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

Page 2

central areas, such as Fulham and Camberwell, the outward movement has increased.

Area.	Population middle of 1901.	Population increase 1901-31 (actual).	Natural increase (Births less deaths) 1901-31.	Intercensal movement of population. Gain( +)or Loss ( —) of population by migration— i.e., actual increase of population less natural increase.
Area.	Population middle of 1901.	Population increase 1901-31 (actual).	Natural increase (Births less deaths) 1901-31.	1901-11.	1911-21.*	1921-31.	Total 1901-31.	Percentage.

Page 2

The changes which have taken place in the tenemental occupation of the county as a whole are broadly indicated in the following table:—

	1911.	1921.	1931.

Page 3

The following table shows the changes which have taken place in the occupancy of 1 to 4 roomed tenements in London during the past four censuses:—

Tenements of	Percentage of total tenements.					Percentage of total population living in one to four-roomed tenements occupied by more than two persons per room
Tenements of	1891.	1901.	1911.	1921.	1931.	1891.	1901.	1911.	1921.	1931.

Page 3

The proportion of the private family population of the county and of each metropolitan borough living in tenements with more than two persons per room in 1911, 1921 and 1931 is shown in the following table, in which the boroughs are arranged in topographical order to facilitate comparison:—

Metropolitan boroughs.	Percentage of total private family population living in tenements occupied by more than two persons per room.
Metropolitan boroughs.	1911.	1921.	1931.

Page 4

The position is illustrated by the following figures for the last three census enumerations:—

Age-Group.	1911.		1921.		1931.
Age-Group.	Number.	Percentage.	Number.	Percentage.	Number.	Percentage.

Page 5

The distribution of deaths by ages in 1932 and recent preceding periods is shown in the following table:—

Period.	0-	1-	2-	5-	10-	15-	20-	25-	35-	45-	55-	65+	All ages.

Page 5

It will be seen from the following table that one of the principal causes of the slight increase on the figures for 1931 was the increased mortality from diarrhoea, associated with the heat wave during August:—

Cause of death.	1911 to 1914.	1915 to 1918.	1919 to 1922.	1923 to 1926.	1927 to 1930.	1928.	1929.	1930.	1931.	1932.

Page 6

The number of notifications of smallpox was 1,131 compared with 1,452 in 1931. The following table shows the incidence of the disease in the years 1931 and 1932 in the separate London boroughs:—

Metropolitan Borough.	Number of notifications.		Metropolitan Borough.	Number of notifications.

Page 7

During the year three deaths from smallpox occurred, particulars of which are as follows:—

Borough.	Age.	Sex.	Vaccinal condition.	Date of death.	Certified cause of death.

Page 8

The following statement shows the numbers of notifications in recent years, excluding duplicate notifications and military cases:—

Year.	1922	1923	1924	1925	1926	1927	1928	1929	1930	1931	1932

Page 8

The following statement shows the age and sex incidence of the notified cases:—

Age.	0-	5-	15-	25-	35-	45-	55-	65-	Total.

Page 9

The death-rates in London and England and Wales in recent years have been as follows:—

Area.	1921.	1922.	1923.	1924.	1925.	1926.	1927.	1928.	1929.	1930.	1931.

Page 9

I he death-rates in London and England and Wales in recent years are shown in the following table:—

Area.	1921.	1922.	1923.	1924.	1925.	1926.	1927.	1928.	1929.	1930.	1931.

Page 9

The seasonal incidence, as shown by the notifications (uncorrected for errors of diagnosis) received in successive four-weekly periods during the year, was as follows:—

l-	5-	9-	13-	17-	21-	25-	29-	33-	37-	41-	45-	49-52

Page 10

The notifications (uncorrected for errors in diagnosis), deaths and crude case-mortality during 1932 were as follows :—

Year 1932. (52 weeks.)	Age-period.												Total.
Year 1932. (52 weeks.)	0-	1-	2-	3-	4-	5-	6-	7-	8-	9-	10-	15 +	Total.

Page 10

The death-rates in London and England and Wales in recent years are shown in the following table:—

Area.	1921.	1922.	1923.	1924.	1925.	1926.	1927.	1928.	1929.	1930.	1931.

Page 10

The seasonal incidence, as shown by the notifications (uncorrected for errors of diagnosis) received in successive four-weekly periods during the year was as follows:—

l-	5-	9-	13-	17-	21-	25-	29-	33-	37-	41-	45-	49-52

Page 10

The notifications (uncorrected for errors in diagnosis), deaths and crude case-mortality during 1932 were as follows:—

Year 1932. (52 weeks.)	Age-period.												Total.
Year 1932. (52 weeks.)	0-	1-	2-	3-	4-	5-	6-	7-	8-	9-	10-	15 +	Total.

Page 10

The death-rates in London and England and Wales in recent years are shown in the following table:—

Area.	1921.	1922.	1923.	1924.	1925.	1926.	1927.	1928.	1929.	1930.	1931

Page 11

The deaths from puerperal fever and other accidents of childbirth per thousand births in each metropolitan borough and in the county of London in the periods 1920 to 1927 and 1928 to 1932, together with the deaths in childbirth in 1932, are shown in the following table:—

Metropolitan boroughs.	Childbirth deaths per 1,000 births.						Number of deaths in childbirth.
	1920-27.			1928-32.			1932.
	Puerperal fever.	Other causes.	Total.	Puer. peral fever.	Other causes.	Total.	Puerperal fever.	Other causes.	Total.

Page 12

The seasonal incidence, as shown by the notifications (uncorrected for errors of diagnosis) received in successive four-weekly periods during the year was as follows :—

l-	5-	9-	13-	17-	21-	25-	29-	33-	37-	41-	45-	49-52

Page 12

The death-rates in London and England and Wales in recent years are shown in the following table:—

Area.	1921.	1922.	1923.	1924.	1925.	1926.	1927.	1928.	1929.	1930.	1931.

Page 12

The weekly deaths from influenza, pneumonia and bronchitis during the latter epidemic period are shown in the following table :—

Disease.	Week ended												Total.
	January.				February.				March.
	7	14	21	28	4	11	18	25	4	11	18	25

Page 13

The annual death-rates from pulmonary and non-pulmonary tuberculosis in recent years are shown in the subjoined table:—

Period.	Pulmonary tuberculosis death-rates.			Non-puhnonary tuberculosis death-rates.
Period.	Males.	Females.	Total.	Males.	Females.	Total.

Page 13

The following is an analysis of the notifications in London during 1932 (52 weeks ended 31st December, 1932):—

Form of tuberculosis notified.	Sex.	Number of formal primary notifications of new cases of tuberculosis.												Total notifications.
Form of tuberculosis notified.	Sex.	0-	1-	5-	10-	15-	20-	25-	35-	45-\|	55-	65 +	Total all ages	Total notifications.

Page 13

These figures include cases not notified before death:—

Form of tuberculosis notified.	Sex.	New cases of tuberculosis coming to knowledgo otherwise than by formal notification.
Form of tuberculosis notified.	Sex.	0-	1-	5-	10-	15-	20-	25-	35-	45-	55-	65 +	Total.

Page 13

The sources of information as to the unnotified cases shown in the above table were as follows :—

Source of information.		Number of cases.
Source of information.		Pulmonary.		Non-pulmonary.

Page 14

Vital statistics for the metropolitan boroughs and the county of London in the year 1932. (Rates per 1,000 of civil population.)

Metropolitan boroughs. Arranged in topographical order.)	Estimated resident populntion 1932.	Births.	Deaths.	Infant mortality (per 1,000 births).	Measles	Scarlet [ever.	Diphtheria.	Whooping cough.	Typhoid fever.	Diarrhoea and Enteritis, age 0-2 (per 1,000 births).	Phthisis.	Pneumonia.	Bronchitis.	Cancer.	Maternal mortality (per 1,000 births).	Notifications of Infectious disease.
Metropolitan boroughs. Arranged in topographical order.)	Estimated resident populntion 1932.	Births.	Deaths.	Infant mortality (per 1,000 births).	Measles	Scarlet [ever.	Diphtheria.	Whooping cough.	Typhoid fever.	Diarrhoea and Enteritis, age 0-2 (per 1,000 births).	Phthisis.	Pneumonia.	Bronchitis.	Cancer.	Maternal mortality (per 1,000 births).	Scarlet fever.	Diphtheria.	Typhoid fever.	Erysipelas.	Cere-bro-spinal fever.	Acute pneumonia.

Page 15

COUNTY OF LONDON.—Notifiable infectious diseases.—Notifications per 1,000 of population.

Period	Annual rates per 1,000 living.
Period	Anthrax	Cerebro-spinal fever	Continued fever	Diphtheria	Dysentery	Encephalitis lethargica	Enteric fever	Erysipelas	Malaria	Ophthalmia neonatorum (per 1,000 births)	Pneumonia	Polioencephalitis	Poliomyelitis	Puerperal fever (per 1,000 births)	Puerperal pyrexia (per 1,000 births)	Scarlet fever	Smallpox	Typhus

Page 16

COUNTY OF LONDON.—Principal vital statistics, 1891-1932.

Period	Annual rate per 1,000 living			Mortality per 1,000 living																Annual mortality per 1,000 births
	Births	Marriages	Deaths (all causes)	Cerebro-spinal fever	Diphtheria	Enteric fever	Scarlet fever	Small-pox	Whooping-cough	Measles	Influenza	Tuberculosis		Pneumonia (all forms)	Bronchitis	Other resp. dis.	Heart disease	Cancer	Diabetes	Infants 0—1	Diarrhoea and enteritis 0—2	Puerperal fever	Other acc. of ch. birth.
	Births	Marriages	Deaths (all causes)	Cerebro-spinal fever	Diphtheria	Enteric fever	Scarlet fever	Small-pox	Whooping-cough	Measles	Influenza	Resp.	Other	Pneumonia (all forms)	Bronchitis	Other resp. dis.	Heart disease	Cancer	Diabetes	Infants 0—1	Diarrhoea and enteritis 0—2	Puerperal fever	Other acc. of ch. birth.

Page 17

Infectious Diseases.—Notifications in the County of London during the 52 weeks ended 31st December, 1932.

Metropolitan borough.	Anthrax.	Cerebrospinal fever.	Continued fever.	Diphtheria (including membranous croup).	Dysentery.	Encephalitis lethargica.	Enteric fever.	Erysipelas.	Malaria.	Ophthalmia neonatorum.	Pneumonia.	Polioencephalitis.	Poliomyelitis.	Puerperal fever.	Puerperal pyrexia.	Scarlet fever.	Smallpox.	Typhus.

Page 18

The following table shows briefly the results obtained in the several years during which the enumeration has been undertaken by the Council:—

Persona.					Persons.
Year.	Common lodging houses (Inmates)	Casual wards (Inmates)	Homeless.	Total.	Year.	Common lodging houses (Inmates)	Casual wards (Inmates)	Homeless.	Total.

Page 19

COUNTY OF LONDON.—Statistics of the administrative work carried out during the year 1932.

Sanitary authority.	Cow-sheda.		Slaughterhouses.		Offensive trades.		Smoke nuisances.				Common lodging houses.		Cleansing of persons and rooms.				Water supply.	Milk-shops.		Ice cream premises.		Restaurants and eating houses.
	No. licensed.	No. of inspections.	No. licensed.	No. of inspections.	No. authorised.	No. of inspections.	Observations.	Intimations.	Complaints.	Notices.	Houses licensed.	Authorised lodgers.	Persons.		Rooms or premises.		Tenement houses extra supply.	No. on register.	No. of inspections.	No. on register.	No. of inspections.	No. of places.	No. of inspections.
	No. licensed.	No. of inspections.	No. licensed.	No. of inspections.	No. authorised.	No. of inspections.	Observations.	Intimations.	Complaints.	Notices.	Houses licensed.	Authorised lodgers.	Adults.	Children.	After infectious diseases.	For vermin.	Tenement houses extra supply.	No. on register.	No. of inspections.	No. on register.	No. of inspections.	No. of places.	No. of inspections.

Page 20

No. of houses.		No. of houses inspected.		No. of notices served.			No. of houses repaired under Housing Act, 1930.		Underground rooms.		Overcrowding.		Houses let in lodgings.		No. of houses for the working classes.		Houses unfit for habitation.
No. of houses.		No. of houses inspected.		No. of notices served.													lepresen-tations.		Closing orders.		Demolition orders.
In borough.	Occupied by the working classes.	Complaints or illness.	House to house.	Under P.H. Act.		Under Housing Act.											lepresen-tations.		Closing orders.		Demolition orders.
				Under P.H. Act.					No. illegally occupied.	No. closed or otherwise remedied	Instances found.	No. remedied.	No. on register.	No. of inspections.	Erected during year.	In course of erection.	No. made.	No. of houses.	No. made.	No. determined.	No. made.	No. of houses demolished.
				Intimation.	Statutory.																	No. of houses demolished.
																						In pursuance of orders.	Voluntarily.
							By owners.	By L.A.I														In pursuance of orders.	Voluntarily.

Page 21

Sanitary Inspectors, 1932.

Sanitary authority.	Population (Census) 1931	Male.		Female.		Health visitors.
Sanitary authority.	Population (Census) 1931	Whole time.	Part time.	Whole time.	Part time.	Whole time.	Part time.

Page 22

Results of Milk Sampling.

Department	Number of samples taken	Number of completed examinations	Number found to be tubercle infected	Number found to be negative	Number of cases of acute intercurrent infection

Page 22

Results op Veterinary Inspection.

Department	Number of visits	Number of examinations made			Number of cows with tuberculosis	Number of cows with other unhealthy conditions (apart from T.B.)
Department	Number of visits	Cows	Bulls	Young stock	Number of cows with tuberculosis

Page 23

A summary of the work done by the hospitals for each of the areas in the joint scheme during the year 1932 is shown in the following table:—

	London.	Middlesex.	Essex.	Surrey.	Kent.	Herts.	Bucks.	East Ham.	West Ham.	Croydon.	Total.	"Other places."	Grand total.

Page 24

The distribution of new cases of venereal disease between the sexes is shown in the following table, the figures for the preceding years being given for comparison :—

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

Page 24

The age and sex distribution were as follows:—

Under 1 year.		1 and under 5 years.		5 and under 15 years.		15 years and over.		Total
M.	F.	M.	F.	M.	F.	M.	F.	M.	F.

Page 25

Comparative figures for the sixteen years during which the scheme has been in force are shown in the following table:—

Year.	New cases.			Total attendances (venereal and non-venereal)	In-patients days.
Year.	Venereal.	Non-venereal	Total.	Total attendances (venereal and non-venereal)	In-patients days.

Page 25

Another point worthy of note is the total number of examinations made of Pathology pathological specimens. Comparative figures for the sixteen years are shown in the and bacteriology following table:—

Year.	From treatment centres.	From medical practitioners.

Page 27

The following table shows the development of the provision for residential treatment in London since 1914, inclusive of cases dealt with by the London Insurance Committee between 1914 and May, 1921, and of those treated directly by the Council under its tuberculosis scheme:— Beds occupied at end of year.

Year.	Adults.	Children.	Total.

Page 29

The following table indicates the number of applications from adults for residential treatment under the tuberculosis scheme during each of the last five years:—

Year	Application for first period of treatment			Application for further treatment			Total applications
Year	Ex-service	Civilian male	Female	Ex-service	Civilian male	Female	Total applications

Page 30

During the year, 1,561 patients were discharged from "observation beds "and their classification was as follows (the corresponding figures for 1931 also being given):—

*Pulmonary.	Number	Percentage.	N u niber	. Percentage.

Page 30

The number of tuberculosis scheme cases under treatment on 31st December, 1932, was as follows (the corresponding figures for the previous year being shown in brackets):—

Page 31

For the purpose of this table patients of 15 years of age on admission are regarded as adults, owing to the "age" division of patients required for the purposes of the Ministry of Health, although treatment for them was arranged in institutions for children.

Immediate results of treatment.	Classification.
	A			Bl			B2			B 3			Surgical.			Total.
	1930.	1931.	1932.	1930.	1931.	1932.	1930.	193l\ 1932.		1930.	1931.	1932.	1930.	293i. 1932.		1930.	1931.	1932.

Page 31

This is shown more clearly in the following table :—

Year	Percentage of A cases discharged as quiescent.	Number of cases discharged.	Percentage of Bl cases discharged as quiescent.	Number of cases discharged.	Percentage of B2 cases discharged as quiescent.	Number of cases discharged.

Page 32

The number of cases under treatment on 31st December, 1932, was 811, distributed as follows:—

Page 32

The condition of the children under 15 years of age (on admission) who were discharged from residential institutions in 1932 is indicated in the following table, the figures in brackets being those for 1931:—

Immediate results of treatment.	Classification.				Surgical.	Total.
Immediate results of treatment.	A	Bl.	B2.	B3.	Surgical.	Total.

Page 36

The following is a summary, for purposes of comparison, of certain sections of the foregoing table:—

Metropolitan borough	Number of new cases examined per 100 deaths from tuberculosis in the borough	Number of contacts examined per 100 deaths from tuberculosis in the borough	Total attendances per case on register	Tuberculosis officers' visits per case on register	Nurses' visits per case on register	Number of definitely tubercular persons on dispensary register per 100 inhabitants	X-ray examinations		Number of cases on register classified as T.B. plus.
Metropolitan borough			Total attendances per case on register	Tuberculosis officers' visits per case on register	Nurses' visits per case on register		per 100 new cases and contacts	per 100 new cases	Number of cases on register classified as T.B. plus.

Page 36

The following table shows the result of the enquiry and also (in brackets) the corresponding figures ascertained from last year's enquiry into the 1925 cases:—

Classification.	Total.	Percentage alive five years after discharge.	Percentage dead.

Page 37

The mortality records are as follows, the figures in brackets referring to last year's enquiry into the 1925 cases:—

Classification.	Total.	Percentage alive five years after discharge.	Percentage dead.

Page 37

The mortality rates of the non-pulmonary cases classified according to the location of the disease are as follows :—

Location of Disease.	Total.	Percentage alive five years after discharge.	Percentage dead.

Page 39

From the inception of the scheme until 1932, 1,856 children have been dealt with, as follows:—

Year	Number	Tear	Number

Page 40

and 32 in places of safety awaiting action. During the year 1,241 cases were examined with the following results:—

Sex	Case classification	Feeble minded		Imbecile		Idiot		Morally defective		Not defective		Total
Sex	Case classification	Children	Adults	Children	Adults	Children	Adults	Children	Adults	Children 1	Adults	Children	Adults

Page 40

The following table shows the number of cases considered and the recommendations made

Description.	Registration of the blind.		Training of the blind.		Total.
Description.	M.	F.	M.	F.	Total.

Page 46

Examination of Staff. During the year 9,009 examinations, including 482 home visits, were made of members of the staff, other than that under the direction of the Education Committee. These may be classified as follows:—

Page 46

As a result of the examinations, 378 officers were deemed to be permanently unfit to carry out their ordinary duties in the service of the Council on the following grounds :—

	Males.	Females.	Total.

Page 47

Fifty-four applicants for appointment to the permanent service failed to pass the medical examination for the following reasons:—

	Males.	Females.	Total.

Page 48

The total number of samples examined in 1932 amounted to 9,480. The following table shows their classification:—

Page 49

As in the case of raw milk for school supplies, the requirement as to the absence of B. Coli in 1/1,000 c.c. was adopted. Raw Milk

School supplies.

Page 50

Of the 1,010 samples of drugs and medical supplies examined during the year 97 (or 9.6 per cent.) were found to be either definitely unsatisfactory for use or below standard strength or quality.

Page 50

Samples of feeding stuffs.

Page 52

The following table giving the averages of all samples taken during the last three years shows clearly the great improvement produced in the atmospheric conditions in the tunnels by the new ventilating plants:—

Year.	Carbon-monoxide.			Fog shade.
Year.	No. of samples.	Average CO content parts per 100,000.	No. of results above limit.*	No. of samples.	Average fog shade.	No. of results above limit.†

Page -

The following is a statement as to the defects dealt with at the 90 treatment centres and the financial arrangements in 1932:—

Defect for which treatment is provided.	Cost to Council (including establishment charges).	Paid to centre committees. Capitation.	Charge to parents.

Page -

The following table shows the numbers inspected in each group, and their classification according to nutrition:—

Age Group.	Number inspected.	Classification.
Age Group.	Number inspected.	(1)	(2)	(3)	(4)

Page -

Taking categories 3 and 4 together, the percentages of each sex found with subnormal nutrition in each of the code age groups, compared with similar percentages in previous years, are given in the following table:—

Age Group.	1920.	1925.	1930.	1931.	1932.

Page -

The boys of to-day weighed 1 stone 2 pounds more and were 1£ inches taller than their predecessors, and considerable improvement was found in the girls.

Page -

Details are set out below:—

Age Group.	1924.		1927.		1930.		1931.		1932.
Age Group.	Sound.	Serious decay.*	Sound.	Serious decay. *	Sound.	Serious decay.*	Sound.	Serious decay.*	Sound.	Serious decay.*

Page -

First Re-inspections, 1932. (Percentages are given in italic type.)

Defect treated.		Treated.						Untreated.
		By private doctor.		Under Council's scheme.		At other hospitals.		Cured naturally.	Improved. For observation only.	Still needing treatment.
		Cured.	Not cured.	Cured.	Not cured.	Cured.	Not. cured.	Cured naturally.	Improved. For observation only.	Still needing treatment.

Page -

Second Re-inspections, 1932.

Page -

Cases out of School for three months, November, 1932, and the four preceding years.

	Cases.					Percentage of total.
	1928.	1929.	1930.	1931.	1932.	1928.	1929.	1930.	1931.	1932

Page -

The following table shows the provision made in 1932, and the number of ailments actually treated during the years, 1920, 1931 and 1932:—

Ailment.	Provision made in 1932.	Ailments treated 1920.	Ailments treated 1931.	Ailments treated 1932.

Page -

The numbers of cases of operations for the removal of tonsils or adenoid growths among school children, and the rate per 1,000 children on the school roll for the years 1923-32 are as follows:—

Year.	Number.	Rate per 1,000.	Year.	Number.	Rate per 1,000.

Page -

Table I—Otorrhœa cases.

Division.	Total no. of examinations made.		New cases.		Cases carried over from 1931.		Old cases returned.		Cases examined, but no treatment required.		Cases cured.		Lost sight of.		Cases transferred elsewhere.
	Patients.	Ears.	Patients.	Ears.	Patients.	Ears.	Patients.	Ears.	Patients.	Ears.	Patients.	Ears.	Patients.	Ears.	Patients.	Ears.

Page -

Table II—Deaf cases.

Division.	Total no. of examinations made.		New cases.		Cases carried over from 1931.		Old cases returned.		Cases cured.		Cases partially relieved.		Cases unrelieved.		Cases requiring no treatment.		Lost sight of.		Cases transferred elsewhere.
	Patients.	Ears.	Patients.	Ears.	Patients.	Ears.	Patients.	Ears.	Patients.	Ears.	Patients.	Ears.	Patients.	Ears.	Patients.	Ears.	Patients.	Ears.	Patients.	Ears.

Page -

Table III—Analysis of Otorrhcea Cases.

Cause of suppuration.	Total ears.	Cured.	Referred for mastoid operation.	Lapsed.	Still under treatment.

Page -

The following are particulars of new patients discharged from Downs hospital during 1932:—

	Patients.	Ears.

Page -

The following are particulars of the cases referred from Downs hospital in 1931, and continuing treatment into 1932:—

	Patients.	Ears.

Page -

In addition to the above the following are particulars of cases which were operated on in Downs hospital and discharged in 1931, but went to the Council's clinics and continued their treatment into 1932:—

	Patients.	Ears.

Page -

The following table shows the growth of the Council's dental treatment scheme during the past 22 years:— Dental inspection and treatment.

Year.	Inspection.			Treatment.
	Number inspected.	Number found to require treatment.	Percentage.	Number of centres.	Number of cases treated.

Page -

Particulars of the examinations and the results of the cleansing schemes during the past six years are given below:—

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

Page -

Rheumatism scheme. The following statistics show the operation and growth of the rheumatism Statistics, scheme during 1932; corresponding figures for two previous years are also shown:—

	1930.	1931.	1932

Page -

The variety of rheumatism from which these children were suffering was:—

	Boys.	Girls.	Total.

Page -

The school doctor selected 1,155 boys (41.6 per cent. of total entrants) for remedial exercises. These may be summarised as follows:—

Page -

The following figures relating to the general health of the boys are interesting:—

Page -

Investigation has been made of the mortality from measles between 1st August, 1931, and 31st July, 1932, in the 13 nursery schools in existence throughout that period:—

Page -

out in the following statements, submitted by Dr. Wm. Moodie, the director of the clinic:—

Ages of Children referred.	Boys.	Girls.	Ages of Children referred.	Boys.	Girls.

Page -

Source of reference.

Page -

Reasons for reference.

Page -

Assignment of cases.

Page -

Results of treatment-—Full service cases.

Page -

Source of reference.

Page -

Reasons for reference.

Page -

Disposal.

Page -

Results of treatment.

Result.	Carried over from 1931.	New rases 1932.	Total.

Page -

Ages of children referred. Ages of children referred.

Page -

Source of reference. (New cases of school age.)

Page -

Diagnosis.

Page -

The number of cases discharged during the year was 242, leaving 260 cases still in hand at the end of the year. The 242 cases discharged may be classified as follows:

Page -

The following table shows the number of children nominated for examination and the recommendations made :—

Defect.	Number nominated.			Suitable for admission to							Returned to elementary school.		Invalided as for the time unfit for any school.		Notified under M.D. Acts.

Page -

The Following statement shows the nature ot the conditions tound among the children certified as suitable for admission to schools for the physically defective at the admission examinations during the year:—

Morbid conditions	Boys.	Girls.	Total.

Page -

The following statement gives an analysis of the 483 cases examined for admission to special schools for the physically defective, as a result of which the children were either returned to elementary schools or were invalided as unfit for any school:—

Morbid conditions.	Elementary school.	Invalided.

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attendance and for similar reasons. As a result of the rota visits and the re-examinations the following re-classifications took place:—

Transferred from schools for	Re-classified for transfer to—
Transferred from schools for	P.D. school.	M.D. school.	Sight saving school.	Blind school.	Deaf school.	Hard of hearing school.	Open- air school.	Epileptic colony.

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There were also 596 cases returned, on improvement, to elementary schools, or, when over 14 years of age, deemed to be no longer certifiable and allowed to leave school. The details are as follow:—

Acton taken.	Special school classification.
Acton taken.	P.D.	M.D.	Blind.	Deaf.	Sight saving.	Hard of hearing.	Total.

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The following table classifies the children who improved to such an extent that they were able to return from the schools for physically defective children to the ordinary elementary schools, or were "no longer certifiable" as defective between the ages of 14 and 16 years :—

Defect.	Cases passed no longer certifiable.	Cases passed fit to return to elementary schools.

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The following table shows the number of cases notified by the education authority under Section 2 (2) of the Mental Deficiency Act, 1913, as amended by the Mental Deficiency Act, 1927, during the year 1932 (the figures in brackets being those for the previous year):—

(a) Feeble-minded—	Boys.		Girls.

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The chief officer of the mental hospitals department lias furnished the following return for the year 1932 on after-care of children formerly attending special schools for the mentally defective, but whose names were not notified to the Mental Hospitals Committee as being cases in which the Education Committee were of opinion that further aid in the form of supervision, guardianship or institutional care under the Mental Deficiency Acts was necessary:—

Classification.			Male.	Female.	Total.	Grand total under headings.

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The following table shows the nature of the charges made :—

Charges.	Boys.	Girls.

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The physical state of the children as shown on the cards of those cases where the records are complete is revealed in the following table:—

Defect.	Boys.	Per cent.	Girls.	Per cent.

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The following table indicates the numbers submitted for each grade and the results of the examinations:—

Status.	Number examined.		Number fit.		Number rejected.		Number who withdrew after being referred for remediable defects or were not due for reexamination until 1933.

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' The numbers of cases of infectious illness reported by head teachers as occurring among school children during 1932, compared with similar figures reported during the preceding five years, are shown below:—

Year.	Diphtheria	Scarlet fever.	Measles and German measles.	Whooping cough.	Chicken pox.	Mump9.	Scabies.	Ophthalmia.

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The following table gives information regarding the schools specially visitea by the school medical staff during the year:—

Division.	Diphtheria.			Scarlet fever.			Smallpox.
Division.	Number of visits.	Number of depts. visited.	Number of children examined.	Number of visits.	Number of depts. visited.	Number of children examined.	Number ,°.fvisits.	Number examined.

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On arrival 20 cases were found to be positive and 35 negative. The following is an analysis of these cases:—

Result.	Positive. (12 operations.)	Negative. (12 operations.)	Total.

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In all, 61 new cases were examined ; these grouped according to the organisms isolated, were as follows:—

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An investigation of virulence of K.L.B. present and isolated from the various cases showed the following results

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During the year, 1,131 cases of smallpox were notified (and confirmed) in London and of these 419 were among school children. The following statement shows the number of cases occurring among the children during the year, grouped in schoo' terms, for each division :—

Division.	Spring term.	Summer term.	Autumn term.	Total.

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The following table summarises the reports submitted by the school nurses in connection with this work :—

Division.	No. of visits to schools. (No. of schools concerned in brackets.)	No. of cases of smallpox found as a result of examination by school nurse.	No. of children excluded by school nurse with suspicious symptoms.	No. of home contacts supervised in school.	No. of absentees (home contacts) reported to borough medical officer of health.	No. of hours devoted to work.

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The following table shows the number of cases of ringworm of the scalp among the children in the Council's schools dealt with during 1932 compared with the figures for preceding years :—

Year.	New cases.	Cured cases.	Cases outstanding at the end of the year.	Percentage of cures effected by X-ray treatment.

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Ihe following figures relating to the consents obtained may be of interest:—

	Number.

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The following summary gives some idea of the progress of the work up to the end of December, 1932 :—

	Number.

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The following is a summary of the work completed during 1932 :—

	Number.

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STATISTICAL TABLES. Table L Medical Inspection, 1932. (a) Routine Inspections.

Group.		Boye.	Girls.	Total.

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Table II. (a) Defects found at medical inspections in 1932. Elementary and special schools.

Disease or defect.	Routine inspections— Defects.				Special inspections— Defects.
	Requiring treatment.		Requiring observation.		Requiring treatment.	Requiring observation.
	Elementary schools.	Special schools.	Element. ary schools.	Special schools.	Requiring treatment.	Requiring observation.

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STATISTICAL TABLES—Table II—continued. (a) Defects found at medical inspections in 1932. Elementary and special schools—continued.

Disease or defect.	Routine inspections— defects.				Special inspections— Defects.
Disease or defect.	Requiring treatment.		Requiring observation.		Elementary schools	Special schools.

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

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

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Table III. (a) Exceptional children in London in 1932.

		Boys.	Girls.	Total.

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Table III —continued. (a) Exceptional children in London in 1932—continued.

		Boys.	Girls.	Total.

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Table III—continued. (a) Exceptional children in London in 1932—continued.

		Boys.	Girls.	Total.

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(6) Reiurn of children suffering from more than one defect, 1932.

Defect.	Type of School.
	Day M.D.		Residential M.D.		Day Blind		Residential Blind		Day Deaf		Residential Deaf		Epileptic colony		Day P.D.		Certified hospital Schls.		At other institutions (Gen. hosp., etc.)		At no Schl.		Total
	Boys.	Girls.	Boys.	Girls.	Boys.	Girls.	Boys.	Girls.	Boys.	Girls.	Boys.	Girls.	Boys.	Girls.	Boys.	Girls.	Boys.	Girls.	Boys.	Girls.	Boys.	1 Girls.	Boys.	Girls.

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Table IV. Treatment table. Group I.—Minor ailments, excluding uncleanliness, for which see Group V.

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

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Group II.—Defective vision and squint (excluding eye defects treated as minor ailments, for which see Group I).

Disease or defect.	Defects dealt with.
Disease or defect.	Under Council's scheme.	Otherwise.	Total.

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Group III.—Treatment of defects of the throat and nose. Number of defects.

Received operative treatment.		Total.	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.

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Group IV.—Dental defects.

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Gboup IV.—Denial defects—continued.

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Group V.—Uncleanliness and verminous conditions.

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Table V. Medical inspection.—Number of children examined, 1922-1932.

Year.	Routine examinations.	Special examinations.	Re- inspections.	Examinations at special enquiries into outbreaks of infectious disease.	Ionisation centre attendances.	Rheumatism supervisory centre attendances.

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Table VI. Medical treatment.—Number of cases treated under the Council's scheme and by other agencies, 1922-1932.

Year,	Minor ailments.		Vision.		Nose and throat.		Dental.
Year,	Under the Council's scheme.	Otherwise.	Under the Council's scheme.	Otherwise.	Under the Council's scheme.	Otherwise.	Under the Council's scheme.	Otherwise.*

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

View report tables

London County Council 1932

139 tables in this report

central areas, such as Fulham and Camberwell, the outward movement has increased.

The changes which have taken place in the tenemental occupation of the county as a whole are broadly indicated in the following table:—

The following table shows the changes which have taken place in the occupancy of 1 to 4 roomed tenements in London during the past four censuses:—

The proportion of the private family population of the county and of each metropolitan borough living in tenements with more than two persons per room in 1911, 1921 and 1931 is shown in the following table, in which the boroughs are arranged in topographical order to facilitate comparison:—

The position is illustrated by the following figures for the last three census enumerations:—

The distribution of deaths by ages in 1932 and recent preceding periods is shown in the following table:—

It will be seen from the following table that one of the principal causes of the slight increase on the figures for 1931 was the increased mortality from diarrhoea, associated with the heat wave during August:—

The number of notifications of smallpox was 1,131 compared with 1,452 in 1931. The following table shows the incidence of the disease in the years 1931 and 1932 in the separate London boroughs:—

During the year three deaths from smallpox occurred, particulars of which are as follows:—

The following statement shows the numbers of notifications in recent years, excluding duplicate notifications and military cases:—

The following statement shows the age and sex incidence of the notified cases:—

The death-rates in London and England and Wales in recent years have been as follows:—

I he death-rates in London and England and Wales in recent years are shown in the following table:—

The seasonal incidence, as shown by the notifications (uncorrected for errors of diagnosis) received in successive four-weekly periods during the year, was as follows:—

The notifications (uncorrected for errors in diagnosis), deaths and crude case-mortality during 1932 were as follows :—

The death-rates in London and England and Wales in recent years are shown in the following table:—

The seasonal incidence, as shown by the notifications (uncorrected for errors of diagnosis) received in successive four-weekly periods during the year was as follows:—

The notifications (uncorrected for errors in diagnosis), deaths and crude case-mortality during 1932 were as follows:—

The death-rates in London and England and Wales in recent years are shown in the following table:—

The deaths from puerperal fever and other accidents of childbirth per thousand births in each metropolitan borough and in the county of London in the periods 1920 to 1927 and 1928 to 1932, together with the deaths in childbirth in 1932, are shown in the following table:—

The seasonal incidence, as shown by the notifications (uncorrected for errors of diagnosis) received in successive four-weekly periods during the year was as follows :—

The death-rates in London and England and Wales in recent years are shown in the following table:—

The weekly deaths from influenza, pneumonia and bronchitis during the latter epidemic period are shown in the following table :—

The annual death-rates from pulmonary and non-pulmonary tuberculosis in recent years are shown in the subjoined table:—

The following is an analysis of the notifications in London during 1932 (52 weeks ended 31st December, 1932):—

These figures include cases not notified before death:—

The sources of information as to the unnotified cases shown in the above table were as follows :—

Vital statistics for the metropolitan boroughs and the county of London in the year 1932. (Rates per 1,000 of civil population.)

COUNTY OF LONDON.—Notifiable infectious diseases.—Notifications per 1,000 of population.

COUNTY OF LONDON.—Principal vital statistics, 1891-1932.

Infectious Diseases.—Notifications in the County of London during the 52 weeks ended 31st December, 1932.

The following table shows briefly the results obtained in the several years during which the enumeration has been undertaken by the Council:—

COUNTY OF LONDON.—Statistics of the administrative work carried out during the year 1932.

Sanitary Inspectors, 1932.

Results of Milk Sampling.

Results op Veterinary Inspection.

A summary of the work done by the hospitals for each of the areas in the joint scheme during the year 1932 is shown in the following table:—

The distribution of new cases of venereal disease between the sexes is shown in the following table, the figures for the preceding years being given for comparison :—

The age and sex distribution were as follows:—

Comparative figures for the sixteen years during which 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 Pathology pathological specimens. Comparative figures for the sixteen years are shown in the and bacteriology following table:—

The following table indicates the number of applications from adults for residential treatment under the tuberculosis scheme during each of the last five years:—

During the year, 1,561 patients were discharged from "observation beds "and their classification was as follows (the corresponding figures for 1931 also being given):—

The number of tuberculosis scheme cases under treatment on 31st December, 1932, was as follows (the corresponding figures for the previous year being shown in brackets):—

For the purpose of this table patients of 15 years of age on admission are regarded as adults, owing to the "age" division of patients required for the purposes of the Ministry of Health, although treatment for them was arranged in institutions for children.

This is shown more clearly in the following table :—

The number of cases under treatment on 31st December, 1932, was 811, distributed as follows:—

The condition of the children under 15 years of age (on admission) who were discharged from residential institutions in 1932 is indicated in the following table, the figures in brackets being those for 1931:—

The following is a summary, for purposes of comparison, of certain sections of the foregoing table:—

The following table shows the result of the enquiry and also (in brackets) the corresponding figures ascertained from last year's enquiry into the 1925 cases:—

The mortality records are as follows, the figures in brackets referring to last year's enquiry into the 1925 cases:—

The mortality rates of the non-pulmonary cases classified according to the location of the disease are as follows :—

From the inception of the scheme until 1932, 1,856 children have been dealt with, as follows:—

and 32 in places of safety awaiting action. During the year 1,241 cases were examined with the following results:—

The following table shows the number of cases considered and the recommendations made

Examination of Staff. During the year 9,009 examinations, including 482 home visits, were made of members of the staff, other than that under the direction of the Education Committee. These may be classified as follows:—

As a result of the examinations, 378 officers were deemed to be permanently unfit to carry out their ordinary duties in the service of the Council on the following grounds :—

Fifty-four applicants for appointment to the permanent service failed to pass the medical examination for the following reasons:—

The total number of samples examined in 1932 amounted to 9,480. The following table shows their classification:—

As in the case of raw milk for school supplies, the requirement as to the absence of B. Coli in 1/1,000 c.c. was adopted. Raw Milk

Of the 1,010 samples of drugs and medical supplies examined during the year 97 (or 9.6 per cent.) were found to be either definitely unsatisfactory for use or below standard strength or quality.

Samples of feeding stuffs.

The following table giving the averages of all samples taken during the last three years shows clearly the great improvement produced in the atmospheric conditions in the tunnels by the new ventilating plants:—

The following is a statement as to the defects dealt with at the 90 treatment centres and the financial arrangements in 1932:—

The following table shows the numbers inspected in each group, and their classification according to nutrition:—

Taking categories 3 and 4 together, the percentages of each sex found with subnormal nutrition in each of the code age groups, compared with similar percentages in previous years, are given in the following table:—

The boys of to-day weighed 1 stone 2 pounds more and were 1£ inches taller than their predecessors, and considerable improvement was found in the girls.

Details are set out below:—

First Re-inspections, 1932. (Percentages are given in italic type.)

Second Re-inspections, 1932.

Cases out of School for three months, November, 1932, and the four preceding years.