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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

London County Council 1905

[Report of the Medical Officer of Health for London County Council]

Published
1906
Pages
244
Tables
201

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201 tables in this report

  • Page -
    The populations of the City of London and each of the metropolitan boroughs, as constituted by the London Government Act of 1899, estimated to the middle of 1905, are shown in the following table—
    Sanitary area.Estimated population, middle of 1905.Sanitary area.Estimated population, middle of 1905.Sanitary area.Estimated population, middle of 1905.
  • Page -
    The marriage rate in successive periods has been as follows—
  • Page -
    Marriages of minors per cent. of total marriages.
    Period.London.England and Wales.
    Males.Females.Males.Females.
  • Page 6
    The birth-rate in successive periods has been as follows:—
  • Page 6
    The corresponding figures for England and Wales are as follows:—
  • Page 6
    The following table shows the birth-rate in the several sanitary areas per 1,000 persons living and per 100 married females aged 15-45 in the period 1901-4 and for the year 1905 (52 weeks):—
    Sanitary area.Births, 1905.Birth-rate per 1,000 persons living.Births per 100 married females aged 15-45.
    1901-4.1905.1901-4.1905.
  • Page 7
    London. Birth-rates per 1,000 persons living in successive decennia.
    Registration District.Birth-rate per 1,000 living.1851-60 = 100.
    1851-601861-701871-801881-901891-19001851-601861-701871-801881-901891-1900
  • Page 8
    Birth-Rates. Comparative figures for certain large towns. 1881-1905.
    Towns.1881188218831884188518861887188818891890189118921893189418951896189718981899190019011902190319041905
  • Page 9
    All causes—Death-rates per 1,000 persons living.
  • Page 9
    The columns showing "death-rates corrected for age and sex distribution" have been obtained by multiplying the crude death-rates by the " factors for correction "published by the Registrar-General in the Annual Summary for 1905.
    Towns.Estimated Populalion middle of 1905.Crude death-rate per 1,000 persons living.Death-rate per 1,000 persons living (corrected for age and sex distribution).
    1895-1904.1905.1895-1904.1905.
  • Page 10
    The following table enables comparison to be made of the death-rates of London with the death-rates of several foreign cities1:— All causes—Death-rates per 1,000 persons living.
    Towns.1895-1904.1905.Towns.1895-1904.1905.
  • Page 10
    Crude and corrected death-rates,4per 1,000 persons living, in the County of London, and the several sanitary districts.
    Standard death-rate.Factor for correction for age and sex distribution.Crude death-rate.Corrected death-rate.Comparative mortality figure (London, 1,000).
    1901-4.1905.1901-4.1905.1901-4.1905.
  • Page 11
    The following table shows the number of deaths1 occurring at several ages in each of the sanitary areas of the Administrative County of London during the year 1905 (365 days)—
    Age-period.0-1-2-3-4-Under 5.5-10-15-20-25-35-45-55-65-75-85 & up- wardsAll ages.
  • Page 12
    Table I. Mean future lifetime of males and females in groups of ages, calculated from the London life table, 1891-1900.
    Age-groups.Males.Females.Age-groups.Males.Females.
  • Page 12
    Table II.
    Age-groups.Deaths calculated according to mean death-rates of 1891-1900.Deaths occurring in the year 1905.Gain ( + ) or loss ( —) of lives in the year 1905, by fluctuation of mortality.Gain (+) or loss (—) of''life capital" in the year 1905 by fluctuations of mortality.
  • Page 13
    The proportion in successive periods has been as follows:—
    Period.Deaths under one year of age per 1,000 births.Period.Deaths under one year of age per 1,000 births.
  • Page 13
    The following table enables comparison to be made of the infant mortality in London and other large English towns. Deaths under one year of age per 1,000 births.
    Towns.1895-1904.1905.Towns.1895-1904.1905.
  • Page 13
    The following table shows the deaths under one year of age and the number of these deaths per 1,000 births in each of the sanitary areas of the County of London for the period 1901-1, and for the year 1905:—
    Sanitary area.Deaths under one year of age, 1905.Deaths under one year of age per 1,000 births.
    1901-4.1905.
  • Page 14
    Deaths1 under one year of age registered in London during the 52 weeks of 1905.
  • Page 14
    County of London, Infantile mortality during the year 1905. Deaths from stated causes in weeks and months under one year of age.
    Cause of Death.Under 1 week.1-2 Weeks.2-3 Weeks.3-4 Weeks.Total 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.11-12 Months.Total Deaths under one year.
  • Page 15
    Continued from previous page...
    Cause of Death.Under 1 Week1-2 Weeks.2-3 Weeks.3-4 Weeks.Total under 1 Month.1-2 Months.2-3 Months.3-4 Mouths.4-5 Months.5-6 Months6-7 Months.7-8 Months.8 9 Months.9-10 Months.10-11 Months.11-12 Months.Total Deaths under One Year.
  • Page 15
    London, 1905. Life Table for the first 12 months of life (based on the mortality of the year 1905).
    Age-period.Registered deaths.Probability of living for one month.Number living at the beginning of each month of age.1902. Number living at the beginning of each month of age in the year 1902.
    X/12Px/12lx/12lx/12
  • Page 16
    Deaths at each interval of age from all causes.
    Sanitary area.0-1 Weeks.1-2 Weeks.2-3 Weeks.3-4 Weeks-.Total 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.11-12 Months.Total under 1 Year.
  • Page 16
    With a view to the consideration of the effect of social condition on the rates of infant mortality at different periods during the first year of life, the following table has been prepared, in which the rates of infant mortality obtaining for groups of districts arranged on the basis of the amount of overcrowding 1shown by the census of 1901 can be compared :—
    Age-period.Proportion of overcrowding in groups of sanitary districts.
    Under 7.5 per cent.7.5 to 12.5 per cent.12.5 to 20.0 per cent.20.0 to 27.5 per cent.Over 27.5 per cent.
  • Page 17
    This will be better appreciated by reference to the following table, in which the mortality of the least overcrowded group of districts is taken as 100:—
    Number of group of districts in order of overcrowding.Comparative mortality figure.
    Children aged 0-3 months.Children aged 3-6 months.Children aged 6-9 months.Children aged 9-12 months.
  • Page 17
    Dr. Sykes also shows the infantile mortality in London in several periods since 1888, when the deaths under one were first given in the Registrar-General's reports in ages 0-3, 3-6, 6-12, months, the table exhibiting the greatest increase of mortality in the first six months of life. Thus :—
    Period.Infantile Mortality per 1,000 Births. London.
    Months.
    0-33-60-66-120-12
  • Page 18
    In the two periods of Dr. Tatham's tables, 1873-77, and 1898-1902, the mean summer temperature stood in the relation to the mean of antecedent years as follows :—
    Year.Temperature above or below the mean in deg. F.Tear.Temperature above or below the mean in deg. F.
  • Page 18
    Again, in the three periods of Dr. Sykes' table the summer temperatures in relation to the mear were as follows :—
    Year.Temperature above or below mean, deg. F.Infantile mortality, Diarrhoeal diseases.Year.Temperature above or below mean, deg. F.Infantile mortality, Diarrhoeal diseases.Year.Temperature above or below in mean, deg. F.Infantile mortality, Diarrhoeal diseases.
  • Page 18
    The following table enables the infant mortality, inclusive of and exclusive of deaths from diarrhoeal diseases, in Dr. Sykes' periods to be compared :—
    Period.Infant Mortality.Infant Mortality, less Diarrheal Diseases.
    MonthsMonths.
    0-33-66-120-120-33-66-120-12
  • Page 18
    If the period 1888-92 be compared with that of 1898-01, and deaths from premature births be deducted from both, the following figures are obtained for the ages 0-3 months :—
    Period.Infant mortality.Less deaths from Premature Birth.Less deaths from Premature Birth and Diarrhoeal diseases.
  • Page 19
    Diarrhœa and epidemic enteritis.
    Nature of feeding.Number of Infants.Deaths per 1,000.
  • Page 19
    Deaths at "all Ages" from certain Diseases and Groups of Diseases. The following table from the Annual Summary of the Registrar-General shows the diminution or excess in the year 1905 under certain of the more important headings in the list of causes of death, as compared with the annual average deaths of the preceding 10 years, corrected for increase of population.
    Cause of death.Diminution in 1905.Excess in 1905.
  • Page 20
    Death-rates per 100,000 living from all causes, and from various causes, in each of the various sanitary areas, 1905 (365 days).
    Sanitary area.Measles.Rheumatic Fever.Carcinoma.Sarcoma.Cancer.Tabes Mesenteric*.Tubercular Meningitis.Phthisis.Other Tube rcular and Scrofulous Diseases.Pneumonia.Other Respiratory Diseases.All other Causes.All Causes.
  • Page 20
    The death-rates in successive periods have been as follows
    Period.Death rate from principal epidemic diseases.Period.Death rate from principal epidemic diseases.
  • Page 21
    Principal epidemic diseases—Death-rates per 1,000 persons living.
    Towns.1895-1904.1905.Towns.1895-1904.1905.
  • Page 21
    Six principal epidemic diseases—Death-rates per 1,000 persons living.
    Towns.1895-1904.1905.Towns.1895-1904.1905.
  • Page 21
    The following table shows the deaths from the principal epidemic diseases and the death-rates per 1,000 persons living in each of the sanitary areas of the County in 1905, and the period 1901-4:—
    Sanitary area.Deaths in 1905.Death-rate per 1,000 persons living.
    1901-4.1905.
  • Page 22
    The death-rates from smallpox in successive periods have been as follows:—
    Period.Smallpox death-rate per 1,000 persons living.Period.Smallpox death-rate per 1,000 persons living.
  • Page 22
    During the complete years in which the notification of infectious diseases has been obligatory, the number of cases of smallpox (uncorrected for errors in diagnosis) notified to the medical officers of health in the various sanitary districts comprised in the administrative county has been as follows—
    Year.Cases notified.Case-rate per 1,000 persons living.
  • Page 22
    Smallpox death-rates per 1,000 persons living.
    Towns.1895-1904.1905.Towns.1895-1904.1905.
  • Page 22
    Smallpox death-rates per 1,000 persons living.
    Towns.1895-1904.1905.Towns.1895-1904.1905.
  • Page 23
    The following table shows the smallpox cases notified, deaths, case-rates, and death-rates in the year 1905, the case-rates in the decennium 1895-1904, and the death-rates in the period 1901-4 in the several sanitary areas of the Administrative County—
    Sanitary area.Notified Cases, 1905.Case-rate per 1,000 persons living.Deaths, 1905.Death-rate per 1,000 persons living.
    1895-1904.1905.1901-1904.1905.
  • Page 23
    The following table shows the number of cases of smallpox notified in London in each week of the year 1905— Smallpox—Notified cases, 1905.
    Week ended.No. of cases notified.Week ended.No. of cases notified.Week ended.No. of cases notified.
  • Page 24
    The actual cases were thus distributed:—
    Area.4 weeks ending 28th Jan.4 weeks ending 25th Feb.5 weeks ending 1st April.4 weeks ending 29th April.4 weeks ending 27th May.5 weeks ending 1st July.4 weeks ending 29th July.Total.
  • Page 25
    The following table has been prepared from the tabular statement referred to:—
    Admissions.Deaths.
  • Page 25
    The number of cases admitted into hospital at several ages classified according to the ondition as to vaccination is as follows :—
    Age period.Vaccinated.Doubtful.Unvaccinated.
    Cases.Deaths.Cases.Deaths.Casts.Deaths.
  • Page 25
    London vaccination returns. The following table shows the proportion of children born in each year who were not finally accounted for in respect of vaccination. It will be observed that this number has, since 1898, been gradually decreasing:—
    Year.Children not Anally accounted for (including ca>es post* poned) per cent, of total births.Year.C hildren not finally accounted for (including cases postponed) per cent. of total births.
  • Page 26
    Number of certificates of conscientious objection and number of children not finally accounted for "per cent of births.
    Metropolitan Union.1893.1899.1900.1901.1902.1903.
  • Page 26
    The death rates from this disease per 1,000 persons living in 1905 and preceding periods have been as follows:—
  • Page 26
    The following table shows the death-rate from measles of children at this age in successive periods:—
    Period.Death-rate per 1,000 persons living at ages 0—5.Period.Death-rate per 1,000 persons living at ages 0—5.
  • Page 27
    The following table shows the deaths and death-rates from measles in 1905 (52 weeks) in each of the sanitary areas of the County:—
    Sanitary area.Deaths 1905.Death-rate per 1,000 persons living.
    1901-4.1905.
  • Page 27
    The following table shows the measles death-rate at age 0-5 obtaining in the several sanitary areas of the County of London during the year 1905. It will be observed that Southwark (5.93) and the City of London (0.78) had, as at " all ages," the highest and lowest death-rates respectively :—
    Sanitary area.Death-rate per 1,000 persons living aged 0-5.Sanitary area.Death-rate per 1,000 persons living aged 0-5.Sanitary area.Death-rate per 1,000 persons living aged 0-5.
  • Page 28
    Measles and overcrowding, 1901-5.
    Proportion of overcrowding in groups of sanitary areas.Measles death-rate at ages 0—5 years 1901-5, per 1,000 living.
  • Page 28
    Measles—Death-rates 'per 1,000 persons living.
    Towns.1895-1904.1905.Towns.1895-1901.1905.
  • Page 28
    Measles—Death-rates per 1,000 persons living.
    Towns.1895-1904.1905.Towns.1895-1904.1905.
  • Page 28
    Measles (365 days).
    Age -period.0—1—2—3—4—Under 5.5—10—15 and upwards.All ages.
  • Page 29
    Continued from previous page...
    Age-poriod.0—1—2_3—4—Under 5.o—10—15 and upwards.All ages.
  • Page 29
    The annual reports of medical officers of health give but little information as to the age of attack of cases coming under their cognisance, but the following figures are supplied by the reports of Dr. Reginald Dudfield, of Paddington, and of Dr. Newman, of Finsbury :—
  • Page 29
    Dr. Reginald Dudfield groups the Paddington cases at the older age, thus—
  • Page 29
    Measles—Aberdeen.
    Age.Number of cases.Attack-rate per 1,000 population at each age.Number of deaths.Fatality. Per cent.Age.Number of cases.Attack-rate per 1,000 population at each age.Number of deaths.Fatality. Per cent.
  • Page 30
    Measles—Deaths all ages 1,000.
    Years.0—1—2—3-4 —5—10- 115—20 +
  • Page 31
    Paddington—Measles.
  • Page 31
    The London rates for 1905 and preceding periods are shown in the following table:—
    Period.Death-rate per 1,000 persons living.Case-rate per l,000 persons living.Case mortality per cent.
  • Page 32
    Scarlet fever—Death-rates per 1,000 persons living.
    Towns.1895-1004.1905.Towns.1895 -1904.1905.
  • Page 32
    Scarlet fever—Death-rates per 1,000 persons living.
    Towns.1895-1904.1905.Towns.1895-1904.1905.
  • Page 32
    The following table shows the scarlet fever case3, deaths, case-rates, and death-rates for the year 1905, the case-rates for the decennium 1895-1904, and the death-rates for the period 1901-4 in the several sanitary districts of the County:—
    Sanitary area.Cases, 1905.Case-rate per 1,000 persons living.Deaths, 1905.Death-rate per 1,000 persons living.
    1895-1904.1905.1901-1904.1905.
  • Page 33
    Dr. Reginald Dudfield shows the number of cases occurring in Paddington and Dr. Bond the number of cases occurring in Holborn to be distributed as follows:—
    Houses withOne case each.Two cases each.Three cases each.Four cases each.
  • Page 33
    Scarlet fever—Notified cases, 1905.
    Period.Notified cases—Ages.Increase ( + ) or decrease ( —) per cent.
    0.33.1313 and upwards.0.33.1313 and upwards.
  • Page 34
    Scarlet fever2, 1905.
    Age.period.Males.Females.
    Notified Cases.Deaths.Case mortality per cent.Bates per 100,000 living.Notified Cases.Deaths.Case mortality per cent.Bates per 100,000 living.
    Cases.Deaths.Cases.Deaths.
  • Page 35
    The diphtheria case.rates, death.rates, and case mortality in 1905, and preceding periods, are shown in the following table:—
    Period.Death.rate per 1,000 persons living.Case.rate per 1,000 persons living.Case mortality per cent.
  • Page 35
    Diphtheria—Death.rates per 1,000 persons living.
    Towns.1895-1904.1905.Towns.1895-1904.1905.
  • Page 35
    Diphtheria—Death.rates per 1,000 persons living.
    Towns.1895-1904.1905.Towns.1895-1904.1905.
  • Page 36
    The following table shows the diphtheria cases, deaths, case-rates, and death-rates for the year 1905, the case-rates for the decennium 1895-1904, and the death-rates for the period 1901-4, in the several sanitary districts:—
    Sanitary area.Notified Oases, 1905.Case-rate per 1,000 persons living.Deaths, 1905.Death-rate per 1,000 persons living.
    1895-1904.1905.1901-4.1905.
  • Page 36
    Diphtheria. Comparative case rates (London taken as 100).
    Sanitary area.Comparative case rates (London case rates taken as 100).
    1891.1892.1893.1894.1895.1896.1897.1898.1899.1900.1901.1902.1903.1904.1905.
  • Page 37
    Continued from previous page...
    Sanitary area.Comparative case rates (London case rates taken as 100).
    1891.1892.1893.1894.1895.1896.1897.1898.1899.1900.1901.1902.1903.1904.1905.
  • Page 38
    Diphtheria—Notified cases, 1904.
    Period.Notified cases—Ages.Increase or decrease per cent.
    0—3.3—13.13 and upwards.0—3.3—13.13 and upwards.
  • Page 38
    The following figures relate to the same places as those mentioned in connection with scarlet fever:—
    Period.London.Holiday resorts.
    Cases. "All Ages."Increase or decrease per cent.Cases. "All Age*."Increase or decrease per cent.
  • Page 38
    Diphtheria, 1905.
    Age.period.Males.Females.
    Notified Cases.Deaths.Case mortality per cent.Rates per 100,000 living.Notified Cases.Deaths.Case mortality per cent.Rates per 100,000 living.
    Cases.Deaths.Cases.Deaths.
  • Page 39
    The death-rates from this disease in 1905 and preceding periods have been as follows—
    Period.Death rate per 1,000 persons living.Period.Death rate per 1,000 persons living.
  • Page 39
    The steady fall of the death-rate during these periods is conspicuous:-
    Period.Death-rate.Period.Death-rate.
  • Page 39
    Whooping-cough—Death-rates per 1,000 persons living.
    Towns.1895-1904.1905.Towns.1895-1904.1905.
  • Page 39
    Whooping-cough—Death-rates per 1,000 persons living.
    Towns.1895-1904.1905.Towns.1895-1904.1905.
  • Page 40
    The following table shows the whooping-cough deaths and death-rates for the year 1905 and the death-rates for the period 1901-4 in the several metropolitan sanitary districts:—
    Sanitary area.Deaths, 1905.Death rate per 1,000 persons living.
    1901-4.1905.
  • Page 40
    W hooping-cough—Aberdeen, 1891-1900.
    Ages.No. of cases.Attack rate per 1,000 of population at each year of age.No. of deaths.Fatality per cent.Ages.No. of cases.Attack rate per 1,000 of population at each year, of age.No. of deaths.Fatality per cent
  • Page 41
    Paddington—Whooping-cough, number of cases per house, 1905.
    Houses with 1 case each,2 cases each,3 cases each,4 cases each.5 cases each.6 cases each,7 cases each.
  • Page 41
    The death-rates trom this disease in successive periods have been as follows:—
    Period.Death-rate per 1,000 persons living.
  • Page 42
    The case-rate and death-rates per 1,000 persons and the case-mortality per cent. in 1905 and preceding periods were as follows:—
    Period.Death-rate per 1,000 persons living.Case-rate per 1,000 persons living.Case mortality per cent.
  • Page 42
    The following table shows the enteric fever cases, deaths, case-rates, and death-rates for the year 1905, the case-rates for the decennium 1895-1904, and the death-rates for the period 1901-4 in the several sanitary districts—
    Sanitary area.Notified Cases, 1905.Case-rate per 1,000 persons living.Deaths, 1905.Death-rate per 1,000 persons living.
    1895-1904.1905.1901-4.1905.
  • Page 43
    Enteric fever 1905.
    Age-period.Males.Females.
    Notified Oases.Deaths.Case mortality per cent.Bates per 100,000 living.Notified Cases.Deaths.Case mortality per cent.Eates per 100,000 living.
    Cases.Deaths.Cases.Deaths.
  • Page 44
    The Widal test for the diagnosis of enteric fever was employed at the cost of sanitary authorities in a number of districts, the results being shown in annual reports, as follows :—
    No. of examinations.No. of positive results.No. of examinations.No. of positive results.
  • Page 44
    Diarrhœa. The deaths in the administrative county of London attributed to epidemic diarrhcea and infective enteritis numbered 2,125 in 1905 (52 weeks), while 1,285 deaths were attributed to diarrhoea and dysentery. The age constitution of these deaths was as follows
    DiseaseUnder 1 year.1-5.5-20.20-40.40-60.60-80.80 and upwardsAll ages.
  • Page 44
    Diarrhea—Death rates per 1,000 persons living.
    Towns.1895-1904.1905.Towns.1835-1964.1905.
  • Page 45
    The deaths and death-rates from diarrhoea for the year 1905, and the death-rates for the period 1901—4 in each of the sanitary areas in London, are shown in the following table :—
    Sanitary area.Deaths, 1905.Death-rate per 1,000 persons living.
    1901-4.1905.
  • Page 46
    The age distribution of these deaths was as follows—
    Under 1 Tear.1-5.5-20.20-40.40-60.00-80.80 and upwards.All a gen.
  • Page 46
    The number of cases notified and the number of deaths registered from this disease since 1890 have been as follows— Erysipelas.
    Year.Notified Cases.Case-rate per 1,000 persons living.Deaths. 1Death-rate1 per 1,0(i0 persons living.
  • Page 46
    The number of cases of erysipelas notified and the case-rate for the year 1905, together with the case-rate in the decennium 1895-1904, in the several sanitary areas are shown in the following table—
    Sanitary area.Cases 1905.Case-rate per 1,000 persons living.
    1895-1904.1905.
  • Page 47
    The following table shows the age and sex distribution of the notified cases of erysipelas in 1905—
    Age.All ages.0-5-10-15-20-25-35-45-55-65-75 and upwards.
  • Page 47
    Ihe number ol cases notified and the number ol deaths registered from this cause since the year 1890 have been as follows— Puerperal fever.
    Year.Notified cases.Deaths.2
  • Page 47
    If these cases and deaths are considered in relation to the total population and total births the following rates are obtained—
    Year.Case-rate per 1,000 living.Case-rate per 1,000 births.Death-rate' per 1,000 living.Death-rate2 per 1,000 births.
  • Page 47
    If the death-rates from the disease per 1,000 births be shown in three quinquennial periods, viz. 1891-5, 1896-1900, and 1901-5, it will be seen that the death-rate has, during this period, declined.
    Period.Death rate per 1,000 births.
  • Page 48
    The deaths from the deseases since 1889 have been as follows:-
    Year.Deaths1 from Influenza.Deaths' from Bronchitis.Deaths' from Pneumonia.
  • Page 48
    The distribution of deaths from influenza throughout the year for each of the years 1890 to 1905 is shown in the following table c— Influenza—Deaths registered in London in four-weekly periods, 1890-1905.
    Number of weeks.1890.1891.1892.1893.1894.1895.1896.1897.1898.1899.1900.1901.1902.1903.1904.1905.
  • Page 48
    Phthisis. The deaths from phthisis in the Administrative County of London during 1905 (52 weeks) numbered 6,622, as compared with 7,526 in the year 1904. The death-rates from this disease in successive periods have been as follows :—
    Period.Death rate per 1,000 persons living.Period.Death rate per 1,000 persons living.
  • Page 49
    Crude and corrected Phthisis death-rates per 1.000 persons living, in the County of London and the several sanitary districts.
    Sanitary area.Standard death rate.1Factor for correction fur age and sex distri-tribution.Crude death-rate.Corrected death-rate.Comparative mortality figure. (London 1,000.)
    1901-4.1905.1901-4.1905.1901-4.1905.
  • Page 49
    It will be seen from the foregoing table that among the several sanitary areas, both in the period 1901.4 and the year 1905 (comparing the corrected death.rates), Holborn (2.60 and 2.50 respectively) had the highest phthisis death-rate, and Hampstead (0'82 and 082 respectively) the lowest. The following table shows the number of deaths from phthisis at several age-periods in each of the sanitary areas. Phthisis (365 days).
    Age-period.0-5-10-15-20-25-35-45-55-65-75-85anc upwardsAll ages.
  • Page 50
    The conditions under which persons suffering from phthisis were housed are shown by the following figures extracted from annual reports:—
  • Page 50
    London, 1901-5. Phthisis death-rates in relation to " overcrowding" (1901 census).
    Percentage of overcrowding in each group of sanitary areas.1901-5 crude phthisis death-rate per 1,000 persons living.Standard death-rate.Factor for age and sex correction.Corrected death-rate per 1,000 persons living.Corrected death-rate (London, 1,000).
  • Page 51
    The death-rates from this disease in successive periods have been as follows:—
    Period.Kate per 1,000 persons living:.Period.Kate per 1,000 persons living.
  • Page 51
    Crude and corrected death-rates per 1,000 persons living in the County of London and the several sanitary districts.
    Sanitary areas.Standard death-rate.Factor for correction for age and sex distribution.Crude death-rate.Corrected death-rate.Comparative mortality figure (London 1,000).
    1901-41905.1901-4.1905.1901-4.1905.
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    The following tables (a), (b), and (c) show the deaths in each of the sanitary districts from cancer at several age-periods under three headings, viz., sarcoma, carcinoma, and cancer, deaths classified under the last-named term being those for which the information given on the certificate of death was insufficient to further distinguish them for purposes of classification. (a) Deaths1 from Sarcoma.
    Age-period.0-5-10-15-20-25-35-45-55-65-75-85 and upwardsAll ages.
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    (b) Deaths1 from Carcinoma.
    Age-period.0-5-| 10-| 15-20-25-35—45-55-65-75-85 and up-wardsAll ages.
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    (c) Deaths1 from Cancer (otherwise undistinguished).
    Age-period.0-5-10-15-20-25-35-45-55-65-75-85 and upwardsAll ages.
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    Deaths at each age-period per 1,000 deaths at " all ages.
    Age-period.All ages.Under 35.35-45-55-65-75-85 and upwards.
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    London, 1901-5. Cancer death-rates in relation to overcrowding 2 (1901 census).
    Percentage of overcrowding in each group of sanitary areas.1901-5'crude cancer death-rate per 1,000 persons living.Standard death-rate.Factor for age and sex correction.Corrected death-rate per 1,000 persons living.Corrected death rate (London, 1,000).
  • Page 54
    The tables published in the annual summary of the Registrar-General, deduced from observations at Greenwich, under the superintendence of the Astronomer Royal, show that the mean temperature of the air in 1905 was 49.9 deg. Fahrenheit, or 0.8 deg. Fahrenheit above the average of the preceding 50 years. The rainfall during the year amounted to 23.03 inches, a decrease of 1.50 inches on the average of the preceding 50 years. The temperature and rainfall in each month of the year 1905 are shown in the following table:—
    Month.Temperature of the air.Departure of mean monthly temperature from average of 50 vears, 1855-1904.Bain.
    Absolute maximum.Absolute minimum.Mean for month.Number of days it fell.Amount collected.
  • Page 55
    PART II. Dairies, Cowsheds and Milkshops. The County Council received during the year 257 applications for cowhouse licences, of which 255 were granted. The number of applications for licences received during the last twelve years and the number granted are shown in the following table. It will be seen that the number of these premises in London is continually decreasing.
    No of applications received.No. of premises for which licences were granted.
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    Cowsheds.
    Sanitary area.Number of cowshed premises.Number of Inspections 1905.Number of notices 1905.Number of prosecutions 1905.
    On register at end of 1904.Added in 1905.Removed in 1905.On register at end of 1905.
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    Examination of cows for tubercular disease of the udder—Summary of Mr. Shaw's reports for the year 1905.
    Details of Examination.1st period, 20th Dec. (1904)—10th April (1905).2nd period, 11th April— 5th July, (1905).3rd period, 6th July— 7th October (1905).4th period, 8th October— 14th Dec. (1905).
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    Offensive Businesses. In the year 1905 the County Council received 322 applications for licences for slaughter-houses and granted 318. The following table shows the number of applications received and the number of slaughter-houses licensed in recent years :—
    Year.No. of applications received.No. of premises for which licences were granted.Tear.No. of applications received.No. of premises for which licences were granted.
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    Continued from previous page...
    Sanitary area.Number of Slaughter-houses.No. of Inspections 1905.No. of notices 1905.
    On Register at end of 1904.Removed in 1905.On Register at end of 1905.
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    The number of authorised offensive businesses other than that of slaughterer of cattle in London, except those under the jurisdiction of the City Corporation, was at the end of the year as follows :—
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    The districts in which these premises are situated, the number of premises, and, for some districts, the number of inspections, are shown in the following table:— Premises used for scheduled offensive businesses.
    Sanitary area.No. on Register at end of 1905.No. of Inspections, 1905.Sanitary area.No. on Register at end of 1905.No. of Inspections, 1905.
  • Page 59
    to £219 16s. The following table shows the action taken by sanitary authorities for the abatement of smoke nuisance, so far as reference to this subject is made in the annual reports of medical officers of health.
    Sanitary Area.Observations and inspections.Nuisances and complaints.Notices.Summonses.
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    The following tabular statement shows the proceedings of district authorities concerning houses represented in 1905 as unfit for human habitation, and in respect of which the County Council has received copies of representations:—
    Sanitary areas.Total number of bouses concerning which the Council has received information that representations have been made from the 1/1/05 to the 31/12/05.Number of houses dealt with by owners, closing crders not obtained.Number of houses for which closing orders were granted.Number of houses for whioh closing orders were refused.Number of houses represented but subsequently dealt with under Public Health (London) Act, 1891.
    Still closed.Demolished.Improved, or being improved.Total.Still closed.Demolished.Improved.Total.
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    Death-rates of persons resident in the County Council's dwellings.
    Cause of death.Death rate per 1000 living.
    Council's dwellings.London.
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    Houses let in lodgings. The following table shows the number of houses let in lodgings on the registers of the several sanitary authorities, and for most districts the number of inspections of such houses. The total number of houses on the register at the end of 1905 in London was 22,284.
    Sanitary area.Number of places.No. of Inspections, 1905.Notices, 1905.Prosecutions, 1905. †
    On register at end of 1904.Added in 1905.Removed in 1905.On register at end of 1905.(a) For overcrowding.(b) For other conditions.Total.
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    A substantial beginning of the use of this Act has been made by the majority of sanitary authorities in 1905, the annual reports for that year showing the numbers of premises and rooms cleansed to be as follows:—
    Premises.Booms.Premises.Rooms
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    Continued from previous page...
    Year.No. of houses on register.Authorised number of lodgers.No. of day visits by inspectors.No. of night visits.No. of prosecutions.No. of convictions.Penalties and costs.No. of deaths. †No. of cases of infectious disease.
    £s.d.
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    The following table shows the total number of licensed and unlicensed common lodging houses, and the authorised accommodation for the different classes of lodgers in the several sanitary areas of London, other than that of the City, on 31st December, 1905.
    Sanitary area.No. of houses.Authorised accommodation.
    Men.Women.Couples.Total.
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    Vacant accommodation in common lodging houses on night of 17th February, 1905.
    Sanitary Area.Vacant Accommodation for
    Men.Women.Married Couples.Total Persons.
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    Sanitary District.Vacant Accommodation for
    Men.Women.Married Couples.Total persons.
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    authorised accommodation is made use of. The results of these censuses, are shown in the following table:—
    Date of Census.Authorised Accommodation.Number of Persons occupying Beds.
    Men.WomenMarried Couples.Total Persons.Men.WomenMarried Couples.ChildrenTotal Persons.
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    Table I. Common lodging houses. Death-rates per 1,000 males living at five age periods from certain causes in London (1904) and in licensed common lodging houses 1904 and 1905.
    Cause of Death.Age 26 to 35.Age 36 to 45.Age 45 to 55.Age 55 to 65.Age C5 and upwards.
    London, 1904.C.L.H 1904.C.L.H. 1905.London, 1904.C.L.H. 1904.C.L.H. 1905.London, 1904.C.L. H 1904.C. L. H 1906.London, 1904.C.L.H. 1904.C.L.H 1905.London, 1904.C.L.H. 1904.C.L.H. 1905.
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    Table II. Common lodging houses. Table showing the number of deaths of males at five age periods from certain causes per 1,000 deaths from all causes in London (1904) and licensed common lodging houses 1904 and 1905.
    Cause of death.Age 25 to 35.Age 35 to 45.Age 45 to 55.Age 55 to 65.Age 65 and upwards.
    London, 1904.C.L.H. 1904.C.L.H. 1905.London, 1904.C.L.H. 1904.C.L.H. 1905.London, 1904.C.L.H. 1904.C.L.H. 1905;London, 1904;C.L.H. 1904.C.L.H. 1906.London, 1904.C.L.H. 1904.C.L.H. 1905.
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    Applications under the Revenue Act.
    Sanitary area.No. of houses for which applications were received during 1905.No. of tenements comprised therein.No. of Tenements for which certificates were
    Granted.Refused.Deferred.
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    In a number of districts underground rooms were found to be illegally occupied. The following table is compiled from information contained in the annual reports of medical officers of health —
    Sanitary area.No. of cases in which illegal occupation was dealt with.No. of rooms closed.Sanitary area.No. of cases in which illegal occupation was dealt with.No. of rooms closed.
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    Overcrowding.
    Sanitary area.No. of dwelling-rooms overcrowded.No. of cases remodied.No. of prosecutions.
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    TABLE SHOWING PROCEEDINGS OF LONDON SANITARY
    Premises, Particulars, Class, &cPaddington.Kensington.Hammersmith.FulhamChelsea.City of Westminster.St. Marylebone.Hampstead.St. Pancras.Islington.Stoke Newington.
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    AUTHORITIES UNDER THE FACTORY AND WORKSHOP ACT.
    Hackney.Holborn.Finabury.City of LondonShoreditch.Bethnal-green.Stepney.Poplar.Southwark.Bermondsey.Lambeth.Battersea.Wandsworth.Caraberwel).Deptford;Greenwich.Lewisham.Woolwich.
  • Page 79
    Ice cream premises.
    Sanitary area.Number of places.No. of inspections 1905.No. of notices 1905.No. of prosecutions under Act, 1905.
    On register at end of 1904.Added in 1905.Removed in 1905.On register at end of 1905.
  • Page 80
    The extent to which mortuaries were used during 1905 is shown in the following table, in which the number of bodies accommodated is stated—
    Sanitary Area.Total number of bodies received.Number of infectious bodies received.Sanitary Area.Total number of bodies received.Number of infectious bodies received.
  • Page 83
    Cleansing of Persons Act, 1897.
  • Page 84
    Continued from previous page...
    Borough.Provision made.If at disinfection station.If any special provision for children.If by Borough Council.Extent to which provision has been utilised.
  • Page 84
    London Water Supply. At the end of 1904 the subsidence reservoirs which had been constructed at Staines came into use, and in 1905 the report of the Water Examiner appointed under the Metropolitan Water Act shows that the capacity of the reservoirs for the several districts of the Metropolitan Water Board and of the filters was as follows:—
    Water area.Capacity of subsidence reservoirs.Number of days' supply.Filter area.Area per million gallons of average daily supply.Monthly rate of filtration.
    Monthly average.Maximum average.
    gallons.acres.acres.gallons.gallons.
  • Page 87
    The following table shows the estimated population on the 6th April, 100"), and the amount of excess of contribution over grant, or of grant over contribution in respect of each district for the year ended 31st March, 1906—
    Sanitary area.Estimated population, 6th April, 1905.Equalisation charge, being excess of contribution over grant.Net grant, being excess of grant over contribution.
    £s.d.£.s.d.
  • Page 88
    Of the 98 cases of puerperal fever that occurred in the practices of midwives information in 93 instances as to the date of the rise of temperature was ascertained, and the following table shows the day of the puerperium on which the rise of temperature was noted.
    Day of Rise of Temperature above 100-4°.No. of cases of puerperal fever in which rise of temperature occurred.
    Recoverv cases.Fatal cases.Total.
  • Page 89
    During the year 1905, 1,113 notices were received and the following were the reasons assigned:—
    Cases.
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    Medical Officers of Health of London Sanitary Areas, in 1905.
    Sanitary area.Medical officer of health.
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    Table I. London. (A.) Measles—Death rates per 1,000,000 living.
    Period.All ages.0—1—2—3—4—5—10—15—20 and upwards
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    Table II. London. (A) Whooping Cough—Death rate per 1,000,000 living.
    Period.All ages0—1 1_2—3—4—5—J 10—15—20 and upwards
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    Table III. London. (A) Scarlet fever—Death rates per 1,000,000 living.
    Period.All ages.0—1—2—3—4—5—10—15—20 and upwards
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    Table IV. London. (A) Diphtheria and Croup—Death rates per 1,000,000 living.
    Period.All ages.0-1—2—3—4—5—10—15—20 and upwards
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    London. Diphtheria.
    Year.Death rate per 100.000 persons living. Diphtheria and Croup.)Death rate at age 3-15 ("all ages " deathCase rate per 100,000 persons livingCase rate at age 3-15("all ages " case rate taken as 100).Case-mortality per cent.Case mortality at age 3-15 ("all ages" case mortality taken as 100.)
    "All ages."Age 3-15.rate taken as 100)."All ages."Age 3-15.'• All ages."Age 3-15.
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    The following is a return of candidates medically examined from 1st January, 1905, to 31st March, 1906:—
    Candidates.Number who applied for examination and re-re-examination .Number outstanding from 1904.Number examined and re-examined.Passed.Rejected.Withdrawn, etc.Outstanding on the 31st March, 1906.
    Unconditionally.Subject to Oculist's Report.Subject to Aurist's or Surgeon's Report.Subject to Dentist's Report.Subject to Successful Vaocination.Subject to re-examination before termination of Probationary Period.
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    Table I.
    AgeNumbers sent up for examination— Totals.Fit;Referred,Rejected.
    Vaccinated.Unvac-cinated.Vision.Dental.Throats. Tonsils.Hearts.Ears.Dirt.Miscellaneous.Totally.As teachers.
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    Table I.—continued.
    Age.Numbers sent up for examination—-Totals.Fit.Referred.Rejected.
    Vaccinated.Unvac- cinated.Vision.Dental.Throats. Tonsils.Hearts.Bars.Dirt.Miscellaneous.Totally.As teachers.
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    Table II. Pupil Teachers.
    Age.Sent up for examination.Fit.Unfit-Vision.Dentist.Throat.Heart.Ears.Dirt.Miscellaneous.Rejected
    Vaccinated.Not Vaccinated.
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    Table III.
    Age.Passed.Rejected.
    Cripple.Blind.Deaf.Cripple.Blind.Deaf.
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    VISITS TO SCHOOLS. The average number of visits to schools made each week for examinations and inspections by officers of the Public Health Department (Education) is as follows:—
    Special Schools.Ordinary Schools.Domiciliary and Special enquiries.
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    Schools examined in regular medical inspection (three months, January to March, 1906).
    Number of Departments.Numbers on Roll.Children Examined.
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    Routine medical examinations of scholars in the three months.
    Vision, Urgent cases.Hearing.Throat and Nose.Speech.Dirt.Physically Defective.Mentally Defective.Other objects.
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    In addition, observations were made of the conditions of the buildings and surroundings, and the following special conditions noted:—
    Departments reported on.Nature of Special Reports.Reports on matters of—
    Lighting.VentilationHeating.Sanitation.Furniture.
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    By setting out the table in the corresponding proportions for reports on 1,000 departments the conditions of the provided and non-provided schools is rendered more comparable.
    Nature of Reports.Reports on matters of—
    Lighting.Ventilation.Heating.Sanitation.Furniture.
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    9834 Boys.
    Average heights in centimetres.Average weights in kilograms.
    Age last birthday.Series A.Series B.Series C.Totals.
    Numbers.Average heights.Numbers.Average heights.Numbers.Average heights.Numbers.Average heights.Series A.Series B.Series C.Totals.
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    8852 Girls.
    Average heights in centimetres.Average weights in kilograms.
    Age last birthday.Series A.Series B.Series C.Totals.
    Numbers:Average heights.Numbers.Average heights.Numbers.Average heights.Numbers.Average heights.Series A.Series B.Series C.Totals.
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    Average heights in centimetres.
    Boys.London.F. S. Boas.Bowditch.Boas.Smedley.Combe.Hasse.
    Boston.
    Age.American generally.Toronto.Chicago.Lausanne.Leipzig Gohlis.
    Non-laboring.Laboring.
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    The ten year olds in our results were distributed as follows:—
    Standards.III.III.IV.V.VI.VII.Totals
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    1347. Children of series B. Ten years old last birthday, giving standards.
    Heights centimetres.I.II.m.IV.V.VI.VII.Totals.Heights centimetres.Approximate inches.
    G.B.G.B.G.B.G.B.G.B.G.B.G.B.
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    The distribution of 4164 of the girls of series B is given at each year of age in the various standards.
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    And the average heights of these various groups are :—
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    A similar table of average heights is obtained for the boys. 4677 boys.
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    Dr. Hanson has attempted in two schools (Vallance Road and The Davenant) to make an estimate of the conditions of the teeth by a simple inspection of the mouths, and gives the following statement:—
    Ages.Children examined.Apparently healthy.At least one carious tooth.Three oarious teeth.Teeth requiring treatment.
    Conservative?Extraction ?
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    The proportions in percentages showing recognisable signs of past rickets were:
    Age.34567Very marked deformity.
    Knock-kneed.Bowed legs.
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    A more detailed analysis of these causes and the way they influence education is of interest:—
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    The extracts from the notes show how the results were tabulated.
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    Dividing the boys into three classes according to the number of hours worked weekly the following results in percentages aie obtained:—
    Hours worked weekly.Actual Number of boys.Fatigue signs.Anaemia.Severe nerve signs.Deformities.Severe heart signg.
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    Since, as will be apparent later, long hours on a Saturday and working during the mid-day interval have special dangers to health, boys working under these conditions have been left out in compiling the following table giving percentages presenting symptoms:—
    Hours worked/weekly.N umber of boys.Fatigue.Anæmia.Severe nerve signs.Deformities.Severe heart signs.
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    Continued from previous page...
    Number of boys.Anaemia.Nerve signs.Deformities.Heart signs.
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    Percentage incidence of various diseases in trades:—
    Trade.Number.Anæmia.Nervous.Deformities.Heart Disease.
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    The following table shows the result of the experiment:—
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    office for microscopical diagnosis. The number of such specimens received during the year, which represent only doubtful cases, have been:—
    Number of specimens forwarded for examination.Found to be ringworm.Found to be Favus.No fungus found.Insufficient material.
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    School closures.—The following table shows the closures during the year :—
    Department.DISEASE.
    Diphtheria.Scarlet Fever.Measles.Mumps.Whooping Cough.Chicken-pox.
    No. of classrooms closedNo. of departments closed.No. of classrooms closedNo. of departments closedNo. of j class-rooms closedNo. of departments closedNo. of class-rooms closedNo. of lepartments closedNo. of classrooms closedNo. of dpartmentsNo. of classrooms closedNo. of departments closed
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    In the case of measles, the disease for which most frequent class closure is required, the cases in infant's schools were distributed through the year as follows :—
    Month.1905.1906.
    April.May.June.July,Aug.Sept.Oct.Nov.Dec.Jan.Feb.March.
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    Disinfection and cleaning.—In no case did closure involve a longer period than two days.
    Department.Disease.
    Diphtheria.Scarlet Fever.Measles.Measles and Mumps.
    Class room.Department.Class room.Department.Class room.Department.Class room.Department.
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    Teesdale-street Council school, February, 1906.
    Department.Number on Roll.Children suffering.Children excluded.VaccinatedNot vaccinated.Percentage not vaccinated.Doubtful.
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    The following table shows the small-pox cases and deaths of children aged 5-13 years in the hospitals of the Metropolitan Asylums Board classified with regard to the conditions as to vaccination:—
    Age-Periods.Vaccinated.Unvaccinated.Doubtful.®
    Cases.Deaths.Cases.Deaths.Cases.Deaths.
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    The populations thus calculated are shown in the following table:— Population at ages 5-13, years, 1901.
    Age periods.Vaccinated.Unvaccinated.
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    These populations when applied to the cases shown in the above Table give the following rates :— Case and death rates per million living.
    Age period.Vaccinated.Unvaccinated.
    Case rate.Death rate.Case rate.Death rate.
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    Cases and death rates per million living.
    Age period.Vaccinated, including doubtful cases.Unvaccinated.
    Case rate,Death rate.Case rate.Death rate.
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    William-street class C. Diphtheria, October, November, 1905.
    Dates.Oct. 13.Nov. 9.Nov. 10.Nov. 13.Nov. 20.Nov. 22.Six months subsequently.
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    Wood-street, Woolwich. Class F. Ages 6-7 Infants. Diphtheria.
    Jan. 19.Jan. 22.Jan. 23.Jan. 24.Jan. 25.Jan. 26.Jan, 30.Six months subsequently.
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    The following figures may be of interest regarding the incidence of diphtheria in London since our bacteriological examinations began in the provided in 1903, and last year in the non-provided schools.
    Carrier cases detected.Average weekly notifications per 100,000.
    All ages.Children at school ages.Children in Provided Schools.
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    [M.O. 19A.] LONDON COUNTY COUNCIL.
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    with a view of transfer from a deaf school to a residential, or to some school of a different kind. Of the other 215 classified according to their hearing, the educational disposal was as follows:—
    Classification Educationally.Sent to Deaf Schools.Deaf and Defective for Homerton.Blind School.[Special School.Imbecile.Invalid.Elementary Schools.Otherwise disposed.
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    The educational treatment allotted to these children was as follows:—
    Invalided.Blind Schools.Deaf.Homerton.Elementary School.Various Special.
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    Causes assigned—
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    Size of Family.—The following table shows that the average normal family is five, whereas in families where mentally defective cases occur it is 7'6. These figures are, however, not final as the mothers interviewed were of all ages from 24 years onward.
    100 families of each class.No. children alive.No. M.D.No mbecile.No. with tubercular; disease.No. dead.Assigned cause of death.Still-born.Miscarriages.Total.
    Specific fevers.Convulsions teething.Tubercle.Consumptive bowels.Various causes.
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    Causes of backwardness :—
    370 Intelligent230 Dull600 Total.
    B.G.B.G.
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    Summary of inquiries made by the Council's Inspectors in 1905-6:—
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    Number of instances in which the smokeholes are constructed of:—
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    Number or instances in which nuisance appears to be caused by:—