edm 25 library borough of edmonton REPORT OF THE Medical Officer of Health and School Medical Officer FOR THE YEAR 1939 BOROUGH OF EDMONTON 19 3 9 His Worship the Mayor Councillor G.T.W.Tott, J.P. Deputy Mayor Councillor Mrs E.M.Hearn. PUBLIC HEALTH COMMITTEE Chairman Alderman J. Reid Alderman Mrs M.M.Barrass. Councillors J.A.G.Beattie, L.E.Berridge, T.J.Dibbens, W.C.Handscomb, Mrs E.M.Moss, A.W.Pearce STAFF OF THE PUBLIC HEALTH DEPARTMENT Medical Officer of Health, School Medical Officer, and Supervisor for the Maternity and Child Welfare Services:- D. REGAN, B.A., B .Sc., M.B., Ch.B., D.P.H. (L'pool) Deputy Medical Officer of Health, and Deputy School M edical Officer:- I.G.McINTYRE, B.A., M.B., B.Ch., B.A.O., D.P.H. Assistant Medical Officers anfl School Medical Officers:- Hilda R.Hay, M.B., Ch.B., D.P.H., (Commenced 2nd January, 1939) Margaret F.Coveney, B.Sc., M.B., Ch.B., D.P.H., (Commenced 1st June, 1939) Senior Sanitary Inspector:%abcd W.Tillcock, M.R.San.I. District Sanitary Inspectors:%abce G.H.Huckle, %abc J. P. Far rar, %abc E.Dodsworth, %abc H.W. Grieves, %abc F.Beilby. %a M rs H.Fowler, Woman Sanitary Inspector. Chief Clerk:F.J.Nash, Cert. R. San: I. J.L.A.Saunders, Infectious Disease Clerk, A.E.Clarke, Records Clerk, D.H.J.Newman, Correspondenc<fcyLl.erk, H.J.Weldon, Junior Clerk. S.Clayton, Shops Acts Inspector, T.G.Marsden, Assistant Shops Acts Inspector,(Commenced 1st August, 1939). % Moiety paid under Public Health Act or by Exchequer Grants. a Certificated Sanitary Inspector. b Certificate of Meat and Food Inspector. c Inspector under the Petroleum Acts. d Inspector of Canal Boats. e Certificate of Smoke Inspector. PREFACE Public Health Department, Town Hall, Edmonton, N.9. His Worship the Mayor, Aldermen and Councillors of the Borough of Edmonton. Mr.Mayor, Ladies and Gentlemen, I have much pleasure in presenting my fifth Annual Report for the year 1939. But for the outbreak of war in September 1939 it would have been my pleasure to submit an Annual Report of work done in the Public Health Department which would have demonstrated that steady progress was taking place in all sections, and a notable expansion under the Maternity and Child Welfare Department. Unfortunately A.R.P. activities consequent on the declaration of war brought the whole of the medical services to a standstill; this however was only permitted for a space of three weeks, actually the whole of the Maternity Services never ceased, but realising the importance of the health services during war time I pressed forward for all the services that could be put into operation to be kept fully going. "At first many people being occupied with their own problems did not utilise these services, but after a short while everything began to move in the usual routine fashion, and it is my intention to keep every possible ordinary service of the Council going to the fullest extent. There are many comments which I would like to make on the year's work which was, up to the time of the declaration of war, one of steady progress, . but I must defer gor another occasion. I would like to mention however, that my-Junior Clerk, Mr.Herbert J.Weldon, joined His Majesty's"Forces in October 1939, and to express my appreciation for the-work which he has done since he became attached to the Department, and I look forward anxiously to his return when Peace is once more restored. Since the beginning of the war I have had to direct my energies to the establishment of the First Aid Services, and it became necessary to adjust the duties of the members of my Department in an attempt to deal with this matter, but I am afraid it will be necessary to obtain extra assistance in the near future. I desire to thank the Members of the Council for thuir kindly consideration and help under .what was an exceedingly trying-year. I would also like to extend my very best thanks to all the Members of my Staff in doing everything they could to alleviate the difficulties that arose from the very abnormal circumstances. I have the honour to be, Mr.Mayor, Ladies & Gentlemen, Your obedient Servant, D. REGAN, Medical Officer of Health. GENERAL STATISTICS Area (in acres) 3,896 Population- Census of 1921 66,809 Census of 1931 77,652 Estimated by the Registrar-General for mid-year, 1939 105,000 Number of Inhabitated Houses and Tenements at the end of 1939 25,726 Number of Inhabitated Houses and Tenemnets at the end of 1938 26,056 Rateable Yalue, April, 1939 £739,505 Estimated product of one penny in the £ for the year ending 31st March, 1940 £ 3,000 Rates in the £ for the year ending 31st March, 1940 14s. 1d SOCIAL CONDITIONS The extent of unemployment may be estimated by the following figures, relating to:- (1) The municipal milk supply to nursing mothers and young children, (2) The number of free dinners given to schoolchildren, and (3) The actual figures supplied by the Director of Public Assistance. Both (1) and (2) are given on purely economic grounds. (1) Municipal Milk Supply:- . . Number of pints granted free during 1938 153,355 " " " " 1939 154,043 (2) Number of free dinners during 1938 94,205 " " " " 1939 (to the end of August) 101,681 (3) Figures re out-relief:- Persons Amount For the year 1938:- (a) Ordinary out-relief 4,693 £46,136 (b) Unemployed out-relief 452 £ 2,658 5,145 £48,794 For the vear 1939:- (a) Ordinary out-relief 4,244 £44,450 (b) Unemployed out-relief 454 £ 2,556 4,698 £47,006 VITAI STATISTICS Grand Total LIVE BIRTHS M F Total Legitimate 843 740 1,583 Illegitimate 23 12 35 1,618 Birth-rate per 1,000 of population 15.41 STILL-BIRTHS Legitimate 34 26 60 Illegitimate 3 3 6 66 Total of live and still-bifcths 1,684 Rate per 1,000 total births 39.19 DEATHS Number 479 440 919 Rate per 1,000 population 9.02 DEATHS FROM PUERPERAL CAUSES Deaths Rate per 1,000 total (live & still) births Puerperal Sepsis 1 .59 Other Puerperal Causes 5 1.78 4 2,57 DEATH-RATE OF INFANTS UNDER ONE YEAR OF AGE Number 35 26 61 All Infants per 1,000 live births 37.7 Legitimate infants per 1,000 legitimate live births 36.6 Illegitimate infants per 1,000 illegitimate live births 85.7 Deaths from, can cer (all ages) 139 " " measles ( -do- ) nil " " whooping Sough (all ages) 2 n " diarrhoea (under 2 years of age) 2 The following causes of death are supplied by the Registrar-General and refer to deaths which were registered during the calendar year:- Causes of Death M F Total Typhoid and Para-typhoid Fevers – – – Measles – – – Scarlet Fever – – – Whooping Cough 2 – 2 Diphtheria 1 – 1 Influenza 2 7 9 Encephalitis Lethargica 2 – 2 Cerebro-spinal Fever – – – Tuberculosis of the Respiratory System 39 23 62 Other Tuberculous Diseases- 3 4 7 Syphilis 1 – 1 General Paralysis of the Insane, Tabes Dorsalis 1 1 2 Cancer, Malignant Disease 66 73 139 Diabetes 4 10 14 Cerebral Haemorrhage, etc. 24 41 65 Heart Disease 132 118 250 Aneurysm 3 – 3 Other Circulatory Diseases 22 18 40 Bronchitis 18 7 25 Pneumonia (-all forms) 34 33 67 Other Respiratory Diseases 7 6 13 Peptic Ulcer 6 4 10 Diarrhoea (under 2 years) 1 1 2 Diarrhoea (over .2 years) 1 1 2 .Appendicitis 4 4 8 Cirrhosis of Liver 1 1 2 Other Diseases..of Liver, etc. – 4 4 Other Digestive Diseases 10 8 18 Acute and Chronic Nephritis 4 8 12 Puerperal Sepsis – 1 1 Other Puerperal Causes – 3 3 Congenital Debility,Premature B irth,Malformations,etc. 21 17 38 Senility 5 6 11 Suicide• 8 4 12 Other Violence 29 11 40 Other defined diseases 27 26 53 Causes Ill-defined or Unknown 1 – 1 TOTAL DEATHS 479 440 919 The following tables give the deaths of those registered during the 52 weeks ended 30th December, 1939, sub-divided as to age groups MALES Causes of Death ALL AGES to 1 1 to 2 2 to 5 5 to 15 15 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 & over Whooping Cough 2 1 1 – – – – – – – – – Diphtheria 1 – – 1 – – – – – – – – Influenza 1 – – – – – – – 1 – – – Encephalitis Lethargica 2 – – – – – 1 – - - 1 – Tuberculosis of the Respiartory System 37 – 1 – – 8. 8 4 10 4 2 - Other T.B.Diseases 3 – – 1 1 – 1 – – – – – General Paralysis of the Insane 1 – – – – – – 1 – – – – Cancer 63 – – – – 1 – 7 13 20 16 6 Diabetes 4 – – – – – – – - 1 2 1 Cerebral Haemorrhage 22 – – – – – – 1 - 5 10 6 Heart Disease 135 – – – – 1 2 7 13 23 43 46 Aneurysm 2 – – – 1 – – – - 1 – – Other Circulatory Diseases 28 – – – – – – 1 3 5 13 6 B ronchitis 18 1 – – – – – 1 2 2 6 6 Pneumonia 37 7 2 1 – 2 2 – 2 11 4 6 Other Respiratory Diseases 9 – – – – – 1 2 3 2 1 – Peptic Ulcer 6 – – – – – – 1 - 3 1 1 Diarrhoea (2 years) 1 – – – 1 – – – - – – – Appendicitis 5 – – – 1 1 – – 2 – – 1 Cirrhosis of Liver 1 – – – – – – – - - 1 – Other Digestive Diswasos 9 1 – 1 – – – 1 2 2 2 – Acute and Chronic Nephritis 4 – – – – – 3 – - - 1 – Congenital Debility, etc., 21 21 – – – – – – - - - – Senility 5 – – – – – – – - - 2 3 Suicide 8 – – – – 1 2 – 1 3 1 – Other Violence 29 2 1 – 5 3 3 1 4 4 3 3 Other Defined Diseases 25 2 – – 1 1 2 2 3 7 5 2 479 35 5 4 10 18 25 29 59 93 114 87 FEMALES Influenza . 7 – – – – – 1 1 – 2 – 3 Tuberculosis of the Respiratory System 22 – – – – 6 7 3 5 1 – – Other T.B.Diseases 4 1 – 1 1 1 – – – – – – General Paralysis of tho Insane 1 – – – – – 1 – – – – – Caneor 75 – – – – – 1 5 15 24 20 10 Diabetes 10 – – – – – – – – 1 6 3 Cerebral Haemorrhage 43 – – – – – – 1 – 10 15 17 Heart Disease 119 – – – 1 – – 3 2 15 35 63 Other Circulatory Diseases 19 – – – – 1 – – 1 3 7 7 B ronchitis 6 1 – – – 1 – – – – – 4 Pneumonia 33 4 – – 2 2 2 3 4' 6 6 4 Other Resjjiratory Diseases 7 1 – – – – 1 – – 1 – 4 Peptic Ulcer 4 – – – – – 1 1 1 – – 1 Diarrhoea (under 2 years) 1 1 – – – – – – – – – – Diarrhoea (over 2 years) 1 – – – – – – – – – – 1 Appendicitis 4 – – – 1 1 – – 1 – – 1 Cirrhosis of Liver 1 – – – – – – – 1 – – – Other Diseases of Liver 1 – – – – – – – – – 1 – Other Digestive Diseases 8 – – – 1 2 – 1 – 1 3 – Acute and Chronic Nephritis 7 – – – – – – 1 4 – 1 1 Puerperal Sepsis 1 – – – – 1 – – – – – – Other Puerperal Causes 3 – – – – 1 1 1 – – – – Congenital Debility., etc. 17 17 – – – – – – – – – – Senility 6 – – – – – – – – – 1 5 Suicide 4 – – – – – 1 2 1 – – – Other Violence 11 1 – – – 1 – 1 – 2 2 4 Other Defined Diseases 21 – – – 4 3 3 1 3 7 3 2 441 26 – 1 10 20 19 24 38 73 100 130 There is a slight difference in respect of the causes of death between those last two tables an d the one supplied by the Registrar General who is in possession of additional information on the matter. INFANTILE MORTALITY The deaths of infants under 1 year of age were as follows:- M F Total Legitimate 33 25 58 Illegitimate 2 1 3 35 26 61 The death-rate of all infants per 1,000 live births was 37.7. A detailed sub-division of the causes etc., of these infants deaths is as follows MALES Causes of Death Under 1 week 2nd. week 3rd : week 4th week Total under 1 mth 1-3 mrfchs 3-6 mths 6-9 mths 9-12 mths Total under 1 year Whooping Cough - - - - - - 1 - - 1 Bronchitis - - - w - - 1 - - 1 Pneumonia 1 - - - 2 1 1 2 7 Violence - - - — - 1 - 1 - 2 Congenital Debility - ■ - - - - 1 - - - 1 Premature Birth 10 1 - - 11 - - - - 11 Injury at B irth 2 - - - 2 - - - - 2 Atelactasis 5 - - - 5 - - - - 5 Icterus Neonatorum - 1 1 - 2 - - - - 2 Other Causes 2 - - - 2 - 1 - 3 Totals 20 2 1 - 23 4 4 2 2 35 FEMALES Other Respiratory Diseases — _ 1 - 1 — - - - 1 Bronchitis - - - - - - 1 - - 1 Pneumonia 1 - - 1 2 1 - 4 T.B.Meningitis - - - - - - - 1 . - 1 Diarrhoea - - - - - 1 - - - 1 Congenital Malformation 1 - - - 1 - - 1 - 2 Congenital Debility - - - - - 2 - - - 2 Premature Birth 4 1 1 1 7 - - - - 7 Injury at Birth 4 - - - 4 - - - - 4 Atelactasis 1 - - - 1 - - - " r 1 Other Causes 1 - - - 1 - - 1 - 2 Totals 12 1 2 1 16 3 4 3 - 26 COMPARATIVE STATISTICS Tho Registrar-General has forwarded provisional figures relating to the Country as a whole, and to London, enabling the following comparisons to be made:- Birth-rate per 1,000 population Live Still Death-rate per .1,000 From diarrhoea etc., under 2 years births Total deaths under 1 year England and Wales 15o0 0.59 4„6 50 London 12.3 0.44 8.2 48 EDMONTON 15.4 0.62 1.2b 37.7 AN NUAL DEATH RiTE PER 1,000 OF POPULATION All Causes Measles Scarlet Fever Cough Diphtheria Influenza England and Wales 12,1 .01 .01 ,03 .05 .21 London 11.9 .00 .00 .03 .02 .18 EDMONTON 9.02 .00 .00 .01 .00 .08 The following table gives the number of births and deaths (registered) sub-divided into tho four wards of the Borough. It should be remembered that births are only of those which occurred in Edmonton and of course of Edmonton addresses; these are registered in Edmonton. Births which take place outside the Borough are not included; this fact accounts for the difference between these figures and tho# supplied by the Registrar-General. The deaths include those taking place, outside the B orough, the information being given us quarterly by the Registrar-General. Ward Births Deaths Infant Deaths Male Female Male Female Male Female Bury Street 247 200 158 132 15 13 Church Street 121 119 79 100 4 5 An gel Road 160 126 96 80 8 2 Silver Street 173 153 141 128 8 6 Vagrants – – 5 1 – – 701 598 479 441 35 26 GENERAL PROVISION OE HEALTH. SERVICES IN THK BOROUGH LABORATORY FACILITIES These are as described in previous reports. The following examinations were carried out during 1939:- Swabs for Diphtheria:- Positive Negative Total. From suspected cases 31 668 699 From contacts 7 248 255 From carriers and old cases 4 5 9 42 921 963 Sputa for the prosonce of tuborclo bacillus Present 2 Not found 28 Total 30 During the year, the following material was sent to the Clinical Research Association for bacteriological examination:- Positive Negative Total Blood for presence of Typhoid organisms – 2 2 Swabs for virulence of K.L.B. – 2 2 Urine for presence of B.Coli. 1 – 1 Swabs for presence of haemolytic streptococci 2 5 7 Vaginal swabs for presence of Gonococci 1 2 3 Designated milks arc sent to the Counties' Public Health Laboratories. The results of these examinations were;- Passed Failed Total Tuberculin Tested Milk 6 2 8 Pasteurised Milk." 2 2 The Middlesex County Council is the Authority under the Sale of Food and Drugs Acts. AMBULANCE FACILITIES The Council possesses three ambulances, housed at the Fire Brigade Station, and the following figures, kindly supplied by the Superintendent, give some idea of the work carried out during the year:- Private Cases 6,771 Accident Cases 730 Maternity Cases 173 Clinic (tonsil cases) 333 Special services 92 False alarms 3 8,102 First aid was rendered on 265 occasions, whilst the resuscitating apparatus was in use 11 times. Tho bedside apparatus for the supply of oxygen was requested by 20 patients. The total mileage of the vehicles was 41,935 miles. The Council's small bus conveys tho deaf and dumb and partially blind children to and from school, picks up a few other children in tho morning taking them to a spot to meet the guide; also conveys children to and from London railway termini in connection with convalescent home treatment. NURSING IN THE HOME This has been described in' previous reports. HOSPITALS Infectious fevers are admitted into the Enfield, Edmonton and Potters Bar Joint Isolation Hospital, situated in Enfield. Arrangements for the treatment of ear, no.se and throat disorders amongst school children arc made with the Prince of Wales's Hospital, Tottenham; ringworm is treated at, and ultra-violet light treatment given in, the North Middlesex County Hospital, Edmonton. NURSING HOMES REGISTRATION The one Maternity Homo and ono Nursing Homo wore discontinued during the year, and there is now only ono Nursing Home registered by the Council. This is kept under supervision by the Medical Officor of Health. No new applications to bo placed on tho Register woro receivod during 1939. SANITARY INSPECTION IN THE AREA Fivo District Sanitary Inspectors are engaged in the sanitary supervision of tho Borough, working under tho supervision of tho Senior Sanitary Inspector. The Woman Sanitary Inspector looks after outworkers' premises, the sanitary condition of f.- ctories where women are employed, tho investigation of notifiable infectious diseases, including tuberculosis. She also assists in the supervision of tho women's public conveniences. The Senior Sanitary Inspector supervises the work of the Borough and is Inspector under tho Canal Boats Acts. At tho outbreak of hostilities the Senior Sanitary Inspector was appointod Controlling Officor for Emergency Petrol Supplies and also Authorised Officer for Decontamination of Food. One Inspector was appointed Mortuary Superintendent, another as Ambulance Officer and a third as Billeting Officer. Tho following tabular statement gives the number and tho nature of the inspections made during the year:- Complaints 1634 Infectious Disease 342 Tuberculosis 181 House-to-houso 95 Factories with mechanical power 137 Factories without " " 60 Other premises under tho Factories Act 9 Outworkers 372 Schools 7 Offensive Trades 63 Shops and stalls 551 Shops Act (Primary) 43 Shops Act (Rc-inspoctions) 9 Smoke observations 104 Sanitary conveniences and urinals 698 Stablos 43 Piggeries 15 Gipsies 11 Potroleum 86 General Inspections 1371 Ro-inspect ions 4873 Sundry visits 1407 Cinemas and halls 24 Visits to Canal 32 A.R.P.Shelters 2001 Billots 528 INSPECTIONS OF PLACES WHERE FOOD IS PREPARED Butchers 303 Fish shops 99 Coffee shops 33 Ice cream shops 96 Dairies and milkshops 100 Slaught erhou so s 97 Bakehouses 49 Food stores (M.C.C. General Powers Act) 42 NUMBER OF NOTICES SERVED * Preliminary or Informal Noticos 1221 Statutory Noticos 241 DEFECTS REMEDIED Houses repaired, cleansed, etc. 706 D.W.Cisterns repaired, covered 8 Water fittings repaired 82 Water taken off main 1 Drains examined, tested, etc. 239 Drains cleared, trapped, repaired 215 Drains re-constructed 110 Chambers inserted 63 Chambers sealed down 31 Soil and vent pipes repaired 79 W.C's repaired, cleansed, etc. 385 Flushing cisterns repaired 106 Waste pipes repaired, etc. 120 Sinks repaired or renewed 54 Roofs repaired 537 Gutters and R.W.P's repaired 403 Yards paved or repaved 180 Scullery floors repaired 53 Spaces under floors ventilated 78 Dampness remedied 268 Floors repaired 148 Coppers and stoves repaired, etc. 247 New dustbins supplied 141 Accumulation of refuse removed 30 Nuisances from animals abated 12 Gipsies removed 1 Other nuisances abated 567 Rooms cleansed after infectious disease 2 Overcrowding abated 7 Water supply restored 2 SANITARY CONVENIENCES There are seven Public Conveniences in the Borough which arc kept under constant supervision by the Public Health Department. RATS AND MICE (DESTRUCTION) ACT, 1919 Tho Middlesex County Council is the Authority for this Borough under tho Act, which places the responsibility upon the occupier of tho premises infested, but the Rat Destruction Officer of tho County Council is always willing to give advice. The Inspectors of the Public Health Department often examine the drainage of premises where it might be possible that the infestation is due to a defect in the house drainage system. MIDDLESEX COUNTY COUNCIL (GENERAL POWERS) ACT, 1938. SECTION 71 HAWKERS> ETC. This Act crime into operation on the 1st January, 1939, tho Council together with other Local Authorities considered the adoptive Sections and put the necessary resolutions and action into being regarding Sections 70 and 71, and as regards the latter Section, up to the end of the year 87 applications had been received for registration. DISINFECTION AND DISINFESTATION Tho following table gives some idea of the work carried out:- Number of journeys to collect bedding 242 " " " " return bedding 221 Rooms disinfected after infectious disease 479 Rooms disinfected after phthisis 113 Rooms disinfected after cancer 14 Disinfostation carried out after vermin 191 Bedding,clothing,etc. disinfected after Infectious disease Number of articles 2,051 Bedding,clothing,etc. disinfected after phthisis Number of articles 455 Bedding,clothing,etc. disinfedted after other cases Number of articles 1,372 The Council distribute a disinfectant powder and fluid to residents who apply for the same at the Town Hall yard. During the year the applicants numbered 31,607. One hour daily is allowed for such distribution with the exception of Fridays and Saturdays. A Formalin Chamber is usod Tor tho disinfection of books, leather goods, etc. - articles, that would bo damaged by steam. Tho number of books and other articles thus disinfected was 602. - Nine Council houses and 182 other houses wore found to be infested, and the-total number of rooms disinfected was 389. The whole of the work is carriec out by the Department, the materials used being Block Disinfostators combined with the use of Insecticides such as Pyagra, etc. PETROLEUM (REGULATIONS) ACTS, 1928 and 1936 During the year 9 now licences and 97 renewals wore granted by the Council. The following is a list of particulars of quantities, etc., affected by those licences:- Petroleum spirit 476,726 gallons Petroleum mixtures 6,020 gallons Carbide of Calcium 1 ton 3 cwt. 78 lb. MORTUARY During the year 60 bodies wore deposited in tho Mortuary, 58 by ordor of the Coroner, and 2 for sanitary reasons. CANAL BOATS ACTS. During the year 32 visits wore paid to the canal and 17 boats were seen, but of this number none wore fitted or used as dwellings or registered under the Acts. PLACES OF PUBLIC ENTERTAImENT Twentyfour inspections of cinemas and other places of entertainment were lade in accordance with tho Circular of the Ministry of Health of 1920. Conditions were found to be generally satisfactory. FACTORY AND WORKSHOP ACTS The following work has been carried out under the Factory and Workshop Act, 1901, and the Factories Act, 1937:- 1 - INSPECTIONS FOR THE PURPOSE OF PROVISIONS AS TO HEALTH Premises Inspections Written Notices Occupiers Prosecuted Factories with mechanical power 137 12 – Factories without mechanical power 60 3 – Other premises under the Act (including works of building and engineering and construction but not including outworkers' premises) 9 – – Totals 206 15 – 2 - DEFECTS FOUND Particulars No: of defects No:of defects in respect of which prosecutions were instituted Found Remedied Referred to H.M. Inspector Want of cleanliness 19 19 – – Overcrowding – – – – Unreasonable temperature – – – – Inadequate v entilation – – – – Ineffective drainage of floors – – – – Sanitary (Insufficient – – – – Conveniences(Unsuitable or defective 20 20 – – (Not separate for sexes – – – – Other offences (not including offences relating to Home Work or offences under Seations mentioned in the Schedule to the Ministry of Health (Factories and Workshops Transfer of Powers)Order 1921, and re-enacted in the Third Schedule to the Factories Act,1937) 7 7 – – Total 46 46 – – 3 - OUTWORK IN UNWHOLESOME PREMISES Nature or Work instances Notices Served Prosecutions Wearing Apparel Making, etc. Cleaning and Washing FACTORIES AND WORKSHOPS, ETC. DEFECTS REMEDIED W.C.Walls cleansed 19 W.C.Cisterns repaired 10 Choked W.C's unstopped 4 W.C.Seats repaired or renewed 5 W.C.Flush pipes repaired 1 W.C.Doors repaired 1 Drains cleared 2 Roofs repaired 2 Workroom cleansed 1 Accumulation of refuse removed 1 SCHOOLS The exclusion of children suffering from infectious diseases and their contacts is dealt with in accordance with the Memorandum issued jointly by the Ministry of Health and the Board of Education. No schools were closed during the year on account of infectious diseases. HOUSING - HOUSING ACT, 1936 OVERCROWDING During the year certificates for permitted numbers were issued in respect of 322 dwellings. CLEARANCE AREAS A scheme was drawn up in respect of Bridport Road, but the Inquiry was not held owing to the outbreak of war. INDIVIDUAL UNFIT HOUSES During the year Demolition Orders havo been made in respect of six houses, and one being demolished. The Council re-housed the persons concerned. 1. INSPECTION OF DWELLING-HOUSES DURING TEE YEAR:- (1) (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 1117 (b) Number of inspections made for the purpose 5509 (2) (a) Number of dwelling-houses (including under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 31 (b) Number of inspections made for the purpose 38 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 8 (4) Number of dwelling-houses (exclusive of those referred to above under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 760 2. REMEDY OF DEFECTS DURING THE YEAR WITHOUT SERVICE OF FORMAL NOTICES:- Nutober of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their Officers 613 3. ACTION UNDER STATUTORY POWERS DURING THE YEAR:- A - Proceedings under Sections 9,10 and 16 of the Housing Act 1936:- (1) Number of dwelling-houses in respect of which notices were served requiring repairs 141 (2) Number of dwelling-houses which were rendered fit after service of formal notices:(a) By owners 167 (b) By Local Authority in default of owners 10 B - Proceedings under Public Health Acts:- (1) Number of dwelling-houses in respect of which notices Were served requiring defects to be remedied 33 (2) Number of dwelling-houses in which defects were remedied after service of formal notices:- (a) By owners • 34 (b) By Local Authority in default of owners 1 C - Proceedings under Sections 11 and 13 of Housing Act, 1936:- (1) Number of dwelling-houses in respect of which demolition orders were made 6 (2) Number of dwelling-houses demolished in pursuance of demolition orders 1 D - Proceedings under Section 12 of the Housing Act, 1936:- (1) Number of separate tenements or underground rooms in respect of which Closing Orders were made 3 . (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenements or rooms having been rendered fit INSPECTION . ND SUPERVISION OF FOOD MILK SUPPLY With respect to the 7Tillc (Special Designations) Order, samples of designated milks are sent to the Counties' Public Health Laboratories for bacteriological examinations; the results are tabulated previously under "Laboratory Facilities". Various licences wore granted as under:- Primary Supplement ary Pasteurised 13 6 Tuberculin Tested 12 5 Accredited - 1 25 12 Two of the above retailers are licensed to bottle Tuberculin Tested milk, and one firm is licensed to pasteurise and bottle milk on the premises; ono firm is licensed to bottle pasteurised milk on the promises. Supplementary licences are granted to milk retailers who live outside the Borough, but who sell milk in the Borough; the primary licence is granted them by the Authority of the area in which they reside. MEAT AND OTHER FOODS The foilovang carcases were examined during or shortly after slaughter:Oxen 18 Sheep and lambs 180 Pigs 101 UNSOUND FOOD The following as a list of tho food surrendered for examination and retained as unfit for human consumption:- 1 box of kippers 7 baskets of cobnuts 7 tins of corned beef 6 stone of dog fish 6 cartons of yeast ( 1j cwt ) 1 box of skate wings 6 tins of prawns 17 boxes of oranges 1497 jars of plum jam 812 jars of raspberry jam 33 bags of popcorns 35 tins of tongue 32 crates of tomatoes 22 rabbits Proceedings were taken for exposing for sale rabbits unfit for human consumption - the dealer being fined 20/- and 2 guineas costs. A prosecution for "Depositing for the purpose of Sale" twelve barrels of grapes was dismissed by the Magistrates. Once again I record the willing assistance rendered by Mr.J.E.Hill, J.P., to the Public Health Department, when orders of condemnation and destruction of foodstuffs have been sought. FOOD AND DRUGS ACT, 1938 This Act came into operation on the 1st October, 1939. The Middlesex County Council informed us that they proposed to appeal to the. Ministry of Health under Section 64- that they shall continue to be the Food & Drugs Authority for the County of Middlesex. It was decided to raise no objection to this Appeal. SHOPS ACTS The Shops Acts Inspector submits a monthly report to the Public Health Committee, and the following is a short summary, from January to September,1939:- Visits to Shops, Licensed Street Traders etc. 2,194 Contraventions 19 Proceedings were taken against 11 traders and fines were inflicted as follows:- 2 of 42/- one of 40/- 5 of 20/- one of 15/- one of 10/- & one of 5/- Following tho outbreak of war tho Inspector and his Assistant wore allocated to Food Control duties. CHEMICAL AND BACTERIOLOGICAL EXAMINATION OF FOOD The only examinations carried out by the Council are those for designated milks; these are sent to the Counties' Public Health Laboratories. The matter was discussed previously. PREVALENCE OF INFECTIOUS DISEASE MEASLES AND WHOOPING COUGH These diseases wero made compulsorily notifiable by the Measles & Whooping Regulations 1939, which came into operation in October of that year. The Regulations wore advertised throughout the Borough and a copy sent to each Registered medical practitioner practising within tho Borough. The diseases still prevail amongst young children. DIPHTHERIA The incidence of Diphtheria was greatly reduced during the year, and only one death occurred. SCARLET FEVER This disease continued to occur throughout the year in a mild form, but her again the incidence was lower than last year. There were no deaths. SMALLPOX No cases of smallpox wero notified during tho year. ENTERIC FEVER Only ono case was notified during the year. DYSENTERY Three casos were notified during the year, but no deaths occurred. IMKUNISATION AGAINST DIPHTHERIA At the beginning of tho year authority was given for tho distribution of leaflets to parents drawing attention to tho fact that the Medical Officer of Health is permitted to immunise children against diphtheria. There was a very good response, some 60C children wero immunised and 12 Schick Tests were performed. Unfortunately the outbreak of war caused a tenporary suspension of tho scheme. The Clinic is held on Saturday mornings at the Town Hall, and 3 injections of T.A.F. aro given at weekly intervals. Tho fall in tho incidence.of diphtheria noted above, was no doubt partly brought about by the success of tho immunisation scheme. PUERPERAL PYREXIA AND OPHTHALMIA NEONATORUM These aro referred to later on under tho heading of Maternity and Child Welfare. FOOD POISONING No cases were reported during the year. PNEUMONIA The number of cases of primary and influenzal pneumonia notified remains about the same DIARRHOEA AND ENTERITIS UNDER 2 YEARS OF AGE The death-rate per 1,000 live births for London as a whole was 8.2 whilst that for Edmonton was 1.23 as compared with 13.1 and 8.5 respectively last year. Tho following table gives the age incidence etc., of those suffering from notifiable diseases, excluding tuberculosis, which is dealt with separately. It must be notad that tho figures in the second column as being removod to hospital includes those already under treatment at a hospital - for instance the North Middlesex County Hospital. This remark applies more particularly to tho infections associated with parturition and include puerperal pyrexia and ophthalmia neonatorum. Disease Total No: of Cases No: remvd to Hosp: Deaths to 1 1 to 2 2 to 3 3 to 4 4 to 5 5 to 10 10 to 15 15 to 20 20 to 35 35 to 45 45 to 65 65 & over Scarlet Fever 182 174 – 1 5 12 11 17 88 17 13 14 2 2 – Diphtheria 49 47 1 – – 3 3 4 24 10 2 3 – – – Enteric Fever 1 1 – – – – – – 1 – - – _ – – – Puerperal Pyrexia 102 98 4 – – – – – – – 4 85 13 – – Pneumonia 66 23 67 – 5 2 2 2 6 6 5 10 7 17 4 Erysipelas 36 13 – – – – – – 1 1 2 9 8 11 4 Ophthalmia Neonatorum 19 19 – 19 – – – – – – – – – – – Dysentery 3 3 – – 1 1 – – – – – 1 – – – Whooping Cough 24 14 2 7 4 4 1 3 5 – – – – – – Measles 2 1 – – – 1 – – 1 – – – – – – Cerebrospinal. Fever 3 3 – 1 – 1 – – 1 – – – – – – The following tables indicates the wards from which the various cases were notified:- Disease B ury Street Ward Church Street Ward Angel Road Ward Silver Street Ward N.Mddx, C.Hosp: Other Instns : Total Scarlet Fever 43 27 42 63 7 – 182 Diphtheria 8 8 12 20 1 – 49 Enteric Fever – – – – 1 – 1 Fuerperal Pyrexia 9 3 10 16 64 – 102 Pneumonia 23 13 21 9 - – 66 Erysipelas 16 4 2 12 2 – 36 Ophthalmia Neonatorum 3 – - 2 14 – 19 Dysentery – – 1 – 2 – 3 Whooping Cough 10 3 4 7 – – 24 Measles 1 – - 1 – – 2 Cerebrospinal Fever 1 1 1 – – – 3 CANCER The incidence of Cancer relative to the various organs of the body is given as under:- Males Females Respiratory 10 5 Genital Organs (female) – 3 Genito-urinary (male) 12 – Breast 1 14 Digestive organs and peritoneum 31 34 Uterus – 10 Buccal cavity and pharynx 3 2 Skin • – 1 Other organs 6 6 53 75 PREVENTION OF BLINDNESS Cases of ophthalmia neonatorum aro promptly visited and, if thought necessary, are removed to St.Margaret's Hospital for treatment. No cases of blindness have arisen during; the year due to this cause. As provided by Section 176 (1) of the Public Health Act, 1936, arrangements have now been entered into with the Middlesex County Council for the treatment at the school clinics of adolescents who are ascertained at schools to be suffering from defective vision. ORTHOPAEDIC SCHEME I am happy to report a further development in the Public Health Service. This was the inauguration of a scheme for orthopaedic treatment for children after leaving school in cases where they are found whilst at school to be needing such treatment. The scheme to include supervision, massage, exercise, operative treatment in hospital and the provision of surgical appliances where such provision forms part of the hospital treatment. The Ministry of Health stated that the scheme would be covered by Section 181 of the Public Health Act,1936, furthermore, the Middlesex County Council stated they had no objection to the scheme. MUNICIPAL FOOT CLINIC Another step further was taken in the year by the decision to establish a Municipal Foot Clinic in the Borough at the Weir Hall Maternity & Child Welfare Clinic. The premises were adapted for the purpose but unfortunately before the clinic could be put into operation the war broke out. TUBERCULOSIS ' • The following table gives details as to age and sex of new cases of tuberculosis, also deaths from the.disease; this latter figure including the deaths of non-notified cases:- Age periods New Cases Deaths Respiratory Non-respiratory Respiratory Non-respiratory Male Female . Male Female Male Female Male Female Under 1 year – – – 1 – – – 1 1 - 5 years 1 – 2 3 1 – 1 1 5-15 " – 1 4 2 – – 1 1 15 - 25 " 9 21 3 3 8 6 – 1 25 - 35 " 16 9 2 – 8 7 1 – 35 - 45 " 9 8 1 1 4 3 – – 45 - 55 „ 7 1 1 1 10 5 – – 55 - 65 " 4 – – – 4 1 – – 65 years upwards 1 1 – – 2 – – – Totals 47 41 13 11 37 22 3 4 In addition, 25 cases of pulmonary tuberculosis and 3 cases of nonpulmonary tuberculosis previously notified in other areas, moved into Edmonton. Tho total number of names thus added to the-Register during the year, excluding of course, non-notified deaths, was:- Males Females Now cases - Respiratory 47 41 Non-respiratory 13 11 Transferred cases - Respiratory 8 17 Non-respiratory – 3 68 72 The cases dying of tuberculosis and not previously notified were:- Ualsg Females Respiratory 2 Non-respiratory 2 1 There were thus 5 non-notified deaths out ot a total of 69 persons registered as dying of tuberculosis (Registerar*s figures). Regarding the non-notification of tho above cases, there vras no suggestion of wilful neglect or of refusal to notify. The non-respiratory forms of tuberculosis notified were:- Males Females Spine 1 1 Other bones and joints 2 2 Meningeal 1 3 Glands 4 2 Abdomen – 2 Kidney 3 1 Testis 2 – The Public Health (Prevention of Tuberculosis) Regulations, 1925, relate to tuberculous employees in the milk trade; whilst Section 172 of the Public Health Act, 1936, gives power to the Local Authority to remove to hospital certain cases of tuberculosis which are dangerous to other people No occasion during the year had occurred in which it has been necessary to invoke these powers. PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1930 The number of cases of tuberculosis on the Register at the end of 1939 was:- Males Females Total Pulmonary forms 273 225 498 Non-pulmonary forms 84 76 160 357 301 658 The corresponding figures at the end of 1938 were:- Males Females Total Pulmonary forms 285 225 510 Non-pulmonary forms 78 72 150 363 297 660 Corresponding figures for previous years were:- Males Females Total 1937 336 260 596 1936 315 252 567 1935 330 265 595 1934 339 281 620 1933 320 281 601 1932 363 284 647 1931 382 311 693 1930 381 311 692 1929 421 352 773 COUNCIL'S EMPLOYEES During 1939 tho Medical Officer of Health paid a total number of 100 visits to those employees who had been onbthe sick list longer than a fortnight and, when necessary, at fortnightly intervals. Of these 12 were "not at home" and one had already resumed duty. Also, during the year, 35 persons were examined prior to their appointment to permanent posts. MATERNITY .AND CHILD VJELFARE COMMITTEE. Chairman- Councillor C. G. JLACEY, G.T.W.Tott., J.P.(Mayor); Mrs.E.M.Hearn (Deputy Mayer): Aldermen Mrs,M.M.Barrass; Mrs.E.A.Young, Councillors - L.E.Berridge; J.A.Beattie; Mrs.E.M.Mo,ss;. A.W.Pearce; J .A.Ward, STAFF D. Regan, B.A., B.Sc., M.B., Ch.B., B.A.G., D.P.H.(L'pool). I.HcIntyre, B.A., M.B., B.Ch., B.A.O., D.P.H., Deputy Medical Officer of Health and Deputy S.choel Medical Officer. Mrs. G.F.Fleetwood-Outrnm, M.B., Ch.B. (Glas), Medical Officer, Maternity and Child Welfare. Retired April, 1939. H. R. Hay, M.B., Ch.B.(Edin), D.P.II., Assistant Medical Officer. M. F. Coveney, B.Sc., N.U.I., M.B., Ch.B.(Sheff)., D.P,H.(Eng)., Assistant Medical Offic r of Health. Commenced June, 1939. H. J. Seddon, F.R.C.S (Eng)., Orthopaedic Surgeon. R. Leslie Dodds, F.R.C.S., Consulting Accoucheur. E. Underbill, L.D.S., R.C.S., Dentist. HEALTH VISITOR SCHOOL NURSES (Combined Service) abde Miss A. Bintcliffe - Lady Superintendent, Health Visitor School Nurses. de Miss A. Naylor bed Miss J. Peterson. d Mrs. C. Boothby bd Miss H. Druce. bed Miss M.R. Hazelton bed Miss R. Bullock. aca Miss J. Anderson bed Miss M. E. Bishop. bed Miss V. Garrett. bed Miss B. F. Lister (Commenced June,1939), c Miss A. F-hy (School Work only). Mrs. C. Tonkin (School Work only)» MASSEUSE. Miss . F. Cozens-Walker, Chartered Masseuse, Orthopaedic Clinic (Part-time). Municipal midwives cdf Mrs. 1. K. M. Wingrove - Non-Medical Supervisor of lidv/ives (Commenced June. 1939). cd Mrs. D.S.C. Gazzard cd Miss A.G. aakor (Commenced June, 1939) d Mrs. S.M.Sims (Retired June 1939) cd Miss A. L. Gov# (Commenced Feb, 1939), d Mrs. A.J.Griffiths cd Miss K.M.James (Commenced March, 1939) cd Miss D.L.N.Noakes cd Miss D.M.Lewis (Commenced Rune,1939) cd Mrs. , „M.Burton (temporary) cd Miss V. Urnmen (temporary). a Maternity and Child Welfare Certificate. b New Health Visitors' Certificate. c State Registered Nurse. d State Certified Midwife. e jSanitary Inspector's Certificate, f Teacher's Certificate of Midwifery. CLERICAL Miss R« Saunders Senior Clerk. Miss N. A. Eyres 1st Assistant. Miss C. Churchley 2nd Assistant. Miss E. Slater 3rd Assistant. Miss I. Wilkins 4th Assistant. DAY NURSERY (on 51.12.59). cd Hiss W. J. Vigar - Matron. g Miss E* A. Weller - Staff Nurse. g Miss J. N. Coryn - Assistant Nurse. g Miss M. E. Noel - Assistant Nurse. Probationers - Miss B. Howell, Miss N. Bright. c State Registered Nurse. d State Registered Midwife. g Certificate of Day Nursery Training. The following information gives details of the Maternity and Child Welfare Clinics at the end of 1959:- (1) Ante-Natal Clinic at Brookfield House, Eore Street (adjoining the 'Town Hall Five sessions weekly. (2) Child Welfare Centre:- (a) At Brookfield House. Four sessions weekly. (b) St. Stephen's Church Hall, Bush Hill Park. One session weekly. Ft. Alphege Church Hall, St. John's Church Hall and Weir Hall Clinics closed at the outbreak of the War. (3) Post-Natal Clinic at Brookfield House. One session weakly. (4) Dental Clinic at Pymmes Park School Clinic, Two sessions weekly. (5) Orthopaedic Clinic at Methodist Central Hall, Fore Street. Two sessions weekly. (6) Obstetric Surgeon attends once a fortnight at Brookfield House. FOREWORD - 1939. The year 1939 dawned with every prospect of many of the chorished dreams of the Maternity and Child Welfare Committee becoming materialised. The shortage of suitable buildings for this Service had long been a very real problem, and schemes were being put into operation for the building of the Forest Road Clinic, the conversion or re-building of Ridge House for Clinic purposes, and the all important question of a New Day Nursery, But for the outbreak of the War these plans would have been well advanced by the end of 1939, and filled a very real need in the district. Moreover, the entire Service was in a healthy condition, shewing progress and expansion in every direction. The Staff of the Health Visiting Service was extended by the appointment of an additional Health Visitor, and changes wore made in the Medical Staff. The Midwifery Service has made excellent advancement and early in the year the Staff was further augmented, and there are now 9 midlives employed by the Council, namely 7 on the permanent staff and 2 in a temporary capacity. Furthermore, the Council appointed a Non-Medical Supervisor of Midwives and Mrs. Wingrove commenced her duties on June 5th, 1939, having been appointed to this position. At the end of June the midwives took over the work of the AnteNatal Clinics hitherto carried out by the Health Visiting Staff, and the midwives are now in close contact with their cases during the whole period of pregnancy. The scheme of Ante—Natal co-operation with the North Middlesex County Hospital continued to be of a satisfactory nature, and the women attended the Council's Clinics for supervision prior to their admission to hospital for confinements. In spite of the War period the attendances at the Ante-Natal Clinics increased from 3,801 in 1938 co 5,271 in 1939. With the outbreak of the war a certain amount of dislocation took place in the Clinic services. The Ante-Natal Clinic sessions remained open, but the work was made very difficult in the early weeks, chiefly on account of the decision of most of the Maternity Hospitals to restrict very severely the number of women admitted to their Wards. This meant that the women were faced with many new problems and required special help and advice. After a short period of about 2 weeks, the Infant Welfare Centres and other essential services re-opened and resumed their normal functions. the Weir Hall Clinic and St. John's Church Hall were taken over by the Civil Defence Autherities, and the St. Alphege Church Hall had to be closed for a short period, and these; sessions were concentrated at the Brookfiela House Centre. The St. Stephen's Church Hall Centre was temporarily closed as well, but had re-opened before the end of 1939, and it is hoped to re-open St. Alphage Church Hall early on 1940. Four of the Nursing Staff were transferred to areas where children had been evacuated, and were responsible for the well-being not only of the school children, but of expectant mothers and children under 5 years of age. Other members of the Nursing Staff assisted in First Aid duties at local Posts for a time. the Day Nursery was evacuated on September 1st to the Colchester area through the Government's Evacuation Scheme- some of the children were billeted at Colchester, others at Groat Horkesley and a third party at Pebmarsh; th. Staff being di tributed in the three areas. The system of billeting nursery parties was found to be unsatisfactory, as it created many problems which were unsolvable. At the end of the year premises wore requisitioned by the Government and arrangements have been made for the children to be transferred to "Foxes", Ramsden Heath, Essex on January 6th, and they should derive much benefit from the country surroundings. The house being of a modern type, is in every way suitable for a Nursery, and further children will be sent as and. when vacancies occur., Under the Government's Evacuation Scheme expectant mothers were also given the opportunity of leaving th Edmonton, area, and a large number of women availed themselves of this arrangement. Mothers from the eighth month of pregnancy ware sent in the care of the Council's Municipal Midwives, and two of the midwives remained in the areas, namely Ongar and Bedford until November, when they returned to their normal duties. The Evacuation Scheme continues in operation but mothers car. now be sent away at the eighth month of pregnancy only. At the request of the Ministry of Health arrangements are being made for the Bay Nursery premises in Fore Street to be equipped as a Refuge for young children who become separated from their parents or guardians after air raids, and the Health Visiting Staff are to assist with this work, under the direction of the Lady Superintendent;. The under-mentioned information will give some small indication only of the work carried out by the Department during the year 1939:- BIRTHS. The total number of births notified during 1939 was as follows:Live births notified by midwives 2,245 " " " " doctors and parents, 213 Stillbirths notified by midwives 121 " " doctors 9 2,589 These figures include births which have taken place in the North Middlesex County Hospital, both of Edmonton and Non-Edmonton residents; excluding these latter the notified births of Edmonton residents are:-- Live births notified by midwives 1,098 " " " " doctors and parents 211 Stillbirths notified by midwives 41 " " " doctors 9 1,359 Number of live Edmonton babies born in outlying Institutions - 268 The following table includes births of Edmonton residents and registered in other districts:- Male. Female. Total. Live Births 853 734 1,587 Stillbirths 29 29 58 882 763 1,645 VISITS PAID BY THE HEALTH VISITORS. The following table gives details as to the visits paid by the Health Visitors:- To expectant Mothers. First visits. Total visits 561 716 To children under 1 year of age First visits Total visits 1,630 8,415 To children between 1 & 5 years t 9,376 Infant Protection visits to children 5 - 9 years. 80 18,587 ANTE-NATAL CLINIC. This Clinic was held five times weekly, and the following are the figures for the year:- Total number of sessions in the year 215 Number of prospective mothers 1,241 (x) Total number of attendances 5,271 Number of consultations 4,927 Average number of attendances:- (1) per session 24.51 (2) For consultations 22.91 (X) Included in this total are 357 cases referred from the North Middlesex County Hospital under the scheme of co-operation with that hospital. POST-NATAL CLINIC. This Clinic is held once weekly and the following are the figures for the year:- Number of Sessions 48 Actual number of mothers who attended 372 Number of consultations 587 Average attendance per session 13.25 Total attendances at Clinic 636 SPECIALISTS' CLINIC. The Consulting Specialist made 26 visits during the year and saw 165 cases, making an average of 6.34 per session. CHILD WELFARE CLINICS The figures relating to attendances are:- Brookfield House. St. Stephens. St. ALphege's. St. Johns. Weir Hall. Number of sessions 183 35 68 34 69 New Cases:(a) Under 1 year 604 117 186 89 173 (b) 1-5 years 196 37 68 27 122 Attendances:(a) Under 1 year 9,226 1,605 3,431 1,432 3,747 (b) 1-5 years 9,300 704 3,078 1,301 3,207 Total attendances 18,526 2,309 6,509 2,733 6,954 Doctor's consultations 4,067 555 1,347 651 1,318 Average at tendances 101.23 65.97 95.72 80.38 100.78 ORTHOPAEDIC CLINIC. The Clinic is held twice weekly and the following are the figures for the year - Number of sessions 88 New cases referred during 1939 123 Attendances:- Surgeon's days. 277 Treatment days 811 Total attendances 1,088 In-patient Treatment. One child was admitted to Stanmore during 1939, and was there for a period of six weeks. Three children who were sent to Stanmore during 1938 were still away in part of 1939. One child was admitted to St. Michaels Hospital, Clacton and was still there at the beginning of 1940. DENIAL CLINIC. Details of the work carried out are:- Mothers. Children. Number of attendances. 806 340 Total number treated 774 327 Fillings 108 6 Dressings 24 487 Scalings 40 2 DENTAL CLINIC Contd. Mothers. Children. Extractions (No. of teeth). (a) Under Gas. 1,231 430 (b) Local Anaesthetic 23 1 Number of Gas Cases 407 190 Dentures. Number supplied - 49 of whom 15 were assisted by Committee. MUNICIPAL MILK SUPPLY. Number of applications. 1,700. Number of renewals 2,043. Number of recipients. 3,454. Number of pints granted free 154,043 Actual number of people who applied for milk 896 Number of expectant mothers who applied for milk 291 DETAILS REGARDING FREE SUPPLIES OF DRIED FOODS, COD LIVER OIL, ETC. Trufood 1,859 tins. Lactogen 14 packets. Cow and Gate 457 packets. Ostermilk 208 tins. Bemax 13 Cartons. Cod Liver Oil and Malt 3,221 Cartons. Pure Cod Liver Oil 477 bottles. Numol 859 Cartons. Halycalcyne 68 bottles. Ferrofax 73 bottles. Farex 58 packets. Grimsby Emulsion 427 bottles. Glucose 603 packets. CONVALESCENT CASES. Number of mothers sent. 1 Number of mothers who took babies with them 6 Children Number sent away through I.C.A.A. 8 TONSILS AND ADENOIDS. The numbers treated during the year were - 13. HOME HELPS. Number of cases where Home Helps were sent - 87. INFECTI0US ILLNESSES. Ophthalmia Neonatorum Nineteen cases were notified during the year and of this number 16 cases were in North Middlesex County Hospital, 3 of which were Edmonton cases. Puerperal Pyrexia. 102 cases were notified during the year and of this number 82 were notified from North Middlesex County Hospital of which 23 were Edmonton cases. Out of the.20 remaining Edmonton mothers, 9 were sent to Queen Charlotte's Hospital, one to the Enfield and Edmonton Joint Isolation Hospital, and all of them made a complete recovery. MIDWIFERY AND MATERNITY SERVICES. The number of claims made by doctors for medical a id during the year 1939 was - 232. MUNICIPAL. MIDWIFERY SERVICE. The following gives information as to the actual bookings for 1939:- Number of women who booked during 1939 735 Less bookings cancelled for various reasons, e.g. admitted to hospital, left district etc. 82 703 Of this number 134 were granted the,services of a midwife free of charge, the women having made application for assistance from the Council. A total of 546 confinements were carried out by the Municipal Midwives, namely 509 as midwives and 37 as maternity nurses, ANTE-NATAL SCHEME OF CO-OPERATION BETWEEN THE COUNCIL AND THE MIDDLESEX COUNTY COUNCIL. Under an arrangement with the Middlesex County Council the Health Visitors visited 235 homes during the year where women had applied to the North Middlesex County Hospital for admission and the Authorities desired to have a report on the home circumstances. 357 women were referred to the Council's Ante-Natal Clinics for attendance for routine supervision purposes prior to their confinements, CHILDREN UNDER 5 YEARS OF AGE DISCHARGED FROM THE NORTH MIDDLESEX COUNTY HOSPITAL. 46 visits were paid to children under 5 years of age who had been discharged from the North Middlesex County Hospital, and it was necessary for them to remain under supervision. DAY NURSERY. The following figures give details of the attendances at the Day Nursery for the year until its evacuation on September 1st, 1939. Whole day 4,841. Half-day(Saturdays) 382 Resident children admitted during the year. 16 INFANT LIFE PROTECTION. Each of the Health Visitors employed by the Council is an Officer for Infant Life Protection, and great care is taken by them in supervising this part of the work. A considerable amount of time and trouble is taken in order to be satisfied in all cases. The number of persons on the register at the end of 1939 was 37, and the number of children 39. STERILISED MATERNITY OUTFITS. 80 mothers applied for Sterilised Maternity Outfits during the year, and of this number 61 came within the Committee's scale and the outfits were granted free of charge. BIRTH CONTROL. There is no Birth Control Clinic in Edmonton but an arrangement has been made to send Edmonton women to the Royal Free Hospital, at a cost of 7/6 for two consultations. Only women coming within the meaning of the Ministry of Health's circular 1408 may be referred by the Medical Officer to the Hospital. 14 patients were referred during 1939, but the Clinic closed on the outbreak of War, and had not re-opened by the end of the year. BOROUGH OF EDMONTON EDUCATION COMMITTEE 1939 Chairman: Alderman T. Ho Harington, J.P. Vice-Chairman; Councillor Mrs. F. Long. His Worship the Mayor; Cr. G. T. W. Tott, J.P. ALDERMEN Mrs. M. M. Barrass. Mrs. E. A. Young. W. F. Middleton. W. Preye. J. fleid. A. J. Hollywood. COUNCILLORS Mrs. E. M. Hearn. Mrs. E. M. Moss. Mrs. H. Nicholson. G. E. Albon. W. Bales. W. A. Edmunds. T. H. Joyce. C. E. Lacey. Whole-Time Medical Staff. D. REGAN, B.A., B.Sc., M.B., Ch.B., B.A.0., D.P.H. (L'pool), School Medical Officer, Medical Officer of Health and Supervisor of Maternity Services. I. G. McINTYRE, B.A., M.B., B.Ch., B.A.O., D.P.H. Deputy School Medical Officer and Deputy Medical Officer of Health. Mrs. M. E. DALBY, M.B., B.S., (Lond.), D.P.H., Assistant School Medical Officer. H. R. HAY, M.B., ChoB., D.P.H., Assistant School Medical Officer and Assistant Medical Officer of Health (Commenced 1.1.39°) M. F. COVENEY, M.B., Ch.B., B.Sc., D.P.H., Assistant School Medical Officer and Assistant Medical Officer of Health. (Commenced 1.6.390 • Whole-Time Dentists. J. F. ARDOUIN, L.D.S., R.C.S., Senior Dentist. E. UNDERBILL, L.D.S., R.C.S., Assistant Dentist. F. H. S. WEISS, L.D.S., R.C.S., Assistant Dentist. Consultants. H. J. SEDDON, F.R.C.S. (Eng.), Orthopaedic Surgeon. Miss L. M. SMITH-CLARK, M.B., Ch.B., Ophthalmic Surgeon. J. BROWNING ALEXANDER, M.R.C.P., Rheumatic Specialist. W. IBBOTSON, F.R.C.S., Aural Specialist. Part-Time Staff. E. H. S. BEBB, M.R.C.S., L.R.C.P., Anaesthetist. Miss M. F. COZENS-WALKER, Chartered Masseuse. Miss B, N. OLDREY, M.S.S.T., Speech Therapist. School Nurses and Health Visitors. Miss A. BINTCLIFFE, Lady Superintendent. Miss A. NAYLOR. -1- School Nurses ana Health Visitors (Cont) Mrs. C. BOOTHBY. Mrs. C. TONKIN. Miss M. R. HAZELTON. Miss A. FAHY. Miss J. ANDERSON. Miss V. GARRETT. Miss J. PATERSON. Miss M. DRUCE. Miss R. BULLOCK. Miss M. E. BISHOP. Miss B. LISTER (Commenced 1.6.39). Dental Attendants. Miss O. BROOKS. Miss C. E. STANBRIDGE. Miss A. E. CHAPLIN, (Resigned. 30th June, 1939). Clerical Staff, B. R. ALLEN, School Medical Clerk. Miss C. D. R. L0GSD0N, Clerk. Miss B. E. T. CROSS, Clerk. H. A. CARLESS, Clerk. S. E. WOODRUFFE, Clerk. To the Chairman and Members of the Education Committee. Ladies and Gentlemen, I beg to submit my fifth Annual Report of the work of the School Medical Services during the year 1939. In accordance with special instructions issued by the Board of Education in form 6.M. it has been found advisable bo contract as far as possible the extent of the text and tables as a war economy ana to concentrate on changes caused by the war in the School Medical Staff and in the special services. In the year 1959 a big step forward was taken in the School Medical Services as there were a sufficient number of Assistant nodical Officers to carry out the necessary number of routine medical and special inspections. It was always possible to have a doctor present at each Minor Ailments session. A very necessary factor in Edmonton. On the outbreak of war in September, 1939 a more or less complete disorganisation of the School Medical Service occurred owing to the immediate evacuation of a large proportion of the school population and the closure of the schools but in spite of such difficulties the services were maintained. One Assistant Medical Officer and four Health Visitors were sent to care for school children in the Reception Areas and to carry out routine medical inspections and other services as were required of them. With the gradual return of many of the school children to Edmonton the services became augmented and can be said that no school child in Edmonton,to my knowledge,suffered any detriment because of lack of service. Because of evacuation parents and others now realize a nd appreciate the very high standard of service that is maintained in the School Medical Department. It is to be hoped that no matter what difficulties present themselves, the same high standard of Medical Service will be maintained in all Departments. I should also like to include in this report my very deep appreciation of the Head Teachers and Teachers for their willing help in all our schemes and I am certain that, without their aid, it would not be possible to keep up the measure of success which has been attained. I should also like to record my most grateful thanks to the Chairman and Members of the Education Committee for the very real interests they displayed in the School Medical Services and their unfailing sympathy with my schemes. 2 I wish also to acknowledge the loyal co-operation of my entire staff ana the willing sacrifice they displayed on the outbreak of war. I have the honour to remain, Your obedient Servant, D. Regan. School Medical Officer. 1- STAFF. Dr. Hilda R. Hay commenced duties as Assistant School Medical Officer on January 1st and Dr. M.F. Coveney on the 1st June, 1939. Mr. F. H. Weiss, assistant Dentist was called to the colours on the out-break of War. Miss Lister, School Nurse/Health Visitor commenced duties on the 1st June, 1939. 2. CO-ORDINATION. The amount of co-rdination between the School Medical, Public Health and Maternity and Child Welfare Departments showed a furtherimprovement in 1939. A gratifying increase in the co-ordination between the local practitioners and the School medical Service was noted, notably in the case of the special services. Very close co-operation continues to exist between the Education Office and the teaching staff and the School Medical Services which leads to smooth working and more satisfactory results. 3. SCHOOL HYGIENE. Arrangements are the same as in previous years. 4. MEDICAL INSPECTION, The number of children fully examined in the routine inspection of each group during 1939 was 3,046 and these were analysed as follows Entrants. 1473 Second Age Group. 52 Third Age Group. 1271 Total 2796 Number of Other Routine Inspections. 250 Grand Total 3046 These figures represent the first seven months of 1939. The Schools did not re-open after the Summer Holidays on account of hostilities . 5. FINDINGS OF MEDICAL INSPECTION. (a) Malnutrition. The following is the classification of the nutrition of children inspected during the year 1939 in the routine age groups. Total A B c D Entrants. 1473 500 878 92 3 Second Age Group. 52 16 32 3 1 Third Age Group. 1271 473 689 96 8 Other Routine Insps. 250 10 192. 42 6 3046 1004 1791 233 18 -3- (b) Cleanliness. Arrangements were conducted on the same lines as in previous years. (c) Minor Ailments and Diseases of the Skin. The attendances at the Minor Ailments Clinics for the year 1939 were as follows Pymmes Park Clinic. 13,567 Croyland Road Clinic. 11,545 (d) Visual Defects and External Eye Diseases. During 1939 the Ophthalnic Clinic continued to be conducteders in the previous year (e) Nose & Throat Defects and (f) Ear Diseases ana Defective Hearing. The Special Clinic for the treatment of these defects continue under the care of Mr. William Ibbotson, ana in addition to his monthly sessions, an Assistant Medical Officer held weekly clinics to keep in touch with the patients and to see that recommendations were being carried out. Seventy-seven new cases and 87 old cases were examined during the year, and the total at tendance was 372. Twenty-four cases were discharged as cured, and 12 cases were traced by the Health Visitors as having left school, or the Borough, during the year. These arrangements lapsed temporarily with the evacuation which followed the outbreak of war, but were resumed at the end of the year. Of the 164 children who attended the Clinic, 59 were found by the Surgeon to be unhealthy in both nose ana throat, 45 to have disease, or defect, only of the nose, including the nasal sinuses, and 11 to have only diseased tonsils. Although only 32 complained of deafness, the Surgeon discovered 104 of the total attenders to be suffering from some defect, or active disease of the ears. Speech defects were present in 24 cases who were then referred to the Special Speech Clinic. Miss Oldrey, the Speech Therapist, has submitted the following report:- "In January, 1939 there were 32 children receiving treatment in the Speech Clinic ana 100 on the waiting list. During the year there have been 66 new cases, making a total of 198 on the books for 1939 or 230 since the Clinic as opened in September 1937. Of the 198, 63 are on the register for present treatment; (27 are receiving this, the remainder being, presumably, evacuees) 32 have been discharged cured; 83 are on the waiting list and 20 have had their names removed for various reasons such as "left the district," refused treatment" etc. etc. In view of the fact that there 100 cases awating treatment in January (some of whom had been on the books for over a year) it was decided to open a fourth session in each week ana one of the sessions was devoted tosevere cases needing more individual treatment than is usually given. Between January and Easter 61 children received treatment.; and between Easter adn July this number was increased to 7l. By the end of July 30 cases had been discharged cured. The clinic was reopened on the l3th November for two sessions per week and since that date 29 children have received treatment of whom 2 have been discharged. As the September to December period is the longest it is reasonable to suppose that, had the work of the clinic not been disturbed by War conditions, the total number of discharges for the year would have reached 50. It is however, encouraging to note that, in spite of difficulties, there are at present 83 cases on the waiting list compared with 100 a year ago" COMPARISONS. 1938 1939 New Cases. 61 66 Received Treatment. 52 85 Discharges 20 32 Waiting List,, 100 83 _4_ The recommendations on the 77 new eases were as follows:- Tonsillectomy and/or adenoidectomy in 30 cases; tonsillectomy alone 4 cases: mastoid drainage in 5 cases definitely, and to be considered in 2 cases; myringotomy 1 case; eustachian catheterisation 7 cases; nasal sinusotomy to be considered in 4 cases, and to be carried out in one case. The operative treatment was carried out, as before, in the Prince of Wales's General Hospital and 35 children returned to the clinic for after care. In audition, convalescent home treatment with a course of UltraViolet Light was recommended in 9 cases, and local treatment to the nose and ears was advised, in the majority of cases and carried out under the Education Authorities arrangements-. (g) Dental Defects. Edmonton is still far from being "dental conscious, "although up hill work is done by the entire School Medical Staff to encourage more regular attendance at the Dental Clinics. The dental scheme continued on the same lines as in 1938 until the outbreak of war, when work was temporarily suspended. It was resmued almost at once at the Pymmes Park Clinic (h) Orthopaedic and Postural Defects. This Special Clinic cortinued to run in the most satisfactory manner, with the Consulting Surgeon attending one session per month, and the Masseuse holding four sessions weekly. On the outbreak of war the Surgeon was unable to attend on account of war duties, but the clinic was continued under the care of the Masseuse. The number of cases attending showed a relative increase during the year, and the total attendances were notably increased. New cases numbered 293. The total attendances were as follows 1537 BOYS and 1930 GIRLS - a total of 3467. (i) Heart Diseases and Rheumatism. No change took place in the arrangements of this clinic during 1939° Dr. Browning Alexander attending on the third Thursday of each month and one of the Assistant Medical Officer seeing cases weekly in the interval. The total attendances for the first 3 months ofl939 were 521, and of the 175 individual crises, 62 were discharged, or left school, or removed from the Borough during the war. It was noted that only a negligible proportion ore irregular in attendance. Although the majority of the cases were of a slight to moderate severity, 46, cases either had rheumatic heart disease when first examined, or developed it during their illness. Forty cases of chorea were included in the total of these cases showed a definitely highter incidence of heart disease. The clinic continued to be mainly advisory in its function, that is, cases Were reommended the appropriate treatment. More serious cases were referred to their own doctors for treatment, or to Hospital when the infection was acute, and one such case died. It was usually found that when such recommendations wore strictly adhered to, definite improvement followed. (j) Tuberculosis. Once again I have to express my gratitude to the Tuberculosis Officer for his unfailing courtesy and promptitude in attending to all cases referred. There is never any difficulty in prevailing on parents to attend this Clinic for reports. During 1939 the number of notified cases and the mortality of children of school age taken from the records of the Public Health Department, is as follows:- -5-  Notified. Doths. M. F. M. F. Pulmonary. 1 2 – – Won-pulmonary. 4 1 1 – In addition 27 cases of suspected tuberculosis were referred for examination from the minor Ailments Clinics. (h) Other Defects and Diseases. These cases are freely referred to the Minor Ailment Clinics and either treated there or referred else where. 6. FOLLOWING-UP. No change occurred in the system of following-up during 1939 with the exception that children who fail to respond twice to summonses to Special Clinics had their names automatically handed to the Health Visitors. This step proved effective in many instances. 7. ARRANGEMENTS FOR TREATMENT. The same arrangements were in effect as in 1938, 8. INFECTIOUS DISEASES. The arrangements made to deal with children suffering from infectious diseases is the same as in previous years. TABLE 1, MEDICAL INSPECTIONS OF CHILDREN ATTENDING PUBLIC ELEMENTARY SCHOOLS A Routine Medical Inspections. Number of Inspections in the prescribed Groups. Entrants. 1473 Second Age Group. 52 Third Age Group. 1271 Total. 2796 Number of other Routine Inspections 250 3046 TABLE II. CLASSIFICATION OF THE NUTRITION 0F CHILDREN INSPECTED DURING THE YEAR IN THE ROUTINE AGE GROUPS UP TO 31st AUGUST, 1939. Age-groups Number _ Inspected A B C D No. % No. % No. % No. % Entrants. 1473 500 33.94 878 5961 92 6.25 5 .2 Second Age-group. 52 16 30.77 32 61.54 5 3.77 l 1.92 Third Age-group. 1271 478 37.61 669 54.21 90 7.55 8 .63 Other Routine Insps. 250 10 4. 192 768 42 1.68 6 2.4 3046 1004 32.96 1791 58.60 235 7.65 18 .59 -6- TABLE III. BLIND CHILDREN Name. Age. Address. At a Public Elementary. School. At another Institutn. At no School or Ins NIL. (Note:- there were 7 children on the roll of the Special School for partially Sighted Children, Lordship Lane, N.22. on the the 31st December 1939. DEAF CHILDREN Name. Age Address At a Public Elementary School. At another Institutn. At no school or Institutn. MARTIN Joyce 14 6, Stockton Rd., Edmonton, IT. 18. - Yes – (note:- There were 8 Edmonton children on the roll of the Special School for Deaf and Dumb Children, Philip Lane, Tottenham, 11.15. on the 31st December, 1939 including Joyce Martin) TABLE IV. TREATMENT TABLES. GROUP I - MINOR AILMENTS (excluding Uncleanliness, for which sec Table VI) DISEASE OR DEFECT. Number of Defects treated, or under treatment during the year Under the Authority's Scheme. Otherwise Total Skin:- Ringworm-Sca1p- (1) X-Ray treatment - 1 1 (11) Other Treatment - - - Ring worm-Body 35 1 36 Scabies 53 - 53 Impetigo 352 3 355 Other Skin Diseases 348 23 371 Minor Eye Defects 338 5 343 Minor Ear Defects 332 35 367 Miscellaneous 3748 264 4012 5206 332 5538 GROUP II - DIRECTIVE VISION AMD SQUINT (excluding Minor Eye Defects treated as Minor Ailments - Group 1) No. of Defects dealt with Under the Authority's Scheme Otherwise Total Errors of Refraction (ineluding Squint) 672 – 672 other defect or disease of the eyes (excluding those reoorded In Group II) 37 – 37 709 – 709 -7- (continued - Defective vision and Squint) Under the Authority's Scheme Otherwise Total No. of children for whom spectacles were:- (a) Prescribed 610 - 610 (b) Obtained 590 - 590 GROUP III - TREATMENT OP DEFECTS OF NOSE AND THROAT. NUMBER OF DEFECTS. Received Operative Treatment . Received other forms of treatment Total number treated Undor the Authority's Scheme, in Clinic or Hospital. By Private Practitioner or Hospital, apart from the Authority's Scheme Total (1) (2) (3) (4) (1) (2) (3) (4) (1) (2) (3) (4) 338 470 26 5 85 16 - - - - 26 5 85 16 (1) Tonsils only. (2) adenoids only. (3) T's & A's. (4) Other defects. GROUP IV. - ORTHOPAEDIC AND POSTURAL DEFECTS. Under the Authority's Scheme Otherwise Total No. Treated. (1) (2) (3) (1) (2) (3) Number of Children treated. 16 – 293 – – – 293 (1): Residential treatment with Education. (2) Residential treatment without education. (3) Non-residential treatment at an Orthopaedic clinic. TABLE V. DFNTAL INSPECTION AND TREATMENT (1) Number of children inspected by the dentist, (a) Routine Age-groups. Age 5 6 7 8 9 10 11 12 13 14 TOTAL No. 482 530 579 745 827 733 567 455 419 224 5561 (b) Specials. 1838 (c) TOTAL (Rotitine & Specials) 7399 (2) Number found to require treatment. 5896 (3) Number actually treated. 4020 (4) Attendances made by children for treatment 7553 (5) Half-days devoted to:- Inspection 44 Treatment 1028 Total 1072 (6) Fillings:- Permanent Teeth 4570 Temporary Teeth 373 4943 (7) Extractions;- Permanent Teeth 1164 Temporary Teeth 5993 Total 7157 (8) Administrations of general anaesthetics for extractions:- 2357 (9) Other operations Permanent Teeth 598 Temporary Teeth 3526 Total 4124. -8- TABLE VI. UNCLEANLINESS AND VERMINOUS CONDITIONS. (1) Average Number of visits per school made during the year by the school nurses. 9 (2) Total number of examinations of children in the Schools by school nurses. 29058 (3) Number of individual children found unclean. 995 (4) Number of individual children cleansed under Section 87 (2) and (3) of the Education Act, 1921 825 (5) Number of cases in which legal proceedings were taken:- (a) Under the Education Act, 1921. – (b) Under the School Attendance Byelaws. - STATEMENT OP THE NUMBER OP CHILDREN NOTIFIED DURING THE YEAR ENDED 31st DECEMBER, 1939, BY THE LOCAL EDUCATION AUTHORITY TO THE LOCAL MENTAL DEFICIENCY AUTHORITY TOTAL NUMBER OF CHILDREN NOTIFIED. Diagnosis. Boys. Girls. 1. (I) Children incapable of receiving benefit or further benefit from instruction in a Special School:- (a) Idiots. 2 – (b) Imbeciles. 2 3 (c) Others. 1 1 (ii) Children unable to be instructed in a Special School without detriment to the interests of other children:- (a) Moral Defectives. – – (b) Others. – – 2. Feeble-minded children notified on leaving a Special School on or before attaining the age of 16. – – 3. Feeble-minded children notified under Article 3, i.e. "special circumstances1' cases. – – 4. Children who in addition to being mentally i defective wore blind or deaf. – – Grand Total. 5 4 SECONDARY SCHOOLS TABLE I Number of Pupils inspected - 1st January to 31st December, 1939 A, ROUTINE MEDICAL INSPECTION. (i) Cases in which a full examination has been made (see para. 4 Circular 1153, Board of Education). Age. 9 10 _ 11 12 13 14 15 16 17 18 19 Total Boys – – 15 129 8 24 47 47 12 5 1 288 Girls - - 21 119 32 20 48 39 9 3 - 291 Total – – 36 248 40 44 | 95 86 21 8 1 579 (ii) Cases in which only partial examination ha3 been made (see para.4 Circular 1153, Board of Education), N I L. -9- CLASSIFICATION 0F THE NUTRITION OP PUPILS INSPECTED DURING THE YEAR, IN AGES Ages . No. of Pupils Inspected . A. (Excellent) No. B. (Normal) No. C. (Slightly subnormal) No. D. (Bad). No. 9. - - - - - 10. - - - - - 11. 36 7 24 5 - 12. 248 39 172 36 1 13. 40 16 21 3 - 14, 44 12 30 2 - 15. 95 23 64 8 - 16. 86 17 63 6 - 17. 21 2 19 - - 18. 8 - 8 - - 19. 1 - 1 - - Total 579 116 402 60 1 Group II Defective Vision andSquint (excluding minor eye defects treated as Minor Ailments - Group 1) Defect or Disease, No. of Defects dealt with. Under the Authority's Schomo. Otherwise. Total[#/##] Errors of Refraction (including squint) 82 – 87 Other defect or disease of the eyes (excluding those recorded as minor ailments). – – X Total. 87 – 87 Total Number of Children for whom Spectacles were prescribed;- (a) Under the Authority"'3 Scheme. 84 (b) Otherwise – Total Number of Children who obtained or received Spectacles:- (a) Under the Authority's Scheme. 84 (b) Otherwise,. DENTAL DEFECTS. (1) Number of Pupils who were:- (a) Inspected by the Dentist:- Ages:- 9. – 10. – 11. 4 12. 20 13. 52 14. 207 15. 225 16. 109 17. 26 18. 6 19. Total 649 Specials. 17 Grand Total 666 -10- Dental Defects (Continued). (b) Found to require treatment. 514 (c) Actually treated. 263 (2) Half days devoted to:- Inspection 6 Treatment - Total 6 (3) Attendances made by pupils for treatment 493 (4) Fillings Permanent Teeth 627 Temporary Teeth - Total 627 (5) Extractions:- Permanent Teeth 189 Temporary Teeth 20 Total 209 (6) Administrations of general anaesthetics for extractions. 99 (7) Other Operations Permanent Teeth 129 Temporary Teeth - Total 129 JUNIOR TECHNICAL SCHOOLS. TABLE I. Number of Pupils inspected - 1st January to 31st December, 19.39 A. ROUTINE MEDICAL INSPECTION. (i) Cases in which a full examination has been made (sec para. 4. Circular 1153, Board of Education). Age. 9 10 11 12 13 14 15 16 17 18 19 Total Boys — — — — — — — — — — — — Girls - — - 4 69 18 1 - — — — 92 Total — — — 4 69 18 1 — — — - 92 (ii) Cases in which only partial examination has been made (see para.4. Circular 1153, Board of Education). N I L. CLASSIFICATION OF NUTRITION OF THE PUPILS EXAMINED DURING THE YEAR. Ages No. of Pupils Inspected A. (Excellent) No. B. (Normal) No. C. (Slightly subnormal). No. D. (Bad). No. 9. - - - - -_ 10. - - - - - 11. - - - - 12. 4 2 2 - - 13. 69 6 56 7 - 14. 18 6 10 2 - 15. 1 - - 1 - 16. - - - - - 17. - - - - - 18. - - M - - 19. - - - - Total 92 14 68 10 - -11- Group II. Defective Vision and Squint (excluding minor eye defects treated as minor ailments - group I.) Defect or Disease. j No. of Defects dealt with. Under the Authority's Scheme. Otherwise. Total Errors of Refraction (including squint) 25 – 25 Other defect or disease of the eyes (excluding those recorded as minor ailments). – – – 25 - 25 Total Number of Children for whom Spectaclcs wore prescribed:- (a) Under the Authority's Scheme. 24 (b) Otherwise. – Total Number of Children who obtained or received Spectacles;- (a) Under the Authority's Scheme. 24 (b) Otherwise. – DENTAL DEFECTS. (1) Number of Pupils who were:- (a) Inspected by the Dentist:Ages- 9. 10. 11. 1 12. 13. 61 14. 62 15. 41 16. 2 17. 18. 19. - Total 167 Specials. 5 Grand Total. 172 (b) Pound to require treatment. 125 (c) Actually treated. , 83 (2) Half days devoted to:- , Inspect ion 1 Treatment - total 1 (3) Attendances made by pupils for treatment 156. (4) Fillings:- Permanent Teeth 158 Temporary Teeth - total 158 (5;' Extractions:- Permanent Teeth 59 Temporary Teeth 3 total 62 (6) Administrations of general anaesthetics for extractions. 34- (7) Other operations:- Permanent Teeth 37 Temporary Teeth - total 37 -12-