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53
Annual Report of the London County Council, 1910.
In 1909, 8,382 persons in London were notified under the Regulations, in 1910 the number of
persons thus notified was 6,258. The year 1909 was the first year in which the Regulations came
into operation, the 1st of January of that year being specified for this purpose in the Regulations.
The notifications of the first year may be thought of as including the total number of persons
thus suffering who received poor law medical relief in that year, and, provided duplicate notifications
were excluded, * the figures of subsequent years should include only new cases receiving poor law
medical relief. As a matter of fact, the figures of 1909 are not complete, for the reason that prior to
the Regulations the system of voluntary notification instituted in many districts had already brought
to the knowledge of the medical officers of health numerous cases of pulmonary tuberculosis, many of
which were notified by poor law medical officers, and these cases were not generally included in the
figures relating to cases occurring in poor law practices notified in 1909 under the Regulations. The
8,382 persons notified in London in 1909 must not, therefore, be regarded as more than a proportion
of the total cases occurring in poor law practices in that year, but the 6,258 cases notified in 1910
give a number more nearly approximating to the total number of new cases in these practices, a number
which may be thought of in connection with the number of deaths—viz., 2,191, occurring in workhouse
establishments in that year. The experience of further years is obviously needed for more
precise indication of the proportion which cases bear to deaths in this class of the population.
During 1910 nineteen of the London medical officers of health were good enough to favour me
with lists of cases occurring in poor law practices and notified to them. I am thus able to show in
total the number of notification certificates received in the districts of Kensington, Hammersmith, Chelsea,
St. Marylebone, Hampstead, Islington, Stoke Newington, Hackney, Finsbury, Shoreditch, Bethnal
Green, Stapney, Poplar, Southwark, Bermondsey, Battersea, Camberwell, Lewisham, and Woolwich.
These notifications numbered 7,523.

The number of voluntary notifications in 1908 was 3,166, in 1909 1,715, and in 1910 2,178.
The fall in 1909 was due to the issue of the Regulations leading to notification under tbem of cases
which would before have appeared as voluntary notifications. It is interesting to note that the
system of voluntary notification has led to increase in 1910 upon the number of cases notified in 1909.
The authorities of some of the hospitals (Brompton, Mount Vernon and Middlesex) have communicated
to the county medical officer particulars of some of the cases of phthisis attending
their institutions, for distribution to the medical officers of health, and the age distribution of 630
patients is thus obtainable.

Comparison of the above with the age distribution of cases in poor law practices shows that
among males the greatest number of cases in these practices occurred at the age period 35-45,
but in hospital practice at the age 25-35. In the case of females, the greatest number of cases occurred
at the age 25-35 in b(\th classes of patients. The highest death-rate in the general population
among males is at the age period 45-55, and among females at the age 35-45.
The age distribution of cases occurring in the common lodging-house population is necessarily
in large degree governed by the special age distribution of that population. Enquiry has been made
with regard to 201 persons notified under the Order, and giving addresses at common lodging-houses
licensed by the Council—viz., 184 males and 17 females. The age distribution of 199 of these
cases was—
0— 5— 10— 15— 20— 25— 35— 45— 55— 65 +
— — — 2 4 32 56 60 34 11