BOROUGH OF HORNSEY. ANNUAL REPORT OF THE Medical Officer of Health AND School Medical Officer FOR 1940 R. P. GARROW, M.D., D.P.H. Printed by "The Hornsey Journal," Ltd., 161, Tottenham Lane. N.8. Borough of Ibornse ANNUAL REPORT for 1940 of the Medical Officer of Health. 2 HEALTH COMMITTEE as at 31st December, 1940. Alderman Elliott E. Brooks (Chairman). 122, Crouch Hill, N.8. The Mayor, Alderman H. G. J. Williams, J.P., 105, The Chine, N.21. Alderman S. G. Goulding, Woodlands, Cranley Gardens, N.10. ,, Wm. J. Grimshaw, 25, Sheldon Avenue, N.6. ,, W. W. Kelland, M.A., 66, Avenue Road, N.6. ,, J. W. Rowlands, J.P., 25, Cholmeley Park, N.6. ,, J. W. Shipp, 40, Coleridge Road, N.8. ,, R. Steeds, 19, Coolhurst Road, N.8. ,, C. Winkley, 72, Woodside Avenue, N.10. Councillor Mrs. J. H. Barrenger, 18, Fordington Road, N.6. „ Mrs. C. M. Cave, 10, Wood Vale, N.10. ,, J. Edwards, 102, Turnpike Lane, N.8. ,, Mrs. M. N. Hill, 16, Bishopswood Road, N.6. ,, G. F. N. Norman, 12, Woodberry Crescent, N.10. ,, F. L. Pascoe, 3/15, Northwood Hall, N.6. ,, T. Tivendale, 12, Colney Hatch Lane, N.10. ,, L. J. Valette, 59, Allison Road, N.8. ,, W. V. Wall, 10, Winchester Place, N.6. ,, F. Wilders, 84, The Vale, N.14. 3 STAFF OF PUBLIC HEALTH DEPARTMENT. †*Medical Officer of Health and School Medical Officer E. P. Garrow, m.d., d.p.h. †*Deputy Medical Officer of Health and Assistant Medical Officer of Schools and Maternity and Child Welfare Centres Marian Lones, b.sc., m.b., b.s., m.r.c.s., l.r.c.p., d.p.h. ‡Obstetric Consultants Dr. A. W. Bourne, 12, Wimpole Street, W.1. Dr. W. Mck. H. McCullauh, 149, Harley Street, W.l. Dr. L. H. W. Williams, 89, Harley Street, W.1. ‡Dentist (M. & C.W. Dental Scheme) H. A. Creeke, l.d.s. †*Senior Sanitary Inspector, l'etroleum Inspector, Shops Acts Inspector, Young Persons Act Inspector, Factory Act Inspector, Food Contamination Officer Henry Eastwood, M.R.San.I. M.S.I.A. Cert. R.San.I. Cert. Insp. of Meat and Poods. † *Sanitary Inspectors and Shops Acts Inspectors, Young Persons Act Inspectors, Factory Act Inspectors J. H. Jesse, M.S.I.A. Cert. R.San.I. Cert. Insp. of Meat and Poods. A.R.P.s. 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 Poods. 4 †*Sanitarv Inspectors and Shops H. Foster, Acts Inspectors, Young Per- M.S.I.A cert. R.San.I. sons Act Inspectors, Factory Cert. Insp. of Meat and Foods. Act Inspectors (contd.) Cert. San. Science. Cert. Smoke Inspector. (Resigned 31st May, 1940.) E. Hundy, M.S.I.A. Cert. R.San.I. Cert. Insp. of Meat and Foods. R. Downes, M.S.I.A. Cert. R.San.I. (Temporary, appointed to Permanent Staff 1st June, 1940.) †Chief Clerk W. Gilroy. (Retired 30th June, 1940.) E. Cheesman. (Appointed 1st July, 1940.) †Assistant Clerks N. Smith. (On Active Service from 11th January, 1940.) Miss P. Aylward, W. A. Simons. (On Active Service from 27th October, 1939.) T. Hadley, (Temporary, appointed to Permanent Staff 23rd December, 1940.) Miss E. A. Smith. (Appointed Temporary 3rd June, 1940.) B. GROVER. Appointed Temporary 22nd May, 1940— 17th August, 1940.) †Health Visitors Mrs. E. Durnford, h.v. Cert., C.M.B. Miss A. Godden, H.v. Cert., S.R.N., C.M.B. Miss E. Hart, h.v. Cert., S.R.N., C.M.B. Miss E. K. Cumming, H.V. Cert., s.r.n., C.M.B. Mrs. L. Hatton, H.V. Cert., S.R.N., C.M.B. (Part time Health Visitor and School Nurse.) †Midwives Miss M. Andrews, c.m.b. Mrs. M. Jamison, c.m.b. Miss L. Hugiies, c.m.b. Miss A. C. Matthews, c.m.b. (Appointed 1st April, 1940.) 5 †Mortuary Keeper C. F. Catlin. †Disinfectors W. H. Lewis. P. Hall. †Medical Services Motor Driver P. Maktin. ‡Veterinary Inspector under Diseases of Animals Acts F. G. Buxton, m.r.c.v.s. 15, Jackson's Lane, N.G. Note: — † Whole-time Officers. * Officers in respect of whom salary contribution is made under the Public Health Acts or by Exchequer Grants. ‡ Part-time Offioers. 6 To the Mayor, Aldermen and Councillors of the Borough of Hornsey. Mr. Mayor, Ladies and Gentlemen, I have the honour to submit my Annual Report for the year ending December 31st, 1940. The birth rate, 1282, is the highest since 1930. The deaths of infants under one year of age numbered 40, which, in 933 births, gives an infant mortality rate of 49 per 1,000 live births, compared with 27 in the previous year. This infant mortality rate is the highest since 1931 and calls for explanation. Analysis of the infant deaths for the year shows that 25 of the total of 46—that is more than half—occurred in the first month of life. Of the remaining 21 infant deaths no fewer than 15 were caused by broncho-pneumonia, three from gastro enteritis and the remaining three from various other causes. The average number of infant deaths per annum from broncho-pneumonia in the ten years 1930-1939 inclusive was six. In 1929 broncho-pneumonia caused 18 infant deaths in Hornsey. The explanation of this excessive infant mortality from bronchopneumonia in 1929 and 1940 was undoubtedly the severity of these winters. The intense cold of the first three months of the year also accounted for the deaths of an unusual number of the oldest residents. The higher mortality amongst very old and very young, together with the deaths caused by enemy action, accounts for the sharp rise in the general death rate from 1116 in 1939 to 1516 in 1940. In spite of these adverse mortality figures, there is no evidence in the statistics of deterioration in the general health of the population. There has been no exceptional prevalence of or mortality from the common infectious diseases. Measles and whooping-cough were added to the list of notifiable diseases at the end of 1939, and during 1940 there were notified 77 cases of the former and 30 of the latter without a death. All forms of tuberculosis caused 49 deaths during the year—the lowest figure ever recorded. 7 The number nf doctors in active prnctice has been considerably reduced by recruitment to the Forces, but those remaining behind have not been overworked. The District Nursing Association has been able to meet all the calls made upon it with a greatly reduced staff. The hospitals, with a large proportion of their beds reserved for war casualties, were still able to receive the civilian sick without undue pressure on their accommodation. Medical examination of babies and toddlers at the centres and of children in the schools confirm the satisfactory state of the health and nutrition of the child population. There is, therefore, ample evidence from many sources that the population has adapted itself to the inconveniences and restrictions of war without injury to its health. I have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your obedient servant, E. P. GARROW. Medical Officer of Health. 8 STATISTICS FOR 1940. (Section A). Social and Economic Statistics. Area (acres) 2,872 „ (square miles) 4.49 Population (Census 1931) 95,524 Do., Registrar-General's estimate, 1940 77,130 Number of inhabited houses (end of 1940), according to Rate Books Not available Rateable value (General Rate) at 31st December ... £1,093.660 Product of a penny rate £4,000 LIVE BIRTHS— *For I.M., etc. †For B. Rate M. F. M. F. Legitimate 469 416 503 438 Illegitimate 32 16 32 16 Total 501 432 535 454 933 989 Birth Rate 12.82 (per 1,000 population). STILL-BIRTHS— M. F. M. F. Legitimate 25 10 27 11 Illegitimate 2 2 2 2 Total 27 12 29 13 39 42 Still-Birth Bate 40.72 (per 1,000 total live and still births). DEATHS— Males 545 Females 624 Total 1,169 Death Rate 15.16 (per 1,000 population). * For calculating Infant and Maternal Mortality rates. † For calculating Birth rate. 9 Deaths from Puerperal Causes. Deaths. Rate per 1,000 total (live and still) births. England and Wales. Puerperal and post-abortive sepsis 2 3.08 0.52 Other maternal causes 1 1.03 1.64 Total 3 4.11 2.16 (excluding abortion) Deaths of Infants under 1 Year of Age. Legitimate Males 20, Females 20 = 40 Illegitimate „ 3, „ 3 6 Total ... ... ... ... 46 Death Rate of Infants under 1 Year of Age. All infants per 1,000 live births 49.30 Legitimate infants per 1,000 legitimate live births 45.21 Illegitimate infants per 1,000 illegitimate live births 125.0 Deaths from Special Causes. Deaths from Cancer (all ages) 179 Deaths from Measles (all ages) 0 Deaths front Whooping Cough (all ages) 0 Deaths from Diarrhoea (under 2 years of age) 3 10 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, with an indication of those made owing to war, in— 1.—(a) Laboratory Facilities. (b) Ambulance Facilities. No Material (c) Nursing in the Home. Changes (d) Treatment Centres and Clinics. During 1940 (e) Hospitals: Public and Voluntary. 3.— (i) Midwifery Service (ii) Maternity Services (iii) Institutional Provision for Mothers Special or Children Section (iv) Health Visitors. (v) Child Life Protection. (vi) Dental, Orthopædic, Etc., Treatment. LABORATOEY FACILITIES. The specimens examined in the laboratory at the Isolation Hospital during 1940 were as follows:— Negative. Positive. Total. Diphtheria specimens 398 68 466 Sputum (T.B.) ,, 134 11 145 Vincents Organisms 6 2 8 Gonococci 2 0 2 Streptococci 5 13 18 Blood for Widal 7 1 8 Faeces 3 0 3 Hair for Ringworm 1 0 1 Cerebro-Spinal Fluid 1 1 2 Total 557 96 653 AMBULANCE FACILITIES. Persons suffering from infectious diseases are removed to hospital by arrangement with the London County Council. The Borough Council provides an ambulance service for street accidents and general cases. 11 The following is a statement showing the use made of the Borough Ambulance under the A.R.P. Medical Officer until January 31st and under the Fire Brigade for the remainder of the year:— Calls- Accidents and illness in street 377 Private cases 734 1,111 Persons conveyed 1,077 Mileage 7,884 Hours ambulance was engaged 976 The "Morris Viceroy" motor conveyance for the transport of mentally and physically defective children, purchased in October, 1931, was replaced in June by a "Leyland Cub" motor coach. The new motor conveyance made its first journey on 3rd June. In addition to the normal journeys in connection with the School Medical Services, the motor conveyance was also used for the conveyance of refugees, persons rendered homeless by enemy action and for other purposes connected with Civil Defence. During the year the "Morris Viceroy" conveyance travelled 1,729 miles and the "Leyland Cub" 5.642. a total of 7,371 miles. The total number of passengers carried by both motor conveyances was 8,740. NURSING FACILITIES. BOROUGH OF HORNSEY NURSING ASSOCIATION. The following is a statement of the infectious diseases nursed during the year by the Queen's District Nurses:— TYPE OF CASE. Total No. of Cases. No. of Visits. No. Convalescent. No. sent to Hospital. No. Died at Home. Pneumonia 3 19 1 1 1 Tuberculosis 3 48 — - 1 Influenza 11 73 11 — - Other diseases in children under 5 15 44 14 1 — Elementary School Children 12 34 12 - — 12 The Council makes an annual subscription of £150 to the Association's funds. NURSING HOMES.—There are 15 Nursing Homes in the Borough registered with the Middlesex County Council under the Nursing Homes Registration Act, 1927. Seven of these, with a total of 49 beds, are registered for the reception of maternity cases. NORTH MIDDLESEX COUNTY HOSPITAL. — The number of beds at North Middlesex County Hospital is 1,384, a decrease of 42 since the last Annual Report. There were 80 beds available for maternity cases at 81st December, 1940, this figure being the same as the normal complement of maternity beds before the war. The number of maternity cases from Hornsey admitted in 1940 was 114, as compared with 127 in 1939. HORNSEY CENTRAL HOSPITAL. — The Hospital has 72 beds and is provided with up-to-date X-Ray and Ultraviolet Ray Departments. There were 745 in-patients treated during the year (including 114 air-raid casualties), of which 567 belonged to the Borough. In addition, 3,113 out-patients were treated. The Council subscribes 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. The Council's open-air swimming pool commenced its season on 4th May and closed on 26th September. During this period 59,711 tickets were issued and 133 season tickets were in use. The satisfactory condition of the water is maintained by a system of filtration, aeration and chlorination. 13 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. Complaints 758 Special inspections 492 Re-inspections 2,929 Families re-housed 18 Overcrowding surveys 26 Notifiable infectious diseases 267 Small-pox Contacts 2 Verminous houses 70 Pests 28 Shops Acts 1,460 Dairies and milkshops 29 Bakehouses 48 Slaughter-houses 8 Butchers' shops 127 Restaurant kitchens 41 Other food shops 370 Food inspections 216 Factories and outworkers 426 Offices (workplaces) 33 Young Persons Act 27 Petroleum stores 91 Offensive trades (fish frying) 28 Piggeries 20 Conveniences 1 Smoke observations 4 Passages 7 Drainage 63 Water tests applied (New Drains) 11 Smoke and chemical tests applied fold drains) 33 14 INSPECTIONS NECESSITATED BY WAR CONDITIONS: Civil Defence Acts (Food Enforcement) 229 Compensation (Defence) Act 110 Fuel and Lighting Order, 1940 80 Rest Centres 28 Air Raid Trench Shelters 236 Grand Total 8,316 NOTIOES. The Notices served during the year are as follows:— Under the— Verbal Preliminary Statutory Public Health and Housing Acts 314 359 13 Housing Bve-laws — 32 2 Shops Acts 83 9 — Factory Acts 12 7 2 409 407 17 SUMMARY OF SANITARY IMPROVEMENTS CARRIED OUT. Drainage. Number of houses and premises redrained 4 Repairs or amendments to existing drains 46 Drains or gullies unstopped or cleansed 52 Manholes provided 8 do. repaired 18 Intercepting traps fixed 3 New gulley traps fixed 22 New soil pipes and ventilating shafts fixed 24 Soil pipes and ventilating shafts repaired 22 Fresh-air inlets provided or repaired 16 15 Water-Closets and Sanitary Fittings. New water-closet buildings 10 New water-closet basins fixed 125 Water-closets unstopped, cleansed or repaired 34 New check cisterns fitted to water-closets; existing check cisterns repaired 36 New sinks provided 27 New lavatory basins provided 24 New waste-pipes fixed 38 Waste-pipes trapped, repaired or unstopped 59 Waste-pipes diverted into proper drain 3 Baths provided or made usable 15 Urinals cleansed 3 Miscellaneous. Roofs repaired 158 Eaves guttering renewed, cleansed or repaired 59 Rain-water pipes provided, repaired 48 Damp walls remedied 108 Damp-proof courses inserted 47 Paving of yards repaired 179 Premises structurally repaired 275 Rooms cleansed, distempered or papered 16 Premises disinfested of vermin 85 Drinking-water cisterns repaired, cleansed and covered 59 Water supply (additional) provided 2 Windows and skylights provided or made usable 36 Sub-floor ventilation 12 Floors repaired 55 Windowsills repaired 26 Sash cords and fittings repaired 45 Sanitary dustbins provided 18 Accumulations of manure and refuse removed 26 Stoves, ranges and coppers repaired or renewed 55 Sundry items 73 Food stores provided 3 1,974 16 Factories. Defects Remedied. Sanitary accommodation—Insufficient 2 Unsuitable or defective 9 Not separate for sexes 1 Workrooms cleansed or repaired 8 Ventilation improved 1 Heating provided 1 22 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 number of lodging-houses on the register at the end of the year was 582. Thirty-two houses have been dealt with under these Byelaws during the year and the following works carried out:— Byelaw. 4 (b) Water supplies 15 4 (c) Washing accommodation 5 4 (d) Food stores 15 5 (a) Repairs to drains 1 5 (b) Means of carrying off waste water ... 1 5 (c) Provision of windows 1 5 (d) Room ventilation provided 1 5 (f) Ventilation to the bedroom and room with cooking apparatus 3 5 (g) Staircase repairs 1 5 (h) Handrails provided 2 45 Offices. The number of offices on the register at the end of the year was 234. Generally speaking, the class of office in this Borough is excellent and it is pleasing to report that in no instance was it necessary to take any action. 17 CLEANSING AND DISINFECTING STATION. Cleansing Station. Seventy-five children and 45 adults have been treated at the Cleansing Station for scabies and 13 adults for verminous heads. One hundred and twelve school children were treated for verminous heads under arrangements made by the Local Education Authority. Disinfecting Station. Work done by disinfectors:— Disinfection. Premises disinfected after notifiable infectious diseases ... 131 „ „ „ T.B 30 ,, ,, for other reasons 133 No. of articles disinfected 4,257 ,, ,, destroyed 216 ,, rooms disinfected 390 Collection and disinfection of library books:— Received. Returned. Destroyed. Public Libraries 72 72 - Private Libraries 18 15 3 Disinfestation. Premises infested with bugs 63 ,, ,, „ cockroaches 2 ,, ,, ,, ants 2 ,, ,, ,, wasps 10 „ ,, ,, flies 2 ,, ,, ,, insects under floor 2 ,, ,, ,, moth 3 bees 1 18 Miscellaneous. Conveyance of drain-testing apparatus 27 Stores, etc., to Midwives 13 Stores, etc., to Welfare Centres 145 Conveyance of A.R.P. apparatus 56 Visits re disinfection of refugees' clothing 6 Visits to Libraries 33 Disinfection of Public Air Raid Shelters 15 Visits to Rest Centres 8 ,, ,, Wardens' Posts 22 ,, ,, Highgate Tube Station Shelter 3 ,, ,, A.R.P. Depots re disinfection of equipment 28 ,, ,, A.F.S. Stations 6 Attendance at Mortuary due to Air Raid Casualties 10 Collection of Unfit Food 13 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-houses inspected for housing defects (under Public Health or Housing Acts) 908 (b) Number of inspections made for (he purpose 3.927 (2) (a) Number of dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 (b) Number of inspections made for the purpose — (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation — 19 (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 371 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 352 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 rendered fit after service of formal notices:— (a) By owners — (b) By local authority in default of owners— B.—Proceedings under Public Health Acts:— (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 13 (2) Number of dwelling-houses in which defects were remedied after service of formal notices:— (a) By owners 13 (b) By local authority in default of owners — C.—Proceedings under Sections 19 and 21 of the Housing Act, 1930:— (1) Number of dwelling-houses in respect of which Demolition Orders were made - (2) Number of dwelling-houses demolished in pursuance of Demolition Orders - 20 D.—Proceedings under Section 20 of the Housing Act, 1930:— (1) Number of separate tenements or underground rooms in respect of which Closing Orders were made 1 (2) Number of separate tenements or underground 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 20 (ii) Number of families dwelling therein 21 (iii) Number of persons dwelling therein 111 (b) Number of new cases of overcrowding reported during the year 5 (c) (i) Number of cases of overcrowding relieved during the year 12 (ii) Number of persons concerned in such cases 63 OTHER HOUSING ACTIVITIES. CLOSING OF BASEMENT ROOMS.—No. 15, Pemberton Road.-—The owner of this dwelling gave a written undertaking not to use the basement rooms as living or sleeping rooms, owing to their dark and damp condition. FAMILIES RE-HOUSED BY THE COUNCIL.—The Council re-housed 95 families, representing 410 persons, from various roads in the Borough. 21 INSPECTION AND SUPERVISION OF FOOD. (Section E.) Dairies and Milkshops. At the end of the year the register showed 55 shops classed as dairies. There were also 75 milkshops on the register, i.e., shops where dairy produce is sold, but where it does not form the principal trade. Thirty-two of the dairies are situated outside Hornsey but deliver milk within the Borough. Special Designated Milk Licences. Producers of, and dealers in, special designated milks are required to obtain licences annually. During the year licences were in force as follows:— Sale of Pasteurised Milk16 „„,, (Supplementary) 3 „„ T.T.5 „(Supplementary) 3 FOOD CONDEMNED. Beef5 cwt. 30 lbs. Lamb1 cwt. 41lbs. 13 ozs. Pork1 cwt. 26 lbs. Offal1 cwt. Pish1 cwt. 98 lbs. Bacon1 cwt. 53 lbs. 6 ozs. Chicken102 lbs. 4 ozs. Rabbit102 lbs. Sausages lb. Tinned Ham and Beef15 lbs. Vegetables1 lb. Butter2 cwt. 91 lbs. 4 ozs. Biscuits½tin. 22 FOOD CONDEMNED AS A RESULT OF AIR RAID DAMAGE.  13 lbs. Bacon 1 lb. Groceries 17 cwt. 44 lbs. Confectionery 6 lbs. Fruit and Vegetables 9 Pork Pies. 1 cwt. 101 lbs. PETROLEUM INSPECTOR'S REPORT, The total number of licences issued for the storage of petroleum spirit for the year was 67 and the quantity of petroleum which could be stored under normal conditions 106,788 gallons. The actual quantity stored is difficult to give because some petrol tanks have been taken over by the Petroleum Board and some for A.R.P. purposes. Moreover, a much smaller quantity is kept at the petrol stations than under normal conditions. Hydro-Carbon. One licence was issued for the storage of 100 gallons of hydro-carbon. Naphtha. One licence was issued for the storage of 2,000 gallons of naphtha. Cellulose Spirit. Two premises were licensed for the storage of 90 gallons of cellulose spirit. Carbide of Calcium. There was one premises licensed for the storage of 10 cwts. of carbide of calcium. H. EASTWOOD, Chief Sanitary Inspector and Petroleum Inspector. 23 INFECTIOUS DISEASES. (Section F.) The incidence of infectious disease in the Borough for a period of 29 years is set out in Table G. DIPHTHERIA IMMUNISATION. Clinics for the immunisation of children against Diphtheria were held at each of the four Welfare Centres in rotation on Saturday mornings. In addition, a letter was sent to the parents of all elementary school children, during the latter part of the year, urging them to have their children immunised. As a result of this campaign, sessions were arranged at the schools and the number of children attending proved very satisfactory. This campaign was still being continued at the end of the year. Since the commencement of holding sessions in Hornsey in 1936, two thousand two hundred and eleven children have been immunised up to the end of 1940. The following are particulars of the children immunised during 1940:— Age 5 years Age under and over 5 years. but under 15. Town Hall Centre21863 Burgoyne Hall Centere12223 Church Road Centre343 Coldfall Centre3826 Elementary School275 412 390 The following children were innoculated. but did not complete a full course of immunisation, during 1940:— Age 5 years Age under and over 5 years. but under 15. Town Hall Centre 12031 Burgoyne Hall Centre3612 Church Road Centre38 Coldfall Centre76 Elementary School390 166 447 Three injections, each of 1 c.c. T.A.F. anti-diphtheritic material, are given at intervals of one month. 24 VACCINATION. The Public Vaccinators inform me that they performed vaccination of persons in the Borough during 1940 as follows:— Dr. E. Buckler .115 Dr. B. Mackay220 PREVENTION OF BLINDNESS. (PUBLIC HEALTH ACT, 1925, SECTION 66.) Two cases of ophthalmia neonatorum were notified, both cases being nursed at home. There was no case of blindness resulting from this infection. Cases Treated. Vision unimpaired. Vision impaired. Total blindness. Deaths. Notified. At home. In hospital or nursing home. 2 2 0 2 0 0 0 TUBERCULOSIS. PUBLIC HEALTH (PREVENTION OF TUBERCULOSIS) BEGULATIONS. No occasion has arisen in the course of the year to put these powers into action. There were 596 beds available solely for Middlesex under the Middlesex County Council's scheme for the treatment of Tuberculosis in sanatoria, namely:—- Institution Accommodation Type of Case Adults Children M F County Sanatorium, 108 108 68 Pulmonary—sanatorium Harefield 4 4 10 ,,observation County Sanatorium, Clare Hall 170 74 — ,,sanatorium Danesbury Manor, Welwyu — 38 6 ,, Victoria Home, Widdicombe, Devon — 6 Non-pulmonary 25 Patients are also sent to the Middlesex County Council's general hospitals and to numerous other voluntary hospitals and sanatoria. The total number of cases on the Tuberculosis Register at the end of 1940 was 853, viz., pulmonary 651, non-pulmonary 202, an increase of 9 on the total for last year. A table showing the history of cases of Tuberculosis during the year will be found on Table H. MORTUARY. One hundred bodies were received at the mortuary and inquests held on 19 of them. DISEASES OF ANIMALS ACTS. 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 1940 as follows:— Inspections made under the Diseases of Animals Acts20 (Horses 4, Pigs 213) Animals inspected:— Under the Parasitic Mange Order: Horses4 Pigs1 Under the Swine Fever Order, 1908: Pigs2 Removal Licences issued4 No action was necessary under the Tuberculosis Order, 1925. 26 LIST OF TABLES. TABLE A.—Vital Statistics, 1911-40. TABLE B.—Causes of, and ages at, death in 1940. TABLE C.—Summary of causes of death, 1931-1939. TABLE D.—Infant Mortality in 1940. Causes of, and ages at, death. TABLE E.—Births, Deaths, Infant Deaths, and Deaths from certain diseases, 1911-1940. TABLEE.—Cases of Infectious Disease notified in 1940. TABLE G.—Cases of Infectious Disease notified 1912-1940. TABLE H.— (1) Notification of, and deaths from, Tuberculosis, 1940. ,,(2) Tuberculosis Register, 1940. TABLE I.—Inspection of Factories, Outworkers, etc., 1940. 27 TABLE A. BOROUGH OP HORNSEY VITAL STATISTICS, 1911-40. Year. Estimated Mid-Year Population. Birtla Kate per 1,000 Population. Death Kate per 1,000 Population. Infant Mortality per 1,000 live Births. 19110 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 16.7 110 49 1922 (Census). 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 12.1 12.1 61.3 1929 90,500 Regr.-Gen.'s Estimate. 88,450 13.8 12.7 54.05 1930 88,450 Census. 13.7 11.8 41.35 1931 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 1107 11.68 37.91 1935 95,330 11.83 10.84 48.7 1936 96,160 120 11.98 40.0 1937 96,520 12.07 11.95 45.49 1938 96,680 12.38 11.26 32.58 1939 † (a)96,610 (b)90.780 11.39 11.16 27.25 1940 77,130 1282 15.16 49.30 ENGLAND and WALES * (Rates in 1940) 14.6 14.3 55 126 County Boroughs and Great Towns, including London • (Rates in 1940) 16.0 15.8 61 148 Smaller Towns Resident Population 25,000—50,000 at 1931 census * (Rates in 1940) 15.7 12.8 54 London * (Rates in 1940) 13.7 17.8 50 * Rates per 1,000 civilian population. † (a) For calculation of Birth rate. (b) „„„ Death rate. or incidence of notifiable infectious disease. TABLE B.—CAUSES OF, AND AGES AT, DEATH, 1940. Total. All Ages. 0—1 l—2 2—5 5—15 15—25 25—35 35—45 45—55 55—65 65—75 75—85 85 & over M F 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 0 0 0 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 2. Cerebrospinal fever 3 1 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... ... ... ... 2 3. Scarlet Fever 0 0 0 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 4. Whooping cough 0 0 0 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 5. Diphtheria 1 0 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 6. Tuberculosis of respiratory system 42 24 18 ... ... ... ... ... ... ... ... 6 2 4 3 3 6 6 2 4 1 1 2 ... 1 ... ... 6 7. Other forms of tuberculosis 7 5 2 ... ... ... ... ... ... ... ... 1 ... ... 1 2 ... ... ... ... ... l 1 ... ... ... ... 7 8. Syphilitic diseases 9 6 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 1 3 ... l ... ... 1 ... ... 8 9. Influenza 11 5 6 ... ... ... ... ... ... ... ... ... ... ... 1 ... 2 1 ... 2 1 ... ... 1 1 ... 1 9 10. Measles 0 0 0 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 10 11. Acute polio-myelitis and polioencephalitis 0 0 0 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 11 12. Acute infectious encephalitis 0 0 0 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 12 13. Cancer of buccal cavity and oesophagus (males only) 13 13 0 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 2 ... 9 ... 1 ... ... ... 13 Cancer of uterus (females) 12 0 12 ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 4 ... 2 ... 5 ... ... ... ... ... 14. Cancer of stomach and duodenum 29 15 14 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 2 1 2 3 7 5 4 3 ... 1 14 15. Cancer of breast 25 0 25 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 6 ... 9 ... 6 ... 2 ... 1 15 16. Cancer of all other sites 100 42 58 ... ... ... ... ... ... ... ... 1 1 ... ... 2 6 3 9 9 14 19 14 6 9 2 4 16 17. Diabetes 11 5 6 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 1 2 1 2 3 ... ... 17 18. Intra cranial vascular lesions 94 40 54 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 3 14 8 14 17 9 20 2 6 18 19. Heart disease 280 121 159 ... ... ... ... ... ... ... ... 1 ... 2 1 1 3 7 5 25 13 42 44 33 60 10 33 19 20. Other diseases of circ. system 25 5 20 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 2 ... 1 1 6 3 4 1 6 20 21. Bronchitis 71 43 28 1 ... ... ... ... ... 1 ... ... ... 1 l 2 ... 2 ... 10 2 12 7 10 11 4 7 21 22. Pneumonia 97 52 45 8 ... ... ... ... ... ... ... ... ... 1 1 ... 4 5 1 14 7 11 10 9 14 3 1 22 23 Other respiratory diseases 12 7 5 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... 1 1 3 2 ... 1 ... 1 23 24. Ulcer of stomach or duodenum 16 10 6 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... 4 3 3 2 1 1 ... ... 24 25. Diarrhoea, under 2 years 3 0 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 25 26 Appendicitis 3 2 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... 1 ... ... ... ... 26 27. Other digestivediseas.es 26 12 14 1 ... ... ... ... ... ... ... ... ... 1 2 ... ... ... 2 1 1 5 6 ... 3 ... ... 27 28. Nephritis 28 15 13 ... ... ... ... ... ... ... ... ... ... 2 1 2 2 1 1 6 2 2 4 ... 2 ... 1 28 29. Puerperal and post-abortive sepsis 2 0 2 ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... 29 30. Other maternal causes 1 0 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... 30 31. Premature birth 12 5 7 5 7 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 31 12. Con. mal., birth injuries, infantile disease 10 3 7 3 7 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 32 33. Suicide 9 7 2 ... ... ... ... ... ... ... ... ... ... 1 ... 1 1 2 1 1 ... 2 ... ... ... ... ... 33 34. Road traffic accidents 21 14 7 ... ... ... ... ... ... ... ... 1 ... ... ... 3 2 2 3 1 ... 3 2 3 ... 1 ... 34 35. Other violent causes 124 64 60 2 ... ... ... ... ... 2 4 6 3 11 9 9 9 6 4 11 11 7 6 5 ii 3 1 25 36. All other causes 72 29 43 1 ... 1 ... ... 1 1 1 1 2 1 3 3 9 3 4 7 3 9 11 3 8 36 t TABLE C.-CAUSES OF AND AT. DEATH. 1931-1939 All Ages 1931 All Ages 1932 All Ages 1933 All Ages 1934 All Ages 1935 All Ages 1936 All Ages 1937 All Ages 1938 All Ages 1939 M F M F M F M F M F M F M F M F M F 1. Typhoid and paratyphoid lever ... ... ... ... ... ... ... ... 1 ... ... 2 ... ... ... 1 0 1 2. Measles ... ... 3 3 ... ... 4 1 1 ... 2 1 ... 1 3 3 0 0 3 Scarlet Fever ... 1 ... ... ... ... 1 1 ... ... 1 ... ... 1 ... ... 0 0 4. Whooping cough 2 1 2 2 1 1 1 ... ... 1 1 2 1 1 3 2 0 5. Diphtheria 2 3 ... 4 1 1 2 2 ... 1 ... 1 ... 1 1 3 4 0 6. Influenza 7 16 11 20 20 25 5 3 7 8 6 7 17 23 4 5 4 13 7. Encephalitis lethargica ... 1 ... ... 1 2 1 ... 1 ... 2 2 ... ... 1 ... 1 0 8. Cerebro-spinal fever ... ... ... 1 ... ... 1 ... ... ... 1 ... ... ... ... ... 1 1 9. Tuberculosis of respiratory system 21 31 23 ... 25 19 27 32 27 27 36 22 27 16 21 16 29 22 10. Other tuberculous diseases 3 2 3 31 11 9 7 ... 6 8 4 1 9 2 7 7 1 2 11 Syphilis 1 3 ... 6 ... 1 ... 1 3 ... 1 ... 3 ... 2 ... 2 1 12. General paralysis of the insane, tabes dorsalis 3 ... 4 3 4 ... 6 ... 4 ... 3 1 5 1 3 1 0 0 13 Cancer, malignant disease 72 107 66 94 75 96 64 112 78 92 83 98 82 97 73 86 77 87 14 Diabetes 4 12 3 10 8 14 6 7 5 11 6 13 6 10 5 12 7 13 15. Cerebral hæmorrhage, etc. 17 52 25 40 23 28 23 35 12 24 18 34 17 33 20 32 24 32 16. Heart disease 110 150 109 181 117 163 111 174 103 168 137 195 153 154 144 204 140 189 17. Aneurysm 2 ... 4 1 2 3 ... 3 4 1 7 3 5 2 3 2 3 1 18. Other circulatory diseases 25 29 24 22 22 31 31 43 24 21 23 42 24 35 25 38 31 26 19 Bronchitis 15 15 21 8 11 18 14 16 13 14 16 17 11 18 10 10 7 10 20. Pneumonia (all forms) 28 40 32 34 34 46 34 39 29 37 31 27 43 37 24 39 32 19 21. Other respiratory diseases 5 6 9 8 3 3 6 2 6 2 1 7 8 6 3 1 3 2 22. Peptic ulcer 7 4 8 3 8 2 11 2 11 4 8 2 11 8 12 4 12 3 23 Diarrhoea, etc. 2 3 4 4 4 6 4 1 13 3 4 6 8 4 5 2 0 4 24. Appendicitis 3 4 2 5 6 2 2 6 2 5 7 4 7 2 7 5 4 9 25. Cirrhosis of liver 2 1 5 2 1 5 1 0 3 3 1 1 1 2 1 2 0 26. Other diseases of liver, etc. 3 1 3 1 1 2 3 4 1 3 4 6 1 2 2 5 2 2 27. Other digestive diseases 10 10 7 14 10 17 15 13 11 12 15 16 5 10 9 11 4 5 28. Acute and chronic nephritis 19 15 12 14 13 14 18 9 16 16 13 22 17 21 8 18 7 18 29. Puerperal sepsis ... 2 ... 4 ... 1 ... 2 ... 2 ... 1 ... 1 ... ... 0 0 30. Other puerperal causes ... 3 ... 2 ... 3 ... 1 ... 1 ... 2 ... 2 ... 3 0 1 31. Congenital debility, premature birth, malformations, etc 24 16 15 17 17 10 14 14 18 13 13 12 25 16 12 13 12 8 32 Senility 8 11 10 24 5 17 8 16 5 16 10 14 5 10 ... 14 3 6 33. Suicide 9 2 9 2 12 4 14 6 4 7 5 4 13 8 7 7 11 5 34 Other violence 16 13 25 18 22 17 24 18 15 22 17 25 17 11 13 21 20 17 35. Other defined diseases 44 41 48 47 41 45 53 34 45 46 44 41 48 48 36 59 38 34 36. Causes ill-defined or unknown ... ... ... ... 1 ... ... 1 1 ... ... ... 1 ... ... 0 0 Totals 462 596 486 625 501 601 515 ! 599 466 568 522 630 570 583 463 626 483 531 1,058 1.111 1.102 1.114 1,034 1.152 1.153 1,089 1,014 29 TABLE D.—INFANT MORTALITY, 1940. CAUSES OF DEATH. Deaths from stated causes at various Ages under One Year of Age. Total Deaths under One Year. DAYS WEEKS MONTHS Under 1 Day 1-7 1-2 2-3 3-4 1-3 3-6 6-9 9-12 Premature Birth 4 6 2 ... ... ... ... ... ... 12 Injury at Birth 1 ... ... ... ... ... ... ... ... 1 Cerebro-Spinal Meningitis ... ... ... ... ... ... ... 1 ... 1 Congenital Malformations ... 1 ... ... ... 1 1 ... ... 3 Pneumonia ... 1 ... 1 ... 5 3 1 ... 13 Bronchitis ... ... ... ... ... 1 ... ... ... 1 Other respiratory diseases ... ... ... ... ... ... ... 1 ... 1 Diarrhoea and Enteritis ... ... ... 1 ... 2 ... ... ... 3 Atelectasis 1 3 ... ... ... ... ... ... ... 4 Melaena Neonatorum 1 ... ... ... ... ... ... ... ... 1 Congenital Syphilis ... ... ... ... ... 1 ... ... ... 1 Other diseases 1 ... ... ... ... ... ... ... ... 1 Other causes 1 ... ... ... 1 ... 1 1 ... 4 Totals 9 10 3 2 1 10 5 4 2 46 30 TABLE E.—BIRTHS, DEATHS, INFANT DEATHS, AND DEATHS FROM CERTAIN DISEASES, 1911-1940.  Population Total Live Births Total Still Births . Total Deaths Total Infant Deaths (under one year) Deaths from Measles Deaths from Whooping Cough Deaths from Diarrhoea (under two yrs.) Deaths from Scarlet Fever Deaths from Diphtheria Deaths from Typhoid Fever Deaths from Cancer Deaths from Tuberculosis (Pulmonary Deaths from Tuberculosis (NonPulmonary) Census 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 ... 79 1 88 1 4 21 1 7 1 82 44 10 1915 1,394 ... 1,007 112 37 7 23 3 11 2 99 58 19 1916 1,404 ... 928 64 0 5 8 0 11 1 106 84 20 1917 1.038 ... 906 73 14 6 3 0 6 0 113 58 25 1918 1,037 ... 1,094 64 6 13 7 2 8 0 130 76 13 1919 1,188 ... 992 76 0 0 6 2 3 1 119 66 11 1920 1.707 ... 903 93 4 7 7 3 20 2 119 61 12 1921 87,691 1,468 ... 968 72 1 2 15 3 13 0 136 74 12 1922 1.372 ... 992 72 3 7 3 S 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 63 1 8 3 0 1 0 143 48 7 1926 1,206 ... 928 57 8 3 2 0 1 1 147 59 8 1927 1,201 ... 1,012 46 0 0 4 1 6 1 131 58 6 1928 1,191 ... 995 73 6 1 3 2 6 1 132 59 10 1929 1,221 ... 1,128 67 0 13 2 0 7 0 143 58 15 1930 1,209 45 1,047 50 4 0 10 2 4 0 156 57 7 1931 95,524 R.-Gen.'s Estimate 1,139 44 1,058 60 0 2 5 1 5 0 179 52 5 1932 96,990 1,103 38 1,111 51 6 3 8 0 4 0 160 54 9 1933 96,070 1,041 41 1,102 45 0 3 6 0 2 0 171 44 20 1934 95, 306 1,055 35 1,114 40 5 2 2 2 4 0 176 59 7 1935 95,330 1,128 36 1,034 55 1 0 15 0 1 1 170 54 14 1936 96,160 1,155 31 1,152 47 3 o 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 1938 96,680 1,197 45 1,089 39 6 4 4 0 4 1 159 37 14 1939*(a) 96,610 1,101 41 1,014 30 0 2 2 0 4 1 164 51 3 (b) 90,780 1940 77,130 † (a) 933 (b)989 †(a)39 (b)42 1,169 46 0 0 3 0 1 0 179 42 7 • (a) For calculation of Birth rates.† (a) For calculation of Infant and Maternal Mortality Rates. (b) „„„ Death rates. (b) „„,. Birth rates. 31 M H be c p "o h W TABLE F—INFECTIOUS DISEASES NOTIFIED, 1940. disease WARDS AGES Admitted to Joint Hospital. Admitted to other Hospitals. In Nursing Home. Nursed at Home. Highgate Muswell Hill. Crouch End Central Hornsey North Haringey South Haringey Stroud Green Finsbury Park. 0— 1 1— 5 5— 15 15— 25 25— 45 45— 65 65 and over Total Scarlet Fever 3 15 0 3 17 18 2 1 0 10 35 5 8 1 0 59 48 I 0 10 Diphtheria 5 24 4 13 5 3 4 5 2 22 12 11 11 5 0 63 54 3 0 6 Typhoid Fever 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 1 Pneumonia 4 18 5 12 10 4 9 1 1 5 6 6 14 21 10 63 0 14 0 49 Erysipelas 6 4 1 3 2 2 5 3 0 0 1 3 3 15 4 26 8 3 0 15 Puerperal Pyrexia 1 1 1 2 2 1 2 3 0 0 0 6 7 0 0 13 0 12 0 1 Ophthalmia Neonatorum 0 0 0 1 0 1 0 0 2 0 0 0 0 0 0 2 0 0 0 2 Encephalitis Lethargica 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 Cerebrospinal Meningitis 1 2 1 9 0 2 1 1 2 4 4 3 3 0 1 17 10 6 0 1 Dysentery 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 Measles 9 18 5 11 4 15 7 8 1 17 42 6 11 0 0 77 3 0 0 74 Whooping Cough 4 1 0 16 1 3 2 3 1 14 14 0 0 0 1 30 3 3 0 24 34 83 817 72 41 49 32 25 9 72 115 40 58 43 16 353 128 42 0 183 Pulmonary 19 30 8 27 16 9 22 9 0 1 3 27 84 20 5 140 NonPulmonary 4 3 2 0 3 1 4 1 0 3 • 3 2 8 1 1 18 Total 57 116 27 99 60 59 58 35 9 76 121 69 150 64 22 511 Admitted to Joint Isol. Hospital 12 40 5 22 18 17 8 6 Other Hptls. 6 3 2 8 5 5 5 8 Nursing Homes 0 0 0 0 0 0 0 0 Nursed at • Home 16 40 10 42 18 27 19 11 32 The following 65 cases were treated in the Isolation Hospital in addition to the above :—German measles 22, Influenzal cold 1, Influenza and laryngitis 3, Influenza 8, Laryngeal stridulous 1, Mumps 1, Infestation 1, Disseminated sclerosis 1, Intestinal toxaemia 1, Appendicitis 1, Suppurating m'i'imwi 1 ■ nViVi^ 1 ' Gftstro - * n a \ upset 2. Toxin rash 2, Sprain of ankle 1. Tonsillitis 3. Gonoirhcea 1. Scabies 1. Skin 33 laryngitis b, mnuenza o, Xjaryngea.1 striuuiuus i, mumps xf xxxiestabiuii x, x_»isseiiiiiia.bt;u. suieiusis i, iiHcsuuai lUAteuua x, Appeuuicitis x, ouppurating Year. Population. Estimated Scarlet Fever. Diphtheria or Croup. Typhoid Fever. Para Typhoid. § Puerperal Fever, Puerperal Pyrexia. Erysipelas. Cerebro Spinal Meningitis. Polio-Myelitis. Ophthalmia Neonatorum. Pemphigus Neonatorum. Malaria. Dysentery. Encephalitis Lethargica. Polio-Encephalitis. Pneumonia. Small-pox. Measles. Whooping Cough. German Measles. total Attack rate per 1,000 population. 1912 84,840 138 88 9 ... 3 ... 39 1 1 ... ... ... ... ... ... ... ... ... ... 279 3.2 1913 86,122 206 116 10 ... 2 26 ... ... ... ... ... ... ... ... ... ... ... ... 359 4.2 1914 86,456 346 101 9 ... 1 ... 24 ... ... 11 ... ... ... ... ... ... ... ... ... 492 5.7 1916 86,800 182 105 18 ... 6 ... 36 9 3 l ... ... ... ... ... ... ... ... ... 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 555 6.3 1921 87,691 (Census) 591 189 2 ... 2 ... 36 ... 2 6 ... 1 1 6 ... 42 ... now fiable 878 10.1 1923 88,007 286 113 1 ... 2 ... 24 ... ... 10 ... 1 ... 1 ... 104 ... 552 6.2 1923 88,325 126 133 1 ... ... 24 2 ... 6 ... 4 ... 2 ... 75 ... 373 4.2 1924 88,661 216 40 3 ... 1 ... 26 ... 1 1 ... ... ... 11 ... 61 ... 359 4 0 1926 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 40 1927 90,000 179 92 6 ... 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 ... 693 6.5 1929 90,500 249 129 3 2 3 8 30 3 1 5 ... 2 ... ... 1 163 ... 599 6.6 1930 88,450 (R.-Oen.'s Estimate 346 115 6 4 4 15 36 1 1 1 ... ... ... ... ... 61 3 592 6.6 1931 95,524 (Census) 247 116 ... 1 7 9 32 ... 1 3 ... 1 ... 2 ... 86 ... 505 5.3 1932 96.990 (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 1936 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 ... 5 1 ... 10 ... ... 80 ... 398 4.1 1938 96,680 142 116 ... 1 ... 26 48 1 ... 4 1 2 4 ... ... 50 ... 397 4.1 1939 90,780 162 62 1 ... ... 15 30 5 ... 7 1 ... 1 ... ... 64 ... 5 3 856 3.8 1940 77,130 59 63 1 ... ... 13 26 17 ... 2 ... ... 1 1 ... 63 ... 77 30 353 4.5 * Excluding Measles and German Measles. § Puerperal Fever became notifiable under the heading "Puerperal Pyrexia" from 1st Oct.,1937 TABLE H—(1) NOTIFICATION OF, AND DEATHS FROM, TUBERCULOSIS, 1940. AGE PERIODS. New Cases. Deaths Pulmonary Non-Pulmonary Pulmonary Non-Pulmonary M F M F M F M F 0 — 1 0 0 0 0 0 0 0 0 1 — 5 0 1 1 2 0 0 0 0 5 — 15 1 2 2 1 0 1 1 0 15 — 26 16 11 2 0 6 2 1 0 25 — 35 36 19 2 3 4 3 0 1 35 — 45 15 14 1 2 3 6 2 0 45 - 65 9 2 1 0 6 2 0 0 65 — 65 7 2 0 0 4 1 0 0 65 and over 3 2 1 0 1 3 1 1 Totals 87 53 10 8 24 18 5 2 Wards : Highgate 11 8 8 1 4 5 2 0 Muswesll Hill 19 11 1 o 4 1 1 0 Crouch End 5 8 2 0 1 0 1 0 Central Hornsey 17 10 0 0 4 4 0 0 North Haringey 13 4 1 2 3 1 0 0 South Haringey 4 5 0 1 3 0 1 1 Stroud Green 14 8 2 2 3 4 0 1 Finsbury Park 5 4 1 0 2 3 0 0 Total 87 53 10 8 24 18 5 2 34 35 Pulmonary. Non-Pulmonary. Total. Male. Female. Male. Female. Male. Female. (a) Number of Cases on Register at commencement of 1940 325 316 103 100 428 416 (b) Number of Cases notified for first time during year under Regulations 61 31 6 5 67 36 (c) Cases restored to Register during 1940 8 3 1 0 9 3 (d) Cases added to Register otherwise than by notification under Regulations : (1) Transferred from other districts 15 15 2 1 17 16 (2) From Death Returns 3 4 1 2 4 6 87 53 10 8 97 61 (e) Number of Cases removed from Register during 1940 69 61 6 13 75 74 (f) Number of Cases remaining on Register at end of 1940 343 308 107 95 450 403 Cases removed from the Register shown under (e) are accounted for as follows : Cured. Removed to another area. Died at Home. Died at Sanatorium or other Institution. Totals. M F M F M F M F M F Pulmonary 5 2 38 36 4 9 22 14 69 61 Non-Pulmonarv 1 0 2 10 0 1 3 2 6 13 36 TABLE I.—FACTORIES AND WORKPLACES. The following is a summary of the result of inspections made at Factories, and Workplaces during the year, with a list of Outworkers' premises. None of the Outworkers' premises was found to be in an unwholesome condition. Number of Premises. (1) Inspections. (2) Written Notices. (3) Prosecutions. (4) Factories (with mechanical power) 78 3 0 Factories (without mechanical power) 96 3 0 Other premises (including works of building and engineering construction but not including outworkers' premises) 91 1 0 Total 265 7 0 DEFECTS FOUND IN FACTORIES AND WORKPLACES. Particulars. (1) Number ot Defects. Number of Prosecutions. (5) Found. (2) Remedied. (3) Referred to H.M. Inspector. (4) Want of cleanliness 8 8 — — Unreasonable temperature 1 1 — — Inadequate ventilation 1 1 — - Sanitary conveniences insufficient 2 2 — — unsuitable or defective 9 9 not separate for sexes 1 1 — — Other offences... (Not Including offences relating to Homework or offences under the Sections mentioned in the Schedule to the Ministry of Health (Factories and Workshops Transfer of Powers) Order, 1921 and re-enacted in the Third Schedule to the Factories Act, 1937). Total 22 22 - — 37 TABLE I.—(contd.). OUTWORKERS, 1940. Nature of Work. Premises. Outworkers. Instances. Notices served. Prosecutions. Art Needlework 1 I 0 0 0 Artificial Flowers 2 2 0 0 0 Bead Stringing 1 3 0 0 0 Boots 7 9 0 0 0 Boxes 1 1 0 0 0 Church Needlework 2 2 0 0 0 Druggists' Sundries 1 1 0 0 0 Embroidery 5 5 0 0 0 Handbags 2 2 0 0 0 Jewel Cases 1 1 0 0 0 Machinery 1 1 0 0 0 Photography 1 3 0 0 0 Silk Tassels 1 1 0 0 0 Toys 1 1 0 0 0 Wearing Apparel 96 122 0 0 0 Total 123 156 0 0 0 39 JSorougb of Ibomse? ANNUAL REPORT ON Maternity and Child Welfare Services 1940 40 MATERNITY & CHILD WELFARE COMMITTEE as at 31st December, 1940. Councillor Mrs. C. M. Cave (Chairman), 10, Wood Vale, N.10. The Mayor, Alderman H. G. J. Williams, J.P., 105, The Chine, N.21. Alderman Elliott E. Brooks, 122, Crouch Hill, N.8. ,,S. G. Goulding, Woodlands, Cranley Gardens, N.10. ,,Wm. J. Grimshaw, 25, Sheldon Avenue, N.6. ,,W. W. Kelland, M.A., 66, Avenue Road, N.6. J. W. Rowlands, J.P., 25, Cholmeley Park, N.6. ,,J. W. Shipp, 40, Coleridge Road, N.8. ,,R. Steeds, 19, Coolhurst Road, N.8. Councillor Mrs. J. H. Barrenger, 18, Fordington Road, N.6. ,,M. W. Burks, 7, Womersley Road, N.8. ,,J. Edwards, 102, Turnpike Lane, N.8. ,,H. G. R. Griffin, 33, Fordington Road, N.6. ,, Mrs. M. N. Hill, 16, Bishopswood Road, N.6. ,, G. F. N. Norman, 12, Woodberry Crescent, N.10. ,, J. A. Raine, 37, Clifton Road, N.8. ,, L. J. Valette, 59, Allison Road, N.8. ,,W. V. Wall, 10, Winchester Place, N.6. ,,F. Wilders, 84, The Yale, N.14. Selected Members: Lady F. O. Dixon, 2, Woodside Avenue, N.6. Mrs. H. M. Inward, 99, Pemberton Road, N.4. Mrs. M. King, 45, Wood Yale, 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. 41 The Welfare Centre serving Stroud Green, Finsbury Park and part of Harringay was opened in September, 1918, at 22, Wightman Road. For some time past these premises have not proved to be either suitable or adequate in size, and in March, 1940, the Welfare Centre was transferred to more commodious premises at Burgoyne Hall, Burgoyne Road, Harringay, these premises having formerly been used as a church hall. MATERNITY HOSPITAL ACCOMMODATION. North Middlesex Hospital.—The maternity admissions from Hornsey to the North Middlesex Hospital numbered 114 in 1940, as compared with 127 in 1939. There is the closest co-operation between the Council's Ante-natal Medical Officers and the obstetric surgeon in charge of the Maternity Department of the Hospital. City of London Maternity Hospital.—An arrangement was entered into as from April 1st, 1937, for the payment of one guinea for each Hornsey mother admitted. During 1940 the number was 34, as compared with 74 in 1939. EMERGENCY MATERNITY UNIT (FLYING SQUAD). The Maternity Department of North Middlesex Hospital has undertaken to provide in cases of urgent necessity (at the request of the doctor or midwife in attendance) a "flying squad"—that is, an ambulance with doctors, nurses and equipment capable of giving immediate treatment in the patient's own home. It was not necessary to ask for the services of the "Flying Squad " during the year. MIDWIFERY SERVICES. There were 25 Midwives, including 4 Borough Midwives, notified to the Middlesex County Council as practising in the Borough, 15 of whom reside outside the Borough. The Borough Midwives attended 341 births, in addition to ante-natal clinics held at the Welfare Centres. One of the conditions upon which the Council's Midwives accept a case is that the expectant mother shall attend an ante-natal clinic. 42 Three thousand and four births have been attended by the Borough Midwives since the appointment of a Midwife was first made in 1922. An increase in the number of Midwives was necessitated by the adoption of a scheme for producing "Painless Childbirth," and a fourth Midwife was appointed on 1st April, 1940. It is a rule of the Central. Midwives Board that where gas and air analgesia is administered at a confinement to produce " Painless Childbirth," that two midwives must be in attendance. In the early part of the year a scheme was brought into operation whereby women could be spared much of the pain associated with childbirth. The method adopted was the administration of a mixture of Nitrous Oxide and air to produce prolonged analgesia, a state of insensitiveness to pain without loss of consciousness. Maternity hospitals adopted this technique to obtain painless childbirth and it was claimed to be so safe that the administration could be left in the hands of a midwife without the presence of a doctor. The Borough Midwives received the necessary training at the North Middlesex County Hospital. "Up to the end of the year twenty-nine mothers had had gas and air administered at their confinements and the results may be claimed to be very satisfactory. PUBLIC HEALTH ACT. 1936 (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 within 36 hours, in addition to being registered within a period of six weeks after birth. PAINLESS CHILDBIRTH. 5 The number of births notified under the Act during 1940 was: Undetermined. Male. Female. Total. Live births 0515444 959 Still births 1 2415 40 1 539 459 999 43 The births were notified:— By doctors 16 ,, Borough Midwives 334 ,, other midwives 199 ,, hospitals 114 ,, parents 4 „ others 309 976 Not notified (from Registrar's returns):— Live births 19 Still births 4 23 999 Of this number there were:— Live births. Still births. Occurring in the Borough and transferred to other districts 101 5 Belonging to Hornsey and occurring in Hospitals, &c., outside the district 387 17 The 893 nett number of notified births belonging to Hornsey were divided among the districts of the Centres as follows:— Live Births. Still Births. Total. Town Hall Centre 418 12 430 Burgoyne Road Centre 200 9 209 Highgate Centre 207 11 218 Coldfall Sub-Centre 34 2 36 859 34 893 44 HOME HELPS. The Hornsey 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). 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 66 186 11 2 187 12 7 1937 10 93 303 1 0 329 9 8 1938 12 136 566 9 0 501 16 11 1939 16 129 520 19 0 482 19 10 1940 6 117 434 7 1 425 8 11 The Council decided to renew the grant of £200 towards the expenses of the Society, for the year ending 31st March, 1941. MILK (MOTHERS & CHILDREN) ORDER. One thousand nine hundred and twenty-seven applications for milk under this Order were dealt with during the year:— 1 pint milk daily free 838 2 pints ,, ,, ,, 632 3 ,, ,, ,, 141 4 ,, ,, ,, 2 1 pint ,, ,, half-price 59 2 pints ,, ,, „ 104 3 ,, ,, ,, 2 11b. dried milk weekly free 30 l½ lbs. ,, ,, ,, 53 2lbs. ,, ,, ,, 20 l1b. ,, ,, ,, half-price 2 l½lbs. ,, ,, ,, 13 Not granted 31 1,927 45 NATIONAL MILK SCHEME. At the end of July the Government introduced a "Cheap Milk Scheme " under the supervision of the Ministry of Food. The scheme was introduced as a war-time food policy in order to provide milk, either free or at a reduced price, to those members of the community most in need of it, i.e., expectant and nursing mothers and children under five years of age. The provision of both liquid and dried milk was covered by the scheme. This new milk scheme is administered by the local Eood Control Office and they have very kindly supplied me with the following particulars of permits issued from the commencement of the scheme until the end of the year:— Liquid Milk.—Permits for Free Milk, 1,183; number of beneficiaries, 1,710. Permits for Cheap Milk, 4,697; number of beneficiaries, 5,532. Dried Milk.—Permits for Free Milk, 42. Permits for Cheap Milk, 40. Permits are issued for one pint of milk daily or one pound dried milk weekly. MATERNITY AND CHILD WELFARE DENTAL SCHEME. The Dental Scheme for mothers and young children, started in 1928, continues to do good work. The following is a record for the year of the work of the Dental Clinic:— Mothers. Children. Old cases 479 77 New cases 186 114 Total attendances 665 293 Finished cases 106 124 Attendances for dentures 125 — Dentures provided 39 — Dentures repaired 4 — Teeth extracted 702 122 Fillings done 86 148 Inspections 174 70 General ansesthetics 77 64 Local ansesthetics 164 9 Other treatments (dressings, scaling, gum treatment, etc.) 49 242 46 Since the outbreak of war the Dental Clinic for Mothers has been held by Mr. Creeke at his private surgery. Children under five have received attention at the School Clinic from the School Dental Surgeon, Miss W. Hunt. ORTHOPÆDICS. The Surgeon attends monthly and the Masseuse four times weekly at the School Clinic 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. Children treated—New cases 66 — Old cases 74 — ,, attendances 126 568 Three children were admitted during the year to the Country Branch of the Royal National Orthopaedic Hospital at Stanmore for in-patient treatment. The cost to the Maternity and Child Welfare Committee was £69 3s. 10d. for the treatment of children under five years for the year to 31st March, 1941. VOLUNTARY COMMITTEES. Valuable assistance to mothers and children attending the Centres has been rendered by the Voluntary Committees during the year in special cases requiring surgical boots, convalescent homes and other forms of treatment. CHILD LIFE PROTECTION. PUBLIC HEALTH ACT, 1936 (Secs. 206—220). Regular visits are paid by the Health Visitors to the homes of foster-mothers in their respective areas, and 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. 47 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: — No. of foster-mothers on the register: Centre— No. 1. No. 2. No. 3 & Sub. Total. At the beginning of 1940 19 8 5 32 ,, ,, end „ , 18 9 4 31 No. of foster-children on the register At the beginning of 1940 22 16 5 43 ,, „ end ,, 29 17 4 50 Died during the year — — — — On whom inquests were held during the year Visits to foster-children: 1st Visits 26 6 10 42 Total Visits 122 198 18 338 No proceedings were taken during the year. 48 MATERNITY STATISTICS. Ante-Natal, Natal and Post-Natal. maternity and child welfare work, 1940. Nature of Work. Centres. Totals. No. 1. No. 2. No. 3 and Sub-Centre. Number of sessions held 166 98 101 365 ,, ante natal sessions held 96 45 35 176 Number of individual Mothers seen by Doctor*— Ante-natal, New cases 334 146 131 611 ,, Old cases 831 467 343 1,641 Post-natal, New cases 51 33 25 109 ,, Old cases 11 11 39 61 1,227 657 538 2,422 Total attendances of Mothers 1,733 551 487 2,771 Number of babies attending Centres for first time : Under 1 year 411 221 145 777 1 — 3 years 94 35 63 192 3—5 „ 55 23 97 175 Number of individual babies on Centre registers: Under 1 year 313 179 114 606 1—5 years 849 392 301 1,542 Babies seen by Doctor 2,739 1,319 802 4,860 Attendances of babies at medical consultations 3,471 2,019 1,289 6,779 Total attendances of babies at Centres : Under 1 year 5,047 3,014 1,103 9,164 1—3 years 2,428 877 667 3,972 3—5 „ 749 278 262 1,289 Refarred to own private doctors 29 7 19 55 Referred to hospitals 51 8 35 94 Visits paid by nurses:— First visits Total visits First visits Total visits First visits Total visits Grand First visits Totals Total visits To expectant mothers 116 207 88 132 115 232 319 571 To infants under one year 429 1,792 253 829 232 915 914 3,536 To children aged 1-5 years 108 3,118 64 1,246 119 1,456 291 5,820 Total visits 653 5,117 405 2,207 466 2,603 1,524 9,927 CHILD LIFE PROTECTION— Visits paid to Foster Children 26 122 6 198 10 18 42 338 RECORD OF WORK OF MUNICIPAL MIDWIVES, 1940. Miss Andrews Mrs. Jamison Miss Hughes Miss Matthews Total Confinements attended 131 73 74 63 341 Ante-natal Clinics attended 58 37 35 31 161 do. visits 376 325 261 206 1,168 Post-natal visits 1,882 1,552 1,418 729 5,581 Borough of Hornsey ANNUAL REPORT OF THE School Medical Officer FOR THE Year ending December 31st 1940 2 HORNSEY EDUCATION COMMITTEE. List of Members, 31st December, 1940 APPOINTED BY HORNSEY. Members of the Town Council— Aldermen Mr. W. G. Barrenger, J.P., 18, Fordington Road, Highgate, N.6. Mr. Wm. J. Grimshaw, 25, Sheldon Avenue, Highgate, N.6. Mr. B. H. Jenkinson, 36, Avenue Road, Highgate, N.6. Mr. W. W. Kelland, M.A., 66, Avenue Road, Highgate, N.6. Mr. J. W. Rowlands, J.P., 25, Cholmeley Park, Highgate, N.6. Councillors Mr. W. E. Lark, 27, Avenue Road, Highgate, N.6 (Chairman). Mr. H. G. R. Griffin, 33, Fordington Road, Highgate, N.6 (Vice-Chairman). Mrs. C. M. Cave, 10, Wood Yale, Muswell Hill, N.10 (Acting Vice-Chairman). Mr. G. K. M. Hutchinson, 8, Grosvenor Gardens, Muswell Hill, N.10. Mr. H. Hynd, 12, Addington Road, Stroud Green, N.4. Mr. D. Y. Johnson, 54, Coolhurst Road, Crouch End, N.8. Mr. J. W. Palmer, 30, Crescent Road, Crouch End, N.8. Mr. L. J. Valette, 59, Allison Road, Harringay, N.8. Mr. W. V. Wall, 10, Winchester Place, Highgate, N.6. Selected Members— Councillor M. W. Burns, 7, Womersley Road, Hornsey, N.8. Rev. W, F. P. Chadwick, M.A., Christ Church Vicarage, Crescent Road, N.8. Mrs. C. Crowther, 37, Bishop's Road. Highgate, N.6. Rev. E. S. Duval, M.A., The Rectory, High Street, Hornsey, N.8. Mr. F. C. Ellerton, 14, Bancroft Avenue, East Finchley, N.2. Mrs. A. Holman, J.P., 8, Hornsey Lane, Highgate, N.6. Mrs. G. M. Reid, B.A., 60a, Shepherd's Hill, Highgate, N.6. 3 STAFF OF SCHOOL MEDICAL SERVICES. School Medical Officer: R. P. Garrow, M..D., D.P.H. Assistant School Medical Officer: Marian Lones, B.Sc., M.B., B.S., D.P.H. Dentists. Winifred M. Hunt, L.D.S. Frances Carter, L.D.S., R.C.S. (Eng.). (Engaged in School Dental work in Cambridge for the duration of the War). Oculist: Dr. Marian Lones. Aurist: F. P. M. Clarke, B.A., B.Sc., L.R.C.P., L.R.F.P.S. (Glas.). Orthopædic Surgeon: J. A. Cholmeley, M.B., F.K.C.S. (Eng.). (Resident Medical Su2)erintendent, . Royal National Orthopaedic Hospital, Country Branch, Stannore). Masseuse: Mrs. Yorke. (Royal National Orthopaedic Hospital). Nurses: Clerk: L. Hatton. H. M. Croak. E. W. Whimster L. M. Oliver Assistant Clerks: 0. Martin. E. Cooper. J. wllmore. Dental Attendant: L. Howard. 4 To the Chairman and Members of the HORNSEY EDUCATION COMMITTEE. Mr. Chairman, Ladies and Gentlemen, I have the honour to submit my Annual Report for the year ending 31st December, 1940 The Board of Education have further reduced the statistical tables and request that the Report should be as brief as possible and concern itself mainly with the effects of the war on the physical and mental welfare of the school children and with any reorganisation of the School Medical Services which has been found necessary to meet war conditions. In Circular 1,490, dated 14th December, 1939, the Board expressed anxiety about the condition of school children in evacuation areas and urged that an intensive effort should be made, especially in regard to cleanliness. In response to this request, routine medical inspection in the first term of 1940 was made to apply to all the children in attendance instead of the usual selected age groups. It was very soon discovered that there was no falling off either in the standard of cleanliness or in the general health and nutrition of the children. Therefore in the summer term we reverted to the normal procedure of medically inspecting the four age groups—entrants, intermediates, Secondary School entrants and leavers. In the third term of the year, which is, in normal years, devoted to the medical inspection of new entrants, the heavy night bombing and frequent day airraid warnings led to evacuation of school children on a considerable scale. The medical and nursing staff were fully occupied in the inspection of evacuees and so the new entrants in the autumn of 1940 were not medically inspected till conditions became quieter in 1941. The figures presented in the statistical tables refer to inspections carried out in 1940. 5 Effects of the War on the Physical and Mental Welfare of the School Children. Of the many surprises which the war has furnished, none is more remarkable than the absence of any disturbance of health, mental or physical, amongst the children. The standards of nutrition and cleanliness have never been so high, and there is, so far as I have been able to observe, a total absence of any adverse influence on the children's nerves. Indeed, one can, in perfect truth, go further, and say that there has been a decided reduction in the number of highly-strung, nervous and difficult children. How can these unexpected results be explained? Nutrition. Amongst 2,008 children medically inspected, 30 were found "slightly sub-normal " in nutrition, and there were none in which the nutrition could be described as "bad." The "slightly subnormal ' group represents 1.5 per cent, of the children examined, as against 4 per cent, in 1937, 5 per cent, in 1938 and 6 per cent, in 1939. This splendid result is due to the extension of the milk in schools scheme to afternoon milk for those children in need of it, in addition to the morning milk, in which the great majority of the children participate. The more that preaching the gospel of good food is translated into the practice of this gospel, the higher will be the generai standards of nutrition, growth, health, vigour, spirits and resistance to infectious disease in the child population. A second factor is the longer rest in bed imposed by the black-out and sheltering from bombs during the winter months. Cleanliness. The standards of cleanliness, clothing and footgear are all satisfactory in the great majority of the children. The troublesome families are few in number, well known to teaching, medical and nursing staffs, and constantly being followed up. The only condition which has shown an increase in incidence is scabies a skin infestation by the itch-mite, which is transmitted by personal contact. The increase is not entirely due to 6 war conditions, as this disease had been on the increase for several years before war broke out. The all-round improvement in cleanliness is due to the public notice given to the condition of many evacuated children in reception areas, resulting in more attention being paid by parents to the efforts of the nurses at routine and special inspections to secure perfect cleanliness of the children. Nerves The neurotic child who, before the war, was bidding fair to become the chief problem in school medicine, has mysteriously receded into the background for the time being. This, I believe, is the general experience, and it is an interesting phenomenon. The explanation-—or, at least, an explanation—may be found in one word, anxiety. Anxiety in some form or in some degree is a universal human emotion. In times of peace and prosperity, parental anxiety, and more especially maternal anxiety, is apt to be directed unduly towards the health of the child. This influence sooner or later in many cases causes signs or symptoms in the child which we call "neurotic" or "nervous." In war, especially totalitarian war, when the whole population of men, women and children are exposed to the risks of death and injury and loss of home, human anxiety has a sufficient and more than sufficient outlet for its energy—hence the relief from neurosis in the children. I have the honour to be, Ladies and Gentlemen, Your obedient servant, R. P. GARROW, School Medical Officer. 7 TABLE I. MEDICAL INSPECTIONS OP CHILDREN ATTENDING PUBLIC ELEMENTARY SCHOOLS. (a)—Routine Medical Inspections. (1) Number of Inspections In the prescribed Groups : Entrants 874 Second Age Group 684 Third Age Group 329 Total 1,887 (2) Number of other Routine Inspections 121 Grand Total 2,008 (b)—Other Inspections. No. of Special Inspections and Re-Inspections 3,658 TABLE II. CLASSIFICATION OP THE NUTRITION OP CHILDREN INSPECTED DURING THE YEAR IN THE ROUTINE AGE GROUPS. AGE GROUPS Number of Children Inspected. A (Excellent) B (Normal) C (Slightly sub-normal) D (Bad) No. % No. % No. % No % Entrants 874 355 41 505 58 14 1.6 — — Second Age-group 684 351 51 320 47 13 1.9 — — Third Age-Group 329 196 60 131 40 2 0.6 — - Other Routine Inspections 121 71 59 49 40 1 0.8 — - TOTAL 2,008 973 49 1,005 50 30 1.5 — - 8 TABLE III. Group I.—Treatment of Minor Ailments (excluding Uncleanliness, for which see Table V.). Total number of Defects treated or under treatment during the year under the Authority's Scheme 833 Group II.—Treatment of Defective Vision and Squint (excluding Minor Eye Defects treated as Minor Ailments—Group I.) Number of Defects dealt with Under the Authority's Scheme Otherwise. Total. Errors of Refraction (including Squint) 281 281 Other Defect or Disease of the Eyes (excluding those recorded in Group 1.) 71 — 71 Total 352 — 352 Under the Authority's Scheme. Otherwise. Total. No. of Children for whom spectacles were (a) Prescribed 227 — 227 (b) Obtained 220 — 220 Group III.—Treatment of Defects of Nose and Throat. Number of Defects. Received Operative Treatment. Received other forms of Treatment. (3) Total number treated. (4) Under the Authority's Scheme, in Clinic or Hospital (1) By Private Practitioner or Hospital, apart from the Authority's Scheme. (2) — - - - - - - 91 91 9 TABLE IV.—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 120 247 221 203 231 242 194 109 145 128 12 1,972 (b) Specials 588 (c) Total (Routine and Specials) 2,560 (2) Number found to require treatment 2,427 (3) Number actually treated 1,475 (4) Attendances made by children for treatment 2,816 (51 Half-days devoted to:— (7) Extractions:— Inspection 25 Permanent teeth 245 Treatment 462 Temporary teeth 1,906 Total 487 Total 2,151 (8) Administrations of genera anaesthetics for extractions 591 (6) Fillings*:— (9) Other operations:— Permanent teeth 3,094 Permanent teeth 481 Temporary Teeth 169 Temporary teeth 1,769 Total 3,263 Total 2,250 * Temporary fillings, whether in permanent or temporary teeth, should be recorded as other operations. TABLE V.—VERMINOUS CONDITIONS. (i.) Average number of visits per school made during the year by the School Nurses 56 (ii.) Total number of examinations of children in the Schools by School Nurses 25,053 (iii.) Number of individual children found unclean 185 (iv.) Number of individual children cleansed under Section 87 (2) and (3) of the Education Act, 1921 185 (v.) Number of cases in which legal proceedings were taken:— (a) Under the Education Act, 1921 - (b) Under School Attendance Byelaws - 10 TABLE VI.—BLIND AND DEAF CHILDREN. 1 At a Public Elementary School. 2 At an Institution other than a Special School. 3 At no School or Institution. 4 Total not receiving suitable education. Blind Children 0 0 0 0 Deaf Children 0 0 0 0 Have the names and addresses of all the blind children included in Column 4 above been forwarded to the appropriate Authority under the Blind Persons Act, 1920? — MENTALLY DEFECTIVE CHILDREN. Total number of children notified during the year ended 31st December, 1940, by the Local Educat-on Authority to the Local Mental Deficiency Authority, under the Mental Deficiency (Notification of Children) Regulations, 1928 5 11 REPORT OX PHYSICAL TRAINING SUBMITTED BY THE PHYSICAL TRAINING ORGANISERS. During the year 1940 the war affected physical education in general very adversely, and we regret to report that few progressive steps were made in this important branch of school work. In the Spring Term many of the schools in the Borough were reopened, and in the comparative quiet at that time it was felt that school life would soon return to normal routine. Head Teachers were seriously concerned about the physical well-being of the children after a long winter of comparative inactivity, but were handicapped by staffing difficulties, due to men being called to the Armed Forces and to the requirements for teaching staff in the reception areas. The time was inopportune for conducting Training Courses of an intensive character, but, in order to give some assistance to those teachers now responsible for Physical Training, modified Courses were arranged in Swimming, Physical Training and Games, in which the greater part of the instruction was given by means of demonstrations with classes of children. The second large-scale evacuation of school children took place in June and as a result the Swimming Course was the only one completed. Thirty-four men and women teachers attended the Courses. It will be readily understood that there was very little attendance at the Playing Fields and Swimming Baths during the year, as it was unwise to send children away from their schools at a time when it was necessary to spend so much time in the air raid shelters. Several visits were paid to schools in the reception areas, and in each case the normal teaching of physical subjects was being creditably undertaken under difficult conditions. Only two evening classes in Recreative Physical Training were arranged in the Borough, and both were formed as a result of demand by the members concerned. The attendance at both classes was satisfactory. 12 Mr. Marr was released from the Army to resume his civilian duties 0n 1st November, as a result of an application made by the Middlesex County Council to the War Office. By the end of the year the comparative freedom from regular air raids gave rise to the hope that Physical Education could again be more extensively developed both for school children and adults, and we look forward to a more progressive year in 1941, supported by the Government's constant emphasis on the importance of Physical and Recreative pursuits. (Signed) FLORENCE E. BREESE, JOHN B. MARR, Organisers of Physical Training.