ORPINGTON URBAN DISTRICT COUNCIL REPORT For the Year 1945 on the Sanitary Conditions and Vital Statistics of the Urban District of Orpington by the Medical Officer of Health Bromley Office Supplies & Printing Co., Ltd. 46, East Street, Bromley. URBAN DISTRICT COUNCIL OF ORPINGTON Health Report for 1945 Madam and Gentlemen, I have pleasure in submitting my Annual Health Report for the year 1945, this being the twenty-third one presented by me as your Medical Officer of Health. The population of the District at mid-year as estimated by the Registrar-General was 49,610, this being an increase of 2,630 over last year. A decrease took place in the Birth Rate, this being equal to 17.8 per thousand of population, as against 22.7 last year. The Death Rate for the year also showed a decrease, the Rate being 10.1 per thousand of population, as compared with 11.4 last year. The Infantile Mortality Rate again remained low, being 28 per thousand registered births. This is the same Rate as recorded in the previous year. During the year 982 Certificates of Notification of cases of Infectious Disease were received. This number is only two above the number notified in 1944. The great majority of these notifications related to cases of measles, whooping cough and scabies. In presenting this Report, I again desire to express my thanks for the kind help and assistance I have received from the Council. I particularly desire to record my appreciation of the loyal services rendered by all members of the Public Health Department. I am, Madam and Gentlemen, Your obedient Servant, P. N. CAVE, Medical Officer of Health, 2 URBAN DISTRICT COUNCIL OF ORPINGTON Public Health Committee Chairman: G. Allison-Beer, Esq. Vice-Chairman: F. W. Buck, Esq. Mrs. H. M. Hebdon. F. J. Hyam, Esq., c.c. Lt.-Col. K. M. Kirkhope, c.i.e. H. J. Lester, Esq., j.p., f.s.a.a. G. E. Barrett, Esq. G. T. May, Esq. F. J. Bell, Esq. P. H. Powell, Esq. J. E. Brittenden, Esq. A. L. Priest, Esq., j.p. C. L. Bruce, Esq. S. Rawlings Smith, Esq., m.a. C. F. Bulpitt, Esq. W. C. Sweatman, Esq. J. Davies, Esq. W. J. Tarry, Esq. G. E. Davis, Esq., m.c., ll.b. T. Temple, Esq. P. W. Dewberry, Esq. E. J. Walker, Esq., m.m. A. H. A. Grenger, Esq. E. Whiddon, Esq. R. Hamilton, Esq. S. R. Woodcock, Esq. W. E. Hawken, Esq. Representatives on the West Kent Joint Hospital Board. C. L. Bruce, Esq. A. L. Priest, Esq., j.p. Representatives on the West Kent Main Sewerage Board. C. L. Bruce, Esq. A. L. Priest, Esq. STAFF: Medical Officer of Health: P. N. Cave, m.a., m.d., m.r.c.s., l.r.c.p., d.p.h. Sanitary Inspectors: J. A. Capon, c.r.s.i., s.i.E.Bd., m.s.i.a. (Chief Sanitary Inspector, etc., and Cleansing Superintendent). F. C. Crowe, m.r.s.i., m.s.i.a. (Deputy Chief Sanitary Inspector, Inspector under the Shops Acts and Food and Drugs Inspector). W. T. Weedy, c.r.s.i., m.s.i.a. (Senior District Sanitary Inspector and Inspector under the Shops Acts). R. Taylor, c.r.s.i., m.s.i.a. (District Sanitary Inspector). D. H. Livesey, m.r.s.i., m.s.i.a. (District Sanitary Inspector). Salvage Officer: Health Visitor: H. T. Cartmel. Mrs. L. Russell, s.r.n., s.c.m., s.r.f.n. Chief Clerk and Shorthand Typist: Miss I. Chamberlain. Part Time Domestic Help Supervisor: Mrs. Q. E. Skevington. Clerks: S. Kurn (Junior Shorthand Typist), I. Healey (Office Junior). 3 SECTION A. STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Area (in acres) 20,842 Registrar-General's estimate of population, mid-1945 49,610 Number of occupied houses, December, 1945 16,077 Rateable Value of District £487,378 Sum represented by a penny rate £1,940 SECTION B. VITAL STATISTICS. Total M. F. Birth Rate per 1,000 of estimated population Live Births Legitimate 824 457 367 Illegitimate 61 28 33 Total Births 885 485 400 17.8 Still-births 27 10 7 Rate per 1.000 (live and still) births 29.4 Deaths 501 244 257 Death rate per 1,000 of estimated population 10.1 Deaths from Puerperal causes: Deaths Rate per 1,000 total live and still, births Puerperal Sepsis Nil Other puerperal causes 1 1.09 Total 1 1.09 Death Rate of Infants under one year of age: — All infants per 1,000 live births (25)28 Legitimate infants per 1,000 legitimate live births (21) 25 Illegitimate infants per 1,000 illegitimate live births (4) 65 Deaths from Cancer (all ages) 102 Deaths from Measles (all ages) Nil Deaths from Whooping Cough (all ages) 1 Deaths from Diarrhoea (under 2 years of age) 3 4 URBAN DISTRICT COUNCIL OF ORPINGTON The population of the District as estimated by the RegistrarGeneral at mid-year, 1945, was 49,610. Births.—During the year 885 Births were registered as belonging to the District, of which number 485 were males and 400 were females. This is equal to a Birth Rate of 17.8 per thousand, as against 22.7 last year. Deaths.—The number of Deaths registered during the year as belonging to the District was 501 (244 males and 257 females). This is equal to a Death Rate of 10.1 per thousand of population, as compared with 11.4 last year. Infantile Mortality.—During the year 25 Deaths were registered as occurring in infants under one year of age (21 legitimate births, 4 illegitimate births). The Infantile Mortality Rate for the year was equal to 28 per thousand registered births, as compared with 28 last year. VITAL STATISTICS. Orpington Urban District England and Wales Birth Rate 17.8 14.1 Death Rate 10.1 11.4 Infantile Mortality Rate 28 46 5 INFECTIOUS DISEASE. The following table shows the number of cases of Infectious Disease notified during the year, the number removed to Hospital, and the total Deaths :— Disease Number Notified Removed to Hospital Deaths Scarlet Fever 64 45 — Diphtheria 14 14 — Erysipelas 17 — — Cerebro-spinal Fever 2 — — Puerperal Pyrexia 33 — — Poliomyelitis 2 — — Pneumonia 56 1 25* Ophthalmia Neonatorum 1 1 — Dysentry 6 — — Scabies 134 — — Whooping Cough 155 — 1 Measles 498 3 — TOTALS 982 64 26 * All forms of Pneumonia. DIPHTHERIA IMMUNISATION CLINIC. The following work has been done in connection with the Diptheria Immunisation Clinic during the year :— Number of sessions held 114 Number of new cases 726 Number of attendances 2601 OPHTHALMIA NEONATORUM. One case was notified during the year. The patient was removed to Hospital, and the vision was not impaired. 6 Birth Rates, Death Rates, Analysis of Mortality, Maternal Mortality and case rate for certain Infectious Diseases in the Year 1945. England and Wales. 126 County Boroughs and Great Towns 148 Smaller Towns (populations 25,000 to 40,000). London Administrative County. Orpington Urban District. Rates per 1,000 Civilian population. Births: Live 16.1 19.1 19.2 15.7 17.8 Still 0.46 0.58 0.53 0.40 0.54 Deaths : All Causes 11.4 13.5 12.3 13.8 10.1 Typhoid and Paratyphoid 0.00 0.00 0.00 0.00 – Scarlet Fever 0.00 0.00 0.00 0.00 — Whooping Cough 0.02 0.02 0.01 0.02 0.02 Diptheria 0.02 0.02 0.02 0.01 – Influenza 0.08 0.07 0.07 0.07 0.08 Small Pox _ — . — Measles 0.02 0.02 0.02 0.01 — Rates per 1,000 live Births. Deaths under 1 year of age 46 54 43 53 28 Deaths from Diarrhoea and Enteritis under 2 years of age. 5.6 7.8 4.5 7.6 3.3 Rates per 1,000 Civilian population. NOTIFICATIONS: Typhoid Fever 0.01 0.01 0.01 0.01 — Paratyphoid Fever 0.01 0.00 0.01 0.00 — Cerebro-spinal Fever 0.05 0.05 0.05 0.06 0.04 Scarlet Fever 1.89 2.02 2.03 1.57 1.29 Whooping Cough 1.64 1.65 1.47 1.25 3.12 Diphtheria 0.46 0.52 0.56 0.31 0.28 Erysipelas 0.25 0.28 0.24 0.31 0.34 Small Pox 0.00 0.00 — 0.00 — Measles 11.67 10.89 11.19 9.03 10.03 Pneumonia 0.87 1.03 0.72 0.78 1.12 Rates per thousand Total Births (Live and Still). NOTIFICATIONS: Puerperal Fever 9.93 12.65 8.81 3.60 36.1 Puerperal Pyrexia 15.87* A dash (—) signifies there were no deaths. * Including Puerperal Fever. 7 TUBERCULOSIS. The following table shows the number of new cases of Tuberculosis notified during the year, together with the number of deaths. Notified. Deaths. Males Females Total Males Females Total Pulmonary 18 12 30 12 8 20 Non - Pulmonary 4 1 5 1 1 2 TOTAL 22 13 35 13 9 22 Treatment of cases of Tuberculosis is carried out by the Kent County Council, and during the year the following number of patients from this District have received treatment:— Number receiving sanatorium treatment 52 Number receiving dispensary treatment 61 Dispensary supervision only 233 PUBLIC HEALTH ACT, 1936. (Section 176). PUBLIC HEALTH (PREVENTION OF TUBERCULOSIS) REGULATIONS, 1925. No action was required to be taken under the above during the year. BACTERIOLOGICAL WORK. The bacteriological work in connection with this District is carried out at the County Laboratory, Maidstone, and during the year the following number of specimens has been examined there :— Positive Negative Total Swabs for Diptheria 7 79 86 Swabs for Hemolytic Streptococci 11 9 20 Sputa for Tubercle 17 — 17 Faeces for Dysentery 1 — 1 Widals for Typhoid Fever — 6 6 TOTALS 36 94 130 In addition, the following emergency work has been carried out at the West Kent Joint Hospital Laboratory by Dr. J. Byers :— Positive Negative Total Swabs for Diptheria 2 84 86 Swabs for Hemolytic Streptococci — – — TOTALS 2 84 86 8 ISOLATION HOSPITAL. This District is served by the West Kent Joint Isolation Hospital, and during the year the following number of patients have been admitted :— Scarlet Fever 45 Diphtheria 14 Measles 3 EMERGENCY DOMESTIC HOME HELP SCHEME. In June of this year the Kent County Council delegated without restriction or conditions their powers in connection with the Emergency Domestic Help Scheme to this Council. In the early days the work involved by this Scheme was incorporated in the work of the existing Public Health staff, but as from mid-November a part-time responsible clerical assistant was wholly employed on the organisation and administration of the Scheme in this District. The foundations of this Scheme have now been soundly laid, and it is hoped that it will gather momentum and become a well-established addition to the services available to the public. DRAINAGE. The houses in the main portion of the District are on the water carriage system, and most of the houses are connected to the public sewers. Work in connection with the extension of the sewer to Knockholt was in progress at the end of the year. 9 SANITARY STATISTICS. No. of houses connected to the sewer No. of houses not connected to sewers No. of houses not provided with a piped water supply No. of wells still in use for the purpose of domestic supply 12,454 2960 351 6 Sanitary Conveniences. W.C.'s Pail or Pan Closets Midden Privies Cesspools No. of No. of houses connected 15,125 294 13 2213 2643 WATER SUPPLY. The mains of the Metropolitan Water Board supply the greater portion of the District. In some outlying parts, however, water is obtained from deep wells and from rain water collected from the roofs of houses and stored in tanks. The supply of water has been satisfactory both as regards quality and quantity. Bacteriological examinations of the water are made monthly, an average of four samples being collected each month. No contamination of the water was discovered during the year, and there does not appear to be any risk of plumbo-solvent action. During the year 48 bacteriological samples of water were examined, and all proved to be satisfactory. Three chemical analyses of rain water used for drinking purposes were made, of which one proved to be of excellent quality. In the other two cases one proved to be of fair quality and the other of a poor nature, and it was advised that the water be boiled before use. PUBLIC CLEANSING. The collection of house refuse throughout the District is by direct labour. Owing to the shortage of labour, the removal of house refuse has presented difficulty. Although collection has not been carried out at pre-war frequency, the service has been maintained throughout the District, and a slight improvement had been effected at the end of the year. 10 HOUSING. 1. Inspection of Dwelling Houses during the year:— (1) (a) Total number of houses inspected for housing defects (Under the Public Health or Housing Acts) 479 (b) Number of inspections made for the purpose 2382 (2) (a) Number of dwelling houses (included under sub-head 1 above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 — (b) Number of inspections made for the purpose — (3) Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation — (4) Number of houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 311 2. Remedy of Defects during the year without Service of Formal Notices. Number of defective dwelling houses rendered fit in consequence of informal action by the Local Authority or their Officers 237 3. 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 — (2) Number of dwelling houses which were dered fit after service of formal notices :— By owners — By Local Authority in default of owners — (b) Proceedings under the Public Health Acts :— (1) Number of houses in respect of which notices were served requiring defects to be remedied 22 11 (2) Number of dwelling houses in which defects were remedied after service of formal notices : (a) By owners 22 (b) By Local Authority in default of owners — (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 — (2) Number of dwelling houses demolished in pursuance of Demolition Orders — (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 — (2) Number of separate tenements or underground rooms in which Closing Orders were determined, the tenement or room having been rendered fit — 4. Housing Act, 1936.—Part IV.—Overcrowding. (a) (i) Number of dwelling houses overcrowded at the end of the year 78 (ii) Number of families dwelling therein 175 (iii) Number of persons dwelling therein 505 (b) Number of new cases of overcrowding reported during the year 15 (c) (i) Number of cases of overcrowding relieved during the year 20 (ii) Number of persons concerned in such cases 81 Number of new houses erected during the year : By the Council Nil By other persons 2 12 CESSPOOL EMPTYING. The emptying of cesspools is carried out as circumstances permit. HEALTH VISITOR. One full-time Health Visitor is employed by the Council. During the year she has paid the following number of visits:— Cases of Tuberculosis 203 Cases of Measles 297 Cases of Mumps 27 Cases of Whooping Cough 98 Cases of verminous persons 3 Cases of Chicken Pox 10 Cases of Scabies 56 Cases of Diabetes 2 Cases of Scarlet Fever 17 Cases of Impetigo 4 Cases of Measles complications 29 Visits to Schools 2 Cases of Scabies complications 5 Ante-natal visits 10 Visits re swabs 13 Visits to Diphtheria contacts 7 Visits re Nursing Homes 3 Visits re Home Helps 13 Visits re holidays for children 18 Visits re Immunisation Clinic 45 Total 862 13 MATERNITY AND CHILD WELFARE. The Maternity and Child Welfare work in this District is carried out by the Kent County Council. The following Clinics and Centres have been established in this area :— ANTE-NATAL CLINICS. Situation Day Sessions Held. Total attendance BIGGIN HILL: First Aid Post. 2nd and 4th Wednesdays. 5th Wednesday (Post-natal clinic). 268 GREEN STREET GREEN: The Baptist Hall. Every Friday. 536 ORPINGTON: Methodist Hall. Every Tuesday, Thursday & Friday. Post-natal, 2nd and 4th Thursday. 868 PETTS WOOD: First Aid Post. Tuesday and Wednesday. 1004 ST. MARY CRAY: First Aid Post, Recreation Ground. Every Friday. Post-natal, 3rd Thursday in alter nate months. 1067 MATERNITY AND CHILD WELFARE CENTRES. CHELSFIELD: Reading Room. 1st and 3rd Thursdays. 694 CUDHAM: Village Hall. 2nd and 4th Tuesdays. 187 CUDHAM (Biggin Hill): First Aid Post. Every Thursday. 1507 DOWNE: Gospel Hall. 1st and 3rd Wednesdays. 473 FARNBOROUGH: Methodist Church Hall. Every Friday. 1987 GREEN STREET GREEN: Baptist Schoolroom. Every Friday. 2047 ORPINGTON: Methodist Church Hall. Every Monday, Tuesday & Friday. 6355 PETTS WOOD: St. Francis Hall. Every Monday and Thursday. 5488 ST. MARY CRAY: First Aid Post, Recreation Ground. Every Tuesday and Wednesday. 4274 NURSING FACILITIES. No change has been made with regard to the nursing facilities for the District. MATERNITY AND NURSING HOMES. The powers under the Public Health Act, 1936, relating to Nursing and Maternity Homes have been delegated by the County Council to the District Council. There is one registered Home within the District, the number of beds available being seven for maternity cases and one for other cases. 14 SUMMARY OF REGULATED TRADES. Number No. of Visits No. of Defects found No. of Defects remedied Dairies 75 182 — — Cowsheds Slaughterhouses 17 13 — — Bakehouses 20 25 2 2 Piggeries 27 23 2 2 Other food preparing places 270 719 — — Factories 180 28 — — Workshops Workplaces Common Lodging Houses 1 1 — — Houses—Let-inLodgings TOTALS 590 991 4 4 15 MILK (SPECIAL DESIGNATIONS) ORDER, 1936. The Council granted the following number of licences under the above Order during the year :— Tuberculin Tested 5 Pasturised 8 MILK SUPPLY. The following number of samples of milk have been examined during the year :— Satisfactory. Unsatisfactory. Tuberculin Tested 49 13 Accredited. 12 7 Mixed Milk 7 — (This does not include samples taken under the Food and Drugs Act.) MEAT INSPECTION. The following table" shows particulars with respect to the inspection of animals slaughtered for human consumption :— Pigs. Number killed (if known) 5 Number inspected 5 SWIMMING BATHS AND POOLS. There is one swimming pool in the District. CAMPING SITES. During the year two licences were granted by the Council with regard to Camping Sites. SMOKE ABATEMENT. Informal action was taken during the year in connection with the emission of smoke from a Public Institution in the District. SHOPS ACTS. During the year 71 inspections were made, and on no occasion was it found necessary to take any formal action. FOOD AND DRUGS ACT, 1938. The powers under the Food and Drugs Act, 1938, are under the control of the Council, and during the year 215 samples were taken (28 Formal and 187 Informal). Three Formal and one Informal samples were reported as being not genuine. 16 The following table shows the number and description of the samples taken :— FORMAL SAMPLES. Description of Sample Number of Samples Submitted Number Genuine Number not Genuine New Milk 28 • 25 3 INFORMAL SAMPLES. Description of Sample Number of Samples Submitted Number Genuine Number not Genuine Arrowroot 1 1 — Aspirin Tablets 3 3 — Bacon 2 2 — Boracic Acid Powder 3 3 — Bismuth Tablets 1 1 — Bronchial Mixture 2 2 — Bun Powder 1 1 — Butter 7 7 — Campden Tablets 1 1 — Carbonate of Soda 2 2 — Cake Mixture 3 3 — Celery Salt 1 1 — Cinnamon 1 1 — Cheese 2 2 — Cheese Cake Mixture 1 1 — Chocolate (Drinking) 1 1 — Cochineal 1 1 — Cocoa 1 1 — Cooking Fat 7 7 — Cough Elixer 1 1 — Cough Mixture 4 4 — Curry Powder 2 2 — Custard Flavour 1 1 — Egg Substitute 2 2 — Extract of Beef 1 1 — Farfols (Rice Substitute) 1 1 — Flavouring, Banana 1 1 — Do. Blackcurrant 1 1 — Do. Cherry 1 1 — Do. Lemon 2 2 — Do. Peppermint 1 1 — Do. Pineapple 1 1 — Flavouring Powder 1 1 — Flavouring, Vanilla 1 1 — Flour Mixture 1 1 — Flour, Bun 2 2 — Do. Cake 1 1 — Do. Scone 2 2 — Friars Balsam 1 1 — Fruit Laxatives 1 1 — Fruit Sauce 2 2 — 17 INFORMAL SAMPLES—(Continued) Description of Sample Number of Samples Submitted Number Genuine Number not Genuine Gelatine Powdered 2 2 — Ginger Beer Powder 1 1 — Ginger, Ground 4 4 — Ginger Wine Essence 2 2 — Gravy Powder 4 4 — Do. Do. Seasoned 1 1 — Gravy Browning 2 2 —— Gravy Salt 1 1 — Herring Savoury 1 1 — Horseradish Cream 1 1 —— Horseradish Sauce 1 1 — Iodine, Tincture of 3 3 — Jelly Desert 1 1 — Lemon Substitute 1 1 — Margarine 7 7 — Meat Extract 1 1 — Do. Do. Cubes 1 1 — Milk, Pasteurised 8 8 — Milk, New 4 3 1 Mustard 1 1 — Mustard, White 1 1 — Mustard Relish 1 1 — Oats, Breakfast 1 1 — Oats, Rolled 2 2 — Ointment, Boracic 2 2 — Do. Glyrosa 1 1 — Do. Zinc 3 3 — Do. Zinc Oxide 1 1 — Oil, Eucalyptus 1 1 — Mustard Liniment 1 1 — Passiflora Tablets 1 1 — Paste, Bloater 1 1 — Do. Ham and Beef 1 1 — Do. Fish 1 1 — Do. Meat 1 1 — Pepper 1 1 — Pilchards (Tinned) 1 1 — Petroleum Jelly 2 2 — Pudding Mixture 6 6 — Raising Powder 1 1 — Rice 2 2 — Saccharine Tablets 2 2 — Savourmix 1 1 — Savoury Spread 1 1 — Semolina 4 4 — Semolina Mould 1 1 — Shredded Wheat 1 1 — Soya Nut Meat 1 1 — Soup Powder 1 1 — Sponge Pudding Powder 1 1 — Sponge Mixture 3 3 — Spice, Mixed 2 2 — Stuffing, Sage and Onion 1 1 — Do. Parsley and Thyme 1 1 — Sugar 4 4 — Table Jelly Crystals 2 2 — 18 INFORMAL SAMPLES—(Continued) Description of Sample Number of Samples Submitted Number Genuine Number not Genuine Throat Sweets 1 1 – Tea 2 2 – Tonic, Children's 1 1 – Do. Restorative 1 1 –- Do. Curatone 1 1 – Uriliac Tablets 1 1 – Vaseline 2 2 – Wheat Flakes 1 1 – Action taken with regard to samples found to be not genuine :— Number of Sample Description of Sample Nature of Adulteration Action Taken 28 New Milk 23.4% of added water Legal proceedings. Fined £20 and £2 2s. costs. Inf. 29 Do. 24.3% of added water Dealt with under Sample No. 28. 33 Do. 10.6% deficient in fat Further sample, No. 40, taken in course of delivery. 40 Do. 20.0% deficient in fat Further samples taken at Farm, and warning letter sent. 19 ERADICATION OF BED BUGS. The following number of houses were found to be infested with bed bugs during the year:— Council houses 2 Other houses 10 COUNCIL HOUSES.—Strict supervision is exercised with regard to possible infestations, and advice given where necessary. In all cases where infestation is found, the necessary action is taken by the Council. OTHER HOUSES.—When cases of infestation are discovered, the occupiers of the premises are given advice. Zaldecide insecticide is used in connection with the disinfestation of premises. The Rodent Operative appointed last year left the Council's service during 1945, and for the remainder of the year the work of disinfestation was carried out by part-time work of one of the existing Public Health Staff. During the year 796 inspections of premises suspected to be infested with rats were carried out. The Council undertakes the work of disinfestation of private premises on the application of the owner or occupier, and during the year 66 cases were dealt with. Disinfestations of premises under the Council's control were also carried out. All water courses within the District received careful supervision, and in one case it was necessary to take action in connection with pollution by oil. RAT INFESTATION. RIVERS AND STREAMS. 20 CLEANSING OF PERSONS. Provision has been made at the Cleansing Station, High Street, Orpington, and the three First Aid Posts in the District for the treatment of Scabies. Patients are referred to the Clinics by Doctors, Health Visitors or School Nurses. During the year 101 treatments have been given in connection with Scabies at the First Aid Posts, and 810 treatments have been carried out at the Cleansing Station. The number of home visits paid by the Nurse was 346. In addition, six verminous heads have been treated. At the Cleansing Station a Nurse is employed solely for the treatment of Scabies and home visiting in connection with these cases. LEGAL PROCEEDINGS. No legal proceedings, with the exception of those taken under the Foods and Drugs Act, have been instituted. ADOPTIVE ACTS AND BYELAWS. No Acts or Byelaws were adopted during the year. 21 CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR 1945. Disease At All Ages At Ages—Years Removed to Hospital Under 1 1 to 2 2 to 3 3 to 4 4 to 5 5 to 10 10 to 15 15 to 25 25 to 45 45 to 65 65 and over Scarlet Fever 64 — 3 1 4 1 28 16 8 3 — — 45 Diphtheria 14 — — — 1 1 4 3 3 2 — — 14 Puerperal Pyrexia 33 — — — — — — — 16 17 — — — Pneumonia 56 1 2 2 2 1 9 3 3 11 17 5 1 Measles 498 16 47 60 55 41 242 22 8 5 1 1 3 Whooping Cough 155 10 18 21 12 16 71 2 — 3 1 1 — Erysipelas 17 — — — — — — — 4 4 6 3 — Dysentery 6 — — — — — — 2 2 2 — — — Cerebro-Spinal Meningitis 2 1 "— — — — — — — 1 — — — Ophthalmia Neonatorum 1 1 — — — — — — — — — — — Poliomyelitis 2 1 — — — — —— — 1 — — —— — Scabies 134 1 2 7 1 6 25 13 26 45 7 1 — Totals 982 31 72 91 75 66 379 61 71 93 32 11 63 22 DEATHS REGISTERED DURING THE YEAR. Males Females Total Typhoid Fever — — — Cerebro-spinal Fever — — — Scarlet Fever — — — Whooping Cough 1 — 1 Diphtheria — — — Tuberculosis of respiratory system 12 8 20 Other Tuberculous diseases 1 1 2 Syphilitic diseases 2 3 5 Influenza 3 1 4 Measles — — — Poliomyelitis and Polioencephalitis — — — Acute Infantile Encephalitis — — — Cancer of Bronchial Cavity 3 12 15 Cancer of stomach and duodenum 15 3 18 Cancer of the breast — 11 11 Cancer (all other forms) 30 28 58 Diabetes 2 1 3 Inter cranial vesc. lesions 17 45 62 Heart Disease 61 64 125 Other diseases of circulatory system 12 11 23 Bronchitis 9 9 18 Pneumonia 16 9 25 Other respiratory diseases 2 4 6 Ulcer of stomach and duodenum 4 — 4 Diarrhoea (under 2 years) 2 1 3 Appendicitis 1 — 1 Other digestive diseases 3 4 7 Nephritis 7 2 9 Post and post-abort, sepsis — — — Other maternal causes — 1 1 Premature birth 2 3 5 Congenital malformation and birth injury 5 4 9 Suicide 2 2 4 Road traffic accidents 5 2 7 Other violent causes 9 15 24 All other causes 18 13 31 TOTALS 244 257 501