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50
Annual Report of the London County Council, 1913.
It will be seen from the foregoing table (comparing the corrected death-rates) that in the quinquennium
1908-12 among the several sanitary districts, Bermondsey (1.15) had the highest cancer deathrate,
and Greenwich (0.91) the lowest; in the year 1913, Greenwich (1.47) had the highest, the
lowest obtaining in Shoreditch (0.83).
In the report for the year 1909 a table was included showing the cancer death-rates in the period
1901-9 in areas presenting different degrees of overcrowding, the object being to compare the deathrates
of populations differently circumstanced in respect of "social condition." The figures for 1913
show that there is no relation between cancer mortality and social condition, whether
measured by the degree of overcrowding or by the percentage of children scheduled for compulsory
education, and in this respect the behaviour of cancer differs altogether from that of phthisis
(see page 42).
Reference may here be made to diagram (V) showing the age incidence of cancer among
populations of different nationality, and to the discussion of the diagram on page 46.
Cerebrospinal Fever.
During 1913, 92 persons were certified to be suffering from cerebro-spinal fever and 6 deaths
were attributed to this disease.

As stated in the last annual report, the larger number of deaths attributed to this cause in 1907
was probably an indirect effect of the Council making an Order requiring cases of this disease to be
notified. The requirement of notification did not become operative until the 12th of March, 1907,
and during the remainder of that year 135 cases were notified, or 50 more than in the whole of the year
1908. In 1909 there were 111 notified cases, 115 in 1910, 101 in 1911 and 105 in 1912. In February,
1912, the Council made the disease permanently notifiable.

Of the 92 cases notified, in 34 the final diagnosis confirmed the original diagnosis, in 30 the
original diagnosis was reversed, and in the remaining 28 no additional evidence was forthcoming. Of
the 34 cases verified on final diagnosis a post mortem examination was made in respect of 4
and bacteriological evidence was obtained in 8; the nature of the latter evidence was usually not fully
stated, and, as the examinations were made by different bacteriologists, there were in all probability
different standards as to what might be considered as bacteriological proof of the disease.
Anterior poliomyelitis.
The Order making the disease notifiable became operative on 1st September, 1911, and during
the remainder of that year 66 cases were notified. During 1913(53 weeks), 145 persons were certified
to be suffering from anterior poliomyelitis as compared with 132 persons in 1912 (52 weeks).

Of the 145 cases notified the diagnosis was confirmed in 61 instances. In 3 cases the original
diagnosis was reversed, and in 81 cases no further evidence was available.
(a) See footnote (c), page 6.