EDM 28 Borough of Edmonton REPORT OF THE Medical Officer of Health School Medical Officer FOR THE YEAR 1943 BOROUGH OF EDMONTON 1943. His Worship the Mayor Deputy Mayor Councillor J.A.Ward.J.P. Councillor Mrs. F.Long.J.P. PUBLIC HEALTH COMMITTEE. Chairman Councillor Mrs.A.M.Glover. Alderman Mrs.M.M.Barrass; T.J.Haiington. Councillors - Mrs.E.M.Hearn; Mrs. E.B.Newsham; L.E.Berridge; Mrs.E.M.Moss; Mrs.A.E.Shingles. 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 Medical Officer Hilda R.Hay, M.B., Ch.B., D.P.H. Assistant Medical Officers and School Medical Officers:- Catherine A.Goggin, M.B., B.Ch., B.A.0., D.P.H. Kathleen M.Hart, M.D.(Lond)., M.B., B.S., D.P.H. Senior Sanitary Inspector %abcd W.Tillcook F.S.I.A., M.R.San.I. District Sanitary Inspectors:- %abce G.II.Huckle, %abc J.P.Farrar. %abc F. Beilby. %abcf E. Dodsworth. %abc H.W.Grieves. Chief Clerk: - F.J.Nash, Cert.R.San,I. (In K.M.Forces). J.L,A.Saunders, Infectious Diseases Clerk. A.E. Clarke, Reoords Clerk.(Seconded to Civil Defence duties) D.H.J.Newuan, Correspondence Clerk. (Resigned 19.5.1943.) H.J.Weldon, Junior Clerk. (In H.M.Foroes). S.Clayton, Shops Acts Inspector. Miss I.M.Bowie, Temporary Clerk. J.H.Cowlard, Laboratory Assistant, R.R.Holland, Temporary Clerk, % Moiety paid under Public Health Act or by Exchequer Grant, 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 f R.S.I. Sanitary Science as applied to Buildings & Public Works. PREFACE. Public Health Department, Town Hall, Edmonton. N.9. His Worship the Mayor, Alderman and Councillors of the Borough of Edmonton. Mr.Mayor, Ladies and Gentlemen, I have much pleasure in presenting my ninth Annual Report for the year 1943, and the fourth under War-time conditions. As in my last Report, this is compiled in accordance with the Ministry of Health Circulars and therefore contains only a brief outline of information. The BIRTH rate continued to increase and it is again to be noted that the MATERNAL MORTALITY is low. The rest of the health conditions of the Borough are somewhat the same as in the previous year. I would like to thank the members of the Council for their unfailing courtesy and co-operation in getting through the year which was exceedingly difficult in every Department, and in conclusion, I would also like to thank the members of my staff for their loyal and efficient co-operation. I have the honour to be, Mr.Mayor, Ladies and Gentlemen, Your obedient Servant, Medical Officer of Health. GENERAL STATISTICS. Area (in acres) 3,896 Population Census of 1921 — Census of 1931 — Estimated by the Registrar-General for mid-year 1943 - Number of inhabited houses and tenements at the end of 1943 26,000 Number of inhabited houses and tenements at the end of 194S 25,926 Rateable value; April, 1943 £ 738,603 Estimated product of Id in the £ for the year ending 31.3,44 £ 3,000 Rates in the £ for the year ending 31.3.44. 15/4d SOCIAL CONDITIONS. The extent of unemployment may be estimated by the following figures relating to:- (1) the number cf free dinners given to schoolchildren, and (2) the actual figures supplied by the Director of Public Assistance. No.1. is given purely on economic grounds. (1) Number of free dinners during 1942 61,483 " paid " " 1942 440,185 " free " 11 1943 88,457 " paid " " 1943 725,313 (2) Figures re out relief:- Persons Amount For the year 1942 (a) Ordinary out-relief 1,869 £ 20,187 (b) Unemployed out-relief 28 1,897 . 29 £ 20,216 For the year 1943 (c) Ordinary out-relief 556 £ 6,256 (b) Unemployed out-relief Nil Nil 556 £ 6,256 VITAL STATISTICS. LIVE BIRTHS M F Total Grand Total Legitimate 810 770 1580 Illegitimate 35 29 64 1644 Birth rate per 1,000 of population STILLBIRTHS Legitimate 28 26 54 Illegitimate - 2 2 56 Total of live and stillbirths 1700 Rate per 1,000 total births 32.94 DEATHS Number 555 475 1030 Rate per 1,000 population DEATHS FROM PUERPERAL CAUSES Deaths Rate per 1,000 total (live and stillbirths) Puerperal and post-abortive sepsis 3 1.76 other maternal causes 1 .58 4 2.34 DEATH RATE OF INFANTS UNDER ONE YEAR OF AGS M F TOTAL Number 50 26 76 All infants per 1,000 live births 46.22 Legitimate infants per 1,000 legitimate live births 46.20 Illegitimate infants per 1,000 illegitimate live births 46.87 Deaths from Cancer (all ages) 154 " " Measles (all ages) - " " Whooping Cough (all ages) 1 " " Diarrhoea (under 2 years of age) 12 The following causes of death are supplied by the Registrar General and refer to deaths which were registered during the calendar year:- Cause of death M F Total Typhoid and para-typhoid fevers — - — Cerebro-spinal fever 3 - 3 Scarlet fever - — — Whooping cough 1 — 1 Diphtheria 2 1 3 Tuberculosis of the respiratory system 32 22 54 Other forms of tuberculosis 7 5 12 Syphilitic diseases 4 5 9 Influenza 11 9 20 Measles — — Acute Poliomyelitis and Polio-encephalitis - 1 1 Acute infective encephalitis - - — Cancer of buccal cavity and oesophagus (M) Uterus (F) 3 5 8 Cancer of stomach and duodenum 16 6 22 Cancer of breast — 17 17 Cancer of all other sites 67 40 107 Diabetes 5 8 13 Intra-cranial vascular lesions 37 55 92 Heart disease 99 118 217 Other diseases of the circulatory system 30 17 47 Bronchitis 60 32 92 Pneumonia 48 27 75 Other respiratory diseases 10 9 19 Ulcer of stomach or duodenum 16 2 18 Diarrhoea (under 2 years) 8 4 12 Appendicitis 3 2 5 Other digestive diseases 9 6 15 Nephritis 8 11 19 Puerperal and post-abortive sepsis - 3 3 Other maternal causes - 1 1 Premature birth 14 11 25 Congenital malformations,birth injuries,infant diseases 13 6 19 Suicide 6 3 9 Road traffic accidents 1 2 3 Other violent causes 8 14 22 All other causes 34 33 67 555 475 1030 The two tables overleaf give the deaths of those registered during the 52 weeks ended 1st January, 1944. The slight difference between the tables overleaf in respect of the causes of death and the one supplied by the Registrar General is that the Registrar General is in possession of additional information on the matter. 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 and over Diphtheria 2 — — — 2 — — — — — — — Typhoid end para-typhoid fever — - - - — — — » - — — — Cerebro-spinal fever 3 1 1 — — — — — — 1 — — Whooping Cough 1 1 - - — — — — - — - — Tuberculosis of the respiratory system 33 1 - - - 5 6 9 5 5 1 1 Other forms of tuberculosis 8 1 - 2 1 2 1 — — — 1 — Syphilitic diseases 4 — — — — — — — — 3 1 — Influenza 11 — — — — 1 — 1 2 2 2 3 Acute encephalitis lethargica — — — — — — — — — — — — Cancer cf buccal cavity & oesophagus 3 — — — — — — — — — 3 - Cancer of stomach and duodenum 15 — — — — — — — 2 5 7 1 Cancer of all other sites 67 — — — — — 3 2 8 18 25 11 Diabetes 5 — — — — — 1 1 — — 2 1 Intra-cranial vascular lesions 37 — — — — - - 1 4 6 16 10 Heart disease 101 — 1 — — — 1 1 8 18 41 31 Other circulatory diseases 32 — — — — - - — 2 5 18 7 Bronchitis 62 - - — — — — 1 8 14 20 19 Pneumonia 50 10 1 — 1 1 — 2 11 3 5 16 Other respiratory diseases 11 - - — 2 1 1 1 3 2 1 Ulcer of stomach or duodeum 17 — — - — — - 4 2 8 3 - Diarrhoea ( under 2 years) 8 8 - - — — — — - — — » —« Appendicitis 3 - - - 1 — 1 1 - — — — Other digestive diseases 9 — - - 1 - - - 3 2 1 2 Nephritis 5 — — — — — — — 1 1 1 2 Premature birth 14 14 - — — — — - - - — Cong.mal.birth injuries,infant dis. 13 13 — — — — — — — — — — Suicide 6 — - - — 1 3 - — 1 1 Road traffic accidents 1 - - - 1 • — - — — - - — Other violence 9 — — - — 1 2 — — 3 2 1 All other causes 30 1 1 - 2 - - 2 1 8 6 9 560 50 4 2 11 10 17 29 58 105 158 116 FEMALES. Diphtheria — — — — — — — — — — — Typhoid and para-typhoid fever — — — — — — — — — — — — Cerebro-spinal fever — — — — — — — — — — — — Whooping cough - - - - — - - - — - - — Tuberculosis of the respiratory system 23 - - - — 6 8 3 1 5 - — Other forms of tuberculosis 5 - 1 - - - - 2 1 - 1 - Syphilitic diseases 5 1 — — — — — 1 - 1 2 - Influenza 9 — — — — — — 2 - 1 2 4 Acute Polio-myelitis 1 - - - - - 1 - - — — — Cancer of uterus 5 — — — — — — 1 2 - 1 1 Cancer of stomach and duodenum 6 — - - - - - - — 1 3 2 Cancer of breast 17 — - - - - 1 1 2 5 3 5 Cancer of all other sites 43 - - 2 - 1 1 4 6 14 10 5 Diabetes 8 - - - — - — — — 4 — 4 Intra-cranial vascular lesions 54 - - - - - 1 1 4 7 12 29 Heart disease 118 — - - 1 3 - 1 3 8 42 60 Other circulatory diseases 18 - - - - - — - — 1 10 7 Bronchitis 31 1 — - - — - - 1 4 5 10 Pneumonia 27 4 - 1 - 1 2 1 2 2 7 7 Other respiratory diseases 9 — - - — — — 1 1 — 2 5 Ulcer of stomach and duodenum 2 1 — 1 Diarrhoea (under 2 years) 4 4 — - - - - — - — — — Appendicitis 2 - — — — - 1 — — 1 — — Other digestive diseases 8 — — — 3 — 1 — — 2 2 Nephritis 11 - - — - 1 2 2 2 — 1 3 Puerperal and post-abortive sepsis 3 — — — — «- 3 — — — "» — Other natornal causes 1 — — - — — - 1 — — — — Premature birth 11 11 — — — — — — — — — — Cong.mal.,birth injuries,inf.dis. 6 6 — — — — — — — — — — Suicide 3 — - — — — 1 2 — — — — Road traffic accidents 2 - — 1 - — 1 — — — — — Other violence 14 - - 2 — — 1 — — 2 4 5 All other causes 33 - - - 1 2 2 2 2 4 9 11 479 27 1 6 2 17 25 26 27 61 116 171 INFANTILE MORTALITY. The deaths of infants under one year of age were as follows;- M F Total Legitimate 49 24 73 Illegitimate 1 2 3 50 26 76 The death rate of all infants per 1,000 live births was 46.23. A detailed sub-division of the causes,etc., of these DEATHS is as follows MALES. Causes of death Under 1 week 2nd week 3rd week 4th week Total under 1 mth 1-3 mths. 3—6 mths 6-9 mths. 9-12 mths. Total unde 1yr. Whooping Cough — — — — — — — 1 — 1 Cerebro-spinal Fever — - - - - — 1 — — 1 Pulmonary Tuberculosis - — - - - — — — 1 1 Other forms T.B. - - - - - — — 1 — 1 Diarrhoea - - — - - 5 2 1 - 8 Pneumonia - 2 1 1 4 2 2 1 1 10 Injury at Birth 1 - - - 1 — — - - 1 Premature birth 11 2 — — 13 1 — — — 14 Atelactasis 1 - - - 1 — — — 1 Congenital malformations 5 - 1 - 6 2 1 — - 9 Other causes - - - 1 1 — 1 - — 3 Totals 18 4 2 2 26 10 7 4 3 50 . FEMALES. Diarrhoea _ 1 1 1 3 1 — — 4 Pneumonia - — - - - 3 1 — — 4 Congenital debility 2 - 1 - 3 - 1 - - 4 Premature birth 10 — - — 10 1 — - — 11 Atelactasis 1 — - — 1 — — — — 1 Bronchitis - - - - - - - 1 - 1 Ashpyxia neonatorum 1 - - - 1 - - — - 1 Syphilis - - - - - 1 - - — 1 14 1 2 1 18 5 3 1 — 27 COMPARATIVE STATISTICS. The Registrar-General has forwarded provisional figures relating to the country as a whole and to London, enabling comparisons to be made as follows Birth rate per 1,000 population Death rate per 1,000 births From diarrhoea,etc. under 2 years. Total d eaths under 1 year Live Still England and Wales 16.5 0.5 5.3 49 London 15.8 0.45 10.4 58 EDMONTON 7.29 46.23 ANNUAL DEATH RATS PER 1,000 of POPULATION All causes Measles Scarlet Fever Whooping Cough Diphtheria Influenza England and Wales 13.1 0.02 0.00 0.03 0.03 0.37 London 15.0 0.02 0.00 0.03 0.02 0.27 EDMONTON - ~ - - — — The following table gives the number of births and deaths (registered) sub-divided into the four Wards of the Borough. It should be remembered that births are only those which occurred in Edmonton of residents; 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 those supplied by the RegistrarGeneral. The deaths include those taking place outside the Borough, the information being given quarterly by the Registrar-General. WARD BIRTHS DEATHS INFANT DEATHS Male Female Male Female Male Female Bury Street 175 182 180 147 17 8 Church Street 106 119 100 114 10 3 Angel Road 149 96 116 91 7 12 Silver Street 170 163 162 128 16 4 Vagrants — — - - - - 600 560 558 480 50 27 LABORATORY FACILITIES. This Department has been of groat assistance in School Medical work, particularly the Open Air School by giving the Medical Department first hand knowledge of what they are dealing with in the vast majority of cases. The Maternity & Child Welfare Department, particularly the Ante-Natal and Post-Natal Clinics, have profited very materially by the information supplied to them, and I have no doubt that in future the work of the Laboratory will prove a great factor in reducing Maternal Mortality. Many oases found in the Borough have also profited by the immediate results obtained which assisted my Department as well as the Medical Practitioners, who are making greater use of this service. From a Public Health standpoint the immediate information obtained from the examination of milk samples obtained in the Borough proved in many instances gratifying and in the cases of samples which failed to pass the proscribed tests, facilitated prompt action being taken. The following examinations were carried out in the Bacteriological Laboratory:- Positive Negative Total Blood counts _ _ 103 Blood - Sedimentation Rate — - 4 Blood - Widal reaction - — 1 Ear swabs for presence of Organisms — - 3 Eye swabs for presence of ??? 1 2 3 Eye swabs for presence of other organisms — - 11 Faeces for presence of Dysentery organisms — 21 21 Faeces for presence of Ova 1 1 2 Faeces for presence of Tubercle Bacilli - 1 1 Mouth swabs for presence of Vincent's Angina 2 - 2 Nasal swabs for presence of Haemolytic strep. - 7 7 Pus for presence of Organisms — — 2 Scalp scrapings for presence of Ringworm - 1 1 Sputa for presence of Tubercle Bacilli 7 31 36 Swabs for presence of K.L.B 140 1617 1757 Positive Negative (a) From suspects 80 907 (b) From oontacts 37 639 (c) From old casos 23 71  Positive Negative Total Throat swabs for presence of Haemolytic strep. 2 51 53 Throat swabs for presence of other organisms — — 6 Umbilical swabs for presence of organisms — — 2 Urine - Bacteriological examinations - — 160 Urine - Chemical examinations — 193 Urine - Microscopical examinations — — 187 Urine for presence of Tubercle Bacilli - — 1 Urine for Urea content — — 1 Vaginal discharge for presence of Tr.Vaginalis 1 — 1 Vaginal swabs for presence of ??? — 13 13 Vaginal swabs for presence of other organisms — — 6 Total number of Examinations 2579 MILK (SPECIAL DESIGNATIONS) ORDER , 1959. 231 Samples of Designated Milks were examined in the Laboratory. Results were as follows Aceredited Milk. 13 Samples were examined and 10 satisfied both the proscribed tests. 1 Sample failed to pass both the Methylene and Coliform tests. 2 Samples failed to pass the Cliform Test only. Pasteurised Milk. 90 Samples were examined and 76 satisfied both the prescribed tests. 3 Samples failed to pass both the Phosphatase Tost and the Bacterial Count standard, 3 Samples failed to pass the Phosphatase Test only. 8 Samples failed to pass the Bacterial Count Standard only. Tuberculin Tested (Pasteurised) Milk. 50 Samples were examined and 42 satisfied both the prescribed tests, 8 Samples failed to pass the Bacterial Count standard only. Tuberculin Tested Milk. 78 Samples were examine and 48 satisfied both the prescribed tests. 18 Samples failed both the Methylene Blue and Coliform Tests, 10 Samples failed to pass the Methylene Blue test only. 4 Samples failed to pass the Coliform Test only, FOOD AND DRUGS ACT, 1958, Samples of Bottle Washings were taken from Dairies in the Borough and were examined in the Laboratory. Results were as follows:— 44 Samples wore examined and 25 pa3sod both the prescribed tests. 6 Samples failed to pass both the Bacterial Count Standard and the Coliform test. 15 Samples failed to pass the Coliform tost only. AMBULANCE FACILITIES. The Council possesses four ambulances, housed at Willis Garage,Weir Hall, and the following figures give some idea of the work carried out during the year. Private cases 7,422 Accident cases 833 Maternity cases 223 School Medical Dept. (Tonsils) 307 Maternity & Child Welfare (Tonsils) 134 Not required 70 False calls 9 Bedside Apparatus 79 Analgesia 35 Special services 301 9,413 First Aid was rendered on 2 41 occasions. The resusitating apparatus was in use on 9 occasions, The total mileage of the vehicles was 41,105 miles. TRANSPORT A 2 ton Bedford Coach convoys the deaf and dumb and partially blind children to and from sohool, picks up a few other children in the morning, taking them to a spot to meet the guide. NURSING IN THE HOME. This has been described in previous reports. HOSPITALS. Infectious diseases are admitted into the Enfield,Edmonton and Potters Bar Joint Isolation Hospital, situated in Enfield. Arrangements for the treatment of ear, nose and throat disorders amongst school children are made with the Prince of Wales's Hospital, Tottenham; ringworm is treated at the North Middlesex County Hospital. Edmonton, and ultra-violet light treatment given at the Council's Clinic. NURSING HOMES REGISTRATION. There is one Nursing Home registered by the Council. This is kept under supervision by the Medical Officer of Health. No now applications to be placed on the register were received during 1943. SANITARY INSPECTION IN THE AREA. Five District Sanitary Inspectors are engaged in the sanitary supervision of the Borough, working under the supervision of the Senior Sanitary Inspector. The Senior Sanitary Inspector supervises the work of the Borough and is Inspector under the Canal Boats Acts. At the outbreak of hostilities the Senior Sanitary Inspector was appointed Controlling Officer for Emergency Petrol Supplies and also the Authorised Officer for the Decontamination of Food (Food Decontamination Officer.) SANITARY CONVENIENCES. There are seven Public Conveniences in the Borough which are kept under constant supervision by the Public Health Department. RATS AND MICE (DESTRUCTION) ACT, 1919. The Middlesex County Council is at present the Authority for this Borough under the Act but owing to the issue of Circular No,680 under the Infestation Order 1943 the powers of the County Council will in the new year be delegated to each Local Authority and it will then be incumbent upon the Council to put into effect the Rats & Mice (Destruction) Act 1919. In the meantime the practice in vogue is that as carried out in previous years. MIDDLESEX COUNTY COUNCIL (GENERAL POWERS) ACT,1938. SECTION 71.HAWKERS.ETC. This Act came into operation on the 1st January,1939, the Council together with other Local Authorities considered the adoptive sections and put the necessary resolutions and action into being regarding Sections 70 and 71. No new applications were received during 1943. DISINFECTION AND DISINFESTATION. The following table gives some idea of the work carried out:- Number of journeys to collect bedding 297 Number of journeys to return bedding 291 Rooms disinfected after infectious disease 978 Rooms disinfected after phthisis 173 Disinfestation carried out after vermin 231 Bedding,clothing,etc.disinfected after infectious disease 4,914 art. Bedding,clothing,etc.disinfected after phthisis 9956 " Bedding,clothing,etc.disinfected after other cases 1,511 " The Council distribute a disinfecting powder and fluid to residents who apply for same at the Town Hall Yard. During the year, the applicants numbered 12,195. One hour daily is allowed for such distribution with the exception of Fridays and Saturdays. A Formalin Chamber is used for the disinfection of books, leather goods,etc., articles that would be damaged by steam. The number of books and other articles thus disinfected was 432. Four Council houses and 99 other houses were found to be infested and the total number of rooms disinfested was 231. The whole of the work is carried out by the Department, the materials used being Block Disinfestaters combined with the use of Insecticides. PETROLEUM (REGULATIONS) ACTS. 1928 & 1936. During the year 6 new licences and 97 renewals were granted by the Council. The following is a list of particulars of quantities ,etc., affected by these licences Petroleum spirit - gallons Petroleum mixtures - " Carbide of calcium - tons MORTUARY. During the year 79 bodies were deposited in the Mortuary, 75 by order of the Coroner and 4 for sanitary reasons. INSPECTIONS. The following tabular statement gives the number and nature of the inspections made during the year:- Complaints 1994 Infectious disease 769 Tuberculosis — Factories with mechanical power 167 Factories without mechanical power 16 Other premises under the Factories Act — Outworkers 8 Schools 2 Offensive trades 3 Shops and Stalls 210 Shops Act (Primary) 20 Shops Act (Re-inspections) - Sanitary conveniences and urinals 228 Smoke observations 1 Stables 22 Piggeries 62 Petroleum 27 General inspections 354 Sundry Visits 1788 Cinemas and Halls 2 Visits to canal 5 A.R.P.Shelters 20 Re-inspections 4804- INSPECTIONS OF PLACES WHERE FOOD IS PREPARED. Butchers 139 Fish shops 34 Coffee shops 42 Dairies and milkshops 105 Slaughterhouses 79 Bakehouses 23 NUMBER OF NOTICES SERVED. Preliminary or Informal notices 1413 Statutory notices 374 DEFECTS REMEDIED. Houses repaired,cleansed,etc. 453 D.W. cisterns repaired,covered 10 Water fittings repaired 96 Drains examined,tested,etc. 535 Drains cleared,trapped,repaired 316 Drains reconstructed 125 Chambers inserted 56 Chambers sealed down 37 Soil and vent pipes repaired 37 W.C's repaired,cleansed,etc. 181 Flushing cisterns repaired 120 Waste pipes repaired,etc. 62 Sinks repaired or renewed 19 Roofs repaired 493 Gutters and R.W.P's repaired 283 Yards paved or repaved 88 Scullery floors repaired 35 Spaces under floors ventilated 36 Dampness remedied 141 Floors repaired 110 Coppers and stoves repaired,etc. 130 New dustbins supplied 111 Accumulation of refuse removed 9 Nuisances from animals abated 7 Other nuisances abated 258 CANAL BOATS ATCS. During the year 5 visits were paid to the Canal and 6 boats wore seen, but of this number none was fitted or used as a dwelling or registered under the Acts. PLACES OF PUBLIC ENTERTAINMENT. Two inspections of cinemas and other places of entertainment were made in accordance with the Circular of the Ministry of Health of 1920. Conditions were found to be generally satisfactory. FACTORIES ACT. 1937. The following work has been carried out under the above Act:- 1. INSPECTIONS FOR THE PURPOSE OF PROVISIONS AS TO HEALTH Premises Inspections Written Notices Occupiers prosecuted Factories with mechanical power 167 17 - Factories without mechanical power 16 - - Other promises under the Act (including works of building and engineering and construction but not including outworkers' premises.) - - - Totals 183 17 - 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 18 18 — — Overcrowding - — — — Unreasonable temperature — — — — Inadequate ventilation — — — — Sanitary Conveniences: Insufficient 11 10 — — Unsuitable or defective 13 13 — — Not separate for sexes 1 — — — Other offences 1 1 — — (not including offences relating to Home work or offences under Sections mentioned in the schedule to the Ministry of Health (Factories & Workshops Transfer of Powers) Order,1921, and re-enacted in the Third Schedule to the Factories Act,1937.) Totals 44 42 — - 3. OUTWORK IN UNWHOLESOME PREMISES. Nature of Work. Instances Notices served, Prosecutions. Wearing Apparel - Making,etc. — •• Cleaning and washing — — FACTORIES DEFECTS REMEDIED. W.C. walls cleansed 17 W.C.cisterns repaired 3 W.C.Seats repaired or renewed 10 W.C. Flush pipes repaired 2 W.C.doors repaired 1 W.C.pans replaced 5 Roofs repaired 2 Workrooms cleansed 1 Sanitary accommodation improved 1 HOUSING - HOUSING ACT. 1936. 1 . INSPECTION OF DWELLING HOUSES DURING THE YEAR:- (1) (a) Total number of dwelling houses inspected for housing defects (under Public Health or Housing Acts ) 1596 (2) (b) Number of inspections made for the purpose 4955 (a Number of dwelling houses (inoluding under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations,1925 & 1932, (b) Number of inspections made for the purpose - (3) Number of dwelling houses found to be in a state so dangerous or injurious to health as to bo unfit for human habitation. - (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. 1108 UNSOUND FOOD The following is a list of the food surrendered for examination and retained as unfit for human consumption 867 tins Milk 23 stone filleted cod 179 tins beans 4½ stone haddock 158 tins peas 3 stone smoked fillets 547 tins canned moat 5 stone dog fish 412 tins canned fish 3 stone cat fish 745 tins fruit 5 stone iceland plaice 54 pots jam 5½ boxes kippers 669 bottles red cabbage 36¼ lbs butter 142 bottles pickled onions 121 lbs boneless beef 23 tins tomatoes 108 lbs pork 48 rolls celery 45 lbs beef 170 rabbits 10 lbs mutton 1 chicken 6 lbs veal 8 stone headless cod 14 lbs bacon stone haddock 215 lbs granulated sugar together with various small consignments of miscellaneous foods. The above items do not include the food dealt with at shops subjected to damage on account of Enemy action". SHOPS ACTS The Shops Acts Inspector submits a monthly report to the Public Health Committee, and the following is a short summary:- Visits to shops, licensed street traders,etc. 3491 Contraventions CHEMICAL AND BACTERIOLOGICAL EXAMINATIONS OF FOOD The only examinations carried out by the Council are those for designated milks. The matter has been discussed previously, PREVALENCE OF INFECTIOUS DISEASE. MEASLES AND WHOOPING COUGH Those diseases were made compulsorily notifiable in October 1939, 996 cases of Measles and 79 cases of Whooping Cough were notified during the year. There were no deaths. DIPHTHERIA 1 am happy to report the continued low incidence of this disease, 92 cases were notified during the year compared with 22 in 1942, There were 2 deaths. SCARLET FEVER This disease continued to occur throughout the year in a mild form; there wore 540 cases compared with 330 in 1942; there were no deaths, "Return" cases numbered 8 allowing for an interval of 28 days between a patient returning home from the Isolation Hospital and the onset of the disease in another inmate of the house. SMALLPOX No cases of smallpox were notified during the year, POLIOMYELITIS 2 cases of this disease were notified during the year. 2. REMEDY OF DEFECTS DURING HIE YEAH WITHOUT SERVICE OF FORMAL NOTICES Number of defective dwelling houses rendered fit in consequence of informal action by the Local Authority or their officers 763 3. ACTION UNDER STATUTORY POWERS DURING THE YEAR. A - Preceedings under Sections 9,10 & 16 of the Housing Act,1936 (1) Number of dwelling houses in respect of which notices were served requiring repairs 133 (2) Number of dwelling houses which were rendered fit after service of formal notices (a) by owners 98 (b) by Local Authority in default of owners 28 B- Proceedings under Public Health Acts:- (1) Number of dwelling houses in respect of which notices were served requiring defects to be remedied 63 (2) Number of houses in which defects were remedied after service of formal notices (a) by owners 41 (b) by Local Authority in default of owners C - Proceedings under Sections 11 & 13 of the Housing Act,1936:- (1) Number of dwelling houses in respect of which demolition orders were made (2) Number of dwelling houses demolished in pursuance of demolition orders D - Proceedings under Section 12 of the Housing Act,1936:- (1) Number of separate tenements or underground rooms in respect of which Closing Orders ware made 1 (2) Number of separate tenements or underground rooms in respect of which Closing Orders wore determined, the tenements or rooms having been rendered fit - SLAUGHTERHOUSES Seventy mine visits were paid and the carcases and organs of 360 pigs were inspected during or shortly after slaughter, permission for slaughter having boon obtained from the Area Meat and Livestock Officer, and the following surrendered 1 Carcase (Weight 96 lbs) 115 Plucks 20 Heads INSPECTION AND SUPERVISION OF FOOD. MIUC SUPPLY Various licences were granted as under:- Primary Supplementary Pasteurised 11 6 Tuberculin tested 9 4 Accredited - 1 20 11 One of the above retailers is licensed to bottle Tuberculin tested milk and one firm is licensed to pasteurise and bottle milk on the premises; one firm is licensed to bottle pasteurised milk on the premises. Supplementary licences are granted to retailors who live outside the Borough but who sell milk in the Borough; the primary licence is granted by the Authority in Which they reside. DYSENTERY 50 cases wore notified during the year of the Sonne type, and investigation failed to reveal the cause of infection. CEREBRO SPINAL FEVER 11 cases were notified during the year. These cases were carefully investigated and precautions taken to prevent the spread of infection. 2 deaths took place. PUERPERAL PYREXTA AND OPHTHALMIA NEONATORUM These are referred to later on under the heading of Maternity & Child Welfare. FOOD POISONING No cases were notified during the year. PNEUMONIA 84 cases were notified during the year. DIARRHOEA AND ENTERITIS UNDER 2 YEARS OF AGE The death rate per 1,000 live births for London was 10.4 whilst that for Edmonton was 7.29 as compared with 8.6 and 8.23 respectively last year. IMMUNISATION. DIPHTHERIA During the year, 3415 appointments were made - 2671 children completed treatment under the Council's arrangements; of these 1509 wore under 5 years of age. 68 children were Schick tested. In 1942, 3000 children completed immunisation treatment. MEASLES Measles Immune Globulin was issued to general practitioners. 2 x 2 c.cs. were issued during the year. WHOOPING COUGH Edmonton children are immunised against Whooping Cough. The material used is 'Vaccine A', and during the year, 1003 appointments wore made for this treatment - 641 children completed treatment. The following table gives the ago, incidence,etc. of those suffering from notifiable diseases, excluding tuberculosis which is dealt with separately. It must be noted that the figures in the second column 'No.removed to hospital') includes those already under treatment at a hospital, for instance, the North Middlesex County Hospital. This remark applies more particularly to the infections associated with parturition and includes puerperal pyrexia and ophthalmia neonatorum. DISEASE Total No .of Cases No. ramvd 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 Be war Scarlet fever 540 457 — — 12 21 34 66 327 62 3 12 3 — — Diphtheria 92 88 2 1 3 . 4 7 6 39 19 5 6 1 1 — Enteric fever 2 2 — — — 1 — - — 1 * — — _ Puerperal Pyrexia 133 131 — - — - — — — — 6 104 21 2 — Pneumonia 84 20 3 4 7 6 3 3 7 4 4 8 11 19 8 Erysipelas 36 16 3 - - — — — 2 1 2 3 13 10 5 Ophth-Neonatcrum 17 17 — 17 — — — — — — — — — — Dysentery 50 43 - 2 - 1 1 — 7 1 1 2 — 6 29 Whooping Cough 79 2 — 8 10 6 9 12 32 — — 2 — — — Measles 996 27 — 54 114 222 331 158 362 43 9 2 1 — — C.S.F. 11 11 1 3 l — 1 1 1 1 1 — 1 1 — Poliomyelitis 2 2 1 — — — — — - 1 - 1 - - - The following table indicates the Wards from which the various cases were Notified:- DISEASE Bury St Ward Church Street Ward Angel Road Ward Silver Street Ward N.Mddx. C.Hosp. Other Instns. Total Scarlet fever 168 146 72 154 — — 540 Diphtheria 25 17 24 25 1 - 92 Enteric fever - 1 — 1 — - 2 Puerperal Pyrexia 17 10 7 13 86 — 133 Pneumonia 34 15 19 16 — — 84 Erysipelas 9 8 13 6 — - 36 Ophth-Neonatorum 1 1 3 1 11 - 17 Dysentery 13 2 4 7 24 — 50 Whooping Cough 20 11 13 33 2 — 79 Measles 335 200 180 280 1 — 996 C.S,F, 4 2 4 1 — - 11 Poliomyelitis 1 1 — — — — 2 CANCER The incidence of Cancer relative to the various organs of the body is given as under:- Males. Females. Breast - 17 Uterus - 5 Buccal cavity and oesophagus 3 - Stomach and duodenum 15 6 All other sites 67 43 85 71 PREVENTION OF BLINDNESS Gases of ophthalmia neonatorum are promptly visited and, if thought necessary, are removed to hospital for treatment. No cases of blindness have arisen during the year due to this cause. As provided by Section 175 (1) of the Public Health Act, 1936, arrangements exist with the Middlesex County Council for the treatment at the school clinics of adolescents who are ascertained at school to bo suffering from defective vision. ORTHOPAEDIC TREATMENT Details of this scheme were set out in my Report for 1939. Financial assistance was rendered for the supply of surgical appliances in 2 cases during the year. ESTABLISHMENTS FOR MASSAGE OR SPECIAL TREATMENT In 1941 the Council resolved that Part 7 of the Middlesex County Council Act, 1934 bo put into operation in the Borough. TUBERCULOSIS The table below gives details of the ages and sex of new cases of Tuberculosis, also deaths from the disease; this latter figure includes the deaths of non-notified cases. Age periods. Now cases Respiratory Non-respiratory Deaths Respiratory Non-respratery Male Female Male Female Male Female Male Female Under 1 year 1 1 1 _ 1 - 1 - 1-5 years 1 — 2 — — — 2 1 5-15" 3 9 5 3 — — 1 — 15- 25 " 25 24 7 5 5 6 2 — 25- 35 12 22 1 2 6 8 1 _ 35- 45 " 22 8 1 2 9 3 — 2 45- 55 " 8 5 — — 5 1 — 1 55- 65 " 7 2 — — 5 5 — — 65 years upwards 1 - 1 - 2 — 1 1 80 71 18 12 33 23 8 5 In addition 12 cases of pulmonary tuberculosis and 1 case of nonpulmonary tuberculosis previously notified in other areas, moved into Edmonton. The total number of names added to the Register for the first time during the year, excluding of course, non-notified deaths was:- Males Females New cases (respiratory) 80 71 (non-respiratory) 18 12 Transferred casos (respiratory) 7 5 (non-respiratory) - 1 105 89 The casos dying of Tuberculosis and not previously notified woro:- Males Females Respiratory 1 — Non-respiratory 3 2 There wore thus 6 non-notified deaths out of a total of 66 persons registered as dying of tuberculosis (Registrar's figures). Regarding the non-notification of the above cases, there was no suggestion of wilful neglect or of refusal to notify. The non-respiratory forms of tuberculosis notified were:- Males Females Genito-urinary tract — 3 Other bones and joints 2 2 Meningeal 3 — Glands 8 5 Spine 1 1 Kidney 2 1 Skin 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 whioh it has been necessary to invoke those powers. PU3LIC HEALTH (TUBERCULOSIS) REGULATIONS, 1930. The number of cases of tuberoulosis on the Register at the end of 1943 was:- Males, Females, Total. Pulmonary forms 325 267 592 Non-pulmonary forms 86 88 174 411 355 766 The corresponding figures at the end of 1942 were:- Males, Females, Total. Pulmonary forma 271 226 497 Non-pulmonary forms 77 78 155 348 304 652 Corresponding figures for previous years were:- Males, Females. Totals. 1941 355 293 648 1940 349 313 662 1939 357 301 658 1938 363 297 660 1937 336 260 596 1936 315 252 567 1935 330 265 595 1934 339 281 620 1933 320 281 601 1932 363 284 647 COUNCIL'S EMPLOYEES During 1943 the Medical Officer of Health paid a total of 232 visits to those employees who had been on the sick list for longer than a fortnight and, when necessary, at fortnightly intervals. Of these 60 were 'not at home' and 3 had already resumed duty. Also, during the year, 7 persons were examined prior to their appointment to permanent posts. MATERNITY AMD CHILD WELFARE COMMITTEE. Chairman-Cr. Mrs. A. M. Glover. Councillors J. Ward (Mayor); Mrs. F. Long (Deputy Mayor) and Alderman T. J. Harington. Councillors: L.E.Berridge; Mrs. E.M.Hearn; Mrs. E.M.Moss; Mrs. E.B. Newsham; Mrs. A.E. Shingles and A.H.Roullier. STAFF. D. Regan, B.A., B.Sc,, M.B., Ch.B., B.A.O., D.P.H(L' pool). H. R. Hay, M.B., Ch.B.(Edin)., D.P.H., Deputy Medical Officer, C. A. Goggin, M.B., B.Ch., B.A.O., D.P.H., Assistant Medical Officer. K. M. Hart, M.B., B.S.(Lond)., M.D., D.P.H., Assistant Medical Officer. J. A. Cholmeloy, F.R.C.S.(Eng)., Orthopaedic Surgeon. R. Leslie Dodds, F.R.C.S., Consulting Accoucheur (On Active Service). Miss K. Robinson, F.R.C.S. (Acting for Mr. Dodds). E. Underhill, 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. Nayior. bd Miss M. Druce. bed Miss M. R. Hozelton, bcd Miss R. Bullock. acd Miss J. M. Anderson. bcd Miss B. F. Lister. bcd Miss V. Garrett. bcd Miss M. V. Hughes (Left Aug. 1943). bcd Miss J. Patercon. bed Miss I. Jones (Coxa. Aug. 1943). c Miss A. Fahy (School work only). Mrs. C. Tonkin (School work only), MASSEUSE Miss M, F. Cozens-Walkor, Chartered Masseuse, Orthopaedic Clinic (Part-time) Left, December, 1943. MUNICIPAL MIDWIVES. cdfg Mrs, R.K,M. Wingrove-Non-Medical Supervisor of Midwives. cdg Miss J. A. W eoks (Senior Midwife), Loft July, 1943. cdg Mrs. M, Johnston-Sonior Midwife. (Commenced September, 1943). cdg Mrs. D.S.C. Gazaard. cdg Miss V. Ummon. dg Mrs. A. Griffiths (Left June '45) edg Mrs. A.M.Burton (temporary). cdg Miss A. G. W alker. dg Miss D. Chaplin (temporary. Left Nov, '43. cdg Miss K. M. James. cd Miss S. Simpson (temporary). cdg Miss D. M. Lewis. cdg Miss E. Read (temporary) Com. Aug. '43. a Maternity and Child Welfare Certificate. b Now Health Visitors' Certificate. c State Registered Nurso. d State Cortifiod Midwife. e Sanitary Inspector's Certificate. f Teacher's Certificate of Midwifery. g Certificate for Gas and Air. h Nursery Nurses Diploma. CLERICAL. Miss R. S. Saunders (Senior Clerk). Miss N. A . lyres. Miss H. P. Turton. Miss W. S. Beattio. Miss J. Blatter. Mrs. V. Carter (Cora. October, 1943). MATRONS - NURSERIES. Harponden-c Miss E. Cadman. Fore Street-h Miss M. W. Betteridge. Hertford Road-c Mrs. I. Drunnond. Florence Road-c Mrs. L. Myers. The following information gives details of the Maternity and Child Welfare Clinics at the end of 1945:- (1) Ante-Natal Clinic at Brookfield House, Fore-Street (adjoining the Town Hall). Five sessions weekly. (2) Child Welfare Contres:- (a) Brookfield House. Four sessions weekly. (b) Methodist Church Hall, Bush Hill Park. One session weekly. (c) St. Alphege Church Hall. Two sessions weekly. (d) Weir Hall. Two sessions weekly. (3) Post-Natal and Advisory Clinic at Brookfield House. One session weekly. (4) Dental Clinic at Croylend Road School Clinic. Two sessions weekly. (5) Orthopaedic Clinic at Methodist Central Hall, Fore Street. Two sessions weekly. (6) Obststric Surgoon attends once a fortnight at Brookfield House. FOREWORD. The year 1943 has been one of progress in all branches of the Maternity and Child Welfare Services. The Clinics have been very well patronised, and the ancillary services greatly appreciated by the mothers. Groat encouragement for the future is given by the fact that, despite the many problems of the war, it has been found possible to expand the work during the year. The Harpenden evacuated nursery was closed in February, 1943 owing to serious staffing difficulties, and the children whose parents desired them to remain away, were transferred to a nursery in another area. Three War-time Nurseries (viz. Fore Street, Hertford Road and Florence Road) provided accommodation for childron under 5 years of age where the mothers have been engaged on war work. A fourth nursery is being built in Silver Street and should be ready for occupation early in the New Year. I should like to take this opportunity of thanking the members of the Maternity Committee and the members of the Staff for their co-operation during the year. The following information will give some indication as to the work carried out by the Department during the year 1943:- BIRTHS The total number of births notified during 1943 was as follows:- Live births notified by midwives 2,195 " " " " doctors and parents 114 Stillbirths notified by midwives 104 " " " doctors 2 2,415 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 1,076 " " " " doctors and parents 109 Stillbirths notified by midwives 35 " " " doctors 2 1,222 Number of live Edmonton babies born in outlying institutions 207 " " stillborn " " " " " " 5 212 The following table includes births of Edmonton residents and those bom and registered in other districts:- Male. Female. Total. Live Births 709 658 1,367 Stillbirths 22 20 42 731 678 1,409 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 79 Total visits 79 To children under 1 year of age:- First visits 1,428 Total visits 8,493 To children between 1 and 5 years of age 11,615 Infant Protection visits to children 5-9 years 47 20,234 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 254 Number of prospective mothers 2,016 (X) Total number of attendances 11,513 Number of consultations 9,094 Average number of attendances:- (a) Per session 45.32 (b) For consultations 35.80 (x) Included in this total are 369 referred from the North Middlesex County Hospital under the scheme of co-operation with that hospital. POST-NATAL CLINIC Number of sessions 46 Actual number of mothers who attended 468 Number of consultations 1,070 Average attendance per session 24.13 Total attendances at clinic 1,110 ADVISORY CLINIC This clinic is held for women from 40-50 years of age in conjunction with the Post-Natal Clinic, who are needing advice, and the following attendances were made:- No. of attendances 9 No. of new cases 3 SPECIALIST' CLINIC The consulting Specialist made 24 visits during the year and saw 175 cases, making an average of 7.29 per session. CHILD WELFARE CLINICS. The figures relating to attendances are:- Brookfield House. Methodist Hall. St, Ediminds. Weir Hall. No. of sessions. 205 50 104 102 Now Cases:- (a) Under 1 year 583 180 224 257 (b) 1-5 years 115 33 32 29 Attendances:- (a) Under 1 year 10,675 3,834 3,926 6,695 (b) 1-5 years 5,905 2.315 2,316 4.730 16,580 6,149 6,242 11,425 Doctor's consultations 4,868 1,106 2,439 2,758 Average attendances 80.87 122.98 60.02 112.00 ORTHOPAEDIC CLINIC. The Clinic is held twice weekly and the following are the figures for the year:- Number of sessions 83 Now cases referred during the year 87 Attendances:- Surgeon's days 221 Treatment days 413 Total attendances 634 In-patient treatment Two children were admitted to stanmore during 1943, the average length of stay being 5 weeks 6 days. One child was still in hospital at the end of December, 1943. DENIAL CLINIC, Details of the work carried out are:- Mothers. Children. No. of sessions 103 71 Number of attendances 1,073 213 Number of new cases 396 139 Total number treated 1,058 210 Fillings 127 4 Dressings 12 301 Scalings 33 2 Extractions (No. of teeth) (a) Under gas 1,662 184 (b) Local Anaesthetic 67 — No. of gas cases. 412 93 Dentures. Number supplied-33 of whom 23 were assisted by the Committee, the remainder paying the full cost. .... SUNLIGHT CLINIC 552 children were referred during the year for sunlight treatment and 2,184 treatments were given. OPHTHALMIC CLINIC. 77 children under 5 years of ago attended this clinic during the year. 54 attendances wore made for Refraction and 106 for re-examination. BIRTH CONTROL CLINIC. 3 women wore referred to this clinic during the year. SPEECH CLINIC. Arrangements arc made with the Education Committee for children under five years of ago to attend the Speech Clinic and 8 children wore referred during the year. DETAILS OF DISTRIBUTION OF MILK, COD LIVER OIL, etc, distributed by the Maternity and Child Welfare Department apart from any scheme of the Ministry of Food, Trufood 152 tins. Ostermilk 313 " Cow & Gate 466 packets. Cod Liver Oil & Malt 36 cartons Halycalcyne 69 packets Glucose 2 " Forsolate 15 " Bemax 10 " FREE MEALS. During the year 12 applications were received 8 of whom wore granted the supply of free meals at the British Restaurants. 2 people had their applications renewed. CONVALESCENT CASES. 3 children were sent away under the contract with the Invalid Children's Aid Association and 3 children were still away at the beginning of the year who had been sent during 1942, TONSILS AND ADENOIDS. 65 children were admitted to hospital for the removal of tonsils and adenoids; of these 40 paid the full cost, 2 were free of charge and 23 were through the H.S.A. INFECTIOUS DISEASES. Ophthalmia Neonatorum. 17 cases were notified during the year and of these 14 occurred in North Middlesex County Hospital, 3 of which wore Edmonton cases. Of the three cases on the district, one was removed to hospital. Puerperal Pyrexia. 133 cases were notified during the year and of this number 120 occurred in North Middlesex County Hospital of which 34 were Edmonton cases. Ten cases occurred on the district of which seven were removed to the Isolation Hospital, and throe further cases were notified from the Mothers' Hospital, Clapton. MIDWIFERY SERVICE. Medical Aid. The number of claims made by doctors for Medical Aid during the year 1943 was 118, of this number 23 cases were granted free of charge, 13 at half cost and the remainder paid the full fee. Midwifery Service Contd. Analysis of work. Actual confinements attended by midwives 715 (Of this number 637 as midwives and 78 as Maternity nurses). Attended by midwives, but women admitted to hospital before 160 Loft district before confinement or mothers evacuated through 156 (Attention and Supervision given by Municipal midwives during AnteNatal period) Gas and Air analgesia. 32 cases were booked during the year, all of when paid the full cost. 22 cases had the Gas and Air administered and 10 were cancelled for various reasons. Evacuation of Expectant Mothers under the Government Scheme at the eighth month of pregnancy. The department is responsible for the arrangements in connection with the evacuation of exectant mothers under the Government Scheme, and in 1943, 360 mothers applied to bo sent away. By December 31st, 192 women had boon sent to reception areas for their confinement. 86 cancelled the arrangements for various reasons. Home Helps. 110 women had the services of a Home Help during 1942; 90 paid the full cost, 6 paid half cost and 14 had the services free of charge. Ante-Natal scheme of co-operation between the Council and North Middlesex County Hospital. Under on arrangement with the Middlesex County Council the Health Visitors visited 79 homes during the year where women applied to the North Middlesex County Hospital for admission and the Authorities desired to have a report on the home circumstances. Sterilised Maternity Outfits. 598 sterilised maternity outfits were issued during the year; 480 were paid for; 47 paid half cost and 71 were granted free of charge. X-Rays. 13 mothers were referred to the hospital for X-Rays during the year, 7 of whom paid the full cost, 4 half cost and 2 were free of charge. CHILDREN UNDER 5 YEARS OF AGE DISCHARGED FROM HIE NORTH MIDDLESEX COUNTY HOSPITAL 49 visits were paid to children under 5 years of age who had been discharged from the hospital and it was necessary for them to remain under supervision. infant life protection. Each Health Visitor employed by the Council is an Officer for Infant Life Protection and groat care is taken by then in-supervising this part of the work. The number of persons on the register at the end of 1943 was 25 and the number of children 29. WAR-TIME NURSERIES. Attendances for the whole year were:- Fore Street-15,718. Hertford Road - 12,100. Florence Road - 9,755 (Opened 27th January, 1943). The evacuated nursery at Harpenden had places for 28 children but was closed in February owing to staffing problems. BOROUGH OF EDMONTON EDUCATION COMMITTEE 1943. Chairman: Cr. W. H. Coleman. Vice-Chairman: Ald. W. Preye. His Worship the Mayor: Cr. J. a. Ward, J.P. Aldermen: A. J. Hollywood, J. Reid, W. F. Middleton, W. A. Ldmunds ana Mrs. E. A. Young. Councillors: Mrs. F. Long, Mrs. H. Nicholson, Mrs. E. k. Hearn, W. Bales, T. H. Joyce, H. Gatward, W. Green, G. X. W. Tott and S. W. Creasey. Whole Time Medical Stall D. Regan, B.a. , B.Sc., M.B., Ch.B., B.A.O., D.P.H.(L'pool). School Medical Officer, Medical Officer of Health and Supervisor of Maternity Services. H. R. Hay, M.B., Ch.B., D.P.H., Deputy School Medical Officer and Deputy Medical Officer of Health. C. A . Goggin, M.B., Ch.B., D.P.H., Assistant School Medical Officer and Assistant Medical Officer of Health. K. Hart, M.B., B.Sc.(Lond.), M.D., D.P.H., Assistant School Medical Officer and Assistant Medical Officer of Health. Whole Time Dental Surgeons. J. F. Ardouin, L.D.S., R.C.S., Senior Surgeon Dentist. E. Underbill, L.D.S., R.C.S., Assistant Surgeon Dentist. F. H. S. Weiss, L.D.S., R.C.S., Assistant Surgeon Dentist (now serving with His Majesty's Forces). Consultants J. A. Cholmeley, F.R.C.S.(Eng.), Orthopaedic Surgeon. Miss L. M. Smith-Clark, M.B., Ch.B., Ophthalmic Surgeon. J. Browning-Alexander, F.R.C.P., Rheumatic Specialist. W. Ibbotson, F.R.C.S., Aural Specialist. V. A. F. Greenish, L.D.S., R.C.S., Orthodontic Specialist. Part-time Staff. Miss M. F. Cozens-Walker, Chartered Masseuse. Miss B. N. Oldrey, M.S.S.T., Speech The rapist. School Nurses and Health Visitors. Miss A. Bintcliffe (Superintendent) Miss B. Lister Miss A. Naylor Miss V. Garrett Mrs. C. Tonkin Miss J. Paterson Miss M. R. Hazelton Miss M. Druce Miss A. Fahy Miss R. Bullock Miss J. Anderson Miss I. Jones (Commenced Aug., 1943.) Dental Attendants Miss 0. Brooks Miss J. Collyer 1 Clerical Staff B. R. Allen, School Medical Clerk (now serving with H.M. Forces). H. A. Carless, Acting School Medical Clerk. S. E. Woodfoffe, Clerk (now serving with H.M. Forces). Miss A. Savill, Clerk/Shorthand-typist. Mrs. E. R. Taylor, Clerk. Mrs. P. R. Thorley, Clerk. Miss V. D. Bruton, Clerk. To the Chairmen and Members of the Education Committee. Ladies and Gentlemen, I bag to submit my ninth Annual Report, for the year, 1943, on the work of the School Medical Department. As requested by the Board of Education the report will be brief, in that it only deals with salient facts, changes in the Department's services, etc. Although frequently faced with many difficulties over which we had no control, the work of the School Medical Department was carried out effectively Curing the year. The condition of the children was found to be, in the main, highly satisfactory. There are, however, still a few weakling and every effort is being made to remedy their defects insofar as it is possible. Otherwise, the duties devolving on the School Medical Department were much the same as in other years. I would like to express my thanks for the help and assistance I have received at all times from the Education Committee and also from the staff of my Department. As usual, the teachers were responsive to any requests made of them notwithstanding their already very full programme. I have the honour to remain, Ladies and Gentlemen, four obedient Servant, D. REGAN. School Madical Officer. 1. STAFF There are no staff changes to report for the year 1943. 2. CO-ORDINATION The co-ordination between the various Departments, general practitioners, Education Offices and teaching staff ran smoothly as in previous years. 3. SCHOOL There are no changes to report regarding school hygiene. 4. MEDICAL INSPECTION The number of children who received full routine medical inspections for all groups during the year 1945 was 6900. The analysis of the' age groups was as follows:- ENTRANTS: 2646 SECOND AGE GROUP: 2252 THIRD AGE GROUP: 2002 2 5. FINDINGS OF MEDICAL INSPECTIONS (a) Malnutrition. The following table shows the classification of nutrion for children inspected in the routine age groups during the year 1943:- Number Inspected A B C D 6900 1054 4994 840 12 (b) Cleanliness. The cleansing of heads and the treatment of scabies continued to bo carried out at the Town Hall Inspection Clinic. (c) Minor Ailments and Diseases of the Skin. The only Clinic in this district for the treatment of Minor Ailments is at Croyland Road. The attendances for 1943 were 22,800. (d) Visual Defects and External Lye Diseases. The clinic for the treatment of visual defects was held, as usual, at the Central Hall, Fore Street, N.9. Statistics are given at the back of this report. (e) Nose and Throat Defects and (f) Ear Diseases and Defective Hearing. Mr. William Ibbotson attended the Aural Clinic at the Croyland Road Clinic twice each month. The yearly attendances were:- New Cases: 327. Old Cases: 259 Total: 586 Children recommended for the removal of their tonsils and/or adenoids were admitted to the L.M.S. Hospital at Barley Lane, Goodmayes, and the Northern Hospital, Winchmore Hill, N.21. The number of children who received operative treatment during 1943 was 160. Arrangements Were also made for children to see the Specialist at the North Middlesex County Hospital, when parents preferred this, and the number of operations carried out there during 1943 was 77. Cases of speech defects were dealt with by Miss Oldrey, the Speech Ther???pist. (g) Dental Defects The treatment of dental defects was carried out at the Croyland Road and Hazelbury Road Dental Clinics. Particulars of attendances, etc., are given at the end of the report. Orthodontic cases were treated at the above two Clinics, and the total number of cases 0.1 the register up to the end of 1943 was 469. (h) Orthopaedic and Postural Defects. Orthopaedic defects were as in previous years, treated at the Special Clinic held at the Central Hall, Fore Street, N.9. Mr. J. A. Cholmeley, the Orthopaedic Specialist, attended the Clinic monthly and Miss Walker, the Masseuse, attended on Monday, Wednesday, Thursday and Friday mornings. The number of attendances during the year was 2707. The Surgeon saw 125 NEW CASES and 268 OLD CASES - TOTAL 393. (i) Heart Diseases and Rheumatism. Dr. J. B. Alexander, F.R.C.P., attended the Clinic, held once monthly, for the purpose of examining children suffering from rheumatism and diseases of the heart. Where necessary, arrangements were made for children to be admitted to Heart Homes. The attendances for 1942 were 95 NEW CASUS and 176 OLD CASES TOTAL: 271. (j) Tuberculosis I must extend my most grateful thanks to the Tuberculosis Officer for the co-operation he has given to this Department when dealing with cases referred to him. The number of notified cases and the mortality of children of school age during 1943, taken from the records of the Public Health Department, was:- Notified Deaths M F M F Pulmonary 3 9 — — Non-pulmonary 5 3 1 — (k) Other Defects ana Diseases These cases were dealt with as in previous years. 6. FOLLOWING-UP The same arrangements were in effect as in previous years. ARRANGEMENTS FOR TREATMENT The arrangements for treatment at the various Clinics were as follows:- Croyland Rd. Minor Ailment Clinic: A doctor was in attendance each morning to advise parents. Rheumatic Clinic: Held the third Thursday in each month - by appointment. Aural Clinic: Held the second and fourth Friday in each month - by appointment only. Ophthalmic Clinic: Held every Monday, with ional extra sessions. New Cases by appointment only. Orthopaedic Clinic: Held the first Friday in each month. By appointment only. Dental Clinics: Held at Hazelbury Rd. and Croyland Rd. Clinics. By appointment only. Orthodontic Clinic: Held once a month at each Clinic. By appointment only. Speech Clinic: ' Four sessions held each week at Hazelbury Road School. By appointment only. Ultra Violet Light Clinic: Held at Central Hall. By appointment only. INFECTIOUS DISEASES Children suffering from infectious diseases were dealt with in the same manner as in previous years. 4 BOARD OF_ EDUCATION Medical Inspection and Treatment Returns Year Ended 31st December, 1943. TABLE I. Medical Inspections of children attending Public Elementary Schools. A - ROUTINE MEDICAL INSPECTIONS (l) No. of Inspections in the Prescribed Age Groups: Entrants: 2646. Second Age Groups: 2252 Third Age Group: 2002. Total: 6900 (2) No. of other Toutine Inspections: Nil GRAND TOTAL: 6900. B - OTHER INSPECTIONS No. of Special Inspections and Re-Inspections 2571 TABLE II Classification og the Nutrition of Children Inspected During the Year in the routine Age Groups. Number of Children Insp. A B C D No. % No. % No. % No. % 6900 1054 15.23 4994 72.38 840 12.17 12 .17 TABLE III Treatment of Minor Ailments (Excluding Uncleanliness). (l) Total No. of Defects treated or under treatment during the year under the Authority's Scheme: 7627 (2) Treatment of Defective Vision and Squint. Under the Authority's Scheme. Errors of Refraction (including squint) 1047 Other defect of disease of the eyes (excluding those recorded in Group 1) — TOTAL 1047 No. of children for whom spectacles were:- (a) Proscribed 981 (b) Obtained 975 (5) Treatment of Defects of Nose and Throat (a) Received Operative Treatment 237 (b) Received Other Forms of Treatment 342 Total Number Treated 579 TABLE IV Dental Inspection and Treatment. (l) Number of children inspected by the Dentist. (a) Routine Age Groups 9010 (b) Specials 1698 Total (Routine & Specials) 10708 (2) Number found to require treatment 6599 (3) Number actually treated 3435 (4) Attendance made by children for treatment 10540 (5) Half-days devoted to:- Inspection: 48 Treatment 754 . 802 5 TABLE IV (continued). (6) Fillings:- Permanent Teeth: 2553 Temporary Teeth: 221 Total: 2774 (7) Extractions:- Permanent Teeth: 1131 Temporary Teeth: 4257 Total: 5338 (3) Administrations of general anaesthetics for extractions: 2233 (9) Other Operations:- Permanent Teeth: 288 Temporary Teeth: 3134 Total: 3422 TABLE V. Vermunous Conditions.. (l) Average number of visits per school made during the year by the School Nurses or other authorised persons: 16 (2) Total number of examinations of children in the school by School Nurses or other authorised persons: 31438 (3) Number of individual children found unclean: 1167 (4) Number of individual children cleansed under Section 87 (2) and (3) of the Education Act, 1921: 897 (5) Number of cases in which legal proceedings were taken:- (a) Under the education Act, 1921. — (b) Under School Attendance Byelaws. — TABLE VI Blind and Deaf Children. Number of totally or almost totally blind and deaf children who are not at the present time receiving education suitable for their special needs. At a Public Elementary School. At an Institution other than a Special School. At no School or Institution. Blind Children — — — Deaf Children — — — 6 SCONDARY SCHOOLS Returns in respect of children attending Secondary and Junior Technical Schools for the year ended 31st December, 1943. A. Cases in which a full examination has been made. Age 9 10 11 12 13 14 15 16 17 18 19 Boys — — 19 138 21 16 32 54 8 2 — Girls (Sec.) — — 7 99 36 12 31 20 2 — — (Tech.) — — — 59 10 2 — — — — TOTAL — — 26 237 116 38 65 74 10 2 — Classification of the Nutrition of Pupils Inspected During the Year, in Ages. Ages Number of Pupils Inspected A (Excellent) (Normal) C (Slightly Subnormal). D (Bad) 11 26 4 21 1 — 12 237 68 148 21 — 13 (Sec.) 57 17 34 6 — (Tech.) 59 10 39 10 — 14 (Sec.) 28 5 21 2 — (Tech.) 10 3 6 1 — 15 (Sec.) 63 10 47 6 — (Tech.) 2 — 2 — — 16 74 27 42 5 — 17 10 3 6 1 — 18 2 — 2 — — TOTAL (Sec.) 497 134 321 42 — (Tech) . 71 13 47 11 — C. Defective Vision ana Squint (excluding minor eye defects treated as minor ailments). Number of Defects dealt with Under the Authority's Scheme Otherwise Total Errors of Refraction (including squint) 163 (Sec.) — 163 59 (Tech.) — 59 Other defect or disease of the eyes (excluding those recorded as minor ailments). (Sec.) — — (Tech.) — — TOTALS 163 (Sec.) — 163 59 (Tech.) — 59 7 Total Number of Children for whom Spectacles were Prescribed: (a) Under the Authority's Scheme: 151 (Sec.) 53 (Tech.) (b) Otherwise; 1 (Sec.) 1 (Tech.) Total Number of Children who Obtained or Received Spectacles: (a) Under the Authority's Scheme 144 (Sec.) 53 (Tech.) (b) Otherwise 1 (Sec.) 1 (Tech.) D. Dental Defects. (l) Number of pupils who were:- (a) Inspected by tho Dentist: - Ages 11 12 13 14 15 16 17 18 19 Secondary — 9.6 199 164 123 92 39 14 — Technical — — — — — — — — — TOTAL: Secondary 727 Technical Nil. Specials: Secondary 34 Technical 12 GRAND TOTALS: Secondary 761 Technical 12 (b) Found to require treatment: Secondary 497 Technical 11 (c) Actually treated: Secondary 416 Technical 11 (2) Half days devoted to: (Sec.) Inspection 63 Total Secondary 68 Treatment 5 (Tech) Technical Nil (3) Attendances by pupils for treatment Secondary 805 Technical 40 (4) Fillings: Permanent Teeth Secondary 789 Technical 26 Temporary Teeth Sec.& Tech Nil TOTAL: Secondary 789 Technical 26 (5) Extractions: Permanent Teeth Secondary 191 " Technical 17 Temporary Teeth Secondary 14 TOTAL: Secondary 191 Technical 17 (6) Administrations of general anaesthetics for extractions: Secondary 106 Technical 9 (7) Other Operations: Permanent Teeth Secondary 217 " Technical 7 Temporary Teeth Sec. & Tech Nil. TOTAL: Secondary 217 Technical 7 8