AC 439(3) AAES CHARLINPTON M HAY 9 TWENTY-NINTH ANNUAL REPORT ON THE HEALTH OF THE URBAN DISTRICT OF HAYES & HARLINGTON MIDDLESEX J. STANLEY LLOYD, M.D., F.R.C.S.Edin. Medical Officer of Health 1933 TWENTY-NINTH ANNUAL REPORT ON THE HEALTH OF THE URBAN DISTRICT OF HAYES & HARLINGTON MIDDLESEX J. STANLEY LLOYD, M.D., F.R.C.S.Edin. Medical Officer of Health 1933 The Urban District Council of Hayes and Harlington. PUBLIC HEALTH AND HOUSING COMMITTEE, 1933. Chairman: Councillor Mrs. Greenhead. Councillor M. Elyan. Councillor A. C. Nicholi.s. Councillor R. W. Gunton, J.P. Councillor D. Page. Councillor A. C. Keen. Councillor H. H. Richins. Councillor C. H. Kelf. Councillor C. Viveash. STAFF OF THE PUBLIC HEALTH DEPARTMENT. Medical Officer of Health: J. Stanley Lloyd, M.D., F.R.C.S.Edin. (Part time). Chief Sanitary Inspector: Richd. Bill, Cert.R.San.Inst, and Certified Meat Inspector. Sanitary Inspector: L. Burke. 3 MEDICAL OFFICER'S ANNUAL REPORT. Public Health Department, Town Hall, Hayes. May, 1934. To the Chairman and Members of the Urban District Council of Hayes and Harlington. Mr. Chairman, Madam and Gentlemen, I have the honour of submitting my Annual Report on the Health of your Urban District for the year 1933. The only outstanding cause of illness during the year was an extensive epidemic of Scarlet Fever, which was fortunately of a mild character and resulted in only one death—showing a case mortality of 0.55 per cent. In this case the child was suffering from other complications which were the actual cause of the fatal result. The birth rate and death rate are both lower than last year, being 18.4 per thousand total population and 7.2 per thousand respectively. The figures for smaller towns in England and Wales are 14.5 and 110 respectively. I have pleasure in expressing to the Members and Officials of the Council my thanks for the assistance I have always received in the discharge of my duties; and I am grateful to the Sanitary Inspectors, Mr. R. Bill and Mr. L. Burke for the conscientious way in which they have carried on their work. I have the honour to be, Your obedient servant, J. STANLEY LLOYD, Medical Officer of Health. 4 SECTION A. STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Area (acres) 5,513 Population (Census, 1931) 23,646 Population (Mid-year, 1933) Registrar-General's Estimate 28,730 Present estimated population at 4 1 persons per house 30,745 Number of inhabited houses end of 1933 7,499 Rateable value £181,528 Sum represented by a penny rate Gross £757 Net (Est.) £692 SOCIAL CONDITIONS. The Urban District of Hayes and Harlington is made up of the Parishes of Hayes, Harlington and Cranford, and was formed in 1930 by the addition of the Parishes of Harlington and Cranford to the Urban District of Hayes. The district was formerly noted for the excellence of the wheat grown here, but every year sees the agricultural area diminishing by reason of the rapid growth of building. The sub-soil is clay in the north and east and gravel in the west, and the height above sea level is about 100 feet. The highest point is 182 feet at Charville Lane, and the lowest 70 feet at Cranford sewage works. The factories in the district are all of recent construction having been built shortly before, during, or after the war. The employees are drawn both from Hayes and from the surrounding districts, while a number of the residents work in outlying areas. A large number of workers arrive and depart daily by train. The principal factories are engaged in the manufacture of aircraft, gramophones, wireless receivers, electrical transformers, woodwork, breeze blocks wire netting, lubricating oils, chocolates, jam, cheese and in colour printing. 5 Several open spaces have been acquired as Public Parks, the total area devoted to this purpose being 190 acres. The district is healthy and the houses, on the whole, in very good repair. No areas can be called slums, any houses in this category having been dealt with by demolition orders from time to time. The unemployment figures for the year show a very gratifying fall throughout the year, the reduction month by month being very consistent. 1,566 unemployed were registered for January, 1933, and 698 for December. Extracts from Vital Statistics of thf: Year. Total M. F. Live Births— Legitimate 518 287 231 Illegitimate 13 5 8 Birth Rate per 1,000 of the estimated resident population 18.4. Stillbirths— Legitimate 16 8 8 Rate per 1,000 total live and still births 29.2. Deaths 207 118 89 Death Rate per 1,000 of the estimated resident population 7.2. Deaths from puerperal causes:— Rate per 1,000 total (live and Deaths. still) births. Puerperal sepsis 1 1.83 Other puerperal causes Nil 0.00 Total 1 1.83 Death rate of Infants under one year of age— All infants per 1,000 live births 47 Legitimate infants per 1,000 legitimate live births 46.3 Illegitimate infants per 1,000 illegitimate live births 77.0 Deaths from Measles (all ages) Nil Deaths from Whooping Cough (all ages) 1 Deaths from Diarrhœa (under 2 years of age) 2 6 CAUSES OF DEATH DURING 1933. Causes of Death. Males. Females. All Causes 118 89 1. Typhoid and Paratyphoid Fevers — — 2. Measles — — 3! Scarlet Fever 1 — 4. Whooping Cough 1 — 5. Diphtheria 2 — 6. Influenza 2 3 7. Encephalitis Lethargica — — 8. Cerebrospinal Fever — — 9. Tuberculosis of respiratory system 12 9 10. Other tuberculous diseases 2 2 11. Syphilis 1 — 12. General paralysis of the insane, tabes dorsalis 1 — 13. Cancer, malignant disease 10 15 14. Diabetes 1 1 15. Cerebral haemorrhage, etc. 4 2 16. Heart disease 18 19 17. Aneurysm — 1 18. Other circulatory diseases 5 2 19. Bronchitis 7 2 20. Pneumonia (all forms) 14 8 21. Other respiratory diseases — 1 22. Peptic ulcer 1 — 23. Diarrhœa, etc. (under 2 years) 2 — 24. Appendicitis 1 — 25. Cirrhosis of liver — — 26. Other diseases of liver, etc. — — 27. Other digestive diseases 2 2 28. Acute and chronic nephritis 1 3 29. Puerperal sepsis — 1 30. Other puerperal causes — — 31. Congenital debility, premature birth, malformations, etc. 11 2 32. Senility 3 6 33. Suicide 1 1 34. Other violence 12 5 35. Other defined diseases 3 4 36. Causes ill-defined or unknown — — Special Causes (included in No. 35 above):— Small-pox — — Poliomyelitis — — Polioencephalitis — — Deaths of Infants under 1 year Total.. 22 3 Legitimate 21 3 Illegitimate 1 — Live Births Total 292 239 Legitimate 287 231 Illegitimate 5 8 Stillbirths Total 8 8 Legitimate 8 7 Illegitimate — 1 Population (Mid-Year) 28,7 30 (Figures furnished by the Registrar-General.) BIRTH-RATES, DEATH-RATES, AND ANALYSIS OF MORTALITY DURING THE YEAR 1933. (Provisional figures.) The rates for England and Wales and for London have been calculated on a population estimated to the middle of 1933, but those for the towns have been calculated on populations estimated to the middle of 1932. Rate per 1,000 Total Population. Annual Death-rate per 1,000 Population. Rate per 1,000 Live Births. Percentage of Total Deaths. Live Births. Stillbirths. All Causes. Typhoid and Paratyphoid fevers. Small-pox. Measles. Scarlet fever. Whooping cough. Diphtheria. Influenza. Violence. Diarrhoea and Enteritis (under 2 years). Total Deaths under 1 year. Certified by Registered Medical Practitioners. Inquest Cases. Certified by Coroner after P.M. No inquest. Uncertified Causes of Death. England and Wales 14.4 0.62 12.3 0.01 0.00 0.05 0.02 0.05 0.06 0.57 0.54 71 64 90.9 6.3 1.9 09 118 County Boroughs and Great Towns, including London 144 0.67 122 000 0.00 0.06 0.02 0.06 0.08 0.55 0.49 9.4 67 91.0 6.0 25 05 132 Smaller Towns (Estimated Resident Populations 25,000 to 50,000 at Census 1931) 14.5 0.63 11.0 0.00 0.00 0.04 0.02 0.04 0.04 053 0.44 49 56 91.7 5.8 1.5 1.0 London 13.2 045 12.2 0.00 0.00 0.02 0.02 0.08 0.08 051 0.58 11.6 59 88.3 6.3 5.4 0.0 Hayes & Harlington 18.4 055 7.2 0.00 0.00 0.00 0.03 003 006 0.17 066 3.27 47 860 101 2.9 1.0 Puerperal Sepsis. Others. Total. per 1,000 Live Births 1.79 2.63 4.42 The maternal mortality rates for England and Wales are as follows: „ „ Total Births 1.71 2.52 4.23 per 1,000 Live Births 1.84 0.00 1.84 ,, ,, ,, „ ,, Hayes and Harlington ,, ,, „ „ Total Births 1.83 0.00 1.83 STREET ACCIDENTS. Through the courtesy of the Commissioner of Police for the Metropolis I am able to give the following statistics. Seven persons died as the result of injury by motor vehicles in this area during the year, two of them being on the High Road, one in Bath Road, one in High Street, Harlington, one in Lansbury Drive, one in Blyth Road, and one in Coldharbour Lane. In addition to this there were 272 other accidents involving personal injury, of which 42 were serious; 20.3 occurring during daylight and 69 after dark. SECTION B. GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. No alteration has been made in the health services of this area during 1933. PUBLIC HEALTH OFFICERS OF THE LOCAL AUTHORITY. The Staff of the Public Health Department consists of one part-time Medical Officer and two Sanitary Inspectors, the Chief Sanitary Inspector being also the Inspector under the Petroleum Acts. The Chief Sanitary Inspector holds the special Meat and Food Inspector's Certificate of the Royal Sanitary Institute, and the other Officer has also passed an examination in meat inspection. Contributions to the salaries of these Officers are received under the Public Health Acts. Hospitals.—Hospital accommodation in this area is adequate. The Urban District Council contributes the equivalent of a penny rate to the Hayes Cottage Hospital, and the Harlington Cottage Hospital, the contributions being apportioned according to the rateable value of the respective parishes, Cranford for this purpose being included with Harlington. There has been no change in nursing arrangements, laboratory facilities, hospitals, ambulance facilities, or clinics and treatment centres. 9 SECTION C. SANITARY CIRCUMSTANCES OF THE AREA. Water.—Four samples of water were submitted for bacteriological examination and a summary of the reports is given below. The two cottages referred to in Report No. 33163 have been provided with a supply from the mains, whilst the three cottages referred to in Report No. 33162 and the two in Report No. 33164 have been condemned as unfit for habitation. Drainage and Sewerage.—During the year nearly five miles of new sewers have been laid apart from those laid under the West Middlesex scheme. A new pumping station has been established near Harlington Corner and temporary disposal works in the Parish of Bedfont. When the West Middlesex sewerage scheme is completed this pumping station will discharge into the mains instead of into the temporary disposal works. Closet Accommodation.—Every house connected with the sewer has a water-closet provided with flushing apparatus. Of the premises not connected with the sewer a number have water-closets and the remainder pail-closets, of which the Council undertake the cleansing. During the year 683 new W.C.s have been constructed, , and one privy with fixed receptacle and 84 with movable receptacles have been converted. The estimated number and type of closets at the end of 1933 are as follows:— Water Closets 7,695 Privies (movable receptacles) 216 Privies (fixed receptacles) 14 PUBLIC CLEANSING. Closed motor vehicles are used to carry house refuse to the dump at Yeading. Weekly collections are made, and the refuse is covered over with dead refuse, that is, refuse which has been standing 10 to 20 years and consolidated. Pail closets are also emptied weekly and a clean pail substituted for the used one. Cesspools are emptied by a 1,000-gallon exhauster and the contents discharged into the sewage disposal works. Yeading refuse dump, used by Paddington Borough Council, is still a source of annoyance to the occupants of houses in the vicinity. It is to be hoped that these boroughs will soon dispose of their refuse by incineration, and that large scale dumping will cease to exist. 10 SUMMARY OF REPORTS ON WATER SAMPLES SUBMITTED FOR BACTERIOLOGICAL EXAMINATION. Report No. Organisms produced on gelatine plates incubated at 20°C. for 3 days. Organisms produced on agar plates incubated at 37.5° C. for 2 days. B. Coli. Streptococci. B. Enteritidis Sporogenes. REMARKS. 33163 190 per c.c. 280 per c.c. Present in 2 c.c. Not found in 30 c.c. Present in 100 c.c. The water is seen to contain a large number of micro-organisms including some of excremental origin. The absence of streptococci suggests that the contamination is not recent and that the water may improve in quality. The close proximity of drains and cesspools is, however, very undesirable, and the water will always be open to suspicion, particularly during long spells of hot weather. 33162 520 per c.c. 373 per c.c. Present in 0 1 c.c. Present in 20 c.c. Present in 25 c.c. The above results show the water to contain a considerable number of excremental organisms and it cannot be regarded as safe for drinking purposes in its present condition. 33164 4.800 per c.c. 1,900 per c.c. Present in 1 c.c. Present in 30 c.c. Present in 10 c.c. The water contains a very large number of microorganisms including many of excremental origin. The remarks to No. 33163 would appear to be equally applicable in this case, but the contamination in this instance is very much heavier. 36491 43 per c.c. 4 per c.c. Not found in 100 c.c. Not found in 30 c.c.. Not found in 100 c.c. The water has a commendably low bacterial content and from a bacteriological point of view is most suitable for drinking purposes. SANITARY INSPECTION OF AREA 1. Complaints. During the year fifty-three complaints were received with respect to the following matters, viz.:— Choked and defective drains 15 Insanitary or dilapidated condition of houses and premises 6 Offensive accumulations or deposits 3 Cesspools overflowing 20 Rats 2 Other nuisances 10 Total 53 2. Inspection of District. Number of houses and premises inspected (ordinary) 1190 ,, ,, houses inspected and particulars recorded (Housing Act, 1930) 114 ,, ,, houses and premises re-inspected 1,290 ,, ,, miscellaneous visits 760 ,, ,, food inspections 933 ,, ,, visits to slaughter-houses 753 ,, ,, ,, ,, dairies, cowsheds and milkshops 168 ,, ,, ,, ,, bakehouses, factories and workshops 27 ,, ,, . „ ,, re water supplies 80 ,, ,, ,, ,, re cases of infectious disease 281 ,, ,, ,, ,, re offensive trades 128 ,, ,, ,, ,, re petroleum stores 74 ,, „ smoke observations and visits to works 29 ,, ,, tents and vans 155 ,, ,, public urinals inspected 159 ,, verminous premises inspected 12 ,, ,, premises disinfected 224 ,, ,, Shops Acts 80 Total 6,257 12 3. Notices Served. Complied OutServed. with, standing. Informal notices 241 238 3 Statutory notices— Section 36 Public Health Act, 1875 11 11 Section 94 Public Health Act, 1875 115 114 1 Section 62 Public Health Act, 1875 8 8 Section 17 Housing Act, 1930 4 4 Totals 138 137 1 4. Summary of Sanitary Improvements Carried Out. Drainage. Number of drains examined, exposed, etc. 4 Drainage systems reconstructed 14 Defective drains unstopped, repaired, etc. 25 Manholes built, altered or repaired 6 Fresh air inlets fixed or repaired 7 Glazed sinks provided 48 Cesspools repaired 2 Water Closets. Defective flushing cisterns renewed or repaired 10 New pans provided 12 W.C. apartment repaired, cleansed, etc. 49 Urinals reconstructed or repaired 1 Privies and pail closets converted to W.C.s 85 General Repairs, Etc. Roofs repaired and made weatherproof 49 Eaves gutters repaired or renewed 26 Damp walls re-pointed or rendered damp-proof 66 Defective brickwork of external walls repaired 45 13 Defective brickwork and plaster work of internal walls repaired 52 Defective wood floors repaired 41 Defective stairs repaired 23 Handrails provided 34 Lighting and ventilation increased 19 Defective tile, brick or concrete floors required 9 Defective doors repaired 21 Defective ceilings repaired 40 Defective windows repaired, made to open or renewed 110 Rooms cleansed 88 Defective stoves, coppers, etc., repaired 65 Sink waste pipes trapped or repaired 49 Insufficient water supply increased 44 Defective yard pavings repaired 24 Offensive accumulations removed 25 New dustbins provided 147 Food stores provided 34 Lighting, etc., of food stores improved 19 SMOKE ABATEMENT. There have been no serious offences under the Act during the year. One factory using waste wood, mostly in the form of chips, has installed a smoke consuming apparatus with a fair amount of success. SPECIAL CLASSES OF PREMISES AND OCCUPATIONS SUBJECT TO CONTROL BY THE LOCAL AUTHORITY. Slaughter Houses. There are ten slaughter houses scattered throughout the District. Classification in Register:— Registered 1 Permanent Licence 2 Annual Licence 7 14 Factories, Workshops, and Workplaces. Forty-five inspections of factories and workshops have been made. There are twenty-six factories and twenty-six workshops on the Register, classified as under:— Factories. Workshops. Aircraft 1 Bakehouses 3 Bakehouses 3 Boot repairing 4 Breeze Block making 1 Cycle Repairs 5 Cheese 1 Dressmaking 1 Cocoa, Chocolates, etc. 1 Joinery and Carpentry 3 Caravans 1 Motor Repairs 3 Engineering 2 Portable Buildings 1 Furniture 3 Smithies 4 Glazed Mantels and Curbs 1 Valet Services 1 Gramophones and Records 1 Wheelwright 1 Infant Foods 1 Jams, etc. 1 Music Rolls 1 Motor Repairs 1 Mineral Waters 1 Oil Blending 1 Printing, etc. 2 Wire Workers 1 Woodworkers 1 Electrical Transformers 1 1. Inspection of Factories, Workshops and Workplaces. Premises. Number of Inspections. Written Notices. Occupiers Prosecuted. Factories (including Factory Laundries) 15 Nil Nil Workshops (including Workshop Laundries) 25 Workplaces (other than Outworkers' premises) 5 Total 45 15 2. Defects Found in Factories, Workshops and Workplaces. Particulars. Number of Defects. Found. Remedied. Nuisances under the Public Health Acts:— Want of cleanliness Nil Nil Want of ventilation Nil Nil Overcrowding Nil Nil Want of drainage of floors Nil Nil Other nuisances:— Sanitary accommodation Insufficient Nil Nil Unsuitable or defective 5 5 Not separate for sexes Nil Nil Offences under the Factory and Workshop Acts:— Other offences Nil Nil Total 5 5 Twelve fish friers and four fat extractors are licensed by the Council. Regular inspections have been made and the trade is conducted satisfactorily. During the year proceedings were instituted against the owner of a travelling fish frying van for establishing and carrying on the trade of a fish frier without the consent of the Local Authority. The Justices dismissed both summonses on the grounds that the definition of premises does not include a van; upon appeal the case was sent back for conviction, and a fine of £2 with two guineas costs was imposed. RAG FLOCK ACTS, 1911 and 1928. There are no places where rag flock is used. SCHOOLS. The usual notification of infectious disease was made to head teachers of schools and to the School Medical Officer. 16 SECTION D. HOUSING. 1.—Inspection of Dwelling Houses During the Year:— (1) (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 1,104 (b) Number of inspections made for the purpose 2,394 (2) (a) Number of dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 114 (b) Number of inspections made for the purpose 179 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 4 (4) Number of dwelling-houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 97 2. Remedy of Defects During the Year without Service of Formal Notices. Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their Officers 85 3. Action under Statutory Powers During the Year. (a) Proceedings under Sections 17, 18 and 23 of the Housing Act, 1930:— (1) Number of dwelling-houses in respect of which notices were served requiring repairs 4 (2) Number of dwelling-houses which were rendered fit after service of formal notices (a) By owners 4 (b) By local authority in default of owners Nil (b) Proceedings under Public Health Acts:— (1) Number of dwelling-houses in respect of which notices were served, requiring defects to be remedied 27 17 (2) Number of dwelling-houses in which defects were remedied after service of formal notices (a) By owners 27 (b) By Local Authority in default of owners Nil (c) Proceedings under sections 19 and 21 of the Housing Act, 1930:— (1) Number of dwelling-houses in respect of which Demolition Orders were made 4 (2) Number of dwelling-houses demolished in pursuance of Demolition Orders 1 (d) Proceedings under Section 20 of the Housing Act, 1930:— (1) Number of separate tenements or underground rooms in respect of which Closing Orders were made Nil (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit Nil SECTION E. INSPECTION AND SUPERVISION OF FOOD. (a) Milk Supply. One hundred and sixty-eight visits of inspection have been made to the cowsheds and dairies in the district, which have been maintained in fair condition. There are approximately 240 milch cows in the district. Inspection of dairy cattle by a veterinary inspector for the detection of tuberculous animals is undertaken by the County Council. A total of 13 samples of milk was submitted for bacterial count. In cases where a large count was recorded visits to the farms or dairies were made and advice given on the necessity for exercising greater care in the cleanliness of the premises and the sterilization of utensils. Subsequent samples showed a decided improvement. No milk to which any of the titles specified in the Milk (Special Designations) Order, 1923, is applied is produced in the district, but such grades of milk are retailed in this area. 18 The table below gives particulars of the 19 licences granted during the year: — Designation. Dealer's Licence. Supplementary Licence. Certified 1 2 Grade "A" (T.T.) 5 5 Grade "A" Nil Nil Pasteurised 2 1 No refusal or revocation of retailers has been made. There are now 55 persons registered in accordance with the Milk and Dairies (Amendment) Act, 1922, as under:— Wholesale Traders or Producers of Milk 15 Retail Purveyors of Milk with premises in the district 27 Retail Purveyors of Milk whose premises are outside the district 13 Total 55 summary of reports upon the bacteriological examination of Samples of Milk. Report No. Temp. Cent. Bact per c.c. 1 /10 1 /100 1 /1000 Bacillus Coli. 36489 20 t.t. 2,550 215 25 3 Negative. 36490 20 T.T. 32,250 Overcrowded 315 33 Negative. 36488 20 A.P. 265 23 3 Sterile. Negative. 34623 21 A.P. 490,000 Overcrowded Overcrowded 490 Positive. (4 tubes) 34624 21 T.T. 37,000 „ 360 38 Positive. (3 tubes) 34625 21 T.T. 73,000 „ 720 74 Positive. (3 tubes) 34626 21 t.t. 7,800 760 78 8 Negative. 34627 21 t.t. 28,500 Overcrowded 280 29 Negative. 44484 12 Ord. 26,000 „ 250 27 Negative. 44488 12 Ord. 176,666 „ 1740 176 Negative. 44487 12 P. 1,766 150 18 2 Negative. 44485 12 P. 7,800 760 78 8 Negative. 44486 12 P. 2,000 190 21 2 Negative. 19 (b) Meat. Meat inspection is carried out by the Sanitary Inspectors, who have made 753 visits of inspection to the slaughter houses, when a total of 6,041 carcases were examined, made up of 150 cattle, 181 calves, 467 sheep and 5,243 pigs. One and a half tons of meat was condemned from 146 carcases, viz., 9 cattle, 137 pigs. No notification of intended slaughter under the Tuberculosis Order of 1925 was received. No system of marking inspected carcases has been adopted. (c) Adulteration, Etc. Through the courtesy of Dr. J. Tate, County Medical Officer, I have received the following return of work done during the year by the County Council Inspectors under the Sale of Food and Drugs Acts in this district. List of samples purchased in the district of Hayes during the year 1933:— Article. No. taken. Adulterated. Milk 64 1 Hake 3 1 Lemon Soles 1 1 Sausages 1 Seasoning 1 70 3 One prosecution was instituted during the year in respect of the sale of haddock for hake, and the vendor was fined £2 and costs. SECTION F. PREVALENCE OF, AND CONTROL OVER INFECTIOUS DISEASES. General. An extensive epidemic of Scarlet Fever was experienced in the Urban District during the year as already noted, starting in September. Hospital accommodation was found to be quite adequate and the epidemic died down to normal proportions in the early part of December. Influenza was not very prevalent and was not of a severe type. 20 School intimations of disease were of value as it was found that in some cases the parents did not trouble to call in a doctor for their sick children. Swabs for the examination of throat and nose discharges were supplied gratis to medical practitioners to assist them in the diagnosis of diphtheria, and antitoxin was also provided free. Notifiable Diseases (other than Tuberculosis) during the Year 1933. Disease. Total Cases Notified. Cases admitted to Hospital. Total Deaths. Scarlet Fever 181 175 1 Diphtheria 20 20 2 Enteric Fever 1 1 — Puerperal Pyrexia. 3 3 1 Pneumonia 41 11 22 Erysipelas 8 3 — Ophthalmia Neonatorum 3 2 — Cerebro-Spinal Fever 1 1 — ANALYSIS OF THE TOTAL CASES AND DEATH. At Ages Disease. Under 1 Year 1 2 3 4 5 10 15 20 35 15 65 and over Total Deaths 2 3 4 5 10 15 20 35 45 65 Scarlet Fever — 1 7 12 9 84 36 8 18 6 — — 1 Diphtheria 1 2 — 2 2 7 2 1 2 — 1 — 2 Enteric Fever — — — — — — — — 1 — — — — Puerperal Pyrexia — — — — — — — — 2 1 — — 1 Pneumonia 9 3 3 2 2 5 2 2 — 7 2 4 22 Erysipelas 1 — — — — 1 — — 2 3 — 1 — Ophthalmia Neonatorum 3 — — — — — — — — — — — — Cerebro-Spinal Fever — — 1 — — — — — — — — — — 21 TUBERCULOSIS. New Cases and Mortality during 1933. Age Periods. New Cases. Deaths. Respiratory. NonRespiratory. Respiratory. NonRespiratory M. F. M. F. M. F. M. F. 0 — — — — — — — — 1 — — — — — — — — 5 1 — 2 3 — 1 — — 15 5 5 — — 2 2 2 — 25 9 7 1 — 5 5 — — 35 4 4 — 1 1 1 — 1 45 3 — — — 2 1 — — 55 2 — — — 1 — — 1 65 and upwards — — — — — — — — Total 24 16 3 4 11 10 2 2 The ratio of non-notified tuberculosis deaths to total tuberculosis deaths is 20 per cent.; of these 60 per cent. are non-respiratory. No action has been taken under the Public Health (Prevention of Tuberculosis) Regulations, 1925, relating to tuberculous employees in the milk trade, nor under the Public Health Act, 1925, Section 62, for the compulsory removal to hospital of persons suffering from tuberculosis. 22