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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 1919

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

Published
1920
Pages
170
Tables
82

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82 tables in this report

  • Page 4
    The distribution of deaths by ages in 1919 and the five preceding years is shown in the following table:—
    Year.0—1—2—5—10—15—20—25—35—45—55—65 +All ages.
  • Page 4
    The death-rate among infants under one year of age was 85 per 1,000 births, a rate below any hitherto recorded in London, the lowest rate previously being 91 per 1,000 births in 1912. The quarterly infant mortality for the past nine years is shown in the following table.
    1911.1912.1913.1914.1915.1916.1917.1918.1919.
  • Page 6
    The following table has been prepared to enable comparison to be made of the exceptional figures for 1919 with other recent years.
    Disease.1911.1912.1913.1914.1915.1916.1917.1918.1919.
  • Page 6
    The following tabular statement shows the presumed origin of the disease and other particulars concerning the 10 cases under review.
    Probable origin.Initials of case, age, and sex.Address.Dates ofRemarks.
    Rash.Removal to hospital.
  • Page 8
    Continued from previous page...
    Probable origin.Initials of case, age, and sex.Address.Dates ofRemarks.
    Rash.Removal to hospital.
  • Page 21
    The following is an analysis of the cases notified in London in 1919 (53 weeks).
    Form of tuberculosis notified.SexNotifications on Form A. (Total of primary notifications received in London boroughs, other than elementary school cases, infra).
    0—1—5—10—15—20—25—35 —45 —55—65 +Age not statedTotal.
  • Page 26
    The age distribution was as follows :—
    Age.Under 33—5,5—10.10—20.20—30.30-40.40—50.50—60.Over 60.Total.
  • Page 27
    There was a slight increase in the incidence of Poliomyelitis and Polioencephalitis during 1919 The following table shows the number of cases notified each year since 1911.
    Year.1911, from 1st Sept.1912.1913.1914.1915.1916.1917.1918.1919.
  • Page 27
    The monthly distribution of confirmed cases during 1919 was as follows :—
    MonthJan.Feb.Mar.AprilMay.June.July.Aug.Sept.Oct.Nov.Dec.
  • Page 27
    The subjoined table shows the age incidence:—
    AgeUnder 33—5.5—10.10—20.20—30.30—40.40—50.50—60.Over 60.
  • Page 27
    The distribution of cases between the two sexes showed little variation. the age incidence set out in monthly distribution is presented in the following table:—
    Jan.Feb.Mar.April.MayJuneJulyAug.Sep.Oct.Nov.Dec.Total
  • Page 33
    Sanitary Staffs. The subjoined table shows the number of sanitary officers and health visitors employed by the sanitary authorities in the Administrative County of London:—
    Sanitary area.Sanitary inspectors.
    Male.Female.Health visitors.
    Whole time.†Part time.Whole time.†Part time.
  • Page 36
    During the year 550 cases were medically examined and classed as follows:—
    Type.Male.Female.Total.Type.Male.Female.Total.
  • Page 36
    The frequencies of the chief types are set out in the accompanying table; although these types form a convenient classification they do not necessarily express actual causes of the deficiency:—
    Type.Idiot.Imbecile.Feebleminded.
  • Page 36
    Cases deemed defective within the meaning of the Mental Deficiency Act, 1913.
    Chronological age.Mental age.Total.
    1.2.3.4.5.6.7.8.9.10.11.12.15.Adult.
  • Page 37
    Cases examined under the Elementary Education (Defective and Epileptic Children) Act.
    Chronological age.Unfit to derive benefit in a special school.Total.Capable of deriving benefit in a special school.Total.
    Mental age.Mental age.
    1.2.3.4.5.6.7.8.9.10.3.4.5.6.7.8.9.10.11.12.
  • Page 37
    Children examined under the Education Acts but deemed suitable for further trial in an elementary school.
    Chronological age.Mental age.
    3.4.5.6.7.8.9.10.11.12.Total.
  • Page 39
    With a view to ascertaining the relationship between the parental age and the nature of the defect, the ages of the parents at the date of the birth of the defective was extracted from the records of those cases in which these dates had been ascertained with any probability of accuracy. The average results were as follows:—
    Type.No. observed.Father's age.Mother's age.
  • Page 40
    The following table shows the information obtained under ( b ) and ( c ):—
    Condition of child.Total cases.Period of gestation.
    Full term.8 months.7 months.6 months or less.Not stated.
  • Page 44
    The following table indicates the number of foster-mothers and nurse-infants 1912-1919.
    1913.1914.1915.1916.1917.1918.1919.
  • Page 45
    The following table shows the extent to which the facilities have been utilised by London patients during the three years the scheme has been in operation. The number of beds available for the use of in-patients is at present 211.
    Year.1917.1918.1919.
  • Page 46
    In the following table will be seen the number of houses, the authorised number of lodgers, the number of convictions, with the penalties inflicted, and other particulars during each year since the outbreak of war:—
    Year.No. of houses licensed.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 cases of infectious disease.
    £s.d
  • Page 46
    In the following table will be seen the number of houses, the authorised number of lodgers, the number of convictions with the penalties inflicted, and other particulars during each year since these houses were licensed by the Council:—
    Year.No. of licensed houses.Authorised number of lodgers.No. of day visits.No. of night visits.No. of prosecutions.No. of convictions.Penalties and costs.No. of cases of infectious diseases.
    £s.d.
  • Page 50
    TABLE II. COUNTY OF LONDON. Statistics of the administrative work carried out during the year 1919.
    Cowsheds.Slaughterhouses.Offensive TradesSmoke nuisances.Underground rooms.Overcrowding.Houses let in lodgings.Common lodging houses.Cleansing of persons and rooms.Water supply.Milk. shops.Ice cream premises.Other food places
    Sanitary Authority.No. licensed.No. of inspections.No. licensedNo. of inspectionsNo. licensed.No. of Inspections.Observations.Complaints.Notices.No. illegally occupied.Vo. closed or otherwise remedied.Instances found.No. remedied.No. on register.No. of inspections.Prosecutions.Houses licensed.Authorised lodgers.Adults.Children.Premises or roomsTenement houses extra supply.No. on register.No. of inspections.No. on register.No. of inspections.No. of places.No. of. Inspections.
  • Page 51
    Table III. county of london. T uberculosis D ispensaries—analysis of R eturns, J an.—dec., 1919.
    123456789101112
    Borough.Rxarained for the first time.No. included under (2). Suffering from Pulmonary Tuberculosis.No. included under (2). Sutfering from Non. Pulmonary Tuberculosis.No. included under (2). Found to be Non. Tuberculous.No. included under 2 where Diagnosis Doubtful.Total Attendances at Dispensary, including those under column 2.Attendances included in column 7 at which systematic examination and records were made.Visits to homes made by Dispensary Medical Officers.Visits to homes made by Dispensary Nurses.Referred to hospital to which Dispensary affiliated.Specimens of sputum examined.
    Insured.Uninsured.Insured.Uninsured.Insured.Uninsured.Insured.Uninsured.Insured.Uninsured.Insured.UninsuredInsured.Uninsured.Insured.Uninsured.Insured.Uninsured.Insured.Uninsured.Insured.Uninsured.
    M.F.M.F.Chldn.M.F.M.F.Chldn.M.F.M.F.Chldn.M.F.M.F.Chldn.M.F.M.F.Chldn.
  • Page 55
    ENTRANT INFANTS.
    Year.Clothing and Footgear.Nutrition.Cleanliness (Head).Cleanliness (Body).
    Good.Fair.Poor.Excellentnormal.Subnormal.Clean.Nits.Verminous.Clean.Dirty.Verminous.
  • Page 56
    LEAVERS (aged 12).
    Year.Clothing and Footgear.Nutrition.Cleanliness (Head).Cleanliness (Body).
    Good.Fair.Poor.Excellent.Normal.Subnormal.Clean.Nits.Verminous.Clean.Dirty.Verminous.
  • Page 58
    The frequencies of myopia, myopic-astigmatism and mixed astigmatism for boys and girls combined for each age with corresponding percentages were as follows:—
    Age.Total examinedNumber defective.Percentages.
  • Page 59
    Stammering children.
    Age.Boys.Girls.Total.
    Moderate.Acute.Slight.Moderate.Acute.Slight.
  • Page 65
    The results of dental treatment at the several centres for the year 1919 are as follows:— RETURN OF DENTAL TREATMENT FOR THE YEAR ENDED 31ST DECEMBER, 1919.
    Hospital or Centre.No. of children attended.No. of attendances made.No. of teeth or roots extracted.No. of stoppings.No. of other operations, e.g., scaling, Immediate regulation, application of Ag. N03, etc.Number of general anaesthetics.
    Nitrous oxide.Ethyl chloride.Other general anaesthetics.
    Temporary.Permanent.
  • Page 92
    The following statement shows the nature of the conditions found among the children certified suitable for admission to physically defective schools at the admission examinations during the year :—
    Morbid condition.Boys.Girls.Total.Morbid condition.Boys.Girls.Total.
  • Page 94
    The number of children on the roll of M.D. schools on the 31st March, 1919 was 6,337. Dr. Shrubsall made an analysis of the "mental ages" of children examined and found suitable for admission to special (M .D.) schools.
    Physical age.Mental age.
    3456789Totals.
  • Page 97
    TABLE I. Number of Chidren Inspected 1st January, 1919, to 31st December, 1919. (a.) Routine Medical Inspection.
    Age.Entrants.Intermediate group.Leavers.Total.
    3.4.5.6.Other ages.Total.8.12.13.14.Other ages.Total.All age groups.
  • Page 97
    (6.) Special I nspections.
    Special cases.*General examination.Re.examinations, i.e., number of children re.inspected.
  • Page 97
    TABLE II. Return of Defects found in the course of Medical Inspection in 1919.
    Code groups.Specials.
    Number referred for treatment.Number requiring observation.
    Elementary Schools.Special Schools.Referred for treatment.Requiring observation.
  • Page 98
    TABLE 111. Numerical Return of all Exceptional Children in the area in 1919,
    Boys.Girls.Total.
  • Page 99
    Continued from previous page...
    Boys.Girls.Total.
  • Page 99
    TABLE IV. Treatment of Defects of Children during 1919.
    Condition.Number of defects found for which treatment was considered necessaryNumber of defects for which no report is yet available.Number of defects treated.Result of treatment.Improved without institutional treatment.Number of defects not treated and still needing treatmentPercentage of defects under treatment or discharged as cured in cases reported upon.
    From previous year, i.e., all cases referred for treatment in 1918, less cases noted as discharged.New.Total.Remedied and discharged.Not fully remedied.
  • Page 99
    TABLE V. Summary relating to Children medically inspected at the Routine Inspections during the Year 1919.
  • Page 100
    Medical Inspection of School Children, 1919.
    Elementary Schools.Special schools.
    Entrants.Intermediate.Leavers.Totals.Urgent and Special.Myope.Deaf.Mentally defective.
    Boys.Girls.BoysGirls.Boys.Girls.Boys.Girls.Boys and Girls.Boys and Girls.Boys and Girls.
  • Page 101
    TABLE VII. M edical I nspection, 1919.
    Clothing and Footgear.Nutrition.Cleanliness of Head.Cleanliness of Body.Teeth.Vision.Mental Condition
    1231234123123193123123
  • Page 102
    TABLE VIII. 1 st Re-inspection.
    Class of ailment and number re-inspected.Number of ailments treated.Cases not Treated.
    By doctor.Under Council's scheme.At other hospitals.Cases cleared up naturally.Cases needing observation only.Cases still needing treatment.
    Cured.Not Cured.Cured.Not Cured.Cured.Not Cured.
  • Page 102
    2 nd Re-inspection.
    Class of ailment and number re.inspected.Number treated.Not Treated.
    By doctor.Under Council's scheme.At other hospitals.Cleared up naturally.Cases needing observation only.Cases still needing treatment.
    Cured.Not Cured.Cured.Not Cured.Cured.Not Cured.
  • Page -
    Deaths 1911—1918, Inclusive.
    Year.Pulmonary.Non.Pulmonary.Total.
    London.England and Wales.London.England and Wales.London.England and Wales.
  • Page -
    Table of Primary Notifications for England and Wales for Four Years 1914.18.
    Phthisis.Other tuberculosis.
  • Page -
    The number of approved dispensary schemes in each calendar year, and the number of separate dispensaries included is shown in the following statement.
    Calendar year.No. of schemes.No. of separate Dispensaries.Calendar year.No. of schemes.No. of separate Dispensaries.
  • Page -
    TABLE I. (1918).
    Metropolitan borough.Primary notifications.Cases of tuberculosis dealt with at dispensaries for first time.
    Number.Per cent, of primary notifications.
    Pulmonary.Non. pulmonary.Pulmonary.Non. pulmonary.Pulmonary.Non. pulmonary.
  • Page -
    TABLE II.
    1917.1918.
  • Page -
    TABLE III.
    1917.1918.
  • Page -
    TABLE IV.
    Average deaths per annum from tuberculosis, 1912.16, inclusive.Average number of primary notifications per annum, 1914.18, inclusive.Estimated number of "new home contacts" per annum.
    Pulmonary.Non.pulmonary.
  • Page -
    TABLE V.
    * Dispensary.Borough.Average number of deaths per annum from tuberculosis, 1912.16 inclusive.Average number of primary notifications per annum, 1914.18 inclusive.Estimated number of new "home contacts" per annum.
    Pulmonary.Non. pulmonary.
  • Page -
    Finance. The following table shows for a number of dispensaries (a) the estimated reasonable cost arrived at in 1915 of providing a dispensary service, and (b) the actual cost during 1916/17/18:—
    Estimate. 1915.Actual cost.
    1916.1917.1918.
    ££££
  • Page -
    The following figures relate to a Municipal Dispensary. They illustrate the gradual rise in costs :—
    Estimate. 1915.Actual cost.Estimate. 1920.21.
    1915.16.1916.17.1917.18.1918.19.
  • Page -
    TABLE I. Showing the proportion of the work of the whole of the London Dispensaries under various headings which related to insured persons.
    Percentage of work which related to insured persons.
    1917.1918.
  • Page -
    The following table shows the growth in the number of beds available and cases treated on the same date in December of each year.
    Year.Beds.Cases treated.
    Adults.Children.Adults.Children.
  • Page -
    CASES DEALT WITH DURING 1919 (UNINSURED).
    Adults.Children. (Under 16.)Total.
  • Page -
    T able I.
    Total.Untraced.Known to be alive December, 1918.Known to be dead December, 1918.
  • Page -
    Table II.
  • Page -
    T able III. The ascertained mortality in each clinical group (exclusive of the 636 untraced cases) was as follows:—
    No. of cases.Known to be alive December, 1918.Known to be dead December, 1918.
  • Page -
    T able IV. (E arly and M oderately advanced C ases only).
    Cases.Alive Dec. 1918.Dead Dec. 1918.
  • Page -
    T able I.
    Total No. of cases treated.Traced, cases known to be alive 31.12.19.Traced cases known to be dead 31.12.19.Untraced.
  • Page -
    Table II.
  • Page -
    Table I.
    No. of cases treated.
  • Page -
    Table II.
    No. of cases treated and traced to 31.12.19.No. known to be alive on 31.12.19.No. known to be dead on 31.12.19.
  • Page -
    The following table indicates the posit on in respect of the finding of tubercle bacilli in the sputum in the cases of the 163 children whose medical history is known up to 31st December, 1919 :— Table III.
    No. of cases.Known to be alive 31.12.19.Known to be dead 31.12.19.
  • Page -
    Table IV.
    No. of cases treated.
  • Page -
    The subsequent medical history of the remaining 30 cases is shown in the following table:— Table V.
    No. of cases treated and tracedKnown to be aliveKnown to be dead
    31.12.19.31.12.19.31.12.19.
  • Page -
    Existing Accommodation and Estimate of Additional Accommodation required.
    Classification of stage of diseaseAdults Insured and Uninsured.Children under 16 years of age.
  • Page -
    I nstitutional A ccommodation— S ummary.
  • Page -
    Estimate of the C ost of I nstitutional T reatment I nvolved.
    ££
  • Page -
    Percentage of total deaths front each cause in workhouses and hospitals in the year 19l2 :—
    Pulmonary tuberculosis.Non.pul monary tuberculosis.
    Male.Female.Male.Female.
  • Page -
    England ani > W alks , 1912.—Proportion of t.ot<il population in each group having different percentages of institutional treatment of cases of fatal pulmonary tuberculosis ;—
    Total percentages of deaths from pulmonary tuberculosis occurring in institutions.Ad ministrative counties.County borough.Metropolitan boroughs.
  • Page -
    The additional deaths in these cases have been allocated to the dispensary districts in the same proportion as those recorded by the Medical Officer of Health.
    Particulars relating to area.Period.. Persons examined for the first time during the period at or in connection with the Dispensary.2. Total attendance at the dispensary.3 and 4. Home visits per 100 new cases of tuberculosis
    Proportion per 100 deaths per annum from tuberculosis (average 1912.1916).Proportion per 1,000 new persons who were found to beNumber of insured person* per 100 new persons.Number per 10,000 population in area served.Per 100 new cases of tuberculosis.Per systematic physical examination.Percentage relating to insured persons.By medical officer.By nurses.
    All personsTuberculous.Non. tuber. culous.Doubtful.Tuberculous.Non. tuberculous.Doubt. lul.Insured.Uninsured.All cases.insured.Uninsured.All cases.Insured.Uninsured.All cases.Insured.Uninsured.All cases.
    Pulm.Non. puim.Pulm.Non. pulm.
  • Page -
    Continued from previous page...
    Particulars relating to area.Period.1. Persons examined for the first time during the period at or in connection with the Dispensary-2. Total attendance at the dispensary-3 and 4. Home visits per 100 new cases of tuberculosis
    Proportion per 100 deaths per annum from tuberculosis (average 1912-1916).Proportion per 1,000 new persons who were found to beNumber of insured persons per 100 new persons.N umber per 10,000 population in area served.Per 100 new cases of tuberculosis.Per systematic physical examination-Percentage relating to Insured personsBy medical officer.By nurses.
    All personsTuberculous.Non-tuberculous.Doubt. ful.Tuberculous.. Non-tuber culous.Doubtful-Insured.Un Insuted.All cases.Insured.Uninsured.All cases.Insured.Uninsured.All cases.Insured.Uninsured.All cases.
    Pulm.Nonpulm.Pulm.Nonpulm.
  • Page -
    Continued from previous page...
    Particulars relating to area.Period.1. Persons examined for the first time during the period at or in connection with the Dispensary.2. Total attendance at the dispensary.3 and 4. Home visits per 100 new cases of tuberculosis
    Proportion per 100 deaths per annum from tuberculosis (average 1912-1916).Proportion per 1,000 new persons who were found to beNumber of Insured persons per 100 new persons.Number per 10,000 population in area served.Per 100 new cases of tuberculosis.Per systematic physical examination.Percentage relating to Insured personsBy medical officer.By nurses.
    All personsTuberculous.Non-tuberculous.Doubtful.Tuberculous.Non-tuberculous.Doubtful.InsuredUninsured.All cases.Insured.Uninsured.All cases.Insured.Uninsured.All cases.Insured.Uninsured.All cases.
    Pulm.Non-pulm.Pulm.Non-pulm.
  • Page -
    Continued from previous page...
    Particulars relating to area.PeriodPersons examined for the first time during the period at or in connection with the Dispensary.2. Total attendance at the dispensary.3 and 4. Home visits per 100 new cases of tuberculosis
    Proportion per 100 deaths per annum from tuberculosis (average 1912-1916).Proportion per 1,000 new persons who were found to beNumber of insured persons per 100 new persons.Number per 10,000 population in area served.Per 100 new cases of tuberculosis.Per systematic physical examination.Percentage relating to insured personsBy medical officer.By nurses.
    All personsTuberculous.Non-tuberculous.Doubtful.Tuberculous.Non-tuberculous.Doubtful.Insured.Un-Insured.All cases.Insured.Uninsured.All cases.Insured.Uninsured.All cases.Insured.Un-insured.All cases.
    Pulm.Non-pulm.Pulm.Non-pulm.
  • Page -
    GRAND TOTALS.
    Particulars relating to area.Period.Persons examined for the first time daring the period at or in connection with the Dispensary.2. Total attendance at the dispensary.8 and 4. Home visits per 100 new cases of tuberculosis
    Proportion per 100 deaths per annum from tuberculosis (average 1912-1916).Proportion per 1,000 new persons who were found to beNumber of insured persons per 100 new persons.Number per 10,000 population in area served.Per 100 new cases ol tuberculosis.Per systematic physical examination.Percentage relating to insured persons.By medical officer.By nurses.
    All personsTuberculous.Non-tuberculous.Doubt ful.Tuberculous.Non-tuberculous.Doubtful.Insured.Uninsured.All cases.Insured.Uninsured.All cases.Insured.Uninsured.All cases.Insured.Un InsuredAll cases.
    Pulm.Non-pulm.Pulm.Non-pulm.
  • Page -
    APPENDIX VIII. Population.—Age-constitution of Male and Female Populations in Metropolitan Boroughs.
    Metropolitan borough.Percentage of population in each age group.Amount by which the borough percentage is greater (+) or less (—) than the London average for each age.Percentage of males in population.
    0—5—MALES.35—55-0—5—FEMALES.35—55+MALES.FEMALES.
    15—25-15—25-0-15—15—20—35—55+0—5—15—25—35—55+
  • Page -
    APPENDIX IX Mortality from Tuberculosis. —Death Rates per 1,000 living during each of the Four Years 1911-14, and Total Deaths in the two periods 1911-14 and 1915-18.*
    Metropolitan Boroughs.Males.PULMONARY TUBERCULOSIS.non-PULMONARY TUBERCULOSIS.
    Total deaths.Females.Males.Total deaths.Females.Total deaths.
    Pre-war death rates.1914.Pre-war death rates.1914.Total deaths.Pre-war death rates.Pre-war death rates.
    1911.1912.1913.1911-14.1915-18.1911.1912.1913.1911-14.1915-18.1911.1912.1913.1914.1911-14.1915-18.1911.1912.1913.1914.1911-141915-18.
  • Page -
    APPENDIX X. Occupations.—Population per 10,000 over 10 years of age employed in certain occupations. Census, 1911.
    Metropolitan Boroughs.males.females.
    Unoccupied and retired.General and Local Government, professional, agents, merchants, etc.Defence of the country.Commercial clerks.Railways.Roads.Domestic service, in and outdoor.General engineering.Building.Furniture, decorating, etc.Printers.Tailors.Boot and shoemakers.Food and lodging, etc.Unoccupied and retired.Civil Service, teaching, literary professional.Domestic scrvice.Hotel and eating house service.LaundriesTailor- esses.Dressmakers, milliners, etc.
  • Page -
    OTHER OCCUPATIONS OF LOCAL IMPORTANCE.
  • Page -
    APPENDIX XI. Housing Conditions.—Number and percentage of persons accommodated in tenements of various sizes in Metropolitan Boroughs, Census 1911.
    Metropolitan borough.Tenements occupied by more than two persons per room.Number of tenements ofPopulation in tenements ofPercentage of total population living in tenements ofAverage number of persons per room in 1-9 room tenements.
    Number.Occupants.
    Number.Per-centage of total population.Children under ten years.1 room.2 rooms.3 rooms.4 rooms.Over 4 rooms.1 room.2 rooms.3 rooms.4 rooms.Over 4 rooms.1 room.rooms. 3 rooms..4 rooms.Over 4 rooms.