WAN 62 Metropolitan Borough of Wandsworth. Annual Report on the health, Sanitary Condition, OF THE BOROUGH, FOR THE YEAR 1915, by P. CALDWELL SMITH, M.A., M.D., D.P.H . Camb., Medical Officer of Health, TOGETHER WITH THE Report of the Public Analyst. 7900 Printed for the Council by ODHAMS LIMITED, 85-94, Long Acre, London, W.C. INDEX. page Ages at Death 25 Analyst, Report of 175 Anthrax Orders 103 Appendicitis and Typhilitis 109 Bacteriological Examinations 57, 101 Bakehouses 144, 146 Births 2 Births and Birth-rates in Sub-Districts 3 Births, Notification of, Act 5 Birth-rate for the Year and for the previous Ten Years 3 Brain and Nervous System, Diseases of the 107 Canal Boats Act 160 Cancer 104 Census, 1911 2 Cerebro-Spinal Fever 54 Circulatory Diseases 107 Clapham, House-to-House Inspections in 127 Clapham: Table of Causes of Death 190 Cleaning of Persons Act 133 Conscientious Objection Certificates granted 34 Cowsheds 139 Cutting-off Notices 118 Death, Ages at 25 Death, Causes of 19, 23 Death-rate, Corrected 13 Death-rate, Corrected, for Age and Sex Distribution 15 Death-rate, Infantile 25 Death-rate for all Metropolitan Boroughs 16 Deaths, Corrected and Uncorrected 14 Deaths, Number of 6 Deaths, Percentage of, at Six Age Periods 25 Deaths in Outlying Institutions 12, 117 Deaths in Public Institutions 8, 116 Deaths in Public Institutions in the Borough of Persons belonging to the Borough 11 ii. . PAGE Deaths in Public Institutions in the Borough of Persons not belonging to the Borough 9 Developmental Diseases 109 Diarrhœa 67 Diarrhoea, Death-rate from 67 Diarrhoea and Enteritis, Number of Deaths under One Year for each Quarter of the Year, both for 1915 and Five Years previous 68 Diarrhoea, Method of Feeding Children who died from 69 Diphtheria 43 Diphtheria and Schools 45 Diphtheria, Cases of, and their Relationship to Schools in the Borough 45 Diphtheria, Number of Dwellings in which multiple Cases occurred 51 Diphtheria, "Return Cases" of 52 Disinfection 131 Disinfection of Schools 65 Enteric Fever 52 Enteric Fever and Shell-Fish 54 Erysipelas 59 Factories and Workshops 141 Factories, Workshops and Workplaces, Inspection of 144 Factories and Workshops, Summary of Work of Female Inspectors 155 Factories and Workshops, Summary of Work of Male Inspectors 151 Feeding of Infants, Report of Female Inspectors on 72 Food Places, Inspection of 134 Glanders and Anthrax Orders 103 Home Work 147 House Refuse, Removal of 136 House-to-house Inspections 122 House-to-house Inspections, Summary of 127 Houses and Premises Inspected 122 Houses Let in Lodgings 141 Housing, Town Planning, etc., Act, 1909 120 iii. PAGE Ice Cream Premises 140 Illegitimate Children, Births of 4 Infant Visiting 72 Infantile Mortality 25, 28 Infantile Mortality from Stated Causes 28 Infantile Mortality, Rate per 1,000 births from five groups of diseases 28 Infective Diseases, Deaths from 29 Infective Diseases, Deaths in External and Internal Institutions 30 Infective Diseases, Death-rate from 30, 31 Infective Diseases, Death-rate per 1,000 for Five Years and 1915 102 Infective Diseases, Death-rate per 1,000, 1905-1915 31 Infective Diseases : Number of Cases Notified 22, 31 Infective Diseases : Number of Notifications received, 1905-1915 32 Infective Diseases: Number of Cases notified from Elementary Schools 62 Infective Diseases : Number of Deaths, 1905-1915 29 Influenza 66 Inspections, details of 124, 125 Institutions, Internal and External 117 Inquests 111 Margarine Act, Proceedings under 164 Measles 59 Measles and other Non-notifiable Diseases reported from Schools 62 Milk and Cream Regulations, 1912 171 Milk Premises, Cowsheds, etc., on Register 137 Milkshops 139 Military Billets 160 Mistaken Diagnosis, Cases of 54 Mortuaries 118 Natural Increase, Rate of 3 Nervous System, Diseases of the 107 Non-Infective Diseases 104 iv. PAGE Notification of Births Act 5 Notification of Infective Diseases 31 Offensive Trades 140 Offensive Trade Refuse 141 Old Age no Ophthalmia Neonatorum 103 Other Infective Diseases 101 Outworkers 147 Overcrowding 128 Police Court Proceedings 135 Polio-Myelitis 103 Population 1 Population of Sub-Districts 1-2 Population of Wards 1 Premature Birth 109 Puerperal Fever 58 Pulmonary Tuberculosis, Deaths in Public Institutions, 1905-1915 100 Pulmonary Tuberculosis, Notification of Cases of 78-81 Putney, House-to-house Inspections in 127 Putney, Table of Causes of Death 191 Rag Flock Act, 1911, Statement of work done under 160 Rated Hereditaments 1 Refugees' Homes 160 Report of Tuberculosis Officer 87 Respiratory Diseases 108 Return Cases of Scarlet Fever and Diphtheria 52 Revenue Act 120 Sale of Food and Drugs Act, Proceedings under 162 Sale of Food and Drugs Acts, Statement of Work under 161 Sanitary Operations, Table of 123 Sanitary Work, General 119 Scarlet Fever 35 Scarlet Fever and Schools 37 Scarlet Fever, Annual Rate of Notified Cases, 1912-1915 37 Scarlet Fever, Number of Dwellings in which Multiple Cases occurred 42 V. PAGE Scarlet Fever, ''Return Cases" of 52 Schools, Disinfection of, for Infective Diseases 65 Schools, other diseases notified from 62 Shelters 138 Slaughter-houses 140 Small-pox 33 Smoke Nuisances 131 Special Inspections 119 Staff 174 Streatham, House-to-house Inspections in 127 Streatham: Table of Causes of Death 192 Tooting, House-to-house Inspections in 127 Tooting : Table of Causes of Death 193 Tuberculin treatment 98 Tuberculosis Dispensaries 87 Tuberculous Diseases 75 Tuberculosis Officer, Report of 87 Underground Rooms 121 Unsound Food 141 Urinals in Connection with Licensed Premises, Inspection of 13 4 Vaccination Returns 34 Violence, Mortality from no Vital Statistics of Whole Borough 21 Wandsworth, House-to-house Inspections in 127 Wandsworth : Table of Causes of Death 194, 195 Water Supply, Cutting-off Notices 118 Whooping Cough 64 Workshops, Summary of Principal Trades carried on 153, 159 Zymotic Diseases, Deaths from 29 Zymotic Diseases, Deaths in External and Internal Institutions 30 Zymotic Diseases, Death-rate from 30, 31 Zymotic Diseases, Death-rate per 1,000 for Five Years and 1915 102 Zymotic Diseases, Death-rate per 1,000, 1905-1915 31 REPORT of the Medical Officer of Health for the Year 1915. To the Mayor, Aldermen, and Councillors of the Metropolitan Borough of Wandsworth. Sir and Gentlemen, I have the honour to present the Annual Report on the health and sanitary condition of the Borough for the year 1915. Population. The population of the Borough to the middle of 1915 has been estimated by the Registrar-General to be 338,998, but in my opinion this estimate is too high. Table I. shows the Census population in 1911 in each Ward, the number of rated hereditaments and the number of persons per rated hereditament in 1911 and the estimated population to the middle of 1915. TABLE I. Ward. Census Population, 1911. Rated hereditaments, 1911. No. of Persons per rated hereditament, 1911. Rated hereditaments, 1915. Four years' natural Increase. Estimated Population, 1915. Clapham, North 28,871 5,704 5.06 5,801 1,071 30,424 „ South 29,721 6,829 4.35 6,985 1,251 31,635 Putney 28,242 6,119 4.6i 6,218 687 29,351 Streatham 49,191 11,756 4.i8 12,566 1,756 54,281 Balham 47,001 10,333 4.55 10,834 1,723 51,017 Tooting 35,958 7,410 4.85 7,839 2,403 40,422 Southfield 34,600 7,385 4.68 7.533 1,608 36,862 Fairfield 20,605 4,087 5.04 4,214 828 22,086 Springfield 37,171 7,016 5.30 7,263 2,187 40,680 Whole Borough 311,360 66,639 4.67 69,253 13,514 336,758 a 2 Report of the Medical Officer of Health. The population estimated from the rated hereditaments is thus 2,240 under that estimated by the Registrar-General. Table II. shows the population of each sub-district, compared with the Census population, uncorrected and corrected for Institutions. TABLE II. Sub-District. Census Population, 1911. Population estimated to middle of 1915. Corrected. Uncorrected. Clapham 58,592 62,289 62,059 Putney 28,242 29.351 29,351 Streatham 96,192 104,794 105,298 Todting 35,958 38,407 40,422 Wandsworth 92,376 96,715 99,628 Whole Borough 311,360 331,556 336,758 The corrected population in Table II. is used to calculate all the rates in this Report. The total population of the Institutions in the Borough was in 1911, 7,855, but as a large proportion of the inmates of the Tooting Home and the Metropolitan Asylums Board's Hospital belong to the Borough, a deduction of 5,202 from the uncorrected population gives the corrected population, viz.:—331,556, compared with 326,945 in the previous year. Births. During the 52 weeks ending the 1st January, 1916, 6,383 births, 3,220 of males and 3,163 of females, were registered, compared with 6,684 in 1914, 6,838 in 1913, and 6,756 in 1912. The total number of births registered in this Borough was 6,210, but 216 births occurred in Institutions outside the Borough of persons belonging to the Borough, and 43 births in Institutions in the Borough of persons not belonging to the Borough, making a corrected total of 6,383. In Table III. is shown the number of births, males and females , the biith-rate, and the rate of natural increase for each sub-district and for the whole Borough. 3 Report of the Medical Officer of Health. TABLE III. Sub-District. Births. Rates. Males. Females. Total. Birth-Rate. Rate of natural increase. Clapham 591 579 1,170 18.78 6.44 Putney... 237 237 474 16.15 3.62 Streatham 954 957 1,911 18.23 6.25 Tooting... 450 438 888 23.12 10.57 Wandsworth ... 988 952 1,940 20.05 6.55 Whole Borough 3,220 3,163 6,383 19.25 6.63 Table IV. shows the birth-rate in the Borough, in the five sub-districts, in London, and in England and Wales, for the year, as well as the rates for the previous 10 years, compared with the decennial average. TABLE IV. Year. Clapham. Putney. Streatham. Tooting. Wandsworth. Whole Borough. London. England and Wales. 1905 25.94 20.49 21.74 39.34 30.62 26.59 27.79 27.3 1906 24.99 19.22 20.92 41.78 31.20 26.47 27.57 27.2 1907 24.25 18.56 21.46 36.67 2993 25.65 26.81 26.4 1908 24.39 20.49 21.66 38.51 29.25 25.54 27.14 26.8 1909 23.29 18.14 20.10 34.05 27.18 24.04 25.75 25.8 1910 21.61 17.94 20.46 31.18 26.38 23.21 25.39 25.05 1911 22.15 16.96 18.78 29.04 23.27 21.73 25.0 24.4 1912 20.62 17.08 18.88 27.12 24.07 21.53 24.7 23.8 1913 20.66 16.74 18.06 27.82 22.61 20.87 24.8 23.9 1914 19.50 16.06 18.61 25.57 22.34 20.44 24.3 23.8 Average for 10 yrs. 22.74 18.16 20.06 33.10 26.68 23.60 25.92 25.44 1915 18.78 16.15 18.23 23.12 20.05 19.25 22.5 21.8 a 2 4 Report of the Medical Officer of Health. The rate for the whole Borough is the lowest yet recorded, being 1.19 under the rate for the previous year, and 4.38 under the decennial average. The birth-rate for the whole of London was 22.5 per 1,000, compared with 24.3 in 1914, and 25.92 the decennial average ; while for England and Wales the rate was 21.8 per 1,000,. compared with 23.8 in 1914, and 25.44 the decennial average. 89 births occurred in the Workhouse, and of these seven belonged to Clapham, seven to Putney, 12 to Streatham, four to Tooting, 16 to Wandsworth, 28 to Battersea, and 15 to other placesOf these 89 births, 73 were illegitimate, six belonging to Clapham, seven to Putney, 11 to Streatham, four to Tooting, nine to Wandsworth, 22 to Battersea, and 14 to other places. In the Borough, excluding the Workhouse, 294 illegitimate births occurred, 23 in Clapham, nine in Putney, 190 in Streatham, 32 in Tooting, and 40 in Wandsworth. 147 of the illegitimate births in Streatham occurred at a private home in that sub-district, and is the cause of the high number and rate n that sub-district. Of the births registered outside the Borough 65, 37 of males and 28 of females, were illegitimate The total number of illegitimate births was 396, 41 of which belonged to Clapham, 20 to Putney, 229 to Streatham, 49 to Tooting, and 57 to Wandsworth, compared with 288 in 1914, 283 in 1913, and 223 in 1912. The percentage of illegitimate births to total births was 6-20 compared with 4.30 in 1914, 4.13 in 1913, and 3.30 in 1912, and 4.43 for England and Wales for 1914. The following Table shows the percentage of illegitimate births to total births for each sub-district and for the whole Borough for the year, and for the three previous years:— 5 Report of the Medical Officer of Health. Sub-district. 1912 1913 1914 1915 Clapham 3.71 3.17 3.23 3.50 Putney 3.27 5.47 4.91 4.21 Streatham 2.59 4.55 6.39 11.98 Tooting 3.40 4.14 4.57 5.51 Wandsworth 3.17 4.04 2.77 2.88 Whole Borough 3.30 4.13 4.30 6.20 Notification of Births Act. During the year 6,027 births were notified, 1,036 from Clapham, 453 from Putney, 1,731 from Streatham, 849 from Tooting, and 1,958 from Wandsworth. 89 births were notified from the Workhouse, of which 46 belonged to this Borough, and 43 to other places. Of the 46 which belonged to this Borough, the home addresses of seven were in Clapham, of seven in Putney, of 12 in Streatham, of four in Tooting, and of 16 in Wandsworth. The following Table shows the number of births notified in each sub-district and in the whole Borough, the persons by whom notified and whether the children were born alive or dead. TABLE v. Sub-district. Total No. of births notified. Notified by : No. born alive. No. born dead. Medical Attendant Parent. Midwife. Other person. Clapham 1,036 325 507 148 56 1,023 13 Putney 453 119 170 161 3 450 3 Streatham 1,731 356 940 309 126 1,706 25 Tooting 849 114 332 385 18 843 6 Wandsworth 1,958 386 753 777 42 1,927 31 Whole Borough 6,027 1,300 2,702 1,780 245 5.949 78 6 Report of the Medical Officer of Health. The next Table shows these births compared with the total births registered in each sub-district and in the whole Borough. TABLE VI. Sub-district. No. of births notified. Still-births. Births less still-births. Births registered. Excess cf registered over notified births. Clapham 1,036 13 1,023 1,089 63 Putney 453 3 450 457 7 Streatham 1,731 25 1,706 1,835 129 Tooting 849 6 843 857 14 Wandsworth 1,958 31 1,927 1,972 45 Whole Borough 6,027 73 5,949 6,210 258 The percentage of births notified, less still-births, to those registered was 957, while only 4.3 per cent, were not notified, compared with 95.1 and 4-9 in 1913, showing an increase of .6 per cent. The proportion of still-births to total births notified was 1.2 Per cent., compared with 1.9 per cent, in 1914. The work carried out by the female Sanitary Inspectors in connection with the Notification of Births Act is given later on in this Report when dealing with Infantile Mortality. Deaths. During the 52 weeks ending the 1st January, 1916, 3,949 deaths, 1,923 of males and 2,026 of females were registered, compared with 3,332 in 1914, 3,344 in 1913, and 3,118 in 1912. 7 Report of the Medical Officer of Health. Compared with 1914 there has been an increase of 617 deaths, and of 307 compared with the decennial average corrected for increase of population. The uncorrected death-rate for the Borough was 11.72 per 1,000, compared with 10-02 in 1914, 10.04 in 1913. and 9.78 in 1912. The average uncorrected rate for the decennium 1905-1914 was 11.05 or -68 below the rate for the year 1915. In the sub-districts these rates were as follows:—9.57 in Clapham, 10.25 in Putney, 8.86 in Streatham, 25.33 in Tooting, and 11.05 in Wandsworth. The reason for the high rate in Tooting is that in that subdistrict there are a number of Public Institutions where persons from other parts of London are received and among whom the mortality is very great. The total number of deaths for the 52 weeks, corrected for both internal and external Institutions and other places was 4,189, c ompared with 3,664 in 1914, 3,588 in 1913, and 3,291 in 1912, and 3,866 the decennial average corrected for increase of population. During the year 1,069 deaths occurred in Public Institutions and 156 in other places in the Borough. Of the total of 1,225 deaths, 1,012 were of persons not belonging and 213 of persons belonging to the Borough. Table VII. shows the total number of Institution deaths arranged according to sub-districts and Institutions in which they occurred, Table VIII. the deaths of persons not belonging to the Borough, and Table IX. the deaths of persons belonging thereto arranged according to causes of death, sex and age, and Institution in which the death occurred. 8 Report of the Medical Officer of Health. TABLE VII. Name of Public Institution. Clapham. Putney. Streatham Tooting. Wands'th. Total. Hostel of God 56 ... ... ... ... 56 St. Anne's Home ... ... 1 ... ... 1 Middlesex County Asylum ... ... 6 ... 158 164 Metropolitan Asylums Board's Fever Hospital ... ... ... 169 ... 169 Fountain Asylum ... ... ... 65 ... 65 Tooting Home ... ... ... 24 ... 24 H. M. Prison ... ... ... ... 7 7 Workhouse ... ... ... ... 12 12 Royal Hospital for Incurables ... ... ... ... 16 16 Tooting Bee Asylum ... ... ... 431 ... 431 The Priory ... ... ... ... ... 6 3rd London General Hosp. ... ... ... ... 74 74 Putney Hospital ... 32 ... ... ... 32 Newlands House Asylum ... ... ... 2 ... 2 Tooting Military Hospital ... ... ... 10 ... 10 TOTAL 56 38 7 701 267 1,069 Other places 52 23 44 11 26 156 GRAND TOTAL 108 61 51 712 293 1,225 Compared with the year 1914 there has been an increase of 215 in the deaths in Institutions, and a decrease of eight in other places, or a total increase of 207. 9 Report of the Medical Officer of Health. Table VIII. Deaths in Public Institutions, &c., in the Borough of Persons not belonging to the Borough, 1915. Causes of death. Death s in or belonging to whole District at subjoined ages. Institutions. All Aggs. Males. Females. Under i year. 1 and under 2. 2 and under 5. 5 and under 15. 15 and under 25. 25 and under 45. 45 and under 65. 65 and upwards. Middlesex County Asylum. Tooting Bee Asylum. Hostel of God. Tooting Home. Fever Hospital. Workhouse. H.M. Prison. Ryl. Hosp. for Incurables. The Priory. Putney Hospital. Fountain Temporary Asylum. Newlands House. |3rd Lon. General Hospital Other Military Hospitals. Other Places. Etneric Fever 11 7 4 ... ... ... ... 6 3 2 ... 3 ... ... ... 4 ... ... ... ... ... ... ... 2 2 ... Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 28 14 14 5 8 6 8 1 ... ... ... ... ... ... ... 16 ... ... ... ... ... 11 ... ... ... 1 Scarlet Fever 20 7 13 1 1 7 7 2 2 ... ... ... ... ... ... 20 ... ... ... ... ... ... ... ... ... ... Whooping Cough ... 1 ... 1 ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... Diptheria, and Membranous Croup 38 21 17 ... 4 14 19 1 ... ... ... ... ... ... ... 38 ... ... ... ... ... ... ... ... ... ... Influnza 7 3 4 ... ... ... ... ... 2 1 4 ... 1 ... ... ... ... ... 4 ... ... ... ... 1 ... 1 Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cerebro-spinal Fever M 5 9 5 1 2 2 2 2 ... ... ... ... ... ... 12 ... ... ... ... 1 ... ... 1 ... ... Other Epidemic Diseases ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Pulmonary Tuberculosis 92 54 38 ... ... 3 13 25 38 10 3 42 9 14 ... ... ... 1 1 ... ... 13 ... 6 2 4 Tuberculous Meningitis 3 2 1 ... ... 1 ... 2 ... ... ... ... 1 ... ... 2 ... ... ... ... ... ... ... ... ... ... Abdominal Tuberculosis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Tuberculous Diseases 6 3 3 ... ... 2 3 ... 1 ... ... 1 3 ... ... ... ... ... ... ... ... 2 ... ... ... ... Other Infective Diseases 1 1 ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... Cancer Malignant Disease ... 49 12 37 ... ... ... 1 1 4 27 16 1 4 29 1 ... ... ... 1 ... 3 ... ... 1 ... 9 Rheumatic Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diabetes 2 2 ... ... ... ... ... ... ... 2 ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 Other General Diseases 9 1 8 ... ... 1 1 ... ... 1 6 ... ... ... 1 ... ... ... 4 ... ... 2 ... ... ... 2 Aleoholism ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Chronic Poisonings ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Meningitis 3 2 1 ... 1 ... 1 ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 2 Cerebral Haemorrhage, Apoplexy 16 9 7 ... ... ... ... ... 1 3 12 2 6 ... 1 ... ... 1 ... 1 ... ... ... ... ... 5 Convulsions 1 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... Other Diseases of Nervous System 89 49 40 ... ... 1 11 9 34 29 5 55 7 ... ... ... ... ... 2 2 ... 14 1 1 ... 7 Organic Diseases of Heart 44 20 24 ... ... ... ... 2 1 17 24 7 23 ... 1 ... 1 ... 1 ... ... ... ... ... ... 11 Other Diseases of Circulatory System 9 4 5 ... ... ... ... 1 1 2 5 1 1 ... ... ... ... ... 1 2 ... ... ... 1 1 2 Bronchitis 27 15 12 1 ... ... ... ... 1 9 16 9 1 1 4 ... ... 1 ... ... ... ... ... ... ... 11 Broncho-Pneumonia 16 7 9 1 1 1 4 2 ... 2 5 2 4 ... ... 3 ... ... ... 1 ... 5 ... ... ... 1 Lobar Pneumonia 3 1 2 ... ... ... ... ... 2 ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... 1 ... 1 Pneumonia (type not distingmshed) 14 12 2 ... ... ... 1 2 3 3 5 ... 7 ... ... ... ... ... ... ... ... 3 ... 1 1 2 Other Diseases of Respiratory System 4 2 2 ... ... 1 ... ... ... 1 2 ... 1 ... ... 1 ... ... 1 ... ... ... ... ... ... ... Ulcer of Stomach 1 1 ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... Diarrhœa ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteritis 3 3 ... ... ... 1 1 ... ... ... 1 ... ... ... 1 ... ... ... ... ... ... 2 ... ... ... ... Appendicitis and Typhlitis 3 1 2 ... ... ... ... 1 1 1 ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 2 Obstructions of Intestines 4 2 2 1 ... ... 1 ... 1 ... 1 ... 1 ... ... ... ... ... ... ... 1 1 ... 1 ... ... Cirrhosis of Liver 2 1 1 ... ... ... ... ... ... 2 ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... Other Diseases of Liver ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Diseases of Digestive System 4 1 3 ... ... 1 1 ... 2 ... ... ... ... 1 ... ... ... ... ... ... ... 2 ... ... ... 1 Nephritis and Bright's Disease 19 9 10 ... ... ... 1 ... 10 8 8 5 I 1 ... ... ... 1 ... ... ... ... ... ... ... Other Diseases of Urinary System 3 2 1 ... ... ... ... ... 1 ... 2 ... ... 1 ... ... ... ... ... ... 1 ... ... ... ... 1 Diseases of Generative System ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerpral Fever 1 ... 1 ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... Other Accidents and Diseases of Pregnancy and Childbirth 1 ... 1 ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... Premature Birth 2 1 1 2 ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... ... Congenital Debility and Malformations 11 7 4 2 ... 2 6 ... 1 ... ... ... 2 ... ... ... 2 ... ... ... ... 7 ... ... ... ... Other Diseases of Early fancy ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Old Age 379 137 242 ... ... ... ... ... ... 14 365 22 345 ... 3 ... 1 ... ... ... ... ... 1 ... ... 7 Deaths fromAccident 15 12 3 ... ... 1 1 4 4 4 1 2 ... ... ... ... ... ... ... ... 5 ... ... ... ... 8 Deaths from Suicide 7 3 4 ... ... ... ... 1 4 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 7 Other Violent Deaths 49 49 ... ... ... ... ... 21 27 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... 43 5 ... Other defined Diseases 1 ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Ill-defined Diseases or unknown ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... All causes 1012 483 529 19 16 45 81 85 139 143 484 157 423 47 13 98 6 4 16 6 15 62 2 61 11 91 10 Report of the Medical Officer of Health. The total number of deaths shown on Table IX. is 213, 124 of males and 89 of females, compared with 194 in 1914, 212 in 1913,. and 191 in 1912. 71 of the deaths occurred in the Fever Hospital, compared with 51 in 1914. 11 in Tooting Home, compared with 30; nine in the Hostel of God, compared with 14; six in the Workhouse, compared with three; eight in the Tooting Bee Asylum, compared with five; none in the Royal Hospital for Incurables, compared with three; 17 in Putney Hospital compared with 16, three in the Fountain Temporary Asylum; seven in the Middlesex Asylum; 13 in the 3rd London General Hospital; and 65 in other places compared with 72. These deaths are allocated to their proper sub-districts in Table XIV. The number of deaths in Table VIII., viz.:—1,012, and that in Table IX., viz.:—213, make up the total of 1,225, the total number of deaths in Public Institutions and other places in the Borough as shown in the last columns of Tables XV., and XVIII., and in column eight of Table XVI. II Report of the Medical Officer oj Health. TABLE IX. Deaths in Public Institutions, &c., in the Borough of Persons belonging to the Borough, 1915. causes of death Deaths in or belonging to whole District at subjoined ages. Institutions. All Ages. Males. Females. Under i year. 1 and under 2. 2 and under 5. 5 and under 15. 15 and under 25. 25 and under 45. 45 and under 65. 65 and upwards. Fever Hospital. Tooting Home. Hostel of God. Workhouse. Tooting Bee Asylum. H.M. Prison. Putney Hospital. Fountain Temporary Asylum. Middlesex Asylum. Military Hospitals. Other Places—not Institutions. Enteric Fever 3 2 1 ... ... ... ... 2 ... 1 ... 3 ... ... ... ... ... ... ... ... ... ... Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 5 3 2 ... 2 1 2 ... ... ... ... 3 ... ... ... ... ... ... 2 ... ... ... Scarlet Fever 18 14 4 1 ... 6 5 5 1 ... ... 18 ... ... ... ... ... ... ... ... ... ... Whooping Cough ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria, Membranous Croup 39 19 20 4 2 16 16 ... 1 ... ... 39 ... ... ... ... ... ... ... ... ... ... Influenza 2 2 ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... ... ... 2 Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cerebro-spinal Fever 2 1 1 ... ... 1 1 ... ... ... ... 2 ... ... ... ... ... ... ... ... ... ... Other Epidemic Diseases ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Pulmonary Tuberculosis 7 7 ... ... ... ... 1 1 2 3 ... ... ... 2 ... ... ... 1 ... 3 1 ... Tuberculous Meningitis 3 ... 3 ... ... 2 ... 1 ... ... ... 1 ... ... ... ... ... 2 ... ... ... ... Abdominal Tuberculosis 3 3 ... ... ... 1 1 1 ... ... ... ... ... ... ... ... ... 1 ... ... 1 1 Other Tuberculous Diseases 1 1 ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... Other Infective Diseases 1 ... 1 ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 Cancer, Malignant Disease 17 6 11 ... ... ... ... ... ... 8 9 ... ... 6 ... ... ... 2 ... ... ... 9 Rheumatic Fever 1 ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... 1 Diabetes ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other General Diseases 3 3 ... 1 ... ... ... 1 ... ... 1 ... ... ... ... ... ... ... ... ... 1 2 Alcoholism 1 1 ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 Chronic Poisonings ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Meningitis 1 1 ... ... ... ... 1 ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... Cerebral Haemorrhage, Apoplexy 7 3 4 ... ... ... ... ... 1 1 5 ... 2 ... 1 ... ... ... ... ... ... 4 Convulsions 2 2 ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 Other Diseases of Nervous System 2 1 1 ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... ... ... 1 1 Organic Diseases of Heart 11 5 6 ... ... ... 1 ... ... 5 5 ... ... 1 2 1 1 ... ... ... ... 6 Other Diseases of Circulatory System 3 2 1 ... ... ... ... ... ... 2 1 ... ... ... ... ... ... ... ... ... ... 3 Bronchitis 10 6 4 ... 1 ... ... ... ... 2 7 ... 6 ... ... ... ... 1 ... 1 ... 2 Broncho-Pneumonia 3 2 1 ... 11 ... ... ... ... 1 1 1 1 ... ... ... ... ... ... ... ... 1 Lobar Pneumonia ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Pneumonia (type not gushed 2 1 1 ... ... ... 1 ... 1 ... ... 1 ... ... ... ... ... ... ... ... ... 1 other Diseases of Respiratory System ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Ulcer of Stomach 1 1 ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... Diarrhœa 1 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... Enteritis 1 ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Appendicitis and Typhlitis 4 2 2 ... ... 1 ... ... 2 ... 1 ... ... ... ... ... ... 1 ... ... ... 3 Obstruction of Intestines 3 1 2 ... ... ... ... ... 1 ... 2 ... ... ... ... ... ... 1 ... ... ... 2 Cirrhosis of Liver ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Diseases of Liver ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Diseases of Digestive System 3 3 ... 1 ... ... ... ... 1 1 ... 1 ... ... ... ... ... 1 ... ... 1 ... Nephritis and Bright's Disease 1 1 ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... 1 Other Diseases of Urinary System ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diseases of Generative System 2 1 1 ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... 2 ... ... ... ... Puerperal Fever 1 ... 1 ... ... ... ... ... 1 ... ... 1 ... ... ... ... ... ... ... ... ... ... Other Accidents and Diseases of Pregnancy and Childbirth ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Premature Birth 1 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... Congenital Debility and formation 3 3 ... 2 ... ... 1 ... ... ... ... ... ... ... 1 ... ... ... 1 ... ... 1 her Diseases of Early Infncy 3 2 1 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 Old Age 15 3 12 ... ... ... ... ... ... ... 15 ... 2 ... 2 7 ... ... ... 2 ... 2 Deaths from Accident 14 8 6 ... 1 1 6 ... 3 1 2 ... ... ... ... ... ... 3 ... ... 1 10 Deaths from Suicide ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Violent Deaths 9 9 ... ... ... ... ... 5 3 ... 1 ... ... ... ... ... 1 ... ... ... 7 1 Other defined Diseases 2 1 1 ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... 1 ... 1 Ill-defined Diseases or unknown 2 2 ... 1 ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 2 All causes 213 124 89 18 7 29 36 16 23 29 55 71 11 9 6 8 3 17 3 7 14 64 12 Report of the Medical Officer of Health In the next Table the number of deaths in Institutions outside the Borough is given in detail, but a complete list of these Institutions with the number of deaths that occurred in each during the year is given in Table LXIII. TABLE X. Deaths in Public Institutions, &c., outside the Borough, of Persons belonging to the Borough, 1915. CAUSES OF DEATH. Deaths in or belonging to whole District at subjoined ages. Deaths in or belonging to Localities (at all ages). Institutions, etc. All Ages. Males. Females. Under 1 year. I and under 2. 2 and under 5. 5 and under 15. 15 and under 25. 25 and under 45. 45 and under 65. 65 and upwards. Clapham. Putney. Streatham. Tooting. Wandsworth. Workhouse and Work- house Infirmaries. General and Special Hospitals, &c. Public Lunatic and Imbecile Asylums. Metropolitan Asylums Board Hospitals. Enteric Fever 2 2 ... ... ... ... ... 1 ... 1 ... ... ... ... ... 2 ... 1 1 ... Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 37 21 16 12 19 5 1 ... ... ... ... 5 7 7 6 12 36 1 ... ... Scarlet Fever 4 3 1 ... ... 2 1 1 ... ... ... ... 1 ... ... 3 ... 2 ... 2 Whooping Cough 14 1 13 4 5 5 ... ... ... ... ... 1 2 ... 1 10 14 ... ... ... Diphtheria and Membranous Croup 6 1 5 1 ... 2 3 ... ... ... ... 4 ... 1 ... 1 1 ... ... 5 Influenza 5 3 2 ... ... ... ... 1 1 3 ... 1 ... 3 1 ... ... 1 4 ... Erysipelas 7 1 6 ... ... ... 1 1 2 ... 3 1 ... 1 3 2 2 4 1 ... Cerebro-spinal Fever 11 7 4 4 1 ... 1 3 2 ... ... 4 ... 1 1 5 ... 9 ... 2 Other Epidemic Diseases 1 ... 1 ... ... ... ... ... ... ... 1 ... ... 1 ... ... ... ... 1 ... Pulmonary Tuberculosis 138 77 61 ... ... 5 3 21 69 34 6 27 13 31 19 48 72 48 18 ... Tuberculous Meningitis 24 16 8 2 3 4 13 2 ... ... ... 4 1 -5 4 12 10 13 ... 1 Abdominal Tuberculosis 4 2 2 ... ... ... 1 ... 2 1 ... ... ... 2 2 ... 1 2 1 ... Other Tuberculous Diseases 21 14 7 3 2 1 4 3 4 3 1 6 1 6 2 6 11 7 3 ... Other Infective Diseases II 10 1 1 1 ... I ... 4 2 2 2 1 5 I 2 6 3 2 ... Cancer, Malignant Disease 114 54 60 ... ... 1 ... 1 18 62 32 19 16 39 12 28 63 50 1 ... Rheumatic Fever 2 1 1 ... ... ... ... 1 1 ... ... 1 ... ... ... 1 ... 2 ... ... Diabetes 7 5 2 ... ... ... ... 1 ... 3 3 1 2 4 ... ... 5 2 ... ... Other General Diseases 13 5 8 ... ... ... ... ... 1 7 5 6 ... 2 3 2 5 8 ... ... Alcoholism 4 1 3 ... ... ... ... ... 2 2 ... ... ... 3 ... 1 4 ... ... ... Chronic Poisonings ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Meningitis 7 6 1 1 ... ... 2 2 2 ... ... ... 1 1 2 3 3 4 ... ... Cerebral Hemorrhage, Apoplexy 48 28 20 ... ... ... ... ... ... ... 24 9 1 17 2 19 40 7 1 ... Convulsions I ... 1 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 ... Other Diseases of Nervous System 72 47 25 3 ... 3 1 5 26 28 6 12 6 22 7 25 22 20 30 ... Organic Diseases of Heart 104 52 52 1 ... ... ... 2 14 41 46 22 7 30 10 35 61 29 14 ... Other diseases of Circulatory System 33 16 17 ... ... ... 1 2 4 13 13 12 2 6 5 8 22 6 5 ... Bronchitis 5-' 28 22 2 3 ... 1 ... 4 14 26 17 1 10 3 19 4i 7 1 1 Broncho-Pneumonia 26 11 15 8 7 2 3 ... 2 2 2 5 3 5 1 12 15 8 3 ... Lobar Pneumonia 25 12 13 2 1 3 1 3 3 9 3 1 2 6 2 14 10 2 10 3 Pneumonia (type not distinguished) 27 13 14 ... ... ... ... 3 8 11 5 5 1 8 1 12 19 7 1 ... Other Diseases of Respiratory System 7 4 3 ... ... ... ... ... ... 4 3 ... ... 2 1 4 4 ... 1 ... Ulcer of Stomach 8 5 3 ... ... ... ... ... 4 4 ... 4 ... 1 2 1 1 7 ... ... Diarrhœa 3i 14 17 28 2 ... ... 1 ... ... ... 4 3 5 5 14 19 11 1 ... Enteritis 25 12 13 19 4 1 ... ... ... 1 ... 5 3 6 3 8 11 13 1 ... Appendicitis and Typhlitis 11 6 5 ... ... 1 3 1 3 3 ... 2 ... 5 1 3 1 10 ... ... Obstruction of Intestines 13 5 8 3 1 1 ... ... 5 1 2 i ... 5 7 2 11 ... ... Cirrhosis of Liver 9 6 3 ... ... ... ... ... ... 8 1 4 ... 1 2 2 8 1 ... ... Other Diseases of Liver 3 2 1 ... ... ... ... ... ... 2 1 ... ... 2 ... 1 ... 3 ... ... Other Diseases of Digestive System 20 11 9 1 ... ... 2 1 6 8 2 3 1 6 ... 10 7 11 2 ... Nephritis and Bright's Disease 44 22 22 3 ... 1 ... 1 7 19 13 4 5 11 6 18 22 19 3 ... Other Diseases of Urinary System 10 6 4 ... ... ... ... ... 3 2 5 3 ... ... ... 3 1 7 2 ... Diseases of Generative System 4 ... 4 ... ... ... ... ... 1 3 ... ... ... 1 1 2 3 1 ... ... Puerperal Fever ... 3 ... 3 ... ... ... ... ... 3 ... ... 1 ... ... 1 1 2 1 ... ... Other Accidents and Diseases of Pregnancy and Childbirth 3 ... 3 ... ... ... ... ... 3 ... ... ... ... ... ... 2 3 ... ... ... Premature Birth 16 9 7 16 ... ... ... ... ... ... ... 3 1 5 3 4 11 5 ... ... Congenital Debility and Malformation 27 11 16 25 1 ... 1 ... ... ... ... 4 2 6 5 10 13 14 ... ... Other Diseases of Early Infancy 1 1 ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... ... Old Age 130 49 81 ... ... ... ... ... ... 1 120 41 6 29 18 36 120 3 7 ... Deaths from Accident 40 30 10 1 1 1 8 2 8 9 10 9 3 11 8 9 12 28 ... ... Deaths from Suicide 8 3 5 ... ... ... ... 1 2 4 1 ... 1 5 1 ... 4 3 1 ... Other Violent Deaths 8 8 ... ... ... ... ... 4 4 ... ... ... 1 4 2 1 ... 8 ... ... Other defined Diseases 10 6 4 ... ... 1 ... ... ... 2 4 1 ... 4 2 3 9 1 ... ... Ill-definedDiseases or unknown 3 3 ... 1 ... ... ... ... ... 1 1 ... 1 ... 1 1 1 2 ... ... All causes 1,252 650 602 143 52 39 54 64 218 332 350 256 96 327 150 423 717 405 116 14 13 Report of the Medical Officer of Health. The total number of deaths in outlying Institutions was 1,252, 650 of males and 602 of females, compared with 1,155 in 1914, 1,066 in 1913, and 940 in 1912. 717 of these deaths occurred in Workhouses and Workhouse Infirmaries; 405 in General and Special Hospitals; 116 in Public Lunatic or Imbecile Asylums; and 14 in the Metropolitan Asylums Board's Hospitals. The hospitals, asylums, etc., in which these deaths occurred are shown in detail on Table LXIII., on page 117. The corrected number of deaths, after adding the deaths of persons belonging to the Borough, and subtracting those of persons dying in the Borough and not belonging thereto, was 4,189, 2,085 of males, and 2,104 of females. The corrected death-rate for the year was 12-63 compared with 11.20 in 1914, 10.95 in 1913, and 10-48 in 1912, and 11.73 the rate for the 10 years 1905-1914. Table XI. shows the total number of deaths and the deathrates for each sub-district and for the whole Borough, corrected and uncorrected for deaths in Public Institutions. The death-rate for the whole of London for the year was 16.1 per 1,000, compared with 14.4 in 1914, 14.2 in 1913, 13.96 in 1912, and 14.83 the decennial average. 14 Report of the Medical Officer of Health. TABLE XL Sub-Districts. Corrected Deaths. Uncorrected Deaths. Corrected Death-rate. Uncorrected Death-rate. Males. Females. Total. Males. Females. Total. Clapham 361 408 769 268 325 593 12.34 9.57 Putney 194 174 368 152 148 300 12.53 10.25 Streatham 615 645 1,260 432 501 933 11.98 8.86 Tooting 251 235 486 485 538 1.023 12.65 25.33 Wandsworth 664 642 1,306 586 514 1,100 13.50 11.05 Whole Borough 2,085 2,104 4,189 1,923 2,026 3.949 12.62 11.72 i5 Report of the Medical Officer of Health. The death-rate in England and Wales in 1915 was 14.8 per 1,000, compared with 137 in 1914, 137 in 1913, and 13-3 in 1912; in the 96 Great Towns 15.9 compared with 15.6 in 1914, 14.3 in 1913, and 13.8 in 1912; and in the 148 Smaller Towns 14.2 compared with 13.1, 12.8 and 12.4. If a comparison is to be made with other places it is necessary to again correct the corrected rate, viz.:—12.62, for age and sex distribution, which gives a rate for this Borough for the year 1915 of 12.67 per 1,000, compared with 11.24 in 1914, 10-99 in 1913, and 11.03 1912. The following Table shows the factor for correction, the crude death-rate, the corrected death-rate; and the comparative mortality figure for London and for the 29 Boroughs, including the City of London, for the year 1915. 16 Report of the Medical Officer of Health. TABLE XII. AREA. Factor for Correction. for age & sex distribution. Crude Death-rate. Standardised Death-rate. ComparativeMortality Figure. England and Wales, 1,000.) England and Wales .9790 15.1 14.8 1,000 London 1.0000 i6.1 16.1 1,087 Lewisham .9826 12.4 12.1 819 WANDSWORTH 1.0045 12.6 12.6 851 Hampstead 1.0572 12.4 13.1 885 Stoke Newington .9512 14.7 13.9 938 Camberwell .9883 14.8 14.6 986 Hackney 1.0066 14.7 14.7 993 Kensington .9957 15.2 15.1 1,020 Hammersmith .9884 15.3 15.1 1,020 Woolwich 1.0249 15.3 15.6 1,054 Chelsea .95'3 16.6 15.7 1,060 St. Marylebone 1.0198 15.4 15.7 1,060 St. Pancras .9471 16.6 15.7 1,060 Paddington .9941 15.9 15.8 1,067 Fulham 1.0340 15.3 15.8 1,067 Battersea 1.0098 16.1 16.0 1,081 Lambeth .9804 16.4 16.0 1,081 Westminster 1.0540 15.5 16.3 1, 101 Islington .9749 16.8 16.3 1,101 Holborn 1.0034 16.7 16.7 1,128 Greenwich .9837 17.6 17.3 1,168 Deptford .9879 17.7 17.4 11175 Bethnal Green 1.0397 I7.3 17.9 1,209 Stepney 1.0433 17.6 18.3 1,236 Poplar .9898 18.9 18.7 1,263. Finsbury .9887 19.6 19.3 1,304 City of London 1.0419 18.8 19.5 1,317 Bermondsey .9976 20.2 20.1 1,358 Shoreditch 1.0331 19.5 20.1 1,358 Southwark 1.0060 20.1 20.2 1,364 17 Report of the Medical Officer of Health. In the separate sub-districts of the Borough the corrected death-rate was 11.98 in Streatham, 12.34 in Putney, 12.53 in Clapham, 12.65 in Tooting and 13.50 in Wandsworth. The rates in all the sub-districts were higher than in 1914, and this increase was due to causes which will be commented on in another part of this Report. Table XIII. shows the death-rate in the Borough, in the five sub-districts, and in England and Wales for the year, as well as the rates for the previous 10 years, compared with the decennial average. During the previous decennium the lowest mortality in the Borough and in London was in 1910, while it was lowest in England and Wales in the year 1912. The rate in 1915, although higher than in 1910, 1912, 1913 and 1914, is lower than the average of the previous 10 years in Tooting, and slightly higher in the other subdistricts. Compared with London and with England and Wales the Borough rate is considerably lower. 18 Report of the Medical Officer of Health. TABLE XIII. Clapham. Putney. Streatham. Tooting. Wandsworth. Whole Borough. London. England and Wales. 1905 12.60 11.75 10.89 16.56 14.28 12.81 15.54 15.28 1906 13.70 11.99 10.86 15.90 14.18 12.98 I5.71 15.46 1907 12.62 11.66 10.76 15.49 13.44 12.09 15.29 15.10 1908 12.75 11.41 10.43 13.62 12.72 11.97 14.87 14.83 1909 13.25 11.80 10.48 13.51 12.71 12.11 14.94 14.61 1910 10.73 10.17 9.50 10.67 11.04 10.38 13.65 13.49 1911 13.15 11.88 11.02 11.73 13.29 12.25 15.8 14.6 1912 11.64 983 9.42 10.20 11.18 10.48 13.96 13.3 1913 10.99 10.69 10.37 10.43 12.77 10.95 14.2 13.7 1914 11.22 10.74 11.35 10.95 11.27 11.20 14.4 13.7 Average, 1905-1914 12.26 11.19 10.50 12.90 12.68 11.72 14.83 14.40 1915 12.53 12.34 11.98 12.01 13.50 12.63 16.1 14.8 19 Report of the Medical Officer of Health. TABLE XIV. Causes of, and Ages at Death, during the year 1915. CAUSES OF DEATH. Deaths in or belonging to whole District at subjoined ages. Deaths in or belonging to Localities (at all ages). Deaths in Public Institutions in the District. All Ages. Males. Females. Under i year. 1 and under 2. 2 and under 5. 5 and under 15. 15 and under 25. 25 and under 45. 45 and under 65. 65 and upwards. Clapham. Putney. Streatham. Tooting. Wandsworth. Enteric Fever ... 6 5 1 ... ... ... ... 3 1 2 ... ... ... 2 2 2 14 Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 152 90 62 30 64 40 17 1 ... ... 20 8 21 24 79 33 Scarlet Kever ... 22 17 5 1 ... 8 6 6 1 ... ... 3 1 8 2 8 38 Whooping Cough 66 24 4- 28 20 16 2 ... ... ... ... 10 6 12 10 28 1 Diphtheria, and Membranous Croup 53 22 31 5 3 19 23 1 2 ... ... 8 4 9 12 20 77 Influenza 90 45 45 2 5 3 1 4 10 22 43 15 8 32 3 32 10 Erysipelas 9 2 7 ... ... ... 1 1 2 1 4 1 ... 2 2 4 ... Cerebro-spinal Fever 2C 12 8 5 3 2 3 4 2 1 ... 4 ... 4 2 10 16 Other Epidemic Diseases 2 1 1 ... ... ... ... ... 1 ... 1 1 ... 1 ... ... ••• Pulmonary Tuberculosis 329 183 146 1 ... 7 9 58 156 81 17 61 32 88 48 100 98 Tuberculous Meningitis 57 31 26 8 10 12 19 4 3 ... 1 8 8 11 11 19 6 Abdominal Tuberculosis... 15 8 7 1 2 1 4 1 4 1 1 2 ... 6 2 5 3 Other Tuberculous Diseases ... 33 23 10 5 3 3 5 3 9 4 1 7 2 9 2 13 7 Other Infective Diseases 18 13 5 5 1 ... 1 ... 5 3 3 4 4 6 I 3 2 Cancer,Malignant Disease 398 151 247 ... ... 1 ... 1 38 198 160 69 47 149 36 97 66 Rheumatic Fever 17 5 12 ... ... ... 3 8 3 2 1 4 2 3 I 7 3 Diabetes 39 23 16 ... ... ... 1 3 7 13 15 6 9 14 3 7 2 Other General Diseases... 56 25 31 2 ... ... 1 2 4 27 20 14 5 17 5 15 10 Alcoholism ... 9 6 3 ... ... ... ... ... 3 5 1 1 1 3 4 1 Chronic Poisonings ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Meningitis 24 12 12 9 1 2 5 2 3 2 ... 4 1 7 6 6 4 Cerebral Haemorrhage, Apoplexy ... 173 71 102 ... ... ... 1 1 3 60 108 42 9 60 16 46 23 Convulsions ... 28 15 13 25 1 2 ... ... ... ... ... 8 3 8 2 7 3 Other Diseases of Nervous System 142 77 65 5 ... 4 1 8 36 49 39 31 11 44 11 45 91 Organic Diseases of Heart 389 204 185 3 ... I 10 8 44 139 184 70 23 137 46 112 55 Other Diseases of Circulatory System 103 48 55 2 3 8 35 54 25 12 40 7 19 12 Bronchitis 381 184 197 36 12 9 2 1 18 82 221 80 28 112 48 113 37 Broncho-Pneumonia 147 78 69 42 26 16 6 1 5 14 37 31 23 30 13 50 21 Lobar Pneumonia 82 42 40 4 2 7 2 6 19 22 20 10 7 23 11 31 3 Pneumonia (type not ... distinguished) 134 73 61 23 11 8 7 7 18 33 27 15 13 38 18 50 16 Other Diseases of Respiratory System 48 21 27 3 1 2 2 2 7 13 17 5 1 22 9 11 4 Ulcer of Stomach 15 11 4 ... ... ... ... ... 8 7 ... 6 1 3 2 3 2 Diarrhcea 6fc 33 35 54 12 1 ... 1 ... ... ... 12 7 10 14 25 1 Enteritis 57 30 27 44 5 1 ... 1 ... 4 2 12 3 15 8 19 4 Appendicitis andTyphlitis 20 II 9 ... ... 2 3 3 6 3 3 2 3 10 1 4 7 Obstruction of Intestines 82 10 13 4 1 1 1 ... 7 2 7 3 3 7 1 9 7 Cirrhosis of Liver 34 21 13 3 23 8 9 4 8 5 8 2 Other Diseases of Liver... 11 8 3 1 ... ... ... ... 3 3 4 1 2 4 4 ... Other Diseases of Digestive System 63 35 28 11 1 1 2 3 9 21 15 7 4 18 7 27 7 Nephritis and Bright's Disease 120 63 57 3 ... 1 ... 2 14 54 46 14 19 38 12 37 20 Other Diseases of Urinary System 24 19 5 ... ... ... ... ... 3 4 17 4 2 11 1 6 3 Diseases of Generative System 11 1 10 ... ... ... ... ... 2 8 1 ... ... 5 1 5 2 Puerperal Fever 4 ... 4 ... ... ... ... ... 4 ... ... 1 ... ... ... 2 2 Other Accidents and Diseases of Pregnancy and Childbirth 12 12 ... ... ... ... ... 12 ... ... ... 3 4 1 4 1 Premature Birth 9c 57 33 90 ... ... ... ... ... ... ... 19 6 25 9 31 3 Congenital Debility and Malformation 111 57 54 107 3 ... 1 ... ... ... ... 19 6 3i 18 37 14 Other Diseases of Early Infancy 24 18 6 24 ... ... ... ... ... ... ... 3 1 4 5 11 3 Old Age 31c 107 203 ... ... ... ... ... ... 1 309 81 19 97 29 84 394 Deaths from Accident ... 81 54 27 5 3 4 13 2 11 16 27 14 10 22 9 26 29 Deaths from Suicide 16 7 9 ... ... ... ... 1 5 9 ... ... 2 10 1 3 7 Other Violent Deaths 18 18 ... ... ... ... ... 10 7 ... 1 ... 2 5 3 8 58 Other defined Diseases ... 23 9 14 2 1 1 3 1 I 4 10 3 1 10 4 5 ... Ill-defined Diseases or unknown 12 5 7 2 ... 1 ... ... 1 5 3 ... 1 5 1 5 3 All causes 4189 2085 2104 590 191 178 157 163 508 073 1420 760 368 1260 486 1306 1225 b 2 20 Report of the Medical Officer of Health. Table XV. is the general mortality Table for the whole district, corrected for internal and external Institutions, and also includes all deaths of Borough residents occurring in other places in London, and in England and Wales during the year. Compared with 1914 there has been an increase in the number of deaths from Measles, Influenza, Whooping Cough, Tuberculous diseases, Cancer, diseases of the circulatory organs and Old Age, and these increases are the cause of the death-rate for the year having been higher than in 1914. The deaths from Suicide have decreased from 22 in 1914 to 16 in 1915, and the deaths from accident from 86 in 1914 to 81 in 1915. The four Tables which follow are inserted by request of the Local Government Board. The number of deaths shown in columns 2 and 11 on Table XVII. do not agree with the total number of deaths shown on Table XIV., as on the former Table the deaths of soldiers and sailors occurring in hospitals, etc., in the Borough have, on the instruction of the Local Government Board, been excluded. TABLE XV. Wandsworth District. Vital Statistics of Whole District during 1915 and previous years. (Table I.) Year. Population estimated to Middle of each Year. 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 i Year of Age. At all Ages. Number. Rate per 1000 Nett Births. Number. Rate. Number. Rate. Number. Rate. 1 2 3 4 5 6 7 8 9 10 11 12 13 1910 299,061 6,873 6,967 23.21 2,856 9.38 564 812 545 78 3,105 10.34 1911 308,156 6,555 6,699 21.73 3,456 11.02 669 989 823 122 3,776 12.25 1912 313,76I 6,580 6,756 21.53 3,118 9.77 767 940 516 76 3,291 10.48 1913 321.340 6,679 6,838 20.87 3,344 10.04 822 1,066 605 88 3,588 10.95 1914 326,945 6,690 6,684 20.44 3,332 10.02 824 1,155 589 88 3,664 11.20 1915 331,556 6,210 6,383 19 25 3,949 11.72 1,012 1,252 590 92 4,189 12.67 Area of District in acres (exclusi ve of area covered by waier) 9,126 Total population at all ages 311360 Number of inhabited houses 48,432 Average number of persons per house 6.42 At Census of 1911. 21 Report of the Medical Officer of Health. 22 TABLE XVI. Wandsworth District. Cases of Infectious Disease notified during the year 1915. (Table II.) Notifiable Disease. No. of Cases Notified. Total Cases Notified in each Locality. Total cases removed to Hospital. At all Ages. At Ages—Years. Clapham. Putney. Streatham. Tooting. Wandsworth. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 45. 45 to 65. 65 and upwards. Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera, Plague ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria (including Membranous Croup) 723 8 184 419 67 40 4 1 74 37 140 206 266 642 Erysipelas 195 4 5 18 15 58 65 30 31 15 43 33 73 32 Scarlet Fever 1.309 10 262 853 121 62 1 ... 194 64 294 312 445 1,209 Typhus Fever 1 ... ... ... ... 1 ... ... ... ... ... 1 ... 1 Enteric Fever 50 ... 3 9 12 18 8 ... 5 6 15 7 17 30 Relapsing Fever, Continued Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Fever 11 ... ... ... 1 8 2 ... 1 1 1 2 6 9 Cerebro-spinal Meningitis 47 5 10 '7 9 1 5 ... 6 2 14 5 20 35 Polio-Myelitis 10 2 6 2 ... ... ... ... ... 1 3 ... 6 6 Ophthalmia Net natorum 44 44 ... ... ... ... ... ... 8 3 10 9 14 5 Pulmonary Tuberculosis 646 4 25 54 119 300 122 22 127 49 170 94 206 ... Other Icrms of Tuberculosis 234 21 47 94 33 26 7 6 35 24 52 44 79 ... Chicken-pox 191 6 56 123 3 3 ... ... 53 11 35 40 52 ... Totals 3,461 104 598 1.589 380 517 214 59 534 213 777 753 1,184 1,960 Report of the Medical Officer of Health. Report of the Medical Officer of Health. TABLE XVII. Wandsworth district. Causes of, and Ages at Death during the Year 1915. (Table III) Causes of Death. Nett Deaths at the subjoined ages of "Residents" whether occurring within or without the district. Total Deaths whether of " Residents" or " non-Residcnts in Institutions in the District. All ages. Under 1 year 1 & under 2 years. 2 & under 5 years 5 & under 15 years. 15 & under 25 years. 25 & under 45 years. 45 & under 65 years. 65 and upwards. 1 2 3 4 5 6 7 8 9 10 11 All causes Certified 4-i25 586 191 178 157 143 488 962 1,420 1,139 Uncertified 16 4 ... ... ... ... 1 2 9 ... Enteric Fever 5 ... ... ... ... 2 1 2 ... io Small-Pox ... ... ... ... ... ... ... ... ... Measles 152 30 64 40 17 1 ... 33 Scarlet Fever 21 1 ... 8 6 5 1 ... ... 38 Whooping Cough 66 28 20 16 2 ... ... ... ... 1 Diphthria and Croup 53 5 3 19 23 1 2 77 Influenza 89 2 5 3 1 4 10 21 43 9 Erysipelas 9 ... ... ... 1 1 2 1 4 ... Phthisis (Pulmonary Tuberculosis) 325 1 ... 7 9 58 152 81 17 89 Tuberculous Meningitis 57 8 10 12 19 4 3 ... 1 6 Other Tuberculous Diseases 47 6 5 4 9 3 13 5 2 9 Cancer malignant disease 397 ... ... 1 ... ... 38 198 160 65 Rheumatic Fever 16 ... ... ... 3 7 3 2 1 3 Meningitis 42 14 4 4 8 4 5 3 ... 19 Organic Heart Disease 384 3 ... 1 10 8 42 136 184 55 Bronchitis 380 36 12 9 2 1 17 82 221 37 Pneumonia (all forms) 361 69 39 31 15 13 41 69 84 38 Other diseases of Respiratory organs 48 3 1 3 2 2 7 13 17 4 Diarrhœa and Enteritis 125 98 17 2 ... 2 ... 4 2 5 Appendicitis and Typhlitis 20 ... ... 2 3 3 6 3 3 7 Cirrhosis of Liver 34 ... ... ... ... ... 3 23 8 2 Alcoholism 9 ... ... ... ... ... 3 5 1 1 Nephritis Bright's Disease 119 3 ... 1 ... 1 14 54 46 20 Puerperal Fever 4 ... ... ... ... ... 4 ... ... 2 Other accidents and diseases of Pregnancy and Parturition 12 ... ... ... ... ... 12 ... ... 1 Congenital Debility and Malformation, including mature Birth 225 221 3 ... 1 ... ... ... ... 20 Violent Deaths, excluding Suicide 82 5 3 4 13 2 11 16 28 31 Suicides 16 ... ... ... ... 1 5 9 1 7 Other Defined Diseases 1,031 55 5 10 13 20 93 232 603 537 Diseases ill-defined or Known 12 2 ... 1 ... ... 1 5 3 3 Totals 4,141 590 191 178 157 143 489 964 1,429 1,139 Sub-Entries included in above figures. Cerebro-spinal Meningitis 18 5 3 2 3 2 2 1 ... 16 Polio-Myelitis 2 1 ... 1 ... ... ... ... ... ... Tetanus 1 ... ... ... ... ... 1 ... ... ... Syphilis 10 5 1 ... ... ... 3 1 ... 1 23 24 Report of the Medical Officer of Health. TABLE XVIII. (Table IV.) Borough of Wandsworth. Infant Mortality. 1915. Nett Deaths from stated causes at various Ages under 1 Year of Age. Cause of Death. Under 1 Week. 1— 2 Weeks. 2—3 Weeks. 3-4 Weeks. Total under 4 Weeks. 4 Weeks and under 3 Months 3 Months and under 6 Months 6 Months and under 9 Months 9 Months and under 12 Months. Total Deaths under 1 year. All Causes- Certified 125 30 22 26 203 82 96 106 99 586 Uncertified 3 ... ... ... 3 1 ... ... ... 4 Small-pox ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... 2 1 12 15 30 Scarlet Fever ... ... ... ... ... ... ... ... 1 1 Whooping Cough ... ... ... ... ... 10 5 6 7 28 Diphtheria and Croup ... ... ... ... ... 1 1 1 2 5 Erysipelas ... ... ... ... ... ... ... ... ... ... Tuberculous Meningitis ... ... ... ... ... ... 3 2 3 8 Abdominal Tuberculosis ... ... ... ... ... ... ... ... 1 1 Other Tuberculous Diseases ... ... ... ... ... ... ... 2 4 6 Meningitis (not Tuberculous) 1 1 ... ... 2 2 1 2 2 9 Convulsions 6 4 1 2 13 1 4 4 3 25 Laryngitis ... ... ... ... ... ... ... ... ... ... Bronchitis ... 3 2 1 6 5 10 10 5 36 Pneumonia (all forms) ... 2 2 1 5 7 17 17 23 69 Diarrhœa ... ... ... 1 1 9 14 17 13 54 Enteritis 1 ... 1 ... 2 10 15 9 8 44 Gastritis ... ... 1 1 2 1 ... ... ... 3 Syphilis 1 ... 1 ... 2 1 1 ... 1 5 Rickets ... ... ... ... ... ... ... 1 1 2 Suffocation, overlying 4 ... ... ... 4 ... ... ... ... 4 Injury at birth 14 1 ... ... 15 ... ... ... ... 15 Atelectasis 7 ... ... ... 7 ... ... ... ... 7 Congenital Malformations 20 1 2 1 24 1 3 2 1 31 Premature birth 55 9 8 10 82 7 1 ... ... 90 Atrophy, Debility and Marasmus 14 7 3 8 32 16 13 11 4 76 Other Causes 5 2 1 1 9 10 7 10 5 41 Totals 128 30 22 26 206 83 96 106 99 590 Nett Births in the year, legitimate, 5,987; illegitimate, 396. Nett Deaths in the year of legitimate infants, 531; illegitimate infants, 59. Report of the Medical Officer of Health 25 Ages at Death. The following Table shows the percentage of deaths to total; deaths at six age periods for each sub-district and for the whole Borough. TABLE XIX. Sub-Districts. Under 1 year. 1 and under 5 years. 5 and under 15 years. 15 and under 25 years. 25 and under 65 years. 65 years and upwards. Clapham 14.04 6.51 3.64 2.99 34.33 38.49 Putney 10.05 8.41 1.65 5.71 38.58 35.60 Streatham 11.38 4.86 2.63 2.87 39.41 38.85 Tooting 19.13 10.69 7.62 5.35 31.69 25.52 Wandsworth 15.69 13.39 4.06 4.37 32.62 29.87 Whole Borough 14.00 8.82 3.75 3.89 35.39 34.15 Infantile Mortality. The following Table shows the number of deaths, the percentage to total deaths, the rate per 1,000 births for the year and for the three previous years for each sub-district and for the whole Borough. TABLE XX. Sub-District. No. of Deaths under one year. Percentage to total Deaths. Rate per 1,000 Births. 1912 1913 1914 1915 Clapham 108 14.04 76 82 76 92 Putney 37 10.05 69 85 87 78 Streatham 147 11.38 58 74 86 76 Tooting 93 19.13 100 91 114 104 Wandsworth 205 15.69 83 103 84 104 Whole Borough 590 14.00 76 88 88 92 26 Report of the Medical Officer of Health. In Table IV. of the Local Government Board's Tables these deaths are shown for the whole Borough at certain groups of ages, and the Tables for the separate sub-districts are included in the Appendix. The total number of births was 6,383, of which 5,987 were legitimate and 396 illegitimate, and of deaths 590, of which 531 were legitimate and 59 illegitimate. From the notifiable infective diseases six deaths occurred during the year, one from Scarlet Fever in Wandsworth, and five from Diphtheria, two in Clapham, two in Tooting and one in Wandsworth. From Measles there were 30 deaths, a considerable increase compared with the previous year. From Whooping Cough there were 28 deaths, from Diarrhoeal diseases 98, from Premature Birth 90, from other diseases of infancy 129, from Tuberculous diseases 15, from diseases of the Respiratory Organs 105, from Convulsions 25, from Syphilis five, from Suffocation (overlying) four, and from other causes 55. Compared with 1914 there has been an increase in the number of deaths from Measles, Whooping Cough, Tuberculous diseases, Respiratory diseases and Convulsions, but a decrease in the number from Diarrhoea, Premature birth and Syphilis. In all the deaths, with four exceptions, two in Clapham, one in Streatham, and one in Wandsworth, the cause of death was certified by a medical man, or by a coroner after inquest. 34.9 per cent, of the deaths occurred in the first month, compared with 38.0 in 1914, 37.7 in 1913, and 44.7 in 1912; 48.9 in the first three months, compared with 55.0, 56-0 and 65.3; and 64.4 in the first six months, compared with 75.7, 74.2 and 80.6. The Table shows that 90 died from Premature Birth, of which 82 occurred under one month, and 107 from Congenital Debility Report of the Medical Officer of Health. 27 and Malformations, compared with 111 in 1914, 113 in 1913, and 103 in 1912. Of the total deaths under one month, viz.: —206, 82 occurred from Premature Birth and 56 from Congenital Debility and Malformations, a percentage of 66-9 compared with 74.5 in 1914. From Diarrhoeal diseases only thiee deaths occurred undei one month. The greatest mortality from these diseases occurred at three to six months, and six to nine months. From Tuberculous diseases 15 deaths occurred; eight from Tuberculous Meningitis, and seven from other Tuberculous diseases, compared with 10 in 1914, and five in 1913; and 105 from diseases of the Respiratory Organs, compared with 88. Nine deaths were registered as due to Meningitis, but enquiries of the medical attendant showed that all these were due to simple Meningitis. Table XXI. shows the proportion of deaths per 1,000 births from five groups of diseases for each week under one month, from one to three months and for each three months up to one year of age. Compared with 1914, the rate from Diarrhoeal diseases was much lower, the rate having been 15.29 per 1,000 compared with 20.26 in 1914. From Premature Birth, Congenital Debility and Malformations the rate was also lower than in 1914, while from Tuberculous diseases and other causes the rate was higher. From the Table it will be seen that the rate from common infective diseases was highest at the ages nine to 12 months, from Diarrhoeal diseases at three to six months, from Premature Birth, etc., under one month, from Tuberculous diseases at three to six and six to nine months, and from other causes at six to nine months. 28 TABLE XXL Causes of Death. Under I Week. 1 and under 2 Weeks 2 and under 3 Weeks 3 and under 4 Weeks Under 1 Month. i and under 3 Months 3 and under 6 Months 6 and under 9 Months 9 and under 12 Months. 1 Total under 1 year. I. Common Infective Disea?es ... ... ... ... ... 2.03 1.09 2.96 3.90 9.98 II. Diarrhceal Diseases .15 ... .15 .15 .47 2.96 4.52 4.06 3.28 15.29 lII. Premature Birth, Congenital Debility and Malformations ... 13.87 2.65 2.03 2.96 2153 37.4 2.65 2.03 .78 30.73 [V. Tuberculous Diseases ... ... ... ... ... ... .47 .62 1.25 2.34 V. Other causes 5.92 2.03 1.24 .93 10.14 4.21 5.46 6.86 6.24 33.70 All causes ... ... ... ... 19.97 4.68 3.43 4.06 32.14 12.95 14.20 16.54 15.45 92.43 Report of the Medical Officer of Health. Report of the Medical Officer of Health. 29 The Infantile Mortal ity for the year, although it does not show any reduction from the average of the last five years, yet is below what might have been anticipated seeing that the climatic conditions were during the summer months most favourable to the production of Diarrhoeal diseases. INFECTIVE DISEASES. The next Table shows the number of deaths from these diseases during the year and for the 10 previous years. This Table is •corrected for Institutions, as a large number of deaths registered in the Borough occurred in the Grove Fever Hospital and belong to other Metropolitan Boroughs. The number above or below the corrected decennial average is also shown. TABLE XXII; 1905 I906 1907 1908 1909 I910 1911 1912 1913 1914 1915 1915 No. above corrected average. elow corrected average. 'Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... Scarlet Fever 28 19 22 21 14 12 10 11 11 13 22 .4 ... Diphtheria 31 50 41 37 29 16 14 18 18 41 53 18.2 ... Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ^Enteric Fever 11 15 10 7 6 8 9 8 5 5 6 ... 2.9 Cont'd Fever 1 1 I 2 1 3 ... ... ... ... ... ... ... Puerpl. Fever 8 11 10 6 10 5 8 11 13 9 4 ... 60 Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... *Erysipelas 14 10 10 6 8 4 10 5 6 11 9 .1 ... Measles 89 65 68 45 108 44 230 51 116 26 152 57.9 ... "Whooping C. 75 55 105 59 67 68 66 57 23 53 66 ... 34 Influenza 41 70 88 82 89 55 24 45 59 58 90 21.6 ... Diarrhoea 203 307 127 .83 120 88 350 85 168 186 125 ... 77.7 Tuberculous Diseases 360 376 352 382 362 351 389 366 355 389 434 21.8 ... Other Infective Diseases 16 16 10 11 14 13 24 28 23 33 40 19.88 ... Totals 877 995 844 841 828 667 1154 685 797 824 1001 47.88 ... 30 Report of the Medical Officer of Health. The total number of deaths from these diseases was i,ooi, 169' in Clapham, 83 in Putney, 236 in Streatham, 144 in Tooting, and 369 in Wandsworth, an increase of 177 compared with 1914, and of 47 compared with the corrected decennial average. Compared with 1914 there has been an increase in the number of deaths from Scarlet Fever, Diphtheria, Tuberculous diseases, Enteric Fever, Measles, Influenza, Whooping Cough, and other infective diseases, and a decrease in the number of deaths from Puerperal Fever, Erysipelas, and Diarrhoea. Compared with the corrected decennial average there has been an increase in the number of deaths from Diphtheria, Erysipelas, Measles, Influenza, Tuberculous diseases, and other infective diseases, but a decrease in all the others. From all infective diseases the death-rate was 3.01 per 1,000, (2.71 in Clapham, 2.82 in Putney, 2.26 in Streatham, 374 in Tooting, and 3-81 in Wandsworth), compared with 2.21 in 1914, and 3.23 the decennial average. The rate from the principal infective diseases, viz.:—Small-pox, Measles, Scarlet Fever, Whooping Cough, Diphtheria, Enteric Fever, and Diarrhoea, was 1.24 per 1,000 (1.04 in Clapham, .98 in Putney, .73 in Streatham, 1.61 in Tooting, and 1.87 in Wandsworth), compared with .99 in 1914, 1.04 in 1913, and 1.73 in 1912. The rate from these diseases was higher than in 1914, chiefly owing to the increase in the number of deaths from Measles. In out-lying Institutions 341 deaths occurred from infective diseases (64 belonging to Clapham, 32 to Putney, 72 to Streatham, 48 to Tooting, and 125 to Wandsworth), compared with 310 in 1914. Of these deaths 183 occurred in Workhouse Infirmaries, 115 in General and Special Hospitals, 33 in Public Lunatic Asylums, and 10 in the Hospitals of the Metropolitan Asylums Board. The causes of death in these Institutions is shown in Table X. Report of the Medical Officer of Health. 31 The next Table shows the death-rates from these diseases for the whole Borough and for each sub-district for the year 1915, as well as for the preceding 10 years, and the rates above or below the decennial average are also shown. TABLE XXIII. Sub-Districts. 1905 1906 1907 1908 1909 1910 1911 1912 1913 1914 1915 1915 Rate above decennial average. Rate below decennial average. Clapham 3.06 3.67 2.66 2.82 2.87 2.09 3.69 2.41 2.19 2.32 2.71 ... •07 Putney 3.32 3.19 2.36 2.36 2.58 2.36 2.57 1.92 2.10 1.85 2.82 .36 ... Streatham 2.44 2.88 2.18 2.58 2.05 1.82 2.89 1.60 1.83 2.20 2.26 .04 ... Tooting 5.47 6.17 5.53 3.90 4.04 2.56 4.84 2.60 3.16 3.35 3.74 ... .38 Wandsworth. 4.01 4.16 3.76 3.39 3.35 2.57 4.65 2.56 3.04 2.85 3.81 .38 ... Borough 3.38 3.73 3.07 2.98 2.85 2.23 3.74 2.18 2.43 2.21 3.01 .13 ... The death-rate was thus -8o above the rate for 1914 and '13 above the decennial average. The rate in all the sub-districts was higher than in the previous year, but in Clapham and Tooting it was lower than the decennial average. Notification of Infective Diseases. The total number of cases of infective diseases notified during the year is shown in Table II. of the Local Government Board's Table at page 22. The number of cases notified in this Borough for the year and for the previous 10 years is shown in the following Table, as also the number above or below the corrected decennial average. 32 Report of the Medical Officer of Health. TABLE XXIV. 1905 1906 1907 1908 1909 1910 1911 1912 1913 1914 1915 1915 No. above decennial average. No. below decennial average. Small-pox 1 ... ... ... ... ... ... ... ... ... ... ... .1 Scarlet Fever 1494 1069 1330 1232 987 687 869 833 971 1417 1309 69 ... Diphtheria 348 566 629 581 380 284 510 431 430 552 723 196 ... Typhus Fevers. ... ... ... ... ... ... ... ... ... ... 1 .1 ... Enteric 96 96 70 60 66 54 58 71 50 48 50 ... 22 *Continued 1 1 ... ... 2 ... 5 2 2 ... ... ... 14 Relapsing ... ... ... ... ...... ... ... ... ... ... ... ... ... Puerperal, 18 25 25 14 26 20 24 27 32 30 11 ... 15 Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas 253 273 213 203 192 182 202 207 204 234 195 ... 46 Cerebrospinal Meningitis ... ... 3 5 ... 5 5 3 9 3 47 43 ... Polio-Myelitis ... ... ... ... ... ... 5 5 13 3 10 7 ... Ophthalmia Neonatorum ... ... ... ... ... ... 34 35 37 51 44 26 ... "Chicken-pox ... ... ... ... ... ... ... ... ... ... 191 ... ... Total 2211 2030 2270 2095 1657 1232 1712 1614 1748 2338 2581 464 ... Report of the Medical Officer of Health. 33 The following Table shows the total number of cases of infective diseases notified during the year, the number removed to hospital, the number that died in hospital and at home, as well as the total number of deaths. TABLE XXV. Cases of Infective Diseases Notified. Disease. No. of cases notified. No. ot patients removed to Hospital. No. died in Hospital. No. died at Home. Total deaths in Hospital and at Home. Small-pox ... ... ... ... ... Scarlet Fever 1,309 1,209 22 ... 22 Erysipelas 195 32 7 2 9 Diphtheria 723 642 45 8 53 Enteric Fever 50 30 5 1 6 Continued Fever ... ... ... ... ... Puerperal Fever 11 9 4 ... 4 Cerebro-spinal Meningitis 47 35 13 7 20 Polio-Myelitis 10 6 2 ... 2 Ophthalmia Neonatorum 44 5 ... ... ... Typhus Fever ... 1 ... ... ... Chicken-pox 191 ... ... ... ... Total 2,581 1,969 98 18 116 No cases of Small-pox were notified during the year, none in 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913 or 1914, one in 1905, six in 1904, and 28 in 1903. One case of Typhus Fever was notified and removed to hospital where on further examination it was found not to be a case of Typhus Fever. 1,309 cases of Scarlet Fever were notified, compared with 1,417 in 1914, and 971 in 1913; of Diphtheria 723 compared with 552, 430 and 431; of Enteric Fever 53, compared with 48, 50 and 71; of Puerperal Fever 11 compared with 30, 32 and 27; and of Erysipelas 195, compared with 234, 204, and 207. Compared with 1914 there has been an increase in the number of cases of Diphtheria, Enteric Fever, Cerebro-Spinal Meningitis, c 34 Report of the Medical Officer of Health. Polio-Myelitis and Ophthalmia Neonatorum, and a decrease in'the number of cases of Scarlet Fever, Erysipelas and Puerperal Fever. Compared with the corrected decennial average there has been an increase in the number of cases of Scarlet Fever, Diphtheria, Cerebro-Spinal Meningitis, Polio-Myelitis and Ophthalmia Neonatorum ; and a decrease in the number of cases of Enteric Fever, Continued Fever, Erysipelas, and Puerperal Fever. The total number of cases notified was 2,581 (372 in Clapham, 140 in Putney, 555 in Streatham, 615 in Tooting, and 899 in Wandsworth), compared with 2,338 in 1914, 1,748 in 1913, and 1,614 *n 1912. The increase over 1914 was due to a large extent owing to the fact that Chicken-pox was made notifiable for three months, 191 cases being notified during that period. Vaccination. Table XXVI. is taken from the official returns of the Vaccination Officers to the Board of Guardians for the year 1914. It shows the number of children successfully vaccinated for the whole Borough, as well as for the separate sub-districts. Streatham, Balham and Tooting are included under the heading of Streatham. TABLE XXVI. SubDistricts. Number of Births returned from 1st January to 31st of December, 1914. Successfully Vaccinated. Insusceptible of Vaccination. Had Small-pox. Dead, Unvaccinated. Certificates of Conscientious objection. Postponed by Medical Certificate. Removed to District, Vaccination Officer of which has been duly apprised. Removed to places unknown, or which cannot be traced; and cases not having been found. Remaining on Books as Unvaccinated. Clapham 1,171 559 4 ... 87 352 9 21 126 13 Putney 456 325 1 ... 24 83 1 9 12 1 Streatham 2,805 1,110 5 ... 192 720 24 34 269 451 Wandswth 2,201 1,177 4 ... 143 511 20 43 277 26 Totals 6,633 3,171 14 ... 446 1,666 54 107 684 491 Report of the Medical Officer of Health. 35 During the year 1914, of 6,633 children whose births were registered, 3,171 or 47.8 per cent. were successfully vaccinated, compared with 45.1 per cent, in 1913, and 52.0 per cent. in 1912. This is a slight increase compared with the previous year, but is, with the exception of 1913, the lowest rate recorded. The returns for the year 1914 again show a decided decrease as regards successful vaccination, compared with the decennial average, and the record of the number of unvaccinated children in the Borough, especially in Streatham and Tooting Sub-Districts, is from a public health point of view, a most unsatisfactory one. Scarlet Fever. 1,309 cases of Scarlet Fever were notified during the year, compared with 1,417 in 1914, 971 in 1913, and 833 in 1912. 194 of these were in Clapham, 64 in Putney, 294 in Streatham, 312 in Tooting, and 445 in Wandsworth. The total number of deaths was 22, and the death-rate per 1,000 population was .06, compared with .03 in 1914. The case mortality was 1.69 per cent., compared with .91 in 1914, 113 in 1913, and 1.32 in 1912. The following Table shows the rate of notified cases per 1,000 persons living for each sub-district and for the whole Borough for the year, and the three previous years, as well as the corresponding rates for the whole of London. c 2 36 Report of the Medical Officer of Health. TABLE XXVII. Sub-Districts. 1912 1913 1914 1915 Clapham 2*24 3*33 3"'5 311 Putney ... i*43 1 50 4'37 218 Streatham 2*32 272 321 280 Tooting... 5'80 4*10 611 8'12 Wandsworth ... 2-42 3'°° 5-25 460 Whole Borough 2*65 2*97 433 394 London ... 2*50 388 5-64 375 In all the sub-districts, with the exception of Tooting, the rate was lower than in 1914, and for the whole Borough it was -39 per 1,000 under the rate for the previous year. In Clapham the greatest number of cases was notified in November, and the smallest in August. In Putney the greatest number of cases was notified in April, * in Streatham in June, in Tooting in October, and in Wandsworth in October. The rate in Tooting was to some extent raised by the notification of cases from the Fever Hospital. The total number of cases notified from this Institution was 37, and if these be excluded the rate instead of being 8'i2 would on that account be reduced to 7-i6 in 1915, and 574 in 1914. In the whole Borough the greatest number of cases, viz.—192, was notified in October, and the smallest in August, viz.—64. Report of the Medical Officer of Health. 37 The following Table shows the number of cases notified in each sub-district during each month of the year 1915 and for the whole year. TABLE XXVIII. SubDistricts. January. February. March. April. May. June. July. August. September. October. November. December. Whole Year. Clapham 17 11 12 18 13 17 11 9 18 27 29 12 194 Putney 6 9 5 11 4 5 6 2 4 4 5 3 64 Streatham 23 19 25 22 28 42 14 23 24 34 24 16 294 Tooting 16 16 19 26 26 28 19 10 31 55 36 3° 312 Wandsworth 21 24 26 36 25 31 36 20 50 72 66 38 445 W'holeBorough 83 79 87 113 96 123 86 64 127 192 160 99 1,309 Scarlet Fever and Schools. The next Table shows the number of cases of Scarlet Fever for each month of the year among children in attendance at elementary and other schools, for each sub-district, also the number for the whole Borough, the number of cases among persons not at school, the number attending schools outside the Borough, as well as the number of cases in which as far as could be ascertained, the diagnosis of Scarlet Fever was incorrect. Of the total number of cases, viz.—1,309, the diagnosis was incorrect in 55 or 4.2 per cent.; 715 or 54.6 per cent. were in attendance at schools in the Borough; 46 or 3.5 per cent. attended schools outside the Borough; while 493 or 37.6 per cent. did not attend school, being either over or under school age. 38 Report of the Medical Officer of Health. The percentage of children attending school in the Borough was as follows :—in Clapham, 77 out of 194, or 39 per cent.; in Putney, 31 out of 64, or 48 per cent.; in Streatham, 206 out of 294, or 70 per cent.; in Tooting, 151 out of 312, or 48 per cent.; and in Wandsworth, 250 out of 445, or 48 per cent. The percentage in Tooting is calculated after deduction of the cases notified in Institutions in that sub-district. In Clapham the schools chiefly affected were New Park Road with 14 cases, Parochial, Old Town with 10 cases, and Haselrigge Road with nine cases. In Putney, of the 31 cases, 11 were in attendance at Hotham Road, and eight at St. Mary's. In Streatham the schools chiefly affected were Smallwood Road with 49 cases, Broadwater Road with 42 cases, Furzedown Demonstration with 22 cases, and Mitcham Lane with 10 cases. 32 of the cases were in attendance at private schools, these chiefly occurring in February, March and June. In Tooting, Tooting Graveney with, 34 cases, Fountain Road with 30 cases, Ensham Street with 25 cases, and Sellincourt Road with 24 cases, were the schools principally attacked during the year. In Wandsworth, Swaffield Road with 41 cases, Earlsfield and Waldron Road with 24 cases each, Eltringham Street with 22 cases, Garratt Lane with 20 cases, St. Faith's with 14 cases, were the schools chiefly affected. 26 of the cases were in attendance at private schools. The Medical Officer of the London County Council excluded three children from three schools during the year, in April, May and June, until a medical certificate was received to the effect that the child was free from infectious disease. The homes of these Report of the Medical Officer of Health. 39 children were visited two or three times to see that medical attendance was provided. It was necessary to carry out disinfection in Furzedown Demonstration, St. Faith's, Parochial Old Town, and Swaffield Road, and several private schools, but in all these cases, with the exception of Swaffield Road, the disinfection was carried out without closing the schools. Swaffield Road School was closed from the 15th November till the 6th December on account of the prevalence of Scarlet Fever and Diphtheria. 40 Report of the Medical Officer of Health. TABLE XXIX. Schools. January. February. March. April. May. J une. July. August. September. October. November. December. Totals. CLAPHAM. Aristotle Road ... ... 1 ... ... ... ... ... ... ... ... 1 Bonneville Road ... ... ... ... 1 ... ... ... ... ... 1 ... 2 Cavendish Road ... ... ... ... ... ... ... ... 1 2 ... 3 Christchurch 3 1 ... ... ... ... ... ... ... 2 ... ... 6 Haselrigge Road ... ... ... ... ... 4 ... ... 3 ... ... ... 9 Uarkhall Uane ... 1 ... ... 2 ... ... ... ... 2 ... ... 5 New Park Road ... ... ... ... 1 1 1 1 ... 3 6 ... 14 New Road 1 ... ... ... ... ... 1 ... ... ... ... ... 2 Parochial, ^lacaulay Road ... ... ... ... ... ... ... ... 1 2 ... ... 3 ,, Old Town ... ... 1 1 ... 1 ... ... 2 3 2 ... 10 St. Andrew's Street ... ... ... ... ... 1 ... 1 2 ... ... ... 4 St. Mary's, Crescent I*ane ... ... ... ... ... ... ... ... 1 ... ... 1 2 ,, St. Alphonsus Road ... ... ... ... ... ... ... ... ... ... 1 ... 1 Telferscot Road ... 1 ... ... ... ... ... ... ... 2 2 ... 5 Wirtemberg Street ... ... ... ... ... ... ... ... ... 1 ... ... 1 Private Schools ... 1 1 2 2 ... ... ... ... ... 1 ... 9 Total 4 4 3* 3 6 7 2 2 10 17 17 2 77 PUTNEY. All Saints ... ... ... ... ... ... 2 ... ... ... ... ... 2 Hotham Road 2 3 ... 3 1 2 ... ... ... ... ... ... 11 Roehampton National, Boys ... 1 1 ... ... 1 ... 1 ... ... ... ... 4 Girls ... 1 ... ... ... ... ... ... ... ... 1 ... 2 St. Mary's ... ... ... 3 ... ... 1 1 ... ... 3 ... 8 Private Schools ... 1 1 ... ... ... 1 1 ... ... ... ... 4 Total 2 6 2 6 1 3 4 3 ... ... 4 ... 31 STREATHAM. Broadwater Road 1 ... ... ... 3 3 ... 2 2 11 14 6 42 ,, Special ... ... ... ... ... 1 ... ... ... ... ... ... 1 Coventry Hall ... ... ... 1 ... ... ... ... ... ... ... ... 1 Eardley Road ... ... ... ... 2 ... ... 3 1 ... ... 1 7 Fircroft Road ... ... ... ... ... ... ... ... ... 1 1 1 3 Furzedown Demonstration ... ... ... 2 7 9 2 1 1 ... ... ... 2 Hearnville Road 1 2 1 2 ... ... 1 ... ... 2 ... ... 9 Hitherfield Road 2 ... ... ... ......... ... ... ... ... ... ... ... 2 Holy Trinity, Upper Tooting 1 ... ... 1 1 ... ... ... ... ... ... ... 3 „ Upper Tulse Hill ... ... ... ... ... 1 ... ... ... ... ... ... 1 Immanuel ... ... ... ... ... ... 1 ... ... ... ... ... 1 Mitcham Lane ...... ... 1 ... ... 6 ... ... ... 1 1 1 10 Oldridge Road 2 1 ... ... 1 1 ... 1 1 1 ... ... 8 Roman Catholic, Nightingale Square 1 1 ... 1 ... ... ... ... ... ... ... ... 3 St. Andrew's, Colmer Road ... 2 1 ... ... ... ... ... ... ... ... ... 3 St. Leonard's ... 1 ... ... ... ... 1 ... ... ... ... 1 3 St. Mary's ... 1 ... ... ... ... ... ... ... 1 1 ... 3 Smallwood Road ... ... ... 2 2 ... 1 3 15 17 7 2 49 Sunny hill Road 1 1 1 ... ... ... ... ... ... ... ... ... 3 Private Schools 3 6 5 ... ... 10 ... 1 ... 1 5 1 32 Total 12 15 9 9 16 3i 6 ii 20 35 29 13 206 Carried forward ... 18 25 14 x8 23 41 12 16 30 52 50 15 314 Report of the Medical Officer of Health. 41 TABLE XXIX.—continued. Schools. January. February. March. April. May. June. July. August. September. October. November. December. Totals. Brought forward 18 25 14 18 23 41 12 16 30 52 50 15 314 TOOTING. Derinton Road ... ... 1 ... 1 ... 2 ... ... 1 ... ... 5 Ensham Street 1 5 ... 2 3 ... 5 1 2 3 ... 3 25 Fountain Road 2 ... ... 3 1 2 ... 1 6 6 8 1 30 Franciscan Road I ... 2 1 2 2 1 ... 6 1 2 18 Roman Catholic, Undine Street ... 2 1 1 5 2 ... ... ... 1 ... 12 Sellincourt Road 4 ... 5 ... 1 6 2 ... 2 2 ... 2 24 Tooting Graveney 1 2 5 ... ... 6 1 5 5 4 5 ... 34 Private Schools ... ... ... 1 1 ... ... ... ... 1 ... ... 3 Total 9 9 13 8 10 21 12 8 15 23 15 8 151 WANDSWORTH. All Saints' 1 ... ... ... ... ... ... ... ... ... ... 1 2 Brandlehow Road 2 ... ... ... ... ... ... ... ... ... ... ... 2 Cambourne Road ... ... 1 3 ... 1 1 ... ... 2 1 1 10 Earlsfield 1 1 ... 1... 4 1 1 1 8 3 3 24 Elliott Central ... ... ... ... ... ... ... ... ... ... ... 1 1 Eltringham Street ... ... ... ... ... ... ... 4 5 3 8 2 22 Garratt Eane 1 1 ... 2 2 2 3 2 3 1 3 ... 20 Magdalen Road ... 1 ... ... ... ... 1 ... 1 ... 2 2 7 Merton Road ... 1 ... 1 ... 1 1 ... 2 ... ... ... 6 Riversdale 1 ... 2 1 1 ... ... ... 1 ... ... ... 6 St. Ann's 1 ... ... 2 ... ... ... ... ... 5 1 ... 9 St. Faith's 1 ... 1 ... ... 5 1 ... 6 ... ... ... 14 St. Joseph's ... ... ... 1 ... ... ... ... ... ... 1 ... 2 St. Michael's ... ... ... 1 ... ... ... ... ... ... ... ... 1 Southfields ... 2 ... ... 3 ... ... ... ... 1 2 ... 8 Swaffield Road 2 2 4 ... 2 ... 4 ... 4 10 6 7 41 Waldron Road 2 ... ... ... ... ... 1 ... 5 3 8 4 24 Wandle ... ... ... 1 2 ... 3 ... 2 1 1 2 12 Warple Way ... ... ... ... 1 ... ... ... ... 4 1 ... 6 West Hill ... ... 1 1 1 ... ... ... ... 1 1 1 7 Private Schools 2 5 1 4 ... 2 1 ... 2 2 6 1 26 Total 14 13 10 18 12 15 17 9 32 41 44 25 250 Total—Schools in Borough 41 47 37 44 45 77 41 33 77 116 109 48 715 Schools Outside Borough 3 2 2 7 4 4 1 6 2 6 5 4 46 No School 34 30 46 59 42 34 30 23 41 66 43 45 493 Incorrect diagnosis 5 ... 2 3 5 8 14 2 7 4 3 2 55 Grand Total 83 79 87 113 96 T„, 123 86 64 127 192 160 99 1,309 42 Report of the Medical Officer of Health. The Chart facing this page shows the number of cases notified in each week during the year. The greatest number, viz.—49, was notified in the third week of October, and the smallest, viz.—nine, in the third week of August Of the total number of cases notified, viz.—1,309, 10 or .76 per cent, were under one year, compared with 11, or .77 per cent, in 1914; 262 or 20.1 per cent, were from one and under five years, compared with 258 or 18.2 per cent.; 853 or 65.1 per cent. from five and under 15 years, compared with 910 or 64.2 per cent.; 121 or 9.2 per cent. from 15 and under 25 years, compared with 154 or 10.9 per cent.; and 63 or 4.8 per cent, from 25 and under 65 years, compared with 84 or 5.9 per cent. The number of dwellings in each sub-district and in the whole Borough in which multiple cases occurred is shown in the following Table. TABLE XXX. Sub-Districts. One case. Two cases. Three cases. Four cases. Five cases and upwards. Total houses invaded. Clapham 108 19 6 2 3* 138 Putney 43 5 1 2 ... 51 Streatham 199 25 8 4 1 237 Tooting 188 31 5 2 3* 229 Wandsworth 262 47 17 7 2 335 Whole Borough 800 127 37 17 9 990 *In Clapham 12 Cases occurred in an Institution. In Tooting 12 Cases occurred in the Fever Hospital, and 22 cases in the Fountain Temporary Asylum. Of the 990 houses invaded, multiple cases occurred in 190, or 19.1 per cent., compared with 147 per cent, in 1914. CHART Showing the number of Scorlet Fever, Diphtheria and Enteric Fever notified, as well as the total cases notified from these diseases during each week of the year 1915. Report of the Medical Officer of Health. 43 The 12 cases which occurred in an Institution in Clapham were children at a home for Waifs and Strays in that sub-district. The first two cases were notified on the 3rd March, followed by one on the 27th, one on the gth April, one each on the 13th and the 15th, one on the 15th May, one on the 16th July, one on the 17th, two on the 25th August, and one on the 27th. Two of the cases were reported not to be Scarlet Fever on admission to theFever Hospital. The cases in July and August occurred after the return of a previous case from hospital. During the year Scarlet Fever was exceedingly prevalent, although not quite so much as in 1914, not only in the Metropolis, but in the districts surrounding it. The rate of incidence in this Borough was slightly above that for the whole of London, the rate in the Borough being 3.94 and in London 3.75 per 1,000 of population. In the various sub-districts the rate was lowest in Putney, next in Streatham, followed by Clapham, Wandsworth and Tooting. In spite of the fact that the number of cases notified was high, the case mortality was very low. The increase of work caused by the outbreak was very great, but in spite of the depletion of the staff on account of war services the usual inquiries were carefully carried out and all necessary precautions taken. Diphtheria. The number of cases of Diphtheria notified during the year shows an increase compared with the previous year, and is also higher than any of the preceding 10 years. The total number of cases notified was 723 (74 in Clapham, 37 in Putney, 140 in Streatham, 206 in Tooting, and 266 in Wandsworth), compared with 552 in 1914, 430 in 1913, and 431 in 1912. This number was 196 above the corrected, and 252 above the uncorrected decennial average. 44 Report of the Medical Officer of Health. In all the sub-districts (with the exception of Putney), there has been an increase compared with 1914, in Clapham of eight, in Streatham of 49, in Tooting of 99, and in Wandsworth of 35, while in Putney the decrease was 20. The greatest number of cases occurred in Wandsworth, and the smallest in Putney. The number of cases notified per 1,000 of population was 2.18, compared with 1.68 in 1914, 1.34 in 1913, and 1.37 in 1912; and in London 2.2, compared with 2.0, 16, 1.57 and 17. 642, or 89 per cent. of the cases were removed to hospital where 45 died, and 81 or 11 per cent, were treated at home with eight deaths. The case mortality was 7.3 per cent., compared with 7-4 in 1914, 4-2 in 1913, and 41 in 1912. The case mortality for the whole of London for the year 1915 was 7.6 per cent., compared with 7.7 in 1914, 5.6 in 1913, and 7.4 in 1912. The case mortality among cases treated in hospital was 7.0 per cent., and among those treated at home 9.8 per cent. The case-rate for the year is .5 above that for the year 1914, and .4 above the average for the 10 years 1905-1914. The highest case-rate was in Tooting, and the lowest in Streatham. The case-rate for the Borough is 1 under that for the whole of London, and the death-rate is also .1 lower. Report of the Medical Officer of Health. 45 The death-rate per 1,000 in the Borough was .15 compared with .12 in 1914, .06 in 1913, and .06 in 1912, and .11 the decennial average. The Chart (facing page 42) shows the number of cases notified during each week of the year. The maximum number of cases, viz.—36, was notified in the first week of November, and the minimum, viz.—three, in the third week of May. The total number of cases, viz.—723, is above the number for 1914, and also the decennial average, but there was no outbreak of any special significance in any part of the Borough, with the exception of two slight outbreaks, one in a school in Tooting in October, and the other in a school in Wandsworth in October and November. The latter is the subject of a special report which appears on page 49. Diphtheria and School Attendance. The following Table shows the number of cases of Diphtheria and their relationship to the schools in the Borough:— 46 Report of the Medical Officer of Health. TABLE XXXI. SCHOOLS. January. February. March. April. May. June. July. August. September. October. November. December. Totals. CLAPHAM. Aristotle Road ... ... ... ... ... ... ... ... 1 ... ... ... 1 Bonneville Road ... ... 1 ... 1 ... ... ... ... ... 1 2 5 Cavendish Road ... ... ... ... ... ... ... ... ... ... 1 ... 1 Christchurch 1 ... ... ... ... ... ... ... ... ... ... ... 1 Haselrigge Road ... ... 3 ... ... ... ... ... 1 2 ... ... 6 Larkhall Lane 1 ... ... ... 1 ... ... ... ... ... ... ... 2 New Park Road ... ... ... ... ... ... ... ... ... 2 ... ... 2 Parochial, Macaulay Road ... ... ... ... ... ... ... ... ... 1 ... ... 1 ,, Old Town ... ... ... ... ... ... 1 ... ... ... ... ... 1 St. Andrew's Street ... ... ... ... ... ... ... ... ... ... 3 1 4 St. Mary's, Crescent Lane ... ... 1 ... ... ... ... ... ... ... ... ... 1 Telferscot Road ... ... ... ... ... ... 1 2 ... ... 1 ... 4 Wirtemberg Street ... ... ... ... ... ... ... ... ... ... 1 ... 1 Private Schools ... ... ... ... ... ... ... ... 1 ... ... 2 3 Total 2 ... 5 ... 2 ... 2 2 3 5 7 5 33 PUTNEY. All Saints' ... ... ... ... ... ... ... ... 2 ... ... ... 2 Hotham Road 1 ... ... ... ... ... ... ... ... 1 ... ... 2 St. Mary's ... ... 1 ... ... ... ... ... ... ... 3 ... 4 Private Schools 1 1 ... ... 1 ... 1 ... ... ... ... ... 4 Total 2 1 1 ... 1 ... 1 ... 2 1 3 ... 12 STREATHAM. Balham High Road ... ... ... ... ... ... ... ... ... ... 2 ... 2 Broadwater Road 1 1 1 ... ... ... ... 1 ... 3 ... 1 8 Coventry Hall ... ... ... ... ... ... ... ... ... ... ... 1 1 Eardley Road 1 ... ... 1 1 ... ... ... ... ... ... 1 4 Fircroft Road ... ... ... 1 ... 2 ... ... ... ... ... 1 4 Furzedown Demonstration ... ... ... 1 1 ... ... 2 6 4 ... ... 14 Hearnville Road 1 ... ... ... ... ... ... ... ... ... 1 ... 2 Holy Trinity,Upper Tooting ... ... ... ... ... ... 1 1 ... ... 2 ... 4 Immanuel ... ... ... ... ... ... ... ... ... 4 3 1 8 Mitcham Lane ... ... ... ... ... 1 ... ... ... ... ... ... 1 Oldridge Road ... ... ... ... ... ... 1 ... ... ... ... 2 3 St. Andrew's, Colmer Road ... ... ... ... ... ... ... ... 1 ... ... 1 2 St. Leonard's 1 ... ... ... ... ... ... ... ... ... ... ... 1 Smallwood Road ... ... ... 1 ... ... 1 ... 1 1 1 2 7 Private Schools 1 2 1 1 1 1 1 1 ... 1 ... 2 12 Total 5 3 2 5 3 4 4 5 8 13 9 12 73 Carried forward 9 4 8 5 6 4 7 7 13 19 19 17 118 47 Report of the Medical Officer of Health. ABLE XXXI.—continued. SCHOOLS. January. February. March. April. May. June. July. August. September. October. November. December. Totals. Brought forward 9 4 8 5 6 4 7 7 13 19 19 17 118 TOOTING. Derinton Road ... ... 1 ... ... ... ... ... 1 ... ... ... 2 Ensham Street ... ... ... 1 ... ... 1 1 5 13 4 3 28 Fountain Road ... ... ... 1 2 ... ... ... ... 2 ... ... 5 Franciscan Road ... ... ... 2 ... ... 1 ... ... ... 2 3 8 Roman Catholic Undine Street ... ... 1 ... ... ... 3 ... 2 5 1 7 19 Scllincourt Road 1 ... 1 ... ... 1 4 1 5 4 2 1 20 Tooting Graveney 2 ... ... ... 2 ... 2 2 1 3 ... 1 13 Private Schools ... ... ... ... ... ... ... ... ... ... ... ... ... Total 3 ... 3 4 4 1 11 4 14 27 9 15 95 WANDSWORTH. All Saints' ... ... 1 ... ... ... 1 ... ... 1 ... ... 3 Brandlehow Road ... 1 1 ... 1 ... ... ... ... 1 2 ... 6 Earlsfield ... 1 1 ... 1 ... ... ... 3 1 1 ... 8 Elliott Central ... ... ... ... ... ... ... ... ... ... ... ... 1 Eltringham Street ... ... ... ... ... 2 ... 2 ... ... ... 2 6 Frogmore Special ...... ... ... ... ... ... ... ... 1 ... ... ... 1 Garratt Lane ... ... ... ... ... ... 1 ... ... 1 1 ... 3 Garratt Lane Special ... ... ... ... ... ... ... ... ... 1 ... ... 1 Magdalen Road ... ... ... ... ... ... 1 ... ... ... ... ... 1 Merton Road 1 ... ... ... ... 2 1 ... ... ... 2 1 7 Riversdale 2 ... ... ... ... 1 1 ... 1 2 3 1 12 St. Ann's ... ... ... ... ... ... ... ... 1 ... ... ... 1 St. Faith's ... ... ... ... ... ... ... ... 1 1 ... ... 2 St. Michael's ... ... 1 ... ... ... ... ... ... ... ... ... 2 St. Thomas's ... ... ... ... 1 ... ... ... ... ... ... ... 1 Southfield 1 ... ... 1 ... ... ... ... ... ... ... 1 3 Swaffield Road ... 1 2 ... ... ... 3 ... 7 13 17 6 49 Waldron Road ... ... ... ... ... ... ... ... 1 ... ... 2 3 Wandle 1 ... ... ... ... 1 ... 1 1 1 1 5 12 Warple Way ... ... ... ... ... ... ... ... 1 1 ... 2 West Hill ... ... ... ... ... ... ... ... ... 3 ... 1 4 Private Schools ... 2 ... ... ... 2 1 2 ... 1 2 1 11 Total 6 6 6 2 4 8 9 5 T7 26 30 20 139 Total—Schools in Borough 18 10 17 11 14 13 27 16 44 72 58 52 352 Schools outside Borough ... 1 ... 4 1 1 2 ... 1 ... 3 2 15 No School 25 20 30 17 10 19 20 27 18 31 48 40 305 Incorrect Diagnosis 5 3 5 4 7 1 3 1 3 8 9 2 51 Grand Total 48 34 52 36 32 34 52 44 66 111 118 96 723 48 Report of the Medical Officer of Health. In Clapham, out of a total of 74 cases, 33 or 44 per cent, occurred in children attending school; in Putney, of 37 cases, 12 or 32 per cent.; in Streatham, of 140 cases, 73 or 52 per cent.; in Tooting, of 206 cases, 95 or 46 per cent.; in Wandsworth, of 266 cases, 139 or 52 per cent.; and in the whole Borough, of 723 cases, 352 were in attendance at schools in the Borough, and 15 at schools outside the Borough, a total of 367, or 50 per cent. Of the remaining cases, viz.—356, in 51 or yo per cent., the diagnosis was incorrect, and 305 or 42 per cent, were not in attendance at school. In Clapham the number of cases of Diphtheria in attendance at school was 33, the greatest number occurring in Haselrigge Road School, and the next in Bonneville Road School. In Putney 12 cases were in attendance at schools, four of these being at St. Mary's School, and four at private schools. In Streatham, Furzedown Demonstration, with 14 cases was the highest, and Broadwater Road with eight the next. In Tooting 95 cases were in attendance at schools, 28 of these being at Ensham Street, 20 cases at Sellincourt Road, and 19 at Undine Street Roman Catholic Schools. In Wandsworth there were 139 cases attending schools, and these occurred sporadically during the year, the greatest number occurring during November. In six of the schools only one case occurred in each, in three two cases, in three three cases, in one four cases, in two six cases, in one seven cases, in one eight cases, in two 12 cases, and in one 49 cases, and 11 cases occurred in various private schools. The principal school affected in Wandsworth was Swaffield Road, where 49 cases occurred, one in February, two in March, three in July, seven in September, 13 in October, 17 in November, and six in December. In consequence of the outbreak at this school the following report has been prepared:— Report of the Medical Officer of Health. 49 Diphtheria at Swaffield Road School, 1915. The outbreak commenced in September, 1915, seven cases being reported among children attending the School during that month, the classes principally affected being B, C and D of the Infants' Department. In consequence of the occurrence of these cases a request was made from the Public Health Department to the London County Council School Medical Officer, that all the children in these classes be examined. The School was visited by the London County Council School Medical Officer on the 16th and 29th September and examinations made, but no unrecognised cases were discovered. 14 cases of Diphtheria were reported during the month of October, one on the 5th, two on the 13th, one on the 15th, two on the 16th, two on the 18th, one on the 19th, one on the 25th, one on the 26th, one on the 27th, one on the 29th, and one on the 30th, 11 of these being in the Infants' Department. The children in this Department were again examined by the School Medical Officer on the 7th October, but no cases were discovered. During November 17 cases were notified—three on the 2nd, five on the 3rd, one on the 5th, two on the 6th, one on the 8th, one on the 10th, one on the 12th, two on the 13th, and one on the 19th. Eight of these were of children attending the Infants' Department, hrete the Girls' Department and six the Boys' Department. The School was visited by the School Medical Officer and the children examined on the 1st November. Swabs were taken and bacteriological examination resulted in five positive and five suspicious cases being discovered. One of these was notified on the 2nd, and four on the 3rd. The school was then frequently visited by the School Medical Officer and any suspicious case at once swabbed. As a consequence two other cases were discovered (in the Girls' Department) on the nth, and notified on the 13th. Arrangements were made by the Medical Officer of the London County Council for Medical Officers to visit the school as d 50 Report of the Medical Officer of Health. often as possible and examine the children, as he was of opinion that this would be more effectual in arresting the outbreak than closing the school and allowing the children to mix in the street and places of amusement and to be without medical supervision. On Friday, the 12th November, a definite request was made from the Public Health Department to the London County Council, Education Department, for the whole school to be closed for a period of not less than three weeks so that thorough disinfection could be carried out by the Council's staff. This request was complied with, the school being closed from Monday the 15th November, to Monday, the 6th December. The school was completely disinfected by the Council's staff during the first week of the closure and was afterwards cleansed by the London County Council staff. From September 8th to November 12th no houses were visited by the Sanitary Inspector after notice from the school that children attending from these houses were suffering from sore throat. The parents were in all cases advised to have the children seen by a Doctor. This advice was generally followed and resulted in nine cases being discovered and notified. From the 2nd September to the 15th November, the date on which the school was closed, 38 cases were notified, and from the latter date to the end of the year, seven further cases were notified, making a total of 45 cases in all. The cases generally were of an exceedingly mild type without clinical symptoms of any kind, and many of them were only discovered on bacteriological examination, two only of them proving fatal. Of the total number of cases notified 51 were incorrectly diagnosed, compared with 42 in 1914, leaving a total of 672 actual cases, compared with 510 in 1914, 376 in 1913, and 390 in 1912. 51 Report of the Medical Officer of Health. The number of dwellings in each sub-district and the whole Borough in which multiple cases occurred is shown in the following Table. TABLE XXXII. Sub-Districts. One case. Two cases. Three cases. Four cases. Five cases and upwards. Total houses invaded. Clapham 49 3 1 ... 2* 55 Putney 26 2 i ... 29 Streatham 96 8 6 ... 1* 111 Tooting 122 17 5 1 3* 148 Wandsworth 188 24 3 4 1 220 Whole Borough 481 54 16 5 7 563 * In Clapham 11 cases occurred in one house. In Streatham 10 cases occurred in an institution. In Tooting 14 cases occurred in the Fever Hospital; and 12 in the Fountain Asylum. Of the 563 houses invaded, multiple cases occurred in 82, or 14.5 per cent., an increase of 2.1 per cent, compared with 1914. 22 of the Elementary Schools, four in Clapham, three in Putney, eight in Streatham, and seven in Wandsworth, remained free from Diphtheria during the year, compared with 20 schools in 1914. In six schools, viz.Ensham Street, Fountain Road, Furzedown Demonstration, Sellincourt Road, Swaffield Road and Roman Catholic, Undine Street, it was necessary to have swabs taken from the throats of the children. In Swaffield Road School many swabs were taken at various times and seven cases were thus discovered. In Undine Street School four positive cases, and one each at Fountain Road, Furzedown Demonstration and Sellincourt Road were also discovered in the same way. D 2 52 Report of the Medical Officer of Health. Of the total number of cases of Diphtheria, eight or 1.1 per cent, occurred among children under one year, 184 or 25.4 per cent, among children from one and under five years, 419 or 57.9 per cent, from five and under 15 years, 67 or 9*2 per cent, from 15 and under 25 years, and 45 or 6.2 per cent, from 25 and under 65 years. Compared with the previous year there has been an increase at all these age groups. Of the 642 cases of Diphtheria removed to Hospital, 51 were reported not to have suffered from Diphtheria. As will be observed from the number of cases notified, Diphtheria was more prevalent during the year 1915, than in the five previous years, and this prevalence was general in London as a whole. The mortality although slightly lower than in 1914, was higher than in the previous five years with the exception of 1909. Return Cases oS Scarlet Fever and Diphtheria. 77 cases of Scarlet Fever occurred after the return of cases from the hospitals of the Metropolitan Asylums Board, compared with 51 in 1914, 45 in 1913, and 39 in 1912. There were also nine cases of Diphtheria, compared with one in 1914, 14 in 1913, and two in 1912. Nine of the return cases of Scarlet Fever occurred in Clapham, six in Putney, 16 in Streatham, 12 in Tooting, and 34 in Wandsworth. One of the return cases of Diphtheria occurred in Putney, one in Streatham, four in Tooting, and three in Wandsworth. Enteric Fever. 50 cases of Enteric Fever were notified during the year (five from Clapham, six from Putney, 15 from Streatham, seven from Report of the Medical Officer of Health. 53 Tooting, and 17 from Wandsworth), compared with 48 in 1914, 50 in 1913, and 71 in 1912, and is 22 under the corrected decennial average. 30 of the cases were removed to hospital where five died, and 20 were treated at home with one death. The total number of deaths was six, two in Streatham, two in Tooting, and two in Wandsworth, compared with five in 1914, five in 1913, and eight in 1912. The number of deaths was one more than in 1914, and is 2.9 under the decennial average. The proportion of cases notified per 1,000 of population was .15 compared with .14 in 1914, .15 in 1913, and .22 in 1912, and with .14 for the whole of London. The corrected death.rate from Fever was .018 per 1,000 compared with .015 in 1914, .015 in 1913, and .02 in 1912; while the rate for the whole of London was -026 compared with *03 in 1914, .02 in 1913, and .025 in 1912. Of the 30 cases removed to hospital, 10 or 33.3 per cent, were found not to be suffering from Enteric Fever, compared with 33.3 per cent, in 1914. The Chart (facing page 42) shows the number of cases notified during each week of the year. In 20 of the weeks during the year no cases were notified, one case each in 17 of the weeks, two cases each in 13 of the weeks, three cases in one of the weeks, and five cases in one of the weeks. The maximum number of cases, viz.—five, was notified in the fourth week of February. Of the 50 cases notified 10 were not Enteric Fever, seven occurred in the Middlesex County Asylum, and one in H.M. Prison, leaving 32 cases in which special inquiries were made as to the probable cause of the disease. 54 Report of the Medical Officer of Health. In four of the cases the disease was probably contracted by eating shell-fish, in three it was contracted outside the Borough, in one the infection was contracted from a previous case, and in four of the cases it was ascertained that ice cream had been partaken by the patient prior to the onset of the disease, while in 20 no history of infection could be ascertained. Of the four cases which were probably contracted by eating shell-fish, two were from oysters, and two from winkles partaken at various and untraceable places. Of the 10 cases which were not Enteric Fever two were fatal,, both from Tubercular Meningitis. The notification rate from this disease was again very low, while the death-rate was only .003 above the lowest rate recorded for this Borough. Cases of Mistaken Diagnosis. In 136 cases (54 of Scarlet Fever, 51 of Diphtheria, 10 of Enteric Fever, 18 of Cerebro-Spinal Fever, one of Typhus Fever, one of Polio-Myelitis, and one of Puerperal Fever), information was received from the Metropolitan Asylums Board's and other hospitals, that the patients were not suffering from the disease notified or any other notifiable disease, compared with 112 in 1914, 113 in 1913, and 88 in 1912. Cerebro-spinal Meningitis. During the year 53 cases of this disease were notified, 30 of males and 23 of females. Two of the cases were notified in January, two in February, 11 in March, 13 in April, 11 in May, four in June, four in July, two in August, two in September, and one each in October and November. The greater number of cases thus occurred in March, April and May, and this was also the case over the whole country. Report of the Medical Officer of Health. 55 The number notified is the highest recorded since the notification of the disease was made compulsory in 1907. Of the total number notified, 18 were on further inquiry found not to have suffered from cerebro-spinal fever, leaving only 35 actual cases, while of this latter number four were cases notified from a Military hospital. Of the 31 cases which properly belonged to the Borough, five were in Clapham, one in Putney, nine in Streatham, three in Tooting, and 13 in Wandsworth. Of the 18 cases wrongly diagnosed, in 10 the true diagnosis was not reported from the hospital, two were cases of posterior-basic meningitis and both died, one a case of tubercular meningitis which proved fatal, one of lobar pneumonia which was fatal, one of cerebral thrombosis which was fatal, while three were contacts in whose nasal secretion the germ had been found, but none of them developed any clinical symptoms of the disease. With regard to the age of the patients, five were under one year, seven from one and under five years, nine from five and under fifteen years, seven from 15 and under 25 years, one 25 and under 35 years, and two from 45 and under 65 years. The greatest incidence of the disease was from five and under 15 years. With regard to confirmation of the diagnosis by examination of the cerebro-spinal fluid removed by lumbar puncture, of the 31 cases, 20 were so examined, and of these 16 gave positive and four negative results. All the four cases from the Military hospital were also examined and all were positive. The mortality from epidemic Cerebro-spinal Meningitis is always high, and it is not surprising that of the 31 cases, 19 or 61.2 per cent, died (four in Clapham, one in Putney, seven in Streatham, two in Tooting, and five in Wandsworth). 56 Report of the Medical Officer of Health. Among those cases where the diagnosis was bacteriologically confirmed, viz.—16, eight died and eight recovered, while of the four where a negative result was obtained, all died. Of the n cases not bacteriologically examined, eight died and three recovered. 20 of the 31 cases were removed to Hospital, and 11 of these recovered and nine died, while of the 11 kept at home only one recovered. In nine of the 10 deaths which occurred at home, the death was sudden, and in these no notification was received until after death. Although the number of cases reported is small, yet the results show that in fulminating cases of this disease, nothing or little can be done, while if the disease is of a milder type, and the case is removed to hospital, the mortality should be about 30 per cent. In only one household affected was there a second case, and this leads one to believe that direct infection from case to case does not readily occur. Neither school infection nor insanitary conditions, with the exception of overcrowding, seemed to play any part in the spread of the disease. The outbreak of the disease was general over the whole of England, and was more prevalent in town than in country districts. The general conclusion arrived at by the Official Advisory Committee of the Medical Research Committee was that the epidemic was not one of Cerebro-spinal fever as such, but was an epidemic of the meningococcus in the throats of the population at large, and that it prevailed in winter and spring because at these seasons people are in closer contact with each other indoors. In this Borough minute and searching inquiry was made into every reported case and special instructions were given to the Sanitary Inspectors to inquire carefully as to the existence of any Report of the Medical Officer of Health. 57 overcrowding. 30 contacts were bacteriologically examined, but the results obtained were not very definite, as in one case only was the organism associated with the disease isolated. Thorough disinfection of all infected houses and articles was carried out by the staff, and I have no reason to doubt that this and other measures to some extent limited the extension of this most fatal disease. In none of the cases in the Borough was there any history of infection by military cases, although in six cases there had been association with soldiers from various camps. Inquiry was made into these, but in no case could any cause of infection be ascertained. In London 701 cases of this disease were notified during the year, compared with 73 in 1914, and 145 in 1913. 24 deaths were registered as having been caused by Meningitis, four in Clapham, one in Putney, seven in Streatham, six in Tooting, and six in Wandsworth, compared with 24 in 1914. Nine of these were of infants under one year, one from one and under two years, two from two and under five years, and 12 over five years. As in previous years inquiries were made from the medical attendant, and in all the cases the deaths were stated to have been caused by simple Meningitis. Bacteriological Examinations. During the year 865 bacteriological examinations were made at the Lister Institute, compared with 889 in 1914, and 726 in 1913. The following Table shows the number of examinations in each sub-district and for the whole Borough, also the disease for which the examination was made and the result of such examination 58 Report of the Medical Officer of Health. TABLE XXXIII. Clapham. Putney. Streatham. Tooting. Wandsworth. Whole Borough. Diphtheria. Negative 101 51 170 45 245 612 Positive 17 23 77 16 75 208 Enteric Fever. Negative 7 6 8 4 9 34 Positive 2 3 3 2 1 11 Totals 127 83 258 67 330 665 In 208 out of 612 examinations for the bacillus of Diphtheria the result was positive, and in n out of 34 examinations of blood in suspected cases of Enteric Fever the Widal re-action was obtained. Puerperal Fever. 11 cases of Puerperal Fever were notified, compared with 30 in 1914, 32 in 1913, and 27 in 1912. One case on further examination proved not to be Puerperal Fever. Of the 10 actual cases, one occurred in Clapham, one in Streatham, two in Tooting, and six in Wandsworth. Four of the cases (one in Clapham, one in Tooting, and two in Wandsworth), or 40 per cent, were fatal, compared with 30 per cent, in 1914, 40 per cent, in 1913, and 40 per cent, in 1912. Nine of the cases were removed to Institutions (three to St. James's Infirmary, five to the Metropolitan Asylums Board's. Hospitals and one to St. Thomas's Hospital), where three died, and. one was treated at home. Report of the Medical Officer of Health. 59 The death-rate was "02 per 1,000, compared with -02 in 1914, .04 in 1913, and .035 in 1912. The case-rate per 1,000 births was 17 compared with 4.4 in 1914, 4.6 in 1913, and 4.0 in 1912, and for the whole of London 2.7 compared with 3.5. In five of the cases registered midwives only were employed while two of the cases were miscarriages, two were premature, and two stillborn. Two nurses came from Battersea, one was a district nurse, and they all had baths at their own homes. In two cases no nurse was employed. In eight cases the personal clothing of the nurse was disinfected. In any case where a registered midwife was in attendance a report was forwarded to the London County Council. Erysipelas. 195 cases of Erysipelas were notified during the year and nine deaths occurred. 31 of the cases and one death occurred in Clapham, 15 cases and no death in Putney, 43 cases and two deaths in Streatham, 33 cases and two deaths in Tooting, and 73 cases and four deaths in Wandsworth. In 1914 the number of cases notified was 234, and the deaths 11. 32 of the cases were removed to the Union Infirmary, where seven died. Measles. During the year 152 deaths, 90 of males and 62 of females, were due to Measles, compared with 26 in 1914, 116 in 1913, 51 in 1912, and 230 in 1911. 6o Report of the Medical Officer of Health. 20 of the deaths occurred in Clapham, eight in Putney, 21 in Streatham, 24 in Tooting, and 79 in Wandsworth. The number of deaths is 126 more than in 19x4, and is 57-9 above the corrected decennial average. 30 of the deaths were of infants under one year, 64 from one and under two years, 40 from two and under five years, 17 from five and under 15 years, and one from 15 and under 25 years; 88 per cent, of the deaths having occurred under five years of age. % The death-rate was .45 per 1,000, compared with .07 in 1914 .36 in 1913, .16 in 1912, and .74 in 1911. The death-rate for the whole of London was *50, compared with .31 in 1914; for England and Wales .43; and for the 96 Great Towns .50; for the 148 smaller towns .52; and for England and Wales, less the 244 towns, .32 per 1,000. During the year 3,194 visits were made in cases of this disease, (compared with 621 in 1914), 337 in Clapham, 211 in Putney, 795 in Streatham, 751 in Tooting, and 1,100 in Wandsworth. Table XXXIV. shows the number of cases of notifiable and non-notifiable diseases notified by the teachers of the elementary schools in the Borough. In all, 6,512 cases were notified, compared with 5,802 in 1914, 4,907 in 1913, and 4,706 in 1912. 2,855 0f these were cases of Measles, 727 of Chicken-pox, 720 of Whooping Cough, 541 of Mumps, and 257 of Ringworm. There was an increase in the number of cases of Measles, and a decrease in the number of cases of the other diseases. Report of the Medical Officer of Health. 61 With regard to Measles, 390 cases were notified from schools in Clapham, 165 in Putney, 720 in Streatham, 549 in Tooting, and 1,031 in Wandsworth. The schools chiefly affected were, in Clapham, Bonneville Road, Haselrigge Road and Telferscot Road; in Putney, Hotham Road; in Streatham, Broadwater Road, Eardley Road, Mitcham Lane, Oldridge Road, Smallwood Road, and St. Leonard's; in Tooting, Franciscan Road and Sellincourt Road; and in Wandsworth, the Earlsfield, Eltringham Street, Garratt Lane, Riversdale, Southfield, Swaffield Road, Waldron Road, and the Wandle. Very few of the schools were quite free from the disease, but in a considerable proportion only a few cases occurred. As in former years the means adopted for the prevention of the spread of the disease were exclusion from school, education of the parents of children where cases had occurred by means of the pamphlet published in the Report for 1911, and disinfection of the premises after cases had recovered. 62 Report of the Medical Officer of Health. TABLE XXXIV. Notifiable and Non-Notifiable Diseases Reported from Schools, 1915. School. Diseases. Scarlet Fever. Diphtheria. Measles. ChickenPox. Whooping Cough. Mumps. Ringworm. Other Diseases. Totals. Clapham— Aristotle Road 1 1 ... ... ... ... ... ... 2 Bonneville Road 2 5 163 103 59 8 7 15 362 Cavendish Road 3 1 34 14 2 22 6 6 88 Christchurch 6 1 3 4 2 6 ... ... 22 Clapham Parochial, Macauley Road 3 1 ... ... ... ... ... ... 4 Clapham Parochial Old Town 10 1 43 12 10 10 1 7 94 Haselrigge Road 9 6 31 45 17 7 1 10 126 Larkhall Lane 5 2 10 4 23 2 6 7 80 New Park Road 14 2 22 4 13 3 3 4 65 New Road 2 ... 4 3 2 ... ... 2 13 St. Andrew's Street 4 4 13 2 11 5 3 7 49 St. Mary's, Crescent Lane 2 1 3 1 ••• ... 3 ... 10 St. Mary's, St. Alphonsus Road 1 ... ... ... ... ... ... ... 1 Telferscot Road 5 4 31 12 22 65 6 5 I50 Wirtemberg Street 1 1 33 6 5 6 4 2 58 Total 68 30 390 210 166 155 40 65 1,124 Putney— All Saints' 2 2 44 3 7 1 7 6 7.2 Hotham Road 11 2 80 21 11 2 5 ... 132 Roehampton National 6 ... 7 3 ... 1 ... 17 St. Mary's 8 4 34 3 15 1 2 ... 67 Total 27 8 165 3° 33 4 15 6 288 Streatham—- Balham High Road ... 2 ... ... ... ... ... ... 2 Broadwater Road 43 8 91 36 17 7 10 2 214 Christchurch ... ... 16 10 6 1 ... ... 33 Coventry Hall 1 1 ... ... ... ... ... ... 2 Eardley Road 7 4 73 4 32 46 1 2 169 Fircroft Road 3 4 45 7 10 3 1 ... 73 Holy Trinity, Balham 3 4 8 7 1 2 ... 1 26 Holy Trinity, Streatham 1 ... 4 1 5 ... ... ... 11 Hearnville Road 9 2 38 12 1 9 ... ... 71 Hitherfield Road 2 ... 43 20 4 2 3 1 75 Immanuel 1 8 30 1 2 ... ... ... 42 Mitcham Lane 10 1 111 38 31 66 8 2 267 Nightingale Sq., R.C. 3 ... 4 ... ... 2 ... ... 9 Oldridge Road 8 3 57 12 17 20 1 3 121 Smallwood Road 49 7 91 34 7 10 12 57 267 St. Andrew's, Colmer Road 3 2 17 ... 7 3 ... 6 38 St. Leonard's 3 1 22 3 15 53 ... 6 103 St. Mary's 3 ... 12 2 8 9 3 ... 37 Sunnyhill Road 3 ... 3 1 10 39 ... ... 56 Furzedown Demonstration 22 14 55 4 3 ... 3 ... 101 Total 174 61 720 182 176 272 42 80 1,707 Carried forward 269 99 1,275 422 375 431 97 151 3,119 63 Report of the Medical Officer of Health. TABLE XXXIV.—continued. Schools. Diseases. Scarlet Fever. Diphtheria. Measles. ChickenPox. Whooping Cough. Mumps. Ringworm. Other Diseases. Totals. Brought forward 269 99 1,275 422 375 431 97 151 3,119 Tooting— Derinton Road 5 2 52 7 5 13 3 5 92 Ensham 25 28 65 23 4 3 2 3 153 Fountain Road 30 5 42 22 3 14 7 27 150 Franciscan Road 18 8 188 59 5 1 2 ... 281 Sellincourt Road 24 20 92 25 29 12 9 70 281 Tooting Graveney 34 13 80 28 8 ... 4 3 170 Undine Street R .C. 12 19 30 1 5 ... 1 ... 68 Total 148 95 549 165 59 43 28 108 1,195 Wandsworth— All Saints' 2 3 28 10 1 1 3 2 50 Brandlehow Road 2 6 54 8 3 4 4 4 85 Cambourn Road 10 ... 9 2 2 3 6 31 63 Earlsfield 24 8 81 10 32 3 19 13 190 Elliott Central 1 1 ... ... ... ... ... ... 2 Eltringham Street 22 6 52 7 21 5 7 25 145 Frogmore Special ... 1 ... ... ... ... ... ... 1 Garratt Lane 20 3 50 24 1 9 30 34 171 Magdalen Road 7 1 9 3 4 ... ... 4 28 Merton Road 6 7 49 4 7 ... 3 2 78 Riversdale 6 12 92 4 32 2 7 ... 155 St. Anne's 9 1 11 5 ... ... 1 ... 27 St. Faith's 14 2 33 11 8 3 2 3 76 St. Joseph's, R.C. 2 ... 9 7 3 3 5 3 32 St. Michael's 1 2 51 8 6 3 2 3 76 St. Thomas's ... 1 ... ... ... ... ... ... 1 Southfield 8 3 100 4 61 2 4 1 183 Swaffield Road 41 49 153 13 55 4 15 33 368 Waldron Road 24 3 108 10 31 21 5 9 211 Wandle 12 12 81 3 13 3 13 11 148 Warple Way 6 2 30 2 4 ... 1 6 51 West Hill 7 4 31 5 2 1 5 2 57 Total 224 127 1,031 140 286 67 132 191 2,198 Grand Total 641 321 2.855 727 720 541 257 450 6,512 The total number of premises disinfected was 1,783 (252 in Clapham, 127 in Putney, 432 in Streatham, 314 in Tooting, and 658 in Wandsworth), compared with 372 in 1914, 1,454 in 1913, 1,006 in 1912, and 2,638 in 1911. 64 Report of the Medical Officer of Health. The greatest number of disinfections was carried out in March,. this being due to the greater prevalence of the disease in Wandsworth. The greatest number of cases occurred in January, February,. March, April, May and June. In the other months of the year the number of disinfections was small as there were very few cases in any part of the Borough. Whooping Cough. 66 deaths were registered during the year, 24 of males and 42 of females, an increase of 13 compared with 1914 (but a decrease of three compared with the decennial average). 10 of the deaths occurred in Clapham, six in Putney, 12 in Streatham, 10 in Tooting, and 28 in Wandsworth. 28 of the death were of infants under one year, 20 of children from one and under two years, 16 from two and under five years,, and two from five and under 15 years. The death-rate was .19 per 1,000, compared with .16 in 1914, •07 in 1913, .15 in 1912, and .25 for the whole of London in 1915. The disease was not quite so prevalent in London and in this Bordugh in the year 1915 as in the previous year. In the subdistricts of Clapham, Streatham and Wandsworth, it was more prevalent than in the other sub-districts. The number of cases notified from schools was 720, compared with 842 in 1914, 496 in 1913, 1,014 in 1912, 286 of these being from schools in the sub-district of Wandsworth, the schools chiefly affected in that sub-district being the Southfield, Swaffield Road,. Earlsfield, Riversdale and Waldron Road. There were also 176 cases notified from schools in Streatham, the schools chiefly affected having been Eardley Road, Mitcham Lane, Broadwater Road and Oldridge Road. Report of the Medical Officer of Health. 65 The greatest mortality from Whooping Cough occurs among children under five years of age. Of the 66 deaths that occurred f rom this disease, 64 were of children under five years. The pamphlet, published in the Report for 1910, was left at every house where a case of Whooping Cough had been notified from school, and also in all other known cases. During the year 337 visits were made by the Sanitary Inspectors in cases of Whooping Cough, 47 in Clapham, 14 in Putney, 96 in Streatham, 41 in Tooting, and 139 in Wandsworth. Other Diseases notified from Schools. In addition to the 2,855 cases of Measles and 720 of Whooping Cough notified by the teachers of elementary schools, there were also notified 727 cases of Chicken-pox, 541 of Mumps, 257 of Ringworm, and 450 of other diseases. Chicken-pox was most prevalent in Clapham and Tooting, Mumps in Streatham, and Ringworm in Wandsworth. Disinfection of Schools. During the year the following schools were disinfected on account of the prevalence of Scarlet Fever, Diphtheria and German Measles. (1) Private School, Balham. Seven rooms disinfected after Scarlet Fever on the 29th January. (2) Furzedown Demonstration, Streatham. 48 rooms disinfected after Scarlet Fever on the 25th May, 9th and 10th July. (3) Private School, Balham. Two rooms disinfected after German Measles on the 19th June. E 66 Report of the Medical Officer of Health. (4) Private School, Balham. Four rooms disinfected after Scarlet Fever on the 10th July. (5) St. Faith's School, Wandsworth. Three rooms disinfected after Scarlet Fever on the 5th October. (6) Parochial, Old Town, Clapham. Three rooms disinfected after Scarlet Fever on the 8th October. (7) Private School, Wandsworth. One room disinfected after Scarlet Fever on the gth November. (8) Swaffield Road School, Wandsworth. 86 rooms disinfected after Scarlet Fever and Diphtheria on the 16th, 18th, 19th and 22nd November. (9) Private School, Balham. Five rooms disinfected after Scarlet Fever on the 29th November. Epidemic Influenza. 90 deaths, 45 of males, and 45 of females, were due to this disease, compared with 58 in 1914,59 in 1913, and 45 in 1912. There has thus been an increase of 32 deaths compared with the previous year, and of 21 compared with the corrected decennial average. 15 of the deaths occurred in Clapham, eight in Putney, 32 in Streatham, three in Tooting, and 32 in Wandsworth. The death-rate was .27 per 1,000, compared with .17 in 1914, .18 in 1913, and .18 in 1912. 22 of the deaths were of persons from 25 and under 65 years, and 43 of persons over 65 years. Report of the Medical Officer of Health. 67 Diarrhœa. 125 deaths, 63 of males and 62 of females, occurred from all forms of Diarrhoea and Enteritis during the year, compared with 186 in' 1914, 168 in 1913, and 85 in 1912. There has thus been a decrease'of 61 in the number of deaths from these diseases compared with the previous year, and of 777 compared with the corrected decennial average. 24 of the deaths occurred in Clapham, 10 in Putney, 25 in Streatham, 32 in Tooting, and 44 in Wandsworth. In all the sub-districts there was a decrease compared with 1914. The death-rate was .37 per 1,000 (in Clapham .38, in Putney .34, in Streatham .23, in Tooting .83, and in Wandsworth .45), compared with .37 in 1914, .51 in 1913, and .27 in 1912. The total number of deaths of children under two years was 116, equal to a rate of 34 per 1,000, compared with .49 in 1914, and .47 in 1913, while the death-rate for the whole of London under two years was .56 per 1,000, compared with .67. Of the total number of deaths registered, 99 or 78 per cent, were of infants under one year, compared with 73 per cent, in 1914, 78 per cent, in 1913, and 70 per cent, in 1912. The following Table shows the number of deaths from Diarrhœa and Enteritis under one year for the four quarters of 1915 and for the five previous years. e 2 68 Report of the Medical Officer of Health. TABLE XXXV. 1910. 1911. 1912. 1913. 1914. 1915. Total deaths under one year from Diarrhoea and Dysentery, including Epidemic Diarrhœa and Zymotic Enteritis in first quarter of the year 4 2 1 3 6 ... Do. in second quarter 6 5 4 5 3 11 Do. in third quarter 14 89 10 33 51 32 Do. in fourth quarter 11 8 3 10 6 21 Total deaths under one year from other forms of Enteritis in first quarter of year 9 ... 12 14 11 7 Do. in second quarter 9 11 11 14 8 5 Do. in third quarter 19 110 15 32 37 18 Do. in fourth quarter 16 40 4 21 14 14 32 out of a total of 54 deaths from Diarrhoea, and 18 out of a total of 44 from Enteritis, occurred in the third quarter of the year. The number of deaths from Diarrhoea, Zymotic Enteritis, and Enteritis under one year represents 21.1 per cent, of the total mortality at that age, compared with 23.3 per cent, in 1914, 21.8 per cent, in 1913, and 11.6 per cent, in 1912. In all the deaths under one year from Diarrhœa and Enteritis, special inquiries were made, and the following Tables show the nature of the food given. 69 Report of the Medical Officer of Health. TABLE XXXVI. Method of Feeding. Age in Months. 0 and under 3. 3 and under 6. 6 and under 9. 9 and under 12. Total. 4.—Breast-fed only 1 5 3 2 11 Do. and cows' milk 1 ... 2 ... 3 Do. and condensed milk ... ... 1 ... 1 Do. and food ... ... ... 1 1 2.—Cows' milk only 7 8 7 5 27 Do. and food ... ... 1 5 6 3.—Condensed milk only 3 5 3 1 12 Do. and food ... 1 4 4 9 4.—Dried milk 1 2 2 1 6 5.—Farinaceous and other foods 3 2 ... ... 5 6.—Unknown 5 7 3 2 '7 Totals 21 30 26 21 98 Of the total of 81 children who died from these diseases where the exact nature of the food given was ascertaiaed, only 11, or 13.5 per cent were nursed by the mother without the addition of any other food, and of these one died in the first three months. In 33, or 40.7 per cent., cows' milk, either alone or with farinaceous food was given; in 21 or 25.9 per cent., condensed milk only or condensed milk and farinaceous food was given; while in six dried milk only was given. In 17 cases, from various causes no information could be obtained. Of the 98 deaths, 26 died in the Union Infirmary, 16 in hospitals outside the Borough, and 12 had been in attendance at hospitals previous to their death for Marasmus or Debility and kindred complaints. 70 Report of the Medical Officer of Health. Of the cases in which no information was obtainable, three died in the Workhouse, one, a nurse child, had been in the Union Infirmary for nine months ; three wrong addresses were given; two mothers had removed directly after the death of the children, and one child died at Gosport. Seven of the deaths occurred in good residential districts and no inquiries were made. Of the contributory causes to the infants' deaths it may be noted that four of the mothers were very ill before the confinement, and one mother was subject to epileptic fits, and twice while nursing fell on the child. In three cases children in the same family had had an attack of Diarrhcea and had probably infected the infant, and three infants had had previous attacks of Diarrhcea when teething. Two fathers and one mother suffered from Pulmonary Tuberculosis, 10 of the infants suffered from indigestion and bowel trouble from birth. The mother of one illegitimate child was only 16 years of age and mentally defective. One infant was admitted to the Union Infirmary at six weeks and died there at the age of five months. One had pneumonia at two months, was in the Union Infirmary from January to April, in the Workhouse during the month of May, then under a doctor till August, when it was admitted to a Hospital where it died. In the case of two deaths, those of twins, an inquest was considered necessary, the verdict being malnutrition in addition to Infective Enteritis, and the mother had had twins three times with an interval of only 15 months between the last two sets. In 14 cases the mothers reported a great many flies had been noticed at the time of the child's illness and death, and in nine cases there were stables at rear of the house. 15 deaths from Diarrhoea occurred among children over one and under two years of age. Seven of these children had been previously visited. Three of these deaths occurred in the Union Infirmary and three in hospitals. One of these children was illegitimate. Report of the Medical Officer of Health. 71 Of the causes contributory to the infants' deaths, four had had digestive trouble from birth, one was in and out of hospital for four months with wasting, diarrhoea and sickness, one had had Whooping Cough, two had had previous attacks of Diarrhoea, three were taken ill and died within 24 hours, having had no previous illness,and one was taken to a Hospital suffering from scalds and shock and died there from Enteritis. Four mothers said they had noticed many flies at the time of the child's illness, and in one case there were stables at the rear of the house. The next Table shows the result of the inquiries made after these deaths, arranged in Wards, and there is also shown the number of infants who had been previously visited, the number of illegitimate infants, and the social status of the parents. It will be also seen in the Table that only 11 of the infants who died from Diarrhœa had been fed in accordance with the pamphlet left by the Inspectors, and also that of the total number of deaths in which information was obtained, viz. :—83, 11 were prematurely born, 27 were delicate from birth, and three were twin children. TABLE XXXV11. Clapham, North. Clapham, South. Putney. Streatham. Balham. Tooting. Southfield. Fairfield. Springfield. Borough. Total Number of Deaths 2 17 7 9 12 18 9 9 '5 98 Wholly breast-fed ... 2 ... 2 1 4 ... ... 2 11 Otherwise fed 2 14 4 5 9 13 7 8 8 70 No information ... 1 3 2 2 1 2 1 5 17 Previously visited (1915) 1 6 4 2 4 10 3 3 6 39 ,, ,, (1914) ... 2 ... ... 2 1 2 1 1 9 Fed according to pamphlet ... ... 2 1 4 1 1 ... 2 11 Breast-fed 1 ... ... ... 2 ... ... 1 4 Otherwise fed 1 7 4 2 6 9 5 4 6 44 Illegitimate ... 3 1 1 1 3 4 1 6 20 Nurse children ... 2 ... ... ... 2 2 1 3 10 Born outside Borough ... 1 1 ... ... 2 2 1 3 10 Premature ... 5 ... ... 2 2 ... 1 1 11 Delicate from birth 1 3 ... 3 4 7 4 2 3 27 Twin Children ... ... ... ... ... ... 2 ... ... 3 72 Report of the Medical Officer of Health. Infant Visiting. During the year the female Sanitary Inspectors have continued the work begun in 1905 in visiting the homes where births had occurred, and they have also had during the year, as is stated in their report, valuable assistance from several voluntary health visitors for short periods. "We herewith submit to you the report on visits among the newly-born infants in the Borough during the year 1915. "In consequence of the War we have only been able to obtain the assistance of two voluntary workers, one for three months during the summer, and the other for the last month of the year. "The total number of visits paid, including re-visits and ineffectual visits was 5,188. The number of first visits totalled 3,096, there were 1,154 second visists and the number of ineffectual visits was 938. The proportion of first to second visits is about the same as in 1914. "166 visits were paid to homes to see to the carrying out of repairs, etc., for which we had previously served notices. "On our first visits to the mothers we found 2,554 infants were breast-fed only. Of the remaining 542, 233 were fed on the breast supplemented by artificial feeding, 143 were fed on cows' milk only, 92 on condensed milk only, and 40 on dried milk. 1,154 infants were re-visited and of these 790 were fed on the breast only. Of the remaining 364, we found in 142 cases artificial feeding was adopted in addition to the breast, 101 were fed on cows' milk only, 73 on condensed milk, and 22 on dried milk. "Among the infants we visited, 106 died, the largest number of deaths occurring during the second to the fourth month of age. Report of the Medical Officer of Health. 73 20 deaths occurred at two to three months, and 22 at three to four months. Only one died at 10 to 11 months, and one at 11 to 12 months. 39 infants died from Diarrhoea and Enteritis, 18 from diseases of the Respiratory organs, 14 from Marasmus, four from Measles, six from prematurity, three from Intestinal toxaemia, two from Tuberculous Meningitis, and one from Cerebro-spinal Meningitis. "Many infants died from prematurity previous to our first visit. 113 of those visited were born prematurely, and 46 children were delicate from birth. 27 twin births were visited. "The pamphlet containing advice on the feeding of infants is in every case handed to the mother on our first visit. Many of the mothers remember the advice given in the case of a previous infant visited. Where infants were reared by hand we found 739 mothers used the boat-shaped bottle and only 22 confessed to using the long tube bottle. "With regard to the practice of giving the 'dummy' or 'comforter,' we found on our first visits that 1,319 of the mothers had not begun to use the dummy, but 1,339 were using it. On our second visits 175 had discontinued its use, but 171 mothers had begun its use since our first visit. "With regard to the employment of midwives we found that 1,306 of the 3,096 mothers we visited had employed their services, while eight had been attended by unregistered midwives. In nearly every case these were neighbours or relatives called in in an emergency. "The sanitary defects found in the houses during our visits to the mothers have been remedied, or if requiring structural work referred to you. 66 intimation notices were served and three statutory notices were required." 74 Report of the Medical Officer of Health. TABLE XXXVIII. Clapham, North. Clapham, South. Putney. Streatham. Balham. Tooting. Southfield. Fairfield. Springfield. Borough. Infants visited 312 229 233 186 231 617 367 291 630 3,096 Breast-fed 271 178 197 145 181 475 306 247 554 2,554 Otherwise fed 41 51 36 41 50 142 61 44 76 542 Infants re-visited 94 60 89 64 91 199 139 125 293 1,154 Breast-fed 71 38 66 36 63 124 95 89 208 790 Otherwise fed 23 22 23 28 28 75 44 36 85 364 Ineffectual visits 89 78 60 29 128 128 102 97 227 938 In all 3,096 infants were visited, compared with 3,337 in 1914, 3,772 in 1913, and 3,059 in 1912. It is satisfactory to observe that infants were visited in all the Wards of the Borough. Out of 3,096 infants, 2,554 or 82.4 per cent. were wholly breast-fed, and 542 or 17.5 per cent. otherwise fed. There is a slight decrease in the number breast-fed compared with previous years, although the percentage of children thus fed shows a slight increase. 1,154 infants were re-visited, and of these 790 or 68.4 per cent. were breast-fed, while 364 or 31.5 per cent. were otherwise fed, which is also a slight decrease compared with previous years. The total number of deaths among those visited was 106, 17 in Clapham, eight in Putney, 22 in Streatham, 23 in Tooting, and 36 in Wandsworth. Table XXXIX. shows these deaths arranged in monthly age periods. The heaviest mortality occurred at two to four months. Report of the Medical Officer of Health. 75 It is a most significant fact that the number of deaths from Diarrhoea and Enteritis among 2,554 infants who were breast-fed was only four, or a percentage mortality of .16, while among 542 infants who were otherwise fed the number of deaths was 44, or a percentage mortality of 8.1. The mortality among infants otherwise fed was thus 50 times greater than those breast-fed. The mortality among the infants visited by the Inspectors was only 34 per 1,000 births, compared with 92 per 1,000, the rate for the Borough for the year. TABLE XXXIX. Wards. Under 1 month. 1—2 months. 2—3 months. 3—4 months. 4—5 months. 5—6 months. 6—7 months. 7—8 | months. 8—9 months. 9—10 months. 10—11 months. II —12 months. Total. Clapham, North ... 1 1 2 ... ... 1 1 ... ... ... ... 6 Clapham, South ... ... 1 3 3 3 ... ... 1 ... ... ... 11 Putney ... 2 3 1 1 ... ... 1 ... ... ... ... 8 Streatham ... ... 2 2 ... 1 4 ... 1 ... ... ... 10 Balham 1 ... 2 3 3 2 ... 1 ... ... ... ... 12 Tooting 1 2 4 6 4 3 ... 1 1 ... 1 ... 23 Southfield ... 1 2 ... ... ... ... 2 ... 2 ... ... 7 Fairfield ... 1 1 4 2 ... ... 2 ... ... ... 1 11. Springfield 1 4 4 1 2 2 ... ... 3 1 ... ... 18 Total 3 11 20 22 15 11 5 8 6 3 1 1 106 Tuberculous Diseases. The total number of deaths from diseases of a Tuberculous nature was 434, compared with 389 in 1914, 355 in 1913, and 366 in 1912. 76 Report of the Medical Officer of Health. 329 of the deaths were due to Pulmonary Tuberculosis, 57 to Tuberculous disease of the Brain and 48 to other forms of Tuberculous diseases. The number of deaths from Pulmonary Tuberculosis and other Tuberculous diseases and the rates per 1,000 for the whole Borough and for the separate sub-districts are shown in the next Table. The corrected death rate from Pulmonary Tuberculosis was .99 per 1,000 compared with .93 in 1914, .88 in 1913, and .96 in 1912; from other Tuberculous diseases .31 compared with .25, .20, and .20; and from all Tuberculous diseases 1.30 compared with 1.19, 1.08 and 1.16. TABLE XL. Sub-District. Pulmonary Tuberculosis. Other Tuberculous Diseases. Total. No. of Deaths. Rate. No. of Deaths. Rate. No. of Deaths. Rate. Clapham 61 .97 17 .27 78 1.25 Putney 32 1.09 10 .34 42 1.43 Streatham 88 .83 26 .24 114 1.07 Tooting 48 1.23 15 .39 63 1.62 Wandsworth 100 1.03 37 .38 137 1.41 Whole Borough 329 .99 105 .31 434 1.30 From all Tuberculous diseases the rates per 1,000 were higher in all the sub-districts than in 1914. With regard to Pulmonary Tuberculosis, the rate for Wandsworth was below, and the rates for Clapham, Putney, Streatham, and Tooting above last year's rates. Report of the Medical Officer of Health. 77 From other Tuberculous diseases the rate was .06 higher than in 1914. This rate was lowest in Streatham and highest in Tooting, and the rate for Pulmonary Tuberculosis was lowest in Streatham and highest in Tooting. The following Table shows the death-rate per 100,000 from Pulmonary Tuberculosis for the whole Borough, and for the separate sub-districts for the year as well as for the preceding 10 years. TABLE XLI. 1905 1906 1907 1908 1909 1910 1911 1912 1913 1914 Average for 10 years. 1915 Clapham 112 117 89 95 104 84 118 116 93 93 102 97 Putney 92 83 67 62 116 85 70 97 55 78 80 109 Streatham 72 76 73 87 60 65 85 73 76 71 73 83 Tooting 101 90 96 86 110 109 81 87 69 87 91 123 Wandsworth 132 121 131 123 109 108 88 112 109 122 115 103 Whole Borough 102 100 95 96 94 88 91 96 88 93 94 99 Compared with the decennial average the rate was higher in the whole Borough, and in all the sub-districts with the exception of Clapham and Wandsworth, where it was five and 12 per 100,000 lower respectively. The rate in Clapham for 1915 is four per 100,000 higher than it was in 1914, but is five under the decennial average. In Putney it was 31 per 100,000 above the rate for 1914, and 29 above the corrected decennial average. In Streatham it was 12 above the rate for 1914, and 10 above the decennial average. In Tooting the rate was 36 higher than it was in 1914, and is 32 above the decennial average; while in Wandsworth the rate was 19 lower than in 1914, and 12 under the decennial average. 78 Report of the Medical Officer of Health. This last sub-district has always had a higher average mortality from Pulmonary Tuberculosis than the other sub-districts. One death from Pulmonary Tuberculosis occurred in an infant under one year, seven in persons from two and under five years, nine from five and under 15 years, 58 from 15 and under 25 years, 156 from 25 and under 45 years, 81 from 45 and under 65 years, and 17 over 65 years. From other Tuberculous diseases 14 deaths occurred under one year, 15 from one and under two years, 16 from two and under five years, 28 from five and under 15 years, eight from 15 and under 25 years, 16 from 25 and under 45 years, five from 45 and under 65 years, and three over 65 years. Among males the rate per 1,000 for Pulmonary Tuberculosis for the year 1915 was 1.22 compared with 1.18 the decennial average; and among females .80 compared with .73; while from other Tuberculous diseases the rate among males was .34, compared with 35; and among females .23 compared with .26. Among children under five years the rate for the year was .13 compared with .16 the decennial average. The rate for males and females for the year 1915 from Pulmonary Tuberculosis was .99 compared with .94 the decennial average. Notification of Tuberculous Diseases. The total number of cases of Pulmonary Tuberculosis notified during 1915 was 646, compared with 706 in 1914, 783 in 1913, and 855 in 1912. Of the total cases notified during the year, viz.:—646,127 were from Clapham, 49 from Putney, 170 from Streatham, 94 from Report of the Medical Officer of Health. 79 Tooting, and 206 from Wandsworth, compared with 706 in 1914, of which 138 were from Clapham, 46 from Putney, 170 from Streatham, 121 from Tooting, and 231 from Wandsworth. There was thus a decrease in Clapham, Tooting and Wandsworth, an increase of three in Putney, and Streatham was the same. Four of the cases were under one year of age, 25 from one and under five years, 54 from five and under 15 years, 119 from 15 and under 25 years, 300 from 25 and under 45 years, 122 from 45 and under 65 years, and 22 over 65 years. In Table XLII. is shown the total number of cases notified since 1908, the number of deaths in each year since that date, the total deaths, the number removed from the district as far as could be ascertained, the number who were stated to have recovered, the number in which no inquiries were made, and the total number of cases still on the Register. In all, 4,253 cases have been notified, and of these, 1,832 or 43.1 per cent. have died, 908 or 21.3 per cent. have removed, 102 or 2.4 per cent. are stated to have recovered, in 24 or .56 per cent. no inquiries have been made, while 1,387 or 32.6 per cent, are still on the Register. It will be noted that in 1912, 1913 and 1914 inquiries have been made in every case, and in 1915 in every case except one, although in 40 cases in 1912, 55 in 1913, and 32 in 1914 these inquiries were made at my request by the private medical practitioner. 80 Report of the Medical Officer of Health. TABLE XL11. Year. Cases Reported. Deaths. Removed. Recovered. No Inquiries. Cases on Register. 1908 1909 1910 1911 1912 1913 1914 1915 Total. 1908 71 25 6 1 1 ... ... 1 ... 34 31 ... 5 1 1909 389 ... 109 48 18 26 9 6 4 220 109 15 4 41 1910 289 ... ... 77 37 28 7 4 3 156 89 5 8 31 1911 514 ... ... ... 113 82 27 22 8 252 162 11 6 83 1912 855 ... ... ... ... 225 105 48 31 409 205 52 ... 189 1913 783 ... ... ... ... ... 180 77 41 298 172 13 ... 300 1914 706 ... ... ... ... ... ... 176 88 264 103 6 ... 333 1915 646 ... ... ... ... ... ... ... 199 199 37 ... 1 409 Total 4,253 25 115 126 169 361 328 334 374 1,832 908 10 24 1,387 The total number of deaths for 1915, shown in Table XLII., viz., 374, does not agree with the number in the Table of deaths on page 19, viz.:—329. The 45 remaining cases did not die from Pulmonary Tuberculosis, although notified as such. Six cases of Pulmonary Tuberculosis were notified by the School Medical Inspectors of the Education Department of the London County Council, these cases having been discovered in the examination of children at school. Of the 646 cases visited by the Inspectors, or in which the information was given by the medical attendant, in 74 this was so indefinite that it was impossible to tabulate it, in the majority of cases no family history being known. Report of the Medical Officer of Health. 81 Seven cases were notified from Common Lodging Houses, 12 were homeless, in 10 cases wrong addresses were given, 11 had removed, in 15 the patients were either lodgers or domestic servants and the occupier of the house could give no information, in 18 cases no definite information was obtainable, and in only one instance the Inspector was refused information. With regard to the notification of cases of non-pulmonary Tuberculosis, in all 234 cases were notified, 35 from Clapham, 24 from Putney, 52 from Streatham, 44 from Tooting, and 79 from Wandsworth. 21 of these were under one year of age, 47 from one and under five years, 94 from five and under 15 years, 33 from 15 and under 25 years, 26 from 25 and under 45 years, seven from 45 and under 65 years, and six over 65 years. Table XLIII. shows the number of these cases notified classified according to the part of the body affected, as well as the number of deaths in each class. The total deaths, viz., 84, do not correspond with the total number on Table XIV., as 13 were registered as having died from Pulmonary Tuberculosis and are included under that heading, two cases died from other causes, two cases which died in 1915, were not notified till 1916, while in the case of three deaths which occurred in Institutions outside the Borough, no notifications could be obtained, and in one case the notification was cancelled. As is to be expected, the deaths from General Tuberculosis shows the highest mortality, seven out of the eight cases notified having been fatal, and the next highest mortality occurred among cases of Tuberculosis of the Brain, 50 out of 52 having been fatal. Out of the total of 234, 84 died, two have removed to other districts, while 148 cases are still on the Register and under observation. 82 Report of the Medical Officer of Health. TABLE XLI11. Localisation of Disease. Number of cases notified. No. of deaths. Removed. On Register. Total. Males. Females. Under 1 year. 1 and under 5. 5 and under 10. 10 and under 15. 15 and under 20. 20 and under 25. 25 and under 35. 35 and under 45. 45 and under 55. 55 and under 65. 65 and upwards. Males. Females. Total. Brain 52 27 25 8 19 12 4 3 2 2 1 ... ... 1 27 23 50 ... 2 Glands, Mediastinal 2 1 1 1 ... ... 1 ... ... ... ... ... ... ... ... 1 1 ... 1 „ Mesenteric 31 15 16 4 10 4 4 1 1 2 3 1 ... 1 7 7 14 ... 17 „ Cervical 62 24 38 1 11 21 15 6 5 2 ... 1 ... ... 1 1 2 ... 60 Bones and joints 55 37 18 2 5 17 12 7 6 1 2 1 1 1 ... 1 1 2 52 Lupus 10 4 6 ... ... ... 2 1 1 2 3 ... ... 1 ... ... ... ... 10 Larynx 3 2 1 ... ... ... ... ... ... ... 1 1 ... 1 1 1 2 ... 1 General Tuberculosis 8 5 3 3 1 1 ... ... ... 1 ... 1 ... 1 5 2 7 ... 1 Other parts 11 5 6 2 1 1 ... ... ... 3 3 ... 1 ... 3 4 7 ... 4 Total 234 120 114 21 47 56 38 18 15 13 13 5 2 6 44 40 84 2 148 Report of the Medical Officer of Health. 83 The next Table shows the number of cases notified, the number which died, removed, and recovered during the years 1913, 1914 and 1915, and the number still remaining on the register at the end of 1915. TABLE LXIV. Year. Cases Notified. Deaths. Removed. Recovered. Cases on Register. 1913. 1914. 1915. Total. 1913 328 46 10 5 61 56 28 178 1914 199 — 68 5 73 21 3 102 1915 234 — — 84 84 2 — 148 Total 761 46 78 94 218 79 31 428 N.B.—The figures for 1913 do not correspond with the number of cases notified as four cases of other forms of Tuberculosis notified in 1913 were in 1914 notified as suffering from Pulmonary Tuberculosis. One case of other forms of Tuberculosis notified in 1913 and one in 1914 were notified in 1915 as suffering from Pulmonary Tuberculosis. Table XLV. is a summary of notifications during the period from the 4th January, 1915, to the 1st January, 1916. It will be seen that 611 primary notifications of Pulmonary Tuberculosis were made on Form A, 314 of males and 297 of females, while the total notifications were 835. 12 cases were notified by School Medical Officers on Form B, seven of males and five of females, while 173 notifications from Poor Law Institutions and 203 from Sanatoria were made on Form C. The number of notifications on Form B by School Medical Officers is exceptionally small. From other forms of Tuberculosis 224 were notified on Form A, 10 by School Medical Officers on Form B, while 26 were notified from Poor Law Institutions and five from Sanatoria on Form C. It may be stated that notifications on Form A are primary notifications, i.e., cases not previously notified. Form B are notifications from School Medical Officers, and Form C are secondary notifications from Poor Law Institutions and Sanatoria on entering such Institutions. 84 Report of the Medical Officer of Health. TABLE XLV. PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1912. Summary of Notifications during the period from 4th January, 1915, to end of the week ending the 1st January, 1916. Age Periods. Number of Notifications on Form A. Number of Notifications on Form B. Number of Notifications on Form C. Primary Notifications. Total Notifications (i.e. including cases previously notified by other doctors) Primary Notifications. Total Notifications (i.e. including cases previously notified by other doctors) Poor Law Institutions. Sanatoria. 0 to 1 1 to 5 5 to 10 10 to 15 15 to 20 20 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 and upwards Total. Under 5 5 to 10 10 to 15 Total. Pulmonary— Malos 1 16 15 11 15 29 72 72 52 19 12 314 401 ... 2 2 4 7 105 120 Females 2 8 8 14 35 31 85 56 30 17 11 297 353 ... 2 ... 2 5 68 82 Non Pulmonary— Males 15 24 31 17 9 3 6 4 2 1 3 115 123 ... 1 3 4 6 18 3 Females 6 23 19 17 9 12 7 10 3 ... 3 109 124 ... 3 1 4 4 8 2 Report of the Medical Officer of Health. 85 Discharges are made on Form D, and of these 295 were received during the year. The 295 certificates received related to 282 cases, 13 having been notified twice. 55 cases were notified as having gone to addresses in Clapham, 32 to Putney, 85 to Streatham, 32 to Tooting, and 89 to Wandsworth. One case in Wandsworth was discharged to a Common Lodging House. The two following Tables show the total number of cases notified and also the number of times they were notified. Of the cases of Pulmonary Tuberculosis, 584 were notified once, 55 twice, six three times, and one four times; while of the cases of other forms of Tuberculosis 229 were notified once, four twice, and one three times. TABLE XLVI. Pulmonary Tuberculosis. Clapham. Putney. Streatham. Tooting. Wandsworth. Whole Borough One Notification 116 42 160 87 179 584 Two Notifications 10 7 9 5 24 55 Three Notifications 1 ... 1 1 3 6 Four Notifications ... ... ... 1 ... 1 Total 127 49 170 94 206 646 86 Report of the Medical Officer of Health. TABLE XLV1I. Other Forms of Tuberculosis. Clapham. Putney. Streatham. Tooting Wandsworth. Whole Borough. One Notification 35 24 52 41 77 229 Two Notifications ... ... ... 3 1 4 Three Notifications ... ... ... ... 1 1 Total 35 24 52 44 79 234 The whole of the work in connection with Pulmonary Tuberculosis has been carried out in a most efficient manner by the Female Sanitary Inspectors, and since the 1st April, 1913, more particularly by the Health Visitor, whose whole time is devoted to this work. The total number of visits made was 2,956 in cases of Pulmonary Tuberculosis, 514 in Clapham, 198 in Putney, 702 in Streatham, 443 in Tooting, and 1,099 in Wandsworth, and 657 in cases of other forms of Tuberculosis, 85 in Clapham, 49 in Putney, 126 in Streatham, 134 in Tooting, and 263 in Wandsworth. In addition to these visits by the Health Visitor, 891 visits were made by the Dispensary Nurse, these visits being made by the instruction of the Tuberculosis Officer to cases under his care at the Dispensary. These numbers are extremely satisfactory when the area of the Borough is taken into consideration. Report of the Medical Officcr of Health. 87 11 of the cases under observation removed to other places and the Medical Officers of Health of these were duly informed, while nine cases notified in other districts were notified to me by the respective Medical Officers of Health. During the year 23 sputum flasks have been supplied, and two were returned after the death of the patient. In 11 of the cases visited the patients already had one, but in many cases the patients objected to their use. During the year disinfection was carried out at 371 premises either after the death or removal of the patient, compared with 399 in 1914, and 420 in 1913. 65 of the premises disinfected were in Clapham, 32 in Putney, 104 in Streatham, 50 in Tooting, and 120 in Wandsworth. Tuberculosis Dispensaries. It will be seen from the Report of the Tuberculosis Officer that a very large amount of work has been carried out during the year, although the absence of the Tuberculosis Officer on military duty and the necessary alteration of the dispensary arrangements resulted in a slight decrease in the number of cases dealt with. It is satisfactory to note that arrangements have now been made by the London County Council for the treatment in sanatoria of non-insured persons, adults and children, and 45 cases, 15 adults and 30 children, have been admitted to sanatoria under the scheme during the year. The work done at the two dispensaries has been somewhat less during the year 1915 than in the previous year. The number of new cases examined during the year was 716, compared with 936 in 1913, and 971 in 1914. The total attendances at the two dispensaries was 6,580, compared with 5,502 in 1913, and 7,657 in 1914. 88 Report of the Medical Officer of Health. On examination of Table XLVIII. the decrease will be seen to be almost entirely at the East Hill dispensary, the new cases (tuberculous) at Balham being 132, compared with 134 in 1914, the nontuberculous new cases being 154, compared with 173 in 1914. In attendances also the two years are very similar at Balham; in 1914, 2,801, in 1915, 2,726. The altered hours of attendance at East Hill since August, 1914, probably accounts largely for the falling off in numbers, patients now being seen in the mornings only, which is not so convenient a time for families to come up as in the afternoon. That this is so is shown by the decrease being almost entirely in the non-tuberculous cases, who are principally contacts. TABLE XLVIII. Number of New Cases, and Total Attendances at the Dispensaries, 1915. Dispensary. New Cases. Total Attendances. Tuberculous. NonTuber culous. Total. Tuberculous. NonTuber culous. Total. 129, East Hill, Wandsworth 198 232 430 2,693 1,161 3.854 Weir Dispensary, Balham 132 154 285 1,969 757 2,726 Totals 330 386 716 4,662 1,918 6,580 Table XLIX. shows the total insured and non insured cases examined during the year, divided into tuberculous and nontuberculous. It also shows the total attendances made by these cases and the average attendance per case. Of the 716 new cases 330 were tuberculous, and 386 non-tuberculous. The 330 tuberculous cases made an average attendance Report of the Medical Officer of Health. 89 of 6.16 per case, compared with 6.72 in 1914. There were 181 tuberculous insured cases, compared with 226 in the previous year, and 149 tuberculous non-insured cases, compared with 153 in 1915. As in the previous two years, the tuberculous insured cases show more males than females, the non-insured more females than males. Of non-tuberculous new cases there were 386, compared with 592 last year. The average attendance per case of these is a little higher this year, being 3.28, compared with 2.2 in 1914. TABLE XLIX. NEW CASES, 1915. Tuberculous. Non-Tuberculous. Totals. M. F. Total. M. F. Total. M. F. Total. Cases— Insured 123 58 181 13 10 23 136 68 204 Non-Insured 48 101 149 156 207 363 204 308 512 Totals 171 159 330 169 217 386 340 376 716 Attendances— Insured 416 225 641 21 28 49 437 253 690 Non-Insured 397 1,004 1,401 582 621 1,203 979 1,625 2,604 Totals 813 1,229 2,042 603 649 1,252 1,416 1,878 3.294 Average Attendances Per Case. 6.16 3.28 4.6o Table L. is similar to Table XLIX., but shows the number of cases of 1913 and 1914 still attending the dispensaries. There were 239 tuberculous cases and 135 non-tuberculous cases which attended, making 2,620 and 666 attendances respectively. The 90 Report of the Medical Officer of Health. average attendance of the tuberculous cases, 10.9, is high, many of them undergoing specific treatment. TABLE L. CASES OF 1913 AND 1914 ATTENDING IN 1915. Tuberculous. Non-Tuberculous Totals. M. F. Total. M. F. Total. M. F. Total. Cases— Insured 48 30 78 0 1 1 48 31 79 Non-insured 65 96 161 77 57 134 142 153 295 Totals 113 126 239 77 58 135 190 184 374 Attendances. Insured 397 302 699 0 1 1 397 303 700 Non-insured 581 1,340 1,921 397 268 665 978 1,608 2,586 Totals 978 1,642 2,620 397 269 666 1,375 1,911 3,286 Average Attendances Per case. 10.9 4.9 8.7 Table LI. shows the sub-districts from which the patients were drawn and the authorities or agencies recommending them. As in previous years, the largest number of cases came from Wandsworth and the smallest from Putney. 252 were recommended by the Public Health Department, compared with 496 in 1914. As previously mentioned, the decrease in the number here is probably due to the dispensary being open in the morning only. Private practitioners recommended exactly the same number, 170, in 1915 as in 1914, while the London Insurance Committee Report of the Medical Officer of Health. 91 sent 79, compared with 124 in 1914. The smaller number sent by the London Insurance Committee can be accounted for by the fact that during the last six months of the year there were fewer applications for sanatorium treatment. 53 were sent in the first six months, and only 26 from July to December. In addition to this, patients seeking sanatorium treatment may now be sent for examination direct to the dispensary by their panel doctor instead of as hitherto having to make application in the first place to the Insurance Committee. This is a saving of time. It means, however, that some of the cases classed as being recommended by "Private Practitioners" would under the old arrangement have been included under those sent by the Insurance Committee. Fifteen cases came from outside the Borough. They were examined and if found to be requiring treatment were transferred to a dispensary in their own area. TABLE LI. RETURN SHOWING SOURCE OF CASES AND SUB-DISTRICTS. Clapham. Putney. Streatham. Tooting. Wandsworth. Outside Borough. Totals. Public Health Department 29 6 67 60 90 ... 252 London Insurance Committee 21 8 21 5 23 1 79 Private Practitioners 24 7 33 34 65 7 170 Charitable Societies 1 2 4 2 3 ... 12 Transfers from other Dispensaries 3 1 6 1 9 1 21 School Authorities 2 2 2 ... 11 ... 17 Existing Dispensary Patients 28 ... 17 15 85 5 150 Other Sources 1 ... 3 3 7 1 15 Totals 109 26 153 120 293 15 716 92 Report of the Medical Officer of Health. Last year the London County Council completed arrangements for the treatment of non-insured persons in sanatoria. Advantage has been taken of this, and during the year 45 cases have obtained sanatorium treatment under this scheme. Of these, 30 were under 15 years of age and 15 over. In almost all the cases the children have derived very great benefit. Quarterly reports are sent to the London County Council after their return home. Analysis of Cases. Table LII. shows the number of tuberculous and non-tuberculous cases grouped in age periods and the percentages found to be tuberculous. Of 716 cases, 330 were found to be tuberculous. This is a little higher percentage than last year, though the number of tuberculous cases was actually 49 less, and is explained by the fewer number of non-tuberculous patients presenting themselves for examination. Under the age of 15 there were 62 cases of tuberculosis, giving a percentage of 17.5, which is also a little higher than in 1914. At ages of 15 and upwards there were 268 cases of tuberculosis, a percentage of 73.8. 93 Report of the Medical Officer of Health. TABLE LIT. DIAGNOSIS AND AGE GROUPING OF ALL CASES. Age Period. Tuberculous. Non-Tuberculous. Totals. Percentage of Tuberculous Cases to Total Cases at each Age. Males. Females. Total. Males. Females. Total. Males. Females. Total. Under 1 year ... ... ... 6 4 10 6 4 10 ... 1 and under 2 years 1 1 2 6 7 13 7 8 15 13.3 2 and under 5 years 2 2 4 34 33 67 36 35 71 5.6 5 and under 10 years 18 10 28 70 49 119 88 59 147 19.0 10 and under 15 years 15 13 28 36 46 82 51 59 110 25.4 15 and under 20 years 18 27 45 2 9 11 20 36 56 80.3 20 and under 25 years 25 19 44 3 9 12 28 28 56 78.5 25 and under 35 years 36 41 77 1 22 23 37 63 100 77.0 35 and under 45 years 31 26 57 6 21 27 37 47 84 67.8 45 and under 65 years 26 17 43 5 14 19 31 31 62 69.3 65 years and upwards ... 2 2 ... 3 3 ... 5 5 40.0 Totals 172 158 330 169 217 386 341 375 716 46.0 Under 15 years 36 26 62 152 139 291 188 165 353 17.5 15 years and upwards 136 132 268 17 78 95 153 210 363 73.8 Totals 172 158 330 169 217 386 341 375 716 46.0 94 Report of the Medical Officer of Health. Table LIII. is similar to the foregoing, but deals with contacts only. During the year 302 contacts were examined for the first time. Of these 214 were under 15 years of age and 88 over. Of the 214 under 15 years of age, 14, or 6.5 per cent. were found to be tuberculous, and of the 88 over 15 years of age, 39.7 per cent. were tuberculous. The examination of contacts is an important part of the work, and though the percentage of tuberculous cases found is small amongst children, the prophylactic treatment of the weakly ones, though not actually suffering from the disease, must be work the benefit of which will be felt in years to come. 95. Report of the Medical Officer of Health. TABLE LIII. DIAGNOSIS AND AGE GROUPING OF ALL CONTACTS, EXAMINED FOR THE FIRST TIME DURING 1915. Age Periods. Tuberculous. Non-Tuberculous. Totals. Percentage of Contacts found to be tuberculous at age period Males. Females. Total. Males. Females. Total. Males. Females. Total. Under 1 year ... ... ... 2 2 4 2 2 4 ... 1 and under 2 years ... 1 1 6 5 11 6 6 12 8.3 2 and under 5 years 1 ... 1 23 22 45 24 22 46 2.1 5 and under 10 years 3 2 5 50 32 82 53 34 87 5.7 10 and under 15 years 5 2 7 25 33 58 30 35 65 10.7 15 and under 20 years 1 6 7 2 5 7 3 11 14 50.0 20 and under 25 years 1 1 2 ... 4 4 1 5 6 33.3 25 and under 35 years 1 8 9 ... 16 16 1 24 25 36.0 35 and under 45 years 5 4 9 4 15 19 9 19 28 32.1 45 and under 65 years 1 6 7 ... 7 7 1 13 14 50.0 65 years and upwards ... 1 1 ... ... ... ... 1 1 100.0 Totals 18 31 49 112 141 253 130 172 302 16.2 Under 15 years 9 5 14 106 94 200 115 99 214 6.5 15 years and upwards 9 26 35 6 47 53 15 73 88 39.7 Totals 18 31 49 112 141 253 130 172 302 16.2 96 Report of the Medical Officer of Health. Table LIV. shows the tuberculous cases classified according to the site of the lesion. Of 330 cases, 286 were pulmonary and 44 had tuberculosis of some part of the body other than lung. Of the non-pulmonary cases, 26 were under 15 years of age. TABLE LIV. SITE OF LESION IN TUBERCULOUS CASES. Age Period. Non-Pulmonary. Pulmonary Tuberculosis. Total. Glands. Joints and Bones. Abdominal. Others. Total NonPulmonary. Under 1 year ... ... ... ... ... ... ... 1 and under 2 years ... ... 1 ... 1 1 2 2 and under 5 years 1 1 ... ... 2 2 4 5 and under 10 years 6 6 2 ... 14 14 28 10 and under 15 years 4 5 ... ... 9 19 25 15 and under 20 years 2 4 1 1 8 37 44 20 and under 25 years 2 3 ... 1 6 38 47 25 and under 35 years 2 1 ... 1 4 73 77 35 and under 45 years ... ... ... ... ... 57 57 45 and under 65 years ... ... ... ... ... 43 43 65 years and upwards ... ... ... ... ... 2 2 Totals 17 20 4 3 44 286 330 Disposal of Cases. The next table shows the disposal of new cases (tuberculous) for 1915 at the end of the year. Of 330 cases, 139 were attending the dispensaries, 29 were in sanatoria, while 76 were under treatment by medical practitioners n their own homes. 33, or 10 per cent., died during the year. A Report of the Medical Officer of Health. 97 certain number of the cases when first seen at the dispensaries were too ill for either dispensary or institutional treatment; a certain number attended at the request of their medical attendant for an opinion only. Disposal of Tuberculous Cases, 1915, at End of Year. Recovered 1 Under treatment at Dispensaries 139 „ in Sanatoria 29 „ at Hospitals 14 „ in Poor Law Infirmaries 3 „ by Medical Practitioners 76 Ceased attending through lack of interest 2 Left the Borough 33 Died 33 Total 330 Table LV. deals with all the tuberculous cases of 1913 and 1914 only. They are divided into 12 classes. The number in Class 1 is very small, but it is seldom possible to consider a patient cured under a lapse of three or four years after recovery. Many of the cases in Classes 2 and 3 may be permanently recovered, and it is hoped that as time goes on there may be a considerable move of cases from 4 to 3, 3 to 2, and from 2 to 1. It will be seen that the percentage numbers of the classes for the two years are remarkably parallel. Most of those in Class 2 are at work, and it is difficult to get them to come up for examination. G 98 Report of the Medical Officer of Health TABLE LV. Disposal at the end of 1915 of all Tuberculous Cases of the Years 1913-14. Class. How disposed of. 1913. 1914. Percentage. 1913. 1914. 1 Recovered and Discharged 5 2 1.4 .53 2 Believed to be keeping well, but not attended during year 56 70 16.3 18.5 3 Much improved. Attending for observation only 33 37 9.6 9.8 4 Still under treatment at Dispensaries 43 57 12.5 15.1 5 Under Medical Practitioner 19 30 5.5 7.9 6 In Sanatoria 5 6 1.4 1.5 7 In or at Hospitals 9 15 2.6 3.9 8 In Poor Law Infirmaries 1 5 .29 1.3 9 Lost sight of 26 12 7.5 3.1 10 Ceased attending through lack of interest 1 1 .29 .26 11 Left the Borough 70 58 20.4 15.3 12 Died 75 86 21.8 22.8 Total 343 379 Specific Treatment. The next table shows the number of cases under specific treatment at the two dispensaries during the year. 74 were so treated, 35 with tuberculin, 31 with Spengler's Immune serum, "I.K.," and in eight others both tuberculin and "I.K." were used. Of the 35 cases treated with tuberculin, 24 showed definite improvement at the end of the year. Four are classed as recovered, but come up at regular intervals for observation and are not yet considered as cured. In two the disease advanced, and in four there was no apparent change, and one died. 99 Report of the Medical Officer of Health. Of the 31 cases treated with "I.K.," the results are not quite so good, but the cases selected for treatment with this serum were mostly advanced, their condition not justifying much hope that any form of treatment would benefit them materially. 10 of the cases showed definite improvement, two to a remarkable extent; one being so ill that he could hardly get to the dispensary, recovered to the extent of being able to walk three to four miles a day. Another benefited so much that she is now at work, and it is feared that this will interrupt the treatment. Another of the cases, one who was discharged from a sanatorium, but not by any means cured, is now in the Army. Five of the cases died, in four the disease advanced, while four seem to have recovered entirely, these being cases of persistent febrile temperature in which nothing seemed to make an impression except this serum. Of the eight cases treated by both tuberculin and "I.K.," only one showed any improvement. One of these eight was also treated with Dr. Mehnarto's Contratoxin, but with no benefit. During the year six cases have been treated with autogenous vaccines prepared from the patient. Only one of these cases was of undoubted tuberculosis, but with marked secondary infection. Considerable benefit was derived from the vaccine. Another case invalided out of the Army but in whom no definite signs of tuberculosis could be made out, has improved very much by the treatment. The four remaining cases, delicate children attending regularly for prophylactic treatment, have all improved, in two marked signs in the lungs having cleared up. Only cases in which ordinary treatment had failed and in which there seemed a reasonable prospect of marked benefit were selected for this form of treatment. 100 Report of the Medical Officer of Health. Results of Specific Treatment at end of Year. Recovered but not yet discharged as cured. Improved. No change. Disease advanced. Died. Total. Tuberculin 4 24 4 2 1 35 Spenglers I.K. 4 10 8 4 5 31 Tuberculin. .I.K. — 1 2 3 2 8 Totals 8 35 14 9 8 74 Deaths from Pulmonary Tuberculosis in Public Institutions. The following Table shows the number of deaths and the rate to total deaths from this disease for the year 1915, and for the previous 10 years:— TABLE LVI. Year. Total Number of Deaths. Institutions. Union Infirmaries. General and Special Hospitals. Total. Number. Rate. Number. Rate. Number. Rate. 1905 266 55 20.6 20 7.5 75 28.1 1906 267 69 25.8 26 9.7 95 35.5 1907 261 65 24.9 37 14.2 102 39.1 1908 273 55 20.1 24 8.8 79 28.9 1909 273 74 27.1 32 11.7 106 38.8 1910 264 65 24.6 33 12.5 98 37.1 1911 280 90 32.1 39 13.9 129 46.0 1912 303 86 28.3 43 14.2 129 42.5 1913 289 85 29.1 47 16.2 132 45.3 1914 305 76 24.9 59 19.3 135 44.2 Average 278 72 25.9 36 12.9 108 38.8 1915 329 72 21.6 48 14.5 120 36.4 101 Report of the Medical Officer of Health. This Table shows that the rates for the present year are lower in the case of Union Infirmaries but higher in General and Special Hospitals, compared with the average for the past 10 years, and lower than 1914 in both cases. Bacteriological Examination of Sputum. 497 examinations of sputum were made at the Lister Institute: 54 from Clapham, 75 from Putney, 130 from Streatham, 51 from Tooting, and 187 from Wandsworth. In 152 of the cases it was reported that the bacillus had been found, and in 345 that it was absent. Other Infective Diseases. 20 deaths were caused by other Infective diseases, five in Clapham, four in Putney, seven in Streatham, one in Tooting, and three in Wandsworth. Five of these were under one year, one from one and under two years, one from five and under 15 years, six from 25 and under 45 years, three from 45 and under 65 years, and four over 65 years. Of these 10 were stated to have been due to Syphilis, seven to Septicaemia, one to Tetanus, and two to Dysentery. With regard to the number of deaths from Syphilis, six were Congenital Syphilis, and four were of adults from Cerebral Syphilis. 19 deaths were caused by Syphilis in 1914, and 10 in 1913. The number of deaths from this disease, however, give little information as to the general prevalence of venereal disease among the community, as it is more than probable that a considerable number of the deaths of infants from Congenital Debility and Marasmus is due to this cause. 102 Report of the Medical Officer of Health. It is now, however, generally recognised that what are entitled the para-syphilitic diseases, as General Paralysis of the Insane and Locomotor Ataxy, are later manifestations of Syphilis, and if the number of deaths from these is taken as a criterion a more reliable estimate may be arrived at. In 1915, the number of deaths from General Paralysis was 26 and from Locomotor Ataxy eight, a total of 34, 30 of males and four of females. In 1914 the number of deaths from General Paralysis was 27, and from Locomotor Ataxy 10, a total of 37, 29 of males and eight of females. The following Table shows the death-rate from Infective diseases for the whole Borough for the year, as well as for the five previous years. TABLE LVII. Death-rate per 1,000. 1910 1911 1912 1913 1914 1915 Small-pox ... ... ... ... ... ... Diarrhoea •30 1.13 .27 .51 .56 .37 Diphtheria .05 .11 .06 .06 .12 .15 Whooping Cough .22 •21 .15 •07 .16 .19 Scarlet Fever .04 .03 .03 •03 .03 .06 Influenza .18 .08 .14 •18 .17 .27 Enteric Fever •026 .029 .02 •02 .015 .018 Measles .14 .74 .16 .36 .07 .45 Tuberculous Diseases 1.17 1.26 1.16 1.08 1.19 1.30 103 Report of the Medical Officer of Health. Acute Polio-Myelitis. 10 cases of the above were notified during the year, one from Putney, three from Streatham, and six from Wandsworth. Two of the cases were under one year of age, six from one and under five years, and two from five and under 15 years. Two of the cases proved fatal. In the whole of London 98 cases were notified, compared with 93 in 1914, and 145 in 1913. Ophthalmia Neonatorum. 44 cases were notified, of which eight were in Clapham, three in Putney, 11 in Streatham, eight in Tooting, and 14 in Wandsworth. 43 of the cases were visited. 28 were attended at birth by midwives. 17 were treated at hospital as out-patients, one as an in-patient in a Metropolitan Asylums Board Hospital with the mother, and three were removed to the Union Infirmary, the 23 remaining being treated at home. Two cases removed and could not be traced, three died of Convulsions, two from Broncho-Pneumonia, and one from Enteritis. The 38 remaining cases have recovered. Eight cases were notified by registered midwives, of which one was also notified by a medical practitioner. Glanders and Anthrax Cases. No cases of the above diseases were notified under the above Orders by the Veterinary Inspector of the London County Council. 104 Report of the Medical Officer of Health. NON-INFECTIVE DISEASES. The next Table shows the number of deaths from these for the year, as well as for the previous decennium for the whole Borough, corrected for External and Internal Institutions. TABLE L VIII. Deaths from Non-Infective Diseases. 1905 1906 1907 1908 1909 1910 191 I 1912 1913 19^ 1915 No. above corrected average. No. below corrected average Cancer 224 256 272 274 275 298 321 338 352 393 398 62 — Circulatory Diseases 346 331 387 350 366 312 359 357 411 426 492 90 — Respiratory „ 512 511 550 543 690 509 531 53o 622 519 792 175 — Premature Birth 317 3i5 285 294 254 249 268 240 234 249 225 — 77 Violence 91 108 90 107 118 91 120 116 115 113 115 — 3 All other Diseases 953 945 988 971 989 1032 1023 1025 1057 1130 1066 — 66 Totals 2443 2466 2572 2539 2692 2358 2622 2606 2791 2840 3188 297 — The above were the cause of 76.1 per cent. of the total deaths, compared with 77.5 in 1914, 77.8 in 1913, and 79.1 in 1912. Cancer. The total number of deaths from Cancer and other malignant diseases was 398, 151 of males and 247 of females, compared with 393 in 1914, 352 in 1913, and 338 in 1912, a decrease of five compared with the previous year, but an increase of 62 compared with the corrected decennial average. The corrected death rate was 1.20 per 1,000, compared with 1.20 in 1914, 1.07 in 1913, and 1.07 in 1912. 105 Report of the Medical Officer of Health. The number of deaths and the death-rate in each sub-district was as follows Clapham, 69 and 1.10; Putney, 47 and 1.60; Streatham, 149 and 1.42; Tooting, 36 and .93; and Wandsworth, 97 and 1.00. One of the deaths occurred at two and under five years, one at 15 and under 25 years, 38 at 25 and under 45 years, 198 at 45 and under 65 years, and 160 over 65 years. The following Table shows the number of deaths according to the part of the body affected. TABLE LIX. Locality of Disease. Males. Females. Total. Intestines 29 58 87 Breast ... 49 49 Stomach 20 27 47 Uterus and Ovary ... 42 42 Liver 14 24 38 Mouth and Throat 26 1 27 Esophagus 19 3 22 Face and Neck 12 4 16 Bladder and Kidney 5 10 15 Abdomen 2 6 8 Pancreas 3 5 8 Other parts 21 13 34 Not specified —- 5 5 Total 151 247 398 In Institutions within the Borough, 17 deaths occurred from Cancer, six males and 11 females. Six of these deaths occurred in the Hostel of God, two in Putney Hospital, and nine in private nursing homes. 106 Report of the Medical Officer of Health. 114 of the deaths, 54 of males and 60 of females, occurred in External Institutions, 63 in Workhouses and Workhouse Infirmaries, and 51 in General and Special Hospitals. 91 of the total deaths occurred among females from Cancer of the Breast or Uterus, compared with 93 in 1914, 77 in 1913, and 73 in 1912. The greatest number of deaths occurred from Cancer of the Intestines, which include Cancer of the Rectum. The next Table shows the death-rate per 100,000 for each of the sub-districts and for the whole Borough for the year and for the 10 preceding years. TABLE LX. Sub-District. 1905. 1906. 1907. 1908. 1909. 1910. 1911 1912. 1913 1914. Average for 10 years. 1915. Clapham 86 96 125 104 99 134 108 141 102 114 110 110 Putney 112 99 90 110 69 121 120 94 119 137 107 160 Streatham 87 92 105 101 106 89 126 104 107 137 105 142 Tooting 48 86 57 75 73 62 64 87 63 98 71 93 Wandsworth 88 102 90 91 94 95 88 101 109 106 96 100 Whole Borough 86 96 99 97 94 99 104 107 107 120 100 120 Compared with 1914 there has been an increase in this rate in Putney and Streatham, and a decrease in Clapham, Tooting and Wandsworth. There has again been an increase in the rate from this disease in all the sub-districts compared with the decennial average with the exception of Clapham, which is the same. It is specially noticeable that the death-rate in Tooting is the lowest and that in Putney and Streatham the highest of the sub-districts compared with this average. 107 Report of the Medical Officer of Health. Diseases of the Brain and Nervous System. From these diseases 377 deaths occurred, compared with 362 in 1914, 364 in 1913, and 305 in 1912. 85 of these deaths occurred in Clapham, 24 in Putney, 119 in Streatham, 35 in Tooting, and 114 in Wandsworth. 24 of the deaths were due to Meningitis, 173 to Cerebral Haemorrhage or Apoplexy, 28 to Convulsions, four to Softening of the Brain, 30 to Paralysis, 26 to General Paralysis of the Insane, eight to Locomotor Ataxy, 13 to Epilepsy, and 71 to other diseases of the Nervous System. The number of deaths from Cerebral Haemorrhage or Apoplexy in each sub-district was as follows: In Clapham 42, in Putney nine, in Streatham 60, in Tooting 16, and in Wandsworth 46, a total of 173, compared with 180 in 1914, 179 in 1913, and 154 in 1912. 39 of the deaths from Diseases of the Brain and Nervous System were under one year, two from one and under two years, eight from two and under five years, seven from five and under 15 years, 11 from 15 and under 25 years, 42 from 25 and under 45 years, 111 from 45 and under 65 years, and 147 over 65 years. Of the total deaths from the above under one year, viz.—39, 25 were from Convulsions, while of the total deaths over 65 years, viz.—147, 108 were from Cerebral Haemorrhage. Circulatory Diseases. From the above group of diseases, 492 deaths occurred, 191 of which, 94 males and 97 females, were due to Valvular disease of the Heart. 95 of these deaths occurred in Clapham, 36 in Putney, 181 in Streatham, 57 in Tooting, and 157 in Wandsworth. 108 Report of the Medical Officer of Health. Of the deaths from all diseases of the Heart, three were under one year, two were from two and under five years, 12 were from five and under 15 years, 11 from 15 and under 25 years, 52 from 25 and under 45 years, 174 from 45 and under 65 years, and 238 over 65 years. The number of deaths in 1915 was 56 more than in 1914, and 90 above the corrected decennial average. Respiratory Diseases. The total number of deaths was 792, 398 of males and 394 of females, compared with 520 in 1914, 622 in 1913, and 530 in 1912. The number of deaths was 272 more than in the previous year, and 175 more than the corrected decennial average. 141 of the deaths occurred in Clapham, 72 in Putney, 225 in Streatham, 99 in Tooting, and 255 in Wandsworth. Compared with 1914, there was an increase in all the subdistricts. 381 of the deaths occurred from Bronchitis, compared with 231 in 1914; 82 from Lobar Pneumonia, 147 from Lobular or Broncho-Pneumonia, 134 from Pneumonia in which the exact form was not distinguished; and 48 from other diseases of the Respiratory Organs. 108 of the deaths were of infants under one year, 52 from one and under two years, 43 from two and under five years, 19 from five and under 15 years, 17 from 15 and under 25 years, 67 from 25 and under 45 years, 164 from 45 and under 65 years, and 322 over 65 years. The greatest number of deaths from these diseases occurred among infants under one year, and of persons over 45. From Bronchitis alone 221 deaths occurred among persons over 65 years of age, compared with 134 in 1914 and 152 in 1913. 109 Report of the Medical Officer of Health. Appendicitis and Typhlitis. 20 deaths occurred from these diseases, 11 of males and nine of females, equal to a rate of 60 per million, compared with 51 in 1914, and 81 in 1913. The total number of deaths in the whole of London for the 52 weeks was 271, equal to a rate of 60 per million. Deaths from other Causes. From Alcoholism, Acute and Chronic, nine deaths, six of males and three of females, occurred; and 34, 21 of males and 13 of females, from Cirrhosis of the Liver, compared with 11 and 35 in 1914. From Nephritis and Bright's disease 120 deaths occurred, 63 of males and 57 of females, compared with 135 in 1914. From Accidents and diseases of Pregnancy and Child Birth 12 deaths occurred, all from 25 and under 45 years. This, added to the number of deaths from Puerperal Fever, viz.—four, gives a total of 16 deaths after child-birth, or a proportion of 232 per 1,000 births, compared with 3.44 in 1914. In London for the year 1915, this rate was 2.66. Of the 12 deaths none occurred in Clapham, three in Putney, four in Streatham, one in Tooting, and four in Wandsworth. Five of the deaths were due to Haemorrhage, two to Embolism, and five to other causes. Diabetes Mellitus was the cause of 39 deaths, 23 of males and 16 of females, six in Clapham, nine in Putney, 14 in Streatham, three in Tooting, and seven in Wandsworth, compared with 39 in 1914. Premature Birth and Developmental Diseases. 225 deaths, 132 of males and 93 of females, were registered as having occurred from these diseases, compared with 249 in 1914, 234 in 1913, and 240 in 1912. The number of deaths is thus 24 under last year, and 77 under the corrected decennial average. 110 Report of the Medical Officer of Health. 90 of the deaths were due to Premature Birth, in to Developmental diseases and 24 from other diseases of Early Infancy. 222 were of infants under one year, three from one and under two years, and one over two years. The number of deaths from these diseases in the Borough is shown more in detail in an earlier part of this Report in Table XVIII., which deals with Infantile Mortality, while for the subdistricts the Tables will be found in the Appendix. Old Age. 310 deaths, 107 of males and 203 of females, occurred from Old Age, compared with 256 in 1914, 237 in 1913, and 236 in 1912. 81 of these occurred in Clapham, 19 in Putney, 97 in Streatham, 29 in Tooting, and 84 in Wandsworth. All these deaths except one were of persons over 65 years. 12 were from 65 and under 70, 46 from 70 and under 75, 62 from 75 and under 80, 96 from 80 and under 85, 63 from 85 and under 90, 24 from 90 and under 95, four from 95 and under 100, one from 100 and under 105, and one from 105 and under 110. 1,429 deaths, or 34.15 per cent. of the total deaths, occurred in persons over 65 years, compared with 33.22 in 1914, 31.9 in 1913, and 32 in 1912. The percentage of deaths over 65 years to total deaths in the sub-districts was as follows:—In Clapham 38.49, in Putney 35.6o, in Streatham 38.85, in Tooting 25.52, and in Wandsworth 29.87. Violence. 115 deaths, 79 of males and 36 of females, occurred from Violence, compared with 113 in 1914, 115 in 1913, and 116 in 1912. 1ll Report of the Medical Officer of Health. 81 of the deaths were due to Accidental, and 16 to Suicidal causes. 18 deaths were caused by other forms of Violence, one being a case of manslaughter, one a spy who was executed at H.M. Prison, and the other 12 were of soldiers who died in England from wounds received in action. 14 of the deaths belonged to Clapham, 14 to Putney, 37 to Streatham, 13 to Tooting, and 37 to Wandsworth. From Accidental causes five of the deaths were of infants under one year, three from one and under two years, four of persons from two and under five years, 13 from five and under 15 years, two from 15 and under 25 years, 11 from 25 and under 45 years, 16 from 45 and under 65 years, and 27 over 65 years. Of the deaths from Suicidal causes, one was from 15 and under 25 years, five from 25 and under 45 years, nine from 45 and under 65 years, and one over 65 years. The number of deaths from Violence is two more than in 1914, but three under the corrected decennial average. Inquests. The next Table shows the number of Inquests held in the Borough during the year. The total number was 197, compared with 180 in 1914, 189 in 1913, and 182 in 1912. 23 of the Inquests were held on persons who died in Clapham, 34 in Putney, 47 in Streatham, 26 in Tooting, and 67 in Wandsworth. 112 Report of the Medical Officer of Health. In 128, or 64.9 per cent. of the cases, a verdict of death from Natural causes was returned; in 50 or 25.3 per cent., from Accidental causes; in 15, or 7.6 per cent., from Suicidal causes; while in four Open verdicts were returned. 33 of the Inquests were held on persons not belonging to the Borough who died in the Borough. Four of these were on persons who died in the Prison, two in the River Thames, five in Putney Hospital, two in Tooting Bec Asylum, two in the Middlesex Asylum, one in Springfield War Hospital, one in the 3rd London General Hospital, two on the railway, and 14 in other places and on the street. 113 Report of the Medical Officer of Health. TABLE LXI. INQUESTS. Sub-Districts. Whole Borough. Clapham. Putney. Streatham. Tooting. Wandsworth Deaths from Natural Causes ... 17 28 24 45 128 Accidental:— ... ... ... ... ... ... Falls 2 1 4 ... 5 12 Knocked down by motor car 1 1 1 1 2 6 Suffocated in bed with parents 1 ... 1 ... 1 3 Scalds ... 2 ... ... 1 3 Fall from tramcar ... 1 1 ... 1 3 Run over by motor lorry ... 2 ... ... 1 3 Fall from ladder ... 1 ... ... 1 2 Thrown from horse ... 1 ... ... 1 2 Knocked down by train ... ... 2 ... ... 2 Drowning ... ... ... ... 2 2 Suffocated at birth 1 ... ... ... ... 1 Fall from window 1 ... ... ... ... 1 Fall from scaffold ... 1 ... ... ... 1 Fall from van ... ... 1 ... ... 1 Fall from loft ... ... ... ... 1 1 Suffocation by piece of bread in throat ... 1 ... ... ... 1 Crushed by machinery ... 1 ... ... ... 1 Thrown off motor cycle ... i ... ... ... 1 Knocked down by bicycle ...... ... 1 ... ... 1 Knocked down by horse van ... ... ... ... 1 1 Suffocation caused by collar pressing on throat when faint ... ... 1 ... ... 1 Suffocation by being pressed too closely to mother's breast ... ... 1 ... ... 1 Suicidal:— Drowning 2 2 ... ... ... 4. Poisoning by Coal Gas ... 1 2 ... 1 4 Gunshot wounds ... ... 2 ... 1 3 Hanging ... ... 1 i ... 2 Poisoning by Oxalic Acid ... 1 ... ... ... 1 Poisoning by Cyanide of Potassium ... ... 1 ... ... 1 Open Verdicts:— Found drowned 1 ... ... ... 2 3 Found dead ... ... ... ... 1 1 Totals 23 34 47 26 167 197 H 114 Report of the Medical Officer of Health. 80 inquests were held on persons belonging to the Borough who died outside the Borough; 13 from Clapham, four from Putney, 27 from Streatham, 15 from Tooting, and 21 from Wandsworth, and the following Table shows the causes of death. 31 of these deaths were from Natural, 39 from Accidental, seven from Suicidal causes, one from Manslaughter, and in two cases open verdicts were returned. "5 Report of the Medical Officer of Health. TABLE LXII. INQUESTS. Sub-Districts. Whole Borough. Clapham. Putney. Streatham. Tooting. Wandsworth Deaths from Natural Causes 5 .. 9 6 11 31 Accidental:— Knocked down by motor car 3 1 .. .. 4 8 Knocked down by railway train 1 .. 2 1 .. 4 Falls 1 .. 2 .. 1 4 Burns .. .. 2 2 .. 4 Fall down stairs .. .. 2 .. 1 3 Thrown out of side car .. .. 1 2 .. 3 Knocked down by horse van .. .. .. .. 2 2 Knocked down by tram car 1 .. .. 1 .. 2 Fall from window 1 .. .. .. 1 2 Fall from ladder .. 1 1 .. .. 2 Crushed by crane 1 .. .. .. .. 1 Scalds .. .. .. 1 .. 1 Suffocation by food in larynx .. .. .. 1 .. 1 Drowning .. .. 1 .. .. 1 Gas poisoning in military mine .. 1 .. .. .. 1 Suicidal:— Cut throat .. .. 2 .. .. 2 Drowning .. .. .. .. 1 1 Gun shot wounds .. .. 1 .. .. 1 Poisoning by Belladonna . . .. .. 1 .. .. 1 Poisoning by Hydrochloric Acid .. .. .. 1 .. 1 Felo-de-Se:— Lead poisoning self administered to procure a miscarriage .. 1 .. .. .. .. Manslaughter:— Knife stab in abdomen .. .. 1 .. .. 1 Open Verdicts:— Found drowned .. .. 1 .. .. 1 Found dead .. .. 1 .. .. 1 Totals 13 4 2 7 15 21 8o H 2 116 Report of the Medical Officer of Health. Deaths and Causes of Death in Public Institutions. In the Public Institutions in the Borough 1,225 deaths occurred during the year, compared with 1,018 in 1914, 1,034 in 1913. and 958 in 1912. Of these, 1,012 deaths were of persons not belonging to the Borough, compared with 824 in 1914, and 213 of persons belonging to the Borough, compared with 194 in 1914. The following Table shows the Institutions where these deaths occurred and the number of deaths in each. The causes of, and ages at death in these persons are shown in Tables VIII., IX., and X. in an earlier part of this Report. 117 Report of the Medical Officer of Health. TABLE LXIII. I.—Institutions within the District receiving sick and infirm persons from outside the District. II.—Institutions outside the District receiving sick and infirm persons from the District. III.—Other Institutions, the Deaths in which have been distributed among the several localities in the District. Name of Institution. No. of Deaths. Name of Institution No. of Deaths Name of Institution. No. of Deaths Name of Institution. No. of Deaths. 32. Long Grove Asylum 25 Fever Hospitals 98 1. Wandsworth Union Infirmaries 683 33. Manor Asylum 7 Fever Hospitals 71 Fountain Temporary Asylum 62 34. Middlesex Hospital 13 Fountain Temporary Asylum 3 Hostel of God 47 2. Banstead Asylum 15 35. Mount Vernon Hospital 2 H.M. Prison 3 H. M. Prison 4 3. Battersea General Hospital 3 36. National Hospital 5 Hostel of God Middlesex County Lunatic 9 Middlesex County Lunatic Asylum 157 37. Peckham House Asylum 7 4. Belgrave Hospital 21 38. Royal Waterloo Hospital 2 Asylum 7 Newlands House 2 5. Belmont Workhouse 3 39. St. Bartholomew's Hospital 7 Putney Hospital 17 Putney Hospital 15 6. Bethlem Royal Hospital 1 5 The Workhouse 6 Royal Hospital for Incurables 16 7. Bolingbroke Hospital 21 40. St. Columbus Hospital 3 Tooting Bec Asylum 8 St. Anne's Home 1 8. Brompton Hospital 10 41. St. George's Hospital 9 Tooting Home 11 The Priory, Roehampton 6 9. Cancer Hospital 7 42. St. Luke's House 8 3rd London General Hospital 13 The Workhouse 6 10. Cane Hill Asylum 15 43. St. Mary's Hospital 4 Tooting Military Hospital 1 Tooting Bec Asylum 423 11. Caterham Asylum 11 44. St. Peter's Hospital 2 Nursing Homes 30 Tooting Home 13 12. Central London Hospital 12 45. St. Thomas's Hospital 56 River Thames 2 3rd London General Hospital 61 13 Charing Cross Hospital 8 46. University College Hospital 4 Other Places 32 Tooting Military Hospital 9 14. Chelsea Infirmary 2 13 Gifford House Hospital 1 15. Colney Hatch Asylum 5 47. Victoria Hospital 9 Weir Red Cross Hospital 1 16. Croydon Infirmary 2 48. Westminster Hospital 13 Nursing Homes 40 17. Downs Sanatorium 7 49. Westminster Infirmary 3 River Thames 2 18. Evelina Hospital 6 50. West London Hospital 4 Other Places 48 19. General Lying-in Hospital 2 51. Northern Hospital 2 1,012 52. South Eastern Hospital 2 20. Gt. Ormonde St. Hospital 2 53. South Western Hospital 7 21. Guy's Hospital 4 54. Western Hospital 3 22. Hanwell Asylum 2 55. Other Institutions 63 23. Homoeopathic Hospital 5 56. Other places not public Institutions 70 24. Holborn Workhouse 11 25. Horton Asylum 6 57. On Railway 4 26. Hospital for Epilepsy 2 58. On Street 7 27. Infants Hospital 16 59. River Thames 2 28. King's College Hospital 6 60. Private Nursing Homes 14 29. Lambeth Infirmary 8 1,252 30. London Hospital 3 31. Leavesden Asylum 2 118 Report of the Medical Officer of Health. Cutting-off Notices. During the year 87 notices with respect to 87 premises were received from the Water Board stating that the supply had been withdrawn. 22 of the premises were in Clapham, 15 in Putney, 20 in Streatham, five in Tooting, and 25 in Wandsworth. The supply was withdrawn for non-payment of rates from 50 premises, from 10 premises in consequence of defects, and in 27 the premises were empty. Compared with 1914, there has been an increase of 40 in the number of notices received, and of 45 in the number of premises affected. Mortuaries. The Mortuaries in Clapham, Streatham, Tooting and Wandsworth have been visited several times during the year, and I am able to report that the By-laws and Regulations have been carried out in a satisfactory manner. With reference to the Wandsworth Mortuary the Public Health Committee have on several occasions had the question of providing a new Mortuary for Wandsworth before them, and plans have been prepared and laid before the Committee, but owing to the war the matter has been postponed. The Mortuary at Tooting has been closed, but a temporary one has been provided pending the erection of a new one in Wandsworth. In Clapham, 21 bodies were removed to the Mortuary, compared with 29 in 1914, in Streatham 35, compared with 46; and in Wandsworth 127, of which 60 were from Wandsworth, 34 from 119 Report of the Medical Officer of Health. Putney, three from Streatham, and 24 from Tooting, and six from Battersea, compared with 115 in 1914—a total of 183, compared with 190 in 1914. Four infectious cases were admitted to the Mortuaries during the year. GENERAL SANITARY WORK IN 1915. The following list shows the special inspections made during the year:— (1)—Inspections were made by myself and the Deputy Medical Officer of Health of Newlands Farm, Putney Vale, on account of complaints made by Military Authorities of offensive smell from the keeping of pigs and from the manure on the land. The pigsties and yard were found to be in an offensive condition and accumulations of manure were discovered. Notices under the Public Health (London) Act, 1891, were served on the owner and the nuisances were abated. (2)—As in previous years, special inspections were made of several localities in consequence of complaints of smells from road gullies and sewer ventilators. The number of complaints was less than in the previous year ; this having been due to the fact that the climatic conditions were more unfavourable. In all, 48 complaints were received, compared with 138 in 1914; two from Clapham North, none from Clapham South, seven from Putney, five from Streatham, six from Balham, seven from Tooting, 10 from Southfield, four from Fairfield, and seven from Springfield Wards. All these complaints were forwarded to the Borough Engineer, who reported that in 44 cases the sewers were flushed and disinfected, in two the manholes were temporarily sealed, while in two cases broken manhole plates were repaired. 120 Report of the Medical Officer of Health. (3)—Special inspections were also made by myself and the Deputy Medical Officer of Health of many premises, chiefly on account of nuisances and damp conditions reported by the Sanitary Inspectors and also to ascertain if any of these premises could be reported to the Council under the Housing, Town Planning, etc., Act, and also the by-laws as to Underground Rooms, made under the above Act. Including the house-to-house inspections and inspections for certificates under the Revenue Act, but excluding the routine inspection of bakehouses, slaughter-houses, cowsheds, and offensive trade premises, 134 inspections were made of premises, chiefly previous to the service of statutory notices, and examination of suspected cases of infectious disease. The attendance of the Deputy Medical Officer of Health at the Police Court was necessary on two occasions during the year. Revenue Act. During the year six certificates were granted under the above Act, and one refused. The certificates granted referred to 15 houses or 32 tenements, and that refused to five houses or 10 tenements. Housing, Town Planning, etc., Act, 1909. All the house-to-house inspections during the year have again been carried out under and for the purposes of Section 17 of this Act, and the results of these inspections have been recorded on the cards, particulars of which were given in the Report for 1910. It has not been found necessary to take any action under this Act, as it has been found, after careful consideration and personal inspection, that the nuisances detected could all be dealt with under the Public Health (London) Act, 1891. 121 Report of the Medical Officer of Health. The table of house-to-house inspections shows, as in former years, the name of the ward in which the inspections took place, the number of houses in which defects were found, and the number of families living in one, two, three, and four rooms and upwards. The defects found are given in the Table of Sanitary Operations, as also the number of intimation and statutory notices served and complied with. Underground Rooms. Several inspections were made of property to ascertain if any additional underground rooms existed, but no cases were this year discovered in which there was illegal occupation of such rooms. All the houses erected for occupation by the working classes during the past 15 years have no basements, and consequently the number of underground rooms in this Borough is very small. Sanitary Operations. Tables LXIV., LXV., and LXVI. show the number and nature of the inspections made during the year by the Male and Female Inspectors respectively. These Tables show in more detail the varied character of the work carried out by the Inspectors. The number of complaints received and attended to was 2,709, compared with 2,548 in 1914, 2,394 in 1913, and 2,528 in 1912. There was an increase in Putney, Tooting and Springfield Wards, and a decrease in all the other Wards, compared with the previous year. Five of these complaints were made to the London County Council, and these were at once attended to. 122 Report of the Medical Officer of Health. The number of houses and premises inspected was 39,410, a decrease of 594 compared with 1914, but an increase of 607, compared with 1913. There was an increase in the number of houses and premises inspected in Putney, Balham, Tooting and Fairfield Wards, and a decrease in Clapham North and South, Streatham, Southfield and Springfield Wards. The total number of house-to-house inspections made was 1,862, compared with 2,396 in 1914, 2,739 in 1913, and 2,674 in 1912. There has been an increase in the number of these inspections in Clapham North, Southfield and Springfield Wards, and a decrease in Clapham South, Putney, Streatham, Tooting, and Fairfield Wards, compared with 1914. The number of these inspections has diminished owing to the changes in the inspectorial staff on account of the war, and the necessary inspections in some of the sub-districts of premises occupied by the military. 123 Report of the Medical Officer of Health. TABLE LX1V. Summary of Sanitary Operations in the Borough during the Year 1915. clapham. putney. streatham tooting. wandsworth. whole borough. North Ward. South Ward. Streatham Ward. Balham Ward. South field Ward. Fairfield Ward. Spri'g field Ward. Number of complaints received and attended to 282 321 133 521 269 333 247 233 370 2709 Number of houses and premises inspected 4541 2775 5575 4513 4232 5063 4404 3085 5222 39410 Number of houses and premises re-inspected 1008 1535 1185 1629 1670 1315 858 1155 1868 12223 Number of house - to - house inspections 500 106 172 71 318 149 208 53 285 1862 Number of preliminary notices served 621 402 263 476 760 612 292 451 883 4760 Ditto complied with 610 430 261 416 701 511 315 446 790 4480 Number of statutory notices served 12 25 3 27 30 25 6 16 82 226 Ditto complied with 11 14 2 31 26 14 6 15 72 191 Notices served for periodical removal of manure ... ... ... ... 1 ... 1 ... ... 2 Number of rooms disinfected after infective diseases 428 437 450 754 842 920 526 478 974 5809 Bedding stoved. 160 172 295 309 .89 598 195 212 416 2546 Overcrowding abated 6 2 4 4 3 5 2 5 9 40 Rooms cleansed and repaired. 302 202 193 500 672 401 202 537 879 3888 Staircases cleansed and repaired 38 49 34 64 184 82 25 85 151 712 Drains cleansed and repaired. 68 58 116 113 123 138 69 42 81 808 Drains tested. 634 275 230 264 5°3 202 259 172 679 3218 Drains found defective 20 25 92 53 50 64 16 14 55 389 Traps fixed to drains 65 31 ... 50 15 36 8 5 ... 210 Bath, lavatory and sink wastes altered to discharge outside over gullies or repaired 29 34 15 37 35 52 3 64 48 317 Rain water pipes disconnected from drains ... ... ... 17 30 ... ... 11 58 Water closets cleansed and repaired 187 85 110 142 227 167 107 134 273 1432 Water closets, separate supply of water laid on to ... ... 2 ... ... ... ... 2 Accumulations of manure, etc removed 31 23 44 59 49 116 12 11 22 367 Urinals cleansed, repaired or Water laid on to 3 ... 10 6 9 6 1 3 1 39 Cesspools abolished ... ... ... ... ... ... ... 1 1 Ashpits provided or repaired 64 61 25 91 89 111 60 43 145 689 Dust complaints received 64 27 94 137 44 71 47 15 40 539 Stables and stables yards drained, paved or cleansed 1 8 2 26 11 54 2 2 15 121 Yards drained, paved or cleansed 37 35 26 57 67 80 32 67 133 534 Unwholesome or dilapidated houses cleansed or repaired ... ... ... ... 3 1 3 4 11 Leaky roofs and gutters repaired 209 122 50 126 96 123 38 107 121 992 Damp courses inserted 10 5 1 5 17 14 2 14 27 95 Damp conditions remedied 58 30 26 83 71 71 21 65 148 573 Houses re-supplied with water 3 4 7 2 6 4 8 6 5 45 Water cisterns cleansed, covered or repaired 39 31 13 58 27 84 14 42 147 455 Animals kept so as to be a nuisance. 1 5 ... 5 13 20 6 5 20 75 Smoke nuisances reported ... 1 2 ... 3 ... 2 3 11 Soil pipes repaired 9 8 18 47 14 17 8 9 15 145 Unclassified nuisances 212 27 50 22 25 10 38 50 20 454 124 Report of the Medical Officer of Health. TABLE LXV. DETAILS OF INSPECTIONS AND RE-INSPECTIONS, 1915. (Male Inspectors.) Inspections Re-Inspections. Totals. Number of complaints received and attended to 2.703 ... 2,703 Number of house-to-house inspections ... 1,862 ... 1,862 Drainage and other sanitary works after notice 3,665 8,664 12,329 Drainage and other sanitary works voluntary 649 1,004 1,653 Number of premises inspected on account of:— Notifiable diseases 3.727 567 4,294 Measles 3,149 45 3,194 Whooping Cough 333 4 337 Pulmonary Tuberculosis 34 1 35 Other Infective Diseases 644 64 708 Verminous conditions 461 31 492 Periodical Inspections:— Houses-let-in-Lodgings 301 383 684 Underground rooms 13 ... 13 Common Lodging Houses 7 ... 7 Food-places Work-places Factories 391 105 496 Workshops 846 64 910 Workshops (Domestic) 251 56 307 Workplaces 659 176 835 Outworkers' premises 121 16 137 Bakehouses 341 216 557 Restaurant kitchens 148 19 167 Cowsheds 50 ... 50 Piggeries 54 1 55 Dairies and Milkshops 688 68 756 Ice Cream Premises 385 40 425 Slaughterhouses 329 ... 329 Places where food is prepared 70 ... 70 Offensive trades 45 2 47 Fried Fish shops 123 12 135 Rag and bone stores 94 2 96 Butchers' shops 378 ... 378 Greengrocers' shops 364 23 387 Fishmongers' shops 244 10 254 Public House urinals 486 30 516 Other sanitary conveniences, schools, &c. 87 ... 87 Smoke observations 68 ... 68 Unsound food 11 3 14 Yards of Mews and Stables 1,938 123 2,061 Legal proceedings:— ... ... (1) Applications and summonses 11 ... 11 (2) Hearings and adjournments 14 ... 14 Other 2,085 35 2,120 Totals 27,829 11,764 39,593 125 Report of the Medical Officer of Health. TABLE LXVI. (Female Inspectors.) Inspections. Re-inspections. Totals. Number of complaints received and attended to 6 .. 6 Number of premises inspected on account of:— Puerperal Fever 26 11 37 Ophthalmia Neonatorum 88 12 100 Diarrhoea 103 4 107 Pulmonary Tuberculosis (1) 2,837 158 2,995 Other forms of Tuberculosis 657 21 678 Notification of Births 5,188 166 5,354 Dressmakers' and Milliners' premises 446 7 453 Laundries— Factory 149 3 152 Workshop 249 18 267 Workplaces 125 8 133 Other Factories 60 14 74 Other Workshops 156 8 164 Other Workplaces 258 6 264 Domestic Workshops 77 7 84 Outworkers' premises 541 15 556 Other 615 2 617 Totals 11,581 460 12,041 The following Table, which is prepared from the figures given in the summary, shows the percentage to total number of families of those living in one, two, three, and four rooms and upwards, in the separate Wards and in the whole Borough, in the premises inspected in 1915. 126 Report of the Medical Officer of Health. TABLE LXVII. Percentage to total living in one, two, three, and four rooms and upwards. Wards. One room. Two rooms. Three rooms. Four rooms and upwards. Clapham, North 9.52 15.48 16.90 58.10 Clapham, South 4.84 16.93 13.71 64.52 Putney ... 6.63 43.37 50.00 Streatham 2.86 14.86 29.14 53.14 Balham 10.16 21.80 36.38 31.66 Tooting .39 1.55 58.91 39.15 Southfield 4.35 11.95 32.61 51.09 Fairfield 14.08 11.27 9.86 64.79 Springfield 8.00 9.47 54.53 28.00 Whole Borough 7.03 13.76 34.72 44.49 Fairfield and Balham Wards had the highest percentage of families living in one room, and Putney the lowest. Balham and Clapham South had the highest percentage living in two rooms and Tooting the lowest. Tooting had the highest percentage living in three rooms, and Fairfield the lowest. Fairfield and Clapham South had the highest percentage living in four rooms and upwards, and Springfield the lowest. In the Borough, of the total families whose houses were inspected during the year, viz.:—2,958, 7.03 per cent. lived in one room, compared with 8.28 per cent, in 1914, 9.50 per cent. in 1913, and 9.50 in 1912; 13.76 per cent. in two rooms compared with 10.97, 12.90, and 13.44; 34.72 Per cent. in three rooms compared with 29.19, 27.44, and 24.85; and 44.49 per cent. in four rooms and upwards compared with 51.56, 50.16, and 52.4. 127 Report of the Medical Officer of Health. The Table of house-to-house inspections which follows shows the number of houses inspected in each Ward, the number of houses in which defects were found, the percentage of defects to houses inspected, as well as the number of families living in one, two, three, and four rooms and upwards. In I,III out of a total of 1,862 houses inspected, or 59.66 per cent., sanitary defects necessitating the service of an intimation notice were found. The highest percentage was in Streatham, where the percentage was 98.19, and thelowest in Southfield, where it was only 29.32, the next lowest being Putney, where it was 40.11. HOUSING, TOWN PLANNING, &c. ACT, 1909. SUMMARY. TABLE LX VIII. Wards. No. of houses inspected. No. of houses in which defects were found. Percentage of defects to houses inspected Number of Families living in One room. Two rooms. Three rooms. Four rooms and upwards. Clapham, North 500 291 58.20 67 109 119 409 Clapham, South 106 6l 57.54 6 21 17 80 Putney 172 69 40.11 ... 13 85 98 Streatham 71 71 100.00 5 26 51 93 Balham 318 229 72.01 69 148 247 215 Tooting 149 56 37.58 1 4 152 101 Southfield 208 61 29.32 12 33 90 141 Fairfield 53 52 98.19 10 8 7 46 Springfield 285 221 71.54 38 45 259 133 Whole Borough 1,862 1,111 59.66 208 407 1,027 1,316 128 Report of the Medical Officer of Health. The total number of intimation notices served was 4,760, compared with 5,897 in 1914, 6,305 in 1913, and 6,620 in 1912, and of statutory notices 226, compared with 406, 540, and 707. The greatest number of intimation notices was served in Balham and Springfield Wards, and the smallest number in Southfield and Putney Wards. The greatest number of statutory notices was served in Springfield and Balham Wards and the smallest number in Putney and Southfield Wards. Only 39 of the statutory notices, 12 in Clapham, one in Putney, four in Balham, II in Tooting, and 11 in Wandsworth, served in 1915, were not complied with at the close of the year. Most of these notices were complied with in the beginning of the current year, with regard to two the premises are unoccupied, and in one a closing order has been obtained. The number of statutory notices served include By-law notices, 65 of which were served in respect of the following contraventions of the By-laws:—Yard paving 30, repairs to water closets 13, repairs to flushing apparatus of water closets 13, cleansing of water closets one, covers to cisterns two, cleansing cisterns four, absence of cover to manure receptacle one, and for an improper fish curing shed one. The number of cases of overcrowding dealt with during the year was 40, compared with 81 in 1914, 75 in 1913, and 76 in 1912. Eight of these were in Clapham, two in Putney, seven in Streatham, five in Tooting, and 16 in Wandsworth. The cases of overcrowding in Clapham were in Rashleigh Street, Wandsworth Road, Heath Road, Nelson's Row, Cambray Road and Gauden Road; in Putney in Floss Street and Disraeli Road; in Streatham in Mill Lane, Danbrook Road, Zennor Road and Larch Road; in Tooting in Sellincourt Road, Pevensey Road, Salvador and Smallwood Road; in Wandsworth in Warple Road, Warple Way, Baylin Road, Point Pleasant, Armoury Yard, Bridge- Report of the Medical Officer of Health. 129 field Grove, Aslett Street, Lydden Grove, Steerforth Street, Guelph Street, Garratt Lane, Franchecourt Road, Inman Road, Cubitt's Cottages and Maskell Road. Most of these were cases of domestic overcrowding and were remedied without difficulty by re-arrangement of the sleeping accommodation, while in several cases lodgers had been taken in by the tenants and these removed. 689 ashpits were provided or repaired, compared with 1,860 in 1914, 1,052 in 1913, 717 in 1912. 539 complaints with reference to the non-removal of house refuse (91 from Clapham, 94 from Putney, 181 from Streatham, 71 from Tooting, and 102 from Wandsworth), were received during the year. These complaints were, as in previous years, attended to by the Dusting Inspectors. 534 yards in connection with dwelling-houses, and 121 in connection with stables, were paved, drained, or cleansed, compared with 869 and 116 in 1914. 3,888 rooms and 712 staircases and passages were cleansed or repaired, compared with 4,896 rooms and 911 staircases and passages in 1914. The greatest number of rooms cleansed was in the Springfield Ward, where 879 were done, and in Balham Ward, where 672 were done, and the smallest number in Putney, Southfield and Clapham South where the numbers were 193, 202 and 202 respectively. 808 drains were cleansed or repaired, and 58 rain-water pipes disconnected from the drains. 36 notices of reconstruction of drains were sent to the Borough Engineer from this Department: six from Clapham, compared with 24 in 1914; two in Putney, compared with four; 14 in Streatham, compared with 41; one in Tooting, compared with nine ; and 13 in Wandsworth, compared with 23. I 130 Report of the Medical Officer of Health. The total number of houses where the drains were reconstructed during the year was 121: 20 in Clapham, four in Putney, 55 in Streatham, five in Tooting, and 37 in Wandsworth. During the year 3,218 drains of houses were tested by the Sanitary Inspectors, 909 in Clapham, 230 in Putney, 767 in Streatham, 202 in Tooting, and 1,110 in Wandsworth, and 389 or 12.0 per cent. were found to be defective. Of the 389 found defective, 45 or 11.6 per cent. were in Clapham, 92 or 2.38 per cent. in Putney, 103 or 26.4 per cent. in Streatham, 64 or 16.4 per cent. in Tooting, and 85 or 21.8 per cent. in Wandsworth. 367 accumulations of manure were removed after service of notice, compared with 329 in 1914: 54 in Clapham, 44 in Putney, 108 in Streatham, 116 in Tooting, and 45 in Wandsworth. There has been an increase in the number of cases dealt with in Clapham, Streatham, and Tooting, and a decrease in Putney and Wandsworth. Two notices were served for the periodical removal of manure every 48 hours, compared with three in 1914, 15 in 1913, and eight in 1912. The number of water closets cleansed and repaired was 1,432, compared with 1,511 in 1914. The greatest number of these were in Balham and Springfield Wards, and the smallest in Clapham South and Southfield Wards. 455 drinking water cisterns were cleansed, covered or repaired : 70 in Clapham, 13 in Putney, 85 in Streatham, 84 in Tooting, and 203 in Wandsworth, compared with 412 in 1914. 75 premises were inspected and notices served where animals were kept in such a manner as to be a nuisance. Six of these were in Clapham, none in Putney, 18 in Streatham, 20 in Tooting, and 31 in Wandsworth. This nuisance was most common in Tooting and Springfield Wards, and the animals kept were chiefly ducks and hens. Report of the Medical Officer of Health. 131 11 smoke nuisances were reported during the year : one in Clapham, two in Putney, none in Streatham, three in Tooting, and five in Wandsworth. In all 66 observations for black smoke were made by the Inspectors, 11 nuisances were reported and 9 notices served. Seventeen complaints of black smoke were received from the Coal Smoke Abatement Society with regard to 31 premises. These complaints were all at once attended to and the premises kept under observation. 145 soil pipes were repaired, 17 in Clapham, 18 in Putney, 61 in Streatham, 17 in Tooting, and 32 in Wandsworth, compared with 145 in 1914, 119 in 1913, and 159 in 1912. 992 leaky roofs and gutters were repaired, compared with 725 in 1914, 746 in 1913, and 870 in 1912. 11 unwholesome or dilapidated houses were cleansed and repaired, three in Tooting, and eight in Wandsworth compared with 22 in 1914, 23 in 1913, and 60 in 1912. A large amount of work has again been carried out to abate nuisances arising from damp conditions. In all, 573 premises have been dealt with, 88 in Clapham, 26 in Putney, 154 in Streatham, 71 in Tooting, and 234 in Wandsworth ; and in 95 of these, 15 in Clapham, one in Putney, 22 in Streatham, 14 in Tooting, and 43 in Wandsworth, damp courses have been inserted. The number of unclassified nuisances was 454, 239 in Clapham, 50 in Putney, 47 in Streatham, 10 in Tooting, and 108 in Wandsworth, compared with 849 in 1914, 947 in 1913, and 929 in 1912. Disinfection. The total number of rooms disinfected after the occurrence of cases of infectious disease was 5,809 (865 in Clapham, 450 in 1 2 132 Report of the Medical Officer of Health. Putney, 1,596 in Streatham, 920 in Tooting, and 1,978 in Wandsworth), compared with 4,030 in 1914, 4,404 in 1913, and 3,787 in 1912. 2,546 lots of bedding were stoved at the Disinfecting Station, compared with 2,268 in 1914, 1,801 in 1913, and 1,744 in 1912. The 2,546 lots of bedding included the following: 1,312 beds, 1,538 bolsters, 3,867 pillows, 1,734 mattresses, 348 palliasses, 3,160 sheets, 2,210 quilts, 757 cushions, 17,290 articles of clothing, 5,942 blankets, 118 carpets, and 7,793 extra articles, a total of 46,069 articles, compared with 28,809 in 1914. 23,101 in 1913, and 21,401 in 1912. 1,873 premises were disinfected after Measles and 371 after Pulmonary Tuberculosis, compared with 372 and 399 in 1914. 64 beds, 32 bolsters, 121 pillows, 67 mattresses, 59 palliasses, 24 sheets, 15 quilts, 31 cushions, 262 articles of clothing, 27 blankets, eight carpets, and 132 extra articles, were removed and destroyed by request of the owners during the year. Disinfection was also carried out by the Sanitary Staff at premises after non-notifiable diseases, chiefly Cancer, and the sum of £36 19s. 7d. was received for such disinfection. 241 rooms were disinfected with sulphur in consequence of their verminous condition and 98 lots of verminous bedding disinfected, compared with 409 rooms and 27 lots of bedding in 1914. During the year, at the request of the Military Authorities, 9,415 articles of clothing and bedding were disinfected on account of having been exposed to infection, and 9,552 articles in consequence of their verminous condition. The Disinfecting Station has been frequently visited during the year, and I am able to report that the work has been carried out by the staff to my entire satisfaction. 133 Report of the Medical Officer of Health. The approximate cost of working and maintaining the Disinfecting Station during the past year, including the cost of disinfectants used in fumigating and cleansing rooms, was as follows:— £ s. d. Wages 861 17 6 Fuel 5 9 0 Horse Hire 93 5 0 Stores, Tools, and other materials 41 16 1 Repairs to Horse Vans 14 8 0 Disinfectants, etc. 13 1 0 Repairs to Motor Van 10 8 11 Motor Running Expenses 89 6 7 Lighting 2 16 2 Insurance 2 7 10 Water 4 10 3 Payment to Highways Committee for Steam 30 0 0 £1.169 6 4 The number of lots of bedding stoved was 2,546. Cost per lot of bedding 9s. 2d. Cleansing of Persons Act. The baths at the Disinfecting Station have been more used this year, chiefly owing to the increase in the number of contacts with cases of infective diseases. The names of 561 children, 105 belonging to Clapham, 28 to Putney, 68 to Streatham, 116 to Tooting, and 244 to Wandsworth, stated to be in a verminous condition, were forwarded to me by the Medical Officer, Education Department, London County Council, and the homes were visited by the Inspectors. In the majority of cases it was stated that only the heads of the children were verminous, but in a few cases the body and clothing were stated to be also verminous. 134 Report of the Medical Officer of Health. These children were cleansed by the officials of the London County Council at the Cleansing Station under the supervision of that Authority. 106 adults had baths, 62 were contacts with cases of infective diseases, and 44 were verminous. Inspection of Urinals in connection with Licensed Premises. The number of urinals inspected was 123, 29 in Clapham, 19 in Putney, 25 in Streatham, 10 in Tooting, and 40 in Wandsworth. 516 inspections were made during the year and 27 notices, chiefly for cleansing, were served and complied with. In the Borough there are at present 14 public sanitary conveniences, while there are in addition 21 urinals only belonging to the Council. 199 inspections of the sanitary conveniences for females were made by the female Sanitary Inspectors. The provision of free conveniences for the use of females has been much appreciated, but these entail a greater amount of supervision on the part of the staff employed. 87 inspections have been made during the year by the Inspectors of other sanitary conveniences, chiefly in the elementary schools in the Borough. Inspection of Premises where Food is prepared for Sale or Sold. During the year 135 inspections have been made of fried fish shops, 378 of butchers' shops, 387 of greengrocers' shops, and 254 of fishmongers' shops, a total of 1,154. 231 of these inspections were in Clapham, 264 in Putney, 228 in Streatham, 120 in Tooting, and 311 in Wandsworth. Report of the Medical Officer of Health. 135 Police Court Proceedings. The list which follows shows particulars of Police Court proceedings under the Public Health (London) Act, 1891, during the year. The total amount of fines inflicted was £1 10s. od., and the costs £112s. od., compared with £32 13s. od. and £2 12s. od. in 1914. TABLE LXIX. Premises. Offences. Result. Fine. . 22, Natal Road, Streatham Nuisance Order made for abatement of nuisance - 51- 22, Bellamy Street, Balham Nuisance .. 5/- 12, Mill Lane, Brixton Hill Contravention of By-laws —Houses-let-in-Lodgings (cleansing) Convicted 20/- 2/- 4, Madeira Road, Streatham Nuisance Closing Order made - 5/- 53 and 54, Park Crescent, Clapham Executing sanitary work without first having given notice Convicted 10/- 2/- 24, Crescent Grove, Clapham " Withdrawn on payment of costs - 21- 31, Hopton Road, Streatham Nuisance Summons withdrawn, work having been carried out - 2/- 12, High Street, Roehampton Nuisance „ .. 2/- 65, Park Hill, Clapham Nuisance Order made for abatement of nuisance .. 5/- 32 and 34, Westbury Street, Clapham Nuisance Summons withdrawn, work having been carried out - 2/- 136 Report of the Medical Officer of Health. Removal of House Refuse. During the year no alteration has been made in the system of removal. The whole of the refuse is now collected and disposed of by contract, with the exception of a portion from the Balham, Streatham and Tooting Wards, which is disposed of at the Destructor. The following Table, taken from the report of the Borough Engineer, shows the quantity collected and the method of disposal in the various Wards of the Borough. TABLE LXX. Wards. Estimated Quantity. How DISPOSED or. Van loads. Tons. Clapham, North and South 4,627 13,928 Barged away from wharf at Nine Elms. „ „ „ „ 1,402 2,727 At Destructor. Balham and Tooting 7,281 12,871 At Destructor. „ „ 752 1,766 Sent to shoot outside the Borough. Streatham 2,986 6,048 At Destructor. „ 2,483 7,679 Sent to shoot outside the Borough. Fairfield, Springfield and Southfield 8,639 24,097 Sent to shoot outside the Borough. Putney 5,014 7,072 Barged away from Ashlone Road Wharf. Borough 33,184 76,188 Report of the Medical Officer of Health. 137 The total cost of collection and disposal was £16,025, compared with £16,101 for the year ending March 31st, 1913. 23 statutory notices were served under Section 37 of the Public Health (London) Act, 1891, to provide ashpits in accordance with the By-laws, and these have been complied with. Inspection of Milkshops, Cowsheds, etc. The following Table shows in concise form the number of milk premises, cowsheds, etc., on the register, the number of inspections, and the number of cases of legal proceedings during the year, as well as other information which it has been thought advisable to group together for the purpose of comparison with other Metropolitan Boroughs. TABLE LXXI. premises. NUMBER OF PLACES Number of inspections, 1915. Number of notices, 1915. Number of prosecutions, 1915. On register at end of 1914. Added in 1915. Removed in 1915. On register at end of 1915. Milk premises 397 33 30 4OO 756 32 ... Cowsheds 11 ... ... 11 50 ... Slaughter-houses 13 ... 1 12 329 2 ... Other offensive trade premises 3 ... 3 47 1 ... Ice cream premises 346 13 12 347 425 34 ... Registered houses let in lodgings 292 ... ... 292 684 *a10 ... b348 ... *a For overcrowding. * b For other conditions. Total number of intimation notices served for all purposes 4,760 Report of the Medical Officer of Health. Overcrowding, 1915:— Number of dwelling rooms overcrowded 40 Number remedied 40 Number of prosecutions — Underground rooms:— Illegal occupation dealt with during year 13 Number of rooms closed — Insanitary houses— Number closed under the Public Health (London) Act, 1891 Number closed under the Housing, Town Planning, etc., Act, 1909 Number of premises cleansed under Sec. 20 of the L.C.C. General Powers Act, 1904 241 Shelters provided under Sec. 60 (4) of the Public Health (London) Act, 1891— Number of persons accommodated during the year 2 Revenue Acts:— Number of houses for which applications were received during year 20 Number of tenements comprised therein 42 Number of tenements for which certificates were : (a) granted 32 (b) refused 10 (c) deferred - Number of prosecutions under By-laws under Public Health Act, 1891— (a) For prevention of nuisance arising from snow, ice, salt, filth, etc. (b) For prevention of nuisance arising from offensive matter running out of any manufactory, etc. (c) For the prevention of keeping of animals in such a manner as to be injurious to health (d) As to paving of yards, etc., of dwelling houses .. 138 Report of the Medical Officer of Health. (e) In connection with the removal of offensive matter, etc. - (f) As to cesspools and privies, removal and disposal of refuse, etc. - (g) For securing the cleanliness of tanks, cisterns, etc. - (h) With respect to water closets, earth closets, etc. - (i) With respect to sufficiency of water supply to water closets - (j) With respect to drainage, etc.(Metropolis Management Act, Section 202) - (k) With respect to deposit of plans as to drainage, etc. (Metropolis Management Acts Amendment (By-laws) Act, 1899) - Mortuaries— Total number of bodies removed 183 Total number of infective bodies removed 4 139 Milkshops. At the close of 1914 there were 397 milkshops on the register, 33 have been added in 1915 and 30 removed, leaving 400 on the Register at the end of 1915. During the year 756 inspections were made of these premises and 32 notices, chiefly for cleansing, were served. Cowsheds. The total number on the Register at the close of 1915 was 11 and 50 inspections were made. I am able to report that all the above were kept in a satisfactory condition during the year, and it was not necessary to serve any notices. 140 Report of the Medical Officer of Health. Slaughter-houses. There were 13 Slaughter-houses and one Knacker's Yard on the Register in 1914, one in Wandsworth was removed, leaving 12 on the Register. The slaughter-house licensed by the London County Council for slaughtering horses for human food was frequently inspected, and during the year 214 horses have been slaughtered on the premises, and all were exported, compared with 268 in 1914. During the year 329 inspections were made of these, but it was only necessary to serve two notices for cleansing. The usual cleansing was carried out by the occupiers at the proper times. During the year the Inspectors inspected the carcases of 548 cattle, 2,323 sheep, 261 pigs, and 12 calves in slaughter-houses and butchers' shops, and reported that these were all sound when exposed for sale. Offensive Trades. There are now only two offensive trade premises in the Borough. 47 inspections of these have been made, and it was necessary to serve one intimation notice for contravention of the By-laws. Ice Cream Premises. At the end of 1914 there were 346 of these on the Register. During 1915, 13 were added and 12 removed, leaving a total of 347 on the Register, 425 inspections were made of these premises during the year and 34 notices were served, all of which were for cleansing. Report of the Medical Officer of Health. 141 Houses let in Lodgings. At the end of 1914 there were 292 houses let in lodgings on the Register. None were added during 1915, and none removed, making a total of 292 on the Register at the end of 1915. 684 inspections of these were made during the year, and 358 notices were served, 10 for overcrowding and 348 for other conditions, chiefly cleansing. On the whole the By-laws have been satisfactorily complied with, although in some instances the cleansing was not carried out at the specified time. Proceedings at the Police Court were taken in one instance, and a fine of 20s. and 2s. costs was imposed. Offensive Trade Refuse. I have again to report that the arrangements which have been made by the Council with a contractor for the removal of this refuse have during the year worked quite satisfactorily, and no complaints have been received. In a certain number of cases this refuse is removed privately, and this has also been carried out in a satisfactory manner. Unsound Food. One trunk of dabs, one trunk of herring, two boxes of haddock, 34 boxes of tomatoes, 26 barrels of apples, 15 baskets of potatoes, four sacks of turnip-tops and seven ducks were destroyed at the request of the owners and the usual certificates granted. FACTORIES AND WORKSHOPS. There has been a decrease in the total number of inspections of the above, compared with 1914, but an examination of the Tables will show that a very large amount of work has been carried out by both the male and female inspectors. 142 Report of the Medical Officer of Health. The Tables which follow are similar to those used in previous Reports, and the whole of the work done by both male and female Inspectors is there shown in a concise form. The total number of workshops on the Register was 1,649, including 114 retail bakehouses, 125 workshop laundries, 253 dressmakers' and milliners' premises, and 1,157 other workshops, but not including 478 factories, 1,158 workplaces, and 511 outworkers' premises. Including all factories, workshops, workplaces, and outworkers' premises, there were on the Register at the end of 1915 3,796 premises, compared with 3,774 in 1914, 3,774 in 1913, and 3,629 in 1912. The total number of notices served was 297, 291 intimation and six statutory, compared with 364 in 1914, 454 in 1913, and 402 in 1912. There were no prosecutions under the Public Health (London) Act, 1891, during the year. Under the head of other workshops are included domestic workshops, and under the head of places where food is prepared for sale are included the kitchens of hotels, restaurants, tripe, fried fish and eel shops, and other places where food is prepared for sale. In all 837 inspections were made of 478 factories, and 60 notices, 57 intimation and three statutory, were served. The total number of the workshops on the Register was 1,649, 125 of which were workshop laundries, 114 workshop bakehouses, and 1,410 other workshops. In all 2,627 inspections of these were made, compared with 2,649 in 1914. in 1913, and 3,227 in 1912, and 107 intimation and two statutory notices were served. Report of the Medical Officer of Health. 143 The total number of workplaces on the Register was 1,158 and 1,469 inspections were made, while 104 intimation notices were served, but only one statutory notice was necessary. The total number of defects found was 394, including 17 cases in which there was a breach of special sanitary requirements for bakehouses, compared with 524 and 22 in 1914. To abate these nuisances, 297 notices, 291 intimation, and six statutory were served, all of which, with the exception of two were complied with at the end of the year. Excluding outworkers' premises 369 defects were found and 367 remedied, but only 268 intimation notices were served, as one notice frequently called attention to several defects on the same premises. 144 Report of the Medical Officer of Health. INSPECTION OF FACTORIES, WORKSHOPS AND WORKPLACES. TABLE LXXII. CLASS OF WORKS. Number of Places Number of Inspections, 1915. Number of Notices. Number of Prosecutions, 1915- On Register at end of 1914. Added in 1915. Removed in 1915. On Register at end of 1915. Intimation, 1915. Statutory, 1915. Under Factory Act. Under Public Health Act. Premises Rooms. Factories Factory Laundries 99 2 6 95 390 184 3 ... ... ... Factory Bakehouses 31 2 ... 33 52 115 5 ... ... ... Other Factories 333 35 18 350 1,135 538 49 3 ... ... Workshops Workshop Laundries 129 6 10 125 373 267 7 ... ... ... Workshop Bakehouses 116 ... 2 114 114 442 12 ... ... ... Other Workshops 1,467 90 147 1,410 1,768 1,918 88 2 ... ... Workplaces Places where Food is prepared for Sale 615 22 35 602 644 656 51 ... ... ... Workplaces other than the above 603 60 107 556 815 813 53 ... ... ... Home-workers' premises 351 270 110 51 51 693 23 ... ... ... Total 3,744 487 435 3,796 5,802 5,626 291 6 ... ... Report of the Medical Officer of Health. 145 The three following tables are inserted by request of the Secretary of State for the guidance of Medical Officers of Health in preparing that part of the Annual Report which relates to factories and workshops. Factories, Workshops, Laundries, Workplaces and Homework. TABLE LXXIII. I.—INSPECTION. Including Inspections made by Sanitary Inspectors or Inspectors of Nuisances. Premises. (1) Number of Inspections. (2) Written Notices. (3) Prosecutions. (4) Factories (Including Factory Laundries.) 837 60 ... Workshops (Including Workshop Laundries.) 2,627 109 ... Workplaces (Other than Outworkers' premises included in Part 3 of this report.) 1,469 105 ... Totals 4,933 274 ... K 146 Report of the Medical Officer of Health. TABLE LXXIV. 2.—DEFECTS FOUND Particulars. 0) Number of Defects Number of Prosecutions (5) Found. (2) Remedied (3) Referred to H.M. Inspector. (4) Nuisances under the Public Health Acts:—* Want of Cleanliness I30 129 ... ... Want of Ventilation 1 1 ... ... Overcrowding 8 8 ... ... Want of drainage of floors ... ... ... ... Other nuisances 158 157 ... ... Sanitary accommodation insufficient 3 3 ... ... unsuitable or defective 76 76 ... ... not separate for sexes 1 1 ... ... Offences under the Factory and Workshop Act:— Illegal occupation of underground bakehouse (S. 101) ... ... ... ... Breach of special sanitary requirements for bakehouses (SS. 97 to 100) 17 17 ... ... Other offences (Excluding offences relating to outwork, which are included in Part 3 of this report.) ... ... ... ... Totals 394 392 ... ... * Including those specified in sections 2, 3, 7 and 8, of the Factory and Workshop Act as remediable under the Public Health Acts. The Table which follows and which relates to Home Work is similar to the one in last year's Report. The number of lists sent in twice a year, was six less than in 1914, but there was an increase of three in the number sent in once a year. Report of the Medical Officer of Health. 147 NATURE OF WORK* (1) OUTWORKERS' LISTS. SECTION 107. OUTWORK IN UNWHOLE SOME PREMISES, SECTION 103. OUTWORK IN INFECTED PREMISES, SECTIONS 109, 110. Lists received from Employers. Notices served on occupiers as to keeping or sending lists. (8) Prosecutions Sending twice in the year. Sending once in the year. Failing to keep or permit inspection of lists. Failing to send lists. (10) instances. Notices served. Prosecutions. Instances. Orders made (S. 110). Prosecutions SS.109,110). Outworkers† Outworkers. Lists† (2) Contractors. (3) Workmen. (4) Lists. (5) Contractors. (6) Workmen. (7) (9) (11) (12) (13) (14) (15) (16) Wearing Apparel— (1) Making, &c 96 129 251 9 1 22 15 ... ... 25 23 ... 14 ... ... (2) Cleaning and washing 2 6 2 ... ... ... ... ... ... ... ... ... ... ... ... Household Linen ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Lace, lace curtains and nets ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Curtains & Furniture hangings ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Furniture and Upholstery ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Electro Plate ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... File making ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Brass and Brass articles ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Fur pulling ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cables and Chains ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Anchors and Grapnels ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cart Gear ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Locks, Latches and Keys ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Umbrellas, &c. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Artificial Flowers ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Nets, other than wire nets ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Tents ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Sacks 6 ... 258 1 ... 15 ... ... ... ... ... ... ... ... ... Racquet and tennis balls ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Paper Bags and Boxes 4 ... 12 ... ... ... ... ... ... ... ... ... ... ... ... Brush making ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Pea picking ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Feather sorting ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Carding, &c., of buttons, &c 2 ... 5 ... ... ... ... ... ... ... ... ... ... ... ... Stuffed Toys ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Basket making ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Totals 110 135 528 10 1 37 15 ... ... 25 23 ... 14 ... ... W 2 * If an occupier gives out work of more than one of the classes specified in column 1, and subdivides his list in such a way as to show the number of workers in each class of work, the list should be included among those in column 2 (or 5 as the case may be) against the principal class only, but the outworkers should be assigned in columns 3 and 4 (or 6 and 7) into their respective classes. A footnote should be added to show that this has been done. † The figures required in columns 2, 3 and 4 are the total number of the lists received from those employers who comply strictly with the statutory duty of sending two lists each year and of the entries of names of outworkers in those lists. The entries in column 2 must necessarily be even numbers, as there will be two lists for each employer—in some previous returns odd numbers have been inserted. The figures in columns 3 and 4 will usually be (approximately) double of the number of individual outworkers whose names are given, since in the February and August lists of the same employer the same outworker's name will often be repeated. 148 Report of the Medical Officer of Health. In all, 110 lists were received twice in the year, containing the names and addresses of 135 contractors and 528 workmen and 10 lists once in the year, containing the names and addresses of one contractor and 37 workmen. There has been an increase in the number of outworkers employed by employers in the Borough during the year owing to the making of textile goods for the War Department. The total number of addresses received from other Councils was 509, compared with 507 in 1914, 521 in 1913, and 511 in 1912, and 339 addresses were forwarded to other Councils, compared with 290 in 1914, 276 in 1913, and 285 in 1912. The number of addresses received has increased by two and the number sent by 49. 40 names and addresses were forwarded to this Borough in error, and are not included in the above Table. The number of notices sent to employers during the year was 15, compared with 61 in 1914, and these had a most satisfactory result. At the end of 1914 there were 351 outworkers' premises on the Register, 270 were added and 110 removed during the year, leaving 511 on the Register at the end of 1915. 693 inspections were made of these premises during the year, and 23 notices, all for cleansing, were served and complied with. During the year 14 cases of infective diseases, seven of Scarlet Fever, four of Diphtheria, one of Erysipelas, one of Cerebral Spinal Meningitis, and one of Chicken-pox, were notified as having occurred in the homes of outworkers, compared with 15 in 1914, and 20 in 1913. In none of these cases was it necessary to make any order under Section 110 of the Factory and ,Workshop Act. Report of the Medical Officer of Health. 149 TABLE LXXVI. 4.—REGISTERED WORKSHOPS. Workshops on the Register (s. 131) at the end of the year. Number. (1) (2) Important classes of workshops, such as workshop bakehouses, may be enumerated here. Workshop Bakehouses 114 „ Laundries 125 Dressmakers' and Milliners' Workshops 253 Bootmakers 137 Smiths 48 Builders 64 Tailors 76 Other 832 Total number of workshops on Register 1,649 TABLE LXXVI I. 5.—OTHER MATTERS. Class. (1) Number. (2) Matters notified to H.M. Inspector of Factories:— Failure to affix Abstract of the Factory and Workshop Act (s. 133) 14 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 8 Reports (of action taken) sent to H.M. Inspector 7 Other Underground Bakehouses (s. 101):— Certificates granted during the year ... In use at the end of the year 41 150 Report of the Medical Officer of Health. The next Table shows in detail the work of the Inspectors in factories and workshops where males are chiefly employed. The Table shows the work done in each sub-district and is grouped under five divisions: (i) factories, (2) workshops, (3) domestic workshops, (4) workplaces, and (5) outworkers' premises. The total number of inspections was 2,721, compared with 3,031 in 1914, 3,510 in 1913, and 4,147 in 1912, and of re-inspections 758, compared with 745, 732 and 656, a total of 3,479 compared with 3,776 in the previous year. 1,094 of the inspections and 158 of the re-inspections were in Clapham, 229 and 206 in Putney, 601 and 141 in Streatham, 103. and 35 in Tooting, and 694 and 218 in W andsworth. No workshops where males were employed were notified to H.M. Inspector, but eight were reported to this Council by H.M. Inspector, all with the exception of two of these having been previously entered on the Register. In five of the workrooms under the supervision of the male Inspectors cases of overcrowding were discovered, and these conditions were remedied. In 67 of these factories, workshops and workplaces the sanitary conveniences were found defective, in three they were insufficient, and in two they were unsuitable or not separate for the sexes. In 113 the workrooms were in a dirty condition, in one they were insufficiently ventilated, and in 136 other nuisances were found. For these 253 intimation and six statutory notices were served, and with the exception of two statutory notices, were complied with. Report of the Medical Officer of Health. 151 TABLE LXXVI II. Clapham. Putney. Streatham. Tooting. Wandsworth. Total. 1.—Factories inspected „ re-inspected Sanitary conveniences insufficient „ „ unsuitable 150 49 62 13 155 429 24 70 25 15 48 182 1 ... ... ... 1 2 ... ... ... ... 1 1 „ „ not separate for sexes ... ... ... ... 1 1 „ „ defective 4 9 ... ... 10 23 Other nuisances 4 2 4 2 23 35 Intimation notices served 4 11 3 2 30 50 Statutory notices served ... ... ... ... 3 3 Legal proceedings ... ... ... ... ... ... II.—Workshops inspected 415 111 240 34 243 io43 re-inspected 68 86 68 15 72 3°9 Workrooms inspected 459 142 272 41 295 1209 „ found overcrowded 5 ... ... ... ... 5 „ insufficiently ventilated ... ... ... ... ... 1 „ in a dirty condition 13 7 13 ... 16 51 Sanitary conveniences insufficient 1 ... ... ... ... 1 „ „ unsuitable ... ... ... ... ... ... „ „ not separate for sexes ... ... ... ... ... ... „ „ defective 4 8 1 ... 7 20 Other nuisances 9 1 ... ... 8 18 Intimation notices served 17 16 8 26 68 Statutory notices served 2 ... ... ... ... 2 Legal proceedings ... ... ... ... ... ... Number of workrooms measured 20 ... 12 ... 5 37 Number of workroom cards distributed ... ... ... ... ... ... Workshops reported to H.M. Inspector on discovery ... ... ... ... ... ... Workshops reported by H.M. Inspector 2 ... 3 1 2 8 III.—Domestic workshops inspected 78 21 94 12 46 251 „ „ re-inspected 11 8 17 4 16 56 Workrooms found overcrowded ... ... ... ... ... ... „ insufficiently ventilated ... ... ... ... ... ... „ in a dirty condition 1 1 11 1 5 19 Other nuisances 4 ... 1 2 13 20 Intimation notices served 5 1 8 2 12 28 Statutory notices served ... ... ... ... ... ... Legal proceedings ... ... ... ... ... ... Domestic workshops reported to H.M. Inspector on discovery ... ... ... ... ... ... IV.—Workplaces inspected 430 39 165 27 216 877 „ re-inspected 52 37 27 1 78 195 Workrooms inspected 349 43 185 27 218 822 ,, found overcrowded ... ... ... ... ... ... „ insufficiently ventilated ... ... ... ... ... ... „ in a dirty condition 7 2 9 1 17 36 152 Report of the Medical Officer of Health. TABLE LXXVIII.—continued. Clapham. Putney. Streatham. Tooting. Wandsworth. Total. Sanitary conveniences insufficient ... ... ... ... ... ... „ „ unsuitable ... ... ... ... ... ... „ „ not separate for sexes ... ... ... ... ... ... „ „ defective 7 ... 1 ... 16 24 Other nuisances 25 3 3 28 59 Intimation notices served 29 5 12 1 50 97 Statutory notices served 1 ... ... ... ... 1 Legal proceedings ... ... ... ... ... ... V.—Home work Premises inspected 21 9 40 17 34 121 „ re-inspected 3 5 4 ... 4 16 Workrooms found overcrowded ... ... ... ... ... ... „ insufficiently ventilated ... ... ... ... ... ... 11 in a dirty condition 2 ... 4 ... 1 7 Other nuisances 1 1 ... ... 2 4 Intimation notices served 3 1 4 ... 2 10 Statutory notices served ... ... ... ... ... ... Legal proceedings ... ... ... ... ... ... Cases of infective diseases notified ... ... ... ... 2 2 Houses visited for inquiry and no workroom found 5 ... ... ... 18 23 Total number of premises inspected 1094 229 601 103 694 2721 „ „ „ re-inspected 158 206 141 35 218 758 „ intimation notices served 58 34 35 6 120 253 „ ,, intimation notices complied with 57 34 35 6 119 251 „ „ statutory notices served 3 ... ... ... 3 6 „ „ statutory notices complied with 2 ... ... ... 2 4 „ „ legal proceedings ... ... ... ... ... ... Table LXXIX. shows the principal trades carried on in the premises on the Register, but it does not include the trades in workplaces, domestic workshops, or in outworkers' premises. Compared with 1914 there has been a decrease of 21 in the number of these trades. 153 Report of the Medical Officer of Health. TABLE LXXIX. SUMMARY OF PRINCIPAL TRADES CARRIED ON IN WORKSHOPS WHERE MEN ARE EMPLOYED. Clapham. Putney. Streatham. Tooting. Wandsworth. Whole Borough. Bootmakers 31 17 43 12 34 137 Bakers 30 13 29 9 33 114 Tailors 19 13 33 4 7 76 Builders 23 12 15 1 13 64 Smiths 15 7 10 5 11 48 Cycle Makers 8 3 10 2 12 35 Wheelwrights 12 1 11 2 7 33 Upholsterers 7 7 10 ... 7 31 Hair dressers 6 13 6 ... 5 30 Motor Engineers 9 ... 7 1 7 24 Watchmakers 9 1 2 ... 4 16 Joiners 5 1 2 ... 4 12 Undertakers 4 ... 1 2 5 12 Printers 2 1 4 ... 4 11 Harness Makers 3 ... 4 1 1 9 Photographers 3 4 1 ... 1 9 Plumbers 6 2 ... ... 1 9 Boat Builders ... 8 ... ... 1 9 Cabinet Makers 2 2 ... ... 1 5 Ironmongers 1 ... 1 ... 2 4 Rag Sorters ... ... ... 3 1 4 Wood Choppers 2 ... 1 ... ... 3 Jewellers 2 ... ... ... ... 2 Tarpaulin and Scale Makers 1 ... ... ... 1 2 Other Trades 36 12 31 5 41 125 Totals 236 117 221 47 203 824 The Tables which follow summarise the work done during the •year by the female Sanitary Inspectors. The total number of premises inspected was 2,061 (489 in Clapham, 322 in Putney, 525 in Streatham, 107 in Tooting, and 618 in Wandsworth). 154 Report of the Medical Officer of Health. 209 inspections were made of factories, 851 of workshops,. 77 of domestic workshops, 383 of workplaces, and 541 of outworkers' premises, while 255 premises were visited for inquiry and no workroom found. There were only three cases of overcrowding discovered, compared with four in 1914, two in 1913, and one in 1912, and these were at once abated, and 17 were found to be in a dirty condition, compared with 25 in 1914, 29 in 1913, and 37 in 1912. All the factories and workshops inspected during the year had separate water closets for the sexes, but in seven factories and one workshop the water closets were defective. Other nuisances were discovered in three factories, three workshops, five workplaces, and 11 outworkers' premises, and these were all abated. It was only necessary to serve 38 intimation notices, and these were all complied with at the end of the year. 14 workshops and one domestic workshop where females were employed were reported to H.M. Inspector of Workshops and 26 were reported to this Council by H.M. Inspector. Only six of the workshops (one in Clapham, four in Streatham, and one in Wandsworth), reported by H.M. Inspector were unknown to the Sanitary Inspectors. The other 20 had been previously reported to H.M. Inspector, or were already on the Register. 155 Report of the Medical Officer of Health. TABLE LXXX. Clapham. Putney. Streatham. Tooting. Wandsworth. Borough. I.—Factories inspected 56 19 23 1 110 209 „ re-inspected 5 6 ... 1 5 17 Sanitary conveniences insufficient ... ... ... ... ... ... ,, ,, unsuitable ... ... ••• ... ... ... „ ,, not separate for sexes ... ... ... ... ... ... ,, „ defective 1 1 ... ... 5 7 Other nuisances ... 1 ... ... 2 3 Intimation notices served 1 2 ... ... 4 7 Statutory notices served ... ... ... ... ... ... Legal proceedings ... ... ... ... ... ... II.—Workshops inspected 190 174 287 5 195 851 ,, re-inspected 6 4 11 ... 12 33. Workrooms inspected 346 236 475 ... 22 391 ... 1470. „ found overcrowded I 2 ... 3 ,, insufficiently ventilated ... ... ... ... ... ... „ in a dircy condition ... ... ... ... ... 10. Sanitary conveniences insufficient ...... ... ... ... ... ... ,, „ unsuitable ... ... ... ... ... ... ,, ,, not separate for sexes ... ... ... ... ... ... „ ,, defective ... ... ... • •• 1 1 Other nuisances ... ... 1 1 1 3 Intimation notices served ... ... 2 2 4 10 Statutory notices served ... ... ... ... ... ... Legal proceedings ... ... ... ... ... ... Number of workrooms measured 22 2 38 ... 18 80 Number of workroom cards distributed 37 2 71 ... ... 10 120. Workshops reported to H.M. Inspector 3 2 ... 9 14 ,, ,, by ,, ,, III.—Domestic workshops inspected 4 ... 7 2 13 26 9 11 27 3 27 77 ,, ,, re-inspected 2 ... 3 ... 2 7 Workrooms found overcrowded ... ... ... ... ... ... „ insufficiently ventilated ... ... ... ... ... • •• ,, in a dirty condition 1 ... ... ... ... 1 Other nuisances ... ... ... ... ... ... Intimation notices served 1 ... ... ... ... 1 Statutory notices served ... ... ... ... ... ... Legal proceedings ... ... ... ... ... ... Domestic workshops reported to H.M. Inspector ... 1 ... ... ... 1 IV.—Workplaces inspecte 83 31 118 44 107 383 „ re-inspected 4 ... 4 2 4 14 Workrooms inspected 117 ... 43 ... 144 59 ... 121 484 „ found overcrowded ... ... ... „ insufficiently ventilated ... ... ... ... ... ... ,, in a dirty condition ... ... ... ... 1 3 Sanitary conveniences insufficient ... ... ... ... ... ... „ ,, unsuitable ... ... ... ... ... ... „ ,, not separate for sexes ... ... ... ... ... ... ,, ,, defective ... ... ... ... ... ... Other nuisances 1 ... 3 ... 1 5 Intimation notices served 1 ... 4 ... 2 7 156 Report of the Medical Officer of Health. TABLE LXXX.—continued. Clapham. Putney. Streatham. Tooting. Wandsworth. Borough. Statutory notices served ... ... ... ... ... ... Legal proceedings ... ... ... ... ... ... V.—Home work. Premises inspected 151 87 70 54 179 541 ,, re-inspected Workrooms found overcrowded 2 6 ... ... 7 15 ... ... ... ... ... ... ,, insufficiently ventilated ... ... ... ... ... ... „ in a dirty condition ... 2 ... ... 1 3 Other nuisances 4 2 1 2 2 11 Intimation notices served 4 4 1 2 2 13 Statutory notices served ... ... ... ... ... ... Legal proceedings ... ... ... ... ... ... Cases of infective disease notified 1 2 ... 5 4 12 Houses visited for inquiry and no room found 52 32 71 15 85 255 Total number of premises inspected 489 322 525 107 618 2061 ,, ,, ,, re-inspected 19 16 18 3 30 86 ,, intimation notices served 9 6 7 4 12 38 ,, ,, complied with ... 6 7 4 12 38 ,, statutory notices served ... ... ... ... ... ... „ ,, ,, complied with ... ... ... ... ... ... „ legal proceedings ... ... ... ... ... ... Table LXXXI. shows the number of factories, workshops, domestic workshops, and workplaces on the Register at the close of 1914, the number removed from, the number added during 1915, and the number on the Register at the end of 1915. The number of workrooms in workshops is also shown. The factories and workshops are divided into dressmakers' and milliners' premises, laundries, and miscellaneous premises; and the workplaces are divided into laundries and miscellaneous premises. Of the 110 factories where women are employed, 73 are laundries and 37 other factories, while of the total workshops, viz.:—471, 253 are dressmakers and milliners, 125 laundries, and 93 other 157 Report of the Medical Officer of Health. workshops, a decrease of 20 dressmakers' and milliners' premises and four laundries, compared with 1914, while the number of other workshops is the same as in the previous year. The total number of domestic workshops on the Register was 63 (nine in Clapham, eight in Putney, 19 in Streatham, five in Tooting and 22 in Wandsworth), compared with 69 in 1914. The total number of workplaces on the Register is 324, a decrease of 33 compared with 1914, of which 91 are laundries, and 233 miscellaneous premises, chiefly dressmakers and milliners. 158 Report of the Medical Officer of Health. TABLE LXXXI. Clapham. Putney. Streatham. Tooting. Wandsworth. Borough. *1 2 3 Total. 1 2 3 Total. 1 2 3 Total. 1 2 3 Total. 1 2 3 Total. 1 2 3 Total. Factories on Register, 1914 ... 14 8 22 ... 5 3 8 ... 15 ... 5 20 ... 1 1 2 ... 42 12 54 ... 77 29 106 „ removed from Register ... 3 ... ... ... ... ... ... ... 2 2 ... ... 1 1 ... 3 1 4 ... 6 4 10 „ added to Register, 1915 ... 1 6 7 ... ... 1 1 ... ... ... ... ... ... 1 1 ... 1 4 5 ... 2 12 14 „ on Register, 1915 ... 12 14 26 ... 5 4 9 ... I5 3 18 ... 1 1 2 ... 40 IS 55 ... 73 37 110 Workshops on Register, 1914 47 28 21 96 52 12 13 77 125 37 46 208 16 8 7 31 33 44 6 83 8 273 129 93 495 „ removed from Register 10 2 1 13 6 1 7 12 4 ... 16 4 1 2 7 3 3 2 35 10 26 71 , added to Register, 1915 2 3 7 12 1 ... 2 3 5 ... 7 12 3 ... 4 7 4 3 6 n I5 6 26 47 „ on Register, 1915 39 29 27 95 47 12 14 73 118 33 S3 204 IS 7 9 31 34 44 10 88 253 125 93 47i Number of workrooms therein 46 78 47 171 62 32 17 111 141 100 61 302 15 19 9 43 37 144 13 194 301 373 147 821 Domestic workshops on Register, 1914 7 8 20 8 26 69 ,, removed from Register 1 1 5 3 6 16 „ added to Register, 1915 3 1 4 ... 2 10 „ on Register, 1915 9 8 '9 5 22 63 *2 3 Total. 2 3 Total. 2 3 Total. 2 3 Total. 2 3 Total. 2 3 Total. Workplaces 011 Register, 1914 18 34 52 9 22 31 47 90 '37 13 35 11 48 23 66 89 110 247 357 „ removed from Register 2 5 7 ... 2 2 17 29 46 3 14 3 17 20 25 64 89 ,, added to Register, 1915 1 12 13 ... 4 4 1 13 14 1 4 5 3 17 20 6 50 56 „ on Register, 1915 17 41 58 9 24 33 31 74 105 11 28 39 23 66 8 9 91 233 324 Number of workrooms therein 36 41 77 19 24 43 53 74 127 22 28 50 47 66 113 177 233 410 * (1) Dressmakers and Milliners. (2) Laundries. (3) Miscellaneous. 159 Report of the Medical Officer of Health. Table LXXXII. shows the nature of the trades carried on in the workshops inspected. The total number, viz.:—894 (167 in Clapham, 117 in Putney, 334 in Streatham, 75 in Tooting, and 201 in Wandsworth), is 43 less than in 1914, the greatest decrease having occurred in Streatham and Tooting, while there has been an increase in Clapham. TABLE LXXXII. Clapham. Putney. Streatham. Tooting. Wandsworth. Borough. Art Needleworkers ... 1 6 1 ... 8 Blouse Makers 6 2 6 2 4 20 Box Makers 1 ... ... ... 1 2 Confectionery Maker ... 1 ... ... ... 1 Corset Makers 2 1 4 1 ... 8 Costumiers 1 I 4 ... 1 7 Dressing Gown Makers 3 ... ... 1 ... 4 Dressmakers 73 65 171 38 106 453 Druggists' Sundries Maker 1 ... ... ... ... 1 Ecclesiastical Embroiderer ... ... 1 ... ... 1 Engraver 1 ... ... ... ... 1 Feather Curlers and Cleaners 1 ... 2 2 1 6 Firework Case Maker ... ... ... 1 ... 1 Flag Maker ... ... 1 ... ... 1 Florists ... ... 6 ... ... 6 Furriers ... 1 2 ... 1 4 Glove Maker ... ... ... ... 1 1 Gold Embroiderer 1 ... ... ... ... 1 Hairworker ... 1 ... ... ... 1 Haversack Makers ... 3 1 ... ... 4 Hosiers 2 ... 1 1 ... 4 Lace Maker ... 1 ... ... ... 1 Laundries (Workshops) 29 12 33 7 44 125 Laundries (Workplaces) 17 9 3i 11 23 91 Linen Embroiderer ... ... 1 ... ... 1 Maker of Celluloid Articles ... 1 ... ... ... 1 Mantle Makers 2 ... ... ... ... 2 Milliners 13 16 34 7 9 79 Munition Maker 1 ... ... ... ... 1 Outfitters 4 ... 9 1 6 20 Paper Bag Maker 1 ... ... ... ... 1 Paper Cap Maker ... ... 1 ... ... 1 Papier Poudre Maker ... ... 1 ... ... 1 Seed Packers 2 ... ... ... ... 2 Shoe Upper Makers 2 ... ... ... ... 2 Tailors 2 1 18 1 4 26 Tea Gown Maker ... 1 ... ... ... 1 Toy Maker ... ... 1 ... ... 1 Upholsterer 1 ... ... ... ... 1 Vest Maker ... ... ... 1 ... 1 Waterproof Maker 1 ... ... ... ... 1 Totals 167 117 334 75 201 894 160 Report of the Medical Officer of Health. Military Billets. During the year several premises were taken for the billeting of soldiers, and pickets were stationed at certain places in the Borough. At the request of the Military Authorities, these premises were all inspected periodically and a report on the conditions found sent to the War Department after such inspections. In all 2,027 inspections were made by the Sanitary Inspectors (42 in Clapham, 250 in Putney, 689 in Streatham, and 1,046 in Wandsworth). Refugees' Homes. Several premises were taken by various organisations for the housing of French and Belgian war refugees, and during the year 70 inspections were made of these premises. 15 of the inspections were in Clapham, 13 in Streatham, and 42 in Wandsworth. In all these cases the arrangements made for the housing of the refugees were quite satisfactory. Canal Boats Act. During the year 37 inspections of Canal Boats were made, but it was not necessary to serve any notices, as on inspection the conditions of all the boats was found to be satisfactory. Statement of Work done under the Rag Flock Act, 1911. 35 workshops were visited by the Inspector and the materials used for bedding and upholstery were examined. 20 examples were procured and submitted for analysis, and all of these were reported as complying with the standard of cleanliness required. 161 Report of the Medical Officer of Health. Statement of Work done under the Sale of Food and Drugs Acts. During the year 1,849 samples of foods and drugs were submitted to the Public Analyst for analysis, compared with 1,789 in 1914, 1,849 in 1913, and 1,500 in 1912. Of the 1,849 samples analysed 940 were purchased as test or informal samples, while 909 were purchased officially. Of the 909 official samples submitted for analysis 86 or 9 4 per cent. were reported to be adulterated or not up to standard, and of those samples which were purchased informally or as test samples 73, or 7.7 per cent. were found adulterated or not up to standard. The total adulterations reported were 159, or 8.6 per cent. of the samples submitted, compared with 10.2 per cent. in 1914, 11 per cent. in 1913, and 18.0 per cent. in 1912. The percentage of milk samples found to be adulterated was 7.8 compared with 7.6 in 1914, 9. in 1913, and 10.9 in1912. In 52 out of the 86 cases in which adulterations were detected in the official samples proceedings were instituted against the vendor, compared with 67 in 1914, 84 in 1913, and 86 in 1912. The total amount received in penalties under the above Acts during the year amounted to £108 15s. 0d., and the costs to £24 17s. od., making a total of £133 12s. 0d., compared with £130 is. 0d. in 1914 and £143 7s. 6d. in 1913. 162 Report of the Medical Officer of Health. TABLE LXXXIII, Case No. Article. Adulteration. Result. Fine. Costs. 16 Milk 7 .5 per cent. extraneous water Summons dismissed. - - 55 Butter 66 per cent. Margarine Warranty proved Convicted 40/- 16/- 81 „ 95 per cent. „ ,, 60/- 16/- 84 Milk 14 per cent, extraneous water ,, 20/- 14/6 110 ,, 5 per cent. „ ,, Warranty raised. Ordered to pay costs — 12/6 115 „ 5 per cent. „ ,, Warranty proved. Dismissed — — 29 „ 65 per cent. milk fat deficient Ordered to pay costs — 12/6 136 ,, 8 per cent. „ „ Warranty proved. Dismissed — — 148 Butter 80 per cent. Margarine Convicted 40/- 12/6 149 „ 80 per cent. „ ,, 40/- 12/6 196 Milk 31 per cent. milk fat deficient Convicted. Same defendant 200/- 10/6 197 Separated Milk 13 per cent. extraneous water 200/- 10/6 202 Milk 21 per cent. milk fat deficient Warranty proved. — — 207 ,, 7 per cent. „ „ Dismissed Ordered to pay costs — 15/- 209 ,, 13.5 per cent. extraneous water Convicted 40/- 20/6 210 ,, 15 per cent. „ „ „ 40/- 20/6 223 ,, 16 per cent. milk fat deficient Defendant absconded. — — 235 ,, 6 per cent. „ „ Warranty proved Dismissed. — — 250 ,, 6 per cent. extraneous water Warranty proved. Dismissed — — 254 ,, 8 per cent. milk fat deficient Warranty raised. Ordered to pay costs — 42/- 2 59 ,, 11 per cent. „ „ Same defendant as No. 223, who absconded — — 262 ,, 11 per cent. „ ,, 314 ,, 6 per cent. „ „ Warranty proved. Dismissed — - 346 ,, 6 per cent. ,, „ and 1 per cent. extraneous water Convicted 40/- 10/6 354 ,, 7 per cent. milk fat deficient Warranty proved. Dismissed — — 377 ,, 6 per cent. „ „ Warranty proved. Dismissed — — 431 ,, 2 per cent.extraneous water Same defendant. Presumption raised and upheld — — 432 ,, 6 per cent. milk fat deficient 434 ,, 3 per cent. extraneous water 442 ,, 4 per cent. milk fat deficient 443 ,, 3 per cent. „ „ 450 ,, 4 per cent. extraneous water Convicted 60/- 10/6 463 ,, 9 per cent. milk fat deficient ,, 40/- 10/6 466 ,, 6 per cent. „ „ Warranty proved. Dismissed — — 474 ,, 13.5 per cent. extraneous water Warranty proved. Dismissed - - 163 Report of the Medical Officer of Health. TABLE LXXXIII.—continued. Case No. Article. Adulteration. Result. Fine. Costs. 482 Butter 25 per cent. Margarine Convicted 60/- 10/6 486 ,, 40 per cent. „ ,, 60/- 14/- 550 Cream 0.11 per cent. Crystallised Boric Acid Warranty proved. Dismissed — — 570 Milk 22 per cent. milk fat deficient Convicted 40/- 12/6 685 ,, 6 5 per cent. extraneous water Roundsman convicted 100/- 10/6 705 ,, 3 per cent. „ „ Roundsman convicted. Same defendant 25 /- 10/6 706 ,, 4 per cent. ,, „ - 10/6 713 ,, 11 per cent. Convicted 10/- 10/6 810 Butter 60 per cent. Margarine ,, 30/- 2416 811 ,, 100 per cent. „ ,, 30/- — 812 ,, 65 per cent. „ ,, 200/- 42/- 813 ,, 100 per cent. „ ,, 200/- 42/- 828 Milk 11 per cent. extraneous water Warranty proved. Dismissed - - 872 Butter 45 per cent. Margarine Convicted 200/- — 873 ,, 100 per cent. „ ,, 200/- — 164 Report of the Medical Officer of Health. PROCEEDINGS UNDER THE MARGARINE ACT. TABLE LXXXIV. Case No. Description of Offence. Result. Fine. Costs. 55 Selling Margarine in an unstamped wrapper Ordered to pay costs — 2/- 56 Exposing Margarine for sale by retail without a proper label ,, ,, — 12/6 81 Selling Margarine in an unstamped wrapper " " — 2/- 148 „ ,, ,, ,, — 2/- 149 „ ,, ,, ,, — 2/- 148 Selling Margarine containing more than 10 per cent. of butter fat Withdrawn - - 149 „ ,, .,, — — 483 Exposing Margarine for sale without proper label Convicted 10/- 10/6 484 ,, ,, ,, 10/- 10/6 810 Selling Margarine in an unstamped wrapper ,, 30/- — 811 ,, ,, ,, 30/- — 812 ,, ,, Withdrawn — — 813 ,, ,, .. — — 872 ,, ,, ,, — — 873 ,, ,, ,, — — 165 Report of the Medical Officer of Health. OTHER OFFENCES. TABLE LXXXV. Nature of Offence. Result. Fine. Cost. Refusing Milk for analysis Convicted 60/— - Obstructing Inspector Convicted 60/- 21/- TABLE LXXXVI. Year. No. of Samples taken. No. Adulterated. Percentage Adulterated. 1905 853 65 7.6 1906 905 84 9.2 1907 989 84 8.4 1908 1,004 88 8.76 1909 1,030 71 6. 89 1910 1,060 96 9.05 1911 927 123 13.2 1912 1,500 271 18.0 1913 1,849 205 11.0 1914 1.789 182 10.2 Average 10 years 1905-1914 1,190 126 10.5 1915 1,849 159 8-6 Table LXXXVI. shows the number of samples taken, the number adulterated, and the percentage of adulterated samples for the 10 years 1905-1914, compared with the year 1915. 166 Report of the Medical Officer of Health. From this table it will be seen that the average percentage of adulterations detected for the 10 years 1905-1914 was 10.5 per cent. compared with 8.6 in 1915. The following table shows the number of formal and informal samples taken in each sub-district of the Borough, together with the number taken per 1,000 of population, the number adulterated, and the percentage adulterated to the formal and informal and to the total samples taken. It will be noted that of the formal samples 9.4 per cent. were adulterated, compared with 11.0 per cent. in 1914, while of the informal 77 per cent. were adulterated, compared with 9.2 per cent. in 1914, thus showing an improvement in the quality of the food submitted for analysis. TABLE LXXXVII. Formal Samples. Informal Samples. Total No. of samples taken. No. per 1,000 of Population. No. Adulterated. Percentage Adulterated. No. of samples taken. No. Adulterated. Percentage Adulterated. No of samples taken. No. Adulterated. Percentage Adulterated. Clapham 184 20 10.8 190 16 84 374 6.0 36 9.6 Putney 94 9 95 92 8 8.7 186 6.3 17 9.1 Streatham 189 18 9.5 280 20 7.1 469 4.4 38 8.1 Tooting 202 21 10.4 175 16 9.1 376 9.7 36 9.5 Wandsworth 241 18 7.4 203 13 6.4 444 4.4 32 7.2 Whole Borough 909 86 9'4 940 73 77 1,849 5'5 159 8.6 Table LXXXVIII. shows in detail the total number of samples analysed during the year; the number found adulterated or not up to standard, and the percentage of adulteration for the year as well as for the previous five years. 167 Report of the Medical Officer of Health. TABLE LXXXVIII. Articles analysed. No. of Samples. Percentage of Adulteration. Examined. Pound adulterated or not up to standard. 1910. 1911. 1912. 1913. 1914. Average for five years. 1915. Milk & Cream 949 83 7.44 11.10 13.63 11.55 7.8 10.3 8.7 Butter 635 65 723 16.40 25.4 12.67 16.1 15.5 10.2 Cheese 1 ... 80.7 ... ... ... ... 16.1 ... Margarine 11 ... ... 20.0 ... ... ... 4.0 ... Lard 24 ... ... ... ... ... ... ... ... Bread ... ... ... ... ... ... ... ... ... Flour 6 ... ... 50.0 ... ... ... 10.0 ... Tea ... ... ... ... ... ... ... ... ... Coffee 26 ... 9.0 10.0 ... ... 12.5 3.8 ... Cocoa 6 ... 8.3 ... ... ... ... 1.7 ... Sugar 24 ... ... 10.0 15.3 ... ... 5.0 ... Mustard ... ... ... ... 25.0 ... ... 5.0 ... Confectionery 4 ... ... ... ... ... 154 ... ... Pepper 14 ... ... ... ... ... ... ... ... Wine, Beer ... ... ... ... ... ... ... ... ... and Spirits Drugs* 66 5 ... 10.0 7.0 6.4 13.2 7.3 7.5 Other articles* 83 6 30.0 25.9 36.7 16.0 16.0 24.9 7.1 All Articles 1,849 159 9.05 I3.2 I 8.0 11.0 10.2 12.2 8.6 * Details of these will be found in the Report of the Public Analyst at the end of this Report. 168 Report of the Medical Officer of Health. Milk and Cream. MILK. 880 samples of milk were procured for analysis during the year. 69 or 7.8 per cent. were reported against as being adulterated or not up to legal standard. 872 samples were purchased officially, of which 68 or 7.8 per cent. were adulterated, and eight samples purchased informally, of which one or 12.5 per cent. was reported against. 38 samples were found to contain added water, 29 were deficient in milk fat, and two were deficient in milk fat and contained added water. Proceedings were taken in 37 cases, and in 32 cases the Public Health Committee, after considering the amount of adulteration and the circumstances of sale, decided not to prosecute the vendors, but to take further samples. 27 samples of milk were taken on delivery at various Public Institutions situated within the Borough. All these samples were reported to be genuine. 57 samples of milk were procured whilst in transit from the farmer to the retailer, the samples being taken as the milk arrived at various railway stations within the Borough, both at mid-night and mid-day deliveries. Seven samples were reported against five of these being from one farmer. Proceedings were instituted against the farmer in these cases, who at the hearing of the summons satisfied the magistrate that the milk had not been tampered with, and that he sold and delivered the milk in the same condition as it came from the cow. The summons was dismissed. 169 Report of the Medical Officer of Health. Four samples of milk were procured during the early mornirg (from 3 to 4 a.m.), from wholesale dealers whilst delivering milk to the retailer. Two of these samples were reported against. Proceedings were instituted and convictions obtained in each case. 19 samples of milk were procured on delivery at private houses, one of which was reported as being adulterated. The adulteration being small, no proceedings were taken, but the vendor was warned. TABLE LXXXIX. Premises. No. of Samples taken. No. Adulterated. Percentage Adulterated. Public Institutions 27 ... ... Railway Stations 57 7 12.3 Retailers' Premises 4 2 50.0 Private Houses 19 1 5.2 140 samples of milk have been taken on Sundays, either in the early morning or at mid-day. 14 or 10 per cent. were reported against as being adulterated, compared with 7.4 per cent. in 1914, I0.6 per cent. in 1913, and 10 per cent. in 1912. 384 samples of milk were taken from milk vendors in the street during the early morning (i.e., 5 to 7 a.m.), on week days, and of these 29 or 7.5 per cent. were reported against. Four samples of milk were taken from automatic milk supply machines and all were reported to be genuine. In 15 cases the defendants relied on a warranty, and in each case the Magistrate was satisfied that the milk sold was in the same condition as received, and therefore dismissed the summons. Proceedings were taken against a milk carrier for refusing milk for analysis and a penalty of 60s. was imposed. Proceedings were also taken against a milk vendor for wiliul obstruction, and a penalty of 60s. and 21s. costs was imposed. 170 Report of the Medical Officer of Health. The following Table shows the number of milk samples taken, the number found adulterated, and the percentage adulteration for the past 10 years, compared with the year 1915. TABLE XC. Year. No. of Samples taken. No. Adulterated. Percentage Adulterated. 1905 510 37 7.25. 1906 526 34 6.44 1907 501 55 10.97 1908 516 37 7.05 1909 545 40 7.16 1910 593 45 7.58 1911 602 67 11.11 1912 712 74 10.39 1913 798 76 9.5 1914 875 67 7.6 Average 10 years, 1905-1914 617 53 8.6 1915 880 69 7.8 CREAM AND PRESERVED CREAM. 36 samples of cream and 33 of preserved cream were taken during the year. Of the latter 33 samples, nine or 25 per cent. were reported against as containing a preservative. The following report on the administration in connection with the Public Health (Milk and Cream) Regulations, 1912, is prepared as requested by the Local Government Board. In three of the 33 cases the amount of boric acid stated on the label was exceeded, and all the samples contained over 35 per cent. of milk fat. I71 Report of the Medical Officer of Health. REPORT ON ADMINISTRATION IN CONNECTION WITH THE PUBLIC HEALTH (MILK AND CREAM) REGULATIONS, 1912. Report for the year ended 31 st December, 1915. 1. Milk and Cream not sold as "Preserved Cream." (a) Number of Samples examined for the presence of a preservative. (b) Number in which a preservative was reported to be present Milk 880 Nil. Cream 36 9 Nature of preservative in each case in column (b). CREAM. • Case No. 550 Cream 0.11 per cent. Crystallised Boric Acid. ,, 545 ,, 0.18 ,, ,, ,, ,, 547 ,, 0.18 „ ,, „ ,, 552 ,, 0.28 „ „ ,, „ 600 ,, 0.30 ,, ,, ,, „ 618 ,, O-45 ,, ,, ,, ,, 619 ,, 0.25 ,, ,, ,, ,, 640 ,, 0.60 „ „ , ,, 641 ,, 0.22 ,, ,, ,, Nature of preservative in each case in column (b). MILK. Nil. Action taken under the Regulations in regard to each case in Column (b). Nil. Vendors were warned. 172 Report of the Medical Officer of Health. (2). Cream sold as Preserved Cream. Instances in which samples have been submitted for analysis to ascertain if the stateme'nt on the label as to preservatives was correct:— (1). Correct statements made 30 (2). Statements incorrect 3 Total 33 (b) Determinations made of milk-fat in cream sold as Preserved Cream:— (1). Above 35 per cent. 33 (2). Below 35 per cent. 0 Total 33 (c) and (d). In each of the 33 samples procured as Preserved Cream the provisions as to labelling were duly observed. (3). Thickening Substances Nil. (4). Other Observations Nil. Butter and Margarine. BUTTER. 635 samples of butter were submitted for analysis during the year, of which 65 or 10.2 per cent. were reported against, compared with 16.1 per cent. in 1914, 12.67 in 1913 and 25.4 per cent. in 1912. Of the 635 samples of butter analysed, 29 samples were taken officially, 15 or 52 per cent. were reported against, whereas of those samples taken informally 50 or 8.2 per cent. were found to be adulterated. In 14 cases proceedings were instituted against the vendors of the adulterated samples. The penalties and costs amounted to £69 11s. 6d., compared with £57 14s. 6d. in 1914, and £50 8s. 0d. in 1913. 173 Report of the Medical Officer of Health. The following Table shows the number of butter samples taken, the number found adulterated, and the percentage of adulteration, together with the average adulteration for the years 1905-1914 compared with the year under review. TABLE XCI. Year. Number of samples taken. Number Adulterated. Percentage of Adulteration. 1905 223 20 8.96 1906 287 19 6.62 1907 334 13 3.89 1908 343 26 7.58 1909 299 16 5.35 1910 3.4 22 7.23 1911 189 31 16.4 1912 389 99 25.4 1913 584 74 12.67 1914 478 77 16.1 Average for 10 years 1905-1914 343 39 11.3 191 5 635 65 10.2 MARGARINE. 11 samples of margarine were submitted for analysis and all returned as genuine. There were two convictions under the Margarine Act, these being in connection with the Sale of Margarine as butter. 174 Report of the Medical Officer of Health. OTHER ARTICLES. A full list of the articles of food and drugs examined under the 'Sale of Food and Drugs Acts, together with the analytical results, is contained in the Report of the Public Analyst at the end of this Report. STAFF. As I was on service in the London District I was able to keep "to some extent in touch with the work. Dr. Oliver Field, who was appointed Deputy Medical Officer of Health, has continued to supervise tne work of the Department and has been of great service to the other officials in the Department. At the Tuberculosis Dispensary, in the absence of Dr. Caley, Dr. P. Nicol has carried out the work at both Dispensaries in a very thorough and satisfactory manner. The members of the staff mentioned in last year's Report are still serving in the forces, and in addition three members of the disinfecting staff are also serving, and the work is being carried on by temporary substitutes. With regard to the other members of the staff, I am pleased to report that they have carried out all their duties in a most thorough and conscientious manner. I have the honour to be, Mr. Mayor and Gentlemen, Your obedient Servant, P. CALDWELL SMITH. 175 ANNUAL STATEMENT Of the work done in the Borough of Wandsworth under the Sale of Food and Drugs Acts, summarised from the statutory quarterly reports. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Wandsworth. Sir and Gentlemen, I have the honour to present the Annual Statement of the work done during the year 1915 under the Sale of Food and Drugs Acts. The total number of samples submitted by the Inspector during the year amounted to 1,849. Of these, 909 were taken with the formalities required by the Sale of Food and Drugs Acts, whilst 940 were obtained informally. Number of samples submitted. The statement following gives the result of analyses of all articles submitted; while in Tables A and B will be found the details of the articles grouped together in the main statement under the headings "Drugs" and "Other Articles." 176 Report of the Medical Officer of Health. Main Statement showing the result of analyses of all Articles submitted under the Sale of Food and Drugs Acts during the year 1915- No of samples examined. No, of samples found adulterated or not up to standard. Formal Informal Total Formal Informal Total Milk and Cream 877 72 949 71 12 83 Butter 29 606 635 15 50 65 Cheese I — 1 0 — 0 Margarine I 10 11 0 0 0 Lard - 24 24 - 0 0 Flour - 3 3 - 0 0 Flour (self-raising) - 3 3 - 0 0 Coffee 1 25 26 0 0 0 Cocoa - 6 6 — 0 0 Sugar - 24 24 — 0 0 Confectionery and Jam - 4 4 - 1 0 Pepper - 14 14 - 0 0 Drugs - 66 66 — 5 5 Other Articles - 83 83 — 6 6 9O9 940 1849 86 73 159 177 Report of the Medical Officer of Health. Table A. Details of Drugs in foregoing Table. Drugs. No. of samples examined. No. of samples found adulterated or not up to standard. Formal. Informal. Total. Formal. Informal. Total. Cream of Tartar 0 2 2 0 0 0 Friar's Balsam 0 2 2 0 0 0 Glycerine 0 5 5 0 0 0 Mercury Preparations 0 2 2 0 1 1 Oil, Almond 0 4 4 0 0 0 „ Camphorated 0 3 3 0 0 0 „ Castor 0 3 3 0 o 0 „ Cod Liver 0 2 2 0 0 0 „ Eucalyptus 0 5 5 0 0 0 Ointment, Boric 0 3 3 0 1 1 Pills, Blaud's 0 2 2 o 0 0 „ Iron 0 2 2 0 0 0 „ Lead and Opium 0 1 I 0 0 0 Powder, Comp. Liq. 0 7 7 0 0 0 „ Rhubarb 0 2 2 0 0 0 Saffron 0 4 4 0 1 1 Spirit of Camphor 0 2 2 0 0 0 Sugar of Milk 0 2 2 0 0 0 Sulphate of Quinine 0 I I 0 0 0 Tincture of Iodine o 3 3 0 2 2 „ of Quinine, ammoniated 0 4 4 0 0 0 „ of Rhubarb 0 5 5 0 0 0 0 66 66 0 5 5 178 Report of the Medical Officer of Health. Table B. Details of "Other Articles." Other Articles. No. of samples examined. No. of samples found adulterated or not up to standard. Formal. Informal. Total. Formal. Informal. Total. Arrowroot 0 4 4 0 0 0 Cake 0 1 1 0 0 0 Cornflour 0 2 2 0 0 0 Fruits, Dried 0 24 24 0 0 0 in Syrup 0 6 6 0 0 0 Ginger 0 3 3 0 0 0 Oatmeal 0 2 2 0 0 0 Olive Oil 0 6 6 0 2 2 Pearl Barley 0 4 4 0 0 O Preserved Peas 0 1 1 0 1 1 „ Beans 0 1 1 0 1 0 Rice 0 5 5 0 0 0 Sago 0 4 4 0 0 0 Semolina 0 3 3 0 0 0 Tapioca 0 8 8 0 1 1 Vinegar 0 9 9 0 1 1 0 83 83 0 6 6 179 Report of the Medical Officer of Health. MILK AND CREAM. The number of samples grouped under this heading amounted to 949. Of these, 877 were taken with the necessary formalities required by the Acts, whilst 72 were submitted informally. The samples were comprised as follows :— No. of samples examined. No. of samples found adulterated or not up to standard. Formal. Informal. Total. Formal. Informal. Total. Milk 852 8 860 67 I 68 Separated Milk 20 0 20 1 0 I Cream, fresh 4 32 36 3 6 9 Cream, preserved 1 32 33 0 5 5 877 72 949 71 12 83 There were three forms of adulteration in the case of the milk samples reported against; namely, deficiency in milk fat, presence of extraneous water, and a combination of both these. Deficiency in milk fat occurred in 29 samples, and ranged from 2 per cent. to 63 per cent. Extraneous water, in quantities varying between 1 per cent. and 15 per cent., was found in 37 samples ; whilst extraneous water accompanied by a deficiency of milk fat occurred in two samples. The one sample of separated milk reported against contained 13 per cent. extraneous water. In no case was preservative found in milk. M 2 The nature and extent of the adulteration reported. 180 Report of the Medical Officer of Health. The average composition of the 792 samples of milk returned as genuine throughout the year was as under :— Total milk solids 12*30 per cent. Milk-fat 3.48 „ Solids-not-fat 8.82 „ Of the creams purchased as fresh, 9 were found to contain Crystallised Boric Acid in amounts varying from 5-6 grains per pound (0-08 per cent.) to 42 grains per pound (o-6o per cent.). Of the creams sold as " preserved," one sample was found to contain 51.8 grains of Crystallised Boric Acid per pound (0.74 per cent.), an excess of 16.8 grains (0.24 per cent.) over the amount declared on the label at the time of purchase, namely, 35 grains per pound (0.5 per cent.). In one other instance also the amount of boron preservative exceeded o-5 per cent., whilst in all other cases the quantity of Crystallised Boric Acid fell below this amount. BUTTER. 635 samples of Butter were submitted during the year, 29 being taken with the necessary formalities Extent and nature of the adulteration quired by the Acts, and 606 being submitted reported. . informally. The nature of the adulteration reported showed that in 9 instances Margarine was wholly substituted for Butter; in 39 cases mixtures of Butter and Margarine were sold ; whilst in 17 instances the Butter sold contained an excess of Boron preservative. All samples were examined for the presence of preservatives, The presence of with the result that out of the 570 samples rePreservatives. turned as genuine, 64 were found to contain no preservative other than salt. Retort of the Medical Officer of Health. 181 The average content of Boron preservative (in terms of Crystallised Boric Acid) contained in the 506 samples of Butter (reported as genuine) which contained this preservative amounted to 0-29 per cent., equivalent to 20.3 grains per lb. Butter. DRUGS. Of the 66 samples—all taken informally—submitted, 5 only were reported against, as under :— Nature of Sample. Nature of Report. Strong Tincture of Iodine 72.5 per cent, deficient in Iodine, and 67 per cent, deficient in Potassium Iodide. White Precipitate Ointment Made with a Paraffin basis instead of Bensolated Lard. Strong Tincture of Iodine 76 per cent, deficient in Iodine, and 58 per cent, deficient in Potassum Iodide. Boracic Ointment 20 per cent. deficient in Boric Acid. Saffron 15 per cent. Potassium Nitrate. OTHER ARTICLES. Under this head 83 samples—all taken informally—were submitted, and the following 6 were reported against:— Nature of Sample. Nature of Report. Tinned Beans (French) 0.35 grains Copper per lb. Tinned Peas 0.47 grains Copper per lb. Tapioca 100 per cent. Sago. Olive Oil 100 per cent. Arachis Oil. Olive Oil 20 per cent. Arachis Oil. Vinegar 17 per cent. deficient in Acetic Acid 182 Report of the Medical Officer of Health. In conclusion, I have to report that the adulteration for the year for all articles submitted amounted to 8-6 per cent. ; for articles submitted formally to 9.4 per cent.; and for articles submitted informally to 7.7 per cent. I have the honour to be, Mr. Mayor and Gentlemen, Your obedient Servant, A. H. M. MUTER, f.i.c., f c.s. South London Central Public Laboratory, 325, Kennington Road, S.E. 18th February, 1916. APPENDIX. PARTICULARS OF DEATHS IN EACH OF THE SUB-DISTRICTS DURING THE YEAR 1915. 184 Report of the Medical Officer of Health. Borough of Wandsworth—Clapham Sub-District. Infant Mortality. 1915. Nett Deaths from stated causes at various Ages under l Year of Age. Causes of Death. Under 1 Week. 1—a Weeks. 2—3 Weeks. 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 la Months Total Deaths under 1 Year. All causes Certified 24 13 3 5 45 12 14 20 15 106 Uncertified 2 ... ... ... 2 ... ... ... ... 2 Small-pox ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... 1 ... 3 ... 4 Scarlet Fever ... ... ... ... ... ... ... ... ... ... Whooping-cough ... ... ... ... ... 2 1 1 1 5 Diphtheria and Croup ... ... ... ... ... ... 1 1 ... 2 Erysipelas ... ... ... ... ... ... ... ... ... ... Tuberculous Meningitis ... ... ... ... ... ... ... ... 1 1 Abdominal Tuberculosis ... ... ... ... ... ... ... ... ... ... Other Tuberculous Diseases ... ... ... ... ... ... ... 2 ... 2 Meningitis (not Tuberculous) ... ... ... ... ... ... ... ... 2 2 Convulsions 1 4 ... 1 6 ... 1 ... ... 7 Laryngitis ... ... ... ... ... ... ... ... ... ... Bronchitis ... 2 ... ... 2 2 ... 1 ... 5 Pneumonia (all forms) ... ... ... ... ... 1 1 1 5 8 Diarrhœa ... ... ... 1 1 ... 2 4 3 10 Enteritis ... ... ... ... ... 1 4 3 1 9 Gastritis ... ... ... ... ... ... ... ... ... ... Syphilis 1 ... ... ... 1 ... ... ... 1 2 Rickets ... ... ... ... ... ... ... ... 1 1 Suffocation, overlying 1 ... ... ... 1 ... ... ... ... 1 Injury at birth 2 ... ... ... 2 ... ... ... ... 2 Atelectasis 1 ... ... ... 1 ... ... ... ... 1 Congenital Malformations 2 1 1 ... 4 ... 1 ... ... 5 Premature birth 14 3 ... 2 19 ... ... ... ... 19 Atrophy. Debility and Marasmus 4 2 1 1 8 3 1 2 ... 14 Other causes ... 1 1 ... 2 2 2 2 ... 8 Totals 26 13 3 5 47 12 14 20 15 108 Nett Births in the year—legitimate, 1,129 ; illegitimate, 41. Nett Deaths in the year of—legitimate infants, 104 ; illegitimate infants, 4. Report of the Medical Officer of Health. 185 Borough of Wandsworth—Putney Sub-District. Infant Mortality. 1915. Nett Deaths from stated causes at various Ages under 1 Year of Age. Causes of Death. Under 1 Week. 1—2 Weeks. Weeles. Weeks. Total under 4 Weeks. 4 Weeks and under3 Months. 3 Months and under 6 Months 6 Months and under 9 Months. 9 Months and under 12 Months Total Deaths under 1 Year. All causes Certified 7 i 2 2 12 7 6 6 6 37 Uncertified ... ... ... ... ... ... ... ... ... ... Small-pox ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... 1 1 2 Scarlet Fever ... ... ... ... ... ... ... ... ... ... Whooping-cough ... ... ... ... ... 2 ... ... ... 2 Diphtheria and Croup ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... Tuberculous Meningitis ... ... ... ... ... ... ... ... 1 1 Abdominal Tuberculosis ... ... ... ... ... ... ... ... ... ... Other Tuberculous Diseases ... ... ... ... ... ... ... ... ... ... Meningitis (not Tuberculous) ... 1 ... ... 1 ... ... ... ... 1 Convulsions 1 ... ... ... 1 ... ... ... 1 2 Laryngitis ... ... ... ... ... ... ... ... ... ... Bronchitis ... ... ... ... ... ... ... 1 2 3 Pneumonia (all forms) ... ... 1 ... 1 ... 2 1 ... 4 Diarrhoea ... ... ... ... ... 2 1 1 ... 4 Enteritis ... ... ... ... ... 1 1 1 ... 3 Gastritis ... ... ... ... ... ... ... ... ... ... Syphilis ... ... 1 ... 1 ... ... ... ... 1 Rickets ... ... ... ... ... ... ... 1 ... 1 Suffocation, overlying ... ... ... ... ... ... ... ... ... ... Injury at birth 1 ... ... ... 1 ... ... ... ... 1 Atelectasis ... ... ... ... ... ... ... ... ... ... Congenital Malformations 1 ... ... ... 1 ... ... ... 1 2 Premature Birth 4 ... ... ... 4 1 1 ... ... 6 Atrophy. Debility and Marasmus ... ... ... 2 2 1 1 ... ... 4 Other causes ... ... ... ... ... ... ... ... ... ... Totals 7 i 2 2 12 7 6 6 6 37 Nett Births in the year—legitimate, 454 : illegitimate, 20 "Nett Deaths in the year of—legitimate infants, 32 ; illegitimate infants, 5 186 Report of the Medical Officer of Health. Borough of Wandsworth—Streatham Sub-District. Infant Mortality. 1915. Nett Deaths from stated causes at various Ages under 1 Year of Age- Cause of Death. Under 1 Week. 1-2 Weeks. 2-3 Weells. 3-4 Weeks. Total under 4 weeks. 4 Weeks and under 3 Months. 3 Months and under 6 Months. 6 Months and underg Months 9 Months and under 12 Months Total Deaths under 1'Year. All causes Certified 31 8 9 6 54 17 32 25 18 146 Uncertified ... ... ... ... ... 1 ... ... ... 1 Small-pox ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... 4 3 ... Scarlet Fever ... ... ... ... ... ... ... ... ... ... Whooping-cough ... ... ... ... ... 3 1 2 1 7 Diphtheria and Croup ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... Tuberculous Meningitis ... ... ... ... ... ... 1 ... ... 1 Abdominal Tuberculosis ... ... ... ... ... ... ... ... ... ... Other Tuberculous Diseases ... ... ... ... ... ... ... ... 1 1 Meningitis (not Tuberculous) 1 ... ... ... 1 ... 1 1 ... 3 Convulsions 2 ... ... 1 3 1 2 1 ... 7 Laryngitis ... ... ... ... ... ... ... ... ... ... Bronchitis ... ... ... 1 1 ... 4 1 ... 6 Pneumonia (all forms) ... ... 1 ... 1 1 7 5 7 21 Diarrhœa ... ... ... ... ... 2 2 2 2 8 Enteritis ... ... 1 ... 1 2 4 4 2 13 Gastritis ... ... ... ... ... ... ... ... ... ... Syphilis ... ... ... ... ... ... 1 ... ... 1 Rickets ... ... ... ... ... ... ... ... ... ... Suffocation, overlying 2 ... ... ... 2 ... ... ... ... 2 Injury at birth 3 1 ... ... 4 ... ... ... ... 4 Atelectasis ... ... ... ... ... ... ... ... ... ... ... Congenital Malformations 4 ... 1 ... 5 ... 1 1 ... 7 Premature birth 12 4 5 2 23 2 ... ... ... 25 Atrophy, Debility and Marasmus 6 2 1 1 10 5 5 2 1 23 Other causes 1 1 ... 1 3 2 3 2 1 11 Totals 31 8 9 6 54 18 32 25 18 147 Nett Births in the year—legitimate, 1,682 ; illegitimate, 229. Nett Deaths in the year of—legitimate infants, 131 ; illegitimate infants, 16. Report of the Medical Officer of Health. 187 Borough of Wandsworth—Tooting Sub-District. Infant Mortality. 1915. Nett Deaths from stated causes at various Ages under 1 Year of Age. Causes of Death. Under 1 Week. 1—2 Weeks. 2-3 Weeks. Weeks. Total under 4 weeks. 4 Weeks and under3 Months. 3 Months and under 6 Months 6 Months and under 9 Months- 9 Months and under 12 Months 1 Total Deaths j under 1 Year.[//### All causes Certified 21 4 3 3 31 15 13 17 17 93 Uncertified ... ... ... ... ... ... ... ... ... ... Small-pox ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... 2 2 Scarlet Fever ... ... ... ... ... ... ... ... ... ... Whooping-cough ... ... ... ... ... 2 ... 1 2 5 Diphtheria and Croup ... ... ... ... ... ... ... ... 2 2 Erysipelas ... ... ... ... ... ... ... ... ... ... Tuberculous Meningitis ... ... ... ... ... ... 1 1 2 Abdominal Tuberculosis ... ... ... ... ... ... ... ... ... ... Other Tuberculous Diseases ... ... ... ... ... ... ... ... 2 2 Meningitis (not Tuberculous) ... ... ... ... ... 2 ... 1 ... 3 Convulsions 1 ... 1 ... 2 ... ... ... ... 2 Laryngitis ... ... ... ... ... ... ... ... ... ... Bronchitis ... ... 2 ... 2 1 2 2 1 8 Pneumonia (all forms) ... 2 ... ... 2 1 1 4 1 9 Diarrhœa ... ... ... ... ... 2 4 4 2 12 Enteritis 1 ... ... ... 1 ... 3 ... 2 6 Gastritis ... ... ... ... ... ... ... ... ... ... Syphilis ... ... ... ... ... ... ... ... ... ... Rickets ... ... ... ... ... ... ... ... ... Suffocation, overlying ... ... ... ... ... ... ... ... ... ... Injury at birth 2 ... ... ... 2 ... ... ... ... 2 Atelectasis 1 ... ... ... 1 ... ... ... ... 1 Congenital Malformations 5 ... ... ... 5 ... ... ... ... 5 Premature birth 7 ... ... 1 8 1 ... ... ... 9 Atrophy, Debility and Marasmus 2 2 ... 2 6 2 2 2 1 15 Other causes 2 ... ... ... 2 4 ... 2 2 10 Totals 21 4 3 3 31 15 13 17 17 93 Nett Births in the year—legitimate, 839 ; illegitimate, 49. Nett Deaths in the year of—legitimate infants, 81 ; illegitimate infants, 12. 188 Report of the Medical Officer of Health. Borough of Wandsworth—Southfield Sub-District. Infant Mortality. 1915. Nett Deaths from stated causes at various Ages under 1 Year of Age. Causes 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 under6 Months. 6 Months and under 9 Months 9 Months and under 12 Months Total Deaths under 1 Year. All causes Certified 27 i 3 5 36 17 18 21 20 112 Uncertified 1 ... ... ... 1 ... ... ... ... 1 Small-pox ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... 1 2 2 5 Scarlet Fever ... ... ... ... ... ... ... ... 1 1 Whooping-cough ... ... ... ... ... ... 1 1 2 4 Diphtheria and Croup ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... Tuberculous Meningitis ... ... ... ... ... ... 1 ... ... 1 Abdominal Tuberculosis ... ... ... ... ... ... ... ... ... ... Other Tuberculous Diseases ... ... ... ... ... ... ... ... ... ... Meningitis (not Tuberculous) ... ... ... ... ... ... ... ... ... ... Convulsions ... ... ... ... ... ... 1 2 1 4 Laryngitis ... ... ... ... ... ... ... ... ... ... Bronchitis ... ... ... ... ... 2 3 2 ... 7 Pneumonia (all forms) ... ... ... 1 1 2 3 4 6 16 Diarrhœa ... ... ... ... ... 1 2 4 4 11 Enteritis ... ... ... ... ... 3 3 1 1 8 Gastritis ... ... 1 1 2 1 ... ... ... 3 Syphilis ... ... ... ... ... 1 ... ... ... 1 Rickets ... ... ... ... ... ... ... ... ... ... Suffocation, overlying 1 ... ... ... 1 ... ... ... ... 1 Injury at birth 5 ... ... ... 5 ... ... ... ... 5 Atelectasis 4 ... ... ... 4 ... ... ... ... 4 Congenital Malformations 4 ... ... ... 4 1 ... ... ... 5 Premature birth 11 1 2 2 16 2 ... ... ... 18 Atrophy, Debility and Marasmus 1 ... ... 1 2 4 2 4 1 13 Other causes 2 ... ... ... 2 ... 1 1 2 6 Totals 28 1 3 5 37 17 18 21 20 3 Nett Births in the year—legitimate, 1,041 ; illegitimate, 35. Nett Deaths in the year of—legitimate infants, 100 ; illegitimate infants, 13. Report of the Medical Officer of Health. 189 Borough of Wandsworth—Springfield Sub-District Infant Mortality. 1915. Nett Deaths from stated causes at various Ages under 1 Year of Age. Causes 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 Deaths under 1 Year. All causes Certified 15 3 2 5 25 14 13 17 23 92 Uncertified ... ... ... ... ... ... ... ... ... ... Small-pox ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... 1 ... 2 ... 10 Scarlet Fever ... ... ... ... ... ... ... ... ... ... Whooping-cough ... ... ... ... ... 1 2 1 1 5 Diphtheria and Croup ... ... ... ... ... 1 ... ... ... 1 Erysipelas ... ... ... ... ... ... ... ... ... ... Tuberculous Meningitis ... ... ... ... ... ... ... 1 1 2 Abdominal Tuberculosis ... ... ... ... ... ... ... ... 1 1 Other Tuberculous Diseases ... ... ... ... ... ... ... ... 1 1 Meningitis (not Tuberculous) ... ... ... ... ... ... ... ... ... ... Convulsions 1 ... ... ... 1 ... ... 1 1 3 Laryngitis ... ... ... ... ... ... ... ... ... ... Bronchitis ... 1 ... ... 1 ... 1 3 2 7 Pneumonia (all forms) ... ... ... ... ... 2 3 2 4 11 Diarrhœa ... ... ... ... ... 2 3 2 2 9 Enteritis ... ... ... ... ... 3 ... ... 2 5 Gastritis ... ... ... ... ... ... ... ... ... ... Syphilis ... ... ... ... ... ... ... ... ... ... Rickets ... ... ... ... ... ... ... ... ... ... Suffocation, overlying ... ... ... ... ... ... ... ... ... ... Injury at birth 1 ... ... ... 1 ... ... ... ... 1 Atelectasis 1 ... ... ... 1 ... ... ... ... 1 Congenital Malformations 4 ... ... 1 5 ... 1 ... ... 7 Premature birth 7 1 1 3 12 1 ... ... ... 13 Atrophy,Debility and Marasmus 1 1 1 1 4 1 2 1 1 ... Other causes ... ... ... ... ... 2 1 3 ... 6 Totals 15 3 2 5 25 14 13 17 23 92 Nett Births in the year—legitimate, 842 ; illegitimate. 22. Nett Deaths in the year of—legitimate infants, 83 ; illegitimate infants, 9. 190 190 Report of the Medical Officer of Health. CLAPHAM, 19x5- Causes of Death. Deaths in or belonging to Whole District at subjoined ages. Deaths in Public Institutions in the Distric All Ages. Males. Females. Under 1 year. 1 and under 2. 2 and under 5. 5 and under 15. 15 and under 25. 25 and under 45. 45 and under 65. 65 and upwards. Enteric Fever ... ... ... ... ... ... ... ... ... ... ... ... Small-pox ... ... ... ... ... ... ... ... ... ... ... ... Measles 20 14 6 4 10 4 2 ... ... ... ... 1 Scarlet Fever 3 2 1 ... ... 2 1 ... ... ... ... ... Whooping Cough 10 3 7 5 3 2 ... ... ... ... ... ... Diphtheria & Membranous Croup 8 2 6 2 ... 2 4 ... ... ... ... ... Influenza ... 15 9 6 ... 1 ... ... ... ... 5 9 3 Erysipelas 1 ... 1 ... ... ... 1 ... ... ... ... ... Cerebro-spinal Fever 4 2 2 3 ... ... ... ... 1 ... ... ... Other Epidemic Diseases 1 1 ... ... ... ... ... ... 1 ... ... ... Pulmonary Tuberculosis 61 35 26 ... ... ... ... 13 27 14 7 18 Tuberculous Meningitis 8 2 6 1 1 t 4 1 ... ... ... ... Abdominal Tuberculosis 2 1 1 ... ... ... ... ... 1 ... 1 ... Other Tuberculous Diseases 7 5 2 2 1 ... 1 1 2 ... ... ... Other Infective Diseases 4 1 3 2 ... ... ... ... 1 ... 1 ... Cancer, Malignant Disease 69 27 42 ... ... ... ... ... 1 32 36 40 Rheumatic Fever 4 1 3 ... ... ... 1 2 1 ... ... 1 Diabetes 6 3 3 ... ... ... ... ... 2 2 2 1 Other General Diseases 14 6 8 1 ... ... 1 ... ... 5 7 1 Alcoholism 1 1 ... ... ... ... ... ... ... 1 ... ... Chronic Poisonings ... ... ... ... ... ... ... ... ... ... ... ... Meningitis 4 1 3 2 1 1 ... ... ... ... ... ... Cerebral Haemorrhage, Apoplexy 42 15 27 ... ... ... ... ... 1 14 27 3 Convulsions 8 2 6 7 ... 1 ... ... ... ... ... 2 Other Diseases of Nervous System 31 10 12 ... ... ... ... 1 5 11 14 3 Organic Diseases of Heart 70 28 42 ... ... ... 3 2 8 23 29 0 Other Diseases of Circulatory System 25 10 15 ... ... ... 1 2 3 8 11 1 Bronchitis 80 34 46 5 2 5 ... ... 8 23 37 8 Broncho-Pneumonia 31 20 11 6 4 5 2 ... 1 4 9 ... Lobar Pneumonia 10 6 4 1 ... 1 ... ... 4 2 2 ... Pneumonia (type not guished) 15 6 9 1 ... ... 1 1 3 5 4 2 Other Diseases of Respiratory System 5 3 2 ... ... ... 1 ... 1 2 1 ... Ulcer of Stomach 6 5 1 ... ... ... ... ... 2 4 ... ... Diarrhœa 12 8 4 10 2 ... ... ... ... ... ... ... Enteritis 12 7 5 9 1 ... ... ... ... 1 1 ... Appendicitis and Typhlitis 2 1 1 ... ... ... ... ... 1 1 ... ... Obstruction of Intestines 3 3 ... 1 ... ... ... ... ... 1 1 ... Cirrhosis of Liver 9 6 3 ... ... ... ... ... ... 6 3 ... Other Diseases of Liver 1 ... 1 ... ... ... ... ... 1 ... ... ... Other Diseases of Digestive System 7 2 5 3 ... ... 1 ... ... 2 1 2 Nephritis and Bright's Disease 14 6 8 ... ... ... ... ... 2 7 5 3 Other Diseases of Urinary System 4 2 2 ... ... ... ... ... 1 1 2 1 Diseases of Generative System ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Fever 1 ... 1 ... ... ... ... ... 1 ... ... ... Other Accidents and Diseases of Pregnancy and Childbirth ... ... ... ... ... ... ... ... ... ... ... ... Premature Birth 19 10 9 19 ... ... ... ... ... ... ... ... Congenital Debility and Malformation 19 10 9 19 ... ... ... ... ... ... ... 1 Other Diseases of Early Infancy 3 2 1 3 ... ... ... ... ... ... ... ... Old Age 81 32 49 ... ... ... ... ... ... 1 80 3 Deaths from Accident 14 7 7 1 ... ... 3 ... 1 4 5 4 Deaths from Suicide ... ... ... ... ... ... ... ... ... ... ... 2 Other Violent Deaths ... ... ... ... ... ... ... ... ... ... ... ... Other defined Diseases 3 1 2 1 ... ... 1 ... ... ... 1 ... Ill-defined Diseases or unknown ... ... ... ... ... ... ... ... ... ... ... ... All causes 769 361 408 108 26 24 28 23 80 134 296 108 igi Report of the Medical Officer of Health. 191 PUTNEY, ! 1915- Causes of Death. Deaths in or belonging to Whole District at subjoined ages. s in Public Institutions in the District. All Ages. | Males. Females. Under 1 year. 1 and under 2. 2 and under 5. 5 and under 15. 15 and under 25. 25 and under 45. 45 and under 65. 65 and upwards. Enteric Fever ... ... ... ... ... ... ... ... ... ... ... ... Small-pox ... ... ... ... ... ... ... ... ... ... ... ... Measles 8 7 1 2 5 1 ... ... ... ... ... ... Scarlet Fever 1 1 ... ... ... ... ... 1 ... ... ... ... Whooping Cough 6 3 3 2 4 ... ... ... ... ... ... ... Diphtheria & Membranous Croup 4 1 3 ... ... 3 ... 1 ... ... ... ... Influenza 8 5 3 ... 1 ... ... ... ... 1 6 ... Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... Cerebro-spinal Fever ... ... ... ... ... ... ... ... ... ... ... 1 Other Epidemic Diseases ... ... ... ... ... ... ... ... ... ... ... ... Pulmonary Tuberculosis 32 20 12 ... ... 1 2 8 14 6 1 1 Tuberculous Meningitis 8 4 4 1 1 3 1 ... 1 ... 1 2 Abdominal Tuberculosis ... ... ... ... ... ... ... ... ... ... ... 1 Other Tuberculous Diseases 2 ... 2 ... ... ... 1 ... 1 ... ... ... Other Infective Diseases 4 3 1 1 ... ... ... ... 1 2 ... 1 Cancer, Malignant Disease 47 20 27 ... ... ... ... ... 7 24 16 6 Rheumatic Fever 2 ... 2 ... ... ... ... 1 1 ... ... ... Diabetes 9 5 4 ... ... ... ... 1 1 3 4 1 Other General Diseases 5 2 3 1 ... ... ... ... 1 1 2 1 Alcoholism 1 1 ... ... ... ... ... ... ... ... 1 1 Chronic Poisonings ... ... ... ... ... ... ... ... ... ... ... ... Meningitis 1 1 ... 1 ... ... ... ... ... ... ... ... Cerebral Hæmorrhage, Apoplexy 9 3 6 ... ... ... ... 1 ... 2 6 2 Convulsions 3 2 1 2 1 ... ... ... ... ... ... ... Other Diseases of Nervous System 11 7 4 ... ... ... ... ... 3 4 4 2 Organic Diseases of the Heart 24 lO 8 ... ... ... ... ... 2 10 12 2 Other Diseases of Circulatory System 12 7 5 ... ... ... ... ... 1 7 4 6 Bronchitis 28 14 14 3 1 ... 1 ... ... 8 15 1 B roncho - Pneumonia 23 12 11 4 5 ... ... ... 2 2 10 2 Lobar Pneumonia 7 3 4 ... ... ... ... 2 3 1 1 ... Pneumonia (type not distinguished) 13 5 8 ... 1 ... 1 ... 1 3 7 1 Other Diseases of Respiratory Systemv 1 ... 1 ... ... ... ... ... ... ... ... ... Ulcer of Stomach 1 1 ... ... ... ... ... ... ... 1 ... ... Diarrhœa 7 3 4 4 3 ... ... ... ... ... ... 1 Enteritis 3 3 ... 3 ... ... ... ... ... ... ... ... Appendicitis and Typhlitis 3 2 1 ... ... ... ... 2 1 ... ... 4 Obstruction of Intestines 3 ... 3 ... ... ... ... ... ... ... 3 2 Cirrhosis of Liver 4 3 1 ... ... ... ... ... ... 3 1 ... Other Diseases of Liver 2 1 1 ... ... ... ... ... ... ... 2 ... Other Diseases of Digestive System 4 3 1 ... ... ... ... 1 1 2 ... 1 Nephritis and Bright's Disease 19 11 8 ... ... ... ... 1 2 8 8 1 Other Diseases of Urinary System 2 1 1 ... ... ... ... ... ... 1 1 1 Diseases of Generative System ... ... ... ... ... ... ... ... ... ... ... 2 Puerperal Fever ... ... ... ... ... ... ... ... ... ... ... 1 Other Accidents and Diseases of Pregnancy and Childbirth 3 ... 3 ... ... ... ... ... 3 ... ... 1 Premature Birth 6 2 4 6 ... ... ... ... ... ... ... 1 Congenital Debility and Malformation 6 2 4 6 ... ... ... ... ... ... ... ... Other Diseases of Early Infancy 1 1 ... 1 ... ... ... ... ... ... ... ... Old Age 19 7 12 ... ... ... ... ... ... ... 19 ... Deaths from Accident 10 8 2 ... ... 1 ... 1 3 ... 5 11 Deaths from Suicide 2 ... 2 ... ... ... ... ... 2 ... ... 3 Other Violent Deaths 2 2 ... ... ... ... ... 1 1 ... ... ... Other Defined Diseases 1 1 ... ... ... ... ... ... ... 1 ... ... Ill-defined Diseases or unknown 1 1 ... ... ... ... ... ... ... ... 1 1 All causes 368 194 174 37 22 9 6 21 52 90 131 61 192 Report of the Medical Officer 0/ Health. STREATHAM, 1915. Causes of Death. Deaths in or belonging to Whole District at subjoined ages. Deaths in Public Institutions in the District. All Ages. Males. Females. Under i year. 1 and under 2. 2 and under 5. 5 and under 15. 15 and under 25. 25 and under 45. 45 and under 65. 65 and upwards. Enteric Fever 2 2 ... ... ... ... ... ... 1 1 ... ... Small-pox ... ... ... ... ... ... ... ... ... ... ... ... Measles 21 16 5 7 7 5 2 ... ... ... ... ... Scarlet Fever 8 6 2 ... ... 1 3 ... 1 ... ... ... Whooping Cough 12 7 5 7 3 1 1 ... ... ... ... ... Diphtheria & MembranousCroup 9 5 4 ... 1 2 6 ... ... ... ... ... Influenza 32 10 16 2 2 1 ... ... 8 5 14 1 Erysipelas 2 2 ... ... ... ... ... ... 1 1 ... ... Cerebro-spinal Fever 4 3 1 ... 1 ... ... ... ... 1 ... ... Other Epidemic Diseases 1 ... 1 ... ... ... ... ... ... ... 1 ... Pulmonary Tuberculosis 88 45 43 ... ... ... 2 ... 48 22 3 4 Tuberculous Meningitis 11 5 6 1 4 2 2 ... 1 ... ... ... Abdominal Tuberculosis 6 2 4 ... 1 ... 2 ... 2 1 ... 1 Other Tuberculous Diseases 9 6 3 1 ... ... 1 1 3 2 1 ... Other Infective Diseases 6 5 1 1 1 ... 1 ... 2 ... 1 ... Cancer, Malignant Disease 149 51 98 ... ... 1 ... ... 10 77 61 9 Rheumatic Fever 3 1 2 ... ... ... ... ... ... 1 1 ... Diabetes 14 10 4 ... ... ... 1 ... 3 4 6 ... Other General Diseases 17 8 9 ... ... ... ... ... ... 1 5 1 Alcoholism 3 2 1 ... ... ... ... ... 1 2 ... ... Chronic Poisonings ... ... ... ... ... ... ... ... ... ... ... ... Meningitis 7 4 3 3 ... 1 1 1 1 ... ... 2 Cerebral Haemorrhage,Apoplexy 60 27 33 ... ... ... 1 ... ... 22 37 2 Convulsions Other Diseases of Nervous 8 4 4 7 ... 1 ... ... ... ... ... ... System 44 24 20 3 ... 2 ... 3 15 12 9 1 Organic Diseases of Heart 137 72 65 1 ... ... 1 2 14 51 68 4 Other Diseases of Circulatory System ... 19 21 ... ... 1 ... ... 2 10 27 1 Bronchitis 1 53 59 6 3 2 ... ... 4 24 73 2 Broncho-Pneumonia ... 15 15 13 3 2 1 ... ... 3 8 1 Lobar Pneumonia ... 9 14 2 ... ... 1 1 2 8 9 1 Pneumonia (type not distinguished) ... 23 15 6 1 2 2 1 5 14 7 ... Other Diseases of Respiratory System ... 9 13 1 ... 1 ... 1 5 5 9 1 Ulcer of Stomach ... 1 2 ... ... ... ... ... 5 ... ... ... Diarrhœa 10 8 2 8 1 1 ... ... ... ... ... ... Enteritis 15 7 8 13 1 ... ... ... ... 1 ... 1 Appendicitis and Typhlitis 10 5 5 ... ... 2 1 1 4 ... 2 3 Obstruction of Intestines 7 3 4 ... 1 ... ... ... 4 ... 2 2 Cirrhosis of Liver 8 5 3 ... ... ... ... ... 2 4 2 ... Other Diseases of Liver 4 3 1 1 ... ... ... ... ... 2 1 ... Other Diseases of Digestive System 18 10 8 2 ... ... ... 1 5 5 5 ... Nephritis and Bright's Disease 38 18 20 ... ... 1 ... ... 2 18 17 2 Other Diseases ot Urinary System 11 10 1 ... ... ... ... ... 2 1 8 1 Diseases o f Generative System 5 ... 5 ... ... ... ... ... ... 5 ... ... Puerperal Fever ... ... ... ... ... ... ... ... ... ... ... ... Other Accidents and Diseases of Pregnancy and Childbirth 4 ... 4 ... ... ... ... ... 4 ... ... ... Premature Birth 25 20 5 25 ... ... ... ... ... ... ... ... Congenital Debility and Malformation 31 15 16 30 1 ... ... ... ... ... ... ... Other Diseases of Early Infancy 4 2 2 4 ... ... ... ... ... ... ... ... Old Age 97 29 68 ... ... ... ... ... ... ... 97 3 Deaths from Accident 22 12 10 ... ... ... 4 ... 2 5 9 4 Deaths from Suicide 10 5 5 ... ... ... ... ... 2 8 ... 2 Other Violent Deaths 5 5 ... ... ... ... ... 2 2 ... 1 3 Other defined Diseases 10 5 5 1 ... ... ... 1 1 3 4 ... Ill-defined Diseases or unknown 5 1 4 ... ... 1 ... ... 1 3 ... ... All causes 1,260 615 645 147 31 30 33 36 163 33 488 51 193 Report of the Medical Officer of Health. TOOTING. 1915. Causes of Death. Deaths in or belonging to Whole District at subjoined ages. Deaths in Public Institutions in the District. All Ages. Males. Females. Under i year. 1 and under 2. 2 and under 5. 5 and under 15. 15 and under 25. 25 and under 45. 45 and under 65. 65 and upwards. Enteric Fever 2 1 1 ... ... ... ... 2 ... ... ... 9 Small-pox ... ... ... ... ... ... ... ... ... ... ... ... Measles 24 13 11 2 10 6 6 ... ... ... ... 32 Scarlet Fever 2 1 1 ... ... ... ... 1 ... ... ... 38 Whooping Cough 10 3 7 5 2 3 3 ... ... ... ... 1 Diphtheria &M embranous Croup 12 6 6 2 ... 6 ... ... 1 ... ... 77 Influenza 3 1 2 ... ... ... ... 1 ... ... 2 1 Erysipelas 2 ... 2 ... ... ... 1 1 ... ... 1 ... Cerebro-spinal Fever 2 ... 2 1 ... ... ... ... ... ... ... 14 Other Epidemic Diseases ... ... ... ... ... ... ... ... ... ... ... ... Pulmonary Tuberculosis 48 22 26 1 ... ... 6 8 57 12 ... 25 Tuberculous Meningitis 11 8 3 2 1 1 1 1 ... ... ... 4 Abdominal Tuberculosis 2 2 ... ... ... ... ... ... 1 ... ... ... Other Tuberculous Diseases 2 1 1 1 1 ... ... ... ... ... ... 5 Other Infective Diseases 1 1 ... ... ... ... ... ... ... ... 1 ... Cancer, Malignant Disease 36 14 22 ... ... ... ... 1 8 17 10 6 Rheumatic Fever 1 ... 1 ... ... ... ... ... 1 ... ... ... Diabetes 3 2 1 ... ... ... ... 1 ... 1 1 ... Other General Diseases 5 3 2 ... ... ... ... ... 1 3 1 3 Alcoholism ... ... ... ... ... ... ... ... ... ... ... ... Chronic Poisonings ... ... ... ... ... ... ... ... ... ... ... ... Meningitis 6 3 3 3 ... ... 3 ... ... ... ... 2 Cerebral Hæmorrhage, Apoplexy 16 7 9 ... ... ... ... ... 1 2 13 10 Convulsions 2 2 ... 2 ... ... ... ... ... ... ... ... Other Diseases of Nervous System 11 7 4 ... ... ... ... 7 3 4 2 23 Organic Diseases of Heart 46 31 15 1 ... 1 5 1 6 13 19 25 Other Diseases of Circulatory System 7 1 6 ... ... ... ... ... ... 4 3 1 Bronchitis 48 28 20 8 2 1 ... ... ... 9 25 13 Broncho-Pneumonia 13 7 6 6 5 1 ... ... ... ... 1 14 Lobar Pneumonia 11 5 6 1 ... 1 1 ... 2 5 1 1 Pneumonia (type not distinguished) 18 8 10 2 ... 3 3 2 3 3 2 12 Other Diseases of Respiratory System 9 4 5 ... ... 2 1 1 1 1 3 2 Ulcer of Stomach 2 1 1 ... ... ... ... ... 1 1 ... 1 Diarrhœa 14 6 8 12 2 ... ... ... ... ... ... ... Enteritis 8 5 3 6 2 ... ... ... ... ... ... 3 Appendicitis and Typhlitis 1 ... 1 ... ... ... 1 ... ... ... ... ... Obstruction of Intestines 1 ... 1 ... ... ... 1 ... ... ... ... 2 Cirrhosis of Liver 5 2 3 ... ... ... ... ... ... 5 ... 1 Other Diseases of Liver ... ... ... ... ... ... ... ... ... ... ... ... Other Diseases of Digestive System 7 4 3 3 ... ... ... 1 ... 2 1 3 Nephritis and Bright's Disease 12 8 4 1 ... ... ... ... 2 6 3 6 Other Diseases of Urinary System 1 1 ... ... ... ... ... ... ... ... 1 ... Diseases of Generative System 1 ... 1 ... ... ... ... ... 1 ... ... ... Puerperal Fever 1 ... 1 ... ... ... ... ... 1 ... ... 1 Other Accidents and Diseases of Pregnancy and Childbirth 1 ... 1 ... ... ... ... ... 1 ... ... ... Premature Birth 9 6 3 9 ... ... ... ... ... ... ... 1 Congenital Debility and Malformation 18 11 7 18 ... ... ... ... ... ... ... 10 Other Diseases of Early Infancy 5 4 1 5 ... ... ... ... ... ... ... 1 Old Age 29 10 19 ... ... ... ... ... ... ... 29 358 Deaths from Accident 9 7 2 1 1 1 2 1 1 2 ... 1 Deaths from Suicide 1 ... 1 ... ... ... ... 1 ... ... ... 1 Other Violent Deaths 3 3 ... ... ... ... ... 2 1 ... ... 4 Other defined Diseases 4 1 3 ... ... ... 2 ... ... ... 2 ... Ill-defined Diseases or unknown 1 1 ... ... ... ... ... 1 ... 1 All causes 486 251 235 93 26 26 37 26 63 91 124 712 N 194 Report of the Medical Officer of Health. WANDSWORTH. Southfield Ward. 1915 Causes of Death. Deaths in or belonging to Whole District at subjoined ages. Deaths in Public Institutions in the District. All Ages. Males. Females. Under 1 year. z and under a. 2 and under 5, 5 and under 15. 15 and under 25. 25 and under 45. 45 and under 65. 65 and upwards. Enteric Fever 1 1 ... ... ... ... ... ... ... 1 ... ... Small-pox ... ... ... ... ... ... ... ... ... ... ... ... Measles 32 17 15 5 13 11 3 ... ... ... ... ... Scarlet Fever 3 3 ... 1 ... ... 1 1 ... ... ... ... Whooping Cough 12 3 9 4 3 4 1 ... ... ... ... ... Diphtheria & Membranous Croup 10 4 6 ... ... 3 6 ... 1 ... ... ... Influenza 15 4 11 ... ... ... 1 ... 2 4 8 4 Erysipelas 4 ... 4 ... ... ... ... ... 1 ... 3 ... Cerebro-spinal Fever 6 4 2 ... 1 2 1 1 1 ... ... ... Other Epidemic Diseases ... ... ... ... ... ... ... ... ... ... ... ... Pulmonary Tuberculosis 54 32 22 ... ... 3 2 9 19 16 5 1 Tuberculous Meningitis 12 8 4 1 2 3 5 1 ... ... ... ... Abdominal Tuberculosis 2 2 ... ... ... 1 ... 1 ... ... ... ... Other Tuberculous Diseases 4 3 1 ... ... 1 ... 1 ... 2 ... ... Other Infective Diseases 2 3 ... 1 ... ... ... ... 1 ... ... ... Cancer, Malignant Disease 67 37 40 ... ... ... ... ... 7 29 31 1 Rheumatic Fever 4 1 3 ... ... ... 1 3 ... ... ... ... Diabetes 4 2 2 ... ... ... ... ... ... 2 2 ... Other General Diseases 12 4 8 ... ... ... ... ... 1 7 4 4 Alcoholism 3 2 1 ... ... ... ... ... 1 2 ... ... Chronic Poisonings ... ... ... ... ... ... ... ... ... ... ... ... Meningitis 5 2 3 ... ... ... 1 1 1 2 ... ... Cerebral Haemorrhage, Apoplexy 27 13 14 ... ... ... ... ... 1 14 12 ... Convulsions 4 2 2 4 ... ... ... ... ... ... ... ... Other Diseases of Nervous System 34 13 21 ... ... 2 1 3 8 14 6 2 Organic Diseases of Heart 66 36 30 ... ... ... 1 2 9 20 34 5 Other Diseases of Circulatory System 17 9 8 ... ... ... 1 1 2 4 9 1 Bronchitis 77 38 39 7 3 1 ... ... 6 15 45 ... Broncho-Pneumonia 30 15 15 10 3 ... 1 ... 1 5 6 ... Lobar Pneumonia 15 13 3 ... 2 3 ... ... 3 3 4 ... Pneumonia (type not distinguished) 21 10 11 6 3 1 ... ... 3 4 4 ... Other Diseases of Respiratory System 5 1 4 1 ... ... ... ... ... 3 1 1 Ulcer of Stomach 1 1 ... ... ... ... ... ... 1 ... ... ... Diarrhœ 14 4 10 11 2 ... ... 1 ... ... ... ... Enteritis 12 5 7 8 ... 1 ... 1 ... 1 1 ... Appendicitis and Typhilitis 1 1 ... ... ... ... 1 ... ... ... ... ... Obstruction of Intestines 4 1 3 2 ... ... ... ... 1 ... ... ... Cirrhosis of Liver 4 3 1 ... ... ... ... ... ... 2 2 ... Other Diseases of Liver 3 3 ... ... ... ... ... ... 1 1 1 ... Other Diseases of Digestive System 20 10 10 3 1 1 1 ... 1 8 5 ... Nephritis and Bright's Disease 38 13 15 1 ... ... ... 1 4 11 11 1 Other Diseases of Urinary System 2 1 1 ... ... ... ... ... ... 1 1 ... Diseases of Generative System 4 1 3 ... ... ... ... ... 1 2 1 ... Puerperal Fever 1 ... 1 ... ... ... ... ... 1 ... ... ... Other Accidents and Diseases of Pregnancy and Childbirth 1 ... 1 ... ... ... ... ... 1 ... ... ... Premature Birth 18 11 7 18 ... ... ... ... ... ... ... ... Congenital Debility and Malformation 18 9 9 18 ... ... ... ... ... ... ... ... Other Diseases of Early Infancy 9 8 1 9 ... ... ... ... ... ... ... 2 Old Age 46 15 31 ... ... ... ... ... ... ... 46 ... Deaths from Accident 30 16 4 1 2 2 3 ... 2 ... 6 5 Deaths from Suicide 3 2 1 ... ... ... ... ... 1 ... 1 ... Other Violent Deaths ... ... ... ... ... ... ... ... ... ... ... ... Other Defined Diseases 3 1 2 ... 1 ... ... ... ... ... 2 ... Ill-defined Diseases of unknown 3 2 1 2 ... ... ... ... ... 1 ... 1 All causes 763 377 386 113 36 44 31 27 82 179 251 28 195 Report of the Medical Officer of Health. WANDSWORTH. Springfield Ward. 1915. Causes of Death. Deaths in or belonging to Whole District at subjoined ages. Deaths in Public Institutions in the District. | All Ages. Males. Females. Under i year. 1 and under 3. | s and under 5. 5 and under Z5. 15 and under 35. 35 and under 45. 45 and under 65. 65 and upwards. Enteric Fever 1 1 ... ... ... ... ... 1 ... ... ... 5 Small-pox ... ... ... ... ... ... ... ... ... ... ... ... Measles 47 23 24 10 19 13 4 1 ... ... ... ... Scarlet Fever 5 4 1 ... ... 5 ... ... ... ... ... ... Whooping Cough 16 5 11 5 5 6 ... ... ... ... ... ... Diphtheria & Membranous Croup 10 4 6 1 3 3 4 ... ... ... ... ... Influenza 17 10 7 ... 1 2 ... 3 ... 7 4 1 Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... Cerebro-spinal Fever 4 3 1 1 1 ... 1 1 ... ... ... 1 Other Epidemic Diseases ... ... ... ... ... ... ... ... ... ... ... ... Pulmonary Tuberculosis 46 29 17 ... ... 3 3 7 21 11 1 49 Tuberculous Meningitis 7 4 3 2 1 2 1 ... 1 ... ... ... Abdominal Tuberculosis 3 1 2 1 1 ... 1 ... ... ... ... 1 Other Tuberculous Diseases 9 8 1 1 1 2 2 ... 3 ... ... 2 Other Infective Diseases 1 1 ... ... ... ... ... ... ... 1 ... 1 Cancer, Malignant Disease 30 12 18 ... ... ... ... ... 5 19 6 4 Rheumatic Fever 3 3 1 ... ... ... 1 1 ... 1 ... ... Diabetes 3 1 3 ... ... ... ... 1 1 1 ... ... Other General Diseases 3 2 1 ... ... ... ... 1 1 ... 1 2 Alcoholism 1 ... 1 ... ... ... ... ... 1 ... ... ... Chronic Poisonings ... ... ... ... ... ... ... ... ... ... ... ... Meningitis 1 1 ... ... ... ... ... ... 1 ... ... ... Cerebral Haemorrhage, Apoplexy 19 6 13 ... ... ... ... ... ... 6 13 6 Convulsions 3 3 ... 3 ... ... ... ... ... ... ... 1 Other Diseases of Nervous System 11 7 4 1 ... ... ... ... 2 4 4 60 Organic Diseases of Heart 46 21 25 1 ... ... ... 1 5 17 22 11 Other Diseases of Circulatory System 2 2 ... ... ... ... ... ... ... 2 ... 2 Bronchitis 36 17 19 7 1 ... 1 1 ... 3 23 13 Broncho-Pneumonia 20 9 11 3 6 4 2 1 1 ... 3 4 Lobar Pneumonia 16 7 9 ... ... 2 ... 3 5 3 3 1 Pneumonia (type not distinguished) 29 21 8 8 6 2 ... 3 3 4 3 1 Other Diseases of Respiratory System 6 4 1 1 ... ... ... ... 2 2 ... Ulcer of Stomach 3 2 ... ... ... ... ... ... 1 1 ... 1 Diarrhœa 11 4 7 9 3 ... ... ... ... ... ... ... Enteritis 7 3 4 5 1 ... ... ... ... 1 ... ... Appendicitis and Typhilitis 3 2 1 ... ... ... ... ... ... 3 1 ... Obstruction of Intestines 5 3 2 1 ... ... ... ... 2 1 1 1 Cirrhosis of Liver 4 2 2 ... ... ... ... ... 1 3 ... 1 Other Diseases of Liver 1 1 ... ... ... ... ... ... 1 ... ... ... Other Diseases of Digestive System 7 6 1 ... ... ... ... ... 2 2 3 1 Nephritis and Bright's Disease 9 7 2 1 ... ... ... ... 2 4 2 7 Other Diseases of Urinary System 4 4 ... ... ... ... ... ... ... ... 4 ... Diseases of Generative System 1 ... 1 ... ... ... ... ... 1 ... ... Puerperal Fever 1 ... 1 ... ... ... ... ... 1 ... ... ... Other Accidents and Diseases of Pregnancy and Childbirth 3 ... 3 ... ... ... ... ... 3 ... ... ... Premature Birth 13 8 5 13 ... ... ... ... ... ... ... 1 Congenital Debility and Malformation 19 10 9 16 2 ... 1 ... ... ... ... 3 Other Diseases of Early Infancy 3 1 1 2 ... ... ... ... ... ... ... ... Old Age 38 14 24 ... ... ... ... ... ... ... 38 28 Deaths from Accident 6 4 2 ... ... ... 1 ... 2 1 2 4 Deaths from Suicide ... ... ... ... ... ... ... ... ... ... ... ... Other Violent Deaths 8 8 ... ... ... ... ... 5 3 ... ... 53 Other defined Diseases 2 ... 2 ... ... 1 ... ... ... ... 1 ... Ill-defined Diseases or unknown 2 ... 2 ... ... ... ... ... ... ... 2 ... All causes 543 287 256 93 50 45 32 30 68 97 139 265