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

Page 14

The distribution of the deaths by ages in 1925 is shown in the following table with corresponding figures for the preceding two years, and the annual average for the years 1911-14 and 1919-22:—

Year.	0-	1—	2—	5—	1-	15—	20—	25—	35—	45—	55—	65 +	All ages.

Page 14

In the following table the deaths under one year of age per thousand births, from the principal causes of infant mortality, are shown for 1925 and preceding years.

Cause of Death.	1911 to 1914.	1915 to 1918.	1919 to 1922.	1921.	1922.	1923.	1924.	1925.

Page 17

The following figures suggest that the heading arterio-sclerosis has, in many instances, replaced "old age" as the certified cause of death:—

Certified cause of death.	Deaths among persons over 65 years of age.
Certified cause of death.	1911.	1916.	1920.

Page 17

The following table compares tne age-incidence of deaths from the principal diseases of the zymotic group in 1851-60, 1881—90 and 1911-20. The figures shown are the percentages (of such deaths) of deaths fron all causes.

Period.	Deaths from zymotic diseases per cent, of deaths from all causes.
Period.	0—15.	15—65.	65 +	All ages.

Page 19

comprised in the zymotic group at ages below five years in the three decennia are as follows:—

Disease.	1851	—60.	1881	—90.	1911	—20.
Disease.	Deaths 0—5.	Per cent. of all causes.	Deaths 0—5.	Per cent, of all causes.	Deaths 0—5.	Per cent, of all causes.

Page 20

diarrhcea. In the following table the extent to which the temperature in the winter quarters of successive five-yearly periods, from 1871 onwards, fell below normal is shown, and it is clearly apparent that the winters of 1886-90 and 1891-95 were altogether exceptional:—

Period.	Number of winter quarters with average temperature below normal.	Aggregate of degrees below normal in the winter quarters referred to in the preceding column.

Page 24

The percentage of such deaths in successive ten-year intervals since 1840 are shown in the following table :—

Year.	Percentage.	Year.	Percentage.	Year.	Percentage.

Page 25

report of the Chief Medical Officer of the Ministry of Health for the year 1924, and brought up to date, emphasises the foregoing remarks.

Year.	England and Wales (including London).		London.
Year.	Cases.	Deaths.	Cases.	Deaths.

Page 30

Table of age incidence (actual cases).

Age periods.	Under 3.	3-5.	5-10.	10-20.	20-30.	30-40.	40-50.	50-60.	Over 60.	Total.

Page 30

Table of yearly prevalence (notified cases).

Year.	1913.	1914.	1915.	1916.	1917.	1918.	1919.	1920.	1921.	1922.	1923.	1924.	1925.

Page 33

The deaths from influenza in the autumn and winter of 1925-26 were as follows:—

Week No.	Deaths.	Week No.	Deaths.	Week No.	Deaths.
1925.		1926.		1926.

Page 36

The results obtained, on an assumption of Dr. Brownlee's 33 weeks' periodicity and by the suggested method of balanced incidences, are compared in the following table, in which are shown the errors in forecast of influenza prevalences in the years 1890-1924 inclusive, (I.) on hypothesis of balanced incidence about the 35th week of the year, and (II.) on hypothesis of periodicity of 33 weeks.

Method of forecast.	Forecast too early by		Forecast correct to within 4 weeks.	Forecast too late by
Method of forecast.	14 weeks or more.	5—13 weeks.	Forecast correct to within 4 weeks.	5—13 weeks.	14 weeks or more.

Page 37

The table on page 37 shows that there are several instances in which the hypothesis fails, but with the reservation which thus attaches to any particular forecast it may be noted that a prevalence of influenza is indicated about the end of 1926.

Registration year (52 or 53* weeks).	Week of influenza prevalence with maximum mortality.	Interval from middle of week of maximum mortality.		Expected interval to next maximum.	Difference be tween actual and expected interval.†	Registration year. (52 or 53* weeks).	Week of influenza prevalence with maximum mortality	Interval from middle of week of maximum mortality.		Expected interval to next maximum.	Duterence between actual and expected interval.†
		To commencement of 35th week of year (weeks).	To week of next maximum mortality (weeks)	Expected interval to next maximum.	Difference be tween actual and expected interval.†			To commencement of 35th week of year (weeks).	To week of next maximum mortality (weeks).	Expected interval to next maximum.	Duterence between actual and expected interval.†
		To commencement of 35th week of year (weeks).	To week of next maximum mortality (weeks)	Column (3) 2.	('olunn (4)-(5).			To commencement of 35th week of year (weeks).	To week of next maximum mortality (weeks).	Column (3) x o	Column (4) — (5).
(1)	(2)	(3)	(4)	(5)	(6)	(1)	(2)	(3)	(4)	(5)	(6)

Page 37

diagnoses. The following is an analysis of the returns, the corresponding figures for the two preceding years being also shown for the purpose of comparison:—

Bacteriological diagnosis.			1925.		1924.		1923.

Page 55

The deaths and death-rate from tuberculosis of the respiratory system by sexes in recent years have been as follows:—

Year.	Deaths.			Death-rates.
Year.	Males.	Females.	Total.	Males.	Females.	Total.

Page 56

The following is an analysis of the notifications in London during 1925 (52 weeks).

Form of tuberculosis notified.	Sex.	Notifications on Form A. (Total of primary notifications received in London borough, other than elementary school cases, injra.)
Form of tuberculosis notified.	Sex.	0-	1-	5-	10-	15-	20-	25-	35-	45-	55-	65 +	Total.

Page 56

The following is an analysis of the notifications in London during 1925 (52 weeks).

Form of tuberculosis notified.	Sex.	Notifications on Form B. (Primary notifications of cases discovered through medical inspection in elementary schools.)				Notifications on Form C. (Secondary notifications from institutions receiving cases.)
Form of tuberculosis notified.	Sex.	0-	5-	10 +	Total.	Poor Law.	Other.

Page 56

These figures include cases not notified before death:—

Form of tuberculosis notified.	Sex.	New cases of tuberculosis coming to knowledge otherwise than by notification on forms A and B.
Form of tuberculosis notified.	Sex.	0-	1-	5-	10-	15-	20-	25-	35-	45-	55-	65 +	Total.

Page 57

Continued from previous page...

Metropolitan borough.	No. of houses.			No. of houses for the working classes.		No. of representations.			No. of closing orders.			No. of houses demolished.
	In borough.	Inhabited by working classes.	Repaired by local authority.	Erected.	In course of erection.	No. of representations.			No. of closing orders.			No. of houses demolished.
	1925.	1925.	1925.	1925.	1925.	1911-14	1915-19	1920-25	1911-14	1915-19	1920-25	1911-14	1915-19	1920-25

Page 64

The first table gives the results of the observation of 158 ex-service and civilian insured cases which were under observation in Brompton and City of London Chest Hospital, Victoria Park, during 1920.

	No. of cases observed.	Tuberculous.	Not tuberculous.

Page 64

Classification of patients referred to observation hospitals:—

	1921.	1922.	1923.	1924.	1925.

Page 64

Adult patients examined at the County Hall, and disposal thereof since 1922:—

	1922.	1923.	1924.	1925.

Page 65

Table shewing development of provision of residential treatment under the Council's Tuberculosis Scheme (1914-1925 inclusive).

Year.	No. of admissions during year. Adults.					No. of beils occupied at end of year. Adults.
Year.	Uninsured.	Insured.	Ex-service men.	Total.	Children.	Un-insur-d.	Insured.	Ex-servicemen.	Total.	Children.

Page 67

After history of the Council's Patients who received residential treatment during part of 1914 and during 1915, and of insured persons recommended for sanatorium benefit in 1914.

	Number of cases.	Numbers known alter tour years to be
	Number of cases.	Alive.	Dead.

Page 67

5,869 applications for institutional treatment of adult patients were received during the year 1925, viz.:—

Page 68

Action taken with regard to adult patients examined at the County Hall during 1925 :—

Observation hospital.	Sanatorium.	Home for advanced cases.	Not accented.	Total.

Page 68

The classification of the 1,334 patients discharged after observation in hospitals :

Page 68

In the remaining 229 cases the diagnosis of tuberculosis was not confirmed. Action taken with regard to 1,105 cases in which tuberculosis was diagnosed, compared with the figures for 1924 :—

	Year.
	1925.	1924.

Page 68

At the commencement of 1925 the Council had in use the following number of beds:—

	Adults.
	Discharged soldiers.	Civilians.	Total adults.	Children.	Total children.

Page 69

The number of cases under treatment on 31st December, 1925, was:—

	Adults.
	Discharged soldiers.	Civilians.	Total adults.	Children.	Total children

Page 70

Continued from previous page...

Year.	Syphilis.	Gonorrhoea.	Soft chancre.	Non-venereal.	Total.

Page 70

It will be seen that in the case of syphilis the figures for 1925 are the lowest recorded since the scheme first came into operation.

Year.	New cases.						Total venereal cases.
	Syphilis.		Soft chancre.		Gonorrhoea.		Total venereal cases.
	M.	F.	M.	F.	M.	F.	M.	F.

Page 70

country. Comparative figures for the nine years the scheme has been in force are shown in the following table :—

Year.	New cases.		Total.	Attendances.	In-patient days.
Year.	Venereal.	Non-venereal.	Total.	Attendances.	In-patient days.

Page 71

Another point worthy of note is the total number of examinations made of pathological specimens. Comparative figures for the nine years are shown in the following table.

Pathological examinations.
Year.	For treatment centres.	For private practitioners.

Page 73

The number of beds available in London for maternity cases is estimated to be as under:—

Page 73

The number of lying-in homes registered in London since 1916 is as under:—

Page 74

During the year 722 cases were examined with the following results:—

	Idiot.	Imbecile.	Feeble minded.	Moral Imbecile.	Not Defective.	Insufficient Evidence.	Total.

Page 77

TABLE I. COUNTY OF LONDON. Vital statistics for the several metropolitan boroughs and the County of London in the year 1925. (Rates per 1,000 of civil population.)

Metropolitan boroughs. (Arranged in topographical order.)	Estimated civil population, 1925.	Births.	Deaths.	Infant mortal- ity (per 1,000 births).	Measles	Scarlet fever.	Diphtheria.	Whoop- ing cough.	Typhoid fever.	Diarrhoea and Enteritis, age 0-2 per 1,000 births).	Phthisis.	Pneumonia.	Bronchitis.	Cancer.	Cases of notifiable infectious disease, (a)
Metropolitan boroughs. (Arranged in topographical order.)	Estimated civil population, 1925.	Births.	Deaths.	Infant mortal- ity (per 1,000 births).	Measles	Scarlet fever.	Diphtheria.	Whoop- ing cough.	Typhoid fever.	Diarrhoea and Enteritis, age 0-2 per 1,000 births).	Phthisis.	Pneumonia.	Bronchitis.	Cancer.	Scarlet fever.	Diphtheria.	Ty-phoid fever.	Erysipelas.	Puerperal fever 'per 1,000 births).	Cerebrospinal fever.	Acute pneumonia.

Page 78

TABLE II. COUNTY OF LONDON. Statistics of the administrative work carried out during the year 1925.

	Cowsheds.		Slaughterhouses.		Offensive Trades.		Smoke nuisances.			Underground rooms.		Overcrowding.		Houses let in lodgings.			Common lodging houses.		Cleansing of persons and rooms.			Water supplj	Milk-shops.		Ice cream premises.		Other food places.
Sanitary Authority.	No. licensed.	No. of inspections.	No. licensed.	No. of inspections.	No. licensed.	No. of inspections.	Observations.	Complaints.	Notices.	No. illegally occupied.	No. closed or otherwise remedied.	Instances found.	No. remedied.	No. on register.	No. of inspections.	Prosecutions.	Houses licensed.	Authorised lodgers.	Adults.	Children.	Premises or rooms.	Tenement houses extra supply.	No. on register.	No. of inspections, j	No. on register.	No. of inspections.	No. of places.	No. of inspections.

Page 79

Table III. Tuberculosis Dispensaries—Analysis of Returns Jan.-Dec., 1925.

1 Borough and dispensary.	2 Under observation on 1-1-1925 pending diagnosis.		3 Examined for first time during 1925, including contacts.		4 Number of contacts included in (3).		5 Number included under (2) and (3) suffering from				6 Number included under (2) and (3) found to be non-tuberculous.		7 Under observation on 31st December. 1925. pending diagnosis or ceased attendance bef re comp etion of d agnosis.		8 Total attendances.	9 Visits to homes by		10 Home consul tations.	11 Number referred to affiliated hospital.	12 No. of specimens of sputum examined
	2 Under observation on 1-1-1925 pending diagnosis.		3 Examined for first time during 1925, including contacts.		4 Number of contacts included in (3).		(a) Pulmonary.		(i) Non-pulmonary.						8 Total attendances.	9 Visits to homes by		10 Home consul tations.	11 Number referred to affiliated hospital.	12 No. of specimens of sputum examined
	Adults.	Children.	Adults.	Children.	Adults.	Children.	Adults.	Child ren.	Adults.	Children.	Adults.	Children.	Adults.	Children.		(a) Tuberculosis officer.	(b)Dispen sa0ry nurse.

Page 84

changes, if any, have taken place. A series of tables has, therefore, been prepared giving the results of the inspection of entrants in the years 1913, 1915, 1920 and 1925.

	Good.	Boys. Average.	Poor.	Good.	Girls. Average.	Poor.
	1.	2.	3.	1.	2.	3.

Page 84

The tendency of the times is thus well illustrated, inequalities at the one end of the scale are being reduced, while the incidence of distress at the other end is being held in check or even lessened.

	Boys.						Girls.
	Clean.	Head Nits.	Vermin.	Clean.	Body Dirty.	Vermin.	Clean.	Head Nits.	Vermin.	Clean.	Body Dirty.	Vermin
	1.	2.	3.	1.	2.	3.	1.	2.	3.	1.	2.	3.

Page 84

been reduced progressively to 9.9 per cent. Body vermin in 1913 were found in one in 50 of all entrant children, in 1925 they are found in only one in a thousand.

		Bovs.			Girls.
	Sound.	Slight caries.	Severe caries.	Sound.	Slight caries. Severe caries.

Page 85

The percentages of those examined referred for treatment amongst entrant infants for certain ailments were as follows:—

	Boys.				Girls.
	1913.	1915.	1920.	1925.	1913.	1915.	1920.	1925.

Page 86

The table printed below shows in biennial periods the findings of the school doctors in regard to the condition of the teeth of twelve-year old children since 1913; and shows that a great improvement has been effected, especially in reduction of the more serious cases of dental decay in the older children:—

	1913.			1915.			1917.			1919.
	1	2	3	1	2	3	1	2	3	1	2	3

Page 87

Children referred for treatment for enlarged tonsils and adenoid growths

		Entrants.		8-year old.		12-year old.
		No.	Per cent.	No.	Per cent.	No.	Per cent.

Page 87

The percentage columns show that at each age group larger proportions of the children inspected have been referred for treatment. Many more children inspected are recorded with enlarged tonsils and adenoid growths than are advised to have treatment, the greater proportion are dealt with in an expectant fashion, being kept under observation while the effect of hygienic advice to the parents is ascertained. The number of children found to have tonsils and adenoids and the proportions of these referred for treatment are shown in the following table for the two years:—

		Entrants.		8-vear old.		12-year old.
		Tonsils and adenoids.	Per cent, referred for treatment.	Tonsils and adenoids.	Per cent, referred for treatment.	Tonsils and adenoids.	Per cent, referred for treatment.

Page 92

The following table shows the number of actual cases of infectious and contagious illnesses reported by head teachers as occurring among school children during the year under review compared with figures for the preceding four years :—

Disease.	Diphtheria.	Scarlet fever.	Measles and German measles.	Whooping cough.	Chicken pox.	Mumps.	Scabies.	Ophthalmia.	King-worm.

Page 93

The number of schools which were visited by medical officers during the year, and the number of departmental visits on the occurrence of local outbreaks of scarlet fever and diphtheria are shown in the subjoined table:— Diphtheria and Scarlet Fever in London, 1925.

Division.	Spring term.	Summer term.	Autumn and winter terms.	Total (depts.).	Total (schools).	No. of children inspected.

Page 94

It will be observed that the percentage of non-clinical or mistaken cases of diphtheria is particularly high, especially in comparison with scarlet fever.

l. Year.	2. Total admissions to 1 M.A.B. hospitals.	3. No. of bacteriological and negative* cases.	4. No. of cases of mistaken diagnosis.	5. Percentage ot cols. 3 and 4 to total admissions.

Page 96

This speeding-up of the return to school of diphtheria carriers since the school nurses were first employed on this work in 1924 is shown in the following table :—

Period of absence from school.	1920.		1924.		1925.
	Carrier cases.	Approx. per cent.	Carrier cases.	Approx. per cent.	Carrier cases.		Approx. per cent.

Page 96

Number of cases of diphtheria and scarlet fever reported from the schools:—

Disease.	Average number of cases annually (1906-1919).	No. of cases occurring in each year of epidemic period.			Average number of cases annually (1923-1925).
Disease.	Average number of cases annually (1906-1919).	1920.	1921.	1922.	Average number of cases annually (1923-1925).

Page 98

These figures, however, only furnish a rough guide, as in a large number of cases no medical advice is sought, and, furthermore, only the first case in a household was notified. The total incidence of measles at the pre-school ages and in the population generally may be estimated at nearly three times the number of cases occurring among school children. The undermentioned table shows the number of cases of measles reported by head teachers of the schools during the past 20 years. Similar figures in respect of scarlet fever and diphtheria are shown for purposes of comparison:—

Year.	No. of cases reported among elementary school children.			Year.	No. of cases reported among elementary school children.
Year.	Measles and German measles.	Scarlet fever.	Diphtheria.	Year.	Measles and German measles.	Scarlet fever.	Diphtheria.

Page 99

The school notifications of measles each month from October to March, were as follows :—

	1925.			1926.			Total.
	Oct. (4 weeks).	Nov. (4 weeks).	Dec. (3½weeks).	Jan. (3 weeks).	Feb. (4 weeks).	Mar. (4 weeks).	Total.

Page 99

The deaths from measles during the 1925-6 epidemic from the beginning of November, 1925, up to the end of March, 1926, are as follows

	November.					December.						January.
Week ending—	7 th.	14th.	21st.	28th.		5th.		12th.		19th.	26th.	2nd.	9th.	16th.		23rd.	30th.

Page 100

For purposes of comparison, similar data with regard to whooping cough are shown:—

Quinquennium.	Measles.		Whooping cough.
Quinquennium.	No. of cases among school children.	No. of deaths (all persons).	No. of cases (school children).	No. of deaths (all persons).

Page 100

The resulting rates for the past ten years are given in the following table, the corresponding rates for whooping-cough being also shown for the purpose of comparison (see also the diagram on p. 101).

Year of birth.	Deaths per 1,000 hom, up to 5th year of ace.
Year of birth.	Measles.	Whooping cough.

Page 103

which have occurred in Poor Law institutions since the order of the Local Government Board came into force:—

Year.	Measles: place of death.
	M.A.B. hospitals.	Poor Law institutions.	Elsewhere.	Total.	M.A.B. and Poor Law.
	M.A.B. hospitals.	Poor Law institutions.	Elsewhere.	Total.	Number.	Per cent. of total.

Page 103

The corresponding figures for whooping-cough are as follows:—

Year.	Whooping cough: place of death.
	M.A.B. hospitals.	Poor Law institution.	Elsewhere.	Total.	M.A.B. and Poor Law.
	M.A.B. hospitals.	Poor Law institution.	Elsewhere.	Total.	N umber of deaths.	Per cent. of total.

Page 108

Encephalitis lethargica has been a notifiable disease since the beginning of 1919, but it is evident that only a proportion of the cases have been recognised in the early or acute stage. In London the numbers notified are as follows:—

Year.	Total notified cases.	Number of these of school age (3-14).	Year.	Total notified cases.	Number of these of school age (3-14).

Page 108

The following table shows the distribution of actually confirmed cases, and the number of deaths in the different age groups, occurring within the scope of the analysis —i.e., from January to September, 1925.

Ages.	—5.	5—15.	15—25.	25—35.	35—45.	45—55.	Over 55.	Total.

Page 110

The following analysis will be of interest as showing the after-effects of the disease in the different age groups:—

Age groups.	1	5-15.	15-25.	25-35.	35-45.	j 45-55.	Over 55.	Total.

Page 112

The children are only admitted on the application of the Council or Boards of Guardians, and the following table shows the age and sex distribution of cases sent in by the two authorities.

Age and sex.	0—.		5—.		10-15.		Total.

Page 112

The medical officer in charge made a classification of the first 50 cases dealt with at the institution, from which it appears that the frequency of the following recognised post-encephalitic symptoms was as follows, some children being included under more than one group.

Page 114

Re-inspections in 1925.

Class of ailment and number seen.	Treated by doctor.		Treated under Council's scheme.		Treated at hospitals not in Council's scheme.		Not treated, but recovered.	Not treated. Improved. For observation	Not treated. Still needing treatment.
Class of ailment and number seen.	Cured.	Not cured.	Cured.	Not cured.	Cured.	Not cured.	Not treated, but recovered.	Not treated. Improved. For observation	Not treated. Still needing treatment.

Page 115

I hat very substantial progress is being made is shown by the following figures :—

Year.	No. of children inspected by dentist.	No. found by dentist, to require treatment.	Percentage found to require treatment,.	No. treated at the Council's centres.

Page 115

Number referred for treatment.		Number treated.

Page 117

Complaint.		Children.			Percentage of total.

Page 119

The following are the statistics relating to the work done under the new scheme from 1st April to 31st December, 1925 :—

Suppurating ears —	Patients.	Ears.

Page 120

This represents a net result of 45-7 per cent, of ears cured of the completed cases.

Purely deaf children —	Patients.	Ears.

Page 120

The following table represents a complete analysis of all the lonisation work done at the ionisation centres from 1st April to 31st December, 1925

Causes of suppuration.	Total cases.	Cured.	Lapsed.	Sent to hospital.	Still under treatment.

Page 121

The details of the work done at the after-care clinic, Kentish Town, including the mastoid operations done at the Downs Hospital, are as follows:—

	Patients.	Ears.

Page 124

A census is taken each year, in November, of the number of children reported chronically out of school, and the numbers of these for the past four years are set out in the following table in which those absent on account of rheumatism are also shown separately.

	1922.	1923.	1924.	1925.

Page 124

The 614 rheumatic children absent in November, 1925. are classified as follows:—

	Boys.	Girls.	Total.

Page 124

The deaths in London in 1924 from rheumatism at ages below 25 were:—

	0-5	5-15	15-25

Page 126

The 614 rheumatic children chronically absent from school in London in November, 1925, were distributed as follows:—

Education District.	No. of cases.	No. of children of school age	Per 1,000

Page 134

Discharges for the year are as follows:—

Page 136

Remedial Exercise Class (G. Dept.), Smallwood Road.—The results obtained in connection with this class continue very satisfactory, and one must again pay tribute to the class teacher (Miss Tayer), to whose efforts these results are entirely due. From the appended table it will be seen that the defects are of the usual types, kyphosis predominating

Defects.	No.	Discharged cured.	Continuing.		Left.
Defects.	No.	Discharged cured.	Improved.	No change.	Left.

Page 137

Number of hours' play available in organised games:—

	Council's parks and open spaces.	Sites under control of Education Committee.	Royal parks, Borough Councils' sites, etc.	Total number of hours' play each week.

Page 139

The results of the work under the Cleansing Scheme, for the last five years are:—

Year.	Examinations at rota visits.	Verminous conditions noted at rota visits.	Per cent.	Verminous children referred to centres.	Subsequently cleansed by parents.	Verminous children cleansed at centres.	Scabies cases bathed at centres.

Page 145

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.

Page 145

These cases were seen by the Council's consulting aural surgeon, with the following results:—

Page 146

The percentage of cases in which deafness may be attributed to congenital syphilis has fallen since 1919:—

1919.	1920.	1921.	1922.	1923.	1924.	1925.

Page 147

The medical records of the children in the Council's residential schools for the blind and deaf have been examined with a view to ascertaining the number of cases whose defect was attributable to venereal disease. The total number of records examined was 298 (100 blind, 198 deaf), and the data obtained were as follows:—

Defeet.	Venereal disease a reasonably certain antecedent.				Venereal disease a possible antecedent-
	Congenital syphilis.		Ophthalmia neonatorum.		Congenital syphilis.		Ophthalmia neonatorum.
	Boys.	Girls.	Boys.	Girls.	Boys.	Girls.	Boys.	Girls.

Page 147

The Association of Directors and Secretaries for Education have been informed in reply to enquiries that the numbers of children (other than imbeciles) who have shown mental deficiency combined with another defect during the past four years are as follows:—

	Boys.	Girls.	Total.

Page 147

The subjoined table shows the mental and chronological ages of 322 mongols at the time of their examinations.

Mental age.	Chronological age.															Total.
Mental age.	2	3	4	5	6	7	8	9	10	11	12	13	14	15	16	Total.

Page 148

The cause of mongolism is as yet unknown, but it has been noted that they are frequently, though not exclusively, the last children of elderly parents; sometimes they come at the end of very large families; the place in family of 315 children is tabulated below.

Place in family.	No. of children in family.
Place in family.	1	2	3	4	5	6	7	8	9	10	11	12	13	14	15	16

Page 148

The ages of the parents of 294 such children are shown in the subjoined table:—

Father's age.	18 to 20	21 to 23	24 to 26	27 to 29	30 to 32	33 to 35	36 to 38	39 to 41	42 to 44	45 to 47	48 to 50	Over 50	Total

Page 150

The number of children on the roll of P.D. schools suffering from heart disease or from rheumatism, or chorea, at the end of 1925, was as follows:—

	Numbers.
Morbid condition.	Boys.	Girls.	Total.

Page 151

The after careers of children formerly attending special (mentally defective) schools are here set out.

	Male.	Female.	Total.

Page 156

Using these groups Dr. Dobbie found the following distribution :—

Robust (Nutrition I.)					Delicate (Nutrition III.).
Fine.		Pernio.	Oily.	Dry.	Fine.	Pernio.	Oily.	Dry.

Page 156

Vascular tone estimated on a three point scale according to the condition of the skin gave a great preponderance of defective states in the " delicate " section.

Nutrition I.				Nutrition III.

Page 164

Dr. Fairfield has made a preliminary survey of the infirmities which have led to a premature termination of the teacher's career, either by death or disablement, in the year ended 31st December, 1925, among the 19,874 teachers (6,126 men, 13,748 women) in the service of the Council. The following table shows the infirmities which led to death:—

Page 164

During the year there were 73 teachers who broke down prematurely, and the morbid conditions are shown in the following table:—

Page 165

Dr. Fairfield has also made the following analysis of 650 cases of women teachers examined by her after reference to the School Medical Officer on account of absences for periods of one month and over.

Page 166

Medical Inspections, 1925. (a) ROUTINE INSPECTIONS. (6) OTHER INSPECTIONS.

Age group.	Boys.	Girls.	Total. \|		Boys.		Girls.	Total.

Page 166

TABLE II. (a) Defects found at Medical Inspections in 1925. ELEMENTARY AND SPECIAL SCHOOLS.

Routine inspections.				Special inspections.
	Defects.			Defects.
Requiring treatment.		Requiring observation.		Requiring treatment.	Requiring observation only.
E.S.	SS.	E.S.	S.S.	Requiring treatment.	Requiring observation only.

Page 167

Continued from previous page...

Routine inspections.				Special inspections.
Defects.				Defects.
Requiring treatment.		Requiring observation.		Requiring treatment.	Requiring observation only.
e.s.	s.s .	e.s.	s.s.	Requiring treatment.	Requiring observation only.

Page 167

(b) Children found at routine medical inspection to require treatment (excluding uncleanliness).

Age group.	Inspected.	Found to require treatment.	Percentage requiring treatment.

Page 167

TABLE III. Exceptional Children in London in 1925.

Blind (including partially blind)—		Boys.	Girls.	T otal.

Page 168

Continued from previous page...

Deaf—continued.		Boys.	Girls.	Total.

Page 169

TABLE IV. Defects treated during 1925. TREATMENT TABLE. Group I.—Minor Ailments (excluding uncleanliness, for which see Group V.).

Disease or defect.	Defects treated or under treatment.
Disease or defect.	Under Council's scheme.	Otherwise.	Total.

Page 169

Group II.—Defective Vision and Squint (excluding eye defects treated as Minor Ailments, Group I.).

Defect or disease.	Defects dealt with.
Defect or disease.	Under Council's scheme.	Otherwise.	Total.

Page 169

Group III.—Treatment of Defects of Throat and Nose. Number of defects.

Received operative treatment.			Received other forms of treatment.	Total number treated.
Under Council's scheme.	Private practitioner or hospital.	Total.	Received other forms of treatment.	Total number treated.

Page 170

Group IV.—Dental Defects.

Page 173

Particulars of action taken in recent years are as follows:—

Year.	Infants removed from foster mothers.	Exemptions.	Deaths.	Infringements discovered.	Cautions.	Prosecutions.	Convictions.

Page 174

Particulars with regard to common lodging-houses licensed by the Council are as follows:—

Year.	Houses licensed.	Lodgers authorised.	Prosecutions.	Convictions.	Penalties and costs.	Cases of infectious disease.

Page 174

Particulars of seamen's lodging-houses licensed by the Council are as follows:—

Year.	Houses licensed.	Lodgers authorised.	Prosecutions.	Convictions.	Penalties and costs.	Cases of infectious disease.

Page 174

The following table gives particulars of licensed slaughterhouses, knackers yards and registered offensive businesses:—

Year.	Slaughterhouses.	Knackers' yards.	Offensive businesses.

Page 181

The quantities of sewage, etc., dealt with during 1925 were as follows:—

Sewage treated—	Million gallons.

Page 183

Repairs, etc., have been carried out during the year to intercepting and main sewers as follows:—

	£

Page 202

Working-class dwellings.—The results of the year's working compared with those of the previous year are as follows:—

Dwellings—	1925-26.					1924-25.
Housing Act, 1925—		£	s.	d.		£	s.	d.

Page 202

The net surplus for the year on dwellings erected under Improvement, etc., Acts, is £14,614 2s. 10d. and is disposed of as follows:—

Surpluses transferred—-	£	8.	d.

Page 204

The net deficiency under all heads for the year 1925-26 was £69,402 18s., as follows:—

	1925-26.			1924-25.
Schemes undertaken by the Council—	£	s.	d.	£	s.	d.

Page 204

The deficiency for 1925-26 is provided for as follows:—

Page 204

Net Deficiency, 1925-26—How Met. The financial results for the year under the several sections are as follows:—

	£	s.	d.

Page 205

This is met or disposed of in the following manner—

	(a) Exchequer subsidy and (b) special contributions by metropolitan borough councils.			Transfers to or from Rate, etc. Accounts.									(a) Carried for- ward or (b) disposed of by internal transfers.
				Special County Account.			General County Account.			Other Accounts.
	£	s.	d.	£	s.	d.	£	s.	d.	£	s.	d.	£	s.	d.

Page 206

Capital Expenditure and Debt. The total capital expenditure in respect of housing up to 31st March, 1926, amounts to £20,399,992 5s. 7d., as follows:—

	Non-assisted schemes.			Assisted (1919) scheme.			Assisted (1923) scheme.			Assisted (1924) scheme.
	£	s.	d.	£	s.	d.	£	s.	d.	£	8.	d.

London's Pulse: Medical Officer of Health reports 1848-1972

View report tables

London County Council 1925

118 tables in this report

The distribution of the deaths by ages in 1925 is shown in the following table with corresponding figures for the preceding two years, and the annual average for the years 1911-14 and 1919-22:—

In the following table the deaths under one year of age per thousand births, from the principal causes of infant mortality, are shown for 1925 and preceding years.

The following figures suggest that the heading arterio-sclerosis has, in many instances, replaced "old age" as the certified cause of death:—

The following table compares tne age-incidence of deaths from the principal diseases of the zymotic group in 1851-60, 1881—90 and 1911-20. The figures shown are the percentages (of such deaths) of deaths fron all causes.

comprised in the zymotic group at ages below five years in the three decennia are as follows:—

diarrhcea. In the following table the extent to which the temperature in the winter quarters of successive five-yearly periods, from 1871 onwards, fell below normal is shown, and it is clearly apparent that the winters of 1886-90 and 1891-95 were altogether exceptional:—

The percentage of such deaths in successive ten-year intervals since 1840 are shown in the following table :—

report of the Chief Medical Officer of the Ministry of Health for the year 1924, and brought up to date, emphasises the foregoing remarks.

Table of age incidence (actual cases).

Table of yearly prevalence (notified cases).

The deaths from influenza in the autumn and winter of 1925-26 were as follows:—

The table on page 37 shows that there are several instances in which the hypothesis fails, but with the reservation which thus attaches to any particular forecast it may be noted that a prevalence of influenza is indicated about the end of 1926.

diagnoses. The following is an analysis of the returns, the corresponding figures for the two preceding years being also shown for the purpose of comparison:—

The deaths and death-rate from tuberculosis of the respiratory system by sexes in recent years have been as follows:—

The following is an analysis of the notifications in London during 1925 (52 weeks).

The following is an analysis of the notifications in London during 1925 (52 weeks).

These figures include cases not notified before death:—

Continued from previous page...

The first table gives the results of the observation of 158 ex-service and civilian insured cases which were under observation in Brompton and City of London Chest Hospital, Victoria Park, during 1920.

Classification of patients referred to observation hospitals:—

Adult patients examined at the County Hall, and disposal thereof since 1922:—

Table shewing development of provision of residential treatment under the Council's Tuberculosis Scheme (1914-1925 inclusive).

After history of the Council's Patients who received residential treatment during part of 1914 and during 1915, and of insured persons recommended for sanatorium benefit in 1914.

5,869 applications for institutional treatment of adult patients were received during the year 1925, viz.:—

Action taken with regard to adult patients examined at the County Hall during 1925 :—

The classification of the 1,334 patients discharged after observation in hospitals :

In the remaining 229 cases the diagnosis of tuberculosis was not confirmed. Action taken with regard to 1,105 cases in which tuberculosis was diagnosed, compared with the figures for 1924 :—

At the commencement of 1925 the Council had in use the following number of beds:—

The number of cases under treatment on 31st December, 1925, was:—

Continued from previous page...

It will be seen that in the case of syphilis the figures for 1925 are the lowest recorded since the scheme first came into operation.

country. Comparative figures for the nine years the scheme has been in force are shown in the following table :—

Another point worthy of note is the total number of examinations made of pathological specimens. Comparative figures for the nine years are shown in the following table.

The number of beds available in London for maternity cases is estimated to be as under:—

The number of lying-in homes registered in London since 1916 is as under:—

During the year 722 cases were examined with the following results:—

TABLE I. COUNTY OF LONDON. Vital statistics for the several metropolitan boroughs and the County of London in the year 1925. (Rates per 1,000 of civil population.)

TABLE II. COUNTY OF LONDON. Statistics of the administrative work carried out during the year 1925.

Table III. Tuberculosis Dispensaries—Analysis of Returns Jan.-Dec., 1925.

changes, if any, have taken place. A series of tables has, therefore, been prepared giving the results of the inspection of entrants in the years 1913, 1915, 1920 and 1925.

The tendency of the times is thus well illustrated, inequalities at the one end of the scale are being reduced, while the incidence of distress at the other end is being held in check or even lessened.

been reduced progressively to 9.9 per cent. Body vermin in 1913 were found in one in 50 of all entrant children, in 1925 they are found in only one in a thousand.

The percentages of those examined referred for treatment amongst entrant infants for certain ailments were as follows:—

Children referred for treatment for enlarged tonsils and adenoid growths

The following table shows the number of actual cases of infectious and contagious illnesses reported by head teachers as occurring among school children during the year under review compared with figures for the preceding four years :—

The number of schools which were visited by medical officers during the year, and the number of departmental visits on the occurrence of local outbreaks of scarlet fever and diphtheria are shown in the subjoined table:— Diphtheria and Scarlet Fever in London, 1925.

It will be observed that the percentage of non-clinical or mistaken cases of diphtheria is particularly high, especially in comparison with scarlet fever.

This speeding-up of the return to school of diphtheria carriers since the school nurses were first employed on this work in 1924 is shown in the following table :—

Number of cases of diphtheria and scarlet fever reported from the schools:—

The school notifications of measles each month from October to March, were as follows :—

The deaths from measles during the 1925-6 epidemic from the beginning of November, 1925, up to the end of March, 1926, are as follows

For purposes of comparison, similar data with regard to whooping cough are shown:—

The resulting rates for the past ten years are given in the following table, the corresponding rates for whooping-cough being also shown for the purpose of comparison (see also the diagram on p. 101).

which have occurred in Poor Law institutions since the order of the Local Government Board came into force:—

The corresponding figures for whooping-cough are as follows:—

Encephalitis lethargica has been a notifiable disease since the beginning of 1919, but it is evident that only a proportion of the cases have been recognised in the early or acute stage. In London the numbers notified are as follows:—

The following table shows the distribution of actually confirmed cases, and the number of deaths in the different age groups, occurring within the scope of the analysis —i.e., from January to September, 1925.

The following analysis will be of interest as showing the after-effects of the disease in the different age groups:—

The children are only admitted on the application of the Council or Boards of Guardians, and the following table shows the age and sex distribution of cases sent in by the two authorities.

The medical officer in charge made a classification of the first 50 cases dealt with at the institution, from which it appears that the frequency of the following recognised post-encephalitic symptoms was as follows, some children being included under more than one group.

Re-inspections in 1925.

I hat very substantial progress is being made is shown by the following figures :—

The following are the statistics relating to the work done under the new scheme from 1st April to 31st December, 1925 :—

This represents a net result of 45-7 per cent, of ears cured of the completed cases.

The following table represents a complete analysis of all the lonisation work done at the ionisation centres from 1st April to 31st December, 1925

The details of the work done at the after-care clinic, Kentish Town, including the mastoid operations done at the Downs Hospital, are as follows:—

A census is taken each year, in November, of the number of children reported chronically out of school, and the numbers of these for the past four years are set out in the following table in which those absent on account of rheumatism are also shown separately.