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Annual Report of the London County Council, 1914.
The usual tables have been included in the administrative section of the report giving particulars
concerning the activities of local authorities in various branches of work. It is gratifying to find that
in spite of the war so much has been accomplished, more especially having in view the claims
made for special service and the exceptional rises incidental to influx of refugees and wounded from
the Continent, which have made it necessary to keep closer watch than ever upon infectious diseases.
On the outbreak of hostilities the late county medical officer of health, Sir Shirley Murphy, was
attached to the staff of the Deputy-Director of Medical Services of the London military district.
The medical officers of health of London sanitary districts also offered their services in connection with
the special arrangements necessary for the housing and feeding of aggregations of men, the maintenance
of sanitary conditions, and the taking of precautions against disease. These duties were performed
under the direction of the military authority, and were additional to the duties performed as officers of
the sanitary authority. Several medical officers of health joined the forces of the Crown for active
service and substitutes have had to be engaged. Despite these wholly abnormal conditions, a very
large amount of work has been done, but the record furnished has necessarily been less complete than
in ordinary years, owing to the exceptional demands made upon the sanitary staffs. For these reasons,
some curtailment of the administrative part of this report has been found to be necessary ; indeed,
the completed reports have not been available in the case of a few of the boroughs.
An account is given on page 64 of the form of procedure adopted and the action taken during
1914 under the Mental Deficiency Act (1913). Other subjects referred to are : the treatment of tuberculosis
under the provisions of the National Insurance Act, 1911 (p. 70) ; a review of the results of
the several enumerations of homeless persons undertaken by the Council during the past ten years
(p. 62); the very satisfactory reduction in the extent of prevalence of verminous conditions in certain
sections of the London population (p. 55) ; the administration of the Midwives Act. 1902 (p. 73) ;
and the year's work of the chemical and analytical branch of the public health department (p. 78).

Movement of In recent annual reports attention has been especially directed to the great importance in rela-
the London tion to vital statistics of the question of movement of the population. In the annual report for 1912,
population in (p 110), reference was made in this connection to evidence pointing to the fact that there has been
ieeent years. recen£ years a distinct outward movement from registration London of young married persons with
their families. The teaching of the figures is borne in upon the minds of those who have direct knowledge
of the very great difficulty experienced by poor persons with four or five children in obtaining accommodation
in tenements within the County of London. Again, in the annual report for 1913 (p. 2), the
importance of local migration was illustrated by instituting comparisons between the age constitution
of the male and female populations, firstly, of England andWales and London, and secondly, of London
north of the Thames and London south of the Thames, and it was pointed out that London attracts
females of the ages 25-35 in greater degree than males. The striking differences shown by the figures
given, illustrate the importance of constantly bearing in mind the variations in age constitution which
exercise so marked an influence in London; in particular, the effect of these variations upon the birth,
marriage, and death-rates must not be forgotten, and to this subject further reference is made on page 5.
Comment, moreover, is made later in this report upon the question of changes in infant mortality which
have probably been influenced by changing age-constitution of the London population, and the disturbing
effect of movement of population upon the phthisis death-rate has been fully discussed elsewhere
(Trans. Roy. Soc. Med., 1912-13) ; again, in last year's report (p. 42), a further examination was
instituted into the question as to how far tuberculosis mortality is affected by altering nomenclature
and changing age constitution.