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of the diseases which are notifiable compulsorily. These do not assist in an assessment
of industrial man-power and woman-power lost through illness, as the heaviest incidence
of the notifiable infectious diseases is among children. They do, however, throw
light on the trends of the epidemic cycles and on the value of measures taken to
prevent their spread. As rates per 1,000 of the population at risk, cannot be given
this year, it must be borne in mind, when studying the figures, that the child population
of London was substantially higher in 1942 than in 1941. Notifications of
measles increased from 11,039 in 1941 to 19,987, and of scarlet fever from 2,372
to 4,416 ; those of whooping-cough declined from 7,944 to 6,234, and of diphtheria
from 2,179 to 1,813. Dysentery, which affects all ages, was notified in 749 cases
compared with 610 in 1941, but enteric fever declined from 210 to 67.
Tuberculosis is an important index of the well-being of a community. The
notifications are still increasing—4,734 of lung cases and 796 of non-pulmonary,
against 4,577 and 675 in 1941; but there has been a substantial fall in the deaths—
2,164 pulmonary and 283 non-pulmonary, compared with 2,552 and 343 in 1941.
It may be that the adverse climatic conditions in the early months of 1941 and the
effects of aerial bombardment (shelter life, etc.) in 1940-41 caused the deaths of a
certain number of tuberculous persons in 1941 who, but for these factors, would
have survived until 1942. This disease still takes a very heavy toll of health, and
indeed of life, and steps are being taken to discover patients earlier, when there is
more hope of a satisfactory result of treatment, by means of miniature radiography,
but details must await the report for 1943.
Comment on the venereal diseases is necessary in a war-time report. A casual
glance at the statistics—1,369 cases of male and 917 of female syphilis attending
the clinics for the first time, compared with 1,799 and 1,065 in 1938, and even greater
reductions in the case of gonorrhoea, might give the impression that all was well,
but it must be remembered that the clinics deal mainly with civilians, who,
at the ages mostly concerned, 18 to 30 years, are not nearly so numerous,
especially the men, as in 1938. New cases among women have increased year by
year since 1940. There is little doubt, that, in each sex, the incidence rate is
increasing. Another factor is that drug treatment of gonorrhoea is now so successful
that many patients who would formerly have attended the public clinics are being
treated by private practitioners. The publicity given recently to the dire effects
of these diseases on the public health is to be greatly welcomed.
The number of patients, 178,182, compared with 154,232 in 1941, admitted
to the Council's public health hospitals continues to increase. The decline in
admissions to the mental hospitals continues. There were 3,873 in 1942 and 3,966
in 1941.
The school medical service has had to expand again in 1942, owing to the return
of children to London. As the medical staffing is mainly by private practitioners,
employed part time, the additional help required has been available. The results
of routine inspections show that the health of the children is well maintained, and
there has been no decline in the nutritional condition. Periodic weighing and
measuring of groups of children have been resumed, and the results generally
bear out the above findings. The social scourges, verminous infestation and
scabies, which, at one time, appeared to be getting out of hand, are now beginning
to decline in incidence. The deterioration of the children's teeth, compared with
their pre-war condition, continues, but to a lesser degree.
The increased birth-rate caused great pressure on both institutional and domiciliary
maternity services. Institutional confinements in the Council's hospitals
increased from 7,793 in 1941 to 12,230 in 1942, and domiciliary confinements under
the Council's scheme from 6,543 to 11,323. In addition, arrangements were made
under the Government's evacuation scheme, for a large number of expectant mothers,
to be evacuated to the country for their confinements.