THE URBAN DISTRICT COUNCIL OF ENFIELD. Annual Report of the Medical Officer of Health For 1925, together with the Annual Report of the Sanitary Inspector. printed by Bennett & Starling, Ltd., enfield. ENP15 s -139 THE URBAN DISTRICT COUNCIL OF ENFIELD. annual IReport of the Medical Officer of Health For 1925, together with the Annual Report of the Sanitary Inspector. printed by Bennett & Starling, Ltd., enfield. 2 PUBLIC OFFICES, ENFIELD. 31st March, 1926. Medical Officer of Health's ANNUAL REPORT FOR 1925, To the Urban District Council of Enfield. Mrs. Cole & Gentlemen, I have the honour to present my first Annual Report which will include a survey of the last five years. Dr. P. P. Warren was your Medical Officer of Health from 1st January to 1st April. I should like to take this opportunity of expressing to Dr. Warren my warm thanks for the kindly help and assistance he gave me when I first joined. Two other new appointments were made during the year, i e. Mrs. Walton and Miss Garlick joined as Health Visitors, the former on 16th June, and the latter on 1st July. The death-rate is still low 9.91 per 1000. There is no improvement in the birth-rate, 17.58 for 1924' 16.48 for 1925. There were a good many cases of Diphtheria during November and December, some of them of a very fatal type. This is however, the case in epidemics of this disease—some are mild, others severe. With my report is the report of Mr. A. J. Munro, your Sanitary Inspector, which I feel sure you will agiee is a very satisfactory one. I wish to thank the Council for their courtesy to me at all times, to the Medical Practitioners for their co-operation, and to Mr. Munro and the whole Sanitary Staff for the excellent way they have carried out their various duties during the year, I am, Mrs. Cole and Gentlemen. Your obedient Servant, J. J. ROBB, Lt.-Col. Medical Officer of Health. 3 In accordance with the memorandum of the Ministry of Health as to the Annual Reports of Medical Officers of Health for this year, I propose in the fiist instance to give some particulars of the physical features and general character of the District and condition of its population. I.—GENERAL STATISTICS. Area (acres) ... ... ... ... ... 12,575 Population (Census 1921) ... ... ... 60,743 do. (estimated for 1925) ... ... 63,740 Number of inhabited houses (1921) ... ... 12,066 Number of families or separate occupiers (1921) 13.712 Rateable value ... ... ... ... ... ^353,820 Sum represented by a penny rate ... ... £1,229 Physical Features. Enfield is one of the largest parishes in England, being sevenand a-half miles long from east to west, about three-and-a half miles across from north to south, and comprises about 20 square miles. It is situated ten miles north of London, and is bounded on the north by Hertfordshire, on the east by Essex, on the South by Edmonton and Southgate, and on the West by South Mimms and Hertfordshire. It contains 12,575 acres, including 412 acres of water, and naturally divides itself into three parts: - the Western, mainly agricultural, with centres of population at Hadley Wood and Cockfosters, is situate on the London clay, and is hilly in character. The Central, including the Ridgeway, Old Town, Bush Hill Park, Clay Hill and Forty Hill, is, like the Western, partly on the London clay, and the remainder on soil of a loamy nature with gravel below. Bush Hill Park is now almost entirely built upon, the inhabitants being mostly industrial. The Kastern part of the District, the lowest point of which (41 feet above Ordnance Datum) is found near the Flour Mills Ponders End, lies in the Lea Valley. The soil is of loam, lying on 4 a deep substratum of gravel. There are two principal centres of population, viz., Ponders End and Enfield Lock, and the inhabitants are mainly employed in local factories, horticulture and market gardening. In addition to the Royal Small Arms Factory at Enfield Lock, there are the following works: The Edison and Swan Electric Light Co., The Enfield Cable Co., the General Iron Foundry, The Cosmos Lamp Works, the Ruberoid Co., the Corticine Floor Covering Co., the Brimsdown Lead Works, Messrs, T. Morson and Sons, Messrs Edwardsou's Patent Glue Works, the Titchfield Works, the Auto-Tool Co., the Vulcan Works Messrs. T. Reddaway and Co., Reeves & Sons, H. Yager Ltd, Mears. Bros., Belling & Co, Haywards Ltd, while there are also many smaller works and several steam laundries in the District. In addition to the employment found in the above mentioned factories, also in agriculture and horticulture, a large number of Enfield residents find their occupation in London, for which purpose the district is served by two Railway Companies, also two lines of Tramways, and several Omnibus routes. I am not aware of any particular occupation which exercises any influence on the public health. POPULATION. The estimated population for Enfield for 1925, is based on the adjusted 1921 census, after allowance for the varying rates of natural increase as evidenced by births and deaths, and migrations as indicated from other sources of information, has been supplied by the Registrar-General as 63,740. BIRTHS. The number of births registered in the District was :— Boys, 469. Girls, 435. Total, 904, including 15 illegitimate births, i.e., 1-65 per cent, of the total. 5 The births of both sexes, including those registered outside the District, also birth-rates for the last five years, were:— Year Boys Girls Total Birthrate per 1,000 Population Illegitimate Birth-rate per 1,000 Population 1921 634 564 1,198 19.72 •57 1922 616 647 1,263 20.36 •51 1923 567 568 1,135 18.19 •35 1924 567 541 1,108 17.58 •33 1925 552 499 1,051 16.48 •47 This shows a gradual decrease in the birth-rate. DEATHS. The deaths registered in the district during the year were 499, of which 219 were males, and 280 females, giving a crude deathrate of 7.82. To these must be added 204 deaths of Enfield residents registered outside the District, and from this total must be subtracted 71 deaths of non residents occurring in the District, which brings the number of deaths to 632 for the year, giving a net death-rate of 9.91 per 1,000 population. Birth-rate Recorded Death-rate Infantile Death-rate England and Wales 18.3 12.2 75.00 London 18.0 11.l7 67.00 105 Great Towns (including London) 18.8 12.2 79.00 157 Smaller Towns 18.3 11.2 74.00 Enfield 16.48 9.91 51.66 6 The corresponding figures for Enfield for the four previous years are :— 1921 1922 1923 1924 Net death-rate ... 9.72 10.03 8.73 9.39 Sixty-eight deaths registered in the District were persons over 80 years of age, 22 being males and 46 females, one woman living to the advanced age of 95. The more important causes of deaths registered were:— Malignant Disease, 77 ; Bronchitis, 52 ; Heart Disease, 94; Old Age, 55 ; Tuberculosis of Respiratory System, 59 ; Pneumonia, 37 ; Apoplexy, 35 ; Diphtheria, 17; whilst among the children, Premature Births accounted for 14; Inanition and Marasmus, 7; Pneumonia, 10; Enteritis, 8. INQUESTS. Thirty-nine inquests were held in Enfield during the year, and the verdicts were as follows :— Natural Causes ... ... 18 Misadventure ... ... 1 Accidental Causes 7 Open Verdict 1 Suicides 12 39 » INFANTILE DEATHS. The total number of deaths which occurred amongst infants under 1 year, including 12 registered outside the District, was 54, giving a death rate of of 51.66 per 1,000 births, as compared with a death-rate of 75 for England and Wales, and 79 for the 105 great towns, including London. The corresponding figures for Enfield for the last four years were 1921, 66.77 ; 1922, 63.34 ; 1923 ; 54.62 ; and 1924, 44.22. 7 The number of deaths of illegitimate children was 3, which gives a death-rate of 100.00 per 1,000 illegitimate infants. The chief causes of death were Premature Birth (including Congenital Defects), 25 ; Pneumonia, 10 ; and Enteritis, 8. II—EXTRACTS FROM VITAL STATISTICS FOR THE YEAR Births:— Males Females Total Legitimate 538 483 1,021 Illegitimate 14 16 30 Birth-rate = 16.48 per 1,000 population. Deaths 301 331 632 Death-rate = 9.91 per 1,000 population. Number of women dying in, or in consequence of, childbirth:- From Sepsis 0 From other causes 0 Deaths of infants under one year of age per 1,000 births:— Legitimate, 48.52 ; illegitimate, 2.85 ; total, 51.66. Deaths from Measles (all ages) 1 Deaths from Whooping Cough (all ages) 1 Deaths from Diarrhoea (under two years of age) 9 Deaths from Diphtheria (all ages) 17 The following table shows the causes of death at all ages during 1925, and Table II. gives an analysis of the causes of death in infants under one year of age:— 8 TABLE I. Causes of and Ages at Death during Year 1925. Causes of Death Nett Deaths at the subjoined ages of " Residents," whether occurring within or without the District. Total Deaths, whether of "Residents ' or "Non-residents" in Institutions in the District All Ages Under 1 year 1 and under 2 2 and under 5 5 and under 15 15 and under 25 25 and under 45 45 and under 65 65 and under 75 75 and upwards All Causes—Certified Uncertified 632 54 6 11 21 34 67 149 146 144 118 Enteric Fever 1 _ - 1 ___ - - Smallpox — — - — — Measles 1 1 - - - - - — Scarlet Fever — - — - — — - Whooping Cough 1 1 - - - - - - 1 Diphtheria 17 - - 2 14 — - 1 — 43 Influenza 5 - - - - - - - 2 3 1 Encephalitis Lethargica — - — - — — - — Meningoccal Meningitis 5 1 1 1 2 — - — — 2 Tuberculosis of Re-piratory System 59 - - - - 18 27 12 2 - 1 O her Tuberculous Disease- 8 1 2 3 2 — Cancer, Malignant Disease 77 - - 1 6 33 26 11 9 Rheumatic Fever 1 - - - 1 - __ - Diabetes 8 - - - - - 1 2 4 1 Cerebral Haemorrhage, etc 36 — 1 6 14 15 — Heart Disease 94 — 1 7 29 32 25 18 Arterio-sclerosis 16 — — 5 11 3 Bronchitis Pneumonia (all forms) 52 37 3 10 2 2 2 3 1 5 10 6 20 5 18 2 7 10 Other Respiratory Diseases 6 - - - - - 1 .3 1 1 — Ulcer of Stomach or Dnode num 7 - - - - 1 1 2 3 - - Diarrhoea <Sc (under 2 years) 9 9 — — — — — — — 3 Appendicitis and Typhlitis 4 - 1 1 1 Cirrhosis of Liver 4 - - 3 1 — Acute and Chronic Nfph'ilis 4 - - - - - - 3 - 1 — Puerperal Sepsis - - - - - Other accidents & diseases of Pregnancy and Parturition - - - - - - - - - - - Congenital Debility an 1 Malformation, Premature Birth 25 25 - - - - - - - - 2 Suicide 11 - 1 3 6 1 - 1 Other Deaths from Violence 12 — 1 1 3 5 — 2 1 Other Defined Diseases 132 5 1 3 2 3 9 25 30 54 15 Causes ill-defined or unknown — — — — — — — — — — - Totals 632 54 6 11 21 34 67 149 146 144 118 Included in above— - - - - - - - - Old Age 55 - - - - - - - 10 45 3 Erysipelas — — — — — — — — — — . 3 Anthrax 1 — — — — — — 1 — - - 9 TABLE II. Infant Mortality. Net Deaths from stated causes at various Ages under One Year of Age. Caushs of Death. Under 1 week. 1 to 2 weeks 2 to 3 weeks. 3 to 4 weeks. Total under 4 weeks 4 weeks and under 3 months. 3 months and under 6 months. 6 months and under 9 months 9 months and under 12 months. Total Deaths under One Year. All Causes—Certified Uncertified 16 3 4 2 25 14 5 5 5 54 Small Pox - - - - Chicken Pox — - Measles - — - — - 1 - - — 1 Scarlet Fever - - — - — - - — Whooping Cough — - Diphtheria and Croup - - - - - - - - - - Erysipelas - - — - Tuberculous Meningitis - - - - - - - - - - Abdominal Tuberculosis - - - - - - - - - - Other Tuberculous Diseases - — - - - - - - - - Meningitis (not Tuberculous) - - - - - - - 1 — 1 Convulsions 1 — - — 1 — - - — 1 Laryngitis - - - - - - - - - - Bronchitis 1 — - — 1 1 - - 1 3 Pneumonia(all forms) - — 1 — 1 2 3 2 2 10 Diarrhoea - - - - - - 1 - - 1 EpidemicDiarrhoes - — - — - — — — — — Enteritis 1 — - — 1 4 — 1 2 8 Gastritis - — - — - — — — — — Syphilis - — - — - — — — — — Ricketts - - - - - - - - - - Suffocation, overlying - —- - - - - - - - - Injury at Birth 1 — - — 1 — — — — 1 Atelectasis 1 — - — 1 — — — — 1 Congenital Malformation 3 — - 1 4 — — — — 4 Premature Birth Atrophy, Debility and 7 2 2 — 11 3 — — — 14 Marasmus 1 1 1 1 4 2 — 1 — 7 Other Causes — — — — — 1 1 — — 2 Totals 16 3 4 2 25 14 5 5 5 54 Net Births in the year :—Legitimate, 1,021 ; Illegitimate, 30. Net Deaths in the year :—Legitimate Infants, 51; Illegitimate, 3. 10 Poor Law Relief, 1925. In reply to an enquiry, I am informed by Mr. E. Ridley, Clerk to the Edmonton Board of Guardians, that the amount of Poor Law Relief given in the Enfield District during 1925 was as follows :— Cases. Amount. Ordinary Relief 1,036 27,194 Unemployed do 1,025 15,287 Total 2,061 42,481 IV.—CAUSES OF SICKNESS. This is not always easy to ascertain, but when definitely known is promptly dealt with. v.-SUMMARY OF NURSING ARRANGEMENTS, HOSPITALS AND OTHER INSTITUTIONS AVAILABLE FOR THE DISTRICT. HOME NURSING. The Ponders End and District Nursing Society provides two Nurses for the assistance of the sick poor. No financial contribution is paid to the Society by the Local Authority. MIDWIVES. The Middlesex County Council is the supervising authority under the Midwives' Acts. There were 12 Midwives practising in the District. 11 CLINICS AND TREATMENT CENTRES. Maternity and Child Welfare Centres :— Four Infant Welfare Centres and three Ante-Natal Clinics are provided by the Council for the District, and are open as follows :— Ponders End.—Alma Road Council Schools, Monday afternoons, 2-5 p.m. Bush Hill Park.—St. Mark's Institute, St. Mark's Road, Tuesday afternoons, 2-5 p.m. Town and Chase.—Armfield Road Institute, Wednesday afternoons, 2-5 p.m. Ordnance.—Tolteridge Road Baptist Sunday School, Thursday afternoons, 2-5 p.m. Ante-Natal Clinics :— Town and Chase.— Armfield Road Institute, second Tuesday in each month, 9.30 a.m. — 12 noon. Ponders End.—Alma Road Council Schools, second Friday in each month, 2-4 p.m. Bush Hill Park.— St. Mark's institute, St. Mark's Road, third Wednesday in each month, 9.30 a.m. — 12 noon. Tuberculosis Dispensary (Middlesex County Council) :— 56, Silver Street, Upper Edmonton. HOSPITALS. 1. Tuberculosis (County of Middlesex Scheme).—There are some 564 beds available for the treatment of this disease in the following Institutions :— Clare Hall Sanatorium. County Council Dispensary, Bell Road, Hounslow. County Council Sanatorium, Harefield. County Council Hospital, Isleworth. 12 In addition to the beds reserved in Institutions in the above list, cases are also sent to others, as follows :— All Saint's Hospital. St. Vincent's Cripple's Home. Pinner. Mount Vernon Hospital, Northwood. Hendon Cottage, Hospital. Prince of Wales, Hospital, Tottenham. Royal Sea-Bathing Hospital, Margate. Victoria Home, Margate. Alexandra Hospital for Hip Disease, Swanley. Heatherwood Tuberculosis Hospital, Ascot. Lord Mayor Treloar's Cripple's Hospital, Alton, "Clevedon", Broadstairs. Sevenoaks Hip Hospital for Children. Hadington Orthopaedic Hospital St. Anthony's Hospital, Cheam. and various London Hospitals. 2. Maternity (Maternity Hostel, North Middlesex Hospital Edmonton).—This is provided by the Edmonton Board of Guardians, and the local authority pays £2 2s. per week for each person admitted from this District. Persons taking advantage of this are required to contribute according to their means. 3. Children.—At the local War Memorial Hospital a Ward containing 20 beds has been set aside for children. 4. Fever.—The District is served by the Enfield and Edmonton Joint Isolation Hospital, which is situated upon 27 acres of land at Winchmore Hill, about three and a-half miles from the centre of the town. The buildings consist of :— An Administrative Block, Nine Pavilions, One Discharge Block, Mortuary, Laundry and Disinfecting Station, Medical Superintendent's Residence, Porter's Lodge, Two Workmen's Cottages, Bungalow, 13 and contains 161 beds, 12 of which are in a special cubicle block which has been found to be of great service in the treatment of cases of doubtful diagnosis, and in the isolation of patients who are admitted suffering from or exposed to more than one infectious disease. The following cases of infectious disease were removed there from the Enfield District. Scarlet Fever 69 Diphtheria 124 Diphtheria Carriers 17 Erysiplelas 3 Mumps 3 Whooping Cough 1 5.— Small Pox.—Enfield is included in the Middlesex Joint Hospital District, and should any case occur it would be removed to the Hospital, Clare Hall, South Mimms. 6.—Other Hospitals.—In addition to the Local War Memorial Hospital, accomodation for ordinary cases of illness is afforded by the North Middlesex Hospital, Edmonton, and the Prince of Wales' Hospital, Tottenham, and many patients also go to the various London Hospitals. OTHER INSTITUTIONS. 1. Unmarried Mothers.—None. 2. Illegitimate Infants and Homeless Children.—Chase Farm Schools and Fortesrue Villas, provided by the Edmonton Board of Guardians ; no contribution is made by the Council. AMBULANCE FACILITIES 14 For Non-Infectious Cases.—Urban District Council of Enfield Ambulance, Fire Station, Ponders End. Number of patients removed 799 St. John Ambulance Brigade Ambulance. VII —SANITARY ADMINISTRATION. ADOPTIVE ACTS There are no local Acts. The following are the Adoptive Acts in force in the District:— Public Health Acts (Amendment) Act, 1890. Came into force February 1st, 1891. Infectious Disease (Prevention) Act, 1890. Came into force February 1st, 1891. Public Health Acts (Amendment) Act. 1907. The following sections came into force on July 27th, 1909. All sections in Part I. Sections 15, 16, 17, 20, 21, 23, 24, 25, 27, 29, 30, 31, 32 and 33 of Part II. Sections 34, 35, 36, 37, 38, 43, 44, 46, 47, 48. 49, 50 and 51 of Part III. Sections 52, 53, 54, 55, 56, 57, 59, 62, 63, 64, 65, and 68 of Part IV. All of Parts V. and VI. Section 81 of Part VII. All of Parts VIII. and IX. Section 95 of Part X. BYE-LAWS AND REGULATIONS. Public Health Act, 1875. With respect to : — Nuisances arisising from snow, filth, dust, ashes, and rubbish, and for the prevention of keeping animals on any premises so as to be injurious to health. (September 15th 1887.) Common Lodging Houses. (September 15th, 1887.) Houses let in Lodgings. (September 15th, 1887.) 15 Slaughter-houses. (September 15th, 1887.) Cleansing of Earth-closets, Privies, Ashpits and Cesspools (September 15th, 1887.) Whith respect to New Streets and Buildings and Alteration to Buildings. (March 10th, 1925.) Housing of the Working Classes Act. 1885. With respect to :— Tents, Vans, Sheds, etc. (February 14th, 1912.) Dairies, Cowsheds and Milkshops Order, 1885. With respect to :— Dairies, Cowsheds and Milkshops. (February 15th, 1900.) The Milk and Dairies (Amendment) Act, 1922. (September 1st, 1922.) The Milk (Special Designations) Order, 1922, made under Sections 3 and 6 of the Milk and Dairies (Amendment) Act, 1922. (December 9th, 1922.) Public Health Act. 1875, Sec. 112, as amended by Sec. 51 of the Public Health Acts Amendment Act, 1907. With respect to :— Offensive Trades (February 26th, 1913), as follows :— Blood-boiler and Blood-drier. Bone Boiler. Fellmonger, Tanner and Leather-dresser. Soap-boiler. Tallow-melter, Fat-melter, or Fat Extractor. Tripe-boiler. Glue-maker and Size-maker. Gut-scraper. Dealer in Rags and Bones. Fish-fryer, Fish-skin-dresser. Manufacturer of Manure from Fish, Offal, Blood or other putrescible animal matter. 16 SANITARY CIRCUMSTANCES OF THE DISTRICT. Water Supply. With the exception of Hadley and Cockfosters, which derive their water from the mains of the Barnet Gas and Water Company, the District is almost entirely supplied by the Metropolitan Water Board. The supply of water, with the possible exception of some few private wells in the rural portions of the District, is ample, the quality good, and the supply practically constant. Streams and Water-Courses. Turkey Street Brook and other streams in the District are under Control of the Middlesex County Council, and observation is also kept on them by your Sanitary Staff, but no sources of contamination were detected. Drainage and Sewerage. The populous parts of the District are all provided with sewers, with outfall to Cuckoo Hall Farm, where it is dealt with by septic tanks, filters and part by irrigation. Two men are employed who devote their whole time to the work of examining and flushing the sewers, and any defect or obstruction found is immediately dealt with. New Sewage Disposal Works. New works consisting of a new outfall Sewer, screening and detritus tanks, sedimentation tanks, substation and automatic pumping station, complete sludging arrangements and ejector station, 4 humus tanks, 5 filters and 12 sludge drying beds were provided during the year at Cuckoo Hall Farm. Closet Accomodation. All the houses in the Urban portion of the District are supplied with W.C.'s of various types, the majority being those of "washdown"' pattern. In the rural parts of the District the accommodation consists of water-closets connected with cesspools, or earthclosets or privies with movable receptacles. 17 Scavenging Removal of Home Refuse. This work is carried out by the Council's own staff, under the direction of the Sanitary Inspector, a weekly collection being made throughout the greater part of the District. Part of the stuff collected is disposed of to brickmakers, and the remainder taken to the Council's Depots at Cartel hatch Lane and Old Road, where it is levelled and covered with earth. Every week one man in the employ of the Council attends to some few earth-closets in a rural part of the District. There are only a few fixed ashpits left; the practice for some years has been to require movable recepticles to be provided, and where any house is found without this provision, the owner is required to make it good. Cesspools. The Council has provided suitable vans and pumps, and undertakes the emptying of cesspools on the application of householders, a small charge being made for each emptying, and they are all kept under observation. 18 STATEMENT PREPARED BY SANITARY INSPECTOR UNDER ARTICLE XIX. (12), MINISTRY OF HEALTH ORDER No 276, 1922. Number of Houses Inspected. Inspections. Under Regulations, Section 17, Housing, Town Planning Act, 1909 0 From House-to-House apart from this Act 349 On Account of Infectious Disease 464 On Account of Phthisis 126 On Account of Complaint by occupant or otherwise 1,054 1,993 77 Factories 154 126 Workshops and workplaces, including 2 laundries 90 Outworkers' premises inspected 27 56 Bakehouses, of which 38 are in use 144 18 Slaughter-houses, of which 10 are in use 1,449 28 Cowsheds inspected frequently 335 31 Dairies and Milkshops inspected frequently 234 22 Schools 117 Public-house urinals inspected 38 Conveniences at Railway Stations inspected 4 Fish Shops: Total number of visits 98 Coffee and Eating Houses: Total number of visits 18 Shops where ice cream is made: Total number of inspections 48 Meat Shops : total number of inspections 255 Meat Stalls in Markets : total number of inspections 677 3,688 Visits to absentees excluded from Elementary Schools 689 Visits in connection with cases of Infectious Disease 3,395 Visits in connection with Phthisis 1,470 Offensive Trades (excluding Fish Shops) 12 Smoke observations 46 Other inspections, including works in progress 8,482 Petroleum Stores inspected 75 Visits re Shops Act 145 Cinemas, etc., inspections 31 Visits and inspections re Rats 22 Visits re Meat Regulations 117 14,484 20,165 19 Notices Issued. Statutory:— Provision of dustbins 62 For repairs to houses, drains and abatement of nuisances 244 Providing sufficient water-closets 49 Paving of yards.~ 2 Cleansing and Limewashing of Cowsheds 0 357 Informal:— Notices 0 Letters sent in lieu of notice 881 881 1,238 Other Notices issued wider Infectious Diseases Acts:- To occupiers 535 To Education Committee and Head Teachers at Schools 1,267 1,802 3,040 Other letters sent 4,155 Result of Service of Statutory Notices:— Number complied with 320 Number outstanding 37 357 20 PREMISES AND OCCUPATIONS WHICH CAN BE CONTROLLED BY BYE-LAWS OR REGULATIONS. OFFENSIVE TRADES. The following offensive trades are established in the District:— Fish Fryers 25 Rag and Bone Dealers 5 Glue Maker 1 Soap Boiler 1 and in connection with these 110 inspections were made during the year. With regard to the Fish-friers, 10 have been established with the consent in writing of the Council, and the majority of the 15 old established businesses have been fitted with up-to-date frying stoves SCHOOLS. There are 22 Public Elementary Schools in Enfield, including a Deaf Centre, 52 departments in all. The Secondary Schools include the Boy's Grammar School and the County School for Girls. In addition there are a number of private establishments. We have also the Chase Farm Schools belonging to the Edmonton Board of Guardians, and a Roman Catholic Institution known as St. Joseph's Home for Destitute Boys. Periodical examinations of the conditions of the public elemtary schools are made by the Sanitary Inspector, and any defects found are brought to the notice of the Education Committee and Managers, with the result that they are usually remedied without delay. 21 Infectious Diseases and Schools. Following a suggestion of the Local Government Board, an arrangement is in force between the Council and Education Committee, under which the Head Teachers of the various schools notify the Medical Officer of Health all absentees suspected to be suffering from any infectious disease. By this means we become aware of many slight cases of infectious diseases which would otherwise escape us. We are thus able to visit the houses, and give instructions as to the precautions necessary to be taken. These cases are also reported to the School Medical Officer. GENERAL HOUSING CONDITIONS. There is in this, as in other districts, a shortage of houses, and the matter has been receiving the close attention of the Housing Committee of the Council. As a result arrangements were made for the erection of some 600 houses in different parts of the District. Of this number 301 have been completed and occupied, and the remainder are in course of erection. Even if these 600 were erected this would not meet the demand, and a great shortage would still be present. Overcrowding. Considerable sub-letting took place during the War to accommodate the large influx of workers required at the several factories in the District. This sub-letting still continues, with the result that theie is considerable overcrowding. This state of affairs will remain until more houses are provided, but every endeavour is made, in any case that comes to the knowledge of your Sanitary Officers, to secure the best possible arrangements for sleeping accommodation. Fitness of Houses. The classes of houses in the District vary considerably, some, both large and small, have been standing for many years. Owing to the restriction of labour and materials during the War, repairs, which, up to that time had received continued attention, came practically to a standstill, with the result that since the Armistice a good deal of leeway has had to be made up; but your Officers as a rule find owners ready to carry out the necessary repairs, so that a considerable amount of work has been carried out. The principal defects found were in connection with roofs, gutters, yard paving and sanitary fittings; there was also dampness in walls and in a number of cases internal repairs and cleansing were necessary. Unhealthy Areas. There are no unhealthy areas in the District, 22 VIII.—PUBLIC HEALTH STAFF. Medical Officer of Health. Lt. Col, J. J. Robb, M.B., D.p.H. Sanitary Inspector. *A. J. Munro, M.R.San.I. Assistant Sanitary Inspectors. Fred wilson, m R.San.I., Cert. Sanitary Inspector's Examination Board (London). Faudell-Phillips Medallist, King's College, London University. Silver and Bronze Medallist, Carpenter's Company. Diploma of R.San. Inst, for Inspection of Meat and other Foods. Cert. Sanitary Science. T. M. Boswell, A.R.San.I., Diploma of R. San. Inst, for Inspection of Meat and other Foods. Noel Smith, A.R.San.I. H- A. wiggett, Cert. R.San.I. Health Visitors. Miss M. E. Newbhgin General Trained Nurses' Certificate; C.M.B.; Member of Royal College of Nursing; State Registered Nurse; Certificate of Queen's Nurses. Mrs. M. Walton C.M.B , Cert. Sanitary Inspector's Examination Board. Cert Sanitary Science. Cert. York Rd. Lying-in Hospital. MlSS M. GarliCK C.M.B., Medical & Surgical Nursing. Invalid Cookery. 23 Clerks. Chief Clerk Sydney Coulter, Cert. R. San. I. 2nd Clerk Miss M. J. Ridler. 3rd Clerk Miss E. W. Bowyer. Junior Clerk S. W. Silver. Junior Clerk S. H. Beyer. General Assistant J. Davis, until his retirement in November, and his place taken by J. Brooks, Part-time Officers. (Maternity and Child Welfare Clinics). *Dr. Margaret Proudlock Dunbar, M.D., B.S. Veterinary Surgeon. H. H. Hide, M.R.C.V.S., for inspection of cows. *Salary contribution made under the Public Health Acts or Exchequer Grants. IX.-HOUSING. Number of new houses erected during the year:— ((?) Total 321 (6) With State assistance under the Housing Acts 1919, 1923 or 1924:— (i) By the Local Authority 137 (ii) By other bodies or persons 3 I. Unfit Dwelling Houses. Inspection — (l) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 1,993 (2) Number of dwelling houses which were inspected and recorded underthe Housing (Inspection of District) Regulations, 1910 None. 24 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation None. (4) Number of dwelling-houses (exclusiveof those referred to under the preceding sub-heading) found not to be in all respects reasonably fit for human habitation 1,357 (The number here given is of houses where any insanitary conditions were found). 2. Remedy of Defects without Service of formal Notices. Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their Officers 1,134 3. Action under Statutory Powers. A.—Proceedings under Section 28 of the Housing, Town Planning, etc., Act, 1919:— (1) Number of dwelling houses in respect of which notices were served requiring repairs None. (2) Number of dwelling-houses which were rendered fit:— (a) By owners None. (b) By Local Authority in default of owners None. (3) Number of dwelling-houses in respect of which Closing Orders became operative in pursuance of declarations by owners of intention to close None. 25 B.—Proceedings under Public Health Acts:— (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 247 (2) Number of dwelling-houses in which defects were remedied— (a) By Owners 201 (b) By Local Authority in default of Owners 6 C.—Proceedings under Sections 17 and 18 of the Housing, Town Planning, etc., Act, 1909:— (1) Number of representations made with a view to the making of Closing Orders None (2) Number of dwelling-houses in respect of which Closing Orders were made None (3) Number of dwelling-houses in respect of which Closing Orders were determined, the dwelling-houses having been rendered fit None (4) Number of dwelling-houses in respect of which Demolition Orders were made None (5) Number of dwelling-houses demolished in pursuance of Demolition Orders None 26 FOOD. Milk. The are 518 cows in Enfield owned by 22 cowkeepers. The dairies are kept in a clean and sanitary condition and the cows are inspected bi-annually by Mr. H. H. Hide, M.R.C.V.S., the Vetinary Surgeon to the Council, and I append copies of his two reports for the year, which are very satisfactory, and show that the Enfield dairy-farmer is fully alive to the danger of keeping tuberculous cows on his premises. Holly House, Lower Edmonton, May 5th, 1925. Dear Sir, I beg to report that I have completed the inspection of the milch cows in the district as shown in the accompanying list. I made a careful examination of the udders and found them, on the whole, satisfactorily free from disease. There were a few cases of induration, two of which proved on bacteriological examination to be affected with Tuberculosis. These were dealt with by the Medical Officer. The herds throughout the district generally appealed healthy, and iu satisfactoiy condition. I am, dear Sir, Yours obediently, (Signed) H. H. Hide, M.R.C.V.S. T. W. Scott, Esq. Holly House, Lower Edmonton, December 19th, 1925. Dear Sir, 1 beg to report that I have completed the inspection of the milch cows throughout the district as shown in the accompanying list. 27 I made a careful examination of the udders and found them, generally, free from disease. A small number were affected with the usual abnormalities incidental to milch cows, and where necessary 1 made a bacteriological examination of the milk but none were affected with Tubercle bacillus. Two cows were reported to me by the owners as being suspected of having Tuberculous udders, but on examination they proved to be free from that disease. The herds in general were in good condition and appeared to be satisfactorily kept. I am, dear Sir, Yours obediently, (Signed) H. H. Hide. T. W. Scott, Esq. With regard to the two cows referred to in the Veterinary Surgeon's May report, both were slaughtered and the carcases disposed of by burying them in lime. The Milk (Special Designations) Order, 1922. Four samples of milk were taken during the year and submitted for analysis. These were all found to be satisfactory. Meat. There are no public abattoirs in the District. Quite a large quantity of meat slaughteied at the Caledonian Market is brought into the District. The number of slaughter-houses in the District at the date specified is as follows:— 1914 January, 1925. December 1925. Registered 10 8 8 Licensed 7 6 6 Total 17 14 14 28 Mr. Fred Wilson and Mr. T. M. Boswell, Assistant Sanitary Inspectors, who both hold the Certificate of the Royal Sanitary Institute a» Inspectors of Meat and Foods, visit the slaughterhouses at very frequent intervals, and, as will be seen by a reference to the Sanitary Inspector's Report, they paid 1,449 such visits during the year, when they examined 5,043 carcases, and secured the surrender of 2 carcases and 81 parcels of diseased organs. PUBLIC HEALTH (MEAT) REGULATIONS. 1924. The butcher's shops and other premises where meats are sold in the District have all been systematically and regularly visited to see that the requirements of the Regulations are strictly complied with. These are however not definite enough to enable us to carry out what is intended. Some of the butchers keep their windows down and so keep out the dust, others say if they do this their meat Is not properly exposed for sale, and in consequence they lose customers, and therefore refuse to keep their windows down, and so the meat is exposed to dust etc. from the street. Bakehouses. All bakehouses in the District are inspected regularly. Other Foods. Every shop selling provisions is inspected frequently. 29 PREVALENCE OF, AND CONTROL OVER INFECTIOUS DISEASES. The following table shows the cases of infectious diseases notified during the year, and the number of deaths which occurred. TABLE III.—Cases of Infectioui Diseases notified during the year 1925. Notifiable Disease. Number of Cases Notified. Total cases removed to Hospital. Deaths. At Ages—Years. At Ages—Years. At all a^es Under 1. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 45. 45 and under 65. 65 and upwards. Under 1 year. 1 and under 2. 2 and under 5. 5 and under 15. 15 and under 25. 25 and under 45. 45 and under 65. 65 and upwards. Totals. Smallpox - - - - - - - - - - - - - - - - - - Cliolera—Plague - - - - - - - - - - - - - - - - - - Diphtheria (including Membraneous Croup) 134 1 17 93 17 6 - 124 - - 2 14 - - 1 - 17 Diphtheria Carriers 23 - 3 15 — 2 2 1 17 - - - - - - - - - Erysipelas 14 - — — 1 6 6 1 3 - - - - - - - - - Scarlet Fever 89 - 17 59 9 4 — — 69 - - - - - - - - - Typhus Fever — - — — — — — — - - - — — - - - - - Enteric Fever 1 - — 1 — — — — 1 - - — — 1 - - - 1 Paratyphoid Fever A — - — — — — — - - - - - - - - - - - Relapsing Fever - - - - - - - - - - - - - - - - - - Continued Fever Puerperal Fever 2 - — — 1 1 — — 2 - - - - - - - - - Measles 132 6 41 76 5 3 1 — — 1 - - - - - - - 1 German Measles 164 3 27 107 23 4 — - - - - - - - - - - - Cerebro-spinal Meningitis - - - - - - - - - - - - - - - - - - Poliomyelitis — — — — — - — — - - - — — - - - - - Ophthalmia Neonatorum 1 1 - - - - - - - - - - - - - - - - Pnlmonary Tuberculosis 106 - 1 19 23 47 16 - - - - - - 18 27 12 2 19 Other forms of Tuberculosis 17 — 4 8 3 2 — — - 1 2 — 3 2 — - 8 Encephalitis Lethargica 4 — — — — 3 — 1 - - - - - - - - - - Malaria — — — — — — — - - - — — — — — — — Pneumonia 65 5 9 13 9 19 8 2 - 10 2 2 2 3 5 6 7 37 Anthrax 1 — — — 1 - 1 — - - — — — 1 — 1 Whooping Cough — — — — — — — — 1 — 1 — — — — — — 1 Mumps — — — — — — - — 1 — — — — — — — — — Totals 753 16 119 391 91 95 36 5 219 11 4 6 16 25 34 20 9 125 30 Diphtheria. The number of cases vary from year to year and they were more numerous than in 1924. Diphtheria being very prevalent in the surrounding districts accounted for some of our cases. One-hundred-and-thirty-four cases of this disease occurred during the year in 90 houses, as follows:— Number of cases where 1 case occurred 70 „ „ 2 cases „ 13 „ „ 3 „ „ 5 „ „ 4 „ „ 1 „ „ 19 „ „ 1 Total number of houses where cases occurred 90 Deaths 17 As soon as a case was notified the contacts were swabbed and in this way I discovered the "carriers"', and insisted on strict isolation of all such cases. Diphtheria Anti-toxin is supplied by the Council free of charge and in addition to the Public Offices, supplies and swabs are kept at various points in the district within easy reach of the Medical Practitioners. To indicate its use, I may say that no less than 250 bottles, each containing 4,000 units were supplied during the year. Small Pox. There being no cases of this disease there was no necessity for me to vaccinate any one during the year. 31 Enteric and Paratyphoid Fever. One case of Paratyphoid Fever was notified during the year, Poliomyelitis. Nil. Cerebro-Spinal Fever. Nil. Encephalitis Lethargica. Four cases of this disease were notified during the year, none of which proved fatal. Scarlet Fever. Eighty-nine cases of Scarlet Fever occurred during the year in 83 houses as follows:— Number of houses where 1 case occurred 77 „ „ 2 cases „ 6 Total number of houses where cases occurred 83 Total number of cases 81 DISINFECTION OF VERMINOUS PERSONS AND THEIR BELONGINGS. Fifteen dwellings, and 15 articles of clothing, etc., were cleansed and disinfected during the year at the request of the Education Committee. TUBERCULOSIS. The following table shows the number of notifications of Pulmonary and other forms of Tuberculosis received during the year :— Ward. Pulmonary Other. Fresh Cases. Old Cases re-notified. Duplicates, Fresh Cases. Old Cases re-noiified Duplicates. Town 12 1 14 - 1 Chase 19 2 28 5 — 5 Ordnance 20 2 29 5 1 2 Green Street and Ponders End 34 4 59 4 - 4 Bush Hill Park 20 3 26 3 — 4 Hadley and Cockfosters 1 — — - — — Totals 106 12 156 17 1 16 32 First Notifications 123 Old Cases re-notified i.e., some by fresli doctors, or coming into District, or under old regulations 13 Duplicate Notifications, i.e., those which report the entering and leaving of Sanatoria 172 Total Notifications 308 The following table gives particulars of the ages of the new case? notified, and deaths from this disease during the year. Age Periods. New Cases. Deaths. Pulmonary. Nonl'ulmonarv Pulmonary. NonPulmonary. M F. M. F. M. F. M. F. 1 to 5 — 1 — 4 — — 1 2 5 to 10 7 4 3 3 — — — — 10 to 15 4 4 1 1 — — — — 15 to 20 7 5 2 1 2 3 1 1 20 to 25 3 8 — — 6 7 1 1 25 to 35 18 17 — — 10 8 — 1 35 to 45 8 4 — — 5 4 — — 45 to 55 7 4 — — 6 — — — 55 to 65 5 — 1 1 6 — — — 65 and upwards — — — — 1 1 — — Totals 59 47 7 10 36 23 3 5 Sex (1st Notifications). Form. Males. Females. Pulmonary 59 47 Other 7 10 Totals 66 57 33 Deaths. The number of deaths from this disease during the year is shown in the following table, viz:— Ward. Pulmonary. Other. Town 10 - Cliase 4 2 Ordnance 11 — Green Street and Ponders End 21 3 Hush Hill Park 13 3 Hadley and Cockfosters — — Totals 59 8 7-4 per cent, of the cases dying of tuberculosis had not previously been notified. Measles and German Measles. This disease was not so prevalent as last year, and the following numbers of notifications were received from the different wards:— Ward. Measles. German Measles. Town 7 8 Chase 15 24 Ordnance 46 76 Green Street and Ponders End 48 41 Bush Hill Park 16 15 Hadley and Cockfosters — — Totals 132 164 Enteritis. Eight deaths occurred from this disease during the year; all were infants under one year of age. 34 ZYMOTIC DISEASES. The following table shows the Deaths registered in the District from the seven chief zymotic diseases during the past five years:— Disease. 1921 1922 1923 1924 1925 Small Pox — — — — — *Scarlet Fever 3 4 2 1 — *Diphtheria 41 25 10 11 43 *Measles 1 1 2 3 1 *Enteric Fever 1 — — — 1 Whooping Cough 3 — - 6 2 Epidemic Enteritis 5 — - — — Totals 54 30 14 21 47 *The actual Enfield deaths were: Diphtheria, 17; Measles, 1; Enteric Fever, 1; and Whooping Cough, 1. The figures for Scarlet Fever and Diptheria include all the deaths which occurred in the Enfield and Edmonton Joint Isolation Hospital, which is situated in the Enfield district. Patients belonging to other districts are also received, so the actual figures are therefore smaller than the apparent. ENFIELD ZYMOTIC DEATH-RATE. The zymotic death-rate, after deducting 27 deaths of persons residing outside the district who died in Institutions in the District, and adding one death of an Enfield resident registered outside the District, is 0.31 per 1,000. Disease. 1924. 1925. Deaths Dtalh-rate Deaihs. Death-rate Scarlet Fever 1 .01 - - Diphtheria 1 .01 17 .26 Enteric Fever — — 1 .01 Erysipelas — — — — Measles 3 .04 1 .01 Whooping Cough 6 .09 1 .01 Epidemic Enteritis — — — — Totals 11 .17 20 .31 35 VI —LABORATORY WORK No. Positive. Negative. Percentages of Positives. Swabs 1,097 76 1,021 6.92 Sputum 341 10 331 2.93 Totals 1,438 86 1,352 5.98 Diphtheria Anti-toxin is supplied by the Council free of charge, and, in addition to the Public Offices, supplies and swabs are kept at various points in the district within easy reach of Medical Practitioners. MATERNITY AND CHILD WELFARE. Medical Officers of Centre*. J. J. Robb, M.B..D.P.H. Lt. Col., Dr. Margaret Dunbar, M.D..B.S. The latter is also Medical Officer of the Ante-Natal Centres. Health Visitors. Miss M. E. Newbegin. Miss Suckling and Miss Ballard having resigned, the following Health Visitors were appointed on the dates mentioned:— Mrs Walton June 16th, 1925. Miss M. Garlick July 1st, 1925. Maternity and Child Welfare Work. Baby Week. This was celebrated on July 7th and 8th. A Garden Party was to have been held in Eagle House Gardens, Ponders End, by kind permission of Dr. Barnes, but the morning proving very wet, the Meeting was transferred to the Enfield Highway Library, from where a portion of the party went to St. James' Lodge on the weather clearing. A Garden Party was also held at the Red Triangle Club, Church Street, on July 8th, which was followed by a further Tea Party at this Club on July 24th, for the Ponders End Mothers who were unable to attend on July 7th on account of the weather. 36 Ante-Natal Clinics. The are now three Ante-Natal Clinics tinder the charge of Dr. Margaret Dunbar; the one for the Town and Chase portion of the District being opened at the beginning of the year. They are situated as follows:— (а) For the Town & Chase Wards— Armfield Road Institute. (б) For the Eastern portion of the District— Alma Road Council Schools, Ponders End. (c) For Bush Hill Park Ward— St. Mark's Institute, St. Mark's Road. Each Centre is opened once a month, and the attendances during the year were:— Centre New Attendances ReAttend ances Total Attendances Average Attendance per Meeting Armfield Road Institute 59 73 132 12.0 St, Mark's Institute 66 64 130 10.8 Alma Road Council Scliool 89 92 181 15.0 Totals 214 229 443 12.6 Maternity Hostel. The arrangements entered into with the Edmonton Board of Guardians as to the supply of beds for Maternity cases, necessitous or otherwise, came into force in June, 1918. With the shortage of housing accommodation, this provision has been much appreciated by many mothers, the majority of whom now make direct application to the Hostel. The following table gives particulars of the work done by the Health Visitors during the year. 37  Town and Chase Bush Hill Park Hadley Ordnance Ponders End Totals Birth Notification Visits 253 184 255 182 874 Ditto Re-visits 1,358 728 — 718 601 3,405 Children, 1-5 yrs. Visits 1,581 1,378 - 1,584 1,263 5,806 Infant Mortality Visits — — — — — General Visits 99 37 5 40 36 217 Ante-Natal Visits 190 131 - 114 108 543 Post-Natal Visits 33 31 — 9 19 92 Blank Visits 249 45 — 104 50 448 Child Death Visits — — — — - — Ophthalmia Neonato rum Visits 4 - - - 4 Puerperal Fever Visits — — — — — — Infectious Disease do. 163 149 — 36 138 486 Totals 3,930 2,683 3 2,860 2,397 11,875 Feeding etc Feeding. Town and Chase % Bush Hill Park. % Hadley % Ordnance. % Ponders End. % Totals. % Natural 207 81 149 81 193 75 143 78 692 78 Artificial 43 13 33 17 — — 57 22 30 16 163 18 Mixed 3 1 2 1 — — 5 2 9 5 19 2 Cradle Used 187 73 130 70 — — 127 49 91 50 535 61 Attendances at Centres. Centre. New Attendances. ReAttend ances. No. on Register 1 1.25. No. on Register 31.12.25 No. of Meetings Average Attendance per Meeting. Town and Chase 218 4,648 710 928 51 95.4 Bush Hill Park 202 5,580 853 1,055 51 113.3 Ordnance 184 4,080 555 739 52 82.0 Ponders End 144 3,632 538 682 48 78.6 Totals 748 17,940 2,656 3.404 202 92.5 38 Number of Births notified: 1,049, 97 per cent, of which were visited. The quantity of Fresh and Dried Milk supplied to necessitous cases under the assisted milk supply scheme during the year was as follows :— Fresh Milk 7,112 gals., costing £641 1s. 10d. Dried Milk 975 lbs., costing £71 19s. 3d. Ophthalmia Neonatorum. Cases. Vision Unimpaired. Vision Impaired. Total Blindness. Deaths. Notified. Treated. At Home. In Hospital. 1 1 — 1 - - - METEOROLOGY The following instruments are installed at the Public Offices : Standard Fortin Barometer. Maximum Thermometer Minimum Thermometer Standard Hygrometer In a Stevenson's screen in grounds of the Public Offices. Terrestial Radiation Thermometer Earth Thermometer In the grounds of the Offices. Campbell-Stakes Sunshine Recorder Rain Gauge On the roof of the Public Offices. Daily records have been taken, and monthly returns sent to the Meteorological Office. The accompanying taMe gives the result of our operations for the year in a condensed form:— 39 METEOROLOGICAL STATISTICS 1925. Month. Barometer. Temperatures Rainfall. Millimetres. Sunshine hours Thunder Storms. Fogs on days. Frosts on days. Snowfalls. Prevailing Winds. Highest Lowest Earth Means. Grass Min. Highest Maximum. Lowest Minimum. Means of latter. Jan. 30.755 on 19th 29.211 on 2nd 44.32 31.03 Min. 25° on 11th 54° on 2nd, 29, 30, & 31 26° on 11th 40.90 46.40 1.63 inches 41.3 0 13 10 0 S.W. Feb. 30.520 on 2nd & 4th 28.754 on 26th 43.8 24.0° on 24th 55° on 10th 27° on 24th 42.0 83.90 3.35 inches. 61.6 0 3 9 3 S.W. Mar. 30.589 on 16th 29.594 on 1st 42.91 20° on 13th 56° on 7th 25° on 13th 41.35 16.6 0.66 inches. 94.5 1 3 13 6 N. and N.W. April 30.246 on 21st 29.490 on 6th 45.6 27° on 4th 64° on 12th 30° on 4lh 47.0 37.0 1.48 inches. 136.8 3 1 4 0 S. W., W. and N.E. May 30.247 on 13th. 29.346 on 28th 50.73 32° on 2nd 80° on 16th 36° on 2nd 46.22 47.5 1.90 inches 209.4 1 0 0 0 S. and S.W. June 30.450 on 10th 29.862 on 21st 56.8 38° on 29th 87° on 11th 40° on 29th 49.6 2.9 0.11 inches. 266.9 0 0 0 0 N. N.W. July 30.334 on 13th 29.480 on 27th 59.13 45° on 8th 89° on 22nd 48° on 8th 54.54 111.6 4.46 inches. 181.8 4 0 0 0 E. S. W. Aug. 30.400 on 30th 29.586 on 21st 59.9 43° on 26th 83° on 17th 44° on 26th 61.0 58.2 2.72 inches. 135.5 4 1 0 0 S. S.W. w. Sept. 30.425 on 14th 29.282 on 22nd 57.23 35° on 15th & 25th 68° on 1st and 3Cth 36° on 15th 54.43 70.2 2.80 inches 124.7 0 2 0 0 N.W. Oct. 30.544 on 9th 28.790 on 23rd 54.3 29° on 15th 71° on 3rd 33° on 14th 52 74.7 2.98 inches 99.1 0 4 2 0 S. S.W. Nov. 30.514 on 19th 29.016 on 8th 48.99 20o on 27th&28th 61° on 3rd 24° on 27th 40.3 40.2 1.60 inches. 80.9 0 3 15 4 N. Dec. 30.600 on 4th 28.576 on 20th 42.1 18° on 6th 56° on 29th 18° on 6th 37 55.1 2.20 inches 46.0 0 6 17 4 S.W. 633.0 m. 25.32 inches. 1478.5 hrs 13 36 70 17 40 Public Offices, Enfield, March 1st, 1926. REPORT OF THE SANITARY INSPECTOR FOR THE YEAR 1925. To the Chairman and Members of The Urban District Council of Enfield. Mrs. Cole and Gentlemen, 1 beg to submit my report for the year ending December 31st, 1925, which includes particulars in tabular form as required by Article 19 (12) of the Ministry of Health Order No. 276, 1922, of the work done in connection with your Sanitary Department under my supervision. STATEMENT PREPARED BY SANITARY INSPECTOR UNDER ARTICLE XIX. (12), MINISTRY OF HEALTH ORDER, No. 276, 1922 Number of Houses Inspected. Inspections. Under Regulations, Sec. 17, Housing, Town Planning Act, 1909 0 From House-to-House apart from this Act 349 On Account of Infectious Disease 464 On Account of Phthisis 126 On Account of Complaint by occupant or other-wise 1,054 1,993 41 Inspections—(continued). Inspections. Brought forward 1,993 77 Factories 154 126 Workshops and workplaces, including 2 laundries 90 Outworkers' premises inspected 27 56 Bakehouses, of which 38 are in use 144 18 Slaughter-houses, of which 10 are in use 1449 28 Cowsheds inspected frequently 335 31 Dairies and Milkshops inspected frequently 234 22 Schools 117 Public-house urinals inspected 38 Conveniences at Railway Stations inspected 4 Fish Shops: Total number of visits 98 Coffee and Fating Houses: Total number of visits 18 Shops where icecream is made: Total number of inspections 48 Meat Shops: Total number of inspections 255 Meat Stalls in Market: do. do. 677 3,688 Visits to absentees excluded from Elementary Schools 689 Visits in connection with cases of Infectious Disease 3395 Visits in connection with Phthisis 1470 Offensive Trades (excluding Fish Shops) 12 Smoke observations 46 Other inspections, including works in progress 8482 Petroleum Stores inspected 75 Visits re Shops Act 145 Cinemas, etc., inspected 31 Visits and inspections re Rats 22 Visits re Meat Regulations 117 14,484 20,165 42 Notices Issued. Statutory:— Provision of Dustbins 62 For repairs to houses, drains and abatement of Nuisances 244 Providing sufficient water-closets 49 Paving of yards 2 Cleansing and Limewashing of Cowsheds 0 357 Informal:— Notices 0 Letters sent in lieu of notice 881 881 1,238 Other Notices issued under Infectious Diseases Acts:— To occupiers 535 To Education Committee and Head Teachers at Schools 1,267 1,802 3,040 Other letters sent 4,155 Result of Service of Statutory Notices:— Number complied with 320 Number outstanding 37 357 43 As to these outstanding notices, the work required was delayed on account of the weather or other reasonable cause. The general character of the defects found in the dwellinghouses inspected is as follows:— Defective drains and ventilating pipes, etc.; W.C. flushing cisterns and pipes out of order; cracked and broken W.C. pans; broken, cracked and porous scullery sinks and waste pipes; leaking roofs; defective gutters; absence of, or broken paving around houses; defective plaster of ceilings and walls; damp walls; want of ventilation under ground floors and general uncleanly conditions. The following are the works carried out as the result of the notices or letters:— Houses or parts of houses cleansed, repaired, etc. 459 Roofs repaired 225 Gutters and downpipes repaired 208 Cesspools emptied 370 Cesspools abolished 1 House drains cleared, repaired, etc. 123 House drains tested, examined, etc. 126 House drains reconstructed 3 Soil-pipes and drains ventilated, including repairs to ventilators 17 Sink-wastes disconnected or repaired 13 New sinks provided 2 Closets provided with proper flushing cisterns or water supply 181 New closets provided 11 Closets repaired, covered, cleansed, etc. 34 Water-closets substituted for earth-closets 0 Storage cisterns repaired, covered, cleansed, etc. 25 Storage cisterns provided 0 Water laid on or restored 17 New wells provided 0 Samples of water taken 1 Yards paved, or existing paving made good 58 Ventilation provided under ground floors and causes of dampness removed, etc. 100 44 Dustbins repaired, or new ones provided 163 Manure heaps removed 19 Fowls and other animals removed 6 Stables cleansed 2 Other nuisances abated 20 Cases of overcrowding abated 0 Ditches cleaned out 1 Disinfection. Houses disinfected:— After infectious disease 402 After Phthisis 99 After verminous cases 15 516 Rooms stripped and re-papered, etc., after occupation by cases of infectious disease 24 Ditto, ditto, by cases of Phthisis 25 Articles of clothing, bedding, etc., disinfected 1,187 Ditto, ditto, destroyed 63 Library Books disinfected 110 Number of Schools disinfected 8 Cases of Scarlet Fever removed to Hospital 69 Cases of Diphtheria removed to Hospital 124 Cases of Diphtheria Carriers removed to Hospital 17 Cases of Erysipelas removed to Hospital 3 Cases of Mumps removed to Hospital 3 Cases of Whooping Cough removed to Hospital 1 217 Private Patients removed to Hospital or Infirmary 799 Gipsy Vans removed from District 11 Articles or parcels of unsound food destroyed or otherwise disposed of 98 It has been our constant endeavour to secure the carrying out of works with as little delay as possible, and to this end many interviews with owners and others have been secured. In a few cases where there seemed unreasonable delay, a warning from the Council that legal proceedings would be taken, proved sufficient to obtain the carrying out of the works required. 45 Visits paid re children excluded from Elementary Schools daring the year numbered 689, and the total inspections and visits for all purposes made by the Staff of the Sanitary Department was 20,165. Removal of House Refuse. Our experience with the two 2½-ton Edison Electric Vehicles in use since March 1921 and August 1923 continuing very satisfactory, a third vehicle of the same make was, with the approval of the Ministry of Health, obtained and commenced working on 2nd June 1925. We have found that these vehicles contribute considerably to the efficiency and reduction of the cost of this work. In addition to these electric vehicles, four horsed vehicles are regularly employed. A good quantity of the refuse was disposed of in the brickfields, and the remainder taken to the Council's Depots. Carterhatch Lane and Old Road, where it is levelled and covered with earth, which afterwards becomes useful for allotments. The quantity of refuse collected during the year was approximately 11,415 tons, and the cost £4,443, or 7/9d. per ton of refuse collected and disposed of. Quantities of trade refuse were also collected from business premises, for which a charge was made. SALVAGE. It is still difficult to dispose of waste materials, and we were only able to sell 48 tons, 11 cwts, 3 qtrs , of waste tins, etc., collected from the refuse at 12s. 6d. per ton, the amount realised being £27 12s. 7d. 849 tons of sifted ashes and breeze were disposed of to a local brickinaker, for which we were paid £31 16s. 9d. 46 FACTORY AND WORKSHOPS ACTS, 1901 AND 1907. A register of all workshops is kept, and at the end of 1925 there were 85 workshops, 41 workplaces, 2 laundries, and 56 bakehouses registered. The following tables give details of the work done in connection with these places:— Inspections. Premises. Number of Inspections. Written Notices. Prosecutions. Factories (including Factory Laundries) 154 — — Workshops (including Workshop Laundries) 83 — — Workplaces 7 — — Bakehouses 144 — — Total 388 — — Defects Found. Particulars Number of Defects. Number of Prosecutions. Found Remedied. Referred to H.M, Inspector Nuisances under the Public Health Acts:— Want of Cleanliness 3 3 — — Want of Ventilation — — — — Overcrowding — — — — Want of Drainage of Floors — — — — Other Nuisances 1 1 — — Sanitary Accomodation:— Insufficient — — — — Unsuitable or Defective 4 4 — — Not separate for sexes — — — — Offences under the Factory and Workshops Acts:— Illegal occupation of underground bakehouse — — — — Breach of special sanitary requirements for bakehouses 22 22 — — Other Offences — — — — Totals 30 30 — — 47 Homework. Lists received from Employers. Notices served on Occupiers as to keeping or sending Lists. Nature of Work. Sending once in the year. Sending twice in the year. Lists Workmen. Lists. Workmen. Making Wearing Apparel 13 18 10 7 12 Artificial Flowers 1 1 2 1 — Millinery 2 2 — — — Boot-making — — 2 1 — Umbrellas — — 2 1 — Totals 16 21 16 10 12 Ten addresses of Outworkers have been forwarded to other districts. PLACES OF PUBLIC ENTERTAINMENT. In accordance with the recommendation contained in the Circular of the Ministry of Health, dated August 25th, 1920,31 visits were made to cinemas and other places of public entertainment. The sanitary accommodation at each place was found to be satisfactory and apparently sufficient. OFFENSIVE TRADES. The following offensive trades are established in the District:— Fish Friers 25 Rag and Bone Dealers 5 Glue Maker 1 Soap Boiler I 48 and in connection with these 110 inspections were made during the year. With regard to the Fish friers, 10 have been established with the consent in writing of the Council and the majority of the oldestablished bnsinesses have now been fitted with up-to-date frying stoves. MILK. Frequent inspections were made of the Cowsheds, Dairies, and Milkshops in the District, and every endeavour made to secure compliance with the requirements of the Dairies, Cowsheds and Milkshops Orders and Regulations in force in the District. Licenses as follows were in force on the 31st December under the Milk (Special Designations) Order, 1922, Section 3 of the Milk and Dairies Amendment Act, 1922. Dealer's Licence to use the Designation "Certified" 2 ,, „ „ ,, "Pasteurised" — Supplementary Licence to use the Designation "Pasteurised" 2 Supplementary Licence to use the Designation Grade " A " 2 UNSOUND MEAT AND FOODS. In this connection frequent visits were paid to the slaughterhouses, shops and markets, the number of inspections for this purpose being:— Slaughter-houses 1,449 Shops 255 Stalls in Markets 677 2,381 49 PUBLIC HEALTH (MEAT) REGULATIONS, 1924. Under the provision of these Regulations which came into operation on the 1st April 1925, six occupiers of slaughterhouses have given notice of the regular practice of slaughtering animals at fixed times on fixed days, and the others give written notice of the day and time of their intention of slaughtering. The number of carcases examined since these Regulations came into force ate as follows:— Cows 132 Organs or parts of carcases found diseased 7 Oxen 490 do. do. 44 Calves 76 do. do. 1 Sheep 2,678 do. do. 7 Pigs 1,395 do' do. 13 Totals 4,771 do. do. 72 These organs or parts of carcases found to be diseased were surrendered and destroyed. The number of carcases examined during the year were as follows:— Cows 148 Oxen 539 Calves 65 Sheep 2765 Pigs 1526 5,043 The carcases generally were in good condition, and there was no case which necessitated the obtaining of a Magistrate's Order. The number of parcels of food-stuffs (15 in all) purchased in the London Markets submitted for inspection as appearing unfit for food, were less than usual, and consisted of fish, rabbits, fruit, etc. 50 Certificates were given in all cases, as it was found that the articles were unfit for the food of man, so that the owner might obtain replacement of the goods or return of the money from the wholesale dealer. Nine certificates in all were granted. I am, Mrs. Cole & Gentlemen, Your obedient Servant, A. J. MUNRO, F.S.I.A, M.R. San.I. Sanitary Inspector.