COUNTY BOROUGH OF EAST HAM. With the Compliments of the Medical Officer of Health EAS O53 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. Medical Officer Maternity and Child Welfare Centre. Chief Tuberculosis Officer. TOGETHER WITH THE REPORT OF THE CHIEF SANITARY & FOOD INSPECTOR. For the Year ended 31st December, 1919. RECORDERS, EAST BAM. 1920. 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 record of sanitary work carried out during the year 1919. The report to the Education Committee is also included, together with an account of the work carried out in connection with the medical inspection of school children, School Clinic, Tuberculosis Dispensary, and Maternity and Child Welfare Centre. The chief need now is for better housing conditions. During the past five years much property hats been neglected, and some of the houses are in a deplorable condition. There is also a large amount of overcrowding in the Borough—two or three families living in a house provided for only one family. The large increase in the number of infectious diseases is due to this fact, but until more houses are provided this will continue. The accommodation at the Isolation Hospital is insufficient to cope with this increase, and as a consequence the wards have been overcrowded. I recommended the enlargement of the Hospital in 1914 and plans were prepared, but owing to the war this was not proceeded with. It is urgent that this should now be done as soon as possible. The provision of accommodation for cases of Tuberculosis has been unsatisfactory, but the. Harts Sanatorium at Woodford will prove an invaluable addition to the measures directed against T uberculosis. I am pleased to report good progress in regard to Maternity and Child Welfare, the success of which depends on the tact and interest of those engaged in the work. Difficulty has been experienced in connection with the supply of milk, but this has been met by the supply of dried milk at cost price. The Day Nurseries have been tiken over by the Corporation, but owing to unsuitable accommodation the best results have not yet been obtained. The voluntary committee who originally started the nurseries deserve full credit for their assistance. I would like to note the terrible overcrowding on the District Railway during early mornings and evenings. This must be a cause of a great deal of ill-health in the. Borough, besides being a factor in the spread of communicable disease. I again wish to express my thanks to the Chairman and Members of the Committee for their support and sympathetic consideration of the proposals brought forward for the improvemerit of conditions relating to the health of the inhabitants of the Borough, and also to the staff for their support. I am, Gentlemen, Your obedient Servant, W. BENTON, Medical Officer of Health. Town Hall, East Ham, E. 6. April, 1920. EAST HAM CORPORATION. PUBLIC HEALTH COMMITTEE. Councillor A. Stokes (Chairman). The Mayor (Councillor J. A. Williams, J.P.). The Deputy-Mayor (Councillor J. J. Francis). Alderman O. R. Anstead, J.P. Councillor W. C. Ford, J.P. 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. Pil.Gram Alderman H. Osborn, J.P. Councillor J. Savage, J.P Councillor R. Banks-Martin, J.P. Councillor F. Smith. Councillor H. Barfield. Councillor A. Stokes. Councillor A. Coles. Councillor A. Taylor. Councillor G. P. Dean. Councillor A. H. Wiseman, J.P. Councillor J. Evans. Councillor H. F. Witherspoon. STAFF OF THE PUBLIC HEALTH DEPARTMENT Clerks: Miss G. Bone, H. G. Luckett, G. W. Friend, W. J. Worley, R. A. Baskett, F. j. Kendall, A.R.San.I., Chief Clerk. Sanitary and Food Control 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. Toody. Health Visitors: Miss B. Bcckton, M.R.San.I., Miss K. Bower, Mrs. A. A. Woodman, M.R.San.I., Miss Alderman, Miss L. Barrett and Miss C. Cox. Inspector of Miduives: Miss K. Bower. Tuberculosis Nurses: Miss F. W. Howe and Miss L. Mallon. Matron of Isolation Hospital: Miss R. Wiison. Veterinary Inspector: H. J. Parkin, M.R.C.V.S. Chief Sanitary and Food Inspector and Inspector Contaijious Diseases (Animals) Act: Joseph G. Banks, A.R.San.I., M.S.I.A. Deputy Medical Officer of Health and Senior Assistant School Medical Officer: D. S. Brough, M.C. M.B., Ch.B., D.P.H. Assistant Medical Officer, Maternity and Child Welfare: S. Eleanor Hill, M.D.Lond. Assistant School Medical Officer: M. M. Thomson, L.R.C.P., L.R.C.S., D P H. Medical Officer of Health, School Medical Officer, Medical Superintendent Isolation Hospital, Chief Tuberculosis Officer, Medical Officer Maternity and Child Welfare Centre: W. Benton, M.R.C.S., L.R.C.P., D.P.H. 5 Summary of Report for 1919. Population, Census 1911, 133,487. Estimated Population for death-rate (Registrar-General), 144,451. Estimated Population for birth-rate (Registrar-General) 150,475. Acreage, 3,326. Persons per acre, 44. Inhabited Houses, Census 1911, 24,263. Births, 2,449. Birth-rate per 1,000 of the estimated population, 16.2. Deaths, 1,427. Death-rate per 1,000 of the estimated population, 9.8. Excess ot births over deaths, 1,022. Zymotic death-rate, 0 67. Infantile Mortality per 1,000 births, 73. Water Supply—Metropolitan Water Board. COMPARATIVE STATISTICS. Annual Rate per 1,000 Living. Rate pet 1,000 registered Births. Birlhs. Deaths. Diarrhtea & Enteritis. (under 2 years.) Infant mortality. England & Wales 18-5 13.8 9.5 89 96 Great Towns 19.0 13.8 12.2 93 London 18.3 13.4 16.2 85 East Ham 16.2 9.8 13.4 73 6 COUNTY BOROUGH OF EAST HAM. PUBLIC HEALTH DEPARTMENT. REPORT OF THE MEDICAL OFFICER OF HEALTH For the year 1919. VITAL STATISTICS. POPULATION. The population of the Borough at the Census of 1911 was 133,487. BIRTHS. During the year 2,449 births were registered (males 1,267, females 1,182) as against 2,205 in 1918, giving a birth-rate of 16.2 per 1,000 population. Illegitimate Births. Fifty-six of these were registered. DEATHS. The numbers of deaths during the year was 1,427, of which 477 were of persons of 65 years and upwards. 481 deaths were reported of persons belonging to the Borough which had taken place in Institutions outside the district. The death-rate for England and Wales was 13'8, and for the 96 great towns 13.8. INQUESTS. 88 inquests were held, 52 deaths being attributed to violence. INFANTILE MORTALITY. 179 deaths of infants under 1 year of age occurred in the Borough, giving a rate of 73 per 1,000 births registered as compared with 69 per 1,000 in 1918. 7 The number of infant deaths and the rate per 1,000 births for the past five years were as follows :— Year. Number of Infant Deaths. Rale per 1,000 Births Registered. 1915 263 79 1916 245 77 1917 221 85 1918 154 69 1019 179 73 The infantile mortality rate in the 96 large towns of England and Wales was 93 per 1,000 births. STATEMENT SHOWING THE WORK NOW BEING CARRIED OUT IN CONNECTION WITH THE SCHEME FOR MATERNITY AND CHILD WELFARE. No. of notified Births 2,098 No. of unnotified Births 351 No. of Deaths under 1 month 72 No. of Deaths under 1 year 179 No. of Still Births notified 45 The Maternity and Child Welfare scheme made considerable progress during the year. Two more Health Visitors having been appointed, making a total of six, it was arranged that one Health Visitor should undertake the work in each of the six wards. After the appointment of a full-time Lady Assistant Medical Officer, the number of infant consultations was increased to five sessions weekly instead of two. This was the more necessary as the baby c'inic, formerly held at the Plaistow Maternity Nurses' Home in Burges Road, was given up, all cases being transferred to the Municipal Inf int Welfate Centre. The White House in Plashet Grove was secured temporarily as a Maternity and Child Welfare Centre, and the Health Visiters' offices were removed there from the Town Hall, and the 1 'fant Consultations from Wakefield Street. With these 8 new premises it was possible to arrange for an Ante-Natal Clinic to be held on three mornings weekly, and the number of new mothers who attended the Clinic up to the end of the year was 51. A large proportion of these came in the hope of being admitted to a Maternity Home, and it was felt that there was an urgent need for such a Home in the Borough. It was also found that a number of the children attending the Infant Consultations required hospital treatment, and whereas cases of acute illness are usually admitted, if referred to a General or Childrens' Hospital, the more chronic cases requiring prolonged treatment, are refused admission, owing to lack of accommodation. It was therefore decided to open a Municipal Maternity Home and Infants' Hospital as soon as suitable premises could be obtained. In November, the Voluntary Day Nursery Committee, having found that their valuable work of maintaining two Day Nurseries in the Borough must be given up, on account of lack of funds, the Council decided to take over one of the Day Nurseries and keep it open, for the benefit of those mothers to whom its sudden closure would involve considerable hardship. As the present house does not come up to the standard required by the Ministry of Health, it is proposed to transfer the Nursery to a more suitable building as soon as possible, and in the meantime to limit the number of children by admitting only the most necessitous cases. As a result of the memorandum issued bv the Ministry of Health in October, on the supply of free or cheap milk to nursing and expectant mothers and to children under five years of age, very numerous applications v. ere received from mothers for grants of milk. These were dealt with by means of a graduated scale of economic circumstances, ensuring that milk was allowed in all really necessitous cases. First visits to houses where births had been registered 3,119 Re-visits, ditto, ditto 7,576 Ante-Natal cases, first visits 188 Ditto re-visits 141 Special [visits 225 Total number of attendances at Infants' Clinic 9,692 9 MIDWIVES' ACT. Fifty-nine midwives notified their intention to practice in the Borough during- the year 1919. Forty of these were attached to the Plaistow Maternity Charity and seven to Sir Henry Tate's Nurses' Home, Silvertown, The remaining twelve practised independently. Of these latter, three left the neighbourhood, one had no csses during the year, and one ceased to practice as a midwife. One case of puerperal fever was reported among the cases attended by midwives; the patient was removed to the London Hospital and recovered. Sixty-four visits have been paid by the Inspector for the inspection of bags and records, and for the investigation of special cases. 199 records of sending for medical help have been sent in For the Mother :— Malpresentat ions. Prolonged Labour. Ruptured Perineum. Retained Placenta and Membranes. A. P. H. P. P. H. Rise of Temperature. Eclampsia. other Causes. 0 18 40 8 3 8 14 2 17 For the Infant :— Dangerous Feebleness. Abnormalities. Dis. from Eyes. Ophthalmia Neonatorum. Artificial Feeding. Other Causes. 40 16 10 6 8 8 NOTIFIABLE INFECTIOUS DISEASES. 3,103 cases of Infectious Disease were notified during the year. Small Pox. One case of this disease occurred, with recovery. Scarlet Fever. 530 cases of this disease were notified during the year as against 212 in 1918. One death occurred from the disease. 403 cases were removed to the Isolation Hospital. 10 Diphtheria. 451 cases of this disease were notified with 29 deaths. 273 cases were notified in 1918 with 18 deaths. 410 cases were removed to the Isolation Hospital. Enteric Fever. Fifteen cases of Enteric (Typhoid) Fever were notified, with 3 deaths. Erysipelas. 72 cases of Erysipelas were notified as against 52 cases in 1918. There were two deaths. Ophthalmia Neonatorum. During the year 13 cases were notified. Puerperal Fever. Six cases of this disease were notified as against one case in 1918. Epidemic Cerebro-Spinal Meningitis. Three cases of this disease (commonly known as Spotted Fever) were notified, all of which proved fatal. Acute Polio-Myelitis. Three cases were notified. Acute Encephalitis Lethargica. Four cases notified, with four deaths. Typhus Fever. No case was notified. Measles and German Measles. 1,672 cases were notified, with 12 deaths. 11 Tuberculosis. The number of deaths from Tuberculosis was 129, as compared with 197 in 1918. The following table shows the number of deaths from Pulmonary and other forms of Tuberculosis :— Pulmonary Tuberculosis (Phthisis) 108 deaths Tuberculosis of the Brain (Meningitis) 9 deaths Other forms of Tuberculosis 12 deaths Under the Public Health (Tuberculosis) Regulations the total number of notifications received was Tuberculosis (Pulmonary) 258 as against 283 in 1918 Tuberculosis (Other forms) 74 as against 80 in 1918 332 363 COMMUNICABLE DISEASES—NON-NOTIFIABLE. Whooping Cough. Twelve deaths were registered as due to Whooping Cough, as against 21 in 1918. MENTAL DEFICIENCY. Following is the number of statutory cases (i.e., subject to be dealt with under Mental Deficiency Act) :— Under supervision 14 Passed by Committee for Institution 10 Now in Institutions, dealt with by Local Authority 7 Other cases in Institutions 7 Education Committee cases (7-16 years of age) 48 Under observation 9 VENEREAL DISEASE. East Ham forms part of the joint scheme with the London County Council and other Authorities by which arrangements are made for cases to attend at various London Hospitals Venereal Disease Clinics. 12 The following table refers to this scheme :— VENEREAL DISEASES. Annual Summary, Year 1919. London Middlesex Essex Surrey Kent Herts Bucks E. Ham W. Ham Croydon Total New Patients:— Syphilis 7,128 645 352 321 230 94 54 113 384 63 9,384 Soft Chancre 331 19 18 12 16 6 5 2 21 2 432 Gonorrhoea 9,635 982 476 345 232 85 50 173 473 81 12,532 Not Venereal 3,814 407 196 162 119 50 20 46 160 42 5,016 Total 20,908 2,053 1,042 840 597 235 129 334 1,038 188 27,364 Total Attendances 232,659 23,710 9,813 9,127 5,620 1,955 1,330 2,848 9,302 1,702 298,060 No. of " In-patient" days 54,431 2,242 2,125 3,174 3,042 892 763 271 1,010 473 68,423 Salvarsan Substitutes, doses given 41,894 3,817 1,835 1,826 1,409 462 414 472 1,405 443 53,977 13 REPORT ON THE BOROUGH BACTERIOLOGICAL LABORATORY. During the year 1919 there were 681 specimens examined for suspected Diphtheria, of which 233 were positive and 448 negative to K.L. B. Results were communicated per telephone or sent by special messenger to the medical practitioners concerned. DISINFECTION. 1,293 premises were disinfected. The steam disinfector at the Isolation Hospital is used for bedding and other articles requiring disinfection. PUBLIC HEALTH (Milk & Cream) REGULATIONS, 1912 & 1917. 240 samples of milk were analysed, all of these were free from preservatives. No samples of cream were taken. 14 FACTORY AND WORKSHOP ACT. Annual Report of the Medical Officer of Health for the year 1919, for the County 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) 15 — — Workshops (Including Workshop Laundries) 111 — — Workplaces (Other than Outworkers' premises included in Part 3 of this Report.) - - - Total 126 — — 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 1 1 — — Want of ventilation 2 2 — — Overcrowding — — — — Want of drainage of floors — — — — Other Nuisances 8 8 - — Sanitary accommodation (i w.c. required for 25 persons) insufficient 2 2 — — unsuitable or defective 1 1 — — not separate for sexes - - - - Offences under the Factory and Workshop Act:— Illegal occupation of underground bakehouses(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 14 14 - — 15 3.—HOME WORK. NATURE OF WORK. OUTWORKERS' LIST, SECTION 107. OUTWORK IN UNWHOLESOME PREMISES, SECTION 108. OUTWORK IN INFECTED PREMISES, SECTIONS 109 & 110 Lists received from Employers. Notices served on Occupiers as to keep ing or sending lists. Prosecutions Failing to keep or permit inspection of lists. Failing to send lists. Sending twice in the Year. Sending once in the Year. Instances. Notices Served. Prosecutions. Instances. Orders made (S. 110). Prosecutions (Sections 109 110.) Lists. Outworkers. Lists. Outworkers. Contractors. Workmen. Contractors. Workmen. Wearing Apparel— (1) making, etc. 3 - 18 9 - 82 - - - - - - - - - (2) cleaning & washing Household Linen 1 8 - - - - - - - - - - - - - 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 Ralls Paper &c.Boxes Paper Bags 1 — 2 - - - - - - - - - - - - Brush Making Pea Picking Feather Sorting Carding&c.of Buttons,&c. Stuffed Toys Basket Making Chocolates & Sweets Cosaques, Xmas Crackers & Xmas Stockings . Flag Making Total 5 8 20 9 - 82 - - - - - - 4 16 4.—REGISTERED WORKSHOPS. Workshops on the Register (s. 131) at the end of the Year. Number. Wearing Apparel Manufacturers 131 Bakehouses. 49 Laundries 41 Printers 11 Other Workshops 118 Total number of Workshops on Register 350 5.—OTHER MATTERS. Class. Number Matters notified to H.M. Inspector of Factories:— Failure to affix Abstract of the Factory and Workshop Act (s. 133) 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 9 Reports (of action taken) sent to H.M. Inspector 9 Other — Underground Bakehouses (s. 101): — Certificates granted during the year — In use at the end of the year 10 17 REPORT ON THE WORK OF THE TUBERCULOSIS DISPENSARY FOR THE YEAR 1919. Number of patients on treatment, December 31st, 1918, 63.5 :— Insured. Uninsured. Children. Males. Females. Males. Females. Males. Females. 249 71 22 132 81 80 Number removed during the year ending December 31st, 1919, 135:— Insured. Uninsured. Children. Males. Females. Males. Females. Males. Females. 63 23 0 18 18 13 -19 of these have died, 21 left the district, 65 have been removed from the Register for other causes. Number added during the year 1919, 142:— Insured. Uninsured. Children. Males. Females. Males. Females. Males. Females. 74 24 4 28 8 4 Number remaining on treatment December 31st, 1919:— Pulmonary, 618. Non-Pulmonary, 62. Total, 680. Insured. Uninsured. Children. Males Females. Males. Females. Males. Females. 276 74 27 137 83 83 The following tables show treatment being received by the patients on Register, December 31st, 1919. Number of patients attending Dispensary for treatment, 327 :— Insured. Uninsured. Children. Males. Females. Males. Females. Males. Females. 152 36 11 58 40 30 Number of patients receiving Domiciliary treatment, 72 :— Insured. Uninsured. Children. Males. Females. Males. Females. Males. Females. 43 8 2 13 5 1 Number of patients receiving Sanatorium treatment, 31 :— Insured. Uninsured. Children. Males. Females. Males. Females. Males. Females. 20 5 0 2 4 0 Number of patients attending for Observation, £50:— Insured. Uninsured. Children. Males. Females. Males. Females. Males. Females. 61 25 14 64 34 52 18 Number of deaths from Pulmonary Tuberculosis on Register of Dispensary during 19118, 90:— Insured 59. Uninsured 27. Children 4. Males, T. B. + 35 Males. T. B. - 11 Females, T. B. + 7 Females, T. B. — . 6 Males, T. B. + 7 Males, T. B. — 4 Females, T. B. + 1 Females, T. B. — 2 Males, T. B. + 27 Males, T. B. — 4 Females, T. 1!. + 0 Females, T. B. - 10 Insured 15. Males, T. B. -f 5 Males, T. B. — 0 Females, T. B. + 9 Females, T. R. — 1 Insured 20. Males, T. B. + 3 Males, T. R. — 11 Females, T. B. + 2 Females, T. B. — 4 Insured 5. Males, T. B. + 3 Males, T. B. - 2 Females, T. B. + 0 Females, T. B. — 0 Insured 17. Males, T. R. + 7 Males,T. B. - 2 Females, T. R. + 3 Females, T. B. 5 Males, T. B. + 2 Males, T. B. — 2 Females, T. B. + 12 Females, T. B. — 11 Males, T. B. + 2 Males, T. B. - 1 Females, T. B. + 3 Females, T. B. — 2 Males, T. B. + 0 Males, T. B. — 0 Females, T. B. + 6 Females, T. B. — 1 Uninsured 7. Males, T. B. + 0 Males, T. B. - 0 Females, T. B. + 6 Females, T. B. — 1 Uninsured 11. Males, T. B. + 0 Males, T. B. — 0 Females, T. B. + 5 Females, T. B. — B Uninsured 1. Males, T. B. + 0 Males, T. B. - 0 Females, T. R. + 1 Females, T. B. — 0 Uninsured 3. Males, T. R. + 0 Males, T. B. — 0 Females, T. B. + 0 Females, T. B — 3 Males, T. B. + 0 Males, T. B. - 1 Females, T. B. + 1 Females, T. R. — 2 Males, T. B.+ 0 Males, T. IV. - 0 Females, T. B. 1 Females, T. B. — 1 Males, T. B. + 0 Males, T. B. — 0 Females, T. B. + 0 Females, T. B. — 1 Children 1. Males, T. B. + 0 Males, T. B. — 0 Females, T. B. + 0 Females, T. B. — 1 Children 7. Males, T. B. + 0 Males, T. B. - 3 Females, T. B. + 0 Females, T. B. - 4 Children 0. Males, T. B.+ 0 Males, T. B. — 0 Females, T. B. + 0 Females, T. B. — 0 Children 1. Males, T. B. + 0 Males, T. B. — 0 Females, T. B. + 0 Females, T. B. — 1 Number of these who have attended for the first time and died during the same year, 24 :— Insured 14. Uninsured 8. Children 2. Number of deaths from Pulmonary Tuberculosis on Register of Dispensary during 1919, 49 :— Insured 41. Uninsured 7. Children 1. Number of these who have attended for the first time and died during the same year, 23 :— Number of patients who left the district during 1918, 38 :— Number of these who have attended for the first time and left the district during the same year, 6 :— Number of patients who left the district during 1919, 21 :— 19 Number of these who have attended for the first time and left during the same year, 2 :— Insured 2. Males, T. B. + 0 Males, T. B. - 1 Females, T. B. + 0 Females, T. B. — 1 Uninsured 0. Males, T. B. + 0 Males, T. B. — 0 Females, T. B. + 0 Females, T. B. — 0 Number of patients who have been removed from the Register for other causes during 1918. 72 :— Children 0. Males, T. B. + 0 Males, T. B. - 0 Females, T. B. + 0 Females, T. B. — 0 Insured 35. Males, T. B. + 0 Males, T. B. — 15 Females, T. B. + 2 Females, T. B. - 18 Uninsured 16. Males. T. B. + 0 Males, T. B. - 4 Females, T. B. + 3 Females, T. B. — 0 Children 21. Males, T. B. + 0 Males, T. B. - 2 Females, T. B. + 9 Females, T. B. — 10 Number of these who were admitted and discharged during the same year, 4 :— Insured 2. Males, T. B. + 0 Males, T. B. - 2 Females, T. B. + 0 Females, T. B. — 0 Uninsured 0. Males, T. B. + 0 Males, 1". B. - Females, T. B. + 0 Females, T. B. — 0 Children 2. Males, T. B. + 0 Males. T. B. - 1 Females, T. B. + 0 Females, T. B. — 1 Number of patients who have been removed from the Register for other causes during 1919, 65 :— Insured 25. Uninsured 14. Children 26. Males, T. B. + 3 Males, T. B. - 14 Females, T. B. + 2 Females, T. B. — 6 Males, T. B. + 0 Males, T. B. - 0 Females, T. B. + 8 Females, T. B. — 6 Males, T. B. + 5 Males, T. B. - 10 Females, T. B. + 5 Females, T. B. — 6 Number of these who were admitted and discharged during the same year, -7 :— Insured 4. Males, T. B. + 0 Males, T. B. - 4 Females, T. B. + 0 Females, T. B 0 Uninsured 2. Males, T. B. + 0 Males, T. B. - 0 Females, T. B. + 2 Females, T. B. — 0 Children 1. Males, T. B. + 0 Males, I'. B. - 0 Females, T. B. + 0 Females, T. B. — 1 95 Sputum examinations were made—28 were found to contain Tubercle Bacilli and 67 were negative. 410 patients were examined for diagnosis—142 were found to be suffering from some form of Tuberculosis and attended for treatment ; 89 were found to have Pulmonary Tuberculosis, 21 of these were contacts ; and 15 were found to have Non-Pulmonary Tuberculosis, 4 of these were contacts. 20 268 were of doubtful diagnosis, so allowed to attend for a period of not less than three months' treatment. Number of patients suffering from Tuberculosis re-admitted during 1919, 38. Number of pre-Tuberculars attending for treatment, 204. Number of school children who have attended as specials for medicine, 52. Nurses' Visits—Soldiers 672 Nurses' Visits—Civilians 1,169 1,841 Number of attendances at Dispensary . 5,538 •2i METEOROLOGICAL RECORD—YEAR 1919. Rain Gauge 5-in. in diameter, placed 1-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. I.owest 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 58° 26° 42°.7 32°.6 37°.6 22 2.61 0.12 0.30 27 th February 52° 16° 41°.0 29°.7 35°.3 12 2 31 0 20 0.48 16th March 56 26° 46°.4 34°.0 40°.2 18 3.06 017 0.53 19th April 70° 27" 53°. 8 37°.6 45°.7 16 3.34 0.21 1.39 27th May 82° 40° 66°.9 46°.6 60°.7 4 0.38 0.09 0.11 9th June 85° 40° 69°.5 50°.0 59°.7 7 1.43 0.20 0.96 20th July 80° 42° 66°.4 50°.2 58°.3 14 2.28 0.16 0.52 20th August 89° 43° 74°.6 53°.9 64°.3 12 2.01 0.17 0.57 28th September 90° 31° 68°.1 48°.0 58°.0 9 1.04 0.1l 0.48 14th October 65° 30° 54°.7 37°.6 46°.1 8 0.95 0.12 0.43 29th November 57° 25° 44°.1 33°.6 38°.8 18 1.28 0.07 0.18 17th &30th December 55° 22° 48°.4 36°.8 42°.6 19 3.15 0.16 0.78 1st Means and Totals for the Year. 90° 16° 56°.4 40°.9 48°.9 159 23.84 0.15 1.39 April 27th The Rainfall for the Year was 4.46 below, and the number of days on which rain fell 10 below the year 1918, at East Ham. 22 CASES OF INFECTIOUS DISEASES NOTIFIED DURING THE YEAR 1919. Notifiable Disease. Number ok Cases Notikied. Ti-.tal Cases Notified inEach Ward. Total. Cases Removed to Hospital. At all Ages. under 1 year. 1 and under 5 years. 5 and undtr 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. Small Pox 1 ... ... ... ... 1 ... .. ... ... ... 1 ... ... 1 Diphtheria (including Membranous Croup). 451 3 90 306 34 17 1 ... 78 61 76 103 38 95 410 Erysipelas 72 2 1 3 9 20 34 3 9 13 18 12 9 11 13 Scarlet Fever 530 6 84 376 44 20 ... ... 113 78 114 91 55 79 403 Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever 15 ... 2 1 2 8 2 ... 5 6 ... 3 1 ... 15 Relapsing Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Continued Fever 1 ... ... ... ... 1 ... ... ... ... ... ... ... 1 ... Puerperal Fever 6 ... ... ... ... 1 5 ... 2 1 ... 3 ... ... 5 Cerebro-Spinal Meningitis 3 ... 1 1 ... 1 ... ... ... 1 ... 1 ... 1 2 Poliomyelitis 3 ... 1 1 ... 1 ... ... 1 ... ... 1 ... 1 2 Ophthalmia Neonatorum 13 13 ... ... ... ... ... ... 2 2 4 2 2 1 2 Encephalitis Lethargica 4 ... ... 1 1 2 ... ... 2 ... ... ... 1 1 2 Pulmonary Tuberculosis 258 ... 5 27 65 125 32 4 28 48 64 48 30 40 135 Other forms of Tuberculosis 74 ... 8 32 17 11 6 ... 8 12 20 18 6 10 20 Measles 1538 41 592 889 9 7 ... ... 176 328 234 429 221 150 21 German Measles 134 1 39 93 1 ... ... ... 68 39 2.5 1 ... 1 ... Totals 3103 66 823 1730 182 215 80 7 492 589 555 713 363 391 1031 23 CAUSES OF DEATH AT DIFFERENT PERIODS OF LIFE IN EAST IIAM, 1919. ]CAUSES OF DEATH. Net Deaths at the subjoined ages of "Residents" whether occurring within or without the Borough. Sex. 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 M 712 92 16 26 45 25 114 186 208 F 715 87 18 21 27 47 99 147 269 1. Enteric Fever M 3 ... ... ... ... ... 2 1 ... F ... ... ... ... ... ... ... ... ... 2. Small-pox M ... ... ... ... ... ... ... ... ... F ... ... ... ... ... ... ... ... ... 3. Measles M 7 1 ... 5 1 ... ... ... ... F 5 2 2 ... 1 ... ... ... ... 4. Scarlet Fever M ... ... ... ... ... ... ... ... ... F 1 1 5. Whooping Cough M 4 1 1 1 1 ... ... ... ... F 8 4 2 1 1 ... ... ... ... 6. Diphtheria and Croup M 12 ... ... 4 8 ... ... ... ... F 17 1 1 5 10 .. ... ... ... 7. Influenza M 39 3 1 1 2 4 13 14 1 F 48 1 1 2 ... 8 18 16 2 8. Erysipelas M 1 1 ... ... ... ... ... ... ... F 1 1 ... ... ... ... ... ... ... 9. Pulmonary Tuberculosis M 63 ... 1 1 1 3 28 24 5 F 45 ... ... 2 2 16 11 10 1 10. Tuberculous Meningitis M 6 1 1 1 2 ... 1 ... ... F 3 1 ... 1 1 ... ... ... ... 11. Other Tuberculous Diseases M 5 ... ... 2 ... 1 2 ... ... F 7 ... ... ... 2 ... 3 2 ... 12. Cancer, Malignant Disease M 64 ... ... ... 1 ... 11 35 17 F 85 ... ... ... ... ... 8 45 32 13. Rheumatic Fever M 5 ... ... ... 3 ... 2 ... ... F 4 ... ... ... 1 2 1 ... ... 14. Meningitis M 3 2 ... ... 1 ... ... ... ... F 4 1 ... ... ... ... 2 ... ... 15. Organic Heart Disease M 61 ... ... ... 1 1 3 24 32 F 60 ... ... ... ... 4 5 19 32 16. Bronchitis M 54 7 ... ... ... ... 2 10 33 F 66 9 2 1 ... 2 ... 6 46 17. Pneumonia (all forms) M 57 10 1 1 3 4 13 11 5 F 72 13 6 6 5 3 11 9 19 18. Other Respiratory Diseases M 14 ... ... ... 1 ... 2 7 4 F 11 1 ... ... ... 1 2 ... 7 19. Diarrhoea, &c. M 20 13 5 ... ... ... 2 ... ... F 20 13 2 ... ... ... ... 1 3 20 Appendicitis and Typhlitis M 5 ... ... ... 4 1 ... ... ... F 4 ... ... ... ... 2 1 ... 1 21. Cirrho[???] of Liver M 1 ... ... ... ... ... ... 1 ... F ... ... ... ... ... ... ... ... ... 21a. Alcoholism M ... ... ... ... ... ... ... ... ... F ... ... ... ... ... ... ... ... ... 22. Nephritis and Bright's Disease M 11 ... ... ... ... ... 1 4 6 F 9 ... ... ... ... ... 2 4 3 23. Puerperal Fever M ... ... ... ... ... ... ... ... ... F 7 ... ... ... ... 2 5 ... ... 24. Parturition, apart from Puerperal Fever M ... ... ... ... ... ... ... ... ... F 5 ... ... ... ... ... 5 ... ... 25. Congenital Debility, &c M 37 37 ... ... ... ... ... ... ... F 30 29 ... ... 1 ... ... ... ... 26. Violence, apart from Suicide M 41 1 ... 2 9 5 12 7 5 F 11 ... ... ... 1 ... ... 2 8 27. Suicide M 6 ... ... ... ... ... 3 3 ... F 1 ... ... ... ... ... 1 ... ... 28. Other Defined Diseases M 193 15 1 5 7 6 17 42 100 F 190 11 ... 3 2 7 20 32 115 29. Causes ill-defined or unknown M ... ... ... ... ... ... ... ... ... F 1 ... ... ... ... ... ... 1 ... 24 ISOLATION HOSPITAL. From 1st April, 1918, to 31st March, 1919. Days. 239 Patients treated in Scarlet Fever Wards 1,732 wks 2 days 12,126 279 Patients treated in Diphtheria Wards 2,089 wks 1 day 14,624 77 Ptients treated in Cubicles 267 wks 3 days 1,872 Number of patient—days 28,622 ESTABLISHMENT CHARGES. £ Provisions 2,896 Linen, Bedding, and Furniture 3& Chandlery and Sundries 554 Lighting, Heating and Water 1,336 Repairs to Hospital and Maintenance of Grounds 469 Rates, Taxes, and Insurance 190 Office Expenses 85 Salaries and Wages 3,174 £9,036 PATIENTS EXPENSES. £ Medicines and Medical Appliances, Antitoxin and Disinfectants 531 Stimulants 17 Maintenance of Ambulances 539 £1,087 Average cost per patient per day, 7s. 1d. COUNTY BOROUGH OF EAST HAM. EDUCATION COMMITTEE. Annual Rcport of the School Medical Officer FOR THE YEAR 1919. 26 EAST HAM EDUCATION COMMITTEE. Councillor G. P. Dean (Chairman). Councillor A. H. Wiseman, J.P. (Fice-Chairman). Councillor J. A. Williams, J.P. (Mayor). Mrs. W. C. Ford. Alderman 0. R. Anstead, J.P. Alderman J. Brooks, J.P. Alderman E. Edwards, J.P. Alderman C. Northfield, J.P. Alderman M. Oakes, J.P. Alderman H. Osborn, J.P. Councillor R. Banks-Martin, J.P. Councillor A. Coles. Councillor J. Evans. Concillor W. C. Ford, J.P. Councillor J. J. Francis. Councillor W. T. Howlett. Councillor G. Mitchell. Councillor V. R. Oliver. Mr. N. Papworth. Councillor W. H. Pilgram. Councillor J. Savage, J.P. Councillor F. Smith. Councillor A. Stokes. Councillor A. Taylor. School Nurses: Mrs. Nears, Miss Kekwick, Mrs. Sorrell and Miss Davy. School Medical Clerk: Mrs. Glass. Assistant School Medical Clerk: Miss I. L. Hollingsworth Dentist: C. II. Taylor, L.D.S. Ophthalmic Surgeon: A. Henry Thompson, M.D. Assistant Medical Officers: D. S Brough, M.C., M.B., Ch.B., D.P.H. Miss M. M. Thomson, L.R.C.P., L.R.C.S. an3 D.P.H. Medical Officer: W. Benton, M.R.C.S., L.R.C.P., D.P.H. 27 STATISTICAL DATA. School Places:— Provided Schools 26,881 Non-Provided Schools 1,090 Total 27,971 Number on Registers:— Provided Schools 24,478 Non-Provided Schools 1,021 Total 25,499 Teaching Staff: Head Assistant Certificated Assistant Uncertificated Supplementary Student Cookery 622 61 496 42 4 13 6 Education Rate. 1919-20 ... ... ... ... 2/7½d. 28 County Borough of East Ham Education Committee. Mr. Chairman, Mrs. Ford, and Gentlemen,— I beg to submit my Annual Report as School Medical Officer for the year ended December 31st, 1919. During the years of the war the work of the School Medical Service was seriously curtailed; makeshift schemes had to be adopted, much necessary work was shelved, and new departures postponed. The year 1919, however, has witnessed an endeavour to return to normal methods. Gradually the full complement of staff has been obtained, arrears of work have been overtaken, and fresh activities inaugurated. The appointment of a full-time Dentist is a distinct step forward, and the work of Dr. Bendix has been much appreciated by children and parents alike. Two new school nurses have been appointed, enabling more intimate supervision of cases requiring following up. The responsibilities of the service continue to increase as time goes on and a considerable increase of work may be expected when the various sections of the new Education Act (1918) come into force. Meantime several pressing problems confront the Committee. An open-air school is urgently required for the use of pretubercular and debilitated children. It is expected that a certain amount of accommodation will be available for sick children at "Harts," but this should be supplementary to, and not a substitute for, an open-air school. Provision for the education of physically defective children is also urgently required, and no time should be lost in hastening this scheme to a practical termination. There is also urgent need for the services of an aurist, but this is dealt with in a later paragraph. The School Clinics continue to do excellent work, and the best testimony to their value is to be found in the increasing numbers of children attending them and in the improved standard of cleanliness obtaining among school children generally. Children harbouring vermin or suffering from infective sores—conditions common in schools a decade ago—are now comparatively rare. Clinics are held at the Town Hall, at Manor Park, and at North Woolwich, whereby treatment centres are provided within easy reach of all schools in the Borough. I wish toexpress my thanks to the Committee for their kind consideration of my recommendations, and also to the Staff for their assistance. Your obedient Servant, WILLIAM BENTON, Medical Officer to Education Committee. TABLE III.—1919. DEFECTS CLASSIFIED ACCORDING TO AGES. 5 years. 6 years. 7 years. 8 years. 9 years. 10 years 1 years. 12 years. 13 years. 14 years. 15 years. Totals. Percentage. Boys. Girls. Boys. Girls. Boys. Girls. Boys. Girls. Boys. Girls. Boys, Girls, Boys. Girls. Boys. Girls. Boys. Girls. Boys. Girls. Boys. Girls. Boys. Girls. Boys. Girls. Number examined 091 671 291 332 96 59 722 714 294 251 49 62 59 49 95 167 533 406 210 113 1 7 3041 2831 ... ... DEFECTS. External Eye Disease— Blepharitis 3 3 ... 2 ... ... 5 8 3 ... ... ... 1 ... ... ... 1 ... 2 2 ... ... 15 15 0.49 0.52 Conjunctivitis 1 1 2 2 ... 1 3 1 ... ... ... ... ... ... ... ... ... ... 6 ... ... ... 12 1 5 1 0.39 0.17 Corneal Opacity ... 1 ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 0.03 0.03 Other Diseases 1 1 ... ... ... ... 2... ... 1 1 2 ... ... ... ... ... ... ... 1 ... 7 2 0 23 0.07 Squint 9 15 3 4 5 ... 8 2 ... 1 ... ... ... 2 1 2 ... ... 3 ... ... ... 29 26 0.95 0.91 Defective Vision— Number examined ... ... ... ... 5 4 559 531 267 241 46 57 53 39 67 157 485 350 159 93 1 2 1642 1474 ... ••• 6/12 Right ... ... ... ... 1 1 47 49 32 31 9 7 4 2 3 10 22 34 9 7 1 ... 129 141 7.8 0.55 Left ... ... ... ... 1 1 63 70 37 35 6 5 4 2 2 7 30 32 9 5 3 150 157 9.1 10.6 6/18 Right ... ... ... ... ... ... 24 18 17 12 2 4 4 4 1 18 18 17 7 3 ... ... 73 71 4.4 4.8 left ... ... ... ... ... 29 19 13 18 1 4 6 6 5 14 18 24 12 8 ... ... 84 93 5.1 6.3 6/24 Right ... ... ... ... ... ... 4 7 3 4 2 1 2 ... 3 ... 9 7 3 5 ... ... 26 24 1.6 1.6 Left ... ... ... ... ... ... 8 5 4 5 2 3 1 ... 2 1 9 8 2 3 ... ... 28 25 1.7 1.6 6/36 Right ... ... ... ... ... ... 4 8 4 2 ... 1 1 ... 3 ... 7 2 2 1 ... ... 21 14 1.3 0.95 Left ... ... ... ... 1 ... 3 3 4 2 ... ... ... ... 5 1 7 1 ... 2 ... ... 20 9 1.2 0.61 6/60 Right ... ... ... ... ... ... ... ... 2 ... ... ... 1 ... ... ... 2 1 ... ... ... ... 5 1 0.3 0.07 Left ... ... ... ... ... ... 1 1 1 ... 1 ... 1 ... ... 3 2 2 2 1 ... ... 8 7 0.48 0.47 6/0 Right ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... 3 ... 0 18 ... Left ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 ... ... ... ... ... 1 1 0.06 0.07 Ear Disease- Deafness Right 5 15 3 6 1 ... 4 8 9 6 1 l 2 ... 1 ... 7 8 3 2 ... ... 36 46 1.1 1.6 left 10 14 ... 6 1 ... 9 12 15 5 1 2 ... ... ... 1 9 9 2 ... ... ... 47 49 1.5 1.7 Discharge Right 19 15 5 7 1 1 4 5 6 9 2 1 2 1 "? 2 12 4 1 2 ... ... 54 47 1.7 1.7 left 19 12 3 5 1 1 8 9 2 4 1 ... ... 2 1 2 12 3 ... 1 ... ... 47 39 1.5 1.4 Defective Speech— Articulation 16 9 1 3 ... ... 3 4 1 ... ... 1 1 ... 2 3 4 2 2 2 ... ... 30 22 0.9 0.77 Stammering 3 ... 1 ... ... ... 1 ... ... ... ... ... 1 ... ... 0... 1 ... 1 ... ... 8 ... 0.26 ... Disease of Heart— Disease 10 9 11 6 3 2 24 18 4 6 2 5 2 1 1 9 23 10 9 1 ... ... 89 67 26 2.3 Anæmia 23 24 25 15 12 11 27 34 14 13 9 8 11 8 10 22 12 26 7 8 ... 1 150 170 4|i 60 Disease of Lungs— Bronchitis 40 28 24 10 7 ... 31 20 3 9 3 1 ... ... ... 6 6 10 3 2 ... ... 117 86 3.8 3.03 Tuberculosis ... ... ... 1 ... ... ... 1 0 03 Tuberculosis Suspected ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 0.03 0.03 Other Disease 6 7 2 2 1 ... 4 3 4 2 1 3 4 1 2 2 ... 6 ... ... ... ... 24 26 0.79 0.91 Disease of Nervous System— Epilepsy 1 ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 0.03 0.03 Chorea ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 0.03 ... Other Disease 16 13 5 3 ... 1 8 8 1 7 2 ... 3 ... 1 2 10 5 1 1 ... 42 35 1 3 1.2 Condition of Head— Nits 15 16 12 48 5 12 9 123 10 28 1 2 ... 2 1 10 3 48 1 13 ... ... 57 346 1.8 12.2 Vermin 5 2 2 4 ... 1 5 3 1 ... ... ... ... 1 ... 1 ... 1 1 ... ... ... 14 13 46 0.45 Condition of Body— Dirty 2 ... 1 1 1 ... 4 2 3 ... ... ... ... ... ... 9 1 2 ... ... ... 22 4 0.72 0.14 Vermin ... ... ... ... ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... 0.06 ... Condition of Clothing— Bad 21 4 14 1 1 ... 30 50 1 ... ... ... ... ... ... ... 12 3 ... 3 ... ... 79 61 2.6 2.1 Dirty 2 2 3 ... ... ... 3 1 1 2 1 ... ... ... 1 ... ... ... ... ... ... 11 5 0.36 0.17 Defective Boots 24 29 15 18 9 1 51 45 22 7 ... ... ... ... ... 1 32 7 12 4 ... ... 165 112 5.4 3.9 Defective Nutrition— Under Normal 55 53 18 22 16 2 47 67 29 11 5 5 3 4 6 13 23 23 13 1 ... ... 215 201 7.07 7.1 Bad 6 4 4 2 1 1 7 2 3 ... 1 1 23 9 0.75 0.31 Decayed Teeth— . . Less than 4 292 274 124 181 48 34 362 356 162 144 26 23 23 24 35 55 254 151 86 54 ... ... 1412 1296 46.4 45.7 More than 4 29 62 30 25 17 3 58 43 9 14 4 4 5 2 7 7 12 6 1 ... ... 162 173 5.4 6.1 Sepsis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Tonsils— Slightly enlarged 129 136 52 69 19 16 145 141 34 41 3 16 9 7 4 14 82 62 34 18 ... 1 511 521 10.8 18.4 Greatly enlarged 21 37 10 11 6 5 39 26 6 9 1 2 2 ... 1 4 17 9 6 2 ... ... 109 105 3.2 3.7 Adenoids— Slightly marked 53 32 21 24 6 1 30 21 16 11 1 8 2 ... ... ... 9 5 3 ... ... ... 141 102 4.6 3.6 Greatly marked 10 11 2 9 ... ... 3 2 3 ... 3 4 ... ... ... ... ... ... ... ... ... ... 21 26 0.69 0.91 Glands — Slightly enlarged 57 70 30 42 11 4 75 77 32 33 2 2 ... ... 4 5 26 10 12 4 ... ... 249 247 8 .1 0.87 Greatly enlarged 5 8 ... 3 ... 1 11 12 6 ... ... ... ... ... ... ... 2 2 ... 2 ... ... 24 28 0.79 0.99 Mouth Breathers 22 7 12 4 6 ... 14 10 8 9 ... ... ... ... ... ... 2 5 1 ... ... ... 65 35 2.1 1.2 Nasal Defects 8 3 1 3 ... ... 5 2 2 ... ... 1 ... ... ... 3 3 3 1 1 ... ... 20 16 0.65 0.56 Mental Defects— Number examined ... 190 228 84 114 29 20 483 431 256 212 34 48 41 36 60 88 411 271 172 74 ... 1 1759 1513 Dull 13 17 14 9 1 1 75 36 37 29 11 7 8 10 2 12 59 59 24 9 244 199 13.9 131 Defective 1 3 1 ... ... ... 3 3 2 ... ... ... ... 1 1 ... 3 1 ... ... ... 12 7 0.68 0.46 Deformities ... 4 1 ... 2 ... 2 3 3 1 2 1 3 3 1 ... 18 8 0.59 0 .28 Ringworm Head ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 0.03 Body ... 1 ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 0.03 0.03 Scabies 1 ... ... ... 1 ... 1 2 ... ... ... ... ... ... ... ... ... 2 ... ... ... ... 3 4 0.09 0.14 Impetigo 5 2 3 2 ... 1 2 2 ... ... ... ... 1 ... ... ... ... ... 1 ... ... ... 12 7 0.39 0.25 Tubercle— Glandular ... 1 1 1 1 ... ... 1... ... ... ... ... ... ... 1 ... 1 ... 1 ... ... ... 5 3 0.16 0.10 Osseous ... ... ... 1 ... ... ... 1 2 ... ... ... 1 ... ... 2 4 1 ... ... 7 5 0.23 0.17 Other Diseases 19 24 7 13 3 1 18 29 8 9 1 ... l 2 1 8 12 12 9 10 ... 2 79 110 2.6 0.39 TABLE III.—1919. SPECIAL CASES.—DEFECTS CLASSIFIED ACCORDING TO AGES. 5years. 6 years. 7 years. 8 years. 9 years. 10 years 11 years. 12 years. 13 years. 14 years. 15 years. Totals. Percentage. Boys. Girls. Boys. Girls. Boys. Girls. Boys Girls. Boys. Girls. Boys. Girls. Boys. Girls. Boys. Girls. Boys. Girls. Boys Girls. Boys. Girls. Boys. Girls. Boys. Girls. Number examined 10 12 21 12 34 45 47 62 22 58 39 53 41 50 34 49 17 26 3 10 ... ... 268 377 ... ... DEFECTS. External Eye Disease— Blepharitis ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 1 ... 0.37 ... Conjunctivitis ... ... ... ... ... ... ... ... ... ... ... 2 ... ... ... ... ... ... ... ... ... ... ... 2 ... 053 Corneal Opacity ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Diseases ... ... ... ... 1 ... ... ... ... 2 ... 2 ... 1 ... 1 2 ... ... ... ... ... 3 6 1.1 1.6 Squint ... ... ... 1 2 ... 1 1 ... ... ... 1 ... ... ... ... ... 1 ... 1 ... 1 3 5 1.1 1.3 Defective Vision— Number examined ... ... ... ... 2 ... 22 17 10 22 20 12 28 10 20 14 7 8 3 5 ... ... 112 88 ... ... 6/12 Right ... ... ... ... ... ... 11 9 3 7 3 5 11 5 4 4 ... ... ... 2 ... ... 32 32 28.6 36.3 Left ... ... ... ... ... ... 11 6 5 6 3 6 9 ... 2 4 2 ... ... 3 ... ... 32 25 28.6 28.4 6/18 Right ... ... ... ... ... ... 1 2 1 1 4 2 6 3 5 2 2 3 ... 2 ... ... 19 15 16.9 17.04 Left ... ... ... ... ... ... 2 2 2 2 5 ... 6 7 6 2 1 4 1 1 ... ... 23 18 20.5 20.5 6/24 Right ... ... ... ... ... ... 2 1 ... 2 2 ... 2 2 1 7 ... 1 2 ... ... ... 9 13 8.03 14.8 Left ... ... ... ... ... ... 3 ... 1 2 2 ... 1 2 1 7 ... 1 1 1 ... ... 9 13 8.03 14.8 6/36 Right ... ... ... ... ... ... ... 2 ... 2 ... ... 1 ... ... ... ... ... ... ... ... ... 1 4 0.88 4.5 left ... ... ... ... 1 ... ... 1 ... 1 ... ... ... 1 ... ... ... ... ... ... ... ... 1 3 0.88 3.4 6/60 Right ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1.1 ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... 1 ... ... ... 1 2 0.88 2.3 6/0 Right ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1.1 Left ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Ear Disease- Deafness Right ... ... ... ... ... ... 1 1 4 1 1 2 1 ... 4 ... ... ... ... ... ... 4 11 1.5 2.9 Left ... ... ... ... ... ... 1 3 ... ... 1 1 2 1 ... 1 ... ... ... ... ... ... 4 6 1.5 1.6 Discharge Right ... ... ... ... ... 1 ... 1 1 2 1 1 ... 1 ... 1 2 1 ... ... ... ... 4 8 1.5 2.1 Left ... ... ... ... ... 1 ... 1 1 2 ... 2 ... 1 ... 1 2 1 ... ... ... ... 3 9 1.1 2.4 Defective Speech— Articulation ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Stammering ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Disease of heart — Disease ... ... ... ... 3 ... ... ... ... 1 1 ... 3 3 2 2 ... 2 ... ... ... ... 9 8 3.3 2.1 Anæmia 2 4 7 2 7 18 9 10 11 7 11 16 10 14 7 14 4 7 1 2 ... ... 69 94 25.8 24.9 Disease of Lungs-— Bronchitis ... ... ... ... 1 1 ... 1 .••• 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 3 0.37 0.79 Tuberculosis ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 0 26 Tuberculosis Suspected ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 0.26 Other Disease ... ... ... ... 1 ... ... 3 1 ... ... ... ... ... ... 2 1 ... ... ... ... ... 3 5 1.1 1.3 Disease of Nervous System— Epilepsy ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Chorea ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Disease ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Condition of Head— Nits ... ... ... ... 1 ... ... 2 1 2 ... ... ... ... 1 ... ... ... ... ... ... ... 3 4 1.1 1.06 Vermin ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Condition of Body— Dirty ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Vermin ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Condition of Clothing— Bad ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Dirty ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 ... ... ... ... ... ... ... 1 1 0.37 0.26 Defective Boots ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Defective Nutrition— Under Normal ... ... ... ... ... ... ... ... 2 ... 1 ... ... ... ... ... ... ... ... ... ... ... 3 ... 1.1 ... Bad ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 ... 0.26 Decayed Teeth— Less than 4 ... 1 2 3 3 4 7 2 3 2 6 3 3 ... 3 ... ... 1 1 ... ... ... 28 16 10.4 4.2 More than 4 ... ... 3 3 4 2 11 5 2 4 3 4 6 5 3 3 3 2 2 ... ... ... 37 28 13.8 7.4 Sepsis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Tonsils— Slightly enlarged 3 2 4 4 6 8 4 3 5 4 3 6 1 5 6 5 3 ... 1 ... ... ... 36 37 13.4 9.8 Greatly enlarged 1 1 1 ... ... 8 1 11 ... 9 ... 10 2 6 3 4 ... 1 ... 2 ... ... 8 52 2.9 13.7 Adenoids— Slightly marked 1 2 ... ... ... 4 3 9 1 1 ... ... ... ... ... ... ... ... ... ... ... ... 5 16 1.8 4.2 Greatly marked ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Glands — Slightly enlarged ... ... ... ... ... ... ... 1 1 1 ... 2 ... ... ... 1 ... 1 ... ... ... ... 1 6 0 37 1.6 Greatly enlarged ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Mouth Breathers ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 0.37 ... Nasal Defects ... ... ... ... ... ... ... ... ... 2 ... ... ... 4 ... ... ... 1 ... ... ... ... ... 7 ... 1.9 Mental Defects— Number examined ... 4 6 8 10 9 3 3 9 6 2 ... 4 ... 5 ... 4 ... 3 1 ... ... 46 31 ... ... Dull ... ... ... ... ... 1 ... ... 4 ... 1 ... 1 ... ... ... 1 ... ... ... ... ... 7 1 15.2 3.2 Defective ... ... 1 ... ... 1 ... 1 ... 1 ... ... ... ... ... ... ... ... ... 1 ... ... 1 4 2.1 12.9 Deformities ... ... ... ... 1 ... ... ... ... 1 ... ... ... ... 1 ... 1 ... ... ... ... ... 3 1 1.1 0.26 Ringworm Head ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Body ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 0.37 ... Scabies ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Impetigo 1 1 ... ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 1 1.1 0.26 Tubercle— Glandular ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 2 ... 7.4 ... Osseous ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 2 ... 7.4 ... Other Diseases 1 ... ... ... 4 ... ... 1 1 2 ... 3 1 2 ... 3 1 ... ... ... ... 15 4 5.6 1.06 TABLE IV.—DEFECTS ARRANGED ACCORDING TO SCHOOLS—1919. 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 Tuborcle. Other Diseases. Blepharitis. Conjunctivitis. Corneal Opacity Other Diseases. Number Examined. 6/12 6/18 6/24 6/36 6/60 6/0 Deafness. Discharge. 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 Brampton Road Boys 297 2 ... ... 3 1 195 13 23 12 14 1 3 3 5 1 2 1 ... 4 3 7 ... 1 ... 14 15 8 ... ... 16 ... ... 9 1 ... ... ... ... ... ... 14 ... 118 38 ... 33 6 8 23 4 14 6 3 297 43 1 4 ... ... ... ... ... 1 11 Girls 285 ... ... ... 1 2 174 8 15 12 12 ... 2 ... 1 ... ... ... ...... 2 6 3 4 1 ... 14 16 1 ... ... 8 ... ... 5 5 1 ... ... ... ... ... 8 ... 115 15 ... 37 16 1 16 5 44 10 1 275 12 1 1 1 ... ... ... ... ... 22 Castle Street, R.C. Boys 47 ... ... ... ... ... 34 10 9 1 3 2 1 2 ... ... ... ... ... ... ... ... ... 1 ... 7 2 1 ... ... ... ... 1 ... ... ... ... ... ... 3 ... 26 ... ... 4 4 1 3 ... 7 1 ... 46 4 ... ... ... ... ... ... 1 1 ... Girls 55 ... ... ... ... ... 44 21 16 3 5 1 2 1 1 ... ... ... 1 1 3 2 2 1 ... 1 1 4 ... ... 2 ... ... 1 9 ... ... ... ... ... ... 1 ... 25 ... ... 1 4 1 a 1 4 3 ... 44 3 ... ... ... ... ... ... ... ... 5 Central Park Road Boys l95 ... ... ... ... 1 70 4 3 4 4 ... ... 3 3 ... ... ... ... 1 ... 1 1 2 ... 4 7 7 ... ... 2 ... ... 9 4 ... ... ... ... ... ... 29 1 89 ... ... 24 9 1 17 ... 36 1. 57 5 ... ... ... ... ... 1 ... ... 3 Girls 232 1 ... ... ... 1 80 6 8 1 1 1 2 ... ... ... ... ... ... 1 2 2 ... 2 ... 5 2 3 1 ... ... ... ... 3 41 ... 1 ... ... ... ... 12 ... 68 19 ... 31 13 2 15 1 36 2 1 47 ... ... ... ... 1 ... ... ... ... 5 Essex Road Boys 163 1 ... ... ... ... 83 4 4 2 1 3 ... ... ... ... ... ... ... ... 2 ... 2 ... ... 10 4 ... ... ... ... ... ... 4 ... 8 ... ... ... 58 7 ... 77 21 ... 28 3 ... ... ... ... ... 1 85 15 ... 2 ... ... 1 ... ... ... 1 Girls 171 1 ... ... ... ... 99 10 9 4 4 3 4 ... ... ... ... ... ... ... ... 2 2 1 ... 6 17 1 ... ... ... ... ... ... 27 ... ... ... ... ... 40 3 ... 86 26 ... 28 5 2 ... ... ... ... ... 113 18 ... ... ... ... ... ... 2 1 ... Fourth Avenue Boys 77 1 ... ... ... 3 53 3 4 6 5 2 2 ... ... ... 1 ... 1 ... ... ... ... ... ... 2 10 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 5 ... 31 13 ... 15 1 ... 1 ... ... ... ... 55 8 ... 5 ... ... ... ... 1 5 1 Girls 82 ... ... ... ... 1 66 3 2 2 5 3 2 ... ... ... ... ...... ... 3 2 3 2 ... ... 2 15 ... ... ... ... ... ... ... 5 1 ... ... ... ... 3 11 ... 31 8 ... 11 3 4 ... 3 1 ... ... 64 3 3 ... ... ... ... ... ... 4 ... Hartley Avenue Boys 157 ... 1 1 ... 1 95 18 25 5 4 2 2 2 2 1 ... ... ... 1 8 5 3 3 ... 2 4 11 ... ... ... ... ... 1 1 ... ... ... ... ... ... 9 ... 77 ... ... 10 1 5 11 1 19 2 2 98 4 ... ... ... ... ... 1 ... ... 6 Girls 165 ... ... ... 1 ... 90 22 25 7 9 2 ... ... ... ... ... ... ... 5 4 4 1 1 ... ... 8 6 ... ... 4 ... ... 4 2 ... ... ... ... ... ... 27 ... 53 16 ... 28 2 2 9 1 20 2 122 10 ... 1 ... ... ... ... ... ... 4 High Street Boys 63 ... 1 ... ... 3 37 ... 1 1 1 ... ... ... ... ... ... ... ... ... ... 5 3 1 ... ... 2 4 ... ... ... ... ... 3 2 ... ... ... ... ... 4 2 1 31 ... ... 9 3 1 2 13 1 ... 38 7 1 ... ... ... ... ... ... ... ... Girls 60 ... ... ... ... ... 37 5 4 2 5 ... ... ... ... ... ... ... ... ... 1 2 ... ... ... ... 2 1 ... ... ... ... ... ... 15 1 ... ... 2 1 3 3 ... 23 ... ... 8 1 ... 2 ... 4 4 ... 13 2 ... ... ... ... ... ... 1 ... 3 Higher Elementary Boys 55 ... ... ... ... 1 45 1 4 1 2 1 ... 1 3 ... ... ... ... 1 1 ... ... ... ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... 13 ... ... 5 1 ... 1 2 4 ... ... 53 ... ... ... ... ... ... ... ... ... ... Girls 58 ... ... ... ... ... 53 1 3 2 ... 2 ... ... ... ... 1 ... ... ... ... ... ... ...... ... 2 4 5 ... ... ... ... ... ... ... ... ... ... ... ... ... 5 ... 20 2 ... 3 1 ... ... ... ... ... 2 ... ... ... ... ... ... ... ... ... ... 3 Kensington Avenue Boys 89 ... ... ... ... ... 56 1 1 ... 1 ... ... ... ... ... ... ... ... ... ... 2 ... 1 8 14 4 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 37 2 ... 18 1 ... ... ... 1 ... ... 23 3 ... 1 ... ... ... ... ... ... ... Girls 50 ... ... ... ... 1 33 3 3 2 1 1 1 1 1 ... 1 ... ... ... ... ... ... ... ... 1 10 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 31 1 ... 17 ... 1 ... ... ... ... ... 38 4 ... ... ... ... ... 1 ... ... 1 Lathom Road Boys 138 ... ... ... ... 1 93 8 5 4 6 ... ... 1 ... 1 3 ... ... ... 2 ... ... 3 ... 1 10 2 ... ... ... ... ... ... 1 ... ... ... ... ... ... 4 ... 38 5 ... 8 1 ... ... ... ... ... ... 114 12 1 ... ... ... ... 2 ... ... ... Girls 119 3 ... ... ... 2 89 2 1 4 2 1 2 ... ... ... ... ... ... 1 ... ... ... ... ... 2 13 2 ... ... ... ... ... ... 12 ... ... ... ... ... ... 4 ... 47 14 ... 16 3 2 8 ... ... ... 1 118 14 ... ... ... ... ... 1 ... ... 1 Manor Park Boys 51 ... 1 ... ... 2 33 1 4 4 3 2 2 2 1 ... ... ... ... 1 1 ... ... ... ... ... 16 1 ... ... ... ... ... ... ... ... ... ... ... ... 2 3 ... 26 3 ... 16 1 ... ... ... 2 ... ... 1 1 ... ... ... ... ... ... ... ... 5 Girls 44 ... ... ... ... 1 30 6 2 1 5 2 ... ... ... ... ... ... ... 1 1 ... ... ... ... ... 15 ... ... ... ... ... ... ... 3 ... ... ... ... ... 1 1 ... 23 1 ... 10 5 ... 2 ... ... ... 1 36 6 ... ... ... ... ... ... ... ... 2 Monega Road Boys 177 ... ... ... ... ... 74 1 1 2 3 2 2 ... ... 1 ... ...... ... ... 1 ... ... ... ... 4 5 3 ... ... 1 ... ... ... 1 1 ... ... ... ... ... 14 ... 99 15 ... 45 6 ... ... ... ... ... ... 90 15 ... 1 ... ... ... ... ... ... 3 Girls 141 1 ... ... ... 2 a4 1 2 4 1 3 ... ... ... ... ... ... ... ... ... ... 1 ... 3 16 1 ... ... ... ... ... ... 9 ... ... ... ... ... ... ... ... 65 16 ... 26 ... 1 ... ... ... ... ... 48 10 ... ... ... ... 1 ... ... ... ... Napier Road Boys 155 ... 1 ... ... 1 71 10 7 ... 2 1 1 ... ... ... ... ... ... 2 3 3 ... 2 ... 5 3 ... ... ... ... ... ... 1 2 2 ... ... ... 3 16 ... 55 ... ... 22 9 6 17 3 30 ... 3 86 17 1 ... ... ... ... 6 ... ... ... Girls 179 1 ... ... ... 3 77 3 5 3 5 ... 1 1 2 ...... 1 ... ... 5 3 2 1 5 ... 2 4 2 ... ... ... ... ... ... 9 1 1 ... 3 ... 7 19 3 85 ... ... 39 7 1 5 8 36 ... ... 104 19 ... ... ... ... ... ... ... ... 6 New Beckton Boys 181 1 ... ... ... 2 53 4 3 1 ... ... ... ... ... ... 1 ... ... 2 ... ... 2 ... 1 6 4 10 ... ... ... ... ... 1 8 ... 4 ... ... 1 3 16 1 62 12 ... 39 9 6 6 ... 5 ... 1 59 5 ... ... ... ... ... ... ... ... 2 Girls 116 ... ... 1 ... 11 51 4 7 2 1 ... ...... ... ... ... ... ... ... 1 1 ... ... ... ... 3 6 6 ... ... ... ... ... ... 24 ... ... ... ... 1 4 2 ... 53 10 ... 39 4 1 ... ... 3 ... 1 45 15 ... ... ... ... ... ... ... 1 Plashet Lane Boys 302 4 ... ... ... 11 207 8 14 13 8 3 6 1 1 ... 1 ... ... 10 11 6 8 1 3 4 15 13 ... ... 1 ... ... 3 4 ... 1 ... 2 3 4 26 6 153 ... ... 35 9 22 20 4 44 5 296 38 2 2 ... ... ... ... ... ... 11 Girls 159 ... ... ... ... ... 79 9 7 2 6 ... ... ... ... ... ... ... ... 5 7 5 1 2 ... 1 6 8 ... ... 3 ... ... 5 15 ... 1 ... ... 2 1 11 ... 71 ... ... 30 a 4 19 ... 22 ... 5 159 16 ... ... ... ... ... ... ... ... 6 St. Winefride's, R.C. Boys 34 ... ... ... 1 ... 13 1 1 ... 1 ... ... ... ... ... ... 1 ... ... 1 ... 1 ... ... ... ... 1 ... ... ... ... ... ... 2 1 2 ... 2 ... 5 4 6 15 3 ... 3 2 ... 1 ... ... ... 1 21 4 ... ... ... ... ... ... ... ... 1 Girls 39 ... ... ... ... ... 13 3 3 ... 2 ... ... ... ... ... ... ... ... 1 1 ... 2 ... ... 1 ... 4 ... ... ... ... ... ... 9 1 ... ... ... ... 3 8 ... 24 6 ... 8 1 ... ... ... ... ... 1 38 3 ... ... ... 1 ... ... ... ... Shrewsbury Road Boys 82 1 ... ... 1 ... 36 4 4 2 2 ... ... ... ... ... ... ... ... 2 2 5 4 6 ... 3 8 ... ... ... 1 ... ... 5 2 ... ... ... ... ... ... 4 2 41 1 ... 14 3 ... 6 18 2 ... 4 2 ... ... ... ... ... ... ... ... 9 Girls 92 ... ... ... ... 2 42 7 8 1 1 1 ... ... ... ... ... ... ... 9 4 5 7 2 ... 1 4 2 ... ... ... ... ... 3 13 ... ... ... ... ... ... 13 1 44 ... ... 19 4 1 4 1 i; 1 ... 3 ... ... ... ... ... ... ... ... ... 8 Sandringham Road Boys 157 ... ... ... 2 1 98 5 10 1 3 1 ... ... ... ... ... ... ... 2 2 1 1 ... 2 8 2 14 ... ... ... ... ... 1 3 1 ... ... ... ... 12 20 3 105 16 ... 36 10 ... 3 ... 4 ... 1 56 4 ... 2 ... ... ... ... ... ... 2 Girls 124 1 ... ... ... 1 66 6 11 3 2 2 ... ... ... ... ... ... ... 1 1 1 1 2 ... 3 3 10 ... ... 1 ... ... 8 13 1 ... ... 3 ... 5 28 1 84 14 ... 30 4 ... 1 ... ... ... ... 72 5 1 ... ... 1 ... ... ... 4 Shaftesbury Road Boys 58 ... ... ... ... 5 38 6 5 2 2 2 1 1 1 ... ... ... ... 2 3 8 8 ... 1 1 9 3 ... ... ... ... ... ... 4 ... ... ... ... 2 ... 14 1 14 1 ... 8 1 5 5 ... 5 ... ... 16 4 ... 1 ... ... ... ... ... ... Girls 71 ... ... ... ... 3 54 6 6 10 10 1 2 4 2 ... 2 ... ... 1 1 5 5 1 ... 5 6 4 ... ... ... 1 ... ... 14 ... ... ... ... ... ... 5 ... 29 2 ... 10 ... ... 1 1 4 ... ... 16 ... ... ... ... ... ... ... ... ... ... Storey Street Boys 62 3 5 ... ... ... 24 3 4 1 1 1 1 1 ... 1 ... ... ... 1 1 1 ... 2 ... ... 4 1 ... ... ... ... ... 1 10 ... 2 ... ... ... ... 1 ... 37 9 ... 4 4 ... 4 1 8 1 2 29 8 1 ... 1 ... 3 Girls 43 ... 2 ... ... 1 4 ... ... ... ... ... ... ... ... ... ... ... ... 2 2 ... ... ... ... 2 ... ... ... ... ... ... ... ... 6 ... ... ... ... ... ... 1 ... 17 ... ... 7 1 ... 2 2 8 2 ... ... ... ... ... ... ... ... ... ... ... 1 Silvertown, R.C. Boys 68 ... ... ... ... ... 30 ... 1 ... 1 ... ... ... ... ... ... ... ... 1 ... 2 1 ... ... 2 2 ... ... ... 1 1 ... ... ... ... 1 ... ... ... ... 2 1 36 ... ... 12 2 ... 3 ... 1 ... 3 44 13 1 ... ... ... ... ... ... ... 5 Girls 52 1 ... ... ... 1 30 5 6 2 1 ... ... 2 1 ... ... ... ... 1 1 ... 1 ... ... 1 ... ... ... ... ... ... ... 1 13 ... ... ... ... ... ... 2 ... 32 4 ... 15 4 1 ... ... 5 1 1 22 7 ... ... ... ... ... 1 ... ... 7 Technical College Boys 43 ... ... ... ... ... 42 3 1 1 4 2 2 1 1 ... ... ... ... ... ... ... ... 1 ... 2 1 ... ... ... ... ... ... 3 ... ... ... ... ... ... ... ... ... 13 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 Girls 57 ... ... ... ... ... 57 1 4 ... 3 ... ... 1 ... 1 2 ... ... ... 1 ... ... ... ... ... 4 ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 9 ... 3 ... ... 2 1 ... ... ... 1 1 1 ... ... ... ... ... ... ... ... ... ... 15 Vicarage Lane Boys 183 ... 2 ... ... 3 89 3 2 7 8 ... 1 1 1 ... ... ... ... 3 4 8 8 4 ... 7 4 3 ... ... 1 ... ... 3 ... 3 2 2 6 2 4 19 1 71 2 ... 44 6 4 9 5 29 5 1 127 27 4 ... ... ... ... 1 ... ... 7 Girls 168 ... 2 ... ... 2 80 2 2 4 6 3 3 3 ... ... ... ... ... 4 5 8 8 3 ... 1 9 10 ... ... 3 ... ... 2 19 1 1 ... 2 ... 1 13 4 107 ... ... 23 6 0 10 3 28 2 1 133 15 1 ... ... ... ... 3 ... ... 6 Walton Road Boys 257 1 1 ... ... 3 73 18 19 3 6 3 1 2 2 ... ... 1 ... 3 4 ... 4 1 ... 8 2 20 ... ... 1 ... ... 1 8 8 ... ... 69 3 70 1 ... 148 24 ... 79 17 (5 9 1 9 ... 2 64 5 ... ... ... 1 2 ... ... ... 5 Girls 269 6 1 ... ... 2 72 6 7 2 3 ... 1 I 1 ... ... ... ... 2 3 3 ... ... ... 11 10 16 ... 1 5 ... ... 2 83 6 ... ... 51 1 44 15 ... 155 19 ... 83 la 5 3 ... 14 ... 2 3 3 ... 4 ... ... 1 1 ... ... 9 Totals Boys 3041 15 12 1 7 29 1642 129 155 73 84 26 28 21 20 5 8 3 1 36 47 54 47 30 8 89 150 117 ... 1 24 1 1 42 57 14 22 2 79 11 165 215 23 1412 165 ... 511 109 05 141 21 249 24 20 1759 244 12 18 ... 1 3 12 5 7 79 Girls 2831 15 5 1 2 26 1474 141 157 71 93 24 25 14 9 1 7 ... 1 40 49 47 39 22 ... 67 170 86 1 1 26 1 35 346 13 4 ... 61 5 112 201 9 1296 173 ... 521 10a 86 102 26 28 16 199 199 7 8 1 1 4 7 3 5 110 Percentage defective Boys ... 0.49 0.39 0.03 0.23 0.95 ... 7.8 9.1 4.4 5.1 1.6 1.7 1.3 1.2 03 0.48 0.18 0.06 11 .15 1.7 1.5 0.9 0.26 2.6 4.9 3 .8 ... 0.03 0.79 0.03 003 1.3 1.8 4.6 0.72 0.06 2.6 0.36 5.4 7.07 0.75 46.4 5.4 ... 16.8 3.2 2.1 4.6 0.69 8.1 0.79 0.65 ... 13.9 0.68 0.59 ... 0.03 0.09 0.39 0.16 0.23 2.6 Girls ... 0.52 0.17 0.03 0.07 0.91 ... 9.55 10.6 4.8 6.3 1.6 1.6 0.95 0.61 007 0.47 ... 007 1.6 1.7 1.7 1.4 0.77 ... 2.3 6.0 3.03 0.03 0.03 0. 91 0.03 ... 1.2 12. 2 0.45 0.14 ... 2.1 0.17 3.9 7.1 031 45.7 6.1 ... 18.4 3.7 1.2 3.0 0.91 0.8 0.99 0.56 ... 13.1 0.46 0.28 0.03 0 .03 0.14 0.25 0.10 0.17 0.39 TABLE IV—SPECIAL CASES.—1919 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-hreathers. Adenoids. Glands. Nasal Defects. Mental Capacity. " Deformities. Infectious Skin Diseases Tuberclc. Other Diseases. Blepharitis. Conjunctivitis. Corneal Opacity Other Diseases. Number Examined. 6/12 6 /18 6/24 6/36 6/60 6/0 Deafness. Discharge. 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, j Osseous. | R L R L R L R L R L R L R L R L Head Bod) Brampton Road Boys 21 ... ... ... ... ... 15 1 1 7 6 3 3 ... ... 1 ... ... ... ... ... 1 1 ... ... 3 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 2 ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 Girls. 18 ... ... ... ... ... 1.3 6 6 5 5 1 ... ... ... ... ... ... ... 1 1 2 2 ... ... ... 4 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 4 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Castle Street, B.C Boys 4 ... ... ... ... ... 2 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Girls 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... 1 Central Park Road. Boys 7 ... ... ... ... ... 5 5 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 6 ... 0 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Girls 5 ... ... ... ... ... 4 1 1 ... ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... Essex Road Boys 0 ... ... ... ... ... 3 2 3 1 1 2 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Girls 4 ... ... ... ... ... 2 ... ... ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... Fourth Avenue Boys 23 1 ft 3 5 3 4 1 1 1 4 1 6 5 Girls 25 1 7 6 4 - ... 4 ... 5 7 3 1 1 ... 12 1 Hartley Avenue Boys 10 7 5 4 2 3 ... 3 9 1 5 Girls 9 ... 4 1 1 1 1 2 1 ... 3 High Street Boys ... Girls ... ... Higher Elementary Boys Girls Kensington Avenue Boys 63 2 2 1 48 1 22 Girls 81 5 2 2 i ... 58 26 Lathom Road Boys 17 1 1 1 3 1 5 3 17 1 1 Girls 10 ... 3 ... 4 3 9 ... 1 Manor Park Boys 16 ... 1 ... 2 6 4 1 1 Girls 83 ... 1 5 ... 3 3 18 40 14 3 1 1 Monega Road Boyr 4 4 2 2 Girls 4 4 1 2 2 3 ... ... Napier Road Boys 5 4 Girls 5 4 2 1 % ... 2 ... ... New Beckton Boys 5 3 1 1 3 Girls 4 ,.. 1 1 ... 1 2 ... ... Plashet Lane Boys 10 8 3 ... Girls V 5 3 3 1 ... ... ... 2 2 St. Winefride's, R.C. Boys 1 1 1 1 ... Girls 1 1 ... ... 1 Shrewsbury Road Boys 7 ... 3 1 2 Girls 2 ... ... 1 1 1 Sandringham Road Boys 3 2 1 Girls 3 ... 3 2 2 ... 1 2 1 Shaftesbury Road Boys 25 ... 2 22 5 4 2 3 2 2 1 1 ?, 1 0 3 1 6 1 3 1 1 3 Girls 16 10 2 2 1 1 1 1 1 1 1 1 2 ... 4 I 2 2 2 1 6 1 Storey Street Boys 1 1 Girls 2 2 2 Silvertown, R.C. Boys 2 1 1 Girls ... ... ... ... ... Technical College Boys Girls ... Vicarage Lane Boys 14 10 6 7 4 4 3 Girls 23 1 10 3 3 6 4 1 3 2 1 3 ... 1 2 2 2 Walton Road Boys 3 2 2 ... 2 1 2 3 ... 1 ... 1 3 Girls . 69 2 6 2 9 6 2 4 3 3 6 3 3 4 4 3 1 1 2 G 7 ... 2 5 ... Totals Boys 268 1 3 3 112 32 32 19 23 9 9 1 1 1 4 4 4 3 9 69 1 3 3 1 28 37 36 8 1 1 46 7 1 3 1 3 ? ? la Girls . 377 2 6 5 88 32 25 15 18 13 13 4 3 1 2 1 11 6 8 9 8 94 3 1 1 5 4 1 1 16 28 37 52 16 6 7 31 1 4 1 1 4 Percentage Bovs ... [) -3. 11 11 786 *>86 16 9 ?0-5 S 03 8 03 0 88 0 88 0.3 11 " 3 25 8 0 37 11 11 037 I \ 10 4 13 8 13 4 29 0-17 15 2 1 11 0'37 11 74 7*4 Girls 0 53 16 1-3 36.3 284 17.04 20 5 118 148 45 84 11 088 11 29 10 21 24 2 1 24 9 079 0 20 026 13 106 026 026 4-2 74 98 13 7 42 1-6 ... 1.9 ... 32 12 9 026 ... 026 ... 106 29 GENERAL REVIEW OF FACTS DISCLOSED BY MEDICAL INSPECTION. Nutrition. 215 boys and 201 girls, percentages of 7.07 and 7.1 respectively, were found to be under normal standard. Defective Clothing. Ragged or insufficient clothing was found in 2.6 per cent, boys and 21 per cent girls. Dirty clothing was found in .36 per cent boys and 2.1 per cent. girls. Defective Boots. This was noted in 5.4 per cent boys and .'9 per cent girls. The high cost of footwear renders it extremely difficult for parents to keep their children adequately shod. External Eye Diseases. All cases of eye disease in children are effectively dealt with. The more simple defects are treated at the Clinics, and the more serious referred to the Eye Specialist. Ringworm. This disease can be very effectively cured by X-ray treatment. Since making arrangements with the London Hospital for the treatment of our cases the incidence of this disease among school children has considerably decreased, while the average length of time each case has to be excluded from school is appreciably diminished. Scabies. A considerable number of cases of this disease continue to appear among school children. Provision is made at the Town Hall for bathing any cases which are unable to have proper treatment at home. This bathing is superintended by the school ruses. Diseases of Throat and Nose. Slight enlargement of tonsils existed in 511 boys, a percentage of 16.8, and 521 girls, a percentage of 18.4. Greater enlargement, requiring surgical treatment, existed in 109 boys and 105 girls. Adenoids are frequently associated with enlarged 30 tonsils. Arrangements have now been made for treatment to be carried out at a hospital, the Committee being- responsible for the cost in necessitous cases. Deafness. This existed in 83 boys and 95 girls, and was most frequently associated with discharging ears, adenoids, and enlarged tonsils. The treatment of ear cases remains as one of the least satisfactory aspects of the school medical service, and the tendency of parents to regard otorrhoea as of little importance leads to a serious loss of efficiency in school children and in many cases determines the production of the unfit man and woman. Diseases of the ear are, unfortunately, very often of a chronic nature requiring constant skilled attention, which few parents are able to provide. In view of the above, therefore, it is hoped that before long the Committee will see their way to arrange for the services of an aurist either at one of the adjacent hospitals or at the School Clinic. Heart and Circulation. Heart affections were present in 89 boys and G7 girls, percentages of 2'G and 2.3 respectively. Disease of the Lungs. Affections of the lungs were present in 142 boys and 114 girls. Most of these were simple catarrhs or bronchitis, but in many cases there arc grounds for suspecting latent tubercular infection. Such cases are classed as pre-tubercular and kept under supervision. It is this class—the pre-tubercular child—for which there such an urgent demand for an open-air school. It is hoped that in the near future better provision will be made for such children. Meantime tubercular or pre-tubercular children arc referred to Wakefield Street Dispensary, but more specialized treatment is necessary. Defective Mental Condition. Out of 3,272 children medically inspected during 1919, 462 were found to be below the average in intelligence, 443 being classed as dull, and 19 as defective. As formerly, special cases for backward or dull children have been held at Sandringham 31 and Shrewsbury Road Schools under specially trained teachers, but though doing excellent work they are quite inadequate for the needs of this large borough. There is urgent demand for a centrally situated Special School for backward and mentally defective children, where all grades, except those of so low a mentality as to need residential treatment, could receive adequate education. Total number examined under M.D. Act26 Ineducable and notified to Mental Deficiency Committee 12 Recommended for Special Classes 5 Recommended for Special Schools 14 Admitted to Special School or Class 2 Awaiting Vacancies 12 Excluded from School 26 Dental Disease. The report of the School Dentist is appended. In September, 1919, Dr. Bendix was appointed full-time dentist in connection with school work, and the beneficial effects of this step are already noticeable. New accommodation has been provided for this branch, and one session per week is set aside for dental work under a general anaesthetic. Cleanliness. All the school children have been examined for cleanliness by the school nurses on repeated occasions during the year. The effect of these constant inspections is gradually becoming apparent and the standard of cleanliness in schools at the present time is higher than in any previous year. Details of this work are furnished in Table VII. Physical Training in Schools. The School Medical Officers have long been impressed with the large amount of minor physical deformities existing among school children. These defects include mouth breathing, round shoulders, defective gait, ungainly carriage and inability to inflate the lungs properly. It is thought that many of these faults might be eradicated by and much improvement in the general 32 bearing and deportment of scholars accrue from more specialized courses in physical drill. To this end it is suggested that a Supervisor of School Physical Training be appointed. This officer would superintend all physical training in the schools, would co-ordinate effort, would modify or extend existing schemes, would establish special classes for special objects and would generally be responsible that the physical training of school children in the Borough was adequate in amount, suitable in nature, and effective in result. Without this unity of control it is felt that the best is not being made of our opportunities, and the above suggestion is respectfully made for your consideration. 33 TABLE I. School Cases. Measles 963 Chicken Pox 95 German Measles 94 Mumps 120 Whooping Cough 39 Scarlet Fever 384 Diphtheria 319 Report of Ophthalmic Surgeon. Boys. Girls. Total Myopia 70 73 143 Myopic Astigmatism 28 22 50 Hypermetropia 68 80 148 Hypermetropic Astigmatism 83 43 126 Mixed Astigmatism 9 12 21 Squint (without error of refraction) 14 16 30 Odd Eyes 5 10 15 Various Diseases 44 70 114 Ciliary Spasms 22 21 43 No Defects 22 38 60 365 385 750 Boys. Girls. Total Numbers excluded 8 4 12 TABLE II. TOWN HALL TREATMENT CLINIC. Shewing the Number of Treatments carried out at the Clinics (Dental and Ophthalmic Cases are not included). Impetigo 1,393 Ear Conditions 769 Septic Conditions 691 Eye Inflammation 611 Ringworm—Body 85 Abscess 61 Injury 33 34 Cases treated at Town Hall Clinic, continued. Scabies 24 Eczema 23 Throat 23 Dermatitis 22 Teeth Extracted 18 Warts 1C Ringworm—Head 11 Chilblains 10 Herpes 10 Whitlow 8 Burns . . 7 Poisoning 5 Favus 4 Seborrhœa 3 Rash 3 Stomatitis 3 Dogbite 2 Shingles 2 Acne 1 Rhinitis 1 Total 3,839 EXCLUSION FORMS ISSUED 1919. Scabies 477 Abscess 19 Impetigo 152 Ear Conditions 16 Throat Affections 131 Eczema 15 Ringworm—Head 100 Chicken Pox 15 Mumps 67 Chorea 15 Septic Sores 64 Tuberculosis (all forms) 11 Diphtheria 59 Heart Affections 10 Enlarged Glands 47 Rash 9 Debility 45 Shingles 8 Ringworm—Body 34 Scarlet Fever 8 Eye Inflammation 28 Dermatitis 8 Anaemia 24 Adenitis 7 Bronchitis 21 Whooping Cough 7 Chest Conditions 19 Poisoning 7 35 Exclusions, continued. Verminous Conditions 6 Pyrexia 1 Gastro Enteritis 5 Neuritis 1 Cough 5 Herpes 1 Injury 5 Inflammation of Kidney 1 Stomatitis 5 Burn 1 Desquamation.. 4 Stomach Affections 1 Synovitis 4 Measles 1 Pleurodynia 4 Nervous Condition . 1 German Measles 3 Vaginal Disease 1 Cardiac 3 Pains in Leg 1 Fits 2 Hæmorrhagia 1 Blepharitis 2 Lungs 1 Adenoids 2 Enlarged Tonsils 1 Nose Bleeding 2 Tachycardia Inflamed Neck 9 Otitis 1 Myopia 9 Chilblains 1 Conjunctivitis 1 Abdominal Swelling 1 Swelling in Groin 1 Favus 1 Pemphigus 1 Pediculi 1 Flat Foot 1 Alopecia 1 Sickness 1 Astigmatism 1 Malnutrition I Pleuritic Pain 1 Epilepsy 1 Total 1,371 MANOR PARK CLINIC. Advised Cases. Teeth 96 Enlarged Tonsils 5 Throat Affections 36 Tuberculosis (all forms) 3 Scabies 30 Inflamed Eyes 9 Ringworm—Head 21 Nervous Condition ... 2 Vision 21 Injury 9. Enlarged Glands 15 Alopecia 2 Debility 10 Anæmia 2 Adenoids 9 Diphtheria 2 Ear Conditions 8 Seborrhœa 2 Chest Conditions 6 Dermatitis 1 Rash 6 Pyrexia 1 36 Advised cases continued, Manor Park Clinic. Synovitis 1 Psoriasis Abdominal Swelling 1 Hip Disease Nose Bleeding 1 Carbuncle Impetigo 1 Pediculi Neuritis 1 K.L. B. Carrier St. Vitus' Dance 1 Mentally Deficient Ringworm—Body 1 Total 305 Treatment Cases, Manor Park Clinic. Impetigo 435 Injury 4 Septic Conditions 184 Ulcerated Mouth 4 Eye Inflammation 181 Dermatitis 4 Ear Conditions 102 Scald 4 Abscess 34 Shingles 4 Ringworm of Body 31 Poisoning 3 Eczema 29 Cellulitis I Whitlow 11 Warts 1 Chilblains 7 Herpes 1 Enlarged Glands 5 Pediculi 1 Total 1,046 NORTH WOOLWICH CLINIC. Advised Cases. Scabies 83 Chest Conditions 3 Teeth 59 Muscular Strain 3 Vision 27 Alopecia 2 Tonsils (Enlarged) 10 Injury 2 Enlarged Glands 9 Heart Affections 1 Throat Affections 6 Seborrhœa 1 Rash 6 Verruca 1 Mumps 4 Hip Disease 1 Deafness 4 Debility 1 Adenoids 3 Defective Speech 1 Anæmia 3 Total 230 37 Treatment Cases, North Woolwich Clinic. Impetigo 229 Enlarged Glands 18 Septic Condition 213 Poisoning 4 Warts 175 Burns 4 Eye Inflammation 111 Ringworm—Body 3 Ear Conditions 83 Boils 2 Chilblains 39 Dermatitis I Injury 21 Total 903 TABLE VI. TOWN HALL INSPECTION CLINIC. Scabies 335 Chorea 12 Teeth 312 Chicken Pox 11 Vision 109 Alopecia 10 Impetigo 93 Eczema 9 Throat Affections 88 Nose Affections 8 Debility 81 Spinal Curvature 7 Ringworm—Head 77 Rheumatism ... 7 Chest Conditions 68 Epilepsy 6 Enlarged Tonsils 61 Sprain 6 Septic Conditions 55 Shingles 6 Tuberculosis 47 Gastritis 5 Enlarged Glands 15 Stomatitis 5 Heart Affections 44 Hernia 5 Anæmia 44 Desquamation 5 Ear Conditions 42 Diseased Leg 5 Mumps 37 Incontinence 4 Adenoids 33 Herpes 4 Eye Inflammation 32 Seborrhœa 4 Abscess 23 Worms 4 Rash 20 Whooping Cough 4 Dermatitis 17 Otitis 3 Mental Deficiency 17 Fits 3 Ringworm—Body 16 Sickness 3 Cough 12 Vaginal Disease 3 Infantile Paralysis 12 Favus 3 Injury 12 Stomach Affections 3 38 Town Hall Inspection Clinic, continued. Endocarditis 2 Hip Joint 1 Tachychardia 2 Chilblains 1 Head Conditions 2 Urticaria 1 Influenza 9 Colic 1 Rupture 2 Pleuritic Pain 1 Flat Foot 2 Dislocation of Hip Joint 1 Warts 2 Jaundice 1 Malnutrition 9 Cheiropompholyx 1 Wasting 2 Enchrondroma 1 German Measles 9 Physically Defective 1 Onychia 9 Hæmoptysis 1 Nervous Condition 2 Ranula 1 Pemphigus 9 Abnormal 1 Synovitis 1 Menstruation 1 Chlorosis 1 Scarlet Fever 1 Tabes Mesenterica 1 Dumb 1 Psoriasis 1 Faintness 1 Pleurodynia 1 Exostosis 1 Mævus 1 Total 1,927 S9 TABLE VII. 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. Brampton Road Boys 394 4 3 ... Napier Road • Boys 863 18 4 ... Girls 349 14 9 ... Girls 1242 158 55 ... Jr. Mixed 657 13 4 ... Infants 1019 69 39 1 Infants 353 9 1 ... New Beckton Boys 549 1 ... 2 Castle Street R.C. Mixed 529 33 6 ... Girls 427 54 3 ... Infants 278 32 9 ... Infants. 590 63 6 ... Central Park Road Boys 545 3 1 ... Plashet Lane Boys 647 12 ... ... Girls 522 59 ... ...... Girls 536 135 ... ... Infants 720 47 ... ... Infants 471 71 3 ... Essex Road Boys 1040 19 8 ... Storey Street Mixed 810 46 5 ... Girls 993 39 0 ... Infants 842 63 10 ... Infants 1008 42 6 ... St. Winefride s R.C. Mixed 384 35 15 ... Fourth Avenue Boys 455 2 ... ... Sandringham Road Boys 748 5 ... ... Girls 809 95 5 1 Girls 694 9 3 ... Infants 311 23 1 1 Infants 641 42 ... ... Hartley Avenue Boys 1429 9 ... ... Shaftesbury Road Boys 1196 13 ... ... Girls 1484 77 13 ... Girl's 1113 66 17 ... Infants 1258 64 9 ... Infants 692 50 6 ... High Street Mixed 598 38 9 ... Shrewsbury Road Mixed 468 28 3 ... Infants 579 59 12 ... Infants 457 34 3 ... Higher Elementary Hoys ... ... ... ... Silvertown R.C. Mixed 669 30 4 ... Girls ... ... ... ... Infants 566 34 6 ... Kensington Avenue Boys 966 9 1 ... Technical College Girls 194 8 3 ... Girls 907 33 1 ... Vicarage Lane Boys 968 22 6 ... Infants 459 9 1 ... Girls 982 87 15 ... Lathom Road Boys 1056 1 ... ... Infants 895 72 19 ... Girls 1001 112 5 ... Walton Road Boys 1004 8 18 ... Infants 963 59 2 ... Girls 970 56 77 ... Manor Park Boys 986 36 ... ... Infants 1738 64 50 ... Girls ... 697 48 7 ... Total 46733 2519 514 9 Infants 616 30 1 ... Monega Road Boys 991 ... ... Girls 922 87 4 ... Percent. 5.4 1.1 0.02 Infants 483 61 3 ... 40 CASES TREATED AT DENTAL CLINIC. Ages. Sex. Number Exam'd. Temporary Teeth. Permanent Teeth. Extractions. Anæsthetics. Scaling. Dressings. Fillings Saveable. Unsaveable. Saveable. Unsaveable. Temp. Teeth. Perm. Teeth. Local. N2O. 5 years B. 29 10 134 13 ... 103 4 ... 5 ... 3 13 G. 41 60 142 2 ... 121 ... 4 2 ... 14 22 6 years B. 99 58 393 24 4 322 2 10 8 5 8 52 G. 90 68 313 11 ... 278 4 10 7 1 4 51 7 years B. 128 77 415 40 12 346 10 16 6 ... 14 49 G. 123 49 458 47 5 412 4 20 4 ... 8 57 8 years B. 100 58 368 56 11 320 4 14 7 ... ... 91 G. 118 19 352 65 23 322 16 16 3 2 7 66 9 years B. 98 16 298 73 21 248 17 6 4 ... 19 52 G. 69 11 221 43 14 183 10 16 2 6 2 33 10 years B. 45 19 129 28 20 123 16 7 3 1 4 28 G. 32 4 79 22 11 78 6 5 3 ... 5 27 11 years B. 22 ... 59 18 7 48 5 6 ... ... ... 11 G. 21 2) 24 22 22 22 18 8 1 ... 2 19 12 years B. 49 4 89 77 37 81 26 15 4 ... 8 73 G. 16 ... 7 23 18 8 17 6 3 ... ... 25 13 years B. 21 2 32 29 29 23 23 14 4 ... ... 25 G. 24 6 27 37 12 28 19 6 4 ... ... 45 14 years B. 12 ... 8 35 13 8 13 4 1 2 6 42 G. 15 ... 3 44 17 2 18 ... 3 ... 3 42 15 years B. 1 ... ... 5 5 ... 5 3 ... ... ... 1 G. ... ... ... ... ... ... ... ... ... ... ... ... Totals B. 604 244 1907 398 162 1622 125 95 42 8 62 440 G. 552 219 1626 319 122 1451 112 91 32 9 45 387 Total ... 1156 493 3533 717 284 3076 237 186 74 17 107 827 Number of attendances for treatment 1,932. Report OF THE Chief Sanitary & Food Inspector FOR THE YEAR 1919. 42 Annual Report of the Chief Sanitary and Food 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 twenty-fourth Annual Report on the work done by the Sanitary Inspectors during the year ended 31st December, 1919. The total number of inspections made during the year under consideration was 3,087. These included visits to premises upon complaints of nuisance, inspections of markets, workshops, slaughterhouses, bakehouses, cowsheds, dairies, etc. There have been 4,563 nuisances discovered, comprising choked and defective drains, leaky roofs, defective sanitary appliances, animals improperly kept, etc. In obtaining abatement of the aforesaid nuisances, the following Notices were served:— Preliminary 1,344 Statutory 39 Dust Bin 303 Water 9 making a total of 1,695 Notices. During the year 1,588 complaints were received, as follows:— Beckton and North Woolwich Ward 160 Central Ward—East 264 Central Ward—West 279 Manor Park Ward 397 Plashet Ward—East 236 Plashet Ward—West 252 The complaints principally referred to defective drainage and appurtenances to the drains proper. The Following is a Record in Detail of the Inspections made during the Year 1919:— Beckton & North Woolwich Ward. Central East Ward. Central West Ward. Manor Park Ward. Plashet East Ward. Plashet West Ward. Total. 1919 1919 1919 1919 1919 1919 1919 Ord. H. to H. Ord. H. to H. Ord. H. to H. Ord. H. to H. Ord. H. to H. Ord. H. to H. Ord. H. to H. Premises found in fair condition 134 7 107 7 130 5 107 3 51 ... 117 1 646 23 Factory and workshop premises 14 ... 26 ... 36 ... 87 ... 8 ... 35 ... 156 ... Outworkers premises 65 ... 50 ... 136 ... 5 ... 28 ... 74 ... 358 ... Bakehouses 10 ... 5 ... 24 ... 27 ... 4 ... 14 ... 84 ... Slaughter-houses 4 ... 22 ... 7 ... 81 ... 1 ... 35 ... 150 ... Dairies 33 ... 27 ... 33 ... 58 ... 6 ... 29 ... 186 ... Urinals inspected 75 ... 49 ... 32 ... 33 ... 4 ... 9 ... 202 ... Walls and ceilings dirty and dilapidated 39 24 71 107 137 30 105 23 77 5 119 3 548 192 Yards improperly paved and dilapidated ... 3 17 26 15 6 14 1 11 ... 16 1 73 37 No forecourt paving ... ... ... ... 7 ... 2 ... 6 ... 2 5 17 5 Drains unstopped and cleansed 297 ... 353 ... 270 ... 300 ... 201 ... 127 ... 1548 ... Defective drains 39 ... 1 ... 1 ... 5 ... 1 ... 5 ... 52 ... Defective w.c. connections 1 ... 4 ... 5 ... 3 ... 1 ... 4 1 18 1 Defective w.c. traps 1 ... 3 ... ... 1 7 1 3 ... 1 ... 15 2 Soil pipes and drains insufficiently ventilated ... ... 2 ... ... ... ... ... ... ... ... ... 2 Defective flushing apparatus 6 2 20 11 29 6 40 5 41 5 37 ... 173 29 Soil pans foul and broken 4 2 6 9 12 ... 7 5 4 1 14 2 47 19 Defective vent pipes 1 2 12 3 9 5 23 ... 7 ... 4 ... 56 10 R.W. pipes and eaves gutters defective 5 2 45 37 36 14 64 27 49 6 38 1 237 87 Do. connected to drain ... ... ... 1 1 ... ... ... ... ... 1 ... 2 1 Roofs leaky 19 13 36 31 70 11 42 15 34 3 64 ... 265 73 Defective sink waste pipes 6 2 8 10 18 6 27 4 8 3 17 3 84 28 Houses without water (M.W.Bd.) ... ... 2 ... 6 ... 2 ... 3 1 2 ... 15 1 Cisterns without covers ... ... 1 ... 4 ... 2 ... 1 ... 4 ... 12 ... Drinking water improperly stored ... ... 5 ... 6 ... 6 ... 6 2 2 ... 25 2 Dilapidated floors 2 3 2 14 23 3 30 4 6 1 11 ... 74 25 Insufficient underfloor ventilation ... ... 1 6 5 4 7 4 3 1 1 2 17 17 Dampness 14 2 51 11 62 4 107 24 47 10 59 2 340 53 Accumulations 3 ... 11 ... 48 ... 12 9 4 ... 7 ... 85 9 Inundations ... ... 3 ... 1 ... 6 ... 3 ... 2 ... 15 ... Overcrowding ... ... 2 ... ... ... 3 ... 3 1 3 ... 11 1 Unsound food 1 ... 19 ... 6 ... 12 ... 1 ... ... ... 39 ... No dust bins 3 ... 5 15 25 1 27 5 12 1 31 ... 103 22 No manure bins ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... Animals improperly kept ... ... 2 ... 1 ... 4 1 1 ... ... ... 9 1 Temporary buildings found ... ... 1 ... ... ... 1 ... 1 ... 1 ... 4 ... Smoke nuisances 3 1 5 2 11 ... 4 ... 9 ... 7 ... 39 3 Rear passages unpaved or undrained ... ... ... ... ... ... ... ... ... ... ... ... ... ... Gipsies . ... ... 82 ... ... ... ... ... ... ... ... ... 82 ... Breaches of Bye-Laws and Regulations ... ... 7 ... 1 ... 2 ... 1 ... 3 ... 14 ... Other nuisances 55 20 104 85 150 21 218 57 97 7 127 ... 751 192 Drains tested 174 ... 42 ... 160 5 157 ... 76 142 ... 821 5 Inspections 336 34 517 118 668 58 549 56 281 8 456 ... 2807 280 43 Complaints Received. Beckton and North Woolwich Ward. Central East Ward. Central West Ward. Manor Park Ward. Plashet East Ward. Plashet West Ward. Total. January 5 12 26 23 12 15 93 February 21 30 19 26 19 32 147 March 11 21 20 27 10 18 107 April 6 19 18 25 19 19 106 May 9 23 28 50 28 19 157 June 5 19 24 32 9 15 104 July 10 31 15 50 28 22 156 August 19 19 8 29 17 20 112 September 17 17 34 43 16 17 144 October 16 16 41 22 30 27 152 November 17 33 26 37 20 20 159 December 24 24 20 33 28 22 151 Total 160 264 279 397 236 252 1583 Complaints.—They referred to the following Nuisances:— Jan. Feb. Mar. April May June July Aug. Sept. Oct. Nov Dec. Total Drains Choked 62 51 45 43 88 54 74 61 36 63 57 67 721 Water cut off 5 ... ... ... 1 ... ... ... ... ... 1 1 8 Accumulations 1 9 9 3 6 1 1 4 2 1 7 8 52 Offensive smells 1 ... 1 ... 2 3 2 3 8 3 5 2 30 No dust bins 3 2 8 4 19 5 11 5 11 12 8 6 94 Dilapidations 2 2 9 11 8 10 18 5 5 2 22 14 108 Overcrowding ... 1 1 2 ... 1 1 ... ... ... 1 8 15 Insanitary condition. 1 7 1 1 2 2 3 ... 6 17 4 ... 44 Dampness 5 31 8 7 4 4 18 8 12 15 6 11 129 Others (various) 13 44 25 35 27 24 28 26 44 39 48 34 387 Total 93 147 107 106 157 101 150 112 144 152 159 151 1588 HOUSE TO HOUSE INSPECTIONS. This important branch of Public Health service is now receiving the fullest attention of the Inspectorial Staff, and a considerable amount of work has already been accomplished. During the period of the war the repairing of houses had to some extent been suspended, with the inevitable result that certain properties deteriorated, and some time must elapse before arrears can be overtaken. The Council, with this end in view, have appointed three additional Assistant Sanitary Inspectors, who work under the District Inspectors. 44 DRAINS UNSTOPPED AND CLEANSED. The important work of unstopping and cleansing of drains has been carried out by the Council's men free of charge. This policy of the Corporation, which has been in operation for many years, continues to work with success. The men engaged are experienced and capable, with a thorough knowledge of manholes and sewer connections. I have frequently referred to the permanent damage done to drains by inexperienced men attempting to remove a stoppage without local knowledge of manholes and connections. During the year 1,548 drains have been unstopped and cleansed. This may appear a large number, but it must be kept in mind that each connection would average six houses and that a careless act of allowing an article to be thrown down the water closet would cause all the six houses to be stopped, and further, the practice of unstopping drains free of charge has been in vogue for over 25 years, and is generally know n throughout the Borough, with the result that stoppages are reported to the Department. DRAINAGE WORK, Etc. At 821 houses drains have been tested and in 87 instances defects were discovered, 52 being defective joints of the drain and in 35 cases the defects were in the traps or connections. 47 obsolete or defective soil pans have been removed and new pans substituted. 56 drain ventilating pipes have been repaired or renewed. The work is carried out under the supervision of the District Sanitary Inspectors. SANITARY APPLIANCES. These include flushing apparatuses, and during the year 173 have been renewed. 84 sink and bath waste pipes have been repaired. A common cause of complaint is an offensive sink waste pipe; too little attention is given by occupiers to the systematic cleansing of waste pipes and gullies, and in many instances cleansing is made almost impracticable by faulty construction, 45 ROOFS, RAINWATER PIPES AND EAVES-GUTTERS. At 504 houses Notices were served to abate nuisances caused by leaky roofs, defective eaves gutters or rainwater pipes. It is essential to the health and comfort of the inmates of a dwelling house that the roof shall be kept at all times watertight and that the eaves gutters and rainwater pipes shall carry off the water to the drains. Much difficulty has been experienced in obtaining material, and in consequence property has deteriorated, but in the near future things will again resume normal conditions. In the meantime a little patience on one side and more energy on the other must be exercised. DIRTY PREMISES. This term includes walls and ceilings being dirty and dilapidated or in such a condition as to be a nuisance. Notices have been served in respect of 548 premises. The figures are comparartively low compared with pre-war times, but as work is now resuming normal conditions a considerable increase must quickly follow. DRINKING WATER. Work to improve the drinking water supply has been done in 52 houses. In 25 instances improved storage, 12 cisterns cleansed and covered, and at 15 houses water reinstated. YARD AND FORECOURT PAVING. The paving of the yard immediately adjoining the dwelling house is an important factor in keeping the house dry and clean, and under the provisions of the East Ham Improvement Act 100 square feet can be insisted upon. At 73 houses during the year paving work has been performed. LAVATORIES AND URINALS. There are 40 urinals in the Borough (excluding those in the Public Parks). 28 are attached to licensed premises and to which the public have access. Special attention has been given by the District Inspectors to cleansing and lighting, and 202 inspections have been made. There are 4 public underground conveniences where Attendants are in charge and a standard of efficiency "maintained. There are also 7 semi-public urinals attached to 46 licensed premises, where the urinals serve a public purpose as well as a private obligation. In these circumstances the Council and the licensees have entered into an agreement as to responsibility for maintenance, etc. Some of these agreements have been working satisfactorily for over 20 years. My experience urges me to suggest that if our streets are to be kept decent and clean more public conveniences should be erected. PASSAGES AT REAR OF PREMISES. Many business premises have a secondary means of access— a passage at the rear which undoubtedly is of great convenience for business; but as these are used in common" by a number of occupiers they become seriously neglected, and I have frequently had to call attention to the lack of cleansing, etc. Notices have been served, and much of the Inspectors' time is given to maintain anything like decency. These passages are dark, and many without gates lend themselves to the commitment of nuisances. My experience again suggests light and the provision of more public conveniences. SMOKE NUISANCES. This kind of nuisance is seldom seen in a serious form, as there are few factory shafts in the Borough. On some 62 occasions observations were made, but the smoke emitted could not be designated a nuisance within the Public Health Act. MORTUARIES. There are two mortuaries, one on the Town Hall site and the other at North Woolwich. They have been periodically inspected and found in an excellent condition. Both buildings are now under the control of a Mortuary Keeper, assisted by his wife who attends to female bodies. There have been 59 bodies admitted and 39 post-mortem examinations held during the year. VAN DWELLERS AND SQUATTERS. 82 visits have been made to the van dwellers and squatters settlements in Langdon Crescent, where they have erected water closets connected to the sewer, and provided a water supply for drinking purposes. By making these provisions the Bye-laws are complied with, but gipsies are gipsies. 47 TEMPORARY BUILDINGS. The erection of temporary structures at rear of premises contrary to Bye-laws is a common practice. Many of these buildings impede light and ventilation, and sometimes encase the drain. All breaches of Byelaws are reported to the Borough Engineer and the buildings inspected by a Sub-Committee, and where proved to be a nuisance their removal ordered. SCHOOLS. The Public and Elementary Schools have been inspected by the District Inspectors. Special attention is given to drains, gullies, urinals, Latrines, etc. In most of the schools the work of cleansing the sanitary conveniences is satisfactorily done. OFFENSIVE TRADES. There are two businesses situate in Langdon Crescent, Wall End, which come within the meaning of this designation. The work consists of gut scraping and ox-gut trimming. Constant attention is given by the District Inspector, and no complaints have been received. The Council were very reluctant, and rightly so, in sanctioning the establishment of the business, but the firm has proved that the business of gut scraping can be performed without being a nuisance. Speaking from experience, one can say that there are frequently more odours given off from the pan of a fried-fish shop than from what is called an offensive trade. The collection of butchers' bones and fish offal is carried out by private contractors, and in the summer months is frequently the cause of much annoyance. Fish offal is usually collected late at niight, but the bone and fat collector invariably selects a time when the maximum amount of annoyance can be caused. The nature of the work is disagreeable, and allowance should be made, but if common sense is applied to the work and suitable vans and receptacles used there is little, if any, nuisance. COMMON LODGING HOUSES. There is only one common lodging house in the Borough, situated in Albert Road, North Woolwich. It is regularly visited and on no occasion has it been necessary to serve any Notice or complain of nuisance. There is accommodation for 42 beds on the premises. 48 BAKEHOUSE, FACTORIES AND WORKSHOPS. There are 350 factories and workshops, excluding outworkers. These factories include bakehouses, laundries, blousemakers, tailors, boot-repairers, shirtmakers, artificial flower makers, etc. During the year 598 inspections have been made, including 156 factories, 84 bakehouses, and 358 out-workers. The Inspectors' attention is chiefly devoted to the ventilation of workrooms and workshops, also to sanitary appliances and accommodation. The Chief Factory Inspector has on 9 occasions informed us of irregularities in factories or workshops discovered by the Home Office Inspectors when discharging their duties and the Chief Factory Inspector has been informed of anything discovered by our Inspectors that come within his province. DAIRIES AND COWSHEDS. There are 11 registered cowsheds and 198 registered dairies in the Borough. During the year, 186 inspections have been made. The premises are usually found in a satisfactory condition. The provisions of the dairies and cowsheds regulations have been complied with. In dairies the principal cause of trouble is dirty utensils, whilst in cowsheds it is the dirty surroundings, which frequently include the milker; but in reviewing past years it is gratifying to note that there has been a decided improvement in cleanliness and purity of the milk supplied, but there yet remains much to be done. SLAUGHTERHOUSES. There are 13 slaughterhouses in the Borough. 150 inspections have been made, as compared with 320 for the previous year. This falling off is due to the fact that a particular slaughterhouse, where 188 inspections were made in 1918, was closed during the greater part of the year 1919. From this slaughterhouse important seizures of unsound and diseased meat, referred to again under the heading of Unsound Food, had been made. The provisions of the Council's byelaws, viz., limewashing and cleansing, have been carried out. 49 UNSOUND FOOD. The markets have been regularly inspected, and on 39 occasions the Inspectors have discovered food—chiefly fruit—exposed for sale in such a condition as to. justify them calling upon the responsible person to have it removed and not used for the food of man. There have been 155 consignments of unsound food surrendered for condemnation as follows:— Meat 2½ tons. Rabbits 353 Fish 52 trunks. Dates 8 cwts. Cheese 1 cwt. Potatoes 21 cwts. Sugar 21 lbs. Jam 3 cwts. Milk 384 tins. Butter 3 cwts. Apples 1 box. Tomatoes 1 railway truck. Jelly Cubes 6 boxes. Eggs 674 155 certificates have been given indicating the condition of the food when submitted for examination. Care is exercised when issuing a certificate to ascertain essential facts. The principle of surrendering unsound food for examination and condemnation is open to serious objection, as there is always the possibility of substitution, whilst on the other hand, if unsound food could not be surrendered, much of it would find its way to the market. In previous reports reference has been made to the practice of selling by sample in the wholesale markets, the purchaser not seeing the article purchased until it arrives at his premises, then to find it in such a condition as to warrant his calling in the local Inspector to pronounce upon its fitness or otherwise for human food. Had the article been examined by the market Inspector before it left his jurisdiction, much time, labour, and expense would be saved. An important seizure of a live cow was made from a slaughter-house in Whitta Road. Together with the District 50 Inspector, I visited the premises in the afternoon, when all appeared to be quiet and the gates locked. From further observation it was discovered that there was something doing, so the gates were mounted and the premises entered, when it was found that a number of carcases were hanging and some 20 live cows awaiting slaughter. One of these showed signs of tuberculosis The animal was therefore seized, condemned, and found when slaughtered to be reeking with disease. The owner and his man were prosecuted, and both heavily fined. FOOD CONTROL ORDERS. Since these Orders became operative, the Sanitary Inspectors have been charged with the responsibility of seeing their provisions carried into effect. It will be seen from the list of prosecutions on pages 53 to 55 that 44 cases have been brought into Court and 42 convictions obtained. The cases dismissed were one for w ilfully w asting food, the other an overcharge on imported meat. Of the 42 convictions 18 were in respect of contraventions of the Spirits (Prices and Description) Order, and fines including costs imposed amounted to .£227 18s. Gd. There were 8 prosecutions under the Meat (Maximum Prices) Order, and fines imposed amounted to £59. Two cases under the Live Stock (Sales) Order, fines imposed being £115. The defendant in this last case was also prosecuted under the Public Health Act for having a diseased animal on his premises and fined the maximum penalty. The other prosecutions were of a miscellaneous character. SALE OF FOOD AND DRUGS ACT. Under the provisions of this Act 330 Samples were taken for the twelve months ending 31st December, as compared with 334 for the previous year. The figures for 1919 are equal to 2.2 samples per 1,000 of the population per annum. Out of the 330 samples 28 proved upon analysis to be adulterated. This is equal to an adulteration rate of 8.5 per cent., as compared with 11.4 per cent. for the year 1918. 51 It will be seen from the following table that 240 samples of milk have been taken, of which 12, equal to 5 per cent. were adulterated, as compared with 11.3 per cent, for the previous year. This shows an improvement in this important food. Whiskey figures among the adulterated articles, and in all the cases the specific gravity was more than 50 degrees under proof, which warranted proceedings being taken under the Sale of Food and Drugs Act. Article Sampled. No. of Samples taken. No. of Adulterated Samples. Milk 240 12 Whiskey 28 11 Gin 15 2 Beer 12 — Rum 7 2 Chocolate 6 - Poultry mixture 6 - Butter 3 - Dripping 2 - Brandy 1 — Chocolate Curd 1 — Egg powder 1 - Dried Eggs 1 - Egg self-raising flour 1 — Self-raising flour 1 — Epsom Salts 1 — Fish-in-Oil 1 — Milk Pudding Powder 1 Camphorated Oil 1 Ammoniated Tincture of Quinine 1 - 52 PROSECUTIONS UNDER THE SALE OF FOOD AND DRUGS ACT FOR YEAR 1919. Date. Article. Offence. Fines. Costs. £ s. d. £ s. d. January Milk 7 per cent. added water Adjourned sine die, ownership not proved March Whisky 57 degrees under proof 10 0 0 May Camphorated Oil 65 per cent. camphor instead of 20 per cent. 1 0 0 0 10 6 May Milk Deficient in Milk Fat, 8 per cent. 1 0 0 0 10 6 May Milk 9 per cent. added water 1 0 0 0 10 6 June Milk Deficient in Milk Fat, 20 per cent. 4 per cent. added water 2 0 0 0 10 6 July Rum 51.5 degrees under proof 20 0 0 ... July Gin 54 degrees under proof 10 0 0 0 10 6 July Milk Deficient in Milk Fat, 11 per cent. 1 10 0 0 10 ft July Milk Deficient in Milk Fat, 20 per cent. 1 1 0 ... September Milk Deficient in Milk Fat, 8 9 per cent. 1 0 0 0 10 6 PROSECUTIONS UNDER THE PUBLIC HEALTH ACT. Date. Offence. Fines. Costs. £ s. d. £ s. d. November Being in possession of a diseased cow 20 0 0 to 10 0 November Aiding and abetting in above case 5 0 0 3 3 0 December Having on unlicensed premises a diseased cow 1 0 0 3 3 0 PROSECUTIONS UNDER THE CONTAGIOUS DISEASES (ANIMALS) ACT. Date. Offence. Fines. . £ s. d. £ s. d. April Moving 6 pigs without a license 1 0 0 - June Moving 33 pigs without a license 7 0 0 - 53 PROSECUTIONS UNDER THE FOOD CONTROL ORDERS FOR THE YEAR 1919. Date. Order Infringed. Offence. Fines. Costs. £ s. d. £ s. d. January Meat (Maximum Prices) Order, 1917 Selling loin of pork above maximum price 15 0 0 ... February Egg (Prices) Order 1918. Selling new laid eggs above maximum price 10 0 0 ... February Egg ((Vices) Order 1918. Selling fresh eggs above maximum price 10 0 0 ... February Egg (Prices) Order 1918. Failing to display egg price list 10 0 0 ...... February Jam and Syrup Restriction (Dealers) Order. Selling jam - not registered 2 0 0 ... March Spirits (Prices and Description) Order 1918. Selling whiskey above maximum price 9 0 0 1 1 0 March Spirits (Prices and Description) Order 1918. Selling whiskey at 57 degrees underproof 10 0 0 v April Dried Fruits Order. Selling sultanas above maximum price 5 0 0 ... April Waste of Food-Stuff Order 1918. Wilfully wasting food (milk) Dismissed. ... April Spirits (Prices and Description) Order 1918. Selling whiskey above maximum price 20 0 0 ... April Beer (Prices and Description) Order 1919. Selling beer in private bar the same not being on sale in public bar 5 0 0 ... April Spirits (Prices and Description) Order 1918. Selling rum above maximum price ... 7 10 0 ... April do. Selling whiskey above maximum price 2 10 0 ... April do. do. 10 0 0 ... April do. do. 10 0 0 0 10 6 April do. do. 5 0 0 0 10 6 May Beer (Prices and Description Order) 1919. Selling Guinness's Stout above maximum price 5 0 0 ... May Spirits (Prices and Description) Order 1918. Selling whiskey above maximum price 3 0 0 3 3 0 54 Date. Order Infringed. Offence. Fines. Costs. £ s. d. £ s. d. June Meat Retail Prices (England and Wales) Order 1918. Selling shoulder of lamb above maximum price 6 0 0 ... June do. Selling leg of lamb above maximum price 6 0 0 ... June do. Selling loin chops above maximum price 6 0 0 ... June do. Selling suet above maximum price 6 0 0 ... June do. Selling imported shoulder of mutton above maximum price 5 0 0 ... June Edible Offal (Maximum Prices) Order 1919. Selling beef (skirt) above maximum price 10 0 0 ... June do. do. 10 0 0 ... June Meat Retail Prices (England and Wales) Order 1918. Selling shoulder of mutton above maximum price 10 0 0 ... July Spirits (Prices and Description) Order 1918. Selling gin above maximnm price 15 0 0 ... July do. Selling gin above maximum price 15 0 0 ... July do. Selling gin above maximum price 10 0 0 ... July do. Selling whiskey above maximum price 10 0 0 3 3 0 July do. Selling whiskey above maximum price 10 0 0 3 3 0 October ... Dried Fruits (Retail Prices) Order 1918. Selling raisins above maximum price 2 0 0 ... October ... do. Selling currants above maximum price 2 0 0 0 10 6 October ... Canned Condensed Milk (Retail Prices) Order 1919. Selling condensed milk above maximum price 5 0 0 ... November Spirits (Prices and Description) Order 1918. Sellling rum above maximum price 8 0 0 3 3 0 November do. Selling whiskey above maximum price 10 0 0 ... November do. Selling whiskey above maximum price 10 0 0 3 3 0 November i do. Selling whiskey above maximum price 15 0 0 5 5 0 55 Date. Order Infringed. Offence. Fines. Costs. £ s. d. £ s. d. November Spirits (Prices and Description ) (Order 1918. Selling whisky above maximum price 3 0 0 November Meat Retail Prices (England and Wales) Order 1918. Selling imported meat above maximum price Case dismissed. November Rice (Retail Prices) Order 1918. Selling rice above maximum price 5 0 0 November do. Not exhibiting a notice indicating that rice was on sale at 4d. per lb 5 0 0 November Live Stock Sales Order Killing cows that had not been purchased in a market 100 0 0 31 10 0 November do. Aiding and abetting in killing cows that had not been purchased in a market 10 0 0 5 5 0 CONTAGIOUS DISEASES OF ANIMALS ACTS. The Hoard of Agriculture and Fisheries have issued many Orders during the year, principally concerning Foot and Mouth Disease and Rabies. Under the latter, the muzzling of dogs became operative in the Borough. There was a reported case of Rabies. The dog was quickly killed by the Council's Veterinary Inspector and removed for post-mortem examination', which proved negative. Under the Parasitic Mange Order, 6 cases have been notified, when the usual Notices were served and disinfecting precautions taken to arrest the spread of the disease. No case of Swine Fever has been reported during the year. Under the Swine Fever (Regulation of Movement) Order, 1908, 32 signed declarations have been received and 31 licences issued, authorising the removal of 562 pigs into the Borough and 50 fat pigs out of the Borough. INFECTIOUS DISEASES. The District Inspectors visit all cases of infectious disease notified. The sanitary arrangements of the house are examined, and where any defect is discovered or amendment required Notice served upon the person responsible and the work carried out under the Inspector's supervision. 56 Directions are given as to isolation and disinfection. A report of the case containing all the necessary particulars required by the Medical Officer of Health is prepared, and every precaution taken to prevent the spread of the disease. DISINFECTANTS. There are 4 depots in the Borough conveniently situated for distributing disinfectants to ratepayers requiring same. They are open daily, and during the year 5 tons of powder and 1,120 gallons of disinfecting fluid have been distributed. TRADE REFUSE. There have been 1,206 loads of trade refuse removed from business premises during the year. The Council remove this free of charge, providing it is placed in a suitable receptacle and deposited in a convenient position ready for collection on the day appointed. The refuse is conveyed to the Destructor Works and destroyed. HOUSE REFUSE. There have been 10,860 loads of house refuse collected during the year, as compared with 9,699 for the previous year— an increase of 1,161 loads. This is due to two reasons, viz., increase in the number of families and the poor quality of fuel. The method of collection is the weekly pail system, and from inception it has worked successfully. The Council have entered into a contract for a fleet of electric motor vans, which will displace horses and effect a considerable saving in money. The cost of collecting house refuse to-day is £79,330 per annum, which is equal to 6s. 9d. per bouse. If this is compalred with the sum spent for the same work for the year 1913 (the year before the war), viz., £74,000 or 2s. ll£d. per house per annum, a considerable increase, accounted for (by the enormous cost for horse hire, which has risen fully 300 per cent. Since the days before the war, wages of the Council's fillers, which were 32s. per week, are now 70s. per week, an increase of over 100 per cent. There may be no prospect of any immediate reduction in wages, but one is sanguine of being able to do the work with electric motor vans with more e Fciency and economy. 57 Dust Collection. Beckton and North Woolwich Ward. Central East Ward. Central West Ward. Manor Park Ward. Plashet East Ward. Plashet West Ward. Total number of Loads Collected. January 137 178 186 203 140 189 1033 February 133 171 142 204 130 139 919 March 149 178 133 242 132 141 975 April 129 181 138 205 168 149 973 May 159 192 158 201 135 149 994 June 112 141 110 172 151 115 801 July 105 143 130 185 129 140 832 August 110 144 128 149 102 102 735 September 99 151 111 171 152 103 787 October 122 179 159 196 128 144 928 November 175 194 141 159 132 138 939 December 98 170 104 260 162 150 944 Totals 1528 2025 1640 2347 1661 1659 10860 DUST BINS. During the year reports have been made to the Committee that 303 houses were without suitable dust bins. On every occasion the Committee authorised enforcement of the provisions of the East Ham Improvement Act, 1903, and Statutory Notices have been served on responsible persons to provide far those premises a suitable galvanised iron dust bin, 18 inches deep and 16 inches in diameter. These sizes may appear small, but when (the bins are full they are quite heavy enough for a man to lift from the ground and throw the contents into the van. T here is a further advantage of a small bin; it can be made of good material and cost the same to produce as a large cheap bin. Further, a large bin encourages some folks to place refuse into it that should be burned. The Council contract to be supplied with a quantity of bins (not less than 250) made to a carefully prepared specification, and these are sold to owners of property at cost price and in most cases are appreciated. PETROLEUM AND EXPLOSIVES ACTS. Licences are issued annually in respect of premises where petroleum is stored for sale and where upwards of 60 gallons are kept for private purposes. In every case the premises are inspected and the provisions of the Act insisted upon. Very few infringements are discovered. Licence holders are informed of 58 the requirements when they apply and invariably comply with them. There are some 28 licensed premises for petroleum and 57 for storage of explosives, which comprise mixed fireworks. RAT EXTERMINATION. The passing of the Rats and Mice Act, 1919, imposes the duty upon the local authority to see that the provisions are carried out. As far back as 1917 the Council entered into a contract with a professional firm of rat-catchers to carry out the work of rat destruction in certain rat-infected areas in the Borough. During the last twelve months' contract this firm destroyed 3,340 rats. The contract was renewed for a further year. In addition, the Council have men who are adept at rat catching, and they devote coniderable time to the work. Rat traps and poisons are sold to persons desiring such, and advice is always given to any enquirer. The Chief Inspector is the Rat Officer for the Borough. CINEMAS AND MUSIC HALLS. The premises licensed for music, dancing and cinema performances have been regularly inspected and special attention given to overcrowding and to the prevention of standing in passages, gangways, and staircases, and further, that the requirements of the Council's byelaws regarding doors and lights are observed. Slight infringements are usually practised at cinemas, to which the attention of the managers has been directed on a few occasions. No prosecutions have been instituted for breaches of byelaws during the year. SANITARY INSPECTORS' ANNUAL CONFERENCE. The Council appointed the Chairman of the Public Health Committee and the Chief Sanitary Inspector to attend the Annual Conference held at Birmingham in July. The Conference was presided over by Sir James Crichton-Browne, M.D., L.L.D., F.R.S., and was addressed by his Worship the Mayor of Birmingham. Subjects of great importance having an immediate bearing on the needs of the hour were considered and discussed and resolutions carried. The Conference lasted several days, and it was generally agreed to have been time profitably spant. I am, Gentlemen, Your obedient Servant, (Signed) JOSEPH G. BANKS, Chief Sanitary Inspector. 59 INDEX. A. Abatement of Nuisances 42 Abattoirs 48 Acreage 5 Acute Encephalitis Lethargica 10 Air Temperature 21 Acute Polio-myelitis 10 B. Bacteriological Laboratory 13, 19 Bakehouses 16. 48 „ Underground 16 Births 5 Still 7 Birth-rate 5 Births, Illegitimate 6 Boots of School Children 29 C. Cancer 23 Cerebro-Spinal Meningitis 10 Children, Medical Inspection of 28 Cinemas and Music Halls 58 Cleanliness of School Children 28, 31, 39 Clinic, Ante-Natal 8 Clinic, School 33,38 Clothing of School Children 29 Communicable Diseases (non- notifiable) 11 Complaints of Nuisances 43 Contagious Diseases (Animals) Act 55 Cowsheds 48 Creche 3,8 D. Dairies 48 Day Nursery 3, 8 Deafness 30 Deaths, Causes of 23 Deaths, No. of 5,6, 23 Death-rate, General 5, 6 Death-rate, Infantile 5 Deaths, Institutional 6 Deaths in Large Towns 5 Death-rate, Zymotic 5 Density of Population 5 Dentistry 31, 40 Diphtheria 10 Dirty Premises 45 Disinfection 13, 56 Drainage Work 44 E. Education Statistics 27 Encephalitis Lethargica 10 Enteric Fever 10 Erysipelas 10 Explosives Act 57 Eye Diseases of School Children 29 Rye, External Inflammation of 29 F. Factory and Workshop Act 14 Food Control (Enforcement of Orders) 50 Food and Drugs Act 50 Food Inspection 50 Food, Unsound and Diseased 49 H. Health Visitors' Visits 8 Hearing of School Children 30 Heart Diseases of School Children 30 Home Work, outworkers 15, 48 Hospital, Admissions to 24 Hospital Cost, per patient 24 House Refuse. Removal 57 House to House -Inspection 44 I. Impetigo 33 Infant Consultation 7 Infantile Mortality 5, 7 Infectious Diseases 9, 22 Infectious Diseases, non-notifiable 11 Influenza 23 Inhabited Houses, Number of 5 Inquests 6 Inspection of Borough 42, 43 L. Laboratory Work 13 Legal Proceedings 52—55 Licences, Animals 55 „ Petroleum 58 Lung Diseases of School Children 30 M. Mange, Parasitic 55 Market Places 49 Maternity and Child Welfare Maternity Home 8 Measles 10, 22 „ German 10, 22 Mental Defects of School Children 30 Mental Deficiency 11, 30 Meteorology 21 Midwives Act 9 Milk and Cream Regulations 13 Milk. Free 9 Mortuaries 46 N. Notices Served 42 Notification of Births 7 Notification of Infectious Diseases 22 Nuisances Abatement 42 Nuisances Discovered 42 Nutrition of School Children 29 O. Offensive Trades 47 Ophthalmia Neonatorum 10 Ophthalmic Report 33 Outworkers 15 Overcrowding 4 60 INDEX—rontinued. P. Passages 46 Petroleum Licences 58 Physical Training 31 Polio Myelitis 10 Population 5, 6 „ for Birth-rate 5, 6 „ for Death-rate 5 Puerperal Fever 10 Prosecutions (Food Control) 53—55 „ Public Health Act 52 (Sale of Food and Drugs Act) 52 R. Rainfall 21 Rat Extermination 58 Refuse Removal 56, 57 Ringworm 20 Roofs Leaky 45 S. Sanatorium 3 Scabies 29 Scarlet Fever 9 School Children, Boots of 29 „ Children, Defective Gloth- ing 29 „ Children Excluded 31 Children, Heart Diseases of 34 „ Children, Lung Diseases 01 30 ,, Children, Nutrition of 29 „ Children, Physical Training 32 „ Children, Skin Diseases of 29 „ Children, Teeth 31, 40 ,, Children, Verminous Conditions 31 „ Dentistry 31, 40 „ Disease of Nose and Throat 29 ,, Open-air 28 Slaughter Houses 48 Small Pox 9 Smoke Nuisances 46 Sputum Examination 19 Staff 4 Summary of Report 5 T. Table—Air Temperature 21 ,, Bacteriological Examinations 13. 19 „ Births Registered 5, 6 „ Birth-rate 5, 6 „ Birth Visiting 7 ,, Cancer 23 „ Causes of Death "23 ,, Cleansing of School Children 39 „ Clinic, Treatment at 33, 34, 35 „ Comparative Statistics 5 ,, Complaints—Nuisances 42, 43 „ Complaints Received 43 ,, Deaths 23 „ Dental Treatment 40 „ Dust Collection 57 Eye Examinations 33 „ Exclusion Forms Issued 34, 35 „ Factories and Workshops 14, 16, 48 Table—Food and Drugs Act, Legal Proceedings 52,53,54,55 „ House Refuse Collection 57 ,, Infantile Mortality 7 ,, Infectious Cases Removed to Hospital 22 „ Infectious Cases Notified 22, 33 ,, Hospital Expenses 21 ,, Hospital Establishment charges 21 „ Mental Deficiency 31 „ Meteorological Record 21 „ Notifications 22 „ Outworkers 15 „ Rainfall 21 „ Record of Inspections Inset „ School Children Excluded 34 „ School Children Defects 33, 38 ,, School Clinic Advised Cases 33, 38 „ School Clinic Results of Treatment 36, 37 „ School Cases 33 „ Statistical Data (Education) 27 „ Tuberculosis 17, 18, 19 „ Tuberculosis Hospital Patients 22 ,, Tuberculosis Notifications 22 ,, Typhoid Fever 22 „ Typhoid Fever Hospital Patients 22 „ Venereal Diseases 12 „ Verminous Condition of School Children 39 „ Vision of School Children 33 Teaching Staff 37 Teeth Decayed 31 Teeth of School Children 31 Temperature 21 Throat Affections 34, 38 Trade Refuse, Removal of 56 Tuberculosis 11 ., Treatment of 17, 19 „ Visits 20 Tuberculous Diseases 11 Tuberculous Diseases of School Children 30 Tuberculosis Dispensary 17 Typhoid Fever 10 Typhus Fever 10 U. Unsound Food 49 Urinal accommodation 45 V. Venereal Disease 11, 12 Verminous Condition of School Children 28,31,39 Vision of School Children 33 W. Water Supply 5 Whooping Cough 11 Workshops 14, 48 z. Zymotic Death-rate5