BOROUGH OF HORNSEY. ANNUAL REPORT OF THE Medical Officer of Health FOR 1941 R. P. GARROW, M.D., D.P.H. Printed by " The Hornsey Journal." Ltd.. 161, Tottenham Lane. N.8. ANNUAL REPORT OF THE Medical Officer of Health FOR 1941 R. P. GARROW, M.D., D.P.H. 2 HEALTH COMMITTEE as at 31st December, 1941. Alderman J. W. Shipp (Chairman), 40, Coleridge Road, N.8. The Mayor, Alderman H. G. J. Williams, J.P., 105, The Chine, N.21, Alderman Mrs. C. M. Cave, 10, Wood Vale, N.10. S. G. Goulding, Woodlands, Cranley Gardens, N.10. ,, Wm. J. Grtmshaw, 25, Sheldon Avenue, N.6. ,, R. Steeds, 19, Coolhnrst Road, N.8 L. .T. Valette, 59, Allison Road, N.H. ,, W. V. Wall, Kitten Lodge, Rowhen Close, Totteridge. ,, C. Winkley, 72, Woodside Avenue, N.10. Councillor Mrs. J. H. Barrexger, 18, Fordington Road, X.6. ,, F. A. P. Boustred, 26, Lanchester Road. N.6. ,, Mrs. X. C. Clegg, 28, Stormont Road, N.6. ,, J. Edwards, 102, Turnpike Lane, N.8. ,, Mrs. M. X. Hill, 16, Bishopswood Road, X.6. ,, G. F. N. Norman, .12, Woodberry Crescent, N.10. ,, F. L. Pascoe, 3/15, Xorthwood Hall, N.6. ,, T. Tivexdale, 12, Colney Hatch Lane, N.10. .T. L. R. Webb, 11, Wilmer Way, N.14. 3 STAFF OF PUBLIC HEALTH DEPARTMENT. †*Medical Officer of Health and School Medical Officer R. P. Garrow, m.d., d.p.h. †*Deputy Mcdical 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.l. Dr. W. Mck. H. McCullagh, 149, Harley 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, 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 Foods. † *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 Foods. 4 †*Sanitary Inspectors and Shops E. Hundy, Acts Inspectors, Young Per- m.s.i.a. Cert. R.S&n.I. sons Act Inspectors, Factory Cert. Insp. of Meat and Foods, Act Inspectors (coutd.) r Downes, M.S.I.A. Cert. R.San.I. †Chief Clerk E. Cheesman. †Assistant Clerks N. Smith. (On Active Servicc from 11th January, 1940.) Miss P. AYlward, W. A. Simons. (On Active Service from 27th October, 1939.) T. Hadley, Miss E. A. Smith. †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. K. Comming, 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.) Miss E. Whimster, H.V. Cert., S.R.N., C.M.B. †Midwives Miss M. Andrews, c.m.b. Mrs. M. Jamison, c.m.b. Miss L. Hughes, c.m.b. Miss A. C. Matthews, c.m.b. †Mortuary Keeper C. F. Catlin. (Retired 23rd May, 1941.) †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. 15, Jackson's Lane, N.6. Note :—† Whole-time Officers. * Officers in respect of whom salary contribution is made under the Public Health Acts or by Exchequer Grants. ‡ Part-time Officers. 5 To the Mayor, Aldermen and Councillors of the Borough of Hornsey. Mr. Mayor, Ladies and Gentlemen, 1 have the honour to submit my Annual Report for the year ending December 31st, 1941. The birth rate was 12 86 per 1,000 of population, practically the same as in the previous year. The death rate was 13 95, as against the unusually high figure of 1516 in 1940. Infant Mortality (63.2). Fifty infants died in 1941 before reaching the age of 1 year. The live births numbered 791. The infant mortality rate is therefore 63. One must go back to the last war to find so high a figure. The fall in infant mortality which has occurred in the last quarter of a century, and most notably in the dozen years before the present war, reached its lowest point in 1939. when it was 27.25. In 1940 it rose to 49, and in 1941 there is this further striking increase to 63. The causes of these infant deaths and the exact ages at which they occurred are set out in detail in the table on Infant Mortality. The most important facts which this analysis reveals are— (1) Thirty of the fifty infant deaths occurred in the first month of life; 25 of them occurred in the first week. (2) Thirty-three deaths resulted from conditions associated with the period of gestation and the process of parturition. (3) Of the causes of deaths of infants from infection after birth, pneumonia (10 deaths) claimed more victims than all the other infections together. The high proportion of the infant deaths occurring in the first month, due to congenital conditions and the hazards of childbirth, is an indication of the strain which the conditions of 1940-1941 placed on expectant and nursing mothers. This appears to be true, whether they chose to have their babies 6 at home, in hospitals in London, or in maternity homes in reception areas. Apart from the rise in infant mortality rate in the last two years, there is nothing in the vital statistics to indicate any adverse influence of war conditions on the public health. There has been no undue prevalence of, or deaths from, any of the infectious diseases. The deaths from all forms of tuberculosis were 49 in 1940 and 48 in 1941—the lowest figures ever recorded in this Borough. The general nutritional state of the child population of school and pre-school ages has been excellent and there has been a conspicuous absence of disease-conditions attributable to insufficient or unsuitable diet. I have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your obedient servant, R. P. GARROW. Medical Officcr of Health. 7 STATISTICS FOR 1941. (Section A). Social and Economic Statistics. Area (acres) 2,872 ,, (square miles) 4-49 Population (Census 1931) 95,524 Do., Registrar-General's estimate, 1941 69,730 Number of inhabited houses (end of 1941), according to Rate Books Not available Rateable value (General Rate) at 31st December £1,052.562 Product of a penny rate £3,650 LIVE BIRTHS *For I.M., etc. †For B . Rate M. F. M. F. Legitimate 377 365 423 424 Illegitimate 26 23 26 24 Total 403 388 449 448 791 897 Birth Rate 12.86 (per 1,000 population). STILL-BIRTHS— M. F. M. F. Legitimate 15 8 16 8 Illegitimate 1 2 1 2 Total 16 10 17 10 26 27 Still.-Birth Rate 29.22 (per 1,000 total live and still births). DEATHS— Males 441 Females 532 Total 973 Death Rate 1395 (per 1,000 population). * For calculating Infant and Maternal Mortality rates, † For calculating Birth rate. 8 Deaths from Puerperal Causes. Deaths. Rate per 1,000 total (live and still) births. England and Wales. Puerperal and post-abortive sepsis 1 1.08 0.48 (excluding abortion) Other maternal causes 2 2.16 1.75 Total 3 3.24 2.23 Deaths of Infants under 1 Year of Age. Legitimate Males 22 'Females 18 = 40 Illegitimate 6 4 = 10 Total .. 50 Death Rate of Infants under* 1 Year of Age. All infants per 1,000 live births 63.2 Legitimate infants per 1,000 legitimate live births 50.56 Illegitimate infants per 1,000 illegitimate live births 204.08 Deaths from Special Causes. Deaths from Cancer (all ages) 146 Deaths from Measles (all ages) 2 Deaths from Whooping Cough (all ages) 1 Deaths from Diarrhœa (under 2 years of age) 8 9 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. (c) Nursing in the Home. (d) Treatment Centres and Clinics. (e) Hospitals: Public and Voluntary. No Material Changes During 1941 3.— (i) Midwifery Service (ii) Maternity Services (iii) Institutional Provision for Mothers or Children (iv) Health Visitors. (v) Child Life Protection. (vi) Dental, Orthopedic, Etc., Treatment. Special Section LABORATORY FACILITIES. The specimens examined in the laboratory at the Isolation Hospital during 1941 were as follows— Negative. Positive. Total. Diphtheria, specimens . 384 74 458 Sputum (T.B.) ,, . 148 12 160 Streptocci 8 4 12 Blood for Widal 8 7 15 Other examinations 18 5 23 Total . 566 102 668 10 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:— Complaints 808 Re-inspections 2,862 Information from builder 107 Special Inspections | 386 Drainage 118 Water tests applied (new drains) 18 Smoke and Chemical tests (old drains) 10 Verminous houses 82 Pests 46 Overcrowding surveys ... 10 Offices (Workplaces) 6 Families rehoused 6 Notifiable Infectious Diseases 662 Scabies 70 Small-pox Contacts — Sunday Trading Inspections 626 Shops Acts .265 Butchers' shops 08 Slaughter-houses 6 Dairies and Milkshops 17 Grocers' shops ... 118 Bakehouses 25 Fish shops 15 Restaurant kitchens 33 Greengrocers' shops 34 Other food shops 51 Food Inspections 73 Factories and outworkers 100 Conveniences 2 Young Persons Act 16 Piggeries 6 Petroleum stores 55 Smoke observations 1 Surveys (P.N.) 7 Re-Surveys (P.N.) 9 11 INSPECTIONS NECESSITATED BY WAR CONDITIONS: Shops: Gas Protection Survey 132 Food Centres 21 Hairdressers-' shops (Survey) 53 Rest Centres 17 Air Raid Trench Shelters 1,697 8,717 NOTICES. The Notices served during the year are as follows: — Under the— Verbal Preliminary Statutory Public Health and Housing Acts 311 423 15 Housing Bye-laws 38 3 Shops Acts 47 4 — Factory Acts 12 8 — 370 473 18 SUMMARY OF SANITARY IMPROVEMENTS CARRIED OUT. Drainage. Number of bouses and premises redrained 4 Repairs or amendments to existing drains 45 Drains or gullies unstopped or cleansed 61 Manholes provided 8 do. repaired 19 Intercepting traps fixed 3 New gulley traps fixed 24 New soil pipes and ventilating shafts fixed 20 Soil pipes and ventilating shafts repaired 27 Fresh-air inlets provided or repaired 12 12 Water-Closets and Sanitary Fittings. New water-closet buildings 7 New water-closet basins fixed 98 Water-closets unstopped, cleansed or repaired 37 New check cisterns fitted to water-closets; existing check cisterns repaired 32 New sinks provided 21 New lavatory basins provided 29 New waste-pipes fixed 41 Waste-pipes trapped, repaired or unstopped 61 Waste-pipes diverted into proper drain 2 Baths provided or made usable 12 Urinals cleansed 1 Miscellaneous. Roofs repaired 184 Eaves guttering renewed, cleansed or repaired 58 Rain-water pipes provided, repaired 51 Damp walls remedied 112 Damp-proof courses inserted 41 Paving of yards repaired 152 Premises structurally repaired 291 Rooms cleansed, distempered or papered 17 Premises disinfested of vermin 106 Drinking-water cisterns repaired, cleansed and covered 43 Water supply (additional) provided 2 Windows and skylights provided or made usable 51 Sub-floor ventilation 7 Floors repaired 62 Windowsills repaired 19 Sash cords and fittings repaired 51 Sanitary dustbins provided 29 Accumulations of manure and refuse removed 24 Stoves, ranges and coppers repaired or renewed 42 Sundry items 94 Food stores provided 4 2,004 13 Factories. Defects Remedied. Sanitary accommodation—Insufficient 3 Unsuitable or defective 8 Not separate for sexes 2 Workrooms cleansed or repaired 10 Ventilation improved 1 Heating provided 1 25 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 578. Thirty-two houses have been dealt with under these Byelaws during the year and the following works carried out: — Byelaw. 4 (b) Water supplies 19 4 (c) Washing accommodation 4 4 (d) Food stores 13 5 (a) Repairs to drains 1 5 (b) Means of carrying off waste water 2 5 (c) Provision of windows 1 5 (d) Room ventilation provided 2 5 (f) Ventilation to the bedroom and room with cooking apparatus 4 5 (g) Staircase repairs — 5 (h) Handrails provided — 46 Offices. The number of offices on the register at the end of the year was 221. 14 CLEANSING AND DISINFECTING STATION. Cleansing Station. One hundred and sixty-two children and 121 adults have been treated at the Cleansing Station for scabies and 16 adults for verminous conditions. One hundred and twenty-two school children were treated for verminous conditions under arrangements made by the Local Education Authority. Disinfecting Station. Work done by disinfectors:— Disinfection. Premises disinfected after notifiable infectious diseases 154 „ „ „ T.B 20 ,, ,, for other reasons 71 No. of articles disinfected 5,962 ,, ,, destroyed 91 ,, rooms disinfected 410 Collection and disinfection of library books:— Received. Returned. Destroyed. Public Libraries 85 85 Private Libraries 17 17 Schools 3 3 — Disinfestation. Premises infested with vermin 59 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) 808 (b) Number of inspections made for the purpose 2,531 15 (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 — (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 397 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 343 3. Action under Statutory Powers during the Year:— A.—Proceedings under Sections 17, 1H 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 18 (2) Number of dwelling-houses in which defects were remedied after service of formal notices:— 16 (a) By owners 18 (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 — I).-—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 29 (ii) Number of families dwelling therein 42 (iii) Number of persons dwelling therein 207 (b) Number of new cases of overcrowding reported during the year 9 (c) (i) Number of cases of overcrowding relieved during the year 6 (ii) Number of persons concerned in such cases 31 OTHER HOUSING ACTIVITIES. FAMILIES EE-HOUSED BY THE COUNCIL.—The Council re-housed 50 families, representing 207 persons, from various roads in the Borough. *These figures are taken from Departmental records, but owing to changes brought about by war conditions the figures may not indicate the final position in regard to overcrowding. 17 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 Milk 17 ,, ,, „ „ (Supplementary) 3 T T 4 „ „ „ „ ,, ,, (Supplementary) 3 FOOD CONDEMNED. Meat 12 cwt. 19 lbs. 14 ozs. Fish 2 cwt. 84 lbs., 11 boxes kippers, 1 box herrings. Bacon 14 lbs. 8 ozs. Fowls 57 Rabbits 344 Fruit 75 lbs. Tinned Meats 36 lbs. Vegetables 1 cwt. Margarine 13¾lbs. Biscuits 20 lbs. Rice 1 cwt. Sugar 3 cwt. 36 lbs. Cheese 12 lbs. and 36 pkts. processed cheese. Pickles gallon Milk 7 tins Baked Beans 12 tins Eggs 1,498 Flour 6 tons 8 cwt, 91 lbs, 18 FOOD CONDEMNED AS A RESULT OF AIR RAID DAMAGE. Groceries 7½ lbs. Beans 6 tins Vegetables 20 lbs. INFECTIOUS DISEASES. (Section F.) IMMUNISATION AGAINST DIPHTHERIA. The Council's diphtheria immunisation scheme, which lias been in operation for five years, consists of special immunisation sessions at Centres 1,2, 3 and 4 on the first, second, third and fourth Saturday morning in each month. The immunising material used is Toxoid antitoxin follicles (T.A.F.) —three doses of 1 c.c. at intervals of one month. Satisfactory progress is being made and there is a steady flow of children at each of the centres. Tn addition, immunisation is carried out of young babies at the infant welfare centres and of school children in the schools. About 40 per cent, of school children are immunised or in process of being immunised and 60 per cent, of pre-school children. Parents now appreciate that the process is simple, safe, painless, free from reaction and entirely harmless. There is also no doubt that in all but a very small minority of children it produces a real and lasting immunity. In the rare event of an attack of diphtheria after immunisation, the illness is mild and the danger of death is practically removed. In these circumstances parents who fail to have their children immunised against diphtheria are taking upon themselves a heavy responsibility, for which they may have reason to be sorry if this treacherous disease enters the household. For it is a treacherous disease—stealing in unsuspected and doing its deadly work so stealthily that a young child may be moribund before the disease is diagnosed. It is frequently stated—sometimes on high authority—that there has been no reduction in the mortality from diphtheria 19 since the beginning of this century. This fortunately is not true of Hornsey, as the following figures show:— Diphtheria Cases and Deaths in Decennia. Decennium. Cases. Deaths. Case Mortality. 1901-1910 1,177 91 7.7 per cent. 1911-1920 988 76 7.7 per cent. 1921-1930 1,904 52 4.7 per cent. 1931-1940 780 27 3.6 per cent. There is a steady reduction in each successive decennium in the number of diphtheria deaths, and in the last two decennia in the case mortality. This is no doubt accounted for, to some extent, at least, by the measures taken for the control of diphtheria—quick detection of the disease by the doctor called in, rapid removal to hospital, efficient treatment, especially in relation to adequacy of dosage of antitoxin, together with measures to prevent the spread of infection at home. It is well, however, to remember that the change in age constitution of the population during the forty years under review would naturally tend to favour a fall in the incidence of diphtheria. The census population of 1901 was 72,056, that of 1931 was 95,523, and, if a census had been possible in normal conditions in 1941, the total population of the Borough would almost certainly have been over 100,000. But whereas 26 per cent, of the 1901 population was under 15 years of age, only 17 per cent, of the 1931 population was under 15, and if a census had been taken in 1941, the proportion under 15 would probably have been in the region of 14 per cent. The full in the birth rate has cost us nearly half our child population in forty years. The diphtheria-susceptible elements in the population are being separated—and so to some extent protected from infection—by the older immune elements in the population. The question might be asked whether 27 deaths in ten years—an average of less than three per annum—is not in itself a satisfactory achievement compared with the early years of the century. The answer is that, since the perfecting of the process of artificial immunisation in the last few years, its complete safety and reliability—27 deaths from diphtheria in ten years are just 27 too many. Our aim should be a decade without a 20 diphtheria death. This has been achieved in some towns in Canada and U.S.A. and there is no reason why it should not be achieved in Hornsey. Since the commencement of holding sessions in Hornsey in 1936 three thousand nine hundred and seventy-two children have been immunised up to the end of 1941. The following are particulars of the children immunised during 1941:— Age under 5 years. Age 5 years and over but under 15. Town Hall Centre 354 285 Burgoyne Hall Centre 182 63 Church Road Centre 54 63 Coldfall Centre 46 102 Elementary Schools — 612 636 1,125 VACCINATION. The Public Vaccinators inform me that they performed vaccination of persons in the Borough during 1941 as follows:— Dr. E. Buckler 100 Dr. R. Mackay 196 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 Vision unimpaired. Vision impaired. Total blindness. Deaths. Notified. Treated At home. In hospital or nursing home. 2 0 2 2 0 0 0 21 TUBERCULOSIS. PUBLIC HEALTH (PREVENTION OF TUBERCULOSIS) REGULATIONS. No occasion has arisen in the course of the year to put these powers into action. There were 696 beds available solely for Middlesex under the Middlesex County Council's scheme for the treatment of Tuberculosis in sanatoria, namely:— Institution Accommodation Types of cases Adults children M F County Sanatorium, Harefield 136 4 164 4 68 10 Pulmonary—sanatorium ,, observation County Sanatorium, Clare Hall 170 72 . ,, sanatorium Danesbury Manor, Welwyn . 57 5 ,, Victoria Home, Widdicombe, Devon . . 6 Non.pulmonary 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 1941 was 874, viz., pulmonary 661), noil.pulmonary 205, an increase of 21 on the total for last year. A table showing the history of cases of Tuberculosis during the year will be found on Table F. MORTUARY. Seventy.three bodies were received at the mortuary and inquests held on 12 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 1941 as follows:— 22 Inspections mads under the Diseases of Animals Acts 28 (Pigs 220) Animals inspected: — Under the Parasitic Mange Order: Horses 1 Under the Swine Fever Order, 1908: Pigs 5 No action was necessary under the Tuberculosis Order, 1925. Five post.mortem examinations on pigs were carried out during the year. 23 LIST OF TABLES. TABLE A.—Vital Statistics, 1912.41. TABLE B.—Causes of, and ages at, death in 1941. TABLE C.—Infant Mortality in 11141. Causes of, and ages at, death. TABLE D.. Births, Deaths, Infant Deaths, and Deaths from certain diseases, 1912.1941. TABLE E.—Cases of Infectious Disease notified in 1941. TABLE F.— (1) Notification of, and deaths from, Tuberculosis, 1941. ,, (2) Tuberculosis Register, 1941. 24 TABLE A. BOROUGH OF HORNSEY VITAL STATISTICS, 1912.1941. Year. Estimated Mid.Year Population. Birth Kate per 1,000 Population. Death Kate per 1,000 Population. Infant Mortallity per 1,000 live Births. 1912 84,840 16.3 9.9 75 1913 85,122 16.7 9.7 56 1914 85,456 17.8 9.2 57 1915 85,800 15.5 12.2 80 1916 86,147 16.0 11.5 46 1917 86,450 11.3 10.9 70 1918 86,942 11.7 13.8 61 1919 87,100 13.6 11.4 64 1920 87,410 19 3 10.3 54 1921 87,691 (Census). 16.7 11.0 49 1922 88,007 15.4 11.2 54 1923 88,325 14.4 10.5 51 1924 88,661 13.4 10.4 41 1925 89,064 13.6 10.6 43.6 1926 89,850 13.4 10.3 47.2 1927 90,000 13.3 11.2 38.3 1928 90,250 12.1 121 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 11.9 11.2 52.6 Regr .Gen.'s Estimate 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 1930 96,160 12.0 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 12.82 15.16 49.30 1941 69,730 12.86 13.95 63.20 ENGLAND and WALES * (Rates in 1941) 14.72 12.29 59 126 County Boroughs and Great Towns, including London * (Rates in 1941) 15.28 14.9 71 148 Smaller Towns Resident Population 25,000—50,000 at 1931 census * (Rates in 1941) 17.0 13.0 56 London * (Rates in 1941) 9.23 16.3 68 * Rates per 1,000 civilian population. † (a) For calculation of Birth rate. (b) „ „ „ Death rate. or Incidence of notifiable infectious disease. 25 TABLE B.—CAUSES OF, AND AGES AT, DEATH, 1941. Total. All Ages. 0—1 1—8 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. Cerebro spinal fever 4 3 1 2 ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 ... ... ... ... ... ... ... ... 2 3. Scarlet Fever 0 0 0 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 4. Whooping cough 1 1 0 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 5. Diphtheria 1 1 0 ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 6. Tuberculosis of respiratory system 43 21 22 ... ... ... ... ... ... ... ... 3 6 ... ... 4 5 ... 2 2 2 1 1 ... ... ... ... 6 7. Other forms of tuberculosis 5 3 2 ... ... ... ... ... ... 2 ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 7 8. Syphilitic diseases 13 7 8 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 3 1 3 1 ... 2 ... 2 8 9. Influenza 7 4 3 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 1 2 ... ... ... ... 1 ... 1 9 10. Measles 2 1 1 1 ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 10 11. Acute polio.myelitis and polioencephalitis 0 0 0 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 11 12. Acute infectious encephalitis 1 0 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 12 13 Cancer of buccal cavity and (esophagus (males only) 7 7 0 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 ... 3 ... 1 ... ... ... 13 Cancer of uterus (females* 10 0 10 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 2 ... 3 ... 4 ... ... ... ... ... 14. Cancer of stomach and duodenum 26 11 15 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 ... 2 2 3 6 3 6 ... 1 14 15. Cancer of breast 15 2 13 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 4 1 5 ... 3 ... 1 ... ... 15 16. Cancer of all other sites 88 45 43 ... ... ... ... ... 1 ... ... ... ... 1 ... 1 4 3 4 20 8 12 14 8 10 ... 2 16 17. Diabetes 9 2 7 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 3 ... 1 1 3 ... ... 17 18. Intra crauial vascular lesions 86 27 59 ... ... ... ... ... ... ... ... ... ... ... ... 2 2 1 4 7 7 11 16 6 23 ... 7 18 19 Heart disease 253 108 145 ... ... ... ... ... ... ... ... 2 1 1 2 3 4 4 4 18 17 40 31 26 50 14 36 19 20. Other diseases of cire system. 23 10 13 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 6 ... 3 5 1 5 ... 3 20 21. Bronchitis 48 31 17 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 2 2 1 9 5 12 4 4 5 21 22. Pneumonia 78 36 42 ... ... ... ... ... ... 1 ... 1 ... ... 3 2 ... 2 3 6 4 9 10 7 14 ... 2 22 23 Other respiratory diseases 9 5 4 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... 1 ... 2 3 ... 1 ... 23 24 Ulcer of stomach or duodenum 9 8 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... 3 ... 2 ... 1 1 ... ... 24 25. Diarrhœa, under 2 years 3 3 0 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 25 26 Appendicitis 2 1 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 ... ... ... ... 26 27. Other digestive diseases 32 12 20 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 3 4 3 5 4 6 ... ... 27 28. Nephritis 18 7 11 ... ... ... ... ... ... 2 ... ... ... ... ... ... ... 1 2 1 2 1 3 2 1 ... 3 28 29. Puerperal and post abortive sepsis 1 0 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... 29 30. Other maternal causes 2 0 2 ... ... ... ... ... ... ... ... ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 30 31. Premature birth 18 10 8 10 8 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 31 32. Con. mal, birth injuries, infantile disease 16 7 9 6 9 ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 32 31. Suicide 6 3 3 ... ... ... ... ... ... ... ... 1 ... 1 1 ... 1 ... 1 2 ... ... ... ... ... ... ... 33 34. Road traffic accidents 10 7 3 ... ... ... ... ... ... ... ... 1 1 2 1 1 ... 1 ... 1 ... 1 ... ... ... 1 ... 34 36. Other violent causes 51 24 27 ... ... ... ... ... ... 2 ... 2 2 1 3 1 3 7 4 7 5 3 4 1 4 ... 2 35 36. All other causes 76 34 42 ... ... 2 ... ... 2 1 ... 2 ... 5 2 ... 5 2 4 8 5 7 7 6 8 1 9 36 Totals 973 441 532 28 22 4 1 2 5 6 1 14 10 18 20 19 26 41 43 96 72 111 119 82 140 20 73 26 TABLE C—INFANT MORTALITY, 1941. CAUSES OF DEATH. Deaths from stated causes at various Ages under One Year of Age. Totsl 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 Conditions associated with Pregnancy aud Birth Premature Birth 1 15 1 ... ... 1 ... ... ... 18 33 Congenital Malformations 1 2 2 ... ... 2 1 ... ... 8 Asphyxia at Birth ... 3 ... ... ... ... ... ... ... 3 Injury at Birth ... 2 ... ... ... ... ... ... ... 2 Congenital Debility ... ... ... ... 1 ... ... ... ... 1 Maternal Toxæmia ... 1 ... ... ... ... ... ... ... 1 Conditions arising from Infection after Birth Pneumonia ... ... 1 ... ... 2 3 2 2 10 17 Enteritis ... ... ... ... ... 1 1 1 ... 3 Cerebro-Spinal Meningitis ... ... ... ... ... ... ... ... 2 2 Whooping Cough Measles ... ... ... ... ... 1 ... ... 1 1 1 Totals 2 23 4 0 1 7 5 3 5 50 27 TABLE D.—BIRTHS, DEATHS. INFANT DEATHS AND DEATHS FROM CERTAIN DISEASES, 1912.1941. YEAR. 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 Heaths from Tuberculosis (Pulmonary Deaths from Tuberculosis (Non. Pulmonary) 1912 84,592 Census 1,385 ... 840 105 5 2 13 3 2 2 114 43 17 1913 1,425 ... 824 81 12 8 12 0 4 3 96 55 14 1914 1,529 ... 791 88 1 4 21 1 7 1 82 44 10 1915 1,394 ... 1,007 112 37 7 23 3 11 2 99 58 13 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 lt'22 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 1,139 44 1,058 60 0 2 5 1 5 0 179 52 5 R..Gyn.'s Estimate 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 0 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 1941 69,730 (a) 791 (b)897 (a)26 (b)127 973 50 2 1 3 0 1 0 145 43 5 * (a) For calculation of Birth rates. †(a) For calculation of Infant and Maternal Mortality Rates, (b) .. „ Death rates. (b) „ „ .. Birth rates. 28 TABLE E—INFECTIOUS DISEASES, NOTIFIED, 1941. DISEASE WARDS AGES Total Admitted to Joint Hospital. Admitted to other Hospitals. In Nursing Home. Nursed at Home. High gate Muswell Hill. Crouch End Central Hornscy North Haringey South Haringey Stroud Green Finsbury Hark. 0— 1— 1 5— 15 15— 25 25— 45 45— 65 65 and over Scarlet Fever 6 13 2 9 3 2 3 1 0 9 14 8 7 1 0 39 25 3 0 11 Diphtheria 9 19 3 7 6 2 2 6 2 10 23 7 9 3 0 54 53 1 0 0 Typhoid Fever 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 1 0 0 Pneumonia 14 9 3 15 5 4 9 3 3 5 2 4 15 22 11 62 3 10 0 49 Erysipelas 1 6 1 3 1 5 2 1 0 0 1 1 5 9 4 20 4 1 0 15 Puerperal Pyrexia 1 5 1 4 2 3 0 0 0 0 0 3 13 0 0 16 0 16 0 0 Ophthalmia Neonatorum 0 0 0 0 0 1 1 0 2 0 0 0 0 0 0 2 0 2 0 0 Encephalitis Lethiargica 0 1 0 1 0 0 0 0 0 0 0 0 1 1 0 2 1 0 0 l Cerebrospinal Meningitis 1 2 1 6 0 1 2 0 2 2 1 1 4 2 1 13 6 5 0 2 Dysentery 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 Measles 14 75 20 118 66 53 65 41 9 192 260 17 3 1 0 482 5 4 0 473 Whooping Cough 27 49 7 59 22 21 32 21 20 93 116 4 3 1 1 238 6 3 0 229 Gastro Enteritis 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 1 1 0 0 0 Para-Typhoid Fever 1 1 1 2 2 1 1 0 0 3 0 4 1 1 0 9 6 2 0 1 Poliomyelitis 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 1 0 1 0 0 Measles and pneumonia 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 1 Whooping Cough and Pneumonia 1 0 0 0 1 0 0 1 2 0 1 0 0 0 0 3 3 0 0 0 Food Poisoning 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 1 77 181 39 257 108 93 117 74 41 316 418 50 62 42 17 946 113 50 0 783 Tuberculosis: 18 23 10 25 19 13 19 13 0 3 1 40 63 26 7 140 Non-Pulm'rv 6 3 0 4 6 0 1 1 1 1 8 3 6 1 1 21 Total 101 207 49 286 133 106 137 88 42 320 427 93 131 69 25 1,107 29 Admitted to Joint Isol. Hospital 16 33 7 22 11 8 6 10 Other Hptls. 8 12 2 13 4 6 3 2 5 . Nursing Homes 00000000 Nursed at Home S3 136 30 222 93 79 108 62 The following 31 cases were treated in the Isolation Hospital in addition to the above:—Influenza and Bronchitis 1, Toxic rash 2, Urticaria 1, Influenza 1, Pyelitis 4, Otitis media 2, Follicular Tonsillitis 1, Observation 1, Infection of palmar sheath and cellulitis 1, Cellulitis 1, Reaction to immunization 1, Bronchitis 1. Intestinal toxaemia 1, Impetigo 2. Gastro.intestinal upset 1, Conjunctivitis dermatitis 1, Mumps 1, Threadworm infection 1, Scabies and Impetigo 1, Coryza 1, Chronic Bronchitis 1, Teething and Coryza 1, Cellulitis of leg and Erysipelas 1, Laryngitis 1, Gastro.enteritis 1. 30 TABLE F.—(1) NOTIFICATION OF, AND DEATHS FROM, TUBERCULOSIS. 1941. 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 0 0 1 - 5 1 2 ] 0 0 0 1 1 5 — 15 1 0 4 4 0 0 2 0 15 — 25 23 17 2 1 3 6 0 0 25 - 35 17 25 0 4 5 6 0 0 35 — 45 14 7 2 0 4 5 0 0 45 55 10 3 0 0 6 2 0 0 55 - 65 10 3 0 1 2 2 0 1 65 and over 3 4 0 1 1 1 0 0 Totals 79 61 10 11 21 22 3 2 Wards: High gate 10 8 2 4 Muswell Hill 16 7 1 2 Crouch End 9 1 0 0 Central Hornsey 14 11 2 2 North Haringcy 10 9 4 3 South Haringey 5 8 0 0 Stroud Green 11 8 0 1 Finsbury Park 4 9 1 0 Totals 79 61 10 11 TABLE F.—(2) TUBERCULOSIS REGISTER. 1941. Pulmonary. Non-Pulmonary. Total. Male Female Male Female Male Female (a) Number of Cases on Register at commencement of 1941 343 308 107 95 450 403 (b) Number of Cases notified for first time during year under Regulations 58 39 4 1 5 62 44 (c) Cases restored to Register during 1941 6 4 1 7 5 (d) Cases added to Register otherwise than by notification under Regulations : (1) Transferred from other districts 9 14 2 4 11 18 (2) From Death Returns 6 4 3 1 9 5 79 61 10 11 89 72 (e) Number of Cases removed from Register during 1941 62 60 10 8 72 68 (f) Number of Cases remaining on Register at end of 1941 360 309 107 98 467 407 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 8 7 25 26 Pulmonary 22 14 62 60 7 13 1 1 4 6 Non-Pulnionarv 5 1 10 8 0 0 31 33 Borough of bornsey ANNUAL REPORT ON Maternity and Child Welfare Services 1941 34 MATERNITY & CHILD WELFARE COMMITTEE as at 31st December, 1941. Alderman W. V. Wall, (Chairman), Kilten Lodge, Rowben Close, Totteridge. The Mayor, Alderman H. G. J. Williams, J.P., 105, The Chine, N.21. Alderman Mrs. C. M. Cave, 10, Wood Vale, N.10. ,, S. G. Goulding, Woodlands, Cranley Gardens, N.10. ,, Wm. J. Grimshaw, 25, Sheldon Avenue, N.6. ,, J. W. Shipp, 40, Coleridge Road, N.8. ,, R. Steeds, 19, Coolhurst Road, N.8. ,, L. J. Valette, 59, Allison Road, N.8. Councillor Mrs. J. H. Barrenger, 18, Fordington Road, N.6. ,, F. A. P. Boustred, 26, Lanchester Road, N.O. ,, M. W. Burns, 7, Womersley Road, N.8. ,, Mrs. N. C. Clegg, 28, Stormont Road, N.O. ,, F D. Dew, 101, Turnpike Lane, 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. ,, G. B. Walker, 7, Waverley Road, N.8. ,, J. L. R. Webb, 11, Wilmer Way, 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 Vale, N.10. Miss B. I. Smith, 43, Weston Park, N.8. Mrs. B. Walton, " Greenaere," The Green, Ealing, W.5. Miss E. F. Wood, 38, Church Crescent, N.10. 35 THE MATERNITY AND CHILD WELFARE SCHEME. The Maternity and Child Welfare Scheme has continued its normal work at the four centres throughout the war. The heavy aerial bombardments in the last few months of 1940 led to the evacuation of a considerable number of expectant and nursing mothers and pre-school children to places of greater safety in the country. This disturbance does not appear to have raised maternal mortality or morbidity, but it is reflected in the increase in premature births and neo-natal deaths. During 1941 there has been a steady return to more normal conditions and the number of attendances at the centres has increased, so that extra sessions have been held for expectant mothers and for infants and young children. MATERNITY HOSPITAL ACCOMMODATION. North Middlesex Hospital.—The maternity admissions from Hornsey to the North Middlesex Hospital numbered 127 in 1941, as compared with 114 in 1940. MIDWIFERY SERVICES. There were 15 Midwives, including 4 Borough Midwives, notified to the Middlesex County Council as practising in the Borough, 6 of whom reside outside the Borough. The Borough Midwives attended 226 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. Three thousand two hundred and sixty.six births have been attended by the Borough Midwives since the appointment of a Midwife was first made in 1922. PAINLESS CHILDBIRTH. Up to the end of the year seventy.five mothers had had gas and air administered at their confinements and the results may be claimed to be very satisfactory. 36 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. The number of births notified under the Act during 1941 was:— Male. Female. Total. Live births 427 409 836 Still births 15 12 27 442 421 863 The births were notified: — By doctors 18 ,, Borough Mid wives 266 ,, other midwives 143 ,, hospitals 127 ,, parents 1 ,, others 295 850 Not notified (from Registrar's returns):— Live births 12 Still births 1 13 863 Of this number there were: — Live births. Still births. Occurring in the Borough and transferred to other districts 88 2 Belonging to Honbsey and occurring in Hospitals, &c., outside the district 396 13 The 773 nett number of notified births belonging to Hornsey were divided among the districts of the Centres as follows: — 37  Live Births. Still Births. Total. Town Hall Centre 387 5 392 Burgoyne Road Centre 129 7 136 Highgate Centre 204 13 217 Coldfall Sub-Centre 28 0 28 748 25 773 HOME HELPS. The Hornsey Home Helps Society, started in 1980 by members of the Voluntary Committees of the Centres, continued its work during the year (Hon. Secretary: Mrs. Inward, 99, Peniberton Boad, N.4). THE NATIONAL MILK SCHEME. The distribution of milk to expectant and nursing mothers and children under five was transferred from the Health Department to the local Food Control Office in 1940. This work, together with the distribution of fruit juices and cod liver oil, is carried out by Food Control in close co-operation with the Maternity Centres, and is an extremely important factor in maintaining the health of mothers, babies and young children. MATERNITY AND CHILD WELFARE DENTAL SCHEME. The following is a record for the year of the work of the Dental Clinic:- Mothers. Children. Old cases 409 62 New cases 153 87 Total attendances 562 233 Finished cases 62 68 Attendances for dentures 127 - Dentures provided 23 - Dentures repaired 5 - Teeth extracted 624 81 Fillings done 77 90 Inspections 162 56 General anaesthetics 81 51 Local anaesthetics 90 1 Other treatments (dressings, scaling, gum treatment, etc.) 97 203 38 ORTHOPAEDICS. The Surgeon attends monthly and the Masseuse three 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 50 50 Old cases 83 577 ,, attendances 139 666 The cost to the Maternity and Child Welfare Committee was £55 10s. l1d. for the treatment of children under five years for the year to 31st March, 1942. 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. 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: — 39 Centre— No. 1 No. 2 No. 3 No. 4 Total No. of foster-mothers on the register: At the beginning of 1941 ... 6 7 2 1 16 " " end " " 6 5 7 3 21 No. of foster-children on the register: At the beginning of 1941 ... 9 12 2 1 24 " " end " " 7 9 7 1 24 Died during the year - - - - - On whom inquests were held during the year - - - - - Visits to foster-children: 1st Visits 16 10 10 2 38 Total Visits 164 117 51 13 345 No proceedings were taken during the year. 40 MATERNITY STATISTICS. Ante.Natal, Natal and Post.Natal. MATERNITY AND CHILD WELFARE WORK, 1941. Nature of Work. Centres. Totals. No. 1. No. a. No. 3. No. 4. Number of sessions held 200 102 49 63 414 ,, ante-natal sessions held 101 50 40 12 203 Number of individual Mothers seen by Doctor:— Ante natal, New cases 330 138 156 40 664 ,, Old cases 946 518 397 85 1.946 Post natal, New cases 41 32 30 0 103 ,, Old cases 9 1 7 5 22 1,3.26 689 590 130 2,735 Total attendances of Mothers 1,875 672 594 130 3,271 Number of babies attending Centres for first time : Under 1 year 433 178 140 45 796 1-3 years 102 42 34 19 197 3-5 " 61 19 10 8 98 Number of individual babies on Centre registers 1,132 494 293 160 2,079 Babies seen by Doctor 3,322 2,154 913 190 6,579 Attendances of babies at medical consultations 4,375 3,178 1,373 192 9,118 Total attendances of babies at Centres : Under 1 year 5,594 2,291 1,343 547 9,775 1—3 years 2,942 959 349 217 4,467 3-5 " 660 321 69 99 1,149 Refarred to own private doctors 55 10 6 13 84 Referred to hospitals 56 8 21 8 93 Visits paid by nurfes: — First visits Total visits First visits Total visits First visits Total visits First Visits Total Visits Grand First visits Totals Total visits To expectant mothers 88 172 91 119 76 159 25 62 280 512 To infants under one year 436 2,111 123 392 241 669 28 228 828 3,400 To children aged 1.5 years 133 2,943 125 770 152 938 28 349 438 5,000 Total visits 657 5,226 339 1,281 469 1,766 81 639 1,546 8,912 CHILD LIFE PROTECTION— Visits paid to Foster Children 16 164 10 117 10 51 2 13 38 345 RECORD OP WORK OF MUNICIPAL MIDWIVES, 1941. Miss Andrews Mrs. Jamison Miss Hughes Miss Matthews Total Confinements attended 115 40 65 77 297 Ante-natal Clinics attended do. visits 59 374 33 175 47 241 47 113 186 903 Post-natal visits 1,691 988 1,173 1,245 5,097