STPAN 90 AC435 Metropolitan Borough of Saint Pancras. REPORT of the MEDICAL OFFICER OF HEALTH FOR THE YEAR 1932. G. SOW DEN, M.D., D.P.H., Barrister-at-Law Printed by F. P. Lewingdon, 26 & 27, Eversholt Street, Camden Town, N.W.1. 43 Metropolitan Borough of Saint Pancras. REPORT of the MEDICAL OFFICER OF HEALTH FOR THE YEAR 1932. G. SOWDEN, M.D., D.P.H., Barrister-at-Law. 3 CONTENTS page Map of Borough, showing statistics by Wards2 Public Health Committee 5 Staff of Public Health Department 6 & 7 Introduction 8 Statistical Summary 10 & 11 Section I—Statistics and Social Conditions of the Area. Population and General Statistics 12 Principal occupations of the inhabitants of the Borough 13 Economic Conditions 13 Marriages 14 Births 14 Illegitimacy 15 Notification of Births 15 Still Births 15 Deaths 16 Inquests 19 Infantile Mortality 19 Death Kates of Infants and Young Children , 22 Section II—General Provision of Health Services. Hospital Accommodation 23 Institutional Provision for Unmarried Mothers 24 Ambulance Facilities 24 Clinics, Treatment Centres, &c '26 Maternity and Child Welfare 28 Block Grants 29&30 Ante-natal 30 At Birth 30 Inlants and Young Children 30 Advice Cards 31 Home Visiting 31 Attendances at Consultations, etc 32 Centres 33 Artificial Light Treatment 35 Dental Clinic 36&37 Day Nurseries 37 Nursery Schools 38 Clinic for Ailing Mothers and Children 38 Convalescent Home Treatment 39 page Home for Sick Poor Children 39 Supply of Milk to Mothers and Children 39 Professional Nursing 41 Home Helps 42 Midwives 42 Midwifery 42 Maternal Mortality 44 Medical examination in elementary schools 46&47 Provision of Insulin 48 Local Legislation 48 Public Health Legislation 48 London County Council By-laws 49 Merchandise Marks (Imported Goods) No 1 Order 49 Public Health (Cleansing of Shellfish) Act, 1932 49 London County Council (General Powers) Act, 1912 49 Housing Consolidated Amendment Regulations, 1932 49 Health Propaganda 49 Section III—Sanitary Circumstances of the Area. Water Supply 50 Public Baths and Washhouses 50 Drainage 50 Rats and Mice 51 Pigeons 51 Refuse Collection and Disposal 51 Mortuary and Coroner's Court 52 Sanitary Inspections 53 Notices served 53 Nuisances and Breaches—Legal Proceedings 53&54 Smoke Abatement 54 Factory and Workshop Acts 54 Inspections 55 Defects found 55 Home Work 56 Factories, Workshops and Workplaces on Register 56 Other matters 57 Premises and Occupations controlled by bye-laws or regulations 57 Offensive Trades 57 4 CONTENTS—continued page Bag and Bone Dealers 57 Eag Flock Acts, 1911-1928 58 Houses Let in Lodgings 58 Lighting of Staircases 58 Canal Boats Acts 58 Rent and Mortgage Interest Restrictions Act, 1923 58 Seotion IV—Housing. Statistics 59 Housing Conditions 61 Overcrowding 62 Housing Schemes— Work of the Estates Committee 62 Section V.—Inspection and Supervision of Food (a) Milk Supply to Cowsheds, Dairies and Milkshops 65 Milk in Sealed Containers 66 Sampling out of Office Hours 66 Milk (Special Designations) Order, 1923 66 Artificial Cream Act, 1929 69 (b) Meat and Other Foods 69 Unsound or diseased food condemned and destroyed 69 Slaughter-houses 69 Fried Fish and Fish Curing Premises 69 Ice Cream Premises 70 Bakehouses and Restaurant Kitchens 70 Underground Bakehouses 70 (e) Food and Drugs (Adulteration) Act, 1928— Samples taken 70 Prosecutions— (a) Food and Drugs (Adulteration) Acts 72 (b) Public Health atives &c in Food) Regulations 1925 72 (c) Milk and Dairies Order, 1926 72 (d) Public Health (London) Act, 1891 7? Prosecutions—continued. page (e) Public Health (Meat) Regulations, 1924 73 (f) & (g) Merchandise Marks (Imported Goods) Orders 73 Wholesale Dealers in Margarine 73 Section VI.—Prevalence of, and control over, Infectious Diseases Notifiable Diseases 73 Notifications and Deaths from notifiable diseases by ages 74 Do by Wards 75 Small Pox 76 Vaccination 76 Scarlet Fever 77 Diphtheria 77 Enteric (Typhoid) Fever 78 Puerperal Fever and Pyrexia 78—80 Erysipelas 80 Cerebro-spinal Meningitis 80 Anterior Poliomyelitis and Polioencephalitis 81 Ophthalmia Neonatorum 81 Encephalitis Lethargica 82 Pneumonia 82 Malaria 82 Dysentery 83 Food Poisoning 83 Measles and German Measles 83 Tuberculosis— New Cases and Deaths 87 Notifications 88 Prevalence and fatality for 10 years 89 Notifications and Deaths by Wards 89 Public Health (Tuberculosis) Regulations, 1930 90 Public Health (Prevention of Tuberculosis) Regulations, 1925 90 Boarding out of Children 90 Provision of Beds, etc 90 Disinfection of Rooms 91 Home Visits and Enquiries 91 Care Committee 91 Dispensary 93 Artificial Light Treatment 93 Report by Tuberculosis Officer 93 Summary of work carried out 94 4a CONTENTS—continued. page Section YII—Other Services. Disinfecting and Cleansing Station 95 Disinfection for Institutions, etc 96 Cleansing Station 96 Bacteriological Work 97 Appendix. Table No 1. Vital Statistics for 11 years 100 Do. 2. Registrar - General's Short List of Causes of Death 101 Do. 3. Births and Deaths in Wards 104 Do. 4. Do in certain large towns and Metropolitan Boroughs 105 Do. 5. Meteorology 106 Do. 6. Work carried out by District Inspectors 107 page Table No, 7. Work carried out by Food Inspectors 108 Do. 8. Do.—Factory & Workshop & Women Inspectors 109 Do. 9. Do.—Centre Superintendents, Women Inspectors and Health Visitors 110 Special Appendix Census, 1931. Housing in Metropolitan Boroughs , 112 Population and Intercensal Variations 113 Acreage, Population, Private Families and Dwellings 114 Dwellings, Rooms and Families 115 Private Families classified by size of family, rooms occupied and density of occupation 116 Institutions and Special Premises 117 Ages (Grouped) by Marital condition 118 5 Metropolitan Borough of St. Pancras. PUBLIC HEALTH COMMITTEE. November, 1931, to October, 1932. November, 1932, to October, 1933. CHAIRMAN. CHAIRMAN. Councillor Charles Henry Denyer, M.A. Councillor Mrs. Evelyn Alliston. DEPUTY-CHAIRMAN. DEPUTY-CHAIRMAN. Coullcillr John Evans Councillor Charles Henry Denyer, M.A. EX-OFFICIO. EX-OFFICIO. The Right Worshipfcl the Mayor The Right Worshipful the Mayor (Alaermau Sidney Bolsom, J.P., F.R.G.S.) (Sir Alfred Davies, C.B.E., J.P., L.C.C.). ALDERMEN. ALDERMEN. Davies, David, J.P., L.C.C. Davies, David, J.P., L.C.C. Escott Arthur, F.I.B.D Escott, Arthur, F.I.B.D. Morrell, Rev. R. Conyers, M.A. Morrell, Rev. R. Conyers, M.A. Rolles, Harry. Rolles, Harry. COUNCILLORS. COUNCILLORS. Ward Ward 3 Allan, Mrs. Isabella Menzies. 3 Allan, Mrs. Isabella Menzieb. 4 Alliston, Mrs. Evelyn. 2 Bell, Mrs. Florence Nightingale 3 Barry, Mrs. Mary Ann. Harrison. 2 Bell, Mrs. Plorence Nightingale 7 Crosby, Miss Ada, M.B.E. Harrison. 1 Davies, John William. 6 Cooper William. 8 Evans, Evan, L.C.C. 7 Crosby, Miss Ada, M.B.E. 8 Evans, John. 1 Davies, John William. 1 Flint, Mrs. Louisa Elizabeth. 8 Evans, Evan, L.C.C. 4 I lynn, William, J.P. 1 Flint, Mrs. Louisa Elizabeth. 6 French, Alexander Cteorge. Flynn, William, J.P. 7 Gurney, Frederick Brown, F.A.I. 6 French, Alexander George. 3 Hewson, Frederick. 3 Hewson, Frederick. 2 Horne, George, J.P. 2 Horne, George, J.P. 7 Jenkins, Edwin. 5 Kemp, Sydney Alfred. 5 Kemp, Sydney Alfred. 5 Radford, Mrs. Laura. 2 Moore, Thomas Fairless. 1 Smerdon, Mrs. Edith Maude. 1 Seward, William Guy. 5 Swann-Mason, Rev. Richard Swann, 1 Smerdon, Mrs. Edith Maude. O.B.E., M.A. 7 Swift, Mansell James, F.R.M.S. 7 Swift, Mansell James, F.R.M.S. 6 STAFF OF THE PUBLIC HEALTH DEPARTMENT at knd of the year 1932. 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. (o) G. A. Back, B.A., M.B., B.Ch., M.R.C.S., L.R.C.P., D.P.H. ASSISTANT MEDICAL OFFICER. (g) P. V. Pritchakd, M.D., D.P.H., M.R.C.P., F.R.F.P.&S. PUBLIC ANALYST. J. Kear Col well, F.I.C. PUBLIC VACCINATORS. Dr. N. J. Goodchild—Ward 1. Dr. A. E. Tait—Wards 5, 6 and 7. Dit. F. L. Pelly—Ward 2. Dr. C. H. A. Aederton—Ward 8. Dr. J. Wigg—Wards 3 and 4. VACCINATION OFFICER. Mr. A. E. Woi.fe. (G) SANITARY INSPECTORS. Inspectors of Food and Food Places. §¶HW. G. Auger. §¶H. R. Chied. Inspectors of Workshops and Factories. ‡Miss M. E. Bibby, B.A. (Lond.). ‡§B. H. Thompson. District Inspectors. *+§HJ. I. Lonnon. ‡M. Jaffa. ‡§W. L. Brown. ‡¶S. W. Capel. *‡¶A. H. Walker. ‡¶H. K. Nixon. ‡§R. E. James. §H. G. West. ¶‡G. W. Adkins. ‡¶E. W. Winchester. ‡R. C. Akers. (G) SANITARY INSPECTORS AND HEALTH VISITORS (FOR TUBERCULOSIS). ‡║†**Miss J. A. J. Camman. ‡||Miss A. Holland. CLERICAL STAFF. W. C. W. Roworth, Chief Clerk. A. Carpenter. (g) Miss A. Andrews, (g) G. N. Cove. ¶ x +R. Warren. xT. H. Hague. (g) J. A. Hoare. xW. C. Mansfield. E. F. Kirby. F. A. J. Goodchild (attached to the Estates Dept.). * Cert. Municipal and County Engineers. ‡ Cert. San. Insp. Examination Board. § San. Insp. Cert. Royal San. Inst. ¶ Cert. Meat and other Foods. || Health Visitor's Certificate, + Smoke Abatement Cert. (L.C.C.). † C.M.B. ** Certificate, Queen Charlotte's Hospital. X Cert. Royal San. Inst, and San. Insp. Exams. Joint Board. (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. Alderton 4 Dr. Albert J. Clarke 1 Dr. B. Marion Cockerell 10 Dr. J. Finch Haines 13 Dr. Janie Lorimer Hawthorne 6 Dr. Nora Leesmith 4 Dr. Lydia A. Leney 4 Dr. J. Balfour Neill 8 Dr. Martin Oldershaw 3 Dr. Mary J. Pirret 8 Dr. Francis L. Provis 4 Dr. Audrey E. Russell 4 Dh. Abraham I. Silverman 4 Dr. Helen Turover 5 (g) Dental Clinic. Mrs. W. A. Murch, L.D.S., Dentist 6 Dr. Jas. Maughan, Ancexthetist 2 (g) Artificial Light Clinic. Dr. P. Y. Pritchard 8 (g) Consulting Obstetric Surgeons. Martin H. Oldershaw, M.D., B.S., F.R.C.S. Francis L. Provis, M.R.C.P., F.R.C.S. (g) Dentists at Tuberculosis Dispensary. Mr. A. J. Maurice, L.D.S. Mr. J. H. Threlfall, L.D.S. Mr. B. R. Vincent, L.D.S. (The above are part-time officers.) (g) Superintendents oj Maternity and Child Welfare Centres. Senior. Jdnior. +||Miss G. R. Bristow. ¶║†Miss M. L. Blair. ║†MRS. E. Crockart. ║†Mrs. S. C. Chapman. ║†Miss M. H. Landel Jones. **||†Miss M. Manger. ¶†Miss M. Tkmpleton. ║†Miss E. M. Robinson. (g) Hrulth Visitors and Inspectors at Maternity and Child Welfare Centres. ‡§||Miss F. A. Anderson. ¶║Miss A. M. U. Harrop. ¶†**Miss E. B. Bagnall. ‡§Mrs. A. Hunter. ‡||Miss V. K. Bi.axland. †Mrs. E. Lurie. ║†Mrs. E. E. Bruce. †║‡MRs. J. Lynn. ║‡Miss M. A. Clarke. ¶║† M. A. Smith. ║†Miss B. M. Harris. (g) Tuberculosis Dispensary. Nurse, ¶‡†Miss S. A. Long. Clerical, etc., Assistant, Miss M. Deed. DISINFECTING AND CLEANSING STAFF. T. Bartholomew (Foreman). Mrs. E. Mace (Matron). A. J. Dibbejj (Disinfector). Mrs. L. Blaby (Assistant). J. Stanley (Driver and Disinfector). J. Root (Mortuary, etc., Caretaker). C. Browne (Do.). (The above are full-time officers.) ‡ Cert. San. Insp. Examination Board. || Health Visitor's Certificate. § San. Insp. Cert. Royal San. Inst. + C.M.B. ¶State Registered Nurse. ** Midwifery Certificate, Queen Charlotte's Hospital. (g) Officers to whose salary contribution is made under the Public Health Acts or by Exchequer Grants. 8 Public Health Department, Town Hall, Pancras Road, N.W. 1. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of St. Pancras. Ladies and Gentlemen, In accordance with the requirements specified in the Sanitary Officers Order and in Circular 1269 of the Ministry of Health, I have the honour to present the Annual Report on the sanitary circumstances, the sanitary administration, and the vital statistics of the Borough for the year 1932. This is the 77th Annual Report which has been presented, and the tenth which it has been my duty to submit to the Members of the Council. The statistical details acertained at the last census with reference to the population of the Borough, age and sex distribution, size of families, number of rooms occupied, etc., are included in this report and will be found in a special appendix on pages 111 to 118. Although the statistics indicate that a considerable amount of overcrowding still exists, particularly amongst families occupying only two rooms, it is encouraging to note that at the 1931 census the percentage of the population of the Borough living at a density of more than two persons per room was 17*6 as compared with a percentage of 22'4 at the previous census in 1921. A summary of the principal statistics for the year 1932 is given on pages 10 and 11, from which it will be noted that a satisfactory standard of Public Health has been maintained. The birth rate, 13-8 per 1000 of population, shows a considerable decrease as compared with previous years and is the lowest ever recorded in the Borough. The death rate was 131 per 1000 of population, as compared with a rate of 13*3 during the previous year. The infantile mortality rate was 69 per 1000 births, as compared with a rate of 68 for the preceding year. Infectious diseases showed no undue prevalence, with the exception of Measles and Influenza. An epidemic of the former disease, which usually occurs in the Metropolis every two years, took place during the period January to June and was responsible for an increase in the number of deaths amongst young children. The outbreak of Influenza commenced late in December (1932) and extended for some time into the following year. The type of illness was not very severe in character, and although Pneumonia was a frequent complication the death rate was not unduly high. The chief effect will be evident in the statistics for next year as the epidemic was only just commencing at the end of the year under review. 9 The principal changes in connection with Maternity and Child Welfare Work were the closing of the Argyle Square Welfare Centre and its amalgamation with the Somers Town Centre and a similar transfer of the work from the Grafton Road to the Camden Town Centre on the completion of the new premises, Barnes House. Further valuable contributions to working class housing accomodation in the Borough were made during the year in connection with the various schemes which are being undertaken by the Borough Council, the London County Council, the St. Pancras House Improvement Society and also on the Crown Estate in the Cumberland Market area. In Somers Town a block containing 18 flats was completed by the Borough Council, and Barnes House, Camden Road, which, in addition to 22 self-contained flats, also provides accommodation for a Welfare Centre, Tuberculosis Dispensary and Show-rooms for the Electricity Department, was completed and occupied early in the year. Two members of the stall of the department retired on superannuation :—Mr. Rackham, a district Sanitary Inspector after 34 years' service and Miss Smythe, Superintendent of the Queen's Crescent Welfare Centre, after 14 years' service from the time the Centre was taken over by the Borough Council. Dr. Ethel Iredell, a part-time Medical Officer at the Somers Town Centre, tendered her resignation in September owing to ill-health. Dr. Iredell had been associated with the Centre since its commencement in 1918, and it was with great regret that news of her death was received within a brief period of her resignation. In conclusion, I have again to thank the Chairman and members of the Public Health Committee for the consideration so constantly extended to me, and the staff of the department for their loyal co-operation. I am, Ladies and Gentlemen, Your obedient Servant, G. SO WD EN, Medical Officer of Health. 10 STATISTICAL SUMMARY. 1.—General Statistics. Area of Borough, 2,694 acres. Area of various public open spaces, 503 acres. Playing fields (private), 7 acres. Undeveloped area, 50 acres. Soil and Situation.—Practically the whole of the Borough is situated on London clay. There are a few superficial deposits of gravel in the south, and lower Bagshot sands in the extreme north. The altitude varies from 48 feet above ordnance datum, the lowest point, which is situated in the south of the Borough in the neighbourhood of Ampton Street, King's Cross Road, to 427 feet above ordnance datum, the highest point, which is in Pond Square in the extreme north of the Borough. The Borough is about four miles long, extending from near Oxford Street in the south to Highgate in the north, and averages about a mile in width. Population (1931 Census), 198,133. Number of inhabited houses (according to Rate Books), 27,040. Number of families or separate occupiers (1931 Census), 56,929. Number of persons per acre (Census year 1931), 74. 2.—Principal Statistics for 1932. Population (Registrar-General's mid-year estimate), 194,000. Number of persons per acre, 72. Births. Males, 1,383 ; females, 1,301. Total, 2,684. Birth rate, 13'8 per 1000 of population. Legitimate births, 2,470; illegitimate births, 214. Excess of births over deaths, 139. Deaths. Males, 1,311 ; females, 1,234. Total, 2,545. Death rate, 13-1 per 1000 of population. Infantile Mortality. Deaths of infants under one year of age per 1000 births, 69, Legitimate rate, 64; illegitimate rate, 131. 11 Maternal (Puerperal) Mortality. Number of women dying in, or in consequence of, child-birth : From Sepsis, 9; from other causes, 5. Total Puerperal Mortality, 51 per 1000 births (live and still). Number of deaths from Measles (all ages), 27. „ „ Whooping Cough (all ages), 25. „ „ Diarrhœa and Enteritis (under 2 years of age), 57. Tuberculosis. Pulmonary. Deaths, 164; death rate per 1000 of population, 0'84. All forms. Deaths, 189; death rate per 1000 of population, 0*97. Rateable value, ±2,084,068. Sum produced by a penny rate, £8,200. Rainfall during the year (recorded at Camden Square), 23'3 inches Comparative Statistics. Rate per 1000 of Population. Rate per 1000 Births. Birth rate Death rate. Infant Mortality. St. Pancras 13.8 13. 69 England and Wales 15.3 12. 65 118 Great Towns 15.4 12. 70 County of London 14. 12. 67 12 Metropolitan Borough of St. Pancras. REPORT OF THE MEDICAL OFFICER OF HEALTH For the Year 1932. Fur the purpose of this Report, the year consists of the 52 weeks ended 31s/ December, 1932. Section l.-STATISTICS AND SOCIAL CONDITIONS OF THE AREA. POPULATION AND GENERAL STATISTICS. The total population of the Borough at the Census of 1931 was 198,133. The Census figure of 198,133 represents a decrease of 6.3 per cent. since the 1921 Census, at which date the population of the Borough was 211,366. The above-mentioned decrease is due to the following factors: the excess of births over deaths would have resulted in an increase of population of 4*5 per cent., but the decrease due to removals from the Borough caused a loss of 10'8 per cent., the difference, 6'3 per cent., represents the net decrease in the population. The mid-year (1932) population of the Borough is estimated by the Registrar-General to be 194,000. In previous years, the estimated population has been divided into civil and total. For this year the estimated total population only is given, as deaths of persons serving in H.M. Forces are now allocated to their area of residence in the same manner as civilian deaths, and the above estimate of total resident population (194,000) has been used for the calculation of both birth and death rates. In a special appendix to this report (pages 111 to 118) the statistical details are given with reference to St. Pancras which were ascertained at the Census taken on April 26th-27tli, 1931. It was found that on the date of the Census the number of private families or separate occupiers was 56,929, comprising a population of 178,341 (90 per cent. of the total population). These were housed in 158,489 rooms, which represents an average number of persons per room of 1*13. Of the remainder of the population, 6'8 per cent, were living in hotels, boardinghouses, etc., and 3'2 per cent, in various institutions. The total number of structurally separate dwellings, occupied and vacant, was 25,670. These contained 163,898 rooms, of which 158,489 were occupied and 5,409 were vacant. 13 The size of the homes or tenements in St. Pancras is indicated by the following: 12,547 families (comprising 20,294 persons) were each living in one room. It should be noted that in 7,590 instances the so-called "family" comprised one person, and in 3,239 cases the " family " consisted of two persons only. 17,342 families (comprising 52,407 persons) were each living in two rooms, and 12,829 families (comprising 43,841 persons) were each living in three rooms. The three groups above mentioned of families living in one, two or three rooms respectively represent 75 per cent. of the total families in the Borough. PRINCIPAL OCCUPATIONS OF THE INHABITANTS OF THE BOROUGH. The information obtained at the last Census (1931) with reference to the numbers engaged in the principal occupations is not yet available, but will doubtless be published in time for inclusion in the next Annual Report. The number of persons of 15 years of age and upwards living in the Borough at the date of the Census (April, 1931), was as follows:— Total Population (age 15 and over), 158,732. Males, 74,522; Females, 84,210. There are no particular industries carried on in the Borough which to any extent affect the public health prejudicially. ECONOMIC CONDITIONS. Although many parts of St. Pancras are inhabited by persons who are in good financial circumstances, a large proportion of the Borough is working class in character. Unemployment or irregular employment are therefore factors which may lead to under nourishment, and are also likely to be associated with inadequate housing accommodation and overcrowding, and so affect the public health adversely. In this connection the following particulars with reference to the amount of out-door relief granted by the Public Assistance Authority and the number of persons registered as unemployed may be of interest. They have been provided by Mr. B. Chapman, local Public Assistance Officer, and Mr. J. II. Powell, Manager of the Labour Exchange:— 13 weeks ended. Average weekly No. of persons receiving ont relief. Average weekly cost of relief. £ 2nd January, 1932 3959 1134† 2nd April, „ 4649 1246* 2nd July. „ 4807 1219 1st October, „ 4722 1225 * Includes winter coal allowances (13 weeks). † ,, ,, ,, (9 weeks) and Christmas allowances (1 week). Number of unemployed at December 31st, 1932:— Men. Boys (14-18). Women. Girls (14-18). Total. 7888 168 1453 113 9622 14 MARRIAGES. The number of marriages celebrated (luring the year was 1,749. This is equal to a rate of 9.0 marriages per 1000 of total population, or a rate of 18.0 persons marrying per 1000 of the population. The average yearly number of marriages during the preceding five years was 1,987, equal to a rate of 9 5 per 1000 of population. BIRTHS. The number of births registered during the year belonging to St. Pancras was 2,687, equal to an annual birth rate of 13.8 per 1000 of population. This is the lowest birth rate recorded in the Borough. The rate for the previous year was 15.1, and the rate for 1930 was 15.4. The actual number of births registered as having taken place in the Borough during the year was 4,224, but this figure has to be corrected by deducting the births of nonresidents, which occurred chiefly in various hospitals and other institutions in the Borough (these numbsred 1,936) anrl by adding the births belonging to St. Pancras which occurred outside the liorough (these numbered 396). The corrected figure being therefore as stated above, 2,684. The corresponding figures for previous years are given in Table 1, on page 100. The following table gives the number of births and the birth rate in each Ward of the Borough for the year 1932, and for comparison the figures for the previous year are also given:— Ward Births and Birth Rates. Ward. 1932. 1931. Births. Birth Rate. Births. Birth Rate. l 472 13.4 530 15.0 2 310 16.1 337 17.4 3 525 16.2 551 16.8 4 346 14.8 356 15.1 5 375 13.3 451 15.9 6 257 14.6 275 15.5 7 126 9.9 137 10.7 8 273 10.8 318 12.5 Borough 2684 13.8 2955 15.1 No less than 2,766 births occurred in Public Institutions in St. Pancras, equal to 65 per cent. of the total births which took place in the Borough. Table 4, on page 105, shows for 1932 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. 15 Illegitimacy. Of the 2,684 net St. Pancras births, 214 were recorded as being illegitimate. This equals 8.0 per cent. of the total births registered. The corresponding figures for the preceding: 10 years were as follows:— Year. Rate. Year. Rate. 1922 5.6 per cent. 1927 6.9 per cent. 1923 5.7 „ 1928 7.3 „ 1924 5.9 „ 1929 7.8 „ 1925 6.3 „ 1930 8.4 „ 1926 6.3 „ 1931 8.3 „ In the years before the great War the illegitimate births in the Borough were from 4 to 5 per cent, of the total births registered. During the war years the rate increased to about 9 per cent., and although a decrease then occurred, a steady increase in the number of illegitimate births has taken place during the past 6 or 7 years. To what extent this is due to an alteration of traditional standards, and to what extent it is caused by overcrowding it is difficult to state, but probably both factors are concerned. Notification of Births. The long delay which might and frequently did occur before a birth was registered was found to diminish the value of the work carried out at the Welfare Centres. At times the death of a child would be reported before information bad been received with reference to its birth. The Notification of Births Act was therefore passed in order to remedy this defect and to give the Local Authority early information of the occurrence of all births. 4,354 notifications of births were received during the year: this includes 144 stillbirths and 4,210 live births, and represents 99.7 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 Register Office within forty-two days of the birth. Still Births. The Births and Deaths Registration Act, 1926, which came into force on July 1st, 1927, requires the birth of any still born child to be registered. The definition of still birth for the purpose of the Act is as follows : — Still bora or still birth shall apply to any child which has issued forth from its mother after the 28th week of pregnancy, and which did not at any time after being completely expelled from its mother, breathe or show any other sign of life. For the purpose of the Births and Deaths Registration Act, a child which, whatever the period of pregnancy, breathes or shows any other sign of life after complete expulsion from the mother, is a live born child, and if it dies even within a brief period only after birth, both the birth and the death must be registered. 16 The fact of still birth must be certified either by the Medical Practitioner or Midwife who was in attendance, or who has examined the child, or by declaration in a prescribed form if no Medical Practitioner or Midwife was present. If, in any of the last mentioned cases, information is given by the Registrar to the Local Authority, the Minister of Health has intimated that the Medical Officer of Health shall arrange for enquiries to be made in order that he may be satisfied that the child was really still born and that there were no suspicious circumstances attaching to the case. In accordance with the instructions of the Ministry of Health, the following table is included which gives particulars, by sex and legitimacy, with reference to all still births registered in the Borough during the year:— Still Births Registered. Inward Transfers. Outward Transfers. Still Births Allocated to the Borough. Total Legitimate and Illegitimate Males 81 8 51 38 Females 81 8 49 40 Illegitimate Males 10 - 4 6 Females 8 2 3 7 Inward transfers relate to still births belonging to the Borough, but which took place in some other area. Outward transfers refer to still births of non-residents, but which took place in the Borough. DEATHS. The net number of St. Pancras deaths registered during the year was 2,545; equal to an annual death rate of 13.1 per 1000 of population. The corresponding rate for the previous year was 13'3 and the average yearly death rate of the Borough for the previous five years was 13.1 per 1000 of population. The actual number of deaths registered as having taken place in the Borough during the year was 2,832. This number has to be corrected by the exclusion of 937 deaths which occurred in the Borough of persons who were not St. Pancras residents, and by the inclusion of 650 deaths of residents which occurred and were registered outside the Borough. The corrected figure is therefore 2,545 and is used in calculating the death rate in this report. In Table 1, on page 100, will be found details of the corresponding figures for previous years. 17 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. 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 Average for 10 years 1932 Heart Disease 461 394 398 381 388 448 465 603 430 553 452 590 Cancer 302 319 298 324 301 292 321 297 357 355 317 359 Tuberculosis—all forms 315 272 271 231 212 217 216 250 189 206 238 189 Pneumonia 265 201 200 204 155 207 181 295 160 203 207 184 Injuries 127 113 114 118 142 132 145 129 165 121 131 123 Bronchitis 308 223 304 274 259 227 138 255 106 143 224 99 Cerebral Hæmorrhage, Embolism, and Apoplexy 120 112 118 123 110 92 67 78 99 92 101 63 Diarrhœa and Enteritis 47 61 63 55 63 35 52 48 52 33 51 61 Congenital Debility, Malformation and Premature Birth 126 119 105 94 100 69 86 88 72 76 94 58 Nephritis and Bright's Disease 67 79 75 75 89 84 83 72 72 61 76 55 Influenza 142 24 80 41 29 83 14 137 14 49 61 41 Measles 107 5 74 3 65 5 127 7 31 2 43 27 Whooping Cough 29 28 46 71 24 35 24 77 4 14 35 25 Erysipelas 12 4 4 12 8 6 2 4 9 8 7 17 Rheumatic Fever 15 8 5 18 10 13 15 7 17 18 13 16 Diphtheria and Croup 44 20 22 34 12 6 12 18 32 19 22 10 Puerperal Fever 4 9 4 4 1 4 3 4 - 2 4 9 Scarlet Fever 20 3 12 — 2 2 1 4 7 2 5 5 Pleurisy 10 8 8 16 5 3 7 5 6 4 7 3 Enteric Fever 1 3 2 3 1 2 1 3 1 1 2 2 The Registrar-General's short list of deaths at different age periods is given in Table 2 on page 101, and, for the purpose of comparison, the death rates for England and Wales, the County of London, the Metropolitan Boroughs, and certain of the large towns are given in Table 4 on page 105. It will be noted that 24 Metropolitan Boroughs had a lower and 4 a higher general death rate than St. Pancras, Of the total 2,545 St. Pancras deaths which occurred during the year, no less than 1,707 took place in public institutions; this equals a proportion of 67 per cent. of the total deaths. 18 As compared with previous years there was an increase in the number of deaths due to Heart Disease, Cancer, Injuries, Enteritis and Measles, and a decrease in those attributed to Tuberculosis, Pneumonia, Bronchitis, Cerebral Hæmorrhage, Bright's Disease, Diphtheria. Deaths of Aged Persons. The corrected number of deaths of residents at 65 years of age and upwards, which occurred during the year 1932 was 1,167. Of these 604 were between the ages of 65 and 75; 434 were between the ages of 75 and 85, and 129 were 85 years of age and upwards. Ward Deaths and Death Rates. The number of deaths and the death rates per 1000 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. 1932. 1931. Deaths. Death Rate. Deaths. Death Rate. 1 424 12.1 469 13.2 2 225 11.7 225 11.6 3 422 13.0 441 13.5 4 359 15.3 350 14.8 5 370 13.1 367 13.1 6 180 10.2 198 11.1 7 168 13.2 161 12.5 8 347 13.8 346 13.6 Homeless 50 — 44 - Borough 2545 13.1 2601 13.3 Deaths of Persons of unknown addresses, etc., included in the Mortality Statistics. The following deaths have been included in the Mortality Statistics of the Borough, I in accordance with the Registrar-General's rules relating to "Transferable Deaths":— Various Asylums 21 High gate Hospital 5 St. Pancras Hospital 19 Middlesex Hospital Annexe 1 Royal Free Hospital 1 Found dead on Primrose Hill 1 Found dead in Public Lavatory, Pancras Road 1 Found dead in suit-case, King's Cross (L.N.E.R. Station) 1 Total 50 19 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 Diseases - - - 2 8 7 17 Pneumonia 3 1 1 2 7 6 20 Cerebral Hæmorrhage - - — 1 2 3 6 Cancer — - — 1 9 3 13 Tuberculosis — 1 — 1 2 — 4 Other causes 12 4 9 5 35 17 82 Accidents- Street Vehicles - 2 8 24 30 30 94 Burns and Scalds - 4 - 1 8 12 25 Railway — - — - 5 - 5 Falls — 2 1 2 30 71 106 Other causes* 8 3 2 6 15 5 39 Suicides† — — - 1 110 16 127 Murder — 1 2 - — — 3 Manslaughter — - — 1 1 — 2 Open Yerdict‡. 4 - - 2 13 2 21 Totals 27 18 23 49 275 172 564§ * Includes 6 cases of coal gas poisoning. J Includes 1 case of coal gas poisoning. † ,, 52 cases ,, ,, § St. Pancras cases 121, ex-Sfc. Pancras 443 (see also page 52) Infantile Mortality. 186 deaths of St. Pancras infants under one year of age occurred during 1932. This gives an Infant Mortality rate (number of deaths under one year of age per 1,000 births) of 69. The corresponding rate for the previous year was 68. The following table gives the deaths and death rates of both legitimate and illegitimate infants for 1932:— Legitimate. Illegitimate. Total. Number of Births 2,470 214 2,684 Number of Deaths (under one year of age) 158 28 186 Death rate per 1000 births 64 131 69 In Table 1, on page 100, the Infantile Mortality rates are given for previous years, and in Table 3, on page 104, the figures will be found for each Ward. Table 4, on page 105, gives the Infant Mortality rates for England and Wales, the County of London, the Metropolitan Boroughs, and certain other large towns. On the next two pages tables are given which indicate:— 1. The causes of death of all children under one year of age during 1932, classified according to age at death. 2. The causes of death of children under one year of age during the ten previous years. In this table the number of births in each year is also given for reference. 20 Nett Deaths from stated causes at various Ages under 1 Year of Age for the Year 1932. CAUSE OF DEATH. Under 1 week. 1—2 weeks. 2—3 weeks. 3—4 weeks. Total under 4 weeks. 4 weeks and under 3 months. 3 months and under 6 months. 6 months and under 9 months. 9 months and under 12 months. Total Deaths under 1 year. Measles - - - - - - - - 6 6 Whooping Cough - - - - - 4 3 3 1 11 Influenza - - - - - 2 - - - 2 Diphtheria - - - - - - - - 1 1 Erysipelas 1 — — — 1 1 — — 1 3 Tuberculous Meningitis - - - - - - - 1 - 1 Other Tuberculous Diseases - - - - - - - 1 - 1 Meningitis {not Tuberculous) - - - - - - 2 1 — 3 Bronchitis - - - - - 1 1 — 1 3 Broncho-pneumonia 2 1 1 1 5 9 5 3 5 27 Lobar-pneumonia - — - - - - - - 1 1 Pneumonia (type not stated) - 1 — - 1 - — — 1 2 Diarrhœa - - - - - 3 1 5 — 9 Enteritis — — 2 2 4 7 12 11 8 42 Gastritis - - - - - 1 - - - 1 Syphilis — — — 1 1 1 — — — 2 Injury at Birth 6 — — — 6 — — — — 6 Atelectasis 6 1 — — 7 1 — - - 8 Congenital Malformations 1 1 1 1 4 4 1 1 - 10 Premature Birth 21 2 3 2 28 4 3 1 - 36 Congenital Debility, Sclerema and Icterus 1 — 1 — 2 — — — — 2 Other causes 3 — 1 1 5 — 2 1 1 9 Totals 41 6 9 8 64 38 30 28 26 186 Nett Births in the year Legitimate 2470 Nett Births in the year Legitimate infants 158 Illegitimate 214 Illegitimate infants 28 21 Deaths from Stated Causes under 1 Year of Age for 1932 and 10 preceding Years. CAUSE OF DEATH. 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 Average for 10 years. 1932 Measles 15 1 15 2 25 - 30 - 3 1 9 6 Scarlet Fever 3 — — — — — — — - — — — Whooping Cough 11 8 13 29 11 15 10 32 2 10 14 11 Diphtheria and Croup — — — 1 1 - — 3 1 1 1 1 Erysipelas 1 1 2 2 — — — — 2 — 1 3 Influenza 7 — 6 2 1 2 — 5 2 1 3 2 Tuberculous Meningitis 3 4 3 2 3 3 — — 1 1 2 1 Other Tuberculous Diseases 8 3 — 1 1 1 2 — 2 2 2 1 Meningitis (not Tuberculous) 2 3 5 4 3 2 1 4 3 8 4 3 Convulsions 8 5 4 4 2 1 1 5 — 1 3 — Bronchitis 21 12 12 19 14 5 9 7 7 4 11 3 Broncho-pneumonia 54 34 51 34 36 42 43 43 20 42 40 27 Lobar-pneumonia 3 1 3 4 2 2 3 4 — 3 2 1 Pneumonia (type not stated) 6 1 3 _ 1 1 2 1 3 1 2 2 Diarrhœa 4 6 6 9 7 3 8 5 6 6 6 9 Enteritis 27 37 46 36 38 24 33 34 36 22 33 42 Gastritis - 1 — 2 — — — 1 — — — 1 Syphilis 8 5 2 5 1 2 4 1 3 2 3 2 Rickets 1 - — — — — — — 1 — — - Suffocation (overlying) 5 1 1 4 3 1 1 — 1 — 2 — Injury at Birth 3 6 4 7 3 9 2 9 4 3 5 6 Atelectasis 4 9 7 2 6 10 11 7 3 4 6 8 Congenital Malformations 31 27 23 20 25 15 20 23 12 23 22 10 Premature Birth 61 70 59 57 57 39 50 46 48 43 53 36 Congenital Debility, Sclerema and Icterus 28 21 24 17 18 14 16 14 8 7 17 2 Other causes 23 16 14 17 16 14 15 18 26 15 17 9 Totals 337 272 303 280 274 205 261 262 194 200 258 186 Nett Births 4559 4348 4112 3880 3612 3299 3274 3170 3208 2955 3642 2681 22 Death Rates of Infants and Young Children. Although the death rate of children under 5 years of age and the Infantile Mortality rate have been falling for a number of years, there appears to have been little or no decrease in the heavy death rate which occurs during the first month of life. The following table gives the total number of deaths in the Borough at all ages, the number of deaths under 5 years of age, under 1 year of age, and under 1 month for each year during the past 12 years. The table also gives the percentage of deaths under 5 years of age to the total deaths at all ages, and the percentage of deaths under 1 month to the total deaths under 1 year for each year during the same period:— Total Deaths Percentage Avera8e Deaths Deaths Percentage Year. deaths at under 5 of total Percentage un(Jer x nnder of death| Percentage all ages. yearsofage. deaths. 6 years year of age. 1 month, under 1 year. 6 years 1921 2778 495 17 360 135 38 1922 3107 618 20 337 117 35 1923 2585 408 16 272 129 47 37 1924 2848 515 18 18 303 96 32 1925 2745 434 16 280 95 34 1926 2680 409 15 274 98 36 The average Birth rate for years 1921-1926 was 19*6. 1927 2621 300 11 205 85 41 1928 2618 423 16 261 82 31 1929 3126 397 13 12 262 95 36 1930 2478 291 12 194 75 39 36 1931 2601 255 10 200 71 36 1932 2515 271 11 186 64 34 The average Birth rate for years 1927-1932 was 15.4. It will be noted that during the past 6 years (1927-32) the deaths of children under 5 years of age have averaged 12 per cent, of the total deaths, but during the previous 6 years (1921-6) the average was 18 per cent., a difference of 6 per cent. During the same periods the average birth rate has fallen from 19.6 during 1921-26 to 15.4 during the years 1927-32, a difference of 4.2. The decrease in the mortality rate of children under 5 years of age has therefore more than compensated for the fall in the birth rate. These figures are also of interest in relation to the system of Block grants which now replace the percentage grants previously made in connection with Maternity and Child Welfare work. One factor in the formula on which the amount of grant is based is the number of children in the area under 5 years of age. Although the number of such children in St. Pancras is decreasing, it is obvious from the above table that the decrease is due to a falling birth rate and not to any increase in the rate of mortality of the children concerned. The table also shows that during the past 6 years (1927-32) the average percentage of deaths under the age of one month to the total deaths under 1 year of age was 36, and during the previous period of 6 years (1921-26) the percentage was 37, or practically the same. It would have been anticipated that the amount of Ante-Natal work which has been carried out during recent years would have had a favourable effect on this heavy mortality during the first month of life, and further inquiry into this point appears to be necessary. 23 Section II.- GENERAL PROVISION OF HEALTH SERVICES. Hospital Accommodation. A. Fever and Small Pox.—Hospital accommodation is provided by the London County Council, who now control the various institutions previously provided by the Metropolitan Asylums Board. B. Tuberculosis.— For patients suffering from this disease Institutional accommodation is provided through the London County Council. C. General, Children's and other Hospitals.— The following are situated within the Borough. The St. Pancras and Highgate Hospitals are primarily intended for residents of the Borough. St Margaret's Hospital admits cases of the kind specified from the whole of the metropolitan area, but the use of the various general and special voluntary hospitals is by no means confined to residents either of this Borough or of the metropolitan area. On the other hand, hospitals situated outside the Borough are largely used by St. Pancras residents. Hospitals. Number of Beds. London County Council General Hospitals. St. Pancras Hospital, King's Road 384 Highgate Hospital, Dartmouth Park Hill 554 London County Council Special Hospital. St. Margaret's Hospital, Leighton Road (for ophthalmia neonatorum and congenital syphilis in children) 60 General and Special Voluntary Hospitals. General. 414 University College Hospital, Gower Street {Obstetric 85 Royal Ear 41 Royal Free Hospital, Gray's Inn Road 281 National Temperance Hospital, Hampstead Road 152 Elizabeth Garrett Anderson Hospital, Euston Road 105 West End Hospital for Nervous Diseases, Regent's Park 78 Hospital for Tropical Diseases, Endsleigh Gardens... 76 Central London Throat, Nose and Ear Hospital, Gray's Inn Road 78 Central London Ophthalmic Hospital, Judd Street . 51 Metropolitan Ear, Nose and Throat Hospital, Fitzroy Square. 22 St. Saviour's Hospital, Osnaburgh Street 21 North-West London Hospital, Bayham Street St. Pancras Dispensary, Oakley Square London Skin Hospital, Fitzroy Square Out- Western Skin Hospital, Hampstead Road patients British Dentists' Hospital, Camden Road . only. London Foot Hospital, Fitzroy Square British Hospital for Nervous Disorders, Camden Road British Red Cross Society Clinic for Rheumatism, Peto Place 24 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. St. Margaret's Home, 13, Burton Street, W.C.1. This Rescue Home, maintained entirely by funds from voluntary sources, provides accommodation for young women and babies requiring care and supervision, and endeavours to find suitable situations for those capable of work. Ambulance Facilities. London Ambulance Service. (Headquarters, The County Hall, S.E.I.) Facilities afforded by the London Ambulance Service (Tel. City 7200), with instructions for obtaining the help of the service. I.— Ambulances Supplied Without Payment. The London County Council provides, within the Administrative County of London, ambulances, free of cost, for the conveyance to:— A.—Hospitals or private residences of:— (i) Persons meeting with accidents or suffering from sudden illnesses in the streets, public places, places of employment, etc.; (ii) Persons meeting with accidents in their homes; (iii) Persons suffering from illnesses in their homes, if a medical practitioner certifies that the case is one of life or death, and that arrangements have been made for the reception of the patient in a hospital; (iv) Parturient women, if the case is one of urgency, whether from the home, place of business, or elsewhere, on the application of a qualified medical practitioner or certified midwife, provided that either a doctor or midwife accompanies the case; and (v) Non-urgent cases of parturition, if the call is made between the hours of 11 p.m. and 8 am. In such cases admission to a maternity bed must have previously been arranged and a card (issued by the County Council to hospitals, maternity homes, etc.) for such admission obtained. This card must be handed to the ambulance attendant at the time of removal. In these cases the husband or a female friend must accompany the patient. (Note.—The Corporation of the City of London maintains its own ambulance service for dealing with cases of accident and illness occuring in the streets within the City area.) B. —The London County Council's hospitals for infectious cases:— Patients can only be removed if the following conditions have been fulfilled : A medical certificate must be handed to the ambulance nurse stating definitely the nature of the disease, and this disease must be one of those admissible to hospital. 25 The nurse, on removing the patient, will leave at the house a notice stating the hospital to which the patient is to be taken, together with a copy of the regulations as to enquiries about, and visiting of, patients. The diseases admissible to hospital are the following: — Anthrax. Ophthalmia neonatorum (b). Cerebro-spinal meningitis. Plague. Cholera. Polio-encephalitis. Continued Fever. Polio-myelitis. Diphtheria. Puerperal fever and Puerperal pyrexia. Dysentery (a). Relapsing fever. Encephalitis Lethargica. Scarlet fever (or Scarlatina). Enteric (or Typhoid or Paratyphoid) fever. Smallpox (or Variola). Glandular fever. Typhus. Malaria. Whooping cough (or Pertussis) (a). Measles (or Morbilli). Zymotic enteritis (or Infantile diarrhoea) (a). Membranous croup. Notes.—In special circumstances, cases of chickenpox, german measles aud mumps may be admitted. (a) Admitted only on application of medical officers of health of metropolitan boroughs. (b) Admitted on application of either a medical practitioner or a certified midwife (medical certificate not essential). II.—Ambulances Supplied ok Payment. Ambulances and ambulance omnibuses are also provided by the London County Council, when not required for the purposes stated above, on payment of charges, as laid down from time to time by the County Council, for the conveyance of infectious and non-infectious cases between private houses, hospitals (other than to the County Council's hospitals, etc., under the provisions of Section 1), nursing homes and for examinations, consultations and treatment by specialists or at special establishments. The conveyance of private persons between addresses both of which are outside the administrative county of London cannot be undertaken, unless in circumstances of exceptional urgency. Arrangements for the reception of an infectious case must be made by or on behalf of the patient before application for an ambulance is sent to the London County Council, and a medical certificate as to the nature of the infection must be handed to the ambulance driver before the patient is removed. The charges as from and including 1st October, 1932, are as follows:— (a) Within the Administrative County of London (private cases). 12s. 6d. for the removal of one patient from one place to another within the administrative County of London, this charge to include, if necessary, the services of a male attendant. A doctor and one friend to be allowed to accompany the patient free of charge. Additional charges to be made as follows:— (i) 5s. if two patients are conveyed together; (ii) 2s. 6d. if the friend accompanying the patient wishes to return in the ambulance during the whole or some part of its journey to the ambulance station; 26 (iii) 5s. for a journey back to the first address or, on to farther addresses, at 5s. plus the prescribed waiting fee, for each address ; (iv) 2s. 6d. a head for each additional person who desires to accompany the patient, together with 2s. 6d. for the return journey, if used; (v) 5s. for the service of a nurse for a period up to two hours, and thereafter at an extra charge of 2s. an hour or part of an hour; (vi) 5s. an hour or part of an hour for keeping an ambulance waiting more than 15 minutes. (b) For journeys extending outside the County and for work carried out for public authorities within and without the County:— For one or two persons, 1s. 6d. a mile up to 50 miles and thereafter 1s. 3d. a mile. For three or four persons, 1s. 10½d. a mile up to 50 miles and thereafter 1s. 6d. a mile. For five to eight persons, 2s. 3d. a mile up to 50 miles and thereafter 1s. 10½d. a mile. For over 8 persons, particulars of charges may be obtained on application to the county medical officer. The mileage is reckoned on the total distance travelled by the ambulance from ambulance station back to ambulance station. The highest number of persons at one time on the journey to be charged for on the total mileage reckoned to and from the ambulance station. For a journey occupying over eight hours, an additional charge, to be determined by the county medical officer of health, to be made to cover drivers' expenses, and where the journey extends to a second day, the person ordering the vehicle to be required to arrange for garaging, and also for lodging and subsistence for the staff. Additional charges to be made as under (a), (v) and (vi) above. No charge will be made in respect of the conveyance by ambulance of patient's doctor who accompanies the patient in the ambulance. Other ambulance facilities include:— St. John's Ambulance Association, St. John's Gate, Clerkenwell, E.C.I. Tel. Clerkenwell 6644. British Red Cross and Order of St. John Ambulances, These convey pregnant women to hospitals from 8 a.m. to 11 p.m. Tel. Sloane 7136. 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. Rhaydon Street, South Highgate The Borough Council. Almeric Paget Clinic, Rochford Street A Voluntary Committee, The Institute of Ray Therapy, 152-154, Camden Road ,, A number of the hospitals in the Borough also provide this treatment. 27 Situation. By whom provided. B. Maternity and Child Welfare Centres. St. Pancras School for Mothers, Ampthill Square The Borough Council, with assistance from the Voluntary Committee. Do. do. Somers Town ,, ,, North St. Pancras School for Mothers, Queen's Crescent ,, ,, South Highgate Centre, Raydon Street ,, ,, Camden Town Centre, Camden Road ,, ,, Caversham Road Centre ,, ,, University College Hospital Centre The Hospital Authorities. Royal Free Hospital Centre ,, ,, C. Day Nurseries. Kentish Town Day Nursery, Gospel Oak Grove The Voluntary Committee, with a subsidy from the Borough Council. Margaret Day Nursery (for fatherless children), 56-59, Clarendon Square ,, ,, Whitefield Day Nursery, 53, Whitfield Street .. ,, ,, Day Nursery, Foundling Hospital Site ,, ,, D. Nursery Schools. Somers Town Nursery School, 18, Crowndale Road A Voluntary Committee. Jellicoe Nursery School, 6a, Rochford Street ,, Mary Ward Nursery School, 16, Burton Street ,, Magdalen Mission Nursery School, 5, Clarendon Street The Mission Authorities. St. Christopher's Hall, Bridgewater Street The Committee of the St. Pancras House Improvement Society, Ltd Trinity Presbyterian Hall, Buck Street The Church Authorities. E. Dental Clinics. Barnes House, Camden Road: For nursing and expectant mothers and children under 5 years of age who attend the Maternity and Child Welfare Centres The Borough Council. Ampthill Square: For mothers and children who attend the Centre at 1, Ampthill Square The Voluntary Committee. St. Pancras Dispensary : For Tuberculosis cases The Borough Council. „ For ordinary cases The Dispensary Committee. Eastman Clinic: For nursing and expectant mothers and children; also provides in-patient treatment for tonsils and adenoid cases, cleft palate, &c. The Committee of the Royal Free Hospital and Clinic. 28 Situation. By whom provided. P. School Clinics. Highgate New Town: Chester Road Voluntary Committees, working under agreement with the London County Council. St. Pancras Centre, Prince of Wales Road Clarendon Square G. Tuberculosis Dispensaries. Barnes House, Camden Road The Borough Council. University College Hospital The Hospital Authorities. H. 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). A complete list giving the days and times at which clinics are available can be obtained on application to the Medical Officer of Health. 1. Clinic for Sick Mothers and Young Children. St. Paneras Dispensary, 39, Oakley Square Medical Officer paid by Borough Council; other expenses paid by Dispensary Committee. J. Convalescent Homes for Sick Poor Children. The Mayoress of St. Paneras Home, "Avalon," St. Alban's Road, N.W. 5. By Voluntary Committee, with grant from Borough Council. Invalid Children's Aid Association (various homes) Subsidy from Borough Council. K. Open Air Schools. Holly Court, Highgate, N. 6 London County Council. Euston Square, N.W. 1 ,, L. Professional Nursing at Home. North London Nursing Association, 6 & 7, Canonbury Place, N. 1 By Voluntary Committee, with grant from Borough Council. Hampstead Nursing Association, 25, Heath Hurst Road, N.W. 3 ,, Metropolitan Nursing Association, 14, Oakley Square, N.W. 1 ,, MATERNITY AND CHILD WELFARE. For many years considerable attention has been devoted to this work in St. Paneras, not only by the Borough Council and the associated voluntary committees, but also by the general and voluntary hospitals, etc. The Local Government Act, which came into force on April 1st, 1930, authorised the Minister of Health to make a scheme determining, in relation to voluntary associations providing maternity and child welfare services, which of those are to be treated as services in respect of which the County Council are to contribute and which are services in respect of 29 which the Metropolitan Borough Councils are to contribute, and the scheme provided for the payment during the fixed grant period to the various voluntary associations of contributions of such amounts as may be specified in the scheme. Each of the annual contributions were to be paid either in a single sum before the 30th of September in each year, or in equal quarterly or half-yearly instalments. The associations in respect of which the County Council make contributions are principally those providing residential accommodation. The following are those to which the St. Pancras Borough Council make contributions, the amount being also stated : — £ St. Pancras School for Mothers 777 Somers Town Welfare Centre249 North St. Pancras School for Mothers136 South Highgate Welfare Centre178 Caversham Road „421 †Grafton Road „32 Camden Town „197 †Argyle Square „ 121 St. Pancras Dispensary 146 University College Hospital 890 Whitefield Day Nursery 564 Kentish Town „ 432 *Margaret ,, 403 Mayoress of St. Pancras Home for Sick Poor Children 758 The payment of the above-mentioned contributions is subject to the following conditions:— 1. That the Borough Council are satisfied as to the efficiency of the maternity and child welfare service provided by the association in respect of which the contribution is payable, and that such service is being used by a reasonable number of those persons for whom it is provided; 2. That no reduction or alteration of such service is made without the consent of the Borough Council; 3. That such service, and any premises in which it is carried on, are open to inspection at all reasonable times by any officer of the Borough Council duly authorised by the Council, and by any officer of the Ministry of Health appointed for that purpose by the Minister; *The grant allocated by the Ministry of Health to the Margaret Day Nursery was based on the expenditure incurred during the standard year (1929) at the old premises then occupied in Ampthill Square. The Committee of the Nursery had, however, acquired a site in Clarendon Square on which a large and well designed day nursery was erected. The accommodation in the new premises was very much greater, and although the expenses were necessarily higher, no increase in the grant made by the Minister could be obtained until the expiration of the period of three years for which the amount of grant had been fixed. Under these circumstances, the Borough Council very generously decided to make a grant of £390 per annum for a period of two years towards the cost of the new premises. At the end of this time the position could be reviewed, as a new scheme would then be made by the Minister of Health. †Owing to the amalgamation of the Grafton Road with the Camden Town Centre and the Argyle Square with the Somers Town Centre the above scheme has been amended by the Minister of Health. The grants to the Grafton Road and Argyle Square Centres have been cancelled and the grants to the Camden Town and Somers Town Centres have been increased to £324 and £275 respectively. 30 4. That the association sends to the Borough Council in each year a copy of the annual report of the association on the maternity and child welfare work of the previous year, together with a statement of the accounts of the association for that year relating to such work and a copy of the auditors' certificate thereon, and furnishes the Borough Council from time to time with such other information relating to the maternity and child welfare services provided by the association and the expenditure thereon as the Borough Council may reasonably require. The above scheme came into operation on April 1st, 1930, and is to continue in force until March 31st, 1933. The work carried out in the Borough in connection with maternity and child welfare may be summarised under the following three headings:— 1. Ante-natal. Special consultations are held at the Centres maintained by the Borough Council and also at the General and Women's Hospitals, both in and adjacent to the Borough. Visits by Council's Health Visitors to the Homes. Classes for mothers, held by the Superintendents of the various Centres. Provision of dinners (at some Centres), milk, and also of dental treatment for expectant and nursing mothers. A scheme of co-operation in Ante-natal work between the Borough Council and University College Hospital, in force since January 1st, 1928. During the year a scheme was brought into operation, in association with the Voluntary Committees, for the provision of sterilised maternity outfits. Arrangements were made by which these could be obtained either at about cost price, or in necessitous cases below cost price, according to individual circumstances. 2. At Birth. A subsidy is paid by the Borough Council to certain hospitals in connection with the admission of necessitous cases to their maternity wards, A subsidy is also paid in connection with certain cases attended at home by midwives on the staff of various hospitals and institutions. The provision by the Borough Council of Consultants' services, bacteriological investigation and skilled nursing in connection with cases developing Puerperal Fever or Puerperal Pyrexia. Hospital accommodation is also available for these cases. A subsidy is paid by the Borough Council to a Voluntary Committee for the provision of Home Helps. 3. Infants and Young Children. The dispatch by post of cards of advice to the individual mothers immediately after the receipt of the notification of birth required by law. The visiting of infants and young children by the Council's staff of health visitors. The provision and maintenance of 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. 31 The provision of a clinic for ailing mothers and young children, the expenses being borne partly by municipal and partly by voluntary funds. The provision of a municipal dental clinic. The subsidisation of a Home for ailing young children. The supply of milk, free or at reduced price. The subsidisation of the four voluntary Day Nurseries in the Borough. The payment for the home nursing of sick infants in certain cases. A Centre for Artificial Light treatment. The provision of convalescent home treatment by means of subsidy to voluntary agencies. The above-mentioned activities are dealt with in detail in the following pages. 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 (19 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 and one part-time trained worker, not paid by the Council, at the Caversham Road Centre, and one part-time trained voluntary (unpaid) worker at the Somers Town Centre. 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, and three trained visitors at the Royal Free Hospital. During 1932 the Council's staff at the various Centres made 21,914 visits to 2,528 children, and 2,648 visits to 1,387 expectant mothers; the trained workers not paid by the Council made 7,472 visits to 558 children, and 661 visits to 475 expectant mothers. The visiting work is set out iu 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. 1387 2648 2528 21914 Trained Centre staff, not paid by Council 475 661 558 7472 Total of all trained workers 1862 3309 3086 29386 Corresponding totals for 5 previous years— 1931 1645 3306 3263 34002 1930 1645 3105 3519 37972 1929 1845 3632 3643 41711 1928 1574 3192 3463 42141 1927 943 2179 3422 39595 32 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. Under 1 year. 1 -2 years 2 - 5 years. Total. Under 1 year. 1 - 2 years. 2-5 years. Total. First visits. Total visits. First visits. Total visits. Per month. Total. Per month. Total. Council Staff. Others. St. Pancras School for Mothers— Ampthill Square. 45 121 228 24 26 278 2865 1117 883 4865 274 337 468 2951 14 170 ‡1 19 3 - Somers Town 57 175 309 18 25 352 4318 1890 1159 7367 235 625 431 5768 16 206 1 12 *4 1(c) North St. Pancras School for Mothers (Queen's Crescent) 101 290 322 16 19 357 4921 1648 1207 7779 162 416 506 4272 18 214 12 17 3 South Highgate Centre — — 83 9 6 98 1570 763 319 2652 85 209 122 1594 8 103 - - 1 - *Grafton Road Centre 10 22 22 1 3 26 384 179 126 689 18 31 40 574 14 23 1 2 2 - Camden Town Centre 164 227 398 48 54 500 5454 2084 1730 9268 309 391 612 4231 20 243 2 23 *4 — § Argyle Square Centre 2 4 54 4 2 60 605 183 80 868 37 55 93 571 8 31 — — 1 — Caversham Road Centre 159 885 328 47 11 386 4739 696 953 6388 258 721 502 4701 15 142 4 48 2 2(d) ‡ Dniversity College Hospital 716 3730 — — — 748 — - — 4271 296 296 158 4168 18 204 18 204 2 †Royal Free Hospital. 232 913 - — — 122 489 235 252 976 188 228 154 556 12 154 12 150 - 3 Totals 1476 6367 — — — 2927 — - - 45123 1862 3309 (a) 3086 29386 (b) 143 1420 141 475 *19 8 * Previous to transference of work of Argyle Square Centre on 25th April the staff at Somers Town was 2 full-time Council Visitors, with an additional visitor attached for 3 days a week. Previous to transference of work of Grafton Road Centre on 22nd February the staff at Camden Town Centre was 3 full-time Council Visitors, with an additional visitor attached for 3 days a week. The Council's visiting staff at the Centres totals 19. An additional visitor was also attached to the following Centres :— Ampthill Square (for 10 months), Grafton Road, Camden Town, Caversham Road, Argyle Square, for 3 days a week ; Queen's Crescent (6 months) for 2 days a week ; South Highgate (6 months) for 3 days a week, and remainder of year for 1 day a week. (a) Exclusive of 13 visits by students (Caversham Road). (b),, 58 „ ( „ ). (c) Part-time trained visitor. (d) 1 full-time and 1 part-time trained visitor Caversham Road, † Figures refer to St. Pancras cases only. (At University College Hospital there is, in addition to these 2 health visitors, 1 Sister with 5 Visiting Maternity Nurses who are detailed to visit special ante-natal cases.) ‡ Ampthill Square Ante-Natal Consultations reduced from 2 to 1 per month from June, 1932. Queen's Crescent ,, ,, increased ,, 1 to 2 ,, ,, August, 1932. % Work of this Centre was transferred to new premises of Camden Town Centre on 22nd February, 1932. § Work of this Centre was transferred to Somers Town Centre on 25th April, 1932. 33 Maternity and Child Welfare Centres. These are 8 in number. Each Centre is managed by a Committee, the members of which not only give valuable help at the various consultations, but in most cases 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 SubCommittee. The Centre at the Royal Free Hospital is not subsidised by the Council. The Table on page 32 gives statistics concerning the work of all the Centres during the year. It will be seen that 475 ante-natal consultations were held, the number of expectant mothers was 1,476 and their total attendances were 6,367. For the two previous years the total attendances were 6,388 and 6,377. The number of consultations for children was 1,420, the children who attended for the first time numbered 2,927, and the total attendances were 45,123. For the two previous years the total attendances of children were 47,557 and 48,091. Particulars concerning 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, interviews with parents (apart from those otherwise recorded) numbered 1,457. Other activities of this centre include the following :— Classes for Mothers. At infant care classes there were 397 attendances; and at needlework, etc., classes, 730 attendances. Dinners for Mothers and Children. These are supplied at a very small charge for necessitous cases. 2,663 dinners were supplied to nursing and expectant mothers, and 2,259 to young children. Observation Day Nursery. This is for children attending the Centre who need special care. There were 2,008 attendances during the year, of which 425 were made by infants under one year of age, and 1,583 by children from 1 to 5 years of age. Dental Clinic. This is provided out of funds from voluntary sources. The Dental Surgeon is Mr. George Thomson, l.d.s. During the year 43 consultations were held, at which 198 treatments were provided for mothers and 166 for children. Details of the work done are eriven in the following: table :— Mothers. Children. Extractions with anaesthetics 47 28 „ without anaesthetics — 1 Fillings 35 86 Scalings 9 — Impressions and fitting dentures, etc. 66 — Examinations and advice 41 51 Totals 198 166 364 Massage Clinic. 113 treatments were given by two trained masseuses, the cost of whose services was not paid by the Borough Council. 34 Argyle Square Centre. The work of this Centre, with the exception of the Dental Clinic, was transferred to the Somers Town Centre on April 25th, at which date the members of the two Committees also combined. The statistics with reference to the work carried out prior to the transfer are given in the table on page 32. The dental clinic was transferred to the Camden Town Centre, as the accommodation there was more adequate, and the central situation rendered it more conveniently accessible to the mothers from other parts of the Borough. Somers Town Centre, Chamberlain House, Ossulston Street. In addition to the Consultations provided by the Borough Council, the Health Visiting Staff had 2,224 interviews with parents, and the Voluntary Committee arranged for knitting, &c., classes, at which 436 attendances were recorded, and 44 mothers and 54 children were sent away on holiday for a period of two weeks. 368 massage treatments to 44 cases were given by a trained voluntary masseuse. The clothing stall was kept well equipped by voluntary knitters. North St. Pancras School for Mothers, Queen's Crescent. During the year 11 voluntary consultations for older children were held by Dr. J. Finch Haines, at which 255 attendances were recorded. Health Talks and Cookery Demonstrations were held, at which 77 attendances were made. Interviews with parents by the Superintendent, other than at classes or clinics, numbered 1,598. 76 children attending this Centre were referred for Artificial Light treatment or for Massage to the Almeric Paget Institute, a Voluntary Society whose premises are at 14, Rochford Street, which is near the Centre. 22 mothers and 33 children were referred to the Council's Dental Clinic for treatment. 13 mothers and 18 children were sent away on holiday or convalescence. Grafton Road Centre. This was amalgamated with the Camden Town Centre on 22nd February. The majority of the members of the Voluntary Committee very generously continued in office by becoming members of the Camden Town Committee, The statistics given in the table on page 32 with reference to the work carried out only deal with the few weeks prior to the amalgamation. Camden Town Centre. 27 mothers and 31 children were sent away on holiday, either to the country or seaside. Interviews with parents by the Superintendent, apart from medical consultations, numbered 2,580. 27 knitting and needlework classes were held during the year, at which the total attendances were 841, and at the 23 ante-natal classes there were 227 attendances. The services of two trained masseuses (not paid by the Borough Council) were available from April to December, during which time two massage clinics were held weekly. There were 627 attendances. 35 South Highgate Centre. Eight mothers and fifteen children were sent on holiday, either to the country or seaside, for a period of two weeks. Caversham Road Centre. In addition to the consultations provided hy 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) were also provided from the same fund. Classes have been held in Needlework, Child Study and Mothercraft, at which there were good attendances. 79 mothers with their children were sent away on holiday. Artificial Light Treatment. The clinic maintained by the Borough Council for the provision of this form of treatment continued to be used. Consultations were held on two days in each week, the average number of patients at each consultation being 35, as compared with 39 during the previous year, and 45 per consultation in 1930. Staff', Equipment- and Statistics for 1932. 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 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. Two Consultations are held weekly. Staff.—The services of Dr. Beaumont were dispensed with and the treatment is now carried out by the Council's Assistant Medical Officer, Dr. P. V. Pritchard. The Superintendent of the Centre is Miss G. R. Bristow, who is assisted at the consultations by a Health Visitor from another Centre. 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.—Particulars with reference to the cases treated are given in the following table, the figures for the previous year being also given for comparison:— 1932.* 1931. Total number of cases treated 64 142 Total number of new cases 17 75 Total number of attendances 806 2506 Number of Consultations held 23 64 Average attendance per Consultation 35 39 Average number of attendances per child 13 18 * No Clinic was held in October, November or December in 1932 as the subject of re-opening after the closing down at Easter was under discussion. 36 Cost. £ s. d. Electric current . . 2 12 7 Cleaning . . .. 116 0 Miscellaneous ., .. 13 3 £5 11 10 No part of the salary of the Medical Officer, Superintendent or Health Visitors is allocated to nor included in the above figures. In addition to the Clinic provided by the Borough Council, Artificial Light Treatment is available at the Almeric Paget Clinic, Rochford Street, the Institute of Ray Therapy, Camden Road, and also at the Voluntary General Hospitals in the Borough. The Borough Council's Dentai, Clinic, Barnes House, Camden Road. At this clinic dental treatment is provided, under the Maternity and Child Welfare Scheme, for nursing or expectant mothers and children under five years of age who are in attendance at the various Welfare Centres. Consultations are held every Thursday morning for fillings, etc., and each third Friday morning for gas (with an extra clinic occasionally). No charge is made for extractions, fillings or scaling, but the patients contribute what they can reasonably afford towards the cost of dentures. The work done during the year is summarised in the following table, the figures for the previous year also being given for comparison :— Work carried out at the Dental Clinic. 1932. 1931. Number of new cases Mothers 161 153 Children 230 201 Total 391 354 Number of | Attendances I For extractions under nitrous oxide (gas) 309 287 „ ,, local anaesthesia 39 33 „ fillings and dressings 406 316 „ scaling 36 25 ,, impressions and fitting dentures. 239 225 ,, examination and advice 501 476 Total attendances 1530 1362 Total number of clinics held 76 73 Number of clinics with nitrous oxide antesthesia 21 19 37 The following table shows the number and cost of the dentures supplied during the year:— Number of Patients supplied with dentures 37. Total cost £129 0s. Od. Amount paid by mothers £54 6s. 6d. Amount paid by Borough Council £29 15s. Od. Amount paid by Public Assistance £21 7s. 6d. Amount paid by various Societies £23 lis. Od. One mother paid the entire cost of two dentures. One mother paid the entire cost of one denture. The Societies who made contributions towards the cost of dentures were the Metropolitan Hospital Sunday Fund, £11 18s. Od. ; the Metropolitan Hospital Saturday Fund, £2 8s. Od , the Charity Organisation Society, ±2 15s. Od.; and various other societies, £6 10s. Od. Dental treatment is also provided at the voluntary clinic which is held at the St. Pancras School for Mothers, see page 33. The Eastman Dental Clinic attached to the Royal Free Hospital is a lavishly equipped clinic which provides dental treatment for children and for nursing and expectant mothers, and operative treatment in connection with enlarged tonsils and adenoids in children. The Dental Section is equipped with 68 chairs and complete electric units, the Surgical wing contains 37 beds for tonsil and adenoid, cleft palate, hare lip, etc , cases requiring operative treatment. The Welfare Centre held in connection with the University College Hospital is able to refer cases needing dental treatment to the dental department of that hospital. Day Nurseries. The Council assists three approved day nurseries in the Borough by the payment of block grants as approved by the Ministry of Health, and also makes a contribution to the Foundling Site Day Nursery based on one-quarter of the expenditure incurred by the Nursery adjusted to the proportion of St. Pancras children attending. Particulars in regard to the day nurseries for the year ended 31st December, 1932, are as follows :— Number of Days Open. Attendances. Average per Day. Whitefield Day Nursery 229 4887 21.3 Kentish Tn. Day Nursery 231 8021 34.7 Margaret Day Nursery 309 10320 33.4 Foundling Site Day Nursery 254 2917 11.5 38 Nursery Schools. The undermentioned Nursery Schools are situated in the Borough. They provide care, facilities for play, training in good habits, and some elementary instruction for children who are (oo young to be admitted to the ordinary schools. They are provided chiefly by voluntary effort, and no grant is made by the Borough Council. The work is valuable and an increase in the amount of accommodation is desirable. Name and Situation. Accommodation. Average daily attendance. Somers Town Nursery School, 18, Crownlale Road 48 43 Jellicoe Nursery School, 6a, Rochford Street 58 48 Mary Ward Nursery School, 16, Burton Street 25 20 Magdalen Mission Nursery School, 5, Clarendon Street 24 20 St Christopher's Nursery School, Bridgwater Street. 40 29 In addition to the above, a nursery school is available each morning from 9.30 to 12 (except Saturdays) in premises in Buck Street, granted by the Trinity Presbyterian Church. The average number of children on the Register is 28, and the average attendance 18. The school is affiliated to the Nursery School Association and two students from the North West Polytechnic take their practical training at the school. A trained social worker, whose salary is paid from voluntary sources, is in charge, and assistance is given by a daily rota of voluntary helpers. Clinic for Aii.ing Mothers, and Children under School Age. A weekly clinic is held by Dr. F. L. Provis at the St. Pancras Dispensary, 39, Oakley Square. Patients are referred from the Town Ilall, from the Welfare Centres, by the Health Visitors, etc., to this clinic. The work carried out during the Year is summarised in the following table, the figures for the previous year also being given for comparison: — 1932. 1931. New Cases: Children under 5 years of age 78 86 Ailing Nursing Mothers 46 29 Ailing Expectant Mothers 45 88 Attendances: Children under 5 years of age 232 215 Ailing Nursing Mothers 87 103 Ailing Expectant Mothers 107 196 Dispensary as a whole (including the above). New Cases : Children under 5 years of age 484 441 Ailing Nursing and Expectant Mothers 91 117 Attendances : Children under 5 years of age 1106 1088 Ailing Nursing and Expectant Mothers 194 299 39 The Medical Officer of this Special Clinic is paid by the Borough Council. He is assisted by a Nurse (part-time), the cost of whose services is defrayed as to one-half by the Committee of the St. Pancras Dispensary and the other half by the Committee of the Mayoress' Home. During the year the Nurse made 923 visits to the homes of children under five. The Dispensary Resident Medical Officer also made numerous 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 age limit for admission is from 18 months to 5 years. 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 has been provided by the St. Pancras Branch of the Dickens Fellowship. The staff consists of a Matron, Assistant Matron, three Probationers and a domestic staff numbering three. A laundry, equipped with electrically-driven machinery, is also attached to the home. 174 children were admitted during the year, and the average length of stay in the Home was about 4 weeks. (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 36 children were sent away during the year. Supply of Milk to Mothers and Children. The Borough Council during the year continued to make grants of milk, either free or at reduced price. As a rule, in the case of expectant mothers, the grants were restricted to the last three months of pregnancy, and in the case of children to those who were under three years of age. Towards the end of 1931 it was considered that there might be an appreciable amount of overlapping between the Public Assistance Department of the London County Council through their relief work and the Borough Council's scheme for the supply of milk, and inquiries showed that in a number of cases grants from the Borough scheme were made to cases known to be in receipt of relief. In October, 1931, after careful revision of the situation, the Welfare Centres were reminded of the instructions issued by the Ministry of Health. These stated, inter alia, that "milk should be given only where the Medical Officer of Health (or in certain cases the Medical Officer of the Centre) is satisfied that a supply is essential on the grounds of health," and "it is the first principle of administration that overlapping with other bodies concerned in the matter should be absolutely avoided." 40 It appeared to be probable that during recent years the question of health as the sole basis for a grant of milk bad not been adhered to, and that purely financial reasons had been considered. This financial problem is the province of the Public Assistance Committee and not the Child Welfare Authority. It was, therefore, decided to work the scheme in closer co-operation with the Public Assistance Officers, and to adhere strictly to the instructions issued by the Ministry of Health. The rules are definite. All applications for grants of milk for children and nursing or expectant mothers as defined above must be based upon the necessity on the grounds of health, no matter to which authority, London County Council or Borough Council, the case is referred. Where a family is in receipt of relief, the application should be made by the Medical Officer of the Welfare or Ante-Natal Centre directly to the Public Assistance Committee on the forms provided. Where the family is not in receipt of relief, the application is considered by the Special (Milk) Sub-Committee of the Borough Council. Grants are made, either free or at half price, in accordance with an approved scale of income. Information is exchanged between the authorities concerned, and a considerable amount of overlapping has been abolished. At the end of 1931 there were 172 families actually in receipt of milk under the Borough scheme. During 1932, 458 new families were added to the list of recipients. By the end of that year there were 225 families receiving grants. The total cost of this scheme in 1930 was £1,330; in 1931, £1,414; and in 1932, £937. FREE. j HALF-PRICE. COST. Month. Pints. Lbs. Pints. Lbs. £ s. d. *January 5964 220 756 20 110 13 11 February 4704 132 196 16 81 2 3 March 4256 180 448 28 71 7 2 *April 5180 184 588 12 83 9 4 May 4172 116 336 12 63 18 2 June 3948 120 252 8 60 14 10 *July 4256 188 308 4 69 7 6 August 3808 156 364 12 62 0 6 September 3976 156 252 16 63 11 6 '*October 5320 200 504 28 97 6 2 November 4760 164 420 16 85 7 7 December 4844 192 364 24 88 11 11 55188 2008 4788 196 £937 10 10 * 5 week months. The Council passed a resolution in July, 1928, that 7\ per cent, be deducted from the accounts of all dairymen supplying milk under the scheme to the value of £2 or over monthly. This has reduced the above total by about £25. The scale in use in making the grants is based on weekly income and was originally drawn up by the Council in 1922. It was discontinued in April, 1928, and a new scale brought into use in consequence of a recommendation by the Minister of Health that the scale should be brought into accord with the fall in the index figure of the cost of living. 41 The present revised income scale is shown hereunder:— Number in Family. After Deduction of Rent. Free. Half-price. £ s. d. £ 8. d. One 0 12 0 0 13 9 Two 0 18 3 1 3 0 Three 1 2 0 1 7 6 Four 1 5 6 1 11 3 Five 1 10 0 1 16 6 Six 1 13 0 2 1 3 Seven 1 16 6 2 5 9 Eight 2 0 0 2 10 3 Families in receipt of less income than that indicated in the table would be entitled to receive milk. Where any doubt exists as to the true circumstances of the family, enquiries are made by the Health Visitors attached to the various Welfare Centres. Professional Nursing in Necessitous Homes. This is now provided by the staff of the three following District Nursing Associations : — Hampstead, Metropolitan and North London. 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, Pemphigus Neonatorum, Infective Enteritis, Acute Primary and Acute Influenzal Pneumonia. Arrangements are also in force with the Metropolitan District Nursing Association, whose local headquarters are at 14, Oakley Square, for the home nursing of cases of Puerperal Fever and Puerperal Pyrexia. Payment by a block grant is made by the Council. The following table gives the number of cases and number of visits during the past year:— District Nursing Association. No. of cases. No. of visits. Average No. of visits per case. Metropolitan 158 2621 16.6 Hampstead 32 634 19.8 North London 5 107 21.4 Total 195 3362 17.2 The Borough Council also remunerated the Hornsey District Nursing Association for 53 visits to one case of Ophthalmia Neonatorum. 42 In addition to the above, the Metropolitan District Nursing Association also undertook the necessary nursing arising in connection with 122 cases, chiefly maternity or tuberculosis, and children's complaints, and to these 1,134 visits were paid. Home Helps. This term is used to describe women who have received a certain amount of training in domestic work, 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 management is in the hands of a Voluntary Committee, on which the Council is represented by two members. An annual grant of £150 is made by the Borough Council for use in respect of maternity cases only. Two permanent "Helps" were employed throughout the year, and 11 temporary "Helps" for emergency cases. 101 applications were received and 84 cases were dealt with during the year, 80 being maternity and 4 sickness cases. The above figures show a decrease in the amount of work carried out as compared with the previous year, during which 116 cases were dealt with, 93 being maternity and 23 sickness cases. The fall in the number of sickness cases is noteworthy as it is in these cases that the services of a Home Help are generally of such great value. Illness is usually sudden and unexpected and help is urgently needed; in maternity cases the requirements are known in advance and due provision can often be made. 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 1932, had notified their intention to practise in St. Pancras was 42. Only 10 of this number are engaged in private practice, the remainder are on the staff of various hospitals and institutions in the Borough. 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, The subsidy is not paid in cases where "Maternity benefit" is payable under the National Health Insurance Act. 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, 43 In the following table particulars are given, for 1932, 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 378 338 .. Royal Free Hospital 85 11 .. Elizabeth Grarrett Anderson Hospital 54 *64 .. St. Pancras Hospital 352 .. .. Middlesex Hospital 99 .. 31 Queen Charlotte's Hospital 85 .. .. City of London Hospital 51 1 .. Royal Northern Hospital 33 .. .. St. Bartholomew's Hospital .. .. 2 Other hospitals 62 .. 1 Queen Mary's Maternity Home 55 .. .. Maternity Nursing Association .. .. 233 Totals 1254 414 267 * 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 46'7 per cent. and those attended at home 25.4 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 mid wives 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 3 0 0 Elizabeth Garrett Anderson Hospital 6 0 0 Queen Charlotte's Hospital 22 0 0 City of London Hospital 21 0 0 Middlesex Hospital 19 0 0 University College Hospital 99 10 0 Charing Cross Hospital 1 0 0 Maternity Nursing Association 3 0 0 Total £174 10 0 44 The corresponding grants for the previous three years were: £215 10s 0d., £"238, iand £243 5s. Od. Maternal Mortality. The following observations and figures have been furnished by Dr. Pritchard, Assistant Medical Officer. This subject has recently received considerable publicity and attention. Unfortunately the term Maternal Mortality has never been definitely defined. Various authorities—the Registrar-General, the Ministry of Health and the local Public Health Authorities—use it to mean markedly different groups of deaths. This is an unfortunate state of affairs, because the use of the terra without a definition can be very misleading. An example will explain the position:—A woman died and the death certificate given was—"Acute Pulmonary CEdema, Asthma, Recent Puerperium." This death counts as a Maternal Death and so increases the figure of Maternal Mortality. This figure, therefore, includes deaths which are merely associated with pregnancy, cases which one cannot include with the figure, which should represent the common risk run by the average woman who becomes pregnant. There would be no difficulty if Maternal Mortality always meant this wide group of deaths. Some authorities, however, use it to mean only those deaths directly due to pregnancy. When a figure is quoted without a definition it is impossible to know whether the small, select, true group or the large indefinite group is indicated. Some authorities use the same terra to indicate either the one or the other, and this occurs in the Departmental Report on Maternal Mortality and Morbidity issued by the Ministry of Health. The clearest classification divides all these deaths into two groups.—Those deaths occurring during pregnancy or childbirth, where the death is directly due to the puerperal state are grouped as Puerperal Maternal Mortality. This group is sub-divided into the deaths which have been due to Puerperal Sepsis and those due to Non-Septic Puerperal causes. Such a group would indicate the average risk of pregnancy very accurately if we could eliminate those cases of abortion which have been artificially induced, but leave insufficient evidence to return a verdict of criminal interference. The second group is reserved for those deaths which are only associated with pregnancy or childbirth, such as the case of Asthma already quoted. They are all classified primarily to their particular cause of death, and then re-grouped as Non-Puerperal Maternal Deaths. They do not include cases following criminal abortion. The Puerperal and Non-Puerperal groups are added together to form the total Maternal Mortality. The qualification, Puerperal or Non-Puerperal, is the important indication to the true meaning of any given term when discussing this subject. Enquiries are made into all these deaths. Reports are made and forwarded to the Special Maternal Mortality Committee appointed by the Ministry of Health. In 1932 there were 14 Puerperal Maternal Deaths, 9 due to Sepsis and 5 to other causes. The 9 Septic Puerperal Maternal Deaths include 3 cases of abortion where the circumstances were very suspicious of criminal interference, but which were returned by the coroner as "Open Verdicts." There were two Non-Puerperal Maternal Deaths. One was a well known epileptic, who contracted Meningitis and Pneumonia after her 14th confinement. The other was a case of Asthma. 45 The Puerperal Maternal Mortality was 51 per 1000 births(live and still). Period Puerperal Maternal Deaths. Full-time Confinements. Abortions, etc. Total Puerperal Maternal Deaths. Post Mortems. Inquests. Puerperal .Mortality Rate (Puerperal Maternal Deaths per 1000 live and still births).* Excluding Abortions. Total. 19251928 Sepsis 8 10 18 Information not available 0.6 1.3 Other Causes. 18 -— 18 1.3 1.3 Totals 26 10 36 1.8 2.6 1929 Sepsis 3 1 4 3 2 0.9 1.3 Other Causes 6 1 7 3 1.9 2.2 Totals 9 2 11 6 2 2.8 3.5 1930 Sepsis - - - - - - - Other Causes. 2 3 5 2 1 0.6 1.6 Totals 2 3 5 2 1 0.6 1.6 1931 Sepsis 2 2 1 1 0.7 0.7 Other Causes 4 1 5 4 1.4 1.7 Totals 6 1 7 5 1 2.1 2.4 1932 Sepsis 6 3 9 8 4 2.2 3.3 Other Causes 4 1 5 4 1 1.4 1.8 Totals 10 4 14 12 5 3.6 5.1 * Previous to 1932 calculation made for live Births only. 46 MEDICAL EXAMINATION OF ELEMENTARY SCHOOL CHILDREN. The information in the two following tables has been supplied by the School Medical Officer of the London County Council : — Routine Medical Examination ok Elementary School Children in St. Pancras, 1932. Defect. Boys. Girls. Entrants, Age 8. Age 12. Age 14. Entrants. Age 8. Age 12. Age 14. Number examined 1018 9G6 1546 773 1073 1026 1549 927 Cases. * Cases. * Cases. * Cases. » Cases. * Cases. * Cases. * Cases. * Malnutrition 5 4 8 6 10 8 4 4 5 5 9 5 9 6 4 4 Skin disease 8 8 5 3 10 9 4 2 7 2 13 7 8 2 5 2 Defective teeth — 381 — 209 — 338 — 192 — 441 — 181 — 281 — 231 Enlarged tonsils 203 93 98 40 93 29 26 8 211 106 126 59 100 34 29 13 Adenoids 27 17 7 5 4 2 — — 31 24 7 5 5 2 2 2 Enlarged tonsils and adenoids 57 36 21 11 9 1 3 2 77 40 25 14 20 6 7 5 Other nose and throat defects 14 8 12 9 12 7 5 4 10 4 8 4 14 12 4 3 Enlarged glands 41 18 14 5 19 7 5 1 52 16 17 6 11 2 2 — Eye disease 44 22 34 17 18 6 5 4 44 26 24 17 19 8 12 9 Vision defect — — 42 167 — 66 — — 68 — 162 - 73 Otorrhcea 18 12 8 7 15 11 5 4 29 20 12 6 14 10 2 1 Other ear disease 1 — 1 1 1 — — 2 — 1 — 1 1 — — Defective hearing 7 4 5 3 12 6 5 1 7 2 6 5 10 8 5 3 Speech defects . 9 3 2 — 5 4 1 1 1 — 3 — 2 — 1 1 Heart defects . 16 — 19 1 34 6 2 1 21 — 38 4 36 6 17 2 Anaemia 9 3 7 5 14 2 3 — 7 4 8 2 13 7 6 3 Lung defects 60 28 23 7 22 5 4 3 50 18 21 10 16 9 6 - Nervous defects . 10 — 15 5 8 2 2 1 3 1 19 4 7 3 2 — Phthisis . 1 — 3 — 6 1 2 — 3 — 4 — 8 — 2 — Other T.B. disease Rickets 9 3 — - 1 — — — 2 — 3 — — — — — Spinal deformities 1 1 6 3 5 4 5 2 1 — 9 3 26 11 12 6 Other deformities 10 1 14 5 15 4 7 1 11 2 11 3 28 10 15 6 Other defects ... 51 20 54 31 65 35 6 5 50 22 51 25 87 46 37 16 Number of children noted for treatment 541 360 553 277 590 356 530 331 Note.—Defects, however slight, are included under "Cases." Those severe enough to require treatment are shown under. * 47 Routine Medical Inspection of Elementary School Children in St. Pancras in 1932. 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 or both eyes. Entrants— Boys 1018 696 296 26 262 728 28 938 69 11 482 34 2 550 302 166 — Girls 1073 764 295 14 277 778 17 1 970 90 13 1044 27 2 565 336 172 — — — Age 8— Boys 966 665 287 14 206 731 29 924 42 — 944 22 — 679 217 70 707 159 89 Girls. 1026 724 295 7 246 752 28 — 932 85 9 1007 19 — 771 209 46 713 189 109 Age 12— Boys . 1546 1115 411 20 408 1097 41 1483 62 1 1525 18 3 1162 351 33 1092 210 242 Girls 1549 1164 373 12 376 1126 47 — 1445 93 11 1513 34 2 1164 345 40 1055 274 220 Age 14— Boys 773 520 243 10 223 538 12 755 16 2 761 11 1 549 207 17 560 95 115 Girls 927 684 234 9 298 610 19 — 869 56 2 909 18 — 655 241 31 644 163 115 Totals 8878 6332 2434 112 2296 6360 221 1 8316 513 49 8685 183 10 6095 2208 576 4771 1090 890 % St. Pancras 71.3 27.4 1.3 25.9 71.6 2.5 93.7 5.8 0.5 97.8 2.1 0.1 68.6 24..9 6.5 70.7 16.1 13.2 % London 58.2 41.1 0.7 21.1 74.3 4.6 96.0 3.6 0.4 97.5 2.4 0.1 68.7 26.3 5.0 61.7 21.3 17.0 48 Provision of Insulin. Owing to the cost of this recently discovered and valuable remedy for the treatment of Diabetes, several applications have been received from Voluntary Hospitals for a supply to be provided, for necessitous patients, at the expense of the Local Authority. With the sanction of the Ministry of Health, this provision can be made under powers contained in Section 77 of the Public Health (London) Act, 1891. During the year, and with the sanction of the Ministry of Health, supplies have been provided, subject to the following conditions: — (a) The Insulin is to be issued by the Medical Officer of Health to the medical practitioner undertaking the treatment of the patient. (b) The name and address, age and sex of each patient to be stated. (c) A quarterly report is to be furnished by the medical practitioner to the Medical Officer of Health giving the following information : — (1) Tbe number of doses of Insulin administered. (2) Particulars concerning any tests made of the urine or of the blood of the patient. (3) The progress of the patient during the period under report. Patients who are insured under the National Health Insurance Act are not eligible under the above scheme, as supplies of Insulin are available for them under the Act. Public Health Officers of the Loc\l Authority. A complete list of the above, including both whole and part time officers, is given on pages 6 and 7. Local Legislation. A.—Local Acts, Bye-Laws, and Regulations in force in the Borough:- 1. St. Pancras (Measles and German Measles) Regulations, 1920. 2. Bye-laws made by the Borough Council: — (a) For the prevention of any nuisances arising from any snow, ice, salt, dust, ashes, rubbish, offal, carrion, fish or filth or other matter or thing in any street. (b) For preventing nuisances arising from any offensive matter running out of any manufactory, brewery, slaughterhouse, knackers' yard, butcher's shop or fishmonger's shop or dunghill into any uncovered place, whether or not surrounded by a fence or wall. (c) For the prevention of the keeping of animals on any premises in such place or manner as to be a nuisance or injurious or dangerous to health. (d) As to the paving of yards and open spaces in connection with a dwelling house. (e) For securing the cleanliness and freedom from pollution of tanks, cisterns and other receptacles used for storing water used or likely to be used by man for drinking or domestic purposes, or for manufacturing drink for the use of man. (f) With respect to the keeping of water-closets supplied with sufficient water for their effective action. (g) Mortuaries. 3. Regulations concerning the use of Post-mortem rooms. 49 4. Bye-laws and Regulations made by the London County Council, but enforced by the Borough Council:— (а) Drainage bye-laws and deposit of drainage plans. (b) Closing and filling up of cesspools and privies. (c) Removal and disposal of house and other refuse. (d) Removal of faecal and offensive matter by road. (e) Waterclosets, earthclosets and privies. (f) Ashpits and cesspools. (g) Receptacles for dung. (h) Conveyance of carcasses of dead horses through streets. (i) Bye-laws with respect to houses divided into separate tenements, etc. ( j) Offensive trades. (k) Rag and bone dealers. (/) Humane slaughtering of animals and poultry. (m) Demolition of buildings. (n)Ice cream vendors and premises. 5. London County Council (General Powers) Acts, 1893-1932. B.— Public Health Legislation either enacted or coming into force during 1932:— (a) Merchandise Marks (Imported Goods) No. 1 Order, 1932. This came into force on June 17th, 1932, and deals with the marking of imported butter. (b) Public Health (Cleansing of Shell-fish) Act, 1932. Came into force on June 16th, 1932. (c) London County Council (General Powers) Act, 1932. This Act contains a number of provisions affecting the Public Health. Premises used for the manufacture or sale of ice cream and certain preserved goods must be registered. Cases of food poisoning are required to be notified by the Medical Practitioner in attendance. The requirements of Section 47 of the Public Health (London) Act, 1891, are extended to include articles of food, whether solid or liquid, intended for human food which are offered as a prize or reward, etc. Certain modifications are made in Section 16 of the Housing Act, 1930, as regards Clearance Areas. (d) The Housing Consolidated Amendment Regulations, 1932, which came into force on August 11th, 1932. HEALTH PROPAGANDA. In addition to the numerous leaflets which are distributed from the various Welfare Centres, Tuberculosis Dispensary, etc., an arrangement is in force, in conjunction with the Education and Public Libraries Committee, to make known the Health Facilities which exist in the Borough by printing this information on the reverse side of the Monthly Lists which are issued to borrowers at the libraries. 50 Arrangements were also made for the issue of the St. Pancras edition of the Monthly Journal known as "Better Health" to be continued. Two thousand copies are issued each month and are distributed through the following agencies:— Infant Welfare Centres. Tuberculosis Dispensary. Electricity Department and Public Libraries. L.C.C. Schools in the Borough. A copy is also sent to each member of the Council and to all medical practitioners in the Borough who place it on the table of their waiting rooms. 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, 13 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 dwellings, 67 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 114 tenement houses under powers contained in Section 78 of the London County Council (General Powers) Act, 1907. PUBLIC BATHS AND WASHHOUSES. These are provided by the Borough Council at the following situations:— Prince of Wales Road, N.W.5; Whitfield Street, W.l; and King Street, N.W.1. A block of 12 slipper baths, available to the public, adjoins the Council's flats at Prospect Terrace, W.C.1. The water supply in all cases is obtained from the mains of the Metropolitan Water Board, but at the Prince of Wales Road Baths an additional supply is available from a deep well on the premises. DRAINAGE. The sanitary inspectors have the duty of supervising all work in connection with drains, including construction, reconstruction and repairs. During the year the following work has been carried out; the figures for the previous year are also given for the purpose of comparison:— Inspections. Inspections. 1932. 1931. Drainage work done under notice 2420 2842 Voluntary drainage work 6647 6552 Drains of new buildings 2652 2733 Total 11719 12127 51 Drainage Register.— The following is an analysis of the Drainage Register during 1932:— Plans deposited—Old Buildings under Notice 78 ,, „ Old Buildings, Voluntary 197 „ „ New Buildings and Additions 61 336 Applications without Plans 302 Total number of Applications and Plans 638 Rats and Mick (Destruction) Act, 1919. During the year 107 complaints were received with reference to nuisances caused by premises being infested by rats. Steps were taken by the service of notices on owners or occupiers, by the testing of drains, and other necessary measures in order to abate the nuisance. Nuisance Caused by Pigeons. During the year complaints were received on several occasions regarding a nuisance arising from the presence of large numbers of these birds. In addition to the fouling of gutters, window ledges, areas, etc., by accumulation of excreta, nuisance is caused by the blocking of rain water and other pipes by their nests. The birds also pick out mortar from between the bricks and so tend to cause dampness to penetrate through the walls. Although Section 52 of the London County Council (General Powers) Act, 1927, authorises local authorities in London to seize, destroy, sell, or otherwise dispose of pigeons in excess of such numbers as the local authority consider reasonable, in practice the section is very difficult to operate. The prevalence of the birds is encouraged by the practice of feeding them adopted by so many kind-hearted but misguided persons, and for the same reason the use of traps has proved a failure, the birds, being so well fed, will not enter the traps to obtain the food which is placed inside. In a number of cases the traps have either been removed or interfered with by these misguided persons, who, doubtless owing to ignorance, object to the destruction of these birds. 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, and daily collections before 10 a.m. in prescribed main streets. Additional collections are also given to flats, eating houses, etc. The use of Pagefield lorries and containers, 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. 52 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 year are also given:— 1932. 1931. Tons. Tons. Quantity of refuse collected 53646 58086 Quantity of refuse burnt at Destructor 34799 36339 Quantity put on rail 18841 21832 Quantity of clinker residual 10545 12366 MORTUARY AND CORONER'S COURT. These buildings are situated in Cambridge Street, at the rear of St. Pancras Gardens. Extensive improvements have been made in connection with the Mortuary during recent years, and it is now a satisfactory and well equipped building. During the year 1931, a number of improvements were carried out to the Coroner's Court. The work included the provision of a separate entrance to the Coroner's Office, the installation of electric heating and provision of additional sanitary accommodation. A room for the Coroner's Officers and a separate room for female witnesses were also provided. Improvements were also made in connection with the lighting, heating and seating arrangements of the Court. In view of the expenditure incurred, the existing lease was cancelled and a new lease of the Court was granted to the London County Council at an increased rental. It is now provided that the use of the Court is not to be restricted solely to the investigation of deaths occurring within the Borough of St. Pancras. This proviso was doubtless desired on account of the recent re-arrangement of Coroners' districts by the London County Council. Permission to make an increased use of the Mortuary and Post-mortem room in connection with cases occurring outside the Borough was not included, and there has been a growing tendency to make use of this accommodation for ex. St. Pancras cases. The attention of the London County Council has been directed to the matter and the subject is still under consideration. The following table, which gives particulars concerning the number of inquests held, number of bodies received and post-mortem examinations made during each of the past five years, shows the very great increase which has occurred in ex. St. Pancras cases, owing to the re-arrangement of Coroners' districts above mentioned:— 1928. 1929. 1930. 1931. 1932. Number of inquests held St. Pancras Cases 165 158 155 101 121 Ex-St. Pancras Cases 98 97 118 260 443 Number of bodies received St. Pancras Cases 215 250 218 222 242 Ex-St. Pancras Cases 28 26 63 374 571 Number of post-mortem examinations made St. Pancras Cases 178 190 173 175 206 Ex-St. Pancras Cases 19 16 34 229 415 Totals 703 737 761 1361 1998 53 SANITARY INSPECTION OF THE AREA. Inspections.—65,633 visits and inspections were made in 1932 by the Council's staff of Inspectors and Health Visitors. Of these inspections, 42,447 were made by the District Sanitary Inspectors, 8,859 by the Inspectors of Food and Food places, 7,271 by the Inspectors of Factories and Workshops, and 7,056 by the Women Sanitary Inspectors and Health Visitors (for Tuberculosis). The inspections dealt with above are exclusive of the visits in connection with the health of expectant mothers and young children made by the Council's staff at the Maternity and Child Welfare Centres (see pages 32 and 110), and by the staff of the Tuberculosis Dispensaries (see page 94); nor do they include the work of the disinfecting staff, particulars of whose work are given on pages 95 and 96. Notices served.—3,726 intimation notices were served by the Inspectors during the year. Of these 3,335 were served by the District Sanitary Inspectors, 390 by the Factory and Workshop Inspectors, and 1 by a Food Inspector. 1,350 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, 8 and 9 on pages 105-110. 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. 9, Tankerton Street Roof and guttering defective 1932 Jan. 20th Order 28 days. Costs £1 8s. 9, Litcham Street Insufficient water-closet accommodation Feb. 18 th Fined £1. Costs £1 3s. 16, St. George's Square „ „ Mar. 16th Fined £1. Costs £2 2s. 98, Marquis Road Rear guttering defective „ 31st Withdrawn, work done. Costs £2. 47, Dickenson Street Yard paving defective Oct. 20th Adjourned sine die. Dangerous Structure notice served by District Surveyor and the receipt of rents had been taken away by the Council for Rates and by mortgagees for arrears of interest. 47, „ Failing to provide portable metal dustbins „ 20th 8, Derby Street Occupied house without a proper and sufficient supply of water on staircase, water fittings in water-closet defective. Nov. 16th Dismissed, work done. Costs £2 2s. 25, Cromer Street Failing to provide a proper metal dustbin „ 22nd Work done. Summonses dismissed on payment of costs £3 3s. 25, „ Washhouse roof, tap on landing, copper, rainwater pipe at rear, ceiling plaster of second-floor back room, and door and frame defective ,, 22nd 54 London County Council Bye-Laws—Housing Act, 1925. Situation of Property. Offence. Date of Hearing of Summons. Result of Proceedings. 47, Dickenson Street Failing to carry out cleansing work 1932. Oct. 20th Adjourned sine die. Dangerous Structure notice served by District Surveyor and the receipt of rents had been taken away by the Council for Rates and by mortgagees for arrears of interest. 8, Derby Street Do. do. Nov. 16th Work done. Summons dismissed on payment of costs (see also Summonses under Public Health (London) Act, 1891). 25, Cromer Street Do. do. „ 22nd Work done. Summons dismissed on payment of costs (see also Summonses under Public Health (London) Act, 1891). London County Council Bye-Laws made under the Metropolis Management Acts. Situation of Property. Offence. Date of Hearing of Summons. Result of Proceedings. 100, Drummond Street Failing to furnish at the foot of the drain ventilating pipe a suitable air-tight access cap or cover 1932. Feb. 2nd Fined £1. 100, „ Reconstructing back portion of drain without depositing plans and giving notice in writing ,, 2nd Fined £1. Costs £1 3s. SMOKE ABATEMENT. 405 observations of chimney shafts were made during the year and two notices were served. There were no prosecutions. The 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, and a bye-law was made under powers contained in Section 2 of the Act on February 17th, 1931, and was allowed by the Minister of Health and came into force on May 19th, 1931. The bye-law states that the emission of black smoke for a period of three minutes, and, after five years from the date of confirmation of this bye-law, for a period of two minutes, in the aggregate within any continuous period of thirty minutes from any one chimney of a building, other than a private dwelling house, shall, until the contrary be proved, be presumed to be a nuisance liable to be dealt with summarily under the Public Health (London) Act, 1891. 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:— 55 1.—Inspections made by Male and Female Sanitary Inspectors. Premises. (1) Number of Inspections. (2) Written Notices. (3) Prosecutions. (4) Factories 2361 197 — Workshops 1948 136 — Workplaces (other than Outworkers' premises included in Part 3 of this Report) 1129 55 — Totals 5438 386 — 2.—Defects Found. Particulars. (1) Number of Defects Number of Prosecutions. (5) Found. (2) Remedied. (3) Referred to H.M. Inspectors. (4) Nuisances under the Public Health Acts*: — Nil. Nil. Want of cleanliness 195 194 Want of ventilation 11 11 Overcrowding 3 3 Want of drainage of floors — — Other nuisances 132 131 Sanitary accommodation— Insufficient 13 13 Unsuitable or defective 175 174 Not separate for sexes 13 13 Other breaches 33 33 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) 58 58 Other offences (excluding offences relating to outwork, which are included in Part 3 of this Report) — — Totals 633 630 * Including those specified in sections 2, 3, 7 & 8 of the Factory and Workshop Act, 1901, as remediable under the Public Health Acts. 56 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 carried out in premises which are insanitary, or in which infectious disease is present. The following lists were received during the year:—32 in respect of the making, etc., of wearing apparel, comprising the names of 67 outworkers (contractors) and 74 outworkers (workmen), 1 in respect of upholstering, comprising the name of 1 outworker (workman), 1 in respect of the making or filling of Christmas crackers, etc., comprising the names of 2 outworkers (workmen), 1 in respect of embroidery, comprising the names of 34 outworkers (workmen), 1 in respect of making, etc., of coat hangers, comprising the names of 18 outworkers (workmen), and 1 in respect of general furnishers, comprising the names of 15 outworkers (contractors) and 2 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 29 274 199 502 Bootmaking 2 — 104 106 Embroidery — 3 32 35 Miscellaneous 1 8 31 40 Totals 32 285 366 683 4.—List of Factories, Workshops (Registered, Sec. 131) and Workplaces. Nature of Work. Factories. Workshops. Workplaces (including Outworkers). Total. Bakehouses 65 89 – 154 Cabinet makers 58 66 — 124 Coach builders 22 16 — 38 Dressmakers 72 120 23 215 Engineers 209 34 — 243 Foundries 14 — — 14 Furniture makers 13 19 — 32 Furriers 7 13 1 21 Laundries 10 6 — 16 Metal workers 35 36 — 71 Milliners 1 18 2 21 Organ builders 8 3 — 11 Pianoforte manufacturers 39 18 1 58 Printing 70 10 — 80 Restaurant kitchens — — 291 291 Tailors 17 231 140 388 Upholsterers 6 36 2 44 Wood carvers 6 18 — 24 Other occupations 511 500 380 1391 Totals 1163 1233 840 3236 57 5.—Other Matters. Class. (1) Number. (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 85 Reports (of action taken) sent to H.M. Inspector 85 In regard to workshops where protected persons have been found to be employed (Public Health (London) Act, 1891, section 27) 12 Underground bakehouses (s. 101):— Certificates granted during the year — In use at the end of the year 84 Bakehouses and restaurant kitchens are also referred to on page 70. 6.—Total Inspections. Premises. Male Inspector. Women Inspector. Total. Factories 1919 442 2361 Workshops 1547 401 1948 Workplaces (including Outworkers' premises) 594 2269 2863 Total 4060 3112 7172 PREMISES AND OCCUPATIONS CONTROLLED BY ACTS, BYE-LAWS OR REGULATIONS. Offensive Trades. There are two licensed premises for such trades in the Borough—a tallow melter's in Tudor Place, which has been in existence since the year 1780, and a soap boiler's in Rochester Place. 46 visits were made to these premises during the year. Rag and Bone Dealers. Additional bye-laws were made in 1928 by the London County Council, under powers given by Section 9 of the London County Council (General Powers) Act, 1908. The bye-laws provide as follows:— 1—A person carrying on the business of a rag and bone dealer shall not sell or distribute or cause or permit to be sold or distributed any article of food or any balloon or toy— (a) in or from any part of the premises used for or in connection with his business, or 58 (b) in the course of his business while carried on from any cart, barrow or other vehicle or receptacle used for the collection or disposal of rags, bones, fat, rabbit skins, or other like articles, or (c) in any other way connected with his business. 2—A person carrying on the business of a rag and bone dealer who shall offend against the foregoing bye-law shall be liable for every such offence to a penalty of Five Pounds. Provided nevertheless that the Court before whom any information may be laid or any proceedings may be taken in respect of any such offence may if the Court think fit adjudge the payment as a penalty of any sum less than the full amount of the penalty imposed by this bye-law. There are 29 premises in the Borough in which the business of a rag and bone dealer is carried on, and these are visited regularly by the Inspectors concerned. Rag Flock Acts, 1911-1928. Rag Flock Premises. The above Acts prohibit the sale or use, for the purpose of making any article of upholstery, cushions or bedding, of unclean flock manufactured from rags. The expression "flock manufactured from rags" is defined in the 1928 Act as flock which has been produced wholly or partly by tearing up woven, or knitted, or felted materials, whether old or new, but does not include flock obtained wholly in the processes of the scouring and finishing of newly woven or newly knitted or newly felted fabrics. Houses Let in Lodgings. Bye-laws dealing with these houses, made under power given by Section 6 of the Housing Act, 1925, came into force on March 5th, 1926. On the 8th June, 1931, the Minister of Health allowed the application to decontrolled houses of certain of the bye-laws which had been held in abeyance. Particulars concerning the inspections made will be found in Table 6 on page 107. Lighting of Staircases of Tenement Buildings. The above provision is required by Section 61 of the London County Council (General Powers) Act, 1927, which came into force on August 1st, 1928. Tenement buildings are regularly inspected in order to ensure that compliance with the Act is maintained. Canal Boats Acts. Under the Canal Boats (Amendment) Regulations, 1925, the responsibility for maintaining a canal boat in a habitable condition is now placed upon the owner, instead of the master. A weekly inspection of the canal and wharves has been made by Inspector Auger. RENT AND MORTGAGE INTEREST RESTRICTIONS ACT, 1923. During the year 21 applications were received from tenants for certificates under this Act, and in 20 cases certificates were granted, specifying the work required to be executed in order to put the houses into a good and tenantable state of repair. In accordance with Section 5 of the Act, 9 applications were made by landlords for the "release" of certificates previously granted to their tenants, the necessary work to the premises having been carried out. In eight cases the "release" certificate was granted. 59 The nature of the work specified on the certificates embraced such items as repairing, cleansing, and decorating the walls and ceilings, and, in addition, many items not ordinarily dealt with by the sanitary inspectors, e.g., repair of chimney flues, stoves, mantel boards, door furniture, floor boards, cupboard doors, etc. 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, Bye-laws, etc. Section IV.— HOUSING. The following particulars concerning the number of new houses and flats erected during the year, and details of the work carried out with reference to existing houses (under the Housing Act and Public Health Acts), are given in the following form in accordance with the requirements of the Ministry of Health:— Number of new houses erected during the year:— (a) Total (including number given separately under (b)) 318 flats (b) With State assistance under the Housing Acts:- (i) By the Local Authority 40 (ii) By other bodies or persons 88 1. Inspection of dwelling-houses. Inspection— (1) (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 2467 (b) Number of inspections made for the purpose 12079 (2) (a) Number of dwelling-houses included under sub-head (1) above which were inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 1235 (b) Number of inspections made for the purpose 7386 (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 1431 2. Remedy of defects without Service of formal Notices. Number of defective dwelling-houses rendered fit in consequence of informal action (intimation only) by the Local Authority or their Officers 2411 3. Action under Statutory Powers. A.— Proceedings under Sections 17, 18 and 23 of the Housing Act, 1930. (1) Number of dwelling-houses in respect of which notices were served requiring repairs 14 (2) Number of dwelling-houses which were rendered fit after service of formal notices:— (a) By owners 13 (b) By Local Authority in default of owners — 60 B.— Proceedings under Public Health Acts:— (1) Number of dwelling-houses in respect of which notices (Statutory) were served requiring defects to be remedied 845 (2) Number of dwelling-houses in which defects were remedied after service of formal (Statutory) notice:— (a) By owners 771 (b) By Local Authority in default of owners Nil. C.— Proceedings under Sections 19 and 21 of the Housing Act, 1930:— (1) Number of dwelling-houses in respect of which Demolition Orders were made Nil. (2) Number of dwelling-houses demolished in pursuance of Demolition Orders (previously made) Nil. D.— Proceedings under Section 20 of the Housing Act, 1930:— (1) Number of separate tenements or underground rooms in respect of which Closing Orders were made 5 (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit Nil. E.— Proceedings under Section 3 of the Housing Act, 1925 (now repealed):— (1) Number of dwelling-houses in respect of which notices were served requiring repairs Nil. (2) Number of dwelling-houses which were rendered fit after service of formal notices:— (a) By owners Nil. (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 declaration by owners of intention to close Nil. F.— Proceedings under Sections 11, 14 and 15 of the Housing Act, 1925:— (1) Number of dwelling-houses in respect of which Closing Orders became operative Nil. (2) Number of dwelling-houses in respect of which Closing Orders were determined, the dwelling-houses having been rendered fit Nil. (3) Number of dwelling-houses in respect of which Demolition Orders become operative Nil. (4) Number of dwelling-houses demolished in pursuance of Demolition Orders Nil. In accordance with paragraph 4 of the Housing Consolidated Amendment Regulations, 1932, the following additional information is given:— (i) Number of representations made to the Local Authority with a view to (a) the serving of notices requiring the execution of works; or (b) the making of Demolition or Closing Orders 10 61 (ii) Number of houses in respect of which an undertaking was accepted under sub-section (2) of section 19 of the Housing Act, 1930 Nil. Particulars concerning Inspection of Tenement Houses are given in Table 6 on page 107. The 318 houses and flats mentioned at the beginning of this Section as having been erected during the year comprised the following:— 40 flats built by the Borough Council (22 in Camden Road, 18 in Somers Town); 52 flats erected by the London County Council on their Ossulston Estate; and 36 flats built by the St. Pancras House Improvement Society, Ltd. (St. Francis Flats' in Bridgewater Street); 166 flats by the Commissioners of Crown Lands (Datehet House in Augustus Street and Ascot House in Redbill Street). HOUSING CONDITIONS. With the exception of a number of blocks of self-contained flats, the greater part of the working-class accommodation in the Borough consists of tenement houses, and the drawbacks associated with this form of housing are well known. Most of these houses are old, and, owing to age and the rough usage associated with numerous tenants, frequent inspections and the service of many notices are required to keep them in anything like suitable condition. Although the majority of the tenement houses have been occupied as such for many years, the number is steadily increasing, as year by year there are streets in which the houses, previously occupied by one family, are now being let to a number of families. The factors mainly responsible being the age of the houses in question, the cost of upkeep the inconvenience of so many stairs, and the migration of many of those able to afford it to the outlying suburbs. The type of tenement house usually found in the Borough is a rather large singlefronted terrace house, generally of three or four storeys, but also having a more or less underground basement. Each floor usually has two rooms, one in front, the other at the back, and although there are many single room tenements, as a rule each floor of two rooms is occupied by one family. In a number of instances there are tenements consisting of three or four rooms, but in such cases the accommodation is necessarily spread over more than one floor. As the majority of the tenement houses in St. Pancras are fairly large, it follows that the average number of families per house is exceptionally high. This view is confirmed by the information obtained at the recent Census (1931), and an interesting table is included in the Special Appendix on page 112, which gives the average size of occupied dwellings, the average number of families per house and the average number of persons per room for each of the metropolitan boroughs. It will be seen that housing pressure, as measured by the proportion of families to dwellings, is higher in St. Pancras than in any other metropolitan borough. There are on the average 2.28 families to each dwelling, and only 18.4 per cent. of the families in St. Pancras are in undivided occupation of separate dwellings. 62 This does not necessarily imply a high degree of overcrowding of persona per room, but it indicates the existence of a very large number of tenement houses, of large size and with an exceptionally high percentage of sub-letting. As regards density of persons per room, the table above referred to shows that at the 1931 Census the room density as regards St. Pancras was 1.13 persons per room, as compared with 1.22 at the Census of 1921. The average for the County of London at the 1931 Census being 0.98 persons per room. According to the report of the Registrar-General on the Census figures, there has been a considerable reduction in both the numbers and proportions scheduled in the "overcrowded" category. As regards existing housing conditions, with the exception of a few houses situated in mews and a small number in one or two somewhat narrow courts or passages, I think it may be stated that, owing to the work carried out during recent years by the Borough Council, the London County Council, the St. Pancras House Improvement Society, by the Office of Works on the Crown Estate and by private enterprise, there are few, if any, streets now existing to which the term "slum" could justly be applied. There are a number of streets in which the houses, although in fair structural condition, are dirty and neglected, but this is chiefly due to the habits of the tenants, coupled with the rough usage which is necessarily associated with a large number of persons per house. The opinion expressed above as to the improvement which has taken place during recent years is supported by an article entitled "Quicker Slum Clearance" which appeared recently in the "British Medical Journal." The article stated: "In some areas remarkable advances have been made in clearing bad tenement, houses and re-establishing their occupants in modern flats. This is a matter which has been dear to the heart of the Ministry of Health for many years, and it has constantly urged local authorities to proceed. The efforts in St. Pancras are a lesson to the whole Country of what can be done when people of goodwill get together. Those who remember the horrors of Somers Town ten or twenty years ago can hardly believe their eyes when they see the pleasant looking blocks that have sprung from the ashes of hideous tumbledown hovels." The greatest difficulty at present is the overcrowding which exists amongst the very poorest section of the community, including those whose employment is irregular, and the problem of providing, in a central situation, housing accommodation having three bedrooms, at a price such families can afford to pay (without curtailing the quantity or quality of their food), is a matter of considerable difficulty. 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. W. C. W. Roworth, 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 63 "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 (56 flats). (b) Flaxman Terrace Dwellings, Euston Road (84 flats and Caretaker's Lodge). (c) Prospect Terrace Dwellings, Gray's Inn Road (71 flats). (d) Una House, Prince of Wales Road (64 flats). (e) The Brookfield Estate, Highgate (113 flats, 90 maisonettes and 2 houses). (f) Somers Town Estate (142 flats), consisting of Aldenham House (26 flats), Wolcot House (18 flats), Johnson House (26 flats), Gladwin House (18 flats), Clarendon House (36 flats), and Morland House (18 flats). (g) Barnes House, Camden Road (22 flats). (h) 110, Leighton Road, Kentish Town. (i) 13 and 15, Bayham Place, Camden Town. (j) 15, Willes Road, Kentish Town. (k) 24, Grafton Road, Kentish Town. (/) 20 and 22, High Street and 3 and 5, Little King Street, Camden Town. (m) 41 and 47, Stanhope Street, Regent's Park. (n) 143, 145, 147, 149, 151, 153, 155, 157, 159 and 161, Great College Street, Camden Town. (o) 9, 10, 11, 12, 13, 14 and 15, Georgiana Street, Camden Town. (p) 67, 69 and 71, Pratt Street. (q) 3, James Street, Camden Town. (r) 207, Arlington Road. (s) 43, 45, 47, 49, 51, 53 and 55, Leighton Road, and 2 and 2a, Lady Margaret Road, Kentish Town (scheduled for demolition in connection with the Leighton Road Housing Scheme). (t) Oak House and Wellington House, East Finchley. Preference is given to persons residing in the Borough when vacancies occur in the Council's dwellings, and preferential consideration is given to applications where the housing conditions are extremely bad, and in all cases persons with families receive first consideration. During the past year there have been 76 changes of tenancies in the Council's properties. "Barnes House," Camden Road. This scheme was completed in January, 1932, and consists of 14 three-room flats, 7 four-room flats, and one six-room flat. The building, which embodies the Council's Tuberculosis Dispensary and Maternity and Child Welfare Centre, has five shops on the ground floor frontage in Camden Road, four of which are utilised by the Council's Electricity Department as showrooms. It was named after Mr. Edmund Barnes, d.l., j.p., the first Mayor of the Borough, who resided in Camden Road, and was opened by His Worship the Mayor, Sir Alfred Davies, c.b.e., j.p., on the 24th February, 1932. 64 Somers Town Housing Scheme— Wolcot Street Area. The block of dwellings which was erected on a portion of the main courtyard at the Somers Town Estate, was completed on 25th July, 1932. It was named "Morland House," in commemoration of George Morland, the celebrated painter, who lived in the Borough for many years, and comprises 18 flats. This is the sixth block of dwellings to be erected by the Borough Council in this area and completes the development of their estate in Somers Town, which now consists of 33 two-room Hats, 95 three-room flats, and 14 four-room flats, a total of 142 flats, comprising 704 rooms. Leighton Road Housing Scheme. The London County Council and the Ministry of Health have sanctioned the Borough Council's scheme for the erection of working class dwellings on the site acquired for housing purposes in Leighton Road and Lady Margaret Road. The approved scheme, as submitted by the Council's Architect, Mr. A. J. Thomas, f.r.i.b.a., comprises 6 two-room flats, 28 threeroom flats and 30 four-room flats, a total of 64 flats, comprising 216 rooms, the original scheme having been remodelled in order to provide for the maximum number of three and four-room flats, as it was felt that the greatest demand was for accommodation of this capacity. The Council have decided, in addition to the electric lighting supply, to provide an electric supply for cooking, heating and hot water. A contract has been entered into with Messrs. Gee, Walker & Slater, Ltd., for carrying out the building work, and it is anticipated that the first half of the estate will be completed in the autumn of 1933. London County Council Housing Estates. The Borough Council continue to avail themselves of the preferential treatment which is given to bad cases of overcrowding and special hardship when recommended to the London County Council. Since the initiation of this scheme in January, 1925, the number of St. Pancras families who have been housed under this arrangement up to December, 1932, is 838. It will, of course, be appreciated that in addition a number of St. Pancras families make direct application to the County Council, and in many cases accommodation is obtained by this method. Housing Schemes in the Borough. Seven estates have been developed by the Borough Council in St. Pancras, under the provisions of the various Housing Acts, comprising a total of 644 flats. Three estates were developed in the pre-war period, with a total of 211 flats, and four estates during the post-war period, comprising 433 flats, and, as already recorded, a further estate is now in course of development at Leighton Road. The London County Council, during the pre-war period, controlled 180 flats in the Borough, and in their Somers Town scheme, which is in course of development, there are already 246 flats in occupation. The Commissioners of Crown Lands have erected 246 flats in the Cumberland Market Area (which includes Swinley House, practically completed in the year under review); and the St. Pancras House Improvement Society, Ltd., have already completed 164 flats in the Somers Town Area. The London County Council are proceeding with their housing activities in the Ossulston Street Area, and it is understood that their estate, when completed, will comprise 481 tenements, so that there remain 234 tenements to be erected on this estate. A fourth block of flats, "Windsor House," is now being erected by the Commissioners of Crown Lands and will comprise 98 tenements. The original intention of the Commissioners was to proceed with further extensive developments in this area. The St. Pancras House Improvement Society, Ltd., are erecting a further block of 47 flats in Bridgewater Street, Somers Town, 65 and it is understood that further extensions of their scheme are contemplated so soon as this is completed. The North St. Pancras House Improvement Society are building a block of 10 flats in Wilkin Street and Litcham Street, and it is proposed to develop this scheme and eventually provide a large block of working-class dwellings in this locality. An appreciable quantity of working class flats were provided in St. Pancras during the pre-war period by private enterprise, and recently there has been evidence that private owners are contemplating building similar flats, although not extensively at the moment. Section V. INSPECTION AND SUPERVISION OF FOOD. (a) MILK SUPPLY. Cowsheds.— There are now no licensed cowsheds in the Borough. Dairies and Milkshops.— The Milk and Dairies Order, 1926, requires the Sanitary Authority to register all persons in their district carrying on the trade of cowkeeper or dairyman, and also all premises which are used as dairies. The term "dairy" does not include a shop from which milk is not supplied otherwise than in properly closed and unopened receptacles in which it was delivered to the shop, and therefore such premises do not require to be registered, but any person selling milk in sealed bottles or other receptacles must be registered as & purveyor of milk. Section 2 of the Milk and Dairies (Amendment) Act, 1922, gives the Local Authority power to refuse registration or to remove from the register any retail purveyor of milk, if they are satisfied that the public health is likely to be endangered by any act or default of such person. Thirty-two applications for registration under the Milk and Dairies Order, 1926, were received and granted during the year (31 retail and 1 wholesale). Fourteen applications in respect of itinerant vendors were also received and granted. The following list gives particulars as to the purveyors of milk on the register at the end of 1932:— Number of purveyors of milk from retail milkshops on the register at the end of 1931 203 Deduct number removed from the register during the year 1932 -26 Add number of purveyors registered by resolution of the Council during 1932 +31 Total number of purveyors of milk from retail milkshops on register at the end of 1932 208 In addition to the above, the following were also on the register at the end of 1932 3 persons (firms) in respect of premises where a wholesale trade in milk is done. 2 „ (firms) „ „ „ cream „ 4 ,, ,, retail ,, ,, „ and 26 itinerant vendors without retail milkshops. 66 Milk in Sealed Containers. During the year 42 persons were registered to sell milk in sealed containers, and 19 were removed from the register. At the end of the year there were 158 persons on this register. Milk Sampling out of Office Hours. Requests are received from time to time from other Metropolitan Boroughs for samples of milk to be taken by the Food Inspectors at railway stations within St. Pancras early in the morning. The Milk and Dairies (Consolidation) Act, which came into force on September 1st, 1925, provides for this duty, and Section 8 (4) of the Act states: "The Authority requiring the samples to be taken shall be liable to defray any reasonable expenses incurred, the amount whereof shall, in default of agreement, be settled by the Local Government Board [Ministry of Health]." The Council decided in February, 1902, that any firm or person requesting a sample of milk to be procured in course of consignment should be required to pay a fee of 10s. 6d., but no charge had been agreed with other Borough Councils requesting our Inspectors to take samples on their behalf. The samples have to be taken very early in the morning, usually between 3 and 4 a.m. After consideration by the Public Health Committee, it was decided that the fee fixed by the Council in 1902 should be adopted in respect of samples taken under the Milk and Dairies (Consolidation) Act, and the following recommendation was approved by the Council:— That any Local Authority requesting the Food Inspectors of this Authority to take a sample of milk in course of consignment from a consignor to a consignee be required to pay at the time of making the request a fee of 10s. 6d. for a sample or samples from any one source, and that the fee be handed over to the Inspector undertaking the sampling. Milk (Special Designations) Order, 1923. The production, distribution and standards of purity of the various grades of milk sold under special designations are governed by powers contained in the Milk and Dairies (Amendment) Act, 1922, and the Milk (Special Designations) Order, 1923. The special designations comprise the following:— "Certified," "Grade A (tuberculin tested)," "Grade A," "Grade A (pasteurised)," and "Pasteurised." Licences to producers of "Certified" and "Grade A (tuberculin tested)" Milk are granted by the Minister of Health, subject to compliance with conditions which are specified in the Order. Licences to sell Milk under the various special designations and for the production of Pasteurised Milk are authorised to be granted by the Borough Council. Any such licence is valid for not more than one year and expires on December 31st in each year. 67 The following licences were granted in respect of the year 1932:— Date of Licence. Name and Address of Licensee. Grades of milk in respect of which Licence is granted. St. Pancras Address at which graded milk will be sold. Dec. 17 th, 1931 United Dairies (London), Ltd., 97, Elgin Avenue, W.9 "Pasteurised" 69, Albany Street, Do. Do. Do. 48, Marchmont Street. Do. Do. Do, 63, Park Street, Do. Do. Do. 126, Regent's Park Road. Do. Do. "Certified" To sell in St. Pancras. Do. Do. "Grade A Tuberculin tested" Do. Do. United Dairies (London), Ltd., 39, High Road, N. 2 "Pasteurised" Do. Do. Do. "Grade A Pasteurised'' Do. Do. Do. "Grade A Tuberculin tested" Do. Do. Do. "Certified" Do. Do. Do. "Pasteurised" 25, Swain's Lane. Do. Do. Do. 51, South Grove. Do. Marshall's Dairies, Ltd., 19, Tudor Place, W. 1 "Grade A Tuberculin tested" 19, Tudor Place. Do. B. Rees, Ltd., 2 & 3, Carthusian Street, E.C. 1 "Pasteurised" To sell in St. Pancras. Do. E. E. Hodges & Co., Easton Dairies, nr. Wells, Somerset "Pasteurised" To sell in St. Pancras. Do. John Evans, 35, Southampton Street, W. 1 "Grade A Tuberculin tested" 35, Southampton Street. Do. Lincolnshire Dairies, Ltd., 31, Oak Village, N.W. 5 "Pasteurised" (Plants) 31, Oak Village. Do. D. M. T. Richards, 161, Whitfield Street, W. 1 "Grade A Tuberculin tested" 161, Whitfield Street. Do. D. Williams, 57, Leighton Road, N.W. 5 "Grade A Tuberculin tested" 57, Leighton Road. Do. J. R. Mills, 23, Francis Street, W.C. 1 "Grade A Tuberculin tested" 23, Francis Street. Do. D. Davies, 10-11, Dukes Road, W.C. 1 "Grade A Tuberculin tested" 10-11, Dukes Road. Do. Do. Do. (Bottling) Do. Do. T. J. Evans, 95, St. Paul's Road, N.W.1 "Grade A Tuberculin tested" 95, St. Paul's Road. Do. H. J. Jenkins. 97, Kentish Town Road, N.W.1 "Grade A Tuberculin tested" 97, Kentish Town Road. April 28th, 1932 Do. "Pasteurised" Do. Dec. 17th, 1931 Griffiths Bros., 51, St. George's Road, N.W.1 "Pasteurised " (Plant) 51, St. George's Road. Dec. lst, 1932 Do. "Grade A Tuberculin tested" (Bottling) Do. Dec. 17th, 1931 London Co-operative Society, Ltd., 54, Maryland Street, E.15 "Grade A Tuberculin tested" "Pasteurised" 135-139 Hampstead Road. Sept.22 nd, 1932 Do. "Grade A Tuberculin tested" 32, Oak Village. Do. Do. "Pasteurised" Do. Jan. 28th, 1932 Express Dairy Co., Ltd., 26, Tavistock Place, W.C,1 "Pasteurised" 26, Tavistock Place. Do. Do. "Certified" Do. Do. Do. "Grade A Tuberculin tested" Do. Do. Do. "Pasteurised" 1, Guilford Street. Do. Do. Do. 12, South Grove. Do. Do. "Certified" Do. Do. Do. "Grade A Tuberculin tested" Do. Do. Do. "Grade A Tuberculin tested" 5 Stibbington Street. [Continued on next page. 68 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. Jan.28th,1932 Express Dairy Co., Ltd., 26, Tavistock Place, W.C.1 "Certified" 5, Stibbington Street. Do. Do. "Pasteurised" Do. Do. Do. Do. 138, Ossulston Street. Do. Do. Do. 46, Mornington Crescent. Do. Do. "Grade A Tuberculin tested" 68, Mansfield Road. Do. Do. "Certified" Do. Do. Do. "Pasteurised" Do. Do. Do. "Grade A Tuberculin tested" 151, Highgate Road. Do. Do. "Certified" Do. Do. Do. "Pasteurised" Do. Do. T. J. Jones, 6, Hastings Street, W.C.1 "Grade A Tuberculin tested" 6, Hastings Street. Do. J. R. James, 155, Hampstead Road, N.W 1 Do. 155, Hampstead Road. Do. Do. "Pasteurised" Do. Do. A. Meredith, 118, Chalton Street, N.W.1 "Pasteurised" (Plant) 118, Chalton Street. Do. Do. "Grade A Tuberculin tested" Do. Do. Do. "Certified" Do. Do. Do. Do. 111, Park Street. Do. Do. "Grade A Tuberculin tested" Do. Do. Do. "Pasteurised" Do. Do. London Wholesale Dairies, Ltd., Vauxhall, S.E. 11 "Grade A Tuberculin tested" To sell in St. Pancras. Do. J. Adams, 15, Crowndale Road, N.W.1 Do. 15, Crowndale Road. Do. E. A. Lewis, 18a, Highgate Road, N.W.5 Do. 18a, Highgate Road. Feb. 26th, 1932 R. A. Evans, 77, Torriano Avenue, N.W.5 Do. 77, Torriano Avenue. Mar. 24th, 1932 W. L. Davies, 41, King Street, N.W.1 Do. 41, King Street. Sept. 22nd, 1932 Independent Milk Supplies, Ltd., 113, Cottenham Road, N.19 "Pasteurised" 63-67, Chenies Mews. Do. City of London Dairies (H Miller), 116-120, Goswell Road, E.C.1 Do. To sell in St. Pancras. Oct. 30th, 1932 Meadowland Milk, Ltd., 166, Kensal Road, W.10 Do. To sell in St. Pancras. Samples of milk sold under special designations are taken at intervals, and are submitted to bacteriological examination, in order to ascertain if they comply with the standard specified in the Order. Four such samples were taken during the year and in each case the result of the examination was satisfactory. As regards "Certified" Milk and "Grade A (Tuberculin tested)" Milk, in those cases in which the latter milk is bottled at the farm, a scheme has been devised by the Ministry of Health, under which the work of sampling is divided between the Local Authorities in whose area the milk is sold. Samples of the grades above mentioned are to be taken on receipt of instructions from the Ministry, and no samples of these Grades were required to be taken in this Borough during the year. 69 Artificial Cream Act, 1929. The above Act, which came into force on June 1st, 1929, requires the registration of all premises in which Artificial Cream is manufactured, sold, or exposed for sale for human consumption. This requirement does not apply to premises where Artificial Cream is not supplied otherwise than in the properly closed and unopened receptacles in which it is delivered to those premises, nor to its manufacture solely for domestic purposes, nor to its manufacture on any premises for use in the preparation on those premises of some other article of food. The number of premises registered during the year, in accordance with the requirements of the Act, was one (retail). Artificial Cream is defined in the Act as an article of food resembling Cream and containing no ingredient which is not derived from milk, except water. In actual practice it is manufactured from Dried Milk, Butter and Water in suitable proportions, and the term Re-constituted Cream would appear to be more appropriate than the word Artificial. (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. The undermentioned unsound or diseased food was surrendered by the owners for destruction or to be dealt with as trade refuse. On two occasions a seizure of unsound food was made. Unsound Food Condemned and Destroyed. Surrendered. Apples, 3 boxes Peaches, 9 boxes Ham, Cooked, 25 lbs. in tins Periwinkles, 2¼ bushels ,, Smoked, 10 lbs. Potatoes, 54 bags Heads, Pigs', 8 Sausages, smoked, 47 lbs. Lemon Soles, 4½ stone Skate, 20¼ stone Liver Paste, 38—7 lb. tins Sprats—1 barrel ,, ,, 18—2 lb. tins Tomatoes, 20 boxes Livers, Bullocks', 4 Tongues, Pigs', 6 ,, Pigs', 8 Turkeys, 909 ,, Sheep's, 1 Yeast, 4 boxes Lungs, Pigs', 6 „ Sheep's, 2 Seized. Bacon, 14¾ lbs. Sausages, 11 lbs. Slaughter-houses. At the end of 1932 there were 4 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 110 inspections during the year. Fried Fish and Fish Curing Premises. In 1932 there were 77 fried fish vendors' premises in the Borough, at 6 of which fish curing was also carried on. There were 17 fish curers' premises, including the 6 above mentioned. 425 visits were made by the Food Inspectors to these premises during the year. 70 Ice Cream Premises. Section 5 of the London County Council (General Powers) Act, 1932, states that "any premises used or proposed to be used for the sale or the manufacture for the purpose of sale of ice cream or other similar commodity or the storage of ice cream or other similar commodity intended for sale shall be registered by the owner or occupier thereof with the Sanitary Authority." Any person offending is liable to a penalty. The section above mentioned does not apply to any premises used as a Hotel, Restaurant or Club. The total number of premises on the register of the department at the end of the year was 241. Bakehouses and Restaurant Kitchens. At the end of 1932 there were 154 bakehouses on the register, including 65 factory bakehouses. 38 of these bakehouses were not in use. 111 of the 154 were underground bakehouses, of which 54 were factory bakehouses, and 27 not in use. At the end of the year 291 restaurant kitchens were on the register. Bakehouses and restaurant kitchens are supervised by the Factory and Workshop Inspectors, and further particulars in regard to them will be found on pages 55 to 57. (c)—FOOD AND DRUGS (ADULTERATION) ACT, 1928. 801 samples have been taken under this Act, of which 463 were formal and 338 informal. Of the formal, 452 proved to be genuine, and 11, or 2.4 per cent., adulterated; and of the informal, 321 were genuine and 17, or 5.3 per cent., adulterated. Articles of food of which samples have been taken. Total number of samples. Genuine. Adulterated. Formal Informal Formal Informal Formal Informal Almonds (ground) — 1 — 1 — — Anchovies (canned) — 1 — 1 — — Arrowroot — 1 — 1 — — Bacon — 4 — 4 — — ,, (cooked) — 1 — 1 — — Baking Powder — 1 — 1 — — Beans (baked, canned) — 2 — 2 — — ,, (French, canned) — 1 — 1 — — Beef (corned) — 2 — 2 — — ,, (minced) 5 9 2 5 3 4 Bisto — 1 — 1 — — Brawn — 5 — 5 — — Butter 99 4 99 4 — — Camphorated Oil — 2 — 2 — — Cascara Sagrada — 1 — 1 — — Castor Oil — 2 — 2 — — Cheese — 2 — 2 — — Cherries (glacé) — 1 — 1 — — Chicken and Ham Roll — 1 — 1 — — Chocolates — 3 — 3 — — Cocoa 6 5 6 5 — — Coffee 8 4 8 4 — — Cornflour — 5 — 5 — — Cough Candy — 1 — 1 — — Cream — 20 — 20 — — ,, (canned) 1 17 1 16 — 1 ,, (trifle) — 1 — 1 — — Currants — 3 — 3 — — Carried forward 119 101 116 96 3 5 71 Articles of food of which samples have been taken. Total number of samples. Genuine. Adulterated. Formal Informal Formal Informal Formal Informal Brought forward 119 101 116 96 3 5 Custard Powder — 3 — 3 — — Dripping — 1 — l — — Essence Flavouring — 1 — l — — Fish Paste — 8 — 8 — — Flour (self-raising) 8 1 8 1 — — Fruit Salad (canned) — 2 — 2 — — Ginger (ground) — 9 — 9 — — Glycerine — 1 — 1 — — Grape Fruit (canned) — 1 — 1 — — Honey — 6 — 6 — — Hot Pot (canned) — 1 — 1 — — Hydrogen Peroxide — 2 — 2 — — Jam — 12 — 12 — — Jelly Crystals — 1 — 1 — — Junket Crystals — 1 — 1 — — Lard 13 — 13 — — — Lemon Cheese — 1 — 1 — — ,, Curd — 3 — 3 — — ,, Squash — 3 — 3 — — Lemonade Powder — 2 — 2 — — Macaroni — 1 — 1 — — Marmalade — 3 — 3 — — Meat Pie — 2 — 2 — — Milk 298 4 294 3 4 1 Milk (canned) — 11 — 11 — — Mincemeat — 3 — 3 — — Mustard 2 7 2 7 — — Olive Oil — 4 — 4 — — Orange Squash — 2 — 2 — — Peas (bottled) — 1 — 1 — — „ (canned) — 13 — 13 — — „ (dried) — 2 — 2 — — Peel (mixed) — 2 — 2 — — Pepper 2 6 2 6 — — Pickles — 2 — 2 — — Pineapple (canned) — 1 — 1 — — Prawns (bottled) — 1 — 1 — — ,, (canned) — 1 — 1 — — Raisins — 2 — 2 — — Rice — 9 — 9 — — Salad (potato) — 1 — 1 — — Salmon (canned) — 2 — 2 — — Sardines — 6 — 6 — — Sauce — 8 — 8 — — Sausages 11 50 9 39 2 11 Sausage Meat — 1 — 1 — — „ Roll — 1 — 1 — — Soup (canned) — 2 — 2 — — ,, (dessicated) — 3 — 3 — — Spinach Puree — 1 — 1 — — Suet (shredded) — 2 — 2 — — Sugar — 3 — 3 — — Sultanas — 1 — 1 — — Sweets — 9 — 9 — — Tea — 1 — 1 — — Toffee — 1 — 1 — — Tomato Pureé (canned) — 4 — 4 — — Tomatoes (canned) — 4 — 4 — — Veal and Ham — 1 — 1 — — Vinegar 4 — 4 — — — ,, (malt) 6 — 4 — 2 — Totals 463 338 452 321 11 17 72 Summonses. (a) Food and Drugs (Adulteration) Act, 1928. No. of Sample. Article. Result of Analysis. Date of Hearing of Summons. Result of Proceedings. Penalty. Costs. 1932. £ s. d. £ s. d. C. 66 Malt vinegar 100 per cent. of vinegar other than malt vinegar June 2nd — 1 1 0 C. 67 „ „ „ „ „ „ — 1 1 0 C.118 Milk Deficient in milk fat, 12 per cent. July 26th 10 0 0 6 5 0 A. 103 „ Added water, 6 per cent Sept. 22nd 1 0 0 2 0 0 A. 104 „ ,, 5.5 per cent „ „ 1 0 0 2 0 0 C. 170 Minced beef Adulterated by the admixture of sulphur dioxide, 0.008 per cent. Oct. 13th 0 7 0 3 3 0 C. 172 „ „ „ 0.004 „ „ 27th — 2 2 0 A. 138 Milk Deficient in milk fat, 18 per cent. 1933. Jan. 5th — 2 0 0 (b) Public Health (Preservatives, etc., in Food) Regulations, 1925. Address where offence committed. Offence. Date of Hearing of Summons. Result of Proceedings. 61, Maiden Road Selling minced beef containing an added preservative contrary to Statute 1932. Oct. 13th Withdrawn—Fine and costs under Food and Drugs (Adulteration) Act, 1928. 51, Maiden Road Selling sausages containing an added preservative, and which were not labelled „ 13th Fined 7s. Costs £3 3s. 0d. 155, Queen's Crescent Selling minced beef containing an added preservative contrary to Statute „ 27th Withdrawn—Costs under Food and Drugs (Adulteration) Act, 1928. (c) Milk and Dairies Order, 1926. Address where offence committed. Offence. Date of Hearing of Summons. Result of Proceedings. Crowndale Road Delivering milk in bottles which were not filled and closed on registered premises 1932. May 18th Fined £1. Georgiana Street Do. do. „ Fined £1, Costs £1 1s. (d) Public Health (London) Act, 1891. Address where offence committed. Offence. Date of Hearing of Summons. Result of Proceedings. 221, High Street Exposing Sausages for sale which were unsound and unfit for the food of man 1932. July 7th Fined £10. Stall in Chalton Street Depositing Bacon for the purpose of sale which was unsound and unfit for the food of man. Sept. 5th Fined £1. Costs £5 5s. 73 (e) Public Health (Meat) Regulations, 1924. Address where offence committed. Offence. Date of Hearing of Summons. Result of Proceedings. Stall in Chalton Street Exposing Meat for sale which was not suitably covered over and screened 1932. Sept. 5th Fined £10. (f) Merchandise Marks (Imported Goods) No. 4 Order, 1929. Address where offence committed. Offence. Date of Hearing of Summons. Result of Proceedings. 17, Hampstead Road Exposing for sale imported raw Tomatoes which were not marked by means of a show ticket bearing the indication of origin. 1932. Aug. 18th Fined £1. Costs £1 1s. (g) Merchandise Marks (Imported Goods) No. 3 Order, 1928. Address where offence committed. Offence. Date of Hearing of Summons. Result of Proceedings. 17, Hampstead Road Exposing for sale imported fresh Apples which were not marked by means of a show ticket bearing the indication of origin. 1932. Aug. 18th Fined £1, Costs £1 1s. Wholesale Dealers in Margarine.— No certificates of registration under the provisions of the Food and Drugs (Adulteration) Act were issued during the year. Section VI.— PREVALENCE OF, AND CONTROL OVER, NOTIFIABLE DISEASES. The undermentioned diseases are compulsorily notifiable in St. Pancras:— A. Under the Public Health (London) Act, 1891:— Small-pox (Variola) Typhus Fever Cholera Typhoid „ Diphtheria and Membranous Croup Enteric ,, Erysipelas Relapsing „ Scarlet Fever (Scarlatina) Continued „ Puerperal ,, B. Under Special Regulations made by the Ministry of Health granted under powers contained in the Public Health Acts:— Plague (1900) Cerebro-spinal Fever and Acute Poliomyelitis (1912) Acute Encephalitis Lethargica and Acute Polio-encephalitis (1919) Puerperal Fever and Puerperal Pyrexia (1926, 1928) Ophthalmia Neonatorum (1926, 1928) Tuberculosis (1930); and the Infectious Diseases (London) Regulations, 1927, for Malaria Dysentery Acute Primary Pneumonia Acute Influenzal Pneumonia; and wherein Enteric Fever is defined to include the Paratyphoid group of Fevers 74 C. Under a Special Local Order of the Ministry of Health in 1920:— Measles German Measles D. Under a Special Order of the London County Council in 1909:— Glanders Anthrax Hydrophobia "when these occur in man." E. Under the London County Council (General Powers) Act, 1932:— Food Poisoning. The following table gives the number of cases notified, the number of deaths which occurred, and the number of patients admitted to hospital during 1932. The notifications have not been corrected for any subsequent revision of diagnosis:— Notifiable Diseases (other than Tuberculosis). diseases. NOTIFICATIONS. Total all Ages. DEATHS. Total all Ages. Number of Cases admitted to Hospital. At Ages—Years. At Ages—Years. Under i. 1 to 5. 5 to 10. 10 to 15. 15 to 25. 25 to 65. 65 upwards. Under 1. 1 to 5. 5 to 10. 10 to 15. 15 to 25. 25 to 65. 65 upwards. 1. Small-pox — — — 2 — 3 — 5 — — — — — — — — 5 2. Scarlatina or Scarlet Fever 3 131 219 85 46 33 — 517 — 2 1 2 — — — 5 499 3. Diphtheria and Membranous Croup 12 96 97 32 37 27 — 301 1 2 4 2 1 — — 10 297 4. Enteric or Typhoid Fever — 1 4 — 1 2 — 8 — — — — 1 — 1 2 8 5. Puerperal Fever — — — — 9 21 — 30 — — — — 3 6 — 9‡ 20 6. Puerperal Pyrexia — — — — 21 25 — 46 — — — — — 1 — 1† 13 7. Erysipelas 6 5 1 2 10 79 14 117 3 1 — — — 8 5 17 88 8. Cerebro-spinal Meningitis 2 3 — 2 4 2 — 13 2 1 — — 2 1 — 6 13 9. Anterior Poliomyelitis and Polioencephalitis — 3 — — 1 — — 4 — 1 — — — — — 1 4 10. Ophthalmia Neonatorum 74 — — — — — — 74 — — — — — — — — 19 11. Encephalitis Lethargica — — — — — — — — — — 1 — — 1 — 2 — 12. Acute Primary Pneumonia 5 29 13 6 27 83 15 178 — — — — — — — — *137 13. Acute Influenzal Pneumonia — 7 5 1 8 40 7 68 — — — — — — — — 26 14. Malaria — — — — — 1 — 1 — — — — — 2 — 2 1 15. Dysentery — 3 1 — — — 4 — — — — — — — — 4 16. Measles 135 1592 1062 28 35 13 — 2865 6 21 — — — — — 27 576 17. German Measles 1 23 18 14 7 2 — 65 — — — — — — — — 6 18. Food Poisoning — 2 — — 6 8 — 16 — — — — — — — — 1 * For Pneumonia Deaths, see Table 2 on page 102. † Cause of Death classified by Registrar General to "Mitral Stenosis." ‡ Including one case not notified to this Borough as the death occurred outside London. 75 The notifications of, and deaths from, the notifiable diseases other than Tuberculosis aro classified in the following table according to the Wards in which they occurred:— DISEASES. Notifications. Deaths. Ward. Whole Borough. Ward. Whole Borough 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1. 2 — — 1 1 — — 1 5 1 — — — — — — — — — 2. Scarlatina or Scarlet Fever 84 63 98 60 50 50 28 84 517 1 — 1 2 — 1 — — 5 3. Diphtheria and Membranous Croup 30 29 49 30 27 59 20 56 †301 2 — 2 2 — 1 2 1 10 4 Enteric or Typhoid Fever 1 2 2 1 1 — 1 — 8 — — — 1 — — 1 — 2 5. Puerperal Fever 3 2 5 5 5 2 4 4 30 — 1 3 — 1 2 — ||9 6. ,, Pyrexia 8 1 7 3 8 2 7 9 †46 — — — — — — — — ‡1 7. Erysipelas 21 12 21 21 12 16 3 11 117 1 3 3 2 5 — 1 2 17 8. Cerebro-spinal Meningitis 2 2 — 3 2 — 2 1 †13 3 — — 2 1 — — — 6 9. Anterior Poliomyelitis and Polio- — 1 — 1 I — 1 — 4 — — — 1 — — — — 1 10. Ophthalmia Neonatorum 9 4 19 5 14 13 5 5 74 — — — — — — — — — 11. Encephalitis Lethargica — — — — — — — — — — 1 1 — — — — — 2 12. Acute Primary Pneumonia 31 16 31 25 27 13 5 30 178 — — — — — — — — 1 13. Acute Influenzal Pneumonia 23 5 10 10 11 2 2 5 68 — — — — — — — — 14. Malaria — — — — — — — — — — — — — — — — 1 2 15. Dysentery — — 1 3 — — — — 4 — — — — — — — — — 16. Measles 402 414 482 433 369 340 96 325 †2865 1 4 7 2 4 5 3 1 27 17. German Measles 14 3 12 4 3 7 6 16 65 — — — — — — — — — 18. Food Poisoning 1 — 3 2 6 — 3 1 16 — — — — — — — — — Total 631 554 740 607 537 505 183 548 4312 9 9 18 13 11 8 9 5 82 *For Pneumonia deaths, see Table, 2 page 102. †Including 7 cases—"homeless." (1 each of Diphtheria, Puerperal Pyrexia, and Cerebro-spinal Meningitis and 4 Measles.) ‡Cause of Death classified by Registrar-General to "Mitral Stenosis." ||Including one case not notified to this Borough as the death occurred outside London. 76 SMALL-POX. Five cases of this disease were notified in the Borough during the year, as compared with four cases during the previous year. The cases were mild in character, and no deaths occurred. VACCINATION. As from April 1st, 1930, the functions previously carried out by the Board of Guardians in respect of Vaccination were transferred to the Borough Council, who decided that these powers and duties should be exercised by the Public Health Committee. The following table gives particulars as regards vaccination in respect of children whose births were registered in the Borough of St. Pancras from 1st January to 31st December, 1931 Vaccinations. lst January to 31s£ December, 1931. Number. Percentage of Births registered. North. South.. East. South. west. Whole Borough North. South. East. South. west. Whole Borough Births registered 637 1966 1896 4499 100.0 100.0 100.0 100.0 Died, unvaccinated 18 105 70 193 2.8 5.3 3.7 4.3 Successfully vaccinated 254 1003 953 2210 399 51.0 50.3 [49.1 Had smallpox — — — — — .— — — Insusceptible of vaccination 1 2 7 10 0.2 0.1 0.4 0.2 Received certificate of conscientious objection 309 525 557 1391 48.5 26.7 29.4 30.9 Postponed by medical certificate 12 10 16 38 1.9 0.5 0.8 0.8 Moved to known address in other districts 9 116 126 251 14 5.9 6.6 5.6 Lost sight of by removal 18 169 146 333 2.8 8.6 7.7 7.4 Unvaccinated and not accounted for in previous columns 16 36 21 73 2.5 1.8 1.1 1.6 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. 1922 4881 2260 46.3 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 1927 3947 1980 50.2 1285 32.6 1928 4019 1937 48.2 1326 33.0 1929 4223 1936 45.8 1373 32.5 1930 4598 2196 47.8 1523 33.1 1931 4499 2210 49.1 1464 32.5 77 Return showing the number of Persons successfully vaccinated and re-vaccinated at the cost of the rates by the Medical Officers of Institutions and the Public Vaccinators during the year ended 30th September, 1932:— Name of Institution or Vaccination District. Name of the Medical Officer or Public Vaccinator. Nos. of Successful Primary Vaccinations of Persons. No. of Successful Re-vaccinations, i.e., Successful Vaccination of Persons who had been Successfully Vaccinated at some previous time. Under one year of age. One year and upwards. Total. Ward 1 Dr. N. J. Goodchild. . 167 14 181 10 „ 2 „ F. L. Pelly 147 23 170 10 Wards 3 and 4 „ J. Wigg 318 20 338 10 ,, 5, 6, and 7 „ A. E. Tait 306 35 341 27 Ward 8 ,, C. H. A. Alderton 175 15 190 Highgate Hospital ,, C. Thackray . . 14 St. Pancras Hospital ,, W. Feldman 14 14 Totals 1127 107 1234 71 SCARLET FEVER. The number of cases notified was 517, as compared with 435 cases during the previous year. It was subsequently ascertained that 21 cases had been incorrectly diagnosed. The actual number of cases was therefore 496. Five deaths occurred; this equals a case mortality of l.0 per hundred cases. 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. There were 24 such cases during the year. In tracing the clinical histories it was found that in 7 houses the original case had definitely developed a nasal discharge shortly after leaving hospital. Such discharges are known to be highly infectious. Several other primary cases were reported to have had colds. In 10 cases there was no illness of any kind in the persons who were just back from hospital, but as the second cases fell within the above definition they are included. Multiple cases in one house—that is, several cases occurring more or less together—are not as frequent as one might expect. In 35 families there were two such cases and in 7 families three multiple cases in each home, in another house 4 and in another 5 multiple cases. There were two epidemics in Children's Homes, one with 5 and one with 7 cases. DIPHTHERIA. The number of cases notified was 301, as compared with 334 cases during the previous year. It was subsequently reported by the hospital authorities that 62 cases had been incorrectly diagnosed, the actual number of cases was therefore 239. This equals an attack rate of 1.2 per 1,000 of population. Ten deaths occurred, giving a case mortality of 41 per cent. 78 Investigation of multiple cases—that is, several cases occurring more or less together in one house —shows that in 10 families there were 2 such cases in each home. In addition, there were 2 small epidemic outbreaks in Hospitals, one of 8 cases and the other of 4. Antitoxin for the treatment of cases of this disease is supplied to medical practitioners free of charge by the Council. During the year 176 thousand units were provided. ENTERIC OR TYPHOID FEVER. Three cases of Enteric and five of Para B. Typhoid were notified during the year. Two cases of Enteric were brought to notice only after death and Post Mortem examination. On further investigation, one of the first group was found to be incorrectly diagonised. One of the cases notified as Para B. Typhoid died. There were therefore nine cases and three deaths; one of these deaths was attributed jointly to Diphtheria and was allocated to Manchester, as the deceased resided there. PUERPERAL PYREXIA AND PUERPERAL FEVER. In 1932 there were 46 notifications of Puerperal Pyrexia. One was withdrawn by the notifying physician. On further investigation 11 of these cases were considered to be Puerperal Fever rather than Puerperal Pyrexia. There were therefore 34 cases of the "Pyrexia" and one of these died from "Streptococcal Meningitis, Broncho Pneumonia and Mitral Stenosis." Thirty cases of Puerperal Fever were notified. One came to notice only after death and eleven were transferred from the list of Puerperal Pyrexia notifications. There were therefore 42 cases of Puerperal Fever and 8 of these died. The next two tables record the details of the cases, together with certain interesting circumstances. 79 Cause of Pyrexia. Total cases notified. Confinement. Infant. Mother. In Institution. At Home. Living. Dead Viable. Non-Viable. Primipara. Unmarried. Average Age. Deaths. Doctor. Midwife. Student. Abortion with no evidence of infection of Organs of Reproduction 3 2 1 — — — — 3 — — 32 — Abortion induced 2 2 — — — — — 2 — — 29 — for health reasons Inflammation of Breast 4 4 — — — 4 — — 4 1 24 — Engorged Breasts 1 1 — — — *1 — — — — 21 — Retained Products of Conception 5 2 1 2 3 — 2 4 1 28 — Pyelitis (B. Coli.) 3 3 — †3 †1 — 2 1 24 — Cystitis (B. Coli.) 3 3 — — — 3 — — 3 1 29 — Influenza 4 2 — 1 i 4 — — 1 — 25 — Sore Throat, Coryza 2 1 — 1 — 2 — — 2 1 24 — Pneumonia 1 1 — — — 1 — — 1 — 26 — Pneumonia and Meningitis 1 1 — — — 1 — — 44 ‡1 Pulmonary Tuberculosis 1 1 — — — 1 — — — — 29 — Perineal Tear 1 — 1 — — 1 — — — — ||34 — Gonorrhoea 1 — 1 — — §1 — 1 I 20 — Shock Premature 1 1 — — — ¶2 — 1 — 20 — Twins Abscess at site of Saline injection 1 1 — — — 1 — — — 38 — Puerperal Pyrexia. Totals 34 25 4 4 1 28 1 7 19 6 26 1 Percentages 100 73.5 11.8 11.8 2.9 77.8 2.8 19.4 55.9 17.7 — 2.9 265 Puerperal Fever. Associated with Abortion 14 5 9 — — — 14 4 4 28 2 Other cases 28 11 7 7 3 24 4 — 13 6 27 6 Totals 42 16 16 7 3 24 4 14 17 10 28 8 Percentages 100 38.1 38.1 16.6 7.1 57.2 9.5 33.3 40.5 23.8 — 19 61.8 *Premature. Died within a few hours of birth. Difficult mother, who refused advice. †Including set of twins, of which one was a stillbirth. ‡Died from Streptococcal Meningitis, Broncho Pneumonia and Mitral Stenosis. ||Hiby born before arrival of medical attendant. Sent into Hospital at once. §Child developed ophthalmia neonatorum. ¶Twins. 80 ERYSIPELAS. 117 cases were notified and 17 deaths occurred, as compared with 96 cases and 8 deaths during the previous year. CEREBRO-SPINAL MENINGITIS. (Cerebro-Spinal Fever, Meningococcal Meningitis, "Spotted Fevf.r.") Thirteen cases were notified during the year, and one other was brought to notice only after death. On further investigation one of these cases was considered to be doubtful and the diagnosis was not verified, three others were found to have been incorrectly diagnosed (one of whom recovered after " Acute Meningitis of unknown origin," one died from "Diarrhoea and Enteritis" and one from "Pneumococcal Meningitis"). There were therefore 10 definite cases and one indefinite case in the Borough and six of the definite cases died. Supervision has been maintained on the five cases which did not end fatally. Two of these have removed to unknown addresses, but were reported to have completely recovered their normal health before moving. The other three have recovered completely. Doubt DEFINITE CASES. ful Cases. Case No. 1 2 3 4 5 6 7 8 9 10 11 Age (in years) .. T62 3 16 28 23 4 16 1^ 44 18 Sex . . ..FFFMMFFMMMM Length of illness ..1/7 6 1 1 1 2 8 12 8 8 2 (in weeks) i_ End Result . . DIED RECOVERED It will be noted that the Case Mortality is over 50 per cent., a very high figure. The disease has a rapid onset and the fatal cases generally die in the early stages. A survey of the treatment is being made and the effect of different brands of serum is being carefully recorded. These reports are sent to the Ministry of Health, and it is hoped that the collection of this data from the whole country will supply the necessary information on the value of Serum Treatment.  1932. 1931. 1930. 1929. 1928. 1927. Puerperal Fever. Cases 4.2 25 33 43 33 36 Deaths 8 3 Nil. 5 3 4 Incidence. 15.2 8.5 10.3 13.6 10.1 10.9 per 1,000 births. Mortality Rate 19.0 12.0 Nil. 11.6 9.1 11.1 per 100 cases. Death Rate 2.9 1.0 Nil. 1.6 0.9 1.2 per 1,000 births. Puerperal Pyrexia. Cases 34 37 37 53 41 33 Incidence 12.3 12.5 11.6 16.7 12.5 10.0 per 1,000 births. 81 ACUTE POLIOMYELITIS AND POLIOENCEPHALITIS. Four cases were notified during the year. One of these cases died. The other three are still receiving Institutional treatment and are reported to be progressing slowly. OPHTHALMIA NEONATORUM. Form as Desired by Ministry or Health. Additional Information. Cases Vision not Impaired. Vision Impaired. Total Blindness. Deaths. Incidence Rate per 1,000 Births. District Nurse in Attendance provided by Borough Council. Cases treated in Special Hospital provided by L.C.C. Notified. Treated At Home. In Hospital. 1932 74 56 18 73 — — 1|| 27.6 30 15 1931 45 26 19 43† — — — 15.2 18 14 1930 31‡ 23 8 30 — — l* 9.1 17 6 1929 36 21 15 34 1 — 1 11.4 11 12 1928 32 24 8 32 — — — 9.8 12 6 1927 38 27 11 37 1 — 1* 11.5 11 5 1926 40 24 16 34† — — 2* 11.0 9 7 • Due to other causes. †Several cases removed to unknown addresses. ‡Excluding one case, information unobtainable. ||Died from Prematurity, congenital Heart Disease and Gonorrhœal Ophthalmia. In addition to the above, there were 47 cases of Mild Inflammation not notifiable as Ophthalmia Neonatorum. This disease is an inflammation of the eyes of newly born infants, resulting in a purulent discharge within 21 days of birth. It has been compulsorily notifiable in London since 1911. During the first few years the incidence averaged about 5 cases per 1,000 births in St. Pancras Borough. By 1920 the incidence had reached 11, and this remained the approximate figure for several years. The rate for 1930 was the lowest for a considerable period. The disease does not seem to be as severe now as formerly. The high incidence can only be explained by the alertness of midwives and doctors, who probably err on the side of safety by notifying all suspicious cases. It is certainly better to err on this side. Out of the 74 notifications this year, only four were considered "grave." There were 18 of " moderate " severity, and the rest were returned as " slight." The true condition is still a prolific cause of blindness. This is definitely seen in those countries where Ophthalmia Neonatorum is not regarded with due consideration. In the past six years, out of 256 cases, including all the doubtful ones, we have had two cases where the vision was permanently impaired. Without our present protective routine, it is probable that the incidence would become higher still, that there would be a greater proportion of true and "grave" cases, and that "Impaired Vision" and "Blindness" would result more commonly. In 27 cases the mother was giving birth to her first baby, and 5 of these mothers were single women. In 46 cases the confinement took place at home, and of these 26 were attended by midwives, 10 by doctors and 10 by medical students. 82 ENCEPHALITIS LETHARGICA. The London County Council offers Institutional treatment in the Special Wards at Winchmore Hill Hospital for these cases, and for those patients who develop post Encephalitic symptoms. This treatment has lately been extended to include adults as well as children. An annual survey is now made of all notified cases. In this manner close contact is maintained with each case., sometimes over a number of years, or until we are satisfied that there are no complications due to the Encephalitis. If at any time the patient shows signs of some complication, treatment is advised immediately and this generally takes the form of the special Institutional care described above. At the end of 1932 there were eight cases from this Borough receiving treatment at Winchmore Hill Hospital. Six cases revisited under the routine were considered to require Institutional treatment, but they refused the offer. Three other cases were advised to have special medical attention owing to some slight relapse or bad report. Eight cases were considered to have shown marked improvement or complete recovery. One case which was notified in 1925 died, but the death was allocated to Cerebral Hæmorrhage. Two cases were brought to notice through death reports. They were not notified before death. These were the only additional cases of Encephalitis Lethargica during 1932. PNEUMONIA. This disease is a frequent complication of other diseases, such as Measles. When it occurs in that manner it is not notifiable. The notifiable forms of Pneumonia are Acute Primary and Acute Influenzal Pneumonia. There were 178 notifications of the former and 68 of the latter during 1932 (as compared with 193 and 79 respectively for 1931). There were 185 deaths from all forms of Pneumonia during the year. If requested by the medical attendant, a visiting nurse is supplied in necessitous cases at the cost of the Borough Council. In 1932, 38 cases were nursed under this arrangement and 806 nursing visits were paid. MALARIA. Four cases of Malaria came to our notice during the year. Case A was notified under the Infectious Diseases (London) Regulation, 1927. The patient was an inmate of the Claybury Mental Hospital and was suffering from General Paralysis of the Insane. Malaria was induced for therapeutic purposes, and at first he responded with great promise. He was discharged from hospital for a month's trial at home, and in compliance with the above regulation the case was reported to this authority. Unfortunately the man relapsed shortly after returning home and had to be sent back to Claybury. Case B was a similar case under treatment in a special Hospital in this district. It was not notified and only became known through the death returns. Case C was a man who had recently returned from Africa, where he had had several attacks of Malaria. He was treated in the Hospital for Tropical Diseases, which is situated in this Borough, but the Notification was forwarded to the Sanitary Authority of his place of residence. Case D was only known on death and no details were obtainable. The man had no fixed abode or relatives. 83 DYSENTERY. Four cases were notified, all being described as suffering from the "Sonne" type of Dysentery. This is a mild form, bacteriological diagnosis is difficult, and under these circumstances it is obvious that there are many difficulties in the recognition of this particular type of Dysentery. All the above cases recovered completely. FOOD POISONING. Under the London County Council (General Powers) Act, 1932, Food Poisoning became a notifiable disease. The act requires that every medical practitioner attending on any person shall, if he suspects or becomes aware that such person is suffering from food poisoning, forthwith send to the Medical Officer of Health of the district in which such person is a notification certificate. This must include particulars of the food from which the patient has, or is suspected to have, contracted the illness. Unfortunately the term "Food Poisoning" has not been defined and many cases are notified which are probably only acute digestive troubles. Food poisoning became compulsorily notifiable on 12th July, 1932. From this date up to the end of the year 16 cases were notified, none of which were serious. It is too early to give a final opinion on the value of this Act; it would appear, however, that it requires some amendment in order to make the statistics in connection therewith accurate and the disease more clearly defined. MEASLES AND GERMAN MEASLES. These diseases were made compulsorily notifiable throughout the country in 1916 under the Public Health (Measles and German Measles) Regulations, 1915, but were revoked by the Ministry of Health in 1919. The St. Pancras Borough Council were satisfied as to the value of notification, and intimated to the Ministry the desire to continue the practice. This was granted, and notification became compulsory under the Metropolitan Boroughs of Lambeth and St. Pancras (Measles and German Measles) Regulations, 1920. Under these Regulations all cases are notifiable by parents and guardians, but only the first case occurring in an outbreak in a household or institution is notifiable by medical practitioners, an interval of two months since the last case constituting a new outbreak. The following details, tables and chart have been prepared by Dr. P. V. Pritchard, Assistant Medical Officer, and demonstrate several important and interesting facts about Measles. Table I. gives the gross figures as regards incidence and deaths. These may be misleading, and they have therefore been worked out in Table II. as Incidence and Mortality Rates. On Table III. these calculations are expressed by two graphs. The tendency for the disease to be prevalent in alternate years is very evident, especially when followed graphically. The third and fourth quarters of the year are usually comparatively free, but frequently a rise commences in December and is continued in the first, and generally, but to a less extent, in the second quarter. The wave in December is frequently seen just prior to an "epidemic year." The value of this knowledge is obvious. On the warning signs of a rise, the machinery to combat an epidemic is put to work in a more particular manner. Leaflets explaining the diagnosis, prevention and treatment of the disease are distributed through all schools, welfare centres, and similar institutions. Much of the time and energy of the staff is especially diverted to combat the spread, and the facilities for nursing the cases at home are increased. In 1927 the Fever Hospitals adopted the practice of 84 admitting cases of Measles. Previously Scarlet Fever had the preference, almost to the complete exclusion of Measles. During epidemic times, when there is a heavy demand for beds, cases of Scarlet Fever are only admitted on the recommendation of the Medical Officer of Health. Measles is considered to be a more serious disease now than Scarlet Fever. It has a higher Mortality Rate, and its complications are more numerous and often very serious and crippling. The Mortality Rate swings irregularly, but with a tendency to follow the curve of incidence and not coincide with it. In the 1928 Annual Report an investigation was made into the result of treatment at home and in institutions, and the mortality of cases treated at home was shown to be markedly less than that for cases removed either to Highgate or one of the Fever Hospitals. There are many factors to consider in this brief statement, but it is evident that, unless home conditions are bad, treatment is better there. Therefore, during epidemics cases are selected for institutional treatment rather on account of home conditions than the gravity of the attack of illness. An analysis of the age distribution demonstrates that Measles is most common between one and five years. It is not frequent in infancy and comparatively uncommon in adult life. In epidemic years the mortality rate is very high in infancy. The expected increase in the incidence of Measles occurred in 1932. The following tables and graph give the details. There were 2,865 notified cases. St. Pancras is one of the few Local Authorities which have made Measles and German Measles notifiable. Because of these measures and the routine "following up" we are able to maintain a strict supervision over the great majority of cases in the Borough. Every case which comes to the notice of this Department in the various ways indicated above, or through the School Authorities, is visited by a Health Visitor. Her visit has a double value. It gives her an introduction into many new families and enables her to spread the teaching of the rules of good health. She also is able to give the mother advice and help as regards the patient. Where actual nursing seems necessary for the case, this is arranged for by the Health Visitor and carried out by the staffs of the several nursing associations. Details of how this work is done under a Block Grant from the Borough Council is reported on page 41. Where a medical practitioner is in attendance a card is left for him, suggesting that, if he agrees that the circumstances show the desirability of a visiting nurse, this will be carried out under his instructions on receipt of the card duly signed. It is surprising how frequently doctors omit to take advantage of this very useful service. German Measles is not common, and generally is a mild disease. There were 65 cases during the year 1932, as compared with 68 cases during 1931. There were no deaths. 85 Table I. MEASLES. year. INCIDENCE. DEATHS. Quarter of the Year. Total. Under 1 year. 1—5 years. 5-15 years. Adults. Quarter of the Year. Total. Under 1 year. 1—5 years. 5—15 years. Adults. 1st 2nd 3rd 4th 1st 2nd 3rd 4th 1932 749 1901 162 53 2865 135 1592 1090 48 8 16 3 — 27 6 21 — — 1931 136 184 55 55 430 31 239 143 17 1 1 — — 2 1 1 — — 1930 1333 1933 172 38 3476 179 1857 1395 45 13 15 3 — 31 3 26 2 — 1929 257 241 58 35 591 28 198 284 81 5 2 — — 7 — 4 3 — 1928 2271 1474 102 29 3876 234 2143 1425 74 47 78 2 — 127 30 87 10 — 1927 32 143 98 144 417 40 230 131 16 — 2 2 1 5 " 5 — — 1926 2674 973 67 20 3734 260 2008 1421 45 33 30 J 1 65 25 38 2 — 1925 328 341 164 400 1233 61 454 643 75 — — 1 2 3 2 1 — — 1924 2363 1582 239 148 4332 256 2620 1375 81 35 31 7 1 74 15 54 3 2 1923 78 122 56 71 327 33 160 111 23 2 3 — — 5 1 4 — — 1922 2448 999 208 73 3728 287 1953 1425 63 75 29 2 1 107 15 81 10 1 1921 63 59 63 964 1149 86 496 544 23 — 1 3 19 23 7 15 1 — 1920 1580 1322 136 55 3093 177 1445 1387 84 31 30 3 1 65 21 38 5 1 1919 59 356 477 142 1034 53 487 453 41 — 4 9 2 15 4 8 3 — 86 Table II. MEASLES. Year. Incidence Rate per 1000 Population. Mortality Rate per 1000 Cases. Quarters of Year. Total. Quarters of Year.  1st 2nd 3rd 4th 1st 2nd 3rd 4th 1932 3.9 9.8 .8 .3 14.8 10.7 8.4 18.5 — 9.4 1931 .7 .9 .3 .3 2.2 7.4 5.4 — — 4.7 1930 6.5 9.5 .9 .2 17.1 9.7 7.8 17.5 — 8.9 1929 1.3 1.2 .3 .2 3.0 19.4 8.3 — — 11.8 1928 11.0 7.1 .5 .1 18.8 20.7 52.8 19.6 — 32.7 1927 .2 .7 .5 .7 2.0 — 13.9 20.4 7.0 12.0 1926 12.3 4.5 .3 .1 17.1 12.3 30.8 14.9 50.0 17.4 1925 1.5 1.6 .8 1.8 5.7 — — 6.1 5.0 2.4 MEASLES. TABLE III. . Incidence Rate per 1000 population ( (SeeTable II) o.. o Mortality Rate per 1000 cases. f Pa9e 86- 87 TUBERCULOSIS. Particulars of all new cases of Tuberculosis and of all deaths from this disease during 1932 are given in the following table in the form required by the Ministry of Health:— Age Periods. New Cases. Deaths. Pulmonary. Non-Pulmonary. Pulmonary. Non-Pulmonary. M. F. M. F. M. F. M. F. 0-1 — 1 1 — — 1 1 — 1-5 — 1 7 7 - — 2 4 5-10 2 — 7 8 — — 1 3 10-15 1 1 1 3 — — — — 15-20 12 16 5 3 1 12 1 — 20-25 26 30 6 8 9 4 1 3 25-35 37 34 10 7 13 17 2 2 35-45 36 20 2 3 18 7 1 — 45-55 37 12 2 1 29 8 — 1 55-65 38 8 1 — 30 3 — 1 65 & upwards 6 6 3 - 6 6 2 — Totals 195 129 45 40 106 58 11 14 The total number of Primary notifications was 331; in addition to these, 31 cases, which had not been notified, came to knowledge by means of special death reports, 43 cases by transfer from other districts, and 4 cases by posthumous notification. The total number of new cases during the year from all sources was therefore 409, equal to a notification rate of 2.11 per 1,000 of population. The total number of new cases during the previous year was 404. The deaths from all forms of Tuberculosis during the year numbered 189, equal to a death rate of 0 97 per 1,000 of population. The total number of deaths in the previous year was 206. It will be noted that, out of a total of 189 deaths from Tuberculosis, 35 were of cases which either died un-notified or were notified only at death. In a certain number of cases some misunderstanding had existed, and the medical attendant was under the impression that the case had been notified previously. 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. 88 The number of cases of Tuberculosis notified and those which came to knowledge by means of Death Reports and transfers from other Districts are given in the following tables :— Public Health (Tuberculosis) Regulations, 1930. Summary of Notifications during the period from 3rd January, 1932, to the 31s< December, 1932 (inclusive). Number of Notifications on Form A, Primary Notifications. Total Notifications (i.e.,including cases previously notified by other Doctors), Age Periods. 0 to 1 1 to 5 5 to 10 1o to 15 15 to 20 20 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 and upwards. Total. Pulmonary Males — — 1 1 10 23 30 23 32 31 4 156 216 Females 1 1 — 1 14 24 29 17 10 8 2 107 156 Non-pulmonary Males — 6 7 — 3 6 8 1 2 1 2 36 37 Females — 4 7 3 3 7 5 3 — — — 32 37 Totals 1 11 15 5 31 60 72 44 44 40 9 331 *446 *Exclusive of 9 " Lost sight of " cases returned. Information obtained from Special Death Reports, by Transfer from other districts, and by Posthumous Notifications. 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 — — 1 — 2 3 7 13 5 7 1 39 Females — — — — 2 6 5 3 2 — 4 22 Non- pulmonary Males 1 1 — 1 2 — 2 1 — — 1 9 Females — 8 1 — — 1 2 — 1 — — 8 Totals 1 4 2 1 6 10 16 17 8 7 6 78 89 The following table gives particulars as to the prevalence and fatality of this dis during the past 10 years : — Year. Estimated Population. Notifications. Deaths. Notification Bate. Death Bate. Pulmonary. Other forms. All forms. Pulmonary. Other forms. All forms. Pulmonary. Other forms. All forms. Pulmonary. Other forms. All forms. 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 l03 492 180 51 231 1.8o 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 1928 205600 353 102 455 191 25 216 1.72 0.50 2.21 0.93 0.12 I.0S 1929 203900 376 93 469 218 32 250 1.84 0.46 2.29 1.07 0.16 1.23 1930 203900 321 76 397 165 24 189 1.54 0.36 1.91 0.79 0.12 O.91 1931 195200 329 75 404 181 25 206 1.68 0.38 2.07 0.93 0.13 1.06 1932 194000 324 85 409 164 25 189 1.67 0.44 2.11 0.84 0.13 0.97 The table below shows the number of new cases and the number of deaths, together with the corresponding rates per 1,000 of population, for each Ward of the Borough during Tuberculosis (All Forms). Ward. New Cases. Deaths. Number. Bate per 1000 of Population. Number. Rate per 1000 of Population, 1 56 1.6 26 0.7 2 36 1.9 15 0.8 3 76 2.3 33 1.0 4 43 1.8 27 1.2 5 57 2.0 31 1.1 6 39 2.2 13 0.7 7 38 3.0 15 1.2 8 59 2.3 27 1.1 Homeless 0 — 2 Totals 409 2.1 189 1.0 90 Public Health (Tuberculosis) Regulations, 1930. These Regulations placed various additional duties upon local Authorities, and included the compilation of a register of cases of Tuberculosis of all kinds who are residents of the Borough. The following table gives this information for the year ended December 31st, 1932 : — Pulmonary. Non-Pulmonary. Total. Number of cases on the Register at the commencement of the year 1932 1294 393 1687 Number of new cases during the year 325 85 410 1619 478 2097 Number of cases removed from the Register during the year (from death or other causes) 342 82 424 Number of cases remaining on the Register at the end of the year 1257 396 1673 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. During the year 15 children have been boarded out under the scheme. Provision of Beds and Bedding for Necessitous Tuberculous Patients.—This valuable step was initiated by the Borough Council in 1924. Beds and bedding are lent to tuberculous patients who would otherwise be compelled to share a bed with another or other persons. They are much appreciated by those to whom they are lent and their use should help to limit the spread of infection. 91 The Health Visitors are instructed to make periodical visits and to report on their condition and the manner in which they are used. Disinfection of Room's. — This procedure is always advised on the admission of a case to Hospital or Sanatorium, on change of residence and after the death of a patient. It is carried out by the Council's staff free of charge. During the past year disinfection was carried out in 105 cases. Home Visits and Inquiries. This work is performed by two special officers, and the number of visits paid by each during the year is shewn in the following table:— Miss Camman .. 3590 „ Holland 3466 Total 7056 In connection with Tuberculosis, the housing conditions of the family are important. Any defects discovered on inspection are reported, and special efforts are made to secure more adequate accommodation if any degree of overcrowding exists. St. Pancras Tuberculosis Care Committee. The Care Committee was constituted in February, 1923, as a voluntary committee in accordance with the wishes of the Ministry of Health, and consists of representatives of various Social Organisations, the Public Assistance Committee, and ten members of the Borough Council, working in connection with the Tuberculosis Dispensary Scheme. The functions of this Committee were indicated in a circular issued by the Ministry of Health to be as follows:—"The primary duty of the Committee should be to consider the economic position of the family of every patient suffering from tuberculosis as soon as he comes within the purview of the dispensary scheme, and to render such advice and assistance as the circumstances of the case dictate, with a view to enabling the family to adjust their circumstances to the new conditions, to maintain their economic independence, and to derive the fullest possible advantage from the medical treatment prescribed. Certain kinds of assistance may be needed in particular cases, viz., additional food, change of air, clothing, better home conditions, more suitable occupation; the provision of financial or other assistance, when necessary, for the family of a patient who is under treatment in a residential institution, or temporarily for a patient and his family on his return home from such an institution. Where the necessity for financial assistance arises, it can be better provided through the agency of existing charitable or public organisations than from a fund administered by the Care Committee, and in such cases it should be the function of the Care Committee to bring the family into touch with the appropriate organisation. A subsidiary, but important, function is to undertake, on behalf of the London County Council, the assessment of charges made in respect of residential treatment afforded to children and to adults whose income exceeds a certain figure. It is important, however, to secure that the activities of Care Committees are not absorbed bv the routine work falling under this head, to the detriment of the main functions which are mentioned above." The Care Committee were fortunate in 1928 in securing the services of Miss Whelon as Hon. Secretary. Since her appointment, not only is the routine work ably and actively carried out, but, thanks to her energy and initiative, a large number of necessitous patients have been helped with clothing and other requisites in order to enable them to accept institutional treatment, and also to assist them when discharged from various institutions. 92 The following particulars concerning the work of the Committee and the cases dealt with have been supplied by the Hon. Secretary—Miss Whelon: — Tuberculosis Care Committee. Report for year 1932. "The Committee has continued to meet fortnightly during the year—the attendances being recorded hereunder:— Councillor Mrs. Alliston, Chairman 4 Dr. Back 24 Miss H. Hill 9 Miss Long, for Miss Bell (School Care 24 Commit tee) Mrs. Philipson 17 Councillor Trott, J.P. 8 Hon. Secretary 24 During the year Miss Emly and Miss Quarterman joined the Committee, representing the Metropolitan District Nursing Association, in place of Miss Wilmshurst. Total number of cases considered by the Tuberculosis Care Committee .. 194 36 cases were assessed at sums varying from 30s. to 1s. 6d. 143 cases were assessed as free from contribution. 15 cases were considered for Dentures. Of the 15 cases considered for Dentures, 6 were assessed at sums varying from 21s. to 2s., and 9 were assessed as free cases. Although the numbers under review vary very little from last year, a considerable amount of time has been devoted to Care work. It has been found necessary on several occasions to make exhaustive enquiries in connection with sickness benefits. Visits have been paid to H.M. Inspectors of the National Health Insurance Scheme, in relation to difficulties in connection with arrears of contributions. In two instances concessions were granted, which enabled patients to obtain past benefit and put them in full benefit for the ensuing year. It has also been found necessary to put patients in touch with the Public Assistance Committee when application has been made for complete outfits of clothing, and in each case sympathetic consideration and help has been given. The Hon. Secretary's working party has met regularly, and much valuable help in the making of garments has been given. During the year 134 garments have been provided for necessitous patients. The Committee is grateful for the co-operation and help of the Charity Organisation Society, Invalid Children's Aid Association, United Services Fund and other Societies. The Hon. Secretary acknowledges with gratitude a grant made during the year towards her clothing cupboard from the Eleanor Palmer Charity and St. Pancras Charities, which has enabled her to give a good deal more help in necessitous cases than otherwise would have been possible. In addition a grant of clothing was received from Princess Mary's Needlework Guild containing many useful garments for patients entering sanatoria. H. M. NVhelon, Hon. Secretary. 93 TUBERCULOSIS DISPENSARY. Nine consultations are held in each week—two in the morning, five in the afternoon, and two in the evening. The new premises provided by the Borough Council for use as a Tuberculosis Dispensary were opened in February, 1932. They are situated on the entrance floor of Barnes House, 9-15, Camden Road, and comprise a waiting room, two consulting rooms, laboratory, rooms for the nurse, health visitors, and clerical assistant, dressing rooms for the patients, and the necessary sanitary accommodation. The building is well adapted for the purpose and enables the work to be carried out under conditions better alike for both patients and staff. The X-ray work which is necessary in connection with patients suffering or suspected to be suffering from Tuberculosis is carried out at the University College Hospital. During the year consideration was given to the cost of this work, and as a result of negotiations with the hospital authorities the fees were reduced from 7s. 6d. per film and 7s. 6d. for a report to 7s. 6d. and 2s. 6d. respectively. The alteration came in force in March. Artificial Light Treatment. Provision as part of Tuberculosis Dispensary Service. The experimental arrangements which had been made by the London County Council for the provision of the above-mentioned form of treatment as part of the Tuberculosis Dispensary Service at certain approved hospitals and other centres in London expired on March 31st, 1929. It was decided that the arrangements should not be renewed, but the County Council state that they have decided to continue the existing arrangements for the treatment of lupus at the London Hospital on the basis of 5s. an attendance for treatment by Finsen lamp, and 1s. an attendance for general ultra violet light treatment; and at the St. Thomas's Hospital on the basis of payment of Is. an attendance for treatment by Kromeyer lamp, and to extend these arrangements to include any hospital providing the requisite facilities and approved for the purpose. Particulars of such hospitals will be communicated in due course. Report on the Work carried out at the Tuberculosis Dispensary. The following report on the work of the Dispensary has been furnished by the Tuberculosis Officer, Dr. Back:— "The total number of cases dealt with at the Dispensary shows no marked change from the previous year, though a somewhat higher proportion were found to be tuberculous, and there is a slight increase in the number on the register at the end of the year. Only 15 per cent. of the contacts of new cases attended, and only 3 of the contacts examined proved to be suffering from tuberculosis. The increased facilities for institutional treatment under the London County Council scheme for Public Assistance are reflected in the following figures. Altogether 394 applications for institutional treatment in respect of 361 patients were made during the year. Twenty-eight of these were for admission to Highgate Hospital and of the remaining 366, 250 were for sanatorium treatment, 78 for hospital treatment, and 38 for observation for diagnosis. Of these, 60 were admitted to Public Assistance Hospitals other than Highgate, 29 to sanatoria under the Public Assistance scheme and 259 to sanatoria and hospitals under the Tuberculosis scheme. Eleven applications only were referred back for treatment in the local hospital and 7 applications were withdrawn by patients. The number of attendances for artificial pneumothorax refills, for which the Council accepted financial responsibility, shows an increase, having risen from 112 to 348. Though this figure, for reasons given in the last report, may be expected to vary considerably from year to year, there are indications that the number of patients to whom this treatment is given is increasing. The results, which are at present being investigated by the London County Council, appear to be satisfactory. 94 On Friday, February 5th, the Tuberculosis Dispensary was closed at 39, Oakley Square and moved to Barnes House, Camden Road, where it was re-opened for patients on Monday, February 8th. The many advantages of the new premises include more hygienic construction, better appearance, more central position and increased accommodation, which provides for a second consulting room, a record room and separate rooms, instead of a single one for office and laboratory work. The additional convenience and efficiency made possible by these improvements have been much appreciated by patients and staff. G. A. BACK, M.B., B.CH., D.P.H." The following table gives a summary of the work carried out at the Tuberculosis Dispensary during the year :— Diagnosis. Pulmonary. Non-Pulmonary. Total. Gband Total. Adults. Children. Adults. Children. Adults. Children. M. P. M. F. M. F. M. F. M. P. M. P. A.—New Cases examined during the year (excluding contacts):— (a) Definitely tuberculous 111 70 2 3 14 18 7 8 125 88 9 11 233 (6) Diagnosis not completed — — — — — — — 14 16 5 3 38 (c) Non-tuberculous — — — — — — — — 57 73 38 20 188 B.—Contacts examined during the year:— (a) Definitely tuberculous — 3 — — — — — — 3 — — 3 (b) Diagnosis not completed — — — — — — — 1 1 — — 2 (c) Non-tuberculous — — — — — — — — 13 25 31 32 101 C.—Cases written off the Dispensary Register as— (a) Recovered 7 8 2 1 2 1 1 2 9 9 3 3 24 (6) Non-tuberculous (including any such cases previously diagnosed and entered on the Dispensary Register as tuberculous) — — — — — — — — 79 105 72 62 308 D.—Number of Cases on Dispensary Register on December 31st:— 352 219 11 9 41 45 36 38 393 264 47 47 751 (b) Diagnosis not completed — — — — — — — — 24 26 7 6 63 1. Number of cases on Dispensary Register on 7. Number of consultations with medical practi- January 1st 809 tioners:— 2. Number of cases transferred from other areas and (a) Personal 12 cases returned after discharge under Head 3 (b) Other 210 in previous years 69 8. Number of visits by Tuberculosis Officers to 3. Number of cases transferred to other areas, homes (including personal consultations) 81 cases not desiring further assistance under the 9. Number of visits by Nurses or Health Visitors scheme, and cases " lost sight of " 202 to homes for Dispensary purposes 4330 4. Cases written off during the year as Dead (all 10. Number of— causes) 95 (a) Specimens of sputum, &c., examined 525 5. Number of attendances at the Dispensary (in- (b) X-ray examinations made in connection eluding Contacts) 3121 with Dispensary work 101 6. Number of Insured persons under Domiciliary 11. Number of "Recovered" cases restored to Treatment on the 31st December 492 Dispensary Register, and included in A (a) and A(b) above — 12. Number of " T.B. plus " cases on Dispensary Register on 31st December ... ... 392 95 Section VII—OTHER SERVICES. DISINFECTING AND CLEANSING STATION. These buildings are situated in Cambridge Street, at the rear of St. Pancras Gardens. Extensive internal alterations authorised by the Council were carried out during 1929 and resulted in a gratifying improvement in the facilities and amenities connected with these buildings. Disinfection. In connection with cases of infectious disease, bedding, clothing, etc., are disinfected by steam under pressure at the Council's Disinfecting Station, Cambridge Street. No charge is made. Library books and articles which would be injured by steam are disinfected by formaldehyde generated in a small chamber. Separate motor vans are used for the collection of infected and delivery of disinfected articles. The work done during the year by the disinfecting staff is shown in the following table:— Disease. No. of cases. No. of bouses. No. of rooms contents disinfected or destroyed. No. of rooms sprayed and fumigated. Small-pox 7 7 10 10 Scarlet Fever 511 506 525 528 Diphtheria 28 280 287 288 Enteric Fever 8 8 8 8 Erysipelas 97 97 91 96 Puerperal Fever aud Pyrexia 7 7 6 7 Encephalitis Lethargica — — — — Polio-myelitis 1 1 — 1 Cerebro-spinal Meningitis 9 9 9 9 Pneumonia 6 6 2 6 Tuberculosis 105 105 58 96 Measles 42 42 22 42 Vermin and Scabies 184 183 172 193 Other Diseases 364 364 832 392 Totals 1622 1615 1517 1676 96 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 58 1468 7 179 Bolsters and pillows 62 3554 2 188 Sheets, blankets and counterpanes 22 4963 — 258 Rugs, mats, cushions, carpets, covers and curtains 22 992 — 69 Wearing apparel 10 2323 1 62 Books ... — 152 — 1 Sundries 40 494 2 9 Totals 214 13946 12 766 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. Disinfection for Institutions, etc.—In addition to the disinfecting work carried out free of charge in connection with infectious disease, disinfections for other conditions are frequently performed for hospitals or private residents. A small charge is made in these cases to cover the cost. The fees received for this work during the year ended 31st March, 1933, amounted to £83 2s. 6d. 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. Total. Vermin 1025 27 4517 *5569 Scabies 116 110 1480 1706 Infectious Disease Contacts 5117 Totals 1146 138 5998 7282 * Includes 528 males and 1 female who had no home address. The staff of the Disinfecting and Cleansing Station consists of a Foreman, a Disinfector and two Motor Drivers and Disinfectors; a Matron of the Cleansing Station and one Woman Assistant. The majority of the children included in the above table have been brought to the cleansing station from the public elementary schools by officers of the London County Council. 97 As the Education Authority, powers were conferred upon them by the London County Council (General Powers) Act, 1907, and the Children Act, 1908, authorising the cleansing of children whose bodies or clothing were infested with vermin, or who were in a foul or filthy condition. The necessary cleansing work is carried out by the staff of the Borough Council on behalf of the County Council. Payment is made by the latter at the rate of two shillings per child in respect of verminous conditions, and one shilling per bath for those suffering from scabies. In connection with children whose bodies or clothing are very verminous, arrangements are made for the homes to be visited by the Sanitary Inspector, as the rooms and bedding may also need disinfesting. It would obviously be useless to deal with the child and neglect the home. BACTERIOLOGICAL WORK. To aid in diagnosis and to detect contact or carrier cases, the Borough Council provides bacteriological diagnosis, free of charge, in connection with certain diseases. In addition to the above, the preparation and supply of vaccines is undertaken, if desired by the medical attendant, for use in connection with cases of Puerperal Fever. This work is performed by Professor F. H. Teale, m.d., of University College Hospital, under an arrangement made with the Council. The undermentioned examinations were made during the year:— Nature of Specimen. Positive. Negative. Total. Swabs for Diphtheria Bacilli 106 1232 1338 Blood for Typhoid Fever 2 — 2 Faeces for ,, — 2 2 Faeces for Tubercle Bacilli — 1 1 Sputum for ,, 59 390 449 In addition to the above a "sterile maternity outfit" was examined. Some of the items in the outfit were found to contain non-pathogenic organisms, showing that the term "sterile" was not strictly correct. The matter was taken up with the firms concerned and the technique of preparation reorganised with a satisfactory result. 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. Table No. 1. VITAL STATISTICS OF WHOLE DISTRICT OF ST. PANCRAS DURING 1932 AND PREVIOUS YEARS. Year. Population estimated to middle of each Year. Civil Population. Births. Total Deaths Registered in the District. Transferable Deaths Nett Deaths belonging to the District. Uncorrected Number. Nett of Nonresidents registered in the District. of Residents not registered in the District. Under 1 Year of Age. At all Ages. Number. Rate. Number. Rate per 1,000 Nett Births. Number. Rate. Number. Rate. 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 130† 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† 1928 206000 205600 3980 3274 15.9* 3053 14.8† 985 550 261 80 2618 12.7† 1929 204400 203900 4231 3170 15.5* 3505 17.2† 1005 626 262 83 3126 15.3† 1930 204400 203900 4660 3208 15.4* 2928 14.1† 999 549 194 60 2478 11.9† 1931 195600 195200 4483 2955 15.1* 2979 15.3† 933 555 200 68 2601 13.3† 1932 194000 — 4224 2684 13.8 2832 14.6 937 650 186 69 2545 13.1 Area of district in acres (land and inland water), 2694; total population at all ages, 198,133; number of inhabited houses, 24,980; average number of persons per house, 7.93; at Census, 1931. *Based on total population. † Based on civil population. 100 101 Table No. 2. REGISTRAR-GENERAL'S SHORT LIST OF THE CAUSES OF DEATH AT DIFFERENT PERIODS OF LIFE IN THE METROPOLIAN BOROUGH OF ST. PANCRAS, 1932. 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 35 years. 35 and under 45 years. 45 and under 55 years. 55 and under 65 years 65 and under 75 years. 75 years and upwards. all causes M 1321 106 28 10 18 38 59 77 161 269 322 233 F 1238 82 29 18 26 41 58 71 99 193 284 334 1. Typhoid and Paratyphoid Fevers M 1 — — — — 1 — — — — — — F 1 — — — — — — — — — 1 — 2. Measles M 14 3 10 1 — — — — — — — — F 13 3 7 3 — — — — — — — — 3. Scarlet Fever M 3 — — 1 2 — — — — — — — F 2 — — 1 1 — — — — — — — 4. Whooping Cough M 11 6 2 3 — — — — — — — — F 14 5 4 4 1 — — — — — — — 5. Diphtheria M 3 1 — — — — — — — — — — F 7 — 2 — 4 1 — — — — — — 6. Influenza M 16 — — — 2 3 2 — 2 4 1 2 F 27 2 — — — — 2 — 2 5 6 10 7. Encephalitis Lethargica M 1 — —_ — — — — — 1 — — — F 1 — — — 1 — — — — — — — 8. Cerebro spinal Fever M 2 — — — — 1 1 — — — — — F 4 2 — 1 — 1 — — — — — — 9. Tuberculosis of Respiratory System M 108 — — — - 10 15 18 29 30 5 1 F 58 1 — — - 16 17 7 8 3 3 3 10. Other Tuberculous Diseases M 11 1 1 1 1 2 2 1 — — 2 — F 14 — 2 2 3 3 2 — 1 1 — - 11. Syphilis M 15 2 — — — — — 3 5 2 3 - F 3 — — — — 1 — — — 2 — — 12. General paralysis of the insane, tabes dorsalis M 21 — — — — — 1 3 8 5 3 1 F 4 — — — — — 1 1 1 1 — — 13. Cancer, Malignant Disease M 172 — — — — — 3 8 21 51 67 22 F 194 — — — — 1 3 18 30 45 64 33 14. Diabetes M 7 — — — — — — — 1 2 — 4 f 15 — — — — 1 — — — 3 11 - 15. Cerebral Hemorrhage, etc. M 39 — — — — — — 1 2 6 19 11 F 25 — — — — 1 1 — 2 3 8 10 102 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 35 years. 35 and under 45 years. 45 and under 55 years. 55 and under 65 years. 65 and under 75 years. 75 years and upwards. 16. Heart Disease M 308 — — — — 2 2 7 28 68 107 94 F 292 — — — 4 4 5 12 13 53 84 117 17. Aneurysm M 9 — — — — — — — 3 4 2 — F 7 — — — — 1 — — 1 2 2 1 18. Other Circulatory Diseases M 41 — — — — — — 1 3 15 13 9 F 66 — — — — — — 1 2 11 25 27 19. Bronchitis M 51 3 — — — — — 1 4 11 14 18 F 46 1 — — — — — 1 2 6 10 26 20. Pneumonia (all forms) M 98 19 7 1 — 1 4 7 17 13 18 11 F 87 13 5 4 3 2 1 5 8 13 12 21 21. Other Respiratory Diseases M 17 1 1 1 — 2 2 1 — 5 1 3 F 10 — 2 — — — 2 1 — 1 1 3 22. Peptic Ulcer M 24 — — — — — 2 3 9 5 5 — F 7 — — — — — — — — 3 4 — 23. Diarrhœa, etc. M 38 33 3 — — — 1 1 — — — — F 22 19 1 — — 1 1 — — — — — 24 Appendicitis M 11 — 1 — 1 1 2 — 2 3 1 — F 4 — — — — 1 — 1 — 1 1 — 25. Cirrhosis of Liver M 2 — — — — — — — 1 1 — — F 4 — — — — — — — 1 — 2 1 26. Other Diseases of Liver, etc. M 3 — — — — — — — — — 2 1 F 5 — — — — — 1 — 1 — 1 2 27. Other Digestive Diseases M 33 2 2 1 2 2 1 3 11 6 3 F 27 1 — 1 5 — 1 4 2 3 6 4 28. Acute and Chronic Nephritis M 35 — — — 2 — 3 3 2 6 12 7 F 34 — — — — 3 — 1 3 8 9 10 29. Puerperal Sepsis F 9 — — — — 3 6 — — — — — 30. Other Puerperal Causes F 5 — — — — — 3 2 — — — — 31. Congenital Debility, Premature Birth, M 30 30 — — — — — — — — — — Malformations, etc. F 29 29 — — — — — — — — — — 103 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 35 years. 35 and under 45 years. 45 and under 55 years. 55 and under 65 years. 65 and under 75 years. 75 years and upwards.   32. Senility M 30 — — — — — — — — — 3 27 F 45 — — — — — — — — 1 3 41 33. Suicide M 27 — — — — — 3 5 10 7 2 — F 14 — — — — — 4 3 5 1 1 — 34. Other violence M 47 1 — 2 3 9 7 5 4 2 9 5 F 31 1 1 1 1 1 3 1 3 4 4 11 35. Other defined Diseases m 93 4 1 — 4 4 7 8 6 18 27 14 F 112 5 5 1 3 3 5 13 14 23 26 14 36. Causes ill-defined or unknown m — — — — — — — — — — — — F — — — — — — — — — — — — Legitimate. Illegitimate. M 95 11 Deaths under 1 year F 66 16 104 Table No. 3. Total Births, Total Deaths, Infantile Deaths, and Deaths from Tuberculosis, with corresponding rates for each ward. Births and 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. Rate. No. Rate. No. Rate. 1 472 13.4 424 12.1 35 74 26 0.7 2 310 16.1 225 11.7 12 39 15 0.8 3 525 16.2 422 13.0 32 61 33 1.0 4 346 14.8 359 15.3 21 61 27 1.2 5 375 13.3 370 13.1 35 93 31 1.1 6 257 14.6 180 10.2 12 47 13 0.7 7 126 9.9 168 13.2 11 87 15 1.2 8 273 10.8 347 13.8 25 92 27 1.1 Homeless — — 50 — 3 — 2 — Borough 2684 13.8 2545 13.1 186 69 189 1.0 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 1932. (52 weeks ended 31st December, 1932.) Estimated Population, Mid. 1932. Birth Rate. Death Rate. Infantile Mortality, Estimated Population, Mid. 1932. Birth Rate. Death Rate. Infantile Mortality. England and Wales 40,201,000 15.3 12.0 65 County of London 4,357,800 14.3 12.3 67 Birmingham 1,009,300 16.3 11.4 68 West. Liverpool 859,500 21.1 13.2 91 Paddington 143,600 13.8 13.3 107 Manchester 763.000 15.5 13.2 86 Kensington 183,500 12.9 13.6 98 Sheffield 513,000 14.4 11.7 73 Hammersmith 133,700 14.5 12.8 66 Leeds 484,900 14.4 13.3 88 Fulham 149,600 14.3 12.4 58 Bristol 403,900 15.0 11.6 53 Chelsea 59,430 11.9 12.9 52 Kingston-upon Hull 318,200 19.2 11.8 68 City of Westminster 126,400 9.3 12.5 67 Bradford 296,300 13.6 14.0 75 North. West Ham 289,300 17.2 11.5 72 St. Marylebone 96,430 10.9 13.1 87 Newcastleon-Tyne 285,100 17.1 12.4 76 Hampstead 90,130 10.9 11.6 54 Stoke-on-Trent 276,500 17.2 12.2 87 St. Pancras 194,000 14.0 13.2 69 Nottingham 270,700 16.4 12.5 80 Islington 319,100 16.0 12.7 68 Portsmouth 253,100 16.2 12.3 60 Stoke Newington 51,680 15.0 12.9 54 Leicester 240,800 14.9 12.5 70 Hackney 214,200 14.5 11.5 54 Croydon 237,300 14.0 10.8 49 Central. Cardiff 222,600 15.7 12.5 76 Holborn 36,440 9.6 14.2 72 Salford 220,300 15.7 13.3 97 Finsbury 69,030 16.0 13.4 88 Plymouth 208,440 15.6 12.6 59 City of London 9,990 6.5 12.8 46 Sunderland 188,200 21.2 13.7 95 East. Willesden 186,800 15.4 9.9 59 Shoreditch 95,800 17.5 12.8 80 Coventry 179,800 18.7 9.7 71 Bethnal Green 106,300 15.4 12.1 69 Bolton 177,700 13.4 12.6 70 Stepney 223,000 16.8 12.5 60 Southampton 177,470 17.2 12.1 54 Poplar 152,400 17.2 12.1 63 Swansea 164,900 16.3 12.0 69 South. Tottenham 156,800 14.1 10.1 51 Southwark 168,900 16.2 13.1 72 Birkenhead 147,700 17.7 11.6 70 Bermondsey 110,100 16.6 12.1 57 Brighton 145,500 13.0 13.9 41 Lambeth 292,300 14.8 12.5 56 Derby 142,400 14.5 11.6 70 Battersea 157,000 14.8 12.1 58 East Ham 141,500 14.6 10.3 54 Wandsworth 353,300 11.8 11.6 63 Rhondda 140,850 17.0 12.5 71 Camberwell 248,000 14.6 12.0 65 Middlesbrough 140,000 20.3 12.9 85 Deptford 105,100 15.9 12.3 65 Oldham 138,900 12.9 14.1 83 Greenwich 99,590 14.8 12.0 81 Ilford 137,480 14.5 8.5 40 Lewisbam 221,500 12.7 10.2 55 Walthamstow 135,010 13.3 10.0 58 Woolwich 146,900 14.0 11.1 60 Wolverhampton 133,300 16.4 11.6 61 Leyton 127,140 13.1 10.5 53 Stockport 126,800 12.6 12.7 72 Norwich 126,600 14.7 12.1 56 105 Table No. 5.—Meteorological Table for Saint Pancras, 1932. (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.) 30.235 30.474 29.990 29.771 29.871 30.085 29.904 30.098 29.931 29.717 30.101 30.115 Air Temperature— Mean of— A. Maximum 48.4 42.6 49.2 52.6 60.7 69.2 71.0 76.9 65.4 55.8 49.0 46.7 B. Minimum 40.0 33.4 34.7 40.4 47.2 51.7 56.8 59.0 51.8 14.3 41.4 39.5 Mean of A and B 44.2 38.0 41.9 46.5 53.9 60.5 63.9 67.9 58.6 50.1 45.2 43.1 Difference from Average +5.4 —2.0 —1.0 —1.9 —1.2 —0.5 —0.4 +4.7 0.0 -0.6 +0.9 +2.6 Humidity—Morning 89.3 87.1 80.9 78.4 78.2 69.2 74.4 77.3 83.4 84.5 87.8 88.9 Earth Temperature at 4 ft. depth 456 43.5 41.9 44.2 47.8 53.0 57.6 — 59.5 54.8 50.9 47.2 Bright Sunshine— Total Observed (daily mean) Hrs. 1.30 2.26 4.27 3.59 3.60 7.06 4.60 6.11 3.22 2.93 1.01 1.40 Per cent. of total possible 16 23 36 26 24 43 29 42 26 27 11 18 Difference from average Hrs. — — — — — — — — — — — — Rain and other forms of precipitation— Number of Days 13 6 12 23 23 4 12 8 20 23 17 6 Total Fall Ins. 1.60 0.27 1.52 2.28 3.76 0.70 1.93 1.57 2.56 5.25 1.38 0.47 Difference from average ,, —0.24 —1.38 —0.32 +0.75 +1.97 —1.30 —0.47 —0.63 +0.75 +2.60 —0.98 —1.93 106 Hour of observation, 9 a.m. (Greenwich time). The readings for Bright Sunshine are those taken at Hampstead—no readings being recorded at Camden Square. 107 Table No. 6.—Report of Work carried out by District Inspectors for the year 1932. Lonnon. Brown. Walker. James. Adkins. Akers. Jaffa. Capel. Nixon. West. winchester Totals. Complaints received, 2,955. Complaints Investigated. Whole house inspected 6 51 16 50 75 55 14 60 29 5 1 362 ,, Re-inspections 19 518 49 127 225 120 42 398 87 17 7 1609 ,, Part of house inspected 381 275 264 246 288 160 384 152 202 285 312 2949 ,, Re-inspections 671 941 788 546 658 425 850 471 864 1266 1116 8596 Infectious Diseases Investigations 231 137 186 156 219 99 223 189 155 156 176 1924 Inspections 123 78 32 113 143 31 135 41 79 55 40 870 Re-inspections 615 226 8 216 179 193 — 212 94 71 38 1852 Smoke Observations 6 — 30 13 45 22 187 53 17 32 — 405 Offensive or Regulated Trades — — — — 2 — — — — 44 1 47 Mews and Stable Yards—Number inspected 413 311 292 305 288 516 289 293 425 282 306 3719 Verminous Persons 7 — — — — — — — — — 10 17 Other Inspections and Re-inspections 32 10 23 30 64 46 300 152 — 32 187 876 Housing Acts and Regulations, 1925 and 1930. Number of Houses Inspected Primary Inspections 10 34 29 205 10 22 163 22 12 5 16 528 Re-inspections 2 228 83 733 17 111 313 192 187 32 71 1969 Underground rooms 1 3 1 1 19 — — 1 1 2 6 35 Houses let in Lodgings (Bye-laws, Sec. 6). Number of Houses Inspected Primary Inspections 14 71 79 106 24 52 118 67 84 12 80 707 Re-inspections 22 585 440 868 76 402 290 376 444 78 601 4182 Drainage. (a) Under Notice, Plans, Supervision, etc. 254 345 164 240 404 283 186 149 143 138 114 2120 (i) Voluntary, do. do. 499 337 974 410 1092 1065 232 645 244 932 217 6647 (c) New Buildings, do. do. 314 135 52 109 175 439 2 269 299 334 524 2652 Attendances at Police Court, etc. 2 2 1 5 — 2 1 2 4 2 2 23 Rent Restrictions Acts — 18 10 10 — — 8 4 4 4 — 58 Totals 3622 4305 3521 4489 4003 4043 3734 3747 3374 3784 3825 42447 Notices served;— Intimations 172 395 217 446 319 190 391 281 307 226 391 3335 R.R.A. — 5 6 3 — — 3 2 3 3 — 25 Totals 172 400 223 449 319 90 394 283 310 229 391 3360 108 Table No. 7.—Inspections and other work of the Food Inspectors during 1932. Mr. Auger. Mr. Child. Total.  Number of Visits to:— Milkshops 354 244 598 Dairies 91 65 156 Cowsheds — — — Ice Cream Premises 106 148 254 Slaughter Houses 28 82 110 Butchers' Shops and Meat Stalls 1285 958 2243 Prepared Meat Premises 28 339 367 Fishmongers' Shops 18 30 48 Fried Fish Shops 158 167 325 Fish Curers' premises 31 69 100 Other Premises where Food or Drugs are sold 31 44 75 Marketing Streets and Places 2245 1146 3391 Attendances at Police Court 8 19 27 Other Visits 218 111 329 Re-inspection after Intimation Notices 4 — 4 Total 4605 3422 8027 Number of Samples taken:— Formal 166 297 463 Informal 239 99 338 Total 405 396 801 Unsound Foods. Surrenders:— †Meat, &c. 4 11 15 Fish 5 2 7 Shell Fish — 1 1 Fruit 3 — 3 Vegetables — 2 2 Yeast — 1 1 Total 12 17 †29 Seizures:- 1 1 2 Canal Boats inspected — — — Notices Served 1 — 1 *See page 70. † In addition the destruction of a surrendered consignment of turkeys was supervised by Mr. Lonnon. 109 Table No. 8. Report of Work carried out by the Factory and Workshop Inspectors during the year 1932. Inspections and Re-Inspections. Thompson. Bibby. Totals. Factories (including factory laundries and bakehouses) 1919 442 2361 Workshops (including workshop laundries and bakehouses) 1547 401 1948 Workplaces (including restaurant kitchens) 591 535 1129 Outworkers' premises — 1734 1734 Other Visits — 99 99 Totals 4060 3211 7271 Notices served relating to:— Factories 178 19 197 Workshops 91 45 136 Workplaces 46 11 57 Others — — — Totals 315 75 390 Table No. 9. Report of Work carried out by Centre Superintendents, Women Inspectors and Health Visitors during the year 1932. Bristow. Crockart. LandelJones. Smyth.* Templeton. Anderson. Blaxland. Camman. Holland. Hunter. Blair. Chapman. Manger. Robinson. Bagnall. Bruce. Clarke. Harris. Harrop. Lurie. Lynn. Smith. Totals. Infants. Under 1 First Visits 71 2 — — — 134 148 — — 110 216 7 98 148 203 233 93 166 157 218 179 138 2321 Subsequent 395 20 3 — 6 313 761 — — 383 475 37 391 520 853 831 660 397 471 610 569 559 8254 „ 1-2 First Visits 5 — — — — 12 1 — — 18 12 1 2 15 6 2 2 11 10 4 6 4 111 Subsequent 307 4 — — 2 285 343 — — 292 240 21 208 283 337 404 469 182 290 472 335 330 4804 „ 2-5 First Visits — — — — — 19 5 — — 17 3 — — 13 9 4 — 6 8 6 5 1 96 Subsequent 405 3 — — 24 501 528 — — 692 324 43 106 416 229 496 481 283 423 498 392 484 6328 Expectant Mothers First Visits 57 13 — — — 89 111 — — 72 89 15 36 69 200 80 55 123 120 70 124 64 1387 Subsequent 93 — — — — 17 105 — — 91 25 15 66 33 331 133 77 42 65 105 37 21 1261 Measles 80 19 — — 10 170 186 — — 141 199 — 80 168 92 361 140 146 209 272 185 189 2647 German Measles 8 — — — — 7 6 — — 7 3 — 3 9 1 3 3 3 2 — 3 1 59 Whooping Cough 32 — — — — 27 23 — — 54 5 1 5 31 10 38 2 8 49 33 39 15 372 Ophthalmia Neonatorum 11 — — — — 16 3 — — 7 11 — 6 3 4 6 2 4 8 4 12 1 98 Puerperal Fever 1 — — — — 1 1 — — 1 3 — 1 2 — — — — 1 1 5 2 19 ,, Pyrexia 1 — — — — 2 5 — — 6 2 1 2 4 1 2 — 3 4 3 8 3 47 Tuberculosis. Dispensary Cases — — — — — — — 1834 2496 — — — — — — — — — — — — — 4330 „ Others — — — — — — — 1756 970 — — — — — — — — — — — — — 2726 Other diseases 50 — — — 1 94 58 — — 118 27 5 2 46 9 107 6 24 162 62 108 67 946 Milk Enquiries 3 2 — — — — 13 — — 5 5 — 1 11 7 1 2 3 3 1 2 4 63 Consultations and Classes attended 120 279 227 36 231 80 127 — — 118 184 213 214 116 135 179 164 185 218 172 196 187 3381 Other Visits 165 281 4 1 45 628 166 — — 808 338 77 183 203 473 127 315 455 610 127 643 293 5942 Totals 1804 623 234 37 319 2395 2590 3590 3466 2940 2161 436 1404 2095 2900 3007 2471 2041 2810 2658 2848 2363, 45192 *7 weeks only. Retired 31st January, 1932—3 weeks' temporary service afterwards. 110 SPECIAL APPENDIX. HOUSING IN METROPOLITAN BOROUGHS. Administrative Area. Increase or Decrease (—) in Occupied Dwellings. Increase or Decrease (—) in Private Families. *Vacant Unfurnished Dwellings, 1931. Average Size of Occupied Dwellings (Rooms). Average Family Occupation (Rooms). Families per Occupied Dwellings. Average Size of Private Family (Persons). Average Persons per Room. More than 2 per room Density. Private Families, 1931. Population. 1931. 1921. No. p.c. No. p.c. No. p.c. 1931. 1921. 1931. 1921. 1931. 1921. 1931. 1921. 1931. 1921. No. p.c. No. p.c. No. p.c. London Administrative County 29,593 4.22 69,133 6.17 11,390 1.52 5.75 5.85 3.53 3.62 1.63 1.60 3.46 3.79 0.98 1.05 89,600 7.5 541,352 13.1 683,498 16.1 25 1.03 3.52 3.70 3.32 3.38 1.06 1.09 3.04 3.31 0.91 0.98 76 3.0 424 5.6 689 6.6 City of London —563 —19.27 —675 —21.27 Battersea 28 0.10 1,630 3.79 216 0.78 5.81 5.86 3.54 3.66 1.64 1.58 3.47 3.82 0.98 1.04 3,023 6.8 18,476 11.9 20,390 12.4 Bermondsey 39 0.21 156 0.55 62 0.34 4-.73 4.80 3.01 3.05 1.57 1.57 3.77 4.08 1.25 1.34 3,839 13.3 23,671 21.8 27,064 23.8 Bethnal Green —125 —0.68 320 1.16 87 0.48 4.32 4.28 2.81 2.83 1.54 1.51 3.79 4.14 1.35 1.46 4,023 14.4 24,969 23.6 31,692 27.8 Camberwell 695 1.68 2,331 3.53 404 0.95 6.02 6.06 3.70 3.76 1.62 1.60 3.55 3.93 0.96 1.04 4,029 5.9 25,331 10.4 33,321 12.8 Chelsea 104 0.96 —223 —1.35 543 4,54 6.07 6.29 4.07 4.07 1.49 1.52 3.29 3.46 0.79 0.85 889 5.4 5,365 10.2 7,859 13.7 Deptford —125 -0.70 1,241 4,43 121 0.68 5.96 5.98 3.62 3.76 1.65 1.57 3.56 3.93 0.98 1.05 1,862 6.4 11,426 11.0 14,122 12.8 Finsbury —520 —4.78 —9 46 —4.73 98 0.93 4.59 4.67 2.50 2.48 1.84 1.84 3.54 3.72 1.42 1.50 3,313 17.4 19,847 29.4 25,350 34.0 Fulham 266 1.02 2,717 6.72 297 1.11 5.73 5.75 3.48 3.65 1.64 1.56 3.38 3.82 0.97 1.05 2,454 5.7 15,398 10.5 20,265 13.1 Greenwich 1,588 9.61 2,172 9.45 166 0.90 5.51 5.70 3.97 4.07 1.39 1.39 3.74 4.10 0.94 1.01 1,597 6.4 10,428 11.1 13,008 13.8 Hackney Hackney 660 1.97 3,123 5.57 408 1.18 6.11 6.17 3.53 3.66 1.73 1.67 3.53 3.86 1.00 1.06 3,264 5.5 20,098 9.6 24,859 11.5 Hammersmith 2,840 14.59 4,082 12.27 263 1.16 5.67 6.09 3.39 3.53 1.67 1.71 3.43 3.67 1.01 1.04 2,192 5.9 12,993 10. 2 16,868 13.8 Hampsted 436 3.04 21,189 10.1 7 527 3.40 7.59 7. 96 4.72 5.23 1.61 1.50 3.32 3. 72 0.70 0.71 577 2.4 3,253 4.1 5,243 6.5 Holborn —317 —4.88 —327 —3.38 121 1.87 4.15 4.35 2.74 2.78 1.51 1.49 2.94 3.12 1.07 1.12 837 8.9 4,718 17.1 5,977 19.8 Islington 1,072 2.55 4,189 4.68 358 0.82 6.41 6.54 2.95 3.04 2.17 2.12 3.30 3.59 1.12 1.18 8,587 9.2 49,449 16.0 62,436 19.4 Kensington 1,193 4.29 4,712 10.96 1,249 4.02 6.80 7.09 4.13 4.52 1.65 1.55 3.32 3.68 0.80 0.81 3,462 7.3 19,985 12.6 26,456 16.7 Lambeth 189 0.39 5,378 6.86 538 1.08 5.95 5.88 3.47 3.62 1.71 1.61 3.35 3.69 0.97 1.02 5,008 6.0 29,652 10.6 36,644 12.7 Lewisham 12,319 35.79 14,988 34.31 590 1.24 5.63 6.21 4.48 4.85 1.26 1.27 3.65 3.90 0.81 0.80 1,225 2.1 8,427 4.1 8,236 4.7 Paddington —152 —0.78 2,394 6.25 592 2.94 7.24 7.53 3.43 3.70 2.11 1.97 3.08 3.43 0.90 0.93 2,743 6.7 15,427 12.1 20,236 15.4 Poplar 276 1.20 1,613 4.33 221 0.94 5.14 5.18 3.08 3.20 1.67 1.62 3.85 4.19 1.25 1.31 4,704 12.1 30,102 20.1 33.104 21.2 St. Marylebone 438 2.56 138 0.51 1,104 5.69 5.90 6.14 3.79 3.79 1.56 1.59 3.09 3.33 0.81 0.88 1,950 7.1 11,098 13.1 16,159 17.9 ST. PANCRAS 320 1.30 276 0.49 349 1.36 6.34 6.57 2.78 2.83 2.28 2.30 3.13 3.45 1.13 1.22 5,521 9.7 31,402 17.6 43,687 22.4 Shoreditch -49 —0.36 —289 —1.14 155 1.12 4.78 4.82 2.60 2.59 1.83 1.85 3.77 4.00 1.45 1.54 4,627 18.4 27,537 29.1 32,452 32.0 Southwark —1,657 —5.75 —355 —0.76 167 0.61 4.73 4.52 2.77 2.78 1.71 1.62 3.54 3.79 1.28 1.36 5,903 12.7 35,517 21.6 4 1,574 23.5 Stepney —1,113 —3.03 -1,175 —2.10 389 1.08 4.53 4.49 2.96 2.95 1.53 1.52 3.92 4.26 1.33 1.45 8,204 15.0 50,420 23.6 68,921 29.0 Stoke Newington —127 —1.53 978 7.02 150 1.79 6.74 6.73 3.70 3.97 1.82 1.67 3.32 3.66 0.90 0.92 544 3.6 3 ,242 6.6 4,137 8.1 Wandsworth 9,026 14.43 14,857 18.45 1,000 1.37 5.89 6.02 4.42 4.63 1.33 1.29 3.50 3.91 0.79 0.84 2,670 2.8 17,336 5.2 21,325 6.8 Westminster —970 —4.13 —890 —2.62 859 3.49 5.90 6.09 4.02 4.09 1.47 1.44 3.07 3.31 0.76 0.81 1,230 3.7 7,223 7.1 11,364 10.1 Woolwich 3,822 14.67 4,529 13.46 331 1.09 5.22 5.26 4.09 4.05 1.28 1.29 3.61 3.92 0.88 0.97 1,247 3.3 7,809 5.7 10,270 7.8 Range of Maximum 35.79 34.31 — 5-69 7.59 7.96 4.72 5.23 2.28 2.30 3.92 4.26 1.45 1.54 — 18.4 — 29.4 — 34.0 Variation Minimum — —19.27 — —21.27 .— 0.34 3.52 3.70 2.50 2.48 1.06 1.09 2.94 3.12 0.70 0.71 — 2.1 — 4.1 — 4.7 *As ascertained from external inspection during the enumeration. 112 POPULATION and Intercensal Variations.— ADMINISTRATIVE COUNTY and METROPOLITAN BOROUGHS. District Population Increase or Decrease (—) 1911. 1921. 1931. 1911-21. 1921-1931. Persons. Persons. Males. Females. Persons. Males. Females. Per cent. Amount. Per cent. Total. by Births and Deaths. By Migration. Administrative County 4,521,685 4,484,523 2,071,579 2,412,944 4,397,003 2,044,108 2,352,895 —0.8 —87,520 —2.0 5.3 —7.3 City of London (County Corporate) 19,657 13,709 6,722 6,987 10,999 5,572 5,427 —30.3 —2,710 —19.8 —3.9 —15.9 Metropolitan Boroughs Battersea 167,743 167,739 78,658 89,081 159,552 75,506 84,046 —0.0 —8,187 —4.9 6.0 —10.9 Bermondsey 125,903 119,452 58,341 61,111 111,542 54,887 56,655 —5.1 —7,910 —6.6 8.3 —14.9 Bethnal Green 128,183 117,238 56,766 60,472 108,194 52,278 55,916 —8.5 —9,044 —7.7 8.5 —16.2 Camberwell 261,328 267,198 125,548 141,650 251,294 118,627 132,667 2.2 —15,904 —5.9 5.7 —11.6 Chelsea 66,385 63,697 25,794 37,903 59,031 23,946 35,085 —4.0 —4,666 —7.3 0.5 —7.8 Deptford 109,496 112,534 54,131 58,403 106,891 51,577 55,314 2.8 —5,643 —5.0 6.6 —11.6 Finsbury 87,923 75,995 36,156 39,839 69,888 33,599 36,289 —13.6 —6,107 —8.0 6.9 —14.9 Fulham 153,284 157,938 73,243 84,695 150,928 70,476 80,452 3.0 —7,010 —4.4 5.5 —9.9 Greenwich 95,968 100,450 48,850 51,600 100,924 49,548 51,376 4.7 474 0.5 6.6 —6.1 Hackney 222,533 222,142 101,993 120,149 215,333 99,794 115,539 —0.2 —6,809 —3.1 5.9 —9.0 Hammersmith 121,521 130,295 62,479 67,816 135,523 64,989 70,534 7.2 5,228 4.0 5.2 —1.2 Hampstead 85,495 86,153 33,253 52,900 88,947 34,926 54,021 0.8 2,794 3.2 1.1 2.1 Holborn 49,357 43,192 20,732 22,460 38,860 18,187 20,673 —12.5 —4,332 —10.0 —0.5 —9.5 Islington 327,403 330,737 154,661 176,076 321,795 152,041 169,754 1.0 —8,942 —2.7 6.4 —9.1 Kensington 172,317 175,859 67,805 108,054 180,677 71,004 109,673 2.1 4,818 2.7 2.2 0.5 Lambeth 298,058 302,868 141,528 161,340 296,147 139,647 156,500 1.6 —6,721 —2.2 5.1 —7.3 Lewisham 160,834 174,194 79,165 95,029 219,953 101,773 118,180 8.3 45,759 26.3 6.0 20.3 Paddington 142,551 144,261 60,491 83,770 144,923 61,503 83.420 1.2 662 0.5 3.2 —2.7 Poplar 162,442 162,578 80,420 82,158 155,089 76,616 78,473 0.1| —7,489 —4.6 9.7 —14.3 St. Marylebone 118,160 104,173 41,007 63,166 97,627 38,789 58,838 —11.8 —6,546 —6.3 1.0 —7.3 ST. PANCRAS 218,387 211,366 99,620 111,746 198.133 94,383 103,750 —3.2 — 13,233 —6.3 4.5 —10.8 Shoreditch 111,390 104,248 50,317 53,931 97,042 47,227 49,815 —6.4 —7,206 —6.9 9.5 —16.4 Southwark 191,907 184,404 89,653 94.751 171,695 84,661 87,034 —3.9 —12,709 —6.9 6.9 —13.8 Stepney 279,804 249,657 122,515 127,142 225,238 110,087 115,151 —10.8 —24,419 —9.8 7.5 —17.3 Stoke Newington 50,659 52,172 23,461 28,711 51,208 23,064 28,144 3.0 —964 —1.9 3.8 —5.7 Wandsworth 311,360 328,307 147,229 181,078 353,110 159,714 193,396 5.4 24,803 7.5 3.4 4.1 Westminster, City of 160,261 141,578 61,380 80,198 129,579 56,496 73,083 —11.7 —11,999 —8.5 —0.8 —7.7 Woolwich 121,376 140,389 69,661 70,728 146,881 73,191 73,690 15.7 6,492 4.6 6.7 —2.1 113 Acreage, Population, Private Families and Dwellings. Definitions. Private Family.—Any person or group of persons included in a separate return as being in separate occupation of any premises or part of premises is treated as a separate family for Census purposes, lodgers being so treated only when returned as boarding separately and not otherwise. Private families comprise all such families with the exception of those enumerated in (i) institutions or (ii) business establishments or boarding-houses in which the number of resident trade assistants or resident boarders exceeds the number of members of the employer's or house-holder's family (including private domestic servants). Structurally Separate Dwellings.—A structurally separate dwelling has been defined for the Census as any room or set of rooms, intended or used for habitation, having separate access either to the street or to a common landing or staircase. Thus each flat in a block of flats is a separate unit; a private house which has not been structurally subdivided is similarly a single unit whether occupied by one family or by several families. But where a private house has been subdivided into maisonettes or portions, each having its front door opening on to the street or on to a common landing or staircase to which visitors have access, then each such portion is treated as a separate uni. Rooms.—For the purpose of the Census the rooms enumerated are the usual living rooms, including bedrooms and kitchens but excluding sculleries, landings, lobbies, closets, bathrooms, or any warehouse, office, or shop rooms. Administrative Area of St. Pancras Metropolitan Borough. Area in Statute Acres (Land and Inland Water). Total Population. 1931. Private Families and Dwellings (See Definitions at beginning of table). 1921. 1931. Persons per Acre. Private Families. Population in Private Families. Structurally Separate Dwellings occupied. Rooms occupied. Persons per room. Persons. Persons. Males. Females. Ward— No. 1 990 35,435 35,872 15,867 20,005 36.2 11,187 34,352 5,717 37,687 0.91 No. 2 162 21,779 19,675 9,621 10,054 121.5 5,416 18,934 2,270 14,659 1.29 No. 3 452 35,559 33,158 15,615 17,543 73.4 10,569 32,357 4,262 29,483 1.10 No. 4 271 25,809 23,955 11,965 11,990 88.4 6,752 21,991 2,872 19,223 1.14 No. 5 342 30,124 28,741 13,737 15,004 84.1 8,605 26,314 3,116 21,765 1.21 No. 6 180 20,570 18,000 8,861 9,139 100.0 4,386 15,621 2,246 10,614 1.47 No. 7 118 15,126 13,022 6,155 6,867 110.4 2,856 8,253 1,058 7,499 1.10 No. 8 179 26,964 25,710 12,562 13,148 143.6 7,158 20,519 3,439 17,559 1.17 Total 2,694 211,366 198,133 94,383 103,750 73.5 56,929 178,341 24,980 158,489 1.13 114 Note.—At the Census of 1931 a departure was made from the lines followed in 1921, by the omission of the record of "buildings." "The heterogeneous collection of structures met with throughout the area has little statistical application in connection with a population study Nor has any attempt been made to obtain a record of dwellings or buildings in course of erection."— (Extract from Census Report, County of London.) Dwellings, Rooms and Families. Definitions:—For definitions of "Private Families," "Structurally Separate Dwellings" and "Rooms" see note at the head of table immediately preceding. Dwellings or parts of dwellings unoccupied on Census night, whether through their being tenantless or through the temporary absence of the occupying family, have all been classified as "vacant." They have been apportioned between "furnished" and "others" from such indications as could be obtained from enquiry or external scrutiny. St. Pancras Metropolitan Borough. Structurally Separate Dwellings of Number of Rooms. 1 Room. 2 Rooms. 3 Rooms. 4 Rooms. 5 Rooms. 6-8 Rooms. 9 or more Rooms. All Sizes. Total. Occupied. Vacant. Furnished. Others. Dwellings occupied by 1 private family 459 1,826 2,455 1,952 1,001 2,023 777 110,493 46,634 45,951 277 406 „ „ 2 private families — 29 68 451 588 2,805 691 4,632 31,020 30,270 347 403 ,, „ 3 or more private families — — 20 98 234 5,532 3,971 9,855 83,232 82,268 516 448 Total Dwellings occupied 459 1,855 2,543 2,501 1,823 10,360 5,439 24,980 160,886 158,489 1,140 1,257 furnished 32 82 108 46 17 39 17 341 1,233 1,233 — Dwellings wholly vacant others 8 39 95 63 29 66 49 349 1,779 — — 1,779 Total dwellings occupied and vacant 499 1,976 2,746 2,610 1,869 10,465 5,505 25,670 163,898 158,489 2,373 3,036 Number of private families therein 459 1,884 2,651 3,169 2,955 26,889 18,922 56,929 — — — — Miscellaneous habitations and institutions housing non-private families 924 115 Private Families Classified by Size of Family, Rooms Occupied and Density of Occpuation. Note.—The following table contains an analysis of the private families within the area according to— (a) the number of persons in the family, and (b) the number of rooms occupied by the family. Where more than one family are enumerated within a structurally separate dwelling, each is classified according to the rooms it severally occupies and not to the total number of rooms in the dwelling. For this purpose rooms shared by more than one family are excluded, as are sculleries or bathrooms, etc., each family being classified to the next lower integral number of rooms occupied, save in the exceptional case of a family housed in a portion of a room only when it is classified as living in one room. The total rooms in Col. (m) may on this account differ slightly from the corresponding totals of rooms shown in Tables on pages 114 and 115. For definitions of "Private family," "Structurally separate dwellings" and "Rooms," see note at heading of table on page 114. Number of Private Families occupying the Following Number of Rooms. Total Private Families k Population in Private Families 1 Rooms occupied m Average Number of Persons per room. n Density of Occupation. Population at following densities of occupation (Persons per room). number of Persons in Family. Cols. 2 1 b 2 c 3 d 4 e 5 | f 1 6-7 g 8-9 h 10 & over, j over 3. o 3 and over 2. P 2 and over 1½. q 1½ and over 1. r 1 7,590 2,083 1,016 279 75 69 17 14 11,143 11,143 17,047 0.65 — — — — 2 3,239 5,859 3,487 1,321 354 318 78 58 14,714 29,428 35,832 0.82 — — 6,478 — 3 1,041 4,193 3,268 1,806 542 475 119 62 11,506 34,518 33,919 1.02 — 3,123 — 12,579 4 422 2,476 2,245 1,650 570 506 120 85 8,074 32,296 26,712 1.21 1,688 — 9,904 8,980 5 160 1,384 1,287 1,118 494 366 109 91 5,009 25,045 18,056 1.39 800 6,920 6,435 5,590 6 61 699 732 686 341 261 88 79 2,947 17,682 11,401 1.55 366 4,194 4,392 6,162 7 25 374 403 449 210 198 49 62 1,770 12,390 7,224 1.72 2,793 2,821 3,143 2,471 8 7 155 216 216 102 79 47 41 863 6,904 3,759 1.84 1,296 1,728 2,544 632 9 2 67 97 126 61 70 18 20 461 4,149 2,079 2.00 621 2,007 549 756 10 — 31 52 56 20 34 8 23 224 2,240 1,125 1.99 830 560 450 170 11 — 14 16 37 17 14 11 12 121 1,331 633 2.10 330 594 154 165 12 — 7 8 21 7 12 3 7 65 780 376 2.07 180 336 144 48 13 — — 2 4 3 1 4 4 18 234 165 1.42 78 52 13 52 14 — — — 2 2 2 1 4 11 154 99 1.56 28 42 28 14 15 and over — — — — — 1 — 2 3 47 46 1.02 — 15 — — 2 Persons and over 4,957 15,259 11,813 7,492 2,723 2,337 655 550 45,786 167,198 141,426 1.18 9,010 22,392 34,234 37,619 Total Private Families 12,547 17,342 12,829 7,771 2,798 2,406 672 564 56,929 — — — — — — — Population in Private Families 20,294 52,407 43,841 31,949 12,578 10,892 3,267 3,113 — 178,341 — 1.13 9,010 22,392 34,234 37,619 Rooms occupied 12,547 34,684 38,487 31,084 13,990 15,206 5,604 6,871 — — 158,473 — — — — — 22.0 30.5 22.5 13.7 4.9 4.2 1.2 1.0 100.0 1931. Percentage of families living in various units of occupation. 22.6 31.0 21.2 | 12.9 4.6 4.5 1.7 1.5 100.0 1921. „ „ „ „ „ „ „ 116 117 INSTITUTIONS AND SPECIAL, PREMISES. Number, Total Population and Inmates. Note.—Poor Law Institutions, appropriated to Public Health Act or Maternity and Child Welfare purposes at the date of the Census, are classified as Hospitals, Nursing Homes, etc., and not as Poor Law Institutions. St. Pancras Metropolitan Borough Number of Institutions. Total Population. Inmates only (Classes 1-12). Persons. Males Females. Persons. Males Females. 1. Workhouses 1 1,020 645 375 960 635 325 2. Other Poor Law Institutions 1 49 49 — 48 48 — 3. Homes for Insane, etc. — — — — — — — 4. „ „ Cripples — — — — — — — 5. „ „ Blind 2 49 — 49 24 — 24 6. „ „ Deaf and Dumb — — — — — — — 7. „ „ Inebriates — — — — — — — 8. Hospitals (not Military, etc.) 15 3,153 975 2,178 2,114 920 1,194 9. Convalescent and Nursing Homes 12 286 56 230 124 48 76 10. Prisons — — — — — — — 11. Other Places of Detention (Reformatories, etc.) 3 166 157 9 3 2 1 12. Naval, Military, etc., Hospitals — — — — — — — 13. Naval, Military, etc., Barracks, etc. 1 461 374 87 — — — 14. Inland Barges and Boats — — — — — — — Ages (Grouped) by Marital Condition. Age last Birthday. Persons. Males. Females. Total. Single. Married. Widowed. Divorced. Total. Single. Married. Widowed. Divorced. All Ages 198,133 94,383 50,103 40,363 3,691 226 103,750 53,074 39,933 10,485 258 0 2,754 1,372 1,372 — — — 1,382 1,382 — — 1 2,564 1,324 1,324 — — — 1,240 1,240 — — — 2 2,405 1,221 1,221 — — — 1,184 1,184 — — — 3 2,376 1,203 1,203 — — — 1,173 1,173 — — — 4 2,394 1,220 1,220 — — — 1,174 1,174 — — — 5—9 13,602 6,912 6,912 — — — 6,690 6,690 — — — 10—14 13,306 6,609 6,609 — — — 6,697 6,697 — — — 15—19 17,174 8,344 8,302 42 — — 8,830 8,656 174 — — 20-24 20,188 9,650 8,340 1,301 9 — 10,538 7,920 2,600 15 3 25—29 18,623 9,088 4,779 4,265 30 14 9,535 4,513 4,935 61 26 30—34 15,826 7,274 2,005 5,165 75 29 8,552 2,807 5,515 182 48 35—39 14,195 6,354 1,279 4,948 94 33 7,841 2,070 5,349 376 46 40—44 13,479 6,174 1,052 4,953 136 33 7,305 1,731 4,880 642 52 45—49 13,172 6,190 1,063 4,859 234 34 6,982 1,401 4,669 881 31 50—54 12,308 5,873 1,002 4,499 345 27 6,435 1,208 4,095 1,108 24 55—59 10,555 5,160 836 3,820 481 23 5,395 955 3,111 1,317 12 60—64 8,618 4,134 640 2,923 561 10 4,484 795 2,206 1,475 8 65—69 6,412 2,936 480 1,874 567 15 3,476 627 1,312 1,531 6 70—74 4,389 1,906 301 1,071 529 5 2,483 436 726 1,319 2 75—79 2,380 957 112 469 373 3 1,423 242 264 917 — 80—84 1,011 345 35 139 171 — 666 131 85 450 — 85—89 324 126 14 35 77 — 198 34 11 153 — 90—94 70 10 2 — 8 — 60 7 1 52 — 95 and over 8 1 — — 1 — 7 1 — 6 — 118