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every caution in this respect a modest claim to some degree of success might, I think,
be justifiable. In an effort of this kind the most important single factor making for
success is the team-work and co-operation of all persons at all levels who are concerned
with the services. I should, therefore, like to say a word of appreciation and thanks
to everybody engaged in this important work at both member and officer level.
I am very happy to record that I have received the greatest possible encouragement
and help from the members of the two borough councils and the divisional health
committee, and particularly from the chairmen of the two metropolitan borough
public health committees and of the divisional health committee. My colleagues in
both the borough councils and also the division have added to their extensive knowledge
and efficiency (which were never, of course, in doubt) a readiness to co-operate and
work together and to give of their best which has been most gratifying.
We look forward to consolidating such success as has so far been attained and a
further more detailed report will be made in due course.
APPENDIX A—DEATHS AND SICKNESS IN
LONDON IN DECEMBER, 1952.
the most outstanding incident concerning the public health of London in 1952, was
the sudden great increase in deaths and sickness which occurred simultaneously with
the dense four-day fog at the beginning of December. Some idea of the relative size
of this phenomenon is given by considering that in a comparatively short time this
increase contributed directly between 0.5 and 1.0 per thousand to the year's general
death-rate of 12.0 per thousand; had no such increase occurred the death-rate would
in all probability have been between 11.0 and 11.5 per thousand.
During December the weather had been on the whole slightly worse than might
be expected for the time of year, with periods of cold and fog somewhat above the
average. The general state of health in the County, as measured by such indices of
morbidity as are available, was also a little worse than normal for the season with signs,
towards the latter part of the month, of the growth of a moderate ' respiratory '
epidemic, which in itself is by no means unusual at this time. Of a true influenza
epidemic there were no signs and it was not until the very last week in December that
one of the influenza viruses was isolated in South-East England, heralding the spread of
ingluenza in London in January and February, 1953.

*The week for sickness benefit certificates ends on Tuesday, i.e., Nov. 4,11, 18, 25 and Dec. 2.
†1951 only. § 1950 and 1951 only.