LEY 019 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 1923, BY J. FRANCIS TAYLOR, M.R.C.S., D.P.H. Surgeon-Major, Honourable Artillery Company. Medical Officer of Health. Ilford SOUTH ESSEX RECORDERS, LIMITED, High Road. Leyton Urban District Council. PUBLIC HEALTH STAFF. MEDICAL OFFICERS. Whole Time : Taylor, John Francis, M.R.C.S. (Eng.), D.P.H. (London), etc., Medical Officer of Health, School Medical Officer, Medical Superintendent of Isolation Hospital, Supervisor and Organiser of Maternity and Infant Welfare Work, etc., etc. Martin, Cecilia McEwan, M B., Ch.B. (Glasg.), Deputy Medical Officer of Health, and Assistant School Medical Officer. Part Time: Kennedy, John, M.B., Ch.B. (Glasg.), School Medical Inspection, Emergency Attendant at Isolation Hospital. Boyd-Mackay, AII.EEN, M.R.C.S. (Eng.) L.R.C.P. (London) Medical Officer Infant Welfare Clinics. Commenced 3rd November, 1922. Shields, Charlotte Annie, M.B., B.S. (London), Medical Officer Infant Welfare and Ante-Natal Clinics. Smith-Clark, Lizzie, M B., Ch.B. (Edin.), School Oculist. DENTISTS—Whole Time: Chandler, Percy Ernest, L.D.S., R.C.S. (Eng.) Horton, James Ernest, L.D.S., R.C.S. (Eng.) School Dentists. Mr. Chandler also does the dental work prescribed for the mothers in connection with the Maternity and Child Welfare Scheme. SANITARY INSPECTORS: Stevens, Wilfred John, Certificate R.S.I., Meat Inspector's Certificate R.S.I. Spencer, Thomas Henry, Certificate R.S.I., Meat Inspector's Certificate R.S.I. Mules, John Frederick, Certificate R.S.I., Meat Inspector's Certificate R.S.I. Smith, George Alfred, Certificate R.S.I., Meat Inspector's Certificate R.S.I. Steeden, Edward James, Certificate R.S.I. Meat Inspector's Certificate R.S.I. Miller, Agnes Mabel, Certificate R.S.I. HEALTH VISITORS : Holland, Edith, Trained Nurse, Certificate Sanitary Inspector's Examination Board (London), Health Visitor's Certificate R.S.I. Dodd, LILIAN Sarah, Trained Nurse, Health Visitor's Certificate R.S.I. Bratton, Maud, Trained Nurse. Roake, Winifred, Trained Nurse, C.M.B., Health Visitor's Certificate R.S.I. Walling, Ethel Winifred, Trained Nurse, Health Visitor's Certificate R.S.I., one-sixth time Health Visitor, five-sixths time School Nurse. TO THE CHAIRMAN AND MEMBERS OF THE LEYTON URBAN DISTRICT COUNCIL. Mr. Chairman, Madam and Gentlemen, I have the honour to submit my Annual Report for the year 1923. It is framed on similar lines to that of last year. I am pleased to report that, in spite of many adverse circumstances, want of sufficient housing accommodation, unemployment, etc., the health of the district has been uniformly good. Our death-rate was 9.25. Our Zymotic death-rate .18. Our infantile mortality rate 45.53. There have been fewer cases of Diphtheria and Scarlet Fever even than last year, in spite of a considerable amount of overcrowding, and not a single death occurred from Scarlet Fever. Our infantile mortality rate is the lowest ever recorded. A truly wonderful improvement in the number of deaths among infants under one year of age has occurred in the last twenty years. I find that in 1904 our infantile mortality rate was 138. Again I have the pleasure of offering my best thanks to you and to the Officials for your and their courtesy and assistance. I am, Mr. Chairman, Madam and Gentlemen, Your obedient Servant, J. FRANCIS TAYLOR. Leyton Urban District Council. ANNUAL HEALTH REPORT FOR 1923, 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 £,526,958, and a rate of 1d. in the £ produces £2,020. For poor rate purposes the rateable value is £549,710 15s., and a 1d. rate produces ,£2,215. AREA, INHABITED HOUSES, POPULATION. The district has a total area of 2,594 acres; at the end of 1923 it contained 23,926 houses, 15 of which were erected during the year. Our present estimated population is 132,800, which number divided among the 23,847 inhabited houses, gives an average of 5.57 per house. At the 1921 Census the number worked out at 5.39 persons per house. BIRTHS. 2,069 births were registered—1,032 males and 1,037 females. To these must be added 150 male and 109 female births (transferable) received from the Registrar-General, which yields a birthrate of 17.53 per 1,000 of the population. Of the above, 56 were illegitimate births, 26 being males and 30 females. Percentage of illegitimate births, 2.41. 5 DEATHS. 1,038 deaths of Leyton residents were registered during the year—465 males and 573 females. To these must be added 107 males and 83 females, being deaths (transferable) received from the Registrar-General. The death-rate for 1923 was 9.25 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, 2; Diphtheria, 4; Whooping Cough, 5; Enteric Fever, 1; Diarrhœa and Enteritis, 12. The Zymotic death-rate for 1023 was .18 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 45.53, there being 106 deaths, 97 of legitimate and 9 of illegitimate infants. NOTIFICATION OF BIRTHS (EXTENSION) ACT, 1915. This Act took effect on September 1st, 1915. Under its terms 1,837 births were notified during the year 1923—833 from medical practitioners, 981 from midwives, and 23 from relatives. The health visitors visited 2,191 newly-born infants and paid 17,852 re-visits. MATERNITY AND INFANT WELFARE WORK. The constitution of the Committee appointed for the conduct of this work necessarily varies each year. The names of the ladies and gentlemen appointed for the year under review are as follows:— Chairman: Councillor T. Jays, M.R.C.S., L.R.C.P. Members: Councillors Cochrane, Groom, Hubbard, Johnson, Read, Stanbridge, Turner, Whiskin, and Mrs. Ringer. 6 Co-opted Members: Mrs. Carr, Mrs. Marshall, Mrs. Osborne, Mrs. Parry, and Mrs. Underwood. The scheme of work detailed in the report of 1920 has been carried out during this year without any material alteration. The health visitors have paid 20,440 visits, of which 7,982 were visits to new-born infants and 10,112 to children between the ages of one and five years. The three clinics have held two sessions each per week. The following figures represent the attendances at these clinics for the past four years:— 1920. 1921. 1922. 1923. Town Hall Clinic 3361 3614 3286 3395 People's Hall „ 3288 5066 4546 4795 Vicarage Road „ 4868 4277 3677 4224 Totals 11517 12957 11509 12414 The ante-natal clinic held 48 sessions and 172 new patients made 300 attendances. DENTAL TREATMENT OF NURSING AND EXPECTANT MOTHERS. Number treated, 75. Extractions under nitrous oxide, 160. Extractions under local anaesthetic, 68. Nitrous oxide was administered by the medical officer of health on 44 occasions. Fillings, 20. Sessions, 10. MILK (MOTHERS AND CHILDREN) ORDERS, 1919 and 1921. The administration of the Order, viz.: the interviewing of applicants and the granting of milk is, as was stated in the annual report for 1921, delegated to a Sub-Committee consisting of the ladies of the Infant Welfare Committee with Mrs. Underwood as Chairman. 7 The scale of necessity is as follows:— No. in Family. Scale. 1 10s. 2 10s. 3 8s. 6d. 4 8s. 5 7s. 6d. 6 7s. 7 6s. 8 6s. 9 5s. 6d. 10 5s. 6d. 11 5s. 6d. 12 5s. In each case the scale shows the weekly income per head after deduction of rent. All the milk is given free and the arrangements for its supply are those stated in the report of 1920. 69,685 pints were given during the year, and the cost was ,£931 4s. 5d. CONVALESCENT HOME FOR NURSING MOTHERS AND BABIES. The Council have continued for another year the arrangement with the National League for Health, Maternity and Child Welfare whereby the League agree to place at the disposal of the Council one cot or bed in their homes at Broadstairs, Maidenhead or Basing for a period of one year, in consideration of a payment of £50. This arrangement dates from the 1st of November, 1923. INFECTIOUS DISEASE. One death from Malaria occurred during the year. No case of Smallpox, Plague, Cholera, or Typhus has been notified. SMALLPOX. We are still without any hospital accommodation for Smallpox. 8 VACCINATION RETURNS. Number of Births. Vaccinated. Certificates of Insusceptibility. Exemptions. Died Unvaccinated under 1 year 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 1921 2465 553 2 1266 108 1922 2166 543 2 1166 71 1923 2069 573 4 968 64 ENTERIC FEVER. Two cases were notified. 1 death occurred. We have no hospital accommodation for Enteric Fever cases. One case was treated in Whipps Cross Hospital, and the other treated at home. Both cases were visited, and in addition to giving suitable advice, etc., endeavour was made to trace the cause of the infection. SCARLET FEVER. Cases notified, 179. There were no deaths. DIPHTHERIA. Cases notified, 149. 4 deaths occurred. Case-fatality per cent., 2.68. Death-rate per 1,000 of the population, .03. PUERPERAL FEVER. Twelve cases of this disease were notified. 6 deaths occurred. The death-rate from Puerperal Fever was .05 per 1,000 of the population. 9 Three cases were attended by medical men and 9 by midwives. One midwife had 3 cases at three months' intervals. Two were attended by midwives from the Essex County Nursing Association, six months intervening between the two cases. All the cases were removed to Whipps Cross Hospital. Disinfection of premises and clothing has been systematically carried out. 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. MIDWIVES. There are some 15 midwives residing in the district, including seven or eight attached to the Essex County Nursing Association in Beachcroft Road, Leytonstone. In addition to these midwives from adjoining authorities practice in the district. MEASLES. There were 2 deaths during the year. Death-rate, .02 per 1,000 of the population. 159 cases of Measles were visited by the health visitors. WHOOPING COUGH. There were 5 deaths during the year. Death-rate per 1,000 of the population, .04. 1 of these deaths occurred in a child under one year of age, 2 between one and two years, and 2 between two and five years. The health visitors visited 72 cases. DIARRHCEA AND ENTERITIS. Diarrhoea and Enteritis caused 11 deaths, 9 of which were of infants under one year of age, and 2 between one and two years. Of these, 3 died at the following Hospitals:—Queen Mary's Hospital, Stratford, 2, and 1 at the Infirmary, Gwendolen Road, Evington, W. Our death-rate from Diarrhoea and Enteritis under two years was 4.73 per 1,000 births. 10 CEREBRO-SPINAL MENINGITIS. No notifications received. ANTERIOR POLIOMYELITIS. Four cases were notified. ENCEPHALITIS LETHARGICA. Two notifications were received. 2 deaths occurred. OPHTHALMIA NEONATORUM. Cases. Vision unimpaired. Vision impaired. Total Blindness. Deaths. Notified. Treated. At home. In hospital. 12 7 5 12 — - - TUBERCULOSIS. One hundred and twenty-five deaths occurred from all forms of Tuberculosis, 101 being notified cases, which represents a deathrate of .94 per 1,000 of the population: The deaths from Pulmonary Tuberculosis were 108 and the rate .81. Notifications of 189 cases of Pulmonary Tuberculosis and 54 of other forms of Tuberculosis were received during the year. TUBERCULOSIS. Age Periods. New Cases. Deaths. Pulmonary. Non-P'lmonary Pulmonary. Non-P'lmonary M. F. M. F. M F. M. F. 0 1 - - - 1 - 1 - 1 — — 3 2 - - .3 1 5 2 4 4 1 1 - 1 - 10 1 7 2 3 - 3 1 - 15 6 14 2 1 4 6 3 1 20 20 18 3 2 9 4 - - 25 23 21 2 1 10 8 2 1 35 19 13 1 1 14 11 1 - 45 15 4 3 — 13 9 - 1 55 13 3 1 1 12 2 1 - 65 and upwards 3 2 1 - — 1 - — Totals 103 86 22 12 64 44 13 4 11 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, 180, High Road, Leyton, on: Mondays: 2—4 p.m. Dr. John Sorley: Thursdays: 10 a.m.—12 p.m. and 6—8 p.m. Fridays: 2—4 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. BACTERIOLOGICAL DIAGNOSIS. The arrangements made by the County Council of Essex 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, Ls being continued. The following specimens were sent:— Diphtheria 353 Ringworm 94 Sputum 20 CANCER. There were 163 deaths during the year, giving a death-rate of 1.23 per 1,000 of the population. AMBULANCE FACILITIES. The Council provide two horsed ambulances for removal of infectious cases. A motor ambulance for non-infectious cases has been supplied by the Red Cross Society and is under the control of the Superintendent of the Fire Brigade. INQUESTS. The following verdicts were recorded at Inquests held in the district during the year:— Natural Causes 46 Accident 20 12 Want of proper attention at birth 4 Accidental suffocation in bed with parents 1 Overlain 1 Manslaughter 1 Drowning 1 Suicide (4 coal gas poisoning, 1 taking spirits of salts, 1 cyanide of potassium poisoning, 1 acetic acid poisoning, 2 run over by railway locomotives, 1 fall from window) 10 INCREASE OF RENT AND MORTGAGE INTEREST (RESTRICTIONS) ACT, 1920. The medical officer of health issued 10 certificates during the year. HOUSING. One hundred and forty-two houses erected under the Council's Scheme, all of Type B, are now in occupation. 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 1039 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 1 Number of dwelling-houses in respect of which representations were made to the local authority with a view to the making of closing orders 1 Number of dwelling-houses in respect of which closing orders were made by the local authority 1 Number of dwelling-houses the defects in which were remedied without the making of closing orders 695 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 lating 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. 13 ISOLATION HOSPITAL. The number of cases of Scarlet Fever and Diphtheria notified during the year has shown a further decrease, the figures being as follows:— 1923 1922 1921 Scarlet Fever 179 463 1,320 Diphtheria 149 189 322 Of the Scarlet Fever cases 117 were admitted to the hospital, and of the Diphtheria cases 108 were admitted. The remainder with the exception of a few cases which were received into other hospitals were treated at home. Those treated at home were supervised to ensure the maintenance of proper isolation. Tracheotomy was performed on three cases for severe laryngeal obstruction. The great feature of the year was that no death occurred among those admitted to hospital. There is no resident medical officer. The medical officer of health is in sole medical charge, assisted by Dr. Kennedy, a local practitioner, who attends in emergencies. The hospital maintains its popularity and many letters have been received from parents testifying to the kindness and consideration shown to their children by the matron and nurses. STATISTICAL RETURNS Admissions:— Male. Female. Under 1 year. 1 and under 5. 5 and under 15. 15 and under 25. 25 and upwards. Diphtheria 53 55 0 33 55 5 5 Scarlet Fever 64 53 0 35 70 2 2 Totals 117 108 0 68 125 7 7 14 The estimated amount of money expended on the hospital during the financial year ending 31st March, 1924, is £5,253, divisible into the following items:— £ s. d. £ s. d. Buildings: Repairs and Maintenance 406 11 11 Furniture and Repairs 47 3 0 Bedding, Linen, &c. 84 0 0 537 14 11 Domestic Utensils 20 12 3 Fuel, Light, Water and Cleaning 608 9 4 629 1 7 Rates and Insurance 279 15 10 Printing, Stationery, &c. 38 4 2 Medicines, Drugs & Surgical Appliances 71 4 6 Provisions 1033 13 9 Ambulance: Horsing and Repairs 136 4 0 Uniforms and Dresses 69 19 9 Salaries, Wages and Allowances 2206 6 4 Contributions to Other Authorities 38 7 0 3873 15 4 Loans—Repayment of Principal and Interest 212 8 2 £5253 0 0 15 REPORT OF SANITARY INSPECTOR. TO THE CHAIRMAN AND MEMBERS OF THE LEVTON URBAN DISTRICT COUNCIL. Mr. Chairman, Madam and Gentlemen, I beg to submit to you my report for the year 1923 INSPECTION OF THE DISTRICT AND ABATEMENT OF NUISANCES. During the year, 1,034 complaints have been received and dealt with. The total number of houses inspected was 3,825, of which defects were found at 2,814, 14,898 re-inspections were made, and notices and letters written in reference to them numbered 3,891, of which 30 were statutory notices. In addition to these, 762 inspections of a miscellaneous character were made and the nuisances found were dealt with. UNFIT DWELLING-HOUSES. I.—Inspection. Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 3,825 Number of dwelling-houses which were inspected and recorded under the Housing (Inspection of District) Regulations, 1910 1,039 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 1,964 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 2,707 16 Proceedings under Public Health Acts. (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 29 (2) Number of dwelling-houses in which defects were remedied— (a) by owners 28 (b) by Local Authority in default of owners 1 The house-to-house inspections totalled 1,039. These inspections were carried out in the following roads:— Lansdowne Road, Leytonstone. Cobden Road, Leytonstone. Acacia Road, Leytonstone. Cecil Road, Leytonstone. Gladstone Street, Leytonstone. Florence Road, Leytonstone. Cathall Road (South Side), Leytonstone. Argyle Street, Leytonstone. Lascelles Road, Leytonstone. Leyton Park Road, Leyton. St. Georges Road, Leyton. Beaconsfield Road, Leyton. Salisbury Road, Leyton. Elm Road, Leyton. Scotts Road, Leyton. Morley Road, Leyton. William Street, Leyton. Farmer Road, Leyton. Byron Road, Leyton. DRAINAGE. The drainage of 127 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. 17 FACTORY AND WORKSHOP ACTS, 1901 and 1907. 154 visits were paid to factories and 551 workshops were inspected during the year and 254 nuisances remediable under the Public Health Acts, or contravening the Factory and Workshop Acts, dealt with, and re-visits made until the necessary work had been carried out. 275 workshops remain on the register. 462 outworkers were notified by other Councils and we forwarded 103 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. 1,516 visits were paid to outworkers' premises and 329 uncleanly and insanitary defects, remedied. INFECTIOUS DISEASE. Appended is a summary of the work in connection therewith : Houses disinfected and the sanitary arrangements examined and tested 610 Loads of infected bedding removed to be disinfected at the Council's steam disinfector and returned 392 Books belonging to public institutions disinfected 181 Also various articles of wearing apparel. POLICE COURT PROCEEDINGS. 12 summonses were issued as follows:— Abatement of nuisances 5 In one case defendant appealed to Quarter Sessions; appeal dismissed with taxed costs. Non-compliance with Justices' Orders 3 Failing to quit premises under Closing Order 3 Allowing house to be occupied without water supply 1 MEAT AND FOOD INSPECTION. 7,192 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:— 18 2 heifer carcases and viscera 1 lamb's liver 2 bullock carcases and viscera 1 calf liver 1 lamb carcase and viscera 3 pairs sheep lungs 2 sheep carcases and viscera 4 pairs ox lungs 2 pig carcases and viscera 1 pair pig's lungs 1,198 lbs. beef (other than whole carcases) 1 ox head 1 pig's head 240 lbs. fresh meat 8 stone plaice 140 lbs. salt meat 8 stone herrings 152 lbs. cooked meat 1 box herrings 100 lbs. fat and suet 16 stone skate 44 lbs. lamb 1 box skate 48 lbs. bacon 10 stone haddocks 137 ox livers 2 boxes haddocks 5 sheep livers 580 tins red currant pulp 8 pigs' livers 48 lbs. plums SLAUGHTER-HOUSES. There are 14 licensed slaughter-houses in the district, of which 10 are annual licences. The slaughter-houses generally are kept in a good condition and the bye-laws well observed. Number of carcases inspected:— Sheep 3862 Bovine 2668 Pigs 1118 Calves 202 Lambs ••• 2780 DAIRIES, COWSHEDS, AND MILKSHOPS. 716 visits have been made to dairies, cowsheds, and milkshops, of which there are 39 dairies, 5 cowsheds, and 97 milkshops on the register, and the requirements under the Dairies, Cowsheds, and Milkshops Orders have been complied with without any statutory proceedings being necessary. 19 BAKEHOUSES. 128 visits have been made to bakehouses; the majority are kept in a satisfactory condition. Insanitary conditions have been dealt with where necessary and remedied by informal notices. MORTUARY. During the year the number of bodies received was 51, on 46 of which post-mortems were performed. PETROLEUM ACTS. To store Petroleum. To store Carbide of Calcium Licences renewed 43 8 New Licences granted after inspection of storage arrangements 12 — The work in connection with the Petroleum Acts is still growing, 219 visits of inspection having been made during the year. There are now 17 underground bulk storage installations in the district. PLACES OF PUBLIC ENTERTAINMENT. In accordance with the recommendation contained in the circular of the Ministry of Health, dated 25th August, 1920, 29 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. UNDERGROUND CONVENIENCES. 638 visits have been made to the three underground public conveniences, the management of which was transferred from the surveyor to the chief sanitary inspector. The general supervision of the men's is carried out by the district inspectors, and of the women's by the woman sanitary inspector. I am, Mr. Chairman, Madam and Gentlemen, Your obedient Servant, W. J. STEVENS. 20 DEATHS. CALENDAR YEAR 1923. CAUSES OF DEATH. Ages. Wards. 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 North. Central South. 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 24 All Causes Certified 1228 106 19 15 25 60 154 329 520 1395 322 104 150 91 107 188 144 113 111 131 73 16 1228 Uncertified ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric fever 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 2 1 ... ... 1 ... ... ... ... 3 ... ... ... ... ... ... ... ... 2 ... ... ... 2 Scarlet fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Whooping cough 5 1 2 2 ... ... ... ... ... 8 1 ... ... ... 1 ... 3 ... 1 ... ... ... 5 Diphtheria 4 ... ... 2 1 ... 1 ... ... ... 1 ... ... ... ... 2 1 ... 1 ... ... ... 4 Influenza 15 ... ... ... 1 1 5 4 4 18 3 4 2 1 ... 1 1 1 1 3 ... 1 15 Encephalitis lethargica 2 ... ... 1 1 ... ... ... ... 1 1 ... ... ... ... 1 ... 1 ... ... ... ... 2 21 Meningococcal meningitis 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... l Tuberculosis of respiratory system 108 1 ... ... 4 23 44 35 1 113 27 9 20 11 8 10 8 15 9 14 4 ... 108 Other tuberculous diseases 17 1 1 3 2 4 4 2 ... 27 8 ... 2 2 2 3 ... 2 2 2 9 ... 17 Cancer, malignant disease 163 ... ... ... ... 2 15 78 68 183 40 15 22 10 13 29 20 14 13 20 6 1 163 Rheumatic fever 3 ... ... ... 2 ... ... ... 1 5 2 1 ... 1 ... ... 1 ... ... ... ... 3 Diabetes 7 ... ... ... ... ... 2 2 3 12 2 1 2 ... ... 1 ... 2 ... 1 ... ... 7 Cerebral hæmorrhage, &c. 67 ... ... ... ... ... 1 13 53 72 12 6 7 5 5 13 13 5 6 3 4 ... 67 Heart disease 149 ... ... ... ... 6 11 45 87 109 20 15 20 9 17 19 21 10 13 16 9 149 Arteriosclerosis 27 ... ... ... ... ... 1 4 22 2 1 1 3 4 4 5 4 3 1 1 1 ... 27 Bronchitis 129 3 1 1 ... ... 2 32 90 133 30 13 17 10 15 15 10 13 8 15 12 1 129 Pneumonia (all forms) 79 9 6 2 2 2 11 20 27 86 10 4 10 8 5 11 9 7 6 10 7 2 79 Other respiratory diseases 18 ... ... 1 ... ... 2 5 10 22 4 4 ... 2 1 5 3 3 ... ... ... ... 18 Ulcer of Stomach or duodenum 8 ... ... ... ... ... 1 4 3 10 1 1 ... ... 1 1 ... 1 1 3 ... ... 8 Diarrhœa, &c. (under 2yrs.) 11 9 2 ... ... ... ... ... ... 16 5 1 2 1 1 2 ... ... ... 2 2 ... 11 Appendicitis and typhlitis 10 ... ... ... ... 2 2 6 ... 17 4 1 1 1 ... 2 2 2 ... 1 ... ... 10 Cirrhosis of liver 7 ... ... ... ... ... 3 4 6 2 ... ... ... 2 2 ... 1 1 1 ... ... 7 Acute & chronic nephritis 43 ... 1 ... 1 4 4 20 13 60 16 3 2 3 3 14 5 3 2 4 4 ... 43 Puerperal sepsis 6 ... ... ... ... 1 5 ... ... 7 5 ... 1 ... ... 3 1 ... 1 ... ... ... ... Other accidents & diseases of pregnancy & parturition 4 ... ... ... ... 1 3 ... ... 4 3 ... 1 ... ... 2 ... ... ... 1 ... ... 4 Congenital debility and malformation, premature birth 55 53 2 ... ... ... ... ... ... 13 11 2 8 3 5 7 4 6 8 6 5 1 55 Suicide 10 ... ... ... ... 1 5 1 3 6 2 ... 2 ... ... 4 ... 1 2 1 ... ... 10 Other deaths from violence 35 2 ... 1 3 5 3 10 11 39 16 3 6 4 1 7 4 2 5 ... 2 1 35 Other defined diseases 179 26 4 2 6 8 32 44 57 251 61 16 15 13 18 21 23 16 21 19 11 6 179 Causes ill-defined or unknown ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... Old age 63 ... ... ... ... ... ... 1 62 171 34 4 7 3 5 8 10 5 6 8 4 3 63 1228 106 19 15 25 60 154 329 520 1395 322 104 150 91 107 188 144 113 111 131 73 16 1228 Special Causes (included above) Poliomyelitis ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 22 INFANTILE MORTALITY, CALENDAR YEAR 1923. 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 2 Months. Total Deaths under 1 Year. All Causes Certified 37 12 1 7 57 21 12 10 6 106 Uncertified ... ... ... ... ... ... ... ... ... ... Small-pox ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... 1 1 Scarlet fever ... ... ... ... ... ... ... ... ... ... Whooping-cough ... ... ... ... ... ... ... ... 1 1 Diphtheria and croup ... ... ... ... ... ... ... ... ... ... Influenza ... ... ... ... ... ... ... ... ... ... Tuberculous meningitis ... ... ... ... ... ... ... ... 1 1 Abdominal tuberculosis ... ... ... ... ... ... ... ... ... ... Other tuberculous diseases ... ... ... ... ... ... 1 ... ... 1 Meningitis (not tuberculous) ... ... ... ... ... ... ... ... ... ... 23 Convulsions 1 1 2 1 1 1 1 6 Laryngitis Bronchitis 2 1 3 Pneumonia (all forms) 1 1 2 2 2 2 1 9 Diarrhoea 1 1 1 Enteritis 1 1 2 1 3 3 9 Gastritis 1 1 2 Syphilis 1 1 Rickets Suffocation, overlying 1 1 1 2 Injury at birth 1 1 1 Atelectasis 4 1 5 5 Congenital malformations 3 3 6 3 12 Premature birth 18 8 3 29 2 31 Atrophy, debility and marasmus 2 1 3 3 1 1 8 Other causes 7 1 8 1 1 1 1 12 Totals 37 12 1 7 57 21 12 10 6 106 Nett Births registered during the calendar year Legitimate 2,272 Illegitimate 56 Nett Deaths registered during the calendar year Legitimate infants 97 Illegitimate infants 9 4 newborn, unknown, 2 found in Epping Forest, off Whipp's Cross Road, 1 on Leyton Marshes and 1 in aqueduct, Lea Bridge Road 24 Cases of Infectious Disease Notified During the Year 1923, 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 10 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 North. Central South. Forest. Leytonstone Grove Green. Harrow Green. Cann Hall. Wanstead Slip. Small-pox Cholera (C) Plague (P) *Diphtheria (including membranous croup) 149 46 77 14 12 9 30 9 11 43 10 4 23 6 4 114 †Erysipelas. 36 2 1 1 3 16 8 5 1 7 4 3 2 1 2 8 6 2 13 ‡Scarlet fever 179 1 48 111 16 3 16 71 10 18 14 9 11 13 13 4 124 Typhus fever Enteric fever 2 1 1 1 1 1 Relapsing fever (R) Continued fever (C) Puerperal fever 12 1 11 2 2 1 l 3 1 2 12 Cerebro-spinal meningitis Poliomyelitis 4 1 2 1 1 3 3 Encephalitis lethargica 2 1 1 1 1 1 §Pulmonary tuberculosis 189 1 14 58 76 35 5 15 32 16 11 18 14 30 15 24 14 131 Other forms of tuberculosis 34 5 10 8 5 5 1 1 3 5 4 2 2 5 6 4 2 11 Ophthalmia neonatorum 12 12 1 4 1 1 2 1 2 5 Pneumonia 54 17 9 14 7 7 12 15 4 2 4 1 5 4 2 5 24 Dysentery Malaria Totals 673 17 103 232 110 137 55 19 57 164 50 51 89 40 59 77 55 31 439 * 3 cases occurred in Whipp's Cross Hospital (2 Nurses) and 1 case in Walthamstow Hospital. †2 cases occurred in Central Home. ‡3 cases occurred in Whipps Cross Hospital (1 Nurse), and 1 in Bethnal Green Schools. § 1 case occurred in Whipps Cross Hospital (Nurse). School Medical Service. TO THE CHAIRMAN AND MEMBERS of the LEYTON EDUCATION COMMITTEE. Mr. Chairman, Ladies and Gentlemen, I' have the honour to present to you the 16th Annual Report of the School Medical Service in Leyton as required by the Education (Administrative Provisions) Act of 1907. The work during; the year, as will be seen from a perusal of the accompanying" report, has continued to be satisfactory. The numbers examined in the "Entrant" and "Intermediate" Groups are somewhat below the average, as outbreaks of Measles and Chickenpox seriously interfered with the attendance during" the winter months. I have the pleasure of again thanking you for the assistance and courteous consideration which you have extended to me and to my colleagues. 1 have also to thank the members of my Staff for their efficient and enthusiastic work throughout the year, and all other Council Officials for their valuable and ready help at all times. I have the honour to remain, Your obedient Servant, J. FRANCIS TAYLOR,, Medical Officer of Health and School Medical Officer. 28 STAFF. School Medical Officer.— J. Fiancis Taylor, M.R.C.S. (Eng.), D.F.H. (London). Assistant School Medical Officers.— Cecilia McEwan Martin, M.B., Ch.B. (Glasgow); John Kennedy, M.B., Ch.B. (Glasgow) (part-time). School Oculist.— Lizzie Smith-Clark, M.B., Ch.B. (Edinburgh). Dentists.— Percy Chandler, L.D.S., R.C.S. (Eng.); James E. Horton, L.D.S., R.C.S. (Eng.). School Nurses.— D. Crawford, M. Sykes, M. Maye, E. W. Walling (part-time). SCHOOL NURSES. There are three whole-time school nurses, and one who is partly employed in the dental department and partly as a health visitor. The arrangement of duties, having been found satisfactory, remains the same as reported last year. One nurse attends the Town Hall clinic in the mornings, and attends school medical inspection or visits in the afternoons. Another attends school medical inspection mornings and afternoons. And the third conducts "surveys of cleanliness," visits cases that require following up, and prepares the children in the school (weighing and measuring) prior to the visit of the school medical officer. Each whole-time school nurse changes duties at the beginning of every month. SCHOOL MEDICAL INSPECTION. The inspection of the children is usually conducted in the teachers' room or alternatively in a classroom specially appropriated for the purpose. The necessary light and quiet for efficient examination and the maximum comfort is thereby ensured. It is the regular practice to issue notices two or three days in advance relative to routine inspections, and it has to be recorded that over 85 per cent. of the children examined are 29 accompanied by their parents. Parents undoubtedly continue to appreciate the value of school medical inspection and display marked eagerness to obtain medical advice regarding their children. The interest of the parent augurs well for the future health of the community. The interest of the parent is also ably seconded by the interest of the teachers. The co-operation of the teachers must be recognised as of the utmost value. "A sound mind in a sound body" is a maxim the truth of which is fully realised, and the educational aspect of medical inspection will ultimately assume its proper place. HEALTH OF THE CHILDREN. The general health of the school children is on the whole good. A slight improvement has to be recorded since the previous year. With the gradual passing of the acute economic depression which followed the boom period of 1919, a gradual return to a more normal state of health is probably to be expected. It is noticeable, however, that "Entrants" continue to be underweight. The number of "Entrants" examined during the year under review is below the average, as a result of much though mild infection during the winter months, and not as one might imagine as a sequence of a low birth-rate in 1917. MINOR AILMENT CLINIC. This clinic is conducted at the Town Hall every morning by the school medical officer. Treatment is carried out by the nurse on duty under his direction. By arrangement, a nurse from the Essex County Nursing Association usually also attends this clinic, and in return for instruction assists the nurse on clinic duty. As in former years, children found with defects by the school medical officer, children found to have obvious defects by the teacher, and children found to be verminous by the nurse at the "head inspections" in the school are given clinic cards and attend the clinic. 30 Attendances and treatment are entered in a register and on special record cards. During the year under review, 2,199 individual children attended. The following is a record of the attendances at) the clinic:— For diseases of the eyes 1,825 For diseases of the ears 825 For ringworm 542 Miscellaneous 6,153 Total 9,345 Although fewer individual children attended the clinic, a greater number of attendances have been registered. Treatment during the first 14 days is free. Cases which require further treatment are charged for according to the income of the parents. No charge, however, is made in the case of necessitous children. EYE CLINIC. This clinic is held on Wednesday and Friday mornings at the Town Hall. Cases are selected by the school medical officers at the routine examinations in the schools, or are referred by the teachers as "specials," and are then examined by appointment. The oculist has subjected to refraction 1,046 cases during the year. Spectacles were prescribed under the Authority's scheme in 995 cases, and in 934 cases were actually purchased. Good work is being done especially in cases of squint, in which it is essential to have early treatment. The oculist also sees children suffering from external conditions of the eye when they are referred from the school clinic. A local optician contracts with the Council to supply spectacles and attends at the Town Hall on Monday afternoons to fit and to repair broken glasses. DENTAL CLINIC. The dental clinic is held every morning and every afternoon at the Town Hall, Wednesday mornings and Fridays excepted. 31 Two dentists are in attendance. The children are inspected in school (routine examination) and selections made for treatment. Originally a nominal fee of 6d. was charged, and this entitled a child to treatment for one year. Thereby a most efficient scheme was established, and a child's teeth were attended to during its whole school career. Unfortunately, as the result of the Board of Education's communication, the fee was raised to 2s. This, coupled with the issue of a form to be completed in necessitous cases, led to a rapid diminution in the number of acceptances. For example, at the last school inspected—Downsell Road—out of 252 cases referred for treatment only 38 accepted (about 15 per cent.), whereas formerly at least 50 per cent accepted. With the abolition of the forms and the reduction of the fee to 1s., it is to be hoped that the dental service will be restored to its former satisfactory condition. TREATMENT OF UNCLEAN LI NESS. On an average six schools are allotted to each whole-time school nurse for the purpose of head inspection. Each school has been visited three times, as in the previous year. The total number of children examined by the nurses in the year was 47,074. The number of individual children found unclean was 3,301, of which G93 were referred to the clinic at the Town Hall. Soaking the hair with oil and combing with Sacker's hygienic comb still proves the most rapid and effective method of removing nits. Several of these combs are in use at the clinic, and are lent to the parents with printed directions for their use. Parents are continuing to purchase this comb from the patentee. The cost of the comb has recently been reduced to 3s. 8d. Arrangements at the same time have been made for the supply of combs in necessitous cases at 2s. l1d. The number of cases of dirty heads reported to the Education Committee was 21, this number being considerably less than the number represented for the previous year. Ten parents were prosecuted, and the fines inflicted with costs amounted to £4 10s. 0d. 32 TONSILS AND ADENOIDS. Enlarged tonsils and the presence of adenoids is one of the most common conditions met with during medical inspection. In some cases where there is only a trace of adenoids medical treatment and breathing exercises are recommended, but very often otorrhcea accompanies the condition. Queen Mary's Hospital for the East End continues to treat cases referred from the Leyton Schools for an inclusive fee of l1s. per case. 204 cases have been operated on, and the results are quite satisfactory. 193 cases were treated by private practitioners, or by other hospitals, and 95 received other forms of treatment. After the operation a course of breathing exercises is recommended, but this is seldom carried out in the homes. It is hoped that when the need for economy is less stringent the Education Committee will consider the appointment of a teacher of remedial exercises. RINGWORM OF THE SCALP. The only satisfactory method of treating ringworm of the scalp is by X-rays. During the year 95 cases of ringworm of the scalp have been noted. Several of these refused X-ray treatment, and were treated otherwise. Fifty-six were referred to the Queen's Hospital, Hackney Road, but only 45 actually accepted treatment. TUBERCULOSIS IN THE SCHOOLS. In the course of medical inspection, very few cases of definite pulmonary tuberculosis were found. When a definite diagnosis was made the child was immediately excluded from school and referred to the Dispensary or to a local practitioner. It is unfortunate, however, that in some cases the parents would not agree to their children being sent to sanatoria for treatment. In doubtful cases the child was referred to the Dispensary and kept under observation. Cases where there is so much chronic bronchitis that diagnosis is difficult, are also kept under observation and referred to the school clinic. Advice is given in every case regarding fresh air, sunlight, food, and exercises. 33 EXCEPTIONAL CHILDREN. Mentally defective, physically defective, epileptic, blind and deaf children are all included under the heading of "exceptional children." Arrangements have been made with other Authorities, as in former years, for the accommodation of such children pending the introduction of special schools or classes in the Leyton area. The education of the mentally defective is now being realised as of the utmost economic importance. Experiments prove that it is possible to educate the definitely feeble-minded child along lines which will enable it to be self-supporting on reaching maturity. The labour involved must necessarily be exceedingly painstaking, but should not be without its due reward. The desired object can only be attained by the provision of special teachers and special schools. The expenditure involved must be considerable, but can be easily justified on many grounds. In this connection a Spccial Sub-Committee has already been appointed. TREATMENT OF OTHER DEFECTS. As in former years, cases that are unsuitable for clinic treatment are referred ot the general hospitals within easy reach of Leyton, or to the local general practitioners. When a child is found to have a defect at school medical inspection, a following-up card is made out at the time and the case is visited at short intervals by the school nurses till treatment is obtained. A note of the result of each visit is made on the card, and the case is only closed when satisfactory treatment has been obtained. The school nurses have visited 1,254 cases during the year, and it is to be recorded that very satisfactory results have been attained. SCHOOLS IN GENERAL. In general, the schools are in a satisfactory condition as regards cleanliness of the schoolrooms, playground and offiees. 34 Kirkdale Road School was reported during the year as requiring cleaning and certain repairs to fires and paving of passage, but apart from the cleaning, nothing further was done on the grounds of economy. High Road School was closed on 31st March, the children being accommodated in either Farmer Road or Capworth Street Schools. OPEN AIR SCHOOLS. So far no provision has been made for open-air schools. Schools for delicate children in the open air are strongly recommended by the Boarcf of Education, and the subject has been repeatedly under consideration, but owing to the need for economynothing has yet been done, as the necessary expenditure could not be authorised. In addition to the provision of open-air schools, adequate arrangements would also require to be provided for the special feeding of the children in order to ensure maximum benefit. The provision of a hot meal in addition to milk would be desirable. An experiment is being conducted at Downsell Road School. The infant mistress, largely on her own initiative, has established an open-air class for the delicate children in her department. The selection of the children is approved by the school medical officer and inspections are carried out at each visit to the school. Although no adequate provision has been made and the conditions might be described as primitive, the children attending the class are undoubtedly benefiting by being in the open a.ir during school hours. The value of an open-air class to the health of delicate children is of the utmost importance, and the provision of an openair school is one which should receive immediate and favourable consideration. EDUCATION (PROVISION OF MEALS) ACT. The cookery centres at Capworth Street and Mayville Road were open during the year, and provided dinners for necessitous children. The centres have been visited by the medical officer. 35 The meals are served under the supervision of women assistants specially employed for this purpose, who are also responsible for the cleanliness of the dining' room and the washing of the dishes, etc. The diet sheets are submitted to and approved by the school medical officer. Children are provided with free meals on the recommendation of the assistant school medical officers or the head teachers. The number of children for whom meals have been provided as compared with previous years is as follows — Table I.—Return of Medical Inspections. (a) Routine Medical Inspections. Number of Code Group Inspections: Entrants 1435 Intermediates 1951 Leavers 1994 Total 5380 Number of other Routine Inspections: (b) Other Inspections. Number of Special Inspections 2708 Number of Re-inspections 7065 Total 9773 Average weekly number of children fed (Dinners only) for years 1914-1923 is as follows:— 1923. 1922. 1921. 1920. 1919. 1918. 1917. 1916. 1915. 1914 74 263 276 55 42 53 72 54 90 312 36 TABLE II. A.— Return of Defects found by Medical Inspection in the Year ended 31st December. Defect or Disease. Routine Inspections. Special Inspections. No. of Defects. No. of Defects. Number requiring Treatment. Number requiring to be kept under observation, but not requiring Treatment. Number requiring Treatment. Number requiring to be kept under observation, but not requiring Treatment. (1) (2) (3) (4) (5) Malnutrition 6 22 5 Uncleanliness 57 748 (See Table IV, Group V). Skin Ringworm— Scalp 6 - 89 - Body 3 - 107 - Scabies 1 - 46 - Impetigo 19 442 - Other Diseases (Non-Tuberculous) 24 1 182 — Eye Blepharitis 16 99 Conjunctivitis 3 48 Keratitis 1 3 Corneal Opacities 1 2 Defective Vision (excluding Squint) 401 2 70 3 Squint 33 4 4 1 Other Conditions 8 — 33 — Ear Defective Hearing 4 9 3 Otitis Media 20 6 9 — Other Ear Diseases 11 3 132 — Nose and Throat Enlarged Tonsils only 250 51 45 1 Adenoids only 76 54 82 9 Enlarged Tonsils and Adenoids 158 18 184 1 Other Conditions 7 1 28 1 Enlarged Cervical Glands (Non-Tuberculous) 32 8 4 — Defective Speech 5 — 2 — Teeth—Dental Diseases 147 — 13 — (See Table IV, Group IV) Heart and Circulation Heart Disease— Organic 15 13 2 — Functional 58 164 11 1 ;Ancemia 277 15 51 8 Lungs Bronchitis 77 7 2 — Other Non-Tuberculous Diseases 72 55 9 9 Tuberculosis ■ Pulmonary— Definite 8 — 2 — Suspected 24 36 53 6 Non-Pulmonary— Glands 6 1 3 — Spine — — 1 — Hip — — — — Other Bones and Joints 1 — 3 — Skin — — — — Other Forms 1 — — — Nervous System Epilepsy 1 — 2 1 Chorea 8 — 14 2 .Other Conditions 14 7 18 7 Deformities Rickets 2 — 3 — Spinal Curvature 3 — 1 — Other Forms 8 — 3 — Other Defects and Diseases 107 9 352 6 37 B.— Number ok individual Children found at Routine Medical Inspection to require Treatment (excluding Uncleanliness and Dental Diseases). Group. Number of Children. Percentage of Children found to require treatment. Inspected. Found to require treatment. (1) (2) (3) (4) Code Groups— Entrants 1435 429 29-9 Intermediates 1951 551 28-2 Leavers 1994 601 30 1 Total (Code Groups) 5380 1581 29 4 Other Routine Inspections 38 TABLE III.— Return of all Exceptional Children in the Area. — — — Boys. Girls. Total. Blind (including partially blind). (1) Suitable for training in a school or class for the Totally Blind. Attending Certified Schools or Classes for the Blind 4 — 4 Attending Public Elementary Schools At other Institutions — — At no School or Institution — — — (2) Suitable for training in a school or class for the Partially Blind. Attending Certified Schools or Classes for the Blind — — — Attending Public Elementary Schools 3 4 7 At other Institutions — — — At no School or Institution 1 1 2 Deaf (including deaf and dumb and partially deaf). (1) Suitable for training in a school or class for the Totally Deaf or Deaf and Dumb. Attending Certified Schools or Classes for the Deat 7 6 13 Attending Public Elementary Schools — — — At other Institutions — — At no School or Institution — — (2) Suitable for training in a school or class for the Partially Deaf. Attending Certified Schools or Classes for the Deaf — — — Attending Public Elementary Schools — 8 8 At other Institutions — — — At no School or Institution — — — Mentally Defective. Feebleminded (cases not notifiable to theLocalControlAuthority) Attending Certified Schools for Mentally Defective Child-ren 2 7 9 Attending Public Elementary Schools 47 23 70 At other Institutions 2 2 4 At no School or Institution 4 3 7 Notified to the Local Control Authority during the year Feebleminded — — — Imbeciles — — — Idiots — — — Epileptics. Suffering from severe Epilepsy. Attending Certified Spccial Schools for Epileptics 3 2 5 In Institutions other than Certified Special Schools — — — Attending Public Elementary Schools 4 1 5 At no School or Institution 1 2 3 Suffering from Epilepsy which is not severe. Attending Public Elementary Schools 8 2 10 At no School or Institution — — — 39 — — Boys. Girls. Total. Physically Defective. Infectious Pulmonary and GlandularTuberculosis. At Sanatoria or Sanatorium Schools approved by the Ministry of Health or the Beard — — — At other Institutions 1 — 1 At no School or Institution 7 6 13 Non - Infectious but active Pulmonary and GlandularTuberculosis. At Sanatoria or Sanatorium Schools approved by the Ministry of Health or the Board — — — At Certified Residential Open Air Schools — — — At Certified Day Open Air Schools — — At Public Elementary Sohools 38 35 73 At other Institutions 3 2 5 At no School or Institution — — — Delicate children (e.g. pre or latent Tuberculosis, Malnutrition, Debility Anæmia, etc.) At Certified Residential Open Air Schools — — — At Certified Day Open Air Schools — — — At Public Elementary Schools — — — At other Institutions — — — At no School or Institution — — — Active Non-Pulmonary Tuberculosis. At Sanatoria or Hospital Schools approved by the Ministry of Health or the Board — — — At Public Elementary Schools 15 11 26 At other Institutions 5 1 6 At no School or Institution 4 4 8 Crippled children (other than those with active Tuberculous disease,) e.g. children suffering from Paralysis,&c., and including those with severe Heart Disease. At Certified Hospital Schools — — — At Certified Residential Cripple Schools 1 2 3 At Certified Day Cripple Schools — — — At Public Elementary Schools 22 25 47 At other Institutions — — — At no School or Institution 6 5 11 40 TABLE IV.— Return of Defects treated during the Year ended 31st December. TREATMENT TABLE. Group I.— Minor Ailments (excluding Uncleanliness, for which see Group V). Number of Defects treated, or under treatment during the year. Disease or Defect. Under the Authority's Scheme. Otherwise. Total. (1) (2) (3) (4) Skin— Ringworm—Scalp 86 86 Ringworm—Body 101 101 Scabies .12 42 Impetigo 430 430 Other skin disease 182 182 Minor Eve Defects— (external and other, but excluding cases falling in Group (II) 174 13 187 Minor Ear Defects 130 43 173 Miscellaneous— eg-, minor injuries, bruises, sores, chilblains, etc.) 319 35 354 Total 1464 91 1555 41 Table IV (contd.). Group II.— Defective Vision and Squint (excluding Minor Eye Defects treated as Minor Ailments—Group I). Number of Defects Dealt with. Defect or Disease. Under the Authority's Scheme. Submitted to refraction by private practition'r or at hospital, apart from the Authority's Scheme. Otherwise. Total. (1) (2) (3) (4) (5) Errors of Refraction (including Squint) (Operations for squint should be recorded separately in the body of the Report) 1046 31 22 1099 Other Defect or Disease of the eyes (excluding those recorded in Group I) 7 8 — 15 Total 1053 39 22 1114 Total number of children for whom spectacles were prescribed (a) Under the Authority's Scheme 995 (b) Otherwise 14 Total number of children who obtained or received spectacles (a) Under the Authority's Scheme 934 (b) Otherwise 14 Group III.— Treatment of Defects of Nose and Throat. Number of Defects. Received Operative Treatment. Under the Authority's Scheme in Clinic or Hospital. By Private Practitioner or Hospital, apart from the Authority's Scheme. Total Received other Forms of Treatment. Total Number Treated. (1) (2) (3) (4) (5) 204 193 397 95 492 42 TABLE IV. Group IV.— Dental Defects. (1) Number of children who were:— (a) Inspected by the Dentist: Aged: Routine Age Groups 5 1,791 Total 15,365 , 6 1,942 7 8 1,846 2,020 9 1,979 10 1,720 11 1,590 12 1,250 13 994 14 233 Specials 236 Grand Total 15,601 (b) Found to require treatment 9,917 (c) Actually treated 4,939 (d) Re-treated during the year as the result of periodical examination 516 (2) Half-days devoted to Inspection 90 Treatment 273 Total 363 (3) Attendances made by children for treatment 5,455 (4) Fillings Permanent Teeth 4,689 Temporary Teeth 2,653 Total 7,342 (5) Extractions Permanent Teeth 420 Temporary Teeth 4,752 Total 5,172 (6) Administrations of general anæsthetics for extractions 146 (7) Other operations Permanent Teeth 250 Temporary Teeth 135 Total 385 Group V.— Uncleanliness and Verminous Conditions. (I) Average number of visits per school made during the year by the School Nurses 3 (II) Total number of examinations of children in the Schools by School Nurses 47,074 (III)Number of individual children found unclean 3,301 (IV) Number of children cleansed under arrangements made by the Local Education Authority No scheme in operation (V) Number of cases in which legal proceedings were taken: (a) Under the Education Act, 1921 Nil (b) Under School Attendance Bye-Laws 10