Ley 016 Leyton Urban District Council. THE ANNUAL REPORT on the Vital Statistics & Sanitary Circumstances of the URBAN DISTRICT OF LEYTON, TOGETHER WITH THE REPORT TO THE EDUCATION COMMITTEE and THE HOSPITAL REPORT FOR THE YEAR 1919, by J. FRANCIS TAYLOR, m.r.c.s., d.p.h. Surgeon-Major, Honourable Artillery Company. Medical Officer of Health. llford: SOUTH ESSEX RECORDERS, LIMITED, High Road. TO THE CHAIRMAN AND MEMBERS OF THE LEYTON URBAN DISTRICT COUNCIL. Mr. Chairman and Gentlemen, I have the honour to submit my Annual Report on the health of the district for the year 1919. The year on the whole may be considered a healthy one. Out death-rate was 11.3 per 1,000 of the population. Our Infantile Mortality rate, 70.1G. Our Zymotic death-rate was .44 per 1,000 of the population. The worst feature was the large number of cases of Diphtheria, but the prevalence of this disease was not peculiair to Leyton. The surrounding districts, and indeed most of those throughout the Kingdom, suffered at least to an equal extent. The number of deaths due to Measles and! Whooping Cough were gratifyingly small, each disease being responsible for three only. The section devoted to Infant Welfare has been fully dealt with, the work of the Clinics and of the Health Visitors being given in detail. My best thanks aire due to the Councillors and Officials for their kindly help at all times. I am, Mr. Chairman and Gentlemen, Your obedient Servant, J. FRANCIS TAYLOR. Leyton Urban District Council. ANNUAL HEALTH REPORT FOR 1919, BY J. FRANCIS TAYLOR, M.R.C.S., D.P.H. Medical Officer of Health. ASSESSABLE AND RATEABLE VALUE. The present assessable value for general district purposes is £,506,715 3s. 6d., and a rate of 1d. in the £ produces £2,000. For poor rate purposes the rateable value is £540,739 0s. 0d., and a 1d. rate produces £2,170 0s. Od. AREA, INHABITED HOUSES, POPULATION. The district has a total area of 2,594 acres; at the end of June it contained 23,742 houses. Two new houses were erected in the district during the year. At the 1911 census the population numbered 124,736, which number divided among the inhabited houses gave an average of 5'63 persons per house. In this report the estimates of population used in calculating the various rates aire those given by the Registrar-General. They are based on the returns furnished under the scheme for the rationing of food. Population for death-rates 123,896 Population for birth-rate 129,062 BIRTHS. 2,044 births were registered—1,062 males and 982 females. To these must be added 67 male and 84 female births (transferable) received from the Registrar-General, which yields a birthrate of 17"0 per 1,000 of the population. Of the above, 85 were illegitimate births, 36 being males and 49 females. Percentage of illegitimate biirths, 3.9. 4 BIRTHS—CALENDAR YEAR 1919. YEAR 1919. Names ok Localities—Wards. Totals. Leyton. Lea Bridge. Central. Forest. Leytonstone. Grove Green. Harrow Green. Cann Hall. stead lip Ward not known. January 8 22 32 17 16 8 18 10 6 ... 137 February 5 16 23 16 13 8 8 14 16 ... 119 March 10 20 30 13 9 16 14 28 12 ... 132 April 8 32 30 16 15 21 24 11 12 ... 169 May 11 22 32 12 12 13 11 13 9 ... 130 June 7 14 30 19 9 22 15 18 16 ... 150 July 17 28 40 19 13 14 24 21 12 ... 188 August 9 25 36 22 9 8 15 21 13 ... 158 September 9 32 25 18 17 17 19 15 9 ... 161 October 14 38 47 40 13 32 34 25 22 ... 265 November 15 38 54 25 15 18 27 26 13 ... 231 December 12 35 43 26 10 24 17 20 17 ... 204 Births received from the Registrar-General (Wards unknown) 151 Totals 125 322 422 243 146 201 226 202 157 151 2195 5 DEATHS. 1,128 deaths of Ley ton residents were registered during the year—538 males and 590 females. To these must be added 119 males and 120 females, being deaths (transferable) received from the Registrar-General. The death-rate for 1919 was 11.3 per 1,000 of the population. ZYMOTIC DEATH-RATE. The deaths which occurred during the year from the seven principal Zymotic diseases were as follows:—Measles, 3; Scarlet Fever, 3; Diphtheria, 23; Whooping Cough, 3; Enteric Feveir, 0; Diarrhcea and Enteritis, 22. The Zymotic death-rate for 1919 was .44 per 1,000 of the population. INFANTILE DEATH-RATE. The infantile mortality rate, i.e., the number of deaths of children under one year of age per 1,000 births was 70.16, there being 154 deaths. NOTIFICATION OF BIRTHS (EXTENSION) ACT, 1915. This Act took effect on September 1st, 1915. Under its terms 2,209 births were notified during the year 1919—1,096 from medical practitioners, 1,057 from midwives, and 76 from relatives. The Health Visitors visited 2,330 newly-born infants and paid 7,038 re-visits. INFANT WELFARE AND ANTE-NATAL WORK. This branch of Public Health work now occupies an important position in the work presided over by the Medical Officer of Health. A Special Committee, the "Infant Welfare Committee," has been constituted, consisting of the undermentioned Members of the Council and co-opted ladies:— Chairman : J. B. Slade, Esq., J.P. Members: Messrs. Abrook, Baker, Clare, Daines, Gompertz, Guy, Haines, Mawer, Mitchell, Moore, and Read, J.P. Co-opted Members: Mrs. Cooper, Mrs. Hart, Mrs. Haslop, Mrs. Read, Mrs. Shimmin, Miss Lister, and Miss Hall. 6 A Sub-Committee, constituted of the above-mentioned ladies, has been formed to deal with the working and administration of the Crfeche, which will be dealt with in detail later on. The permanent staff appointed by the Council consists of the following:— J. F. Taylor (Medical Officer of Health), Superintendent and Organiser. Elizabeth Sloan-Chesser, M.D., Medical Officer to the Infant Welfare and Ante-Natal Clinics and Creche. Charlotte A. Shields, M.B., Lond., Medical Officer to the Infant Welfare Clinics and Creche. Percy Chandler, L.D.S., R.C.S., Eng., Dentist to the AnteNatal Clinic. Health Visitors— Edit'n Holland (Trained Nurse), Sanitary Inspector's, London Examination Board, and Health Visitor's Certificate, Royal Sanitary Institute. Lilian Dodd (Trained Nurse), Health Visitor's Certificate, Royal Sanitary Institute. Maud Bratton (Trained Nurse). Clare E. Heath (Trained Nurse), C.M.B., Health Visitor's Certificate, Royal Sanitary Institute. (Part Time)— Winifred Roake (Trained Nurse), C.M.B., Health Visitor's Certificate, Royal Sanitary Institute. During the year Miss Heath resigned and Miss Roake was appointed as full-time Health Visitor. Miss Bessie Clipstong (Trained N urse), C.M.B., one of the School Nurses, was promoted to take Miss Roake's place as part-time Health Visitor. Three Infant Welfare Clinics are now in full operation, and are held respectively at the Town Hall, the People's Hall, Harrow Green, and the rooms attached to the Baptist Church, Vicarage Road. Each are largely patronised and do an immense amount ot useful vvotrk. At each of these Clinics, in addition to the examinations by the doctors, systematic weighings of the infants, giving of advice to the mothers, and proper records of each case being kept on cards provided for the purpose, Glaxo, Virol, Virolax, Lactagol, 7 Parrish's Food, Cod Liver Oil and Malt is supplied at practically cost price to those unable to afford to buy of the retail chemist. Samples of infants' clothing are also on view, and instruction given as to how to make the various garments. In addition to these Clinics, one for expectant mothers, the Ante-Natal Clinic, is held at the People's Hall. A Dental Clinic for mothers is held once a week at the Town Hall, at which expectant and nursing mothers requiring dental treatment are advised to attend. The details of the work of this Clinic will be found in the Dentist's report to the Education Committee. A brief account of each Clinic is appended. TOWN HALL INFANT WELFARE CLINIC. This, the first to be established, was started in February, 1917. It is held every Friday afternoon. Dr. Sloan-Chesser attends, and' is assisted by Nurse Holland and Nurse Roake, in addition to the following voluntary helpers: —Miss Lister, Mirs. Muir, Mrs. Hawley, Mrs. Clayton, Mrs. W ood, Mrs. Atkins, Mrs. Harvey, Mrs. Bowra, and Mrs. Lebbon. Miss Lister, who is also a co-opted member of the Infant Welfare Committee and a member of the Leyton Health Society, is especially deserving of mention. She has been a most enthusiastic supporter of the work ever since its inception, and has rendered most valuable aid in many directions. Mrs. Muir also takes a great interest in the work, and spends a great deal of time in instructing the mothers in the making of suitable garments for their children. Mrs. Hawley and Mrs. Clayton perform useful work in assisting to keep records. Mrs. Wood and Mrs. Atkins assist in dispensing the Glaxo, Virol, etc. And Mrs. Harvey, Mrs. Bowra, and Mrs. Lebbon entertain the mothers and supply them with tea and biscuits, a charge of one penny per head being charged for these refreshments. During the year 2,376 attendances have been recorded, 392 of which were first attendances. PEOPLE'S HALL INFANT WELFARE CLINIC. This Clinic was started in May, 1917, and is held on Tuesday afternoons. Dr. Sloan-Chesser, assisted by Nurse Bratton, attends, and in addition to the undermentioned voluntary helpers receives 8 sistance from Sister Alice and some of the Nurses of the Essex County Nursing Association. These Nurses, who will ultimately be drafted to various country districts throughout Essex, receive instruction in Infant Welfare work. At this Clinic, in addition to the above, we are fortunate in having the services of the following voluntary helpers:—Mrs. Muddiman, Mrs. Harvey, and Mrs. Atkins. These ladies give a welcome to the mothers, dispense tea and biscuits, and assist in the sale of Glaxo, etc. The Essex Nurses, to whom many of the mothers are personally known, assist, among other things, in compiling the records. During the year 2,588 attendances have been recorded, 498 of which were first attendances. VICARAGE ROAD INFANT WELFARE CLINIC. This Clinic was opened in October, 1918, and is held on Wednesday afternoons. Dr. Shields attends, and is assisted by Nurse Dodd and Nurse Roake. The following voluntary helpers alsoi attend and render valuable assistance:—Mrs. Sanders, Mrs. Mayhevv, Mrs. Stuchberv, Mrs. Thomas, Mrs. Clayton, and Miss Coxhead. These ladies converse with the mothers, entertain them to tea and biscuits at one penny per head, assist with the clerical work, the sale of Glaxo, etc., and give instruction in the making of garments for the little ones. Some of the Essex Nurses attend at this Clinic, assist, and receive instruction. During the year 2,837 attendances have been recorded, 3i66 of which were first attendances. The Ante-Natal Clinic was opened in September, 1917. It is held at the People's Hall on Tuesday mornings. Dr. SloanChesser attends, and is assisted by Sister Alice and the Midwives of the Essex County Association. SPECIAL REPORT BY DR. ELIZABETH SLOAN-CHESSER. Major Taylor has asked me to say a few words about the Ante-Natal Centre. Number of new patients in 1919 121 Number of days Clinic open 45 Number of attendances 193 Average weekly attendance 4 9 We have worked in co-operation with Sister Alice, Matron of the Essex Training Centre for Midwives, and several of the Nurses attend the Clinic to assist with the patients and to receive teaching in abdominal examination, pelvic measurement, etc. My endeavour has been to advise expectant mothers about the conservation of their health and that of the unborn child, and to give simple advice about clothing, diet, etc. Patients with abnormal symptoms or signs are put under medical care. Several cases have been referred' to the Tuberculosis Dispensary with most satisfactory results. One case of Hirschsprung's Disease, a rare condition and an extremely dangerous complication of pregnancy, was at my request successfully operated on by Mr. Loekhart Mummery. Two cases of generally contracted pelvis were sent to Queen Charlotte's Hospital for special obstetric treatment at child-birth. Several cases of Venereal Disease were sent to Venereal Disease Clinics for treatment, thus preventing miscarriage or early death of the child. One advantage of Ante-Natall Clinics is the opportunity they give for encouraging breast-feeding by instructing the mothers in the care of the nipples, the stimulation of the milk supply by suitable diet, by education of the new-born infant, and by making the mother realise, that she may jeopardise her chance of nursing by the unwise administration of cow's milk or patent foods during the first two days of life. Such teaching is followed up by care of the baby when it is afterwards brought to the afternoon Baby Clinic. An investigation into 1,000 of the women attending our Leyton and Leytonstone Clinics, which was carried out by me, with the assistance of the Health Visitors, brought forth the fact that 5i4 pein cent. suckled all their babies, 14 per cent. reared all their children on the bottle, 10- per cent. nursed all but one, and 10 per cent. all but two of their family; the remaining 12 per cent. nuirsed all but three or four. Of the same group of women, 76 per cent. reared all their children, 18 per cent. all but one, 2 per cent. all but two, and 4 per cent. lost moire than two. I did not find that the deathrate amongst bottle babies was much higher than that of breastfed babies, the proportion being—of 30 children who died, 12 were breast-fed and 18 were reared on the bottle. At the same time, the chief aim of our work is to encourage breast-feeding. My experience warrants me in saying that 90 per cent. of mothers can and should nurse their babies. 10 When I have (1) educated the baby to desire to feed every three hours for the first three months of life, (2) arranged the mother's daily life upon a hygienic basis and still the milk is insufficient, I then advise the mother to bathe with cold and hot water alternately the breasts night and morning, and of course the mouth is attended to by the Dentist, oral sepsis being a very usual cause of failure to breast-feed the baby. At Leytonstone when these measures fail I apply Faradisation (electric treatment) to the breasts twice or three times a week. This is carried out under my directions by Sister Alice's Nurses, and the results have surpassed my expectations. In most cases the child improves in health, and an average gain of to 5 ounces is maintained if the patients are able to attend regularly for treatment. I may say that this work is original, and whilst I feel sure that electric treatment will be utilised very largely in the future, it was at the Leyton and Leytonstone Centres that the work was first originated. Nurse Dodd and Nurse Bratton at the Town Hall, and Sister Alice's Nurses at Harrow Green, have helped by their untiring work and care to make the experiment a real success, and 1 have to thank Major Taylor for allowing this work to be carried out under excellent conditions and for the help he permitted his Nurses to give. It is a pleasure to be able to state that the regular staff, the voluntary helpers, and the Nurses of the Essex Nursing Association have all worked together in the happiest possible manner, with one aim only—the good of the cause—and that no friction of any kind whatever has occurred. DUTIES OF THE HEALTH VISITORS. Each of the Health Visitors is apportioned a district, and she presides over the Clinic in her district, thus:— Nurse Holland visits in the Central and Wanstead Slip Wards and presides over the Town Hall Clinic. Nurse Dodd visits in the Lea Bridge and Leyton Wards and presides over the Vicarage Road Clinic. Nurse Bratton visits in the Harrow Green and Grove Green Wards and presides over the People's Hall Clinic. Nurse Roake visits in the Cann Hall and Forest Wards and assists at the Town Hall and Vicarage Road Clinics. Nurse Clipstone (part-time) visits in the Leytonstone Ward. 11 The Health Visitor visits each newly-born infant as early as practicable after the tenth day of its birth, and subsequently follows 'it up until it attains the age of five years, when it comes under the supervision of the School Medical Service. The Health Visitor at her visit to a newly-born infant sees any other children under five years of age, and suitably advises the mother on any question affecting their health. The Health Visitor also visits cases of Measles, Whooping Cough, Summer Diarrhoea, Influenza, and other cases obtained from the lists of absent children furnished by the School Attendance Officer. During the year 11,016 visits have been paid by the Health Visitors. SUPPLY OF MILK TO NURSING AND EXPECTANT MOTHERS AND TO CHILDREN UNDER FIVE YEARS OF AGE. The Council issued instructions to their Medical Officer oiF Health to supply milk, as authorised by the Ministry of Health, to necessitous cases. During the month of November 1,187 pints were supplied free. During the month of December 1,817 pints were supplied free. CRECHE. Prior to June, 1919, a small Creche was in existence for some twelve months at the Church House, High Road, Leyton. It was financed by voluntary contributions; a benevolent lady not residing in the district was the principal benefactor. In May, 1919, being in low7 water through want of funds, an appeal was made to the Council for financial assistance. Accordingly the Council made application to the Ministry of Health for permission to subsidise the undertaking. In the meantime the Church Authorities, finding they required the premises for other work, terminated the tenancy, and the Creche was closed on 27th June, 1919. The Council then determined to inaugurate a Cr&che of its own at "Wrentham," in Church Road, within easy distance of Church House. 12 Miss Milbank, who had been Nurse-in-Charge of, and was consequently well known to the mothers and children attending the former Cr&che, was appointed Nurse-in-Charge. A Caretaker and his wife were appointed, Mr. and Mrs. Coates. A Domestic Help was advertised for, and Mrs. Harvey was appointed at 25s. per week (without board or residence). A Sub-Committee, consisting of the lady members of the Infant Welfare Committee, was appointed to preside over its affairs, including the selection of the children. Miss Milbank shortly after resigned her position as Nurse-inCharge. Mrs. Haslop, a member of the Committee, undertook her duties for a few weeks. They were then, pending the -appointment of a new Nurse-in-Charge, undertaken by Nurses Crawford and Walling, School Nurses. The position now (April) is as set forth in the Scheme detailed below, and which was presented to the Council on 24th February, 1920. SCHEME FOR DAY NURSERY, "WRENTHAM." The voluntary Creche at Church House closed down on June 27th, 1919. The Council thereupon agreed to establish a Creche at "Wrentham." "Wrentham" is a detached house standing in a garden of about a third of an acre, in Church Road. It is a two-storey building. On the ground floor are three reception rooms (one of considerable size), a kitchen and a scullery. These rooms are used for the children. On the first floor are five bedrooms, a bath room, and a lavatory. Of these five rooms, two are proposed to be used for a resident Matron and one for a Domestic Help. The others may be required for the development of the Cr&che. STAFF. In addition to the Matron and Domestic Help, an Assistant and a Probationer to look after the children are at present employed. It is also proposed to engage another woman at 25s. per week. She is to be trained as a Home Help for a period of three months, and her services are to be utilised in the interests of the Creche. 13 The Matron is to have a salary of £2 per week and two rooms. The Assistant has 25s. per week, and the Probationer {a girl of 14 years of age) has 12s. per week. The Domestic Help's wages is not yet decided upon. No meals are supplied to the staff. At present there are 14 children on the books, and the attendance averages from 7 or 8 to 12 children per day. The Cr&che is open every week day, except Saturday, from 8 a.m. to 6 p.m. Dr. Elizabeth Sloan-Chesser or Dr. Charlotte A. Shields visits weekly. The Medical Officer of Health or his deputy is available at any other time. A charge of 9d. per diem is made for each child. INFECTIOUS DISEASE. 5 cases of Dysentery and 81 of Malaria were notified during the year (old military cases). No case of Plague, Cholera, Smallpox, or Typhus has been notified. SMALLPOX. On October 8th I received the following letter from the Medical Officer of Health to the Essex County Council:— 26, High Street, Chelmsford. 8th October, 1919. Dear Sir, Smallpox Hospital Accommodation. I have to inform you that the County Council, as the Authority for the provision of Smallpox Hospital accommodation for South-West Essex, is now making arrangements as under :— 1. Dagenliam Hospital.—In the event of an epidemic, cases to be sent there. 2. Orsett Joint Hospital.—All sporadic cases to be sent there. 14 The latter arrangement with the Orsett Joint Hospital Board operates from October 1st, 1919, and in the event of a case arising in your area please communicate at once with that Board, whose telephone number is Tilbury 248. 1 am sending you this preliminary .notice so that you may be aware of the arrangements made tentatively for the treatment of Smallpox. Full details of the scheme will be forwarded to you as soon as completed. Yours faithfully, W. A. Bullough, County Medical Officer. Dr. J. Taylor, Town Hall, Leyton. It iis satisfactory to know that in the event of a case of Smallpox occurring in Leyton there is a hospital to which it can be sent. But it will be noted that these arrangements are only tentative, and a fuller and more ambitious scheme is foreshadowed, to which I am looking forward with much hope. As I have repeatedly pointed out in former reports, the absence of any arrangement for the isolation of Smallpox cases is a grave blot on our sanitary administration. I am glad to be able to report that no case of Smallpox has been notified during the year. The following returns from the Vaccination Officer show the unsatisfactory state of infantile vaccination in Leyton:— VACCINATION RETURNS. Number of Births. Vaccinated. Certificates of Insusceptibility. Exemptions Died Unvaccinated under 1 year. 1912 2797 1156 5 1069 154 1913 2925 1152 10 1192 169 1914 2752 1011 17 1238 142 19L5 2572 1032 4 1037 162 1916 2603 965 4 1093 139 1917 1944 583 7 857 103 1918 1701 434 2 709 94 1919 2066 463 5 756 79 15 ENTERIC FEVER. 4 cases were notified. There were no deaths. Each case was visited, and in addition to giving suitable advice, etc., endeavour was made to trace the cause of the infection. The following table shows conclusively that Leyton's sanitary condition, judged by the standard of Enteric Fever incidence, is satisfactory.:- Case. Sex. Age. Yrs. Where Treated. Result. Remarks. 1 M. 19 West Hani Infirmary Recovered Cause not traced 2 M. 11 West Ham Infirmary Recovered Unable to trace source of infection. Had been in tlie habit of bathing in tributary of River Lea, Leyton Marshes. 3 F. 17 West Ham Infirmary Recovered Patient had complained of the drinking water at her business address. 4 F. 21 West Ham Infirmary Recovered Cause not traced. SCARLET FEVER. Cases notified, 208. There were 3 deaths. Case-fatality ,per cent., 1.4. Death-rate per 1,000 of the population, .02. DIPHTHERIA. Cases notified, 263. 23 deaths occurred, including 1 death on the 16th January at the Waltham Joint Hospital, Waltham Abbey, and another on the 27th September at the North-Eastern Hospital. Case-fatality per cent., 8.7. Death-rate per 1,000 of the population, .19. PUERPERAL FEVER. 12 cases of this disease were notified. There were 5 deaths. The death-rate from Puerperal Fever was '04 per 1,000 of the population. The County is the authority for the administration of the Midwives Act, and the County Medical Officer of Health has been promptly notified of all cases coming under his jurisdiction. 16 Disinfection of premises and clothing has been systematically carried out. MEASLES. There were 3 deaths during the year. Death-rate, .02 per 1,000 of the population. 1,156 cases of Measles and 103 of German Measles were notified. The Health Visitors ipaid 1,208 visits to these cases. 1 case was nursed by Nurses from the Essex County Nursing Association. WHOOPING COUGH. There were 3 deaths during the vear. Death-rate per 1,000 of the population, .02. 1 of these deaths occurred in a child under one year of age, 1 between one and two. years, and 1 between two and five years. The Health Visitors visited 177 cases. DIARRHœA AND ENTERITIS. Diarrhœa and Enteritis caused 22 deaths, 18 of which were of infants under one year of age, and 4 between one and two years. Of these, 3 died at the following Hospitals:—Queen's Hospital, 1; Royal Free1 Hospital, 1; and Queen Mary's Hospital, 1. Our death-rate from Diarrhoea and Enteritis under two years was lO'O per 1,000 births. CEREBRO-SPINAL MENINGITIS. 1 cases of Cerebro-Spinal Meningitis have been notified during the year. Two cases terminated fatally. 17 The following are particulars of the cases:— Case Date of Notification Sex Age Yrs. Result. Remarks. 1 27.1.19 Female 12 Died 16.2.19 Onset 21.1.19. Patient was at school on the 20th January. Had not been away from home. No relation to any military rases. Lumbar puncture. Fluid turbid and under pressure. Removed to Eastern Hospital 25.1.19. Clothing, bedding and premises disinfected. 2 8.4.19 Male 10 Recovered Taken ill 30.3.19 and removed to West Ham Infirmary 3.4.19. Bacteriological examination positive. No history as to source of infection. Patient had not been away from home or in contact with any member of H.M. Forces. Clothing, bedding and premises disinfected. 3 16.6.19 Female 38 Recovered Died Onset of illness 10.6.19, No history as to source, of infection. No relation to any military cases. Removed to West Ham Infirmary 11.6.19. Lumbar puncture positive. Clothing, bedding and premises disinfected. 4 28.10.19 Male 21 25.10.19 Patient was a private in 17th Royal Fusiliers. Returned from the Rhine to Purfleet where he was demobilised 30.8.19. Stated not to have been very well since this date. First saw a doctor 24.9.19. Removed to Walthamstow Hospital 14.10.19. Lumbar puncture positive. Clothing, bedding and premises disinfected. ANTERIOR POLIOMYELITIS. No case was notified. OPHTHALMIA NEONATORUM. 25 cases were notified. 22 notifications from doctors and 9 from midwives were received. 6 of these cases were notified both by doctor and midwife. All the cases were visited and followed up. At the end of the year, of the 25 cases 23 were cured without damage to vision. The remaining 2 cases removed to other districts, and no information as to their ultimate progress is obtainable. 15 were treated by private practitioners and 10 at hospitals. 18 TUBERCULOSIS. 140 deaths occurred from all forms of Tuberculosis, representing a death-rate of 1.1 per 1,000 of the population. The corresponding figures for Pulmonary Tuberculosis were 110 and .9. Notifications of 266 cases of Pulmonary Tuberculosis and 62 of other forms of Tuberculosis were received during the year. These cases were attended to by the Tuberculosis Officer or his staff and verbal and written instructions given as to the necessary precautions to be taken to prevent the spread of the disease. Dr. Sorley now attends at the Tuberculosis Dispensary, 180, , High Road, Leyton:— Mondays 2.0—4.0 p.m. Thursdays 10.0a.m. tol2.0p.m. Thursdays 6.0—8.0 p.m. Fridays 2.0—4.0 p.m. Close co-operation is maintained between the Tuberculosis Officer, who is appointed by the Essex County Council, and the Medical Officer of Health. The arrangements as set forth in the report' of the year 1913 have been continued. Notifications of cases of Tuberculosis have been received from the following Institutions:— Lungs. Othter forms. Total. West Ham Infirmary 33 11 44 Hospitals Victoria Park 25 — 25 London 2 21 23 Brompton 6 — 6 Mount Vernon 3 — 3 Others 18 5 23 Sanatoria- Black Notley 42 — 42 Chingford 14 1 15 Colchester 12 — 12 Ilford 9 1 10 Halstead 9 - 9 Maltings Farm 7 — 7 Royal National, Ventnor 4 — 4 Devon & Cornwall 3 — 3 Harold Court 4 1 5 Others 8 3 11 Leyton Dispensary 31 5 30 Others 3 3 233 48 281 19 BACTERIOLOGICAL DIAGNOSIS. The arrangements made with the County Medical Officer of Health for the examination of pathological specimens are still in force and continue to work satisfactorily. During the year the following numbers of samples have been sent for examination:— Diphtheria 144 Ringworm 140 Sputum 15 Widal's Test 1 Shaving brush for Anthrax 1 301 CANCER. There were 111 deaths during the year, giving a death-rate ol '9 per 1,000 of the population. INQUESTS. The following verdicts were recorded at Inquests held in the district during the year:— Natural Causes 33 Accident 16 Misadventure 1 Manslaughter 2 Drowning 1 Overlain 1 Want of proper attention at birth 1 Suicide (2 self-inflicted wounds, 1 hanging, 2 coal gas poisoning, 1 carbolic acid poisoning, 1 fall from window) 7 HOUSING. House-to-house inspection is regularly carried on, especially in the poorer neighbourhoods, in which it is found that houses tend to become more or less insanitary chiefly owing to the class of tenants occupying them. 20 STATEMENT, required by Article V. of the Housing (Inspection of District) Regulations, 1910, in regard to the inspection of dwelling-houses under Section 17 (1) of the Housing, Town Planning, &c., Act, 1909. Number of dwelling-houses inspected under and for the purposes of the section 498 Number of such dwelling-houses which were considered to be in a state so dangerous or injurious to health as to be unfit for human habitation 51 Number of dwelling-houses in respect of which representations were made to the local authority with a view to the making of closing orders 4 Number of dwelling-houses in respect of which closing orders were made by the local authority 3 Number of dwelling-houses the defects in which were remedied without the making of closing orders 435 Number of dwelling-houses which, after the making of closing orders, were made fit for human habitation Nil. General character of the defects found to exist in the dwelling-houses inspected . Leaking drains; broken ventilating pipes; w.c. flushing cisterns and pipes out of order; cracked and broken w.c. pans; broken, cracked and porous scullery sinks and waste pipes; leaking roofs; absence of, or broken paving around houses; holes in plaster of ceilings and walls; damp walls; want of ventilation under ground floors; general uncleanly conditions. CUSTOMS AND INLAND REVENUE ACT, 1890. Section 26 (2). The Medical Officer of Health received applications in respect of 2 tenements. As formerly, insistence on the provision of suitable storage for food was made a condition for the granting of certificates. SITUATION OF TENEMENTS. Address. No. of Tenements. Certificates granted. Certificates not granted. Matlock Road, 51 2 — 2 Matlock Road, 53 21 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. Jan. Feb. Mar. April. May. June. July. Aug. Sept. Oct. Nov. Dec. Totals 60 to 65 years 7 22 7 4 7 7 9 6 8 8 12 5 102 65 to 70 years 13 18 14 7 2 5 17 8 10 10 8 8 120 70 to 80 years 23 28 23 28 18 6 13 16 16 24 16 22 233 80 to 90 years 11 15 21 12 6 8 5 4 8 8 15 5 118 90 years and upwards 1 2 4 1 1 1 1 2 13 Totals 55 85 69 51 34 26 44 35 43 50 52 42 586 Influenza 4 53 41 5 3 1 1 3 1 2 114 Phthisis 7 12 11 14 4 8 5 12 8 11 9 9 110 Rheumatic Fever 1 ... 1 ... ... 1 1 ... ... ... ... 3 7 Bronchitis 17 42 21 13 10 6 8 5 4 14 11 12 163 Pneumonia (all forms) 8 18 8 4 1 2 3 2 7 7 8 9 77 Other diseases of Respiratory Organs Nephritis and Bright's Disease 2 3 3 2 1 1 1 1 3 17 7 3 4 5 4 2 2 2 6 4 3 7 49 Diphtheria (notifications) 16 6 12 13 9 12 23 18 36 38 33 47 263 Rainfall in inches in Leyton 2.23 1.62 2.27 2.73 .47 1.65 1.79 1.11 99 .62 .72 1.66 17.86 Number of days on which Rain fell 22 14 18 16 4 7 14 12 10 7 20 21 165 22 FACTORIES, WORKSHOPS, LAUNDRIES, WORKPLACES, AND HOMEWORK. 1.—INSPECTION OF FACTORIES, WORKSHOPS, AND WORKPLACES. Including Inspections made by Sanitary Inspectors or Inspectors of Nuisances. Premises. (1) Number of Inspections. (2) Written Notices. (3) Prosecutions. (4) Factories (Including Factory Laundries.) 89 17 ... Workshops (Including Workshop Laundries.) 477 99 ... Workplaces (Other than Outworkers' premises included in Part 3 of this Report.) Totals 566 116 ... 23 2.—DEFECTS FOUND IN FACTORIES, WORKSHOPS, AND WORKPLACES. Particulars. Number of Defects. Found and Remedied. (1) (2) Nuisances under the Public Health Acts:— Want of cleanliness 75 Want of ventilation 18 Overcrowding 5 Want of Drainage of floors 2 Other nuisances 136 Sanitary accommodation - insufficient 7 unsuitable or defective 75 not separate for sexes 5 Offences under the Factory and Workshop Acts:— Illegal occupation of underground bakehouse (s. 101) Breach of special sanitary requirements for bakehouses (ss. 97 to 100) 6 Other offences (Excluding offences relating to outwork which are included in Part 3 of this Report) Total 329 24 3.—REGISTERED WORKSHOPS. Woikshops on the Register (s. 131) at the end of the year. (1) Number. (2) Ordinary Workshops 254 Laundries 11 Bakehouses 24 Total Number of Workshops on Register 289 4.—OTHER MATTERS. Class. (1). Number. (2) Matters notified to H.M. Inspector of Factories :— Failure to affix Abstract of the Factory and Workshop Acts (s. 133, 1901) 44 Action taken in matters referred by H.M. Inspector as remediable under the Public Health Acts, but not under the Factory and Workshop Acts (s. 5, 1901)— Notified by H.M. Inspector 31 Reports (of action taken) sent to H.M. Inspector 26 Other 3 Underground Bakehouses (s. 101):— Certificates granted during the year In use at the end of the year 6 25 5.—HOME WORK. NATURE OF WORK. outworkers' lists, section 107. outwork in unwholesome premises, section 108. outwork in infected premises, secs. 109, 110. Lists received from Employers. Notices served on Occupiers as to keeping or sending lists. Instances and Notices served. Instances and Orders made (s. 110). Sending once in the year. Sending twice in the year. Lists. Outworkers. Lists. Outworkers. Contractors. Workmen. Contractors. Workmen. Wearing Apparel—Making, etc. 30 ... 70 33 ... 240 79 289 9 Lace, lace curtains, and nets, etc. ... ... ... ... ... ... 1 Furniture and upholstery 1 ... 10 ... ... ... 3 Artificial flowers ... ... ... ... ... ... 7 Racquet and tennis balls ... ... ... ... ... ... 1 Paper, etc., boxes, paper bags ... ... ... ... 6 Brush making 1 ... 1 ... ... ... 15 Stuffed toys and leather boxes 1 ... 1 ... ... ... 4 Cosaques and Christmas crackers ... ... ... ... ... ... 5 Linen packing condensers ... ... ... ... ... 7 ... Gas mantles ... ... ... ... ... ... ... Rope making ... ... ... ... ... ... ... Army Equipment ... ... ... ... ... ... ... Feather Curling, etc. 1 ... 3 ... ... ... l Totals 34 ... 85 35 ... ...247 79 333 9 N.B.—No home-workers were known to be engaged during the year in the following occupations: Household linen; Furniture hangings ; Electro-plate; File-making; Brass and brass articles; Fur-pulling; Cables and chains; Anchors and grapnels; Cart-gear; Locks, etc.; Umbrellas; Nets, other than wire nets; Tents; Sacks; Pea-picking; Carding of buttons; Basket-making ; Chocolates and sweetmeats; Textile-weaving. 26 FACTORY AND WORKSHOP ACTS, 1901 and 1907. Factories include all places in which mechanical power is used, and are inspected by H.M. Inspector of Factories, and apart from dealing with any nuisances remediable under the Public Health Act that he may notify, our Inspectors do not interfere. It is the duty of the District Council to secure proper provision of means of escape in case of fire and the enforcement of sufficient sanitary accommodation. This work is carried out by the Surveyor. 89 visits were made to factories and seventeen notices served to remedy defects found. Workshops include any premises (not being Factories) in which manual labour is exercised by way of trade and for the purposes of gain in, and incidental to, the making, altering, repairing, finishing or adapting for sale of any article, and to or over which the employer of the persons working there has the right of access or control. 477 workshops were inspected during the year and 329 nuisances remediable under the Public Health Acts, or contravening the Factory and Workshop Acts, dealt with, and revisits made until the necessary work had been carried out. 289 workshops remain on the register. Grouping of Workshops. Manufacture of blouses, underclothing, &c. 72 „ „ boots, shoes, &c. 19 „ „ ties, neckwear, &c. 5 „ „ leather and fancy goods 6 „ „ brushes 2 27 Manufacture of firelighters 1 „ „ bedding, upholstering, &c. 3 „ „ polishes, gums, &c. 2 „ „ food products and sweets 3 „ „ scales, tools, &c. 2 „ „ children's toys, &c. 6 „ ether sprays 1 „ „ wooden boxes 1 „ „ drawing instruments, &c. 3 Dressmaking 29 Millinery 21 Tailoring and alteration of costumes 31 Art-needlework and embroideries 3 Corset-making 1 Bakehouses 24 Laundries 11 Cabinet-making, &c. 4 Picture framing 1 Manufacture of paper articles 3 Chopping firewood 5 Rag-sorting 5 Cycle repairing and motor works 7 Wheelwrights and carriage painter and shoeing forges 5 Printing and book-binding 1 Rope making 1 Cork-cutting 1 Whalebone cutting 1 Glass blowing 1 Wire Workers 3 28 Furriers 2 Fibre works 1 Feather curling, &c. 1 Packing inks, &c. 1 289 Homework.—The District Council, under section 107-110 is given important powers for controlling the conditions under which certain classes of work as specified from time to time by the Secretary of State, are done in the homes of the workers, and the Act further provides that employers shall notify twice yearly the Local Authority of the district from which they give out work, the names and addresses of all persons doing work of specified trades in their homes. Some employers are very dilatory in sending their lists, and notices have to be sent reminding them of their obligation. Other employers are not sufficiently careful in revising their lists, and names of outworkers who have given up or removed from the address supplied are sent in without correction year after year, thus causing a lot of unnecessary work. 493 outworkers were notified by other Councils and we forwarded 152 addresses to them. It is frequently found that the worker is employed by more than one firm, and the name is notified two or three times, but in the figures given only the actual addresses are counted. 86 enquiries were made at shops and other places to ascertain whether workpeople are employed, and such enquiries have led to the discovery of many unregistered workrooms, as well as to employers of outworkers who had not supplied lists. 29 1,451 visits were paid to the homes of the outworkers and 1,120 inspections were made. In 331 cases it was found that the addresses were incorrect. Uncleanly and insanitary conditions in 334 instances were found and dealt with. Nine cases of infectious disease occurred in the homes of the workers. The usual immediate action was taken to prevent the spread of the disease. 30 ISOLATION HOSPITAL. In last year's report it was stated that this Hospital, which was closed during the later period of the war, was again opened for the reception of Scarlet Fever and Diphtheria patients on 13th December, 1918. The subjoined figures and particulars therefore relate to a full calendar year. The Hospital as a part of the Public Health Service has a Sub-Committee of its own, which meets once a month at the Hospital, and of which Capt. D. M. Smith, J.P., is Chairman. The Medical Officer of Health is the Medical Superintendent and attends the patients. The Deputy Medical Officer of Health attends in his absence. An arrangement also exists whereby Dr. Kennedy, a local practitioner, can be summoned in an emergency. The Matron, Miss Ryan, has held the position for many years, and is thoroughly conversant with her duties. These arrangements are adequate for the efficient conduct of the Hospital, and dispense with the services of a Resident Medical Officer. As mentioned in the report to the Education Committee, children suffering from Scabies are treated at the Hospital by means of baths and inunction with sulphur ointment, their clothing at the same time undergoing disinfection. During the year this treatment has been carried out on 426 occasions. STATISTICAL RETURNS:— Admissions:— At all ages. Under 1 year. 1 to 5. 5 to 15. 15 to 25. 25 and upwards. Scarlet Fever 88 0 26 55 6 0 Diphtheria 181 2 40 127 8 4 Totals 269 2 66 182 14 4 Sex of Patients Admitted. Males. Females Scarlet Fever Cases 55 33 Diphtheria Cases 84 97 31 Scarlet Fever. Diphtheria. Under treatment at beginning of year 2 10 ,, ,, ,, end of year 8 36 Admitted during year 88 181 Discharged during year 76 136 Died during year 3 18 There were 5 cases of Tracheotomy. The Causes of Death were:— Male, 7 years, Diphtheria 43 days, Paralysis 24 days, in hospital 36 days. Male, 5 years, Diphtheria 12 days, Paralysis 7 days, in hospital 8 days. Male, 6 years, Diphtheria 6 days, Toxaemia, in hospital 2 days. Male, 5 years, Diphtheria 52 days, Paralysis 38 days, in hospital 50 days. Male, 10 years, Diphtheria, Toxaemia, in hospital 2 days. Male, 3½ years, Diphtheria, Haemorrhage 9 days, in hospital 7 days. Male, 7 years, Diphtheria, Toxaemia, in hospital 1 day. Male, 5 years, Diphtheria, Paralysis, in hospital 17 days. Male, 1 year 9 months, Diphtheria, Tracheotomy, in hospital 2 days. Male, 7 years, Diphtheria, Haemorrhage, in hospital 10 days. Female, 2 years, Diphtheria 4 days, in hospital 2 days. Female, 6 years, Diphtheria 10 days, Cardiac Paralysis, in hospital 7 days. Female, 5 years, Diphtheria, Septicaemia, in hospital 6 days. Female, 5 years, Diphtheria, Septicaemia, in hospital 4 days. Female, 9 years, Diphtheria 5 days, Toxaemia and Heart Failure, in hospital 9 days. Female, 4 years, Diphtheria 7 days, Tracheotomy, in hospital 3 days. Female, 6 years, Diphtheria, Haemorrhage, in hospital 4 days. Female, 1 year 9 months, Diphtheria, Tracheotomy, in hospital 1 day. Female, 5 years, Scarlet Fever, Septic, in hospital 17 days. Male, 3 years, Scarlet Fever 10 days, in hospital 10 days. 32 Female, 3 years, Scarlet Fever, Toxaemia, In hospital 5 days. Male, 25 years, Tuberculosis of Lungs, Morbus Cordis. Female, 5 years, Septic wound of hand, Septicaemia, in hospital 8 days. Male, 2 years, Pertussis, Broncho-pneumonia, in hospital 19 days. The amount of money expended on the Hospital during the financial year was £5,416 10s. 3d., and is divisible into the following items:— £ s. d. £ s. d. Buildings: Repairs and Maintenance 423 4 7 Furniture and Repairs 13 17 8 Bedding, Linen, &c. 23 1 0 460 3 3 Domestic Utensils 83 10 10 Fuel, Light, Water and Cleaning 567 17 6 651 8 4 Rates, Printing, Stationery, &c. 236 7 11 Medicines, Drugs and Surgical Appliances 194 12 8 Provisions ... 1,183 19 5 Removal of Patients 990 17 0 Uniforms 107 19 5 Salaries, Wages and Allowances 1,591 2 3 1,699 1 8 £5,416 10 3 33 REPORT OF SANITARY INSPECTOR. TO THE CHAIRMAN AND MEMBERS OF THE LEYTON URBAN DISTRICT COUNCIL. Gentlemen, I beg to submit to you my report for the year 1919. I was demobilised in February, 1919, and was appointed Inspector of Nuisances on 1st April, 1919, the appointment having become vacant through the death of Mr. H. Miller, which occurred on 7th January, 1919. INFECTIOUS DISEASE. 1,111 cases of Infectious Diseases (excluding Measles) were notified during the above-mentioned period. Appended is a summary of the work in connection therewith : Houses disinfected and the sanitary arrangements examined and tested: Tuberculosis Cases 198 Other Infectious Diseases 446 Loads of infected bedding removed to be disinfected at the Council's Steam Disinfector and returned 581 Books belonging to Public Institutions disinfected 42 Number of articles, wearing apparel, military equipment, &'c., disinfected 105 Disinfectants are supplied in cases of Infectious Disease, and can be obtained at the Town Hall at any time during office hours. On December 2nd, notification was received by the Medical Officer of Health from the City of London Medical Officer that certain shaving brushes from consignments infected with Anthrax had been sent to traders in the district. Visits were made to these tradesmen and in five cases suspected brushes were purchased and destroyed. All shops in the district where shaving brushes are sold or likely to be sold were visited1 to ascertain if any brushes from infected consignments had been delivered to them. 34 INSPECTION OF THE DISTRICT AND ABATEMENT OF NUISANCES. Many complaints have been received from inhabitants of the district and been dealt with. Owing to relaxation during the war, defects in house property have very largely increased and are now made much more difficult to deal with owing to the very abnormal cost and scarcity of material and labour. Much has, however, been achieved1 by persistently calling attention of owners to the necessity for remedying the defects. The increase in rates being passed on to tenants under the provisions of the Increase of Rents and Mortgage Restrictions Act has been responsible for some somewhat frivolous complaints, while many of the complaints were from people who would have found other accommodation in normal times and left it to the landlord to execute the necessary repairs for a new tenant. On the other hand numerous complaints have been received from occupiers who in normal times would have anticipated ejectment as the inevitable consequence of complaint. Only one summons for abatement of nuisance was taken out and this was withdrawn, the nuisance being abated and the defendant paving costs. House to house inspection has been made at 498 houses in the following roads:— Avondale Road, Leyton Boundary Road, Leyton Burchell Road, Leyton Chertsey Road, Leytonstone Capworth Street, Leyton Dawlish Road, Leyton Goldsmith Road, Leyton High Road, Leyton (portion) Lea Bridge Gardens, Leyton Millais Road, Leyton Manby Road, Leyton Napier Road, Leytonstone Temple Mills Crescent, Leyton Wilmot Road, Leyton Three empty houses have been inspected in accordance with the provisions of the Housing and Town Planning Act, 1919, with a view to requiring them to be made in all respects reasonably fit for human habitation. 35 SUMMARY OF INSPECTIONS AND RESULTS:— Total number of houses and premises inspected 4362 „ „ houses and premises re-inspected 5046 Number of visits to slaughterhouses 928 „ „ dairies, cowsheds and milk- shops 152 „ „ food shops 982 „ „ bakehouses 87 „ „ workshops 288 „ offensive trade premises 1036 Miscellaneous inspections 123 Complaints received 1137 Notices served and letters written in reference to same 3564 Intimations to Metropolitan Water Board re waste of water 64 Defective drains remedied 124 Choked drains cleared 162 Drain manholes properly covered or sealed 26 Defective gullies or connections and percolation around same remedied 279 Air inlets provided to drains or repaired 59 Houses entirely re-drained with intercepting traps and manholes provided between the house drains and sewer and with efficient air inlet and outlet ventilators 13 Foul w.c.'s and drains cleansed 101 Defective w.c.'s repaired, new traps and straight backed pans provided where necessary 165 Defective w.c. flush cisterns and flush pipes renewed or repaired and water supply provided 332 Defective soil pipes repaired or renewed 15 Ventilating shafts repaired or provided to soil pipes and drains 146 Foul and defective sinks cleansed or renewed 19 Sink, bath and lavatory waste pipes and rain pipes trapped or disconnected 26 36 Defective sink, bath and lavatory waste pipes renewed or repaired 136 Defective rain pipes and gutters renewed or repaired 1059 Defective house roofs repaired 636 Defective floors of sculleries or cellars repaired, paved or concreted 118 Yards around back additions of houses and forecourts paved or repaired 227 Yards cleansed 15 Houses in a general insanitary, dilapidated or filthy condition repaired and cleansed 1382 Damp conditions in house or part of house remedied 756 Ventilation provided under ground floors 189 Nuisances arising from stagnant water in basements of houses abated 25 Nuisances arising from insanitary^ condition of stables abated 1 Manure receptacles provided 4 Mews in filthy condition paved, drained and cleansed 1 Water supplies to houses restored and water fittings repaired 172 Domestic water cisterns removed from improper positions or cleansed or repaired 10 Covers to domestic water cisterns provided 8 Nuisances caused by overcrowding 9 Nuisances caused by fish, offal, manure and other refuse deposits abated 136 Nuisances caused by animals kept in an insanitary state abated 31 Smoke nuisances abated 5 Foul and defective urinals cleansed or repaired 14 Vacant plots of land fenced in 2 37 DRAINAGE. The drainage of 13 houses has been reconstructed. In some 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. MEAT AND FOOD INSPECTION. Owing to insufficient staff in the early part of the year and abnormal post-war conditions, inspections of traders' premises have not been so frequent as desirable; the generally good condition of these has, however, been fairly well maintained. The following was found to be unfit for food of man and dealt with accordingly:— 11 Cow Carcases & Viscera 7 Pig Carcases & Viscera 2 Heifer Carcases & Viscen 1 Bullock Carcase & Viscers 1 Sheep Carcase & Viscera 1 Lamb Carcase & Viscera 9455 lbs. Mutton Hind Quarters Beef Fore Quarters Beef 105 lbs. Beef 18 Viscera of Pigs 2 Viscera of Bullocks 1 Viscera of Cow 1 Viscera of Heifer 8 pairs Sheep's Lungs 5 pairs Pigs' Lungs 4 pairs Ox Lungs 53 Ox Livers 13 Sheep's Livers 21 Sheep's Plucks 7 Pigs' Plucks 49 Pigs' Heads 1493½ lbs. Bacon 3 boxes Bacon 439 Wild Rabbits 615 lbs. Rabbits 8 cases Rabbits 29 lbs. Cheese 72 lbs. Butter 180 Eggs 1 tin Corned Beef 2 boxes Herrings 2 barrels Herrings 11 stones Herrings 4 boxes Haddocks 10 boxes Mackerel 19 boxes Kippers 4 stones Skate 2 bags Winkles 7 galls. Shrimps 2 Lobsters 4921 lbs. Dates 3½ cases Bananas 1 barrel Apples 38 SLAUGHTERHOUSES. The Slaughterhouses are visited regularly, and at any odd times when it is known that slaughtering is being carried on. We find that generally the bye-laws relating to them are well observed. Number of carcases inspected:— Pigs 370 Sheep 2152 Bullocks 1617 Calves 72 Lambs 14 The following is a list of slaughterhouses at present in use:— Keepers of Slaughterhouses. Norwood, A. & Son, 650, High Road, Leytonstone. Wilson, W. H., 249, High Road, Leytonstone. Furze, E. R., 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. T. Cox & Co., 442, High Road, Leyton. Smith, A. J., 48, Lansdowne Road, Leytonstone. Carr, A. H., 55, Hainault Road, Leytonstone. Gattrill, C. F., 177, Francis Road, Leyton. Stratford Co-operative and Industrial Society, Ltd., South Birkbeck Road, Leytonstone. Simonds, S. R., Old Manor Farm, Capworth Street, Leyton. DAIRIES, COWSHEDS, AND MILKSHOPS. The number of dairies, cowsheds, and milkshops on the register for the year ended December 31st, 1919, was 100. There are at present 4 cowsheds in use in the district; these, together with the dairies and milkshops, are visited periodically, special attention being given to the cleanliness of the premises and general sanitary conditions. 39 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 regard uncleanly or other insanitary conditions. OFFENSIVE TRADES. The following offensive trades are established in the District:— Tripe Boilers 2 Fat Melters 1 Fat Extractors 1 Gut Scrapers 1 Bone Boilers 1 Fish Friers 33 Rag and Bone Dealers 15 Established during 1919:— Applications for permission to establish Permission granted. Fish Friers 9 9 Rag and Bone 3 — MORTUARY. During the year the number of bodies received was 58. There were 45 post-mortems and 56 inquests held. PETROLEUM. 29 licences were issued after inspection as to the suitability of the premises. I am, Gentlemen, Your obedient Servant, W. J. STEVENS. 40 TABLE I. Vital Statistics of Whole District during 1919 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 Res dents not registered in the District. Under 1 Year of Age. At all Ages. Number. Rate. Number. Rate. Number. Rate per 1000 Nett Births. Number. Rate. 1 2 3 4 5 6 7 8 9 10 11 12 13 1914 130847 2751 2800 21.4 2163 16.5 1034 234 219 78.2 1363 10.4 1915 124497 2595 2655 21.3 2462 19.8 1225 273 225 84.7 1510 12.1 1916 132107 2558 2560 19.4 2387 19.6 1188 272 197 76.9 1471 12.1 1917 125352 1918 2005 16.0 2312 20.5 1213 315 172 85.8 1414 12.6 1918 125352 1687 1791 14.3 2661 23.7 1214 276 161 89.9 1723 15.3 1919 130000 2044 2195 17.0 2127 17.2 999 269 154 70.16 1397 11.3 Area of District in acres (land and inland water) 2594 Total population at all ages 124736 Total families or separate occupiers 27346 At census 1911. 41 Table II.—Cases of Infectious Disease Notified During the Year 1919, 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 and under 5. 5 and under 15. 15 and under 25. 25 and under 45. 45 and under 65. 65 and upwards. Ley ton. Lea Bridge. Central. Forest. Leytonstone Grove Green. Harrow Green. Cann Hall. Wanstead Slip. Small Pox ... ... ... ...... ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera (C) Plague (P) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... *Diphtheria (including Membranous Croup) 263 1 60 174 12 15 1 ... 9 03 23 32 21 29 24 40 22 199 †Erysipelas 79 5 4 9 24 26 11 2 13 12 12 5 9 14 6 6 13 ‡Scarlet Fever 208 2 48 132 21 5 ... ... 11 33 40 31 10 25 25 20 13 84 Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Pneumonia 101 1 7 11 12 47 19 4 6 17 15 9 6 9 17 9 13 ... Enteric Fever 4 ... ... 1 3 ... ... ... 1 2 ... 1 ... ... ... ... ... 4 ||Malaria 81 ... ... ... 18 59 4 ... 15 3 28 3 3 10 9 7 3 ... Relapsing Fever (R) Continued Fever (C) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ¶Dysentery 5 ... ... ... ... 5 ... ... ... ... 2 1 1 1 ... ... ... ... Puerperal Fever 12 ... ... ... 8 9 ... ... ... 1 4 2 ... 2 1 ... 2 6 Cerebro-spinal Meningitis 4 ... ... 2 1 1 ... ... 1 2 ... ... ... ... ... ... 1 3 Anthrax 1 ... ... ... 1 ... ... ... 1 ... ... ... ... ... ... ... ... 1 Poliomyelitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... §Pulmonary Tuberculosis 266 § 3 33 68 123 35 4 23 35 57 32 16 28 34 19 20 78 Other forms of Tuberculosis 62 2 15 24 5 14 2 ... 8 8 9 8 5 10 6 6 2 16 Ophthalmia Neonatorum 25 25 ... ... ... ... ... ... 1 1 7 1 1 4 3 2 5 ... Measles 1156 22 347 760 15 11 1 ... 81 233 270 249 79 62 49 70 63 ... „ (German) 103 3 17 70 12 1 ... ... 7 19 21 23 15 3 8 6 1 ... Totals ... 2370 50 502 1211 180 314 88 19 160 430 488 404 162 192 190 185 151 404 *13 cases occured in West Ham Infirmary, 1 in West Ham Workhouse and 3 in Bethnal Green Schools, †7 cases occurred in West Ham Workhouse, ‡1 case occurred in West Ham Infirmary. §2 cases homeless. Wards not known. ||Old military cases. ¶Old military cases. 42 TABLE III. DEATHS. CALENDAR YEAR 1919. Ages. Wards. 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. 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 1394 154 27 48 57 74 210 344 480 399 231 91 182 282 174 161 119 1914 147 103 11 1394 Uncertified 3 ... ... ... ... ... ... ... 3 ... ... ... ... 1 1 ... 1 ... ... ... ... 3 Enteric Fever ... ... ... ... ... ... ... ... ... 3 ... ... ... ... ... ... ... ... ... ... ... ... Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 3 1 ... ... 2 ... ... ... ... 2 ... ... 1 ... 1 ... ... ... ... 1 ... 3 Scarlet Fever 3 ... ... 2 1 ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 1 ... 3 Whooping Cough 3 1 1 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 2 ... ... 3 Diphtheria and Croup 23 ... 2 7 14 ... ... ... ... ... 1 ... 7 3 2 1 4 ? 3 1 23 Influenza 114 4 ... 3 5 13 54 25 10 61 21 6 12 29 17 12 9 10 10 9 ... 114 Erysipelas 5 ... ... ... ... 2 1 1 1 2 3 ... 2 2 1 ... ... ... ... ... ... 5 4^ Phthisis (Pulmonary Tuberculosis) 110 ... 1 3 5 22 42 32 5 85 20 7 12 25 18 10 7 11 13 6 1 110 Tuberculous Meningitis 12 1 ... 4 3 1 3 ... ... 17 2 2 2 3 1 2 2 ... ... ... ... 12 Other Tuberculous Diseases 18 3 2 5 ... 4 1 3 ... 18 5 2 2 3 3 2 1 3 1 1 ... 18 Cancer, malignant disease 111 ... ... ... ... 1 14 55 41 84 16 3 15 27 15 11 11 8 11 9 1 111 Rheumatic Fever 7 ... ... ... 2 1 2 1 1 4 ... ... 1 1 1 ... ... 1 3 ... ... 7 Meningitis 11 1 3 2 2 1 ... 2 ... 3 1 ... 2 2 5 ... ... ... 1 1 ... 11 Organic Heart Disease 145 ... ... 1 1 4 12 48 79 59 11 16 13 21 16 29 16 13 13 8 145 Bronchitis 139 8 3 3 3 ... 6 30 86 78 14 8 22 35 15 11 13 10 15 10 ... 139 Pneumonia (all forms) 77 14 7 8 6 5 8 18 11 58 12 4 16 13 6 9 10 3 5 9 2 77 Other diseases of Respiratory Organs 17 1 ... 1 1 ... 1 4 9 14 2 2 3 3 4 2 ... 2 1 ... ... 17 Diarrhoea and Enteritis 22 18 4 ... ... ... ... ... ... 31 8 3 4 2 ... 2 3 4 1 3 ... 22 Appendicitis and Typhlitis 7 ... ... ... 1 4 1 1 ... 3 3 1 2 1 ... ... 1 ... 2 ... ... 7 Cirrhosis of Liver 3 ... ... ... ... ... ... l 2 4 ... ... ... 1 ... 1 1 ... ... ... ... 3 Alcoholism ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... Nephritis and Bright's Disease 49 1 ... ... ... 3 6 28 11 21 5 5 4 6 4 8 3 8 8 3 49 Puerperal Fever 5 ... ... ... ... ... 5 ... ... 7 3 ... ... 1 1 ... ... 1 ... 2 ... 5 Other accidents and diseases of Pregnancy and Parturition 6 ... ... ... ... ... 6 ... ... 2 ... ... 2 1 ... ... ... 2 ... 1 ... 6 Congenital Debility and Malformation, including Premature Birth 71 66 2 2 ... ... 1 ... ... 8 3 2 6 19 13 2 9 9 4 7 ... 71 Violent Deaths, excluding Suicide 40 8 ... 1 4 4 8 9 6 17 5 2 2 12 3 4 3 5 4 3 2 40 Suicide 10 ... ... ... ... ... 6 2 2 3 1 ... 1 3 2 1 2 ... 1 ... ... 10 Other Defined Diseases 284 26 2 5 "i 9 33 81 121 195 46 19 40 50 33 40 24 22 34 21 1 284 Diseases Ill-defined or Unknown 3 1 ... ... ... ... ... 2 ... 4 ... ... ... 1 1 ... ... ... ... 1 3 Old Age 99 ... ... ... ... ... ... 1 98 215 49 8 11 18 14 13 1 10 14 7 3 99 1397 154 27 48 51 74 210 344 483 999 231 91 182 283 175 161 120 124 147 103 11 1397 Sub-Entries included in above figures— Cerebro-spinal Meningitis ... ... ... ... 1 1 ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 ... ... Poliomyelitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4^ Table III a. Cause's of, and Ages at, Death, Calendar Year, 1919. The detailed International List of Causes of Death as adapted for use in England and Wales. No. Diseases. Males. Females. AGES. All Ages. 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65- 75- 85- 1.—General Diseases. 6 Measles 2 1 1 ... 2 ... ... ... ... ... ... ... ... ... ... 3 7 Scarlet Fever 1 2 ... 2 1 ... ... ... ... ... ... ... ... ... ... 3 8 Whooping Cough 2 1 1 2 ... ... ... ... ... ... ... ... ... ... ... 3 9 Diphtheria, Croup 14 9 ... 9 13 1 ... ... ... ... ... ... ... ... ... 23 10 Influenza 55 59 4 3 3 2 3 10 39 15 14 11 5 2 3 114 14 Dysentery 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 18 Erysipelas 2 3 ... ... ... ... 1 1 1 ... 1 ... 1 ... ... 5 20 Pyaemia, Septicaemia ... 1 ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 28 Pulmonary Tuberculosis 57 50 ... 3 3 ... 14 8 18 23 17 14 4 1 ... 107 29 Acute Miliary Tuberculosis 2 1 ... 1 ... ... ... ... ... 1 1 ... ... ... ... 3 30 Tuberculous Meningitis 2 10 1 4 3 ... 1 ... 3 ... ... ... ... ... ... 12 31 Tuberculosis of Peritoneum and Intestines 6 4 3 3 ... ... 2 ... ... 2 ... ... ... ... 10 32 Tuberculosis of Spinal Column 2 ... ... 1 ... ... 1 ... ... ... ... ... ... ... ... 2 33 Tuberculosis of Joints 1 ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 1 34 Tuberculosis of other Organs 2 ... ... 1 ... ... ... ... ... 1 ... ... ... ... ... 2 35 Disseminated Tuberculosis 2 1 ... 2 ... ... ... ... ... ... 1 ... ... ... ... 3 37 Syphilis 3 3 3 ... ... ... ... ... ... ... 2 1 ... ... ... 6 38 Other Venereal Diseases 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 39 Cancer of the Buccal Cavity 3 ... ... ... ... ... ... ... ... 1 2 ... ... ... 3 40 Cancer of the Stomach, Liver 23 20 ... ... ... ... ... 1 ... 4 6 14 10 8 ... 43 41 Cancer of the Peritoneum, Intestines, Rectum 7 11 ... ... ... ... ... ... 1 1 1 8 6 1 ... 18 45 42 Cancer of the Female Genital Organs ... 15 ... ... ... ... ... ... 1 ... 6 2 4 2 ... 15 43 Cancer of the Breast ... 11 ... ... ......... ... ... ... ... 4 1 3 3 ... 11 44 Cancer of the Skin 1 2 ... ... ... ... ... ... ... ... ... 2 1 ... ... 3 45 Cancer of other or unspecified organs 12 6 ... ... ... ... ... ... 1 2 2 7 5 1 ... 18 47 Rheumatic Fever 5 2 ... ... ... 2 1 ... ... 2 ... 1 1 ... ... 7 48 Chronic Rheumatism, Gout 1 5 ... ... ... ... ... ... ... ... 1 2 2 l ... 6 50 Diabetes 3 8 ... ... ... ... ... ... 2 ... 2 2 4 1 ... 11 53 Leucocythæmia 3 2 ... ... ... ... ... ... ... ... 2 ... ... 1 ... 5 54 Anæmia, Chlorosis 2 2 ... ... ... ... ... ... 1 ... 1 2 ... ... ... 4 55 Other General Diseases ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 II.—Diseases of the Nervous System and of the Organs of Special Sense. 60 Encephalitis 1 1 ... 1 ... ... ... ... ... 1 ... ... ... ... ... 2 61 Meningitis 4 5 1 5 1 ... ... ... ... ... ... 2 ... ... ... 9 61a Cerebro-Spinal Fever 1 1 ... ... ... 1 ... 1 ... ... ... ... ... ... ... 2 62 Locomotor Ataxy ... 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 63 Other Diseases of the Spinal Cord 5 4 2 ... ... ... 2 ... 1 1 2 1 ... ... ... 9 64 Cerebral Haemorrhage, Apoplexy 33 48 2 ... ... ... ... ... ... 3 4 20 34 17 1 81 65 Softening of the Brain ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 66 Paralysis without Specified Cause 3 7 ... ... ... ... ... ... ... 1 1 2 4 2 ... 10 67 General Paralysis of the Insane 7 1 ... ... ... ... ... ... 2 1 6 ... ... ... ... 8 69 Epilepsy 3 5 1 ... 1 ... 1 2 1 1 1 ... ... ... 8 70 Convulsions (non-puerperal) ... 1 ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 71 Infantile Convulsions 4 ... 3 1 ... ... ... ... ... ... ... ... ... ... ... 4 9t Causes of, and Ages at, Death, Calendar Year, 1919.—Continued. No. Diseases. Males. Females. AGES. All Ages. 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65- 75- 85- 73 Hysteria, Neuralgia, Neuritis ... 2 ... ... ... ... ... ... ... ... ... ... 2 ... ... 2 74 Other Diseases of the Nervous System 4 2 ... 1 1 ... ... ... 1 2 ... ... ... 1 ... 6 76 Diseases of the Ears 1 1 ... ... ... 1 ... ... ... ... 1 ... ... ... ... 2 III.—Diseases of the Circulatory System. 77 Pericarditis 1 1 ... ... ... ... ... ... ... ... 2 ... ... ... ... 2 78 Acute Endocarditis 1 3 ... ... ... 1 1 ... 1 1 ... ... ... ... ... 4 79 Organic Disease of the Heart 62 83 ... 1 ... 1 1 3 5 7 20 28 48 27 4 145 81 Diseases of the Arteries, Atheroma, Aneurysm, &c. 7 6 ... ... ... ... ... ... ... 1 1 3 6 1 1 13 82 Embolism, and Thrombosis 4 4 ... ... ... ... ... 1 1 ... 1 2 2 1 ... 8 83 Diseases of the Veins (Varices, Haemorrhoids, Phlebitis, &c.) 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 85 Haemorrhage; other Diseases of the Circulatory System 2 1 ... ... ... ... ... ... ... ... 1 ... 2 ... ... 3 IV.—Diseases of the Respiratory System. 87 Diseases of the Larynx ... 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 88 Diseases of the Thyroid Body ... 3 ... ... ... ... ... ... ... ... 1 ... 2 ... ... 3 47 89& 90 Bronchitis 70 69 8 6 2 1 ... ... 2 4 10 20 37 41 8 139 91 Broncho-Pneumonia 20 20 12 14 2 ... 1 ... ... ... 3 1 2 5 ... 40 92 Pneumonia, Lobar & undefined 25 12 2 1 3 1 2 2 3 5 8 6 4 ... ... 37 93 Pleurisy 3 ... ... ... ... ... ... ... ... ... 1 ... 2 ... ... 3 94 Pulmonary Congestion, Pulmonary Apoplexy 3 3 1 1 ... ... ... ... ... ... ... 1 2 ... 1 6 96 Asthma 1 3 ... ... ... ... ... ... ... 1 1 ... 1 ... 1 4 V.—Diseases of the Digestive System. 100 Diseases of the Pharynx 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 102 Ulcer of the Stomach 1 2 ... ... ... ... ... ... 1 ... 1 ... ... 1 ... 3 103 Other Diseases of the Stomach 4 2 2 1 ... ... ... ... ... 1 ... ... 1 ... 6 104 and Diarrhoea and Enteritis 9 13 18 4 ... ... ... ... ... ... ... ... ... ... ... 22 105 5 6 ... 1 ... ... ... ... 3 ... 1 ... 2 4 ... 11 108 Appendicitis 6 1 ... ... ... 1 3 ... ... 1 ... 1 ... ... ... 7 109 Hernia, Intestinal Obstruction 9 7 2 1 ... 1 ... ... ... ... 2 ... 6 4 ... 16 110 Other Diseases of the Intestines 1 ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 113 Cirrhosis of the Liver 2 1 ... ... ... ... ... ... ... ... ... 1 2 ... ... 3 114 Biliary Calculi 2 2 ... ... ... ... ... ... ... ... ... 1 3 ... ... 4 115 Other Diseases of the Liver 2 1 ... ... ... ... ... ... ... ... 1 2 ... ... ... 3 VI.— Non-venereal Diseases of the Genito-urinary System and Annexa. 119 Acute Nephritis 1 2 1 ... ... ... 1 ... ... ... 1 ... ... ... ... 3 120 Bright's Disease 20 26 ... ... ... ... ... 2 2 4 7 20 8 2 1 46 48 Causes of, and Ages at, Death, Calendar Year, 1919.—Continued. No. Diseases. Males. Females. AGES. All Ages. 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65- 75- 85- 122 Other Diseases of the Kidneys and Annexa 1 2 2 ... ... ... ... ... ... 1 ... ... ... ... ... 3 123 Culculi of the Urinary Passages 1 1 ... ... ... ... ... ... 1 ... ... 1 ... ... ... 2 124 Diseases of the Bladder 2 ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 2 126 Diseases of the Prostate 9 ... ... ... ... ... ... ... ... ... ... 1 2 5 1 9 130 Other Disease of the Uterus ... 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 131 Cysts and other tumors of the Ovary ... 2 ... ... ... ... ... 1 1 ... ... ... ... ... ... 2 133 Non-Puerperal Diseases of the breast (non-cancerous) ... 1 ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 VII.—The Puerperal State. 134 Accidents of Pregnancy ... 1 ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 135 Puerperal Hæmorrhage ... 2 ... ... ... ... ... ... 2 ... ... ... ... ... ... 2 136 Other Accidents of Labor ... 2 ... ... ... ... ... ... 1 1 ... ... ... ... ... 2 137 Puerperal Fever ... 5 ... ... ... ... ... ... 2 3 ... ... ... ... ... 5 138 Puerperal Albuminuria and convulsions ... 1 ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 VIII.—Diseases of the Skin and of the Cellular Tissue. \ 142 Gangrene 3 2 ... ... ... 1 ... ... ... ... ... 2 ... 1 1 5 an 144 Acute Abscess ... 2 ... ... ... ... ... ... ... ... ... ... 2 ... ... 2 IX.—Diseases of the Bones and of the Organs of Locomotion. 146 Diseases of the Bones 2 ... ... ... ... ... ... ... ... 1 ... ... 1 ... ... 2 X.—Malformations. 150 Congenital Malformations 10 3 8 4 ... ... ... ... 1 ... ... ... ... ... ... 13 XI.—Early Infancy. 151 Premature Birth, Infantile Debility,Icterus,and Sclerema 35 23 58 ... ... ... ... ... ... ... ... ... ... ... ... 58 152 Other Diseases peculiar to Early Infancy 4 2 6 ... ... ... ... ... ... ... ... ... ... ... ... 6 153 Lack of Care 1 1 2 ... ... ... ... ... ... ... ... ... ... ... ... 2 XII.—Old Age. 154a Senile Dementia 1 1 ... ... ... ... ... ... ... ... ... ... 1 1 ... 2 154b Senile Decay 40 57 ... ... ... ... ... ... ... ... ... 1 19 44 33 97 XIII.—External Causes. 155 Suicide by Poison 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 156 Suicide by Asphyxia ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 157 Suicide by Hanging or Strangulation 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 160 Suicide by Cutting or Piercing Instruments 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 161 Suicide by Jumping from High Places ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 50 Causes of, and Ages at, Death, Calendar Year, 1919.—Continued. No. Diseases. Males. Females. AGES. All Ages. 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65 75- 85 162 Suicide by Crushing 3 ... ... ... ... ... ... ... 1 1 ... ... ... 1 ... 3 163 Other Suicides ... 1 ... ... ... ... ... ... ... 2 ... ... ... ... ... 2 165 Other Acute Poisonings ... 1 ... ... ... ... ... ... ... .... 1 ... ... ... ... 1 167 Burns (Conflagrat on excepted) ... 2 ... ... ... 1 ... ... ... ... ... ... ... 1 ... 2 168 Absorption of Deleterious Gases (Conflagration excepted) 2 5 5 ... ... ... ... 1 ... 1 ... ... ... ... ... 7 169 Accidental Drowning 3 ... ... ... ... 1 ... ... ... 1 ... 1 ... ... ... 3 171 Injury by Cutting or Piercing Instruments 1 ... ... ... ... ... ... ... ... 1 ......... ... ... ... ... 1 172 Injury by Fall 6 1 ... ... ... ... ... ... 1 ... 3 ... 3 ... ... 7 175 Injury by other Crushing (Vehicles, Railways, Landslides, &c.) 6 3 ... 1 1 ... ... 2 1 ... 2 1 1 ... ... 9 179 Effects of Heat 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 182 Homicide by Firearms 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 184 Homicide by other means ... 2 2 ... ... ... ... ... ... ... ... ... ... ... ... 2 185 Fractures (cause not specified) 1 1 1 ... ... ... ... ... ... ... ... ... ... 1 ... 2 186 Other Violence 4 ... ... ... ... 1 1 ... 1 1 ... ... ... ... ... 4 XIV.—Ill-defined Causes. 188 Syncope, Sudden Death 1 1 ... ... ... ... ... ... ... ... 1 1 ... ... ... 2 189 Ill-defined Causes or Unknown 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 Totals, General Diseases 215 230 14 32 26 7 24 21 69 53 61 71 46 18 3 445 Totals, Diseases of the Nervous System and of the Organs of Special Sense 60 80 9 8 3 2 3 3 5 9 14 27 41 21 1 146 Totals, Diseases of the Circulatory System 78 98 ... 1 ... 2 2 4 7 9 26 33 58 29 5 176 Totals, Diseases of the Respiratory System 122 111 23 22 7 3 3 2 5 10 24 28 50 46 10 233 Totals, Diseases of the Digestive System 42 35 22 7 ... 2 3 1 4 2 6 6 14 10 ... 77 Totals,Non-Venereal Diseasesof theGenito-Urinary System and Annexa 34 35 3 ... ... ... 1 3 5 5 8 24 10 7 3 69 Totals the Puerperal State ... 11 ... ... ... ... ... ... 7 4 ... ... ... ... ... 11 Totals. Diseases of the Skin and of the Cellular Tissue 3 4 ... ... ... 1 ... ... ... ... ... 2 2 1 1 7 Totals, Diseases of the Bones and of the Organs of Locomotion 2 ... ... ... ... ... ... ... ... 1 ... ... 1 ... ... 2 Totals, Malformations 10 3 8 4 ... ... ... ... 1 ... ... ... ... ... ... 13 Totals, Early Infancy 40 26 66 ... ... ... ... ... ... ... ... ... ... ... ... 66 Totals, Old Age 41 58 ... ... ... ... ... ... ... ... ... 1 20 45 33 99 Totals, External Causes 32 18 8 1 1 3 1 3 5 9 9 2 4 3 1 50 Totals, Ill-defined Causes 2 1 1 ... ... ... ... ... ... ... 1 1 ... ... ... 3 Grand Totals 687 710 154 75 37 20 37 37 108 102 149 195 246 180 57 1397 There were no Deaths from the Causes of Deaths represented in the International List by the following numbers:—1, 2, 4, 5, 11, 12, 13, 15, 16, 17, 19, 21 22, 23 24,25, 26, 27, 36, 46, 4951, 52, 56, 57, 58, 59, 68, 72, 75, 80, 81, 86,95, 97, 98, 99, 101, 106, 107, 111, 112, 116, 117, 118, 121, 125, 127, 128, 129, 132, 139, 140, 141, 143, 145, 147, 148, 149, 158, 159, 164, 166, 170, 173, 171, 176, 177, 178, 180, 181, 183, 187. 51 Table No. IV. INFANTILE MORTALITY, CALENDAR YEAR 1919 Nett Deaths from Stated Causes at various Ages under One Year of Age. CAUSES OF DEATH. Under 1 Week. 1-2 Weeks. 2-3 Weeks. 3-4- Weeks. Total under 4 Weeks. 1 Weeks and under 3 Months. 3 Months and under 6 Months. 6 Months and under 9 Months 9 Months and underl2Months. Total Deaths under 1 Year. All Causes Certified 50 7 8 6 71 31 23 15 13 154 Uncertified ... ... ... ... ... ... ... ... ... ... Small-pox ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... 1 1 Scarlet Fever ... ... ... ... ... ... ... ... ... ... Whooping-Cough. ... ... 1 ... 1 ... ... ... ... 1 Diphtheria and Croup ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... Tuberculous Meningitis ... ... ... ... ... ... ... 1 ... 1 Abdominal Tuberculosis. ... ... ... ... ... ... ... ... ... ... Other Tuberculous Diseases ... ... ... ... ... 2 ... ... 1 3 Meningitis (not Tuberculous) ... ... ... ... ... ... 1 ... ... 1 52 Convulsions 2 1 ... ... 3 ... ... ... ... 3 Laryngitis ... ... ... ... ... ... ... ... ... ... Bronchitis 1 ... ... ... 1 3 3 ... 1 8 Pneumonia (all forms) 2 ... ... ... 2 3 2 3 4 14 Diarrhoea ... ... ... ... ... ... ... 1 ... 1 Enteritis ... ... ... 1 1 6 4 5 1 17 Gastritis ... ... ... ... ... ... ... ... 1 1 Syphilis ... ... ... 1 1 1 1 ... ... 3 Rickets ... ... ... ... ... ... ... ... ... ... Suffocation, overlying 1 ... ... ... 1 2 2 ... ... 5 Injury at Birth ... ... ... ... ... ... ... ... ... ... Atelectasis 4 ... ... ... 4 ... ... ... ... 4 Congenital Malformations 3 ... 1 ... 4 3 ... 1 ... 8 Premature Birth 27 1 2 1 31 2 1 ... ... 34 Atrophy, Debility and Marasmus 4 3 4 2 13 6 5 ... ... 24 Other Causes 6 2 ... 1 9 3 4 4 4 24 Death received from the Registrar-General (cause of death not known) 1 Totals 50 7 8 6 71 31 23 15 13 154 Nett Births registered during the calendar year Legitimate 2,110 Nett Deaths registered during the calendar year Legitimate infants 139 Illegitimate 85 Illegitimate infants 15 1 infant abandoned in Norlington Road. Died in West Hum, Workhouse 1/4/19. 1 newborn, unknown, found on Leylon Marshes. 53 Table IVa. INFANTILE MORTALITY, CALENDAR YEAR 1919. 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 6 19 36 19 6 20 20 11 14 2 154 Uncertified ... ... ... ... ... ... ... ... ... ... ... Small-pox ... ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... ... Measles ... 1 ... ... ... ... ... ... ... ... 1 Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... Whooping-Cough ... ... ... ... ... ... ... 1 ... ... 1 Diphtheria and Croup ... ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... ... Tuberculous Meningitis ... ... ... ... ... 1 ... ... ... ... 1 Abdominal Tuberculosis ... ... ... ... ... ... ... ... ... ... ... ... Other Tuberculous Diseases 1 ... 1 ... ... ... 1 ... ... ... 3 Meningitis (not Tuberculous) ... ... 1 ... ... ... ... ... ... ... 1 Convulsions ... 1 1 ... ... ... ... 1 ... ... 3 54 Laryngitis ... ... ... ... ... ... ... ... ... ... ... Bronchitis ... 2 1 2 1 ... 1 1 ... ... 8 Pneumonia (all forms) ... 3 3 ... 1 2 ... 2 3 ... 14 Diarrhoea ... ... ... ... ... ... 1 ... ... ... 1 Enteritis 1 4 2 ... 1 3 3 1 2 ... 17 Gastritis ... ... ... 1 ... ... ... ... ... ... 1 Syphilis ... 1 2 ... ... 3 Rickets ... ... ... ... ... ... ... ...... ... ... ... Suffocation, overlying ... ...... 2 1 ... 1 1 ... ... ... 5 Injury at Birth ... ... ... ... ... ... ... ... ... ... ... Atelectasis ... ... 2 ... ... ... 1 ... ... ... 4 Congenital Malformations 1 1 3 ... 1 ... ... ... ... ... 8 Premature Birth 1 2 6 7 ... 3 9 2 3 1 34 Atrophy, Debility and Marasmus ... 1 a 4 ... 2 2 2 4 24 Other Causes 1 2 7 2 2 5 1 1 2 1 24 Death received from the Registrar-General (Ward not known 1 1 Totals 6 19 36 19 6 20 20 11 14 3 154 Nett Births registered during the calendar year Legitimate 2,110 Nett Deaths registered during the calendar year Legitimate Infants 139 Illegitimate 85 Illegitimate Infants 15 1 infant abandoned in Norlington Road. Died in West Ham Workhouse 1/4/19. 1 newborn, unknown, found on Leyton Marshes. 55 Leyton Urban District Council. ANNUAL REPORT to the EDUCATION COMMITTEE, embodying the Twelfth Annual Report on the MEDICAL INSPECTION OF SCHOOL CHILDREN Under the Education (Administrative Provisions) Act of 1907, For the Year 1919, by J. FRANCIS TAYLOR, M.R.C.S., D.P.H. Surgeon-Major, Honourable Artillery Company, Medical Officer of Health. ILFORD: South Esskx Recorders, Limited, High Road. 59 TO THE CHAIRMAN AND MEMBERS of the LEYTON EDUCATION COMMITTEE. Mr. Chairman, Ladies and Gentlemen, I beg to present the Twelfth Annual Report on the work of the School Medical Service in Leyton under the Education (Administrative Provisions.) Act of 1907. For the first time since 1914 the examination of routine groups of children has been attempted, but owing to Dr. Ball relinquishing his appointment in August to take up the duties of Medical Officer of Health of Middleton, and a successor not being obtainable until March, 1920, only the Entrants' Group were dealt with. Dr. Kennedy, however, continued the examination of the "Specials," or ailing children. The amount of work done during the year in the various: branches, i.e., Eye, Dental and Minor Ailments, etc., sections will be evident on a study of the details contained in the body of the Report. Again my thanks are due and are hereby accorded to members and officials for their invariable courtesy and assistance. I am, Mr. Chairman, Ladies and Gentlemen, Your obedient Servant, J. FRANCIS TAYLOR, School Medical Officer 60 STAFF. Your School Medical Officer was demobilised in February, and from that time resumed his whole time employment under the Council. Dr. Ball also returned from military duties early in the year, but left us in August on his appointment as Medical Officer of Health to the Borough of Middleton. Whilst he was with us he re-commenced the routine inspections at the schools, and completed the examinations of the Entrants. After August, Dr. Kennedy resumed his work of inspection of the ailing children, but as Dr. Ball's position was not filled until March of this year (1920), the examination of the Routine Groups was suspended. Late in the year, William Nicoll, M.A., M.D., D.Sc. St. Andrew's University, D.P.H. Cambridge, who had been doing School Medical Work under the East Sussex County Council, was appointed Deputy Medical Officer of Health and Deputy School Medical Officer. The three School Nurses, one of whose time is wholly taken up with the School Dentist, have visited the schools with the doctors and independently; have visited the homes of the children for following up cases referred for treatment, and for other reasons, e.g., enquiring into home conditions of cases of Scabies, etc. ; have attended the Inspection Clinic and carried out the treatment of minor ailments. A second Dental Surgeon, Mr. James Ernest Horton, L.D.S., R.C.S. Eng., has been appointed, and will commence his duties in May, 1920. SCHOOL CLINICS. INSPECTION CLINIC. As previously reported, the Inspection and Minor Ailments' Clinic are held every morning at the Town Hall, and are closely associated, children being passed on from the Inspection to the 61 Treatment Clinic. Verminous cases, and children in need of such treatment as is available at the School Clinics, and who are noted as requiring attention during the course of medical inspection at the schools, are referred to the Inspection and Treatment Clinics. Many large hospitals are easily reached from Leyton, and parents can obtain skilled (advice and treatment for any condition arising in their children;in addition, cases are received into the West Ham Infirmary. Records of attendances and treatment are entered in a register, and upon special cards. During the year, 1,079 boys and 1,192 girls attended the Inspection Clinic. The following table shows the conditions dealt with :— Boys. Girls. Vermin of head and body 131 519 Ringworm of scalp 95 73 Ringworm of other parts of body 66 39 Scabies 113 138 Other skin diseases 373 198 Ear diseases 47 21 External eye diseases 65 42 Lung diseases 26 10 Heart disease 20 18 Throat diseases 25 19 Miscellaneous 118 115 Total 1,079 1,192 MINOR AILMENTS CLINIC. Treatment :— For diseases of eyes on 2,111 occasions. ,, ,, ears on 1,114 ,, ,, Ringworm on 1,087 ,, ,, Other affections 6,640 ,, Total 10,952 62 OPHTHALMIC SURGEONS REPORT ON THE WORK OF THE EYE CLINIC. The selection of new cases for Ophthalmic examination is made from :— (1) Children found with defective vision by the School Medical Officer at the Schools. (2) Children suffering from obvious defects sent to the School Clinic by the teachers. 694 cases were examined at the Clinic. Of these the defects were as follows :— *Myopia 96 Myopic astigmatism 56 Hypermetropia 132 Hypermetropic astigmatism 140 Mixed astigmatism 43 Hypermetropia with squint 39 Myopia with squint 15 Squint only 14 Odd eyes 11 Various diseases 40 No defect 108 Total 694 * 10 of these cases were excluded for varying periods. VARIOUS DISEASES. 40 disease cases were seen. These included iritis, nystagmus, optic atrophy, artificial eye and cataract. The remainder were cases of corneal ulcer, corneal opacity, conjunctivitis and ciliary spasm. Myopia and squint cases requiring supervision are seen at intervals of three to nine months. A. HENRY THOMPSON. 63 DENTAL SURGEON'S REPORT ON THE WORK OF THE DENTAL CLINIC. CONDITION OF CHILDREN'S TEETH AT INSPECTION. School. Number of Children Inspected. Percentage of Children with Percentage of Children with 1 or more Permanent Teeth Decayed. Sound Teeth. 1-3 Temporary Teeth Decayed. 4 or more Temporary Teeth Decayed 1st Inspection. Re-Inspected. 1st Inspection. Re-Inspected. 1st Inspection. Re-Inspected. 1st Inspection. Re-Inspect-i ed. 1st Inspection. Re-Inspected. Davies Lane 73 121 6.8 16.5 13.9 28.8 21.1 8.7 9.7 40.2 Church Road 90 102 12.2 14.7 11.9 33.8 26.0 4.1 10.4 36.9 Cann Hall Road 103 152 19.4 15.7 9.8 37 6 22.7 4.3 8.6 40.3 Cobbold Road 48 85 41 11.7 7.5 30.8 26.3 135 8.2 45.1 Farmer Road 91 121 14.2 11.5 15.0 30.3 20.7 8.9 10.3 37.7 St. Joseph's 42 52 16.6 25.0 19.1 34.0 18.0 2.1 7.4 24.4 Capworth Street 148 203 11.4 14.7 131 34.7 23.0 7.6 9.6 31.0 High Road 14 38 0.0 15 .7 7.6 42.3 17.3 9.6 11.5 44.2 Lea Bridge Road 41 64 29. 2 25.0 13. 3 35.2 15.2 6 6 3.8 20 .9 Newport Road 156 227 15.1 22.9 11.3 29.0 21.6 8.9 5.8 23.7 Sybourn Street 87 133 12.6 18.0 11.8 31 .3 21.3 7.1 4.0 26.8 Canterbury Road 89 115 17.9 13.9 11.7 29.4 23.5 9.3 6.3 34.8 Kirkdale Road 100 128 16. 0 17.1 10.5 28.5 25 4 8.3 6.1 31.5 Norlington Road 146 302 15.7 12.2 10.2 41.9 17.1 7.8 5.5 38.1 Trumpington Road 88 129 15.9 10.1 10.1 34.5 23.5 9.2 5.0 32.7 1316 1972 13.8 16.3 11.7 33.8 21.5 8.6 7.4 33.8 64 • Number of Children Treated at Dental Clinic. School. Inspected. Re.inspected. With Dental Caries. Received Treatment. Completed Treatment. Per cent. Completed Treatment. Mayville Road 19 18 Report. 85 74 33.6 Davies Lane... 73 121 169 82 73 37.6 Church Road 90 102 166 92 84 43.7 Cann Hall Road 103 152 211 113 103 40.3 Cobbold Road 48 85 121 52 43 32.3 Farmer Road 91 121 185 102 97 45.7 St. Joseph's 42 52 74 41 38 40.4 Capworth Street 148 203 304 192 173 49.4 High Road 14 38 46 24 23 44.2 Lea Bridge Road 41 64 77 47 42 40.0 Newport Road 156 227 304 166 142 37.0 Sybourn Street 87 133 185 99 92 43.6 Canterbury Road 89 115 172 82 76 42.6 Kirkdale Road 100 128 190 106 103 48.2 Norlington Road 146 302 388 146 140 45.7 Trumpington Road 88 129 189 Not Commerced. 1316 1972 2781 1429 1303 41.6 Number of children inspected in 1919, 3,288. Number of children treated :— Routine cases 1,429 Routine cases brought forward froni 1918... 322 Casuals 645 Total number of children treated in 1919 2,396 DENTAL TREATMENT OF MOTHERS. 101 mothers of the Infant Welfare Clinic received dental treatment. Treatment consisted of 112 fillings, 461 extractions under Nitrous Oxide, 14 with local injections, 19 scalings, etc. Nitrous Oxide was administered by the Medical Officer on 93 occasions, which averaged 4.9 extractions for each administration, 65 Treatment Carried Out at School Clinic. School. Fillings. Extractions. Dressings and Scalings. Mayville Road 114 92 17 Davies Lane 106 78 14 Church Road 142 121 24 Cann Hall Road 176 122 29 Cobbold Road 85 74 12 Farmer Road 134 138 26 St. Joseph's 48 55 12 Capworth Street 245 267 31 High Road 34 30 6 Lea Bridge Road 56 62 14 Newport Road 233 211 56 Sybourn Street 160 102 13 Canterbury Road 160 78 20 Kirkdale Road 209 109 32 Norlington Road 231 176 33 2133 1715 339 Brought forward from 1918. Fillings, 541; extractions, 458; dressings, 61. Casuals, 1919: Fillings, 147; extractions, 593; dressings, 34. Full total of year's work: Fillings, 2,821; extractions, 2,766; dressings, 434. 629 teeth were extracted under Nitrous Oxide, which was administered by the Medical Officer on 187 occasions. RINGWORM OF SCALP. Cases requiring X-ray treatment are treated at the London Hospital on payment by the Council of £1 Is. per case. During the year 84 children have been so treated. SCABIES. The arrangements made for the treatment of these cases at the Isolation Hospital, reported last year, have been continued, and treatment was given on 426 occasions. 66 MENTALLY DEFECTIVE, BLIND AND DEAF CHILDREN. Three blind children are maintained at the East London Home and School for Blind Children at Clapton, and one attended the Morning Lane Day Centre, Hackney, but in July was transferred to Elm Court Residential School, West Norwood. One blind and mentally defective child is resident in the Hastings and St. Leonard's Home. One mentally defective child is in Hopwell Hall, Derbyshire, two in Littleton House School, Cambridge, three girls in Royal Eastern Counties Institution, Colchester, and ten boys and four girls attend the Walthamstow Day Centre. Mine children attend the Water Lane Deaf and Dumb Centre, West Ham, three attend a similar centre at Gainsborough Road, Walthamstow, and one the Royal Institution, Edgbaston. Epileptic Children.—One girl is resident at Chalfont St. Peters, three at Much Hadham, Hertfordshire, one at the Epileptic Colony, Lingfield, and one at the Royal Eastern Counties Institution, Colchesiter. PROCEDURE IN VERMINOUS CASES AND OTHER CONDITIONS DUE TO NEGLECT. When children are found to be verminous they are sent to the Inspection Clinic and then excluded from School by the School Medical Officer. After the lapse of several weeks' exclusion from School, during which time they have been instructed and cautioned, the parents are summoned to attend before the various School Attendance Sub-Committees. The parents of 145 children were thus dealt with, and prosecutions for non-attendance at School instituted in 44 instances, as a result of which fines and costs amounting to ,£11 18s. were inflicted. EDUCATION (PROVISION OF MEALS) ACT. Meals have been provided during the year at two of the School Cooking Centres—Mayville Road and Capworth Street 67 Schools. In consequence of the decrease in numbers requiring meals the centre at Ruckholt Road has been discontinued. The meals are prepared by the pupils attending for cookery lessons, under the supervision of the Instructress at each Centre. They are served by a woman assistant specially appointed for this purpose, who assists in the preparation of the food, supervises the children at their meals, and is responsible for the cleanliness of the dining room and washing of dishes. The number of children for whom meals have had to be provided as compared withprevious years is shown in the following table :— 1919. 1918. 1917. 1916. 1915. 1914 Average weekly number of children 42 53 72 54 90 312 fed (Dinners only are provided.) STATISTICAL TABLES. TABLE I.—Number of Children Inspected from '1st January, 1919, to 31st December, 1919. A.—" Code " Groups. Entrants. Age 3 4 5 6 Other Ages Total Boys 644 494 411 1549 Girls 562 414 424 1400 Totals 1206 908 835 2949 B.—Groups other than "Code." Intermediate Group (other than 8 years). Special Cases. Re-examinations (i.e. No. of Children Re-examined). (1) (2) (3) (4) Boys 1371 1107 Girls 1621 1305 Totals 2992 2412 68 TABLE II.—'Return of Defects found in the Course of Medical Inspection in 1919. Defect or Disease. Code Groups. Specials. Number referred for Treatment Number requiring to be kept under observation. Number referred for Treatment Number requiring to be kept under observation. (1) (2) (3) (4) (5) Malnutrition 5 - 2 - Uncleanliness— - - - Head 1 — 642 — Body — — 14 - Skin Ringworm— Head - - 169 - Body - - 106 - Scabies — — 251 — Impetigo - - 370 — .ther Diseases 1 — 216 — Eye Defective Vision and Squint 86 19 353 8 External Eye Disease 3 — 116 — Ear 'Defective Hearing 5 5 15 — _ Ear Disease 3 1 81 1 Teeth Dental Disease 7 — — Nose and Throat Enlarged Tonsils Adenoids Enlarged Tonsils and Adenoids 50 33 31 8 13 4 58 90 34 1 3 Defective Speech — 6 10 — Heart and Circulation Heart Disease— Organic 2 18 18 3 Functional — 1 1 — Anaemia 9 — 42 1 Lungs - 'Pulmonary Tuberculosis— Definite - — 22 — Suspected o 1 16 1 Chronic Bronchitis ... - —- 1 — Other Diseases 3 1 4 — Nervous System Epilepsy - 2 — Chorea 1 2 11 — Other Diseases 1 4 5 1 Non-pulmonary Tuberculosis— Glands ... 1 — 8 — Bones and Joints 2 1 2 1 Other Forms — — 6 — Rickets 2 — 2 — Deformities 1 5 - 1 Other Defects or Diseases 4 7 203 4 69 TABLE III.—Numerical Return of all Exceptional Children in the area in 1919. Boys. Girls. Total. Blind (including partially blind) Attending Public Elementary Schools Attending Certified Schools for the Blind 1 3 4 Not at School — — — Deaf and Dumb (including partially deaf) Attending Public Elementary Schools 4 4 8 Attending Certified Schools for the Deaf 10 4 14 Not at School - - — Mentally Deficient Feeble Minded Attending Public Elementary Schools 4 3 7 Attending Certified Schools for Mentally Defective Children ... 13 8 21 Notified to the Local (Control) Authority during the year 10 1 11 Not at School 3 2 5 Imbeciles * APSchool - - - Not at School 4 o 6 Idiots — - - — Epileptics Attending Public Elementary Schools 7 4" 11 Attending Certified Schools for Epileptics - 5 5 Not at School 3 4 7 Physically Defective nary Tuberculosis Attending Public Elementary Schools 69 67 136 Attending Certified Schools for Physically Defective Children Not at School 12 2 14 Other forms of Tuberculosis (Cripples) Attending Public Elementary Schools 34 13 47 Attending Certified Schools for Physically Defective Children - - - Not at School — — — Cripples other than Tubercular Attending Public Elementary Schools 5 8 13 Attending Certified Schools for Physically Defective Children Not at School 3 2 5 TABLE IV.—Treatment of Defects of Children during 19,19. Condition. No. of defects found for which Treatment was considered necessary. No. of defects for which no report is available. No. of defects treated. Results of Treatment. No. of defects not treated. Percentage of defects treated. From previous year. 1919. Total. Remedied. Improved. Unchanged. Clothing 5 - 5 - 5 - 5 - - 100.0 Footgear 1 - 1 - 1 - 1 - - 100.0 Cleanliness of Head 14 538 552 - 552 492 60 - - 100.0 Cleanliness of Body 3 4 7 - 7 5 2 - - 100.0 Nutrition 12 7 19 4 13 - 8 6 2 68.4 Nose and Throat 389 320 709 169 290 154 112 24 250 40.9 External Eye Disease 21 110 131 4 127 92 32 3 - 96.9 Ear Disease 30 80 110 9 99 67 26 6 2 90.0 Teeth - - - - - - - - - - Heart and Circulation 102 51 158 31 109 6 72 31 13 712 Lungs 26 32 58 9 49 5 37 7 84.5 Nervous System 19 23 42 10 27 7 17 3 5 64.3 Skin 35 1,053 1,088 5 1,083 939 144 - - 99.5 Rickets 1 2 3 - 1 - 1 - 2 23.8 Deformities 5 6 11 - 3 1 1 1 8 27.3 Tuberculosis — Non-Pulmonary 2 12 14 1 13 2 9 2 - 92 .9 Speech 13 16 29 13 15 - 13 2 1 51.7 Mental Condition 50 23 73 7 47 - 18 29 19 64.4 Vision and Squint 293 457 750 21 552 393 20 139 177 78.6 Hearing 6 22 28 9 14 1 8 5 5 50.0 Miscellaneous 28 164 187 9 177 134 43 - 1 94.7 Totals 1,050 2,920 3,970 301 3,184 2,298 629 257 485 80.2 70 71 TABLE V.—Inspection, Treatment, &c., of Children during 1919. (1) The total number of children medically inspected (whether Code Group, special or ailing child) 8,353 (2) The number of children in (1) suffering from defects (other than uncleanliness or defective clothing or footgear) who require to be kept under observation (but not referred for treatment) 599 (3) The number of children in (1) who were referred ror treatment (excluding uncleanliness, defective clothing, etc.) 3,405 (4) The number of children in (3) who received treatment for one or more defects (excluding uncleanliness, defective clothing, etc.) ... 2,619