AC434 (1) Hmnsty BOROUGH OF HORNSEY. ANNUAL REPORT OF THE Medical Officer of Health AND School Medical Officer FOR R. P. GARROW, M.D., D.P.H. Printed by "The Hornsey Journal." Ltd.. 161. Tottenham Lane. N.8. HOR 029 Borough of 1bornsey ANNUAL REPORT for 1937 of the Medical Officer of Health. INDEX. Admissions to Hospitals, 41. Ambulances, 8, 9. Ante-natal Clinics and Services, 51, 52. Area of Borough, 6. Attack rate, infectious disease, 42. Bacteriological examinations, 8. Bakehouses, 15, 18. Bed-bug eradication, 23. Births and rates, 6, 36, 40, 53, 54. Blindness prevention, 30. Borough Nursing Association, 9, 10, 11. Butchers, 15, 18. Bye-laws, 16, 18, 19. Cancer deaths, 7, 37, 38, 40. Carbide, 34. Cellulose spirit, 34. Cerebro-spinal meningitis, 41, 42. Child Life Protection, 57, 58. Cinemas, 15, 18. City of London Maternity Hospital, 52. Cleansing station, 22. Clinics, 51. Committees, 1, 48, 49 , 50. Dairies, 15, 18, 20, 27. Deaths and rates, 6, 7, 36, 37, 40. „ Causes of, 37, 38, 40. Dental scheme and treatment, 55, 56. Diarrhoea, 7, 40. Diphtheria, 40, 41, 42. „immunization, 30. Diseases of Animals Acts, 32. Disinfection and disinfestation, 22, 23. „ vans, 22. Dog nuisance, 23. Drain tests, 16. Drains opened, 16. Drainage, 16. Dysentery, 41, 42. Encephalitis lethargica, 42. Enteric fever, 40, 41, 42. Emergency unit (maternity), 52. Erysipelas, 41, 42. Factories and workshops, 15, 18, 45. fish shops, 18. Pood Inspection, 27, 29. „ condemned, 28, 29. „ samples, 29. Food stores provided, 17. Foster mothers and children, 57, 58. Flying squad (maternity). 52. Gas Works, Hornsey, 21. German measles, 42. Health committed. Visiting, 59. „Visitors, 3, 49, 51. Home Helps, 54. Home Nursing, 11. Hornsey Central Hospital, 12. Hornsey Deanery Association, 12. Hornsey Nursing Association, 9, 10, 11. Hospital services, 11, 12, 52. Housing— Byelaws, 16, 18, 19. Families rehoused, 13, 14. House-to-house inspections, 16, 26. Inspections, 24, 25. Lodgings, 19. Overcrowding survey, 26. Returns of work, 16, 24, 25. Statistics, 24, 25. Hydro-carbon, 33. Illegitimate births, 6. 7. „ deaths, 7. Immunization, diphtheria, 30. Increase of Rents Act, 16. Infant deaths and rates, 7, 36, 39, 40. „ „ causes, 39. Infant life protection, 57, 58 Infantile paralysis, 42. Infectious disease. 30, 41. Attack rate, 42. Diphtheria, 40, 41, 42. Notifications, 41, 42. Scarlet fever, 40, 41, 42. Inhabited houses, 6. Inquests, 31. Inspections made, 15. Isolation Hospital, cases admitted, 41. Laboratory work, 8. Library books, 22. Libraries (Shops) Act, 19. Licences, 15, 28. Malaria, 42. Maternal mortality, 7. Maternity and Child Welfare Committee, 48. Maternity cases arrangements, 52. Masseuse. 56. Maternity and Child Welfare— Analysis of attendances, 59. Ante-natal, 51, 52, 59. Assistance given, 57. Births notified, 53. 54. Centres, 51. Child Life Protection, 57. 58. Clinics, 51. Committee, 48. Dental treatment, 55, 56. Maternity and Child Welfare (contd.) Plying squad (maternity), 52. Foster children, 57, 58. Health visiting, 59. Home helps, 54. Hospital arrangements, 52. Maternal deaths, 7. Midwives, 52. Fee reduced, 52. Milk grants, 54, 55. Orthopaedic scheme, 56. Premises, 51. Sessions, 51. Staff, 49, 51. Statistics, 59. Time-table, 51. Toddlers' playroom, 57. Voluntary Committees, 49, 50, 56. Year's work, 59. Measles, 7, 40, 42. Meat inspection, 28, 29. Meningitis, 41, 42. Midwives, 52, 59. Milk grants, 54, 55. „ licences, 27, 28. samples, 22, 27. „ shops, 15, 18, 20, 27. „ (Special Designations) Order, 1936. 27, 28. Mortuary, 31. Musio and Dancing Licences, 15. Naphtha, 34. Neurosis, 4. North Middlesex Hospital, 11, 12. 52. Notifications of Births Act, 53, 54. Nursing Association, 9. 10, 11. „ Classes, 11. „ Homes, 11. Offensive trades, 15, 18. Ophthalmia neonatorum, 30, 31, 41, 42. Orthopaedic scheme, 56. Outworkers, 18, 46. Overcrowding, 15, 25, 26. Para-typhoid, 41, 42. Passages, 15. Pests, house, 22, 23. Petroleum Acts, 15, 18, 33. „ licences, 33, 34. Piggeries, 15. Pemphigus neonatorum, 41, 42. Pneumonia, 41, 42. Poliomyelitis, 42. Polio encephalitis, 42. Population, 6, 36. Preface, 4. Puerperal fever and pyrexia, 2, 7, 41, 42. Rag Flock Act, 15. Rateable value and produce of Id. rate, 6, Refuse shoots, 15, 18. Restaurants, 15, 18. Retail Meat Dealers' Act, 19. Sale of Food and Drugs Act, 29 Sanitary notices served, 16. Sanitary work, 16, 17. Scabies, 15, 22. Scarlet fever, 40, 41, 42. Schools, 12, 13. Shoots, refuse, 15, 18. Shops Acts, 15, 16, 19. Action, 16, 19. List of, 20, 21. Slaughter-houses, 15, 18, 29. Small-pox, 42. Smoke, 15, 21. Stables, 15. Staff, 2, 3, 49. Statutory notices, 16. Statistics tables, 6, 36 to 46, 59. Still-births, 6, 40. Subscriptions, annual, 10. Sunday Trading (Shops) Act, 10. Swimming Pool, 12. Tables, list of, 35. Toddlers' playroom, 57. Tuberculosis, Cases of, 41, 43, 44. „ Deaths, 38, 40, 43. „ Register, 31, 43, 44. „ Sanatoria and beds, 31 Typhoid fever 40, 41, 42. Unmarried mothers, 12. Vaccination, 30. Verminous houses, 15, 22, 23. Veterinary Inspector, 3. 32. Visits by inspectors, 15. Visiting of children, 57, 58. Vital statistics, 6. 36. ,, „ England, &c., 36. Voluntary workers, 49, 50. Welfare centres. 51. Whooping-cough, 7, 40. Workshops, 15, 18, 45. 1 HEALTH COMMITTEE as at 31st December, 1937. Councillor L. J. Valette {Chairman), 59, Allison Road, N.8. The Mayor, Alderman H. G. Williams, J.P., 105, The Chine, N.21. Alderman W. W. Kelland, M.A., 14, Hillside Mansions, N.6. ,, J. W. Rowlands, J.P., 25, Cholmeley Park, N.6. ,, R. Steeds, 19, Coolhurst Road, N.8. ,, C. H. summersby, J.P., e/o Benyons Ltd., Market Square, Newbury. Councillor Mrs. J. H. Barrenger, 18, Fordington Road, N.G. ,, Elliott E. Brooks, 122, Crouch Hill, N.8. Mrs. C. M. Cave, 10, Wood Vale, N.10. ,, J. Edwards, 102, Turnpike Lane, N.8. ,, S. G. Goulding, Woodlands, Cranley Gardens, N.10. ,, W. J. Grimshaw, 25, Sheldon Avenue, N.6. ,, Mrs. M. N. Hill, 16, Bishopswood Road, N.6. G. K. M. Hutchinson, 8, Grosvenor Gardens, N.10. ,, F. L. Pascoe, 110, Highgate Hill, N.6. ,, T. Tivendale, 12, Colney Hatch Lane, N.10. ,, W. V. Wall, 10, Winchester Place, N.6. ,, J. L. R. Webb, 11, Wilmer Way, N.14. ,, C. Winkley, J.P., 72, Woodside Avenue, N.10. 2 STAFF OF PUBLIC HEALTH DEPARTMENT. †*Medical Officer of Health and School Medical Officer 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., d.c.o.g. † Assistant Part-time Medical Officer for Maternity and Child Welfare 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, 89, Harley Street, w.l. ‡ Dentist (M. & C.W. Dental Scheme) H. A. Creeke, l.d.s. †*Senior Sanitary Inspector, Petroleum Inspector, Shops Acts Inspector. Henry Eastwood, M.R.San.I. M.S.I.A. Cert. R.San.I. Cert. Insp. of Meat and Foods. †*Sanitary Inspectors and Shops Acts Inspectors J. H. Jesse, M.S.I.A. Cert. R.San.I. Cert. Insp. of Meat and Foods. J. D. Chance, M.S.I.A. Cert. R.San.I. Cert. Insp. of Meat and Foods. W. J. Wilson, M.S.I.A. Cert. R.San.I Cert. Insp. of Meat and Foods. H. Foster, M.S.I.A. Cert. R.San.I Cert. Insp. of Meat and Foods. 3 †Chief Clerk W. Gilroy. (Assistant Clerks E. Cheesman. N. Smith. Miss P. Aylward, (Appointed 1st Jan., 1937). W. A. Simons. † Health Visitors Miss J. I. Macpherson, Dip. N.H.S., H.V. Cert., C.M.B. Mrs. E. Durnford, H.V. Cert., C.M.B. Miss A. Godden, H.V. Cert., C.M.b. Miss E. Hart, H.V. Cert., S.R.N., C.M.B. Miss F. H. H. Ross (part time) H.V. Cert., S.R.N., C.M.B. (Resigned 1st April, 1937). Mrs. C. Martin, c.m.b. (Part time, Temporary). Mrs. A. Kear, H.V. Cert., S.R.N., C.M.B. (Temporary). Miss E. Andrews (Temporary, Sept. to Dec.). † Midwives Miss M. Andrews, c.m.b. Mrs. M. Jamison, c.m.b. (Appointed from 1st July. 1937). Miss L. Hughes, c.m.b. (Appointed from 1st July, 1937). † 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. 4 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, 1937. The arrangement and contents of annual health reports are prescribed by the Minister of Health in a circular of twelve foolscap pages of printed matter. This report follows the suggested arrangement in every detail except one—namely, in regard to Maternity and Child Welfare. This work, carried on under a separate Committee— the Maternity and Child Welfare Committee—is so large and important a branch of preventive medicine that it has been taken out of Section B (General Provision of Health Services for the area) and appears as a separate section. The vital statistics— birth-rate, death-rate and infantmortality rate (Table A)—do not show any significant difference from those of preceding years. In a Borough in which conditions of life are stable, and where sanitary and health services have been maintained at a high level for years, it would indeed be surprising if violent fluctuations occurred in the vital statistics. It is the duty of the Medical Officer of Health to note specially in his Annual Report "any causes of sickness or invalidity which have been specially noteworthy in the area during the year." This duty is generally understood to refer specially to outbreaks of illness of an infectious nature, e.g., an exceptionally high incidence of diphtheria or scarlet fever or measles or whooping-cough or the occurrence of an outbreak of typhoid fever or of food poisoning. There is fortunately seldom anything of special note to record in these directions in Hornsey. The year under review is no exception. Yet in another direction, not usually regarded as coming within the scope of an annual health report, the position appears to be not so happy. I refer to the very important matter of mental health. While certain infectious diseases have been eradicated entirely and others are coming slowly but surely under control; while the average nutrition of the population has improved considerably and life on the physical side has been 5 made safer, it has, I fear, to be admitted that there is an increase in the number of persons who feel the "strain of modern life who suffer from what is vaguely called" nerves who are, in the language of modern medical psychology, suffering from neuroses or psycho-neuroses, and who are liable in circumstances of special strain to have a complete "nervous breakdown." It has also to be admitted that the opportunities for obtaining treatment (psycho-therapy) are woefully inadequate; whilst the vast field of effort which lies before preventive medicine in this direction has scarcely been entered on. The time has come when the duty of the Maternity and Child Welfare and School Medical services will be not only to advise mothers on how to feed their infants and protect their children from physical diseases, but also to help parents to guide their children through infancy, childhood and early adolescence without sowing in them the seeds of neurosis. The year has been an exceptionally busy one in every department of the work and I desire to express my thanks to the officers of the department for the excellent way in which they have carried out their duties. Each year new health legislation brings added duties to the sanitary inspectors, health visitors, midwives and to the clerical staff. We desire to thank the Voluntary Workers at the Centres for the untiring zeal with which they give their services, and the members of the Council for their continued interest in the Health Services of the Borough. I am, Mr. Mayor, Ladies and Gentlemen, Your obedient servant, R. P. GARROW, Medical Officer of Health. 6 STATISTICS FOR 1937. (Section A). Social and Economic Statistics. Area (acres) 2,872 ,, (square miles) 449 Population (Census 1931) 95,524 Do., Registrar-General's estimate (mid 1937) 90,520 Number of inhabited houses (end of 1937), according to Rate Books 22,251 Rateable value (General Rate) at 31st December £1,081,539 Product of a penny rate £4,250 LIVE BIRTHS— Legitimate Males 561 ,, Females 555 Illegitimate Males 22 ,, Females 27 Total 1,165 Birth-Rate 12.07 per 1,000 population (Registrar-General's estimate). STILL-BIRTHS— Legitimate Males 14 ,, Females 15 Illegitimate Males 3 ,, Females 2 Total 34 Rate per 1,000 total (live and still) births, 292 DEATHS— Male 570 Females 583 Total 1,153 Death-Rate 11.95 per 1,000 population (Registrar-General's estimate). 7 Deaths from Puerperal Causes. Deaths. Rate per 1,000 total (live and still) births England and Wales. Puerperal sepsis 1 085 0.94 Other puerperal causes 2 1.71 2.17 Total 3 257 311 Deaths of Infants under 1 Year of Age. Legitimate Males 31, Females 18 = 49 Illegitimate „ a, 1 = 4 Total 53 Death Kate of Infants under 1 Yeah of Age. All infants per 1,000 live births 45.49 Legitimate infants per 1,000 legitimate live births 43.9 Illegitimate infants per 1,000 illegitimate live births 81.6 Deaths from Cancer (all ages) 179 Deaths from Measles (all ages) 1 Deaths from Whooping Cough (all ages) 3 Deaths from Diarrhoea (under 2 years of age) 6 8 GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. (Section B). 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) Treatment Centres and Clinics. (e) Hospitals : Public and Voluntary. 3.—(i) Midwifery & Maternity, &c., Services. (ii) Institutional Provision for Mothers and Children. (iii) Health Visitors. (iv) Infant Life Protection. (v) Orthopaedic Treatment. LABORATORY FACILITIES. Special Section The specimens examined in the laboratory at the Isolation Hospital during 1937 were as follows: — Negative Positive Total Diphtheria specimens 867 72 939 Sputum (T.B.) ,, 218 18 236 Swabs for Streptococci 12 2 14 Hairs for Ringworm 11 3 14 Blood for Widal test 3 1 4 Other 11 0 11 Total 1,122 96 1,218 AMBULANCE FACILITIES. The ambulance arrangements with the London County Council for the transport of infectious cases, and the Councils ambulance for street accidents and general ambulance services are unaltered and continue to be satisfactory and adequate. The "Morris Viceroy" motor conveyance for the transport of mentally and physically defective children, purchased in October, 1931, continues in active service. It travelled 12,097 miles and 21,667 passengers were carried. 9 The following is a statement of the work done by the Borough Ambulance under the Fire Brigade: — Calls- Accidents and illness in street 470 Private cases 798 1,268 Persons conveyed 1,249 Mileage 8,950 Hours ambulance was engaged 1,088 NURSING FACILITIES. BOROUGH OF HORNSEY NURSING ASSOCIATION. Officers : President: His Worship the Mayor of Hornsey. Vice-Presidents: Mr. James Anderson Mr. Aid. W. G. Barrenger, J.P. Mr. J. Gray Buchanan, J.P. Mr. Aid. G. A. Double Mr. Coun. Wm. J. Grimshaw Professor W. W. Jameson, M.D. Mr. S. M. Mason Mr. Aid. W. J. Rowlands, J.P. Mr. E. E. Metivier Mrs. Sedorski Hon. Treasurer: Mr. A. E. Stevens Hon. Secretary: Mr. R. H. Crookall General Committee. Chairman: Mr. Aid. G. A. Double Chairman, Executive Committee: Mr. Coun. L. J. Valette Vice-Chairman, Executive Committee: Mrs. Dixon Dr. Roy Anderson Miss I. Harvey Mr. Coun. S. H. Baker Mr. Aid. H. E. Hill Mr. Walter Brown Mrs. Maley Rev. E. S. Duval, M.A. Miss MYerson Mr. L. Fish Mrs. Priesack Dr. R. P. Garrow, M.O.H. Miss Quare Miss M. E. Gill, M.B.E. Rev. Dr. C. E. Simpson Dr. E. C. Girling Rt. Rev. Abbott Smith, C.R.L. Mr. W. Owen-Griffiths Capt. H. Tilley, M.B.E Mrs. Lovell Harrison, Mr. Coun. L. J. Valette M.B.E., J.P. Miss D. Winkley 10 Hon. Area Secretaries: Mrs. Dixon Miss A. Lacey, M.B.E. Mrs. Noton Mrs. Sedorski Mr. J. Walters Superintendent: Miss Ivett The Hornsey Nursing Association provides fully-trained visiting nurses for the care of medical and surgical cases of all kinds in their own homes. There has been such a steady increase from year to year in the demand for this service that the staff now number nine, in addition to the Superintendent. These nurses paid over thirteen thousand visits in the course of the year to 728 cases, many of which would have had to go to Hospital if skilled attention were not available at home. This is true economy—for there is no relation between the modest cost of a visiting nurse in the home and the ever-mounting cost of a hospital bed. New Headquarters.—The large house standing in its own grounds at 32. Haringey Park. N.8, close to the Town Hall, has been purchased as a residence for the staff and headquarters of the Association. It is at present undergoing reconstruction and extension to provide bed-sitting-rooms for the fourteen nurses which, it is anticipated, will be required when the service is fully developed in the Borough. When reconstruction is complete the Association, with the approval of the Queen's Institute of District Nursing, will take candidates for training, i.e., hospital-trained nurses who wish to do six months' district nursing to qualify as Queen's Nurses. These trainees will be under contract to give eighteen months' service to the Association. In view of the purchase by the Nursing Association of premises, 32, Haringey Park, for the establishment of a Nurses' Home, the sum of £50 subscribed to the Association by the Council was increased to £100. I know of no organisation working for health in the Borough which is more deserving of supporT than the Hornsey Nursing Association. 11 The following is a statement of the infectious diseases nursed during the year by 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 37 685 26 2 5 Tuberculosis 6 401 1 — 2 Influenza 36 267 32 1 — Abortion 1 10 — 1 — Measles 2 2 2 — – Ophthalmia Neonatorum 1 1 — — — Mumps 3 39 S — – Chicken Pox 1 2 1 — — Scarlet Fever 1 3 — 1 — Whooping Cough 2 19 2 — — Other diseases in children under 5 68 237 68 — — Elementary School Children 77 462 74 1 1 HOME NURSING CLASSES were again successfully conducted during the Winter Session at Hornsey High School, under the Higher Education Committee. Miss Ivett, Superintendent of the Nursing Association, who conducted these classes for several years, has been succeeded by Miss E. Hart, one of the Council's Health Visitors, and it is proposed to extend the lectures to include " infant care and management." NURSING HOMES.—There are 22 Nursing Homes in the Borough registered with the Middlesex County Council under the Nursing Homes Registration Act, 1927. Twelve of these, with a total of 85 beds, are registered for the reception of maternity cases. NORTH MIDDLESEX HOSPITAL.—The number of beds at North Middlesex Hospital is 1,150, an increase of 200 since the last Annual Report. 12 The number of cases from Hornsey treated there in 1937 was:—Maternity 206 (1936—172), other cases 1,450 (1,250 in 1936), a total of 1,655. HORNSEY CENTRAL HOSPITAL.—The Hospital has now 61 beds, an increase of 12 since last year. The Children's Ward is now completed and is to be formally opened by H.R.H. the Duchess of Kent on the 24th May, 1938. The Hospital is provided with up-to-date X-Ray and Ultraviolet Ray Departments. There were 732 cases treated during the year, of which 604 belonged to the Borough. In addition, 1,997 out-patients were treated. The Council subscribe an annual sum of £200 to the Hospital funds. HORNSEY DEANERY ASSOCIATION.—An annual sum of £50 is subscribed by the Council to this Home for Unmarried Mothers in Eastern Road. OPEN-AIR SWIMMING POOL. No material alterations have been made during the year to the very complete Open-air Swimming Pool opened in 1929. Despite competition by the opening of Open-air Pools in several districts near to Hornsey, it is pleasing to record that there was a slight increase in the number of persons using the Pool, viz., 100,708, as against 100,494 in 1936. The season-ticket holders at 712 are, however, 302 less than the previous year. The satisfactory condition of the water is maintained by a system of filtration, aeration and chlorination, and regular inspections are made by the Medical Officer of Health. SCHOOLS. The sanitary condition of the public elementary schools continues at a high standard. The alterations and additions at Highgate Council School were completed during the year, including gymnasium with shower baths, and the lavatories replaced by moden-type appliances. 13 The alterations and additions at North and South harringay Schools were also put in hand. This matter is dealt with more fully in the Annual Report of the School Medical Officer. Another important addition to the schools' facilities is the new school playing Held in Aylmer Road, provided for the Highgate elementary schools. HOUSING. During the year 1937 70 families, representing 397 persons were rehoused as follows: — Families. Persons. North wood Road 1 5 North Hill Avenue 2 7 South wood Lane 2 7 Archway Road 2 10 North Hill 1 4 Yeatman Road 2 10 Gaskell Road 2 19 Barrenger Road 2 17 Steeds Road 2 12 Hill Road 5 48 Tether down 1 5 Eastwood Road 1 6 Queen's Parade 1 7 Fortis Green 1 3 Alexandra Gardens 1 8 Beech wood Road 1 5 North View Road 1 10 Nightingale Lane 19 New land Road 1 4 Boy ton Road 1 4 East field Road 4 19 The Camp sbourne 1 3 Myddelton Road 3 14 Brook Road 1 12 St. Joseph's Road 1 10 Grove house Road 1 7 West field Road 1 17 14 Families. Persons. St. Mary's Road 1 4 St. Ann's Road 1 5 Tops field Road 1 4 Park Road 1 0 Coleridge Road 1 4 Ivy Gardens 1 3 Nelson Road 1 4 Denton Road 1 5 Oak field Road 1 4 May field Road 1 4 Drylands Road 1 4 Enfield Road 1 4 Rathcoole Gardens 2 10 Rathcoole Avenue 1 5 Glebe Road 1 3 Turnpike Lane 1 4 Clarendon Road 1 5 Wightman Road 1 4 Sydney . Road 1 5 Hampden Road 2 8 Effingham Road 1 5 Umfreville Road 1 8 Woodstock Road 2 7 15 SANITARY CIRCUMSTANCES OF THE AREA. (Section C.) SANITARY INSPECTION. The following statement of the work of the Sanitary Inspectors has been prepared by Mr. Henry Eastwood, Chief Sanitary Inspector: — Visits. House-to-house inspections 132 Special inspections 1,789 Re-inspections 7,483 Transfer to Council houses 3 Notifiable infectious diseases 220 Tuberculosis 8 Deaths 10 Scabies 3 Verminous houses 65 Shops Acts 1,009 Factories, workshops and outworkers 463 Cinemas, etc. 5 Overcrowding 686 Petroleum stores 148 Rag Flock Act 3 Dairies and milkshops 9 Bakehouses 38 Slaughter-houses 41 Butchers' shops 34 Restaurant kitchens 15 Other food shops 84 Offensive trades (fish frying) 16 Annual licences (Music and Dancing) 43 Stables 31 Overcrowding survey 14,425 Piggeries 2 Conveniences 1 Smoke observations 1 Sidings 2 Refuse tips 1 Passages 15 16 Drainage 102 Drainage Fee tests 10 Water tests applied (new drains) 68 Smoke and chemical tests applied (old drains) 81 Drains examined under Sees. 48 & 287, Public Health Act. 1936 4 27,050 NOTIOES. The Notices given during the year are as follows: — Under the— Verbal Preliminary Statutory Public Health and Housing Acts 466 762 150 Housing Bye-Laws — 68 20 Shops Act, 1934 153 20 — Increase of Rents Act — — — 619 850 170 SUMMARY OF SANITARY IMPROVEMENTS CARRIED OUT. Drainage. Number of houses and premises redrained 28 Repairs or amendments to existing drains 70 Drains or gullies unstopped or cleansed 87 Manholes provided 53 do. repaired 36 Intercepting traps fixed 13 New gulley traps fixed 132 New soil pipes and ventilating shafts fixed 91 Soil pipes and ventilating shafts repaired 51 Fresh-air inlets provided or repaired 54 17 Water-Closets and Sanitary Fittings. New water-closet buildings 13 New water-closet basins fixed 268 Water-closets unstopped, cleansed or repaired 59 New check cisterns fitted to water-closets; existing cheek cisterns repaired 93 New sinks provided 196 New lavatory basins provided 118 New waste pipes fixed 185 Waste-pipes trapped, repaired or unstopped 350 Waste-pipes diverted into proper drain 19 Baths provided or made usable 68 Urinals cleansed 1 Miscellaneous. Roofs repaired 358 Eaves, guttering renewed, cleansed or repaired 139 Rain-water pipes provided, repaired or unstopped 135 Damp walls remedied 131 Damp-proof courses inserted 105 Paving of yards repaired 159 Premises structually repaired 1,175 Rooms cleansed, distempered or papered 604 Rooms disinfested of vermin 45 Drinking-water cisterns repaired, cleansed and covered 68 Water supply reinstated 1 do. (additional) provided 8 Windows and skylights provided or made usable 118 Sub-floor ventilation 122 Floors repaired 141 Window sills repaired 88 Sash cords and fittings repaired 154 Sanitary dustbins provided 121 Accumulations of manure and refuse removed 64 Stoves, ranges and coppers repaired or renewed 175 Sundry items 587 Food stores provided 9 6,442 18 Factories and Workshops. Defects Remedied. Sanitary accommodation—Insufficient 5 Unsuitable or defective 6 Not separate for sexes 1 Workrooms cleansed or repaired 12 24 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 30 Milk purveyors in connection with other businesses 76 Bakehouses 20 Catering trades 77 Slaughter-houses 6 Butchers' shops 56 Fish shops 23 Factories, workshops and. work-places 323 Outworkers' premises 134 Cinemas 6 Places of public entertainment 32 Shoots (refuse) 1 Offensive trades (fish frying) 10 Licensed petroleum stores 878 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. The amended Byelaws made necessary by the new standards laid down in the Housing Act, 1936, were confirmed on the fifth day of May, 1937, and came into operation on the first day of June, 1937. 19 The number of lodging-houses on the register at the end of the year was 552. Fifty-eight houses have been dealt with under these Byelaws during the year and the following works carried out:— Byelaw. *11 (f) Sash-cord and window fittings 4 4(a) Closet accommodation 2 4(b) Water supplies 9 4 (c) Washing accommodation 30 4(d) Food stores 113 10 Staircase lighting 10 5 (c). Closet ventilation 1 169 * Not included in new Byelaws. SHOPS ACTS, 1912-1936. In addition to the Shops Acts of 1912, 1913, 1928 and 1934, three new Shops Acts came into operation during the year, namely, The Shops Act, 1936, which applies to premises and places where the business of lending books or periodicals is carried on. Date of operation from 1st January, 1937. The Retail Meat Dealers Shops (Sunday Closing) Act, 1936. Date of operation from 1st January, 1937. The Shops (Sunday Trading Restriction) Act, 1936. Date of operation from 1st May, 1937. The following are the particulars of action taken during the year under the provisions of the Shops Act, 1934, relating to ventilation and temperature of shops and to sanitary conveniences : — Notices. Complied with. Temperature 4 4 Sanitary accommodation 8 8 Washing facilities 2 2 Meal facilities 1 1 One thousand four hundred and forty-four visits have been paid to shops during week-days and 652 during Sundays, and, apart from a number of minor infringements, which were dealt with, the provisions of the Shops Acts, 1912-36, have, generally speaking, been well observed. 20 There are 1,416 shops in the Borough engaged in the following trades: — Shops. Antiques 4 Bakers 20 Butchers 56 Builders and Builders' Merchants 18 Carpets and Lino 4 Catering 80 Chemists 26 China and Glass 5 Cleaners and Dyers 8 Coal Merchants 31 Confectioners 106 Cooked Meats 6 Corn Chandlers 7 Drapers, Ladies' Outfitters, Milliners, etc. 137 Electrical, Radio and Gas Fittings 43 Fishmongers 23 Florists 18 Footwear 74 Furniture 38 Greengrocery 75 Grocers 122. Hairdressers 68 Herbalists and Health Food Stores 4 Household and Domestic Stores, Oil and Colour Shops, and Bazaars 29 Ironmongers 13 Watches, Jewellery and Pawnbroker 17 Leather Goods and Saddlers 10 Milkshops 27 Music, etc. 7 Newsagents, Stationers, Bookshops and Libraries 81 Motors, Motor-cycles and Cycles 29 Off-licences 43 Opticians 4 Photographers 8 21 Pictures and Picture Framing 3 Public-houses 37 Tailors, Gentlemen's Outfitters and Hosiers 43 Tobacconists 53 Timber Merchants 8 Wardrobe Dealers 8 Sewing Machines 2 Sports Goods, Toys and Games 0 Umbrellas 4 Miscellaneous 11 1,416 SMOKE ABATEMENT. As a result of complaints of nuisance from residents living near to the Gas Works belonging to the Hornsey Gas Company, Dr. R. Lessing, Consulting Chemist and Chemical Engineer, was called in to investigate and report. His investigations consisted of two parts: — (1) A preliminary investigation of complaints of dust and smoke nuisance from residents in the vicinity of the Gas Works, and an examination of the * samples taken. (2) An inspection of the Hornsey Gas Works and an examination of the samples taken from these Works. Two reports were submitted by Dr. Lessing, i.e., on the 18th .January, 1937, and on the 26th April, 1937. In his last report Dr. Lessing stated that there was little to complain of the retort house operations, and that any abatement of smoke and dust pollution from this source could only be obtained at a cost which would seriously affect the economics of the manufacture of coal gas. He added that he was of the opinion that an improvement of the existing plant to the water gas process would be feasible, and could be effected at a reasonable expense by applying the experience which had been gained during recent years in the elimination of dust and grit from chimney gases. 22 I understand the Gas Company have since installed a new dust interceptor in connection with the water gas process, and I am informed that this plant is practically not in use during the summer months. DISINFECTION AND DIS INFEST AT ION. No. of rooms fumigated after notifiable infectious disease 290 „ „ „ non 61 „ T.B 43 „ „ disinfected after death 64 ,, articles disinfected 4,656 „ „ destroyed 219 ,, verminous rooms disinfested 156 CLEANSING STATION. Fourteen cases have been treated at the cleansing station for scabies, three of which were Wood Green cases. In addition 328 school children were treated for verminous heads under arrangement made by the Local Education Authority. The following work has been carried out by the disinfecting staff during the year: — On account of vermin, etc.: — Disinfestation (premises) 82 Spraying for cockroaches (12). wasps' nests (6), ants (4), flies (5), insects under floorboards (4), silver fish (2), spraying of stagnant water (1) 34 Collecting and disinfecting library books: — Received Returned Destroyed Public Libraries 94 92 2 School Libraries 29 26 3 Private Libraries 63 36 27 67 Conveyance of drain-testing appliances Visits in connection with Welfare Centres Samples taken to laboratory for analvsis: — Milk 20 23 ERADICATION OF BED BUGS. The number of Council houses disinfested was 12. The number of other houses disinfested was 82. The methods employed consist of easing the architraves, skirtings, stripping of walls, etc., including in bad cases the opening up of the floors of infested rooms and spraying with a suitable insecticidal fluid such as Pyagra (Jeyes' preparation) and Zaldecide (Newton Chambers' preparation). The beds and bedding are examined and dealt with. If badly infested, the bedsteads are destroyed. Bedding is treated at the Council's steam disinfector. The belongings of tenants to be moved into Council houses or Hornsey Housing Trust dwellings are examined and, where considered necessary, treated as previously described. The work of disinfestation is carried out by the Local Authority. Supervision is exercised by the district sanitary inspectors in all cases and disinfestation carried out by the Council's disinfecting staff. The sanitary inspectors advise whenever necessary and several visits are made in every case. DOG NUISANCE. Two hundred and six metal plates are affixed to lamp columns in various parts of the Borough. During the year 10 more have been fixed and 75 replaced. 24 HOUSING STATISTICS. (Section D). 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-bouses spected for housing defects (under Public Health or Housing Acts) 2,128 (b) Number of inspections made for the purpose 7,083 (2) (a) Number of dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 132 (b) Number of inspections made for the purpose 481 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation — (4) 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 1,770 2. Remedy of Defects during the Year without service of formal Notices :— Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their Officers 1.771 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 (b) By local authority in default of owners 25 B.—Proceedings under Public Health Acts: (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 118 (2) Number of dwelling-houses in which defects were remedied after service of formal notices: — (a) By owners 100 (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 (2) Number of dwelling-houses demolished in pursuance of Demolition Orders 6 D.—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 — (2) Number of separate tenements or ground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit — 4. Housing Act, 1936. Overcrowding: — (a) (i) Number of dwellings overcrowded at the end of the year 120 (ii) Number of families dwelling therein 262 (iii) Number of persons dwelling therein 1,124 (b) Number of new cases of overcrowding reported during the year 82 (c) (i) Number of cases of overcrowding relieved during the year 86 (ii) Number of persons concerned in such cases 539 26 HOUSING ACT, 1936. The detailed examination of working-class accommodation in the district, including the measurement of habitable rooms, was practically completed in June of this year. Changes such as occupancy and the difficulty some owners and agents had in deciding what constituted working-class accommodation have resulted in fresh applications from time to time since that date. A temporary staff of four men was engaged to assist the sanitary inspectors, working in all 24 weeks, and the cost of this work was £296. 12,767 houses have been visited and the permitted number allowed under this Act forwarded to the landlords or agents. This practice of sending out the permitted number with or without application on the part of the landlords or agents was put into operation so as to ensure as far as possible that the permitted number allowed would be entered in the rent book or similar document. HOUSE-TO-HOUSE INSPECTIONS. The number of these inspections is as follows: — Ward. Road. Finsbury Park Perth Road 39 Stroud Green Enfield Gardens 12 Central Hornsey Myddelton Road 30 Highgate Holmesdale Road 33 Crouch End Alexandra Gardens 18 132 27 INSPECTION AND SUPERVISION OF FOOD. (Section E.) The inspection of food and supervision of places where food is prepared or sold was carried out by the Sanitary Inspectors throughout the year. No outbreak of food poisoning occurred during the year, 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. Dairies and Milkshops. 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 58 classed as dairies and 74 classed as milkshops. the principal trade of which is not dairy produce. Of the dairies. 28 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 20 informal samples for bacteriological examination during the year. There are no cowsheds in the Borough. Milk (Special Designations) Order. 1036. Circular 1,535. This Order, which came into force on 1st June, 1936, revokes the Orders of 1923 and 1924 and prescribes the following amended special designations for milk: — PASTEURISED Milk has been heated at 145° Fahr. for 30 minutes to destroy any disease germs. TUBERCULIN TESTED Milk comes from cows that have passed the tuberculin test for freedom from tuberculosis. Tuberculin Tested Milk (Pasteurised) is Tuberculin Tested Milk which is also Pasteurised. Tuberculin Tested Milk (Certified) is Tuberculin Tested Milk which is bottled on the farm. 28 ACCREDITED Milk comes from cows that have passed a veterinary inspection, but not a test for tuberculosis. The old designations— Certified Grade A (Tuberculin Tested) Grade A are abolished. Special Designated Milk Licences. Producers of, and dealers in, special designated milk are required to obtain licences annually. During the year licences were in force as follows: — Sale of Pasteurised Milk 17 ,, ,, ,, ,, (Supplementary) ,, ,, T T 7 ,, ,, ,, (Supplementary) 4 Meat and Other Foods. Under the Public Health (Meat) Regulations, 1924, notice of intention to slaughter animals has 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 301 animals have been inspected under the Regulations. Meat offal weighing 36½lbs. was condemned, surrendered and destroyed. Statistics of Slaughtering. 1926-1937. 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 1935 0 321 0 0 321 1936 0 285 0 0 285 1937 0 301 0 0 301 29 There are six licensed slaughter-houses in the Borough. Articles of food brought from 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 were condemned and destroyed: — lbs. ozs. Bacon 3 9 Rabbits 86 0 Pork 2,398 0 Haddock 90 0 Barley 28 0 Dog's Food 3 8 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 217 2 ,, Sterilised 9 3 Butter 5 — Lard 6 — Cream 1 — Rolled Oats 2 — Sausages 4 — Sheep's Liver 5 1 Gin 3 — Whisky 10 3 Stout 1 1 Cyder 1 — Vinegar 11 8 275 18 30 INFECTIOUS DISEASES. (Section F.) The incidence of twenty of the common and uncommon infectious diseases in the Borough for a period of 27 years is set out in table G. DIPHTHERIA IMMUNISATION. The Saturday morning monthly clinic for immunisation of children against diptheria, started in 1936, is held at each of the four Welfare Centres in rotation. At the end of 1936 1,641 children had been injected and there were 434 completed cases, i.e., each receiving the requisite three injections. The following table shows the figures for 1937: — Total injections Completed Cases. Brook Road and Town Hall Centres 501 143 Wightman Road Centre 698 181 Highgate Centre 132 60 Coldfall Sub-Centre 475 61 1,806 445 VACCINATION. The Public Vaccinators inform me that they have performed vaccination of persons in the Borough during 1937 as follows: — Dr. E. Buckler 121 Dr. R. Anderson 269 children, 20 adults PREVENTION OF BLINDNESS. (PUBLIC HEALTH ACT, 1925. SECTION 66.) 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. Five cases of ophthalmia neonatorum were notified. Three were treated in hospital and two were nursed at home. 31 Cases Treated Vision Vision Total unimpaired. impaired. blindness. . Deaths. Notified. In hospital At home. or nursing home. 5 2 3 5 0 0 0 TUBERCULOSIS. PUBLIC HEALTH (PREVENTION OF TUBERCULOSIS) REGULATIONS. No occasion has arisen in the course of the year to put these powers into action. Sanatorium provision for all forms of Tuberculosis in Hornsey is made by the Middlesex County Council. There are 582 beds available solely for Middlesex under the Middlesex County Council scheme for the treatment of Tuberculosis in sanatoria, namely: — Harefield Sanatorium, Uxbridge 378 beds Clare Hall Sanatorium, South Minims 198 ,, Victoria Home, Margate 6 ,, Pulmonary cases in excess of these numbers and nonpulmonary cases are maintained by the County Council in sanatoria and hospitals in various parts of the country. The total number of cases on the Tuberculosis Register at the end of 1937 was 805, viz., pulmonary 605, non-pulmonary 200, an increase of 49 on the total for last year. A table showing the history of Tuberculosis cases during the year will be found on Table H. MORTUARY. Ninety-four bodies were received at the mortuary and inquests held on 29 of them. 32 DISEASES OF ANIMALS ACT. Mr. F. G. Buxton, the Veterinary Inspector, has kindly supplied me with details of his work in the Borough under the Diseases of Animals Acts and Orders during 1937, as follows: — Inspections made under the Diseases of Animals Acts 22 Animals inspected 400 pigs, 4 horses Removal Licences issued 49 Inspection of contact horses under the Parasitic Mange Order 4 No action was necessary under the Tuberculosis Order, 1925. 33 PETROLEUM INSPECTOR'S REPORT. The following is a Report of the Petroleum Inspector for the year 1937: — PETROLEUM (REGULATIONS) ACTS, 1928 & 1938. AND REGULATIONS AND ORDERS RELATING THERETO. Petroleum is defined as " Petroleum, which when tested in a prescribed manner gives off an inflammable vapour at a temperature of less than 73 deg. Fahrenheit." The quantity of petroleum stored under licence, apart from quantities stored under proper conditions which do not necessitate a licence, totals 101,552 gallons. 98,550 gallons are stored in underground steel tanks and 3,002 gallons kept in properly sealed two-gallon cans. The total number of licences issued is 82. The Superintendent of the Fire Brigade was appointed an additional Petroleum Inspector in October of this year. All plans relating to new petrol installations are 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. The change-over from hand-operated to electrically-operated pumps continues. The Borough Electrical Engineer is notified in every case so that the wiring can be inspected. There is a greater tendency to the spilling of petrol from electrically-operated pumps, owing to the operator's attention being more intent on the dial than on the tank and nozzle, and I have found it necessary to insist on adequate supplies of sand near these pumps in addition to foam fire extinguishers required by regulations, and also to advise a pre-set type of electric pump which only delivers the quantity it is set for and does not necessitate the operator's attention to the dial when once set. Hydro-Carbon. There is one licence issued for the storage of 100 gallons of hydro-carbon. 34 Naphtha. There is one licence issued for the storage of 2,000 gallons of naphtha. Cellulose Spirit. Two premises are licensed for the storage of cellulose spirit and the total quantity kept on these premises is 84 gallons. Carbide of Calcium. There is one premises licensed for the storage of Carbide of Calcium and the quantity stored under licence is 10 cwts. H. EASTWOOD, Chief Sanitary Inspector and Petroleum Inspector. 35 LIST OF TABLES. TABLE A.—-Vital Statistics, 1911-37. TABLE B.—Causes of, and ages at, deatth in 1937. TABLE C.—Summary of causes of death, 1932-1936. TABLE D.—Infant Mortality in 1937. Causes of, and ages at, death. TABLE E.—Births, Deaths, Infant Deaths, and Deaths from certain diseases, 1901-1937. TABLE F.—Cases of Infectious Disease notified in 1937. TABLE G.—Cases of Infectious Disease notified 1911-1937. TABLE H.—(1) Notification of, and deaths from, Tuberculosis, 1937. ,, (2) Tuberculosis Register, 1937. TABLE I.—Inspection of Factories, Outworkers, etc., 1937. 36 TABLE A. BOROUGH OF HORNSEY VITAL STATISTICS, 1911-1937. Year. Estimated Mid-Year Population. Birtb Kate per 1,000 Population. Death Kate per 1,000 Population. Infant Mortality per 1.000 live Birtbs. 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 88,326 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 90,250 121 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 Regr -Gen.'s Estimate 11 9 11.2 52.6 1932 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 1935 95,330 11.83 10.84 48.7 1936 96,160 12.0 11.98 40.0 1937 96,520 12.07 11.95 45.49 ENGLAND and WALES (Rates in 1937) 14.9 12.4 58 125 County Borough and Great Towns, including London (Rates in 1937) 14.9 12.5 62 148 Smaller Towns Populations 25,000 to 50,000 (Rates in 1937) 15.3 11.9 55 London (Rates in 1937) 13.3 12.3 60 L8 TABLE 2 All Ages. 0-1 1-2 2-5 5-15 15-25 25-35 35-45 45-55 55-65 65-75 75&over [ Total. 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 0 0 0 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 2. Measles 1 0 1 ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... 3 3. Scarlet Fever 1 0 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 4. Whooping cough 3 2 1 ... ... ... 1 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 5. Diphtheria 1 0 1 ... ... ... ... ... ... ... 1 ... ... ... ... 1 ... ... ... 1 6 6 5 6 10 6 6. Influenza 40 17 23 1 ... ... ... ... ... ... ... ... ... ... ... 2 2 ... ... 7 7. Encephalitis lethargica 0 0 0 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 8 8. Cerebro spinal fever 0 0 0 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 9 9 Tuberculosis of respiratory system 43 27 16 ... ... ... ... ... ... ... ... 2 2 10 4 6 5 7 2 2 2 ... 1 ... ... 10 10. Other tuberculous diseases 11 9 2 1 ... ... ... ... ... ... ... 3 1 ... ... 1 ... 3 ... 1 ... ... 1 ... ... 1 1 11. Syphilis 3 3 0 l ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... 12. General paralysis of the insane, 12 tabes dorsalis 6 5 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... 2 1 ... ... 1 ... 13 Cancer, malignant disease 179 82 97 ... ... ... ... ... ... ... 1 1 1 ... 5 1 3 9 13 23 22 30 39 18 13 13 14. Diabetes 16 6 10 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 1 3 2 2 6 14 15. Cerebral haemorrhage, etc. 50 17 33 ... ... ... ... ... ... ... ... ... ... ... ... 3 ... 4 3 5 7 11 7 10 15 16. Heart disease 307 153 154 ... ...... ... ... ... ... ... ... 1 ... 3 7 3 2 12 8 31 17 47 36 56 84 16 17. Aneurysm 7 5 2 ... ... ... ... ... ... 1 ... ... ... 1 ... 1 ... ... ... 1 1 1 ... ... 1 17 18. Other circulatory diseases 59 24 35 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 1 2 6 9 13 11 15 18 19. Bronchitis 29 11 18 ... ... ... ... ... ... ... 1 ... 1 ... ... 1 ... ... 1 ... 3 2 4 8 8 19 20. Pneumonia (all forms) 80 43 37 5 1 ... 1 ... ... ... 1 ... ... 1 2 3 ... 7 7 5 4 8 11 14 10 20 21 Other respiratory diseases 14 8 6 ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 2 ... 2 1 2 1 1 4 21 22 Peptic ulcer 19 11 8 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 3 3 3 2 4 2 ... 1 22 23. Diarrhœa, etc. 12 8 4 2 1 3 ... ... ... ... ... 1 ... ... ... 1 ... ... 1 ... 1 ... 1 1 23 24 Appendicitis 9 7 2 ... ... ... ... ... ... 1 ... 2 ... ... ... ... ... 1 1 3 ... ... 1 ... ... 24 25. Cirrhosis of liver 2 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... 25 26. Other diseases of liver, etc. 3 1 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 1 ... ... 26 27. Other digestive diseases 15 5 10 ... ... ... ... ... ... ... ... 1 ... 1 ... ... 1 1 ... ... 3 1 2 1 4 27 28. Acute and chronic nephritis 38 17 21 ... ... ... ... ... ... ... ... 1 1 1 ... 3 1 ... 4 6 3 2 5 4 7 28 29. Puerperal sepsis 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 29 30. Other puerperal causes 2 ... 2 ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... ... ... ... 30 31. Congenital debility, premature ... birth, malformations, etc. 41 25 16 24 15 ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 31 32. Senility 15 5 10 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 5 9 32 33. Suicide 21 13 8 ... ... ... ... ... ... ... ... 1 ... 1 3 1 1 3 1 3 2 3 ... 1 1 33 34. Other violence 28 17 11 ... ... ... ... 1 ... 1 ... 3 ... 4 ... 1 ... 3 1 2 1 1 4 1 5 34 35. Other defined diseases 96 48 48 ... 1 ... ... 1 ... 1 4 3 1 ... 3 3 5 2 9 13 8 7 10 18 7 35 36. Causes ill-defined or unknown 1 0 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 36 Totals 153 570 583 34 19 3 2 4 0 4 9 20 10 22 24 27 26 58 56 107 89 135 151 156 197 Special causes included in 35 above Small-pox Poliomyelitis Polioencephalitis 38 TABLE C. CAUSES OF, AND AGES AT, DEATH, 1932-1936. All Ages 1932 All Ages 1933 All Ages 1934 All Ages 1935 All Ages 1936 M F M F M F M F M F 1. Typhoid and paratyphoid fever ... ... ... ... ... ... 1 ... ... 2 2. Measles 3 3 ... ... 4 1 1 ... 2 1 3. Scarlet Fever ... ... ... ... 1 1 ... ... 1 ... 4. Whooping cough 1 2 2 1 1 1 ... ... 1 1 5. Diphtheria ... 4 1 1 2 2 ... 1 ... 1 6. Influenza 11 20 20 25 5 3 7 8 6 7 7. Encephalitis lethargica ... ... 1 2 1 ... 1 ... 2 2 8. Cerebro-spinal fever ... 1 ... ... 1 ... ... ... 1 ... 9. Tuberculosis of respiratory system 23 31 25 19 27 32 27 27 36 22 10. Other tuberculous diseases 3 6 11 9 7 ... 6 8 4 1 11. Syphilis ... ... ... 1 ... 1 3 ... 1 ... 12. General paralysis of the insane, tabes dorsalis 4 3 4 ... 6 ... 4 .. 3 1 13. Cancer, malignant disease 66 94 75 96 64 112 78 92 83 98 14. Diabetes 3 10 8 14 6 7 5 11 6 13 15. Cerebral hæmorrhage, etc. 25 40 23 28 23 35 12 24 18 34 16.Heart disease 109 181 117 163 111 174 103 168 137 195 17. Aneurysm 4 1 2 3 ... 3 4 1 7 3 18. Other circulatory diseases 24 22 22 31 31 43 24 21 23 42 19. Bronchitis 21 8 13 18 14 16 13 14 16 17 20. Pneumonia (all forms) 32 34 34 46 34 39 29 37 31 27 21. Other respiratory diseases 9 6 3 3 6 2 6 2 1 7 22. Peptic ulcer 8 3 8 2 11 2 11 4 8 2 23. Diarrhoea, etc. 4 4 4 6 4 1 13 3 4 6 24. Appendicitis 2 5 6 2 2 6 2 5 7 4 25. Cirrhosis of liver 5 2 1 ... 5 1 0 3 3 1 26. Other diseases of liver, etc. 3 1 1 2 3 4 1 3 4 6 27. Other digestive diseases 7 14 10 17 15 13 11 12 15 16 28 Acute and chronic nephritis 12 14 13 14 18 9 16 16 13 22 29. Puerperal sepsis ... 4 ... 1 ... 2 ... 2 ... 1 30. Other puerperal causes ... 2 ... 3 ... 1 ... 1 ... 2 31. Congenital debility, premature 32 birth, malformations, etc. 15 17 17 10 14 14 18 13 13 12 32. Senility 10 24 5 17 8 16 5 16 10 14 33. Suicide 9 2 12 4 14 6 4 7 5 4 34.Other violence 25 18 22 17 24 18 15 22 17 25 35. Other defined diseases 48 47 41 45 53 34 45 46 44 41 36. Causes ill-defined or unknown ... ... ... 1 ... ... 1 1 ... ... Totals 486 625 501 601 515 599 466 568 522 630 Special causes included in 35 above 1,111 1,102 1,114 1,034 1,152 Small-pox Poliomyelitis Polioencepha itis A Table of causes, etc., of death under previous classification for 1921-30 appeared in Report for 1932. 39 TABLE D. INFANT MORTALITY, 1937. CAUSES OF DEATH. Deaths from staked causes at various Ages under One Year of Age. Total Deaths under One Year. Under 1 Day Under 1 Week. 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 4 Weeks. 1-3 Months. 3-6 Months. 6-9 Months. 9-12 Months. M F M F M F M F M F M F M F M F M F M F M F Premature Birth 4 2 2 3 ... 2 ... 1 1 ... 7 8 1 1 ... ... ... ... ... ... 8 9 Injury at Birth 2 ... 2 2 ... ... ... ... ... ... 4 2 ... ... ... ... ... ... ... ... 4 2 Congenital Malformation ... ... 1 ... 1 1 ... ... 1 ... 4 1 ... 1 1 ... 1 ... ... 1 6 3 Congenital Debility ... ... ... ... 1 ... ... ... 1 ... 2 ... ... ... 2 ... ... ... ... ... 4 ... Atelectasis ... ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... Diarrhæa ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... ... 1 ... ... 2 1 Pneumonia ... ... ... ... 1 ... ... ... ... ... 1 ... 1 ... 1 ... 2 ... ... 1 5 1 Measles ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 Meningitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 Tuberculosis (non-pulmonary) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... Icterus Neonatorum ... ... 1 ... ... 1 ... ... ... ... 1 1 ... ... ... ... ... ... ... ... 1 1 Syphilis ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 ... Influenza ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 ... Total 6 2 7 5 3 4 1 1 3 ... 20 12 4 2 6 1 4 1 ... 3 34 19 53 40 BIRTHS, DEATHS, INFANT DEATHS, AND DEATHS FROM CERTAIN DISEASES, 1901-1937. 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 Diarrhœa (under two yrs. Deaths from Scarlet Fever Deaths from Diphtheria Deaths from Typhoid Fever Deaths from Cancer Deaths from Tuberculosis (Pulmonary) Deaths from Tuberculosis (NonPulmonary) 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 1,561 ... 589 130 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 1,391 ... 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 1 408 ... 968 72 1 2 15 3 13 0 136 74 12 1922 1 372 ... 992 72 3 7 3 3 7 0 143 60 13 1923 1,217 ... 928 64 4 1 5 1 4 1 136 47 11 1924 1,189 ... 928 48 2 2 1 1 2 0 146 55 7 1925 1,214 ... 946 53 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 15 1930 1,209 45 1,047 50 4 0 10 2 4 0 156 57 7 1931 95,524 k.-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 1935 95,330 1,128 36 1,034 55 1 0 15 0 1 1 170 54 14 1936 96,160 1,15-5 31 1,152 47 3 2 8 1 1 2 181 58 5 1937 96,520 1,165 34 1,153 53 1 3 6 1 1 0 179 43 11 41 Excluding T. B AOBS Total Admitted to Joint Hospital. Admitted to other Hospitals. In Nursing Home, "S E 55 o 51 z DISEASE Hijhgate Mus well Hill. Crouch End Central Horniey North Haringey South Haringey Stroud Green Finsbury Hark. O— 1 1— 5 5- 15 1525 25— 45 45— 65 65 and over Scarlet Fever 10 23 11 44 11 11 22 5 0 27 78 16 11 5 0 137 116 5 0 16 1 Diphtheria 26 12 5 25 5 15 8 9 3 27 47 14 10 4 0 105 99 6 0 0 1 Typhoid Fever 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 Para Typhoid 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 0 0 Pneumonia 9 10 2 16 8 10 22 3 4 8 3 5 17 28 15 80 0 16 2 62 80 Erysipelas 6 4 3 10 4 4 10 3 3 1 2 3 11 18 6 44 15 3 0 26 0 *Puetperal Fever 1 0 0 1 1 0 0 0 0 0 0 2 1 0 — 3 0 3 0 0 3 Puerperal Pyrexia 1 1 0 2 1 2 3 0 0 0 0 4 6 0 — 10 0 8 1 1 0 Ophthalmia Neonatorum 1 0 0 2 2 0 0 0 5 0 0 0 0 0 — 5 0 3 0 2 0 Pemphigus Neonatorum 0 1 0 0 0 0 0 0 1 0 0 0 0 0 — 1 0 0 1 0 0 Cerebro-Spinal Meningitis 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 Dysentery 3 4 0 0 0 0 3 0 1 1 2 0 2 2 2 10 1 3 0 6 0 58 56 21 100 33 42 68 20 17 64 133 45 59 57 23 398 233 48 4 113 Tuberculosis : Pulmonary 17 28 4 25 16 10 23 11 0 1 2 29 79 22 1 134 43 NonPulmonary 2 4 1 7 3 1 3 2 1 1 5 6 7 1 2 23 11 Total 77 88 26 132 52 53 94 33 18 66 140 80 145 80 26 555 Admitted to Joint Isol. 33 33 16 66 15 27 29 14 Hospital Other Hptls 9 3 1 7 6 9 9 4 Nursing Homes 1 2 0 0 0 0 1 0 Nursed at Home 15 18 4 27 12 6 29 2 The following 63 cases were treated in the Isolation Hospital in addition to the above : —3 Measles, 1 Measles and Pneumonia, 3 German Measles, 1 Chicken Pox, 1 Chicken Pox and Bronchitis, 2 Mastoid, 10 Whooping Cough, 1 Whooping Cough and Pneumonia, 3 Rheumatism, 5 Tonsillitis, 1 Lymphangitis, 6 Influenza, 1 Influenza and Pyelitis, 6 Pyelitis, 2 Colic, 3 Local Sepsis, 1 Septicaemia, 1 Conjunctivitis, 1 Enteritis, 1 Abrasions, 1 Leg injury, 1 Pulpitis of finger, 1 ? Enteric, 1 ? Scarlet Fever, 1 ? Chorea, 2 Convalesence after operation, 3 for Observation. * Included under heading Puerperal Pyrexia from 1st Oct., 1937. 42 Year. Population. Estimated Scarlet Fever. Diphtheria or Croup. Typhoid Fever. Para Typhoid. § Puerperal Fever. Puerperal Pyrejia. Erysipelas. Cerebro Spinal Meningitis. Polio-Myelitis. Ophthalmia Neonatorum. Pemphigus Neonatorum. Malaria. Dysentery. ! Encephalitis Lethargica. Polio-Encephalitis. Pneumonia. J Small-pox. Measles. German Measles. Total Attacl 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* 1920 87,410 245 149 6 ... 2 ... 27 1 3 8 ... 10 2 4 ... 98 ... not now notifiable 555 6.3 1921 87,691 (Census) 591 189 2 ... 2 ... 36 ... 2 6 ... 1 1 6 ... 42 ... 878 10.1 1922 88,007 286 123 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 6 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 88,450 346 115 5 4 4 15 36 1 1 1 ... ... ... ... ... 61 3 592 6.6 1931 (H.-Gen.'s hstimate) 95,524 (Census) 247 116 ... 1 7 9 32 ... 1 3 ... 1 ... 2 ... 86 ... 505 5.3 1932 96,990 (R. 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 ... 57 ... 416 4.3 1934 95,306 283 63 1 ... 4 14 36 ... 3 10 ... 1 ... ... ... 41 ... 456 4.7 1935 95,330 245 83 1 ... 2 9 25 1 1 6 ... ... 2 1 ... 44 ... 420 4.4 1936 96,160 158 58 4 2 4 8 39 1 ... 6 ... ... 2 ... 1 58 ... 341 3.5 1937 96.520 137 105 1 1 §3 10 44 1 ... 6 1 ... 10 ... ... 80 ... 398 4.1 * Excluding Measles and German Measles. § Puerperal Fever became notifiable under the heading "Puerperal Pyrexia" from 1st Oct., 1937. 43 TABLE H.— (1) NOTIFICATION OF, AND DEATHS FROM, TUBERCULOSIS, 1937. AGE PERIODS. New Cases. Deaths Pulmonary Non-Pulmonary Pulmonary Non-Pulmonary M F M F M F M F 0 — 1 0 0 1 0 0 0 1 0 1 - 5 1 0 1 0 0 0 0 0 5 — 15 2 0 0 5 0 0 0 0 15 — 25 15 14 3 3 2 2 3 1 25 - 35 23 31 3 4 10 4 0 0 35 — 45 13 12 0 0 6 5 1 0 45 — 55 8 3 0 0 7 2 3 0 55 — 65 8 3 0 1 2 2 1 0 65 and over 0 1 1 1 0 1 0 1 Totals 70 64 9 14 27 16 9 2 Wards : Highgate 10 7 2 0 1 0 0 0 Muswell Hill 14 14 0 4 7 2 3 1 Crouch End 3 1 1 0 1 2 0 0 Central Hornsey 14 11 4 3 5 5 4 0 North Haringey 8 8 2 1 3 0 0 0 South Haringey 6 4 0 1 2 1 0 0 Stroud Green 8 15 0 3 6 5 2 0 Finsbury Park 7 4 0 2 2 1 0 1 Totals 70 64 9 14 27 16 9 2 44 Pulmonary. Non-Pulmcn»ry, Total. Male. Female. Male. Female. Male. Female. (a) Number of Cases on Register at commencement of 1937 308 262 93 93 401 355 (b) Number of Cases notified for first time during year under Regulations 48 41 8 5 56 46 (c) Cases restored to Register during 1937 3 2 0 1 3 3 (d) Cases added to Register otherwise than by notifications under Regulations : (1) Transferred from other districts 17 19 0 6 17 25 (2) From Death Returns 2 2 1 2 3 4 (e) Number of Cases removed from Register during 1937 57 42 3 6 60 48 (f) Number of Cases remaining on Register at end of 1937 321 284 99 101 420 385 Cases removed from the Register shown under (c) 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. Cases closed by T.B.O. Totals. M F M F M F M F M F M F M F 0 1 5 7 17 18 Pulmonary 27 7 0 2 56 43 7 8 0 1 0 1 1 2 Non-Pulmonarv 1 1 0 0 3 6 1 1 45 TABLE I.—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 Prosecutions. (1) (2) (3) (4) Factories (Including Factory Laundries) 118 1 0 Workshops 202 5 0 (Including Workshop Laundries) Workplaces (Other than Outworkers' premises) 3 2 0 Total 323 8 0 DEFECTS FOUND IN FACTORIES, WORKSHOPS & WORKPLACES. Particulars. Number ol Defects. Number of Prosecutions. Found. Remedied. Referred to H.M. (1) (2) (3) (4) (5) Nuisances under the Public Health Acts:—» Want of cleanliness 12 12 — — Want of ventilation — — — — Overcrowding — — — — Want of Drainage of floors — — — — Other nuisances — — — — Sanitary accommodation ' insufficient 3 5 — — unsuitable or defective 6 6 not separate for sexes 1 1 — — Offences 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 24 24 5 — Including those specified in sections 2, 3, 7 and 8 of the Factory and Workshop Act, 1901, as remediable under the Public Health Acts. 46 TABLE I.— (contd.). OUTWORKERS, 1937. Nature of Work. (1) Premises. Outworkers, j Instances. Notices served. Prosecutions. Wearing Apparel 104 136 0 0 0 Boots 6 9 0 0 0 Embroidery 7 7 0 0 0 Carnival Hats 2 4 0 0 0 Church Needlework 1 1 0 0 0 Curtains 1 3 0 0 0 Cellophane Covers 1 1 0 0 0 Boxes 1 4 0 0 0 Artifioial Flowers 5 5 0 0 0 Laundry 1 1 0 0 0 Cushions 1 2 0 0 0 Jewel Cases 2 2 0 0 0 Bead Stringing 1 1 0 0 0 Art Needlework 1 1 0 0 0 Silk Tassels 4 5 0 0 0 Dolls Clothes 1 1 0 0 0 Toys 3 3 0 0 0 Photography 1 1 0 0 0 Upholstery 1 1 0 0 0 Coat Hangers 2 2 0 0 0 Down Quilts. 1 1 0 0 0 Machinery 1 1 0 0 0 Suspensory Bandages 1 1 0 0 0 Total 149 193 0 0 0 47 Borough of lbornseg ANNUAL REPORT ON Maternity and Child Welfare Services 1937 48 MATERNITY & CHILD WELFARE COMMITTEE as at 31st December, 1937 Councillor Mrs. M. N. Hill (Chairman), 16, Bishopswood Road, N.G. The Mayor, Alderman H. G. Williams, J.P., 105, The Cliine, N.21. Alderman W. W. Kelland, M.A., 14, Hillside Mansions, N.6. ,, R. Steeds, 19, Coolhurst Eoad, N.8. ,, C. H. summersby, J.P., c/o Benyons Ltd., Market Square, Newbury. Councillor Mrs. J. H. Barrenger, 18, Fordington Road, N.6. ,, Elliott E. Brooks, 122, Crouch Hill, N.8. Mrs. C. M. Cave, 10, Wood Vale, N.10. ,, J. Edwards, 102, Turnpike Lane, N.8. ,, S. G. Goulding, Woodlands, Cranley Gardens, N.10. ,, H. G. R. Griffin, 12, Avenue Road, N.6. ,, W. J. Grimsiiaw, 25, Sheldon Avenue, N.6. ,, G. K. M. Hutchinson, 8, Grosvenor Gardens, N.10. ,, G. F. N. Norman, 12, Woodberry Crescent, N.10. ,, J. Sanderson, 12, Woollaston Road, N.4. ,, T. Tivendale, 12, Colney Hatch Lane, N.10. ,, L. J. Valette, 59, Allison Road, N.8. W. V. Wall, 10, Winchester Place, N.6. J. L. R. Webb, 11, Wilmer Way, N.14. Selected Members: Mrs. F. 0. Dixon, 2, Woodside Avenue, N.6. Mrs. H. M. Inward, 99, Pemberton Road, N.4. Mrs. M. King, 45, Wood Vale, N.10. Miss B. I. Smith, 43, Weston Park, N.8. Mrs. B. Walton, " Greenacre," The Green, Ealing, W.5. Miss E. F. Wood, 38, Church Crescent, N.10. 49 MATERNITY AND CHILD WELFARE STAFF. Medical Superintendent: Dr. R. P. Garrow Medical Officers at Centres: Dr. J. Sutherland Dr. Muriel Radford Health Visitors: Mrs. E. Durnford. Town Hall Centre. Miss A. Godden, Town Hall Centre. Miss E. Hart, Harringay Centre. Miss J. I. Macpherson, Highgate Centre. Mrs. A. Kear, Highgate Centre (temporary). Mrs. C. M. Martin, Coldfall Sub-Centre (temporary and part-time School Nurse). Borough Midwives: Miss M. Andrews, Town Hall Centre. Mrs. M. Jamison, Harringay Centre. Miss L. Hughes, Highgate Centre. Voluntary Committees. Voluntary Committee (No. 1 Centre), Town Hall. Mrs. B. H. Walton (Chairman and Hon. Treas.), Green Acre, The Green, High Street, W.5. Miss B. I. Smith (Hon Sec.), 43, Weston Park, N.8. Miss Bligh, 25, Summerland Mansions, N.10. Mrs. Boden, 27, Cranmore Way, N.10. Miss Borroson, 36, Cascade Avenue, N.10. Mrs. Bradficld, 86, Etheldene Avenue, N.10. Miss Deane, 38, Wolseley Road, N.8. Mrs. Eason, 29, Queen's Avenue, N.10. Miss Faulkner, 9, Aubrey Road, N.8. Miss Forsyth, 42, Cascade Avenue, N.10. Mrs. Howey, 9, Beech Drive, N.2. Miss Hume, 55, Twyford Avenue, N.10. Mrs. Moore, 18, Buckingham Avenue, N.20. Mrs. Powers, 31, Pages Lane, N.10. Mrs. Price, 35, Park Way, Friern Lane, N.ll. Mrs. Purkis, 11, Church Crescent, Whetstone, N.20. Miss Shrosbree, 26, Cedar Court, N.10. 50 Voluntary Committee (No. 2 Centre), Wigittman Road. Mrs. J. H. Barrenger (Chairman), 18, Fordington Road, N.6. Mrs. King (Hon. Sec. and Treas.), 45, Wood Vale, N.10. Mrs. Bradley, 2, Odsey Villas, Umfreville Road, N.4. Mrs. Brereton, " Borcombe," Middle Lane, N.8. Mrs. Bridgman, 5, Seymour Road, N.8. Mrs. Cutting, 10, Strafford Gate, Potters Bar. Mrs. Harris, 45, Barrington Road, N.8. Mrs. J. Inward, 99, Pemberton Road, N.4. Mrs. Jones, .32, Duckett Road, N.4. Mrs. Newman, 2, Endymion Road, N.4. Mrs. Roberts, 10, Glasslvn Road, N.8. Mrs. Strachan, 26, Florence Road, N.4. Miss Winkley, 72, Woodside Avenue, N.10. Voluntary Committee (No. 3 Centre), Church Road. Mrs. Hill (Chairman), 16, Bishopswood Road, N.6. Mrs. Dixon (Hon. Sec.), 2, Woodside Avenue, N. Miss Wood (Hon. Treasr.), 38, Church Crescent, N.10. Miss Benn, 25, Connaught Gardens, N.10. Mrs. Bruce Low, 24, Cholmeley Crescent, N.6. Miss Grant, " Tregarthen," Cranley Gardens, N.10. Miss Hodgson, " Belle Vue," Church Road, N.6. Mrs. Roberts, " Rheidol," Great North Road, N.6. Mrs. Shannon, 10, Creighton Avenue, N.10. Mrs. A. L. Thomson, 2, View Road, N.6. 51 MATERNITY AND CHILD WELFARE CENTRES TIME TABLE. Centre. Conditions of Tenancy. District Served. Sessions and Doctor. h Visitor./ Ante-natal. Children. No. 1 Brook Road Mission Hall, opened in Oct., 1916 transferred to Town Hall Centre 1st March, 1937 10 years' lease, from 29/9/26 Yearly rent £90 (determined) Hornsey N. Haringey Crouch End Thursdays, 2—4 p.m. Dr. J. Sutherland Mondays, 2—4 p.m (Dr. J. Sutherland) Wednesdays, 10—12 and 2—4 Thursdays, 10—12 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 29/9,88 Yearly ground rent £12 Lease purchased by the Council on 24/1/18 Stroud Green Finsbury Park N. & S. Haringey 1 st and 3rd Tuesdays, 2—4 Dr. J. Sutherland Mondays, 2—4 Tuesdays, 10—12 & 2nd, 4th & 5th Tuesdays, 2—4 Dr. M. Radford Miss E. Hart No. 3 Mission Hall, Church Road, Highgate, opened in October, 1925 21 years' lease, from 24/6/25 Yearly relit £90 Highgate Muswell Hill 2nd Fridays, 10—12 Dr. J. Sutherland Fridays, 2—4 (I)r. R. P. Garrow) MissJ. Macpherson Miss E. Andrews (temporary) 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. Sutherland) Miss F. Ross (part-time) resgd. 1st April, 1937 Mrs. Martin (temp'y) 52 MATERNITY HOSPITAL ACCOMMODATION. North Middlesex Hospital.—Tlie maternity admissions from Hornsev to the North Middlesex Hospital increase each year. Tlie number in 1937 was 206, compared with 172 in 1936. There is the closest co-operation between the Council's Ante-natal Medical Officer (Dr. Jean Sutherland) and tlie obstetric surgeon in charge of the Maternity Department of flic Hospital. City of London Maternity Hospital.—An arrangement was entered into as from April 1st, 1937, for the payment of one guinea for each Hornsev mother admitted. In the nine months to December 31st, 1937, the number was 25. EMERGENCY MATERNITY UNIT (FLYING SQUAD). The Maternity Department of North Middlesex Hospital lias undertaken to provide in cases of urgent necessity (at the request of the midwife or doctor in attendance) a " flying squad "—that is, an ambulance with nurses and doctors and equipment capable of giving immediate treatment in the patient's own home in cases of emergency. Fortunately no case has arisen for calling the unit since the arrangement was entered into. MIDWIFERY SERVICES. There are 18 Midwives, including the 3 Borough Midwivcs, notified to the Middlesex County -Council as practising in the Borough. 9 of whom reside outside the Borough. The Borough Midwives attended 218 births, in addition to ante-natal clinics held at the Welfare Centres—Brook Pond (now the Town Hall), Wightman Road, Church Road, Highgate, and Coldfall School 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 the midwives' fee was made in 59 necessitous cases. Two thousand, one hundred and fourtv-four births have been attended by the Borough Midwife sincc the appointment was first made in 1922. 53 PUBLIC HEALTH ACT, 193G (Sec. 203). NOTIFICATION OF BIRTHS. All live births and still births of seven months and over must be notified to the Medical Officer of Health w ithin 36 hours, in addition to being registered within a period of six weeks after birth. Tlie number of births notified under the Acts during 1937 was: — Male. Female. Total Live births 679 660 1,339 Still births 15 22 37 694 682 1,376 Tlie births were notified: — By Doctors 133 ,, Borough Midwives 203 ,, other Midwives 318 ,, Hospitals 203 ,, parents 11 ,, others 477 1,345 Unnotified (from Registrar's return): — Live births 26 Still births 5 31 1,376 Of this number there were: — Live births. Still births. Occurring in the Borough and transferred to other districts 179 3 Belonging to Hornsev and occurring in Hospitals, &c., outside the district 615 19 Tlie 1,194 nett number of notified I lirths belonging to Hornsev were divided among the districts of the Centres as follows: — 54 Live Still Births Births Total Town Hall Centreh 556 16 572 Wight man Road Cent re 276 11 287 Highgate Centre 294 16 310 Coldfall Sub-Centre 25 0 25 1,151 43 1,194 HOME HELPS. The Hornsev Home Helps Society was started in 1930 by members of the Voluntary Committees of the Centres (Hon. Secretary, Mrs. Inward, 99, Pemberton Road, N.4). In spite of the difficulties of this work, steady progress has been made, as shown by the yearly figures: — Year. No. of Helps on Books Mothers served. Income. Expenditure. £. s. d. £. s. d. 1930 3 4 11 2 0 9 0 0 1931 4 12 38 19 0 37 11 5½ 1932 4 5 21 5 0 16 12 0 1933 5 11 37 9 0 36 6 10 1934 5 14 44 9 6 44 8 2 1935 6 35 125 17 0 127 13 0 1936 8 66 206 11 2 207 12 7 1937 12 93 290 8 9 277 18 0 MILK (MOTHERS & CHILDREN) ORDERS. 1,545 applications for milk under this Order were dealt with during the year, of which 1,498 were granted and 47 refused: — ½ pint milk daily free 6 1 pint ,, ,, ,, 773 1½ pints ,, ,, ,, 1 2 pints ,, ,, 507 3 pints ,, ,, ,, 39 1 pint ,, ,, half-price 49 2 pints ,, ,, ,, 43 3 pints ,, ,, ,, 1 lib. dried milk weekly free 51 lilbs. ,, ,, ,, ,, 14 55 21bs. „ ,, ,, ,, 10 31bs. „ ,, ,, ,, 2 lib. ,, half-price 2 Not granted 47 1,545 The number last year was 1,394. The total of the accounts paid to 31st December amounted to £726. The cost per pint was 3d. from May to August and 3Jd. from September to March, from which price a discount of 5 per cent, is deducted from milk purveyors' accounts. MATERNITY AND CHILD WELFARE DENTAL SCHEME. The Dental Scheme for mothers and young children, started in 1928, continues to do good work. Tlie cost of dentures for mothers, in excess of what the mothers are ahle to pay, was home by the Voluntary Committees of tlie Centres until 1936, when it was taken over by the Maternity and Child Welf are Committee. Tlie following is a record for the year of the Dental Clinic for Mothers and Children. Expenditure Ox Milk. Maternity & Child Welfare. Year ending 31st March. Amount. £. s. d. 1927 104 19 9 1928 68 10 4 1929 40 15 2 1930 128 0 5 1931 245 0 0 1932 278 0 0 1933 389 0 0 1934 399 0 0 1935 408 0 0 1936 466 0 0 1937 726 0 0 56 Mothers. Children. Clinics held 101 Old cases 424 147 New cases 93 131 Total attendances 517 278 Finished cases 86 158 Attendances for dentures 182 — Dentures provided 39 — Dentures repaired 11 — Teeth extracted 795 200 Fillings done 39 25 Inspections 72 73 Gas cases 67 34 Local injections 119 9 Other treatments (dressings), scaling, gum treament, etc.) 30 206 A charge of 7s. 6d. per session is made for the use of the Dental facilities at the School Clinic by the Education Committee, the cost for the service for the year for use of premises, etc., being £37. ORTHOPAEDICS. The Surgeon attends monthly and the Masseuse three times weekly for the treatment of elementary school children and children under five years. The following are the statistics for the year for children under five:— Surgeon. Masseuse Sessions held 12 126 Children treated—New cases 41 — Old cases 19 — ,, attendances 60 513 The cost, which is divided proportionately between the Education and Maternity and Child Welfare Committees, was £44 lis. 9d. for the treatment of children under five years for the year to 31st March, 1938. Two children under 5 years were treated as in-patients at the Royal National Orthopaedic Hospital at Stanmore. 57 VOLUNTARY COMMITTEES. Assistance to mothers and children attending the Centres has been rendered by the Voluntary Committees during the year:— No. 1 Centres. No. 2 No. 3 Assistance providing Home Helps 10 — 16 ,, for Holidays and Convalescence 6 4 14 ,, ,, Dentures 6 2 10 ,, ,, Spectacles 3 3 1 ,, ,, Surgical instruments 1 — 1 ,, ,, Shoes 3 — — ,, ,, Extra nourishment 1 — — TODDLERS' PLAYROOM AT HIGHGATE. The Toddlers' Playroom, started in November, 1931, under Miss Benn, has a morning session from 9—12 on five days per week (Monday to Friday). There are 25 children between the ages of 2 and 5 years on the roll, who made a total of 3,090 attendances during the year. There is a nominal charge made for children:—11 paid 2/perweek; 6, 1/6; 2, 1/-; 2, 6d. and 4 were free. CHILD LIFE PROTECTION. PUBLIC HEALTH ACT, 1936 (Secs. 206—220)). The Children Act, 1908, and the Children and Yonng Persons Acts, 1932 & 1933, have been superseded in the main and incorporated in the Public Health Act, 1936. The work, however, is still 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. The number of requests for foster-mothers is much in excess of the number available and requests are often received from Societies and Authorities outside the Borough. 58 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 1937 21 10 15 52 ,, „ end ,, ,, 11 19 13 43 No. of foster-children on the register: At the beginning of 1937 24 16 19 50 „ „ end „ ,, 10 25 13 48 Died during the year — 1 — 1 On wham inquests were held during the year — — — — Visits to foster-children: 1st Visits 30 16 13 59 Total Visits 169 175 78 422 No proceedings were taken during the year. 59 MATERNITY STATISTICS. Ante-Natal, Natal and Post-Natal. MATERNITY AND CHILD WELFARE WORK. 1937 Nature of Work. Centres. Totals. No. 1. No. 2. No. 3 and Sub-Centre. Number of sessions held 179 102 78 359 „ ante-natal sessions held 50 24 22 96 Number of individual Mothers seen by Doctor:— Aute-uatal, New oases 218 91 64 373 „ Old cases 456 192 100 748 Post-natal, New cases 31 16 11 61 „ Old cases 5 9 0 14 713 308 175 1,196 Totilattendan.es of Mothers 973 32 213 1,509 Number of babies attending Centres for first time: Under 1 year 435 230 141 806 1-3 years 89 58 50 197 3—5 ,, 52 21 23 96 Number of individual babies on Centre registers: Under 1 year 356 173 238 767 1—5 years 803 375 228 1,406 Babies seen by Doctor 2,899 1,595 798 5,292 Attendances of babies at medica consultations 3,637 1,911 1,010 6,558 Total attendances of babies a Centrers Under 1 years 5,936 2,913 1,513 10,362 1—3 years 2,729 930 647 4,306 3-5 842 186 216 1,244 Referred to own private doctors 54 24 7 85 deferred to hospitals 231 61 13 305 ^ isits paid by nurses: — First visits Tota visits First visits Tots visits First visits Tota visits Grand First, visits Totals Total visits To expectant mothers 109 205 75 94 73 103 257 402 To infants under one year 549 2,410 282 800 237 734 1,068 3,944 To children aged 1-5 years . 133 3,051 87 806 54 1,170 274 5,627 Total visits paid by Nurses 791 6,266 444 1,700 364 2,007 1,599 9,973 CHILD LIFE PROTECTION— Visits paid to Foster Children 30 169 16 75 13 78 59 322 RECORD OF WORK OF MUNICIPAL MIDWIVES, 1937. Miss Andrews Mrs. Jameson 'Miss Hughes Total Confinements attended 144 44 30 218 Ante-natal Clinics attended 73 12 5 90 do. visits 675 161 261 1,097 Pout-natal visits 2,506 750 539 3,795 * Mrs. Jameson and Miss Hughes took up duty under the Midwives Act from 1st July. Borougb of Ibornseg ANNUAL REPORT OF THE School Medical Officer FOR THE Year ending December 31st 1937 3 HORNSEY EDUCATION COMMITTEE. List of Members, 31st December, 1937 APPOINTED BY HORNSEi-. Members of the Town Council— Aldermen Mr. W. G. Barrenger, J.P., 18, Fording ton Road, 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, Highgate, N.6. Mr. J. W. Rowlands, J.P., 25, Cholmeley Park, Highgate, N.6. Councillors Mrs. C. M. Gave, 10, Wood Vale, Muswell Hill, N.10 (Chairman). Mr. H. G. R. Griffin, 12, Avenue Road, Highgate, N.G (Vice-Chairman). Mr. S. H. Baker, 33, Coolhurst Road, Crouch End, N.8. Mr. W. J. Grimshaw, J.P., 25, Sheldon Avenue, Highgate, N.6. Mr. G. K. M. Hutchinson, 8, Grosvenor Gardens, N.10. Mr. D. V. Johnson, 54, Coolhurst Road, Crouch End, N.8 Mr. W. B. Lark, 27, Avenue Road, Highgate, N.6. Mr. W. J. Lendrum, 4, Creighton Avenue, Muswell Hill, N.10. Mr. J. W. Palmer, 30, Crescent Road, Crouch End, N.8. Mr. L. J. Valette, 59, Allison Road, Harringay, N.8. Co-optative Members— The Rev. E. S. Duval, M.A., The Rectory, High Street, Hornsey. Mr. F. C. Ellerton, 14, Bancroft Avenue, N.2. Mr. J. H. Ford, M.A., 5, Woodland Gardens, Muswell Hill, N.10. Mrs. A. Holman, J.P., 8, Hornsey Lane, Highgate, N.6. Mr. W. E. Paterson, M.A., B.Sc., 7, Donovan Avenue, N.10. Mrs. G. M. Reid, B.A., 60a, Shepherd's Hill, Highgate, N.6. Mr. H. Tompkins, 7, Danvers Road, Hornsey, N.8. 4 MEMBERS OF THE CENTRAL CARE SUB-COMMITTEE. Six members of the Education Committee— Councillors Mrs. G. M. Cave, G. K. M. Hutchinson, W. E. Lark, L. J. Valette, and Mrs. G. M. Keid, B.A., and Mr. H. Tompkins. Four Head Teachers of Elementary Schools nominated by the Hornsey Head Teachers' Association— Miss F. A. Barter, Mr. G. Simmonds, B.A., Miss H. -M. Stone, and Mr. H. Turner. The Chairman or Hon. Secretary of cach of the six District Care Committees as may be nominated by the District Care Committee— Mrs. H. M. Durrant, Mrs. M. L. Easterling, Mrs. J. Faradav, Mrs. J. I. Grimshaw, Mr. G. A. Henderson 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, Mr. W. Percival, M.A., and Mrs. E.. M. Tompkins. 5 LIST OF MEMBERS OF THE DISTRICT CARE COMMITTEES. N.B.—Mr. Councillor Valette, the Chairman of the Central Care Committee, is an ex-officio member of all the District Care Committees. Campsbourne. Members of the Central Cure Sub-Committee— Mrs. D. M. Johnson, Mrs. U. M. lteid, B.A., fMr. H. Tompkins. Head Teachers— Miss L. Regis, Miss D. F. Smith, Mr. H. Turner, Mr. J. W. T. Harris, Miss M. D. Sibley. Other Members— Mrs. G. T. Arnold, *Mrs. H. M. Durrant, Mrs. E. Gardiner, Mrs. A. D. Kinsman, Mrs. A. F. Lamble, Mrs. L. Whittle. Crouch End. Members of the Central Care Sub-Committee— *Mr. G. A. Henderson, Mrs. G. M. Reid, B.A., Mrs. H. Tompkins. Head Teachers— Miss F. A. Barter, Mr. J. lliffe, Miss A. E. Walmsley. Other Members— Mrs. E. Barnard, Mr. F. C. Carter, fMrs. E. H. Hare, Mrs. D. Holt, Miss F. Milborrow, Mrs. J. Stevenson. Harringay. Members of the Central Care Sub-Committee— Mr. W. Percival, M.A., Mrs. N. L. Brixey, *Mrs. C. Easterling, fMr. L. J. Valette. Head Teachers— Miss G. M. Ryde, B.Sc., Mr. L. A. Wilson, Mr. W. B. Cann, Mr. J. H. Spilman, B.Sc., Miss H. M. Stone. Secretary t chairman 6 Other Members— Mrs. J. H. Barrenger, Mrs. H. Betts, Mrs. Hawkins, Mrs. H. M. Hay, Mr. G. Pain, Mrs. L. J. Valette. Highgate. Members of the Central Care Sub-Committee— *Mrs. J. I. Grimshaw. Head Teachers— Mr. T. Ei. Durban, Miss 11. Spalding, Mr. E. 11. Lewis, Miss E. Towler. Other Members— Miss Dow, Mrs. E. Farrell, fMrs. G. Farquharson, the Rev. W. G. Howard, Mrs. A. Imber, Mr. S. Mason. Muswell Hill. Members uf the Central Care Sub-Committee— fCouncillor Mrs. C. M. Cave, * Mrs. E. Simmonds. Head Teachers— Miss E. F. Catley, Mr. I. T. Plant, Miss M. N. Clarke, Mr. G. Simmonds, B.A. Other Members— The Rev. E. J. A. Dunn, Mr. F. G. Edwardes, Mrs. M. Heppell, Mrs. A. Holman, J.P., Councillor F. J. Randall. Stkoud Green. Members of the Central Care Sub-Covimittee— Mrs. N. L. Brixey, *Mrs. J. Faraday, fCouncillor W. V. Wall. Head Teachers— Miss Ei. M. Cockhill, Mr. F. W. Jaggard, Miss P. Jones. Other Members— Mrs. J. Ashworth, Mrs. A. Cole, Miss Freeman, Mrs. K. Knowles, Mrs. H. H. Smith, Mrs. Wall. * Secretary. t Chairman- 7 STAFF OF SCHOOL MEDICAL SERVICE. School Medical Officer: R. P. Garrow, M.D., D.P.H. Assistant School Medical Officer: Jean Sutherland, M.B., Cli.B., D.P.H., D.C.O.G. Dentist: Winifred M. Hunt, L.D.S. Oculist: J. S. Boden, M.B., B.S. Aurist: A. R. Friel, M.A., M.D., F.R.C.S. (I.). 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 (Resigned 31/12/37.) L. M. Oliver. F. E. Paris. F. Ross (Resigned .30/4/37.) Clerk: H. M. Croak Assistant Clerks: El Cooper. J. WlILLMORE. 8 To the Chairman and Members of the EDUCATION COMMITTEE. Madam Chairman, Ladies and Gentlemen, I have the honour to submit my Annual Report for the year ending 31st December, 1937. The general scope of the work and the arrangements for carrying it out have been completely reviewed in previous years. With one possible exception, to be mentioned later (dental treatment), the work satisfies all the Board of Education's requirements. In these circumstances it is unnecessary to report in detail under all the heads set out in the Board's memorandum of January, 1934, on the form and content of Annual Reports on School Medical Services. Members of the Education Committee, Teaching Staffs, and members of Care Committees are all in closj touch with the School Medical Service and understand fully its aims and ideals. The Board of Education can always, and occasionally does, ask for information on specific points. I will, therefore, confine myself to mentioning as briefly as possible any changes which have taken place or are pending in regard to this service. CHANGES IN STAFF. Ear, Nose and Throat Suroeon. Dr. A. R. Friel has retired from his post as Ear, Nose and Throat Surgeon, and his place has been taken by Dr. Clark. T wish to pay special tribute to the pioneer work in conservative methods of dealing with otorrhoea, rhinitis, and other conditions of the ear, nose and throat, which Dr. Friel has developed and practised at the Clinic during his thirteen years tenure of this post. I believe his work is destined to influence practice in this field far beyond the boundaries of Hornsey and long after he has ceased to take any active part in it. (Table on Page 30.) School Nurses. I very much regret to record that two School Nurses have retired on account of ill-health, Miss Ross and Miss Anscombe. Both have given devoted service to the school children for many years. I am glad to know that they have recovered W health considerably since being relieved of the strain of duty. 9 Their places have been taken by Mrs. Hatton and Miss Whimster. Clerical Staff. Miss H. Powell, at the School Clinic, resigned to get married, and takes with her the best wishes of the staff. Her place has been taken by Miss Cooper, and, on account of the increase in the volume of work, Miss Willmore has been appointed as third clerk. Medical Inspection in the Schools. Dr. Jean Sutherland carries out medical inspection in the girls' and infants' departments and I do the boys' departments. We are greatly indebted to the Head Teachers for the arrangements which they make to facilitate this work and for the keen interest they take in the findings of medical examinations. The results are set out in the statistical tables at the end of this report. It is not easy to convey in figures the results of such an annual survey. The impression gained in the course of this work is that there is a steady gain in the general physique of the children. Less attention is being paid to "defects" of a trifling transitory nature; more attention is being directed to the nutritional state and general physique and posture of the children. Sound nutrition and intelligent physical education can do more for the rising generation than schemes of medical treatment. In this connection I desire to emphasise the great work being done by the teaching staffs in handling the milk in schools scheme and in collaboration with the organisers of physical training. Dental Treatment. The Authority's schemes of treatment at the School Clinic tor minor ailments, skin conditions, ear, nose and'throat defects, errors of refraction, deformities, etc., are all equal to 'he demands made on them. That is to say, all defects of whatever nature found at routine medical inspection or at special inspections which are not treated by private doctors "> at hospital can secure the necessary treatment without delay I lie School Clinic. TTie one exception to this is dental treatment. It is highly desirable in the interests of the 10 children's health that dental inspection and treatment of nil the childrenin all the departments should be carried out annually. One whole-time dentist cannot do this for 7,000 elementary school children. The Authority has, therefore, decided to furnish and equip the second dental surgery at the School Clinic and appoint an additional dentist half-time. A dental attendant is also to be appointed. It is hoped that with the increase of service dental inspection and treatment may be completed throughout the schools in the course of one year. The practice of the school dentist (.Miss Winifred Hunt) is to carry out dental inspection of a whole school and offer treatment for the children requiring it. The percentage of acceptances varies from 63 to 75 in different schools and is higher than the average for the country as a whole. A certain number have treatment from their private dentists and some attend dental hospitals. Those accepting the treatment offered at the School Clinic are sent for in batches forenoon and afternoon until the dental treatment at that school is completed. The children forming each batch are selected by the Head Teacher with a view to causing as little disturbance of school routine as possible. The greater portion of the dentist's time is occupied in fillings. Some extractions are done with local antesthesia and one session per week is devoted to extraction under general anaesthetic, administered bv the Assistant Medical Officer. Portions of two sessions per week of the dentist's time is devoted to emergencies—i.e., children sent from the schools with toothache, dental abscess and other casualties. Tf dental treatment offered at routine dental inspection is refused by the parents the child is not eligible for any kind of dental treatment until the next routine dental inspection of the school. When the more distant schools are being done the school dentist has fewer cases per session and does more work per child in order to reduce the number of visits a child has to undertake. I" the case of Coldfall, the most distant school from the Clinic, the transport of the children in batches by the ambulance effects a great saving in the time of the children and expense to the parents. On completion of the work at one school the dentist proceeds to the next school, and so on until the 11 rota is completed. At present this occupies eighteen months or more. It is hoped that under the new arrangements it may be completed within the year as medical inspection and treatment are. The high percentage of acceptances of dental treatment is in itself sufficient testimony to the quality of Miss Hunt's work and the great patience, tact and kindness with which she handles the children. 1 desire also to acknowledge that in this, as, indeed, in every department of the work, we have the greatest possible support from the teachers. NUliSEHY CLASSES. The first nursery class in the Borough of Hornsey was opened on 20th May, 1937, by Miss Lillian de Lissa, Chairman of the Nursery School Association of Great Britain, the Mayor of Hornsey presiding. It was built in connection with the Oainpsbourne Infants' School, under the direction of Mr. L. It. Hiscock, F.R.L.B..A. The lay-out, building, equipment, staffing and organisation are on the principle that if a thing is worth doing it is worth doing well. The accommodation is for 40 children between 3 and 5 years of age in a nursery playroom about 27ft. x 30ft., warmed by six heating panels in the ceiling and an electric fire, and lighted on east and south sides by very long windows. On the south side the playroom opens by French windows on to a spacious balcony with a glass roof. Holler blinds are provided to draw under the glass roof in hot weather. Passing southward from the verandah is a separate playground) for the nursery class children about 50 yards in length by about 10 yards at its narrowest part and 20 yards at its widest. This contains two flower beds, a grass plot, and is surrounded by a border of shrubs. A fenced-in sand-pit has been built in one of the corners near the playroom. A drinking fountain is provided. On the western side of the playroom—i.e., towards Nightingale Lane—is the sanitary provision, consisting ol three small low pedestal w.c.'s, each with its own flushing cistern operated by a chain pull. There are six wash hand basins, large and small slop sinks, a drinking fountain, and two mirrors on the walls adjusted for the height of children of 3 to 5 years of age. Separate mugs, toothbrushes, combs and 12 towels are provided for each child, and there is ample accommodation for the hanging of coats and hats. On the opposite side of the entrance lobby from the sanitary accommodation are the kitchen and larder, fully equipped for cooking by electricity, and there is a separate vv.c. and wash hand basin for the Cook-attendant and her assistant. On the north side of the nursery playroom are two rooms—one entered directly, the toy store room, and the other, entered via the playground, is the medical inspection and treatment room. The whole forms a wonderfully complete and compact scheme. The daily routine, which varies to some extent according to the weather, is as follows:— 8.40—9. 0 a.m. Children arrive via the separate entrance from Nightingale Lane. Undress, put on overalls, clean teeth. 9. 0—9.30 Daily inspection by Nurse. 9.30—10.30 Free play in the open air (or indoors if wet). 10.30 Milk—the contents of the l/3rd pint bottle are warmed and tipped into a drinking mug for the children. 10.45—11.15 Individual occupation and sense training (toys, apparatus, etc.). 11.15—11.25 Singing. 11.25—12. 0 Wash hands and faces and prepare for dinner. 12. 0—12.30 p.m. Dinner (menu arranged in three weeks' rotation is appended herewith). 12.30—1.15 Clearing away after dinner and preparing for sleep. 1.15—3. 0 Sleep. 3.30—4. 0 Free play and preparing for going home. 13 The nursery playroom is under the general charge of Miss Smith, Head Mistress of Campsbourue Infants' Department, and the Committee have been fortunate in the choice of Miss Elliott as teacher in charge of the class. She is ably assisted in the work by Miss Pile. The children are seen each morning by the School Nurse, who is on the look-out for any signs of infection, so that immediate exclusion can be effected in order, if possible, to diminish the incidence of infectious disease. Medical inspection is carried out each term—that is to say, three teims annually—and in addition any child can be referred by teacher or parent to tho School Medical Officer for any particular reason at any time. Nukseky Class—Menus. Every dinner includes a rusk made from wholemeal bread and a piece of raw apple with skin left on. First Week. Monday. Boiled mutton Parsley sauce. Potatoes, onions, carrots. Stewed fruit and egg custard. Tuesday. Vegetable soup Stock from meat bones, lentils, onions, carrots, potatoes. Date or sultana pudding. Wednesday. Diver and bacon stewed with onions, carrots and potatoes. Stewed fruit and milk pudding. Thursday. Shepherd's pie and greens. Stewed fruit and egg custard. Friday. Fisli baked in milk and butter, parsley sauce, potatoes and tomatoes. Apple batter. Second Week. Monday. Scotch broth, containing mutton, barley, onions, carrots and potatoes. Bread and butter pudding with sultanas. 14 Tuesday. Lentil pie with potatoes, tomatots or carrots, and gruvv from meat bones. Blancmange. Wednesday. Minced beef, potatoes, carrots, onions. Stewed fruit and egg custard. Thursday. Vegetable soup. Apple pudding. Friday. Steamed fish, potatoes, tomatoes and parsley sauce. Third Week. Monday. Scrambled eggs, tomatoes and potatoes. Stewed fruit and custard. Tuesday. Liver and bacon, with potatoes, carrots and onions. Blancmange. Wednesday. Shepherd's pie and greens. lioly-poly, with sultanas or syrup. Thursday. Boiled mutton, potatoes and vegetables. Milk pudding. Friday. Fish pie, tomatoes and parsley sauce. Stewed fruit with junket; custard or blancmange. SCHOOL HYGIENE. Alterations and Additions to School Buildings. During 10157 the structural alterations and additions at the Highgate Council School were completed, and those at the North and South Harringay Schools were put in hand. At Highgate a large gymnasium, with shower baths was built, many of the old classrooms were substantially improved and the children's offices, cloakrooms and lavatories were replaced by others of modern type. At North Harringay the main additions consist of a much-needed hall for each department in place of one hall for the Infants, Junior and Senior Departments. Shower baths and changing rooms are provided between the 15 second and third storeys so as to be available for both Juniors and Seniors. A separate gymnasium, with showers and changing room, lias been erected at South Harringay for the Senior Girls and Juniors. An additional classroom lias also been built at this school and the children's offices, cloakroom and lavatories have been modernised. New staff rooms and medical inspection room have been provided in the Infants' and Junior School. The new school playing field at Ayhner Road provided for the Highgate elementary schools was opened for play during the year, and a small pavilion, with dressing-rooms, lavatories, etc., has been built on the field. Work of the Care Committees. The six District Care Committees serving Campsbourne, Crouch End, Harringay, Highgate, Muswell Hill and Stroud Green meet regularly and give patient and sympathetic attention and assistance in various forms to children with special needs. The District Committees keep in touch with each other through the Central Care Sub-Committee of the Education Committee, which meets quarterly at the Town Hall. The total income of the six District Care Committees for the year was £314 (all from voluntary sources) and the expenditure was £221, leaving a balance of £93. The money is spent in assisting parents to provide spectacles ordered by the school oculist, in providing additional milk in schools for certain children and in various other ways. The Children's Holiday Fund administered by the Central ''are Sub-Committee sent 169 children away for holidays at a cost of about £250. The same Sub-Committee also spent over £1^0 in providing necessitous children with new boots and in repairing old ones. The Education Authority has reason to be proud of this magnificent organisation in which its own members, coopted members, teachers, officials and parents co-operate for the welfare of the school children. I am, Ladies and Gentlemen, Your obedient servant, R, P. GARROW, School Medical Officer. 16 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 9 & 4 p.m. Throat Operations : (b) Tonsils and Adenoids Hornsey Central Hospital. Surgical Staff of the Hospital. As required. (0 Defective Visiou. School Clinic. School Oculist (Dr. J. S. Bodeu). Two sessions weekly, Tuesday afternoons, Thursday mornings. (d) Ear Disease and defective hearing. School Clinic. School Aurist (Dr. A. R. Friel) One session weekly, Saturday morning. (e) Dental Defects. School Clinic. School Dentist Miss W. M Hunt Full time. Eleven sessions weekly. (f) Crippling defects. School Clinic. Orthopaedic Surgeon (Mr. H J.Seddnn). One session monthly, 4th Monday morning in each month. Masseuse (Mrs. Yorke). Four sessions weekly, Monday, Wednesday, Friday afternoons & Saturday mornings. (g) Stammering and other speech defects. School Clinic. Special Teacher Miss Bennett Three sessions weekly, Monday, Thursday & Friday afternoons. (h) Conditions requiring medical consultation. School Clinics and Infant Welfare Centres. S.M.O. and A.S.M.O. Seven sessions or part sessions weekly. 17 TABLE I. RETURN OF MEDICAL INSPECTIONS, 1937, ATTENDING PUBLIC ELEMENTARY SCHOOLS (see note a). (a)—Routine Medical Inspections. Number of Inspections in the prescribed Groups— (see note b). Entrants 744 Second Age Group 1,523 Third Age Group 363 Total 2,630 Number of other routine inspections (see note c). 484 Grand Total 3,114 (b)—Other Inspections. Number of special inspections (see note d). 2,012 Number of re-inspections (see note e). 2,963 Total 4,975 (c)—Children Found to Require Treatment. Number of individual children (see note f) found at Routine Medical Inspection to Require Treatment (excluding Uncleanliness and Dental Diseases). Prescribed Groups : Defective Vision excluding Squint. All other conditions recorded in Table 2a. Total. Entrants 1 24 25 Second Age Group 95 31 126 Third Age Group 34 5 39 Total (Prescribed Groups) 130 60 190 Other Routine Inspections 27 10 37 Grand Total (see note g) 157 70 227 18 NOTES ON TABLE I. (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 Regular tions relating to Special Services—Grant Regulations No. 19. (II) on the school premises (or at a place specially sanotioned 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 be recorded as an attendance for treatment. (f) No Individual child should be counted more than once, even if It la found to be suffering from more than one defect. (g) This total should not exceed the total of column 2 of Part A. of Table II. on Form 8 b.M. 19 TABLE II. (A) RETURN OF DEFECTS FOUND BY MEDICAL INSPECTION IN THE YEAR ENDED 31st DECEMBER, 1937. 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 tint requiring treatment. (1) (2) (3. (4) (5) Skin (1) Ringworm, scalp - ... ... 9 ... (2) „ body - ... ... 7 ... (3) Scabies - 2 ... 19 ... (4) Impetigo . 2 ... 41 ... (5) Other Diseases (Non tuber culous) 2 ... 148 ... TOTAL (Heads 1 to 5) 6 ... 224 ... Eye (6) Blepharitis 4 1 6 ... (7) Conjunctivitis 2 ... 32 ... (8) Keratitis . ... ... ... ... (9) Corneal Opacities ... ... ... ... (10) Other Conditions (excluding Defective Vision and Squint ... 2 11 ... TOTAL (Heads 6 to 10) 6 3 49 ... (11) Defective Vision vexclnding Squint) 157 11 135 ... (12) Squint . 16 ... 39 ... Ear (13) Defective Hearing 5 ... 8 ... (14) Otitis Media 2 ... 26 ... (I5) Other Ear Diseases ... ... 43 ... Nose and Th roat (16) Chronic Tonsillitis only - 3 ... 18 ... (17) Adenoids only . ... ... ... ... (18) Chronic Tonsillitis and Adenoids ... ... ... ... (19)Other conditions 19 ... 88 ... (20) Enlarged Cervical Glands (N on-Tuberculous) ... ... 36 ... (21) Defective Speech ... ... ... ... Heart and Circulation Heart Disease ... ... ... ... (22) Organic . ... 3 ... ... (23) Functional ... ... ... ... (24) Ansemia . ... ... ... ... Lungs (25) Bronchitis ... 2 ... ... (26) Other Non-Tuberculous Diseases ... ... ... ... Tuberculosis Pulmonary ; (27) Definite . ... ... ... ... (28) Suspected . ... ... ... ... Non-Pulmonary : (29) Glands . ... ... ... ... (30) Bones and Joints ... ... ... ... (31) Skin ... ... ... ... (32) Other Forms - ... ... ... ... Nervous System (33) Epilepsy . ... ... ... ... (34) Chorea . ... 1 3 ... (35) Other Conditions ... 2 ... ... Deformities (36) Rickets . ... 17 ... ... (37) Spinal Curvature 3 4 ... ... (38) Other Forms - 16 266 10 ... (3S») Other Defects and Diseases (excluding Uncleanliness and Dental Diseases 1 ... 730 ... TOTALS - 234 309 1409 ... 20 TABLE II (continued) (B) CLASSIFICATION OF THE NUTRITION OF CHILDREN INSPECTED DURING THE YEAR IN THE ROUTINE AGE GROUPS. (See Administrative Memorandum No. 124, dated 31st December, 1934.) AGE GROUPS Number of Children 1nspected. A (Excellent) B (Normal) c (Slightly sub-normal D (Bad) No. % No. % No. /o No. % Entrants 744 194 26% 519 70% 31 4% — Second Age-group 1,523 605 40% 846 55% 72 5% — Third Age-Group 363 178 49% 167 46% 18 5% — Other Routine Inspections 484 316 65% 153 32% 15 3% — TOTAL 3,114 1,293 41% 1,685 54% 136 40% — TABLE III. BLIND CHILDREN. A blind child is defined by Section 69 of the Education Act, 1921, as one who is "too blind to be able to read the ordinary school books used by children." This definition covers some children who are totally, or almost totally, blind and can only be appropriately taught in a school for blind children, and others who have partial sight and can be appropriately taught in a school for partially sighted children. Only the first class should be included in this section At Certified Schools for the Blind. At Public Elementary School At other Institution. Total. . 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. — 2 — — — 2 21 DEAF CHILDREN. A deaf child is defined by Section 69 of the Education Act, 1921, as one who is "too deaf to be taught In a class of hearing children in an elementary school." This definition covers some children who are totally, or almost totally, deaf and can only be appropriately taught in a school for deaf children, and others who have partial hearing and can be appropriately taught in a school for partially deaf children. Only the first class should be included in this section. At Certified School for the Deaf. At Public Elemenary At other Institution At no School or Institution. Total. 38 - - - 38 PARTIALLY DEAF CHILDREN. Enter in this Section only children who can appropriately be taught only 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. — — — — — Nil. MENTALLY DEFECTIVE CHILDREN. Feeele-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 At . At Schools for Public no School Mentally Defective Elementary At other or Total. Children. School. Institutions. Institutions. 38 _ _ _ 38 22 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. 2 — — 1 3 PHYSICALLY DEFECTIVE CHILDREN. A.—Tuberculous Children. 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. Only children diagnosed as tuberculous and requiring treatment for tuberculosis at a sanatorium, a dispensary, or elsewhere should be recorded in this category. 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 conforms to the description of a crippled child given at the head of Section C below. All other tuberculous children who are regarded as being no longer in need of treatment should be recorded as delicate children, provided the Medical Officer is prepared to certify under Section 55 of the Education Act, 1921, that they are incapable by reason of physical defect of receiving proper benefit from the instruction In the ordinary Public Elementary Schools. 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. — — 2 1 3 * It is essential that tuberculous children who are, or may be. n source of infection to others should be promptly excluded from Public Elementary Schools. 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.† At other Institutions. At no School or Institution. Total. 3 — 1 — 4 23 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. Sucn 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 under Section 55 of the Education Act, 1921, that they are incapable by reason of physical defect of receiving proper benefit from the instruction in the ordinary Public Elementary Schools. At At At At Certified Public other Institution. no School Special Elcmenfiry or Total. Schools. Schools. Institution. — — — ' — 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, and in whose case the Medical Officer would be prepared to certify under Section 55 of the Education Act, 1921, that they are incapable by reason of such physical defect of receiving proper benefit from the Instruction in the ordinary Public Elementary Schools. At At At Certified Public no School . Total Special Elementary At other Institution. Schools. School Institution. 9 — — 1 10 D. CHILDREN WITH HEART DISEASE. This section should be confined to children in whose case the Medical Officer would be prepared to certify, under Section 55 of the Education Act. 1921, that they are incapable by reason of such physical defect of receiving proper benefit from the instruction In the ordinary Public Elementary Schools. At At At Certified Public At no School Special Elementary other or Total. Schools. Schools. Institution. Institution. — 2 — 13 24 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 (Feeble-minded). Severe Epilepsy. Active Tuberculosis. Crippling (as defined in Section C above). Heart Disease. The clinical condition causing the defect need not be specified; it will, for example, be sufficient to enter in Coloum 1, Blind and Feeble-minded. Deaf. Crippled and Heart. Should there be no children suffering from Multiple Defects, please enter "Nil." Combination of Defect. At Certified Special Schools. At Public Elementary Schools. At other Institutions. At no School or Institution. Total. — — — — — Nil. 25 TABLE IV. YEAR ENDED 31st DECEMBER, 1937. TREATMENT TABLE. (see note a). 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— 9 — 9 Ringworm-Scalp (i) X-Ray Treatment. If none, indicate by dash. (ii) Other Treatment. — — — Ringworm-Body 7 — 7 Scabies 21 — 21 Impetigo 43 — 43 Other Skin Disease 150 — 150 Minor Eye Defects (External and other, but excluding cases falling in Group II). 49 — 49 Minor Ear Defects (See note c). 43 — 43 Miscellaneous (e.g., minor injuries, bruises, sores, chilblains, etc.) 315 — 315 Total 637 — 637 26 TABLE IV. (continued.) Group II.—Defective Vision and Squint (excluding Minor Eye Defects treated as Minor Ailments—Group I.). Number of Defects dealt with Under the Authority's Scheme (see note b) Otherwise. Total. Errors of Refraction (including Squint). (Operations for squint should be recorded separately in the body of the School Medical Officer's Report). 511 12 523 Other Defect or Disease of the Eyes (excluding those recorded in Group 1.). 42 — 42 Total 553 12 565 Under the Authority's Scheme. Otherwise. Total. No. of Children for whom spectacles were (a) Prescribed 447 — 447 (b) Obtained 440 — 440 Group III.—Treatment of Defects of Nose and Throat. Number of Defects. Received Operative Treatment. Received other forms of Treatment. (4) Total number treated. (5) Under the Authority's Scheme, in Clinic or Hospital (see note b). (1) By Private Practitioner or Hospital, apart from the Authority's Scheme. (2) Total. (3) (i) 19 (ii) (iii) (iv) (i) (ii) (iii) (iv) (i) 19 (ii) (iii) (iv) 106 125 (i) Tonsils only. (ii) Adenoids only. (iii) Tonsils and Adenoids, (iv) Other defects of the nose and throat. 27 Group IV.—Orthop/edic and Postural Defects. (see note d). Under the Authority's Scheme. (See note b)(1) Otherwise. '2) Total number treated. (set note e.) Residential treatment with education. (1) Residential treatment without education. (2) Non-residential treatment at an orthopaedic clinic. (3) Residential treatment with education. (1) Residential treatment without education. (2) Non-residential treatment at an orthopaedic clinic. (3) Number of children treated. 5 205 210 TABLE V—DENTAL INSPECTION AND TREATMENT. (1) Number of children Inspected by the Dentist: — (a) Routine age-groups: AGE 5 6 7 8 9 10 11 12 13 14 15 TOTAL Number 70 261 264 342 348 413 427 288 226 193 83 2,920 (b) Specials (see note (f) 1,083 (c) TOTAL (Routine and Specials) 4,003 (2) Number found to require treatment *3,679 (3) Number actually treated 2,642 (4) Attendances made by children for treatment 4,360 (5) Half-days devoted to:— (7) Extractions:— Inspection 24 Permanent Teeth 538 Treatment 460 Temporary Teeth 2,786 Total 484 Total 3,324 (8) Administration of general aneethetics for extractions 876 (6) Fillings:—(See note g) (9) Other operations: Permanent Teeth 3,059 Permanent Teeth 144 Temporary Teeth 2 Temporary Teeth 2,479 Total 3,061 Total 2,623 TABLE VI.—UNCLEANLINESS AND VERMINOUS CONDITIONS (see note h). (i.) Average number of visits per school made during the year by the School Nurses 47 (11.) Total number of examinations of children in the schools by School Nurses 29,334 (iii.) Number of individual children found unclean (see note i) 336 (lv.) Number of children cleansed under arrangements made by the Local Education Authority 382 (v.) Number of cases in which legal proceedings were taken: — (a) Under the Education Act, 1921 0 (b) Under School Attendance Byelaws 0 This number is in excess of the previous years on account of including the specials treated. 28 NOTES ON TABI.E IV. (a) The Tables 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. (g) Temporary fillings, whether in permanent or temporary teeth, should be recorded as other operations. (h.) 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. (t) (1) All cases of uncleanliness, however slight, should be recorded. (ii) The return should relate to individual children and not to instances of uncleanliness. N.B.—The above Tables 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.). 29 TABLE VII. LIST OF SCHOOLS IN THE BOROUGH. School. Department. Authorized accommodation. Averagr No. on the Rolls for qr. ended 31/12/37. Head Teacher. Campsbourue Junr. 420 311.2 Mr. H. Turner ” Senr. Girls 320 228.6 Miss L. Regis ” Infants 440 273.7 Miss D. F. Smith Coldfall Mixed 520 540.6 Mr. G. Simmonds, B.A. ” Infants 400 260.0 Miss M. N. Clarke Crouch End Boys 360 264.5 Mr. J. Iiffe ” Junior 400 461.4 Miss F. A. Barter Rokesly Infants 480 412.6 Miss A E. Walmsley Higligate Mixed 328 312.1 Mr T. E. Durbau ” Infants 264 130.1 Miss R. Spalding Hariingay Senr. Boys 312 238.3 Mr. W. B. Cann North Harriugay Junr. Mxd. 418 387.1 Mr. J. H. Spilman, B.Sc. ” Infants 446 262.7 Miss H. M. Stone HarriDgay Senr. Girls 320 209.1 Miss G. M. Ryde, B.Sc. South Harringay Infants & Junr. Mxd. 340 320.3 Mr. L. A. Wilson Stroud Green Senr. Mixed 346 347.7 Mr. F. W. Jaggard ” ” Junr. Mixed 408 315.5 Miss E. M. Cockhill ” ” Infants 344 287.1 Miss R Jones Muswell Hill Junr. Mixed 200 183.7 Miss E. F. Catley St. Mary's Mixed 580 556.1 Mr. J. W. T. Harris ” Infants 240 257.6 Miss M. D. Sibley St. Michael's Mixed 196 125.8 Mr. E R. Lewis ” Infants 168 72.4 Miss E. Towler St. James Junr. Mixed 240 234.4 Mr. I. T. Plant Totals 8,480 6,992.6 30 REPORT OF DR. A. R. FRIEL, M.A., M.D., F.R.C.S., School Aurist. The following table gives a summary of tlie conditions treated and the results obtained: — Total (Ears). Cured. Lost Sight of. Still under treatment. Hospital. Acute Suppurative Otitis Media 21 19 2 — — Chronic Suppurative Otitis Media Due to (1) Tympanic sepsis 7 5 — 2 — (2) T. S. & Granulations 3 2 — 1 — (3) T.S. and Polyp 2 1 — 1 — (4) Mastoid 6 — 1 1 4 External Otitis 5 4 — 1 — Not Diagnosed 3 3 — — — Totals 47 34 3 6 4 A. R. FRIEL, Aural Surgeon.