BRE7 BOROUGH OF BRANTFORD AND CHISWICK REPCRT ON THE HEALTH OF THE DISTRICT SCHOOL MEDICAL SERVICE FOR THE YEAR - 1939 R.C. LEANING, M.B., B.S. (London), M.R.C.S., L.R.C.P., D.P.H., R.C.S., (Eng.) Medical Officer of Health School Medical Officer. 2 BOROUGH OF BRENTFORD AND CHISWICK PUBLIC HEALTH COMMITTEE Councillor Mrs. Hill, Chairman. Alderman DAVIS Councillor W, DAVIES „ EDWARDS FULLERTON-BUSTARD „ HOWARD „ GROGAN Councillor BOWIE „ HOLMAN „ . Mrs.BURDEN „ PALMER „ SINCLAIR Ex Offico: Alderman JENKIN, J.P., and LEAHY, J.P., and Councillor CLELAND EDUCATION COMMITTEE Alderman LEAHY, J.P., Chairman. Councillor COURT, Vice-Chairman. Alderman JENKIN, J.P. Mr A.H. CHARLTON, J.P. „ STROUD Mr. G.R. DAVIDGE Councillor BRENTON Mrs. M.E. DAVIES „ MRS. BURDEN Mr. H. GARLICK „ DAVIES Mr. H. HYDE-JOHNSON „ MRS. HILL Major H.W. JENKS, M.B.E. „ KITCHINGMAN Mrs. D. JOPP „ PENNY Mrs. M.LONGFORD „ SINCLAIR Mr. C. PENDLEBURY, M.A. County Alderman Mrs. BARNES, J.I „ „ MILLS County Councillor HUGHES,J.P. JOHNSON, J. JP. MATERNITY AND CHILD WELFARE COMMITTEE Councillor Mrs. BURDEN, Chairman. Alderman EDWARDS Councillor GROGUN „ JENKIN, J.P. „ Mrs. HILL „ LEAHY, J.P. „ HOLMAN Councillor BOWIE „ PALMER „ BRENTON „ SINCLAIR „ CLELAND „ CONNER „ COURT Co-opted Members: Mrs. E.A. BIRD, Mrs. HARVEY, Mrs. KING, Mrs, MOUNTFORD, Mrs. RAINBIRD, Mrs. STROUD, and Mrs. WRIGHT. MILK SUB-COMMITTEE Councillor MRS. BURDEN MRS. KING „ MRS. HILL MRS. MOUNTFORD „ SINCLAIR MRS. RAINBIRD MRS. E.A BIRD MRS. STROUD MRS. HARVEY MRS. WRIGHT VOLUNTARY LADY HELPERS AT THE MATERNITY AND CHILD WELFARE CLINICS Brentford Clinics MRS. E. BIRD MRS. JONES MRS. G. BURDEN MRS. MILES MRS. S. BURDEN MRS. MOUNTFORD MRS. DAVIS MRS. RAINBIRD VOLUNTARY LADY HELPERS AT THE MATERNITY AND CHILD WELFARE CLINIC (CONTD ) Chiswick Clinics miss Barker MRS. FROWMOW MRS. LITTLE MISS BATES MRS. GENTRY MISS PHTLLIPE MRS. G. BROWN MISS GOCDE MRS. TURNER MRS. BUTCHER MRS. HARVEY MRS. WRIGHT MRS. FORD MRS. KING 2 PUBLIC HEALTH ST/*FF (Including Staff for School Medical Service) Male * R.C. LEANING, M.B., B.S. (Lond) M.R.C.S,, L.R.C.P., D.P.H., R.C.S. (Eng,); Medical Officer of Health, School Medical Officer, Medical Superintendent, Maternity and Child Welfare Clinics. (Whole time). * ED. MICKLEWRIGHT, ,M.R. San.I., Certified Inspector of Meat and Other Foods etc., Chief Sanitary Inspector, Inspector for Petroleum Acts, Shops Acts, Factory Acts and Canal Boats. (Whole time), * L.C. WEBB, A.R. San. I., Certified Inspector of Meat and Other Foods etc., Certificates of the Royal Sanitary Institute, Sanitarv Inspector, Inspector for Shops Acts, and Canal Boats, (whole time;, * T.M. JOHNSON, A.R. San.I., Certified Inspector of Meat and Other Foods etc., Certificates of the Royal Sanitary Institute,•Sanitary Inspector, Inspector for Shops Acts. (Whole time). * A.G. ROBINSON. A.R. San. I., Certified Inspector of Meat and Other Foods etc., Certificates of the Royal Sanitary Institute, Sanitary Inspector, Inspector for Shops Acts. (Whole time). G.W. BURDEN, A.R. San. I., Certified Inspector of Meat and Other Foods etc.. Certificates of the Royal Sanitary Institute, General Assistant Sanitary Inspector (Whole time) (Resigned January 1939) R.A.G. JAMES, Certificates of Royal Sanitary Institute, General Assistant Sanitary Inspector. (Whole time). P.G. SMITH, Senior Clerk. (Whole time). B.C. SMITH, Clerk. (Whole time). J. FRIAR, Clerk. (Whole time). Female * MISS S.P. GRIFFITHS, M.R.C.S., L.R.C.P., D.P.H., Assistant Medical Officer of Health, Assistant School Medical Officer, (Whole time). * MISS. M.M. LORETZ, L.D.S., R.C.S, (Eng), Senior Dental Surgeon (Whole time). * MISS A.S. STEWART, L.D.S. (St. Andrews), Assistant Dental Surgeon. (Whole time) Appointed May 1938, * MISS H. CHITTY, Trained Nurse; Health Visitor's Certificate of the Royal Sanitary Institute, Certificate of the Central Midwives Board; Health Visitor and School Nurse. (Who„ . time). Resigned July 1939. * MRS. F, THOMPSON, Trained Nurse; Health Visitor's Certificate of the Royal Sanitary Institute, New Health Visitor's Certificate, Certificate of the Central Midwives Board; Health Visitor and School Nurse. (Whole time), Resigned April, 1939. 3 * MISS M.E. CATHERWOOD, Trained Nurse; New Health Visitor's Certificate, Certificate of the Central Midwives Board; Health Visitor and School Nurse. (Whole time). * MRS. R.E. CLARKE} Trained Nurse; Health Visitor's Certificate of the Royal Sanitary Institute; New Health Visitor's Certificate; Certificate of the Centra. Midwives Board; Health Visitor and Schoo1 Nurse. (Whole time). *MISS B.C. BROUGHTON, Trained Nurse; New Health Visitor's Certificate Certificate of the Central Midwives Board; Health Visitor and School Nurse. (Whole time). * MISS C.E. JENKINS, Trained Nurse; New Health Visitor's Certificate Certificate of the Central Midwives Board; Health Visitor and School Nurse. (Whole time). * MISS A.M. EDWARDS, Trained Nurse; New Health Visitor's Certificate Certificate of the Central Midwives Board; Health Visitor and School Nurse. (Whole time). Appointed May, 1939. * MISS M.A. BRADSHAW, Trained Nurse; New Health Visitor's Certificate; Certificate of the Central Midwives Board; Health Visitor and School Nurse. (Whole time). Appointed August, 1939. * MISS M. MARSHALL, Clerk of the Maternity and Child Welfare Clinic, Chiswick Centre. (Whole time). * MISS J. GOLLEY, Clerk to the Maternity and Child Welfare Clinic, Brentford Centre. (Whole time). * MISS M.E. REEVE, Clerk to School Medical Service, Chiswick Centre. Appointed May, 1939. (Whole time). * MISS B.J. COPP, Clerk to School Medical Service, Brentford Centre (Whole time). * MISS L. KING, Assistant to the Dental Surgeon, Brentford Centre. (Whole time). * MISS M, MALDEN, Assistant to the Dental Surgeon, Chiswick Centre. (Whole time). * MISS K. FREEMAN, Clerk to the Dental Surgeon (Whole time). * MISS P. EVESTAFF, Clerk to the Dental Surgeon. (Whole time). * MISS E. WALTERS, Matron - Day Nursery. (Whole time). PART-TIME MEDICAL STAFF * H.J. SEDDON, F.R.C.S., Consulting Surgeon to the Orthopaedic Clinic. * G. SLOT, M.D., M.R.C.P., D.P.H., Consulting Physician to the Rheumatism Clinic. * W.C. KING-BROWN, M.B., B.S., M.R.C.S., Medical Officer Diphtheria Immunisation Clinic. * T.M. TYRRELL, M.B., B. Chir. (Cantab), F.R.C.S., (Eng).Ophthalmic Surgeon. * Contribution is made to the salaries of Officers so marked. 4 BOROUGH OF BRENTFORD AND CHISWICK PUBLIC HEALTH DEPARTMENT, TOWN BALL, CHISWICK. To the Mayor, Aldermen and Councillors of the Borough of Brentford and Chiswick. LADIES AND GENTLEMEN, In presenting the Annual Report for 1939, the work undertaken in this Department cannot be gaged if no mention is made of the large amount of A.R.P. we undertook, Up to June, all duties were carried out normally, but we were then instructed to concentrate on organising Stretcher Parties, Ambulances and First Aid Posts, This necessitated some re-arrangement of our routine, but we were able to do so without curtailing the Social & School Services. When the war broke out, however, everything was changed^ for the evacuation with closure of schools resulted in the shuttingdown of all special clinics and a great diminution of work in the M & C. Welfare Centres. The Civil Defence work became intense and arduous and the staff generally put in many hours ungrudgingly on their new duties. The Chief Sanitary Inspector was Ambulance Officer and my Chief-of-Staff, sharing duties in the Report Centre. The other Sanitary Inspectors and the Dental Surgeons served long shifts at the Ambulance Stations. The Health Visitors took charge of the First Aid Posts and fitted (with some difficulty) this work with their diminished M & C»W. and School Medical work, for M & C.W. Clinics and Minor Ailments Clinics had still to be kept open. One Health Visitor went to help in a reception area. Of the Clerical Staff, one was seconded to the Report Centre, one became an Ambulance Driver and another Ambulance Attendant. Others did shifts at First Aid Posts and others were engaged long hours in clerical work connectcd with enrollments and equipment etc. I have reported on this at some length as I would like to put on record my great appreciation of the invaluable work cheerfully undertaken by all, xor while all this new work was being performed there was no neglect of urgent and essential matters connected with their normal duties. The figures for vital statistics were of course somewhat upset owing to the abnormal state of the population during the last quarter of the year, but never-the-less it can be stated that the general health of the Borough was satisfactory. I am, Ladies and Gentlemen, Your obedient Servant, R.C. LEANING. 5 SECTION A. STATISTICS AND SOCIAL CONDITIONS OF THE AREA. 1. GENERAL STATISTICS, 1939. Area in acres (including 116 acres of foreshore of River Thames and 24 acres of inland water) 2449.5 Population - Census 1931 62,617 Registrar-General's estimate for area mid 1939 .(a)6l,100 (b)58,200 2. EXTRACTS FROM VITAL STATISTICS OF YEAR. Total. M. F. Live Births; Birth Rate per 1,000 of Legitimate 686 356 330 estimated resident Illegitimate 45 20 25 lation, 11.96 Stillbirths: 20 12 8 Rate per 1,000 total (live and still)births 26.6 Deaths: 703 346 357 Death Rate per 1,000 of estimated resident population 12.08 Deaths. Rate per 1,000 total (live and still) births. Deaths from puerperal causes: Puerperal Sepsis - - Other puerperal causes 2 2.66 TOTAL 2 2.66 Death Rate of Infants under one year of age: All infants per 1,000 live births 41 Legitimate infants per 1,000 legitimate live births 35 Illegitimate infants per 1,000 illegitimate live births l33 Deaths from Cancer (all ages) 110 Deaths from Measles (all ages) - Deaths from Whooping Cough (all ages) 2 Deaths from Diarrhoea (under 2 years of age) 6 Zymotic Death Rate 0.22 COMPARISON OF VITAL STATISTICS Birth Death Infant Rate. Rate. Mortality. Brentford and Chiswick 11.96 12.08 42 England and Wales 15.0 12.1 50 126 County Boroughs and Great Towns, including London 14.8 12.0 53 London 12.3 11.9 48 (a) Vital Statistics. POPULATION. The Registrar-General's estimate of the total population of the Borough for the year 1939 is 61,470, which shows a decrease of 550 from that for 1937 and a decrease of 1,147 from the Census figure. The decrease of 550 is no doubt largely accounted for by plans for the extension of the Great West Road, which cuts through the residential part of Chiswick and has caused so many houses of the better class type to be vacated and their occupants to move out of the Borough. The excess of births over deaths during the past eight years is 1.058, but this of course is only one factor taken into account when forming the estimate. 6 BIRTHS. There were 731 births registered as belonging to the area during the year (376 male and 355 female). Of these 45 were illegitimate (20 male and 25 female). In addition there were 20 stillbirths registered, 2 of which were illegitimate. The Birth Rate for the Borough for 1939 was therefore 11.96. DEATHS, Table 1 on page 7 shows the causes of the 703 deaths of residents of the area, which is equivalent to a Recorded Death Rate of 12.08 per 1,000 of the estimated population and a Corrected Death Rate of 12.32 for the purposes of comparison with other areas. A perusal of Table 1 appended, which sets out the causes of death, will show that Cancer accounted for 110 deaths and Tuberculosis (all forms) for 41 deaths. In the preceding year these diseases were responsible for 122 and 42 deaths respectively. ZYMOTIC DEATH BATE. This rate is calculated from the number of deaths occurring from the seven principal zymotic disease, viz. small-pox, Scarlet Fever. Diphtheria, Measles, Fever (Typhus, Typhoid and Continued), Whooping Cough and Diarrhoea. The total number of deaths from those causes was 13, which gives a zymotic death rate of 0.22 per 1,000 of the population. INFANTILE MORTALITY. The total number of deaths of infants tinder one year of age was 30, Of this number, 6 were illegitimate children. This gives an Infantile Mortality Rate of 41 per 1,000 live births. Analysing this figure, one finds that the Infantile Mortality Rate among legitimate children was 35 while that among illegitimate infants was 133. The low Infantile Mortality Rate of 41 compares very favourably with the figures for all other parts of the country. Of the 30 infant deaths, 24 occurred outside the area, whiles 17 were neo-natal, i.e., occurring during the first four weeks of The following sets out the Birth, Death and Infantile Mortality Rates during the past ten years:- Year Birth Rate. Death Rate. Infantile Mortality Rate. 1930 16.6 11.31 48 1931 14.27 10.42 49 1932 13.93 10.45 49 1933 13.39 11.75 46 1934 12.48 11.37 61 1935 13.43 10.31 41 1936 13.35 12.24 49 1937 12.12 11.74 52 1938 13.26 11.14 42 1939 11.96 12.08 41 (b) Social Conditions There is little to add to my remarks in many of my previous reports relative to the social conditions of the Borough, As pointed out last year, there are now many large and important industries carried on in the area, particularly in the Great West Road area. These industries include scientific instrument makers, manufacturing chemists, card box manufacturers, knitting mills, 7 (b) Social Conditions (contd) aeroplane accessories, motor and marine engineers, transport and railway works, and many others* TABLE 1. PARTICULARS OF BIRTHS AND DEATHS AS SUPPLIED BY THE REGISTRARGENERAL FOR THE YEAR 1939. Cause of Death . Males Females. All Causes 336 347 1. Thyphoid Fever,etc - - 2.Measles - - 3. Scarlet Fever - 4.Whooping Fever - 2 5. Diphtheria 2 - 6. Influenza 3 4 7. Encephalitis Lethargica - - 8. Cerebro-spinal Fever - - 9. Respiratory Tuberculosis 18 18 10. Other Tuberculosis diseases 2 3 11. Syphilis 2 - 12.General paralysis of the insane,etc 2 - 13. Cancer 49 6l 14. Diabetes 4 5 15. Cerebral Haemorrhage 12 18 16. Heart Diseases 102 107 17. Aneurysm 2 1 18.Other circulatory diseases 16 26 19. Bronchitis 10 7 20. Pheumonia 21 9 21.Other respiratory diseases - 2 22. Peptic Ulcer 8 3 23.Diarrhoea, etc. (under two years) 2 4 24. Appendicitis 2 - 25. Cirrhosis of liver 4 1 26. Other liver diseases - 27. Other digestive diseases 8 8 28. Nephritis 7 29. Puerperal Sepsis - - 30. Other Puerperal causes - 2 31. Congenital causes etc 9 7 32. Senility 7 15 33. Suicide 5 4 34. Other violence 19 13 35. Other defined diseases 28 26 36. Ill-defined causes 1 - 37.Diarrhoea, 2 years and over 1 2 Special Causes (included in No.35 above) Small-pox - - Poliomyelitis 1 - Polioenceohalitis - 1 Deaths of Infants under 1 year Total 14 16 Legitimate 11 i 13 Illegitimate 3 3 Live Births - For I M R etc., For Birth Rate, M. F. M. F. Tote 364 348 376 355 Legitimate 346 323 356 330 Illegitimate 18 25 20 25 Still-births - Total 12 8 Legitimate 10 8 Illegitimate 2 - POPULATION (a) 61,100 (b)58,200 8 TABLE 11. INFANTILE MORTALITY DURING THE YEiAl 1939. Net deaths from stated causes at various ages under one year. CAUSE OF DEATH Under 1 week. 1-2 weeks. 2-3 weeks 3-4 weeks. I Total under 4 weeks. 1-3 months. 3 - 6 months. 6-9 months. 9-12 months. Total under 1 year. 1. Small-pox - - - - - - - - - - 2. Chicken-pox - - - - - - - - - - 3. Measles • - - - - - - - 4. Scarlet Fever - - - - - - - - - - 5. Whooping Cough - - - - - - 1 - 1 2 6. Diphtheria or Croup - - - - - - - - - - 7. Erysipelas - - -- - - - - - 8. Tuberculosis Meningitis - - - - - - - - - - 9. Abdominal Tuberculosis - - - - - - - - - - 10. Other Tuberc. Diseases - - - - - - - - - - 11. Meningitis (non T.B.) - - - - - - - 1 - 1 12. Convulsions - - - - - 1 - - 1 13. Laryngitis - - - - - - - - - - 14. Bronchitis - - - - - - - - - - 15. Pneumonia (all forms) - - 1 - 1 - - - 1 2 16. Diarrhoea - - - - - - - - - - 17. Enteritis - - 1 - 1 1 2 - - 4 18. Gastritis - - - - - - - - - - 19. Rickets - - - - - - - - - - 20. Suffocation, overlying - - - - - - - - - - 21. Injury at Birth 3 - - 1 4 - - - - 4 22. Atelectasis - - - - - - - - - - 23. Congenital Malformation - - - - - - - - - 4 24. 7 - - - 7 - - - - 7 25. Atrophy, Debility and Marasmus - - - - - 2 - - - 2 26. Pemphigus Neonatorum - - - - - - - - - - 27. 1* - - - l - 2 - - 3 TOTALS 13 1 2 1 17 5 5 1 2 30 * Murder. BIRTHS:- Legitimate 686 Illegitimate 45 DEATHS:- Legitimate 24 Illegitimate 6 INFANTILE MORTALITY RATE PER 1,000 Births = 41 9 SECTION ' B' GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. The following information is included and set out in such form as required by the Ministry of Health Circular No, 1728, relative to the preparation of Annual Reports for the year 1938 (1) PUBLIC HEALTH OFFICERS OF THE AUTHORITY. A list of all health officers employed by the Council is incorporated at the beginning of the Report. (2) DEVELOPMENT AND CHANGES IN CERTAIN SERVICES PROVIDED IN THE AREA. (a) Laboratory Facilities. No change has taken place in the arrangements for the examination of clinical material submitted by medical men for bacteriological examination. Details of the work carried out in the Council's laboratory will be found set out on page 34. (b) Ambulance Facilities. The ambulance arrangements for the Borough are both adequate and up-to-date. Four motor ambulances for public use are maintained, and all are now equipped with outfits for the administration of morphine sulphate by medical men in cases of urgency. The use these ambulances were put to during the year is reflected in the following figures Number of puolic calls dealt with during 1939 786 Number of'private calls dealt with during 1939 490 The Joint Hospitals Committee maintain their own motor ambulances for the removal of infectious patients to hospital, and in addition the Middlesex County Council have a special motor service for the removal of the many patients of the Borough using the Councy Hospitals. (c) Nursing in the Home. No change has taken place in this service. The Brentford and Chiswick Nursing Association, in affiliation with the Queen's Institute of District Nursing, still continues to function, and employs two nurses for work in the district. (d) Clinios and Treatment Centres. A Table showing a complete list of Clinics and Treatment Centresgiving particulars of establishment and control, will be found appended at the end of this sub-section. (e) Hospitals - Public and Voluntary. Two voluntary Hospitals exist within the Borough boundaries, viz., the Chiswick Hospital, and the Brentford Hospital. The former Hospital, which has undergone extensive reconstruction, has not been re-opened to the public. The proximity of the Borough to London renders the large Metropolitan Hospitals available to residents, and many take advantage of this fact as well as of the Hospital in the Royal Borough of Richmond. . The Middlesex County Council Hospital. mainly the West Middlesex Hospital situated in the adjoining' Borough of Hoston and Isleworth - deal with large numbers of patients requiring hospital treatment, including many maternity cases unable to obtain accommodation in the Maternity Hospital of the Joint Hospitals Committee. TABLE OF CLINICS AND TREATMENT CENTRES. DESCRIPTION ADDRESS WHEN HELD PROVIDED BY 1. M.& C.W. Clinics (consultation and simple treatment). Health Centre, Albany Road, Bfd. Twice weekly on Mondays and Wednesdays, 2 p.m. to 5 p.m. Council, under control of M.& C.W. Committee. 2. Ditto. Heath field Terrace, Chiswick. Thrice weekly, on Wednesdays, Thursdays, and Fridays, 2 p.m. to 5 P.m. Ditto. 3. Ante-Natal Clinic. Health Centre, Albany Road, Bfd. Once weekly on Wednesdays at 10.30 a.m. Ditto* 4. Ditto. Heath field Terrace. Once weekly on Tuesdays at 1.30 p.m. Ditto. 5. Minor Ailment Clinic. Health Centre, Bfd. Each weekday at 9 Education Committee. 6. Ditto. Heathfield Terrace. Ditto. Ditto. 7. Dental Clinic. Health Centre, Bfd. Mondays to Fridays at 9 a.m. and 2 p.m. for elementary school children,as required for patients from M.& C.W. Clinics. Education Committee by arrangement with the Council for M.& C.W. patients. 0 8. Ditto. Heathfield Terrace. Daily for elementary school-children. As required for patients from M.& C.W. Clinics Mondays and Tuesdays at 5 p.m. to 6 p.m. for Secondary School Children. Ditto. • 0 9. Eye Clinic. Health Centre, Bfd. One session weekly on Thursdays at 9.30 a.m for elementary school children. 1. Education Committee. 10. Tonsils & Adenoids. Chiswick Hospital. For elementary school children as required, Ditto. 11. Ringworm (X-Ray). Ditto. Ditto. Ditto. 12. Rheumatism Clinic. Sea1th Centre, Bfd. Once weekly, on Thursdays at 11.30 a.m. Ditto. 13. Artificial Sunlight Clinic. Ditto. Once weekly, on Wednesdays at 2 p.m. Ditto. 14. Orthopaedic Clinic. Ditto. Twice weekly on Mondays and Thursdays at 2 p.m. Education Committee and M.& C.W. Committee„ 1 15. Diphtheria Immunisation Clinic0 Heathfield Terrace. One session weekly on Mondays at 2 p.m. Brentford and Cniswick Town Council. l6. Day Nursery. Bennett Street, W.4. Weekdays. Ditto, - 170 Tuberculosis Dispensary. 14 Heathfield Terrace. Once weekly on Thursdays at 10.0 a.m. Middlesex County Council , 180 Venereal Disease Clinic And Clinics established within the District, but patients may attend the Special Clinic at the West London Hospital in the neighbouring Borough of Hammersmith. N.B. Ø Arrangements have also been made for treating school-children from Secondary Schools at these Clinics, # This hospital was closed during 1938 and other arrangements have been made until the Hospital re-opens. X Closed since outbreak of war. * Transferred to 28 Bell Road, Hounslow, in September, 1939. Attendance daily. 10 SUMMARY OR WORK AT THE MATERNITY AND CHILD WELFARE CLINICS, 1939. BRENTFORD AREA CHISWICK AREA Grand Totals 1939 Grand Totals 1938 Monday Clinics Wednesday Clinics Total Wednesday Clinics Thursday Clinics Friday Clinics Total Number of new Members enrolled during the year*. Under 1 year 71 103 174 1 30 192 116 338 512 571 Over 1 year 27 20 47 5 50 38 93 140 194 TOTAL: 98 123 221 35 242 154 431 652 765 Number of children attending and weighed: Under 1 year 1098 1967 3065 520 2712 2067 5299 8364 9017 Over 1 year 948 1666 2614 124 760 1314 2198 4812 5659 TOTAL: 2046 3633 5679 644 3472 3381 7497 13176 14676 Number of children seen by Doctor: Under 1 year 369 459 828 99 810 724 1633 2461 3004 Over 1 year 332 342 674 62 423 471 956 1630 2108 TOTAL: 701 801 1502 161 1233 1195 2589 4091 5112 -11- -12- (3) MATERNITY AND CHILD WELFARE. The remarks made in former reports regarding these Clinics might be repeated here in respect of the policy followed and the scope of work undertaken. There are special Clinics for Dental, Eye, Orthopaedic, Rheumatism, and cases requiring Artificial Sunlight, each of which is attended by a Specialist skilled in the particular treatment indicated. It should be mentioned that all these Clinics, together with that for treating Minor Ailments, are available for both the Maternity and Child Welfare and the School Medical Services, and for children attending Day Nurseries. From the Maternity and Child Welfare Clinics the following were sent to our own treatment Clinics:- Dental Clinic: 164 mothers, 143 children. Orthopaedic Clinic: 41 children. Artificial Sunlight: 52 children. Rheumatism Clinic: 3 children. Eye Clinic: 12 children. Immunisation Clinic: In all cases, mothers bringing their children to the Maternity and Child Welfare Centres are asked to have them immunised against Diphtheria. ORTHOPAEDIC CLINIC. 41 children attended this clinic from the Maternity and Child Welfare Clinics. A classification of the conditions found and treated will be found in the "Schools" section of this report. ARTIFICIAL SUNLIGHT CLINIC: Dealt with 52 cases for treatment referred from Maternity and Child Welfare Clinic. DENTAL CLINIC: Miss Loretz, the Dental Surgeon, gives the following table of work done for mothers and children attending the Maternity and Child Welfare and Ante-Natal Clinics:- Chiswick Brentford Total Sessions devoted to treatment 50 47 97 Patients treated: Mothers 111 53 164 Children 88 55 143 Totals 199 105 304 Attendances: Mother 478 502 980 Children 260 205 465 Totals 738 707 1445 Teeth filled: Permanent 171 156 327 Temporary 115 61 176 Totals 286 217 503 Teeth extracted: Permanent 350 356 706 Temporary 179 169 348 Totals 529 525 1O54 Teeth treated with AgN03 108 81 189 Administrations of Nitrous Oxide 214 174 388 Dentures 10 13 23 Repairs 2 1 3 Scalings 27 38 65 Dressings 53 58 111 -13- « ANTE-NATAL CLINICS Two sessions are held weekly, one in Brentford and one in Chiswick. During the year 470 expectant mothers made 2,206 attendances. As 751 births were notified, this number represents 62.6 per cent of these births; the percentages in 1938 and 1937 were 64.7 and 53.4- respectively. At her first attendance each mother is given a general systematic examination and a blood tost is done if there is any indication that such an investigation is necessary. She is asked to attend the Clinic each month during the earlier periods, and weekly during the last month of pregnancy, unless it happens that more frequent examinations anr required. If & patient does not keep her appointment and in certain conditions of health, she is visited by one of the Nurses. 650 ante-natal visits were made during the year, which included visits in connection with the investigation of home conditions. POST NATAL CLINICS. These are held once weekly in eceh district, at the end of the ante-natal Session. all mothers attending the Ante-Natal Clinics are invited to these Clinics after their confinements, but only a small percentage attends. During the year 56 mothers made 92 attendances, or 7.5 percent of the notified births. The conditions found and treatments adopted were similar to those referred to in previous reports. SUPPLY OF MILK AND POOD: The following information was given to tho Ministry on Peru M.& C.W.96.- Terms of Supply Milk Meals supplied at Dining Centres. Other Poods Expectant Mothers. Nursing Mothers Children under 5 yrs Expectant Mothers Nursing Mothers Children under 5 yrs Expectant Mothers. Nursing Mothers. Children ! under 5 yrs. Free, or at loss then cost price in necessitous Cases Yes Yes Yea NO NO NO Yes Yea Yes At cost price, in other caaes (e.g.) sale of dried milk at Centres Yes Yes Yea NO NO NO Yes Yes Yes *Cod Liver Oil and Malt, Virol, Bemax, etc., Total quantity of milk supplied during the year to expectant and nursing mothers and young children:- Liquid Dried Milk Milk (gallons) (1bs.) (i) By the Council 943 11149 (ii) By voluntary associations operating in area of the Council Nil Nil TOTALS 943 11149 ANTE-NATAL CLINICS district Number of clinics held during year. Number of expectant mothers attending for the first time. Total number of expectant mothers attending. Number of post-natal mothers attending. Total number of attendances made. Average attendance per session Brentford 57 150 194 12 865 15 Chiswick 46 275 276 44 1341 28 TOTALS 103 425 470 56 2206 21 -14- -15- MATERNAL MORTALITY, The following two deaths connected with pregnancy were reported during the year, as under: Age. Where died. Cause of Death. If attended Ante-Natal Clinic. 1). 25 West Middx. Hospital. Acute dilation of stomach and peritonitis following self-induced abortion. 2) 26 Queen Charlotte's Hosp. Post-partum haemorrhage. Severe toxemia of pregnancy. The following table shows the number of deaths connected with pregnancy during the last ten years:- Year Died from Sepsis. Died from other causes connected with pregnancy. 1930 4 2 1931 1 3 1932 1 1 1933 3 2 1934 1 3 1935 - - 1936 2 3 1937 - - 1938 2 2 1939 - 2 TOTAL 14 18 This shows an average of 3.1 Per year for the last ten years. INSTITUTIONAL PROVISION FOR MOTHERS AND CHILDREN: Other than the Maternity Hospital under the control of the Joint Hospitals Committee, the Council make no actual provision for institutional treatment for mothers and children. Such requirement is, however, adequately met by the Hospitals under the control of the Middlesex CountyCouncil, as well as the local voluntary Hospitals, who are always willirg to accept recommended cases. MIDWIVES ACT, 1936, The Middlesex County Council is the Supervising Authority for the Borough, and Queen Charlotte's Hospital undertakes the Domiciliary treatment of Midwifery. A Nurse from this Hospital attends each Ante-Natal Clinic in the Borough, so that all necessary arrangements can be made with those mothers wishing to engage their services, and also so that they may obtain reports on the health and special conditions of the prospective patients. The service has five auto-bicycles and two small cars which enable the Nurses to reach their patients quickly at any time of the day or night. It also enables them to carry a Gas and Air Analgesic Apparatus to each case. HEALTH VISITORS: Six Nurses are engaged in this work, but as each Nurse is also halftime School Nurse, the equivalent of whole-time services devoted by the whole staff to Health Visiting (including attendances at Infant Welfare Centres) is three. -16- A brief summary of their work during the year is shown in the following Table:- Number of visits paid during the year by all Health Visitors:- (a) To expectant mothers: First Visits 431 Total Visits 650 (b) To children under 1 year of age: First Visits 619 Total Visits 1852 (c) To children between the ages of 1 and 5 years: 2741 (d) Other Visits: ophthalmia Neonatorum 14 Whooping Cough 16 Epidemic Diarrhoea — Infant Life Protection Visits 235 TOTAL 5508 CHILD LIFE PROTECTION (UNDER THE PUBLIC HEALTH ACT, 1936). The six Health Visitors and School Nurses employed by the Council are appointed Infant Life Protection Visitors under the above-mentioned act, and as will be seen from the summary of visits made as shown above, combine the work with that of Health Visiting. In addition to the visits from the Health Visitors, the majority of the foster-parents are required to bring foster-children to the Child Welfare Clinics for periodical medical examination. The following table sets out particulars of registration during the year:- 1), Number of foster-parents on the Register: (a) At the beginning of the year 29 (b) At the end of the year 26 2). Number of children on the Register: (a) At the beginning of the year 37 (b) At the end of the year 31 (c) Who died during the year - (d) On whom inquests were held during the year - DAY NURSERY. The Day Nursery, situated in Bennett Street, Chiswick, was established in 1910 by private enterprise and handed over to the Local Authority in 1923. The following details may be noted here:- Hours of opening: Mondays to Fridays, 7.45 to 6.30 p.m. Saturdays, 7.45 a.m. to 1.0 p.m. Parents or Guardians are responsible for conducting the children to and from the Day Nursery. Age Limits of Children accepted: From day of birth to school age. Accommodation provided: Playrooms, bathrooms, nurses' pavilion (separate from Day Nursery), kitchens, etc. Capacity of Nursery: 42 children in winter and 45 in summer. -17- Charge to parents: 9d per day, and 5d per half day. The Staff of the Day Nursery consists of one Matron, one Staff Nurse, and five probationers. The attendances made during 1939 were as followss:- Whole days 9,984 Half days 987 The site on which the Nursery stands is required in connection with the Great West Hoad extension scheme, so it is necessary to re-build olswhere. An admirable site has been obtained, and plans for a new Nursery have been submitted. (Owing to the outbreak of war nothing Further has been done in this matrer.) -18- SECTION 'C: SANITARY INSPECTION OF THE AREA. 1, WATER SUPPLY: Direct from the mains of the Metropolitan Water Board throughout the Borough, with the exception of one small private house and three factory premises, which draw their supplies from private wells. Samples from the latter were quite satisfactory. 2. DRAINAGE AND SEWERAGE2:- Particulars of drainage works carried out in the Borough will be found in the attached tables. No main sewerage works were carried out during the year. The soil sewerage system of the Borough is connected up with the West Middlesex Scheme, with its sewage works in the neighbouring Borough of Heston and Isleworth. 3. RIVERS AND STREAMS: No serious complaints dealt with during the year. 4. CLOSET ACCOMMODATION: All houses etc., supplied with water-closets connected with the sewerage system, except in three cases. 5. PUBLIC CLEANSING: Under the supervision of the Borough Engineer's Department. Weekly collection of house refuse with more frequent collection from the large blocks of residential flats. The Borough refuse is disposed of by barging to a site on the lower reaches of the Thames. 6. SANITARY INSPECTION OF AREA. Tabular Statement of the Work of the Sanitary Department,1939• INSPECTIONS. Number of premises inspected on complaint 821 Number of premises inspected in connection with infectious disease 163 Number of primary inspections 2573 Number of re-inspections 2100 Total number of inspections and re-inspections 4673 ACTION TAKEN (other than Housing Act,1936). Cautionary or intimation notices served 733 Statutory Orders issued (under Public Health Acts) 3 Summonses served - Number of Certificates under Rent &c. (Restrictions) Acts issued to Tenants 5 Number of Clearance Certificates issued to owners 1 Particulars of Sanitary Defects referred to in Notices served and other Matters. (a) DRAINAGE OF EXISTING BUILDINGS. New W.C's provided, repaired, supplied with water or otherwise improved 180 Percentage of houses provided with waterclosets 100% Tested (smoke) 37 Unstopped, repaired, traoped, etc 78 Waste pipes, rainwater pipes disconnected, repaired, etc 48 New soil pipes and ventilating shafts fixed 37 New sinks provided 39 Disconnecting traps and chambers inserted 32 -19- (a) DRAINAGE OF EXISTING BUILDINGS (Contd). Reconstructsd (whole system) 7 Reconstructed (connections) 29 Percentage of houses draining into sewers 99.9 Surface water drains reconstructed 3 Surface water drains repaired 4 (b) W^TER supply AND WATER SERVICE. Draw taps on main 17 Percentage of houses supplied from Public Water Service 99.9 (c) REFUSE. New bins provided 40 Frequency of refuse removed from each house Weekly Number of Complaints received -Dealth with by Engineer's Department. Method of disposal: Barging away to controlled tip. (d) SUNDRY NUISANCES. Overcrowding Urgent casus reported to Housing Committee. Smoke - Minor complaints only 3 Accumulation of refuse 3 Foul ditches, ponds, etc., and stagnant water 7 Dampness 251 Yards repaired or repaved 34 Leaky roofs and eaves guttering 301 Premises repaired and cleansed 526 Other nuisances 509 (e) DISINFECTION. Premises disinfected: Ordinary notifiable diseases 139 Phthisis 26 Cancer 20 Other diseases 12 Rooms stripped and cleansed (Section l67, Public Health Act, 1936) - Premises treated for vermin 84 Premises treated for other pests 32 (f) SLAUGHTERHOUSES. Number on Register (including one Knacker's Yard) 5 Inspections made periodically at time of slaughter. Contraventions of bye-laws - Number of animals slaughtered in district during the year: Oxen 229 Sheep and Lambs 1307 Pigs 521 Slaughter of Animals Act, 1933: Number of licences to slaughter animals issued during the year: New Licences 1 Renewed Licences 9 MILK AND DAIRIES (AMENDMENT) ACT, 1922. MILK (SPECIAL DESIGNATIONS) ORDER,1936. MILK AND DAIRIES ORDER, 1926. -20- Number of premises registered: (a) Selling loose milk 13 (b) Selling in bottles and sealed containers 36 (c) Selling in scaled cartons only (B.D.Milk) 31 TOTAL 80 Number of Licences issued to sells (a) Tuberculin Tested Milk 7 (b) Accredited Milk 1 (c) Pasteurised Milk 17 Bakehouses. Number in district in use 20 Contraventions of Factory Acts - UNSOUND FOOD. MEAT: Beef 89 1bs. Lambs' Liver 10 1bs. Bacon 46 1bs. Chicken 17½ 1bs. FISH 1 cwt. PEAS (57 bags) 1 tn, 1 qr,121bs OFFENSIVE TRADES. Number of premises in district 18 Nature of trades: One soap boiler, two rag and bono dealers and fifteen fried fish shops. Number carried on under yearly licence 3 Number of inspections made 38 CANAL BOATS. Number registered during the year: Motor propelled boats - Other boats (wide) Nil Registration Certificates cancelled Nil Number of Duplicate Copies of Registration Certificates issued Nil Number of boats inspected Nil Number of complaint notes signed Nil Number of boats on Register: Motor propelled boats 97 Other boats 418 PETROLEUM ACTS. Number of applications received for licences to store and sell petroleum spirit 107 Number of applications received for licences to store and sell patroleum mixture 19 Number of applications received for licences to store and sell carbide of calcium 9 Number of gallons of petroleum spirit covered by licences 194,178 Number of gallons of petroleum mixture covered by licences 1935 Quantity of carbide of calcium covered by licences. 16 tons 15 cwts 24 1bs. -21- FACTORIES, WORKSHOPS AND WORKPLACES. 1. INSPECTION OF FACTORIES, WORKSHOPS AND WORKPLACES. Including Inspections made by Sanitary Inspectors, Premises. Number of inspections. Number of written notices. Number of prosecutions. Factories (including factory 86 - - Workshops (including work- 13 - - Workplaces (other than out- workers' premises - - - T0TAL; 99 - - 2. DEFECTS FOUND IN FACTORIES, WORKSHOPS AND WORKPLACES. Particulars. Number of Defects. Number of prosecutions. found. Remedied. Referredto H.M. Inspector, *NUISANCES UNDER THE PUBLIC HEALTH ACTS: ' Wantof cleanliness - - - - Want of ventilation - - - - Overcrowding - - - - Want of drainage of floors. - - - - Other nuisances 5 5 - - SANITARY ACCOMMODATION: Insufficient 1 1 — - Unsuitable or defective - - - - Not separate for sexes - - - - OFFENCES UNDER FACTORY ACT,1937: Illegal occupation of ground bakehouses (Sec.54) - - - - OTHER OFFENCES, excluding offences relating to outwork and offences under the Sect- ions mentioned in the Schedule to the Ministry of Health (Factories and Workshops Transfer of Power - - - - TOTals 6 6* - - *Remedy secured by personal visit or letter. 7. SMOKE ABATEMENT: See preceding tables. Little trouble was experienced in this connection during the year, and it was not found necessary to issue any statutory notices under the Public Health Act, 1936. 8. SWIMMING BATHS AND POOLS: There are no privately owned swimming baths open to the public within the Borough. The Council have their own open air baths, situated at Chiswick and a covered bath at Brentford. In both cases the water is subject to constant filtration and cleansing. Samples are taken periodically by the Engineer's Bept, for examination, and no complaints as to the quality of the water wore received. -22- 9. ERADICATION OF BED BUGS: This problem is one that requires the careful consideration of every Local Authority, and during 1939 the Housing Committee of the Council have given and at tho time of writing are still giving the matter special consideration. (a) The number of houses found to be infested by and treated for bugs by the Public Health Department is as under:- (i) Council Houses 11 (ii) Other Houses 73 The figure under (i) above does not, however, reflect the true position, as where Council houses undergoing redecoration are found to be infested, disinfestation is carried out by the Works Department, and only in really bad infestations is this Department called in to help. (b) The method employed in disinfestation is mainly that of a contact insecticide. In bad cases all removable woodwork - such as picture rails, architraves and skirting boards - is taken down and burnt and the promises thoroughly sprayed with a proved insecticide. The woodwork is not replaced, but the walls are made good and a skirting formed with Keen's Cement. One or more sprayingsmay be necessary, (c) The Council now have the services of a very efficient Housing Manager, who I understand is doing valuable work by way of supervision and education of the tenants in the fight against this pest. 10. SCHOOL'S: The general hygiene and sanitation of the schools throughout the area is very good. Owing to the evacuation of school-children after the outbreak of war some of the schools were closed down. Two schools, Beverley Road and Hogarth Girls' School were utilised as Ambulance Stations. -23- SECTION 'D' HOUSING. The following statistics have been supplied to me by the Borough Engineer:- Number of new houses etc., erected during the year 1939:- (1) Total number of new houses and flats erected within the Borough 41 (2) Number of new houses erected by the Local Authority with State assistance under the Housing Acts; (a) within the Borough (included in (1) above) 8 (b) Outside the Borough area Nil N.B. - The Council have a Differential Rent Scheme in operation whereby necessitous cases are enabled to enjoy a lower rental than the normal during periods of unemployment or other distress. Appended is a tabular statement of the work carried out under the Housing (Inspection of District) Regulations, 1925, From this it will beseem that 509 houses were inspected under the abovementioned Regulations during the year. HOUSING ACT, 1936. Dealing with the progress made with the putting into effect of the scheme prepared by the Council and submitted to the Ministry of Health in connection with "Slum Clearance," etc., as required by the provisions of the Housing Act, 1930 (now incorporated in the above-mentioned Act), the following summary sets out the actual position at the end of 1939:- (a) Number of Clearance Orders (including. Compulsory Purchase Orders) made by the Borough Council and confirmed or awaiting confirmation by the Minister of Health 35 (b) Number of houses actually demolished in Clearance Areas 268 (c) Number of houses where Clearance Orders have been confirmed but houses not yet demolished - (d) Number of individual houses demolished under Demolition Orders 8 (e) Number of houses whore Demolition Orders have been made but houses not yet demolished - *(f) Number of houses demolished by owners in anticipation of action by the LLocal Authority 31 *(g) Number of houses scheduled for demolition, but where official action is still to be taken 34 *This number is likely to be augmented considerably as and when the Council are in a position to re-house the displaced tenants. The following Table is a copy of the Quarterly Return (Form H.256) to the Ministry of Health and sets out the work. under the Housing Act, 1930, and the corresponding provisions in the Housing Act, 1936, from its commencement to the end of 1939. The figures referred to in the above summary, however, are not clearly reflected therein, as only such figures are included as relate to completed transactions under the Act, -24- WORK UNDER THE HOUSING ACTS, 1930 AND I936 (COPT OP OFFICIAL RETURN) SHOWING POSITION aT 31ST DECEMBER 1939 Number of dwellinghouses demolished Number of persons displaced up to 31st Dec.1939. Number of dwellinghouses made fit Unfit Houses Other Houses • PART A:- Clearance Area- (i) Land coloured pink 263 - 868 (ii) Land coloured Grey — - - PART B:- Improvement areas - - - PART C.- lasanitary houses not included in Clearance areaa or Improvement Areas. (1) Number of dwelling-houses demolished as a result of formal procedure under Section II 8 (2) Number of dwelling-houses demolished a St. result of informal notices preliminary to formal procedure under Section XI 31 (3) Number of dwelling-houses closed, but not demolished, as a result of undertakings ( which have not been cancelled) by owners under Section II not to use Houses for human habitation - (4) Parts of buildings closcd (Section 12) - (5) Number of persons displaced as a result of action: Under (1) above 46 Under ( 2) above No record. Under (3/ above - Under ( 4) above - (6) Number of dwelling-houses made fit: (i) as a result of formal notices under Sections 9 to 12 76 (ii) as a result of informal notices preliminary to formal procedure under Sections 9 to 12 3,845. HOUSING STATISTICS. 1. Inspection of Dwelling-houses during the year. (1) (a) Total number of dwelling-houses inspected for housing defects (under Public Health Act or Housing Acts) 769 (b) Number of inspections made for the purpose (primary) 769 (2) (a) Number of dwelling-houses (included under head (1) above; which were inspected and recordod under the Housing (Consolidation) Regulations. 1925 293 -25- (b) Number of inspections made for the purpose (primary) 293 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation Nil (*Houses in Clearance Areas and Individual Unfit Houses) (4) Number of dwelling-houses (exclusive of these referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 741 2, Remedy of Defects during tho year without service of formal Notices. Number of defective dwelling-houses rendered fit in consequeace of informal action by the Local Authority or their Officers 733 3. Action under Statutory Powers during the year, (a) Proceedings under Sections 9,10 and 16 of the Housing Act, 1936. (1) Number of dwelling-houses in respect of which notices were served requiring repairs 5 (2) Number of dwelling-houses which were rendered fit after service of formal notices: (i) by owners 5 (ii) by Local Authority in default of owners - (b) Proceedings under Public Health Acts: (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 3 (2) Number of dwelling-houses in which defects were remedied after service of formal notices (i) by owners 3 (ii) by Local Authority in default of owners (c) Proceedings under Suctions 11 and 13 of the Housing Act, 1936; (1) Number of dwelling-houses in respect of which Demolition Orders were made - (2.) Number of dwelling-houses demolished in pursuance of Demolition Orders made in 1937 7 (d) Proceedings under Section 12 of the Housing Act, 1936: (1) Number of separate tenements or underground rooms in respect of which Closing Orders were made — (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit - -26- 4. Housing Act, 1936 - Overcrowding, (a) ( i) Number of dwellings overcrowded at end of year 122 (ii) Number of families dwelling therein 123 (iii) Number of persons dwelling therein 938 (b) Number of new cases of overcrowding reported during the year 14 (c) (i) Number of cases of overcrowding relieved during the year 35 (ii) Number of persons concerned in such cases 238 (d) Particulars of any cases in which dwelling houses have again become overcrowded after the Local Authority have taken steps for the abatement of overcrowding Nil (a) Other information regarding statistics for 1939: (1) Number of overcrowded families at beginning of the year 143 (2) Now cases of overcrowding reported during 1939: (i) Families overorowded before "Appointed Day" (not previously reported) 4 (ii) Families overcrowded since "Appointed Day" due to natural increase etc 8 (iii) Families committing offcnces by overcrowding 2 Total new cases of overcrowding 14 (3) Overcrowding relieved during the year: (i) Families overcrowded before "Appointed Day" (a) Re-housed by Council 10 (b) abated by removal, decrease in family or extra accommodation taken over, atc 14 (ii) Families overcrowded due to natural increase: (a) Re-housed by Council 2 (b) Abated by removal, decrease in family or extra accomodation taken over etc 8 (iii)Overcrowding Offences: Solf-abated after notice 1 (1) Total cases re-housed by the Council during 1939 12 (2) Total cases relieving own overcrowding by removal, decrease in family or extra accommodation being taken over, etc. 23 Total cases relieved 35 -27- (4) Abatement of overcrowding in Council properties (included in (3) above:- ( i) Number of cases relieved by transfer to other Council properties 4 (ii) Number of cases who relieved their own overcrowding by removal, decrease in family or extra accommodation being taken over 9 Total cases relieved 13 (5) Position of Overcrowded Families at end of 1939: (1) Number of cases still overcrowded who overcrowded on "Appointment Day" 102 (ii) Number of cases still overcrowded due to natural increase etc 19 (iii) Number of cases committing offences 2 Total cases existing at end of 1939 123 BOROUGH OF BRENTFORD AND CHISWICK HOUSE-TO-HOUSE INSFECTION DURING THE YEAR 1939 STREET OR ROAD Number of Inspections. Houses let in two Tenements. Houses let in three Tenements. Houses let in four Tenements. , Number of Inhabitants Number of Living Rooms. Number of Sleeping Rooms. Average Number of NUISANCES AND SANITARY DEFECTS. Defective Drains. Defective Connections. Choked Drains. Defective Soil Pipes and Drain Ventilators. Defective Fresh Air Inlets. Absence of,and Broken Manhole Covers, etc. Absence of and Leaky and Defective Sinks. Defective Water-Closets. Water Supply to W.C.s. Leaky Roofs. Defective Eaves Guttering. Defective Waste,Rainwater Pipes, etc. Dampness in Walls,Floors, Insufficient Ashpits. Defective Paving of Yards, Outhouses, etc, Improper Situation of, or Construction of Drinking Water Cisterns. Premises requiring Repairing and Cleanslneg Overcrowding. Nuisances from Keeping Animals, ect. Accsingulations of stagnant Water Accuma Lations of off enslve Matter Manual, ect. Other Defeecits Adults Children TOTAL Persons Per House,including Children.. Living and Sleeping Rooms per House. EASTERN DISTRICT: Alkerden Road 22 15 1 — 107 19 126 66 71 5.7 6.2 - — — — - — 1 - 1 1 - 1 6 - - - 10 - - - - 10 Coomba Road 28 15 6 1 168 51 219 87 104 7.8 6.8 - - - - - - 5 3 6 6 - 3 16 1 4 - 28 - - - - 45 Duke Road (Part of) 72 26 - - 294 40 334 215 219 4.6 6.0 - - - 2 - - 7 5 3 18 3 5 35 1 3 1 36 - - 1 - 46 Ma nor Gardens 5 — — — 12 4 16 10 10 3.2 4.0 — — — - — — — 1 - — — - 2 3 - - 5 — - — — 3 TOTALS 127 _ 56 7 1 581 114 695 378 404 5.5 6.2 — — — 2 — - - 9 10 251 3 9 59 5 7 1 79 — — 1 - 104 CENTRAL DISTRICT: Belmont Grove 42 11 - - 174 31 205 129 117 4.9 5.9 - - - - 1 - - 2 4 7 3 5 16 3 - - 31 - - - - 47 Mills Cottages 5 - - - 13 2 15 5 10 3.0 3.0 — — — — — — — — — - - - — 3 1 — 3 — - — — 8 Mills Row 20 — — — 58 13 731 20 40 3.6 3.0 - — — — — —> — — 3 — 2 1 7 3 1 — 16 — — — — 36 TOTALS 67 11 — — 245 46 291 154 167 4.3 4.8 — — — — 1 — — 2 7 7 5 6 23 9 2 — 50 — — — 91 WESTERN DISTRICT: Braemar Road 54 - - - 165 12 177 109 135 3.3 4.5 - - - - - - - 2 1 12 - 1 9 3 4 3 19 - - 2 - 18 Green Dragon Lane 45 - - — 140 11 151 92 102 3.4 4.3 - - 3 • - - 2 1 3 18 4 2 5 2 4 - 26 - — 1 - 30 TOTALS 99 — — — 305 23 3,2c 201 237 3.3 4.4 - - 3 — — — 2 3 4 30 4 3 14 8 3 45 — — 3 — 48 GRAND TOTALS 293 67 7 1 1131 183 1314 733 808 4.5 5.3 - - 3 2 1 - 15 14 21 62 12 18 96 19 17 4 174 - - 4 - 243 -28- -29- SECIIOM E. INSPECTION AND SUPERVISION OF FOOD. (a) Milk Supply. The following statistics relate to the sale of milk in the area: Registration particulars; Number of premises registered: (a) Selling loose milk 13 (b) Selling in bottles and sealed containers 36 ( c) Selling in sealed cartons only (B.D.Milk) 31 TOTAL 80 In addition to the above, 11 persons are registered as "purveyors of milk" working from registered premises outside the Borough. There are no cowkeepers or farms within the Borough. Milk (Special Designations) Order, 1936. The following licences were issued by the Council under the above-mentioned Order: Number of Dealers' Licences to sell: (a) Tuberculin Tested Milk 7 (b) Accredited Milk 1 ( c) Pasteurised Milk 17 (b) Meat and Other Foods. The major portion of the meat supply to the Borough cornea through the Central Meat Market of London, but in addition there is one wholesale distributing, depot located in the Brentford "Wholesale Fruit and Vegetable Market, There are only four private slaughter-houses operating in the Borough in a small way, and in two only arc cattle slaughtered in very moderate numbers. (o) and (d) Adulteration etc. This Work is in the hands of the Middlesex County Council, and no samples were submitted to the County Analyst by this Authority. ' ' > (e) Nutrition - Dissemination of Knowledge. Ho special action was taken in this respect beyond that the , nutritional value of various foods is taught to children at the Domestic Subjects Centres and lectures arc given to mothers attending the Maternity and Child Welfare Clinics by the Health Visitors and to School Children by the Dental Surgeons. 30 SECTION 'F' PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES. The following Tables set out the particulars of the incidence of notified diseases within the Borough during 1936, including their classifications in "age" and "ward" distribution. A. - NOTIFIABLE DISUSES DURING THE YEAR. Disease. Total Cases notified. Cases admitted to Hospitals. Total Deaths. Small Pox - - - Scarlet Fever 123 101 - Diphtheria 30 29 2 Enteric Fever (including Para- typhoid) - - - Puerperal Pyrexia 4 4 - Pneumonia 32 4* 4 Erysipelas 6 2 - Dysontery 2 1 — Poliomyelitis 2 2 - Measles ф 1 1 — Whooping Cough ф 1 1 — *Full details of other patients suffering from Pneumonia who received hospital treatment are not available. ф Notifiable since 23rd October, 1939. B. - OPHTHALMIA NEONATORUM. Cases notified. Cases treated at Home. Cases treated in Hospital. Vision unimpaired. Vision impaired. Total Blindness. Deaths. - - - - - - - -31.- C.- AGES OF CASES OF INFECTIOUS DISEASES NOTIFIED DURING THE YEAR 1939. NOTIFIABLE DISEASE. NUMBER OF CASES NOTIFIED - At Ages - Years. At All Ages. Under 1 1 2 3 ;4 5 and under 10 10 and under 15 15 and under 20 20 and under 35 35 and under 45 45 and under 65 65 and over. Small Pox — — — — — — — — — — — — — Scarlet Fever 123 — 2 5 10 11 63 14 3 8 5 2 — Diphtheria 30 — 1 2 6 4 13 2 1 1 - — — Enteric Fever (including Paratyphoid). — — — — — — — — — — — — — Puerperal Pyrexia 4 — — — — — — — — 4 — — — Pneumonia 32 — 1 — — — 2 — 2 4 8 11 4 Erysipelas 6 — — — — — — — 1 1 1 2 1 Dysentery 2 — — — — — 1 — — — 1 — — Acute A nterior Poliomyelitis 2 — — — — — 1 — 1 — — — — Measles* 1 — — — — — — 1 — — — — — Whooping Cough* 1 — 1 — — — — — — — — — — *NOTIFIABLE SINCE 23RD OCTOBER, 1939. 32 D.- CASES OF INFECTIOUS DISEASES NOTIFIED DURING THE YEAR 1939. CLASSIFIED IN WARDS. NOTIFIABLE DISEASE. NUMBER OF CASES NOTIFIED Brentford East. Brentford Central. Brentford West. Bedford Park. Chiswick Park. Grove Park. Gunnersbury. Old Chiswick Turnham Green. Scaret FEver 9 14 14 1 18 26 16 21 4 Diphtheria 7 2 7 2 2 2 2 - 6 Enteric Fever (including Paratyphoid) - - - - - - - - - Puerperal Pyrexia 1 - - 1 - - 1 - 1 Pneumonia - 4 8 2 3 4 4 5 2 Erysipolas - 1 2 2 - - - - 1 Ophthalmia Neonatorum - - - - - - - - - Dysentery - - 1 - 1 - - - - Acute Anterior Poliomyelitis - 1 - 1 - - - - - Measlce - - - - - - 1 - - Whooping Cough - 1 - - - - - - - Tuberculosis - Respiratory 4 9 10 3 10 7 9 10 7 Non- respiratory 1 2 2 2 - 3 - 2 4 -33- The Hospital accommodation available for the Borough both for notifiable and non-notifiable infectious cases, is not only ample but up to date in every way. The Annual Report of the Medical Superintendent of the Joint Hospital, under the control of the Ealing and Brentford Hospitals Committee, was submitted to that Committee in the form of a special report and is therefore not included in this report. No doubt after the termination of the war, thn Medical Superintendent will issue a comprehensive report dealing with the Hospitals' activities during the whole war period. Notes on the incidence etc., of the principal notifiable diseasess- (1) Scarlet Fever. Number of cases notified during year = 123 Attack rate per 1,000 of population = 2.0 Number of cases receiving hospital treatment = 101 (2) (a) Diphtheriat:- Number of cases notified during year = 30 Attack rate per 1,000 of population = 49 Number of cases receiving hospital treatment = 29 .• * * (b) Diphtheria Immunization Clinic. This Clinic operated over a period of 7 months only up to the time of the Mid-Summer school holidays. Number of Clinics held = 25 Number of children attending = 400 Number of attendances made = 1560 Average attendance per clinic = 61 Number of certificates issued = 290 No child immunized during this or previous years was notified as suffering from Diphtheria. Prevention of Blindness. No action was taken under Section 176 of the Public Health Act, 1936 for the prevention of blindness or for the treatment of persons suffering from any disease or injury to the eyes. Tuberculosis. No action was necessary or taken by the Authority under the Public Health (Tuberculosis) Regulations 1925, or under Section 172 of the Public Health Act, 1936. The following Table gives particulars of new cases of Tuberculosis both pulmonary and non-pulmonary, notified during 193ri , as well as particulars of deaths which occurred as a result of the disease. -34- E. - TUBERCULOSIS. AGE PERIODS NEW CASES DEATHS. Respiratory don Respiratory Respiratory 1 Non 1 Respiratory Male. Female. Male. Female. Male. Female. Male Female Under 1 year - - - - - - - - 1 to 5 years 1 2 1 - - - 1 - 5 to 15 years - 1 - - - - - - 15 to 25 years 10 9 4 1 1 5 - - 25 to 35 years 7 12 2 2 3 4 - 2 35 to 45 years 7 4 1 2 5 4 - - 45 to 55 years 6 1 - - 7 1 - - 55 to 65 years 4 3 - 1 1 3 1 1 65 and over 1 1 1 1 1 1 - - TOTALS 36 33 9 7 18 18 2 3 The above figures again represent an average which appears fairly constant in this area. Respiratory Tuberculosis was responsible, for 36 deaths during the year. So far as can be ascertained, there is no particular evidence which points to excessive incidence or mortality in relation to any particular occupation. The efficiency of notification of this disease in the area is good, and no trouble in any way is experienced. The domiciliary, sanatorium and hospital treatment of the disease is under the control of the Middlesex County Council. (a) Disinfection Sc. Disinfestation. No change has taken place in the method of disinfection, viz, formalin Spraying, fumigation with Formaldehyde Gas and the stoving of bedding etc., as and when necessary. Terminal disinfection after Scarlet Fever, Diphtheria etc., is still in operation. Particulars of this work will be found set out on page 19. Disinfestation is referred to under Section C. (b) Laboratory Work. The following Table sets out a record of the bacteriological work during the year, all of which was carried out in the Council's Laboratory:- Suspected Disease. Result. Totals. Positive. Negative. Diphtheria 29 390 419 Tuberculosis 34 147 181 Other Diseases 1 3 4 N.B. - in addition to the above, a number of urine examinations were made in connection with the Clinics, etc. JOINT COMMITTEE FOR EDUCATION IN BRENTFORD & CHISWICK. ANNUAL REPORT ON THE MEDICAL INSPECTION OF ELEMENTARY SCHOOL CHILDREN FOR THE YEAR ENDING 31ST DECEMBER, 1939 R.C. LEANING, M.B., B.S., (Lond), M.R.C.S., L.R.C.P., D.P.H., R.C.S., (Eng)• School Medical Officer. -35- BOROUGH OF BRENTFORD & CHISWICK. EDUCATION ACT, 1921. REPORT ON THE MEDICAL INSPECTION AND TREATMENT OF ELEMENTARY SCHOOL CHILDREN FOR THE YEAR ENDING 31ST DECEMBER, 1939. To the Chairman and Members of the Education Committee. Ladies and Gentlemen, I beg to submit the following report on the work of the School Medical Service for the year 1939. Owing to the outbreak of hostilities in September of 1939, report is of necessity in an abbreviated form and should be regarded in the nature of an interim report, only such information as required by the Board of Education being given. 1. STAFF No material changes in the numbers and duties of the staff took place during the year. 2.- SCHOOL HYGlENE AND ACCOMMODATION. The accommodation of the schools in the Borough is of course fairly constant and may be taken as set out in my report for 1938. My remarks in that report relating to general hygiene also apply, as by reason of the outbreak of War tho Hogarth group of schools have so far not been affected by the construction of the new arterial road. 3- MEDICAL INSPECTION. As required by the Board of Education, the following inspections were made during the year:- (a) Routine Inspections. Of the three code groups, Entrants, Intermediates (viz. those of about eight years of age who have just been, or about to be, transferred from the Infants' to a higher school) and a group who will be twelve years during the year. There is also a fourth group of children of other ages who have not been examined in one of the above groups. This fourth group consists of children who were examined a few weeks before they left school and the findings were entered on special forms for the information of the Juvenile Employment Committee. 19 Entrants, 48l Intermediates, 488 Third Age Group and 284 Others (1272 in all) were examined during the year. (b) Special Inspections:- These arc special inspections made by the School Medical Officers of children suffering from some special disease or disability and are generally seen at the Minor Ailment Clinic. The figure below does not include the inspections of special groups of cases, such as cripples or children suffering from mental deficiency or those attending clinics other than the Minor Ailment Clinic, or school classes in which there have been cases of certain infectious diseases. 959 Special Inspections were made during the year. -36- (c) Re-inspections, 1156 in number. FINDINGS OF MEDICAL INSPECTIONS. The number of individual children found at Routine Inspections to require 'treatment (excluding uncleanliness and Dental diseases) were Entrants 3; Second Age Group 113; Third Ago Group 112 and Others 32. Total 260. Uncleanliness. 28 Cases were seen at Routine Inspection and 6 at Special Inspection. Lega proceedings were taken in 1 case under the School Attendance Byclaws. During the year the nurses made 207 visits to the school for personal hygiene inspections, an average of 8.6 visits per school. They made 17860 examinations, viz. 16776 inspections and 1084 re-inspections. Defects were found in972 instances and the number of individual children found to be unclean was 371. The distribution of these defective children was as follows:- Brentford Area:- Lionel Road. 25; St. John's 31; St.George's 19; St. Paul's 11; Ealing Rd Juniors 7; Ealing Rd. Infants' 9; Canal Boat 19; Senim.v Girls' 6; Senior Boys' 2; and Clifden Rd. Infants' 1, Chiswick Area:- Hogarth Schools:- Infants' 46; Junior Girls' 40. Senior Girls' 29, Belmont Schools:- Infants' 15; Senior Mixed 6; Junior Mixed 12. Strand Schools:- Infants' 35; Junior Mixed 20; Senior Mixed 10. Beverley Infants' 26 Central Girls' 2 Minor Ailments. The following ailments requiring treatment, classified under this heading were found during the year:- Routine Inspections. Special Inspections. Total Skin(including Ringworm Scabies and Impetigo). 10 185 195 Minor Eye Defects (excluding squint and Defective vision) 13 31 44 Ear Defects 3 71 74 Dental Caries 123 21 144 Miscellaneous (minor injuries bruises, chilblains) etc . 18 121 139 -37- Tonsils and Adenoids. During the year 192 cases wore found - 124 at Routine and 68 at Special Inspections. Of these cases 101 (or 53%) required operative treatment, 48 being referred for Tonsils only, 1 for Adenoids only and 52 for both Tonsils & Adenoids. In addition 102 children were referred for other conditions of the nose and throat, chiefly acute or sub-acute catarrh. Skin Diseases. 195 cases of skin diseases were seen during the year, of which 38 were suffering from contagious impetigo. There were 3 cases of Ringworm of the scalp and 8 of the body. 43 cases of Scabies were seen. The remaining 103 were cases of boils etc. External Eye Disease. 44 cases were seen during the year. At Routine Inspections there were 11 cases of Blepharitis. At Special Inspections there were 15 cases of Blepharitis, 10 of Conjunctivitis, the remainder consisting of Styres, Cysts etc. Vision(including squint). 170 cases of Defective Vision were seen at Routine Inspections and 8 were brought to the Minor Ailment Clinic. Of these, 126 were referred for treatment and 52 were kept under observation as they were already supplied with glasses which appeared to be satisfactory. Of those above cases, 6 were suffering from squint, 4 being seen at Routine Inspections and 2 at Minor Ailment Clinics. They were all referred for treatment. Ear Diseases and Defective Hearing. 4 cases of Defective Hearing were seen. There were 37 cases of Otitis Media, 3 being found at Routine Inspections and 34 at Special Inspections. Dental Defects. At Routine Inspection 123 cases were found and at Special Inspection 21 cases were brought by parents. Minor Ailments. Inspections of special cases 959 Re-inspections of special cases 609 Number of individual children attending 2958 NUmber of attendances made 10242 Number of exclusion certificates issued 675 Number of return certificates issued 497 Tonsils & Adenoids. 41 children were operated upon at the West Middlesex Hospital. 12 received other forms of treatment by removing peptic teeth and getting them to attend the Orthopaedic Clinic for breathing exercises. -38- Eye Clinic. The attendances at the Eye Clinic were as follows:- Clinics Attendances Retino- Pre Spectacles Repairs. Others. held. including scopies. scrip issued. (reports) those for " tions. "eye drops" 26 702 233 196 172 90 110 Orthopaedic Clinie. No. of Children. Attendances. School Children. For general deformities 196 657 For breathing exercises 29 65 M & C.W, Children. For general deformities 41 l65 For breathing exercises Totals 266 888 Rheumatism Clinic. During the year 173 children (of whom 6l were new patients) made 443 attendances at the Rheumatism Clinie. The hospital treatment obtained is shewn as follows:- Hospital. Rheumatism. Heart Disease. Chorea. Royal Waterloo. 4 1 Royal Richmond. 14 3 West Middlesex. 13 - Totals 67 4 The Invalid Children's Aid Association obtained treatment at Convalescent Homes for the following cases:- Highgate Three, cases of Rheumatism and one of Chorea. St. Leonard's Three cases of Chorea. St. Monica's One erase of Chorea. Milford One case of Chorea. Walton-on-Thames One case of Rheumatism. Brighton One case of Rheumatism. Home visits by School Nurses. Number of visits 1108 Re-inspections. Re-examinations of (a) children found to be defective at Routine Inspections and (b) children found to be defective at Special Inspections. The total number of these examinations were 547 609 respectively, viz. 1156 in all. Sunlight Clinic. ~ No. of "hildren. Attendances. School Children, 87 256 fa. & C.W. -Children, 52 128 Totals. 139 384 -39- 4. SPECIAL REPORTS & TABLES. Attached will be found special report supplied to me by the Consulting Surgeon of the Opthalmic Clinic, a detailed report of the defects treated at the Orthopaedic Clinic and the special tables required by the Board of Education. With regard to co-operation with parents, other organisations etc., there was practically no variation from that stated in previous reports. "I have pleasure in submitting a report of the Eye Clinic for 1939. Owing to the War, the Eye Clinic was closed during the autumn, but it has been working again since the beginning of February 1940. In this matter Brentford has shown great initiative as this is the first eye clinic in the London region to re-open since the war began. During 1939 there were 292 examinations made, excluding weekly examinations of cases which were being treated for squint and "lazy" eyes. Of these, 247 were of Council School children, and 45 of County Schools children. The majority of these were cases of defective vision. In passing, I should like to pay a tribute to the efficiency of the nursing staff, firstly for their care in conducting the school examinations, which they always carry out with the greatest efficiency, and secondly for the efficient way in which they conduct the clinic itself. The proportion of eye defects shown in the clinic bear a close relation to those quoted by other statistics. A short table is appended. Myopia (short-sighted) 45 cases 19% Hypermotropic (Long sighted) 48 cases 20% Myopia astigmatism 42 cases 17.5% Hypermetropic astigmatism 62 cases 26% Squint Internal 15 cases 5% Squint,External 2 cases 1% "Lazy" eye 18 cases 7½% External eye diseases: Acute Conjunctivitis 6 cases 2.5% Blepheritis and styes 16 cases 8% Phlyctenular Conjunctivitis 4 cases 1.5% It must be remembered that some cases appear twice in this table, where two conditions were coincidental. County School children. Myopia 19 cases 37.5% Mypermetropia 3 cases 7% Miopia astigmatism 14 cases 29% Hypermetropic astigmatism 5 cases 12% Conjunctivitis 1 case 2% The high incidence of short sighted children here is due to the fact that these children have been preselected, it being a well known fact that myopic children are naturally more studious than the normal. The new departures from the previous procedure have been adopted; the children with "lazy eyes have been formed into a special group, attending weekly or fortnightly, and having the good eye covered under supervision with a plaster pad, to make the "lazy" eye work properly. This has also been applied in certain selected cases of squint. Secondly, all cases of myopia are examined as a routine every six months, to avoid the missing of any cases of progressive myopia. These children, when discovered are seen at monthly intervals and kept on Calcium by the mouth, to keep the short sight from progressing at too rapid a rate Only one case of progressive myopia has failed to respond out of 12 cases treated; this was probably a case of congenital origin, and in any case was very far progressed by the time it ca me to the clinic. -40- The health of the children seen, is of a very high standard as can be gauged by the very low incidence of Phlyctenular Conjunctivitis (4 cases), a disease chiefly of malnutrition. The only other case of interest was a pair of male twins with exactly similar eye defeats, such that their glasses were interchangeable. Orthopaedic Report. 1. Congenital- Defects. School Welfare. A.-Club-Foot - - B. Metatarsal Varus, pes arcuatus 1 1 C. Irregular Toes 4 2 D. Dislocation of the hip. 2 - E. Spastic paralysis. 2 - F. Other conditions. 2 - 2. Birth Injuries. A. Nerve injuries. 1 - B. Fractures. - - C. Torticollis. 1 2 D. Other conditions. - - Rickety Deformities. 0 A. Bow Tibea. 6 8 B. Knock Knees. - 1 C. Bow Legs - Intoeing. 3 2 D. Other Conditions, - 4, Knock Knees (Non-rickety) 13 9 4a Q.C.T. do . 1 10 5. Postural Defects of the spine including flat chest. 23 - 6. a. Structural curvature of the spine. - - b. Depressed sternum etc. 2 - / 7a. Flat Feet. 14 2 b. Foot Strain. 6 - c. Pes cavus when not due to A.P.M. - - d. Hallus valgus. 2 - e. Hammer Toes. 2 - f. Hallux Rigidus 1 - 8. Infantile Paralysis. 2 1 9. Sequelae of acute fevers (details) and septic arthritis. 2 - 10a Fractures. 2 / - b.Other injuries. 6 11. T.B. Joihts. - - 12. Other bone diseases (Non T.B) 3 13. Osteomyelitis. - - 14. Other conditions including postural intoeing. 4 2 15. Non Orthopaedic. - - l6. Nothing abnormal discovered. 4 1 ) BOARD OF EDUCATION. MEDICAL INSPECTION RETURNS . YEAR ENDED 31st DECEMBER, 1939. BRENTFORD AND CHISVICK. TABLE 1. MEDICAL INSPECTIONS OF CHILDREN ATTENDING PUBLIC ELEMENTARY SCHOOLS. A. ROUTINE MEDICAL,INSPECTIONS. Number of Inspections in the prescribed Groups Entrants 19 Second Age Group 481 Third Age Group 488 Total 988 Number of other Routine Inspections 284 Grand Total 1.272 B. OTHER INSPECTIONS, Number of Special Inspections and Re-Inspections 2,115 TABLE 11. CLASSIFICATION OF THE NUTRITION OF CHILDREN INSPECTED DURING THE YEAR IN THE ROUTINE AGE GROUPS UP TO 31st AUGUST, 1939. Age-groups Number of Children Inspected A Excellent B Normal C Slightly" Subnormal D Bad No. 07. /O No. % . No. % No % Entrants 19 2 10.5 13 68.4 4 21.1 - - Second Age-group 481 165 34.3 220 45.7 94 19.5 2 ■0.4 Third Age-group 488 193 39.5 223 45.7 69 14.1 3 0.6 Other Routine Inspections 284 187 65.8 86 30.3 4 3.9 - - Total 1,272 547 43.0 542 42.6 178 14.0 . 5 0.4 TABLE III BLIND CHILDREN. Children who are totally, or almost totally, blind and can only be appropriately taught in a school for blind children. Name. Age Address. At a Public Elementary School. At another Institution At no School or Institution. Burridge Pamela (Progressive retinitis pigmentosa) 14 132 Whitestile Rd., Brentford. East London School. DEAF CHILDREN. Children whose hearing is so defective and whose speech and language are so little developed that they require education by methods used by deaf children without naturally acquired speech or language. Name | Age. Address. At a Public Elementary School. At another Institution At no School or Institution. Endersby Eric 8 51 Carville Cres. Brentford. - Anerley. - Endersby Robert 13 51 Carville Cres. Brentford. - Anerley. - Colegate Florence 16 5 Horticultural place, Chiswick. - Oak Lodge. - Simmonds Sylvia 11 27 Wellesley Rd., Chiswick. - Anerley. - BOARD OF -EDUCATION. MEDI-CAL INSPECTION RETURNS. TABLE IV. TREATMENT TABLES. .... ' ■ i GROUP 14 - MINOR AILMENTS (excluding Uncleanliness> for which see Table VI.) Disease or Defect. Number of Defects treated, or under treatment during the year. Under the Authority's Scheme. Otherwise. Total. : Skin:- Ringworm - Scalp (1) X—Rav Treatment 1 - 1 (2) -Other " 2 - 2 Ringworm Body 8 - 8 40 - 40 Other- skin disease 37 97 - 37 97 Minor Eye Defects:- (External and other, but excluding cases falling in Group 11) 31 - 31 Minor Ear Defects 71 - Miscellaneous (e.g. minor injuries, bruises sores, chilblains etc.) 121 18 139 TOTAL 408 18 426 GROUP II DEFECTIVE VISION AND SQUINT (excluding Minor Eye Defects treated as Minor Ailments - Group II) Number of Defects dealt with. Under the Authority's Scheme. Otherwise. Total ERRORS OF REFRACTION (including squint) 233 - 233 Other Defect or Disease of the eyes (excluding those recorded in Group 1) - - - TOTAL 233 - 233 GROUP 11 (continued) Under the Authority's Scheme. Otherwise. Total. No. of children for whom spectacles were:- (a) Prescribed 196 - 196 (b) Obtained 172 - 172 GROUP 111 - TRSATMENT OF DEFECTS OF NOSE AND THROAT. NUMBER OF DEFECTS. Received Operative Treatment Received other forms of Treatment. Total Number Treated. Under the Authority's Scheme in Clinic or Hospital. By Private Practitioner or Hospital apart from the Authority's Scheme. Total 1 2. 3. 4. 1. 2. 3. 4. 1. 2. 13. 4. - - - - - - 41 • - - 41 - 12 53 1. Tonsils only. 2. Adenoids only. 3. Tonsils and Adenoids. 4. Other defects of the nose and throat. GROUP IV - ORTHOPAEDIC AND POSTURAL DEFECTS. Under the Authority's Scheme Otherwise Total Number treated. Residential treatment with education. Residential treatiaent without education. Nonresidential treatment at an orthopaedic clinic. Resideatial treatment with education. Residential treatment without education. NonResidential treatment at an orthopaedic clinic. 5 - 92 - - - 92 TABLE V - DENTAL INSPECTION AND TREATMENT. 1) Number of children inspected by the Dentist:- a) Routine age-groups:- Age 4 5 6 7 8 9 10 11 12 13 14 15 16 Total Number 52 86 189 203 214 205 218 237 204 136 135 32 16 1,927 b ) Specials c)Total (Routine and Specials) 3,245 2) Number found to require treatment 2,472 4) Attendances made by children for treatment 4,592 . TABLE V (continued). 5) Half-days devoted to:- Extractions:- Insoection 22 Permanent Teeth 534 Treatment 599 Temporary Teeth 2,017 Total 621 Total 2,551 6) Fillings 8) Administrations of General Anaesthetics Permanent Teeth 3,322 Temporary Teeth 482 9) Other Operations:- Total Permanent Teeth 537 Temporary Teeth 415 952 TABLE VI - UN CLEAN LINESS AND VERMINOUS CONDITIONS. 1) Average number of visits per school made during the year by the School Nurses 8.6 2) Total number of examinations of children in the 17,860 3) Number of individual children found unclean 371 4) Number of individual cnildren cleansed under Section 87 (.2) and (3) of the Education Act, 1921 25 5) Number of cases in which legal proceedings were taken:-