E Wanstead Urban District Council Annual Report OF MEDICAL OFFICER SANITARY INSPECTOR AND HEALTH VISITOR 1925. WANS 1 Wanstead Urban District Council. Annual Report OF MEDICAL OFFICER SANITARY INSPECTOR AND HEALTH VISITOR. 1925. To the Chairman and Members of The Wanstead Urban District Council. Gentlemen, I have the honour to submit my Annual Report for the year 1925, and I include in it a summary of the work done by the Sanitary and Food Inspector, and by the Health Visitor. The Minister of Health desires that my report for 1925 should be a survey report and should refer to any special matters which have occurred in the past five years. Complete details for that period are to be found in the Statistical Tables at the end of this report, and I cannot say that there is anything very striking to which to draw your attention. One matter which is not referred to in my report is the condition of the lake in front of Overton Drive, known as "The Basin," which gave rise to complaint in the Autumn of 1925. This lake had been, famous as a fishpond for years, when suddenly at the time mentioned hundreds of fish of many varieties, including shell fish, began to die. Fishermen and others interested had the water analysed without any cause being found for the fish mortality, and the District Council were subsequently approached and their aid enlisted. Professor Wilfred Rushton, biologist and fish expert, was engaged to give his advice. He made post-mortem examinations of various fish and made other investigations, and he favoured the view that changes in the composition of the water supplied by springs in the lake were responsible. Unfortunately, he could suggest no practical remedy, and I fear that there are now no fish surviving. The vexed question of the population of the District still, in my opinion, requires adjustment. The Registrar-General's estimation is 15,880, an increase of 500 over the previous year, and a net total, since the census was taken in 1921, of 583. During that period, however, local considerations do not appear to have counted largely. The Convent of the Good Shepherd, formerly known as the Royal Seamen's Orphanage, was vacant at the time of the census, and has now about 320 inmates. Births have exceeded deaths by 285. Upwards of 550 new houses have come into occupation, with a probable average of four inmates per house. These facts would lead to the conclusion that our population is about 17,600, less the number who have emigrated 4 The effect it has on our vital statistics is that a greater population would, of course, decrease our already small birth rate, but it would, on the other hand, show a more favourable death rate, although, even on the official figure for population, this is the reverse of perturbing, as you may see from the comparative figures following:— Birth Bate. Death Bate. Infantile Mortality (per 1,000 births). Wanstead 13.2 9.4 23.2 England and Wales 18.3 12.2 75 I am, Gentlemen, Your obedient Servant, PATRICK F. MACGREGOR. 5 NATURAL AND SOCIAL CONDITIONS OF WANSTEAD Area (acres) 1,679 Population (1921) Census 15,297 Population (1925) (Estimated by R.G.) 15,880 Estimated Number of Inhabited Houses (1921) 3,767 „ „ „ „ (1925) 4,317 Rateable Value £130,570 Sum represented by a Penny Rate £544 The District can be best described as a parallelogram of 1,679 acres, extending 2½ miles North and South along the West side of the River Roding, and having an average width of little over a mile. It has a general slope from N.W. to S.E., the highest point (170 feet above sea level) being the extreme N.W. corner of the district, and the lowest point (20 feet) at the extreme S.E. corner, that is on the flood lands attached to the Council's Sewage Farm. The subsoil is mainly gravel, intersected with layers of clay, while the higher levels of the district are of clay formation. Extending from the Western boundary to the centre of the District is an interesting plateau (102 ft.) composed of post-glacial gravel of an average depth of 18 ft., forming perhaps the healthiest residential locality immediately to the East of London. Tracts of forest land and of water, including Wanstead Park and Wanstead Flats, and comprising in all about 509 acres, abound in the southern portion; and these permanent open spaces, being secured against the future inroads of the builder, will doubtless preserve to a large extent the present residential character of the district. The population is fairly distributed north and south, while the central part contains practically the whole of the cottage, shop, and business premises. Here the population is more compact. Many of the inhabitants are employed in the Metropolis in business or professional affairs, and there are a large number of retired middle-class residents. The minor proportion of the population is made up of local tradespeople, outdoor servants, skilled artisans, and various officials and others employed in the industrial districts within more or less easy reach. Local industries are almost entirely confined to local needs, and the number of persons employed in factories and workshops is very small. Extracts from Vital Statistics of the Year. Total. M. F. Birth Legitimate 210 113 97 Birth Rate 13.2 per 1,000 „ Illegitimate 1 1 - „ „ „ „ Deaths 150 70 80 Death Rate 9.4 per 1,000 Number of women dying in, or in consefrom sepsis None quence of childbirth ,, other causes None 6 Deaths of Infants under one year of ago, per 1,000 births 23.2 Legitimate ... 3 Illegitimate. 2 Total 5 Deaths from Measles (all ages) 1 „ „ Whooping Cough (all ages) 2 „ „ Diarrhœa (under 2 years of age) None Births notified by Medical Practitioners or Parents 250 Births notified by Midwives 22 Stillbirths 8 General Provision of Health Services in the District. Hospitals provided or subsidised by the Local Authority or by the County Council:— 1. Tuberculosis.—County Council. 2. Maternity.—None. 3. Children.—None. 4.—Fever.—The Wanstead Isolation Hospital is situated in the S.E. corner of the district and adjoins Wanstead Park. It consists of two pavilions, each sub-divided into wards capable of very complete isolation. 5.—Small Pox.—The negotiations which took place in 1921 between this and other districts to provide joint hospital accommodation for small pox cases, have been completed and a very satisfactory contract has been made with the Borough of West Ham for the treatment of any cases of small pox which may occur in the district. Voluntary Hospitals available for the District include:— The Walthamstow, Wanstead and Leyton Children's and General Hospital situated in Orford Road, Walthamstow. Queen Mary's Hospital, Stratford, E. London Hospital, Whitechapel, E., and others. Ambulance Facilities:— (a) For infectious cases.—The Council's own ambulance is kept for the purpose of removing infectious cases to the Isolation Hospital. (b) For non-infectious cases.—Not yet arranged. Clinics and Treatment Centres.—The Wanstead and Woodford Maternity and Child Welfare Centre (voluntary) on Hermon Hill, close to the northern boundary of the district. Maternity and Child Welfare Centre (Wanstead U.D.C.), Dover Road, South Wanstead. Day Nurseries.—None. The School Clinic, administered by the County Authorities is situated in the High Road, South Woodford. Tuberculosis.—The Tuberculosis Dispensary, at 180, High Road, Leyton, is under the control of the County Authority. Venereal Disease.—County scheme, various London hospitals. 7 Public Health Staff. Public Health Officers. Qualifications. Extent of Duties. Salary Contributions. Medical Officer of Health M.D., D.P.H Part time Under Public Health Act (half). Sanitary Inspector (Royal San. Inst.) Whole time Do. Do. (half) a. Sanitary Inspector's Certificate. b. Meat & Food Inspector's Certificate. Health Visitor (Royal San. Inst.) Health Visitor's Certificate, also Certificate lor 3 years' General Training in Nursing. Whole time By Exchequer grant. Professional Nursing in the Home:— (a) General: Nurse Heale Wanstead District Nurses Fund, (supported by private subscriptions). (b) Infectious Diseases: Measles: Health Visitor. Midwives.—The supervision of midwives is carried out by the County Council. Number of Midwives practising in the District.— Two, not subsidised. Adoptive Acts, Bye-laws, and Regulations in force in the District:— Infectious Diseases (Notification) Act, 1889, adopted Jan., 1891. Do. (Prevention) Act, 1890, do. 1891. Public Health (Amendment) Act, 1890, Parts 2 and 3, adopted Dec., 1890. Do. Do. 1907, do. May, 1908. Local Bye-laws are in force respecting:— New Streets and Buildings: adopted February, 1907. The Regulation of Slaughterhouses, The Prevention of Nuisances arising adopted July, 1879. from Snow and Filth, and The Keeping of Animals, 8 Regulations: Dairy Regulations: adopted July, 1888. Public Health Act, 1925: Not adopted, but under consideration. Sanitary Circumstances of the District. Water.—The water service of the district is supplied by the Metropolitan Water Board and continues to be of good quality. Rivers and Streams.—The only river in the district is the Boding into which the effluent from our sewage disposal works is discharged. The most recent inspection of the latter yielded the following results:— Effluent from river above Works 3.2 per cent. Effluent from river below Works 3.4 „ Sprinkler Effluent 3.6 „ Contact Bed 6.4 „ The Standard Impurity figures are:— Passable Effluent 10 per cent. Good Effluent 7 „ River water which may be used after infiltration for drinking purposes 2.5 „ Not to be so used 3.5 „ Drainage and Sewerage.—The Wanstead Council is fortunate in governing a district where the "lie of the land" permits the whole of the surface-water and sewage to be discharged by gravitation without the expense of pumping or lifting. The drainage system is "combined," as far as domestic sanitation is concerned, i.e., the rainwater and sewage are led away by the same pipes. The surface drainage of the streets, however, is in most cases carried off by an entirely separate system of drains, discharging into open water-courses or ponds, which provide also a means of drainage for the numerous open spaces of t-he district. But in the Northern part of Wanstead the greater part of the surface-water is collected by the brick conduit of 3 ft. 6 in. diameter, which extends from the Eagle Pond overflow eastwards through the Cowley Road and Nightingale Lane depression, across Nightingale Farm to the river Roding. Lower down, into the same river, various discharges of surface-water take place, as e.g., into the ditch on the east side of Redbridge Lane, below the Rectory. Turning now to the sewage system, the main outfall-sewer (2 ft. 4 in. by 3 ft. 6 in.) of Wanstead runs from the northern boundary in a southerly direction through the fields of Nightingale Farm at the rear of the houses on the east side of Buckingham Road; it strikes Redbridge Lane at the right-angled bend below the 9 old Rectory, traverses Wanstead Park, and terminates at the Sewage Farm on the north side of the City of London Cemetery. It collects on its way the whole of the sewage of Wanstead, with the exception of the Aldersbrook and Lake House Estates; these have an independent main sewer of 18 in. diameter following the route—Woodlands Avenue, Northumberland Avenue, to the Sewage Farm. Modern additions to the Sewage Disposal Works were completed in 1915, and were fully described in my Annual Report for that year. Schools.—There are two elementary schools, viz., the old Church Schools, in High Street, and one of modern construction in Aldersbrook. The old Rectory was converted into a secondary school in 1924, pending the erection of the Wanstead High School, now in process of building. There are also twelve or more private schools in the district. Prevalence of and Control over Infectious Diseases. Infectious Diseases Generally.—Outbreaks of diphtheria recurred at one of the children's institutions during January and March. Here the Sanitary Inspector found a number of unsealed drain inlets from which the emanation of drain gas had continuously escaped into the playgrounds. These were subsequently remedied. The rise or fall in number of the more prevalent infectious diseases during the past five years, is as follows:— 1921. 1922. 1923. 1924. 1925. Diphtheria 37 33 5 20 47 Scarlet. Fever 72 50 37 25 17 Tuberculosis 20 11 28 22 20 Enterics Fever — — 2 7 — Encephalitis Lethargica 2 1 1 3 2 Pneumonia (all forms) 2 15 8 9 12 Chicken Pox 28 30 52 32 59 Measles 20 74 20 216 58 German Measles — 2 2 18 49 Laboratory Work. Bacteriological Diagnosis.— Bacteriological aids to diagnosis have been utilised as follows:— No. of throat swabs submitted to the Essex Public Health Laboratories 236 Do., for Vincent's Angina 15 Do., for Virulence Test 1 Do., Sputum Specimens 1 Do., Blood Specimen for Typhoid and Para. Typhoid B 1 Total 254 10 Notifiable Diseases (other than Tuberculosis) during the year 1925 Disease. Total cases notified Cases admitted to Hospital. Total Deaths. Diphtheria 47 39 1 Scarlet Fever 17 13 1 Enteric Fever (including Paratyphoid) — — — Puerperal Fever — — — Pneumonia 12 — 6 Erysipelas 3 2 1 Varicella 59 1 — †Measles 58 1 1 German Measles 49 — — Encephalitis Lethargica 2 — 1 Ophthalmia Neonatorum — — — Acute Poliomyelitis — — — The case rate for the principle notifiable diseases per 1,000 living is represented as follows:— England and Wales. Wanstead. Diphtheria 1.23 2.9 Scarlet Fever 2.36 1.07 Enteric Fever 0.07 0.0 Erysipelas 0.39 0.018 † Measles remains on the list of Notifiable Diseases in Wanstead. TUBERCULOSIS. New Cases and Mortality during 1925. Age Periods. NEW CASES. DEATH. Pulmonary. Non-Pulmonary. Pulmonary. Non-Pulmorary. M. F. M. F. M. F. M. F. 0 - - - - - - - - 1 - - - 1 - - - - 5 - - - 1 - - - - 10 - 1 1 - - - - - 15 2 - - 1 - - - - 20 1 - - - 1 1 - - 25 2 1 - - 1 - - - 35 2 - - - 1 - - - 45 1 3 1 - - - - - 55 1 1 - - - 1 - - 65 and upwards - - - - - - - - Totals 9 6 2 3 3 2 — — 11 The number of cases of Tuberculosis notified during the year was 46, which included transfers from Sanatorium Institutions. 50 cases remained on the Register on the 1st January. 23 new cases were notified during the year. 27 cases were removed during the year. 46 cases remained on the Register at the close of the year. Public Health (Prevention of Tuberculosis) Regulations, 1925. There was no need for any action under these regulations relating to tuberculous employees in the milk trade. Maternity and Child Welfare. Although we have two Maternity and Child Welfare Centres in the District we depend chiefly for carrying out the spirit of the work in this department on visits by a well-informed and tactful Health Visitor, who, although constantly referring the mothers to the family doctor is herself able to do a vast amount of practical and educational good in the course of her daily rounds. Health Visitor's Report. To expectant mothers Initial visits 29 Subsequent visits 85 Total 114 To infants—initial visits 150 To infants under 1 year of age 1,468 Children between one and five years of age 1,894 Total 3,626 Free Milk. Cases. Pints Daily. January 8 9½ February 7 8½ March 7 8½ April 7 9½ May 7 9 June 8 10 July 6 8 August 5 6 September 4 5 October 5 8 November 7 10 December 6 9 12 ANNUAL REPORT OF THE SANITARY INSPECTOR To the Chairman and Members of The Wanstead Urban District Council Gentlemen, I have the honour to submit the following report for the year 1925, my thirteenth year of office. A tabulated statement of particulars, required in accordance with Article 19 (2) of the Sanitary Officers Order, 1922, is included. Complaints.—215 complaints were received; these were, principally, in reference to sanitary defects, and to non-removal of house refuse, including departures from the ordinary routine times of collection. Scavenging.—The collection and removal of house refuse is carried out by contract, and the contractor is responsible for maintaining a weekly collection throughout the year. The debris is carted away from the district immediately following collection. Considerable inconvenience was occasioned during the sharp December frosts, when the condition of the roads was too slippery for horse traffic, and, in consequence of which, collections were more or less disorganised throughout that particular month. With very few exceptions, portable galvanised iron dust bins are in general use throughout the district. Closet Accommodation.—There are no privies. Pail closets and cesspools exist in isolated situations only, probably not exceeding a dozen altogether; otherwise, the water carriage system prevails throughout the district. Arrangements for disinfection of premises and bedding and the extent of their use:— Description. Method. Number during 1924. House Rooms Formalin Gas—lamps 87 School Class Rooms Loads of bedding and other textile articles removed from infected houses Formaldehyde solution, Sprayers Council's Steam Disinfector (under pressure) 12 68 Bedding, etc. of Isolation Hospital Do. (following hospital discharges) Bedding, etc. destroyed on request of owners removed and burnt 10 13 Inspection and Supervision of Food. Milk Supply.—There are six registered dairymen and two cowkeepers occuping premises within, the district, and the residents are also well served from without. Two cowsheds have been converted to other uses, one to a motor garage, the other to stables. The sale of milk in sealed bottles has gained increasing popularity, the largest retailers in the district having abandoned all hand propelled prams as well as metal cans in favour of bottle service by horse vehicles. Undoubtedly sealed milk deliveries direct from the dairy ensures freedom from sources of contamination. Enormous breakages in bottles, however, must prove expensive. Milk (Special Designations) Order, 1925.—All graded milk sold in the district is bottled elsewhere, and the quantity sold is probably very small in proportion to the milk supply generally. The following licences, including supplementary, were granted under this Order. "Certified" Milk 2 "Grade A" (Tuberculin Tested) Milk 4 " Pasteurised" Milk 1 Slaughterhouses.—No change has taken place in the number of slaughterhouses in use for many years past. These number two, both of which are well constructed, commodious premises, containing excellent lairage for cattle. The occupiers are licensed and the licences are: subject to annual renewal. The business is well conducted, and, whenever possible, the examination of carcases takes place at times of slaughter. Public Health (Meat) Regulations, 1924. These1 Regulations were duly observed in regard to slaughterhouses, both as to notice of intended slaughter and to the presence of abnormal conditions discovered following slaughter. Owing to the latter obligation one carcase of beef was examined and found to be affected with generalised tuberculosis and destroyed. The butchers' shops generally are provided with glass fronts. In, one instance of rei-occupation improvements to floors and ventilation of the shop and store were effected, and in another, dirty and unsuitable back premises used for sausage making were given up on request. There are no meat stalls in the district. Bakehouses.—There are five bakehouses in the district, including two underground, and the Bakehouse Regulations were duly observed. Foods.—The quality of food sold in the district is, as a rule, excellent, being obtained largely from the London markets. My attention is called to any consignment giving rise to doubt, and, in ease of 14 condemnation compensation for loss is obtained on production of a certificate to that effect. In this way both beef and fish consignments were dealt with. Sale of Food and Drugs Acts.—46 samples of milk were submitted for analysis, and two were deficient in fats to the extent of 5 and 6 per cent, respectively. It was decided to caution the vendors in each case. The Milk and Cream Regulations.—No samples were taken under the Milk and Cream Regulations. Petroleum Acts.—Eight licences for the storage and sale of petrol were renewed. Since 1922 six of these premises have adopted underground bulk storage tanks and pumps. The total amount of storage capacity under licence now exceeds 5,000 gallons. An application for a portable tank and pump was disapproved, having regard to its proposed use over the public footpath as well as the tendency for obstructing traffic on a narrow portion of arterial road. Housing Statistics for the Year 1925. Number of new houses erected during the year: — (a) Total 207 (b) With State assistance under the Housing Acts, 1919, 1923 or 1924— (i) By the Local Authority — (ii) By other bodies or persons — 1. Utifit dwelling-houses. Inspection—(1) Total number of dwelling - houses inspected for housing defects (under Public Health or Housing Acts) 250 (2) Number of dwelling-houses which were inspected and recorded under the Housing (Inspection of District) Regulations, 1910 47 (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 dwelling-houses (exclusive of those referred to under the preceding sub-heading) found not to be in all respects reasonably fit for human habitation 47 2. Remedy of Defects without Service of formal Notices. Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their Officers 120 15 3 Action- under Statutory Powers. A —Proceedings under section 28 of the Housing, Town Planning, &c., Act, 1919. (1) Number of dwelling-houses in respect of which notices were served requiring repairs — (2) Number of dwelling-houses which were rendered fit: — (a) by owners — (b) by Local Authority in default of owners — (3) Number of dwelling-houses in respect of which Closing Orders became operative in pursuance: of declarations by owners of intention to close — B.—Proceedings under Public Health Acts. (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 5 (2) Number of dwelling-houses in which defects were remedied: — (а) by owners 5 (б) by Local Authority in default of owners — 0.—Proceedings under sections 17 and 18 of the Housing,, Town- Planning, &c., Act, 1909. (1) Number of representations made with a view to the making of Closing Orders — (2) Number of dwelling-houses in respect of which Closing Orders were made — (3) Number of dwelling-houses in respect of which Demolition Orders were made — (4) Number of dwelling-houses demolished in pursuance of Demolition Orders — 16 Tabular summary of the work of the Sanitary Inspector under Article XIX, Sanitary Officers Order, 1925. A B C Nature and Number of Inspections made. Number of Notices served. Result of Service of Notice. Nature. Number. Statutary. Informal. Notices complied with. Remaining in hand. Prosecutions Instituted. Pending 1. Dwelling Houses 2:0 7 56 56 7 — — 2. Schools 18 — 1 1 — — — 3. Ditches, Watercourses, etc. — — — — — — — 4. Offensive Accumulations 22 1 9 10 — — — 5. Keeping of Animals 11 — 4 4 — — — 6 (a) Slaughterhouses 125 — — — — — — (b) Other places where food is produced or sold 97 — 5 5 — — — 7, (a) Dairies 28 1 1 2 — — — (b) Cowsheds 52 1 1 2 — — — (c) Milkshops 17 — — — — — — 8. (a) Factories 11 — 3 3 — — — (b) Workshops 22 — 2 2 — — — (c) Workplaces 12 — 4 4 — — — (d) Outworkers 9 — 1 1 — — — 9. Bakehouses 20 — 1 1 — — — 10. Infectious Diseases 170 — 19 15 4 — — 11. Petroleum Storage 70 — 2 2 — — — 12. Miscellaneous 860 — 17 13 4 — — Total 1,794 10 126 121 15 — — I am, Gentlemen, Your obedient Servant, HENRY C. HOWARD, m.s.i.a., a.r.san.inst., Sanitary and Food Inspector. TABLE 1. VITAL STATISTICS OF WHOLE DISTRICT DURING PREVIOUS YEARS. Year. Population estimated by Registrar General to Middle of Year. Births. Total Deaths Registered in the District Transferable Deaths. Net Deaths belonging to the District. Under 1 Year of Age. At all Ages. Uncorrected Number Net Number Rate of Nonresidents registered in the District of Residents not registered in the District Number. Rate per 1,000 Net Births. Number Rate Number Rate 1 2 3 4 5 6 7 8 9 10 11 12 13 1920 15,420 366 293 19.0 123 7.9 21 61 17 58.0 163 10.5 1921 15,210 264 205 13.4 127 8.3 15 50 9 43.4 162 10.5 1922 15,210 248 223 14.6 119 7.8 19 34 6 26.9 134 8.8 1923 15,260 295 221 14.4 108 7.7 12 50 7 31.2 146 9.5 1924 15,380 222 181 11.7 133 8.6 20 52 7 38.6 165 10.7 1925 15,880 239 211 13.2 131 8.2 18 37 5 23.2 150 9.4 Area of District in acres (land and inland water). 1,679 Total population at all ages 15,297 Number of inhabited houses 3,767 Average number of persons per house 4 At Census of 1921. TABLE II. CAUSES OP DEATH During the Yeah 1925. Net Deaths at the subjoined Ages of Residents. Under 1 Year. 1 and under 2. 2 and under 5. 5 and under 15. 15 and under 25. 25 and under 45. 45 to 65. 65 upwards. All Ages. 1 Enteric Fever .. .. .. .. .. .. .. .. .. 2 Small-pox .. .. .. .. .. .. .. .. .. 3 Measles .. .. 1 .. .. .. .. .. 1 4 Scarlet Fever .. .. .. 1 .. .. .. .. 1 5 Whooping Cough 1 .. 1 .. .. .. .. .. 2 6 Diphtheria .. 1 .. .. .. .. .. .. 1 7 Influenza .. .. .. .. .. .. 3 3 6 8 Encephalitis Lethargica .. .. .. .. .. .. 1 .. 1 9 Meningococcal Meningitis .. .. .. .. .. .. .. .. .. 10 Tuberculosis of Respiratory System .. .. .. 1 1 6 3 1 12 11 Other Tuberculous Diseases .. .. .. .. .. .. .. .. .. 12 Cancer, Malignant Disease .. .. .. .. .. 1 10 15 26 13 Rheumatic Fever .. .. .. .. .. .. .. 1 1 14 Diabetes .. .. .. .. .. .. .. 1 1 15 Cerebral Haemorrhage, &c. .. .. .. .. .. .. 1 11 12 16 Heart Disease .. .. .. .. .. 2 4 14 20 17 Arterio-Sclerosis .. .. .. .. .. .. .. 6 6 18 Bronchitis .. .. .. .. .. .. 1 4 5 19 Pneumonia (all forms) .. .. .. .. 1 2 3 .. 6 20 Other Respiratory Diseases .. .. .. .. .. .. .. .. .. 21 Ulcer of Stomach or Duodenum .. .. .. .. .. 1 .. 1 2 22 Diarrhoea, &c. (under 2 years) .. .. .. .. .. .. .. .. .. 23 Appendicitis and Typhlitis .. .. .. .. 1 .. .. .. 1 24 Cirrhosis of Liver .. .. .. .. .. .. .. .. .. 25 Acute and Chronic Nephritis .. .. .. .. .. .. 4 3 7 26 Puerperal Sepsis .. .. .. .. .. .. .. .. .. 27 Other Accidents and Diseases of Pregnancy and Parturition .. .. .. .. .. .. .. .. .. 28 Congenital Debility and Malformation, Premature Birth 1 .. .. .. .. .. .. .. 1 29 Suicide .. .. .. .. .. 1 1 .. 2 30 Other Deaths from Violence .. .. .. .. .. 2 .. 2 4 31 Other Defined Diseases 3 .. .. 1 .. 1 2 25 32 5 1 2 3 3 16 33 87 150 TABLE III. CASES OF INFECTIOUS DISEASES notified during the year 1925. Notifiable Diseases. Cases Notified in Whole District. Total Cases Notified in Institutions in the District. Total Cases Removed to Hospital. At all Ages. At Ages—Years. Under 1 1 to 5 5 to 15 15 to 25 25 to 45 45 to 65 65 and upwards. Diphtheria (including Membranous croup) 47 .. 7 27 13 .. .. .. 28 39 Scarlet Fever 17 .. 4 13 .. .. .. .. 1 13 Enteric Fever .. .. .. .. .. .. .. .. .. .. Puerperal Fever .. .. .. .. .. .. .. .. .. .. Pneumonia 12 .. 1 3 1 2 4 1 •• •• Erysipelas 3 .. •• .. •• 1 2 •• 2 2 Varicella 59 2 10 42 3 2 .. •• 9 1 Measles 59 .. 7 46 4 1 .. .. 1 1 German Measles 49 •• 4 30 10 5 .. •• .. .. Encephalitis Lethargica 2 .. .. 1 .. .. 1 .. •• •• Totals 247 2 33 162 31 11 7 1 41 56 Isolation Hospital—Empress Avenue, Manor Park. TABLE IV. INFANTILE MORTALITY DURING THE YEAR 1925. Net Deaths from stated Causes at various Ages under One Year of Age. Causes of Death (All Causes, Certified.) Under 1 Week 1 to 2 Weeks 2 to 3 Weeks 3 to 4 Weeks Total under 4 Weeks 4 Weeks and under 3 Months 3 to 6 Months 6 to 9 Months 9 to 12 Months Total Deaths under 1 year Whooping Cough .. .. .. .. .. .. 1 .. .. 1 Congenital Debility .. 1 .. 1 .. .. .. .. 1 Intussusception .. .. .. .. .. .. .. 1 .. 1 Unknown 2 .. .. .. 2 .. .. .. .. 2 Total 2 1 .. .. 3 .. 1 1 .. 5 Net Births in the year Legitimate 210 Illegitimate 1 Net Deaths in the year of Legitimate Infants 3 Illegitimate Infants 2 TABLE V. I.-INSPECTION OF FACTORIES, WORKSHOPS AND WORKPLACES. Including Inspections made by Sanitary Inspectors. Premises Number of (1) Inspections. (2) Written Notices. (3) Prosecutions. (4) Factories —Including Factory Laundries 11 1 .. Workshops—Including Workshop Laundries 23 3 .. Workplaces (other than Outworkers' premises) 12 2 .. Totals 46 6 .. 2.—DEFECTS FOUND. Particulars Number of Defects. Number of Prosecutions. Found Remedied Referred to H.M. Inspector. (1) (2) (3) (4) (5) Nuisances under the Public Health Acts:— Want of Cleanliness 5 5 .. .. Want of Ventilation 2 2 .. .. Sanitary accommodation unsuitable or defective 5 5 .. .. Other Nuisances 7 7 .. .. Offencts under the Factory and Workshop Acts:— .. .. .. .. Totals 19 19 .. ..