Borough of Edmonton REPORT of the MEDICAL OFFICER OF HEALTH for the year 1951 Borough of Edmonton With the Compliments of the Medical Officet of Health. Public Health Department, Town Hall, Edmonton, N.9. Borough of Edmonton REPORT of the MEDICAL OFFICER OF HEALTH * for the year 1951 Borough of Edmonton 1951 His Worship the Mayor - Councillor R. J. Grant, J.P. Deputy Mayor Alderman T. H. Joyce PUBLIC HEALTH COMMITTEE Chairman: Alderman Mrs. F. Long, J.P. Vice-Chairman: Councillor L. E. Berridge. Members: The Mayor (Councillor R. J. Grant, J.P.) {Ex Officio) The Deputy Mayor (Alderman T. H. Joyce) (Ex Officio) Councillor H. F. Edwards “ Mrs. A. M. Glover “ J. D. Habgood “ G. K. McLeod “ Mrs. R. A. Smythe “ Miss M. L. F. Strutt 3 PREFACE Public Health Department. Town Hall, Edmonton, N.9. His Worship the Mayor, Aldermen and Councillors of the Borough of Edmonton. Your Worship, Ladies and Gentlemen, This is my 17th Annual Report for the year 1951 on the health and sanitary circumstances of the Borough. The Report is compiled in accordance with the requirements of the Ministry of Health Circular 42/51. The National Health Service Act is now three years in existence and it has created difficulties which it is to be hoped will be healed in time and with better administration. It has taken some considerable effort to align the services which we had in this Borough with those of another, difficulties have arisen, as they always do, under similar circumstances. Rendering an account of your stewardship in common to a Committee who possess little powers of administration seems to be a very futile proposition. It is to be hoped that wiser counsels will prevail in order to reduce the amount of administrative wor in providing a service to the people. At present the administration of the Medical Officer of Health and the Area Medical Officer is in one building, and it is to be hoped that an Area Health Office will be provided in the not too distant future, this will separate the Sanitary from the Area Health Administration, and while it will prove a useful purpose in the health administration of the area as a whole, it will undoubtedly create difficulties in the Medical Officer of Health's Department. It is apparent that the National Health Service Act was built up around Health Centres; as none of these is forthcoming the administration of the Health Services must of necessity be very 5 scattered. It appears to me that some co¬ordinating Committee is necessary to bring Hospitals, General Practitioners' Service and Local Health Authority Services into line. Old people can be dealt with under a variety of Acts. While some effort is being made under these Acts to alleviate distress caused by the difficulties of our time which hit the old people hardest of all. when it comes to the expenditure of money Authorities tend to economise, and the result is that the old people do not receive the necessary consideration which is their due. It is not true to say that they are entirely neglected, but the efforts needed in this direction are so great that a more co¬ordinated effort should be made before the old people will really receive what is their due. To apply the principles of prevention to the aged, some machinery must be got into existence which will tend to prevent old age from developing prematurely. My mind is centred in this respect on the establishment of Geriatric Clinics, where the problems which beset advancing years may be elucidated and dealt with. Housing is still causing considerable anxiety to a certain section of the population, and it would appear that the problem is an ever-increasing one in the face of the present national housing effort. That the individual should now proceed to build for himself appears out of the question on account of the great cost, likewise the cost of extensive repairs make it impossible for the landlord to save ageing property from becoming unfit for human habitation. The efforts made in clearance areas and house building by Local Authorities, although great in themselves, fall far short of what is needed. Food production does not appear to be having the impetus that is required to meet the needs of our population; at the same rime the health of the population is better now than ever before. Unless we increase our food production there appears little chance of abolishing the rationing system, although as I have already said, the population seems to be well nourished, yet one constantly hears from many people that they feel so tired. 6 Individual efforts seem to be getting more limited, and the fact that we have more freedom and recreational facilities at hand than ever before does not seem to be producing the effects that we had at one time thought possible. Health Education in our Borough is proceeding apace, but the demand for Health Education amongst the genera! population is now becoming more seriously felt. The Clean Food Campaign has not progressed as much as I would wish, but nevertheless, improvement in many spheres of food preparation and production is becoming more apparent. These factors are matters of great consolation to me personally, because after many years now of effort by your Officers, the population seems to be more health and hygiene conscious. We are now coming to the stage in our development where the population will demand higher standards in the services and facilities that are available to them. This is a good thing, for in this way the individuals that go to make up our community will help to establish their own good standards of health and hygiene. There are many houses still in the Borough which lack the facilities to make this possible. It is contemplated to establish Clearance Areas in order that the Council may, in their own good time. proceed with demolition and the establishment of suitable permanent homes. I have on many occasions drawn attention to the very dilapidated state of some of the buildings, and it is a source of great consolation to the members of my staff and myself that the Council now intend to proceed. At this stage I would like to mention the hygiene in schools. Your Education Department will remember that I have on many occasions mentioned certain separate schools in order that the sanitary accommodation should be improved. During the year I have, in company with my Senior Sanitary Inspector, presented a general survey drawing attention to some of the W.C. accommodation in our schools; no great progress has been made in this direction, and I would draw the Council's attention seriously to this great fault again. 7 Teachers endeavour to inculcate into the minds of young people the hygiene and sanitary conditions so necessary to their good health, if there is within the premises of the school conditions of sanitation which do not coincide with the teaching given, clearly the efforts of our teachers are wasted. We have again been beset by an outbreak of Sonne Dysentery; this forms part of a national condition which is difficult to curtail. This disease is not a very serious one, but it leads to a tremendous amount of loss of school, and in some cases to loss of working hours. Birth Rate has again fallen, the same circumstances as I mentioned in my last Report still appertain—the rising cost of living and the difficulty of obtaining suitable housing accommodation. Death Rate has risen and although it compares favourably with the country as a whole, it gives an uneasy feeling to see any rise in this direction. The rise, however, occurred mainly amongst old people. Infantile Mortality Rate is again lower and the NeonNatal Rate is likewise down. This fact reflects not only the great efforts of our doctors, midwives and health visitors, but also the increasing realisation amongst our young mothers of factors concerning the healthy upbringing of children. Maternal Mortality Rate is down to the extremely low figure of 0.71. There are three outstanding facts which must in future receive the attention of both Council and Staff alike, namely: — (1) The causation of slums. (2) The aetiology of old age. (3) The prevention of tuberculosis. 1. (a) This is caused in many instances by the occupants. (b) The complete absence of an all-out effort to improve ageing properties. 2. (a) The increasing tendency of the family to abandon their ageing parents. 8 (b) The Members of the family to take their parents too much for granted. (c) Premature senility. (d) The increased cost of living. 3. (a) The old routine methods for detecting tuberculosis are now not sufficient. (b) The tendency, still prevalent, to conceal recurring illness without seeking medical advice. (c) No facilities are readily available to General Practitioners to detect tuberculosis in its early stages. (d) Overcrowded housing conditions. On the whole the health and sanitary circumstances of Edmonton is a matter to be proud of, and I commend to you my Staff for the splendid team work they have displayed in bringing about this satisfactory result. I would like to thank my Staff for their devotion to duty and their loyal co¬operation during the year. In conclusion, my thanks are due to the members of the Public Health Committee and the Council for their help and courtesy during the past year. I have the honour to be. Your Worship, Ladies and Gentlemen, Your obedient servant, D. REGAN. Medical Officer of Health. 9 STATISTICS AND SOCIAL CONDITIONS OF THE AREA Area (in acres) 3,896 Population— Census of 1921 66,809 Census of 1931 77,652 Estimated by the Registrar-General for mid-year 1951 103,300 Number of inhabited houses and tenements at the end of 1951 28,564 Number of inhabited houses and tenements at the end of 1950 28,485 Rateable value, April, 1951 Estimated product of 1d. in the £ for the year ending March 31st, £746,589 1952 £3,010 Rates in the £ for the year ending March 31st, 1952 19s. 6d. VITAL STATISTICS. Live Births. M. F. Total. Grand Total. Legitimate 666 647 1,313 Illegitimate 25 34 59 1,372 Birth-rate per 1,000 of population 13.28 Stillbirths. Legitimate 20 10 30 Illegitimate 2 — 2 32 Total of live and stillbirths 1,404 Rate per 1,000 total births 22.79 Deaths. Number 589 514 1,103 Rate per 1,000 population 10.67 Maternal Mortality Deaths. Rate per 1,000 total (live and stillbirths). Toxaemias of Pregnancy 1 0.71 Complication of Pregnancy and Delivery — — 1 0.71 Death rate of infants under one year of age. M. F. Total. Number 17 16 33 All infants per 1,000 live births 24.05 Legitimate infants per 1,000 legitimate live births 22.84 Illegitimate infants per 1,000 illegitimate live births 50.84 Deaths from Cancer (all ages) 201 Measles (all ages) 1 Whooping Cough (all ages) — „ „ Diarrhoea (under 2 years of age) 1 10 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 Tuberculosis, respiratory 14 9 23 Tuberculosis, other 2 1 3 Syphilitic disease 3 ... 3 Diphtheria ... ... ... Whooping Cough ... ... ... Meningococcal infections ... ... ... Acute Poliomyelitis ... ... ... Measles ... 1 1 Other infective and parasitic diseases 1 ... 1 Malignant neoplasm, stomach 15 19 34 Malignant neoplasm, lung, bronchus 25 8 33 Malignant neoplasm, breast 1 14 15 Malignant neoplasm, uterus ... 5 5 Other malignant and lymphatic neoplasms 66 48 114 Leukaemia, aleukæmia 2 ... 2 Diabetes 2 8 10 Vascular lesions of nervous system 52 59 111 Coronary disease, angina 67 37 104 Hypertension with heart disease 28 22 50 Other heart disease 75 103 178 Other circulatory disease 29 16 45 Influenza 6 7 13 Pneumonia 25 32 57 Bronchitis 72 37 1 9 Other diseases of the respiratory system 5 4 9 Ulcer of stomach and duodenum 14 3 17 Gastritis, Enteritis and Diarrhoea 2 4 6 Nephritis, and Nephrosis 5 3 8 Hyperplasia of Prostate 11 ... 11 Pregnancy, childbirth, abortion ... 1 1 Congenital malformations 5 2 7 Other defined and ill-defined diseases 44 57 101 Motor Vehicle Accidents 6 3 9 All other accidents 7 7 14 Suicide 5 4 9 Homicide and operations of war ... ... ... TOTALS 589 514 1,103 11 The two following tables give the deaths of those registered during the 52 weeks ended 29th December, 1951. The slight difference between the following tables 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 Tuberculosis, respiratory 16 ... ... ... ... ... ... 2 7 2 4 1 Tuberculosis, other 2 ... ... ... 1 ... ... ... ... ... ... 1 Syphilitic disease 3 ... ... ... ... ... ... ... 1 1 1 Diphtheria ... ... ... ... ... ... ... ... ... ... ... ... Whooping Cough ... ... ... ... ... ... ... ... ... ... ... ... Meningococcal infections ... ... ... ... ... ... ... ... ... ... ... ... Acute Poliomyelitis ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... ... ... Other infective and parasitic diseases 1 ... ... ... ... ... ... ... ... ... 1 ... Malignant neoplasm, stomach 15 ... ... ... ... ... ... 2 4 3 3 3 Malignant neoplasm, lung, bronchus 26 ... ... ... ... ... 1 3 3 9 7 3 Malignant neoplasm, breast 1 ... ... ... ... ... ... ... ... ... ... 1 Malignant neoplasm, uterus ... ... ... ... ... ... ... ... ... ... ... ... Other malignant and lymphatic neoplasms 66 ... ... 1 ... 1 1 2 5 15 21 20 Leukaemia, aleukæ00mia 2 ... ... ... ... ... ... ... 1 ... ... ... Diabetes 2 ... ... ... ... ... ... ... ... ... 1 1 Vascular, lesions of nervous system 58 ... ... ... ... ... 1 1 5 9 18 24 Coronary disease, angina 66 ... ... ... ... ... 1 5 14 19 15 12 Hypertension with heart disease 27 ... ... ... ... ... ... 1 1 2 10 13 Other heart diseases 75 ... ... ... ... 1 1 3 3 7 22 38 Other circulatory disease 26 ... ... ... ... ... ... ... 2 3 9 12 Influenza 6 ... ... ... ... ... ... 1 1 ... 1 3 Pneumonia 27 3 1 ... ... ... ... 1 1 1 0 11 Bronchitis 72 ... ... ... ... ... 1 1 4 19 24 23 Other disease of respiratory system 5 ... ... ... ... ... ... ... 1 1 1 2 Ulcer of stomach and duodenum 14 ... ... ... ... ... 1 3 4 2 ... 4 Gastritis, Enteritis and Diarrhoea 1 1 ... ... ... ... ... ... ... ... ... ... Nephritis and nephrosis 5 ... ... ... ... ... 1 ... 1 1 ... 2 Hyperplasia of prostate 11 ... ... ... ... ... ... ... ... 1 5 5 Pregnancy, childbirth, abortion ... ... ... ... ... ... ... ... ... ... ... ... Congenital malformations 1 4 ... ... ... ... ... ... ... ... ... ... Other defined and ill-defined diseases 42 8 ... ... ... 1 1 3 9 3 4 13 Motor Vehicle Accidents 6 ... ... 1 ... 1 ... 3 ... ... ... 1 All other accidents 8 1 ... ... ... 1 ... 1 ... 1 3 ... Suicide 5 ... ... ... ... ... 1 ... ... 1 1 2 Homicide and operations of war ... ... ... ... ... ... ... ... ... ... ... ... TOTALS 592 17 1 2 3 5 10 32 67 100 159 196 12 FEMALES 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 Tuberculosis, respiratory 9 ... ... ... ... 2 3 ... ... 3 1 ... Tuberculosis, other 1 ... ... ... ... ... ... ... 1 ... • •• ... Syphilitic disease ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria ... ... ... ... ... ... ... ... ... ... ... ... Whooping Cough ... ... ... ... ... ... ... ... ... ... ... ... Meningococcal infections ... ... ... ... ... ... ... ... ... ... ... ... Acute Poliomyelitis ... ... ... ... ... ... ... ... ... ... ... ... Measles 1 ... ... 1 ... ... ... ... ... ... ... ... Other infective and parasitic diseases ... ... ... ... ... ... ... ... ... ... ... ... Malignant neoplasm, stomach 19 ... ... ... ... ... ... ... ... 1 9 9 Malignant neoplasm, lung, bronchus 8 ... ... ... ... ... ... 1 1 3 3 ... Malignant neoplasm, breast 14 ... ... ... ... ... ... 2 1 2 4 5 Malignant neoplasm, uterus 5 ... ... ... ... ... ... ... 1 1 2 1 Other malignant and lymphatic neoplasms 44 ... ... ... ... ... ... 4 8 0 14 9 Leukemia, aleukæmia ... ... ... ... ... ... ... ... ... ... ... ... Diabetes 8 ... ... ... ... ... ... ... 1 2 1 4 Vascular, lesions of nervous system 65 1 ... ... ... 1 1 3 1 10 15 33 Coronary disease, angina 37 ... ... ... ... ... ... ... l 4 13 19 Hypertension with heart disease 22 ... ... ... ... ... ... 1 ... 2 8 11 Other heart diseases 103 ... ... ... ... ... 1 ... 5 6 26 65 Other circulatory disease 18 ... ... ... ... ... 2 1 1 5 1 8 Influenza 6 ... ... ... ... ... ... ... ... 2 3 1 Pneumonia 35 4 ... ... ... ... ... ... ... 4 10 17 Bronchitis 35 ... ... ... ... ... ... ... 2 5 9 19 Other disease of respiratory system 6 ... ... ... ... ... ... ... 2 ... 1 2 Ulcer of stomach and duodenum 3 ... ... ... ... ... ... ... ... ... 3 ... Gastritis, Enteritis and ... ... ... ... ... ... ... ... ... ... ... ... rhoea 2 ... ... ... ... ... ... l ... ... ... 1 Nephritis and nephrosis 4 ... ... ... ... ... ... ... 1 1 1 1 Hyperplasia of prostate ... ... ... ... ... ... ... ... ... ... ... ... Pregnancy, childbirth, abortion 1 ... ... ... ... ... ... 1 ... ... ... ... Congenital malformations 2 1 ... 1 ... ... ... ... ... ... ... ... Other defined and ill-defined diseases 54 9 ... ... 1 1 ... 1 6 5 13 18 Motor Vehicle Accidents 3 ... ... ... 1 ... ... ... 1 ... ... 1 All other accidents 7 ... ... ... ... ... ... ... l ... 1 4 Suicide 4 ... ... ... ... ... ... ... 1 l 1 1 Homicide and operations of war ... ... ... ... ... ••• ... ... ... ... ... ... TOTALS 515 16 ... 2 2 4 7 15 35 66 139 229 13 INFANTILE MORTALITY. The deaths of infants under one year of age were as follows:— M. F. Total Legitimate 15 15 30 Illegitimate 2 1 3 17 16 33 The death rate of all infants per 1,000 live births was 24.05. The death rate of all infants under one month of age per 1,000 live births was 17.49 A detailed sub-division of the causes, etc., of these DEATHS is as follows: — MALES. Causes of Death One week Second Week Third Week Fourth Week Total under 1 month 1—3 months 3—6 months 6—9 months 9—12 months Total under 1 year Pneumonia 1 ... ... ... 1 ... 1 1 ... 3 Congenital Malformations ... 1 ... 1 2 2 ... ... ... 4 Premature Birth 5 ... ... ... 5 ... ... ... ... 5 Atelectasis 2 ... ... ... 2 ... ... ... ... 2 Other Causes 1 ... ... ... 1 ... ... 1 ... 2 Gastro-enteritis ... ... ... ... ... ... 1 ... ... 1 Totals 9 1 ... 1 11 2 2 2 ... 17 FEMALES. Causes of Death One week Second week Third week Fourth week Total under 1 month 1—3 months 1 3—6 months 6—9 months 9—12 months Total under 1 year Pneumonia 1 1 ... ... 2 ... ... 2 ... 4 Premature Birth 7 ... ... ... 7 ... ... ... ... 7 Congenital Malformations 1 ... ... ... 1 ... ... ... ... 1 Other Causes 1 ... ... ... 1 ... ... ... 1 2 Injury at Birth 2 ... ... ... 2 ... ... ... ... 2 Totals 12 1 ... ... 13 ... ... 2 1 16 14 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 deaths under 1 year Live Still England and Wales 15.5 0.36 1.4 29.6 London 17.8 0.37 0.7 26 4 Edmonton 13.28 0.30 0.72 24.05 Annual Death Rate per 1,000 of Population. All Causes Whooping Cough Diphtheria Influenza England and Wales 12.5 0.01 0.00 0.38 London 13.1 0.01 0.00 0.23 Edmonton 10 67 0.00 0.00 0.12 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 Registrar-General. The deaths include those taken place outside the Borough, the information being given quarterly by the Registrar-General. Ward Births Deaths Infant Deaths M. F. M. F. M. F. Bury Street 143 154 172 142 4 2 Church Street 61 57 125 130 3 1 Angel Road 80 82 127 94 7 4 Silver Street 109 106 167 149 3 9 Vagrants ... ... 1 ... ... ... 393 399 592 515 17 16 15 LABORATORY SERVICE The following specimens submitted from the Edmonton area were examined by the Medical Research Council Laboratory (Edmonton), during the year as follows:— Nature of Examination Positive Negative Total Blood Counts — — 81 Blood—Haemoglobin Estimation — — 428 Blood—Kahn Reaction — — 336 Blood—Rhesus Factor — — 338 Blood—Grouping — — 338 Blood—Sedimentation Rate — — — Blood—Wassermann Reaction — — — Eye swabs for organisms — — 9 Faeces for the presence of organisms 205 867 1,072 Faeces for the presence of Sonne Dysentery 668 3,202 3,870 Hairs from scalp for presence of Ringworm — — 1 Pre-nasal swabs for H. Pertussis — 1 1 Swabs for presence of C. Diphtherias: (a) From Suspect Cases — 128 128 (b) From Contacts — 12 12 (c) From Carriers and old cases, etc. — 1 1 Swabs for presence of Haemolytic Streptococci 284 1,783 2,067 Swabs for presence of Vincent's Angina 1 31 32 Urines — — 380 Vaginal swabs for presence of organisms 2 43 45 Abscess from English leg of lamb for T.B. — 1 1 Acriflavine ointment for contamination — 1 1 Ear swabs — 4 4 Faeces for Typhoid Fever — 2 2 Faeces for presence of Salmonella Typhi-Murium 2 — 2 Lamb and bacon pie — — 1 Mouth swab — — 1 Pus from carbuncle — — 1 Penis swab — 1 1 Rectal swab — 1 1 Swab from Umbilicus — — 1 „ Boil — — 2 „ Cups — — 8 „ Saucers — — 1 „ Plates — — 9 Slide for Threadworm — 3 3 Sample of washing-up water — — 8 Sample of main water supply — — 1 Vomit — — 1 Water from cistern — — 1 Sputum for T.B. - 3 3 Total 9,192 16 MILK (SPECIAL DESIGNATION) REGULATIONS 1949, Thirty-one samples of Designated Milks were examined during 1951. Results were as follows: — Pasteurised Milk. 17 Samples were examined. 12 Samples satisfied both the prescribed tests. 5 Samples failed to pass the Methylene Blue test. (4 of these results may be disregarded in view of the rise in temperature to above 65° F.) Tuberculin Tested (Pasteurised) Milk. 8 Samples were examined. 7 Samples satisfied both the prescribed tests. 1 Sample failed the Methylene Blue test but the result may be disregarded in view of the rise in temperature to above 65° F. Sterilised Milk. 6 Samples were examined and all passed the Turbidity test. The Milk (Special Designations) (Specified Areas) Order 1951, came into operation on 1st October, 1951. This Order applies to certain areas specified in the Schedule of the Order, including the whole of the County of Middlesex. In the specified areas it will be illegal for any person to sell by retail for human consumption any milk other than milk which may be sold as specially designated milk. SANITARY CIRCUMSTANCES OF THE AREA. The water supply of the Borough has at all times been satisfactory both in quality and quantity. The Metropolitan Water Board is responsible for the supply which is piped direct to every dwelling-house throughout the Borough, and serves the entire population. The co-operation of the Board has at all times been of the fullest. 17 The following table gives details of the work carried out during the year. 1. Prevalence of Rats and Mice. Type of Property Local Authority. Dwellinghouses Agricultural All other (including Business and Industrial) Total i. Number of Properties inspected by the Local Authority during 1951 as a result (a) of notification or (b) otherwise. (a) 8 696 .. 96 800 (b) .. 104 .. .. 104 2. Number of Properties (under 1) found to be infested by rats. Major 3 .. .. 9 12 Minor 2 468 .. 62 532 3. Number Of Properties (under 1) found to be seriously infested by mice 1 72 .. 20 93 4. Number of Infested Properties (under 2 and 3) treated by the Local Authority. 7 549 .. 90 637 5. Number of Notices served 1 under Section 4 (1) Treatment .. .. .. .. .. (2) Structural Works (i.e. Proofing) .. .. .. 1 1 Total .. .. .. 1 1 18 SANITARY INSPECTION IN THE AREA. Six District Sanitary Inspectors and one woman Sanitary Inspector 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. Sanitary Conveniences. There are seven Public Conveniences in the Borough which are kept under constant supervision by the Public Health Department. During the year free hand-washing facilities were introduced. Liquid soap containers and paper towels were provided at each Public Convenience. This innovation has proved very successful. Rodent Control. Under this heading your Senior Sanitary Inspector, as Officer-in-Charge, Rodent Control, reported as follows: — The Prevention of Damage by Pests Act, 1949 came into force on the 31st March, 1950. The Council have an Assistant Rodent Officer, two Rodent Operators, the part-time services of a Junior Clerk and appointed the District Sanitary Inspectors as Rodent Officers. The District Sanitary Inspectors in cases where there was a possibility of the infestation being due to defective drainage visited the premises and tested the drainage and any defects discovered were dealt with through the usual channels. In 80 per cent of the cases defects were discovered and as one can quite appreciate entailed quite a large amount of work. 2 Measures of Control. Type of Property. Properties Inspected. No. of Inspections Notices Served. Treatment Completed. Block Treatments Rats. Mice. Local Authority's Premises 21 172 .. 9 1 .. Dwelling Houses 740 2,766 .. 413 50 .. Business Premises 83 570 1 23 18 .. Total 844 3 50S 1 445 69 .. Disinfection and Disinfestation. The following table gives some idea of the work carried out: — Number of journeys to collect bedding ... 296 „ return bedding ... 294 Rooms disinfected after infectious disease 204 „ „ „ phthisis 92 other cases ... 52 vermin ... 335 Bedding, clothing, etc., disinfected after infectious disease 2951 articles • „ „ „ „ phthisis 379 „ other cases 1504 „ vermin 34 „ 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 6,388. 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 2,048. Ten Council properties and 106 other houses were found to be infested, the total number of rooms disinfested was 335. The whole of the work is carried out by the Department, the materials used being Insecticides containing D.D.T. as a base. 19 During the year maintenance treatments of the sewers took place by the Borough Engineer's Department. Middlesex County Council Act, 1950, Section 11. Section II of this Act, which relates to Hawkers of Food and their Premises,came into operation on the 1st of April, 1951. Five persons and their premises were registered during the year, and two persons were registered to trade in the Borough where storage premises are located in other districts. Rent and Mortgage Interest (Restrictions) Acts 1920-1933 During the year your Senior Sanitary Inspector issued one Certificate under the above Acts upon application of the Occupier of a dwelling-house in the District. Petroleum (Regulations) Acts, 1928 and 1936. During the year 6 new licences and 112 renewals were granted by the Council. The following is a list of particulars of quantities, etc., affected by these licences: — Petroleum spirit 429,894 galls. Petroleum mixtures (cellulose) 11,661 „ Carbide of calcium 200 lb. Rubber solution 100 lb. + 750 galls. Mortuary. During the year 99 bodies were deposited in the Mortuary, 97 by order of the Coroner and 2 for sanitary reasons. Inspections. The following tabular statement gives the number and the nature of the inspections made during the year:— Complaints 2,271 Infectious Diseases 736 Infectious Diseases, other visits 11 Food Poisoning 12 Tuberculosis 1 House-to-House 177 Factories with mechanical power 335 Factories without mechanical power 4 Factories (other) 7 Outworkers 25 Schools 25 Offensive trades 9 Shops and Stalls 154 Shops Act (Primary) 2 Shops Act (Re-inspections) 25 Sanitary conveniences and urinals 156 Smoke observations 108 Rat infestation 422 Petroleum 153 General inspections 450 Sundry visits 1,768 Cinemas and Halls 21 Stables and Piggeries 153 Moveable Dwellings 21 Re-inspections 7,911 Sampling Ice Cream 20 Sampling Milk 26 Rag Flock 14 20 Inspection of Places where Food is Prepared. Butchers 143 Fish shops 83 Cafes 159 Dairies and milkshops 75 Slaughterhouses 13 Bakehouses (Factory) 64 Bakehouses (Workshops) 5 Ice cream shops 99 Canteens 88 Other food premises 176 Number of Notices Served. Preliminary or Informal Notices 643 Statutory Notices 734 Defects Remedied. Roofs repaired 1,128 Gutters and rainwater pipes repaired 623 Brickwork or Pointing repaired 362 Chimney Stacks, etc., repaired or rebuilt 76 Yards or forecourts repaved or repaired 68 Drains examined, tested or exposed 530 Drains cleared, trapped or repaired 277 Drains re-constructed 188 Chambers inserted or built up to ground level 90 Soil and vent pipes, new fixed or repaired 108 W.C.s repaired or improved 370 Flushing cisterns repaired or new fixed 122 Sink waste pipes repaired or new fixed 104 New sinks fixed 52 Drinking water cisterns covered, cleansed, repaired 5 Water fittings repaired 41 Water taken off main or restored 19 Internal walls 1,376 Ceilings repaired, cleansed, etc. 1,222 Floors repaired 263 Floors ventilated 96 Dampness remedied 227 Window frames or sashes repaired or renewed 1,085 Fireplaces, stoves repaired 245 Coppers repaired 17 New dustbins supplied 16 Premises rat-proofed 66 Improper keeping of animals discontinued — Foul accumulations removed 6 Other nuisances abated 644 Moveable dwellings removed 6 21 Places of Public Entertainment. Twenty-one 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 ACTS, 1937 AND 1948. The following work has been carried out under the above Act:— 1.—Inspections for the Purpose of Provisions as to Health. Premises Number in Register Inspections Written Notices Occupiers Prosecuted Factories with mechanical power 12 10 1 — Factories without mechanical power 219 373 44 — Other premises under the Act (including works of building and engineering and construction but not including outworkers' premises) 5 8 - - Totals 236 391 45 — 2.—Defects Found. Particulars Number of defects No. of defects in respect of which prosecutions were instituted Found Remedied Referred to H.M. Inspector by H.M. Inspector Want of cleanliness 4 4 1 _ Overcrowding — — — — — Unreasonable temperature — — — — — Inadequate ventilation 2 2 — — — Ineffective drainage of floors 1 1 — — — Sanitary Conveniences : Insufficient 4 4 — — — Unsuitable or defective 48 47 — 3 — Not separate for sexes 1 1 — 1 — Other offences 9 9 1 — (Not including offences relating to outwork) Totals 69 68 1 5 — 22 3.—OUTWORK—Sections 110 and 111 Nature of Work Section no Section in No. of Outworkers in August list No. of cases of default in sending lists to the Council No. of prosecutions for failure to supply lists No. of instances of work in unwholesome premises Notices served Prosecutions Wearing apparel, making, etc. 272 — — — Artificial flowers 9 — — — — — Furniture and upholstery 3 -- — — — — The making of boxes or other receptacles or parts thereof made wholly or partially of paper 26 - - - - - Brush making 62 - — — — — Stuffed toys 16 — — — — — Cosaques, Christmas crackers, Christmas stockings, etc. 12 - - - - - Lampshades 4 — — — — — Brass and Brass articles 6 — — — — — Carding, etc., of Buttons. etc. 10 — — — — — Curtains and Furniture Hangings 2 — — — — — Totals 422 — — — — — Hag Flock and Other Filling Materials Act, 1951. This Act came into force on the 1st November, 1951, and up to the end of the year ten premises were registered by the Council where Filling Materials were used, and two licences granted for the storage of Rag Flock. HOUSING. 1.—Re-development Areas. Following representations by the Medical Officer of Health, the Council on the 25th September, 1951, made Clearance Area Compulsory Purchase Orders under Part 3 of the Housing Act, 1936, comprising the following premises:— (a) Beaconsfield Road Clearance Area 1951 4 to 58, Beaconsfield Road (even numbers inclusive). (b) Penn Street Clearance Area 1951 1 to 6, Penn Street (inclusive). 8 to 11, Penn Street (inclusive). 41 to 51, Sebastopol Road (odd numbers inclusive). 23 (c) Sebastopol Road (No. 1) Clearance Area 1951 21 and 23, Sebastopol Road. (d) Sebastopol Road (No. 2) Clearance Area 1951 20 to 26, Sebastopol Road (even numbers inclusive). Making a total of 50 houses involving 179 persons. A Public Inquiry was held in January, 1952, and the Ministry of Housing and Local Government subsequently confirmed the Orders. HOUSING ACT, 1936. 2. Inspection of Dwelling Houses During the Year:— (1) (a) Total number of dwelling houses inspected for housing defects (under Public Health or Housing Acts) 2,269 (b) Number of inspections made for the purpose 9,866 (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 177 (b) Number of inspections made for the purpose 573 (3) Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 61 (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 1,994 3. Remedy of Defects During the Year without Service of Formal Notices Number of defective dwelling houses rendered fit in consequence of informal action by the Local Authority or their officers 471 4. 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 313 (2) Number of dwelling houses which were rendered fit after service of formal notices:— (a) By owners 209 (b) By Local Authority in default of owners 24 24 B.—Proceedings under Public Health Acts:— (1) Number of dwelling houses in respect of which notices were served requiring defects to be remedied 421 (2) Number of houses in which defects were remedied after service of formal notices:— (a) By owners 368 (b) By Local Authority in default of owners 6 C.—Proceedings under Sections 11 and 13 of the Housing Act, 1936:— (1) Number of dwelling houses in respect of which demolition orders were made 10 (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 were made — (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenements or rooms having been rendered fit. SLAUGHTERHOUSES. Thirteen visits were paid and the caseases and organs of 31 pigs killed were inspected during or shortly after slaughter. None was found to be affected with tuberculosis. Nine carcases of which some part or organ was condemned, showed a percentage of the number inspected affected with disease, other than tuberculosis, of 29.03. The following organs were surrendered:— 8 sets of Lungs; 1 Liver; 1 Pluck. INSPECTION AND SUPERVISION OF FOOD. Milk Supply. Various licences were granted as under:— Primary Supplementary Pasteurised 46 17 Tuberculin tested 23 15 Sterilised 89 16 158 48 Suplementary licences are granted to retailers who live outside the Borough but who sell milk in the Borough; the primary licence is granted by the Authority in which the premises are situate. 25 Food and Drugs Act, 1938—Section 14 During the year fifteen premises were registered for the Sale and Storage of Ice Cream. Number on Register at end of year:— Manufacturers and Vendors 7 Vendors only 176 Unsound Food. The following is a list of the food surrendered for examination and retained as unfit for human consumption:— 1168 tins Meat 281 tins Tomatoes 2590 „ Milk 1872 lbs. „ 1076 „ Fish 51 boats „ 154 „ Jams, etc. 99 lbs. Offal 783 „ Soups 527¼ lbs. Beef 531 „ Beans 5 tins Brawn 1314 „ Beetroot 72 Faggots 37 „ Carrots 69 „ Mixed Veg. 23 stones Haddock 803 „ Peas 2 „ Halibut 32 „ Potatoes 5 „ Herrings 121 „ Spinach 2 „ Kippers 19 „ Turnips 2 „ Plaice 383 „ Apples 55 jars Mussels 62 „ Apricots 116 lbs. Prawns 946 lbs. „ 36¼ stones Skate 1 „ Blackcurrants 1 „ Sole 397 „ Cherries 2 „ Whiting 20 „ Damsons 31 „ Roes 15 pkts. Dates 44 cwt. 16 lb. 15 „ Figs & 5 picnic Ham 20 tins Gooseberries 9 tins & 41 lbs. Chicken 18 „ Grapefruit 3 lbs. Suet 9 „ Grapes 18½ „ Sweets 764 „ Greengages 128 Cakes 7 „ Raspberries 38 lbs. Cake 380 „ Plums 12 „ Semolina 13 „ Prunes 62 pkts. Cereals 20 lbs. 115 Puddings 11 tins Peaches 36 lbs. Biscuits 46 „ Pears 4 pkts. Macaroni 256 boxes 60 Jellies 52 tons Pineapple 29 lbs. Mutton 72 „ Oranges 5 „ Veal 22 „ Rhubarb 97 „ Lamb 20 „ Strawberries 12 ¼ „ Pork 112 „ Tomato Juice 6 „ Sausages 62 „ Fruit Juices 745 „ Rabbit 26 3 Meat Pies 31 tins Fish Paste 14 stones Cod 37 jars Meat Paste 15½ Dog Fish 15 cartons Chocolate Spread 73 Fish Cakes 8 „ Sandwich Spread 8 bottles Vinegar 212 tins Spaghetti 5597 pkts. Cheese 2851 „ Baby Food 110 jars Pickle 8 „ Celery 152 bottles Sauce 2 lbs. Nuts SHOPS ACT and STREET TRADING The Shops Act 1950 came into operation on 1st October, 1950; this Act consolidates the Shops Acts, 1912 to 1938- and certain other enactments relating to shops. The Department administers three local Orders under the Act. There are approximately 1,226 shops and places other than shops in the Borough which are liable to inspection. The Shops Acts and Street Trading Inspector submits a monthly report to the Public Health Committee, and the following is a short summary of the work carried out during the year. Visits to Shops, Licensed Street Traders, etc. 1,320 Washing facilities, sink water heaters installed 25 Contraventions were in the main of a minor character, mostly concerned with the exhibition of notices. Shops Act, 1950 Section 17(1) Conditions of Employment Provisions as to assistants' half-holiday. Letters of warning were sent where 3 assistants were found working in a shop on the occasion of their weekly half-holiday. Shops Act 1950—Sunday Trading Thirty-seven shops were visited in addition to supervisory operations and observations. One contravention was discovered; a letter of warning was sent. Registers required to be kept under this Act were inspected periodically. Shops Act 1950—Closing Orders (Section 2). A communication was received from the Edmonton Branch London and Provincial Hairdressers' Association requesting that the Winter Closing of Hairdressers' Shops should be 6.30 p.m., Monday, Tuesday, Wednesday and Saturday, late night Friday 7 p.m., during Winter 1951-52. Enquiries were made in accordance with Section 2 of the above Act; the result of the poll showed a majority of opinion to continue with the existing closing hours during the winter. In view of this the Council were not prepared to make an Order for amended winter closing hours. 27 Young Persons (Employment) Act, 1938 Cinemas and Boot and Shoe Repairing are the only occupations where young persons are being employed under the above Act. The Registers kept at these premises were perodically inspected. Middlesex County Council Act, 1944-1950. Street Trading.—No Legal proceedings were instituted during 1951. In 16 instances letters of warning were issued. The inspection of shops, stalls and other traders' premises coming within the scope of the Acts has been carried out throughout the year, including Sundays and evenings. PREVALENCE OF INFECTIOUS DISEASE. Measles and Whooping Cough. These diseases were made cumpulsory notifiable in October, 1939. 1,610 cases of Measles and 349 cases of Whooping Cough were notified during the year. There was one death from Measles. Diphtheria. Two cases were notified during the year; no cases were notified in 1950. Scarlet Fever. Continued to occur throughout the year in a mild form. There were 189 cases compared with 331 in 1950; there were no deaths. "Return" cases numbered one, 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. 28 Dysentery. During the year 661 cases of Dysentery were notified—604 Sonne, 3 Bacillary, 38 Giardia, 16 Sal. Typhi-Murium and 1 Sal. Newport. Of the 661 cases referred to above, 437 were notified during the first four months of the year, and was a continuation of the outbreak which commenced in the Borough towards the end of 1950. Action taken to deal with the situation was fully reported upon in my Annual Report for 1950. The effectiveness of these measures (and in particular the exclusion of all cases of diarrhoea in schools and nurseries until a negative laboratory test was obtained) is illustrated by the attached diagram of the Sonne Dysentery epidemic of 1950-51. I am indebted to Dr. M. Thomas of the Public Health Laboratory Service (Edmonton), who prepared the diagram. No major outbreaks occurred after the institution of the control measures and it should be emphasised that control of this kind was only made possible by the full co-operation of the General Practitioners, Education Department and Teachers, the Staff of the Public Health Laboratory Service (Edmonton) and the Staff of the Health Department. The careful bacteriological investigation of cases and household contacts has (in addition to aiding the control of the epidemic) yielded valuable information about the epidemiology of Sonne Dysentery, in particular about the specially high rate of attack and length of infectivity of children under 14 years of age as compared with persons over that age. Again I would like to thank Dr. M. Thomas for the excellent work and assistance she has rendered to me in connection with this epidemic, and would add that I always had the full support and co-operation of Dr. Thomas at all times. I would like to draw the attention of the Corporation to the immense assistance rendered by the Laboratory Service in the Town Hall. 29 Number of new Cases per week (1) All contacts visited and sample stool tested. (2) Infected persons and their households excluded from schools, nurseries and food handling. (3) Schools asked to question returning absentees and not to re-admit those who have had diarrhoea or vomiting until a negative report on a stool sample has been obtained. (4) Infected nurseries closed 25 days and children re-admitted after a negative stool test. Meningococcal Infection Two cases were notified during the year. Ophthalmia Neonatorum. Twenty cases were notified during the year (all in North Middlesex Hospital) and of this total 6 were Edmonton cases. Puerperal Pyrexia. The Puerperal Pyrexia Regulations 1951 which came into operation on 1st August, 1951, replaces Regulations previously in force, and modify the definition of Puerperal Pyrexia. It is anticipated the new Regulations will result in an increase in notifications of this disease. For the first seven months of the year 19 notifications were received and 60 during the subsequent five months. During 1950 36 cases were notified. 79 cases were notified during the year (2 at home, 73 in North Middlesex Hospital and 4 in other Institutions). Of this total, 25 were Edmonton cases. Food Poisoning. Four cases (non-fatal) were notified during the year, as follows:— Case No Sex Age Suspected Cause of Illness Organism Responsible 1 M 56 Duck egg Salmonella Typhi-Murium 2 M 33 Beef Staphylococci 3 F 29 Beef Staphylococci 4 F 49 Ham Unknown Pneumonia. 48 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 0.7, whilst that for Edmonton was 0.72 as compared with 1.0 and 0.69 respectively last year. 32 Poliomyelitis. During the year 3 confirmed cases of Poliomyelitis (all Paralytic) occurred in the Borough. Notifications were received in January (2) and December (1). There were no deaths. 2 cases were notified in 1950. The following table gives the age, 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 Hospital. This remark applies more particularly to the infections associated with parturition and includes puerperal pyrexia and ophthalmia neonatorum. The number of deaths from Pneumonia includes all forms of this disease. Disease Total No. of Cases No. Removed to Hospital 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 and over Scarlet Fever 189 139 ... ... 3 10 9 34 117 10 2 2 2 ... ... Measles 1610 24 1 63 160 238 270 303 559 7 3 6 1 ... ... Whooping Cough 349 18 ... 23 41 42 46 62 119 8 3 1 4 ... ... Pneumonia 48 3 57 2 ... ... 2 2 6 ... 1 4 3 15 13 Puerp. Pyrexia 79 77 ... ... ... ... ... ... ... 13 49 17 Erysipelas 25 3 ... ... ... ... ... ... 1 1 ... 4 5 8 6 Food Poisoning 4 ... ... ... ... ... ... ... ... ... ... 2 ... 2 ... Poliomyelitis 3 2 ... ... ... ... ... 1 1 ... ... ... ... ... ... Ophth- Neonatorum 20 20 ... 20 ... ... ... ... ... ... ... ... ... ... ... Dysentery 601 10 ... 17 45 64 46 62 139 71 19 114 45 32 7 Meningococcal Infection 2 2 ... ... ... 1 1 ... ... ... ... ... ... ... ... Diphtheria 2 2 ... ... ... ... ... ... ... ... 1 ... 1 ... ... Paratyphoid 'B' 2 2 ... ... ... ... ... 1 ... ... ... 1 ... ... ... 33 The following table indicates the Wards from which the various cases were notified:— Disease Bury Street Ward Church Street Ward Angel Road Ward Silver Street Ward N. Middx. Hosp. Other Instns. Total Scarlet Fever 46 41 58 44 ... ... 189 Measles 671 193 341 403 2 ... 1,610 Whooping Cough 121 60 69 98 1 ... 349 Pneumonia 6 16 8 18 ... ... 48 Puerperal Pyrexia 1 ... 1 ... 73 4 79 Erysipelas 6 1 3 15 ... ... 25 Food Poisoning 1 ... 1 2 ... ... 4 Poliomyelitis 1 ... 1 1 ... ... 3 Ophth-Neonatorum ... ... ... ... 20 ... 20 Dysentery 223 102 109 227 ... ... 661 Meningococcal Infection 1 ... 1 ... ... ... 2 Diphtheria 1 1 ... ... ... ... 2 Paratyphoid 'B' ... 2 ... ... ... ... 2 IMMUNISATION. As and from 5th July, 1948, immunisation against Diphtheria and Whooping Cough became the responsibility of the Middlesex County Council. Diphtheria. During the year, 1,716 appointments were made—1,106 children completed treatment; of these 954 were under 5 years of age. In October, 1950, combined Diphtheria and Whooping Cough immunisation was introduced; 586 children completed this treatment. Of the 954 children referred to above, 575 received the combined treatment. 3 children were Shick tested. In addition 1,670 children received a re-inforcing injection. Up to 31st December, 1951 53.95% of children under 5 years of age and 84.23% of children from 5-15 years of age had completed immunisation treatment. Whooping Cough. During the year 156 appointments were made for this treatment—113 children completed treatment. In addition, 586 children completed combined Diphtheria and Whooping Cough treatment. 126 children were given reinforcing injection. CANCER. The incidence of Cancer relative to the various organs of the body is given as under:— Males Females Breast 1 14 Uterus – 5 Lung, Bronchus 26 8 Stomach 15 19 All other sites 66 44 108 90 34 NATIONAL ASSISTANCE ACT, 1948. Section 47.—Removal to suitable premises of persons in need of care and attention. No action was necessary during the year under this Section. Several cases were dealt with by the Public Health Department, and admission to suitable premises was obtained without recourse of legal action. ESTABLISHMENTS FOR MASSAGE OR SPECIAL TREATMENT. Seven existing licences under the Middlesex County Council Act were renewed during the year. 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 New Cases Deaths Respiratory N on-respiratory Respiratory Non-respiratory M. F. M. F. M. F. M. F.  Under 1 year 1 2 ... ... ... ... ... ... 1— 5 years 6 4 1 ... ... ... ... ... 5—15 „ 4 10 3 ... ... ... 1 ... 15—25 „ 21 19 2 5 ... 2 ... ... 25—35 „ 14 14 ... 2 ... 3 ... ... 35—45 „ 9 6 1 ... 2 ... ... ... 45—55 „ 14 7 ... ... 7 ... ... 1 55—65 „ 8 1 ... ... 2 3 ... ... 65 years upwards 6 1 2 ... 6 1 1 ... 83 64 9 7 16 9 2 1 In addition, 27 cases of pulmonary tuberculosis and 1 case of nonpulmonary tuberculosis previously notified in other areas, moved into Edmonton. 35 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) 83 64 (non-respiratory) 9 7 Transferred cases (respiratory) 11 16 (non-respiratory) 1 — 104 87 The cases dying of Tuberculosis and not previously notified were:— Males Females Respiratory 1 1 Non-respiratory — 1 There were thus 3 non-notified deaths out of a total of 26 persons registered as dying of tuberculosis (Registrar's figures). Regarding the nonnotification 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 Peritoneum — 2 Other bones and joints 2 1 Glands 2 4 Spine 1 — Genito-Urinary System 1 — Meninges 2 — Skin 1 — 9 7 Public Health (Tuberculosis) Regulations, 1930. The number of cases of tuberculosis on the Register at the end of 1951 was:— Males Females Total Pulmonary forms 500 439 939 Non-pulmonary forms 70 97 167 570 536 1,106 36 The corresponding figures at the end of 1950 were:— Males Females Total Pulmonary forms 452 403 855 Non-pulmonary forms 67 95 162 519 498 1,017 Corresponding figures for previous years were: Males Females Total 1949 509 468 977 1948 500 452 952 1947 442 405 847 1946 417 375 792 1945 389 332 721 1944 370 319 689 1943 411 355 766 1942 348 304 652 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 COUNCIL'S EMPLOYEES. During 1951 the Medical Officer of Health paid a total of 199 visits to those employees who had been on the sick list for longer than a fortnight and when necessary, at fortnightly intervals. Of these 21 were "not at home" and 3 had already resumed duty. Also, during the year, 81 persons were examined prior to appointment to permanent posts. 37 Printed by Jolly the Printer Ltd. (T.U.) 238, Fore Street Edmonton, N.18.