EAS 38 COUNTY BOROUGH Of EAST HAM. PUBLIC HEALTH DEPARTMENT. Annual Report on the Health and Sanitary Condition of the Borough, and THE REPORT TO THE EDUCATION COMMITTEE, by W. BENTON, M.R.C.S., L.R.C.P., 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, 1915. Recorders, Ltd., High Road, Ilford. 1916. COUNTY BOROUGH Of EAST HAM. PUBLIC HEALTH DEPARTMENT. Annual Report on the Health and Sanitary Condition of the Borough, and THE REPORT TO THE EDUCATION COMMITTEE, by W. BENTON, M.R.C.S., L.R.C.P., 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, 1915. Recorders, Ltd., High Road, Ilford. 1916. To His Worship the Mayor, the Aldermen, and Councillors of the County 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 carried out during the year 1915. The Report to the Education Committee is also included, together with an account of the work done in connection with the Medical Inspection of School Children and School Clinic. In the interests of economy, owing to the war, the Report is condensed as much as possible, but from the facts given it will be seen that the health of the Borough is still in a very satisfactory position in regard to its mortality statistics, the death-rate being 11.7 and Infantile Mortality 79 per 1,000 births. Besides my other varied duties, during the rush of recruits at the end of the year I assisted in their examination and also acted as Medical Officer to the different Battalions formed in the Borough until they were drafted elsewhere. I again wish to express my thanks to my staff for the support extended to me. I am, Gentlemen, Your obedient Servant, W. BENTON, Medical Officer of Health. Town Hall, East Ham. March, 1916. EAST HAM CORPORATION. PUBLIC HEALTH COMMITTEE. Councillor A. H. Wiseman (Chairman). The Mayor (Alderman R. Banks-Martin, .J.P.). The Deputy-Mayor (Councillor J. A. Williams). Alderman O. R. Anstead, J.P. Councillor J. J. Francis. Alderman J. Brooks, J.P. Councillor W. T. Howlett. Alderman E. Edwards, J.P. Councillor G. Mitchell. Alderman C. Northfield, J.P. Councillor V. R. Oliver. Alderman M. Oakes, J.P. Councillor W. H. Pilgram. Councillor H. Barfield. Councillor J. Savage. Councillor A. Coles. Councillor F. Smith. Councillor G. P. Dean. Councillor A. Stokes. Councillor J. Evans. Councillor A. Taylor. Councillor W. C. Ford, J.P. Councillor H. F. Witherspoon. STAFF OF THE PUBLIC HEALTH DEPARTMENT. Clerks: G. W. Friend, *W. J. Worley, *R. A. Baskett, *F. J. Kendall, A.R.San.I., Chief Clerk. W. L. Garrett, Acting Chief Clerk. Sanitary Inspectors: M. J. J. Hillyard, M.S.I.A., J. G. Anderson, M.S.I.a., G. D. lill, M.S.i.a. Shops Act Inspector: *W. S. C. Tooby. Health Visitors: *Miss B. Kerr, A.R.San.I., .and Miss B. Buckton. Senior Tuberculosis Nurse and Inspector of Midwives: Miss E. Webb, A. R.San .I. Tuberculosis Nurse: Miss Stevens. School Nurses: *Miss H. Forbes, Miss F. Howe, and *Miss L. Mallon. School Medical Clerk: Miss P. Perry. Assistant School Medical Clerk: Miss I. Hollingsworth. 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., M.S.I.A. Tuberculosis Officer: W. O. Pitt, M.D., D.P.H. Deputy Medical Officer of Health and Senior Assistant School Medical Officer: *W. A. Berry, M.D., B.S. (Lond.), D.P.H. Assistant School Medical Officer: *D. S. Brough, M.B., Ch.B., D.P.H. Medical Officer of Health, School Medical Officer, and Medical Superintendent Isolation Hospital: W. Benton, M.R.C.S., L.R.C.P., D.P.H. *Members of Staff on Active Service. 5 Summary of Report for 1915. Population, Census 1911, 133,487. Estimated Population to middle of year 1915, 142,582. Persons per acre, 44. Inhabited Houses, Census 1911, 29,289. Births, 3,300. Birth-rate per 1,000 of the estimated population, 23.1. Deaths, 1,674. Death-rate per 1,000 of the estimated population, 11.7. Excess of Births over Deaths, 1,552. Zymotic Death-rate, 0.8. Infantile Mortality per 1,000 Births, 79. Total Rainfall, 30.4. Borough Isolation Hospital, Roman Road, East Ham. Hospital for Small Pox, Dagenham (Joint Hospital). Water Supply—Metropolitan Water Board. COMPARATIVE STATISTICS. Annual Rate per 1,000 living. Deaths under one year per 1000 births. Births. Deaths. Crude. Standardised. England and Wales 21.9 15.1 14.8 110 96 great towns, including London 22.8 15.6 15.9 117 148 smaller towns 21.6 14.0 14.2 114 England and Wales less the 244 towns 20.7 14.8 13.6 98 London 22.6 16.1 16.1 112 EAST HAM 22.6 11.7 ... 79 6 BOROUGH OF EAST HAM. PUBLIC HEALTH DEPARTMENT. REPORT of the MEDICAL OFFICER OF HEALTH For the year 1915. VITAL STATISTICS. POPULATION. The population of the Borough at the Census of 1911 was 133,487. The estimated population, according to the Registrar General, at the middle of 1915, was 142,582. BIRTHS. During the year 3,300 births were registered as against 3,436 in 1914, giving a birth-rate of 23.1 per 1,000 population. Of these 1,654 were males and 1,646 females. Illegitimate Births. Sixty-nine of these were registered. DEATHS. The number of deaths which took place in the Borough during the year was 1,145. Of these 4 were non-residents, and can therefore be excluded. 533 deaths were reported of persons belonging to the Borough which had taken place in Institutions outside the district. 7 Including these we have a nett total of 1,674 (848 males and 826 females), which gives a rate of 11.7. The death-rate for England and Wales was 14.8, and for the 96 great towns 15.9. No uncertified deaths were recorded in 1915. INQUESTS. 186 inquests were held. Post-mortem examinations were held on 44 cases. The following were the causes certified by Coroners:— Heart Disease 29 Suicides 13 Convulsions 2 Pneumonia 12 Suffocation (overlaying in bed) 1 Burns 1 Cerebral Hæmorrhage 7 Murder 1 Accidents 34 Bronchitis 5 Pulmonary Tuberculosis 6 Drowning 9 Want of proper attention at birth 1 Cerebro-Spinal Fever 2 Diphtheria 1 Other causes 62 186 INFANTILE MORTALITY. 263 deaths of infants under 1 year of age occurred in the Borough, giving a rate of 79 per 1,000 births registered as compared with 77 per 1,000 in 1914 and 63 in 1913. The number of infant deaths and the rate per 1,000 births for the past five years were as follows:— 8 Year. Number of Infant Deaths. Rate per 1,000 Births Registered. 1911 412 119 1912 256 71 1913 226 63 1914 267 77 1915 263 79 STATEMENT SHOWING THE WORK NOW BEING CARRIED OUT IN CONNECTION WITH THE SCHEME FOR MATERNITY AND CHILD WELFARE. Ante-Natal classes are held on Wednesday afternoons. Short addresses are given by the Inspector of Midwives. Practical demonstrations in clothing infants are held and patterns are given. Visits are made by the Health Visitors to homes of expectant mothers. Five maternity boxes have been provided out of voluntary funds for loan in necessitous cases. Milk is also supplied out of the same fund. Any cases requiring medical advice are referred to the Medical Officer of Health or Lady Assistant School Medical Officer. Infant consultations have in the past been held on Friday afternoons, but the numbers in attendance have increased to such an extent that it has now been decided to have two afternoons per week. The infants are weighed, advice given, and in those cases where necessary Virol is supplied, the parents making a small payment. Either the Medical Officer of Health or Assistant School Medical Officer attends to give advice. Cases of Ophthalmia Neonatorum are visited, and when the Health Visitor is not satisfied with the treatment, the parent is advised to bring the infant to the Clinic. 9 The following is a summary of the work carried out by the Health Visitors for the year 1915:— Births 1,688 Re-visits 1,907 Phthisis 422 Re-visits 456 Special Visits 88 Ophthalmia Neonatorum 16 Re-visits 8 Cases reported N.S.P.C.C. 7 Ante-Natal 176 Re-visits 75 Total 4,843 Total attendances at Infants' Consultation, 5,550. An analysis of this follows:— Births. Re-visits. B'ckt'n and North W'lw'h Central East. Central West. Manor Park. Plashet East. Plashet West. B'ckt'n and North W'lw'h Central East. Central West. Manor Park. Plashet East. shet West. 155 339 329 450 124 291 154 336 328 569 167 353 Ante-Natal. Re-visits. B'ckt'n and North W'lw'h Central East. Central West. Manor Park. Pla- shet East. Pla- shet West. B'ckt'n and North W'lw'h Central East. Central West. Manor Park. Plashet East. Plashet West. 26 37 39 40 11 23 6 9 13 30 3 14 Phthisis. Re-visits. B'ckt'n and North W'lw'h Central East. Central West. Manor Park. Pla- shet East. Fla- shet West. B'ckt'n and North W'lw'h Central East. Central West. Manor Park. Pla- shet East. Plashet West. 38 91 115 91 34 53 57 92 103 95 32 77 10 Summary of work at Infants' Consultation for 1915:— Number on Register 755 Total Attendances 5,550 NOTIFIABLE INFECTIOUS DISEASES. 1,257 cases of Infectious Disease were notified during the year as against 1,173 in the previous year. Small Pox. No case was notified during the year. Scarlet Fever. 499 cases of this disease were notified during the year as against 677 cases in 1914. 10 deaths occurred from the disease, giving a death-rate of 0.07 as compared with 0.05 for the year 1914. Diphtheria. 204 cases of this disease were notified during the year, with 16 deaths. 319 cases were notified in 1914, with 27 deaths. Enteric Fever. 5 cases of Enteric (Typhoid) Fever were notified. There were 3 deaths. Erysipelas. 96 cases of Erysipelas were notified as against 130 cases in 1914. 5 deaths occurred. Ophthalmia Neonatorum. During the year 16 cases were notified. Puerperal Fever. 4 cases of this disease were notified as against 4 cases in 191,4. 2 deaths occurred. Epidemic Cerebro-Spinal Meningitis. 8 cases of this disease (commonly known as Spotted Fever) were notified, 4 of which proved fatal. 11 Acute Polio-Myelitis. No case of this disease was notified. Typhus Fever. No case was notified. Tuberculosis. The number of deaths from Tuberculosis during the year was 185 as compared with 181 in 1914. The following table shows the number of deaths from Pulmonthy Tuberculosis and other forms of the disease:— Pulmonary Tuberculosis (Phthisis), 139 deaths. Tuberculosis of the Brain, 17 deaths. Other forms of Tuberculosis, 29 deaths. Under the Public Health (Tuberculosis) Regulation the total number of notifications received was 424. Tuberculosis (Pulmonary) 342 as against 550 in 1914. Tuberculosis (Other Forms) 82 as against 115 in 1914. 424 665 COMMUNICABLE DISEASES NON-NOTIFIABLE. Measles. 552 cases of Measles were registered from the Schools. 24 deaths occurred from Measles and complications, 19 of these being children under school age, viz., 3 under 1 year, 8 between the ages of 1 and 2 years, and 8 between 2 and 5 years. Whooping Cough. This disease was more prevalent in the Borough than in previous years, and 31 deaths were registered as due to Whooping Cough as against 19 in 1914 and 15 in 1913. This disease ought to be made notifiable. It is quite a common experience during visits to Picture Theatres to find children present suffering from Whooping Cough, thus spreading infection. Cancer (Malignant Disease). 135 deaths were registered as due to Cancer as compared with 108 in the previous year. 109 of these deaths were in persons of 45 years and upwards. 12 Other Diseases. Respiratory diseases, excluding Bronchitis, Pneumonia and other diseases connected with the respiratory system accounted for 367 deaths, of which 111 were of 65 years of age and upwards. REPORT ON THE BOROUGH BACTERIOLOGICAL LABORATORY. During the year 1915 there were 998 specimens examined. The following is a summary of the number of specimens examined, with results:— Specimens. Positive. Negative. Suspected Diphtheria 829 157 672 Suspected Ringworm 22 16 6 Sputum for suspected Tuberculosis 147 36 111 Results, if positive, are communicated per telephone or sent by special messenger. Negative results are sent by post. A number of specimens of sputum were examined for the Army Recruiting Medical Officer. DISINFECTION. 1,113 premises were disinfected. The steam disinfector at the Isolation Hospital is used for bedding and other articles requiring disinfection. 13 FACTORY AND WORKSHOP ACT. Annual Report of the Medical Officer of Health for the year 1915, for the Borough of East Ham, on the administration of the Factory & Workshop Act, 1901, in connection with Factories, Workshops, Workplaces & Homework. 1.—INSPECTION. Including Inspections made by Sanitary Inspectors. PREMISES Number of Inspections. Written Notices. Prosecutions. Factories (Including Factory Laundries) 58 — — Workshops (Including Workshop Laundries) 314 7 — Workplaces (Other than Outworkers' premises included in Part 3 of this Report.) — — — Total 372 7 — 2.—DEFECTS FOUND IN FACTORIES, WORKSHOPS, AND WORKPLACES. PARTICULARS. Number of Defects. Number of Prosecutions. Found. Remedied. Referred to H.M. Inspector. Nuisances under the Public Health Acts:— Want of cleanliness 10 — — — Want of ventilation 3 — — — Overcrowding 3 — — — Want of drainage of floors — — — — Other Nuisances 17 — — — Sanitary accommodation (I w.c. required for 25 persons) insufficient — — — — unsuitable or defective — — — — not separate for sexes — — — — Offences under the Factory and Workshop Act:— Illegal occupation of underground bakehouse(s. 101) — — — — Breach of Special sanitary requirements for bakehouses (ss. 97 to 100). — — — — Other offences (Excluding offences relating to outwork which are included in Part 3 of this Report.) — — — — Total 33 — — — 14 3.—HOME WORK. NATURE OF WORK. OUTWORKERS' LIST, SECTION 107. OUTWORK IN UNWHOLESOME PREMISES, SECTION ic8. OUTWORK IN INFECTED PREMISES, SECTIONS 109 & 110. Lists received from Employers. Notices served on Occupiers as to keeping or sending lists. Prosecutions Sending twice in the Year. Sending once in the Year. Failing to keep or permit inspection of lists. Failing to send lists. Instances. Notices Served. Prosecutions. Instances. Orders made (S. 110). Prosecutions (Sections ic9, 110.) Lists. Outworkers. Lists. Outworkers. Contractors. Workmen. Contractors. Workmen. Wearing Apparel— (1) making, etc. 1 1 1 11 4 100 — — — — — — — — (2) cleaning & washing — — — — — — — — — — — — — — — Household Linen — — — — — — — — — — — — — — — Lace, Lace Curtains and Nets Curtains and Furniture Hangings Furniture & Upholstery Electro plate File making Brass & Brass Articles Fur pulling Cables and Chains Anchors and Grapnels Cart Gear Locks, Latches & Keys Umbrellas, &c. Artificial Flowers Nets, other than wire nets (sieves) Tents & Sacks Racquet & Tennis Balls Paper, &c., Boxes, Paper Bags Brush Making Pea Picking Feather Sorting Carding &c. of Buttons,&c. Stuffed Toys Basket Making Chocolates & Sweets Cosaques, Xmas Crackers & Xmas Stockings Textile weaving Total 1 1 1 11 4 100 — — — — — — — — 15 4.—REGISTERED WORKSHOPS. 5.—OTHER MATTERS. Workshops on the Register (s. 131) at the end of the Year. Number. Class. Number. Wearing Apparel Manufacturers 101 Matters notified to H.M. Inspector of Factories:— Bakehouses 49 Failure to affix Abstract of the Factory and Workshop Act (s. 133) 6 Laundries 48 Printers 11 Action taken in matters referred by H.M. Inspector as remediable under the Public Health Acts, but not under the Factory and Workshop Act (s. 5) . Notified by H.M. Inspector 7 Other Workshops 102 Reports (of action taken) sent to H.M. Inspector 7 Other Nil. Underground Bakehouses (s. 101):— Certificates granted during the year Nil. Total number of Workshops on Register 311 In use at the end of the year 10 16 FOOD AND DRUGS ACT. Number of samples taken in East Ham from May 1st* to December 31st. 1915:— Milk 155 Butter 132 Other samples 123 Total 410 Details of legal proceedings instituted under this Act will be found on pages 57 and 58. Cautions have been given where proceedings were not advisable. FOOD INSPECTION. The inspection of food is carried out as far as possible by the Inspectors and myself, but in a Borough of this size there should be sufficient work for a special Inspector to devote most of his time to this work. During the latter part of the year since the outbreak of war there has been a great demand for meat to supply the troops and a considerable amount of slaughtering has taken place at the slaughter-houses in the Borough. HOUSING, TOWN PLANNING, Etc., ACT, 1909. Systematic inspection of dwelling houses under the above Act has been carried out in the Borough as requested by the Order of the Local Government Board. Article 5 requires the Medical Officer of Health to include in his Annual Report information and particulars as to the inspections made and results. The following is a statement of the work carried out:— (1) Number of houses inspected, 1,329. (2) Number of houses found unfit for habitation,. 1. (3) Number of representations to the Local Authority, 1. (4) Number of closing orders made, 1. (5) Number of houses remedied without closing order, 809. (6) Number of closing orders determined, 1. (7) Number of houses dealt with under Section 15, Nil. (8) Number of houses dealt with under Public Health Act, 2,311. General character of defects:— Dirty walls and ceilings. Drinking-water improperly stored. Defective flushing apparatuses. Soil pans foul and broken. Yards and forecourts improperly paved. *The Sale of Food and Drugs Act was not administered by this Authority prior to May 1st, 1915. 17 MIDWIVES' ACT, 1902. 42 midwives gave notice of intention to practice in the Borough during the year. 25 of these were attached to the Plaistow Maternity Charity, 4 to Sir Henry Tate's Nurses' Home, Silvertown, leaving 13 Midwives in private practices. Miss Webb paid 73 visits to the homes of the Midwives for the purposes of inspection of bags and records. In a few cases these were unsatisfactory, but improvements have been made. Four Midwives did not take cases during 1915. One Midwife in practice before the passing of the Act died during the year. 12 unqualified women who have been known to act as Midwives have been cautioned. 1,404 cases have been attended by Midwives in the Borough, and 1,822 cases by Medical Practitioners. There have been 47 stillbirths notified. 23 of these were notified by Medical Practitioners and 24 by Midwives. 43 twin births—21 by Doctors and 22 by Midwives. I have received 139 "Records for sending for medical help" in the following instances:— For the Mother:— Malpresentations. Prolonged Labour. Ruptured Perineum. Retained Placeuta and Membranes. A. P. H. P. P. H. Rise of Temperature. Eclampsia. Other Causes. 6 14 25 3 4 4 12 0 17 For the Infant:— Premature. Feeble. Abnormalities. Dis. from Eyes. Ophthalmia. Other Causes. 7 18 3 9 9 8 One woman died during labour from Pneumonia and Cardiac disease. An inquest was held and the Midwife exonerated from blame. 18 A case of Septicaemia was notified. The woman was removed to the Infirmary and died two months later of Pyosalpinx. The cause of original infection could not be ascertained. All cases of Ophthalmia Neonatorum have been visited, and where treatment could not be satisfactorily carried out at home removal to hospital has been advised. All the Midwives' cases have recovered. Ante-Natal Visiting and Classes. Attempts have been made to follow up this work to meet the requirements of the Local Government Board. One hundred and seventy-seven visits and seventy-five revisits, have been made to the homes of expectant mothers. Classes have been started and short talks and practical advice given on the clothing, feeding, and care of infants. Fifteen women have attended and forty-three attendances made. Five maternity boxes have been provided, and milk is also given in necessitous cases. REPORT ON THE WORK OF THE TUBERCULOSIS DISPENSARY FOR THE YEAR 1915. Gentlemen, In drawing up this the first Annual Report to the East Ham County Borough Council of the Tuberculosis work in the Borough, I have endeavoured to establish a method by which a progressive view of the work from year to year may be obtained. It would be desirable, if possible, to submit a Report showing how the various cases dealt with have fared; but attempts to do so have resulted in such an incongruous heap of detail that no useful information could be deduced therefrom, and, after all, however interesting any such particular details may be to the individuals immediately concerned, viz., the patients, the friends, the nurse and doctor, the facts which concern a responsible public authority are, "What is the total amount of work being done? How is it done? What are the total results? What is the cost? Do results justify the cost? Could better results be obtained by other methods?" 19 In this Report, then, I have determined to omit individual details, and have sought to strike a level which may year by year be compared with the levels of previous years and so give a broad view of the results. The simplest method which has occurred to me is to take a definite point in the year and give a statement of the facts as they then are. This, read in comparison and conjunction with the similar statements of the previous years, will, as time goes on, form a barometric reading of the work. All the various changes and interchanges, new cases and deaths, progress and retrogression, which are of daily occurrence, will be found on the broad average of a year's work to level themselves out and will be reflected in the statement of the annual level. These details are of course also given in their totals, and the effect of any one of them which is excessive can be noted. The most obvious point to take to draw the summary is the last day of the year, and in the following tables I have therefore given the exact statement for the 31st December, 1915. The corresponding statement for the 31st December, 1914, is also given as far as possible. But as the records at that date were not so complete as they are now, the statement is also not quite complete. In each table the 1914 statement is given above and the 1915 below, and placed so that the corresponding columns are carried downwards through the two years so that they may be easily compared. Thus, taking the first figures given of insured patients with Pulmonary Tuberculosis (the common form of Consumption) we see there were 132 male patients with Tubercle Bacilli in the sputum on the books on December 31st, 1914, as against 102 on December 31st, 1915, and so on for the other columns and tables. PULMONARY TUBERCULOSIS, 1914. Insured. Working Capacity. At Work. No. Good. FGood Fair. Poor. Nil. Full. Part. Nil. Males, T. B. + 132 22 25 27 19 39 51 9 72 Males, T. B. — 119 68 24 13 8 6 83 7 29 Females, T. B. + 27 4 9 6 3 12 6 3 18 Females, T. B. — 102 52 24 18 8 ... 70 12 20 20 1915. Working Capacity. At Work. No. Good. FGood Fair. Poor. Nil. Full. Part. Nil. Males, T. B. + 102 31 26 17 11 17 54 1 47 Males, T. B. — 118 89 10 9 7 3 96 4 18 Females, T. B. + 13 6 ... 4 ... 3 5 2 6 Females, T. B. — 82 58 20 4 ... ... 62 9 11 NON-PULMONARY TUBERCULOSIS, 1914. No. Part Affected. Working Capacity. At Work. Good. FGood Fair. Poor. Nil. Full Part. Nil. Males 1 Kidney ... 1 ... ... ... 1 ... ... Males 1 Spine 1 ... ... ... ... 1 ... ... Females 1 Gland ... ... 1 ... ... ... ... 1 1915. No. Part Affected. Working Capacity. At Work. Good. FGood Fair. Poor. Nil. Full. Part. Nil. Males 1 Kidney 1 ... ... ... ... 1 ... ... Males 3 Spine 2 ... ... 1 ... 2 ... 1 Males 2 Glands 1 1 ... ... ... 2 ... ... Females 1 Glands 1 ... ... ... ... 1 ... ... PULMONARY TUBERCULOSIS, 1914. Uninsured. Working Capacity. At Work. No. Good. FGood Fair. Poor. Nil. Full. Part. Nil. Males, T. B. + 5 ... 1 ... ... 4 1 ... 4 Males, T. B. — 4 2 2 ... ... ... 4 ... ... Females, T. B. + 28 2 4 11 4 7 10 8 10 Females, T. B. — 77 30 19 23 3 2 58 15 4 91 1915. Working Capacity. At Work. No. Good. FGood Fair. Poor. Nil. Full. Part. Nil. Males, T. B. + 6 ... 2 2 1 1 2 ... 4 Males, T. B. — 1 ... ... ... l ... ... ... 1 Females, T. B. + 20 6 4 4 5 1 11 3 6 Females, T. B. — 91 43 31 15 2 ... 76 10 5 During 1914 no uninsured case of Non-Pulmonary Tuberculosis attended Dispensary. NON-PULMONARY TUBERCULOSIS, 1915. No. Part Affected. Working Capacity. At Work. Good. FGood Fair. Poor. Nil. Full. Part. Nil. Males 1 Hip ... ... 1 ... ... ... ... 1 Females 3 Glands 1 2 ... ... ... 2 1 ... Females 1 Fingers ... ... 1 ... ... ... 1 ... PULMONARY TUBERCULOSIS, 1914. Children. Working Capacity. At School. Not at Shool. No. Good. FGood Fair. Poor. Nil. Males, T. B. + ... ... ... ... ... ... ... ... Males, T. B. — 126 69 24 20 10 3 80 46 Females, T. B. + ... ... ... ... ... ... ... ... Females, T. B. — 115 52 28 27 2 6 76 39 1915. Working Capacity. At School. Not at School. No. Good. FGood Fair. Poor. Nil. Males, T. B. + ... ... ... ... ... ... ... ... Males, T. B. — 100 77 12 5 1 5 79 21 Females, T. B. + 1 ... ... ... 1 ... ... 1 Females, T. B. — 108 75 20 8 l 4 81 27 22 NON-PULMONARY TUBERCULOSIS, 1914. No. Part Affected. Working Capacity. At School. Not at School. Good. FGood Fair. Poor. Nil. Males 6 Glands 4 1 ... ... 1 4 2 Males 2 Hip ... ... ... ... 2 2 ... Females 2 Glands 1 ... 1 ... ... 1 1 Females 1 Hip ... ... ... ... 1 1 ... 1915. No. Part Affected. Working Capacity. At School. Not at School. Good. FGood Fair. Poor. Nil. Males 9 Glands 5 1 2 ... 1 6 3 Males 1 Spine ... ... 1 ... ... 1 ... Males 2 Hip 1 ... ... ... 1 1 1 Males 1 Ankle 1 ... ... ... ... 1 ... Females 2 Glands 2 ... ... ... ... 2 ... Females 1 Knee ... ... ... ... 1 ... l Females 1 Peritoneum 1 ... ... ... ... 1 ... Females 1 Hip ... ... ... ... l 1 ... It will be seen that the figures are divided into various headings and sub-headings. The first division is into insured, uninsured adults and children. The only reason for dividing the uninsured from the insured is that the insured are to a certain extent, viz., as regards treatment, provided for by the National Insurance Act. From the point of view of the Tuberculosis problem it is an artificial division. Children are taken separately, as they constitute a widely separated factor from adults in the problem. Under each of these headings various other groupings are given. (1) Most important is the division of the number of patients having Tubercle Bacilli in the sputum from those who have not. The record of the number having Tubercle Bacilli in the sputum is so important that I would recommend that a chart be made to record it in diagram from year to year, and hung in some readily seen place, as in the Public Health Office. It should be a record of the total number of Tubercle Bacilli + eases in the Borough. 23 (2) Male and Female.—This is a division usually made in statistics. Its chief interest lies in the different life that women lead from men, viz., domestic as against business. There is a very remarkable difference in the total number of males and females (insured and uninsured) having Tubercle Bacilli +, viz., 108 and 34 for 1915. The cause of this is not clear. It may be that women are less liable than men to Tuberculosis, or that in their avocations they are less subject to exposure generally, or that they are less exposed to infection by the Tubercle Bacillus. (3) Working Capacity.—This and the following divisions are included in order to give an estimate of the result of treatment. The working capacity is the capability of the patient for work as estimated by the physician. In some cases the patient is not at work when he could be, or he may be at work more or less than he ought to be in the physician's opinion. (4) At Work.—This heading is given as the best possible test as to results of treatment. It is obvious that the chief aim of treatment is to restore a patient to the position of economic independence, and the best test of this is the fact whether he is or is not earning his own livelihood. The defect of this heading is that it does not include all patients, because some do not work because they have no need to. It is by comparing these two tables from year to year that an idea will be obtained as to the value of the treatment which patients receive. (5) Discharges.—This includes patients who for one reason or another have been removed from the books. With regard to the figures themselves it is not of much value to compare them this year, as two years by themselves are not sufficient to' form an opinion as to the tendency of the disease whether it is gaining ground or being conquered. Taking the cases of Tubercle Bacilli + there are 141 adults and 1 child for 1915 as against 192 adults in 1914 table. This is a substantial reduction, and if maintained ought in the course of a few years to lead to a marked improvement in all the figures in the tables. It will be noted that there is only one case in 1914 of a child having T.B. + and none in 1915. It is very rare to find the Bacillus in the sputum in children, and I think a diagnosis of definite Pul- 24 monary Tuberculosis in children should be made with great caution. The reason I lay so much stress on the figure showing the number of cases with Tubercle Bacilli in the sputum is twofold. Firstly, because it is the only certain test we have that a patient is suffering from Pulmonary Tuberculosis. In all other cases the diagnosis is merely an opinion more or less accurate according to the experience of the physician. Secondly and most important, we must always remember that everyone of these cases is a source of infection, or rather a source of supply of the Tubercle Bacillus. Whether he is a source of infection depends on his personal habits and his circumstances generally. There is at present a vast amount of money being spent on the treatment of patients who have developed Consumption with the hope of curing them, and only too frequently this hope is not fulfilled; whereas there is very little being done to cut off the supply of the Bacillus. It is a matter which ought very seriously to be considered by Sanitary Authorities whether money would not be better spent by using it for this purpose. In these times there is not likely to be money forthcoming for both prevention and treatment, and in my opinion cheaper, quicker and better results would be obtained by measures which would cut off the supply of the Tubercle Bacillus than by attempting to arrest the mischief after it has been allowed to get a start. Turning to the figures setting out the working capacity and the work being done by the patients, it will be seen that those for 1915 show a slight improvement on those of 1914. This, if it is maintained in coming years, will show that the treatment obtained is having a beneficial result on the individuals. Regarded from the wider aspect, this may be a two-edged sword, for whilst prolonging the activity of the individual it may also (though it should not) be prolonging the supply of infection. Lastly, considering the number of deaths, we see that there are 60 for 1915 as against 54 for 1914. This is an increase, and if continued would tend to prove that though our methods of treatment have beneficial results they are not curative. The remaining tables call for no special comment, as they explain themselves. They form a record of the work being done. 25 PULMONARY TUBERCULOSIS. Number of patients on treatment, December 31st, 1914, 749. Insured. Uninsured. Children. Males. Females. Males. Females. Males. Females. 253 130 9 105 134 118 Number removed during the year ending December 31st, 1915, 206 Insured. Uninsured. Children. Males. Females. Males. Females. Males. Females. 72 41 5 35 32 21 60 of these have died, 74 left the district, 72 have been removed from Register for other causes. Number added during the year, 129. Insured. Uninsured. Children. Males. Females. Males. Females. Males. Females. 45 7 4 45 11 17 Number remaining on treatment, December 31st, 1915, 672. Insured. Uninsured. Children. Males. Females. Males. Females. Males. Females. 226 96 8 115 113 114 The following table shows treatment being received by. the 672 patient? on Register, December 31st, 1915. Number of patients attending Dispensary for treatment, 238. Insured. Uninsured. Children. Males. Females. Males. Females. Males. Females. 76 30 8 52 113 114 Number of patients receiving domiciliary treatment, 32. Insured. Uninsured. Children. Males. Females. Males. Females. Males. Females. 26 6 0 0 0 0 Number of patients receiving Sanatorium treatment, 24. Insured. Uninsured. Children. Males. Females. Males. Females. Males. Females. 13 8 0 1 1 1 Number of patients attending for observation, 378. Insured. Uninsured. Children. Males. Females. Males. Females. Males. Females. 111 52 0 62 74 79 Number of deaths from Pulmonary Tuberculosis during 1914, 54. Insured 42. Uninsured 9. Children 3. Males, T. B. + 32 Males, T. B. + 0 Males, T. B. + 0 Males, T. B. — 4 Males, T. B. — 0 Males, T. B. — 1 Females, T. B. + 4 Females, T. B. + 8 Females, T. B. + 0 Females, T. B. - 2 Females, T. B. - 1 Females, T. B. - 2 26 Number of these who have attended for the first time and died during the same year, 16. Insured 14. Uninsured 1. Children 1. Males, T. B. + 11 Males, T. B. + 0 Males, T. B. + 0 Males, T. B. — 2 Males, T. B. - 0 Males, T. B. — 0 Females, T. B. + 1 Females, T. B. + 0 Females, T. B. + 0 Females, T. B. — 0 Females, T. B. — 1 Females, T. B. — 1 Number of deaths from Pulmonary Tuberculosis during 1915, 60. Insured 43. Uninsured 14. Children 3. Males, T. B. + 28 Males, T. B. + 3 Males, T. B. + 0 Males, T. B. — 4 Males, T. B. — 0 Males, T. B. - 1 Females, T. B. + 11 Females, T. B. + 8 Females, T. B. + 0 Females, T. B. — 0 Females, T. B. — 3 Females, T. B. — 2 Number of these who have attended for the first time and died during the same year, 17. Insured 13. Uninsured 3. Children 1. Males, T. B. + 7 Males, T. B. + 1 Males, T. B. + 0 Males, T. B. — 3 Males, T. B. — 0 Males, T. B. — 0 Females, T. B. + 3 Females, T. B. + 2 Females, T. B. + 0 Females, T. B. — 0 Females, T. B. — 0 Females, T. B. — 1 Number of patients who left the district during 1914, 60. Insured 36. Uninsured 10. Children 14. Males, T. B. + 7 Males, T. B. + 0 Males, T. B. + 0 Males, T. B. - 14 Males, T. B. — 0 Males, T. B. — 8 Females, T. B. + 1 Females, T. B. + 4 Females, T. B. + 0 Females, T. B. — 14 Females, T. B. — 6 Females, T. B. — 6 Number of these who attended for the first time and left the district during the same year, 24. Insured 11. Uninsured 5. Children 8. Males, T. B. + 2 Males, T. B. + 0 Males, T. B. + 0 Males, T. B. - 2 Males, T. B. - 0 Males, T. B. — 5 Females, T. B. + 1 Females, T. B. + 0 Females, T. B. + 0 Females, T. B. — 6 Females, T. B. — 5 Females, T. B. — 3 Number of patients who left the district during 1915, 74. Insured 44. Uninsured 15. Children 15. Males, T. B. + 10 Males, T. B. + 0 Males, T. B. + 0 Males, T. B. — 17 Males, T. B. — 0 Males, T. B. — 12 Females, T. B. + 2 Females, T. B. + 3 Females, T. B. + 0 Females, T. B. — 15 Females, T. B — 12 Females, T. B. — 3 Number of these who have attended for the first time and left during the same year, 18. Insured 13. Uninsured 3. Children 2. Males, T. B. + 3 Males, T. B. + 0 Males, T. B. + 0 Males, T. B. — 3 Males, T. B. — 0 Males, T. B. - 2 Females, T. B. + 2 Females, T. B. + 0 Females, T. B. + 0 Females, T. B. - 5 Females, T. B. — 3 Females, T. B. — 0 27 Number of patients who have been removed from Register for other causes during 1914, 68. Insured 30. Uninsured 11. ren 27. Males, T. B. + 1 Males, T. B. + 0 Males, T. B. + 0 Males, T. B. - 15 Males, T. B. - 0 Males, T. B. - 12 Females, T. B. + 0 Females, T. B. + 2 Females, T. B. + 0 Females, T. B. - 14 Females, T. B. — 9 Females, T. B. — 15 Number of these who were admitted and discharged during the same year, 29. Insured 8. Uninsured 4. Children 17. Males, T. B. + 0 Males, T. B. + 0 Males, T. B. + 0 Males, T. B. — 3 Males, T. B. - 0 Males, T. B. — 8 Females, T. B. + 0 Females, T. B. + 0 Females, T. B. + 0 Females, T. B. — 5 Females, T. B. — 4 Females, T. B. — 9 Number of patients who have been removed from Register for other causes during 1915, 72. Insured 26. Uninsured 11. Children 35. Males, T. B. + 2 Males, T. B. + 2 Males, T. B. + 0 Males, T. B. — 13 Males, T. B. - 0 Males, T. B. - 20 Females, T. B. + 0 Females, T. B. + 0 Females, T. B. + 0 Females, T. B. — 11 Females, T. B. — 9 Females, T. B. — 15 Number of these who were admitted and discharged during same year, 7. Insured 3. Uninsured 1. Children 3. Males, T. B. + 0 Males, T. B. + 0 Males, T. B. + 0 Males, T. B.— 2 Males, T. B. - 0 Males, T. B. - 1 Females, T. B. + 0 Females, T. B. + 0 Females, T. B. + 0 Females, T. B. — 1 Females, T. B. — 1 Females, T. B. — 2 During the year there have been various changes at the Dispensary owing to the political state—firstly, from the taking over of the work by the County Borough Council from the Essex County Council; and secondly, owing to the war. These changes have not, however, interfered with the harmonious carrying on of the work which appears at present to be very satisfactory. Every facility is being given to patients to receive all the benefits that are available. It was found necessary to largely revise the method of keeping the records. This involved a great deal of clerical work, but it was completed before the end of 1915, and is now up to date and in good working order, and I find it very efficient. This clerical work was done by Miss Stevens, the Dispensary Nurse, and I take this opportunity of thanking her for the efficient way in which that and her general work at the Dispensary has been done. I would 28 like also to thank Dr. Benton, the Medical Officer of Health, for the kind help he continually gives, and also the members of his Staff. Owing to the present arrangements, Dr. Benton has had exceptional opportunities for seeing the work, and the various changes which I have made have been done with his advice and sanction. I am, Gentlemen, Yours faithfully, W. O. PITT, Tuberculosis Officer. 29 METEOROLOGICAL RECORD—YEAR 1915. Rain Gauge 5-in. in diameter, placed I-foot above ground, 15 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 Maximum. Lowest Minimum. Mean of No. of Days on which Rain fell, 0.01 inches and over. Amount collected in inches. Mean rate of fall for Rainy Days. Greatest fall in 24 hours. Date of greatest fall. All Highest. All Lowest. January 54° 17° 44°.1 34°.3 39°.3 20 3.58 1.8 0.88 22nd February 53° 26° 47°.0 34°.4 40°.0 19 2.58 0.13 0.42 8th March 58° 25° 48°.2 35°.7 41°.5 13 0.81 0.06 0.20 2nd & 25th April 71° 29° 55°.2 38°.1 46°.7 9 1.10 0.12 0.27 12th May 75° 35° 63°.1 43°.5 53°.4 8 3.12 0.39 1.50 13th June 86° 38° 68°.8 50°.3 58°.8 6 0.40 0.06 0.15 28th July 84° 47° 69°.0 52°.8 60°.5 15 4.09 0.27 0.59 6th August 76° 45° 70°.1 54°.2 61°.6 14 4.01 0.29 1.29 10th September 77° 37° 66°.9 48°.7 57°.3 7 1.78 0.25 1.40 29th October 69° 32° 56°.1 42°.7 49°.0 12 1.68 0.14 0.71 31st November 57° 25° 45°.4 33°.5 38°.5 8 2.41 0.30 0.67 11th December 57° 29° 48°.9 38°.1 43°.3 24 4.85 0.20 0.65 9th Means and Totals for the Year. 86° 17° 56°.9 42°.2 49°.2 155 30.41 0.28 1.50 May 13th The Rainfall for the Year was 8.01 above, and the number of days on which rain fell 1 below the year 1914, at East Ham. 30 TABLE 1. Vital Statistics of Whole Borough during 1915 and previous Years. YEAR. 1 Population estimated to Middle of each Year. 2 BIRTHS. TOTAL. DEATHS REGISTERED IN THE BOROUGH. TRANSFERABLE DEATHS * NETT DEATHS BELONGING TO THE BOROUGH. Uncorrected Number. 3 Nett. of Nonresidents Registere d in the Borough. 8 of Residents not Registered in the Borough. 9 Under 1 Year of Age. At all Ages. Number. 4 Rate. 5 Number. 6 Rate. 7 Number. 0 Rate per 1,000 Nett Births. 11 Number. 12 Rate. 13 1910 130,596 3,411 3,455 26.4 1,069 8.2 36 297 312 90 1,330 10.2 1911 134,441 3,417 3,466 25.8 1,230 9.1 17 410 412 119 1,623 12.1 1913 138,450 3,518 3,573 25.8 1,048 7.5 21 426 256 71 1,474 10.6 191.3 142,467 3,536 3,596 25.2 1,044 7.3 32 425 226 63 1,437 10.1 1914 146,526 3,373 3,436 23.5 1,031 7.0 18 515 267 77 1,528 10.4 1915 142,582 3,226 3,300 23.1 1,145 8.0 4 533 263 79 6,674 11.7 This Table is arranged to show the gross births and deaths in the Borough, and the births and deaths properly belonging to it with the corresponding rates. * "Transferable Deaths" are deaths of persons having a fixed or usual residence in East Ham, who died in another district. 31 TABLE II. CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR . 1915. Notifiable Disease. Number of Cases Notified. Total Cases Notified in Each Ward. Total Cases Removed to Hospital. At all Ages. Under 1 year. 1 and under 5 years. 5 and under 15 years. 15 and under 25 years. 25 and under 45 years. 45 and under 65 years. 65 and upwards. Beckton and North Woolwich Ward. Central Ward East. Central Ward West. Manor Park Ward. Plashet Ward East. Plashet Ward West. Total. Small Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria (including Membranous Croup). 204 2 53 137 8 4 ... ... 26 48 34 25 28 43 204 188 Erysipelas 96 3 1 3 7 32 41 9 10 19 23 19 7 18 96 5 Scarlet Fever 499 2 113 323 39 22 ... ... 79 81 70 130 53 86 499 402 Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever 5 ... ... 2 ... 3 ... ... 2 2 1 ... ... ... 5 5 Relapsing Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Continued Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Fever 4 ... ... ... ... 3 1 ... ... 1 1 2 ... ... 4 ... Cerebro-Spinal Meningitis 8 ... 2 2 3 1 ... ... 3 ... 4 ... 1 ... 8 1 Poliomyelitis 1 1 1 1 ... Ophthalmia Neonatorum 16 16 ... ... ... ... ... ... 1 3 3 4 2 3 16 Pulmonary Tuberculosis 342 2 3 76 87 134 39 1 44 72 84 71 25 46 342 70 Other forms of Tuberculosis 82 2 13 43 14 8 2 ... 9 19 17 21 7 9 82 10 Totals 1257 27 186 586 158 207 83 10 174 245 238 272 123 205 1257 681 32 TABLE III . Deaths Registered during the Calendar Year 1915 classified by age and cause. Causes of Death. Nett Deaths at the subjoined ages of "Residents" whether occurring within or without the Borough (a). Total Deaths whether of "Residents" or "Non-Residents" in Institutions in the Borough (6). All ages. Under 1 year. 1 and under 2 years. 2 and under 5 years. 5 and under 15 years. 15 and under 25 years. 25 and under 45 years. 45 and under 65 years. 65 and upwards. All causes Certified (c) - - - - - - - - - - Uncertified - - - - - - - - - - 1. Enteric Fever 3 - - - - - 3 - - 2 2. Small-pox - - - - - - - - - - 3. Measles 24 3 8 8 4 1 - - - 1 4. Scarlet Fever 10 - - 3 5 1 1 - - 9 5. Whooping Cough 31 19 7 4 1 - - - - - 6. Diphtheria and Croup 16 - - 7 9 - - - - 12 7. Influenza 16 - - - - - 4 7 5 - 8. Erysipelas 5 1 - - - - 4 - - - 9. Phthisis (Pulmonary Tuberculosis) 139 2 - 1 4 26 61 40 5 5 10. Tuberculous Meningitis 17 2 6 2 3 2 1 1 - 1 11. Other Tuberculous Diseases 29 3 7 4 6 2 5 1 1 1 12. Cancer, Malignant Disease 135 - - 1 - 2 23 60 49 - 13. Rheumatic Fever 8 - - - 4 1 1 2 - - 14. Meningitis 24 5 4 - 5 6 2 2 - 1 15. Organic Heart Disease 159 4 1 - 8 12 20 53 61 - 16. Bronchitis 152 32 6 3 - 1 5 35 70 - 17. Pneumonia (all forms) 193 36 22 17 9 3 29 42 35 3 18. Other Diseases of Respiratory Organs 22 2 - 1 - 3 5 5 6 - 19. Diarrhœa and Enteritis 35 23 7 - 2 - 1 2 - - 20. Appendicitis and Typhlitis 8 - - - 4 2 1 1 - 1 21. Cirrhosis of Liver 12 - - - - - 2 8 2 - 21a. Alcoholism 2 - - - - - 2 - - - 22. Nephritis and Bright's Disease 40 - 1 2 - 1 5 22 9 - 23. Puerperal Fever 2 - - - - - 2 - - - 24. Other accidents and diseases of Pregnancy and Parturition 6 - - - - 1 5 - - - 25. Congenital Debility and Malformation, including Premature Birth 102 96 2 - 2 - - 2 - - 26. Violent Deaths, excluding Suicide 66 6 3 3 4 7 10 22 11 6 27. Suicide 15 - - - - - 8 4 3 1 28. Other Defined Diseases 400 28 4 7 12 9 41 86 213 2 29. Diseases ill-defined or unknown 3 1 1 - - - - 1 - - Totals 1674 263 79 63 82 80 241 396 470 45 SubEntries included in above figures. 14 (a) Cerebro-Spinal Meningitis 9 - 1 - 2 5 - 1 - 1 28 (a) Poliomyelitis - - - - - - - - - - "Pneumonia other than Broncho Pneumonia 98 7 4 3 5 5 19 34 21 - 33 TABLE IV. . INFANTILE MORTALITY. 1915. Nett Deaths from stated causes at various Ages under One Year of Age. CAUSE OF DEATH. Under 1 Week. 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 4 weeks. 4 weeks and under 3 Months. 3 Months and under 6 Months. 6 Months and under 9 Months. 9 Months and under 12 Months. Total Deaths under One Year. All Causes Certified - - - - - - - - - - Uncertified - - - - - - - - - - Small-pox - - - - - - - - - - Chicken-pox - - - - - - - - - - Measles - - - - - - - 3 - 3 Scarlet Fever - - - - - - - - - - Whooping Cough - - - 2 2 4 4 5 4 19 Diphtheria and Croup - - - - - - - - - - Erysipelas - - - - - - 1 - - 1 Tuberculous Meningitis - - - - - - - 1 1 2 Abdominal Tuberculosis - - - - - - - - - - Other Tuberculous Diseases - - - 1 1 1 2 1 - 5 Meningitis (not Tuberculous) - - - - - - 1 3 1 5 Convulsions 3 1 1 1 6 4 3 4 - 17 Laryngitis - - - - - - - - - - Bronchitis - - - - - 11 9 9 3 32 Pneumonia (all forms) 1 - 2 - 3 3 10 11 9 36 Diarrhœa - - - - - 3 7 5 1 16 Enteritis - - - - - - 3 3 1 7 Gastritis - - - - - - - - - - Syphilis - - 1 - 1 - - - - 1 Rickets - - - - - - - - - - Suffocation, overlying - - - - - 1 - - - 1 Injury at Birth - - - - - - - - - - Atelectasis 2 - - - 2 - - - - 2 Congenital Malformations 6 1 1 - 8 3 - - - 11 Premature Birth 37 6 6 2 51 2 - - - 53 A trophy, Debility, and Marasmus 4 7 1 2 14 10 4 2 2 32 Other Causes 5 - - 1 6 6 3 3 2 20 Totals 58 15 12 9 94 48 47 50 24 263 Nett Births registered during the calendar year: legitimate, 3231; illegitimate, 69. Nett Deaths registered during the calendar year of legitimate infants, 255; illegitimate infants, 8. BOROUGH OF EAST HAM. EDUCATION COMMITTEE. Annual Report OF THE School School Medical Officer FOR THE YEAR 1915. 36 EAST HAM EDUCATION COMMITTEE Alderman E. Edwards, J.P. (Chairman). Councillor H. Barfield (Vice-Chairman). Councillor R. Banks-Martin, J.P. (Mayor). Councillor J. A. Williams (Deputy-Mayor). Mrs. W. C. Ford. Alderman 0. R. Anstead, J.P. Alderman J. Brooks, J.P. Alderman C. Northfield, J.P. Alderman M. Oakes, J.P. Alderman H. osborn. Councillor A. Coles. Councillor G. P. Dean. Councillor J. Evans. Councillor W. C. Ford. Councillor J. J. Francis. Councillor W. T. Howlett. Councillor V. R. Oliver. Mr. N. Papwokth. Councillor W. H. Pilgram. Councillor J. Savage. Councillor F. Smith. Councillor A. Taylor. Councillor A. H. Wiseman. Clerks: Miss P. G. Perry and Miss I. Hollingsworth. School Nurses: *Miss Forbes, Miss Howe, and *Miss Mallon. Temporary, Miss E. Grafton. Dentist: C. H. Taylor, L.D.S. Ophthalmic Surgeon: A. Henry Thompson, M.D. Assistant Medical Officers: *W. A. Berry, M.D., B.S. (Lond.), D.P.H. *D. S. Brough, M.B., B.Ch. D.P.H. Temporary, Alice M. Burn, M.B., Ch.B., D.P.H. and Ethel M. Minett, M.B., B.S. (Lond.). Medical Officer: W. Benton, M.R.C.S., L.R.C.P., D.P.H. *0n Active Service. 37 STATISTICAL DATA. School Places:— Provided Schools 27,177 Non-Provided Schools 1,142 Total 28,319 Number on Registers:— Provided Schools 24,922 Non-Provided Schools 1,022 Total 25,944 Teaching Staff: 643 Head 62 Assistant Certificated 505 Assistant Uncertificated 50 Supplementary 5 Student 16 Cookery 5 Education Rate. 1915-16 2/5 38 County Borough of East Ham Education Committee. Mr. Chairman, Mrs. Ford, and Gentlemen,— I beg to submit my Annua] Report as School Medical Officer for the year ending December 31st, 1915. The Report has, in accordance with the suggestion of the Board of Education, been curtailed in the interest of economy, but from the tables given it will be noted that under the present circumstances the work undertaken has been even more than was expected at the commencement of the year. As it was not possible to carry out the full routine work of Medical Inspection, special attention was given to specially selected cases and those cases requiring treatment at the School Clinic. Comparative Statement of Work. 1914. 1915. Routine Inspections 7,881 6,845 Special Cases 458 199 Re-inspections 1,397 1,033 Visits for Medical Inspection 310 255 Consultations at Inspection Clinic 5,885 4,591 Number of Treatments at. Clinic 1,737 3,457 Nurses' Special Visits to Departments 41 21 Nurses' Visits to Homes 878 511 Children Examined for Cleanliness 15,209 13,372 Number of Cleansings 59 — PARENTS PRESENT AT MEDICAL INSPECTION. During the year 1915 the percentage of parents present at Inspection was 31.1 as compared with 30'5 in 1914. 39 Ages examined Routine Inspection. Special Inspection. Boys Girls Boys Girls 5 years 679 559 - - 6 „ 263 262 - - 7 „ 99 129 - - 8 „ 1,095 1,225 4 1 9 „ - - 27 33 10 „ - - 15 43 11 „ - - 32 44 12 „ 1,200 1,028 - - 13 „ 88 113 - - 14 „ 6 9 - - 15 „ - - - - 3,520 3,325 78 121 The annexed table gives the complete notification of infectious diseases in school children received for the year 1914:- Total number excluded 1,311 Total number at Inspection Clinic 4,591 40 SCHOOL CASES, 1915. SCHOOLS. Dept. Measles Wh. Cough. Chicken Pox. Mumps. Ringworm Total. Head Body Brampton Road Infants 32 9 3 ... ... ... 37 Boys ... ... ... ... ... ... Girls ... ... ... ... ... ... Central Park Road Infants 7 ... ... ... 2 ... 11 Boys ... ... ... ... ... ... Girls ... ... ... ... 2 ... Castle Street R.C. Infants 2 ... ... ... ... ... 4 Boys 1 ... ... ... ... ... Girls 1 ... ... ... ... ... Essex Road Infants 45 14 13 40 ... ... 114 Boys ... ... ... 1 ... 1 Girls ... ... ... ... ... ... Fourth Avenue Infants 86 10 12 44 1 ... Boys 9 ... 1 4 ... ... Girls 18 ... 7 19 1 Hartley Avenue Infants ... 1 ... 3 1 1 7 Boys ... ... ... ... ... ... Girls ... ... ... ... ... 1 High Street Infants 31 10 5 22 2 2 78 Boys ... ... ... ... 4 1 Girls ... ... ... ... ... 1 Kensington Avenue Infants 14 38 7 ... 5 2 86 Boys ... ... ... ... ... ... Girls ... 1 14 3 2 ... Lathom Road Infants 30 ... 2 ... ... 2 37 Boys ... ... ... 1 1 ... Girls ... ... ... ... 1 ... Manor Park Infants 48 5 18 27 ... 2 103 Boys ... ... ... ... ... ... Girls 2 ... ... 1 ... ... Monega Road Infants 3 5 ... 2 ... ... 41 Boys 1 ... ... ... ... ... Girls ... ... ... ... ... ... Napier Road Infants 23 38 8 ... 3 5 89 Boys ... 2 ... 1 2 2 Girls ... ... ... 4 ... 1 New Beckton Infants 85 1 36 62 1 ... 202 Boys ... ... ... ... 1 ... Girls 5 ... 2 9 ... ... North Woolwich Infants 18 9 2 ... ... ... 29 Mixed ... ... ... ... ... ... Plashet Lane Infants 24 6 24 21 ... 2 83 Boys ... ... 1 1 ... 1 Girls ... ... 1 1 ... 1 St. Winefride's R.C. Infants ... ... ... ... ... ... - Mixed ... ... ... ... ... ... Sandringham Road Infants ... ... 10 ... ... ... 10 Boys ... ... ... ... ... ... Girls ... ... ... ... ... ... Shaftesbury Road Infants 13 ... 18 4 ... ... 59 Boys ... ... ... ... ... ... Girls ... ... ... 21 3 ... Shrewsbury Road Infants ... 10 4 ... ... 1 24 Boys 1 1 1 1 1 ... Girls ... 1 3 ... ... ... Silvertown R.C. Infants 1 4 ... 3 ... ... 9 Mixed ... ... ... ... ... 1 Vicarage Lane Infants ... ... ... ... 3 ... 5 Mixed ... ... ... ... 1 1 Walton Road Infants 22 9 2 57 ... ... 117 Boys ... ... ... 5 ... ... Girls ... ... ... 21 1 ... Totals 522 167 224 378 37 29 1357 DEFECTS CLASSIFIED ACCORDING TO AGES. 5 years. 6 years. 7 years. 8 years. 12 years. 13 years. 14 years. Totals. Percentage. Boys. Girls. Boys. Girls. Boys. Girls. Boys. Girls. Boys. Girls. Boys. Girls Boys. Girls. Boys. Girls. Boys. Girls. Number examined 679 559 263 262 99 129 1095 1225 1200 1028 88 113 6 9 3520 3325 ... ... DEFECTS. External Eye Disease— Blepharitis 2 7 ... 4 ... 2 7 4 8 9 1 ... ... ... 18 26 0.51 0.78 Conjunctivitis 2 1 3 ... 1 ... 4 7 12 1 1 ... ... ... 23 9 0.65 0.27 Corneal Opacity ... ... ... ... ... ... 7 9 3 ... 1 ... ... ... 11 10 0.31 0.3 Other Disease ... ... ... ... ... ... 2 1 1 ... ... ... ... ... 3 1 0.08 0.03 Squint 2 3 3 3 2 2 15 10 5 5 1 ... ... ... 29 23 0.82 0.69 Defective Vision— Number examined ... ... ... ... 10 9 1170 1198 1200 1024 88 110 6 9 2474 2350 ... ... 6/12 Right ... ... ... ... ... ... 41 36 63 49 5 7 ... ... 109 92 4.4 39 Left ... ... ... ... ... ... 49 53 82 59 8 5 ... ... 139 117 5.6 4.9 6/18 Right ... ... ... ... ... ... 20 23 28 42 2 6 ... ... 50 71 2.02 3.02 Left ... ... ... ... ... ... 20 19 23 30 2 3 ... ... 45 52 1.8 2.2 6/24 Right ... ... ... ... ... ... 6 8 24 18 2 1 ... ... 32 27 1.3 1.1 Left ... ... ... ... ... ... 7 13 21 20 2 5 ... ... 30 38 1.2 1.6 6/36 Right ... ... ... ... ... ... 6 4 11 9 1 2 ... ... 18 16 0.72 0.64 Left ... ... ... ... ... ... 7 8 11 5 ... 2 ... 1 18 16 0.72 0.64 6/60 Right ... ... ... ... ... ... 2 3 3 5 1 3 ... ... 6 11 0.24 0.47 Left ... ... ... ... ... ... 4 4 10 4 2 ... ... ... 16 8 0.64 0.34 6/0 Right ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 ... 0.04 Left ... ... ... ... ... ... 1 ... ... 1 ... ... ... ... 1 1 0.04 0.04 Ear Disease— Deafness Right 1 1 ... 1 ... ... 14 5 15 10 1 1 ... ... 31 18 0.88 0.54 Left 2 2 1 2 1 ... 11 5 14 12 2 ... ... ... 31 21 0.88 0.63 Discharge Right ... 2 2 1 ... ... 3 4 1 ... 8 10 ... 1 14 18 0.39 0.54 Left 3 2 4 ... ... ... 5 3 7 6 ... ... ... ... 19 11 0.54 0.33 Other Disease ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Defective Speech— Articulation 15 3 7 4 ... ... 6 11 15 8 ... ... ... ... 43 26 1.2 0.78 Stammering 3 ... ... ... ... ... 4 4 11 1 ... ... ... ... 18 5 0.51 0.15 Disease of Heart— Disease 5 11 5 13 ... 2 21 30 14 18 2 4 1 48 78 1,3 2.3 Anaemia 2 1 ... ... 1 ... 7 2 3 3 ... ... ... ... 13 6 037 018 Disease of Lungs— Bronchitis 16 16 8 15 2 ... 54 42 27 26 4 1 ... ... 110 101 3.1 3.03 Tuberculosis ... ... ... ... 1 ... ... 1 2 1 ... ... ... ... 3 2 0.08 0.06 Tuberculosis Suspected ... ... 1 ... ... ... ... 1 ... ... ... ... ... ... 1 1 0.02 0.03 Other Disease ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Disease of Nervous System— Epilepsy 2 ... ... ... 1 ... ... 1 ... ... ... ... ... ... 3 1 0.08 0.03 Chorea ... ... ... ... 1 ... 3 3 2 ... 1 ... ... ... 7 3 0.19 0.08 Other Disease ... ... ... ... ... ... ... ... ... ... ... 2 ... ... ... 2 ... 0.06 Condition of Head— Nits 10 58 5 34 2 15 33 217 21 125 1 20 1 ... 73 469 21 14.1 Vermin 2 3 ... 5 1 ... 4 14 1 5 ... ... ... ... 8 27 0.22 0.81 Condition of Body— Dirty 5 ... ... 2 1 ... 15 6 10 3 3 3 ... ... 34 14 0.96 0.42 Vermin 1 ... ... ... ... 1 7 5 6 ... 2 1 ... ... 16 7 0.45 0.21 Condition of Clothing— Bad 1 ... ... ... ... ... 1 ... 1 2 1 ... ... ... 4 2 0.11 0.06 Dirty 3 1 2 1 2 1 10 9 5 1 3 1 ... ... 25 14 0.71 0.42 Defective Boots 9 ... 2 2 1 1 19 16 18 3 2 1 ... ... 51 23 1.4 0.69 Defective Nutrition— Under Normal 44 32 19 29 5 9 105 50 65 63 3 8 1 ... 242 191 6.9 5.7 Bad ... ... 1 ... ... ... 4 3 ... 1 ... ... ... ... 5 4 0.14 0.12 Decayed Teeth— Less than 4 374 318 149 137 42 68 759 822 759 640 48 93 5 7 2130 2085 60.5 62.7 More than 4 125 94 68 69 10 23 118 142 34 26 2 1 ... ... 373 352 106 10.6 Sepsis 12 9 11 6 2 5 ... 16 1 3 1 ... ... ... 27 39 0.76 1.1 Tonsils— Slightly enlarged 131 85 63 62 13 14 141 159 157 115 7 12 2 2 514 449 14.6 13.5 Greatly enlarged 35 30 20 16 2 4 62 53 45 44 1 6 ... 1 165 153 4.7 4.6 Adenoids— Slightly marked 15 9 7 7 1 2 16 15 8 4 ... ... ... 1 47 38 1.3 11 Greatly marked 1 1 1 ... ... ... 6 2 ... ... ... ... ... ... 8 3 0.22 0.08 Glands— Slightly enlarged 65 22 25 29 4 5 34 35 27 22 ... 3 ... ... 155 117 4.4 3.5 Greatly enlarged 5 10 2 12 ... 1 13 7 6 3 1 1 ... ... 27 34 0.76 1.02 Mouth Breathers 38 18 19 9 5 2 26 18 19 10 1 ... ... ... 108 57 3.1 1.7 Nasal Defects 91 60 67 34 13 5 31 35 15 8 ... ... ... ... 227 142 6.4 4.2 Mental Defects— Number examined 92 81 13 17 28 9 1119 1188 1200 921 86 103 6 7 2544 2326 ... ... Dull 6 1 2 1 1 ... 73 104 54 104 7 ... 3 ... 146 214 5.7 9.2 Defective ... ... ... ... ... ... 3 ... 9 5 ... ... 1 ... 13 5 0.51 0.21 Deformities 7 3 4 3 1 4 33 24 23 25 2 3 ... ... 70 62 1.9 1.7 Ringworm Head ... ... ... ... 2 ... 1 1 1 1 ... ... ... ... 4 2 0.11 0.06 Body ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Scabies ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Impetigo 4 ... 2 2 ... ... 11 3 ... 1 ... ... ... ... 17 6 0.45 0.18 Tubercle— Glandular 2 2 ... ... ... ... 2 ... 3 1 ... ... ... ... 7 3 0.19 0.08 Osseous ... ... 1 ... ... ... 2 1 1 ... 2 ... ... ... 6 1 0.17 0.03 Other Diseases 13 9 5 4 ... ... 26 22 16 23 2 4 ... ... 62 62 1.7 1.8 DEFECTS ARRANGED ACCORDING TO SCHOOLS. SCHOOLS. Sex. Total Number Examined. External Eye Disease. Squint. Vision. Disease of Ears. Speech. Disease of Heart. Disease of Lungs. Disease of Nervous System. Condition of Head. Condition of Body. Condition of Clothing. Defective Boots. Nutrition. Teeth. Tonsils. Mouth.breathers. Adenoids. Glands. Nasal Defects. Mental Capacity. Deformities. Infectious Skin Diseases Tubercle. Other Diseases. Blepharitis. Con. junctivitis. Corneal Opacity. Other Diseases. Number Examined. 6/12 6/18 6/24 6/36 6/60 6/0 Deafness. Discharge. Other Disease. Defective Articulation. Stammering. Disease. Anæmia. Bronchitis. Tuberculosis Tuberculosis suspected. Other Disease. Epilepsy. Chorea. Other Disease. Nits. Vermin. Dirty. Vermin. Bad. Dirty. Under Normal. Bad. Less than 4. More than 4. Sepsis. Slightly Enlarged. Greatly Enlarged. Slightly Marked. Greatly Marked. Slightly Enlarged. Greatly Enlarged. Number Examined. Dull. Defective. Ringworm Scabies. Impetigo. Glandular. Osseous. R L R L R L R L R L R L R L R L Head Body Castle Street, R.C. Boys 41 4 ... ... ... ... 31 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 4 1 ... ... ... ... ... 1 ... ... ... ... 1 1 6 ... 91 5 ... 1 3 ... ... ... 1 1 ... 31 ... ... 2 ... ... ... ... ... ... 2 Girls 44 1 ... ... ... 1 33 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... 1 1 ... ... ... ... ... 7 ... ... ... ... ... ... 3 ... 18 4 ... 2 1 ... ... ... 1 ... 1 33 2 ... 2 ... ... ... ... ... ... ... Central Park Road Boys 341 ... 4 1 ... ... 212 7 5 ... 1 ... ... 1 ... ... 1 ... ... 2 3 3 2 ... 7 2 7 1 13 ... ... ... ... 2 ... 5 ... 2 ... ... ... ... 42 1 196 41 7 48 16 14 5 ... 25 2 28 210 8 ... 11 ... ... ... ... 1 ... 4 Girls 345 3 2 1 ... 3 219 4 4 2 3 ... ... ... ... ... 1 ... ... 1 2 ... 1 ... 4 ... 12 ... 13 ... ... ... ... ... 2 29 3 ... ... ... ... 1 30 ... 206 43 7 38 18 6 ... 19 2 31 219 9 ... 8 1 ... ... ... 1 ... 5 Essex Road Boys 239 ... ... ... ... 4 142 5 10 2 ... 2 4 2 3 ... ... ... ... 3 4 ... ... ... 2 2 1 1 7 ... ... ... 2 ... ... 2 ... 1 ... ... 1 ... 16 ... 136 30 5 52 21 7 2 ... 10 1 27 156 4 ... 2 ... ... ... 5 ... 2 ... Girls 203 2 ... ... ... ... 121 7 5 2 1 2 4 1 2 ... 1 ... ... 3 2 1 ... ... 1 1 3 1 8 ... ... ... ... ... ... 36 1 2 ... ... ... ... 8 ... 127 21 2 35 12 3 2 ... 13 ... 25 121 4 ... 1 ... ... ... 2 ... ... 2 Fourth Avenue Boys 132 ... 1 1 1 ... 132 7 9 8 6 4 2 1 ... 1 1 ... ... ... ... ... ... ... ... 2 ... 2 2 ... ... ... ... ... ... 4 ... 3 1 ... 2 1 8 3 114 18 ... 17 12 4 1 ... ... ... ... 132 20 5 2 ... ... ... 4 ... ... 3 Girls 121 ... ... ... ... 1 121 3 2 5 3 ... 2 2 3 1 1 ... ... ... ... 1 1 ... ... ... ... 1 2 ... ... ... ... ... ... 2 ... ... ... ... ... 1 ... ... 114 17 ... 12 16 7 ... ... ... ... ... 121 39 1 ... ... ... ... 4 ... ... 2 Hartley Avenue Boys 225 1 2 ... ... 3 160 10 11 5 3 3 2 ... 1 ... 1 ... ... 3 3 ... 2 ... 3 1 ... 1 17 ... ... ... ... ... ... 7 ... 3 ... ... ... 1 25 ... 118 18 ... 19 10 2 3 1 8 3 11 215 6 ... 3 ... ... ... ... ... ... 1 Girls 216 1 ... 1 ... 3 174 2 4 ... 1 1 1 3 1 ... 1 ... ... 2 ... 2 1 ... ... ... ... 1 5 1 ... ... 1 ... ... 24 2 ... ... ... ... 1 20 ... 130 8 ... 19 7 2 3 1 7 4 4 216 5 ... 5 ... ... ... ... 1 ... 2 High Street Boys 140 ... 2 ... ... 1 96 ... 1 ... ... ... ... ... ... 1 ... ... ... 1 1 ... ... ... 3 ... 2 ... 3 ... ... ... 1 1 ... 4 ... ... ... ... ... 2 7 ... 84 10 ... 13 3 2 4 ... 13 ... 3 106 7 ... 4 1 ... ... ... ... 2 1 Girls 197 3 ... ... ... ... 161 9 7 9 5 2 2 ... 2 2 ... ... ... ... 1 ... 1 ... 4 1 1 ... 3 ... ... ... ... 1 ... 45 ... 6 1 ... 2 ... 15 ... 148 7 ... 24 10 ... 3 1 7 3 3 124 8 ... 4 ... ... ... ... ... ... 3 Lathom Road Boys 273 1 ... ... ... 1 126 5 6 11 6 3 3 ... 2 ... 2 ... 1 ... ... ... ... ... 3 4 8 2 4 ... ... ... ... ... ... 2 ... 2 ... ... 1 ... 15 1 173 36 7 54 24 1 12 ... 26 ... 42 81 8 ... 6 ... ... ... 1 2 ... 2 Girls 327 2 ... 3 ... 1 142 4 7 10 4 5 6 2 1 1 ... ... ... 1 3 1 ... ... ... ... 10 1 11 ... ... ... ... ... ... 37 1 ... ... ... ... 23 ... 171 50 10 39 9 7 2 ... 17 12 2 142 6 ... 4 ... ... ... 1 ... ... 2 Manor Park Boys 90 ... 1 1 ... ... 90 2 6 3 4 2 1 ... 1 ... 1 ... ... ... 1 ... ... ... ... 1 3 1 3 ... ... ... ... ... ... ... 3 ... 4 2 1 2 ... ... 5557 7 ... 27 2 3 ... ... 4 1 3 90 ... ... 3 ... ... ... 1 1 ... 4 Girls 112 ... 1 1 ... 1 112 7 8 5 5 4 3 ... 1 1 ... ... ... 1 ... ... ... ... 4 ... 2 ... ... ... 1 ... ... ... ... ... 2 1 ... ... ... ... ... 2 70 15 ... 24 4 1 1 ... 4 ... ... 112 6 2 2 ... ... ... 1 ... ... 6 Monega Road Boys 156 ... 1 ... ... ... 156 5 5 3 2 ... 2 3 3 ... 2 ... ... ... ... 1 1 ... ... 3 5 ... 6 ... ... ... ... 2 ... ... ... ... 1 ... 1 ... ... ... 99 10 ... 26 11 6 ... ... 3 ... ... 154 15 ... 14 ... ... ... 1 ... 2 Girls 127 1 1 1 ... ... 127 2 8 7 4 4 5 2 3 ... 1 1 1 ... ... ... ... ... ... ... 9 1 11 ... ... ... ... ... ... 9 ... ... ... ... ... ... ... ... 80 6 ... 16 6 2 3 ... 5 ... ... 68 1 ... 8 ... ... ... ... ... ... 6 Napier Road Boys 260 4 1 3 ... 5 170 11 13 2 2 ... ... ... ... ... ... ... ... 4 4 1 4 ... 7 1 ... ... 9 ... ... ... ... ...... ... 5 2 3 ... ... 4 11 13 ... 199 15 ... 13 8 3 7 1 13 3 17 170 10 ... 1 2 ... ... ... 1 1 10 Girls 209 5 1 ... ... 1 138 4 3 2 2 2 2 1 ... 1 ... ... ... 1 1 2 ... ... 1 ... 2 ... 5 ... ... ... ... ... ... 51 6 ... 3 ... 4 5 11 ... 168 13 ... 18 5 1 4 3 7 3 6 137 9 ... 3 ... ... ... ... ... 1 1 New Beckton Boys 119 1 3 1 ... ... 119 5 7 1 1 2 3 1 2 ... ... ... ... 2 1 ... ... ... 4 ... 6 ... 3 ... ... ... ... ... ... ... ... 2 1 ... 1 4 1 ... 60 2 ... 27 4 5 ... ... 1 1 1 119 8 ... 3 ... ... ... 2 1 ... 1 Girls 75 ... 2 ... ... ... 77 3 6 7 7 1 1 1 ... 1 ... ... ... 2 2 ... ... ... ... ... 7 ... 4 ... ... ... ... ... ... 1 ... 1 ... 2 ... 2 ... ... 41 1 ... 11 3 1 ... ... ... ... ... 69 6 ... 4 ... ... ... 1 ... ... 5 Kensington Avenue Boys 257 ... 1 ... ... 1 134 6 7 6 7 2 1 2 2 1 1 ... ... 1 ... ... ... ... 3 ... 10 ... 4 ... 1 ... ... ... ... 3 ... ... ... ... ... ... 5 ... 156 35 1 52 7 10 1 1 3 ... 16 134 1 ... 2 ... ... ... ... ... ... 5 Girls 224 1 ... ... ... 2 129 3 11 3 2 2 5 1 1 2 1 ... ... 1 1 2 1 ... 3 ... 7 1 4 ... ... ... ... ... ... 7 ... ... ... ... ... ... 5 ... 141 32 ... 52 12 11 2 ... 2 1 11 132 ... ... 2 ... ... ... ... ... ... 3 Plashet Lane Boys 254 5 3 ... ... 1 209 12 16 6 8 4 3 5 2 1 4 ... ... 4 6 4 4 ... 5 2 2 ... 10 2 ... ... ... 1 ... 11 ... 6 3 2 3 12 12 ... 1 46 18 ... 23 4 6 14 ... 15 4 5 254 27 6 6 ... ... ... 1 ... 1 7 Girls 183 2 ... ... ... 2 133 9 14 6 2 1 3 ... ... 1 1 ... ... 1 ... 1 ... ... 3 ... ... ... 3 ... ... ... ... 1 ... 26 3 ... ... ... 1 3 9 ... 165 10 ... 18 5 1 2 1 3 1 6 178 19 1 1 ... ... ... 1 1 ... 2 St. Winefride's, R.C. Boys 20 ... ... ... ... ... 20 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 5 ... ... ... ... ... ... 2 ... 16 4 ... 3 ... ... ... ... ... ... ... 20 6 ... ... ... ... ... ... ... ... ... Girls 21 ... ... ... ... ... 21 5 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 8 ... ... ... ... ... ... ... ... 21 ... ... 5 3 ... ... ... ... ... ... 21 3 ... ... ... ... ... ... ... ... ... Shrewsbury Road Boys 125 ... ... ... ... 1 97 4 4 2 ... 1 1 ... ... ... ... ... ... 1 1 ... 1 ... 1 ... ... ... 4 ... ... ... ... ... ... 2 ... 1 ... ... ... 1 6 ... 71 12 ... 14 3 2 2 ... 9 1 4 97 ... ... ... ... ... ... ... ... 1 2 Girls 111 1 ... ... ... 1 76 5 7 ... ... 2 1 1 1 ... ... ... ... ... ... 1 2 ... 1 ... 3 ... 1 ... ... ... ... ... ... 7 ... ... ... ... ... 1 7 ... 60 12 ... 9 6 ... 2 ... 3 3 6 76 ... ... 1 ... ... ... ... ... ... ... Sandringham Road Boys 138 ... 1 1 ... 2 78 8 9 ... ... 2 2 1 1 ... ... ... ... ... ... ... ... ... 1 ... 1 ... 2 ... ... ... ... ... ... 1 ... 1 ... ... ... ... 11 ... 88 15 3 26 3 6 ... ... 4 ... 17 78 6 ... 2 ... ... ... ... 1 ... 2 Girls 123 ... 2 ... ... ... 74 4 3 4 5 ... ... ... ... ... ... ... ... 1 1 1 1 ... 1 ... 6 ... 12 ... ... ... ... ... ... 8 4 1 1 ... ... ... 4 ... 79 15 2 30 3 2 1 ... 7 ... 13 68 3 ... 4 ... ... ... ... ... ... 8 Shaftesbury Road Boys 247 2 1 1 1 1 164 1 3 1 ... ... 1 ... ... ... ... ... ... 4 1 3 3 ... 1 ... ... ... 11 ... ... ... ... ... ... 4 2 1 ... ... ... 4 15 ... 152 8 ... 25 9 2 7 1 6 5 9 164 4 ... 3 1 ... ... ... ... ... 2 Girls 230 1 ... 2 ... 3 163 3 3 4 4 1 ... ... ... ... ... ... ... 2 3 1 ... ... 2 1 4 ... 6 ... ... ... ... ... ... 26 3 ... 1 ... ... 1 16 ... 129 38 ... 16 9 1 7 ... 6 1 6 163 64 1 7 1 ... ... ... ... ... 4 Vicarage Lane Boys 196 ... 1 1 ... 5 145 8 8 ... 3 4 3 2 1 2 2 ... ... 3 1 2 2 ... ... ... 3 ... 5 ... ... ... ... 1 ... 5 ... 2 2 ... 2 5 27 ... 103 15 1 13 7 1 3 1 13 3 7 145 10 2 3 ... ... ... 2 ... ... 9 Girls 194 2 ... ... ... 1 1.17 10 9 5 4 ... 2 1 ... 1 1 ... ... 1 3 3 2 ... ... 2 3 ... 4 ... ... ... ... 1 ... 37 1 ... ... ... 1 1 14 1 88 14 ... 15 6 1 ... ... 9 3 6 137 18 ... 3 ... ... ... ... ... ... 4 Walton Road Boys 267 ... 1 1 1 4 193 12 17 ... 2 3 2 ... ... ... 1 ... ... 3 5 ... ... ... 2 ... ... 4 2 ... ... ... ... ... ... 12 ... 8 4 ... 8 7 31 ... 217 64 3 61 18 15 5 3 1 2 27 188 6 ... 3 ... ... ... ... ... 1 3 Girls 263 1 ... 1 1 3 192 8 11 ... ... ... 1 1 1 ... ... ... ... 1 1 2 1 ... 2 ... 8 ... 8 ... ... ... ... ... ... 109 2 3 . 1 ... 6 7 26 1 129 47 18 66 18 10 3 ... 7 1 22 189 12 ... 3 ... ... ... ... ... ... 7 Totals Boys 3520 18 23 11 3 29 2474 109 139 50 45 32 30 18 18 6 16 ... 1 31 31 14 19 ... 43 18 48 13 110 3 1 ... 3 7 ... 73 7 35 16 4 25 51 242 5 2130 373 27 514 165 108 47 8 155 27 227 2544 146 13 70 4 ... ... 17 7 6 62 Girls 3325 26 9 10 1 23 2350 92 117 71 52 27 38 16 16 11 8 1 1 18 21 18 11 ... 26 5 78 6 101 2 1 ... 1 3 2 469 28 14 7 2 14 23 191 4 2085 352 39 449 153 57 38 3 117 34 142 2326 214 5 62 2 ... ... 6 3 1 62 Percentage defective Boys ... 0.51 0.65 0.31 0.02 0.82 ... 4.4 5.6 2.02 1.8 1.3 1.2 0.72 0.72 0.24 0.64 ... 0.04 0.88 0.88 0.39 0.54 ... 1 2 0.51 1.3 0.37 3.1 0.08 0.02 ... 0.08 0.19 ... 2.1 0.22 0.96 0.4 0.11 0.71 1.4 6.9 0.14 60.5 10.6 0.76 14.6 4.7 3.1 1.3 0.22 4.4 0.76 6.4 ... 5.7 0.51 1.9 0.11 ... ... 0.45 0.19 0.17 1.7 Girls ... 0.78 0.27 0.03 0.03 0.69 ... 3.9 4.9 3.02 2.2 1.1 1.6 0.64 0.64 0.47 0.34 0.04 0.04 0.54 0.63 0.54 0.32 ... 0.78 0.15 2.3 0.18 3.03 0.06 0.03 ... 0.03 0.08 0.06 14.1 0.81 0.42 0.21 0.00 0.42 0.69 5.7 0.12 62.7 10.6 1.1 13.5 4.6 1.7 1.18 0.08 3.5 1.08 4.2 ... 9.2 0.21 1.7 0.06 ... ... 0.18 0.08 0.03 1.8 41 SPEC1AL CASES W1TH DEFECTS. Ages. Dept. Number examined. Squint. Vision defective. Deafness and discharging ears. Adenoids and enlarged tonsils. Other defects. No defects found. Total number of defects. Slight defect. Great defect 8 years Boys 4 - - - - 1 - 3 1 Girls 1 — — — — — 1 — 1 9 years Boys 27 1 — 5 — — 5 17 11 Girls 3.3 1 2 — 1 5 4 19 14 10 years Boys 15 — 1 9 — — 4 8 14 Girls 43 — 5 17 — 1 10 15 33 11 years Boys 32 — 2 7 1 1 3 15 14 Girls 44 — 6 5 1 7 16 5 35 Totals Boys 78 1 3 21 1 2 12 43 40 Girls 121 l 13 22 2 13 31 39 83 Total — 199 2 16 43 3 15 43 82 123 42 TABLE OF VERMINOUS CONDITIONS FOUND AT EXAMINATIONS FOR GENERAL CLEANLINESS. SCHOOLS. Dept. Number Exam'd. Few Nits. Many Nits and Vermin. Body and Clothing Verminous. SCHOOLS. Dept. Number Exam'd. Few Nits. Many Nits and Vermin. Body and Clothing Verminous. Castle Street R.C. Infants 100 10 17 5 Napier Road Girls 424 82 70 10 Mixed 77 12 28 8 Boys ... ... ... ... Infants 459 66 43 10 Central Park Road Girls 487 39 42 ... Boys 501 15 6 ... New Beckton Girls ... ... ... ... Infants 547 25 30 1 Boys ... ... ... ... Infants ... ... ... ... Essex Road Girls 464 22 13 1 Boys 442 16 9 4 North Woolwich Mixed ... ... ... ... Infants 696 34 14 1 Plashet Lane Girls 428 91 100 12 Fourth Avenue Girls ... ... ... ... Boys ... ... ... ... Boys ... ... ... ... Infants 468 70 65 10 Infants ... ... ... ... St. Winefride's R.C. Mixed ... ... ... ... Hartley Avenue Girls 451 72 51 2 Boys 465 20 18 5 Sandringham Road Girls ... ... ... ... Infants 515 68 33 4 Boys ... ... ... ... Infants ... ... ... ... High Street Girls 290 30 71 5 Boys 280 12 22 7 Shaftesbury Road Girls ... ... ... Infants 295 40 37 6 Boys ... ... ... ... Infants ... ... ... ... Kensington Avenue Girls ... ... ... ... Boys ... ... ... ... Shrewsbury Road Girls 200 ... ... 4 Infants 924 11 7 ... Boys ... ... ... ... Infants ... ... ... ... Lathom Road Girls 447 26 14 1 Boys 423 6 1 1 Silvertown R.C. Infants ... ... ... ... Infants 693 23 16 4 Mixed ... ... ... ... Manor Park Girls ... ... ... ... Vicarage Lane Girls 412 67 71 11 Boys ... ... ... ... Boys ... ... ... ... Infants ... ... ... ... Infants 509 75 55 8 Monega Road Girls ... ... ... ... Walton Road Girls 855 55 27 10 Boys ... ... ... ... Boys 435 16 8 8 Infants ... ... ... ... Infants 662 42 26 6 Total 8529 481 429 55 Total 4843 564 465 89 43 TABLE OF RESULTS AFTER FOLLOWING UP. Clinic. Hospital. Private Practitioner. Home Treatment. No Treatment. Number in whom treatment was unnecessary through spontaneous cure or relief. Left. Refused. Totals. Glasses. Treatment. Operation. Glasses. Treatment. Operation. Glasses. Treatment. Defective Vision including Squint 234 7 ... 81 5 ... 15 6 ... 210 138 45 52 793 Enlarged Tonsils, Adenoids and Glands ... ... 63 ... 8 5 3 13 ... 139 13 7 14 265 Discharging Ears and Deafness ... 7 7 ... 6 ... ... 17 8 23 ... 2 ... 70 Inflamed Eyes ... 2 ... ... ... ... ... ... 4 1 ... ... ... 7 Malnutrition, Anaemia and Debility ... ... ... ... ... ... ... 1 ... 2 ... 1 ... 4 Ringworm, Impetigo and other skin affections ... 1 ... ... 2 ... ... ... 1 1 ... ... ... 5 Heart and Lung affections ... 1 ... ... 4 ... ... 34 19 54 ... 4 ... 116 Decayed Teeth ... 84 ... ... 8 ... ... 15 5 137 4 5 8 266 Other conditions ... ... 2 ... 15 ... ... 6 12 45 1 3 1 85 234 102 72 81 48 5 18 92 49 612 156 67 75 1611 44 TABLE OF RESULTS OF CLINIC TREATMENT (Dental and Vision Cases Excluded). Cured. Relieved. Unchanged. Left the Borough. Totals. Impetigo 63 ... 1 ... 64 Blepharitis 28 1 8 ... 37 Corneal Ulceration and other external eye inflammation. 44 3 14 ... 61 Discharging Ears and Deafness 45 ... 21 ... 66 Ringworm— Body 8 ... ... ... 8 Head 1 ... ... ... 1 Septic Wounds, Abscesses, &c. 191 ... 10 ... 201 Eczema ... ... ... ... ... Scabies ... ... ... ... ... Totals 380 4 54 ... 438 TREATMENT CLINIC. SHEWING THE NUMBER OF TREATMENTS CARRIED OUT. AT THE CLINIC (DENTAL AND OPHTHALMIC CASES ARE NOT INCLUDED). Number of Times Treated 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 24 25 27 28 29 30 35 36 37 40 42 44 50 55 57 59 61 85 Totals. Impetigo 20 4 3 1 3 3 1 1 3 1 1 ... 4 2 ... ... ... 1 ... ... ... ... ... ... 1 ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... 298 Blepharitis 10 3 2 2 3 3 1 3 ... ... ... 1 ... ... 1 1 1 ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 1 ... ... ... 326 External Inflammation of Eyes other than Blepharitis. 18 7 3 1 1 1 8 ... 3 1 2 2 2 3 2 1 ... ... ... 1 1 ... ... ... ... 1 1 ... ... ... 1 1 1 1 1 ... ... ... ... ... 620 Discharging Ears and Deafness 21 4 2 4 2 1 6 1 2 1 3 1 1 ... 1 ... 1 ... 2 1 ... 1 ... ... ... ... 3 1 ... ... ... 3 1 ... 1 1 1 1 1 939 Ringworm Body 4 2 ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 20 Head 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 Septic Sores and Abscess Formation. 63 24 13 18 11 14 10 7 7 9 4 5 2 6 5 3 1 ... 1 2 3 1 ... 1 1 1 ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 1253 Eczema ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Scabies ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Totals 137 88 69 104 105 132 189 96 135 120 77 132 117 168 120 96 34 36 19 120 105 22 24 25 54 56 29 90 70 36 37 80 168 88 50 110 114 59 61 85 3457 45 APPENDIX I. Report of Ophthalmic Surgeon. The selection of cases for Ophthalmic examination is made partly on the results of the preliminary test of vision at the schools and partly from special cases complaining of difficulty with distant vision or persistent headache, etc., and referred by the teachers to the Inspection Clinic. Children with eye symptoms or visual defects are requested to attend the Inspection Clinic held on Friday forenoons. A further examination is made under more perfect conditions of light. Where there is found a defect sufficient to suggest the necessity for glasses, atropine ointment is put into the eyes and a small box of ointment, with simple instructions as to its application, is given to the parent, who is told to bring the child again on the Tuesday following. On Tuesdays the new cases are seen. Towards the end of the session the Optician attends and takes measurements of the children requiring glasses and also distributes glasses ordered to those children who were seen the previous week. By this means the Surgeon is enabled to make a final inspection and the suitability of such spectacles is ensured. Further, the dual attendance of the Surgeon and Optician is a distinct advantage in cases where questions arise as to special points in spectacles. Provision of Spectacles. Spectacles are now supplied at a flat rate of 2s. 6d. per pair. For this price a good solid nickel or nickel steel frame and best quality lenses are provided. In cases where parents are unable to pay for the spectacles the Committee provide the same. 47 cases of squint were treated by means of shades worn for varying periods. 46 Squint cases with refractive error have responded to the shade treatment (i.e., exclusion of the good eye whilst at school) very satisfactorily. Myopia and squint cases are kept under observation at intervals varying from 3 to 12 months. During the year 1915 there were 612 cases examined as follows, as compared with 474 in 1914 :— Boys. Girls. Total. Myopia 33 56 89 Simple Myopic Astigmatism 3 7 10 Compound Myopic Astigmatism 20 22 42 Hypermetropia 55 73 128 Simple Hypermetropic Astigmatism 30 37 67 Compound Hypermetropic Astigmatism 36 32 68 Mixed Astigmatism 17 15 32 Odd Eyes 7 11 18 Squint without error of refraction 2 3 5 Corneal Opacities 3 3 6 Ciliary Spasms 35 20 55 Cataract 3 0 3 Various Congenital Defect 2 3 5 No defects 25 59 84 Total 271 341 612 Each of the above received appropriate treatment. Inspections for General Cleanliness under Section 122 of the Children Act, 1908. 1914. 1915. Children examined for cleanliness 15,209 13,372 Number of Statutory Notices served 505 165 Number of cleansings 59 — Number cleansed Statutorily 37 — 47 CASES EXAMINED BY SCHOOL DENTIST. Numbers not requiring treatment. Numbers still requiring treatment. Numbers treated. Total number examined. Boys. Girls. Boys. Girls. Boys. Girls. Boys. Girls. Brampton Road ... ... ... ... 1 ... l ... Castle Street R.C. ... ... ... ... 1 5 l 5 Central Park Road 39 45 102 120 17 11 158 176 Essex Road 36 37 129 97 27 23 192 157 Fourth Avenue 29 23 70 65 26 42 125 130 Hartley Avenue ... ... ... ... 19 13 19 13 High Street ... ... ... ... 6 16 6 16 Higher Elementary ... ... ... ... 1 1 1 1 Kensington Avenue ... ... ... ... 6 17 6 17 Lathom Road ... ... ... ... 25 28 25 28 Manor Park 42 41 111 117 43 47 196 205 Monega Road ... ... ... ... 16 11 16 11 Napier Road ... ... ... ... 15 21 15 21 New Beckton ... ... ... ... 1 6 1 6 North Woolwich ... ... ... ... 4 3 4 3 Plashet Lane ... ... ... ... 20 27 20 27 St. Winefride's R.C. ... ... ... ... 3 ... 3 ... Sandringham Road ... ... ... ... 4 5 4 5 Shaftesbury Road ... ... ... ... 18 12 18 12 Shrewsbury Road ... ... ... ... 8 5 8 a Silvertown R.C. ... ... ... ... ... 1 ... 1 Vicarage Lane ... ... ... ... 26 24 26 24 Walton Road ... ... ... ... 4 6 4 6 146 146 412 399 289 325 848 870 48 CASES TREATED AT DENTAL CLINIC. Ages. Sex. Number Exam'd. Temporary Teeth. Permanent Teeth. Extractions. Anaesthetics. Scalings. Dressings. Fillings. Saveable. Unsaveable. Saveable. Unsaveable. Temp. Teeth. Perm. Teeth. Local. N2O. 5 years B. 38 ... 200 ... ... 183 ... 20 ... ... 1 1 G. 29 6 136 4 ... 125 ... 18 ... ... ... 6 6 years B. 73 6 313 5 2 267 3 27 ... ... ... 9 G. 103 9 384 9 8 319 1 25 ... ... ... 20 7 years B. 79 5 351 11 3 347 3 15 ... ... ... 10 G. 80 3 319 16 4 313 3 13 ... ... ... 15 8 years B. 59 8 246 16 11 231 5 24 ... ... 2 10 G. 74 12 274 29 15 266 14 27 ... ... 1 17 9 years B. 29 ... 113 7 10 111 7 17 ... 1 1 4 G. 15 ... 50 3 5 46 3 5 ... ... ... 3 10 years B. 19 ... 35 10 17 28 13 17 ... 1 1 6 G. 14 ... 15 7 13 22 13 8 ... ... ... 6 11 years B. 12 ... 18 5 14 18 12 8 ... ... ... 2 G. 12 ... 12 3 13 10 11 10 ... ... 2 3 12 years B. 4 ... 5 2 4 5 4 ... ... ... 2 G. 13 ... 14 13 10 11 13 10 ... ... ... 1 13 years B. 11 ... 17 1 23 17 17 11 ... ... ... ... G. 5 ... ... 15 8 ... 4 2 ... ... ... 15 14 years B. ... ... ... ... ... ... ... ... ... ...... ... ... G. 1 ... ... ... 4 ... 4 3 ... ... ... ... Totals B. 324 19 1298 57 84 1207 64 139 ... 2 5 44 G. 346 30 1204 99 80 1112 66 121 ... ... 3 86 670 49 2502 156 164 2319 130 260 ... 2 8 130 Report OF THE Chief Sanitary Inspector FOR THE YEAR 1915. 50 Annual Report of the Chief Sanitary Inspector. To His Worship the Mayor, the Aldermen and Councillors of the County Borough of East Ham. Mr. Mayor and Gentlemen, I have the honour to submit to you my twentieth Annual Report on the work done by the Sanitary Inspectors during the year ended 31st December, 1915. INSPECTION OF THE BOROUGH AND ABATEMENT OF NUISANCES. The total number of primary inspections made during the year under consideration was 5,475 as compared with 6,022 for the year 1914. These include house to house inspections, visits to premises upon complaint of nuisance, inspection of markets, workshops, slaughterhouses, bakehouses, cowsheds, dairies, etc. The health of the Borough is the first consideration of the * inspectorial staff, who perform this work with one object in view —that the Borough may maintain its good record of being a healthy district. PRIMARY INSPECTIONS. Beckton and N. Woolwich Ward. Central Ward East. Central Ward West. Manor Park Ward. Plashet Ward East. Plashet Ward West. Total. 1914 1915 1914 1915 1914 1915 1914 1915 1914 1915 1914 1915 1914 1915 January 23 48 263 213 60 72 124 76 20 22 93 61 583 492 February 69 19 128 263 150 61 84 104 44 23 90 98 565 568 March 34 77 136 105 132 145 135 84 61 26 117 75 615 512 April 15 54 148 130 112 99 111 76 25 33 85 49 496 441 M ay 96 21 92 188 164 104 151 71 39 18 97 72 639 474 June 173 86 59 106 68 206 112 137 75 19 51 47 538 601 July 105 162 104 60 63 86 133 85 90 29 75 66 570 488 August 38 35 58 47 48 28 70 59 6 12 11 36 231 217 September 125 109 66 106 88 88 63 83 16 15 31 42 389 443 October 119 74 100 172 150 86 79 90 36 17 40 62 524 501 November 161 27 120 170 57 52 85 67 24 0/ 38 87 485 460 December 46 18 168 95 85 56 45 41 18 22 25 46 387 278 Totals 1004 730 1442 1655 1177 1083 1192 973 454 293 753 741 6022 5475 The Following is a Record in Detail of the Inspections made during the Year 1915:— Beck ton & North Woolwich Ward. Central East Ward. Central West Ward. Manor Park Ward. Plashet East Ward. Plashet West Ward. Total. 1915 1915 1915 1915 1915 1915 1915 Ord. H.toH. Ord. H. to H. Ord. H.toH. Ord. H.toH. Ord. H.toH. Ord. H.toH. Ord. H.toH. Premises found in fair condition 122 112 139 289 134 93 106 ... 43 ... 66 25 610 519 Factory and workshop premises 35 ... 62 ... 83 ... 90 ... 20 ... 67 ... 357 ... Outworkers' premises 60 ... 89 ... 162 ... 44 ... 39 ... 164 ... 558 ... Bakehouses 9 ... 18 ... 30 ... 26 ... 21 ... 21 ... 125 ... Slaughter-houses 2 ... 9 ... 6 ... 162 ... 5 ... 27 ... 211 ... Dairies 83 ... 74 ... 76 ... 105 ... 24 ... 41 ... 403 ... Urinals inspected 36 ... 55 40 ... 17 ... 10 ... 16 ... 174 ... Walls and ceilings dirty and dilapidated 22 74 40 241 60 84 55 ... 26 ... 57 18 260 417 Yards improperly paved and dilapidated 5 12 12 54 26 51 15 ... 9 ... 22 13 89 130 No forecourt paving ... ... 4 2 8 18 3 ... 6 ... 17 45 38 65 Drains unstopped and cleansed 297 ... 420 ... 438 ... 351 ... 185 ... 228 ... 1919 ... Defective drains ... ... 1 1 17 1 64 1 6 ... 25 2 113 5 Defective W.C. connections 1 1 1 3 2 ... ... ... 2 ... 3 ... 9 4 Defective W.C. traps 1 ... 1 ... 1 ... ... ... 1 ... 1 ... 5 ... Soil pipes and drains insufficiently ventilated ... ... ... ... ... 1 ... ... ... ... ... 1 ... 2 Defective flushing apparatus 3 6 10 27 9 12 17 ... 7 ... 12 10 58 55 Soil pans foul and broken 2 4 9 13 14 12 19 ... 12 ... 27 23 83 52 Defective vent pipes 3 ... 18 11 6 11 15 ... 11 ... 8 ... 61 22 R W. pipes and eaves gutters defective 1 10 26 68 18 20 28 ... 8 ... 18 5 99 103 Do. connected to drain ... ... ... ... ... 1 3 ... ... ... 2 ... 5 1 Hoofs leaky 6 25 37 101 31 26 16 ... 6 ... 19 12 115 164 Defective sink waste pipes 2 8 11 24 18 16 19 ... 6 ... 6 1 62 49 Houses without water (M.W.Bd.) ... ... 5 ... 1 ... ... ... ... ... 2 ... 8 ... Cisterns without covers ... ... ... ... 5 2 1 ... 2 ... 7 9 15 11 Drinking water improperly stored ... ... 13 3 14 11 18 ... 10 ... 10 17 65 31 Dilapidated floors ... 3 4 28 7 12 5 ... ... ... 3 1 19 44 Insufficient underfloor ventilation 1 2 4 13 3 21 ... ... 4 ... 12 12 24 48 Dampness 4 3 14 36 19 17 27 ... 13 ... 18 7 95 63 Accumulations 9 ... 11 4 19 3 18 ... 5 ... 9 3 71 10 Inundations ... ... 2 ... ... ... ... ... 1 ... 2 ... 5 ... Overcrowding ... ... 5 ... 7 ... 11 ... ... ... ... ... 23 ... Unsound food ... ... 2 ... ... ... 2 ... ... ... ... ... 4 ... No dust bins ... 8 5 15 12 3 4 ... 4 ... 5 2 30 28 No manure bins 1 ... ... ... 2 ... ... ... ... ... 1 ... 4 ... Animals improperly kept 1 ... 2 1 3 ... 6 ... ... ... 2 1 14 2 Temporary buildings found 2 ... 4 ... 1 ... 4 ... ... ... 1 ... 12 ... Smoke nuisance 9 ... 120 1 ... ... 2 ... ... ... ... ... 131 1 Rear passages unpaved or undrained ... ... ... ... 1 ... ... ... ... ... 1 ... 2 ... Gipsies 3 ... 153 ... ... ... 10 ... ... ... ... ... 166 ... Breaches of Bye-Laws and Regulations ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other nuisances 20 22 60 123 66 46 67 ... 26 ... 62 16 301 207 Drains tested 80 14 92 ... 82 ... 121 ... 82 ... 74 1 531 15 Inspections 224 271 6c5 090 419 267 529 ... 172 ... 302 101 2311 1329 51 As a result of the 5,475 inspections made of premises in the Borough, some 3,514 nuisances were discovered. These nuisances comprised choked and defective drains, dirty and dilapidated walls and ceilings, defective yard pavings, leaky roofs, drinking water improperly stored in cisterns, unsound food, offensive accumulations, defective sanitary appliances, animals (particularly poultry) kept near dwelling houses in dirty condition, etc. To obtain the abatement of the nuisances referred to in the table necessitated the serving of 1,051 preliminary notices, 86 statutory notices, 14 water notices, 159 dust bin notices, a large number of intimation letters, together with numerous interviews. COMPLAINTS RECEIVED. During the year, 1,218 complaints were received, 589 written and G29 verbal, the figures for the previous year being 1,157 complaints, 678 written and 479 verbal. The majority of the written complaints were anonymous. COMPLAINTS RECEIVED. Beckton and N. Woolwich Ward. Central Ward East. Central Ward West. Manor Park Ward. Plashet Ward East. Plashet Ward West. Total. 1914 1915 1914 1915 1914 1915 1914 1915 1914 1915 1914 1915 1914 1915 January 6 8 20 12 18 17 17 35 4 6 10 8 75 86 February 7 7 31 15 10 18 13 25 6 8 4 6 71 79 March 8 8 19 22 13 18 13 21 16 15 37 11 106 95 April 3 2 27 23 11 22 39 21 1 12 17 12 98 92 May 6 13 19 20 17 23 42 15 14 7 27 30 125 108 June 9 6 12 20 18 22 30 22 13 16 9 15 91 101 July 11 6 18 17 22 23 44 28 7 9 16 13 118 96 August 12 8 12 26 12 42 41 31 8 7 8 24 93 138 September 13 4 14 27 32 32 22 13 11 6 19 11 111 93 October 13 9 13 25 36 34 26 23 13 5 13 12 114 108 November 2 11 13 34 27 27 33 23 8 6 6 8 89 109 December 9 28 13 20 13 23 17 25 7 5 7 12 66 113 Totals 99 110 211 261 229 301 337 282 108 102 173 162 1157 1218 52 They referred to the following nuisances COMPLAINTS—NUISANCES. Jan. Feb. Mar. April May June July Aug. Sept. Oct. Nov. Dec. Total. Drains Choked 39 33 64 42 35 36 39 71 40 58 76 69 602 Accumulations (Refuse, etc.) 2 13 7 13 19 15 12 4 9 3 4 12 113 Water cut off — — 1 1 — — 1 1 1 1 — — 6 Dilapidations — 1 — 3 3 5 1 4 6 5 — 4 32 Insanitary condition. 2 — — 2 9 1 1 8 1 — — — 24 Overcrowding — 2 — 4 2 3 6 3 1 — — 1 22 No dust bins 2 2 2 — 1 4 3 — 6 8 2 4 34 Dampness 5 4 1 1 1 — 5 2 1 4 9 6 39 Others (various) 36 23 16 23 33 33 24 34 15 23 13 17 290 Offensive smells — 1 4 3 5 4 4 11 13 6 5 — 56 Total 86 79 95 92 108 101 96 138 93 108 109 113 1218 HOUSE TO HOUSE INSPECTION. In previous reports special reference has been made to the importance of this branch of Public Health service, and as much time as is at the disposal of the inspectorial staff is given to this work, but the visitation of infectious cases receives first claim upon the Inspectors' time. The number of premises visited was 1,329 as compared with 2,027 for the previous year. Of the 1,329 premises visited, 564 were found in such a condition as to warrant no action being taken by the Inspector for the abatement of any nuisance. This figure is equal to 40'2 premises in fair condition, and 59'8 premises at which nuisances existed. The latter figures may appear high, but house to house inspections are made in selected areas where the Inspector's experience tells him he is required. It will be observed that there is a decrease of 698 in the number of inspections made. 53 HOUSE TO HOUSE INSPECTION. NAME OF ROAD. Number of Premises Inspected. Number of Premises where Defects Existed. Number of Premises found in Fair Condition. Beckton and North Woolwich Ward. Albert Road 20 5 15 Church Street 6 2 4 Claremont Street 14 11 3 Elizabeth Street 18 13 5 Fabian Street 10 7 3 Glenister Street 62 32 30 High Street, North Woolwich 32 18 14 Robert Street 15 14 1 Storey Street 58 22 36 Rancliffe Road 3 3 — 238 127 1ll Central Ward East. Burges Road 12 12 Beckett Avenue 17 8 9 Langton Avenue 18 2 16 Barking Road 13 2 11 Brighton Road 74 48 26 Bonny Downs Road 81 44 37 Calverton Hoad 24 11 13 Folkestone Road 5 5 — Howard Road _ — Market Street 48 33 15 Melbourne Road 6 — 6 St. Olaves Road 3 — 3 Talbot Road 50 27 23 Telham Road 89 57 32 Wall End Road 35 12 23 Nelson Street 3 3 — Mountfield Road 104 53 51 Napier Road 20 20 — Vicarage Lane 5 4 1 Wellington Road 44 31 13 651 360 291 Central Ward West. Bartle Avenue 44 23 21 Colvin Road 16 12 4 Central Park Road 10 5 5 Ernald Avenue 114 62 52 Greenleaf Road 15 15 — Kings Road 37 31 6 Grosvenor Road 31 21 10 Spencer Road 4 4 — Macaulay Road 68 29 39 Plashet Ward West. 339 202 137 Johnson's Passage 6 6 — Green Street (Ann's Cottages) 2 2 — South Esk Road 93 68 25 101 76 25 —1329 —765 —564 54 DRAINS UNSTOPPED AND CLEANSED. The work of unstopping and cleansing drains has received the usual attention. The policy of the Council to send their own men free of charge to do this important work, essential to the good health of the Borough, is still in operation. There are 27,517 houses in the Borough, and at 1,919 the drains have been unstopped and cleansed, being 6.9 per cent. The figures for the year 1913 were 1,852, being 6.8 per cent. DRAINAGE WORK. At 346 houses the drains have been tested, and in 118 instances defects in the drains have been discovered. 5 of these were the result of house to house inspections, and 113 by routine work, such as visits caused by the occurrence of a case of infectious disease, or complaint of offensive smells. In addition to the 118 defective drains there were 13 defective water closet connections and 5 defective water closet traps. In 135 instances soil pans were renewed or cleansed, and 83 new ventilating pipes were erected. For the carrying out of these sanitary amendments the District Inspectors supervised and passed the work. No pipes were permitted to be covered until they were tested. SANITARY APPLIANCES. This term includes the appurtenances to the drains proper, and during the year there have been 113 flushing apparatuses to the water closets renewed or repaired, as compared with 180 for the previous year. 1ll waste pipes from scullery sinks and baths were dealt with, as compared with 137 for the year 1914. DIRTY PREMISES. Under this form of nuisance are included dirty walls and ceilings, and at 677 premises the internal cleansing of walls and ceilings has been performed, the figures for the previous year being 904. By reference to the nuisance table inset facing page So , it will be seen that there have been 1,329 house to house inspections made, and at 417 of the houses internal dirty walls and ceilings were discovered. This is equal to 31'4 per cent. of the inspections made, while as a result of ordinary routine work, which includes the inspections made upon complaint, and at dairies, slaughterhouses, bakehouses, etc., the inspections were 2,311, and nuisances arising from dirty walls and ceilings were 260, being equal to 11.2 per cent., the figures for 1914 being 9.6. 55 UNSOUND FOOD. The markets have been regularly inspected, and in five instances unsound food was discovered and destroyed. On four other occasions important seizures were effected, legal proceedings instituted and heavy penalties imposed. In one instance the seizure comprised a live cow, which was emaciated and which proved to be extremely diseased with Tuberculosis. The carcase was condemned. The Stipendiary Magistrate convicted, an appeal was made, and the case went to Quarter Sessions, where the conviction was upheld. The other three seizures were important, one being the dead carcase of a pig seized from a cart outside a Butcher's shop, another seizure being a van-load of meat in transit, and the third a carcase of a cow deposited in a shed adjoining a slaughterhouse. SALE OF FOOD AND DRUGS ACT. Upon becoming a County Borough in April, the work of taking samples of food and drugs commenced, and from that date until the end of the year 410 samples were procured, of which 31 proved to be adulterated, being equal to 7.5 per cent. TRADE REFUSE, 1915. During the year 13,318 loads of House and Trade Refuse have been collected and deposited at the Council's Destructor, as compared with 13,414 loads for the year 1914. Loads. January 165 February 150 March 168 April 152 May 160 June 160 July 164 August 154 September 161 October 158 November 157 December 163 Total 1,912 56 DUST COLLECTION. NUMBER OF LOADS COLLECTED DURING THE YEARS 1914 AND 1915 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. 1914 1915 1914 1915 1914 1915 1914 1915 1914 1915 1914 1915 1914 1915 JANUARY 173 192 202 221 193 172 227 213 123 142 177 150 1095 1090 FEBRUARY 122 128 160 165 128 131 206 207 131 134 142 144 889 909 MARCH 120 129 173 180 126 143 250 250 156 184 144 179 969 1065 APRIL 147 139 167 184 145 163 226 210 171 151 193 153 1054 1000 MAY 152 147 194 173 149 130 234 247 142 144 150 144 1021 985 JUNE 115 123 167 177 122 125 218 224 163 165 142 157 927 971 JULY 128 155 178 172 160 173 216 223 146 135 178 154 1006 1012 AUGUST 134 107 160 135 126 112 178 194 122 137 127 119 847 824 SEPTEMBER 106 111 156 146 113 125 197 189 146 132 138 151 856 854 OCTOBER 143 150 175 179 150 136 195 189 132 124 152 124 947 902 NOVEMBER 118 122 159 170 128 119 230 225 116 141 158 126 909 903 DECEMBER 91 117 151 166 128 151 221 162 168 134 186 161 945 891 TOTALS 1,549 1,620 2,042 2,088 1,668 1,680 2,598 2,533 1,716 1,723 1,887 1,762 11,465 11,406 57 SUMMARY OF LEGAL PROCEEDINGS. 1915. Date. Address. Offence. t. January Whitta Road Depositing an animal intended for human food Fined £20 ; £7 7s. costs, conviction appealed against, but upheld. April Romford Road Depositing the carcase of a Pig intended for human food Fined £10; costs. ,, Forest View Road Depositing the carcase of a Cow intended for human food Fined £15 ; costs. „ Romford Road Being in possession of a consignment of unsound beef intended for human food Fined £15; costs. June Albeit Road Selling to the prejudice of the purchaser. Sale of Food and Drugs Act Fined £2 10s. ,, Hertford Road 3 cases Contravening Bve-laws, Tents, Vans, used for human habitation Fined £1 each, or 11 days ,, Katherine Road Selling to the prejudice of the purchaser. Sale of Food and Drugs Act Fined £2 10s. Od. ,, Green Street Ditto Fined £'.2 10s. 6d. „ High Street North Contravening Shops Act not exhibiting Notice Fined 15/- August Romford Road Ditto Fined 10 - „ Katherine Road Selling to the prejudice of the purchaser. Sale of Food and Drugs Act Fined £2 10s. 6d. ,, Plashet Lane Contravening Bakers' Half Holiday Order, 1913 Fined lo/- ,, High Street, South 4 cases Contravening Bye-law, Tents, Vans, used for human habitation 3 cases Fined £2 each, 1 case dismissed. September High Street North Selling to the prejudice of the purchaser. Sale of Food and Drugs Act Fined £1 ,, High Street North Ditto Fined £l ,, Barking Road Ditto Fined £1 ,, High Street, South Ditto Fined £1 October Katherine Road Contravening Sale of Food and Drugs Act. Name of Vendor not on Cart or Vessel Fined 5/- ,, Katherine Road Selling to the prejudice of the purchaser. Sale of Food and Drugs Act Fined £2 10s. 6d. 58 SUMMARY OF LEGAL PROCEEDINGS (continued). Date. Address. Offence. Result. October ,, Romford Road Selling to the prejudice of the purchaser. Sale of Food and Drugs Act ... Fined £2 10s. 6d. ,, Vicarage Lane Ditto Fined £1. ,, Melbourne Road Ditto Fined £3 0s. 6d. ,, High Street North Ditto Fined £2 10s. 6d. ,, High Street North Ditto Fined £1 10s. 6d. ,, High Street North Ditto Fined £1 10s. 6d. November Wakefield Street Ditto Fined £3 10s. 6d. ,, High Street South Ditto Fined £2 10s. 6d. ,, Barking Road Ditto Dissmissed—Warranty proved. December Hertford Road, 12 cases Contravening Bye-law, Tents, Vans, used for human habitation. Fined £1 each, or 11 days, one defendant went to prison. ,, Barking Road Selling to the prejudice of the purchaser. Sale of Food and Drugs Act Fined £2 0s. 6d. „ Barking Road Contravening the Margarine Act, failing to exhibit Label Fined £1 0s. 6d. ,, St. Bernards Road Sale of Food and Drugs Act, refusal to sell Fined £2 10s. ,, Wakefield Street Contravening Margarine Act, Improper wrapper Fined £2 10s. 6d. ,, Albert Road Selling to the prejudice of the purchaser. Sale of Food and Drugs Act Fined £1 10s. Gd. ,, Romford Road Contravening Margarine Act, improper wrapper Fined £2 10s. 6d. JOSEPH G. BANKS, Chief Sanitary Inspector. . .