10 LEY 34 Bourough of Leyton. HEALTH REPORT FOR THE YEAR 1940 ANDREW W. FORREST, M.A., M.D., Ch.B., D.P.H., Medical Officer of Health, School Medical Officer, :: Medical Superintendent of Isolation Hospital. :: 1 HIS WORSHIP THE MAYOR (Mb. Alderman A. G. Cochrane, J.P.), ex-officio Member of Committees. PUBLIC HEALTH COMMITTEE: DISEASES OF ANIMALS ACT COMMITTEE. Chairman : Alderman Shimmin, B.Sc. Members : Alderman Bechervaise. Councillor Mrs. Crown. „ Mrs. Hammond. „ Flack. „ Mrs. Mawer. „ Gowar. „ Mrs. Shimmin. „ Hinton, J.P. Councillor Bass. „ Levy. „ Bell. „ Rayner. „ Rigg. MATERNITY AND CHILD WELFARE COMMITTEE. Chairman : Alderman Mrs. Shimmin. Members : Alderman Fitzgerald. Councillor Hurry. „ Mrs. Hammond. „ Mrs. King. „ Mrs. Mawer. „ Leonard. Councillor Mrs. Crown. „ Turner. „ Whatnall. Co-opted Members : Mrs. Burrell. Mrs. Sortwell. „ Martin. „ Waller. „ Mereday. EDUCATION COMMITTEE. Chairman : Alderman Bechervaise. Members : Alderman Fitzgerald. Councillor Hinton, J.P. „ Mrs. Hammond. „ Mrs. King. „ Shimmin, B.Sc. „ Levy. „ Mrs. Shimmin. „ Pearce. Councillor Allanson, J.P. „ Rayner. „ Burrell. „ Rigg. „ Hawkins (W. F.). „ Turner. Co-opted Members : Mrs. A. G. Cochrane. Mrs. Waller. „ Dare. Mr. W. C. Russell, J.P. „ Ringer. „ Reid. 2 Borough of Leyton. PUBLIC HEALTH OFFICERS OF THE AUTHORITY. A. MEDICAL—Whole Time. *Forrest, Andrew W., M.A., M.D., M.B., Ch.B., D.P.H., Medical Officer of Health School Medical Officer, Medical Superintendent of Isolation Hospital. *Rennie, James Little, M.B., Ch.B., F.R.F.P.S.(Glasg.), D.P.H., Deputy Medical Officer of Health and Deputy School Medical Officer. *Menzies, Hllda F., M.D., M.B., Ch.B., D.P.H., Assistant Medical Officer of Health (Maternity and Child Welfare). *Gilchrist, Mary Lyle, M.D., M.B., Ch.B., D.P.H., Assistant Medical Officer of Health. MEDICAL—Part Time. *Cardell, John Douglas Magor, M.B., B.S. (Lond.), F.R.C.S. (Eng.), M.R.C.S., L.R.C.P., Ophthalmic Surgeon. *Howell, Bernard Whitchurch, M.B., B.S. (Lond.), F.R.C.S. (Eng.), M.R.C.S., L.R.C.P. (Lond.), Orthopædic Surgeon. *Brews, Richard Alan, F.R.C.S. (Eng.), M.D. (Lond.), M.S., M.B., B.S., M.R.C.P., (Lond.), M.R.C.S. (Eng.), L.R.C.P. (Lond.), Consultant Obstetrician. *Sandiford, Cyril Ratcliffe, M.D. (Manch.), M.B., Ch.B., F.R.C.S. (Ed.), Aural Surgeon. (Died August, 1940.) Magauran, Wilfrid Henry Bertram, M.D., N.U.I., M.Ch., B.Ch., B.A.O., F.R.C.S. (Eng.), Aural Surgeon. (Commenced 27.11.40.) *Elman, Claude, M.l). (Lond.), M.B., B.S., M.R.C.P. (Lond.), M.R.C.S. (Eng.), L.R.C.P. (Lond.), Physician i/c Heart Clinic. *Clark, Annie Simpson, M.B.. Ch.B., Medical Officer i/c Post Natal and Gynaecological Clinic. B. DENTAL SURGEONS. Senior Dental Surgeon. Hall, Arthur Edward, L.D.S. (Liverpool). Dental Surgeons. *Horton, James Ernest, L.D.S., R.C.S. (Eng.). *Grant, David Reginald Brash, L.D.S., R.C.S. (Edin.). (Died 30.1.1040.) C. SANITARY INSPECTORS. Senior Sanitary Inspector. *Gray, Edward Henry, Certificate R.S.I., Meat Inspector's Certificate R.S.I. Sanitary Inspectors. *Steeden, Edward James, Certificate R.S.I., Meat Inspector's Certificate R.S.I. *Smith, Victor Wynn, Certificate R.S.I., Meat Inspector's Certificate R.S.I. *Reeves, Reginald Alfred, Certificate R.S.I., Meat Inspector's Certificate R.S.I. *Reeve, Frederick William, Certificate R.S.I., Meat Inspector's Certificate R.S.I. *Barnes, Arthur Edward, Certificate R.S.I., Meat Inspector's Certificate R.S.I. *Nightingale, A. G., Certificate R.S.I., Meat Inspector's Certificate R.S.I. *Waring, John Edwin, Certificate R.S.I., Meat Inspector's Certificate R.S.I. *Sadler. Frederick Albert, Certificate R.S.I., Meat Inspector's Certificate R.S.I. D. NURSING STAFF. Matron. Borough Isolation Hospital. Murphy, Elizabeth, S.R.N., S.R.F.N. 3 Health Visitors. *Bratton, Maud, S.R.N. (Retired 31.1.40). * Walling, Ethel Winifred, S.C.M., S.R.N., Health Visitor's Certificate R.S.T. *Kitterhing, Margery, S.C.M., S.R.N.. Health Visitor's Certificate R.S.I. *Sizer, Agnes, S.R.N., S.C.M., Health Visitor's Certificate R.S.I. *Hughes, Emily Dobeen, S.R.N., S.C.M., Health Visitor's Certificate R.S.I. (Resigned 5.7.40). *Norman, Joyce H., S.R.N., S.C.M., Health Visitor's Certificate R.S.I. *Roger, Margaret, S.R.N., S.C.M., Health Visitor's Certificate R.S.I. School Nurses. *Crawford, Daisy, S.R.N., Health Visitor's Certificate R.S.T. *Sykes, Martha, S.R.N. *Maye, Marie, S.R.N., Health Visitor's Certificate R.S.I. *Edwards, Ruth, S.R.N., S.C.M. *Stiles, Eleanor, S.R.N., S.C.M. *Corby, Elizabeth, S.R.N. *Acton, Lucy, S.R.N., S.C.M. Municipal Midwives. Robebts, Elizabeth, S.R.N., S.C.M. Daines, Emily, S.R.N.. S.C.M. Thompson, Mabel, S.R.N., S.C.M. E. OTHER STAFF. Analysts under the Food and Drugs Act. Dyer, Bebnard, D.Sc., F.I.C. Taylor, George, F.I.C. Veterinary Inspector under the Diseases of Animals Act. Scott, Eustace Edward, M.R.C.V.S. Masseuse. *Findlay, Mtss A. E., Cert. Chartered Society of Massage, etc. Chiropodists. O'Brien, John, M.I.S.Ch. Stokes, Miss Florence, M.I.S.Ch. (Resigned 31.12.1940). Orthoptist. *Smith, Miss Glennis. Dental Attendant. *Grimshaw, Miss Peggy. Mortuary Keeper. Miles, Esau George. F. CLERICAL STAFF. Chief Clerk. *Reserve, George Frederick. Clerks. Jacobs, E. E. Softley, W. D. Brighting, G. Halsey, C. S. Freeman, A. L. Thurlow, G. Clarke, J. Ware, F. C. Lamb, E. E. *Hayes, Miss A. (Resigned 31.3.1940). *Payne, Miss W. Brighton, Mtss I. (Commenced 15.6.40). * Proportion of Salary contributed under Public Health Acts or by Exchequer Grants. 4 TO THE MAYOR, ALDERMEN AND COUNCILLORS OF THE BOROUGH OF LEYTON. Mr. Mayor, Ladies and Gentlemen, In accordance with the direction of the Ministry of Health and the Board of Education, this Report during the war period has been shortened as far as possible. Since the outbreak of war the arrangements for Civil Defence, and especially the duties connected with the A.R.P. Casualty Service, have imposed a very heavy responsibility and burden on the staff of your Health Department; but as the Ministry of Health do not include these activities and duties among the subjects to be dealt with in Annual Reports by Medical Officers of Health, no reference is made to them in the following report. In view of the national emergency the Registrar General was unable to supply the official population figures for the year 1939 in time for the section dealing with Vital Statistics to be included in last year's annual report. The vital statistics for the year 1939 are therefore included along with those for the year under review (1940). In addition to their normal official duties by day, all members of your medical staff, along with certain members of your nursing, sanitary and clerical staff have voluntarily undertaken, as their contribution to the national emergency, duties in connection with your A.R.P. Casualty and other Civil Defence Services which have entailed their being available for duty almost continuously day and night. I have been greatly impressed by the cheerful devotion to duty shown by these members of the staff during the trying times since the outbreak of war ; and I am grateful for the loyal cooperation and industry of all members of my staff in surmounting the many difficulties which have arisen during the year under review. It is my privilege to acknowledge again the support accorded to me by the Chairmen and Members of the Committees concerned with the work of the Health Department. I have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your obedient servant, 5 Extract from Vital Statistics for the years 1939 and 1940. 1939. 1940. Live Births:— Legitimate Males 717 673 Females 729 645 Illegitimate Males 30 18 Females 23 17 Totals 1,499 1,353 Birth Rate per 1,000 of population 12.90 14.02 Stillbirths:— Males 20 24 Females 15 21 Rate per 1,000 total (live and still) births 22.81 32.18 Deaths:— Males 623 865 Females 619 698 Totals 1,242 1,563 Death Rate per 1,000. 11.21 16.2 Number of women dying from diseases and accident; of pregnancy and childbirth:— From Sepsis 1 1 From other causes 3 1 Rate per 1,000 total (live and still) births 2.61 1.43 Death rate of infants under one year of age:— All infants per 1,000 live births 31.65 39.03 Legitimate infants per 1,000 mate live births 29.28 36.91 Illegitimate infants per 1,000 mate live births 94.34 114.28 Deaths from Cancer (all ages) 186 196 „ ,, Measles (all ages) Nil Nil ,, „ Whooping Cough (all ages) Nil Nil ,, ,, Diarrhœa (under 2 year of age) 3 5 6 TABLE 1. Registered Births, 1939. Leyton. Lea Bridge. Central North. Central South. Forest. Leytonstone. Grove Green. Harrow Green. Cann Hall. Wanstead Slip. Total. January 2 8 3 8 5 8 2 9 1 3 49 February 4 7 5 4 7 6 6 5 7 4 55 March 7 7 5 5 7 6 4 10 3 5 59 April 3 3 2 6 6 9 6 5 10 6 56 May 3 5 9 5 6 10 3 2 2 1 46 June 5 8 7 3 6 7 7 5 2 5 55 July 2 5 5 — 10 2 5 2 6 2 39 August 2 8 3 5 12 7 5 6 4 4 56 September 4 6 4 1 9 10 6 4 5 8 57 October 2 7 2 1 4 9 3 5 6 6 45 November 4 7 4 7 4 4 2 2 5 6 45 December 3 7 4 3 4 4 7 4 5 2 43 Transferables 69 154 86 75 146 113 74 76 55 46 894 Totals 110 232 139 123 226 195 130 135 111 98 1499 7 TABLE 2. Registered Births, 1940. Leyton. Lea Bridge. Central North. Central South. Forest. Leytonstone. Grove Green. Harrow Green. Cann Hall. Wanstead Slip. Total. January 5 5 6 3 11 3 5 9 3 9 59 February 1 7 4 8 10 8 9 7 10 8 72 March 2 5 4 11 10 7 8 13 4 4 68 April 7 6 6 4 8 6 3 5 4 5 54 May 1 7 7 7 8 8 5 9 9 7 68 June 6 7 4 6 3 8 2 6 9 4 55 July 3 4 6 11 7 5 5 3 4 1 49 August 3 5 5 5 4 8 8 3 5 2 48 September 4 6 3 8 5 8 7 9 4 6 60 October 5 8 8 1 14 3 7 7 4 2 59 November 3 2 6 1 1 3 2 6 2 4 30 December 3 5 1 2 4 2 1 — 3 2 23 Transferables 57 122 66 86 101 77 56 49 52 42 708 Totals 100 189 126 153 186 146 118 126 113 96 1353 8 TABLE 3. CAUSES OF DEATH AT DIFFERENT PERIODS OF LIFE IN THE BOROUGH OF LEYTON, 1930. Ages at Death in Years. Wards. CAUSES OF DEATH. Male. Female. Total 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 years and upwards. In Public Institutions in the District. Leyton. Lea Bridge. Central North. Central South. Forest. Leytons tone. Grove Green. Harrow Green. Cann Hall. Wanstead Slip. Ward not known. 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 25 Typhoid Fever ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Scarlet fever 1 ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... Whooping cough ... ... ... ... ... ... ... ... ... ... ... 5 ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria 2 1 ... ... ... 2 1 ... ... ... ... 1 1 ... 1 2 ... ... ... ... ... ... ... ... Influenza 10 13 ... ... ... 1 1 3 2 7 9 6 3 3 2 3 4 2 3 2 3 ... ... Encephalitis lethargica 2 ... ... ... ... ... ... ... 2 ... ... 6 ... ... 1 ... ... 1 ... ... ... ... ... ... Cerebro-spinal fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Tuberculosis of respiratory ... system 32 24 ... ... ... ... ... 10 22 18 6 95 15 5 9 4 3 10 3 4 5 10 3 ... Other tuberculous diseases 5 2 ... 1 1 ... 1 1 1 2 ... 16 4 ... ... ... ... ... ... 2 2 1 2 ... 9 Syphilis 3 ... ... ... ... ... ... ... ... 3 ... ... 1 ... 1 ... ... ... 1 ... 1 ... ... ... General paralysis of the insane, tabes dorsalis 2 ... ... ... ... ... ... ... ... ... 2 1 ... 1 ... ... ... ... ... ... ... 1 ... ... Cancer, malignant disease 101 85 ... ... ... 2 ... ... 14 75 94 308 60 13 28 11 24 26 25 13 15 23 8 ... Diabetes 4 11 ... ... ... ... ... ... 1 4 10 22 5 2 4 3 ... ... 3 ... 1 ... 2 ... Cerebral hemorrhage, etc. 43 60 ... 2 ... ... ... ... 3 23 75 146 33 7 12 11 11 16 11 5 9 14 7 ... Heart disease . 160 187 ... ... ... ... 1 1 11 74 260 416 67 36 40 24 39 48 48 28 27 37 16 4 Aneurysm 3 1 ... ... ... ... ... ... 1 3 ... 2 ... ... ... ... ... 2 ... ... ... 1 1 ... Other circulatory diseases 23 27 ... ... ... ... ... ... ... 12 38 40 17 3 9 3 6 9 6 3 4 3 4 ... Bronchitis 21 22 ... 2 ... ... ... ... 2 11 28 112 12 5 2 5 3 4 10 5 6 3 ... Pneumonia (all forms) 39 30 ... 6 1 1 2 1 4 25 29 117 21 7 14 3 9 10 3 4 4 11 4 ... Other respiratory diseases 2 2 4 ... ... ... ... ... ... 4 ... 10 2 3 ... ... ... ... 1 ... ... ... ... ... Peptic ulcer l5 4 ... ... ... ... ... ... 2 9 8 25 7 1 3 ... 3 1 3 2 5 1 ... ... Diarrhœa, etc. 3 ... ... 3 ... ... ... ... ... ... 18 ... ... ... 1 ... l 1 ... ... ... ... ... Appendicitis 1 3 ... ... ... ... ... 1 ... ... 3 15 ... 1 ... ... 1 l 1 ... ... ... ... ... Cirrhosis of liver 2 1 ... ... ... ... ... ... ... 1 2 ... 1 ... l ... 1 ... 1 ... ... Other diseases of liver, etc. 2 4 ... ... ... ... ... ... ... 2 4 4 1 1 1 ... o I ... ... ... ... ... ... Other digestive diseases 12 12 ... ... ... ... ... ... 5 8 11 26 4 3 2 2 l 4 4 1 3 1 3 ... Acute and chronic nephritis 10 11 ... ... ... ... ... ... 1 12 8 48 8 1 4 3 l 4 4 2 ... 1 1 ... Puerperal sepsis ... 1 ... ... ... ... ... ... 1 ... ... 2 1 1 ... ... ... ... ... ... ... ... ... ... Other puerperal causes ... 3 ... ... ... ... ... 1 2 ... ... 4 1 1 2 ... ... ... ... ... ... ... ... ... Congenital debility, ture birth, malformations, etc. 17 11 ... 28 ... ... ... ... ... ... ... 14 5 6 2 5 2 3 3 3 2 1 1 ... Senility 30 36 ... ... ... ...... ... ... ... ... 66 286 55 5 7 8 13 7 3 7 10 5 1 Suicide 14 12 ... ... ... ... ... l 7 11 7 7 4 3 3 2 8 1 1 4 4 ... Other violence 18 11 ... 1 ... 1 2 5 1 6 13 62 17 1 3 1 2 6 5 3 1 3 3 1 Other defined causes 46 45 ... 3 ... ... 3 3 19 26 37 171 29 9 13 5 10 15 11 8 4 7 9 ... Causes ill-defined or unknown ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Totals 623 i 319 1242 46 2 7 12 28 101 336 710 1987 374 117 164 93 122 188 152 86 99 139 76 6 10 TABLE 4. CAUSES OF DEATH AT DIFFERENT PERIODS OF LIFE IN THE BOROUGH OF LEYTON, 1940. Sex. All Ages. Ages at Death in Years. In Public Institutions in the District 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 35 years. 35 and under 45 years. 45 and under 55 years. 55 and under 65 years. 65 and under 75 years. 75 years and upwards Not belonging to District. Belonging to District. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 1. Typhoid and paratyphoid fevers M ... ... ... ... ... ... ... ... ... ... ... ... ... ... F ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2. Cerebro-spinal fever M 1 ... ... 1 ... ... ... ... ... ... ... ... ... ... F ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3. Scarlet fever M ... ... ... ... ... ... ... ... ... ... ... ... ... ... F ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4. Whooping cough M ... ... ... ... ... ... ... ... ... ... ... ... ... ... F ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5. Diphtheria M ... ... ... ... ... ... ... ... ... ... ... ... ... ... F. ...... ... ... ... ... ... ... ... ... ... ... ... ... ... 6. Tuberculosis of respiratory system M 44 ... ... ... ... 6 3 10 9 9 7 ... ... ... F 18 ... ... ... 1 3 5 5 3 1 ... ... ... ... 7. Other forms of tuberculosis M 7 ... 1 ... 2 1 1 2 ... ... ... ... ... ... F 4 ... ... 2 ... ... 1 1 ... ... ... ... ... ... 8. Syphilitic disease M 7 ... ... ... ... ... ... ... 1 3 3 ... ... ... F 1 ... ... ... ... ... ... ... 1 ... ... ... ... 9. Influenza M 9 1 ... ... ... 1 ... ... 3 3 ... 1 ... ... F 4 ... ... ... ... ... ... ... ... 4 ... ... ... ... 10. Measles M ... ... ... ... ... ... ... ... ... ... ... ... ... ... F ... ... ... ... ... ... ... ... ... ... ... ... ... ... 11. Acute poliomyelitis and polioencephalitis M ... ... ... ... ... ... ... ... ... ... ... ... ... ... F ... ... ... ... ... ... ... ... ... ... ... ... ... ... 12. Acute infectious encephalitis M 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... F ... ... ... ... ... ... ... ... ... ... ... ... ... ... 13. Cancer of buccal cavity and oesophagus (males only). M 13 ... ... ... ... ... ... ... ... 5 4 4 ... ... 13. Cancer of uterus F 8 ... ... ... ... ... ... ... ... 5 3 ... ... ... 14. Cancer of stomach and duodenum M 13 ... ... ... ... ... ... 1 3 1 4 4 ... ... F 15 ... ... ... ... ... ... ... ... 4 7 4 ... ... 11 15. Cancer of breast M 1 ... ... ... ... ... ... ... 1 ... ... ... ... F 15 ... ... ... ... ... ... 3 ... 3 9 ... ... ... 16. Cancer of all other sites M 87 ... ... ... ... 1 2 6 10 26 25 17 ... ... F 44 ... ... ... ... ... ... ... 5 14 11 14 ... ... 17. Diabetes M 7 ... ... ... ... ... ... 1 ... 2 2 2 ... ... F 6 ... ... ... ... ... ... ... 1 1 3 1 ... ... 18. Intra-cranial vascular lesions M 48 ... ... ... ... 1 ... ... 2 9 20 16 ... ... F 72 ... ... ... ... ... 2 2 4 10 29 25 ... ... 19. Heart disease M 220 ... ... ... ... 2 1 6 18 60 67 66 ... ... F 167 ... ... ... 1 2 1 1 1 21 50 90 ... ... 20. Other diseases of circulatory system M 15 ... ... ... ... ... ... ... 2 5 2 6 ... ... F 13 ... ... ... ... ... 1 1 1 4 2 4 ... ... 21. Bronchitis M 77 ... ... ... ... ... ... 1 6 24 30 16 ... ... F 57 ... ... ... ... ... ... 2 1 3 19 32 ... ... 22. Pneumonia M 41 10 1 ... ... ... 1 4 3 9 10 3 ... ... F 37 4 1 ... 1 ... 4 1 3 3 7 13 ... ... 23. Other respiratory diseases M 13 ... ... ... ... 1 1 1 1 4 2 3 ... ... F 13 ... ... ... ... ... 1 2 2 2 3 3 ... ... 24. Ulceration of the stomach or duodenum M 12 ... ... ... ... ... 1 ... 2 6 3 ... ... ... F 4 ... ... ... ... ... ... ... ... 2 1 1 ... ... 25. Diarrhoea (under 2 years of age) M 3 3 ... ... ... ... ... ... ... ... ... ... ... ... F 2 2 ... ... ... ... ... ... ... ... ... ... ... ... 26. Appendicitis M 3 ... ... ... ... ... ... ... ... 1 2 ... ... ... F 1 ... ... ... ... ... 1 ... ... ... ... ... ... ... 27. Other digestive diseases M 17 ... ... ... 1 ... 1 1 ... 8 5 1 ... ... F 23 ... ... 1 ... ... ... 2 3 7 5 5 ... ... 28. Nephritis M 7 ... ... ... 1 ... ... ... ... 2 1 3 ... ... F 15 ... ... ... ... 1 ... 1 1 ... 9 3 ... ... 29. Puerperal and post-abortive sepsis. F 1 ... ... ... ... ... ... 1 ... ... ... ... ... ... 30. Other maternal causes F 1 ... ... ... ... ... 1 ... ... ... ... ... ... ... 31. Premature birth M 7 7 ... ... ... ... ... ... ... ... ... ... ... ... F 3 3 ... ... ... ... ... ... ... ... ... ... ... ... 32. Congenital malformations M 11 10 1 ... ... ... ... ... ... ... ... ... ... ... F 9 5 1 1 1 ... 1 ... ... ... ... ... ... ... 33. Suicide M 10 ... ... ... ... 1 2 1 1 3 2 ... ... ... F 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... 34. Road traffic accidents M 9 ... ... ... ... ... ... 2 3 4 ... ... ... ... F 3 ... ... ... ... ... ... 2 ... ... 1 ... ... ... 35. Other violent causes M 97 1 ... 1 6 18 9 14 17 15 8 8 ... ... F 92 l 2 1 4 14 7 10 13 10 15 15 ... ... 36. All other causes M 85 2 ... 1 ... 2 7 1 9 17 15 31 ... ... F 69 1 ... ... ... 2 6 7 4 6 16 27 ... ... Totals M 865 F 698 50 7 8 18 56 60 92 132 318 404 418 2302 510 12 TABLE 5. DEATHS IN WARDS, 1940. CAUSES OF DEATH. Leyton Lea Bridge. Central North. Central South. Forest Leytonstone. Grove Green. Harrow Green. Cann Hall. Wanstead Slip. Ward Not Known. 1 2 3 4 5 6 7 8 9 10 11 12 1. Typhoid and paratyphoid fevers ... ... ... ... ... ... ... ... ... ... ... 2. Cerebro-spinal fever ... ... ... ... ... ... ... ... ... ... ... 3. Scarlet fever ... ... ... ... ... ... ... ... ... ... ... 4. Whooping cough ... ... ... ... ... ... ... ... ... ... ... 5. Diphtheria ... ... ... ... ... ... ... ... ... ... ... 6. Tuberculosis of respiratory system 7 7 5 11 7 5 6 3 7 4 ... 7. Other forms of tuberculosis ... 2 2 1 3 1 1 ... 1 ... ... 8. Syphilitic diseases ... ... 3 ... 2 ... 1 1 ... 1 ... 9. Influenza 1 2 2 ... ... 1 2 3 1 1 ... 10. Measles ... ... ... ... ... ... ... ... ... ... ... 11. Acute poliomyelitis and polioencephalitis ... ... ... ... ... ... ... ... ... ... ... 12. Acute infectious encephalitis ... ... ... ... 1 ... ... ... ... ... ... 13. Cancer of buccal cavity and oesophagus (males only) ... 2 3 2 3 ... 1 2 ... ... ... 13. Cancer of uterus ... 4 ... ... ... ... 2 1 ... 1 ... 14. Cancer of stomach and duodenum ... 8 3 4 2 7 2 ... 2 ... ... 15. Cancer of breast 1 6 ... 1 2 ... 1 2 2 l ... 16. Cancer of all other sites 10 29 13 8 23 8 10 11 10 8 1 17. Diabetes ... 1 1 1 3 1 1 ... 2 2 1 18.Ingtra eranial vascular lesions 10 16 9 9 17 18 12 11 6 12 ... 19. Heart disease 36 53 43 40 42 36 35 36 33 32 1 20. Other diseases of circulatory system 3 8 3 1 1 4 1 2 3 2 ... 21. Bronchitis 8 19 8 12 19 14 8 18 15 13 ... 22. Pneumonia 1 10 3 10 15 12 5 2 6 14 ... 23. Other respiratory diseases 1 4 3 4 3 4 2 1 1 3 ... 24. Ulcer of stomach or duodenum 1 4 ... 1 1 3 2 1 1 2 ... 13 25. Diarrhœa (under 2 years) 2 1 ... ... ... ... ... ... 2 ... ... 26. APPENDICITIS ... ... ... ... 1 ... ... 1 2 ... ... 27. Other digestive diseases 6 5 3 4 5 3 4 6 3 1 ... 28. Nephritis 1 1 1 2 2 4 2 1 4 4 ... 29. Puerperal and post-abortive sis ... ... 1 ... ... ... ... ... ... ... ... 30. Other maternal causes ... ... ... ... ... 1 ... ... ... ... ... 31. Premature birth. 2 1 ... 4 ... ... ... ... 3 ... ... 32. Congential malformaions ... 2 4 2 2 3 2 5 ... ... ... 33. Suicide ... 2 2 1 ... 3 1 ... 2 ... ... 34. Road Traffic accidents 2 ... ... ... 3 4 1 ... 1 1 ... 35. Other violent causes 13 27 19 11 32 22 9 23 21 11 1 36. All other causes 11 30 16 15 23 8 13 10 11 17 ... Totals 116 244 147 144 213 162 124 140 139 130 4 14 TABLE 6. Vital Statistics of Whole District during 1940 and Previous Years. Year. Population estimated to Middle of each Year. Births. Total Deaths Registered in the Borough. Transferable Deaths Nett Deaths belonging to the Borough. Uncorrected Number. Nett. of Nonresidents registered in the Borough. of Residents not registered in the Borough. Under 1 Year of Age. At all Ages. Number. Rate. N umber. Rate. Number. Rate per 1,000 Nett Births. Number. Rate. 1 2 3 4 5 6 7 8 9 10 11 • 12 13 1929 128300 1233 1731 13.49 3008 23.4 1751 253 100 57.77 1510 11.76 1930 128300 1199 1757 13.60 2692 20.9 1688 218 81 46.09 1222 9.52 1931 128600 1264 1812 14.09 2872 22.3 1770 263 71 39.18 1365 10.61 1932 127140 1029 1666 13.10 2913 22.7 1808 236 89 53.42 1341 10.54 1933 125700 812 1499 11.91 3070 24.4 1888 286 76 50.70 1468 11.67 1934 123430 819 1454 11.78 2864 23.2 1774 227 64 44.02 1317 10.67 1935 121690 777 1493 12.26 2671 21.9 1789 243 60 40.18 1225 10.06 1936 119900 661 1421 11.85 3028 25.2 2018 262 74 52.07 1272 10.61 1937 118100 653 1420 12.02 3190 27.0 2104 263 75 52.81 1349 11.42 1938 117200 656 1509 12.87 2934 25.0 1938 152 70 46.38 1148 9.79 1939 B 116100* D 110800* 605 1499 12.90 2951 26.6 1987 278 46 31.65 1242 11.21 1940 96500 645 1353 14.02 3865 40.0 2302 335 50 39.03 1563 16.2 * Population as estimated for purposes of B—Birth Rate ; D—Death Rate. 15 TABLE 7. Birth-rate, Death-bate and Analysis of Mortality During tte Year 1939. Birthrate per 1,000 Total Population. Annual Death-rate per 1,000 Population. Rate per 1,000 Births. Percentage of Total Deaths. All Causes. Enteric Fever. Smallpox. Measles. Scarlet Fever. Whooping Cough. Diphtheria. Influenza. Diarrhoea and Enteritis (under 2 Years). Total Deaths under 1 Year. Certified by Registered Medical | Practitioners. Inquest Cases. Certified by Coroner after P.M. No Inquest. Uncertified Causes of Death. Live Births. Still Births. England and Wales 15.0 0.59 12.1 0.00 0.00 0.01 0.01 0.03 0.05 0.21 4.6 50 ... ... ... ... 126 County Boroughs and Great Towns, including London 14.8 0.59 12.0 0.00 0.00 0.01 0.00 0.03 0.05 0.19 6.3 53 ... ... ... ... 148 Smaller Towns. Estimated Resident Populations 25,000 to 50,000 at Census, 1931 15.6 0.57 11.2 0.00 0.00 0.01 0.00 0.02 0.04 0.20 3.0 40 ... ... ... ... London 12.3 0.44 11.9 0.00 0.00 0.00 0.00 0.03 0.02 0.18 8.2 48 ... ... ... ... LEYTON 12.90 0.30 11.21 0.00 0.00 0.00 0.01 0.00 0.02 0.20 2.00 31 87.92 4.91 7.16 0.01 TABLE 8. Birth-rate, Death-rate and Analysis of Mortality During the Year 1940. Birthrate per 1,000 Total Population. Annual Death-rate per 1,000 Population. Rate per 1,000 Births. Percentage of Total Deaths. All Causes. Enteric Fever. Smallpox. Measles. Scarlet Fever. Whooping Couhg. Diphtheria. Influenza. Diarrhoea and Enteritis (under 2 Years). Total Deaths under 1 Year. Certified by Registered Medical Practitioners. Inquest Cases. Certified by Coroner after P.M. No Inquest. Uncertified Causes of Death. Live Births. Still Births. England and Wales 14.6 0.55 14.3 0.00 0.02 0.00 0.02 0.06 0.32 4.6 55 ... ... ... ... 126 County Boroughs and Great Towns, including London 16.0 0.64 15.8 0.00 ... 0.02 0.00 0.02 0.07 0.29 5.9 61 ... ... ... ... 148 Smaller Towns. Estimated Resident Populations 25,000 to 50,000 at Census, 1931 15.7 0.55 12.8 0.00 ... 0.02 0.00 0.02 0.05 0.30 4.4 54 ... ... ... ... London 13.7 0.44 17.8 0.00 ... 0.01 0.00 0.00 0.01 0.18 5.8 50 ... ... ... ... LEYTON 14.02 0.46 16.2 0.00 ... 0.00 0.00 0.00 0.00 0.13 3.6 36 89.8 3.2 7.0 ... 16 17 TABLE 9. Comparative Statistics of Births, Mortality, Etc. LEYTON, 1892-1940. Year. Population. Births. Birth Rate. Deaths. Death Rate. Deaths under 1 year. Infantile Death Rate. 1892 63000 2210 35.08 972 15.4 313 141 1893 64000 2316 36.18 1019 15.7 306 130 1894 70000 2224 31.7 825 11.6 258 116 1895 75000 2292 30.05 1080 14.4 346 150 1896 77000 2372 30.08 926 11.8 326 137 1897 85000 2501 29.3 1011 11.9 356 142 1898 90000 2560 28.4 1125 12.5 374 146 1899 93000 2698 29.0 1262 13.5 420 155 1900 100000 2932 29.32 1179 11.8 410 140 1901 100000 2963 29.63 1243 12.4 404 136 1902 100000 3152 31.52 1183 11.8 336 106 1903 102000 3273 32.08 1112 10.9 322 99 1904 104000 3198 30.07 1370 13.1 444 138 1905 105000 3209 30.05 1177 11.2 303 94 1906 108000 3344 30.9 1327 12.2 382 114.5 1907 120000 3190 26.6 1269 10.6 182 86.6 1908 121200 3071 25.3 1185 9.8 242 78.8 1909 121200 2979 24.6 1208 9.9 244 81.9 1910 123300 3011 24.4 1112 9.0 191 63.4 1911 124736 2931 23.5 1473 11.8 327 116.6 1912 126700 2797 22.1 1343 10.6 223 79.7 1913 129366 2904 22.4 1336 10.3 242 83.3 1914 130847 2800 21.4 1363 10.4 219 78.2 1915 124497 2655 21.3 1510 12.1 225 84.7 1916 B132107* 2560 19.4 D121420* 1471 12.1 197 76.9 1917 B125352* 2005 16.0 D112452* 1414 12.6 172 85.8 1918 B125352* 1791 14.3 Dl12452* 1723 15.3 161 89.9 1919 B129062* 2195 17.0 D123896* 1397 11.3 154 70.16 1920 128832 3168 24.6 1330 10.3 207 65.34 1921 128432 2679 20.86 1290 10.04 182 67.94 1922 131600 2416 18.36 1420 10.79 155 64.16 1923 132800 2328 17.53 1228 9.25 106 45.53 1924 133500 2101 15.74 1325 9.92 110 52.36 1925 132700 2091 15.76 1349 10.16 114 54.51 1926 130000 2022 15.55 1261 9.7 131 64.79 1927 128920 1826 14.16 1322 10.25 80 43.81 1928 130300 1853 14.22 1290 9.90 91 49.10 1929 128300 1731 13.49 1510 11.76 100 57.77 1930 128300 1757 13.69 1222 9.52 81 46.09 1931 128600 1812 14.09 1365 10.61 71 39.18 1932 127140 1666 13.10 1341 10.54 89 53.43 1933 125700 1499 11.91 1468 11.67 76 50.70 1934 123430 1454 11.78 1317 10.67 64 44.02 1935 121690 1493 12.26 1225 10.06 60 40.18 1936 119900 1421 11.85 1272 10.61 74 52.07 1937 118100 1420 12.02 1349 11.42 75 52.81 1938 117200 1509 12.87 1148 9.79 70 46.38 1939 B116100* 1499 12.90 1242 11.21 46 31.65 Dl10800* 1940 96500 1353 14.02 1563 16.2 50 39.03 * Population as estimated for purposes of B, Birth Rate, D, Death Rate. 18 SECTION B. GENERAL PROVISIONS OF HEALTH SERVICES FOR THE AREA. NURSING ARRANGEMENTS, CLINICS, HOSPITALS AND OTHER INSTITUTIONS AVAILABLE IN THE BOROUGH. The outbreak of war on 3rd September, 1939, necessitated temporary cancellation, modification and re-arrangement of certain health services. Information regarding such services will be found in the appropriate section of previous Annual Reports. Public Mortuary. Number of bodies deposited, death being due to:— Natural causes 92 Suicide 8 Street accidents 2 Other accidents 3 105 Number of Post-mortem examinations performed 102 Number of Inquests held 16 In 89 instances no inquest was considered necessary in view of the post-mortem findings that death was due to natural causes. ESTABLISHMENTS FOR MASSAGE AND SPECIAL TREATMENT. In my last Annual Report I included a special report dealing with the Council's powers with regard to the licensing of establishments for massage and other forms of special treatment. In order to safeguard against the exploitation of medical auxiliary work by persons of inadequate training, I submitted the recommendation that in future licences be granted only to persons possessing technical qualifications recognised and approved by the Board of Registration of Medical Auxiliaries. In March, 1939, your Council instructed the Town Clerk to draft a Byelaw giving effect to the suggestions contained in my report. This draft Byelaw was subsequently approved by your Council, and thereafter the statutory notice of the Council's 19 intention to frame the Byelaw was duly given. As no objection to the Council's intention was received, the Byeiaw was adopted by the Council and subsequently confirmed by the Secretary of State for Home Affairs in December, 1940. The Byelaw states that— " No person shall administer massage or special treatment at any establishment within the Borough of Leyton, licensed under Part IV of the Essex County Council Act, 1933, unless such person possesses appropriate qualifications in Medical Auxiliary work approved by the Board of Registration of Medical Auxiliaries as evidenced by the entry of that person's name in the National Register of Medical Auxiliary Services. Provided that this Byelaw shall not apply to any establishment licensed at the date of confirmation of this Byelaw until the expiration of two years from such date of confirmation." Before that time it had been the practice of your Council to grant new licenses only to persons possessing qualifications recognised by that Board. Therefore the Byelaw merely gives legal effect to what was your established though unwritten rule. Although the power to make Byelaws prescribing technical qualifications is common to all Authorities possessing powers of control over these establishments, Leyton Corporation was the first Authority in the country to make a Byelaw prescribing technical qualifications. Since that time other Authorities have made similar Byelaws. FOOT CLINIC. The number of treatments given during 1940 was 5,117, a decrease of 1,064 on last year. Two factors may be held responsible for this decrease:— (1) the severe weather in January and February, which confined many people, especially the old and infirm, to their homes; and (2) the large evacuation which followed the onset of daylight and night bombing after 7th September. Notwithstanding these conditions the number of new cases who received treatment was 387 ; of whom 340 were adults and 47 children. 20 Summary of Attendances and Treatment. During the year 5,117 attendances were made, an average of 5.27 attendances per patient. First Attendances (new cases). Subsequent Attendances. Total Attendances. Average No. of Visits per Patient. No. Per cent. Males 87 1,078 1,165 22.77 5.00 Females 253 3,424 3,677 71.86 5.44 Children 47 228 275 5.37 4.44 Total 387 4,730 5,117 — 5.27 During the year the numbers of persons who received free treatment was 130, 33.59 per cent, of the total number of new cases. First Attendances (new cases). Subsequent Attendances. Total Attendances. Males. Females. Males. Females. Males. Females. Old age pensioners 32 53 712 1,384 744 1,437 Unemployed 6 8 86 290 102 298 Widows — 31 — 656 — 687 Totals 38 92 808 2,330 846 2,422 21 SECTION C. SANITARY CIRCUMSTANCES OF THE AREA. SANITARY INSPECTIONS OF THE AREA. Inspections. The table below gives a summary oi the Inspections made by the Sanitary Inspectors:— Number of dwelling-houses inspected 1,465 Number of house-to-house inspections 92 Miscellaneous inspections 639 Re-inspections 6,551 Piggeries Nil Places of entertainment 12 Schools 24 Stables 101 Public Conveniences 26 Urinals 60 Inspections under Rats and Mice (Destruction) Act 375 Visits in connection with infectious disease 200 Factories without mechanical power 114 Factories with mechanical power 395 Offices 22 Outworkers' premises 750 Rag and bone dealers 5 Foster-mothers'premises 32 Hairdressers' premises 169 Public Houses 23 Nature of Work Executed and Improvements Effected in Dwelling-houses and other Premises under the Provisions of the Housing and Public Health Acts. Dampness remedied 424 Sashcords renewed 63 Plaster repaired 368 Roofs repaired or renewed 294 Guttering repaired or renewed 115 Yards paved 44 Drains relaid or partly relaid 16 22 Choked drains cleared 29 New w.c. pan and traps provided 37 Sinks provided 23 W.c. cisterns repaired or renewed 56 Rain water pipes repaired or renewed 67 Vent pipes repaired or renewed 12 Sink waste pipes renewed 77 Stoves repaired or renewed 93 Coppers repaired or renewed 20 Floors repaired 64 Rooms redecorated 673 Windows, sills, etc., repaired 92 Miscellaneous defects remedied 367 Verminous Houses. Infested. Disinfested. Number of Council houses Nil Nil Number of other houses 157 157 Eradication of Bed Bugs. (See Annual Report, 1938.) Rag Flock Acts, 1911-1928. There are no premises within the Borough where rag flock is known to be manufactured. Rats and Mice (Destruction Act), 1919. Three hundred and seventy-five visits were paid in connection with complaints received, and rat biscuits were issued to the occupiers of 67 premises. At 58 premises the source of rat infestation was definitely traced and the premises freed of rats. A.R.P., Civil Defence, etc. Visits were made to the following:— Air Raid Shelters 505 Wardens Posts 71 Houses re War Refugees 1,557 Miscellaneous 30 Air Raid Damage. Food Shops 524 Houses 871 Factories 16 23 SECTION D. HOUSING. Complaints. During the year 942 complaints of nuisances were received and investigated. The nature of the complaints included sanitary defects in houses, drains choked or defective, premises infested with vermin, etc. Notices. Notices served—Informal 757 Statutory—Housing Acts Nil Public Health Acts 127 Re-drainage Nil Notices complied with—Informal 1,008 Statutory— Housing Acts Nil Public Health Acts 162 Re-drainage Nil Housing. Number of houses erected during the year:— (a) Total (including numbers given separately under (b)). (i) By the Local Authority Nil (ii) By other Local Authorities Nil (iii) By other bodies and persons : Houses Nil Flats Nil (b) With State assistance under the Housing Acts. (i) By the Local Authority:— (a) For the purposes of Part v of the Act of 1936 Nil (b) For other purposes Nil (ii) By other bodies or persons Nil I.—Inspection of Dwelling-houses during the Year:— (1) (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 1,465 (6) Number of inspections made for the purpose 8,016 24 (2) (a) Number of dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 & 1932 92 (b) Number of inspections made for the purpose 378 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation Nil (4) Number of dwelling-houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 757 II.—Remedy of Defects during the Year without Service of Formal Notices:— Number of defective dwelling-houses rendered fit in consequence of informal action taken by the Local Authority or their officers 1,008 III.—Action under Statutory Powers during the Year:— (a) Proceedings under Sections 9, 10 and 16 of the Housing Act, 1936:— (1) Number of dwelling-houses in respect of which notices were served requiring repairs Nil (2) Number of dwelling-houses which were rendered fit after service of formal notices:— (a) By owners Nil (ib) By Local Authority in default of owners Nil (b) Proceedings under Public Health Acts:— (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 127 (2) Number of dwelling-houses in which defects were remedied after service of formal notices:— (a) By owners 162 (b) By Local Authority in default of owners Nil 25 (c) Proceedings under Sections 11 and 13 of the Housing Act 1936 (1) Number of dwelling-houses in respect of which demolition orders were made Nil (2) Number of dwelling-houses demolished in pursuance of demolition orders Nil (d) Proceedings under Section 12 of the Housing Act, 1936:— (1) Number of separate tenements or underground rooms in respect of which Closing Orders were made Nil (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit Nil IV.—Housing Act, 1936. Part IV—Overcrowding :— Owing to the destruction of premises by enemy action and the movement of occupants rendered homeless, it has not been possible to furnish reliable information with regard to overcrowding. Housing Act, 1936. Information regarding 104 houses and 109 flats was supplied in connection with the " permitted number of persons " in dwellings under the Act. Repair of Unfit Houses. In eight instances it was found necessary to take legal proceedings for non-compliance with a notice served to remedy a nuisance in accordance with the Public Health Act, 1936 :— 30, Norman Road 2S. 0d. professional costs. 10s. Court costs each house. Order 3 months. 34, „ 1, Denmark Villas, 20s, fine on each house. Order 14 days. 2, ,, 21, Manby Road 10s. 6d. costs. Order 28 days. 23, „ 10s. 6d. costs. Order 28 days. 12, Toronto Road 21s. costs. l1s. Court costs. Order 1 month. 26 House-to-House Inspection. The houses in the under-mentioned roads have been inspected during the year :— Browning Road. Lea Hall Road. Livingstone Road. The number of dwelling-houses inspected and recorded under Housing Consolidated Regulations was 92. Rent and Mortgage Interest Restriction Act, 1920-1933. No applications for certificates were received. SECTION E. INSPECTION AND SUPERVISION OF FOOD. Inspections. The following visits were made to food premises during the year:— Slaughter-houses 932 Butchers 889 Bakehouses 106 Fishmongers 95 Milkshops and dairies 431 Provision shops 491 Dining rooms 240 Ice-cream dealers 278 Greengrocers 198 Fish friers 54 MILK. Dairies and Milkshops. Number of premises on register 212 Premises added to register during year 17 Premises removed from register during year 45 Visits of inspection 431 27 As the result of inspection infringements were found at 7 premises, and the necessary action was taken in each case. Twelve persons were found to be retailing designated milk although not licensed in that respect, and cautions were given in each case. Bacteriological Examinations. Undesignated Milk.—Five samples were taken. Designated Milk. Licences. No. Granted. No. of Samples taken. Result. Satisfactory. Un satisfactory. Tuberculin Tested 10 - - - Accredited 3 - - - Pasteurised 73 4 4 - Supplementary Licences - - - - Tuberculin Tested 2 - - - Pasteurised ... 2 - - - Totals 90 4 4 — Food and Drugs Act, 1938. Ice Cream. Premises on Register at 31-12-1940 201 Premises registered during 1940 22 Premises removed from Register during 1940 39 Visits of inspection by Sanitary Inspectors 278 Samples taken for bacteriological examination 18 Twenty-two premises were registered for the manufacture, storage or sale of ice cream during the year. Manufacturers of Preserved Food, etc. Premises on Register at 31-12-1940 67 Premises registered during 1940 67 Premises removed from Register during 1940 Nil MEAT. Slaughter - Houses.— There are eight licensed slaughterhouses in the Borough, and 932 inspections of these slaughterhouses were made. 28 Carcases and Viscera Inspected:— Animals Inspected. London Co-operative Society Abattoir. Other SlaughterHouses. Cattle 3,418 119 Calves Nil 37 Swine 24,362 32 Sheep 64,793 228 92,573 416 SUMMARY OF CARCASES INSPECTED AND CONDEMNED. Cattle, excluding Cows. Cows. Calves. Sheep and Lambs. Pigs. Number killed 3,537 Nil 37 65,021 24,394 Number inspected 3,537 Nil 37 65,021 24,394 All diseases except Tuberculosis:— Whole carcases condemned 37 Nil 5 257 151 Carcases of which some part or organ was condemned 3,060 Nil 32 14,416 3,023 Percentage of the number inspected affected with disease other than tuberculosis 87.56 Nil 100% 22.57 13.01 Tuberculosis only:— Whole carcases condemned 39 Nil Nil Nil 133 Carcases of which some part or organ was condemned 558 Nil Nil Nil 3,807 Percentage of the number inspected affected with tuberculosis 16.89 Nil Nil Nil 16.10 Slaughter of Animals Act, 1933. Forty-one persons were licensed as slaughtermen during the year. 29 Premises and Occupations which can be Controlled by Bye-Laws and Regulations. Premises. Slaughter-houses 8 Dairies, Milkshops and Dairymen 212 Butchers' shops, Stalls and Provision shops 248 Ice Cream dealers 201 Chimneys—other than private dwelling-houses approximately 100 Hairdressers'Premises 83 Offensive Trades. Rag and Bone dealers 4 Fish friers 27 Tripe boiler 1 Fat melter 1 Fat extractor 1 Gut scraper 1 Bone boiler 1 Blood boiler and blood drier 1 An application to continue the trades of tripe boiler, fat melter, fat extractor, gut scraper, bone boiler, blood boiler and blood drier was received, and permission given to carry on the trades for a further twelve months. One application to continue the trade of a fish frier was received and permission given for a further limited period. Fifty-four inspections were made of the premises where fish frying is carried on. Contagious Diseases of Animals Acts, 1894-1927. Fifty-two licences were issued in respect of the movement of:— Pigs 6,365 from other areas into this district for the purpose of slaughter. 30 Food and Drugs Act, 1938. The number of samples taken for analysis under the provisions of this Act from 1st January to the 31st December was 173, as follows :— Samples Samples analysed. unsatisfactory. Arrowroot 1 — Ale 1 Almonds, ground 1 Beef, minced 1 — Brisling 1 — Butter 1 Black Pudding 1 Cornflour 1 Custard Powder 2 Cocoa 4 Coffee and Chicory Extract 2 Curry Powder 2 Castor Oil 1 Camphorated Oil 2 Cheese spread 1 — Chocolate flake 1 Coffee 2 Coffee extract 1 — Coffee and chicory essence 1 — Chop sauce 1 — Cough Syrup 1 Cheese 1 — Cream Soda 1 — Chocolate (tin) 1 — Cake flour 1 — Cake 1 — Chocolate Mint Cream 1 — Dripping 2 — Epsom Salts 2 — Egg powder 2 — Flour, self-raising 3 — Fruit, dried 1 — Fish paste 1 — Glycerine 2 — Glauber's salts 3 — Herrings in tomato sauce 1 — 31 Samples Samples analysed. unsatisfactory Herbs, dried 1 Honey 1 — IceCream 3 2 Jam 4 — Jelly 3 Lemon Cheese 2 — Lemon Spread 1 — Milk 32 2 Milk Powder 1 — Marmalade 3 — Milk, condensed 1 — Meat pie 1 — Mustard, mixed 1 — Milk pudding mixture 1 — Mustard Pickles 1 Macaroni 1 Mustard sauce 1 Milk, malted 1 Oatmeal 2 Olive oil 2 Ointment, zinc I — Ointment, boric acid 1 Oats, rolled 1 Peas, tinned 1 Pearl barley 4 Pepper 2 — Pineapple 1 Peel, candied 1 — Pickles 1 — Rice 5 — Rissole mixture 1 — Raisins 1 — Sausages 7 — Sardines 5 — Sago 2 — Salad oil 1 — Sulphur ointment 3 — Suet, shredded 1 — Steak and Kidney pie 3 2 Soup powder 3 — Sponge powder 1 — 32 Samples Samples analysed. unsatisfactory. Salt 1 — Sulphur tablets 1 Stomach powder 1 Spice, mixed 1 Sweets 1 — Suet, beef 1 Tapioca 3 Tea 2 Vinegar 1 173 6 In one instance it was found necessary to take legal proceedings n the case of a sample of milk found to contain 6 per cent, water. fine of £2 and 10s. 6d. costs was imposed. In another instance a sample of milk was found to be 3 perent. deficient in milk fat. A letter of caution was sent. SECTION F. FACTORIES. THE FACTORIES ACT, 1937. 1. INSPECTIONS FOR PURPOSES OF PROVISIONS AS TO HEALTH. Including inspections made by Sanitary Inspectors. Premises. Number of Inspections. Written Notices. Occupiers Prosecuted. (1) (2) (3) (4) Factories with mechanical power 448 37 Factories without mechanical power 167 2 Other Premises under the Act (including works of building and engineering construction but not including outworkers' premises) Total 615 39 — 33 2. DEFECTS FOUND. Particulars. Number of Defects. Found. Remedied. Referred to H.M. Inspector. (1) (2) (3) (4) Lack of cleanliness 22 21 — Sanitary Conveniences:— Insufficient 4 4 — Unsuitable or defective 17 17 — Dirty 4 4 — Lack of heating 1 1 — Other Offences 8 8 — Total 56 55 — OUTWORK IN UNWHOLESOME PREMISES. (Section 111 of Act of 1937). Nature of Work. Instances. Notices served. Prosecutions. (1) (2) (3) (4) Nil Nil Nil — 34 MATERNITY AND CHILD WELFARE. On 15th October the Council's Health Centre at Park House sustained severe damage as the result of enemy action, the result being that the clinic sessions had to be discontinued. Before the end of that month it was possible to arrange for all clinic services formerly held at Park House Centre to be transferred to Council premises in the Public Baths, Cathall Road. Fortunately the medical, dental and nursing equipment at Park House sustained very little damage. INFANT WELFARE. Notification of Births.—Eleven hundred and sixty-nine notifications of births were received during the year. By medical practitioners 303 By midwives 865 By parents and others 1 During the year under review, the total attendances at the Council's Infant Welfare Centres were 8,929, a decrease of 6,290 compared with the figure (15,219) for the previous year. The number of children examined by the Clinic Medical Officers was 2,927 as compared with 5,919 examined during the previous year. Health Visitors. During the year the Health Visitors have made 15,442 visits to homes, as follows:— (а) To expectant mothers:— First visits 176 Total visits 192 (б) To children under 1 year of age:— First visits 1,239 Total visits 5,905 (c) To children between the ages of 1 and 5 years:— Total visits 9,345 Ox TABLE 10. ATTENDANCES, EXAMINATIONS, ETC., 1940. Leyton Green. Parle House. All Centres. p.m. Mon. p.m. Wed. p.m. Tries. p.m. Thurs. Under 1 year— 1st attendances 206 249 226 185 866 Subsequent attendances 1,441 1,888 1,479 1,462 6,270 Total attendances 1,647 2,137 1,705 1,647 7,136 1-5 years— 1st attendances 34 39 33 36 142 Subsequent attendances 236 525 436 354 1,651 Total attendances 370 564 469 390 1,793 Total attendances, both age groups 2,017 2,701 2,174 2,037 8,929 Average attendance per session 40.34 52.96 47.26 23.39 48.00 Number examined by clinic M.O. 753 837 714 623 2,927 Average number examined per doctor per session 15.06 16.41 15.52 15.97 15.73 Number weighed 2,001 2,678 2,174 2,037 8,890 36 Dental Treatment. I am pleased to be able to report that the falling off in numbers is not as great as one might reasonably expect in the circumstances. This is especially gratifying as it is during the pre-school years that one can do so much towards conserving the temporary dentition, thereby enabling the child to get its permanent dentition without the early loss of so many temporary teeth due to caries, abscesses, etc., with the consequent irregularity of the succeeding teeth. Many opportunities are also afforded at this time to talk to the mothers on dental hygiene, and of seeking their co-operation by way of regular acceptance of treatment during the child's school years. The attached table gives some idea of the work carried out under this heading:— Expectant Children. Mothers. Patients treated 93 186 Attendances 220 375 Extractions 420 555 Fillings 36 86 Other dental operations 58 45 Advice only 50 100 Anaesthetics— General 76 151 Local 28 52 Dentures supplied— Full upper and lower 4 Partial upper and lower 2 Full upper and partial lower 1 Full lower and partial upper 1 8 Artificial Sunlight Treatment. Orthopaedic Treatment. All medical records relating to physically defective children were destroyed by enemy action. 37 Special Eye Clinic. During the year the Council's Ophthalmic Surgeon (J. D. Magor Cardell, M.B., F.R.C.S.) had referred to him by the Clinic Medical Officers 20 pre-school children, who made 50 attendances for examination and treatment. Convalescent Home Treatment. Children. During the year 5 children, recommended by the Clinic Medical Officers, were sent to Convalescent Homes by the Maternity and Child Welfare Authority through the agency of the Invalid Children's Aid Association. Ophthalmia Neonatorum. No. of Cases Notified. Treated Vision Unimpaired. Vision Impaired. Total Blindness. Deaths. At Home. In Hosp. 4 2 2 4 — — — Infant and Foetal Mortality. The following figures show the variations in the infantile and neo-natal mortality rates and in the number of stillbirths during the last five year period. Year. Births. Deaths under Mortality Rates Stillbirths. 1 year. 4 weeks. Infantile. Neo-natal. 1936 1421 74 38 52.07 26.74 44 1937 1420 75 37 52.81 26.05 60 1938 1509 70 43 46.38 28.56 41 1939 1499 46 27 31.65 18.57 35 1940 1353 50 28 39.03 21.85 45 38 TABLE 11. Infantile Mortality, Year 1939—Ages. 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 12 Months. Total Deaths under 1 Year. Smallpox Chickenpox Measles Scarlet fever Whooping cough Diphtheria and croup Influenza Tuberculous meningitis i Abdominal tuberculosis Other tuberculous diseases Meningitis (not tuberculous) Convulsions Laryngitis Bronchitis 2 2 Pneumonia (all forms) 2 6 Diarrhoea i 1 Enteritis 1 i 2 Gastritis Syphilis Rickets Suffocation, overlying Injury at birth 4 4 4 Atelectasis 2 2 2 Congenital malformations 2 i 3 i 4 Premature birth 14 1 16 2 19 Atrophy, debility and marasmus Other causes 1 i 2 3 Totals 24 i 2 27 9 6 3 1 46 Nett Births registered during the calendar year Legitimate 1,446 Illegitimate 53 Nett Deaths registered during the calendar year Legitimate infants 41 Illegitimate infants 5 39 TABLE 11a. Infantile Mortality During the Year 1939—Wards. CAUSE OF DEATH. Leyton. Lea Bridge. Central North. Central South. Forest. Leytonstone. Grove Green. Harrow Green. Cann Hall. Wanstead Slip. Ward not known. Total Deaths under 1 Year. Smallpox ... ... ... ... ... ... ... ... ... ... ... ... Chickenpox ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... ... ... Scarlet fever ... ... ... ... ... ... ... ... ... ... ... ... Whooping cough ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria and croup ... ... ... ... ... ... ... ... ... ... ... ... Influenza ... ... ... ... ... ... ... ... ... ... ... ... Tuberculous meningitis ... ... ... ... ... ... ... 1 ... ... ... 1 Abdominal tuberculosis ... ... ... ... ... ... ... ... ... ... ... ... Other tuberculous diseases ... ... ... ... ... ... ... ... ... ... ... ... Meningitis (not tuberculous) ... 1 ... 1 ... ... ... ... ... ... ... 2 Convulsions ... ... ... ... ... ... ... ... ... ... ... ... Laryngitis ... ... ... ... ... ... ... ... ... ... ... ... Bronchitis ... ... ... ... ... ... ... 1 1 ... ... 2 Pneumonia (all forms) 1 1 ... ... 1 ... 2 ... 1 ... ... 6 Diarrhoea ... ... 1 ... ... ... ... ... ... ... ... 1 Enteritis ... ... ... ... 1 1 ... ... ... ... ... 2 Gastritis ... ... ... ... ... ... ... ... ... ... ... ... Syphilis ... ... ... ... ... ... ... ... ... ... ... ... Rickets ... ... ... ... ... ... ... ... ... ... ... ... Suffocation, overlying ... ... ... ... ... ... ... ... ... ... ... ... Injury at birth ... ... ... ... ... 1 ... I 1 ... ... 4 Atelectasis ... ... ... ... ... 1 1 ... ... ... ... 2 Congenital malformations 2 ... ... ... ... ... ... 1 ... ... 1 4 Premature birth 4 2 5 1 3 1 3 ... ... ... ... 19 Atrophy, Debility and Marasmus ... ... ... ... ... ... ... ... ... ... ... ... Other causes ... 1 ... ... ... 1 1 ... ... ... ... 3 Totals 7 5 6 3 5 5 7 4 3 ... 1 46 40 TABLE 12. Infantile Mortality, Year 1940—Ages. 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 12 Months. Total Deaths under 1 Year. Smallpox ... ... ... ... ... ... ... ... ... ... Chickenpox ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... Scarlet fever ... ... ... ... ... ... ... ... ... ... Whooping cough ... ... ... ... ... ... ... ... ... ... Diphtheria and croup ... ... ... ... ... ... ... ... ... ... Influenza ... ... ... ... ... 1 ... ... ... 1 Tuberculous meningitis ... ... ... ... ... ... ... ... ... ... Abdominal tuberculosis ... ... ... ... ... ... ... ... ... ... Other tuberculous diseases ... ... ... ... ... ... ... ... ... ... Meningitis (not tuberculous) ... ... ... ... ... ... ... ... ... ... Convulsions ... ... ... ... ... ... ... ... ... ... Laryngitis ... ... ... ... ... ... ... ... ... ... Bronchitis ... ... ... ... ... ... ... ... ... ... Pneumonia (all forms) 1 2 ... 1 4 2 4 4 ... 14 Diarrhoea ... ... ... ... ... ... ... ... ... ... Enteritis ... ... ... 1 1 1 2 ... 1 5 Gastritis ... ... ... ... ... ... ... ... ... ... Syphilis ... ... ... ... ... ... ... ... ... ... Rickets ... ... ... ... ... ... ... ... ... ... Suffocation, overlying ... ... ... ... ... ... ... ... ... ... Injury at birth 4 ... ... ... 4 ... ... ... ... 4 Atelectasis 2 ... ... ... 2 ... ... ... ... 2 Congenital malformations 2 1 ... ... 3 2 ... ... ... 5 Premature birth 10 ... ... ... 10 ... ... ... ... 10 Atrophy, debility and marasmus ... ... ... ... ... 1 ... ... ... 1 Other causes 4 ... ... ... 4 ... 1 1 2 8 Totals 23 3 ... 2 28 7 7 5 3 50 Nett Births registered during the calendar year Legitimate 1,318 Illegitimate 35 Nett, Deaths registered during the calendar year Legitimate infants 46 Illegitimate infants 4 41 TABLE 12a. Infantile Mortality During the Year 1940—Wards. CAUSE OF DEATH. Leyton. Lea Bridge. Central North. Central South. Forest. Leytonstone. Grove Green. Harrow Green. Cann Hall. Wanstead Slip. Ward not known. Total Deaths under 1 Year. Smallpox ... ... ... ... ... ... ... ... ... ... ... ... Chickenpox ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... ... ... Scarlet fever ... ... ... ... ... ... ... ... ... ... ... ... Whooping cough ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria and croup ... ... ... ... ... ... ... ... ... ... ... ... Influenza ... ... 1 ... ... ... ... ... ... ... ... 1 Tuberculous meningitis ... ... ... ... ... ... ... ... ... ... ... ... Abdominal tuberculosis ... ... ... ... ... ... ... ... ... ... ... ... Other tuberculous diseases ... ... ... ... ... ... ... ... ... ... ... ... Meningitis (not tuberculous) ... ... ... ... ... ... ... ... ... ... ... ... Convulsions ... ... ... ... ... ... ... ... ... ... ... ... Laryngitis ... ... ... ... ... ... ... ... ... ... ... ... Bronchitis ... ... ... ... ... ... ... ... ... ... ... ... Pneumonia (all forms) ... 1 ... 2 1 3 4 ... 1 2 ... 14 Diarrhoea ... ... ... ... ... ... ... ... ... ... ... ... Enteritis 2 1 ... ... ... ... ... ... ... ... ... 5 Gastritis ... ... ... ... ... ... ... ... ... ... ... ... Syphilis ... ... ... ... ... ... ... ... ... ... ... ... Rickets ... ... ... ... ... ... ... ... ... ... ... ... Suffocation, overlying ... ... ... ... ... ... ... ... ... ... ... ... Injury at birth ... ... 3 ... ... ... ... 1 ... ... ... 4 Atelectasis ... ... ... ... ... 1 ... 1 ... ... ... 2 Congenital malformations ... 1 ... 1 1 ... 1 1 ... ... ... 5 Premature birth 2 1 ... 4 ... ... ... ... 3 ... ... 10 Atrophy, Debility and Marasmus ... ... ... ... ... ... ... 1 ... ... ... 1 Other causes 2 1 1 1 1 ... ... l 1 ... ... 8 Totals 6 5 5 8 3 4 5 5 7 2 ... 50 42 Public Health Act, 1936. Child Life Protection. On 1st January, 23 foster mothers and 24 children—and at the end of the year 17 foster mothers and 18 children—were subject to inspection. The Council's Child Protection Visitors made 139 visits of inspection during the year. Summary, Year 1940. Number of nurse children on Register, 1st January 24 Number of nurse children notified by foster mothers during the year 24 Nurse children removed :— To parents or relatives 13 To another foster mother 3 With foster mother to another area 4 Adopted 1 To institutions 5 Evacuated under Government Scheme 2 Attained 9 years of age 1 Removed—No trace 1 Number of nurse children on Register on 31st December 18 Ante-Natal Clinics— Attendances.—During 1940, the attendances were :— Centre. First Attendances. Subsequent Attendances. Total. Park House Clinic 228 386 614 Leyton Green Clinic 195 268 463 423 654 1,077 The average number in attendance at the Ante-Natal Clinics held at the Council's two Centres during 1940 was 8.48 per session. The number of home visits made by Health Visitors to expectant mothers during the year was 192. Maternity Beds. In November, 1939, your Council entered into an agreement with the Mother's Hospital, Clapton, for the provision of maternity bed accommodation on the following terms :— Total cost per bed for fourteen days : Five guineas for first confinements. Four guineas for subsequent confinements. Any case kept in hospital more than fourteen days is charged at the rate of 6s. 0d. per additional day. 43 Forty-seven patients were admitted during 1940 under the terms of this agreement. Nursing Homes Registration Act, 1927. There are three registered nursing homes in the Borough. These institutions were inspected on 12 occasions. Home Helps. Under the Council's scheme for the provision of home helps, 172 applications for home helps were dealt with. In 139 cases (19 of whom made application in 1939), home helps were provided, 43 of these cases having the charges remitted in accordance with the Council's scale. In the 52 remaining cases, 11 made other arrangements for the confinement, and 13 cases had not been confined at the end of the year. Puerperal Pyrexia. Saventeen cases of puerperal pyrexia were notified during the year. The causes of pyrexia were considered to be :— Pyelitis 3 Puerperal mania 1 Endometritis 1 Influenza 2 Cystitis 1 Absorption of blood from peritoneal cavity following caesarean section 1 Puerperal sepsis 1 Mastitis 5 Not known 2 17 Obstetric Consultant. The advice of the Council's Consultant Obstetrician was sought on one occasion during the year. 44 Maternity Mortality. There were two maternal deaths of Leyton residents during the year. The causes of death were :— Acute general peritonitis following instrumental perforation of uterus 1 Puerperal eclampsia 1 2 Medical Aid. In accordance with the Rules of the Central Midwives' Board, a midwife must notify the Local Supervising Authority within 36 hours of every occasion on which she sends for medical aid. One hundred and eighty such notifications were received. Fees paid to Doctors under Section 14 (1) of the Midwives' Acts, 1918. One hundred and sixty-one accounts were received from general medical practitioners for assistance rendered to midwives under the provisions of this section. The total amount paid to medical practitioners during the year was £237 7s. Od. Assisted Milk Supply. As it is a condition of grant that the mothers or infants must attend the Authority's Centres—unless when unable to attend, in which case the home is visited by a Health Visitor—all mothers and infants in receipt of milk free or at reduced price are under medical supervision. Year. Pints of Fresh Milk. Packets of Dried Milk. Cost to Council. £ s. d. 1936 64,624 356 757 12 8 1937 61,598 395 824 11 11 1938 78,352 736 1,106 2 9 1939 71,728 930 1,042 15 4 1940 57,824 868 866 1 7 In accordance with Ministry of Health Circular No. 2053 the distribution of fresh milk under the Council's Scheme for assisted 45 milk supply ceased on the 31st July. The distribution of dried milk was continued until 31st August in accordance with a supplementary Ministry of Health Circular (2089) as arrangements for the provision of National Dried Milk could not be made hy the Ministry of Food until the end of August. The names and addresses of all persons receiving milk under the Council's Scheme were given to the local Food Executive Officer to ensure continuity of supply. Post-Natal and Gynaecological Clinic. The following figures show in statistical form the attendances during 1940 :—- Leyton Green. Park House. Total. Number of Sessions 16 10 26 Letters of Invitation 419 264 683 First Attendances 123 84 209 Re-attendances ... 67 51 119 During the year 26 sessions of the Post-Natal and Gynaecological Clinic were held. The number of new patients who attended was 209, out of 683 who received appointments to attend (= 30.6 per cent.). Of these, 192 were post-natal (i.e., they had had a confinement within the previous three months) ; and 16 were gynaecological. The disposal of these cases was as follows :— Discharged after one attendance 109 Re-attended for examination and treatment 119 The total number of attendances was 328. The average attendance per session was 12.57—with a maximum of 22 and a minimum of 1. Free medical prescriptions were issued in 37 cases at a total cost of £5 11s. 7d.; and 42 prescriptions were issued for payment by the patients. 46 The following are the main conditions which have been found on examination :— Subinvolution of the uterus 19 Retroversion of the uterus 43 Defective perineum 3 Cystocele and rectocele 3 Cervical erosion 15 Vaginitis 3 Ovarian cyst 1 Prolapsed uterus 2 Pregnancy 2 Sterility 2 Marked ansemia 16 Birth control 10 Record of Cases attended by Council Midwives, 1939 and 1940. Midwives (8) employed by Council (3) E.C.N.A. (5) Midwives employed by the E.C.N.A. under arrangement made with the Local Supervising Authority in pursuance of Sec. 1 of the Midwives' Act, 1936. Total 1939 1940 1939 1940 1939 1940 Cases attended :— (a) As Midwives 145 172 303 333 448 505 (b) As Maternity Nurses 23 36 85 68 108 104 Ante-natal Visits 612 700 415 1,298 1,027 1,998 Ante-natal Examinations 1,076 1,333 1,374 1,497 2,450 2,830 Post-natal Visits 3,242 3,768 7,517 7,849 10,759 11,617 47 SECTION G. PREVALENCE OF, AND CONTROL OVER INFECTIOUS AND OTHER DISEASES. SMALLPOX. During the year 1940 no case of smallpox occurred in the area. ENTERIC FEVER. Ten cases of enteric fever occurred during the year. SCARLET FEVER. Year. Cases Notified. Deaths. Case Fatality per cent. 1936 367 2 0.54 1937 309 0 0.00 1938 293 0 0.00 1939 233 1 0.43 1940 87 0 0.00 DIPHTHERIA. Year. Oases Notified. Deaths. Case Fatality per cent. 1935 276 8 2.89 1936 231 11 4.76 1937 161 7 4.34 1938 188 2 1.06 1939 148 3 2.02 1940 55 0 0.00 ARTIFICIAL IMMUNISATION AGAINST DIPHTHERIA. Immunisation by Private Medical Practitioners. Number of private medical practitioners who applied for supplies of toxoid-antitoxin 15 Number of children immunised 16 48 Record of Attendances during 1940. The following figures give particulars regarding the children dealt with at the municipal diphtheria immunisation clinics during 1940. The figures refer only to children who have finished—or failed to complete—the full course of innoculations during the year. Children who had commenced—but had not yet completed—the course at the end of the year will be shown in the report for next year. Under 2 yrs. 2-5 years. 5-10 years. 10-15 years. Total. Number of children who attended for immunisation 20 60 26 6 112 „ „ who completed course 19 58 25 6 108 „ ,, naturally immune — 3 1 1 5 ,, ,, immune after one injection — — — — — „ „ immune after 2 injections 19 51 22 5 97 „ „ immune after 3 injections — — — — — „ „ immune after 4 injections — 4 2 — 6 „ „ immune after 5 injections — — — — — „ „ immune after 6 injections — — — — — Removed from district 1 1 1 — 3 Failed to attend for Final Schick Test — 1 — — 1 „ „ Schick Reading — — — — — „ „ after 1 injection — — — — — Total number of Attendances during 1940 78 234 99 21 432 Incidence of Diphtheria Among Protected Persons. It is not claimed that artificial immunisation will prevent a person from infection by diphtheria organisms. What is claimed is that successful artificial immunisation will prevent the immunised person from developing the dangerous toxaemic manifestations of diphtheria. During 1940 one Leyton child, who had been immunised previously, was notified to be suffering from diphtheria. The following table gives in summary form the information regarding this case. Age. Sex. Date of Immunisation. Schick Test Negative. Date of Notification. Swab Results. T=Throat. N=Nose. E = Ear. 8 yrs. F. 25.2.37 15.7.37 10.7.40 T+ Not clinical diphtheria 49 TUBERCULOSIS. Notifications.—One hundred and six patients were notified for the first time in 1940 as suffering from tuberculosis. The number was made up as follows :— Males. Females. Total. Pulmonary Tuberculosis 49 33 82 Non-Pulmonary Tuberculosis 11 13 24 60 46 106 During the year it was found possible to remove from the tuberculosis register the names of 3 children and 12 adults in whom evidence of active disease had ceased to exist. The following is a statement of particulars appearing in the Register of Notifications of Cases of Tuberculosis for the year ended 31st December, 1940 Pulmonary. Non-Pulmonary. total M. F. Total. M. F. Total. Number on Register at commencement of year 288 229 517 39 51 90 607 Number first notified during the year 49 33 82 11 13 24 106 Number of cases entered in Register otherwise than by Notification 17 14 31 4 3 7 38 Number removed from the Register during the year 96 56 152 18 17 35 187 Number remaining at the end of the year 258 220 478 36 50 86 564 Details of cases removed from the Register during the year:— Died 49 19 68 7 4 11 79 Removed from the district 44 33 77 6 10 16 93 De-notified 3 4 7 5 3 8 15 Deaths.—Seventy-three deaths from tuberculosis were recorded. 50 The following table gives particulars regarding the new cases which have occurred during the year :— Age Periods. New Cases. Pulmonary. Non-Pulmonary. M. F. M. F. 0 — — — — 1 — 2 4 2 5 — — 1 3 10 — 1 1 — 15 4 3 2 1 20 7 8 1 1 25 17 14 2 1 35 4 4 — 3 45 11 1 — 1 55 2 — — — 05 and upwards 4 — — 1 Totals 49 33 11 13 Institutional Treatment. During 1940 the following Leyton patients were sent to sanatoria or other institutions for the treatment of Tuberculosis :— Pulmonary. Non-Pulmonary. Total. Males. Females. Males. Females. Adults 44 38 2 3 87 Children 1 0 4 1 6 51 TABLE No. 13. CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR 1940. DISEASE. At All Ages Under 1 1-2 2-3 3-4 4-5 5-10 10-15 15-20 20-35 35-45 45-65 65 and up Smallpox ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria 55 3 6 4 4 6 8 6 6 6 3 3 — Erysipelas 31 ... ... ... ... 1 ... ... 1 3 6 14 6 Scarlet Fever 87 ... 3 6 5 4 36 20 3 7 ... 3 ... Pemphigus Neon ... ... ... ... ... ... ... ... ... ... ... ... ... Pulmonary T.B. 81 ... ... 1 1 ... ... 1 7 46 8 14 ... T.B. Others 24 ... 3 ... 1 2 4 1 3 5 3 2 ... Pneumoma 50 3 1 2 ... 4 2 1 9 7 16 5 ... Ophthalmia Neon. 4 4 ... ... ... ... ... ... ... ... ... ... ... Enteric Fever 10 ... ... 1 ... ... 2 ... 4 2 1 ... ... Puerperal Pyrexia 17 ... ... ... ... ... ... ... 2 12 3 ... ... Cerebrospinal Meningitis 10 2 1 3 ... ... 1 ... 1 ... ... 2 ... Poliomyelitis ... ... ... ... ... ... ... ... ... ... ... ... ... Enc. Lethargiea ... ... ... ... ... ... ... ... ... ... ... ... ... Dysentery 1 ... ... ... ... ... ... 1 ... ... ... ... ... Measles 127 11 7 10 7 13 44 6 9 11 3 4 2 Whooping Cough 8 1 1 4 ... ... 1 ... ... ... 1 ... ... Totals 505 24 22 31 18 30 99 35 45 99 44 47 11 52 TABLE 14. CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR 1940. DISEASE. Total. Leyton. Lea Bridge. Central North. Central South. Forest. Leytonstone. Grove Green. Harrow Green. Cann Hall. Wanstead Slip. Removed to Hospitals. Smallpox ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria 55 4 6 3 6 8 7 12 2 1 6 55 Erysipelas 31 ... 10 3 4 3 5 2 1 2 1 9 Scarlet Fever 87 3 14 7 6 13 5 6 8 21 4 56 Pemphigus Neon. ... ... ... ... ... ... ... ... ... ... ... ... Pulmonary T.B. 81 5 13 8 10 11 8 7 7 10 2 ... T.B. Others 24 1 5 1 3 2 3 2 2 5 ... ... Pneumonia 50 ... 14 ... 7 14 5 2 4 1 3 18 Ophthalmia Neon. 4 ... 1 1 1 ... 1 ... ... ... 1 3 Enteric Fever 10 ... ... 1 ... 9 ... ... ... ... ... 10 Puerperal Pyrexia 17 ... 4 2 1 3 3 1 1 1 1 13 Cerebrospinal Meningitis 10 ... 1 2 2 1 ... 3 ... 1 ... 10 Poliomyelitis ... ... ... ... ... ... ... ... ... ... ... ... Enc. Lethargica ... ... ... ... ... ... ... ... ... ... ... ... Dysentery 1 ... ... ... ... 1 ... ... ... ... ... ... Measles 127 9 6 10 38 17 11 11 5 9 11 14 Whooping Cough 8 1 1 1 1 1 ... 1 ... 1 1 2 Totals 505 23 75 39 78 83 48 47 30 52 30 191 53 SCHOOL MEDICAL SERVICE. GOVERNMENT EVACUATION SCHEME. When war broke out the school roll was declining and an approximate roll as at 31st March, 1940, would be 11,700. Estimated figures showing the present distribution (December, 1940) of these children are given below :— (a) In Leyton 5,000 (b)Evacuated — (i) In Essex (remaining from the September, 1939, evacuation) 900 (ii) In two National Camps—as from April, 1940. (Central Schools) 480 (iii) In West Country and Wales (5 counties). June, 1940, evacuation 1,260 (iv) In Home and South Midland, etc., counties. Plan V " trickle " scheme—since June, 1940 610 (v) With Mothers—officially 1,450 (vi) Privately—recorded 700 (vii) „ unrecorded 730 (c) Children under five still in Leyton and at present excluded from School 570 11,700 In addition to the above figures, 1,860 children under School age have been officially evacuated with their Mothers. Following the first evacuation in September, 1939, schooling was resumed in all schools in Leyton on a voluntary basis early in November of the same year, and compulsory education was restored in April, 1940. Adequate air raid shelter accommodation is provided in all Schools ; and normal schooling began again in the Borough on 15th July, 1940. 54 DAMAGE TO PREMISES. After Park House Health Centre was damaged by enemy action on 15th October, all school medical service clinics serving that area were transferred to premises in Cathall Road Public Baths. On 5th December enemy action was responsible for the destruction of that part of Knotts Green Special School containing the medical inspection room, orthopaedic clinic and artificial sunlight clinic ; and all the current medical records relating to physically and mentally defective children were destroyed. ROUTINE MEDICAL INSPECTION. A.—Routine Medical Inspection. Number of Inspections in the prescribed groups. Entrants 682 Second Age Group 549 Third Age Group 549 Total 1,780 Of 1,780 children who were examined in the code age-groups, 1,453 (or over 81 per cent.) were accompanied by their parents. B.—Other Inspections. Special Inspections. The number of special inspections during the year was 2,657 comparing with 5,108 during the previous year. Re-inspections. The number of re-inspections during 1940 was 3,112. 55 The Findings of Medical Inspection. Number of Individual Children found at Routine Medical Inspection to require Treatment (excluding Defects of Nutrition, 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 682 100 14.6 Second Age Group 549 116 21.1 Third Age Group 549 90 16.4 Total (Code Groups) 1780 306 17.1 Uncleanliness and Verminous Conditions.—At the special inspections held by the school nurses, 664 children were found to be unclean out of a total number of 9,871 examined (i.e., 6.7 per cent.). Cleanliness Surveys in Individual Schools. School. Number of Examinations. Number Cautioned. Number Excluded. Canterbury Road 393 4 — Capworth Street 754 41 11 Cann Hall Road 270 6 2 Church Road 589 46 8 Connaught Road 527 22 11 Downsell Road 563 61 13 Da vies Lane 907 27 10 Farmer Road 944 24 11 Goodall Road 873 73 17 Kirkdale Road 179 4 1 Lea Bridge Road 59 3 — Mayville Road 1,007 75 51 Norlington Road 366 39 8 Newport Road 754 24 5 Ruckholt Road 65 1 2 Sy bourn Street 706 18 3 St. Joseph's 204 6 — Trumpington Road 230 4 — Tom Hood 181 — — Knotts Green 300 24 5 Total 9,871 504 160 Number of individual children found unclean 664 of whom 160 were referred to the Minor Ailments Clinics. 56 TABLE II. A.—Return of Defects found by Medical Inspection in the Year ended 31st December, 1940. Defect or Disease. Routine Inspections. Special Inspections. Number requiring Treatment. Observation. Number requiring Treatment. Observation. (1) (2) (3) (4) (5) Skin Ringworm—Scalp ... ... 2 ... Body ... ... 9 ... Scabies ... ... 47 ... Impetigo 1 ... 55 ... Other diseases (non-T.B.) 6 ... 266 ... Eye Blepharitis 7 1 27 ... Conjunctivitis 1 ... 31 ... Keratitis ... ... 1 ... Corneal Opacities ... ... 2 ... Defective Vision 102 15 67 ... Squint 12 ... 51 ... Other conditions 5 ... 13 ... Ear Defective Hearing 1 ... 7 ... Otitis Media 4 5 26 ... Other Ear Diseases 7 1 47 ... Nose & Throat Chronic Tonsilitis only 52 29 35 ... Adenoids only 8 2 ... ... Chronic Tonsilitis & Adenoids 10 2 24 ... Other conditions 13 3 91 1 Enlarged Cervical Glands (non-T.B.) 15 6 28 ... Defective Speech ... ... 11 ... Heart and Circu- lation Heart Disease— Organic 4 ... 14 ... Functional 6 5 ... ... Anaemia 5 ... 48 ... Lungs Bronchitis 8 6 33 ... Other non-T.B. Diseases 5 11 24 ... Tuberculosis Pulmonary— Definite ... 1 2 ... Suspected ... 2 ... ... Non-Pulmonary— Glands ... 4 ... ... Bones and Joints ... ... 1 ... Skin ... ... ... ... Nervous Other Forms 1 3 ... ... Epilepsy 1 ... 4 ... Chorea ... ... 7 ... System Deformities Other conditions 3 1 45 1 Rickets 1 ... ... ... Spinal Curvature 2 ... 2 ... Other Forms 26 13 31 ... Other Defects and Diseases 32 11 1,113 2 Totals 338 121 2,164 4 57 MEDICAL TREATMENT. Minor Ailments Clinic. Attendances. During the year 1,494 children attended the clinic, and 3,620 attendances were registered. Defective Vision—Of the 1,780 children subjected to routine code group inspection in the schools, 127 (7.1 per cent.) were found to be suffering from some eye defect requiring treatment Special Eye Clinic.— During the year, the Ophthalmic Surgeon had referred to him 512 children, who made 559 attendances for examination and treatment. Report by the Authority's Ophthalmic Surgeon (J. D. Magor Cardell, M B., B.S., F.R.C.S.). The work of the Eye Clinic has been influenced by evacuation and by war conditions generally. The number of children attending the clinic has been greatly reduced and the school population having been in a fluctuating state, it is not possible to record the relative incidence of myopia or other defects. That many children have spent much time in badly lit shelters reading or otherwise focussing on near objects must uncover and emphasise ocular defects which, under better conditions, would not have become noticeable. Such defects will probably come under observation in the future. It must be recorded that, though there is ample opportunity of detecting any nervousness during the routine examination of children's eyes, no evil effects from exposure to air raids could be detected. The children of Leyton must obviously be made of the same resilient stuff as is found in the rest of the country. Squint Clinic. Report by Orthoptist (Miss G. Montague Smith). The following table classifies the cases dealt with at the special Squint Clinic during the past year. For many children the 58 course of treatment has temporarily ceased owing to evacuation, or failure to attend because of raids. The results therefore cannot compare with those of previous years when the course of treatment was carried on uninterruptedly. I. Number of attendances made 785 Number of children attending clinic 121 (New cases 39, Old cases 82) Observation cases—no detectable squint 8 Left district 12 Left school 3 Failed to attend 5 Unsuitable for treatment 3 Awaiting operation 4 Previously discharged cases attending for "check-up" 19 II. Treated for defective vision (Amblyopia only) 12 Cured 1 (*now having orthoptic Improving 8 treatment) Only just commenced 2 (one now evacuated) Poor attendance 1 111. Treated with orthoptic exercises 34 Discharged ... 6 (4 cured with stereopsis) (2 improved) Still on Treatment 10 ( + 1*) Rest from Treatment 2 Awaiting operation 2 Evacuated 8 Will not attend because of raids 6 Waiting list (20 evacuated) 21 59 School Dental Service. Findings of Dental Inspection. The following table shows in statistical form the results of school dental inspection in individual schools and over the whole area. School. Number inspected. Number referred for treatment. Number accepting treatment. Percentage of acceptances. Boys. Girls. Boys. Girls. Canterbury 249 123 124 65 84 44.0 Cann Hall 127 112 85 74 76 47.8 Capworth 183 428 108 239 210 46.7 Church 42 283 18 161 103 57.5 Connaught 39 94 26 60 50 58.0 Davies Lane 307 121 206 80 169 59.1 Downsell 148 37 115 17 56 42.4 Farmer 331 40 200 27 106 46.7 Goodall 191 244 134 168 152 50.3 Kirkdale 39 17 18 10 11 39.0 Knotts Green 33 31 28 26 35 64.8 Lea Bridge 27 23 16 15 14 45.1 Mayville 58 151 43 109 112 73.6 Newport 362 74 227 41 118 44.0 Norlington 99 355 57 190 124 50.0 Ruckholt 207 173 109 106 144 67.0 Sy bourn 330 176 183 106 172 59.5 St. Joseph's 33 33 21 17 20 52.6 Tom Hood 219 186 137 122 149 57.5 Trumpington 170 149 113 103 131 60.6 3,194 2,850 1,968 1,736 2,036 54.9 REPORT BY THE AUTHORITY'S SENIOR DENTAL OFFICER (A. E. HALL, L.D.S.) During the year 1940 dental inspection and treatment have been carried out in the Borough of Leyton closely following the Board of Education Circular No. 1523 of 21st August, 1940. From the beginning of the year until the end of March there was one Dental Officer working full-time within the Borough and one full-time in Essex with our evacuees. From April until June the officer who had worked full time in Essex divided his time equally between Essex and Leyton, and from June onwards almost full time within the Borough, with occasional visits to the County as circumstances demanded. It was found possible to carry our dental inspection in all the schools of the Borough during the year, and complete the treatment of all children who accepted. 60 Attendances. Good attendances were experienced at the clinics until after the second evacuation in June, 1940. Following this, and also as a result of repeated air raid warnings and nightly attack, there were many broken appointments. After some weeks, however, attendances improved and maintained a steady level. Several other factors have also had an adverse affect on attendances mainly under the following heads:— (1) Park House Clinic being closed due to unexploded bombs it was necessary to transfer the usual attendants there to Leyton Green Clinic. (2) October 21st—November 2nd, all Park House work again transferred to Leyton Green Clinic. (3) November 4th, 1940, Cathall Road Combined Treatment Centre being opened, all Park House work was again transferred there until the end of the period dealt with in this report. (4) Many of the regular acceptors of dental treatment also accepted evacuation. Percentage Acceptance Rates. These figures show big differences in many instances from previous reports, and in present circumstances cannot be used in a comparative sense. For example:— Norlington acceptance rate shows a fall from 73.5 per cent. to 50.0 per cent. This was due to evacuation following so closely upon inspection that there had not been time for acceptance forms to be returned. Mayville shows an increase from 14 per cent, to 73.6 per cent. Here the exceptionally low figure in the first instance was due, as above, to the 1939 evacuation following closely upon inspection. When the 1940 inspection was due the school was temporarily closed, and notices were sent to the children's homes to attend at the clinic for inspection, and, where necessary, treatment. Consequently nearly every case found to require treatment received it at the time of inspection, and all wastage due to the parent forgetting to return the form, or due to children being evacuated before they had received treatment, was eliminated. Secondary Schools. All pupils attending the Leyton Secondary School for Boys have been inspected and offered treatment where necessary irrespective of whether they normally attend there, or are attending there from other areas. 61 The non-evacuees of the Leyton Secondary School for girls who now attend school in Walthamstow are not dealt with in this report. Dental Treatment in Reception Areas. Central School Camps. Early in July, 1940, all children at the Ruckholt and Tom Hood Camps were dentally inspected by one of the Council's Dental Officers. Parents were invited to accept treatment in the usual manner, and the results notified to the respective County Authorities. As little had been done for these children by the middle of November, except by way of emergency treatment at the Tilford Camp, one of your Dental Officers established a dental clinic in the Camp hospital, and having inspected all the new entrants since the July inspection, and also re-inspected all children who had sound mouths the previous July, carried out complete treatment for all the acceptors. Below is a brief analysis of the nine days work:— Number of children examined 245 Number referred for treatment 114 Number actually treated 106 Fillings—Permanent teeth 137 Extractions—Permanent teeth 41 Temporary teeth 42 Scalings 7 Local anaesthetics administered 102 At Tom Hood Camp one of the West Sussex Dental Officers had commenced treatment but had been held up from September 22nd until November 5th by chicken-pox in the Camp. Here again all new entrants were inspected, together with the sound mouths from the July inspection. Treatment, although proceeding, is much in arrear being only on a part-time basis. Secondary Schools. The Leyton Secondary School children evacuated to Brentwood have received treatment during the year. Elementary Schools. Mr. Horton worked full-time in the County of Essex until the end of March, 1940. Thereafter several sessions weekly which were reduced in frequency as the number of Leyton children in Essex was reduced by further evacuation to new areas. 62 The following table shows the work done for these children by Mr. Horton. Secondary Elementary Number of children examined 328 639 Number found to require treatment 106 225 Attendances made by children for treatment – 324 Half-days to inspection 2 12 Half-days to treatment 13 71 Fillings—Permanent teeth 50 219 Temporary teeth – 6 Extractions—Permanent teeth 1 66 Temporary teeth – 199 Other operations—Permanent teeth 9 58 Temporary teeth – 8 General anaesthetics for extractions – 89 General anaesthetics admin istered for the County – 100 I am unable to report on the dental condition, or facilities offered for treatment to our Leyton children evacuated to the West Country. ORTHOPAEDIC CLINIC. ARTIFICIAL SUNLIGHT CLINIC. All the records relating to the Othopaedic Clinic and the Artificial Sunlight Clinic were destroyed by enemy action. AURAL CLINIC. This work, which was suspended at the outbreak of war, was begun again in December, 1939. It is with great regret that I have to report the sudden death, in August, 1940, of Mr. C. R. Sandiford, F.R.C.S., who has filled the appointment of Aural Consultant (part-time) since the initiation of the Council's Special Aural Clinic in July, 1938. Mr. Sandiford was an expert surgeon, a sound clinician, and a specialist who commanded the respect and confidence of both patients and staff. His death was a severe loss to the department. Mr. Sandiford's successor, Mr. W. H. B. Magauran, F.R.C.S., took over the duties of Aural Consultant in November, 1940. The following list shows the relevant particulars regarding the Leyton school children who attended the Aural Clinic for treatment during 1940. 63 AURAL CLINIC. School Cases. Nature of Disease. Still under treatment. Recommended Hospital treatment. Recommended Special School. Discharged as cured. Discharged as improved. Discharged as no treatment required. Discharged as left district. Discharged as left school. Totals. (i) Acute Suppurative Otitis Media 3 ... ... 3 ... ... ... ... 6 (ii) „ Catarrhal ,, „ 2 ... ... 1 ... ... ... ... 3 (iii) Chronic Suppurative Otitis Media due to:— 1. Tympanic Sepsis ... ... ... 2 ... ... 1 ... 3 2. ,, „ and Granulations 1 ... ... 1 ... ... ... 1 3 3. „ ,, and Polypi ... ... ... ... ... ... ... ... ... 4. ,, „ and previous Mastoid Operation ... ... ... 2 1 ... ... ... 3 5. Other causes ... ... ... ... 1 ... ... ... 1 (iv) Mastoid Disease (previous operation) 1 1 ... ... ... ... ... ... 2 (v) Partial Deafness due to:— 1. Nerve Deafness 1 ... ... ... ... ... ... ... 1 2. Tonsils and Adenoids 3 ... ... ... ... ... ... ... 3 3. Retraction of Memhrana Tympani ... ... ... ... 1 ... 1 ... 2 4. Scarring ... ... ... ... ... ... ... ... ... 5. Catarrhal Rhinitis 3 ... ... 4 ... ... ... 1 8 6. Wax ... ... ... ... ... ... ... ... ... 7. Other Causes ... ... ... ... 1 ... ... ... 1 (vi) Nasal Cases:— 1. Hypertrophic Rhinitis 1 ... ... ... 2 ... ... ... 3 2. Sinusitis 2 ... ... ... ... ... ... ... 2 3. Atrophic Rhinitis 4 ... ... ... ... ... ... ... 4 4. Deviated Septum ... ... ... ... 2 ... 1 1 4 5. Foreign Body ... ... ... ... ... ... ... ... ... 6. Polypus 4 ... ... 1 ... ... ... ... 5 (vii) Tonsils and Adenoids 25 25 ... 6 ... 1 ... ... 57 (viii) Other Diseases or Defects 6 ... ... 4 ... ... ... ... 10 Totals 56 26 ... 24 8 1 3 3 121 64 PHYSICALLY AND MENTALLY DEFECTIVE CHILDREN. Mental Defective Children. Statutory Medical Examinations. During the year, some 53 children were referred for statutory medical examination. As the result of examination these 53 children were classified as follows :— Idiots 0 Imbeciles 1 Moral defectives 0 On attaining 16 years of age—for supervision under the M.D. (Notification of Children) Regulations 1 Certified to Local Education Authority as feebleminded 5 Remained under certificate 18 Certificate withdrawn 1 Dull and backward 9 Backward 2 Borderline cases—to be re-assessed in six months 11 Normal 5 53 Knotts Green Special School for Mental Defectives. Admitted 3 Discharged 8 Physically Defective Children. Knotts Green Open Air School. Admitted during the year 21 Discharged 42 65 PROVISION OF MEALS. The provision of meals to children attending the elementary schools is undertaken by the Education Authority under powers granted by Sections 82-85 of the Educatiin Act, 1921. The average number of children fed per week :—40 The number of individual children fed under the Authority's arrangements during 1940 was as follows:— Ordinary Meals. Milk Meals. Free 122 901 For payment 17 Totals 139 901 Number of meals supplied:— Ordinary Meals. Milk Meals. Free 9,443 156,835 For payment 844 – Totals 10,287 156,835 The above figures relate to the financial year ended 31st March, 1941. 66 PUBLIC ELEMENTARY SCHOOLS. STATISTICAL APPENDIX. TABLE I.—Returns of Medical Inspections, a. Routine Medical Inspections. Number of Code Group Inspections:— Entrants 682 Second Age Group 549 Third Age Group 549 Total 1,780 b. Other Inspections. Number of Special Inspections 2,657 Number of Re-inspections 3,112 Total 5,769 C. Children Found to Require Treatment. Number of individual children found at Routine Medical Inspection tn require treatment (excluding defects of Nutrition, Uncleanliness and Dental Diseases). Group. For Defective Vision (excluding Squint). For all other Conditions recorded in Table II.A. Total. Percentage of children found to require Treatment. Entrants – 100 100 14.6 Second Age Group 42 74 110 21.1 Third Age Group 58 32 90 16.4 Total (Prescribed Groups) 100 206 306 17.2 Other Routine Inspections – – – – Grand Total 100 206 306 17.2 67 TABLE II. Classification of the Nutrition of Children Inspected during the Year in the Routine Age Groups. Age Groups. No. of Children Inspected. A. (Excellent). B. (Normal). C. (Slightly Subnormal). D. (Bad). No. % No. % No. % No. % Entrants 682 64 9 483 71 121 18 14 2 Second Age Group 549 78 14 407 74 64 11 – – Third Age Group 549 48 8 405 74 93 17 3 0.5 Other Routine Inspections – – – – – – – – – Total 1,780 190 10 1,295 73 278 15 17 0.9 TABLE III.—Return of Defects Treated during the Year ended 31st December, 1940. TREATMENT TABLE. Group I.—Minor Ailments (excluding Uncleanliness, for which see Table V). Disease or Defect. Number of Defects treated or under treatment during the year. Under the Authority's Scheme. Otherwise. Total. (1) (2) (3) (4) Skin— Ringworm— Scalp—(1) X-ray treatment – – – (2) Other 2 – 2 Body 9 – 9 Scabies 47 – 47 Impetigo 55 – 55 Other skin diseases 265 – 265 Minor Eye Defects— (External and other, but excluding cases falling in Group II.) 113 – 113 Minor Ear Defects 73 – 73 Miscellaneous— (e.g., minor injuries, bruises, sores, chilblains, etc.) 380 – 380 Total 944 – 944 68 TABLE III.—contd. Group II.—Defective Vision and Squint (excluding Minor Eye Defects treated as Minor Ailments.—Group I.). Defect or Disease. Number of Defects dealt with. Under the Authority's Scheme. Otherwise. Total. (1) (2) (3) (4) Errors of refraction (including squint) 400 40 440 Other defect or disease of the eyes (excluding those recorded in Group I.) 102 – 102 Total 502 40 602 Under the Authority's Scheme. Otherwise. Total. No. of Children for whom Spectacles were:— (a) Prescribed 356 40 396 (b) Obtained 354 42 396 TABLE IV. Dental Inspection and Treatment (1) Number of children who were:— (a) Inspected by the Dentist:— Aged: Age Groups 3 Total 6,044 4 5 346 6 649 7 601 8 672 9 686 10 722 11 577 12 665 13 616 14 447 15 56 16 7 69 Specials (Casuals) 651 Grand Total 6,695 (b) Found to require treatment 3,704 (c) Actually treated 2,349 (2) Half-days devoted to Inspection 81 Treatment 469—Total 550 (3) Attendances made by children for treatment 4,576 (4) Fillings, Permanent Teeth 2,408 Temporary ,, 164-Total 2,572 (5) Extractions, Permanent Teeth 644 Temporary ,, 4,278—Total 5,722 (6) Administrations of general anaesthetics for tions 1,430 (7) Other operations, Permanent Teeth 355 Temporary „ 66—Total 421 TABLE V. Uncleanliness and Verminous Conditions. (1) Average number of visits per school made during the year by the School Nurses 3 (2) Total number of examinations of children in the Schools by School Nurses 10,061 (3) Number of individual children found unclean 501 (4) Number of children cleansed under arrangements made by the Local Education Authority – (5) Number of cases in which Legal proceedings were taken:— (a) Under the Education Act, 1921 – (b) Under the School Attendance Bye-laws – 70 TABLE VI. Blind and Deaf Children. (1) (2) (3) (4) At a Public Elementary School. At an Institution other than a Special School At no School or Institution. Total not receiving suitable Education. Blind Children – – – – Deaf Children – – – – Mentally Defective Children. Total number of children notified during the year ended 31st December, 1940, by the Local Education Authority to the Local Mental Deficiency Authority, under the Mental Deficiency (Notification of Children) Regulations, 1928 8 SECONDARY SCHOOLS. STATISTICAL APPENDIX. TABLE I.—Returns of Medical Inspections. a. Routine Medical Inspections. Number of Code Group Inspections:— County High School for Boys 150 „ Girls Nil Total 150 Number of other Routine Inspections – b. Other Inspections. Number of Special Inspections Nil Number of Re-inspections Nil Total – 71 Children Found to Require Treatment. Group. Number of Children. Percentage of Children found to require treatment. Inspected. Found to require treatment. (1) (2) (3) ( 4) County High School for Girls – – – County High School for Boys 150 9 6.0 TABLE II. Classification of the Nutrition of Children Inspected during the Year in the Routine Age Groups. Age Groups. No. of Children Inspected. A. (Excellent). B. (Normal). C. (Slightly Subnormal). D. (Bad). No. % No. % No. % No. % County High School for Girls Nil ... ... ... ... ... ... ... ... County High School for Boys 150 49 32.7 99 66.0 2 1.3 ... ... 72 TABLE 3.—Return or Defects Treated during the Year. TREATMENT TABLE. Group I.—Minor Ailments (excluding Uncleanliness). Disease or Defect. Number of Defects treated or under treatment during the year. Under the Authority's Scheme. Otherwise. Total. (1) (2) (3) (4) Skin— Ringworm— Scalp—(1) X-ray treatment – – – (2) Other – – – Body – – – Scabies – – – Impetigo – – – Other skin diseases 1 – 1 Minor Eye Defects— (External and other, but excluding cases falling in Group II.) – – – Minor Ear Defects 1 – 1 Miscellaneous— (e.g., minor injuries, bruises, sores, chilblains, etc.) 2 – 2 Total 4 – 4 TABLE 3.—contd. Group II.—Defective Vision and Squint (excluding Minor Eye Defects treated as Minor Ailments.—Group I.). Defect or Disease. Number of Defects dealt with. Under the Authority's Scheme. Otherwise. Total. (1) (2) (3) (4) Errors of refraction (including squint) 37 18 55 Other defect or disease of the eyes (excluding those recorded in Group I.) 4 – 4 Total 41 18 69 Total number of children for whom spectacles were prescribed— (а) Under the Authority's Scheme 28 (b) Otherwise 18 73 TABLE 4. Dental Inspection and Treatment. (1) Number of children who were:— (a) Inspected by the Dentist:— Aged: Age Groups 11 51 Total 512 12 83 13 145 14 50 15 172 16 6 17 5 18 – Specials (Casuals) 5 Grand Total 517 (b) Found to require treatment 211 (c) Actually treated 91 (2) Half-days devoted to Inspection 3 Treatment 21—Total 24 (3) Attendances made by children for treatment 169 (4) Fillings, Permanent Teeth 171 Temporary ,, Nil—Total 171 (5) Extractions, Permanent Teeth 3 Temporary „ 9—Total 42 (6) Administrations of general anaesthetics for extractions 16 (7) Other operations, Permanent Teeth 39 Temporary ,, Nil—Total 39