FEL 28 Feltham Urban District Council. ANNUAL REPORT OF THE Medical Officer of Health, FOR THE YEAR 1915. C. DWIGHT MORRIS, Medical Officer of Health. " Parkside," Feltham, Middx. June 1st, 1916. Geo. W. Lancett, Typ., Feltham. 3 FELTHAM URBAN DISTRICT COUNCIL. Mr. Chairman and Gentlemen, I beg to present my Annual Report for the year 1915. VITAL STATISTICS. The estimated Civil Population of the Feltham Urban District is given by the Registrar General as 5124, and most of the rates are calculated upon this estimate, but the Birth Rate is calculated on the total population of 1914, viz., 5891. The number of Deaths registered in the district was 57, which gives a Death Rate of 11.1 per thousand. There were 13 deaths registered outside the district, and one registered as non-resident, which gives a Corrected Death Rate of 13.4. The number of Births registered in the district was 127, which calculated on the total Population of 1914, viz., 5891, gives a Birth Rate of 23.2 per thousand. Out of 127 Births, 7 died before reaching the age of 1 year, giving an Infant Mortality Rate of 55.1. Of these 1 died under 1 week, 1 under 2 weeks, 1 under 3 months, and 4 between 9 and 12 months old. Two were from Whooping Cough, 2 from Prematurity, 1 Wasting, 1 from Bronchitis, and 1 Convulsions. This rate is a great improvement on the year 1913 of 112.9, and a slight improvement of 1914 of 56 per thousand births. The Zymotic Death Rate comes out at 1.3, owing to 3 deaths from Measles, and 4 from Whooping Cough. INFECTIOUS DISEASE. Of the 4 principal Infectious Diseases, 18 were notified during the year, and compared with England and Wales the following are the attack rates per thousand of population:— Feltham. England & Wales. Scarlet Fever 1.76. 3.59. Diphtheria nil. 1.52. Enteric Fever 0.59. 0.18. Erysipelas 1.67. 0.66. There were no Deaths among the 8 Scarlet Fever, 7 Erysipelas, and 2 Enteric cases. One Enteric died in Hospital from an Orbital Abscess, and Meningitis following it. All the Scarlet Fever cases, and 2 Enteric Fever cases were removed to the Isolation Hospital. 4 TUBERCULOSIS. Of these 15 were notified, 12 Pulmonary, and 3 other forms, with 3 deaths. The majority of these cases received special treatment at the Hounslow Tuberculosis centre, and the various Convalescent Homes or Hospitals. Comparison with England and Wales, the Tuberculosis Rate per thousand of population:— Feltham, 2.9. England and Wales, 2.7. I can only account for this slight increase of average, owing to the two successively wet seasons, and the advice given to live in the country. In reviewing the Deaths as a whole, Longevity stands out well, as 8 lived to between 60 and 70; 14 lived to between 70 and 80 ; and 4 lived to between 80 and 90 years. As to the Birth Rate, this has improved from 21.3 in 1913, 21.2 in 1914, to the present year, 1915, of 23.2. The Notification of Births (Extension) Act only came into force on the 1st September, 1915, and no Health Visitor being appointed, it is premature to say what effect this will have, until in full working order. EPIDEMICS. A small epidemic of Measles, followed by Mumps, occurred in July aud August. Measles caused 3 deaths between the ages of 2 and 5 years. Councils all over the country were asked to consider the advisability of adding Measles aud Whooping Cough to their list of Notifiable Diseases, who had not already done so. Many, like ourselves, refused, with the result that Measles, aud German Measles, is now Notifiable from the 1st January, 1916, and there is a strong possibility of Whoopiug Cough following at a later date. BILLETING OF SOLDIERS. Many enquiries were made by the Military Authorities as to the suitability of certain houses for troops, and although the neighbouring district of Ashford dealt with over a thousand men, it was not until the end of the year that the 3rd 25th Cyclists London Corps who had been temporarily in residence at Butts Farm, Hanworth, and Tudor House, Hanworth Park, that the district felt the full force of Billeting, and which remained well into this year. Further reference will be made to this in next year's report. WATER SUPPLY. About 85 per cent of houses are now supplied with water from the Public Main, which is the South West Suburban Water Company, which takes its store from the Thames at Egham. Regular Bacteriological and Chemical Analyses are made, in conjunction with a scheme with other districts which are supplied by them. There is a strong feeling amongst those who have the safeguarding of the Public Health, that, until the Company see their way to increase their storage, by installing settling resevoirs, all the districts supplied are not in a really safe position. 5 The few remaining wells are examined from time to time, two at least were cleansed and repaired during the year. HOUSING AND TOWN PLANNING ACT. Three representations were made under Sec. 17 of the Act, and three houses were closed by your Authority. The Number of Cautionary Notices and the Statutory Notices, under the Public Health Act, means that you have been on the lenient side, owing to the abnormal conditions prevailing at the present time. Building operations are at a standstill, not a single new house has been erected, several have been transformed, and so far there is ample accomodation for the needs of the people, though at times I have noticed that owing to the male members being absent at the front, two families have occupied one house, without overcrowding. SEWAGE DISPOSAL, DUSTBIN COLLECTION, SCAVENGING, AND STREET WATERING. All these are carried out much as in former years. The two continuously wet seasons put rather a strain on the sewage disposal arrangements, as much of the subsoil water got into the cesspools, owing to the great height of the water in the laud, which was very manifest, for a long period, in the Thames valley. DAIRIES, MILKSHOPS, BAKERS', SLAUGHTER HOUSES, AND FOOD DEPOTS. These are all kept uuder observation, by occasional visits, both of the Sanitary Inspector and myself. A small amount of fruit was condemned during the year at the request of a shopkeeper. GENERAL SUMMARY. It is generally understood that all Annual Reports will be curtailed as much as possible. The rates speak for themselves. A low Death Rate an increased Birth Rate, a declining Infant Mortality Rate, are facts beyond dispute. I have to thank my colleagues, the Clerk and Sanitary Inspector, also the Members of the Sanitary Committee, and Council for the help they have always given in carrying out the duties entrusted to me, hoping that the outlook may be brighter for everybody, when the time comes again to place before you the next Annual Report. I beg to remain, Your obedient servant, C. DWIGHT MORRIS, Medical Officer of Health. June 1st, 1916. 6 SANITARY WORK, 1915. Enumerate (1) Adoptive Acts, (2) Bye-laws in force in the District. Infectious Diseases (Prevention) Act, 1890. Public Health Amendment Act, 1890, part 3. Bye-laws as to New Streets and Buildings. Do. with respect to Nuisances. Do. under sec. 44, Public Health Act, 1875. Do. with respect to Slaughter Houses. Particulars as to Staff employed in Sanitary Department— 4 men for cesspool emptying. 2 men for house refuse collecting. Sanitary Inspector is also the Surveyor. Inspections- Number of Premises Inspected on Complaint 11 Number of Premises Inspected in connection with Infectious Diseases 15 Number of Premises under Periodical Inspection 30 Houses Inspected from House-to-House 140 Total Number of Inspections and Re-inspections made 493 Dwelling Houses— Number of Houses found to be in a state Dangerous or Injurious to Health 3 Number of Representations made by M.O.H. 3 Number of Closing orders made by L.A. 3 Action Taken— Cautionary or Intimation Notices given 130 Statutory Orders issued 80 Summonses served 2 Convictions obtained 2 Movable Dwellings, Caravans, Tents, &c.— Number observed during the year 9 Number of Nuisances therefrom abated 2 Number removed from District 7 Bakehouses- Number in District 3 Slaughter Houses- Number on Register 2 Number of Inspections made 15 Frequency of Inspection At least Quarterly. 7 Dairies and Milkshops— Number on Register 2 Number of Inspections made 11 Frequency of Inspection At least Quarterly Unsound Food- Meat (including organs) seized and surrendered. (Approximate weight in pounds.) 21bs. Fruit and Vegetables seized and surrendered. (Approximate weight in pounds.) 30lbs. Method of disposal Buried. Water Supply and Water Service— Wells—Cleansed, Repaired, &c 2 Percentage of Houses supplied from Public Water Service 85% Percentage of Houses supplied on Constant System 85% Number of Samples obtained for Analysis— From Local Wells 5 From Public Supply 4 Drainage and Sewerage of existing Buildings— Water Closets—Repaired, Supplied with Water, or otherwise Improved 15 Percentage of Houses provided with Water Closets 77% Drains—Examined, Tested, Exposed, &c. 18 Unstopped, Repaired, Trapped, &c. 81 Waste Pipes, Rain Water Pipes Disconnected, Repaired, &c. 8 Cesspools—Rendered Impervious, Emptied, Cleansed, &c. 900 Disinfection— Rooms Disinfected—Ordinary Infectious Diseases 12 Phthisis 3 Rooms Stripped and Cleansed 7 Dust— New Bins provided 42 How frequently is dust removed from each house ? Weekly Method of Disposal Tipping Sundry Nuisances abated— Overcrowding 2 Accumulation of Refuse 16 Foul Ditches, Ponds, &c., and Stagnant Water 23 Foul Pigs and other Animals 7 Dampness 25 Yards repaved or repaired 4 TABLE. I.—Vital Statistics of Whole District during 1915 and previous years. FELTHAM URBAN DISTRICT COUNCIL. Year. Population estimated to Middle of each Year. Births. Total Deaths Registered in the District. Transferable Deaths. Nett Deaths belonging to the District. Uncorrected Number. Net. of Nonresidents registered in the District of Residents not registered in the District. Under 1 Year of Age. At all Ages. Number. Rate. Number. Rate. Number. Rate per 1,000 Nett Girths. Number. Rate. 1 2 3 4 5 6 7 8 9 10 11 12 13 1910 5125 139 25.6 49 9.0 12 15 100.7 61 11.2 1911 5135 145 147 28.5 49 9.5 3 11 20 136.0 57 11.1 1912 5105 135 26.4 48 9.4 14 18 133.3 62 12.1 1913 5816 124 21.3 54 9.2 6 14 112.9 60 12.0 1914 5891 125 125 21.2 54 9.1 1 16 7 56 70 11.8 1915 5124 127 23.2 57 11.1 1 13 7 55.1 69 13.4 Area of District in acres (exclusive of area covered by water)—1790. Total population at all ages 6135. Number of inhabited houses 1100 Average number of persons per house 4 .6 At Census of 1911. TABLE II.—Cases of Infectious Disease notified during the Year 1915. FELTHAM URBAN DISTRICT COUNCIL. Notifiable Disease. Number of Cases Notified. At all Ages. At Ages—years. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 45. 45 to 65. 65 and upwards. Diphtheria (including Membranous Croup) — — — — — — — — Erysipelas 7 — 1 — 1 2 3 — Scarlet Fever 8 — 1 6 1 — — — Enteric Fever 3 — — — 2 — 1 — Opthalmia Neonatorum — — — — — — — — Pulmonary Tuberculosis 12 — — 2 2 7 1 — Tuberculosis, Other forms 3 — 1 1 — 1 — — Totals 33 — 3 9 6 10 5 — Total Cases removed to Hospital: Scarlet Fever, 8 ; Enteric Fever, 2. Isolation Hospital—Staines Joint Hospital, and Clare Hall for Small Pox. TABLE III.—Causes of, and Ages at Death during the Year 1915. FELTHAM URBAN DISTRICT COUNCIL. Causes of Death. nett Deaths at the subjoined Ages of "residents" whether occurring within or without 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 upwards. Measles 3 — — 3 — — — — — Whooping Cough 4 2 1 1 — — — — — Influenza 4 — — — — — — — 4 Erysipelas 1 — — — 1 — — — — Phthisis (Pulmonary Tuberculosis) 3 — — — — — 3 — — Other tuberculous diseases 1 — 1 — — — — — — Cancer, malignant disease 7 — — — — — 2 2 3 Meningitis 1 — 1 — — — — — — Organic Heart Disease 4 — — — — — — 2 2 Bronchitis 6 1 — — — — — 1 4 Pneumonia 3 — 2 — — 1 — — — Cirrhosis of Liver 1 — — — — — — 1 — Nephritis & Bright's Disease 2 — — — — — 1 — 1 Congenital Debility, Marasmus, and Malformation, including Premature Birth 2 9 — — — — — — — Violent Deaths, excluding Suicide 3 — — — 1 1 1 — — Other Defined Diseases 24 2 1 1 — 1 2 5 12 All causes 69 7 6 5 2 3 9 11 26 TABLE IV.—Infant Mortality during the Year 1915. Nett Deaths from stated causes at various Ages under 1 year of Age. FELTHAM URBAN DISTRICT COUNCIL. Cause of Death. Under 1 Week. 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 1 Month. 1-3 Months. 3-6 Months. 6-9 Months. 9-12 Months. Total Deaths under 1 Year. Whooping Cough — — — — — 1 — — 1 2 Convulsions — — — — — — — — 1 1 Bronchitis — — — — — — — — 1 1 Premature Birth — 1 — — 1 — — — — 1 Atrophy, Debility, Marasmus 1 — — — 1 — — — 1 2 Other Causes — — — — — — — — — — Totals 1 1 — — 2 1 — — 4 7 Nett births in the year, legitimate 123, illegitimate 4. Nett deaths in the year, legitimate infants 7, illegitimate infants 0. Factories, Workshops, Workplaces, and Homework. 1.—INSPECTION. Including Inspections made by Sanitary Inspectors or Inspectors of Nuisances. Premises. Number of Inspections. Written Notices. Prosecutions. Factories (including Factory Laundries) 12 — — Workshops (including Workshop Laundries) 22 — — Workplaces — — — Total 34 — — 2—DEFECTS FOUND IN FACTORIES, WORKSHOPS & WORKPLACES. Found. Remedied. Want of cleanliness 1 1 Tel. 55 Elder House, Berwick. Messages should, if possible, be sent by 10.30 a.m. Urban District of Fincbley. Annual Reports for 1915 of the MEDICAL OFFICER OF HEALTH and SCHOOL MEDICAL OFFICER together with the Annual Report of the SANITARY INSPECTOR. Finchley. A. Warden & Co., Ltd., " Finchley and Hendon Times" Office, ii, Regents Parade, Finchley, N 1916. Finch ley Urban District Council. REPORT OF THE MEDIGAL OFFICER OF HEALTH For the Year 1915. TO THE CHAIRMAN AND MEMBERS OF THE FINCHLEY URBAN DISTRICT COUNCIL Mr. Chairman, Mrs. Hardie, and Gentlemen,— I beg to present the report on the health of the Finchley Urban District for the year 1915. The vital statistics continue to be very favourable. There have been several temporary changes in the clerical staff owing to the absence of Mr. Harland and Mr. Newbery, who have joined the military forces. Mr. Eldred, Assistant Inspector, joined the Forces in 1915, and Mr. Hudson in 1916. An additional Health Visitor and School Nurse was appointed in February, 1916. It is with much regret that I have to state that Mrs. Brand died in September. She acted for 28 years as matron (1) at the Fever Hospital and afterwards at the Small Pox Hospital, and her work was always carried out most efficiently. Your obedient servant, J. R. PRIOR. 5 VITAL STATISTICS. Population. The estimated population at the middle of 1915 was 47,812. The estimate given by the Registrar-General is 44,185. Births. The number of births belonging to Finchley, for the year 1915. is 912; of these 892 were registered in the district, and 20 elsewhere. The birth-rate is 19.07 per 1,000 of the population, as compared with 20.99 in 1914; or based on the RegistrarGeneral's figure is 20.64. The following table shews the number of births recorded and the birth-rate for each Ward of the district:— No. of Births. Birth Rate. North Finchley 289 21.24 East Finchley 346 21.25 West Finchley 257 14.33 The birth-rate for England and Wales for 1915 is 21.8. Illegitimate Births. 32 illegitimate births were registered, i.e., 3.5 per cent. of the total births, as compared with 3.01 in 1914. Deaths. 422 deaths were registered within the district; 22 were of persons temporarily residing here, and 97 deaths occurred outside the district among persons who usually reside in the district. This nett total is 497, and equals a nett death-rate of 10.39 per 1,000 of the population, as compared with 9.24 in 1914; or based on the Registrar-General's figure is 11.24. The corrected death-rate is 10.56. The death-rate for England and Wales is 15.1. 6 The following table shews the death-rate for each Ward: Ward. Estimated Population. Number of Deaths Death Rate. North Finchley 13,605 185 13.59 East Finchley 16,281 158 9.7 West Finchley 17,925 154 8.03 Deaths Among Young Children. 25 deaths occurred among children between the ages of 1 and 5 years. The number last year was also 25. Seven were due to Measles, 1 to Diphtheria, 1 to Tuberculous Meningitis, 2 to Other Tuberculous Diseases, 1 to Organic Heart Disease, 11 to Pneumonia, 1 to Congenital Debility, and 1 to violent deaths (excluding suicides). Deaths from Epidemic (or Zymotic) Diseases. The following table shews the number of deaths due to Zymotic Diseases during the years 1914 and 1915:— 1914. 1915. Enteric Fever — 1 Measles 4 10 Scarlet Fever — 2 Whooping Cough 4 2 Diphtheria 1 4 Diarrhoea (under 2 years) 11 6 Infant Mortality. 60 deaths occurred among children under 1 year of age; this is equal to a death-rate of 65.79 per 1,000 births as compared with 66.45 in 1914. The infantile death-rate for the whole of England and Wales was 114. 7 Birth Notifications, 1915. Number of births registered in district—912. No. of Parents who notified. No of Doctors who notified. No of Cert Nurses who notified. No. of other people who notified. Before letter 382 After letter 221 231 45 21 Total 603 Total number who notified—900. Number of people who notified without a letter 679=77.7 per cent. of all births (last year 70.8 were notified). Summary of visits by the Lady Health Visitor in connection with the Notification of Births Act:— Number of houses visited 200 Number of additional visits 301 Total visits 561 Of the 200 infants visited 177 (88.5 per cent.) were breast fed. Prevalence and Control over Acute Infectious Disease. The total number of cases of acute infectious disease notified during the year was 298, which is equal to an attack rate of 6.2 per 1,000 of the population; or on the RegistrarGeneral's figures 6.74, as compared with 245 cases and an attack rate of 5.3 in 1914. . Scarlet Fever. 161 cases of Scarlet Fever were notified during the year with 2 deaths, as compared with 120 cases and no deaths in 1914. 113 cases were removed to hospital ; this equals 70.1 per cent. of the number notified, as compared with 86 cases and a rate of 71.6 for 1914. 8 " Return Cases " of Scarlet Fever. 7 "Return Cases" of Scarlet Fever occurred in the district. 3 of these occurred within 5 days of the home-coming of the alleged infecting patient, 2 within 7 days, 1 within 10 days, and 1 within 2 days. This equals 4.7 per cent. of those discharged. Diphtheria. 80 cases of Diphtheria were notified during the year, with 4 deaths, as compared with 87 cases and 1 death in 1914. 61 cases were removed to hospital; this equals 76.25 per cent. of the number notified, as compared with 63 cases and a rate of 72.4 for 1914. Enteric Fever. 4 cases of Enteric Fever were notified. AH were "primary" infections. The cases were thoroughly investigated, but the source of infection was uncertain. The 4 cases represent infection in 4 houses. 1 case was removed to hospital and 1 to a nursing home. The serum of three of the patients was examined for Widal's reaction, and was found to be positive in two instances. Of the four cases one ended fatally. Cerebro-Spinal Meningitis. 6 cases of Cerebro-Spinal Meningitis were notified, and 4 deaths occurred. One of the patients was a non-resident. 1 case was removed to the hospital and 1 to a nursing home. In one case, on investigation, it was found that there were 2 cases of Pneumonia in the house: both recovered. Acute Poliomyelitis. 1 case of Acute Poliomyelitis was notified during 1915. Small Pox. No case was notified. 9 Puerperal Fever. 5 cases of Puerperal Fever were notified in 1915, as compared with none in 1914. Erysipelas. 33 cases were notified during 1915, and no deaths occurred, as compared with 29 cases and 3 deaths for 1914. Ophthalmia Neonatorum. 8 Notifications of Ophthalmia Neonatorum were received during the year, as compared with 4 in 1914. All of the cases were in receipt of proper medical attention. Non-Notifiable Infectious Diseases. Measles. There were 10 deaths from Measles in 1915, as compared with 4 deaths in 1914. Whooping Cough. 2 deaths occurred among children under 5 years of age, as compared with 4 in 1914. The following table shews the number of cases of infectious disease which occurred in each Ward. Scarlet Fever Diphtheria Enteric Fever Erysipelas Ophthalmia Neonatorum Cerehro Spinal Fever Puerperal Fever Acute Poliomyelitis Total North Finchley 51 29 1 23 3 3 2 — 112 East Finchley 60 27 1 6 3 1 2 — 100 West Finchley 50 24 2 4 2 2 1 1 86 161 80 4 33 8 6 5 1 298 Of these 298 cases 177 were removed to hospital, or 59.4 per cent., as compared with 62.85 per cent. last year. 10 The following table shews the number of cases removed to hospital from each Ward of the district:— Scarlet Fever. Diphtheria. Enteric Fever. Cerebro Spinal Fever. Total. North Finchley 37 20 1 1 59 East Finchley 43 23 — — 66 West Finchley 33 18 1 — 52 113 61 2 1 177 The number of deaths and death rate from the following diseases is shewn in the table below:— Number of Deaths. Death-rate per 1,000 population. Scarlet Fever 2 04 Diphtheria 4 .08 Enteric Fever 1 .02 Measles 10 .21 Whooping Cough 2 .04 Diarrhœa 6 .13 Tuberculosis. 32 deaths were due to some form of Tuberculosis, which is equal to a death rate of .67 per 1,000 of the population as compared with 33 deaths and a rate of .71 in 1914. 24 of the deaths were due to Pulmonary Tuberculosis, which gives a Phthisis death rate of .5, as compared with .59 in 1914. 145 notifications in respect of 68 casts of Pulmonary Tuberculosis and 16 cases of "Other Forms of Tuberculosis" were received during the year. 81 were visited by the Health Visitor or Medical Officer of Health, and in the remainder the Medical Practitioner expressed the wish that no visit should be made, and assured me that all precautions were being taken. The Nurse made 171 visits in connection with these notifications. During the year 28 rooms and 307 articles were disinfected in connection with the control of this disease. 11 Cancer. 60 deaths were due to Cancer, this being equal to a death rate of 1.25 per 1,000 of the population. 23 of the deaths in Finchley occurred among males and 37 among females. The mean age at death was 56.6 years in the males and 61 years in the females. Bacteriological Examinations. The following is a record of the work done in the Council's Laboratory during the year:— Diphtheria— 406 swabs were examined. 62 were positive. 311 were negative. 10 were indefinite. 23 were sterile. Phthisis— 61 specimens of sputum were examined. 13 were positive. 48 were negative. Ringworm— 56 specimens of diseased hairs were examined for the sports of Ringworm. Most of these were from children in the public elementary schools, but some were sent by medical practitioners. Other specimens 7. In addition to the above, 61 specimens were examined by other institutions, viz.:— 18 Diphtheria swabs, 4 positive, 14 negative. 4 Sputa, 3 positive, 1 negative. 16 Blood (Widal) tests, 3 positive, 12 negative, 1 indefinite Cerebro-Spinal Meningitis— 23 swabs were examined. 23 were negative. 12 Inspection of Dairy Cows. During the year the quarterly inspection of dairy cows has been undertaken by the Council's Veterinary Surgeon. In no instance was a case of tuberculosis discovered. Inspection of Slaughter houses, Etc. Slaughterhouses, Bakehouses, etc., have, as in former years, been subject to regular inspection. 13 FACTORIES AND WORKSHOPS. 1.—Inspection. Including Inspections made by the Sanitary Inspectors. Premises. Number of Inspections. Written Notices Prosecutions. Factories (Including Factory Laundries) 5 — — Workshops (Including Workshop Laundries) 392 10 letters. — Total 397 10 — 2 — Defects Found. Particulars. Number of Defects. No of Prosecutions. Found Remedied. Referred to H.M. Inspector. Nuisances under the Public Health Acts* Want of Cleanliness 13 13 — — Want of ventilation — — — — Overcrowding 2 2 — — Want of drainage of floors — — — — Other nuisances 20 20 — — †Sanitary accommo dation insufficient — — — — unsuitable or defective — — — — not separate for sexes — — — — Offences under the Factory and Workshop Act Illegal occupation of under ground bakehouse (s 101) — — — — Breach of special sanitary requirements for bakehouses (ss. 97 to 100) 9 9 — — Other offences — (Excluding offences relating to out work which are included in part 3 of this Report) — — — — Total 44 44 — — *Including those specified in sections 2, 3, 7, and 8 of the Factory and Workshop Act as remediable under the Public Health Act. †Public Health Acts Amendment Act, 1890, Part 3, adopted Oct., 1890. 14 3.—Home Work. Nature of Work. Outworkers' List, Section 107 Number of Inspections of Outworkers' premises. Lists received from Employers sending twice in the year Numbers of Addresses of Outworkers received from other Councils. Numbers of Addresses of Outworkers forwarded to other Councils. Lists. Outworkers Wearing Apparel — Making, &c 6 6 34 3 18 4.— Registered Workshops. Workshops on the Register (S 131) at the end of the Year. Number. Dressmakers and Milliners 35 Laundries 12 Bootmakers 24 Bakers 20 Restaurant Kitchens 11 Motor and Cycle Engineers 21 Stonemasons 6 Saddlers 3 Ironmongers 4 Farriers 7 Tailors 16 Upholsterers 3 Coachbuilders and Wheelwrights 3 Other Workshops 10 Total number of Workshops on Register 175 5.—Other Matters. Class (1) Number (2) Matters notified to H.M. Inspector of Factories — Failure to affix Abstract of the Factory and Workshop Acts (S. 133) ... Action taken in matters referted by K M Inspector as remediable under the Public Health Acts, but not under the Factory and workshop Act (S. 5 1901) Notified by H.M. Inspector ... Reports (of action taken) sent to H.M. Inspector ... Other ... Underground Bakehouses (S. 101)— Certificates granted during the year ... In use at the end of the year 2 15 16 Table 1. Vital Statistics or Whole District During 1915 and Previous Years. Year Population estimated to middle of each year Births Total Deaths Registered in the District Transferable Deaths Nett Deaths belonging to the District Uncorrected Number Nett Of Non-residents registered in the District Of Residents not registered in the District Under 1 Year of Age At all Ages Number Rate Number Rate Number Rate per 1,000 Nett Births Number Rate 1 2 3 4 5 6 7 8 9 10 11 12 13 1910 38,253 ... 889 23.2 321 8.3 14 60 56 62.9 367 9.5 1911 39,815 939 960 24.1 304 7.6 17 68 71 73.9 355 8.9 1912 41,899 952 973 23.2 319 7.6 15 75 61 62.6 379 9.0 1913 44,208 918 930 21.03 358 8.09 23 57 60 64.5 392 8.86 1914 45,868 941 963 20.99 361 7.83 20 82 64 66.45 423 9.24 1915 47,812 892 912 19.07 422 8.82 22 97 60 65.79 497 10.39 Area of District in acres (land and inland water) 3,384. At Census of 1911 Total population at all ages 39,419. Total families or separate occupiers 7,642. 17- 18 Table II.—Cases of Infectious Disease Notified During the Year 1915. Notifiable DISEASE. No of Cases Notified. Total Cases Notified in each Ward. (Removed to Hospital | from Each Ward. Total Cases removed to Hospital. At all Ages. At Ages—Years. 1 North Ward. 2 East Ward. 3 West Ward. 4 No th Ward. 5 East Ward. 6 West Ward. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 45. 45 to 65. 65 and upwards. Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera, Plague ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria (including Membranous croup) 80 ... 10 52 8 10 ... ... 30 27 23 20 23 18 61 Erysipelas 33* 1 ... 1 4 8 11 6 24 6 3 ... ... ... ... Scarlet Fever 161 i 30 82 28 18 2 ... 51 60 50 37 43 33 113 Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever 4 ... ... ... ... 4 ... ... 1 1 2 1 ... 1 2 Relapsing Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Continued Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Fever 5* ... ... ... ... 3 ... ... 2 1 2 ... ... ... ... Cerebrospinal Meningitis 6 1 1 1 ... 2 1 ... 3 1 2 1 ... ... 1 Poliomyelitis 1 ... ... 1 ... ... ... ... ... ... 1 ... ... ... ... Ophthalmia Neonatorum 8* 7 ... ... ... ... ... ... 3 3 2 ... ... ... ... Pulmonary Tuberculosis 68* ... 1 3 8 40 14 1 27 24 17 ... ... ... ... Other forms of Tuberculosis 16 1 3 8 3 1 ... ... 4 9 3 ... ... ... ... Totals 382 11 45 148 51 86 28 7 145 132 105 59 66 52 177 Isolation Hospital or Hospitals, Sanatoria, etc. The Borough of Hornsey Isolation Hospital, Muswell Hill, N. The Small Pox Hospital, Summers Lane, North Finchley. *In 6 of these cases the ages of the patients could not be ascertained, and therefore cannot be allocated. 19 Table III. Causes of and Ages at Death during the Year 1915 Causes of Deaths Nett Deaths at the Subjoined Ages of "Residents'' whether occurring within or without the District. Total Deaths whether of " Residents " or " NonResidents in Institutions in the District All ages Under 1 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 1 2 3 4 5 6 7 8 9 10 11 All causes Certified 497 to 13 11 14 20 78 119 182 49 Uncertified ... ... ... ... ... ... ... ... ... Enteric Fever 1 ... ... ... ... ... 1 ... ... ... Small-pox ... ... ... ... ... ... ... ... ... ... Measles 10 1 2 4 2 ... 1 ... ... ... Scarlet Fever 2 ... ... ... 1 ... 1 ... ... ... Whooping Cough 2 2 ... ... ... ... ... ... ... ... Diphtheria and Croup 4 ... ... 1 3 ... ... ... ... ... Influenza 14 ... ... ... ... ... 3 4 7 1 Erysipelas ... ... ... ... ... ... ... ... ... ... Phthisis (Pulmonary Tuberculosis) 24 ... ... ... 1 5 13 5 ... 3 Tuberculous Meningitis 2 ... 1 ... ... 1 ... ... ... 1 Other Tuberculous Diseases 6 ... 1 1 1 3 ... ... ... 2 Cancer. Malignant Disease 60 ... ... ... ... 1 7 34 18 5 Rheumatic Fever ... ... ... ... ... ... ... ... ... ... *Meningitis 3 1 ... ... ... ... 2 ... ... 1 Organic Heart Disease 60 ... ... 1 ... 1 9 25 24 5 Bronchitis 44 5 ... ... ... ... 1 3 36 2 Pneumonia (all forms) 33 6 9 2 ... 3 4 3 5 2 Other Diseases of Respiratory Organs 6 2 ... ... ... ... ... 3 1 ... Diarrhœa and Enteritis 6 6 ... ... ... ... ... ... ... ... Appendicitis & Typhlitis 2 ... ... ... 1 ... 1 ... ... 1 Cirrhosis of Liver 5 ... ... ... ... ... 2 1 2 1 Alcoholism ... ... ... ... ... ... ... ... ... ... Nephritis and Bright's Disease 21 ... ... ... 1 ... 6 2 12 2 Puerperal Fever ... ... ... ... ... ... ... ... ... ... Other Accidents and Diseases of Pregnancy and Parturition 2 ... ... ... ... ... 2 ... ... ... Congenital Debility and Malformation, including Premature Birth 30 28 ... 1 1 ... ... ... ... ... Violent Deaths (excluding Suicide) 15 1 ... 1 1 3 4 2 3 3 Suicide 3 ... ... ... ... ... 2 ... 1 ... Other Defined Diseases 39 8 ... ... 1 2 19 36 73 19 Diseases, ill defined or unknown 3 ... ... ... 1 1 ... 1 ... ... Totals 497 60 13 11 14 20 78 119 182 49 *Cerebro-spinal Meningitis, 3. 20 Table IV. Infant Mortality during the Year 1915. Nett deaths from stated causes at various ages under I year of age. Causes of Death Under 1 Week 1-2 Weeks 2-3 Weeks 3-4 Week Total under 4 Weeks 4 Weeks and under 3 M'ths 3-6 Months 6-9 Months 9-12 Months Total Deaths under 1 year. All causes Certified 15 2 3 2 22 10 8 11 9 60 Uncertified ... ... ... ... ... ... ... ... ... ... Small-pox ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... 1 1 Scarlet-fever ... ... ... ... ... ... ... ... ... ... Whooping-Cough ... ... ... ... ... ... ... 1 1 2 Diphtheria and Croup ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... Tuberculous Meningitis ... ... ... ... ... ... ... ... ... ... Abdominal Tuberculosis ... ... ... ... ... ... ... ... ... ... Other Tuberculous Diseases ... ... ... ... ... ... ... ... ... ... Meningitis (nut '/ liberation*) ... ... ... ... ... ... ... 1 ... 1 Convulsions ... ... ... ... ... ... ... ... 1 1 Laryngitis ... ... ... ... ... ... ... ... ... ... Bronchitis ... ... ... 1 1 1 ... 3 ... 5 Pneumonia (all forms) ... ... ... ... ... 1 1 1 3 6 Diarrhœa ... ... ... ... ... ... ... ... ... ... Enteritis ... ... ... ... ... 1 1 3 1 6 Gastritis ... ... ... ... ... ... ... ... ... ... Syphilis ... ... ... ... ... ... ... ... ... ... Rickets ... ... ... ... ... ... ... ... ... ... Suffocation, over lying 1 ... ... ... 1 ... ... ... ... 1 Injury at birth ... ... ... ... ... ... ... ... ... ... Atelectasis ... ... ... ... ... ... ... ... ... ... Congenital Malformations ... ... ... 1 1 1 ... ... ... 2 Premature birth 11 ... 1 ... 12 1 ... ... ... 13 Atrophy, Debility and Marasmus 2 2 2 ... 6 2 4 1 ... 13 Other Causes 1 ... ... ... 1 3 2 1 2 9 Totals 15 2 3 2 22 10 8 11 9 60 Nett Births registered during the calender year Legitimate 880 Illegitimate 32 Nett Deaths registered during the calender year of Legitimate infants 54 Illegitimate infants 6 21 Finchley Urban District Council. ANNUAL REPORT of the SANITARY INSPECTOR For the Year 1915. To the Chairman and Members of the Finchley Urban District Council. Mrs. Hardie and Gentlemen,— I have the honour to present to you my Fourteenth Annual Report dealing with the work carried out by your Sanitary Inspectors during the year 1915. The usual statement explaining the details of the more important sections of work which has been performed, is, on this occasion, omitted, in order to economise, as far as possible, in regard to the cost of printing. The total number of inspections made during the year was 7,661, as compared with 9,522 in 1914. On 679 of the premises visited, nuisances to the number of 1,277 were discovered, and in dealing with the sanitary defects from which they arose, 184 "Intimation" Notices and 146 "Statutory" Notices were served. The numbers of letters written and received with reference to the business of the department were respectively 968 and 707. At the end of the year 1,138 of the nuisances discovered had been abated, the work of remedying 96 was in hand, and the remaining 43 were outstanding. 22 Inspections. The total number of inspections made in regard to each section of work is recorded in the appended table, together with a summary of the sanitary improvements carried out:— House to House Inspections 5 Special Inspections 2364 Re-Inspections after Order or Notice 1580 Visits to Works in progress 1251 Visits to Factories and Workshops (including Bakehouses) 397 Visits to Slaughterhouses 224 Visits to Cowsheds, Dairies, and Milkshops 74 Visits to Ice Cream Premises 47 Visits to Food Shops 329 Visits re Infectious Disease 1077 Miscellaneous 313 Total number of inspections and re-inspections 7661 Summary of Sanitary Improvements carried out. Drainage. Number of old drains examined, tested, exposed, etc. 102 Number of Houses and Premises re-drained 62 Repairs or Amendments to existing Drains 23 Drains or Gullies unstopped and cleansed 22 Length in yards of Stoneware Drains laid 1622 Length in yards of Heavy Cast-iron Drains laid 119 Manholes provided 70 Manholes altered and repaired 17 Intercepting traps fixed 30 New Fresh Air Inlets provided 9 New Gully Traps fixed 162 New Soil Pipes and Ventilating Shafts fixed 44 Soil Pipes and Ventilating Shafts repaired 4 Water Tests applied 262 Smoke Tests applied 104 Air Tests applied 39 23 Water Closets and Sanitary Fittings. New w.c. basins fixed 40 W.C.'s unstopped, cleansed or repaired 15 New Flushing Boxes fitted to w.c.'s 15 Existing Flushing Boxes repaired 30 W.C. Flush Pipe Connections repaired 7 Water Supply laid on to w.c.'s 3 New w.c. Apartments provided 6 W.C. Apartments lighted, repaired and ventilated 5 Lavatory Basin provided 2 Baths provided 2 New Impervious Sinks provided 15 New Waste Pipes fixed 21 Waste Pipes repaired or unstopped 16 Existing Waste Pipes trapped 56 Sanitary Conveniences. New Urinal constructed 1 Miscellaneous. Roofs repaired 16 Eaves Guttering cleansed and repaired 19 New Stack Pipes provided 12 Existing Stack Pipes repaired or unstopped 13 Existing Stack Pipes disconnected from Drains 26 Damp Walls remedied 59 Ventilation under floors provided 10 Yards paved 31 Paving of Yards repaired 13 Stable Floors repaved 7 Floors of Rooms repaired 11 Floors of Rooms relaid 10 Rooms repaired, cleansed and limewashed 98 Windows repaired and made to open 22 Workrooms cleansed and repaired 18 Cisterns repaired, cleansed and covered 14 Movable sanitary dustbins provided 167 Nuisances from overcrowding abated 7 24 Nuisances from animals abated 7 Nuisances from flooded cellars abated 5 Manure receptacles provided 10 Stables cleansed 26 Accumulations of manure and refuse removed 13 Surface Water Wells filled in 3 Miscellaneous 16 Unsound Food Destroyed— Two pigs' heads; 4 sets of lungs; 1 sheep's pluck; 2 boxes of apples. Infectious Disease and Disinfection. Cases of Infectious Disease notified (excluding Phthisis) 298 Number of rooms fumigated after infectious disease 365 Verminous rooms fumigated 10 Number of articles disinfected 7289 N.B.—In addition to the above work of disinfection, 52 stovings of bedding, etc. (803 articles) were carried out, and 41 patients were removed to Hospital for the Friern Barnet District Council. Inspection of Billets. During the time a Battalion of the Middlesex Regiment was stationed in the district, the billets were systematically inspected. In a few instances, bedding and clothes used by soldiers were subjected to steam disinfection. Complaints. Two hundred and twenty-two complaints were received with respect to the following matters, viz.:— Alleged defective drains 22 Blocked drains 11 Insanitary w.c.'s 3 Flushing boxes out of order 3 Insanitary condition of private roads or passages 6 Insanitary condition of houses 10 25 Water supply 3 Nuisance from dampness 19 Nuisance from overcrowding 5 Nuisance from animals 11 Accumulations of refuse or manure 27 Burning of refuse 3 Nuisance on unfenced building land 14 Non-removal of house refuse 29 Absence of or defective ashbins 9 Accumulations of water in basement or cellar 3 Smoke nuisances 3 Foul ponds and ditches 7 Smells from public sewers or street gullies 13 Nuisance from rats 1 Other complaints 20 222 The communications in regard to the non-removal of house refuse and smells from the public sewers were acknowledged and handed to your Council's Surveyor, in whose department these matters are dealt with. The other complaints were promptly investigated, and in those cases in which the Council had power to interfere, the necessary steps were immediately taken to remove the cause of complaint. Enquiries and Inspections after Infectious Disease. One thousand and seventy-seven visits were paid in connection with the cases of infectious disease which occurred in the district during the year. No fewer than 7,289 articles were removed to the Council's disinfecting station and passed through the steam disinfecting apparatus; 365 rooms were fumigated and the walls of the rooms were stripped and cleansed where necessary. The walls and floors of the infected parts of the premises were also sprayed with a disinfectant fluid. 26 The drains and sanitary fittings in connection with the infected houses were examined, and, as a result, the undermentioned defects were discovered and satisfactorily remedied by the owners or occupiers:— Defective drains 8 Defective and insanitary w.c.'s 8 Defective soil pipes and ventilating shafts 6 Defective manholes and covers 7 Defective fresh air inlets to drains 4 Blocked drains, w.c.'s or gullies 4 Defective cementing round gullies 10 Defective connections between w.c. basins and flush pipes 5 W.C. flush boxes out of repair 13 Insanitary stone trough 4 Defective and untrapped waste pipes 17 Defective roofs 12 Defective rain water guttering and stack pipes 6 Absence of or defective yard paving 6 Damp walls 8 Dirty ceilings and walls of rooms 37 Defective floors 3 Dirty and uncovered service water cisterns 7 Defective ashbins 19 Miscellaneous defects 14 flame Licences. Twelve licences were granted to deal in Game. Petroleum Acts, 1871 to 1881. Thirty-three licences were granted for the keeping of Petroleum Spirit and Carbide of Calcium. Legal Proceedings. It was not necessary to institute any legal proceedings during the year. 27 My two assistants, Messrs. F. Hudson and E. F. Eldred, and the two male clerks in the Public Health Department, Messrs. Harland and Newbery, are all on active service. I wish to again thank the Chairman and Members of the Council for their kindly consideration and support, and also the officers of other departments, who are always most willing to render all possible assistance. I am, Mrs. Hardie and Gentlemen, Your obedient servant, E. J. FRANKLIN, M.R.San.I., Chief Sanitary Inspector. Public Health Department, 3, The Hawthorns, Regents Park Road, Church End, Finchley. April, 1916. 29 ANNUAL REPORT Of THE SCHOOL MEDICAL OFFICER For 1915. The Urban District of Finchley comprises an area of 3,384 acres, with an estimated population in 1915 of 47,812. The staff now consists of 1 Medical Officer and 2 Nurses (the second Nurse having been appointed in February, 1916) and a Dentist who attends one half-day a week. The whole of the work in connection with the Ophthalmic Clinic is undertaken by the School Medical Officer, who also undertakes the treatment of certain minor detects. There arc 8 Public Elementary Schools (4 Council and 4 Non-provided), organised in 17 departments. These provide accommodation for 5,627 children, (but 40 must be added to this figure, the increase being due to the fact that the cookery centre at Squires Lane School has been utilised as a class room). The present number on the register is 4,717, with an average attendance of 4,198, 89 per cent. Statistical Tables. During the year 1915, 1,494 children have been medically examined. The word "entrants" includes all children from 5 to 7 years of age. The word " intermediates" denotes children between the ages of 8 and 12, and the word "leavers" is used in the same sense as in the Code of Regulations for Elementary Schools. The following table gives the number of children of different age periods examined at the various schools:— 5 6 7 8 9 10 11 12 13 14 Over 14 B G B G B G B G B G B B G B G B G B G B G Sq. Lane 23 13 22 15 5 10 6 5 9 4 24 21 18 18 13 18 21 15 2 5 - - Leng 27 42 10 10 2 3 1 2 12 6 23 21 12 5 38 27 24 24 - 1 - - North R. 27 30 42 37 16 8 9 9 6 12 8 11 1 9 - 5 - - - 1 - - Albert S 19 24 10 5 5 5 4 7 15 13 16 14 9 5 23 22 21 14 - 1 - - St. Mary's 17 17 9 15 5 3 3 2 9 7 5 6 3 2 14 11 6 6 - - - - St. John's 4 10 8 6 1 4 1 1 4 8 5 5 1 4 10 9 8 1 - - - - Christ Ch. 12 13 5 4 - 1 - 5 13 10 6 4 8 2 6 7 5 4 - - - - Holy Trin. 13 5 3 10 8 6 7 6 10 9 3 3 2 2 9 17 13 5 2 - - 1 142 154 109 102 41 40 31 37 78 69 90 85 54 47 113 116 98 69 4 8 - 1 30 The following table shews which of the children examined received their first, second, or third inspection:- 1st Insp. 2nd Insp. 3rd Insp. Gross School. B G B G B G Total. Squires Lane 80 59 47 54 16 11 267 Long Lane 48 60 58 52 43 29 290 North Road 96 106 12 15 — 1 230 Albeit Street 52 52 31 30 39 28 232 St. Mary's 41 49 25 20 5 6 146 St. John's 16 25 17 15 9 8 90 Christ Church 19 24 24 24 12 2 105 Holy Trinity 32 30 24 20 14 14 134 384 405 238 230 138 99 1494 The Presence of Parents at Medical Inspection. The following table shews the number and percentages of parents who attended at the different schools:— School. Total Parents. % Squires Lane 182 68 Long Lane 123 42 North Road 167 73 Albert Street 127 55 St. Mary's 86 59 St. John's 48 53 Christ Church 57 54 Holy Trinity 63 47 853 57 57 per cent. of the parents attended the examination of their children as compared with 65 per cent. last year. 31 Defects Found in the Course of Inspection. Nutrition. The following table shews the total results under the heading of each age group:— Entrants Interm. Leavers Totals. Boys Gills Boys Girls Boys Girls Boys Girls No. Examined 292 296 253 238 215 200 760 734 No Nutrition below normal 19 30 19 20 16 16 54 66 Per cent. 6.5 10.1 7.5 8.4 7.4 8.0 7.1 9.0 Excellent Nutrition. No Examined 292 296 253 238 215 200 760 734 No. Excellent Nutrition 47 41 38 29 39 52 124 122 Per cent. 16.0 13.9 15.0 12.1 18.1 26.0 16.3 16.7 Diseases of the Lungs and Tuberculosis. Amongst the 1,494 children examined, there were found 8 casta in which pulmonary tuberculosis was suspected. In the infante there were 2 girls with tubercular glands and 1 boy in the intermediate group, and 3 cases of suspected tubercular glands. There were 3 casts of old tubercular scars—2 amongst the boys and 1 amongst the girls; also 2 suspected cases. In the intermediate group there were 2 boys with tuberculosis of the joints and 1 girl with tuberculosis of the jaw. Of other diseases of the lungs, there were discovered 21 cases of chronic bronchitis, distributed amongst the various groups, as follows:—Infant Boys 8, Girls 6, Intermediate Boys Girls 2. Adenoids and Enlarged Tonsils. Entrants Interm. Leavers Totals B G B G B G B G Mouth Breathers — 1 4 2 1 — 5 3 Slight Enlargement of Tonsils 54 53 33 23 29 8 116 84 Marked Enlargement of Tonsils 14 14 6 7 — 1 20 22 Marked Adenoids 1 — — l — 2 1 3 Slight Adenoids 16 — 4 3 — — 20 3 (25) (24) (16) (14) (2) (1) (43) (39) Removed previous to Inspection 15 10 6 6 3 5 24 21 32 The numbers set out in brackets shew the number of children in which the presence of Adenoids was suspected, but not sufficiently evident without making a digital examination of the naso-pharynx. Diseases of the Ear and Defective Hearing. Of the 1,494 children examined, 32 were found to be suffering from diseases of the ear or defective hearing. 17 occurred amongst the boys (2.2 per cent.), and 15 instances were found amongst the girls (2.0 per cent.), the whole equalling 2.1 per cent., as compared with 2.6 per cent. for 1914. Of these 32 children, 3 suffered from obstruction, 5 from chronic discharge; from the ear—2 from the right, 2 from the left—and in one instance a child suffered from double otorrhoea. This is equal to .53 per cent., as compared with .91 per cents for last year. In 14 cases the deafness was due to adenoids, and in the remaining 10 instances to various causes. The following table sets out more fully the various conditions found:— Entrants Interm. Leavers Total B G B G B G B G Obstruction 1 1 — — 1 — 2 1 Otorrhœa — — 2 1 — 1 2 2 Double Otorrhœa 1 — — — — — 1 — Peaf — 2 — 2 5 1 5 5 Deaf due to Adenoids 5 7 2 — — — 7 7 No. Examined 588 491 415 1,494 Percentage 3.0 1.4 2.0 2.1 Diseases of the Heart and Circulation. The following table gives the number of diseases of the heart found amongst the 3 groups:— Query Infants Interm. Leavers Boys Girls Boys Girls Boys Girls Mitral Disease 3 1 3 1 — — — Functional Disease 1 1 — 1 — — 1 Hypertrophy 1 (slight) 1 1 1 — — 2 Slight Dilatation 1 — — — — — — Anæmia 2 — 2 3 8 1 3 Other Diseases — — — — — — 1 8 3 6 6 8 1 7 33 Rickets. In 4 instances children were found to be suffering from evidence of former rickets; 3 of these cases occurred in boys and 1 in girls. Deformity. The following deformities were met with:— Kyphosis 1 Lateral Curvature 1 Goitre 2 Round Shouldered 5 Pigeon Cheated 2 Other Deformities 2 13 Diseases of the Nervous System. 3 cases of Infantile Paralysis were met with—3 in the boys. Also 1 case of Facial Paralysis, and 1 case of Spactic Paraplegia. Diseases of the Skin. In 23 instances children were found to be suffering from an affection of the skin. In one case only was a child found to be suffering from Scabies during the course of inspection. 1 case of Ringworm was met with during the course of inspection. 4 cases of Impetigo were met with—1 in the infants and 2 boys and one girl in the intermediate group. 4 cases of Icthyosis—2 boys and 2 girls in the intermediate group. 3 cases of Eczema were met with, and there were 10 children with other defects. 34 Defective Speech. Of the 1,494 children examined 8 had marked defects of speech. Marked defect of articulation was present in 7 cases —4 boys and 3 girls (infants), and in 1 instance a pronounced lisp was present. Clothing and Footgear. The following tables shew the number of children whose clothing or footgear was unsatisfactory or bad:— Clothing. Infts Interm Leavers Total Per cent. B G B G B G B G B G Unsatisfactory 26 13 60 22 41 21 127 56 16.7 7.6 Bad 6 3 13 4 36 6 55 13 7.2 1.8 Footgear. Unsatisfactory 21 13 20 16 27 11 68 40 8 9 5 4 Bad 13 17 21 9 27 7 61 33 80 4 5 From the above figures it will be seen that of the boys 23.9 per cent. are wearing clothes and 16.9 per cent. are wearing boots which cannot be considered to be satisfactory. Of the girls. 9.4 have clothes and 9.9 have boots of the same standard. Uncleanliness. The following tables shew the number of children who gave evidence of their hair being in a verminous condition— column A, badly affected; column B, slight traces only. This refers to those who have come under observation during the course of their routine medical inspection. Infts. Interm. Leavers Total Per. cent. B G B G B G B G B G A 4 20 — 21 2 26 6 67 .8 9.1 B 8 42 9 29 12 23 29 94 3.8 12.8 Body 16 23 15 12 20 13 51 48 6.7 6.5 35 The following table sets out these figures according to the first, second, or third examination:— 1st 2nd 3rd Total Per cent. B G B G B G B G B G A 4 29 — 24 2 14 6 67 8 9.1 B 10 54 11 28 8 12 29 94 3.8 12.8 Body 20 27 20 14 11 7 51 48 0.7 6.5 Teeth. Of the 1,494 children examined, 245 boys and 241 girls were found to have under 4 decayed teeth, and 112 boys and 78 girls were found to have over 4 decayed teeth. Statement of Work carried out at the Dental Clinic during the 12 months ended December 31st, 1915. Number of children examined by the dentist 1315 Number of children found to have defective "second" teeth 322 Number of children whose parents interviewed the doctor with respect to treatment 183 Number of children whose parents wished arrangement to be made for treatment at Dental Clinic 150 Number of children who actually received treatment 179 Number of teeth "filled" 288 Extractions 102 Dressings 4 The Work of the School Nurse. The following is a brief summary of the work of the School Nurse during 1915:— 36 School Visits:— Attendance at Medical, Dental and Eye Inspection 130 Additional visits to Schools in connection with examinations as to general cleanliness, hair, etc. 498 Total number of visits to Schools 628 "Domiciliary" Visits:— Visits re cases of ringworm 100 Visits re defects found at time of Medical Inspection and general "following up" 535 Visits re uncleanliness of head, etc. 228 Total number of visits to homes 863 Diseases of the Eye. During the course of inspection 74 children were found to have defective vision—37 boys and 37 girls. In 35 cases external diseases of the eye were met with, as compared with 18 for last year. The following table shews the diseases discovered:— Infts Interm. Leavers. Boys Girls Boys Girls Boys Girls Blepharitis 5 6 5 7 5 4 Conjunctivitis 1 — — — — — Ulceration of Cornea 1 — — — — — Corneal Opacities — 1 — — — — Eye Clinic. Since 1914 special attention has been given to diseases of the eye and errors of refraction. During the year the number of attendances at the Eye Clinic was 311. and the number of new patients 155. 37 The following table shews in detail the defects found:— Boys. Girls. Hypermetropia, under-4 10 10 Hypermetropia, over-4 6 6 Hypermetropic Astigmatism 3 13 Mixed Astigmatism 1 5 Myopia, under-4 8 7 Myopia, over-4 — 3 Myopic Astigmatism — 3 Squint 7 7 Referred on account of headache and error found 1 2 36 56  Boys. Girls. Phlyctenular Ulcer 1 2 Blepharitis 4 5 Corneal Nebulae — 1 Hordeolum — 1 Mybomean Cyst — 1 Angio-Neurotic Oedema — 1 Injury 1 — 6 11 The Ophthalmic Clinic has been most successful, and evidently has provided a long felt want. A large number of children have attended, as will be seen from the above figures. Ringworm. At the beginning of 1915 the number of children excluded on account of ringworm of the scalp was 12. During the year 15 additional cases were excluded, making a total of 27 cases dealt with during 1915. At the end of the year 8 children were on the exclusion list. One of the 15 new cases was among new-comers to this district already suffering from ringworm. 38 The following is a tabulated analysis of the cases:— No. of cases on exclusion list during 1915 No. of cases re-admitted during 1915. No. of cases on exclusion list at Dec. 31, 1915. 1913—A 3 3 1 1914- B 9 9 — 1915 C 15 15 7 Totals 27 27 8 (A) Refers to cases excluded during 1913. (B) Refers to cases excluded during 1914. (C) Refers to cases excluded during 1915. Treatment. During the year 1915, 15 children received X-Ray Treatment at the London Hospitals. One of these was excluded during the latter part of 1913, 7 in 1914, and the remaining 7 in 1915. 15 have returned to school. Of the remaining 12 cases 2 were excluded in 1913, 2 in 1914, and 8 in 1915. These cases have been treated by drugs, 4 of which had only returned to school by the 31st December, 1915. Four casts of ringworm were treated by the School Medical Officer, and 96 attendances were made by children suffering from ringworm.