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Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London

Holborn 1923

Annual report of the Medical Officer of Health, for the year 1923

Published
1924
Author
Hutt, C. W.
Pages
100
Tables
97

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97 tables in this report

  • Page 3
    STATISTICAL SUMMARY, 1923.
  • Page 3
    Vital Statistics, 1923. England and Wales, London and Holborn.
    Annual Rates per 1,000 living.Deaths under 1 year to 1,000 Births.
    Births.Deaths.
  • Page 5
    The following information is from the Report of the Census, 1921, respecting the average ages, etc., of population, and is supplemental to that included in the Annual Report for 1922:—
    Average Age of Population.Children under 5 years per 1,000 of population.Females per 1,000 Male population
    M.F.M.F.
  • Page 6
    The following table gives the population in Holborn over 12 years of age in relation to marriage and occupation:—
    Males.Females.
    Single.Married.Widowed or Divorced.Single.Married.Widowed or Divorced.
  • Page 7
    The following table gives the corrected number of births and the corrected birth-rates for the sixteen years 1908-1923:—
    Year.Total Births.Legitimate Births.Illegitimate Births.
    No.Rate per 1000 of Population.No.Rate per 1000 of population.Proportion per 1000 total Registered BirthsNo.Rate per 1000 of population.Proportion per 1000 total Registered Births.
  • Page 7
    Of these deaths the following occurred in Public Institutions, etc., within the area of the Borough:—
    Institution.Residents.Non-Residents.
    St. Giles and Bloomsbury.Holborn.St. Giles and Bloomsbury.Holborn.
  • Page 8
    Corrected Deaths and Death-Rates, 1923, compared with 1922.
    Year.Total Deaths at all ages registered in District.Deaths in Public Institutions in District.Deaths of of nonresidents of Borough registered in District.Deat hs of residents registered beyond the District.Nett Deaths at all ages.Death Rate for BoroughDeath Rate. Registration London.
  • Page 8
    Seasonal Mortality. The mortality in the four quarters of the year is shown below:—
    Deaths.Death-rate per 1,000.
  • Page 8
    Infantile Mortality. The number of deaths of children under one year of age, and the number of deaths of children under one year of age per 1,000 corrected births, were the following:—
    Year.Deaths under 1 year of age.Deaths under 1 year per 1000 corrected legitimate Births.Deaths under 1 year per 1000 corrected illegitimate Births.Deaths under 1 year per 1000 corrected Births.London.
    Deaths under 1 year per 1000 Births.
  • Page 9
    Death-rate per 1,000 corrected births in 1923 and in ten preceding years during which details respecting births have been supplied.
    1913191419151916191719181919192019211922Av'ge, 1913-221923
  • Page 9
    The Clerk to the Guardians of the Holborn Union has kindly supplied me with the following information relating to persons from the Holborn Division of the Union who received Poor Law Relief during the year 1923:—
  • Page 10
    Sanitary Inspectors' and Health Visitors' Work, Year 1923.
    Mr. BennettMr. ClarkMr. LarardMiss CharlesworthMiss ShinnieTotal
  • Page 11
    Continued from previous page...
    Mr. BennettMr. ClarkMr. LarardMiss CharlesworthMiss ShinnieTotal
  • Page 11
    The total number of notices served for nuisances found in dwelling houses and factories, workshops and workplaces, and premises subject to various By-laws, was 1,560, viz.:—
  • Page 12
    The following Table shows the work done to abate nuisances for which intimation notices were served:—
    Water Supply—Houses.Factories, Workshops and Workplaces.
  • Page 13
    The following Table shows the nuisances for which the 79 Statutory Notices were issued under the Public Health (London) Act, 1891.
  • Page 14
    The following firms of rat-catchers carry out work connected with rat repression for owners and occupiers in the Borough at the following rates:—
    Small Houses 8 rooms.Stables 10 horses.Shops small.Hotels, &c., ard large shops.
  • Page 17
    Hygienic Arrangements for Staff of Hotels, Restaurants and Eating Houses. In connection with 221 premises of this nature inspected during the year the following defects were found:—
  • Page 17
    During the year the sanitary accommodation provided at 101 houses licensed for the sale of beer, wine and spirits, was inspected, and the following conditions found:—
  • Page 21
    The following table refers to the six samples examined as mentioned above:—
    Date sample taken.Nature of Shop where purchased.No. of Organising per cc. grown at 37° C for 24 hours.Minimal volume containing Bacillus Coli.
  • Page 22
    During the year 1923, licences available up to the 31st December, 1923, for the sale of "designated" milk in the Borough were issued as follows:—
  • Page 22
    Up to the date of the preparation of this Report licences for the year 1924 have been issued as follows:—
  • Page 23
    The second schedule of the Order gives the appropriate percentage of milk fat and milk solids as under:—
    Description of Condensed Milk.Percentage of milk fat.Percentage of all milk solids including fat.
  • Page 23
    The conditions ascertained as the result of our inspections of the kitchens, cooking and washing arrangements, dining rooms, etc., of 221 hotels, restaurants and eating houses follows
  • Page 24
    Other defects found were—
  • Page 25
    Kitchen Refuse—
  • Page 25
    Storage of Food. The provision for storage of food both before and after cooking is shown in the following table:— Provision for Storage of Food.
    Type of Restaurants, etc.
    Hotels and high-class restaurants.Restaurants for average business employee.Restaurants, working class.
  • Page 26
    The inspection of hotels, restaurants and eating houses (221) showed the following defects in the washing up arrangements:—
  • Page 27
    Public Houses. In the 101 public houses inspected the conditions found were as follows:— Bars and Washing-up Sinks.
    No. of Houses.Number of Sinks.
    Nil.123456
  • Page 27
    Water laid on to Sinks in Bars.
  • Page 27
    After EACH use Glasses Rinsed or Washed with:—
  • Page 27
    Method of Drying.
  • Page 27
    Glasses washed in Hot Water with Soap, Soda, etc.
  • Page 29
    Ice cream is manufactured in the Italian Colony as follows:—
  • Page 29
    In addition ice cream was also manufactured on the following premises:—
    Mr. Bennett's District.Mr. Clark's District.Mr. Larard's District.
  • Page 30
    The number of such places on the register at the end of the year was as follows:—
  • Page 30
    Unsound Food. The following unsound food was condemned during the year 1923:—
    Commodity.Quantity.Condition.Result of Action taken.
  • Page 32
    The particulars of samples reported to be deficient in fat were as follows :—
    Fat.Water.Protein.Deficiency of Fat.
  • Page 34
    The following table shows the fat content of the 208 samples:—
    Percentage of Fat.Number of Samples.
    Shops.Restaurants.Streets.Total
  • Page 35
    The following table shows the average composition of milk samples purchased during each month of 1923. For the purpose of comparison, I have included corresponding figures for the Borough of Stepney, for which I am indebted to Dr. D. L. Thomas, Medical Officer of Health of that Borough.
    Number of Samples examined.Total Solids, per cent. average.Solids Non-fat. Per cent. average.Fat. Per cent. average.
    Holborn.Stepney.Holborn.Stepney.Holborn.Stepney.Holborn.Stepney.
  • Page 37
    The following is a list of articles purchased during 1923:—
    ARTICLE.Purchased.Genuine.Adulterated.Proceedings taken.Convictions.Fines and Costs.
  • Page 38
    Continued from previous page...
    ARTICLE.Purchased.Genuine.Adulterated.Proceedings taken.Convictions.Fines and Costs.
  • Page 39
    ENGLAND AND WALES. Common Infectious Diseases. Deaths at all Ages.
    1913.1914.1915.1916.1917.1918.1919.1920.1921.1922.Yearly average 1913-1922.
  • Page 41
    The following Table, kindly supplied by the Vaccination Officer of the Holborn Union gives information respecting vaccination in the Borough of Holborn: —
    Total Number of BirthsVaccinatedDied before VaccinationCons. ObjectorsInsusceptiblePostponed by Medical CertificateRemoved. No information as to VaccinationRemoved. Reported VaccinatedTemporarily unaccounted for
  • Page 41
    Careful note was kept as to the homes to which the respective leaflets were issued and the replies received. Thirty-two reply post-cards were received, namely, leaflet "W" eighteen, leaflet "H" fourteen. The replies were to the following effect:—
    Leaflet "H"Leaflet"W"
  • Page 42
    Diphtheria. Ninety-eight notifications of diphtheria relating to residents in the Borough were received during the year at the following ages:—
  • Page 43
    Diphtheria Contacts. Bacteriological Examination of Nose and Throat Swabs.
    Contacts swabbed.Positive Results.Contacts positive.
    Nose and Throat.Nose only.Throat only.
  • Page 44
    Schick Testing and Anti-Diphtheria Immunisation.
    Total tested.Result of Test.Immunisation of Positives.Tested af ter third inoculation and found
    Negative.Positive.Not read.Three inoculations.Failed to complete three inoculationsDid not begin inoculations.Negative.Positive.
  • Page 45
    Ages of Persons Schick-Tested with Result of Test.
    Age.6 to 12 months1 to 2 years2 to 3 years3 to 4 years4 to 5 years5 to 6 years6 to 7 years7 to 8 years8 to 9 years9 to 10 years10 to 11 years11 to 12 years12 to 13 years13 to 14 years15 and above years
  • Page 45
    Ages of Persons Immunised.
    Age.a to 12 months1 to 2 years2 to 3 years3 to 4 3 years4 to 5 years6 to 6 years6 to 7 years7 to 8 years8 to 9 years9 to 10 years10 to 11 years11 to 12 years12 to 13 3 years13 to 14 years15 and above years
  • Page 47
    In the majority of cases the disease was not ascribed to any cause, but the following was given in 14 instances: —
  • Page 48
    Bacteriological Work. The following Table gives details of the examinations made during the year:—
    DiphtheriaEnteric FeverConsumptionOther Diseases
    Number SubmittedResult of ExaminationNumber SubmittedResult of ExaminationNumber SubmittedResult of ExaminationNumber SubmittedResult of Examination
  • Page 50
    Public Health (Tuberculosis) Regulations, 1912. Summary of Notifications during the period from the 31st December, 1922, to the 29th December, 1923, in the Metropolitan Borough of Holborn.
    Age-periods.Notifications on Form A.Notifications on Form B.Number of Notifications on Form C.
    Number of Primary Notifications.Number of Primary Notifications.
    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 Primary Notifications.Total Notifications on Form A.Under 5.5 to 10.10 to 15.Total Primary Notifications.Total Notifications on Form B.Poor Law InstitutionsSanatoria.
  • Page 50
    Supplemental Return. New cases of Tuberculosis coming to the knowledge of the Medical Officer of Health during the period from the 31st December, 1922, to the 29th December, 1923, otherwise than by notification on Form A or Form B under the Public Health (Tuberculosis) Regulations, 1912.
    Age-periods.0 to 11 to 55 to 1010 to 1515 to 2020 to 2525 to 3535 to 4545 to 5556 to 6565 and upwards.Total Cases
  • Page 51
    The following summary gives the position at the end of 1923, of the 85 new cases respecting which information was received during the year: —
  • Page 51
    The following indicates the reasons for non-attendance in the remaining cases:—
  • Page 52
    The 131 admissions were to the following institutions: —
  • Page 53
    The following Table shows where the patients died in their own homes or institutions:— Showing the number of Patients who died in their own homes and the number who died away from home in Hospitals or other Institutions.
    0-1-5-10-15-20-25-35-45-55-65-All Ages.
    Males.Females.Total.
  • Page 53
    Number of Cases examined for the first time in 1923 :—
    Insured.Non-Insured.Children under 15.
    Males.Females.Males.Females,M.F.Total.
  • Page 54
    Analysis of 158 New Cases in 1923 :—
    Examined for first time during year.Found to be suffering from Tuberculosis.Not suffering from TuberculosisDoubtful Cases.
    Pulmonary.Non-Pulmonary.
  • Page 54
    Attendances and Examinations at the Dispensary in 1923 :—
    Insured.Non-Insured.Total.
  • Page 59
    From the 395 notifications of birth forms from doctors or midwives, we are able to give the following information as to by whom the mothers were attended at the confinement, etc.:—
  • Page 59
    An analysis has been made of the birth cards to ascertain where the mothers living in crowded houses were confined. The information obtained is given below :—
    Living inConfined at Home.In Hospital.
    No.Percentage.No.Percentage.
  • Page 59
    The visits paid to the homes by the Health Visitors during the year were as follows:—
    First Visits.Revisits.Total.
  • Page 60
    The following is an analysis of the attendance at the Municipal Centre, 10, John Street.
    Tuesday,Wednesday.Thursday.Friday,
    Medical Consultation (alternate weeks) 2—5.30 p.m.Ante-Natal and Post-Natal cases only (alternate weeks) 2—5.30 p.m.Children and Mothers seen at Ante-Natal ConsultationMedical Consultation 2—5.30 p.m.Class 3—5-30 p.m.Dentist. 2—4 p.m.Medical Consultation 2—5.30p.m.
  • Page 62
    Of the 481 about whom information was obtained—
  • Page 62
    Six of the ante-natal cases were expectant mothers for the first time; a number of the expectant mothers were found to have defects either due to or especially of concern in view of their pregnancy, the number and kind of defect present being as follows: —
  • Page 63
    Maternal and Infant Consultations. Details as regards the work at the Maternal and Infant Consultations at 10, John Street and the Mary Ward Centres during the year are as follows: —
    Reason for Attendance.Number attending.
    Mothers—John St.Mary Ward.
  • Page 66
    Scale of Necessity. The approved scale of necessity adopted by the Council on the 14th October, 1921, continued in force during during the year 1923 as follows:—
    Person in Family.Free Milk,Half-cost Milk.
    £s.d.£s.d.
  • Page 66
    The following Table shows new cases assisted in 1923:—
    Milk.Prepared Milk.
    Free.Part Cost.Free.Part Cost.
  • Page 68
    Deaths of Infants under One Year of Age. The homes were visited in a large proportion of the infant deaths, and any requisite information obtained, and when required, suitable advice given. The cause and age of death are given in the following Table:—
    Cause of DeathUnder 1 Week1-2 Weeks2-3 Weeks3-4 WeeksTotal under 4 Weeks4 Weeks and under 3 Months3-6 Months6-9 Months9-12 MonthsTotal under 1 Year
    MFMFMFMFMFBoth sexesMFMFMFMFMFBoth sexes
  • Page 69
    Deaths of Children 1 to 5 Years. Fourteen children between the ages 1 to 5 years died from the following causes:—
    Cause of Death.Ages.Total. 1—5
    1-22-33-44-5
    M.F.M.F.M.F.M.F.M.F.Both Sexes.
  • Page 70
    Six Cases Notified in Accordance with the Public Health (Ophthalmia Neonatorum) Regulations, 1914.
    Case Number.Age when Notified.Age at Onset.By whom Notified.Type of Disease on Health Visitor's first visit.Where Treated.Medical Attendance and Nursing.Result.Birth Notified byREMARKS.
  • Page 71
    Eight Cases not Notified in accordance with the Public Health (Ophthalmia Neonatorum) Regulations, 1914.
    Case NumberAge when Information receivedAge at OnsetInformationType of Disease on Health Visitor's first visitWhere treatedMedical Attendance and NursingResultAttended byRemarks
    129 days3 daysFound by Health VisitorModerateCentral Ophthalmic Hospita1 (out patient)Doctor and Monthly Nurse. Out-patient Central London Ophthalmic Hospital,CuredDoctor.
    211 days8 daysFound by Health VisitorSlightMiddlesex Hospital (out-patient)District Nurse and out-patient Middlesex HospitalCuredMidwife
    511daysFirst dayFound by Health VisitorSlightMiddlesex Hospital (out-patient)District Nurse and out-patient Middlesex HospitalCuredMidwife
    613 days3 daysFound by Health VisitorSlight. Both eyesCharing Cross Hospital (out-patient)Midwife and out-patient Charing Cross HospitalCuredMidwife
    911 days9 daysFound by Health VisitorSlightHomeMotherCuredExtern Department Hospital
    1012 days3 daysFound by Health VisitorSlightMaternity Hospital and Central London Ophthalmic Hospital (out-patient)Out patient Central London Ophthalmic HospitalCuredBorn in Hospital
    1112 days3 daysFound by Health VisitorSlightUniversity College Hospital (out-patient)Midwife and out-patient University College HospitalCuredMidwife
    1318 days2 daysFound by Health VisitorModerateMaternity Hospital then Central London Ophthalmic Hospital, (out patient)Out-patient Central London Ophthalmic HospitalRemoved to another DistrictBorn in Hospital
  • Page 72
    55 had contacts, the number of contacts were 242, of whom 101 were susceptible, 141 having already suffered from an attack.
  • Page 73
    The number of contacts was 20 of whom 7 were susceptible, 13 having already suffered from an attack.
  • Page 74
    Contacts. (138 enquiries.) Forty-nine had no contacts; 89 had contacts. The number of contacts were 348 of whom 192 were susceptible, 156 already having suffered from an attack
  • Page 75
    Their services were used as follows:—
  • Page 77
    Medical Inspection in Public Elementary Schools in Holborn. I.
    Age, Group and number examined.Condition of Clothing.Nutrition.Cleanliness—Head.Cleanliness—Body.Condition of Teeth.Vision.Mental Condition.
    Good.Fair.Bad.Good.Average.Poor.Bad.Clean.Nits present.Pediculi.Clean.Dirty.Pediculi.All sound.Not more than 3 decayed.4 or more decayed.6/6 in both eyes.6/9 in either or both eyes.6/12 or worse in either eye.Average.Poor.Mentally deficient.
  • Page 78
    Defects Found. At Mcdical Inspections in Public Elementary Schools in Holborn.
    Entrants.Age 8.Age 12.
    Boys.Girls.Boys.Girls.Boys.Girls.
    Number Examined173183151178137191
    Defects :—
    Skin Disease......3 [3]1 [1]1 [1]...
    Enlarged Tonsils6 [5]7 [4]8 [3]9 [7]3 [2]2 [2]
    Adenoids2 [2]3 [2]...3 [3]1 [1]...
    Tonsils and Adenoids3 [3]3 [3]......1 [1]...
    Other Nose and Threat1 [1]2 [2]1 [-]2 [1]......
    Enlarged Glands of Neck......1 [-]1 [1]1 [-]1 [1]
    External Eye Disease11 [9]3 [2]5 [4]3 [3]1 [-]...
    Vision for TreatmentNot Examined[5][5][7][13]
    Otorrhœa and Otitis2 [1]4 [3]1 [1]2 [2]2 [2]2 [1]
    Other Ear Disease...1 [1]...1 [1]...
    Hearing Defect......1 [1].........
    Stammering..................
    Other Speech..................
    Heart Defects2 [-]6 [1]7 [-]5 [2]4 [-]3 [-]
    Anaemia......1 [-]2 [1]...1 [-]
    Bronchitis and other Lung Disease12 [6]9 [5]5 [2]6 [1]1 [-]2 [1]
    Nervous Disease1 [-]1 [-]1[-]2 [-]2 [-]
    Phthisis..................
    Other Tubercular Disease..................
    Rickets1 [-].........1 [-]...
    Spinal Defects1 [-]...1 [-]1 [-]2 [2]...
    Other Deformities3 [3].........1 [-]2 [2]
    Infectious Disease...2 [2]............
    Other Defects1 [1]2 [1]3 [2]4 [3]1 [-]5 [2]
    †Cases for Dental Treatment[28][24][22][30][4][10]
  • Page 79
    Deaths of Children 5-15 years.
    Ages.Total.
    567891011121314Both Sexes.
    MFMFMFMFMFMFMFMFMFMFMF
  • Page 85
    Occupation of Basement Rooms. Generally throughout the Borough buildings are constructed with basements. Efforts were made to ascertain the number of such basements used for dwelling purposes with the following results: —
  • Page 85
    HOUSING CONDITIONS. Statistics. Year Ended 31st December, 1921. 1.—GENERAL.
  • Page 87
    3.—UNHEALTHY AREAS.
  • Page 88
    APPENDIX. TABLE I. Vital Statistics of Whole District during 1923 and Ten Previous Years.
    YearPopulation estimated to Middle of each Year.Births.Total Deaths Registered in the DistrictTransferable DeathsNett Deaths belonging to the District.
    Under 1 Year of AgeAt all Ages
    Uncorrected NumberNettNumberRateof Non residents registered in the Districtof Residents not registered in the DistrictNumberRate per 1,000BirthNumberRate
    NumberGate
  • Page 89
    TABLE II. Causes of, and Ages at, Death, 1923.
    Causes of Death.NET DEATHS AT THE SUBJOINED AGES OF "RESIDENTS," whether occurring within or without the District.Total Deaths whether of "Residents" or "Non-Residents" in Institutions in the District.
    All Ages.Under 1 year.1 and under 2 years.2 and under 5 years.5 and under 15 years.15 and under 25 years.25 and under 45 years.45 and under 65 years.65 and under 75 years.75 and upwards.
  • Page 90
    TABLE III. Cases of Infectious Disease notified during the year 1923.
    Notifiable Disease.Number of Cases Notified.Total Cases Notified in each Locality (e.g. Parish or Ward) of the District.
    At all Ages.At Ages—Years.St. Giles and Bloomsbury.Holborn.Total Cases Removed to Hospitals.
    Under 11 to 55 to 1616 to 2525 to 4545 to 6565 and wards.
  • Page 91
    TABLE IV. Infectious Diseases in Holborn for the last Eleven Years.
    NOTIFICATIONSDEATHS
    Decennial Average, 1913-1922Year 1923Decennial Average, 1913-1922Year 1923
    NumberRate per 1,000London HateNumberRate per 1,000London RateNumberRate per 1,000London RateNumberRate per 1,000London Rate
  • Page 92
    TABLE V. INFORMATION REQUIRED BY THE LONDON COUNTY COUNCIL.
    PREMISES.Number on Register at end of 1923.Number of Inspections.Number of Prosecutions.
  • Page 92
    Smoke Nuisances—
  • Page 93
    TABLE VI. Factories, Workshops, Laundries, Workplaces and Homework 1.—INSPECTION. Including Inspections made by Sanitary Inspectors.
    PREMISES.Number of
    Inspections.Written Notices.Prosecutions.
    Intimations.Statutory.
  • Page 93
    2.—DEFECTS FOUND.
    Particulars.Number of Defects.Number of Prosecutions.
    Found.Remedied.Referred to H.M. Inspector.
  • Page 94
    TABLE VI — continued. 3.—HOME WORK.
    NATURE OF WORK.Outworkers' Lists, Section 107.Outwork in Unwholesome Premises, Section 108.Outwork in Infected Premises. Sections 109, 110.
    Lists received from Employers.Notices served on occupiers as to keeping or sending lists.Prosecutions.Instances.Notices servedProsecutions.Instances.Orders made (S. 110).Prosecutions (Sections 109, 110)
    Sending twice in the year.Sending once in the year.Failing to keep or permit inspection of lists.Failing to send lists.
    Lists.Outworkers.Lists.Outworkers.
    Contractors.Workmen.Contractors.Workmen.
  • Page 95
    TABLE VI.—continued. 4.—REGISTERED WORKSHOPS.
    Workshops on the Register (s. 131) at the end of the year.Number.
  • Page 95
    5.—OTHER MATTERS.
    Class.Number.
    (1)(2)
  • Page 96
    LEGAL PROCEEDINGS. SALE OF FOOD AND DRUGS ACTS, 1875-1907.
    Date.Name and Address.Offence.Result.
  • Page 96
    PUBLIC HEALTH (LONDON) ACT, 1891.
    Date.Name.Premises.Offence.Result.