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9d48a81c-4c4b-4a6d-8c23-c8780874120a | It is hoped that this parent will appreciate the results of medical inspection. It would be well if the large stores which cater for the needs of the 'working classes would stock school children's garments of a more hygienic type than those which are now supplied. The expense need not be greater, it is only a question of altered pattern, but at present the only firms sufficiently enlightened in this direction provide materials whose cost is beyond the reach of the working-class income. Many of the mothers are really anxious to do the best by their children, but both ways and means must be made very simple before they are willing to accept innovations. As more instruction is given in hygiene and home management to the older girls while at school, we may hope that increased knowledge in the ways of physiological righteousness will filter through to the homes. Hindrances to Treatment. |
f5958d60-10ac-4106-925e-792f8cad378c | In the process of giving advice to parents who are present during the medical inspection of their children with reference to the treatment of simple ailments, we are often confronted with a fixed belief in some remedy which has been in use through several ' generations of a family, and treatment of this kind is persisted in to the exclusion of more scientific remedies. In some cases the principle underlying the treatment is quite obscure, but in others it is interesting to sift out the grain of truth at the foundation of the wide-spread belief in a remedy. For instance, every School Medical Officer will have met with cases of ringworm to which ink has been freely applied with no result in checking the spread of the ringworm. It is possible that in former days the ingredients of ink were more caustic in character, and thus genuine cures may have resulted. The present variety of ink merely serves as a danger-signal, and this function is still better discharged by the use of iodine, which has the advantage of also being curative. |
98eff5ed-efb9-43e7-909d-6ff754dba6ef | 110 There are still parents who hold that whooping-cough may be cured by taking a child near gas works or through a tunnel. Whether improvement is obtained through the counter-irritant action of the vapours inhaled, or due to the mild antiseptic effect of the sulphuric fumes, are certainly not problems considered by the parents, but they are more ready to adopt this dramatic remedy than the simpler treatment of antiseptic vapours like Sanitas or Formalin through the medium of a bronchitis kettle in a bed-room. Other " cures'' are of a pleasanter nature. If sufferers from measles are conducted " through a field of new-mown hay," we can well believe that improvement may result to the health of the patient from country air as opposed to the stuffy atmosphere of a bed-room, where doors and windows are tightly closed " to avoid a chill," though again the counter-irritation theory may play some part in lessening the coryza of this complaint. |
83d55c79-7093-48cf-993d-999477a486ed | During the course of a year's work the routine examination of children accompanied by their mothers brings to light an astonishing number of popular beliefs. In lung complaints there is a special value in goose grease, it is considered far superior to other oils or medical remedies. Possibly this is due to the energy and faith with which it is applied. Bronchitis is held to be a necessary accompaniment of teething, and is not supposed to respond to treatment until the period of dentition is finished. The eyes are a field for many observations, a squint is often considered a hereditary distinction—" styes" may be treated by friction applied by a wedding-ring which must be of gold, and blepharitis is numbered among the maladies peculiar to the " spring of the year" for which it would be contrary to Nature to attempt a remedy. The value of ear-rings as a cure for weak sight may have a basis in the old treatment by counter-irritation or blistering. |
87a93037-bf7e-4c41-a1ad-76332bb928b0 | 111 Bead necklaces are exceedingly common among young children, or in the case of boys an amulet may be worn. This is partly for ornament and partly as a prophylactic against disease; blue beads have a special merit in " keeping away colds or quinsy," and coral is for " luck." Both are probably a relic of the times when people feared the Evil Eye, and even now these beads are worn next the skin and never removed by night or day, lest some dire illness should result. There is a considerable amount of ignorance with regard todischarge of the ear; one popular idea is that no harm can result while the ear continues to discharge. Another fallacy which exists is that the discharge will cease when the child reaches the mystic age of seven years, or at puberty. It is true that in some cases the mischief clears up of itself, but not before the hearing of the child has been permanently damaged. |
6056945f-bdda-42c9-b010-0a1c1b69a517 | It is difficult to understand why a plug of " chewing tobacco " should be inserted into the ear in cases of otorrhoea, but in some parts this is a popular remedy. With regard to infectious diseases we learn that these may be of the " inward " or " outward " variety. There is a great dread of any application of soap and water on these occasions, either during the actual illness or apparently during convalescence, and as the chief idea is to keep the sufferer warm, the condition of the patient's skin leaves much to be desired. It is interesting to note that there is no opposition to weighing the children during medical inspection, when one remembers the popular prejudice against weighing new-born infants. This process is held to be unlucky and the ehildren will not thrive unless a medicine containing rabbits' brains be administered! Perhaps the most deep-seated of all superstitions circles about the mystic age of seven. |
cf9bc434-e948-4d7e-9628-b1f0add1283d | Numbers of parents of fairly educated type explain their delay in getting treatment of some childish ailment because " he will grow out of it when he is seven." At that, 112 age enlarged tonsils and adenoids are miraculously supposed to vanish, ear discharge or squints will be things of the past, and for this reason the inspection of children at a third age period will be an advantage, as necessity for treatment can be urged in a child of eight years old where the magic number has failed, and where the child will still be under medical observation for several years of his school life. Mothercraft. In last year's report we suggested a scheme by which the senior girls from the Council's schools might attend the creche in Bollo Bridge Road to have lessons in infant care and management. Unfortunately owing to illness and changes among the staff of the creche it has not been possible to put the scheme into working order during 1911. |
35d15221-aedd-4551-b659-c392ca4eed69 | We hope that future years will bring into practice this very important branch of education for the elder scholars in the Girls' Department. Mentally and Physically Defective Children. It has been the practice of the Education Committee of this district to enter into an arrangement by which physically and mentally defective children are sent to the special schools of the London County Council. At present, three mentally defective children are conducted to and from school by a guide appointed for the purpose. Unfortunately, we have been informed that there will be no further vacancies for children outside the London area in these schools; so in future the education of further cases of physically or mentally defective children will present some difficulty, as there are too few children to warrant the establishment of a special school in this district. The following cases are among those which have received special consideration:— M. J., aged 11, came from Norwood, where she had attended a special class for backward children. |
86010a16-6357-4acc-a581-f8b05d2ac4ff | Her case seems to be one of arrested development, as she did not walk or speak until 113 six years of age. On examination, no sign of feeble-mindedness is shown, but the child is backward for her age; so she has been kept in an ordinary school in the class suited to her attainments, and has made fair progress there. A. G., aged seven, had never been to school. He appeared to be a border-line case between feeble-mindedness and imbecility, and was quite unsuited for an ordinary class. Failing a special school, this child has remained at home, but it is possible that the L.C.C. would have considered him ineducable. V. D., aged 11, formerly attended a special school in Clerkenwell, and was backward rather than mentally defective. He is in attendance at one of the Council's schools, but makes very little progress. Cleft, Palate. One child, L. |
55782c58-638d-4304-9495-16be969d356a | McC., who was found during medical inspection to be suffering from cleft palate, has been admitted to the Royal Free Hospital, under Mr. James Berry, F.R.C.S., and has undergone two operations there. Her condition is now much improved. Blind Children. Two blind children attend the Blind School in Edinburgh Road, and one is in a residential school for the blind at Southsea. There are three cases of progressive myopia in the district; one of these is in attendance at Moorfields Hospital, and two are under the observation of the School Oculist. One of these children is excluded from school; in the other case arrangements have been made with the head teacher that the child does on fine work, or anything involving strain to the eyes. One child, R.E., who was noted in last year's report as suffering from progressive myopia, was drowned in the river at Kew during the summer holidays. |
1b463218-7b7b-489b-9015-51663622bc80 | 114 Deaf Children are sent to the Ackmar Road School under the L.C.C. Six children are at present attending this school and are conducted under care of a guide, We have recently recommended the admission of three other children to this centre. One child has been in attendance at the Victoria Hospital for Sick Children, and was considered by the doctor there to be a case of word-deafness; the two other cases have been under observation of the S.M.O. for some time, and their condition does not improve, in spite of hospital treatment. Dumb Children. Arrangements are being made to transfer one child, who formerly attended the Ackmar Road Centre, to a residential school for the deaf and dumb at Margate. Physically-Defectve Children. |
2c7d5749-81e0-4a11-a058-1c07b498be0b | The arrangements made in previous years continue in force, and physically-defective children are specially examined by the S.M.O., and it is now possible to suggest that children with slight curvature of the spine shall be treated with special exercises, under the care of a certificated instructor who lives in the district. This is a private arrangement made by the parents, and in all cases the instructor only works under the direction of a doctor, but it should prove of some value in the district. The following cases needed the special consideration of the Committee during the past year:— E. B., aged 10, suffers from tuberculous disease of the kneejoint, and his leg is in a plaster support. He has resided at Putney, and attended a special school under the L.C.C. Since July, 1911, he was in a convalescent home at Walberswick, and was discharged in September. The child gets about well on crutches and lives near Southfield Road Schools. |
16badb69-5a66-4c78-9c1f-2c60c0b637d2 | He is a bright, intelligent child, and is anxious to attend school, so the plan is being tried of allowing him to go to the Junior Department, where he is provided with a special Ilkley chair and table on the L.C.C. pattern, as in this way the injured leg is kept straight. 115 I. C., aged 10, had her left leg amputated at the hip-joint, but she can walk fairly well on crutches. She has not previously been to school, but both parents and child are anxious that she should receive some education. The girl lives very near the Beaumont Park Schools, and the mother has made arrangements with a neighbour's child to escort her to school, so I. C. is being tried in the Infants Department in order to avoid the difficulty with stairs. In all cases of physical deformity, parents are warned that full responsibility cannot be undertaken by the teachers, though special arrangements are made to minimise risk of any accident. |
e65bd215-2e6a-4e13-87c7-110041f69f9e | We have much pleasure in reporting the progress of A. B., a child who was suffering from tuberculous disease of the kneejoint. The child had to wear an apparatus to keep her knee stiff, and at the request of the S.M.O. in 1908 the Education Committee provided her with an Ilkley couch and table, which the child used in school. The child has been under observation of the S.M.O., and has always made good progress, both physically and mentally. In October, 1911, she had improved so much that the special couch and apparatus were no longer necessary. A. B. is now able to use an ordinary desk, to her great delight, and the head mistress states that she is one of the most promising pupils in the dancing class! The chair and table have been transferred to another school for a similar case, where an equally satisfactory result is much desired. The original cost of the special chair was £1 10s. |
dcc60431-af5e-4dd0-86e5-e0517fba6571 | 6d., and it has the advantage of being suitable for children of different sizes. An alternative method of education in the case of A. B. would have been attendance at one of the L.C.C. special schools, at a cost of £10 per annum in addition to the charge of conveyance, and the special chair is still in use; so the financial outlay has proved a good investment. 116 Organised Games are now part of the curriculum of the public elementary school, and the following remarks are intended to show the purpose of these games as carried out in the Acton Schools. Organised games may be considered under the heading of physical exercises, because it has been shown that the exercises which have a beneficial effect upon both respiration and circulation, and contribute to the better nutrition of the body, are to be found in the natural play movements of the children—running, jumping, skipping, dancing, or games of all kinds. |
3ffa768a-3a53-40cf-b447-d28319cb5200 | If these movements can be executed under conditions where a good supply of fresh air and suitable food are obtained, it will be seen that the structure of the body is built up wisely during the growing period. Children are therefore encouraged to take part in all kinds of running games, in which a considerable number can take share at the same time, as this develops the spirit of fair play and comradeship. For girls, the exercise of skipping is particularly useful. Naturally, this new form of physical development along pleasant paths is more popular with the children than the mechanical precision of the formal " drill" lessons, though both serve a useful purpose. It has been said that, " as a test of true discipline, good play is as real as good work," and some of the organised games are not only interesting and exciting, but also in many cases instructive. Throughout the schools the games are well adjusted to the size and age of the children, though some schools are more fortunate in playground accommodation than others. |
38b03bc4-50c9-40e4-88cf-0da34695e2fa | In the senior departments, the principal games for the boys are football and cricket, while the girls have basket-ball, net-ball and hockey. Of course, on the asphalte the play in hockey is very fast, and somewhat unfits the girls for field play, but the value of the games cannot be over-estimated, and the girls thoroughly enjoy them. 117 One of the Councillors has taken great interest in the hockey, and presented a number of sticks to one of the poorer schools for the use of the scholars. Teams are selected from the picked players in each school, and matches are arranged with the schools of the surrounding districts. On Saturday morning the scholars in one school are sometimes taken by the Teachers to the park for special coaching to work up for a match; in another part of the district a pitch laid out in the Recreation Ground, a short distance from the school, is eagerly desired by both teachers and scholars. |
46906972-c56f-405c-920b-23833be7e020 | In some of the newer schools the playground is marked out for tennis, but this is not so popular, as only four can play at a time. Moreover, for drainage purposes the asphalte cannot be entirely level, and this is a great drawback in tennis. Other games include bean bags, twos and threes, circular jumping, leapfrog in columns, fox and geese, &c. The value of these games lies in the free muscular movements which they encourage and the precision of hand and eye which is developed. Those who have watched these games can easily understand how a few minutes' recreation on a cold morning would improve the children's circulation and render them in a better condition for subsequent lessons. Certain games, such as bean bags, could be employed even within the limits of a class-room, but all recreative exercises should be performed with open windows, to get the air of the room thoroughly changed. In the Infants Department, the children have an interesting combination of work and games. |
ce926c99-1419-4ad5-9e8f-030aa418a023 | Geography is taught in the happiest manner by dances and songs. For instance, a Japanese song and dance is represented by the children carrying Jap. umbrellas and copying the postures adopted by the people of the country. We have also seen delightful dances of elves and fairies, where the children wore beautiful but inexpensive paper caps which had been made by the teachers. 118 At one school, in the kindergarten section, each of the tiny children has a little armchair and a table, which gives them ample space for their free games, and in an attractive way they begin their education. History lessons afford scope for dramatic talent, though this may lead to unusual developments, as the following incident shows. A teacher in one of our infant schools was watching her class at play, and found they were acting a story which represented their last history lesson; so she was much pleased with their originality and interest. |
9db4be2d-7bc2-4340-93f5-db731da78439 | On another occasion, the subject of the game seemed unfamiliar, and on enquiry the teacher was told, " Oh, we are playing C—,"alluding to a recent murder trial which had attracted much popular interest, and which the children must have heard discussed at home. An interesting lesson is given on the laying of the tea table and dinner table, and the manner to be observed at meal time. The little scholars are taught how to speak to each other, how to handle their food and to eat and drink. This seems a very useful lesson, as, even if food be scanty, every child should be taught to behave properly at table. Nature study is encouraged in a most delightful way. Each child is taught the steps in the growth of a plant, from the sowing of the seed to the full development of the plant. |
edfef6cb-c621-459f-820c-4ef274e1b4a8 | In one school, eggshells tinted in various colours are used as flower pots; each child has its own 'pot," and the teacher instructs how the seeds are to be sown. After this, the growth is watched daily by the children, and thus they become familiar with the laws of Nature. In other schools, instruction is given in animal and bird life by the school aviary or aquarium, where goldfish are kept; or, for other lessons, the children sometimes bring their pets. 119 In some of the Infants' Departments, excellent examples are shown of toys or models manufactured by the children themselves from simple materials. One consists of a large doll's house, whose walls are formed of empty matchboxes, strengthened by paper on either side. A very elaborate staircase is also constructed of matchboxes, and has an inviting appearance; the chairs and tables are of paper, cut out and folded by the children and then ornamented with a coat of paint. |
af2ee546-90f1-473e-b250-c71f4d632853 | Carpets and rugs have been plaited and woven to measure by the children, so that as many scholars as possible share in the work. The occupants are dolls wearing crinkled paper dresses, which can easily be renewed when soiled. Another department has made beautiful models of a lighthouse constructed of paper, and a large pillar-box made of glazed linen, in which the letters written by the scholars to one another are posted, and the children take weekly turns to act as school postman. The whole effects obtained are excellent, and are highly creditable both to teachers and scholars concerned in the production. The general combination of work and play has a wonderful fascination, and tends to arouse feelings of envy as we remember days when the rudiments of learning were only attained by more laborious and less interesting methods. Gardening. |
ded3d9d3-9bd9-4643-a618-1914d5de16a7 | In former reports we have drawn attention to the good work which is being performed in Nature-study, especially where the playground space permits of small plots being used as individual gardens for the scholars. At Acton Wells Boys' School a further development of a gardening scheme has taken place during the past year. 120 Two plots of land have been secured, providing space for 28 boys (forming two classes) to receive instruction in practical gardening; each boy possesses his own plot and unites with the others in the care of a propogating plot, under the direction of the teacher. All measurements of the ground into plots and formation of paths are done by the boys, who also make careful drawings showing the distribution of the crops. Each plot is divided into three sections, with a view to provide for a proper rotation of crops in successive years, and the boys are thus taught how to obtain the maximum value from the land at their disposal. |
37715e68-2109-46ec-8016-0732e72a2460 | Careful notes are made of each day's work, and accounts kept by each boy of the expenditure upon his plot, with the value of the produce obtained from it The scholars are allowed to have the produce from their own plots. An allowance of 1s. per head is granted to provide seed. In the first year's working an expenditure of 8½d. per head produced a return in garden produce of 5s. 2d. per head, but it is estimated that when in full working order a return of 10s. worth of produce may be expected from an outlay of 1s. per head for seed. A disused shed has been secured as a tool-house, and the scholars are given directions on the care of their tools. As mentioned in last year's report, a small greenhouse has been erected in the playground of the school, the wooden portion of which is mainly composed of disused school desks. |
4ad7d632-9fd8-4007-ad73-fa3b19db47fe | Practical instruction in gardening is given for two hours weekly, and the scholars seem exceedingly keen on their work. This interesting scheme has been drawn up by the Head Teacher, who has done much practical gardening, and he is assisted in giving the instruction by one of the class teachers. We feel the educational advantages of this kind of training for boys are as important as lessons in mothercraft are for the 121 elder girls, as education on these lines is not only an immediate benefit and a healthy training, but tends to produce an improved class of citizens in the future Examination of Teachers. Fifteen candidates have been medically examined during 1911. These are either examined as bursars or on appointment to school in this district. Of these, three were referred, and were subsequently reexamined ; one was passed, and directions were given in the case of the other two. A record of each physical examination, together with the family history of the candidate, is entered on a card and filed for subsequent reference. |
1ed6d36e-56b7-4907-a481-466d5bc613a2 | This method has been found useful when, for various reasons, it is necessary to make a second examination. Special Examination of Teachers. Two teachers have been examined, as the Committee required special reports concerning their health. SWIMMING. During the season of 1911, 35 swimming classes were held weekly during school hours and four out of school hours. Total, 39 classes weekly. During the season, 240 scholars—167 boys and 73 girls—have earned the swimming certificate awarded by the Committee for children who this year have learned to swim, 40 yards in the case of boys and 20 yards in the case of girls. 122 School. Classes per week. No. of attendances made No. of Scholars in School who can swim. No. |
8a904186-8210-449b-bd5f-030c1b2e2ad7 | of Scholars who have learnt to swim this season, Acton Boys 1 860 19 12 Acton Wells Mixed 2 899 50 34 Beaumont Park Boys 6 3058 117 77 Beaumont Park Girls 1 478 29 18 Central Senior 5 2197 139 55 Central Junior 2 966 24 16 Priory Boys 5 2249 77 51 Priory Girls 2 972 24 13 South Acton Boys 5 2054 82 65 South Acton Girls 2 1061 24 11 Southfield Road Senior 6 2533 114 72 Roman Catholic 2 678 38 29 Total 39 18005 737 453 In conclusion, we beg to thank the staff of the Education Department and the teachers for the assistance we have received, not only in compiling this report, but also in the work of medical inspection. |
7f395235-e559-4c2b-b0ee-928c0ce944d5 | We remain, Your obedient servants, D. J. THOMAS. LILIAN E. WILSON. |
ce8b586e-c287-42c8-a14a-b684aa005208 | Urban District of Acton. . Annual Report . OF THE Medical Officer of Health TOGETHER WITH THE REPORT ON THE Medical Inspection of Schools, for the Year 1913. BS XI/18 ACT 20 Urban District of Acton, . Annual Report . OF THE Medical Officer of Health . . for the Year . . 1913. INDEX. Page. Anterior Poliomyelitis 32 Baby Show 62 Birth Rate 10 , , District 10 , , Illegitimate 13 , , Ward 11 Cancer 73 Census Statistics „ Age incidence of population 17 , , Buildings 7 , , Population 7 , , Street population in South West Ward 8 , , Ward distribution of population 8 Dairies and Cowsheds 75 Day Nursery 55 Death Rate 14 „ , Age incidence 15 , Outside deaths 18 , , |
593439e5-041d-45fa-b341-eb45b4536429 | Ward distribution 17 Diarrhooal Diseases 65 Diphtheria 27 Enteric Fever 81 Factories and Workshops 81 & 88 Home Office Table 88 Housing 76 House to House Inspection 79 Infant Consultations 60 Infantile Mortality 45 „ * 1907—1910 49 & 57 1911—1913 57 , , Employment of married women in relation to 50 Inquests 73 Inhabited house duty—exemption 76 Isolation Hospital 81 Laboratory—Council 75 Local Goverment Board Tables 83-88 Measles 36 Mortality between 1 and 5 years of age 69 Mortuary—Public 74 Notification of Births Act, 1907 72 Notification of Infectious Diseases 19 Acton, 1913 19 1890—1913 22 , , , |
5456797b-bf10-4d4b-a617-4337b173d34e | County of Middlesex 20 Outworkers 89 Population 6 Sanitary Improvements—Table of 91 Scarlet Fever 29 Sewage Disposal 76 Slaughter Houses 75 Tuberculosis 37 , Deaths 37 , Notification 37 , Occupation of sufferers 37 & 43 Unsound Food 75 Whooping Cough 37 Zymotic death-rate 19 3 By the Order of the Local Government Board, dated December 13th, 1910, Article 19, section 14, it is prescribed that the Medical Officer of Health shall as soon as practicable after December 31st in each year make an Annual Report to the Council up to the end of December, on the Sanitary circumstances, the Sanitary Administration, and the vital statistics of the District. |
ef442f3e-0761-4aa8-afb4-8056897d8381 | * In addition to any other matters upon which he may consider it desirable to report, his Annual Report shall contain the information indicated in the following paragraphs, together with such further information as We may from time to time require:— (a) An account of any influences threatening the health of the District, the prevalence of infectious or epidemic disease therein, and the measures taken for their prevention. (b) An account of all general and special enquiries made during the year. (c) An account of the work performed by the Inspector of Nuisances during the year, including the statement supplied in pursuance of Article 20 (16) of this Order. (d) A statement as to the conditions affecting the wholesomeness of the milk produced or sold in the District. (e) A statement as to the conditions affecting the wholesomeness of foods for human consumption, other than milk, produced or sold in the District. |
3180b4cc-caa7-4531-8ae4-db3c91462177 | (f) A statement as to the sufficiency and quality of the water supply of the District and of its several parts, and in areas where the supply is from waterworks, information as to whether the supply is constant or intermittent. (g) A statement as to the pollution of rivers or streams in the District. (h) A statement as to the character and sufficiency of the arrangements for the drainage, and sewage disposal in all parts of the District. 4 (i) A statement as to the privy, water-closet, and other closet accommodation in the District, including information as to the approximate number of each type of privy and closet. (k) A statement as to the character and efficiency of the arrangements for the removal of house-refuse, and the cleansing of earth closets, privies, ashpits, and cesspools in the District. |
2d4ff01e-e189-42ff-8b6a-3bc55a12aeb0 | (k) A statement with regard to the housing accommodation of the District as required by Article 5 of the Housing (Inspection of District) Regulations, 1910, and an account of any other action taken by the Council under the Housing, Town Planning, &c., Act, 1909, bearing on the public health. (I) A statement as to the vital statistics of the District, including a tabular statement, in such form as We may from time to time direct, of the sickness and mortality within the District. Under section 132 of the Factory and Workshop Act, 1901, the Medical Officer of Health is also required in his Annual Report to report specifically on the administration of the Act in workshops and workplaces, and to send a copy of his Annual Report, or so much of it as deals with this subject, to the Secretary of State. ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH FOR THE YEAR 1913. Council Offices, Acton, March, 1914. |
d2155352-243c-45d6-9398-3b94f2df9f77 | To the Chairman and Members of the Urban District Council of Acton. Miss Smee and Gentlemen, I beg to submit my Annual Report on the Vital Statistics and Sanitary conditions of the district for the year 1913. The population at midsummer has been estimated at 60,000. This is lower by over 2,000 than the estimate of the RegistrarGeneral. The birth-rate still continues to diminish, and last year it was the lowest on record. The death-rate is slightly higher than that of 1912, but lower than the quinquennial and the decennial average. The infantile mortality is also higher than that of 1912, but with that exception it is by a considerable margin the lowest on record. 446 compulsory notifications of infectious diseases were received. This number is lower than that of 1912, due to the reduced prevalence of Scarlet Fever, only 80 cases of this disease being notified compared with 315 in 1912. |
df4a1a10-c980-43f8-b387-d5437f9242f0 | There was an increase in the number of notifications of Diphtheria, but the number of deaths from the disease remained the same as in the previous year. 6 There was another reduction in the number of notifications of Enteric Fever, and no death occurred from the disease. The Public Health Tuberculosis Regulations, 1912, came into force on February 1st, 1913, and, as a result, there was an increase in the number of notifications of Tuberculosis. There is also a higher death-rate from Pulmonary Tuberculosis or Consumption of the Lungs. The work of the Laboratory has considerably increased, owing largely to the examination of contacts prior to their return to school. 1,528 specimens were examined during the year. The routine inspection of dwelling houses has proceeded steadily, and 594 house-to-house inspections were made, but some streets have already required reinspection. |
a8961ae8-38a5-4c12-a26d-cfae975d6204 | A number of houses in Shaftesbury Road, Junction Road, and Stanley Road are let out in one and two-roomed tenements, and it is only by frequent inspections that the premises are kept in a fairly sanitary condition and overcrowding prevented. The following is a summary of the vital statistics for the Year:— Estimated population 60,000 Birth-rate per 1,000 inhabitants 25.3 Death rate per 1,000 inhabitants 11.55 Phthisis death-rate per 1,000 inhabitants 1. Death-rate from other forms of Tuberculosis per 1,000 inhabitants .24 Zymotic death-rate per 1,000 inhabitants 1.24 Respiratory death-rate per 1,000 inhabitants 2.1 Cancer death-rate per 1,000 inhabitants .9 Infantile mortality per 1,000 births 83. |
b66d8ea1-824e-4e73-9feb-a7b4f1615ec3 | POPULATION, SOCIAL CONDITIONS, &c. At the Census of 1911, the population of Acton was 57,497The preliminary figure was 57,523, but subsequently it was revised. It had been hoped that the final results of the Census would have been published ere this, and deductions from the report could have been made. Some of the figures have already been publishd, and it probably will be advisable to include them here. The following table gives the number of the different kinds of buildings, together with the number of occupiers in each class of building:— 7 1901 1911 Total Total (Cols. 4-11) Buildings used as Dwellings Vessels, Sheds, Vagrants, &c. Separate Flats (included in col. 5) Buildings not used as Dwellings Ordinary Dwelling Houses Blocks of Flats Shops Hotels, Inns and Public Houses Offices, Warehouses, Workshops and Factories Institutions Others Kind of Building No. |
79ae07be-a9d8-4a3b-8caa-84f3e00887a9 | Cols—1 2 3 4 5 6 7 8 9 10 11 12 13 14 URBAN DISTRICTS Acton U.D. |
38c7e35b-7088-4a6d-9b98-4b6d724cb76e | Places of Worship 20 Number Inhabited 6,086 9,445 7,587 1,161 540 38 46 40 33 - 2,447 Government and Municipal Buildings 4 Separate Occupicrs 8,326 12,965 9,652 2,471 677 38 48 40 34 5 2,471 Shops 98 Population 37,744 57,497 43,273 10,439 2,825 234 184 333 187 22 10,439 Offices 10 Uninhabited 454 490 438 2 35 1 9 1 4 - 98 Warehouses, Workshops, Factories 122 Being built 131 77 61 1 13 - 2 - - - 10 Theatres and other places of amusement 1 8 The number of persons in each Ward was:- North-East. North-West. South-East. |
c0d3959f-0b26-4e5b-91ee-0d34713ff13a | South-West. 14.576 11.492 14.599 16,830 The population of the South-West Ward was obtained in greater detail from the Registrar-General, and the following table gives the particulars as to the population and sex distribution in each street:— Street. Population. South-West Ward. Males. |
2c57027c-d723-414a-8cc6-6f586dea76b4 | Females Acton Lane 252 267 Albert Grove 17 18 All Saints' Road 83 98 Antrobus Road 181 193 Avenue Crescent 42 72 Avenue Gardens 68 106 Avenue Road 125 179 Beaumont Road 225 261 Bollo Bridge Road 538 661 Bollo Lane 290 334 Braemar Road 14 14 Bridgman Road 263 249 Brouncker Road 135 163 Church Path 192 220 Cleveland Road 27 31 Colville Road 414 432 Cunnington Street 25 34 Enfield Road 74 81 Fletcher Road 247 256 Hanbury Road 195 199 Heathfield Road 52 117 Holland Terrace 90 97 junction Road 81 94 Kent Road 180 207 Kingswood Road 220 226 Leythe Road 173 200 Margaret Terrace 95 115 9 Meon Road 150 139 Newton Avenue 170 155 Osborne Road 479 3. |
cb9d3528-ebc2-498e-b4a4-f8da1824b2f5 | 17 Packington Road 178 199 Palmerston Road 164 175 Park Road East 104 134 Park Road North 331 398 Petersfield Road 347 340 Ramsay Road 160 162 Reynolds Road 26 36 Roslin Road 55 72 Rothschild Road 321 333 Shaftesbury Road 122 153 Strafford Road 204 230 Stanley Road 236 255 Steele Road 53 73 Stirling Road 278 306 Temple Road 141 148 Weston Road 215 219 8,032 8,798 At midsummer, 1913, the Registrar-General estimated the population to be 62,230. It has been explained in previous reports that this estimate is based on the assumption that the rate of increase which obtained in the last intercensal period is being maintained. There is ground to believe that this increase is not maintained, and that the increase in the intercensal period was not an uniform one. |
0ecc585e-5a24-4a72-9f30-190a1e637138 | The great increase occurred between 1901 and 1905. Since 1905 the increase has been fairly constant, but the extent is not nearly as great as it was prior to that date. I estimate the population on June 30th, 1913, to be 60,000, and the rates in this Report are based on that estimate. This estimate is based on the number of new houses erected. The Surveyor has kindly supplied me with particulars of buildings erected, and between July 1st, 1912, and July 1st, 1913, 167 dwelling houses, 13 factories, 2 shops, and 40 additions to buildings were completed. 10 BIRTHS. Number of Births 1,522 Birth-rate per 1,000 inhabitants 25.3 Birth-rate per 1,000 inhabitants in England and Wales 23.9 Birth-rate per 1,000 inhabitants in the 96 large towns. |
1b6b100a-3454-44e0-92b4-4dcd6cb6a5f4 | 25.1 1,486 births were registered in the district, 778 males and 708 females. In addition, the Registrar-General transferred 36 births from other districts to Acton—19 males and 17 females. There were no outward transfers. The birth-rate of 1913 is the lowest on record for Acton, and is .4 per 1,000 lower than that of 1912. In last year's report the birth-rate was given for Acton since 1878, and it was apparent that the decline was a steady and a continuous one. Until the Census figures are published it is impossible to state what relation this decrease bears to that observed throughout the kingdom. It is probable that the large decrease observed here since 1905 is partly due to an altered ageincidence of the population. The decreased birth-rate has exercised the minds of many people for years, and during the past year a Private Commission on the Birth-rate was established. |
f2b08b24-dc0f-400b-998a-e570cacd20a9 | France has gone a step further, and appointed n Parliamentary Committee to inquire into the national, social, and fiscal aspects of its declining birth-rate. In France, matters are more serious than in this country; in 1912 there was an excess of deaths over births, and a shortage of 34,000 lives, equal to a good-sized town. The Private Commission might not expect to do so much as a Royal one would have accomplished; but the former might do some things which a Royal one might miss for the witnesses would be free to speak in private, and the Commission might thus get a nearer sight and insight into what was really taking place amongst the population. 11 The inquiry is to be made in various directions. The extent and character of the decline are to be considered under such headings as the present British birth-rate and infantile mortality, general and classified according to income, occupation, province and county, urban and rural. |
17ceb37b-3c1c-4029-9ce2-600ea8cf69a3 | Statistics showing the proportion of sterile to total marriages, and the extent of the declining birth-rates in foreign countries will be prepared. The alleged causes are to be investigated, and the effects of the decline are to be searched. The question will also be considered in its national and economic aspects. Although it is known that since 1877 the birth-rate throughout the country has been steadily declining, it is curious how large social movements may take origin, and even gain considerable impetus before the community in general has fairly realised that they exist. It has been so in large measure with the causes underlying the phenomenon of the falling birth-rate. Nevertheless, there is probably no one who will deny, that one of them, at least, is the practice of voluntarily limiting the number of births which take place in married life. |
db236792-fff7-4a77-90c4-b0d170baad59 | An examination of the figures for Acton for the last seven years will show that whereas the birth-rate in the North-East, North-West, and South-East Wards has been falling rapidly, in the South-West Ward the rate remains fairly constant. The following table gives the birth-rate per 1,000 inhabitants since 1907, in each of the Wards :— North-East. North-West. South-East. South-West. 1913 21.7 17.7 23.9 33. 19102 22.1 18.9 23.9 33. |
865d8744-d5ac-4214-85f8-2c7ef2d9b77a | 1911 19.7 17.5 24.7 34.2 1910 21.9 19.9 26.3 32.3 1909 23.6 19.1 28.0 31.8 1908 26.9 19.5 31.2 33.1 1907 25.5 20.2 32.0 33.6 12 It is not self-evident that the fact of a declining birth-rate is an occasion for regret. If the birth-rate had declined uniformly over the whole district it is doubtful if it could be considered an occasion for regret. It is too readily assumed that decrease of the birth-rate in this country is intimately connected with physical degeneracy; but the unaided mother of a family, even when she is fortunate enough to escape being a contributory wage-earner, can rarely do justice to the numerous progeny which she is capable of bearing. |
be4715b4-6344-4516-afae-70d4a7b43ce0 | In many instances restricted child-bearing is compensated in improved mothering of a fewer offspring. Of the births that occur in the South-West Ward, in more than one-half of the cases, the mother is employed in occupation outside the home. On the other hand, the fact remains that the human race has now begun an experiment upon its reproduction similar to those which it has in times past made upon its digestion and other bodily functions. No one can tell what effects this quiet concealed and yet widespread and persistent experimenting will have. The crux of the problem lies in the fact that the larger the family the less adequate the provision which can be made by the parents for their children. It cannot be argued from this, though, that declining fertility necessarily implies superior quality of the offspring. Given a fixed income anywhere near the poverty line, it is obvious that a parent can provide better housing, nourishment, and education for two children than for five. |
0f1ba9d5-ccd3-4be8-abc5-4f86f4496281 | Environmental advantages which thus accrue to the diminished number of the offspring outweigh the disadvantages of a slackening of the intensity of natural selection operating upon a larger number of children, some of whom must be weeded out. Again, are the effects upon the health and morals of a nation of the employment of artificial methods of restricting fertility so prejudicial as to counterbalance the individual advantages? Opinions differ fundamentally with respect to them, and it is very doubtful if some of the measures which are being suggested to arrest the decline will have the slightest effect. C. R. O. 6. Publications and Correspondence intended for the Copyright Receipt Office of the British Museum should be addressed:— The Clerk in Charge, Copyright Receipt Office, British Museum, London, W.C. Continuations should be delivered, as issued. 13 One unsatisfactory feature in connection with the birth-rate has been the increase in the proportion of illegitimate births. Prior to 1912 the outside births were not transferred. |
cb6af4a5-e6f9-4dd4-8386-b07319d85942 | The illegitimate birth-rate, of course, is considerably affected by this arrangement; but, apart from this, the illegitimate birth-rate is higher than it has been for some years. Of the 36 births that occurred outside the district in 1913, 19 were born out of wedlock. Altogether the infants registered as having been born out of wedlock numbered 76, which number corresponds to a rate of 50 per 1,000 births. The illegitimate birth* and the rate per 1,000 births since 1907 are as follows:— Number Rate. 1913 76 50 1912 71 47 1911 43 29 1910 36 24 1909 29 19.2 1908 42 26.8 1907 37 24 Excluding the outside births which were transferred in 1912 and 1913, the illegitimate birth-rate has been as follows:— Number. |
2e108917-e6dd-41dd-9698-00ef4859d7ad | Rate per 1,000 births. 1913 56 37.9 1912 53 36 1911 43 29 1910 36 24 1909 29 19.2 1908 42 26.8 1907 37 24 It will be seen that since 1909, a steady and marked increase has occurred in the illegitimate birth-rate. 14 This increase is partly due to the fact that there are 3 or 4 houses in the district which are being used for lying-in purposes, and for some reason or other the mother gives the place of birth as her usual residence. The majority of these births are illegitimate ones, and do not really belong to the district, but as the mother chooses to utilise the place of birth as her usual place of residence, the births have to be accepted as belonging to Acton. The births registered in the district had the following Ward distribution:— North-East. North-West. South-East South-West. |
9f1f3a04-81f8-47ed-9ef8-4d09f1e8e6a9 | 334 231 359 562 DEATHS. Number 693. Crude. Corrected. Death-rate per 1,000 inhabitants 11.5 12.28 Death rate per 1,000 inhabitants in England and Wales - 13.7 Death-rate per 1,000 inhabitants in 96 large towns 14.3 508 deaths were registered in the district, of these 12 belonged to other districts, and are not included in the returns. 197 deaths of "residents" occurred outside the district. The total number of deaths belonging to the district is 693, which corresponds to a death-rate of 11.5 per 1,000 inhabitants. The rate 11.5 per 1,000 is the "crude death-rate," and makes no allowance for the inequalities of age and sex distribution in the district as compared with England and Wales. |
9472ac28-55f4-4a4b-9556-85015bc8d046 | In former Reports it has been explained that the Registrar-General published a table of factors for all the large towns, and that the "factor for correction "for Acton is 1.04640. If the crude death-rate of 11.5 be multiplied by this factor for correction, the result obtained—12.28 —is the " corrected death-rate " for the district in 1913. 15 A comparison of the death-rate of Acton with that of the 96 large towns shows that Acton occupies the 16th place in the list; that is, 15 of the large towns had a lower death-rate than Acton, and 80 had a higher one. The death-rate is .7 higher than that of 1912, and .7 per 1,000 lower than the quinquennial average 1908-1912. |
d5965d5e-06d6-4d91-beed-f47cf43e605f | The diseases which caused the most marked increase in the number of deaths were Measles, Phthisis or Pulmonary Tuberc ulosis, Organic Heart Disease, and Diarrhoea. The ages at death last year were as follows:— Under 1 year. 1-2. 2-5. 5-15. 15-25. 25-45. 45-65. Over 65. 127 56 33 26 26 99 156 170 Compared with 1912 there was a higher rate in the age periods under 1 year, 1-2 years, 25-45 years, 45-65 years, and a lower rate in the other age periods. |
2610e5ef-9245-4eaf-b533-c78bccd5d665 | It is difficult to calculate exactly the number of persons living at each age period An examination of the Census figures shows that the increase in the population took place fairly uniformly in all the age periods, and it is natural to assume that the age-distribution of the increased population since the Census remains fairly constant. Buc the greatly reduced infantile mortality in the last two years would affect the age periods under 1 year and 1-2 years, and raise the numbers in these two age periods out of proportion to the numbers in the other age-periods. The number of children living under two years can be fairly accurately computed, as emigration and immigration do not affect these age-periods to any considerable extent. The number of children under 1 year can be estimated by taking the number of births and subtracting the number of deaths under 1 year. |
15aff42a-fdb8-4a08-8d17-a43f85f3f9ca | A more accurate method to estimate the number living at midsummer in any year, is to take the number of births in the first half of the year under review and the second half of the preceding year, and subtract the deaths under 1 year which have occurred in the same two half-years. If either of these two methods had been done for the year 1911, the result would almost exactly correspond with the figure at the Census 16 enumeration. In 1911, 1,486 births and 205 deaths under 1 year occurred; the resultant figure would be 1,281. In 1910, 1,475 births and 151 deaths under 1 year occurred. If the second method, that is, abstracting the deaths in the second half of 1910 and the first half of 1911 from the births in the same period, the resultant figure would be 1,285. enumerated figure at the Census was 1,283. |
d224fe98-5004-46ef-882f-b8927b0a5ab0 | We estimate the numbers at the age-periods under 1 year and between 1-2 years by this method, and assume that the increase in the other age-periods has been in the same ratio as in the last intercensal period, the death-rate per 1,000 living at each period last year was as follows:— Under 1 year. 1-2. 2-5. 5-15. 15-25. 25-45. 45-65- Over 65. 90 40 8 2.2 2.2 5 17.4 70 Incidentally, it might be mentioned that these figures show the importance of a "factor for correction," before instituting a comparison between the death-rate of one district and that of another. As far as sanitary conditions are concerned, the persons in all the age-periods are affected in a similar manner; but the death-rate at the extremes of life are very much higher than those in the middle periods. |
30f8388a-c614-4c3c-93a5-a269bf3f8971 | A district with an abnormal proportion of its inhabitants living between the ages 5-45 would, therefore, have a lower death-rate than another district which contained a higher proportion of children and old people. The following table gives the number of deaths at the different age-groups since 1905:— Under 1. 1-5. 5-15. 15-25. 25-65. Over 65. |
ddd3a53e-66c6-48ed-9085-8153015903b2 | 1905 172 73 18 24 200 141 1906 201 91 26 19 194 156 1907 200 94 38 28 217 160 1908 188 106 29 23 209 168 1909 ,58 102 40 30 208 170 1910 151 55 18 20 203 176 1911 205 116 34 28 224 170 1912 107 72 3i 30 216 177 1913 127 89 26 26 245 170 17 With the exception of the two age-periods under 1 year and between 1-5 years, the increase in the numbers in every age-period since 1905 has probably been a fairly uniform one. The following figures represent the number of persons living at each age period, as enumerated at the Census:— Under 1. 1-2. |
8565e82b-0ec9-4682-9133-05d7a7ad4414 | 2-5. 5-15 15-25. 25-45. 45-65- Over 65. 1,283 1,211 3,929 10,930 10,286 19,010 8,624 2,325 These figures do not extend back for a sufficient period to institute any comparison, and, moreover they are not sufficiently comprehensive for the purpose, but they point to the same result as has been arrived at by an analysis of the figures for the whole kingdom. The improvement in mortality has not taken place at all periods of life, the higher ages participating in it little or at all. The improved conditions of life have, so far, had relatively small effect on the prospects of life after the age of 45, and practically none after the age of 55. |
9eff2e42-5acb-4c16-a757-5ba884f3a859 | In view of the immense improvement in this country in the death-rate during youth and early adult life, and of the more favourable death-rate experienced in some parts of adult life in other countries, there can be no reasonable doubt that much mortality occurring in adult life, which anticipates death in old age, is preventable in character and should be prevented. Ward Distribution— North-East. North-West. Scuth-East. South-West. 164 119 132 275 The addresses of three could not be traced. The deaths occurred outside the district, and the address given was, simply, Acton. Based upon the estimated population of each Ward the deathrate per 1,000 was:— North-East. North-West. South-East. South-West. 10.6 9.5 8.9 16.1 The death-rate is higher in the North-East and South-West Wards, and lower in the two other Wards. |
ffa14046-ac5d-49a0-8ad2-6f18ab1904ab | The causes of death and Ward distribution of the different diseases are given on Tables 3 and 5 at the end of the Report. 18 The addresses outside the district where residents died together with the number of deaths were as follows:— Union Infirmary 109 West London Hospital 21 Middlesex County Asylum 16 Middlesex Hospital 5 St. Mary's Hospital 4 Children's Hospital 4 St. Luke's House, Kensington 2 St. Bartholomew's Hospital 2 University College Hospital 2 Infants' Hospital 2 Barrogate Road, Chiswick 2 Grand Junction Canal 1 Footway, High Road, Chiswick 1 District Railway, Bollo Lane 1 St. |
844c9d1b-8bd2-4cbd-86da-deb613236373 | George's Hospital 1 Charing Cross Hospital 1 Belgrave Street, Brighton 1 Berkshire Asylum 1 Llandudno 1 Chelsea Hospital for Women 1 Brecon 1 Bethlem Hospital, Southwark 1 Central Station, Liverpool 1 Queen Mary's Hospital, Carshalton 1 Westminster Hospital 1 Ha Ha Brook, Richmond 1 Cambridge Terrace, Sidmouth 1 Homoepathic Hospital 1 The Meadow, Hanger Lane 1 St. Peter's Hospital, Henrietta Street 1 Buchanan Hospital, Hastings 1 Consumption Hospital, Kensington 1 High Road, Chiswick 1 London County Asylum 1 Guy's Hospital 1 19 Fulham Infirmary 1 Northern Hospital, Winchmore Hill 1 Chiswick Hospital 1 St. Thomas' Hospital 1 ZYMOTIC DISEASES. Deaths, 76; Death-rate per 1,000, 1.3. |
b16ee743-1483-489b-94a9-12d0519dddfe | The so-called Zymotic death-rate includes deaths from seven the principal Zymotic diseases: Small-pox, Measles, Whooping>ugh, Scarlet Fever, Diphtheria, Diarrhoea and Enteric Fever. Most of these diseases are separately dealt with. NOTIFICATION OF INFECTIOUS DISEASE. The following notifications of infectious disease were received during the year:— N.-East. N.-West. S.-East. S.-West. Total. |
09190377-d286-4e94-9463-9cf537040494 | Scarlet Fever 24 10 19 27 80 Diphtheria 34 18 20 45 117 Enteric Fever 2 1 1 — 4 Erysipelas 9 4 12 8 33 Puerperal Fever 3 1 1 — 5 Pulmonary Tuberculosis 38 21 26 74 159 Other forms of Tuberculosis 11 3 12 16 42 Poliomyelitis 1 1 1 3 6 122 59 92 173 446 Before we make a comparison of infectious disease in the district last year with previous years, a comparison with the rest of the county would be interesting, and the material for such comparison is available. |
967fb1d8-d8d0-4bca-b60b-d6b6567bb409 | Taking the county as a whole, Scarlet Fever was much more prevalent in 1913 than in either of the two previous years, the attack rate being equal to 3.57 per 1,000 of the population, compared with 2.98 and 2.90 in 1912 and 1911 respectively. The increase was much more noticeable in the urban districts than in the rural, where the attack rate was only slightly higher than in former years. 20 The attack rate in Acton was 1.28. It will be observed in the tables that there is a slight discrepancy between the figures in the Annual Report and those in the return of the Local Government Board. This is due to two causes. The Annual Report is for the year ending December 31st, 1913, but the return of the Local Government Board is for the 52 weeks ending January 3rd. |
cf4d63a5-aba4-4d9d-b39f-14d9cec885f6 | So that the comparison for the whole county should hold good, I have included the figures in the comparative columns for the county as given in the Local Government return, but in the table giving the figures for former years, the figures for 1913 are the correct ones for the year. Diphtheria was not appreciably more prevalent than in 1912 and 1911, and all classes of districts were almost equally affected. The attack rate for 1913 was 1.39 per 1,000 inhabitants, as compared with 1.24 in 1912 and 1.32 in 1911. The attack rate in Acton was 1.88. Typhoid Fever was also less prevalent, and the decline in the disease recorded in 1912 was well maintained in 1913. The attack-rate was .22 per 1,000, as compared with .23 in 1912 and .38 in 1911. |
93eb5b77-d1c1-4529-855d-ecfd8a2600af | In Acton the attack rate was .07 per 1,000 inhabitants. The following table gives the attack-rates per 1,000 inhabitants in the County:— Boroughs and Urban Districts. Scarlet Fever. Diphtheria. Enteric Fever. Puerperal Fever. Erysipelas. Acton 1.28 1.88 .07 .07 .6 Brentford 2.46 1.92 — — .84 Chiswick 1.35 1.20 .05 .03 .78 Ealing 5.14 .83 .08 — .66 Edmonton 6.82 1.86 .16 .04 .76 Enfield 2.84 1.31 .03 .09 .57 Feltham 3.64 .19 .19 — .96 Finchley 2.23 1.20 .14 .10 .17 Friern Barnet 1.89 .46 .07 .07 . |
9ed6ff1c-daf5-4f64-a98a-59c65d0e7cec | 52 Greenford 20.07 1.82 — — 1.82 Hampton 3.25 .21 — .10 .31 21 Hampton Wick 1.25 1.67 — — — Hanwell 3.11 1.28 .05 .05 1.04 Harrow 5.01 .67 .06 — .28 Hayes 3.35 .67 — — .89 Hendon 2.2 4 1.44 .27 .02 .46 Heston & Isleworth 2.40 1.18 .07 .13 .53 Hornsey 2.46 1.36 .13 .02 .31 Kingsbury — — — — — Ruislip 2.89 2.59 .15 — — Northwood Southall, 3.60 1.53 — .04 .25 Norwood Southgate 2.66 .58 .11 — .61 Staines 1.92 1.48 — — — Sunbury-onThames . |
74551c52-6cb2-4f7f-9b64-6c67cd2c5ace | 43 .43 Teddington 1.63 .44 .05 .l6 .54 Tottenham 4.21 1.92 .08 .04 .58 Twickenham 3.84 1.77 — .13 .23 Uxbridge 1.51 2.83 — — .57 Wealdstone 4.17 1.81 .16 .08 .55 Wembley 2.26 2.61 .35 —. |
ca5ddda3-5ac4-4087-ab48-d25b36e86495 | .26 Willesden 3.24 1.49 .11 .07 .60 Wood Green 3.68 1.38 .02 .06 .66 Yiewsley 4.93 .67 — — .90 Rural Districts— Hendon 4.10 2.95 .07 — .07 South Minims .35 .35 — — .71 Staines 2.76 .45 .04 .04 .8 Uxbridge .74 1.06 — — .21 A return was submitted giving the number of cases of Scarlet Fever, Diphtheria, and Enteric Fever notified since the Infectious Diseases Notification Act came into force, together with the number of deaths from these diseases, and it was resolved by the Health Committee that these figures should be included in the Annual Report. 22 SCARLET FEVER. Total number. Rate per 1,000 inhabitants. Cases. Deaths. Cases. Deaths. 1890 108 3 4.5 . |
3fa06aa3-bf1b-4200-95cf-1e733fd53d22 | 12 1891 63 4 2.6 .l6 1892 74 0 3.0 — 1893 192 10 7.3 .39 1894 86 3 3.1 .11 1895 67 3 2.4 .1 1896 193 1 6.5 .034 1897 93 0 3.0 — 1898 167 3 5.0 .09 1899 111 2 3.2 .06 1900 243 6 6.7 .16 1901 82 2 2.1 .05 1902 109 1 2.6 .025 1903 76 2 1.7 .05 1904 129 1 2.7 .02 1905 137 2 2.7 .04 1906 170 7 3.2 . |
79a2e92c-e9e9-4d59-81bb-e59606b08a14 | 13 1907 267 6 5.0 .11 1908 484 15 8.8 .272 1909 469 16 8.3 .28 1910 109 2 1.9 .035 1911 234 6 4.0 .1 1912 315 5 5.3 .085 1913 80 2 1.33 .033 Prior to 1905, the deaths and the death-rate may not be strictly accurate. Some of the cases were isolated in outside hospitals, but if any death occurred, it was not included in the returns. It probably affects the Diphtheria and Enteric Fever death-rate to a greater extent than it does the Scarlet Fever rate. 23 DIPHTHERIA. Total number. Rate per 1,000 inhabitants. Cases. Deaths. Cases. Deaths. 1890 14 7 .5 .3 1891 8 2 . |
015938a0-b33e-439b-a1f1-4dd5aaa255a5 | 3 .08 1892 27 4 1.0 .16 1893 41 2 1.6 .077 1894 22 5 .8 .18 1895 32 5 1.1 .17 1896 21 8 .7 .27 1897 89 28 2.8 .9 1898 35 8 1.07 .24 1899 49 7 1.4 .21 1900 28 4 .7 .11 1901 34 6 .8 .15 1902 33 4 .8 .1 1903 22 2 .5 .05 1904 32 2 .7 .04 1905 49 4 .98 .08 1906 46 2 .88 .03 1907 63 5 1.2 .09 1908 83 7 1.5 . |
2c7018a5-00df-4e6b-8071-cc754e2dae2c | 127 1909 104 22 1.8 .39 1910 118 9 2.0 .158 1911 115 9 2.0 .15 1912 100 8 1.7 .133 1913 117 8 1.9 .131 The increase in Diphtheria is more apparent than real. Formerly, only clinical cases of Diphtheria were notified. Now, owing to the extension of bacteriological facilities many cases which exhibit only symptoms of sore throat without membrane, but which prove to have the Klebs Loeffler bacilli present, are notified. A large number of swabs are also taken from school children who suffer from sore throat, and where the Diphtheria bacilli are present, are notified. On the other hand, since 1894 the fatality has been greatly reduced owing to the introduction of Antitoxin. 24 ENTERIC FEVER. Total number. |
3c617d6a-0445-488f-b060-0ddd44a1f89d | Rale per 1,000 inhabitants. Cases. Deaths. Cases. Deaths. 1890 13 1 .55 .04 1891 13 0 .5 — 1892 15 3 .6 .12 1893 19 4 .7 .15 1894 15 2 .55 .07 1895 28 2 1.0 .07 1896 14 2 .5 .07 1897 10 2 .33 .06 1898 9 0 .28 — 1899 46 7 1.3 .2 1900 29 4 .8 .11 1901 27 1 .7 .025 1902 14 4 .3 .1 1903 40 5 .9 . |
04b6d29b-b4a4-4a57-a27d-66a7f2334aeb | 11 1904 8 3 .17 .06 1905 12 6 .24 .12 1906 12 3 .23 .05 1907 13 3 .24 .05 1908 14 2 .25 .036 1909 4 1 .07 .018 1910 16 2 .28 .035 1911 17 4 .29 .067 1912 9 1 .15 .017 1913 4 0 .065 — It will be interesting to give the statistics since 1881, though, of course, the notifications cannot be included, as the Notification of Infectious Diseases Act was not in force before 1890 :— Scarlet Fever. Diphtheria. Enteric Fever. Deaths. Rate per 1,000. Deaths. Rate per 1,000. Deaths. Rate per 1,000. |
ff4f6233-b36c-4ffe-8eaf-7e57a00aafb7 | 1881 6 .35 11 .62 2 .11 1882 5 .27 4 .21 6 .32 1883 6 .31 2 .1 4 .21 25 1884 2 1 8 .4 5 .25 1885 0 — 3 .14 3 .14 1886 0 — 5 .24 6 .28 1887 10 .46 5 .23 4 .18 1888 2 .091 2 .091 0 — 1889 1 .043 8 .35 1 .043 These figures are capable of almost any kind of grouping, and their analysis would serve very little purpose unless some guide might be had in the framing of the estimates for the coming year. |
b4e03e33-1abf-4f43-a8bc-760af776a11a | Taking the death-rate from Scarlet Fever as being the simplest and freest of complications, it will be seen that if the 21 years, 18811901, be divided into 3-year periods, and the 12 years, 1902-1913, into 4-year periods, the periods of maximum and minimum prevalence exactly alternate, and in the one group of periods the prevalence is, roughly, four times as great as in the other. Average Annual Death-rate per 1,000 inhabitants. |
e475299f-cf33-4583-af21-9bdc46c3894b | 1881-1883 .31 1884-1886 .033 1887-1889 .201 1890-1892 .093 1893-1895 .2 1896-1898 .041 1899-1901 .09 1902-1905 .023 1906-1909 .198 1910-1913 .063 The case rate works out in a slightly different manner, and between 1890 and 1891 there seemed to be a period of minimum prevalence of two years alternatively with a period of maximum prevalence of one year. The period 1901-1906 was a period of minimum prevalence followed by a period of maximum prevalence of 3 years, 1907-1909. Then there followed a period of minimum prevalence of 2 years, with a period of maximum prevalence of 1 year. This alternation is slightly masked, as the period of maximum prevalence commenced in the latter part of 1911. |
31fd3c76-d306-495e-99dc-5229d7076cbd | We are now in the period of minimum prevalence, and it will probably continue during 1914 in the absence of any unforeseen circumstances. 26 Diphtheria here has behaved in a very similar manner as it has done throughout the kingdom. The periods of maximum and minimum prevalence are longer than those of Scarlet Fever. If we take the death-rate, the 8 years, 1892-1899, was a period of maximum prevalence. The following 8 years, 1900-1907, was a period of minimum prevalence, followed by a period of maximum prevalence, which will probably continue for another 2 years, but with a gradual droop in the curve. A desire was expressed that these figures should be worked out in the form of graphs, and the two following graphs give the attack-rates and death-rates respectively per 100,000 inhabitants :— Death-rate per 1,000,000 inhabitants, 1881-1913. Notifications 1890-1913. |
3039979a-9956-45c9-a5ac-90f223a2124c | Case Rate per 10,000 Inhabitants. 27 DIPHTHERIA. 117 casus of Diphtheria were notified, and 8 deaths occurred from the disease. 3 other notifications were received, but subsequently withdrawn; 4 cases were wrongly diagnosed, but the notification was not withdrawn. Although the number of notifications was higher by 17 than that of the previous year, the number of deaths remained at the same number, with the result that the fatality of the disease was reduced to 6.8 per cent. There are few phenomena more remarkable than the apparently lessened fatality from Diphtheria which has been noticed during the last 10 years. If we take the last 10 years, 1904-1913, and compare them with the previous 14 years following the introduction of the Infectious Diseases Notification Act, we find that the case-rate in 1904-1913 is nearly 50 per cent. |
dad9ea21-ad0e-457e-a22f-ab1153566ecc | higher than in the earlier period, but the death-rate in the earlier period is 50 per cent. higher. The actual figures are: 1890-1903, average annual case rate, 1 per 1,000; death-rate, .21 per 1,000. In 1904-1913, the figures are: Case-rate, 1.46 per 1,000; death-rate, .13. The death-rate in the earlier period is understated, for, in addition to the fact that outside deaths were not included in the returns, the more accurate means of diagnosis would tend to magnify the death-rate in the later period. Various reasons have been assigned as the cause of this reduced fatality of the disease, but many of these are based on the assumption that the type of disease is now of a much milder character than formerly. |
674533dc-753d-42a1-8f78-5749cf892616 | There is a widespread impression that the disease is now milder in character, though the figures which are adduced in favour of this are hopelessly inaccurate, and there is no definite proof of the relative mildness of the disease. To offer explanation of a cause which is not proved to be existent is unprofitable, if not foolish, and the most frequently offered is probably the most fallacious of all. This is the explanation which attributes the mildness to a gradually accumulating inherited immunity, affecting the community as a whole. But why should this immunity only show itself during the last decade or two? 28 Considering the countless ages which have passed since life has existed, and since Diphtheria has probably made its appearance, what sort of gradually acquired inherited racial immunity would that be which showed no effect for hundreds or thousands of generations, and then sprang up armed in the present one? |
7f74a082-d333-48e4-bd1d-ce365d14ccd1 | It is possible that the lower fatality and decreased mortality are due, not to the mildness of the type, but to the improvement in the methods of treatment and diagnosis. The discovery of Antitoxin and the appreciation of the importance of its early use have revolutionised the treatment of the disease. The treatment, under certain conditions, can be more effectually carried out in a hospital, inasmuch as the liability of secondary infection is lessened, and the nursing is of a more skilled character, but the reduced fatality is not entirely due to hospital isolation. Another important factor is the improved means of diagnosis. The bacteriological examination not only enables an earlier diagnosis to be made, but many cases are now diagnosed as Diphtheria which formerly passed as "sore throat" or tonsilitis. For instance, last year, 160 children suffering from sore throat were sent from the schools for examination, and in 33 of them the Diphtheria bacillus was found. |
44740a28-0cdc-42fb-b15a-0015f0d0a4e4 | In the majority of these, the clinical signs in the throat would not have enabled anyone to diagnose Diphtheria, and in many of the other cases notified during the year, the diagnosis was made only after a bacteriological examination. The facilities for the bacteriological examination of the throat are being more and more appreciated by doctors, and last year 207 swabs were sent by medical practitioners for examination; 72 of these were positive and 135 were negative. This examination affects the case fatality in two ways; an increased number of cases are notified, and specific treatment is earlier carried out. The age-incidence and the ward distribution of the disease are given on a subsequent page, and from that it will be observed that the proportion of children of school age is higher than it has been for some years. The percentage of school children to the total notified was 56.4, as compared with 49 in 1912. 29 Multiple cases occurred in 11 houses. |
d2c3cbce-cc4e-47fa-b219-9026d9137cda | There were 5 notifications from 1 house, 3 from another house, and 2 each from 9 houses. SCARLET FEVER. 80 cases of Scarlet Fever were notified; of these 4 were wrongly diagnosed, and were not suffering from the disease. 4 others were also notified, but the notifications were withdrawn by the doctor in attendance on the case. 2 deaths were registered as due to the disease. The monthly distribution of the notified cases was as follows:— January 12 July 4 February 5 August 3 March 11 September 4 April 8 October 3 May 9 November 7 June 7 December 7 At no period of the year was there an undue prevalence of the disease, but the highest number of notifications were received in the first quarter and the lowest in the third quarter. 5 cases occurred in 1 house, 4 cases occurred in another house, and 2 cases each occurred in 5 houses; 4 cases were notified from the Cottage Hospital. |
fa48aa80-e36b-4039-8fe8-de95d51a4573 | 4 cases occurred in houses after the discharge of a child living in the same house from the Fever Hospital, but in all of them doubt exists whether the discharged patient was the infecting agent. The first case was that of P. S. The case was notified on April 7th. The child was taken ill early on on April 6th; when the parents woke up on April 6th, the child complained of sickness, and had an attack of vomiting. The rash appeared on the same day. 2 families lived in the same house, and V. B., a member of the other family, was removed to the hospital on February 17th and discharged on April 5th. V. B. arrived home from the Fever Hospital about midday on April 5th. P. S. did not come into close contact with him. It is certain that the 2 children did not play 30 together; the disparity in the ages of the two was too great. |
e5112bfd-63be-4100-8a89-f33d709b756e | If they came in contact with each other, it could only have been a casual meeting in the passage somewhere during the afternoon of April 5th; no evidence of such a meeting could be obtained. If V. B. was the infecting agent the incubation period could only be from 12 to 16 hours. 2 other children from the same house had been removed to the Hospital. A. B. and F. B., brothers of V. B., were removed to Hospital on March 1st and March 6th respectively. These two could not have been the source of infection. A sister, F. B., had also suffered from a sore throat, but had developed no other signs of Scarlet Fever. It is possible that this sister had an abortive attack of Scarlet Fever, and was the infecting agent. No outside source of infection could be traced. The previous case notified in the district occurred on March 26th, and P. S. had not been in contact with that one. |
9aa8a79d-4a37-4287-b10d-f57b4ed116e8 | The second "return" case was that of M. D., who was notified of Scarlet Fever on March 21st, 1913. R. D., a twin brother, was notified of Scarlet Fever on December 10th, 1912, and discharged from the Hospital on January 29th, 1913. R. D. had no complication of any kind whilst in the Hospital, and was not in contact with any acute cases. He had Chicken Pox on admission, and was kept in the separation ward for nearly a month, and was then transferred to a convalescent ward. It will be seen that the period which elapsed between the discharge of one case and the occurrence of another exceeds the one month which is sometimes arbitrarily taken, but there are other reasons for believing that R. D. did not infect M. D., and it will be convenient to consider the question in conjunction with the third so-called " return " case. W. W. was notified of Scarlet Fever on September 16th. |
1e1c0a1b-018f-4c11-8030-c76d39819884 | A. W., his brother, was admitted to the. Hospital on June 18th, and discharged on September 4th. If we trace the Scarlet Fever history of this family we shall find the probable infecting agent of both " return " cases. 31 In July, 1912, L. W., a sister of W. W. and A. W., was notified of Scarlet Fever. She was admitted to the Hospital and discharged on August 30th, 1912. She had enlarged Tonsils and Adenoids. Both these families lived next door to each other in East Acton, and it is probable that L. W. remained intermittently infectious until September, 1913. Between September, 1912, and September, 1913, 5 cases of Scarlet Fever occurred in houses in close proximity to L. W.'s home. |
f77349a2-d9d0-4881-8566-156d52d0b4bf | On the latter date L. W. was taken to Hospital to be operated on for the removal of Tonsils and Adenoids, and subsequent to the operation no further cases occurred in the immediate neighbourhood. It is now held by many authorities that under certain conditions Scarlet Fever may remain intermittently infectious for prolonged periods, ' and one of the conditions under which the period of infectivity seems to be prolonged is the presence of enlarged Tonsils and Adenoids. In this instance, the disappearance of Scarlet Fever from the immediate neighbourhood was coincident with the removal of the Tonsils and Adenoids in a possibly infecting case. The fourth case was that of H. S., who was notified of Scarlet Fever on January 20th, 1913. A younger brother, W. S., was admitted to Hospital on November 22nd, 1912, and discharged on January nth, 1913. |
2cc0e4e2-c474-4b46-8353-9be88cdfa82b | H. S. worked in Hammersmith, and within a month 3 cases of Scarlet Fever had occurred amongst the employees of the firm. In the room he worked was employed another person who was discharged from a Fever Hospital in December. He had been in the Hospital for 3 months on account of Nephritis following Scarlet Fever. ENTERIC FEVER. 4 cases of Enteric Fever were notified, and there was no death from the disease. In one case the patient received all his meals outside the district, and he had eaten some oysters about 3 weeks before the onset of his illness. 32 In the second case there was a history of a disease resembling Enteric Fever in one of the children about 2 years ago, and this child had suffered from Diarrhoea a few months before the receipt of the present notification. The excreta of this child were sent for bacteriological examination, but no Typhoid bacilli were present. |
00d82d88-6f60-4cfd-a2c2-7f176e029536 | In the other 2 cases the source of infection was not traced. ACL'TE ANTERIOR POLIOMYELITIS. During the year 6 cases of Acute Anterior Poliomyelitis have been notified, and a history of these cases is given in the following pages. In 3 of these there was no paralysis at the time they were visited, and all the children were able to use their limbs. It is admitted that cases of Poliomyelitis occur in which no paralysis supervenes, but usually the diagnosis is made on the initial symptoms, and the association with other paralytic cases. In these 3 cases there was no association with paralytic cases, and the symptoms were in no way similar to those ushering in the graver forms. In one there was a history of an accident, and as the bruise caused by the accident cleared up, the lameness disappeared. |
615868e1-fb71-42c8-b08c-996e1eb4d4f4 | In the second the child was only 4 months old, and the suspected weakness only lasted a short time. In the third the only symptoms were diarrhoea and vomiting. Moreover, no precautions were taken to prevent these children mixing with the other patients in the wards or in the out-patients' department. In the other cases, death occurred in one, and paralysis supervened in the other two. All the surviving children are kept under observation. 1. A. B., girl, 4½ years old, notified on April 14th, 1913, from the West London Hospital. 33 History. The mother goes out to do laundry work, and the child is taken daily to the house of a neighbour, who looks after the child while the mother is at work. About the middle of February the child fell downstairs in the baby-minder's house, and she seemed to have lost the use of the muscles of the right leg. |
d33f1967-d057-4564-8c51-2aa6935eab5f | On the following day the mother noticed that the right hip was tender and painful. There was no weakness prior to the accident, and there was no evidence to show that the fall was the result and not the cause of the illness. An uncle had been paralysed for 41 years. Progress. The child was taken 10 a local doctor, who advised the mother to obtain Hospital treatment. The child attended as an outpatient of the West London Hospital, and the case was notified as Acute Anterior Poliomyelitis. Massage and electrical treatment were applied. At the present time there is no paralysis of any of the muscles, and the child can flex, extend, adduct, and abduct the hip-joint to its fullest extent. 2. M. C., girl, aged 2 years. Notified on July 29th, 1913. History. |
07804be7-229b-4048-959c-81b88c67d05b | The child complained of no pain, but the mother noticed, about the middle of July, that one day the child could not lift her right arm when she awoke from her sleep. Child was taken to a local doctor, who advised the mother to take the child to St. Mary's Hospital, where Acute Anterior Poliomyelitis was diagnosed. There was no history of paralysis in any near relative, and the child, as far as could be ascertained, had not been in contact with the previous case notified in the district. The other children in the house returned to school after the summer holidays. 34 Progress. Some of the muscles around the right shoulder-joint are apparently paralysed, and the child cannot raise the right arm without assistance beyond a right angle. 3. I. J., girl, 3 years of age. Notified on August 9th, 1913. History. The child was suddenly taken ill about the middle of July. |
cca375ca-782c-4dbd-b0d2-9a174df1cd66 | She was attended by a local doctor, and on August 2nd was admitted into the Great Ormond Street Hospital for Children. The child was an in-patient at Great Ormond Street from August 2nd to August 9th. She had always been in good health until the middle of July. A sister of the patient's father is suffering from paralysis, but the history is vague. This aunt, who is now 10 years of age, suffered from Measles when she was 9 months old, and an affection of the eye followed the attack of Measles. The eye was removed, and paralysis of the right side of the body ensued. This aunt stayed with her brother in Acton from the beginning of March to the end of May this year. Progress. The extensors of the foot are paralysed, and the child is wearing a splint. No children from the house attend school. 4. L. L., boy, aged 4½ years. |
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