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pneumonia.
From inquiries made it was ascertained that 3 of the patients were in institutions when they
sickened, and that 1 was attacked when away from the Borough. In 7 instances the cases were
marked "errors." Four patients were reported as having the disease twice during the year. From
each of 17 houses 2 cases were reported, but in 11 instances the second case was in a second familyleaving
6 families in which 2 cases occurred during the year.
Of the 302 cases notified 193 were removed to institutions, equal to 63.7 per cent. of the total
cases, 164 of the patients being admitted to the Paddington Hospital.
Fatal terminations were recorded in 73 instances, equal to a fatality of 24.1 per cent. of the
reported cases, as compared with 29.1 per cent, in 1922. Among the 193 patients treated at home 24
deaths occurred, 22.0 per cent. of those cases, the corresponding figure for 1922 being 26.3. Of the
cases removed to institutions, 49 ended in death, 25.3 per cent., as compared with 30.6 in 1922. It is
more than probable that the improvement in notification has been sufficient to account for the apparent
reduction in fatality. In 18 instances notification of the case was received after the death of the
patient.
Mortality from Pneumonia.—There were in all 154 deaths from all forms of pneumonia during the
year, 89 (44 of males, 45 of females) from broncho-pneumonia, 35 (males, 26; females, 9) from lobar
pneumonia, and 30 (males, 16; females, 14) from "pneumonia." The 154 deaths represent a total
mortality of 1.05 per 1,000 persons, the mortality for males being 1.40 and that for females 0.80. The
sex-rates recorded last year were slightly higher than the mean rates for 1910-12 (males, 1.17; females,
0.72), and 1920-22 (males, 1.32 ; females, 0.70).
Incompleteness of Notification.—Notification of the pneumonias was introduced immediately after
the epidemic of influenza in the autumn and winter of 1918-19, one (if not the principal) of the objects
of notification being to provide (if possible) some indication of a return of an epidemic of that disease.
Such indication will not be forthcoming unless notification be as nearly complete as is humanly possible.
In this Borough there is no room for doubt as to the improvement in notification which has taken place
in the course of the last (say) three years. The annual increase in the number of cases notified, shown
in Table 3, confirms that statement. An examination of the annual totals of notifications (all forms
of pneumonia) obtained from a summation of the returns issued weekly by the M.A.B., discloses the
fact that the cases notified in the Borough during last year numbered 338, the fifth highest in the
County, higher totals being returned from Poplar (460), Wandsworth (432), Stepney (352) and Battersea
(342). The differences between the total for Paddington (338) and those for the areas immediately
adjacent thereto are remarkable. For Kensington the total for the year is 125, that for Hammersmith
83, that for Willesden 131, that for Hampstead 48, that for St. Marylebone 52, and that for
Westminster 59.

N. Notified cases. Figures in parentheses, numbers of cases terminating fatally.
D. Deaths certified due to pneumonia. Figures in parentheses, numbers of cases notified during life,
(a) Two deaths certified due to causes other than pneumonia.
As an example attention may be specially directed to the figures for Church Ward. In that Ward 83
cases of acute primary pneumonia were reported, 22 (including 2 in which the deaths were certified to
have been due to causes other than one of the pneumonias) ended fatally. On the other hand,there
were 22 deaths assigned to broncho-pneumonia, of which only 8 represented cases notified during the
lives of the patients. There were also 16 deaths from lobar (and undefined) pneumonia, of which 12
followed notified cases of the disease.