CEY 11 Leyton Urban District Council. THE ANNUAL REPORT on the Vital Statistics and Sanitary Circumstances of the URBAN DISTRICT OF LEYTON, TOGETHER WITH THE REPORT TO THE EDUCATION COMMITTEE and THE HOSPITAL REPORT FOR THE YEAR 1911, by J. FRANCIS TAYLOR, M.R.C.S., D.P.H., Medical Officer of Heallh. London: WATERLOW BROS. & LAYTON, LTD. 24 & 25, Birchin Lane, E.C. TABLE OF CONTENTS. Page Report of the Medical Officer of Health— Assessable and Rateable Value 7 Area, Inhabited Houses, Population 7, 8 Births 8,9 Births—Table 10 Deaths 9, 11 Deaths from Certain Specified Causes for the past 4 years 12 Zymotic Death-Rate 12, 13 Infantile Mortality Rate 13, 14 Smallpox 14-18 Vaccination Returns 19 Enteric Fever 19,20 Chart showing Notifications of Scarlet Fever and Diphtheria Facing p. 20 Scarlet Fever 21, 22 Diphtheria 22 Measles 22-24 Whooping Cough 24 Diarrhoea and Enteritis 24-27 Phthisis—Pulmonary Tuberculosis 28-30 Puerperal Fever 30 Cerebro-Spinal Meningitis, Acute Polio-Myelitis, Acute Polio- Encephalitis 31, 32 Bacteriological Diagnosis 32, 33 Cancer 33, 34 Inquests 34 Senile Mortality and Mortality from Certain Diseases 35 Meteorology 36-46 Notes on Sanitary Work and Matters Incidental Thereto— Sewerage and Drainage 47 Sewage Disposal 47, 48 Pollution of Rivers and Streams in the District 48 Removal and Disposal of House Refuse 48 Offensive Trades 48, 49 Sanitary Conveniences 49 Water Supply of the District 49 Milk Supply 50 Unsound Food and Food Inspections 50, 51 Slaughter-Houses and Meat Inspection 51, 52 Tuberculous Meat 53-55 Number of Carcases and Parts of Carcases Condemned for Tuberculosis 55 Unsound Fish 56 Food Poisoning 56-58 Trade Refuse 59 Customs and Inland Revenue Act 59, 60 4 Page. Report on Factories, Workshops, Laundries, Workplaces, and Homework— 1.—Inspection 61 2.—Defects Found 62 3.—Registered Workshops 63 4.—Home Work 64, 65 5.—Other Matters 63 Report on the Work of the Temporary Isolation Hospital 66-68 Admissions 68 Scarlet Fever 68, 69 Diphtheria 68, 69 Hospital Expenditure 70 Report of the Sanitary Inspector— Infectious Disease 71,72 Inspection of the District, and Abatement of Nuisances 73-75 Drainage and Sewerage 75 Premises Inspected in Connection with Food Supply 75 Works Carried out as the Result of the Inspections 76, 77 Dairies, Cowsheds, and Milkshops 77-84 Slaughter-Houses 84, 85 Unsound Food 85, 86 Bakehouses 86 Dining Rooms 86 Factory and Workshop Act, 1901—Factories 86, 87 Workshops 87, 88 Outworkers 88, 89 Mortuary 89 Petroleum 89 Dust Collection 89, 90 Annual Report to the Education Committee, embodying the Fourth Annual Report on the Medical Inspection of School Children, under the Education (Administrative Provisions) Act of 1907 93-140 Local Government Board Tables:— Table I.—Vital Statistics of Whole District during 1911 and previous Years 142, 143 „ II.—Cases of Infectious Disease Notified during Year 144 „ HI.—Deaths—Ages—Whole Year 146,147 „ IIIa.— „ Wards „ 148,149 „ IIIb.—Causes of, and Ages at Death (Long Schedule) 150, 157 „ IV. —Infantile Mortality during the Year (Ages) 158, 159 „ IVa.— „ „ (Wards) 160,161 Deaths—Summary—Ages and Wards 162, 163 ,, Short Schedule Monthly Editions 164-187 Cases of Infectious Disease notified—Monthly Editions 188-199 Leyton Urban District Council. PUBLIC HEALTH COMMITTEE. CHAIRMAN: Mr. Councillor TRUMBLE, J.P., E.C.C. MEMBERS: Mr. Councillor COX. Mr. Councillor PITTAM. Mr. Councillor DOLDEN. Mr. Councillor SLADE, J.P., Mr. Councillor DOWDING. E.C.C. Mr. Councillor HENNAH. Mr. Councillor D. M. SMITH. Mr. Councillor HURRY, J.P. Mr. Councillor UPTON. Mr. Councillor MATTHEWS. Mr. Councillor WALLER, J.P., Mr. Councillor MITCHELL. E.C.C. STAFF: Chief Sanitary Inspector: HORATIO MILLER. Assistant Sanitary Inspectors: J. G. FORSYTHE. F. G. ENGLAND. W. J. STEVENS. Lady Sanitary Inspector: Miss MILLER. CLERKS: F. L. H. WILLIAMS (Chief Clerk). G. F. LESERVE. E. E. JACOBS. MATRON OF ISOLATION HOSPITAL: Miss RYAN. ASSISTANT MEDICAL OFFICER: D. KIRKHOPE, M.D.Glasg., D.P.H.Cambs. MEDICAL OFFICER OF HEALTH: J. F. TAYLOR, M.R.C.S., D.P.H.Lond. TO THE CHAIRMAN AND MEMBERS OF THE LEYTON URBAN DISTRICT COUNCIL. Mr. Chairman and Gentlemen, I beg to submit my Annual Report on the Health and General Sanitary circumstances of the District for the year 1911. The birth-rate continues to diminish. The death-rate and infantile mortality rate are both higher than they have been for some years, chiefly owing to the exceptionally hot and dry summer, which caused an increased number of deaths from Diarrhoea among infants. An epidemic of Measles in the spring also contributed to this increased mortality. These undesirable features were by no means confined to Leyton, many other towns suffering more severely than we did. By means of the two Orders issued by the Local Government Board the notification of all cases of Pulmonary Tuberculosis is now made compulsory. You have extended your powers under the provisions of the Infectious Disease (Notification) Act by making epidemic Cerebrospinal Meningitis, Acute Polio-Encephalitis, and Acute PolioMyelitis notifiable diseases. I have from year to year brought forward instances occurring in this District illustrating the necessity for providing adequate facilities for more thorough methods of meat inspection. These facilities will never be obtained until Public Abattoirs are compulsory throughout the kingdom. This year's Report contains further instances emphasising that necessity. I have again to thank all the Members and Officials of the Council for the many acts of kindness and consideration they have extended to me during the year. I am, Mr. Chairman and Gentlemen, Your obedient Servant, J. FRANCIS TAYLOR. Legton Urban District Council. ANNUAL HEALTH REPORT FOR 1911, by J. FRANCIS TAYLOR, M.R.C.S., D.P.H., Medical Officer of Health. The general characteristics of the District and of its inhabitants have been outlined in the last three or four Reports, and as no material change has taken place in either it is unnecessary to repeat them here. ASSESSABLE AND RATEABLE VALUE.• The present assessable value is £481,450 0s. 0d. for general district purposes, and a rate of Id. in the £1 produces £1,855 0s. 0d. For poor rate purposes the rateable value is £514,374 15s. 0d., and a Id. rate produces £1,973 10s. 0d. AREA, INHABITED HOUSES, POPULATION. The district has a total area of 2,594 acres; at the end of May it contained 23,360 houses, and of these 1.213 were uninhabited. The census of 1911 gave our population as 124,736, and on this number of inhabitants the various rates have been calculated. 8 The census population divided among the inhabited houses gives an average of 5.63 persons per house. The number of inhabitants in each ward at the time of the census has been ascertained:— Ward. Area in _ acres. Number of houses. Persons per acre. dumber of Inhabitec houses. Population. Leyton 432 1800 21.1 1705 9110 Lea Bridge 521 3281 35.9 3142 18684 Forest 599 3134 27.6 2966 16544 Central 233 4230 961 3985 22390 Leytonstone 326 2942 41.1 2811 13410 Harrow Green 139 1941 95.3 1799 13245 Grove Green 121 1862 85.9 1737 10402 Cann Hall 135 2515 92.3 2430 12459 Wanstead Slip 88 1655 98.8 1572 8492 2594 23360 481 22147 124736 BIRTHS. During the year 2,931 births were registered, giving a birthrate of 23.5 per 1,000 of the population. Of these 1,475 were males and 1,456 females. The corresponding rate for England and Wales was 24.4; for the 77 Great Towns, 25.6; and for London, 25.0. Our birth-rate for 1910 was 24.4 per 1,000 of population. „ „ 1909 „ 24.6 „ „ „ „ 1908 „ 25.3 „ „ „ „ 1907 „ 26.6 „ „ 9 It will thus be noted that our birth-rate continues to progressively diminish. Economic conditions in the present day do not tend to encourage large families. The man "without encumbrance" has the advantage in the labour market over the man with a large family, and the latter finds increasing difficulty in housing his numerous progeny. Landlords do not favour large families in those who can pay but small rentals. Thus it comes about that amongst many of the more provident of the populace of limited means the number of children per family are becoming fewer and fewer. This I believe to be the chief factor in the diminishing birth-rate. How it is to be remedied is one of the most difficult problems remaining to be solved. The number of illegitimate births was 74, and of these 3!) were males and 35 females. Our illegitimate birth-rate is therefore -59 per 1,000 of the population. The mothers of a very large majority of the illegitimate children were described as domestic servants. « DEATHS. From the commencement of the year a new procedure has been adopted by the Registrar-General, viz., that of sifting out the deaths which occur in a district where the person so dying was not a resident therein. For instance, under the old system, Births.—1911. Year 1911. Names of Localities—Wards. Totals. Leyton. Lea Bridge. Central. Forest. Leytonstone. Grove Green. Harrow Green. Cann Hall. Wanstead Slip. Ward not known. January 19 36 58 23 14 16 23 17 21 — 227 February 15 42 43 28 21 20 16 25 11 — 221 March 16 57 57 34 15 25 36 34 20 1 295 April 11 46 49 24 12 21 18 23 17 — 221 May 16 43 49 34 17 27 35 28 14 — 263 June 21 48 54 34 14 23 26 25 10 — 255 July 16 32 46 26 16 21 27 23 18 — 225 August 23 60 54 34 22 44 27 32 17 — 313 September 13 35 44 24 20 31 17 21 16 — 221 October 15 37 44 29 9 19 28 15 8 — 204 November 22 36 51 37 8 30 33 20 20 — 257 December 17 33 33 21 15 17 29 17 19 — 201 Births received from County Medical Officer of Health (Wards not known) 28 Totals 204 505 582 348 183 294 315 280 191 1 2931 10 11 it a resident of Leyton were taken to a London Hospital and died there, the death would be registered in the registration area in which the Hospital is situated, and I might never hear of the death. But now all such "transferable" deaths are sent to the County Medical Officer of Health, who transmits to me such as are referable to Leyton. I should receive quarterly a list of these "transferred deaths," but owing to the new machinery involved not being as yet fully developed there is considerable delay in receiving these returns: e.g., those for the last quarter of the year have not yet come to hand. I am therefore only able to add to the deaths received from the local registrars the transferable deaths for the first three quarters of the year. These, however, amount to 168, and consequently raise our death-rate from 10.4 to 11.8 per 1,000 of the population. The total number of deaths belonging to the District of which I have received particulars is 1,473. Of this number 744 were those of males and 728 females. One body—that of a newly-born infant—was so mutilated as to render the sex unascertainable. Our death-rate for 1911, as above stated, is 11.8. In 1910 it was 9; in 1909, 9.96; nd in 1908 and 1907, 9.8 and 10.6 respectively. The death-rate for England and Wales in 1911 was 14.6; for the 77 Great Towns, 15.5; and for London, 15.0. 12 Below I have tabulated the number of deaths occurring from certain specified causes for the past four years. This table shows a marked increase during the year 1911 of deaths from Diarrhoeal diseases, Measles, Pneumonia, and to a less extent from Tubercular diseases and Cancer. 1908 1909 1910 1911 Diarrhoeal Diseases 52 36 21 126 Measles 23 29 16 76 Pneumonia (all forms) 49 38 67 101 Tubercular Diseases 145 135 133 171 Cancer 84 83 87 99 Enteric Fever 4 3 2 5 Whooping Cough 12 33 16 20 Diphtheria 18 27 22 14 Influenza 23 11 15 11 Scarlet Fever 15 8 16 7 Puerperal Fever 6 6 3 2 Premature Births, Congenital Debility, &c. 124 130 116 J 24 Nephritis and Bright's Disease 34 62 40 43 Suicides 6 8 7 3 ZYMOTIC DEATH-RATE. The deaths which occurred during the year from the seven principal Zymotic diseases were distributed among those diseases as follows:—Measles, 76; Scarlet Fever, 7; Diphtheria, 14; Whooping Cough, 20; Enteric Fever, 5; Diarrhoea and Enteritis under two years of age, 108. 13 In 1906 our Zymotic death-rate was 2.3 per 1,000 of the population „ 1907 „ „ „ „ 1.7 „ 1908 „ „ „ .9 „ 1909 „ „ „ „ .97 „ „ „ 1910 „ „ „ .65 „ „ „ 1911 „ „ „ „ 1.84 „ „ It will thus be seen that our Zymotic death-rate was higher in 1911 than in any year since 1906. This increase is accounted for by the large number of deaths which occurred from Diarrhoea and Measles. The Zymotic death-rate for England and Wales was 1.88 „ „ „ „ London „ 2.19 „ „ „ „ „ the 77 Great Towns „ 2.29 INFANTILE MORTALITY RATE. The infantile mortality rate, i.e., the number of deaths of children under one year of age per 1,000 births, was 111.6. In 1906 our infantile mortality rate was 114.5 „ 1907 „ „ „ „ 86.5 „ 1908 „ „ „ „ 78.8 „ 1909 „ „ „ „ 81.9 „ 1910 „ „ „ „ 63.4 „ 1911 „ „ „ „ 111.6 On reference to the tables it will be seen that of the 327 deaths which occurred in infants under one year of age, 119, or 36.3 per 14 cent., were due to premature birth and various other ante-natal causes, while 87, or 26.6 per cent., were due to Diarrhoea and Enteritis. The infantile mortality rate for England and Wales was 130 „ ,, „ ,, London „ 128 „ „ „ „ the Great Towns „ 140 SMALL-POX. Two cases were notified during the year, but on further investigation they proved not to be Small-pox. On the 7th November 1911, the Clerk received a letter from the Metropolitan Asylums Board, and on 14th November I reported to the Public Health Committee, on the necessity for making provision for hospital accommodation of Small-pox. The following are copies of the letter and of my report:— Copy. Metropolitan Asylums Board, Embankment, London, E.C., 6th November, 1911. Sir, SMALL-POX. I am instructed by the Board to communicate with you concerning the existing arrangement for the admission to their hospitals, on certain terms and conditions—one of which is that the arrangement is terminable at short notice—of cases of Smallpox from the district of Leyton. 15 In view of the fact that outbreaks of Small-pox in the districts adjacent to the Metropolis are not unlikely to synchronise with an epidemic in London, and bearing in mind the rapidity with which Small-pox assumes serious proportions, it seems imperative that the assistance the Board will be justified in affording in extrametropolitan authorities must be limited to the reception of an intermittent case or two. It is hoped that this, pending immediate local provision for further cases, will be found useful. I am therefore to acquaint you, in common with other authorities outside the Metropcl: from whose districts it has been conditionally agreed to receive cases, that the facilities which this Board may be relied upon to give must be regarded as strictly limited to admitting a sporadic case or two and that the Board will not undertake to receive any which may occur subsequently. I shall be glad if you will kindly acknowledge the receipt of this letter. I am, Sir, Your obedient Servant, (sgd.) T. DUNCOMBE MANN, Clerk to the Board. The Clerk, Leyton Urban District Council. 16 TO THE PUBLIC HEALTH COMMITTEE. Gentlemen, In reference to the letter from the Metropolitan Asylums Board as to the reception into their hospitals of cases of Small-pox from Leyton, in which they point out that in the case of an epidemic of that disease they could not, assuming what is most likely, that the epidemic affected London and Leyton simultaneously, undertake to provide accommodation for more than a sporadic case or two, I may be permitted to refer to a paragraph in my Annual Report of 1909. "This arrangement (arrangement with the Metropolitan Asylums Board for the reception of Small-pox cases from Leyton), however, is terminable at short notice The. Metropolitan Asylums Board refuse to enter into any lengthy agreement, and state it is not their practice to do so. This refusal to enter into such an agreement is to be regretted, for in the event of an epidemic of Small-pox, in which we in common with London might be involved, we might be left to shift for ourselves at the very time we most required hospital accommodation." The matter was discussed by this Committee, and it was thought that the refusal of the Metropolitan Asylums Board to enter into an agreement was a mere technicality, and that we were amply secured. That such is not the case the present letter sufficiently emphasises, and I cannot too strongly urge the Council to make immediate provision to insure the protection of the inhabitants 17 of the district from the ravages of a Small-pox epidemic by themselves providing or by arranging for hospital accommodation on an adequate scale. Hospital accommodation for Small-pox in this district may be provided in one of two ways—either by providing and staffing such a hospital, or by entering into an arrangement with some other authority. The former method, besides being probably the more expensive, is impracticable so far as building a Small-pox hospital within the confines of the district is concerned, for the Local Government Board will not grant a loan:—where the site has within a quarter of a mile of it either a hospital, a workhouse, or any similar establishment, or a population of as many as 200 persons—or where the site has within half a mile of it a population of as many as 600 persons, whether in one or more institutions or in dwellinghouses. These restrictions as to site for a Small-pox hospital are based on scientific investigations which have proved the peculiar tendency of Small-pox infection to spread from such institutions; and they should, in my opinion, be observed quite independently of any application to the Local Government Board for sanction to borrow money for the erection of the hospital. The other alternative—that of entering into an arrangement with some other authority—has at different times engaged your attention. West Ham and a combination of authorities having a Smallpox Hospital at South Mimms might now be approached and 18 asked what accommodation for Small-pox, in the event of an epidemic, they could grant to Leyton, and what the cost would be. Naturally, they will want a somewhat higher premium now than they asked some years ago, but that will have to be faced; when we consider how much we have saved during those years through sheer luck we shall realize that even if we now have to pay more we may still be something to the good. As to the absolute necessity for providing hospital accommodation against an epidemic of Small-pox, I entertain not a particle of doubt. In the unvaccinated condition of the population at the' present time, isolation and disinfection are the only weapons we possess against Small-pox, and one shudders to think of the appalling disfigurement and loss of life which is bound to occur if we neglect to provide means of isolation. I may add the cost of an epidemic in terms of money has been over and over again proved to be many times more, when remedial'and preventive measures are left until they are actually needed and until people become panic-stricken, than when they are carefully and calmly planned during a quiescent period. As to the likelihood of an epidemic of Small-pox occurring, it only requires an unrecognised case of the disease to be introduced into the midst of our susceptible and unvaccinated population to set up a serious epidemic. I am, Gentlemen, Your obedient Servant, J. FRANCIS TAYLOR. On the above report the Committee resolved to communicate with West Ham and with the South Mimms Hospital Authorities, and the matter is still sub judice. 19 VACCINATION RETURNS. The following are the details as to infant Vaccination in the District for the past five years :— Number of Births. Vaccinated. Certificates of Insusceptibility. Exemptions. Died Unvaccinated under i year. 1907 3190 2089 9 188 203 1908 3071 1756 12 487 199 1909 2979 1396 12 556 173 1910 3011 1241 10 730 140 1911 2931 976 11 658 180 ENTERIC FEVER. 28 cases were notified, with 5 deaths. Our death-rate from Enteric Fever was therefore .04. The death-rate from this disease for England and Wales was .07 ; for the 77 Great Towns, .06; and for London, .03. Careful enquiries as to the origin of the disease were made in every case, but in the majority of instances it was found impossible to assign it to any particular cause. 20 The following table illustrates in brief the salient features of the notified cases:— Case Sex. Age. Where Treated. Result. Remarks. Yrs. 1 M. 45 At home Died Not traceable. 2 M. 4 At. Eastern Hospital Recovered Occurred in Bethnal Green Schools. 3 F. 32 At London Hospital " Not traceable. 4 M. 32 At West Ham Infirmary " Endocarditis, not Enteric Fever. 5 M. 35 At London Hospital Died Not traceable. 6 M. 3 At home Recovered Doubtful case. 7 M. 12 At Walthamstow Hospl " Not traceable. 8 F. 18 At home Died Doubtful case. 9 F. 30 At West Ham Infirmary Recovered Not Enteric Fever. 10 F. 18 " " " Not traceable. 11 M. 43 " " " " 12 M. 32 " " " " 13 M. 22 " " " 14 F. 7 At home " Had been in the habit of eating raw carrots. 15 F. 12 " Had stayed at Ramsgate three weeks prior to notification, but had not eaten any shell fish. Has been in the habit of eating raw watercress procured from divers sources 16 At Walthamstow Hospl. " Not traceable. 17 M. 43 At home " Visited Ramsgate and partook of oysters there about a month previous to his ailing. 18 M. 35 At West Ham Infirmary " Not traceable. 19 M. 7 " " " Occurred in same house as case 18. 20 F. 18 At home " Doubtful case. 21 M. 7 „ 22 M. 27 At West Ham Infirmary Died Not traceable. 23 F. 8 At home Recovered In the habit of eating fried fish. 24 M. 8 At West Ham Infirmary " Not traceable. 25 F. 12 At home " In contact with case 18. Eats fried fish. 26 M. 32 Died Had been in the habit of eating oysters in various shops in London. 27 F. 45 " Recovered Occurred in same house as case 21. 28 M. 12 At London Hospital Died On P.M. examination case provad to be "Appendicitis," and not Enteric Fever. 29 M. 10 At West Ham Infirmary Recovered Not Enteric Fever. One case, viz.:—No. 25 was notified as Continued Fever. Chart showing Notifications of Scarlet Fever and Diphtheria received each week during 1911. SCARLET FEVER in Black. DIPHTHERIA in Red 21 SCARLET FEVER. 460 cases were notified and 7 deaths occurred, a case fatality of 1.5 per cent. In 1907 the case-fatality was 2.5 per cent. „ 1908 „ „ 2.6 „ 1909 „ „ 1.6 „ 1910 „ „ 2.88 „ 1911 „ „ 1.5 Our death-rate from Scarlet Fever for the year 1911 was .06 per 1,000 of the population; that of England and Wales, .05; of the 77 Great Towns, .06; and of London, .04. From the above figures it will be seen that Scarlet Fever was very prevalent during the year; and also, from the low deathrate, that it was of a mild type. The two circumstances stand to each other in the relationship of cause and effect. That is to say, the disease often appeared in such mild and anomalous forms as to escape recognition, and so "missed" cases were enabled to go about and spread the disease. Several medical practitioners of great experience told me that on account of the absence of definite symptoms they often had the greatest difficulty in making a positive diagnosis. Among careless people, where no doctor was called in, the disease was put down as a cold, or as a Spring or Autumn Rash, &c. 22 Under such circumstances the control of the disease becomes exceedingly difficult. No evidence of the disease being spread through the agency of milk occurred. DIPHTHERIA. 174 cases were notified, with 14 deaths, a case fatality of 8 per cent. In 1907 the case-fatality was 14-7 per cent. „ 1908 „ „ 8.2 „ 1909 „ „ 13.4 „ 1910 „ „ 13.2 „ 1911 „ 80 In 1911 our death-rate from this disease was .11 per 1,000 of the population; whilst that of England and Wales was .13; of the 77 Great Towns, .15; and of London, .14. MEASLES. Measles was the cause of 76 deaths during the year, representing a death-rate of .6 per 1,000 of the population. The corresponding rate for England and Wales was .36; for the 77 Great Towns, .47; and for London, .57. 23 The 76 deaths were distributed throughout the year as follows:— Jan. Feb. March. April. May. June. July. Aug. Sept. Oct. Nov. Dec. 5 13 37 12 4 2 2 1 0 0 0 0 MEASLES—DEATHS. 16 of the deaths occurred in children under one year of age; 28 one and under two years; 22 in the age period two and under five years; and the remaining 10 in the period five and under 15 years. The school teachers notify me each week of children absent from school on account of illness, and the ailment from which they believe them to be suffering. In this manner I was notified of 2,461 cases of Measles. As children under five years of age are not admitted to our schools, I have no record of the cases occurring in children under that age. The Infant and Junior Mixed departments of two schools were closed for a fortnight, but without much apparent benefit. Nearly all the elementary schools of the district were affected by the epidemic. 24 Beyond the closing of the two schools already mentioned, the measures adopted to check the epidemic consisted in excluding all children from school who had not previously suffered from Measles, and in distributing throughout the district leaflets of advice. Having no Health Visitors I could not make any arrangements for the cases to be visited. WHOOPING COUGH. Whooping Cough caused 20 deaths, and so was responsible for a death-rate of -16 per 1,000 of the population. The corresponding rate for England and Wales was .21; for the 77 Great Towns, .24; and for London, .23. DIARRHCEA AND ENTERITIS. Diarrhoea and Enteritis are accountable for 126 deaths. 87 of these deaths occurred in children under one year of age and 21 in those aged one and under two years; only 2 deaths occurred between two and five years; 2 between five and 15; none between 15 and 25; 2 between 25 and 45; 4 between 45 and 65; and 8 between 65 and upwards.  Jan. Feb. Mar. Apr. May June July Aug. Sept. Oct. Nov. Dec. Deaths from Diarrhœa and Enteritis— All ages 3 2 0 3 1 3 4 54 29 7 3 2 Under one year 1 0 0 2 0 2 3 37 23 5 2 2 Over one year and under two years.. 0 2 0 1 0 1 1 6 4 2 0 0 Air temperature (mean) highest 70.9 81.1 81.1 72.1 ,, ,, lowest 50.3 55.0 57.0 47.9 Earth temperatures (4 ft.) 58.6 62.7 66.4 62.8 25 26 It will be seen from the above table, although the thermometer 4 ft. below the earth's surface registered 58.6° in June and 62.7° in July (Ballard showed that Diarrhœal mortality began to rise when the 4 ft. earth thermometer registered about 56°), no considerable rise took place until August, when the 4 ft. earth temperature reached 66.4°. The maximum mortality, however, coincides with the maximum temperature. The mean air temperatures, it will be noted, were practically the same for July and August, thus emphasising what Ballard pointed out, that they had little or nothing to do with the increase of Diarrhoeal mortality. In 1902 these diseases caused the deaths of 45 children under 5 years of age. ,, . 1903 „ „ 35 ,, ,, ,, 1904 ,, ,, ,, „ 180 ,, ,, ,, 1905 ,, ,, ,, „ 52 ,, ,, ,, 1906 ,, „ ,, „ 116 ,, ,, „ 1907 „ „ „ „ 37 ,, ,, ,, 1908 ,, ,, ,, ,, 36 „ ,, „ 1909 ,, ,, ,, ,, 34 ,, ,, ,, 1910 ,, ,, ,, ,, 16 „ ,, ,,1911 ,, ,, ,, ,, 110 ,, ,, Last year I remarked that the decline in these diseases was mainly to be attributed to the cool summers experienced during those years. 1911, an exceptionally hot summer, has verified that statement by the toll it has taken of the lives of young children. 27 The measures taken to control the mortality among infants during the months of August and September, when these diseases were most prevalent, consisted in:. 1. Exceptional activity in seeing to the prompt removal of manure and refuse, &c., from the neighbourhood of dwellings. The Sanitary Inspectors had strict injunctions in going the ordinary rounds in their respective districts to look to these matters, and to make special inspections to ascertain the existence of nuisances of this character. 2. Circulars giving advice as to feeding of infants and the general hygienic management of " Diarrhoea," including advice to seek medical attention early in all cases, were distributed throughout the district. 3. Our infantile mortality rate has been so low that the Council have not thought it advisable to adopt the Notification of Births Act ; but owing to the exceptional weather conditions which obtained in August, I thought it desirable to ascertain from the Birth Returns furnished by the Registrars the addresses of infants born within the last 12 months. As the schools were closed, I secured the aid of our School Nurse, and she visited the homes of infants. This special service, voluntarily rendered, was of material value. Our death.rate from Diarrhoea and Enteritis under 2 years was .86 England and Wales' ,, „ ,, „ ,, 1.06 77 Great Towns' „ „ „ „ „ 1.31 London's „ „ „ „ „ 1.18 28 PHTHISIS—PULMONARY TUBERCULOSIS. 118 deaths occurred from this disease, representing a death. rate of .9 per 1,000 of the population. In 1908 the Local Government Board issued an Order making Pulmonary Tuberculosis, occurring among patients under the control of Poor Law Guardians, a notifiable disease. In 1911, two further Orders have been issued by the Board—the first one, which came into operation at the commencement of the year 1911, extended compulsory notification to institutional cases; and the second, which came into force on 1st January, 1912, provided for the notification of all cases occurring in the private practice of Medical Practitioners, including those coming under the notice of the School Medical Inspectors in the course of their duties. By means of these three Orders all cases of Pulmonary Tuberculosis should be notified to the Medical Officer of Health. The last Order, the provisions of which do not affect the year under review, I reported on to the Council, who instructed me to obtain all the necessary materials for commencing the notification of cases on the 1st January, 1912. I further asked for a Health Visitor to enable me, where I thought the procedure necessary, to have the cases visited at their homes. The question of making such an appointment has been referred to a joint Sub.Committee of the Public Health and Education Committees, who I trust will see fit to recommend such an appointment to the Council. As we have no hospitals in Leyton, the provisions of the first Order of 1911, known as the Pulmonary Tuberculosis (Hospital) 29 Regulations, 1911, only affects us so far as the receiving of inward notifications, i.e., notifications sent to us from other districts. Of these I have received 124 during the year. Although some are received as in.patients for short periods, the great majority of the subjects of these notifications are only treated as out.patients at Hospitals. I think it is a defect in these notifications that the Hospital Authorities are not required to notify us of the discharge of all in.patients, together with their intended destinations. It seems to me to be quite as necessary in the case of hospitals as in that of Workhouses and Poor Law infirmaries. I find that some 30 cases have through this cause been lost sight of during the year. Eight cases removed leaving no address, and could not be traced. A few cases removed into other districts, and the Medical Officer of Health concerned was notified of their advent. In three cases the new address given by the patient was found to be incorrect. 22 cases died. The following is a list of the hospitals furnishing the notifications:—Victoria Park, 77; Mount Vernon, 11; Brompton, 11; London, 10; City Road Chest Hospital, 9; West Ham Hospital, 4; University College, 3; St. Bartholomew's, 3; German Hospital, 2; Tuberculin Dispensary, 363, Kennington Road, 2; and the following institutions contributed one each:—St. George's Hospital; Chest Hospital, St. Leonards.on.Sea; National Hospital, Ventnor; St. Catherine's Hospital, Ramsgate; Metropolitan Hospital; Middlesex Hospital; National Sanatorium, Benenden, Kent; National Hospital for Consumption, St. Lawrence, I.W.; Mildmay Mission Hospital, Bethnal Green ; Margaret Street Hospital. 30 The number of cases notified to me by Poor Law Medical Officers under the 1908 Regulations was 70. Of this number 60 entered the infirmary, 14 died there, and 17 left that institution. Six died in their own homes, and of these four after leaving the infirmary. All cases of Phthisis notified during the year have been visited about once a month by the Assistant Medical Officer. Premises vacated by patients (whether by death or otherwise) have been disinfected and cleansed. Printed and verbal instructions as to hygienic management have been given; disinfectants have been provided; and in many cases, on the prescription of the Medical Officer of Health, sputum bottles have been supplied to the sufferers. We have no "sanatorium" or institution, other than the West Ham Poor Law Infirmary, to which we can send patients. PUERPERAL FEVER. Nine cases of this disease were notified, and two deaths occurred: a case.fatality of 22.2 per cent. The fatality per cent. of the total number of births is .068. A case.fatality of 22.2 per cent. would seem to point to Puerperal Fever being an exceptionally fatal disease, but its fatality would be considerably reduced if all cases of the disease were notified. I am confident that only a small proportion of cases are notified, and I drew attention to this matter in my last year's report, where my views on the subject— the result of some twenty years' experience in general medical practice—are set forth. Of the nine notified cases four occurred in the practice of midwives. 31 CEREBRO-SPINAL MENINGITIS, ACUTE POLIO-MYELITIS, ACUTE POLIO.ENCEPHALITIS. On 12th September I reported as follows:— TO THE CHAIRMAN AND MEMBERS OF THE PUBLIC HEALTH COMMITTEE. Gentlemen, For some years past Epidemic Cerebro-Spinal Meningitis has been a notifiable disease in London and elsewhere. Recently attention has been drawn to the two diseases, Acute Polio.Myelitis and Acute Polio.Encephalitis, and a somewhat serious epidemic of these two diseases has occurred in the West of England. In view, no doubt, of this epidemic, and also on account of the constant influx of visitors and travellers from all parts, some of whom may be infected with these diseases, the County of London has so recently as August 25th, 1911, made Acute Polio. Myelitis and Acute Polio.Encephalitis notifiable diseases. Leyton, on account of its large population and its resemblance in many other respects to a London Borough, and especially in view of the fact that a large proportion of its inhabitants spend the greater part of the day in London, should, in my opinion, in respect to the notification of the above.named diseases, be treated on all.fours with a London Borough. I, therefore, beg to advise that the following diseases, " Cerebrospinal Meningitis," "Acute Polio.Myelitis," "Acute Polio.Encephalitis," be added to the list of compulsory notifiable diseases, and the resolution embodying these additions forwarded to the 32 Local Government Board for their sanction as prescribed in the Infectious Diseases (Notification) Acts of 1889 and 1899. The expenses in connection with the notification of these diseases would in the absence of any cases, be limited to the cost of printing and issuing circulars; while, on the other hand, should the disease be introduced into Leyton, the early knowledge of its presence would enable us to take measures to limit its spread. When I point out that these diseases, when they do not directly cause death, in a large percentage of cases leave their victims permanently paralysed, I think there can be no difference of opinion as to the cost being justifiable. I am, Gentlemen, Your obedient Servant, J. FRANCIS TAYLOR. The Committee having adopted the suggestions, the Council passed a resolution in favour of the notification of the above diseases; and the assent of the Local Government Board having been obtained, arrangements have been made to carry out the provisions of the Council's Order commencing 1st January, 1912. BACTERIOLOGICAL DIAGNOSIS. We have no Bacteriological Laboratory, but arrangements have been made with the County Medical Officer of Health for bacteriological examinations. Any medical man practising in the district can obtain the necessary swabs, &c., free of charge by applying at the Town Hall. 33 This arrangement for obtaining bacteriological diagnosis is also available for the use of the Medical Officer of Health. The following is the number of bacteriological examinations made during the year :— Diphtheria. 77 Ringworm 35 Sputum 21 Widal's Test 2 135 CANCER. In 1908 Cancer caused 84 deaths. „ 1909 „ „ 83 „ 1910 „ „ 87 „ 1911 „ „ 99 Our death.rate from Cancer is .89 per 1,000 of the population. The following list gives the seat of the disease and the sex of the person dying of Cancer :— Male. Female. Tongue 1 — Jaw — 2 Face — 1 Tonsil 1 - Œsophagus 11 - Stomach 7 6 Liver 3 5 Bowels 7 6 Abdomen 3 — Chest — 1 c 34 Male. Female. Mediastinum — 1 Kidney 1 — Bladder 3 1 Scrotum 1 — Breast — 14 Uterus — 11 Ovaries — 2 Spine 1 1 Leg 1 1 Lymphatic Glands 5 1 Rodent Ulcer — 1 45 54 99 INQUESTS. The following verdicts were recorded at Inquests held in the district during the year :— Natural Causes 42 Accidents 23 Suicide 4 Want of proper attention at birth 12 Overlaying an Infant 6 Found Drowned 1 Alcoholism 1 Murder 1 One newborn infant found dead in River Lea had been so injured as to render sex and cause of death unascertainable. Suicides.—Mode of death: Two by drowning, one by hanging, and one not stated. SENILE MORTALITY AND MORTALITY FROM CERTAIN DISEASES. The following table is designed to illustrate the relationship of cold and dampness of the atmosphere to the deaths of old people and to certain diseases. The numbers are, of course, too small to make any reliable deductions, but extended over a series of years they may be expected to supply some useful information. Jan. Feb. Mar. April. May. June. July. Aug. Sept. Oct. Nov. Dec. Totals. 60 to 65 years 16 5 11 9 10 5 5 8 2 6 6 4 87 65 to 70 years 13 12 4 13 10 6 4 8 6 5 10 10 101 70 to 80 years 26 19 19 7 13 10 12 13 11 20 23 22 195 80 to 90 years 5 14 9 2 6 7 7 13 3 8 9 12 95 90 years and upwards 1 2 0 1 1 0 0 1 2 1 0 0 9 Totals 61 52 43 32 40 28 28 43 24 40 48 48 487 Diphtheria (Notifications) 13 20 7 15 11 10 16 6 18 18 19 23 Influenza 1 2 1 1 1 1 0 0 0 0 2 2 Phthisis 12 12 11 11 9 7 12 11 12 5 8 8 Rheumatic Fever 0 0 1 2 2 1 0 0 0 0 0 1 Broncho- Pneumonia 3 5 8 4 1 1 0 1 1 1 3 5 Pneumonia (all other forms) 9 11 10 4 5 3 1 5 2 4 7 7 Other Diseases of Respiratory Organs 0 1 1 1 2 0 0 0 0 0 1 1 Nephritis and Bright's Disease 5 3 2 5 7 3 3 2 4 2 3 4 Mean Temperature of Air 381 40.7 421 46.9 57.2 60.6 68 69 60 50.7 43.8 411 Percentage Humidity 89 83 86 76 78 70 63 71 71 89 85 90 Rainfall (in inches) 1.16 1.27 1.78 1.38 10 2.51 •32 •43 1.26 2.92 312 3.68 35 36 METEOROLOGY, 1911. January and February.—During the first twelve days of January the distribution of pressure underwent considerable variations, disturbances moving in various directions, and strong and high winds were felt daily in many parts of the country. On the 11th and 12th the conditions were governed by a complex disturbance which produced the two most stormy days of the first quarter of the year. After January 12th the conditions were greatly altered, and for several weeks, down to the middle of February, areas of high barometric pressure were in the ascendant over these islands and Western Europe generally; but notwithstanding the existence of the anti.cyclones, the weather itself differed from time to time. There were successive days of cloudless or all but cloudless skies, with many hours of bright sunshine; others were overcast and dull to gloomy, and in some localities there was a good deal of fog at times. Without any marked alteration in the pressure distribution, a sudden change of temperature occurred in the last night of the month, and on the morning of February 1st there was frost in nearly every part of the Kingdom. After this the cold moderated somewhat, but temperature continued below the normal for some days. A striking feature of the anti.cyclonic period was the dryness of the weather. Over a very extensive region 37 there were only one or two trifling showers of rain or deposition of moisture in the form of dew or fog in five weeks. The conditions gradually became less settled after February 12th, and from the 15th onward strong southwesterly and westerly winds and gales were reported daily. These were accompanied by general mildness and frequent and heavy rain, there being many records of more than an inch a day. January.—Mean temperatures: Highest, 42°; lowest, 34.2°. Rainfall at Leyton, 1T6 inches. February.—Mean temperatures: Highest, 46°; lowest, 35.3°. Rainfall at Leyton, 1.27 inches. March.—Singular weather conditions were experienced during March. The winds were North.Westerly in the early days, afterwards Northerly to Easterly, and while gales were not frequent the number of winds of forces 4.7 was considerably above the average. Temperature was within moderate limits most of the time, but there was sharp frost in isolated situations on various dates. Dull weather, with a deficiency of sunshine and frequent but not heavy rain, ruled over Southern, Midland, 38 and Eastern England, the conditions improving greatly to Westward and Northward. Heavy rain fell pretty generally over the Southern half of England on the 12th. Rainfall for Leyton, 1.78 inches. April.—April opened with rather more than a week of cold North and North-East winds (reaching the force of a gale on our Southern and Eastern coasts), the midday temperatures recorded in the South of England on the 5th and 6th being in some places the lowest ever observed at so advanced a period in the season. Heavy showers of snow or sleet were experienced at about the same time in the Eastern and Southern parts of Great Britain. In the Western districts the weather was fair and less cold. After the 11th an anti.cyclone spread down from the North.Westward, and fine weather set in generally, with high day temperatures, but a continuance of frosty nights. Between the 17th and 19th the conditions were influenced by a cyclonic disturbance which extended slowly from the Atlantic, causing rain in all districts, with a gale from between South and West over a considerable portion of England and Ireland. In the closing part of the month fresh to strong Westerly and South.Westerly winds prevailed, with mild showery weather. Mean temperatures : Highest, 55.3°; lowest, 38.6°. Rainfall at Leyton, 1.38 inches. 39 May.—Similar conditions prevailed throughout the opening days of May, a gale being experienced on the English and Irish coasts between the 1st and 3rd. After the 4th a brief improvement took place, but between the 10th and 16th very unsettled conditions were occasioned by a complex barometric depression which extended over the United Kingdom from the Southward; thunderstorms, accompanied in many instances by heavy falls of rain, commencing in the South.West of England on the 10th, and afterwards extending over nearly the whole country. For the remainder of May the weather was mostly fair, warm, and dry, but thunderstorms of considerable severity occurred in many districts between the 25th and 27th, and again on the 31st. Between the 29th and 31st the thermometer rose to 80° and upwards in many parts of the United Kingdom. Mean temperatures : Highest, 68.1° ; lowest, 46.3°. Rainfall at Leyton, 1.0 inches. June.—The early part of June was mostly fine and warm, but thunderstorms occurred in the South.Western districts on the 8th. After a spell of cool Northerly winds between the 12th and 14th, when ground frosts of destructive severity were experienced in many parts of the country, the weather became very changeable generally, the wind being mainly from the West or South.West, and often strong in force. Heavy rain fell in the West of Scotland 40 on the 21st; and on the 23rd and 24th, when the centre of a deep barometric depression passed Northward from the South-East of England to the Norwegian coasts, a still heavier fall was experienced over the Eastern half of Great Britain, the downpour being especially severe in Northumberland and Berwickshire. In the latter half of June the thermometer was mostly below its normal level. Mean temperatures : Highest, 70.9°; lowest, 50.3°. Rainfall at Leyton, 2.51 inches. July.—July opened with a long spell of warmth and drought, most places in the Southern parts of England and Wales reporting an entire absence of rain extending over at least three weeks. In many parts of South Wales and the South. West of England no rain fell for at least 28 days. Temperature was almost continuously above the normal, the warmest spells occurring on the 7th and 8th, between the 12th and 14th, and the 21st and 22nd. On the first and second of these occasions the thermometer rose to 85° and upwards in many parts of England, the readings on the 8th being as high as 90° at a few of the Southern stations, and as high as 91° at Wilton, Salisbury. On the 21st and 22nd shade readings above 90° were recorded in several parts of the Midland and South.Eastern counties, the thermometer rising to 96° at Greenwich and to 97° at Epsom. 41 After the 24th of the month the weather became less settled, and on the 25th, 28th, and 29th severe thunder. stc ms occurred in many parts of the country. On the last.mentioned date a sudden squall of wind, of a tornadolike character, travelled rapidly from West to East across the Southern parts of Wales and England. Great heat was again experienced about this time, the thermometer on the 29th exceeding 90° in several parts of England and Wales, and touching 93° at Bath, Rugby, Epsom, and Matfield (Kent). Mean temperatures: Highest, 81.1°; lowest, 55°. Rainfall at Leyton, .32 inch. August.—At the beginning of August heavy falls of rain occurred in some parts of Wales and the West of England, but in our Southern and Eastern counties a renewal of fine dry weather was experienced, many places reporting an absence of rain lasting at least for 18 days. Temperature remained considerably above the average, and on the 9th the thermometer over England rose to a higher level than at any previous time on record. At a large number of stations the shade maxima exceeded 95°, and at the Royal Observatory, Greenwich, the thermometer touched 100°, the reading being 3° higher than the previous maximum registered since the establishment of regular meteorological observations in 1841. Four 42 days later, on the 13th, shade readings slightly above 90° were again observed in a few isolated parts of the country. In the latter half of the month the conditions became less settled,, with thunderstorms and heavy rains, in many places on the 20th and 21st, and again on the 30th. Most districts experienced very long intervals of fine, bright weather, but in the closing week the air was much cooler than in the earlier part of the month. Mean temperatures: Highest, 81.1° ; lowest, 57°. Rainfall at Leyton, .43 inch. September.—The early days of September were marked by a renewal of high temperatures. On the 2nd the thermometer over our Eastern, Midland, and South.Eastern Counties again rose above 85°, a maximum of 90° being recorded at Camden Square and at Cromer and Hillington, and a reading of 91° at East Ham. Still higher values were recorded on the 8th, when a shade maxima of 90° and upwards were observed over a wide area, and a reading of 94° at Greenwich, Isleworth, and Raunds (Northampton). Thunderstorms occurred on the same day in several parts of England, and more generally on the 11th and 12th, the latter day being further marked by a very heavy fall of rain in Wales and the North.West of England. 43 After the middle of September no shade temperature appreciably above 70° was recorded in any part of the United Kingdom, and although the weather was often fine and sunny, the general conditions were showery and unsettled, with occasional frost at night. Quite at the close of the month a gale blew from the Northward or North.Westward in the rear of a cyclonic disturbance which passed across North Britain, the storm being of unusual severity on our East and South.East Coasts, and in fact over the entire North Sea area. Mean temperatures : Highest, 72.1° ; lowest, 47.9°. Rainfall at Leyton, 1.26 inch. « October.—October commenced with a short spell of cold Northerly winds, blowing on the 1st with the force of a strong gale on our Eastern and South.Eastern Coasts. After the 4th a long spell of dry anti.cyclonic weather set in, light variable winds being experienced, with fairly high temperatures, and with occasional night fogs over the inland districts. At many places in the West and North no rain was experienced for 12 or more consecutive days, but in the South.East of England heavy falls occurred on the 4th, the 7th, and the 13th. After the 19th the weather was influenced by cyclonic disturbances which arrived in quick succession from the Atlantic, and was consequently mild, stormy, and wet, the only frost of any consequence occurring on the night of the 28th. 44 The gales of the 21st.22nd, 26th.27th, and 29th.31st were of considerable strength, and the rain.storms of the 24th and 29th were also heavy, the whole of England and Wales being affected on the former date, and nearly all parts of the United Kingdom on the latter. Mean temperatures : Highest, 57.4° ; lowest, 43.9°. Rainfall at Leyton, 2.92 inches. November.—November was generally rough and unsettled, but in the intervals between the departure and arrival of the numerous cyclonic systems which came in from the Atlantic the weather was often brilliantly fine, and, as a result, the total duration of sunshine for the month was nearly everywhere in excess of the average. Until about the 18th the prevailing winds wer£ from the South.West or West, often blowing with the force of a gale; between the 3rd and 7th, and more especially on the 5th, the storms were in many places of considerable violence. During the presence of this strong equatorial current the thermometer was almost continuously above the average, the only night frost of any consequence being observed on the 11th. Rain fell daily in all districts, very heavily on the 11th over the entire Southern half of England. After the 18th a gradual but complete reversal took place in the distribution of pressure, the barometer becoming highest to the Northward, and lowest to the Southward, of the United Kingdom. 45 With this change the wind shifted to the Northward and afterwards to the Eastward, and the weather became much colder and drier, with occasional showers of hail, sleet or snow in the Northern and Eastern districts. Mean temperatures : Highest, 49.2° ; lowest, 38.4°. Rainfall at Leyton, 3.12 inches. December.—In December the conditions were affected by an almost constant succession of cyclonic systems which spread in from the Atlantic, the centres of the various disturbances passing, as a rule, North.Eastwards between Scotland and Iceland. The prevailing winds were therefore from between South and West, often blowing with the force of a gale, but seldom with as much violence as in the early part of November. Temperature was, as a rule, well above the average, and severe frost was entirely absent, the coldest weather occurring on the nights of the 6th.8th, or on those of the 22nd or 23rd. The most striking feature of the weather of December was the frequency of heavy rains, more especially over the Western and Southern portions of the country. At most places situated in the Southern parts both of England and Wales the total fall for the month was considerably more than twice as much as the average, 46 and in some localities it was more than three times as much; Wilton, near Salisbury, reporting a total amounting to more than three and a half times the average. At many Southern stations the month was the wettest December noted in records extending back for 40 or 50 years, and at Ross, Herefordshire, for as many as 94 years. Mean temperatures : Highest, 48.6° ; lowest, 39.7°. Rainfall at Leyton, 3.68 inches. 47 NOTES ON SANITARY WORK, AND MATTERS INCIDENTAL THERETO. SEWERAGE AND DRAINAGE. In the following roads during the year 1911 the Sewers have been wholly or partly reconstructed :— Hainault Road. Vicarage Road. Old 12 in. pipes taken up for a distance of 200 yards and replaced by 9 in. pipes. Numerous house drains have been relaid, for particulars of which see Sanitary Inspector's Report. SEWAGE DISPOSAL. The sewage works are under the superintendence of the Engineer and Surveyor, and during the year he has been making experiments with powders other than Hanson's, which has been used for many years. The experiments have been conducted with a view to economy, as Hanson's powder costs considerably more than that of other manufacturers. The tests so far go to prove the superiority of sulphurous powders; but Hanson's works having closed down, considerable difficulty has been occasioned through inability to obtain a regular supply of similar powder elsewhere. 48 There has been an increased demand on the part of farmers for our sludge, for which they are now paying 3d. per ton. 11,246 tons of sludge has thus been disposed of. POLLUTION OF RIVERS AND STREAMS IN THE DISTRICT. The Dagenham Brook, as pointed out in last year's Report, suffers considerable pollution by the sewage effluents of Leyton and Walthamstow. During the year several cesspools receiving the drainage of pigstyes wfere found to discharge their overflow into that river. The Dagenham Commissioners, with our assistance, are taking measures to cause the discontinuance of this practice. REMOVAL AND DISPOSAL OF HOUSE REFUSE. The same system as described in last year's Report has been continued, and has worked satisfactorily. Each house has its house refuse collected twice weekly. 11,246 tons of house refuse and 767 tons of pressed sludge has been burnt in the destructor. The dust carts provided by the contractor are ordinary open two.wheel carts, covered only with a tarpaulin. In the loading and during their passage through the streets of these carts an appreciable amount of dust, &c., gets blown about. It would be a great improvement if the contractor were to supply properly covered carts. OFFENSIVE TRADES. As stated last year, the only scheduled offensive trade in the district is that of a few tripe dressers. 49 It was mentioned also that application had been made to the Local Government Board for permission to add "Rag and Bone Stores" to the list, and in October I further recommended the Council to apply for permission to include the trade of "Fish Frier." The Council adopted my recommendation. SANITARY CONVENIENCES. The underground sanitary convenience at Leytonstone, alluded to in last year's Report as being under construction, was completed and opened on 16th January. We have now two of these conveniences in the district. Each one has a w.c. reserved without payment for the use of women. In last year's Report the need for more of these conveniences was pointed out, and as the result the Surveyor has been instructed to report as to the practicability of building another in the Leytonstone Road, near the end of Cann Hall Road, or failing to obtain a site there, at Harrow Green. The question of providing one in the Lea Bridge Road at the junction of this road with Markhouse Road, Walthamstow, is also being entertained. WATER SUPPLY OF THE DISTRICT. As stated in former Reports, this is obtained from the Metropolitan Water Board. It is plentiful and of satisfactory quality. The prolonged drought of the past summer, during the whole of which time we experienced no shortage of supply, is a severe test of the Board's capacity to meet our requirements even under exceptional circumstances. d 50 MILK SUPPLY. As stated in previous Reports, the bulk of the milk of the district is imported. A few cowkeepers still remain, and among these two changes have taken place during the year ; one cow. keeper who had given up keeping cows having resumed the practice, and one having given up entirely. The Food and Drugs Act being under the administration of the County, we have taken no samples to test adulteration. All dairies, cowsheds and milk.shops have been systematically supervised and a fair hygienic standard maintained. Certain leaflets and cards published by the National League for Physical Education and Improvement have been circulated among cowkeepers, dairymen, and milk.sellers. These leaflets, &c., # though the excellent advice they contain may not be complied with to the letter, have an educative effect, and bring home to milk dealers the trend of modern science. We still await the additional powers we expect to have conferred upon us by the promised Milk Act. Nothing in the condition of the cows or in the history of any milk having come to my knowledge to make me suspect tuberculous infection, no milk has been submitted to bacteriological tests. UNSOUND FOOD AND FOOD INSPECTIONS. The work of inspecting premises where food is prepared or offered for sale has been vigilantly pursued during the year. All 51 three of the Assistant Sanitary Inspectors now possess the qualification of Food Inspector granted by the' Royal Sanitary Institute ; Mr. England having passed the examination during the year. The amount and description of the unsound food condemned and destroyed will be seen by reference to the Report of the Sanitary Inspector. Most of this was voluntarily surrendered, the details of that which was seized are given below. SLAUGHTERHOUSES AND MEAT INSPECTION. There are now 17 slaughterhouses in the district, one less than last year. This one was attached to a butcher's shop in the High Road, Leyton, and both the shop and the slaughterhouse are now vacant. It was one of the old slaughterhouses with a license which was issued years ago, without any restriction as to duration. The license of a slaughterhouse being vested in the occupier and not in the premises, the opportunity of granting an annual license is always taken advantage of when a butcher's business changes hands. The hold this gives us over the conduct of the business is distinctly advantageous, and should the Council at any time see their way to establish a Municipal Abattoir, the closing of these private slaughterhouses would be a simple matter. In the early part of the year a man, who on subsequent investigation proved to. be a notorious trafficker in unsound meat of all kinds, opened a shop in Leyton. But thanks to the vigilance of our Inspectors his sojourn in Leyton was brief. He had been established little more than a week when Mr. England found exposed 52 for sale 43 pieces of beef, roughly amounting to about 3 quarters of a carcase, which he judged to be of a suspicious character and as to which he sought my advice. I found the beef in question to be very black, sticky, and of soapy consistency, giving me the idea that the animal had been insufficiently bled ; this aroused the suspicion that it had not been slaughtered, but had died of some disease or accident. I therefore seized it, and on finding that the remainder of the carcase had been disposed of in Smithfield Market I communicated with the Veterinary Inspector of that Market, who had that portion seized. I found on further enquiry that the owner of the meat was a native of Bishop Stortford, and on making enquiries there ascertained that he bore a most unenviable character, and that he had recently served a term of imprisonment for a similar offence. He disappeared from his shop immediately after our seizure, and it was some considerable time before the police were able to find him to serve a summons. At the Police Court proceedings he did not appear. The Bench inflicted a fine of £10 and costs, or in default a month's imprisonment. He was not found for many months, but on the 15th of November, 1911, he appeared at Stratford Police Court and paid the fine. He was then, on his return to Bishop Stortford, served with a summons at the instance of the City of London Authorities, and in default of paying £10 and costs went to prison for a month. .53 TUBERCULOUS MEAT. The carcases of four pigs which exhibited Tuberculous lesions have been seized during the year. In two of these cases the carcases had been purchased in Smithfield Market, and on the owners satisfying me that they had relied on the inspection in operation there, and that they had acted in good faith, I recommended the Council to forego prosecuting them. The other two pigs were bought alive at the Smithfield Club Cattle Show at Christmas time, and although in splendid condition, each of them on examination were proved to be slightly affected with Tubercle : one in the submaxillary glands only, the other also showing a few scattered lesions in the liver and spleen. In all these cases the carcases were examined by experts on behalf of the owners, who agreed with me as to the nature of the lesions. It is my practice, acting on the recommendations of the Royal Commission on Tuberculosis, 1898, to condemn the whole carcase of any pig I find to be affected by Tuberculosis in any degree. As to this practice there appears to be a great divergence of opinion throughout the country. I find in many towns, and also in Smithfield Market, that where the glands of the head and neck only are affected it is considered sufficient to seize the head and pass the rest of the carcase. I am told that in a good many places, when evidence of Tuberculosis is found in the glands of the head or neck, all the other 54 glands are examined, the carcase is split down the vertebrae, and if no further evidences are found the carcase, minus the head, is passed. The above procedure seems to be hardly sufficient. In a relatively large proportion of the animals examined in the slaughter-house the viscera, lungs, spleen, liver, &c., are found to be affected. No opportunity is afforded to examine the viscera in situ in the prepared carcase; for in such case the viscera have been removed and may be altogether absent. Also when the viscera have beer) separated from the carcase it is not always possible to determine from which particular animal the organs in question have been taken. The one satisfactory way to ensure that a carcase is fit for human food is to inspect it in the slaughterhouse, where there is opportunity of examining all the viscera before and after removal. As such examination of all carcases is impossible in private slaughterhouses, the only real remedy is to establish public abattoirs. England is much behind the Continent in this matter. Those engaged in the trade urge that the condemnation of the whole carcase of a pig for only slight Tuberculous lesions, seeing the frequency with which such lesions are found on slaughter to exist in animals which during life appear to be perfectly healthy, is paralysing the English pig trade. Many butchers, after one or two experiences of the kind mentioned above, will no longer buy any but Danish pig carcases. There is no reason to believe that the Danish pig is freer from 55 Tuberculosis than the English pig. But the carcases of Danish pigs imported to this country are certified to have been systematically examined and to have been found free of disease before shipment ; they are also liable to inspection on arrival in this country by the Officers of the several Port Sanitary Authorities. The buyer has therefore a substantial guarantee with his purchase. The English pig-keeper will not compete successfully against his foreign trade rival, while he puts, often without his knowledge, Tubercular carcases on the market. It is essential, not only for the protection of the public health but also in the interests of the pig-keeper, that the carcases of English pigs should be carefully examined before being offered for sale. If systematic attempts were made to eradicate tubercle from the herds, and if pigs were kept under better hygienic conditions and their food more carefully selected, there is no reason to doubt that Tuberculosis would be as rare as it is now common among these animals. The remedy lies in the hands of the pig-keeper. NUMBER OF CARCASES AND PARTS OF CARCASES CONDEMNED FOR TUBERCULOSIS. Carcases of six pigs. Viscera of four pigs. Fore-quarters of a bullock. Two bullocks' livers. Two bullocks' lungs. Two bullocks' hearts. 56 UNSOUND FISH. On the 15th November, in the course of some investigations I was making as to certain cases of Enteric Fever, I had occasion to call at a fried fish shop, and I took the opportunity to make an inspection of the hygienic conditions of the premises and of the fish in course of preparation for food. The result of my inspection of the latter was that I seized and had destroyed 11 st. plaice, 35 lbs. haddocks, and 20 lbs. hake, which I considered to be stale and unfit for human food. This seizure brought me a visit from the Chief Inspector of the Worshipful Company of Fishmongers, who maintained in effect that the fish was fit for food. The fish certainly was not actually putrid, but it was decidedly stale, and had evidently been kept a long time in ice. Unfortunately it is a matter of considerable difficulty at times to decide when fish which has been kept in ice becomes unfit for food, and consequently when it should be condemned. In my opinion too much latitude is generally allowed in this respect, and the demand for a higher standard of freshness could and would be easily met. The seizure and condemnation of fish in the state in which this was found to be does a great deal of good in raising the standard throughout the neighbourhood. This I have proved to be the case, for on ordering more frequent visits to be paid to the fish shops my Inspectors report a general all-round improvement in the quality of the fish sold. FOOD POISONING. The following is a report on certain cases of illness following the consumption of whelks:— WHELK POISONING. On 27th December I received a communication from the Police to the effect that they had been called on the previous evening to 65, Hibbert Road, on account of certain persons suspected to be suffering from symptoms of poisoning following the consumption of whelks. On visiting the house I found that a Mr. and Mrs. " S.," who resided there, had had a numerous gathering of relatives to spend the day with them. The whole family party, amounting to 27 individuals, had all partaken during the day of the same articles of food. » In the evening two or three members of the family went out. and purchased some whelks at a stall near the " Bakers' Arms." Nine members of the family partook of the whelks, and within about an hour after so doing were taken ill one after the other, with certain symptoms of illness, the most prominent features of which were giddiness and visual disturbances; also one or two of the younger affected members developed rashes. The illness was limited strictly to those who had eaten the whelks, all the others escaping. As soon as the symptoms of illness appeared the people, suspecting poisoning, sent for the police and a doctor. Emetics and purgatives, &c., were promptly administered. When I called (about 18 hours after the first signs of illness had occurred) most of those who had been affected had recovered and the others were much better; no fatality occurred. 58 t communicated with the doctor who attended the patients, but he was able to add little to the information I had already received, and although he had taken a sample of the whelks and promised, if possible, to let me have it, I failed to receive it. I was equally unfortunate in an attempt to procure a sample from Hibbert Road. I was, however, told both by the doctor and the people of Hibbert Road that there was nothing noticeably wrong with the whelks, except that they were black at the ends. On making enquiries of the proprietor of the stall it was found that he resided in East Ham. I therefore communicated with the Medical Officer of Health for that Borough, asking him to let me know as to the man's sanitary surroundings, and particularly as to the place where he stored his goods. His reply was to the effect that the goods were not stored at his home, but somewhere in the neighbourhood of the "Bakers' Arms." The place of storage proved to be a shed, which was found to be clean and in a sanitary state, so that no suspicion arose as to contamination occurring there. The proprietor of the stall said he had sold many dozens of the whelks, which he had purchased in Billingsgate Market on 26th December, and had received no other intimation of their having caused illness. He stated both he and his wife had eaten some with no ill-effects. At a subsequent interview, however, he said that he had heard that some of the same consignment had caused illness in another district. TRADE REFUSE. The question of the disposal of trade refuse was considered on the application of the Leyton Tradesmen's Association. It has been the practice in this district for the trade refuse, with the exception of greengrocery and factory refuse, to be removed in the ordinary course with the house refuse. The greengrocery and factory refuse has been removed by the proprietors of those establishments. The Association requested the Council to remove all refuse free of cost. Ultimately a compromise was arrived at, the Council agreeing to destroy all tradesmen's combustible refuse free of charge, subject to its being delivered at the Council's Destructor Works by the tradesmen not later than 10 a.m. (Saturdays and Sundays excepted), and subject to the quantity sent from any one shop not exceeding half a ton per week. CUSTOMS AND INLAND REVENUE ACT. The Customs and Inland Revenue Act of 1890, Section 26 (2), provides that landlords of houses, let in tenements at rents not exceeding seven shillings and sixpence a week for each dwelling, may be exempted from the inhabited house duty; provided a certificate of the Medical Officer of Health of the district is produced stating that " the house is so constructed as to afford suitable accommodation for each of the families or persons inhabiting it, and that due provision is made for their sanitary requirements." In accordance with the above provisions I have received applications in respect of 66 tenements. 60 The situation of these tenements and the results of the applications for certificates are shewn in the following table:— Road. No. of Tenements. Certificate Granted. Certificate not Granted. Pevensey, 69 to 77 5 5 — Pearcroft, 88, 88a, 90, 90a, 92, 92a, 94, 94a 8 8 - Harvey, 12 to 22 6 6 — Frith, 70 to 76 4 4 — Livingstone, 14, 18, 24, 26, 32, 34, 36, 40 8 8 - High Road, Leyton, 718 to 724 4 4 — Melford, 38 to 44 2 2 — Dawlish, 91 and 91a 2 2 — Cathall, 58 to 66 5 5 — Millais, 64 to 74 5 5 — Leslie, 7 and 9 2 2 — Huxley, 54 and 56 2 2 — Morley, 21 1 1 — Melford, 22 and 24 2 2 — Scotts, 5, 5a, 7, 7a, 9, 9a 6 6 — Lindley, 35 1 1 — Park Grove, 30 to 34 3 3 — 66 66 - 61 FACTORIES, WORKSHOPS, LAUNDRIES, WORKPLACES and HOMEWORK. 1.—Inspection. Including Inspections made by Sanitary Inspectors or Inspectors of Nuisances. Premises. a) Number of Inspections. (2) Written Notices. (3) Factories (Including Factory Laundries.) 11 5 Workshops (Including Workshop Laundries.) Workplaces (Other than Outworkers' premises included in Part 3 of this Report.) 411 73 Totals 422 78 2.—Defects Found. Particulars. Number of Defects. Found. Remedied. (1) (2) (3) Nuisances under the Public Health Acts :— Want of Cleanliness 70 70 Want of Ventilation 5 5 Overcrowding 16 16 Want of Drainage of floors — — Other nuisances .. 64 64 insufficient 1 1 Sanitary accommodation unsuitable or defective 31 31 L not separate for sexes 2 2 Offences under the Factory and Workshop Act:— Illegal occupation of underground bakehouse (s. 101) — Breach of special sanitary requirements for houses (ss. 97 to 100) 29 29 Other offences — - (Excluding offences relating to outwork which are included in Part 3 of this Report.) Totals 218 218 63 3.—Registered Workshops. Workshops on the Register (s. 131) at the end of the year. (1) Number. (2) Ordinary Workshops 198 Laundries 17 Bakehouses 45 Total Number of Workshops on Register 260 5.—Other Matters. Class. ID- Number (2) Matters notified to H. M. Inspector of Factories :— Failure to affix Abstract of the Factory and Workshop Act (s. 133) 41 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)— Notified by H.M. Inspector 10 Reports (of action taken) sent to H.M. Inspector 9 Other — Underground Bakehouses (s. 101):— Certificates granted during the year Nil In use at the end of the year 5 4.—Home Work. NATURE OF WORK. outworkers' lists, section 107. Notices served on Occupiers as to keeping or sending lists. Inspection of Outworkers' premises. outwork in unwholesome premises, section 108. outwork in infected premises, secs. 109, 110. Lists received from Employers. Addresses of Outworkers. Instances. Notices served. Instances. Orders made (s. 110). Twice in the year. Once in the year. Received from other Councils Forwarded to other Councils. Lists. Outworkers. Lists. Outworkers. Contractors. Workmen. Contractors. Workmen. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) Wearing Apparel— (1) Making, &c. (2) Cleaning and washing 74 — 444 12 — 28 36* 697 36* 192 68 241 † 920 278 278 5 5 Household linen — — — — — — — — — — — — — — Lace, lace curtains and nets — — — — — — 2 — — 1 — — — — Curtains and furniture hangings Furniture and upholstery — — — — — — — 4 — — — 2 — — — — Electro-plate — — — — — — — — — — — — — — File making (leaden seats) .. — — — 1 — 1 — — 1 — — — — Brass and brass articles — — — — — — — — — — — — — — 64 Fur pulling — — — — — — — — — — — — — — Cables and chains — — — — — — — — — — — — — — Anchors and grapnels — — — — — — — — — — — — — — Cart gear — — — — — — — — — — — — — — Locks, latches, and keys — — — — — — — — — — — — — — Umbrellas, &c. — — —— — — — 5 — — 7 — — — —— Artificial flowers — — — — — — 4 — — 3 — — — — Nets, other than wire nets — — — — — — Tents — — — — — — — — — — — — — — Sacks — — — — — — — — — — — — — — Racquet and tennis balls — — — — — — — — — — — — — — Paper bags and boxes — — — — — — 2 — — 3 — — — 0000Brush making — —— — — — — 30 — — 36 — — — —— Pea Picking — — — — — — — — — — — — — —— Feather sorting — — — — — — 1 — — 1 — — — —— Carding, &c., of buttons, &c. — — — — — — — — — — — — — — Stuffed toys (flags) — — — — — 5 — — 3 — — — —— Basket making —— — — — — — — — — — — — — — Totals 74 — 444 13 — 29 786 228 68 1218 278 278 5 5 * Received in error. †Incorrect addresses, work given up, or removals. 65 66 REPORT ON THE WORK OF THE TEMPORARY ISOLATION HOSPITAL FOR 1911. The present temporary Isolation Hospital, as stated in last year's report, has been in existence since 1896; it has continued to give satisfaction to the Council, to the patients, and to myself. The total number of patients treated during the year was 372, against 442 during 1910. The decrease is due to a lesser number of Scarlet Fever patients —viz., 263 against 352. The number of Diphtheria patients was slightly in excess of those treated in 1910—viz., 109 against 90. The total number of patients' days in hospital was 18,938. The total amount expended on the hospital was £3,125 10s. 3d., which gives an average cost of 3s. 3 6d. per patient per diem. The amount expended on provisions was £891 7s. 1d., which includes the cost of food for the Staff. This gives a daily average of l129d. per patient. 67 The side wards, which accommodate two patients each and of which there are five, have been fitted with gas radiators. The-:e radiators are very convenient, are easily regulated, and are found to be quite satisfactory in use. The ward kitchens have been furnished with a high dado of Emdeca sheeting, which is a great improvement on the bare wooden walls which previously existed. The administration block has suffered from an invasion of rats, and although many expedients have been adopted to get rid of them, up to now our efforts have not been crowned with success. Chiefly for this reason, I recommended the building of an entirely new rat-proof larder in which all food should be stored. It is constructed of brickwork with a tiled roof, and cost about £40. All the hospital buildings have been repainted outside. Each of the wards has been thoroughly cleansed and disinfected at least once during the year, some of them twice. STAFF. The Staff consists of a Matron, 14 Nurses, and 11 Domestic Staff. 68 This year an additional Porter has been appointed for night duty, so that we now have two Porters in addition to the part-time services of the two Ambulance men. The rules and regulations for the government of the hospital and defining the duties of each member of the Staff have been revised and amplified. STATISTICAL RETURNS. Admissions. At all Ages. Under 1 year. 1 to 5. 5 to 15 15 to 25. 25 to 65. Scarlet Fever 263 1 55 179 24 4 Diphtheria 109 1 27 73 4 4 Total 372 2 82 252 28 8 Of the 263 Scarlet Fever Cases, 110 were males, and 153 females; and of the 109 Diphtheria Cases, 52 were males, and 57 females. Scarlet Fever. Diphtheria. Under treatment at beginning of year 60 12 Under treatment at end of year 62 15 Admitted during year 263 109 Discharged during year 257 99 Died during year 4 7 Four deaths occurred from Scarlet Fever, the particulars of which are as follows :— Male, 2 years. Scarlet Fever 26 days, Measles 6 days ; in hospital 25 days. 69 Female, 6 years. Scarlet Fever 59 days, Measles 20 days, Pleuropneumonia ; in hospital 58 days. Female, 5 years. Scarlet Fever 23 days, Diphtheria 23 days, Cardiac Paralysis ; in hospital 23 days. Female 5 years. Scarlet Fever 5 days, Heart Failure ; in hospital 2 days. Seven deaths occurred from Diphtheria, the particulars of which are as follows :— Male, 10 years. Diphtheria 15 days, Cardiac Paralysis; in hospital 12 days. Male, 8 years. Diphtheria 2 months, Endocarditis 14 days; in hospital 63 days. Male, 1¾ years. Laryngeal Diphtheria, Tracheotomy 8½ hours; in hospital 9½ hours. Male, 4 years. Diphtheria 2 days; in hospital 1 day. Male, 5 years. Diphtheria, Paralysis; in hospital 44 days. Female, 11 months. Diphtheria, Broncho-Pneumonia 18 days; Laryngeal Obstruction 8 days; Tracheotomy 8 days; in hospital 10 days. Male, 5 years. Haemorrhagic Diphtheria, Laryngeal Obstruction, Heart Failure ; in hospital 30 minutes. Tracheotomy was performed nine times, and was successful in saving life in seven instances. 70 The amount of money expended on the Hospital during the year was £3,171 17s. 9d., and is divisible into the following items:- £ s. d. £ s. d. Buildings—Painting and Special Repairs 135 2 8 Heating arrangements 74 4 10 Sundry Repairs 82 13 1 292 0 7 Furniture 48 3 7 Bedding, Linen, &c. 38 1 11 Toilet Requisites 2 18 7½ Domestic Utensils 32 9 11 121 14 0½ Fuel, Light, W ater, and Cleaning 403 13 1 Provisions 891 7 1 Medicines and Surgical Appliances 81 10 7½ Removal of Patients, &c. 147 4 7 Printing, Stationery, and other Administrative Charges 85 15 0 Uniforms 53 12 8 Salaries, Wages, and Allowances 1048 12 7 1102 5 3 Contributions to other Authorities 46 7 6 £3171 17 9 Again I desire to record my best thanks to the Matron and Staff for their loyalty and devotion in carrying out their various duties. To the Matron particularly I am greatly indebted for the able manner in which she has supervised and controlled her Staff, which has resulted in the best results being obtained with a minimum of friction. 71 REPORT OF SANITARY INSPECTOR. TO THE CHAIRMAN AND MEMBERS OF THE LEYTON URBAN DISTRICT COUNCIL. Gentlemen,— I present to you my Twenty-first Annual Report, for the year ending December 31st, 1911, giving full particulars of the work carried out in the Sanitary Department. INFECTIOUS DISEASE. The number of cases of Infectious Diseases notified during that period was 983, as compared with 912 last year. These 983 cases occurred in 646 houses. Under the superintendence and direction of the Medical Officer of Health the infected houses have been visited ; instructions given as to isolation of the infectious sick ; and where such cases have been treated at their homes, subsequent visits have been made to see that our instructions have been carried out. In investigating the probable source of infection, inquiries have been made concerning milk supply, schools attended, the nature of employment of the inmates, and also whether any public books, &c., are on the premises. Necessary steps have been taken in connection with the above matters to prevent the spread of disease. 72 The occupiers of infected houses are cautioned as to sending infected clothing to laundries, and against taking into the house milk cans belonging to milk vendors. On the convalescence or removal to hospital of the sufferers the premises and bedding, &c., are disinfected under out supervision ; the sanitary arrangements and drains are also inspected ; and notices have been served to carry out the necessary work and to remedy defects, dilapidations, or uncleanly conditions found to exist. The work of ascertaining that the requirements of these notices are complied with entails several visits to each house and considerable correspondence. Appended is a summary of the work in connection therewith :— Houses infected and disinfected 646 Houses inspected and the sanitary arrangements examined and tested 646 Loads of infected bedding removed to be disinfected at the Council's Steam Disinfector and returned 608 Books belonging to Public Institutions disinfected 100 No. of articles of wearing apparel disinfected 114 Brushes disinfected 48 Quantities of bedding from the Public Institutions have been removed and disinfected at the Steam Disinfector. Disinfectants are supplied in cases of Infectious Disease, and can be obtained at the Town Hall at any time during office hours. 73 INSPECTION OF THE DISTRICT AND ABATEMENT OF NUISANCES. In investigating complaints received and under the scheme of House to House Inspection, 3,923 houses have been inspected. This has necessitated 8,791 re-visits in order to ascertain if the insanitary conditions found to exist at the first visit have been remedied and that the structural work (often necessary) was being efficiently carried out. Houses inspected 4217 Houses re-inspected 8791 Connections of drains tested 3715 Notices served 4374 Complaints received 395 Defective drains remedied 381 W.C.s in defective state, new traps and straight- backed pans provided where necessary 404 Sink, bath and lavatory wastes, and rain pipes made to discharge in open air over trapped gullies 192 Defective gullies replaced, and defective connections of gullies remedied 510 New sink and bath waste pipes provided and repaired 168 New salt-glazed stoneware sinks provided. 128 Bath, waste and lavatory sink pipes trapped 34 Ventilating shafts repaired, or provided to soil pipes and drains 133 Defective soil pipes remedied, &c. 4 74 Flush cisterns supplied to w.C.s with efficient flush pipes 35 Flush cisterns and flush pipes repaired 341 Yards paved around back additions of houses and forecourts paved or repaired 417 Yards cleansed 26 New manhole covers provided and sealed 22 Manholes rendered and repaired 17 Ventilation provided under flooring 364 Floors of sculleries paved and repaired, and cellar floors concreted 66 House roofs and guttering repaired and renewed 313 Houses in a general insanitary, dilapidated, or filthy condition, repaired and cleansed 1398 Walls of back additions properly rendered 73 Nuisances abated arising from stagnant water in basements of houses 19 Air inlets provided to drains and repaired 82 Drains in cellars removed 4 Stables paved and drained 8 Mews in filthy condition paved, drained and cleansed 3 Manure receptacles provided 8 Houses entirely redrained with intercepting syphons and manholes provided between the house drains and sewer, and with efficient air inlets and outlets 75 Water supplies to houses restored and water fittings repaired 59 Covers to domestic water cisterns provided 152 75 Domestic water cisterns removed from improper position, or cleansed or repaired 65 Nuisances by overcrowding abated 11 Nuisances caused by fish, offal, manure, and other refuse deposits abated 163 Nuisances caused by animals kept in an insanitary state abated 42 Books disinfected 100 Smoke nuisances abated 6 Plots of land fenced in 1 Urinals repaired 10 DRAINAGE AND SEWERAGE. The drainage of 75 houses has been reconstructed. In many cases the drains formed portions of combined systems of drainage, and in such instances the work has been done by the Council's workmen and the expenses incurred have been recovered from the owners. Daring the year 23 ventilating shafts were provided to the public sewers. PREMISES INSPECTED IN CONNECTION WITH FOOD SUPPLY. Slaughter-houses Milkshops Cowsheds Dairies, &c. Other trades 2544 76 WORKS CARRIED OUT AS A RESULT OF THE INSPECTIONS. Cowsheds, Dairies, and Milkshops. Cleansed 32 Paving repaired 5 Flush cisterns repaired 1 Ventilating shaft repaired 1 Fish Shops. Cleansed.. 8 Paving repaired 5 Roof repaired 1 Accumulations of refuse removed 3 Bakehouses. Cleansed 30 Flush cistern repaired 1 New ventilating shaft provided 1 Accumulation of refuse removed 1 Dining Rooms. Cleansed.. 14 Drains cleared 2 New w.c. trap provided 1 Paving repaired 1 Flush cistern repaired 1 Lid to cistern provided 1 Cement work around gullies repaired 3 77 Slaughter-houses and Butchers' Shops. Cleansed 18 Paving repaired 2 Receptacle provided for offal 1 New ventilating shaft provided 1 Accumulation of refuse removed 1 Greengrocers. Flush cistern repaired 3 Accumulations of refuse removed 12 Ice Cream Shops. Cleansed 7 New w.c. trap provided 1 Guttering repaired 1 Flush cisterns repaired 5 Tops to gullies provided 6 Accumulations of refuse removed 4 DAIRIES, COWSHEDS, AND MILKSHOPS. The number of milkshops, &c., on the register for the year ending December 31st, 1911, is 169. Several new milkshops were opened during the year and registered under the order. In a number of instances the businesses were discontinued, the premises being no longer used as milkshops. It is now the custom in the case of general shops and premises which are unsuitable for the storage and sale of milk to refuse registration. 78 There are at present 8 cowsheds in use in the district; these together with the milkshops are visited periodically, special attention being given to the cleanliness of the premises and general sanitary conditions. The following is a list of the Cowkeepers, Dairymen, and Milksellers in the district Cowkeepers. White, J., 14, Capworth Street, Leyton. Barber, J., 120, Harrow Road, Leytonstone. Abbott Bros., Hainault Road, Leytonstone. Frost, Wm., 155, Ashville Road, Leytonstone. Reader, J. W., 218, Francis Road, Leyton. Sister Deborah, Home of Good Shepherd, Leytonstone. Chambers, J. T., 74, Cecil Road, Leytonstone. Horning, E. J., Old Manor Farm, Capworth Street, Leyton. Dairymen. Abbott Bros., Hainault Road, Leytonstone. Abbott Bros., 1, Colworth Road, Leytonstone. Adams, E. J., 305, Church Road, Leyton. Barber, J., 120, Harrow Road, Leytonstone. Barker, H. T., 384, Lea Bridge Road, Leyton. Brazier, R., 64, Crownfield Road, Leytonstone. Bardsley, J. T., 4a, Grange Park Road, Leyton. Brown, W., 112, Stewart Road, Leyton. Blake, G. L., 113, Vicarage Road, Leyton. 79 Chamber, J., 74, Cecil Road, Leytonstone. Claxton, W., Oliver Road, Leyton. Cowell, W., 71, Crownfield Road, Leytonstone. Collins, W., 733, High Road, Leytonstone. Deborah, Sister, Home of Good Shepherd, Davies Lane, Leytonstone. Davies, D. A., 315, Lea Bridge Road, Leyton. Downer, H., 37, Chester Street, Leytonstone. Deathe & Sons, 318, Lea Bridge Road, Leyton. Ettell, C. J., 28, Ruckholt Road, Leyton. Frost, W. H., 155, Ashville Road, Leytonstone. Fail, E., 32, Church Lane, Leytonstone. Farmers and Cleveland Dairies Co., Ltd., 128, Leytonstone Road. Hall, J., 336, High Road, Leytonstone. Horning, E. J., Old Manor Farm, Capworth Street, Leyton. Harris, J. H., 3, Chester Street, Leytonstone. Hickford, F. H., 59, Morley Road, Leyton. Hughes, —, 37, Park Road, Leyton. Jones, J., 234, Odessa Road, Leytonstone. Jones, W. W., 525, High Road, Leytonstone. Laver, J., 637, Lea Bridge Road, Leyton. Lawton, F. F., 374, Grove Green Road, Leytonstone. Moreton, T., 1, Matlock Parade, Hoe Street, Leyton. Marston, G., 732, High Road, Leyton. Morris, A. F., 312, Cann Hall Road, Leytonstone. Nicholls, W., 37, Cobden Road, Leytonstone. Pring, H. J., 216, High Road, Leyton. Reader, J. W., 218, Francis Road, Leyton. 80 Sheepwash, A. J., 24, St. Patrick's Terrace, Union Road, Leytonstone. Smith, C. H., 350, High Road, Leyton. Smith, C. H., 91, Farmer Road, Leyton. Smythe, J. P., 684, High Road, Leytonstone. Stratford Co-operative Society, 141, Cann Hall Road, Leytonstone. Stratford Co-operative Society, 378, High Road, Leyton. Snewin, F. W., 331, Lea Bridge Road, Leyton. Tyler Bros., Blenheim Road, Leytonstone. Thomas, T. A., 20, The Parade, Grove Green Road, Leytonstone. Turner, A. E., 460, Lea Bridge Road, Leyton. Willson, F., 269, Markhouse Road, Leyton. Wish, J. F., 44, Harvey Road, Leytonstone. White, J., 14, Capworth Street, Leyton. Wright, R., 460, High Road, Leyton. Vaughan, E., 9, Leigh Road, Leyton. Milksellers. Allen, G., 3, Esther Road, Leytonstone. Allen, C. H., 86, Union Road, Leytonstone. Appling, E. M. L., 55, Boundary Road, Leyton. Brady, E., 1, West Street, Leytonstone. Baker, G., 24, Wadley Road, Leytonstone. Blundell, M., 123, Newport Road, Leyton. Bone, E., 70, Southwell Grove Road, Leytonstone. Bryon, W., 168, Albert Road, Leyton. Barber, C., 100, Harrow Road, Leytonstone. 81 Bayles, D. J., 17, Trinity Street, Leytonstone. Beale, T., 32, Wragby Road, Leytonstone. Burwood, B., 291, Murchison Road, Leyton. Bannister, R., 2, Oakdale Road, Leytonstone. Barnard, E., 309, High Road, Leytonstone. Bale, R., 353, High Road, Leytonstone. Callam, F., 128, Ashville Road, Leytonstone. Collins, T. J., 107, Belmont Park Road, Leyton. Carrott, A., 57, Stewart Road, Leyton. Coffin, A., 221, Cann Hall Road, Leytonstone. Clark, C. W., 585, High Road, Leytonstone. Crowe, E., 40, Holloway Road, Leytonstone. Clarke, H., 136, High Road, Leyton. Claydon, G., 338, Lea Bridge Road, Leyton. Collier, F. W., 64, Norman Road, Leytonstone. Daly, C., 114, High Road, Leyton. Drabble, J. W., 13, Park Grove Road, Leytonstone. Daniel, G. C., 228, Cann Hall Road, Leytonstone. Durrant, T. C., 62, Ashville Road, Leytonstone. Dalrymple, P., 12, Manby Road, Leyton. Edwards, A. G., 256, Odessa Road, Leytonstone. Eldridge, W., 2, Trumpington Road, Leytonstone. Endersley, W., 19, Sansom Road,- Leytonstone. Fairman, A., 24, Percy Street, Leytonstone. Franklin, J. L., 31, Wadley Road, Leytonstone. Finch, E. W., 131, Cathall Road, Leytonstone. Frost, H., 312, Cann Hall Road, Leytonstone. Gomm, W., 125, Cathall Road, Leytonstone. Glydne, H., 6, Cathall Road, Leytonstone. F 82 Godfrey, A., 32, Lincoln Street, Leytonstone. Gambiragio, L., 754, High Road, Leytonstone. Gould, S. J., 70, Woodhouse Road, Leytonstone. Gray, R., 7, West Street, Leytonstone. Gaston, F., 224, Ramsay Road, Leytonstone. Glover, W. H., 36, Borthwick Road, Leytonstone. Hitchin, F., 1, Skeltons Lane, Leyton. Horner, A., 64, Granleigh Road, Leytonstone. Haust, F., 579, Lea Bridge Road, Leyton. Hawkes, E. W., 150, High Road, Leyton. Hawley, G., 78, Scotts Road, Leyton. Hammond, J., 90, Pevensey Road, Leytonstone. Howard, H., 87, Beaumont Road, Leyton. Heath, E. J., 115, Downsell Road, Leyton. Howard, C., 32, Dunmow Road North, Leytonstone. Hayhow, W., 24, Carlisle Road, Leyton. Hocking, J., 255, Ramsay Road, Leytonstone. Hardy, F., 78, Ruckholt Road, Leyton. Hook, F., 20, Crownfield Road, Leytonstone. Howes, A., 67, Dawlish Road, Leyton. Hopkins, J. M., 192, Dames Road, Leytonstone. Hall, A. E., 14, Holloway Road, Leytonstone. Jones, C. W., 20, Beaumont Road, Leyton. Jones, A., 107, Granleigh Road, Leytonstone. Johnson, M., 74, High Road, Leyton. James, M., 260, High Road, Leytonstone. Kirk, M., 45, Grange Road, Leyton. Kirby, J., 78, Cobden Road, Leytonstone. King, G., 136, High Road, Leyton. 83 Long, G., 10, Cheneys Road, Leytonstone. Ladd, R. W., 2, Gladstone Street, Leytonstone. McPherson, J. H., 90, Vansittart Road, Leytonstone. Morris, J., 867, High Road, Leytonstone. Merder, A. E., 599, High Road, Leytonstone. Mullett, S., 33, Ellingham Road, Leytonstone. Matthews, L., 181, Beaumont Road, Leyton. Miles, W. L., 48, James Lane, Leytonstone. Norris, T., 100, Selby Road, Leytonstone. Oxford, W. E., 203, Newport Road, Leyton. Peirce, H. M., 23, Trinity Street, Leytonstone. Prior, W., 40, Beaumont Road, Leyton. Pegg, M. A., .10, Millais Road, Leyton. Parr, J., 121, Thorpe Road, Leytonstone. Parker, J., 19, Jesse Road, Leyton. Purdy, M. A., 142, Dawlish Road, Leyton. Robertson, F., 92, Leyton High Road, Robbins, S., 125, Francis Road, Leyton. Reeves, G., 171, Capworth Street, Leyton. Radford, H., 47, Forest Road, Leytonstone. Rivell, G. W., 136, Vicarage Road, Leyton. Rollings, C., 213, Francis Road, Leyton. Richardson, J. W., 71, Claude Road, Leyton. Shiers, A., 35, Boundary Road, Leyton. Sewell, G., 249, Cann Hall Road, Leytonstone. Stephens, J., 664, High Road, Leyton. Smith, J., 122, Napier Road, Leytonstone. Stoner, A., 11, King Street, Leyton. Stiff, H., 55, Harrow Road, Leytonstone. 84 Slow, J., 57, Boundary Road, Leyton. Stains, E., 228, Francis Road, Leyton. Southgate, M. A., 802, High Road, Leyton. Scott, W., 42, Park Road, Leyton. Shonk, S., 2, Cary Road, Leytonstone. Scott, W., 46, Mayville Road, Leytonstone. Seabrooke, W. E., 20, Holloway Road, Leytonstone. Vant, R. L., 54, Manby Road, Leyton. Weber, C. F., 108, Grove Green Road, Leytonstone. Warren, S., 5, Etloe Terrace, Church Road, Leyton. Wolpert, A., 499, High Road, Leytonstone. Woolcock, R., 38, Victoria Road, Leytonstone. Williams, W., 7, Crownfield Road, Leytonstone. Ward, C. H., 33, Dunmow Road North, Leytonstone. Woodham, F. S., 648, High Road, Leyton. Williams, A., 134, High Road, Leyton. Wright, S., 150, Union Road, Leytonstone. Waters, F., 444, High Road, Leytonstone. Weber, M. H., 121, Park Road, Leyton. Walkling, E. C., 463, High Road, Leytonstone. Whent, H., 675, High Road, Leytonstone. Woolward, A. C., 9, Temple Street, Leytonstone. SLAUGHTER-HOUSES. The Slaughter-houses are visited several times every week, and at any time when it is known that slaughtering is being carried on. We find that generally they are kept in a satisfactory condition. 85 Keepers of Slaughter-houses. Norwood, A. & Son, 650, High Road, Leytonstone. Blumenstock, C., 249, High Road, Leytonstone. Cole, A., 412, High Road, Leytonstone. Nichols, A. A., 710, High Road, Leytonstone. Woollard, T. F., 728, High Road, Leytonstone. Harmer, C. & Sons, 168, High Road, Leytonstone. Rumbal, J. H., 615, High Road, Leyton. Seagrave, W., 442, High Road, Leyton. Measures, J., 807, High Road, Leyton. Smith, A. J., 48, Lansdowne Road, Leytonstone. Tolchard, W. D., 55, Hainault Road, Leytonstone. Abbott, E., Hainault Road, Leytonstone. Simonds, T., Ive Farm, Church Road, Leyton. Frost, S., 155, Ashville Road, Leytonstone. Gatrill, C. F., 177, Francis Road, Leyton. Wright, G., 540, Lea Bridge Road, Leyton. Smith, G., 467, High Road, Leystonstone. UNSOUND FOOD. In connection with the inspection of Shops, Stalls, and Slaughter-houses, a quantity of food was found diseased and unfit for the food of man. Accordingly it was destroyed. It consisted of 6 Pig Carcases. 2 pads of Haddocks. 1 Carcase of Calf. 1 box of Whiting. Portion of Carcase of Cow. 1 box of Mackerel. Forequarters of Bullock. 1 barrel of Mackerel. 86 9 joints of Mutton. 180 pairs of Kippers. 36 Ox Tails. 128 lb. of Cod Fish. 4 lb. of Beef. 11 stone of Plaice. 4 pairs of Lungs. 20 lb. of Hake. 35 Sheeps' Livers. 1 box of Bloaters. 11 Bullocks' Livers. 4 bags of Brussel Sprouts. 3 Lambs' Livers. BAKEHOUSES. The Bakehouses in the district have been frequently visited during the year. The majority are kept in a very satisfactory condition ; where necessary, notices have been served as regards uncleanly or other insanitary conditions. DINING ROOMS. The inspection of the Dining Rooms in the district has been periodically carried out. Notices were served where uncleanly or insanitary arrangements existed. Particular attention has been paid to the food supplied. FACTORY AND WORKSHOP ACT, 1901. Factories.—Factories include all places in which mechanical power is used in the aid of manufacturing processes, and the duties of Sanitary Authorities with regard to them are limited chiefly to securing provision of means of escape in case of fire and of sufficient sanitary conveniences. 87 Eleven factories were visited during 1911. Workshops.—At the beginning of 1911 the number of workshops on the Register was 241, and at the end of the year the number was 260. The registered workshops are grouped as follows :— Making, &c., of wearing apparel 172 Bakehouses 45 Laundries 17 Sheet metal and wire works 5 Wood chopping 4 Brushmaking 2 Dyers 3 and one of each of the following:— Fancy Leather Goods. Cabinet making. Rag sorting. Printing. Cork cutting. Artificial Stone. Wheelwright. Fancy Goods. Polishes. Scales. Motor Garage. Ether Spray. 88 411 inspections were made during 1911. Defects numbering 218 were found in the factories and workshops, and were dealt with and remedied. H.M. Inspector of Factories was notified of 41 instances where the occupier of a workshop had failed to affix an Abstract of the Factory and Workshop Act in pursuance of Section 133 of this Act. OUTWORKERS. This term applies to persons who are employed at certain classes of work in their own homes; under the Factory and Workshop Act powers are given to Sanitary Authorities for controlling the conditions under which the work is done, chiefly with the aim of preventing work being done under uncleanly or insanitary conditions and on premises where there is dangerous infectious disease. • A Register is kept of the homes of the outworkers, and they are regularly inspected, and any insanitary conditions found are remedied. During 1911 the names of 786 outworkers were received from other Councils. 87 lists, containing the names of 473 outworkers, were sent in by employers residing in our district, and 228 of these were drafted on to the various Councils. 89 977 inspections of the outworkers' homes were made ; and in addition 241 visits were paid to addresses returned on the lists, but it was found on calling at the houses that the work had been given up or that the occupiers had removed. The removals were in most instances traced. In 278 instances it was found necessary to serve notices with regard to uncleanly or insanitary conditions. Infectious diseases occurred in five of the outworkers' homes. Necessary precautions were taken to prevent the spread of infection. MORTUARY. During the year the number of bodies leceived was 96. There were 32 post-mortems and 96 inquests held. PETROLEUM. Twenty-two licenses were issued after inspection as to the suitability of the premises. DUST COLLECTION. 20,582 tons of house refuse, comprising 18,386 loads, were removed in 1911 to the Destructor. During the year the dust collection has been carried out in a satisfactory manner, and although the population has increased, the cost for removal has been reduced. G 90 This reduction is due to a readjustment of the arrangements which had previously been in force. Very few complaints as to collection were received. The amount expended from January 1st to December 31st, 1910, was £2,468 3s. 9d., and from January 1st to December 31st, 1911, £2,392 17s. 2d., thus showing a saving of £75 6s. 7d. for the past year. I am, Gentlemen, Your obedient Servant, H. MILLER. Leyton Urban District Council. ANNUAL REPORT TO THE EDUCATION COMMITTEE, EMBODYING THE FOURTH ANNUAL REPORT on the Batch9-126Under the Education (Administrative Provisions) Act of 1907, For the Year 1911. by J. FRANCIS TAYLOR, M.R.C.S., D.PH., Medical Officer to the Education Committee and Medical Officer of Health. LONDON: Waterlow Bros. & Layton, Limited, 24 & 25, Birchin Lane, E.C. H 95 Leyton Urben District Council Members & Officials of Education Committee. Chairman : Mr. Councillor SLADE, J.P., E.C.C. Mr. Councillor COX. Mr. Councillor DRURY-FREEMAN. Mr. Councillor GUY. Mr. Councillor HALL. Mr. Councillor HEATHER. Mr. Councillor HURRY, J.P. Mr. Councillor MATTHEWS. Mr. Councillor MITCHELL. Alderman MUSGRAVE, J.P., E.C.C. Mr. Councillor PITTAM. Mr. Councillor D. M. SMITH. Mr. Councillor TRUMBLE, J.P., E.C.C. Mr. Councillor WALLER, J.P., E.C.C. Mrs. HEATHER. R. W. PUDDICOMBE, Esq. 1 Co-opted Mrs. WALKER. J. WEBB, Esq. J Members. R. VINCENT, Clerk and Solicitor. W. JACQUES, A.R.I.B.A., Architect. T. TILEY, Organising Inspector. Clerks. A. W. BAKER. H. P. TONGUE. W. H. EDWARDS. L. J. HOWLETT. Attendance Officers. S. A. LASH, Superintendent. A. CHAPMAN. C. J. BAKER. B. OXBROUGH. J. SIMMONS. A. D. SHARP. A. W. HUGHES. H. G. ELLIS. EDITH HOLLAND, School Nurse. DAVID C. KIRKHOPE, M.D.Glasg., D.P.H., Assistant Medical Officer. JOHN FRANCIS TAYLOR, M.R.C.S.Eng., D.P.H., (Medical Officer of Health), School Medical Officer. 97 TO THE CHAIRMAN AND MEMBERS of the LEYTON EDUCATION COMMITTEE. Mr. Chairman, Ladies and Gentlemen, I have the honour to submit my Fourth Annual Report as your School Medical Officer. It is pleasing to be able to state that Dr. Kirkhope reports an all-round general improvement in the standard of cleanliness among the scholars attending the Schools. Ringworm also shows a satisfactory decrease. The Chief Medical Officer of the Board of Education having intimated in his Annual Report that the Board will look for a section in the Report of each School Medical Officer dealing with the working of the Provision of Meals Act in areas where that Act has been adopted, I have referred to this matter, and have given my views on the problem so far as it concerns Leyton. It is satisfactory to be able to report that an appreciable number of parents have found the means to remedy the defects in 98 their children found in the course of Medical Inspection. A large number of children, especially those who suffered from such disabilities as Adenoids and Defective Sight, have obtained treatment at various hospitals. How far the Insurance Act, when it comes into operation, will affect the hospital treatment of school children remains to be seen. I desire, in conclusion, to express my appreciation of the courtesy and consideration I have always experienced at your hands, Ladies and Gentlemen, and also of the co-operation and help extended to me by the Teachers, Attendance and other Officers of the Education Committee. I am, Mr. Chairman, Ladies and Gentlemen, Your obedient Servant, J. FRANCIS TAYLOR. The number of children on the books attending the Council's Elementary Schools in December, 1911, was 20,800; in 1910 it was 20,337 ; in 1909 it was 20,282 ; and in 1908 it was 20,133. 5,166 were medically inspected under section 13 of the Education (Administrative Provisions) Act, 1907. 1,387 of these were " Entrants." 2,329 ,, ,, " Leavers." 1,358 ,, ,, between the ages of 7 and 8 years ; and 92 ,, ,, " Special" cases. The number of those children whose parents objected to their being medically examined and the schools to which they belonged are as follows:—Newport Road, 41; Goodall Road, 29 ; Norlington 90 Road, 10; Ruckholt Road, 8; Davies Lane, 7; St. Joseph's (R.C.), 7; Capworth Street, 6; Farmer Road, 6; Cann Hall Road, 6; Kirkdale Road, 5; Trumpington Road, 6; Sybourn Street, 4; Mayville Road, 2; Church Road, 2; Cobbold Road, 1. Total, 140. Although the teachers took strong exception to the suggestion contained in last year's report that their personal influence might affect the number of objectors, I cannot refrain from pointing out that the two schools which furnished the highest numbers of this class head the list again this year, viz., Newport Road and Goodall Road. With the exception of these two schools the number of those objecting to medical examination is exceedingly few. Throughout the year, as formerly, notices have been sent to the parents advising them of the date and time their children were to be inspected and inviting their attendance. The percentages of children in each class who were attended by their parents works out as follows :—" Entrants," 85 per cent.; " Leavers," 66 per cent.; and those between 7 and 8 years of age, 81-5 per cent. As in former years, all the examinations have taken place at the schools, and no serious interference with school work has been reported. The methods adopted have been similar to those outlined in previous reports; any deviation from these is recorded under its appropriate heading. 100 CHILDREN ENTERING SCHOOL FOR THE FIRST TIME.." ENTRANTS." Total, 1,387 Boys, 695; Girls, 692. Boys : 5 to 6 years of age, number examined 534 695 1387 „ 6to 7 „ 161 Girls: 5 to 6 „ „ „ 516 692 6 to 7 „ „ „ 166 Average Age Children in Family. culosis in Family Measles. Whooping Cough. Chicken Pox. Scarlet Fever. Diphtheria. Boys 56 5 6/12 4.0 22 414 266 189 37 13 „ 6.7 6 * 4.3 12 118 78 61 13 8 Girls 5.6 5 6/12 4.2 24 428 281 227 39 6 „ 6.7 6 4/12 3.7 7 130 89 66 13 3 In addition to the above, the past history of the following illnesses and operations occurred with the noted frequency:— Boys.—Operation for Rupture, 4; Operation for Tonsils and Adenoids, 36; Operation for Peritonitis, 1; Operation for Tubercular Glands, 2; Mastoid Operation, 1; Circumcision, 12; Ringworm, 5; Mumps, 9; Pleurisy and Pneumonia, 24; Enteric Fever, 1; German Measles, 1; Eczema, 4; Meningitis, 2; Fits, 2; Tubercular Bone. 1; Spinal Curvature, 2; " Consumption of Bowels," 1; Tubercular Peritonitis, 1; Tubercular Meningitis, 1; Rickets, 1; Tonsillitis, 5. 101 Girls.—Operation for Tonsils and Adenoids, 36; Mastoid Operation, 1; Operation for Intussusception, 2; Pleurisy and Pneumonia, 20; Ringworm, 9; Erysipelas, 1; Mumps, 8; German Measles, 6; Post-Diphtheritic Paralysis, 1; Post-Scarlatinal Nephritis, 2; Eczema, 3; Hipjoint Disease, 2; Tonsillitis, 8; Rickets, 4; Fits, 2; Tubercular Glands, 3; Meningitis, 1; Jaundice, 1. VACCINATION. Age 5-6. Age 6-7. Boys. Girls. Boys. Girls. 4 or more marks 254 256 59 71 3 marks 48 59 14 19 2 „ 70 66 21 19 1 mark 44 38 20 11 0 „ 118 107 47 46 CLOTHING AND FOOTGEAR. Age 5-6. Age 6-7. Boys. Girls. Boys. Girls. Good 502 497 145 160 Indifferent 15 12 4 4 Bad 17 17 12 2 In only two bad cases, and these occurring amongst girls, was the clothing objected to on the score of marked uncleanness. The other cases of indifference or poorness of clothing depended upon insufficiency or disrepair. 102 HEIGHT AND WEIGHT. Average Height in inches. Average Weight in pounds. Metric Scale. c.m. Kilos. Boys: age 5-6 40.6 34.3 103.2 15.56 Girls: „ 5-6 40.75 37.2 103.43 16.88 Boys: „ 6-7 42.6 40.5 108.24 18.37 Girls: „ 6-7 42.7 39.9 108.51 18.12 The extremes in point of height amongst the 5-year old boys were 84 c.m. and 118.75 c.m.; in point of weight, 12.3 kilos and 23-1 kilos. Boys : 6 to 7 Height varied from 92.25 c.m. to 120 c.m. Weight „ 13.1 kilos, to 23.7 kilos. Girls : 5 to 6 Height „ „ 85.75 c.m. to 117.5 c.m. Weight „ „ 11.2 kilos, to 24.6 kilos. Girls : 6 to 7 Height „ „ 87.5 c.m. to 122 c.m. Weight „ „ 10.2 kilos, to 25.5 kilos. NUTRITION. Age 5-6. Age 6-7. Boys. Girls. Boys. Girls. Good 370 302 126 107 Moderate 115 147 30 39 Subnormal 49 77 5 20 In determining under which heading—good, moderate or subnormal—a child was to be placed, I adopted the following method. Having ascertained from health tables that for the age of five years males should average in height 1016 m.m. and in weight 18.14 kilos., giving an equivalent of 178 grammes per centimetre, I took a number (160) sufficiently low to include all who could fairly be 103 considered well nourished. The equivalent 160 and over embraced those classified as good; 150 and under those called subnormal. I consider from the experience of the method gained during the past year that it is about as good as can be devised for the purpose, and if universally adopted would allow of comparison with results from other districts. I take cognisance of the three factors which essentially enter into the question of nutrition—namely, age, height and weight.—(D. C. Kirkhope.) CLEANLINESS AND CONDITION OF SKIN. Age 5-6. Age 6-7. Boys. Girls. Boys. Girls. Satisfactory 498 431 144 137 *Unsatisfactory 36 95 17 29 * Some Nils, S8 Excluded with Nits, 17; Skin somewhat dirty, 45; Skin dirty, 2; Flea-bitten, 45; Body Lice, 9; Eczema, 2; Psoriasis, 1; Scurfy Scalp, 1. TEETH. Number of Carious Teeth. 0 1 2 3 4 5 6 7 Boys: 5-6 211 66 50 51 55 27 17 11 Boys: 6-7 53 9 19 18 9 14 5 10 Girls: 5-6 219 62 66 42 45 32 12 13 Girls: 6-7 50 21 23 14 20 5 12 7 8 9 10 11 12 13 14 16 Boys: 5-6 16 11 10 5 - 3 1 - Boys: 6-7 6 7 6 2 1 2 - - Girls: 5-6 11 8 7 2 2 1 3 1 Girls: 6-7 6 4 2 2 — — — - 104 NOSE, THROAT AND MOUTH. Age 5-6. Age 6-7. Boys. Girls. Boys. Girls. Satisfactory 432 450 128 140 Unsatisfactory 102 76 33 26 Slightly Enlarged Cervical Glands, 132; Markedly Enlarged Cervical Glands, 24; Slightly Enlarged Tonsils, 34; Markedly Enlarged Tonsils, 35; Enlarged Submaxillary Gland, 1; Mouth Breathing and Adenoids, 21; Rhinorrhœa, 7; Tonsillitis, 1; Tonsillar Cyst, 1; Gingivitis, 1; Alveolar Abscess, 1. EXTERNAL EYE DISEASES. Age 5-6. Age 6-7. Boys. Girls. Boys. Girls. Satisfactory 525 518 158 166 Unsatisfactory 9 8 3 - Blepharitis, 4; Squint, 13; Hordeolum, 1; Phlyctenular Ophthalmia, 2; Cataract, 1. EAR DISEASES. Age 5-6. Age 6-7. Boys. Girls. Boys. Girls. Satisfactory 526 507 158 164 Unsatisfactory 8 19 3 2 Otorrhœa, 32. HEARING. Age 5-6. Age 6-7. Boys. Girls. Boys. Girls. Satisfactory 519 497 155 158 Unsatisfactory 15 29 6 8 Markedly Defective in one case. 105 SPEECH. Age 5-6. Age 6-7. Boys. Girls. Boys. Girls. Satisfactory 501 504 157 162 Unsatisfactory 33 22 4 4 HEART. Age 5-6. Age 6-7. Boys. Girls. Boys. Girls. Satisfactory 530 524 160 166 Unsatisfactory 4 2 1 — Aortic Obstruction, 1; Congenital Heart Defect, 1; Irregularity of Heart s Action, 1; Mitral Regurgitation, 4. LUNGS. Age 5-6. Age 6-7. Boys. Girls. Boys. Girls. Satisfactory 471 471 139 156 * Unsatisfactory 63 55 22 10 * Bronchitis and Bronchial Catarrh. NERVOUS SYSTEM. Age 5-6. Age 6-7. Boys. Girls. Boys. Girls. Satisfactory 533 525 161 166 * Unsatisfactory 1 1 — — * Epilepsy, 1; Infantile Paralysis, 1. TUBERCULOSIS. Age 5-6. Age 6-7. Boys. Girls. Boys. Girls. Satisfactory 533 524 159 164 * Unsatisfactory 1 2 2 2 * Tuberculosis of Lung. 106 RICKETS. Age 5-6. Age 6-7. Boys. Girls. Boys. Girls. Satisfactory 533 526 160 166 Unsatisfactory 1 - 1 - DEFORMITIES. Age 5-6. Age 6-7. Boys. Girls. Boys. Girls Satisfactory 528 522 156 166 Unsatisfactory 6 4 5 - Pigeon Chest, 14; Congenital Dislocation of Hip. 1. INFECTIOUS OR CONTAGIOUS DISEASES. Age 5-6. Age 6-7. Boys. Girls. Boys. Girls. Satisfactory 523 517 159 163 Unsatisfactory 11 9 2 3 Ringworm, 7; Impetigo, 8; Scabies, 4; Whooping Cough, 2; Chicken Pox, 3 ; German Measles, 1. OTHER DISEASES OR DEFECTS. Age 5-6. Age 6-7. Boys. Girls. Boys. Girls. Satisfactory 527 525 159 165 Unsatisfactory 7 1 2 1 Rupture, 8; Anaemia, 2; Incontinence, 1. 107 CHILDREN BETWEEN 7 AND 8 YEARS OF AGE. Total 1,358:—Boys, 698; Girls, 660. Average Age. Children in Family. Tuberculosis in Family. Measles. Whooping Cough. Chicken Pox. Scarlet Fever. Diphtheria. Boys 75/12 4.0 12 559 404 307 81 18 Girls 75/12 4.2 22 540 400 320 72 19 In addition to the above, the past history of the following illnesses and operations occurred with the noted frequency Boys.— Operation for Tonsils and Adenoids, 56; Circumcision, 15; Operation for Rupture, 5; Osteotomy, 1; Mastoid Operation, 1; Mumps, 15; Pleurisy and Pneumonia, 25; Ringworm, 5; Tonsillitis, 10; Rheumatism, 5; German Measles, 3; Enteric Fever, 1; Rickets, 5; Fits and Epilepsy, 4; "Consumption of Bowls," 2; Meningitis, 2; Eczema, 7; Enteritis, 1; Tubercular Abscess of Neck, 1; Tubercular Glands, 4; Appendicitis, 1; Chorea, 1; Concussion, 1; Ptomaine Poisoning, 1. Girls.— Operation for Tonsils and Adenoids, 46; Operation for Tubercular Glands, 1; Mastoid Operation, 1; Operation for Appendicitis, 1; Enucleation of Eyeball, 1; Pleurisy and Pneumonia, 28; Rheumatism, 3; Mumps, 24; Ringworm, 8; Favus, 1; German Measles, 5; Tonsillitis, 7; Enteric Fever, 2; Tubercular Bone, 2; Hipjoint Disease, 1; Marasmus, 1; Cancrum Oris, 1; Chorea, 2; Jaundice, 1; Eczema, 4; Rickets, 1; Fits, 1; Paralysis, 1; Concussion, 2. 108 VACCINATION. Boys. Girls. 4 or more marks 322 282 3 marks 77 92 2 „ 98 93 1 mark 49 41 0 „ 152 152 CLOTHING AND FOOTGEAR. Boys. Girls. Good 655 633 Indifferent 17 6 Bad 26 21 Thirteen of the bad cases being so classified on account of extreme dirtiness of the clothing. HEIGHT AND WEIGHT. Average Height in inches. Average Weight in pounds. Metric Scale. C.M. Kilos. Boys 451 45.75 114.52 20.76 Girls 451 44.65 114.57 20.26 The extremes in point of height amongst the boys were 95.5 c.m. and 132 c.m. The extremes in point of weight amongst the boys were 14.9 kilos, and 29.9 kilos. The extremes in point of height amongst the girls were 93. c.m. and 130.5 c.m. The extremes in point of weight amongst the girls were 14.2 kilos, and 29.2 kilos. 109 NUTRITION. Boys. Girls. Good 474 347 Moderate 132 177 Subnormal 92 136 According to the life tables the average height for children aged seven years last birthday is 116.8 c.m., and weight 22.57 kilos, giving an equivalent of 193 grammes per c.m. For the purposes of this enquiry and for the same reasons set forth under "Infants," I adopted the standard 175 as likely to embrace all who could be considered as well nourished, between 175 and 165 were considered moderately nourished, and below 165 as subnormal.—(D. C. Kirkhope.) CLEANLINESS AND CONDITION OF SKIN. Boys. Girls. Satisfactory 626 501 *Unsatisfactory 72 159 * Some Nits, 128; Excluded with Nits, 18; Skin somewhat dirty, 38; Skin dirty, 8; Flea-bitten, 49; Body Lice, 9; Xeroderma, 1; Herpes, 1; Psoriasis, 2; Eczema, 4; Scurfy Scalp, Skin severely scratched, 1. TEETH. Number of Carious Teeth. 0 1 2 3 4 5 6 7 8 Boys 170 96 97 83 66 45 41 27 27 Girls 152 85 95 67 60 54 45 29 33 9 10 11 12 13 14 15 16 Boys 21 11 8 2 2 1 1 — Girls 16 10 8 3 2 — — 1 I 110 THROAT AND NOSE. Boys. Girls. Satisfactory 541 542 * Unsatisfactory 157 118 * Slightly Enlarged Cervical Glands, 139; Markedly Enlarged Cervical Glands, 30; Slightly Enlarged Tonsils, 52; Markedly Enlarged Tonsils, 39; Mouth Breathing and Adenoids, 31; Rhinorrhœa, 9; Deviation of Nasal Septum, 1; Post-nasal Catarrh, 1; Tonsillitis, 2. EXTERNAL EYE DISEASES. Boys. Girls. Satisfactory 681 652 Unsatisfactory 17 8 Otosis, 1; Squint, 14; Blepharitis, 9; Hordeolum, 1. VISION. Bays. Girls. Satisfactory 505 491 Unsatisfactory 133 125 Unable to read letters 60 44 EAR DISEASES. Boys. Girls. Satisfactory 672 644 * Unsatisfactory 26 16 * Otorrhœa, 38; Otitis Media, 1; Eczema of Ear, 2; Abscess of External Auditory Meatus, 1. HEARING. Boys. Girls. Satisfactory 654 629 Unsatisfactory 44 31 Marked Dullness of Hearing in one case. 1ll SPEECH. Boys. Girls. Satisfactory 662 649 Unsatisfactory 36 11 MENTAL CONDITION. Boys. Girls. Satisfactory 638 622 * Unsatisfactory 60 38 * Mentally Defective, 2. HEART. Boys. Girls. Satisfactory 696 656 * Unsatisfactory 2 4 * Mitral Regurgitation, 5 ; Congenital Heart Defect, 1. LUNGS. Boys. Girls. Satisfactory 644 603 * Unsatisfactory 54 57 * Bronchitis and Bronchial Catarrh, Broncho-pneumonia, 1. NERVOUS SYSTEM. Boys. Girls. Satisfactory 696 655 * Unsatisfactory 2 5 * Epilepsy, 3; Infantile Paralysis, 1; Facial Paralysis, 1; Paralysis of Arm, 1; Muscular Atrophy, 1. 112 TUBERCULOSIS. Boys Girls. Satisfactory 694 655 * Unsatisfactory 4 5 * Tuberculosis of Lung, 9. RICKETS. Boys. Girls. No evidence 696 659 Present 2 1 DEFORMITIES. Boys. Girls. Absent 687 652 * Present 11 8 * Irregularity of Chest Formation, 1; Pigeon Chest, 15; Spinal Curvature, 3. INFECTIOUS AND CONTAGIOUS DISEASES. Boys. Girls. Absent 690 655 * Present 8 5 * Scabies, 6; Ringworm, 4; Whooping Cough, 1; Chicken Pox, 1; Impetigo, 1. OTHER DISEASES OR DEFECTS. Boys. Girls. No evidence 687 656 * Present 11 4 * Incontinence, 4. Oxyuris Vermicularis, 2; Anaemia, 2; Rupture, 4 ; Cleft Uvula, 1; Cleft Palate, 1; Phimosis, 1. 113 CHILDREN DUE TO LEAVE SCHOOL. Total, 2,329:—Boys, 1,268; Girls, 1,061. Boys 12 to 13 = 155 1,268 2,329 13 to 14 = 1,042 14 to 15 = 69 15 to 16 = 2 Girls 12 to 13 = 138 1,061 13 to 14 = 880 14 to 15 = 41 15 to 16 = 2 Average Age. Children in Family. Tuberculosis in Family. Measles. Whooping Cough. Chicken Pox. Scarlet Fever. Diphtheria Boys 12-13 1210/12 4.8 10 127 80 63 27 6 13-14 135/12 5.1 43 841 505 448 193 66 14-15 143/12 4.1 1 57 35 31 18 9 15-16 153/12 7.5 0 2 1 1 1 1 Girls 12-13 1210/12 5.3 9 117 77 68 27 9 13-14 135/12 4.8 55 777 540 453 182 56 14-15 142/12 4.0 1 38 31 27 8 0 15-16 154/12 2.0 0 2 2 1 1 0 In the past history the following illnesses and operations were noted:— Boys.—Operation for Tonsils and Adenoids, 96; Circumcision, 20; Mastoid Operation, 6; Operation for Rupture, 3; Operation for Tubercular Glands, 5; Tracheotomy, 4; Operation for Appendicitis, 6; Empyema, 2; Operation for Stone, 1; Operation for Squint, 2; Enucleation of Eyeball, 1; Operation for Stricture, 1; 114 Pleurisy and Pneumonia, 53; Nephritis, 3; Rheumatism, 24; Mumps, 43; Ringworm, 13; Tonsillitis, 29; Small-pox, 1; Enteric Fever, 4; German Measles, 3; Erysipelas, 1; Hip-joint Disease, 2; Tubercular Knee, 1; Peritonitis, 2; Chorea, 6; Rickets, 3; Fits, 4; Meningitis, 4; Concussion of Brain, 2; Jaundice, 3; Rupture, 1; Hydrocele, 1; Eczema, 7. Girls.—Operation for Tonsils and Adenoids, 98; Operation for Rupture, 3; Operation for Squint, 1; Mastoid Operation, 3; Osteotomy, 1; Amputation of Leg, 1; Operation for Nasal Obstruction, 1; Operation for Tubercular Glands, 9; Operation for Tubercular Bone, 1; Excision of Elbow, 1; Operation for Appendicitis, 3 Rheumatism, 36; Post-Diphtheritic Paralysis, 1; Mumps, 24; Typhoid, 5; Nephritis, 2; Pleurisy and Pneumonia, 63; Ringworm, 9; German Measles, 3; Small-pox, 1; Tubercular Knee, 1; Meningitis, 3; Hip-joint Disease, 1; Cystitis, 1; Jaundice, 11; Tonsillitis, 35; Chorea, 10; Paralysis, 1; Fits, 2; Rickets, 5; Concussion of Brain, 2; Sunstroke, 1; Ptomaine Poisoning, 1. VACCINATION. 12-13. 13-14. 14-15. 15-16. Boys. Girls. Boys Girls. Boys. Girls. Boys. Girls. 4 or more marks 36 40 285 229 13 12 - - 3 marks 24 19 113 123 14 3 1 - 2 25 21 146 120 10 10 1 2 1 mark 22 20 113 94 4 4 - - 0 „ 48 38 385 314 28 12 — — CLOTHING AND FOOTGEAR. 12-13. 13-14. 14-15. 15-16. Boys. Girls. Boys. Girls. Boys. Girls. Boys. Girls. Good 142 135 952 833 67 41 2 2 Indifferent 11 - 48 24 2 - - - Bad 2 3 42 23 0 - - - In 9 of the bad cases the clothing was objected to on account of its dirty condition. 115 HEIGHT AND WEIGHT. Average Height in inches. Average Weight in pounds. Metric Scale. C.M. Kilos. Boys 12-13 55.4 73.4 140.75 33.29 Girls 12-13 56.1 74.4 142.57 33.75 Boys 13-14 56.5 77.9 143.56 35.34 Girls 13-14 57.9 81.5 147.1 37 Boys 14-15 58.6 84.9 148.97 38.55 Girls 14-15 60 91.9 152.55 41.7 Boys 15-16 611 99.4 155.25 45.1 Girls 15-16 64.5 115.7 164.12 52.5 Boys 12-13 Height varied from 126 c.m. to 160.5 c.m. Weight „ „ 25.6 kilos to 49.6 kilos. Girls 12-13 Height „ „ 127.25 c.m. to 167 c.m. Weight „ „ 23.9 kilos to 51.5 kilos. Boys 13-14 Height „ „ 120.75 c.m. to 171.25 c.m. Weight „ „ 21.9 kilos to 58.7 kilos. Girls 13-14 Height „ „ 122 c.m. to 169.75 c.m. Weight „ „ 22.1 kilos to 65 kilos. Boys 14-15 Height „ „ 126.75 c.m. to 173 c.m. Weight „ „ 27.4 kilos to 56.4 kilos. Girls 14-15 Height „ „ 141 c.m. to 168 c.m. Weight „ „ 32.2 kilos to 55 kilos. Boys 15-16 Height „ „ 154.25 c.m. to 154.25 c.m. Weight „ „ 44.9 kilos to 45.3 kilos. Girls 15-16 Height „ „ 161 c.m. to 167.25 c.m. Weight „ „ 52.4 kilos to 52.7 kilos. NUTRITION. Age 12-13 13-14 14-15 15-16 Boys. Girls. Boys. Girls. Boys. Girls. Boys. Girls. Good 112 94 764 657 59 36 1 2 Moderate 36 28 214 162 10 5 1 - Subnormal 7 16 64 61 — — — — 116 Children under 13 years of age were classified as good if the gram. centimetre ratio reached 220, and subnormal if it fell below 200. For children over 13 years the corresponding numbers were 230 and 210. CLEANLINESS AND CONDITION OF SKIN. Age 12-13 13-14 14-15 15-16 Boys. Girls. Boys. Girls. Boys. Girls. Boys. Girls. Satisfactory 143 103 952 664 68 37 2 2 * Unsatisfactory 12 35 90 216 1 4 — — * Some Nits, 174; Excluded with Nits, 46; Somewhat dirty skin, 90; Dirty skin, 17; Flea-bitten, 35; Body Lice, 17; Psoriasis, 4; Xerodema, 2; Sores, 2; Eczema, 3. TEETH. Number of Carious Teeth. 0 1 2 3 4 5 6 Boys 12-13 51 31 29 24 9 8 1 Girls 12-13 48 32 24 17 15 1 - Boys 13-14 330 239 204 135 85 29 13 Girls 13-14 272 206 173 117 78 18 6 Boys 14-15 20 12 21 4 10 — 1 Girls 14-15 9 10 9 5 4 1 2 Boys 15-16 1 1 — - - - - Girls 15-16 - - - 2 - - - 7 8 9 10 12 13 14 Boys 12-13 2 - - - - - - Girls 12-13 - 1 - - - - - Boys 13-14 1 3 - 1 - 1 1 Girls 13-14 5 2 2 — 1 - - Boys 14-15 1 - - - - - - Girls 14-15 - - - 1 - - - Boys 15-16 - - - - - - - Girls 15-16 - - - - - - - 117 THROAT AND NOSE. Age 12-13 13-14 14-15 15-16 Boys. Girls. Boys. Girls. Boys. Girls. Boys. Girls. Satisfactory 140 109 829 719 58 33 2 2 * Unsatisfactory 15 29 213 161 11 8 — — * Slightly Enlarged Cervical Glands, 196; Enlarged Cervical Glands, 30; Slightly Enlarged Tonsils, 103 Enlarged Tonsils requiring treatment, 89; Enlarged Submaxillary Glands, 3; Enlarged Sublingual Gland, 1; Enlarged Submental Gland, 1; Post-nasal Catarrh, 15; Adenoids and Mouth Breathing, 12; Spur of Nasal Septum, 2; Deviation of Nasal Septum, 1 ; Rhinorrhœa, 3; Tonsillitis, 4; Tonsillar Cyst, 1. EXTERNAL EYE DISEASES. Age 12-13 13-14 14-15 15-16 Boys. Girls. Boys. Girls. Boys. Girls. Boys. Girls. Satisfactory 152 136 1,033 868 68 41 2 2 * Unsatisfactory 3 2 9 12 1 — — — * Blepharitis, 7; Squint, 15; Corneal Opacity, 1; Conjunctivitis, 1; Interstitial Reratitis, 2; Ptosis of Eyelid, 1. VISION. Age 12-13 13-14 14-15 15-16 Boys. Girls. Boys. Girls. Boys. Girls. Boys. Girls. Satisfactory 128 120 844 705 59 34 1 2 Unsatisfactory 27 18 198 175 10 7 1 — EAR DISEASES. Age 12-13 13-14 14-15 15-16 Boys. Girls. Boys. Girls. Boys. Girls. Boys. Girls. Satisfactory 148 135 1,021 861 68 39 2 2 * Unsatisfactory 7 3 21 19 1 2 — — * Otorrhœa. 118 HEARING. Age 12-13 13-14 14-15 15-16 Boys. Girls. Boys. Girls. Boys. Girls. Boys Girls. Satisfactory 149 133 1,001 852 65 38 2 2 Unsatisfactory 6 5 41 28 4 3 - - SPEECH. Age 12-13 13-14 14 15 15-16 Boys. Girls. Boys. Girls. Boys. Girls. Boys. Girls. Satisfactory 152 138 1,025 880 68 41 2 1 Unsatisfactory 3 - 17 - 1 - - 1 MENTAL. Age 12-13 13-14 14-15 15-16 Boys. Girls. Boys. Girls. Boys. Girls. Boys. Girls. Satisfactory 116 95 796 711 63 39 1 2 * Unsatisfactory 39 43 246 169 6 2 1 — * Mental Defect, 25. The others were backward, having failed to pass the fifth standard. HEART AND CIRCULATION. Age 12-13 13-14 14-15 15-16 Boys. Girls. Boys. Girls. Boys. Girls. Boys. Girls. Satisfactory 153 136 1,032 855 68 38 2 2 * Unsatisfactory 2 2 10 25 1 3 — — * Mitral Regurgitation, 36; Congenital Heart Defect, 3; Mitral Obstruction and Regurgitation, 1; Aortic and Mitral Regurgitation, 1; Aortic Incompetence, 1; Bruit de Galop, 1. LUNGS. Age 12-13 13-14 14-15 15-16 Boys. Girls. Boys. Girls. Boys. Girls. Boys. Girls Satisfactory 151 134 1,021 859 67 40 1 2 * Unsatisfactory 4 4 21 21 2 1 1 — * Bronchitis and Bronchial Catarrh. 119 NERVOUS DISEASES. Age 12-13 13-14 14-15 15-16 Boys. Girls. Boys. Girls. Boys. Girls. Boys. Girls. Satisfactory 151 138 1,035 877 69 40 2 2 * Unsatisfactory 4 — 7 3 — 1 - - * Chorea, 4; Infantile Paralysis, 5; Epilepsy, 5; Facial Paralysis, 1. TUBERCULOSIS. Age 12-13 13-14 14-15 15-16 Boys. Girls. Boys. Girls. Boys. Girls. Boys. Girls. Satisfactory 154 138 1,039 874 69 41 2 2 * Unsatisfactory 1 — 3 6 — — — — * Tuberculosis of Lung 10. RICKETS. Age 12-13 13-14 14-15 15-16 Boys. Girls. Boys. Girls. Boys. Girls. Boys. Girls. No Evidence 155 138 1,042 879 69 41 2 2 Present - - - 1 - - - - DEFORMITIES. Age 12-13 13-14 14-15 15-16 Boys. Girls. Boys Girls. Boys. Girls. Boys. Girls. Absent 155 137 1,035 871 69 39 2 2 * Present — 1 7 9 — 2 — — * Pigeon Chest, 3; Spinal Curvature, 7; Talipes equinus, 1; Congenital Dislocation of Hip, 3; Deformity of Foot, 1; Undescended Testis, 1; Cleft Uvula, 1; Tracheal Warts, 1; Cleft Palate, 1. INFECTIOUS AND CONTAGIOUS DISEASES. Age 12-13 13-14 14-15 15-16 Boys. Girls. Boys. Girls. Boys. Girls. Boys. Girls. Absent 154 138 1,035 873 69 41 2 2 * Present 1 — 7 7 — — — — * Scabies, 8; Ringworm, 5; Impetigo, 1; Diphtheria, 1. 120 OTHER DISEASES OR DEFECTS. Age 12-13 13-14 14-15 15-16 Boys. Girls. Boys. Girls . Boys. Girls. Boys. Girls. Absent 155 137 1,037 878 69 41 2 2 * Present — 1 5 2 — — — - * Congenital Syphilis, 2; Enlarged Spleen, 1; Eneuresis, 2; Albino, 1; Rupture, 2. SPECIAL EXAMINATIONS. The Teachers are encouraged to bring before the Medical Inspector at the time he is visiting the School any cases concerning whom they may, for any reason, desire a medical opinion. Of the 92 children thus examined, the examination was justified in 74 instances. The following is a list of the defects found:— Defective Sight in 30 instances. Deafness, Otorrhœa, Post-Nasal Catarrh, and Adenoids „ 6 „ Heart Disease „ 3 „ Impetigo „ 8 „ Conjunctivitis „ 2 „ Anaemia „ 2 „ Verminous „ 8 „ Epilepsy „ 2 „ Chicken Pox „ 2 „ Ringworm „ 1 instance. Measles „ 1 „ Scarlet Fever „ 1 „ Eczema „ 1 „ Urticaria „ 1 „ Enlarged Tonsils „ 1 „ Alopecia „ 1 „ Mental Defect „ 1 „ Infantile Paralysis „ 1 „ Enlarged Glands „ 1 „ Rheumatism „ 1 „ 121 CASES AS TO WHOM RECOMMENDATIONS WERE FORWARDED TO THE PARENTS TO SEEK MEDICAL TREATMENT, WITH RESULTS. Total. Treated or improved. No improvement. Result not ascertained on account of— Having left School. Absence from School. Enlarged Tonsils 233 56 98 58 21 Enlarged Glands 206 88 72 29 17 Defective Sight 761 273 279 162 47 Deafness and Otorrhœa 146 63 41 29 13 Mouth Breathing and Adenoid 78 37 29 3 9 Heart Disease 30 10 6 11 3 Squint 24 2 19 2 1 Blepharitis 17 6 4 4 3 Post-Nasal Catarrh 15 8 1 6 — Bronchitis 11 7 2 1 1 Phthisis 14 7 2 3 2 Rhinorrhœa 12 5 6 1 — Pneumonia 1 1 - - - Psoriasis 1 - - - 1 Tonsillitis 2 2 - - - Enuresis 1 1 - - - Spinal Curvature 4 2 1 - 1 Ansemia 2 2 - - - Corneal Opacity 2 1 1 - - Cataract 1 - 1 - - Chorea 2 — 1 - 1 Conjunctivitis 1 1 - - - Cleft Palate 1 - 1 - - Scabies 1 1 - - - Epilepsy 4 - 3 1 - Exostosis of Jaw 1 - - 1 - Impetigo 2 1 — — 1 Hammer Toe 1 - - 1 - Deviation of Septum Nasi 1 — - 1 - Hernia 1 - 1 - - 1576 574 568 313 121 122 TREATMENT OF THOSE CHILDREN FOUND ON INSPECTION TO BE DEFECTIVE. The above table shows that 36.6 per cent. of those recommended to obtain treatment acted on the recommendation. This result is very satisfactory; it demonstrates that medical examination of school children is not altogether useless when unaccompanied by provision for treatment by the School Medical Officer of the defects found. I attribute no small amount of this success to the efforts of the teachers. As before stated, I supply a register to each school containing the names of those children who are recommended to obtain treatment, and request the teacher to ascertain from time to time if the children have been treated, and to try to stimulate the parents to a sense of their responsibility in the matter. In expressing my gratitude to the teachers on the success they have thus achieved, I do not hesitate to confess that it is tinged with a lively sense of future favours in the same direction. I do not think that the teachers have by any means exhausted the possibilities of their influence, and I look forward with considerable confidence to the 36.6 per cent. of success in another year growing into 70 per cent., or even more. And I would point out that the 36.6 per cent. which I have taken is the lowest possible figure, for it entirely disregards the 434 children who had either left school or who were absent when the inquiries were made. During the year the Education Committee received a deputation from the Local Branch of the British Medical Association on the subject of those children found on inspection to require treatment. The deputation outlined a scheme similar in all its essential features to that in operation at Wandsworth. 123 The Council, having in view the uncertainty as to how far the Insurance Act would affect the treatment of school children, did not see its way to taking any action at that time, but promised that the Branch should receive intimation before it undertook anything in the way of providing treatment. Up to now nothing further has been done in the matter. Methods employed for the protection of Children attending the Elementary Schools. SCHOOL CLOSURE. Canterbury Road and Capworth Street Schools were each closed for 14 days on account of the epidemic of Measles which occurred in the Spring. This closure did not appear to be productive of much good. The epidemic was universal throughout the district, and all the schools were affected more or less. The following list is compiled from the notifications sent weekly to me by the teachers, and shows the extent to which each school was involved:— MEASLES. Boys. Girls. Infants. Total Kirkdale Road 24 26 95 145 Harrow Green 5 9 75 89 Newport Road 10 59 113 182 Mayville Road 6 9 58 73 Lea Bridge Road - - 18 18 Ruckholt Road 21 30 118 169 Capworth Street (Infants' Department closed for 14 days) 24 12 113 149 Goodall Road 15 24 119 158 Davies Lane 6 3 168 177 Farmer Road 11 35 105 151 124  Boys. Girls. Infants. Total. Norlington Road 28 20 150 198 Sybourne Street — — 83 83 Cann Hall Road 14 13 161 188 Cobbold Road — — 50 50 Downsell Road 7 21 122 150 Trumpington Road 25 35 126 186 St. Joseph's (R.C.) - - 26 26 Church Road 1 9 29 39 High Road - - 46 46 Canterbury Road (closed for 14 days) - - 184 184 EXCLUSION OF INDIVIDUAL SCHOLARS. In the Measles epidemic above referred to all contacts from infected houses who had not previously suffered from Measles were excluded from School attendance, and leaflets of advice were left at practically every house in the district. The Inspection Clinic held each school morning during the year at the Town Hall has been continued, and 3,426 examinations were made. The following is a list of the various ailments from which these children have been found to be suffering and the proportions in which they occurred:— Ringworm 127 Alopecia Areata 5 Eczema 35 Impetigo Contagiosa 115 Herpes 13 Scabies 38 Other forms of Skin Disease 53 Boils and Abscesses 5 Verminous Cases 277 125 Defective Vision 6 Conjunctivitis 12 Blepharitis 12 Stye 2 Otorrhœa 13 Earache 1 Tonsillitis 23 Adenoids 1 Stomatitis 4 Rhinorrhœa 3 Enlarged Cervical Glands 17 Phthisis 12 Lupus 1 Other forms of Tuberculosis 3 Scarlet Fever 2 Desquamation 6 Measles 8 Whooping Cough 2 Chicken Pox 2 Mumps 2 Influenza 1 Rheumatism 2 Chorea 4 Heart Disease 2 Anaemia 2 Malaise 3 Debility 2 Bronchitis 3 Neuroses 2 Mental Deficiency 1 Epilepsy 4 Those children in the above list who were excluded from school reported themselves week by week until I was able to certify them fit to return. E 126 RINGWORM OF SCALP. 105 cases of Ringworm of the Scalp were certified as fit to return to school during the year. Of these the following is a return of the length of time absence from school was necessary:— Under 1 month 12 cases. 1 to 3 months 18 , 3 „ 4 „ 8 „ 4 „ 6 „ 18 „ 6 „ 8 „ 19 „ 8 „ 10 „ 15 „ 10 „ 12 „ 6 „ 12 „ 14 „ 6 „ 14 „ 16 „ 0 case. 16 „ 18 „ 1 „ 18 „ 20 „ 1 „ 20 „ 25 „ 1 „ And 10 cases were lost sight of on account of having left school or removed from district. VERMINOUS CHILDREN. 44 prosecutions were undertaken for non-attendance at school of children suffering from verminous conditions of hair and scalp, with the following results:— 1 fine of 10s. and costs. 27 fines of 5s. and costs. 127 14 summonses were adjourned and then withdrawn, the children becoming fit to return to school in the interval covering the period of adjournment. 2 summonses were dismissed. BLIND CHILDREN. Three blind children are being maintained at our Council's expense at the East London Home and School for the Blind, at Clapton. DEAF AND DUMB CHILDREN. 10 children have been sent to the Water Lane Deaf and Dumb Centre, West Ham, our Council defraying expenses. MENTALLY DEFECTIVE CHILDREN. Four children are attending the Walthamstow Centre at Shernhall Street, these being paid for by our Council. SCHOOL NURSES OR HEALTH VISITORS. In last year's report I drew attention to the fact that we only possessed one School Nurse, and that her time was fully occupied in attending and assisting at the Medical Inspections at the schools ; and I recommended that another School Nurse or Health Visitor should be appointed. The matter has been referred to a joint Sub-Committee of the Education and Public Health Committees. I think it possible that had we had such an officer during the Measles epidemic, to visit the invaded homes of the poorer section of the inhabitants, the mortality from that disease might have been lessened. 128 PROVISION OF MEALS. The Board of Education having intimated that in future reports of School Medical Officers they will look for a section dealing with the Act, I have visited the various feeding centres and seen the children eating their dinners. With two exceptions (Downsell Road and Farmer Road Schools, where the Caretakers provide the meals) the children are fed at various coffee-shops throughout the district. COFFEE-SHOPS. On the score of convenience and economy coffee shop feeding doubtless has much to recommend it, but it does not lend itself to the educational aspect of the question. I found that there was practically no supervision. In only one instance did I find a. teacher present. The meals were served in a very rough and ready fashion, a newspaper usually did duty for a table cloth ; and although I admit I did not see any very flagrant cases of misbehaviour, no effort to teach manners, &c., was observed. No special accommodation was provided for the children except in two instances: in one of these a separate room was set apart, and in the other an out-house was used for the purpose. The former was where I found the teacher present, and this, as one would expect, was the best-conducted meal I observed throughout my tour of inspections. The latter (the out-house) was bare, cold, damp and cheerless, and is in my opinion quite unfitted to be used as a dining-room. 129 Meals Provided by Caretakers. FARMER ROAD SCHOOL. Here the children are fed in the kitchen of the Caretaker's cottage and they are supervised by the Caretaker's wife. She seemed desirous of doing her best, but her efforts in the direction of inculcating manners, &c., fell short of the standard which should be attained. DOWNSELL ROAD SCHOOL. In this school the meals are taken up to each of the three departments of the school; but as the following details serve to illustrate (except in the Girls' department), no adequate provision exists for the proper service of the meals. Boys' Department. In this department I found a table improvised out of a blackboard placed on a coal bunker. At this dining-table the boys stood to eat their food. Girls' Department. Only three girls were on the feeding list. I found them comfortably seated at a small table covered by a clean white cloth. Here it was evident that the teachers had made an effort to conform to a civilised standard; but the means at their disposal would not have permitted them to maintain this standard, had the number of girls been larger. Infants' Department. Here the little ones were seated at their desks, which were covered with brown paper. 130 In all these departments teachers were present. The food provided, both at the coffee-shops and at the schools, was nourishing and of fairly good quality. The cooking, however, was not always all that could be desired—thus, for instance, the puddings were sometimes under-cooked, which rendered them doughy and indigestible. I am also of opinion that more variety in the menus is desirable. The same flavoured soup and stew day after day induces nausea, and is not calculated to produce the maximum benefits. PROPOSED NEW FEEDING CENTRE AT MAYVILLE SCHOOL. The Canteen Sub-Committee being alive to many of the defects above outlined are considering a scheme for establishing an experimental centre at the Mayville School, where they propose to assemble the children from some nine or ten other schools at breakfast and dinner time. This school has a sort of Hall which was erected subsequent to the building of the rest of the school, and which is peculiarly suitable for use as a dining hall. The Sub-Committee's suggestion is to suitably equip this Hall on strictly modern lines, and to engage a cook and the necessary help. The full Committee had the scheme brought to their notice at their last meeting in December, but for the present they have withheld their sanction pending further enquiries as to details. I desire heartily to commend the scheme, as I am convinced that in every way it will be a great improvement on the existing arrangements. 131 A Canteen Committee provides the necessary machinery for the administration of the Provision of Meals Act. The constitution of this Committee is as follows:— Councillor J. B. Slade, J.P. (Chairman) Councillor Hurry Councillor Mitchell Councillor D. M. Smith Members of Education Committee. Mr. Cooke Mr. Shimmin Mr. P. W. Smith Mr. Toop Mr. Wire Miss Lamb Miss Parsons Miss Pringuer Teachers. Mr. Coles Mr. Craske Mr. Young Mr. Webb Miss Vincent Mr. Lash Co-opted Members. (Superintendent of Visiting Officers.) I, as School Medical Officer, up to the present time have taken no share in the working of the Act, but in view of the suggestions thrown out in the Annual Report of the Chief Medical Officer of the Board of Education, I presented the following Report to the Education Committee, who have passed it on to the Canteen Sub-Committee for their consideration. December, 1911. To the Chairman and Members of the Leyton Education Authority. Mr. Chairman, Ladies and Gentlemen, PROVISION OF MEALS. The Board of Education have intimated that in future Annual Reports of School Medical Officers, for areas in which the Provision of Meals Act has been put in operation, they will look for a section dealing with the Act. 132 In areas in which the Act is in operation the following important functions in relation to its working may appropriately devolve upon the School Medical Officer and his assistants. (1) He should report to the Local Education Authority all cases of bad or insufficient nutrition observed in the course of medical inspection (whether routine inspection or special inspection). Such cases should be put on the feeding list pending investigations as to the cause of malnutrition. (2) Cases of doubt as to the propriety of keeping any child (whether selected as the result of medical inspection or otherwise) on the feeding list should be referred to him for report before the decision is taken. (3) Cases of the temporary exclusion from the feeding list of children who are temporarily excluded on medical grounds from school attendance should be notified to him. (4) He should periodically inspect the registers of the attendance at meals, both as regards the attendance generally and as regards the attendance of individual children with whose cases he has previously been concerned. (5) He should approve the dietary. (6) He should satisfy himself of the hygienic conditions of the feeding centres. (7) He should supervise the quality, quantity, cooking and service of the food. 133 (8) He should attempt to form and record a judgment upon the effects of the proceedings taken under the Act upon the physical well-being of the children, both generally and as regards individual cases. The above is an extract from the Annual Report for 1910 of the Chief Medical Officer of the Board of Education. From the above quotations it is evident the suggestion is that the School Medical Officer should carry out the above outlined duties, and I am therefore bringing them to your notice, together with certain observations of my own thereon. Paragraph 1, which deals with children found on medical inspection to exhibit symptoms of bad or insufficient nutrition, immadiately raises the question as to how to feed such children in addition to those already being fed, and still to keep within the limit of the halfpenny rate. To enable you to come to a workable conclusion I have endeavoured to estimate the number who would be likely to require feeding. I find on reference to my Annual Report for 1910 that 299 children were reported to be badly nourished. Likewise in the Report issued by the Board of Education on the Working of the Provision of Meals Act for the year ending March 31st, 1910, I find that the total number of children fed by the Education Authority of Leyton was 1,490, and that the cost for food was £692. At the same rate the cost of feeding 299 would amount to about £139, so that the two classes together would cost £831, and as a halfpenny rate produces £973, on these figures there would be a balance of £142. But it is quite probable that some of those children recommended for feeding as the result of medical inspection would be found on investigation to be already fed as the result of the system of selection obtaining. 134 It might also be possible to recover the cost of the meals from some of the parents. On this point, of course, only the members of the Canteen Committee are justified to speak. I do not know, and therefore I have no right to criticise, the methods at present in vogue for the selection of children to be fed; but it is possible that a stricter supervision of the lists might reveal some cases who for various reasons might be taken off the lists. In these, and possibly other ways which do not occur to me, it seems it would be possible to feed both classes of children and still keep within the limit of the halfpenny rate. I do not desire, nor is it the intention of the Board of Education, to administer the Provision of Meals Act on an exclusively medical basis. Paragraphs 2 and 3.—The duty of advising as to the propriety of keeping any child on the feeding list, and as to the feeding of any child temporarily excluded from school on medical grounds, could be carried out in co-operation with the Chief School Attendance Officer by the latter bringing such children before me, with all particulars of their cases, at the Town Hall. Paragraphs 4, 5, 6 and 7 do not appear to me to require any detailed comment. Paragraph 8.—To enable me to form and to record a judgment upon the effects of the proceedings taken under the Act it will be necessary to weigh the children periodically. In order to do this it will be necessary to provide weighing machines, either at each school or at each feeding centre. At present we have only two weighing machines; these are in constant use, and could not be made available for the purpose. 135 In conclusion, I venture to hope that the question of feeding those children found on medical inspection to be insufficiently nourished will engage your immediate attention, in order that the work may be commenced as early as possible in the New Year. I am, Mr. Chairman, Ladies and Gentlemen, Your obedient Servant, J. FRANCIS TAYLOR, School Medical Officer. More School Accommodation. The necessity for providing more school accommodation in the N.W. portion of the District has been realised for some time past, both by many members of the Council and by his Majesty's Inspector. A scheme for providing such accommodation is now under Consideration. Improvements effected in the Schools during the year. These may be classified under the headings of (1) General, and (2) Detailed—i.e., those affecting particular schools. 1.—GENERAL IMPROVEMENTS. The following schools were painted and cleansed during the Summer Vacation:— Cost. £ High Road School, exterior and portion of interior 97 Newport Road School, exterior and interior 600 Davies Lane School, exterior 149 Cobbold Road School, interior 124 Cann Hall Road School, exterior and interior 480 136 The latrines of the schools in the District were cleansed and whitewashed throughout, according to custom, during the Easter vacation, and at the same time the drains were overhauled and flushed under the superintendence of the Surveyor to the District. As the result of reports from me recommending more frequent cleansing of the class-rooms, &c., including desks and the tops of cupboards, &c., and the necessity for more frequent window cleaning, arrangements have been made by the appointment of 25 women scrubbers for the cleansing to be carried out six times during the year instead of only four times, as has hitherto been the practice. The windows also are now cleaned four instead of three times yearly. 2.—DETAILED IMPROVEMENTS. Capworth Street School. 1. The lavatory basins throughout the three departments of the school have been re-enamelled. 2. The placing of the dustbins immediately outside the windows of one of the infants' cloak-rooms, animadverted upon in last year's report, has been discontinued. They are now kept at the side of the Caretaker's cottage. 3. New boiler supplied, at a cost of £25 10s. 0d., for the purpose of maintaining the heating apparatus in operation. 4. Twelve single locker desks supplied to the Boys' Department, to replace twelve dual desks, for use in the Central Class. Three similar desks supplied to Girls' Department for like purpose. 5. Thirty dual desks supplied to the Girls' Department. 137 Cann Hall Road School. 1. The small cloak-room in the Girls' Department, referred to in last year's report as being very dark and ill-ventilated, has been converted by the provision of shelves, &c., into a stock room. 2. Tar paving in playground overhauled and repaired. 3. Exterior and interior re-painted and cleansed. Church Road School. 1. Dual desks to the number of 78 supplied to replace old long desks; 50 of this number were obtained from Farmer Road School, where the provision of a similar number of single locker desks had rendered them superfluous. Cobbold Road School. 1. Interior re-painted and cleansed. 2. New boiler supplied, at cost of £27 10s. 0d., for the purpose of maintaining the heating apparatus. Canterbury Road School. The playground, which was gravelled, has now been tar paved. Davies Lane School. 1. Boiler dismantled and re-set, it having been found to be leaking. 2. Radiators fixed in Class Rooms 7 and 8, these rooms requiring additional heating. 3. Exterior re-painted. 138 Farmer Road School. 1. Fifty single locker desks supplied to Boys' and Girls' Departments for the use of the older scholars (25 to each department). The dual desks thus replaced sent to Church Road School. 2. A new hot-water radiator supplied to each of the large class rooms, Nos. 2 and 8, in the Boys' Department, on the representation of the School Medical Officer that the heating in those rooms was inadequate. Goodall Road School. 1. New hot-water radiator supplied, on recommendation of the School Medical Officer, to Class Room No. 8 in Infants' Department; also new hot-water radiators installed in the four end class rooms in both Boys' and Girls' Departments. 2. The trough in the Boys' latrines having been reported to be leaking, the same has been repaired; but it is proposed that it shall be removed and separate pan closets substituted. Harrow Green School. 1. Additional air grating at each end of Infants' latrines for the purpose of affording freer ventilation. 2. Worn-out stove in class room of Infants' Department replaced by a new hurdle stove. High Road School. 1. Exterior and portion of interior painted and cleansed. Kirkdale Road School. Lower flight of stairs in Girls' Department re-blocked, the old blocks having worn away and left the stairs in a slippery and dangerous state. 139 Lea Bridge Road School. 1. Roof ventilators supplied to the hall to afford additional light and ventilation. 2. Thirty dual desks supplied, also three movable screens for class in hall. Mayville Road School. 1. Tar paving in playgrounds re-topped and repaired. 2. Porcelain sink with glazed tiles surrounding it provided in the Cookery Department. 3. Extra ventilation of Boys' urinal provided, as recommended in last year's report. Newport Road School. 1. Exterior and interior repainted and cleansed. 2. Floor board in Class Room No. 6 in Infants' Department relaid, the old one being worn out. Norlington Road School. 1. An application was received from Miss Grinter (the Head Teacher in Girls' Department) for the tops of the Cupboards to be made flat, to facilitate cleansing from deposits of dust, &c. The Committee, however, considering the request to be rather of the nature of a counsel of perfection, declined it. For my own part, I sympathise with Miss Grinter, and hope the Council may yet see their way to reconsider their decision. It is in collections of dust that the microbes of disease lurk, and any attempts to rid the school premises of dirt and dust are to be commended and encouraged. 2. Radiator supplied to Class Room II. in the Boys' Department, one having already been supplied to Class Room I., a room identical in dimension, &c. 140 Ruckholt Road School. H.M. Inspector having reported— (a) That some lower desks are required for the use of the younger children in the Girls' Department; (b) That in the Infants' Department there is much sary dull glass, which makes the rooms less bright than they otherwise would be, and at the same time necessitates the frequent use of artificial light ; It was resolved to rearrange the desks, and if necessary transfer some smaller desks from other schools. With regard to the dull glass, the Architect was instructed to replace this with clear glass as the panes become broken. St. Joseph's School (R.C.). 1. Gallery in Infants' Department removed, and small chairs and folding tables supplied on a level floor. 2. Increased latrine accommodation provided. 3. Screen erected in the upper rooms to form a corridor, which obviates the necessity of passing through the class rooms. Sybourn Street School. 1. Thirty dual desks provided. 2. Trees planted in playground. 3. The gravel in playground being worn into holes, six loads of hoggin have been supplied for the purpose of levelling it. It is proposed to tar pave this playground next year. Trumpington Road School. Tar paving repaired. The following are the Local Government Board Tables of Deaths, Infectious Diseases and Infantile Mortality, &c. The deaths for the year are also given in the long Schedule designed by the Society of Medical Officers of Health. L 142 TABLE I. Vital Statistics of Whole District during 1911 and previous Years. Year. Population estimated to Middle of each Year. Births. Total Deaths Registered in the District. Transferable Deaths^ Nett Deaths belonging to the District. Uncorrected Number. Nett. of Nonresidents registered in the District. of Residents not registered in the District. Under 1 Year of Age. At all Ages. Number. Rate. Number. Rate per 1000 Nett Births. Number. Rate. Number. Rate. 1 2 3 4 5 6 7 8 9 10 11 12 13 1906 108000 — 3344 30.9 2355 21.8 1028 — 382 1142 1327 12.3 1907 120000 — 3190 26.6 2006 16.7 753 16 276 86.5 1269 10.6 1908 121200 — 3071 25.3 2299 19.0 1120 6 242 78.8 1185 9.8 1909 121200 2979 24.6 2336 19.3 1144 16 244 81.9 1208 9.96 143 1910 123300 — 3011 24.4 2125 17.2 1028 15 191 63.4 1112 9.0 1911 124736 2903 2931 23.5 2555 20.5 1250 168 327 111.6 1473 11.8 Rates in Columns 5, 7, and 13 calculated per 1000 of estimated gross population. Area of District in acres (exclusive of area covered by water) 2594 Total population at all ages 124736' Number of inhabited houses 22147 Average number of persons per house 5.63 At Census of 1911. I. Institutions within the District receiving Sick and Infirm Persons from outside the District.—West Ham Infirmary, West Ham Workhouse. II. Institutions outside the District receiving Sick and Infirm Persons from the District.—Walthamstow Hospital, West Ham Hospital, London Fever Hospital, various London General and Children's Hospitals, Metropolitan Asylums Board Hospitals, &c. III. Other Institutions, the Deaths in which have been distributed among the several Localities in the District.—Great Northern Central Hospital; Walthamstow Hospital; Leyton, Walthamstow and Wanstead Children's and General Hospital; London County Asylum, Banstead; Essex County Asylum, South Weald; Guy's Hospital; Queen's Hospital; St. Bartholomew's Hospital; German Hospital; London Hospital; East London Hospital, Shadwell; Manor Asylum, Epsom; King's College Hospital; West Ham Hospital; National Hospital; Metropolitan Hospital; East Sussex County Asylum, Hellingly; University College Hospital; Homoeopathic Hospital; Children's Hospital, Great Ormond Street; Poplar Hospital; Victoria Park Hospital; City of London Lying-in Hospital. 141 Table II.—Cases of Infectious Disease Notified During the Year, 1911, including Cases which OCCURRED in West Ham Union, Infirmary, &c., but OT those Imported. NOTIFIABLE DISEASE. Number of Cases Notified. Total Cases Notified in each Locality— Wards. Total Cases removed to Hospital. At all Ages. At Ages—Years. 1 2 3 4 5 6 7 8 9 Under L 1 to 5. 5 to 15. 15 to 25. 25 to 45. 45 to 65. 65 and upwards. Leyton. Lea Bridge. Central. Forest. Leytonstone. Grove Green. Harrow Green. Cann Hall. Wantsead Slip. *Small-pox 2 — — — 1 1 — — — — 1 — — 1 — — — — Cholera — — — — — — — — — — — — — — — — — — †Diphtheria (including Membranous Croup 174 3 47 107 8 7 2 — 10 38 27 18 12 18 11 ?4 16 124 ‡Erysipelas 112 6 1 8 11 42 29 15 8 23 7 18 9 7 13 14 13 33 §Scarlet Fever 460 1 104 305 35 15 — — 40 66 82 38 26 45 48 77 38 272 Typhus Fever — — — — — — — — — — — — — — — — — — ||Enteric Fever 28 — 3 9 4 10 2 — 1 7 3 1 2 1 2 2 9 15 Relapsing Fever — — — — — — — — — — — — — — — — — — Continued Fever 4 — 1 1 — 2 — — — 1 — — — — — — 3 1 Puerperal Fever 9 — — — 2 7 — — 1 — 2 1 1 1 1 2 — 6 Plague — — — — — — — — — — — — — — — — — — ¶Under Tuberculosis Regulations, 1908 70 — 1 4 9 39 16 1 8 7 6 6 9 10 10 7 8 63 Phthisis Under Tuberculosis Regulations, 1911 124 — — 12 24 71 17 — 12 19 21 7 10 13 12 18 12 28 Others — — — — — — — — — — — — — — — — — — Totals 983 10 157 446 94 194 66 16 80 161 149 89 62 96 103 144 99 542 *These cases proved not to be Small-pox. One Certificate withdrawn (Grove Green Ward, 24 years), †One case included in above proved not to be Diphtheria. Certificate withdrawn (Forest Ward, 13 years). ‡Including three cases which occurred in W. H. Workhouse and three in West Ham Infirmary. ' § Three cases proved to be Measles and one German Measles. || Three cases included in above proved not to be Enteric. One Case occurred in Bethnal Green Schools. ¶Five cases occurred in West Ham Workhouse and six admitted—homeless. One case occurred at the Home of the Good Shepherd. 146 Table III. DEATHS—1911. Ages.—Whole Year. CAUSES OF DEATH.- 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. In Public Institutions in the Disrict. Not belonging to district. Belonging to district. 1 2 3 4 5 6 7 8 9 10 11 12 All causes Certified 1471 326 93 61 66 54 189 282 400 1250 283 Uncertified 2 1 - - - - 1 - - - Enteric Fever 5 - - - - 2 3 - - 8 2 Small-pox - - - - - - - - - - - Measles 76 16 28 22 10 - - - - 45 13 Scarlet Fever 7 - - 2 5 - - - - - - Whooping Cough 20 10 4 6 - - - - - - 3 Diphtheria and Croup 14 1 5 2 6 - - - - - - Influenza 11 1 — — — 1 3 2 4 3 1 Erysipelas 5 - - - - - 4 1 — 5 4 147 Cerebro-Spinal Fever - - - - - - - - - - v Phthisis (Pulmonary Tuberculosis) 118 2 2 1 6 20 58 27 2 201 42 Tuberculous Meningitis 26 3 10 8 3 - 2 — — 4 1 Other Tuberculous Diseases 27 11 1 5 4 1 2 3 — 23 2 Rheumatic Fever 7 — — — 1 1 2 3 — 2 — Cancer, Malignant Disease 99 — — — — 1 12 52 34 108 20 Bronchitis 130 20 4 — 1 1 5 26 73 79 17 Broncho-Pneumonia 33 8 6 5 6 — 2 — 6 20 7 Pneumonia (all other forms) 68 6 1 2 1 3 19 18 18 53 16 Other Diseases of Respiratory Organs 7 I 1 1 — — 2 1 1 4 1 18 Diarrhoea and Enteritis 126 87 21 2 2 — 2 4 8 48 Appendicitis and Typhlitis 5 — — — — 3 1 1 — 3 — Alcoholism 1 - - - - - - 1 — 2 — Cirrhosis of Liver 8 — — - — — — 6 2 12 2 Nephritis and Bright's Disease 43 — — — — 2 1 18 22 81 9 Puerperal Fever 2 — — — — — 2 — — 3 2 Other Accidents and Diseases of Pregnancy and Parturition 3 — — — — 1 2 — — 2 — Congenital Debility and Malformation, including Premature Birth 120 115 2 1 1 1 - - - 43 17 Violent Deaths, excluding Suicide 56 14 2 3 8 2 9 10 8 20 14 Suicides 3 — — — — — 1 2 — 2 — Old Age 96 - - - - - - 2 94 132 33 Other Defined Diseases 354 32 6 1 12 15 57 103 128 340 53 Diseases Ill-defined or Unknown 3 - - - - - 1 2 — 7 — All Causes 1473 327 93 61 66 54 190 282 400 1250 283 District Total 1473 148 Table III a. DEATHS—1911. Wards.—Whole Year. CAUSES OF DEATH. Leyton. Lea Bridge. Central. Forest. Leytonstone. Grove Green. Harrow Green. Cann Hall. Wanstead Slip. Ward not known. Totals. 1 2 3 4 5 6 7 8 9 10 11 12 All causes Certified 130 210 258 161 123 174 146 140 114 15 1471 Uncertified - 1 - - - - 1 - - - 2 Enteric Fever 1 1 - - 1 - 1 1 - - 5 Small-pox - - - - - - - - - - - Measles 4 6 17 6 - 17 10 6 9 1 76 Scarlet Fever — 1 1 - 1 - 2 2 - - 7 Whooping Cough — 1 3 3 - 2 4 2 5 - 20 Diphtheria and Croup 1 4 3 — - 4 1 1 - - 14 Influenza 4 1 2 2 - - 2 - - - 11 Erysipelas 1 - 1 - - 1 1 - 1 - 5 149 Cerebro-Spinal Fever - - - - - - - - - - - Phthisis (Pulmonary Tuberculosis) 11 18 23 9 8 13 11 17 7 1 118 Tuberculous Meningitis 3 4 4 4 1 - 5 3 2 — 26 Other Tuberculous Diseases 2 5 4 2 2 4 3 3 2 — 27 Rheumatic Fever — — — 1 1 2 1 1 1 — 7 Cancer, Malignant Disease 8 9 13 18 14 11 10 8 5 3 99 Bronchitis 10 17 21 15 16 10 15 12 13 1 130 Broncho-Pneumonia 4 5 4 1 4 4 2 3 6 — 33 Pneumonia (all other forms) 5 10 8 11 6 8 8 4 8 — 68 Other Diseases of Respiratory Organs — 1 1 1 - 2 — 1 1 - 7 Diarrhoea and Enteritis 11 21 28 9 5 16 15 13 5 3 126 Appendicitis and Typhlitis 1 2 1 1 - - - - - - 5 Alcoholism — — 1 — — — — — — — 1 Cirrhosis of Liver 2 3 1 — 1 1 — — .— — 8 Nephritis and Bright's Disease 4 3 10 2 7 5 3 4 5 — 43 Puerperal Fever — — 1 — - - - 1 — — 2 Other Accidents and Diseases of Pregnancy and Parturition - - 1 - - 1 1 - - - 3 Congenital Debility and Malformation, including Premature Birth 9 23 29 9 9 13 10 11 7 - 120 Violent Deaths, excluding Suicide 8 11 9 5 3 5 4 7 3 1 56 Suicides — — — 1 1 — — 1 — — 3 Old Age 12 10 14 12 4 17 9 7 9 2 96 Other Defined Diseases 29 54 57 49 38 38 29 32 25 3 354 Diseases Ill-defined or Unknown — 1 1 — 1 — — — — — 3 All Causes 130 211 258 161 123 174 147 140 114 15 1473 District Total 1473 150 TABLE III b. Causes of, and Ages at, Death, Twelve Months ending December 31ST, 1911. Diseases. Males. Females. AGES. All Ages. 0- 1- 5- 10- 15- 20- 2.5- 35- 45- 55- 65- 75- 85- Small-pox— (a) Vaccinated - - - - - - - - - - - - - - - - (b) Unvaccinated - - - - - - - - - - - - - - - - (c) No Statement - - - - - - - - - - - - - - - - Measles 34 42 16 10 10 - - - - - - - - - - 76 Scarlet Fever 3 4 — 2 5 - - - - - - - - - - 7 Typhus Fever — — — — — — — - - - - — — — — — Epidemic Influenza 6 5 1 — — — 1 - 2 1 1 1 3 1 — 11 Whooping Cough 8 12 10 10 - - - - - - - - - - - 20 Diphtheria 10 4 1 7 5 1 - - - - - - - - - 14 Enteric Fever 3 2 — — — — 2 - - 1 - — — — — 5 Asiatic Cholera — — — — — — — - — — - — — — — — Diarrhœa, Dysentery 20 12 23 2 1 — — - — 1 - 3 1 1 — 32 Epidemic Enteritis 26 28 44 7 1 — — - — — 1 — 1 — — 54 Other Allied Diseases - - - - - - - - - - - - - - - - Hydrophobia - - - - - - - - - - - - - - - - Glanders - - - - - - - - - - - - - - - - Tetanus - - - - - - - - - - - - - - - - Anthrax - - - - - - - - - - - - - - - - Cowpox - - - - - - - - - - - - - - - - 151 Syphilis 3 2 4 - - - - - - - - 1 - - - 5 Gonorrhœa — — — — — — — — — — — 1 — — — 1 Phagedæna - - - - - - - - - - - - - - - - Erysipelas 1 4 - - - - - - 2 2 1 — — — — 5 Puerperal Fever — 2 — — — — — — 1 1 — — — — — 2 Pyæmia 6 2 4 - - - - - 2 - - - 2 - - 8 Infective Endocarditis 4 3 - - - 1 1 1 1 — 1 — 1 1 — 7 Other Allied Diseases — 2 — 1 — — — — — — 1 — — — — 2 Malarial Fever - - - - - - - - - - - - - - - - Rheumatic Fever 5 2 — — 1 — 1 — 1 1 1 2 — — — 7 Rheumatism of Heart- - - - - - - - - - - - - - - - - Tuberculosis of Brain 11 12 3 18 1 2 - - 2 - - - - - - 26 Tuberculosis of Larynx 1 1 — — — — — — — 1 — 1 — — - 2 Phthisis 80 38 2 3 — 6 8 12 29 29 19 8 2 — - 118 Abdominal Tuberculosis 6 5 9 2 — — — — — — — — — — — 11 General Tuberculosis 4 2 1 3 1 1 - - - - - - - - - 6 Other forms Tuberculosis 3 5 1 1 1 1 — 1 — 1 — 2 — — — 8 Other Infective Diseases - - - - - - - - - - - - - - - - Thrush - - - - - - - - - - - - - - - - Actinomycosis - - - - - - - - - - - - - - - - Hydatid Diseases - - - - - - - - - - - - - - - - Securvy - - - - - - - - - - - - - - - - Other Diseases due to Altered Food - - - - - - - - - - - - - - - - Totals 238 189 119 106 26 12 13 14 42 38 25 19 10 3 — 427 152 Causes of, and Ages at, Death, Twelve Months ending December 31ST, 1911.—Continued. Diseases. Males. Females. ages. All Ages. 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65- 75- 85- Acute Alcoholism - - - - - - - - - - - - - - - - Chronic Alcoholism — 1 - - - - - - - - - 1 - - - 1 Chronic Industrial Poisonings - - - - - - - - - - - - - - - - Other Chronic Poisonings - - - - - - - - - - - - - - - - Osteo-arthritis — 7 - - - - - - - - 2 1 2 2 - 7 Gout 1 1 - - - - - - - - 1 1 - - - 2 Cancer 44 55 - - - - 1 - - 12 20 32 22 10 2 99 Diabetes Mellitus 2 6 — — — — — — 1 — — 2 5 — - 8 Purpura Hæmorrhagica 1 2 - - - - - - 2 - 1 - - - - 3 Hæmophilia - - - - - - - - - - - - - - - - Anæmia 2 2 — — — — — - - - 1 3 - - - 4 Lymphadenoma 1 - - - - 1 - - - - - - - - - 1 Premature Birth 23 28 51 - - - - - - - - - - - - 51 Injury at Birth 1 — 1 - - - - - - - - - - - - 1 Debility at Birth 4 1 5 - - - - - - - - - - - - 5 Atelectasis 2 2 4 - - - - - - - - - - - - 4 Congenital Defects 11 9 18 - 1 - - 1 - - - - - - - 20 Want of Breast Milk 1 1 2 - - - - - - - - - - - - 2 Atrophy, Debility, Marasmus 23 16 39 - - - - - - - - - - - - 39 Dentition 2 — 2 — — — — — — — — — — — — 2 Rickets 2 1 — 3 — — — — — — — — — — - 3 Old Age, Senile Decay 36 60 - - - - - - - - - 2 20 48 26 96 153 Convulsions 8 2 9 — 1 — — — — - - - - - - 10 Meningitis 2 3 1 2 2 - - - - - - - - - - 5 Encephalitis - - - - - - - - - - - - - - - - Apoplexy 3 8 - - - - - - - - 1 2 5 2 1 11 Softening of Brain — 1 — — — — — — — — 1 — — - - 1 Hemiplegia 4 2 - - - - - - - - - 1 2 2 1 6 General Paralysis of Insane 7 - - - - - - - - 2 1 1 3 — — 7 Other forms of Insanity 5 2 - - - - - - 2 — 2 2 1 — — 7 Chorea — — — — — — — — — — — — — — — — Cerebral Tumour 3 3 — — — — 1 — 2 2 1 — — - - 6 Epilepsy 6 3 — — — 1 — 1 2 3 2 — — — — 9 Laryngismus Stridulus - - - - - - - - - - - - - - - - Locomotor Ataxy 3 1 - - - - - - - - 2 - 2 - - 4 Paraplegia — 1 — — — — — — — — — — 1 — — 1 Other forms, Brain Diseases 1 - - - - - - - - - - - 1 - - 1 Otitis - 1 - - - - - - 1 - - - - - - 1 Disease of Nose, Epistaxis - - - - - - - - - - - - - - - - Diseases of Eye - — — — — — — — — — — — — - - - Pericarditis 2 2 1 1 1 - - - - - 1 - - - - 4 Endocarditis 25 24 — 1 — 1 1 2 4 7 8 11 10 3 1 49 Hypertrophy of Heart — — — — — — — — — — — — — — — — Angina Pectoris 2 2 - - - - - - - - 1 1 1 — 1 4 Aneurism 1 - - - - - - - 1 - - - - - - 1 Senile Gangrene - - - - - - - - - - - - - - - - Embolism, Thrombosis 7 2 — — 1 — — — — 1 1 1 4 1 - 9 Phlebitis - - - - - - - - - - - - - - - - Varicose Veins - - - - - - - - - - - - - - - - Totals 235 249 133 7 6 3 3 4 15 27 46 61 79 68 32 484 154 Causes of, and Ages at, Death, Twelve Months ending December 31ST, 1911.—Continued. Diseases. Males. Females. AGES. All Ages. 0- 1 5- 15- 20- 25- 35- 45- 55- 65- 75- 85- Other Diseases, Heart and Vessels 52 60 1 - - - 4 - 4 8 8 26 45 15 1 112 Laryngitis 1 — — — — — — — — 1 — — — — 1 Croup - - - - - - - - - - - - - - - - Other Diseases, Larynx and Trachea - - - - - - - - - - - - - - - - Acute Bronchitis 15 23 20 4 1 — 1 — —. 1 — 2 7 2 — 38 Chronic Bronchitis 41 51 - - - - - - - 4 6 18 30 30 4 92 Lobar Pneumonia 9 2 - - - - - 1 1 4 2 2 1 — — 11 Lobular Pneumonia 14 19 8 11 6 — — — 1 1 — — 2 3 1 33 Pneumonia 30 27 6 3 1 — — 2 6 8 6 8 11 5 1 57 Emphysema, Asthma — 1 - - - - - - - - - - 1 - - 1 Pleurisy 2 —. 1 1 - - - - - - - - - - - 2 Other Diseases, Respiratory System 3 1 — 1 — — — — - 2 1 — — — — 4 Diseases of Mouth and Annexa 1 - - - 1 - - - - - - - - - - 1 Diseases of Pharynx - - - - - - - - - - - - - - - - Diseases of (Esophagus - - — - - - - - - - - - - - - - Ulcer of Stomach and Duodenum 1 6 - - - - - 1 1 2 1 1 1 — — 7 Other Diseases of Stomach 3 5 4 - - - - - - - 2 — 1 1 — 8 Enteritis 18 22 20 14 — - - - 1 - - - 1 4 — 40 Appendicitis 4 1 - - - - 1 2 1 - - 1 - - - 5 155 Obstruction of Intestine 7 3 1 2 – – – – 1 1 2 2 – 1 – 10 Other Diseases of Intestine – – – – – – – – – – – – – – – – Cirrhosis of Liver 7 1 – – – – – – – – 1 5 1 1 – 8 Other Diseases of Liver 2 5 – – – – – – – 1 1 1 3 – 1 7 Peritonitis — 2 1 – – – – – – – 1 – – – – 2 Other Diseases, Digestive System 1 3 – – – – – – – 2 1 – – 1 – 4 Diseases, Lymphatic System and Glands – 2 – – – – – 2 – – – – – – – 2 Acute Nephritis 2 2 – – – – – – 1 – – – 2 – 1 4 Bright's Disease 16 23 – – – – 1 1 – – 11 7 13 4 2 39 Calculus 1 – – – 1 – – – – – – – – – – 1 Diseases of Bladder and Prostate 2 1 – – – – – – – – – – 1 2 – 3 Other Diseases, Urinary System – 1 – – – – – – – 1 – – – – – 1 Diseases of Testis and Penis – – – – – – – – – – – – – – – – Diseases of Ovaries – – – – – – – – – – – – – – – – Diseases of Uterus and Appendages – 3 – – – – – – – 3 – – – – – 3 Diseases of Vagina and External Genitals – – – – – – – – – – – – – – – – Diseases of Breast – – – – – – – – – – – – – – – – Abortion, Miscarriage – – – – – – – – – – – – – – – – Puerperal Mania – – – – – – – – – – – – – – – – Puerperal Convulsions – 2 – – – – – – – 1 – – – – – 2 Placenta, Prævia, Flooding – 1 – – – – – – – 1 – – – – – 1 Totals 232 267 62 36 10 – – 10 17 40 44 73 120 69 11 499 156 Causes of, and Ages at, Death, Twelve Months ending December 31st, 1911.—Continued Diseases. Males. Females. AGES. All Ages. 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65- 75- 85- Puerperal Thrombosis – – – – – – – – – – – – – – – – Other Diseases, Pregnancy, and Childbirth – – – – – – – – – – – – – – – – Arthritis, Ostitis, Periostitis 1 – – – – – 1 – – – – – – – – 1 Other Diseases, Osseous System 1 – – – – 1 – – – – – – – – – 1 Ulcer, Bedsore – – – – – – – – – – – – – – – – Eczema – – – – – – – – – – – – – – – – Pemphigus – – – – – – – – – – – – – – – – Other Diseases, Integumentary System – – – – – – – – – – – – – – – – Accidents and Negligence— In Mines and Quarries In Vehicular Traffic 2 5 – 1 2 1 – – – 2 1 – – – – 7 On Railways 5 – – – – – – 1 2 1 1 – – – – 5 On Ships, Boats, &c. (not drowning) 1 – – – – – – – – – – 1 – – – 1 In Building Operations – – – – – – – – – – – – – – – – By Machinery – – – – – – – – – – – – – – – – By Weapons and Implements – – – – – – – – – – – – – – – – Burns and Scalds 4 1 – 2 1 – – – – – 1 – – 1 – 5 Poisons, Poisonous Vapours 2 – – – – – – – – 1 – – – 1 – 2 Surgical Narcosis – – – – – – – – – – – – – – – – Effects of Electric Shock – – – – – – – – – – – – – – – – Corrosions by Chemicals – – – – – – – – – – – – – – – – Drowning 3 4 1 1 3 – – – – 1 1 – – – – 7 157 Suffocation, overlaid in Bed 3 2 5 – – – – – – – – – – – – 5 Suffocation, Otherwise 3 1 1 – 1 – – – – – – 1 1 – – 4 Falls not specified 4 3 – – – – – – – – 2 1 3 1 – 7 Weather Agencies 1 – – – – – – – – 1 – – – – – 1 Otherwise, not stated 3 6 4 1 – – – 1 – 1 1 – 1 – – 9 Homicide 1 – 1 – – – – – – – – – – – – 1 Suicides—: By Poison – – – – – – – – – – – – – – – – By Asphyxia – – – – – – – – – – – – – – – – By Hanging and Strangulation 2 – – – – – – – – – 1 1 – – – 2 By Drowning 1 – – – – – – – – 1 – – – – – 1 By Shooting – – – – – – – – – – – – – – – – By Cut or Stab – – – – – – – – – – – – – – – – By Precipitation from Elevated Places – – – – – – – – – – – – – – – – By Crushing – – – – – – – – – – – – – – – – By other and unspecified methods 1 – – – – – – – – 1 – – – – – 1 Execution – – – – – – – – – – – – – – – – Sudden Death, cause not ascertained 1 – – – – – – – – – 1 – – – 1 Ill-defined and unspecified causes 1 *? 1 – – – – – – – – 1 – – – 2 Totals, Sheet No. 4 39 23 13 5 7 2 1 2 2 9 8 6 5 3 – 63 Totals, Sheet No. 3 232 267 62 36 10 – 7 10 17 40 44 73 120 69 11 499 Totals, Sheet No. 2 235 249 13.1 7 6 3 3 4 15 27 46 61 79 68 32 484 Totals, Sheet No. 1 238 189 119 106 26 12 13 14 42 38 25 19 10 3 – 427 Grand Totals 744 728 327 154 39 17 21 30 76 11 123 159 214 143 43 1,473 * Sex not ascertained. 158 Table No. IV. INFANTILE MORTALITY DURING THE YEAR 1911. 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 1 Month. 1-3 Months. 3-6 Months. 6-9 Months. 9-12 Months. Total Deaths under 1 Year All Causes Certified 62 12 19 13 107 55 58 55 52 327 Uncertified 1 – – – – – – – – – Small-pox — — — — — — — — — — Chicken-pox — — — — — — — — — Measles – – – – – – 1 4 11 16 Scarlet Fever — — — — — — — — — — Diphtheria and Croup – – – – – – – – 1 1 Whooping-cough — — — — — 1 1 3 5 10 Diarrhoea 1 — 1 — 2 8 14 17 7 48 Enteritis — 1 1 — 2 9 15 10 3 39 Tuberculous Meningitis – – – – – – 1 1 1 3 Abdominal Tuberculosis – – – – – – 5 — 4 9 Other Tuberculous Diseases – – – – – – – 2 2 4 Congenital Malformations 10 1 1 1 13 4 1 — — 18 159 Premature Birth 35 6 4 1 46 3 — 1 1 51 Atrophy, Debility and Marasmus 2 2 5 5 14 15 8 7 2 46 Atelectasis 3 — 1 — 4 — — — — 4 Injury at Birth. 1 — — — 1 — — — — 1 Erysipelas – – – – – – – – – – Syphilis 1 — — 1 2 2 — — — 4 Rickets – – – – – – – – – – Meningitis (not Tuberculous) – – – – – – 1 — — 1 Convulsions 1 — 1 3 5 1 — 2 1 9 Gastritis 1 — — 2 3 1 — — — 4 Laryngitis – – – – – – – – – – Bronchitis – — 3 — 3 6 6 1 4 20 Pneumonia fall forms) — 2 — — 2 I 1 2 8 14 Suffocation, overlying – – – – – 3 1 — 1 5 Other Causes 8 — 2 — 10 1 3 5 1 20 Totals 63 12 19 ,3 107 55 58 55 52 327 Nett Births in the Year Legitimate 2,857 Illegitimate 74 Nett Deaths in the Year Legitimate infants 312 Illegitimate infants 15 Deaths from all Causes at all Ages 1,473 Birth Rate 23.5 Population—Census, 1911 124,736 Infantile Mortality Rate 111.6 160 Table IV a. INFANTILE MORTALITY DURING THE YEAR 1911. Deaths from Stated Causes as they occurred in the various Wards under One Year of Age. CAUSE OF DEATH. Leyton. Lea. Bridge. Central. Forest. Leytonstone. Grove Green. Harrow Green. Cann Hall. Wanstead Slip. Ward not known. Total Deaths under 1 Year. All Causes Certified 29 47 65 30 22 44 38 0 22 – – Uncertified ~~ – – – – – – – – – – Small-pox — — — — — — – – – — — Chicken-pox — — — — — — — — — — — Measles 3 — 1 — — 6 3 2 1 — 16 Scarlet Fever — — — — — — — – — — — Diphtheria and Croup — — — — — 1 — – — — 1 Whooping-cough — 1 2 — — 2 1 1 3 — 10 Diarrhoea 5 6 6 6 3 9 10 1 2 — 48 Enteritis 3 6 5 4 2 5 3 0 2 — 39 Tuberculous Meningitis — — 1 1 — - 1 – — — 3 Abdominal Tuberculosis 2 1 1 — — — 1 2 2 — 9 Other Tuberculous Diseases 1 1 2 – — — — — — - 4 Congenital Malformations 1 1 7 1 4 1 1 2 — — 18 161 Premature Birth 4 9 14 5 2 6 6 3 2 — 51 Atrophy, Debility and Marasmus 3 9 7 4 3 8 2 5 5 — 46 Atelectasis — — 1 — 2 — 1 — — — 4 Injury at Birth — — — — — 1 — — — 1 Erysipelas — — — — — — — — — — — Syphilis — — — 1 1 1 1 — — — 4 Rickets — — — — — — — — — — — Meningitis (not Tuberculous) — — — — 1 — — — — — 1 Convulsions 1 1 5 — — 1 1 — — — 9 Gastritis — 2 — — 1 — — 1 — — 4 Laryngitis — — — — — — — — — — — Bronchitis — 1 5 5 — 2 4 2 1 — 20 Pneumonia (all forms) 4 1 4 1 — — 1 — 3 — 14 Suffocation, overlying — 3 — — 1 — — — 1 — 5 Other Causes 2 5 4 2 2 2 1 2 — — 20 Totals .. 29 47 65 30 22 44 38 30 22 — 327 Nett Births in the Year Legitimate 2,857 Illegitimate 74 Nett Deaths in the Year of Legitimate Infants 312 Illegitimate Infants 15 Deaths from all Causes at all Ages 1,473 Birth Rate 23.5 Population, Census 1911 124.736 Infantile Mortality Rate 111.6 162 DEATHS.—1911. Ages.—Whole Year Wards.—Whole Year. Causes of Death. 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. Is Public institutions in the District. Leyton. Lea Bridge. Central. Forest. Leytonstone. Grove Green. Harrow Green. Cann Hall. Wanstead Slip. Ward not known. Totals. Not belonging to district. Belonging to district. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 All causes Certified 1471 326 93 61 66 54 189 282 400 1250 283 130 210 258 161 123 174 146 140 114 15 1471 Uncertified 2 1 – – – – 1 – – – – – 1 – – – – 1 – — — 2 Enteric Fever 5 – – – – 2 3 – – 8 2 1 1 – – 1 – 1 1 – – 5 Small-pox — — — — — — — — — — – – – – Measles 76 16 28 22 10 — — — — 45 13 4 6 17 6 17 10 6 9 1 76 Scarlet Fever 7 — — 2 5 — —. — — — — — 1 1 1 2 2 – 7 Whooping Cough 20 10 4 6 – – – – – – 3 1 3 3 2 4 2 5 – 20 Diphtheria and Croup 14 1 5 2 6 — — — — 1 4 3 4 1 1 – 14 Influenza.. 11 1 — 1 3 2 4 3 1 4 1 2 2 – 2 – – – 11 Erysipelas 5 – – – – – 4 1 — 5 4 1 — 1 – – 1 1 1 5 Cerebro-Spinal Fever – – – – – – – – – – – – – – – – – – – – – – 103 Phthisis (Pulmonary Tuberculosis) 118 2 2 1 6 20 58 27 2 201 42 11 18 23 9 8 13 11 17 7 1 118 Tuberculous Meningitis 26 3 10 8 3 — 2 — — 4 1 3 4 4 4 1 — 5 3 2 — 26 Other Tuberculous Diseases 27 11 1 5 4 1 2 3 — 23 2 2 5 4 2 2 4 3 3 2 — 27 Rheumatic Fever 7 — — — 1 1 2 3 — 2 — — — — 1 1 2 1 1 1 — 7 Cancer. Malignant Disease 99 — — — — 1 12 52 34 108 20 8 9 13 18 14 11 10 8 5 3 99 Bronchitis 130 20 4 — 1 1 5 26 73 79 17 10 17 21 15 16 10 15 12 13 1 130 Broncho-Pneumonia 33 8 6 5 6 — 2 — 6 20 7 4 5 4 1 4 4 2 3 6 — 33 Pneumonia (all other forms) 68 6 1 2 1 3 19 18 18 53 16 5 10 8 11 6 8 8 4 8 — 68 Other Diseases of Respiratory Organs 7 1 1 1 — — 2 1 1 4 1 — 1 1 1 — 2 — 1 1 — 7 Diarrhoea and Enteritis 126 87 21 2 2 — 2 4 8 48 18 11 21 28 9 5 16 15 13 5 3 126 Appendicitis and Typhlitis 5 — — — — 3 1 1 — 3 — 1 2 1 1 — — — — — — 5 Alcoholism 1 — — — — — — 1 — 2 — — 1 — — — — — — — 1 Cirrhosis of Liver 8 — — — — — — 6 2 12 2 2 3 1 — 1 1 — — — — 8 Nephritis and Bright's Disease 43 — — — — 2 1 18 22 81 9 4 3 10 2 7 5 3 4 5 — 3 Puerperal Fever 2 — — — — — 2 — — 3 2 — 1 — — — — 1 — — 2 Other Accidents and Diseases of Pregnancy and Parturition 3 — — — — 1 2 — — 2 — — — 1 — — 1 1 — — — 3 Congenital Debility and Malformation, including Premature Birth 120 115 2 1 1 1 — — — 43 17 9 23 29 9 9 13 10 11 7 — 120 Violent Deaths, excluding Suicide 56 14 2 3 8 2 9 10 8 20 14 8 11 9 5 3 5 4 7 3 1 56 Suicides 3 — — — — — 1 2 — 2 — — — — 1 1 1 1 — 1 — — 3 Old Age 96 — — — — — — 2 94 132 33 12 10 14 12 4 17 9 7 9 2 96 Other Defined Diseases 354 32 6 1 12 15 57 103 128 340 59 29 54 57 49 38 38 29 32 25 3 354 Diseases Ill-defined or Unknown 3 — — — — — 1 2 — 7 — — 1 1 — 1 — — — — — 3 All Causes 1473 327 93 61 66 54 190 282 400 1250 283 130 211 258 161 123 174 147 140 114 15 1473 District Total 1473 1473 164 Principal Causes of Death.—January, 1911. CAUSES OF DEATH. 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. In Public Institutions in the District. Not belonging to District. Belonging to District. 1 2 3 4 5 6 7 8 9 10 11 12 All causes Certified 157 20 8 8 6 6 21 44 44 92 22 Uncertified 1 – – – – – 1 – – – – Enteric Fever 1 – – – – – 1 2 — Small-pox – – – – – – – – – – – Measles 5 – 3 1 1 – – – – – – Scarlet Fever 1 – – – 1 – – – – – – Whooping Cough 4 1 1 2 — — — – — – – Diphtheria and Croup – – – – – – – – – – – Influenza 1 – – – – – – – 1 – 1 Erysipelas I – – – – – – – – – – 165 Cerebro-Spinal Fever — —- — — — — — — — — – Phthisis (Pulmonary Tuberculosis) 12 – – – – 2 5 5 – 16 4 Tuberculous Meningitis 3 1 — 1 1 — — — — 1 — Other Tuberculous Diseases 5 1 — 1 2 — 1 — — 2 2 Rheumatic Fever — — — — — — — — — — — Cancer, Malignant Disease 10 — — — — — 2 6 2 4 2 Bronchitis 28 — 2 — 1 1 3 10 11 11 3 Broncho-Pneumonia 3 — 2 — — — — — 1 3 — Pneumonia (all other forms) 9 1 — 2 — — 2 3 1 4 1 Other diseases of Respiratory Organs — — — — — — — — — 1 — Diarrhoea and Enteritis 3 1 – – – – – 2 — 1 — Appendicitis and Typhlitis — — — — — — — — — — — Alcoholism – – – – – – – – – – – Cirrhosis of Liver 2 – – – – – – 1 1 1 — Nephritis and Bright's Disease 5 — — — — — — 3 2 6 — Puerperal Fever – – – – – – – – – – – Other Accidents and Diseases of Pregnancy and Parturition – – – – – – – – – – – Congenital Debility and Malformation, including Premature Birth 14 13 – – – 1 – – – 6 – Violent Deaths, excluding Suicide 3 — — — — — 1 2 — 1 — Suicides 1 – – – – – – 1 – – – Old Age 8 – – – – – – – 8 15 1 Other Defined Diseases 37 2 — 1 – 2 5 10 17 18 7 Diseases Ill-defined or Unknown 2 — — — — — 1 1 — — — All Causes 158 20 8 8 6 6 22 44 44 92 22 District Total 158 166 Principal Causes of Death.—February,1911. CAUSES OF DEATH. All Ages. j 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. In Public Institutions in the District. Not belonging to District. Belonging to District. 1 2 3 4 5 6 7 8 9 10 11 12 All causes Certified 145 22 8 8 11 3 18 27 48 111 25 Uncertified – – – – – – – – – – – Enteric Fever – – – – – – – – – 1 – Small-pox – – – – – – – – – – – Measles 13 2 3 6 2 — — — — 2 1 Scarlet Fever 3 — — 1 2 – – – – – – Whooping Cough 2 1 — 1 – – – – – – – Diphtheria and Croup 3 — 1 — 2 — — — — — — Influenza 2 – – – – – – – 2 1 — Erysipelas – – – – – – – – – – – 167 Cerebro-Spinal Fever – – – – – – – – – – – Phthisis (Pulmonary Tuberculosis) 12 — — 1 8 3 — 18 6 Tuberculous Meningitis 1 – – – 1 – – – – – – Other Tuberculous Diseases 1 — — — – — — 1 — 1 – Rheumatic Fever — — — — — — — — — — – Cancer, Malignant Disease 8 – – – – – 1 2 5 7 1 Bronchitis 22 3 1 — — — 1 3 14 16 2 Broncho-Pneumonia 5 1 1 — 3 — – — — 4 1 Pneumonia (all other forms) 11 — — — 1 — 3 4 3 7 2 Other diseases of Respiratory Organs 1 1 – – – – – – – – Diarrhoea and Enteritis 2 — 2 – – – – – – – 1 Appendicitis and Typhlitis 1 — — — — 1 — — — 2 — Alcoholism 1 — — — — — — 1 — — — Cirrhosis of Liver 1 — — — — — — 1 — — — Nephritis and Bright's Disease 3 – – – – – – – 3 7 1 Puerperal Fever 1 – – – – – 1 – – – 1 Other Accidents and Diseases of Pregnancy and Parturition – – – – – – – – – – – Congenital Debilitv and Malformation, including Premature Birth 9 9 – – – – – – – 4 1 Violent Deaths, excluding Suicide 7 2 – — — 1 i 1 2 5 2 Suicides – — — — Old Age 9 – – — — — – — 9 9 2 Other Defined Diseases 26 2 3 11 10 26 4 Diseases ill-defined or unknown 1 1 – – – – – – – 1 – All Causes 145 22 8 8 11 3 18 27 48 111 25 District Total 145 168 Principal Causes of Death.—March, 1911. CAUSES OF DEATH. 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. In Public Institutions in the District. Not belonging to District. Belonging to District. 1 2 3 4 5 6 7 8 9 10 11 12 All causes Certified 168 37 19 18 9 7 20 26 32 136 37 Uncertified – – – – – – – – – – – Enteric Fever – – – – – – – – – – – Small-pox – – – – – – – – – – – Measles 37 8 11 13 5 – – — — 12 4 Scarlet Fever — — — — — – – — — — — Whooping Cough 6 3 1 2 – – – – – – 3 Diphtheria and Croup 1 – – – 1 – – – – – – Influenza 1 — – — — – 1 — — 1 — Erysipelas – – – – – – – – – – – 169 Cerebro-Spinal Fever – – – – – – – – – – – Phthisis (Pulmonary Tuberculosis) 11 1 — – 3 5 2 21 5 Tuberculous Meningitis 3 — 2 – – – 1 – – – – Other Tuberculous Diseases 2 — — — 1 — 1 — — 1 — Rheumatic Fever 1 – – – – – – 1 – – – Cancer, Malignant Disease 14 — — — – 1 1 7 5 14 3 Bronchitis 18 4 1 — – — — 1 12 11 3 Broncho-Pneumonia 8 3 2 2 – — — — 1 4 3 Pneumonia (all other forms) 10 1 1 — – 1 2 3 2 4 1 Other Diseases of Respiratory Organs 1 — — 1 – — — — — 3 — Diarrhoea and Enteritis – – – – – – – – – 1 — Appendicitis and Typhlitis — Alcoholism — — Cirrhosis of Liver 1 — — – 1 – 2 — Nephritis and Bright's Disease 2 — — — – — 1 1 – 9 1 Puerperal Fever 1 — — — – — 1 — — — 1 Other Accidents and Diseases of Pregnancy and Parturition – – – – – – – – – – – Congenital Debility and Malformation, including Premature Birth 12 12 – – – – – – – 2 2 Violent Deaths, excluding Suicide 4 2 1 – — — 1 — 3 — Suicides 1 – 1 — 1 — Old Age 5 – – – – – – – 5 17 3 Other Defined Diseases 29 3 – – 2 2 7 8 7 30 8 Diseases Ill-defined or Unknown – – – – – – – – – – – All Causes 168 37 19 18 9 7 20 26 32 136 37 District Total 168 170 Principal Causes of Death.—April, iqii. CAUSES OF DEATH. 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. In Public Institutions in the District. Not belonging to District. Belonging to District. 1 2 3 4 5 6 7 8 9 10 11 12 All causes Certified 126 22 11 8 7 4 20 31 23 117 24 Uncertified 1 1 – – – – — — – – – Enteric Fever – – – – – – – – – – – Small-pox – – – – – – – – – – – Measles 12 4 5 2 1 23 3 Scarlet Fever — — . — Whooping Cough 3 1 1 1 – – — — – — — Diphtheria and Croup 3 — 1 1 1 – — — – — — Influenza 1 — — — 1 Erysipelas — — — — – – — — – – – 171 Cerebro-Spinal Fever – – – – – – – – – – – Phthisis (Pulmonary Tuberculosis) 11 — — — 1 1 6 3 — 17 2 Tuberculous Meningitis 2 — — 1 1 — — — — — — Other Tuberculous Diseases 3 1 — 2 3 — Rheumatic Fever 2 — — — — — 1 1 — — — Cancer, Malignant Disease 9 – – – – – 2 5 2 15 1 Bronchitis 5 2 – – – – – 2 1 6 2 Broncho-Pneumonia 4 2 — 1 1 — — — — 1 — Pneumonia (all other forms) 4 – – – – – – 2 2 6 2 Other Diseases of Respiratory Organs 1 – – – – – 1 – – – – Diarrhoea and Enteritis 3 2 1 – – – – – – – – Appendicitis and Typhlitis 2 — — — — 1 — 1 — — — Alcoholism – – – – – – – – – – – Cirrhosis of Liver 1 — — — — — — 1 — — 1 Nephritis and Bright's Disease 5 — — — — 1 — 3 1 3 — Puerperal Fever — — — — — — — — — — — Other Accidents and Diseases of Pregnancy and Parturition – – – – – – – – – – – Congenital Debility and Malformation, including Premature Birth 10 10 – – – – – – – 3 1 Violent Deaths, excluding Suicide 4 — — — 1 — 1 1 1 — 1 Suicides — — — — — — — — — — — Old Age 7 – – – – – – – 7 13 2 Other Defined Diseases 35 1 3 — 1 1 8 12 9 27 9 Diseases Ill-defined or Unknown — — – — — — — — — — — All Causes 127 23 11 8 7 4 20 31 23 117 24 District Total 127 172 Principal Causes of Death.—May, 1911. CAUSES OF DEATH. 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. In Public Institutions in the District. Not belonging to District. Belonging to District. 1 2 3 4 5 6 7 8 9 10 11 12 All causes Certified 107 17 6 3 5 6 15 25 30 114 22 Uncertified – – – – – – – – – – – Enteric Fever – – – – – – – – – – – Small-pox – – – – – – – – – – – Measles 4 1 3 — — — — – — 6 3 Scarlet Fever — — — — — — — – — — Whooping Cough 1 1 — — — — — – — — — Diphtheria and Croup i — — 1 — — — – — — — Influenza 1 — — — — — — 1 — 1 — Erysipelas — — — — — — — – — 2 — 173 Cerebro-Spinal Fever – – – – – – – – – – – Phthisis (Pulmonary Tuberculosis) 9 – – – 1 4 – 2 1 19 1 Tuberculous Meningitis 2 — 1 1 – – – – – – 1 Other Tuberculous Diseases 1 — — — — — — 1 — 4 – Rheumatic Fever 2 — — — — — 1 1 — — – Cancer, Malignant Disease 7 – – – – – – 6 1 5 1 Bronchitis 4 – – – – – – 2 2 7 – Broncho-Pneumonia 1 — — — — — 1 – — 2 – Pneumonia (all other forms) 5 1 — — — — 2 — 2 8 2 Other Diseases of Respiratory Organs 2 — 1 — — — — 1 — – 1 Diarrhoea and Enteritis 1 – – – – – – – 1 3 – Appendicitis and Typhlitis – – – – – – – – – 1 — Alcoholism – – – – – – – – – – – Cirrhosis of Liver – – – – – – – – – – – Nephritis and Bright's Disease 7 – – – – – – 4 3 5 1 Puerperal Fever – – – – – – – – – – – Other Accidents and Diseases of Pregnancy and Parturition 1 – – – – 1 – – – – – Congenital Debility and Malformation, including Premature Birth 9 9 – – – – – – – 3 3 Violent Deaths, excluding Suicide 6 — — 1 1 — 2 1 1 – 2 Suicides – – – – – – – – – – – Old Age 9 – – – – – – – 9 6 3 Other Defined Diseases 34 5 1 — 3 1 8 6 10 40 4 Diseases Ill-defined or Unknown — — — — — — — – — 2 — All Causes 107 17 6 3 5 6 15 25 30 114 22 District Total 107 174 Principal Causes of Death.—June, 1911. CAUSES OF DEATH. 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. 6o and upwards. In Public Institutions in the District. Not belonging to District. Belonging to District. 1 2 3 4 5 6 7 8 9 10 11 12 All causes Certified 79 13 4 1 3 2 18 15 23 73 16 Uncertified – – – – – – – – – – – Enteric Fever – – – – – – – – – – – Small-pox — — — — — — — — – Measles 2 — 2 — — — — 2 2 Scarlet Fever — — — — — — — — Whooping Cough — — — — — — — — – — — Diphtheria and Croup 1 — ' — — 1 — — — – — — Influenza 1 — — – — — 1 — – Erysipelas — — — – — — — — – — — 175 Cerebro-Spinal Fever — — — – — — — — — – – Phthisis (Pulmonary Tuberculosis) 7 — 6 1 20 1 Tuberculous Meningitis 1 – – – – – 1 – – – – Other Tuberculous Diseases 3 1 — 1 — — — 1 — 3 — Rheumatic Fever 1 — — – 1 — — — — — Cancer, Malignant Disease 8 — — — — — 1 3 4 5 1 Bronchitis 2 — — — — — 1 — 1 3 2 Broncho-Pneumonia 1 — 1 — — — — 1 Pneumonia (all other forms) 3 — — — 1 1 1 3 — Other Diseases of Respiratory Organs – – – – – – – – – – – Diarrhoea and Enteritis 3 2 1 — — — — — — 1 1 Appendicitis and Typhlitis 1 — — — — — 1 — — — — Alcoholism — — — — — Cirrhosis of Liver — — — Nephritis and Bright's Disease 3 — — — — — — 2 1 5 1 Puerperal Fever — — — — — — — — — — — Other Accidents and Diseases of Pregnancy and Parturition 1 – – – – – 1 – – – – Congenital Debility and Malformation, including Premature Birth 6 5 – – 1 – – – – 1 – Violent Deaths, excluding Suicide 4 3 – – – – – – 1 4 1 Suicides — — — — Old Age 8 — — — — — — 1 7 8 2 Other Defined Diseases 23 2 – – – 2 5 6 8 16 4 Diseases Ill-defined or Unknown — — — — — — — — — 2 — All Causes 79 13 4 1 3 2 18 15 23 73 16 District Total 79 176 Principal Causes of Death.—July, 1911. CAUSES OF DEATH. 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. In Public Institutions in the District. Not belonging to District. Belonging to District. 1 2 3 4 5 6 7 8 9 10 11 12 All causes Certified 92 17 6 3 6 2 16 19 23 75 11 Uncertified – – – – – – – – – – – Enteric Fever 1 – – – – 1 – – – – – Small-pox Measles 2 1 – – 1 Scarlet Fever — – – – Whooping Cough 3 2 1 – – – – – – – – Diphtheria and Croup 1 1 – – – – – – – – – Influenza — — Erysipelas — — – – – – – – – — — 177 Cerebro-Spinal Fever – – – – – – – – – – – Phthisis (Pulmonary Tuberculosis) 12 1 1 – 1 1 5 3 – 17 5 Tuberculous Meningitis 3 — 1 2 – – – – – – – Other Tuberculous Diseases 1 1 – – – – – – – – – Rheumatic Fever – – – – – – – – – – – Cancer, Malignant Disease 12 – – – – – 1 5 6 10 2 Bronchitis 5 – – – – – – – 5 4 1 Broncho-Pneumonia – – – – – – – – – – – Pneumonia (all other forms) 1 — — — — — 1 – – 2 — Other Diseases of Respiratory Organs – – – – – – – – – – – Diarrhoea and Enteritis 5 3 2 – – – – – – 2 1 Appendicitis and Typhlitis – – – – – – – – – – – Alcoholism – – – – – – – – – – — Cirrhosis of Liver 1 – – – – – – 1 – – – Nephritis and Bright's Disease 3 – – – – – – 1 2 10 1 Puerperal Fever – – – – – – – – – – – Other Accidents and Diseases of Pregnancy and Parturition – – – – – – – – – – – Congenital Debility and Malformation, including Premature Birth 4 4 – – – – – – – 2 Violent Deaths, excluding Suicide 5 1 — 1 1 — 2 — — — — Suicides 1 — — — — — 1 — — 1 — Old Age 3 – – – – – – – 3 9 — Other Defined Diseases 29 3 1 — 3 — 6 9 7 18 1 Diseases Ill-defined or Unknown – – – – – – – – – – – All Causes 92 17 6 3 6 2 16 19 23 75 11 District Total 92 178 Principal Causes of Death.—August, 1911. CAUSES OF DEATH. 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. In Public Institutions in the District. Not belonging to District. Belonging to District. 1 2 3 4 5 6 7 8 9 10 11 12 All causes Certified 169 71 11 5 4 3 14 26 35 120 28 Uncertified – – – – – – – – – – – Enteric Fever – – – – – – – – – – – Small-pox – – – – – – – – – – – Measles 1 – 1 – – – – – – – – Scarlet Fever – – – – – – – – – – – Whooping Cough – – – – – – – – – – – Diphtheria and Croup – – – – – – – – – – – Influenza – – – – – – – – – – – Erysipelas 1 – – – – – – 1 – 1 – 179 Cerebro-Spinal Fever — — — — — Phthisis (Pulmonary Tuberculosis) 11 1 – 1 7 2 – 21 7 Tuberculous Meningitis 3 1 – 2 1 – Other Tuberculous Diseases 2 2 6 – Rheumatic Fever – – – – – – – Cancer, Malignant Disease 8 1 4 3 7 3 Bronchitis 1 – – – 1 – – – Broncho-Pneumonia 1 1 – – – – – – – 1 Pneumonia (all other forms) 5 – – 2 1 2 2 – Other Diseases of Respiratory Organs – – – – – – – Diarrhoea and Enteritis 67 46 9 2 2 1 1 6 17 7 Appendicitis and Typhlitis 1 – 1 – – – – – Alcoholism – – – – – 1 – Cirrhosis of Liver – – – – – – – – Nephritis and Bright's Disease 2 – – – – 1 1 15 1 Puerperal Fever – – – – – – – – Other Accidents and Diseases of Pregnancy and Parturition 1 – – – – – 1 – – – – Congenital Debility and Malformation, including Premature Birth 15 15 – – – – – – – 2 3 Violent Deaths, excluding Suicide 6 2 2 – 1 – 1 1 2 Suicides – – – – – – – – Old Age 10 – – – – – – – 10 11 1 Other Defined Diseases 34 4 1 – – 1 1 15 12 33 3 Diseases Ill-defined or Unknown – – – – – – – – – 2 – All Causes 169 71 11 5 4 3 14 26 35 120 28 District Total 169 180 Principal Causes of Death.—September, 1911. CAUSES OF DEATH 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. In Public Institutions in the District. Not belonging to District. Belonging to District. 1 2 3 4 5 6 7 8 9 10 11 12 All causes Certified 115 44 6 2 6 6 14 15 22 112 20 Uncertified – – – – – – – – – – – Enteric Fever 1 – 1 1 1 Small-pox – – – – – – – – – – – Measles – – – – – – – – – – – Scarlet Fever 2 – – 1 1 – – – – – – Whooping Cough – – – – – – – – – – – Diphtheria and Croup – – – – – – – – – – – Influenza – – – – – – – – – – – Erysipelas – – – – – – – – – – – 181 Cerebro-Spinal Fever — — — — — — — — — — — Phthisis (Pulmonary Tuberculosis) 12 — — — 1 2 6 2 1 14 3 Tuberculous Meningitis 1 — 1 — — — — — 1 — Other Tuberculous Diseases 3 1 1 1 — — — — — 1 — Rheumatic Fever — — — — — — — — — 1 — Cancer. Malignant Disease 5 — 3 2 — 8 2 Bronchitis 3 — — — — — — — 3 7 1 Broncho-Pneumonia 1 — — — — — 1 — — 2 — Pneumonia (all other forms) 2 1 — — — 1 — — — 3 — Other Diseases of Respiratory Organs — — — — — — — — — — Diarrhoea and Enteritis 30 24 4 — — — — 1 1 8 1 Appendicitis and Typhlitis — — — — — — — — — — — Alcoholism — — — — — — — — — — — Cirrhosis of Liver — — — — — — — — — 5 — Nephritis and Bright's Disease 4 — — — — — — 2 2 6 1 Puerperal Fever — — — — — — — — — 1 — Other Accidents and Diseases of Pregnancy and Parturition — — — — — — — — — — Congenital Debility and Malformation, including Premature Birth 15 15 — — — — — — — 11 9 Violent Deaths, excluding Suicide 8 1 — — 1 1 1 3 1 1 3 Suicides — — — — — — — — — — — Old Age 7 — — — — — — — 7 7 3 Other Defined Diseases 21 2 — — 3 1 3 5 7 35 3 Diseases Ill-defined or Unknown — — — — — — — — — — — All Causes 115 44 6 2 6 6 14 15 22 112 20 District Total 115 182 Principal Causes of Death.—October, 1911. causes of death. 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. In Public Institutions in the District. Not belonging to District. Belonging to District. 1 2 3 4 5 6 7 8 9 10 11 12 All causes Certified 100 23 7 2 3 4 12 15 34 103 26 Uncertified — — — — — — — — — — — Enteric Fever 1 — — — — — 1 — — 1 1 Small-pox — — — — — — — — — — — Measles — — — — — — — — — — — Scarlet Fever — — — — — — — — — — — Whooping Cough Diphtheria and Croup 1 — — — 1 — — — — — — Influenza — — — — — — — — — — — Erysipelas 1 — — — — — 1 — — 1 1 183 Cerebro-Spinal Fever — — — — — — — — — — — Phthisis (Pulmonary Tuberculosis) 5 — 1 — 1 — 3 — — 14 2 Tuberculous Meningitis 2 — 1 1 — — — — — — — Other Tuberculous Diseases 3 2 — — 1 — — — — 1 — Rheumatic Fever — — — — — — — — — 1 — Cancer, Malignant Disease 4 — — — — — — 4 — 11 1 Bronchitis 9 1 — — — — — 2 6 3 1 Broncho-Pneumonia 1 — — — — — — — 1 1 — Pneumonia (all other, forms) 4 1 — — — — 3 — — 4 1 Other Diseases of Respiratory Organs — — — — — — — — — — — Diarrhoea and Enteritis .. 7 5 2 — — — — — — 14 5 Appendicitis and Typhlitis — — — — — — — — — — — Alcoholism — — — — — — — — — — — Cirrhosis of Liver., 1 — — — — — — — 1 2 — Nephritis and Bright's Disease 2 — — — — — — — 2 5 — Puerperal Fever — — — — — — — — — 2 — Other Accidents and Diseases of Pregnancy and Parturition — — — — — — — — — 1 — Congenital Debility and Malformation, including Premature Birth 11 8 2 1 — — — — — 8 2 Violent Deaths, excluding Suicide 3 — 1 — — — — 1 1 — 3 Suicides — — — — — — — — — — — Old Age 9 — — — — — — — 9 6 5 Other Defined Diseases 36 6 — — — 4 4 8 14 28 4 Diseases Ill-defined or Unknown — — — — — — — — — — — All Causes 100 23 7 2 3 4 12 15 34 103 26 District Total 100 184 Principal Causes of Death.—November, 1911. CAUSES OF DEATH. 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. In Public Institutions in the District. Not belonging to District. Belonging to District. 1 2 3 4 5 6 7 8 9 10 11 12 All causes Certified 109 23 2 2 4 6 10 20 42 111 29 Uncertified — — — — — — — — — — — Enteric Fever 1 — — — — — 1 — — 2 — Small-pox — — — — — — — — — — — Measles — — — — — — — — — — — Scarlet Fever 1 — — — 1 — — — — — — Whooping Cough — — — — — — — — — — — Diphtheria and Croup — — — — — — — — — — — Influenza 2 1 — — — — — — 1 — — Erysipelas 2 — — — — 2 — — 1 2 185 Cerebro-Spinal Fever – – – – – – – – – – – Phthisis (Pulmonary Tuberculosis) 8 – – – – 5 3 – – 15 2 Tuberculous Meningitis 3 1 2 – – – – – – 1 – Other Tuberculous Diseases 2 2 – – – – – – – 1 – Rheumatic Fever – – – – – – – – – – Cancer, Malignant Disease 7 – – – – – – 3 4 10 2 Bronchitis 14 4 – – – – – 4 6 8 2 Broncho-Pneumonia 3 1 – 1 1 – – – – 1 Pneumonia (all other forms) 7 1 — – — 1 — 2 3 4 2 Other Diseases of Respiratory Organs 1 — — — — — — 1 — — Diarrhoea and Enteritis 3 2 – – – – 1 – – 1 1 Appendicits and Enteritis – – – – – – – – – – – Alcoholism – – – – – – – – – 1 – Cirrhosis of Liver 1 – – – – – 1 – 1 1 Nephritis and Bright's Disease 3 – – – – – – – 3 6 2 Puerperal Fever – – – – – – – – – – – Other Accidents and Diseases of Pregnancy and Parturition – – – – – – – – – 1 – Congenital Debility and Malformation, including Premature Birth 8 8 – – – – – – – – 2 Violent Deaths, excluding Suicide 5 2 – 1 2 – – – – 3 – Suicides – – – – – – – – – – – Old Age 11 – – – – – – 1 10 19 6 Other Defined Diseases 27 1 – – – 3 9 14 36 7 Diseases Ill-defined or Unknown – – – – – – – – – – – All Causes 109 23 2 2 4 6 10 20 42 111 29 District Total 109 186 Principal Causes of Death.—December, 1911. CAUSE OF DEATH. 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. In Public Institutions in the District. Not belonging to District. Belonging to District. 1 2 3 4 5 6 7 8 9 10 11 12 All causes Certified 104 17 5 1 2 5 10 20 44 86 23 Uncertified – – – – – – – – – – – Enteric Fever – – – – – – – – – 1 – Small-pox – – – – – – – – – – – Measles – – – – – – – – – – – Scarlet Fever – – – – – – – – – – – Whooping Cough 1 1 – – – – – – – – – Diphtheria and Croup 3 – 3 – – – – – – – – Influenza 2 – – – – 1 – 1 – – – Erysipelas – – – – – – – – – – – 187 Cerebro-Spinal Fever – – – – – – – – – – – Phthisis (Pulmonary Tuberculosis) 8 – – – 1 – 3 4 – 9 4 Tuberculous Meningitis 2 – 2 – – – – – – – – Other Tuberculous Diseases 1 – – – – 1 – – – – – Rheumatic Fever 1 – – – – 1 – – – – – Cancer, Malignant Disease 7 – – – – – – 5 2 12 1 Bronchitis 19 6 – – – – – 1 12 3 – Broncho-Pneumonia 5 – – 1 1 – – 1 3 2 1 Pneumonia (all other forms) 7 – – – – – 3 2 2 6 5 Other Diseases of Respiratory Organs 1 – – – – – 1 – – – – Diarrhoea and Enteritis 2 2 – – – – – – – – 1 Appendicitis and Typhlitis – – – – – – – – – – – Alcoholism – – – – – – – – – – – Cirrhosis of Liver – – – – – – – – – 1 – Nephritis and Bright's Disease 4 – – – – 1 – 1 2 4 – Puerperal Fever – – – – – – – – – – – Other Accidents and Diseases of Pregnancy and Parturition – – – – – – – – – – – Congenital Debility and Malformation, including Premature Birth 7 7 – – – – – – – 1 1 Violent Deaths, excluding Suicide 1 1 – – – – – – – 2 – Suicides – – – – – – – – – – – Old Age 10 — — — — — — — 10 12 5 Other Defined Diseases 23 – – – – 1 3 6 13 33 5 Diseases Ill-defined or Unknown — — — — — – – – — — — All Causes 104 17 5 1 2 5 10 20 44 86 23 District Total 104 188 Cases of Infectious Disease Notified during the Month of January, 1911, including Cases which occurred in west Ham union, infirmary, &c., but not those imported. notifiable disease. Number of Cases Notified. Total Cases Notified in each Locality— Wards. Total Cases removed to Hospital. At Ages—Years. 1 2 3 4 5 6 7 8 9 At all Ages. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 45. 45 to 65. 65 and upwards. Leyton. Lea Bridge. Central. Forest. Leytonstone. Grove Green. Harrow Green. Cann Hall. Wanstead Slip. Small-pox – – – – – – – – – – – – – – – – – – Cholera – – – – – – – – – – – – – – – – – – Diphtheria (including Membranous Croup) 13 – 5 8 – – – – 1 5 2 2 – 3 – – – 10 *Erysipelas 9 1 – – 3 3 1 1 – – – 1 1 2 1 1 3 3 Scarlet Fever 32 – 10 18 2 2 – – 6 3 9 1 3 6 3 — 1 19 Typhus Fever – – – – – – – – – – – – – – – – – – Enteric Fever – – – – – – – – – – – – – – – – – – Relapsing Fever – – – – – – – – – – – – – – – – – – Continued Fever – – – – – – – – – – – – – – – – – – Puerperal Fever – – – – – – – – – – – – – – – – – – Plague – – – – – – – – – – – – – – – – – – †Phthisis Under Tuberculosis Regulations, 1908 10 – – – 3 4 2 1 2 1 – 2 – 1 2 1 1 8 Under Tuberculosis Regulations, 1911 – – – – – – – – – – – – – – – – – – Others – – – – – – – – – – – – – – – – – – Totals 64 1 15 26 8 9 3 2 9 9 11 6 4 12 6 2 5 40 * Including one case which occurred in West Ham Workhouse, † Including two cases—Homeless. 189 Cases of Infectious Disease Notified during the Month of February, 1911, including Cases which occurred in west ham union, infirmary, &c., but not those imported. NOTIFIABLE DISEASE. Number of Cases Notified. Total Cases Notified in each Locality— Wards. Total Cases removed to Hospital. At all Ages. At Ages—Years. 1 2 3 4 5 6 7 8 9 Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 45. 45 to 65. 65 and upwards. Leyton. Lea Bridge. Central. Forest. Leytonstone. Grove Green. Harrow Green. Cann Hall. Wanstead Slip. ¶Small-pox 1 – – – – 1 – – – – 1 – – – – – – 1 Cholera – – – – – – – – – – – – – – – – – – Diphtheria (including Membranous Croup) 20 – 6 12 – 1 1 – – 6 4 2 – 2 2 3 1 11 *Erysipelas 6 – – 1 – 2 1 – – 1 – 3 – – 1 1 – 4 Scarlet Fever 28 – 11 15 1 1 – – 2 1 5 – 4 9 1 4 2 9 Typhus Fever – – – – – – – – – – – – – – – – – †Enteric Fever 2 – 1 — – — 1 — — — — — 1 — 1 — — 1 Relapsing Fever – – – – – – – – – – – – – – – – – – Continued Fever – – – – – – – – – – – – – – – – – Puerperal Fever 1 – – – – 1 – – – – – – – – – 1 – 1 Plague – – – – – – – – – – – – – – – – – – ‡Phthisis Under Tuberculosis Regulations, 1908 6 – – – 1 4 1 – 1 – 1 2 – 1 1 – – 6 Under Tuberculosis Regulations, 1911 – – – – – – – – – – – – – – – – – – Others – – – – – – – – – – – – – – – – – – Totals 64 — 18 28 2 10 4 2 3 8 11 7 5 12 6 9 3 33 * Including two cases which occurred in West Ham Infirmary, and one in West Ham Workhouse. ¶ Case proved not to be Small-pox. † Including one case which occurred in Eethnal Green Schools, † Including one case admitted to West Ham Workhouse—Homeless. 190 Cases of Infectious Disease Notified during the Month of March, 1911, including Cases which occurred in West Ham Union, Infirmary, &c., but not those Imported. NOTIFIABLE DISEASE. Number of Cases Notified. Total Cases Notified in each Locality— Wards. Total Cases removed to Hospital. At Ages—Years. 1 2 3 4 5 6 7 8 9 At all Ages. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 45. 45 to 65. 65 and upwards. Leyton. Lea Bridge. Central. Forest. Leytonstone. Grove Green. Harrow Green. Cann Hall. Wanstead Slip. Small-pos – – – – – – – – – – – – – – – – – – Cholera – – – – – – – – – – – – – – – – – – Diphtheria (including Membranous Croup) 7 – 4 3 – – – – – 2 2 – – – 1 2 – 7 Erysipelas 5 1 – – – – 4 – 1 – – – 1 1 2 – – 2 *Scarlet Fever 20 1 3 11 4 1 – – 1 4 7 – 2 2 – 2 2 12 Typhus Fever – – – – – – – – – – – – – – – – – – Relapsing Fever 1 – – – – 1 – – – – 1 – – – – – – 1 Continued Fever – – – – – – – – – – – – – – – – – – Continued Fever – – – – – – – – – – – – – – – – – – Puerperal Fever 2 – – – – 2 – – – – 2 – – – – – – 1 Plague – – – – – – – – – – – – – – – – – Phthisis Under Tuberculosis Regulations, 1908 4 – – – 1 2 1 – – 1 1 1 – – 1 – – 3 Under Tuberculosis Regulations, 1911 – – – – – – – – – – – – – – – – – – Other – – – – – – – – – – – – – – – – – – Totals 39 2 7 14 5 6 5 — 2 7 13 1 3 3 4 4 2 26 * One case included in above proved to be Measles. 191 Cases of Infectious Disease Notified during the Month of April, 1911, including Cases which occurred in west ham union, infirmary, &c., but not those imported. NOTIFIABLE DISEASE. Number of Cases Notified. Total Cases Notified in each Locality— Wards. Total Cases removed to Hospital. At all Ages. At Ages—Years. 1 2 3 4 5 6 7 8 9 Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 45. 45 to 65. 65 and upwards. Leyton. Lea Bridge. Central. Forest. Leytonstone. Grove Green. Harrow Green. Cann Hall. Wanstead Slip. Small-pox – – – – – – – – – – – – – – – – – – Cholera – – – – – – – – – – – – – – – – – – Diphtheria (including Membranous Croup) 15 – 6 9 – – – – 1 4 2 2 – 3 1 1 1 12 † Erysipelas 11 – – 1 1 4 3 2 – 4 1 1 1 – 1 2 1 3 *Scarlet Fever 32 – 6 20 3 3 – – 2 3 9 4 5 – 2 6 1 9 Typhus Fever – – — – – – — — — — — — — — — — — — ‡Enteric Fever 1 – – – – 1 – – – 1 – – – – – – – 1 Relapsing Fever – – – – – – – – – – – – – – – – – – Continued Fever – – – – – – – – – – – – – – – – – – Puerperal Fever – – – – – – – – – – – – – – – – – – Plague – – – – – – – – – – – – – – – – – Phthisis Under Tuberculosis Regulations, 1908 1 – – – – – 1 – – – 1 – – – – – – 1 Under Tuberculosis Regulations, 1911 – – – – – – – – – – – – – – – – – – Others — – — — — — — — — — — — — — — — — – Totals 60 – 12 30 4 8 4 2 3 12 13 7 6 3 4 9 3 26 * One case included in above proved to be German Measles. ‡ This case proved not to be Enteric Fever. † One case included in above occurred in West Ham Infirmary, and one in West Ham Workhouse. 192 Cases of Infectious Disease Notified during the Month of May, 1911, including Cases which occurred in west Ham union, infirmary, &c., but not those imported. notifiable disease. Number of Cases Notified. Total Cases Notified in each Locality— Wards. Total Cases removed to Hospital. At all Ages. At Ages—Years. 1 2 3 4 5 6 7 8 9 Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 45. 45 to 65. 65 and upwards. Leyton. Lea Bridge. Central. Forest. Leytonstone. Grove Green. Harrow Green. Cann Hall. Wanstead Slip. *Small-Pox 1 – – – 1 – – – – – – – – 1 – – – – Cholera – – – – – – – – – – – – – – – – – – ‡Diphtheria (including Membranous Croup) 11 – 2 7 1 – 1 – – 2 – 1 4 9 1 1 – 8 ¶Erysipelas 5 1 – – – 1 1 2 – 3 – 1 – – 1 – – 3 †Scarlet Fever 20 — 6 13 – 1 — – 1 3 3 3 – 2 – 6 2 12 Typhus Fever – – – – – – – – – – – – – – – – – – Enteric Fever 1 – – – – 1 – – – – – – – – – 1 – 1 Relapsing Fever – – – – – – – – – – – – – – – – – – Continued Fever – – – – – – – – – – – – – – – – – – Puerperal Fever 1 – – – – 1 – – – – – – 1 – – – – – Plague – – – – – – – – – – – – – – – – – – Phthisis Under Tuberculosis Regulations, 1908 1 – – – – 1 – – – – – – – – 1 – – 1 Under Tuberculosis Regulations, 1911 41 – – 3 8 24 6 – 1 3 12 2 6 6 5 4 2 13 Others – — — – – – – — – – – – – – — – – – Totals 81 1 8 23 10 29 8 2 2 11 15 7 11 11 8 12 4 38 * Case proved not to be Small pox; Certificate withdrawn. † One of these cases proved not to be Diphtheria; Certificate withdrawn. (Age 13 years. Forest Ward.) †Two of these cases proved to be Measles. ¶ Including one case which occurred in Forest House, James Lane, Leyton, and one in West Ham Workhouse. 193 Cases of Infectious Disease Notified during the Month of June, 1911, including Cases which occurred in west ham union, infirmary, &c., but not those imported. NOTIFIABLE DISEASE. Number of Cases Notified. Total Cases Notified in each Locality— Wards. Total Cases removed to Hospital. At all Ages. At Ages—Years. 1 2 3 4 5 6 7 8 9 Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 45. 45 to 65. 65 and upwards. Leyton. Lea Bridge. Central. Forest. Leytonstons. Grove Green. Harrow Green. Cann Hall. Wanstead Slip. Small-pox – – – – – – – – – – – – – – – – – – Cholera – – – – – – – – – – – – – – – – – – Diphtheria (including Membranous Croup) 10 – – 10 – – – – – 2 3 – – 1 1 2 1 8 Erysipelas 6 1 — — – 3 1 1 — 1 — — 1 — 2 1 1 1 Scarlet Fever 24 – 8 13 2 1 – – 1 – 2 2 1 3 3 3 9 18 Typhus Fever – – – – – – – – – – – – – – – – – – Enteric Fever 1 – 1 – – – – – – – – – – – – – 1 — Relapsing Fever – – – – – – – – – – – – – – – – – – Contined Fever – – – – – – – – – – – – – – – – – – Pureperlal Fever – – – – – – – – – – – – – – – – – – Plague – – – – – – – – – – – – – – – – – – Phthisis Under Tuberculosis Regulations, 1908 – – – 1 – 3 1 – – 1 – 1 1 1 1 – – 4 Under Tuberculosis Regula1ions, 1911 23 – – 3 6 13 1 – 2 4 1 2 2 4 1 3 4 6 Others – – – – – – – – – – – – – – – – – – Totals 69 1 9 27 8 20 3 1 3 8 6 5 5 9 8 9 16 37 194 Cases of Infectious Disease Notified during the Month of July, 1911, including Cases which occurred in West Ham Union, Infirmary, &c., but not those Imported. NOTIFIABLE DISEASE. Number of Cases Notified. Total Cases Notified in each Locality— Wards. Total Cases removed to Hospital. At all Ages. At Ages—Years. 1 2 3 4 5 6 7 8 9 Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 45. 45 to 65. 65 and upwards. Leyton. Lea Bridge. Central. Forest. Leytonstone. Grove Green. Harrow Green. Cann Hall. Wanstead Slip. Small-pox – – – – – – – – – – – – – – – – – – Cholera – – – – – – – – – – – – – – – – – – Diphtheria (including Membranous Croup) 16 2 2 10 1 1 – – – – 1 2 2 3 1 3 4 11 *Erysipelas 9 – – – 2 2 4 1 – 3 2 1 – 2 – 1 – 1 Scarlet Fever 12 – 5 6 1 – – – 2 2 1 2 1 2 – 2 – 10 Typhus Fever – – – – – – – – – – – – –– – – – – – Enteric Fever 3 – – 1 1 1 – – – 1 – 1 – – – 1 – 1 Relapsing Fever – – – – – – – – – – – – – – – – – – Continued Fever – – – – – – – – – – – – – – – – – – Puerperal Fever 2 – – – – 2 – – – – – – – 1 1 – – 2 Plague – – – – – – – – – – – – – – – – – – Phthisis Under Tuberculosis Regulations, 1908 12 – – – 3 3 1 – – 2 2 – 1 4 – 2 1 12 Under Tuberculosis Regulations, 1911 18 – – 1 2 11 4 – 2 3 5 – 1 1 – 4 2 3 Others — — — — — — — — – – – — – – — – – – Totals 72 2 7 18 10 25 9 1 4 11 11 6 5 13 2 13 7 40 195 Cases of Infectious Disease Notified during the Month of August, 1911, including Cases which occurred in west ham union, infirmary, &c., but not those imported. NOTIFIABLE DISEASE. Number of Cases Notified Total Cases Notified in each Locality— Wards. Total Cases removed to Hospital. At all Ages. At Ages—Years. 1 2 3 4 5 6 7 8 9 Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 45 45 to 65. 65 and upwards. Leyton. Lea Bridge. Central. Forest. Leytonstone. Grove Green. Harrow Green. Cann Hall. Wanstead Slip. Small-pox – – – – – – – – – – – – – – – – – – Cholera – – – – – – – – – – – – – – – – – – Diphtheria (including Membranous Croup) 6 – – 3 2 1 – – 1 2 – – – 1 1 – 1 5 Erysipelas 3 — – — — 3 — — — — 1 – – — — 1 1 2 Scarlet Fever 29 — 5 19 5 — — — 3 4 7 2 – 2 7 1 3 27 Typhus Fever – – – – – – – – – – – – – – – – – – Enteric Fever 1 – – – 1 – – – 1 – – – – – – – – 1 Relapsing Fever – – – – – – – – – – – – – – – – – – Continued Fever – – – – – – – – – – – – – – – – – – Puerperal –Fever – – – – – – – – – – – – – – – – – – Plague – – – – – – – – – – – – – – – – – – Phthisis Under Tuberculosis Regulations, 1908 7 – 1 2 2 2 2 1 1 2 1 7 Under Tuberculosis Regulations, 1911 13 – – 1 3 8 1 3 4 2 2 1 1 2 Others – – – – – – – – – – – – – – – – – – Totals 59 — 6 25 11 14 3 — 10 10 11 2 — 4 10 5 7 44 196 Cases of Infectious Disease Notified during the Month of September, 1911, including Cases which occurred in west ham union, infirmary, &c., but not those imported. NOTIFIABLE DISEASE. Number of Cases Notified. Total Cases Notified in each Locality Wards. Total Cases removed to Hospital. At all Ages. At Ages—Years. 1 2 3 4 5 6 7 8 9 Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 45. 45 to 65. 65 and upwards. Leyton. Lea Bridge. Central. Forest. Leytonstone. Grove Green. Harrow Green. Cann Hall. Wanstead Slip. Small-pox — — — — — — — — — — — — — — — — — — Cholera — — — — — — — — — — — — — — — — — — Diphtheria (including Membranoue Croup) 18 — 7 10 — 1 — — — 1 2 4 4 — 2 2 3 13 *Erysipelas 11 — — — 2 6 1 2 1 1 — 4 1 — 1 1 2 4 55 — 9 44 1 1 — — — — — — — — — — — — Typhus Fever — — — — — — — — — — — — — — — — — — Enteric Fever 7 — 1 2 1 3 — — — — — — — — — — — — Relapsing Fever — — — — — — — — — — — — — — — — — — Continued Fever — — — — — — — — — — — — — — — — — 1 Puerperal Fever 1 — — — — 1 — — — — — 1 — — — — — 1 Plague — — — — — — — — — — — — — — — — — — †Phthisis Under Tuberculosis Regulations, 1908 6 — — 1 — 4 1 — — 1 — — — 1 2 — 2 5 Under Tuberculosis Regulations, 1911 7 — — 1 1 3 2 — — — — 2 — 2 — 2 1 1 Others — — — — — — — — — — — — — — — — — — Totals 105 — 17 58 5 19 4 2 3 11 13 16 11 8 13 18 12 64 * Including one case which occurred in Forest House, James Lane, Leyton, and one case Ham in West Ham Infiniary. † Including one case admitted to West Ham Workhouse and one case which occurred in the Home of the Good shepnerd. 197 Cases of Infectious Disease Notified during the Month of October, 1911, including Cases which occurred in west HaM union, Infirmary, &c., but not those imported. NOTIFIABLE DISEASE. Number of Cases Notified. Total Cases Notified in each locality— Wards. Total Cases removed to Hospital. At all Ages. At Ages—Years. 1 2 3 4 5 6 7 8 9 Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 45. 45 to 65. 65 and upwards. Leyton. Lea Bridge. Central. Forest. Leytonstone. Grove Green. Harrow Green. Cann Hall. Wanstead Slip. Small-pox — — — — — — — — — — — — — — — — — Cholera — — — — — — — — — — — — — — — — — — Diphtheria (including Membranous Croup) 18 — 3 12 1 2 — — 2 6 2 — — 1 2 1 4 11 Erysipelas 13 — — 3 2 3 5 4 1 1 — 3 1 — 2 1 2 Scarlet Fever 79 — 11 56 9 3 — — 10 15 16 6 2 3 10 13 4 41 Typhus Fever — — — — — — — — — — — — — — — — — — Enteric Fever 6 — — 3 1 2 — — — 2 1 — — — — — 3 2 Relapsing Fever — — — — — — — — — — — — — — — — — — Continued Fever 2 — 1 — — 1 — — — — — — — — — — 2 — Puerperal Fever 1 — — — 1 — — — 1 — — — — — — — — — Plague — — — — — — — — — — — — — — — — — — Phthisis Under Tuberculosis Regulations, 1908 7 — — — — 3 4 — 1 — — 1 — — 2 1 2 7 Under Tuberculosis Regulations, 1911 9 — — — 2 6 1 — — 3 — 1 — 1 — 2 2 2 Others — — — — — — — — — — — — — — — — — — Totals 135 — 15 74 16 20 10 — 18 27 20 8 5 6 14 19 18 65 * Including two cases which occurred in West Ham Workhouse and one in Forest Cottage, James Lane, Leyton. 198 Cases of Infectious Disease Notified during the Month of November, 1911, including Cases which occurred in west ham union, infirmary, &c., but not those imported. NOTIFIABLE DISEASE. Number of Cases Notified. Total Cases Notified in each Locality— Wards. Total Cases removed to Hospital. At all Ages At Ages—Yeays. 1 2 3 4 5 6 7 8 9 Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 45. 45 to 65. 65 and upwards. Leyton. Lea Bridge. Central. Forest. Leytonstone. Grove Green. Harrow Green. Cann Hall. Wanstead Slip. Small-pox – – – – – – – – – – – – – – – – – – Cholera — – – – – – – – – – – – – – – – – – Diphtheria (including Membranous Croup) 19 1 5 11 1 1 – – – 3 6 4 1 – — 4 1 11 Erysipelas 25 2 1 3 1 11 6 1 2 5 2 6 1 – 4 2 3 5 Scarlet Fever 73 — 16 49 6 2 — – 5 19 9 5 2 5 12 8 8 39 Typhus Fever — — — — — — – — — — — — — — — — — Enteric Fever 2 — — 1 — 1 – – – 1 – – 1 – – – – 1 Relapsing Fever – – – – – – – – – – – – – – – – – – Continued Fever 1 — — 1 – – – – – – – – – – – – 1 — Puerperal Fever 1 — — — 1 — — – — — — — — — — 1 — 1 Plague — – – – – – – – – – – – – – – – – – Phthisis Under Tuberculosis Regulations, 1908 6 – 1 4 1 – 1 1 — — – 1 1 1 1 4 Under Tuberculosis Regulations, 1911 9 – – 2 1 5 1 – 3 1 1 — 1 — 1 1 1 1 Others — – – – – – – – – – – – – – – – – – Totals 136 3 22 67 11 24 8 1 11 30 18 15 6 6 18 17 15 62 * Including one case which occurred in West ham worknouse. 199 Cases of Infectious Disease Notified during the Month of December, 1911, including Cases which occurred in west Ham union, infirmary, &c., but not those imported. NOTIFIABLE DISEASE. Number of Cases Notified. Total Cases Notified in each Locality— Wards. Total Cases removed to Hospital. At Ages —Years. 1 2 3 4 5 6 7 8 0 At all Ages. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 45. 45 to 65. 65 and upwards. Leyton. Lea Bridge. Central. Forest. Leytonstone. Grove Green. Harrow Green. Cann Hall. Wanstead Slip. Small-pox – – – – – – – – – – – – – – – – – Cholera – – – – – – – – – – – – – – – – – – Diphtheria (including Membranous Croup) 23 – 8 13 2 – – – 5 5 3 1 1 2 1 5 – 17 Erysipelas 9 – — — — 4 2 3 — 4 — 1 — 1 — 3 – 3 Scarlet Fever 56 – 14 40 1 1 — — 5 7 3 8 — 6 3 19 5 40 Typhus Fever — – — — — — — — — — — — — — — — — — Enteric Fever 3 – – 2 – – 1 – – – 1 – – – – – 2 2 Relapsing Fever – – – – – – – – – – – – – – – – – – Continued Fever – – – – – – – – – – – – – – – – – – Puerperal Fever – – – – – – – – – – – – – – – – – – Plagus – – – – – – – – – – – – – – – – – – Phthisis Under Tuberculosis Regulations, 1908 5 – – – – 4 1 – 1 – – – – – 4 – – 4 Under Tuberculosis Regulations, 1911 4 – – 1 1 1 1 – 1 1 2 — — — Others – – – – – – – – – – – – – – – – – – Totals 100 — 22 56 4 10 5 3 12 17 7 10 1 9 10 27 7 66