Ac4411(1) LEYTON LEY17 Leyton Urban District Council. essix THE ANNUAL REPORT on the Vital Statistics & Sanitary Circumstances OF THE. URBAN DISTRICT0F LEYTON, TOGETHER WITH THE REPORT TO THE EDUCATION COMMITTEE AND THE HOSPITAL REPORT FOR THE YEAR 1920, BY J. FRANCIS TAYLOR, m.r.c.s., d.p.h. Surgeon-Major, Honourable Artillery Company. Medical Officer of health. IIford: SOUTH ESSEX RECORDERS, LIMITED, High Road. ' V C1-12 Sh. 470 Xe\>ton THrban SMetrict Council. Public Hkalth Department, Telephone NO. ToWN HALL, 425 Walthamstow. Leyton, N.E. I92/ . - 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 1920, BY J. FRANCIS TAYLOR, M.R.C.S., D.P.H. Surgeon-Major, Honourable Artillery Company. Medical Officer of Health. IIford: SOUTH ESSEX RECORDERS, LIMITED, High Road. 8151 Leyton Urban District Council. PUBLIC HEALTH COMMITTEE. Chair man: Mr. Councillor Shanks. Members: Mr.Councillor Cant. Mr. Councillor Mawer. Mr.Councillor Clare. Mr. Councillor Parker. Mr.Councillor Daines. Mr.Councillor Phillips. Mr.Councillor Griggs. Mr.Councillor Smith, J.P. Mr.Councillor Hennah. Mr.Councillor Wintersgill. Mr. Councillor Hubbard. . Mrs. Councillor Marshall. Mr. Councillor Hurry, J.P. STAFF. Chief Sanitary Inspector: W. J. Stevens. Assistant Sanitary Inspectors: T. H. Spencer. J. F. Mules. G. A. Smith. Miss A. M. Miller. Health Visitors: Miss Edith Holland. Mrs. Maud Bratton. Miss Lilian Dodd. Miss Winifred Roake. Miss Bessie H. Clipstone. Miss E. Willing (part-lime). Clerks: F. L. H. Williams. G. F. Leserve. E. E. Jacobs. Matron of Isolation Hospital: Miss Ryan. Assistant Medical Officer : William Nicoll, M.D. (St. Andrew's), D.P.H. (Cambs.), from 1st May till 31st July. Cecilia McEwan-Martin, M.B., Ch.B. (Glasg.), commenced duties 1st September. Medical Officer of Health: J. F. Taylor, M.R.C.S. (Eng.), D.P.H. (London). TO THE CI-IAIKMAN AXD MEMBERS OF THE LEYTON URBAN DISTRICT COUNCIL. Mr. Chairman, Madam and Gentlemen, I have the honour to submit my Annual Report on the health of the district for the year 1920. As will be gleaned from the statistics contained therein, in spite of the overcrowding and other adverse influences, the results of the Great War, the general health of the district continues to be quite satisfactory. Our death-rate was 10.3 per 1,000 of the population. Our Infant Mortality rate, 65.34. Our Zymotic death-rate was .79 per 1,000 of the population. Throughout the country in general the year has been remarkable for the large number of cases of Scarlet Fever and Diphtheria, and our hospital accommodation has been severely taxed to accommodate these cases. One case of Smallpox occurred, which proved fatal. The patient, a girl, had never been vaccinated. The success of the Infant Clinics has been so pronounced that additional sessions have become necessary. 143,517 pints of milk have been distributed free to expectant and nursing mothers and children under 5 years of age. It is again a pleasant duty to record my thanks to the Councillors and Officials for their courtesy and help. I am, Mr. Chairman, Madam and Gentlemen, Your obedient Servant, J. FRANCIS TAYLOR. Leoton urban District Council. ANNUAL HEALTH REPORT FOR 1920, 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 £518,638 7s. 6d., and a rate of Id. in the £ produces £2,100. For poor rate purposes the rateable value is £541,575 5s. 0d., and a Id. rate produces £2,218 0s. 0d. AREA, INHABITED HOUSES, POPULATION. The district has a total area of 2,594 acres; at the end of June it contained 23,747 houses. Four 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 estimate of population used in calculating the various rates is given by the Registrar-General. The figures are based on the returns furnished under the scheme for the rationing of food. BIRTHS. 2,914 births were registered—1,495 males and 1,449 females. To these must be added 127 male and 97 female births (transferable) received from the Registrar-General, which yields a birthrate of 24.6 per 1,000 of the copulation. Of the above, 98 were illegitimate births, 51 being males and 47 females. Percentage of illegitimate births, 3.1. 6 BIRTHS—CALENDAR YEAR 1920. YEAR 1920. Leyton. Lea Bridge. Names ok Localities—Wards. Totals. Central. Forest. Leytonstone. Grove Green. Harrow Green. Cann Hall. Wanstead Slip Ward not known. January 16 66 58 41 25 46 47 28 20 ... 347 February 10 25 57 28 19 28 37 17 22 ... 243 March 17 44 51 25 21 17 30 15 22 ... 242 April 26 46 56 53 24 33 22 18 29 ... 307 May 22 33 53 22 14 25 29 29 20 ... 247 Tune 10 29 55 32 20 34 24 22 8 ... 234 July 20 58 62 40 11 24 24 30 23 ... 292 August 10 33 57 30 10 25 16 22 21 ... 224 September 15 35 37 24 18 23 18 20 20 ... 210 October 21 42 57 38 20 19 34 25 27 ... 283 November 8 26 36 21 11 14 16 20 12 ... 164 December 12 24 36 12 11 14 22 11 9 ... 151 Births received from the Registrar-General (Wards unknown 224 Totals 187 461 615 366 201 302 319 257 233 224 3168 7 DEATHS. 1,092 deaths of Leyton residents were registered during the year—547 males and 545 females. To these must be added 127 males and 111 females, being deaths (transferable) received from the Registrar-General. The death-rate for 1920 was 10'3 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, 1G; Scarlet Fever, 5; Diphtheria, 27; Whooping Cough, 24; Enteric Fever, 1 ; Diarrhoea and Enteritis, 29. The Zymotic death-rate for 1920 was "79 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 65.34, there being 207 deaths. NOTIFICATION OF BIRTHS (EXTENSION) ACT, 1915. This Act took effect on September 1st, 1915. Under its terms 2,983 births were notified during the year 1920—1,585 from medical practitioners, 1,334 from midwives, and 67 from relatives. The Health Visitors visited 3,041 newly-born infants and paid 10,558 re-visits. MATERNITY AND INFANT WELFARE WORK. The following ladies and gentlemen constitute the Committee appointed to deal with this work Chairman: Mr. Councillor Clare. Members: Messrs. Councillors Baker, Cant, S. C. Cochrane, Daines, Griggs, Haines, J.P., Harris, Hubbard, Mrs. Councillor Marshall, Messrs. Councillors Mawer, Payne, Shanks, and Wintersgill. Co-opted Members: Mrs. Carr, Mrs. Cooper, Mrs. Enever, Miss Hall, Mrs. Hart, Miss Lister, and Mrs. Underwood. 8 Staff:— J. F. Taylor, Medical Officer of Health, Superintendent and Organiser. Elizabeth Sloan-Chesser, M.D., Glasg., Charlotte A. Shields, M.B., London, and Cecilia McEwan-Martin, M.B., Glasg., Medical Officers to Infant Welfare and AnteNatal Clinics and Creche. Percy E. Chandler, L.D.S., R.C.S., Eng., Dentist to the AnteNatal Clinic. Health Visitors— Edith Holland (Trained Nurse), Sanitary Inspector's Certificate, Health Visitor's Certificate. Lilian Dodd (Trained Nurse), Health Visitor's Certificate. Maud Bratton (Trained Nurse). Winifred Roake (Trained Nurse), C.M.B., Health Visitor's Certificate. Bessie H. Clipstone (Trained Nurse), C.M.B. Ethel Walling (Trained Nurse), Health Visitor's Certificate (part time). The following figures, which represent the attendances at the Infant Welfare Clinics during the years 1010 and 1920 respectively, are eloquent testimony to the popularity of these Institutions:— 1919. 1920. Town Hall Clinic 2376 3361 People's Hall 2588 3288 Vicarage Road 2837 4868 In consequence of their large increase, in addition to the original afternoon session, a morning session has been inaugurated at each of the Clinics. The morning session was commenced at the Town Hall on June 26th, at the People's Hall on October 11th, and at Vicarage Road on June 5th. 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, 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. 9 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. Dr. Sloan-Chesser attends, and is assisted by Nurse Holland and Nurse Clipstone, in addition to the following voluntary helpers:—Miss Lister, Mrs. Muir, Mrs. Hawkey, Mrs. Clayton, Mrs. Wood, Mrs. Atkins, Mrs. Harvey, Mrs. Bowra, Mrs. Lebbon and Mrs. Wagstaffe. 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. Hawkey 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 ptnnv per head being made for these refreshments. During the year 3,361 attendances have been recorded, 503 of which were first attendances. PEOPLE'S HALL INFANT WELFARE CLINIC. This Clinic was started in May, 1917, and is held on Tuesdays. 10 Dr. Sloan-Chesser, assisted by Nurse Bratton, attends, and in addition to- the undermentioned voluntary helpelrs receives assistance 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, Mrs. Atkins, and Mrs. Eastman. 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 3,288 attendances have been recorded, 390 of which were first attendances. VICARAGE ROAD INFANT WELFARE CLINIC. This Clinic was opened in October, 1918, and is held on Wednesdays. Dr. Shields attends, and is assisted by Nurse Dodd and Nurse Roake. The following voluntary helpers also attend and render valuable assistance:—Mrs. Sanders, Mrs. Mayhew, Mrs. Stuchbery, 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 4,868 attendances have lieen recorded, 626 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. Sloan- Chesser or Dr. Shields attends, and they are assisted by Sister Alice and the Midwives of the Essex County Association. 235 attendances by 147 prospective mothers were recorded. 11 The friendly relations existing between the regular staff, the voluntary helpers, and the Nurses of the Essex Nursing Association have contributed in no small degree to the success achieved in this department of the Public Health Service. DUTIES OF THE HEALTH VISITORS. Each of the Health Visitors is apportioned a district, and she attends the Clinic in her district, thus:— Nurse Holland visits in the Central and Wanstead Slip Wards and attends the Town Hall Clinic. Nurse Dodd visits in the Lea Bridge and Ley ton Wards and attends the Vicarage Road Clinic. Nurse Bratton visits in the Harrow Green and Grove Green Wards and attends the People's Hall Clinic. Nurse Roake visits in the Cann Hall and Forest Wards and assists at the Vicarage Road Clinic. Nurse Clipstone visits in the Leytonstone and Central Wards and assists at the Town Hall Clinic. Nurse Walling (part time) visits in the Leyton Ward. 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 oif 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 15,111 visits have been paid by the Health Visitors. 12 SUPPLY OF MILK TO NURSING AND EXPECTANT MOTHERS AND TO CHILDREN UNDER FIVE YEARS OF AGE. Milk (Mothers and Children) Order, 1919. The Council instructed the Medical Officer of Health to administer this Order in so far as it referred to necessitous cases. The standard of necessity adopted is a weekly income below 10s. per head per week after allowing deduction for rent. The amount of milk given depends upon the particular circumstances of each case. In all cases the milk is supplied free. An order is sent to a milk vendor to supply one, two, or in a very few cases three pints per diem for one month, after which the case is reviewed. The milk vendor delivers the milk to the recipient at his or her house, and he sends his account in to the Council. 143,517 pints have been supplied during the year. The cost for the year ending 31st March was ^3,484 12s. lOd. CRECHE. The history of this undertaking was fully reported in last year's Annual Report, and as its career terminated owing to lack of support from those for whom it was intended after about 18 months' trial, on the 25th of March, 1921, nothing is to be gained by further pursuing its varying phases. Suffice it to say that although the premises were very desirable, except perhaps as regards situation, and everything was done for the welfare of the children under the supervision of a Sub-Committee consisting of the ladies of the Committee, it was not patronised as it should have been had it met a real want. Opinions differed somewhat as to the cause of its non-popularity. Some thought the house was rather out of the way, but against this argument the fact that a Cr&ehe run by the Essex County Nursing Association at Harrow Green, in the centre of one of the least favoured from the financial point of view of its inhabitants, is also meagrelv patronised. CONVALESCENT HOME FOR NURSING MOTHERS AND BABIES. The Council have entered into an arrangement, with the consent of the Ministry of Health, with the National League for Health, Maternity and Child Welfare whereby the League agree 13 to place at the disposal of the Council one cot or bed in their Home at Shooter's Hill, for a period of one year, in consideration of a payment of ,£50. This arrangement dates from the 1st November, 1920. Prior to the agreement with the League our Ladies' Subcommittee visited the Home, and were very favourably impressed with both the Home itself and the manner in which it is conducted, which favourable impression has been endorsed by those mothers who have had the opportunity of enjoying its benefits. FOOD POISONING. One small outbreak of food poisoning came under my notice during the year. Several cases of illness of a gastro-inlestinal type, i.e., profuse vomiting, some diarrhoea, and cramps, occurred shortly after eating a certain brand of tinned beef bought at a shop in the district. On investigation the tin in question was found to be one of a largish consignment of old Army stock, and a considerable number of tins had been consumed without any ill effects. The remainder of the tins on the premises of the dealer were found on examination to be sound. Also nothing wrong could be detected in the meat we were able to examine. The premises of the dealer were clean, and he impressed me as exercising every care in the conduct of his business. All the persons who suffered recovered. INFECTIOUS DISEASE. 4 cases of Dysentery and 20 of Malaria were notified during the year (old military cases). 1 case of Smallpox was notified. No case of Plague, Cholera, or Typhus has been notified. SMALLPOX. One case occurred during the year. A girl, 5 years of age, w as admitted to the Whipps Cross Hospital on the 17th February for, I believe, Appendicitis. She was subsequently thought to be suffering from Measles, but on 3rd March she was notified as a case of Smallpox. 14 She was removed to Orsett Hospital and died on the 7th March. The girl was one of a family of seven children, aged from 20 to 2 years, who lived at 6, Angle Street, Leytonstone, a district occupied by the poorer class of inhabitant. All the members of the family, with the exception of the father, mother, and eldest son, who refused, were at once vaccinated by me. All the contacts who could be discovered were followed up and kept under observation, and fortunately no further case occurred. The neighbouring Boroughs of West Ham and East Ham had a considerable number of cases at about this time, so thai we were fortunate in only having this one case. No definite history of contact with anyone infected could be traced, but the child paid a visit to Woolwich, travelling by tramcar and train, on Sunday, the loth February. She bad never been vaccinated. VACCINATION RETURNS. Number of Births. Vaccinated. Certificates of Insusceptibility. Exemptions Died Unvaccinated under 1 year 1913 2925 1152 10 1192 169 1914 2752 1011 17 1238 142 1915 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 1920 2968 796 5 1274 115 ENTERIC FEVER. 7 cases were notified. 1 death occurred. 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. 15 Case. Sex. Age. Where Treated. Result. Remarks. Yrs. 1 F. 5 Whipps Cross Hospital Recovered Occurred in Whipps Cross Hospital. 2 M. 18 At his mother's home, Recovered Cause not traced. Upminster, Essex 3 F. 41 At home Recovered Patient arrived from abroad and fell ill a day or two later. 4 M. 50 Whipps Cross Hospital Recovered Had been staying at Southend for a fortnight and while there had eaten oysters. 5 M. 32 Whipps Cross Hospital Recovered Unable to trace source of infection. 6 M. 34 Whipps Cross Hospital Died ,, ,, ,, 23.7.20 7 M. 15 Whipps Cross Hospital Recovered ,, „ ,, SCARLET FEVER. Cases notified, 450. There were 5 deaths. Case-fatality per cent., 1.1 Death-rate per 1,000 of the population, '04. DIPHTHERIA. Cases notified, 354. 27 deaths occurred, including 1 death on the 1st March at the Children's Hospital, Great Ormond Street, and another on the 3rd March at the Wanstead Isolation Hospital. Case-fatality per cent, 7.6. Death-rate per 1,000 of the population, .21. PUERPERAL FEVER. 6 cases of this disease were notified. 1 death occurred. The death-rate from Puerperal Fever was .007 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. Disinfection of premises and clothing has been systematically carried out. MEASLES. There were 16 deaths during the year. Death-rate, .12 per 1,000 of the population. 16 941 cases of Measles and 60 of German Measles were visited by the Health Visitors. WHOOPING COUGH. There were 21 deaths during the year. Death-rate per 1,000 of the population, .19. 7 of these deaths occurred in children under one year of age, 8 between one and two years, 7 between two and five years, and 2 between five and fifteen years. The Health Visitors visited 321 cases. DIARRHCEA AND ENTERITIS. Diarrhoea and Enteritis caused 29 deaths, 27 of which were of infants under one year of age, and 2 between one and two years. Of these, 4 died at the following Hospitals:—Queen's Hospital 3, and London Hospital 1. 1 death occurred at 230, High Street, W. Our death-rate from Diarrhoea and Enteritis under two years was 9'2 per 1,000 births. CEREBRO-SPINAL MENINGITIS. 1 case of Cerebro-Spinal Meningitis has been notified during the year. The patient died. The following are particulars of the case:— Case Date of Notification SEX Age Yrs. Result Remarks[ 1 30.6.20 Male 20 Died 28.6.20 Onset of illness 25.6.20. No history as to source of infection. No relation to any military rases. Removed to Whipps Cross Hospital 26.6.20. Lumbar puncture positive. The diagnosis was also confirmed post mortem. Clothing, bedding and premises disinfected. 17 ANTERIOR POLIOMYELITIS. 2 cases were notified. The following' are particulars of the cases:- Case Date of Notification. Sex. Age Yrs. Result Remarks 1 10.9.20 Female 4 Lower limbs paralysed (still in Whipps Cross Hospital 27.1.21). Onset 24.8.20. Removed to Whipps Cross Hospital 10.9.20. House disinfected. 2 1.11.20 Male 2 Still some paresis of lower limbs.but not regarded as permanent. Onset 19.10.20. Removed to London Hospital 30.10.20. House disinfected. 18 TUBERCULOSIS. 112 deaths occurred from all forms of Tuberculosis, representing a death-rate of .9 per 1,000 of the population. The corresponding figures for Pulmonary Tuberculosis were 94 and .73. Notifications of 168 cases of Pulmonary Tuberculosis and 48 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. Charlotte Brown attends at the Tuberculosis Dispensary, ISO, High Road, Leyton, on: Mondays 2.30—4.30 p.m. and Dr. John Sorley on: Thursdays 10.0 a.m. ,, 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. cases of Tuberculosis have been received from the following Institutions:— Notifications of cases of Tuberculosis have been received from the following Institutions:— Lungs. Other forms. Total. Whipps Cross Hospital 37 7 44 Central Home, Union Road 1 — 1 Hospitals London 5 16 21 Victoria Park 6 - 6 Queen Mary's, Stratford 5 3 8 Urompton 4 — 4 Others 16 13 29 Sanatoria— Halstead 8 — 8 Maltings Farm 4 — 4 Black Notley 22 — 22 Royal National, Bournemouth 4 — 4 Chingford 6 — 6 Colchester 12 12 Pap worth Hall Colony, Cambridge 3 - 3 Royal National, Ventnor 4 4 IIford 3 - 3 Others 10 - 10 150 39 189 19 BACTERIOLOGICAL DIAGNOSIS. The County Council of Essex made arrangements at the end of the year 1919 with Dr. John Beale, Essex Public Health Laboratory, 91, Queen Victoria Street, E.C.4, for the examination of specimens sent by any Authority throughout the County free of charge. Formerly the Leyton Council used to pay for these examinations. The new arrangement has been made use of during the year, and the following are the number of specimens sent Diphtheria 307 Ringworm 107 Sputum 18 Widal's Test 1 Malaria 1 CANCER. There were 118 deaths during the year, giving a death-rate of .9 per 1,000 of the population. INQUESTS. The following verdicts were recorded at Inquests held in the district during the year:— Natural Causes 41 Accident 19 Drowning 1 Murder 1 Drinking corrosive acid whilst of unsound mind 1 Want of proper attention at birth 3 Accidental poisoning 1 Suicide (2 self-inflicted wounds, 1 hanging, 1 carbolic acid poisoning, 1 fall from window, 1 jumping in front of train) 6 20 HOUSING. During the war it was impossible to maintain the pre-war level of house sanitation, with the result that there are many more houses requiring attention than formerly. The pre-war average of complaints received from tenants was about 200 per annum. 1,452 of these complaints were received in 1920. Each of these complaints necessitate several visits on the part of the Sanitary Inspectors. Consequently they have less time for routine house-to-house inspection. Only 161 houses were so inspected, against 1,550 in 1915. It is therefore evident that more Sanitary Inspectors are required. I recommended to the Public Health Committee the appointment of another Sanitary Inspector in October, and again in February, 1921, but in view of the heavy rates they have not yet been able to see their way to adopt my recommendation. We have at present one Chief Sanitary Inspector, three Male Assistant Inspectors, and one Woman Assistant Inspector. To provide more accommodation for the working classes the Council are building 142 houses on the Barclay Estate, 79 of which are in process of erection. 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 513 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 75 Number of dwelling-houses in respect of which representations were made to the local authority with a view to the making of closing orders Nil. Number of dwelling-houses in respect of which closing orders were made by the local authority Nil. Number of dwelling-houses the defects in which were remedied without the making of closing orders 312 21 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 did not receive any applications during the year. INCREASE OF RENT AND MORTGAGE INTEREST (RESTRICTIONS) ACT, 1920. The Council directed that the certificate of the Sanitary Authority, II. 2 of the above Act, shall be issued by the Medical Officer of Health. The first certificate was given on the 26th November, and five in all up to December 31st. 22 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 3 6 8 11 6 6 5 10 5 5 8 6 79 65 to 70 years 11 9 5 11 7 1 8 2 5 8 7 8 82 70 to 80 years 20 21 20 20 18 8 23 7 8 12 15 24 196 80 to 90 years 8 9 11 11 9 8 10 8 3 9 10 17 113 90 years and upwards 1 ... 2 1 ... 1 1 ... 1 ... 2 1 10 Totals 43 45 46 54 40 24 47 27 22 34 42 56 480 Influenza 2 2 13 17 5 ... 1 ... ... ... 3 1 44 Phthisis 8 5 8 9 7 6 5 4 4 5 7 5 73 Rheumatic Fever ... ... ... 2 ... ... 2 ... ... ... 1 ... 5 Bronchitis 24 19 16 9 2 1 3 1 3 5 11 13 107 Pneumonia (all forms) 17 9 12 18 5 1 5 6 3 4 8 11 99 Other diseases of Respiratory Organs 1 1 3 1 1 1 3 1 2 ... 5 3 22 Nephritis and Bright's Disease 4 4 6 7 3 ... 7 7 2 ... 2 6 48 Diphtheria (notifications) 60 28 31 21 16 17 21 13 25 43 49 30 354 Rainfall in inches in Leyton 1.2 .5 1.7 2.8 .57 1.31 3.36 1.76 3.23 1.13 .76 1.72 20 06 Number of days on which Rain fell 14 10 14 19 11 8 13 8 12 9 7 20 145 23 FACTORIES, WORKSHOPS, LAUNDRIES, WORKPLACES, AND HOMEWORK. 1.—INSPECTION OF FACTORIES, WORKSHOPS, AND WORKPLACES. Including Inspections made by Sanitary Inspectors or Inspectors of Nuisances. Premises. Number of Inspections. Written Notices. Prosecutions. (1) (2) (3) (4) Factories (Including Factory Laundries.) 73 17 ... Workshops (Including Workshop Laundries.) 497 88 ... Workplaces (Other than Outworkers' premises included in Part 3 of this Report.) Totals 570 105 ... 24 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 51 Want of ventilation 17 Overcrowding 2 Want of Drainage of floors 3 Other nuisances 154 Sanitary accommodation insufficient 1 unsuitable or defective 56 not separate for sexes 2 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) 10 Other offences (Excluding offences relating to outwork which are included in Part 3 of this Report) ... Total 298 25 3.—REGISTERED WORKSHOPS. Workshops on the Register (s. 131) at the end of the year. (1) Number. (2) Ordinary Workshops 248 Laundries 11 Bakehouses ... 24 Total Number of Workshops on Register 283 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) 21 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 ... Reports (of action taken) sent to H.M. Inspector ... Other ... Underground Bakehouses (s. 101):— Certificates granted during the year ... In use at the end of the year 6 26 6.—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. Outworkers. Outworkers. Lists. Contractors. Workmen. Lists. Contractors. Workmen. Wearing Apparel—Making, etc 15 ... 31 82 ... 255 121 298 9 Lace, lace curtains, and nets, etc ... ... ... ... ... ... 1 ... Furniture and upholstery 2 ... 6 ... ... ... 6 ... Artificial Flowers ... ... ... ... ... ... 3 ... Racquet and tennis balls ... ... ... ... ... ... 1 ... Paper, etc., boxes, paper bags ... ... ... ... ... ... 2 1 Brush making ... ... ... ... ... ... 23 ... Stuffed toys and leather boxes ... ... ... 2 ... 2 4 ... Cosaques and Christmass ... ... ... ... ... ... 12 2 Linen Packing Condenser ... ... ... 2 ... 6 1 ... Gas mantles ... ... ... ... ... ... 1 ... Rope making ... ... ... ... ... ... 2 ... Beadwork ... ... ... ... ... ... ... ... Feather Curling, etc. 1 ... 2 ... ... ... ... ... Umbrellas 1 ... 1 ... ... ... ... ... Totals 19 ... 40 86 ... 263 121 354 12 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.; Nets, other than wire nets; Tents; Sacks; Pea-picking; Carding of buttons; Basket-making; Chocolates and sweetmeats; Textile-weaving. 27 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. 73 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. 497 workshops were inspected during the year and 296 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. 283 workshops remain on the register. Grouping of Workshops. Manufacture of blouses, underclothing, &c. 19 „ „ boots, shoes, &c 22 „ „ ties, neckwear, &-c. 7 „ „ leather and fancy goods 9 „ „ brushes 3 58 Manufacture of firelighters 1 „ „ bedding, upholstering, &c. 1 „ „ battery cases, &c. 2 „ „ food products and sweets 3 „ „ changeable signs 1 „ „ children's toys, &c. 3 „ „ chemists' requisites 1 „ „ wooden boxes 3 „ „scientific instruments, scales, tools, &c. 3 Dressmaking 28 Millinery 19 Tailoring and alteration of costumes 40 Art-needlework and embroideries 3 Corset-making 1 Bakehouses 24 Laundries 11 Cabinet-making, &c. 4 Picture framing 1 Manufacture of paper articles 1 Chopping firewood 6 Rag-sorting 3 Cycle repairing and motor and engineering works 10 Wheelwrights and Carriage painter and shoeing forges 7 Printing and book-binding 1 Rope making 1 Cork-cutting 1 Whalebone cutting 1 Glass blowing 3 Wire and hardware work 3 29 Coating paper 1 Furriers 2 Fibre works 1 Feather curling, &c. 1 Bottling and packing inks, &c. 1 Cornchandlcrs 1 283 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. 488 outworkers were notified by other Councils and we forwarded 141 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. 60 enquiries were made at shops and other places to ascertain whether workpeople are employed, and such enquiries have led to 30 the discovery of many unregistered workrooms, as well as to employers of outworkers who had not supplied lists. 1,625 visits were paid to the homes of the outworkers and l,260 inspections were made. In 365 cases it was found that the addresses were incorrect. Uncleanly and insanitary conditions in 354 instances were found and dealt with. Twelve cases of infectious disease occurred in the homes of the workers. The usual immediate action was taken to prevent the spread of the disease. 31 ISOLATION HOSPITAL. The temporary hospital in Auckland Road, constructed of corrugated iron, which has done duty for some twenty years, has again satisfactorily fulfilled its mission during the year under report. Owing to the adoption of an eight-hour day, and the want of accommodation for the extra staff thereby entailed, it was not possible at any time to accommodate the full complement of patients, viz., 70 Scarlet Fever and 22 Diphtheria, for which the Hospital is adapted. However, in spite of this, all the cases which from a public health point of view, or which by reason of the severity of the symptoms, etc., required hospital treatment, were accommodated. The building of extra bedrooms for the staff is contemplated. Almost all the Scarlet Fever cases were of a mild type. A large proportion of the Diphtheria cases were seriously ill. In some of these the disease had existed for many days untreated, and in others, although treated sufficiently early to save life, the treatment did not prevent the various forms of paralysis which result from the toxins formed in this disease. There is no doubt that Diphtheria is a disease par excellence, which should receive unremitting, attention at the hands of experienced doctors and nurses, and this attention in a district like Leyton can only, except in a minority of cases, be secured by removal to hospital. In pursuance of this principle, during the height of the epidemic two of the Scarlet Fever Wards were, in addition to the ordinary Diphtheria Ward, taken over for the treatment of Diphtheria, and a number of mild Scarlet Fever cases were treated in their homes. This arrangement worked quite satisfactorily, except that nearly everybody wanted their Scarlet Fever cases removed. The Hospital has maintained its reputation, which is a very high one, in the estimation of the inhabitants, and justly so, as under the superintendence of the Matron the requirements and comfort of the patients receive unremitting attention. There is no Resident Medical Officer, but in addition to the Medical Officer of Health, who is also the Medical Superintendent of the Hospital, and the Assistant Medical Officer of Health, Dr. Kennedy, a local practitioner, is paid £50 per annum to give his services in emergencies. 32 STATISTICAL RETURNS Admissions:— At all ages. Under 1 year. 1 to 5. 5 to 15. 15 to 25. 25 and upwards. Diphtheria 207 0 70 120 7 7 Scarlet Fever 176 0 26 127 19 7 Totals 383 0 96 247 26 14 Sex of Patients Admitted. Males. Females. Diphtheria 93 114 Scarlet Fever 86 90 Diphtheria. Scarlet Fever. Under treatment at beginning of year 37 14 „ „ „ end of year 20 40 Admitted during year 207 176 Discharged 199 133 Died 22 4 Tracheotomy was performed on nine children for laryngeal obstruction, and in six of these it was the means of saving their lives. The Causes of Death were:— Male, 5 years, Diphtheria, Heart Failure, in hospital 3 days. Male, 4 years, Diphtheria, Toxaemia, in hospital 9 days. Male, 6 years, Diphtheria, Syncope, in hospital 6 days. Male, 5 years, Diphtheria, Broncho-pneumonia, in hospital 9 days. Male, 3 years, Diphtheria, Heart Failure, in hospital 6 days. Male, 4 years, Diphtheria, Heart Failure, in hospital 5 days. Male, 7 years, Diphtheria, Cardiac Paralysis, in hospital 14 days. Female, 3 years, Diphtheria, Paralysis, in hospital 18 days. Female, 5 years, Diphtheria, Laryngeal Obstruction, Tracheotomy, in hospital 3 days. Female, 1 years, Diphtheria, Cardiac Paralysis, in hospital 3 days. Female, 4 years, Diphtheria, Laryngeal Obstruction, Tracheotomy, in hospital 2 days. Female, 3 years, Diphtheria, Toxaemia, in hospital 3 days. 33 Female, 6 years, Diphtheria, Paralysis, in hospital 5 days. Female, 6 years, Diphtheria, Cardiac Paralysis, in hospital 9 days. Female, 5 years, Diphtheria, Toxaemia, in hospital 7 days. Female, 2½ years, Diphtheria, Paralysis, in hospital 33 days. Female, 6 years, Diphtheria, Toxaemia, in hospital 10 days. Female, 4 years, Diphtheria, Haemorrhage, in hospital 4 days. Female, 3 years, Diphtheria, Laryngeal Obstruction, Tracheotomy, in hospital 7 days. Male, 3 years, Nephritis, Uraemia, in hospital 12 days. Male, 4 years, Nephritis, Syncope, in hospital 12 days. Female, 4 years, Pertussis, Convulsions, in hospital 14 days. Female, 4 years, Septic wound of finger, Septic Meningitis, in hospital 9 days. Male, G years, Scarlet Fever, Septicaemia, in hospital 1 day. Female, 15 years, Scarlet Fever, Uriemia, in hospital 2 days. Female, 5 years, Scarlet Fever, Septicaemia, in hospital 2 days. The amount of money expended on the Hospital during the financial year ended 31st March, 1921, was £7,263 15s. 10d., and is divisible into the following items:— £ s. d. £ s d Buildings : Repairs and Maintenance 686 15 6 Furniture and Repairs 1 14 4 Bedding, Linen, &c. 209 7 10½ 897 17 8½ Domestic Utensils 31 18 5 Fuel, Light, Water and Cleaning 727 10 5 759 8 10 Rates, Printing, Stationery, &c. 338 1 11 Medicines, Drugs and Surgical Appliances 150 4 0 Provisions 1,477 15 7 Removal of Patients 1,212 13 6½ Uniforms 99 12 11 Salaries, Wages and Allowances 2,309 19 9 Contributions to Other Authorities 18 1 7 5,606 9 3½ £7,263 15 10 34 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 1920. INFECTIOUS DISEASE. 1,235 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 826 Loads of infected bedding removed to be disinfected at the Council's Steam Disinfector and returned 798 Books belonging to Public Institutions disinfected 152 Number of articles of wearing apparel, &c., disinfected:— 5 doz. blouses. 1 packing case of underclothing. 39 doz. pair Scouts knickers. 5½ doz. ties. 4 gross nail stone boxes 35 gross bon-bons 6 gross paper hats. 18 articles of miscellaneous clothing. Disinfectants are supplied in cases of Infectious Diseases, and can be obtained at the Town Hall at any time during office hours. 35 HOUSING CONDITIONS. Statistics. Year ended 31st December, 1920. 1.—GENERAL. (1) Estimated population 128,832 (2) General death-rate 10.3 (3) Death-rate from tuberculosis .9 (4) Infantile mortality 65.34 (5) Number of dwelling-houses of all classes 23,747 (6) Number of working-class dwelling-houses 23,000 (7) Number of new working-class houses erected Nil 2.—UNFIT DWELLING-HOUSES. I.—Inspection. (1) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 4,144 (2) Number of dwelling-houses which were inspected and recorded under the Housing (Inspection of District) Regulations, 1910 513 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 75 (4) Number of dwelling-houses (exclusive of those referred to under the preceding sub-heading) found not to be in all respects reasonably fit for human habitation 2,401 II.—Remedy of Defects without Service of Formal Notices. Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their officers 2,019 36 III—Action under Statutory Powers. A. Proceedings under Section 28 of the Housing, Town Planning, etc., Act, 1919. (1) Number of dwelling-houses in respect of which notices were served requiring' repairs 8 (2) Number of dwelling-houses which were rendered fit— (a) by owners 2 (b) by Local Authority in default of owners (work completed during 1921) 4 (3) Number of dwelling-houses in respect of which Closing Orders became operative in pursuance of declarations by owners of intention to close Nil B. Proceedings under Public Health Acts. (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 70 (2) Number of dwelling-houses in which defects were remedied— (a) by owners 35 (b) by Local Authority in default of owners (see above; dealt with under the Housing and Town Planning Act, 1919; proceedings abandoned; owner had no means) 4 C. Proceedings under Sections 17 and 18 of the Housing, Town Planning, etc., Act, 1909. (1) Number of representations made with a view to the making of Closing Orders Nil (2) Number of dwelling-houses in respect of which Closing Orders were made Nil (3) Number of dwelling-houses in respect of which Closing Orders were determined, the dwelling-houses having been rendered fit Nil 37 (4) Number of dwelling-houses in respect of which Demolition Orders were made Nil (5) Number of dwelling-houses demolished in pursuance of Demolition Orders Nil 3.—UNHEALTHY AREAS. Areas represented to the Local Authority with a view to Improvement Schemes under (a), Part I., or (b) Part II., of the Act of 1890:— (1) Name of area Lea Bridge Gardens. (2) Acreage 12⅓ (3) Number of working-class houses in area 47 (4) Number of working-class persons to be placed 200 4.—Number of houses not complying with the building byelaws erected with consent of Local Authority under Section 25 of the Housing, Town Planning, etc., Act, 1919 Nil 5.—Staff engaged on housing work with, brielly, the duties of each officer Nil 38 INSPECTION OF THE DISTRICT AND ABATEMENT OF NUISANCES. During the year no less than 1,452 complaints have been received and dealt with, and as a direct consequence it has only been possible to carry out house-to-house inspection at 464 houses. The effect of the Increase of Rents and Mortgage Interest (Restrictions) Act, 1920, has been to increase the number of complaints. The Act has, however, proved useful, necessary repairs usually being put in hand when the landlord has been informed of the issue of a certificate. Though all possible means have been adopted to persuade offenders against the Public Health Acts to comply with notices, it was necessary to take out summonses in 27 instances. The following is a list of proceedings taken:— 1. 31-3-20 510, Lea Bridge Rd. 2. 2-G-20 71, Burchell Road 3. „ 73 „ 4. „ 75 „ 5. „ 77 „ 6. 16-6-20 75, Sidmouth Road 7. „ 71 „ 8. „ 79 „ 9. „ 81 „ 10. „ 83 „ 11. „ 85 „ 12. 25-8-20 79 „ 13. „ 81 „ 14. „ 85 „ 15. 1-9-20 44, Leyspring Road 16. 22-10-20 „ „ Want of cleansing Order to comand Whitewashplete in 21 days, ing Costs 14/- Defective SaniOrders to comtary arrangeplete in 28 days, ments Costs 10/- on each summons. „ „ Orders to plete in 28 days. Costs 10/- on each summons. Non-compliance Summonses withwith Justices drawn. DefendOrder ant to pay costs of 2/6 on each summons. Animals so kept Ordered to reas to be a nuismove animals. ance Non-compliance Fined 70/- or 31 with Justices' days Order 39 17. 24-11 -20 71, Burchell Road 18. „ 73 „ 19. „ 75 „ 20. „ 77 „ 21. 8-12-20 8, Morris Road 22. „ 20 „ 23. „ 22 „ 24. „ 28 „ 25. 22-12-20 167, Dawlish Road 26. „ 169 „ 27. „ 171 „ Non-compliance Fined 20/- on with Justices' each summons. Order Defective saniSummonses withtary arrangedrawn, ments „ „ Adjourned. The number of house-to-house inspections—464 in 1920, against 1765 in 1914—is not, in my opinion, by any means satisfactory, but with the present staff it is impossible to do more and cope with the extraordinary number of complaints. Consideration of increase of staff has been adjourned by the Public Health Committee. House-to-house inspection has been made in the following roads:— Sidmouth Road, Leyton. Dawlish Road, Leyton. Claude Road, Leyton. Millais Road, Leyton. Frith Road, Leyton. Morris Road, Leytonstone. Gilbert Street, Leytonstone. Goldsmith Road, Leyton. Nursery Cottages, Hitcham King Street, Leyton. Road, Leyton. Beaumont Road, Leyton. Peterborough Road, Leyton. Fifteen houses have been inspected in accordance with the provisions of Section 28 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, and necessary repairs have been carried out by the owners at 7 houses. The necessary work at the remaining 8 is to be completed by the Council. SUMMARY OF INSPECTIONS AND RESULTS Total number of houses and premises inspected 4144 „ „ houses and premises re-inspected 10746 Number of visits to slaughterhouses 916 „ „ dairies, cowsheds and shops 207 40 Number of visits to food shops 534 „ „ bakehouses 79 „ „ workshops 497 „ „ offensive trade premises 719 Miscellaneous inspections 393 Complaints received 1452 Notices served and letters written in reference to same 4851 Intimations to Metropolitan Water Board re waste of water 91 Defective drains remedied 149 Choked drains cleared 262 Drain manholes properly covered or sealed 27 Defective gullies or connections and percolation around same remedied 335 Air inlets provided to drains or repaired 75 Houses entirely re-drained with intercepting traps and manholes provided between the house drains and sewer and with efficient air inlet and outlet ventilators 47 Foul w.c.'s and drains cleansed 122 Defective w.c.'s repaired, new traps and straight backed pans provided where necessary 104 Defective w.c. flush cisterns and flush pipes renewed or repaired and water supply provided 263 Defective soil pipes repaired or renewed 17 Ventilating shafts repaired or provided to soil pipes and drains 119 Foul and defective sinks cleansed or renewed 30 Sink, bath and lavatory waste pipes and rain pipes trapped or disconnected 23 Visits to piggeries 36 „ „ urinals 81 „ „ stables 73 „ „ schools 96 Defective sink, bath and lavatory waste pipes renewed or repaired 188 41 Defective rain pipes and gutters renewed or repaired 674 Defective house roofs repaired 627 Defective floors of sculleries or cellars repaired, paved or concreted 163 Yards around back additions of houses and forecourts paved or repaired 329 Yards cleansed 23 Houses in a general insanitary, dilapidated or filthy condition repaired and cleanscd 1545 Damp conditions in house or part of house remedied 859 Ventilation provided under ground floors 220 Nuisances arising from stagnant water in basements of houses abated 31 Nuisances arising from insanitary condition of stables abated 3 Manure receptacles provided 1 Water supplies to houses restored and water fittings repaired 107 Domestic water cisterns removed from improper positions or cleansed or repaired 26 Covers to domestic water cisterns provided 23 Nuisances caused by overcrowding 6 Nuisances caused by fish, offal, manure and other refuse deposits abated 105 Nuisances caused by animals kept in an insanitary state abated 69 Smoke observations taken 26 Smoke nuisances abated 2 Foul and defective urinals cleansed or repaired 11 Coppers repaired 111 Stoves 122 42 DRAINAGE. The drainage of 17 houses has been reconstructed. In some cases the drains formed portions of combined systems of drainage, and in such instances on default of the owners the work has been done by the Council's workmen and the expenses incurred have been recovered from the owners. MEAT AND FOOD INSPECTION. 2,457 visits to slaughter-houses, butchers and other food shops have been made. The generally good condition of these has been well maintained. The following was found to be unfit for food of man and dealt with accordingly:— 7 Cow Carcases and Viscera 3 Bullock Carcases and cera 2 Pig Carcases and Viscera 27 Sheep Carcases 2931 lbs. Mutton (other than whole carcases) 1662 lbs. Beef (other than whole carcases) 8 pairs Ox Lungs 1 pair Pig's Lungs. 11 Ox Livers 4 Pigs' Heads 13 Slink Calves 343 lbs. Rabbits 13 boxes Mackerel 3 boxes Hake 3 boxes Cod 2 boxes Bloaters 2 boxes Haddocks 10 boxes Kippers 1 barrel Herrings 14 stone Skate 29 lbs. Haddocks. 1 bag Winkles 1 crate Bananas 120 Eggs. 53 lbs. Bacon. 50 lbs. Cheese. 64 tins Milk. 11 6-lb. tins Corned Beef 4 tins Salmon 3 tins tomatoes 3 tins Beans 1 tin fish paste 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. 43 Number of carcases inspected :— Pigs 581 Sheep 2411 Bullocks 2005 Calves 243 Lambs 5 The following is a list of slaughterhouses at present in use:— Keepers of Slaughterhouses. Norwood, A. & Son, 650, High Road, Leytonstone. Geller, J., 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, Hainauit 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, 1920, was 105. 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. BAKEHOUSES. The bakehouses in the district have been frequently visited during the year. The majority are kept in a very satisfactory condition; where necessary, notices have been served as regards uncleanly or other insanitary conditions and complied with. 44 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 MORTUARY. During the year the number of bodies received was 75, on 68 of which post-mortems were performed. PETROLEUM ACTS. To store To store Petroleum. Carbide of Calcium. Licences renewed 26 1 New Licences granted after inspection of storage arrangements 11 1 It will be seen that the work under the Petroleum Acts is rapidly growing. THE RATS AND MICE (DESTRUCTION) ACT, 1919 The Rats and Mice (Destruction) Act came into force in December, 1919. By Section 2 the County Council are responsible for carrying out the duties under this Act, and by the same section it is provided that a County Council may, with the consent of the Council of any Borough or County district in the County, delegate its powers and duties under this Act to that Borough or District Council. The County Council has not delegated its powers and duties to this Council; 49 complaints have, however, been received at the Public Health Office and dealt with. In some cases drains were 45 found to be defective and necessary repairs insisted on. It is to be regretted that all houses are not provided with rat-proof larders and dustbins, and that the time is far distant when the average individual will realise that rats will not trouble those houses where food for rats is unobtainable. PLACES OF PUBLIC ENTERTAINMENT. In accordance with the recommendation contained in the circular of the Ministry of Health, dated 25th August, 1920, 15 visits to cinemas and other places of public entertainment have been made and sanitary accommodation found to be satisfactory and apparently sufficient in all cases. No standard as to sufficiency has been laid down. I am, Gentlemen, Your obedient Servant, W. J. STEVENS. 46 TABLE I. Vital Statistics of Whole District during 1920 and Previous Years. Year. Population estimated to Middle of each Year. Births. Total. Deaths Registered in the District. Transferable Deaths Nett Deaths belonging to the District. Uncorrected Number. Nett. of Nonresidents registered in the District. of Residents not registered in the District. Under 1 Year of Age. At all Ages. Number. Rate. Number. Rate per 1000 Nett Births. Number. Rate. Number. Rate. 1 2 3 4 5 6 7 8 9 10 11 12 13 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 1920 128832 2944 3168 24-6 2278 17 7 1186 238 207 65.34 1330 10.3 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 47 Table II.—Cases of Infectious Disease Notified During the Year 1920, including Cases which OCCURRED in Central Home, Union Road, Whipps Cross Hospital, &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. Leyton. Lea Bridge. Central. Forest. Leytonstone Grove Green. Harrow Green. Cann Hall. Wanstead Slip. Small Pox 1 1 1 1 Cholera (C) Plague (P) *Diphtheria (including Membranous Croup) 354 3 92 209 31 18 1 11 80 53 47 24 41 50 34 14 228 †("Erysipelas 57 3 1 5 3 20 17 8 5 9 8 3 6 5 8 8 5 21 ‡Scarlet Fever 450 2 55 334 48 11 22 59 88 56 33 45 46 70 31 197 Typhus Fever §Enteric Fever 7 1 2 3 1 2 2 2 1 5 Relapsing Fever (R) Continued Fever (C) ║Puerperal Fever 6 4 2 1 1 2 5 Cerebro-spinal Meningitis 1 1 Poliomyelitis 2 2 1 l 2 Encephalitis Lethargica 1 1 1 1 ¶Pulmonary Tuberculosis 168 1 15 50 71 27 4 14 25 32 27 13 11 28 7 11 39 **Other forms of Tuberculosis 48 3 17 15 9 3 1 5 4 8 3 8 7 7 2 4 15 Ophthalmia Neonatorum 15 15 1 4 3 1 1 2 3 3 †† Pneumonia 100 1 9 19 16 33 17 5 17 16 23 7 6 6 13 3 9 54 ‡‡Malaria 20 5 14 1 5 2 7 1 2 3 §§Dysentery 4 1 3 2 1 1 Anthrax 1 1 1 1 Totals 1235 24 163 602 174 187 67 18 83 199 229 147 93 117 158 129 80 573 * 8 cases occurred in Whipps Cross Hospital (3 on Staff), 1 in Central Home, Union Road and 5 in Bethnal Green Schools. ‡‡ Old military cases. † 5 cases occurred in Central Home, Union Road. §§ Old military cases. ‡ 2 cases occurred in Bethnal Green Schools. 1 in Forest Lodge Convalescent Home, 6 in Whipps Cross Hospital (Staff), 6 in West Ham Union Home, 60, Davies Lane, and 1 in Central Home, Union Road. 1 case proved not to be scarlet fever, 1 case withdrawn. § 1 case occurred in Whipps Cross Hospital. || 1 case from Bermondsey (notified from Nursing Home, 19, Holly Road). ¶ 3 cases occurred in Central Home, Union Road, 1 in Whipps Cross Hospital (Nurse), and 1 in Bethnal Green Schools. ** 1 case occurred in Bethnal Green Schools. †† 2 cases occurred in Central Home, Union Road. 48 TABLE III. DEATHS. CALENDAR YEAR 1920. 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 1330 207 31 54 72 60 158 301 447 1186 268 111 194 231 164 162 114 148 110 90 6 1330 Uncertified Enteric Fever 1 1 3 1 1 1 Small-pox ] 1 1 1 Measles 16 1 2 8 4 1 1 1 1 2 1 1 7 2 1 16 Scarlet Fever 5 2 2 1 1 1 1 5 Whooping Cough 24 7 8 7 2 8 1 4 3 4 4 4 3 1 1 24 Diphtheria and Croup 27 1 1 12 12 1 1 2 3 8 2 1 3 3 4 1 27 Influenza 46 3 2 3 18 13 7 46 15 1 6 7 8 9 6 5 46 Erysipelas 2 1 1 11 1 1 1 v 2 49 Phthisis (Pulmonary Tuberculosis) 94 3 ... ... 1 26 36 26 2 130 23 9 13 20 8 10 8 12 5 9 ... 94 Tuberculous Meningitis 10 1 1 2 3 2 1 ... ... 7 2 1 1 1 1 1 2 ... ... 3 ... 10 Other Tuberculous Diseases 8 ... ... 2 2 3 1 ... ... 23 3 1 1 1 1 1 2 1 ... ... ... 8 Cancer, malignant disease 118 ... ... ... ... 2 10 57 49 94 24 4 15 23 16 22 8 9 11 10 ... 118 Rheumatic Fever 6 ... ... ... 3 1 1 ... 1 6 1 ... 1 1 1 ... 1 ... 1 1 ... 6 Meningitis 6 1 ... 2 1 1 ... 1 ... 4 2 ... 2 1 1 ... ... 2 ... ... ... 6 Organic Heart Disease 128 ... ... 1 4 2 14 39 68 95 20 13 18 21 14 18 12 12 11 9 ... 128 Bronchitis 109 18 3 1 3 ... 6 22 56 92 12 10 13 23 15 10 11 12 9 6 ... 109 Pneumonia (all forms) 112 24 11 11 5 1 14 24 22 69 30 7 26 11 15 7 9 13 10 13 1 112 Other diseases of Respiratory Organs 25 1 1 ... 2 1 2 9 9 28 6 4 6 ... 2 3 4 3 1 2 ... 25 Diarrhoea and Enteritis 29 27 2 ... ... ... ... ... ... 29 10 3 5 7 3 2 2 1 3 3 ... 29 Appendicitis and Typhlitis 4 ... ... ... 1 ... ... 1 2 5 1 ... 2 1 ... 1 ... ... ... ... ... 4 Cirrhosis of Liver 3 ... ... ... ... ... 1 1 1 8 ... ... ... 1 ... ... 1 ... ... ... ... 3 Alcoholism ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Nephritis and Blight's Disease 55 1 ... 2 ... 2 6 17 27 44 12 ... 6 11 6 8 7 3 6 3 ... 55 Puerperal Fever 1 ... ... ... ... 1 ... ... 7 ... ... ... ... 1 ... ... ... ... ... ... 1 Other accidents and diseases of Pregnancy and Parturition 7 ... ... ... ... ... 7 ... ... 5 1 ... 1 1 1 3 ... 1 ... ... ... 7 Congenital Debility and Malformation, including Premature Birth 83 82 1 ... ... ... ... ... ... 27 3 6 10 13 8 7 8 19 6 5 1 83 Violent Deaths, excluding Suicide 34 3 1 1 5 3 5 8 8 29 8 4 3 4 9 5 2 5 1 1 ... 34 Suicide 9 ... ... ... ... 2 1 5 1 3 1 2 1 ... 2 1 ... 1 2 ... ... 9 Other Defined Diseases 280 34 ... 3 19 9 31 76 108 218 53 25 45 58 34 33 15 27 26 15 2 280 Diseases Ill-defined or Unknown 1 ... ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... ... ... ... l Old Age 86 ... ... ... ... ... ... ... 86 193 38 7 9 11 11 15 7 9 9 6 2 86 1330 207 31 54 72 60 158 301 447 1186 268 111 194 231 164 162 114 148 110 90 6 1330 Sub-Entries included in above figures— Cerebro-spinal Meningitis ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... Poliomyelitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Encephalitis Lethargrica ... ... ... ... 1 ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... ... ... ... 50 Table III A. Causes of, and Ages at, Death, Calendar Year, 1920. 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. 1 Enteric Fever 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 5 Smallpox ... 1 ... ... 1 ... ... ... ... ... ... ... ... ... ... 1 6 Measles 5 11 1 10 4 ... ... ... 1 ... ... ... ... ... ... l6 7 Scarlet Fever 3 2 ... 2 2 ... 1 ... ... ... ... ... ... ... ... 5 8 Whooping Cough 12 12 7 15 2 ... ... ... ... ... ... ... ... ... ... 24 9 Diphtheria, Croup 14 13 1 13 10 2 ... 1 ... ... ... ... ... ... ... 27 10 Influenza 22 24 3 ... ... 2 2 1 11 7 5 8 3 2 2 46 18 Erysipelas 1 1 ... ... ... ... ... ... 1 ... ... 1 ... ... ... 2 20 Pyaemia, Septicaemia 4 2 1 1 ... ... ... ... ... 1 1 1 1 ... ... 6 25 Mycoses 1 ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 28 Pulmonary Tuberculosis 44 47 2 ... ... ... 12 13 19 17 12 14 2 ... ... 91 29 Acute Miliary Tuberculosis 1 2 1 ... ... 1 1 ... ... ... ... ... ... ... ... 3 30 Tuberculous Meningitis 4 6 1 3 2 1 1 1 ... 1 ... ... ... ... ... 10 31 Tuberculosis of Peritoneum and Intestines 2 ... ... 1 ... ... 1 ... ... ... ... ... ... ... ... 2 32 Tuberculosis of Spinal Column 2 ... ... ... ... 1 1 ... ... ... ... ... ... ... ... 2 34 Tuberculosis of other Organs 1 ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 35 Disseminated Tuberculosis 2 1 ... 1 1 ... ... ... 1 ... ... ... ... ... ... 3 37 Syphilis 2 ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... 2 39 Cancer of the Buccal Cavity 1 1 ... ... ... ... ... ... ... ... ... ... 1 1 ... 9 40 Cancer of the Stomach, Liver 23 18 ... ... ... ... ... ... ... 6 6 11 11 6 1 41 41 Cancer of the Peritoneum Intestines, Rectum 18 10 ... ... ... ... ... 1 ... 1 5 8 9 3 1 28 51 42 Cancer of the Female Genital Organs ... 14 ... ... ... ... ... ... ... 1 4 5 2 2 ... 14 43 Cancer of the Breast ... 12 ... ... ... ... ... ... ... 1 5 3 1 2 ... 12 44 Cancer of the Skin ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 45 Cancer of other or unspecified organs. 15 5 ... ... ... ... 1 ... ... 1 3 7 5 2 1 20 46 Other Tumours (situation illdefined) ... 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 47 Rheumatic Fever 4 2 ... ... 2 1 ... l ... 1 ... ... ... 1 ... 6 48 Chronic Rheumatism, Gout ... 4 ... ... ... ... ... ... ... ... ... 2 1 1 ... 4 50 Diabetes 3 5 ... ... ... ... ... ... 1 ... 2 2 3 ... ... 8 51 Exophthalmic Goitre ... 2 ... ... ... ... 1 ... 1 ... ... ... ... ... ... 2 52 Addison's Disease 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 53 Leucocythæmia 3 1 ... ... 2 ... ... ... ... 1 1 ... ... ... ... 4 54 Anæmia, Chlorosis 1 1 ... ... 1 ... ... ... ... ... 1 ... ... ... 2 55 Other General Diseases ... 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 II. Diseases of the Nervous System and of the Organs of Special Sense. 60 Encephalitis 3 ... ... ... 1 ... ... ... 1 1 ... ... ... ... ... 3 61 Meningitis 3 2 1 2 1 ... ... ... ... ... 1 ... ... ... ... 5 61a Cerebro-spinal Fever 1 ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 1 62 Locomotor Ataxy 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 63 Other Diseases of the Spinal Cord 3 6 ... ... ... ... ... ... ... ... l 1 4 2 1 9 64 Cerebral Hæmorrhage. Apoplexy 32 33 1 ... ... ... ... ... ... 3 5 14 23 15 4 65 66 Paralysis without Specified Cause ... 7 ... ... ... ... ... ... ... ... 1 ... 4 2 ... 7 67 General Paralysis of the Insane 8 ... ... ... ... ... ... ... ... 2 3 3 ... ... ... 8 68 Other Forms of Mental Alienation ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 69 Epilepsy 3 3 ... ... 1 1 ... ... 2 ... 1 ... ... ... 6 71 Infantile Convulsions 1 1 1 1 ... ... ... ... ... ... ... ... ... ... ... 2 52 Causes of, and Ages at, Death, Calendar Year, 1920.—Continued. No. Diseases. Males. Females. AGES. All Ages. 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65- 75- 85- 72 Chorea ... 1 ... ... ... ... 1 ... ... ... ... ... ... ... ... 1 74 Other Diseases of the Nervous System 2 1 ... ... 1 ... ... ... ... ... 1 ... 1 ... ... 3 76 Diseases of the Ears 2 4 1 ... 2 3 ... ... ... ... ... ... ... ... ... 6 III.—Diseases of the Circulatory System. 77 Pericarditis 1 2 1 ... ... 1 1 ... ... ... ... ... ... ... ... 3 78 Acute Endocarditis 11 2 ... ... 1 ... 1 1 6 1 2 ... 1 ... ... 13 79 Organic Disease of the Heart 55 73 ... 1 1 3 ... 2 6 8 11 28 38 25 5 128 80 Angina Pectoris 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 81 Diseases of the Arteries, Atheroma, Aneurysm, &c. 4 9 ... ... ... ... ... ... ... ... 3 2 1 6 1 13 82 Embolism and Thrombosis 1 8 ... ... ... ... ... ... ... ... ... 2 2 5 ... 9 84 Diseases of the Lymphatic system (Lymphangitis, &c.) 1 ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 85 Haemorrhage; other Diseases of the Circulatory System 1 ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 IV.—Diseases of the Respiratory System. 87 Diseases of the Larynx ... 2 ... ... 2 ... ... ... ... ... ... ... ... ... ... 2 88 Diseases of the Thyroid Body 1 1 ... ... ... ... ... ... ... 1 ... 1 ... ... ... 2 53 89 & 90 Bronchitis 58 51 18 4 2 1 ... ... 1 5 3 19 22 28 6 109 91 Broncho-Pneumonia 36 22 20 17 2 2 ... ... 1 2 3 1 8 1 1 58 92 Pneumonia, Lobar & undefined 27 27 4 5 ... 1 ... 1 8 3 11 9 9 3 ... 54 93 Pleurisy 3 2 ... 1 ... ... ... ... ... ... 2 2 ... ... ... 5 94 Pulmonary Congestion, Pulmonary Apoplexy 4 4 1 ... ... ... ... 1 ... ... 2 ... 1 1 2 8 96 Asthma 2 5 ... ... ... ... ... ... ... 1 ... 1 3 1 1 7 98 Other Diseases of the Respiratory System 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 V.— Diseases of the Digestive System. 100 Diseases of the Pharynx 3 1 ... ... ... 1 1 ... ... ... ... 1 ... 1 ... 4 102 Ulcer of the Stomach 4 5 ... ... ... ... ... ... 2 1 2 2 1 1 ... 9 103 Other Diseases of the Stomach 5 5 2 ... 1 ... ... ... ... ... 1 1 3 2 ... 10 104 and 105 Diarrhoea and Enteritis 19 10 27 2 ... ... ... ... ... ... ... ... ... ... ... 29 2 5 ... ... ... ... ... ... 1 ... 2 1 1 1 1 7 108 Appendicitis 4 ... ... ... 1 ... ... ... ... ... 1 ... 2 ... ... 4 109 Hernia, Intestinal Obstruction 8 7 2 1 1 ... ... ... 1 1 1 8 3 2 ... 15 110 Other Diseases of the Intestines 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 112 Hydatid of Liver ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 113 Cirrhosis of the Liver 2 1 ... ... ... ... ... ... 1 ... 1 ... 1 ... ... 3 114 Biliary Calculi ... 2 ... ... ... ... ... ... ... ... ... 1 ... ... 1 2 VI.—Non-venereal Diseases of the Genito-urinary System and Annexa. 119 Acute Nephritis 3 3 1 2 ... ... ... ... 1 ... 1 ... 1 ... ... 6 120 Bright's Disease 27 22 ... ... ... ... 1 1 1 4 7 9 14 11 1 49 54 Causes of, and Ages at, Death, Calendar Year, 1920.—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 2 1 ... ... ... ... ... ... 1 ... 1 ... ... 1 ... 3 123 Culculi of the Urinary Passages 1 1 ... ... ... ... ... ... ... ... 1 1 ... ... ... 2 124 Diseases of the Bladder 3 ... ... ... ... ... ... ... ... ... ... ... ... 3 ... 3 125 Diseases of the Urethra, Urinary Abscess, &c. 1 ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 126 Diseases of the Prostate 2 ... ... ... ... ... ... ... ... ... ... ... ... 2 ... 2 129 Uterine Tumour (non-cancerous) ... 1 ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 VII. The Puerperal State. 134 Accidents of Pregnancy ... 1 ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 135 Puerperal Hemorrhage ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 136 Other Accidents of Labor ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 137 Puerperal Fever ... 1 ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 138 Puerperal Albuminuria and convulsions ... 4 ... ... ... ... ... ... 1 3 ... ... ... ... ... 4 VIII.—Diseases of the Skin and of the Cellular Tissue. 142 Gangrene 3 2 ... ... ... ... ... ... ... ... ... 1 2 1 1 5 143 Carbuncle, Boil ... 1 ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 55 144 Acute Abscess ... 2 ... ... ... ... ... ... ... 1 ... ... 1 ... ... 2 145 Diseases of the Integumentary System 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 IX.—Diseases of the Bones and of the Organs of Locomotion. 146 Diseases of the Bones 1 1 1 ... 1 ... ... ... ... ... ... ... ... ... ... 2 149 Other Diseases of Locomotor System 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 X.—Malformations. 150 Congenital Malformations 9 4 12 1 ... ... ... ... ... ... ... ... ... ... ... 13 XI.—Early Infancy. 151 Premature Birth, Infantile Debility, Icterus, and Sclerema 37 32 69 ... ... ... ... ... ... ... ... ... ... ... ... 69 152 Other Diseases peculiar to Early Infancy 12 9 21 ... ... ... ... ... ... ... ... ... ... ... ... 21 153 Lack of Care 2 ... 2 ... ... ... ... ... ... ... ... ... ... ... ... 2 XII.—Old Age. 154a Senile Dementia 1 5 ... ... ... ... ... ... ... ... ... ... 1 4 1 6 154b Senile Decay 35 44 ... ... ... ... ... ... ... ... ... ... 11 52 16 79 XIII.—External Causes. 155 Suicide by Poison 1 1 ... ... ... ... ... ... ... ... 1 1 ... ... ... 2 156 Suicide by Asphyxia 1 ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 157 Suicide by Hanging or Strangulation ... 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 56 Causes of, and Ages at, Death, Calendar Year, 1920.—Continued. No. Diseases. Males. Females. AGES. All Ages. 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65 75- 85- 158 Suicide by Drowning ... 1 ... ... ... ... 1 ... ... ... ... ... ... ... ... 1 161 Suicide by Jumping from High Places ... 1 ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 162 Suicide by Crushing 1 ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 168 Other Suicides . .. 2 ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... 2 165 Other Acute Poisoning® 1 ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 167 Burns (Conflagration excepted) ... 4 1 ... ... 1 ... 1 ... ... ... ... ... 1 ... 4 168 Absorption of Deleterious Gases (Conflagration excepted) ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 169 Accidental Drowning 1 1 ... 1 ... ... ... 1 ... ... ... ... ... ... ... 2 172 Injury by Fall 7 2 ... ... ... ... ... ... 1 1 ... 3 2 2 ... 9 174 Injury by Machines 2 ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... 2 175 Injury by other Crushing (Vehicles, Railways, Landslides, &c.) 10 2 ... ... 1 2 ... 1 1 1 3 1 1 1 ... 12 178 Excessive Cold. . ... 1 ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 184 Homicide by other means 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 185 Fractures (cause not specified) ... 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 1 186 Other Violence 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 XIV.—Ill-defined Causes. 189 Ill-defined Causes 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 57 Totals, General Diseases 190 200 18 46 27 9 21 19 36 38 46 65 39 21 5 390 Totals, Diseases of the Nervous System and of the Organs of Special Sense 59 59 4 3 6 4 2 1 2 9 12 19 32 19 5 118 Totals, Diseases of the Circulatory System 75 94 1 1 2 4 2 4 12 9 17 33 42 36 6 169 Totals, Diseases of the Respiratory System 132 114 43 27 6 4 ... 2 10 12 22 33 43 34 10 246 Totals, Diseases of the Digestive System 48 37 32 3 3 1 1 ... 5 3 8 9 11 7 2 85 Totals, Non-Venereal Diseasesof the Genito-Urinary System and Annexa 39 28 1 2 ... ... 1 1 3 4 11 11 15 17 1 67 Totals, the Puerperal State ... 8 ... ... ... ... ... ... 3 5 ... ... ... ... ... 8 Totals. Diseases of the Skin and of the Cellular Tissue 4 5 ... ... ... ... ... 1 ... 1 ... 1 4 1 1 9 Totals, Diseases of the Bones and of the Organs of Locomotion 2 1 1 ... 1 ... ... ... ... ... ... ... 1 ... ... 3 Totals, Malformations 9 4 12 1 ... ... ... ... ... ... ... ... ... ... ... 13 Totals, Early Infancy 51 41 92 ... ... ... ... ... ... ... ... ... ... ... ... 92 Totals, Old Age 36 49 ... ... ... ... ... ... ... ... ... ... 12 56 17 85 Totals, External Causes 28 16 3 2 1 4 1 5 4 2 6 7 4 4 1 44 Totals, III-defined Causes 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 Grand Totals 674 656 207 85 46 26 28 33 75 83 123 178 203 195 48 1330 There were no Deaths from the Causes of Deaths represented in the International List by the following numbers:—2, 3, 4, 11, 12, 13, 14, 15, 16, 17, 19, 21. 22, 23, 24, 26, 27, 33, 36, 38, 49, 56, 57, 58, 59, 65, 70, 73, 75, 83, 86, 95, 97, 99, 101, 106, 107, 111, 115, 116, 117, 118, 121, 127, 128, 130, 131, 132, 133, 139, 140, 141, 147, 148, 159, 160, 164, 166, 170, 171, 173, 176, 177, 179, 180, 181, 182, 183, 187, 188. 58 Table No. IV. INFANTILE MORTALITY, CALENDAR YEAR 1920. 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. 4 Weeks and under 3 Months. 3 Months and under 6 Months. 6 Months and under 9 Months 9 Months and under 12Months. Total Deaths under 1 Year. All Causes Certified 70 15 9 6 100 43 33 19 12 207 Uncertified ... ... ... ... ... ... ... ... ... ... Small-pox ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... 1 1 Scarlet Fever ... ... ... ... ... ... ... ... ... ... Whooping-Cough ... ... ... 1 1 1 1 2 2 7 Diphtheria and Croup ... ... ... ... ... ... ... ... 1 1 Influenza ... ... ... ... ... 2 1 ... ... 3 Erysipelas ... ... ... ... ... ... ... ... ... ... Tuberculous Meningitis ... ... ... ... ... ... 1 ... ... 1 Abdominal Tuberculosis ... ... ... ... ... ... ... ... ... ... Other Tuberculous Diseases ... ... ... ... ... ... 2 1 ... 3 59 Meningitis (not Tuberculous) ... ... ... ... ... ... ... 1 ... 1 Convulsions ... ... ... ... ... 1 ... ... ... 1 Laryngitis ... ... ... ... ... ... ... ... ... ... Bronchitis 1 1 1 3 6 5 5 2 ... 18 Pneumonia (all forms) ... ... ... ... ... 8 5 6 5 24 Diarrhoea ... ... ... ... ... 1 2 ... ... 3 Enteritis ... 1 1 ... 2 8 9 3 2 24 Gastritis ... ... ... ... ... ... 1 ... ... 1 Syphilis ... ... ... ... ... 1 ... ... ... 1 Rickets ... ... ... ... ... ... ... ... ... ... Suffocation, overlying ... ... ... ... ... ... ... ... ... ... Injury at Birth ... ... ... ... ... ... ... ... ... ... Atelectasis 7 1 ... 1 9 ... ... ... ... 9 Congenital Malformations 4 2 1 ... 7 3 2 ... ... 12 Premature Birth 36 4 4 ... 44 2 ... ... ... 46 Atrophy, Debility and Marasmus 10 2 2 ... 14 7 2 1 ... 24 Other Causes 12 4 ... 1 17 4 2 3 1 27 Totals 70 15 9 6 100 43 33 19 12 207 Nett Births registered during the calendar year Legitimate 3,070 Nett Deaths registered during the calendar year Legitimate infants 196 Illegitimate 98 Illegitimate infants 11 1 newborn, unknown, found in Bushwood, Leytonstone, 1 in Boundary Road and 1 on Wanstead Flats. 60 Table IVA. INFANTILE MORTALITY, CALENDAR YEAR 1920. 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 16 30 39 23 16 19 34 14 13 3 207 Uncertified ... ... ... ... ... ... ... ... ... ... ... Small-pox ... ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... 1 ... ... ... 1 Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... Whooping-Cough 1 ... 2 1 1 2 ... ... ... ... 7 Diphtheria and Croup ... ... ... ... 1 ... ... ... ... ... 1 Influenza ... ... ... 1 1 1 ... ... ... ... 3 Erysipelas ... ... ... ... ... ... ... ... ... ... ... Tuberculous Meningitis ... ... 1 ... ... ... ... ... ... ... 1 Abdominal Tuberculosis ... ... ... ... ... ... ... ... ... ... Other Tuberculous Diseases 1 ... ... ... ... ... ... 2 ... 3 Meningitis (not Tuberculous) ... ... ... 1 ... ... ... ... ... ... 1 61 Convulsions ... ... ... ... ... ... 1 ... ... ... 1 Laryngitis ... ... ... ... ... ... ... ... ... ... ... Bronchitis 1 1 5 4 1 2 2 1 1 18 Pneumonia (all forms) 2 6 3 3 ... 3 4 2 1 ... 24 Diarrhoea ... ... ... ... 1 ... ... 1 1 ... 3 Enteritis 2 4 7 2 2 2 1 2 2 ... 24 Gastritis 1 ... ... ... ... ... ... ... ... ... 1 Syphilis ... ... ... 1 ... ... ... ... ... ... 1 Rickets ... ... ... ... ... ... ... ... ... ... ... Suffocation, overlying ... ... ... ... ... ... ... ... ... ... ... Injury at Birth ... ... ... ... ... ... ... ... ... ... ... Atelectasis 2 ... 4 ... ... ... ... 2 1 ... 9 Congenital Malformations 3 1 4 1 1 1 ... 1 ... ... 12 Premature Birth 3 4 4 6 3 4 15 3 3 1 46 Atrophy, Debility and Marasmus ... 5 5 1 3 2 4 2 2 ... 24 Other Causes 1 8 4 2 2 2 6 ... ... 2 27 Totals 16 30 39 23 16 19 34 14 13 3 207 Nett Births registered during the calendar year Legitimate 3,070 Nett Deaths registered during the calendar year Legitimate Infants 106 Illegitimate 98 Illegitimate Infants 11 1 newborn, unknown, found in Bushwood, Leytonstone, 1 in Boundary Road and 1 on Wanstead Flats. Leyton Urban District Council. ANNUAL REPORT to the EDUCATION COMMITTEE, embodying the Thirteenth Annual Report on the MEDICAL INSPECTION OF SCHOOL CHILDREN Under the Education (Administrative Provisions) Act of 1907, For the Year 1920, by J. FRANCIS TAYLOR, M.R.C.S., D.P.H. Surgeon-Major, Honourable Artillery Company, Medical Officer of Health. Leyton Urban District Council. EDUCATION COMMITTEE. Chairman: Mr. Councillor Heather, J.P. Members: Mr. Councillor Baker. Mr. Councillor Wintersgili. Mr. Councillor Clare. Mr. Councillor Hurry, J.P. Mr. Councillor Daines. Mr. Councillor Mawer. Mr. Councillor Haines, J.P. Mr. Councillor Phillips. Mr. Councillor Hall. Mr. Councillor Shanks. Mr. Councillor Harris. Mr. Councillor Smith, J.P. Mrs. Councillor Marshall. Co-opted Members : Mrs. E. A. Enever. Mrs. E. Heather. Mr. James Webb. Nominees of the Leyton Teachers' Association, (N. U.T.J Mr. H. H. Gill, B.Sc. Miss F. Craddock, L.L.A. Miss M. F. Friggens. Managers of St. Joseph's R.C. School (Section 6, Education Act, 1902). Mr. Councillor Haines, J.P. Mr. Councillor Hurry, J.P. STAFF OF MEDICAL DEPARTMENT. Clerks : Miss Herrick. Edward Newman (temporary), appointed 1st November. School Nurses: Miss E. W. Walling. Miss M. Sykes (from 1st Nov.). Miss D. Crawford. Miss Marie Maye (from 11th Nov.). Dentists : Percy E. Chandler, L.D.S.R.C.S. (Eng.). James E. Horton, L.D.S.R.C.S. (Eng.). Oculist : A. H. Thompson, M.D. (Edin.), resigned 30th September. Miss Lizzie Smith-Clark, M.B., Ch.B. Edin.), from 20th October. Assistant School Medical Officers: William Nicoll, M.D. (St. And.), D.P.H. (Cambs.), from 1st May till 31st July. Cecilia McEwan-Martin, M.B., Ch.B. (Glasg.), from 1st Sept. John Kennedy, M.B., Ch.B. (Glasg.), part time. School Medical Officer: J. F. Taylor, M.R.C.S. (Eng.), D.P.H. (London). 65 TO THE CHAIRMAN AND MEMBERS of the LEYTON EDUCATION COMMITTEE. Mr. Chairman, Ladies and Gentlemen, I beg to present the Thirteenth Annual Report of the School Medical Service in Leyton under the Education (Administrative Provisions) Act of 1907. In consequence of our being unable to commence routine inspections in the Schools before the beginning of May, when Dr. Nicoll took up his duties, it was possible to examine only two groups—"Entrants" and "Leavers." During 1921, with Dr. Martin working whole time and Dr. Kennedy three sessions per week, I hope to be able to examine the "Intermediate" Group in addition to the "Entrants," "Leavers," and "Specials" as required by the Board of Education. The additional work done in the Dental Department through the appointment of Mr. Horton, who commenced his duties in May, is shown by the number of children treated in 1920, which was 3,287, whereas in 1919 it was 2,396. The employment of the Oculist for two sessions per week instead of one was instituted in 1921, and therefore the additional work done in this section will be shown in next year's report. I take this opportunity to thank all those with whom I have worked, both members and officials, for their courtesy and help. I am, Mr. Chairman, Ladies and Gentlemen, Your obedient Servant, J. FRANCIS TAYLOR. 66 STAFF. As mentioned in last year's Report, William Nicoll, M.D. (St. And.), D.P.H. (Cambs.), was appointed Assistant School Medical Officer late in that year. He carried out routine inspection of "Entrants" from May 1st until July 31st, when he resigned to take up the appointment of Assistant Medical Officer of Health at Battersea. Cecilia McEwan-Martin, M.B., Ch. B. (Glasg.), was appointed to fill the vacancy thus created, and commenced duties on September 1st. John Kennedy, M.B., Ch.B. (Glasg.), a local practitioner, who was mentioned in last year's Report as assisting in school inspection, was re-appointed to this work, and he has devoted three sessions per week to it. From November our staff of School Nurses has been increased from three to four. The School Oculist, A. H. Thompson, M.D. (Edin.), resigned at the end of September, and Lizzie Smith-Clark, M.B., Ch.B. (Edin.) was appointed in his stead. Our second School Dentist, James E. Horton, L.D.S.R.C.S. (Eng.), commenced his duties in May. 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 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, 67 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 Whipps Cross Hospital. Records of attendances and treatment are entered in a register, and upon special cards. During the year 1,325 boys and 1,005 girls attended the Inspection Clinic. The following table shows the conditions dealt with:— Boys. Girls. Vermin of head and body 96 151 Ringworm of scalp 109 81 Ringworm of other parts of body 85 36 Scabies 123 110 Other skin diseases 523 299 Ear diseases 60 59 External eye diseases 98 104 Lung diseases 29 19 Heart disease 13 10 Throat diseases 33 33 Miscellaneous 156 103 Total 1,325 1,005 MINOR AILMENTS CLINIC. Treatment:— For diseases of eyes on 2,888 occasions. ,, ,, ears on 1,065 ,, ,, Ringworm on 825 ,, ,, Other affections 5,433 „ Total 10,211 92 children suffering from Ringworm of the scalp were treated by X-rays at the London Hospital. 68 OPHTHALMIC SURGEON'S 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. 1,063 cases were examined at the Clinic. Of these the defects were as follows:— *Myopia 132 Myopic astigmatism 75 Hypermetropia 161 Hypermetropic astigmatism 153 Mixed astigmatism 49 Hypermetropia with squint 19 Myopia with squint 8 Squint only 12 Odd eyes 9 Various diseases 57 No defect 105 Re-inspected 283 Total 1,063 * 8 of these cases were excluded for varying periods. VARIOUS DISEASES. 57 disease cases were seen. These included Iritis, Keratitis, Cataract, Lachrymal Duct obstructed, Phlyctenular Ophthalmia, Wound of Eye, Blepharitis, Optic Atrophy, Retinitis, Artificial Eye, Corneal Ulcers, Corneal Opacity, Conjunctivitis, and Ciliary Spasm. Myopia and Squint cases requiring supervision are seen at intervals of three to nine months. 69 DENTAL SURGEONS' 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. ed. 1st Inspection. Re-Inspect. High Road 36 54 16.6 9.1 25.0 46.3 58.3 29.6 8.3 62.9 Mayville Road 109 171 19.5 14.0 24.8 45.0 55.9 29.8 7.3 46.8 Davies Lane 101 167 11.8 14 .4 24.7 32.3 61.3 33.5 15.8 53.8 Church Road 106 178 10.3 9.0 19.8 42.1 69.9 36.8 11.3 56.1 Newport Road 154 264 9.7 17.0 24.3 40.1 64.9 46.2 9.0 50.5 Capworth Street 260 304 14.2 17.4 14.2 29.2 71.6 38.8 19.2 49.3 Cobbold Road 47 80 8.5 10.0 19.1 37.5 74.5 46.2 4.2 53.7 Norlington Road 151 367 17.9 23.0 10.0 35.8 71.8 31.1 8.0 j 52.8 Harrow Green 69 191 7.2 14.1 34.7 48.6 57.9 15.7 11.5 56.5 Goodall Road 154 312 9.0 17.3 48.0 57.6 40.2 9.6 24.0 42.9 Downsell Road 93 255 17.2 11.7 29.0 61.5 45.1 11.7 11.8 54.9 Ruckholt Road 72 141 13.8 22.6 27.7 44.6 56.9 12.7 18.0 46.0 Cann Hall Road 92 238 17.3 12.1 32.6 58.8 45.6 14.7 17.3 58.4 Farmer Rord 93 193 11.8 12.9 38.7 55.9 47.3 16.0 11.8 46.1 St. Joseph's 44 66 11.3 7.5 59.0 59.0 27.2 6.0 20.4 63.6 Lea Bridge Road 71 46 15.4 10.8 32.3 63.0 52.1 26.0 19.7 32 Sybourn Street 90 171 16.6 12.8 36.6 64.9 44.4 9.3 17.7 53.2 Kirkdale Road 95 182 21.0 4.3 41.0 56.5 37.8 11.5 22.1 76.3 Trumpington Road 82 171 10.9 10.0 34.1 54.9 51.2 17.0 18.2 60.2 1919 3551 13.6 13.1 30.3 49.6 54.4 23.2 14.5 53.5 70 Number of Children Treated at Dental Clinic. School. Inspected. Re-inspected. With Dental Caries. Received Treatment. Completed Treatment. Per cent. Completed Treatment. High Road 36 54 79 34 34 30.8 Mayville Road 109 171 236 103 100 35.7 Davies Lane 101 167 234 93 93 34.4 Church Road 106 178 257 121 116 40.8 Newport Road 154 264 358 228 210 50.2 Capworth Street 260 304 474 228 200 37.2 Cobbold Road 47 80 115 58 47 37.0 Norlington Road 151 367 408 Not Commenced. Trumpington Road 1919 Report. 106 97 44.7 Harrow Green 69 191 231 91 79 30.3 Goodall Road 154 312 401 268 251 53.8 Downsell Road 93 255 300 163 140 40.2 Ruckholt Road 72 141 169 115 110 51.6 Cann Hall Road 92 238 285 159 144 43.6 Farmer Road 93 193 253 133 120 41.9 St. Joseph's 44 66 101 43 42 38.1 Lea Bridge Road 71 46 101 26 26 22.2 Sybourn Street 90 171 199 113 108 46.3 Kirkdale Road 95 182 249 104 104 37.5 Trumpington Road 82 171 234 6 6 — 1919 3551 4684 2192 2027 39.7 Number of children inspected in 1920, 5,470. Number of children treated:— Routine cases 2,192 Routine cases from 1919 359 Casuals 736 Total number of children treated in 1920 3,287 DENTAL TREATMENT OF MOTHERS. 114 mothers of the Infant Welfare Clinics received dental treatment. Treatment consisted of 143 filling's, 565 extractions under nitrous oxide, 55 with local injections, 26 scalings, etc. Nitrous oxide was administered by the Medical Officer on 107 occasions, which averaged 5.2 extractions for each administration. 71 Treatment Carried Out at School Clinic. School. Fillings. Extractions. Dressings and Scalings. High Road 46 89 11 Mayville Road 199 245 17 Davies Lane 182 224 9 Church Road 232 265 40 Newport Road 398 492 16 Capworth Street 390 480 14 Cobbold Road 85 122 8 Trumpington Road 205 106 20 Harrow Green 164 119 5 Goodall Road 469 323 44 Downsell Road 238 196 25 Ruckholt Road 235 158 27 Cann Hall Road 263 260 9 Farmer Road 212 221 13 St. Joseph's 65 63 9 Lea Bridge Road 43 49 — Sybourn Street 242 143 20 Kirkdale Road 189 115 7 3857 3670 294 Brought forward from 1919: Filling's, 792; extractions, 541; dressings, etc., 71. Casuals, 1920: Fillings, 200; extractions, 824; dressings, etc., 36. Full total of year's work: Fillings, 4,849; extractions, 5,035; dressings, etc., 401. 836 teeth were extracted under nitrous oxide, which was administered on 274 occasions. MENTALLY DEFECTIVE, BLIND AND DEAF CHILDREN. Two 'blind children are maintained at the East London Home and School for Blind Children at Clapton, and one at Elm Court Residential School, West Norwood. One mentally defective child is in Hopwell Hall, Derbyshire, two in Littleton House School, Cambridge, four girls and two 72 boys in Royal Eastern Counties Institution, Colchester, and five boys and five girls attend the Walthamstow Day Centre. Nine 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.— Two children are 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 81 children were thus dealt with, and prosecutions for non-attendance at School instituted in 25 instances, as a result of which fines and costs amounting to £7 5s. were inflicted. EDUCATION (PROVISION OF MEALS) ACTS. Four cookery instruction centres have been established by the Leyton Education Committee at the following schools: Mayville Road, Ruckholt Road, Capworth Street and Cann Hall Road. During the year 1919 two of these centres, Mayville Road and Capworth Street, were used for the provision of dinners for necessitous children. In 1920 the two other centres were employed for this purpose. Ruckholt Road Centre, which prior to 1919 was so used, but was discontinued as being no longer considered necessary, was reopened in October, and Cann Hall Road Centre, not previously so used, was opened in December. 73 At Ruckholt Road, Mayville Road and Capworth Street Schools the meals are prepared by the pupils attending the Centre for cookery lessons, under the supervision of the cookery instructress. 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 plates and dishes, etc. At Cann Mall Road School the woman assistant cooks the food as well as carrying out the duties of service and supervision of the meals, etc. The dietaries have been submitted to and approved by the School Medical Officer. Many children found during the course of medical inspection to require extra feeding in order to obtain full benefit of the education provided, have been recommended by the School Medical Officer to receive free dinners, which recommendations have been adopted. The number of children for whom meals have been provided, as compared with previous years, is as follows:— 1920. 1919. 1918. 1917. 1916. 1915. 1914. Average weekly number of children fed 55 42 53 72 54 90 312 (Dinners only are provided.) THE EMPLOYMENT OF CHILDREN IN MENTS RULES, 1920. Under the provisions of the above rules made by the Board of Education under Section 3 of the Prevention of Cruelty to Children Act, 1904, as amended by Section 13 (2) of the Education Act, 1918, which require that the applicant for a licence must produce a certificate from the School Medical Officer certifying that the child may be employed in the manner proposed without detriment to health, physical development, and education, I have issued 15 certificates. 74 STATISTICAL TABLES. TABLE I.— Number of Children Inspected from 1st January, 1920, to 31st December, 1920. A.—"Code" Groups. Age Entrants 3 4 5 6 Other Ages Total Boys 4 803 483 179 1469 Girls 7 766 489 221 1483 Totals 11 1569 972 400 2952 Age Intermediate Group Leavers 8 12 13 14 Other Ages Total Grand Total Boys 725 235 9 969 2438 Girls 847 242 30 1119 2602 Totals 1572 477 39 2088 5040 B.— Groups other than "Code." Intermediate Group (other than 8 years). Special Cases. Re-examinations (i.e. No. of Children amined). (1) (2) (3) (4) Boys 1640 999 Girls 1363 1125 Totals 3003 2124 75 TABLE II.— Return of Defects found in the Course of Medical Inspection in 1920. Defect or Disease. Code Groups. Specials. Number referred for Treatment Number requiring to be kept under observation, but not referred for Treatment, Number referred for Treatment Number requiring to be kept under observation but not referred for Treatment. (1) (2) (3) (4) (5) Skin Malnutrition 38 1 - - Uncleanliness— Head 673 — 212 — Body 179 — 15 — Skin Ringworm— Head 4 1 151 — Body 2 — 120 — Scabies 24 — 216 — Impetigo 42 — 564 — Other Disease 32 — 251 — Eye Defective Vision and Squint 416 46 74 6 External Eye Disease 84 2 196 — Ear Defective Hearing 108 8 13 1 Ear Disease 117 4 125 — Teeth Dental Disease 390 — 6 — Nose and Throat Enlarged Tonsils 136 8 59 1 Adenoids 53 2 34 11 Enlarged Tonsils and Adenoids 67 3 28 1 Defective Speech 107 — 3 1 Heart and Circulation Heart Disease— Organic 53 3 5 4 Functional 20 11 1 4 Anæmia 154 — 52 2 Lungs Pulmonary Tuberculosis— Definite 16 — 22 — Suspected 10 5 23 — Chronic Bronchitis 188 — 7 6 Other Disease 66 — 4 — Nervous System Epilepsy 5 - 14 — Chorea 7 5 16 1 Other Disease 10 2 4 3 Non-pulmonary Tuberculosis— Glands 48 — 7 4 Bones and Joints 2 1 4 — Other Forms 2 — 1 — Rickets 27 - 3 1 Deformities 31 13 25 2 Other Defects or Diseases 105 34 298 17 (This includes M.D.'s.) 76 TABLE III.— Numerical Return of all Exceptional Children in the Area in 1920. Boys. Girls. Total. Blind (including partially blind) Attending Public Elementary Schools 2 - 2 Attending Certified Schools for the Blind 2 1 3 Not at School — — — Deaf and Dumb (including partially deaf) Attending Public Elementary Schools 1 4 5 Attending Certified Schools for the Deaf 8 6 14 Not at School — - — Mentally Deficient Feeble Minded Attending Public Elementary Schools 56 21 77 Attending Certified Schools for Mentally Defective Children 12 8 20 Notified to the Local (Control) Authority during the year 36 15 51 Not at School - - — Imbeciles At School - - - Not at School 12 *5 17 Idiots — 1 1 2 Epileptics Attending Public Elementary Schools 7 3 10 Attending Certified Schools for Epileptics 3 6 9 Not at School 1 - 1 Physically Defective Pulmonary Tuberculosis Attending Public Elementary Schools 48 34 82 Attending Certified Schools for Physically Defective Children - - - Not at School 15 23 38 Other forms of Tuberculosis Attending Public Elementary Schools 27 16 43 Attending Certified Schools for Physically Defective Children - - - Not at School 12 8 20 Cripples other than Tubercular Attending Public Elementary Schools 14 11 25 Attending Certified Schools for Physically Defective Children - 1 1 Not at School 1 - 1 Dull or Backward Retarded 2 years 8 13 21 Retarded 3 years 6 9 15 * One case notified to Local Control Authority during the year. 77 TABLE IV.— Treatment of Defects of Children during 1920. 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. New. 1920. Total. Remedied. Improved. Unchanged. Clothing 1 1 2 - 2 - 2 - - 100.0 Footwear - - - - - - — — — — Cleanliness of Head 34 885 919 - 917 817 99 1 2 99.7 Cleanliness of Body 4 194 198 - 198 75 123 - — 100.0 Nutrition 22 38 60 5 55 18 37 - — 91.6 Nose and Throat 487 377 864 88 462 313 142 7 314 53.4 External Eye Disease 43 280 323 5 313 227 73 13 5 96.9 Ear Disease 42 242 284 17 265 176 80 9 2 93.3 Teeth 5 396 401 — 401 401 — — — 100.0 Heart and Circulation 172 285 457 49 388 88 223 77 20 84.9 Lungs 47 336 383 71 296 131 127 38 16 77.2 Nervous System 36 56 92 5 85 10 55 20 2 92.3 Skin 101 1,406 1,507 2 1,504 1,391 112 1 1 99.8 Rickets 3 40 43 3 35 1 10 24 6 81.3 Deformities 9 56 65 4 44 2 11 31 17 67.6 Tuberculosis — Non-Pulmonary 9 64 78 21 48 9 28 11 4 65.7 Speech 30 110 140 11 125 14 99 12 4 89.2 Mental Condition 53 67 120 7 62 1 34 27 51 51.6 Vision and Squint 864 490 1,354 99 1,173 412 531 230 82 86.6 Hearing 27 121 148 12 130 33 83 14 6 87.8 Miscellaneous 40 335 375 10 363 269 79 15 2 96.8 Totals 2,029 5,779 7,808 409 6,866 4,388 1,948 530 533 87.9 78 TABLE V.— Inspection, Treatment, &c., of Children during 1920. (1) The total number of children medically inspected (whether Code Group, special or ailing child) 8,043 excluding re-inspections (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) 217 (3) The number of children in (1) who were referred for treatment (excluding uncleanliness, defective clothing, etc.) 3,908 (4) The number of children in (3) who received treatment for one or more defects (excluding uncleanliness, defective clothing, etc.) 3,387 * „ ' '