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Diphtheria Immunisation.—Clinic facilities were available at Maternity and Child Welfare Centres Nos. 1 and 2
and at the Middlesex Hospital. Treatments were also carried out at the day nurseries, and at three elementary schools
where, apart from new cases, 140 additional protective injections were given. Twelve general practitioners who wished
to carry out immunisation of their patients in the home or at the surgery were supplied with the necessary prophylactic
free of charge. A.P.T. (Alum Precipitated Toxoid) was the agent generally employed. T.A.F. (Toxoid-Antitoxin
Floccules) was used in a small proportion of cases.
Action as suggested in paragraphs 7 and 9 of Ministry of Health Circular 194/45, dated the 14th November, 1945, was
continued fully during the year, and follow-up of the comparatively small number of young children still not immunised
was intensified. It will already have been noted that extensive arrangements for treatment were made throughout
the district, and at the welfare centres, for example, immunisation is carried out at any clinic if necessary, in addition
to the special sessions held for the purpose. As mentioned in last year's report, new record cards were brought into
use in order to comply with the Minister's request for uniformity.

Vaccination.—Sir Lionel Whitby, C.V.O., M.C., who had held the appointment of Public Vaccinator for the Middlesex
Hospital District for six years, resigned at the end of 1945, and his Deputy, Dr. C. J. C. Britton, was appointed to the
position on the 1st January, 1946. Dr. P. T. J. C. P. Warner succeeded Dr. Britton as Deputy Public Vaccinator.
Dr. C. R. McClure was re-appointed Public Vaccinator for the North Marylebone District as from the 1st April, 1946,
on returning from service with H.M. Forces. Dr. Myles Colt, who had carried out vaccinations in both the North and
South Districts throughout the war, continued in office as Public Vaccinator for South Marylebone as Dr. J. L. Boyd,
the former Public Vaccinator for that District, did not, on demobilisation, desire reinstatement in the position.
Vaccinations carried out in the whole Borough numbered 578 (primary, 494 ; re-vaccinations, 84). Vaccination
was successful in 507 instances ; unsuccessful in 58 ; while 13 cases were not available for inspection. Of the 1,101
children whose births were registered in 1945, 782 (71.02%) were successfully vaccinated.
Scabies.—The Council's Cleansing Station in Lisson Grove dealt with 1,835 cases of scabies : adults 483 (men 332,
women 151); children 1,352 (boys 564; girls 788). Domiciliary visits paid in connection with St. Marylebone cases
numbered 167.
Impetigo.—One woman, 17 boys and 34 girls received treatment for this condition at the Cleansing Station.
Venereal Diseases.—Continued assistance was given to the propaganda campaign for drawing public attention to
the dangers of these conditions and to the adequate facilities which exist for those in need of treatment.
Under the grant received by the Central Council for Health Education from the London County Council, films dealing
with sex education and venereal diseases were shown to the staff of a local hospital and to a nursing division of the
St. John Ambulance Brigade, and lecture courses and talks on these subjects were given to health visitors, industrial
nursing students, a youth club and to girls employed at a large general stores.
Blood specimens from patients attending the Council's ante-natal clinics continued to be submitted, as a routine
measure, to a group laboratory of the London County Council for the Wassermann reaction and Kahn test.
Insulin.—Supplies of insulin for the poorer inhabitants suffering from diabetes were provided free of cost by the
Council in two cases, under the authority of Ministry of Health Circular 2734, dated 4th January, 1943.
Food Poisoning.—Three cases of food poisoning, which is notifiable in the Borough, were reported. Sausage sandwich
was the suspected article in two (unrelated) cases : in the third, the source of infection could not be traced. In no
instance was the presence of food poisoning organisms revealed by bacteriological investigation.
Tuberculosis—New Cases and Mortality.—Table 8, prepared at the request of the Ministry of Health, contains
information with regard to age and sex distribution of all forms of tuberculosis.

ncluding all primary notifications and also any other new cases of tuberculosis which
came to the knowledge of the Medical Officer of Health during the year.