LEY 38 Borough of Leyton. HEALTH REPORT FOR THE YEAR 1944. ANDREW W. FORREST, M.A., M.D., Ch.B., D.P.H., Medical Officer of Health, School Medical Officer. 1 TO THE MAYOR, ALDERMEN AND COUNCILLORS OF THE BOROUGH OF LEYTON. Mr. Mayor, Ladies and Gentlemen, As in the previous war years, my Annual Report for the year 1944 is in the abridged and abbreviated form suggested by the Ministry of Health and Ministry of Education. The number of births registered during 1944 was 1613, representing a birth rate of 18.87 per thousand of the population; the comparative birth rate for England and Wales was 17.6. With the exception of the year 1941, there has occurred a gradual and progressive rise in the Leyton birth rate from 11.85 in the year 1936 to 18.87 in the year under review. The general death rate from all causes was 15.04 per thousand of the population, the infantile mortality rate 42.15 per thousand live births, and the maternal mortality rate 1.20 per thousand total births. Since the year 1938 the Health Department has been obliged to increase its scope and activities by the provision of medical, nursing and ambulance service facilities connected with the war effort. These include the establishment, equipment and operation of such Civil Defence Casualty Services as First Aid Posts (stationary and mobile), Gas Cleansing Centres, Ambulance and Mortuary Services. Two wartime Day Nurseries have provided care and supervision for the children of women war workers. Medical Aid Posts have supplied medical and nursing facilities for the occupants of three large underground tunnel shelters. Special arrangements have been in operation for the decontamination of food. The different forms of enemy air activity, and the damage caused thereby, have presented health and housing problems requiring constant and vigilant attention by the sanitary department. The evacuation of mothers and children to reception areas throughout the country called for the institution of arrangements for the medical inspection of large numbers of evacuees at very short notice. These, and many allied services connected with the war effort, have been provided in addition to the normal peace-time health services by a depleted medical, nursing, sanitary and clerical staff, who have been engaged in voluntary war work outside their official hours of duty. 2 I desire to record my appreciation of the valuable and faithful manner in which the members of the staff of my department have shouldered and carried through the responsible and onerous extra duties and responsibilities which have devolved on them during the past six trying years. I have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your obedient servant, 4 Extract from Vital Statistics for the year 1944. Live Births:— Legitimate Males 815 Females 735 Illegitimate Males 30 Females 33 Totals 1,613 Birth Rate per 1,000 of population 18.87 Stillbirths:— Males 24 Females 30 Rate per 1,000 total (live and still) births 32.39 Deaths:— Males 685 Females 600 Totals 1,285 Death Rate per 1,000 15.04 Number of women dying from diseases and accidents of pregnancy and childbirth:— From Sepsis 0 From other causes 2 Rate per 1,000 total (live and still) births 1.20 Death rate of infants under one year of age:— All infants per 1,000 live births 42.15 Legitimate infants per 1,000 legitimate live births 38.71 Illegitimate infants per 1,000 illegitimate live births 126.98 Deaths from Cancer (all ages) 178 „ ,, Measles (all ages) 0 „ „ Whooping Cough (all ages) 4 „ „ Diarrhoea (under 2 years of age) 9 5 TABLE 1. Registered Births, 1944. Leyton. Lea Bridge. Central North. Central South. Forest. Leytonstone. Grove Green. Harrow Green. Cann Hall. Wanstead Slip. Total. January 3 6 9 7 12 6 8 6 9 7 73 February 4 7 1 6 9 4 2 5 2 1 41 March 7 7 6 4 7 9 10 7 10 3 70 April 2 7 7 8 16 10 8 2 6 7 73 May 2 7 4 4 15 4 7 14 5 3 65 June 4 9 4 5 9 13 4 4 6 6 64 July 3 3 9 4 6 2 5 5 8 3 48 August 3 5 — 3 6 7 5 8 3 2 42 September — 10 1 — 1 5 3 3 3 — 26 October — 8 1 5 4 10 3 3 — 1 35 November 2 4 2 1 6 6 4 2 5 2 34 December 5 2 2 12 3 3 4 6 — 2 39 Transferables 95 166 85 93 198 132 58 61 50 65 1003 Totals 130 241 131 152 292 211 121 126 107 102 1613 6 TABLE 2. CAUSES OF DEATH AT DIFFERENT PERIODS OF LIFE IN THE BOROUGH OF LEYTON, 1941. 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 ... ... ... ... ... ... ... ... ... ... ... ... ... ... F ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3. Scarlet fever M ... ... ... ... ... ... ... ... ... ... ... ... ... ... F ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4. Whooping cough M 1 1 ... ... ... ... ... ... ... ... ... ... ... ... F 3 2 1 ... ... ... ... ... ... ... ... ... ... ... 5. Diphtheria M 1 ... ... 1 ... ... ... ... ... ... ... ... ... ... F ... ... ... ... ... ... ... ... ... ... ... ... ... ... 6. Tuberculosis of respiratory system M 30 ... ... ... ... 2 5 4 8 7 4 ... ... ... F 26 ... ... 1 ... 1 9 7 3 3 2 ... ... ... 7. Other forms of tuberculosis M 4 ... ... ... 1 1 ... ... ... ... 1 1 ... ... F 4 1 1 ... ... 1 ... ... 1 ... ... ... ... ... 8. Syphilitic disease M 11 ... ... ... ... ... ... ... 5 2 2 2 ... ... F 2 ... ... ... ... ... ... ... ... 1 ... 1 ... ... 9. Influenza M 3 ... ... 1 ... ... ... ... 1 1 ... ... ... ... F 3 ... ... ... ... 1 ... ... 1 ... ... 1 ... ... 10. Measles M ... ... ... ... ... ... ... ... ... ... ... ... ... ... F ... ... ... ... ... ... ... ... ... ... ... ... ... ... 11. Acute poliomyelitis and polioencephalitis M ... ... ... ... ... ... ... ... ... ... ... ... ... ... F ... ... ... ... ... ... ... ... ... ... ... ... ... ... 12. Acute infectious encephalitis M 1 ... ... ... ... ... ... 1 ... ... ... ... ... ... F 2 ... ... ... ... 1 ... 1 ... ... ... ... ... ... 13. Cancer of buccal cavity and oesophagus (males only) M 9 ... ... ... ... ... ... ... 1 1 6 1 ... ... 13. Cancer of uterus F 12 ... ... ... ... ... ... 1 6 1 4 ... ... ... 14. Cancer of stomach and duodenum M 24 ... ... ... ... ... 1 ... 4 7 7 5 ... ... F 12 ... ... ... ... ... ... ... 4 1 2 5 ... ... 7 15. Cancer of breast M ... ... ... ... ... ... ... ... ... ... ... ... ... ... F 18 ... ... ... ... ... ... 2 1 6 5 4 ... ... 16. Cancer of all other sites M 59 ... ... ... ... ... ... 5 2 13 30 9 ... ... F 44 ... ... ... ... 1 1 2 7 9 12 12 ... ... 17. Diabetes M 4 ... ... ... ... ... ... ... ... ... 3 1 ... ... F 2 ... ... ... ... ... ... ... ... ... 1 1 ... ... 18. Intra-cranial vascular lesions M 50 ... ... ... ... ... 1 2 2 12 20 13 ... ... F 57 ... ... ... ... ... ... ... 3 11 15 28 ... ... 19. Heart disease M 135 ... ... ... ... 1 ... 4 7 33 40 50 ... ... F 105 ... ... ... ... 1 2 1 5 10 26 60 ... ... 20. Other diseases of circulatory system M 18 ... ... ... ... ... ... ... 2 6 4 6 ... ... F 16 ... ... ... ... ... ... ... 1 2 6 7 ... ... 21. Bronohitis M 66 4 ... ... ... 1 ... 1 5 15 27 13 ... ... F 39 1 ... ... ... ... ... ... 1 2 13 22 ... ... 22. Pneumonia M 36 11 ... ... ... ... 3 ... 1 8 9 4 ... ... F 27 7 ... ... ... ... ... 2 3 5 6 4 ... ... 23. Other respiratory diseases M 6 ... ... ... ... ... ... 1 1 3 1 ... ... ... F 3 ... ... ... ... ... 1 ... 1 ... 1 ... ... ... 24. Ulceration of the stomach or duodenum M 12 ... ... ... ... ... ... 3 2 5 ... 2 ... ... F 5 ... ... ... ... ... ... ... ... 2 2 1 ... ... 25. Diarrhoea (under 2 years of age) M 7 6 1 ... ... ... ... ... ... ... ... ... ... ... F 2 2 ... ... ... ... ... ... ... ... ... ... ... ... 26. Appendicitis M 2 ... ... ... ... 1 ... ... ... ... ... 1 ... ... F 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... 27. Other digestive diseases M 6 ... ... ... ... ... 1 1 ... 2 2 ... ... ... F 19 ... ... ... ... 2 1 2 ... 3 3 4 ... ... 28 Nephritis M 7 ... ... ... ... ... ... ... ... 2 3 2 ... ... F 7 ... ... 1 ... ... ... ... ... 2 2 2 ... ... 29. Puerperal and post-abortive sepsis. F ... ... ... ... ... ... ... ... ... ... ... ... ... ... 30. Other maternal causes F 2 ... ... ... ... ... 2 ... ... ... ... ... ... ... 31. Premature birth M 3 3 ... ... ... ... ... ... ... ... ... ... ... ... F 3 3 ... ... ... ... ... ... ... 1 ... ... ... ... 32. Congenital malformations M 15 12 ... ... ... ... 1 ... 1 ... ... ... ... F 11 11 ... ... ... ... ... ... ... ... ... ... ... ... 33. Suicide M 6 ... ... ... ... ... 1 1 1 ... 2 1 ... ... F 3 ... ... ... ... ... 1 ... 1 1 ... ... ... ... 34. Road traffic accidents M 12 ... ... ... ... 1 1 2 l 2 5 ... ... ... F 2 ... ... ... ... 1 ... ... ... ... 1 ... ... ... 35. Other violent causes M 82 1 4 2 6 10 8 7 8 21 8 7 ... ... F 82 ... ... 1 4 6 12 6 17 17 10 9 ... ... 36. All other causes M 75 ... 1 ... ... 2 2 4 2 4 10 50 ... ... F 88 2 ... ... 1 3 6 1 4 4 14 54 ... ... Totals M 685 68 8 7 12 37 58 61 116 225 310 383 1731 498 F 600 8 TABLE 3. DEATHS IN WARDS, 1944. 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 ... 3 ... ... 1 ... ... ... ... ... ... 5. Diphtheria ... ... ... ... 1 ... ... ... ... ... ... 6. Tuberculosis of respiratory system 1 10 3 3 10 11 5 2 4 7 ... 7. Other forms of tuberculosis 2 1 2 ... ... ... 1 ... 1 1 ... 8. Syphilitic diseases 4 3 1 ... 2 1 ... ... 1 1 ... 9. Influenza 1 ... 1 1 1 ... ... ... 1 1 ... 10. Measles ... ... ... ... ... ... ... ... ... ... ... 11. Acute poliomyelitis and polioencephalitis ... ... ... ... ... ... ... ... ... ... ... 12. Acute infectious encephalitis ... ... ... 1 ... ... ... 1 1 ... ... 13. Cancer of buccal cavity and oesophagus (males only) ... 1 2 ... 2 1 2 ... 1 ... ... 13. Cancer of uterus 1 2 ... 1 1 2 ... l 3 1 ... 14. Cancer of stomach and duodenum 3 4 2 3 7 7 4 1 3 2 ... 15. Cancer of breast ... 2 1 3 5 1 1 2 2 1 ... 16. Cancer of all other sites 4 10 8 12 23 14 6 6 10 10 ... 17. Diabetes ... 1 1 ... ... 1 1 ... 2 ... ... 18. Intra-cranial vascular lesions 9 22 6 11 14 13 9 6 8 9 ... 19. Heart disease 26 33 27 15 36 39 12 19 13 20 ... 20. Other diseases of circulatory system 3 5 3 3 6 8 3 1 1 1 ... 21. Bronchitis 8 18 3 11 10 22 16 4 8 5 ... 22. Pneumonia 5 8 4 8 10 8 9 6 3 2 ... 23. Other respiratory diseases ... 2 1 1 1 1 1 1 ... 1 ... 24. Ulcer of stomach or duodenum ... 3 2 1 4 2 2 1 1 1 ... 9 1 25. Diarrhoea (under 2 years) ... 3 ... ... 1 2 1 ... ... 2 ... 26. Appendicitis ... ... ... ... 1 ... ... 2 ... ... ... 27. Other digestive diseases 1 4 1 3 4 7 1 2 ... 2 ... 28. Nephritis 1 1 2 2 4 1 ... ... 3 ... ... 29. Puerperal and post-abortive sepsis ... ... ... ... ... ... ... ... ... ... ... 30. Other maternal causes ... ... ... ... 1 1 ... ... ... ... ... 31. Premature birth 2 ... 1 ... 1 l ... 1 ... ... ... 32. Congenital malformations 3 6 2 2 4 3 1 1 2 2 ... 33. Suicide ... 1 2 1 3 1 ... ... ... 1 ... 34 Road Traffic accidents 1 2 2 1 2 4 1 1 ... ... ... 35. Other violent causes 10 15 33 27 35 15 2 5 16 6 ... 36. All other causes 4 20 6 26 22 15 10 15 23 12 ... Totals 99 180 116 136 212 181 88 78 107 88 ... 10 TABLE 4. Vital Statistics of Whole District during 1944 and Previous Years. Year. Births. Total Deaths registered in the Borough. Transferable Deaths Nett Deaths belonging to the Borough. Inward Transferables Nett. of Nonresidents registered in the Borough. of Residents not registered in the Borough. Under l Year of Age. At all Ages. Number. Rate. Number. Rate per 1,000 Nett Births. Number. Rate. Number. Rate. 1 3 4 5 6 7 8 9 10 11 12 13 1930 1199 1757 13.60 2692 20.9 1688 218 81 46.09 1222 9.52 1931 1264 1812 14.09 2872 22.3 1770 263 71 39.18 1365 10.61 1932 1029 1666 13.10 2913 22.7 1808 236 89 53.42 1341 10.54 1933 812 1499 11.91 3070 24.4 1888 286 76 50.70 1468 11.67 1934 819 1454 11.78 2864 23.2 1774 227 64 44.02 1317 10.67 1936 777 1493 12.26 2671 21.9 1789 243 60 40.18 1225 10.06 1936 661 1421 11.85 3028 26.2 2018 262 74 52.07 1272 10.61 1937 653 1420 12.02 3190 27.0 2104 263 75 52.81 1349 11.42 1938 666 1509 12.87 2934 25.0 1938 152 70 46.38 1148 9.79 1939 605 1499 12.90 2951 26.6 1987 278 46 31.65 1242 11.21 1940 645 1353 14.02 3865 40.0 2302 335 50 39.03 1563 16.2 1941 705 1129 13.31 2430 28.6 1288 341 37 38.30 1142 13.46 1942 814 1452 16.69 2373 27.3 1546 296 73 50.27 1123 12.91 1943 871 1595 18.14 2769 31.5 1810 289 57 35.73 1248 14.20 1944 1003 1613 18.87 2779 32.5 1778 284 68 42.15 1285 15.04 11 TABLE 5. Birth-rate, Death-rate and Analysis of Mortality During the Year 1944 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 17.6 0.50 11.6 0.00 0.00 0.01 0.00 0.03 0.02 0.12 4.8 46 ... ... ... ... 126 County Boroughs and Great Towns, including London 20.3 0.64 13.7 0.00 0.00 0.01 0.00 0.03 0.03 0.10 7.3 52 ... ... ... ... 148 Smaller Towns. Estimated Resident Populations 25,000 to 50,000 at Census, 1931 20.9 0.61 12.4 0.00 0.00 0.01 0.00 0.02 0.03 0.11 4.4 44 ... ... ... ... London 15.0 0.42 15.7 0.00 0.00 0.00 0.00 0.04 0.01 0.08 10.1 61 ... ... ... ... LEYTON 18.87 0.63 15.04 0.00 0.00 0.00 0.00 0.04 0.01 0.07 5.5 42 84.68 3.27 11.90 ... 12 TABLE 6. Comparative Statistics of Births, Mortality, Etc. LEYTON, 1892-1944. 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 1471 12.1 197 76.9 D121420* 1917 B125352* 2005 16.0 1414 12.6 172 85.8 D112452* 1918 B125352* 1791 14.3 1723 15.3 161 89.9 D112452* 1919 B129062* 2195 17.0 1397 11.3 154 70.16 D123896 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 B116100* 1939 D110800* 1499 12.90 1242 11.21 46 31.65 1940 96500 1353 14.02 1563 16.2 50 39.03 1941 84790 1129 13.31 1142 13.46 37 38.30 1942 86960 1452 16.69 1123 12.91 73 50.27 1943 87880 1595 18.14 1248 14.20 57 35.73 1944 85440 1613 18.87 1285 15.04 68 42.15 * Population as estimated for purposes of b, Birth Rate, d, Death Rate. 13 GENERAL PROVISIONS OF HEALTH SERVICES FOR THE AREA. FOOT CLINIC. Mr. G. T. Hall was appointed part-time Temporary Assistant in February, 1944, in place of Mr. Pay, and took over duties on Tuesdays, Thursdays, Fridays and Saturdays. Miss J. M. Hunter assisted on Mondays and Wednesdays. This arrangement was carried out by Miss Hunter until 27th March, 1944, after which date she was able to assist on Wednesdays only. This resulted in approximately 580 treatments less in the year. In June, 1944, Miss Nichols, clerk, was transferred to the Town Hall, and assistance in the clerical work was kindly given by women on the staff of the First Aid Post at the Public Baths, High Road. Despite these difficulties and the Flying Bomb menace from June until September, there was an increase of 234 treatments. Summary of Attendances and Treatment. The number of patients who attended for treatment was 1,474; and the total treatments given were 6,072 (4.1 treatments per patient). First Attendances (new cases). Subsequent Attendances. Total Attendances. Males 100 1,119 1,219 Females 337 4,109 4,446 Children 63 344 407 Total 500 5,572 6,072 During the year the numbers of persons who received free treatment was 40 (8.0 per cent. of the total number of new oases.) The following figures show the attendances of patients who received free treatment. First Attendances (new cases). Subsequent Attendances. Total Attendances. Males. Females. Males. Females. Males. Females. Old age pensioners 14 26 339 1,076 353 1,102 Unemployed — — — — — — Widows — — — — — — Totals 14 26 339 1,076 353 1,102 14 SCABIES. My Annual Report for the year 1943 contains a description of the arrangements made for the control and treatment of scabies. The Special Clinic at Ruckholt Road School is still available as a treatment centre. Attendances at Special Clinic. Number of patients treated 845 Children 328 Adults 517 Number of patients who had One routine treatment 845 Two „ „ (544 Three ,, ,, 204 Four „ „ 57 Five „ „ 19 Six „ „ 13 Local treatment, no bath 208 1,990 CIVIL AMBULANCE SERVICE. On 1st October, 1943, the Council's fleet of three Civil Ambulances was transferred from Harrow Green Fire Station to the new Auckland Road Garage; and since that date the vehicles have been manned by ambulance drivers and attendants of the Civil Defence Ambulance Service. The following table gives particulars of the cases transported by the ambulances during the year:- Maternity Cases 350 Accident and Illness 490 Transfers, Hospitals, etc. 1,150 1,990 15 SANITARY CIRCUMSTANCES OF THE AREA. SANITARY INSPECTIONS OF THE AREA. Inspections. The table below gives a summary of the Inspections made by the Sanitary Inspectors:— Number of dwelling-houses inspected 1,707 Miscellaneous inspections 862 Re-inspections 7,323 Places of entertainment 14 Schools 31 School Canteens 13 Stables 45 Urinals 145 Inspections under Rats and Mice (Destruction) Act 1,464 Visits in connection with infectious disease 183 Factories without mechanical power 7 Factories with mechanical power 271 Rag and bone dealers — Foster-mothers' premises 14 Hairdressers' premises 59 Public Houses 64 Offensive Trades 81 Piggeries 1 16 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 183 Sashcords renewed 49 Plaster repaired 301 Roofs repaired or renewed 224 Guttering repaired or renewed 102 Yards paved 6 Drains relaid or partly relaid 22 Choked drains cleared 42 New w.c. pans and traps provided 40 Sinks provided 16 W.c. cisterns repaired or renewed 99 Rain water pipes repaired or renewed 58 Vent pipes repaired or renewed 29 Sink waste pipes repaired or renewed 66 Stoves repaired or renewed 108 Coppers repaired or renewed 9 Floors repaired 99 Rooms redecorated 245 Windows, sills, etc., repaired 39 Cement work to sink waste gullies repaired 18 Miscellaneous defects remedied 201 Verminous Houses. Infested. Disinfested. Number of houses 235 235 17 Rats and Mice (Destruction) Act, 1919. Ministry of Food—Infestation Order 1943 S. R. & O. 680. Complaints received and investigated 264. Complaints according to wards:— Harrow Green 23 Cann Hall 20 Leyton 20 Leytonstone 34 Forest 41 Wanstead Slip 25 Grove Green 28 Lea Bridge 36 Central South 13 Central North 24 264 Inspections of premises:— Food premises 814 Other premises 650 Premises freed *200 * At the remaining 64 infested premises the drainage system requires relaying. Treatment of Sewers:—The manholes were baited in accordance with instructions of the Ministry of Food, who state that whilst there has undoubtedly been a substantial kill there is probably a considerable residual population of rats in the sewers and that it is desirable that further treatment should be carried out in conjunction with block control schemes for dealing with surface infestation and suggesting that the Council should employ at least four full-time operatives as soon as possible. This matter was under consideration by the Council at the end of the year. A.R.P., Civil Defence, etc. Visits were made to the following:— Air Raid Shelters, Wardens and Fire Guard Posts 26 Food Depots 41 First Aid Posts 1 Decontamination of food; demonstrations, visits, etc. 215 Emergency Water Supply 1 Rest Centres 1 Feeding Centres 2 Visits following Air Raid Incidents 141 18 HOUSING. Complaints. During the year 1,888 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 682 Statutory—Housing Acts. Nil Public Health Acts 86 Notices complied with—Informal 794 Statutory— Housing Acts Nil Public Health Acts 67 Legal Proceedings. Public Health Act, 1936:— 92 Millais Road Order made and costs awarded Corporation. 86 Fillebrook Road—Proceedings adjourned "sine die." 7 Tennyson Road —Order made and costs awarded Corporation. 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 19 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) 1,707 (b) Number of inspections made for the purpose 9,030 (2) (a) Number of dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 & 1932 151 (6) Number of inspections made for the purpose 1,217 (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 682 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 794 III.—Action under Statutory Powers during the Year:— (а) 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 &fter service of formal notices:— (a) By owners Nil (b) 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 86 20 (2) Number of dwelling-houses in which defects were remedied after service of forma] notices:— (а) By owners 67 (b) By Local Authority in default of owners Nil (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. Requisitioning for Families Inadequately Housed. (Ministry of Health Circular No. 2845.) Premises inspected 149 Visits made 929 Schedules of repair prepared 29 Premises repaired 28 Premises occupied 28 Landlord and Tenant (War Damage) Acts, 1939-1941. Eighteen applications were received from owners of houses for "Certificates of fitness." Twelve certificates were issued. Housing Act, 1936. Information regarding 99 houses and 18 flats was supplied in connection with the "permitted number of persons" in dwellings under the Act. 21 INSPECTION AND SUPERVISION OF FOOD. Inspections. The following visits were made to food premises during the year:— Slaughter-houses 51 Butchers 223 Bakehouses 73 Fishmongers 103 Milkshops and dairies 268 Provision shops 752 Dining rooms 157 Greengrocers 104 Fish friers 67 Meat Depots 210 MILK. Dairies and Milkshops. Number of premises on register 183 (Owing to restrictions imposed by rationing, there are only now 76 premises from which milk is sold.) Premises added to register during year Nil Premises removed from register during year 2 Visits of inspection 268 Bacteriological Examinations. Designated Milk. Licences. No. Granted. No. of Samples taken. Result. Satisfactory. Unsatisfactory. Tuberculin Tested 9 2 2 — Accredited 2 — — — Pasteurised 22 11 9 2 Supplementary Licences — — — — Tuberculin Tested 1 — — — Pasteurised 2 — — — Totals 36 13 11 2 Manufacturers of Preserved Food, etc. Premises on Register at 31-12-1944 67 Premises registered during 1944 Nil Premises removed from Register during 1944 Nil 22 MEAT. Slaughter-Houses.—There are six licensed slaughterhouses in the Borough, and 51 inspections of these slaughterhouses were made. Eighteen pigs were inspected and found to be free from disease. Meat and Foods condemned and destroyed. Bacon 4,349 lbs. Other meat 17,230 „ Fish 1,499 „ Fats 1,417 „ Cheese 240 „ Sugar 564 „ Dried Fruit 542 „ Tea 334 „ Sweets 560 „ Chocolate 364 bars Eggs 851 Pickles, vinegar, etc. 1,459 bottles Jam and marmalade 1,625 lbs. Flour, rice and oatmeal 4,800 ,, Tinned foods 2,383 tins Miscellaneous foods 1,240 packets Premises and Occupations which can be Controlled by Bye-Laws and Regulations. Premises. Slaughter-houses. 6 Dairies, Milkshops and Dairymen 185 Butchers' shops, Stalls and Provision shops 291 Hairdressers' Premises 52 Fish friers 17 Offensive Trades. Rag and Bone dealers 3 Tripe boiler 1 Contagious Diseases of Animals Acts and Orders. During the year Orders were issued as under:— Anthrax Order, 1938. Pig 1 Sheep 1 23 Transit of Horses, Asses and Mules Order, 1943. This Order provides that a person in charge of an animal shall not carry in a road vehicle such animal if owing to infirmity, illness, injury, fatigue or any other cause it cannot be carried without unnecessary suffering. Cattle Pens, Temple Mills Railway Siding. These pens were kept under observation during the year, but it was not found necessary to issue any notices under the Order. 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 91. Samples analysed. Samples unsatisfactory. Apple Green Colouring 1 — Baking Powder 1 — Breakfast Food 1 — Butter 2 — Cascara Tablets 1 — Castor Oil 1 — Chicken and Ham Paste 1 — Chocolate Pudding Mixture 1 — Cocoa 1 — Cochineal, Liquid 1 — Cream Flavour Shake 1 — Curry Powder 10 — Custard Flavour 1 — Egg Powder Substitute 2 — Gelatine 5 — Gelatine Powder 1 — Ginger, Ground 1 — Glycerine 1 — Golden Raising Powder 2 — Ham and Beef Paste 1 — Junket Powder 2 — Lemon Essence 1 — Liver Pills 1 — 24  Samples analysed. Samples unsatisfactory. Malted Milk Tablets 1 — Margarine 1 — Meat Paste 2 — Milk 18 1 Mint Sauce in Malt Vinegar 1 — Mustard ... 1 — Mustard Sauce 1 — Pepper 1 — Rheumatic Tablets 1 — Salad Dressing Powder 1 — Salmon and Shrimp Paste 1 — Sandwich Spread 1 — Sardine and Tomato Sauce 1 — Sausages 1 — Soya Flour 1 — Spice, Mixed 3 — Spoon 1 — Sugar, Granulated 1 1 Sulphur Tablets 1 — Tea 1 — Tonic Tablets 1 — Vegetable Extract 1 — Vinegar 2 — Whisky 4 — Yeast Tablets 2 — Zinc and Castor Oil Ointment 1 — 91 2 Legal Proceedings. Food and Drugs Act, 1938. Milk unfit for human consumption: (1) £10 fine and £5 5s. 0d. costs. (2) £5 fine and £1 1s. 0d. costs. 25 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 275 3 — Factories without mechanical power 20 — — Other Premises under the Act (including works of building and engineering construction but not including outworkers' premises) — — — Total 295 3 — 2. DEFECTS FOUND. Particulars. Number of Defects. Found. Remedied. Referred to H.M. Inspector. (1) • (2) (3) (4) Lack of cleanliness — — — Sanitary Conveniences:— Insufficient 3 3 — Dirty — — — Other Offences — — — Total 3 3 — OUTWORK IN UNWHOLESOME PREMISES. (Section 111 of Act of 1937). Nature of Work. Instances. Notices served. Prosecutions. (1) (2) (3) (4) Nil Nil Nil — 26 MATERNITY AND CHILD WELFARE. INFANT WELFARE. Notification of Births.—Thirteen hundred and three notifications of births were received during the year. By medical practitioners 295 By midwives 1,008 By parents and others — During the year under review, the total attendances at the Council's Infant Welfare. Centres were 11,053, a decrease of 3,811 compared with the figure (14,864) for the previous year. The number of children examined by the Clinic Medical Officers was 3,758 as compared with 4,186 examined during the previous year. Health Visitors. During the year the Health Visitors have made 16,880 visits to homes, as follows:— (a) To expectant mothers:— First visits 270 Total visits 294 (b) To children under 1 year of age:— First visits 1,412 Total visits 8,168 (c) To children between the ages of 1 and 5 years:— Total visits 8,418 27 TABLE 7. ATTENDANCES, EXAMINATIONS, etc., 1944. Leyton Green. Park House. All Centres. Under 1 year— 1st attendances 532 491 1,023 Subsequent attendances 3,907 4,020 7,927 Total attendances 4,439 4,511 8,950 1-5 years— 1st attendances 46 46 92 Subsequent attendances 919 1,092 2,011 Total attendances 965 1,138 2,103 Total attendances, both age groups 5,404 5,649 11,053 Average attendance per session 5,404 54.84 54.45 Number examined by clinic doctor 1,868 1,890 3,758 Number weighed 5,399 5,627 11,026 28 Dental Treatment. Expectant Mothers. Children. Patients treated 124 52 Attendances 313 98 Extractions 592 127 Fillings 66 21 Other dental operations 103 13 Advice only 61 31 Anaesthetics— General 92 40 Local 80 6 Dentures supplied— Full upper and lower 11 Full upper 4 Full upper and partial lower 6 Partial upper 5 Partial upper and lower 1 27 Orthopaedic Treatment. Primary Examinations.—During the year 6 children were referred from the Infant Welfare Clinics to the Council's Orthopaedic Surgeon. Re-examinations.—In addition to the 6 new cases mentioned above, 16 children under five years of age attended for re-examination by the Orthopaedic Surgeon. Treatment.—Forty-eight children made 236 attendances for special treatment by the Council's Masseuse (Miss Findlay). Provision of Surgical Appliances.—Twenty-three children were supplied with surgical appliances on the recommendation of the Orthopaedic Surgeon. 29 Special Eye Clinic. The Council's Ophthalmic Surgeon (J. D. Magor Cardell, M.B., F.R.C.S.) had referred to him by the Clinic Medical Officers 70 pre-school children, who made 87 attendances for examination and treatment. Artificial Sunlight Treatment. Number of cases treated 63 Total number of attendances 797 Convalescent Home Treatment. Children. Seven 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. Nursing Mothers. Arrangements were made for five mothers and their babies to have periods of convalescence following confinement. 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 per 1,000 Live Births Stillbirths. 1 year. 4 weeks. Infantile. Neo-natal. 1940 1353 50 28 39.03 21.85 45 1941 1129 37 20 38.30 20.70 31 1942 1452 73 43 50.27 29.61 49 1943 1595 57 36 35.73 22.57 38 1944 1613 68 31 42.15 19.21 54 30 TABLE 8. Infantile Mortality, Year 1944—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 ... ... ... ... ... 2 ... ... 1 3 Diphtheria and croup ... ... ... ... ... ... ... ... ... ... Influenza ... ... ... ... ... ... ... ... ... ... Tuberculous meningitis ... ... ... ... ... ... ... ... 1 1 Abdominal tuberculosis ... ... ... ... ... ... ... ... ... ... Other tuberculous diseases ... ... ... ... ... ... ... ... ... ... Meningitis (not tuberculous) 1 ... ... ... 1 1 ... ... ... 2 Convulsions ... ... ... ... ... ... ... ... ... ... Laryngitis ... ... ... ... ... ... ... ... ... ... Bronchitis ... 1 ... ... 1 3 1 ... ... 5 Pneumonia (all forms) 1 ... 2 ... 3 9 2 2 2 18 Diarrhoea ... 1 ... ... 1 ... ... ... ... 1 Enteritis ... ... ... ... ... 2 3 2 ... 7 Gastritis ... ... ... ... ... ... ... ... ... ... Syphilis ... ... ... ... ... ... ... ... ... ... Rickets ... ... ... ... ... ... ... ... ... ... Suffocation, overlying ... ... ... ... ... ... ... ... ... ... Injury at birth 1 ... ... ... 1 ... ... ... ... 1 Atelectasis 2 ... ... ... 2 ... ... ... ... 2 Congenital malformations 9 2 2 ... 13 2 1 2 ... 18 Premature birth 5 1 ... ... 6 ... ... ... ... 6 Atrophy, debility and marasmus 1 1 1 ... 3 ... ... ... ... 3 Other causes ... ... ... ... ... ... 1 ... ... 1 Totals 20 6 5 ... 31 19 8 6 4 68 Nett Births registered during the calendar year Legitimate 1,550 Nett Deaths registered during the calendar year legitimate infants 60 Illegitimate 63 Illegitimate infants 8 31 TABLE 9. Infantile Mortality During the Year 1944—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 ... 2 ... ... 1 ... ... ... ... ... ... 3 Diphtheria and croup ... ... ... ... ... ... ... ... ... ... ... ... Influenza ... ... ... ... ... ... ... ... ... ... ... ... Tuberculous meningitis ... ... ... ... ... ... ... ... ... 1 ... 1 Abdominal tuberculosis ... ... ... ... ... ... ... ... ... ... ... ... Other tuberculous diseases ... ... ... ... ... ... ... ... ... ... ... ... Meningitis (not tuberculous) ... ... ... ... ... ... ... 1 1 ... ... 2 Convulsions ... ... ... ... ... ... ... ... ... ... ... ... Laryngitis ... ... ... ... ... ... ... ... ... ... ... ... Bronchitis 1 1 ... ... 1 1 ... ... ... 1 ... 5 Pneumonia (all forms) 3 3 ... 1 3 1 3 2 1 1 ... 18 Diarrhoea ... 1 ... ... ... ... ... ... ... ... ... 1 Enteritis ... 2 ... ... 1 2 ... ... ... 2 ... 7 Gastritis ... ... ... ... ... ... ... ... ... ... ... ... Syphilis ... ... ... ... ... ... ... ... ... ... ... ... Rickets ... ... ... ... ... ... ... ... ... ... ... ... Suffocation, overlying ... ... ... ... ... ... ... ... ... ... ... ... Injury at birth ... ... ... ... 1 ... ... ... ... ... ... 1 Atelectasis ... 1 ... 1 ... ... ... ... ... ... ... 2 Congenital malformations 2 4 1 1 3 2 1 1 1 2 ... 18 Premature birth 2 ... 1 ... 1 1 ... 1 ... ... ... 6 Atrophy, Debility and Marasmus ... 1 1 ... ... 1 ... ... ... ... ... 3 Other causes ... 1 ... ... ... ... ... ... ... ... ... 1 Totals 8 16 3 3 11 8 4 5 3 7 ... 68 32 Public Health Act, 1936. Child Life Protection. On 1st January, 10 foster mothers and 11 children—and at the end of the year 9 foster mothers and 9 children—were subject to inspection. The Council's Child Protection Visitors made 41 visits of inspection during the year. Summary, Year 1944. Number of nurse children on Register, 1st January 11 Number of nurse children notified by foster mothers during the year 5 Nurse children removed:— To parents or relatives 4 Adopted 1 To institutions 1 Removed—No trace 1 Died — Number of nurse children on Register on 31st December 9 Ante-Natal Clinics— Attendances.— First Subsequent Attendances. Attendances. Total. 514 1,037 1,551 The average number in attendance at the Ante-Natal Clinics held at the Council's two Centres during 1944 was 10.77 per session. The number of home visits made by Health Visitors to expectant mothers during the year was 294. Maternity Beds. Three hundred and forty patients were admitted during 1944 under the terms of the agreement with the Mothers' Hospital, Clapton and Queen Mary's Hospital, Stratford. Public Health Act, 1936. Registration of Nursing Homes. There are two registered nursing homes in the Borough. Ten inspections were made to these institutions during the year. 33 Home Helps. Under the Council's scheme for the provision of home helps, 166 applications, 24 of whom made application in 1943, for home helps were dealt with. In 122 cases home helps were provided, 14 of these cases having the charges remitted in accordance with the Council's scale. In the 44 remaining cases, 20 made other arrangements for the confinement, and 24 cases had not been confined at the end of the year. Puerperal Pyrexia. Ten cases of puerperal pyrexia were notified during the year. The causes of pyrexia were considered to be:— Local uterine infection 4 Mastitis 1 Not known 2 Endometritis 1 Obstructed labour L Prolonged labour 1 10 Obstetric Consultant. . The advice of the Council's Consultant Obstetrician was sought on one occasion during the year. Maternity Mortality. There were 2 maternal deaths of Leyton residents during the year. 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 seventy-one such notifications were received. Fees paid to Doctors under Section 14 (1) of the Midwives' Acts, 1918. One hundred and sixty 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 £255 17s. 6d. 34 Post-Natal and Gynaecological Clinic. Leyton Green Health Centre. Number of Sessions 12 Letters of Invitation 166 First Attendances 91 Re-attendances 65 Report by Dr. Anne S. Clark, M.B., Ch.B. During the year 12 sessions of the Post-Natal and Gynaecological Clinic were held. The number of new patients who attended was 91, out of 166 who received appointments to attend (= 54.82 per cent.). Of these, 66 were post-natal (i.e., they had had confinements within the previous three months); and 25 were gynaecological. The disposal of these cases was as follows:— Discharged after one attendance 41 Re-attended for examination and treatment 50 The total number of attendances was 156. The average attendance per session was 13.00—with a maximum of 19 and a minimum of 5. Free medical prescriptions were issued in 41 cases at a total cost of £8 lis. 1d.; and 16 prescriptions were issued for payment by the patients. The following are the main conditions which have been found on examination:— Prolapse of the uterus 1 Subinvolution of the uterus 6 Cystocele and rectocele 2 Retroversion of the uterus 8 Anaemia 3 Defective perineum 1 Cervical erosion 6 Cervical polypus 1 Vaginitis 2 Sterility 1 Pregnancy 2 Birth control 22 35 Record of Cases attended by Council Midwives, 1944. Midwives (8) employed by Council (4) 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 Cases attended:— (a) As Midwives 175 313 488 (b) As Maternity Nurses 24 46 70 Ante-natal Visits 573 1,901 2,474 Ante-natal Examinations 1,519 2,53.5 4,054 Post-natal Visits 3,841 6,867 10,708 WAR-TIME DAY NURSERIES. In 1942 two war-time Day Nurseries, one at Knotts Green and one in Ellingham Road, were established in this Borough; and they have both been open for the care of children during the year 1944. Extension of Nursery Accommodation. In August, 1943, a communication was received from the Ministry of Health to the effect that representation had been made by the Ministry of Labour and National Service that additional nursery accommodation was required in the Borough. Thereupon, in order to. ascertain the extent of such need and the amount of nursery accommodation required, a special investigation of factories was undertaken in order to find out the number of employed mothers who wished accommodation to be found in war-time nurseries for their children under 5 years of age. After consideration of all aspects of the representation made by the Ministry of Labour and National Service, the Maternity and Child Welfare Authority recommended (1) the erection of a new nursery on a suitable site in the Lea Bridge area; and (2) an extension of 36 the existing accommodation at Ellingham Road Nursery. These proposals, with the necessary plans and specifications, were forwarded to the Ministry of Health. In May, 1944, the Minister of Health indicated that, after full consideration of all present circumstances, it had been decided that the scheme submitted by your Council for the erection of a new nursery in the Lea Bridge area should not proceed ; and in June, 1944, decided that the scheme for the extension of Ellingham Road Nursery should be abandoned. Attendances. From the table on page 38 it will be seen that the attendances at Knotts Green and Ellingham Road Nurseries were good for the first six months of the year. As a result of the "flying bomb" menace, which commenced in June, the attendances during July and August were less than half what they had been previously. Subsequently there was a gradual improvement in attendances, but these attendances had not regained their normal level by the end of the year. Outbreak of Sonne Dysentery at Knotts Green Day Nursery. On 12th October it was reported that two children attending Knotts Green Day Nursery were absent suffering from diarrhoea, with blood and mucus in the stools. It was discovered that a probationer, who had been working temporarily in a nursery outside London, and had returned to duty in Leyton on 2nd October, had been off duty during September with an illness which had been diagnosed as "gastric influenza," but whose symptoms had included diarrhoea and vomiting. At that time several children in the Nursery where she was working were absent on account of dysentery. Rectal swabs from the two children with symptoms and from the probationer (now free from symptoms) were all returned positive for Sonne dysentery. Subsequently all members of the staff and all the children who were then attending the nursery were swabbed, and the swabs were delivered to the laboratory on the day they were taken. No other members of the staff gave positive swabs. Of the 39 children, 14 gave positive swabs. Two were considered sufficiently ill to be removed to hospital. In three cases there were no symptoms reported, and in two other cases the 37 children were ill only for a few hours. One child, who had no symptoms at the time of the investigation, was discovered to have had diarrhoea on 4th October, when two other members of the family were ill. Three negative swabs taken at three-day intervals were required before any infected child was allowed to return to the Nursery. In addition, the two children under one year who were in attendance at the Nursery were excluded until 3rd November by which time it was judged that the outbreak was checked, and new admissions were accepted. Eight of the 14 infected persons gave only one positive swab. This included the probationer. For all except two children the last positive swabs were received on 23rd October. The remaining two were still positive on 11th November (although in each case the previous swab had been negative); and it was decided to give a course of succinyl sulphathiazole (20 grammes) spread over five days, i.e. 4 grammes a day. At the conclusion of the course further swabs were taken and were found to be negative. TABLE No. 10. WAR-TIME DAY NURSERIES — AVERAGE DAILY ATTENDANCE, 1944. Month. Knotts Green Nursery. Ellingham Road Nursery. Mondays to Fridays Saturdays Average total attendances. Mondays to Fridays. Saturdays Average total attendances. Under 2 - years. Over 2 years. Under 2 years. Over 2 years. Mon. to Fri. Sats. Under 2 years. Over 2 years. Under 2 years. Over 2 years. Mon. to Fri. Sats. January 12.38 31.95 2.60 11.20 44.33 13.80 11.38 33.38 5.60 15.60 44.76 21.20 February 14.70 33.19 4.50 11.25 47.95 15.75 13.23 34.52 6.25 15.25 47.75 21.50 March 9.00 32.95 3.75 13.50 41.95 17.25 11.56 34.82 5.50 16.00 46.38 21.50 April 11.94 35.26 5.75 11.00 47.20 16.75 10.47 33.89 5.25 15.50 44.36 20.75 May 14.36 36.68 6.00 15.66 51.04 21.66 12.50 35.45 6.00 15.33 47.95 21.33 June 12.13 30.59 5.25 15.50 42.72 20.75 13.22 33.18 4.75 15.25 46.40 20.00 July 4.57 18.23 2.40 9.00 22.80 11.40 7.38 24.52 3.40 9.60 31.90 13.00 August 5.50 14.27 2.00 5.33 19.77 7.33 5.81 15.81 2.33 4.00 21.62 6.33 September 8.57 22.76 3.40 10.80 31.33 14.20 3.33 12.76 1.00 5.60 16.09 6.60 October 8.09 21.31 3.75 7.25 29.40 11.00 6.45 24.40 4.50 11.75 30.85 16.25 November 9.00 25.27 4.50 8.00 34.27 12.50 6.36 24.22 4.00 11.00 30.58 15.00 December 10.47 31.57 2.50 9.00 42.04 11.50 7.73 23.68 4.25 9.00 31.41 13.25 Average for Year 10.64 27.83 3.86 10.62 37.90 14.49 9.12 27.55 4.40 11.99 36.67 16.39 38 39 PREVALENCE OF, AND CONTROL OVER INFECTIOUS AND OTHER DISEASES. SMALLPOX. During the year no case of smallpox occurred in the area. ENTERIC FEVER. During the year no case of enteric fever occured in the area. CEREBRO-SPINAL MENINGITIS. 2 cases were notified during the year. MEASLES. 136 cases of measles were notified during the year. WHOOPING COUGH. 198 cases of whooping cough were notified during the year. SCARLET FEVER. Year. Cases Notified. Deaths. Case Fatality per cent. 1940 87 0 0.00 1941 64 1 1.56 1942 318 0 0.00 1943 386 0 0.00 1944 110 0 0.00 DIPHTHERIA. Year. Cases Notified. Deaths. Case Fatality per cent. 1940 55 0 0.00 1941 44 1 2.27 1942 39 0 0.00 1943 28 1 3.57 1944 24 1 4.16 ARTIFICIAL IMMUNISATION AGAINST DIPHTHERIA. Immunisation by Private Medical Practitioners. Number of private medical practitioners who applied for supplies of toxoid-antitoxin 13 Number of children immunised 44 40 Municipal Clinic. The routine course of immunisation is an initial dose of 0.2 c.c. A.P.T., followed by a second dose of 0.5 c.c. four weeks later. RETURN FOR THE YEAR 1944. Age 0-5 years. Age 5-15 years. Total. 1. Number of children who completed the course of immunisation during the year 671 75 746 2. (a) Approximate estimated child population at end of year 6,540 11,010 (b) Percentage of child population considered to be immunised at end of year 41.10 74.16 Incidence of Diphtheria Among Protected Persons. During 1944 eleven Leyton children, who had been immunised previously, were notified to be suffering from diphtheria. The following table gives in summary form the information regarding these cases. Age. Sex. Date of Immunisation. Date of Notification. Swab Results T=Throat. N=Nose. E=Ear. Diagnosis. 2 M 2.7.43 17.1.44 — Bronchitis and Cervical Adonitis. 14 F .40 2.2.44 T — Follicular Tonsillitis 6 M 19.8.43 2.2.44 T + „ „ 10 F 18.9.41 12.2.44 T + Tonsillitis 9 F 19.6.42 6.3.44 T — Scarlatina Anginosa 3 M 4.6.43 11.3.44 T — Tonsillitis 4 M 30.6.43 18.5.44 T — Follicular Tonsillitis 4 F 11.7.42 10.7.44 — Not Diphtheria 6 M 26.2.43 23.7.44 N & T+ Mild Diphtheria 12 F 23.7.42 29.9.44 T — Vincents Angina 10 M 27.1.43 4.12.44 T — Not Clinical Diphtheria 41 TUBERCULOSIS. Notifications.—One hundred and five patients were notified for the first time in 1944 as suffering from tuberculosis. The number was made up as follows:— Males. Females. Total. Pulmonary Tuberculosis 43 41 84 Non-Pulmonary Tuberculosis 11 10 21 * 54 51 105 The following is a statement of particulars appearing in the Register of Notifications of Cases of Tuberculosis for the year ended 31st December, 1944:— Pulmonary. Non-Pulmonary. total M. F. Total. M. F. Total. Number on Register at commencement of year 288 218 506 32 40 72' 578 Number first notified during the year 43 41 84 11 10 21 105 Number of cases entered in Register otherwise than by Notification 21 5 26 2 — 2 28 Number removed from the Register during the year 65 56 121 8 8 16 137 Number remaining at the end of the year 287 208 495 37 42 79 574 Details of cases removed from the Register during the year:— Died 43 30 73 3 5 8 81 Removed from the district 19 25 44 4 1 5 49 De-notified 3 1 4 1 2 3 7 Deaths.—Sixty-four deaths from tuberculosis were recorded. 42 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 1 — — 2 1 5 2 1 1 — 10 — — 1 — 15 4 5 2 — 20 5 10 1 1 25 9 12 1 2 35 10 8 2 — 45 6 3 — 4 55 4 2 1 1 65 and upwards 3 — — — Totals 43 41 11 10 Institutional Treatment. During 1944 the following Ley ton patients were sent to sanatoria or other institutions for the treatment of Tuberculosis:— Pulmonary. Non-Pulmonary. Males. Females. Males. Females. Total. Adults 41 35 5 3 84 Children 2 1 Nil Nil 3 43 TABLE No. 11. CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR 1944. 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 24 ... 3 2 3 2 4 5 1 3 1 ... ... Erysipelas 27 2 ... ... ... ... ... ... 1 1 3 16 4 Scarlet Fever 110 1 9 4 14 18 34 14 8 5 2 1 ... Pemphigus Neon. ... ... ... ... ... ... ... ... ... ... ... ... ... Pulmonary T.B. ... ... ... ... ... ... ... ... ... ... ... ... ... T.B. Others ... ... ... ... ... ... ... ... ... ... ... ... ... Pneumonia 67 2 5 4 2 2 9 3 2 12 3 13 10 Ophthalmia Neon. 5 5 ... ... ... ... ... ... ... ... ... ... ... Typhoid Fever ... ... ... ... ... ... ... ... ... ... ... ... ... Paratyphoid Fever ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Pyrexia 10 ... ... ... ... ... ... ... ... 9 1 ... ... Cerebrospinal Meningitis 2 ... 1 ... ... ... 1 ... ... ... ... ... ... Poliomyelitis ... ... ... ... ... ... ... ... ... ... ... ... ... Enc. Lethargica ... ... ... ... ... ... ... ... ... ... ... ... ... Dysentery. 24 2 4 6 5 ... 1 ... 3 2 ... ... 1 Measles 136 3 10 10 14 24 54 7 12 1 1 ... ... Whooping Cough 198 31 34 36 23 40 32 2 ... ... ... ... ... Totals 603 46 66 62 61 86 135 31 27 33 11 30 15 44 TABLE 12. CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR 1944. DISEASE. Total. Leyton. Lea Bridge. Central North. Central South. Forest. Leytonstone. Grove Green. Harrow Green. Cann Hall. Wanstead Slip. Removed to Hospitals. Smallpox ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria 24 1 2 3 2 7 3 2 ... 3 1 20 Erysipelas 27 4 5 1 3 5 5 ... ... 4 ... 5 Scarlet Fever 110 4 26 10 8 8 8 4 7 18 17 44 Pemphigus Neon. ... ... ... ... ... ... ... ... ... ... ... ... Pulmonary T.B. ... ... ... ... ... ... ... ... ... ... ... ... T.B. Others ... ... ... ... ... ... ... ... ... ... ... ... Pneumonia 67 4 26 1 8 11 3 1 3 4 6 30 Ophthalmia Neon. 5 ... ... ... ... ... ... ... 4 ... 1 5 Typhoid Fever ... ... ... ... ... ... ... ... ... ... ... ... Paratyphoid Fever ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Pyrexia 10 1 1 ... 3 4 ... 1 ... ... ... 7 Cerebrospinal Meningitis 2 ... . 1 ... ... ... ... ... ... ... 1 2 Poliomyelitis ... ... ... ... ... ... ... ... ... ... ... ... Enc. Lethargica ... ... ... ... ... ... ... ... ... ... ... ... Dysentery 24 1 5 3 2 8 1 ... 1 1 2 7 Measles 136 23 39 13 10 15 11 3 2 8 12 8 Whooping Cough 198 18 51 37 25 30 10 2 21 2 2 24 Totals 603 56 156 68 61 88 41 13 38 40 42 152 45 SCHOOL MEDICAL SERVICE. GOVERNMENT EVACUATION SCHEME. Assuming a continuing decline in the school roll, an approximate roll as at 31st March, 1944, would be 11,000. Estimated figures showing the present distribution (December, 1944) of these children are given below:— (a) In Leyton Over 5 years 6,990 Under 5 years 419 (b) Evacuated:— (i) In National Camp at Itchingfield—as from April, 1940. (Central Schools, etc.) (Owing to decrease in numbers the Camp at Tilford was discontinued in May, 1943, and the children whose parents so desired were transferred to Itchingfield.) 175 (ii) In reception areas or removed 3,416 11,000 Normal (full-time) schooling, which was resumed in the Borough on 15th July, 1940, has been maintained since that time. ROUTINE MEDICAL INSPECTION. A.—Routine Medical Inspection. Number of Inspections in the prescribed groups. Entrants 1282 Second Age Group 647 Third Age Group 759 Total 2,688 Of 2,688 children who were examined in the code age-groups, 2,267 (or over 84 per cent.) were accompanied by their parents. B.—Other Inspections. Special Inspections. The number of special inspections during the year was 2,797 comparing with 3,874 during the previous year. Re-inspections. The number of re-inspections during 1944 was 6,212. 46 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 1,282 274 21.37 Second Age Group V 647 166 25.65 Third Age Group 759 199 26.21 Total (Code Groups) 2,688 639 23.77 Uncleanliness and Verminous Conditions.—At the special inspections held by the school nurses, 1,001 children were found to be unclean out of a total number of 18,090 examined (i.e., 5.5 per cent. Cleanliness Surveys in Individual Schools. School. Number of Examinations. Number Cautioned. Number Excluded. Canterbury Road 1,196 15 4 Capworth Street 2,074 140 31 Cann Hall Road 1,022 41 4 Church Road 1,388 59 11 Connaught Road 1,112 38 10 Downsell Road 1,249 42 18 Davies Lane ... 1,145 43 9 Farmer Road ... 965 21 6 Goodall Road ... 954 40 6 Kirkdale Road 345 7 3 Lea Bridge Road 51 2 1 Mayville Road 1,969 247 24 Norlington Road 1,065 32 6 Newport Road 1,339 58 16 Sybourn Street 1,122 14 2 St. Joseph's 167 5 4 Trumpington Road 843 33 5 Knotts Green 84 4 ... Total 18,090 841 160 Number of individual children found unclean 1,001 of whom 160 were referred to the Minor Ailments Clinics. 47 Return of Defects found by Medical Inspection in the Year ended 31st December, 1944. Defect or Disease. Routine Inspections. Special Inspections. Number requiring Treatment. Observation. Number requiring Treatment. Observation. (1) (2) (3) (4) (5) Skin Ringworm—Scalp ... ... 8 ... Body ... ... 20 ... Scabies 6 ... 102 ... Impetigo 2 ... 72 ... Other diseases (non-T.B.) 12 3 734 ... Eye Blepharitis 11 ... 54 ... Conjunctivitis 4 ... 104 ... Keratitis 3 ... ... ... Corneal Opacities ... ... ... ... Defective Vision 137 30 73 ... Squint 29 1 15 ... Other conditions 8 ... 182 ... Ear Defective Hearing 8 6 17 ... Otitis Media 22 4 100 ... Other Ear Diseases 7 5 172 ... Nose & Throat Chronic Tonsilitis only 18 15 59 ... Adenoids only 7 17 6 ... Chronic Tonsilitis & Adenoids 26 17 18 ... Other conditions 30 5 254 1 Enlarged Cervical Glands (non-T.B.) 11 14 52 ... Defective Speech 9 4 11 ... Heart and Circulation Heart Disease— Organic 2 1 2 ... Functional 3 17 8 l Anaemia 7 1 29 ... Lungs Bronchitis 53 13 46 1 Other non-T.B. Diseases 14 11 62 l Tuberculosis Pulmonary— Definite ... ... ... ... Suspected ... 1 6 ... Non-Pulmonary— Glands ... ... 2 ... Bones and Joints ... ... 1 ... Skin ... ... ... ... Other Forms ... 3 ... ... Nervous System Epilepsy 1 ... 3 ... Chorea ... ... 2 ... Other conditions 4 5 73 1 Deformities Rickets 1 ... 1 ... Spinal Curvature ... ... ... ... Other Forms 176 24 70 Other Defects and Diseases 87 14 1,853 3 Totals 698 211 4,211 8 48 MEDICAL TREATMENT. Minor Ailments Clinics. Attendances. During the year 2,625 children attended the clinics, and 10,976 attendances were registered. Defective Vision.—Of the 2,688 children subjected to routine code group inspection in the schools, 163 (6.8 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 673 children, who made 867 attendances for examination and treatment. Resignation of Consulting Ophthalmic Surgeon. After occupying the appointment of Consulting Ophthalmic Surgeon to this Council since May, 1925, J. D. M. Cardell, M.B., B.S., F.R.C.S. was compelled—owing to pressure of other duties— to relinquish his appointment in October, 1944. The vacancy has been filled by the temporary appointment of A. L. Adam, M.R.C.S., L.R.C.P., M.B., B.S., D.O.M.S. Squint Clinic. Report by Orthoptist (Miss G. Montague Smith). It is impossible to give the usual report this year owing to so much evacuation. Many children have had their treatment curtailed, and clinics also have had to be cut down during periods of severe bombing. At present the clinics are working again to full capacity, although there are still many children evacuated and therefore not getting regular treatment. It cannot be too highly stressed that one of the essential factors in Orthoptics, i.e., continuity of treatment, is being very seriously affected at the present time. I would like to take this opportunity of thanking Mr. Cardell for his great help and interest in the Orthoptic Clinic at all times, and his kind co-operation will be greatly missed. Yearly Attendances 1,528 New Cases 51 Old Cases 117 • 49 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 154 77 91 46 94 68.61 Cann Hall 296 234 137 114 214 85.26 Capworth 35 69 23 44 33 49.25 Church 187 614 93 353 239 53.56 Connaught 195 487 95 271 219 59.83 Davies Lane 664 277 371 133 274 54.36 Downsell 491 373 278 200 364 76.15 Farmer 208 66 134 39 88 50.86 Goodall 354 318 191 166 216 60.50 Kirkdale 70 52 18 18 27 75.00 Knotts Green 26 26 21 20 25 60.97 Lea Bridge 14 15 7 11 11 61.10 Mayville 219 405 108 250 190 53.06 Newport 347 118 155 56 136 64.45 Norlington 161 336 74 185 150 57.91 Ruekholt ... ... ... ... ... ... Sybourn 577 289 354 173 351 66.6 St. Joseph's 101 77 70 44 19 16.66 Tom Hood ... ... ... ... ... ... Trumpington 96 80 52 40 47 51.00 4,195 3,913 2 272 2,163 2,697 60.81 Report by the Authority's Senior Dental Officer (A. E. Hall, L.D.S.) General. There was some disturbance of the regular routine work of the dental surgeries during the second half of 1944, due to a return of enemy action in the form of flying bombs from 15th June onwards, accompanied by an increase in the number of children leaving the area. This resulted in an increase in the number of broken appointments, and due to some movement of the school population it was found necessary to pay an increased number of visits to the schools to cover the annual dental inspection. It was pleasing, and somewhat surprising, to note that the decrease in the acceptance of treatment rate was only 0.96 per cent. Of the two dental surgeries in operation at the present time, that at Leyton Green was damaged by blast on two occasions during the year, resulting in it being out of operation from Monday, 50 26th June until 7th July; and again from Saturday, 15th July until Monday, 24th July. During these periods as much of the work as was possible was transferred to Park House. The dental attendant at Leyton Green left to join the Forces on 12th September, and was replaced in a temporary capacity the following day. Elementary Schools. All elementary schools in the Borough were dentally inspected during the year, it being found necessary to re-visit several of the schools inspected soon after the commencement of the flying bomb attacks as at that time the numbers in attendance were rather low. The work done for these children showed an increase over the previous year until the re-commencement of the raids, but the final result at the end of the year showed a slight decrease when compared with 1943. The acceptance rate had not fallen 1 per cent, but the attendances for treatment were much fewer. Table IV in th" Statistical Summary on page 59 gives some idea of the work done for these children. Secondary Schools. Both the Leytori County High Schools, for Girls and for Boys, were inspected and treated during the year. Of the 386 children requiring treatment, 347 were treated during the year, or 89.8 per cent. Table IV in the Statistical Summary on page 63 gives some idea of the work done for these children. * Maternity and Child Welfare. All cases referred by the Medical Officers for dental treatment were seen, and advised or treated. The number of mothers attending remained at about the same level as the previous year, but the number of pre-school children decreased slightly. For details of treatment, including dentures supplied, see page 28. I am still pleased to be able to record an improvement in the caries incidence of pre-school children, and also of the school entrants. This I believe to be due, in part at least, to a war-time 51 diet, and comparative absence of sweets; and I hope to be able to collect data from three groups for comparison, viz. :— (a) Pre-war children whose caries incidence at 5 years of age is already known. (b) Pre-war conceived, and post-uterine war-time fed, children. (c) War-time fed children since conception (this group will be the school entrants of five years of age this year). War-time Day Nurseries. Most of these children, above two years of age, have been dentally inspected and offered treatment where necessary.. One would wish to see these children every three months, but cannot do so under present conditions due to staff shortage and the needs of the school children. Orthopaedic Clinic. The following figures show the number of school children •examined and treated during the year. Examinations. Primary examinations 33 Re-examinations 100 Treatment. Number of children who attended for 146 Attendances made 1,150 Surgical Appliances. The following have been supplied :— Surgical alteration to boots 1 pair and 1 single Repair to splint 1 Minor surgical alterations to boots 48 Artificial Sunlight Clinic. Number of children attending 148 Attendances made 2,270 Aural Clinic. The following table shows the relevant particulars regarding the Leyton School children who attended the Aural Clinic for treatment during 1944. 52 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 9 ... ... 1 ... ... 2 7 . 19 (ii) „ Catarrhal „ „ 1 2 ... 1 ... ... ... 2 6 (iii) Chronic Suppurative Otitis Media due to :— 1. Tympanic Sepsis ... ... ... ... ... ... ... ... ... 2. „ „ and Granulations 1 ... ... ... ... ... ... ... 1 3. „ „ and Polypi 1 ... ... ... ... ... ... ... 1 4. „ and previous Mastoid Operation ... ... ... ... ... ... ... ... ... 5. Other causes ... ... ... ... ... ... ... ... ... (iv) Mastoid Disease (previous operation) ... ... ... ... ... ... ... ... ... (v) Partial Deafness due to :— 1. Nerve Deafness ... ... ... ... ... ... ... ... ... 2. Tonsils and Adenoids ... ... ... ... ... ... ... ... ... 3. Retraction of Membrana Tympani ... ... ... ... ... ... ... ... ... 4. Scarring 1 ... ... ... ... ... ... ... 1 5. Catarrhal Rhinitis 2 ... ... ... ... ... ... ... 4 6. Wax ... ... ... ... ... ... ... ... ... 7. Other Causes ... ... ... ... ... ... ... ... ... (vi) Nasal Cases :— 1. Hypertrophic Rhinitis ... ... ... ... ... ... ... ... ... 2. Sinusitis 1 1 ... ... ... ... ... 3 5 3. Atrophic Rhinitis ... ... ... ... ... ... ... ... ... 4. Deviated Septum ... ... ... ... ... ... ... ... 1 5. Foreign Body ... ... ... ... ... ... ... ... ... 6. Polypus ... ... ... ... ... ... ... ... ... (vii) Tonsils and Adenoids ... ... 21 ... ... ... ... 1 6 28 (viii) Other Diseases or Defects 2 2 ... ... ... ... ... 4 8 Totals 18 27 ... 2 ... ... 4 23 74 53 PHYSICALLY AND MENTALLY DEFECTIVE CHILDREN. Mentally 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 On attaining 16 years of age—for supervision under the M.D. (Notification of Children) Regulations 1 Certified to Local Education Authority as feebleminded 6 Remained under certificate 1 Certificate withdrawn 2 Dull and backward 18 Borderline cases—to be re-assessed in six months 9 Cases under certifying age 1 Behaviour problems:— With average intelligence 10 Below ,, ,, 0 Above „ 4 53 Knotts Green Special School for Mental Defectives. Admitted 4 Discharged 5 Physically Defective Children. Knotts Green Open Air School. Admitted during the year 19 Discharged 12 * Observations by Dr. Mary L. Gilchrist. The educational problems associated with war conditions have greatly increased the number of children referred for examination owing to failure in school work. This problem of the slightly dull child, who is working far below his actual capacity, can best be solved by special classes in the junior school, where a teacher specially interested could have a small class and have time to teach 54 each child in an individual fashion. The appointment of an educational psychologist, full or part-time, to assist with advice and training in these classes would be a great help to schools and children alike. The child who is not progressing at school, and who suffers from a feeling of inferiority all the time, is the child who gets into mischief and becomes the " juvenile delinquent." The earlier his problem is tackled in school the less rehabilitation work is required later ; and early provision for such help in junior schools would soon show results. There would be a need for such special classes in secondary schools at present; but after a few years, with the problem tackled energetically in the junior schools, such special classes might not be necessary. These classes, designed for children with intelligence quotients above 70 per cent., would not solve the special problem of the very retarded children who would still attend schools specially designed for them. PROVISION OF MEALS. The number of individual children fed under the Authority's arrangements during 1944 was :— Ordinary Milk Meals. Meals. Free 905 1,789 For payment 4,584 8,713* Totals 5,489 10,502 *Estimated. Number of meals supplied :— Ordinary Milk Meals. Meals. Free 123,739 337,521 For payment ... 377,650 1,646,697 Totals ...501,389 1,984,218 The above figures relate to the financial year ended 31st March, 1945. 55 NUTRITION. The following table shows in statistical form the average heights and weights (inches and lbs. respectively) of children examined in the prescribed groups during the years 1943 and 1944. 1943 Group. Boys. Girls. No. examined Average height Average weight No. examined • Average height Average weight Entrants— 1935 1 44.0 45.0 1 45.0 45.0 1936 94 45.27 47.84 78 46.33 48.30 1937 161 42.33 42.59 162 42.46 41.83 1938 227 41.00 40.01 180 40.54 38.48 1939 127 39.03 37.35 141 39.29 36.54 1940 3 35.66 31.33 2 38.50 34.00 Second Age Group 474 51.48 63.71 414 51.18 62.38 Third Age Group 410 58.42 87.73 434 59.31 91.82 1944 Group. Boys. Girls. No. examined Average height Average weight No. examined Average height Average weight Entrants— 1936 — — — 1 44.00 41.00 1937 85 45.66 47.24 77 45.89 47.60 1938 233 43.46 43.16 222 43.07 42.03 1939 222 41.33 40.19 238 40.61 38.03 1940 *121 38-41 35.74 7.6 38.19 34.88 1941 4 35.75 33.75 1 36.00 30.00 Second Age Group 362 51.40 64.38 285 51.00 62.34 Third Age Group 393 58.71 90.12 366 58.93 91.20 * Two not weighed. Observations by Dr. Mary L. Gilchrist. The nutrition of the school children appears to be well maintained. A comparison of weights and heights with those obtained before the war is unfortunately not able to be made with much accuracy. The routine inspection groups are not examined in the same school terms as they were before the war resulting in the leaver group being 6/12 or so younger and the intermediate group about 6/12 older. This would account for any fall in the heights and weights of the leaver group and a rise in heights and weights of the intermediate groups. The nutrition and the heights and weights of the entrants to the schools appear to be much the same as before the war. 56 PUBLIC ELEMENTARY SCHOOLS. STATISTICAL APPENDIX. TABLE I.—Returns of Medical Inspections, a. Routine Medical Inspections. Number of Code Group Inspections :— Entrants 1,282 Second Age Group 647 Third Age Group 759 Total 2,688 B. Other Inspections. Number of Special Inspections 2,797 Number of Re-inspections 6,212 Total 9,009 C. Children Found to Require Treatment. Number of individual children found at Routine Medical Inspection to require treatment (excluding defects of Nutrition. Uncleanliness and Dental Diseases). Group. For Defective Vision (excluding Squint). For all other Conditions Total. Percentage of children found to require Treatment. Entrants 3 271 274 21.37 Second Age Group 43 123 166 25.65 Third Age Group 91 108 199 26.21 Total (Prescribed Groups) 137 602 639 23.77 Other Routine Inspections — — — — Grand Total 137 502 639 23.77 57 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 1,282 177 13.8 801 62.5 298 23.2 6 0.4 Second Age Group 647 119 18.4 429 66.3 96 14.8 3 0.4 Third Age Group 759 198 26.0 447 58.9 112 14.7 2 .02 Other Routine Inspections – – – – – – – – Total 2,688 494 18.3 1,677 62.3 506 18.8 11 0.4 TABLE III.—Return or Defects Treated during the Year ended 31st December, 1944. TREATMENT TABLE. Group I.—Minor Ailments (excluding Uncleanliness, for which see Table V). Disease or Defect. (1) Number of Defects treated or under treatment during the year. Under the Authority's Scheme. (2) Otherwise. (3) Total. (4) Skin— Ringworm— Scalp—(1) X-ray treatment 3 1 4 (2)Other 4 — 4 Body 20 — 20 Soabies 102 102 Impetigo 72 — 72 Other skin diseases 734 — 734 Minor Eye Defects— (External and other, but excluding cases falling in Group II.) 248 248 Minor Ear Defects 253 — 253 M iscellaneous— (e.g., minor injuries, bruises, sores, chilblains, etc.) 769 769 Total 2,205 1 2,206 58 TABLE III.—contd. 3roup II.—Defective Vision and Squint (excluding Minor Eye Defects "treated as Minor Ailments.—Group I.). Defect or Disease. (1) Number of Defects dealt with. Under the Authority's Scheme. (2) Otherwise. (3) Total. (4) Errors of refraction (including squint) 550 30 580 Other defect or disease of the eyes , (excluding those recorded in Group I.) 102 7 109 Total 652 37 689 Under the Authority's Scheme. Otherwise. Total. No. of Children for whom Spectacles were :— (a) Prescribed 413 30 443 (6) Obtained 410 33 443 TABLE III.—contd. Group III.—Treatment of Defects of Nose and Throat. Number of Defects. Received Other Forms of Treatment. (4) Total Number Treated. (5) Received Operative Treatment. Under the Authority's Scheme in Clinic or Hospital. (1) By Private Practitioner or Hospital, apart from the Authority's Scheme. (2) Total. (3) (1) (2) (3) (4) (1) (2) (3) (4) (1) (2) (3) (4) 18 1 5 19 8 — 1 15 26 1 6 34 63 130 (1) Tonsils only. (2) Adenoids only. (3) Tonsils and adenoids. (4) Other defects of the nose and throat. 59 TABLE IV. Dental Inspection and Treatment. (1) Number of children who were :— (a) Inspected by the Dentist:— • Age Groups Aged : Total 8,108 3 88 4 337 5 657 6 829 7 822 8 853 9 876 10 873 11 808 12 729 13 801 14 420 15 14 I 16 1 Specials (Casuals) 699 Grand Total 8,807 (b) Found to require treatment 5,519 (c) Actually treated 2,366 (2) Half-days devoted to Inspection 70 Treatment 739—Total 809 (3) Attendances made by children for treatment 4,459 (4) Fillings, Permanent Teeth 2,456 Temporary ,, 385--Total 2,841 (5) Extractions, Permanent Teeth 445 Temporary ,, 3,373—Total 3,818 (6) Administrations of general anaesthetics for extractions 1,195 (7) Other operations, Permanent Teeth 160 Temporary ,, 68—Total 228 60 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 18,090 (3) Number of individual children found unclean 1,001 (4) Number of children cleansed under arrangements made by the Local Education Authority — (5) Number of cases in which Legal proceedings were taken :— (o) Under the Education Act, 1921 — (b) Under the School Attendance Bye-laws — TABLE VI. Blind and Deaf Children. (1) At a Public Elementary School. (2) At an Institution other than a Special School (3) At no School or Institution. (4) Total not receiving suitable Education. Blind Children — — — — Deaf Children — — — — 61 SECONDARY SCHOOLS. STATISTICAL APPENDIX. TABLE I.—Returns of Medical Inspections, a. Routine Medical Inspections. Number of Code Group Inspections :— County, High School for Boys 211 „ „ ,, ,, Girls 159 Total 370 Number of other Routine Inspections — b. Other Inspections. Number of Special Inspections 119 Number of Re-inspections 112 Total 231 Children Found to Require Treatment. Group. (1) Number of Children. Percentage of Children found to require treatment. (4) Inspected. (2) Found to require treatment. (3) County High School for Boys 211 22 10.42 County High School for Girls 159 36 22.64 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 Boys 211 52 24.6 146 69.2 13 6.1 ... ... County High School for Girls 159 43 27.0 106 66.6 10 6.2 ... ... 62 TABLE III.—Return of Defects Treated during the Year. TREATMENT TABLE. Group I.—Minor Ailments (excluding Uncleanliness). Disease or Defect. (1) Number of Defects treated or under treatment during the year. Under the Authority's Scheme. (2) Otherwise. (3) Total. (4) Skin— Ringworm— Scalp—(1) X-ray treatment — — — (2)Other — — — Body — — — Scabies 2 — 2 Impetigo — — — Other skin diseases 9 — 9 Minor Eye Defects— (External and other, but excluding cases falling in Group II.) 10 — 10 Minor Ear Defects 1 — 1 Miscellaneous— (e.g., minor injuries, bruises, sores, chilblains, etc.) 17 — 17 Total 39 — 39 TABLE III.—contd. Group II.—Defective Vision and Squint (excluding Minor Eye Defects treated as minor Ailments. Group I.). Defect or Disease. (1) Number of Defects dealt with. Under the Authority's Scheme. (2) Otherwise. (3) Total. (4) Errors of refraction (including squint) 81 20 101 Other defect or disease of the eyes (excluding those recorded in Group I.) 13 — 13 Total 94 20 114 Total number of children for whom spectacles were prescribed— (a) Under the Authority's Schema 107 (b) Otherwise 20 63 TABLE IV. Dental Inspection and Treatment. (1) Number of children who were :— (a) Inspected by the Dentist:— Aged : Age Groups 10 7 Total 729 11 108 12 124 13 194 14 127 15 89 16 45 17 28 18 7 Specials (Casuals) Nil Grand Total 729 (6) Found to require treatment 386 (c) Actually treated 347 (2) Half-days devoted to Inspection 5 Treatment 90—Total 95 (3) Attendances made by children for treatment 499 (4) Fillings, Permanent Teeth 711 Temporary ,, Nil—Total 711 (5) Extractions, Permanent Teeth 114 Temporary ,, 49—Total 163 (6) Administrations of general anaesthetics for extractions 54 (7) Other operations, Permanent Teeth 76 Temporary ,, Nil—Total 76