Borough of Acton ANNUAL REPORT of the Medical Officer of Health together with the Report on the Medical Inspection of Schools FOR THE YEAR 1940 ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH FOR THE YEAR 1940. Public Health Department, Town Hall, Acton, W.3. To the Mayor, Aldermen and Councillors of the Borough of Acton. Ladies and Gentlemen, I beg to submit the annual report on the health of the Borough for the year 1940'. The report of the School Medical Service is given at the end as a separate report. This year's annual report is curtailed, as requested by the Ministry of Health, and contains only the essential information with regard to statistics and general work of the Health department. As a result of Mr. Kinch, Chief Sanitary Inspector, retiring in December, 1939, Mr. Jenkins was appointed Chief Sanitary Inspector. Mr. Cackett was appointed as temporary Sanitary Inspector in March, 1940, and the Council in December confirmed his appointment to the permanent staff. The statistics for the Borough show that the Birth Rate per 1,000 of the population is 14.04 as compared with 11.7 for 1939. The death rate for 1940 is 14.7 as compared with 10.1 for 1939. The Infantile Mortality rate of children under 1 year is 58.3 as compared with 59 for 1939. There were two deaths caused by 4 childbirth in 1940, and 4 in 1939. Every endeavour is made by careful ante-natal treatment and advice given to expectant mothers at the ante-natal clinic, to ensure that all is done to avoid any complication during the actual confinement of the mother. As Civil Defence matters are of such vital importance in our national life, and as the local Authorities are responsible for much of the organisation of Air Raid Precautions, some brief notes are appended with regard to various matters of this branch of the Service. It will be observed that further improvements at the Depots have been carried out. During the year considerable improvements have been made in the condition of the Depots of the Acton Casualty Sen-ice. Sleeping accommodation has been improved by the issue of twotier metal bunks, mattresses and pillows, for the personnel of the Stations, to replace the original camp beds. Individual sleeping equipment, which includes three blankets, one pillow slip and two towels, has now been allocated to all personnel. A house at 59 Gunnersbury Lane has been provided as a resting place for day duty nurses, and protected sleeping accommodation for the night duty shift stationed at Acton Hospital First Aid Post. No. 11 Gunnersbury Lane has been taken over to accommodate the ambulance staff previously stationed at 28 Gunnersbury Lane. This step has proved to be very satisfactory, as besides No. 11 being a far more suitable building, it is adjacent to the garage. The caretaker's house at East Acton School has been acquired for the use of the ambulance personnel stationed there. An extra room has been granted by the Director of Education for the female personnel at Acton Wells School. Further improvement has been made in the sleeping accommodation at Stretcher Party Post No. 3, as the Middlesex County Council authorised the building of protective accommodation in which 45 persons can rest and sleep. A canteen has been installed at this Post and is entirely run by the personnel. I feel you should be informed of the splendid way in which the A.R.P. Casualty Sendees behaved during the aerial bombardments and carried out their duties in an exemplary manner often at considerable personal risk. I should like to thank the staff of the Public Health Department for their kindly co-operation and loyalty throughout the year. I remain, Your Obedient Servant, GEORGE E. B. PAYNE. 5 STAFF. George E. B. Payne, m.d., m.r.c.s., d.p.h., Medical Officer of Health and School Medical Officer. Elsie Madeley, m.b., ch.b., d.p.h., Assistant Medical Officer of Health and School Medical Officer. P. H. Slater, l.d.s. School Dentist. J. J. Jenkins, M.R.San.I., Cert, of Royal Sanitary Institute; holds Meat and Smoke Certificates, Chief Sanitary Inspector (Inspector under Diseases of Animals Acts, Rag Flock Act, and Fabrics Misdescription Act). J. J. Matthews, Cert, of Royal Sanitary Institute, holds Meat and Smoke Certificates; Deputy Chief Sanitary Inspector. M. Dowie, Cert, of Royal Sanitary Institute, holds Meat Certificate; Sanitary Inspector. G. W. Burden, Cert, of Royal Sanitary Institute; Sanitary Inspector. (On War Service). H. V. Cackett, Cert, of Royal Sanitary Institute, holds Meat Certificate; Sanitary Inspector. (.Appointed 21.12.40). A. H. G. Johnson, Cert, of Royal Sanitary Institute; holds Meat Certificate; Meat Inspector. Miss B. G. Sorlie, s.r.n., Certificate of Royal Sanitary Institute, C.m.b., H.V. Diploma, Health Visitor and School Nurse. Miss W. E. Bennett, s.'r.n., Health Visitor's Certificate of Royal Sanitary Institute, c.m.b., Health Visitor and School Nurse. Miss W. L. Orfeur, s.r.n., Health Visitor's Certificate of Royal Sanitary Institute, c.m.b., Health Visitor and School Nurse. Miss A. Woosnam, s.r.n., c.m.b., Health Visitor and School Nurse. Miss N. Lapham, s.r.n., Certificate of Royal Sanitary Institute, c.m.b., Health Visitor and School Nurse. Miss Evans, s.r.n., School Nurse. 6 A. S. M. Pratt, Barrister-at-Law; Chief Clerk. Miss A. Kent, " Clerk. (Resigned July 1940). Miss V. 1. Peters, Senior Clerk. (Appointed October 1940). Mrs. J. Jeffery, Clerk. Miss J. Warburton, b.a.(hons.), Clerk. (Resigned October 1940). Miss M. G. Hester, Clerk. Miss B. Kellaway, Clerk. (Resigned December 1940). Miss M. Pears, Clerk. (Appointed December 1940). Miss D. Beezley, Clerk. (Appointed December 1940). Miss F. A. Cavendish, Matron, Day Nursery. G. Baker, Disinfector. (Retired December. 1940). T. W. Mason, Mortuary Keeper. (On War Service). G. H. J. Saunders, Disinfector and Acting Mortuary Keeper. SECTION A. General Statistics. Arear 2,317 acres. Population Census, 1931 70,510 ,, Registrar General's estimate, 1940 55,830 Rateable Value £813,784 (Sum represented by the product of a penny rate, £2,850). General Rate in the £1 (half-year) 6/4d. 7 Extract from Vital Statistics. Live Births. Total (B.R.) M. F. Legitimate 752 373 379 Illegitimate 32 15 17 Birth rate per 1,000 of the estimated population—14.04 Still Births. Legitimate 19 10 9 Illegitimate 2 2 —" Deaths 805 Death rate per 1,000 inhabitants 14.3 ,, ,, (adjusted) 14.7 Deaths front Puerperal Causes (Heading 29 and 30 of the Registrar General's Short List). Rate per 1,000 total Deaths. (live & still) births. No. 29. Puerperal Sepsis 1 1.3 No. 30. Other Puerperal Causes 1 1.3 Death rate of Infants under 1 year of age. . All infants per 1,000 live births 58.3 Legitimate infants per 1,000 legitimate live births 60.9 Illegitimate infants per 1,000 illegitimate live births 31.2 Deaths from Cancer (all ages) 112 Deaths from Measles (all ages) . Nil Deaths from Whooping Cough (all ages) Nil Deaths from Diphtheria (all ages) 1 Diarrhoea (under 2 years of age) 7 8 SECTION B. GENERAL PROVISION OF HEALTH SERVICES IN THE AREA. Laboratory Facilities.— During this year the Laboratory has been re-opened for the examination of swabs and sputa. Examination required for specimens other than those previously mentioned a risent either to the London Counties Laboratory or to the Ministry of Health Emergency Medical Service Laboratory at Ealing. Ambulance Facilities.— The Acton and Wembley Joint Hospital Committee possesses an Ambulance for the removal of infectious cases from the Acton and Wembley areas. Two ambulances for accident and non-infectious cases are at the Fire Station and are available at all hours. Nursing in the Home.— Since April 1st a combined Committee of the Public Health Committee and the Acton Hospital Council have administered the arrangements for nursing patients in their homes. This arrangement has worked satisfactorily, and during the year 381 sick patients were nursed and the nurses paid 11,319 visits to the homes of the patients. Hospital Provision.— The Isolation Hospital is now managed by the Acton and Wembley Joint Hospital Committee. The Acton Voluntary Hospital is still carrying on although admission of cases is limited since the Hospital is a Casualty Clearing Hospital for A.R.P. Casualties. Maternity and Child Welfare.— Every endeavour has been made to maintain the Ante-Natal and Maternity and Child Welfare Clinics, and the same number of clinics have been held this year as in 1939. Maternal Mortality.— There were two maternal deaths during 1940; one death occurred in Hospital as a result of obstetrical shock following a difficult and prolonged labour necessitating delivery by means of forceps; the other was the result of miscarriage, death being due to puerperal sepsis. Infantile Mortality.— There were 43 deaths of infants under 1 year, giving an Infantile Mortality figure of 58.3. Day Nursery.— As mentioned in the Annual Report for 1939, the Acton Day Nursery was evacuated to a house near Woking. Owing to the condition of overcrowding that occurred there, further 9 premises were acquired at Hook Heath near Woking. Acting on a a Ministry Circular, the local Supervising Authority for Maternity and Child Welfare in the reception area was made responsible for the administration of the Home, and since the date of thisi Circular the Surrey County Council have taken over the administration of the Nursery. Since being evacuated to Woking, all the children have improved in physical appearance, brought about doubtless by the regularity of a well balanced diet in addition to the general training necessaw for young children. Nurse Children.— The number of Nurse children visited by the Infant Life Protection visitors during 1940 was 21. This low figure as compared with previous years may be accounted, for by the fact that Acton is an evacuation area. Milk for Children and Mothers,.— The Ministry of Health arranged for children between 2 and 5 years to receive daily a pint of liquid milk, and this has been extended to Expectant and Nursing Mothers. In May 1940 the Ministry of Health further provided a National Dried Milk for young babies. Both these schemes are administered by the Food Executive Office on behalf of the Ministry of Health and Food. Actual figures of milk provided under this scheme cannot be given as the local Food Officer is unable to provide me with this information. He has been instructed by the Ministry of Food that such information is confidential. During the year 1940 the Maternity and Child Welfare Committee sold 8,083 lbs. of proprietary dried foods and issued free 3,886 lbs. As a consequence of the issue of milk by the Ministry of Food, there is a considerable drop in the amount of dried food sold and issued free by the Maternity and Child Welfare Committee. TABLE 1. INFANT WELFARE CENTRES, 1940. Number of Centres provided and maintained by the Council Total number of attendances at all Centres during the year:- 4 (a) By children under 1 year of age 6,092 (b) By children between 1 and 5 years of age 3,480 Number of children who attended for the first time during the year: — (a) Under 1 year of age 550 (b) Between 1 and 5 years of age 93 10 TABLE 2. ANTE-NATAL CLINIC. Number of Expectant Mothers who attended 513 Number of attendances made by Expectant Mothers 1,381 Mothers referred for Dental Treatment at the Clinic 212 Mothers supplied with Dentures 29 Mothers treated at Ophthalmic Clinic 1 Expectant Mothers to whom dried milk was supplied free 32 Number of lbs. of Dried Milk supplied free 3,886 PREVALENCE AND CONTROL OF INFECTIOUS DISEASES. 1.—Notifications. The number of notifications of Infectious Diseases received this year was 214. From Table 5 the various infectious diseases can be examined; there were 26 cases of Scarlet Fever and 7 cases of Diphtheria. There were 5 cases of Enteric Fever with one death. The person who died as a result of Enteric Fever was diagnosed post mortem and on investigation no cause could be traced. Of the four other cases, no definite source of infection could be found, but as all four girls were new arrivals to the area from the North of England, enquiries were made, but no cases of Enteric had occurred in the area from which these cases arrived. During 1940 the number of cases of Scabies sent to the Health Department for cleansing by the Local Authority has increased from 43 cases in 1939 to 63 cases. This probably represents only a proportion of the actual number of infected persons in the Borough, and one is inclined to the view that, should persons continue to live in Air Raid Shelters during the next winter when raids may be expected, then cases of Scabies will increase unless prompt action is taken when cases are first recognised. Percentage of notified live births represented by number of children who attended a Centre for the first time during the year 70.1% Children treated at Dental Clinic 92 Children treated at Ophthalmic Clinic 22 CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR 1940. Notifiable Disease. / Cases notified in whole District. At Ages—Years. Ward Distribution. At all Ages Under 1 1 to 6 5 to 15 15 to 25 25 to 45 45 to 65 Over 65 North East North 1 West South East South West Scarlet Fever 20 - 6 1 1 3 6 - - 9 7 7 3 Diphtheria 7 - - 6 I - - - 1 - - 6 Pneumonia 24 1 2 l 2 4 8 6 9 5 5 5 Erysipelas 11 1 - - 1 - 6 1 3 1 1 4 Puerperal Pyrexia 7 - - - 3 4 - - 2 1 1 3 Paratyphoid 4 - - - 4 - - - - 4 - - Tuberculosis (resp.) 78 - 1 2 21 29 22 3 24 19 18 17 Tuberculosis (other) 10 1 1 1 1 6 - - 3 2 - 5 Measles 28 4 9 8 7 - - - 5 10 11 2 Whooping Cough 4 4 - - - - - - - 1 1 - Enteric 1 - - - - - 1 - - 1 - - Ophthalmia Neonatorum 2 2 - - - - - - - 1 1 - Meningitis 14 1 3 2 4 3 1 - 8 2 2 TOTALS 214 14 22 31 47 52 38 10 66 54 47 47 11 OPHTHALMIA NEONATORUM. Cases. Vision unimpaired. Vision impaired. Total Blindness. Deaths. Notified. Treated. At home. In hospital. 2 1 1 2 - - - 12 13 ISOLATION HOSPITAL. Dr. Thomas, Medical Superintendent of the Acton and Wembley Joint Hospital up to September 1940, has furnished the following report: — The total number of patients admitted to the Hospital in the year was 338—5 more than in 1939, and comparing with 633 in 1938, and an average of 610 in the four years 1934-1938. Of the total number of patients admitted, 20 of them were from outside districts, 84 were refugee children and 22 were soldiers billeted in Acton and Wembley. Although the number of admissions of Acton and Wembley residents is lower than that of the previous year, the conditions are so abnormal that no conclusions can be drawn. > It will probably be remembered that the Central Authorities could not arrange for the establishment at the hospital of a Casualty Clearing Station, as it was considered to be too near danger zones, and might become a target of enemy planes, but it was one of the few fever hospitals in the immediate neighbourhood, in the grounds of which no hostile bombs fell during the year. This accounts for the admissions of cases from outside districts during the year. We also had to send cases to outside hospitals, but that was because of our inability to provide for the isolation of that particular disease at the time. It will be noticed that during the year, persons suffering from 16 diseases were admitted, compared with 9 diseases in 1939, yet we were fortunate to escape cross-infection. Scarlet Fever. 125 cases of Scaret Fever were admitted, and no deaths; 7 of the cases were diagnosed not to be Scarlet Fever—3 from Acton, 3 from Wembley, and 1 from Ealing. 9 cases were admitted from houses where a patient had been discharged from hospital less than a month previously. Only one mastoid operation was performed during the year. Diphtheria. 46 cases of Diphtheria were admitted, with one death. Nine of these were probably wrongly diagnosed before admission, 5 from Acton, 3 from Wembley and 1 from Hendon. 14 Cerebro-Spinal Meningitis. During the Spring of the year 14 cases of Cerebro-Spinal Meningitis were admitted; one of these was a contact, the other cases were severe but there was only one death. In the Autumn a case which proved fatal was also admitted. One of the most remarkable achievements in connection with the disease has been the success which has been obtained in its treatment with M & B 693, by means of which the mortality has been materially reduced. In the last War, the mortality in some outbreaks of the disease exceeded 50%. The bacteriological examination of the Cerebro-Spinal fluid was done at the Ministry of Health Regional Laboratory at Ealing. German Measles. 31 cases of German Measles were admitted, of which 16 were soldiers billeted in the district. Most of the cases occurred in the early Spring. There were no deaths. Measles. 80 cases of Measles were admitted, of which 74 were refugee children. In the early summer, the buildings connected with the Wembley Stadium and Wembley Pool were adapted for the reception of refugees from Gibraltar. The children were immediately examined there, and following a case of Measles which occurred 'on board one of the ships which carried the refugees, an outbreak occurred amongst those accommodated at Wembley. The refugees admitted were as follows: — Under 1 year. 1-2 years. 2-3 years. 3-4 years. 18 19 8 6 4-5 years. 5-10 years. Over 10 years. 6 15 2 Certain aspects of the outbreak were interesting. Not only was there no death, but with one exception there were no complications. One of the children at the end of the second week developed a night temperature for about 9 days, and then made an uninterrupted recovery. All the other children recovered quickly without any complications. 15 This result was obtained though the majority of the children were at an age when complications from Measles are common. As a matter of interest it might be mentioned that all the cases were treated with M & B 693, as a possible preventive of pulmonary complications though the figures are too small in themselves to be of much use. There were other factors which influenced the results. Most of the cases occurred during the warm months of the year, and a summer epidemic of Measles is always less fatal than a winter one. The cases arose from one source of infection, and it used to be held that an epidemic became more fatal if the infection was mixed and massive. The vast majority of the cases were diagnosed and treated in an early stage of the illness. Many of the cases were sent into 'hospital before the rash had appeared. In the early or catarrhal stages, Koplik's spots appear on the mucous membrane of the mouth, and many of the cases were diagnosed and sent to the hospital on the appearance of Koplik's spots. It is at this stage that the disease is most infectious, and this early diagnosis not only limited the infection and probably saved many other children, from developing, the disease, but contributed also to the good results of hospital treatment. In general practice, the doctor is not called in to see the patient at this early stage, and thus does not have a good chance of diagnosing the case in the catarrhal stage. It is usually only possible to detect these early cases when a careful inspection of contacts is made, which in this instance was made by the doctors in charge of the medical supervision of the refugee children." ACTON & WEMBLEY JOINT HOSPITAL REPORT FOR THE YEAR, 1940. Patients admitted during 1939—333. Patients admitted during 1940—338. Patients admitted : S.F. Diph. try. Mens. G. Meas. C.S.M. Typhoid. Fncephalitis. Flu. Dysentery. Wh.C. C.pox. Puerperal Fever. Mumps. 1 mpetigo. Mastoid. Acton 23 12 4 2 13 5 4 - - - - 2 2 2 - - WVmbley 88 26 8 77 18 10 - 2 1 4 4 5 - - 1 1 Ealing 7 6 - 1 - - - - - - 1 - - - - - Hendon 7 2 - - - - -«- - - - - - - - - - 125 46 12 80 31 15 4 2 1 4 5 7 2 2 1 1 Total = 338. Patients discharged S.F. Dipli. Kry. Meas.' (J. Mens. C.S.M. Typhoid. Fncepha litis. 'Flu. Dysentery. VVh.C. C.l'ox. Puerperal Fever. M umps. 1 mpe- Mastoid. Acton 24 11 3 2 13 5 4 - - - - 2 2 2 - - Wembley 81 25 8 76 19 7 - 2 1 4 3 5 - - 1 1 Ealing 4 6 - 1 - - - - - - - - - - - - Hendon 7 2 - - - - - - - - - - - - - - 116 44 11 79 32 12 4 2 1 4 3 7 2 2 1 1 Total = 321. Deaths : Acton Fry. 1 C.S.M Diph. ; l Wembley — 2 - Patients in Hospital, January 1st, 1910= 9 Total = 4 1 2 1 Patients in Hospital, January 1st, 1941 = 22. 16 17 2.—Tuberculosis. Particulars of new cases and of deaths from the disease during 1940 are given below. 78 cases of Pulmonary Tuberculosis and 10 cases of other forms of Tuberculosis were notified during the year. There were 35 deaths from Pulmonary Tuberculosis and no deaths from other forms of Tuberculosis. The following Table gives the age incidence of new cases of Tuberculosis in 1940 and of the deaths from the disease in the area in 1940. Age Periods. New Cases. Deaths. Respiratory Non-Respiratory Respiratory Non-Respiratory M. F. M. F. M F. M. F. 0— - - 1 - - - - - 5 2 l 1 - - 1 - - 15— 14 7 - 1 1 3 - - 25— 12 11 1 4 4 4 - - 35— 6 - - 1 3 2 - - 45— 13 2 - - 5 - - - 55- 7 - - - 8 1 - - 65 and upwards 2 1 - - 2 - - - Totals 50 22 3 7 24 11 - - 18 19 The following is a statement of the particulars appearing in the Register of cases of Tuberculosis on 31st December, 1940. Pulmonary. NonPulmonary. Total. Number of Cases on the Register at the commencement of the year 222 males 44 males 200 females 43 females . 509 Number of Cases notified for the first time during the year 56 males 3 males 22 females 7 females 88 Number of Cases previously removed from the Register which have been restored thereto during the year 1 male — males 1 female — females 2 Number of Cases added to the Register other than by notification 10 males — males 5 females 1 female 16 Number of Cases removed from the Register during the year 44 males 2 males 23 females 2 females 71 Number of Cases remaining on the Register at the end of the year 245 males 45 males 205 females 49 females 544 SECTION C. SANITARY CIRCUMSTANCES OF THE AREA. Water Supply. The Borough is supplied with water by the Metropolitan Water Board. 20 Drainage and Sewerage. All the dwelling houses are provided with water closets and are drained into the main sewerage system. By arrangement with the London County Council the sewage is discharged into the London sewers. Storm water is filtered and emptied into the Thames. Public Cleansing. The house refuse is collected by the Council and burnt in the Destructor. Last year 16,465 tons of refuse were collected and burned. Sanitary Inspection of the Area. The following table includes the tabular statement furnished by the Sanitary Inspector under Article 27 (18) of the Sanitary Officers (Outside London) Regulations, 1935. TABULAR STATEMENT OF INSPECTIONS AND DETAIL OF WORK CARRIED OUT BY THE SANITARY INSPECTORS. Number of Inspections made and Action Taken. Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 1,024 (1) Dealt with by service of Informal Notice 647 (2) Dealt with by service of Statutory Notice under Section 9, Housing Act, 1936 136 (3) Dealt with by service of Statutory Notice under Public Health Acts 27 21 Premises (other than defective dwelling-houses) inspected for nuisances and miscellaneous defects 1,251 (1) Dealt with by service of Informal Notice 775 (2) Dealt with by service of Statutory Notice under Public Health Act, etc. 18 Re-inspections subsequent to service of Notice 4,645 Inspections after notification of Infectious Disease 207 Number of Premises under Periodical Inspection. Factories 490 Bakehouses 34 Slaughterhouses 2 Public House Urinals 31 Common Lodging Houses 1 Butchers' Shops 40 Fishmongers' Shops 17 Fish and Chip Shops 18 Greengrocers' Shops 86 Premises where food is manufactured or prepared 55 Grocery and Provision Shops 182 Dairies 15 Cowsheds Nil Piggeries 3 Rag and Bone Dealers 9 Mews 4 Schools (11 Elementary, 1 County, 1 Technical, 1 Private) 14 Caravan Grounds 1 Hairdressers' Shops 42 Rent Restriction Act. Number of Certificates granted 10 22 Detail of Work carried out. Sanitary Dustbins provided 292 Yards paved or yard paving repaired 71 Insanitary forecourts remedied 7 Defective drains repaired or reconstructed 36 Defective soil pipes and ventilating shafts repaired or renewed 29 Defective fresh air inlets repaired or renewed 17 Defective gullies removed and replaced by new 43 Rain water downpipes disconnected from drain 15 Dishing and curb to gullies repaired and new gratings-fixed 51 Defective W.C. pan and traps removed and replaced by new 53 Defective W.C. flushing apparatus repaired or new fixed 173 Defective W.C. seats repaired or new fixed 70 Defective flush pipe connections repaired 13 Insanitary sinks removed or new fixed 31 Sink waste pipes repaired or trapped 66 Insanitary wall surface above sinks remedied 35 Ventilated food cupboards provided 10 Drinking water cisterns cleansed 54 Defective covers to drinking water cisterns repaired or new fixed 39 Insanitary sites beneath floors concreted 17 Spaces beneath floors ventilated 14 Dampness in walls from defective damp-proof course remedied 130 Dampness from defective roof, rain water gutterings, etc., remedied 418 Defective plastering repaired (number of rooms) 344 Rooms where dirty walls and ceilings have been cleansed and redecorated 778 Defective floors repaired 100 Defective or dangerous stairs repaired 24 Defective doors and windows repaired 408 Defective kitchen ranges and fire grates repaired 157 Defective washing coppers repaired 24 Coal cupboards provided or repaired 2 New W.C. apartments provided 14 Accumulations of offensive matter removed 42 Drains unstopped and cleansed 84 Drains tested, exposed for examination, etc 41 Smoke observations taken 52 Smoke nuisances abated on service of notice 6 Miscellaneous nuisances abated 93 Notifications of waste of water sent to Metropolitan Water Board 71 23 Meat Inspection. Tables, showing the meat inspection carried out at the two slaughterhouses in the Borough, will be found on pages CARCASES INSPECTED AND CONDEMNED. Cattle, excluding Cows Cows Calves Sheep & Lambs Pigs 1. Number killed 24 — 349 6,078 115,033 2. Number inspected 24 — 349 6,078 115,033 3. All diseases EXCEPT TUBERCULOSIS— Whole carcases condemned — \ — — 19 68 Carcases of, which some part or organ was condemned 4 — 1 896 8,070 Percentage of the number inspected affected with disease other than Tuberculosis 16.00% — .28% 15.05% 7.07% 4. TUBERCULOSIS ONLY— Whole carcases condemned 1 — 1 — 208 Carcases of which some part or organ was condemned 9 — 2 — 7,204 Percentage of the number inspected affected with Tuberculosis .41.66% — .85% — 6.44% 24 NUMBER OF PIGS' CARCASES INSPECTED FROM 1st JANUARY TO 31st DECEMBER, 1940, WITH ANALYSIS OF SURRENDERS ON ACCOUNT OF DISEASE. 1940. No. of Carcases Inspected. 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. Weight of Ribs Diseased. Plucks (Lungs, Livers and Hearts). Mesenteries, Stomachs and Intestines Pieces of Pork. January 4615 129 2 - - - - - 28 188 lbs. - February 4807 185 28 — - 2 — - 13 2123 ,, — March 11972 289 32 1 1 8 2 8 lbs. 1 1593 ,, — April 10083 281 14 — - 2 — — — 2088 „ 519 lbs. May 16498 567 44 — 1 4 1 92 lbs. — 653 „ 67 ,, June 1 2382 267 20 — 1 - 2 — 33 2453 ,, 22 ,, July 11833 117 18 - 1 1 1 428lbs. 103 1660 ,, 31 ,, August 10123 617 21 — 7 1 11 44 lbs. 298 993 ,, 324 ,, September 10696 557 5 - 4 1 1 120 lbs. 228 1016 ,, 389 ,, October 4247 325 7 — 8 - 1 11 lbs. 104 004 „ 253 ,, November 6947 374 10 — 2 1 — 35 lbs. 104 921 ,, 444 ,, December 5914 212 2 — 3 — — 93 486„ 40 ,, Total 108017 4220 203 1 23 20 19 744 lbs. 1005 14778 lbs. 2089 lbs. 25 INQUESTS. Suicide 8 Accidental Fall 2 Motor Car Accident 5 Accidental Burns 2 Other Causes 6 Total 23 POST-MORTEM WITHOUT INQUEST. Heart Disease 15 Respiratory Conditions 10 Fractured Skull 5 Other Causes 18 Total 48 26 AGES AT DEATH, AND WARD DISTRIBUTION OF DEATHS IN 1940. Causes of Death. Age in Years. Ward Distribution. Total Under 1 year 1 and under 2 2 and under 5 5 and under 15 l5 ard under 25 25 and under 45 45 and under 65 65 and upwards North East North West South East South West Enteric Fever 1 — - — — — - 1 — - — — 1 Influenza 4 — - — — - 2 — 2 2 2 — — Diphtheria 1 — - — 1 — —- - — — — - 1 Cerebro-Spinal Fever 1 - - - - - 1 — — - — 1 — ' Pulmonary T.B 37 - — 1 5 13 15 3 9 7 8 13 Other T.B 1 — — 1 1 2 — — — 1 2 1 Nervous Diseases 7 ~~~ - — — - 1 2 4 2 2 2 1 Diabetes 6 - - - - - — 1 5 1 1 2 2 Cancer 112 — - — — 1 8 15 58 33 23 28 28 Sarcoma Hypernephroma 4 — - — 1 - — 2 1 1 1 1 1 Cerebral Haemorrhage, Thrombosis 58 2 — — - 3 14 39 25 9 12 12 Heart Disease 108 1 — — 2 7 39 100 46 28 39 45 Other circulatory diseases 27 — - — — - - 10 17 0 9 8 4 Bronchitis 38 3 — — - 1 9 25 13 9 6 10 Pneumonia 60 8 2 - — - 5 18 33 20 11 12 23 Other respiratory diseases 20 2 — — — - 2 10 6 7 4 6 4 Peptic Ulcer 5 — — — — — — 4 1 1 1 — 3 Diarrhoea and Gastro. Enteritis 7 7 — — — — - — — 1 2 1 2 Cirrhosis of Liver and Gall Bladder 4 — — — 1 — — 2 1 4 - — Diseases of Alimentary tract 9 — — — 1 3 1 2 2 1 2) 1 2 Cerebral Tumour 5 - - - - - 1 1 3 1 2 — 2 Nephritis 32 — — — 2 — 2 8 20 14 10 5 3 Senility 49 — — — — — — —. 49 15 6 11 17 Enlarged Prostate 4 — — — — — - — 4 1 1 1 1 Childbirth 1 — — — — 1 — - - 1 — — - Other diseases of Parturition 1 - - - - - 1 — — - — — 1 Cong. Debility and Prematurity 17 17 — — — — — — — 10 2 4 1 Suicides 8 - — — — 1 1 2 1 2 — 5 1 Other deaths from Violence 17 — 1 - — 1 2 5 8 10 2 4 1 Deaths from War Operations 86 1 — 4 3 13 25 31 9 35 24 22 5 Infantile Convulsions 2 2| — — — - - - - 1 — - 1 Epilepsy 2 — - — — 2 — — 1 — - 1 Other ill-defined Diseases 12 1 — — — 1 5 5 3 1 1 1 TOTALS 805 43 4 1 11 28 81 226 408 269 164 181 191 27 BACTERIOLOGICAL EXAMINATIONS. (a) For Diphtheria. Positive.Negative. Total Examinations, 74 5 69 Sent by Medical Practitioners 2 37 Convalescents (1st Swab) — 4 Contacts (1st Swab) — — 19 Precautionary Swabs — — 7 School Sore Throats — 2 (b) For Haemolytic Streptococcus. Positive. Negative. Total Examinations — — — (c) For Vincent's Angina. Positive. Negative. Total Examinations, 1 — — — 1 (d) For Ringworm. Positive. Negative. Total Examinations, 1 — — — 1 (e) For Tubercle. Positive. Negative. Total Examinations, 46 — 15 31 28 ANNUAL REPORT of the School Medical Officer FOR THE YEAR 1940. Town Hall, Acton, W.3. To the Chairman and Members of the Acton Education Committee. Ladies and Gentlemen, We beg to submit the following report upon the schools and school children of Acton for the year 1940. Following the request of the Board of Education, the report will be short and the Statistical Tables have been yet further condensed. This has been a very difficult school year, the school population fluctuating constantly. Compulsory school attendance was re-introduced as from 26th February, 1940, for all children for whom reasonable shelter accommodation could be provided. No children under 5 were admitted to school. 29 In June a second large evacuation of children took place and thereafter the " Trickle " Scheme operated. In spite of this, in September 1940 there were 3,237 children on the school rolls, and at the end of 1940 there were still nearly 2,000 children on the rolls. Attendance at school was bad, especially following heavy enemy action in the autumn. Children who had been evacuated came back and were re-evacuated sometimes as often as three or four times. In some cases the children's return was completely justified, as the parent would find on visiting that the child was uncomfortable, unhappy, or unclean. Several children were brought back because they had contracted Scabies. The 'milk in schools' scheme was begun in May 1940 and free meals and milk were supplied to necessitous children. The numbers of such children in Acton were much less than in peace time as there was almost no unemployment and in a number of cases both parents were working. Children whose parents wished it, were allowed to have school meals and pay for them, but in most cases arrangements were made at home with relatives or friends. All the usual clinics operated throughout the year, Minor Ailment, Dental, Ophthalmic, Rheumatic, Nose & Ear Clinics, etc. There were no changes in the staff and work was carried on as normally as possible. 30 AVERAGE HEIGHTS AND WEIGHTS. LEAVERS (BOYS) Total 12 yrs. of age. 13 yrs. of age. 14 yrs. of age. No. seen Height ins. Weight lbs. No. seen Height ins. Weight lbs. No. seen Height ins. Weight lbs. Acton Wells 15 13 59.5 84.8 2 63.1 100.7 ... ... John Perryn 23 15 58.3 80 8 60.2 87.9 ... - Priory 52 38 58 80.7 14 60.3 90.5 ... ... Southfield 46 38 58.6 80.6 8 58.2 94.3 ... ... Turnham Gn. R.C. 8 7 58.5 82.2 1 66 131.5 ... ...— .... West Acton 14 14 58.9 83.9 ... ... ... ... ... 158 125 ... ... 83 ... ... ... ... LEAVERS (GIRLS) Acton Wells 20 15 60.8 94.4 5 62.6 101 ... ... Beaumont Park 50 43 59.6 88.3 7 59.9 89.3 ... ... John Perryn 31 28 59.4 87.3 3 60.4 85.3 ... ... Priory 62 52 59.8 86.9 9 61.7 96.1 1 62.5 101 Turnham Gn. R.C. 8 6 59.5 85.8 2 64.5 105.7 ... ... West Acton 9 9 59.7 92 ... ... .... ... ... 180 153 ... ... 26 ... ... 1 ... 31 AVERAGE HEIGHTS AND WEIGHTS. INTERMEDIATES (BOYS) Total Age Groups. No. soon 7 8 9 Height ins. Weight lbs. No. seen Height ins. Weight lbs. No. seen Height ins. Weight lbs. Acton Wells 8 ... ... ... 7 50.8 56.7 1 53 77.5 Beaumont Park 10 6 50 58.5 3 51.3 58.2 1 52.8 62.8 Berrymede 43 16 49.8 57.6 22 50.2 57.4 5 53.8 66.6 Derwentwater 44 12 48.1 50.2 22 50.7 60.1 10 53 65.1 John Perryn 29 9 49.8 56.1 18 50.6 58.1 2 50 56.6 Priory 1 1 45.8 43 ... ... ... ... ... ... Rothschild 31 7 49.2 56.9 23 50.3 57 1 52 61.8 Southfield 27 8 50.1 58.9 13 50.1 56.9 6 52.7 63.9 Roman Catholic 20 6. 49.7 56.2 14 50.6 57.4 ... ... ... West Acton 16 2 51.1 56.9 13 51.1 58.4 1 51 56.8 229 67 ... ... 135 ... ... 27 ... ... (GIRLS) Acton Wells 7 2 50.2 51.2 5 51.3 57.4 ... ... ... Beaumont Park 14 7 50.7 59 6 51.5 61.4 1 52.8 57.5 Berrymede 50 11 49.5 56.5 35 50.2 56.7 4 52.3 65.4 Derwentwater 42 14 49.1 54.8 17 51.1 59.6 11 51.7 59.4 John Perrvn 27 5 49.3 54.4 17 50.3 55.4 5 52.9 64.4 Priory 4 4 49.1 52.2 ... ... ... ... ... ... Rothschild 1 ... ... ... 1 50 49.3 ... ... ... Southfield 36 4 48.9 48.6 23 50.5 59 11 53.3 62.7 Roman Catholic 10 6 50.1 54.7 4 51 61 ... ... ... West Acton 12 4 51.9 59 7 50.9 57.2 1 56 69 205 57 ... ... 115 ... ... 33 ... ... 32 AVERAGE HEIGHTS AND WEIGHTS. ENTRANTS. 5 6 BOYS. Total .No. seen Ht. Ht. No. seen Ht. Ht Acton Wells 5 1 41.5 31.5 4 46.2 46.7 Beaumont Park 8 6 43.3 42.8 2 47 46.6 Berrymede 7 7 45.5 45.9 Derwentwater 19 15 44 43.8 4 46.3 46.9 John Perryn 15 11 43.6 42 4 46.9 48.6 Priory 18 10 43.1 40.5 8 46.9 46.3 Rothschild 10 8 43.8 43.8 2 44.1 41 Southfield 18 17 44.8 43.8 1 50.5 55.8. Roman Catholic 3 4 43.8 43.3 1 47.8 49.8 West Acton 9 6 45.3 41.7 3 46.4 44.4 114 85 29 GIRLS. Acton Wells 3 3 42.9 53.6 Beaumont Park 10 6 43.8 40.8 4 47.1 51 Berrymede 7 6 44.1 44.5 1 43.3 41 Derwentwater 26 22 43.4 40.8 4 48.5 52.2 John Perryn 14 10 45.2 42.5 4 46 43.4 Priory 16 11 44.7 43 5 44.6 40.5 Rothschild 9 7 43.5 42.7 2 47.6 48 Southfield 21 12 44.4 42.8 9 46.6 56.2 Roman Catholic 4 2 44 45.6 2 46.1 49.9 West Acton 4 2 44.4 42.9 2 45.5 44.6 114 81 33 33 INFECTIOUS DISEASES.' Scarlet Fever. 4 cases only were reported during 1940 in the school population, 3 at Southfield School and 1 at Rothschild. Diphtheria. 2 cases only were reported during 1940 in the school population, 1 at Berrymede School and 1 at Prioiy. Free immunisation is still being offered to all our school children and the scheme is run on the same lines as indicated in previous Annual Reports. Percentages of children inoculated in our schools are given in the following Table, but it must be remembered that the school population was varying and fluctuating during the year, and these end of the year figures therefore are merely interesting and not likely to be representative for long of the conditions at each school. PERCENTAGES OF CHILDREN INOCULATED. table I. Schbol. Age Groups. Under 7. 7—11. 11—14. Totals Acton Wells 29.1% 43.5% 57% 46.5% Beaumont Park 53.6% 66.1% 59.7% 59.9% Berrymede 24.4% 43.05% — 38.3% Derwentwater 37.3% 46.5% — 42.7% John Perryn 44.4% 51.8% 60.9% 53.4% Priory 47.05% — 40.3% 41.6% Rothschild 42.1% 66.6% — 57.5% Southfield 54.4% 47.7% 51.7% 50.3% Roman Catholic 63.6% 40% 13.3% 37.5% West Acton 38.08% 62.3% 59.09% 55.2% Total 41.6% 50.3% 49.2% 47.8% Inoculation figures for 1940 are given in detail below but are, as was to be expected, poor. The bulk of children inoculated were of pre-school age, which is as it should be and a step in the right direction. It is in the early years of life that Diphtheria is particularly dangerous. 34 TABLB II. DIPHTHERIA IMMUNISATION—1940. School. Primary Schick test. 1st. Inoculations with A.P.T. 3rd. Re-inoculation after Schick test after 3 years. Pos. Neg. 2nd. 3 years. Pos. Neg. Acton Wells 2 3 2 - - 6 Beaumont Park — — 7 — — — — — Berrymede — 1 — — — — — — Derwentwater 4 3 12 — — 1 — — John Perryn 1 1 8 - — 11 — — Priory — 1 7 2 4 6 — — Rothschild — — — — — 1 — — Southfield 4 2 13 — 2 15 — — Other Schools — — 2 — — — — Infant Welfare — — 253 218 184 — — — Isolation Hospital — — 3 2 2 " — — — Total 11 11 307 222 192 34 - 6 35 Scabies. This disease continues to be a serious nuisance. 45 cases were treated, some at home, and some were sent to cleansing baths at Kensington, with which borough Acton has an arrangement for this purpose. Table 3 shows the distribution of these cases. TABLE 3 DISTRIBUTION OF SCABIES. 5.1.40. Esmond Road Southfield Baths 6.1.40. St. Albans Avenue (2 children) Southfield „ 16.1.40. Maldon Road Derwentwater Home treatm't 22.1.40. Saxon Drive (2 children) West Acton „ „ 31.1.40. St. Andrews Road (2 children) John Perryn „ 7.2.40. Petersfield Road (2 children) Berrymede Baths 17.2.40. St. Albans Avenue Beaumont Park Home treatm't 22.2.40. Colville Road Berrymede „ „ 22.2.40. Shakespeare Road Priory „ „ 24.2.40. Mill Hill Road Priory „ „ 12.3.40. Holland Terrace (2 children) Berrymede „ „ 15.3.40. Osborne Road Priory „ „ *8.4.40. St. Albans Avenue (2 children) Southfield „ „ 16.4.40. Somerset Road Special (M.D.) „ „ *16.4.40. St. Andrews Road (2 children) John Perryn Baths 22.4.40. Bayham Road (2 children) Southfield Home treatm't 28.5.40. Essex Road Derwentwater „ „ 22.5.40. The Vale (2 children) Southfield „ „ 8.6.40. The Vale (2 children) Southfield „ ,, 11.6.40. Essex Pk. Mews, The Vale Southfield „ „ 11.6.40. Goldsmith Road Priory „ „ 12.6.40. Palmerston Road Priory Baths 18.6.40. Birkbeck Road Priory „ 18.6.40. Lynton Road Derwentwater Home treatm't 1.7.40. Acorn Gardens Acton Wells „ „ 12.7.40. Packington Road Berrymede „ „ 25.7.40. Bollo Lane (2 children) Berrymede Baths 8.8.40. Stirling Road (2 children) Berrymede „ 3.9.40. Birkbeck Avenue Derwentwater Home treatm't 13.11.40. Packington Road Priory Baths 21.11.40. Cowper Road Derwentwater Home treatm't 25.11.40. Shakespeare Road County School „ „ 25.11.40. Newburgh Road County School „ „ * Denotes a return case. 36 PROVISION OF MEALS. Free meals were distributed from 1st May 1940 at two feeding centres, Priory and John Perryn School. The numbers were few as there is very little unemployment now amongst parents of school children. Nutrition surveys were held each term by the School Medical (Officer, the Head Teacher of each school being requested to bring forward for examination any children suspected of being undernourished. School Nurses and Head Teachers were also requested to be constantly on the outlook for such cases and to refer them to the Medical Officer for inspection. Free milk was supplied to all schools as from 1st May, 1940. the numbers again were low, as the table given below shows. At one point milk could not be supplied to some of the schools owing to difficulties in supplying l/3rd pint bottles. In most of the schools quart bottles of milk are now being supplied, the children bring cups and the milk is divided out. One school supplied Horlicks malted milk instead of plain milk, during the winter. table 4. Provision of Meals and Milk. — Number of meals supplied 741 Number of bottles of milk 6,185 Number of children to whom meals and milk were granted 21 Number of children to whom free milk was granted 23 THROAT, EAR & NOSE CLINIC. These Clinics were run in conjunction as in previous years. Children suffering from post nasal catarrh were treated where the disease consisted of: — (a) Post nasal catarrh only giving rise to symptoms of deafness. (b) Post nasal catarrh with ear discharge. (c) Post nasal catarrh giving rise to symptoms suggesting necessary removal of Tonsils and Adenoids,—i.e., large tonsils, enlarged glands, obstruction to nasal breathing, etc. 37 TABLE 5. Nose Clinic. Cured 13 Not cured and referred to Hospital for further treatment 2 Evacuated before completion of treatment 11 Left Acton 2 Did not report for examination after treatment— result unknown 2 30 Ear Clinic. (i) Those suffering from Otorrhoea. Cured 2 Referred to Hospital because of complications 1 Failed to attend for treatment 1 Evacuated before finishing treatment 5 9 (ii) Those suffering from Earache. Due to external otitis 3 Due to wax 2 Due to bad teeth 2 Due to head colds 4 11 (iii) Those suffering front Deafness. Due to wax 2 38 REPORT OF THE DENTAL SURGEON. With the re-opening of the schools in January 1940, we were able to resume regular school dental inspections with corresponding benefit to the number of children treated. The percentage of acceptances seems to have remained about the same as last year. Other figures cannot of course be compared with 1939, the earlier months of which were normal. With regard to Maternity and Child Welfare work, the number of mothers examined was 213 as against 174 in 1938, that being the last complete normal working year. The number treated was 205 as-against 99 in 1938. The number of infants treated was 92 as against 74 in 1938. Further figures are given below of the work undertaken for Maternity and Child Welfare cases and for pupils attending the Acton County and Junior Technical Schools. Maternity & Child Welfare. Technical & County Schools Mothers examined 213 Number examined 492 Mothers referred 212 Referred for treatment 309 Mothers treated 205 Number treated 246 Children examined 88 Attendances 388 Children referred 85 Permanent Fillings 276 Children treated 92 Permanent Extractions 124 Permanent Fillings 87 Temporary Fillings — Permanent Extractions 823 Temporary Extractions 21 Temporary Fillings 18. Dressings 79 \ Temporary Extractions 286 Dressings 204 Number of attendances 663 Dentures supplied 29 P. H. Slater. 39 REPORT OF THE SCHOOL OCULIST. The numbers referred for treatment have again been reduced owing to war conditions. During the year, 182 Elementary school children were referred for examination. Of these, 30 did not require glasses, 116 obtained glasses through the Clinic, 3 obtained glasses privately, and 33 refused treatment or left Acton. There were 3 cases of external eye disease. 22 children and 1 mother were referred from the Welfare Centres. Of these, 12 children and 1 mother obtained glasses, 3 children did not require glasses and 7 children refused treatment or left the district. There was 1 case of external eye disease. 40 boys were referred from the Secondary and Junior Technical Schools. Of these, 34 obtained glasses and 6 did not require glasses. There was 1 case of external eye disease. It has not been possible to arrange for any orthoptic training, owing to war conditions, but every effort is being made by occlusion and regular supervision to prevent the occurrence of amblyopia. v. e. Brander. EXCEPTIONAL CHILDREN. TABLE 6. Deject. In Hosp. Residential Spec. or Open Air Sch. Ord. Elem. School Evacuated At home. Total Tuberculosis - » - - - - Delicate — 2 2 5 — 9 Rheumatism — 1 1 2 1 5 Crippled — 1 — — — 1 Epilepsy — 3 1 — — 4 Deaf & Dumb — 4 — 1 — 5 Blind and - 1 - 2 - 3 Partially Sighted. The above table gives the position as accurately as it is possible to ascertain it. 40 VISITS PAID BY SCHOOL NURSES. The following are the number of home visits paid by the Nurses during the year. The visits have been divided into school distribution. Acton Wells 20 Southfield 38 Beaumont Park 72' West Acton 13 Berrymede 93 Roman Catholic 4 Derwentwater 15 Special School 10 John Perryn 5 Priory 85 85 Total 422 Rothschild 67 MEDICAL INSPECTION RETURNS. TABLE I. A.—Routine Medical Inspections. Number of Inspections in the prescribed Groups:— Entrants 228 Second Age Group 431 Third Age Group 338 Total 1000 Number of other Routine Inspections Grand Total 1000 B.—Other Inspections. Number of Special Inspections and Re-Inspections 2627 41 TABLE II. Classification of the Nutrition of Children Inspected during the Year in the Routine Age Croups. Age-groups ' Number of Children Inspected A (Excellent) B (Normal) C (Slightly subnormal) D (Bad) No. % No. % No. % No. % Entrants 228 62 22.8 156 68.4 20 8.7 — — Second Age-group 434 122 28.1 274 63.1 36 8.2 2 4 Third Age-group 338 123 36.3 194 57.3 21 6.2 . — — Other Routine Inspections — ; — — — — — - — Total 1000 297 29.7 624 62.4 77 7.7 2 .2 42 TABLE III. Group 1.—Minor Ailments (excluding Uncleanliness. for which see Table V. Total Number of Defects treated or under treatment during the year under the Authority's Scheme 375 Group II.—Defective Vision and Squint (excluding Minor Eye Defects treated as Minor Ailments—Group I). No. of defects death with Defect or Disease. Under the Authority's Scheme Otherwise Total (1) (2) (3) (4) Errors of Refraction (including squint) 179 3 182 Other defect or disease of the eyes (excluding those recorded in Group I) 4 — 4 Total 183 3 186 No. of Children for whom spectacles were— (a) Prescribed 116 3 119 (b) Obtained 116 3 119 Group III.—Treatment of Defects of Nose and Throat. Number of Defects. Received Operative Treatment Under the Authority's scheme, in Clinic or Hospital By Private Practitioner or Hospital, apart from the Authority's Scheme Received other forms of Treatment. Total number treated. (1) (2) (3) (4) - - — - 43 TABLE IV. Dental Inspection and Treatment. (1) Number of children inspected by the Dentist: (4) Attendances made by children for treatment 1834 Age: 5) Half-days devoted to: (a) Routine age-groups - 5— 313 Inspection 25 Treatment 436 6—317 Total 461 7— 350 8—357 9— 357 (6) Fillings : 10— 340 Permanent Teeth 853 11— -286 Temporary Teeth 40 12— 316 13— 277 Total 893 14— 36' -2949 (7) Extractions: Permanent Teeth 433 (b) Specials 17 Temporary Teeth Total 1672 2105 (c)Total (Routine & Special) 2966 (8) Administrations of general anaesthetics for extractions 979 (9) Other Operations: (2)Number found to require treatment 2093 Permanent Teeth 113 Temporary Teeth 62 (3) Number actually treated 1342 Total 175 TABLE V. Verminous Conditions. Average number of visits per school made during the year by the School Nurses 7 Total number of examinations of children in the Schools by School Nurses 14558 Number of individual children found unclean:— Vermin and Nits 27 Slightly Infested 209 Number of individual children cleansed under Section 87 (2) and (3) of the Education Act, 1921 — Number of cases in which legal proceedings were taken:— (a) Under the Education Act, 1921 - (b) Under School Attendance Byelaws — 44 TABLE VI. Blind and Deaf Children. 1. At a Public Elementary School. 2. At an institution other than a Special School. 3. At no School or Institution 4. Total not receiving suitable education. Blind Children — — — Nil Deaf Children — — — Nil Mentally Defective Children. Total number of children notified during the year ended 31st December, 1940, by the Local Education Authority to the Local Mental Deficiency Authority, under the Mental Deficiency (Notification of Children) Regulations, 1928 1 We are, Your Obedient Servants, G. E. B. PAYNE, E. MADELEY.