AC 4355 STPAN 85 Metropolitan Borough of Saint Pancras. REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1927. G. SOWDEN, M.D., D.F.H., M.R.C S, L.R.C.P., Barrister.at.Eaw, Fellow of the Royal Institute of Public Health Printed by F. P. Lewingdon. 26 and 27, Eversholt Street. London N.W. 1. ' Metropolitan Barough of Saint Pancras. REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1927. 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 12 Economic Conditions 12 Marriages 13 Births 13 Illegitimacy 14 Notification of Births 14 Deaths 14 Inquests 17 Infantile Mortality 17 Section II—General Provision of Health Services. Hospital Accommodation 20 Institutional Provision for Unmarried Mothers 21 Ambulance Facilities 21 Clinics, Treatment Centres, &c. 21 Maternity and Child Welfare 22 Advice Cards 23 Home Visiting 23 Centres 26 In.Patient Treatment of Children under 5 years of age 28 Artificial Light Treatment 28 Dental Clinic 30 Day Nurseries 32 Clinic for Ailing Mothers and Children 32 Convalescent Home Treatment 32 Home for Sick Poor Children 32 Supply of Milk to Mothers and Children 33 Public Health Officers of the Local Authority 34 Professional Nursing 34 Home Helps 35 Midwives 35 Midwifery 36 page Legislation in force 37 National Rat Week 38 Section III.—Sanitary Circumstances of the Area. Water Supply 38 Drainage 38 Refuse Collection and Disposal 39 Mortuary 39 Sanitary Inspections 39 Notices served 40 Nuisances—Legal Proceedings 40 Smoke Abatement 41 Atmospheric Pollution with Arsenical dust. 42 Factory and Workshop Acts 43 Inspections 43 & 46 Defects found 44 Home Work 44 Outwork in Infected or Insanitary Premises 45 Factories, Workshops and Workplaces on Register 45 Other matters 45 Premises and Occupations controlled by by.laws or regulations 46 Offensive Trades 46 Houses Let in Lodgings 46 Underground Rooms 46 Canal Boats Acts 46 Rent and Mortgage Restrictions Act, 1923 46 Medical Examination of School Children 47 Section IV.—Housing. Statistics 49 Overcrowding 50 Housing Schemes 51 Work of the Estates Committee 52 Section Y.—Inspection and Supervision of Food. (a) Milk Supply 55 Cowsheds, Dairies and Milkshops 55 Bottled Milk 55 Milk (Special Designations) Order, 1923 55 4 CONTENTS—continual. page (b) Meat and Other Foods 56 Unsound or diseased food condemned and destroyed 57 Slaughter.houses 57 Fried Fish and Fish Curing Premises 57 Ice Cream Premises 57 Bakehouses and Restaurant Kitchens 57 (c) Sale of Food and Drugs Acts,— Samples taken 58 Prosecutions:— (a) Sale of Food and Drugs Acts 59 (b) Milk and Dairies Order, 1926 60 (c) Public Health (Meat) lations, 1924 60 Wholesale Dealers in Margarine 60 Milk and Cream Regulations 60 page Malaria 67 Dysentery 67 Measles and German Measles 67 Hospital Accommodation 67 Epidemic Jaundice 67 Tuberculosis— New Cases and Deaths 68 Notifications 70 Prevalence and fatality for 10 years 71 Notifications and Deaths by Wards 71 Public Health (Tuberculosis) Regulations, 1924 71 Public Health (Prevention of Tuberculosis) Regulations, 1925 72 Boarding.out of Children 72 Care Committee 72 Dispensary 72 Report by Tuberculosis Officer 73 Summary of work carried out 74 Section VI.—Prevalence of, and control oyer, Infectious Diseases. Notifications and Deaths from notifiable diseases by ages 62 Do. by Wards 63 Smallpox 64 Vaccination 64 Scarlet Fever 64 Diphtheria 65 Enteric (Typhoid) Fever 65 Puerperal Fever 65 Puerperal Pyrexia 65 Erysipelas 65 Anthrax 66 Cerebrospinal Meningitis 66 Anterior Poliomyelitis and Polioencephalitis 66 Ophthalmia Neonatorum 66 Encephalitis Lethargica 66 Pneumonia 67 Section VII.—Other Services. Disinfecting and Cleansing Station 75 Bacteriological Work 76 Appendix. Table No. 1. Vital Statistics for 11 years 78 Do. 2. Registrar . General's Short List of Causes of Death 79 Do. 3. Births and Deaths in Wards 81 Do. 4. Do., certain large towns and Metropolitan Boroughs 82 Do. 5. Meteorology 83 Do. 6. Work caried out by District Inspectors 84 Do. 7. Do.—Food Inspectors 85 Do. 8. Do.—Factory & Workshop & Women Inspectors 86 5 Metropolitan Borough of Saint Pancras. PUBLIC HEALTH COMMITTEE. 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 Mf.nzif.s. 4 Alliston, Mrs. Evelyn. 6 Cambridge, Mrs. Mary Winifred. 1 Bateman, William Edward. 2 Bland, Mrs. Violet. 8 Campion, John Sissons. 8 Crosby, Miss Ada, M.B.E. 1 Da vies, 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. November, 1927, to October, 1928. CHAIRMAN. Alderman Alfred Solomon, J.P. DEPUTY.CHAIR A1 AN. Councillor Evan Evans. EX.OFFICIO. The Right Worshipful The Mayor (Councillor A. Squire, J.P., F.A.I.). ALDERMEN. Gregg, Dn. Edward Andrew. Rolles, Harry. Swift, Mansell Jambs, F.R.M.S. COUNCILLORS. Ward 3 Allan, Mrs. Isabella Menzies. 4 Alliston, Mrs. Evelyn. 6 Bambridge, Mrs. Mary Winifred. 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. 1 Garner, James Alfred. 1 Gurney, Frederick Brown, F.A.I. 3 Hf.wson, Frederick. 7 Jenkins, Edwin. 4 Johnson, Job, J.P. 5 Kemp, Frederick William Isaac. 6 Martin, Arthur Henry. 3 Morrell, Rev. R. Conyers, M.A. 5 Paterson, Mrs. Louisa Sophia. 2 Salmon.Brunsdon, Mrs. Elizabeth, 5 Washington, Alfred Charles, 6 STAFF OF THE PUBLIC HEALTH DEPARTMENT at end of 1927. MEDICAL OFFICER OF HEALTH AND ADMINISTRATIVE TUBERCULOSIS OFFICER. (G) G. Sowden, M.D., D.P.H., M.R.C.S., L.R.C.P. TUBERCULOSIS OFFICER. (g) A. Viney, M.R.C.S., L.R.C.P., D.P.H. ASSISTANT MEDICAL OFFICER. (G) G. A. Back, B.A., M.R.C.S., L.Et.C P., D.P.H. PUBLIC ANALYST. J. Rear Colwell, F.I.C. (G) SANITARY INSPECTORS AND HEALTH VISITORS. Inspectors of Food and Food Places. §¶W. G. Auger. §¶fH. R. Child. Inspector of Workshops and Factories. ‡§B. H. Thompson. District Inspectors. §G. Rackham. ¶†G. W. Adkins. *‡§ ¶Lonnon. ‡R. C. Akers. ‡§W. L. Brown. ‡M. Jaffa. §E. M. Dillon. ‡¶S. W. Capel. *‡§¶A. H. Walker. ‡¶H. K. Nixon. ‡§R. E. James. §H. G. West. Seniorl Woman Sanitary Inspector. JMiss M. E. Bibby, B.A. (Lond.). Women Sanitary Inspectors and Health Visitors. ‡||Miss C. Smith. ‡||Miss V. K. Blaxland. ‡||Miss F. A. Anderson. ‡||+**Miss J. A. J. Camman. ‡§Mrs. A. Hunter. ‡||Miss A. Holland. CLERICAL STAFF. A. D. Corrick, Chief Clerk. A. G. Capel. (g) A. Carpenter. G. N. Cove [attached to the Estates Dept.). J. D. Holiday. T. H. Hague. (g) Miss A. Andrews. W. C. Mansfield. (g) H. G. Avril. R. Warren. * Cert. Municipal and County Engineers. ‡ Cert. San. Insp. Examination Board. § San. Inap. Cert. Royal San. Inst. ¶ Cert. Meat and other Foods. ; || Health Visitor's Certificate. † C.M.B. ** Certificate, Queen Charlotte's Hospital. (g) Officers to whose salary contribution is made under the Public Health Acts or by Exchequer Grants, 7 BOROUGH COUNCIL STAFF AT THE CENTRES AND CLINICS. (G) Medical Officers. No. of Consultations per month. Dr. Chas. H. A. Aluerton 4 Dr. II. Searle Baker 4 Dr. B. Marion Cockerell 15 Dr. A. Gertrude Grogan 4 Dr. J. Finch Haines 13 Dr. Janie Lorimer Hawthorne 5 Dr. Ethel F. Iredell 4 Dr. Lydia A. Leney 8 Dr. J. Balfour Neill 8 Dr. Martin Oldershaw 2 Dk. Margaret R. Paterson 4 Dr. Mary J. Pirret 10 Dr. Francis L. Provis 13 Dr. Helen Turover 5 (g) Dental Clinic. Mrs. W. A. Murch, L.D.S., Dentint 10 Dr. Jas. Maughan, Anmthetist 2 (g) Artificial Light Clinic. Dr. William Beaumont 12 (g) Consulting Obstetric Surgeons. Martin H. Oldershaw, M.D., M.B., B.S., F.R.C.S., L R.C.P. Francis L. Provis, M.R.C.P., F.R.C.S., M.R.C.S., L.R.C.P. (g) Dentists at Tuberculosis Dispensary. Mr. Southcomb May, L.D.S. Mr. A. J. Maurice, L.D.S. (The above are part.time officers.) (g) Superintendents of Maternity and Child Welfare Centres. Senior. Junior. *‡Miss G. R. Bristow. J§Miss M. L. Blair. ‡§Mrs. E. Crockart. +§Mrs. S. C. Chapman. ‡§Miss M. H. Landel Jones. iss M. Manger. Miss M. Smyth. J§Miss E. M. Robinson. §Miss M. Templeton. (g) Health Visitors at Maternity and Child Welfare Centres, §Miss E. B. Bagnall. §Mrs. E. Lurie. SMrs. E. E. Bruce. *J§Mrs. J. Lynn. *JMiss M. A. Clarke. J§Mrs. M. A. Smith. J§Miss B. M. Harris. *§Miss V. B. "Woodruff. JMiss A. M. LT. Harrop. (g) Tuberculosis Dispensary. Nurse Visitor, *§Miss S. A. Long. Clerical and General Assistant, Miss Margaret Deed. DISINFECTING AND CLEANSING STAFF. Foreman of Disinfecting Station . . . . T. Bartholomew. Disinfector .. .. .. .. A. J. Dibben. Motor Driver and Disinfector . . . . J. Stanley. , . . C. Browne. Matron of Personal Cleansing Station . . Mrs. E. Mace. Assistant at ,, ,, . . Mrs. A. Styles. „ () tt ., Mrs. L. Blaby. Resident Caretaker, Mortuaries and Coroner's Court J. Root. (The above are full.time officers.) * Cert. San. Insp. Examination Board, f San. Insp. Cert. Royal San. Inst. J Health Visitor's Certificate. § C.M.B. 1f Midwifery Certificate, Queen Charlotte's Hospital. (g) Officers to whose salary contribution is made under the Public Health Acts or by Exchequer Gran 8 Public Health Department, Town Hall, Pancras Road, N.W. 1. To the Mayor, Aldermen and Councillors oe the Metropolitan Borough of St. Pancras. Mr. Mayor, Ladies and Gentlemen, I have the honour to present the 72nd Annual Report on the vital statistics and sanitary condition of the Borough, including particulars of the work carried out during the year by the staff of the Public Health Department. This is the fifth Annual Report which it has been my duty to submit to the Members of the Council. The Minister of Health has intimated that the Reports of Medical Officers of Health for the year 1927 should be "ordinary" reports, that is, reports less detailed in character than the " Survey " Reports which are required periodically. A summary of the principal statistics for the year 1927 will be found on page 10. These statistics will be seen to be extremely satisfactory if compared with the corresponding figures for previous years. The principal items to which attention may be directed are as follows: — The death rate was 12.3 per 1000 of population. With one exception, this is the lowest general death rate hitherto recorded for the Borough. The infantile death rate was only 62 per 1000 births, as compared with 76 for the preceding year. This is without exception the lowest infantile mortality rate ever recorded in St. Pancras. There was a decrease in the number of deaths from Cancer, Bronchitis, Diphtheria, Cerebral Haemorrhage, Measles and Infective Enteritis; but a slight increase in those due to Heart disease, Pneumonia, Influenza and Whooping Cough. The birth rate again shewed a decrease, being only 15.5 per 1000 of population. This is the lowest birth rate hitherto recorded in the Borough. As regards Wards, the highest birth rate occurred in Ward 6, the lowest in Ward 7. Notifiable infectious diseases showed no undue prevalence. A special feature was the marked decrease in the number of cases of Diphtheria, and the number of deaths due to this disease was lower than has been recorded in any previous report. The Housing Scheme in Somers Town initiated by the Borough Council is making rapid progress, and accommodation for a number of tenants should soon be available. The larger scheme in this area, which is being undertaken by the London County 9 Council, is not progressing so rapidly as could be desired. The foundations of the first block of buildings have been commenced, but no accommodation will be available for some considerable time. Improvements made during the year in the Public Health services of the Borough include the following:— Increased facilities for Artificial Light Treatment. Arran gements for the Home Nursing of Cases of Pemphigus Neonatorum. A scheme of co.operation in ante.natal work between University College Hospital and the Council's Welfare Centres. The payment of a grant by the Borough Council to University College Hospital in connection with the admission of certain maternity patients to the Hospital. Rc.airangcmcnt of the Ante.Natal Consultations at the Council's Welfare Centres. An agreement with the Royal Free Hospital for the admission of children who may be referred from the Council's Welfare Centres. The appointment of two Consulting Obstetric Surgeons, the provision of facilities for bacteriological diagnosis and skilled nursing in connection with the diagnosis and treatment of necessitous cases of Puerperal Fever and Puerperal Pyrexia. Details with reference to the above matters will be found in the body of the report. In conclusion, I have again to thank the Chairman and Members of the Public Health Committee for the great consideration so constantly accorded to me, and to the staff of the department I must express my appreciation of their loyal co.operation and the high standard they have attained in the performance of their duties. I am, Ladies and Gentlemen, Your obedient Servant, Medical Officer of Health. 10 SUMMARY OF REPORT FOR 1927. 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, Ring'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 (1927) Civilian, 212,800. Total, 213,200. Number of persons per acre, 79. Number of inhabited houses (1921 Census), 24,660. Number of families or separate occupiers (1921 Census), 56,653. Births. Males, 1,714 ; females, 1,585. Total, 3,299. Legitimate births, 3,071 ; illegitimate births, 228. Birth rate, 15*5 per 1,000 of population. Excess of births over deaths, 678. Deaths. Males, 1,409 ; females, 1,212. Total, 2,621. Death rate, 12'3 per 1,000 of population. Infantile Mortality Rate. Legitimate, 56; illegitimate, 145. Total, 62 per 1,000 births. Maternal Mortality. Number of women dying in, or in consequence of child.birth : From Sepsis, 4 ; from other causes, 5. Maternal death.rate per 1,000 births, 2.7. Measles, deaths from (all ages), 5. Whooping Cough „ 35. Diarrhoea and Enteritis, deaths from (under 2 years of age), 28. Tuberculosis. Pulmonary. Deaths, 197 ; death rate, 0.93 per 1,000 of population. All forms. Deaths, 217 ; death rate, 1.02 per 1,000 of population. Rateable value, £2,087,456. Sum produced by a penny rate, £8,530. Rainfall (total) during the year (recorded at Camden Square), 33'84 inches. Comparative Statistics. Rate per 1,000 of Population. Rate per 1,000 Births. Birth.rate Death.rate. Infant Mortality. St. Pancras 15.5 12.3 62 England and Wales 16.7 12.3 69 107 Great Towns 17.1 12.2 71 County of London 16.1 11.9 59 11 Metropolitan Borough of Saint Pancras. REPORT OF THE MEDICAL OFFICER OF HEALTH For the Year 1927. For the purpose of this Report, the year consists of the 52 weeks ended 31st December, 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. According to the estimates of the Registrar-General, during the years from 1923 to 1926 the population of St. Pancras increased from 214,400 to 216,800. For the year 1927 the Registrar.General estimates the total population of the Borough at the low figure of 213,200. These estimates are based upon information obtained with reference to the movement of persons to and from the Borough, allowing also for the natural increase due to the excess of births over deaths. It is somewhat surprising to learn that, during the past twelve months, the steady increase which had occurred during the preceeding four years should have been more than obliterated. The increase of population due to the development of the Holly Lodge Estate may have been counterbalanced by the clearance of a portion of the Somers Town Housing Site, and also by the emigration of a number of families who were living under overcrowded conditions, and who were granted accommodation at Becontree, Downham, or other places outside the Metropolis. Allowing for these various factors, I am of opinion that the Registrar.General has under.estimated the population, and therefore the death and other rates based on this estimate are caused to appear unduly high. The figures of the Registrar.General have, however, been used throughout this report, the estimate of total population being used for calculating the marriage and birth rates and the estimate of the civilian population for calculating the death rate. 12 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 1'2 years of age)': Males, 78,036; Females, 90,616. Males. Occupation. Number. Percentage. Transport Workers (Railways, &c.) 1.3714 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 „ Females. Occupation. Number. Percentage. Personal Service (Domestic, Waitresses, &c.) 13350 15 % Makers of Textiles 5523 6 „ Clerks and Typists 4928 o ft 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 13 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. £ . 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, 1920 31290 4267 Lady day, 1926 36061 5427 Michaelmas, 1926 43351 6242 Lady day, 1927 45159 5695 Michaelmas, 1927 37825 4998 MARRIAGES. The number of marriages celebrated during the year was 1,910. This is equal to a rate of 8.7 per 1,000 of total population. The average yearly number of marriages during the preceding five years was 1,903, equal to a rate of 8.8 per 1,000 of population. BIRTHS. The number of births registered during the year belonging to St. Pancras was 3,299, equal to an annual birth rate of 155 per 1,000 of population. This is the lowest birth rate ever recorded in the Borough. During the latter years of the great war the birth rate fell abnormally, but even during those years did not reach the low level recorded in 1927. The actual number of births registered as having taken place in the Borough during the year was 3,925. This figure has to be corrected by deducting the births of non residents, which occurred chiefly in various public institutions in the Borough— these numbered 1,168, and adding the births belonging to St. Pancras which occurred outside the Borough—these numbered 542. The corrected figure is therefore as stated above, 3,299. The corresponding figures for previous years will be seen in Table 1, on page 78. The following table gives the number of births and the birth-rate in each ward of 14 the Borough for the past year. For comparison the figures for the previous year are also given:— Ward Births and Birth Rates. Ward. 1927. 1926. Births. Birth Rate. Births. Birth Rate. 1 485 13.6 489 13.5 2 337 15 3 427 191 3 585 16.3 612 16.8 4 406 15.6 454 17.1 5 535 17.6 566 18.3 6 371 17.9 448 21.2 7 191 12.5 164 10.6 8 389 14.3 452 16.3 Borough 3299 15.5 3612 16.7 1,703 births occurred in Public Institutions, equal to 434 per cent. of the total births which took place in the Borough. Table 4, on page 82, shows for 1927 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 3,299 net St. Pancras births, 228 were returned as illegitimate. This equals 6.9 per cent, of the total births. The corresponding figures for the preceding 10 years were as follows: — Year. Rate. Year. Rate. 1917 7.2 per cent. 1922 5.6 per cent. 1918 9.5 „ 1923 57 „ 1919 8.4 „ 1924 5.9 „ 1920 5.6 „ 1925 6.3 ,, 1921 5.5 „ 1926 6.3 „ Notification of Births. 3,928 notifications of births were received during the year: this includes 135 stillbirths and 3,793 live births, and represents 97 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. DEATHS. The net number of St. Pancras deaths registered during the year was 2,621; this equals an annual death rate of 123 per 1,000 of population. 15 The average yearly death rate of the Borough during the previous live years was 13.0 per 1,000 of population. The actual number of deaths registered as having occurred in the Borough during the year 1927 was 3,034. This figure has to be corrected by the exclusion of 939 deaths which occurred in the Borough of persons who were not St. Pancras residents, and by the inclusion of 526 deaths of residents which occurred and were registered outside the Borough. The corrected figure of 2,621 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. Causes 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. 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 Average for 10 years. 1927 Heart Disease 404 389 370 442 435 461 394 398 3S1 388 406 448 Cancer 281 269 245 299 290 302 319 298 324 301 293 292 Bronchitis 250 228 301 236 276 308 223 304 274 259 266 227 Tuberculosis—all forms 444 485 341 312 304 315 272 271 231 212 3 19 217 Pneumonia 254 376 179 197 173 265 201 200 204 155 220 207 Injuries 125 119 108 92 88 127 113 114 118 142 115 132 Cerebral Haemorrhage, Embolism, and Apoplexy 116 131 91 98 126 120 112 118 123 110 114 92 Premature Birth, Debility and Congenital Defects 144 132 162 201 149 134 134 118 105 114 139 91 Nephritis and Blight's Disease 104 98 61 95 60 67 79 75 75 89 80 84 Influenza 21 700 260 46 57 142 24 80 41 29 140 83 Diarrhœa and Enteritis 97 56 68 54 98 47 61 63 55 63 66 35 Whooping Cough 27 80 7 6o 38 29 28 46 71 24 41 35 Rheumatic Fever 7 8 7 6 16 15 8 5 18 10 10 13 Erysipelas 3 11 9 12 3 12 4 4 12 8 8 6 Diphtheria and Croup 25 31 21 33 51 44 20 22 34 12 29 6 Measles 118 75 15 65 23 107 5 74 3 65 55 5 Puerperal Fever 5 2 9 8 4 4 9 4 4 1 5 4 Pleurisy 10 14 9 12 7 10 8 8 16 5 10 3 Scarlet Fever 4 7 5 11 7 20 3 12 . 2 7 2 Enteric Fever 6 5 2 1 3 1 3 2 3 1 3 2 16 The Registrar-General's short list of deaths at different periods of life will be found in Table 2 on page 79. For purpose of comparison, the death rates for England and Wales, the County of Loudon, the Metropolitan Boroughs, and certain of the large towns are given in Table 4 on page 82. It will be noted that 17 Metropolitan Boroughs had a lower and 11 a higher general death rate than St. Pancras, Of the total 2,621 St. Pancras deaths which occurred during the year, no less than 1,570 took place in public institutions, either within or outside the Borough ; this equals a proportion of 60 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 Deaths and Death Rates. Ward. 1927. 1926. Deaths Death Rate. Deaths. Death Bate. 1 388 10.9 397 10.9 2 257 11.7 257 11.5 3 421 11.8 459 12.6 4 363 14.0 317 12.0 5 416 13.7 414 13.4 6 267 12.9 253 120 7 156 10.2 187 12.1 8 323 11.9 362 12.8 Homeless 30 - 44 - Borough 2621 12.3 2680 12.4 17 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 1 - 2 1 11 12 27 Pneumonia 3 1 - - 3 3 10 Cancer - - - - 3 1 3 Tuberculosis - - - - 2 1 3 Other causes 2 1 4 1 17 11 36 Accidents— Street Vehicles - 4 8 1 18 9 40 Burns and Scalds - 4 1 4 3 4 16 Railway - - - - 6 - 6 Falls - - 2 1 7 6 16 Other causes* 7 1 5 6 13 8 40 Suicides† - - - 3 32 4 39 Murder 3 - - - - - 3 Manslaughter - - - - - 1 1 Open Verdict 3 - 1 1 1 1 7 Totals 19 11 23 18 115 61 247 * Includes 3 cases of coal gas poisoning, † „ 9 cases „ „ Infantile Mortality. 205 deaths of infants under 1 year of age occurred in the Borough during the year. This is equal to a rate of 62 per thousand births, as compared with a rate of 76 for the previous year. The Infantile Mortality rate for 1927 is the lowest recorded for the Borough, and an even lower rate would have been attained but for the unfortunate prevalence of whooping cough and broncho-pneumonia in the early part of the year. The decreased mortality during 1927 was chiefly due to the absence of measles, to an improvement in the neo-natal mortality, and to a decrease in the number of deaths from diarrhœa and enteritis. In Table 1, on page 78, the corresponding rates for previous years are given, and in Table 3, on page 81, the figures will be found for the different wards. Table 4, on page 82, gives the infant mortality rates for England and Wales, the Count 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 1927, 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. 18 1927.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. Whooping Cough - - - 2 2 4 2 3 4 15 Influenza - - - - - - 1 - 1 2 Tuberculous Meningitis - - - - - - - 1 2 3 Other Tuberculous Diseases - - - - - - - 1 - 1 Meningitis (not Tuberculous) - - - - - - 1 1 2 Convulsions 1 - - - 1 - —- - - 1 Bronchitis - - - - - 1 1 1 2 5 Broncho-pneumonia 5 1 - - 6 4 12 4 16 42 Lobar-pneumonia - - - - - 1 1 - - 2 Pneumonia (type not stated) - - - - - 1 - - - 1 Diarrhœa - - - - - 2 1 - - 3 Enteritis 1 - 1 - 2 6 9 4 3 24 Syphilis 1 - - - 1 1 - - - 2 Suffocation (overlying) - - - - - - 1 - - 1 Injury at Birth 8 1 - - 9 - - - - 9 Atelectasis 8 1 - 1 10 - - - - 10 Congenital Malformations 8 - 1 1 10 2 - 1 2 15 Premature Birth 29 4 1 - 34 5 - - - 39 Atrophy, Debility and Marasmus - 2 - - 2 5 4 1 1 13 Other causes 8 - - - 8 2 2 2 1 15 Totals 69 9 3 4 85 34 31 19 33 205 Nett Births in the year Nett Deaths in the year 3 19 Deaths from Stated Causes under 1 Year of Age for 1927 and 10 preceding Years. CAUSE OF DEATH. 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 Average for 10 years. 1927 Measles 30 16 4 21 7 15 1 15 2 25 14 - Scarlet Fever - - 1 - - 3 - - - . - - Whooping Cough 14 27 2 18 18 11 8 13 29 11 15 15 Diphtheria and Croup 1 1 - 2 2 - - - 1 1 1 - Erysipelas 1 1 - — . 1 1 2 2 - 1 - Influenza - 18 11 2 2 7 - 6 2 1 5 2 Tuberculous Meningitis 4 8 4 6 4 3 4 3 2 3 4 3 Abdominal Tuberculosis 2 1 1 - 1 1 1 - - - 1 - Other Tuberculous Diseases 7 3 2 2 3 7 2 . 1 1 3 1 Meningitis (not Tuberculous) 10 3 6 7 3 2 3 5 4 3 5 2 Convulsions 5 3 6 7 8 8 5 4 4 2 5 1 Laryngitis 1 . - - - - 1 - - 1 - - Bronchitis 16 17 23 27 13 21 12 12 19 14 17 5 Broncho-pneumonia 47 29 24 60 39 54 34 51 34 36 41 42 Lobar-pneumonia 4 6 1 5 1 3 1 3 4 2 3 2 Pneumonia (type not stated) 9 9 8 4 3 6 1 3 - 1 4 1 Diarrhœa 8 6 10 11 11 4 6 6 9 7 8 3 Enteritis 52 31 37 26 63 27 37 46 36 38 39 24 Gastritis 4 1 3 2 2 . 1 - 2 . 1 - Syphilis 16 13 11 15 14 8 5 2 5 1 9 2 Rickets 2 - - 1 1 1 . - - - 1 - Suffocation (overlying) 13 6 1 2 2 5 1 1 4 3 4 1 Injury at Birth 3 2 6 5 3 3 6 4 7 3 4 9 Atelectasis 9 8 7 10 8 4 9 7 2 6 7 10 Congenital Malformations 19 17 31 33 25 31 27 23 20 25 25 15 Premature Birth 61 50 68 105 75 61 70 59 57 57 66 39 Atrophy, Debility and Marasmus 44 46 45 40 34 28 21 24 17 18 32 13 Other causes 20 18 24 24 18 23 15 14 17 15 19 15 Totals 402 340 336 435 360 337 272 303 280 274 334 205 N ett Births 3796 3318 3824 5934 1761 4559 4348 1112 3880 3612 4215 3299 20 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 353 Highgate Hospital, Dartmouth Park Hill 554 Metropolitan Asylums Board Hospital. St. Margaret's Hospital, Leigliton Road (for ophthalmia neonatorum and marasmus) 65 General and Special Voluntary Hospitals. General 413 University College Hospital, Gower Street Obstetric 64 (Royal Ear 38 Royal Free Hospital, Gray's Inn Road 266 London Temperance Hospital. Hampstead Road 140 Elizabeth Garrett Anderson Hospital, Euston Road 40 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 * Half the hospital closed for extension. 21 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 bv the Ministry of Health. Ambulance Facilities. For infectious cases ambulances are 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. For Maternity cases the London Ambulance Service provided by the London County Council is available between the hours of 11 p.m. and 8 a.m. 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 Clinics. Raydon Street, South Highgate The Borough Council. Cromer Sunlight Centre, Cromer Street A Voluntary Committee. 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 ” Camden Town Centre, Camden Road ” Argyle Square Centre ” Caversham Road Centre ” Oakley Square Centre ” University College Hospital Centre .. The Hospital Authorities. f Royal Free Hospital Centre ” Cromer Welfare Centre, Cromer Street A Voluntary Committee. C.— Day 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 ” Whitfield Street Day Nursery, 53, Whitfield Street ” † a grant is made by the Borough Council in respect of the Visitor's Salary. 22 Situation. By whom provided. D. Dental Clinics. Argyle Square : For mothers and children who The Borough Council, attend the Maternity and Child W elfare Centres Ampthill Square: For mothers and children who The Voluntary Committee, attend the Centre at 1, Ampthill Square St. Pancras Dispensary : For Tuberculosis cases The Borough Council. „ For oi'dinary cases .. The Dispensary Committee. E. . School Clinics. Highgate New Town: Chester Road Voluntary Committees working St. Pancras Centre, Prince of Wales Road under agreement with the Lancing Street Centre, Churchwav.. 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, Gower Street (for male and female patients). H. Clinic for Sick Mothers and Young Children. St. Pancras Dispensary, 39, Oakley Square .. Medical Officer paid by Borough Council; other expenses paid by Dispensary Committee. I. Convalescent Homes for Sick Poor Children. The Mayoress of St. Pancras Home, " Avalon," By Voluntary Committee, with St. Alban's Road grant from Borough Council. Invalid Children's Aid Association (for various Subsidy from Borough Council, homes) MATERNITY AND CHILD WELFARE. The statistics for the year in regard to births and deaths of infants will be found on pages 13, 14 and 17 to 19 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. (б) The visiting of expectant and nursing mothers and babies by the 23 Council's staff of health visitors, who work (a) from the Town Hall and (4) from the Centres. (c) The provision and maintenance of Maternity and Child Welfare Centres. These 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 ailing young 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. (A) The subsidisation of a voluntary fund for the provision of Home Helps. (i) The subsidisation of the three voluntary Day Nurseries in the Borough. (,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 home nursing of sick infants in certain cases. (/) 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 means of subsidy to voluntary agencies. (o) The provision of consultations with an obstetric specialist, bacteriological examination and skilled nursing in connection with necessitous cases of Puerperal Fever and Puerperal Pyrexia, 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 Health Visitors at the Welfare Centres are full.time workers (18 in number), 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 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 1927 the Council's staff at the various Centres made 29,422 visits to 3,007 children, and 2,039 to 900 expectant mothers; the trained workers not paid by the Council made 10,173 visits to 415 children, and 140 visits to 43 expectant mothers. 24 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. Centre Staff, paid by Council 900 2039 3007 29422 Trained Centre staff, not paid by Council 43 140 415 10173 Total of all trained workers 943 2179 3417 39595 Corresponding totals for 5 previous years— 1926 1618 3651 4030 48686 1925 2007 4979 4542 55547 1924 1921 4621 4571 53884 1923 2084 4953 5401 52759 1922 2342 4770 6194 50347 25 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. Under 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 ; Borough 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. St. Pancras School for Mothers- Amptbill Square 97 472 319 59 378 3642 2094 5736 150 — 201 — 624 — 4791 — -(1) 180 —(2) 43 3 Chalton Street 31 69 164 11 175 2277 1715 3992 42 — 188 30 301 — 4625 1223 12 145 1 12 2 North St. Pancras School for Mothers, Queen's Crescent 88 194 304 39 343 4258 3260 7518 84 — 278 — 487 — 4302 — 18 217 —(3) 21 3 South Highgate Centre — — 63 10 73 1258 839 2097 20 — 47 — 95 — 1191 — —(4) 74 — — 1 Grafton Road Centre 46 105 197 42 239 2374 1590 3964 70 — 302 — 292 37 3800 839 13 159 1 12 2 Camden Town Centre, Camden Road 156 185 299 46 345 4160 2329 6489 160 — 249 — 556 — 3418 94 -(5) 226 — (6) 15 3 Argyle Square Centre 18 45 241 35 276 2581 1439 4020 81 — 196 — 369 — 4090 — 13 162 1(7) 6 1 Caversham Road Centre 120 676 293 32 325 4362 1405 5767 115 9 350 61 160 192 2398 3438 12 140 4 48 2 (†) Maternity Nursing Association, Oakley Square 38 42 19 2 23 400 450 850 — 34 — 49 1 — 189 94 8 25 1 3 1 University College Hospital 810 3766 — — 537 — — 2591 — — — — — 186 — 4485 9 101 18 208 — Royal Free Hospital, Gray's Inn Road 305 1131 — — 161 565 509 1074 178 — 228 — 117 — 618 - 12 149 —(8) 175 — Totals 1709 6685 — — 2875 — — 44098 900 43 2039 140 3002 415 29422 10173 — 1578 — 543 18 † January to March only. (1) January to March, 18; April to December, 14, (2) January to October, 4; November and December, 2. (3) January to October, 2; November and December, 1. (4) January to June, 8; July to December, 4. (5) January to March, 16; April to December, 20, (6) January to March, 2; April to December, 1. (7) Joint consultation at Chalton Street from July. (8) January to July, 16 ; August to December, 12. 26 Maternity and Child Welfare Centres. These are 10 in number. Each Centre is managed by a Committee, the members of which not only give valuable help at the various consultations, but also provide 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 on page 25 gives statistics concerning the work of all the Centres during 1927. It will be seen that 1,578 infant consultations and 543 ante-natal consultations were held during the year. The children who attended for the first time numbered 2,875. The total attendances of all children was 44,098, as compared with 47,735 in 1926, and 49,470 in 1925. The total attendances of expectant mothers numbered 6,685, as compared with 6,822 and 6,736 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, Ampthill Square. In addition to the consultations provided by the Council, other activities of this centre include the following:— Classes for Mothers. At infant care classes there were 482 attendances; ante-natal care, 256 attendances; and at needlework, etc., classes, 594 attendances. Dinners for Mothers and Children. These are supplied at a very small charge for necessitous cases. 2,875 dinners were supplied to nursing and expectant mothers, and 3,241 to young children. Observation Day Nursery. This is for children needing special care. There were 1,723 attendances during the year, of which 910 were made by infants under one year of age, and 813 by children over one year. Interviews with parents (other than already recorded) numbered 6,099. Dental Clinic. This is provided out of funds from voluntary sources. The Dental Surgeon is Mr. George Thomson, L.D.S. During the year 35 consultations were held, at which 394 attendances were made. Details of the work done are given in the following table:— Mothers, Children. Extractions with anaesthetics 49 15 „ without anaesthetics — 6 Fillings 47 104 Scalings 22 — Impressions and fitting dentures, etc. 76 — Examinations and advice 26 49 Totals 220 174 27 Chalton Street Centre. The additional activities of this Centre included the provision of knitting and needlework classes at which 316 attendances were recorded. 26 mothers and 37 children were sent away for a holiday. North St. Pancras School for Mothers, Queen's Crescent. During the year 19 voluntary consultations for older children was held by Dr. J. Finch Haines. "Health Talks" and "Mothercraft" classes were held twice a month, 372 attendances being recorded. Interviews with parents by the Superintendent, other than at classes or clinics, numbered 2,745. South Highgate. Centre. As the Artificial Light Clinic is held at this Centre, and occupies much of the Superintendent's time, there is little opportunity for undertaking any additional work. A cookery class, however, was held each Tuesday evening during the early months of the year, the average attendance being 10. The lecturer at this class was kindly provided by the London County Council. Grafton Road Centre. 67 voluntary consultations were held during the year, the Medical Officers being Dr. McKenna and Dr. Richard H. Wace. 413 dinners were supplied to nursing and expectant mothers. 11 mothers and 17 children were sent away for convalescence, Camden Road Centre. A short series of Health lectures were given to expectant mothers during the early months of the year. 20 mothers and 21 children in need of a change were sent to the seaside for a fortnight's holiday. Argyle Square Centre. Sewing classes were held at which the attendances numbered 198. Interviews with parents, other than at classes or clinics, were about 600. Caversham Road Centre. In addition to the consultations provided by the Council, a number of others have been held, the cost of which has been defrayed out of funds from voluntary sources. The services of two qualified Health Visitors (one full-time and one part-time) was also provided from the same fund. Classes were held in a number of subjects, the attendances being as follows;—Needlework 664, Child Study 468, Cookery 81, Hygiene 50. 28 Additional Facilities for the In-Patient Treatment of Children under 5 years of age. During the year an arrangement was made with the Royal Free Hospital for the admission of children from the Council's Welfare Centres, who are considered to require observation or special feeding. A fee of thirty shillings per week is to be paid for each child admitted. Artificial Light Treatment. The clinic for providing this treatment was opened in February, 1925. The patients are selected by 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 being defrayed by the Borough Council. Three consultations, each of two hours' duration, are held weekly. Staff.—The Medical Officer carrying out the treatment is Dr. Wm. Beaumont, m.r.c.s., l.r.c.p. The Superintendent of the Centre is Miss G. R. Bristow, and assistance is given 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 225. The number of new patients being 154. The total number of attendances was 5,861. The number of Consultations held, 120. Average attendance per Consultation, 49. Average number of attendances per child, 26. Cost. £ s. d. Electric current 1118 5 Cleaning 8 14 0 Consultation fees 190 11 6 Miscellaneous 3 10 9 £214 14 8 This clinic appears to be increasing in popularity and the results obtained are encouraging. As compared with the previous year the total attendances show an increase of 1,278, and the average attendance per consultation increased from 40 to 49. Medical Report on the work of the Artificial Light Clinic. The following report on the cases treated has been supplied by Dr. Beaumont, the Medical Officer in Charge:— "The Third Annual Report on the work of this Clinic more than ever justifies its existence, and confirms the value of the work done and the benefit to the children who have been treated. 29 The following types of cases have been treated:— Rickets 115 (a) early. (b) late or bony. (c) teething disorders. (d) looseness of ligaments and flabbiness. Bronchial Affections 20 (a) idiopathic. (b) bronchial asthma. (c) congenital. Incipient Tuberculosis 5 (a) alimentary. (b) congenital. Enlarged Glands of Neck 6 Debility 22 (a) following severe illness. Delayed Development (cause unknown) 20 Nervous Instability 9 (a) congenital. (h) 'only childism.' Malnutrition 14 (a) poverty. (b) dietetic error. Other Causes 10 (a) anaemia. (b) congenital heart. (c) St. Vitus' dance. (d) nasal catarrh. I. Results of Treatment. Observations recorded in previous reports have been confirmed most emphatically, and, in addition, the following fresh points are noted:— (i) Persistent Constipation—a not uncommon condition in children and often incident upon other conditions. After 24 treatments this has responded strikingly, and with extended treatment has resulted in a complete cure. (ii) Congenital Heart Disease (valvular defects). A marked improvement in the general circulation, with a less tendency to blueness and coldness of extremities. (iii) Asthma. All cases showed mitigation of the severity and frequency of attacks. One child, commencing an attack while at the Clinic, was immediately treated for 15 minutes and the spasm ceased. (iv) Teething Disorders. A curious condition was noted in many cases—the children cut several teeth after the first few treatments until the normal number of teeth were through, then progress conformed to the average. (v) Looseness of ligaments and lack of muscular tone. It was very noticeable how the flabby child quickly became firm and steady on its limbs. (vi) Nasal Catarrh. The thick purulent discharge quickly clears, and the thin watery discharge responds to about 20 treatments and nearly always completely disappears. (vii) Late Bony Rickets. Where there is marked genu valgum or varum very little improvement has been noted, und in these cases sunlight treatment should be merely an auxiliary treatment. 30 II. General Observations. (i) Limitation of dose. It has been found that this gives as good results and eliminates such unpleasant features as sleeplessness, and a tendency to diarrhoea, which sometimes follow an exposure of more than 15 minutes. (ii) Extended treatment—as many as 80 exposures. This is a definite economy, the results being more permanent, with a less tendency to relapse. (iii) Auxiliary treatment —Cod Liver Oil or Calc. Lact. Better and quicker results are obtained, especially in Rickets and Debility. (iv) General educative effect. By emphasising the importance of skin reaction the mothers realise the value of free skin action resulting from general cleanliness and suitable clothing. (v) Improved resistance to disease. Those children who during treatment have contracted measles in the recent epidemic have had it in a much milder form and made a quicker recovery, with not a single instance of complications. During the past twelve months the method of following up cases has been adopted, although the response of the mothers leaves something to be desired. Cases treated during the two previous years have attended the clinic to report as to progress or relapse after cessation of treatment, and this has enabled us to note the effect on treatment resumed, where necessary, after a lapse of time. On the whole the results shown have been most encouraging and fully justify the assertion made at the beginning of this Report." Chomer Street Artificial Light Centre. Additional facilities for Artificial Light Treatment became available during the latter part of the year. A Voluntary Committee having established a Welfare Centre in Cromer Street, equipped with a lamp (Mercury-Vapour) for providing this treatment, very generously offered to treat, either free or at quite nominal rates, suitable cases recommended by the Medical Officers of the Borough Council Welfare Centres. This will be a great convenience to patients living in the South of the Borough, many of whom found the long journey to the Council's Light Clinic at Highgate somewhat arduous. The Borough Council's Dental Clinic, 40, Argyle Square. At this clinic dental treatment is provided for mothers (nursing or expectant) 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 arc expected to contribute what they can reasonably afford towards the cost of dentures. 31 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. 1927. 1926. Number of new cases Mothers 240 213 Children 178 205 Total 418 418 Number of Attendances For extractions under nitrous oxide (gas) 347 358 „ „ local anaesthesia 140 117 „ fillings and dressings 318 311 „ scaling 42 61 ,, impressions and fitting dentures 465 530 ,, examination and advice 610 628 Total attendances 1922 2005 Total number of clinics held 114 110 Number of clinics with nitrous oxide anæsthesia 25 23 The following table shows the number and cost of the dentures supplied during the year:- Number of Patients supplied with dentures 70. Total cost £224 0s. 0d. Amount paid by mothers £165 4s. 0d. Amount paid by Borough Council £21 10s. 0d. Amount paid by various Societies £37 6s. 0d. 14 mothers paid the entire cost of two dentures each. 23 mothers paid the entire cost of one denture each. The Societies who made contributions towards the cost of dentures were the Metropolitan Hospital Sunday Fund, £23 15s. 0d.; the Metropolitan Hospital Saturday Fund, 16s.; and various other societies (chiefly through the Charity Organisation Society), £12 15s. Od. The general supervision of the work, arranging appointments, recording attendances and the collection of contributions, etc., continued to be efficiently carried out by Miss C. Smith, one of the Council's Women Inspectors until her illness, which unfortunately proved fatal in December. The loss of her services in connection with this work is keenly felt. Dental treatment is also provided at the voluntary clinic, which is held at the St. Pancras School for Mothers, see page 26. The Centres held in 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. 32 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 dayinurseries for the year ended 31st March, 1928, are as follows:— Grant paid by Borough Council. No. of Days Open. Attendances. Average per Day. £ s. d. Whitefield Day Nursery 155 1 6 237 6487 27.4 Kentish Tn. DayNursery 132 6 7 236 8260 35.0 Margaret Day Nursery 132 8 5 252 5040 20.0 The Council also made a contribution of £100 to the Hampstead and North St. Pancras Day Nursery, 27-29, Pond Street, N.W. 3. Although this institution is situated in Hampstead, it is used to a considerable extent by St. Pancras mothers who reside in the north of the Borough. Clinic for Ailing 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 1927, new cases under five years of age numbered 104, ailing mothers 17, and expectant mothers (new cases) 62. The total attendances at this clinic were 294 of children under five, 92 of ailing mothers, and 121 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, 650; attendances, 2751; ailing mothers and expectant mothers: new cases, 100; attendances, 246. The Medical Officer of this Special Clinic is paid by the Borough Council. He is assisted by a Nurse (half-time), the cost of whose services is defrayed from voluntary funds. During the year the Nurse made 1,024 visits to the homes of children under five. The Dispensary Resident Medical Officer also made 377 home visits to sick children under five years of age. The cost of the other work of the Dispensary amongst women and children is defrayed out of 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 and the necessary staff. The Borough Council makes an annual grant of £350. 33 In previous years the age limit for admission was from 2 to 5 years of age, hut during the past year children of 18 months have been admitted. The children are either convalescent after illness, or are weak, badly nourished, etc., and require good food, fresh air, and special care. A large garden is attached to the home and an outdoor playroom was provided during the year by St. Pancras Branch of the Dickens Fellowship. The staff consists of a Matron, Assistant Matron, 3 Probationers and a domestic staff numbering 3. A laundry, equipped with electrically-driven machinery, is also attached to the home. No children were in residence at the beginning of the year owing to an outbreak of infectious disease at the end of the previous year. 147 were admitted during the year. The average length of stay in the Home was 26 days. (b) Children requiring a longer period of convalescence, or who require more skilled nursing are sent to various homes by the Invalid Children's Aid Association, and a contribution towards the cost is made by the Borough Council. Under this scheme 29 children were sent away during the year. Supply of Milk to Mothers, and Children under School Age. The Council continued during 1927 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 1927 is shown in the following figures:— Pints of Milk Granted Free. Pints of Milk Granted Half-price. Cost to Council. 1927. £ s. d. January 8961 830 136 13 2 February 7913 826 121 4 0 March 8554 1176 133 8 5 April 7739 857 102 0 6 May 6813 824 94 8 3 June 6355 874 92 6 0 July 5965 1062 89 16 3 August 5516 980 82 17 3 September 5850 949 86 7 0 October 6006 795 101 15 6 November 6796 772 113 3 0 December 7204 723 119 1 5 Totals 83672 10668 1273 0 9 At the end of 1926 there were 251 families in receipt of milk through the Council's scheme. 268 new families were added to the list of recipients during 1927, and at the end of 1927 there were 203 families in receipt of milk. As will be seen from the table above, 34 there were supplied in 1927, 83,672 pints of milk free and 10,668 pints at half-price, at a cost to the Council of £1,273 0s. 9d., 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. The undermentioned changes in the staff occurred during the year:—Dr. Margaret E. Alden, Dr. Ruth Elliott and Dr. Jessie S. Muir resigned their appointments as Medical Officers at the Council's Welfare Centres. The services of Dr. Kathleen Lander were no longer required owing to a re-arrangement of Ante-Natal Consultations. Dr. Helen Turover was appointed Medical Officer to the St. Pancras School for Mothers, Ampthill Square. Miss K. L. Allfrey, Superintendent Camden Road Centre, resigned, Miss M. Templeton being appointed to fill the vacancy. Mr. E. M. Dillon, Sanitary Inspector, was absent throughout the year owing to a fractured leg. This officer has now been superannuated. Miss C. Smith, Woman Sanitary Inspector and Health Visitor, died in December, 1927. Professional Nursing in Necessitous Homes. 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. During the year the Council made arrangements for the home nursing of Pemphigus Neonatorum, and in connection with this a communication was received from the Minister of Health, stating that 35 he sanctions the proposal of the Council to make arrangements with the District Nursing Associations for the home nursing in necessitous cases of mother and child when the latter is suffering from pemphigus neonatorum, at a charge of 1s. 6d. per visit. While the cost of visits for maternity nursing (i.e., till the end of the lying-in period) of the mother can rank for grant, such grant is not at present available in respect of the cost of the nursing visits to the baby suffering from pemphigus. The matter will be considered in connection with any revision of the regulations. Since October 1, 1926, an arrangement has also been in force with the Central St. Pancras and Metropolitan District Nursing 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 1927:- District Nursing Association. No. of cases. No. of visits. Average per case. Central St. Pancras 41 544 13.3 Metropolitan 34 549 16.1 Hampstead 9 149 16.6 North London 23 331 14.4 Total 107 1573 14.7 Home Helps. This is a term used to describe women who have received a certain amount of training in domestic duties, including the care of young children. They are provided for necessitous families where the mother is incapacitated on account of sickness or child-birth. The Borough Council makes an annual grant of £150 for use in respect of maternity cases only. The management is in the hands of a Voluntary Committee, on which the Council is represented by two members. During the past year the resignations were accepted of the Honorary Treasurer and Secretary. These vacancies were filled, and the Committee has recently carried out a considerable amount of useful re-organisation. Two new Home Helps have been appointed, definite hours have been fixed, and the scope of the duties defined. The necessary supervision of their work has been secured by the appointment of a visitor (part-time) who calls at the homes, interviews the mother, and also collects payments according to the assessment which has been made. 56 cases were dealt with during 1927, 41 being maternity and 15 sickness cases. Midwives. In the Metropolis, the supervising authority for midwives is the London County Council. According to figures supplied by that authority the number of midwives who in 1927 had notified their intention to practise in St. Pancras was 34. Private midwives are not subsidised by the Borough Council, but a subsidy is paid for each approved necessitous case attended in the patient's home by midwives on the staff of certain hospitals and by midwives employed by the Maternity Nursing Association, A subsidy is not given in cases where "Maternity benefit" is payable. 36 Midwifery. There are a large number of institutions, situated either within or near the Borough, which provide midwifery attendance either at the patient's home or by admission as in-patients. In the following table particulars are given, for 1927, with reference to all St. Pancras women who were attended in their confinements by the staff of the various institutions:— Institution. Admitted as In-patients, Attended at Home. By Students. By Midwives. University College Hospital 320 563 127 Royal Free Hospital 120 18 .. Elizabeth Garrett Anderson Hospital 13 *131 .. St. Pancras Hospital 182 .. .. Middlesex Hospital 121 .. 49 Queen Charlotte's Hospital 155 .. .. City of London Hospital 56 .. .. Royal Northern Hospital 25 .. .. St. Bartholomew's Hospital .. 2 .. Other hospitals 38 .. .. Queen Mary's Maternity Home 54 .. .. Maternity Nursing Association .. .. 296 *Attended by qualified staff. It will be seen from the above table that full use is made of the institutional facilities which are available. The cases admitted as in-patients represented 33 per cent. and those attended at home 36 per cent. of the total number of St. Pancras births. As compared with the previous year there was a decrease in the number of cases attended at home and an increase in the number of those admitted as in-patients. The Borough Council pays a subsidy to certain hospitals for the admission of cases to their maternity wards, and also pays a subsidy for cases attended at home by midwives on the staff of certain institutions. No subsidy is paid for cases attended by medical students. The following table gives the names of the hospitals, etc., and the amount paid during the past year:— £ s. d. Royal Free Hospital 13 0 0 Elizabeth Garrett Anderson Hospital 8 0 0 Queen Charlotte's Hospital 57 0 0 City of London Hospital 22 0 0 Middlesex Hospital 44 15 0 University College Hospital 103 15 0 Maternity Nursing Association 15 15 0 Total £264 5 0 The corresponding grants for the previous three years were £216 5s. 0d., £275 10s. 0d. and £412 5s. 0d. 37 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 Connty Council, but enforced by the Borough Council:— (а) With reference to the removal of offensive matter, 1893. (б) „ „ closets, ashpits, etc. (c) „ „ offensive trades. (d) „ ,, drainage construction and accessories thereof. (e) „ „ Rag and bone dealers, 1923. (f) ,, „ Houses let in lodgings, 1926. 5. London County Council (General Powers) Acts, 1893-1926. B.-New (Public Health) legislation which came into force in 1927:— 1. Lead Paint (Protection against Poisoning) Act. 2. Births and Deaths Registration Act. 3. Public Health (Smoke Abatement) Act. 4. Coroners (Amendment) Act. 5. Public Health (Preservatives, etc., in Food) Amendment Regulations. 6. London County Council (General Powers) Act, 1927. C —The undermentioned Public Health legislation was enacted during 1927, but does not come into force until the following year:— Public Health (Condensed Milk) Amendment Regulations, 1927. Public Health (Dried Milk) Amendment Regulations, 1927. The above-mentioned regulations are primarily designed to secure that in the labelling of condensed and dried skimmed milks greater prominence shall be given to the words "Unfit for Babies," and that those words shall also be printed on the outside of any paper or other wrapper in which lins of such milk may be enclosed. Infectious Diseases (London) Regulations, 1927. These will come into force on 1st January, 1928, and deal with malaria, dysentery, acute primary pneumonia, acute influenzal pneumonia, typhus fever, relapsing fever and enteric fever. 38 National Rat Week. Rats and Mice (Destruction) Act, 1919. The Ministry of Agriculture and Fisheries issued a notice suggesting that the above should be observed during the week commencing Monday, 31st October, 1927. This suggestion was accepted and the measures enumerated below were adopted (a) A circular was forwarded to the occupiers of all premises particularly likely to be infested—such as railway sheds and sidings, goods yards, wharves, slaughter-houses, corn chandlers, etc. Attention was also called to the necessity of abolishing refuse and rubbish heaps of all kinds. (b) The chemists and hardware dealers in the Borough were asked to stock, exhibit, or advertise suitable raticides, traps, etc., during the week. 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, 3 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, 56 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 233 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:— Inspections. Drainage work done under notice 3570 Voluntary drainage work 5400 Drains of new buildings 2510 11480 Drainage Register.—The following is an analysis of the Drainage Register during 1927:— Plans deposited—Old Buildings under Notice 168 „ „ Old Buildings, Voluntary 181 ,, „ New Buildings and Additions 77 426 Applications without Plans 269 Total number of Applications and Plans 695 39 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. 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. For the purpose of comparison the figures for the previous vear are also given:— 1927. 1926. Tons. Cwts. Tons. Cwts. Quantity of refuse collected 55780 4 53625 12 Quantity of refuse burnt at Destructor 35251 15 33349 0 Quantity put on rail 20436 15 20420 12 Quantity of clinker residual 14534 5 15866 18 It will be noted that during the past year a more efficient combustion has been secured, the quantity of clinker residual being less by 1332 tons, although the amount of refuse burnt was 1902 tons more than during the previous year. 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 1925 this is now a satisfactory and well-equipped building. 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 152 95 247 „ bodies received 133 87 220 ,, post-mortem examinations 96 62 158 SANITARY INSPECTION OF THE AREA. Inspections.—78,082 visits and inspections were made in 1927 by the Council's staff of Inspectors and Health Visitors. Of these inspections, 41,564 were made by the District Sanitary Inspectors, 9,683 by the Inspectors of Food and Food places, 3,621 by the Inspector of Factories and Workshops, and 23,214 by the Women Sanitary Inspectors and Health Visitors. 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 25), and by the staff of the Tuberculosis Dispensaries (see page 74); nor do they include the work of the disinfecting staff, particulars of whose work is given on page 75. 40 Notices served.—3,707 intimation notices were served by the Inspectors during the year. Of these 3,414 were served by the District Sanitary Inspectors, 285 by the Factory and Workshop Inspector, 2 by a Food Inspector, and 6 by the Senior Woman Sanitary Inspector. 2,002 Statutory notices were served for non-compliance with certain of the above intimation notices. Details of the work performed by the various Inspectors and Health Visitors will be found in Tables 6, 7 and 8 on pages 84-86. 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. 68, Marsden Street Drain defective Jan. 13th Order 28 days. 108, Weedington Road Insufficient water-closet accommodation Mar. 24th Withdrawn—work carried out, costs £1 1s. 193, Dartmouth Park Hill Failing to provide portable metal dustbin „ 25th Fined £1, costs £2 2s. 108, Weedington Road Defective yard paving „ 24th Costs £1 1s.—withdrawn; work carried out. 46, Marsden Street Occupied house without a proper and sufficient supply of water „ 24th Costs £2s 2s. „ 11a, Kentish Town Road Defective roof „ 24th Costs £2 2s.—Order 21 days. 67, Chalton Street „ April 5th Costs 10s. 6d.—Order 14 days. 115, Regent's Park Road Occupied house without a proper and sufficient supply of water May 19th Costs £1 ls.—withdrawn; work carried out. 156, Arlington Road Dampness of basement front room „ 25th Summons dismissed. 12, Hawley Mews Water closet without external ventilation, soil pipe defective and sink waste connected to water-closet July 7th Costs £1 5s.—Order 28 days. 11, Dickinson Street Roof, fresh air inlet and washhouse paving defective Aug. 11th Costs .£6 8s.—work carried out. „ Yard paving defective „ 11th Costs £l 13s, 6d. „ 4, Dunollie Place Fixing new pan and trap without giving notice Nov. 2nd Costs £2 2s. 6, Modbury Street Failing to provide portable metal dustbin „ 24 th Costs £2 2s. 5, Chaston Street Dustbin and ceiling defective „ 24th Costs £1 1s.—Order 28 days. 6, „ Guttering and water fittings defective and ceiling of ground floor front room down „ 24th Costs £1 1s. „ 32, Maiden Road Occupied house without a proper and sufficient supply of water upstairs „ 24th Order 14 days. 7, Litcham Sreet Failing to provide sufficient water closet accommodation „ 24th Withdrawn. 7, Queen's Mews Walls and ceilings, first floor, dirty and defective drain. Dec. 6th Costs £1 5s.—Order 28 days. 78, Chalton Street Roof and guttering defective „ 13th Costs £2 2s.—Order 7 days. 81, Harrison Street Main, washhouse and water closet roofs defective. „ 14th Fined 1s., costs £l 1s. 4, Lucas Place Water closet basin broken and unable to be used „ 14th Withdrawn—work carried out. 31, Harrison Street Failing to provide sufficient water closet accommodation „ 14th Fined 1s., costs £1 1s. 41, „ „ „ „ 14th Fined 1s., costs £1 1s. 47, „ „ „ „ 14th Fined 1s., costs £1 1s 51, „ „ „ 14th Fined 1s., costs £1 1s. 61, „ „ „ „ 14th Fined 1s., costs £1 1s. 65, „ „ „ 1„ 14th Fined 1s., costs £1 1s. 81, „ Failing to remedy defective condition of water closet door „ 14th Fined 1s., costs £1 1s. 41 London County Council Bye-laws—Housing Act, 1925. Situation of Property. Offence. Date of Hearing of Summons. Result of Proceedings. 23, Marsden Street Failing to provide and maintain in connection with tap on staircase efficient means for carrying off waste water June 2nd Fined 1s., costs £1 l1s. 6d.— work carried out. 17. „ „ „ „ 2nd Fined 1s., costs £1 l1s. 6d.— work carried out. 11, Dickinson Street Failing to carry out cleansing work Aug. 11th Costs £1 13s. 6d.—work carried out. 7, Litcham Street „ „ Nov. 24th Fined 1s., costs £l 5s. 6, Chaston Street „ „ „ 21th Fined £2. 5. „ „ „ „ 24th Fined £2. 31. Harrison Street „ „ Dec. 14th Fined 1s., costs £1 1s. 47, „ „ „ „ 14th Fined 1s., costs £1 1s. 63, „ Failing to renew unclean or unwholesome wall coverings necessary for the effective cleansing of rooms, staircases, basement passage, water closet, washhouse and yard ,, 14th Fined 1s., costs £1 1s. 81, „ Failing to cleanse walls of washhouse and second floor back room „ 14th Fined 1s., coats £1 1s. Under the London County Council (General Powers) Act, 1922. Situation of Property Offence. Date of Hearing of Summons. Result of Proceedings. 11, Dickenson Street Rooms verminous Aug. 11th Work carried out. Costs £1 13s. 6d. 41, Dickenson Street Failing to strip, purify and cleanse rooms Dec. 6th Fined £5. Under the London County Council By-laws made under the Metropolis Management Act. Situation of Property. Offence. Date of Hearing Summons. Result of Proceedings. 28, Carlton Street Improperly constructing a sink June 2nd Fined £2., costs .£1 1s. 24, Wellington Street Failing to cause a newly constructed sink waste to discharge over gully July 7th Costs £1. 1s. 234, Camden Road Making addition to drain without depositing plans Oct. 27th Costs £1 4s. 32, Hillway Altering pipes or other means of communicating with a sewer without depositing plans Nov, 7th Costs £2 2s. SMOKE ABATEMENT. 255 observations of chimney shafts were made during the year and 3 notices were served. There were no prosecutions. The new Public Health (Smoke Abatement) Act, 1926, came into force on July 1st, 1927. The term "smoke" is now extended to include soot, ash, grit and gritty particles ; the penalties for non-compliance with the Act are increased, and power is given to local authorities to make bye-laws regulating the emission of smoke. The Authority for this purpose, for the Metropolis, is the London County Council. In connection with the above subject, a complaint was received during the year with reference to the quantity of dust, stated to contain a dangerous amount of arsenic, and which was alleged to be discharged from the shafts of the Council's Electric Light Works. 42 The matter was investigated, and the following special report was presented to the Public Health Committee:— Atmospheric Pollution with Arsenical Dust. This report is presented in consequence of a complaint which was received in June last concerning the quantity of dust stated to be discharged from the chimneys of the Council's Electric Light Works. The complaint, which came from a business firm, stated that not only was the dust a nuisance, but that samples of it collected from the roof and yard of their premises had been analysed by their chemist, who reported that it contained arsenic to the extent of 125 parts per million. The opinion was expressed that the continued administration of arsenic which would occur by inhalation of the dust and also by the consumption of food which had been contaminated with it (when exposed in provision and other shops in the neighbourhood) might be deleterious to health. As special appliances are installed in the Electric Light Works in order to prevent any nuisance being caused by the discharge of dust, it was unlikely that the nuisance came from the source alleged. Apart, however, from the question of dust, the presence of so much arsenic appeared to render the subject sufficiently important to warrant further investigation. Samples of dust were, therefore, taken from the roof, rain.water gutter and chimney shaft of the Electric Light Station, from similar situations in the premises of the firm making the complaint, and also from two other factories in the vicinity. These are described in the report as factories A, B and C respectively. Samples of dust were also taken from the yard, roof and flue of the Council's Refuse Destructor which adjoins the Electric Light Works. The samples were submitted to Mr. J. Kear Colwell, F.I.C., the Public Analyst, who reported as follows:— 1. Flue Dust. Source of sample. Arsenic (As2 03) Paris per million. Electric Light Works (1) 7.0 „ „ (2) 14.0 Refuse Destructor 100.0 Factory A 400.0 „ B 500.0 „ C 450.0 2. Dust from Rain Water Gutters. Electric Light Works 100.0 Refuse Destructor (Yard) 150.0 Factory A 200.0 „ B 150.0 „ C (Yard) 200.0 3. Dust from Roof. Electric Light Works 175.0 Refuse Destructor 50.0 Factory A 130.0 „ B 120.0 „ C 150.0 4. Pulverised Coal. Electric Light Works 3.0 43 With reference to the quantity of arsenic present in the dust collected from the roofs, yards and rain water gutters, it must be remembered that the weather during the period of investigation was frequently wet, and therefore a certain amount of arsenic may have been dissolved out of the dust deposited in these situations. During very dry weather it is possible that a higher percentage of arsenic may be present. As regards the source of the arsenic, it is probably derived from the coal which is used in the furnaces. Although the pulverised coal in use at the Electric Light Works at the time the samples were taken contained a very small percentage of arsenic, various kinds of coal may contain considerably larger quantities. Enquiries were may at the factories A, B and C in order to ascertain if any other fuel or substances which might contain arsenic were burnt in the furnaces, but the results were negative. The most important point is—does any danger to health arise owing to the presence of this amount of arsenic in furnace dust when this is discharged into the atmosphere ? The smallest fatal dose of arsenic is 2 grains. It would require more than half a pound of the flue dust obtained from factory B (which contained the highest percentage) to yield 2 grains of arsenic. It is therefore very improbable that the small quantity which may be inhaled from atmospheric dust is at all injurious. I doubt if it is generally known that arsenic may be present in such quantity in flue dust and in the dust from factory and other chimneys. It would be interesting to know if the analyses here recorded are unusual, and, if not, to what extent arsenic is present in flue dust, and especially in the atmospheric dust of large manufacturing towns with a larger number of factories and using various kinds of coal. In conclusion, it might be mentioned that the Public Health (Smoke Abatement) Act, which came into force in July last, not only prohibits the emission of smoke from factories, etc., in such quantities as to be a nuisance, but also includes in the prohibition, ash, grit and gritty particles. The provisions of this Act should therefore tend to lessen atmospheric pollution from the sources mentioned, and at the same time should further decrease any slight risk which may have existed owing to the presence of arsenic in the atmospheric dust of large towns. 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 1744 153 — Workshops 2744 113 — Workplaces (other than Outworkers' premises included in Part 3 of this Report) 895 25 — Totals 5383 291 — 44 2.—Defects Found. Particulars. Number of Defects Number of Prosecutions. Found. Remedied. Referred to H.M. Inspectors. (1) (2) (3) (4) (5) Nuisances under the Public Health Acts*:— Want of cleanliness 112 103 Nil. Nil. Want of ventilation 1 1 Overcrowding 1 1 Want of drainage of floors — — Other nuisances 83 74 Sanitary accommodation— Insufficient 19 14 Unsuitable or defective 89 79 Not separate for sexes 26 22 Other breaches 34 31 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) 65 58 Other offences (excluding offences relating to outwork, which are included in Part 3 of this Report) 8 8 Totals 438 391 - - * 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:-15 in respect of the making, etc., of wearing apparel, comprising the names of 56 outworkers (contractors) and 77 outworkers (workmen), 1 in respect of upholstering, containing the names of 3 outworkers (workmen), 2 in respect of the making of cardboard boxes, comprising the names of 10 outworkers (workmen) and 1 in respect of the making or filling of Christmas crackers, etc., comprising the names of 7 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 8 167 222 397 Card boxes — — 3 3 Artificial flowers — — — - Miscellaneous — 3 17 20 Totals 8 170 242 420 45 Outwork in Infected or Insanitary Premises. Seven 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 93 - 156 Cabinet makers 38 65 — 103 Coach builders 15 14 — 29 Dressmakers 25 88 12 125 Engineers 138 35 — 173 Foundries 14 6 — 20 Furniture makers 10 19 — 29 Furriers — 13 2 15 Laundries 10 2 — 12 Metal workers 28 34 — 62 Milliners — 11 7 18 Organ builders 6 4 — 10 Pianoforte manufacturers 37 20 — 57 Printing 64 11 — 75 Restaurant kitchens — — 379 379 Tailors 2 173 120 295 Upholsterers — 36 — 36 Wood carvers 1 17 — 18 Others 461 586 226 1273 Totals 912 1227 746 2885 5.—Other Matters. Class Number. (l) (2) Matters 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 39 Reports (of action taken) sent to H.M. Inspector 39 In regard to workshops where protected persons have been found to be employed (Public Health (London) Act, 1891, section 27) 41 Underground bakehouses (s. 101):— Certificates granted during the year — In use at the end of the year 86 Bakehouses and restaurant kitchens are also referred to on page 57. 46 6.—Total Inspections. Premises. Mate Inspectors. Women Inspectors. | Total. Factories 1552 192 1744 Workshops 1654 1090 2744 Workplaces (including Outworkers' premises) 415 1409 1824 Total 3621 2691 6312 PREMISES AND OCCUPATIONS CONTROLLED BY BY-LAWS OR REGULATIONS. Offensive Trades. One only is carried on in the Borough—a tallow melter. This particular business has been in existence since the year 1780. 48 visits were made to these premises during the year, no complaints have been received, and the business is well conducted. Houses Let in Lodgings. 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 6 on page 84. Underground Rooms (Housing Act, 1925, Section 18 (1)). Inconsequence of inadequate housing accommodation, it has neither been possible nor advisable to take any action in connection with these rooms. An underground room is better than no room. 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 9 canal boats, which were registered for the occupation of 23 adults and 14 children, and were actually occupied by 17 adults and 13 children. A weekly inspection of the canal and wharves has also been made. RENT AND MORTGAGE INTEREST RESTRICTIONS ACT, 1923. During the year 58 applications were received from tenants for certificates under this Act, and in 50 cases certificates were granted, specifying the work required to be executed to put the houses into a good and tenantable state of repair. In accordance with Section 5 of the Act, 12 applications were made by landlords for a report stating that the necessary work to the premises had been carried out, and in each case the "release" certificate was granted. 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 which cannot be dealt with by the sanitary inspectors under any other Act, e.g., repair of chimney Hues, stoves, mantel boards, staircase rails and balusters, door furniture, window fasteners,, floor boards, cupboard doors, etc. 47 In the majority of cases where an examination of premises for the purpose of issuing a certificate under the Act was made by an inspector, 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 l927. They are classified in the following Tables:— Routine Medical Examination of Elementary School Children in St. Pancras, 1927. Defect. Boys. Girls. Entrants. Age 8. Age 12. Age 14. Entrants. Age 8. Age 12. Age 14. Number examined 1800 1189 1335 1407 1660 1223 1296 1327 Cases * Cases * Cases * Cases * Cases * Cases * Cases * Cases * Malnutrition 17 16 18 16 4 3 — — 20 20 20 20 5 5 6 6 Skin disease 20 15 17 15 7 7 9 8 17 14 13 9 8 7 18 14 Defective teeth — 489 — 228 — 200 — 209 - 492 — 237 — 194 - 242 Enlarged tonsils 227 72 107 28 67 18 48 5 211 82 119 38 73 36 57 27 Adenoids 56 32 25 15 5 3 4 4 63 29 15 10 2 2 3 2 Tonsils & adenoids 136 85 21 7 8 6 5 2 145 78 44 25 10 6 11 9 Other nose and throat 19 10 17 12 9 7 10 7 17 14 7 4 8 8 7 6 Enlarged glands 111 7 56 3 32 — 11 2 93 — 27 3 14 1 5 1 Eye disease 62 50 12 7 7 6 7 3 43 36 23 15 9 5 16 8 Defective vision — — - 129 — 170 — 132 — - — 159 — 184 - 155 Otorrhœa 27 18 11 10 20 18 7 7 33 26 21 16 10 7 9 8 Other ear discharge 5 4 6 3 6 6 4 3 9 5 6 3 2 2 5 5 Defective hearing 10 6 15 6 17 6 10 6 11 6 7 3 11 4 10 9 Speech defects 8 1 1 — 1 — 3 1 1 — - — 1 — 2 — Heart defects 36 3 20 3 20 5 19 2 36 3 14 1 23 6 22 6 Anæmia 49 24 39 18 15 7 15 5 30 14 51 31 33 15 32 17 Lung defects 98 50 31 19 12 2 7 — 89 37 33 23 5 4 5 3 Nervous system 12 3 10 4 1 1 — — 11 2 12 5 4 1 6 4 Phthisis 6 1 5 — 4 1 2 — 6 1 5 — 3 1 3 — Other T.B. disease 1 1 1 — 1 — 1 — 2 1 — — — — — — Rickets 10 4 2 1 4 — 2 — 3 1 2 2 1 — 1 — Spinal deformities 4 4 7 5 7 6 8 7 2 1 8 2 8 8 16 14 Other deformities 9 6 7 3 12 7 17 2 7 4 7 2 20 10 25 6 Other defects 50 31 32 18 23 13 10 8 50 33 40 27 44 29 23 14 Number of children noted for treatment 746 447 412 369 731 510 459 460 Note —Defects, however slight, are included under "Cases." Those severe enough to require treatment are shown uDder *. 48 Routine Medical Examination of Elementary School Children in St. Pancras in 1927. 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 1800 1352 439 9 313 1440 46 1 1750 48 2 1780 20 — 931 615 254 — — — Girls 1660 1215 433 12 292 1324 44 - 1559 95 6 1632 27 1 820 598 242 — — — Age 8— Boys 1189 838 345 6 109 1032 48 — 1151 36 2 1157 30 2 676 408 105 690 265 204 Girls 1223 890 330 3 142 1034 46 1 1115 93 15 1197 26 — 681 435 107 659 320 231 Age 12— Boys 1335 996 332 7 150 1165 20 — 1302 33 — 1315 19 1 842 460 33 840 199 270 Girls 1296 984 312 — 145 1125 25 1 1174 115 7 1278 18 — 856 409 31 787 232 275 Age 14— Boys 1407 1077 325 5 227 1159 21 - 1385 20 2 1397 10 — 924 448 35 965 177 260 Girls 1327 1008 318 1 292 1007 28 — 1239 82 6 1311 14 2 872 409 46 851 180 292 Totals 11237 8360 2834 43 1670 9286 278 3 10675 522 40 11067 164 6 6602 3782 853 4792 1373 1532 % St. Pancras 74.4 25.2 0.4 14.9 82.6 2.5 — 95.0 4.6 0.4 98.4 1.5 0.1 58.8 33.6 7.6 62.3 17.8 19.9 % London 58.7 40.2 1.1 20.2 74.8 5.0 — 93.5 5.9 0.6 96.6 3.3 0.1 63.0 29.4 7.6 54.2 25.9 19.9 The St. Pancras School Clinics and Treatment Centres are given on Page 21. 49 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 (6)) 46 houses 249 flats (b) AVith State assistance under the Housing Acts: — (i) By the Local Authority Nil. (ii) By other bodies or persons Nil. 1. Unfit dwelling-houses. Inspection—(1) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 2793 (2) Number of dwelling-houses which were inspected and recorded under the Housing Consolidated Regulations, 1925 310 (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 1643 2. Remedy of defects wit/tout Service of formal Notices. Number of defective dwelling-houses rendered tit in consequence of informal action (intimation only) by the Local Authority or their Officers 1556 3. Action under Statutory Powers. A.—Proceedings under Section 3 of the Housing Act, 1925. (1) Number of dwelling-houses in respect of which notices were served requiring repairs 244 (2) Number of dwelling-houses which were rendered fit after service of formal notices:— (а) By owners 234 (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. B. — Proceedings under Public Health Acts. (1) Number of dwelling-houses in respect of which notices (Statutory) were served requiring defects to be remedied 1206 (2) Number of dwelling-houses in which defects were remedied after service of formal (Statutory) notice : — (а) By owners 992 (b) By Local Authority in default of owners Nil. 50 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 6 on page 84. OVERCROWDING. This is still prevalent. In the latter part of the year a report on " Inspection of Houses and overcrowding " was submitted to the Public Health Committee in order to give information concerning average housing conditions, as existing in tenement houses in the Borough at the present time. The following extracts from the report give the main items of information: — " The houses in question were inspected by the District Inspectors in accordance with the requirements of the Housing Act and the Housing Consolidated Regulations. As the list includes a number of houses in each Ward, the conditions may be taken to represent average housing conditions in working class areas in the Borough as a whole. The houses inspected were as follows:— Wards 1 2 3 4 5 6 7 8 Houses 156 320 180 349 40 87 3 231 The total number of houses inspected was 1,336; these contain 7,896 rooms, and are occupied by 8,861 adults and 3,565 children. The total number of occupants is therefore 12,426, which equals an average of 1.6 persons per room. The standard with reference to overcrowding adopted by the Registrar-General includes all cases in which there are more than two persons per room. From the above figures it would appear that no serious amount of overcrowding existed. Such a conclusion, however, would be quite erroneous, for although the average number of persons per room, taking the figures as a whole, is not excessive, in many cases individual rooms were found to be grossly overcrowded. The following are examples : — In 25 instances 4 persons were found to be living in 1 room. „ 14 „ 9 „ „ 2 rooms. „ 24 „ 5 „ „ 1 room. „ 5 „ 11 „ „ 2 rooms. „ 6 6 „ „ 1 room. „ 6 7 „ „ 1 room. It is therefore obvious that serious overcrowding is still prevalent. 51 In a number of cases the sleeping accommodation was inadequate to allow of separation of the sexes for the adult members of the family. It will be noted that of the 1,366 houses inspected, 80 families, comprising 479 persons, were living at a density of from 4 to 7 persons per room. It is estimated that the total number of working class houses in the Borough is about 16,000. If the same percentage of overcrowding exists in these houses, it means that about 930 families, comprising over 5,500 persons, are living under similar conditions of serious overcrowding. During the last few years a number of families living in the Borough have been provided with housing accommodation on the various Estates of the London County Council situated on the outskirts of London. This accommodation, usually, is granted only to families where the man is in regular work and is able to pay the requisite rent for the amount of accommodation considered to be necessary. During the past year 210 families, consisting of 1057 persons, and who were living in 410 rooms, were provided with accommodation. It will be noted that these were living at an average density of less than 3 persons per room. A policy which deals only with the best type of workmen, and removes them out of London, leaves a very difficult problem to be solved by local authorities if they are to provide accommodation for the casual labourer, men frequently out of work, persons with large families and low wages, the unemployed and the unemployable. It is amongst these that overcrowding is most prevalent, and they are not in a position to pay an adequate rent for the amount of accommodation which they require. The undermentioned are examples of the cases in question : they are numerous and present an almost insoluble problem : — R.S.— Casual labourer (frequently out of work), has a wife and five children. One small room, about 800 cub. feet. Rent 5s. 4d. per week. Owes a considerable amount for rent, has relief from Guardians. J.S.—Addresses envelopes, earns 30s. per week. Wife and 9 Children. Two Rooms. Rent 12s. l1d. Owes nearly a year's rent. Has relief from Guardians. C.S.—Man (out of work), Wife and six Children (including daughters of 20 and 18 years of age), living in one room. HOUSING SCHEMES. 1.— Wolcot Street Area.—Details concerning the progress of this scheme are given under "Work of the Estates Committee" (page 53). 2.—Ossulston Street Area.—The Foundations of the First (Central) Block of dwellings to be erected on this site by the London County Council were commenced in November and a Foundation Stone was laid by the Minister of Health (the Rt. Hon. Neville Chamberlain, M.P.) on February 1st, 1928. The work appears to be proceeding rather slowly and accommodation on this site, therefore, will not be available for some time. 3.—St. Pancras Home Improvement Society.—This is a Public Utility Society registered under the Industrial and Provident Societies Acts, 1893-1913. The objects of the Society include the conversion of houses, too large for single families, into several working class dwellings, each suitable in size and adequately equipped, and the rebuilding of derelict houses in the form of flats suitable for working class families. 52 The Society aims at re-housing original tenants at the original rents. The work is extremely valuable, not only as regards the provision of suitable and much needed accommodation, but as an object lesson illustrating what can be done in the way of converting old and dilapidated buildings. The following particulars concerning the work carried out during 1927 is from information kindly supplied by the Estate Managers and Honorary Secretaries :— A.—Clarendon and Gee Streets. —This site consists of eight houses, five of which had been dealt with during 1926. During the past year the scheme of conversion into selfcontained flats was completed by dealing with the three remaining houses. The work included the repair of dilapidations, the installation of baths and sinks and connecting up to coppers to supply hot water. 15.—Drummond Cresent Area.—A considerable sum has been expended in general repair work. Plans were also drawn up for building eight flats on a vacant site at the corner of Drummond Crescent and Little Drummond Street. This included the demolition of two small houses, one of which, very dilapidated and structually unsound, was a bad type of cottage, used as a tenement house. In its 7 rooms, three of them very small, were housed four families and two single tenants, totalling 23 persons. One of the families displaced was re-housed by the St. Pancras Borough Council and the remainder by the Society. The work of demolition and rebuilding was commenced in October and it is anticipated the new flats will be ready for occupation about the end of May, 1928. The accommodation to be provided is as follows:—four flats each of 4 rooms, with scullery and bath room, to be let at 18s. per week, and 4 flats each containing 5 rooms, with scullery and bath room, to be let at 22s. 6d. per week. C.—In September, 1927, the Society acquired the freehold of two blocks of premises in Somers Town, comprising 96 tenement houses. The property was in a very dilapidated condition, and during the three months to the end of the year about £230) was spent in urgent repairs and in cleaning and redecorating the worst rooms. 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 " tenantable 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." The dwellings controlled by the Committee comprise :— (a) Goldington Buildings, Great College Street (57 flats). (b) Flaxman Terrace Dwellings, Euston Road (84 flats). (c) Prospect Terrace Dwellings, Gray's Inn Road (71 flats). (d) Una House, Prince of Wales Road (65 flats). 53 (c) The Brookfield Estate, Higligate (110 flats, 90 maisonettes and 2 houses). (f) 110 and 112, Leighton Road, Kentish Town. (g) 40, Argvle Square (the main part of the premises are used as a Maternity and Child Welfare Centre and Dental Clinic, but rooms in the upper part of the house are let). (h) 13 and 15, Bayham Place, Camden Town. (i) 15, Willes Road, Kentish Town. (j) 24, Grafton Road Kentish Town. (k) 20 and 22, High Street and 3 and 5, Little King Street, Camden Town. (/) 5, Camden Road (the lower part is used as Electricity Showrooms, and the upper part let in rooms). (m) 63, Pratt Street, Camden Town. (n) 41 and 47, Stanhope Street, Regent's Park. (o) 155, 157, 159 and 161, Great College Street, Camden Town. (p) 9, 10, 11, 12, 13, 14 and 15, Georgiana Street, Camden Town. The vacancies occurring in the Council's dwellings are filled from a waiting list of applicants, which is an extensive one, and preference is given to St. Pancras families. It is worth remarking that during the year under review (1927), 58 changes of tenancies occurred in the above-mentioned premises, and the housing conditions of that number of families were accordingly improved. Somers Town Housing Scheme (Wolcot Street Area). The Borough Council have acquired the freehold and leasehold interests in several properties in Johnson Street, Wolcot Street and Clarendon Street, for the purpose of carrying out a housing scheme on this insanitary area. Eleven of the houses (21 to 28, Wolcot Street and 63, 64 and 65, Clarendon Street) have already been demolished in connection with the two blocks of working-class dwellings now being erected on the site. The housing scheme is for the erection at present of four blocks of dwellings (Blocks A, B, C and D) with 88 separate tenements, comprising 24 two-room, 56 three-room and 8 four-room dwellings. Each tenement will, in addition, be provided with 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, will be built later, and the total scheme will provide for 124 separate tenements. The Council have fixed the weekly rents, inclusive of current rates and water charges, as follows:—13s. 9d. for two-room; 16s. 9d. for three-room; and 19s. for four-room tenements. For the next section of building (Blocks C and D) the following forty properties will be demolished Nos. 1 to 20 and 44 to 54, "Wolcot Street, 34 to 39, Johnson Street, and 38, 39 and 40, Clarendon Street. It is anticipated that in July, 1928, Blocks A and B, comprising 44 dwellings, will be completed and ready for the occupation of families from the adjoining houses which are to be pulled down for the purpose of erecting Blocks C and D. Brookfield Estate Flats and Goldington Buildings. Provision or Pr am and Cycle Sheds. The Council decided to meet the need of accommodation for the storage of prams and cycles at these buildings in response to the wishes of many of the tenants. It is found that considerable damage is done to the walls, staircases and inside the flats through prams and cycles being taken up and down stairs and stored in the passages of flats, and there is a great strain, especially on the women, in having to carry prams up and down stairs. At the 54 other blocks of dwellings maintained by the Council provision has already been made for prams and cycles. A small weekly charge is made to the tenants using the sheds, and the following regulations have been made:—(a) A shed must not be used for any other purpose than for storing a perambulator or cycle; (6) motor cycles are prohibited; and (c) the use of a shed is entirely at the tenant's risk as regards loss or damage of the contents. Phovision of Baths, Flaxman Terrace Dwkllings. Baths have been fitted in the sculleries of a large number of these flats under a scheme adopted by the Council, placing the matter on a satisfactory financial basis, and tenants pay an extra rent of sixpence per week for the additional convenience. Tenants have expressed their great satisfaction with the action of the Council in providing the baths. 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 Council, subject to its being retained for use as allotments or as an open space. There are 30 allotments under cultivation. London County Council Housing Estate. The London County Council have placed at the disposal of the Metropolitan Borough Councils a quota of the new housing accommodation being provided at their Becontree, Downham and Watling Estates, to be utilised for bad cases of overcrowding and cases of special hardship. This scheme was initiated in January, 1925, and the number of St. Pancras families benefited to the end of 1927 is 317. There would be, in addition, a large number of St. Pancras families accommodated in County Council's dwellings from the L.C.C. ordinary waiting list. The work involved in connection with this matter, the amount of correspondence, enquiries, interviews, etc., is considerable, but the results amply compensate for the amount of time occupied and trouble caused. It will be of interest to record the progress being made with the development of the three housing estates to which the Borough Council nominate cases. The information is supplied by the County Council. Becontree, Essex. On this estate, which is approximately 2,770 acres in extent, a total of about 26,000 houses can be erected. Up to 28th April, 1928, 13,673 houses had been completed, 2,222 others were in course of erection, and orders had been given to the contractors for a further 1,829 houses, the construction of which has not yet been commenced, making a total of 17,724 houses for which the County Council has so far approved capital estimates. In regard to the Becontree Estate, the County Council are now in a position to deal with any applications received, as cottages have recently become available for letting in large numbers. Preference is given to persons residing within the County of London. Downham, Lewisham and Bromley (522 acres). This estate is being developed by the erection of 5,932 houses, of which 3,588 have been completed. Watling, Hendon (387 acres). The development of this estate was commenced in January, 1926. Already 2,134 houses have been completed, and 1,417 others are in course of erection. The estate when finished will comprise about 4,018 houses. Staff. The administrative work in connection with the Estates Committee (Chairman; 55 Alderman Thomas A. Collins, j.p. ; Deputy-Chairman : Councillor II. E. Capes) is carried out by Mr. A. D. Corrick, the Clerk to the Committee, who is assisted by Mr. G. N. Cove, and the Housing Superintendent, Mr. L. Barnard. The Resident Caretakers at the several blocks of buildings are as follows:—Prospect Terrace, Mr. II. A. Reid; Brookfield Estate, Mr. H. 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 are now no licensed cowsheds in the Borough. The license for the one which previously existed expired in October and has not been renewed. Dairies and Milkshops.- Thirty-one applications for registration under the Dairies, Cowsheds and Milkshops Orders were received during the year. Of this number, 29 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 1927 : — Number of purveyors of milk from retail milkshops on the register at the end of 1926 212 Deduct number removed from the register during the year 1927 —32 Add number of purveyors registered by resolution of the Council during 1927 +29 Total number of purveyors of milk from retail milkshops on register at the end of 1927 209 In addition to the above, there were also on the register at the end of 1927 two persons in respect of premises where a wholesale cream trade only is done, and 14 itinerant vendors without retail milkshops. Bottled Milk. During the year 70 persons were registered to sell milk in sealed bottles. Five of this number were afterwards removed, so that at the end of the year there were 65 persons on the register. 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. 56 The following licences for the Sale of Graded Milk were granted in respect of 1927 : 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. 16th, 1926 Marshall's Dairies, Ltd., 19, Tudor Place, W. 1 " Grade A Tuberculin tested " 19, Tudor Place. Do. Welfords & Premier Dairies, Ltd., 233, Seven Sisters Koad, N. 4 " Certified " To sell in St. Pancras. Do. Manor Farm Dairy, Ltd., 39, High Road, East Finchley, N. 2 Do. Do. Do. Do. " Pasteurised " 25, Swain's Lane. Do. United Dairies (London), Ltd., " Certified " 63. Park Street, 97, Elgin Avenue, W. 9 '' Grade A Do. Do. Do. Tuberculin tested " Do. Do. " Pasteurised " Do. Do. Do. Do, 69, Albany Street, Do. Do. Do. 177, Albany Street. Do. Do. Do. 48, Marchmont Street. Do. Do. Do. 126, Regent's Park Road. Jan. 20th. 1927 J. R. Mills & Sons, 23, Francis Street, W.C. 1 " Grade A " 23, Francis Street. Do. Express Dairy Co., Ltd., 26-30, Tavistock Place, W.C. 1 " Certified " 50, Gower Place. Do. Do. " Grade A Tuberculin tested " Do. Do. Do. " Certified " 12, South Grove. Do. Do. " Grade A Tuberculin tested " Do. Do. Do. " Certified " 26, Tavistock Place. Do. Do. " Grade A Tuberculin tested " Do. Do. Lord Rayleigh's Dairies, Ltd., 16, Caroline Street, W.C. 1 Do. " Certified " To sell in St. Pancras. Do. Do. D. Davies, 10-11, Woburn buildings, Dukes Road, W.C. 1 Do. 10-11, Woburn Buildings, Dukes Road. Do. Do. " Grade A Tubercul n tested " Do. Do. Do. " Grade A " (Bottling) Do. Do. J. Evans, 35, Southampton Street, W. 1 " Certified " 35, Southampton Street. Do. Lincolnshire Dairies Ltd., 31, " Grade A " 31, Oak Village. Oak Village, N.W.5. Feb. 17th, 1927 Welfords & Premier Dairies, Ltd., 233, Seven Sisters Road, N. 4 " Certified " 51, South Grove. Do. Do. " Pasteurised " Do. Do. Evan Jones, 137, King's Cross Road, W.C. 1 " Grade A " 137, King's Cross Road. Do. Do. " Certified " Do. Do. G. S. Daunton, 1, Guilford Street, W.C. 1 " Grade A Tuberculin tested '' 1, Guilford Street. Mar. 17th, 1927 H. J. Jenkins, 97, Kentish Town Road, N.W. 1 " Grade A " 97, Kentish Town Road. Apl. 13th, 1927 Lincolnshire Dairies, Ltd., 31, Oak Village, N.W. 5 " Pasteurised " (Plant) 31, Oak Village. June 16th. 1927 Stapleton & Sons, Ltd., Brooklands Farm,Stoke Newington '' Grade A Tuberculin tested " To sell in St. Pancras. (b) 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. 57 During the year the undermentioned unsound or diseased food was surrendered by the owners, either for destruction or to be dealt with as trade refuse. There were no seizures. Unsound Food Condemned and Destroyed. Apples, 13 barrels and 2 boxes Apricots, 42 crates and 40 boxes Beef, about 25 stone Black Currants, 18 lbs. Bream, 1 box Cabbages, 1 truck Catfish, 2 boxes Cod, 1 trunk and 1 box Condensed Milk, 15 tins Grapes, 10 baskets Greengages, 21 crates Haddocks, 1 case and 4 boxes Haddocks' Roe, 4 boxes. Head, Bullock's, 1 „ Pig's, 1 Heart, Bullock's, 1 Livers, Bullocks', 10 Liver, Pig's, 1 „ Sheep's, 2 Lungs, Bullock's, 1 pair Mackerel, 6 Mussels, ½ bushel and 2 bags Pears, 17 boats and 200 lbs. Plaice, 2 cases Rabbits, 150 Salmon, smoked, 42 lbs. Skate, 2 cases and 2 boxes Sauerkraut, 1 barrel Tomatoes, 96 boxes Tongue, Bullock's, I „ Sheep's, 18 Whiting, 1 trunk "Witches, 2 boxes Yeast, 10 .baskets Slaughter-houses. At the end of 1927 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 132 inspections during the year. Fried Fish and Fish Curing Premises. In 1927 there were 78 fried fish vendors' premises in the Borough, at 4 of which fish curing was also carried on. There were 21 fish curers' premises, including the 4 above mentioned. 377 visits were made by the Food Inspectors to these premises during the year. Ice-cream Premises. 328 ice-cream premises were known to the department; 290 visits were paid to them by the Food Inspectors during the year. Bakehouses and Restaurant Kitchens. At the end of 1927 there were 156 bakehouses on the register, including 63 factory bakehouses. 35 of these bakehouses were not in use. 115 of the 156 were underground bakehouses, of which 55 were factory bakehouses, and 29 not in use. At the end of the year 379 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 44 and 45. 58 (c)—SALE OF FOOD AND DRUGS ACTS. 800 samples have been taken under these Acts, of which 571 were formal and 229 informal. Of the formal, 547 proved to be genuine, and 24, or 4'2 per cent., adulterated, and of the informal, 204 were genuine and 25, or 10.9 per cent, adulterated. Articles of food of which samples have been taken. Total number of samples. Genuine. Adulterated. Formal Informal Formal Informal Formal Informal Apricots (canned) - 2 - 2 - - Bacon - 4 4 - - Beans (canned) - 2 1 - 1 Black pudding - 1 1 - - Brawn - 2 - 2 - - Butter 142 6 140 6 2 - Cake - 4 - 4 - - Cake flour 1 - 1 - - - Cheese - 2 - 2 - - Chocolates - 1 - 1 - - Cocoa 8 1 8 1 - - Coffee 8 1 8 1 - - Cornflour 1 - 1 - - Cream 2 14 1 8 1 6 Cream (canned) - 2 - 2 - - Cream (preserved) 1 7 1 6 - 1 Currants - 3 - 3 - - Custard powder 2 - 2 - - - Devonshire roll - 1 - 1 - - Dripping 5 - 5 - - - Fish paste 5 6 5 6 - - Flour 23 1 23 1 - Fruit (mixed dried) 1 — 1 - - Fruit salad (canned) - 4 — 4 - „ (dried) - 1 — 1 - - Ginger beer - 1 - 1 - - Glycerine 5 - 5 - - Grapes 1 — 1 - Herrings in tomato (canned) - 2 — 2 - - Honey - 2 - 2 - - Haricot beans 1 - 1 - - - Jam 1 13 1 12 - 1 Jelly cream . - 1 — 1 - — Jelly crystals 1 - 1 - - Lard 19 - 19 - - - Lemonade - 1 - 1 - - Lemon curd - 2 - 2 - Lime juice - 1 — 1 - — Lobster 1 — 1 — — Margarine 1 — 1 - - — Macaroni - 1 - 1 - - Meat cutlet - 2 - 2 - - ,, croquette — 1 — 1 — Pie — 10 — 10 - — Milk 309 2 295 1 14 1 „ (condensed) — 9 — 9 — — Mustard 5 — 5 - — - ,, compound 1 — 1 - — — ,, pickle — 1 — 1 — — Minced meat 1 - 1 - - Oatmeal 1 - 1 - - Peaches (canned) — 1 — 1 — — Carried forward 541 120 524 110 17 10 59 Articles of food of which samples have been taken. Total number of samples. Genuine. Adulterated. Formal Informal Formal Informal Formal Informal Brought forward 541 120 524 110 17 10 Pears — 1 1 — — ,, (canned) — 1 — 1 — — ,, (dried) — 1 — 1 — — Polonie — 3 — 3 — — Peas (dried) 1 — 1 — — — ,, (canned) — 3 — 2 — 1 Peel (candied) ,, — 1 — 1 — — Pepper 7 — 7 — — — Pine apple (canned) — 2 — 2 — — Pork and beans (canned) — 2 — 2 — — Pork pie — 1 — 1 — — Potato salad — 1 — 1 — — Prawns (canned) — 1 — 1 — — Prunes — 1 — 1 — — Raisins — 4 — 4 — — Rice 4 — 4 — — — Rissoles (meat) .: — 2 — 2 — — Sardines (canned) — 1 — 1 — — Sausage roll — 2 — 2 — — Sausages 11 53 5 41 .6 12 Soda water — 1 — 1 — — Sponge cake — 4 — 4 — — Steak pie — 1 — 1 — — Suet — 1 — 1 — — Sugar 1 1 1 — — 1 Sweets — 8 — 8 — — Swiss roll 1 1 — — 1 1 Tomatoes — 1 — 1 — — Tongue — 1 — 1 — — Vinegar 4 — 4 — — — ,, (malt) 1 — 1 — — — Wine (Australian) — 2 — 2 — — Salmon (canned) — 8 — 8 — — Totals .. 571 229 547 204 24 25 Prosecutions were undertaken as regards 8 samples, which were reported as being adulterated. The results of the proceedings are stated in the following table:— 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. 1927, £ s. d. £ s. d. Dismissed under the Probation of Offenders Act A. 5 Milk Deficient in milk fat, 8 0 per cent. Feb. 23rd 5 5 0 c. 46 „ „ 60 „ April 12 th. 4 0 0 2 2 0 A. 83 „ „ 126 „ May 4th — 2 0 0 C. 134 „ „ 180 „ June 30th 3 0 0 1 1 0 C. 141 „ „ 20.6 „ ,, „ 4 0 0 1 1 0 c. 147 „ „ 7.0 „ „ „ 1 0 0 1 1 0 C. 151 „ Added water, 3 4 per cent. July 7th 2 0 0 2 2 0 C. 152 „ Deficient in milk fat, 6.0 per cent. „ „ 20 0 0 2 2 0 (50 (b) Milk and Dairies Okder, 1926. Address where offence committed. Offence. Date of Hearing of Summons Result of Proceedings. Euston Street Delivering milk in bottles which were not tilled and closed on registered premises 1927. May 4th Costs 10s. 6d. Do. Do. do. ,, Dismissed under the Probation of Offenders Act. Stanhope Street Do. do. May 5th Costs £1 l1s. 6d. Do. Do. do. ,, Fined £1. Clarence Gardens .. Do. do. May 6th Costs £1 l1s. 6d. Do. Do. do. ,, Fined £1. Clarence Road Do. do June 2nd „ £5. Do. Do. do. ,, ,, 5s. Prince of Wales Road Do. do. ,, ,, £5. Do. Do. do. ,, „ 5s. Camden Road Do. do. ,, „ £2. Do. Do. do. „ ,, 5s. Hadley Street Do. do. ,, ,, £2. Cleveland Street Do. do. July 18th Costs £2 2s. Do. Do. do. ,, Penalty 10s. Cromer Street Do. do. July 19th „ £1. Do. Do. do. ,, „ 10s. (c) Public Health (Meat) Regulations, 1924. Address where offence committed. Offence. Date of Hearing of Summons. Result of Proceedings. Chalton Street Exposing meat on a stall without proper covering 1927. Dec. 1st Fined 15s costs £1 Is. Wholesale Dealers in Margarine.—One certificate of registration under the provisions of the Sale of Food and Drugs Acts was issued during the year. PUBLIC HEALTH (MILK AND CREAM) REGULATIONS, 1912 AND 1917. Report for Year ended 31st December, 1927. 1. Milk, and Cream not sold as Preserved Cream. — (a) Number of samples examined for the presence of a preservative. (6) Number in which a preservative was reported to be present. Milk 311 Nil. Cream 18 7 Nature of preservative in each case in column (b), and action taken under Regulations in regard to it: C. 224. Cream. 0.157 per cent, of boron trioxide, equal to 0.278 per cent, of boric acid. A warning letter was addressed to the vendor by order of the Public Health Committee. No legal proceedings were instituted. C. 23. Cream. 0.322 per cent, of boron trioxide, equal to 0.570 per cent, of boric acid. Informal sample. 61 C. 67. Cream. 0.092 per cent, of boron trioxide, equal to 0.163 per cent, of boric acid. Informal sample. A. 65. Cream. 0. 097 percent, of boron trioxide, equal to 0.171 per cent, of boric acid. Informal sample. A. 70. Cream. 0.119 per cent, of boron trioxide, equal to 0.211 per cent, of boric acid. Informal sample. C. 28. Cream. 0.109 per ccnt. of boron trioxide, equal to 0.193 per cent, of boric acid. Informal sample. C. 44. Cream. 0.091 per cent, of boron trioxide, equal to 0161 per cent, of boric acid. Informal sample. 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 7 (ii) Statements incorrect 1 Total 8 (iii) Percentage of preservative found in Percentage stated on statutory each sample: Boric acid, 0.216, label: 0.4. 0 057 0.211, 0.181, 0.136(2), 0.124, 0.769, (6) Determinations made of milk fat in cream sold as preserved cream ;— (i) Above 35 per cent. 8 (ii) Below 35 per cent. — Total 8 (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:— C. 27. Preserved Cream. 0'434 per cent, of boron trioxide, equal to 0.769 per cent, of boric acid. Informal sample. 3. Thickening Substances.—Any evidence of their addition to cream or to preserved cream. Action taken where found: None. 62 Section VI.—PREVALENCE OF, AND CONTROL OVER, INFECTIOUS DISEASES. With the exception of Scarlet Fever, 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 1927. 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—YE\RS. Under i. 1 to 5. 5 to 10. 10 to 15. 15 to 25. 25 to 65. 65 unwards. Under 1. 1 to 5 5 to 10. 10 to 15. 15 to 25. 25 to 65. 65 upwards. I. Scarlatina or Scarlet Fever 1 147 233 74 44 28 — 527 — 1 - — — 1 — 2 516 2. Diphtheria and Membranous Croup 5 121 156 40 33 35 — 390 — 4 2 — — — — 6 388 3. Enteric or Typhoid Fever — 1 1 2 9 8 — 21 — — — — — 2 — 2 17 4 Puerperal Fever — — — — 8 '4 — 22 — — — — 2 2 — 4 21 5. Puerperal Pyrexia — - — 12 35 — 47 — — — — — — — — 24 6. Erysipelas 4 2 4 1 9 70 8 98 — — — — 6 — 6 60 7. Anthrax — - — — — I — I — — — — — — — — 1 8. Cerebrospinal Meningitis 1 1 1 — — — — 3 1 1 1 — _ — — 3 3 9. Anterior Poliomyelitis and Polioencephalitis — 1 — 1 ' — — 3 — — — 1 — — — 1 2 10, Ophthalmia Neonatorum 38 — — — — — — 38 — — — — — — — 8 11. Encephalitis Lethargica — - — — s 3 1 9 - — — — 1 — 2 3 12. Acute Primary Pneumonia 4 35 26 6 19 80 8 178 — — — — — — — — 93 13. Acute Influenzal Pneumonia 3 16 7 1 19 66 9 121 — — — - — — — — 59 14. Malaria — — — — — 2 — 2 — — — - — — — — 2 15. Dysentery — — — — — 1 — 1 — — — — — — — — — 16. Measles 40 230 118 13 14 2 — 417 — 5 — — — — — 5 87 17. German Measles 3 25 18 6 7 1 — 60 — — — — — — ——- — 4 * For Pneumonia deaths see Table 2 on page 79. 63 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:— Notifications. Deaths. INFECTIOUS DISEASES. Ward. Whole Borough. Ward. Whole Borough 1 2 3 4 5 6 7 8 1 2 3 4 1 5 6 7 8 I. Scarlatina or Scarlet Fever 120 74 95 67 54 3° 21 66 527 — — 1 1 — — — — 2 2. Diphtheria and Membranous Croup 58 44 110 29 64 37 17 3' 393 1 3 1 - 1 — — — 6 3 Enteric or Typhoid Fever 2 1 3 2 5 2 — 6 21 — — — — — — 2 — 2 4. Puerperal Fever 2 2 3 5 4 3 1 2 22 — — 1 1 1 — — 1 4 5. ,, Pyrexia 9 3 8 3 7 8 4 5 47 — — — — — — — — — 6. Erysipelas '5 8 16 12 13 14 6 14 98 — 2 1 1 — 2 — — 6 7. Anthrax — — 1 — — — — — 1 — — — — — — — — — 8. Cerebrospinal Meningitis 1 — — — — 1 — 3 1 — — — 2 — — — 3 9. Anterior Poliomyelitis and Polioencephalitis — — — 2 1 — — 3 — — — 1 — — — — — 10. Ophthalmia Neonatorum 4 — 5 6 10 3 5 5 38 — — — — — — — — 11. Encephalitis Lethargica 2 — 4 1 — — — 2 9 — — — 1 — — — 1 2 12. Acute Primary Pneumonia 19 20 51 19 25 12 10 22 178 — — — — — — — — — 13. Acute Influenzal Pneumonia 29 10 29 8 24 8 7 6 121 — — — — — — — — — — — 1 1 — — — — 2 — — — — — — — — —— 15. Dysentery 1 — — — — — — — 1 — — — — — — — — — 16. Measles 53 19 29 35 145 42 15 79 417 —- — 1 — 3 1 — — 5 17. German Measles 10 7 8 15 6 3 2 9 60 — — — — — — — — — Totals 325 188 363 205 358 163 89 247 1938 2 5 S 5 7 3 2 2 31 * For Pneumonia deaths see Table 2 page 79. 64 SMALL-POX. No case of this disease was notified in the Borough during the year. A number of is were reported from time to time to have been in contact with cases of small-pox ing in other Metropolitan Boroughs or elsewhere. When possible, such persons were ated and kept under observation until the incubation period was concluded. "VACCINATIONS. 1st January to 31.s/ December, 1926. Number. Percentage of Births registered. North. East. West. South. Whole Borough North. East. West. South. Whole Borough hs registered 695 1009 782 1655 4141 100.0 100.0 100.0 100.0 100.0 d, nnvaccinated 32 42 41 84 199 4.6 4.2 5.2 5.1 4.8 ces&fully vaccinated 319 491 394 880 2084 45.9 48.7 50.4 53.1 503 smallpox — — — — — — — — — jsceptible of vaccination 1 1 — 3 5 0.2 01 — 0.2 0.1 eived certificate of contentious objection 313 334 301 443 1391 45 .0 331 38.5 26.7 33 .6 fcponed by medical certificate — 4 5 7 16 — 0.4 0.6 0.5 0.4 red to known address in other istricts 9 58 4 110 181 1.3 5.7 0.5 6.5 4.4 t sight of by removal 16 67 32 121 236 2.3 6.6 4.2 7.3 5.7 vaccinated and not accounted or in previous columns 5 12 5 7 29 0.7 1.2 0.6 0.6 0.7 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. 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 40'9 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 1926 4141 2084 50.3 1420 34.3 SCARLET FEYER. The number of cases notified was 527, as compared with 432 during the previous year, is subsequently ascertained that 29 cases had been incorrectly diagnosed. The actual ber of cases was therefore 498. Two deaths occurred ; this equals a case mortality of 0.4 ent. 65 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. 18 such cases occurred during the year. Three cases occurred in one house, all due to the same source of infection. Two of the suspected sources of infection were found to be suffering from nasal discharge, but the remainder showed no obvious signs of being infectious. DIPHTHERIA. The number of cases notified was 390, as compared with 523 during the previous year. It was subsequently reported by the hospital authorities that 43 cases had been incorrectly diagnosed, the actual number of cases was therefore 347. Six deaths occurred, giving a case mortality of 1'7 per cent.—the lowest ever recorded in this Borough. The attack rate was 1.6 per 1,000 of population, as compared with 2.05 in 1926. Antitoxin for the treatment of cases of this disease is supplied to medical practitioners free of charge by the Council. During the year 304 thousand units were provided. ENTERIC (TYPHOID) FEVER. Twenty-one cases were notified and two deaths occurred, as compared with fifteen cases and one death in the previous year. On further investigation four cases were found to have been incorrectly diagnosed, the actual number of cases was therefore seventeen. Based on bacteriological examination, five cases were reported to.be suffering from Typhoid and nine from Para-typhoid fever. In the remaining cases definite bacteriological information was not available. Two cases contracted the disease in France, one in America and one at Margate. Both the fatal cases contracted the disease abroad. PUERPERAL FEVER. Twenty-two cases were notified and four deaths occurred. In addition to the above, fourteen cases notified as Puerperal Pyrexia were found on further investigation to be suffering from Puerperal Fever. The total number of cases which occurred during the year was therefore thirty six. This equals an incidence rate of 10.9 per 1,000 births and a case mortality of 11.1 per cent. PUERPERAL PYREXIA. Forty-seven cases were notified during the year. On further investigation the causes of this condition were reported to be— Puerperal Fever 14 Mastitis 6 Influenza 6 Doubtful 3 Cystitis 3 Lacerated Perineum. 1 Pyelitis Pneumonia and Empyema 1 Breast Abcess 1 Pulmonary Embolus 1 Reaction from difficult labour 1 Axillary Abcess 1 Pneumonia 1 Pleurisy 1 Pharyngitis 1 Pulmonary Tuberculosis 1 Peritonitis 1 Paratyphoid B 1 Pyelitis 1 Constipation 1 Cold 1 ERYSIPELAS. Ninety-eight cases were notified and 6 deaths occurred, as compared with 80 cases and 8 deaths during the previous year. 66 ANTHRAX. One case of this disease was notified. It occurred in a man employed by a firm of taxidermists, who were dealing with the carcases of two elephants, which were subsequently discovered to have died of the disease. As soon as this information was received the remains of the elephants were destroyed, and all persons who had handled them were kept under observation. The case in question developed a week later, and the patient was immediately given a dose of serum and sent to St. Thomas's Hospital, where he recovered. The elephants died at the gardens of the Zoological Society of London. It was not discovered how they became infected. CEREBROSPINAL MENINGITIS. (Cerebro-spinal Fever.) Three cases were notified, and in each case the diagnosis was confirmed by bacteriological examination. One case proved fatal. The existence of two other (unnotified) cases was disclosed by death reports. ANTERIOR POLIOMYELITIS AND POLIOENCEPHALITIS. Three cases were notified. One proved fatal in a few days, and of the other two, one was first admitted to Highgate Hospital, and both finally received treatment in the special hospitals provided by the Metropolitan Asylums Board. OPHTHALMIA NEONATORUM. Thirty-eight cases were notified, which equals an incidence rate of 11.5 per 1,000 births. The services of a district nurse were provided in eleven instances. Five cases were admitted to the special hospital provided for the treatment 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. Treated. Notified. At Home. In Hospital. 38 27 11 37† l 0 1* * From other causes. † Includes 4 cases removed from the Borough before complete recovery. In addition to the above cases, nine cases of mild inflammation of the eye in the newlyborn, not notifiable as Ophthalmia Neonatorum, were brought to notice by the London County Council or by Welfare Centres. ENCEPHALITIS LETHARGICA. Nine cases were notified, but on further investigation two cases were found to have been incorrectly diagnosed. There were therefore seven genuine new cases during the year. Of these two died from the disease and one from other causes. One case has moved to an unknown address, and the remainder were found to have made fair recoveries when visited recently. 67 PNEUMONIA. This disease is a frequent complication of other diseases, but when occurring in that way is not notifiable. The notifiable forms of Pneumonia are Acute Primary and Acute Influenzal Pneumonia. 178 cases of the former and 121 of the latter were notified during the year. If requested by the medical attendant, a visiting nurse is supplied in necessitous cases at the cost of the Borough Council. During the year 68 cases were nursed under this arrangement, 1039 nursing visits being paid. MALARIA. Two cases were notified ; in both instances the disease had been contracted abroad. No deaths were reported during the year. DYSENTERY. One case was notified, but the diagnosis was not confirmed by bacteriological examination. The patient had not been abroad and no source of infection was discovered. No deaths were 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 another 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. Hospital Accommodation. During the year a decision to abandon the previous practice of always admitting cases of scarlet fever to hospital in preference to measles was adopted. Under the new arrangement, when the incidence of infectious disease is such that the supply of beds is sufficient for all case3, medical practitioners will be able, as in the past, to secure the removal of a patient by direct application to the Metropolitan Asylums Board. During epidemic periods, however, cases of either disease will only be admitted on the recommendation of the Medical Officer of Health. At such periods the selection of cases for hospital will depend on whether the home conditions are suitable for treating an infectious patient, and it is designed to take into account the fact that measles has now a higher mortality rate than scarlet fever. 417 cases of Measles and 60 cases of German Measles were notified during the year, and since the incidence of Scarlet Fever was small no application of the new arrangement was necessary. During December it became apparent that an epidemic of measles was beginning, and in accordance with the suggestion of the County Medical Officer of Health a special leaflet explaining the prevention and treatment of the disease was distributed to all schools, welfare centies and similar institutions where cases of measles were found to have occurred. The services of a nurse were provided in all cases where this was desired by the medical attendant and 91 cases were admitted to hospital. Only five deaths were reported. EPIDEMIC JAUNDICE. During the latter part of November the Resident Medical Officer at the St. Pancras Dispensary reported the occurence of four eases of jaundice in children attending one of the London County Council Schools. Two of the cases were sisters and it appeared likely that the jaundice was of the epidemic type. On further investigation by enquiry from medical 68 practitioners and the London County Council Schools, it was discovered that at least sixteen cases of jaundice had occurred in children residing in Wards 5, 6 and 8 during the previous 3 months. The information available indicated that the disease was mild in character and disappeared in from 4 to 14 days without the occurrence of nephritis or haemorrhage. It has been shown that epidemics of jaundice of severe type may be due to an organism, the leptospira ictero-hæmorrhagica, which is spread by rats, and it has been suggested that even epidemics of the mild form may be due to the same cause. In the present instance, material from two eases was forwarded to Dr. Teale, of University College Hospital, in order to make a bacteriological examination, but no signs of leptospira were found. Epidemic catarrhal jaundice has lately been the subject of a report from the Ministry of Health. It is thought that epidemics of jaundice have become more frequent in recent years, and several of these epidemics have been carefully investigated. They usually occur during November and amongst children, but up to the present no cause for them has been discovered. TUBERCULOSIS. Particulars of all new cases of Tuberculosis and of all deaths from this disease during 1927 are given in the following table in the form required by the Ministry of Health :— Age Periods. New Cases. Deaths. Pulmonary. N on-Pulmonary. Pulmonary. Non-Pulmonary. M. F. M. F. M. F. .M- F. 0—1 1 — — 2 — — 1 3 1—5 — 1 7 6 — — 3 3 5—10 4 3 11 14 — — — — 10—15 3 3 6 4 — 2 1 -— 15—20 16 24 8 5 3 10 1 1 20—25 16 23 3 2 15 11 — 2 25—35 37 36 5 6 9 20 1 — 36—45 62 40 3 1 25 20 — 3 45—55 48 21 4 — 35 12 1 — 55—65 18 9 1 1 13 8 — — 65 & upwards 6 7 1 2 8 6 — — Totals 211 167 49 43 108 89 8 12 The total number of Primary notifications was 397 ; in addition to these, 42 cases, which had not been notified, came to knowledge by means of special death reports, and 31 cases by transfer from other districts. The total number of new cases during the year from all sources was therefore 470, equal to a notification rate of 2.21 per 1,000 of population. The deaths from all forms of Tuberculosis during the year numbered 217, equal to a death-rate of 1*02 per 1,000 of population. 69 The corresponding rate for the previous year was 0.98 per 1,000 of population. It will be noted that, out of a total of 217 deaths from Tuberculosis, 42 (or nearly 20 per cent.) were of cases which either died un-notitied or were notified only at death. It is not satisfactory that so large a proportion of cases should come to knowledge only at so late a period. In 6 instances Meningitis was stated to have been the cause of death, and this form of Tuberculosis is at times difficult to diagnose. Tn 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. 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. Of the 42 cases dying un-notified or notified only at death, 10 occurred in Poor Law Institutions, 15 in other Institutions or Hospitals, and 17 at home. 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 :— 70 Public Health (Tuberculosis) .Regulations, 1912. Summary of Notifications during the period from 2nd January, 1927, to the 31 st December, 1927 (inclusive). Number of Notifications on Form A, Number of Notifications on Form B. Numoer of Notifications on Form C. Number of Not fications on Form D. Primary Notifications. Total Notifications (i.e.,including cases previously notified by other Doctors), Primary Notifications. Total Notifications (i.e,, including cases previously notified by other Doctors). Poor 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. Total. Under 5 5 to 10 10 to 15 Total, Pulmonary Males 1 — 4 — 15 15 32 52 41 13 4 177 231 — — 1 1 1 24 167 18 107 Females — 1 3 1 22 21 30 32 20 7 3 140 181 ~~ — — ~~ — 19 100 14 69 Non-pulmonary Males — 5 8 3 7 3 5 2 4 1 1 39 47 ~~ 2 — 2 5 1 26 — 23 Females 1 5 14 4 4 2 5 — — 1 2 38 44 — — — — 1 1 22 1 22 Totals 2 11 29 8 48 41 72 86 65 22 10 394 503 — 2 1 3 7 45 ^5 33 221 Cases not Notified—Information obtained from Special Death Reports and by Transfer from other districts. Age Periods. 0 to 1 1 to 5 5 to 10 10 to 15 15 to 20 20 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 and upwards. Total. Pulmonary Males — — — 2 1 1 5 10 7 5 2 33 Females — — — 2 2 0 6 8 1 2 4 27 Non-Pulmonary Males — 2 1 3 1 — — 1 — — — 8 Females 1 1 — — 1 — 1 1 — — — 5 Totals . 1 3 1 7 5 3 12 20 8 7 6 73 71 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. 1918 218387 I034 203 1237 403 82 485 4.74 0.93 5.67 1.85 0.37 2.22 1919 218387 799 206 1005 268 73 341 3.66 094 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 I .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 1927 212800 378 92 470 197 20 217 1.78 0.43 2.21 0.93 0.09 1.02 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 83 2.3 36 1 .0 2 40 1.8 18 0.8 3 78 2.2 33 0.9 4 61 2.3 31 1.2 5 70 2.3 31 1.0 6 35 1.7 26 1.3 7 46 3.0 13 0.9 8 54 2.0 25 0.9 Homeless 3 — 4 — Totals 470 2.2 217 1.0 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. 72 The following table gives this information for the year ended December 31st, 1927 : — Pulmonary. Non-Pulmonary. Total. Number of cases on the Register at the commencement of the year 1927 1241 443 1684 Number of cases notified during the year 378 92 470 Number of cases removed from the Register during the year (from 1619 535 2154 death or other causes) 320 70 390 Number of cases remaining on the Register at the end of the year 1299 465 1764 Public Health (Prevention of Tuberculosis) Regulations, 1925. No formal action was necessary during the year under the above regulations. Boarding out of Children from Tuberculous Homes. This scheme was initiated in 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. 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. Daring the year 5 children have been boarded out under the scheme. The Tuberculosis Care Committee. No meeting of the full Committee was held during the year ; a small Sub-Committee 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 73 room, consulting room, office and lavatory. 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 year of 1927 has been one of increased activity in the Tuberculosis Dispensary. The number of new cases show a marked increase, 793 as against 685. The number of attendances have risen from 4,533 to 5,094, and the number of visits of Health Visitors from 4,580 to 5,279. There have been 917 sputa examined and 55 X-ray reports obtained, as against 804 and 33 in 1926. Of the 793 new cases, 198 were Contact cases and of these 8 were found to be definitely tuberculous. Twenty-two cases have been recommended for hospital observation previous to diagnosis, nine of these being subsequently diagnosed as tuberculous. Two hundred and twenty-five cases have been sent up by private doctors for an opinion. Two hundred and thirteen cases have been recommended for Institutional treatment, and of these 158 have already returned, 18 are still away, and the remainder, for various reasons, did not go away or were refused vacancies. Of the 158 who have had Sanatorium treatment, 99 returned "Improved," 26 "Stationary," 9 "Worse," 15 died, and 9 have not yet been seen since their return. Throughout the year, the work of the Tuberculosis Dispensary has continued smoothly, and close touch has been kept with local Medical Practitioners, Ministry of Pensions, British Red Cross Association, Charity Organisation Society and various charitable organisations. The task of finding work for patients who have returned from Sanatorium fit for light, or part-time work, remains most difficult. Where possible, cases are referred to the local Labour Exchange, with suggestions as to suitable occupations, and although by this means few find employment, it is found that the majority of patients who obtain work do so by their own initiative. It has been noticed that an increasing number of people appear to realise the main symptoms of phthisis and to seek advice early, if any of these symptoms occur ; and a growing number of patients are advised to go to the Dispensary by other patients or neighbours because they appear to have symptoms of consumption. In consequence, a larger number of cases are seen for the first time in the earlier stages than were formerly. This is encouraging, as great importance is attached to the educational side of the Dispensary work. A. VINEY, M.R.C.S., L.R.C.P., D.P.H." 74 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 105 74 3 — 6 1 10 8 111 75 13 8 (b) Doubtfully tuberculous — - — — — — — - 54 53 11 4 (c) Non-tuberculous - - - - - - - - 57 60 73 66 B.—Contacts examined during the year:— (a) Definitely tuberculous 3 3 - - - - - 2 3 3 — 2 (6) Doubtfully tuberculous - - - - - - - - - 9 1 6 (c) Non-tuberculous - - - - - - - - 10 31 72 61 C.—Cases written off the Dispensary Register as- (a) Cured — 1 — 2 — — 3 1 — 1 3 2 (b) Diagnosis not confirmed or non-tuberculous (including cancellation of cases notified in error) — - - - - - - - 77 113 152 133 D.—Number of Persons on Dispensary Register on December 31st:— (a) Diagnosis completed 356 245 22 25 22 17 39 32 378 262 61 57 (b) Diagnosis not completed — - — — — — — - 43 56 17 11 Number of persons on Dispensary Register on Number of patients to whom Dental Treatment was January 1st 807 given, at or in connection with the Dispensary ... j 25 Number of patients transferred from other areas Number of consultations with medical practi- and of "lost sight of " cases returned 59 tioners :— Number of patients transferred to other areas and (a) At homes of applicants 19 cases “lost sight of" 212 (b) Otherwise 206 Died during the year 80 Number of other visits by Tuberculosis Officers to Number of observation cases under A (b) and B (6) homes 133 above in which period of observation exceeded Number of visits by Nurses or Health Visitors to 2 months 25 homes for Dispensary purposes 5279 Number of attendances at the Dispensary (includ- Number of— ing Contacts) 5094 («) Specimens of sputum, Ac., examined 917 Number of attendances of non-pulmonary cases at (b) X-ray examinations made in connection Orthopaedic Out-stations for treatment or super- with Dispensary work 55 vision — Number of Insured persons on Dispensary Register Number of attendances, at General Hospitals or on 31st December 484 other Institutions approved for the purpose, of Number of Insured persons under Domiciliary patients for— Treatment on the 31st December 160 (a) " Light" treatment 11 Number of Reports received during the year in (b) Other special forms of treatment 47 respect of Insured persons :— | (a) Form G P. 17 — (4) Form G.P. 36 17 75 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 Booms Contents Disinfected or Destroyed. No. of Rooms Sprayed and Fumigated. Scarlet Fever 509 501 527 516 Diphtheria 364 358 388 384 Enteric Fever 15 15 16 6 Erysipelas 78 78 78 2 Puerperal Fever and Pyrexia 13 13 13 6 Encephalitis Lethargica 3 3 4 5 Cerebrospinal Meningitis 2 2 2 2 Poliomyelitis 1 1 1 1 Tuberculosis 177 177 185 155 Measles 13 13 15 13 Vermin aud Scabies 100 100 126 82 Other Diseases 288 288 297 59 Totals 1563 1549 1652 1231 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 82 1577 11 53 Bolsters and pillows 45 3376 7 47 Sheets, blankets aud counterpanes 35 4680 10 50 Rugs, mats, cushions, carpets, covers and curtains 31 715 17 83 Wearing apparel 21 2024 6 — Books 5 94 - — Sundries 18 316 3 1 Totals 237 12782 54 181 The tables above are exclusive of the disinfection of the clothing of persons who attended the cleansing station on account of being infested by vermin or suffering from scabies. 76 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 1182 51 4760 *5993 Scabies 29 60 780 869 Totals 1211 111 5540 6862 *Includes 735 males and 9 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. BACTERIOLOGICAL W0IIK. 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. II. 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 178 1288 1466 Blood re Typhoid Fever 1 11 12 Sputnm for Tubercle Bacilli 55 451 506 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 1927 AND PREVIOUS YEARS. Year. Population estimated to middle of each Year. Civil Population. Births. Total Deaths Registered in the District. Transferable Deaths Nett Deaths belonging to the District. Uncorrected Number. Nett of Nonresidents registered in the District. of Residents not registered in the District. Under 1 Year of Age. At all Ages. Number. Rate per 1,000Nett Births. Number. Rate. Number. Rate. Number. Rate. 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† 1927 213200 212800 3925 3299 15.5* 3034 14.3† 939 526 205 62 2621 12.3† Area of district in acres (land and inland water), 2694.4; total population at all ages, 21l,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 Table No. 2. REGISTRAR GENERAL'S SHORT LIST OF THE CAUSES OF DEATH AT DIFFERENT PERIObS OF LIFE IN THE METROPOLITAN BOROUGH OF ST. PANCRAS, 1927. CAUSES OF DEATH. Sex. All ages. Under 1 year. 1 and under 2 years. 2 and under 5 years. 5 and under 15 years. 15 and under 25 years. 25 and under 45 years. 45 and under 65 years. 65 and under 75 years. 75 years and upwards. ALL CAUSES M 1407 112 35 27 35 47 148 452 32 222 F 1213 94 15 19 15 56 155 332 252 275 1. Enteric Fever M 2 - — - - - 1 1 - — F - - - - - - - - - - 2. Small Pox M - - - - - - - - - - F — - - - - - - - - - 3. Measles M 3 - 2 1 - - - - - - F 2 — 1 1 — - - - - - 4. Scarlet Fever M — — — - — — — — — — F 2 — — - 1 — - 1 — — 5. Whooping Cough M 18 4 7 2 — - - - - - F 22 11 3 7 1 — — — — - 6. Diphtheria M 3 — 1 1 1 - - - - - F 3 - 1 2 — - - - - - 7. Influenza M 38 1 1 1 1 — 10 16 6 2 F 45 1 — — — 4 6 14 11 9 8. Encephalitis Lethargica M 1 — — - — 1 — - — — F 1 — — - — — - 1 — — 9. Meningococcal Meningitis M 1 — — — 1 — — - — — F 3 2 — 1 — — - - - - 10. Tuberculosis of Respiratory System M 109 — - — — 18 34 49 7 1 F 88 — — — 2 21 39 20 5 1 11. Other Tuberculous Diseases M 7 1 1 1 1 1 1 1 — — F 12 3 1 2 — 3 3 — — — 12. Cancer, Malignant Disease M 141 — — 1 — — 9 55 51 25 F 155 — — — — — 23 71 36 25 13. Rheumatic Fever M — — — — — - — - - - F 5 — — — — 2 1 1 — 1 14. Diabetes M 11 - - - - - 1 3 5 2 F 16 - - - - - 2 7 6 1 15. Cerebral Hæmorrhage, etc. M 50 - - - - - 2 20 18 10 F 46 — — — — 1 — 16 17 12 80 Table No. 2—continued. CAUSES OF DEATH. Sex. All ages. Under 1 year. 1 and under 2 years. 2 and under 5 years. 5 and under 15 years. 15 and under 25 years. 25 and under 45 years. 45 and under 65 years. 65 and under 75 years. 75 years and upwards. 16. Heart Disease M 240 — — — 2 2 12 75 85 64 F 207 — — — 2 8 19 56 48 74 17. Arterio-sclerosis M 76 — — — - — 1 19 27 29 F 70 — — — - — 1 12 21 36 18. Bronchitis M 134 3 1 - - 1 8 49 41 31 F 105 2 1 — 1 - 3 30 36 32 19. Pneumonia (all forms) M 125 26 14 6 7 — 12 40 15 5 F 81 20 6 3 1 1 6 17 14 13 20. Other Respiratory Diseases M 18 _ 1 — 1 — 4 8 1 3 F 15 1 - 1 — 1 1 3 5 3 21. Ulcer of Stomach or Duodenum M 21 - — - — 2 4 13 1 1 F 6 - - - - - - 5 — 1 22. Diarrhæa, etc. M 22 18 — 1 2 — - — 1 — F 13 9 - - 1 — 1 2 — — 26. Appendicitis and Typhlitis M 9 — — — 4 — 3 2 — — F 6 — 1 — 2 — 2 1 — — 24. Cirrhosis of Liver M 12 - - - - - — 9 3 — F 8 — - - — — 2 6 — - 25. Acute and Chronic Nephritis M 43 — - 1 — 1 6 16 15 4 F 27 - — — 1 2 12 6 6 26. Puerperal Sepsis M - - - - - - - - - - F 4 - - - - 2 3 - - - 27. Other Accidents and Diseases of Pregnancy and Parturition M - - - - - - - - - - F 5 — — — — 1 4 - - — 28. Congenital Debilitv and Malformation, Premature Birth M 41 40 — 1 - - - - - - F 31 31 - - - - - - - - 29. Suicide M 20 - — - 2 4 9 5 — F 13 — — — — 1 7 5 — — 30. Other Deaths from violence M 65 3 2 6 9 8 10 15 8 4 F 34 3 - 2 1 6 6 4 10 2 31. Other defined Diseases M 200 16 5 5 6 10 25 52 40 41 F 187 10 1 — 3 4 25 48 37 59 32. Causes ill-defined or unknown M 2 — — — — 1 1 — — — F 1 1 - - - - - - - - Legit, Illegit. M 96 16 Deaths under 1 year F 77 17 81 Table No. 3. 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 rniti Deaths.—Outward transfers are excluded, and then births and 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. 1 Rate. No. Rate. No. Rate. 1 485 13.6 388 10.9 28 58 36 1.0 2 337 15.3 257 11.7 25 74 18 0.8 3 585 16.3 421 11.8 33 56 33 0.9 4 406 15.6 363 14.0 25 62 31 1.2 5 535 17.6 416 13.7 33 62 31 1.0 6 371 17.9 267 12.9 21 57 26 1.3 7 191 12.5 156 10.2 10 52 13 0.9 8 389 14.3 323 11.9 27 69 25 0.9 Homeless — — 30 — 3 — 4 - Borough 3299 15.5 2621 12.3 205 62 217 1.0 82 Table No. 4.—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 1927. (52 weeks ended 31st December, 1927.) - Estimated Population, Mid. 1926. Birth Rate. Death Bate. Infantile Mortality. - Estimated Population, Mid. 1926. Birth Rate. Death Rate (Crude). Infantile Mortality. England and Wales †139,290,000 16.7 12.3 69 Country of London †4,605,400 16.1 11.9 59 Birmingham 934,300 19.2 11.8 72 West. Liverpool 862,600 22.2 13.5 91 Paddington 146,700 15.2 12.8 78 Manchester 752,000 18.3 13.7 82 Kensington 179,800 14.8 13.1 65 Sheffield 523,300 16.6 12.1 89 Hammersmith 134,400 15.4 12.5 58 Leeds 473,400 17.0 12.8 77 Fulham 164,300 14.9 11.0 67 Bristol 383,300 17.1 12.3 56 Chelsea 64,820 13.2 13.5 74 West Ham 315,900 21.3 10.9 60 City of Westminster 138,400 9.9 11.7 67 Hull 294,600 19.3 13.2 91 North Bradford 288,700 14.9 14.4 92 St. Marylebone 105,800 13.0 11.5 59 Newcastle on-Tyne 284,700 21.8 12.3 75 Hampstead 87,530 11.7 11.6 49 Stoke-on-Trent 275,600 21.5 13.3 97 St. Pancras 216,400 15.2 11.9 61 Nottingham 268,000 17.3 13.7 82 Islington 339,200 17.3 12.0 55 Salford 247,400 16.7 12.9 75 Stoke Newinwton 53,080 13.8 11.8 64 Leicester 241,700 17.0 12.4 76 Hackney 228,500 15.5 11.3 64 Portsmouth 231,500 17.6 12.4 54 Central. Cardiff 225,600 18.8 12.3 76 Holborn 43,200 11.7 12.0 38 Croydon 205,900 16.1 11.6 53 Finsbury 77,550 18.6 12.8 51 Plymouth 187,800 17.8 13.3 58 City of London 13,230 8.6 11.5 96 Bolton 177,000 15.0 13.6 76 East. Southampton 169,300 17.7 12.6 62 Shoreditch 107,400 20.4 12.2 73 Willesden 165,270 13.9 10.2 65 Bethnal Green 119,600 19.7 11.1 57 Sunderland 163,800 22.6 13.5 92 Stepney 255,400 18.0 11.4 66 Swansea 163,200 18.2 12.1 82 Poplar 169,000 19.6 11.5 66 Rhondda 162,500 16.9 10.9 84 South Birkenhead 158,000 18.5 11.9 92 Southwark 188,600 18.6 12.9 60 Tottenham 151,120 12.5 10.7 79 Bermondsey 123,100 19.6 12.6 61 East Ham 146,600 12.7 9.7 62 Lambeth 311,300 16.0 12.2 54 Oldham 143,000 14.6 13.9 87 Battersea 171,900 16.3 11.8 53 Brighton 139,500 14.5 13.1 52 Wandsworth 342,100 13.6 11.2 51 Derby 136,600 17.9 12.2 66 Camberwell 275,400 15.4 11.1 52 Middlesbrough 138,600 23.6 13.2 91 Deptford 115,700 16.5 11.1 58 Wolverhampton 131,000 19.8 11.9 85 Greenwich 103,300 16.2 10.7 54 Leyton 130,000 10.6 10.2 56 Lewisham 187,800 15.2 10.8 45 Coventry 127,800 16.7 10.7 6o Woolwich 141,900 15.3 10.3 43 Gateshead 127,700 19.7 12.8 100 Walthamstow 125,500 14.3 10.4 58 Stockport 125,400 14.9 12.0 71 † Estimated population to middle of 1927. 83 Table No. 5.—Meteorological Table for Saint Pancras, 1927. (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.) 29.832 30.073 29.756 29.955 30.065 29.917 29.894 29.883 29.805 30.058 29.970 29.906 Air temperature— Mean of— A. Maximum 45.0 44.7 53.0 56.5 66.2 66.4 69.1 70.8 63.0 58.5 48.2 39.3 B. Minimum 36.5 36.0 40.9 41.7 46.6 50.3 56.0 55.7 50.7 45.8 39.2 33.6 Mean of A and B 40.7 40.3 46.9 49.1 56.4 58.3 62.5 63.3 56.9 52.1 43.7 36.5 Difference from Averag +1.9 +0.3 +4.0 +0.7 +1.3 —2.7 —1.8 +0.1 —1.7 +1.4 —0.6 —4.0 Humidity—Morning 91 92 85 74 70 73 80 83 87 89 91 92 Earth Temperature at 4 ft. depth 44.0 42.6 44.0 45.9 50.0 53.5 56.0 58.2 57.5 53.4 50.6 46.4 Bright Sunshine— Total Observed (daily mean) Hrs. 0.65 0.73 2.75 5.14 7.40 5.63 4.30 5.55 2.66 1.75 1.00 0.42 Per cent, of total possible 8 7 23 37 47 34 27 38 2l 16 11 5 Difference from average Hrs. — — — — — — — — — — — — Rain and other forms of precipitation— Number of Days 17 14 17 14 10 16 17 21 16 14 15 11 Total Fall Ins. 1.78 3.34 2.57 2.02 1.29 2.80 3.24 3.97 4.77 1.29 2.60 4.17 Difference from average ,, —0.08 +1.69 +0.71 +0.47 —0.47 +0.79 +0.83 +1.77 +2.95 —1.34 +0.24 +1.77 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. 84 Table No. 6.—Report of Work carried out by District Inspectors for the year 1927. Rackham. Lonnon. Brown. Dillon. Walkfr. James. Adkins. Akfrs. Jaffa. Capel. Nixon. West. Totals. Complaints received, 2,707 Complaints Investigated. Whole house inspected 5 8 42 — 26 28 112 80 32 80 104 28 545 ,, Part of house inspected 142 422 204 — 256 203 176 151 404 122 335 313 2728 ,, Re-inspections 639 828 1021 — 590 831 701 715 751 794 1367 1241 9478 Infectious Diseases Investigations and inspections 136 278 185 — 135 191 390 146 153 331 269 201 2415 Re-inspections 29 521 290 — 37 215 315 144 51 438 155 159 2354 Smoke Observations 2 — 2 — 60 12 33 2 118 20 6 - 255 Offensive or Regulated Trades - - - - - - - 1 46 — 1 - 48 Mews and Stable Yards—Number Inspected 284 532 236 — l65 291 233 431 716 406 409 233 4236 Other Inspections 3nd Re-inspections 70 17 7 — 19 41 131 11 18 144 16 80 554 Housing Acts and Regulations, 1925. Number of Houses Inspected Primary Inspections 1 2 21 — 15 19 28 50 31 103 — 40 310 Re-inspections 2 9 226 — 185 45 79 323 80 488 110 197 1744 Underground rooms illegally occupied Inspections — — — - — — — — — — — 2 2 Re-inspections - — 1 - — — — 9 — 3 12 — 25 Houses let in Lodgings (Bye-laws, Sec. 6). Number of Tenements Inspectsd Primary Inspections — 7 115 — 164 240 22 69 4 51 16 50 738 Re-inspections — 5 597 — 1293 1586 4 365 26 191 141 297 4505 Drainage. (a) Under Notice, Plans, Supervision, etc. 260 321 309 — 130 292 497 306 159 317 412 567 3570 (b) Voluntary, do. do. 300 673 379 — 272 141 882 694 964 271 328 496 5400 (c) New Buildings do. do. 1457 123 2 — 225 81 - 40 — 172 410 — 2510 (d) Tested after Infectious Disease, 607. Attendances at Police Court, etc. 5 — 8 — 5 19 — 10 — 6 — 13 66 Rent and Mortgage Interest Restrictions Acts. Inspections 2 8 4 — — 6 1 6 4 2 2 — 35 Re-inspections — — 15 — — 10 1 2 11 5 - 2 46 Totals 3334 3754 3664 — 3877 4251 3605 3555 3568 3944 4093 3919 41564 Notices served;— Intimations 141 230 323 — 268 476 281 328 252 356 401 358 3414 R.R.A, (Tenants) 1 8 4 - — 1 — - — 5 11 2 35 Do. Release (Owners) — — — — — — — 1 _ 4 4 — 9 Totals 142 238 327 — 268 477 281 332 252 365 416 360 3458 Note.—Inspector Dillon absent throughout the year owing to a fractured leg. 85 Table No. 7.—Inspections and other work of the Food Inspectors during 1927. Mr. Auger. Mr. Child. Total. Number of Visits to:— Milkshops 379 395 774 Dairies 32 45 77 Cowsheds — 14 14 Ice Cream Premises 110 180 290 Slaughter Houses 63 69 132 Butchers'Shops and Meat Stalls 1581 1568 3149 Prepared Meat Premises 21 241 262 Fishmongers'Shops 13 91 104 Fried Fish Shops 130 161 291 Fish Curers' premises 28 58 86 Other Premises where Food or Drugs are sold 69 57 126 Marketing Streets and Places 1994 1104 3098 Attendances at Police Court 10 16 26 Other Visits 167 220 387 Re inspection after Intimation Notices — 1 1 Total 4597 4220 8817 *Number of Samples taken:— Formal 241 †341 582 Informal 159 70 229 Total 400 411 811 Unsound Foods. Surrenders:— Meat, &c. 10 5 15 Fish 10 3 13 Shell Fish — 2 2 Fruit 3 6 9 Vegetables — 1 1 Yeast — 1 1 Condensed Milk — 1 1 23 19 42 Seizures - - - Canal Boats inspected 13 - 13 Notices Served — 2 2 * See page 58. ‡ Including 11 samples taken for other Boroughs under the Jlilk and Dairies (Consolidation) Act, 1915. 86 Table No. 8. Report of Work carried out by the Factory and Workshop and Women Inspectors during the year 1927. Inspections and Re-Inspections Thompson. Bibby. Smith. Hunter. Anderson. Blaxland. Camman. Holland. Totals. Factories (including factory laundries and bakehouses) 1552 161 4 - 1 - 25 1 1744 Workshops (including workshop laundries and bakehouses) 1654 452 132 47 36 19 382 22 2744 Workplaces (including Restaurant kitchens) 415 15 75 66 64 42 106 112 895 Outworkers' premises — 2 222 70 91 74 338 132 929 Measles - — 120 146 187 94 117 105 769 German Measles — — 13 45 36 2 1 12 109 Whooping Cough — — 60 316 212 83 52 295 1018 Ophthalmia Neonatorum — — 40 33 39 41 42 45 240 Puerperal Fever — — 7 7 6 8 18 6 52 ,, Pyrexia — — 12 8 9 9 16 15 69 Tuberculosis — 2 1330 1256 1149 2036 1426 1865 9064 Other diseases — - 241 590 1137 224 252 355 2799 Infectious Disease (after care) - — 205 318 226 117 672 413 1951 Milk Enquiries — 201 50 23 51 35 76 40 476 Assisting at Centres — - 98 68 20 52 8 4 250 Attendance at Tuberculosis Dispensary — 3 127 108 91 144 117 109 699 Hospitals or other Institutions - 88 302 21 9 88 52 89 649 Verminous Persons - — 184 160 242 206 157 273 1222 Other Visits — 9 143 130 79 350 213 232 1156 Totals 3621 933 3365 3412 3685 3624 4070 4125 26835 Notices served relating to:— Factories 152 1 - - - - - - 153 Workshops 110 3 - - - - - - 113 Workplaces 23 2 - - - - - - 25 Others - - - - - - - - - Totals 285 6 - - - - - - 291