ILF 4 Urban District of Ilford. ANNUAL REPORT of the Medical Officer of Health, School Medical Officer, and Medical Superintendent of the Isolation Hospital, Including the Report of the Inspector of Nusiances, FOR THE YEAR 1915. GEOFFREY EUGENE OATES, M.D., B.S., London; M.R.C.P., London; D.P.H., Cambridge; of Grays Inn, Barrister-at-Law, Fellow of the Society of Medical Officers of Health, Fellowof the Royal Institute of Public Health, Member of the Royal Sanitary Institute. ILFORD: South Essex Recorders, Ltd., High Road. Urban District of Ilford. ANNUAL REPORT of the Medical Officer of Health, School Medical Officer, and Medical Superintendent of the Isolation Hospital, Including the Report of the Inspector of Nusiances, FOR THE YEAR 1915. GEOFFREY EUGENE OATES, M.D., U.S., London; M.R.C.P., London; D.P.H., Cambridge; of Grays Inn, Barrister-at-Law, Fellow of the Society of Medical Officers of Health, Fellow of the Royal Institute of Public Health, Member of the Royal Sanitary Institute. ILFORD: South Essex Recorders, Ltd., High Road. Ilford Urban District Council. PUBLIC HEALTH COMMITTEE, 1915—1916. Councillor G. Cushing, Chairman. Councillor F. D. Smith, Vice-Chairman. Councillor W. T. Cadness. Councillor A. Kapadia. Councillor W. J. T. Cullis. Councillor J. Lowe. Councillor W. Everett. Councillor W. J. 0. Sheat, C.C. Councillor Geo. Gunary, J.P, Councillor R. Stroud, J.P., C.A. Councillor J. Hawkins. Councillor O. Waters. OFFICERS of the PUBLIC HEALTH DEPARTMENT. Medical Officer of Health: G. E. Oates, M.D., B.S., M.R.C.P. (Lond.), D.P.H., Barrister-at-Law. Assistant Medical Officer of Health: (Vacant.) Inspector of Nuisances: F. W. King, Mem. Royal San. Inst.. F.I.S.E. Assistant Inspectors of Nuisances: H. C. Monkcom, Assoc. Royal San. Inst., A.I.S.E. T. V. Haigh, Mem. Royal San. Inst. C. W. Fisher, Assoc. Royal San. Inst. Health Visitor: Miss E. 0. Bagshaw, C.M.B. Clerk: F. J. Bull. Assistant Clerks: G. A. Aldous. A. A. Rogers. E. C. Burn. ISOLATION HOSPITAL. Medical Superintendent: G. E. Oates, M.D., M.R.C.P., D.P.H. Matron: Miss C. A. Barling. EDUCATION COMMITTEE, 1915—1916. Councillor W. J. O. Sheat, C.C., Chairman. *Mr. Herbert Gilbey, C.C., Vice-Chairman. *Mr. J. R. Baldwin. *Mr. D. Hunter. Councillor W. T. Cadness. Councillor A. Kapadia. Councillor G. Church. Councillor J. Lowe. Councillor W. J. T. Cullis. *Mr. J. Norton. †Councillor G. Cushing. Councillor T. Philpot, J.P. Councillor F. H. Dane. *Mr. J. Reynolds. Councillor W. H. Gillard. Councillor F. D. Smith. Councillor W. P. Griggs, J.P., Councillor W. H. Stevens. C.A. *Mrs. E. G. Tucker. †Councillor G. Gunary, J.P. *Mr. H. J. Weston. *Co-opted Member. †Ex-officio Member. Secretary to the Committee: W. S. Torbitt, M.A., LL.M. School Medical Officer: G. E. Oates, M.D., M.R.C.P., D.P.H. School Dentist: H. Drake, L.D.S., R.C.S. (Eng.). School Nurse: Miss E. O. Bagshaw, PREFACE. Public Health Department, Ilford. April nth, 1916. To the Chairman and Members of the ILFORD URBAN DISTRICT COUNCIL. Gentlemen, I herewith present my Annual Report for the year 1915. In the interests of economy it is considerably abbreviated. During the year the Council was fortunate in maintaining its medical and dental staff intact and substantial progress was made. The health of the town continues to be good, although the infantile mortality has increased. The new Tuberculosis Pavilion at the Isolation Hospital, giving accommodation to twelve patients, was completed during the year and is now in use. In conclusion I should like to thank the officials and staff of the Public Health Department and the Hospital for the interest and zeal they have shown in the work during the past year. I am, Gentlemen, Your obedient Servant, GEOFFREY E. OATES. 6 STATISTICAL SUMMARY. Enumerated Population at Census, 1911 78,188 Estimated Civil Population at middle of 1915 84,581 Registrar-General's Estimate 80,832 Area of District in Statute Acres—Land 8,470 „ „ „ Inland Water 26 „ „ „ Tidal Water 7 Density of Population, i.e., No. of Persons per acre 9.9 Total number of births registered for 1915 1,538 *Representing a birth-rate of 19.1 per 1,000 Total number of births registered for 1914 1.490 *Representing a birth-rate of 18.3 per 1,000 Total number of deaths registered for 1915 846 *Representing a death-rate of 10.5 per 1,000 Total number of deaths registered for 1914 721 *Representing a death-rate of 8.8 per 1,000 Total number of deaths from the seven principal Zymotic diseases in 1915 66 *Representing a Zymotic death-rate of .82 per 1,000 Total number of deaths from the seven principal Zymotic diseases in 1914 30 *Representing a Zymotic death-rate of .53 per 1,000 Total number of deaths under one year of age 122 Giving an Infantile Mortality rate to every 1,000 births registered of 79 Rateable Value—Houses £440,362 0 0 „ „ Land 7,075 10 0 £447,437 10 0 Education Rate:- Elementary 1s. 8d. Higher 0s. 1d. Assessable Value £432,300 5 0 General District Rate 3s. 8d. in the £ Poor Rate 4s. 8d. ,, *Calculated on the estimated nett population. 7 POPULATION. Owing to the rapid increase in the population of Ilford, it is necessary to devote some care to the estimate of population for the year. The method employed was fully explained in my last Annual Report. The following data must be employed:— Number of buildings at the Census in 1911 16,726 Total number of buildings erected from the time of the Census of 1911 up to the middle of 1915 1,387 Total number of buildings known to have been demolished in the same period 17 Estimated number of buildings unoccupied in the middle of 1915 200 Nett estimated number of inhabited buildings in the middle of 1915 17,896 Estimated population apart from institutions (allowing a population of 4.61 per inhabited building) 82,500 Population of Institutions, viz.:— Claybury Asylum 2,981 West Ham Asylum 1.250 Barnardo's Homes 1.484 Ilford Isolation Hospital 80 Ilford Emergency Hospital (excluding soldiers) 36 5.831 Estimated gross population 88,331 For the purpose of calculating the death-rate and birthrate, Claybury Asylum and West Ham Asylum are considered not to be a part of this district. Subtracting 4,231, this being the population of the two institutions, we get a total of 84,100 persons as the nett estimated population for the district. It is unfortunately difficult to make an accurate estimate of the population of 1915 owing to several disturbing 8 factors. There has been, in the first place, much going from and coming to the district. It may be roughly estimated that about 350 Belgian refugees were temporarily domiciled in Ilford in the middle of the year. An appreciable number of aliens left the district during the year either voluntarily or otherwise. An increasing number of men were away on military service, and against this must be placed the presence of troops stationed in the district. A certain number of our inhabitants have left the district to take up munition work elsewhere. The absence of relatives on military service has caused disorganisation of family life, the family perhaps moving to lodgings or taking in lodgers or changing their places of residence. The population returns of Claybury and West Ham Asylums show that these institutions were used to their full capacity. For the purpose of estimating the death, marriage and birth-rates the Registrar-General proposes to use the civil population (apart from soldiers) as a basis. His estimate for the civil population in the year 1915 is 80,832. This estimate is, I presume, calculated on the assumption that Ilford has furnished as large a proportion of soldiers as has the country as a whole. At the time of issue of this report this will no doubt be a fact. But in the middle of the year 1915 the assumption was not, I believe, a correct one. This is no reflection on the patriotism of the town, but simply means that in times of peace Ilford is not a recruiting town. Hence the drain on the civil population due to enlistment was late in making evident its effect. For the purpose of calculating the birth-rate and deathrate for the year I propose to use the mean between the figure 88,331, calculated on the basis of house population, and the Registrar-General's estimate of 80,832. This gives a figure 84,581 for the estimated gross civil population. Deducting institutions, there is left a nett estimated civil population of 80,350. 9 TABLE I. Vital Statistics of Whole District during 1915 and Previous Years. Year. Gross Population estimated to middle of each year. Nett Population estimated to middle of each year (a). Births. Total Deaths Registered in the District. Transferable Deaths. Nett Deaths belonging to the District. Uncorrected Number. Nett (b). of Non-Residents registered in the District.† of Residents not registered in the District.† Under 1 Year of age. At all ages. Number. Rate (c). Number. Rate (d). Number. Rate per 1,000 Nett Births. Number. Rate (e). 1 2 2a 3 4 5 6 7 8 9 10 11 12 13 1910 77,057 73,269 1.679 ... 22.9 772 10.0 273 102 124 74 601 8.2 1911 79,122 75,446 1,589 1,597 21.2 870 11.0 307 141 136 85 704 9.3 1912 81,378 77,623 1,492 1,492 19.2 828 10.2 313 118 94 63 633 8.1 1913 83,257 79,459 1,485 1,504 18.9 920 11.05 331 154 102 68 743 9.4 1914 85,932 82,098 1,490 1,505 18.3 926 10.8 352 147 93 62 721 8.8 1915 84,581 80,350 1,511 1,538 19.1 1,091 12.9 410 165 122 79 846 10.5 For Notes, see next page. 10 Notes on Table I. In column 6 there is entered the whole of the deaths registered during the year as having actually occurred in the district. In column 12 there is entered the number in column 6, corrected by the subtraction of the number in column 8 and the addition of the number in column 9. Deaths in column 10 are similarly corrected by the subtraction of the deaths under 1, and included in the number given in column 8, and the addition of the deaths under 1 included in the number given in column 9. (а) The nett estimated population is found by deducting the population of Claybury and West Ham Asylums from the gross estimated population. (b) The nett number of births is obtained by taking the uncorrected number of births supplied by the local Registrar and adding to or subtracting from it such a number as is supplied for this purpose by the Registrar-General. (c) The birth-rate is calculated on the estimated nett population. (d) Calculated on the estimated gross population. (e) Calculated on the estimated nett population. "Transferable Deaths" are deaths of persons who, having a fixed, or usual residence in England or Wales, die in a district other than that in which they resided. The deaths of persons without fixed or usual residence, e.g., casuals, are not included in columns 8 or 9, except in certain instances under 3 (b) below. There is stated in column 8 the number of transferable deaths of "non-residents" which have been deducted, and there is in column 9 the number of deaths of "residents" registered outside the district which have been added in calculating the nett deathrate of the district. The following special cases arise as to Transferable Deaths:— (1) Persons dying in Institutions for the sick or infirm, such as hospitals, lunatic asylums, .workhouses, and nursing homes (but not almshouses) must be regarded as residents of the district in which they had a fixed or usual residence at the time of admission. If the person dying in an Institution had no fixed residence at the time of admission, the death is not transferable. If the patient has been directly transferred from one such Institution to another, the death is transferable to the district of residence at the time of admission to the first Institution. (2) The deaths of infants born and dying within a year of birth in an Institution to which the mother was admitted for her confinement should be referred to the district of fixed or usual residence of the parent. (3) Deaths from violence are to be referred (a) to the district of residence, under the general rule; (b) if this district is unknown, or the deceased had no fixed abode, to the district where the accident occurred, if known; (c) failing this, to the district where death occurred, if known; and (d) failing this, to the district where the body was found. Area of District in acres (land and inland water), 8,496. Total population at all ages, 78,188, at Census, 1911. Total families or separate occupiers, 16,843, at Census, 1911. 11 BIRTHS. The number of births registered in Ilford during the year was 1,511. Of these, 763 were of males and 748 of females. 12 males and 15 females born were illegitimate. After allowing for births occurring in other districts and properly belonging to Ilford, there is a nett total of 1,538 births. This is a slight increase on last year's figure of 1,505. The birth-rate calculated on the nett estimated civil population (which excludes Claybury and West Ham Asylums) is 19.1. This is slightly in excess of last year's rate, 18.3. DEATHS. The number of deaths registered in the district during the year was 1,091. 410 deaths are those of non-residents registered within the district (principally in the larger institutions), and must be subtracted from the total. These deaths occurred as follows:— In Claybury (L.C.C.) Asylum 292 In West Ham Borough Asylum 111 Deaths in the district of other non-residents 7 Total 410 To be added to the total are 165 deaths of Ilford residents registered as having died in other districts. This latter figure includes deaths in the following institutions:— The Infirmary, Romford 70 Essex and Colchester Asylum 24 London Hospital 22 In other hospitals, institutions or residences outside Ilford 49 Total 165 12 The total number of deaths accountable to Ilford is therefore seen to be 846. This gives a death-rate of 10.5 calculated on the estimated nett civil population. This compares with a death-rate of 8.8 in the previous year. There is no doubt that the mental and physical strain felt by the community during last year has had its effect on the death-rate. 13 TABLE III. Deaths Registered during the Calendar Year 1915 classified by age and cause. Causes of Death. Nett Deaths at the subjoined ages of "Residents" whether occurring within or without the District (a). Total Deaths whether of "Residents" or "Non-Residents" in Institutions in the District (6). All ages. Under 1 year. 1 and under 2 years. 2 and under 5 years. 5 and under 15 years. 15 and under 25 years. 25 and under 45 years 45 and under 65 years. 65 and upwards. 1 2 3 4 5 6 7 8 9 10 11 All causes Certified (c) 813 121 44 27 27 35 120 169 300 - Uncertified 3 1 — — — — - 1 1 — 1. Enteric Fever 2 — — — — 1 1 — — 1 2. Small-pox — — — — - — — — — — 3. Measles 17 3 6 5 3 - - - - - 4. Scarlet Fever 2 - — 1 — 1 - - — 2 5. Whooping Cough 9 5 4 - - - - - - — 6. Diphtheria and Croup 10 — 3 5 1 — 1 — — 6 7. Influenza 26 1 — — — — 3 8 14 1 8. Erysipelas — — — — — — - — — 1 9. Phthisis (Pulmonary Tuberculosis) 74 1 - 1 1 18 37 13 3 69 10. Tuberculous Meningitis 15 6 2 2 4 — 1 — — 2 11. Other Tuberculous Diseases 12 4 1 2 1 1 1 2 — 4 12. Cancer, Malignant Disease 69 — — — — 2 5 30 32 18 13. Rheumatic Fever 3 — — — 3 2 — 1 — 1 14. Meningitis 10 1 5 2 1 1 — — — 2 15. Organic Heart Disease 90 1 — 1 2 2 10 21 53 31 16. Bronchitis 57 8 7 — - — — 9 33 12 17. Pneumonia (all forms) 57 10 5 2 3 1 11 11 14 60 18. Other Diseases of Respiratory Organs 20 1 - - - - 3 4 12 9 19. Diarrhoea and Enteritis 26 12 4 — 2 1 1 4 2 12 20. Appendicitis and Typhlitis 2 — — — — 1 1 - — 2 21. Cirrhosis of Liver 6 - - - - - 2 4 — 3 21a. Alcoholism 1 - - - - - - 1 — — 22. Nephritis and Bright's Disease 19 - - 1 - - 3 7 8 29 23. Puerperal Fever — — — — — — — — — — 24. Other accidents and diseases of Pregnancy and Parturition 5 - - - - 1 3 1 - - 25. Congenital Debility and Malformation, including Premature Birth 48 48 - - - - - - - 7 26. Violent Deaths, excluding Suicide 23 1 2 2 2 1 7 5 3 11 27. Suicide 5 — — — — — 3 2 — — 28. Other Defined Diseases 233 20 5 3 4 2 27 47 125 188 29. Diseases ill-defined or unknown 2 — - - - - - - 2 — Totals 846 122 44 27 27 35 120 170 301 471 SubEntries included in above figures. 14 (a) Cerebro-Spinal Meningitis 2 1 - - - 1 - - - - 28 (a) Poliomyelitis 1 — 1 — — — - - — — Pneumonia, Lobar and Undefined (92) 33 3 2 1 1 1 8 7 10 15 Dysentery — — — — — — — — — 30 Senility 47 - - - - - - 1 46 7 For notes, see next page. 14 Notes to Table III. The classification and numbering of Causes of Death are those of the "Short List" on page XXV. of the Manual of the International List of Causes of Death, which should be consulted and followed in all cases of doubt. (а) All "Transferable Deaths" of residents, i.e., of persons resident in the District who have died outside it, are included with the other deaths in Columns 2-10. Transferable deaths of nonresidents, i.e., of persons resident elsewhere in England and Wales who have died in the District, are in like manner excluded from these columns. For the precise meaning of the term "transferable deaths" see footnote to Table I. (b) All deaths occurring in institutions for the sick and infirm situated within the district, whether of residents or of non-residents, are entered in the last column of Table III. (c) All deaths certified by registered Medical titioners and all Inquest cases are classed as "Certified"; all other deaths are regarded as "Uncertified." (d) Title 19 includes deaths from Diarrhoea and Enteritis at all ages. 15 Deaths of soldiers that have occurred in hospitals and institutions and addresses in this district—including that of one who died outside the district, he having been a resident of this locality:— No. in Register. When and Where Died. Age. Years. Rank and previous Residence. Cause of Death. 341 27th May, Emergency Hospital 29 Private, 5th Durham Light Infantry, of Stockton-on-Tees Septicaemia, 17 days, following gunshot wound of thigh 386 6th June, Emergency Hospital 43 Private, 1st Rifle Brigade, of Limehouse Shrapnel wound of brain, Meningitis Inward Transfer 25th March, Borough Fever Hospital 23 Gunner, R.F.A. Battery, of Ilford Cerebro Spinal Meningitis, Delirium Tremens 90 loth March, 50, South Pk. Parade, Ilford 45 Battery Sergeant Major, 2nd East Anglian Brigade (Reserve) (1) Acute Laryngeal Tuberculosis, (2) Exhaustion. 193 12th April, 21, Madras Road 22 Private, Army Ordnance Corps, School Teacher (1) Phthisis, (2) Laryngitis MATERNITY AND CHILD WELFARE. Summary of Expenditure incurred during the twelve months ended the 31st March, 1915, in respect of Maternity and Child Welfare work:— £ s. d. (a) Salary of Health Visitor 29 9 9 (f) Clerical assistance 16 0 0 (f) Heating, lighting and cleaning 2 1 2 (g) Printing, stationery, postage, etc. 7 4 11 16  £ s. d. (h) Other items of expenditure incurred:— Proportion of cost of Health Visitor's bicycle 1 3 4 Cost of maintenance in Isolation Hospital of two cases of Ophthalmia Neonatorum—Mother and child in each case at 42s. per week— total 3½ weeks 7 7 0 Cost of maintenance of one case of Puerperal Fever—2½ weeks at 30s. per week 3 15 0 Total £67 1 2 Amount of Grant received from the Local Government Board in respect of the year 1915-1916 £33 10 7 During the year the Ilford School for Mothers continued its beneficial work. The following figures show how the work here is expanding:- Number of infants on the register at the beginning of 1915 52 Ditto at end of 1915 93 New admissions during the year 82 Number of sessions 50 Total attendances 900 Average attendance 18 In my last Annual Report I gave an outline of the work carried out by the institution. 17 TABLE IV. INFANTILE MORTALITY. 1915. Nett Deaths from stated causes at various Ages under One Year of Age. CAUSE OF DEATH. Under 1 Week. 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 4 weeks. 4 weeks and under 3 Months. 3 Months and under 6 Months. 6 Months and under 9 Months. 9 Months and under 12 Months. Total Deaths under One Year. All Causes Certified 39 7 6 2 54 19 24 11 13 121 Uncertified — — — — — — 1 - — 1 Small-pox — — — — — — — - — — Chicken-pox — — — — — — — - — — Measles — — — — — — — 1 2 3 Scarlet Fever — — — — — — — - - — Whooping Cough — — — — — 1 2 - 2 5 Diphtheria and Croup - - - - - - - - - - Erysipelas — — — — — — — — — — Tuberculous Meningitis (30) - - - - - 1 3 - 2 6 Abdominal Tuberculosis (31) - - - - - - 2 1 1 4 Other Tuberculous Diseases - - - - - - 1 - - 1 Meningitis (not Tuberculous) (61) - - - - - - 1 - - 1 Convulsions (71) 1 1 1 — 3 — 1 1 1 6 Laryngitis (87b) — — — — — — — 1 — 1 Bronchitis — — — 1 1 1 6 - — 8 Pneumonia (all forms) (91 & 92) 1 - - - 1 1 2 3 3 10 Diarrhœa (104 b, e & f) — 1 — — 1 2 1 1 — 5 Enteritis (104 a, c, d & g) 1 — 2 — 3 — 2 2 — 7 Gastritis (103 a) — — - — — — — — — — Syphilis — — — — — 1 — 1 — 2 Rickets (36 a) — — — — — — 1 — 1 2 Suffocation, overlying - - - - - - - - - - Injury at Birth (152 c) — — — — — — — — — — Atelectasis (152 b) 4 — — — 4 1 — — — 5 Congenital Malformations (150) 2 - - - 2 2 - - - 4 Premature Birth (151 a) 25 2 1 1 29 2 — — — 31 Atrophy, Debility, and Marasmus (151 b) 3 - 2 - 6 4 3 - — 13 Other Causes 2 2 — — 4 3 — — 1 8 Totals 39 7 6 2 54 19 25 11 13 122 Nett Births registered during the calendar year: legitimate, 1490; illegitimate, 48. Nett Deaths registered during the calendar year of legitimate infants, 104; illegitimate infants, 18. Note.—The numbers given in brackets after certain causes of death indicate the numbers of the corresponding headings in the detailed international list of causes of death, 1909. 18 INFANTILE MORTALITY. The number of infants dying within the first year of their life was 122, the total number born being 1,538. The infantile mortality or rate of death per 1,000 births was therefore 79. This figure, while slightly in excess of last year's figure, 62, is not unsatisfactory. On the previous page is seen an analysis of the causes of death in infants during the first year of life. As compared with the previous year there was over double the number of deaths from prematurity, and most of these occurred within one week of birth. The following table shows the infantile mortality in each ward of the district:— Ward. No. of Births. Infantile Mortality per 1,000 Births. Cranbrook 113 35 Park 209 95 Seven Kings 208 67 North Hainault 100 *240 South Hainault 246 65 Clementswood 273 55 Loxford 389 74 Ilford 1,538 122 *Deducting from the North Hainault Ward the deaths of infants occurring in the Village Homes, Barkingside, there is left an infantile mortality rate of 120 per 1,000 births for that ward. NOTIFIABLE DISEASES. During 1915, 585 cases were notified as compared with 643 in 1913 and 607 in 1914. Of these, 4 cases occurred in Claybury and West Ham Asylums and 21 cases in Barnardo's Girls Village Homes, Barkingside. 19 Small-Pox. No case was notified during the year. The Vaccination Officer informs me that 744 primary vaccinations were performed during the year. Less than 50% therefore of the children born were vaccinated. I have again to call attention to this unsatisfactory state of affairs, feeling that it can only be a matter of time before the inevitable Small-Pox epidemic occurs. It is to be hoped that this calamity may be postponed until our other national misfortunes have arrived at a happy solution. Scarlet Fever. 224 cases of this disease were notified during the year. The type of the disease continued to be a mild one. Diphtheria. 128 cases of this disease were notified. The other cases of notifiable disease are summarised in the appended Table II., and call for no comment. Ages and Sex of notified cases of Tuberculosis. Diseases. Sex. Under 1 year 1 to 5 years. 5 to 15 years. 15 to 25 years. 25 to 35 years. 35 to 45 years. 45 to 55 years. 55 to 65 years. Over 05 years. Totals. Pulmonary Tuberculosis M - - 4 12 16 10 4 7 - 53 F — 2 11 11 16 12 4 3 2 61 Tuberculosis (all other forms) M 2 9 7 6 1 1 1 - — 27 F 3 2 14 5 2 2 — — — 28 5 13 36 34 35 25 9 10 2 169 TABLE II. Cases of Infectious Disease Notified during the Year 1915. Notifiable Disease. Number of Cases Notified. Total Cases Notified in each Ward. Total cases removed to Hospital. At all Ages. At Ages—Years. Cranbrook Ward. Park Ward. Seven Kings Ward. North Hainault Ward. Loxford Ward. Clementswood Ward. South Hainault Ward. Under 1. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 45. 45 and under 65. 65 and upwards. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera (C) Plague (P) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria (including Membranous croup) 128 ... 25 79 10 14 ... ... 10 17 17 1 10 40 27 101 Erysipelas 40 ... 1 5 3 15 18 4 4 4 5 5 11 13 4 1 Scarlet Fever 224 1 24 150 36 12 1 ... 15 43 29 11 43 57 26 182 Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever 4 ... ... ... 1 3 ... ... 1 1 ... ... 1 1 ... 3 Relapsing Fever (R) Continued Fever (C) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cerebro spinal Fever 4 ... 1 ... 1 ... 2 ... ... ... ... 1 2 1 ... 2 Acute Poliomyelitis 3 ... 3 ... ... ... ... ... 1 ... 1 ... ... 1 ... ... Ophthalmia Neonatorum 6 6 ... ... ... ... ... ... ... 1 1 1 1 2 ... 1 Pulmonary Tuberculosis 114 ... 2 15 23 54 18 2 9 23 13 15 17 29 8 ... Other forms of Tuberculosis 54 5 11 21 10 6 1 ... 4 3 7 12 13 7 8 ... Totals 12 67 270 84 104 40 6 50 92 73 46 98 151 73 290 Isolation Hospital and Sanatorium, Grove Road, Chadwell Health. 21 ISOLATION HOSPITAL. Number of patients in hospital at beginning of year:— Scarlet Fever 28 Diphtheria 25 Pulmonary Tuberculosis 10 Number of patients admitted during the year:— Scarlet Fever 182 Diphtheria 101 Enteric Fever 3 Erysipelas 1 Cerebro-Spinal Fever 2 Ophthalmia Neonatorum 1 Pulmonary Tuberculosis 51 Number of patients remaining in hospital on 1st January, 1916:— Scarlet Fever 22 Diphtheria 21 Pulmonary Tuberculosis 8 The following shows the average length of stay of patients in the hospital:- Average stay in hospital of Scarlet Fever patients 45.1 days. Average stay in hospital of Diphtheria patients 33.4 days. Average number of patients in hospital per day 48.2 Average stay in hospital of all patients 43.49 days. Percentage of cases notified removed to the Isolation Hospital:— Scarlet Fever 80.8 Diphtheria 78.9 Enteric Fever 75.0 Erysipelas 2.17 Cerebro-Spinal Fever 50.0 Ophthalmia Neonatorum 16.66 22 The Tuberculosis Pavilion, with accommodation for 12 patients, was completed and opened during the year. It has been built by agreement with the Essex County Council, who send the patients for treatment and pay for the running expenses. BACTERIOLOGICAL LABORATORY. During the year 749 examinations were carried out as under:— Swab examinations for Diphtheria 595 Sputum examinations for Tubercle Bacilli 35 Hair examinations for Ringworm 118 Examination of serum for Meningoccous 1 FOOD AND DRUGS ACTS. These Acts are administered by the County Council. Mr. H. C. Card, the Chief Inspector, has kindly given me certain particulars, which I append. Samples of milk taken 132 Samples of butter taken 91 Other samples 11 Total 234 Proceedings were taken in seven cases, the following lines beino; inflicted:— Milk Fine £1 and 9s. costs. Milk Fine 10s. and 9s. costs. Milk Fine £1 and 5s. costs. Milk Fine £20 and 5s. costs. Margarine Fine 10s. Milk Fine £2 and 6s. costs. Camphorated Oil Fine 10s. and £1 6s. 0d. costs. Written cautions were given in three instances, and further steps were taken in certain instances where informal sampling disclosed adulteration. 23 MILK SUPPLY. There were in the Ilford district at the end of the year 51 dairies and milkshops and 11 cowsheds on the register. BAKEHOUSES. There are 34 bakehouses in the district, including 10 factory bakehouses. There is I underground bakehouse. SLAUGHTERHOUSES. There are three licensed slaughterhouses in the district. SUPERVISION OF FOOD SUPPLY. During the year the following articles were condemned as being unfit for the food of man:— Tuberculous lungs and liver of ox. 1 side of a sheep. 5 bushels of winkles. 1 carcase of beef. 60 quarts of milk. 1 rabbit. 1 set of ox lungs. 2 forequarters of beef with organs and head of cow. Set of lung trimmings. 1 barrel of Almeria grapes. HOUSING AND TOWN PLANNING ACT, 1909. Following are particulars as to work under the Housing and Town Planning Act, 1909:— Number of houses inspected 338 Number represented to the Local Authority as being unfit for human habitation 4 Number of closing orders made by the Local Authority 4 Number of closing orders determined 4 Number of houses voluntarily demolished after closing order — Number of houses the defects in which were remedied without closing orders 284 Orders to execute work under Section 15 109 24 INSPECTION OF THE DISTRICT AND THE ABATEMENT OF NUISANCES. Summary of visits as recorded during year 1915:— Houses and premises inspected 3585 Do. do. re-inspected (works in progress) 4073 Visits during disinfection 878 Houses in which nuisances were detected 669 Do. do. abated 640 Notices served 745 Do. complied with 738 Houses disinfected 446 Articles do. 3234 The following is a list of notices served and complied with during the year:— NOTICES SERVED, &c. 1915 Notices. Served 1915 Complied with 1915 Statutory 41 43 Informal 309 321 Pave Yard (Ilford Improvement Act) 34 42 Provide Dustbin (Ilford Improvement Act 116 126 Cleanse Water Storage Cistern (Bye-laws) 72 80 Cover Do. Do. 19 18 Provide Water to Dwelling-House 7 7 Cleanse Dwelling-House (Infectious Diseases (Prevention) Act, 1890) 38 37 Housing and Town Planning Act, 1909 109 64 Totals 745 738 25 COMPLAINTS. During the year 199 complaints have been received and investigated. The following is a summary:— Accumulation of manure and refuse 23 Animals improperly kept 13 Bad smells from drains 11 Bad smells in houses 5 Blocked drains and w.c.'s 15 Cesspools full and overflowing 5 Defective drains and w.c.'s 16 Defective dustbins 9 Dirty and verminous houses 6 Defective roofs, gutters and downpipes 16 Defective water fittings 9 Defective w.c. fittings 11 Dampness of premises 6 Flooding of premises 7 Overcrowding 2 Sanitary defects 17 Smoke nuisances 6 Unwholesome water 1 Water in basements 6 Miscellaneous 13 199 REMOVAL OF HOUSE REFUSE. The Chief Sanitary Inspector, Mr. F. W. King, is responsible for this work, and I am obliged to him for the following particulars :— 26 During the 52 weeks ended on the 1st January, 1916, the number of horses and vans engaged in the collection and the number of loads of house refuse removed were as follows:— Horses and vans, 6,709. Loads, 13,578. Collection took place on 307 days. Average number of horses and vans per day, 21.85. Average number of loads per horse per day, 2.02. The refuse was disposed of as under:— Deposited at St. Swithin's shoot 12,894 loads. Deposited at Brown's shoot 547 loads. Deposited elsewhere 137 loads. For 1914 the average number of horses per day was 21.11 and the average number of loads per horse per day 2.24, the total number of loads collected being 14,529. SEWERAGE AND SEWAGE DISPOSAL. The methods whereby the sewage of the district is disposed of have been detailed in previous reports. There are in the district in addition:— 83 Cesspools and privies. 56 Pail closets. 27 FACTORIES, WORKSHOPS, WORKPLACES, AND HOMEWORK. I INSPECTION OF FACTORIES, WORKSHOPS, AND WORKPLACES. Including Inspections made by Sanitary Inspectors or Inspectors of Nuisances. Premises. Number of Inspections. Written Notices. Prosecutions. (1) (2) (3) (4) Factories (including Factory Laundries) 17 3 1 Workshops (including Workshop Laundries) 344 7 … Workplaces (other than Outworkers' premises included in Part 3 of this report) … … … Total 361 110 1 28 2.—DEFECTS FOUND IN FACTORIES, WORKSHOPS, AND WORKPLACES Particulars. Number of Defects. Number of Prosecutions. Found. Remedied. Referrec to H.M. Insp'tor (i) (2) (3) (4) (5) Nuisances under the Public Health Acts:—* Want of cleanliness Want of ventilation 1 1 Overcrowding 1 1 Want of drainage of floors Other nuisances 4 4 Sanitary accommodation insufficient unsuitable or defective 4 4 not separate for sexes Offences under the Factory and Workshop Acts:— Illegal occupation of underground bakehouse (s. 101) Breach of special sanitary requirements for bakehouses (ss. 97 to too) 1 1 1 Other offences (Excluding offences relating to outwork which are included in Part 3 of this report.) Total 11 11 … I * Including those specified in sections 2, 3, 7 and 8 of the Factory and Workshop Act, 1901, as remediable under the Public Health Acts. 29 3—HOME WORK. NATURE OF WORK. OUTWORKERS LISTS, SECTION 107. Lists received from Employers. Sending twice in the year. Sending once in the year. Outworkers. Outworkers. Lists. Contractors. Workmen. Lists. Contractors. Workmen. (1) (2) (3) (4) (5) (6) (7) Wearing Apparel— Making, &c. 22 27 16 … … … Cleaning and Washing … … … … … … Household Linen … … … … … … Lace, Lace Curtains and Nets 2 … 5 3 … 7 Total 24 27 21 3 … 7 Note.—No home-workers were known to be engaged in the following occupations:—Curtains and Furniture Hangings; Furniture and Upholstery; Electro-plate; File Making; Brass and Brass Articles; Fur Pulling; Cables and Chains; Anchors and Grapnels; Cart Gear; Locks, Latches and Keys; Umbrellas, etc.; Artificial Flowers; Nets, other than Wire Nets; Tents; Sacks; Racquet and Tennis Balls; Paper, etc., Boxes, Paper Bags; Brush Making; Pea Picking; Feather Sorting; Carding, etc., of Buttons, etc.; Stuffed Toys; Basket Making; Chocolates and Sweetmeats; Cosaques, Christmas Crackers, Christmas Stockings, etc. ; Textile Weaving. 30 4—REGISTERED WORKSHOPS. Workshops on the Register (s. 131) at the end of the year. (1) Number (2) Bakehouses (excluding io Factory Bakehouses) 24 Boot Repairs 52 Carpentering 17 Dressmakers 104 Laundries 18 Milliners 24 Tailoring 42 Wearing Apparel and Underclothing 51 Miscellaneous Workshops 146 Total number of Workshops on Register 478 5.—OTHER MATTERS. Class. Number (a) (2) Matters notified to H.M. Inspector of Factories:— Failure to affix Abstract of the Factory and Workshop Act (s. 133, 1901) 13 Action taken in matters referred by H.M. Inspector as remediable under the Public Health. Acts, but not under the Factory and Workshop Act (s. 5, 1901) Notified by H.M. Inspector 5 Reports (of action taken) sent to H.M. Inspector 4 Other Underground Bakehouses (s. 101) : — In use at the end of the year 1 ANNUAL REPORT of the School Medical Officer for the Year ending December 31st, 1915. 32 INSPECTION CLINIC. An inspection clinic is held every morning from 9—10 a.m. at the Public Health Offices. The number of children attending increased very much as compared with previous years. The usual result of a child's attending the inspection clinic is that it is excluded from school for a definite period or else certified as being fit for school. During 1915, 3,804 certificates were issued. GENERAL STATEMENT OF EXTENT AND SCOPE OF MEDICAL INSPECTION. Number of visits paid to the 34 different departments of the 16 schools in the district, 171. Number of children examined during the year, 3,299 (1,658 boys and 1,641 girls). Number of children presented for special examinations, 62 (22 boys and 40 girls). Total time occupied by these examinations, 269 hours 40 minutes, or an average per child of 4.81 minutes. Percentage of parents present at these examinations, 58.90. MENTALLY DEFECTIVE AND DULL CHILDREN. The passing of the Mental Deficiency Act, 1913, and the Elementary Education (Defective and Epileptic Children) Act, 1914, has thrown an important duty on the Education Committee, that of searching out all children reputed or appearing to be mentally defective. All feeble-minded children between the ages of seven and sixteen years must furthermore be educated in special schools or classes. No step in the provision of these schools or classes was made during the year. 33 The model arrangements of the Board of Education for dealing with supposed mentally defective children were adopted by the Education Committee, and during the year an exhaustive examination was made of all the children in Ilford suspected of mental defect. The School Medical Officer is brought into touch with these children through the school teachers and School Attendance Officers. The child is then subjected to a combined medical and psychological examination at the hands of the School Medical Officer. Where necessary a pedogogical report is also obtained from the child's teacher. As a result of this examination the child is classified as (a) normal, dull or backward; (b) feeble-minded; (c) imbecile; (d) idiot; (e) moral imbecile. The following table shows the number of children examined, the source of discovery of the child and the result of the examination:— Boys. Girls. Total. A B c A B c Not mentally defective, i.e., mentally normal, dull or backward – 16 2 1 16 38 Feeble-minded, under 7 years– _ _ 1 1 do. 7- 15 years 5 16 1 6 11 2 41 Imbecile, under 7 years 2 — 2 do. 7-15 years 9 — — 4 1 — 14 Idiot, under 7 years do. 7-15 years 1 — — 2 — — 3 Moral imbeciles — — — — — — — A—Reported by School Attendance Officer. B Reported by School Teacher. C—Reported by School Doctor. 34 WORK OF THE SCHOOL DENTIST. Mr. H. Drake continued his work throughout the year. The work has been highly successful and evidently appreciated by the children and parents. The main principles of the work were described in my last report, and it will suffice to give the figures for this year. Number of children inspected at school:— Primarily 1,354 Re-inspected 175 1529 Number of children with sound teeth 447 or 29% Number of children requiring treatment 1,082 „ „ accepting treatment.. 6260^8% Number of children on whom treatment was completed during the year:— Children in routine group, 7-8 years— Boys 299 Girls 306 605 At other ages (casuals)— Boys 267 Girls 398 665 Total 1,270 Total attendances made by children 3,198 Treatment comprised:—Dressings, 237; Fillings, 1,194; Scalings, 20; Root Fillings, 11 Alveolar Abscess, 4; Regulations, 14; Ulcerative Stomatitis, 1. Teeth extracted—Temporary 2,203 Permanent 497 2,700 35 Anaesthetics administered—Local 19 General 1,090 1,109 Amount received in fees— £ s. d. 884 cases at is 44 4 0 From County High School children (8 cases at 3s.) 140 Special cases were treated as follows:— Mentally Physically Tuber- Defective. Defective. culous. Dull. Blind. Totals. Boys 13 1 — 4 1 19 Girls 8 3 3 1 1 16 Total 35 By special arrangement with the County High School Governors, 8 of their children (4 boys and 4 girls) were treated at a charge of 3s. per head. PRESCRIPTION OF SPECTACLES. 196 children were examined with the following results:— Spectacles prescribed for 165 ,, not required 24 Hospital treatment recommended 6 Re-examined 1 X-RAY TREATMENT FOR RINGWORM. 17 children received X-Ray treatment during the year. DISINFECTION OF SCHOOLS. Disinfection was carried out in all the schools during the year. 36 TABLE I. Number of Children inspected 1st January, 1915, to 31st December, 1915. A. "CODE" GROUPS. Age in Years. Entrants. Intermediate Group. Leavers. Grand Total. 3 4 5 6 Other Ages. Total. 8 12 13 14 Other Ages. Total. Boys — 2 474 240 208 984 145 368 151 10 — 529 1658 Girls — 1 382 233 315 931 135 454 105 15 1 575 1641 Totals — 3 856 473 583 1915 280 822 256 25 1 1104 3299 B. GROUPS OTHER THAN "CODE." Intermediate Group (other than 8 years). Special Cases. Re-Examinations (i.e. No. of Children re-examined.) Boys — 22 — Girls — 40 — Totals — 62 — TABLE II.—RETURN SHOWING THE PHYSICAL CONDITION OF CHILDREN INSPECTED. Condition. Entrants. Leavers. Intermediate Group. Total. Special Cases. Boys. Girls. Total. Per cent. Boys. Girls. Total. Per cent. Boys. Girls Total. Per cent. Boys. Girls. Total. Per cent. Boys. Girls. Total. Total Inspected … … … … 984 931 1915 … 529 575 1104 … 145 135 280 … 1658 1641 3299 … 22 40 62 Clothing Satisfactory 944 916 1860 97.13 501 557 1058 95.83 143 134 277 98.93 1588 1607 3195 96.85 22 40 62 Unsatisfactory 40 15 55 2.87 28 18 46 4.17 2 1 3 1.07 70 34 104 3.15 … … … Footgear Satisfactory 968 922 1890 98.69 504 559 1063 96.29 142 132 274 97.86 1614 1613 3227 97.82 22 40 62 Unsatisfactory 10 9 25 1.31 25 16 41 3.71 3 3 6 2.14 44 28 72 2.18 … … … Cleanliness of head Clean (i.e. no nits or pediculi) 972 757 1729 90.29 525 483 1008 91.30 145 104 249 88.93 1642 1344 2986 90.51 21 36 57 Nits only 12 172 184 9.61 3 89 92 8.33 … 31 31 11.07 15 292 307 9.31 1 3 4 Pediculi … 2 2 .10 1 3 4 .36 … … … … 1 5 6 .18 … 1 1 Cleanliness of body Clean 963 921 1884 98.38 523 569 1092 98.91 144 135 279 99.64 1630 1625 3255 98.67 22 40 62 Dirty 20 10 30 1.57 6 5 11 1.00 1 … 1 .36 27 15 42 1.27 … … … Pediculi present 1 … 1 .05 … 1 1 .09 … … … … 1 1 2 .06 … … … Nutrition Excellent 16 13 29 1.51 39 43 82 7.43 4 4 8 2.86 59 60 119 3.61 22 40 62 Normal 955 905 1860 97.13 474 516 990 89.67 135 128 263 93.93 1564 1549 3113 94.36 … … … Below normal 13 13 26 1.36 15 16 31 2.81 6 3 9 3.21 34 32 66 2.00 … … … Bad … … … … 1 … 1 .09 … … … … 1 … 1 .03 … … … Nose and throat No defect 856 830 1686 88.04 486 516 1002 90.76 120 118 238 85.00 1462 1464 2926 88.09 20 40 60 Mouth breathers 37 14 51 2.06 8 13 21 1.90 5 6 11 3.93 50 33 83 2.52 2 … 2 Tonsils: slightly enlarged 67 68 135 7.05 30 38 68 6.16 18 9 27 9.64 115 115 230 6.97 … … … Tonsils: much enlarged 11 14 25 1.31 3 4 7 .63 1 1 2 .71 15 19 34 1.03 … … … Adenoids: slight 9 3 12 .63 2 2 4 .36 1 … 1 .36 12 5 17 .52 … … … Adenoids : marked 4 2 6 .31 … 2 2 .18 … 1 1 .36 4 5 9 .27 … … … TABLE II.—RETURN SHOWING THE PHYSICAL CONDITION OF CHILDREN INSPECTED. Condition. Entrants. Leavers. Intermediate Group. Total. Special Cases. Boys. Girls. Total. Per cent. Boys. Girls. Total. Per cent. Boys. Girls. Total. Per cent. Boys. Girls. Total. Per cent. Boys. Girls. Total. External eye disease No disease 975 921 1896 99.01 524 567 1091 98.82 142 132 274 97.86 1641 1620 3261 98.85 20 39 59 Blepharitis 6 3 9 .47 3 5 8 .72 … … … … 9 8 17 .52 1 … 1 Conjunctivitis … 2 2 .10 … … … … … 1 1 .36 … 3 3 .09 1 1 2 Corneal opacities … 2 2 .10 1 … 1 .09 2 … 2 .71 3 2 5 .15 … … … Other disease 3 3 6 .31 1 3 4 .36 1 2 3 1.07 5 8 13 .39 … … … Ear disease No disease 973 917 1890 98.69 525 565 1090 98.73 142 129 271 96.79 1640 1611 3251 98.56 22 35 57 Obstruction: Right 4 5 9 .47 1 1 2 .18 1 1 2 .71 6 7 13 .39 … 1 1 Obstruction: Left 3 5 8 .42 1 1 2 .18 1 1 2 .71 5 7 12 .36 … I 1 Otorrhoea: Right 1 2 3 .16 1 4 5 .45 1 2 3 1.07 3 8 11 .33 … 2 2 Otorrhoea: Left 3 2 5 .26 1 4 5 .45 … 2 2 .71 4 8 12 .36 … 1 1 Other disease … … … … … … … … … … … … … … … … … … … Teeth Sound 187 179 366 19.11 159 186 345 31.25 25 33 58 20.71 371 398 769 23.31 21 39 00 Less than tour decayed 494 515 1009 52.87 307 332 639 57.88 91 70 161 57.50 892 917 1809 54.83 … … … Four or more decayed 303 237 540 28.02 63 57 120 10.87 29 32 61 21.79 395 326 721 21.86 … … … Sepsis … … … … … … … … … … … … … … … … 1 1 2 Heart and circulation No disease 970 918 1888 98.59 520 565 108…5 98.28 143 133 276 98.57 1633 1616 3249 98.49 22 … 1 Organic disease 6 4 10 .52 3 3 6 .54 … 2 2 .71 9 9 18 .54 … 1 1 Functional disease 4 … 4 .21 1 1 2 .18 … … … … 5 1 6 .18 … … … Anaemia 4 6 10 .52 5 6 11 1.00 1 … 1 .36 10 12 22 .67 … … … Other defect … 3 3 .16 … … … … 1 … 1 .36 1 3 4 .12 … … … Lungs No disease 902 920 1882 98.28 524 570 1094 99.10 143 134 277 98.93 1629 1624 3253 98.61 21 39 60 Chronic bronchitis and bronchial catarrh 21 10 31 1.62 1 3 4 .36 1 … 1 .36 23 13 36 1.09 … … … Tuberculosis … … … … 2 … 2 .18 … … …… … 2 … 2 .06 … … … Lungs— continued Tuberculosis suspected 1 1 2 .10 2 2 4 .36 1 1 2 .71 4 4 8 .24 … 1 1 Other disease … … … … … … ... … … … … … … … … … 1 … 1 Nervous System No disease 982 929 1911 99.80 526 573 1099 99.55 145 134 279 99.64 1653 1636 3289 99.68 22 39 61 Epilepsy (major or minor) 1 … 1 .05 … … … … … … … … 1 … 1 .05 … … … Chorea 1 1 2 .10 … … … … … … … … 1 1 2 .06 … … … Other disease … 1 1 .05 3 2 5 .45 … 1 1 .36 3 4 7 .21 … 1 1 Skin No disease 975 922 1897 99.06 524 571 1095 99.19 145 134 279 99.64 1644 1627 3271 99.14 21 40 61 Ringworm: body … … … … ... … … … … … … … … … … … … … … Ringworm : head … … … … … … … … … … … … … … … … … … Impetigo 6 1 7 .37 2 2 4 .36 … … … … 8 3 11 .33 … … … Scabies 1 … 1 .05 … … … … … … … … 1 … 1 .05 … … 1 Other disease 2 8 10 .52 3 2 5 .45 … 1 1 .36 5 11 16 .48 1 … 1 Rickets No disease 983 929 1912 99.84 528 575 1103 99.91 145 135 280 100 1656 1639 3295 99.88 22 40 62 Slight 1 1 2 .10 1 … 1 .09 … … … … 2 1 3 .09 … … … Marked … 1 1 .05 … … … … … … … … … 1 1 .03 … … … Deformities No deformity 975 920 1901 99.27 525 575 1100 99.64 145 135 280 100 1645 1636 3281 99.46 22 39 61 Deformity present 9 5 14 .73 4 … 4 .36 … … … … 13 5 18 .54 … 1 1 Tuberculosis (non. pulmonary) No disease 984 931 1915 100 529 574 1103 99.91 145 135 280 100 1658 1640 3298 99.91 22 39 61 Glandular … … … … … … … … … … … … … … … … … … … Bones and Joints … … … … … … … … … … … … … … … … … ... … Other forms … … … … … 1 1 .09 … … … … … 1 1 .09 … 1 1 Speech Not defective 945 914 1859 97.08 520 572 1092 98.92 144 135 279 99.64 1609 1621 3230 97.91 20 39 … Defective articulation 33 14 47 2.45 4 2 6 .54 1 … 1 .36 38 16 54 1.64 2 … 2 Stammering 6 3 9 .47 5 1 6 .54 … … … … 11 4 15 .45 … 1 1 Mental Condition Normal 980 927 1907 99.58 527 574 1101 99.73 144 135 279 99.64 1651 1636 3287 99.64 22 38 60 Dull or backward 3 4 7 .37 1 1 2 .18 1 … 1 .36 5 5 10 .30 … 1 1 i Mentally Defective (all grades) 1 … 1 .05 1 … 1 .09 … … … … 2 … 2 .06 … 1 1 TABLE II.—RETURN SHOWING THE PHYSICAL CONDITION OF CHILDREN INSPECTED. Condition. Entrants. Leavers. Intermediate Group. Total. Special Cases. Boys. Girls. Total. Per cent. Boys. Girls. Total. Per cent. Boys. Girls. Total. Per cent. Boys. Girls. Total. Per cent. Boys. Girls. Total. Vision 6 6 each eye (normal vision) 904 849 1753 91.54 452 496 948 85.87 125 108 233 83.21 1481 1453 2934 88.94 19 25 44 Less than 6/6, but not less than (6/9 in one or both eyes 47 59 106 5.54 27 33 60 5.43 11 16 27 9.64 85 108 193 5.85 … 3 3 Less than 6/9 in one or both eyes (i.e., 6/12ths or less and requiring treatment) 73 76 149 7.78 84 93 177 16.03 17 28 45 16.07 174 197 371 11.25 2 12 14 Squint 20 24 44 2.30 6 11 17 1.54 5 1 6 2.14 31 36 67 2.03 1 1 Hearing (whisper) No defect 931 907 1838 95.98 519 564 1083 98.10 142 126 268 95.71 1592 1597 3189 96.67 19 36 Defective 53 24 77 4.02 10 11 21 1.90 3 9 12 4.29 66 44 110 3.33 3 4 7 Other Disease or Defect Not present 829 824 1653 86.32 427 476 903 81.79 100 107 207. 73.93 1356 1407 2763 83.75 19 38 57 Present 155 107 262 13.68 102 99 201 18.21 45 28 73 26.07 302 234 636 16.25 3 2 5 41 TABLE III. Numerical Return of all Exceptional Children in the Area. Boys. Girls. Total. Blind (including partially blind). Attending Public Elementary Schools — — — Attending Certified Schools for the Blind 2 1 3 Not at School — 1 1 Deaf and Dumb (including partially deaf). Attending Public Elementary Schools — — — Attending Certified Schools for the Deaf 4 — 6 Not at School 1 — 1 Mentally Deficient. Feebleminded. Attending Public Elementary Schools 11 7 18 Attending Certified Schools for Mentally Defective Children — — — Notified to the Loca1 (Control) Authority during the year — — — Not at School 7 13 20 Imbeciles. At School — — — Not at School 7 7 14 Idiots. 2 3 5 Epileptics. Attending Public Elementary Schools — 1 1 Attending Certified Schools — — — Not at School 3 2 5 Physically Defective. Pulmonary Tuberculosis. Attending Public Elementary Schools 3 2 5 Attending Certified Schools for Physically Defective Children — — — Not at School 3 4 7 42 TABLE III.—continued. Numerical Return of all Exceptional Children in the Area. Boys. Girls. Total. Physically Defective. Other forms of Tuberculosis. Attending Public Elementary Schools 5 5 10 Attending Certified Schools for Physically Defective Children — — — Not at School . — — — Cripples, other than Tubercular. Attending Public Elementary Schools * * * Attending Certified Schools for Physically Defective Children — — — Not at School 2 4 6 Dull or Backward Retarded two years * * * Retarded three years * * * * Figures not complete. N.B.—This list does not include children in Barnardo's Village Homes and other institutions in the district. 43 TABLE IV.—Treatment of Defects of Children during 1915. Condition. No. of defects for which Treatment was considered necessary. No. of defects for which no report is available. No. of defects treated. Results of Treatment. No. of defects not treated. Per centage of defects treated. From previous Year. New. Total. Remedied. Improved. Unchanged. Clothing 1 5 6 1 3 3 … … 2 50.0 Footgear … 18 18 2 10 7 … 3 6 55.6 Cleanliness of Body … 3 3 1 1 … … 1 1 33.3 Nutrition ... . 1 1 2 … 1 1 … … 1 50.0 Nose and Throat 23 52 75 6 41 6 4 31 28 54.7 External Eye Disease … 4 4 … 2 … 1 1 2 50.0 Ear Disease … 13 13 1 9 … 3 6 3 69.7 Teeth 2 13 15 3 10 10 … … 2 66.7 Heart and Circulation 2 34 36 6 19 5 9 5 11 52.8 Lungs 1 39 40 1 28 11 8 9 11 70.0 Nervous System … 3 3 1 2 … 1 1 … 66.7 Skin 2 18 20 1 11 8 2 1 8 55.0 Rickets … … … … … … … … … … Deformities 1 10 11 … 4 … 2 2 7 36.4 Tuberculosis,Non-Pulmonary … … … … … … … … … … Speech … 2 2 1 … … … … 1 … Mental Condition … … … … …… … … … … … Vision and Squint 109 420 529 6 125 104 … 21 … … Hearing 18 76 94 8 61 16 17 28 25 64.9 Miscellaneous 4 15 19 1 11 4 1 6 7 57.9 Total 164 726 890 39 338 175 48 115 115 38.0 44 Summary of Infectious Diseases and Children who have been excluded owing to Contact with Patients in connection with the Schools during the year ended the 31st December, 1915. SCHOOLS. Number on Roll. DISEASES AND CONTACTS. Scarlet Fever. Diphtheria. Enteric Fever. Measles. German Measles. Chicken Pox. Mumps. Whooping Cough. Ringworm Totals. 1915. Totals. 1914. Cases Contacts Cases Contacts Cases Contacts Cases Contacts Cases Contacts Cases Contacts Cases Contacts Cases Contacts Cases Cases Contacts Cases Contacts Downshall 1503 21 23 7 10 — — 175 34 10 8 17 5 11 — 51 14 6 298 94 44 27 Cleveland Road 1372 32 21 6 6 — — 33 19 2 — 33 12 24 — 32 20 2 164 78 86 49 Christchurch 1311 19 17 5 10 — — 97 40 6 7 53 11 60 6 7 3 6 253 94 92 58 Loxford 1268 6 8 6 5 — — 59 12 1 — 50 9 21 2 9 — 5 157 36 116 30 Highland 931 2 4 3 2 — — 111 19 1 1 10 3 80 1 5 3 1 213 33 43 19 South Park 1268 11 20 9 9 — — 98 21 8 3 57 13 19 — 8 2 — 210 74 80 51 Uphall 1175 9 12 — — — — 45 20 — — 27 6 84 2 40 21 6 211 61 132 72 National and Church Infants 381 2 3 1 — — — 14 12 1 — 4 3 9 — 7 2 — 38 20 31 62 Newbury Park 556 4 5 3 2 — — 48 10 1 — 54 32 16 — 60 39 — 186 88 9 2 Goodmayes 1046 9 6 6 13 — — 99 11 3 — 5 — 117 5 9 — 4 252 35 216 77 Chadwell 257 1 4 1 4 — — 3 — — — 12 5 3 — 11 11 2 33 24 6 14 Barkingside 283 — — — — — — 24 13 — — 20 19 17 — 29 23 1 91 55 23 24 Roman Catholic 332 2 3 8 9 — — 8 2 — 1 8 6 14 — 3 1 1 44 22 11 6 Valentines 106 1 — — — — — 1 1 — — 2 1 2 — 1 — 1 8 2 13 20 Little Health 133 — — 1 1 — — 2 1 — — 10 12 — — 13 16 — 26 30 7 7 County High School — 1 2 1 — — — — — 1 — — — — — — — — 3 2 5 11 Private Schools — 16 13 9 6 — — — — — — — — — — — — — 26 19 11 9 Totals — 136 147 66 77 — — 817 215 34 20 362 137 479 16 285 155 35 2214 767 925 538