Health Report for 1925 FOE THE beddington AND wallington urban district BY THE Medical officer of Health WALLINGTON : William Pile, Ltd., 19, Manor Road. Health Report for 1925 FOR THE beddington AND wallington urban district BY THE medical officer of health WALLINGTON: William Pile, Ltd., 19, Manor Road. 3 Urban District Council of Beddington and Wallington. HEALTH REPORT FOR 1926. Mrs. Thomas and Gentlemen, I have pleasure in submitting my 28th Annual Report upon the Health and Sanitary Conditions of the District. The Birth Rate for the year was 12.4 per thousand of estimated population, this being the lowest Birth Rate recorded since 1918. The Rate for England and Wales was 18.3. The Death Rate was 10.1, as against 10.0 in 1924. The Rate for England and Wales being 12.2 and 12.2 respectively. The Infantile Mortality Rate was exceptionally low, being only 19 per thousand births, this being the lowest for any year since the constitution of the District. The year has been a satisfactory one from the point of view of incidence of Infectious Disease, no epidemics of any consequence arising. I have again to place on record' the kind help and assistance which I have received from the Council and all its officers with whom my work has brought me into contact. I am, Mrs. Thomas and Gentlemen, Your obedient Servant, C. M. FEGEN, Medical Officer of Health. 24, London Road, West Croydon. 4 Urban District Council of Beddington and Wallington. public health committee. Chairman: Mrs. F. BRYANT (first part of year). Mr. W. G. STORER, J.P. (second part of year). Mr. BENNETTS, J.P. Mr. NOBLE. Mr. A. DAW. Mrs. THOMAS, B.A. Mr. GARDNER. Mr. VALE. Mr. LEWIS. Mr. WOOD. maternity and child welfare committee. Mrs. BRYANT. Mr. STORER, J.P. Mrs, THOMAS, B.A. Mr. NOBLE, Mr. DAW. Mrs. HOLDEN. Mr. GARDNER. Mrs. JEFFREY. Mr. LEWIS. Mrs. CLIFFORD-SMITH. representatives on the wandle valley joint isolation hospital board. Mr. BENNETTS, J.P. Mr. CLIFFORD-SMITH, J.P. Mrs. THOMAS, B.A. representatives on the wandle valley sewerage board. Mr. BENNETTS, J.P. Mr. STORER, J.P. Mr. CLIFFORD-SMITH, J.P. Mr. WOOD representative on the joint small pox hospital board. Mr. CLIFFORD-SMITH, J.P. staff. Medical Officer of Health: C. M. FEGEN, D.P.H., Etc. Assistant Medical Officer of Health: R. J. O. TAYLOR, D.P.H. (first part of year). E. C. LOUDON, D.P.H. (second part of year). Sanitary Inspector: F. H. LENNARD, M.R.S.I. Health Visitor: M. HOLMAN, C.M.B. Clerks: S. E. CRISP, C.R.S.I. Miss M. C. BULLOCK. 5 STATISTICS. 1.—GENERAL. Area (acres), 3,029. Population (1925), 16,700. Number of inhabited houses, 4,582. Rateable Value, £176,873. Sum represented by a penny rate, £737. 2.—EXTRACTS FROM VITAL STATISTICS OF THE YEAR. Births:- Total M. F. Legitimate 200 110 90 Illegitimate 8 1 7 Birth Rate, 12.4 Deaths, 169. Death Rate, 10.1. Number of women dying in, or in consequence of, childbirth:— From Sepsis Nil. From other causes Nil. Deaths of infants under one year of age:— Per 1,000 Legitimate Births 20 Per 1,000 Illegitimate Births Nil. Total 19 Deaths from:— Measles (all ages) Nil. Whooping Cough (all ages) Nil. Diarrhoea (under 2 years) Nil. 6 HEALTH REPORT FOR 1925. AREA AND POPULATION. The Urban District of Beddington and Wallington has a total area of 3,029 acres, and is divided into six wards. The number of occupied houses within the District was : In 1916 3834 In 1917 3861 In 1918 3867 In 1919 3873 In 1920 3870 In 1921 3948 In 1922 4081 In 1923 4248 In 1924 4436 In 1925 4582 The number of occupied houses in the respective Wards were:— Beddington North 680 Bedding-ton Central 567 Bedding-ton South 888 2135 Wallington North 652 Wallington Central 1080 Wallington South 715 2447 The average number of persons occupying each house was 3.6. The estimated population for 1925 was 16,700. The number of inmates of the Royal Female Orphanage is 113. VITAL STATISTICS. Births. During the year 208 Births were registered as belonging to the District, of which 111 were males and 97 were females. The Birth Rate for the year was 12.4 per thousand of population, as against 13.8 last year. The Birth Rate for England and Wales in 1925 was 18.3 per thousand of population, and in 1924 18.8. 7 The number of illegitimate births registered as occurring in the District was 8, as against 6 last year. This gives a percentage rate of total births of 3.8, as against 2.6 last year. REGISTERED BIRTHS AND BIRTH RATES. Ward. Estimated Population. Births. Birthrates. Male. Female. Totals. Beddington— North 2530 28 16 39 15.4 Central 2100 8 11 19 9.0 South 3150 25 11 30 11.4 Wallington — North 2360 20 17 37 15.6 Central 3960 10 13 23 5.8 South 2600 10 4 14 5.3 Births occurring outside District. 15 25 40 Totals 16700 111 97 208 12.4 DEATHS. Exclusive of those deaths which occurred in Public Institutions situated within the District, but belonging to other districts, the deaths registered amounted to 169. In this number are included those deaths which were transferred by the Registrar-General of persons who had died outside, but who belonged to this District. The number of these deaths was 54. These deaths chiefly occurred at the Workhouse, Workhouse Infirmary, and General Hospital at Croydon; the County Asylum at Netherne; the War Memorial Hospital at Carshalton; and the Wandle Valley Joint Hospital Board's Hospital at Beddington Corner. The mortality corresponds to a death rate of 10.1 per thousand of population, as against 10.0 last year. The Death Rate in England and Wales for 1925 was 12.2, as against 12.2 last year. INFANTILE MORTALITY. During the year 4 deaths were registered as occurring in infants under one year of age (all of which were legitimate), as against 11 last year. 8 The Infantile Mortality Rate was 19 per thousand births, as against 39 last year. The Infantile Mortality Rate for England and Wales was 75 in 1925, and 75 in 1924. CAUSES OF DEATH. The Deaths registered during 1925 included: — 2 from Influenza (1) 11 from Tuberculosis (13) 36 from Cancer (23) 29 from Heart Diseases (18) 23 from Respiratory Diseases (24) (The figures in brackets refer to last year's Deaths). For the third year in succession no Deaths occurred from Measles and Whooping Cough, and for the past four years there have been no deaths from Scarlet Fever, and no deaths from Diphtheria for five years. The following Table shows the Birth Rate, Death Rate per 1,000 of population, and Infantile Mortality Rate per 1,000 registered Births, for each of the years 1915-1925, together with the rate for England and Wales. Year. Birth Rate. Death Rate. Infantile Mortality Rate Beddington and Wallington England and Wales. Beddington and Wallington England and Wales. Beddington and Wallington England and Wales. 1915 14.5 21.8 11.4 15.1 71 110 1916 14.8 21.6 10.5 14.0 79 91 1917 13.4 17.8 11.4 14.4 72 97 1918 12.3 17.7 115 17.6 47 97 1919 12.7 18.5 10.8 13.8 73 89 1920 17.9 25.4 8.7 12.4 52 80 1921 15.5 22.4 9.9 12.1 72 83 1922 14.3 20.6 9.9 12.9 60 77 1923 13.5 19.7 10.5 11.6 49 69 1924 13.8 18.8 10.0 12.2 39 75 1925 12.4 18.3 10.1 12.2 19 75 ZYMOTIC DEATH RATE. The Zymotic Death Rate is a term commonly applied to the rates of deaths occurring from the principal Zymotic complaints, viz., Scarlet Fever, Small Pox, Diphtheria, Whooping Cough, Diarrhoea and "Fever," which latter term includes Typhus, Typhoid (or Enteric) and continued Fevers. Again this year no deaths occurred from these complaints. 9 Tuberculosis.—The Deaths from Pulmonary Tuberculosis (Phthisis or Consumption of the Lungs) numbered 8. This is equal to a Death Rate of 0.47 per thousand of population, as against 0.78 last year. Cancer.—The deaths from Cancer numbered 36. This gives a Death Rate of 2.15 per thousand of population, as against 1.38 last year. The following Table shows the number of Deaths and the rate per cent. of total deaths from specified causes:— Cause of Death. Number of Deaths. Percentage Rate of Total Deaths Influenza 2 1.18 Tuberculosis of respiratory system 8 4.73 Other Tuberculous diseases 3 1.77 Cancer 36 21.30 Cerebral Hemorrhage 16 9.46 Heart disease 29 17.15 Arteriosclerosis 5 2.95 Bronchitis 8 4.73 Pneumonia (all forms) 9 5.32 Other respiratory diseases 6 3.55 Ulcer of stomach or duodenum 3 1.77 Appendicitis and Typhlitis 2 1.18 Nephritis 5 2.95 Congenital debility, malformation and premature birth 3 1.77 Violence (including suicide) 5 2.95 The following Table shows the number of Deaths at various ages, together with the rate per cent. of total deaths:— Ages. Number of Deaths. Per cent. of Total Deaths. Under one year 4 2.36 1 and under 2 years 2 1.18 2 and under 5 years nil — 5 and under 15 year 4 2.36 15 and under 25 years 10 5.91 25 and under 45 years 21 12.42 45 and under 65 years 50 29.58 65 years and over 78 46.15 It will be noticed that over 46 per cent. of the total Deaths occurred in persons of 65 years and over. 10 Birth-rate, Death-rate, and Analysis of Mortality during the Year 1925. Birthrate per 1,000 Total Population. Annual Death-rate per 1,000 Population. Kate per 1,000 Births. All Causes. Enteric Fever. Small pox. Measles. Scarlet Fever Whooping Cough. Diphtheria. Influenza. Violence. Diarrhœa and Enteritis (under 2 Years). Total Deaths under One Year. England and Wales 18.3 12.2 0.01 0.00 0.13 0.03 0.15 0.07 0.32 0.47 8.4 75 105 County Boroughs and Great 18.8 12.2 0.01 0.00 0.17 0.03 0.18 0.09 0.30 0.43 10.8 79 Towns, including London. 157 Smaller Towns (1921 18.3 11.2 0.01 0.00 0.15 0.02 0.14 0.06 0.31 0.38 7.6 74 Adjusted Populations 20,000— 50,000). London 18.0 11.7 0.01 0.00 0.08 0.02 0.19 0.11 0.23 0.46 10.6 67 Beddinoton and Wellington Urban District 12.4 10.1 0.00 0.00 0.00 0.00 0.00 0.00 0.11 0.29 0.00 19 11 INFECTIOUS DISEASE. The year 1925 has been a satisfactory one from the point of view of incidence of Infectious Disease. The Council, while recognising that the prevention of all diseases is a material factor in raising the general standard of health in the District, is necessarily concerned in the early diagnosis of many diseases. Such early recognition is primarily of the greatest importance to the patient, but it is also of course of importance to those brought in contact with the sufferer and, therefore, to the public at large. Arrangements have existed for many years whereby a medical practitioner can secure assistance for making an early diagnosis in suspicious or doubtful cases of such diseases as Diphtheria and Tuberculosis, by having swabs and sputum examined at the Wandle Valley Isolation Hospital, Beddington Corner, free of all cost. Special outfits for collecting such specimens for examination are also provided. Antitoxin for use in suspected cases of diphtheria or suspicious throat illness is also provided free of cost to the Medical Practitioner for his or her use pending the receipt of the result of the bacteriological examination. It cannot be too strongly urged that in all cases of throat illness bacteriological examination of the throat secretions should be made at the earliest possible moment, and that pending such examination antitoxin should at once be administered. No ill result from such administration can occur in cases which are found on examination afterwards not to be diphtheria. But the time gained in cases of diphtheria by such early administration is of the very greatest importance in checking at its early stages the virulence of this disease. The earlier diphtheria is diagnosed the better it is for the patient, so that adequate treatment can be given, isolation carried out and for the prevention of any extension of this disease. Extension of the disease means not only risk of life to those attacked, but it also means increase in cost of hospital treatment for such cases. One of the largest items in the treatment of such cases is that of antitoxin, and it is not unusual for a patient sent in to the Hospital after the disease is established to cost over £5 for antitoxin alone. It is well to emphasise the fact that before the employment of antitoxin the mortality rate was over 40 per cent. of actual 12 cases; to-day that rate has fallen to between 4 per cent. and 5 per cent.; but in these lower rates are included cases which are not recognised in their early stages as being diphtheria, and so miss early treatment. With regard to the early diagnosis of tuberculosis, here again the examination of sputum is of the utmost assistance to the Medical Practitioners, and consequently to the material advantage of the sufferers. It will be seen from the report on page 14 to what extent this valuable service is used in the District, and the Council desires that the very fullest use shall be made of the facilities so afforded for the diagnosis of certain bacterial diseases. 13 The following Table will show the number of cases notified each year since 1915:- 1915 (9 m'ths) 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 Scarlet Fever 39 16 8 34 62 67 74 59 28 15 33 Diphtheria 14 24 9 23 43 47 34 19 40 15 12 Typhoid Fever 1 1 — 1 3 5 1 6 1 — Erysipelas 6 9 4 3 4 5 8 4 4 2 7 Poliomyelitis 1 — — — 2 — — — - - — Opthalmia Neonatorum 1 — — 1 - 2 — — — — 1 Puerperal Fever — 1 — - 1 — 2 — 2 — — Measles — 87 241 158 39 — — — — — — Cerebro Spinal Meningitis — — — 1 — — 1 — — 1 — Pneumonia — — — — 16 3 8 4 5 9 2 Malaria — — — — 6 4 - - - - - Chicken Pox — — — — 3 — — — 6 3 — Dysentery — — — — — — 1 — — — — Encenhalitis Lethareiea — — — — — — 1 — 3 1 — Tuberculosis Pulmonary 17 16 22 27 18 16 15 12 18 18 18 Other forms 6 8 4 4 — — 3 1 6 — 5 Total 35 162 288 252 197 149 148 99 118 65 78 14 The following Table shows the number of cases notified, cases removed to Hospital, and the percentage of the cases notified which were removed to Hospital. Disease. Number Notified. Total Removed to Hospital. Per cent. of Cases Removed to Hospital. Scarlet Fever 33 30 90.9 Diphtheria 12 10 83.3 Erysipelas 7 4 57.1 Pneumonia 2 - — Ophthalmia Neonatorum 1 * — SCARLET FEVER. An increase in the number of cases of Scarlet Fever notified took place, viz., 33 as against 15 last year. The largest number of cases came from the Wallington North and Central Wards, 12 cases occurring in each. Thirty cases were removed to the Isolation Hospital. No Deaths have occurred for the past four years. DIPHTHERIA. Twelve cases of Diphtheria were notified as against 15 last year. Ten cases were removed to the Isolation Hospital. It is a satisfactory feature that for five years no deaths have occurred from this complaint. The number of swabs examined at the Wandle Valley Joint Hospital from this District numbered 130. OPHTHALMIA NEONATORUM. One case was notified. ERYSIPELAS. Seven cases were notified, of which 4 were removed to the Isolation Hospital. TUBERCULOSIS. Twenty-three new cases of Tuberculosis were notified during the year, of which 18 were pulmonary and 5 were other forms of Tuberculosis. 15 The sanatorium and dispensary treatment for Tuberculosis is under the control of the Surrey County Council. During the year 35 specimens of sputum have been examined from suspected cases in this District during the year. The following Table shows the total cases notified, classified by age and sex, together with the deaths registered:— Age —Periods New Cases. Deaths. Pulmonary. NonPulmonary. Pulmonary. NonPulmonary. M F M F M F M F Under 1 year - - - - - - - - 1 and under 5 - - - - - - - - 5 and under 10 — — — 1 — — — 2 10 and under 15 — — 1 — — — — — 15 and under 20 — 1 — — — 1 — 1 20 and under 25 1 1 — 1 1 — — — 25 and under 3 5 1 2 — — 1 — — — 35 and under 45 5 1 — 1 1 — — — 45 and under 55 1 1 - 1 1 1 — — 55 and under 65 1 1 — — 1 — — — 65 and over 1 1 — — - 1 — - Total 10 8 1 4 5 3 — 3 These cases were distributed amongst the following wards:— Localisation. Beddington. Wallington. Total North Central South North Central South Pulmonary 2 1 3 3 7 2 18 Non-Pulmonary 1 2 2 - - 5 HEALTH VISITOR. The Council employs one Health Visitor, who devotes her whole time to the service of the Council and works under the supervision of the Medical Officer of Health. 16 During the year she has paid the following number of visits:— Number of visits to houses where children have been born 118 Number of re-visits re Births 1195 Number of visits re Tuberculosis 29 Number of Ante-natal visits 28 Number of visits re Deaths under one year 1 MATERNITY AND CHILD WELFARE. Four Maternity and Child Welfare Centres have been established by the Council, and a large amount of useful work has been done. The Medical Officer in Charge is the Medical Officer of Health, who attends each Centre once a month. Infant foods are supplied at the Centres at cost price to mothers where this has been necessary. These foods are only supplied on the recommendation of the Medical Officer. An agreement is in force with the Carshalton Memorial Hospital whereby special treatment is obtainable for children needing it, and during the year 11 children have attended this Hospital. Two children received treatment at other Institutions. The following are the Centres, together with the times of Sessions:— Address. When Sessions are Held. Baptist Hall, Queen's Road Fortnightly. Second and fourth Wednesday in each month. Wesleyan Hall, Sandy Lane Fortnightly. First and third Tuesday in each month. Hackbridge Methodist Hall Fortnightly. Second and fourth Tuesday in each month. Village Hall, Beddington First Monday in each month. 17 The following Table shows the attendances, etc., at the Centres. Name of Centre. Voluntary Helpers, Number of Sessions Held. Total number of children on books, 31st Dec., 1925. Attendance. Average Attendance Number of Children sent for Treatment. Adults. Children. To Carshalton Hospital. To other Institutions. Hackbridge Mrs. Crouch. 24 61 647 753 31 8 — Mrs. Holden Mrs. Wright Bandon Hill Mrs. Bryant 24 36 197 257 11 1 1 Mrs. Jeffrey Wallington Mrs. Clifford-Smith 23 60 447 513 22 1 — Mrs. James Mrs. Buck .. Mrs. Jeffrey Beddington Village Mrs. Franklin 12 12 67 95 8 1 1 The District is indebted to the valuable help given at the Centres by the Voluntary Helpers, whose assistance is greatly appreciated. 18 SCHOOLS. Inspection. Routine visits are paid to all schools within the District, and when occasion requires special visits are paid. During the year the following number of visits have been paid:— Number of ordinary and special visits 25 Certificate's given for School Attendance purposes 38 Medical Inspection. The Medical Inspection of school children is carried out by the Education Department of the Surrey County Council. The Medical Officer of Health is, when necessary, called in to examine children suspected to be suffering from infectious or contagious disease. Closure of Schools. In the following instances it was found necessary to close a school, owing to the prevalence of infectious disease amongst the scholars:— Bandon Hill Schools.—12th January to 31st January, for Mumps. Beddington Church of England School.—14th January to 31st January, for Mumps. Bute Road Schools.—From 12th March to 8th April, for Mumps. AMBULANCE FACILITIES. For Infectious Cases.—The Wandle Valley Joint Hospital Board have provided two motor ambulances for the removal of cases of Infectious Disease to the Hospital. HOUSING, &c. A certain amount of overcrowding still exists in the District, and the Council is endeavouring to remedy this trouble. The existing scheme of the Council provides for the erection of some 88 houses, 24 of which were completed and occupied by the end of the year. The erection of the remainder is proceeding. The chief cause of overcrowding appears to be due to sub-letting, owing to the tenants being unable to pay existing rents. 19 The genera] standard of houses within the District is very good. The character of defects found on inspection does not indicate the existence of serious structural defects. The occupiers of the working class houses are, with few exceptions, quite a good class of tenant, the number of dirty and destructive tenants being small. There could, with advantage, be more supervision by certain owners of property, and there appears to be a tendency for some owners not to carry out any repairs until they are requested to do so by the Sanitary Authority. Number of new houses erected during the year (a) Total (including numbers given separately under (b) ) 241 (b) With State assistance under the Housing Acts: (i) By the Local Authority 24 (ii) By other bodies or persons 6 1. Unfit Dwelling Houses. Inspection. (1) Total number of Dwelling Houses inspected for housing defects (under Public Health or Housing Acts) 292 (2) Number of Dwelling Houses which were inspected and recorded under the Housing (Inspection of District) Regulations, 1910, or the Housing Consolidation Regulations, 1925 46 (3) Number of Dwelling Houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation — (4) Number of Dwelling Houses (excluding those referred to under the preceding sub-heading) found not to be in all respects reasonably fit for human habitation 138 2. Remedy of Defects Without Service of Formal Notices. Number of defective Dwelling Houses rendered fit in consequence of the Local Authority or their Officers 134 3. Action under Statutory Powers. A. Proceedings under Section 3 of the Housing Act, 1925:— (1) Number of Dwelling Houses of which notices were served requiring repairs — 20 (2) Number of Dwelling Houses which were rendered fit after service of formal notices :— (a) By owners — (b) By Local Authority in default of owners — (3) Number of Dwelling Houses in respect of which Closing Orders became operative in pursuance of declarations by owners of intention to close — B. Proceedings under the Public Health Acts:— (1) Number of Dwelling Houses in respect of which notices were served requiring defects to be remedied 4 (2) Number of Dwelling Houses in which defects were remedied after service of formal notices :— (a) By owners 4 (b) By Local Authority in default of owners — C. Proceedings under Sections 11, 14 and 15 of the Housing Act, 1925:— (1) Number of representations made with the view to making of Closing Order — (2) Number of Dwelling Houses in respect of which Closing Orders were made — (3) Number of Dwelling Houses in respect of which Closing Orders were determined, the Dwelling House having been rendered fit — (4) Number of Dwelling Houses in which Demolition Orders were made — (5) Number of Dwelling Houses demolished in pursuance of Demolition Orders — Water Supply. The District has a constant supply of water provided by the Sutton Water Company, but there still remain a few premises where private wells are still in use. During the year I have examined 184 samples of water for the determination of the hardness. Closet Accommodation. Practically the whole of the District is on the water carriage system, the closets being connected to the main drainage system. In parts of the District where no sewer is available, closet accommodation is provided by means of earth closets with removable receptacles, or by drainage to cesspools. The approximate number of these is:—Earth closets, 26; cesspools, 8. 21 Scavenging. The removal of house refuse is carried out by the Council, and deposited on a site within the District. Portable galvanised iron covered dustbins for the storage of house refuse are in use throughout the District. The Council has not generally undertaken the work of removal of the contents of earth closets and cesspools. This is usually carried out by the occupier of the premises in a satisfactory manner. BYE-LAWS AND REGULATIONS. The following Bye-laws and Regulations are in force within the District:— Bye-laws: Slaughterhouses. Nuisances. Houses let in Lodgings. Tents, vans, sheds, and similar structures. Regulations: Dairies, Cowsheds and Milkshops. OFFENSIVE TRADES, ETC. There are no Offensive Trades within the District, nor are there any Common Lodging Houses nor Houses let in Lodgings. REGULATED TRADES. MILK, COWSHEDS, AND DAIRIES. There are 4 cowsheds and 13 dairies, and during the year 135 visits of inspection have been paid. The number of producers and purveyors of milk on the registers at the end of the year was 22:— Producers and Wholesale Purveyors of Milk 4 Retail Purveyors of Milk 18 The milk supply of the District is chiefly from outside sources. The cowsheds and dairies within the District are subject to frequent inspection, and the conditions generally found are satisfactory. The cowsheds were visited each quarter of the year by the Veterinary Surgeon (Mr.R.Thrale,M.R.C.V.S.), appointed by the Council, and the average number of cows examined was 128. 22 MILK (SPECIAL DESIGNATIONS) ORDER, 1923. During the year the Council issued the undermentioned licences authorising the sale of graded milk within the District:— Certified 4 Grade "A" Pasteurised 1 Pasteurised 1 SLAUGHTERHOUSE AND MEAT AND FOOD INSPECTION. The Public Health (Meat) Regulations, 1924, came into force on the 1st April, 1925, and provides, inter alia, for notice to be given by the butcher of any animals he proposes to slaughter for human food. There is one slaughterhouse in the District, which is licensed annually. The slaughterhouse was visited frequently during the year, and no infringements of the Byelaws or Regulations were observed. The Byelaw making compulsory the stunning of animals by means of a mechanically-operated instrument is in force in the District. The number of visits paid to the slaughterhouse and other premises for the purpose of inspecting the meat and other foods deposited thereon was 311. The undermentioned food was found to be unfit for human consumption, and was destroyed:— Pork 391bs. (Tuberculosis). Offal 141bs. (Tuberculosis). Total 531bs. The number of slaughterhouses at various times were : In January, In December, In 1920. 1925 1925. Registered — — — Licensed 111 BAKEHOUSES. There are 9 bakehouses in use in the District, one being underground. Fifty-six visits were paid to these premises during the year, and the under-mentioned conditions were discovered and remedied:— Lime-washing required 2 Defective condition of premises 1 23 SALE OF FOOD AND DRUGS ACTS. The Surrey County Council carries out the duties under the Sale of Food and Drugs Acts, and during the year the following number of samples have been taken in this District:— Articles. Analysed. Adulterated or Deteriorated. Prosecutions. Convictions. Formal formal Total Formal Informal Total Milk 29 .. 29 .. .. .. .. .. Cream 3 .. 3 1 .. 1 .. .. Butter .. .. .. .. .. .. .. .. Cheese .. .. .. .. .. .. .. .. Margarine .. .. .. .. .. .. .. .. Lard .. .. .. .. .. .. .. .. Bread .. .. .. .. .. .. .. .. Flour .. .. .. .. .. .. .. .. Tea .. .. .. .. .. .. .. .. Coffee .. .. .. .. .. .. .. .. Cocoa .. .. .. .. .. .. .. .. Sugar .. .. .. .. .. .. .. .. Mustard .. .. .. .. .. .. .. .. Confectionery and Jam .. .. .. .. .. .. .. .. Pepper .. .. .. .. .. .. .. .. Wine .. .. .. .. .. .. .. .. Beer .. .. .. .. .. .. .. .. Spirits .. .. .. .. .. .. .. .. Drugs .. .. .. .. .. .. .. .. Other articles .. 1 1 .. .. .. .. .. Totals 32 1 33 1 .. l .. .. 24 TABLE 1. CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR 1925. Disease. Number of Cases Notified. Total Cases Notified in each Ward. Total Cases Removed to Hospital. At Ages—Years. Beddington. Wellington At all Ages. Under 1 year. 1 and under 2. 2 to 3. 3 to 4. 4 to 5. 5 to 10. 10 to 15. 15 to 20. 20 to 35. 35 to 45. 45 to 65. 65 and over. North. Central. South. North. Central. South. Scarlet Fever 33 .. .. 3 2 3 14 3 3 4 1 .. .. 6 .. 2 12 12 1 30 Diphtheria 12 1 .. .. 1 1 1 2 2 4 .. .. .. .. 1 3 7 1 10 Erysipelas 7 .. .. .. .. .. .. .. 1 .. 1 3 2 1 2 4 4 Pneumonia 2 .. .. .. .. .. .. .. .. .. 1 1 1 1 .. .. Ophthalmia Neonatorum 1 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. Totals 55 2 .. 3 3 4 15 5 6 8 3 4 2 7 3 3 16 24 2 44 25 TABLE II. DEATHS REGISTERED DURING THE CALENDER YEAR 1925, CLASSIFIED BY AGE AND CAUSE. Cause of Deaths. 1 Nett Deaths at the subjoined ages of "Residents" whether occurring within or without the District. 3 4 5 6 7 8 9 10 All Ages. Under 1. 1 & under 2. 2 & under 5. 5 & under 15. 15 & under 25. 25 & under 45. 45 & under 65. 66 & upwards. Enteric Fever .. .. .. .. .. .. .. .. .. Small Pox .. .. .. .. .. .. .. .. .. Measles .. .. .. .. .. .. .. .. .. Scarlet Fever .. .. .. .. .. .. .. .. .. Whooping Cough .. .. .. .. .. .. .. .. .. Diphtheria .. .. .. .. Influenza 2 .. .. .. .. .. .. 2 .. Encephalitis Lethargica .. .. .. .. .. .. .. .. .. Meningococcal Meningitis .. .. .. .. .. .. .. .. Tuberculosis of the Respiratory System 8 .. .. .. .. 2 .. 3 1 Other Tube culous Diseases 3 .. .. .. .. 1 .. .. .. Cancer, malignant disease 36 18 13 Rheumatic Fever .. .. .. .. .. .. .. .. .. Diabetes 1 .. .. .. .. .. .. 1 .. Cerebral Hemorrhage, etc 16 .. .. .. .. .. .. 5 11 Heart Disease 29 .. .. .. .. .. .. 5 19 Arterio-sclerosis 5 .. .. .. .. .. .. .. 5 Bronchitis 8 .. .. .. .. .. .. .. 8 Pneumonia (all forms) 9 .. 1 .. .. .. .. 2 4 Other respiratory diseases 6 .. 1 .. .. .. .. 2 2 Ulcer of Stomach or Duodenum 3 .. .. .. .. .. .. 2 1 Diarrhoea, etc. (under two years) .. .. .. .. .. .. .. .. Appendicitis and Typhlitis 2 .. .. .. .. .. .. .. .. Cirrhosis of Liver 1 .. .. .. .. .. .. .. .. Acute and Chronic Nephritis 5 .. .. .. .. .. .. .. 3 Puerperal Sepsis .. .. .. .. .. .. .. .. Other accidents and diseases of Pregnancy and Parturition .. .. .. .. .. .. .. .. .. Congenital Debility and Malformation, Premature Birth 3 3 .. .. .. .. .. .. .. Suicide 1 .. .. .. .. .. .. .. .. Other Deaths from Violence 1 .. .. .. .. 1 2 1 Other Defined Diseases 26 1 .. .. .. 3 6 .. 9 Causes Ill-defined or Unknown 1 .. .. .. .. .. .. .. 1 Totals 169 4 2 .. 4 10 21 50 78 26 REPORT on the administration of the Factory and Workshop Act, 1901, in connection with FACTORIES, WORKSHOPS AND WORKPLACES. 1.—Inspection of Factories, Workshops and Workplaces. Including Inspections made by Sanitary Inspectors or Inspectors of Nuisances. Premises. (1) No. of Inspections. (2) Written Notices. (3) Occupiers Prosecuted. (4) Factories (including Factory laundries) 58 — — Workshops (including Workshop laundries) 62 — — Workplaces (other than Outworkers' premises) — — — Total 120 — — 2.—Defects found in Factories, Workshops and Workplaces. Particulars. (1) Number of defects. Number of offences in respect to which prosecutions were instituted. (6) Found. (2) Remedied. (3) Referred to H.M. Inspector (4) Nuisances under the Public Health Acts— Want of cleanliness 2 2 — — Other Nuisances 4 4 — — Sanitary accommodation unsuitable or defective — — — — 6 6 — — 27 ISOLATION HOSPITAL. This District is one of the constituent Authorities forming part of the Wandle Valley Joint Isolation Hospital Board, the other Authorities being the Coulsdon and Purley, Merton and Morden, and Mitcham Urban District Councils. The Hospital, which was established by the Croydon Rural District Council, was first opened for the reception of patients at the beginning of March, 1899. The accommodation then provided was 10 beds for Scarlet Fever cases, 10 beds for Diphtheria cases, 4 beds for Typhoid Fever cases, and 4 beds for doubtful cases. The nominal number of beds is now 78, but on many occasions a much larger number of patients have been under treatment at the same time. The enlargements and additions made to the Hospital since its first erection have been:— 1904. Scarlet Fever pavilion for 22 beds, which was opened in June, 1905. Additional dormitory to administrative block. Hand laundry converted to a steam laundry. 1910. Cubicle block for 12 beds. Quarters for Resident Medical Officer. 1922. Cubicle block for 16 beds. 1925. Electric lighting installed. By arrangement with the Surrey County Council, cases of Tuberculosis have been admitted, but in November, owing to the large number of cases of ordinary infectious diseases being under treatment, it was deemed advisable to suspend the admittance of cases of Tuberculosis. Since the Hospital was opened, 9,909 patients have been under treatment. The following Table shows the percentage number of cases admitted for the past four years:— Scarlet Fever. Diphtheria. Tuberculosis. Other Diseases. 1922 61 37 — 1 1923 57 33 5 3 1924 40 49 7 3 1925 42 45 5 7 28 During the year 558 patients were admitted to the Hospital, of which 38 died. The lowest number under treatment at one time was in September, there being only 32 patients, and the highest number was in November, with 117 patients. The following Table shows the number of cases admitted, the number of deaths, and case mortality for each complaint:— Disease. Cases. Deaths. Case Mortality (per cent.). Scarlet Fever 237 3 1.26 Diphtheria 254 10 3.93 Pneumonia 3 1 33.0 Erysipelas 10 — — Typhoid Fever 11 1 9.09 Measles 5 — — Cerebror-spinal F ever 2 1 50.0 Chicken Pox 1 — — iPuerperal Fever 2 1 50.0 Encephalitis Lethargica 1 1 100.0 Tuberculosis 28 20 71.42 No Disease 4† — — Total 558 38 6.80 * Patient died from Acute Nephritis. † Babies admitted with their mothers. BACTERIOLOGICAL LABORATORY. During the year the following number of examinations have been made by the Resident Medical Officer:— Number of swabs for diphtheria 1690 Number of specimens of sputum 198 These were divided amongst the constituent Authorities, and patients at the Hospital as under:— Swabs for Diphtheria. Sputa. Beddington and Wallington 130 35 Coulsdon and Purley 103 29 Mitcham 675 86 Cases in Hospital 782 48 1690 198 29 ANNUAL REPORT OF THE SANITARY INSPECTOR. Statement showing the number of Inspections made and the work carried out in the administration of the Public Health Acts, Housing Acts, Byelaws, etc., in the District during the Year 1925. DWELLING HOUSES. The total number of dwelling houses inspected during the year was 292, of which number 46 were inspections made in accordance with the Housing (Inspection of District) Regulations, 1910. Of the total, 154 houses were found to be reasonably fit for human habitation and free from nuisance. The defects discovered during the inspections numbered 428, and are shown classified in the following Table:— Defective water fittings 6 Defects in drains and drainage fittings 116 Defects in water closets 29 Defective sinks and waste-pipes 7 Defective paving of back yards 8 Dampness, defective roofs, etc. 52 Defective internal walls and ceilings 40 Dirty internal walls and ceilings 84 Defective windows, broken sash-cords, etc. 39 Defective dustbins 20 Other defects or nuisances 25 Total 428 INFECTIOUS DISEASE AND DISINFECTION. Number of visits paid to premises on occurrence of Infectious Disease 110 Number of reports sent to Medical Officer of Health 52 Number of notifications of Infectious Disease sent to schools 38 Number of rooms disinfected 93 Lots of bedding and clothing disinfected 98 COMPLAINTS. Eighty-one complaints were received during the year, and were due to the following causes:— 30 Defects in dwelling houses 27 Drainage defects (including stoppages) 20 Accumulations of offensive refuse 6 Animals kept so as to be a nuisance 6 Miscellaneous 22 Total 81 All the complaints received prompt attention. INCREASE OF RENT (RESTRICTIONS) ACTS. Two applications for Certificates under the above Acts were received during the year. A Certificate was granted in each case. RATS AND MICE (DESTRUCTION) ACT, 1919. One hundred and seven visits were paid to premises where rats were prevalent. In addition to this number, inquiries were made during routine inspections of premises, and advice given where necessary. Certain structural defects which encouraged the entry of rats into premises were remedied. The number of notices sent to occupiers during the year was 114. OFFENSIVE TRADES. There are no offensive trades carried on within the District. NOTICES. In connection with the nuisances and defects discovered, notices as under were served during the year:— Informal notices served (including verbal intimatioins) Statutory notices served:— 138 Sec. 94, P.H. Act, 1875 4 Sec. 41, P.H. Act, 1875 1 5 Total 143 31 DETAILS OF DEFECTS REMEDIED AND SANITARY IMPROVEMENTS EFFECTED DURING THE YEAR. Water fitting's repaired 8 30 Drains relaid or repaired Drains unstopped and cleansed 23 Soil pipes and ventilating pipes repaired or renewed 31 Manholes newly constructed or repaired 14 Gullies renewed or cleansed 5 New stoppers fixed in rodeyes of interceptors 5 New pans fixed to water-closets 4 Flushing- cisterns to water-closets repaired or renewed 6 Flush pipes and pan joints repaired or renewed 6 Glazed stoneware sinks provided 2 Waste pipes from sinks, etc., repaired and renewed 7 New dustbins provided 21 Yards paved or paving repaired 9 Roofs and gutters repaired 41 Damp-proof courses fixed 7 External walls repaired 11 Internal walls repaired 49 Rooms cleansed 102 Windows repaired 41 Fireplaces repaired 13 Offensive refuse removed 5 Miscellaneous defects remedied 22 Total *462 * Including 79 defects outstanding at end of year 1924 SUMMARY OF WORK DONE DURING THE YEAR. Number of houses inspected 292 Number of visits to works in progress and re-inspections 693 Number of visits to schools 25 Number of miscellaneous visits and inspections 377 Number of visits to dairies, cowsheds and milkshops 135 Number of visits to factories and workshops 120 Number of visits to slaughterhouse and food stores 311 Number of visits to piggeries 14 Number of visits to stables 121 Number of visits to urinals 61 Number of visits re infectious disease 110 Number of visits re rats 107 Number of complaints received and investigated 81 Number of preliminary notices served (nuisances) 138 Number of statutory notices served (nuisances) 5 32 Number of notices served re rats 114 Number of interviews re nuisances, etc. 216 Number of tests applied to drains 223 Number of rooms disinfected 93 Number of lots of bedding and clothing disinfected .. 98 Number of water samples taken 185 Total number of defects and nuisances discovered 434 Total number of defects and nuisances remedied *462 *Including 79 outstanding at end of year 1924. F. H. LENNARD, M.R.San.I., Sanitary Inspector. — Actual No. of Cases. — — Scarlet Fever.- — No. of Cases per 100,000. — — Annual No.of Cases — . " -Tuberculosis.- — No. of Cases per 100,000. —