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1c55d8e8-760e-41e7-a11c-03a62f69dba3 | 13 Cows' Livers. 1 Belly. 3 Sets of Ox Lungs with Hearts. 1 Chine. 3 Legs. 1 Stirk's Carcase with Offal. 2 Feet. 40 lbs. of Pork. 2 Stirks' Heads & Tongues. 122 Plucks. 1 set of Stirk's Lungs with Heart. 2220 lbs. of Chitterlings. Cattle. 3 Stirks' Livers. 3 Calves' Carcases with Offal. 7 Cows' Carcases with Offal. 16 Cows' Otfals complete. 8 Forequarters of Beef. 32 Calves' Plucks. 2 Short F'quarters of Beef. 3 Calves' Kidneys. 1 Side of Beef. 2 Calves' Livers. 1 Topside of Beef. 1 Stirk's Carcase with Offal (Emaciated). 5 Rumps of Beef. |
ecd97ea1-d5e8-43b6-a349-4de1c8087d99 | 193O 22 Parasites. 1 Clod Sticking and Shin of Beef. Pigs. 1 Skin. 1 Stirk's Shoulder. Cattle. 4 Calves' Heads. 4 sets Cows' Lungs with Hearts. 9 Calves' Plucks. 18 Calves' Livers. 15 sets Cows' Lungs. 2 Calves' Kidneys. 37 Cows' Livers. 1 Loin of Veal. 4 Cows' Kidneys. Sheep. 4 Stirk's Livers. 1 set Calf's Lungs. 1 Shoulder of Mutton. Sheep. ½ Chine of Mutton. 135 sets Sheeps' Lungs. Bruising. Pigs. 64 Sheeps' Livers. 2 Hindquarters of Pork. 7 Sheeps' Plucks. Goats. 4 Legs (Fractured). 56 lbs. of Pork. |
8481c36b-c722-4e53-8289-630dc3374d7b | 1 Goat's Liver. Pleurisy. Cattle. Cattle. 1 set Cow's Lungs with Heart. 1 Forequarter of Beef. 2 Shins of Beef. 2 sets Stirks' Lungs with Hearts. 1 Flank of Beef. 1 Top Piece of Beef. 9 sets Calves' Lungs with Hearts. 1 Gross Piece of Beef. 1 Clod and Sticking of Beef. 11 Calves' Plucks. 1 Calf's Carcase. 7 Breasts of Veal. 3 Calves' Kidneys. Sheep. 2 Legs of Veal (Fractured). 2 Breasts of Veal „ 2 sets of Sheeps' Lungs. Dropsy. Cattle. 7 Sheeps' Plucks. 4 Ribs of Mutton. 2 Flanks of Beef. 5 Breasts of Mutton. |
4d6db972-7b9c-4faa-a053-d90049bc472e | 2 Clods, Stickings, Shins, Briskets and Flanks of Beef. Suppurating Pleurisy. Cattle. 1 Calf's Carcase. 1 Calf's Carcase with Offal (Congested). 5 Calves' Plucks. Sheep 1 set Cow's Lungs with Heart (Parasitic). 2 Forequarters of Mutton. 2 Shoulders of Veal (Parasitic). 1 Sheep's Pluck. Abscesses. 1 Cows' Carcase with Offal. Pigs. 1 Stirk's Carcase with Offal (Emaciated). 1 Carcase with Head (Pyaemic). 1 Cow's Carcase with Offal (Emaciated). Cattle. 1 Cow's Head. 1 Cow's Carcase (Tuberculous). 1 Topside of Beef. 1930 23 Dropsy. Emphysema. Sheep. |
d1b652bd-8dc2-4347-a3e2-c16bf825a8a0 | 1 set Stirk's Lungs with Heart. 14 Carcases with Offal (Emaciated). Cattle. Cystic. Pericarditis. Cattle. 1 set Calf's Lungs with Heart. 2 Ox Kidneys. 2 Stirk's Kidneys. Bacterial Necrosis. 1 Cow's Kidney. 1 Calf's Liver. Sheep. Pseudo Leukemia. 2 Sheeps' Kidneys. 1 Calf's Carcase with Offal. Unsound. Pyaemia Pigs. 1 Calf's Carcase with Offal. 1 Carcase with Head. Pneumonia. Cattle. 1 set Ox Lungs. 1 Calf with Offal. 2 Hindquarters of Beef. 2 set's Calves' Lungs with Hearts. Other Conditions. Urticaria. Pigs. 1 set Calf's Lungs. |
db30abe9-f97e-4493-acf2-a0d9663e35e6 | 2 Skins. Cirrhosis. 36 lbs. of Pork. 8 Cows' Livers. Arthritis. 5 Calves' Livers. 1 Hock. 5 Stirks' Livers. Cattle. Adenitis. Congestion. 11 Calves' Livers. 1 Cow's Offal. 4 Calves' Plucks. 1 Cow's Liver. Died. 1 set Cow's Lungs. 1 Calf with Offal. 1 Calf's Pluck. 3 Calves' with Offal (died in transit). Actinomycosis. 1 Ox Head with Tongue. Cavernous Angioma. 14 Cows' Heads with Tongues. 4 Cows' Livers. Hydro-Nephrosis. 2 Stirks' Heads with Tongues. 2 Calves' Kidneys. Endocarditis. 1 Cow's Liver. |
15866bd7-4672-4c3b-befd-654ad1240006 | 1 Calf's Heart. Moribund. 1 Cow with Offal. Jaundice. 10 Calves with Offal. 1 Calf's Pluck. Nephritis. Pseudo Hodgkins Disease. 11 Cows' Kidneys. 1 Calf's Carcase with Offal. 6 Calves' Kidneys. Sheep. Fatty Infiltration. Lymphomata. 1 Cow's Liver. 2 Sheeps' Kidneys. Other Foods. Unsound. 1 Box of Kippers. 5 stones of Smoked Cod Fish 2 Tins of Prawns. 930 24 TABLE II. NUMBER OF PIGS' CARCASES INSPECTED FROM 1st JANUARY TO 31st DECEMBER, 1930, WITH ANALYSIS OF SURRENDERS ON ACCOUNT OF DISEASE (TUBERCULOSIS). 1930 No. of Carcases Inspected. |
266cee44-deed-4851-966b-95b24f0bd40b | No. of Heads Diseased. No. of Carcases Diseased. No. of Sides Diseased. No. of Fore Quarters Diseased. No. of Hind Quarters Diseased. No. of Legs Diseased. No. of Shoulders Diseased. Plucks (Lungs, Livers and Hearts). Mesenteries, Stomachs and Intestines Pieces of Pork. Weights Tons Cwts. Qrs. Lbs. January 1273 8 1 — - - 1 - 9 224 lbs. — lbs. 3 2 4 February 1002 6 2 — — 2 1 - 10 192 „ 70 „ 6 1 4 March 1042 11 1 — —. —, 6 — 10 248 „ 28 „ 6 0 19 April 950 7 2 — — — |
348a3fd1-d394-46aa-813e-a0c38259f435 | 1 — 10 248 „ 64 „ 5 2 20 May 951 8 2 — — — — 1 11 208 „ 42 „ 7 3 9 June 679 — — — — — — 1 8 152 „ - „ * 3 1 16 July 703 8 - - - - - - 11 176 „ 20 „ * 4 1 5 August 692 6 — — — — - - 8 136 „ 37 „ * 2 0 1 September 1265 11 1 — - - - - 9 216 „ - „ * 4 0 17 October 1536 8 2 — — - - - 14 288 „ 34 „ 3 3 16 November 1237 14 1 - - - - - 16 280 „ - „ 4 2 3 December 1323 6 - — — — - — 6 |
41efa9bd-7556-4789-9817-88084c01fbc9 | 160 „ 11 „ 1 1 2 Total 12659 93 12 — — 2 9 2 123 2528 „ 312 „ 2 14 0 14 * Sent to Kensington Destructor. 1930 25 TABLE III. Counties from which animals were consigned, and percentage diseased (1st Jan.—31st Dec. 1930). County No. of Towns from which Animals were consigned No. of Carcases Inspected No. of Animals Diseased Percentage of Animals Diseased Bedfordshire 2 135 2 1.48% Berkshire 2 7 — — Buckinghamshire 1 8 — — Cambridgeshire 6 674 5 .74% Dorsetshire 6 1569 21 1.34% Essex 3 89 — — Gloucestershire 2 282 5 1.77% Hampshire 11 456 2 . |
79424c77-e6e2-42c6-9074-aa86ab92bc7e | 43% Huntingdonshire 2 179 — — Ireland 1 11 — — London 1 14 — — Middlesex 9 276 - — Norfolk 14 2596 27 1.04% Nottinghamshire 1 30 6 20.0 % Somerset 10 902 12 1.33% Suffolk 18 3593 24 .67% Surrey 5 831 — — Sussex 1 77 2 2.59% Warwickshire 1 910 8 .88% Yorkshire 1 20 — — Total 97 12,659 114 .90% BIRTHS. Table 7 gives particulars of the births registered and notified in the district, and the births belonging to the district which have occurred and been registered outside the district. As there is no Maternity Home in the district the number of "outside" births tends to become higher and higher. There is a greater demand for institutional care in the birth of children. |
da8eca13-ed0a-4695-a148-bde4cb3d2641 | The factors which operate in the case of illness are also in operation when such an event as a confinement is about to take place. Modern houses are so planned and constructed as to occupy the least possible amount of space, and there is hardly sufficient room in them to allow of any nursing with any degree of comfort. The total number of births are those registered during the calendar year and are corrected for inward and outward transfers. This figure is obtained at the end of the year from the Registrar General. Last year the total number was 1,105, and is equal to a birth-rate of 16.9 per 1,000 inhabitants. This rate is higher than that of 1929, and is higher than that of England and Wales and that of the 107 great towns. |
d6c53145-fcfb-44b7-b12e-7e12d750d77d | 1930 26 The birth-returns recieved from the Registrar General do not permit of the allocation of the whole of the births into wards, but if the ward birth-rate is based upon the notification figures and 1 per thousand added to these rates, it will be sufficiently correct for all practical purposes. The birth-rate, based upon the notifications in the different wards was :— North East. North West. South East. South West. 16.7 17.3 10.6 19.6 69 children were born out of wedlock, which number corresponds to an illegitimate birth-rate of 6.2 per cent. of the total births. This is not the highest illegitimate birth-rate on record for the district, but it very nearly approaches the record. The highest rate was in 1915 when it reached 6.3 per cent., and in 1917 and 1919, the rates equalled that of last year, namely 6.2 per cent. |
5ec3836d-3398-4dbb-8e8a-90344dd6d34a | It is sometimes assumed that the increased incidence of illegitimacy was a war phenomenon, but this is not quite true of this district. The illegitimate birth-rate began to ascend in 1912 when the rate was 4.7 per cent. and previous to that date it had never been higher than 3 per cent. In 1913 it was 5 per cent. and in 1914 5.1 per cent. After the war it gradually descended from 4 per cent. in 1920 to 2.9 per cent. in 1924. Since 1924 it has gradually risen. Although illegitimacy is primarily a social que.stion it has its public health aspects, and usually is reflected in a district's statistics, especially in infantile mortality. It is not generally admitted that the infantile mortality is higher amongst children born out of wedlock than amongst legitimately born children. |
f518f590-80d7-4bcc-9259-b489e72a2fed | 41 still-births were registered, a number which is equal to .63 per 1,000 of the inhabitants and represents 3.7 per cent. of the total live births registered. DEATHS. 440 deaths were registered in the district: of these 31 were of non-residents. 284 deaths of residents occurre.d outside the district. The total number of deaths belonging to the district is 693, which corresponds to a death-rate of 10.6 per 1,000 inhabitants. On Table 1 is given the death-rate for England and Wales and the large towns. It will be seen that our death-rate is lower than that of the whole of England and Wales, and also of London and the 107 large towns, in which group Acton is included. On Table 2 is given the statistics for the district in the last 6 years, and from that table it will be seen that last year's deathrate was considerably lower than that of 1929. |
4825b8dd-f942-4d71-bb93-b49700175cc6 | In 1929, there was an extensive epidemic of Influenza which reflected itself in the death-returns of that year. 1930 27 Ward Distribution of the Deaths. North East. North West. South East. South West. 196 168 143 186 Death-rate of each Ward. North East. North West. South East. South West. 10.3 12.3 9.5 10.6 The comparatively high death-rate in the North- West Ward is probably due to the age-distribution of the population in the different wards. Causes of Death. In some of the important causes of death, I have endeavoured to bring our returns to correspond with those of the Registrar General, but in several others, the figures are hopelessly at variance. |
e5fcc1df-a707-4bc8-aff0-f2324f3c7be3 | The total number of deaths is the same as that of the Registrar General, and this also holds true of the principal infectious diseases, and some causes such as suicide and other violent deaths, though in the. case of the latter some difficulty arises. In the manual of the international list of causes of death issued by the Registrar General, certain rules are given for the selection of one or more jointly stated causes of death. Where any forms, of violence and disease are jointly stated as causes of death, the violence is to be preferred except in the following instances :— (a) Deaths from any definite disease stated to have been accelerated, aggravated, &c. by accident are to be classed to the disease. |
70172305-e427-433d-92b8-26ec1d1b0af2 | (b) Deaths from tetanus, erysipelas, pyaemia, septicaemia, blood poisoning, &c., following accident are to be classed to the disease if the injury is slight, such as "scratch" or abrasion, but if the injury was apparently severe enough to be of itself dangerous to life (e.g. by vehicle, machinery, &c.), the death is to be classed to violence. Unfortunately the verdict given at an inquest does not always give sufficient evidence upon these points. For instance there were three inquests and in all cases it was stated that the cause of death was Myocarditis accelerated by an accident. In one case the accident was a fall downstairs, in the second the man had fallen out of bed, but in the third the woman wa.s knocked down by a motor cycle in the street. Obviously the latter was a violent death though a specific disease was mentioned. |
704fad0f-7bda-4777-81f4-1277111dd2fc | In another case it was stated that the cause of death was Pneumonia and acute Phlebitis accelerated by being knocked down by a motor van. Other verdicts might be quoted which show that there are difficulties in assigning the cause of death, but these are insignificant compared with the vagueness and indefiniteness of some of the certificates which are sent by medical practitioners. It is unfortunate, but true, that under 28 present conditions it is not possible to get even approximately correct death-returns. Under the best conditions it is not possible to get exact returns. It has been computed that even with full post-mortem examination, the cause of death can be accurately given in about 85 to 90 per cent, of the cases, but that under present conditions the exact cause of death is not given in more than about one-half of the deaths. There are many reasons for this want of accuracy, but I need only point out one of them. I refer to the suspicion with which the. |
06542b1c-ae92-4fd4-b795-0e08d48020dc | doctors look upon the present method of death certification. The Act of 1926 made it possible to obtain a death certificate slightly less inaccurate and evasive than was obtainable before its passage, and that is all that can be said about it. In practice it has made hardly any difference, apart from the ordering of a post-mortem examination without an inquest and the registration of still-births. The alteration of the law so that the certificate is sent direct to the registrar instead of being given to the relatives of the deceased looked on the surface as though it would allow the practitioner to state what he knew to be true without the risk of offence to the bereaved; in practice it does nothing of the kind. The signing of the death certificate and sending in a separate envelope to the local registrar and the filling up of the separate slip for relatives to be handed to the registrar is the greatest farce which can be imagined. |
8a14cf6c-1926-4096-b772-7d8c588dfe79 | Although it keeps the original certificate from the relatives, they can obtain copies and for many purposes must obtain a copy, and they can compel the registrar to furnish them with a copy. It is obvious that in spite of the elaborate precautions the death certificate is by no means private. The copies are used mainly for insurance purposes, and solely in the interest of the insurance companies. There are many reasons why insurance companies should not obtain a copy of the death certificate. It should suffice that companies are informed that a certain person had died on a certain date. If any further information be required, this should be obtained from the doctor in attendance. If we want reliable death-returns, the first essential should be an assurance to the doctor that the death certificate is a strictly confidential one. An opportunity offered itself when the Local Government Act, 1929 abolished the Boards of Guardians to bring about an effective reform, but it was missed and the vital statistics will still continue in the same unsatisfactory condition. |
209c6464-afa3-4f94-a59c-80a75f73df64 | The death certificate should be treated in the same confidential manner as a tuberculosis notification, and under the present condition this cannot be done. Deaths in Public Institutions. Of the total number of deaths, 329 occurred in Public Institutions and 14 in Nursing Homes. It has been pointed out in previous reports that there is an increasing tendency to remove the patient to an institution whenever an illness occurs in a 1930 29 private house. There are many reasons for this phenomenon and one of these is the preference shown for smaller houses. In London many people prefer to live in service flats, but even in the suburbs owing to the difficulty of obtaining domestic assistance, spare rooms are becoming fewer and scarcer. When an illness happens there are insufficient facilities for efficient nursing of the case. Inquests and Coroner's Inquiries. 40 inquests were held and in 24 instances the Coroner issued a certificate without an inquest after he had ordered a postmortem examination. Scarlet Fever. |
16cc998c-7375-484e-8b13-37a2444abee6 | INFECTIOUS DISEASES. 207 cases of Scarlet Fever occurred in the district during 1930, and there was one death from the disease. The fatal case was one in which the patient suffered from both Scarlet Fever and Measles. During the early part of the year there was an epidemic of Measles and some of the patients contracted both diseases. Apart from instances of double infection, the disease was of a mild character. It is possible that the mildne.ss of the disease forms one of the greatest difficulties in the control of Scarlet Fever epidemics, and it is doubtful if any of the means at our disposal at the present time arc effe.ctive in preventing the spread of an epidemic. |
802def5c-dcfe-49df-ba21-6b6a26b55a69 | Accepting the general opinion that most cases of Scarlet Fever are contracted directly from another human source, and that the infecting person may be quite unrecognisable either as a mild case or as a clinically healthy carrier, it is easy to see how the conditions of today favour the spread of Scarlet Fever and make its control a very difficult matter. The aggregation of people in towns and cities, the enormous increase in transport facilities and the growing inclination to be carried in vehicles rather than to walk, all these facts of modern life have multiplied the opportunities for susceptibles coming into contact with infectives; they have aiso made it almost impossible in thickly populated districts to trace any case to its origin. Among the newer suggestions for the control of Scarlet Fever is the active immunisation by means of the Scarlet Fever Streptococcus Toxin. |
2a1c6365-e48a-42f8-867c-8484805780ca | Those who have had the widest experience of the practical application of measures dealing with the Scarlet Fever problem are almost universally of the opinion that the routine active immunisation of susceptible individuals is not advisable for not only do the attendant reactions prevent its general acceptance, but the immunity lasts only about two years. The position is different from that encountered in the case of Diphtheria. Active immunisation of Scarlet Fever contacts after Dick testing may be useful in isolated communities and in boarding schools, but under present conditions it is not a feasible method in towns and especially in the inner suburbs of London. 1930 30 Diphtheria. 103 cases of Diphtheria were notified and 9 deaths occurred; 2 of the deaths occurred outside and had not been notified to us. They were in the infirmary and had contracted Diphtheria there. There is a considerable increase both in the notifications and the deaths, compared with 1929. In 1929 only one death occurred from this disease. |
cab50ebb-c892-4190-be80-3ffbf86eed56 | The disease was distributed throughout the district and no particular area or school had any abnormal incidence. Tuberculosis. 97 cases of Pulmonary Tuberculosis and 13 cases of other forms of Tuberculosis were notified during the year. There were 57 deaths from Pulmonary Tuberculosis and 9 deaths from other forms of Tuberculosis. There was an increase in the number of deaths and in the number of notifications both from Pulmonary Tuberculosis and from other forms of Tuberculosis. |
af299783-cd47-4a70-94de-3479ba8c54b4 | The death notification interval of the 57 patients who died of Pulmonary Tuberculosis in 1930 was :— Information from Death Returns 10 Died within 1 month after notification 7 Died between 1 and 3 months after notification 6 Died between 3 and 6 months after notification 5 Died between 6 and 12 months after notification 9 Died between 1 and 2 years after notification 7 Died between 2 and 3 years after notification 3 Died over 3 years after notification 10 On December 31st the following is a statement of the particulars appearing in the Register of cases of Tuberculosis. Pulmonary. Non-Pulmonary. Total Males. Females. Males. Females. |
ff3cbb16-98b5-4c93-91a2-18ca7c74d80b | Number of Cases of T. B. on the Register at the commencement of year 116 106 24 17 263 Number of Cases notified for the first time during the year 54 49 9 4 116 Number of Cases removed from the Register during the year 51 31 3 1 86 Number of Cases remaining on the Register at the end of the year 119 124 30 20 293 During the year the Tuberculosis Officer removed 12 cases 6f Pulmonary Tuberculosis and 2 cases of Non-Pulmonary Tuberculosis from the Register. These are, of course, in addition to the cases removed on account of death. 31 1930 In 1930, the Tuberculosis Officer examined 64 new cases of Pulmonary Tuberculosis and 11 new cases of Non-Pulmonary Tuberculosis. 55 patients were admitted to Sanatoria under the county scheme and 18 were admitted to Hospitals. |
d56597af-7501-494a-a87d-f7f675d86b0d | I pointed out in last years report the conditions under which notification is not sent or there is delay in notification,, and the same conditions obtained last year. In 1930 the Public Health (Tuberculosis) Regulations 1930, were issued. These consolidated and amended the Public Health (Tuberculosis) Regulations of 1912, 1921 and 1924. The new Regulations came into operation on January l st, 1931. The most important alteration has been the wording of the first proviso to article V of the Regulations of 1912, which has been amended with a view to making it clear that previous notification in another sanitary district of the same county or another county does not relieve a medical practitioner from the duty of notifying. The new regulation requires that the case shall be notified unless the practitioner has reasonable grounds for believing that it has already been notified to the Medical Officer of Health for the same sanitary district. |
2539e595-a02e-4286-8dae-9cff58a1aa77 | The regulation means that the case must be notified if a patient has moved from one sanitary district to another. Meningococcal Meningitis. Meningococcal Meningitis, or as it is sometimes called, Spotted Fever is a compulsorily notifiable infectious disease, but owing to the peculiar conditions under which it occurs, all the cases which occur are not notified. The disease was described in detail in last year's report, and it is unnecessary to deal with the subject again this year. It is curious, though, that the same number of deaths occurred in 1930 as in 1929, but none of these cases had previously been notified. There were five deaths from the disease, but there was no notification. Encephalitis Letharigca. There were 2 notifications of Encephalitis Lethargica and 4 deaths from the disease. |
7420f109-9943-4154-9bcb-893507d9d734 | The two cases notified this year proved fatal, and as far as could be ascertained the other two fatal cases had not previously bee.n notified. This phenomenon is not surprising. Many cases of this disease remain unnotified. Frequently the initial symptoms are so trivial that the nature of the disease has remained undiagnosed, but the severity of the acute phase of the disease is no criterion of what is to follow. The mildest acute cases may finish with the worst chronic stages, whereas the most acute cases frequently recover completely, if they do not die at once. This is probably due to the fact the post-encephalitic .symptoms are not sequelae, due to destroyed nerve cells, but are caused by continued chronic infection. What the infection is remains as yet unknown. The 32 disease is not infectious in any ordinary meaning that can be given to the word. |
42c4ff1e-835b-4ed5-b146-e49c3bde891f | There is no evidence to show that the infection is spread from case to case, and multiple cases in the same house or same family are very rare. Its history in this, and other countries shows that it occurs in epidemics, and it is difficult to conceive a disease as an epidemic that is not at some stage spread from person to person. Carriers have been suggested but their existence has never been proved. Small-Pox. During the year 7 cases of Small-Pox were notified. All the cases were of the mild type which has been prevalent in and around London during the past few years. Although the cases have been similar to each other clinically, from an infectious point of view there has been a considerable difference. In this respect it resembles the virulent type of disease, the so-called Eastern or Asiatic Small-Pox. In most epidemics of the virulent type of Small-Pox there are instances in which the disease is intensely infectious, whilst at other times the disease seems hardly at all infectious. |
c552a66d-3e45-4d28-9474-aa0bf945014a | Presumably the same strain of germ or virus is present at both periods, but at one time the infectivity seems to be much greater than at another time. The same phenomenon has been noticed in the present epidemic. The number of admissions to the Metropolitan Small-Pox hospital in 1929 was 3,031, made up mainly of the mild "native" type, but including some of the Tuscanian group. There were 10 deaths, one in a patient who had not had Small-Pox; two and possibly three of the Tuscanian cases; two premature infants, towards whose deaths Small-Pox may have contributed a little; two cases in which it may have had more say and two of confluent Small-Pox who died from septic absorption following maturation. These figures suggest that there was no change in the type of the disease. I believe that the same phenomenon has been observed in 1930. The type has been mild and there has been no tendency to enhanced virulence in the cases. |
0298c8d5-a633-4e7c-8294-568aa871b43a | All the cases which occurred here were of the same mild character. The first occurred at East Acton, and was notified on June 17th. The patient was a bus conductor, but he had been confined to the house from the time the rash appeared until his removal to Hospital. The contacts were easily traced and they all consented to be vaccinated or re-vaccinated. The children in the house had not been previously vaccinated. No further cases occurred as a result of infection from this patient. The case was a simple one, the contacts were easily traced and re-vaccinated and control was not difficult. The next instance was of an entirely different character. Two cases were notified from Ramsey Road,— one on June 28th and the other on July 1st. These were two brothers, and on enquiry, it was found that another brother had been ill about three 33 1930 weeks previously. He had seen a doctor who had diagnosed Chicken-Pox. |
78bccd45-f5f2-4c41-af3f-be2d771b8ea4 | When the "Chicken-Pox" patient was examined at the end of June, it was evident that he had had Small-Pox. During his illness he had not been confined to the house, but had wandered freely about the district. He had probably been in contact with hundreds of people and any attempt to trace the contacts was impossible, and yet, as far as can be ascertained, no further cases resulted. The third outbreak occurred in North Acton. This was, of course, the fourth case in the district. It was notified on July 26th, and the rash appeared on July 20th. It is almost certain that this patient had been in no way connected with the previous cases in Acton. Her husband was employed in one of the local factories, but no illness resembling Small-Pox occurred amongst the other employees. Her sister from Crayford had visited and the patient had been in London on several occasions. The source of infection, though was not traced. |
d3f0cd00-b20c-45d6-b4b9-ab7262abdcf7 | This again, was a fairly simple case. She was confined to bed from the date of the eruption of the rash and no one outside the family had visited her. The contacts were easily traced and the only other case which occurred was a daughter. The fourth importation was in August, and the case was notified on August 15th. On that date he attended the Acton Hospital as an out-patient suffering from a rash on the face, which was diagnosed as Small-Pox. The patient had mixed with a number of persons, and the list of contacts was very incomplete. No further cases occurred. During the summer months the infectivity of the disease appeared to be a low one. Several other instances could be given. A case was notified in Chiswick. He was employed in a factory in Acton and he had been at work for two days after the appearance of the rash. |
82b49e08-0df3-4d94-b629-05db2bd22bc1 | He had been in immediate contact with a score of people, in probable contact with another score and in possible contact with about 500 persons. It was impossible to visit the houses daily of all these and supervision had to be exercised through the factory. No other cases occurred, and the immunity was not due to recent vaccination or re-vaccination. In contrast with the low infectivity of the disease during the summer months, has been the high infectivity of the disease in December. A case was notified on December 13th. She was one of 5 Small-Pox contacts which had been forwarded from Hammersmith. It appears that a missed case had occurred in that borough, and was discovered through a notified case early in December. On December 6th, the Medical Officer of Health of Hammersmith received a notification of Small-Pox. |
cc62e7d1-43be-435d-8284-6cc569423e9a | On enquiry he found that another inmate of the same house had had a rash about the middle of November, and the case had been diagnosed as Chicken-Pox, but which was undoubtedly Small-Pox. During 1930 34 the period between November 16th and December 6th the house was visited by very many people. Among the contacts was one person who lived in Acton and 4 others who worked here, but who lived in Hammersmith. The contact who resided here contracted Small-Pox and 3 out of the 4 contacts who worked here but resided elsewhere also contracted the disease. I understand that other contacts of this same case have also contracted SmallPox. One of the contacts caused us much anxiety. The four were employed in local laundries and the proprietors refused to take the risk of Small-Pox amongst their employees, and arrangements were made for the contacts to keep away from work until quarrantine was over or re-vaccination had been successful. |
329b3869-051b-41ab-bde4-b0ee3c1b38b9 | As usual in missed cases, some contacts are either missed or their identity concealed, and one of the laundry workers was not included in the list. She developed Small-Pox, the rash appearing on December 5th and she was at work on December 4th. Other medical officers of health have told me of cases which have occurred in the late autumn and winter of this year, and in which the infectivity appears to be high. In former times, winter was always considered a favourable season for epidemics of Small-Pox in temperate regions, and various reasons were given for this seasonal incidence. One of the favourite reasons was that there was more overcrowding of person.s in houses in winter and thus a condition favourable to the spread of infection was produced. No satisfactory reason has been adduced for the varying degree of infcctivity of Small-Pox, even when the type of the disease does not vary. ISOLATION HOSPITAL. |
9c3f12a9-bdcc-46b2-8f09-064baa518cf0 | During the year 459 cases were admitted into the Hospital compared with 419 in 1929. On January 1st, 1930, there were 75 cases in the Hospital and on January 1st, 1931, there were 41. 476 cases were discharged and there were 22 deaths. The following is a list of the cases admitted :— Scarlet Fever Acton Wembley Kingsbury Total 165 91 23 279 Diphtheria 92 49 36 177 Measles 2 - - 2 Other Diseases - 1 - 1 259 141 59 459 The 22 deaths were as follows :— Kings- Other Acton Wembley bury Districts Total Scarlet Fever 1 3 - - 4 Diphtheria 8 3 3 1 15 Other Diseases 3 - - - 3 12 6 3 1 22 35 1930 Scarlet Fever. |
dec4157d-7c92-4320-a052-8ae5a924a0c1 | 279 cases of Scarlet Fever were admitted, and there were 4 deaths from the disease. The high mortality was due to cases of mixed infection which were admitted early in the year. In the early part of the year there were epidmics of Measles and Whooping Cough, and several cases of Scarlet Fever were admitted incubating either Measles or Whooping Cough. Diphtheria. 177 cases of Diphtheria were admitted with 11 deaths. BACTERIOLOGICAL EXAMINATIONS. (a) For Diphtheria Positive. Negative. Total Examinations— 1551 193 1358 Sent by Medical Practitioners 57 409 do. (re-examinations) 6 48 Sent from Isolation Hospital 116 583 do. (re-examinations) 1 3 Convalescents (1st Swabs) — 31 Contacts 4 156 do. (2nd examinations) 4 58 do. |
94720c4c-7191-4589-9fa9-fbff4c9208b4 | (3rd examinations) — 2 Precautionary Swabs — 12 School Sore Throats 4 50 do. (2nd Swab) 1 3 do. (3rd Swab) — 2 do. (4th Swab) — 1 (b) For Ringworm. Positive. Negative. Total Exmainations— 5 4 1 (c) For Tubercle. Positive. Negative. Total Examinations— 154 31 123 MATERNITY AND CHILD WELFARE. Infantile Mortality. 56 deaths occurred in children under one year of age. This number corresponds to an infantile mortality of 50 per 1,000 births. The infantile mortality is lower than that of England and Wales and that of the 107 great towns and of London. |
9aed1511-77f5-47f4-a226-a496abf6c3ba | It is also the lowest infantile mortality for the district, the next lowest being that of 1926 when it was 55 per 1,000 and 1928 when it was also 55 per 1,000 births. It is natural to review the results of any activities when anyparticular stage is reached, though the division may be quite artificial and arbitary. It is not so very long ago when public health authorities looked upon an infantile mortality of 100 per 1,000 births as a goal which might ultimately be reached. Although that figure now appears absurdly high, it must be remembered that in the early years of this century, the infantile 1 9 30 36 mortality was invariably between 150 and 200 per 1,000 births, and when a town reached the 100 per 1,000 it rejoiced. |
86b738fd-265b-4ede-91bd-1ccbacd530fa | We have now reached the figure of 50 per 1,000 births, and it is natural to enquire what are the factors which have been instrumental in this reduction of the infantile mortality. Many factors have been in operation, but I think it is fair to claim that one of the most important of these is the infant care scheme which is now a part and parcel of every public health department in the country. The development of Infant Welfare Scheme.s has be.en a gradual one— the appointment of health visitors, the passage of the Notification of Births Act, the establishment of Child Welfare Clinics, and Pre-natal Clinics, the provision of Maternity Beds, etc. All these activities have had immense educative effects upon the mothers, and if I were to single out one of these, I should place the establishment of breast feeding as one of the most important. |
249f76ff-a741-4b66-a7e7-f60321f27261 | At the beginning of this century it was seriously suggested that mothers were losing the power to secrete milk, as so few of them naturally fed their babies, but the experience gained in infant welfare work, has shown that it is a very rare phenomenon for a woman to be unable to nurse her own baby. If a woman is capable of performing the difficult task of bringing a living baby into this world she has it within her power to keep it alive afterwards with nutriment from her breast. It is admitted that the occasional unsuitability of the mother's milk for the infant is not a unique phenomenon, for the same phenomenon is sometimes witnessed in the animal world. The precise biological explanation of these case.s has not been forthcoming, and in any individual case nothing more can be said than that there is some incompatibility between the nutrient properties of the milk of the individual mother and the nutritive requirements of the child in question. |
4a45e939-60c7-43cd-ae39-65a6b51f1e8f | It is possible that the occurence of such a case in the past has determined the doctor in his advice to wean in other cases without enquiry into all the circumstance.s and using every endeavour to avoid unnecessary weaning. Women are too prone to believe on insufficient grounds that they cannot nurse their babies, and they are often aided and abetted in their belief usually by ignorant friends and relatives but sometimes by doctors and nurses who should know better. The present-day baby is not easy to rear, breast milk or no breast milk. The trouble commences during the establishment of the milk flow, and difficulties are often experienced later in maintaining the activity of the mammary glands. We frequently hear the. remark that the milk "went away" as soon as the mother got up after the confinement. It is true and has been proved experimentally that there may be a diminution in the amount of milk secreted immediately following the resumption of household duties. |
340cf7f9-d903-44c6-82aa-6d7e491e28f9 | One of the most important conditions of breast feeding 37 1930 is a cheerful mental attitude on the part of the mother. The worries incidental upon the active resumption of household duties and the increased exertion probably do affect the secretion of the milk, but these are not sufficient to take the baby off the breast. It is gratifying to know that frequently the advice of the health visitors is successful in showing that these conditions are transient and temporary and that the suckling should be persevered with. We frequently hear the remark that the mother believes her milk is "too thin," or that her milk does not agree with the baby, and she imagines that in some other way her milk was not sufficiently nutritious. When things go wrong, as they often do, the tendency is to utilise the. resources placed within easy reach, without making any search for other causes for the want of growth and progress in the baby. It is so easy to lay the blame on the food, and so difficult to examine all the circumstances. |
e04190e0-ed9f-44fc-a6ef-eb5eae1677f3 | If the infant is breast fed, he is weaned, if bottle fed, his food is changed. There may be no justification for believing that if breast fed milk fails there will be any better results with an artificial substitute. The breast fed infant requires a considerable amount of management even though the milk be of the best quality. But it is ea.sier to change the food than to see.k patiently for the cause. From the point of view of the baby the advantages of breast feeding are so enormous that every effort should be made by all concerned to make lactation a success. The artificially fed baby may put on weight adequately, indeed, the weight chart may be better than that of a breast fed baby, but nevertheless, there may be differences which are obvious to the expert observer. Thus the vascularity of the skin may be deficient and the baby will therefore not exhibit the rosy fresh appearance of perfect health. |
4c808dbb-96f6-4d4e-88eb-f2a915c18cb9 | Artificially fed infants are known to be more liable to rickets than breast fed infants, although the hygienic conditions in regard to light and fresh air be perfect. It is true that rickets does develop occasionally in breast fed babies, but the liability is far less, and the comparative absence of severe rickets at the present time is probably due to the increased vogue of breast feeding. The most important difference, however, between the two classes of infants concerns the matter of resistance to infection in which the breast fed baby is considerably superior. Babies fed on cow's milk suffer more from those infective intestinal disorders of an acute or chronic character, which so seriously affect their nutrition. Our efforts are therefore directed towards the establishment of breast feeding, but there are other directions in which advice is often urgently needed. Too often the babies are irregularly fed. If a baby cries, the mother imagines that he is hungry and gives him a feed, thereby starting a train of digestive troubles by irregular feeding. 930. |
f36595f8-4ba7-431f-bf06-72ec47c3ae71 | 38 But it is not only on the question of food and feeding that advance has been made, though in some other directions the obstacles are greater. I think it will be admitted that an improvement has occurred in the matter of clothing. One of our greatest difficulties in effecting an improvement in the matter of clothing has been the fight against tradition. From time immemorial, it has been the custom to wrap up the tiny baby in swaddling clothes, which so cramp the baby's movements that he is unable to move his limbs. It has taken may years to educate the mothers to the fact that the only exercise the baby: can have is by kicking his legs and moving his arms about, and that the.se movements are restricted when he is confined in his long clothes. These long clothes also exclude the beneficial effects of the sun and the air from his body. |
85698a3d-5d3f-4ddf-88e7-a1f22e614d41 | Mothers are becoming much more sensible of the good effects of exposure of the body to the action of the sun, and they make every effort to put the baby out of doors in the perambulator. Occasionally we hear of the. difficulties which the mothers have to contend with. They may be occupying an unstairs flat and they are not allowed the use of the back garden. Fortunately, most of the houses in Acton have a fair sized garden, but this garden is often in the sole possession of the tenants of the ground floor flat. But the mothers make every effort to overcome this difficulty by trying to take the baby out in the perambulator during some part of the day. We are fortunate in this district in the matter of open spaces, and I think it can be said that the mothers are taking increasing advantage of these open spaces for the benefit of the baby's health. There is one other article of clothing which is taking a great deal of time in its banishment. |
ccc081a0-a7fa-41a1-a3fe-a756836f885b | Some mothers still cling to the old tight binder around the baby. Its original purpose, I imagine, was its supposed efficacy in imparting support to the back and protection to the organs of the abdomen. If this function were at any time fulfilled, it would have to be so tight as to be positively harmful. More frequently it was found to have slipped up under the arms and impeded the free movements of the chest, and in this manner was more harmful even than in its original position and more uncomfortable. These conceptions of what is a suitable clothing are gradually passing away and the tight binder is gradually giving way to the warm loose vest reaching to the lower part of the body. These are some of the features in which success has been gradually attained and the success is reflected not only in a lowered infantile mortality, but also in a much lower mortality in the years immediately following. In contemplating the lowered infantile mortality we sometimes lose sight of the still greater improvement which has taken place in the age period 1 to 5 years. |
f7c56559-aa2f-446a-bcba-d0201c3f465c | The baby reaches the end of his first year in a far better condition to withstand the trials and illnesses which await the toddler. 39 1930 But there is one period in which success has not been attained, or at any rate to a very limited extent. 1 refer to the mortality in the first few weeks of life. The lowered mortality is almost entirely limited to the later months. The mortality in the first month of life remains almost unaltered. Last year of the 56 deaths which occurred amongst children under one year of age, 33 of them occurred in the first 4 weeks after birth, and this is about the same proportion which is observed year after year. About one half of the deaths of infants under 12 months occur in the first 4 weeks of life. It is difficult to see how this waste can be avoided, except by greater efforts to conserve the health of the mother. Until this can be accomplished, , there is not much prospect of reducing much further the infantile mortality. |
41b77154-6c4a-49eb-8207-54a27fc91d68 | Fortunately, there is a greater tendency on the part of expectant mothers to consult their doctors or to attend a prenatal clinic. One of the difficulties which militates against the success of our pre-natal clinic was the want of provision of maternity beds for normal cases of confinement. It is hoped that the arrangements which are now being made for maternity beds will overcome this difficulty and popularise the pre-natal clinic. Maternal Mortality. Two deaths occurred from Puerperal Sepsis and two deaths from diseases of Parturition. One of the latter was due to Necrosis of the Liver and the other to uncontrolled vomiting of pregnancy. There were 4 notifications of Puerperal Fever and 9 notifications of Puerperal Pyrexia. It is significant that the four deaths which occurred in childbirth, not only occurred, in a hospital, but the confinement took place in the hospital, and there had been no difficulty in the admission of the patient. |
22d622cf-9b2f-4fed-b845-023731c36245 | Two of the deaths were due to Puerperal Sepsis and this is the condition which is generally regarded as one which should be prevented. The particulars of the deaths were as follows :— (1) Single woman aged 34 years, admitted to Charing Cross Hospital as a married woman. Cause of death— Toxaemia of pregnancy. Child born alive and lived 27½ hours. Attended pre-natal clinic regularly, but there were no prenatal symptoms. Baby was delivered on June 18th, and the patient died on June 22nd. Post-mortem, there was massive Necrosis of the Liver. (2) Single woman admitted to Hospital as a married woman. Attended pre-natal clinic at Queen Charlottes Hospital, and there was no difficulty in admission to the hospital. Cause of death— Puerperal Sepsis. 1930 40 (3) Single woman admitted as a married woman to Hammersmith Maternity Hospital, Ducane Road. |
e5f87aa5-e642-4cd0-bfe5-5fb2d4bfc1db | Attended pre-natal clinic. Admitted to Hospital September 1st, baby born September 2nd. Date of death, September 19th. Cause of death— Puerperal Sepsis. (4) Single woman admitted to Hospital for uncontrolled vomiting of pregnancy. Under present conditions it is difficult to see how these four deaths could have been prevented. The difficulty of eradicating puerperal fever lies in the fact that there is very much yet to discover in connection with the disease. Although it is known that certain microbes cause puerperal fever, it is possible that more than one variety may be capable of doing so. At one time it was thought that the disease was due to the germ called haemolytic streptococcus, but now it is possible that another strain called the anaerobic streptococcus may also be an occasional cause. |
4e43f475-4637-4921-b76b-2c7736383c55 | Of more importance is the mode by which these dangerous types of streptococcus reach the woman who is giving birth to a child. Some are convinced that the woman carried these dangerous microbes on her own person, and is therefore selfinfected. It is known that a few women, about 25 in every 1,000, do carry streptococci, which are indistinguishable from those of puerperal fever, but most of these women, in spite of having potentially dangerous microbes do not get puerperal fever after their child-birth. Why some women are able to resist the attack of microbes while others do not is still a matter which awaits further research. One of the advantages of pre-natal examination and investigation is the possibility of remedying any focus which may result in auto-infection, and also in detecting any abnormal condition which may result in a long difficult labour. Great fatigue docs diminish the power of the blood to kill microbes. |
e2d1ab89-c9f9-479d-b656-832c15073456 | In the majority of cases of puerperal fever, though, the infecting organism is introduced from an outside source by those in attendance during labour. An improvement in this respect can only come from better midwifery. Not only will this result in less exhaustion of the mother, and therefore in less diminution of her powers to resist infection, but it will mean greater vigilance in guarding against the transference of dangerous microbes to the mothers during and after child-birth. The improvement may mean a revolution in the. practice of both doctors and midwives. It was formerly taught that extraneous infection was usually brought about by the transfer of streptococci from an infected patient to an uninfected one. This, of course, is still a source of infection and prevention here is largely a question of the sterilisation of the hands and instruments. There is much more room for improvement in the sterilisation of the hands apart 1930 41 from the occurrence of cases of puerperal fever. |
e580e86b-b75d-435d-ba76-21982691c917 | Some nurses and doctors do not appreciate that a perfunctory rinsing of the hands in a disinfectant for a few seconds does not suffice to sterilise them or even get rid of the dangerous microbes. One of the highest authorities on the subject states that we ought to recognise frankly that the use of naked hands in midwifery is wrong and should give place to a general employment of rubber gloves. But another source of infection has recently been recognised. Investigations have recently been and are still being carried out which point to another source of outside infection. It is possible and even probable that haemolytic streptococci can be carried in the throats of attendants at the confinement. The occurrence of a sore throat in any one in attendance becomes at once a serious matter. |
197bbe3d-fa59-4acf-8e4b-b71594b346ea | The reports already issued suggest that the phophylaxis of puerperal fever cannot be effective unless rigid asepsis of hands and instruments or the wearing of rubber gloves is supplemented by the use of masks by attendants during examination and delivery. They also point to a new regime in maternity hospital practice designed to secure definite bed isolation in the wards and stringent aseptic surgical technique, including masking of the attendants during manipulative interference, delivery and treatment. Pre-natal Clinic. The clinic is held once a fortnight in the School Clinic and Dr. Bell is in charge. 24 sessions were held with a total of 170 attendances. There is an agreement with the Acton General Hospital for the reception of complicated cases of pregnancy and during the year six patients were admitted under the scheme. Although the numbers who have attended the pre-natal clinic are higher than those of previous years, the working of our maternity scheme cannot be regarded as entirely satisfactory. |
9b939694-8fb4-4d61-83eb-e6d70e11d1a5 | Certain developments have already taken place in 1951, and a report will be submitted to the Committee which will bring the pre-natal work more in line with these developments. Child Welfare Centres. There has been no change in the arrangement of the child welfare centres in the year. It was stated in last year's report that the attendances at East Acton School necessitated a weekly opening of the Centre there instead of a fortnightly one. Six sessions are now held weekly: two each in Church Road and Palmerston Road, and one each in East Acton School and Steele Road. A reference to Table 8 will show that the work has gradually increased. In almost every branch of the work the figures arc higher than those of the previous year. 1930 42 Day Nursery. The Nursery is situated in Bollo Bridge Road, and is open on five days a week. Saturday opening has been tried but the attendance did not justify the Saturday opening. |
733de1e1-b1af-4192-9ad5-3b4ad5c4bb3e | The Nursery was open on 212 occasions, and 4,307 whole-day and 177 half-day attendances were made. Nurse Children. Section 2 of the Local Government Act, 1929, provided that as from April 1st, 1930, the functions under Part I. of the Children Act, 1908, formerly discharged by poor law authorities, should be discharged by the councils of counties and county boroughs as functions under the Maternity and Child Welfare Act, 1918, except that where the council of a district have established a maternity and child welfare committee, the said functions shall in that district be discharged by the council of that district. The main object of Part I. of the Children Act is to secure that any child under seven years of age. who is maintained "for reward" shall be notified to the local authority in order that it may be kept under observation and supervision. |
3fe86639-c1fe-488b-a4d9-80f817d29671 | Every person who undertakes for reward the nursing and maintenance of one or more infants under the age of seven years apart from their parents, or having no parents, must give notice to the local authority, giving certain particulars. Written notice must also be given in the case of death, or change of residence or removal of the child. Certain persons are prohibited from receiving children for reward, and under certain conditions children can, on an order from a magistrate, be removed from premises or persons that are undesirable or unsatisfactory. The local authority has to provide for the administration of the Act and the Boards of Guardians had to appoint Infant Protection Visitors, but in a Memorandum issued by the Ministry of Health, it was suggested that the Health Visitors should be appointed Infant Protection Visitors under Part I. of the Children Act, and the Council adopted this suggestion. The Health Visitors were already visiting most of the children under 5 years of age who had been adopted for reward, and it simply meant that they should continue visiting until the children were seven years of age. |
d40ea77e-1808-4ca3-8b3c-47e8290c5eff | Two officers carry out home visiting of infants and school children in their respective areas. When the duties were taken over from the Guardians, a list of children was forwarded, and on this list there were 39 names Between April 1st and December 31st 26 other names were added, but 13 names were removed from the register in the same period. There were remaining on the register on December 31st, 52 names. TABLE 1. BIRTH-RATE, DEATH-RATE, AND ANALYSIS OF MORTALITY DURING THE YEAR 1930. Rate per 1,000 population Annual Death-rate per 1,000 Population. Rate per 1,000 Births Percentage of Total Deaths Live Births. . StillBirths. All Causes Enteric Fever Small Pox -Measles Scarlet Fever Whooping Cough Diphtheria Influenza Violence Diarrhoea and Enteritis (under 2 yrs.) |
a85c7747-8fd3-40fd-9f2e-f79b0a9d7e57 | Total deaths under 1 year Certified by Registered Medical Practitioners Inquest Cases Certified by Coroner after P.M. No Inquest Uncertified Causes of Death England and Wales 16.3 0.69 11.4 0.01 0.00 0.10 002 0.05 0.09 0.12 0.55 6.0 60. 90.4 8.9 1.7 1.0 107 County Boroughs and Great Towns, including London 16.6 0.71 11.5 0.01 0.00 0.15 0.02 0.05 0.10 0.11 0.50 8.3 64. |
6c1c1f36-a165-42d5-8748-153756eb097e | 90.6 6.6 2.3 0.5 150 Smaller Towns (1921 Adjusted Population, 20,000—50,000) 16.2 0.69 10 5 0.00 0.00 0.83 0.01 0.05 0.07 0.13 0.43 4.4 55. 91.8 5.9 1.2 1.1 London 15.7 0.56 11.4 0.01 0.00 0.23 0.02 0.03 0.10 0.08 0.55 9.9 59. |
6d92866d-4776-4563-8017-b0b364676f71 | 88.3 7.4 4.3 0.0 Acton 16.9 0.63 10.6 0.00 0.00 0.13 0.02 0.03 0.13 0.06 0.38 5.5 50. 90.8 5.8 3.4 0.0 1930 43 TABLE 2. VITAL STATISTICS FOR THE WHOLE DISTRICT DURING 1930 AND PREVIOUS YEARS. Year Population estimated to Middle of each Year Births Nett Total Deaths Registered in the District Transferable Deaths Nett Deaths belonging to the District Under 1 year of Age At all Ages Number Rate Number Rate of Non-Residents Registered in the District of Residents Registered outside Dist. |
3bde1a41-a8d9-42ee-9487-4027bf1b1b7d | Number Rate per 1,000 Births Number Rate per 1,000 inhabitants 1925 63,110 1047 16.5 446 6.8 18 241 80 76 669 10.6 1926 63,040 1098 17.4 422 6.7 15 250 60 55 657 10.4 1927 63,750 1026 16.1 445 6.9 21 280 62 60 704 11.04 1928 64,870 1003 15.4 479 7.4 29 244 . |
277b6369-475a-45fe-999d-0d19610127a1 | 55 55 694 10.7 1929 65,200 1026 15.7 540 8.3 21 307 85 83 826 12.7 1930 65,200 1105 16.9 440 6.7 31 284 56 50 693 10.6 1930 44 TABLE 3. AGES AT DEATH, AND WARD DISTRIBUTION OF DEATHS IN 1930. Causes of Death. Age in Years. Ward Distribution. All ages Under 1 year 1 and under 2 2 and under 5 5 and under 15 15 and under 25 25 and under 45 45 and under 05 65 and upwards North East North West South East South West Whooping Cough 2 - - 2 - - - - - 1 - 1 - Measles 9 1 3 3 2 - - - - |
e877d222-8010-4e62-8624-17c3f1c851bc | 1 1 2 5 Scarlet Fever 1 - - - 1 - - - - 1 - - - Diphtheria 9 1 - 5 3 - - - - 5 - 1 3 Encephalitis Lethargica 4 - - 1 - - 2 - 1 - 3 1 - Meningococcal Meningitis 5 1 1 - - 2 - 1 - - 1 2 2 Influenza 4 - - - - - - 2 2 1 2 - 1 Phthisis 57 - - - 1 9 31 15 1 15 7 11 24 Other tubercular diseases 9 2 1 3 1 - 1 1 - 4 1 - 4 Syphilis 2 - - - - - - 2 - - 1 - 1 Cancer 86 - - - - - 5 40 |
aac48cdc-031b-4bed-9477-29e25a40b261 | 41 23 24 22 17 Rheumatic Fever 2 - - - - - 1 1 - 1 - - 1 Heart Disease 77 - - - 4 5 9 19 40 24 23 10 20 Cerebral Haemorrhage 35 - - - - - 1 12 22 9 13 4 9 Arterio-scelerosis 38 - - - - - - 11 27 8 10 10 10 Diabetes 5 - - 1 - - - 2 2 2 1 2 - Bronchitis 41 1 2 - - - 1 16 21 9 7 12 13 Pneumonia (all forms) 42 4 3 5 1 - 8 9 12 9 9 8 16 Other respiratory diseases 9 - - 2 1 1 1 2 2 3 2 1 |
719d7916-1214-4bb8-abea-e96f93b1165f | 3 Diarrhoea 6 5 1 - - - - - - 2 2 - 2 Ulcer of Stomach and Duodenum 12 - - - - - - 5 4 3 4 3 2 Appendicitis 2 - - - - - 1 - 1 - - 1 1 Cirrhosis of Liver 3 - - - - - - 2 1 1 - 1 1 Nephritis 27 - - - - 1 2 13 11 10 7 6 4 Puerperal sepsis 2 - - - - 1 1 - - 1 1 - - Oilier diseases or accidents of Parturition 2 - - - - 1 1 - - - 1 1 - Prem. |
eb6d5931-4002-4042-a857-e69032aa0eae | births, congenital diseases & deformity 37 37 - - - - - - - 11 9 6 11 Suicide 6 - - - - 2 2 - 2 2 2 1 1 Other violent deaths 24 - - - 2 8 3 5 6 13 6 2 3 Other defined diseases 134 4 4 1 1 4 9 26 85 36 31 35 32 TOTALS 693 56 15 23 17 34 82 184 282 196 108 143 186 1930 45 TABLE 4. INFANTILE MORTALITY 1930. Causes of Death. Ages. Wards. Total Under 1 week 1—2 weeks 2 3 weeks 3—4 weeks| 1—3 months 3—6 montns 6—9 montns 9— 2 montns North |
28cf3f4e-3b7b-40b3-bedd-3f24576f8582 | East North West South East South West Measles 1 - - - - - - - 1 - - - 1 Diphtheria 1 - - - - - 1 _ - - - - 1 Tubercular Meningitis 2 - - - - - - - 2 1 - - 1 Myocarditis 1 - - - - - - 1 - - - - 1 Bronchitis 1 - - 1 - - - - - 1 - - - Pneumonia 4 - - - - - - 2 2 - 1 - 3 Diarrhoea 5 - - - - 1 3 1 - 1 2 - 2 Premature Birth 20 18 - - 1 1 - - - 3 6 5 6 Congenital Malformation 4 4 - - - - - - - 1 - 1 2 Injury at Birth 5 5 - - - - - - - |
2df2de65-392a-4c24-b304-3096d00b5479 | 3 2 - - Asphyxia Neonatorum 2 2 - - - - - - - - 1 1 - Hydrocephalus 2 - - - - - - 1 1 1 1 - - Inanition 2 - - - 1 - 1 - - 1 - - 1 Asthesia 1 - - - - - 1 - - 1 - - - Atelectasis 1 - 1 - - - - - - - - - 1 Accidental Burns 1 - - - - - - 1 - 1 - - - Status Lvmphaticus 1 - - - 1 - - - - 1 - - - Otitis Media 1 - - - - 1 - - - - - - 1 Meningitis 1 - - - - - 1 - - - 1 - - TOTALS 56 29 1 1 3 3 7 6 6 15 14 |
ce66883d-6bd9-45e5-b173-5e1628ff2a6d | 7 20 1930 46 TABLE 5. CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR 1930. Notifiable Disease. Cases notified in whole District. At Ages— Years. Ward Distribution. At all Ages Under 1 1 to 5 6 to 15 16 to 25 26 to 45 46 to 65 Over 65 North East North West South East South West Small-Pox 7 - - 3 1 3 - - 2 2 - 3 Scarlet-Fever 207 - 60 108 21 18 - - 75 30 41 61 Diphtheria 103 1 32 58 8 4 - - 38 21 10 34 Typhoid 1 - - - - - 1 - - 1 - - Paratyphoid B. |
c7c4c9e0-031a-4a91-bc1e-247c4f904bbd | 2 - - 1 1 - - - - 2 - - Pneumonia 37 - 8 2 4 11 7 5 7 7 6 17 Puerperal Fever 4 - - - 2 2 - - 1 1 - 2 Encephalitis Lethargica 2 - 1 - - 1 - - - 2 - - Ophthalmia Neonatorum 10 10 - - - - - - 2 2 - 6 Puerperal Pyrexia 9 - - - 6 3 - - 3 3 - 3 Erysipelas 20 - 1 1 2 6 7 3 5 8 1 6 Tuberculosis (resp.) |
d46e4ae1-6f3d-4dae-bf96-0d21e338fd6b | 97 1 - 3 27 53 13 - 27 23 12 35 Tuberculosis (other) 13 1 1 4 4 2 1 - 3 1 4 5 TOTALS 512 13 103 180 76 103 29 8 163 103 74 172 1930 47 19 30 48 TABLE 6. CASES REMOVED TO HOSPITAL. N. East. N. West. S. East. S. West Total Scarlet Fever 62 20 36 53 171 Diphtheria 38 21 10 34 103 Typhoid - 1 - - 1 Paratyphoid B. |
0204f8c0-d87f-40ce-aaef-bd769c012afd | - 1 - - 1 Pneumonia 3 2 1 5 11 Puerperal Fever 1 - - - 1 Encephalitis Lethargica - 2 - - 2 Puerperal Pyrexia 1 2 - - 3 Erysipelas 1 1 - 3 5 106 51 47 95 299 TABLE 7. BIRTHS. Live Births. Male. Female. Total 555 550 Legitimate 523 513 Illegitimate 32 37 Still Births. Total 26 15 Legitimate 22 15 Illegitimate 4 - Notified Live Births. Ward Distribution. Total. N. East. N. West. S. East. S. West. |
e8479aee-ff50-4177-b94e-4aea47ece8cc | Total Births notified in the district 830 256 179 114 281 Notifications received from other districts 217 58 54 48 57 Births registered but not previously notified 12 4 3 — 5 1059 318 236 152 343 Notified Still Births. Inside 15. Outside 8. Notification's were received from :— Doctors and Parents 747. Midwives 323. TABLE 8. INFANT WELFARE CENTRES, 1930. |
277fac33-0ada-440c-a141-6a99e0297bdf | Health Visitors' Attendances 299 Number of Children who attended 1765 Number of attendances by Children 16352 Number of Children under 1 year of age 874 1930 49 Number of Children over 1 year of age 891 Children who attended for first time 1372 Children treated at Dental Clinic 165 Children treated at Ophthalmic Clinic 8 Mothers treated at Ophthalmic Clinic — Children treated for Enlarged Tonsils and Adenoids 3 table 9. ANTE-NATAL CLINIC. Number of attendances by Dr. Bell 24 Number of Expectant Mothers who attended 113 Number of attendances made by Expectant Mothers 170 Mothers referred for Dental treatment at the Clinic 46 Mothers supplied with Dentures 10 Expectant Mothers to whom Dried Milk was supplied 20 Number of packets of Dried Milk supplied 248 table 10. INQUESTS. Inquests— 40. |
263b852f-5338-45fb-85f9-07cbc2c60b3f | Run over by a motor car 11 Fall in road 1 Accidental fall 8 Fall from bicycle 1 Suicide 7 Accidental drowning 1 Injury at birth 3 Killed by a train 1 Accidental burns 2 Phthisis 1 Knocked down by a bicycle 1 Syncope 1 Injury to finger 1 Toxaemia of pregnancy 1 Coroner's Certificate after Post-Mortem without Inquest—24. Fatty degeneration of Heart 4 Status Lymphaticus 1 Arterio-scelerosis 4 Bronchitis 1 Cerebral Haemorrhage 2 Endocarditis 1 Cardiac Denegeration 2 Ulcer of Stomach 1 Nephritis 2 Congenital heart disease 1 Pneumonia 2 Intestinal obstruction 1 Rupture of Aortic valve 1 Meningococcal Meningitis 1 FACTORIES, WORKSHOPS AND WORKPLACES. |
e9d9df93-ab99-4a50-9f7f-3bf52439170b | 1.—Inspection of Factories, Workshops and Workplaces including Inspections made by Sanitary Inspectors. Number of Premises. Inspections. Written Notices. (1) (2) (3) Factories 83 7 (Including Factory Laundries). Workshops 304 18 (Including Workshop Laundries). Workplaces 18 Nil (Other than Outworkers' Premises). Total 405 25 1930 50 2.—Defects found in Factories, Workshops and Workplaces. Nuisances under the Public Health Acts :— Particulars. Found. |
0a708b64-546b-4a00-b07a-ef0a493446b2 | Remedied (1) (2) (3) Want of Cleanliness 17 17 Want of Ventilation Nil Nil Overcrowding Nil Nil Want of drainage of Floors Nil Nil Other Nuisances 12 12 Sanitary Accommodation — Insufficient Nil Nil Unsuitable or defective 28 28 Nor separate for sexes Nil Nil Offences under the Factory and Workshop Acts :— Illegal Occupation of underground Bakehouses Nil Nil Other Offences Nil Nil Total 57 57 3.— Outwork in unwholesome premises, Section 108 Nil HOUSING. Number of Houses erected during the year :— (a) Total [including number given separately under (b) 514 (b) With State assistance under the Housing Acts :— (i) By the Local Authority 12 (ii) By other bodies or persons Nil 1.—Unfit Dwelling Houses. Inspection. |
a00a705e-124c-4c9a-8193-aed86e4d6ce3 | (1) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 1244 (2) Number of dwelling-houses which are inspected and recorded under the Housing (Inspection of District) Regulations 1910, or the Housing Consolidated Regulations, 1925 670 (3) Number of dwelling-houses found to be in a state so dangerous or injurious as to be unfit for human habitation Nil (4) Number of dwelling houses (exclusive of those referred to under the preceding Sub-Head) found not to be in all respects reasonably fit for human habitation 1172 51 1930 2.— Remedy of Defects without Service of Formal Notices. Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their Officers 811 3.— Action under Statutory Powers. A.— Proceedings under Section 3 of the Housing Act, 1925, and under Section 17 of the Housing Act, 1930. |
0321d17c-d28e-47c6-9941-c7b127302316 | (1) Number of dwelling-houses in respect of which notices were served requiring repair 189 (2) Number of dwelling-houses which were rendered fit after the service of formal notices (a) by owners 189 (b) by local authority in default of owners Nil (3) Number of dwelling-houses in respcct of which Closing Orders became operative in pursuance of declarations by owners of intention to close Nil B.— Proceedings under Public Health Acts. (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 172 (2) Number of dwelling-houses in which defects were remedied after service of formal notices :— (a) by owners 172 (b) by local authority in default of owners Nil C.— Proceedings under Sections 11, 14 and 15 of the Housing Act, 1925. |
13896391-b405-4707-8d3b-3949f1df7c32 | (1) Number of representations made with a view to making of Closing Orders Nil (2) Number of dwelling-houses in respect of which Closing Orders were made Nil (3) Number of dwelling-houses in respect of which Closing Orders were determined, the dwellinghouses having been rendered fit Nil (4) Number of dwelling-houses in respect of which Demolition Orders were made Nil (5) Number of dwelling-houses demolished in pursuance of Demolition Order,s Nil 1030 52 STAFF. D. J. Thomas, m.r.c.s., l.r.c.p., d.p.h., Medical Officer of Health (Medical Superintendent of the Isolation Hospital and School Medical Officer). M. W. Kinch, Member of the Royal Sanitary Institute, holds Meat and Smoke Certificates; Chief Sanitary Inspector (Inspector under Diseases of Animals Acts and the Rag Flock Act). J. J. Jenkins, Cert, of Royal Sanitary Institute; holds Meat and Smoke Certificates, Sanitary Inspector. |
bcb6da69-2b55-4990-8aea-e9f9c7d36a26 | (Inspector under Fabrics Mis-description Act). E. W. Brooks, Cert, of Royal Sanitary Institute. Sanitary Inspector. J. J. Matthews, Cert, of Royal Sanitary Institute; holds Meat Certificate, Sanitary Inspector. Miss A. Cooksey, Certificate of Royal Sanitary Institute. Health Visitor. Miss J. Welsh, Certificate of Royal Sanitary Institute, C.m.r., Health Visitor. Miss B. G. Sorlie, s.r.n. Certificate of Royal Sanitary Institute, c.m.b., H.V. Diploma, Health Visitor (and part-time School Nurse). Miss A. Woosnam, s.r.n., c.m.b., Health Visitor (and part-time School Nurse). W. Goodfellow,* Cert, of Royal Sanitary Institute; holds Meat Certificate, Chie.f Clerk. Miss G. Overall,* Clerk. Mrs. Light, Clerk. Miss V.E.Arnold, Clerk. |
303e3913-f242-44e6-96f3-dc4f23062ea8 | Note..— To the salaries of all the above officials, excepting those marked with an asterisk, contribution is made under the Public Health Acts or by Exchequer Grants. I have again to thank all the members of the Public Health Department for ungrudging assistance during the year. I am, Your Obedient Servant, D. J. THOMAS. |
67951b46-e05d-4473-ac41-58b19dfa3973 | Act 34 Borough of Acton. ANNUAL REPORT OF THE Medical Officer of Health TOGETHER WITH THE Report on the Medical Inspection of Schools FOR THE YEAR 1931. ANNUAL REPORT OF THE Medical Officer of Health FOR THE YEAR 1931. Public Health Department, Municipal Offices, Acton, W.3. To the Mayor, Aldermen and Councillors of the Borough of Acton. Mrs. Barnes and Gentlemen, I herewith submit the Annual Report required by the Ministry of Health, together with the Annual Report on the School Medical Services. The estimated population is that of the Registrar General for the middle of the year 1931. It is, of course, based upon the figures obtained at last year's census. The birth-rate is considerably lower than that given in the report for 1930, but that is principally due to the corrected population. In last year's report the figures were based upon a much lower estimated population. |
025fd91b-5fbb-40c4-874b-564219efb3c7 | Apart from this, though, the actual number of births is lower than that of 1930. The birth-rate last year was the lowest recorded for the district. The death-rate is slightly higher than that of 1930, but I have explained in previous reports that an apparently higher death-rate must be expected owing to the altered and altering age-distribution of the population. The increased number of deaths has occurred among the older persons. The death-rate at ages under 65 years of age, is, with one exception lower than in any previous year. The infantile mortality is also higher, but an infantile mortality of 60 per 1,000 births is, on the whole, satisfactory for a district such as Acton is. 4 The incidence of all the infectious diseases was considerably lower. There was no death from Whooping Cough and Scarlet Fever and a diminution in the number of deaths from Measles and Diphtheria. |
6c8702f2-a8c6-49e1-a421-4d409b63f280 | There were 5 maternal deaths; 3 from sepsis following abortion. There is reason to think that the practice of abortion is widespread, not only in this district but also in other surrounding districts. A feature of recent annual reports has been the inclusion of deaths from germ disease of the central nervous system, such as encephalitis lethargica, cerebro-spinal meningitis, anterior poliomyelitis, &c. Last year 4 deaths occurred from encephalitis lethargica, or sleepy sickness. Cancer still seems to be on the increase and last year claimed a higher number of deaths. |
ba9b9467-37de-444f-8a5b-d70a5b457530 | The following is a summary of the vital and other statistics for the year 1931:— Area of Borough 2,305 acres Population (estimated midsummer 1931) 70,560 Population (Census 1931) 70,523 Number of inhabitated houses (Census 1931)— figures not yet available Number of inhabited houses (end of 1931) according to Rate Book 15,803 Number of families or separate occupiers (Census 1931 figures not yet available Rateable Value (1st October, 1931) £700,401 Net produce of a penny rate ((year ending 31st March, 1931) £2,812 13s. |
229be275-edd1-466c-a15c-477488821870 | 5d Total number of births registered 1,019 Legitimate 962 Illegitimate 57 Birth-rate per 1,000 inhabitants 14.4 Number of deaths 742 Death-rate per 1,000 inhabitants 10.5 Number of women dying in, or in consequence of childbirth— from sepsis 1 from abortion 3 from other causes 1 Maternal mortality per 1,000 births 5 5 Deaths of infants under 1 year of age— 62 Legitimate 54 Illegitimate 8 Infantile mortality per 1,000 births 61 Death-rate per 1,000 Total Deaths Population. Measles 1 .01 Whooping Cough — — Diphtheria 4 .06 Scarlet Fever — —. Influenza 7 .10 Tuberculosis of Lungs 43 .60 Tuberculosis (other forms) 11 .15 Tuberculosis (all forms) 54 .76 POPULATION. |
b0d3409e-67b6-4638-bf93-b10a9ca535a5 | Only the preliminary results of the Census have as yet been published. The preliminary report was published in August, 1931, and in that report the population was given as 70,523— 33,230 males and 37,293 females. The figure now given by the Registrar General is slightly different and is 70,560. A memorandum accompanies the estimate in which it is stated that the 1931 estimate of population noted differs from the 1931 Census population in that it purports to represent the resident popluation of the area, which is not necessarily comparable with the population enumerated at the Census. The analysis of the returns in respect of the "usual residence" question asked on the Census schedule has not yet been completed and the figure now given is to that extent approximate; it is believed, however, that it is sufficiently accurate for the purpose for which is supplied. The only other item which has been published is the ward population. |
53c954eb-9272-413e-9c6a-5ac4ae3191a0 | This is based upon the number 70,523 and will be corrected when the final figures are published. The 70,523 inhabitants were distributed among the wards as follows :— North-East. North-West. South-East. South- West., 22,383 16,763 16,525 14,852 It was anticipated that increases had taken place in the NorthEast and North-West Wards, but it was hardly expected that there had been so large a decrease in the South-West Ward. The ward population in the last three censuses was as follows : North-East. North-West. South-East. South-West. |
03313a5c-2f5f-44ed-8a0b-179506cfb13b | 1911 14,576 11,492 14,599 16,830 1921 16,353 12,329 15,094 17,523 1931 22,383 16,763 16,525 14,852 6 It will be remembered that the Registrar General's estimate of the population in 1929 was 65,200 and we were asked to use this figure for 1930. The various rates were calculated upon the basis of this estimate and it is obvious that the birth-rate and death-rate given for these years are fallacious. It is important therefore to revise the population, not only for 1930 but for the other years between 1921 and 1931. It is difficult though to estimate the population for the inter-censal years. The usual method is based on the assumption that the yearly increase has been at the same rate through out the inter-censal period. |
64b31eeb-302c-4d0a-b8e8-cba5e3c0b4df | The problem is similar to one of compound interest, the sum of money and the population both increasing from year to year not merely by the addition of the interest but of interest on the interest. A series of numbers is said to increase or decrease in geometrical progression when the successive numbers differ by a common ratio. It is a useful assumption, that a population increases in regular geometrical progression, but it is easy to show how wrong it is in theory, especially in a small district, where new industries are being established, or where the erection of houses had proceeded in an irregular manner during the intecensal period. Although new industries have been established in this district, and the number of new houses erected was higher in the second than in the first half of the inter-censal period, the method mentioned above is as accurate as any other. As probably it will be the method adopted by the Registrar General it will be more convenient to adopt it. |
96386e81-7bdc-4836-84f1-9439dd85ccf7 | The population in the ten years based on this method of calculation would be :— 1921 (Census) 61,299 1926 65,760 1922 62,170 1927 66,700 1923 63,060 1928 67,645 1924 63,945 1929 68,600 1925 64,845 1930 69,565 1931 (Census) 70,560 The number of dwelling houses and flats erected in the intercensal period was as follows :— Year ending Year ending 31st March, 1922 140 31st March, 1927 431 do. 1923 126 do. 1928 322 do. 1924 99 do. 1929 233 do. 1925 241 do. 1930 605 do. 1926 304 do. |
c2785fcf-37f6-4476-8696-75ba935d251e | 1931 448 An examination of these two tables would suggest that the population in the years 1922— 1925 would be over-estimated, but there are certain considerations which might modify this view. The Census of 1921 was not taken until the middle of June and not as 7 usual in the beginning of April. Some holiday movement was already in progress at the time of the Census and the Registrar General from figures at his disposal made certain adjustments in the population of certain districts. The adjusted figure for Acton was 62,000. I think on the whole the estimated populations given above are as accurate as those which would be obtained by any other method of estimation. SOCIAL CONDITIONS OF THE DISTRICT. There is no change in the social conditions of the district. The northern part of the district is almost entirely covered with factories. The north-east and south-east wards are mainly residential in character, and so is the southern part of the north-west ward. |
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