declined proportionately as the death-rate of women from all causes, or as the general death-rate, or as the infantile mortality rate has declined. In other words, owing to childbirth, mothers are not sharing equally with the rest of the community in the improvement which has occurred in public health. The Regulations point out that the Borough Council have power, with the sanction of the Minister of Health, to make provision for:— (1) Institutional Treatment. (2) Bacteriological Diagnosis. (3) Nursing (at home). (4) Consultation with an Obstetric Specialist. 38 Arrangements have been made by the Council for the provision of the abovementioned facilities for any necessitous case, resident in the Borough. 7. Widows', Orphans' and Old Age Contributory Pensions Act:— This came into force on January 1, 1926. The duties of the Local Authority are chiefly those specified in Section 6(2). The Local Authority for the County of London is the County Council, but Section 41(2) gives power to delegate the duties to the Borough Council, and this power was exercised. C.—The undermentioned Public Health legislation was enacted during 1926, but does not come into force until the following year;— 1. Lead Paint (Protection against Poisoning) Act, 1926. 2. Births and Deaths Registration Act, 1926. 3. Public Health (Smoke Abatement) Act, 1926. 4. Coroners (Amendment) Act, 1926. 5. Public Health (Preservatives, etc., in Food) Amendment Regulations, 1926. Section III.—SANITARY CIRCUMSTANCES OF THE AREA, WATER SUPPLY. This is provided and controlled by the Metropolitan Water Board. Several industrial undertakings in the Borough have provided a private supply of good quality by means of deep wells. The Borough Council also obtains by means of a deep well a considerable supply for use at the Public Baths, Prince of Wales Road. Under Section 49 of the Public Health (London) Act, 8 notices were received and the necessary action was taken with reference to premises in which the water supply had been cut off. In connection with new houses, 58 certificates were issued under Section 48(2) of the Public Health (London) Act, to the effect that a proper and sufficient supply of water for sanitary and domestic purposes had been provided. An additional supply of water was furnished to the upper floors of 170 tenement houses under powers contained in Section 78 of the London County Council (General Powers) Act, 1907. DRAINAGE. The sanitary inspectors have the duty of supervising all work upon drains, including construction, reconstruction and repairs. During the year the following work has been carried out:— First inspections. quent re-inspections. Drainage work done under notice 485 4384 Voluntary drainage work 1148 3668 Drains of new buildings 73 1991 1706 10043 39 Drainage Register.—The following is an analysis of the Drainage Register during 1926:— Plans deposited—Old Buildings under Notice 187 ,, ,, Old Buildings, Voluntary 193 ,, „ New Buildings and Additions 29 409 Applications without Plans 266 Total number of Applications and Plans 675 Refuse Collection and Disposal. A.—A weekly collection is made in all parts of the Borough with the exception of Wards 2 and 6, in which a collection is made twice weekly during the summer months. The use of Pagefield trucks, first introduced in 1925, has very much facilitated this work. From the point of view of public health the method of refuse collection, almost universally practised in this country, leaves much to be desired. The evil-smelling contents of the dustbins when emptied into the collecting carts, generally with considerable vigour in order to dislodge the putrescent mass so often present at the bottom, leads to the distribution of clouds of objectionable dust, not only upon the passers-by, but also into the open doorways and windows of shops where meat, fish, fruit and other foods are exposed. The practice, in use in some Continental towns, of removing the full bins closed, and at the same time leaving a clean empty bin is probably impracticable, owing to cost. But a more ideal method than the one at present in use is urgently needed. B.—The methods of refuse disposal are :— (a) By combustion in the Destructor. (b) Removal to the country by rail or barge. The following figures for the past year, kindly supplied by Mr. E. W. Swinstead, m.i.m. & cy. e., the Borough Engineer, give some idea of the enormous amount of refuse to be dealt with :— Tons. Cwts. Quantity of refuse collected 53625 12 Quantity of refuse burnt at Destructor 33349 0 Quantity put on rail and barge (barge during strike) 20420 12 Quantity of clinker residual 15866 18 The quantity of refuse to be disposed of has increased during recent years, and is still increasing, owing to the more extended use of gas and electric cookers. When kitchen ranges were more generally used it was possible to burn a considerable amount of refuse. MORTUARY. This is situated in Cambridge Street, N.W. 1. As a result of the improvements carried out during the previous year this is now a satisfactory and well-equipped building. 40 The following table gives particulars concerning the number of inquests held, bodies received and post-mortem examinations made during the year. Male. Female. Total. Number of inquests held 193 108 301 ,, bodies received 118 78 196 ,, post-mortem examinations 96 65 161 SANITARY INSPECTION OF THE AREA. Inspections.—Altogether 75,811 inspections were made in 1926 by the staff of Inspectors and Visitors. These consisted of 34,162 initial inspections and 41,649 re-inspections. Of these inspections, 43,978 .were made by the District Sanitary Inspectors, 7,276 by the Sanitary Inspectors of Food and Food places, 2,873 by the Sanitary Inspector of Factories and Workshops, and 21,684 by the Women Sanitary Inspectors and Health Visitors. The work of the various classes of Inspectors and Visitors is set out in Tables 7, 8 and 9, on pages 87 to 90. The inspections dealt with above are exclusive of the visits made by the Council's staff at the Maternity and Child Welfare Centres (see page 24), and by the staff of the Tuberculosis Dispensaries (see page 73); nor do they include the work of the disinfecting staff (see page 74). Notices served and result of service.—4,455 intimation notices (comprising 10,692 items) were served by the Sanitary Inspectors during 1926. These were made up as follows :— — District Inspectors. Factory and Workshop Inspector. Food Inspectors. Women Inspectors. Total. In respect of Nuisances 5968 — 2 — 5970 In respect of the Tenement House By-laws 1819 — — — 1819 In respect of Breaches of Statutes in Factories, Workshops, and Workplaces 11 414 — — 425 In respect of other Breaches of Statutes and By-laws 2473 — 5 — 2478 Totals 10271 414 7 — 10692 These intimations are classified in Tables 10, 11, 12 and 13, on pages 91 and 92. 41 1,762 Statutory notices (comprising 2,920 items) were served during 1926 and the early part of 1927, following non-compliance with these intimation notices. These are also classified in Tables 10, 11, 12 and 13, on pages 91 and 92. The following prosecutions were undertaken during the year in respect of general sanitary work :— Summonses. Under the Public Health (London) Act, 1891 (except in respect of Food). Situation of Property. Offence. Date of Hearing of Summons. Result of Proceedings. 3, Queen Street Drain defective Jan. 26th Costs .£1 1s.—Order 14 days. 4. ,, Drain defective ,, 26th Costs <£1 1s.—Order 14 days. 100, Baybam Street Walls and ceilings dirty, roof, plaster, sash cords, window frames, grate and floor boards defective ; rats on premises ,, 26th Costs ,£1 1s.—Order 14 days. 57, ,, Walls and ceilings dirty „ 26th Costs 4s.—Order 14 days . 57, „ Water closet and accessories not maintained in proper condition of repair „ 26th Costs £1 Is.—notice complied with. 6, Queen Street Roof defective Feb. 2nd Fined £5, costs £2 2s. 7, „ Drain defective ,, 2nd Fined £5. 8, Southampton Road Water closet basin foul, drain and yard paving defective and soil pipe improperly ventilated ,, 4th Costs o£2 2s.—notice complied with. 3,St. Leonard's Square Walls and ceilings dirty, absence of proper and sufficient supply of water „ 4th Costs £1 5s.—Order 14 days. 15, Newbury Mews Absence of dustbin „ 4th Costs £1 5s.—notice complied 15, „ Walls and ceilings dirty „ 4th with. 46, Warden Road Failing to provide sufficient water closet accommodation ,, 4th Costs £1 5s.—notice complied with. 32, Prince of Wales Road Walls and ceilings dirty; drain, water fittings in water closet and inlet of drain defective „ 11th Costs £1 1s.—notice complied with. 6, Leighton Grove Walls and ceilings dirty; water closet basin loul; flooring defective Mar. 11th. Costs £1 1s.—notice complied with. 4, Rochford Street Walls and ceilings dirty ; drain defective ,, 18th Costs .£1 3s.—Order 28 days. 4, „ Yard paving defective „ 18th Fined £1. 7, Bassett Street Absence of proper and sufficient supply of water ,, 18th Costs £1 3s,—notice complied with. 73, Cbalton Street Walls and ceilings dirty; drain and flues defective June 9th Costs £1 11s. 6d.—Order 28 days. 4, Charles Street Walls and ceilings dirty; drain defective „ 16th Costs £15s —Order 28 days. Yard, rear of Ferdinand Place Offensive accumulation „ 24th Costs £1 1s.—Order 14 days. 43, Weedington Road Yard paving defective „ 24th Costs £1 1s.—notice complied with. 43, ,, Absence of proper and sufficient supply of water; washhouse paving defective „ 24th Costs £1 1s.—notice complied with. 24, Leighton Road Walls and ceilings dirty; roof defective „ 28th Costs £1 3s.—Order 12 weeks. 34, Britannia Street Roof and guttering defective Nov. 10th Costs £1 5s.—Order 14 days. 28, Carlton Street Absence of proper and sufficient supply of water „ 25th Costs £1 5s,—Order 14 days. In seven cases proceedings were taken under the London County Council by-laws for carrying or causing to be carried by road in London certain offensive matters during hours other than those permitted. Fines were inflicted amounting to £9, and costs £1 9s. 42 Under the London County Council (General Powers) Act, 1922. Situation of Property. Offence. Date of Hearing of Summons. Result of Proceedings. 3, St. Leonard's Square Rooms verminous Feb. 4th Summons withdrawn—notice complied with. 8, Southampton Road Do. „ 4th Do. 32, Prince of Wales Road Do. „ 11th Costs £1 1s. Summons withdrawn - notice complied with. 6, Leighton Grove Do. Mar. 11th Do. Under the London County Council By-laws made under the Metropolis Management Act. Situation of Property. Offence. Date of Hearing Summons. Result of Proceedings. ' 258, Camden Road Making addition to drain without depositing plans Mar. 15th Fined 10s., £2 2s. costs. Smoke Abatement— 288 observations of chimney shafts were made and 15 notices were served. There were no prosecutions. FACTORY AND WORKSHOP ACTS. Information concerning the work carried out under the above Acts is given in the following tables in the form required by the Home Secretary:— 1. —Inspections made by Male and Female Sanitary Inspectors. Premises. Number of Inspections. Written Notices. Prosecutions. (1) (2) (3) (4) Factories 1120 197 — Workshops 1477 186 — Workplaces (other than Outworkers' premises included in Part 3 of this Report) 431 42 — Totals 3028 425 — 43 2.—Defects Found. Particulars. Number of Defects Number of Prosecutions. Found. Remedied. Referred to H.M. Inspectors. (1) (2) (3) (4) (5) N uisances under the Public Health Acts* : — Want of cleanliness 111 102 Want of ventilation 5 4 Overcrowding l 1 Want of drainage of floors — — Other nuisances 76 70 Sanitary accommodation— Insufficient 15 11 Unsuitable or defective 56 48 Not separate for sexes 17 17 Nil. 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) 97 96 Other offences (excluding offences relating to outwork, which are included in Part 3 of this Report) 47 47 Totals 425 396 — — * Including those specified in sections 2, 3, 7 & 8 of the Factory and Workshop Act, 1901, as remediable under the Public Health Acts. 3.—Home Work. In certain industries specified in the Act, if work is given out by Employers or Contractors to be done by workers at home, lists containing the names and addresses of such workers must be forwarded to the Local Authority. The object of this is to prevent work being done in premises which are insanitary, or in which infectious disease is present. The following lists were received during the year:—16 in respect of the making, etc., of wearing apparel, comprising the names of 63 outworkers (contractors) and 67 outworkers (workmen), 1 in respect of upholstering, containing the names of 3 outworkers (workmen), 1 in respect of the making of cardboard boxes, comprising the names of 12 outworkers (workmen) and 1 in respect of the making or filling of Christmas crackers, etc., comprising the names of 12 outworkers (workmen). The following table gives the number and type of outworkers' premises in the Borough and the principal industries concerned :— Nature of Work. Nature of Premises. Total. Factories. Workshops. Workplaces. Wearing apparel 9 151 212 372 Card boxes — — 4 4 Artificial flowers — 1 1 Miscellaneous 2 2 10 14 Totals 11 153 227 391 44 Outwork in Infected or Insanitary Premise. Three instances occurred during the year and the necessary precautions were taken. 4.—List of Factories, Workshops (Registered, Sec. 131) and Workplaces. Nature of Work, Factories. Workshops. Workplaces (including Outworkers). Total. Bakehouses 63 95 — 158 Cabinet makers 37 63 — 100 Coach builders 12 16 — 28 Dressmakers 24 101 13 138 Engineers 126 36 — 162 Foundries 13 6 — 19 Furniture makers 10 19 — 29 Furriers — 13 2 15 Laundries 10 16 — 26 Metal workers 28 34 — 62 Milliners — 20 7 27 Organ builders 6 4 — 10 Pianoforte manufacturers 36 22 — 58 Printing 61 13 — 74 Restaurant kitchens — — 375 375 Tailors 2 173 120 295 Upholsterers — 37 — 37 Wood carvers — 17 — 17 Others 441 606 226 1273 Totals 869 1291 743 2903 Bakehouses and restaurant kitchens are also referred to on page 55. 5.—Other Matters. Class Number. (1) (2) Mattera notified to H.M. 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 Acts, but not under the Factory and Workshop Act (s. 5)— Notified by H.M. Inspector 35 Reports (of action taken) sent to H.M. Inspector 35 In regard to workshops where protected persons have been found to be employed (Public Health (London) Act, 1891, section 27) 6 Underground bakehouses (s. 101) :— Certificates granted during the year — In use at the end of the year 806 45 6.—Total Inspections. Premises. Male Inspectors. Women Inspectors. Total. Factories 1100 20 1120 Workshops 1357 378 1735 Workplaces (including Outworkers' premises) 430 580 1010 Total 2887 978 3865 PREMISES AND OCCUPATIONS CONTROLLED BY BY-LAWS OR REGULATIONS. Offensive Trades. One only is carried on in the Borough—a tallow inciter. This particular business has been in existence since the year 1780. 47 visits were made to these premises during the year. In consequence of a complaint certain improvements were suggested and adopted, and as a result no further complaints have been received. Rag and Bone Dealers. 30 of these premises are on the register. 7 inspections were made during the year. Houses Let in Lodgings. New by-laws dealing with these houses, made under power given by Section 6 of the Housing Act, came into force on March 5th, 1926. Particulars concerning the inspections made will be found in table 7 on page 87. Underground Rooms (Housing Act, 1925, Section 18 (1)). Inconsequence of inadequate housing accommodation, it has neither been possible nor advisable to take any action. Even an unsatisfactory underground room is better than no room at all. Canal Boats Acts. Under the Canal Boats (Amendment) Regulations, 1925, the responsibility of maintaining a canal boat in a habitable condition is now placed upon the owner, instead of the master. During the year Inspector Auger examined 8 canal boats, which were registered for the occupation of 18 adults and 18 children, and were actually occupied by 15 adults and 14 children. A weekly inspection of the canal and wharves has also been made. RENT AND MORTGAGE INTEREST RESTRICTIONS ACT, 1923. During the year 80 applications were received from tenants for certificates under this Act, and in 73 cases certificates were granted, specifying the work required to be executed, to put the dwelling houses into a good and tenantable state of repair. In accordance with Section 5 of the Act, 25 applications were made by landlords for the "release" of certificates previously granted to their tenants, the necessary work to the premises having been carried out. In 24 cases the release certificate was granted, and 1 application was refused. The nature of the work specified on the certificates embraced such items as repairing, cleansing, and decorating the walls and ceilings, and, in addition, many items not ordinarily dealt with by the sanitary inspectors, e.g., repair of chimney flues, stoves, mantel boards, staircase rails and balusters, door furniture, window fasteners, floor boards, cupboard doors, etc. 46 In the majority of cases where an examination of premises for the purpose of issuing a certificate under this Act was made, opportunity was also taken of serving, where applicable, Intimation Notices on the owners for the abatement of nuisances or for remedying breaches under the Public Health (London) Act, the London County Council (General Powers) Acts, By-laws, etc. SCHOOLS. The medical inspection of children in Elementary Schools in St. Pancras is carried out by the London County Council, independently of the Borough Council. The County Medical Officer has kindly furnished me with particulars of medical inspections of school children in St. Pancras during l926. They are classified in the following Tables : — Routine Medical Examination of Elementary School Children in St. Pancras, 1926. Defect. Boys. Girls. Entrants. A ge 8. Age 12. Age 14. Entrants. Age 8. Age 12. Age 14 Number examined 1616 982 1549 1423 1700 979 1523 1406 Cases. * Cases. * Cases. * Cases. * Cases. * Cases. * Cases. * Cases. * Malnutrition 15 14 19 17 10 9 2 0 10 9 16 15 12 8 3 3 Skin disease 23 18 10 30 14 11 13 10 31 21 3 2 11 6 12 11 Defective teeth — 460 — 203 — 228 — 216 — 477 — 206 _ 267 — 281 Enlarged tonsils 143 46 65 14 19 9 44 14 132 40 55 21 70 24 39 9 Adenoids 74 19 16 10 6 3 4 1 63 37 18 13 8 6 1 — Tonsils & adenoids 118 72 36 23 20 8 10 8 119 67 39 17 12 8 14 11 Other nose and throat 38 26 5 4 10 8 9 8 28 16 11 8 13 9 9 6 Enlarged glands 51 3 10 1 13 3 3 — 38 3 12 4 19 1 13 5 Eye disease 49 33 13 9 15 11 10 8 46 32 19 14 15 8 14 10 Defective vision — — — 89 — 218 — 141 — — — 109 — 217 — 125 Otorrhœa 33 21 13 10 19 18 17 14 43 25 9 6 27 23 15 12 Other ear disease 3 2 3 — 4 2 3 3 5 3 4 2 4 4 — — Defective hearing 6 2 9 6 20 9 14 4 7 1 11 6 15 6 5 4 Speech defects 7 2 1 1 8 4 2 — 1 — — — 3 1 — — Heart defects 39 3 21 1 33 5 22 1 30 5 27 6 43 11 31 5 Anæsmia 44 21 28 17 40 20 20 7 38 11 31 16 48 24 23 10 Lung defects 92 43 20 3 15 7 10 3 77 30 16 7 16 4 6 — Nervous system 12 2 8 1 5 — 3 — 11 2 8 2 12 — 5 2 Phthisis 5 4 1 — 2 — — — 4 2 5 2 3 — — — Other T. B. disease 1 1 — — — — — — — — — — — — 1 1 Rickets 19 6 2 1 2 — 2 1 10 3 3 — 4 1 1 1 Spinal deformities 3 0 2 — 4 3 2 2 2 1 10 3 14 8 11 8 Other deformities 5 2 7 3 17 2 12 — 2 1 9 2 28 11 21 9 Other defects 62 42 21 12 29 16 21 9 63 39 32 23 56 19 35 20 Number of children noted for treatment 697 343 507 412 698 381 570 464 Note.—Defects, however slight, are included under "Cases." Those severe enough to require treatment are shown under * 47 Routine Medical Examination of Elementary School Children in St. Pancras in 1920. Age Group. Number examined. Clothing and Boots. Nutrition. Cleanliness of Head. Cleanliness of Body. Teeth. Vision. Good. Fair. Poor. Good. Average. Below normal. Bad. Clean. Nits. Pediculi. Clean. Dirty. Pediculi. All sound. Less than four decayed. Four or more decayed. 6/6 in both eyes. 6/9 in either or both eyes. 6/12 or worse in either eye. Entrants— Boys 1616 1151 453 12 208 1371 36 1 1565 49 2 1582 32 2 878 461 277 — — — Girls 1700 1199 499 2 221 1442 36 1 1514 166 20 1659 40 1 924 511 265 — Age 8— Boys 982 701 2.5 6 110 823 48 1 938 43 1 945 36 1 611 310 61 461 350 151 Girls 979 701 2.6 2 148 793 38 — 845 114 20 952 27 — 603 298 78 435 355 174 Age 12— Boys 1549 1151 392 6 204 1304 41 — 1512 35 2 1531 15 3 1014 477 58 877 330 326 Girls 1523 1095 420 8 228 1259 86 — 1345 156 22 1506 17 — 1079 406 38 804 387 332 Age 14— Boys. 1123 1059 358 6 251 1153 19 1392 28 3 1403 18 2 997 394 32 895 248 275 Girls 1106 1074 328 4 317 1073 15 1 1297 97 12 1385 21 — 986 383 37 865 252 283 Totals 11178 8131 3001 46 1687 9218 269 4 10408 688 82 10963 206 9 7092 32.40 846 4337 1922 1541 % St. Pancras 72.8 268 0.4 151 82.5 24 — 931 6.2 0.7 98.1 1.8 0.1 63.4 29.0 7.6 55.6 246 198 % London 60.2 38.5 1.8 214 72.8 5.8 — 925 6.9 0.6 96.0 39 0.1 64.2 28.5 7.3 54.7 255 19.8 43 The St. Pancras School Clinics and Treatment Centres are mentioned on page 20. Section IV.—HOUSING. The following particulars concerning the number of new houses erected during the year, and details of the work carried out with reference to existing houses (under the Housing Act and Public Health Acts), are given in the following form in accordance with the requirements of the Ministry of Health : — Number of new houses erected during the year:— (a) Total (including number given separately under (b)) 50 houses (b) With State assistance under the Housing Acts : — (i) By the Local Authority Nil. (ii) By other bodies or persons Nil. 1. Unfit dwelling-house. Inspection—(1) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 3264 (2) Number of dwelling-houses which were inspected and recorded under the Housing Consolidated Regulations, 1925 708 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation . Nil. (4) Number of dwelling-houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 2027 2. Remedy of defects without Service of formal Notices. Number of defective dwelling-houses rendered fit in consequence of informal action (intimation only) by the Local Authority or their Officers 1880 3. Action under Statutory Powers. A.—Proceedings under Section 3 of the Housing Act, 1925. (1) Number of dwelling-houses inrespcct of which notices were served requiring repairs 447 (2) Number of dwelling-houses which were rendered fit after service of formal notices:— (a) By owners 409 (b) By Local Authority in default of owners Nil. (3) Number of dwelling-houses in respect of which Closing Orders became operative in pursuance of declarations by owners of intention to close Nil. 15.—Proceedings under Public Health Acts. (1) Number of dwelling-houses in respect of which notices (Statutory) were served requiring defects to be remedied 1710 (2) Number of dwelling-houses in which defects were remedied after service of formal (Statutory) notice : — (a) By owners 1674 (b) By Local Authority in default of owners Nil. 49 C.—Proceedings under Sections 11,14 and 15 of the Housing Act, 1925:— (1) Number of representations made with a view to the making of Closing Orders Nil. (2) Number of dwelling-houses in respect of which Closing Orders were made Nil. (3) Number of dwelling-houses in respect of which Closing Orders were determined, the dwelling-houses having been rendered fit Nil. (4) Number of dwelling-houses in respect of which Demolition Orders were made Nil. (5) Number of dwelling-houses demolished in pursuance of Demolition Orders Nil. Particulars concerning Inspection of Tenement Houses are given in table 7 on page 87. OVERCROWDING. This is still very prevalent. In the course of various inspections, cases have been found where six, seven, and in one case eight persons were living in one room. The London County Council allocate to each Metropolitan Borough a certain amount of accommodation in their various housing estates. This accommodation is used to relieve the most serious cases of overcrowding which are discovered. During the past year 90 families, comprising 472 persons, who were living in 167 rooms, have been provided with adequate housing accommodation under this scheme. HOUSING SCHEMES. 1. Wolcot Struct Area.—The proposals of the Borough Council for dealing with this area were initiated in 1919, and have been the subject of continued discussion with the central authorities during the past seven years. In December the London County Council intimated that they were not prepared to sanction the necessary loan, on account of the high cost of the proposed dwellings. Amended plans are now to be prepared for a more economical type of building. 2. Ossulston Street Area.—This was represented to be an insanitary area by your Medical Officer of Health in January, 1925. An official inquiry was held in August of the the same year, and the scheme, as amended, was confirmed by the Minister of Health in April, 1926. The clearance of the area and the erection of new buildings will be carried out by the London County Council. Much preparatory work has been done, but it is doubtful if building operations will commence for some time, as housing accommodation must be provided for tenants who will be displaced. WORK OF THE ESTATES COMMITTEE OF THE BOROUGH COUNCIL. The following account of the principal matters dealt with during the year has been furnished by Mr. A. D. Corrick, Clerk to the Estates Committee :— The Estates Committee is appointed by the Council to " take over, control and manage " all houses and other properties of the Council, except such as are used by any department of " the Council for its own purposes; to see that such houses and properties are kept in " tenant able condition and let at reasonable rents; to prepare schemes under the Housing of " the Working Classes Acts for the improvement or reconstruction of insanitary areas, and to " supervise the erection of houses for the working classes; and to deal with such other " matters as may be referred to the Committee by the Council." 50 The dwellings controlled by the Committee comprise (а) Goldington Buildings, Great College Street (57 flats) ; (b) Flaxman Terrace, near Euston Road (84 flats); (c) Prospect Terrace, Gray's Inn Road (71 flats) ; (d) Una House, Prince of Wales Road (65 fiats) ; and (e) The Brookfleld Estate, Highgate (110 flats, 90 maisonettes and 2 houses). The vacancies occurring in these dwellings are few in number, and for which there is a long waiting list. It has been necessary to utilise such empties as have occurred to assist in the Somers Town Housing Scheme by a system of transfers. Before the proposed flats on the Wolcot Street area are built, empty possession of eleven houses on the site has to be obtained, and the task of providing accommodation for the several families is a difficult one. Somers Town Housing. Wolcot Sirekt Area. The Borough Council's scheme for the clearance of this slum area and the erection of four blocks of working-class dwellings on the site has been under reconsideration. The Order of the Minister of Health sanctioning this housing scheme is dated 2nd May, 1925, although negotiations in respect thereof date back years earlier. It is provided that no State financial assistance will be afforded. The plans were approved and sealed in September, 1925, and all steps have been taken to acquire the various interests in the property required at a cost of £19,000. Tenders were invited by the Council from prominent firms for the erection of the buildings, but, as the lowest tender received was considerably in excess of the original estimate of the cost, it was decided to obtain fresh tenders. The amount of the lowest tender received as a result of the first, tendering was £52,860, and the lowest tender in the second tendering was £49,894. The Council accepted this latter tender, and application was made to the London County Council for sanction to the borrowing of a loan to cover the cost of buildings, fees and charges. Their Finance Committee were not prepared to sanction the loan as they considered the cost too high, and conferences were held to see whether any reductions could be made. It was agreed that the scheme was more expensive than a normal housing scheme, because of exceptional factors. Certain modifications were made which reduced the amount of the building tender bv about £15,000 to £47,014. The County Council, however, would not sanction a loan even at the reduced figure, on the ground that the cost of erecting the dwellings would exceed £270 a room and would result in an annual deficiency of about £1,750 during a period of 60 years. From the Borough Council's point of view this was regarded as unsatisfactory, because thev were anxious and pledged to proceed with the erection of the dwellings. They considered they had done all that could be reasonably expected of them in reducing building costs, and were prepared to accept the responsibility of the annual financial loss referred (o. They appealed to the Minister of Health to assist in obtaining sanction to the borrowing of the amount required to enable them to proceed with the scheme in accordance with the Order. After negotiations, the Ministry advised that the Council's Architect should prepare fresh plans for a more economical scheme of building, to be drawn up in consultation with the Ministry's Architect. 51 These plans have been prepared and approved by the Ministry, and it is now proposed to erect four blocks of dwellings with 88 separate tenements, as against 70 in the original scheme. The blocks are larger and will extend into Clarendon Street, necessitating the acquisition of more property. The 88 dwellings will consist of 248 rooms, comprising 24 two-room, 56 three-room, and 8 four-room tenements. Each dwelling will also have a kitchen containing a gas cooker, copper, bath, sink, larder and dresser. There will be a separate w.c. and coal bunker in lobby. A fifth block, comprising 36 dwellings, would be built on the Clarendon Street site (the freehold of which is owned by the Council) when the leases fall in. The total scheme, including extension later of the fifth block, will provide 124 separate tenements. The Borough Council have accepted (May. 1927) a tender for the erection of the buildings, and application has been made to the London County Council for the necessary loan sanction. Fitzroy Park Allotments. In connection with a contribution made by the Borough Council towards the purchase of Kenwood as an open space, a piece of land, about one acre in extent abutting on Fitzroy Park, was conveyed to the Borough Council, subject to its being retained for use as allotments or as an open space. During the year a few more plots have been formed on this field for allotments by the clearing of trees and shrubs. A number of young trees were saved and replanted at the Council's dwellings in Prince of Wales Road. Fencing protection and the lopping of trees have greatly benefited the new plots, as well as the adjoining plots. There are now 30 allotments under cultivation. Staff. The administrative work in connection with the Estates Committee (Chairman: Alderman Thomas A. Collins, j.p. ; Deputy-Chairman : Councillor II. E. Capes) is carried out by Mr. A. 1). Corrick, the Clerk to the Committee, who is assisted by Mr. Gr. N. Cove, and the Housing Superintendent, Mr. L. Barnard. The Resident Caretakers at the several blocks of buildings are as follows:—Prospect Terrace, Mr. H. A. Reid; Brookfield Estate, Mr. II. J. Ambrose; Flaxman Terrace, Mr. C. Hanson; Una House, Mr. J. F. Clegg; Goldington Buildings, Mr. G. S. Tunbridge. Section V.-INSPECTION AND SUPERVISION OF FOOD. (a) MILK SUPPLY. Cowsheds.—There is only one licensed cowshed in the Borough; this can accommodate 24 cows, but was occupied during the year by only 10. This small number of cows only contribute a negligible fraction of the milk required in the Borough, practically the whole supply being brought in from farms in the country, either by rail or motor transport. Dairies and Milk shops.—The registration of these was materially affected by the new Milk and Dairies Order, which came into force on October 1st, 1926. The following report on the subject was presented to the Public Health Committee: — Registration of Dairies and Dairymen. The question of Rsgistration in connection with the above frequently comcs before this 52 Committee, but the principles upon which decisions have been based in the past are now altered owing to legislative changes. A new Milk and Dairies Order came into force in October, 1926, which abolishes all previous Dairies, Cowsheds and Milkshop Orders and all Regulations made by local authorities under those Orders. The principal provisions of the new Order are as follows:— (a) Every local authority must keep a register of all pet sons carrying on in their district the trade of dairyman. The word "dairyman " is stated in the Act to include a purveyor of milk, and this means a seller of milk, whether wholesale or by retail. (b) A register of all premises used as dairies. (c) The word " dairy " includes any farm, cowshed, milk store, milkshop or other place from which milk is supplied on or for sale, or in which milk is kept or used for purposes of sale or manufacture into butter, cheese, dried milk or condensed milk for sale, and, in the case of a purveyor of milk who does not occupy any premises for the sale of milk, includes the place where he keeps the vessels used by him for the sale of milk, but does not include a shop from which milk is not supplied othericise than in properly closed and unopened receptacles in tchich it was delivered to the shop, or a shop or other place in which milk is sold for consumption on the premises only. (d) Where a person delivers milk in bottles, he shall cause every such bottle to be filled and closed on registered premises, and no person shall remove or tamper with the disc or other device used for closing the bottle at any time after it has left such premises and before it is delivered to the consumer. (e) Before commencing to use as a cowshed, or as a place for the keeping of milk, a building not previously used for that purpose, the occupier shall give one month's notice in writing to the Sanitary Authority of his intention to do so. Conclusions. (1) In view of the preceding, it may be stated that, as regards dairies, the local authority must register the premises and also the person who occupies the dairy. (2) Power to refuse registration of a " dairy " if the premises arc unsuitable is given by the Milk and Dairies (Amendment) Act, 1922, and also by the London County Council (General Powers) Act, 1908, both of these being still in force. (3) Premises from which milk is not sold otherwise than in closed receptacles (e.g. bottles) are not dairies, and therefore are not required to be registered. The occupier of such premises is, however, required to be registered as a dairyman or purveyor of milk. (4) The policy of this Committee in the past, with reference to small general shops, has been to refuse registration, both for the sale of loose milk or of milk in bottles, if certain articles deemed to be objectionable were stocked or sold, it having been considered that the milk might be contaminated and that the bottles might be opened. In future, with reference to the sale of loose milk in such shops, the Committee will have power to refuse registration if the premises are unsuitable, as such shops come within the definition of dairies, but it will not be possible to continue the previous policy as regards shops selling only bottled milk. In these cases 53 the occupier must be registered as a purveyor of milk, and will then be kept under observation. Action can be taken if the bottles are opened on such premises, as this is now a punishable offence. As an additional safeguard, I would suggest that when registering a purveyor of milk as above, the sanction of the application be definitely endorsed " for the sale of milk in unopened bottles only." G. Sowden, Medical Officer of Health. Dairies and Milkshops.—Twenty-three applications for registration under the Dairies, Cowsheds and Milkshops Orders were received during the year. Of this number, 21 were granted and 2 refused. One application in respect of an itinerant vendor was also received and granted. The following list gives particulars as to the purveyors of milk on the register at the end of 1926:— Number of purveyors of milk from retail milkshops on the register at the end of 1925 213 Deduct number removed from the register during the year 1926 -22 Add number of purveyors registered by resolution of the Council during 1926 +21 Total number of purveyors of milk from retail milkshops on register at the end of 1926 212 In addition to the above, there were also on the register at the end of 1926 one person in respect of premises where a wholesale milk trade only is done, and 12 itinerant vendors without retail milkshops. The one cowshed in the Borough also has a retail milkshop attached to it, and is included in the total of 212. Milk (Special Designations) Order, 1923. The special designations under which milk may be sold comprise the following:— "Certified," "Grade A (tuberculin tested)," "Grade A," and "Pasteurised." The Order states the conditions which must be complied with before a licence can be granted in connection with the production, distribution and sale of such milk. Any such licence is valid for not more than one year and expires on December 31st in each year. 54 The following licences for the Sale of Graded Milk were granted in rcspect of 1926:— Date of Licence. Name and Address of Licensee. Grades of milk in respect of which Licence is granted. St. Pancras Address at which graded milk will be sold. Dec. 17 th, 1925 United Dairies (London), Ltd., 97, Elgin Avenue, W. 9 " Certified " 63, Park Street, N.W. 1. Do. Do. " Grade A Tuberculin tested '' Do. Do. Do. " Pasteurised " Do. Do. Do. Do. 69, Albany Street, N.W. 1. Do. Do. Do. 48, Marchmont Street. Do. Do. Do. 126, Regent's Park Road. Do. Welfords & Premier Dairies. Ltd., 233, Seven Sisters Road, N. 4 " Certified " Supplementary licence to sell in St. Pancras. Do. Manor Farm Dairy Co., Ltd., 39, High Road, East Finchley, N. 2 Do. Do. Do. Do. " Pasteurised " Do. Do. Lord Rayleigh's Dairies, Ltd., 16, Caroline Street, W.C. 1 " Certified " Do. Do. Do. " Grade A Tuberculin tested " Do Jan. 21st, 1926 Express Dairy Co., Ltd., 26-30, Tavistock Place, W.C. 1 " Certified " 26, Tavistock Place, W.C. 1. Do. Do. " Grade A Tuberculin tested " Do. Do. Do. " Certified " 12, South Grove, N. 6. Do. Do. " Grade A Tuberculin tested " Do. Do. Marshall's Dairies, Ltd., 19, Tudor Place, W. 1 Do. 19, Tudor Place. Do. Manor Farm Dairy, 39, High Road, East Finchley, N. 2 " Pasteurised " 26, High Street, N. 6. Do. Do. Do. Swain's Lane. Do. Vicarage Farm Dairy Co., Ltd., 277-9, Kentish Town Road " Grade A " 277-9, Kentish Town Road. Do. Do. " Certified " Do. Do. Do. " Pasteurised " Do. Do. J. R. Mills & Sons, 23, Francis Street, W.C. 1 " Grade A " 23, Francis Street. Do. J. Evans, 35, Southampton Street, W. 1 Do. 35, Southampton Street. Do. T. Jones, 23, Haverstock Road, N.W. 5 " Certified " 23, Haverstock Road. Feb. 18th, 1926 Evan Jones, 137, King's Cross Road, W.C. 1 Do. 137, King's Cross Road. Mar. 18th, 1926 D. Davies, 10-11, Woburn Buildings, Dukes Road, W.C. 1 " Grade A " 10-11, Woburn Buildings. Do. Do, " Certified " Do. Apl. 22nd, 1926 A. Meredith, 118, Chalton Street " Grade A Tuberculin tested " 118, Chalton Street. Licence Refused. One application in respect of the establishment in which the process of pasteurisation is carried out was not granted, as the type of apparatus was not considered to be satisfactory. (6) MEAT AND OTHER FOODS. The two special Food Inspectors have kept under regular observation food exposed or deposited for sale in slaughter-houses, butchers' shops, cooked meat shops, fishmongers' premises, stalls, market places, etc. 55 During the year the undermentioned unsound or diseased food was surrendered by the owners or seized, either for destruction or to be dealt with as trade refuse:— Unsound or Diseased Food Condemned and Destroyed. Apples, 2 boxes Onions, 26 boxes Bananas, 18 crates Pears, 20 boxes Beef, 41 stone, 5 lbs. Peas (Green), 49 bags and 73 half bags Bullock's carcase, 84 stone Pig's head, 1 Cabbage, part truck load Pomegranates, 1 case Cherries, 14 half bushel baskets Pork, 104 lbs. Cranberries, 48 baskets Potatoes, 5½ tons, and 151 bags Geese, 4Babbits, 86 Grapes, 1 barrel Skate, 7 stone Greens, 200 bags Strawberries, 5 tubs Green tops, 79 bags Strawberry Puree, 42 10½-lb. tins Haddocks, 1 box and 6 stone Tomatoes, 64 boxes Livers (Ox), 17 Turkey, 1 Mussels, 1 bag Whiting, 1 trunk Seized. Ground Rice, 10½ lbs. Slaughter-houses. At the end of 1926 there were 5 licensed slaughter-houses (private) in the Borough. Structurally they do not conform to a high standard of excellence. They are kept under periodical inspection by the Food Inspectors, who made 151 inspections during the year. Fried Fish and Fish Curing Premises. In 1926, there were 79 fried fish vendors' premises in the Borough, at 4 of which fish curing was also carried on. There were 20 fish curers' premises, including the 4 above mentioned. 441 visits were made by the Food Inspectors to these premises during the year. Ice-Cream Premises. 339 ice-cream premises were known to the department; 379 visits were paid to them by the Food Inspectors during the year. Bakehouses and Bestaurant Kitchens. At the end of 1926 there were 158 bakehouses on the register, including 63 factory bakehouses. 37 of these bakehouses were not in use. 117 of the 158 were underground bakehouses, of which 55 were factory bakehouses, and 31 not in use. At the end of the year 375 restaurant kitchens were on the register. Bakehouses and restaurant kitchens are supervised by the Factory and Workshop Inspector and further particulars in regard to them will be found on pages 43 and 44. 56 CHEMICAL WORK. The Public Analyst is Mr. J. Kear Colwell, f.i.c. In connection with the grading scheme for the Council's officers, which was adopted during the year, a revision was made of the terms and conditions attached to the above appointment. The rate of remuneration was stabilised at a fee of eleven shillings per sample, and the number of samples to be examined during the year was increased to a minimum of 800. Arsenic in Apples. In consequence of the publicity which was given during the year as to the frequency of this contamination, a number of examples were examined, and a brief report was submitted on the subject, from which the following extract is given:— " I have thought it advisable to report on this subject, as during the past few weeks it has been referred to rather frequently in the public press, and some information may be desired as to the prevalence of this contamination and the amount of risk connected with it. In various parts of the country apples have been found to be contaminated with arsenic, occasionally in sufficient quantity to be dangerous to health. A number of samples have been taken in this Borough and submitted to analysis. In several instances small quantities of arsenic have been found, but so far the amounts have been insignificant. The largest amount so far discovered was one-sixtieth of a grain per lb. It is practically all on the surface of the fruit, so that there is no danger if the apples are peeled before being eaten. The Minister of Health is dealing with the subject, and has suggested that if any samples are found to be dangerously contaminated, arrangements should be made to have them withdrawn from sale. It is suggested that this course should be adopted." Strawberry Jam. A sample of this when submitted to analysis was found to contain at least 10 per cent, of " apple matter." It is a custom with many manufacturers to add a certain proportion of apple juice to strawberry jam in order to make it set firmly, but this addition should be clearly stated on the label. In this instance the local vendor had purchased the jam from a very well-known manufacturer. There was nothing on the label to indicate that any admixture was present, and it had been sold exactly as received. Under the circumstances it would not have been equitable to take proceedings against the vendor, and action could not be taken against the manufacturer as his premises were not in the area of the local Authority. The manufacturer readily gave an undertaking that in future all labels should comply strictly with the Act, but the Committee decided that the facts mentioned should be brought the notice of the Ministry of Health, 57 (n)—SALE OF FOOD AND DRUGS ACTS. 820 samples have been taken under these Acts. 791 of these proved to be genuine and 29, or 3'5 per cent., adulterated. The details are given in the following table:— Articles of food of which samples have been taken. Total number of samples. Genuine. Adulterated. Apples 25 24 1 Apple stalks 1 1 — Brawn 1 1 — Butter 128 127 1 Cheese 21 21 — Cocoa 33 33 — Coffee 33 33 — Cream 11 9 2 Do. (Preserved) 14 14 — Custard Powder 6 6 — Dripping 5 5 — Fish Paste 1 1 — Flour (Self-Raising) 29 29 — Jam 32 31 1 Lard 25 25 — Lemon Crystals 1 1 — Margarine 20 20 — Meat Paste 1 1 — Milk 384 361 23 Mustard 9 8 1 Oatmeal 1 1 — Pepper 11 11 — Rice 12 12 — Sausages 1 1 — Vinegar 10 10 — Vinegar (Malt) 5 5 — Totals 820 791 29 Note.—The 820 include four informal samples of milk, one of apple stalks, one of cheese and one of meat paste. Prosecutions were undertaken as regards 21 of the above 29 samples, which were reported as being adulterated. The results of the proceedings are stated in the following table;— 58 Summonses. (a) 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. 1926. £ s. d. £ s. d. C. 20 Milk Deficient in milk fat, 10 per cent. ... Mar. 11th 1 0 0 — — — C. 75 „ 60 „ April 8th 3 0 0 3 0 0 C. 80 „ „ 8 „ „ „ 5 0 0 5 0 0 C. 87 „ „ 7 „ „ „ 3 0 0 3 0 0 c. 88 „ „ 33 „ „ „ 3 0 0 — — — A. 66 „ „ 5.3 „ „ 22nd. Dismissed on payment of £5.5 5s. 0d. costs. Magistrate satisfied that milk was in the same condition as given by the cows. A. 68 „ „ 3.6„ „ „ A. 71 „ „ 9.0 „ „ „ A. 72 „ „ 5.0 „ „ „ A. 78 „ Added water-, 16.2 per cent. „ „ 15 0 0 — — — A. 79 „ „ 130„ „ „ 15 0 0 — — — A. 80 „ „ 181 „ „ „ 15 0 0 5 5 0 A. 81 „ „ 137 „ „ „ 15 0 0 — — — C. 95 „ Deficient in milk fat, 8.3 per cent. „ 29th — — — 2 2 0 C. 104 „ Added colouring matter „ „ 1 1 0 2 2 0 C. 167 „ Deficient in milk fat, 4 per cent Aug. 19th — — — 3 3 0 C. 169 „ „ 4 „ „ „ — — — 2 2 0 C. 171 „ „ 6 „ „ „ — — — 3 3 0 C. 175 „ „ 8.3 „ „ „ — — — 2 2 0 C. 182 „ „ 4.6 „ „ „ — — — 1 1 0 A. 230 „ „ 16.6 „ Oct. 19th 0 10 0 — — — (b) Under the Milk and Dairies (Consolidation) Act, 1915. Address where offence committed. Offence. Date of Hearing of Summons t of Proceedings. St. Paul's Road Selling milk from a vehicle without the name and address of seller being conspicuously inscribed thereon 1926. Mar. 10th. . Withdrawn on suggestion of Magistrate. Bridgewater Street Do. do. Aug. 19th Fined 5s. (c) Under the Dairies, Cowsheds and Milkshops Amending Order, 1886 Address where offence committed. Offence. Date of Hearing of Summons. Result of Proceedings. Bridgewater Street Selling milk without being registered 1926. Aug. 19th Fined 10s. 59 PUBLIC HEALTH (MILK AND CREAM) REGULATIONS, 1912 AND 1917. Report for Year ended 31st December, 1926. 1. Milk, and Cream not sold as Preserved Cream. — (a) Number of samples examined for the presence of a preservative. (V) Number in which a preservative was reported to be present. Milk 384 Nil. Cream 11 2 Nature of preservative in each ease in column (b), and action taken under Regulations in regard to it:— C. 199. Cream. 0.158 per cent. of boron trioxide, equal to 0.280 per cent. of boric acid. A. 223. Cream. 0.107 per cent. of boron trioxide, equal to 0.189 per cent. of boric acid. A warning letter was addressed to the vendors by order of the Public Health Committee. No legal proceedings were instituted. 2. Cream sold as Preserved Cream. (a) Instances in which samples have been submitted for analysis to ascertain if the statements on the labels as to Preservatives were correct:— (i) Correct statements made 14 (ii) Statements incorrect — Total 14 (iii) Percentage of preservative found in Percentage stated on statutory each sample: Boric acid, 0.223, label: 0.4. 0.236, 0.211, 0.273, 0.161, 0. 099, 0.260, 0.161, 0.248, 0.186, 0.149. 0.223, 0.124 and nil. (b) Determinations made of milk fat in cream sold as preserved cream: — (i) Above 35 per cent 14 (ii) Below 35 per cent — Total 14 (c) Instances where (apart from analysis) the requirements as to labelling or declaration of preserved cream in Article V (1) and the proviso in Article V (2) of the Regulations have not been observed: None. (d) Particulars of each case in which the Regulations have not been complied with, and action taken : None. 3. Thickening Substances.—Any evidence of their addition to cream or to preserved cream, Action taken where found: None. 60 Section VI.—PREVALENCE OF, AND CONTROL OVER, INFECTIOUS DISEASES. With the exception of Measles, all notifiable diseases were much less prevalent than during the previous year. The following table gives the number of cases notified, the number of deaths which occurred, and the number of patients admitted to hospital during 1926. The notifications have not been corrected for any subsequent revision of diagnosis:— Notifiable; Diseases (other than Tuberculosis). DISEASES. NOTIFICATIONS. Total all Ages. DEATHS. Total all Ages. Number of Cases admitted to Hospital. At Ages—Years. At Ages—Years. Under 1. 1 to 5. 5 to 10. 10 to 15. 15 to 25. 25 to 65. 65 upwards. Under 1. 1 to 5. 5 to 10. 10 to 15. 15 to 25. 25 to65 65 upwards. 1. Variola or Small-pox — — — — — 1 — 1 — — — — — — — — 1 2. Scarlatina or Scarlet Fever 4 139 167 63 37 21 — 432 — 1 — — — 1 — 2 426 3. Diphtheria and Membranous Croup 8 147 204 83 43 37 1 523 1 7 4 — — — — 12 510 4. Enteric or Typhoid Fever — 3 1 2 3 5 1 15 — — — — — 1 — 1 14 5. Puerperal Fever — — — — 4 10 — 14 — — — — 1 — — 1 12 6. Puerperal Pyrexia — — — — 6 7 — 13 — — — — — — — — 11 7. Erysipelas 2 1 2 5 3 49 18 80 — — — 1 — 6 1 8 51 8. Anthrax — — — — — 1 — 1 — — — — — — — — 1 9. Cerebrospinal Meningitis — 3 — — — — — 3 — 1 — — — — — 1 3 10. Anterior Poliomyelitis and Polioencephalitis 1 — 1 — — — — 2 — 1 — — 1 1 — 3 1 11. Ophthalmia Neonatorum 43 — — — — — — — — — — — — — — — — 12. Encephalitis Lethargica — 1 1 — 3 5 1 11 1 1 — 1 2 — 5 8 13. Acute Primary Pneumonia 17 52 24 8 13 89 15 218 — — — — — — — — 114 14. Acute Influenzal Pneumonia — 4 4 1 8 40 3 60 — — — — — — — — 25 15. Malaria — — — — 1 1 — 2 — — — — — 3 — 3 2 16. Dysentery — 1 — — — 1 — 2 — — — — — 4 — 4 2 17. Measles 260 2008 1367 54 25 20 — 3734 25 38 2 — — — — 65 371 18. German Measles 14 39 55 14 15 6 — 143 — — — 1 — — — 1 7 61 The notifications of, and deaths from, the notifiable infectious diseases other than Tuberculosis are classified in the following table according to the Wards in which they occurred:— INFECTIOUS DISEASES. Notifications. Deaths. Ward. Whole Borough. Ward. Whole Borough 1 2 3 4 5 6 7 8 1 2 3 4 5 6 8 1. Variola or Small-pox — — 1 — — — — — 1 — — — — — — — —- 2. Scarlatina or Scarlet Fever 57 58 99 58 39 42 27 52 432 — — 1 1 — — — — 2 3. Diphtheria and Membranous Croup 75 76 86 61 98 42 13 72 523 1 1 4 3 2 — — 1 12 4. Entericor Typhoid Fever 2 — 1 2 2 4 1 3 15 1 — — — — — — — 1 5. Puerperal Fever — 1 5 5 — 2 — 1 14 — — 1 — — — — — 1 6. ,, Pyrexia — — 4 4 3 — 1 1 13 — — — — — — — — — 7. Erysipelas 11 6 14 7 13 10 2 17 80 3 2 — 1 — 1 1 — 8 8. Anthrax — — 1 — — — — — 1 — — — — — — — — — 9. Cerebrospinal Meningitis 1 1 — — — — 1 — 3 1 — — — — — — — 1 10. Anterior Poliomyelitis and Polioencephalitis — — 1 — — — — 1 2 — — 1 1 — — 1 3 11. Ophthalmia Neonatorum 7 4 3 6 7 1 6 9 43 — — — — — — — — — 12. Encephalitis Lethargica 6 1 — — 2 1 — 1 11 1 1 2 — 1 — — — 5 13. Acute Primary Pneumonia 31 16 50 21 31 42 2 25 218 — — — — — — — — — 14. Acute Influenzal Pneumonia 8 6 9 6 14 4 3 10 60 — — — — — — — — — 15. Malaria 1 — — 1 — — — — 2 — — — — — — 2 1 3 16. Dysentery — — 1 — 1 — — — 2 — — 1 — 2 — 1 — 4 17. Measles 439 143 746 514 713 479 72 228 3734 7 7 8 7 8 18 3 7 65 18. German Measles 27 10 16 21 30 7 18 14 143 — — — — — — — 1 1 Totals 665 622 1037 706 953 634 246 434 5297 14 11 18 12 14 19 7 11 106 62 SMALL-POX. A case of this disease occurred in October. The patient was a woman, 52 years of age, who had not been vaccinated since infancy. The attack was a severe one, and the disease confluent in type, but, after being very dangerously ill, she ultimately recovered. At the onset of symptoms the patient went for advice to a hospital situated outside the Borough, where she was detained as an in-patient. A few days later the rash appeared, and the nature of the illness was recognised. All contacts, both at home and in the hospital, were traced and vaccinated; this was a task of some magnitude, owing to their number. One contact developed the disease. In this case vaccination had not been possible until several days after exposure to infection. Although an attack of Small-pox was not prevented, yet, due to the vaccination, the type of the disease was rendered very mild. In September several cases of Small-pox occurred in an adjoining Borough. The first patient had a very mild attack, and did not consult a doctor; the nature of the illness was, therefore, not recognised at the time. The subsequent cases who were infected by this patient were of a severe type, and two deaths occurred. The first patient, prior to discovery and isolation, had visited a number of places in St. Pancras. These premises were disinfected, and all contacts kept under observation. In February some anxiety and a considerable amount of work was caused by the arrival in the Borough, at a large Hotel, of 157 persons who had been in contact with a case of Small-pox. These were a party of South African students, male and female, who had been touring Europe. One member of the party contracted Small-pox of a very severe type, and died at The Hague. The authorities there would have kept the remainder of the party in quarantine, but, through tbe intervention of the Medical Officer of the Ministry of Health, they were released from quarantine and brought to London. A large number required to be re-vaccinated, and the entire party had to be kept under daily observation for some time. The position was further complicated by the occurrence of an outbreak of German Measles during the Small-pox incubation period. Considerable care had to be exercised, owing to the fact that an initial rash of Measles type occasionally occurs at the onset of an attack of Smallpox. Fortunately no other cases of the latter disease occurred. VACCINATION. The following table is drawn up from returns, kindly supplied by the Clerk to the Guardians, in respect of children whose births were registered in the Parish of St. Pancras from January 1st to December 31st, 1925:— Caccinations 1st January to 31st December, 1925. — Number. Percentage of Births registered. North. East. West. South. Whole Borough North. East. West. South. Whole Borough Births registered 819 1145 844 1313 4121 1000 1000 1000 100.0 100.0 Dead, unvaccinated 29 63 44 71 207 3.5 5.5 5.2 5.4 5.0 Successfully vaccinated 367 514 441 666 1988 44.8 44.9 52.3 50.7 48.2 Had smallpox — — — — — — — — — — Insusceptible of vaccination 2 1 2 — 5 0.2 01 0.2 — 0.1 Received certificate of conscientious objection 396 414 298 401 1509 48.5 362 35.2 30.5 36.7 Postponed by medical certificate 7 16 9 9 41 0.9 1.4 1.1 0.8 1.0 Moved to known address in other districts 6 56 3 52 117 0.7 4.9 0.4 4.0 2.8 Lost sight of by removal 11 76 38 109 234 1.8 6.6 4.5 8.3 5.7 Unvaccinated and not accounted for in previous columns 1 5 9 5 20 0.1 0.4 1.1 0.3 0.5 63 The corresponding figures for the past ten years are as follows:— Year. Births. Successfully Vaccinated. Per cent. Conscientious Objections, and Children otherwise escaping Vaccination. Per cent. 1916 4322 1594 36.9 1179 27.3 1917 3664 1581 43 1 1014 27.7 1918 3338 1281 38.4 932 27.9 1919 3874 1733 44.7 1155 29.8 1920 6086 2693 44.3 2118 34.8 1921 5102 2085 409 1934 37.9 1922 4881 2260 463 1775 36.4 1923 4682 2491 53.2 1444 30.8 1924 4398 2254 51.3 1355 30.8 1925 4121 1988 48-2 1529 37-2 SCARLET FEVER. The number of cases notified was 432, as compared with 651 cases during the previous year. It was subsequently ascertained that 43 cases had been incorrectly diagnosed. The actual number of cases was therefore 389. Two deaths occurred ; this equals a case mortality of 0.5 per cent. Return Cases.—This term is applied to cases of Scarlet Fever which occur in a house within 28 days of the return from hospital of a previous case. 21 such cases occurred during the year. Two cases occurred in one house, but were not related to the same source of infection. Two of the suspected sources of infection were suffering from Otorrhœa (ear discharge) when discharged from hospital, and four from nasal discharge. Four others developed nasal discharge within a few days of returning home. The remainder showed no obvious signs of being infectious. DIPHTHERIA. The number of cases notified was 523, as compared with 704 cases during the previous year. It was subsequently reported by the hospital authorities that 79 cases had been incorrectly diagnosed, the actual number of cases was therefore 444. This equals an attack rate of 2.05 per 1,000 of population. Twelve deaths occurred, giving a case mortality of 2.7 per cent. This is the lowest death-rate from Diphtheria ever recorded in the Borough. Antitoxin for the treatment of cases of this disease is supplied to medical practitioners bv the Council, free of charge. During the year 296 thousand uuits were provided. Pretention of Diphtheria.—The following brief report on this subject was made to the Public Health Committee in November : — Diphtheria Prevention. I beg to submit the following report on the subject of Diphtheria Prevention. The subject compels attention, owing to the fact that the prevalence of Diphtheria in London has increased considerably during recent years. 64 The following table gives the number of notifications in London during the past twenty-one years—arranged in three periods, each of seven years:— Years. Cases of Diphtheria notified, 1904-1910 50,692 1911-1917 57,603 1918-1924 84,410 As a result of recent medical research, it is now possible by means of a simple test —the Schick Test (named after its discover, Dr. Schick) — to ascertain whether or not a person is susceptible to Diphtheria. Some persons are naturally immune, others, and especially children, are susceptible. Those who are found to be susceptible can be protected against Diphtheria by a method of inoculation. This consists of three small injections under the skin at intervals of one week. It is a simple procedure without pain or subsequent discomfort, and there is no sore place as in vaccination. In New York this method has been available for some time, and over a million children have been protected. It is, therefore, significant to note that, although Diphtheria is becoming more prevalent in London, it is decreasing in New York. It has recently been reported that during the past six months the number of cases of Diphtheria in New York is less than has ever been known before in that city during any similar period. I suggest this method of protection should be made available, free of charge, at one of the Welfare Centres, and that parents be urged to give their children the benefit of the protection thus provided. I am, Your obedient Servant, G. Sowen, Medical Officer of Health. The Committee decided to again consider the matter, and desired to have a further report giving an estimate as to the probable cost of the proposal. ENTERIC (TYPHOID) FEVER. Fifteen cases were notified and one death occurred, as compared with sixteen cases and three deaths in the previous year. On further investigation four cases were found to have been incorrectly diagnosed, the actual number of cases was therefore eleven. Based 011 bacteriological examination six cases were reported to be suffering from Typhoid and two from Para-typhoid fever. In the remaining cases definite bacteriological information was not available. One patient contracted the disease in Egypt, but the illness only developed by the time he arrived in this country. Three cases occurred in one house, the occupation followed by one member of this family was that of sewerman. In the case which proved fatal the disease was contracted and the patient treated in an institution situated outside the Borough. PUERPERAL FEVER. Fourteen cases were notified and one death occurred. On further investigation two of the cases were found to have been incorrectly diagnosed. In addition to the above, nine of the cases which were notified to be suffering from Puerperal Pyrexia were found to be really suffering from Puerperal Fever. The total number of cases, therefore, which occurred during the year was twenty one. This equals an incidence rate of 5.8 per 1,000 births and a case mortality of 4.8 per cent. The fatal case occurred in a woman who was not attended at her confinement, either by a doctor or midwife. 65 PUERPERAL PYREXIA. This condition was made notifiable by Regulations which came into force on October 1st, 1926. From that date until the end of the year thirteen cases were notified. Special inquiries were made concerning these cases in order to ascertain the cause of the Pyrexia. In two instances this was attributed to Mastitis, in one to Erysipelas, and in one to Pneumonia. The remaining nine cases were found to be suffering from conditions which should have caused them to have been notified as cases of Puerperal Fever and not as Puerperal Pyrexia. These nine cases have therefore been included in the list of Puerperal Fever cases. ERYSIPELAS. 80 cases were notified and 8 deaths occurred, as compared with 117 cases and 12 deaths during the previous year. ANTHRAX. One case was notified, but on further investigation it was found to have been incorrectly diagnosed. CEREBRO-SPINAL MENINGITIS. (Cerebro-Spinal Fever.) Three cases were notified, but one of these was subsequently found to have been incorrectly diagnosed. Of the two genuine cases one proved fatal. ANTERIOR POLIOMYELITIS AND POLIOENCEPHALITIS. Two cases were notified. One was admitted to the special hospital provided for cases of this disease, the other received treatment at a voluntary hospital in the Borough. Three deaths were registered as having been due to this disease, the existence of these three cases was only disclosed on death, as none of them had been notified previously. OPHTHALMIA NEONATORUM. Forty-three cases were notified, but three of these were subsequently found not to be St. Pancras cases; there were therefore 40 cases belonging to the Borough. This equals an incidence rate of 11.0 per 1000 births. The services of a visiting nurse were provided in 9 instances. Seven cases were admitted to the special hospital provided by the Metropolitan Asylums Board for the treatment of cases of this disease. The following table gives details concerning the cases in the form desired by the Ministry of Health:— Cases. Vision not Impaired. Vision Impaired. Total Blindness. Deaths. Notified. Treated. At Home. In Hospital. 40 24 16 34† 0 0 2* * Died from other causes. † Information not available respeoting 4 cases owing to removal from the Borough. 66 With reference to the 40 St. Pancras cases, the births were attended us follows:—By medical practitioners, 7 ; by midwives, 10; by medical students, 14 ; hospital (in-patients), 9. ENCEPHALITIS LETHARGICA. Eleven cases were notified and two other cases came to knowledge during the year. On further investigation five of the notified cases were found to have been incorrectly diagnosed. There were therefore eight genuine new cases during the year. Of these four have died, one is receiving treatment in an institution, one has been lost sight of, two have made a satisfactory recovery and were well when recently visited. One case, notified in 1925, died during 1926, making a total of five deaths from this disease during the year. PNEUMONIA. This disease is a frequent complication of other diseases, but when occurring in this way is not notifiable. The notifiable forms of Pneumonia are Acute Primary and Acute Influenzal Pneumonia. 218 cases of the former and 60 of the latter were notified during the year. If requested bv the medical attendant, a visiting nurse is supplied in necessitous cases at the cost of the Borough Council. During the year 65 cases were nursed under this arrangement, 873 nursing visits being paid. MALARIA. Two cases were notified ; in both instances the disease had been contracted abroad. One of the cases proved fatal. Two other deaths were registered as having been due to Malaria, but neither of these cases had been notified. DYSENTERY. Two cases were notified. In each instance the cause of the disease proved to be Flexner's Bacillus. This germ is a fairly common cause of Dysentery in this country, and the infection may be spread by persons who are " carriers," and who do not show any symptoms of the disease. Four deaths due to Dysentery, of eases which had not been notified, were also reported. MEASLES AND GERMAN MEASLES. These diseases are compulsorily notifiable in St. Pancras under Special Regulations sanctioned in 1920. All cases are notifiable by parents or guardians, but only the first case occurring in a house during an outbreak is notifiable by the medical attendant. An interval of two months since the previous case constitutes a fresh outbreak. From 1916 to 1919 inclusive these diseases were notifiable throughout the whole of England and Wales ; but at the end of the year 1919 notification was abandoned by order of the Ministry of Health. In a few districts, St. Pancras being one, notification was retained by means of a special local regulation. During the year 3,734 cases of Measles and 143 of German Measles were notified. Sixty-five deaths were registered as having been due to Measles and one to German Measles. Measles was very prevalent during the first four months of the year, and the type of the disease was somewhat severe. The services of a nurse were provided in all cases where this was desired by the medical attendant. 371 cases were admitted to hospital; these were usually cases where the home conditions were unsuitable. The death-rate from Measles was particularly high in Ward 6, in which is situated the Somers Town area. 67 TUBERCULOSIS. Particulars of all new cases of Tuberculosis and of all deaths from this disease during 1926 are given in the following table in the form required by the Ministry of Health :— Age Periods. New Cases. Deaths, Pulmonary. Non-Pulmonary. Pulmonary. Non-Pulmonary. M. F. M. F. M. F. M. F. 0—1 — — 4 2 — — 2 2 1—5 2 1 11 10 — — 5 5 5—10 4 4 20 17 — — — 5 10—15 5 3 5 5 1 1 1 — 15—20 8 9 4 4 5 4 1 1 20—25 35 26 6 3 9 11 1 1 25—35 51 44 3 6 18 18 1 2 35—45 37 24 3 2 27 10 1 2 45—55 43 13 — — 25 9 1 — 55—65 25 10 3 3 20 6 2 3 65 & upwards 7 3 1 — 9 2 1 — Totals 217 137 60 52 111 61 16 21 The total number of Primary notifications was 388 ; in addition to these, 51 cases, which had not been notified, came to knowledge by means of special death reports, and 27 cases by transfer from other districts. The total number of new cases during the year from all sources was therefore 466, equal to a notification rate of 2.15 per 1,000 of population. The deaths from all forms of Tuberculosis during the year numbered 212, equal to a death-rate of 0.98 per 1,000 of population. The corresponding rate for the previous year was 1.07 per 1,000 of population. It will be noted that, out of a total of 212 deaths from Tuberculosis, 51 were of cases which either died un-notified or were notified only at death. It is not satisfactory that so large a proportion of cases should come to knowledge only at death. In 8 instances Meningitis was stated to have been the cause of death, and this form of Tuberculosis is at times difficult to diagnose. In a certain number of cases some misunderstanding had existed, and the medical attendant was under the impression that the case had been notified previously. Allowing for all such cases the percentage of un-notified cases remains unduly high. 68 In a number of instances notifications were received very soon after the death of the patient, but these were not accepted, as such notifications do not comply with the regulations. In all cases of failure to notify, a communication is sent to the certifying practitioner asking for an explanation of the circumstances under which formal notification was not made. No case occurred in which it appeared to be desirable to institute proceedings for deliberate or wilful neglect to comply with the regulations. The following table gives details as regards " notification " with reference to all fatal cases of Tuberculosis which occurred during 1926:— Total deaths from all forms of Tuberculosis 212 Number dying un-notified or notified only at death 51 Number notified within 1 month of death 23 „„„3months „ 24 „„„ 6 months ,, 14 Of the 51 cases dying un-notified or notified only at death, 13 occurred in Poor Law Institutions, 23 in other Institutions or Hospitals, and 15 at home, etc. The number of cases of Tuberculosis notified and those which came to knowledge by means of Death Reports and transfers from other Districts are given in the following tables:— Public Health (Tuberculosis) .Regulations, 1912. Summary of Notifications daring the period from 3rd January, 1926, to the 1st January, 1927 (inclusive). 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 the other Doctors). Poor Law Institutions. Sanatoria. Poor Law Institutions. Sanatoria. Age Periods. 0 to 1 1 to 5 5 to 10 10 to 15 15 to 20 20 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 and upwards. Local. Under 5 5 to 10 10 to 15 Total. Pulmonary Males — l 2 3 7 32 42 27 37 19 a 172 217 1 1 — 2 2 48 184 22 132 Females — 1 3 2 8 24 40 22 12 9 3 124 166 — 1 — 1 1 32 80 9 55 Non-pulmonary Males 2 9 18 4 4 6 2 3 — 2 1 51 57 — — 1 1 2 1 28 — 19 Females — 6 12 5 1 3 4 2 — 2 — 35 42 — 2 — 2 4 2 :6 — 10 Totals 2 17 35 14 20 65 88 54 49 32 6 382 482 1 4 1 6 9 83 318 31 216 Age Periods. Cases not Notified—Information obtained from Special Death Reports and by Transfer from other districts. 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 1 3 9 10 6 6 5 43 Females — — — 1 1 2 4 2 1 1 — 12 Non-Pulmonary Males 2 2 2 — — — 1 — — 1 — 8 Females 2 4 3 — 3 — 2 — — 1 — 15 Totals 4 6 6 3 5 5 16 12 7 9 5 78 70 The following table gives particulars as to the prevalence and fatality of this disease during the past 10 years:— Year. Estimated Population. Primary Notifications. Deaths. Notification Bate. Death Rate. Pulmonary. Other forms. All forms. Pulmonary. Other forms. All forms. Pulmonary. Other forms. All forms. Pulmonary. Other forms. All forms. 1917 218387 825 169 994 353 91 444 3.78 0.77 4.55 1.62 0.42 2.03 1918 218387 1034 203 1237 403 82 485 4.74 0.93 5.67 1.85 0.37 2.22 1919 218387 799 206 1005 268 73 34 > 3.66 0.94 4.60 1.23 0.33 1.56 1920 218387 684 132 816 249 63 312 3.07 0.59 3.67 1.12 0.28 1.40 1921 212900 546 153 699 250 54 304 2.56 0.72 3.28 1.17 0.25 1.43 1922 212500 534 148 682 257 58 315 2.51 0.70 3.21 1.21 0.27 1.48 1923 214400 440 137 577 211 61 272 2.05 0.64 2.69 0.98 0.28 1.27 1924 214300 447 119 566 227 44 271 2.05 0.54 2.59 1.04 0.20 1.24 1925 215900 389 103 492 180 51 231 1.80 0.48 2.28 0.83 0.24 1.07 1926 216400 354 112 466 175 37 212 1.64 0.52 2.15 0.81 0.17 0.98 The table below shows the number of notifications and the number of deaths, together with the corresponding rates per 1,000 of population for each Ward of the Borough:— Tuberculosis (All Forms). Ward. Notifications. Deaths. Number. Kate per 1000 of Population. Number. Rate per 1000 of Population.[/### 1 61 1.7 26 0.7 2 39 1.7 16 0.7 3 87 2.4 44 1.2 4 56 2.1 24 0.9 5 68 2.2 33 1.1 6 50 2.4 23 1.1 7 35 2.3 17 11 8 62 2.2 28 1.0 Homeless 8 — 1 — Totals 466 2.2 212 1.0 71 Public Health (Tuberculosis) Regulations, 1924. These Regulations placed various additional duties upon local Authorities, and included the compilation of a register of cases of Tuberculosis of all kinds who are residents of the Borough. The following table gives this information for the year ended December 31st, 1926:— Pulmonary. Non-Pulmonary. Total. Number of cases on the Register at the commencement of the year 1926 1187 428 1615 Number of cases notified during the year 356 114 470 1543 542 2085 Number of cases removed from the Register during the year (from death or other causes) 302 99 401 dumber of cases remaining on the Register at the end of the year 1241 443 1684 Public Health (Prevention of Tuberculosis) Regulations, 1925. These regulations, which came into force on the 31st July, 1925, provide that " no " person who is aware that he is suffering from tuberculosis of the respiratory tract shall enter " upon any employment or occupation in connection with a dairy which would involve the "milking of cows, the treatment of milk, or the handling of vessels used for containing milk." The Council may require any such person to discontinue his employment or occupation in that capacity. No formal action was taken during the year under the above regulations. A youth who had recently commenced work in a dairy, and who was found to be suffering from early Tuberculosis, voluntarily gave up this work, and later, when discharged from the sanatorium, took up other employment as the result of an informal letter of advice. Boarding-out of Children from Tuberculous Homes. This scheme was initiated ill 1925, and provided for:— (a) The boarding out of children living in heavily infected and overcrowded homes, and for (b) The boarding out of children who were being discharged from Institutions, if the homes were unsuitable and inimical to the maintenance of health. 72 At a later date the scheme was further extended to include : (c) " Weakly " children, living under conditions likely to subject them to infection, and children, in suitable instances, whose parents were under treatment for tuberculosis. Originally the children were sent away for a limited period. When the scheme was extended it was decided that the children, in all categories, might be kept away as long as the home conditions were unfavourable. The arrangements are made by the Invalid Children's Aid Association, on behalf of the London County Council. During the year 14 children have been boarded out under the scheme. The Tuberculosis Care Committee. Only one meeting of the full Committee has been held during the year ; a small SubCommittee has met, usually once a week, to deal with routine duties. TUBERCULOSIS DISPENSARY. This is situated at 39, Oakley Square, and forms part of the premises of the St. Pancras General Dispensary. It comprises the first floor of the building, and consists of a waiting room, consulting room, office and laboratory. Two dressing rooms are obtained by partitioning off a portion of the waiting room. Nine consultations are held in each week, 2 in the morning, 5 in the afternoon, and 2 in the evening. The following report on the work of the Dispensary during the year has been furnished by the Tuberculosis Officer:— The number of New Cases who attended the Dispensary during the year 1926 was 685, as compared with 700 in 1925. The attendances, however, increased from 4,010 to 4,580, this can perhaps be accounted for by the increase in the number of visits of the Health Visitors to the homes of patients by over 1,000 visits. The new Return of Work required by the Ministry of Health in Memorandum 37/T has necessitated revising the Dispensary Register and has increased the clerical work of the Dispensary, but it is hoped that, once the new system is established, this side of the Dispensary work will decrease again. The Monthly Reports to the Council have been revised in order to make them supplement the Annual Report. The relations between the Dispensary and the General Practitioners continue to be friendly, and there has been a noticeable increase in the number of early and suspicious cases sent up for diagnosis. The year has been uneventful, but the total work done is satisfactory. A. VINEY, m.r.c.s., l.r.c.p., d.p.h. 73 The following table gives a summary of the work carried out at the Tuberculosis Dispensary during the year:— Pulmonary. Non-Pulmonary. Total. Adults. Children. Adults. Children. Adults. Children. M. F. M. F. M. F. M. F. M. F. M. F. A.—New Cases examined during the year (excluding contacts):— (a) Definitely tuberculous 104 59 2 3 6 4 4 7 110 63 6 10 (b) Doubtfully tuberculous — — — — — — — — 40 48 18 13 (c) Non-tuberculous — — — — — — — — 33 53 58 59 B.—Contacts examined during the year:— (a) Definitely tuberculous 3 3 1 1 — — 1 — 3 3 2 1 (b) Doubtfully tuberculous — — — — — — — — 1 7 4 2 (c) Non-tuberculous — — — — — — — — 8 33 60 50 C.—Cases written off the Dispensary Register as— (a) Cured 1 2 — 3 1 1 2 — 2 3 2 3 (b) Diagnosis not confirmed or non-tuberculous (including cancellation of cases notified in error) — — — — — — — — 56 105 127 122 D.—Number of Persons on Dispensary Register on December 31st:— (a) Diagnosis completed 333 227 16 39 25 22 40 32 358 249 56 71 (b) Diagnosis not completed — — — — — — — — 22 34 10 7 Number of persons on Dispensary Register on January 1st 663 Number of patients transferred from other areas and of " lost sight of " cases returned 48 Number of patients transferred to other areas and cases " lost sight of" 118 Died during the year 51 Number of observation cases under A (b) and B (b) above in which period of observation exceeded 2 months 39 Number of attendances at the Dispensary (including Contacts) 4533 Number of attendances of non-pulmonary cases at Orthopaedic Out-stations for treatment or supervision 3 Number of attendances, at General Hospitals or other Institutions approved for the purpose, of patients for— (a) " Light" treatment 32 (b) Other special forms of treatment 44 Number of patients to whom Dental Treatment was given, at or in connection with the Dispensary 43 Number of consultations with medical practitioners:— (а) At homes of applicants 26 (b) Otherwise 91 Number of other visits by Tuberculosis Officers to homes 145 Number of visits by Nurses or Health Visitors to homes for Dispensary purposes 4580 Number of— (a) Specimens of sputum, &c., examined 804 (b) X-ray examinations made in connection with Dispensary work 33 Number of Insured persons on Dispensary Register on 31st December 600 Number of Insured persons under Domiciliary Treatment on the 31st December 202 Number of Reports received during the year in respect of Insured persons:— (a) Form G.P. 17 8 (b) Form G.P. 36 14 (c) Form G.P, 35 10 74 Section VII.—OTHER SERVICES. 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. Small-pox 1 1 6 6 Scarlet Fever 405 393 413 411 Diphtheria 496 490 513 510 Enteric Fever 12 11 11 1 Erysipelas 57 57 57 — Puerperal Fever 13 11 14 7 Encephalitis Lethargica 3 3 3 2 Cerebrospinal Meningitis 1 1 1 1 Poliomyelitis 2 2 2 — Tuberculosis 187 187 206 151 Measles 31 31 32 29 Vermin and Scabies 79 79 106 79 Other Diseases 287 287 309 59 Totals 1574 1553 1673 1256 The following table gives the number of articles disinfected or destroyed during the year on account of infectious disease or verminous condition:— Infectious Disease. Verminous. Destroyed. Disinfected. Destroyed. Disinfected. Beds, mattresses and palliasses 59 1619 8 69 Bolsters and pillows 31 3390 1 60 Sheets, blankets and counterpanes 16 4332 — 119 Rugs, mats, cushions, carpets, covers and curtains 18 691 — 30 Wearing apparel 21 1649 — 31 Books — 64 — — Sundries 18 291 — 4 Totals 163 12036 9 313 The tables above are exclusive of the disinfection of the clothing of persons who Attended tbe cleansing station on account of being infested by vermin or suffering from scabies, 75 Cleansing Station. The amount of work carried out during the year is shown in the following table. The figures represent the number of attendances. At each attendance the person receives a bath, and the clothing is disinfected:- Men. Women. Children under 15. Total. Vermin 945 56 4749 *5750 Scabies 20 53 583 656 Totals 965 109 5332 6406 • Includes 503 males and 11 females who had no home address, The staff of the Disinfecting and Cleansing Station consists of a Foreman, a Disinfector and 2 Motor Drivers and Disinfectors; a Matron of the Cleansing Station and 2 Women Assistants. DISINFECTING VANS. The question of substituting motor, in place of horse-drawn, vehicles was considered by the Public Health Committee during the year. The Council endorsed a recommendation to purchase two 12-cwt. Morris Chassis, each fitted with a special zinc-lined body made to the Council's specification. These have proved very satisfactory in use, and the transport of infected and disinfected articles is carried out with much greater expedition. BACTERIOLOGICAL WORK. To aid in diagnosis and to detect contact or carrier cases the Borough Council provides bacteriological diagnosis, free of charge, in connection with certain diseases. In addition to the above, the preparation and supply of vaccines is undertaken, if desired by the medical attendant, for use in connection with cases of Puerperal Fever. This work is performed under an arrangement made with the Council by Professor F. H. Teale, m.d., of University College Hospital. The undermentioned examinations were made during the year:— Nature of Specimen. Positive. Negative. Total. Swabs for Diphtheria Bacilli 253 1159 1412 Blood, re Typhoid Fever 3 6 9 Sputum for Tubercle Bacilli 50 458 508 Facilities for the examination of Cerebro-spinal fluid in suspected cases of Poliomyelitis, Encephalitis Lethargica and Cerebro-spinal Fever are available through the London County Council's laboratory, and for the examination of blood in cases of suspected Malaria through the Ministry of Health. APPENDIX. 78 Table No. 1. VITAL STATISTICS OF WHOLE DISTRICT OF ST. PANCRAS DURING 1926 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. Number. Rate. Number. Rate per 1,000 Nett Births. Number. Rate. 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+ 1918 196883 175716 3339 3318 16.8* 3789 21.5† 626 751 340 102 3914 22.3† 1919 228585 219434 3804 3824 16.7* 3104 14.1† 670 496 336 88 2930 13.4† 1920 228980 228178 6191 5934 25.4* 3007 12.9† 713 601 435 73 2895 12.4† 1921 212900 — 5099 4764 22.4 2836 13.3 651 593 360 76 2778 13.0 1922 212500 — 4865 4559 21.5 3219 15.1 715 603 337 74 3107 14.6 1923 214400 — 4654 4348 20.3 2735 12.8 634 484 272 63 2585 12.1 1924 214600 214300 4447 4112 18.8* 2937 13.4† 640 551 303 74 2848 13.0† 1925 216300 215900 4111 3880 17.9* 2864 13.3† 680 561 280 72 2745 12.7† 1926 216800 216400 4129 3612 16.7* 2992 13.8† 855 543 274 76 2680 12.4† Area of district in acres (land and inland water), 2694.4; total population at all ages, 211,366; number of inhabited houses, 24,660; average number of persons per house, 8.57; at Census, 1921. *Based on total population. †Based on civil population. 79 'able No. 2. Deaths Registered from all Causes for the Year 1926. Nots.—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 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. Persons 1.— General Diseases. 1. Enteric Fever - - - - - - - - - - - - — — - - - 1 - — - - - - - - - 1 — 1 2. Typhus Fever - - - - - - - - — - — — — — - - - - - - — - - - - - — — — — — 3. Relapsing Fever - - - - - - - - - - — - — - - - - - - - - - — - - - — — — — — 4. Malaria - - - - - - - - - - - - - - - 1 1 - 1 - - - — - - - — — 2 1 3 5. Small Pox— (a) Vaccinated - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - (b) Not Vaccinated - - - - - - - - - - - - - - - - - - - - - - - - - — - — - - - (c) Doubtful - - - - - - - - - - - - - - - - - - - - - - - - - — - — - - - 6. Measles 13 12 17 9 7 5 37 26 - 2 — - - - - - - - - - - - - - - — - — 37 28 65 7. Scarlet Fever - - - - 1 - 1 - - - - - - - - 1 - - - - - - - - - — - — 1 1 2 8. Whooping Cough 4 7 5 3 2 2 11 12 - 1 — - - - - - - - - - - - - - - — - - 11 13 24 9. (a) Diphtheria 1 - 3 - 2 2 6 2 2 2 - - - - - - - - - - - - - - - - - - 8 4 12 (b) Croup - - - - - - - - - - - - - - _ - - - - - - - - - - - - - - - - 10. Influenza - 1 - 1 - - - 2 - - - - - 1 2 1 4 1 1 - 2 8 3 1 1 1 - 1 13 16 29 11. Miliary Fever - - - - - - - - - - - - - - - - - - - - - - - - - - - — - - - 12. Asiatic Cholera - - - - - - - - - - - - - - - - - - - - - - - - - - - — - - - 13. Cholera Nostras - - - - - - - - - - - - - - - - - - - - - - - - - - - — - - - 14. Dysentery - - - - - - - - - - - - - - - - 2 - - 2 - - - - - - - — 2 2 4 15. Plague - - - - - - - - - - - - - - - - - - - - - - - — - - - — - — - 16 Yellow Fever - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 17 Leprosy - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 18. Erysipelas - - - - - - - - - - - 1 - - - - 1 - 1 - - 2 2 - - 1 - - 5 3 8 19 (a) Mumps - - - - - l - 1 - - - - - - - - — - - - - - - - - - - — 1 — 1 (6) German Measles - - - - - - - - - - 1 - - - - - - - - - - - - - - - - - 1 - 1 (c) Varicella - - - — - - - - - - - - - - - - - - - - - - - - - - - - - - — (d) Other Epidemic Diseases - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - — 20 (a) Pyæmia - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - — (b) Septicæmia - 1 1 - - - - 1 1 - - - - - - - - - - - - - 1 - - - - - 2 1 3 (c) Vaccinia - - - — - - - - - - - - - - - - - - - - - - - - - - - — - — 21 Glanders - - - - - - - - - - - - - - - - - - - - - - - - - - - - — - — 22 Anthrax (Splenic Fever) - - - - - - - - - - - - - - - - - - - - - - - - - - - - — - — 23 Rabies - - - — - - - - - - - - - - - - — - - - - - - - - - - - — - — 24 Tetanus 1 - - - - - 1 - - - - - 1 - - - - - - - - - - - - - - - 2 - 2 25 Mycoses - - - - - - - - — - - - - - - - - - - - - - - - - - - - - - - 26 Pellagra - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 27 Beri-beri - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - — 28 (a) Pulmonary Tuberculosis - - - - - - - - - - 1 1 12 15 16 16 27 10 23 8 18 6 8 1 — 1 - - 105 58 163 (b) Phthisis (not defined as tuberculous) - - - - - - - - - - - - 2 - 2 2 - - 2 1 2 - 1 - — - - - 9 3 12 29 (a) Acute Phthisis - - - — - - - — - - - - 1 2 - 1 - - - - - - - - - - - - 1 3 4 (b) Acute Miliary Tuberculosis 1 - - 1 - - 1 1 - 1 - - - - - - - - - - - - - - - - - - 1 2 3 30 Tuberculous Meningitis 1 2 1 - 2 4 4 6 - 2 - - - - - - - - - - - - - - - - - - 4 8 12 31 (a) Tabes Mesenterica - - - - - - - - - 1 - - - - - - - - 1 - - - - - - - - - 1 1 2 (b) Other peritoneal & intestinal tubercle - - - — 2 - 2 - - - - - - - - 1 - 2 - - - - - - - - - - 2 3 5 32 . Tuberculosis of Spinal Column - - - - - - - - - - - - 1 - - - - - - 1 - - — - - - - 2 - 2 33 . Tuberculosis of Joints - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - — 34 (a.) Lupus - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - — (b) Scrofula - - - - - - - - - - - - - - - - - - - - - - - — - - - - - - - (c) Tuberculosis of other Organs - - - - - - - - - 1 1 - - - - - 1 - - - - 1 - - 1 - - - 3 2 5 35 Disseminated Tuberculosis - - - - - - - - - - - - - - - 1 - - - - 1 2 - — - - - - 2 2 4 36. Rickets, Softening of Bones - - 1 - - - 1 - - - - - - - - - - - - - - - - - - - - - 1 - 1 37. Syphilis - 1 - - - - - 1 _L — 1 2." - - 2 2 4 38 . Other Venereal Diseases - - - - - - - - - - - - - - - - - - - - - - - - - - - - - — — 39. Cancer of the Buccal Cavity - - - - - - - - - - - - - - - - - - 6 - 10 1 4 3 4 - - - 24 4 28 40. ,, Stomach, Liver, &c. - - - - - 1 - 1 - - - - - 2 1 2 2 8 4 25 9 16 7 7 4 - 2 60 30 90 41 ,, Peritoneum, Intestines, and Rectum - - - - - - - - - - - - 1 - 1 - 2 1 2 7 7 6 11 7 - 5 - - 24 26 50 42. „ Female Genital Organs - - - - - - - - - - - - - - - - - 9 - 11 - 9 - 5 - 4 - - - 38 38 43. ,, Breast - - - - - - - - - - - - - - - 2 - - - 8 - 6 - 8 - 3 - 1 - 28 28 44. ,, Skin - - - - - - - - - - - - - - - - - - - - - - 1 - - - - - - 1 1 45. Cancer of other or unspecified Organs - - - - 1 1 1 1 - - - - - 2 2 - - 4 6 6 3 18 4 10 4 5 6 - 42 24 66 46. Other Tumours (situation undefined) - - - - - - - - - - - - - - - - - - - 1 3 1 1 l - 1 - - 4 4 8 47. Rheumatic Fever - - - - - - - - - - - - 1 - 2 1 - 1 - 1 - 1 - 1 1 - - - 6 4 10 48. (a) Chronic Rheumatism - - - - - - - - - - - - - - - - - - - - 1 - - - - - 1 - - 3 3 (b)Osteo-Arthritis - - - - - - - - - - - - - - - - - - 1 - - - 1 - 1 - 2 - - 5 5 (e) Gout - - - - - - - - - - - - - - - - - - - - - - 1 - - - - - 1 - 1 9. Scurvy - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 80 Deaths Registered from all Causes for the Year 1926—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. per sons 1. General Diseases—con. 50. Diabetes — — - — — — — - - — 1 - - - — - 1 1 — 1 1 2 1 5 1 — - - 5 9 14 51. Exophthalmic Goitre — — — — — - — h — — - - 2 — - - 1 — — - — — 1 — — - - — 4 4 52. Addison's Disease - - - - - - - - - - - - - - 1 1 - - - - - 1 — - - - 1 2 3 53. Leucocythæmia Lymphadenoma — — — — 1 — 1 — 1 — — - - - — - 2 2 — 1 1 1 - - - - - - 4 4 8 54. Anæmia, Chlorosis — — — — — — - — - - - - - - - 2 - 1 — — 2 1 2 — — 1 - - 4 5 9 55. (a) Diabetes insipidus - — — - - - — — — — - — — - — — - — - - - — - - (b) Purpura — — - — — — - - - — - - - - — — - — — — — — — — — - - — — — - (c) Hæmophilia — — — — — — - — — — - — — — — — — — — — — — — (d)Other General Diseases - — — - — - - - - - - - - — — — - - — — - - — - — - - - — — - 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 — 1 2. Diseases of the Nervous System and of the Organs of Special Sense. 60. (a) Encephalitis Lethargica — - — - 1 — 1 - 1 — - - l - — - - - — 1 - 1 - - - — - — 3 2 5 (b) Encephalitis, other forms - 1 — — — 1 1 1 — — j 2 2 4 61. (a) Cerebrospinal Fever - — 1 — — 1 — - — — - — — - - - - - - — - - - - - 1 — 1 (b) Posterior Basal Meningitis — - — - — — - - - — - - - - — - - - - - - - — - - - — — - — (c) Meningitis, other forms 1 2 — 1 — — 1 3 - - - - - 1 — - - 1 1 1 - - — - - - — 2 6 8 62. Locomotor Ataxy — - - — — — - — — — — - — — — - - - 3 - 2 2 - - 1 - - 6 2 8 63. (a) Anterior Poliomyelitis — — - — — 1 - 1 - - - - 1 — - 1 - 1 - - - - - - - — 2 1 3 (b) Other Diseases of the Spinal Cord — - - - — — - - - — - — - 1 — 1 2 - 1 2 4 - 5 2 1 3 - — 13 9 22 64. Cerebral Hemorrhage, Apoplexy - - - - - - - - - — — - - - — - - 1 4 3 5 13 5 16 6 12 2 2 22 47 69 65. Softening of Brain - - - - - - - - - - - - - - - - 1 - - 1 - - - - 1 — - 1 2 2 4 66. Paralysis without specified cause — - - - - — - - - - - - - - — l 1 - - 1 - - - 2 4 4 - 1 5 9 14 67. General Paralysis of the Insane - - - - - - - - - - - - - - - 1 3 - 5 2 2 - 2 - - - - — 12 3 15 68. Other forms of Mental Alienation — — — — — — - — - - - - - 1 — l 2 2 2 1 - - - - - - - — 4 5 9 69. Epilepsy — — — — — — - — — — — l 1 2 2 2 5 2 - 2 1 - 1 - — - — 9 10 19 70. Convulsions (Non-puerperal; 5 years and over) — - — — — — - — - — — — - - — - - - - - - - - - - - - - - - — 71. Infantile Convulsions (under 5 years) — 2 — — - — - 2 - — — — - — - - - - - - - - - - - - — — 2 2 72. Chorea - — — - - - - - - — — — - — - - - - - - - - - - — — — — — 73. Hysteria, Neuralgia, Neuritis — — — — — — - - - — - — - — — - - 1 1 - - - - 1 - — - - — 2 2 74. Other Diseases of the Nervous System — — — 1 — 1 — 1 — — — 1 1 — 2 1 1 1 1 - - 2 - - - — 8 4 12 75. Diseases of the Eyes and Annexa - - - - - - - - - — - - - — — - - - - - - - - - - - - - — - 1 76. (a) Mastoid Disease — — — — - — — - - - — 1 - — - - - - — - - - - - - - - - - 1 1 (b) Other Diseases of the Ears 1 - — — — — 1 — — — — — - 1 - 1 - 1 - - - - - - - - — 4 - 4 3. Diseases of the Circulatory System. 1 77. Pericarditis — — — — — — — — - — — — 1 — — - - — - - - - - - - - - — 1 — 1 78. Acute Myocarditis and Endocarditis — — — — — — - — - — — — — 2 — 1 1 2 5 - 2 2 - - - - - — 8 7 15 79. (a) Valvular Disease — — — — — — - — — — 1 2 3 1 — 3 1 8 8 7 18 8 9 7 4 10 1 4 45 50 95 (b) Fatty Degeneration of the Heart - — — — - — - — - - - - - — — 1 2 1 1 4 4 2 8 3 1 1 - 1 16 12 28 (c) Other Organic Disease of the Heart - - — - — — - - - — - - — 1 — - 6 1 15 8 34 3 33 32 29 52 7 9 124 126 250 80. Angina Pectoris - - - - - - - - - - - - - - - - - - 2 1 3 - 1 - 2 2 - - 8 3 11 81. (a) Aneurysm — - - — — — - - - - - - — — - - 2 1 1 1 1 1 3 - - - - - 7 3 10 (b) Arterial Sclerosis — — — — — — - — — — - — — - 1 - - 2 2 3 8 7 19 17 14 22 5 9 49 60 109 (c) Other Diseases of Arteries — — — — — — - — — — — — — — — - - - - - - - - 1 - - - — — 1 1 82. (a) Cerebral Embolism and Thrombosis — — — — — - - — — — — — — — — - l 2 2 2 2 2 4 6 7 12 1 — 17 24 41 (b) Other Embolism and Thrombosis — — — — — — — - - — — — — — — 2 - - - - - - 1 - 1 - - 1 2 3 5 83. Diseases of the Veins (Varices, Haemorrhoids, Phlebitis, etc.) - - - - - - - - - - - - - - - - - 1 - - - - - - - - - - — 1 1 84. (a) Status Lymphaticus — — — — — — - — — — — — — — - - - 1 - - - 1 - - - - - - 1 2 2 (b) Other Diseases of the Lymphatic System — - — — — — - - - — — — — - - - - - - - - - - - - - - - - — — 85. Hæmorrhage; other Diseases of the Circulatory System — — — — 1 - 1 — - — — — — — - - - - - - 1 - - - - - - - 2 — 2 4. Diseases of the Respiratory System. 86. Diseases of the Nasal Fossæ — — — — — - - - - — — — - — - - - - - - - - - - - - - - — — — 87. Diseases of the Larynx - 1 - - - - - 1 - - - - - - - - - 1 1 - - - - - - - - - 1 2 3 88. Diseases of the Thyroid Body 1 - - - - 1 - - - - - - - - - - - - - - - - 1 - 1 - - 1 2 3 89 & 90. Bronchitis 7 7 3 3 - 13 7 - - - - - 1 4 - 6 2 11 6 26 24 40 30 34 32 9 14 143 116 259 91. Broncho-Pneumonia 22 14 5 3 6 1 33 18 — — - - - l - 2 1 7 3 7 2 7 4 1 4 - 1 58 33 91 92. (a) Lobar Pneumonia 1 1 — 1 — 2 1 4 — — 1 — 5 — 2 2 31 - 6 3 3 2 7 3 - 1 - 1 28 16 44 (b) Pneumonia (type not stated) 1 — — 1 1 — 2 1 — - — — — - 1 1 l - 2 1 2 1 5 1 - 2 - - 13 7 20 93. Pleurisy — — - - — — - - - - - - - - 1 - - - 1 - 1 - 1 - - 1 - - 4 1 5 81 Deaths Registered from all Causes for the Year 1926—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. PERSONS 4. Diseases of the Respiratory System—con. 94. Pulmonary Congestion,Pulmonary Apoplexy - - - — — - — — — - — — — 1 - - - - - - - - - - 1 — — 1 1 2 95. Gangrene of the Lung - - - — — - — — — — - - — — — — 1 — — — - - — — — — — - 2 — 2 96. Asthma - - - - — - — - - — - — 1 - — — 1 — 1 — 3 — 6 4 1 — — - 13 4 17 97. Pulmonary Emphysema - — - — — - — — - — - — — — — — — — — — — — 1 1 - — — 1 1 2 98. (a) Fibroid Disease of the Lung - - - - - - - - - - - - - - - - - - 1 — 1 - - - - - - — 2 — 2 (b) Other Diseases of the Respiratory System - - - - - - - - - - - - - - - - - - - - 1 - - - - - - - 3 - 3 5. Diseases of the Digestive System. 99. (a) Diseases of the Teeth and Gums - - — — — - - - - - - - — - - - — — — — — - - - - - - - — — - (b) Other Diseases of the Mouth and Annexa - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 100 Diseases of Pharynx, Tonsillitis - - — — 1 - 1 — - - - — — — — — — — — — — — — — — — 1 — 1 101 Diseases of (Esophagus — - - — — - - - - — - — — — — — — — 1 — - - — - — — — - 1 — 1 102 Perforating Ulcer of Stomach — - - - - - - - - - - - — — — 1 3 - 4 3 1 - 2 - — — — — 10 4 14 103 (a) Inflammation of Stomach — — — 1 - 1 - - — - — — — — — 1 — 1 1 2 - — 1 — 2 — - 5 4 9 (b) Other Diseases of Stomach — — — - - - - - - - — — — — — — — 1 1 — - — 1 — — — 3 3 104 & 105. (a) Infective Enteritis 3 2 - - - — 3 2 - - - - — — — — — — — - - — - — - — — 3 2 5 (b) Diarrhoea (not returned as infective) 4 3 1 - - - 5 3 - - - - - - - - - - - - - - - - - - - - 5 3 8 (c) Enteritis (not returned as infective) 5 6 - 1 - 1 5 8 - - - - — - — 1 — 1 l 1 1 - - - - - - - 7 11 18 (d) Gastro-Enteritis (not returned as infective) 14 8 5 - - 19 8 - - - - - - - - - - - - - 1 - - 1 1 — - 21 11 32 (e) Dyspepsia (under 2 years of age) — — - - - - - - - - - — — — — — — — — - - - - — — — — — — — (f) Colic - - - - - - - - - - - — — — — — — — - - - — - — — — — — — — (g) Ulceration of Intestines — - - - - - - - - - - — — — — — — — — — 1 - — — — — — — 1 — 1 (h) Duodenal Ulcer — - - - - - - - - - - — — — 1 - — — - - - - - 1 — — - - 1 1 2 106 Ankylostomiasis - - - - - - - — - - - — - - - - - - - - - - — — — — - - - - - 107 Other Intestinal Parasites - - - - - - - — - - - — — — — - — — - - — — — — - — - - — 108 Appendicitis - - - - 1 - 1 - - - - — 1 2 2 — - — 3 1 2 - — - 1 — — - 11 5 16 109. (a) Hernia — - - - - — - - - - - 1 - - - - - - - - - - 1 1 1 1 — — 5 8 13 (b) Intestinal Obstruction 3 - - - 1 - 4 - - - - - 2 — — 3 1 1 1 1 - - 2 — 2 1 — 12 7 19 110 Other Diseases of the Intestines - - - - - - - - - - - - — — — — 1 1 — 1 - - — 1 — - - - 2 3 5 111 Acute Yellow Atrophy of Liver — - - - - - - — - - - - - 1 — — - — - - - - — - - — — — — 1 1 112 Hydatid of Liver — - - - - - - - - - - - — — — — - 1 - — - - — - — — — — — 1 1 113 (a) Cirrhosis of the Liver (not returned as alcoholic) - - - - - - - - - - - - - 1 2 1 - - 5 4 7 1 2 2 - - - - 16 9 25 (b) Cirrhosis of the Liver (returned as alcoholic) - - - - - - - - - - - - - - - - - - - 1 - - - - - - - - - 1 1 (c) Diseases formerly classed to " Other Diseases of Liver and Gall Bladder' - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 114 Biliary Calculi - - - - - - - - - - - — - - 1 — - — - - 2 - 3 - - - - 3 5 8 115 Other Diseases of the Liver - - - - - - - - - - - — — — — - 1 - 2 - - 2 2 — 2 — — 2 8 10 116 Diseases of the Spleen - - - - - - - - - - - - — - — - — - — - - - - - - — — — — 117. Peritonitis (cause unstated) - - - - - - - - - 2 - 1 - — — - — 2 1 - - - - — - 2 4 6 118. Other Diseases of the Digestive System - - - - - - - - - - - — - — 1 1 - — 1 — 2 - - - 1 - — — 5 1 6 6. Non-Venereal Diseases of the Genito-Urinary System and Annexa. 119. Acute Nephritis - - - - - - - - - - - - 1 - - -_ 1 - — - - - 1 - - - - 3 - 3 120. Bright'sDisease - - - - - - - - - - - - - - 1 3 - - 5 6 17 13 19 6 7 1 - - 53 33 86 121. Chyluria - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 122. Other Diseases of the Kidney and Aunexa - - - - - - - - - - - - - - - 1 - 1 - 1 - - - 1 - - - - 2 4 6 123. Calculi of the Urinary Passages - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 124. Diseases of the Bladder - - 1 - - - 1 - - - - - - - - - - - - - - - 1 - 2 1 - - 4 1 5 125. Diseases of the Urethra, Urinary Abscess &c. - - - - - - - - - - - - - - - - 1 - 1 - - - 2 - 1 - - - 5 - 5 126. Diseases of the Prostate - - - - - - - - - - - - - - - - - - 1 - 1 - 4 - 2 - 1 - 9 - 9 127. Non-Venereal Diseases of Male Genita Organs - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 128. Uterine Hasmorrhage (Non-puerperal) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 129. Uterine Tumour (Non-cancerous) - - - - - - - - - - - - - - - - - 2 - - - - - - - - - - - 2 2 130. Other Diseases of the Uterus - - - - - - - - - - - - - - - 1 - - - 1 - - - - - - - - - 2 2 131. Ovarian Cyst, Tumour (Non-cancerous) - - - - - - - - - - - - - - - 1 - - - 1 - - - - - - - - - 2 2 135. Other Diseases of the Female Genita Organs - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 1 1 136. Non-puerperal Diseases of the Breas (Non-cancerous) - - - - - - - - - - - - - - - - - - - - - - - - - 1 - - - 1 1 82 Deaths Registered from all Causes for the Year 1926—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. PERSONS 7. The Puerperal State. 134. Accidents of Pregnancy - - - - - - - - - - - — 2 - 1 — - - - — — — — — - - 3 3 135. Puerperal Hæmorrhage - — — - - - - - - — — - — — 1 - - — - - — — - — — — — — 1 1 136. Other Accidents of Childbirth - — - - - - - - - - - - - - - 1 — - — - - - - - - - - 1 1 137. Puerperal Fever — - - - - - - — - - 1 — — - - — — — — — - — — — — — 1 1 138. ,, Albuminuria and Convulsions — — - - - - - - - - - — — 1 - 1 — — — — — - — — — — — 2 2 139. ,, Phlegmasia Alba Dolens, Embolism, and sudden death - - - - - - - - - - - - - - - 1 - 1 - - - - - - - - - - - 2 2 140. ,, Insanity - - - - — - - - — - — — - — — - - — - — — - - — — — — — — 141. ,, Diseases of the Breast - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 8. Diseases of the Skin and of the Cellular Tissue 142. (a) Senile Gangrene - - - - - - - - - — - — - - — - - - - — 1 — 1 - 2 1 — — 4 1 5 (b) Gangrene (other types) - - - - - - - - - - - - - - - - - - - — — — — - - — - — - - - 143. Carbuncle, Boil - - - - - - - - - - - - - - 1 - l - - - 1 — - - — - — 2 1 3 144. Phlegmon, Acute Abscess - - 1 - - - 1 - - - - - - - — — — - - — — — - - — - — 1 1 2 145. Diseases of the Integumentary System - - 1 - - - 1 - - - - - - - - - l — — - - 2 — - - — - - 2 2 4 9. Diseases of the Bones and of the Organs of Locomotion. 146. Diseases of the Bones - - - - - 1 - 1 - 1 - - 2 - - 1 1 — — l 1 — - - - - - — 4 4 8 147. Diseases of the Joints - - 1 - 1 - 2 - - - - - - - - - l — — — - — 1 - - - - — 4 - 4 148. Amputations - - - - - - - - - - - - - - - - — — — — - - - - - - - - - - - 149. Other Diseases of Locomotor System - - - - - - - - - - - - - - - - - — 1 - - - - - - - - - 1 - 1 10. Malformations. 150. Congenital Malformations l8 7 1 - - - 19 7 - - - - - - - - - - — — - - - - - - - - 19 7 26 11. Diseases of Early Infancy. 151. (a) Premature Birth 32 25 - - - - 32 25 - - - - - - - - - - - — - - - - - - - - 32 25 57 (b) Infantile Debility, Icterus, an Sclerema 7 11 - - - - - 7 11 - - - - - - - - - - - - - - - - - - - 7 11 18 152. Other Diseases peculiar to early Infancy 9 5 - - - - 9 5 - - - - - - - - — - - — - - - - - - - - 9 5 14 153. Lack of Care - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 12. Old Age. 154. (a) Senile Dementia - - - - - - - - - - - - - - - - — - - - - - 2 - 2 1 - 1 4 2 6 \b) Senile Decay - - - - - - - - - - - - - - - - — - - - - 1 11 5 22 33 4 8 37 47 84 13. AJ factions Produced by External Causes. 155. to 163. Suicides - - - - - - - - - - - - 2 1 1 1 4 3 6 4 6 2 3 2 — - - - 22 13 35 164. Poisoning by Food - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 165. Other Acute Poisonings - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 1 1 166. Conflagration - - - - - - - - - - - - - - - - - - - - - — - - - - - - - - - 167. Burns (Conflagration excepted) - - 2 - 2 - 4 - - - - 1 - 1 - - - - - - - - - 1 - - - - 4 3 7 168. Absorption of Deleterious Gases (Confla gration excepted) 3 2 - - - - 3 2 - - - - - 1 1 - 1 - - - - - - - - - - - 5 3 8 169. Accidental Drowning - - - - - — - - 1 - - - 1 - - - - - 1 - 1 - - - - - - - 4 - 4 170 to 176. Injuries - - - - 2 2 2 2 9 2 2 2 3 - 6 1 6 3 3 2 10 3 5 2 6 - 3 52 22 74 177. Starvation - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 178. Excessive Cold - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 179. Effects of Heat - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 180. Lightning - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 181. Electricity (Lightning excepted) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 182. to 184. Homicide - - - - - - - - - 1 - - - 1 - - 1 — - - - 1 - - - - - - 1 3 4 185. Fractures (cause not specified) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 186. Other Violence 1 - — - - - 1 - 2 - 1 - 1 - - - - 2 - 1 - - - - - - - 9 - 9 14. Ill-defined Causes. 187. Dropsy - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 188. (a) Syncope (aged 1 year and under 70) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - (b) 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 (c) Teething - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - (d) Pyrexia - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - (e) Other ill-defined Deaths - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - (f) Cause not specified - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 83 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 45 42 34 121 12 7 42 57 89 105 155 106 50 5 740 Diseases of the Nervous System and of the Organs of Special Sense 6 2 3 11 3 1 8 10 28 34 33 36 32 6 202 Diseases of the Circulatory System - - 1 1 - 3 8 8 31 62 119 114 157 38 571 Diseases of the Respiratory System 55 13 13 81 - 1 7 18 18 43 74 111 80 25 453 Diseases of the Digestive System 48 7 5 60 5 2 8 14 11 34 37 20 13 1 205 Non-Venereal Diseases of the Genito-Urinary System and Annexa - 1 - 1 - - 1 7 14 16 33 34 15 1 122 The Puerperal State — — - - - - 1 5 4 - - - - - 10 Diseases of the Skin and of the Cellular Tissue - 2 - 2 - - - 1 2 - 4 2 3 - 14 Diseases of the Bones and of the Organs of Locomotion - 1 2 3 1 - 2 1 2 2 1 1 - - 13 Malformations 25 1 - 26 - - - - - - - - - - 26 Diseases of Early Infancy 89 — — 89 — - - - - - - - - - 89 Old Age — — — — — — — - — - 1 18 58 18 90 Affection produced by External Causes 6 2 6 14 15 6 11 11 18 18 24 14 8 3 142 III-defined Causes — — — - - - - - - - - 3 - - 3 Totals 274 71 64 409 36 20 88 127 208 314 481 489 416 92 2680 84 Table No. 4. Total Births, Total Deaths, Infantile Deaths, and Deaths from Tuberculosis, with corresponding rates for each ward. Population.—The estimated population for the year is distributed amongst the Wards and Sub-Districts in the same proportion as at the 1921 Census. Births.—Outward transfers are excluded, and then births in St. Pancras institutions are classified according to home address, and inward transfers distributed amongst the Wards and Sub-Districts in proportion to their respective populations. Deaths.—Outward transfers are excluded, and then deaths in public institutions and inward transfers are classified according to home address. Wards. Births. Deaths. Deaths under 1 year. Deaths, Tuberculosis (all forms). No. Rate. No. Rate. No. Kate. No, Rate. 1 489 13.5 397 10.9 30 61 26 0.7 2 427 191 257 11.5 26 61 16 0.7 3 612 16.8 459 12.6 43 70 44 1.2 4 454 17.1 317 12.0 35 77 24 0.9 5 566 18.3 414 13.4 48 85 33 1.1 6 448 21.2 253 12.0 39 87 23 1.1 7 164 10.6 187 121 19 116 17 1.1 8 452 16.3 352 12.8 32 71 28 1.0 Homeless — — 44 — 2 — 1 — Borough 3612 16.7 2680 12.4 . 274 76 212 1.0 85 Table No. 5.—Showing the Birth rates, Death rates, and Infantile Mortality rates of England and Wales and certain of the large Towns, and of London and the Metropolitan Boroughs for 1926. (52 weeks ended 1st January, 1927.) Estimated Population, Mid. 1925. Birth Rate. Death Rate. Infantile Mortality . Estimated Population, Mid. 1925. Birth Rate. Death Rate (Crude). tile Mortality. England and Wales †39,067,000 17.8 11.6 70 County of London 4,602,000 17.1 11.4 64 Birmingham 945,900 19.3 11.3 70 West. Liverpool 856,000 23.2 13.3 103 Paddington 147,100 15.4 12.3 84 Manchester 755,800 19.3 13.0 83 Kensington 179,400 15.1 12.4 61 Sheffield 526,900 17.3 11.1 78 Hammersmith 134,500 16.3 11.3 67 Leeds 472,900 17.8 12.5 87 Fulham 163,700 16.8 10.7 65 Bristol 365,700 17.8 11.3 68 Chelsea 64,820 13.8 12.4 65 West Ham 318,500 23.6 10.6 56 City of Westminster 139,600 11.8 11.2 62 Hull 297,300 19.8 12.7 91 North. Bradford 290,200 16.2 18.2 92 St. Marylebone 106,100 12.8 12.6 82 Newcastle on.Tyne 286,800 23.4 12.2 78 Hampstead 88,040 12.2 10.1 58 Stoke.on.Trent 278,900 21.6 12.2 99 St. Pancras 215,900 16.8 12.2 76 Nottingham 270,600 18.2 12.7 98 Islington 339,200 18.5 12.0 67 Salford 244,700 17.9 11.8 98 Stoke Newington 53,190 15.6 11.0 49 Leicester 242,100 17.6 11.9 74 Hackney 228,300 17.8 10.6 60 Portsmouth 232,900 18.5 11.3 53 Central. Cardiff 227,100 20.6 10.4 59 Holborn 43,315 12.4 11.7 90 Croydon 199,300 17.8 11.1 59 Finsbury 77,560 20.6 12.8 67 Plymouth 192,100 18.2 13.1 70 City of London 13,340 7.9 10.9 66 Bolton 180,400 159 13.7 101 East. Willesden 168,900 14.5 9.5 58 Shoreditch 107,300 23.3 11.9 66 Southampton 168,600 18.6 11.1 56 Bethnal Green 119,800 20.9 11.6 72 Rhondda 167,570 19.2 10.1 69 Stepney 255,370 19.7 11.7 65 Sunderland 166,000 23.4 13.5 99 Poplar 168,500 21.7 11.3 70 Swansea 163,200 19.3 10.7 78 South. Birkenhead 155,500 21.1 10.6 82 Southwark 189,000 20.2 12.7 70 Tottenham 153,600 13.8 9.6 68 Bermondsey 123,000 20.8 11.9 56 East Ham 147,200 13.7 9.4 68 Lambeth 311,100 17.2 11.5 54 Oldham 146,200 15.8 15.2 102 Battersea 172,100 17.3 11.2 61 Brighton 137,800 15.7 12.1 59 Wandsworth 340,900 14.3 10.4 64 Middlesbrough 136,200 24.9 12.8 98 Camberwell 275,400 16.6 11.0 64 Derby 134,400 19.3 10.9 66 Deptford 115,900 18.2 11.1 56 Leyton 132,700 11.8 9.5 82 Greenwich 102,936 17.8 10.9 63 Walthamslow 130,800 15.3 8.8 49 Lewisbam 185,600 15.5 10.0 40 Coventry 129,100 17.3 10.0 68 Woolwich 140,740 16.9 10.1 42 Gateshead 129,000 21.2 12.8 96 Blackburn 126,900 14.1 12.5 88 Stockport 125,900 16.0 12.2 76 + Estimated population to middle of 1926. 86 Table No. 6.—Meteorological Table for Saint Pancras, 1926. (Deduced from observations at Camden Square, N.W. 1.) January. February. March. April. May. June. July. August. September. October. November. December. Barometer— Mean Pressure at 32° F. at station level (Bar. 112 ft. above M.S.L.) 29.886 29.864 30.076 29.878 29.893 29.932 30.034 30.092 30.118 29.924 29.644 30.311 Air temperature— Mean of— A. Maximum 451 50.3 51.5 58.3 60.6 67.7 72.8 74.2 69.8 55.2 49.5 43.5 B. Minimum 36.0 41.5 39.5 43.3 45.9 51.4 56.6 56.0 53.5 42.2 41.1 35.6 Mean of A and B 40.5 45.9 45.5 50.8 53.3 59.5 64.7 65.1 6l.7 48.7 45.3 39.5 Difference from Average +1.7 +5.9 +2.6 +2.4 -1.8 -1.5 +0.4 +19 +3.1 +2.0 +1.0 -1.0 Humidity—Morning 90 91 79 79 73 74 79 77 86 85 90 90 Earth Temperature at 4 ft. depth 43.3 43.9 45.0 46.5 48.7 53.5 57.7 59.1 59.5 55.2 50.0 46.6 Bright Sunshine— Total Observed (daily mean) Hrs. 0.66 1.13 2.34 2.28 4.85 6.31 5.50 6.60 3.57 2.47 0.75 1.23 Per cent. of total possible 8 11 20 17 31 38 34 46 28 23 8 16 Difference from average Hrs. — — — - - — — — - — — — Rain and other forms of precipitation. Number of Days 18 19 9 17 13 10 15 13 11 13 25 6 Total Fall Ins. 2.64 3.07 0.30 3.15 2.30 3.27 2.08 1.55 1.52 2.21 4.71 0.43 Difference from average +079 + 1.42 -1.54 -1.61 +0.51 +1.26 -032 -0.67 -0.28 -0.43 +2.36 -1.97 Hour of observation, 9 a.m. (Greenwich time). The readings for Bright Sunshine are those taken at Regent's Park—no readings being recorded at Camden Square. 87 Table No. 7. Inspections and Re-inspections made by District Inspectors and by the Factory and Workshop Inspector during the year 1926. DUTIES AND PREMISES. RACKHAM. Lonnon. Brown. Dillon. Walker. James. Adkins Akers. Jaffa. Capel. Nixon. West. Thompson. Totals. tions. Re-inspections. Inspactions. Re-inspections. inspections. Re-inspections. inspections. Re-inspections. inspections. Re-mspections. Inspections. Re-inspections. Inspections. Re-inspections. Inspections. Re-inspections. Inspections. Re-inspections. Inspections. Re-inspections. Inspec- tions. Re-inspections. Inspections. Re-inspections. Inspections. Re-inspections. Inspections. Re-inspections. District Inspectors. Inspection of Dwelling Houses— After Infectious Disease 43 1 90 296 67 304 95 16 32 30 92 248 134 348 58 229 78 103 130 416 76 122 83 158 - - 978 2271 Upon Complaint (whole house inspected) 5 — 10 189 44 375 141 88 32 9 43 211 108 502 5 10 13 4 120 583 76 329 38 107 — — 635 2407 Registered tenement houses (as such) 4 - — — — — — — 48 277 81 412 — — — — — — — — 50 190 24 157 — — 207 1036 Housing Act, 1925 - - — — 124 625 59 491 - 42 85 438 2 49 107 516 11 9 87 520 158 189 75 540 — — 708 3419 Houses let in lodgings (By-laws) 71 260 — — 53 138 125 171 107 787 219 750 24 5 - - 31 160 18 55 36 225 37 275 — — 721 2826 Other house to house inspections - - — — — 8 10 — — — — 7 21 — — — — — 9 — — - - — — 15 40 Complaints (not involving the complete inspection of a dwelling house) 145 640 287 904 168 524 200 601 229 912 250 556 178 420 252 524 359 439 179 285 253 415 325 920 - - 2825 7140 Drainage— Under notice. Plans, supervision, &c. 5 226 56 350 45 498 137 772 5 61 25 357 52 566 93 238 15 23 16 270 11 418 25 605 — — 485 4384 Voluntary. Do. do. 26 288 94 456 44 275 6 211 22 259 27 203 105 387 525 — 176 848 53 195 31 368 39 178 — — 1148 3668 New Buildings. Do. do. 2 1016 8 22 1 2 5 165 8 61 - 6 - - 34 - - - 14 150 1 569 - - - - 73 199 Yards of Mews and Stables 299 - 540 - 246 2 202 2 440 5 232 — 253 3 433 — 926 24 465 6 457 12 239 5 - - 4732 59 Smoke Shafts observed 1 — - — - — 6 1 71 — 9 — 12 3 — — 135 - 18 6 22 4 - - — — 274 14 Regulated Trades— Offensive trades - - - - - - - - - - - - - - - - - - - - - - - - - - 71 - Rag and bone dealers - - - - - - - - - - - - - - - - - - - - - - - - - - 7 - Other effluvia businesses - - - - - - - - - - - - - - 7 - - - - - - - - - - - 7 - Inspection of Market Streets - - - - - - - - - - - - - - - - - - - - - - - - - - - - Visits to closed underground rooms - - - - - - - - - - - - - - - - - - - - - - - - - - - - Infectious Diseases. Inquiry, removal, disinfection, &c, 70 4 134 7 107 9 93 3 115 9 126 2 172 121 — 135 — 196 — 109 11 103 11 — — 1481 62 Bakehouses— Workshop - - - - - - - - - - - - - - - - - - - - - - - - 163 142 170 142 Factory - - - - - - - - - - - - - - - - - - - - - - - - 162 168 162 168 Restaurant kitchens - - - - - - - - - - - - - - - - - - - - - - - - 63 138 63 138 Laundries— Workshop - - - - - - - - - - - - - - - - - - - - - - - - 2 - 2 - Factory - - - - - - - - - - - - - - - - - - - - - - - - 3 28 3 28 Other Factories - - - - - - - - - — - - - - - - - - - - - - 1 3 213 522 214 525 Other Workshops - - - - - - - - 2 - - - - - - - - - - - - - - - 371 669 374 669 Other Workplaces - - - - - - - - - - - - - - - - - - - - - - - - 91 138 91 138 Other Duties 10 2 7 — 1 - 40 3 9 — 16 2 22 - 16 - 29 8 14 - 19 5 70 7 - - 253 27 Totals 681 2437 1233 2224 900 2752 1117 2534 1120 2452 1205 3185 1069 2310 1675 1517 1961 1618 1310 2495 1299 2857 1061 2966 1068 1805 15699 31152 88 Table No. 8.—Inspections and Re-inspections and other work of the Food Inspectors during 1926. DUTIES AND PREMISES. Visits and Inspections. Re-inspections after Intimation Notices, Mr. Auger. Mr. Child. Totals. Mr. Auger. Mr. Child. Totals. Milkshops 388 334 722 - - - Dairies 69 17 86 - - - Cowsheds 5 28 33 - - - Other Premises of Milk Purveyors — 16 16 - - - Margarine Factories — — — - - - Butter Factories 2 — 2 - - - Ice Cream Premises 154 222 376 3 - 3 Slaughter Houses 57 94 151 - - - Premises where Prepared Meats are made (sausages, pies. tripe, cooked meat, &c.) 86 354 440 - - - Butchers' Shops 27 86 113 — - — Fried Fish Shops and Fish Curers' premises 148 290 438 3 - 3 Marketing Places 2158 1712 3870 — - — Other Premises where Food or Drugs are sold 34 1 35 — - — Other Visits 7 104 111 — — Total 3135 3258 6393 6 — 6 SAMPLES, &c., TAKEN. Formal Samples Informal Samples No. of Milk samples 171 209 380 1 3 4 ,, Cream samples 10 15 25 — — — ,, Butter and Margarine samples 71 77 I48 — — — ,, Other samples (specified below)— Apples 10 15 25 — — — Apple Stalks — — — 1 — 1 Brawn 1 - 1 - - - Cheese 15 5 20 1 — 1 Cocoa 23 10 33 — — — Coffee 23 10 33 — — — Custard Powder 1 5 6 - - - Dripping 5 - 5 — — — Fish Paste 1 — 1 — — — Flour 14 15 29 - - - Jam 22 10 32 - - - Lard 10 15 25 — — — Lemon Crystals — 1 1 — — — Meat Paste - — - 1 - 1 Mustard 4 5 9 - - - Oatmeal 1 - 1 — - - Pepper 6 5 11 — — — Rice 2 10 12 — — — Sausages 1 — 1 — — — Vinegar 15 10 15 — — — Total 1396 417 813 4 3 7 89 Table No. 8 (con.).—Inspections and Re-inspections and other work of the Food Inspectors during 1926. UNSOUND FOOD. Mr. Auger. Mr. Child. Totals. Mr. Auger. Mr. Child. Totals. No. of surrenders and seizures:— surrendered. Seized. Meat, &c 8 6 14 — - Fish 2 4 6 — - - Shellfish 1 - 1 — — — Other Foods (specified below):— Fruit 7 3 10 - - - Ground Rice — — — - 1 1 Vegetables 1 10 11 — - - Total 19 23 42 — 1 1 Inspections of Registered Canal Boats 14 — 14 — — - 06 Table No. 9. Visits, etc., made by Women Inspectors during 1926. First Visits. Subsequent Visits. Call made, but admission not obtained. Miss Bibby. Miss Smith. Miss Anderson. Mrs. Hunter. Miss Blaxland. Miss Camman. Miss Holland. Total. Miss Bibby. Miss Smith. Miss Anderson. Mrs. Hunter. Miss Blaxland. Miss Camman. Miss Holland. Total. Miss Bibby. Miss Smith. Miss . 1 Anderson. Mrs. Hunter. Miss Blaxland. Miss Camman. Miss Holland. Total. Grand Total. Infants - 1 51 3 - 25 - 86 - 6 22 13 - - - 41 - 2 2 1 - 2 - 7 128 Expectant Mothers - - 1 1 - - 1 3 - - - - - - - - - - - - - - - - 3 Ophthalmia Neonatorum 6 8 7 11 11 14 57 — 22 18 21 14 18 8 101 — 8 — 7 5 9 1 30 188 Puerperal Fever 3 2 1 2 3 6 17 — 1 2 4 1 4 1 15 — — — — 1 1 1 3 33 ,, Pyrexia 1 — 2 - 2 2 7 — — — 1 — 2 2 5 — 1 — — — — 1 13 Tuberculosis—Discharged Soldiers & Sailors 13 v 3 6 17 17 63 93 141 43 271 147 132 1127 — 21 5 11 34 18 11 100 1290 Do. Others 58 54 45 94 62 87 100 — 881 597 731 1278 1286 1174 5947 — 274 32 250 233 147 201 1137 7484 Measles and German 574 529 721 841 719 972 4356 108 91 63 31 30 67 390 54 3 18 49 10 22 156 4902 Whooping Cough 14 •24 4 18 10 130 20c 7 15 29 2 — 1 54 — 3 — 6 3 — — 12 266 4 10 2 1 4 2 23 — 3 5 15 — — — 23 — 8 — 4 — — 3 15 61 Other Cases of Illness 165 325 183 108 482 448 1711 — 55 197 173 63 1 6 195 — 60 19 38 3b 8 3 166 2372 Verminous Persons 115 100 91 87 130 178 701 — 7 47 19 8 — 1 82 - 58 10 44 19 9 18 158 941 To Hospitals and other Voluntary Institutions 74 442 112 101 205 177 206 1317 - - - - - - - - - - - 4 - - 4 1321 Factories - 2 6 6 4 2 — 20 - - - - - - - - - - - - - - - - 20 Workshops — 26 10 257 4 15 15 327 — — 4 8 1 5 — 18 - 4 — 26 — — 3 33 378 Workplaces — 36 4 206 16 32 86 380 - 36 8 6 6 37 — 93 — 32 — 50 5 5 15 107 580 Milk Enquiries - 86 45 56 77 121 77 462 — 12 15 8 12 6 6 59 — 10 3 25 12 6 12 68 589 Attendances at Clinics — 105 87 24 58 6 9 289 - - - - - - - - - - - - - - - - 289 Other Visits and Inspections 18 58 40 117 179 65 311 788 - 5 9 l 10 2 - 27 - 1 - 3 2 2 — 11 826 Totals 92 1709 1415 1830 1711 1183 2561 11201 - 1236 1171 1135 1697 1838 1398 8475 - 539 74 483 405 217 290 2008 21684 91 Table No. 10.—Intimations as to Nuisances and Breaches of Statutes and By-laics served by the Sanitary Inspectors during 1926. and the resulting Statutory Notices in 1926 and the early part of 1927. Schedule of Nuisances. Intimations. Statutory Notices. 1 Part of the house in a dirty condition ... 884 261 2 „ ,, damp „ 319 129 3 Roof defective 1040 365 4 Guttering defective 256 78 5 Water fittings defective 265 63 6 Water-closet apartment with absence of external ventilation 42 16 7 ,, ,, so foul as to be a nuisance or dangerous to health 16 2 8 Water-closet basin foul 92 19 9 „ ,, defective 171 44 10 „ ,, choked 79 10 11 Urinal in a foul condition 1 — 12 Privy in a foul condition — — 13 Soil pipe defective 31 8 14 ,, unventilated 39 11 15 ,, improperly ventilated 4 — 16 Absence of waste pipe to sink, lavatory or bath 2 — 17 Waste pipe of sink, lavatory, or bath connected with drain 4 — 18 ,, ,, ,, defective 122 41 19 „ ,, „ ,, foul 28 10 20 Inlet of drain improperly trapped 11 4 21 Drain defective 238 70 22 ,, stopped 131 16 23 ,, ventilating pipe defective 179 48 24 Rain-water pipe in direct communication with drain 21 5 25 ,, defective 220 52 26 Unpaved condition of roadway 1 — 27 Undrained ,, ,, 1 — 28 Area or part unpaved 6 1 29 ,, undrained — — 30 Yard or space unpaved 8 6 31 ,, ,, undrained 4 2 32 Defective condition of washhouse paving 135 44 33 Dust-bin defective 521 82 34 ,, in an improper position 2 1 35 Accumulation of stagnant water which is a nuisance dangerous to health 40 6 30 Accumulation or deposit which is a nuisance dangerous to health 131 22 37 Animals kept in such a manner as to be a nuisance dangerous to health 20 2 38 Part of the house so overcrowded as to be dangerous to health 16 4 39 Space below floor in basement or ground floor insufficiently ventilated 143 35 40 Issuing of black smoke in such a quantity as to be a nuisance 7 2 41 Discharging smoke in such a manner as to cause part of a building to be a nuisance dangerous to health 9 4 42 Tent, vanished, 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 ... 2 1 43 Other nuisances ... 729 223 Totals 5970 1687 Table No. 11. Registered Tenement Houses—Breaches of By-Laws. Intimations. Statutory Notices. 1 Overcrowding 4 3 2 Inadequate water supply 2 — 3 Contaminated water supply — — 4 Foul closet, basin or trap ... . . 15 7 — — 6 Want of annual cleansing ... 20 7 637 202 8 ,, ,, ,, in solo use 816 248 9 Want of cleansing of the room or part of the dwelling 22 9 10 Animals improperly kept 6 2 11 Other breaches 297 103 Totals 1819 581 92 Table No. 12. Factories, Workshops and Work Places—Breaches of Statutes. Intimations. Statutory Notices. 1 Want of cleanliness 111 11 2 Want of ventilation 5 l 3 Want of air space, overcrowding ... 1 l 4 Sanitary accommodation, absent or insufficient- 15 3 5 ,, ,, unsuitable or defective 56 9 6 ,, ,, not separate for sexes 17 4 7 Want of drainage of floors — — 8 Other nuisances 76 8 9 Illegal occupation of underground bakehouse — — 10 Breach of special sanitary requirements for bakehouses 97 — 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 47 6 Totals 425 43 Table No. 13. Breaches of other Statutes and Statutory By-laws. Intimations Statutory Notices. l An occupied house without a proper and sufficient supply of water 240 120 2 Water supply used for domestic purposes connected with cisteru which is used for flushing the water-closet - - 3 Water-closet not supplied with a sufficient quantity of water for securing its effective action 169 43 4 Tank, cistern, or other receptacle for storing of water used or likely to be used by man for drinking purposes—dirty condition of 32 9 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 ... 21 7 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 1 - 7 Animals so kept as to be likely to pollute the water supply — — 8 Offensive matters not deposited in manure receptacle 1 9 Manure not removed at proper intervals 13 3 10 Manure—absence of proper receptacle for 7 2 11 Manure receptacle not properly constructed 1 — 12 Sufficient drain to stables or cowshed—absence of a 1 — 13 Receptacle for house refuse—absence of a proper 275 49 14 Receptacle for house refuse—absence of a proper cover for 8 2 15 Yard or open space unpaved 1 — 16 ,, paving defective 305 110 17 Insufficient water-closet accommodation to "lodging house" 77 45 18 A furnace improperly constructed or negligently used ... — — 19 Effluvia arising from premises used for trade, business, or facture which is a nuisance dangerous to the inhabitants of the district 1 — 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 1 1 23 Steam whistle—use of a, without authority 2 — 24 Parts of houses infested with vermin requiring stripping, purifying, and cleansing 580 130 25 Articles in an unwholesome condition requiring to be purified or destroyed 16 3 26 Underground room illegally occupied as a dwelling 12 1 27 Name and address of Medical Officer of Health and of landlord, etc., not inscribed in rent book 30 1 28 Other breaches 684 83 Totals 2478 609 «