AC439(1)HORNSEY BOROUGH OF HORNSEY. ANNUAL REPORT OF THE Medical Officer of Health AND School Medical Officer FOR 1934 R. P. GARROW, M.D., D.P.H. Printed by The "Hornsey Journal" Ltd., 161, Tottenham Lane, Hornsey, N.8. HOR 026 Borough of 1bornse\>. ANNUAL REPORT FOR 1934 OF THE Medical Officer of Health. INDEX Admissions to Hospital, 47. Allotments, 26. Ambulances, 8, 9. Ante-natal Clinics, 12, 13, 51. Area of Borough, 6. Attack rate, infectious disease, 48. Bacteriological examinations. 9. Bakehouses, 26, 28. Baths and Wash-houses, 29. Births and rates, 6, 14, 42, 46. Blindness prevention, 38, 39. Borough Nursing Association, 9, 10. Boundaries—change of, 6. Butchers, 26, 28. Bye-laws, 28, 29. Cancer deaths, 43, 44, 46. Carbide, 37. Cellulose spirit, 36. Cerebro-spinal meningitis, 48 Charity) expenditure, 11. Children Acts, 8, 18, 51. Cinemas, 26, 28. Cleansing station, 30. Clinics, 8, 12, 13, 51. Closing Orders, 25. Committees, 1, 2. Controlled houses, 29. Conveniences, 26. Dairies, 26, 28, 31. Deaths and rates, 7, 42. Causes of, 43, 44, 46. Dental scheme and treatment, 3, 15. Diarrhœa, 7, 43, 44, 46. Diphtheria, 43, 44, 46, 47, 48. ,, immunization, 38. Diseases of Animals Acts, 4, 40. Disinfection and Dlsinfestation, 29 Vans, 30. Dog nuisance, 30. Drain tests, 26. Drains opened, 26. Drainage, 26, 27. Dysentery, 48. Encephalitis lethargica, 43, 44, 48 Enteric fever, g, 43, 44, 46, 47. 48 Entertainment places. 26, 28. Erysipelas, 47, 48. Factories and workshops, 26. 28, 32, 52 Fish shops, 28. "Five-year " programme, 19, 20. Flats erected, 20. Food inspection, 30. condemned, 31, 32. samples, 33. Poster mothers and children, 8 18. 51. Funds disbursed, 11. Goulding Court, 20. Grimshaw Close, 20. Hairdressers (Sunday Closing) Act, 35. Health Committee, 1. Services, 8, 11. „ Visiting, 51. Visitors, 8. Home Nursing, 8, 10. Hornsey Central Hospital, 11. Hornsey Deanery Association, 11. Hornsey Housing Trust, Ltd., 21. Hornsey Nursing Association, 9. Horticultural poisons, 37. Hospital services, 8, 11. Houses controlled and decontrolled. 29. demolished, 20. erected, 20. Housing, 19. Byelaws, 28, 29. Families rehoused, 22. "Five-year" programme, 19, 20. House-to-house inspections, 25. Inspections, 23. Returns of work, 23. Statistics, 23. Trust, 21. Hydro-carbon, 36. Humane slaughtering, 32. Illegitimate births, 6. „ deaths, 7. Immunization, Diphtheria, 38. Increase of Rents Act, 26. Infant deaths and rates, 7, 42, 45. „ Causes, 45, 46. Infant Life Protection, 8, 18, 51. Infantile paralysis, 47, 48. Infectious disease, 37. Attack rate, 48. Diphtheria, 43, 44, 46, 47, 48. Notifications, 47, 48. Prevalence, 37. Scarlet fever, 43, 44, 46, 47. 48. Inhabited houses, 6. Inquests, 40. Inspections made, 25. Isolation Hospital, cases admitted to. 47. Kent's Cottages, 20. Lavender Cottages, 20. Laboratory work, 8, 9. Library books. 30. Licences, 31, 32, 36. Malaria, 48. Maternal mortality, 16. Maternity and Child Welfare Committee, 2. Maternity cases arrangements, 17. Masseuse, 19. Maternity and Child Welfare — Analysis of attendances, 51. Ante-natal, 12. Birth notified, 14. Centres, 12, 13. Children Act, 8, 18, 51. Clinics, 12, 13, 51. Committee, 2. Dental treatment, 3, 15. Foster ohildren, 8, 18, 51. Health visiting, 51. Hospital arrangements, 8, 11, 17. maternity cases, 17. Maternal deaths, 6, 16. Midwife, 4, 8, 12, 51. Fee reduced, 12. Milk grants, 15, 16. Nursery school. 16. Orthopaedic scheme, 8, 18, 19. Sessions, 13, 51. Staff, 4, 5, 14. Time-table, 13. Toddlers' playroom, 16. Voluntary Committees, 16. Year's work, 51. Measles, 7, 43, 44, 46, 48. Meat inspection, 31, 32. „ condemned, 31. Meningitis, 48. Midwives, 4, 8, 12, 51. Milk grants, 15, 16. licences, 31. „ samples, 31. „ shops, 26, 28. Mortuary, 40. Muir, Dr. J., Resignation, 5, 13. Music and dancing licences. 26. 28. Naphtha, 36. North Hill flats, 20. „ (No. 15, 17 & 17a), 20. North Road Cottages, 20. Notification of Births Act, 14. Nursery School, 16. Nursing Association, 9. Nursing Homes, 10. Ophthalmia neonatorum, 38, 39, 47. 48 Orthopaedic scheme, 8, 18. 19 Outworkers, 28. 52, Overcrowding, 21. 26. 28 Para-typhoid, 48. Passageways, 26. Pests, House, 30. Petroleum Acts, 26. 35. licences. 28. 36 Piggeries, 26. Pneumonia, 43, 44, 47. 48 Poisons Act, licences, 37 Poliomyelitis, 47, 48 Polio Encephalitis. 48 Population, 6, 42. Preface, 5. Puerperal fever and pyrexia, 3, 7, 47, 48. Radford, Dr. M„ Appointment, 5, 13. Rag Flock Act, 26. Rateable value and produce of Id. rate, 6. Refuse shoots, 26, 28. Rent and Mortgage Interest (Restrictions) Act, 26. Restaurants, 26, 28. Rose Cottages demolished, 20 Rowlands Close, 20. St. James's Lane Housing area, 20 Sale of Food and Drugs Act, 33. Sanitary notices served, 24. Sanitary work, 26, 27, 28. Scabies, 30. Scarlet fever, 43, 44, 46, 47, 48. Shoots, refuse, 26, 28. Shops Act, 26, 33. list of, 33, 34, 35. Sickness, causes, 8. Slaughter-houses, 26, 28. 31, 32. Slaughtering byelaws, 32. Slaughtermen's licences, 32. Small-pox, 26. 48. Smoke, 26. Social services, 11. Stables, 26 Staff. 3, 4, 13. Statutory notices, 24. Statistics, 6, 7, 42. Still-births, 7, 46. Subscriptions. Annual. 10. 11 Summersby Road, 20. Tables, list of, 41. Toddlers' Playroom, 16. Tottenham Lane Cottages, 20. Townsend's Yard, 20. Tuberculosis, Cases of, 40. 47. 49 Deaths, 43, 44. 46, 49. Register, 49 50. Sanatoria and beds. 39. „ Sputums, 9. Turnpike Lane housing area. 20 Typhoid fever, 9. 43, 44, 46. 47. 48 Unmarried mothers. 11. Vaccination. 38. Verminous houses, 26 Veterinary Inspector, 4. 40 Visits by Inspectors. 25. Visiting of Children, 51. Vital statistics. 6. 7, 42. „ „ England. Sec . 42. Voluntary Committee's work, 16 Ward's Cottages. 20 Welfare Centres, 13. Woodside Cottages. 20. Whooping-cough. 7, 43. 44. 46. Workshops, 28, 52. 1 HEALTH COMMITTEE as at 31st December, 1934. Alderman J. W. Rowlands (Chairman), 25, Cholmeley Park, N.6. The Mayor, Councillor W. ,T. Grimshaw, J.P., 25, Sheldon Avenue, N.6. Alderman P. Everington, 81, Mount View Road, N.4. ,, W. W. Kelland, M.A., 14, Hillside Mansions, N.6. ,, R. Steeds, 19, Coolhurst Road, N.8 Councillor Mrs. J. H. Barrexger, 20, Southwood Hall, N.6. ,, E. Brooks, 122, Crouch Hill, N.8. Mrs. C. M. Cave, 10, Wood Vale, N.10. ,, J. Edwards, 102, Turnpike Lane, N.8. ,, Mrs. M. N. Hill, 16, Bishopswood Road, N.6. ,, G. K. M. Hutchinson, 8, Grosvenor Gardens, N.10. ,, W. J. Lendrum, 10, Leaside Avenue, N.10. ,, F. J. Randall, 25, Muswell Avenue, N.10. ,, J. W. Shipp, 12, Berkeley Road, N.8. ,, L. J. Valette, 59, Allison Road, N.8. ,, W. V. Wall, 168, Stroud Green Road, N.4. ,, C. Winkley, 72, Woodside Avenue, N.10. 2 MATERNITY & CHILD WELFARE COMMITTEE as at 31st December, 1934. Councillor E. Brooks (Chairman), 122, Crouch Hill, N.8. The Mayor, Councillor W. J. Grimshaw, J.P., 25, Sheldon Avenue, N.6. Alderman P. Everington, 81, Mount View Road, N.4. ,, W. W. Kelland, M.A., 14, Hillside Mansions, N.6. ,, R. Steeds, 19, Coolhurst Road, N.8. Councillor Mrs. J. H. Barrenger, 20, Southwood Hall, N.6. ,, Mrs. C. M. Cave, 10, Wood Vale, N.10. ,, J. Edwards, 102, Turnpike Lane, N.8. ,, S. G. Goulding, Woodlands, Cranley Gardens, N.10. ,, Mrs. M. N. Hill, 16, Bishopswood Road, N.6. ,, G. K. M. Hutchinson, 8, Grosvenor Gardens, N.10. ,, B. G. Marriott, 5, Cholmeley Court, N.6. ,, J. W. Shipp, 12, Berkeley Road, N.8. ,, L. J. Valette, 59, Allison Road, N.8. ,, W. V. Wall, 168, Stroud Green Road, N.4. Selected Members: Mrs. L. J. Bond, 125, Mount View Road, N.4. Mrs. M. I. Dixey, 39, Stormont Road, N.6. Mrs. F. O. Dixon, 2, Woodside Avenue, N.6. Mrs. H.M. Inward, 99, Pemberton Road, N.4. Mrs. F. M. Merry, 20, Etheldene Avenue, N.10. Mrs. B. Walton, " Greenacre," The Green, Ealing, W.5, 3 STAFF OF PUBLIC HEALTH DEPARTMENT. *Medical Officer of Health R. P. Garrow, M.D., D.P.H †*Deputy Medical Officer of Health and Assistant Medical Officer of Schools and Maternity and Child Welfare Centres Jean Sutherland, M.B., Ch.B., D.P.H. ‡Assistant Medical Officer for Maternity and Child Welfare Jessie Muir, M.B., Ch.B. (Resigned July, 1934). Muriel Radford, M.B., B.Sc., D.P.H. {Consultants (Puerperal Fever and Pyrexia Regulations) Dr. J. B. Banister, 129, Harley Street, W.l. Dr. A. W. Bourne, 14, Devonshire Street, W.l. Dr. L. H. W. Williams, 70, Harley Street, W.l. {Dentists (M. & C.W. Dental Scheme) Dr. B. Hamilton, L.D.S., L.R.C.S., L.R.C.P. L. Rowlands, L.D.S. †*Senior Sanitary Inspector Henry Eastwood, M.R.San .1. M.S.I.A. Cert. R.San.I., Cert. Insp. of Meat and Poods. †*Sanitary Inspectors J. Goodman, Cert. R.San.I. J. H. Jesse, M.S.I.A. Cert. R.San.I„ Cert. Insp. of Meat and Poods. J. D. Chance, M.S.I.A. Cert. R.San.I., Cert. Insp. of Meat and Foods. A. E. GOODAY, M.S.I.A. Cert. R.San.I., Cert. Insp. of Meat and Foods. †Chief Clerk W. Gilroy. 4 †Assistant Clerks E. Cheesman, A. Wickham. N. Smith. (Appointed 27th August, 1934). d. Bryant (Temporary). (Resigned 31st August, 1934). †Health Visitors A. Glover, J. I. Macpherson, Dip. N.H.S.. H.V. Cert., C.M.B E. Dornford, H.V. Cert., C.M.B A. Godden, H.V. Cert.. C.M.B. F.R. H. Ross (part time). h.v. Cert., S.R.N., C.M.B. †Midwife M. Andrews, c.m.b. †(Mortuary Keeper C. F. Catlin. †Disinfectors W. H. Lewis. P. Hall. (Medical Services Motor Driver P. Martin. ‡Veterinary Inspector under Diseases of Animals Acts F. G. Buxton, M.R.C.V.S. Note:—†Whole time Officers. *Officers in respect of whom salary contribution is made under the Public Health Acts or by Exchequer Grants. ‡Part time Officers. 5 To the Mayor, Aldermen and Councillors of the Borough of Hornsey. Ladies and Gentlemen, I have the honour to submit my Annual Report on the Health of the Borough for the year ending December 31st, 1934. The vital statistics are highly satisfactory. The infant mortality rate is the lowest ever recorded in the Borough (37.9 infant deaths per 1,000 births), whilst the maternal mortality rate of 2.75 per 1,000 births is also low compared with 4.41 for the country as a whole. These figures reflect the favourable position of the Borough socially and economically and the efficiency of its social services. The Maternity and Child Welfare Committee received with great regret the resignation on account of ill-health of Dr. Jessie Muir, Medical Officer at the Centres since 1925. Her position has been filled by the appointment of Dr. Muriel Radford. I am, Ladies and Gentlemen, Your obedient servant, R. P. GARROW, Medical Officer of Health. 6 STATISTICS FOR 1934. (SECTION A.) Population—Change of Boundaries. The statistics of births, deaths and notifiable diseases supplied by the Registrar-General for the calendar year are composite figures combining the records for the first portion of the year prior to the change of boundaries which took place as from 1st April with those for the altered area for the remaining portion of the year. The Registrar-General's normal mid-1934 estimate of population for the Borough as now constituted is 95,271, but for use with the composite statistics, a working population figure, modified to take account of the fact that the records do not wholly relate to the entire year, is provided, viz., 95,306, on which figure the vital statistics are calculated. This figure is a decrease of 664 on the Registrar-General's estimate of last year, viz., 96,070. Social and Economic Statistics. Area (acres) 2,874 Population (Census 1931) 95,524 Do., Registrar-General's estimate (mid 1934) 95,306 Number of inhabited houses (end of 1934), according to Rate Books 21,794 Rateable value (General Rate) £1,018,750 Product of a penny rate £4,068 LIVE BIRTHS— Legitimate Males 525 ,, Females 499 Illegitimate Males 16 ,, Females 15 Total 1,055 Birth Rate 11.07 per 1,000 population (Registrar-General's estimate). 7 STILL-BIRTHS— Legitimate Males 18 ,, Females 16 Illegitimate Males — ,, Females 1 Total 35 Rate per 1,000 total (live and still) births, 32.1. DEATHS— Male 515 Female 599 Total 1.114 Death Rate 11.68 per 1,000 population (Registrar-General's estimate). Deaths from Puerperal Causes. Deaths. Rate per 1,000 total (live and still) births. England and Wales. Puerperal sepsis 2 1.9 1.95 Other puerperal causes 1 0.9 2.46 Total 3 2.75 4.41 Deaths of Infants under 1 Year of Age. Legitimate Males 22. Females 16 = 38 Illegitimate ,, 1, ,, 1= 2 Total 40 Death Rate of Infants under 1 Year of Age. All infants per 1,000 live births 37.91 Legitimate infants per 1,000 legitimate live births 36.0 Illegitimate infants per 1,000 illegitimate live births 64.5 Deaths from Measles (all ages) 5 Deaths from Whooping-Cough (all ages) 2 Deaths from Diarrhœa (under 2 years of age) 2 8 SPECIAL CAUSES OF SICKNESS. The area has not been visited during the year by any unusual causes of sickness or invalidity. Occupational disease or disability is practically never observed. Whilst there has been a good deal of unemployment in recent years, the health and physique of the population has not deteriorated. On the contrary—thanks to the efficacy of various agencies at work—there has been steady improvement in the average physical condition of the young population. GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. Under this heading the Minister of Health asks for an account of any developments or changes during the year in— 1.—(a) Laboratory Facilities. (b) Ambulance Facilities. (c) Nursing in the Home. (d) Clinics and Treatment Centres. 3.—(i) Midwifery and Maternity Services. (ii) Institutional Provision for Mothers and Children. (iii) Health Visitors. (iv) Infant Life Protection. (v) Orthopædic Treatment. These services are all fully organised, and no developments or changes have been found necessary. 9 LABORATORY FACILITIES. The specimens examined in the laboratory at the Isolation Hospital during 1934 were as follows: — Negative. Positive.  Diphtheria specimens 1,014 50 Sputum (T.B.) ,, 188 20 Enteric fever ,, 6 2 Other ,, 7 6 1,215 78 Total 1,293 AMBULANCE FACILITIES. The ambulance arrangements with the London County Council for the transport of infectious cases, and the Council's ambulance for street accidents and general ambulance services continue to be satisfactory and adequate. The "Morris Viceroy" motor conveyance, purchased in October, 1931, for the transport of mentally and physically defective children, travelled 11.029 miles and carried over 21,205 passengers. The following is a statement of the work done by the Borough Ambulance under the Fire Brigade: — Calls 1,054 Persons conveyed 1,051 Street illness and accidents 438 Other cases 616 Mileage 6,680 NURSING FACILITIES. HORNSEY NURSING ASSOCIATION. President—The Mayor of Hornsey. Honorary Secretary— Mr. R. H. Crookall, 9, Birchington Road, N.8. Honorary Treasurer— Mr. S. M. Mason, 50, North Hill, N.6. Superintendent-—Miss Ivett, 2, Ravenstone Road, N.8. Tele.: Mountview 6971. 10 The Hornsey Nursing Association, established eight years ago, in affiliation with the Queen's Institute of District Nursing, grows steadily in public esteem and usefulness, thanks to the untiring efforts of the Committee and its honorary officers, and the high standard of service provided by the nurses. During 1934 they paid 12,757 visits to 503 cases. This work represents an immense saving on Hospital and Nursing Home treatment, as many of the cases would certainly have to go to some institution if home nursing of the standard provided by the Nursing Association were not available. There is a staff of five trained nurses in addition to the Superintendent. The income is derived from— (1) Voluntary subscriptions and donations. (2) Provident contributions of members. (3) Patients' payments. (4) Public Authorities (for services rendered). The following is a statement of the infectious diseases nursed during the year bv the Queen's District Nurses: — name of disease. No. of New Cases. No. of Visits. No. Convalescent. No. sent to Hospital No. Died at Home Pneumonia 25 309 15 4 4 Tuberculosis 6 537 1 3 1 Influenza 11 100 8 1 1 Measles 5 38 5 — — Erysipelas 1 - — — — Pemphigus Neonatorum 1 40 1 — — Other diseases in children under 5 19 139 16 2 1 Elementary Sohool Children 32 237 32 — — A sum of 25 guineas is subscribed to the Association annually by the Council and £5 by the Education Committee for this service. HOME NURSING CLASSES, conducted by Miss Ivett, the Superintendent, at Hornsey High School, under the Higher Education Committee, continue to be a success. NURSING HOMES.—There are 27 Nursing Homes in the Borough registered with the Middlesex County Council under the Nursing Home3 Registration Act, 1927. Sixteen of these are registered for thp reception of maternity cases, with approximately 117 beds. 11 HORNSEY CENTRAL HOSPITAL.—The Hospital, which has 49 beds, treated 695 cases, of which 601 were Hornsey cases. 1,315 out-patients were also treated. The Council subscribe an annual sum of £200 to the Hospital funds. HORNSEY DEANERY ASSOCIATION.—A sum of £50 is subscribed annually by the Council to the Home for Unmarried Mothers in Eastern Road. SOCIAL AND ECONOMIC CONDITIONS IN THE AREA. The following is a list supplied by the Relieving Officer, Mr. R. Parry, of the amount disbursed from public and voluntary funds during 1934: — Summary. £ s. d. Public Assistance 23,237 8 7 National Health Insurance 968 17 6 War Pensions 448 6 0 Unemployment Benefit 7,161 9 3 Old Age Pensions 8,150 0 0 Widows' Pensions 1,645 0 0 Hornsey Y.M.C.A 47 0 0 Hornsey Y.W.C.A 500 Muswell Hill Girl Guides 100 Central Boot Fund 107 6 10 Ferme Park Carol Singers 17 10 0 School Care Committees 128 1 10 Hornsey Coal Eund (Charity) 125 4 10 Welfare Centres-—Milk supplied by Council 402 9 0 Hornsey Parochial Charities 562 2 0 Private Charity conducted by Mrs. James 12 0 0 Harringay Constitutional Club 4 10 0 United Services Fund 423 17 0 British Legion, Muswell Hill 60 5 3 United Services, Muswell Hill 30 0 0 Distress Fund 75 2 3 Private Fund (anonymous) 200 Mrs. Lovell Harrison's Special Fund 10 9 8 British Legion, Hornsey 696 8 0 Central Distress Committee, Hornsey 74 9 3 The Incorporated Soldiers' & Sailors' Help Society 133 3 8 £44,529 0 11 12 MIDWIFERY SERVICES. The Local Supervising Authority under the Midwives Act is the Middlesex County Council. There are 28 Midwives, including the Municipal Midwife, notified to the Middlesex County Council as practising in the Borough, 10 of whom reside outside the Borough. The Municipal Midwife attended 147 births, in addition to 79 ante-natal clinics held at the Welfare Centres—Brook Road, Wightman Road, Church Road, Highgate, and Coldfall Clinic. One of the conditions upon which the Council's Midwife accepts a case is that the expectant mother shall attend an ante-natal clinic. A reduction of her fee was made in 45 necessitous cases. 1,572 births have been attended by the Borough Midwife since the appointment was first made in 1922. MATERNITY AND CHILD WELFARE. The work of the Maternity and Child Welfare Department is organised round four centres in the Borough, particulars of which are set out in tabular form in this Report. At each of these centres the main objective or ideal constantly pursued is to give advice to the mothers of healthy infants how to keep them healthy and bring them up to school age strong, welldeveloped boys and girls. They are not in any sense treatment centres or centres for ailing infants and children. The advice given by the Medical Officers at the centres is followed up by advice given by the Health Visitors in the homes. An important feature of the work at the centres is the invaluable support of the voluntary workers, some of whom have given their services ever since the centres started. They, indeed, were the pioneers in starting the centres, and it must be a source of satisfaction to them specially to see from week to week the high standard of infant hygiene and nutrition attained. These good results are obtained by a majority of mothers, in spite of quite slender resources, and reflect great credit on the mothers themselves. 13 Sessions and Doctor. Centre. Conditions of Tenancy. District Served. Health Visitor. Ante-natal. Children. No. 1 Brook Road Mission Hall, opened in October, 1916 10 years' lease, from 29/9/26 Yearly rent £90 E.& W. Hornsey N. Haringey Crouch End Thursdays, 2-4 p.m. Dr. J. Sutherland 2nd and 4th Mondays, 2-4 p.m. (Dr. J. Sutherland) Wednesdays, 10-10 and 2-4 Thursdayd, 10-12 Dr. J, Muir Dr. M. Radford. Mrs. E. Durnford Miss A. Godden No. 2 22, Wightman Road, opened in September, 1918 Held under Lease for 99 years, from 22/9/88 Yearly ground rent £12 Lease Purchased by the Council on 24/1/18 Stroud Green Finsbury Park N.& S. Haringey 1st and 3rd Tuesdays, J. 2-4 Dr. J. Muir Dr. M. Radford 1st and 3rd Mondays (Dr. J. Sutherland) Tuesdays, 10-12 and 2-4 Dr. J. Muir Dr. M. Rasford Miss A. Glover No. 3 Mission Hall, Church Road, Highgate, opened in October, 1925 21 years' lease, from 24/6/25 Yearly rent £90 Highgate Muswell Hill 2nd Fridays, 10-12 Dr. J. Sutherland Fridays,2-4 (Dr. R.P. Garrow Miss J. Macpherson No. 3 Sub - Centre Coldfall School, opened in September, 1928 School Clinic Premises Council's Muswell Hill Housing Estate 4th Fridays, 10-12 Dr. J. Sutherland 1st and 3rd Fridays, 10-12 (Dr. J. Srtherland) Miss F. Ross (part-time) * Dr. Jessie Muir resigned in June and Dr. Radford succeeded her in September. 14 NOTIFICATION OF BIRTHS ACTS, 1907 & 1915. All live births and still births of seven months and over must be notified to the Medical Officer of Health within 36 hours, in addition to being registered within a period of six weeks after birth. The number of births notified under the Acts during 1934 was: — Male. Female. Total. Live births 626 590 1,216 Still births 16 19 35 642 609 1,251 The births were notified: — By Doctors 153 ,, Borough Midwife 126 ,, other Midwives 341 ,, Hospitals 139 ,, parents 28 ,, others 407 1,194 Unnotified (from Registrar's return): — Live births 54 Still births 3 57 1,251 Of this number there were:— Live births, stillbirths Occurring in the Borough and transferred to other districts 194 Belonging to Hornsey and occurring in Hospitals, etc., outside the district 428 17 16 The 1,054 nett number of notified births belonging to Hornsey were divided among the districts of the Centres as follows: — Brook Road 538 Wightman Road 257 Highgate 234 Coldfall Sub-Centre 25 1,054 DENTAL CLINIC. The following is a record for the year of the Dental Clinic for Mothers and Children which was started in 1928: — Mothers. Children. Clinics held 45 25 Old cases 172 112 New cases 51 80 Finished cases 27 38 Total attendances 223 192 Attendances for dentures 67 - Gas cases - 48 Teeth extracted - 92 Fillings done - 7 Dentures provided 13 - Inspections 31 35 Other treatments (dressings, scaling, gum treatment, etc.) 23 63 MILK (MOTHERS AND CHILDREN) ORDERS. One thousand and twenty-nine applications for milk under this Order were dealt with during the year, of which 1,012 were granted and 17 refused, as follows: — 1 pint milk daily free 881 2 pints ,, ,, ,, 84 1 pint ,, ,, half-price 14 1 lb. dried milk weekly free 27 2 lbs. „ ,, „ 6 Not granted 17 1,029 16 The number last year was 1,129. The total of the accounts paid to 31st December amounted to £391 16s. 3d. The cost per pint is 3d. from April to September and 3½d. from October to March, from which price a discount of 5 per cent, is deducted. VOLUNTARY COMMITTEES. The voluntary workers continue to do invaluable work, for which I have no doubt they feel amply rewarded by the large numbers of healthy infants and happy mothers whose acquaintance they make at the Centres. TODDLERS' PLAYROOM. The Toddlers' Playroom, started in November, 1931, and conducted at no expense to the Council by Miss Benn at the Highgate Centre, continues to be a success. The Playroom is open each morning from Monday to Friday and the maximum attendance is 19. There are 27 between the ages of 2 and 5 on the rolls and the total attendances made during the year was 3,870. MATERNAL MORTALITY. During the year under review much has been said and written on "Maternal Mortality and Morbidity," i.e., the deaths and disabilities of mothers resulting directly or indirectly from childbirth. The subject has been freely discussed in medical and lay papers and on public platforms. So far as I have observed, no new truth has emerged. There is a constant insistence, now becoming somewhat monotonous, that maternal mortality is terribly and unnecessarily high, and shows no sign of reduction. Circular 1,433, dated October 10th, 1934, from the Ministry of Health, addressed to Maternity and Child Welfare Authorities, calls attention to Circular 1,167 of 11th November, 1930, and the accompanying Memorandum 156/M.C.W. on the subject of Maternal Mortality. 17 Although the maternal mortality figure for Hornsey is not high (it is less than 3 per 1,000 births for 1934, and therefore lower than the average for the country as a whole), nevertheless careful consideration has been given to these circulars and the memorandum. The expectant mother in Homsey has open to her a number of ways in which she may provide for medical and other services necessary to safeguard her health during the expectant period and at her confinement. (1) She may consult her private doctor, whose duty it is to advise her on all matters relating to her health, and assist her in obtaining a nurse or midwife or consultant if there is any difficulty anticipated. When the mother is too poor to pay for a consultant, and yet does not wish to go to Hospital, the Council provide a consultant at the request of the doctor. (2) She may decide to employ a midwife for her confinement. If any difficulty arises, it is the midwife's duty to call in a doctor, whose fee is paid by the County Council. (3) She may attend one of the Council's Ante-natal Clinics, where advice is given and arrangements can be made for the confinement to be conducted by the Municipal Midwife or in Hospital. (4) She may make her own arrangements for ante-natal care and confinement and post-natal care at one of the Maternity Hospitals of the Metropolis, or in the Maternity Department of one of the General Hospitals. Whatever method she chooses, there is available for her every known method of ante-natal, obstetric and post-natal examination, and all the services ancillary to the obstetric art. No maternal death or disability in Hornsey can be attributed to failure on the part of the various agencies, voluntary and official, to provide the necessary services. 18 INFANT LIFE PROTECTION. CHILDREN ACT, 1908, AND CHILDREN AND YOUNG PERSONS ACT. 1932. The work under these Acts is carried out by the Health Visitors in their respective areas. Foster-mothers are encouraged to bring the children to the centres for periodical medical examination. A register of foster-mothers and foster-children is kept by the Medical Officer of Health and at each Centre. The following is a summary of the Register: — Centre— No. 3. No. 1. No. 2. & Sub. Total No. of foster-mothers on the register— At the beginning of 1934 20 8 10 38 „ ,,, end ,, „ 15 10 14 39 No. of foster-children on the register— At the beginning of 1934 18 9 27 594 ;; ,, end „ 20 8 36 64 Died during the year - - 1 1 On whom inquests were held during the year - - - Visits to foster-children— 1st Visits 9 12 20 41 Total Visits 150 117 186 418 5 No proceedings were taken during the year. ORTHOPÆDIC TREATMENT. A joint (Maternity and Child Welfare and Education Committees) scheme for the early diagnosis and treatment and prevention of crippling conditions in children from birth to schoolleaving age has been in operation for about five years, and is giving highly satisfactory results at relatively small cost. The local centre of this scheme is at the School Clinic, and hospital cases are admitted to the country branch of the Roval National Orthopaedic Hospital at Stanmore. 19 The surgeon attends monthly and the masseuse three times weekly for the treatment of elementary school children and children under five. The following are the statistics for the year: — Surgeon. Masseuse. Sessions held 10 131 Children treated 90 337 ,, attendances 102 390 The cost, which is divided proportionately between the Education and Maternity and Child Welfare Committees, was £28 13s. 1d. for the treatment of children under five years. SANITARY CIRCUMSTANCES OF THE AREA. The Minister of Health requires information on extensions or developments regarding— (1) Water supply. (2) Drainage and sewerage. (3) Rivers and streams—Prevention of pollution. (4) Closet accommodation. (5) Public cleansing. (6) Sanitary inspection of the area. (7) Smoke abatement. (8) Schools. All these essential services are fully developed and maintained at the highest possible level of efficiency. HOUSING. The five-year programme initiated in 1930 for the closing and demolition of houses unfit for habitation and the re-housing of their occupants in modern flats has been carried out steadily and is nearing completion. The Borough is now practically in the position of having no unfit houses in use as dwellings. The steps by which this position has been attained are set out below: — 20 SITE. Number of Unfit Houses. Date of Demolition. Development of Site " Churchyard Bottom " or Woodside Cottages 9 1930 18 Council flats built re-named " Summersby Rd." " Ward's Cottages," North Hill 16 1932 21 Council flats built re-named "Rowlands Close " North Road Cottages, Highgate 21 1933 24 Council flats built re-named " Grimshaw Close " 15, 17 & 17a, North Hill 3 1933 1 Private Development block of 14 flats built in 1934, named " North Hill Court " 1 and 2 " Pickering Cottaces," at rear of above 2 1934 1 and 3, Rose Cottages, Fortis Green 2 1933 nil. St. James' Lane 26 1934 27 Council flats now in course of erection Turnpike Lane 4 1934 33 Council flats built and named " Goulding Court Colney Hatch Lane 4 1934 —35 To be developed privately Tottenham Lane 15 1935 Road widening and private development North Hill " Bartholomew Terrace " 4 1935 Private development in flats Highgate Village " Townsend's Yard " 9 1935 Private development Highgate Village " Kent's Cottages " 6 Closed, but not yet demolished " Lavender Cottages " off Park Road, Crouch End, N.8 5 Closed, but not yet demolished " Aldbury " " Maismore " " Laurelhurst " St. James Lane, Muswell Hill 6 Closed, but not yet demolished To be developed in connection with an adjoining factory 21 HOUSING REPAIRS AND OVERCROWDING. The care of tit houses by the early detection and repair of defects, and the prevention and alleviation of overcrowding, are important aspects of housing which have received the unremitting attention of the Health Committee and Department throughout the year. Cases of ovnrcrowding are relieved whenever suitable accommodation can he found or when rearrangement of rooms or families is practicable. Whilst new cases of overcrowding are found from time to time, it must be remembered that these arc few in number in relation to the 20,000 and more inhabited houses in the Borough. Thus T think it can be fairly claimed that in Hornsey the provision of homes, the social service upon which the success of all other social services must depend, is sound and satisfactory. HORNSEY HOUSING TRUST. I desire to acknowledge the good and growing work of the Hornsey Housing Trust, Ltd., in providing accommodation in the case of families not eligible for Council houses and unable to fitul suitable accommodation privately. OVERCROWDING. During the year 24 fresh cases of overcrowding have been found and 31 cases abated. There were 33 known cases of overcrowding existing in the Borough at the end of the year. The following is a statement of overcrowding conditions extending over a period of five years: — Cases found 154 ,, abated 121 ,, unabated 33 Visits paid 937 22 Re-Housing. — The Borough Engineer informs me that during the year 108 families, representing 463 persons, have been re-housed: — Families. Persons. St. James's Lane 13 49 Townsend's Yard 9 33 Kent's Cottages 5 14 High Street, Hornsey 5 24 Hampden Road 3 13 Birkbeck Road 3 12 Nightingale Lane 3 13 North Hill 3 17 Rathcoole Gardens 3 13 Newlands Road 3 12 Steeds Road 3 17 Hill Road 3 14 South View Road 3 16 Tottenham Lane 2 12 Everington Road 2 13 Summersby Road 2 9 North View Road 2 6 Bovton Road 2 8 Rectory Road 2 8 Clarendon Road 2 7 Holmesdale Road 2 6 Archway Road 2 8 Park Road 2 9 Onslow Gardens 1 5 Muswell Avenue 1 4 Page's Lane 1 5 Muswell Hill Place 1 2 Bishopswood Road 1 4 Priory Road 1 3 St. Mary's Road 1 5 Holland Road 1 6 Grove House Road 1 5 Linzee Road 1 3 Lightfoot Road 1 9 Haringey Grove 1 4 23 Families. Persons. The Grove 1 5 Upper Tollington Park 1 4 Ferme Park Road 1 3 Denton Road 1 5 Uplands Road 1 5 Canon Road 1 4 Woodstock Road 1 4 Turnpike Lane 1 2 Oampsbourne Road 1 3 Myddelton Road 1 7 Inderwick Road 1 4 Spencer Road 1 4 Hanbury Road 1 4 Barrenger Road 1 4 Marriott Road 1 6 Beechwood Road 1 7 Storey Road 1 4 HOUSING STATISTICS. The housing statistics of the year as required by the Ministry of Health are set out below: — 1. Inspection of Dwelling-houses during the Year: — (1) (a) Total number of dwelling-houses spected for housing defects (under Public Health or Housing Acts) 2,064 (b) Number of inspections made for the purpose 7,783 (2) (a) Number of dwelling-houses (included under sub-bend (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 345 (b) Number of inspections made for the purpose 2,067 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation — 24 (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 1,384 2. Remedy of Dcfects during the Year without service of formal Notices: — Number of defective dwelling-houses rendered fit in consequence of informal action bv the Local Authority or their officers 1,088 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 — (2) Number of dwelling-houses which were dered fit after service of formal notices: — (a) By owners — (h) By local authority in default of owners — B.—Proceedings under Public Health Acts: (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 53 (2) Number of dwelling-houses in which defects were remedied after service of formal notices: — (a) By owners 53 (b) By local authority in default of owners - 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 - (2) Number of dwelling-houses demolished in pursuance of Demolition Orders - 25 P.—Proceedings under section 20 of the Housing Act, 1930: (1) Number of separate tenements or ground rooms in respect of which Closing Orders were made 1 (2) Number of separate tenements or ground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit 1 HOUSE-TO-HOUSE INSPECTIONS. Ward. Road. Highgate South wood Lane 7 Muswell Hill Road 5 Crouch End Alexandra Gardens 13 Stroud Green Crouch End Hill 32 East Hornsey Haringev Road 57 West Hornsey Myddelton Road 59 Brook Road 35 The Campsbourne 21 South Haringey Coningsby Road 11 Lothair Road 78 Venetia Road 16 Tancred Road 11 345 The following statement of the work of the Sanitary Inspectors has been prepared by Mr. Henry Eastwood, Chief Sanitary Inspector: — The visits made, the notices served and the sanitary improvements carried out are recorded in the following tables: — Visits. House-to-house inspections 345 Special inspections 1,335 Re-inspections 9,230 Transfer to Council houses 2 Notifiable infections diseases 331 Tuberculosis 51 Deaths 71 26 Verminous houses 146 Shops Acts 868 Factories, workshops and outworkers 525 Rent Restriction Act 3 Cinemas, etc. 11 Overcrowding 148 Petroleum stores 257 Rag Flock Act 4 Dairies and milkshops 44 Bakehouses 48 Slaughter-houses 124 Butchers' shops 51 Restaurant kitchens 39 Other food shops 342 Annual licences (Music and Dancing) 39 Stables 58 Piggeries 6 Conveniences 21 Smoke observations 20 Refuse tips 67 Passages 96 Allotments 8 Drainage 79 Drainage Fee tests 2 Water tests applied (new drains) 35 Smoke and chemical tests applied (old drains) 30 Drains examined under Sec. 41, Public Health Act, 1875 11 Small-pox Contacts—Visits 42 14,489 SUMMARY OF SANITARY IMPROVEMENTS CARRIED OUT. Drainage. Number of houses and premises redrained 22 Repairs or amendments to existing drains 144 Drains or gullies unstopped or cleansed 63 27 Manholes provided 33 do. repaired 31 Intercepting traps fixed 22 New gulley traps fixed 113 New soil pipes and ventilating shafts fixed 48 Soil pipes and ventilating shafts repaired 60 Fresh-air inlets provided or repaired 73 Water-Closets and Sanitary Fittings. New water-closet basins fixed 220 Water-closets unstopped, cleansed or repaired 40 New check cisterns fitted to water-closets; existing check cisterns repaired 126 New sinks provided 175 New lavatory basins provided 97 New waste-pipes fixed 260 Waste-pipes trapped, repaired or unstopped 392 Urinals repaired or renewed 6 Miscellaneous. Roofs repaired 187 Eaves guttering renewed, cleansed or repaired 91 Rain-water pipes provided, repaired or unstopped 101 do. disconnected from drains 8 Damp walls remedied 138 Damp-proof courses inserted 30 Paving of yards repaired 118 Premises structurally repaired 1,088 Rooms cleansed, distempered or papered 674 Rooms disinfested of vermin 234 Work-rooms cleansed or repaired 28 Drinking-water cisterns repaired, cleansed and covered 78 Water supply reinstated 2 do. (additional) provided 21 Baths provided or made usable 56 Windows and skylights provided or made usable 107 Floors repaired 163 Window sills repaired 83 Sash cords and fittings repaired 123 Sanitary dustbins provided 200 28 Accumulations of manure and refuse removed 37 Stoves, ranges and coppers repaired or renewed 206 Sundry items 395 Food stores provided 78 Overcrowding abated 31 6,202 PREMISES INSPECTED PERIODICALLY. The following premises were inspected periodically during the year and any matters requiring attention were dealt with: — No. in District. Dairies and milkshops 36 Milk purveyors in connection with other businesses 64 Bakehouses 27 Catering trades 58 Slaughter-houses 6 Butchers' shops 53 Fish shops 24 Factories, workshops and work-places 307 Outworkers' premises 152 Cinemas 7 Places of public entertainment 32 Shoots (refuse) 2 Overcrowded houses 33 Licensed petroleum stores 83 884 BYELAWS RELATING TO HOUSES INTENDED OR USED FOR OCCUPATION BY THE WORKING CLASSES AND LET IN LODGINGS OR OCCUPIED BY MEMBERS OF MORE THAN ONE FAMILY. These Byelaws were made on 24th March, 1930, and cmfirmed on 13th May, 1930. They do not apply to any lodging' house in which the owner resides and not more than one family is lodged. Parts of these byelaws, involving structural alterations, do not apply to any lodging-house the rent of which is for 29 the time being controlled by the Rent and Mortgage (Restrictions) Acts, 1920, 1923 and 1933. The number on the register at present arc classified as follows: — Decontrolled lodging-houses 232 Partly controlled 40 Fully controlled 84 Total 356 Seventy-seven houses have been dealt with under these Byelaws during the year and the following works carried out: — Byelaw. 11 (b) Means of carrying off waste water (including provision of sinks) 24 11 (f) Sash-cords and window fittings 8 15 (a) Closet accommodation 6 15 (b) Water supplies 21 15 (c) Washing accommodation 19 15 (d) Food stores 78 15 (e) Preparation and cooking of food 1 17 Artificial lighting 4 22 Handrails 1 162 Note.—In regard to washing accommodation, Byelaw 15 (c), the baths and wash-houses erected by the Borough Council in High Street, Hornsey, opened on the 14th April, 1932, and extended during last year by additional slipper baths and washhouse accommodation, are very popular and are satisfying a long-felt want, particularly in the immediate neighbourhood. DISINFECTION AND DISINFEST AT I ON. Number of rooms fumigated after notifiable infectious disease 417 „ „ „ „ non „ ,, „ 213 „ „ „ „ T.B. 77 „ articles disinfected 6,941 „ ,, destroyed 185 „ verminous rooms disinfested 234 30 CLEANSING STATION.—Three adults and 5 children have been treated at the cleansing station for various reasons. There were also 4 adults and 5 children from Wood Green treated, at an agreed charge per treatment. The following work has been carried out by the disinfecting staff during the year: — Disinfection of rooms and removal of bedding for treatment at station 941 On account of vermin, etc.: — Disinfestations (premises) 146 Spraying for cockroaches (5), wasps' nests (1), silverfish (2), ants (5), dogs distemper (1) 14 Posting bills re Dog Nuisance in different parts of the Borough 280 Collecting .and disinfecting library books: — Received Returned Destroyed Publio Libraries 212 191 — School Libraries 48 35 7 Private Libraries 56 21 35 Drain tests and conveyance of drain-testing appliances 56 Visits in connection with Welfare Centres 97 Mileage run. Green van 3,253 Blue van 3,110 INSPECTION AND SUPERVISION OF FOOD. The inspection of food and supervision of places where food is prepared and sold was carried out by the Sanitary Inspectors throughout the year. In spite of a warm, dry summer in 1934, no outbreak of food poisoning occurred, and, indeed, the food supply is now generally so wholesome and free from contamination. and the methods of handling so good, that disease or infection resulting from the ingestion of food is a rare occurrence. 31 Dairies and Milksitops. Every dairyman or purveyor of milk must be registered with the Sanitary Authority of the district in which his dairy premises are situated; if he retails milk in the district of another Sanitary Authority he must also be registered with that Authority. At the end of the year the register showed 63 classed as dairies and 64 classed as milkshops the principal trade of which is not dairy produce. Of the dairies. 27 are situated outside and operate also inside the Borough. The dairies and milkshops have been inspected periodically and a high standard of cleanliness has been found to exist. These inspections have been amplified by the taking of 12 informal samples for bacteriological examination during the year. There are no cowsheds in the Borough. Special Designated Milks. Producers of, and dealers in, special designated milk are required to obtain licences annually. During the year licences were granted as follows: — Pasteurising and sale of Pasteurised Milk 1 Sale of Pasteurised Milk 16 Sale of Pasteurised Milk (Supplementary) 2 Sale of Certified Milk 3 Sale of Grade "A" (T.T.) Milk 4 Sale of Grade "A" (T.T.) Milk (Supplementary) 1 Sale of Grade "A" Milk 4 Sale of Grade "A" (Pasteurised) Milk 1 Meat and Other Foods. Under the Public Health (Meat) .Regulations, 1924, notice of intention to slaughter animals lias to be sent by the butchers to the Medical Officer of Health. In this way the Inspectors are enabled to examine the carcase and organs of every animal killed for human consumption. During the year the carcases and meat offal of 626 animals have been inspected under the Regulations. Meat offal weighing •n all 119 lbs. 4 ozs. was condemned, surrendered and destroyed !n the Council's incinerator. 32 Statistics of Slaughtering, 1926-1934. Year Beasts. Sheep. Swine Calves. Total. 1926 195 2,843 27 0 3,065 1927 144 2,374 21 16 2,555 1928 58 1,526 0 1 1,585 1929 21 1,303 0 1 1,325 1930 4 1,024 0 0 1,028 1931 4 741 34 0 779 1932 73 1,930 0 30 2,033 1933 3 842 0 0 845 1934 2 624 0 0 626 There are six licensed slaughter-houses in the Borough. The Byelaws relating to slaughter-houses were revised in November, 1930, and the use of a " mechanical killer " made compulsory in the slaughter of any bull, ox, cow or heifer. All the butchers in the Borough on whose premises slaughtering takes place have undertaken to use the mechanical stunner for all animals. In these circumstances it was not considered necessary to make any alteration in the Byelaws. The Slaughter of Animals Act. 1933, which supersedes the Council's byelaw as to slaughtering of larger animals, also requires the holding of a licence to slaughter and stun animals in slaughter-houses. Seven persons have been so licensed, and the licences remain in force for a period of three years to 31st December, 1936. Articles of food brought from the London markets and found to be unsound on arrival at their destination are submitted for examination, condemned, surrendered and destroyed, and a " condemnment " note is given, which enables the dealer to obtain credit from the wholesaler. This arrangement is quite good and results in prompt notification. The following was condemned and destroyed: — Green peas 2 pecks Cherries 2 quarters (56 lbs.) Asparagus 72 bundles Cooked ham 18 lbs. 8 ozs, 33 All diseased meat and food is destroyed at the Council's incinerator. FOOD ADULTERATION. Mr. R. Robinson, Chief Officer of the Public Control Department of the Middlesex County Council, has kindly supplied me with the following information regarding samples of food taken during the year in the Borough: — Article. Samples. Adulterated. Milk 213 1 ,, Sterilised 2 — Butter 12 — Minced beef 7 — Cream pastry 6 1 Hake 5 3 Lemon sole 5 1 Whisky 5 1 Gin 1 — 256 7 SHOPS ACTS. Eight hundred and sixty-eight visits have been paid to shops during the year, and, apart from a number of minor infringements, which were dealt with, the provisions of the Shops Acts, 1912-1928, have, generally speaking, been well observed. No legal action has been necessary. There are 1,325 shops in the Borough engaged in the following trades: — Grocers 126 Confectioners 108 Drapers, Costumiers, Ladies' Outfitters, etc. 85 Boots 73 Greengrocers 70 Restaurant Kitchens, Tea-rooms and Coffee-bars 70 Hairdressers and Barbers 57 Stationers and Newsagents 56 Butchers 54 Tobacconists 52 34 Off-licences 40 Dairies and Milkshops 29 Public-houses 37 Bakers 33 Coal Merchants 31 Gas and Electrical Fittings and Wireless 37 Tailors and Men's Outfitters 30 Furniture and Upholsterers 36 Chemists 28 Fishmongers 24 Oil and Colour Shops, General and Domestic Stores 26 Watches and Jewellery 16 Milliners 15 Ironmongery and Hardware 18 Florists 14 Builders and Decorators 10 Cycles and Motor Bepairs 14 Cooked Meats 10 Hosiers 7 Saddlers and Leather Goods 9 Booksellers and Libraries 9 Photographers 7 Pianos and Music 7 Corn chandlers 7 Timber Merchants 6 Wardrobe Dealers and Dress Agencies 5 Carpets and Lino 6 Clothes Pressing, Cleaning and Bepairing 4 Picture Frames 4 Art Needlework and Wool 7 Bazaars 4 Antique Shops 4 Umbrellas 4 Toys 3 Opticians 5 Furriers 3 Blinds 2 Sewing Machines 2 35 Pawnbrokers 1 Baby Carriages 1 Corsets 1 Herbalist 1 Basket Ware 1 Cutlery 1 China and Glass 1 Cork Goods 1 Builders' Merchants 3 Eggs and Jams 1 Animal Pets 1 Stamps and Albums 1 Funeral Furnishers 1 Sports Dealers 2 Arts and Crafts 1 Knitted Goods 1 Fishing tackle 1 Salvage and job stores 1 1,325 Hairdressers' and Barbers' Shops (Sunday Closing) Act, 1930. This Act came into operation on the 1st day of January, 1931, and provides for the compulsory closing of hairdressers' and barbers' shops on Sundays. No infringement of this Act has been observed during the year. H. EASTWOOD, Chief Sanitary Inspector. PETROLEUM INSPECTOR'S REPORT. The following is a Report of the Petroleum Inspector for the year 1934 : — PETROLEUM ACTS, ETC. Since the coming into force of the Petroleum (Consolidation) Act, 1928, which defined Petroleum Spirit as " Petroleum, which when tested in a prescribed manner gives off an inflammable 36 vapour at a temperature of less than 73 deg. Fahrenheit," there have been a number of fresh Regulations and Orders, namely: — Petroleum Spirit (Motor Vehicles, etc.) Regulations of 1929. Petroleum (Carbide of Calcium) Order of 1929. Petroleum Spirit (Conveyance) Regulations of 1932, Cellulose Solutions Regulations of 1932. It was felt advisable in the circumstances to revise and bring up to date the conditions attached to the Licences affecting premises and also persons engaged in the handling of Petroleum Spirit. This was done and the amended and amplified conditions were allowed by the Committee and issued with the fresh licences in November of this year. The quantity of petroleum stored under licence, apart from quantities stored under proper conditions which do not necessitate a licence, has now reached the enormous total of 100,474 gallons. 96,620 gallons is stored in underground steel tanks and 3,854 gallons kept in properly sealed two-gallon cans. The total number of licences issued is 83. Hydro-Carbon. There is one licence issued for the storage of 100 gallons of hydro-carbon. Naphtha. There is one licence issued for the storage of 2,000 gallons of naphtha. Cellulose Spirit. Two premises are licensed solely for the storage of cellulose spirit and the total quantity kept on these premises is 50 gallons. One item of importance during the year has been the installation of a Benzol plant at the Hornsey Gas Company b works. The storage accommodation for this is 10,000 gallons and for Naphthalene 2,000 gallons. The co-operation of the Fire Brigade Superintendents of Wood Green and Hornsey was obtained in the provision of suitable and efficient fire-extinguishing apparatus at certain points 37 of the plant and the result has proved satisfactory to all concerned. especially when it is borne in mind that, the readiest access in case of fire would be from the Wood Green entrance. I have this year been accompanied by the Fire Brigade Superintendent when visiting the petrol stations, and he has personally tested the fire-extinguishing apparatus. This combined visit had for its object the perfecting, as far as possible, of conditions to ensure safety, and has been beneficial to both officers and in the best interests of the Council. Carbide of Calcium. There is one premises licensed for the storage of Carbide of Calcium and the quantity stored under licence is 10 cwts. Horticultural Poisons. There are two licences in force for the sale of horticultural poisons under the Poisons and Pharmacy Act. The premises licensed were inspected from time to time and contraventions of the conditions attached to the licences dealt with. Plans relating to new petrol installations have been submitted to the Committee for their approval. The construction of new installations has been carefully supervised and. tanks and pipe lines for bulk storage installations tested. H. EASTWOOD, Petroleum Inspector. PREVALENCE OF, AND CONTROL OVER, INFECTIOUS DISEASE. Nothing of an unusual or unexpected nature has occurred during the year in regard to infectious diseases. The common infections have all been with us, but not one of them has assumed any special virulence in type or has spread so as to exceed the usual normal limits of numbers. There appears to be a general tendency towards fewer serious complications in diphtheria, scarlet fever, measles, whooping-cough, etc., and this I believe t° be due to the improved nutrition and physical development of the young population. We appear to be making some progress 38 towards what I believe to be the happiest solution of the infectious disease problem as a whole, namely, " salting without sequeke" —a state of affairs in which strong, healthy, robust children take the common infectious diseases to which they are susceptible and recover without any damaging sequelae. DIPHTHERIA IMMUNISATION. The question of starting a campaign to secure protection of the young population from diphtheria by artificial immunisation has been carefully considered by the Health Committee. The prospect of securing a response big enough to result in protection of the community was not considered favourable. It was decided to provide facilities for artificial immunisation at the School Clinics for those who wish it and are unable to pay for this service privately. From information received from doctors in practice a certain number of children are being done by their family doctors. VACCINATION. The Public Vaccinators inform me that they have performed vaccination of persons in the Borough during 1934 as follows: — Dr. E. Buckler 102 Dr. T. E. Pearman (3 months) 49 Dr. R. Anderson (9 months) 184 Dr. Pearman retired from the position of Public Vaccinator at the end of March and was succeeded by Dr. Roy Anderson. PREVENTION OF BLINDNESS. (SECTION 66, PUBLIC HEALTH ACT, 1925.) All cases of ophthalmia neonatorum likely to cause blindness or permanent damage to the eyes are admitted to St. Margaret s Hospital (Kentish Town) of the London County Council, where they receive the most efficient treatment. The doctors in practice and the midwives all know of this excellent arrangement and the result is that year after year we have a record of no blindness resulting from this dangerous infection. 39 Ten cases of ophthalmia neonatorum were notified. Nine were treated in St. Margaret's (L.C.C.) Hospital and one was nursed at home. Cases Notified. Treated Vision unimpaired. Vision impaired. Total blindness. Deaths. At home. In hospital or nursing home. 10 1 1 9 10 0 0 0 TUBERCULOSIS. PUBLIC HEALTH (PREVENTION OF TUBERCULOSIS) REGULATIONS, 1925, AND SECTION 62, PUBLIC HEALTH ACT, 1925. No occasion has arisen in the course of the year to put these powers into action. Sanatorium provision for all forms of Tuberculosis in Hornsev is .made bv the Middlesex County Council. There are 543 beds available solely for Middlesex under the Middlesex County Council scheme for the treatment of Tuberculosis in sanatoria, allotted as follows:— Accommodation. TYPE OF CASE. Adults Child'n M. F. County Sanatorium, Harefield 129 129 56 Pulmonary—Sanatorium 8 ,, —observation 2 2 County Sanatorium, Clare Hall, South Mimtns 120 66 - ,, late sanatorium and hospital Heatherwood Hospital, Ascot - - 25 Non-pulmonary Victoria Home, Margate — — 6 „ 40 A number of Tuberculosis patients were maintained by the County Council in other institutions approved by the Ministry of Health. The total number of cases on the Tuberculosis Register at the end of 1934 was 738, viz., pulmonary 5.58, non-pulmonary 180, an increase of 20 on the total for last year. Dr. Dobson, the Middlesex Tuberculosis Officer for Hornsev, has kindly supplied the following particulars of Hornsey eases of Tuberculosis on his Register; — New Tubercular cases 93 Transfers into district not included in above 21 New Non-tubercular cases, including contacts 102 Tubercular cases on Dispensary Register 367 Cases undiagnosed at end of year 1 Tubercular cases on Register at 31st Dec., 1934 260 MORTUARY. Seventy-five bodies were received at the .mortuary and inquests held on 25 of them. DISEASES OF ANIMALS ACT. Mr. F. G. Buxton, the Veterinary Inspector, reports that during the year he inspected 17 pigs and issued removal licences in respect of 54 pigs and 2 pigeons. No action was necessary under the Tuberculosis Order, 1925. 41 LIST OF TABLES. TABLE A.—Vital Statistics, 1911-34. TABLE B.—Causes of, and ages at, death in 1934. TABLE C.—Summary of causes of death, 1931-1933. TABLE D.—Infant Mortality in 1934. Causes of, and ages at, death. TABLE E.—Births, Deaths, Infant Deaths, and Deaths from certain diseases, 1901-1934. TABLE F.—Cases of Infectious Disease notified in 1934. TABLE G.—Cases of Infectious Disease notified, 1911-1934. TABLE H.—(1) Notification of, and deaths from, Tuberculosis, 1934. „ (2) Tuberculosis Register, 1934. TABLE I.—Work done at the Maternity and Child Welfare Centres and by Municipal Midwife, 1934. TABLE J.—Inspection of Factories, Outworkers, etc., 1934. 42 TABLE A. BOROUGH OF HORNSEY VITAL STATISTICS, 1911-1934. Year. Estimated Mid-Year Population. Birth Rate per 1,000 Population. Death Hate per 1,000 Population. Infant Mortality per 1,000 live Births. 1911 84,592 (Census). 17.5 9.6 78 1912 84,840 16.3 9.9 75 1913 85,122 16.7 9.7 56 1914 85,456 17.8 9.2 57 1915 85,800 15.5 12.2 80 1916 86,147 16.0 11.5 46 1917 86,450 11.3 10.9 70 1918 86,942 11.7 13.8 61 1919 87,100 13.6 11.4 64 1920 87,410 19.3 10.3 54 1921 87,691 (Census). 16.7 11.0 49 1922 88,007 15.4 11.2 54 1923 88,325 14.4 10.5 51 1924 88,661 13.4 10.4 41 1925 89,064 13.6 10.6 43.6 1926 89,850 13.4 10.3 47.2 1927 90,000 13.3 11.2 38.3 1928 90,250 12.1 12.1 61.3 1929 90,500 Regr.-Gen.'s Estimate. 88,450 13.8 12.7 54.05 1930 88,450 13.7 11.8 41-35 1931 Census. 95,524 11.9 11.2 52.6 1932 Regr.-Gen.'s Estimate 96,990 11.37 11.45 46.2 1933 96,070 10.85 12.2 43.2 1934 95,306 11.07 11.68 37.91 ENGLAND and WALES (Rates in 1934) 14.8 11.8 59 121 County Borough and Great Towns, including London . (Rates in 1934) 14.7 11.8 63 135 Smaller Towns Populations 25,000 to 50,000 (Rates in 1934) 15.0 11.3 53 London (Rates in 1934) 13.2 11.9 67 43 TABLE B:- CAUSES OF, AND AGES AT, DEATH, 1934 (NEW CLASSIFICATION). Total. All ages. 0—1 1—2 2—5 5—15 15—25 25—35 35—45 45—55 S5 —65 65—75 76 & over 1 M F M F M F M F M F M F M F M F M F M F M F M F 1. Typhoid and paratyphoid fevers ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 2. Measles 5 1 4 1 ... ... 2 ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 2 3.Scarlet Fever 2 1 1 ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 4.Whooping cough 2 1 1 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 5.Diphtheria 4 2 2 ... ... ... ... 1 ... 1 2 ... ... ... ... ... ... ... ... ... ... ... ... ... 5 6. Influenza 8 5 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 ... 1 1 ... 2 ... ... 6 7. Encephalitis lethargica 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 7 8. Cerebro-spiual fever 1 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ...... ... ... ... ... ... ... 8 9. Tuberculosis of respiratory system 59 27 32 ... ... ... ... ... ... 1 ... 5 ... 3 8 5 5 7 5 3 3 3 ... ... ... 9 10. Other tuberculous diseases 7 7 ... ... ... ... ... 1 ... ... ... 2 ... 1 ... 1 ... ... ... ... ... 2 ... ... ... 10 11. Syphilis 1 ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 11 12. General paralysis of the insane, tabes dorsalis 6 6 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... ... ... 1 ... ... ... 12 13. Cancer, malignant disease 176 64 112 ... ... ... ... ... ... ... ... ... ... ... 4 ... 5 4 15 24 33 18 27 12 28 13 14. Diabetes 13 6 7 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 5 3 ... 3 14 15. Cerebral hsBmorrhage, etc. 58 23 35 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 5 4 7 5 8 9 15 15 16. Heart disease 285 111 174 ... ... ... ... ... ... l ... 2 ... ... 3 ... 1 10 7 18 24 35 63 43 75 lfi 17. Aneurysm 3 ... 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 2 ... ... 17 18. Other circulatory diseases 74 31 43 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 ... 4 8 9 8 13 27 18 19. Bronchitis 30 14 16 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 3 3 3 6 7 7 19 20. Pneumonia (all forms ) 73 34 39 3 1 2 2 ... ... ... 1 ... ... 4 ... ... 4 4 2 8 6 5 8 6 15 20 21 Other respiratory diseases 8 6 2 ... ... ... ... ... ... 1 ... ... ... 2 ... ... ... 1 ... ... ... 1 ... 1 2 21 22. Peptic ulcer 13 11 2 ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 5 ... 4 1 1 ... 22 23. Diarrhoea, etc 5 4 1 2 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 23 24 Appendicitis 8 2 b ... ... ... ... ...1 1 l ... ... ... ... 2 ... ... ... 1 ... ... ... 2 ... ... 24 25. Cirrhosis of liver 6 5 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 1 ... 3 ... ... ... 25 26. Other diseases of liver, etc. 7 3 4 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 2 2 ... 2 26 27. Other digestive diseases ... 15 13 1 ... ... ... ... ... l ... 2 ... ... 4 ... ... 3 ... 4 6 3 1 1 3 27 28. Acute and chronic nephritis 27 18 9 ... ... ... ... ... ... l 1 ... ... 1 ... ... 1 2 ... 2 2 4 4 6 1 28 29. Puerperal sepsis 2 ... 2 ... ... ... ... ... ... ... ... ... ... ... 2 ... ... ... ... ... ... ... ... ... ... 29 30. Other puerperal causes 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... 30 31. Congenital debility, premature birth, malformations, etc. 28 14 14 14 13 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 31 32. Senility 24 8 16 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 8 16 32 33. Suicide 20 14 6 ... ... ... ... ... ... ... ... ... ... 2 2 2 ... 6 3 2 1 2 ... ... ... 33 34. Other violence 42 24 18 ... 1 1 ... ... ... 2 1 1 2 6 ... 1 1 4 1 4 ... 2 3 3 9 34 35. Other defined diseaees 87 53 34 2 ... 1 ... 1 ... 1 2 1 1 3 2 1 4 7 6 10 7 11 7 15 5 35 36. Causes ill-defined or unknown ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 36 Total 1,114 515 599 23 17 7 3 6 2 11 7 14 15 24 28 26 21 66 48 94 |101 118 148 126 209 Special causes included in 35 above Small-pox Poliomyelitis Polioencephalitis 44 TABLE C—CAUSES OP, AND AGES AT, DEATH, 1931-1933 (NEW CLASSIFICATION). All Ages 1931 All Ages 1932 All Ages 1933 M F M F M F 1. Typhoid and paratyphoid fever ... ... ... ... ... ... 2. Measles ... ... 3 3 ... ... 3. Scarlet Kever ... 1 ... ... ... ... 4. Whooping cough ... 2 1 2 2 1 5. Diphtheria 2 3 ... 4 1 1 6. Influenza 7 16 11 20 20 25 7. Encephalitis lethargica ... 1 ... ... 1 2 8. Cerebro-spinal fever ... ... ... 1 ... ...it. Tuberculosis of respiratory system 21 31 23 31 25 19 10. Other tuberculous diseases 3 2 3 6 11 9 11. Syphilis 1 3 ... ... ... 1 12. General paralysis of the insane, tabes dorsalis 3 4 3 4 13 Cancer, malignant disease 72 107 66 94 75 96 14. Diabetes 4 12 3 10 8 14 15. Cerebral hemorrhage, etc 17 52 25 40 23 28 16. Heart disease 110 150 109 181 117 163 17. Aneurysm 2 4 1 2 3 18. Other circulatory diseases 25 29 24 22 22 31 19. Bronchitis 15 15 21 8 13 18 20. Pneumonia (all forms) 28 40 32 34 34 46 21. Other respiratory diseases 5 6 9 8 3 3 22. Peptic ulcer 7 4 8 s 8 2 23. Diarrhoea, etc. 2 3 4 4 4 6 24. Appendicitis 3 4 2 5 6 2 25. Cirrhosis of liver 2 1 5 2 1 26. Other diseases of liver, etc. 3 1 3 I 1 2 27. Other digestive diseases 10 10 7 14 10 17 28. Acute and chronio nephritis 19 15 12 14 13 14 29. Puerperal sepsis ... 2 ... 4 ... 1 30. Other puerperal causes ... 3 ... 2 ... 3 31. Congenital debility, premature birth, malformations, eto. 24 16 15 17 17 10 32 Senility 8 11 10 24 5 17 33. Suicide 9 2 9 2 12 4 .14. Other violence 16 13 25 18 22 17 35. Other defined diseases 44 41 48 47 41 45 36. Causes ill-defined or unknown ... 1 Totals 462 596 486 625 501 601 Special causes included iu 35 above 1,058 1,111 1,102 Small-pox Poliomyelitis Polioencephalitis A Table of causes, etc., of death under previous classification for 1921-30 appeared in Report for 1932. TABLE D.—INFANT MORTALITY, 1934. CAUSES OF DEATH. Deaths from stated causes at various Ages under One Year of Age. Total Deaths under One Year. Under 1 Week. 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 4 Weeks. 1-3 Month3. 1 3-6 Months. 6-9 Months. 9-12 Months. Premature Birth 10 1 1 1 13 — — — — 13 Marasmus 1 — — — 1 — 1 — — 2 Gastric Enteritis — — — — — 1 — 1 1 3 Pneumonia — — — — — 1 — 2 1 4 Atelectasis 1 — — — 1 — — — 1 Forceps Delivery 2 — — — 2 — — 2 Asthenia — 1 — — 1 — — — — 1 Inattention at Birth 1 — — — 1 — — — — 1 Inanition 1 — — — 1 — — — 1 Icterus Neonatorum 1 — — — 1 — 1 Status Lymphaticus — — — — — 1 1 Whooping Cough — — — — — — — 1 1 2 Intussusception — 1 — — 1 — 1 Hydrocephalus — — — — — — 2 2 Cerebral Haemorrhage 1 — — — 1 1 Spina Bifida 1 — — — 1 — — — — 1 Lues — — — — — 1 — — — 1 Disease of Digestion 1 — — — 1 — — — — 1 Other Diseases — — — — — — — 1 — 1 Total 20 3 1 1 25 4 3 5 3 40 45 46 BIRTHS. DEATHS. INFANT DEATHS. AND DEATHS FROM CERTAIN DISEASES, 1901 -1934. YEAR. Population Census. Total Live Births Total Still Births Total Deaths Total Infant Deaths (under one year) Deaths from Measles Deaths from Whooping Cough Deaths from Diarrhoea (under two years) Deaths from | Scarlet Fever Deaths from Diphtheria Deaths from Typhoid Fever. Deaths from Cancer. Deaths from Tuberculosis (Pulmonary) Deaths from Tuberculosis (Non-Pulmonary) 1901 72,056 1,511 ... 597 127 8 14 6 1 8 3 47 45 18 1902 1,565 ... 620 129 7 9 1 0 9 6 51 45 22 1903 1.661 ... 689 130 15 19 1 1 8 1 62 46 20 1904 1 659 ... 690 145 18 17 21 1 7 2 49 54 23 1905 1,567 ... 696 106 9 10 6 3 8 2 65 58 16 1906 1,603 ... 769 136 18 4 22 6 13 5 65 47 13 1907 1,524 ... 766 116 5 19 3 4 9 4 76 50 19 1908 1,485 ... 752 95 12 11 3 3 9 2 84 53 16 1909 1,508 ... 787 87 12 12 0 3 10 0 75 57 26 1910 1,393 ... 737 84 1 10 0 4 8 3 88 41 18 1911 84,592 1.479 ... 812 116 20 15 35 1 6 1 103 55 23 1912 1,385 ... 840 105 5 2 13 3 2 2 114 43 17 1913 1.425 ... 824 81 12 8 12 0 4 3 96 55 14 1914 1,529 ... 791 88 1 4 21 1 7 1 82 44 10 1915 1,394 ... 1,007 112 37 7 23 3 11 2 99 58 19 1916 1,404 ... 928 64 0 5 8 0 11 1 106 84 20 1917 1,038 ... 906 73 14 6 3 0 6 0 113 58 25 1918 1,037 ... 1,094 64 6 13 7 2 8 0 130 76 13 1919 1,188 ... 992 76 0 0 6 2 3 1 119 66 11 1920 1.707 ... 903 93 4 7 7 3 20 2 119 61 12 1921 87,691 1,468 ... 968 72 1 2 15 3 13 0 136 74 12 1H22 1 372 ... 992 72 3 7 3 1 6 0 143 60 13 1923 1,217 ... 928 64 4 1 5 1 6 1 136 47 11 1924 1,189 ... 928 48 2 2 1 1 2 0 146 55 7 1925 1,214 ... 946 63 1 8 3 0 1 0 143 48 7 1926 1,206 ... 928 57 8 3 2 0 1 1 147 59 8 1927 1,201 ... 1,012 46 0 0 4 1 6 1 131 58 6 1928 1,191 ... 995 73 6 1 3 2 6 1 132 59 10 1929 1,221 ... 1,128 67 0 13 2 0 7 0 143 58 16 1930 1,209 45 1.047 50 4 0 10 2 4 0 156 57 7 1931 95,524 R-Gen.'s Estimate 1,139 44 1,058 60 0 2 5 1 5 0 179 52 5 1932 96,990 1,103 38 1,111 51 6 3 8 0 4 0 160 54 9 1933 96,070 1,041 41 1,102 45 0 3 6 0 2 0 171 44 20 1934 95,306 1,055 35 1,114 40 5 2 2 2 4 0 176 59 7 47 TABLE F:- INFECTIOUS DISEASESS NOTIFIED, 1934 DISEASE WARDS. ACES Total Admitted to Joint Hospital. Admitted to other Hospitals. In Nursing Home. Nursed at Home. Registered Deaths Highgate Muswell Hill. Crouch End West Hornsey Bast Hornsey North Haringey South Haringey Stroud Green Finsbury Park. 0— 1 l— 5 5— 15 15— 25 25— 45 45— 65 65 and over Scarlet Fever 44 74 24 44 37 15 11 17 17 3 48 162 38 28 4 — 283 218 5 — 60 2 Diphtheria 9 17 3 4 8 5 3 7 7 — 14 24 15 9 1 — 63 50 10 — 3 4 Typhoid — 1 — — — — — — — — — — — — 1 — 1 — — — 1 — Pneumonia 5 6 3 10 7 2 1 2 5 1 7 3 3 8 9 10 41 1 14 — 26 73 Erysipelas 3 3 1 10 6 1 3 5 4 1 — 1 — 12 13 9 36 16 2 — 18 — Puerperal Fever 1 I — — 1 — 1 — — — — — — 4 — — 4 — 4 — — 3 Puerperal Pyrexia 2 4 — 1 — 2 2 3 — — — — 2 12 — — 14 — 11 2 1 — Ophthalmia Neonatorum 3 1 — — 5 1 — — — 10 — — — — — — 10 — 7 2 1 — Poliomyelitis — — — — — — — — — — — — — — — — — — — — — Malaria — — — — — — — — — — — — — — — — — — — — — — 67 107 31 69 64 27 21 37 33 15 72 190 58 74 28 19 456 285 57 4 110 — Tuberculosis : Pulmonary 21 15 8 14 17 16 11 11 9 — 1 6 36 48 26 5 122 59 NonPulmonary 6 4 — 3 4 3 4 5 3 — 6 7 9 5 4 1 32 7 Total 94 126 39 86 85 46 36 53 45 15 79 203 103 127 58 25 610 Admitted to Joint Isol. 45 69 21 48 42 10 12 19 19 Hospital Other Hptls 9 7 1 8 7 8 5 8 4 Nursing Homes 2 2 — — — — — — — Nursed at Home 11 29 9 13 15 9 4 10 10 Note.—The following 57 cases were also admitted to the Isolation Hospital in addition to the above:—8 Tonsillitis, 10 Measles, 5 Whooping Cough, 6 Measles and Pneumonia, 3 Influenza, 1 German Measles, 2 found not to be Diphtheria, 4 found not to be Scarlet Fever, 1 Septic Throat, 2 Local Sepsis, 1 Appendicitis, 1 Colic, 2 Injury, 1 Otitis Media, 1 Measles, Otitis Media and Croup, 1 Measles and Otitis Media, 1 Measles and Bronohitls, 1 Furunculosis, 1 Asthma, 1 Lumbago, 1 Injury to Leg, and 3 for Observation. Excluding T.B. 48 TABLE G. NOTIFICATIONS OF INFECTIOUS DISEASE. 1911-1934. Year. Population. Estimated Scarlet Fever. Diphtheria or Croup. Typhoid Fever. Para Typhoid. Puerperal Fever. Puerperal Pyrexia. Erysipelas. Cerebral Spinal Meningitis. Polio-Myelitis. Ophthalmia Neonatorum. Malaria. Dysentery. Encephalitis Lethargica. Polio Encephalitis. Pneumonia. Small-pox. Measles. German Measles. Total Attack rate per 1,000 population. 1911 84,592 (Census) 179 133 6 — 2 — 40 — — — — — — — — 1 — — 361 4.2 1912 84,840 138 88 9 — 3 — 39 1 1 — — — — — — — — — 279 3.2 1913 85,122 206 115 10 — 2 — 26 — — — — — — — — — — — 359 4.2 1914 85,456 346 101 9 — 1 — 24 — — 11 — — — — — — — — 492 5.7 1915 85,800 182 105 18 — 5 — 35 9 3 1 — — — — — — — — 358 4.1 1916 86,147 103 77 8 — 1 — 32 2 6 9 — — — — — — 207 281 726 2.7 * 1917 86,450 132 66 4 — 1 — 28 4 — 1 — — — — — — 1,227 881 2,344 2.7 * 1918 86,942 89 67 8 — 2 — 23 1 3 2 — — — — — — 796 119 1,110 2.3 * 1919 87,100 203 87 6 — 4 — 42 4 1 5 21 2 5 — 112 — 224 285 1,001 5.7 * not now notifiable 1920 87,410 245 149 6 — 2 — 27 1 3 8 10 2 4 — 98 — 555 6.3 1921 87,691 (Census) 591 189 2 — 2 — 36 — 2 6 1 1 6 — 42 — 878 10.1 1922 88,007 286 113 1 — 2 — 24 — — 10 1 — 1 — 104 — 552 6.2 1923 88,325 126 133 1 — — — 24 2 — 6 4 — 2 — 75 — 373 4.2 1924 88,661 215 40 3 — 1 — 26 — 1 1 — — 11 — 61 — 359 4.0 1925 89,064 126 53 10 — 1 — 26 2 2 4 1 1 7 — 60 — 293 3.3 1926 89,850 140 116 4 — 4 22 — 2 8 — — 6 — 56 — 364 4.0 1927 90,000 179 92 6 1 1 14 34 2 3 5 1 — — — 89 — 427 4.7 1928 90,250 328 104 4 — 3 22 24 4 1 6 1 — 2 — 94 — 593 6.5 1929 90,500 249 129 3 2 3 8 30 3 1 5 2 — — 1 163 — 599 6.6 1930 88,450 R.-Gen.'s Estimate) 346 115 5 4 4 15 36 1 1 — — — 61 3 592 6.6 1931 95,524 (Census) 247 116 — 1 7 9 32 — 1 3 1 — 2 — 86 — 505 5.3 1932 96,990 Gen.'s Estimate) 123 70 2 3 4 14 28 2 2 2 — — 1 — 52 5 308 3.2 1933 96,070 241 44 1 2 4 10 46 — 2 7 — — 2 — 67 — 416 4.8 1934 95,306 283 63 1 — 4 14 36 — 3 10 1 — — — 41 456 4.7 * Excluding Measles and German Measles. 49 table H. (1) notifications of, and deaths from, tuberculosis, 1934. AGE PERIODS. New Cases. Deaths Pulmonary Non-Pulmonary Pulmonary Non-Pulmonary m f m F m F m F 0 — 1 — — — — — — — — 1 — 5 1 — 4 2 — — 1 — 5 — 16 4 2 5 2 1 — — — 15 — 25 18 18 6 3 5 10 2 — 25 — 35 12 17 3 1 3 8 1 — 35 — 45 11 8 — 1 5 5 1 — 45 — 55 14 7 — 1 7 6 — — 55 — 65 4 1 — 3 3 3 — — 65 and over 5 — 1 — 3 — 2 — Totals 69 53 19 13 27 32 7 — Wards ;— Highgate 11 10 4 2 4 4 — — Muswell Hill 8 7 2 2 — 5 — — Crouch End 6 2 — — — 2 — — West Hornsey 10 4 2 1 5 4 1 — East Hornsey 6 11 3 1 6 5 2 — North Haringey 8 8 2 1 3 3 1 — South Haringey 7 4 1 3 3 2 — — Stroud Green 7 4 3 2 5 3 2 — Finsbury Park 6 3 2 1 1 4 1 — Totals 69 53 19 13 27 32 7 — 60 TABLE H:- (2) TUBERCULOSIS REGISTER, 1934 Pulmonary. Non-Pulmonary. Total. Male. Female. Male. Female. Male. Female. (a) Number of Cases on Register at commencement of 1934 275 279 81 83 356 362 (b) Number of Cases notified for first time during year under Regulations 62 34 12 9 64 43 (o) Cases restored to Register during 1934 — 1 — — — 1 (d) Cases added to Register otherwise than by notifications under Reuglations : (1) Transferred from other districts 10 16 4 3 14 19 (2) From Death Returns 7 2 3 1 10 3 (e) Number of Cases removed from Register during 1934 57 61 9 7 66 68 (f) Number of Cases remaining on register at end of 1934 287 271 91 89 378 360 Cases removed from the Register shown under (o) are accounted for as follows:— Found not to be T.B Cured. Removed to another area. Died at Home. Died at Sanatorium or other Institution. Other Reasons. Totals. M F M F M F M F M F M F M F — — 9 4 20 22 Pulmonary 18 20 — 2 57 61 10 13 — 1 2 2 — 3 Non-Pulmonarv 5 1 1 — 9 7 1 — — 1 11 6 20 25 11 13 23 21 1 2 66 68 51 TABLE I. MATERNITY AND CHILD WELFARE WORK, 1934. Nature of Work. Centres. Totals. Mo. 1. No. a. No. 3 and Sub-Centre. Number of sessions held 187 115 71 373 „ ante-natal sessions held 47 23 22 92 Number of individual Mothers seen by Doctor:— Ante-natal, New cases 168 45 58 271 „ Old cases 319 117 117 553 Post-natal, New cases 33 13 3 „ Old cases 12 3 - 15 532 178 178 888 Total attendances of Mothers 745 212 177 1,134 Number of babies attending Centres for first time: Under 1 year 314 181 128 623 1-5 years 83 54 49 186 Number of individual babies on Centre registers: Under 1 year 279 238 100 617 1—5 years 680 191 344 1,215 Babies seen by Doctor 2,308 1,312 962 4,582 Attendances of babies at medical consultations 3,064 1,761 1,204 6,029 Total attendances of babies at Centres: Under 1 year 4,812 2,440 1,413 8,665 1 5 years 3,357 1,037 818 5,212 Referred to own private doctors 16 24 2 42 Referred to hospitals 154 36 4 194 Visits paid by nurses:— First visits Total visits First visits Total visits First visits Total visits Grand First visits Totals Total visits To expectant mothers 109 190 87 156 62 105 258 451 To infants under one year 522 1,308 236 1,354 258 1,148 1,016 3,810 To children aged 1-5 years 123 3,232 65 1,653 88 2,077 276 6,962 Total visits paid by Nurses 754 4,730 388 3,163 408 3,330 1,560 11,223 CHILDREN ACTS— Visits paid to Foster Children 9 150 12 117 11 186 32 443 RECORD OF WORK OF MUNICIPAL MIDWIFE, 1934. Confinements attended 147 Ante-natal Clinics attended 79 do. visits 546 Post-natal visits 1,955 52 TABLE J—FACTORIES, WORKSHOPS AND WORKPLACES. The following is a summary of the result of inspections made at Factories, Workshops and Workplaces during the year, with a list of Outworkers' premises, a copy of which has been forwarded to the Home Office, as required. None of the Outworkers' premises was found to be in an unwholesome condition. Premises. Number of Inspections. Written Notices. Prosecutions. (1) (2) (3) (4) Factories (Including Factory Laundries) 141 2 0 Workshops (Including Workshop Laundries) 210 4 0 Workplaces (Other than Outworkers' premises) 10 0 0 Total 161 6 0 DEFECTS FOUND IN FACTORIES, WORKSHOPS 4 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 12 12 Waut of ventilation — — — — Overcrowding — — — — Want of Drainage of floors — — — — Other nuisances 12 12 — — Sanitary accommodation insufficient — — — — unsuitable or defective 1 1 not separate for sexes 3 3 Offenas under the Factory and Workshop Acts:— Illegal occupation of underground bakehouse (s. 101) — — — — Other offences — — — — (Excluding offences relating to outwork and offences under the Sections mentioned in the Schedule to the Ministry of Health (Factories and Workshops Transfer of Powers) Order, 1921). 5 Total 28 28 6 — Including those specified in sections 2, 3, 7 and 8 of the Factory and Workshop Act, 1901, as remediable under the Public Health Act6. 53 TABLE J.—(contd.) OUTWORKERS, 1934. Nature of Work. Premises. Outworkers. Instances. Notices served. Prosecutions. Wearing Apparel 99 115 0 0 0 Boots 5 6 0 0 0 Embroidery 3 3 0 0 0 Furs 3 9 0 0 0 Carnival Hats 3 4 0 0 0 Church Needlework 1 1 0 0 0 Curtains 1 1 0 0 0 Cellophane Covers 1 1 0 0 0 Boxes 2 2 0 0 0 Umbrellas 1 1 0 0 0 Artificial Flowers. 2 2 0 0 0 Brushes 1 1 0 0 0 Cushions 1 1 0 0 0 Jewel Cases 1 1 0 0 0 Bead Stringing 1 1 0 0 0 Art Needlework 1 1 0 0 0 Nets other than Wire Nets 1 1 0 0 0 Dolls Clothes 1 1 0 0 0 Total 128 152 0 0 0 Borough of hornsey. ANNUAL REPORT OF THE School Medical Officer FOR THE Year ending December 31st, 1934 3 HORNSEY EDUCATION COMMITTEE. List of Members, 31st December, 1934. APPOINTED BY HORNSEY. Members of the Town Council— The Mayor (Mr. Councillor W. J. Grimsiiaw, J.P.), 25, Sheldon Avenue, Highgate, N.6. ' AldErMen. Mr. W. G. Barrexger, 20, Southwood Hall, Highgate, N.6. Mr. B. H. Jenkinson, 36, Avenue Road, Highgate, N.6. Mr. W. W. Kelland, M.A., 14, Hillside Mansions, Jackson's Lane, N-.6. Mr. J. W. Rowlands, 25, Cholmeley Park, N.6. Councillors. Mr. D. V. Johnson, 54, Coolhurst Road, Crouch End, N.8 (Chairman). Mrs. C. M. Cave, 10, Wood Vale, Muswell Hill, N.10 (ViceChairman). Mr. W. J. Lendrum, 10, Leaside Avenue, N.10. Mr. A. A. Bell, 120, Wightman Road, N.4. Mr. G. k. Hutchinson, 8, Grosvenor Gardens, N.10. Mr. J. W. Palmer, 30, Crescent Road, Crouch End, N.8. Mr. S. H. Baker, 33, Coolhurst Road, N.8. Mr. L. J. Valette, 59, Allison Road, N.8. Mr. W. V. Wall, 10, Winchester Place, N.6. Co-optative Members— The Rev. H. Wood, M.A., St. Paul's Vicarage, Wightman Road, N.4. Mr. J. H. Ford, M.A., 5, Woodland Gardens, Muswell Hill, N.10. Mr. W. E. Paterson, M.A., B.Sc., 7, Donovan Avenue, N.10. Mrs. A. Holman, J.P., 8, Hornsey Lane, Highgate, N.6. Mr. P. C. Ellerton, 6, Bancroft Avenue, N.2. Mrs. G. Reid, 60a, Shepherd's Hill. Mr. H. Tompkins, 7, Danvers Road, N.8. Director of Education— A. W. Allen, Esq., M.A., Education Office, 79, Crouch End Hill, N.8. 4 MEMBERS OF THE CENTRAL CARE SUB-COMMITTEE. Chairman - Mr. Councillor L. J. Valette. Six members of the Education Committee— Councillors Mrs. C. M. Cave, G. K. M. Hutchinson, L. J. Valette and W. V. Wall, Mrs. G. M. Eeid, B.A., and Mr. H. Tompkins. Four Head Teachers of Elementary Schools nominated by the Hornsey Head Teachers' Association— Miss F. A. Barter, Mr. F. W. Jaggard, Miss H. M. Stone and Mr. H. Turner. The Chairman or Hon. Secretary of each of the six District Care Committees as may be nominated by the District Care Committee— Mrs. J. Faraday, Mrs. N. \V. Findlay, M.A., Mrs. H. M. Hay, Mrs. E. J. Luckett, Miss M. Owen and Mrs. E. Simmonds. Four other persons residing in the Borough who possess experience or knowledge of social work among school children or young persons— Mr. W. P. Bannister, M.A., Mrs. N. Brixey, Mrs. D. M. Johnson and Mrs. E. M. Tompkins. MEMBERS OF THE DISTRICT CARE COMMITTEES. Campsbourne.—Councillor L. J. Valette (ex-officio), Mrs. D. M. Johnson, Mrs. G. M. Reid, B.A., Mr. H. Tompkins, fMr. H. Turner, Miss G. S. Litchfield, Miss D. F. Smith, Miss M. DSibley, Mr. J. \V. T. Harris, Mrs. H. M. Durrant, Mrs. E. Gardiner, Mrs. W. C. Hardwick, Mrs. A. E. Lanible, *Mrs. E. J. Luckett and Mrs. L. Whittle. Crouch End.—Councillor L. J. Valette (ex-officio), *Mrs. N. W. Findlay, M.A., Councillor G. K. M. Hutchinson, Mrs. E. M. Tompkins, Miss F. A. Barter, Mr. J. Iliffe, Miss A. E. Walmsley, †Mrs. A. M. Halford, Mrs. E. H. Hare, Miss F. Milborrow and Mrs. J. Stevenson. * Secretary. †Chairman. 5 Harringay.—†Councillor L. J. Valette (ex-officio), Mr. W. P. Bannister, M.A., Mrs. N. L. Brixey, *Mrs. H. M. Hay, Miss R. Jones, Miss G. M. Ryde, B.Sc., Mr. G. F. Shaw, M.A., Mr. J. H. Spilman, B.Sc., Miss H. M. Stone, Councillor Mrs. J. H. Barrenger, Mrs. H. Betts, Mrs. C. Easterling, Mrs. G. Hodd, Mr. G. Pain, Mrs. R. Owen and Mrs. L. J. Valette. Highgate.—Councillor L. J. Valette (ex-officio), *Miss M. Owen, Mr. T. E. Durban, Mr. E. R. Lewis, Miss R. Spalding, Miss E. Towler, Mrs. E. Farrell, †Mrs. G. Farquharson, Rev. F. Hawkins, M.A., Mrs. A. Imber and Mr. S. Mason. Muswell Hill.— Councillor L. J. Valette (ex-officio), {Councillor Mrs. C. M. Cave, *Mrs. E. Simmonds, Miss E. F. Catley, Miss M. Clarke, Mr. I. T. Plant, Mr. G. Simmonds, B.A., Mr. F. G. Edwardes, Mrs. M. Heppell, Mrs. A. Holman, J.P., Mr. F. J. Randall and Rev. W. B. Williams. Stroud Green.—Councillor L. J. Valette (ex-officio), Mrs. N. L. Brixey, *Mrs. J. Faraday, †Councillor W. V. Wall, Miss E. M. Cockhill, Mr. F. W. Jaggard, Miss E. Pitson, Mrs. J. Ashworth, Mrs. E. E. Brooks, Miss M. Freeman, Mrs. K. Knowles, Mrs. W. Turner and Mrs. M. Wall. * Secretary. † Chairman. 6 1—.STAFF OF SCHOOL MEDICAL SERVICE. School Medical Officer: R. P. Garrow, M.D., D.P.H. Assistant School Medical Officer: Jean Sutherland, M.B., Ch.B., D.P.H. Dentist: Betty C. Hamilton, L.D.S., L.R.C.S., L.R.C.P. (Edin.), Oculist: J. S. Boden, M.B., B.S. Aurist: A. R. Friel, M.A., M.D., F.R.C.S. (I.). Radiologist: J. Morison, M.D. Orthopaedic Surgeon: H. J. Seddon, F.R.C.S. (Eng.) (Resident Medical Superintendent, Royal National Orthopaedic Hospital, Country Branch, Stanmore). Masseuse: Mrs. Yorke (Royal National Orthopaedic Hospital). Nurses: M. Anscombe. L. M. Oliver F. E. Paris. F. Rosa. Clerk: H. M. Croak. Assistant Clerk : H. Powell. 7 To the Chairman and Members of the EDUCATION COMMITTEE. Mr. Chairman, Ladies and Gentlemen, I have the honour to submit my Annual Report, on the work of the School Medical Service for the year ending December 31st, 1034. The scheme of medical inspection and treatment is complete and satisfies the Board of Education's requirements. There is now so little change from year to year in the more strictly medical side of the work that it seems unnecessary to repeat in detail the scope and findings of medical inspection and the various schemes of treatment established to remedy defects found. I would prefer to record certain developments of the year which are not medical, in the narrow sense, but are of inestimable value in promoting the physical well-being of the elementary school population, viz.: — 1.—Extension of School Milk Scheme.—In 1030 the National Milk Publicity Council's scheme for the supply of onethird of a pint of milk daily in bottles with straws for consumption by school children, at a cost of one penny per bottle, was taken up in Hornsey. with the result that by the end of 1031 2,275 children were drinking this quantity of milk daily in schools at the morning break at 10.30. In 1934 the Milk Marketing Board launched a scheme for enabling this milk to be obtained for a halfpenny. The result has been an increase in the numbers at all the schools, the total being 4,417 early in 1935. I am so much impressed with the value of this measure that I have come to the conclusion that no child, however favourable its home conditions may be, receives full benefit from its education unless it partakes of this morning milk. For the less fortunate children it is a correspondingly greater boon. The proper nutrition of the growing population is now widely recognised as the .most important responsibility of parents and public authorities. The milk in school scheme is an essential adjunct to sound feeding of children at home. 2.—Appointment of Organisers of Physical Training.— Miss Patricia S. Beale and Mr. Robert S. Squires. B.Sc., were 8 appointed organisers of physical training for the elementary schools of Tottenham, Finchley, Hornsey and Wood Green, commencing duties on October 1st, 1934. The need for education of the bodies of children of school age is only too painfully obvious to any observant person having opportunities of seeing large numbers of these children stripped. Postural and nutritional defects in varying degrees prevent many of the children from attaining the standard of good physique which nature intended for them. In recent years in Hornsey the Head Teachers and their staffs have taken a keen interest in this aspect of school life and there are signs all round that the awakening interest in physical education is bringing about an improvement in average physique. It is hoped that this movement will gain in impetus from the appointment of organisers of physical training. 3.—Improvement in school, Hygiene.— The year 1934 has been one of great activity in school building: — (a) A new Infants' School has been built and opened at Rokesly Avenue. (b) Crouch End School is undergoing reconstruction— the new junior department was completed in December, 1934. and the senior department is nearing completion. (c) At North Harringay School six additional class- rooms have been built, and sliding partitions have been erected in place of fixed partitions. (d) At South Harringay School a covered way has been provided between the two buildings. When the reconstruction of Crouch End School is completed in 1935 and Holy Innocents' School closed, the Authority will be in the position of having all the elementary schools in the area well up to the most modern standards of school construction and hygiene. Treatment. Whilst prevention of defects and the building up of a sound physique resistant to disease are the main objectives of school medical work, it has to be admitted that in the course of 9 inspection many conditions are found which call for treatment. The scheme of treatment, as set out in the table, is done by workers with special skill and experience in each of the departments, and the results obtained are highly gratifying. For example, Dr. A. R. Friel, the Ear, Nose and Throat Specialist, submits the following data in regard to conditions treated during the year: — Total (Ears). Cured. Lost Sight of. Still under treatment. Hospital. Acute Suppurative Otitis Media 48 42 2 3 1 Chronic Suppurative Otitis Media Due to (1) Tympanic sepsis 9 9 - — — (2) T.S & Granulations 5 1 1 3 — (3) T S.i Polypus 1 1 — — — Attic Disease 6 4 1 1 — Mastoid Disease 2 — — 1 1 External Otitis 7 3 1 1 2 Totals 78 60 5 9 4 These valuable results are obtained by medical or physiological methods of treatment, which are now taking the place of the more radical surgical operations on the nose and throat. Statistics. The statistical tables required by the Board of Education annually are furnished at the end of this report. I wish to thank the staff, medical, dental, nursing and clerical, for the efficient and harmonious way in which the work is done, and to record our appreciation of the valuable co-operation of the Director of Education and his staff and of the Head Teachers and their staffs. I desire also to acknowledge the immense value of the work of the District Care Committees, and to thank the Education Authority for its continued interest in every phase of the work. I have the honour to be, Ladies and Gentlemen, Your obedient servant, R. P. GARROW. School Medical Officer. 10 School Medical Service Scheme of Treatment. Condition treated. Where treated. By whom. When. (a) Minor ailments including skin disease and external eye disease. School Clinic. Clinic Nurse (Miss Paris). Daily at 4 p m. Throat Operations: (b) Tonsils and Adenoids Hornsey Central Hospital. Surgical Staff of the Hospital. As required. (c) Defective Vision. School Clinic. School Oculist (Dr. Boden). Two sessions weekly, Tuesday afternoons, Thursday mornings. (d) Ear Disease and defective hearing. School Clinic. School Aurist (Dr. Friel). One session weekly, Saturday morning. (e) Dental Defects. School Clinic. School Dentist (Dr Betty C. Hamilton). Full time. Eleven sessions weekly. (f) Crippling defects. School Clinic. Orthopædic Surgeon (Mr. Seddon). Masseuse (Mrs. Yorke). One session monthly. 4th Monday morning in each month. Three sessions weekly, Monday, Wednesday & Friday afternoons. (g) Stammering and other speech defects. Sehool Clinic. Special Teacher (Miss Bains). Two sessions weekly, Monday and Wednesday afternoons. (h) Ringworm. Address: Haddon Court, Southwood Lawn Rd., N.6. Private doctor by arrangement with Education Authority (Dr. Morison) Each cape as required. (i) Conditions requiring medical consultation. School Clinics and Infant Welfare Centres. S.M.O. and A.S.M.O. Seven sessions or part sessions weekly. 11 TABLE I. RETURN OF MEDICAL INSPECTIONS (see note a). (a)—Routine Medical Inspections. Number of Inspections in the prescribed Groups— (see note b). Entrants 910 2nd Age Groups 1,442 3rd 493 Total 2,846 Number of other routine inspections 683 (see note c). (b)—Other Inspections. Number of special inspections 1,635 (sec note d). Number of re-inspections 3,615 (see note e). Total 5,150 12 NOTES ON TABLE 1. (a) The return refers to a complete calendar year. (b) This heading relates solely to the routine medical inspection of the three ordinary age groups, i.e., to medical inspection carried out:-— (i) In compliance with Article 17 of the Consolidated Regulations relating to Special Services—Grant Regulations No. 19. (ii) on the school premises (or at a place specially sanctioned by the Board); (iii) for the purpose of making a report on each child on the lines of the approved Schedule set out in Circular 582. (c) Under this heading may be recorded routine inspections, if any, of children who do not fall under the three prescribed age-groups, e.g., routine inspections of a fourth age-group or of other groups of children, as distinct from those who are individually selected on account of some suspected ill-health for " Special " Inspection. (d) A Special Inspection is a medical inspection by the School Medical Officer himself or by one of the Medical Officers on his staff of a child specially selected or referred for such inspection, i.e., not inspected at a routine medical inspection as defined above. Such children may be selected by the Medical Officer during a visit to the School or may be referred to him by the Teachers. School Nurses, Attendance Officers. Parents, or otherwise. It is immaterial for the purpose of this heading whether the children are inspected at the School or at the Inspection Clinic or elsewhere. If a child happens to come before the School Medical Officer for special inspection during a year in which it falls into one of the routine groups, its routine inspection should be entered in Part A of Table I. and its special inspection in Part B. The inspection to be recorded under the heading of special inspections should be only the first inspection of the child so referred for a particular defect. If a child who has been specially inspected for one defect is subsequently specially inspected for another defect, such subsequent inspection should be recorded as a Special Inspection and not as a Re-inspection. (e) Under this heading should be entered the medical inspections of children who as the result of a routine or special inspection come up later on for subsequent re-inspection, whether at the School or at the Inspection Clinic. The first inspection in every case will be entered as a routine or special inspection as the case may be. Every subsequent inspection of the same defect will be entered as a re-inspection. Care should be taken to see that nothing is included under the head of special inspections or re-inspections except such inspections as are defined above. Attendances for treatment by a Nurse, or for examinations by anyone other than a Doctor on the staff of the School Medical Service, should not be recorded as medical inspections. If, however, at any such attendance a child is also examined by one of the Authority's Medical Officers, this should be recorded as a special inspection or re-inspection as the case may be, even if treatment is also given: but such attendance may also of course recorded as an attendance for treatment. 13 TABLE n. (A)—RETURN OP DEFECTS FOUND BY MEDICAL INSPECTION IN THE YEAR ENDED 31st DECEMBER. 1934. DEFECT OR DISEASE. Routine Inspections. Special Inspections. No of Defects. No, of Defects. Requiring treatment. Requiring to be kept under observation, but not requiring treatment. Requiring treatment. Requiring to be kept under observation, but not requiring treatment. (l) (2) (3) (4) (5) Malnutrition 68 16 ... ... Skin Ringworm, scalp ... ... ... ... ,, body ... ... 3 ... Scabies 4 ... 27 ... Impetigo 1 ... 63 ... Other Diseases (Non-tuberculous) 12 ... 104 ... Eye Blepharitis 10 ... 9 ... Conjunctivitis ... 1 ... 40 ... Keratitis ... ... ... ... Corneal Opacities ... ... ... ... Defective Vision excluding Squint) 218 25 181 ... Squint 14 11 41 ... Other Conditions 2 ... 18 ... Ear Defective Hearing 7 ... 28 ... Otitis Media 6 ... 1 ... Other Ear Diseases 1 ... 29 ... Nose and Throat Chronic Tonsillitis only - 6 17 5 ... Adenoids only . ... ... ... ... Chronic Tonsillitis and Adenoids 1 ... ... ... Other conditions 19 2 57 ... Enlarged Cervical Glands (Non-Tuberculous) ... 4 ... ... Defective Speech 3 ... ... ... Heart and Circulation Heart Disease : Organic ... 13 ... ... Functional ... ... ... ... Anæmia ... 1 ... ... Lungs Bronchitis ... ... ... ... Tuberculosis Other Non-TuberculouH Diseases Pulmonary ; ... ... ... ... Definite ... ... ... ... Suspected ... ... ... ... Non-Pulmonary : Glands ... ... ... ... Bones and Joints ... ... ... ... Skin ... ... ... ... , Other Forms ... ... ... ... Nervous System [Epilepsy ... ... ... ... Chorea ... 2 ... ... Other Conditions 2 2 1 ... Deformities Rickets 6 1 ... ... Spinal Curvature 9 ... ... ... Other Forms 259 32 4 ... Other Defects and Diseases (excluding uncleanliness and Dental Diseases ... 1 715 ... TOTALS 649 127 1326 14 TABLE II (continued) (B)—NUMBER OF INDIVIDUAL CHILDREN (see note a) FOUND AT ROUTINE MEDICAL INSPECTION TO REQUIRE TREATMENT (EXCLUDING UNCLEANLINESS AND DENTAL DISEASES). Group Number of Children. Inspected (see note 6). Found to require Treatment. (1) (2) (3) Prescribed Group:- Entrants 910 107 Second Age Group 1,442 174 Third Age Group 493 93 Total (prescribed groups) 2,845 374 Other routine inspections 683 107 Grand Total 3,528 481 (c) NOTES ON TABLE II. (a) No individual child should be counted more than once in Table II., B., even if it is found to be suffering from more than one defect. (b) The figures in this column will of course be the same as those given in Table I. A. (Forms a.M.). (c) This total should not exceed the total of Column (2) of Table II. A. 15 TABLE in. RETURN OF ALL EXCEPTIONAL CHILDREN IN THE AREA. It is assumed that every Authority will have a complete list of all exceptional children in their area compiled from returns made continuously during the year and kept constantly up to date. In order to secure uniformity, Authorities are requested to make up this Table from their list of exceptional children as it stands on the last day of each calendar year. Children sent by the Authority to day or residential schools outside the area should be included in this Table; children who are living in residential schools in the area, or attend day schools in the area, but who come from other areas, should not be included. Children who are living in residential schools in the area, or attend day schools in the area, but who come from other areas, should not be included. For the purpose of this Table, no child should be included who has not been examined by the School Medical Officer, by a medical member of the Authority's staff, or by the Tuberculosis Officer. Tuberculous children in areas other than Counties or County Boroughs who have been ascertained by the County Tuberculosis Officer should not appear in the Table for the County but in the Table for the appropriate area. The definitions of defective children as given in the Education Act, 1921, must be very carefully borne in mind. No child should be entered under more than one heading in this form. CHILDREN SUFFERING FROM MULTIPLE DEFECTS. Information is only required in respect of children suffering from any combination of the following types of defect:— Blindness (excluding partially sighted children). Deafness (excluding partially deaf children). Mental Defect. Epilepsy. Active Tuberculosis. Crippling (as defined in the penultimate category of the Table). Heart Disease. The actual combination of defects should be stated on a separate sheet, together with the type of school attended, e.g., in the case of a mentally defective epileptic child, the return should show whether the School attended is a school for mentally defective or for epileptic children. 8tate here the number of children suffering from any combination of the above defects * Should there be no such children please enter " NIL. 16 BLIND CHILDREN. A blind child is a child who is too blind to be able to read the ordinary school books used by children. Enter in this Section only children who are so blind that they can only be appropriately taught in a school for blind children. At Certified Schools for the Blind. At Public Elementary Schools. At other Institutions. At no School or Institution. Total. Boys Girls 1 1 PARTIALLY SIGHTED CHILDREN. Enter in this Section only children who, though they cannot read ordinary school books or cannot read them without injury to their eyesight, have such power of vision that they can appropriately be taught in a school for the partially sighted. Children who are able by means of suitable glasses to read the ordinary school books used by children without fatigue or injury to their vision should not be included in this Table. At Certified Schools for the Blind. At Certified Schools for the Partially Sighted. At Public Elementary Schools. At other Institutions. At no School or Institution. Total. Boys 3 6 Girls 3 DEAF CHILDREN. A deaf child is a child who is too deaf to be taught in a class of hearing children in an elementary school. Enter in this Section only children who are so deaf that they can only be appropriately taught in a school for the deaf. At Certified Schools for the Deaf. At Public Elementary Schools. At other Institutions. At no School or Institution. Total. Boys Girls 1 1 17 PARTIALLY DEAF CHILDREN. Enter In this Section only children who can appropriately be taught in a school for the partially deaf. At Certified Schools for the Deaf. At Certified Schools for the Partially Deaf. At Public Elementary Schools. At other Institutions. At no School or Institution. Total. Boys 3 4 Girls 1 MENTALLY DEFECTIVE CHILDREN. Feeble-minded Children. Mentally Defective children are children who, not being Imbecile and not being merely dull or backward, are Incapable by reason of mental defect of receiving proper benefit from the instruction in the ordinary Public Elementary Schools but are not incapable by reason of that defect of receiving benefit from instruction in Special Schools for mentally defective children. The following Table should include all such children except those who have been notified to the Local Authority under the Mental Deficiency Act in accordance with Article 3 of the Mental Deficiency (Notification of Children) Regulations, 1928. Particulars relating to these children should be entered in the return of notified children—Form 307 M. At Certified Schools for Mentally Defective Children. At Public Elementary Schools. At other Institutions. At no School or Institution. Total. Boys 22 Girls 13 OD EPILEPTIC CHILDREN. Children Suffering From Severe Epilepsy. In this part of the Table only those children should be included who are epileptic within the meaning of the Act, i.e., children who, not being Idiots or imbeciles, are unfit by reason of severe epilepsy to attend the ordinary Public Elementary Schools. For practical purposes the Board are of opinion that children who are subject to attacks of major epilepsy in school should be recorded as severe" cases and excluded from ordinary Public Elementary Schools. At Certified Special Schools. At Public Elementary Schools. At other Institutions. At- no School or Institution. Total. Boys Nil, Girls 18 PHYSICALLY DEFECTIVE CHILDREN. Physically Defective children are children, who, by reason of physical defect, are incapable of receiving proper benefit from the instruction in the ordinary Public Elementary Schools, but are not incapable by reason of that defect of receiving benefit from instruction in Special Schools for physically defective children. The exact classification of physically defective children is admittedly a matter of difficulty. Valuable information, however, will be obtained if School Medical Officers will record these defective children as accurately as possible under the selected sub-headings. A. TUBERCULOUS CHILDREN. In this category should be placed only cases diagnosed as tuberculous and requiring treatment for tuberculosis at a sanatorium, a dispensary, or elsewhere. Children suffering from crippling due to tuberculosis which is regarded as being no longer in need of treatment should be recorded as crippled children, provided that the degree of crippling is such as to interfere materially with a child's normal mode of life. All other cases of tuberculosis regarded as being no longer in need of treatment should be recorded as delicate children. 1.—Children Suffering From Pulmonary Tuberculosis. (Including pleura and intra-thoracic glands.) At Certified Special Schools. At Public Elementary Schools.† At other Institutions. At no School or Institution. Total. Boys Nil Girls II-—Children Suffering From Non-pulmonary Tuberculosis. (This category should include tuberculosis of all sites other than those shown in (I) above.) At Certified Special Schools. At Public Elementary Schools.f At other Institutions. At no School or Institution. Total. Boys 2 4 Girls 2 † It is essential that tuberculous children who are, or may be, a source of infection to others should be promptly excluded from Public Elementary Schools. 19 B. DELICATE CHILDREN. This Section should be confined to children (except those Included In other groups) whose general health renders it desirable that they should be specially selected for admission to an Open Air School. Such children should be included irrespective of the actual provision of Open Air Schools in the area, or of the practicability in present circumstances of sending the children to Residential Schools. At the same time It should be remembered that children should not be regarded as suitable for admission to an Open Air School unless the Medical Officer would be prepared to certify that they are incapable by reason of physical defect of receiving proper benefit from the instruction in the ordinary Public Elementary Schools. At Certified Special Schools. At Public Elementary Schools. At other Institutions At no School or Institution. Total. Boys Girls Nil. C. CRIPPLED CHILDREN. This Section should be confined to children (other than those diagnosed as tuberculous and in need of treatment for that disease) who are suffering from a degree of crippling sufficiently severe to Interfere materially with a child's normal mode of life, i.e., children who generally speaking are unable to take part, in any complete sense, in physical exercises or games or such activities of the School curriculum as gardening or forms of handwork usually engaged in by other children. At Certified Special Schools. At Public Elementary Schools. At other Institutions. At no School or Institution. Total. Boys 14 28 Girls 14 D. CHILDREN WITH HEART DISEASE. This Section should be confined to children whose defect is so sever as to necessitate the provision of educational facilities other than thos of the Public Elementary School. At Certified Special Schools. At Public Elementary Schools. At other Institutions. At no School or Institution. Total. Boys Girls Nil. 20 TABLE IV. RETURN OP DEFECTS TREATED DURING THE YEAR ENDED 31st DECEMBER. 1934. (see note a). TREATMENT TABLE. Group I.—Minor Ailments (excluding Uncleanliness, for which see Group VI.). DISEASE OR DEFECT. (1) Number of Defects treated or under treatment during the year. Under the Authority's Scheme (see note b). (2) Otherwise. (3) Total. (4) Skin— Ringworm-Scalp — — (i) X-Ray Treatment. If none, indicate by dash. (ii) Other Treatment. Ringworm-Body 3 — 3 Scabies 27 — 27 Impetigo 63 — 63 Other Skin Disease 104 — 104 Minor Eye Defects (External and other, but excluding oases falling in Group II). 26 - 26 Minor Ear Defects (See note c). 38 — 38 Miscellaneous (e.g., minor iujuries, bruises, sores, chilblains, etc.) 243 - 243 Total 504 — 504 21 TABLE IV. (continued ) Group II.—Defective Vision and Squint (excluding Minor Eye Defects treated as Minor Aliments—Group I.). DEPECT OR DISEASE. (1) Number of Defects dealt with No. of children for whom spectacles were Under the Authority's Scheme (see note b) (2) Otherwise. (3) Total. (4) Prescribed (1) Obtained (2) (i) Under the Authority's Scheme (»•) Otherwise. (i) Under the Authority's Scheme. (ii) Otherwise. Errors of Refraction (including Squint). (Operations for squint should be recorded separately in the body of the School Medical Officer's Report). 514 96 610 Other Defect or Disease of the Eyes (excluding those recorded in Group 1.). 36 36 Total 550 96 646 464 450 Group III.—Treatment of Defects of Nose and Throat. Number of Defects. Received Operative Treatment. Received other forms of Treatment. Total number treated. Undar the Authority's Scheme, in Clinic or Hospital (see note b). By Private Practitioner or Hospital, apart from the Authority's Scheme. Total. (1) (2) (3) (4) (5) (i} (ii) (iii) (iv) (i) (ii) (iii) (iv) (i) (ii) (iii) (iv) 76 86 10 10 (i) Tonsils only. (ii) Adenoids only. (iii) Tonsils and Adenoids, (iv) Other defects of the nose and throat. 22 Group IV.—Orthopedic and Postural Defects. (see note d). Under the Authority's Scheme (See note b) (1) Otherwise. (2) Total number treated. (see note) Residential treatment with education. (1) Residential treatment without education. (2) Non-residential treatment at an orthopedic clinic. (3) Residential treatment with education. (1) Residential treatment without education. (2) Non-residential treatment at an orthopaedic clinic. (3) Number of children treated. 9 173 182 Group V.—Dental Defects. (1) Number of Children who were : — (i) Inspected by the Dentist : Aged : 5 287 6 394 7 418 8 430 9 504 Routine Age Groups 10 515 Total 4577 11 520 12 503 13 481 14 403 15 122 Specials (see note f) 151 Grand Total 4728 (ii) Found to require treatment 3431 (iii) Actually treated 2431 Retreated 1130 (2) Half-days devoted to:— Inspection 35 Total 439 Treatment 404 (3) Attendances made by children for ment 4435 (4) Fillings:—(See note g) Permanent Teeth 2707 ) Total 2717 Temporary Teeth 10 (5) Extractions:— Permanent Teeth 346 Total 2881 Temporary Teeth 2535 (6) Administration of general snsestheties for extractions 1374 (7) Other operations:— Permanent Teeth 630 Total 1751 Temporary Teeth 1121 Group VI.—Uncleanliness and Verminous Conditions. (see note h). (I.) Average number of visits per school made during the year by the School Nurses—48. (11.) Total number of examinations of children In the Schools by School Nurses—29,746. (iii) Number of Individual children found unclean (sec note i)—309. (iv.) Number of children cleansed under arrangements made by the Local Education Authority—207. (v.) Number of cases in which legal proceedings were taken: — (a) Under the Education Act, 1921—Nil. (b) Under School Attendance Byelaws—Nil. 23 NOTES ON TABLE IV. (a) The Table should deal with all defects treated during the year, however they were brought to the Authority's notice, i.e., whether by routine Inspection, special inspection, or otherwise, during the year in question or previously. (b) This heading should include all cases that received treatment under definite arrangements or agreements for treatment made by the Local Education Authority and sanctioned by the Board of Education under Section 80 of the Education Act, 1921. Cases which, after being recommended for treatment or advised to obtain it, actually received treatment by private practitioners, or by means of direct application to hospitals, or by the use of hospital tickets supplied by private persons, etc., should be entered under other headings. (e) If any treatment is given for more serious diseases of the ear (e.g., operative treatment in hospital) it should not be recorded here but In the body of the School Medical Officer's Annual Report. (d) Postural defects which received non-residential treatment otherwise than at an orthopaedic clinic should not be recorded in this Table. (e) A child may be recorded in more than one category and therefore the total number of children treated will not necessarily be the same as the sum of the figures in the separate categories. (/) The heading "Specials" in this Table relates to all children inspected by the School Dentist otherwise than in the course of the routine inspection of children in one of the age groups covered by the Authority's approved scheme, namely, to children specially selected by him, or referred by Medical Officers, Parents, Teachers, etc., on account of urgency. The number inspected in each age group should be separately shown, as well as the total, but under "Specials" only the total number should be given. (9) Temporary fillings, whether in permanent or temporary teeth, should be recorded as other operations. (ft) A statement as to the arrangements made by the Local Education Authority for cleansing verminous children and a record of the cases in which legal proceedings were taken, should be included in the body of the School Medical Officer's Report. (i) (1) All cases of uncleanliness, however slight, should be recorded. (11) The return should relate to individual children and not to Instances of uncleanliness. N.B.—Groups I.—VI. above cover all the defects for which treatment is normally provided as part of the School Medical Service. Particulars as to the measures adopted by the Authority for providing treatment for other types of defect or for securing improvement in types of defect which do not fall to be treated under the Authority's own scheme and for which the Authority neither incur expenditure nor accept any responsibility, together with a statement of the effect of the measures taken, should be included in the body of the School Medical Officer's Report. It is convenient for such particulars to follow the headings of Table II. (Form 8 b.M.). 24 TABLE VII. LIST OF SCHOOLS IN THE BOROUGH School, Department. Authorized accommodation. Average No. on the Rolls for qr. ended 31/12/34. Head Teacher. Campsbourne Boys' 388 349 Mr. H. Turner „ Girls' 388 304 Miss G. S. Litchfield „ Infants' 400 257 Miss D. F. Smith Coldfall M ixed 520 567 Mr. G. Simmonds, B.A. „ Infants' 400 263 Miss M. N. Clarke Crouch End Boys' 456 334 Mr. J. Iliffe „ Girls' 450 287 Miss F. A. Barter Rokesly Infants' 480 469 Miss A. E. Walmsley Highgate Mixed 328 320 Mr. T. E. Durban „ Infants' 264 129 Miss R. Spalding Harringay Senr. Boys' 312 295 Mr. G. F. Shaw, M.A. North Harringay Junr. Mxd 448 443 Mr. J. H. Spilman, B Sc. „ Infants' 446 317 Miss H. M. Stone Harringay Senr. Girls' 440 273 Miss G. M. Ryde, B.Sc. South Harringay Infants' & Junr. Mxd. 240 308 Miss R Jones Stroud Green Senr. Mixed 350 410 Mr. F. W. Jaggard „ Junr. Mixed 416 335 Miss R. M. Cockhill „ Infants' 352 280 Miss E. Pitson Muswell Hill Junr. Mixed 200 146 Miss E. F. Catley St. Mary's Mixed 580 523 Mr. J. W. T. Harris „ Infants' 240 254 Miss M. D. Sibley St. Michael's Mixed 196 120 Mr. E. R. Lewis „ Infauts' 168 97 Miss E. Towler St. James' Junr. Mixed 240 245 Mr. I. T. Plant Totals 8,702 7,315