CAS 048 BOROUGH OF EAST HAM. PUBLIC HEALTH DEPARTMENT. Annual Report ON THE Health and Sanitary Condition of the Borough INCLUDING Report on the Isolation Hospital and Bacteriological Laboratory, AND THE REPORT TO THE EDUCATION COMMITTEE, BY W. BENTON, M.R.C.S., L.R.C.P., L.S.A., D.P.H., Medical Officer of Health, Medical Superintendent of the Borough Hospital, Medical Officer to the Education Committee. together with the report of the CHIEF SANITARY INSPECTOR, For the Year ended 31st December, 1910. South Essex Printing and Publishing Co., Ltd., High Street South, East Ham, E. 1911. To His Worship the Mayor, the Aldermen and Councillors of the Borough of East Ham. Gentlemen, I beg to present the Annual Report on the state of the Public Health and the record of Sanitary work during the year 1910, together with reports on the Isolation Hospital and Bacteriological Laboratory. The Report to the Education Committee is also included, together with an account of the work done in connection with Medical Inspection of School Children. The Report of the late Medical Officer of Health is, in accordance with the suggestion of the Local Government Board, incorporated with this. This year has been a most healthy one, due in my opinion to not having had such severe extremes of temperature. The General Death.rate being as low as 8.5— the lowest hitherto recorded, as also the rate of Infantile Mortality (90 per 1000 registered births). There has been a remarkable diminution of Infectious Diseases notified, viz., only 600. The Zymotic Death.rate being as low as 0.67. I am, Gentlemen, Yours faithfully, W. BENTON, Medical Officer of Health. Town Hall, East Ham, March, 1911. EAST HAM CORPORATION PUBLIC HEALTH COMMITTEE. Alderman J. Brooks, J.P., (Chairman). The Mayor (Councillor E. Edwards, J.P.). The Deputy.Mayor (Councillor Mukueu. Oakes, J.P.). Alderman O. R. Axstead, J.P. Councillor G. P. Dean. Alderman C. Northfield, J.P. Councillor J. Evans. Alderman J. Prince. .T.P. Councillor W. C. Ford, J.P. Councillor F. Bradley. Councillor W. T. Howi.ett, L.T.C. Councillor G. Brown. Councillor H.Evan Jones, J.P..C.C. Councillor T. W. Cashman, J.P. Councillor T. J. McCarthy, C.C. Councillor A. Coles. Councillor A. Taylor. Councillor F. G. Cos i! urn, C.C. Councillor C. J. Warwick. Councillor T. Hassan Cowi.er. CouncillorH F. Witiierspoox, C.C. STAFF OF THE PUBLIC HEALTH DEPARTMENT. W. J. Wori.ey, Junior Clerk. W. L. Garrett, Junior Clerk. F. J. Kendall, Chief Cleric. Sanitary Inspectors : M. J. J. Hillyard, J. G. Anderson, G. D. Lii.l. School Nurse and Health 1 initor : Miss A. Kay. Matron of Isolation Hospital: Miss Wilson. Veterinary Inspector: H. J. Parkin, M.R.C.V.S. Chief Sanitary Inspector and Inspector Contagious Diseases (Animals) Act: Joseph G. Banks, A.R. San. I. Deputy Medical Officer of Health : W. A. Milne. M B., Ch.B., D.P.H. Medical Officer of Health. School Medical Officer, and the Medical Superintendent Isolation Hospital : W. Benton, M.R.C.S.. L.R.C.P., L.S.A., D.P.H. Fellow of the Royal Institute of Public Health. Fellow of the Society of Medical Officers of Health. Member of the lloyal Sanitary Institute. Member of Grays Inns of Court. 4 Summary of Report for 1910. Population, Census, 1901, 96,018. Persons per acre, 33. Estimated Population, 1910, 156,208. Persons per acre, 47. Inhabited Houses, Census 1901, 16,681. Estimated Inhabited Houses, 1910, 24,286. Births, 3,455. Birth.rate per 1,000, 22.1. Deaths, 1,330. Death.rate per 1,000, 8.5. Excess of Births over Deaths, 2,125. Zymotic Death.rate, 0.67. Infantile Mortality per 1,000 Births, 90. Total Rainfall, 23.6 inches. Borough Isolation Hospital, Roman Road, East Ham. Hospital for Small Pox, Dagenham (Joint Hospital). Water Supply— Metropolitan Water Board. COMPARATIVE STATISTICS. Rates per 1,000 of Population. Rate per 1,000 Registered Births. Births. Deaths. Zymotic Deaths. Infant Mortality. England and Wales 24.8 13.4 0.99 106 77 Great Towns 25.0 13.4 1.23 115 London 23.9 12.7 1.14 102 EAST HAM 22.1 8.5 0.67 90 5 STATISTICAL DATA. Year. Population. Rateable Value. General District Hate. Poor Rate and Education Rate. *1878 7,500 £33,661 3/. 2/6 1881 10,706 £9,401 3/. 2/6 1891 32,712 £127,721 2/. 3/2 1901 96,018 £341,088 3/6 4/9 1910 156,208 £516,795 3/9 6/1 * East Ham Local Government District was constituted on Oth December, 1878 ACTS OF PARLIAMENT, BYE.LAWS, AND REGULATIONS IN FORCE IN THE BOROUGH. SPECIAL ACTS. East Ham Improvement Act, 1898. East Ham Improvement Act, 1903. ADOPTED ACTS. Infectious Diseases (Notification) Act, 1889. do. (Prevention) Act, 1890. Public Health Acts Amendment Act, 1890. Public Baths and Wash.houses Acts. Housing of the Working Classes Act, 1890. Public Libraries Act, 1892. BYE.LAWS, REGULATIONS, ETC. Tents, Vans, and similar structures for human habitation. Removal of House Refuse. New Streets and Buildings and alterations to Buildings. Common Lodging Houses. Dairies, Cowsheds and Milkshops. Slaughter Houses, Bakehouses and Nuisances. Public Pleasure Grounds. Houses let in lodgings or occupied by members of more than one family. Hairdressers and Barbers Closing Order. 6 BOROUGH OF EAST HAM. PUBLIC HEALTH DEPARTMENT. REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1910. VITAL STATISTICS. POPULATION. The population of the Borough according to the Registrar General.s estimate at the middle of 1910 was 156,208. It is probable that this estimate is somewhat too high, and the population of the Borough is not so great as this (see Ward Population Table following), but for calculating the various rates in the report the estimate given by the Registrar General has been used. WARD POPULATION. The following table gives the population of each Ward according to (1) an enumeration of the occupied houses; (2) the estimate of the Registrar General:— Population based on Number of Occupied Houses. (1) Population according to Estimate of Registrar General. (2) Difference. Beckton and North Woolwich Ward 20,214 13,988 . 6,226 Central Ward— East 26,878 28.743 +1,865 Central Ward— West 24,971 28,994 + 4.023 Manor Park Ward 27,717 32,683 +4,966 Plashet Ward— East 19,066 23,974 + 4,908 Plashet Ward— West 24,034 27,826 + 3,792 BOROUGH 142,880 156,208 + 13,328 7 WARD DENSITY OF POPULATION. The area of the Borough excluding Inland Water is 3,326 acres. The estimated population at the middle of the year being 156,208, gives an average density of 46.9 persons per acre. The number of persons at the census of 1901 was 33 per acre. The density of the population in the different Wards varies considerably, depending chiefly on the open spaces and undeveloped land. Area in Density, acres. Beckton and North Woolwich Ward 901 15.5 Central Ward— East 622 46.2 Central Ward— West 513 56.5 Manor Park Ward 784 46.8 Plashet Ward— East 283 84.7 Plashet Ward— West 223 124.8 BOROUGH 3326 46 9 BIRTHS. The total number of births registered in the Borough during the year was 3,455. Of these 1,756 were boys and 1,699 girls, giving a rate of only 22.1 per 1,000 of population. The birth.rate of England and Wales for the year was 24.8 per 1,000, whilst the average rate for the 77 large towns was 25.0 per 1,000. 8 The following table gives the number of births and the birth.rate in the Borough as a whole and in each of the Wards:— Births Rate per 1,000 Population. Beckton and North Woolwich Ward 416 29.7 Central Ward— East 696 24.3 Central Ward— West 662 22.8 Manor Park Ward 757 23.1 Plashet Ward— East 401 16.7 Plashet Ward— West 523 18.8 BOROUGH 3,455 22.1 The birth.rate still continues to fall, being only 22.1 as against 23.5 for 1909, and for the past ten years an average of 307. The following table gives the population, the number of births and birth.rate for the past 10 years:— Year. Population. No. of Births registered. Birth.rate. 1902 104,023 3,805 36.5 1903 110,451 3,805 34.4 1904 116,902 3,717 31.7 1905 123,381 3,687 29.8 1906 129,886 3,656 28,1 1907 136,421 3,690 27.0 1908 142,976 3,534 24.7 1909 149,575 3,518 23.5 1910 156,208 3,455 22.1 On the opposite page the variations in the birth.rate during the past 20 years are graphically shown. Chart showing Birth Rate of fast Ham for the past 20 Years. 10 ILLEGITIMATE BIRTHS. The number of these registered was 80, which represents 2.3 per cent, of the total births. In 1909 the percentage of these was 1.4 per cent. 30 of these illegitimate births occurred in the Workhouse. The death.rate of these illegitimate infants under 1 year was equal to 287 per 1,000 births registered. The rate for legitimate infants of the same age being 86 per 1,000. DEATHS. I am pleased to note that the death rate for 1910 is the lowest yet registered in the Borough, giving a rate for the year of 8.5, as against 9.4 last year. The number of deaths which took place in the Borough during the year was 1,069. Of these 36 were non.residents of the Borough and can therefore be excluded. Particulars concerning them were sent to the district to which they belonged. 297 deaths were reported of persons belonging to the Borough which had taken place in various institutions outside the district. .44 occurred in the Workhouse, 125 in the Infirmary, and 128 in various Hospitals, etc. Including these we have a net total of 1,330 belonging to the Borough, which gives a rate of 8.5. Chart showing Death Rate of East Ham for the past 20 Year. 12 The following table, giving the net death rate for England and Wales and for the 77 Great Towns for the year 1910 has been taken from the quarterly returns of the Registrar.General. The position of East Ham is fourth on the list. Death Rate per 1,000. England and Wales 13.4 77 Great Towns 13.4 Hornsey 77 South Shields 13.6 Kings Norton 8.0 Birmingham 13.7 Handsworth 8.4 Leeds 13.7 EAST HAM 8.5 Portsmouth 13.8 Walthamstow 9.1 Newcastle.on.Tyne 13.9 Willesden 9.1 Bradford 14.0 Ley ton 9.3 Grimsby 14.0 Reading 9.9 Blackburn 14.2 Aston Manor 10.8 Brighton 14.2 Croydon 10.9 Coventry 14.2 Smethwick 10.9 Nottingham 14.2 Derby 11.1 Barrow in Furness 14.3 Burton.on.Trent 11.3 Great Yarmouth 14.4 Leicester 11.3 St. Helens 14.5 Northampton 11.4 Warrington 14.5 Tottenham 11.4 Bootle 14.7 Bristol 11.5 Bury 14.7 West Hartlepool 11.5 Rochdale 14.9 Devonport 11.6 Salford 15.1 Bournemouth 11.7 Dewsbury 15.2 Southampton 11.7 Wigan 15.2 West Ham 11.7 Hull 15.2 York 11.8 Stockton.on.Tees 15.2 Cardiff 11.9 Rhondda 15.6 Walsall 12.0 Stockport 15.7 Hastings 12.5 Sunderland 15.9 Norwich 12.5 Manchester 16.0 Wallasey 12.5 Birkenhead l6.2 Wolverhampton 12.5 Preston 16.2 13 London 127 Burnley 16.3 West Bromwich 127 Merthyr Tydfil 16.4 Halifax 12.8 Huddersfield 16.6 Gateshead 13.0 Stoke.on.Trent 16.7 Bolton 13.4 Middlesbrough 16.8 Newport (Mon.) 13.4 Tynemouth 17.1 Sheffield 13.4 Oldham 17.3 Plymouth 13.5 Swansea 17.6 Rotherham 13.5 Liverpool 17.7 Ipswich 13.6 Diagram shewing relative importance of various diseases as causes of (/eath during /S/0. 15 CORRECTED DEATH.RATE. Before any comparison can be made between various towns, correction must be made for varying age and sex distribution. The age and sex distribution influences the death.rate in East Ham on account of an excess of young people. The corrected death.rate for last year is equal to 9.0 per 1,000 of population. WARD DEATH.RATES. The number of deaths and the death.rate in each of the wards are given in the following table. For purposes of comparison the death.rate for the previous year is also given:— Ward. Deaths. Death.rate. (1910). Death.rate. (1909). Beckton and North Woolwich 132 9.4 11.1 Central— East 220 7.6 8.9 Central— West 281 9.7 10.3 Manor Park 275 8.4 10.5 Plashet— East 192 8.0 7.7 Plashet— West 230 8.2 8.4 BOROUGH 1,330 8.5 9.4 UNCERTIFIED DEATHS. One only was recorded, stated by the Registrar to be due to syncope and old age, as compared with two deaths for 1909. INQUESTS. 16 82 Inquests were held during the year. The following were the causes certified by the Coroner:— Under 1 year. 1 5 5 15 15 25 25 65 65 and over. Total. Heart Diseases . . . . 15 3 18 Suicides . — — 2 9 — 11 Falls — 2 — 1 3 . 6 Convulsions 3 2 — . — — 5 Pneumonia 1 4 — — — — 5 Suffocation (overlaid in bed) 5 — — — — — 5 Burns and Scalds — 2 — 1 1 — 4 Cerebral Hemorrhage . — — . 2 2 4 Murder 1 . — — 2 — 3 Street Accidents . — 2 — — — 2 Bronchitis 1 — — — — 1 2 Phthisis . — — 1 1 . 2 Alcoholism — — — . 1 — 1 Drowning . — 1 — — — 1 Diarrhoea . — — — . 1 1 Gastritis . — — — 1 . 1 Want of proper attention at Birth 1 — . — . . 1 Other Causes 2 3 — 1 4 . 10 INFANTILE MORTALITY. During the year 312 deaths of infants under 1 year of age occurred in the Borough. This equals a death.rate of 90 for every 1,000 births registered. 17 The number of infant deaths and the rate per 1,000 births For the past five years were as follows:— Year. Number of Infant Deaths. Rate per 1,000 Births. 1906 473 129 1907 386 105 1908 368 104 1909 334 95 1910 312 90 It is a source of gratification to find that the infantile mortality has again fallen and is the lowest recorded. Table V. gives a tabulated list of the causes of death of all children under 1 year of age. There was a diminution in the death.rate from Epidemic Diarrhoea in infants owing to there being no extremes of temperature. This disease is found to be much more common in bottle.fed infants. Once again the Wasting Diseases, which include Premature Birth, Atrophy, etc., are responsible for nearly 50 per cent, of infant deaths. These are practically unpreventable, as in most cases they are due to the parents. constitutional condition. With a view to remedying these conditions, the Notification of Births Act (1907) was passed, but has not yet been adopted in this Borough. In other districts where in force and a trained Nurse as Health Visitor has been appointed to call on and advise the parents as to the care and feeding of the children, the mortality from such causes as bad feeding and insanitary conditions has been diminished. B 18 Although there has been a severe epidemic of Measles during the year, there have only been three deaths of children under one year. Also one from Scarlet Fever and one from Diphtheria. The following table gives the rate of infantile mortality and other allied statistics for each Ward in the Borough for 1910:— Borough. Beckton & North W.lwich. Central East. Central West. Manor Park. Plashet East. Plashet West. Population 156,208 13,988 28,743 28,994 32,683 23,974 27,826 Births 3,455 416 696 662 757 401 523 Birth.rate 221 297 243 22.8 231 16.7 18.8 Deaths 1,330 132 220 281 275 192 230 Death.rate 8.5 9.4 76 9.7 8.6 8.0 8.2 Deaths under 1 year 312 46 57 59 75 39 36 Infant Mortality Rate 90 110 82 89 99 97 69 Death.rate per 1,000 births from Diarr. hœal diseases 12 17 19 10 10 5 10 Death.rate per 1,000 births from "Wasting diseases" 63 65 33 45 41 57 27 ZYMOTIC MORTALITY. The number of deaths from the seven principal Zymotic Diseases was 105. This equals a mortality rate of 0.67 per 1,000 of population. 19 The following table gives the number of deaths from each of the seven Chief Zymotic Diseases during the past five years:— Zymotic Diseases. 1906 1907 1908 1909 1910 Deaths Death. rate. Deaths Death. rate. Deaths Death. rate. Deaths Death. rate. Deaths Death. rate. Small Pox . . . . . . . . . . Scarlet Fever 18 0.13 22 0.16 24 0.16 15 0.10 3 0.02 Diphtheria 27 0.20 42 0.31 65 0.45 24 0.16 13 0.08 Enteric Fever 8 0.06 2 0.01 3 0.02 5 0.03 5 0.03 Measles 32 0.24 70 0.49 29 0.20 57 0.38 12 0.08 Whooping Cough 24 0.18 62 0.44 7 0.05 32 0.21 24 0.15 Diarrhcea 150 1.15 44 0.32 81 0.56 54 0.37 48 0.31 Totals 259 1.99 242 1.77 209 1.46 187 1.25 105 0.67 Deathsand Death. rate from all causes 1491 11.4 1504 11.0 1419 9.9 1412 9.4 1330 8.5 As will be seen from above table, the total number of deaths in 1910 is the lowest for the past five years. The number of deaths from each Zymotic disease and the death.rate per 1,000 of population from all these diseases in each Ward during 1910 is shown in the following Table:— Zymotic Diseases. Beckton and North Woolwich. Central East. Central West. Manor Park. Plashet East. Plashet West. Scarlet Fever 1 . 1 . . 1 Diphtheria 2 3 — 2 2 4 Enteric Fever 1 2 . . — — Measles — 4 2 5 ..... 1 Whooping Cough 2 6 5 7 — 4 Diarrhoea 8 14 8 9 3 6 Totals 14 29 17 24 5 16 Kate per 1,000 of population 1.0 1.0 0.6 0.7 0.2 0.6 20 NOTIFIABLE INFECTIOUS DISEASES. The total number of Infectious Diseases notified was 600. This is the lowest number for 20 years, being over 300 less than last year. During the past 5 years the total number of cases notified and the attack rates per 1,000 of population have been as follows:— 1906 1907 1908 1909 1910 No. of cases 1,230 1,617 1,634 966 600 Attack rate per 1,000 of population 9.4 11.8 11.4 6.4 3.8 The following table shows the distribution of the cases notified during the past year together with the death.rates and attack rates for each disease:— Notifiable Diseases. Cases notified. Deaths. Attack rate per 1,000. Death.rate per 1,000. Small Pox — — . — Scarlet Fever 329 3 2.13 0.02 Diphtheria 142 13 0.9 0.08 Enteric Fever 19 5 0.12 0.03 Puerperal Fever 6 4 . — Erysipelas 104 4 0.66 0.02 Total 600 29 3.8 0.18 The number of cases of each disease notified during the past year, the percentage removed to Hospital, and the attack rates per 1,000 of Population for each of the Wards are given in the Table opposite:— TABLE SHEWING NOTIFICATIONS OF EACH INFECTIOUS DISEASE FOR THE PAST FIVE YEARS—1906.1910 Scarlet Fever. Diphtheria. Typhoid Fever. Erysipelas. Puerperal Fever. Totals. 1906 1907 1908 1909 1910 1906 1907 1908 1909 1910 1906 1907 1908 1909 1910 1906 1907 1908 1909 1910 1906 1907 1908 1909 1910 1906 1907 1908 1909 1910 January 80 76 82 82 21 34 21 41 27 11 2 5 2 1 .. 13 14 13 5 7 2 1 1 .. 1 131 117 139 115 40 February 68 47 80 65 54 36 20 51 34 16 .. .. 2 1 20 12 9 8 7 1 1 .. .. .. 125 80 142 108 77 March 53 44 68 53 35 19 17 32 47 7 1 .. 2 .. .. 11 7 11 11 15 1 .. 1 .. .. 85 68 114 111 57 April 54 49 90 57 16 10 16 37 27 10 .. 6 .. .. .. 6 8 14 9 6 .. 1 .. .. .. 70 80 141 93 32 May 66 78 69 42 24 12 16 41 17 14 1 4 1 .. .. 10 11 12 4 5 .. .. 2 .. 1 89 109 125 63 44 June 35 55 58 55 26 11 10 43 13 16 5 3 1 .. .. 9 6 14 12 6 .. .. 1 .. .. 60 74 117 80 48 July 60 86 96 56 28 19 24 39 19 4 3 4 1 .. 1 7 5 14 5 6 .. .. .. .. .. 89 119 150 80 39 August 50 73 87 26 20 17 18 32 8 8 4 5 3 1 1 9 7 7 9 9 .. .. .. .. 1 80 103 829 44 39 September 49 117 115 35 24 25 55 33 17 11 9 2 2 3 3 10 12 13 7 8 .. 1 .. .. .. 93 187 163 62 46 October 108 157 97 35 18 30 71 46 22 20 8 2 2 .. 7 15 8 8 10 9 1 1 .. 1 1 162 239 153 68 55 November 94 184 89 25 41 20 51 30 25 11 2 3 2 2 3 22 14 23 10 16 .. .. .. .. .. 138 252 144 62 71 December 73 114 69 45 22 16 57 31 15 14 4 3 1 2 4 14 14 16 18 10 1 1 .. .. 2 108 189 117 80 52 Totals 790 1080 1000 576 329 249 376 456 271 142 39 37 19 10 19 146 118 154 108 104 6 6 5 1 6 1230 1617 1634 966 600 NOTIFIABLE DISEASES. CASES NOTIFIED IN EACH WARD. BOROUGH. ATTACK RATE PER 1,000 OF POPULATION. BOROUGH. PERCENTAGE OF CASES REMOVED TO HOSPITAL. BOROUGH. Beckton & North Woolwich. Central East. Central West. Manor Park. Plashet East. Plashet West. Beckton & North Woolwich. Central East. Central West. Manor Park. Plashet East. Plashet West. Beckton & North Woolwich. Central East. Central West. Manor Park. Plashet East. Plashet West. Small Pox — — . . . . . . . . . . . . . . . . . . . Scarlet Fever 52 34 77 50 36 80 329 3.7 1.2 2.7 1.5 2.8 2.1 82 68 74 90 6l 70 75 Diphtheria 22 26 16 33 19 26 142 1.6 0.9 0.6 1.0 0.8 0.9 0.9 77 84 87 76 89 77 81 Enteric Fever 1 6 3 6 1 2 19 0.07 0.2 0.1 0.2 0.05 0.07 0.1 100 83 100 83 100 50 84 Puerperal Fever — 3 2 1 — — 6 — — — — — — — — 66 — — — — 33 Erysipelas 3 15 22 31 15 18 104 0.2 0.5 o.8 0.9 o.6 0.7 o.6 33 20 14 10 — 6 10 Phthisis :— Poor Law 4 11 12 11 7 11 56 0.5 0.6 0.8 0.5 0.4 0.5 0.5 86 53 67 69 50 73 65 Voluntary 3 6 5 3 4 30 22 The following Table gives the total notification rate per 1,000 of population for each Ward during the past five years:— 1906. 1907. 1908. 1909. 1910. Beckton & N. Woolwich Ward 7.2 9.9 12.2 6.4 5.6 Central Ward— East 8.2 10.5 11.5 6.7 2.9 Central Ward— West 10.8 13.3 14.7 7.9 4.1 Manor Park Ward 8.5 16.1 11.6 6.7 3.7 Plashet Ward— East 8.2 9.5 11.1 6.1 2.9 Plashet Ward— West 11.8 9.0 7.8 4.7 4.5 SMALL POX. No case has occurred in the Borough for the past six years. SCARLET FEVER. 329 cases were notified during the year as compared with 576 cases during 1909. This disease diminished both in number and severity of attack. In some cases there was a doubt until desquamation occurred, and it is these cases that are so liable to spread the disease. The number of deaths from Scarlet Fever being only three, gives a death.rate of 0 9 per cent, as compared with 2.6 per cent, for the previous year. The following Table gives the number of cases of Scarle Fever notified, the attack-rate per 1,000 of population and the case mortality of the disease during the past five years:— Year. Population. Cases Notified. Attack rate per 1,000 of Population. Mortality per 100 Cases notified. 1906 129,886 790 6.08 2.2 1907 136,421 1,080 7.91 2.0 1908 142,976 1,000 6.99 2.4 1909 149.575 576 3.85 2.6 1910 156,208 329 2.11 0.9 23 DIPHTHERIA. The number of cases notified during the year was 142 as compared with 271 during the previous year. The number of deaths was 13, which gives a death.rate of 9.1 percent., as compared with 24 deaths and a death.rate of 8.8 per cent, during the yrar 1909. The Wards in which the disease was most prevalent were Manor Park, Central Ward East, and Plashet Ward West. In Plashet Ward West six of the cases were contact cases. The Bacteriological Laboratory has, in my opinion, been lesponsible for the diminution of cases and for the low death. rate in discovering early cases as well as contacts. The free supply of Antitoxine to Medical practitioners is still continued, and this also, no doubt, is responsible in keeping down the death.rate. The death.rate from Diphtheria was equal to 0.08 per 1,000 of population compared with 0.16 during the previous year. The rate for England Wales was 0.11, and the average rate for the 77 Great Towns was 0.11 per 1,000 of population. The following Table gives the number of cases notified, attack.rate per 1,000 of population, and the mortality percent, during the past five years:— Year. Population. Cases Notified. Attack rate per 1,000 of Population. Mortality per 100 Cases notified. 1906 129,886 249 1.90 10.8 1907 136,421 376 2.75 11.17 1908 142,976 456 3.19 14.25 1909 149,576 271 1.81 8.86 1910 156,208 142 0.91 9.15 24 ENTERIC FEVER. During the first six months of the year no cases of Enteric Fever were notified. In October, seven cases were notified, and in four of them a history of the patient having recently eaten shell-fish was obtained. Two other cases were of brothers who had been drinking impure water. The following Table gives the number of cases notified, the attack-rate and the death-rate from this disease during the past five years:— Year. Population. Cases notified. Attack rate per 1,000 of Population. Mortality per 100 Cases Notified. 1906 129,886 39 0.32 22.8 1907 136,421 37 0.27 5.4 1908 142,976 19 0.13 15.8 1909 149,576 10 0.07 50.0 1910 156,208 19 0.12 26.3 Of the 19 cases notified last year, 16 were admitted to the Borough Isolation Hospital, to the London Hospital, or to the Guardians' Infirmary. The number of deaths from this disease was five, which equals a rate of 0.03 per 1,000 of population. The rate for England and Wales was 0.05, and the average for the 77 Great Towns 0.05 per 1,000 of population. ERYSIPELAS. There were 104 cases of Erysipelas notified as compared with 108 during the previous year. 4 deaths occurred from this disease. The disease was of a mild character and being only slightly infectious most of the cases were treated at home. The few cases removed to the Isolation Hospital were those that could not conveniently be nursed at home. PUERPERAL FEVER. This disease is not nearly so prevalent as it used to be since nurses and midwives have been taught antiseptic methods of treatment. Six cases were notified during the year—.of these, 4 died of the disease. 25 TUBERCULOSIS. 163 deaths were registered from Tubercular diseases in various forms as compared with 149 last year. Tuberculosis of Lungs 111 Tuberculosis of Brain 28 General Tuberculosis 13 Abdominal Tuberculosis 6 Tubercular Larynx 3 Other forms of Tuberculosis 2 The number of deaths and the death-rate from all forms of this disease for the past five years are given in the following Table:— Year. No. of Deaths. Death-rate per 1,000 of Population. 1906 169 1.30 1907 175 1.28 1908 171 1.18 1909 149 0.99 1910 163 1.04 TUBERCULOSIS OF THE LUNGS (PHTHISIS) hi deaths were registered as due to this cause. 98 of these were between the ages of 15 and 65 years. This is the most important form of the disease from the Preventive Medicine point of view. There is a slight increase in the rate of last year. (1909 death-rate, 0.65; 1910 death-rate, 0.71). During the year, 56 cases have been notified by the Poor Law Authorities. Voluntary notification (that for which no fee is paid) has been a failure, but I am pleased to note that owing to free Bacteriological examination of sputum in the Laboratory for Medical Practitioners the true prevalence of the disease is more known. Each Practitioner in the Borough has been supplied with a sputum outfit, viz., a small wide-mouthed bottle in a tin, with instructions as to obtaining sputum and name and age of the patient, together with a short history of the illness. 26 There are about 60,000 persons who die from this disease every year in this country. The principal predisposing causes of Tuberculosis are insufficient and improper food, insanitary houses, personal uncleanliness and poverty. As Phthisis causes most deaths during the wage-earning period of life, i.e., between the ages of 25 and 65 years, it is a serious question for the nation, and Public Health Authorities should take concerted action, assisted by the State, to arrest the disease. We have, during the year, taken in some 14 cases for treatment at the Isolation Hospital, but the results were not satisfactory, as most of the cases notified and admitted were in an advanced stage. It is to be hoped that the time is not far distant when general notification will be brought about and then more cases might be treated with some measure of success. All cases notified are visited, and printed instructions are left giving information concerning the disease and disposal of sputum, etc. Pocket sputum bottles are supplied where the patient is unable to purchase one. Disinfection of the room occupied by a consumptive is carried out when possible, in fact the public are being gradually taught how infectious this disease is, and often write to the Public Health Department for their room and bedding to be disinfected. The introduction of Health Visitors by some Sanitary Authorities and Voluntary Health Societies, together with the "Press," have done good service in educating the public as to the nature of the disease and adoption of methods for prevention of the spread of infection. The advantage of taking these cases into a Hospital for open-air treatment is that they are taught the necessity of fresh air and amount of exercise to take, also the best food to combat the disease. 27 The distribution of Tuberculosis in the various Wards is shown in the following Table, which gives the number of deaths and death-rate per 1,000 of population:— Ward. No. of deaths registered. Death- rate. Beckton and North Woolwich Ward 17 1.2 Central Ward— East 31 1.1 Central Ward— West 36 1.2 Manor Park Ward 20 0.6 Plashet Ward— East 25 1.1 Plashet Ward— West 34 1.2 MEASLES. This disease was very prevalent during the year, but of a mild type. 577 cases were reported by the teachers in the Elementary Schools. It is very satisfactory to note that only 12 deaths occurred in the Borough during the year from this disease, as against 57 during 1909. Of the deaths, three were under the age of one year, and nine between one and five years of age. It was found necessary to close one School during the year (Fourth Avenue— Infants' Department only) and several other Schools were disinfected with marked results. The death-rate was equal to 0.08 per 1,000 of population, compared with a rate of 0.38 during the previous year. The death-rate from this disease in England and Wales was 0.22, and the average rate for the 77 Great Towns was 0.31 per 1,000 of population. In connection with this disease printed forms have been sent to each Infants' Department of the Elementary Schools, giving the symptoms of Measles, directions for isolation, and nursing, to be given to each child's parents. WHOOPING COUGH. 24 deaths occurred from this disease as compared with 32 deaths during 1909, 22 being under 5 years of age, This disease, as also Measles, is very fatal to young children on account of Respiratory complications such as 28 Bronchitis and more especially Broncho-Pneumonia, so that if by care infection can be prevented until after 5 years of age the chance of recovery is greater. MUMPS. No deaths were recorded from this disease. 224 cases were reported by the School Teachers, chiefly during the early part of the year. MALIGNANT DISEASE. 93 deaths were registered (including 7 from Sarcoma) as due to various forms of Cancer, compared with 102 during the previous year. The parts of the body attacked and the sex distribution of the cases are shown in the following table:— Parts affected. Males. Females. Total. Stomach and Alimentary Canal 17 15 32 Uterus — 7 7 Liver 8 5 13 Breast 1 7 8 Tongue and Throat 10 1 11 Bladder 5 1 6 Various parts 3 8 16 49 44 93 29 The number of deaths from Malignant Disease during the past 5 years is as follows:— Year. Deaths. Death-rate per 1,000 of Population. 1906 74 0.68 1907 77 0.57 1908 89 0.62 1909 102 0.68 1910 93 0.59 BACTERIOLOGICAL LABORATORY. The Laboratory is adequately equipped for examination of blood in Typhoid Fever cases, swabs from throats and Sputum. The Medical Practitioners in the Borough are given free diagnosis, and the number of examinations shows a yearly increase in cases of sputum. It is also made use of by the Assistant Medical Officer and the School Nurses where any suspicious throat cases come under supervision. An examination of a swab from the throat or discharges from a Diphtheria patient is always taken before the patient leaves the Isolation Hospital. The number of specimens examined each year since the Laboratory opened is shown in the following table:— 30 BACTERIOLOGICAL EXAMINATIONS. DISEASES SUSPECTED. Year. Tuberculosis. Diphtheria. Typhoid Fever. Ringworm, Meningitis, etc. . 1906 13 345 4 2 364 1907 51 418 — 14 483 1908 26 752 — 6 784 1909 31 936 — 2 969 1910 85 710 6 5 806 Total 206 3161 10 29 3406 The results of examination if positive are sent to Medical Practitioners either by telephone or special messenger. Negative results are sent by post. BAKEHOUSES, The whole of the Bakehouses are periodically visited by the Inspectors to ensure that the regulations as to cleanliness and ventilation are carried out. The Chief Sanitary Inspector and myself visited a number where this was net satisfactory, to which the owners' attention was drawn. COWSHEDS, DAIRIES AND MILKSHOPS. There are 6 cowsheds and 155 dairies and milkshops in the Borough. They are all inspected regularly to see if they are keDt in the best possible sanitary condition. Most of the milk is brought into the Borough by rail from the country districts of Essex. It is pleasing to note that dealers are recognising the fact that it is very important to prevent dust and micro-organisms gaining access to milk during storage. 31 In connection with quality and adulteration the County Council Authorities are at present responsible for the working of the Food and Drugs Act. Particulars of the samples taken and results of analyses are given on page 35. CUSTOMS AND INLAND REVENUE ACT. By the authority of Section. 26, 53 and 54 Vict., c. 8, and Section 11,3 Ed. VII., c. 46, exemption from Inhabited House Duty is granted to owners of tenements of an annual value of less than £10, if the Medical Officer is satisfied that they afford suitable accommodation for each of the families or persons dwelling therein and that due provision is made for their sanitary requirements. During the year a number of tenements were visited and many certificates were refused, the premises not being suitable for two families. Certificates were granted in respect of 46 tenements. DISINFECTION. 857 premises were disinfected during the year chiefly by spraying with Coal Tar disinfectant. The steam disinfector at the Isolation Hospital is used for bedding and other articles that require disinfection. FACTORY AND WORKSHOP ACT. Annual Report of the Medical Officer of Health for the year 1910 for the Borough of East Ham on the administration of the Factory & Workshop Act, 1901, in connection with Factories, Workshops, Laundries, Workplaces & Homework. 1 .— INSPECTION. Including Inspections made by Sanitary Inspectors. Premises. Number of Inspections. Written Notices. Prosecutions. Factories (Including Factory Laundries) 92 — — Workshops (Including Workshop Laundries) 385 16 — Workplaces (Other than Outworkers' premises included in Part 3 of this Report.) - - - Total 477 16 — 2— DEFECTS FOUND IN FACTORIES, WORKSHOPS, AND WORKPLACES. Particulars. Number of Defects. Number of Prosecutions. Found. Remedied. Referred to H.M. Inspector- Nuiscuices under the Public Health Acts :— Want of cleanliness 34 34 — — Want of ventilation 21 21 — — Overcrowding 4 4 — — Want of drainage of floors 1 1 — — Other Nuisances 51 51 — — Sanitary accommodation (1 w,c, required for 25 persons) insufficient 2 2 — — unsuitable or defective 1 1 — — not separate for sexes — — — — Offences under the Factory and Workshop Act: — Illegal occupation of underground bakehouse(s.lOl) — — — — Breach of Special sanitary requirements for bakehouses (ss. 97 to 100). 24 24 — — Other offences (Excluding offences relating to outwork which are included in Part 3 of this Report.) - - - - Total 138 138 — — 3.—HOME WORK. NATURE OF WORK. OUTWORKERS' LISTS, SECTION 107. OUTWORK IN UNWHOLESOME PREMISES, SECTION 108. OUTWORK IN INFECTED PREMISES, SECTIONS 109 & no. Lists received from Employers. Addresses of Outworkers. Notices served on Occupiers as to keeping or sending lists. Prosecutions. Inspections of Outworkers' ['remises Instances Notices Served. Prosecutions. Instances. Orders made (S. 110). Prosecutions (Sections 109, 110.) Sending twice in the Year. Sending once in the Year. Received frcm other Councils Forwarded to other Councils. Failing to keep or permit inspection of lists. Failing to send lists. Lists. Outworkers. Lists. Outworkers. Contrac tors. Workmen. Contrac tors. Workmen. Wearing Apparel— 120† 120† 204* (1) making, etc. 20 9 85 6 3 21 684 46 — — — 460 — — 2 — — (2) cleaning & washing Lace, lace curtains and nets - - - 1 1 2 1 2 - - - - - - - - - - Artificial Flowers — — — — — — — - — - — 1 — — — — — — Nets, other than wire nets Tents Sacks Furniture & Upholstery Fur pulling Feather Sorting Umbrellas, &c. — — — — — — — — — — — 1 — — — — — — Crdng&c,of buttons,&c - - - - - - - - - - - 1 - - - - - - Paper Bags and Boxes 2 — 10 — — — 1 5 — - - 5 - — — — — — Basket Making Brush making - - - - - - 1 - - - - 6 - - - - - - Racquet & tennis balls Stuffed Toys File making Electro Plate Cables and Chains Anchors and Grapnels Cart Gear Locks Latches & Keys Pea Picking Total 22 9 1 95 7 4 23 807 173 — — - 678 — - - 2 — - * Incorrect addresses, work given up, or removals. † Received in error. c 4.— REGISTERED WORKSHOPS. Workshops on the Register (s. 131) at the end of the year. Number. Wearing apparel Manufacturers 137 Bakehouses 50 Laundries 47 Printers 10 Other workshops 55 Total number of workshops on Register 299 5.- OTHER MATTERS. Class Number. Matters notified to H.M. Inspector of Factories :— Failure to affix Abstract of the Factory and Workshop Act (s. 133) 21 Action taken in matters referred by H.M. Inspector as remediable under the Public Health Acts, but not underthe Factory and Workshop Act (s. 5). Notified by H.M. Inspector 3 Reports (of action taken) sent to H.M. Inspector. 3 Other — Underground Bakehouses (s. 101) :— Certificates granted during the year Nil In use at the end of the year 10 35 FOOD AND DRUGS ACT. The Inspector for this district, Mr. McKirdy, has furnished the following particulars as to the number of samples taken and results of analyses during the past year:— Article. Number Submitted. Genuine. Adulterated. Milk 142 134 8 Butter 1l6 105 11 Bread 1 1 — Totals 259 240 19 Proceedings were instituted in 14 cases with the following results:— FOR BUTTER ADULTERATION. i dealer was fined £4 and costs 15s. 6d. 1 „ „ £3 I2S. 4 dealers were each fined £2 and costs 10s. 1 dealer was fined £1 and costs 10s. 1 dealer was fined 10s. and special costs £8 2s. FOR MILK ADULTERATION. 1 dealer was fined £6 and costs 12s., or one month. (Defendant was unable to pay and went to prison.) t dealer was fined £2 and costs 24s. 6d. 2 dealers were fined £2 10s. and costs 15s. 6d. 1 dealer was fined £1 and costs l1s. 1 dealer was fined £ 1 and costs 10s. In addition, for offences under the Margarine Act, four dealers were fined £1 and costs 18s. 6d., £1 and costs 5s., £2 and costs 10s., and £1 and costs 10s. Of the remaining cases of'adulteration, in two milk cases the amount was light and the vendor cautioned. Three samples of adulterated butter were purchased unofficially for detective purposes and no proceedings were possible on them. 36 FOOD AND MEAT INSPECTION. As far as practicable the strictest supervision is exercised by the Inspectors, who have had many years' experience in this important work. The Slaughter-houses have received constant attention and on two occasions during the year important seizures of Tuberculous meat were made at registered Slaughter-houses in the Borough. In both instances they were cows which had been imported for the purpose of being killed and prepared for human food, and had it not been for the vigilance of the Inspectors, there is little doubt that this object would have been achieved. The seizures were accomplished under difficulties, the carcases condemned, prosecutions in both cases instituted, and heavy penalties imposed. The Chief Inspector's Annual Report contains details. The markets and shops have been regularly inspected, and on several occasions doubtful food has been destroyed by the owners in the presence of the Inspectors, but in no instance was any food exposed for sale in such a condition as to warrant prosecution, with the exception of the two above-mentioned Tuberculous meat cases. Parcels of unsound food which have been purchased in the ma'kets from wholesale merchants (frequently from samples) have been surrendered and destroyed as unfit for human food. HOUSE ACCOMMODATION. In June the houses in the Borough were counted for the purpose of ascertaining the population. At that date it was found that there were 25,472 dwelling houses, and of this number 24,286 were occupied. It is the practice for all newly constructed houses to be inspected by a representative of the Engineer's Department and the Chief Sanitary Inspector when the buildings are completed and ready for occupation, and, if upon inspection they are found to be constructed in accordance with the Building 37 Bye-laws, a Certificate is issued by the Borough Engineer certifying their fitness for habitation. During the year 1910, 555 premises were certified. Plans were submitted and passed for the erection of 669 buildings, comprising 639 single tenements, 7 double tenements, 14 shops and business premises, 7 Cinematograph Theatres, a Church and School. In addition, 12 licenses have been granted, subject to conditions, for the erection of temporary buildings. In the South of the Borough, near the Docks and Beckton Gas Works, the Council some years ago erected 220 Artizans' Dwellings. They are double tenements containing two bedrooms, sitting-room, scullery with bath, etc. and let at 7s. per week first floor, and 6s. 6d. per week for the ground floor. Building operations are still progressing, as will be seen by the number of plans submitted and houses completed. MORTUARIES. The new mortuary at the rear of the Public Health buildings is completed and will soon be ready for use. PARKS AND OPEN SPACES. The following list gives the situation and acreage of the public parks and open spaces in the Borough :— Beckton and N. Woolwich Beckton Park 12 acres. Do. Victoria Gardens 8 „ Central Ward— East Barking Road Recreation Ground 8 „ Do. Vicarage Lane Ground 2 „ Central Ward— West Central Park 30 ,, Manor Park Ward Wanstead Flats 92 „ Do. Recreation Ground 8 ,, Plashet Ward— East Plashet Park 15 ,, 38 SEWAGE DISPOSAL. The Borough is sewered on the separate system, that is, surface water, etc., is kept out of the foul system. The rain-water, however, from the back slopes of the roofs and back yards is admitted into the sewer, so that there is a considerable increase in the flow during wet weather. The sewage contains very little trade effluent. The method of purification is by chemical precipitation by lime and alumina, followed by filtration through a clinker bacteria bed. The final effluent is discharged into barking Creek, a tidal tributary of the Thames. Owing to the district being flat, the main sewer on reaching the works is situated at a very low level. This necessitates pumping the whole of the sewage into the precipitaton tanks and from these it has again to be pumped on to the filter beds. REFUSE DESTRUCTOR. This was installed by Meldrum Bros., Ltd., in 1904, and is of the under-feed type. During the year, 16,800 tons of refuse were deposited. The heat of combustion is applied to the generation of steam for pumping sewage. SWIMMING BATH. The plans and estimates for providing a suitable and much needed covered bath have been passed by the Council. There is no doubt this will be of great benefit to the Borough for promoting cleanliness and health as well as for the purpose of teaching swimming. WATER SUPPLY. This is supplied by the Metropolitan Water Board and is of excellent purity and constant supply. There are still some houses found with drinking-water cisterns in unsatisfactory positions, also without suitable covers, but these when discovered are remedied. 39 METEOROLOGICAL RECORD— YEAR 1910. Rain Gauge 5-in. in diameter, placed 1-foot above ground, 12.5 feet above sea level. Temperature taken in the shade of a Stevenson's Screen, 5 feet from the ground. Months. Temperature of Air during the Month. Mean Temperature of Air. Rainfall. Highest. Lowest. Mean of No. of Days on which Rain fell, 0.01 inches and over. Total fall in inches. Mean rate of fall for Rainy Days. Greatest fall in 24 hours. Date of greatest fall. All Highest. All Lowest January 55° 21° 44°.8 34°.5 39°.6 12 1.43 0.12 0.46 27th February 55° 28° 47°.8 35°.9 41°.9 21 2.46 0.12 0.39 22nd March 57° 29° 50°.7 34°.6 42°.6 7 0.92 0.13 0.38 9th April 63° 32° 54°.4 38°.8 46°.6 16 1.43 0.09 0.34 16th May 75° 33° 61°.9 45°.2 53°.6 17 1.83 0.11 0.44 18th June 81° 45° 69°.4 51°.8 60°.6 14 2.02 0.14 0.42 23rd July 75° 47° 65°.7 51°.9 58°.8 15 2.61 0.17 0.57 5th August 76° 48° 69°.2 53°.4 61°.3 18 2.52 0.14 0.79 4th September 77 39° 64°.8 48°.4 56°.6 3 0.80 0.26 0.70 12th October 74° 38° 59°.7 47°.1 53°.4 13 1.84 0.14 0.42 31st November 52° 22° 45°.5 31°.8 38°.6 13 3.08 0.23 0.67 27th December 55° 26° 49°.1 39°.1 44°.1 16 2.63 0.16 0.44 1st Means and Totals for the Year. 81° 21° 56°.9 42°.7 49°.8 165 23.6 0.15 0.79 Aug. 4th The Rainfall for the Year was J inch below, and the number of days on which rain fell 6 below the year 1909, at East Ham. 40 TABLE 1. Vital Statistics of Whole District during 1910 and ten previous Years:— Year Population estimated to Middle of each Year. BIRTHS. Total Deaths Registered in the Borough. Total Deaths in Public Institutions in the Borough. Deaths of Non-residents registered in Public Institution}? in the Borough Deaths of Residents registered in Public Institutions beyond the Borough. Nett Deaths at all Ages belonging to the Borough. Under 1 Year of Age. At all Ages. Number. Rate * Number. Rate per 1,000 Births registered. Number. Rate.* Number. Rate.* 1 2 3 4 5 6 7 8 9 10 11 12 13 1900 92,000 3,297 35.8 549 166 1,255 13.6 35 .. 48 1,303 14.1 1901 96,000 3,503 36.4 549 156 1,279 13.3 34 .. 178 1,457 15.1 1902 104,023 3,805 36.5 446 117 1,120 10.7 44 .. 122 1,242 11.9 1903 110,451 3,805 34.4 430 113 1,133 10.2 37 .. 132 1,265 11.4 1904 116,902 3,717 31.7 575 154 1,406 120 54 2 208 1,612 13.7 1905 123,381 3,687 29.8 478 129 1,308 10.5 53 3 220 1,525 12.3 1906 129,886 3,656 281 473 129 1,224 9.4 44 15 271 1,491 11.4 1907 136,421 3,690 27.0 386 105 1,280 9.4 67 12 236 1,504 11.0 1908 142,976 3,534 24.7 368 104 1,181 8.2 101 27 265 1,419 9.9 1909 149,575 3,518 23.5 334 95 1,160 7.8 55 26 278 1,412 9.4 Averages for years 19001909. 120,161 3,621 30.7 458 126 1,234 10.5 52 8 195 1,423 120 1910 156,208 3,455 22.1 312 90 1,069 6.8 55 36 297 1,330 8.5 * Rates in Columns 4, 8, and 13 calculated per 1,000 of estimated population. Note.— The deaths included in Column 7 of this table are the whole of those registered during the year as having actually occurred within the Borough. The deaths included in Column 12 are the number in Column 7, corrected by the subtraction of the number in Column 10 and the addition of the number in Column 11. By the term "Non-residents" is meant persons brought into the Borough on account of sickness or infirmity, and dying in public institutions here ; and by the term "Residents" is meant persons who have been taken out of the Borough on account of sickness or infirmity, and have died in public institutions elsewhere. The "Public institutions" taken into account for the purposes of these Tables are those into which persons are habitually received on account of sickness or infirmity, such as hospitals, workhouses, and lunatic asylums. TABLE II. Vital Statistics of separate Wards in 1910 and previous years: YEAR. Whole District. Beckton & North Woolwich Ward. Central Ward East. Centrai Ward West. Manor Park Ward Plash et Ward East. Plash et Ward West. Population estimated to middle of each year Births reg:stored. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at a.l Ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all Ages. , Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 year. Population c??? ated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 year. 1900 92,000 3297 1303 548 1901 96,000 3503 1457 549 1902 104,023 3805 1242 446 1903 110,451 3805 1265 430 1904 116,902 3717 1612 575 1905 123,381 3687 1525 478 7469 279 149 49 20,245 656 285 98 22,931 793 298 84 17242 801 337 115 20,147 514 194 54 25,347 644 262 78 1906 129,886 3656 1491 473 7593 254 125 66 22,895 737 247 99 24,873 772 309 107 28,540 826 338 116 20,581 483 208 56 25,404 584 264 59 1907 136,421 3690 1504 386 8523 296 143 40 24,895 722 252 82 25,873 746 295 72 28,940 810 342 86 21,581 494 211 48 26,609 622 261 58 1908 112,976 3534 1419 368 11,442 296 119 28 25,558 715 255 64 26,053 721 274 83 30,181 765 333 86 22,315 480 189 52 27,427 557 249 55 1909 149,575 3518 1412 334 12,553 324 140 37 27,659 685 246 68 28.115 702 290 71 30,962 731 327 81 22,776 476 177 32 27,510 600 232 46 Averages of Years 1900 to 1909 120,161 3621 1423 458 . 1910 156,208 3455 1330 312 13,988 416 130 47 28,743 696 226 57 28,994 662 275 58 32,683 767 277 75 23,974 401 192 39 27,826 523 230 36 TABLE III. CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR 1910. Notifiable Disease. Cases Notified in Whole District. Total Cases Notified in Each Ward. No. of Cases removed to Hospital from each Ward. At all Ages. Under 1 year. 1 to 5. 5 to 15. 15 to 25. 25 to 65. 65 and upwards. Beckton and North Woolwich Ward. Central Ward East. Central Ward West. Manor Park ward. Plashet Ward East . Plashet Ward West. Total. Beckton and North Woolwich Ward. Central Ward East. Central Ward West. Manor Park Ward. Plashet Ward East. Plashet Ward West. Total. Small Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diphtheria (including Membranous Croup) 142 2 50 82 6 2 .. 22 26 16 33 19 26 142 17 22 14 25 17 20 115 Erysipelas 104 7 6 5 13 65 8 3 15 22 31 15 18 104 1 3 3 3 .. 1 11 Scarlet Fever 329 1 94 198 25 11 .. 52 34 77 50 36 80 329 43 23 57 45 22 56 246 Typhus Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric Fever 19 .. 1 7 7 4 .. 1 6 3 6 1 2 19 1 5 3 5 1 1 16 Relapsing Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Continued Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever 6 .. .. .. 1 5 .. .. 3 2 1 .. .. 6 .. 2 .. .. .. .. 2 Plague .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Totals 600 10 151 292 52 87 8 78 84 120 121 71 126 600 62 55 77 78 40 78 390 Phthisis Poor Law 56 .. .. 2 3 50 1 4 11 12 11 7 11 56 3 8 10 9 5 9 44 Voluntary 30 .. .. 2 9 19 .. 3 6 9 5 3 4 30 3 1 4 2 .. 2 12 43 TABLE IV. Schedule Number. Causes of Death in East Ham during year ending 31st December, 1910. Deaths at the subjoined Ages of " Residents " whether occurring in or beyond the Borough. Deaths at all Ages of Residents" belonging to Wards, whether occurring in or beyond the Borough Total Deaths in Public institutions in the Borough. All ages. Under 1. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. Beckton .& N. W'wich. Central East. Central West. Manor Park. Plashet East. Plashet West. Residents. NonResidents. 1 Small Pox (a) Vaccinated - - - - - - - - - - - - - - - (b) Unvaccinated - - - - - - - - - - - - - - - (c) No Statement - - - - - - - - - - - - - - - 2 Measles 12 3 9 - - - - - 4 2 5 - 1 1 18 3 Scarlet Fever 3 1 - 2 - - - 1 - 1 - - 1 2 1 4 Typhus Fever - - - - - - - - - - - - - - - 5 Epidemic Influenza 17 - 1 1 - 10 5 1 4 4 3 2 3 - - C whooping Cough 24 12 10 2 - - - 2 6 5 7 - 4 - - 7 Diphtheria and Memb Croup 13 1 6 6 - - - 2 3 - 2 2 4 8 - 8 Enteric Fever 5 - 1 1 2 1 - 1 2 1 1 - - - - 9 Asiatic Cholera - - - - - - - - - - - - - - - 10 Diarrhoea, Dysentery 48 42 4 - - 1 1 8 14 8 9 3 6 - 4 11 Epidemic Enteritis - - - - - - - - - - - - - - - 12 Other Allied Diseases 2 1 1 - - - - - 1 1 - - - - - 13 Hydrophobia - - - - - - - - - - - - - - - 14 Glanders - - - - - - - - - - - - - - - 15 Tetanus - - - - - - - - - - - - - - - 16 Anthrax - - - - - - - - - - - - - - - I8 Syphilis 2 2 - - - - - - 2 - - - - - - 19 Gonorrhoea - - - - - - - - - - - - - - - 21 Erysipelas 4 3 - - - 1 - - - 2 - 1 1 - - 22 Puerperal Fever 4 - - - - 4 - - - 2 2 - - - — 23 Pyaemia 4 - - - 1 3 - 1 1 1 - 1 - - - 24 Infective Endocarditis 1 — — - - 1 - - - - 1 - - - - 25 Other Allied Diseases 6 1 — — 1 1 3 1 1 — 1 1 2 - — 26 Malarial Fever 1 - - - - 1 - - 1 - - - - - - 27 Rheumatic Fever 10 - 1 1 1 7 - 2 1 - 4 1 2 - - 28 Rheumatism of Heart 3 - - 1 - 2 — — 1 1 - 1 — — — 29 Tuberculosis of Brain 28 5 10 7 - - - 4 4 9 2 3 6 - - 30 Tuberculosis of Larynx 3 - - - 1 2 - 1 - - - - 2 - - 31 Tuberculosis of Lungs 111 - 3 4 18 80 6 9 23 22 14 20 23 2 - 32 33 Abdominal Tuberculosis General Tuberculosis 0 13 2 2 2 6 1 4 1 2 1 1 '> 3 2 2 2 3 — 6 34 Other forms Tuberculosis 2 - - - - 2 — — 2 - - — — — — 36 Thrush - - - - - - - - - - - - - - - 37 Actinomycosis — - - - - - - - - - - - — — — 38 Hydatid Disease — — — — - — — - — — — — — — — 39 Scurvy - - - - - - - - - - - - - - - 40 Ptomaine-Poisoning — — — — - — — - — — — — — — — 41 Acute Alcoholism — — — — - — — — - — — - — — — 42 Chronic Alcoholism 2 — — - — 2 — — — — 2 — — — — 43 Chronic Industrial Poisonings - - - - - - - - - - - - - - - 41 Other Chronic Poisonings - — - - - - — — — — - - - - - 45 Osteo-arthritis. 10 — - - 2 3 5 1 2 2 - 2 3 - — 46 Gout 1 — - — — — 1 — — — — 1 — — — 47 Cancer 93 — 3 - 1 55 34 6 13 17 17 10 21 — — 48 Diabetes Mellitus 11 - - - - 7 4 - 3 1 2 1 4 - - Carried forward 439 75 63 27 28 187 59 43 90 84 76 60 80 13 29 44 Schedule Number. Causes of Death in East Ham During year ending December 31st, 1910. Deaths at the subjoined Ages of "Residents" whether occurring in or beyond the Borough. Deaths at all Ages of "Residents" belonging to Wards, whether occurring in or beyond the Borough. Total Deaths in Public tions in the Borough. All Ages. Under 1. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. Beckton A N W'wich. Central East. Central West, Manor Park. Plashet East. Plashet West. Residents. NonResidents. Brought forward 439 75 63 27 28 187 59 43 90 84 76 60 86 13 29 49 Purpura Hemorrhagica - - - - - - - - - - - - - - - 50 Hemophilia - - - - - - - - - - - - - - - 51 Anaemia 4 — — — — 2 2 — — 1 2 — 1 - - 52 Lympliadenoma - - - - - - - - - - - - - - - 53 Premature Birth 70 70 - - - - - 14 12 15 12 8 9 - - 54 Injury at Birth - - - - - - - - - - - - - - - 55 Debility at Birth 2 2 - - - - - 1 - - 1 - - - - 56 Atelectasis 5 5 - — — — — — - 1 — 2 2 - - 57 Congenital Defects 6 6 — — — — — 2 — — 3 1 — — - 58 Want of Breast Milk — — - - - - - — - - - - - - 59 Atrophy, Debility, Marasmus 67 65 2 — — — — 10 11 l5 16 12 3 — 5 60 Dentition 3 2 1 - - - - - 1 1 1 — — — — 61 Rickets 4 4 — — — — — — — 3 1 — — — — 62 Old Age, Senile Decay 32 - - - - - 33 1 2 8 12 5 5 - - 63 Convulsions 18 16 2 - - - - 3 2 - 10 2 1 - - 64 Meningitis 4 2 1 1 - - - - - 1 1 2 - - - 65 Encephalitis - - - - - - - - - - - - - - - 66 Apoplexy 5 — — — — 1 4 — — — 1 1 3 - - 67 Softening of Brain 3 — — — — — 3 - 1 — — 1 l - - 68 Hemiplegia 9 — — — — 4 5 — 3 3 1 2 - - - 69 General Paralysis of Insane 2 — — — — 2 — - — 2 - - - - - 70 Other forms of Insanity 2 - - - - 2 - - 1 - 1 - - - - 71 Chorea - - - - - - - - - - - - - - - 72 Cerebral Tumour 3 - - 2 - 1 - - - 2 - - 1 - - 73 Epilepsy 3 — — — 1 2 — — — 1 1 - l - - 74 Laryngismus Stridulus - - - - - - - - - - - - - - - 75 Locomotor Ataxia 1 - - - - 1 - - - - 1 - - - - 76 Paraplegia 6 — 1 — — 3 2 - 1 2 1 1 1 - - 77 Other forms Drain Disease 8 — - - 2 6 - 2 1 3 1 - 1 - - 78 Otitis, Otorrhœa 1 - - 1 - - - - - - 1 - - - - 79 Diseases of Nose 1 - - 1 - - - 1 - - - - - - - 80 Diseases of Eye - - - - - - - - - - - - - - - 81 Pericarditis 2 - - 1 1 - - 1 - - - - l - - 82 Endocarditis, Valvular Dis. of Heart 60 — 1 — 8 25 16 1 10 10 12 7 7 — — 83 Hypertrophy of Heart - - - - - - - - - - - - - - - 84 Angina Pectoris 1 - - - - 1 - - - 1 - - - - — 85 Aneurism 5 — — — — 4 1 — 1 2 — — 2 — - 86 Senile Gangrene 1 - - - - - 1 - - - 1 - - - - 87 Embolism, Thrombosis 16 1 — — — 5 10 4 4 2 2 2 2 — - 88 Phlebitis - - - - - - - - - - - - - - - 89 Varicose Veins - - - - - - - - - - - - - - - 90 Other Diseases Heart and Vessels 127 1 - 2 1 48 75 11 25 22 28 22 19 - - Carried forward 901 249 71 35 41 294 211 97 165 179 186 128 146 13 34 45 Schedule Number. Causes of Death in East Ham during year ending December 31st. 1910. Deaths at the subjoined Ages of "Residents" whether occurring in or beyond the Borough. Deaths at all Ages of "Residents" belonging to Wards, whether occurring in or beyond the Borough. Total Deaths in Public Institutions in the Borough. All Ages. Under 1. 1 and under 5. 5 and under 15, 15 and 1 under 25. 25 and under 65. 65 and upwards. Beckton & N.W'wich. Central East. Central West. Manor Park. Plashet East. Plashet West. Residents. Non- Residents. Brought forward 901 249 71 35 41 294 211 97 105 179 186 128 140 13 34 91 Laryngitis 2 1 - - 1 - - 1 - - - 1 - - - 92 Croup - - — — - - - - - - - - - - - 93 Other Diseases of Larynx and Trachea - — - — - — — — — — — - - - — 94 Acute Bronchitis 55 22 5 - 2 11 15 4 6 18 11 10 6 — — 95 Chronic Bronchitis 54 — — — — 18 36 5 6 13 12 7 11 - - 90 Lobar Pneumonia 12 1 2 — 2 6 1 1 3 - 5 2 1 - - 97 Lobular Pneumonia 50 14 20 3 - 9 4 5 6 20 10 2 7 — — 98 Pneumonia 45 6 6 — — 23 10 5 9 2 12 6 11 — — 99 Emphysema, Asthma 8 — — 1 — 4 3 — — 2 1 1 4 - - 100 Pleurisy 3 — — — 1 2 — — — 1 1 - 1 — — 101 Other Diseases Respiratory System 3 - 1 1 - - 1 1 - - 1 1 - — — 102 Diseases of Mouth and A nnexa 1 - - - - 1 - - - - - 1 - - - 103 Diseases of Pharynx - - - - - - - - - - - - - - - 101 Diseases of OEsophagus 1 — — — - 1 - — — - - 1 - - - 105 Ulcer of Stomach and Duodenum 9 - 1 — 1 5 - — 1 3 — 2 3 - - 106 Other Diseases of Stomach 10 1 2 — - 5 2 1 1 1 3 1 3 - - 107 Enteritis 15 - 9 — - 4 2 - - 6 3 2 1 - 1 108 Appendicitis 7 1 — 1 2 3 — — 1 3 3 - - - - 109 Obstruction of Intestine 15 2 2 — — 3 8 1 2 3 3 2 4 1 - 110 Other Diseases of Intestine 1 1 — — - - - - — 1 — — — - - 111 Cirrhosis of Liver 15 — — — — 15 — — 2 3 3 5 2 - - 112 Other Diseases of Liver 1 — — — — — 1 - — — — — 1 - - 113 Peritonitis 3 — — 1 1 1 - — — — 1 1 1 — — 114 Other Diseases, Digestive System 1 — — — — 1 — - 1 — — - — - - 115 Diseases of Lymphatic System and Glands 5 - - — 1 4 — 1 1 1 - - 2 - - 110 Acute Nephritis 13 - 1 - 2 7 3 1 1 2 3 3 3 - - 117 Bright's Disease 16 — - - - 9 7 1 2 3 1 3 3 - - 118 Calculus 1 - - - - - 1 - - - - 1 - - - 119 Diseases of Bladder and Prostate 4 - - — 1 1 2 - - 2 - - 2 - - 120 Other Diseases Urinary System 4 — - — - 2 2 - - 1 1 2 — - - 121 Diseases of Testis and Penis - - - - - - - - - - - - - - - 122 Diseases of Ovaries — - - - - - - - - - - - - - - 123 Diseases of Uterus and Appendages 2 - - - - 1 1 - - - 1 - 1 - - 124 Diseases of Vagina and External Genitals - — - - — - - — — — - - - — - 125 Diseases of Breast - — — - - - - - - - - - - - - 120 Abortion, Miscarriage — — — - - - - - - - - - - - - 127 Puerperal Mania — — - - - - - - - - - - - - - 128 Puerperal Convulsions 1 — — 1 - - - - - - - 1 - - - 129 Placenta Praevia. Flooding 1 — — - - 1 - - - - - 1 - - - 130 Puerperal Thrombosis 1 - - - - 1 - - 1 — - - - - - 131 Other Diseases Pregnancy and Childbirth 7 2 - - - 5 - - 2 2 1 - 2 - - Carried forward 1267 300 120 43 55 437 312 124 213 266 262 184 218 14 35 46 Schedule Number. Causes of Death in East Ham during Year ending December 31st 1910. Deaths at the subjoined Ages of "Residents" whether occurring in or beyond the Borough. Deaths at all Ages of "Residents" belonging to Wards, whether occurring in or beyond the Borough. Total Deaths in Public Institutions in the Borough. All ages. Under 1. 1 and under 5 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. Beck ton & N. W.wich. Central East. Central West. Manor Park. Plashet East. Plashet West. Residents. Non. Residents. Brought forward 1267 300 120 43 55 437 312 124 213 266 262 184 218 14 35 1KB Arthritis, Ostitis, Periostitis 1 — — 1 — — - — — 1 — — — - - 133 Other Diseases Osseous System 2 — 1 1 — — - 1 1 — — — - — - 134 Ulcer, Bedsore 2 - - — — 1 1 1 - - - — 1 - - 135 Eczema - - - - - - - - - - - - - - - 136 Pemphigus - - — - — - - - - - — 1 1 - - 137 Other Diseases Integumentary System - - - — - - - - — — - — — - - Accidents and Negligence. 138 In Mines and Quarries - — — — — - — — — - — - — — — 139 In Vehicular Traffic 2 — — 2 — — — — — 2 2 — - — - 140 On Railways 3 — — — — 3 — — 1 2 — — — — - 141 On Ships. Boats, &c. (not drowning) 1 - — - — 1 — — — 1 — - - - - 142 In Building Operations - - - - - - - - - - - - - - - 113 By Machinery 1 - — - - 1 - - - 1 - - - - - 144 By Weapons and Implements - - - - - - - - - - - - - - - 145 Burns and scalds 4 — 2 — 1 1 — — 2 - 2 — - 3 — 146 Poisons, Poisonous Vapours 1 - - - - 1 - - - - - 1 - - - 147 Surgical Narcosis 1 — 1 - - - - - 1 - - - - 1 - 148 Effects of Electric Shock - - - - - - - - - - - - - - - 149 Corrosions by Chemicals - - - - - - - - - - - - - - - 150 Drowning 3 — — 1 — 2 - - 1 1 1 — - - - 151 Suffocation, Overlaid in Bed 6 6 — — — — — — 1 1 3 1 — — - 152 Otherwise 1 - - 1 - - - - - - - - 1 - - 153 Falls, not specified 9 — 2 1 — 2 4 — 1 1 1 3 3 1 1 l54 Weather Agencies - - - - - - - - - - - - - - - 155 Otherwise, not stated 1 1 - - - — - — — — — — 1 - — l06 Homicide 1 1 - - - 3 - - 1 1 - 1 1 - - Suicides, 157 By Poison - - - - - - - - - - - - - - - 158 By Asphyxia - - - - - - - - - - - - - - - 159 By Hanging and Strangulation 2 — — — 1 1 — 1 — 1 — - - - - 164 By Drowning 1 - - - 1 - - - - 1 - - - - - 161 By Shooting 4 — — — — 4 - 2 — 1 1 — - — - 162 By Cut or Stab 3 - — — — 3 - 2 — - — — 1 — — 163 By Precipitation from Elevated Places — — — — — — — — — — — — — — - 164 By Crushing - - — — — - - - - - - - - - - 165 By other and unspecified methods 1 — — — — 1 - - - - 1 - - - - 166 Execution - - - - - - - - - - - - - - - 167 Sudden Death, cause not ascertained - - - - - - - - - - - - - - - 168 Ill defined and unspecified causes 8 2 - - - 6 - 1 1 1 - 1 2 - Total 1330 312 126 30 58 467 317 132 223 279 275 192 229 19 36 TABLE V. INFANTILE MORTALITY DURING THE YEAR 1910. Deaths from stated Causes In Weeks and Months under One Year of Age. Cause of Df.ath. Under I Week 1-2 Weeks 2-3 Weeks. 3-4 WeeUs. Total under 1 Month. 1-2 Months. 2-3 Months. 3-4 Months. 4-5 Months. 5-6 Months. 6-7 Months 7-8 Months. 8-9 Months. 9-10 Months. 10-11 Months. 11-12 Months. Total Deaths under 1 Year. All Causes— Certified 87 20 11 9 127 33 21 19 17 13 15 13 15 17 13 9 312 Uncertified - - - - - - - - - - - - - - - - - Common Infectious Diseases. Small Pox - - - - - - - - - - - - - - - - - Chicken Pox - - - - - - - - - - - - - - - 1 1 Measles - - - - - - - - - - - 1 1 1 - - 3 Scarlet Fever - - - - - - - - - - - - 1 - - - 1 Diphtheria (including Membranous Croup) - - - - - - - - - - - - - 1 - - 1 Whooping Cough - - - - - - 1 2 2 2 - 2 - 2 - 1 12 ii. Diarrhœal Diseases Diarrhoea, all forms - - - - - 5 - 1 3 - 1 1 1 1 - - 13 Enteritis, Muco-enteritis, Gastro enteritis - - - - - 2 - 3 1 3 3 1 1 3 2 1 20 iii. Wasting Diseases, Gastritis, Gastro-intestinal Catarrh - 1 - - 1 1 2 3 - 1 - - - - - 1 9 Premature Birth 52 9 4 3 68 2 - - - - - - - - - - 70 Congenital Defects 7 1 1 2 11 1 1 - - - - - - - - - 13 Injury at Birth - - - - - - - - - - - - - - - - - Want of Breast Milk, Starvation - - - - - - - - - - - - - - - - - Atrophy, Debility, Marasmus 14 5 3 2 24 14 3 5 2 2 1 2 4 2 - - 65 iv. Tuberculous Diseases. Tuberculous Meningitis - - - - - - - - 1 - 1 - - - 2 1 5 Tuberculous Peritonitis: Tabes Mesenterica - - - - - - - 1 - - 1 - - - - - 2 Other Tuberculous Diseases - - - - - - - - - - - 1 1 - - - 2 v. Other Causes. Erysipelas - - - - - 1 - - - - - - 1 1 - - 3 Syphilis 1 - - - 1 1 - - - - - - - - - - 2 Rickets - - - - - - - - 1 1 1 - - - - - 4 Meningitis (not Tuberculous) - - - - - - - - - - - 1 1 - - - 2 Convulsions 5 2 1 2 10 1 3 1 - 1 - - - - - - 16 Bronchitis - 1 - - 1 1 2 1 3 1 2 1 2 4 2 2 22 Laryngitis - - - - - - - - - - - - - - 1 - 1 Pneumonia 1 - - - 1 1 2 1 2 1 4 2 1 1 4 1 21 Suffocation (overlying) 1 - - - 1 2 1 - - - 1 - - 1 - - 6 Other Causes 6 1 2 — 9 1 1 1 1 1 - 1 1 - 1 1 18 87 20 11 9 127 33 21 19 17 13 15 13 15 17 13 9 312 Births in the year— Legitimate, 3,375; Illegitimate, 80. Total, 3,455. Males, 1,756 ; Females. 1.699. Deaths from all Causes at all Ages, 1,330.Legitimate Infanta 989- Deaths in the year of legitimate intants, 289, Illegitimate Infants, 23. 48 APPENDIX I. Report on the Borough Isolation Hospital. HOSPITAL SUBCOMMITTEE. Alderman J. BROOKS, J.P., Chairman. The Mayor (Councillor E. EDWARDS, J.P.) The Deputy-Mayor (Councillor MURRELL OAKES, J.P.) Alderman O. R. ANSTEAD, J.P. Alderman C. NORTHFIELD, J.P. Councillor F. BRADLEY. Councillor F. G. COSBURN, C.C. Councillor G. P. DEAN. Councillor J. EVANS. Councillor T. J. McCARTHY, C.C. Councillor A. TAYLOR. 49 Report on the Borough Isolation Hospital. It is pleasing to note that during the past year the accommodation at the Hospital has been greater than the requirements owing to the still diminishing prevalence of Infectious Disease. The new Scarlet Fever Block lias not been used for the last eight months. The Enteric Wards have been used for " Open Air Treatment " of Phthisis. One Diphtheria Ward has been sufficient to treat all our cases of this disease and during the latter part of the year the other ward was used for Enteric Fever cases. The cubicles have quite justified their use as Observation Wards for doubtful cases, and for patients suffering from double infection. The following table shows the number of patients admitted and under treatment during the year and also the mortality per cent, of completed cases: — D 50  In Hospital Dec 31st, 1909. Admitted Total under treatment. Discharged. Died. Death-rate per cent, of completed cases. Remaining in Hospital Dec. 31st, 1910. Scarlet Fever Wards 42 176 218 183 3 1.59 32 Diphtheria Wards 19 136 155 136 8 5.55 11 Enteric Wards — 9 9 6 3 33.3 — Cubicles 4 79 83 74 2 2.63 7 65 400 465 399 l6 - 50 In calculating the mortality rate, cases incorrectly diagnosed have been excluded. Also in connection with Diphtheria, the death rate is calculated on actual cases of Clinical Diphtheria. 5 SCARLET FEVER. Only 218 cases of Scarlet Fever were under treatment in the Hospital during the year as compared with 572 cases last year. The cases have been comparatively mild, and only three died of the disease, giving a death rate of 1.61. It is noteworthy that there has been no death in the Hospital from Scarlet Fever since May. One fatal case was due to complication of Diphtheria and Cellulitis of the neck, and another developed Meningitis. The chief complications which occurred in the 218 cases under treatment during the year were as follows:— Complication. No. of Cases. Complication. No. of Cases. Nephritis 12 Pneumonia 3 Abscess in gland of neck 7 Scarlatinal Rheumatism 3 Mastoid Disease 4 Endocarditis 1 In some instances, patients admilted were in the incubation stage of some disease other than Scarlet Fever, but any case of doubt was isolated in the Cubicles. The following table gives particulars of the diseases and conditions associated with Scarlet Fever cases admitted during the year:— Disease. No. of Cases. Disease. No. of Cases. Cellulitis 7 Ringworm 3 Eczema 5 Chicken Pox 1 Whooping Cough 4 German Measles 1 Measles 3 Gangrene 1 Mumps 3 The patients are detained for a minimum period of six weeks. The more severe cases with complications are detained for a much longer period, a few cases being in the Hospital as long as three months. 52 The result is that the average duration of stay in the Hospital is considerably above that of the minimum period. (See Table on p 56). These prolonged cases are chiefly amongst those suffering from Nephritis (inflammation of the kidney), a common complication of Scarlet Fever, which if not sufficiently treated ends in Chronic Bright's Disease. I have also found that it is most important to prolong the stay in Hospital when the patient suffers from Otorrhcea or Suppurative Rhinitis on account of the discharge being very contagious. DIPHTHERIA. 155 cases of this disease were treated during the year, as compared with 261 in 1909 and 362 in 1908. Eight deaths occurred, giving a case mortality of 5.55, this being the lowest rate from this disease for the last seven years, as the table below shows:— 1904 14.6 1908 12.7 1905 11.9 1909 7.27 1906 10.9 1910 5.55 1907 9.4 In Diphtheria, early treatment with injection of Antitoxine is most important, and it is noteworthy that of the 8 deaths not one of these had been injected before admission. The Council provides Antitoxine free of charge to all Medical Practitioners for cases within the Borough, and this, with free Bacteriological diagnosis, accounts for the low death rate. Antitoxine was given to all cases on admission. 14 cases were Laryngeal, which is the most fatal form. 53 Tracheotomy was performed on four cases with one death. The chief complications which occurred were :— Antitoxine Rashes 63 Adenitis 2 Paralysis 6 Pneumonia 2 Albuminuria 3 Bronchitis 1 The average stay in the hospital was six weeks. In each a Bacteriological examination of a swab from the throat or nose was undertaken before the patient was discharged. ENTERIC FEVER. Nine cases of this disease were admitted during the last four months of the year. Amongst these 9 cases there were 3 deaths. In all the cases admitted the diagnosis was correct. One case, a little boy aged 9 years, had the severe Meningeal type of Typhoid. Another case which died was one which had not been diagnosed in the early stages and had a relapse after being admitted to hospital. The third death occurred in a man whose health had been bad before he developed the disease. CUBICLES. Co-existence of more than one disease in the same patient was by no means uncommon, and these cases were treated in the cubicles. It is obvious how dangerous it would have been to put these cases into an ordinary ward, or in cases where the diagnosis was doubtful. I regret that we have not been able to make more use of these cubicles owing to insufficient heating, but this is now under consideration by the Council, and I hope the trouble will be remedied before the summer is over. 83 cases were treated with only 2 deaths. PHTHISIS. Fourteen cases of Pulmonary Tuberculosis were treated in the Hospital during the year. Most of them were advanced cases and two died during the bad weather in November from Bronchitis complicating the disease. Seven greatly benefited by the treatment. Our intention was to educate them in " open air treatment," also management of their expectoration, instruction as to diet and to lessen the danger of infecting others. S4 HOSPITAL ACCOMMODATION. The following Table gives the total bed accommodation a the Hospital:— Beds. Cubic feet per bed. Diphtheria Wards 20 1,000 Enteric Wards 20 1,000 Cubicles 12 1,500 Scarlet Fever ("A" Block). 20 2,000 Scarlet Fever ("B " Block) 52 1,000 The Diphtheria and Enteric Wards, together with the A Administration Block, are temporary buildings of wood and iron. The following list gives the number of the Staff at present engaged:— Matron I Cook I Laundry Attendant 2 Sisters 12 Maids 2 Ambulance Drivers 7 Staff Nurses a Gardeners I Boiler Attendant II Probationer Nurses 5 Laundresses 2 Porters HEALTH OF STAFF. During the year none of the Nursing Staff contracted any infectious disease. The Matron was indisposed with Influenza and Bronchitis. One Nurse had a Septic Phlebitis, contracted whilst nursing an Enteric patient, but is now convalescent. The efficiency of the work done by all members of the Hospital Staff is beyond question. This is testified to by the number of letters of thanks that are received throughout the year from patients themselves and also from parents of patients who have been treated in the Hospital. 55 HOSPITAL ACCOUNTS. For the Year Ended 31st March, 1910. ESTABLISHMENT CHARGES. £ Provisions 1147 Linen, Bedding and Furniture 308 Chandlery and Sundries 319 Lighting, Heating and Water 794 Repairs to Hospital and Maintenance to Grounds, including Lodge 456 Rates, Taxes and Insurance 120 Office Expenses 34 2s. 8¼d. average per person per day. Salaries 1567 4745 Special Expenditure. £ Painting Temporary Buildings 95 Painting Scarlet Fever Ward 179 Altering Fsnce 82 356 £5101 *The financial year ended at this date. It therefore does not coincide with the remainder of this report, the year for which ended on 31st December. 56 PATIENTS' EXPENSES. £ Medicines (including Antitoxine and Disinfectants) I90 3d. average per person per day. Stimulants 6 Horsing Ambulance 270 £466 Total cost of upkeep, 2s. 11£d. per person per day. Days Average days each in Hospital Scarlet Fever. Balance of cases in Hospital 1st April, 1909 1.950 - 336 recovered Scarlet Fever cases 14,638 43 12 fatal Scarlet Fever Cases 155 16.743 13 Diphtheria. Balance of cases in Hospital 1st April, 1909 1,209 155 recovered Diphtheria cases 6,080 39 11 fatal Diphtheria cases 54 7.163 5 Typhoid Fever. 1 recovered Typhoid Fever case 48 48 48 2 recovered Erysipelas cases 39 19 2 recovered German Measles cases 26 13 Staff. 38 Hospital Staff 365 13,870 Total 37,889 BOROUGH OF EAST HAM. Report of the Medical officer to the Education Committee FOR THE YEAR 1910. EAST HAM EDUCATION COMMITTEE. Alderman H. Osborn, J.P. (Chairnuin). Councillor W. T. Howlett, L.l'.C. (Vice-Chairman). Councillor E. Edwards, J.P. (Mayor). Councillor M. Oakes, J.P. (Deputy-Mayor). Mrs. Ford. Alderman O. R. Anstead, J.P. Councillor T. Hassan Cowper. Alderman R. Banks-Martin, J.P. Councillor G. P. Dean. Aldermun J. Brooks, J.P. Councillor J. Evans. Alderman C. North field, J.P. Councillor W. C. Ford, J.P. Alderman J. Prince, J.P. Councillor H. Evan Jones, J,P., C.C. Councillor F. Bradley. Councillor J. Lawrence, J.P. Councillor W. Brown. Councillor T. J. McCarthy, C.C. Councillor T. W. Cashman, J.P. Councillor A. Taylor. Councillor A. Coles. Councillor C. J. Warwick. • Councillor F. G. Cosburn. C.C. Councillor H. F Witherspoon, C.C. Clerk : Miss P. Perry. School Nurse. Miss A. Kay. Secretary: H. C. Padgett. Assistant Medical Officer (part time) W. A. Milne. M B., D.P.H. Medical Officer : W. Benton, M.R.C.S., L.R.C.P., D.P.Ii. STATISTICAL DATA. School Places: Provided Schools 25,280 Non-provided Schools 1,129 Total 26,409 Number on Registers:— Provided Schools 24,110 Non-provided Schools 1,014 Total 25,124 Cost per Child (excluding Administration and Capital Charges) 1908-9. £3 14s. 3d. per annum. Teaching Staff • Head Assistant Assistant Supplementary Student Cookery Certificated Uncertificated 631 57 437 121 5 7 4 Education Rate. 1908-9, 1/10 1909-10, 2/2 1910-11, 2/2½ Grants Received, 1908-9 £60,554 4 10 (Including Special grant for necessitous districts £16,076). Since 1874, 17 New Schools have been erected 1 Temporary School opened and alterations made to two Schools 61 BOROUGH OF EAST HAM EDUCATION COMMITTEE. Mr. Chairman, Mrs. Ford, and Gentlemen, I beg to submit my Report on the Public Elementary Schools, the Medical Inspection of School Children and other duties performed for the Committee during the year 1910. In accordance with the Education Act, 1907, and the Memorandum of the Board of Education, the children recommended for examination are :— (а) Newly admitted children. (£) Children about 7 years of age. (c) Children of 10th year of age. (d) Those children about to leave school. During 1909 those children under (a) and (d) were examined, but last year by attempting to exanrne the children about 7 years of age, and having no further assistance, we were unable to attend all the school?. The Board of Education require that not less than three inspections during the school life of the child will be necessary :— (a Newly admitted children. (б) Children about 7 years of age. (c) At about the 10th year. And where practicable, those about to leave school. To do this work it is necessary to have a full lime Assistant School Medical Officer. A second Nurse has already been appointed. I wish to record the valuable assistance rendered by the Teachers. The co-operation of the Teachers in this work is most essential. In one or two instances it has been difficult to make a Teacher realise the importance of attention to the physical condition of the child. 62 To assist in fhe work the Teachers have been asked to weigh and measure the children, thus saving a considerable amount of time for the Nurse. The Head Teacher is generally present when the examination takes place and can give the Medical Inspector information concerning the mental capacity and habits of the child. In addition to this the Teacher assists in preparing the children for examination, also in sending out notices and forms to the parents. Before dealing with the year's work on Medical Inspection, particulars concerning accommodation and school buildings are given :— LIST OF SCHOOLS WITH ACCOMMODATION, & DETAILS OF LIGHTING & HEATING. SCHOOL. Date opened. Accommodation. Infants. Boys. Girls. Artificial Lighting. Heating. Central Park RD. 1899 600 524 524 Fairly good. By incandescent gas mantles. Radiators and open grates. The latter not of good design. Essex Rd. 1898 582 500 500 Inadequate. Ordinary gas burners. Radiators and open grates. Fourth Avenue 1890 330 408 408 do. Stoves and open grates. Hartley Avenue 1903 521 560 560 do. Radiators and open grates. High St. 1874 357 358 405 do. Open grates. Kensington Ave. 1901 541 516 516 do. New light being tried Radiators and open grates. Lathom Road 1898 571 480 1X0 Inadequate. Ordinary gas burners Slow combustion stoves in Main Hall. Open grates in Class Room. Former unsatisfactory. Manor Park 1893 400 400 400 do. Open grates. Monega Road 1906 552 520 520 do. Radiators and open grates. Napier Road 1902 530 568 568 do. Radiators and open grates. 63 LIST OF SCHOOLS WITH ACCOMMODATION, & DETAILS OF LIGHTING & HEATING. SCHOOL. Date opened, Accommodation, Infants. Boys. Girls. Artificial Lighting .Heating. New Beckton 1887 420 372 300 Inadequate. Ordinary gasburners. Radiators, not well distributed. North "Woolwich 1893 472 Inadequate. Stoves and open grates. Plashet Lane 1890 535 596 520 Inadequate. Ordinary gas 1 minors. Radiators, hot water pipesj&opeu grates. SandringHam Rd. 1896 780 620 620 do. Radiators and open grates. Shaftesbury RD. 1894 69X 600 600 Bray's burners and incandescent mantles. Radiators and open grates Shrewsbury Rd. 1887 254 410 34X Inadequate. Ordinary gas burners. Open grates. Vicarage Lane 1911 516 516 Electric Light. New School. Walton Road 1900 629 540 540 Inadequate. Ordinary gas burners. Open grates of obsolete type. *Castle St. R.C. 1903 60 240 do. Radiaters and open grates. *Silvertown R.C. 212 348 do. 1 gas stove, slow combustion stoves and open grates. *St. Winefride's R.C. 1909 300 do. Open grates. * Non-provided Schools. SCHOOL ACCOMMODATION. There are 21 Schorls, including three non-provided Schools. The total accommodation is 26,409, and the number of children on the r gisters at the end of last year was 25,124. The new School at Vicarage Lane w.ts op ned in January, 1911. 64 SCHOOL BUILDINGS. The majority of these are satisfactory. I intend during the year to make a systematic investigation and inspection of the Schools and hope to give a full report next year. During the latter part of the year there was a severe epidemic of Measles in the Infants' Departments of several Schools, chiefly Fourth Avenue, Shrewsbury Road, Monega Road, and Sandringham Road. It was found advisable to close Fourth Avenue School (Infants' Department) for three weeks, as the attendance fell below 50 per cent., and every class was affected. The School was disinfected and cleansed during the closure. I did not think it necessary to close the other Schools, but they were disinfected at the week-ends with satisfactory results. MEDICAL INSPECTION. The erroneous idea prevailing in many quarters as to the object and purpose of Medical Inspection appears to be rapidly disappearing. There are not nearly so many objections as in previous years, and many parents have shown great interest in the examination of the children by being present and requested advice on the physical fitness. Besides Medical Inspection for physical defects, what is required is information regarding the circumstances and environment of the childrfen concerned. Also it is obvious that the chief value of Medical Inspection lies in remedying the defects found. This question has not up to the present time been seriously considered by this Authority, but I intend to suggest that with further assistance we may establish a School Clinic to treat defects found as the necessary corollary to Medical Inspection. To compile records may be of use from a statistical point of view, but it is necessary for suitable treatment to be undertaken to show that the money spent on inspection is well laid out. 65 Method of Inspection.— No actual alteration has been made in the method of inspection. The procedure is as follows:— (1). The parents are notified and invited to by present at the inspection. (2). The teachers record the child's attendance and their opinion as to its mental capacity, also I have asked them in the future to weigh and measure the children. (3). The nurse examines the vision of the older boys and girls with test types, also notes the condition of the child as to cleanliness. (4). The above details are entered on the Inspection Card by the Clerk in readiness for the Doctor when he attends for inspection. The Schedule of Inspection is the same as last year and is reproduced on the next two pages. I have been dissatisfied with certain details in the preparation of complete and accurate records necessary to follow up the cases, and a new procedure is to be adopted to solve this difficulty. h EAST HAM EDUCATION COMMITTEE. Confidential. I. (PP) II. (PP) III. (PP) IV. ((PP) I. II III IV Date Boots Age 8 Nutrition *Standard 9 Cleanliness Clothing Sufficiency *Vision Teeth: 10 Decayed Cleanliness 0 *Mental Capacity II Tonsils External Eye dis Adenoids Glands 2 Ear Disease 12 Nose 3 Hearing i3 Tubercle 4 Speech Deformities14 Congenital Acquired 5 Heart and Circulation Infectious or Contagious Disease 15 Lungs Other Diseases or 16 * Defects 6 Nervous System „ 7 Condition of Head „ Body Medical Officer's Initials Age 4-12 5-12 6-12 7-12 9-12 10-12 11-12 12-12 13-12 14-12 Height, b centimeters. Weight, b kilograms. * Omit on Admission a G- Good. A—Average D- Dull Def— Defective b With clothes, without boots. Name Date of Birth Surname first). Address Removed to Removed to Do School Date of leaving School Date of admission Scarlet Fever. Diphtheria. . Measles. | Whooping Cough. Chicken Pox. Mumps. Rheumatic Fever. Date of Illnesses Year 19 19 19 19 19 19 19 19 1 i« 19 Actual at tendances Possible attendances . Family History (if exceptional) Directions to Parents or Teachers General Observations. Occupation F. I M * Total Number of Rooms Families Adults Children II Consumption on Fathers side ? III Do. on Mother's side ? Work before or after School. Nature IV Duration 68 NUMBER OF CHILDREN EXAMINED. The following Table gives the number of children examined in the schools attended:— School. Infants. Boys. Girls. Total. Central Park 130 I05 114 349 Napier Road 74 179 H3 496 North Woolwich 138 - — 138 New Beckton 80 82 30 192 High Street 71 75 104 250 Plashet Lane 114 236 71 421 Walton Road 199 147 112 458 Castle Street R C. 36 24 30 90 Silvertown R.C. 65 33 28 126 Total 1007 881 632 2520 THE EXAMINATION OF THE CHILDREN. The requirements of the Memorandum issued by the Board of Education are fully carried out. The clothes are sufficiently opened to permit of a thorough examination of the Heart, Lungs, etc. The time occupied in examination varies, but on an average takes about five minutes each child. If the parents are present, which is to be desired, much more information can be obtained of the previous history of the child, and advice can be given as to the future occupation suitable for particular children. It often happens that a child is suffering from Heart Disease without the parents' knowledge. 69 HEIGHT AND WEIGHT. In the following Tables the height and weight of the children examined is compared with the Standard of the Anthropological Society. The height and weight are both taken with the boots off. The weight of a child is a guide to its general condition:— HEIGHT TABLE. East Ham Children. Standards of Anthropological Society, AGE. Years. BOYS GIRLS. BOYS. Inches. GIRLS. Inches. No. Exam'd. Inches. Cms. No. Exuded. Inches Cms. 5 324 40.8 103.6 333 40.8 103.6 41.0 40.5 6 120 43.7 108.3 133 42.4 107.9 44.0 42.8 7 108 45.9 116.8 48 45.1 114.7 45.9 44.4 8 390 46.9 119.3 349 47.0 119.6 47.0 46.6 9 6l 47.5 120.7 35 47.3 120.3 49.7 48.7 13 230 56.2 142.9 198 56.7 144.3 56.9 57.7 14 63 57.2 145.4 17 587 149.2 59.3 59.8 It will be noticed that the height of East Ham children compares favourably with the Standard of the Anthropological Society. 70 WEIGHT. East Ham Children. Standards of Anthropological Society. AGE. Years. BOYS. GIRLS. BOYS. GIRLS. No. Exam'd. lbs. Kilos. No. Exam'd. lbs. Kilos. lbs. Ids. 5 324 37.7 17.4 333 37.0 16.8 39.9 39.2 6 120 39.2 17.8 133 39.5 17.9 44.4 41.7 7 108 46.9 21.3 48 44.6 20.0 49.7 47.5 8 390 48.6 22.6 349 47.2 21.4 54'9 52.1 9 6l 50.7 23.0 35 47.6 21.6 60.5 55.5 13 230 78.3 35.5 198 79.6 36.2 82.6 87.2 14 63 80.9 36.8 17 81.8 37.2 92.0 96.7 At every age period the above table shows that the average weight of East Ham Children, both boys and girls, is much below the Standard. The average height and weight of the children examined in each school and each age period are shown in the following table. The averages for the total number examined are also given:— «vj HEIGHT IN INCHES. SCHOOLS. 5 YEARS. 6. YEARS. 7 YEARS. 8 YEARS. 9 YEARS. 1.1 YEARS. 14 YEARS. Boys. Girls. Boys. Girls. Boys. Girls. Boys. Girls. Boys. Girls. Hoys Girls. Boys. Girls. Central Park 41.2 41.1 42.5 42.4 48.8 45.1 48.0 48.0 ... 46.4 56.5 57.2 57.8 57.0 High Street 40.4 40.3 43.4 41.7 47.8 43.2 47.5 47.8 45.3 43.6 56.2 57.4 58.3 59.1 Napier Road 40.2 40.4 4.2.7 41.9 44.1 43.7 46.6 46.7 48.0 47.8 56.5 57.0 58.4 58.2 North Woolwich 41.1 41.4 45.0 44.1 46.0 46.1 46.8 47.6 ... 50.5 ... ... ... ... New Beckton 40.8 41.0 42.4 42.3 46.7 46.6 47.0 46.7 47.5 47.8 56.0 55.1 57.2 ... Plashet Lane 40.6 40.9 42.6 40.6 45.5 ... 47.2 47.1 48.0 47.7 56.1 57.9 56.4 59.8 Walton Road 40.9 40.6 41.4 43.2 44.9 44.0 45.5 46.3 48.2 48.1 56.5 54.8 55.3 533 Castle Street R. C 41.1 41.4 42.7 43.2 44.1 43.5 6.2 48.1 ... ... 56.9 57.3 56.9 54.9 Silvertown R. C. 40.7 40.5 40.9 42.6 45.3 48.8 47.6 45.2 47.8 467 554 57.5 57.5 ... Average for whole Borough 40.8 40.8 42.6 42.4 45.9 45.1 46.9 47.0 47.5 47.3 56.2 56.7 57.2 58.7 to WEIGHT IN POUNDS. SCHOOLS. 5 YEARS. 6 YEARS. 7 YEARS. 8 YEARS. 9 YEARS. 13 YEARS. 14 YEARS. Boys. Girls. Hoys. Girls. Boys. Girls. Boys. Girls. Boys. Girls. Boys. Girls. Boys. Girls. Central Park 36.8 36.1 37.7 37.7 55.0 43.2 48.5 50.5 ... 463 78'0 73'8 83.4 83.6 High Street 38.6 36.4 34.4 37.0 48.5 43.6 52.5 49.1 44.1 39.5 77.6 81.4 78.9 79.8 Napier Road 35.7 36.1 43.6 38.8 42.1 43.9 48.9 47.8 51.1 49.6 75.8 76.7 81.2 83.6 North Woolwich 36.8 36.6 42.5 43.6 44.3 43.9 52.7 44.3 ... 48.0 ... ... ... ... New Beckton 40.1 40.5 41.4 41.0 49.4 47.4 52.7 50.5 53.1 61.3 76.3 79.4 83.4 ... Plashet Lane 37.5 37.5 41.0 39.0 47.4 ... 49.6 47.4 53.1 48.5 76.3 81.4 88.9 83.6 Walton Road 38.1 37.0 38.8 38.6 43.6 41.4 47.6 45.0 47.8 47.6 82.3 78.7 87.3 92.8 Castle Street R.C. 36.8 36.4 39.7 38.8 44.1 35.3 46.7 44.3 ... ... 83.1 83.8 77.2 68.3 Silvertown R. C. 30.0 37.0 37.9 41.4 47.6 54.7 49.6 46.9 55.5 502 76.0 81.6 89.5 ... Average for whole Borough 37.7 37.0 39.7 39.5 46.9 44.2 49.8 47.3 50.7 47.0 78.3 79.6 83.7 81.9 DEFECTS CLASSIFIED ACCORDlNG To SCHOOLS. Schools. Department. Number Examined. Vision defective. Squint and External Eye Disease. Hearing Defective. Ear Discharge. Speech Defective. Heart Affections. Tuberculosis (all forms.) Disease of Nervous System. Vermin of Head. Vermin of Body. Clothing Insufficient. Clothing very Dirty. Boots Defective. Nutrition under Normal. Teeth Decayed 3 or less. Teeth Decayed 4 or more. Tonsils Enlarged. Tonsils much enlarged. Adenoids. Mentally Dull. Mentally Defective. Rickets. Deformities. Infectious Diseases. Ringworm and other Skin diseases. Notices sent to Parents. Central Park Infants 130 ... 9 1 9 1 2 1 ... ... ... 1 1 ... ... 37 29 14 7 4 ... ... 1 1 ... 1 21 Boys 105 17 1 1 3 ... 2 ... ... ... 1 1 1 1 51 37 10 3 1 3 7 ... ... 2 1 3 25 Girls 114 11 9 ... 3 ... 1 ... ... ... ... 1 ... ... ... 63 32 12 3 20 ... ... ... 1 2 31 High Street Infants 71 ... 2 ... l 1 2 2 1 7 3 2 2 3 ... 17 16 12 2 2 ... ... ... ... 2 5 23 Boys 75 7 ... ... 2 ... ... ... ... ... ... ... 1 3 ... 32 20 5 7 1 10 ... ... ... ... 3 16 Girls 104 13 2 ... ... 1 3 ... ... 5 ... 1 ... 2 2 45 34 6 2 1 ... ... ... 3 ... 3 21 Napier Road Infants 174 ... 4 1 10 1 ... 1 ... 5 1 3 6 12 19 42 17 27 2 1 ... ... ... 2 ... 2 37 Boys 179- 14 8 ... 4 1 3 1 ... ... 1 1 7 12 18 78 32 23 5 4 19 ... ... 4 l 5 34 Girls 143 11 1 1 2 ... 3 ... ... 2 ... ... ... 2 19 5/ 36 14 8 2 17 ... ... I 1 ... 34 North Woolwich Infants 138 ... 4 ... ... ... 2 ... ... 15 ... 5 4 4 1 32 8 16 11 2 ... ... ... 1 1 2 28 New Beckton Infants 180 ... 2 ... 9 1 9 ... ... 2 ... ... ... 4 3 30 7 15 5 2 ... ... ... 1 2 2 27 Boys 82 9 4 2 2 1 ... ... ... ... ... 1 1 ... 8 19 13 14 7 2 ... ... ... ... 1 1 19 Girls 30 4 3 ... 1 ... ... ... ... 2 ... ... ... ... 3 17 7 7 5 1 4 ... ... ... ... 20 Plashet Lane. Infants 114 ... 5 ... 9 3 2 ... ... 1 ... 1 3 ... ... 40 21 11 4 3 ... ... ... 9 3 5 32 48 Boys 236 26 7 1 9 4 7 5 ... 1 1 4 ... ... 25 107 55 22 7 4 23 ... ... 5 2 4 Girls 71 7 2 ... ... ... 2 ... ... ... ... ... 1 ... ... 30 24 11 3 1 16 ... ... ... 2 3 32 Walton Road Infants 199 ... 5 ... 2 2 2 2 ... 26 4 3 10 14 20 56 35 27 9 1 ... ... ... 6 1 2 58 Boys 147 15 4 ... 3 ... ... 1 ... 2 5 8 6 19 10 60 36 13 7 5 27 9 ... 1 ... 3 46 Girls 112 7 ... ... ... ... 4 ... ... 24 2 ... 1 5 9 48 25 6 10 2 21 ... ... ... 1 1 42 Castle Street R.C. Infants 36 ... 3 ... ... ... 1 ... ... ... ... ... ... ... ... 9 7 3 3 1 ... ... ... 1 ... ... 11 Boys 24 5 2 ... ... ... 1 ... ... ... ... ... ... 2 ... 9 11 1 2 ... 4 ... ... ... ... ... 7 Girls 30 8 ... ... 2 ... 1 ... ... ... ... ... ... 2 ... 18 7 1 ... 1 5 ... ... ... ... ... 11 Silvertown R.C. Infants 65 ... 3 ... 3 1 2 ... ... ... ... ... ... ... 2 18 11 7 1 ... ... ... ... ... 1 2 12 Boys 33 3 1 ... ... 1 ... ... ... ... ... ... 1 6 2 15 6 6 2 ... 8 1 ... ... 1 4 12 Girls 28 5 ... ... ... ... ... 2 ... 3 2 ... ... 5 2 12 7 6 ... ... ... 1 1 1 ... 2 12 Total 2520 162 67 7 53 18 42 15 2 95 20 32 53 126 143 942 533 289 115 41 183 5 6 33 21 55 659 TOTAL DEFECTS AT ALL AGES. 5 years 6 years. 7 years 8 years. 9 years. 13 years 14 years. All Ages. Total* Percentage Defective. Boys. Girls. Boys. Girls. Boys. Girls. Boys. Girls. Boys. Girls. Boys 1 Girls. Boys. Girls. Boys. Girls. Boys & Girls. Number Examined 324 333 120 133 108 48 391 349 61 35 230 198 63 17 1378 1142 2520 defects. Defective Vision ... ... ... ... 8 40 31 3 ... 23 24 1 1 96 66 162 6.4 Squint and Externa] Eye Disease 8 6 7 ... 4 ... 16 7 1 1 3 1 2 ... 45 22 67 2.6 Hearing and Ear Discharge 5 9 4 ... ... 1 9 7 2 1 6 3 ... ... 36 24 60 2.4 Speech Defects 5 ... ... ... ... ... 2 1 ... ... 1 ... l ... 12 6 18 0.7 Heart Affections 3 7 ... 2 3 1 3 7 1 ... 4 7 2 ... 18 24 42 1.7 Tuberculosis 3 ... ... 2 4 1 3 ... ... ... 1 1 ... ... 13 2 15 0.6 Disease of Nervous System ... ... ... ... ... ... 1 ... ... ... 1 ... ... ... 2 ... 2 0.1 Vermin of— Head 3 21 5 18 2 9 2 24 ... ... ... ... ... ... 12 83 95 3.7 Body 3 3 3 2 1 2 2 I 1 ... 2 ... ... ... 12 8 20 0.8 Clothing— Deficient 8 4 4 3 4 ] 3 2 ... ... 1 1 ... ... 21 11 32 1.2 Very Dirty 9 5 7 1 8 5 9 2 1 ... 3 ... 1 ... 43 10 53 2.1 Boots Defective 15 14 8 8 10 2 20 8 8 4 13 2 2 ... 86 40 126 5.0 Nutrition under Normal 11 8 7 7 13 6 30 20 5 3 12 5 3 ... 92 51 143 5.7 Decayed Teeth— 3 or less 84 79 36 31 44 18 154 158 30 14 102 105 21 5 509 433 942 37.4 4 or more 52 34 17 21 28 9 98 126 18 8 45 32 18 5 291 242 533 21.1 Tonsils— Enlarged 49 36 12 21 21 6 36 36 9 4 93 16 .7 1 165 124 289 1 1.4 Much Enlarged 13 11 3 6 6 7 22 16 1 5 7 9 4 59 56 115 4.6 Adenoids 8 2 2 3 5 2 4 5 3 2 1 3 2 1 26 18 44 1.7 Mentally— Dull ... ... ... 1 5 3 44 43 11 5 30 25 4 1 104 79 183 7.2 Defective ... ... ... ... ... 1 1 ... ... 1 1 ... 1 ... 3 2 5 0.2 0.2 Rickets ... ... ... 1 1 ... ... 1 ... ... ... 1 ... ... 3 3 6 Deformities 5 2 5 1 3 ... 5 4 1 ... 1 3 ... ... 23 10 33 1.3 Infectious Diseases 3 4 ... ... 1 3 1 2 1 1 3 2 ... ... 9 12 21 0.8 Ringworm and Other Skin Diseases 9 4 1 2 2 ... 8 4 4 1 8 7 2 ... 37 18 55 2.2 Parents Notified of Defects 62 87 30 40 33 11 101 120 9 17 45 47 11 3 320 339 659 26.1 * This total does not represent only the preceding columns. A few children of ages 9 to 12 years who were also examined are included. 74 GENERAL REVIEW OF THE FACTS DISCLOSED BY MEDICAL INSPECTION. Diseases of the Eye. —67 were found to be suffering from external disease of the Eye, chiefly Blepharitis and Conjunctivitis. Visual Defects.—Of the 934 boys examined in the upper schools 96 were found to be suffering from defective sight, and of the 676 girls 66 were discovered. The infants were not tested in vision owing to the fact that they were not old enough to read the vision test card. The defects are in cases of vision worse than 6/12 Diseases of the Ear.—The number of children suffering from some disease of the ear or defects of hearing was 6o, equal to 2.4 percent. The hearing was tested in some cases by means of the watch test, and in others by the whisper test. The latter is the most perfect test but takes much longer to carry out. Wax in the ear was present in a number of cases, and in this respect, as in discharging ears, it is most important that attention should be given to this before permanent trouble is caused. It is very often tedious treatment that is required on the part of the parents to remedy this. Speech Defects.—Minor defects of speech were present in 18 cases, ten of these being at five years of age. These will probably be remedied by education. The remainder were either due to disease of the palate or nervous disease (Stammering)- Heart and Circulation.—42 cases of disease of the heart and circulation were discovered. In some cases the parents were entirely ignorant of any organic disease being present. Some of the cases were slight, caused by Anaemia and insufficient feeding. Others no doubt were suffering from over-work and did not get sufficiert sleep, being employed early in the morning and late at night. In my opinion this should be forbidden whilst children are attending school. 75 The chief cause of organic heart disease was found to be Rheumatism. Tuberculosis.—15 cases of Tuberculosis were found. In most of these cases there was either a bad family history of Tuberculosis or the disease was associated with poverty and insufficient food, together with insanitary surroundings. It is to be hoped that in the course of time this disease will be quite extinct. Verminous Condition.—One of the first results of Medical Inspection was to show the prevalence of verminous condition of children. I am pleased to note that there appears to be a great improvement in this respect, due chiefly to the attention paid by the School Nurse. 115 were found to have either vermin on the body or head. Vermin were found in the heads of girls to a much larger extent than in boys —83 out of 1,142 examined. This is chiefly due to the prevailing fashion of girls wearing long hair. It is difficult to get the parents to have their children's hair cut short during school life. If this were done it would be possible in a short time to entirely eradicate vermin from our schools. Cards are given calling attention to the condition and also advice as to how to treat it. In cases of vermin of the body a number were cleansed at our Cleansing Station. The time of the School Nurse is largely occupied in visiting those parents who send their children to school in such a condition as to be a nuisance to others. I have had teachers complain to me of having picked up vermin from dirty children. I think that in time the constant supervision of the School Nurse (although at times it becomes a very disagreeable duly to perform) will ensure a much higher standard of cleanliness. Clothing and Boots.—32 cases were found with insufficient clothing. These cases were assisted by the School Nurse as far as possible. 126 children were found to be wearing defective boots. 76 Nutrition.—143 cases were recorded as being under normal condition. Under this heading those have been included who show loss of flesh and whose apprarance seems to indicate poor health, although no sign of any particular disease is present. It is not always easy to say whether this is due to want of feeding, improper feeding, or disease. Concerning underfed children, the provision of meals by the Care Committee has done much to remedy this. Objection has been raised against the "Provision of Meals" Act, as tending to undermine parental responsibility, but it should be remembered that if this is withheld, it is the child that suffers and ultimately the community, as it is impossible for a child to be educated if not sufficiently fed and clothed. Teeth.—Out of 2,520 children examined, 942 were found to have three or less decayed teeth, and 533 four or more. It is surprising how few parents take heed about their childrens' teeth, and it is difficult to get them to take the slighest interest in this matter, yet decayed teeth are a source of trouble and illness, causing Indigestion, Enlarged Glands, and general Malnutrition. It is a common idea that there is no need to attend to the primary teeth. Tonsils and Adenoids.—289 children were found to be suffering from enlarged tonsils—115 much enlarged—and 44 from Adenoids. Adenoids are usually associated with enlarged tonsils. No physical examination is made to ascertain if Adenoids are present, as this is disagreeable to the child. They are diagnosed from subjective symptoms, often causing a child to be deaf and appear dull mentally. Their removal often results in much improvement in the child, both mentally and physically. The parents of the children who have much enlarged tonsils and Adenoids are advised to seek Medical adviqe. 77 Mental Condition.—183 were discovered to be dull and five mentally defective. The teachers were asked to give their opinion as to this condition in the children, except those in the Infants' Department. Rickets.—Only six cases showed evidence of Rickets in early life by deformity of the chest, spine, or bones. Deformities.— Deformity of the chest, curvature of the spine and legs in some form was discovered in 33 cases, chiefly in those children below eight years of age. Infectious Diseases.—21 cases were found equal to o.8 per cent., which included Scarlet Fever, Diphtheria, etc. Ringworm and Skin Diseases.—A number of cases of Ringworm were brought to my notice by the School Nurse, who examines all the heads, and microscopical examination was made of the hair in doubtful cases. This disease still continues to be a troublesome complaint in school life, as sometimes when children have been permitted to return to school as cured, the disease recurs, and other children become infected. Contagious Impetigo has been very common in some schools, but by the advice given to the parents it has soon been got rid of. The Work of the School Nurse.—The duties of the School Nurse are various and manifold. She examines the children in the schools periodically (apart from the Medical Inspection) to ascertain the condition of cleanliness of head and body to detect any skin disease, ringworm, etc. She visits the home of any children excluded for uncleanliness or disease, and gives advice to parents. Her reception is often unpleasant, but there is no doubt that great good has resulted from her interviews. She becomes acquainted with the homes and often obtains assistance where required ; such as grants of clothing, letters for hospital treatment, etc. The Nurse also assists the Medical Inspector in the examination of the children. She saves the time of the Doctor by taking note of the condition of the head, examines the vision, and prepares the child for examination. 78 She visits the parents of those children who are found at the medical inspection to have any physical defects and ascertains whether medical advice or treatment has been obtained. During the past year, Nurse Kay paid 940 visits to homes of children suffering from different ailments. There was a large number of cases and it was found impossible to visit as often as needed, but now a second Nurse has been appointed more will be done. She has brought a large number of cases for me to see at my office that were kept out of school (causing a needless loss of grant) owing to minor ailments which might soon be remedied by proper treatment. Diseases and Defects found which have been remedied.— It is one thing to discover a defect, but quite another to see that defect remedied, yet if treatment is not obtained, the money expended in Medical Inspection is wasted. There is no doubt that there are a great many people in this district who cannot afford to pay for necessary treatment when ordered. I, myself, have given parents a letter for a hospital, and have been told that they could not afford the expense of the journey. It is for these cases I should suggest to your Committee that permission be asked from the Board of Education that we may be able to treat or assist. I have found cases, for instance, where glasses were ordered for defective vision, the parents being unable to purchase them, much to the detriment of the child. DISEASES AND DEFECTS FOUND ON EXAMINATION, WHICH HAVE BEEN TREATED. Where defects are found during the Medical Inspection, a notice is sent to the parents notifying them and asking them to take the child with the notice to their Medical man. 79 After a time the School Nurse visits the home or school to ascertain if the treatment advised has been carried out. The following table gives the number of cases treated up to the end of the year:— Diseases, etc. Number Remedied. Impetigo (contagious) 131 Nits in head 95 Enlarged Tonsils 68 Teeth (extracted) 56 Defective Vision 42 Ringworm 38 Otorrhœa 29 Squint 24 Adenoids 12 Conjunctivitis 12 Tubercular Glands 5 Hernia 4 Anæmia 3 Artificial Eyes (obtained through Surgical Aid Society) 3 Corneal Ulcer 2 Boots obtained to remedy shortness of limb 1 Various 54 It will be seen by above table that much more has been done in the way of treatment of defects than in the previous year, chiefly through the visits of the School Nurse and parents taking advantage of the advice given. METHODS AVAILABLE FOR THE TREATMENT OF DEFECTS. Many of the defects are of minor character, such as Skin Diseases, Cerumen in Ear, External Eye Disease, Verminous Condition, but there are the important conditions requiring treatment, viz., Adenoids, Enlarged Tonsils, Teeth, Defective Vision and Diseases of the Ear causing deafness. 80 A number of these cases cannot afford to pay a General Practitioner and will not take the trouble to attend a London Hospital on account of the time and expense of getting there. Also most of the large hospitals are raising objection to so many school children being sent for treatment. East Ham is unprovided with a hospital out-patient department to cope with the work. The district is amply supplied with general Medical Practitioners who in their private practice deal with the majority of minor cases requiring treatment, but for operations of the throat and nose and for dental affections the majority of the parents cannot afford to pay. There remains the Poor Law provision which is also unsatisfactory. As will be seen from the defects found and remedied (p.79) there is much to be done and this is a serious problem. I should suggest that a School Clinic be established as an immediate solution of the problem of dealing with the defects. Section 13, sub-section (8) of the Education (Administrative Provision) Act, 1907, includes among the powers and duties of a local Education Authority the power to make such arrangements as may be sanctioned by the Board of Education for attending to the health and physical conditions of the children educated in Public Elementary Schools. We have power to exclude from school all children who are considered to be unfit for attendance until the defects found are remedied. It is useless urging parents to obtain treatment if no adequate provision is made for such treatment. School Clinics have already been established at Deptford, Bradford, York, Brighton, Sheffield, etc. The routine work of the school clinic should be re-examination of cases referred from Medical Inspection, treatment of Ringworm, Impetigo, Itch, Eardischarges, etc. Only those cases which are known not to be under treatment by a Medical Man and those who upon enquiry are found to be unable to pay for treatment would be undertaken. Defective Vision.—These should be tested and spectacles provided, the parents paying the whole or Dart of cost. 81 Teeth. —Extractions should be undertaken, and later, if possible, an arrangement should be made for stopping decayed teeth, as this is very prevalent and productive of serious evils to health. It will probably be said that a school clinic will be abused, but this objection applies also to hospital treatment. I should not treat cases until I was satisfied that the cases were necessitous. A school clinic would find provision for timely treatment for many children who are now hopelessly neglected, thus preventing much loss of attendance at school, for efficient Medical treatment would be followed by more efficient educational results. Cleansing Scheme,—Much good work has been done in cleansing verminous children at the Cleansing Station at the rear of the Town Hall, under Section 122 d., Children Act, 1908 The School Nurse is provided with Authority given in writing by the Education Authority to visit a school and examine the children. If she finds a child is verminous my attention is called to the condition and a Notice is sent to the parent, guardian, or person liable to maintain the said child to cleanse according to the instructions given. The child is again examined after a interval of not less than 24 hours' delivery of the Notice and if still in a verminous or filthy condition a Notice is served "Authority to remove the child for cleansing." The child is then brought to the Cleansing Station, cleansed and bathed, whilst the clothing is disinfected. In some cases the child's bedroom and bed clothes are cleansed and disinfected at the same time. INFECTIOUS DISEASES. Information concerning notifiable infectious diseases occurring in school children is sent by the Medical Officer of Health to all Head Teachers. The teacher notifies the Medical Officer of Health of all non-notifiable diseases. Precaution Notices are sent to all cases. During the past year the following cases occurred amongst children attending the different elementary schools in the Borough:— F SCHOOL CASES, 1910 SCHOOLS. Dept. Scarlet Fever. Diphtheria TyphFever. Measles. Wh. Cough Chicken Pox. Mumps Ringworm Total. Central Park Road Infants 12 1 .. 20 .. 7 .. .. 53 Boys 3 1 .. .. .. 1 .. .. Girls 8 .. .. .. .. .. .. .. Castle Street R.C. Infants .. .. .. .. .. .. .. .. 4 Boys 1 .. .. .. .. .. .. 1 Girls . .. .. .. .. .. .. .. 2 Essex Road Infants 6 3 .. 30 .. 17 .. 2 64 Boys 3 .. .. .. .. .. .. .. Girls 3 .. .. .. .. .. .. .. Fourth Avenue Infants 2 .. .. 123 24 9 2 5 258 Boys .. 1 .. 44 2 1 10 .. Girls 1 2 .. 12 .. 3 13 .. Hartley Avenue Infants 2 3 .. .. .. .. .. .. 5 Boys .. .. .. .. .. .. .. .. Girls .. .. .. .. .. .. .. .. High Street Infants 1 .. .. 2 .. 4 .. 6 24 Boys 4 .. .. .. .. .. .. 4 Girls .. 2 .. .. .. .. .. 1 Kensington Avenue Infants 1 1 .. 84 .. 41 .. .. 165 Boys 2 1 .. 2 .. .. .. Girls 1 3 .. .. .. 1 .. .. Lathom Road Infants 5 4 .. 90 .. 4 .. .. 107 Boys 2 2 .. .. .. .. .. .. Girls . .. .. .. .. .. .. .. .. Monega Road Infants 8 4 .. .. .. 60 .. .. 170 Boys 10 .. .. .. .. 1 .. .. Girls 3 .. .. .. .. .. .. .. Manor Park Infants 6 5 .. .. .. .. .. .. 70 Boys 2 .. .... .. .. .. .. Girls 4 3 Napier Road Infants 2 2 .. .. .. .. .. .. 9 Boys .. 1 .. .. .. .. .. .. Girls 2 1 .. .. .. .. .. .. New Beckton Infants 3 4 .. .. .. .. 9 .. 33 Boys 1 .. .. .. .. .. 4 .. Girls 3 2 .. .. .. .. 1 .. North Woolwich Infants 2 .. .. .. .. .. 11 .. 16 Mixed 2 .. 1 .. .. .. .. .. Plashet Lane Infants 14 .. 1 .. .. 1 .. 2 55 Boys 4 .. .. 2 .. 6 .. 3 Girls 4 .. 1 4 .. .. .. .. Sandringham Road Infants 3 3 .. .. .. .. .. .. 14 Boys 3 1 .. .. .. .. .. .. Girls 3 1 .. .. .. .. .. .. Shaftesbury Road Infants 4 2 .. 30 .. .. .. .. 46 Boys 2 .. .. .. .. .. .. .. Girls 4 4 .. .. .. .. .. .. Shrewsbury Road Infants 1 .. .. 70 .. .. .. .. 97 Boys 2 3 .. .. .. .. .. .. Girls 1 2 .. 15 .. .. .. .. Silvertown R.C. Infants .. .. .. .. .. .. .. .. - Mixed .. .. .. .. .. .. .. .. St.Winefride's R.C. Infants 1 .. .. .. .. 6 2 2 37 Mixed .. .. .. .. .. 2 12 6 Vicarage Lane Infants .. 1 .. .. .. 2 .. .. 3 Infants 4 .. .. 4 16 20 46 4 133 Walton Road Boys 2 1 .. 1 1 1 15 7 Girls 2 .. .. .. .. 4 1 1 Totals 159 71 5 577 69 196 224 62 1363 83 In conclusion I wish to express my indebtedness to the Head Teachers for help and courtesy extended to the School Nurse and myself. To Nurse Kay for the excellent work which she has accomplished, especially in visiting parents to advise them re treatment. Also to Mr. Padgett for information re school accommodation, statistics, attendance of scholars, etc. Your Obedient Servant, WILLIAM BENTON, Medical Officer to Education Committee. Report of the Chief Sanitary Inspector FOR THE YEAR 1910. 87 Annual Report of the Chief Sanitary Inspector. To His Worship the Mayor, the Aldermen and Councillors of the Borough of East Hani. Mr. Mayor and Gentlemen, I have the honour to present to you my fifteenth annual report of the work done by the Sanitary Inspectors during the year ended 31st December, 1910. Inspection of the Borough and Abatement of Nuisances.—It is with pleasure I bring before your notice details of the work which the Inspectorial Staff has executed during the year under consideration to render the Borough more healthy and to improve its sanitation. The efficiency of the work is best judged by the healthy condition of the Burgesses and the low death rate which has prevailed in the Borough for many years. Reference to the table tabulating the sanitary defects dealt with will establish the usefulness and practicability of the Work performed. In investigating complaints lodged, notification of infectious diseases received, house to house inspections, etc., 4,867 primary visits to premises were made as under:- Beckton and N. Woolwich Ward. Central East Ward. Central West Ward. Manor Park Ward. Plashet East Ward. Plashet West Ward. Total. January 46 72 146 89 26 23 402 February 60 69 102 81 42 72 426 March 66 69 84 78 39 54 390 April 73 38 63 92 17 82 365 May 53 64 57 73 21 91 359 June 62 73 98 56 25 73 387 July 67 44 56 88 26 35 316 August 51 53 78 54 26 46 308 September 59 115 172 124 23 62 555 October 64 95 126 130 40 70 525 November 40 84 170 114 145 71 524 December 18 42 106 81 14 49 310 Totals 659 818 1,258 1,060 344 728 4,867 88 Resulting from the 4,867 inspections made, 6,769 nuisances have been discovered and dealt with by the Inspectors, necessitating the service of 1,216 Preliminary Notices, 92 Statutory Notices, 15 Water Notices, 301 Dust Bin Notices, and a large number of Intimation Letters. Of the 6,769 nuisances reported, 4,830 were the result of routine work and 1,939 by house to house inspection. The following is a tabulated statement shewing sanitary defects discovered as a result of inspections made and dealt with under the Public Health Acts, East Ham Improvement Acts, and the Council's Bye-Laws for the years 1909-1910:— The Following is a Record in Detail of the Inspections made during the Years 1909—1910:— Beckton and North Woolwich Ward. Central East Ward. Central West Ward. Manor Park Ward. Plashet East Ward. Plashet West Ward. Total. General. H to H General. H to H General. H to H General. h to H General. H to H General. H to H General. H to H 19091910 1909 1910 1909 1910 1909 1910 1909 1910 1909 1910 1909 1910 1909 1910 1909 1910 1909 1910 1909 1910 1909 1910 1909 1910 1909 1910 Inspections 465 503 93 156 736 715 376 103 655 802 534 456 824 928 353 132 320 341 43 3 435 649 40 79 3435 3938 1439 929 Premises round in fair condition 248 266 18 42 326 331 85 9 342 415 183 76 358 422 29 15 146 163 10 - 209 329 9 11 1629 1926 1021 334 153 Factories, workshops, and outworkers' premises inspected 18 60 - - 117 121 - - 104 260 - - 159 213 - - 83 135 - - 92 232 - - 573 - - Bakehouses, slaughter-houses and dairies inspected 38 45 - - 73 94 - - 62 113 - - 151 243 - - 36 27 - - 47 94 - - 407 616 - - Barbers' and Hairdressers' Premises inspected (2 months only) - 2 - - - 40 - - - 42 - - - 49 - - - 17 - - - 22 - - - 172 - - Urinals inspected 22| 27 — - 21 34 - - 14 22 - - 12 21 - - 4 4 - - 10 14 - - 83 122 - - Walls and ceilings dirty and dilapidated 15 20 20 44 47 42 70 14 45 54 96 87 68 55 83 27 32 15 - 1 46 55 - 17 253 241 269 190 Yards improperly paved and dilapidated .. 9 10 7 8 22 27 93 28 19 24 60 109 42 42 143 18 12 16 8 2 19 26 11 33 123 145 322 198 No forecourt pavjng 1 4 — 12 15 4 65 40 13 14 82 163 9 5 47 3 2 4 11 - 30 21 18 33 70 52 223 251 Drains unstopped and cleansed 419 525 — — 34 303 — - 259 483 — - 365 447 - — 140 107 - - l88 252 - - 1605 2117 - — Defective drains 8 9 18 17 5 5 20 12 35 33 98 73 15 13 3 10 7 8 1 - 42 48 2 21 112 116 142 133 Defective w.c. connections 3 9 — 1 6 10 3 2 3 9 - 6 9 13 2 1 2 5 - - 5 5 - - 28 51 5 8 10 Defective w.c. traps 3 3 — — 2 4 2 ,2 1 3 — 1 5 9 6 1 3 4 - - 2 3 - 3 16 26 4 Soil pipes and drains insufficiently ventilated - 1 - - - - - - 5 - - - - - - - - - - - - - - - - - - - Defective (lushing apparatus 2 16 2 5 22 27 27 2 21 16 28 17 33 27 53 8 13 14 - — 13 18 - 3 104 118 110 35 Soil pans foul and broken 4 8 3 7 21 8 41 12 43 31 101 70 29 25 32 37 16 14 2 1 63 49 2 22 176 135 181 149 Defective vent pipes 8 8 — 2 16 14 26 5 6 13 26 31 14 24 38 14 6 9 1 — 14 6 - 1 64 74 91 53 R.w. pipes and eaves gutters defective 8 6 8 28 19 13 37 11 6 19 29 40 20 17 112 22 5 5 3 2 8 10 - 21 66 70 189 124 Do. connected to drain - — — — - - 4 1 3 1 24 2 6 4 2 - 2 - - - 3 - - 1 14 5 30 4 Roofs leaky 2 8 4 10 10 4 18 6 9 12 39 38 12 7 53 11 5 1 - - 17 6 - 13 55 38 114 78 Defective sink waste pipes 6 6 7 2 4 9 11 11 7 15 18 15 9 11 30 4 6 6 1 - 11 5 - 1 43 52 67 33 Houses without water (M.W.Bd.) - 3 — — 5 - - - 5 - - - 14 12; - — 8 - - - 9 7 - 41 22 - - Cisterns without covers 11 6 — 8 15 13 41 - 18 10 38 30 45 24 101 28 9 11 - - 18 11 6 3 116 75 186 69 Drinking water improperly stored — 2 — 20 10 13 25 13 7 5 8 95 14 26 s 11 11 7 - - 9 9 - - 51 62 41 139 Dilapidated floors 2 7 8 26 6 2 10 5 1 8 12 10 6 6 31 10 - 3 — - 4 7 - 1 19 33 61 52 Insufficient underfioor ventilation 25 6 15 51 9 9 107 41 21 18 160 143 34 13 78 17 8 5 14 2 20 17 17 36 117 68 391 290 Dampness — 4 4 7 8 7 10 4 5 6 9 2 17 22 62 12 7 5 - - 6 10 - 1 43 54 85 26 Accumulations 29 29 1 9 40 33 - 1 38 37 7 5 64 70 29 4 20 9 - - 29 37 - 2 220 215 37 21 Inundations - 1 - - 2 - - - 2 6 - - 8 2 - - - - - - 2 1 - - 14 10 - Overcrowding - - - — 5 2 - - 6 1 - - 8 7 5 1 1 1 1 - 4 2 - - 24 19 6 1 Unsound food - - - — 2 - - - 5 - - - 4 10 - - - - - - 2 3 - - 13 13 - - No dust bins 9 4 — — 7 8 1 3 4 2 3 2 22 8 33 6 6 2 - - 6 9 - 2 54 33 37 13 No manure bins 2 1 - — — - 1 1 - ] 1 — 2 2l 2 - - - - - - - - - 4 4 14 1 Animals improperly kept Temporary buildings found 1 3 — — 3 6 — — 6 5 3 2 11 15 1 3 4 2 — — 2 4 - 1 27 35 4 6 3 5 — 1 4 9 1 — 3 1 2 — 10 5 — — 4 1 — — 2 3 — — 26 24 3 1 Smoke nuisances 1 9 1 — 44 26 — 1 1 2 1 — 1 6 1 — 1 1 1 — 2 6 - - 50 50 4 1 Rear passages unpaved or undrained 9 — — — — 1 — — — — — — — — — — — — — — — 1 — — 9 2 — — Gipsies 81 38 — — 97 107 — — 9 — — — 59 9 — — — 1 - - - - - - 246 155 — — Breaches of Bye-Laws and Regulations — 8 — — 2 10 — — 2 12 — — 2 11 2 2 — 1 — — — 3 - — 6 45 2 2 Other nuisances 24 20 — 8 84 29 17 9 44 25 16 19 51 53 28 17 17 20 2 — 28 23 1 2 212 170 64 55 Drains tested 51 107 22 29 11 67 22 29 138 110 86 82 145 104 2 13 97 55 3 121 122 2 30 666 565 137 183 90 Complaints Received.—During the year 1910, 1,035 complaints were received (565 written and 470 verbal), as compared with 996 for the previous year. There is an increase in the number of verbal complaints, but this is explained by the more general use of the telephone. Many of the complaints were of a frivolous nature, and others entirely outside the provisions of the Public Health Acts, but the majority were complaints of bona-fide nuisances requiring abatement. Complaints were received from premises in the various. Wards as follows:— Beck ton and North Woolwich Ward. Central Ward East. Central Ward West. Manor Park Ward. Plasliet Ward East. Plasliet Ward West. Total. 99 176 216 274 117 153 1035 House to House Inspection.—929 House to House Inspections have been made at premises set forth in the following Table. The defects discovered are tabulated in the preceding Table HOUSE TO HOUSE INSPECTION. Name of Road. Number of premises Inspected. Number of premises where defects existed. Number of premises found in fair condition. Abbotts Road 55 42 13 Albert Road 11 5 6 Arragon Road 97 71 26 Barking Road 10 8 2 Barrington Road 3 3 ... Bartle Avenue 34 34 ... Beaconsfield Street 27 9 18 Bonny Downs Road 12 12 ... Bristol Road 6 6 ... Burges Road 4 4 ... Caledon Road 10 10 ... Castle Street 16 16 ... Charlemont Road 1 1 • • • Claremont Street 35 35 ... Cleves Road 7 7 ... Dickens Road 35 33 2 Eastbourne Road 4 4 ... Elizabeth Street 11 11 ... Ernald Avenue 28 28 ... Ferndale Street 12 12 ... First Avenue 2 2 ... Forest View Road 1 1 ... Fourth Avenue 52 43 9 Grantham Road 44 43 1 Greenhill Grove 1 1 ... Heigham Road 6 6 ... High Street, North Woolwich 31 19 12 High Street South 2 1 1 Johnson's Place, Green Street 16 8 8 Kings Road 46 46 ... Latimer Avenue 2 2 ... Lawrence Avenue 7 7 ... Manor Way 12 5 7 Masterman Road 3 ... 3 Melbourne Road 3 3 ... Mountfield Road 1 1 ... Muir Street 1 1 ... Parkhurst Road 22 21 1 Poulet Road 7 7 ... Prestbury Road 15 9 6 Priory Road 29 16 13 Ranelagh Road 5 5 ... Redclyffe Road 3 3 ... Robert Street 6 6 ... Roman Road 6 6 ... Romford Road 2 2 ... Sheridan Road 3 3 ... Sherrard Road 2 2 ... Stafford Road 20 20 ... Stanley Street 3 3 ... Strone Road 2 2 ... Talbot Road 29 24 5 Thackeray Road 44 34 10 Tudor Road 46 41 5 Walton Road 27 24 3 Wellington Road I 1 ... Woodstock Road 6 6 ... Whitfield Road 3 3 ... 929 778 153 92 In previous reports I have referred to the great importance of systematic house to house inspection with a view of ascertaining any nuisances which exist requiring the intervention of the Local Authority for abatement. Under the provisions of the Public Health Act, 1875, it is incumbent upon the Sanitary Authority to see that periodical inspections are made with this object, but it had always been doubtful if the Local Authority or its officer had the power of entry unless satisfactory reason could be shown that a nuisance existed, although it must be admitted one seldom experienced any difficulty in obtaining admission to premises. The Housing, Town Planning, etc. Act, 1909, makes it obligatory on the part of the Local Authority to cause from time to time inspection to be made of the inhabited houses in their district to ascertain whether such inhabited houses are in such a condition as to render them unfit for human habitation, for which purpose it shall be the duty of the Local Authority and of every Officer of the Local Authority to comply with such Regulations and to keep such records as may be prescribed by the Local Government Board. Under all previous legislation a Court of Summary Jurisdiction decided upon the evidence placed before it by the Local Authority through its Health Officers on the one side, and the owners of the property in question on the other, when a house was in such a state to be dangerous or injurious to health, as to render it unfit for human habitation, but a Closing Order is now obtainable without application to the Court; the Local Authority having power to make Closing Orders upon houses when, in their judgment, the insanitary condition of such houses warrants it. The owner may, if dissatisfied with the Local Authority's decision, appeal to the Local Government Board. In considering the number of house to house visitations, it will be seen that it was only possible to visit 929 of the 26,000 houses in the Borough. It will be noticed at a glance that with the same Inspectorial Staff, and providing no additional houses are built, it will take over 26 years to inspect the whole of the premises in the district. In reviewing this 93 kind of work one is compelled to admit that these figures are a little astonishing, and call for inquiry. I think one might state from an experience covering many years, that there is a large number of people—a class whose numbers are daily increasing—who take a practical and intelligent interest in the sanitary condition of the house in which they live, and the application of hygienic principles to their every-day life, but on the other hand a number of people exist who have little regard for the sanitary condition of their home, the health of themselves, children, or neighbours. Some discussion has taken place, and suggestions have been made as to how frequently house to house inspections should be made; it has been stated by some authorities that once in every five years is sufficient, but one cannot lay down a hard and fast rule, for it altogether depends upon the character of the people and the houses they live in. If houses are scampingly built, with small rooms and little convenience, rents may be low, but the occupants are of the poorest and usually those who have the largest families. The more persons occupying a house the greater is the strain upon its durability, and as property owning is an investment, owners do not voluntarily spend more money than can be helped on repairs or cleansing, seldom troubling to do work of a sanitary character until a Notice has been served. Another aspect to consider is that the very poorest people are the last to complain, and it often happens when an inspection is made the occupiers will plead with the Inspector to make it quite clear to the landlord that they are not responsible for his visit, especially is this the case when there is a little rent due. To definitely lay down a rule that this class of property shall be inspected every five years is totally inadequate. While there are properties in the Borough to inspect even as frequently as this would be waste of valuable time, for it must appeal to those who are acquainted with the different estates of this Borough that the occupants of villas of Wanstead Park and Woodgrange, who are in most cases business men and owners, do not require a Sanitary Inspector knocking at their door every five years. My experience of the occupiers of 94 Villadom is that if they have the slightest suspicion of anything being wrong they at once write a letter of complaint or requisition the services of the Inspector by telephone. There is an important aspect for consideration, and that is that the large majority of the houses in the Borough are of the six-roomed cottage type mostly, occupied by artizans and workers engaged in the City. It must be remembered that in 1881 there were under 2,000 houses then existing; in 1891, under 6,000; in 1901, 16,000; to-day there are 26,000. It will be noticed that 16,000 houses are 10 years old, and about 6,000 houses are 20 years old. Judging from observation during my Inspectorship, together with the character of the buildings which have been erected, one may, I think, express the opinion that the first ten years' life of the houses is the best, but after that period repairs become necessary, and dilapidations more frequent. In reviewing the past together with the number of houses built, it will be gathered that the district is comparatively new, and systematic house to house inspection hardly necessary, but these conditions cannot always prevail, and undoubtedly a great deal more time and attention must be given to this most important department of the work in the future. How it is to be done with the same number of Inspectors one cannot plan at the moment, but I feel it my duty to draw attention to it. It is futile to make inspections, unless there is time to follow up the work necessary for the abatement of the nuisances which have been set forth in the Notices served, by personal inspectorial supervision; and it is here where there is a great expenditure of time, but time that is well spent and cannot be dispensed with. Housing,Town Planning, &c. Act, 1909.—In September, 1910, the Local Government Board drew attention, by printed circular, to the duty of the Local Authority under this Act previously referred to in the paragraph dealing with House to House Inspection. The Local Government Board have by virtue of the powers vested in them by Sub-section (1), of Section 17, of the Housing,Town Planning, &c. Act, 1909, issued a code of 95 tions cited the "Housing (Inspection of District) Regulations, 1910," imposing an important responsibility on Local Authorities and specific duties that are to be observed by Health Officers. The Local Authorities are as early as practicable to determine the procedure to be adopted to give effect to these regulations, being guided by the varying needs of localities; and also cause to be prepared a list of dwellinghouses which in the opinion of the Medical Officer of Health are unfit for human habitation. With a view to uniformity and thoroughness, the Officer making the inspection has to specially report on the following matters (by the Board's instructions):— The arrangements for preventing the contamination of the water supply. Closet accommodation. Drainage. Light, free circulation of air, dampness and cleanliness. Paving, drainage, etc. Dust bin accommodation, etc. Rooms unfit for human habitation. Defects (general) that may tend to render a house unfit for human habitation. The Board have further prescribed that records of the inspections made shall be accurately kept under appropriate headings, which are tabulated in the Regulations. In reviewing the requirements of the Regulations with the detailed Table of nuisances on page 89 (which has been our practice for many years to observe when inspecting houses), it will be seen that all the items to which the Board direct special attention with the exception of light and free circulation of air, have been included in our list of sanitary defects, and as the Borough is a comparatively new district, the houses having been built under modern bye-laws, these two last-named defects are seldom met with except in the cases of erection of wooden structures by tenants, when they have been dealt with under the bye-laws as temporary buildings. 96 The keeping of records and general office work has always been a special feature of the Public Health Department. An accurate and detailed account of the work performed, and for which a small special staff of trained clerks is engaged, has been observed for the past sixteen years, so no new departure will be necessary to comply with the Board's wishes. The sections of the Housing, Town Planning etc. Act, dealing with insanitary and dilapidated houses will be of greater advantage to East Ham in years to come than at present, as it is, as I have previously stated, a comparatively new district, but any legislation, which assists in making healthy homes— which means happier people—must be welcomed by all interested in the common good of their fellows. Drains Unstopped and Cleansed.—In reviewing the nature of the nuisances in the Table on page 89, it will be seen that choked drains occupy the foremost position, the number of houses affected and attended to equals 2,117, being an increase of 512 for the previous year. In Beckton and North Woolwich Ward there are 2,605 houses, and at 525 of these it was necessary for the drains to receive attention, being equal to 20 per cent. These figures certainly appear large, but the explanation is that the system of drainage is of the kind known as " Combined," and if the main drain is choked near the sewer connection it affects a large number of houses, and judging from the articles we frequently have had to remove from drains, one is compelled to state that there has often been carelessness on the part of the tenants. In Plashet Ward East there are 3,482 houses, and at 107 of these we have been called upon to clear the drains, which is equal to nearly 3 per cent., while in Plashet Ward West there are 4,402 houses, and 252 stoppages occurred, which is equal to 5-7 per cent. In Central Ward West the figures are 4,204 houses, stoppages 483, or ii'4 per cent., and in Central Ward East 4,252 houses, 303 stoppages, or 6-6 per cent. The combined Plashet Wards are equal to 4-5 per cent., while the two Central Wards equal 9-0 per cent. The system of drainage in both districts is the same, 97 but property in the Central Wards is older and smaller. In Manor Park Ward there are 5,058 houses, stoppages 447, or 8.7 per cent. This Ward includes the low.lying district of Little Ilford, where it is impossible to obtain efficient falls to the drains, and where stoppages are often the result of thoughtlessness. The work of unstopping and cleansing drains is still carried out by the Council's own workmen, who have had many years' training and are thoroughly capable men, experienced in the work, and conscious of its importance; they discharge their duties (which are most onerous and frequently dangerous) most creditably. When it is considered what serious damage is often done to drains by indifferent workmen, I think the Council's policy of undertaking and carrying out this most important work free of charge will commend itself to every practical sanitarian. Drainage Work.— During the past year a large amount of time has been devoted to the testing and examination of drains, and at 748 houses the drains have been tested either by Chemicals, Smoke, or Water, and in 310 instances defects have been discovered, with the result that at 249 of the premises it has necessitated the re.construction of the drainage system, and at 61 houses the relaying of the branch drain connections. In addition there have been 314 new soil pans and traps fixed, and 9 new soil pipes erected. At the whole of these works of Sanitary amendment the work has been done under the strict supervision of the District Inspector, and no pipes were permitted to be covered until the new work had been water. tested and passed. It occasionally happens that cheap and indifferent jobbers will try to complete the work before intimating to the Inspector that the work has commenced, notwithstanding the fact that it is specially pointed out in the Notice served calling upon them to do the work that information must be given to the Inspector before commencing, and a stamped post card accompanies every Drain Notice. However, I am pleased to add that it is the general rule to inform the Inspector. G 98 Early in the year a conviction was obtained and the work ordered by the Court to be done a second time. In this case the owner repaired a broken drain-pipe at night by the aid of a candle light, the work being badly done. Under the East Ham Improvement Act, 1903, a person performing bad drain work is liable to be proceeded against, and if his master can satisfy the Court that he is not responsible, the workman himself is liable to conviction. The work connected with drainage re-construction must be regarded as the most important devolving upon an Inspector, the fact that the work is hidden from view, and defects (if any) cannot be seen, adds to the responsibility of the person who supervises and passes it. One knows that to conscientiously discharge these duties involves the expenditure of much time, but it is a good investment for the prevention of recurrence of Sanitary defects, which should be the primary object of a Health Official. The principal drainage work for the year 1910 has been done at the following premises: — RE-CONSTRUCTION OF DRAINS. New Lodging House, Albert Road, North Woolwich. 119 to 127 Arragon Road. 62 to 76 Castle Street. 17 to 33 Claremont Street. 114 and 127 Claremont Road. 90 to 102 Cleves Road. 42 Durham Road. 2 and 4 First Avenue. 9 to 16 Johnson's Place, Green Street. 26 to 36 High Street, North Woolwich. 307 High Street. 498 Katherine Road. 1 to 39 Kings Road. 6 Malvern Road. 23 and 25 Manor Way, North Woolwich. 35 Plashet Lane. 1 to 11 Priory Road. 30 Priory Road. 99 23, 25 and 35 Prestbury Road. 31 to 39 Redelyffe Road. 418 and 539 Romford Road. 10 Shrewsbury Road. 39 and 80 Stafford Road. 39 Wyndham Road. Sanitary Appliances.—In addition to the drain proper, there are the appurtenances thereto, and during the year 153 Water Closet Flushing Apparatuses, 85 Sink Waste Pipes and 127 Drain Ventilating Pipes have been eith.r renewed or repaired, as a result of the Department's intervention. Dirty Premises.—This term includes dirty walls and ceilings, and at 431 premises Notices have been served to have cleansing work performed. There is a decrease from the previous year, which was 522, and the year 1909 was 479. These figures are certainly small in comparison with the number of inspections made, although it is sometimes difficult to determine a standard of cleanliness for walls and ceilings. The Public Health Act's designation is "Filthy, or premises in such a state as to be a nuisance or injurious to health." As to the amount of dirt required on walls to constitute a nuisance one must be guided by experience, but it is surprising and sometimes amusing to listen to some aggrieved complainants when they desire the paper taken off the walls because it has been on for a period of perhaps two years, although the paper may be a varnished one, perfectly clean, and had recently been thoroughly washed. Some innocent people have a wonderful conception of an Inspector's power and seem very disappointed when informed of his limit in respect of cleansing and redecoration of interior walls and ceilings of hoases. Roofs, Eaves-Gutters and Rainwater Pipes.—Notices have been served relating to 310 premises where it has been necessary to repair roofs and cause them to be watertight, or reinstate eaves-gutters or rainwater pipes. Much damage is often done to property, causing dilapidation, dampness and discomfort, if not ill-health to the occupants, by failing to keep in a good state of repair these necessary adjuncts to a dwelling-house. 100 One regrets that the Building Bye-laws do not give greater power over the quality of the materials used in new buildings, when the health of the people depends as much upon what a house is built as the manner in which it is built. Houses without Water.—On 22 occasions the Metropolitan Water Board found it necessary to cut off the water from premises, as compared with 41 for the previous year. The water is usually cut off for waste, but not before owners have been given ample time to remedy the cause. Considering that there are 26,000 houses in the Borough, the number must be regarded as small. Upon receiving information from the Water Board that the water has been cut off, the premises are forthwith visited and a 24 hours Notice served. In the event of the water not being reinstated, the Council order Legal Proceedings to be instituted under the East Ham Improvement Act. On only one occasion has it been necessary to seek the aid of the Court, the particulars of which are recorded under "Summary proceedings (vide p. 123). Storage of Drinking Water.—For the year now under consideration, special attention has been given to the position of the drinking water cisterns and accessibility thereof for cleansing purposes, and 201 cases have been dealt with for improper storage, and 144 cisterns have been ordered to be fitted with tight-fitting covers. In most cases of improper storage a draw tap from the rising main has been fixed. It is amazing to find the appalling indifference that still exists among many people as to the internal condition of the drinking-water cistern, it is a common experience to find occupiers who are unaware that they have a cistern until it is discovered in the roof, to get at which requires some personal effort not to be found in every occupier of a dwelling-house, and it is with pleasure that we welcome the present conditions insisted upon in all new houses by the Borough Engineer's Department, viz., the fixing of a 101 draw-tap from the rising main, in addition to the covered cistern, which is placed in an accessible position for cleansing. This must have a beneficial result upon the health of the people. Dampness.—With a view to abating and preventing dampness in dwellings, attention has been given to the underfloor ventilation, defective damp courses and accumulations of water in basements, and in 448 premises nuisances arising from these causes have been discovered and dealt with by Notice on owners to remedy. Yard and Forecourt Paving.—By the powers vested in the Council under the East Ham Improvements Acts, 100 superficial feet of hard durable paving can be insisted upon in all premises within the Borough. This concession, which Parliament conferred upon East Ham, has been of enormous benefit, although the full amount is seldom asked for as it is not necessary. But a cement path immediately adjoining the brickwork at the back and front of a house is most essential, both for keeping the house dry and the floors clean. During the year 1910, Notices have been served calling upon owners either to provide or repair paving of 646 houses as compared with 738 for the previous year. Overcrowding.—Twenty cases of overcrowding were investigated and dealt with by the service of Notice during the year, as compared with 30 for the previous year. These cases occurred principally in the Central West and Manor Park Wards. The Notices served were complied with either by procuring more accommodation or re-arrangement of sleeping rooms. The subject of overcrowding with its causes and remedies has been fully dealt with in my previous reports, and as there is a substantial reduction in the number of reported cases for the year under consideration, I do not propose to make any further comments this year. Urinals.—There are eight Public Conveniences in the Borough, two are underground and six on the ground level. 102 The underground urinals are situated at East Ham Broadway, and Manor Park Broadway, the others are distributed about the Borough. Special men are engagtd (who work under the direction of the Borough Engineer) in keeping them clean. They are frequently inspected and have always been found in a fatisfactory condition. Many of the external urinals attached to Public Houses require constant attention, and in some instances Notices have had to be served for the abatement of nuisances, while some are inadequate in size and suitability. Smoke Nuisances. —Several complaints have been received during the year, relative to the emission of black smoke from chimneys in the Borough, and some fifty observations have been taken and reports made to the Public Health Committee. Notices were authorised to be served in many instances, and the nuisances complained of have either been abated or improvements affected. Passages at Rear of Premises.—The nuisances arising from passages at rear of business premises have been pointed out in previous reports. One cannot commend the Tradesmen for the energy displayed or supervision exercised in keeping these passages clean. Much of an Inspector's time is expended in endeavouring to bring about an improvement, but without much success. Temporary Buildings.—The erection of wooden structures at rear of inhabited dwelling-houses is common to most smallclass property, and in some instances little, if any, harm results therefrom; but there is a limit that few people are capable of appreciating, especially is this the case when the building is erected for housing animals, such as fowls, rabbits, etc. Fowls are certainly first favourites among the artizan class, largely because they are most profitable, and each year one has to report that flower-beds and gardens have given way to fowlhouses and rabbit-hutches. 103 On 25 occasions during the year wooden structures have been reported to the Borough Engineer for removal, as there were flagrant violations of the Bye-laws, such as enclosing bedroom windows or outside water-closets, impeding ventilation, etc., and on 41 occasions Notices had to be served under the Public Health Act, 1875, upon occupiers of premises for keeping animals in such a state as to be a nuisance or injurious to health. Gipsies.—155 Inspections of Gipsy Caravans and Squatters' Tents have been made during the year, as compared with 246 for the previous year. It will be noticed there is a decrease of 91, which is largely attributable to the decision of the Council to enforce the Bye-Laws, which make it compulsory for occupiers of Caravans, Tents, or other structures to provide suitable water receptacles and sanitary utensils. During the year 11 Summonses were granted against occupiers of caravans for non compliance with the Bye-Laws. When the Summonses were called, only four answered—the other seven had decamped, but convictions were obtained in each case and penalties imposed. It is true that in only two instances have the fines been recovered, but the remaining nine debtors are absenting themselves from the Borough, which is of much greater benefit to the district than their money. The Gipsy nuisance lessens each year; as vacant land becomes covered with houses opportunities for encampment diminish. Mortuaries.—The Council's mortuaries at Wakefield Street and North Woolwich have been regularly inspected and found in a clean and satisfactory condition. This will be the last time the Wakefield Street Mortuary will be referred to, as the new mortuary, an excellently-arranged and fully-equipped building on the Town Hall site, will take its place. The old building has served the Borough for many years, and it is surprising how well the work has been done in such a small and inconvenient place. The new building will be appreciated by those whose duty it is to perform work there. 104 Schools.—The Public and Private Elementary Schools are periodically visited and the sanitary appliances examined. The general condition of the Latrines, Urinals, Gullies, etc., has been found to be satisfactory, most of the caretakers taking keen interest in endeavouring to keep the school for which they are responsible, clean. Disinfectants.—For the general convenience of the inhabitants, the Council have four stations for distribution of disinfectants. They are situated in different parts of the Borough. The Town Hall is the principal depot and store, the others are at Church Road, Cyprus, New Beckton, and North Woolwich Manor Way. These issuing depots are much appreciated. Disinfectants are obtainable free of charge in all cases of Infectious Disease, etc. Dairies and Cowsheds.—There are seven registered cowsheds and 155 dairies in the Borough and during the year, 317 inspections have been made. Details of the inspections are entered in the Dairies Register. In the cowsheds special attention has been given to enforce the regulations made by the Council under the Dairies, Cowsheds and Milkshops Order, regulating cubic capacity for the cows, proper and suitable lighiing, ventilation, drainage, water supply, cleansing, limewashing, etc. No serious breach of the regulations has been reported, but it has been necessary to write threatening letters on one or two occasions for laxity in general cleanliness. In connection with these Milk Stores and Dairies, much care has been exercised to see that utensils are clean, adequate provision is made for providing boiling water for cleansing, and that the storage of milk and appliances is not subject to contaminating influences. Unsound Food.—The Market places have been regularly inspected and on occasions unsound food has been discovered exposed for sale, by the Inspector. The cases were not flagrant and no legal proceedings were instituted. 105 There have been surrendered at the Town Hall for examination and des' ruction some 16 consignments of unsound food comprising:— 80 lbs. Cod. 1 box Catfish. 1 „ Filleted Haddock. 2 trunks Haddock. 1 trunk Halibut 2 cases Herrings. 1 trunk Skate. 1 box Kippers. 43 Bloaters. 4 trunks Whiting. 10 boxes Grapes. The practice of giving certificates of condemnation for the unsound food which has been surrendered by an owner prevents much food of an improper character being sold to the public. It has been suggested that the practice is open to abuse by unscrupulous persons, but every care is taken on our part by observation and investigation to prevent this form of fraud. The markets are regularly inspected and speaking generally the food offered for sale, although cheap, must be regarded as good in quality. Diseased Meat.—Two very important seizures were effected during the year from two private registered slaughter-houses, one in Manor Park Ward and one in Plashet Ward West. In the former case the district Inspector entered the slaughter-house and discovered the carcase of a tuberculous cow being "dressed." He subsequently returned with the Chief Inspector and a Veterinary Surgeon and the whole carcase was seized, condemned, and destroyed by order of the Magistrate. Legal proceedings were instituted and argued before the Stipendiary Magistrate, and the case being considered of great importance a barrister was briefed. The ground of the information was the the carcase of the diseased cow was being prepared for the food of man; the defence being 106 that the cow was apparently in excellent condition prior to slaughter, that the price paid was the full value of a sound cow, and that it was not until after the animal had been killed and opened that there was any disclosure of disease, and that the owner would have surrendered the carcase for condemnation if it had not been seized. His Worship, the Stipendiary Magistrate, in hearing the case exercised great patience and astuteness in eliciting the facts, his questions to witnesses on both sides proving how anxious he was to administer justice, and all in Court (except perhaps the defendant) agreed that his decision was a just one, the maximum penalty and costs being inflicted. The second seizure comprised the whole carcase of a tuberculous cow (excepting the offal which had been removed) and several parts of a second carcase. This seizure was effected front an old slaughter-house which had not been used for killing for some time, but had been brought into requisition to meet the urgent need of a cattle dealer, who had been stopped from killing "wasters" in an adjoining district. Five aged cows were brought to this slaughter-house one morning and killed, the offal removed, and the carcases left to hang. The slaughter-house was carefully locked, but observation had been kept on the cows when grazing in a meadow, and the morning they were missed, all the private slaughter-houses were visited, and at mid-day they were located, although it neccessitated entering the slaughter-house through a fanlight (which had been left open) to effect a seizure. The whole five carcases were carefully examined by a Veterinary Surgeon and the Medical Officer of Health. It was considered advisable to seize one whole carcase and several parts of a second carcase upon which tubercular lesions had been discovered. These parcels were subsequently submitted to one of His Majesty's Justices of the Peace, condemned and ordered to be destroyed. The person representing himself as the owner was fined £20 and costs. The result of these two cases is most gratifying and has acted as a deterrent, for the defendant in the second action has not to our knowledge visited the Borough since with the object of killing any worn-out cows. 107 Slaughter-houses.—I have frequently pointed out in previous reports that the obscure private slaughter-house is often used for killing and preparing carcases for market, and the difficulties associated with thorough inspection. Killing is usually done at nights and Sundays, and the first objector the Inspector meets when visiting at. night is the faithful but ferocious dog who not only informs his master that someone is coming, but keeps the Inspector at bay for his master's convenience. It is provided in the Public Health Act, 1890, that a "licensed" slaughter-honse may be closed upon the occupier's conviction by a Court of Summary Jurisdiction for having upon the premises, meat not fit for the food of man. The wording of the Section is "The occupier of any building licensed as aforesaid," but as the worst slaughter-houses in the Borough are "Registered" we are legally advised that we cannot claim the advantages of this section. The position certainly seems a little ludicrous—that which is considered to be an offence serious enough to close a licensed slaughter-house, has not the same effect in the case of a registered slaughter-house. It is to be hoped that the private slaughter-houses will soon receive the attention of Parliament, and that some legislation will be enacted giving more drastic powers to Local Authorities respecting old slaughter-houses. A further advantage in detecting diseased carcases would be to make it compulsory for every slaughterman to give notice to the Local Inspector and obtain a permit before killing. This would (in my opinion) eliminate from the Trade, the nefarious dealer in old " Screw " cows, and do no injustice to the honest trader. Public abattoirs have been advocated for many years, but their general adoption in small towns is very slow, and one is afraid that while the door of the private slaughter-house is open, diseased animals will be taken there in preference to the Public Abattoir. There are 15 registered or licensed Slaughter-houses in the Borough, and during the year 124 inspections have been made. 108 Special attention has been given to cleansing of premises and utensils. The general condition may be considered at fairly satisfactory. Annual Licenses have been renewed with the exception of that for 536, Romford Road, which License has lapsed. The following is a list of the Slaughter-houses in the Borough:— Beckton Road. Forest View Farm. 10, Greenhill Grove. 319, Green Street. 363, Green Street. 14, High Street North. 170, High Street North. 89, Plashet Grove. 32a, Plashet Lane. 638, Romford Road. 6, Station Road. 28, Station Road. Shaftesbury Road. 24, Wakefield Street. 65, Whitta Road. Infectious Diseases.—In all cases of Infectious Diseases notified the premises are forthwith visited by the district Inspector, the sanitary arrangements of the house with its surrounding conditions are examined, the drain tested, and where any sanitary defects are discovered, or stripping and cleansing required, Notices are served upon the person responsible and the work done under the Inspector's direction. Directions are given as to isolation and a printed list of precautions handed to the responsible person setting forth the rules to be observed to prevent the spread of infection. A report of each case containing full details required for the Medical Officer of Health is prepared by the Inspector. The Librarian is notified of the existence of any infected premises to which books from the Public Libraries have been 109 supplied, and the proprietors of Laundries are informed when any of their customers have an infectious case in their house. Books from an infected house are returned direct to the Sanitary Inspector, and disinfected by being placed in an airtight chamber and subjected to S.O.2 fumigation under pressure. The Head Teachers of day schools and the responsible officials of Sunday schools are advised of all cases of infectious disease occurring at houses where scholars attending their respective schools reside. Bakehouses, Factories and Workshops.—There are 299 factories and workshops on the Register; which include Laundries, Bakehouses, Blouse-makers, Tailors, Boot-makers, Shirt-makers, etc. During the year 477 inspections have been made as compared with 262 for the previous year. Notices have been served calling attention to breaches of the Factory and Workshop Act. This is a branch of work in which to some extent there is dual responsibility, as the Inspectors of the Home Office (Factory Department) have certain powers and duties in connection with factories which are occasionally somewhat confusing. For example, a bakehouse which one has known and inspected periodically for years may in the course of 24 hours become a factory by the simple introduction of a motor-worked dough-mixer, when it comes under the supervision of H.M. Inspector of Factories. I am happy to say that in spite of this dual control there has been no clashing of interests between the two authorities, the relations between this department and the Factory department of the Home Office are amicable and every effort is made on both sides to work satisfactorily together. We have been notified 3 times by the Chief Inspector of Factories, of nuisances existing in workshops calling for abatement, and on 21 occasions we have informed the Chief Inspector of irregularities which came within his province. 110 At one workshop in Plashet West Ward it was found that owing to an increase in the business and the difficulty of keeping one of the workrooms up to a sufficiently high temperature in cold weather, the owner re-arranged his workrooms in such a way as to necessitate a large proportion of his employees having to pass from one room through the whole length of another before reaching an exit. In ordinary circumstances this involved no difficulty or danger but it is obvious that in the case of fire—or what often amounts to the same thing so far as risk to limb is concerned—an alarm of fire, this arrangement was far from being satisfactory. The question of an emergency exit was carefully considered, and I am pleased to report that the owner after full discussion agreed to the reasonableness of providing an external iron stair exit and has further arranged to give his employees periodical fire drill. The latter point, although outside the jurisdiction of the local Authority, in fact of any Statutory Authority, appears to me to be of equal, if indeed not greater, importance than the provision of the most elaborate mechanical schemes for safety. One hopes that this example will be followed at an early date by all employers, particularly of female labour. Common Lodging House —In the early part of the year a Common Lodging House was opened at North Woolwich, with accommodation for 42 beds. The premises formerly served as a Police Station, but have since been adapted for the purpose for which they are now used. Regular inspections have been made and the premises found in a satisfactory condition. This is the only Common Lodging House in the Borough. Trade Refuse.—The collection and disposal of Trade Refuse continues to work satisfactorily. The Council collect tradesmen's refuse (except obnoxious matter) twice in every week free of charge. To carry out the work necessitates the employment of two horses, vans and men at a cost of about £275 per annum. By reference to the nuisance table on page 89 it will be seen that nuisances arising from offensive accumulations have decreased from 257 in 1909 to 236 in 1910, while for the year 111 1908, the year prior to free collection, it was 303. The form of nuisance referred to in the table is the depositing of garbage on vacant land, or allowing it to accumulate at the rear of business premises, and although it is collected free of cost there are still some tradesmen who will not co-operate with the Council in facilitating the work by placing the refuse in a receptacle, but choose rather to sweep it into the Public Highway to the annoyance of the general public. The Council have powers under their Bye-Laws to deal with this form of nuisance, and it has been recently necessary to specially report the infringement of the Bye-Law, and final letters of caution have been sent to tradesmen who have been in the habit of using the public highway as a common refusepit informing them that future infractions of the Bye-Law will result in legal proceedings being instituted against them. Undoubtedly this course will have to be resorted to before some people will assist in keeping the Borough clean. Offal and Bone Refuse collection.—Some annoyance is frequently caused in the summer months by the collection of fish offal from the fishmongers' shops and bones and waste fat from the butchers' shops. The refuse from these trades has a marketable value, and tradesmen have no difficulty in obtaining persons who will collect the refuse from their premises, but the objection from the Local Authority's standpoint is to the kind of van used for collecting purposes, the condition in which the vans are kept, and to the hours of collection. Complaints have been received of the offensive odours emitted from these van?, and letters have been sent to the responsible persons calling their attention to the nuisance. The Council has in past years exercised itself very considerably to mitigate this form of nuisance by successfully obtaining several injunctions against offal carriers prohibiting them from creating a nuisance by sending their vans through the district. The neighbouring Authorities equally benefitted 112 by these proceedings, as the vans collect in, and travel through, districts adjoining East Ham; but as most of the persons against whom injunctions were granted have left the business, the Council may in the near future have to reconsider the question. Collection of House Refuse.—During the year 1910, 12,917 loads of House Refuse were collected from houses in the Borough. The work of collecting house refuse has been vested in the Public Health Department for many years. There are 26 men, including the foreman, engaged; 16 are Contractor's and 9 the Council's workmen. The collection is by the weekly system. Occupiers are requested to place the dust receptacles in a convenient position ready for the dustman on the day of collection. The Council has a Bye-law imposing this obligation on the occupier, which I am pleased to report it has never been necessary to enforce as the Burgesses willingly co-operate in facilitating the work by placing the dust bin ready for the dustman on the day of collection. The whole of the refuse is conveyed to the Council's Destructor, where it is used for generating steam for pumping purposes in connection with the sewage works. The three years' contract with the present contractor expires this year, and as it was the first contract of its kind in this district it is with some satisfaction that one reviews its working. The payment for contracting prior to 1908 was is. per hour for horse and driver. It can be readily appreciated that the slower the horses moved the more shillings could be earned, but this go-as-you-please style did not facilitate the collection of dust, and eventually resulted in bringing about the present method. The principle of the existing contract is that the contractor has for a specific sum to provide as many horses and drivers as shall be found necessary to collect the refuse from all premises in the Borough once in every week, the Council to furnish as many vans as required and to employ fillers as may be found necessary, the work to commence and finish at stated hours. 113 The working of the contract has been most satisfactory. There have been few complaints of non-collection. The time of leaving off has always been earlier than the hour fixed by the contract, and the horses supplied have been a credit to the contractor. The Council has also saved a very substantial sum for the ratepayers. Report to Public Health Committee re Repairs to Dust Vans, 1909 and 1910. In compliance with your request, I beg to report there are twenty vans and two carts at work in the Borough removing refuse from houses and premises. There are in addition seven spare carts which have been used four times a year for Dust Collection during the holiday season, and are also frequently used by the Borough Engineer when required. The dust vans, carts, and spare carts have been repaired when necessary and charged to one Works Order number. The total amount spent on repairs during the year ending March 31st, 1910, equals £217, or £7 9s. 7d. per vehicle per annum, which is 2s. iod. per week. This sum may appear large, but the nature of the work and the age of some of the vans must be considered; the first vans have now been running for nearly twelve years. The cost of repairs for tipping vans must necessarily be more than ordinary vans, the mechanism is frequently put out of order by the jolting, etc. The wear and tear of a dust van may be considered great, for it is rough, hard work. During the year, six vans have been thoroughly overhauled, the covers removed, sides raised, and two carts have also been rebuilt. The sum of £200 provided in the estimate for the current year will enable us to remove several more covers and apply some much needed paint to the worst of those vans which have not received attention this year, and thereby lessen the cost of repairs in the future. 1 would also suggest the transference of the seven spare carts to the Borough Engineer, which will relieve the Dust Collection Department from keeping them in repair in the future. H 114 Dust Bins.—It has been necessary to report to the Public Health Committee, some 301 houses as not being provided with suitable dust bins, and authority has been given in each instance for the service of the usual Statutory Notice upon the owner, under the provisions of the East Ham Improvement Act, to furnish each house with an efficient, portable, galvanized iron bin, failing the compliance with this Notice, the Council has exercised its power by providing the bin and recovering the cost. The following table gives the number of loads of house refuse dealt with:— DUST COLLECTION. NUMBER OF LOADS COLLECTED DURING 1910 FROM:- Beckton and North Woolw'h Ward. Central Ward East. Central Ward West. Manor Park Ward. Plashet Ward East. Plashet Ward West. Total Loads Collected per Month. JANUARY 97 221 172 297 163 181 1131 FEBRUARY 70 215 178 231 168 179 1041 MARCH 69 225 195 246 218 235 1188 APRIL 89 263 214 254 172 188 1180 MAY 69 216 180 281 185 178 1109 JUNE 71 189 174 234 168 203 1039 JULY 110 227 154 244 149 161 1045 AUGUST 87 185 121 237 163 164 957 SEPTEMBER 100 218 168 220 154 182 1042 OCTOBER 96 195 136 260 150 164 1001 NOVEMBER 101 219 141 236 181 185 1063 DECEMBER 132 241 185 215 152 196 1121 1091 2614 2018 2955 2023 2216 12,917 116 Petroleum Licenses.—The premises licensed for the storage of Petroleum have been systematically inspected to see that the provisions of the Petroleum Acts were observed and that suitable accommodation was provided. The requirements have been rigidly enforced in every instance. The Licenses (which are annual) are never issued until my report has been made to the Town Clerk. There are now some 19 premises licensed for the storage of Petroleum in the Borough. Shop Hours Act, 1904.—In 1909, at the request of the Hairdressers and Barbers in the Borough, an Early Closing Order was submitted to the Home Secretary who, after some amendment, confirmed the Order. The carrying out of the provisions of this Order relating to the hours of closing were left to the Local Hairdressers Association, but the Council in October, 1910, decided that the work in future should be done by the Sanitary Inspectors, and during the last two months of the year 172 premises were visited at closing time. Several Hairdressers were reported to the Committee for infractions of the Order, but no legal proceedings were instituted during this period. Sanitary Inspectors' Congress, 1910. Report of Chairman of the Public Health Committee and Chief Sanitary Inspector re Sanitary Inspectors' Congress, London, August 29th to September 3id, 1910. Gentlemen, In compliance with your request we beg to report attending the Conference held under the auspices of the Sanitary Inspectors' Association in London and adjacent districts from August 29th to September 3rd. The Conference was housed, by courtesy of the Fishmongers' Company, at Fishmongers' Hall, London Bridge, and some 400 delegates assembled daily. Monday.—The Conference opened on Monday, 29th August, the whole of the first day being devoted to the business of the Sanitary Inspectors' Association 117 Tuesday.—On Tuesday, the Conference was resumed at ten o'clock, when the Prime Warden of the Fishmongers' Company, Bryan Durant, Esq., received the delegates in a few well-chosen words of welcome. This was followed by the Presidential Address of Sir James Crichton Browne, F.R.S. Sir James, as is usual at the3e meetings, made the subject of his discourse one of the matters that form part of Public Health Administration, and on this occasion selected for his subject, "Food and Fish Supply." He pointed out that last year 248,075 tons of fish were delivered at Billingsgate, and 946 tons were seized and destroyed as unfit for human food. Sir James's address, which lasted nearly two hours, embraced every aspect of the fish industry, was listened to by a large audience with rapt attention. The dangers of Fish as a food and the great need of constant and vigilant supervision by the Inspectors were pointed out, and many valuable hints given of which the members readily availed themselves. Sir James also dealt at length with the value of fish as a food and the urgent necessity of bringing it within the teach of poor people, especially in Inland Towns and Rural Districts. Sir James resumed his seat amid great applause, and was accorded a hearty vote of thanks. Following Sir James's address was a paper by Mr. J. Roberts, Chief Inspector to the Fishmongers' Company, entitled, "The Distinguishing and Inspection of Marketable Fishes." Mr. Roberts's paper, accompanied by demonstrations, was a valuable contribution and useful to every Inspector in the discharge of his duties. The next paper was by Dr. Andrew Balfour, M.D., D.P.H., F.R.S.E., on " Tropical Sanitation." This paper was very instructive and especially helpful to Inspectors who are engaged in tropical countries, or who are contemplating taking up such appointments. The delegates were then entertained by the Fishmongers' Company to lunch, which consisted very largely of fish. After lunch, the party was conducted over the works of Messrs. Peak, Frean & Co., and were shown the processes and methods of biscuit manufacture. 118 Wednesday.—The Conference re-opened, Sir James Crichton Browne presiding. The first paper was by Mr. John Quinton, of Liverpool, on "Sanitary Inspectors in the Making for Efficiency." The paper was an exceedingly practical one, dealing with the causes as well as the remedies ot ex'sting insanitary conditions. This paper was followed by a very spirited discussion. The next subject introduced for consideration was entitled, "Feeding the People," an excellent paper read by Mr. W. W. West, of Walthamstow. The writer showed the amount of food consumed by the nation, the character of the food and where it came from, also the dangers it was subjected to, and the responsibilities devolving upon local authorities and their officers for safeguarding the people's health and interest in procuring a wholesome food supply. The discussion that followed this paper was instructive and useful to all Inspectors present. The third paper read on Wednesday was by Mr. Walter Smith, of Northumberland, on the "Housing, Town Planning Act, &c., 1909, from a Sanitary Inspector's point of view." Mr. Smith showed in his paper that the Act was a most valuable one, in-as-much as it gave the Inspector greater powers and simplified the mode of procedure in dealing with houses unfit for human habitation, etc. This paper was much appreciated and a very interesting discussion followed. In the afternoon the delegates visited Messrs. Monsted's Margarine Factory, Southall, and were conducted over the enormous works, the largest of their kind in the world, the various processes in the manufacture of margarine being shown. One interesting feature of this visit was that at the tea served at the works, half the slices of bread on the tables had upon them butter and half pure vegetable margarine. After the repast the guests were invited to differentiate between the butter and the margarine that they had just eaten, but no one was bold enough to attempt it. 119 Thursday.—The Conference resumed, Sir James Crichton Browne presiding. The first paper was read by Mr. H. C. Cameron, High Commissioner, New Zealand Government, entitled " Our New Zealand Food Supply, its Collection, Inspection and Distribution. Mr. Cameron devoted himself to showing the great care exercised by the New Zealand Government to protect the food from contamination in its collection and transportation, and in seeing that only the best of the produce is shipped for transport. Mr. Cameron explained very fully the methods of food inspection, and criticised very severely the lax methods adopted in this country in the distribution, especially with regard to frozen meat. The second paper was read by Mr. C. W. H. Biggs, of London, on "The advance of civilization from a sanitary point of view." The third paper was read by Miss Ethel Tawney, of Croydon, on "The Medical Inspection of School Children as it effects the administration of Public Health." The three papers were much appreciated by the delegates and a very helpful discussion followed. Later the delegates travelled to Sudbury to inspect the Model Walker Gordon Dairy Farms and Laboratories. The party was received at Sudbury by Mr. Titus Barham who explained in detail the principle upon which the milk was prepared for invalids and children. He then conducted the delegates through the cowsheds and subsequently entertained them at Sudbury Hall to a garden party. Friday.—The conference resumed, Sir James CrichtonBrowne presiding. The subject down for consideration was "London's Water Supply." A very interesting paper was read by Mr. E. B. Barnard, Chairman of the Metropolitan Water Board on "The Work of the Water Board." Mr. Barnard dealt with every aspect of this vast undertaking from its inception, 120 Specially referring to the difficulties and how they were overcome. At the conclusion of the morning's proceedings the delegates boarded two steam yachts and went up river to Hampton for the purpose of viewing the great reservoirs. The company was received at Hampton by the Chairman and Members of the Water Board who conducted them, as far as time would permit, over the works. Saturday.—The delegates re-assembled, the first business being to move votes of thanks to the various persons and corporate bodies who had worked for the success of the Conference. The delegates subsequently visited Ealing Sewage Works, Ealing Model School for Physical Training. The Conference closing by a visit to the Model Bakery and New Zealand Pavilion, etc., at the Japan-British Exhibition. The Conference was the 25th held by the Sanitary Inspectors' Association, and the general opinion of those attending was that it was one of the most profitable from the Inspectors standpoint that had yet been organised. CONTAGIOUS DISEASES (ANIMALS) ACTS. Swine Fever.—The prevalence of Swine Fever throughout the country has compelled the Board of Agriculture to keep in force the Swine Fever (Regulation of Movement) Order of 1908, which prohibits the removal of pigs, without a license, out of a scheduled area into another area, or vice versa. In the case of store pigs, before a license can be issued it is necessary for the owner to sign a declaration that the pigs have been in their last place of abode for 28 days, and that they are not suspected of disease. Every care is taken to prevent the transmission of Swine Fever from one area to another. East Ham, for the purposes of the Swine Fever Order, is part of the Metropolitan Area. During the year nearly 100 declarations were made and received, and licenses granted authorising the removal in or out of the Borough of upwards of 121 2,000 pigs. Many of them have been sent to provincial towns and others to the London markets. There have been 3 cases of reported Swine Fever in consequence of pigs dying. The Board of Agriculture was informed and Notices (Form "A") were served upon the responsible persons, but in no case was the report confirmed by the Veterinary Inspector of the Board of Agriculture. It is now upwards of two years since a genuine case of Swine Fever occurred in the Borough. Glanders.—There have been two outbreaks of Glanders during the year, affecting three horses, as compared with five outbreaks, affecting nine horses, for the year 1910. Of the three horses killed, two were clinical cases and one contact animal which was mallein tested and re-acted. Post Mortem examinations were held by the Veterinary Inspector and glandular lesions discovered in the lungs of each horse. The carcases were destroyed in che Council's Destructor, together with wooden mangers, nosebags, horse cloths, and any articles that were liable to retain infection. Compensation has been paid in accordance with the provisions of the Glanders and Farcy Order, 1907. Manure has been removed and destroyed, and stables disinfected with Lime and Carbolic Acid. Full enquiry as to the origin or cause of the outbreak has also been made. During the year, 5 horses have been Mallein tested, but in only one instance was there any re-action. In April, at the invitation of the London County Council, a Conference was held in London to consider the urgent necessity of suggesting to the Board of Agriculture the advisability of issuing an Order, having for its object uniformity of action by the respective Authorities in and around London in cases of outbreaks of Glanders, and in this connection the following suggestions were made: — Report re suggested amendment to the Glanders Older the for Extirpation of Glanders. 1. That powers be obtained for the destruction of infected nose bags, halters, horse cloths, brushes, fodder, and any other articles that have been used in connection 122 with glandered horses, and the Local Authority be empowered to pay compensation accordingly. 2. That the Local Authority shall test all contact horses (with or without the consent of the owner) and re-test (if necessary) as often as required for a period of three months. 3. That should the owner of a contact horse desire to sell within three months, it shall be obligatory for him to furnish the Local Authority with the name and address of the purchaser. 4. That the Local Authority shall have control over suspected glandered horses as long as in their opinion it may be found necessary. 5. That in the opinion of the East Ham Local Authority it is not desirable to form a joint Committee for the whole of the Metropolitan Police Area to administer the Contagious Diseases of Animals Act, 1894, but that the provisions of the Act are better carried out by persons having an intimate knowledge of the locality. Parasitic Mange.—The Essex (Parasitic Mange) Order made by the Board of Agriculture has been in operation during the year. The Order provides that it is compulsory for every owner of a diseased or suspected animal to isolate it and immediately notify the case. During the year 8 notifications have been received. Every case has been visited by the Veterinary Inspector, and a certificate received verifying the disease. At the termination of the cases, the stables, harness and utensils were disinfected in accordance with the regulations made by the Council under the powers given by the Diseases of Animals Act, 1894. During the year a diseased horse was sent from a City Sale-yard to stables within the Borough. The Council drew the Corporation of the City of London's attention to the practice of sending diseased horses to Public Repositories in the City for sale, and subsequently to purchasers' stables, but it appears that if the animals have been treated with a suitable dressing and a certificate given by the Veterinary Inspector the animal may be transmitted from one district to another. 123 SUMMARY PROCEEDINGS. Date, 1910. Address. Offence. Statutory Powers for Proceedings. Result of Proceedings. Mar. Whitta Road, Manor Park Pigs not marked in accordance with the provisions of the Swine Fever (Movement) Order, 1908. Contagious Diseases (Animals) Act, 1894. Fined £1 10s. and Costs. April Vacant Land off Hertford Road Failing to provide any water receptacles and a sufficient supply of wholesome water for the use of the inmates of a caravan. Council's Bye - Laws for Caravan and Tent Dwellers. Fined £1 and Costs. April Vacant Land off Burges Road Failure to provide suitable receptacles and a sufficient supply of wholesome water for the use of the inmates of a caravan. Do. Fined 10s. & Costs. April Vacant Land off Burges Road Do. do. Do. Do. April Vacant Land off Hertford Road Do. do. Do. Do. April Vacant Land off Hertford Road Do. do. Do. Do. April Vacant Land off Hertford Road Do. do. Do. Do. April Dersingham Avenue, Manor Park Occupying a dwelling house without providing a wholesome supply of water for drinking purposes. East Ham Improvement Act, 1898. Fined £1 and Costs, or 7 days. (The defendant went to prison.) 124 SUMMARY PROCEEDINGS—continued. Date, 1910. Address. Offence. Statutory Powers for Proceedings. Result of Proceedings. June Whitta Road, Manor Park Having possession of a Tuberculous carcase of a cow intended for the food of man. Public Health Acts, 1875— 1890. Fined £20 & Costs. June Vacant Land off Hertford Road Failure to provide suitable receptacles and a sufficient supply of wholesome water for the use of the inmates of a caravan. Council's Bye - Laws for Caravan and Tent Dwellers. Fined 10s. & Costs. June Vacant Land off Hertford Road Do. do. Do. Do. June Shaftesbury Road, Having possession of a Tuberculous carcase of a cow intended for the food of man. Public Health Acts, 1875— 1890. Fined £20 & Costs. Dec. Dersingham Avenue Manor Park Occupying a dwelling house without providing a wholesome supply of water for drinking purposes. East Ham Improvement Act, 1898. Fined £1 and Costs or 14 days. (The defendant went to prison.) Dec. High Street North Pigs not marked in accordance with the provisions of the Swine Fever (Movement) Order, 1908. Contagious Diseases (Animals) Act, 1894. Fined £1 15s. and Costs. Three Gipsy Summonses not served. Defendants decamped. J. G. BANKS, A.R. San. Inst., Chief Sanitary Inspector. 125 Table showing the Localities in which certain Diseases of a Zymotic character occurred during the year 1910. LOCALITY. No. of Occupied Houses. June, 1910. Scarlet Fever. Diphtheria. Typhoid Fever. Erysipelas. Puerperal Fever. Phthisis. Albert Road 117 4 .. .. .. .. .. Alexandra Road 80 1 .. .. .. .. .. Altmore Avenue 191 3 1 .. .. .. .. Arthur Road 11 .. 1 .. .. .. .. Ashford Road 49 2 .. .. .. .. .. Abbotts Road 58 .. 1 .. 1 .. 2 Aintree Avenue 60 .. 1 .. .. .. .. Arragon Road 114 6 .. .. 1 .. 1 Albany Road 45 .. 3 1 .. .. .. Aldersbrook Lane 1 .. .. .. .. .. .. Aldersbrook Road 26 .. .. .. .. .. .. Alverstone Road 141 1 .. .. .. .. 1 Ann's Cottages 8 .. .. .. .. .. .. Ashley Road 28 1 .. .. .. .. 1 Beaconsfield Street 28 1 2 .. .. .. .. Beckton Road 107 .. .. .. .. .. 1 Becket Avenue 59 .. .. .. .. .. 1 Bedford Road 22 .. .. .. .. .. .. Blenheim Road 68 .. .. .. .. .. .. Brooks Avenue 63 .. 1 .. .. .. .. Burnaby Street .. .. .. .. .. .. .. Bridge Road 38 .. .. .. .. 1 .. Brighton Road 60 .. .. .. .. .. .. Brookwood Road .. .. .. .. .. .. .. Bonny Downs Road 65 2 1 .. 1 .. 1 Burges Road North 223 .. 2 .. 2 .. .. Burges Road South 11 .. .. .. .. .. .. Bartle Avenue 61 .. .. .. .. .. .. Bendish Road 47 .. .. .. .. 1 .. Benson Avenue 67 .. .. .. 1 .. .. Boleyn Road 95 .. 1 .. 1 .. 1 Barking Road 296 7 .. 2 1 .. 1 Boundary Road 105 2 .. .. .. .. .. Brancaster Road 6 .. .. .. .. .. .. Barrington Road 36 .. .. .. .. .. .. Browning Road 223 .. 1 .. 1 .. .. Bath Road 6 .. .. .. .. .. .. Byron Avenue 229 3 2 .. .. .. .. Berkeley Road 35 .. .. .. .. .. .. Bristol Road 137 3 1 .. .. .. .. Balmoral Road 1 .. .. .. .. .. .. Birchdale Road 73 2 .. .. .. .. .. Central Avenue .. .. .. .. .. .. .. Clacton Road 62 4 .. .. .. .. .. Cotswold Gardens 15 .. .. .. .. .. .. Creek Terrace 33 .. .. .. .. .. .. Cyprus Place 37 .. 1 .. .. .. 1 120 LOCALITY. No. of Occupied Houses, June, 1910 Scarlet Fever. Diphtheria. Typhoid Fever. Erysipelas. Puerperal Fever. Phthisis. Cameron Street 19 1 .. .. .. .. .. Church Street 24 .. .. .. .. .. .. Claremont Street 52 1 .. .. .. .. .. Calverton Road 64 .. .. .. .. .. .. Charlemont Road 123 1 2 .. .. 1 .. Caulfield Road 204 .. .. .. 1 .. 2 Caledon Road 148 1 2 .. .. .. .. Clements Road 171 .. 1 .. .. .. .. Compton Avenue 74 1 .. .. .. .. .. Campbell Road 36 .. .. .. .. .. .. Castle Street 37 4 .. .. .. .. 1 Cleves Road 98 4 .. .. 1 .. 1 Colvin Road 60 2 .. .. .. 1 .. Creighton Avenue 75 1 2 .. .. .. .. Central Park Road 265 1 1 .. 1 .. .. Charlotte Terrace 5 .. .. .. .. .. .. Capel Road 69 1 .. .. .. .. .. Carlyle Road 114 4 1 .. .. .. .. Chesterford Road 95 1 .. .. .. .. .. Carlton Road 47 .. 1 .. .. .. .. Clarence Road 28 .. .. .. .. .. .. Cumberland Road 16 .. .. .. .. .. .. Colchester Avenue 65 1 .. .. 1 .. .. Church Road 153 1 1 .. 2 .. .. Colston Road 40 .. 3 1 .. .. .. Clifton Road 33 1 .. .. .. .. .. Coleridge Avenue 75 2 .. .. .. .. .. Crescent Road 47 .. .. .. .. .. .. Cowper Avenue 23 .. .. .. 2 .. .. Cromwell Road 62 3 .. .. .. .. .. Chester Road 70 .. .. .. .. .. .. Claremont Road 57 3 .. .. .. .. .. Denbigh Road 50 2 .. .. .. .. .. Drew Road 5 .. .. .. .. .. .. Dukes Avenue 3 .. .. .. .. .. .. Dickens Road 56 1 .. 1 .. .. .. Doré Road 38 .. .. .. .. .. 2 Dersingham Avenue 161 5 3 .. 2 .. 1 Durham Road 92 2 1 .. 1 .. .. Dorset Road 69 .. .. .. 1 .. .. Elizabeth Street 135 5 3 1 .. .. 1 Eastbourne Road 58 .. .. .. .. .. .. Eversleigh Road 69 3 .. .. .. .. 1 Ernald Avenue 63 .. 1 .. 1 .. 1 Empress Avenue 32 .. 1 .. .. .. .. Eighth Avenue 42 .. 2 .. .. .. .. 127 LOCALITY. No. of Occupied Houses, June, 1910. Scarlet Fever. Diphtheria. Typhoid Fever Erysipelas. Puerperal Fever. Phthisis. Elsenham Road 29 1 .. .. .. .. .. East Avenue 64 .. .. .. .. .. .. Essex Road 108 1 .. .. .. .. .. Elizabeth Road 111 1 1 .. .. .. .. Edith Road 31 .. .. .. .. .. .. Frinton Road 83 .. .. .. .. .. .. Factory Road 1 .. .. .. •• .. .. Francis Street 22 .. .. .. .. .. .. Ferndale Street 10 2 3 .. .. .. .. Fabian Street 29 .. .. .. .. .. .. Folkestone Road 21 .. .. .. .. .. .. Friars Road 94 2 1 .. .. .. .. Florence Road 36 .. .. .. .. .. .. Fifth Avenue 40 .. .. .. .. .. .. Fourth Avenue 119 1 1 .. 2 .. .. First Avenue 135 1 .. 1 .. .. .. Forest View Road 26 .. 1 .. .. .. .. Forest Drive 40 1 .. .. .. .. .. Fry Road 15 .. 2 .. .. .. .. Finden Road 19 .. .. .. .. .. .. Grosvenor Gardens 26 .. .. .. .. .. .. Glenister Street 30 1 .. .. .. .. 1 Gresham Road 15 .. .. .. .. .. .. Gooseley Lane 49 .. .. .. .. .. .. Gillett Avenue 56 .. .. .. .. .. .. Grosvenor Road 29 .. .. .. .. .. 1 Greenleaf Road 14 1 .. .. .. .. .. Gainsborough Avenue 43 .. .. .. .. .. .. Grantham Road 133 2 .. .. .. .. 2 Gordon Road 10 .. .. .. .. .. .. Gladding Road 12 .. .. .. .. .. .. Gloucester Road 49 .. .. .. .. .. 1 Greenhill Grove 96 2 1 .. 1 .. 1 Goldsmith Avenue 113 2 3 .. .. .. .. Gladstone Avenue 92 1 1 .. .. .. .. Green Street 210 3 4 .. 2 .. 1 Hubert Road 51 1 .. .. .. .. .. Hollington Road 84 1 1 .. .. .. .. Haldane Road 19 .. .. .. .. .. .. Henniker Gardens 111 3 .. .. .. .. .. Hatherley Gardens.. 125 4 1 .. .. .. .. High Street, N. Woolwich 38 2 .. .. .. .. 2 Hall Road 96 1 .. .. .. .. .. Hertford Road 4 .. .. .. .. .. .. Hoollway Road 7 .. .. .. .. .. .. 128 LOCALITY. No. of Occupied Houses, June, 1910. Scarlet Fever. Diphtheria. Typhoid lever. Erysipelas. Puerperal Fever. Phthisis. Holland Road 10 .. .. .. .. .. .. Howard Road 10 .. .. .. .. .. .. Henry Road 14 .. .. .. .. .. .. Holme Road 84 .. .. .. .. .. .. Harrow Road 37 .. .. .. 1 .. .. Heigham Road 136 1 .. .. .. .. .. Hartley Avenue 39 .. .. .. .. .. .. Hockley Avenue 68 2 2 .. .. .. .. High Street South 123 .. 1 .. .. .. .. Herbert Road 135 5 1 .. 3 .. 2 Harcourt Avenue 108 1 2 .. .. .. .. High Street North 419 2 2 .. 2 .. 2 Halley Road 370 2 2 1 .. .. 2 Henderson Road 91 1 .. .. .. .. .. Hilda Road 28 .. .. .. .. .. .. Hampton Road 28 .. .. .. .. .. .. Johnstone Road 21 .. .. .. .. .. .. Jephson Road 54 .. .. .. 2 .. 1 Johnson's Place 7 •• .. •• .. .. .. Kennard Street 2 .. .. .. .. .. .. Keppel Road 104 1 2 1 .. .. .. Kempton Road 157 1 1 .. .. .. .. Kimberley Avenue 2 .. .. .. .. .. .. Kings Road 31 3 .. .. .. .. 1 Katherine Road 386 8 .. .. 5 .. 3 Kensington Avenue 151 .. .. .. .. .. 1 Lonsdale Avenue 61 3 .. .. .. .. .. Livingstone Street 19 3 .. .. 1 .. .. Lichfield Road 55 .. .. .. .. .. .. Leigh Road 89 1 .. .. 1 .. .. Lydeard Road 20 .. .. .. .. .. .. Latimer Avenue 71 .. 1 .. 1 .. .. Langdon Road 15 .. .. .. .. .. .. Lloyd Road 36 .. .. .. .. .. .. Lathom Road 168 1 .. .. 2 1 1 Langton Avenue 41 1 .. .. .. .. .. Ladysmith Avenue 39 1 .. .. .. .. .. Loxford Avenue 67 1 .. .. .. .. .. Lawrence Road 74 3 .. .. .. .. 1 Leader Avenue .. .. .. .. .. .. .. Landseer Avenue 91 3 1 .. .. .. .. Little Ilford Lane 139 1 1 .. 1 .. 1 Little Ilford Avenue 24 .. 1 .. .. .. .. Lawrence Avenue 217 1 .. .. 2 .. 2 Lancaster Road 81 1 .. .. .. .. .. Lansdowne Road 64 1 1 .. 1 .. 1 129 LOCALITY. No, of Occupied Houses. June, 1910. Scarlet Fever. Diphtheria. Typhoid Fever. Erysipelas. Puerperal Fever. Phthisis. Masterman Road 87 1 2 .. .. .. .. Mitcham Road 80 .. 1 .. 1 .. .. Marlow Road 68 .. .. .. .. .. .. Milk Street 9 .. .. .. .. .. .. Muir Street 11 .. .. .. .. .. .. Manor Way 12 .. .. .. • • .. .. Montpelier Gardens 57 .. .. .. .. .. .. Mountfield Road 77 .. .. .. .. .. .. Market Street 90 1 .. .. 1 .. 1 Melbourne Road 108 .. 3 1 .. .. .. Mafeking Avenue 11 .. .. .. .. .. .. Myrtle Road 7 .. .. .. .. .. .. Malvern Road 55 .. .. 2 1 .. .. Macaulay Road 68 6 .. .. 1 .. 2 Meanley Road 129 .. .. .. 1 .. .. Morris Avenue 57 .. .. .. .. .. .. Michigan Avenue 18 .. .. .. .. .. .. Manor Park Road 52 .. 1 .. .. .. .. Merlin Road 27 .. .. .. .. .. .. Monega Road 356 7 .. .. 2 .. .. Marlborough Road 58 .. 1 .. .. .. 1 Milton Avenue 161 3 .. .. .. .. 1 Newland Street 6 .. .. .. .. .. .. Norfolk Road 79 4 .. .. .. .. .. Northfield Road 53 3 .. .. .. .. .. Nelson Street 33 .. .. .. .. .. .. Norman Road 22 .. .. .. .. .. .. Napier Road 82 .. .. .. .. 1 1 Navarre Road 29 .. .. .. .. .. .. Nigel Road 74 1 .. .. .. .. .. Outram Road 72 .. .. .. 1 .. .. Oakfield Road 112 .. .. .. 1 .. .. Oregon Avenue 22 .. .. .. 1 .. .. Osborne Road 37 .. .. .. .. .. .. Pulleyns Avenue 57 .. .. .. .. .. .. Plevna Street 13 1 .. .. .. .. .. Poulet Road 51 .. .. .. .. .. .. Park Avenue 29 .. 1 .. .. .. .. Parr Road 87 2 .. .. .. .. .. Priory Road 66 2 .. .. 1 .. 2 Parkhurst Road 246 2 1 Plashet Lane 158 1 .. .. .. .. .. Prestbury Road 71 2 .. .. 1 .. 1 Park Road 62 1 .. .. .. .. .. Plashet Grove 157 3 .. .. 1 .. .. 130 LOCALITY. No. of Occupied Houses. June, 1910, Scarlet lever. Diphtheria. Typhoid Fever. Erysipelas Puerperal Fever Phthisis Robert Street 32 2 .. .. .. .. 1 Roman Road 174 3 5 .. .. .. .. Rancliffe Road 37 .. .. .. .. .. .. Rane lagh Road 81 1 •• •• .. .. 1 Redelyffe Road 46 2 .. .. 1 .. .. Romford Road 477 3 2 .. 2 .. .. Rabbits Road 7 .. 1 .. .. .. .. Rectory Road 44 .. .. .. 1 .. .. Reynolds Avenue .. .. .. .. .. .. .. Rosebery Avenue 164 1 1 .. 1 .. 2 Ruskin Avenue 143 .. 1 .. .. .. 1 Rixsen Road 31 .. 1 .. .. .. .. Rosedale Road 74 2 .. .. •• .. .. Rothsay Road 51 .. .. .. .. .. .. Ratcliffe Road 50 1 .. 1 •• •• .. Rutland Road 88 3 3 .. 2 .. .. Station Street 11 .. .. .. .. .. .. Shepstone Street .. .. •• .. .. .. .. Savage Gardens 118 4 .. .. .. .. 1 Stanley Street 16 .. .. .. .. .. 1 Staveley Street 5 .. .. .. .. .. .. Storey Street 51 .. .. .. .. .. .. Saxon Road 10 .. 1 .. .. .. .. Southchurch Road 28 .. .. .. .. .. .. Stevenage Road 38 .. .. 1 .. .. .. Springfield Road 27 .. .. .. .. .. .. St. Olaves Road 46 1 .. 2 .. .. 1 St. Albans Avenue 84 .. 1 .. .. .. .. Southend Road 77 .. .. .. 1 .. .. Skeffington Road 102 1 .. .. .. .. 1 Shoebury Road 21 .. .. .. .. .. .. Streatfield Avenue 67 3 2 .. .. .. .. Sussex Road 4 .. .. .. .. .. .. St. Bartholomew's Road 39 .. 1 .. .. .. .. Stamford Road 108 .. .. .. 1 .. .. St. John's Road 79 .. .. .. 2 .. .. Spencer Road 42 1 .. .. 2 .. .. Sr. Bernard's Road 95 .. .. .. .. .. 2 Seymour Road 86 3 .. .. .. .. 1 St. Martin's Avenue 52 2 .. .. .. .. .. Station Road 42 .. 2 .. .. .. .. St. Margaret's Road 52 .. .. .. .. .. .. Salisbury Road 68 .. .. .. 1 .. .. Second Avenue 144 3 1 .. .. .. 1 131 LOCALITY. No. of Occupied Houses, June, 1910 Scarlet Fever. Diphtheria. Typhoid Fever. Erysipelas. Puerperal Fever. Phthisis. Selborne Avenue 27 .. .. .. .. .. .. Sixth Avenue 166 .. .. .. 1 .. .. Seventh Avenue 112 1 .. .. 3 .. .. Sheringham Avenue 207 1 1 .. 1 .. .. School Road 20 .. .. .. .. • • .. Sebert Road 1 .. .. .. .. .. .. Sheridan Road 87 1 .. .. 1 .. .. Sibley Grove 107 .. .. .. 3 .. .. Shelley Avenue 143 .. .. .. 1 .. .. Stanley Road 48 2 .. .. .. .. .. Swinburne Avenue 22 .. .. .. .. .. .. Shakespeare Crescent 223 3 .. .. .. .. .. Strone Road 400 5 4 .. 2 .. 1 Sherrard Road 411 10 3 .. .. .. 1 Shrewsbury Road 283 11 2 .. 1 .. 1 St. Stephen's Road 134 2 .. .. .. .. .. Shaftesbury Road 49 .. .. .. .. .. .. South Esk Road 184 3 4 .. 1 .. 1 St. Dunstan's Road 22 .. .. .. .. .. .. Sandringham Road 31 1 1 .. .. .. .. Stafford Road 108 5 1 .. .. .. .. Tilbury Road 6 .. .. .. .. .. .. Telham Road 92 3 1 1 1 .. 1 Talbot Road 106 .. .. 1 .. .. 3 Thorpe Road 46 .. .. .. .. .. .. Thackeray Road 56 6 .. .. 1 .. .. Tudor Road 76 3 .. .. .. .. .. Temple Road 16 5 .. .. .. .. .. The Chase 3 .. .. .. .. .. .. The Warren 23 .. 1 .. 1 .. .. Toronto Avenue 12 .. .. .. .. .. .. Third Avenue 148 2 .. .. .. .. 1 Trevelyan Avenue .. .. .. .. .. .. .. Tennyson Avenue 46 1 .. .. .. .. .. Vicarage Lane 32 1 .. .. .. .. .. Victoria Avenue 78 1 .. .. .. .. 1 Vernon Avenue 7 .. .. .. .. .. .. Welbeck Road 44 1 .. .. .. .. .. White Horse Road 23 .. .. .. .. .. .. Wolsey Avenue 83 .. 1 .. .. .. .. Wall End Road 27 .. .. .. .. .. .. Welstead Road 93 .. .. .. 1 .. 2 Wellington Road 75 .. .. .. .. .. 1 Winter Avenue 36 .. .. .. .. .. .. Wakefield Street 153 4 .. .. .. .. 1 132 LOCALITY. No. of Occupied Houses, June, 1910. Scarlet Fever. Diphtheria. Typhoid Fever. Erysipelas. Puerperal Fever. Phthisis. Wilson Road 40 .. .. .. .. .. .. Worcester Road 50 .. .. .. 1 .. .. Wanstead Park Avenue 100 2 2 .. .. .. .. Walton Road 137 .. .. 3 .. .. .. Washington Avenue 43 .. .. .. .. .. .. Whitta Road 44 1 .. .. .. .. .. Wentworth Road 33 .. .. .. .. .. .. Wolferton Road 6 .. .. .. .. .. .. Warwick Road 26 1 2 .. .. .. .. Woodhouse Grove 42 1 .. .. .. .. .. Wordsworth Avenue 53 1 .. .. .. .. .. Washington Road 10 .. .. .. .. .. .. Waterloo Road 25 .. .. .. .. .. 1 Walpole Road 38 .. .. .. .. .. .. Whitfield Road 47 .. 1 .. .. .. .. Whittaker Road 41 1 1 .. .. .. 1 Wyndham Road 40 .. .. .. .. .. .. Wortley Road 34 .. .. .. .. .. .. Woodstock Road 56 .. .. .. .. .. .. Windsor Road 65 1 1 .. .. .. .. York Road 99 3 .. .. .. .. 1 133 INDEX. A PAGE Abatement of Nuisances 87 Acreage 7 Acts adopted 5 Acts, Bye-Laws, and Regulations in force 5 Adenoids 76, 79 Air Temperature 39 Alleys 102 Antitoxine 23, 52 Area 7 Artizan's Dwellings 37 B Back Passages 102 Bacteriological Laboratory 23, 29 Bakehouses 30, 109 Births 4, 7, 8 Birth-rate 4, 7, 8 Births, Illegitimate 10 Boots of School Children 73, 75 Building Operations 37 Bye-Laws (Streets and Buildings) 5 C Cancer 28 Chart—Birth-rate, 20 years 9 „ Death-rate, 20 years 10 „ Relative Fatality 14 Children Act 81 Children, Medical Inspection of 64 Cleansing Station 81 Clothing of School Children 75 Common Lodging-house 110 Comparative Statistics 4 134 INDEX—continued. PAGE Complaints 90 Conference, Glanders extirpation 121 „ Sanitary Inspectors 116 Contagious Diseases (Animals) Act 121 Cost of Upkeep of Isolation Hospital 55, 56 Cowsheds 30, 104 Customs and Inland Revenue Act 31 D Dairies 30, 104 Deaths 4, 10 Death-rate, Illegitimate Children 10 Death-rate, Corrected 15 Death-rate, General 10 Death-rate, Zymotic 4, 18 Death-rate, Infantile 4, 16 Deaths of Non-Residents 10 Deaths, Uncertified 15 Deformities of School Children 73, 77 Diagram showing Relative Fatality 14 Diarrhœa 17, 47 Diphtheria 23, 52 Dirty Premises 99 Disinfectant Stations 104 Disinfection of Premises 31, 64 „ of Library Books 109 Diseases and Defects remedied in School Children 78, 79 Drainage Work 96, 97 E Ear Diseases of School Children 73, 74, 79 Education Statistics 60 Employment of Children 74 Enteric Fever 24, 53 Erysipelas 24 Eye Diseases of School Children 73, 74, 79 135 INDEX—continued. F PAGE Factory and Workshop Act 32, 109 Filter Bed 38 Fish Offal Collection 111 Food and Drugs Act 35 Food Inspection 36, 104 Food, Unsound and Diseased 36, 104 G Gipsies 103 Glanders extirpation Conference 121 Glanders Outbreaks 121 H Hairdressers' and Barbers' Closing Order 116 Hearing of School Children 74 Heart Disease of School Children 68, 73, 74 Hospital Accommodation 49, 54 Hospital Buildings 54 Hospital Cubicles 49, 50, 53 Hospital Establishment Charges 55 Hospital Patients' Expenses 56 Hospital Staff 54 Hospital Staff, Health of 54 House Refuse Removal 112 House to House Inspection 90, 92 Housing 36, 37 Housing, Town Planning, etc., Act 94 I Infantile Mortality 4, 16 Infectious Diseases 20, 81, 108 Infectious Diseases of School Children 77 Infectious Disease, Attack Rate 20, 21 Inhabited Houses, Number of 4, 36 Inhabited House Duty Exemption 31 Inquests 15 Inspection of Borough 87, 92 Isolation Hospital 49 136 INDEX—continued. L PAGE Laboratory Work 29 Legal Proceedings 35, 104, 123 M Malignant Disease 28 Mange, Parasitic 122 Market Places 104 Measles 27, 64 Meat, Diseased 36 Medical Inspection of School Children 64 „ „ Attendance of Parents 64 „ „ Defects 73 „ „ Height and Weight 69, 70, 71, 72 „ „ Method of 61, 65, 68 „ „ Number Examined 68 „ „ Objections to 64 „ „ Scope of 61 „ „ Schedule of 65 Membranous Croup 52 Mental Capacity of School Children 73, 77 Meteorology 39 Milkshops 30 Mortuaries 37, 103 Mumps 28 N Nervous Diseases of School Children 73 Notices served 88 Notification of Infectious Diseases 20 Notification Rate 20 Nutrition of School Children 73, 76 Nuisances discovered 88, 89 O Observation Wards (Hospital) 49, 53 Offal Collection 111 Offensive Accumulations 110 137 INDEX—continued. PAGE Open Spaces 37 Outworkers 33 Overcrowding 101 P Parasitic Mange Order 122 Parks and Open Spaces 37 Passages 102 Petroleum Licenses 116 Phthisis 25, 53 Population 4, 5, 6, 7 „ Density of 7 „ Natural Increase of 4 Puerperal Fever 24 Pulmonary Tuberculosis 25 R Rainfall 4, 39 Rateable Value and Rates 5 Refuse Destructor 38 Regulations 5, 95 Rickets 73, 77 Ringworm 73, 77 S Sanitary Inspectors' Conference 116 Sarcoma 28 Scarlet Fever 22, 51 Schools, Elementary 62, 63, 104 School Accommodation 63 „ Buildings 64 „Clinic 80, 81 „ Closure 27, 64 „ Heating 62, 63 „ Lighting 62, 63 „ Places 60, 63 „ Nurse 77,81 Shop Hours Act 116 138 1NDEX—continued. PAGE Sewerage and Sewage Disposal 38 Skin Diseases of School Children 73, 77, 79 Slaughter Houses 107 Small Pox 22 Smoke Nuisances 102 Speech Defects of School Children 74 Statistics (Comparative) 4 Statistical Data 5 Swine Fever 121 Swimming Bath 38 T Table—Acreage 7 „ Attack Rate 20, 21 „ Average Stay of Hospital Patients 56 „ Bacteriological Examinations 30 „ Births 2 „ Birth-rate 8 „ Boots of School Children 73 „ Cancer Mortality 28, 29 „ Clothing of School Children 73 „ Comparative Statistics 4 „ Complaints received 90 „ Cost of Up-keep of Isolation Hospital 55, 56 „ Deaths 42, 43, 44, 45, 46, 47 „ Death-rates 77 Great Towns 12, 13 „ Density of Population 7 „ Diphtheria, Attack Rate 20, 23 „ „ Hospital Patients 50 „ „ Mortality 20, 23, 52 „ „ Notifications 23 „ Diseases and Defects Remedied 79 „ Drainage Work 98 „ Dust Collection 113 „ Enteric Fever, Attack Rate 20, 24 „ „ „ Hospital Patients 24, 50 „ „ „ Mortality 20 „ „ „ Notifications 24 „ Erysipelas Mortality 20 „ „ Notifications 20 139 INDEX—continued. PAGE Table—Factories and Workshops 32, 34 „ Food and Drugs Act, Legal Proceedings 35 „ Height of School Children 69, 71 „ Hospital Accommodation 54 „ Hospital Staff 54 „ Hospital Patients, Scarlet Fever 50 „ Hospital Patients, Diphtheria 50 „ House-to-House Inspection 91 „ House Refuse Collection 113 „ Infantile Mortality 17, 18, 47 „ Infectious Cases Removed to Hospital 20, 42 „ „ „ Schools 82 „ „ „ Notified 125 et seq. „ Inquests 16 „ Inspections made 87, 89 „ Isolation Hospital 50 „ Legal Proceedings 124, 125 „ Medical Inspection, Number of Children examined 68 Defects 73 „ „ „ Schedule of 66, 67 „ Meteorological Record 39 „ Notifications 21, 42 „ Notification Rate 20, 21, 22 „ Nuisances Discovered 89 „ Other Diseases treated in Hospital 51, 53 „ Outworkers 33 „ Parks and Open Spaces 37 „ Population 6, 8 „ Population, Ward 6 „ Pulmonary Tuberculosis, Hospital Patients 42 „ „ „ Notifications 21, 42 „ Rainfall 39 „ Scarlet Fever, Attack Rate 20, 22 „ „ „ Hospital Patients 50 „ „ „ Mortality 20, 22 „ „ „ Notifications 22 „ Schedule of Medical Inspection 66, 67 „ Slaughter Houses 108 „ Statistical Data 5 140 INDEX—continued. PAGE Table—Statistical Data (Education) 60 „ Tuberculous Disease Mortality 25, 27 „ Typhoid Fever 24 „ Verminous condition of School Children 73 „ Vital Statistics (10 years) 40, 41 „ Ward Death Rates 15 „ Ward Population 6 „ Weight of Children 70, 72 „ Zymotic Case Rate 21 „ Zymotic Mortality 19 Teeth of School Children 73, 76, 79, 81 Temperature 39 Temporary Buildings 95, 102 Tonsils, Enlarged 76, 79 Tracheotomy 53 Trade Refuse, Removal of 110 Tuberculous Diseases 25, 47 „ „ of School Children 74, 75 Typhoid Fever 24, 53 U Unsound Food 36, 104 Urinals 101 V Verminous condition of School Children 75, 79 Vision of School Children 73, 74, 79, 80 W Ward Death Rates 15 Ward Population 6 Wasting Diseases 17, 47 Water Supply 38, 100 Whooping Cough 27 Workshops 32, 34, 109 Work of Children out of School Hours 74 Work of School Nurse 77 Z Zymotic Death Rate 4, 18 Zymotic Diseases 20