(hath Mam 13) HES 2 Heston and Isleworth Urban District Conncil HESTON& ISLEWORTH For the Year ending 31st December, 1915. 1915. REPORT on The Health of the HESTON and ISLEWORTH URBAN DISTRICT FOR THE YEAR 1915 by W. BRAMWELL REID. M.B.. D.P.H.. Deputy Medical Officer of Health. THE HEALTH COMMITTEE of the heston and isleworth urban district council For the Year ending April, 1916. W. G. Palmer, Esq. (Chairman). W. Mann, Esq. (Vice-Chairman). A. A. Bergin, Esq., j.p. (Chairman of the Council). F. Nowell, Esq. (Vice-Chairman of the Council). C. Arnold, Esq. *D. Bonnett, Esq. C. Crush, Esq. A. L. Lang, Esq. W. G. Lobjoit, Esq., j.p., c.c. P. F. C. Meyers, Esq. J. J. Wilmot, Esq. W. W. Woods, Esq. Medical Officer of Health : Thomas Strain, m.d., d.p.h. Deputy Medical Officer of Health: w. bramwell Reid, m.b., d.p.H. Vice Dr. G. A. S. Gordon, resigned. 4 Health Department, Council House, Hounslow. 2nd October, 1916. To the Chaiunan and Members of the Heston and Isleworth Urban District Council. Gentlemen, I beg to submit herewith my Report for the year 1915 as your Deputy Medical Officer of Health. In accordance with the circumstances of the time, the Report has been simplified and cut down considerably as compared with previous years. The vital statistics for the year compare somewhat unfavourably with those for recent years, although the death and infant death rates for this district are still better than those rates in the country as a whole. This is strikingly shown in the graphs which have been drawn by the Chief Clerk and appear on Pages 7, 8 and 11. The persistent and rapid decline in the birth rate is a subject for serious consideration. As will be pointed out, however, the shifting of population arising out of War conditions renders it inadvisable to rely too much upon the statistics for the year under report. The valuable scheme of Maternity and Infant Welfare Centres formulated by Dr. Strain, was carried into effect during the year and has resulted in very useful work being done in the conservation of infant life and health. The resignation of Mr. L. Marsden has led to the further reduction of the Inspectorial Staff from originally four to two, which has necessarily involved a curtailment of sanitary work. It is, however, to the credit of the inspectors who remain that the volume of work done has reached such a comparatively high level. Some difficulty has been experienced in securing the execution of necessary 6anitary work owing t,o the financial and labour restrictions arising out of the War, and an extra allowance of tact and patience has been called for. Despite the substitution of temporary girl clerks for the male clerks who have enlisted or left, I am glad to record that the office work is conducted efficiently, both to the credit of the Chief Clerk and the goodwill of his assistants. I cannot conclude without a very sympathetic reference to the great loss which the Council and the Department have sustained in the death of Dr. Strain. My personal feelings of respect and sorrow at this untoward event are, I know, shared by every member of the staff who has served under the late Medical Officer of Health. I am, Gentlemen, Your obedient servant, W BRAMWELL REID, Deputy Medical Officer of Health. 5 SUMMARY OF VITAL STATISTICS, 1915. Area: Heston acres 3708 Isleworth 3185 Total 6893 Population: Residents 48722 Non-residents in Public Institutions 1013 49735 Registrar-General's estimate of civil population 41836 Birth rate (crude) 19.66 (nett) 1964 England and Wales 21.8 London 22.6 Death rate (crude) 20.08 (nett) 12.49 Corrected for age and sex constitution (standard) 11.75 England and Wales (standard) 14.8 London (standard) 16.1 Infantile Mortality Rate 102.4 per 1000 births. England and Wales 110 ,, „ London 112 ,, ,, VITAL STATISTICS for 1915, in Wards. Heston. Hounslow North. Hounslow South. Isleworth North. Isleworth South. Whole District. Population (nett) 7102 10633 13916 9614 7457 48722 Total Births 139 184 310 171 153 957 Illegitimate Births 4 10 23 10 6 53 Birth rate 18.1 17.3 22.2 17.7 20.5 19.6 Total Deaths 75 123 202 116 93 609 Death rate 10.5 11.6 14.5 12.1 12.5 12.5 Total Infant Deaths 10 10 39 20 19 98 Infant Death rate 71.9 54.3 125.9 116.9 124.2 102.4 6 VITAL STATISTICS. Deaths. The number of deaths registered in the district was 999, but 443 of these did not belong to this district, while 53 residents died without the district. Thus the number of deaths properly attributable to the district was 609, which gives the death-rate for the district of 12 49 per 1,000 of the population. The death-rate for the district, when corrected for the age and sex constitution of the population, is 1175 per 1,000, and this is comparable with the following figures:—14.8 for England and Wales and 161 per 1,000 for London. This death-rate shews a slight increase above that of last year, but is lower than the average of the 148 smaller towns, which is 14 2 per 1,000. These figures must be read in the light of the abnormal conditions resulting from the War. The transfer of large bodies of men from civil life to the Army, accompanied by some shifting of population in connection with munition work and altered domestic arrangements, has rendered it difficult to rely on the ordinary estimates of population. On the other hand, the Eegistrar-General's estimate of civil population (41,836) appears very low in comparison with the known shortage of housing accommodation in the district. If the Registrar-General's estimate be accepted and 17 military deaths are deducted from the deaths chargeable to the district, the death-rate for the civil population would be 14.1. 7 Similar remarks with regard to the difficult}' of exact calculation apply to the death-rates for the various wards. The deaths attributable to Hounslow North Ward include 10 of the 17 military deaths which have occurred in the district. Deaths of Residents in Public Institutions. (a). Within the district 116 (b). Outside the district 53 169 DEATH RATE, 1894-1915. Heston and Isleworth England and Wales Births. The total number of births registered during the year was 978, but 37 of these did not belong to this district, while 16 births properly belonging to this district occurred outside the district. The nett number of births thus attributable to the district is 957, giving a birth-rate of 19.64 per 1,000. The birth-rate of England and Wales is 218 per 1,000. This low and falling birthrate is especially serious if we bear in mind the fact that the Infantile Mortality Rate is over 100 per 1,000 births. 8 If the Registrar-General's estimate of the civil population be adopted as a basis, the birth-rate works out at 22.9 per 1,000. BIRTH RATE, 1894-1915. Heston and Isleworth England and Wales The following figures give the number of illegitimate births :— Resident Births. Heston. Isleworth. legitimate. illegitimate. legitimate. illegitimate. 309 14 595 39 Non-resident Births. Legitimate. 8 Illegitimate. 29 Notification of Births Act, 1907. The accompanying table (based on monthly reports of Health Visitors) shews the work done under the Notification of Births Act, 1907, during the year 1915. 9  Heston Ward. Hounslow North Ward. Hounslow South Ward. Isleworth North Ward. Isleworth South Ward. Heston • and Isleworth Urban District. Births notified 113 163 252 139 121 788 Births visited 82 151 231 140 101 705 Feeding—Natural 77 132 196 123 91 619 Artificial 3 10 25 9 8 55 Both ... 6 9 3 2 20 Noinformation 2 3 1 5 ... 11 Still births 1 7 4 7 3 22 Sleeping with parents 56 104 161 100 70 491 Using comforter 29 47 90 41 34 241 Mother working during pregnancy 6 21 31 22 17 97 Births unnotified 18 13 25 28 17 101 Births unvisited 49 25 45 29 39 189 Births revisited 250 440 616 566 410 2282 The appointment of a third Health Visitor has resulted in a considerable increase of work under the Notification of Births Act. Although the new Health Visitor only took up her duties in September, 2282 revisits were made to infants, as compared with 560 in the previous year. Most infants are revisited now at least three times in the first three months, once every three months until a year old and again at the age of two. The percentage (88) of children who are receiving mother's milk shews a slight decrease compared with that of last year, 89. 10 The number of still births notified this year is 22. It is noteworthy that this is the only reliable figure which is available as to the number of still births in the district, and it is a matter which requires further investigation that one child in 44 born is still-born. The reduction in the number of women employed during pregnancy, which was noted last year, has not continued, the percentage (13) being the same this year. Maternity and Infant Welfare Centres. During the year, arrangements were made to carry into effect the scheme for Maternity and Infant Welfare Centres, which had been formulated by Dr. Strain and adopted by the Health Committee and Council. The centres were opened in September, 1915. One centre is located at the Council House, where an Infant Clinic is held every Monday afternoon from 2 to 4 and maternity cases are seen on Thursday afternoons at 2.30. The other centre is located at the Isleworth Public Hall, where an Infant Clinic is held every Wednesday from 2 to 4, any maternity cases being seen between the same hours. The Infant Clinics are proving successful, but very few persons have, as yet, taken advantage of the maternity consultations. Infant Deaths. The total number of infant deaths during 1915 was 98, giving an Infant Mortality rate of 102 4 per 1,000 births. This figure is higher than that of 1914, which was 97 9 per 1,000 births. The figure for this year is, however, lower than the rate for England and Wales for the same period (110), and London, 112. The Infant Mortality rate, as seen in the table on page 5 (Vital Statistics), varies from 54.3 in Hounslow North Ward, which is the lowest, to 125.9 in Hounslow South Ward, where the rate is highest. 11 The steady reduction of the Infant Death Rate in the district during the last twenty years is shewn by the following graph :— INFECTIOUS DISEASE. Table II. at the end of the report shews the various iufectious diseases notified during the year, and the incidence of these diseases at various age-periods and in the different wards of the district. Isolation Hospital Accommodation. This district, with the Borough of Richmond (Surrey), maintains two Isolation Hospitals :— (1). Mogden Hospital for Scarlet Fever, Diphtheria, Enteric Fever, and, accommodation permitting, Puerperal Fever. It has 61 beds, allowing 1,500 cubic feet of air space to each bed. (2). Dockwell Isolation Hospital for Small-pox. It has 13 beds, allowing 1,500 cubic feet of air space per bed. 12 No definite number of beds is assigned to either authority, but on the basis of the amount of money spent by each in the upkeep of the Hospitals, it may be said that there are 45 beds (37 at Mogden, and 8 at Dockwell) for Richmond, and 29 beds (24 at Mogden, and 5 at Dockwell) for Heston and Isleworth. Cases removed to Hospital. During the year, 191 of the 246 cases notified were removed to Hospital. Of these 191, 30 were admitted to the Infirmary, 5 entered Metropolitan Asylums Boards' Hospital, one was treated in the Military Hospital, and one in the Hounslow Hospital, leaving 154 chargeable to the District Rate at Mogden Hospital, and 1 at Dockwell Hospital. Scarlet Fever. The following table shews the number of cases which have been notified, and the number and percentage of cases which have been removed to Hospital :— No. of cases notified 96 No. of cases removed to Hospital 78 Percentage of cases removed to Hospital 80 6 The incidence rate of Scarlet Fever in the population was 1.9 per 1,000, as compared with 2 8 last year. Ten cases occurred in public institutions in the district, 5 of the persons affected being non-residents. The prevalence of the disease was greatest in January and December. The disease continues to be of a mild type, only one death having taken place from this cause during the year. Diphtheria. The following table shews the number of notifications received, and the percentage of cases of Diphtheria removed to Hospital:— No. of cases notified 92 No. of cases removed to Hospital 75 Percentage of cases removed to Hospital 81.5 13 The incidence rate per 1,000 of the population was 18 as against 2.31 for last year. Eight cases occurred in public institutions during the year, 6 of the persons affected being non-residents. Seven deaths took place from this cause, i.e., a case mortality rate of 7.5 per cent. Antitoxin. The Council's arrangements for providing Antitoxin were the same as in previous years. A supply of this Serum is always maintained at the Health Department, and is supplied free of charge for the poorer inhabitants of the district. During 1915, in 19 cases Antitoxin has been supplied to medical practitioners, and in seven cases the Council have paid the charges. Typhoid Fever. Only one case was notified. This case occurred at the Military Hospital and was treated there. No deaths were recorded from this cause. Erysipelas. Thirty-two cases of this disease were notified, of whom 16 were institution cases, 15 of the persons affected being non-residents. No cases proved fatal. Puerperal Fever. Eight cases of this disease were notified, of which 7 were institution cases, 6 of the persons affected being non-residents. Six cases proved fatal, four being non-residents. Ophthalmia Neonatorum. In this district 10 children were notified as suffering from this disease, 6 of the cases occurring at the Infirmary. This is 14 equal to a case rate of 102 per 1,000 births occurring in the district, but it will be noted that more than half the cases occurred at the Infirmary, many of them coming from addresses outside the district. In the cases visited by the Health Visitors no injury to the eyesight occurred. Epidemic Cerebro Spinal Meningitis. Three cases of this disease were notified, one of which proved fatal. In the other two cases bacteriological evidence failed to confirm the original diagnosis. Five suspected cases (4 of them military cases) came under observation, but bacteriological examination of swabs or specimens of cerebro spinal fluid proved negative in all but one (military) case. Acute Polio Myelitis. Three cases of this disease were notified, one case being treated at Mogden Hospital, one at Hounslow Hospital and one at home. Pulmonary Tuberculosis. The number of cases notified during the year was 71, the age and ward distribution being set out in Table II. at the end of the report. Other Forms of Tuberculosis. The number of cases notified during the year was 21, the age and ward distribution of these being shown in Table II. at the end of the report. The localization of the disease in the 19 fatal cases during the year is shown as under:— 9 Tuberculosis of Meninges. 4 „ „ Abdomen. 1 „ „ Larynx. 1 „ „ Hip. 4 Generalised Tuberculosis, 19 15 COUNCIL LABORATORY. The following table gives a statement of the work in the Laboratory during the year 1915:— Diagnosis of Disease. Result. Total. Positive. Negative. Diphtheria 60 224 284 Tuberculosis 36 110 246 Typhoid Fever ... 7 7 Ringworm 37 13 50 Gonorrhoea 8 2 10 Tinea 1 ... 1 Total 142 356 498 One sample of water was analysed. There has been a steady increase in the number of bacteriological examinations made in the Laboratory since it was opened on the 14th April, 1910, a,s shown in the following table:— 1910 (8½ months) 49 1911 79 1912 134 1913 173 1914 378 During the year under report, the number of specimens has again substantially increased (to 498), chiefly on account of the bacteriological work undertaken for the Hounslow Military Hospital. SANITARY ADMINISTRATION. The remarks which were made in last year's report with regard to the water supply, drainage and sewerage, closet accommodation and scavenging of the district, apply generally to the year under report. 16 Sanitary Inspection of the District. Details of the inspections and work done is set out in Table X. in the Appendix to this report. The number of premises inspected on receipt of complaint was 247, and the number of house-to-house inspections 21. Inspections of houses where infectious diseases had been notified numbered 149. Nuisances, Contraventions of Bye-laws, Defective Drainage, etc. The number of unremedied nuisances brought forward from 1914 was 158. The number of nuisances recorded during the year was 599, but during the year 469 nuisances were remedied, leaving 288 premises in which nuisances still existed at the end of the year. Table shewing Nuisances, etc., reported to and directions given and action taken by the Health Committee, together with the results of such action during 1915:— Premises. I No. of houses dealt with. No. of houses in respect of which notices were authorised. No. of houses in respect of which notices were served. No. of houses in respect of which the notices were complied with. No. of houses carried forward to 1916. 1914 1915 Brought forward from 1914— 10 10 8 3 7 3 Dealt with in 1915 24 23 ... 19 14 10 Total 34 33 8 22 21 13 Premises and Occupations controlled by Bye-laws or Regulations. There are about 350 premises in this district which call for periodical inspection such as the following Houses let in Lodgings, Common Lodging Houses, Bakehouses, Slaughter-houses, Cowsheds, Dairies and Milkshops, Offensive Trades, Laundries (non factory) and Workshops and Work Places. 17 No regulations have yet been made with regard to underground sleeping rooms. Houses let in Lodgings. A few houses are registered under the bye-laws as houses let in lodgings, but it is certain that a greater number of houses in this district are let in lodgings. According to the results of the Census, there were 8,786 families in the district, whereas there were only 8,006 occupied houses. This shews that over 9 per cent. of the houses in this district are occupied by members of more than one family. Common Lodging Houses. There are two houses in the district registered as Common Lodging Houses. One is licensed to receive 61 and the other 35 persons. The number of inspections made during the year was 8. These houses, having regard to the class of lodger received, are kept in a very satisfactory condition. Bakehouses. Twenty-eight visits to the 18 bakehouses in the district were made and one contravention of the Factory Act detected. Slaughter-houses. The ten slaugher-houses in the district were visited 78 times during the year, the visits taking place as far as possible when slaughtering is occurring. In one instance a contravention of bye-laws was found. Offensive Trades. One hundred and thirty-seven inspections were made to fried fish shops during the year. Bye-laws for the regulation of this trade have now been prepared and approved by the Local Government Board. HOUSING. Houses with Sanitary Defects. The following table gives the information required by the Local Government Board relative to this class of property, dealt with during the year under the Housing (Inspection of District) Regulations, 1910:— 18 Table shewing the number of dwelling houses inspected and dealt with during 1915:— Premises. Brought forward from 1914. No. of houses inspected, 1915. No. of houses in respect of which Intimation Notices served. No. of houses in respect of which Statutory Notices were served. No. of houses in which notices were complied with. No. of houses carried forward to 1916. 1914 1915 Brought forward from 1914– † 1, Douglas Road l ... ... ... ... ... 1 2, 3, 6, 7, Castle Place 4 ... ... 4* ... 4 ... 297, Staines Road 1 ... ... ... 1 1 ... 2-10, Brickfield Yard 5 ... ... 5 ... 5 ... 1-7, Retreat Terrace 7 ... ... ... ... 7 ... 1-13, 120-130, 143, 169, Linkfield Road 13 ... ... 13 ... 5 8 1-4, Gilbert's Cottages, W. 4 ... ... ... ... 4 ... 7-23, Derby Road 9 ... ... 4 ... 6 3 83, 85, Pears' Road 2 ... ... ... 2 2 ... Inspected in 1915— 1, 4, 5, Castle Place ... 3 ... ... ... 3 ... 1, 2, Wharf Cottages ... 2 2 ... 2 ... 2 2-8, Orchard Road ... 4 4 ... 4 ... 4 46 9 6 26 9 37 18 *Under Section 15 of the Housing, Town Planning, etc., Act, 1909. † Unoccupied. 19 The procedure adopted in these cases is to give the owner a written intimation of the defects requiring remedy ; after the lapse of a reasonable time the Health Committee give instructions to serve Statutory Notices. Houses Unfit for Human Habitation. The following statement gives the information which the Local Government Board requires the Medical Officer to furnish for the year ending December 31st, 1915, in relation to houses represented by him as unfit for human habitation:— Number of houses represented by Medical Officer of Health 12 ,, Closing Orders made by the Local Authority 16 ,, appeals against Closing Orders 0 ,, notices served on occupying tenants 5 ,, occupying tenants summoned 0 ,, Orders made by Court requiring occupying tenants to quit 0 „ Closing Orders determined 8 (C.O. made in 1914) ,, Demolition Orders made 16 ,, appeals against Demolition Orders 1 (in respect of 3 D.O.) ,, Demolition Orders obeyed 4 ,, Demolition Orders enforced 0 ,, demolitions carried out without Demolition Orders being made 3 The following table gives more detailed information in regard to the houses represented as unfit during the year 1915, and the action taken in those remaining on the records at the end of 1914:— 20 Table shewing dwelling houses represented as unfit for human habitation:— Premises. No. of houses represented by M.O.H. Date Closing Orders made. Date Closing Orders determined. Date Demolition Orders made. Date Demolition Orders obeyed. Date Demolition enforced. Br't forw'd from 1914— a1-7, Castle Place 7 b 1-3, Poplar Cottages 3 24/2/14 ... 22/12/14* c299-311, Staines Rd. 7 28/4/14 28/9/15 27/4/15 42, Derby Road 1 28/4/14 26/1/15 27/10/14 d40-44. Derby Road 2 Wild's Rents 1 26/5/14 ... 22/12/14 6/9/15 13, 14, Town Wharf 2 26/5/14 ... 22/12/14 6/9/15 17, Town Wharf 1 26/5/14 ... 22/12/14 5/7/15 10-16, Church Street 4 2-3/2/15 ... 26/10/15* 28 1915— 15, South Street 1 27/4/15 ... 23/11/15* el-3, Gumley Terrace 3 27/4/15 1-4, Gilbert's Cottages, E. 4 23/3/15 ... 26/10/15 1-4, Baker's Cotts. 4 18/12/15 12 16 8 16 4 a—Nos. 2, 3, G and 7, dealt with under Section 15. Rendered fit 4/8/15. b—Appeals lodged against Demolition Order. L.G.B. enquiry held 15/3/15. Order made 18/5/15 operative 18/8/15. c—Operation of Demolition Orders postponed for 3 months. d—Consideration of Closing Orders postponed 6/4/14. Being dealt with under Public Health Acts. c—Houses demolished voluntarily 6/7/15. *—Demolition deferred until after the War. New Houses. I am informed by the Surveyor that four houses suitable for the working classes were erected during the year. FOOD. Milk Supply. No material change has been observed during the past year in the conditions under which cow-keeping and milk-vending are carried on in the district. 21 Other Food. During the year 1613 visits have been paid to premises where food is sold. Special evening inspections are periodically made in connection with the sale of fruit, etc., from hawkers' barrows. The quantity of unsound food found during the year was approximately:— Fruit 17 lbs. Meat 10 cwt. 1 qr. 17 lbs. Fish 1 cwt. 7 lbs. This includes parts of carcases of animals surrendered and condemned during slaughtering. In one case, a consignment of 22 rabbits to the Brentford Union Infirmary was seized and condemned. Proceedings were taken against the vendor, who was fined £44. No special supervision has been exercised over other premises, such as Restaurants, Eating-houses, etc., where food is prepared, stored, or exposed for sale. FACTORY AND WORKSHOP ACT, 1901. A statement of the number of inspections made and defects noted is to be found in Tables V., VI., VII., VIII. and IX., in the Appendix. SHOPS ACTS. The number of contraventions of the Acts which were reported during the year was as follows:— Open on half-holidays 1 Notices not exhibited 9 Notices not exhibited in a conspicuous position — Notices not in prescribed form 3 Notices (assistants) not exhibited — 13 No legal proceedings were taken. 22 APPENDIX. Page. Vital Statistics:— Table I.—Vital Statistics for Whole District 23 Table II.—Cases of Infectious Disease 25 Table III.—Causes of and Ages at Death 26 Table IV.—Infantile Mortality 28 Factory and Workshop Act, 1901:— Table V.—Inspection of Factories, Workshops and Workplaces 29 Table VI.—Defects found in Factories, Workshops and Workplaces 29 Table VII.— Homework (outworkers) 30 Table VIII.—Registered Workshops 31 Table IX.—Other Matters 31 Sanitary Work :—Table X. 32 List of adoptive Acts and Bye-laws in force in the District 36 Canal Boats:— Annual Report, 1915 37 23 Table I. Vital Statistics of Whole District during 1915 and previous years. Year. Population estimated to middle of each year. Biuths. Total Deaths Registered in the District. Transferable Deaths. \ Nett Deaths belonging to thr District. Uncorrected Number. Nett. of Nonresidents registered in the District. of Residents not registered in the District. Under 1 year of age. At all Ages. Number, t Kate. * Number, t Rate per 1,000 Nett Births. Number, t Kate. * Number. Kate. * 1 2 3 4 5 6 7 8 9 10 11 12 13 1910 43,120 1117 1050 25.01 738 17.11 276 31 105 100.0 493 11.74 1911 43,684 1075 1018 23.94 850 19.46 340 68 165 162.0 578 13.53 1912 45,191 1087 1017 23.09 786 17.38 312 29 87 85.5 474 10.76 1913 46,749 1141 1095 24.01 807 17.57 324 53 117 100.7 536 11.73 1914 48,361 1039 1001 21.05 864 17.86 385 65 98 97.90 544 11.43 1915 49,735 978 957 19.64 999 20.08 443 53 98 102.40 609 12.49 24 NOTES FOR TABLE I. Notes.—"The Kates in Column 7 are calculated per 1000 of the estimated gross population. The rates in Columns 5 and 13 have been calculated on a nett population obtained by deducting from the estimated gross population the average number of inmates not belonging to the district in public institutions, viz.:— Name of Institution. Average number of inmates not belonging to District for 1915 Union Workhouse 549 ,, Infirmary 282 ,, School 116 Mogden Isolation Hospital 9 Wyke House Private Lunatic Asylum 32 Gunnersbury House 25 Total 1013 † The deaths included in Column 6 of this table are the whole of those registered during the year as having actually occurred within the district. See note appended to Table III. with regard to military deaths. The deaths included in Column 12 are the number in Column 6, corrected by the subtraction of the number in Column 8 and the addition of the number in Column 9. The deaths in Column 10 are corrected by subtraction of the deaths under I, included in the number given in Column 8, and by addition of the deaths under I, included in the number given in Column 9. ‡ "Transferable Deaths" are deaths of persons, who, having a fixed or usual residence in England or Wales, die in a district other than that in which they resided. The deaths of persons without fixed or usual residence, e.g., casuals, are not included in Column 8 or 9, except in certain instances under 3 (b) below. The following special cases arise as to Transferable Deaths:— (1). Persons dying in institutions for the sick or infirm, such as Hospitals, lunatic asylums, workhouses, and nursing homes (but not almshouses) must be regarded as residents of the district in which they had a fixed or usual residence at the time of admission. If the person dying in an Institution had no fixed residence at the time of admission, the death is not transferable. If the patient has been directly transferred from one such Institution to another, the death is transferable to the district of residence at the time of admission to the first Institution. (2). The deaths of infants born and dying within a year of birth in an Institution to which the mother was admitted for her confinement should be referred to the district of fixed or usual residence of the parent. (3). Deaths from Violence are to be referred (a) to the district of residence, under the general rule; (b) if this district is unknown, or the deceased had no fixed abode, to the district where the accident occurred, if known; (c) failing this, to the district where death occurred, if known; (d) failing this, to the district where the body was found. Area of District in acres (exclusive of area covered by water) 6,893*631. Total population at all ages, 43,316. Number of families or separate occupiers, 8,786. At Census of 1911. Number of inhabited houses, 8006. Average number of persons per house, 5.4. 25 Table II. Cases of Infectious Disease notified during the Year 1915. Notifiable Disease. Number of Casks Notified. Total Casks Notified in each Locality. (e.g., Parish or Ward) of the District. Total cases removed to Hospital. At all Ages. At Ages—Years. Heston Hounslow North. Hounslow South. Isleworth North. Isleworth South. Under 1 1 and under 5 years. 5 and under 15 yrs. 15 and under 25 yrs. 25 and under 45 yrs. 45 and under 05 yrs. 65 and upw'ds Small-pox 1 ... ... 1 ... ... ... ... ... ... ... ... 1 1 Cholera (c) Plague (p) Diphtheria (including Membranous croup) 92 ... 20 58 10 4 ... ... l6 12 41 18 5 75 Erysipelas 32 1 1 1 2 9 9 9 2 3 7 19 1 17 Scarlet Fever 96 ... 13 72 8 3 ... ... l6 16 22 30 12 78 Typhus Fever Enteric Fever 1* ... ... ... 1 ... ... ... ... 1 ... ... ... 1 Relapsing Fever Continued Fever Puerperal Fever 8 ... ... ... ... 7 1 ... 1 1 ... 6 ... 8 Cerebro-spinal Meningitis 3 ... ... 3 ... ... ... ... ... ... 1 2 ... 3 Poliomyelitis 3 ... 2 ... 1 ... ... ... ... 1 2 ... ... 2 Ophthalmia Neonatorum 10 10 ... ... ... ... ... ... ... 2 1 7 ... 6 Pulmonary Tuberculosis 71 1 3 6 14 33 14 ... 12 9 25 19 6 Other forms of Tuberculosis 21 1 3 9 5 2 1 ... 7 2 5 4 3 Totals 338 13 42 150 41 58 25 9 54 47 104 105 28 191 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 upwards. 1 2 3 4 5 6 7 8 9 10 11 All causes Certified 609 98 28 21 22 23 75 116 226 559 Uncertified ... ... ... ... ... ... ... ... ... ... 1 Enteric Fever ... ... ... ... ... ... ... ... ... 1 2 Smallpox 8 Measles 20 6 8 4 2 ... ... ... ... 7 4 Scarlet Fever 1 ... ... 1 ... ... ... ... ... 3 5 Whooping-cough 8 5 2 1 6 Diphtheria and Croup 7 ... 1 1 3 1 1 ... ... 6 7 Influenza ... ... ... ... ... ... ... ... ... 2 8 Erysipelas 9 Phthisis (Pulmonary Tuberculosis) 47* ... ... ... 1 8 23 15 ... 61 10 Tuberculous Meningitis 9 2 2 2 2 1 ... ... ... 2 11 Other tuberculous diseases 10 1 ... 3 1 1 3 1 ... 7 12 Cancer, malignant disease 49* ... ... ... ... ... 4 19 26 34 13 Rheumatic Fever 3 ... ... ... 1 ... 1 1 ... 1 14 Meningitis 7* 1 1 ... 2 1 2 ... ... 4 15 Organic Heart Disease 64* 1 ... ... 3 ... 6 15 39 54 16 Bronchitis 62 7 2 ... 1 ... 6 10 36 104 17 Pneumonia (all forms) 62* 14 9 5 ... ... 10 12 12 37 18 Other diseases, Respiratory Organs 9 1 1 ... ... ... 1 3 3 8 19 Diarrhoea and Enteritis 17* 13 2 ... ... 1 ... ... 1 10 20 Appendicitis and Typhlitis 2 ... ... 1 ... 1 ... ... ... 1 21 Cirrhosis of Liver 1 ... ... ... ... ... ... ... 1 3 21a. Alcoholism... 1* ... ... ... ... ... 1 ... ... 1 22 Nephritis and Bright's Disease ... 14* ... ... ... ... ... 2 4 8 11 23 Puerperal Fever 2 ... ... ... ... ... 2 ... ... 6 24 Other accidents and diseases of Pregnancy and Parturition 1 ... ... ... ... ... 1 ... ... 1 25 Congenital Debility& Malformation including Premature Birth 38 38 ... ... ... ... ... ... ... 16 26 Violent Deaths, excluding Suicide 20* 1 ... 1 2 4 5 5 2 13 27 Suicide 3 ... ... ... ... 1 ... 1 1 4 28 Other defined diseases 152* 8 2 4 4 7 30 97 164 29 Diseases ill-defined or unknown ... ... ... ... ... ... ... ... ... 3 609* 98 28 21 22 23 75 116 226 559 *Including Military Deaths as per attached table. 27 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 upwards. 2 3 4 5 6. 7 8 9 10 11 Sub-Entries included in above figures. 14 (a). Cerero-spinal Meningitis 1 ... ... ... 1 ... ... ... ... 1 17 (a). Broncho-pneumonia 29 11 7 3 ... ... 1 3 4 8 Deaths of Soldiers, etc. Disease. No. Ages. 9. Pulmonary Tuberculosis 1 46 12. Cancer 1 25 14. Meningitis 1 32 15. Heart Disease 1 67 17. Pneumonia 5 26, 32, 43, 43, 55. 19. Gastro Enteritis 1 18 21a. Alcoholism 1 32 22. Nephritis 1 54 26. Accidents 3 23, 24, 33. 28. Other defined diseases 2 40, 64. 17 28 Infantile Mortality during the year 1915. Nett Deaths from stated Causes at various Ages under 1 Year of Age Cause of Death. Under 1 week 1-2 weeks 2-3 weeks 3-4 weeks Total under 4 weeks. 4 weeks and under 3 mts. 3 mts. and under 6 mts. 6 mts. and under 9 mts. 9 mts. and under IS mts. Total Deaths under 1 year. All causes Certified 23 7 4 4 38 19 10 14 17 93 Uncertified ... ... ... ... ... ... ... ... ... ... Smallpox Chickenpox Measles ... ... ... ... ... ... ... 4 2 6 Scarlet Fever Whooping Cough ... ... ... ... ... ... 1 2 2 5 Diphtheria and Croup Erysipelas Tuberculous Meningitis ... ... ... ... ... ... ... 2 ... 2 Abdominal Tuberculosis ... ... ... ... ... ... 1 ... ... 1 Other Tuberculous Diseases Meningitis (not Tuberculous) ... ... ... ... ... ... ... ... 1 1 Convulsions Laryngitis Bronchitis ... ... 1 ... 1 ... 2 1 3 7 Pneumonia (all forms) ... ... ... 1 1 4 1 ... 8 14 Diarrhœa ... ... 1 ... 1 1 ... 2 ... 4 Enteritis ... ... ... ... ... 5 2 2 ... 9 Gastritis ... ... ... ... ... ... 1 ... ... 1 Syphilis Rickets Suffocation, overlying 1 ... ... ... 1 ... ... ... ... 1 Injury at Birth Atelectasis Congenital Malformations ... 2 ... 1 3 3 ... ... ... 6 Premature Birth 19 4 ... 1 24 3 1 ... ... 28 Atrophy, Debility and Marasmus 1 ... 2 ... 3 1 ... ... ... 4 Other Causes 2 1 ... 1 4 2 1 1 1 9 23 7 4 4 38 19 10 14 17 98 Nett Births Legitimate 904 Nett Deaths Legitimate infants 90 Illegitimate 53 Illegitimate infants 8 Table IV 29 Report on the administration of the Factory and Workshop Act, 1901, Table V.—INSPECTION OF FACTORIES, WORKSHOPS AND WORKPLACES. Premises. Number of Inspections. Written Notices. Prosecutions. 1 2 3 4 Factories (including Factory Laundries) 1 Workshops (including Workshop Laundries) 98 5 Workplaces (other than Outworkers' premises included in Table VII. 35 1 "A Total 169 7 Nil. Table VI.—DEFECTS FOUND IN FACTORIES, WORKSHOPS AND WORKPLACES. Particulars. Number of Defects. Number of Prosecutions. Found. Remedied. Referred to H.M. Inspector. 1 2 3 4 5 Nuisances under the Public Health Acts:Want of cleanliness 14 17 Nil. Nil. Want of ventilation 1 1 Overcrowding Want of drainage of floors Other nuisances 4 6 †Sanitary accommodation— Insufficient 1 Unsuitable or defective 5 10 Not separate for sexes 1 2 Ounces under the Factory and Work- shop Act:— Illegal occupation of underground bakehouse (s.101) Breach of special sanitary requirements for bakehouses (ss. 97-100) 1 1 Other offences (excluding offences relating to outwork which are included in Table VII 1 Total 27 38 Nil. Nil. †Section 22 of the Public Health Acts Amendment Act, 1890, has been adopted by the District Council, and the standard of sufficiency and suitability of sanitary accommodation for persons employed in factories and workshops enforced is that required by the Sanitary Accommodation Order of 4th February, 1903. 30 Table VII.—HOMEWORK. NATURE OF WORK. OUTWORKERS' LISTS, SECTION 107. Inspections of Outworkers' premises. Outworkers' lists, Section 107. Outwork in unwholesome premises, Section 108. Outwork in infected premises, Sections 109, 110. Lists received from Employers. Addresses of Outworkers. Prosecutions. Instances. Instances. Sending twice in the year. Sending once in the year. Received from other Councils Forwarded to other Councils. Lists. Outworkers. Lists. Outworkers. Contractors Workmen. Contractors Workmen. 1 2 3 4 5 6 7 8 9 10 11 12 18 Wearing Apparel— making, &c. 6 ... 9 1 ... 4 17 2 11 ... 1 Do., washing and cleansing 2 ... 2 ... ... ... ... 1 Furniture and upholstery 6 ... 8 1 ... 1 ... ... 6 Total 14 ... 19 2 ... 5 17 3 17 ... 1 31 Table VIII.—REGISTERED WORKSHOPS. Workshops on the Register (s. 131) at the end of the year. Number. Bakehouses (Retail) 18 Laundries (non-factory) 24 Workshops and Workplaces 201 Total number of workshops on Register 243 Table IX.—OTHER MATTERS. Class. Number. Matters notified to H.M. Inspector of Factories:— Failure to affix Abstract of the Factory and Workshop Act, (s.133) 1 Action taken in matters referred by H.M. Inspector as remediable under the Public Health Acts, but not under the Factory Act (s.5) — Notified by H.M. Inspector 1 Reports (of action taken) sent to H.M. Inspector 1 Other Underground Bakehouses (s. 101):— Certificates granted during the year In use at the end of the year 1 32 Table X. Sanitary Work. Inspections:— Number of premises inspected on complaint 247 Number of premises inspected in connection with Infectious Diseases (No. of visits made—454) ... 149 Number of premises, such as Cowsheds, Dairies, Slaughter-houses, Workshops, Workplaces, (fee., tinder periodical inspection about 350 Houses inspected from house-to-house (Housing, Town Planning, etc., Act, 1909) 21 Total number of inspections and re-inspections made 5,125 Action Taken (other than under Housing, Town Planning, &c., Act, 1909): Cautionary or Intimation Notices given verbal 144 717 written 573 Statutory Orders issued 109 Summonses served 12 Dwelling Houses and action under Housing, Town Planning, &c., Act, 1909 :—See Page 17. Houses let in lodgings (Tenement Houses): Number registered under Bye-laws 10 Number of inspections made 25 Number of contraventions — 33 Common Lodging Houses: Number registered under Byelaws 2 Number of inspections made 8 Number of contraventions 1 Canal Boats used as Dwellings:–See Page 37. Movable Dwellings, Caravans, Tents, &c.: Number observed during the year 34 Number of inspections made 77 Number of nuisances therefrom abated 100 Number removed from district 34 Bakehouses: Number in district 18 Number of inspections made 28 Contraventions of Factory Acts 1 Slaughter-houses: Number on register in district 10 Number of inspections made 78 Contraventions of Bye-laws 1 Cowsheds: Number on register: Premises 8, Sheds 18 Number of inspections made 13 Contraventions of Regulations 1 Dairies and Milkshops: Number on register 50 Number of inspections made 135 Contraventions of Regulations 21 34 Inspection of Food: Meat 522 Fish 226 Provisions 199 Greengroceries and fruit 532 Hawkers' foodstuffs 126 Other premises 8 Unsound Food: (a) Animals seized (b) Articles or parcels seized 1 Animals condemmed by Magistrate 22 Articles or parcels condemmed by Magistrate 10 Animals surrendered after application 1 Articles or parcels surrendered 3 Organs or parts surrendered during slaughtering 6 Offensive Trades: Number of premises in district 15 Number of inspections made 137 Contraventions of Bye-laws 3 Water Supply and Water Service: Supply provided 10 Cisterns— New provided — Cleansed, repaired, covered, &c. 7 Abolished 7 Draw-taps placed on mains 84 Drainage and Sewerage of existing Buildings: Water closets— Number of water closets substituted for dry receptacles 1 Repaired, supplied with water or otherwise improved 315 Drains— Examined, exposed, &c. 1 Unstopped, repaired, trapped, &c. 50 35 Waste pipes, 13, rain-water pipes, 79, provided, disconnected, repaired, &c. 92 Soil pipes or ventilating shafts fixed or repaired 30 Disconnecting traps or chambers inserted or repaired 13 Constructed 3 Reconstructed 11 Total No. of tests and re-tests applied 126 Other works to drains 75 Disinfection:— Rooms disinfected— (а) Ordinary infectious diseases 209 (b) Tuberculosis 44 Rooms stripped and cleansed 157 Articles disinfected or destroyed— (a) Ordinary infectious diseases 1791 (b) Tuberculosis 322 Dust: New bins provided 155 Receptacles repaired 5 Ashpits abolished 4 Sundry Nuisances abated: Overcrowding 3 Smoke 1 Accumulation of refuse 7 Foul pigs and other animals 22 Dampness 396 Internal repairs (walls, ceilings, &c.) 1029 Yards paved or repaired 111 Other nuisances 32 Other Inspections: Petroleum Acts 62 Shops Act 125 36 Adoptive Acts in Force in District: *Infectious Diseases (Prevention) Act, 1890. *Public Health Acts Amendment Act, 1900, Part 111. *Public Health Acts Amendment Act, 1907, Parts II., *111., *IV., *V„ VI. and VIII. *Notification of Births Act, 1907. Baths and Wash-houses Act, 1816-82. Burial Acts, 1852-85. (Applicable to parts of district only). Private Street Works Act, 1892. Public Libraries Act, 1892. Bye-laws in Force in District: *Common Lodging Houses (P.H.A. 1875, s. 80) *Cleansing, etc., and Removal of Refuse (P.H.A. 1875, s. 44). *Houses Let in Lodgings (P.H.A. 1875, s. 90). *Tents, Vans, Sheds, etc. (H.W.C.A. 1885, s. 9 (2) ). *Slaughter Houses (P.H.A. 1875, s. 169 and T.I.C.A. 1847, s. 128). *Prevention of Nuisances (P.H.A. 1875, s. 44). *Keeping of Animals (P.H.A 1875, s. 44). *Removal of Offensive Matters (P.H.A.A.A. 1890, s. 26). New Streets and Buildings (P.H.A. 1875, s. 157 and P.H.A.A.A. 1890, s. 23). Pleasure Grounds (P.H.A. 1875, s. 164). *Fish Frying (P.H.A. 1875, s. 113). Regulations made by Local Authority in force in District: *Dairies, Cowsheds and Milkshops (D.C.M.O. 1885, s. 13). Allotments (A.A. 1887, s. 6). *These are administered wholly or partly by the Health Committee. The unstarred are administered by other Committees of the Council. 37 HESTON & ISLEWORTH URBAN DISTRICT COUNCIL. Health Depahtment, Council House, Hounslow. January 3rd, 1916. To the Secretary, Local Government Board. Canal Boats Acts, 1877 and 1885. Sir, In accordance with Section 3 of the Canal Boats Act, 1884, I beg herewith to present the Annual Report for the year ending December 31st, 1915, as to the execution of the Canal Boats Acts, 1877 and 1884, and of the Regulations made thereunder, within the Urban District of Heston and Isleworth, Middlesex. During the absence of Mr. W. E. Balchin on military duty, Mr. R. H. Butler, Inspector of Nuisances, has acted as Canal Boat Inspector. Owing to the reduction of the Inspectorial Staff due to enlistment and removal, it has not been possible to maintain the usual number of inspections. 23 inspections were made of 23 boats. On 2 of these boats 3 infringements of the Acts and Regulations were found, as under:— No. of boats with 1 infringement only 1 „ „ 2 but not 3 infringements 1 The following table gives details as regards these contraventions:— 38 Infringements with respeot to— Carried forward from 1914 Found during 1915. Remed'd during 1915. Carried forward to 1916. (a). Registration ... ... ... ... (b). Notification of change of Master ... ... ... ... (c). Certificates 1 ... 1 ... (d). Marking ... ... ... ... (e). Overcrowding ... 1 ... 1 (f). Separation of the sexes ... ... ... ... (g). Cleanliness ... ... ... ... (It). Ventilation ... ... ... ... (i). Painting ... 1 ... 1 (j). Provision of water cask ... ... ... ... (k). Removal of bilge water ... 1 ... 1 (l). Notification of infectious disease ... ... ... ... (vi). Admittance of Inspector ... ... ... ... (11). Habitable Condition 1 ... 1 ... 2 3 2 3 No case of infectious disease was reported as occurring amongst the Canal Boat population during the year. I am, Gentlemen, Your obedient servant, William Bramwell Reid, Deputy Medical Officer of Health. HESTON and ISLEWORTH URBAN DISTRICT EDUCATION COMMITTEE. eighth Annual Report OF THE School Medical Officer FOR THE Year ending 31st December, 1915. 50 (9.M.O.) (50. M.O.H.) MEMBERS OF EDUCATION COMMITTEE, 1915-16. H. J. NIAS, Esq. (Chairman). S. SMITH, Esq. (Vice-Chairman). Members of the Council:— A. A. BERGIN, Esq., j.p. (ex-officio), (Chairman of the Council). F. NOWELL, Esq. (ex-officio), (Vice-Chairman of the Council). S. SMITH, Esq. (Vice-Chairman of the Education Committee). J. J. BONNETT, Esq. C. CEUSH, Esq. E. W. HEATH, Esq. A. L. LANG, Esq. F. W. LANGSTONE, Esq. W. G. LOBJOIT, Esq., j.p.,c.c. W. G. PALMER, Esq. W. E. SHUFF, Esq. J. WEATHERS, Esq. Selected Members:— Mrs. C. F. EVA. Mrs. W.FUNGE. E. W. GOODE, Esq. P. MURPHY, Esq. H. J. NIAS, Esq. (Chairman). School Medical Officer: THOMAS STRAIN, m.d., d.p.h. Deputy School Medical Officer: W. BRAMWELL REID, m.b., d.p.h. 3 Health Department, Council House, Hounslow. 8th May, 1916. To the Chairman and Members of the Heston and Isleworth Urban District Education Committee. Ladies and Gentlemen, Owing to Dr. Strain's absence with His Majesty's Forces in France, I have the honour to present the Report of the School Medical Officer for 1915. Acting on the instructions of the Board of Education, I have cut down the Report very considerably, but, in spite of this, I hope that the Committee will recognize that the work of the Department has been carried on very much as before. The Clinics for Defective Vision and the X-Ray Treatment of Ringworm that were established last summer, have resulted in a large number of both classes being treated and remedied, and in a consequent gain in the matter of school attendance. Beyond this, however, my year's experience compels me to endorse your Medical Officer's opinion as to the necessity for a further development in the direction of the treatment of minor ailments, and also for the establishment of a class or classes for dull and backward children. In presenting this Report, I beg to express my indebtedness to Mr. Lloyd, Chief Clerk of the Health Department, for the great assistance which he has at all times unstintedly given me in many matters in which I was inexperienced when you appointed me as Deputy for Dr. Strain. I am, Ladies and Gentlemen, Your obedient servant, W. BRAMWELL REID, Acting School Medical Officer. 4 GENERAL SUMMARY. 124 visits were made to school departments for the purpose of Routine Medical Inspection. In addition, numerous other visits were made regarding Medical Treatment Cases, Special Cases, Infectious Diseases, etc. Two half-days in each week are devoted to an Inspection Clinic, where cases are referred by the School Attendance Committees, School Attendance Officers and Teachers, also children found on medical inspection to be in need of further examination. One clinic is held at the Health Department, the other at the Isleworth Public Hall. The accommodation at the Public Hall is not very suitable, no waiting room being provided. From these tables, it will be seen that this year the total number of children examined was 3414, as against 3464 last year. These 3414 children were examined 5055 times, as against 5888 examinations during 1914. The following statements show the children who have been inspected during the year:— 5 Table 1.–NUMBER OF CHILDREN INSPECTED. Code Groups. Entrants. Intermediates. Leavers. Grand Total. Year of Birth 1909 1908 Total. 1906 1905 Total. 1903 1902 Total. Half-Year 1st 2nd 1st 2nd 1st 2nd 1st 2nd 1st 2nd 1st 2nd Boys 138 94 9 7 248 185 157 14 10 366 206 157 ... 8 371 985 Girls 157 83 5 4 249 197 164 13 11 385 159 147 8 314 948 Totals 472 25 497 703 48 751 669 16 685 1933 Special Cases. Re-examinations. No. examined 1003* 478 *These 1003 special cases involved 2644 examinations. 6 Shewing the number of SPECIAL CASES excluded, re-admitted, and under observation during 52 weeks ending 25th December, 1915. Cases remaining excluded at 26-12-14. Cases coming under observation during 52 weeks under report. Cases excluded during 52 weeks under report. Cases re-admitted during 52 weeks under report. Cases remaining excluded or under observation at 25-12-15. No. of examinations made of cases during 52 weeks under report. Total No. Attendances lost in cases excluded for a known period. 1a Ringworm 35 98 91 135 12 582 13025 1 Other Diseases of Skin 6 252 204 194 17 673 4996 2a Defective Vision ... 49 2 1 4 54 61 2 Other affections of Eye 6 44 15 22 3 113 2442 3a Carious Teeth ... 6 ... ... ... 5 ... 3 Other dis. of mouth, throat, &c. 4 97 43 40 6 202 1372 4a Pulmonary Tuberculosis 13 5 5 10 7 27 3144 4 Other diseases of Lungs 7 45 30 26 10 109 1271 5 Other forms of Tuberculosis ... 2 2 3 2 10 1519 6 Diseasesof Heart & Circulat'n 5 20 14 16 6 65 1210 7 Diseases of Nervous System 4 34 22 19 13 86 1240 8 Mental Conditions 1 9 2 1 4 13 440 9 Physical Defects 2 8 5 2 3 20 689 10 Diseases of Digestive System 4 20 11 9 5 62 355 11 Other Diseases 2 89 50 49 10 149 922 12 Nitty & Verminous Conditions 2 116 98 100 3 370 1835 13 Other reasons 5 109 16 16 1 104 917 Totals 96 1003 610 643 106 2644 35438 7 ROUTINE MEDICAL INSPECTION. The selection of children due for this inspection during 1915 included:— 1. Those born during the year 1909. 2. Those born in the year 1903. 3. Those born in the year 1906. 4. Those absent at last Medical Inspection. Extent of the Examination. The Board of Education has prescribed the extent of the medical examination of scholars attending public elementary schools, and the examination of scholars in this district has been conducted on the lines laid down by the Board. 939 parents, or 48.6 per cent., attended the inspection. Objections to the examination of their children were received from parents in 11 instances. The conditions found in respect of Clothing and Footgear were less satisfactory than last year. This was also the case with regard to Cleanliness of Head and Body. Warning notices were sent in 113 cases, and in 25 cases the children were excluded from school until the head was free from nits. Eight of the parents of children excluded were prosecuted, a fine of 5/- being imposed in six cases. A slight improvement in Nutrition has been recorded, 85.6 per cent. being classed as normal, 12.0 per cent. as below normal, and 2.4 per cent. as bad. The observations in respect of Dental Conditions show a marked improvement, 40.9 per cent. being sound, 43 4 per cent. having less than four decayed teeth, and 15.5 per cent. having four or more decayed teeth. Oral sepsis was noted in 0.2 per cent. of cases. Fewer Nose and Throat defects were noted, and the same may be said of external Eye Diseases. 8 In view of the establishment by the Committee of a School Clinic for the treatment of Defective Vision, it may be useful to state that 25.5 per cent. of the children tested this year were found to have defective vision: 11.5 per cent. less than 6/6, but not less than 6/9 in one or both eyes, 13.3 per cent. less than 6/9 in one or both eyes, and 0 7 per cent. with squint. The number of defects in connection with the Ear was similar to that found last year. Heart and Circulation. Three cases of organic heart disease were detected. Murmurs and irregularities were detected in 48 other cases on auscultation, which were probably functional in origin. Anœmia was diagnosed in ten instances. Lung Conditions. 29 cases of Bronchitis and Bronchial Catarrh were discovered; no children were definitely diagnosed as suffering from Pulmonary Tuberculosis, but in two instances children were classed as Pretubercular, or "Suspicious"; while 8 other children were suffering from other diseases of the lungs. Other Tubercular Diseases. No children were found to be suffering from other forms of Tuberculosis. Skin Diseases. 18 children were found to be suffering from some skin disease. Deformities. The following children were found presenting deformities as set out hereunder:— Paralysis 1 Pigeon and Flat Chest 11 Scoliosis 21 Rickets 2 Flat Feet 6 9 Nervous Diseases. Three cases of Epilepsy, and three of Chorea were detected. Other Defects. Two cases of Phimosis, and two of Hernia were also observed. INFECTIOUS DISEASE. The following cases of infectious illness have been notified by School Attendance Officers during the year ending 31st December, 1915:— German Measles. Mumps. Chicken Pox. Measles. Whooping Cough. Total. 4 68 173 338 91 677 SPECIAL CASES. The figures in the accompanying table give in greater detail information relating to children coming under notice for the various conditions set out in the table. It will be seen that Bingworm and other skin diseases constitute the largest group of cases, but the incidence of Eingworm of the Scalp has been very considerably reduced by the treatment of cases at the School Clinic. Those children who are excluded are re-examined at frequent intervals, and are closely followed up in order to encourage the parents to have the condition remedied, and permit the child returning to school. 10 TREATMENT OF DEFECTS, 1915. (Cases discovered at Routine Medical Inspection). DEFECT. No. of defects found. No. of defects for which no report. No. of defects treated. Result of Treatment. No. of defects not treated. Percentage of defects treated. From previous year. New. Total. Remedied Improved. Unchan'd. la Ringworm ... l l ... 1 l ... ... ... ... 1 Other Diseases of Skin ... 8 8 6 2 2 ... ... ... ... 2a Defective Vision 168 157 325 127 116 92* 5 19† 82 585 2 Other Conditions of Eye 1 2 3 3 ... ... ... ... ... 3a Carious Teeth 143 83 226 145 10 7 3 ... 71 12.3 3 Other dis. of mouth, throat, nose &c. 244 203 447 294 41 23 9 9 112 26.8 4a Pulmonary Tuberculosis ... ... ... ... ... ... ... ... ... ... 4 Other Diseases of Lungs ... 10 10 9 1 1 ... ... ... ... 5 Other forms of Tuberculosis ... 5 5 5 ... ... ... ... ... ... 6 Heart and Circulation ... 23 2.3 18 ... ... ... ... ... ... 7 Nervous System ... 3 3 3 ... ... ... ... ... ... 8 Mental Conditions ... ... ... ... ... ... ... ... ... ... 9 Physical Defects ... 19 20 15 1 ... ... 1 ... 20.0 10 Digestive System ... ... ... ... ... ... ... ... ... ... 11 Other Diseases ... 6 6 6 ... ... ... ... ... ... 12 Nitty and Verminous Conditions ... 87 87 78 9 9 ... ... ... ... 13a Clothing ... 77 77 72 3 ... 3 ... 2 ... 136 Footgear ... 128 128 115 8 3 5 ... 5 ... 13c Nutrition ... 45 45 40 3 ... 3 ... 2 ... Totals 557 857 1414 936 195 138 28 29 283 40.8 * Including 83 dealt with at School Clinic, †Including 8 dealt with at School Clinic; glasses not required or useless. 11 MEDICAL TREATMENT. From this table it will be seen that 195 out of 478 did obtain treatment, i.e., 40 8 per cent. This percentage is below that for 1913 and 1914, and it is still evident that a very large proportion of cases remains untreated. Treatment of Eye Cases. The children re-examined in order to see if they had secured treatment was 198, of whom 116, or 58 5 per cent. had been treated. Of the cases treated, 91 or 78 per cent., were dealt with at the School Clinic. Throat, Nose and Ear Cases. It will be observed that only 26.8 per cent. of the children suffering from these conditions received treatment. Dental Conditions. It is also important to observe that only 12 3 per cent. of the dental cases had obtained treatment. School Clinic. The most important event of the year in the School Medical Department was the opening of the School Clinics at the Alexandra Schools for the treatment of Defective Eyesight and Ringworm of the head. The Eye Clinic was opened on the 7th July, and Dr. A. Roemmele, the ophthalmologist, has made 26 attendances to prescribe glasses. Glasses were prescribed in 92 cases (83 cases discovered at routine inspection, and nine specially referred), and in eight cases glasses were found not to be required, or to be useless on account of other defects. The Ringworm Clinic was opened on the 23rd June, and 18 sessions have been held by Dr. D. Arthur, the Radiographer. Thirty-six cases have been treated. Others might also have been dealt with, but for the prejudice of some parents against the preliminary cutting of the hair for the treatment. 12 EXCEPTIONAL CHILDREN. During the year progress has been made in the classification of Mentally Abnormal children, detailed examinations of 24 children having been made. The following figures show the number of children now classified:— Boys. Girls. Total. Imbecile— Not at school — 1 Mentally Deficient (Feeble minded)— Attending public elementary schools 8 8 16 Attending certified schools 1 2 3 Not at school 7 5 12 Dull or backward 76 34 110 The numbers of other defective children are similar to those of last year.