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Tuberculosis,
There was some increase in the number of cases of pulmonary tuberculosis notified, both among
males and females, mainly in the first half of the year. The mortality is also higher than in 1917, but
this increase is largely due to the influenza epidemics. There can be little doubt that restriction of
movement of population due to the war has had some influence in raising the case rate of tuberculosis.
A suggestion that the differing age incidence of phthisis mortality in various parts of Great Britain is
to be accounted for by the existence of different types of pulmonary tuberculosis is discussed in the
section dealing with tuberculosis (p. 6), and it is pointed out that the influence exerted bv movement
of population needs to be carefully considered in this connection.
Administration.
The tuberculosis scheme of Mav, 1914, was further extended during 1918. The number of cases
treated during the year included 739 adults and 1,050 children. Two boroughs which had not completed
their dispensary schemes in 1917 did so in 1918. The arrangements made with the Invalid Children's
Aid Association were continued and the work of the Tuberculosis ('are Committees was further developed.
The scheme for London and the Home Counties for the diagnosis and treatment of venereal diseases,
inaugurated on 1st January, 1917, was continued in operation throughout 1918. Provision was made for
the inclusion of three additional hospitals, a total of 25, and three special hostels for women were added.
In all 16,372 persons (of whom 12.538 were London patients) made use of the facilities, as compared
with rather more than 12,000 in 1917. An arrangement was entered into with the National Council for
Combating Venereal Disease with a view to making more generally known the nature of the facilities
provided.
During the year a large amount of work was undertaken in connection with the preparation of
reports upon housing schemes (see p. 11). Reference is made to the work under Part I. of the Children
Act, 1908 (p. 15), under the Midwives Act (p. 15), and the Mental Deficiency Act (p. 14). The risks
of introduction of infectious diseases from abroad made it necessary to keep close watch upon common
and seamen's lodging houses and upon soldiers' rest homes (p. 17). Account of the work in the
chemical branch of the department is given on p. 18.
Population
A.—Vital Statistics.
The population of London County at the census of 3rd April. 1911, was 4,521,085, and it was
estimated by the Registrar-General to have declined to 4,518,021 in the middle of 1914. Since then
annual estimates of the civil population have been made by the Registrar-General on the basis of the
National Register of August. 1915, supplemented, during the last two vears by information collected in
connection with the rationing of food.
Since the early months of 1915 there has been little migration from England and Wales and
such growth of civil population as has occurred results from the excess of births over deaths. This
natural increase did not amount by the middle of 1918 to more than one-fifth of the number of civilians
enlisted in the meantime. London has, however, been throughout the centre of all military administration
and hence the decrease in total population by the middle of 1918 was less relatively than in England and
Wales as a whole. The Registrar-General estimates the total population at 4,430,929.
So many circumstances influenced the movements of the population to and from and in London
during the war that the annual average population deduced from data relating to a particular time of
the year must necessarily be uncertain. The frequent air raids upon London in the autumn of 1917 led
to an exodus on a large scale from certain districts ; subsequently a reaction set in, and at the present
time the total population of London, so far as may be judged from the existing demand for accommodation,
must be as great as if not greater than it was in 1914.
Bv the end of this year the distribution of population will have become more normal owing to
demobilisation and the closing of munition works. The civil populations of the Metropolitan Boroughs
in the middle of 1918, estimated by the Registrar General, are shown in Table I., page 20.
Marriages.
The marriages registered in London in 1918 numbered 42,875 as compared with 39,352 in 1917.
The marriages in the first quarter were considerably above the average, and this no doubt is associated
with the increase in enlistments during this period.
The marriage rate for 1918 is estimated at 19 as compared with 26, 19 and 17 in the years 1915-17,
and an average of 18*5 in the period 1911-14. The total number of marriages in the four war years
1915-18 exceeded those in the pre-war period 1911-14 by more than 17,000.
Births.
The births in London during 1918 numbered 70,976 as against 80,550 in 1917, and a yearly average
of 110,951 during the pre-war period 1911-14. The Registrar-General estimates the birth-rate at 16 0
per 1,000 of the total population.
The average annual number of births during the four war years 1915-18 was 88,000, a decline
of 23,000 on the pre-war average ; hence the war has resulted in the loss of about 90,000 births in London.
The percentage reduction in the number of births is found in London to be greatest in the poorest
class of population. The decline in a representative group of the poorer class populations comprising
Stepnev. Bethnal Green, Shoreditch, Finsbury and Bermondsey, amounts to 42 per cent, upon the