WIL 12 Willesden Urban District Council. THE 34th ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH, ON THE Vital Statistics and Sanitary Condition OF THE URBAN DISTRICT OF WILLESDEN, FOR THE YEAR 1909, BY WILLIAM BUTLER, M.B., C.M., D.P.H., Medical Officer of Health and School Medical Officer, Willesden. London: Morton & Burt, Ltd., Printers, Paddington and Willesden. 1910. CONTENTS. Page. Vital Statistics 13—30 Infantile Mortality and Birth Enquiries 31—36 Vital Statistics of the Wards 37—40 Infectious Diseases 41—58 Sanitary Administration 59—72 Factory and Workshop Act 73—80 Local Government Board Tables 81—93 APPENDIX. 1. Annual Report of School Medical Officer. 2. Hospital Report. 3 Quarterly Reports. INDEX A. Page. Analysis of Notification 44 B. Bakehouses 75 Births and Birth Rates 19 — 22 Births— Illegitimate 20 Inquiries 33—35 Rates in Wards, 1900—1909 22 Rates in Willesden and England and Wales, 1875—1909 21 Wards, Distribution of 20 C. Canal Boats, No. Inspected 71 Cancer— Deaths from 28 Mortality Rate, 1875—1909 27 Wards, Age and Sex Distribution in 29 Chart— Deaths Registered each Week 24 Common Lodging Houses 65 Customs and Inland Revenue Act 66,71 D. Dairies and Milkshops 68, 71 Deaths— At Age Periods 23 Cancer, No. of, from 1875—1909 27 „ Remarks on 28 Cancer, Wards, Age and Sex Distribution 29 4 Page Causes of 86—91 Chart showing Weekly 24 Rates, 1875—1909 24 Rates of Wards 39 Rates, Corrected 39 Illegitimate 26 Inquests 25 Phthisis, from 1875—1909 27 „ Remarks on 27 Uncertified 26 Diarrhoea and Infantile Mortality Table 32 Diphtheria- Remarks on 54 Death Rates, 1875—1909 50 Fatality Rates, 1888—1909 49 Incidence Rate, 1888—1909 49 Notifications under 15 years of Age 47 Ward Incidence 48 E. Erysipelas, Ward Incidence 48 F. Factory and Workshop Act, 1901, Remarks on 74—76 Factory and Workshop Act, 1901, Tables showing details of work under 77 — 80 H. Health of Scholars in Public Elementary Schools 57 House Refuse— Collection of 60 Complaints, No. of, 1901—1910 61 Men and Carts employed, Table showing No. of 61 Table of Cost 63 5 Page. House Refuse—continued. Table of Quantities 62 Quantity Collected per Month 64 Home Workers 79 Housing of Working Classes Act 67 „ „ „ No. of Notices served 71 I. Ice Cream 67 Illegitimate Births 20 „ Deaths 26 Infantile Deaths, Causes of 92, 93 Infantile Mortality and Diarrhœa Deaths 32 „ „ Rates of Wards 39 „ „ Remarks on 33 Infectious Diseases— Analysis of, in Wards 44 Tables of, 1892—1909 46 Inquests 25 Inspection and Re-inspection of Premises 71 Inspection of Manholes 70 Isolation Hospital 54 L. Laundries 74 Legal Proceedings 69 Local Government Board Tables 81—93 M. Manhole Inspection 70 Marriages and Marriage Rates 19 Measles in Public Elementary Schools 55,56,57 „ Death Rates, 1875—1909 50 Meteorological Tables 17, 18 Mews, Stables, &c., No. Inspected 71 Milkshops and Dairies 68,71 6 Page. Mortality— Infantile Rates, 1875—1909 32 „ „ Remarks on 33 Phthisis, Rates, 1875—1909 27 Rates, Ward 39 Zymotic, Rates, 1894—1909 42 N. Notifications, Road Analysis of 44 Notification of Infectious Diseases, Table of 46 Nuisances, Table of Inspection of 71 O. Offensive Trades 66 P. Persons per Acre 9 Phthisis 28 „ Death Rates, 1875—1909 27 Population — At Censal Periods 14 Estimated in Wards and Drainage Areas, 1909 (Midsummer) 16 Remarks on 12 Public Health Committee 8 Public Health Department, Staff of 8 R. Rateable Value 9 S. Statistical Summary, 1909 9 Sanitary Administration 59 Scarlet Fever- Scarlet Fever, Remarks on 51 Death Rates, 1875-1909 50 7 Page. Scarlet Fever—continued. Fatality Rate, 1888—1909 49 Incidence Rates, „ „ 49 Incidence Rate in Wards 48 Notifications under 15 years of age 47 Return Cases 52 Schools, Public Elementary, Health of Scholars in 57 Measles in 35 Sewage Disposal 65 Slaughter Houses, No. Inspected 71 Small Pox 43 Smoke Nuisance 67 Staff, Public Health Department 9 Summary of principal items of Work, 1909 71 Summonses issued, No. of 69—71 T. Tuberculous Disease 28 Typhoid Fever, Remarks on 54 Death Rates, 1875- 1909 50 Fatality Rate, 1888—1909 49 Incidence Rate, 1888—1909 49 U. Uncertified Deaths 26 V. Vaccination Returns 45 Vital Statistics, Wards 38 W. Ward Mortality Rates 39 Weekly Death Chart 24 Whooping Cough Death Rates, 1875—1909 50 Z. Zymotic Mortality Rates 42 8 PUBLIC HEALTH COMMITTEE, 1909-10. Chairman: Councillor J. E HILL. Mr. Councillor W. RILEY, J.P., Chairman of Council (ex-officio). Mr. Councillor C. H. PARKER, Vice-Chairman of Council (ex officio) Mr. Councillor J. ANDREWS. Mr. Councillor C. BIDDISCOMBE. Mr. Councillor E. T. BUTTERISS. Mr. Councillor W. R. DUNN. Mr. Councillor F. HILBORN. Mr. Councillor J. W. INGLEDEW. STAFF OF PUBLIC HEALTH DEPARTMENT. WILLIAM BUTLER, M.B., D.P.H., Medical Officer of Health and School Medical Officer. H. de Lima Woods, Chief Sanitary Inspector, Cert, of Royal Sanit. Inst., also for Meat and other Foods. J. H. Smith, Sanitary Inspector, Cert, of Royal Sanit. Inst. A. W. Loughlin, „ „ „ „ G. W. Wilson, „ „ „ „ F. Sheriff, „ „ „ „ T. L. Morley, „ „ „ „ Miss K. Gaul, Lady Health Visitor, Cert. Sanit. Insp. Exam. Board. „ Cook, Assistant, „ „ „ „ Thompson, B.Sc. „ „ „ „ „ Briscoe, „ „ „ „ „ McColl, „ „ „ „ A. A. Gibb, Senior Clerk. J. Barker, Clerk. L. Louth, „ A. Paterson, „ W. Pell, Junior Clerk. 9 STATISTICAL SUMMARY FOR 1909. Population estimated to middle of year 150,145 Area 4,383 acres Population per acre 34 „ Metropolitan District 1,081 „ „ „ 72 „ Brent District 3,302 „ „ „ 21 Soil—The London Clay. Altitude varies from 78 ft. to 242 ft. above Ordnance Datum. Rateable Value, £877,769. s. d. Metropolitan District 2 8 General District Rate Brent District 3 2 Poor Rate (Including Education Rate) 4 8 Rate per 1,000 Population. Marriage Rate 13.8 Birth Rate 27.8 Crude Death Rate 9.6 Nett Death Rate 11.2 Corrected Death Rate 12.0 Infantile Mortality Rate (per 1,000 births,) 94 Zymotic Mortality Rate 1.1 Infectious Diseases, Notification Rate 6.6 10 PUBLIC HEALTH REPORT For 1909. To the Chairman and Members of the Willesden District Council. Gentlemen, I beg leave to submit the thirty-fourth Annual Report on the health and sanitary circumstances of Willesden. The work of the Public Health Department steadily increases as year by year Parliament throws greater and more extended responsibilities upon local authorities. The last few years have witnessed a silent revolution in the nature and province of public health administration. The venue may be said not so much to have changed as to have expanded so as to embrace not only the environment, which was more particularly the object of solicitude in the past, but the personal health and the habits and conduct of the people upon which their physical well-being is conditioned. This change in the province, which properly may be considered to fall within the domain of public concern and control, is viewed approvingly or with hostility from varying standpoints, but with these the administrator as such is less concerned than with the execution of the measures which, however they be viewed, are imposed by statutory obligations, the outcome of the inevitable exigencies of the time. The protection of the expectant mother and the care and instructed nurture of her offspring mark the commencement of a sustained communal interest which is continued through childhood 11 and the vicissitudes of illness and physical disabilities to the search for and control of all the adverse circumstances to which they are related as effects. So comprehensive an interest finds its organised expression in the public health administration of the local authorities, and the public health report is an attempt to record the measures and results of efforts in this connection. The condensation of recorded fact presented in a page of statistics is at best an indifferent picture of accomplishment, and its meaning and significance may be perceived only in the accumulated results of years of routine. Even so, and though much be the evidence of mere failure, the tabulated statements are convenient milestones which show at least the distance travelled though the end be discerned but dimly. 13 A.— VITAL STATISTICS. 14 POPULATION. The population of Willesden, estimated to Midsummer 1909, is 150,145. Since 1901, the year of the census, the population, estimated to Midsummer each year, has been as follows:— Year. Estim. Pop. Estimated annual increment of Population. Excess of Births over Deaths. 1901 116,089 — 2,141 1902 122,211 6,122 2,120 1903 129,315 7,104 2,477 1904 134,539 5,224 2,776 1905 140,758 6,219 2,457 1906 142,871 2,113 2,600 1907 146,107 3,236 2,543 1908 149,035 2,928 2,472 1909 150,145 1,110 2,494 The population of Willesden from 1851, according to the Census returns, has been as follows:— 1851 2,960 1861 3,879 1871 15,869 1881 27,453 1891 61,265 1901 114,811 It may seem strange with an excess of births over deaths amounting to 2,494 that the estimated increase of population for the year amounts only to 1,110. The explanation lies in the fact that only 155 occupied houses have been added to the District during the year, the number of empty houses having increased from 949 to 1,027. It may be remarked that since Midsummer the number of empty houses has diminished to 933 at Christmas. At first sight it would appear that an excess of births over deaths of 2,494 persons 15 would not in any case be associated with a diminished population as has actually occurred during the last six months of the year. It is to be remembered, however, that the population is estimated on the assumption that the average number of persons per house as ascertained at the census remains constant throughout the intercensal period. This average number of persons per house is an expression for the whole District, which may be said to discount the tendency of older houses to increase their average number of persons and of new houses to be occupied by considerably fewer persons than the average for the District. Although this assumption is subject to error from fluctuation, the intercensal fluctuations are inestimable, and experience has shown that, by taking the datum as constant, the error falls within the range of practical utility. 16 Table No. 1. POPULATION ESTIMATED TO MIDSUMMER, 1909. NAME OF WARD. Drainage Areas. Population estimated on the number of houses in occupation in each Ward as ascertained by enumeration. Houses in Occupation. Total Number of Empty Tenements. No. of Houses recently erected but unoccupied. No. of Houses in course of erection. Per centage of empties exclusive of houses recently erected. Per centage of empties inclusive of houses recently erected. Per centage of Houses empty at Census. Population in Drainage Areas. Wards. 1 Room. 2 Rooms. 3 Rooms. Over 3 Rooms. Population. 1908.9. Houses No. of Kmpty Houses Church End Met. .. 24043 Mids'r. 3679 169 6 5 172 84 4 12 4.6 4.7 5.96 Brent. 24043 Xmas. 3680 169 1 1 214 40 3 — 4.6 4.7 Harlesden Met. 8249 22509 Mids'r. 3774 161 2 4 102 67 10 15 4.3 4.5 3.88 Brent. 14260 Xmas. 3755 153 1 5 103 65 24 8 4.1 4.7 Kensal Green Met. 30117 30154 Mids'r. 4178 125 8 14 129 64 6 9 3.0 3.1 2.92 Brent. 37 Xmas. 4172 83 1 5 103 53 4 2 2.0 2.1 S. Kilburn Met. 14622 14622 Mids'r. 1316 50 4 119 52 9 — — 3.8 — 1.26 Brent. .. Xmas. 1316 55 - 41 100 12 - - 4.2 - Mid. Kilburn Met 12150 12150 Mids'r. 1586 97 4 33 53 37 - - 6.1 - 4.16 Brent. .. Xmas. 1595 106 8 30 59 23 - - 6.6 - N. Kilburn Met. 9787 9787 Mids'r. 1687 131 — 1 52 50 11 — 7.8 8.4 2.62 Brent. .. Xmas. 1685 101 4 9 32 17 8 5 6.0 6.7 Willesden Green Met. 2875 33611 Mids'r. 5777 294 1 1 77 101 162 51 5.1 7.9 7.37 Brent. 30736 Xmas. 5725 248 3 4 124 71 155 58 4.3 7.0 Willesden U.D.) aggregate of the Wards Met. 77800 146876 Mids'r. 21997 1027 25 177 637 412 193 87 4.7 5.5 4.02 Brent. 69076 Xmas. 21928 915 18 95 735 281 194 73 4.2 5.2 Population as estimated to Midsummer, 1909, by the Registrar-General, 160,424. Population estimated on the assumption that the average number of persons per house at census has remained constant for the whole of Willesden—150,145, Midsummer, 1909. 150,453, Christmas, 1908. 17 Table No. 2. METEOROLOGICAL OBSERVATIONS. Taken at the Hospital, Dog Lane, Neasden. Readings at 10.0 a.m. daily. Altitude of ground at Meteorological Station, 97.64 O.D. Altitude of Rim of Rain Gauge, 102.36 O.D. 1909. Year 1909. TEMPERATURE Mean degree of Humidity. Rainfall in inches. Number of days on which Rain was measured. Number of Hours of bright Sunshine. Sunshine recorded at Greenwich. of the air shewn in degrees Fahrenheit. 4-foot Earth Thermometer. Highest Lowest Range in Month. Mean of all Highest. Mean of all Lowest. Max. Min. January 50.25 19.00 31.25 42.43 33.02 48.50 46.00 88° .73 10 64.2 60.6 February 56.00 15.00 41.00 43.97 29.23 46.00 44.00 84° .21 4 69.0 91.3 March 59.50 11.00 48.50 44.31 34.00 44.00 42.00 88° 2.57 18 65.5 75.3 April 71.75 26.50 45.25 59.20 38.02 46.25 42.50 73° 1.97 11 229.2 249.5 May 82.00 31.00 51.00 60.20 40.43 49.25 46.50 70° 2.56 12 297.1 325.9 June 75.50 37.75 37.75 62.60 47.23 52.00 49.25 80° 4.05 17 113.8 106.9 July 75.75 41.00 34.75 68.15 52.10 54.00 52.00 73° 3.36 17 187.0 179.1 August 85.50 42.75 42.75 71.62 51.27 56.25 54.00 75° 1.68 10 213.4 227.5 September 68.50 34.75 33.75 62.53 47.97 56.25 54.75 80° 2.62 90 114.0 106.2 October 65.75 26.25 39.50 58.20 46.63 54.50 52.75 85° 3.41 23 79.8 90.7 November 55.75 26.00 29.75 46.63 35.38 52.75 48.25 86° 079 10 77.6 77.5 December 53.00 19.00 34.00 45.35 34.34 48.00 45.00 90° 2.51 21 42.6 50.2 Means 66.61 27.50 39.10 55.43 40.80 50.65 48.08 81° 26.46 Total 173 Total 1543.2 Total 1640.7 Total Mean of last 7 years 74.07 18.28 39.3 56.5 40.3 51.22 48.78 79° 24.96 134 18 Table No. 3. METEOROLOGIGAL OBSERVATIONS. 7 years 1902-1908 inclusive. Month. TEMPERATURE Mean Humidity 6 Years. Mean Rainfall in Inches. Mean No. of Days on which Rain was Measured (6 Years). of the air shewn ill decrees Fahrenheit. 4 feet Earth Thermometer. Mean Highest in 7 Years. Lowest in 7 Years. Mean Annual Range. Mean Highest Mean Lowest Maximum in 7 Years, Minimum in 7 Years. January 60.5 1906 14.0 1906 35.1 443 32.5 46.21 43.93 87° 1.79 10 February 57.9 1903 10.7 1902 32.0 44.8 33.2 44.21 43.05 85° 1.38 9 March 69.0 1907 11.0 1909 39.8 48.0 34.0 44.25 42.93 81° 1.92 14 April 71.7 1909 15.0 1906 41.0 539 34.7 45.89 44.03 76° 1.47 10 May 82.0 1909 17.0 1906 45.9 60.6 41.0 49.22 45.93 72° 1.94 12 June 81.7 1903 24.0 1906 42.5 66.6 46.2 53.19 49.36 72° 3.08 12 July 86.5 1904 37.2 1905 40.1 73.2 51.2 57.11 53.07 70° 2.25 10 August 87.0 1904 25.5 1905 42.1 69.6 50.2 57.75 56.87 71° 2.65 12 September 92.0 1906 26.5 1905 44.3 64.9 47.3 57.75 56.18 77° 1.81 9 October 79.0 1908 10.0 1905 38.2 58.0 42.7 56.21 53.50 83° 2.66 14 November 64.5 1908 11.5 1905 35.8 49.6 36.7 53.39 49.75 88° 2.24 11 December 57.0 1907 17.0 1906 35.2 44.7 34.5 49.46 46.71 89° 1.77 11 Means 74.07 18.28 39.3 56.5 40.3 51.22 48.78 79° TOTAL 24.96 TOTAL 134 19 MARRIAGES. In the following Tables are given the statistics relating to Marriages in Willesden. Table NO. 4.—MARRIAGES. 1909. First Quarter. Second Quarter. Third Quarter Fourth Quarter. Total. Church of England 87 149 206 140 582 Nonconformist Churches - — — — 160 Registrar's Office — — — — 294 Totals 87 149 206 140 1,036 The total of 1,036 marriages for the year gives a marriage rate of 13.8 per 1,000 persons living. Since 1900 the marriage rates per 1,000 have been as follows:— Marriage Rate per 1900 1901 1902 1903 1904 1905 1906 1907 1908 1909 1,000 persons 10.8 11.2 12.4 12.9 12.4 12.7 13.1 13.1 13.0 13.8 Percentage performed otherwise than in Church of England 26.8 28.4 26.1 25.1 29.1 32.9 33.1 33.3 41.7 43.8 England and Wales, Ditto — 33.4 33.9 34.9 35.8 36.4 36.8 37.6 38.4 — BIRTHS. The Birth Rate for the year shows a slight increase on that of last year. Willesden. England & Wales. Birth-rate on Total population, All ages. Rate per 1,000. Willesden. England & Wales. Birth-rate on Female population, 15-45 years. Rate per 1,000. 1904 32.9 27.9 116.5 111.8 1905 29.8 27.2 107.4 108.9 1906 30.1 27.1 107.6 108.3 1907 29.4 26.3 105.8 105.1 1908 27.5 26.5 98.8 106.1 1909 27.8 25.6 99.9 20 Table No. 5. BIRTHS REGISTERED IN WILLESDEN * 1909. Boys. Girls. Totals. First Quarter 586 511 1,097 Second „ 538 497 1,035 Third „ 521 487 1,008 Fourth „ 542 490 1,032 Totals 2,187 1,985 4,172 *Including Births in Queen Charlotte's Hospital and other places outside Willesden, mothers having been removed from Willesden immediately prior to their confinement. Table No. 6. BIRTHS DISTRIBUTED INTO WARDS. wards. First Quarter. Second Quarter. Third Quarter. Fourth Quarter. Total. Rate per 1,000 of Population. Church End 218 209 201 205 833 34.6 Harlesden 196 185 188 181 750 33.3 Kensal Green 202 179 200 181 762 25.3 South Kilburn 120 110 95 114 439 30.0 Mid Kilburn 80 97 88 95 860 29.6 North Kilburn 57 50 47 44 198 20.2 Willesden Green 224 205 189 212 830 24.7 Totals 1,097 1,035 1,008 1,032 4,172 27.8 Table No. 7. ILLEGITIMATE BIRTHS. Year. No. Registered in Willesden. No. born of Willesden mothers outside District. Total. Rate per 1,000 births. 1906 111 14 125 29 1907 98 27 125 29 1908 76 18 94 23 1909 108 22 130 31 21 Table No 8. Birth-Rate. 1875 1876 1877 1878 1879 1880 1881 1882 1883 1884 1885 Willesden 44.7 43.4 41.1 40.2 37.6 38.3 34.4 33.3 33.3 34.1 35.6 England and Wales 35.4 36.3 36.0 35.6 34.7 34.2 33.9 33.8 33.5 33.6 32.9 Birth-Rate. 1886 1887 1888 1889 1890 1891 1892 1893 1894 1895 1896 1897 Willeaden 35.7 33.8 32.1 33.7 29.4 33.1 31.7 32.5 30.7 31.2 32.2 31.0 England and Wales 32.8 31.9 31.2 31.1 30.2 31.4 30.4 30.7 29.6 30.3 29.6 29.6 Birth-Rate. 1898 1899 1900 1901 1902 1903 1904 1905 1906 1907 1908 1909 Willesden 31.5 31.5 31.2 33.1 31.3 31.9 32.9 29.8 30.1 29.4 27.5 27.8 England and Wales 29.3 29.1 28.7 28.5 28.5 28.4 27.9 27.2 27.0 26.3 26.5 25.6 22 Table No. 9. Church End. Harlesden. Kensal Green. South Kilburn. Mid Kilburn. North Kilburn, Willesden Green. 1900 42.0 28.0 35.1 30.1 30.9 17.2 29.3 1901 38.9 29.7 34.7 29.5 30.0 20.3 30.6 1902 39.0 28.8 34.4 29.9 27.6 24.3 29.4 1903 38.3 35.1 32.8 30.4 27.3 22.0 27.8 1904 39.8 36.3 32.3 30.2 28.7 21.6 30.6 1905 37.3 33.7 28.9 30.4 28.1 21.6 27.4 1906 35.8 32.7 29.6 32.7 31.7 20.2 26.6 1907 36.9 29.7 27.8 30.3 29.9 21.2 27.5 1908 35.4 32.1 26.1 27.8 29.6 18.4 24.3 1909 34.6 33.3 25.3 30.0 29.6 20.2 24.7 Mean 37.8 31.9 30.7 30.1 29.3 20.7 27.8 This increase it will be perceived by reference to Table (9) has been associated with slight increases in the ward birth rates of Harlesden, South Kilburn, North Kilburn, and Willesden Green and with decrease in the rates of Church End and Kensal Green The variations are too trivial to permit of any significance being attached to them. 23 Table No. 10. 1909. DEATHS FROM ALL CAUSES AT DIFFERENT AGE PERIODS. 0 to 1 1 to 5 5 to 10 10 to 15 15 to 20 20 to 25 25 to 35 35 to 45 45 to 55 65 to 65 65 to 75 75 to 85 85 and up. All Ages. 1st Quarter 129 59 14 4 9 11 44 44 43 50 68 51 19 545 2nd „ 87 52 10 6 5 4 27 36 42 41 48 30 10 398 3rd „ 84 27 8 5 3 7 10 34 35 41 34 23 5 316 4th „ 91 29 15 6 8 14 25 31 36 35 55 45 7 397 See Note * — — 1 1 1 1 1 5 6 3 2 1 — 22 Males 240 86 18 13 14 22 51 79 88 90 89 55 11 856 Females 151 81 30 9 12 15 56 71 74 80 118 95 30 822 1909 391 167 48 22 26 37 107 150 162 170 207 150 41 1,678 * The deaths appearing in this line were returned at the end of the year and so were not included in the statistics of the respective quarters in which they occurred. 24 Table No. 11. DEATH RATES. 1875 TO 1909. Year. Number of Deaths. Rate per 1,000. Year. Number of Deaths. Rate per 1,000. 1875 385 21.4 1893 1,070 15.5 1876 401 21.7 1894 917 13.2 1877 346 17.7 1895 1,143 14.5 1878 441 21.4 *1896 1,312 15.3 1879 376 16.8 1897 1,343 14.4 1880 471 18.7 1898 1,388 13.9 1881 490 17.6 1899 1,643 15.2 1882 587 18.1 1900 1,577 13.6 1883 538 15.4 1901 1,529 13.2 1884 530 14.7 1902 1,709 13.9 1885 632 16.2 1903 1,655 12.8 1886 685 15.5 1904 1,645 12.2 1887 701 14.3 1905 1,744 12.4 1888 835 15.8 1906 1,672 11.8 1889 686 12.0 1907 1,704 11.8 1890 882 14.4 1908 1,623 10.9 1891 860 13.8 1909 1,678 11.2 1892 945 14.4 * Prior to 1896 only the crude death rate is given. For 1896 and all subsequent Tears the death rate is net, i.e., is corrected for deaths of residents occurring outside the district and nonresidents dying within 25 DEATHS. The deaths registered in the District were 1,448: males, 719; females, 729. Those registered outside the District of persons belonging to it were 242, giving a total of 1,690. There were 12 deaths registered in the District of persons not belonging to it, making 1,678 deaths properly accredited to the District. The crude death-rate for the year is 9.6 per 1,000. Corrected for deaths of residents dying outside the District and of non-residents dying within, it is 11.2 per 1,000. Corrected for the age and sex distribution of Willesden's population it is 12.0. The death-rates for the last seven years, corrected for residents dying outside the district, and for non-residents dying within, are as follows:— 1903 1904 1905 1906 1907 1908 1909 12.8 12.2 12.4 11.8 11.8 10.9 11.2 INQUESTS. Total number of Inquests held in Willesden on residents during the year 1909—87. On non-residents - 4. The following is an abstract of the verdicts. Residents Phthisis 1, Septic Disease 1, Bronchitis 2, Pneumonia 11, other Diseases of Respiratory Organs 1, Suicide 7, Cirrhosis of liver 2, Heart Disease 13, Accidents 28, Congenital Defects 2, Disease of Nervous System 12, Disease of Digestive System 1, other causes 6. Non-residents:—Found Drowned 1, Accident 1, Suicide 1, Disease of Lung 1. C 26 Table No. 12. RETURN OF INQUESTS, &c., HELD DURING THE YEAR ENDED 31ST DECEMBER, 1909. Mortuary. Inquests. Removed for Accommodation. No. of Post Mortems. Male. Female. Church End Kilburn 46 42 30 72 DEATHS NOT CERTIFIED. Ascribed to: Premature Birth 3, Consumption 1, Epilepsy 2, Heart Disease 2 = 8. DEATHS OF ILLEGITIMATE CHILDREN Dying in Willesden during year 1909 (exclusive of Non-Residents), Measles 1, Whooping Cough 2, Diarrhoea 4, Enteritis 1, Bronchitis 1, Pneumonia 1, Venereal Disease 1, Accidents 1, Marasmus 3, Disease of Nervous System 1, Disease of Digestive System 1, other causes 6—Total 23. Dying outside District, but belonging to Willesden: Marasmus 1. Tabes Mesenterica 1, Meningitis 1=3. 27 Table No. 13. PHTHISIS AND CANCER MORTALITY 1875 to 1909. Year. Number of Deaths from Phthisis. Rate per 1,000 of Population. Number of Deaths from Cancer. Rate per 1,000 of Population. 1875 37 2.03 7 .385 1876 24 1.30 11 .596 1877 32 1.64 8 .410 1878 40 1.94 16 .727 1879 35 1.56 10 .447 1880 36 1.42 8 .317 1881 44 1.60 - — 1882 27 0.83 14 .431 1883 56 1.60 10 .285 1884 35 0.96 20 .553 1885 55 1.42 21 .543 1886 35 0.79 18 .406 1887 47 0.95 12 .244 1888 47 0.87 36 .680 1889 55 0.96 25 .437 1890 73 1.18 29 .472 1891 67 1.07 36 .578 1892 65 0.98 35 .531 1893 73 1.06 37 .535 1894 72 0.98 32 .434 1895 96 1.08 44 .555 1896* 88 1.02 51 .594 1897 86 0.92 30 .322 1898 100 1.00 46 .462 1899 135 1.25 55 .511 1900 103 0.89 73 .634 1901 96 0.81 85 .746 1902 111 0.909 97 .794 1903 113 0.873 107 .827 1904 141 1.04 111 .825 1905 146 1.037 115 .817 1906 139 .981 111 .783 1907 138 .955 108 .748 1908 120 .805 112 .751 1909 131 .872 120 .799 * Deaths outside district included in this and subsequent years. C 2 28 DEATHS FROM PHTHISIS AND OTHER TUBERCULAR DISEASES. The deaths from Phthisis number 131, and from other Tubercular diseases 65. The phthisical death rate (872 per million) represents a slight increase on the rate of last year, but is well below the average of recent years. During the year cases have been notified by the officers of the Poor Law authority. Such cases as are not receiving institutional indoor treatment are kept under observation, being systematically visited by the Lady Health Visitors. Sputum bottles are supplied to suitable cases, disinfection is carried out where indicated, and appropriate instructions are issued as occasion suggests. CANCER. The death-rate from Cancer (799 per million) is slightly in excess of the rates experienced during the last four years. The deaths of females are more than double the deaths of males ascribed to this disease. 29 Table 14. CANCER DEATHS, 1909 (Distributed According to Age and Sex.) Wards. l to 5 20 to 25 25 to 35 35 to 45 45 to 65 55 to 65 65 to 75 75 to 85 85 up. total. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. Church End ... ... ... ... ... ... ... ... 1 1 2 1 ... 5 2 3 ... ... 5 10 15 Harlesden ... ... ... ... ... 1 ... 2 ... 2 1 1 ... 2 2 1 ... ... 3 9 12 Kensal Green 2 ... ... ... 1 1 1 2 1 4 3 7 2 3 1 2 ... 1 11 20 31 South Kilburn ... ... ... ... ... ... 1 ... ... 3 1 1 1 2 ... 1 ... ... 3 7 10 Mid Kilburn ... ... ... ... ... ... ... ... ... ... 2 5 1 ... ... 2 ... ... 3 7 10 North Kilburn ... ... ... ... ... 1 ... ... 1 1 ... 2 2 5 ... 1 ... ... 3 10 13 Willesden Green ... ... ... 1 ... 1 2 2 ... 4 4 3 1 5 3 2 ... 1 10 19 29 Infirmary ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Willesden U. D 2 ... ... 1 1 4 4 6 3 15 13 20 7 22 8 12 ... 2 38 82 120 31 INFANTILE MORTALITY. 32 Table No. 15. INFANTILE MORTALITY AND DIARRHŒA DEATHS. 1875 TO 1909. Year. Infantile Deaths. Infantile Mortality Rate per 1,000 Births. Deaths from Diarrhœa. Rate per 1,000 of Population. 1875 131 162 28 1.54 1876 120 149 28 1.52 1877 113 140 8 0.41 1878 167 201 23 1.11 1879 118 130 12 0.54 1880 168 173 29 1.11 1881 — — 37 1.35 1882 202 186 31 0.95 1883 196 167 28 0.80 1884 203 164 42 1.16 1885 235 172 33 0.85 1886 265 164 37 0.83 1887 264 159 45 0.92 1888 290 170 36 0.68 1889 276 143 43 0.75 1890 287 158 38 0.62 1891 273 132 32 0.51 1892 333 159 36 0.54 1893 345 153 52 0.78 1894 299 132 31 0.42 1895 373 150 56 0.70 1896* 460 167 72 0.84 1897 444 155 122 1.81 1898 427 136 104 1.04 1899 537 159 169 1.57 1900 497 139 137 1.19 1901 495 131 123 1.05 1902 436 130 104 0.85 1903 509 123 81 0.62 1904 509 115 146 1.08 1905 490 117 100 0.71 1906 493 115 157 1.17 1907 451 106 54 0.37 1908 397 97 57 0.38 1909 391 94 47 0.31 * Deaths occurring outside the district included in this and all subsequent years. ;i3 INFANTILE MORTALITY. It is satisfactory to record a still further decline in the rate of Infantile Mortality. The rate (94 per 1,000 births) is not only the lowest experienced but is less than half of certain rates recorded in the past. I have on other occasions pointed out that the type of weather experienced during recent summers has been highly favourable to infant survival. Until we have again been subject to a hot, dry summer it is difficult to say to what extent the low infantile mortality is due to increased care and more intelligent fostering of infants. I shall, therefore, again reserve my comments upon the ascertained results of health visiting, so far as infant nurture is concerned, until circumstances justify the expression of an opinion which has been tested by less favourable conditions than those prevailing during recent summers. Miss Gaul's report upon this province of her work I reproduce as heretofore. BIRTH ENQUIRIES, 1909. "Enquiries into the conditions under which infants are reared have been continued during the year 1909. Some 1,300 houses from which births have been notified were visited during the year, and a large number of these were revisited once or more as may have been deemed necessary. The visitors are well received, and usually expected. The mothers generally appreciate the interest taken in the babies, and are glad of advice on many points. There is a steady increase in the numbers of infants who sleep in separate cots or cradles. Unfortunately, however, the figures fall during the winter months. This is owing to the lack of sufficient warm bed covering in many cases; but also, and perhaps more frequently, to the idea which many mothers have that the babies cannot be kept warm in winter except in the mother's arms, and that the mother's bed is the natural place for a baby to sleep in. 34 Woollen vests and flannel garments are gradually coming into favour, but these are frequently only adopted when the infants are put into short clothing. This is usually due to one of two reasons, either (1) lack of means to procure what is necessary, or (2) the baby's outfit having been provided and being already in use when the Health Visitor arrives. The mother thinks it unnecessary to alter her method for this baby until the clothes for shortening have to be provided. The problem of the ever-present poverty has still to be faced. Especially during the winter months the need for providing meals for the babies as well as for the school children is very real. Thanks are due to the Paddington Health Society for the generous way in which they have given milk during the summer months to Willesden babies treated at Paddington Green Children's Hospital for diarrhoea and marasmus. Orders for specially-prepared milk are issued by the medical staff of the hospital, and the milk is provided by the Health Society. This milk is, of course, intended for children residing in Paddington only, but in many cases this rule has been broken, and the Willesden babies have materially benefited thereby. The Health Visitors, as well as the mothers, have much appreciated this help, but it is sad to think that Willesden mothers should have to seek help for their babies outside their own district. Adequate food for nursing and pregnant mothers should also be forthcoming. It is possible to provide meals for mothers at a very small cost, as has already been proved in several London boroughs, as well as in Paris and Germany. It is attempting a very hopeless task to try to educate mothers in personal and domestic hygiene when the most evident things to them are the need for food and the difficulties experienced in procuring it in what often proves the most expensive and unsatisfactory manner. One wonders whether in like circumstances they, too, would not lose heart and feel it was not worth while trying to improve matters. It is so much easier to let things go; and, 35 when it may mean choosing between soap for cleansing purposes and something to eat, it is little to be wondered at that the dirt remains. The need for a Health Society with a "Welcome" or School for Mothers becomes more and more apparent. The mothers frequently ask whether there is any place where the babies can be weighed and seen by a doctor. Some of the Kilburn and Kensal Green mothers have taken their babies to the Paddington Health Society for this purpose, and to hear the lectures given there. In many cases constant supervision and advice is necessary in order to do real good. If these babies were weighed regularly the mothers could more readily see and realize the gradual results attained by acting upon the advice given. Short addresses or lectures given to a number of mothers at one time would be of great benefit, and in some cases would do more good than the individual advice given at the homes. These classes or meetings create a spirit of rivalry in the mothers as to whose baby shall be the best cared for that does not always exist without some encouragement. A baby show might do much to foster this spirit, but would need to be very carefully arranged. The great hope that may be entertained for the reduction of infantile mortality and a better standard of infant rearing must rest largely with the mothers of the next generation. The more efficient training of girls in domestic economy and hygiene is all-important. At present they leave school at the age of 14 years — too young to realize the importance of what they are being taught. Few, if any, of these girls get any further training to fit them for the position of housewife and mother. It is to be hoped that something may be done in the near future to remedy these evils." 37 VITAL STATISTICS OF THE WARDS. 38 VITAL STATISTICS OF THE WARDS. Particular interest attaches to the Ward Vital Statistics this year as it is the last in which the old ward divisional areas appear. The seven wards into which for 15 years the district has been divided are now replaced by eleven wards, and with them the old ward boundaries disappear. The changing character of the respective ward populations in so rapidly-developing a district as Willesden reduces the reliability of the figures the further removed from the census are the estimates on which they are based. For the same reason the vital statistics of the new wards must necessarily be the crudest approximations until the census returns of 1911 enable more accurate data to be used in the calculation of the ward rates. It is satisfactory to note that the old ward divisions have been eclipsed at a time when their vital statistics exhibit their health conditions in a most satisfactory light. They disappear with a record it is improbable they would greatly have improved upon. 39 WARD MORTALITY RATES. Table No. 16. WARDS. Mean Death Rate 1904-8. 1909. Corrected. Nett Death Hates 1909, per 1,000. Mean Rate of Infantile Mortality. 1904-1908. 1909. Rate of Infantile Mortality Per 1,000. Zymotic rate Per 1,000. Diarrhœa. Per 1,000. Phthisis. per 1,000. Church End 13.3 12.5 11.9 135 102 1.7 .6 .8 Harlesden 12.7 12.9 11.5 117 96 11 .3 .9 Kensal Green 9.7 11.3 10.4 90 96 11 .4 .8 South Kilburn 15.1 14.8 14.2 130 116 1.8 .6 1.6 Mid Kilburn 15.6 15.7 15.2 123 106 1.6 .3 1.0 North Kilburn 9.8 10.8 9.8 78 66 .4 — .4 Willesden Green 9.7 11.0 9.7 88 71 .4 .1 .8 Willesden 11.8 12 .0 11.2 110 94 1.1 .3 .9 41 INFECTIOUS DISEASES. D 42 Table No. 17. ZYMOTIC MORTALITY DURING THE LAST 15 YEARS. RATE PER 1,000. 1894. 1895. 1896. 1897. 1898. 1899. 1900. 1901. 1902. 1903. 1904. 1905. 1906. 1907. 1908. 1909. 1909. Rate for 76 Great Towns. Rate for Eng. and Wales less the 218 towns. Scarlet fever 0.09 0.21 0.19 0.11 0.10 0.14 0.10 0.10 0.09 0.08 0.01 0.03 0.07 0.13 0.09 0.10 0.11 0.06 Enteric fever 0.15 0.15 0.12 0.12 0.09 0.09 0.12 0.08 0.12 0.06 0.05 0.08 0.04 0.02 0.05 0.03 0.06 0.06 Diarrhœa 0.42 0.70 0.84 1.31 1.04 1.57 1.19 1.05 0.85 0.62 1.08 0.71 1.17 0.37 0.38 0.31 0.38 0.17 Diphtheria 0.21 0.42 0.33 0.72 0.68 0.43 0.24 0.45 0.43 0.07 0.14 0.09 0.11 0. 12 0.09 0.06 0.15 0.14 *Zymotic death-rate 1.94 1.66 3.40 2.86 2.54 2.75 2.38 2.26 2.16 2.02 1.70 1.76 1.70 1.48 1.08 1.08 1.42 0.80 Rate from all causes 1.32 14.5 15.3 14.4 13.9 15.2 13.6 13.2 13.9 12.8 12.2 12.4 11.8 11.8 10.9 11.2 14.7 14.5 * Zymotic death-rate is the death-rate from the seven principal zymotic diseases, viz., Small Pox, Measles, Scarlet Fever. Diarrhœa, Diphtheria, Whooping Cough, and Typhoid Fever. 43 INFECTIOUS DISEASES. There were notified during the year altogether 988 cases of infectious disease. This gives a notification rate of 6.6 per 1,000 compared with 7.3 per 1,000 last year. SMALL POX. For the fifth year in succession the district has remained free from small pox. Nothing could be more satisfactory in this respect if only one could feel assured that this long period of complete immunity were founded upon permanent conditions of security. A glance at the vaccination returns, however, shows that the opposite of this is the case, and that with each year of freedom from menace an increasing proportion of the population fails to secure the protection from small pox attack which vaccination confers. Referring to the variation in the proportion of conscientious objectors in my Report for 1908, I wrote as follows:— "In the non-small pox years, 1898-1900, conscientious objectors rapidly increased from 2.5 per cent. to 6.2 per cent. During the small pox years which followed 1900 the number of conscientious objectors underwent a marked diminution. During the succeeding non-small pox years the disappearance of the disease produced a condition of things during which conscientious objection progressively increased." This progressive increase has continued at an alarming rate during the present year. For every 100 children vaccinated there are 24 6 who escape owing to the statutory declarations of their parents. Nearly half of the surviving children remain unprotected from small pox by vaccination. I have said, and I repeat with a full sense of the responsibility of the utterance, that I know of no circumstance affecting the health of Willesden so charged with menace as this unprotected state of its population in regard to small pox. Experience has shown —and, unfortunately, there is no reason to anticipate that it will not again show—that disaster in the form of ravaging epidemics of small pox sooner or later overtake those communities who neglect extensively to protect themselves from its attack. The pity of it is that a healthy population, such as that of Willesden, should thoughtlessly challenge so formidable a conflict. D 2 44 Table No. 18. ANALYSIS OF NOTIFICATIONS. Wards. Total No. of Roads. Total No. of Roads Infected. Total No. of Roads not Infected. Average No. of Cases per Infected Road. Average No. of Cases per Road. Infected Roads per cent. of whole. Notification Rate per 1,000 of Population. 1906 1907 1908 1909 1906 1907 1908 1909 1906 1907 1908 1909 1906 1907 1908 1909 Church End 86 50 36 4.6 3.8 4.1 3.3 3.0 2.4 2.6 1.9 65.4 62.4 62.8 58.1 10.7 8.3 9.2 6.8 Harlesden 73 45 28 3.6 5.9 2.8 3.8 1.9 2.8 1.8 2.3 53.4 46.6 65.8 61.6 6.5 9.1 6.1 7.6 Kensal Green 71 46 25 5.1 4.7 4.9 4.2 3.4 3.6 3.3 2.7 66.6 75.0 66.6 65.0 8.6 8.8 7.6 6.4 South Kilburn 39 22 17 4.6 4.8 5.9 5.0 2.8 2.4 3.4 2.8 61.5 48.7 59.0 56.4 7.4 6.2 9.2 7.5 Mid Kilburn 34 21 13 3.9 2.9 4.2 4.3 2.2 1.6 2.6 2.6 55.8 52.9 61.8 61.8 6.1 4.3 7.2 7.4 North Kilburn 38 20 18 2.9 1.9 2.2 2.4 1.6 1.0 1.1 1.3 52.6 52.6 50.0 52.6 5.8 3.8 4.1 4.9 Willesden Green 117 56 61 3.6 3.1 4.2 3.8 1.9 1.6 2.2 1.8 51.9 52.3 51.4 47.9 6.7 5.6 7.2 6.4 Willesden 458 260 198 4.2 4.0 4.0 3.8 2.4 2.3 2.4 2.2 58.3 56.7 59.6 56.6 7.6 7.0 7.3 6.6 46 Table No. 19. VACCINATION RETURNS. 1 2 3 4 5 6 7 8 9 10 11 12 Years. No. of Births. Successfully Vaccinated. Insusceptible. Dead. Conscientious Objectors. Postponed by Doctor. Gone Away. Unvaccinated. Percentage of Survivors unprotected by Vaccination. Conscientious Objectors per 100 Children Vaccinated. Cases of Small Pox Notified. 1898 3,125 1,474 13 257 37 117 259 968 48 2.5 1 1899 3,375 1,615 24 345 63 76 91 1,161 46 3.9 0 1900 3,560 1,704 8 253 106 56 268 1,165 48 6.2 0 1901 3,670 2,351 12 304 120 40 280 563 30 5.1 10 1902 3,835 2,548 28 353 84 39 352 430 27 3.3 88 1903 4,070 2,687 27 346 84 52 322 552 27 3.1 7 1904 4,357 2,697 19 308 100 56 355 852 35 3.7 12 1905 4,135 2,448 15 286 75 64 297 950 36 3.0 0 1906 4,190 2,325 19 290 102 68 348 1,038 40 4.3 0 1907 4,170 2,314 15 269 157 61 329 1,025 40 6.7 0 1908 4,030 2,096 16 225 378 61 319 935 44 18.0 0 1909 4,066 2,015 17 244 495 61 319 915 47 24.6 0 46 Table No. 20. NOTIFICATIONS. 1892. 1893. 1894. 1895. 1896. 1897. 1898. 1899. 1900. 1901. 1902. 1903. 1904. 1905. 1906. 1907. 1908. 1909. Small Pox 5 23 21 5 2 — 1 — — 10 88 7 12 — — — - - Scarlet Fever 366 589 268 392 475 510 361 414 335 553 466 502 326 397 637 641 737 638 Diphtheria 141 221 125 179 171 270 333 317 225 399 433 217 351 273 280 251 211 207 Croup (Memb.) 4 8 4 7 2 5 2 2 1 5 7 4 2 2 6 3 4 — Typhus Fever — 1 — — — — — — — — — — — — - — — — Typhoid Fever 28 47 70 69 52 52 66 79 77 57 73 45 38 41 46 28 41 41 Continued Fever - — 2 — 1 1 — — — — — — — — 1 - - — Puerperal Fever 4 6 4 8 10 9 2 6 8 2 8 11 5 13 9 13 7 8 Cholera Nostras 1 1 1 — 1 2 - 1 - - - - - - - - - - Erysipelas 85 139 63 81 101 107 70 82 89 79 104 76 73 86 103 77 78 94 Plague (Pestisminor) — — — — — — — — — 1 — — — — — — — — Cerebro-Spinal Meningitis - - - - - - - - - - - - - - — 3 3 — Totals 634 1,025 558 741 815 956 835 901 735 1,106 1,179 862 807 812 1,082 1,016 1,081 988 Rate per 1,000 9.4 15.0 7.5 9.3 9.5 10.3 8.4 8.3 6.4 9.5 9.6 6.7 5.9 5.8 7.6 7.0 7.3 6.6 47 Table No. 21. CASES NOTIFIED UNDER 15 YEARS OF AGE DURING THE YEAR 1909. wards. scarlet fever. diphtheria. Notified under 15 years of age. Notification rate per 1,000 population under 15 years of age. Notified under 15 years of age. Notification rate per 1,000 population under 15 years of age. Church End 81 8.6 35 3.7 Harlesden 78 10.9 41 5.7 Kensal Green 123 11.6 22 2.1 South Kilburn 72 13.2 12 2.2 Mid Kilburn 62 15.8 9 2.3 North Kilburn 28 12.1 5 2.2 Willesden Green 119 11.6 50 4.9 Willesden Urban District 563 11.2 174 3.5 Mean of years, 1905—9 536 11.0 203 4.2 48 Table No. 22. WARD INCIDENCE OF SCARLET FEVER, DIPHTHERIA AND ERYSIPELAS. Wards. SCARLET FEVER. DIPHTHERIA. ERYSIPELAS. Rate. Quinquennial Means. Decennial Means. Rate. Quinquennial Means. Decennial Means. Rate. Quinquennial Means. Decennial Means. 1909 1899 to 1903. 1904 to 1908. 1899 to 1908. 1900. 1899 to 1903. 1904 to 1908. 1899 to 1908. 1909. 1899 to 1903. 1904 to 1908. 1899 to 1908. Church End 3.9 5.8 4.7 5.2 1.8 5.5 3.9 4.7 0.4 0.6 0.6 0.6 Harlesden 4.0 4.5 4.0 4.2 2.5 3.4 1.9 2.6 0.8 0.9 0.7 0.8 Kensal Green 4.4 3.6 4.3 4.0 0.8 2.4 1.7 2.1 0.8 0.6 0.6 0.6 South Kilburn 5.6 3.1 3.8 3.5 0.9 2.0 1.2 1.6 0.8 0.8 0.7 0.6 Mid Kilburn 5.5 2.9 3.1 3.0 1.0 1.5 1.2 1.8 0.7 0.9 0.7 0.8 North Kilburn 3.2 2.8 2.5 2.6 0.5 1.3 1.1 1.2 0.7 0.3 0.4 0.3 Willesden Green 4.2 3.5 3.5 3.5 1.5 1.7 1.7 1.7 0.4 0.6 0.5 0.5 49 Table No. 23. FATALITY AND INCIDENCE FROM SCARLET FEVER, DIPHTHERIA, AND TYPHOID FEVER, PER 1,000— 1888 TO 1909. Year. Fatality Rate. Scarlet Fever. Deaths per 1,000 cases. Incidence Rate. Scarlet Fever. Cases per 1,000 population. Fatality Rate, diphtheria. Deaths per 1.000 cases. Incidence Rate. Diphtheria. Cases per 1,000 population. Fatality Rate. Typhoid Fever. Deaths per 1,000 cases. Incidence. Rate. Typhoid Fever. Cases per 1,000 population. 1888 60 3.8 193 1.2 209 0.81 1889 13 2.6 69 1.8 71 0.49 1890 11 2.9 140 2.4 170 0.66 1891 15 2.1 78 1.2 121 0.53 1892 22 5.5 127 2.1 214 0.42 1893 25 8.5 199 3.1 191 0.66 1894 26 3.6 126 1.7 157 0.96 1895 43 4.9 190 2.2 174 0.87 1896 35 5.5 169 2.1 211 0.66 1897 21 5.4 250 2.9 230 0.56 1898 28 3.6 204 3.3 136 0.66 1899 38 3.9 148 2.9 128 0.73 1900 35 2.9 124 1.9 181 0.68 1901 21 4.9 138 3.4 175 0.49 1902 27 3.8 122 3.5 205 0.60 1903 22 3.8 46 1.6 290 0.34 1904 6 2.4 54 2.6 211 0.27 1905 13 2.8 51 1.9 293 0.29 1906 17 4.5 57 2.0 152 0.32 1907 30 4.4 71 1.7 143 0.19 1908 19 5.0 65 1.4 195 0.27 Mean Rate. 25 4.1 125 2.2 184 0.55 1909 26 4.4 48 1.4 146 0.27 50 Table No. 24. DEATH RATES FROM SCARLET FEVER, DIPHTHERIA, TYPHOID FEVER, MEASLES AND WHOOPING COUGH per 100,000. 1875 TO 1909. Year Scarlet Fever. Diphtheria. Typhoid Fever. Measles. Whooping Cough. 1875 66 33 71 0 38 1870 59 27 48 78 238 1877 128 10 41 87 30 1878 19 14 29 29 174 1879 35 35 9 13 27 1880 99 8 15 75 99 1881 47 3 22 25 47 1882 24 3 15 141 86 1883 20 11 17 14 34 1884 13 16 11 11 58 1885 13 36 23 52 44 1886 2 15 4 67 79 1887 28 12 16 59 22 *1888 22 22 17 66 77 1889 4 12 3 14 17 1890 3 31 11 55 70 1891 3 11 6 8 67 1892 12 27 9 73 55 1893 21 63 13 15 49 1894 9 21 15 60 42 1895 21 42 15 6 10 1896 20 34 12 144 47 1897 12 69 13 14 48 1898 10 65 8 49 124 1899 15 42 10 23 30 1900 10 24 12 45 26 1901 10 45 9 7 49 1902 10 43 12 54 20 1903 9 7 7 54 58 1904 1 14 6 33 7 1905 4 10 9 36 47 1906 8 11 5 17 17 1907 13 12 3 31 51 1908 9 9 5 36 8 1909 11 7 4 27 22 MEAN. 1876-1887 42 26.5 17 22.5 24 16.5 50 45 75 56.5 1888-1909 11 28 9 40 38 *Infectious Diseases Notification compulsory in Willesden from this year. 51 SCARLET FEVER 638 cases of Scarlet Fever were notified during the year, as compared with 737 for the corresponding period last year. In my last Annual Report I pointed out that from 1904 there had been a progressive increase in the number of cases of Scarlet Fever notified, and that a continuance of this increase would result in the prevalence of cases of infectious disease in excess of the hospital accommodation provided. The question of hospital extension was considered and a scheme approved by the Public Health Committee, but the Council decided, in view of the declining incidence of the disease, to postpone further action in the matter. 1 desire to urge the importance of the scheme upon the further attention of the Council. The administrative buildings at the hospital are inadequate for the normal provision of beds, and temporary buildings are used for hou-ing the permanent staff. If the administrative buildings are adequate there should be no difficulty in dealing with such emergencies as are likely to arise, but to leave this until the inadequacy of the provision is demonstrated by breakdown is neither wise nor economical. The additional expenditure required (about £7,000) is not great, and the very considerable expenditure represented in the existing hospital loses much of its justification when the withholding of a small proportional increase threatens to limit the usefulness of the provision made. 52 Table No. 25. TABLE showing the Number of Return Cases of Scarlet Fever, 1905—9, distributed as the primary cases gave rise respectively to 1, 2, 3, or 4 Return Cases. Year. No. of Infecting Cases giving rise to Return Cases. No. of Infecting Cases giving rise to 1 Return Case. No. of Infecting Cases giving rise to 2 Return Cases No. of Infecting Cases giving rise to 3 Return Cases No. of Infecting Cases giving rise to 4 Return Cases Total Cases of Scarlet Fever notified. Percentage of Return Cases. Total No. of Infecting Cases. Total No. of Return Cases during the year 1905 14 18 12 l - 1 397 4.5 1906 23 26 20 3 — — 637 4.1 1907 27 28 26 1 - — 641 4.4 1908 51 70 37 11 1 2 737 9.5 1909 56 66 48 7 — 1 638 10.3 Totals 171 208 143 23 1 4 3,050 0.8 Table No. 26. TABLE showing Return and Secondary Cases. Year. No. of Infecting Cases. No. of Return Cases. No. of Cases occurring in houses Secondary to Return, cases not necessarily themselves Returns. 1909 56 66 12 From the above tables it will be seen that the number of Keturn Cases has increased both actually and proportionately in recent years. This increase is in part merely apparent, and in so far is due to improvements in administrative procedure which have led to an increased discovery of cases which formerly would not have been classified as 53 "Return Cases." In part,, however, it would appear to be actual, and to this extent is an expression of a very interesting feature - if feature further observation should show it to be. The feature which is suggested by the facts is that with a high epidemicity of the disease there is a greater prevalence of Return Cases. Should more extended observations show this to be the case it would prove a very interesting and extremely suggestive phenomenon I associate it with a view I have expressed elsewhere.* "It would seem necessary, in order to account for many of the facts in the spread of scarlet fever, to postulate carrier cases analogous to the demonstrable passive bearers of the diphtheria bacillus and the more recently discovered typhoid carriers. The voiding of typhoid bacilli has been shown to be an intermittent phenomenon in one detected carrier of the disease, and an analogous process may be inferred in scarlet fever. There appears to be little ground for seeking an extracorporeal habitat for the infectious material of scarlet fever if we except the one cultural medium —milk; and a view more consonant with all the facts would seem to be that there is continuously diffused throughout the community the flora—if it be a flora—of scarlatinal infectivity which under suitable seasonal and other conditions is communicated from person to person in toxic quantity and degree, from time to time appearing phenomenally as sporadic or epidemic scarlet fever." The bearing of the facts under consideration upon this view is one which lends support to the contention. If the normal persistent habitat of scarlet fever infection is found to be the bodies of persons who have previously suffered from the disease, au increase in the number of these discovered to be capable of spreading infection at times when the infection is rife is to be expected. Be the explanation what it may, the facts are interesting. *"The Intermittent Infectiousness of Scarlet Fever." Proc. Roy. Soc. Med., 1909, II., Epidem. Sec., p. 74. 54 DIPHTHERIA. 207 cases of Diphtheria were notified as compared with 211 last year. This is the fewest number of cases notified since 1896. Diphtheria has shown a most marked decline during recent years. This may not improbably in some measure be due to the type of weather which has prevailed during this period. Unless the other conditions had continued the same it would not be justifiable to ascribe the decline to the purposive efforts made to this end. TYPHOID FEVER. 41 cases of Typhoid Fever—the same number as last year were notified. This gives an incidence rate only about half of the incidence rate for the whole period during which it has been notifiable. ISOLATION HOSPITAL. All particulars relating to the hospital will be found in the report of the Medical Superintendent, appended. 55 MEASLES. In consequence of the system of notification by the teachers of cases of Measles occurring among children attending public elementary schools, which has been in operation since 1903, it has been possible each year to give the results of investigation into the prevalence of this disease. In a Special Report on attendance at schools of children under five years of age appended to my last Annual Report, I published a table showing the results of investigation into the age incidence of measles upon children definitely exposed to attack. The definition of "definitely exposed to infection" was taken as meaning "living in the same house though not necessarily in the same family as an ascertained case of measles." In the case of tenement houses there is no doubt that for practical purposes this is sufficient, but I considered that greater reliability would attach to the figures if the definition were narrowed so as to apply only to members of a family in which the disease had appeared. This has been done in the investigations carried out during the year, and the following table shows the results of the enquiry. ► 56 TABLE showing the incidence of Measles upon Children definitely exposed to infection, distributed according to age and history of previous attack. CONTACTS STATED NOT PREVIOUSLY TO HAVE SUFFERED. Age Periods. 1908. 1909. 1908.9 totals. No. of Contacts in House. No. of Contacts attacked. Percentage attacked. No of Contacts in Home. No. of Contacts attacked. Percentage attacked. No. of Contacts. No. of Contacts attacked. Per. centage attacked. 0—4 256 202 78.9 454 339 74.7 710 541 76.2 4.5 34 28 82.3 72 53 73.6 106 81 76.4 5—6 20 14 70.0 48 30 62.5 68 44 64.7 6 —1 11 8 72.7 35 24 68.5 46 32 69.5 7—8 15 11 73.3 35 14 40.0 50 25 50.0 8—9 11 5 45.4 27 11 40.8 38 16 42.1 9—10 10 5 50.0 19 7 36.8 29 12 41.4 10.15 25 2 8.0 35 7 20.0 60 9 15.0 15 and up 20 — — 73 4 5.5 93 4 4.3 402 275 68.4 798 489 61.3 1200 764 63.7 CONTACTS STATED PREVIOUSLY TO HAVE SUFFERED. 0—4 63 2 3.2 46 5 10.9 109 7 64 4—5 33 4 12.1 34 2 5.9 67 6 9.0 5—6 40 2 5.0 39 1 2.6 79 3 3.8 6.7 55 2 3.6 66 1 1.5 121 3 2.5 7.8 62 2 3.2 105 — — 167 2 1.2 8—9 57 — - 125 6 4.8 182 6 3.3 9—10 69 2 2.9 139 1 0.7 208 3 1.4 10-15 280 1 0.3 466 3 0 6 746 4 0.5 15 and up 1122 3 0.2 1735 — — 2857 3 0.1 1781 18 1.01 2755 19 0.7 4536 37 0.8 The immunity conferred by increasing age in children is strikingly confirmed by the further figures of the cases investigated. A remarkable fact brought out by more detailed analysis of the age group 0—4 is the striking immunity of infants under six months of age and the very high degree of susceptibility of infants between six and twelve 57 months of age. A larger number of facts than those yet dealt with is necessary, however, before formulating further conclusions. The following Table shows the more detailed analysis referred to:— Age. No of Co in House. No. of Contacts attacked. Percentage of Contacts attacked. Months. 0-6 73 6 8.2 6—12 41 39 95.1 Yr. Yrs. 1—4 340 294 86.4 HEALTH OF SCHOLARS ATTENDING PUBLIC ELEMENTARY SCHOOLS. The section relating to the health of school children is omitted from this report as the matter is fully dealt with in my report as School Medical Officer submitted herewith. E 59 SANITARY ADMINISTRATION. E 2 60 HOUSE REFUSE REMOVAL. In the following tables are given the data relating to the Collection of House Refuse. In Tables 28 and 29, the period for which the data are given is divided into two quinquennia. During the first of these (1900-1904-5) the cost of refuse removal was high, and was rapidly increasing both in respect of the total cost per annum and of the relative cost per cubic yard, per house, and per head of population. Upon the completion of the contract in March, 1905, in which the total cost of house refuse removal had reached the high figure of £10,929, I prepared comparative tables of cost and quantities of refuse removal, which were embodied in my Annual Report for the year 1904 and reproduced in a report on the Collection of House Refuse, submitted in the first instance to the Motors and Dust Destructor Committee. In the report it was pointed out that not only the cost, but the quantity also of house refuse removed per head and per house had gone steadily up during the preceding eight years. It was further pointed out that " the increase in quantity per house has not kept pace with the increased quantity per head, for while per house the increase in the eight years ending 1903 amounts to 25 6 per cent., that per head has gone up by 37-5 per cent." As a result of investigation it was discovered that while " the average amount per annum collected from houses of all classes amounted to 4 4 cubic yards, that from business premises of all classes amounted to 21 *8 cubic yards per annum." I concluded that " the disproportionate increase in the amount of refuse collected per person, as well as the amount collected per house, is due either to an increased proportion of business premises in the district or to an increased contribution from them of what is termed domestic refuse. As a consequence of this investigation, which left little doubt that a large amount of " trade refuse" was being removed as "house refuse" at the public cost—a procedure for which there was neither statutory 61 power nor equitable sanction—instructions were given for the exercise of stricter observance of the distinction between "trade1" and "house" refuse in the supervision of refuse removal. This effected not only greater economies in the C03t and quantities of refuse removal, but was associated with an improvement in the hygienic condition of trade premises. For, whereas formerly trade refuse was permitted to accumulate on trade premises until removed by the contractor, it was now in large measure incinerated, so that only the innocuous ashes remained for removal. The tables show the large reductions which have been effected in the quantities of refuse removed and in the number of vans, horses, and men employed, with the consequent saving in cost which has been possible as a result of this policy. Table No. 27. DATA RELATING TO REMOVAL OF HOUSE REFUSE. Year. Maximum No. of carts employed. Minimum No. of carts employed. Average No. of carts employed. Maximum No. of men employed. Minimum No. of men employed. Total No. of complaints. Percentage of complaints to total No. of houses. 1901-2 34 20 24 58 36 189 1.09 1902-3 38 21 24 69 38 167 0.91 1903-4 39 22 25 70 36 139 0.72 1904-5 37 24 27 70 43 104 0.51 1905-6 29 18 19 58 36 198 0.95 1906-7 27 18 20 54 36 220 1.04 1907-8 22 10 18 44 20 105 0.48 1908-9 26 18 21 45 36 334 1.52 1909-10 23 15 18 42 30 111 0.50 62 Table No. 28. REMOVAL OF HOUSE REFUSE. TABLE OF QUANTITIES. Year. Annual quantity collected. †Standard Quantities in cubic yards. No. of Houses in District, Michaelmas. Population of district, Michaelmas. Amount of Refuse collected per house per annum. Amount of Refuse per head of population. In cubic yds. In tons. 1900.1 79,875 25,905 84,100 16,820 115,201 Cubic yds. 4.7 Cubic yd. .69 1901.2 83,587 27,109 86,290 17,258 117,619 4.8 .71 1902.3 91,170 29,568 90,940 18,188 123,987 5.0 .73 1903.4 99,761 32,354 95,860 19,172 130,621 5.2 .76 1904.5 99,510 32,273 100,045 20,009 135,613 4.9 .73 1905.6 88,860 28,819 80,866 20,735 140,692 4.3 .63 1906.7 79,137 25,666 82,325 21,109 142,772 3.7 .55 1907.8 80,100 25,978 83,791 21,485 141,912 3.7 .55 1908.9 86,002 27,912 85,199 21,846 149,744 3.9 .57 1909.10 82,442 26,738 86,069 22,069 151,000 3.7 .55 †Standard quantities are calculated upon the respective mean quantities of refuse collected per house (5.0 cubic yards during the qui Equennium 1900.4 and 3.9 cubic yards during the quinquennium 1905.9). They represent the theoretical number of cubic yards of refuse removed per annum on the assumption that the mean quantity per house had remained constant for all houses during the respective five yearly periods. The quantity in the respective quinquennia rises steadily and proportionately to the number of new houses added to the district. Table No. 29. REMOVAL OF HOUSE REFUSE. TABLE OF COST. Year. Total Cost of Collection. Standard Cost.† Cost per Cubic Yard. Cost per House. Cost per Head of Population. Rate in the £. SubDistricts. Total. 1 2 3 £ £ £ d. s. d. d. d. 19001 2,095 1,600 3,127 £6,822 £8,235 20.5 8 1 14.2 3.13 19012 2,475 1,895 3,452 £7,822 £8,449 22.5 9 0¾ 16.0 3.45 19023 2,725 2,495 3,752 £8,972 £8,905 23.6 9 10½ 17.4 3.69 19034 3,100 2,950 3,895 £9,945 £9,386 23.9 10 4½ 18.3 3.83 19045 3,445 3,489 3,995 £10,929 £9,796 26.4 10 11 19.3 3.99 19056 2,500 2,150 2,800 £7,450 £6,200 20.1 7 2} 12.8 2.60 19067 *1,930 *2,156 *2,258 £6,250 £6,312 19.0 5 11 10.5 2 .10 19078 *2,300 *2,450 *2,250 £6,850 £6,424 20.5 6 4¼ 11.3 2.20 19089 *1,955 *1,925 *2,055 £5,855 £6,532 16.3 5 4¼ 9.4 1.84 190910 1,715 1,939 1,050 £5,604 £6,599 16.3 5 0¾ 8.9 1.74 *Alternative to inclusive contract for the District. †Standard cost is calculated upon the mean cost of removal (23.5d. per cubic yard during the quinquennium 19004 and 18.4d. during the quinquennium 19059). This standard cost represents the theoretical total cost per annum for house refuse removal on the assumption that the mean number of cubic yards per house collected and the price per cubic yard had remained constant during the respective five yearly periods. The standard cost, in each of the respective quinquennia rises steadily and proportionately to the number of new houses added each year to the district. 63 64 Table No. 30. Total actual No. of loads removed. Average No. per day. Average cost per van load. Average capacity of van. 12,330 404 9/1 cubic yards. 6.68 Table No. 31. No. of working days. Total cubic yards removed. Average quantity per day. (Cubic yards.) 1909-10. April 24 7,027 293 May 25 6,671 267 June 26 7,101 273 July 27 6,940 257 August 25 6,362 254 September 26 6,234 240 October 26 6,524 251 November 26 6,886 265 December 25 7,289 291 January 26 7,384 284 February 24 6,702 279 March 25 7,322 293 65 SEWAGE DISPOSAL. The sewage of the Brent area is still treated at the Sewage Works, but the work of constructing the sewers by which the sewage of the Brent area, like that of the Metropolitan area, shall discharge into the Metropolitan sewers has commenced, and it is hoped that in a short time no sewage treatment will be necessary in Willesden. COMMON LODGING HOUSES. There are two Common Lodging Houses in the district—one situated at Willesden Green and the other at Kilburn. They are visited frequently, and found to be kept in a satisfactory and cleanly condition. Considerable alteration has been made during the year to the common lodging house in Kilburn. The premises have been altered with a view of increasing the accommodation. The work is not yet finished. The table gives the particulars relating to each. Table No. 32. Locality. Total No. of rooms. No. with 2 beds in room. No. with 3 beds in room. No. with 4 beds in room. No. with 6 beds in room. Total accommodation 108, Villiers Road 14 — 9 4 1 49 1 & 2, Malvern Gardens 27 6 13 8 — 83 41 6 22 12 1 132 66 CUSTOMS AND INLAND REVENUE ACT. Name of Road. Houses where certificate refused. Houses where certificate was granted. Redfern Road - 6 Church Road — 1 College Road 3 — Lushington Road 1 — Rutland Park Mansions 4 11 Clifford Gardens 19 — Buchanan Gardens 14 — Brondesbury Villas 5 — 46 18 During the year 64 applications were received for exemption certificates under Sections 11 and 26 of the Customs and Inland Revenue Acts. The number last year was 67. The above table gives the roads where the houses are situated and the number granted or refused. OFFENSIVE TRADES. The bye-laws regulating the trade of Rag and Bone Merchant were put into operation during the year. Three summonses were issued against a marine store dealer, a persistent offender against their provisions. The magistrate imposed a fine of 15s. and costs, and as a result the trade has since been carried on without creating nuisance. No complaints were received during the year in respect of any of the marine store dealers carrying on business in the district. Fat boiling is still carried on at a Pig Farm, situated on the extreme border of the district, but no complaints have been received, and the conditions have always been found satisfactory upon inspection 67 ICE CREAM. All premises where ice cream was likely to be sold were visited. In no instance was any gross insanitary condition observed. Cleansing of rooms and sculleries was required in a few cases; defective paving in one instance. Shops where ice cream is usually sold are confectioners, sweetstuffs, mineral water, and newspaper shops, and in some instances general shops. Many of the shops did not make any cream during the season owing to the cold summer. SMOKE NUISANCE. The year has been practically free from serious complaints relating to the emission of smoke. Complaints were received from residents in Harley Road of smoke from a locomotive engine engaged on the construction works of the London and North Western Railway. The nuisance was effectually abated upon representations being made to the Company before reporting to the Council. Several complaints of smoke from shafts belonging to laundries were received during the year. The nuisance was abated after notice, the use of coke being substituted for that of coal. HOUSING OF THE WORKING CLASSES ACT, 1890. Notices were served in respect of seven premises:— 137, Cambridge Road. 139, ,, „ 17, Park Mows, Kilburn. 19 „ „ 2, Stracey Road. 4, „ „ The Old Six Bells, Church End 68 In five instances the premises were vacated, and the work specified in the notices duly executed and the premises re-occupied. In the case of 137, Cambridge Road it became necessary to take proceedings at the Harlesden Police Court. The owner was ordered to execute the work within one month and to pay a fine of 10s and costs. In the case of the Old Six Bells, owing to the premises being old and dilapidated the premises were closed by consent of the owner with a view of the house being pulled down. MILKSHOPS. District. Number in District. Total No. of Inspections. No. found satisfactory. No. found defective. No. where articles other than Milk are sold. No. where steam is used for cleansing. No. 2 27 99 20 7 7 5 „ 3 27 98 23 4 15 2 „ 4 22 84 19 3 2 — „ 5 28 85 24 4 7 6 „ 6 40 97 35 5 27 — Total 144 463 121 23 58 13 Total number in district, 144. All are inspected at least three times a year ; many four times. Speaking generally, they were found to be kept in a cleanly condition. Thirteen have steam appliances for cleansing and sterilising. 69 In a number of instances the provision for cleansing is not satisfactory. Washing of milk vessels is done in troughs or tubs with water not at boiling temperature. The domestic copper is still in use in some of the older milkshops. Of total persons selling milk, 58 or 40 per cent, sell other commodities, usually in general shops where a miscellaneous assortment of articles is kept for sale. Defects found usually consist of want of cleansing of walls, and defective paving ; in two instances defective drains were remedied ; in one a choked drain was discovered. LEGAL PROCEEDINGS. The following table gives details of proceedings taken during the year:— Nature of Contravention. Locality. Date of summons Result. Omitting to store rags in proper metal vessels with tight-fitting covers (Three summonses issued) Brett Road Mar. 18 Fined 15s. Allowing premises to be in a state injurious to health. Cambridge Road Mar. 18 Ordered to comply within one month. Fined 10s. & costs. Exposing in a public place a person who was suffering from scarlet fever. Cholmondeloy Avenue Oct. 7 Fined £1 and costs. 70 Table No. 33. SHOWING RESULTS OF INSPECTION OF MANHOLES IN WILLESDEN, 1905—1909. Date. Total Inspections. Drains choked at Interceptor. Percentage. Stoppers of raking arm missing. Percentage. October, 1905 6,745 288 4.25 654 9.7 January, 1906 504 49 9.7 41 8.1 November, 1906 5,322 204 3.8 266 5.0 Various dates, 1907 1,227 119 9 .7 33 2.7 „ „ 1908 5,548 190 34 83 1.5 „ „ 1909 6,144 158 2.6 110 1.8 Total 25,490 1,008 3.9 1,187 4.6 71 Summary of Principal Items of Work for Year ending December 31st, 1909. Table No. 34. Description of Work. Quarter Total 1909. 1st. 2nd. 3rd. 4th. Inspection of Houses- Number inspected on complaint 215 248 273 182 918 „ ,, for special inquiry 10 15 56 20 101 „ „ from house to bouse 224 269 167 183 843 „ „ (Housing of the Working Classes Act, 1890) 4 2 1 7 „ „ for Inland Revenue Certificate 40 8 16 64 Re-Inspection of Houses- Number re-inspected 171 208 144 184 707 Number of visits to premises where works of amendment are in operation •2236 2512 2163 2712 9,623 Number of Birth Enquiries 188 260 974 779 2,401 „ Infantile Death Enquiries 113 124 75 116 428 Cases of Infectious disease visited 344 237 214 180 975 „ „ „ re-visited 104 113 96 118 431 „ „ „ removed 287 190 159 138 774 Number of rooms disinfected 391 284 253 228 1,156 Cases of Non-notifiable diseases visited 1667 1905 979 929 5,480 „ „ „ „ re-visited .. 300 663 847 859 2,669 Number of rooms disinfected after Consumption 4 21 21 44 90 Cancer 2 2 2 2 8 Other Diseases 7 12 10 22 51 Inspection of Mews, Stables, etc. 44 60 68 61 233 ,, of Dairies, Milkshops, etc 101 114 103 140 458 „ of Canal Boats 22 20 22 18 82 „ of Slaughterhouses 72 57 39 45 213 Visits re Miscellaneous subjects 130 288 213 192 822 Observations and Inspections re Smoke Nuisance 4 40 5 8 57 Nuisances abated— Number of new drains constructed 13 14 20 20 67' „ drains amended 42 32 25 46 145 „ „ tested 96 135 97 92 420 ,, „ inspected 46 65 66 41 218 „ nuisances of various descriptions abated 331 393 404 395 1,523 Sanitary notices issued 314 410 352 312 1,388 Statutory „ „ 92 95 92 142 421 „ ,, „ under the Housing of the WorkiDg Classes Aot, 1890 4 2 - 1 7 Number of later received 1510 1059 1383 965 4,917 „ „ written 863 804 650 747 3,064 Number of Summonses issued 3 — 1 1 5 73 FACTORY AND WORKSHOP ACT, 1901. F 74 SANITARY CONDITION OF WORKSHOPS WHERE WrOMEN ARE EMPLOYED. INSPECTIONS UNDER THE FACTORY AND WORKSHOP ACT. The supervision of workshops, laundries and home-workers premises is carried out by the District Inspectors and Lady Health Visitors. All workshops where women are employed are inspected by the Lady Health Visitors, but where defects requiring structural alterations are discovered they are referred to the District Sanitary Inspectors who supervise the work of reconstruction necessary to amend the condition. WORKSHOPS AND WORKPLACES WHERE WOMEN ARE EMPLOYED. The Laundries, Workshops, and Workplaces where women are employed have been inspected during the year 1909, and have been revisited as frequently as the conditions found may have required. Laundries.—The larger and specially-built laundries are usually well kept and have ample air space for the number of people employed therein. The smaller hand laundries still leave much to be desired. The Factory and Workshops Act, 1908, provides for all ironing stoves to be adequately screened. This provision does not appear to have made any real difference in the condition of the smaller laundries. The only screens provided are those formed by the clothes drying around the stoves, and the Home Office Inspectors deem this a sufficient compliance with the provisions of the Act. Overhead drying is still generally found in the ironing rooms, especially during the winter months. 75 Workshops.—The cleanliness and general conditions of the workshops are on the whole good, but the ventilation is frequently unsatisfactory. The Factory and Workshops Act provides that 250 cubic feet of air-space shall be allowed for each worker, and in workshops where overtime is allowed or where the room is used for sleeping purposes, 400 cubic feet is the minimum requirement. Dressmakers in particular employ the full number allowed, and during the year overcrowding was discovered, but was abated after a warning notice had been served. It is difficult to prevail upon the occupiers of workrooms to keep them adequately ventilated however good the means of ventilation at their disposal may be. The occupation, as a rule, being sedentary the least draught is noticed immediately, with the result that, except at midsummer, the windows are kept shut while the rooms are in use. Twenty-seven dressmakers' workrooms have been discontinued during the year. In many cases work has been given up altogether, but some of the workshops have been removed to different premises, usually outside Willesden. Outworkers.—The outworkers' premises were found to be, as a rule, very well kept. In six cases cleansing notices were served, and were in all cases complied with without delay. A large number of outworkers have given up work during the year, and many take in work for only short periods. One case of infectious disease occurred in the home of an outworker. BAKEHOUSES. All the bakehouses were visited several times during the year. The principal defect discovered was the need for more frequent cleansing. The number found to be in satisfactory condition was 38. F 2 76 One case of gross negligence came under observation—preserved plums and cherries found stored in w.c. chamber, the closet pan of which was full of fœces and filth. No. in District. No with dirty walls Other nuisances. No. found satisfactory. Above ground 47 14 10 26 Underground 24 7 4 12 Total 71 21 14 33 77 Table No. 35. FACTORIES, WORKSHOPS, LAUNDRIES, WORKPLACES, AND HOMEWORK. 1.—INSPECTION—Including Inspections made by Sanitary Inspectors or Inspectors of Nuisances Premises. (1) Number of Primary Inspections. (2 Written Notices. (3) Prosecutions. (4) Factories (including Factory laundries) 60 35 - Workshops (including Workshop laundries) 423 125 — Workplaces (other than Outworkers' premises included in Part 3 of this Report) — — — Total 483 160 — 2 —DEFECTS FOUND. Particulars. (1) Number of Defects. Number of Prosecutions. (5) Found. (i) Remedied. (») Referred to II M Inspector (4) Nuisances under the Public Health Acts:— Want of Cleanliness 107 107 — — Want of Ventilation — — — — Overcrowding 6 6 — — Want of drainage of floors 9 9 — — Other Nuisances 181 169 — — Sanitary accommodation— Insufficient 6 6 — — Unsuitable or defective 1 1 — — Not separate for Sexes 63 63 — — Offences under the Factory and Workshop Act:— Illegal occupation of underground bakehouses (S. 101).. — - - - Breach of special sanitary requirements for bakehouses (SS. 97 to 100) 34 34 — — Other offences (Excluding offences relating to outwork which are included in Part 3 of this Report.) 13 13 - - Total 420 408 — — 78 Table No. 36. 4—REGISTERED WORKSHOPS. Workshops on the Register (s. 131) at the end of the year. (1) Number. (2) Factories, Laundries 60 Workshops, Laundries 70 Domestic Laundries 27 Bakehouses 69 Dressmakers 97 Outworkers 119 Tailors 24 Bootmakers 35 Metalworkers 7 Wood Workers 14 Cycle Makers 15 Upholsterers 5 Miscellaneous 46 Total number of Workshops on Register 588 5.—OTHER MATTERS. Class. (1) Number. (2) Matters notified to H.M. Inspector of Factories:— Failure to affix Abstract of the Factory and Workshop Act (s. 133) 51 Action taken in matters referred by H.M. Inspector as remediable under the Public Health Acts, but not under the Factory and Workshop Act (s. 5)— Notified by H.M. Inspector 28 Reports (of action taken) sent to H.M. Inspector — Other — Underground Bakehouses (s. 101) :— Certificates granted during the year In use at the end of the year 24 79 Table No. 37. 3.—HOME WORK Nature of Work. (1) Outworkers' Lists, Section 107. Notices served on Occupiers as to keeping or sending lists. (10) Inspection of Outworkers' Premises. (13) Outwork in Unwholesome Premises. Section 109. Outwork in Infected Premises, Sections 109, 110. Lists received from Employers. Addresses of Outworkers. Twice in the Year. Once in the Year. Received from other Councils. (8) Forwarded to other Councils. (9 Lists. (2) Outworkers. Lists. (5) Outworkers. Instances. (14) Notices Served. (15) Instances. (17) Contractors. (3) Workmen. (4) Contractors. (6) Workmen. (7) Wearing Apparel— (1) making, &c. 30 8 54 17 4 30 114 27 43 129 6 6 1 (2) cleaning and washing 16 14 8 9 7 5 3 2 - 9 2 2 - Lace, lace curtains, and nets - — — — — — 3 — - 3 - - - Artificial Flowers - — — — — — 1 - - 1 - - - Furniture and upholstery 2 — 2 1 — 1 7 - - 8 - - - Umbrellas, &c. - - - - — — 1 - - 1 - - - Paper bags and boxes - - - — — — 1 — - 1 - - - Brush making - - — — — — 1 - - 1 - - - Miscellaneous - - - - - - - - - 8 - - - Total 48 22 64 27 11 36 131 29 43 161 8 8 1 Table No. 38. Description of Defects, etc. Factory Laundries. Workshop Laundries. Domestic Laundries. Dressmakers. Miscellaneous Workshops. Outworkers. Bakehouses. Total. Description of Work or Occupation carried on by- Miscellaneous Workshops. Miscellaneous Outworkers. Total. No. Inspected 60 85 33 85 151 161 69 644 Want of Cleanliness 16 19 4 19 14 5 30 107 Tailors 29 37 66 Want of Ventilation — — — — - — — — Dressmakers — 12 12 Overcrowding — 2 — 2 2 — — 6 Bootmakers 35 17 52 Sanitary Accommodlation Insufficient — — — — 1 — — 1 Blousemakers — 9 9 Sanitary Accommodlation Unsuitable or Defective 12 15 2 15 14 1 4 63 Cabinet Makers 14 — 14 Sanitary Accommodlation Not Separate for Sexes 1 — — — — — — 1 Seamstresses 3 54 57 Other Nuisances 35 50 9 50 21 3 13 181 Upholsterers 5 8 13 Failure to Affix Abstract 3 19 — 6 — — — 28 Wearing Apparel No. of Males employed 165 81 14 2 275 24 197 758 Cleaners — 9 9 No. of Females employed 1150 478 86 500 125 88 — 2,427 Metal Workers 7 — 7 Total No. of Persons employed 1315 559 100 502 400 112 197 3,185 Cycle Makers 15 — 15 No. of Workshops discontinued — 15 6 27 10 42 4 104 Miscellaneous 46 15 61 Workshops Re-visited 42 66 10 38 60 5 — 221 , Re-inspected 19 14 12 2 — — 29 76 Rooms Measured 29 25 5 25 29 — — 113 Space Notice sent 6 26 5 31 13 81 Totals 154 161 315 80 81 local government board tables. 82 Table No. I. Year. Population estimated to Middle of each Year. Births. Total Deaths Registered in the District Total Deaths in Public Institutions in the District. Deaths of Nonresidents registered in District. Deaths of residents registered beyond District. Deaths at all Ages. Nett. Deaths under One Year or Age. Deaths at all Ages. Total. Number. Hate.* Number. Rate per 1,000 Births registered. N umber. Hate.* Number. Rate.* 1899 107,044 3,375 31.5 537 150.9 1,448 13.5 - 4 199 1,643 15.2 1900 114,905 3,559 31.1 463 130.1 1,359 11.8 — 7 225 1,577 13.6 1901 116,089 3,670 31.7 456 124.2 1,325 11.4 5.1 9 213 1,529 13.2 1902 122,211 3,835 31.4 498 129.8 1,447 11.8 5.5 6 268 1,709 13.9 1903 129,315 4,132 32.0 483 116.8 ' 1,507 11.5 16.8 11 169 1,655 12.8 1904 134,539 4,421 32.9 487 110.1 1,479 11.0 19.3 14 180 1,645 12.2 1905 140,758 4,201 29.8 463 1102 1,572 11..2 22.3 10 182 1,744 12.4 1906 141,714 4,272 30.1 477 111.7 1,518 10.7 21.9 17 171 1,672 11.8 1907 144,376 4,247 29.4 436 102.7 1,545 10.7 22.2 6 165 1,704 11.8 1908 149,035 4,095 27.5 376 91.8 1,453 9.7 25.5 11 181 1,623 10.9 Averages for 1899—08. 129,999 | 3,981 30.7 468 117.8 1,465 11.3 — 9 194 1,651 12.8 1909 150,149 4,172 27.8 368 88.2 1,448 9 6 234 12 242 1,678 11.2 *Rates calculated per 1,000 of estimated population. 83 Table No. 11. Names of Localities. CHURCH END. harlesden. kensal green. SOUTH KILBURN. Year. Population estimated to middle of each Year. Births Registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each Year. Births Registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each Year. Births Registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each Year. Births Registered. Deaths at all Ages. Deaths under 1 year. 1899 15,144 655 238 106 16,499 477 196 68 19,199 680 242 111 13,644 463 239 82 1900 16,688 701 278 100 17,542 491 214 70 22,380 785 304 94 13,819 416 279 66 1901 19,367 754 278 125 17,115 508 226 59 23,541 817 261 78 14,625 431 278 66 1902 20,153 786 281 95 17,924 576 233 78 25,296 871 294 99 14,923 447 352 104 1903 20,927 801 339 114 19,145 672 256 73 27,208 893 264 85 14,923 454 256 77 1904 21,728 871 273 117 20,098 735 267 80 28,540 931 287 91 14,934 473 239 64 1905 23,077 860 346 123 20,696 697 256 82 29,611 856 299 81 14,991 455 228 55 1906 23,846 853 319 124 21,755 711 288 103 28,473 843 274 78 14,969 489 225 59 1907 24,215 893 312 109 22,166 659 258 68 29,162 812 280 72 14,738 446 240 69 1908 24,153 854 308 112 21,861 702 288 77 30,184 789 280 59 14,484 403 189 47 Averages for 1899 to 1908 20,930 803 297 112 19,480 623 248 76 26,359 828 278 85 14,605 448 253 69 1909 .. 24,043 833* 285 85 22,509 750* 259 72 30,154 762* 314 73 14,622 439" 207 51 *Including Willesden Children born in Willesden Workhouse and Outside Districts. 84 Table No. II—continued. Names of Localities. mid kilburn. north kilburn. willesden green. Ward Unknown. Year. Population estimated to middle of each Year. Births Registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each Year. Births Registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each Year. Births Registered. Deaths at all Ages. Deaths under 1 year. Deaths Registered. Deaths under 1 year. 1899 12,201 380 179 56 12,662 208 138 33 17,695 512 213 79 1900 12,298 380 185 49 13,002 224 118 23 19,176 562 199 61 1901 12,290 370 160 44 9,913 201 123 2!) 19,238 589 203 59 1902 12,477 344 203 65 10,259 249 134 31 21,179 622 218 64 1903 12,542 349 186 54 10,353 228 105 25 24,217 673 260 79 1904 12,558 373 213 55 10,416 230 96 21 26,265 808 270 81 1905 12,264 345 196 47 10,070 218 109 23 28,112 770 297 75 13 4 1906 12,305 390 171 44 10,165 205 114 16 29,366 781 267 68 14 1 1907 12,322 369 215 44 9,982 212 94 14 31,174 856 297 74 8 1 1908 12,175 360 165 36 9,951 183 85 9 33,071 804 298 57 10 Averages for 1899 to 1908 12,343 366 187 49 10,677 216 112 22 24,949 698 252 70 — — 1909 12,150 360* 185 38 9,787 198* 96 13 33,611 830* 326 59 6 — *Including Willesden Children born in Willesden Workhouse and Outside Districts. 85 Table No. III. CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR 190S). Notifiable Diseases. Cases notified in Whole District. Total Cases notified in each Locality. Wards. No. of Cases removed to Hospital from each Locality. Wards. Total No. of Cases Removed to Hospital. At all Ages. Under 1 year. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. Church End. Harlesden. Kensal Green. South Kilburn. Mid Kilbum. North Kilburn. Willesden Green. Church End Harlesden. Kensal Green. South Kilburn. Mid Kilburn. North Kilburn. Willesden Green | Small Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diphtheria and Membranous Croup 207 8 61 110 12 20 1 44 57 94 13 12 5 52 35 48 22 12 10 4 40 171 Erysipelas 94 5 3 7 8 61 10 10 19 23 12 8 7 15 1 2 1 .. .. 1 1 6 Scarlet Fever 638 2 160 401 46 29 .. 94 89 133 82 67 31 142 90 76 111 78 62 33 106 556 Typhus Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric Fever 41 .. 2 13 12 14 .. 15 2 11 2 3 4 4 15 2 10 .. 1 4 2 34 Relapsing Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Continued Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever 8 .. .. .. 1 7 .. .. 3 2 .. .. 1 2 .. .. .. .. .. .. .. .. Plague .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cerebro-Spinal Meningitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Totals 988 10 226 331 79 131 11 163 170 193 109 90 48 215 141 128 144 90 73 42 149 767 86 Table IV. CAUSES OF, AND AGES AT, DEATH DURING YEAR 1909. (Inclusive of those dying outside the District.) CAUSES OF DEATH. DEATHS AT SUBJOINED AGES. DEATHS IN LOCALITIES. (At all Ages.) At all Ages 0 to 1 1 to 5 5 to 15 15 to 25 25 to 65 65 and Up. Church End. Hailesden. Kensal Green. S. Kilburn Mid-Kilburn. N. Kilburn. W illesden Green. Waid Unknown. Small Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles 41 9 30 2 .. .. .. 15 4 9 3 2 1 7 .. Scarlet Fever 16 1 10 4 .. 1 .. 3 2 3 4 2 .. .. .. Whooping Cough 43 25 17 1 .. .. .. 4 11 7 10 10 1 .. .. Diph. and Memb. Croup 10 .. 6 4 .. .. .. 3 1 1 .. .. .. .. .. Croup .. .. .. .. .. .. .. .. .. .. .. .. .. .. .... Typhus Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric Fever 6 .. .. .. 2 4 .. 2 .. 3 .. 1 .. .. .. Other continued .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Epidemic Influenza 36 2 2 .. .. 14 17 3 7 12 2 .. .. 1 .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Tetanus 2 2 .. .. .. .. .. .. .. 2 .. .. .. .. .. Diarrhœa 47 42 2 2 .. .. .. 14 6 11 9 4 .. 3 .. Enteritis 15 9 4 .. .. 1 1 4 4 2 2 2 .. 1 .. Puerperal Fever 2 .. .. .. .. 2 .. .. 2 .. .. .. .. .. .. Erysipelas 2 .. .. .. .. .. .. .. 1 .. .. .. .. .. •• Other Septic Diseases 15 1 1 1 .. 11 1 1 1 3 4 1 .. 5 .. Phthisis 131 2 3 6 21 96 3 19 21 25 23 12 4 27 .. Other Tubercular Diseases 65 14 27 10 3 10 1 12 9 13 5 11 4 10 .. Cancer 120 .. 2 .. 1 66 51 15 12 31 10 10 13 29 .. Bronchitis 125 21 4 .. 1 32 67 22 24 25 12 12 7 23 .. Pneumonia 140 33 24 3 6 54 20 26 20 22 18 17 9 28 .. Pleurisy 5 .. 1 .. 1 2 1 1 1 1 1 1 .. .. .. Other Diseases, Respiratory Organs 18 .. 1 1 .. 13 3 4 5 3 2 1 1 2 .. Alcoholism (Acute) 1 .. .. .. .. 1 .. .. .. .. .. .. .. .. .. Cirrhosis of Liver 21 .. .. 1 1 12 1 .. 4 3 4 2 3 5 .. Venereal Disease 9 7 .. .. .. 2 .. .. 1 3 .. .. 1 2 .. Premature Birth 72 72 .. .. .. .. .. 13 14 13 8 8 4 12 .. Accidents and Diseases of Parturition 10 .. .. .. 2 8 .. 1 1 3 2 .. .. 5 .. Heart Disease 144 .. 2 12 10 72 48 20 17 28 23 8 13 35 .. Accidents 46 7 4 7 3 15 10 8 7 4 6 10 1 10 .. Suicide 10 .. .. .. .. 8 2 1 4 1 1 2 1 .. .. Murder 1 .. .. 1 .. .. .. .. .. .. .. .. .. 1 .. Congenital Defects 41 40 1 .. .. .. .. 7 6 9 5 3 3 8 .. Want of Breast Milk, Marasmus 52 47 4 .. .. 1 .. 13 13 2 10 6 .. 8 .. Diseases of Nervous System 169 29 12 4 4 78 47 31 22 25 20 16 9 44 2 Diseases of Digestive System 53 8 3 5 .. 24 13 6 4 11 4 7 5 15 1 Diseases of Urinary System 52 1 .. 1 1 27 22 7 8 9 6 7 3 11 1 All other causes 158 19 7 5 6 40 81 28 27 29 15 20 9 29 1 Totals 1678 391 167 70 63 589 398 285 259 314 207 185 96 326 6 87 Table IV. DEATHS OF WILLESDEN RESIDENTS DURING THE YEAR 1909 (Inclusive of those dying outside the District). Long Table. CAUSE OF DEATH 0 to 1 1 to 9 5 to 10 10 to 15 15 to 20 20 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 to 85 85 & Up. At all Ages. Small Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .... Measles 9 30 2 .. .. .. .. .. .. .. .. .. .. 41 Scarlet Fever 1 10 4 .. .. .. 1 .. .. .. .. .. .. 16 Whooping Cough 25 17 1 .. .. .. .. .. .. .... .. .. .. 43 Diph. Membranous Croup .. 6 4 .. .. .. .. .. .. .. .. .... .. 10 Croup .. .. .. .. .. .. .. .. .. .. .. .. .. .. Typhus Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric Fever .. .. .. .. .. .. .. .. .. .. .. .. .. 6 Other continued .. .. .. .. .. .. .. .. .. .. .. .. .. .. Epidemic Influenza 2 2 .. .. .. 1 .. 2 6 6 6 8 3 36 Cholera .. .. .. .. .. .. .. .. .. .. .. .. .... .. Tetanus 2 .. .. .. .. .. .. .. .. .. .. .. .. 2 Diarrhoea & Dye. Zym. or Epidemic Ent. 42 2 2 .. .. .. .. .. .. .. 1 .. .. 47 Enteritis (Enteritis and Gastro Enteritis) 9 4 .. .. .. .. .. .. .. 1 1 .. .. 15 Glanders (Farcy) .. .. .. .. .. .. .. .. .. .. .. .. .. .. Anthrax (Splenic Fever) .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cow Pox (Accidents of Vaccination) .. .. .. .. .. .. .. .. .. .. .. .. .. .. Syphilis 7 .... .. .. .. .. .. 1 1 .. .. .. .. 9 Gonorrhœa .. .. .. .. .. .. .. .. .. .. .. .. .. .. Phagædena .. .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas .. .. .. .. .. .. .. .. .. .. 1 .. 1 2 Puerperal Fever .. .. .. .. .. .. 2 .. .. .. .. .. .. 2 Pyaemia Septicaemia .. 1 1 .. .. .. 1 2 1 1 .. .. .. 7 Infective Endocarditis .. .. .. .. .. .. .. 3 1 .. .. .. .. 4 Other Allied Diseases 1 .. .. .. .. .. .. 2 .. .. 1 .. .. 4 Malarial Fever .. .. .. .. .. .. .. .. .. .. .. .... .. .... 88 Table IV—DEATHS OF WILLESDEN RESIDENTS—continued CAUSE OF DEATH. 0 to 1 1 to 5 5 to 10 10 to 15 19 to 20 20 to 25 25 to 35 35 to 45 45 to 55 55 to 65 69 to 79 79 to 85 85 & Up. At all Ages. Rheumatic Fever .. 1 1 2 4 1 .. 1 1 .. .. .. .. 11 Rheumatism of the Heart .. .... .. .. .. .. .. .. .. .. .. .. .. .. Tuberc. of Brain or Meninges, aeute Hydrocephalus 8 20 6 1 .. .. 1 .. .. .. .. .. .. 36 Tuberculosis of Larynx .. .. .. .. .. .. 1 .. .. 1 .. 1 .. 3 Tuberculosis of Lungs 2 3 3 3 6 15 38 32 17 9 3 .. .. 131 Tuberculosis of Intestines, Tabes Mesenterica 4 5 .. .. .. .. .. .. 1 .. .. .. .. 10 General Tube'losis T'br'clr Die. of undefined position 1 2 1 2 1 2 3 .. 1 .. .. .. .. 13 Other forms of Tuberculosis, Scrofula 1 .. .. .. .. .. .. 2 .. .. .. .. 3 Other Infective Dis., Rubeola, Varicella, etc. .. .. .. .. .. .. .. .. .. .. .. .. .. .... Thrush 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 Purpura .. .. .. .. .. .. .. .. .. .. .. .. .. .. Acute Alcoholism, Delirium Tremens .. .. .. .. .. .. .. 1 .. .. .. .. .. 1 Chronic Alcoholism, Cirrhosis of Liver .. .. .. 1 .. 1 2 5 2 3 5 1 .. 20 Chronie Industrial Poisoning .. .. .. .. .. .. .. .. .. .. .. .. .. .. Osteo Arthritis Rheumatoid Arth.Chronic Rheu'ism. .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 Haemophilia 1 .. .. .. .. .. .. .. 1 .. .. .. .. 2 Cancer Malignnt Growth .. 2 .. .. .. 1 5 10 18 33 29 20 2 120 Diabetes Mellitus .. .. .. .. .. .. 1 1 1 3 1 2 .. 9 Lymphadenoma Hodgkins Dis. .. .. 1 .. .. .. 1 1 .. .. .. .. .. 3 Anaemia Leucocythemia .. 1 .. .. 1 .. .. 3 .. 2 .. .. .. 7 Premature Birth 72 .. .. .. .. .. .. .. .. .. .. .. .. 72 Injury at Birth 6 .. .. .. .. .. .. .. .. .. .. .. .. 6 Debility at Birth 15 .. .. .. .. .. .. .. .. .. .. .. .. 15 Atelectasis 4 .. .. .. .. .. .. .. .. .. .. .. .. 4 Congenital Delects .. .. .. .. .. .. .. .. .. .. .. .. .. .. Malformation of Heart, Congenital Heart Disease 5 1 .. .. .. .. .. .. .. .. .. .. .. 6 Spina Befida Hydrocephalus 6 .. .. .. .. .. .. .. .. .. .. .. .. 6 Imperforate Anus & other Cong'l Rectal Malform'ns .. .. .... .. .. .. .. .. .. .. .. .. .. .. Other Congenital Defects, Icterus Neonatorum 6 .. .. .. .. .. .. .. .. .. .. .. .. 6 Cleft Palate Hare-lip 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 89 Table IV.—DEATHS OF WILLESDEN RESIDENTS— continued. CAUSE OF DEATH. 0 to 1 1 to 5 5 to 10 10 to 15 15 to 20 20 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 to 85 85 & Up. At all Ages. Want of Breast Milk .. .. .. .. .. .. .. .. .. .. .. .. .. .. Atrophy Debility Marasmus Starvation 46 4 .. .. .. .. .. 1 .. .. .. .. .. 51 Dentition 11 2 .. .. .. .. .. .. .. .. .. .. .. 13 Rickets 2 .. .. .. .. .. .. .. .. .. .. .. .. 2 Old Age, Senile Decay .. .. .. .. .. .. .. .. .. 3 16 31 17 67 Convulsions 22 5 .. 1 .. .. .. .. .. .. .. .. .. 28 Meningitis 4 6 1 .. 1 2 1 3 .. .. .. .. .. 18 Apoplexy 1 .. .. .. .. .. .. 7 10 17 12 15 4 66 Softening of Brain .. .. .. .. .. .. .. .. .. l .. .. .. 1 Hemipigia Brain Paralysis .. .. .. .. .. .. .. .. 1 .. 1 2 .. 4 General Paralysis of Insane .. .. .. .. .. .. 1 8 5 2 .. .. .. 16 Other Forms of Insanity .. .. .. .. .. .. 1 .. .. 1 1 1 .. 4 Chorea .. .. 1 .. .. .. .. .. .. .. .. .. .. 1 Cerebral Tumour .. .. .. .. .. 1 1 .. .. 1 .. .. .. 3 Epilepsy 1 .. .. .. .. .. .. .. .. .. 1 1 .. 3 Laryngismus Stridulus 1 1 .. .. .. .. .. .. .. .. .. .. .. 2 Locomotor Ataxy .. .. .. .. .. .. .. 1 2 3 .. .. .. 6 Paraplegia, Diseases of Spinal Cord .. .. .. .. .. .. .. 1 •• 1 1 .. .. 3 Other & ill defined dis. of Brain or Nervous System .. .. 1 .. .. .. .. .. .. 2 3 .. 1 7 Otitis Otorrhœa .. 2 .. 1 .. .. 1 .. .. .... .. .. .. 4 Diseases of Nose, Epistaxis .. .. .. .. .. .. .. 1 .. .. .. .. 1 Pericarditis .. .. 1 .. .. .. .. .. 1 .. .. .. .. 2 Endocarditis, Valvular Disease of Heart .. 2 5 6 4 5 5 18 2 V 21 28 16 .. 139 Hypertrophy of Heart .. .. .. .. .. 1 .. .. .. .. .. 1 .. 2 Angina Pectoris .. .. .. .. .. .. .. .. .. 1 .. 1 .. 2 Anerism .. .. .. .. .. .. 1 1 1 .. 2 .. .. 6 Senile Gangreene .. .. .. .. .. .. .. .. .. .. 4 1 .. 5 Emblism Thrombosis .. .. .. .. .. .. 1 .. .. 3 2 4 .. 10 90 Table IV.-DEATHS OF WILLESDEN RESIDENTS—ctmtinued. CAUSE OF DEATH. 0 to 1 1 to 5 5 to 10 10 to 15 15 to 20 20 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 to 85 85 & Up. At all Ages. Other & ill-defined Dis. of Heart & Circulat'y Syst. .. .. .. .. .. .. .. 1 1 .. 2 .. .. 4 Laryngitis .. 1 1 .. .. .. .. .. .. 1 .. .. .. 3 Other Diseases of Larynx and Trachea .. .. .. .. .. .. .. .. .. .. .. .. .. ... Acute Bronchitis 21 4 .. .. .. 1 1 1 9 7 9 6 3 62 Bronchitis and Chronic Bronchitis .. .. .. .. .. .. .. 1 6 7 29 15 5 63 Lobular Broncho Pneumonia 27 12 3 .. .. .. 2 1 1 4 1 3 .. 54 Lobar Croupous, Pneumonia .. 1 .. .. .. 1 1 3 2 1 1 .. .. 10 Pneumonia From not stated 6 11 .. .. 3 2 9 9 13 8 10 5 .. 76 Emphysema Asthma .. .. .. .. .. .. 1 2 5 1 3 .. .. 12 Pleurisy and Empyema .. 1 .. .. 1 .. 1 2 .. .. 1 .. .. 6 Other and ill-defined Dis. of Respirafory System .. .. .. .. .. .. 1 .. 1 .. .. .. .. 2 Diseases of Pharynx .. .. .. .. .. .. .. .. .. .. .. .. .... .. Ulcer of Stomach and Duodenum .. .. .. .. .. .. 1 1 .. .. .. .. .. 2 Other Diseases of Stomach 5 1 .. 1 .... .. .. .. .. 2 3 2 .. 14 Stricture of Duodenum .. .. .. .. .. .. .. .. .. .. .. .. .. .. Appendicitis .. 1 1 1 .. .. .. 2 2 .. 1 .. .. 8 Obstruction of Intestine 2 1 .. .. .. .. 1 1 1 3 2 2 .. 14 Other diseases of Intestine 1 .. 1 .. .. .. 1 1 .. .. .. .. .. 4 Cirrhosis of Liver .. .. .. .. .. .. .. .. .. .. 1 .. .. 1 Disease of Liver (other than Cirrhosis) .. .. .. .. .. •• 1 .. 1 3 .. .. .. 6 Peritonitis .. .. 1 .. .. .. 2 .. 1 1 .. .. .. 5 Other ill-defined Disease of Digestive System .. .. .. .. .. .. .. 2 .. .. 1 .. .. 3 Acute Nephritis 1 .. .. 1 .. .. 1 .. .. 3 .. .. .. 6 Bright's Disease .. .. .. .. .. 1 2 6 6 9 12 5 .. 41 Calculus .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diseeas of Bladder and Prostate .. .. .. .. .... .. .. .. .. 3 1 .. 4 Other and ill-defined disease Urinary System .. .. .. .. .. .. .. .. .. .. 1 .. .. 1 Disease of Ovaries .. .. .. .. .. .. 1 • • 1 .. .. .. .. 2 Disease of Uterus and Appendages .. .. .. .. .. .. 1 .. 1 .. .. .. .. 2 Disease of Vagina and External Genital Organs .. .. .. .. .. .. .. .. .. .. .. .. .. .. 91 Table IV.—DEATHS OF WILLESDEN RESIDENTS—continued. CAUSE OF DEATH. 0 to 1 1 to 5 5 to 10 10 to 15 15 to 20 20 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 to 85 85 & Up. At all Ages. Abortion, Miscarriage .. .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Mania .. .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Convulsions .. .. .. .. ..1 .. ..1 .. .. .. .. .. .. 2 Placenta Praevia, Flooding .. .. .. .. .. .. 1 2 .. .. .. .. .. 3 Puerperal Thrombosis or Embolism .. .. .. .. .. .. 2 .. .. .. .. .. .. 2 Other & ill-def. accid'ts & dis. of Preg. & Childbirth .. .. .. .. .. 1 .. 2 .. .. .. .. .. 3 Other and ill-defined diseases of Osseous System .. .. .. .. .. .. 1 .. .. .. 1 .. .. 2 Pemphigus 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 Ulcer, Bedsore .. .. .. .. .. .. .. .. .. .. .. .. .. .. Eczema .. .. .. .. .. .. .. .. .. .. .. .. .. .. Deaths from external causes by accident or negligence In Vehicular Traffic .. .. 1 .. 1 .. .. 2 1 .. 1 .. .. 6 On Railways .. .. .. .. .. .. 2 .. .. .. .. .. .. 2 In Building operations .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 Poisons, Poisonous Vapours .. .. .. .. .. .. 1 .. 2 1 .. .. .... 4 Surgical Operations .. .. .. 1 .. .. .. .. .. .. .. .. 1 Burns and Scalds .. 4 2 1 .. .. 1 .. .. .. 1 .. .. 9 Drowning .. .. 1 .. 1 .. .. .. .. .. .... .. .. 2 Suffocation, Overlaid in bed 3 .. .. .. .. .. .. .. .. .. .. .. .. 3 Suffocation otherwise 2 .. .. .. .. .. .. .. 2 1 .. .. 5 Falls—not specified .. .. .. .. 1 .. .. .. 1 1 3 .. 6 By Falling bodies.. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Otherwise not stated 2 .. 1 .. .. .. 1 .. .. .. .. 2 1 7 Homicide .. .. 1 .. .. .. .. .. .. .. .. .. .. 1 Suicides .. .. .. .. .. .. .. .. .. .. .. .. .. .. By Hanging .. .. .. .. .. .. .. 2 • • .. .. .. .. 2 By Poison .. .. .. .. .. .. 1 .. 2 .. 1 .. .. 4 By Asphyxia .. .. .. .. .. .. .. .. .. .. 1 .. .. 1 By Shooting .. .. .. .. .. .. .. .... .. .. .. .. .. .. By Cut or Stab .. .. .. .. .. .. .. .. 1 .. .. .. .. 1 By Drowning .. .. .. .. .. .. .. 1 1 .. .. .. .. 2 By Crushing, Railway, etc. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other and ill-defined and not specified causes 1 1 .. .. .. .. .. 1 .. 2 1 .. .. 6 Totals 391 167 48 22 26 37 107 150 162 170 207 150 41 1678 92 Table V. INFANTILE MORTALITY DURING THE YEAR 1909. Deaths from stated Causes in Weeks and Mouths under One Year of Age. cause of death. Under 1 Week. 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 1 Month. 1-2 Months. 2 3 Months. 3-4 Months. 1-5 Mouths. \ 5-6 Months. 6-7 Months. 7-8 Months. 8-9 Months. 9-10 Months. 10-11 Months. 11-12 Months. Total Deaths under One Year. All Causes Certified 77 19 21 13 130 40 30 33 20 17 21 24 21 13 20 18 387 Uncertified 3 .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. Common Infectious Diseases Small-pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Chicken-pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles .. .. .. .. .. .. .. .. .. .. 1 1 .. .. 3 4 .. Scarlet Fever .. .. .. .. .. .. .. .. .. .. .. .... .. .. .. .. .. Diphtheria (including Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Whooping Cough .. .. .. .. .. 4 3 2 .. 2 1 2 1 3 4 3 25 Diarrhœal Diseases Diarrhoea, all forms .. .. 1 .. 1 3 4 12 4 2 3 4 .. 1 1 2 42 Enteritis, Muco-enteritis, Gastro-enteritis .. 1 .. .. 1 2 1 3 .. .. 1 .. .. .. .. 1 9 Gastritis, Gastrointestinal Catarrh .. .. .... .. .. .. .. .. .. .. .. .. .. .. .. .. Wasting Diseases Premature Birth 48 6 6 4 64 2 3 .. 1 .. .. .. .. .. .. .. 72 Congenital Defects 9 2 2 1 14 2 1 .. 1 1 1 .. .. 1 1 .. 22 Injury at Birth 4 1 .. 1 6 .. .. .. .... .. .. .. .. .. .. .. Atrophy, Debility, Marasmus .. 4 3 4 11 5 8 8 4 2 1 4 1 1 .. 1 46 93 Table V.—continued. INFANTILE MORTALITY DURING THE YEAR 1909. Deaths from stated Causes in Weeks and Months under One Year o* Age. CAUSE OF DEATH. Under 1 Week. 1-2 "Weeks. 2-3 "Weeks. 3-4 Weeks. Total under 1 Month. 1-2 Months. 2-3 Months. 3-4 Months. 4-5 Months. 5-6 Months. 6-7 Months. 7-8 Months. 8-9 Months. 9-10 Months. 10-11 Months. 11-12 Months. Total Deaths under One Year. Tuberculous Diseases Tuberculous Meningitis .. .. 1 .. .. 1 .. .. .. 2 2 1 1 .. .. .. 8 Tuberculous Peritonitis: Tabes Mesenterica .. .. .. .... .. 1 .. 1 .. .. .. 2 .. .. .. 4 Other Tuberculous Diseases .. .. .. 1 1 .. .. .. .. .. .. 1 1 .. 1 .. 4 Other Causes Erysipelas .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Syphilis .. 1 4 .. 5 1 1 .. .. .. .. .. .. .. .. .. 7 Rickets .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. 1 2 Meningitis (not Tuberculous) .. .. .. .. .. .. .. .. 3 .. .. .. .. 1 .. .. 4 Convulsions 4 2 1 .. 1 5 2 1 .. 2 2 2 1 .. .. .. 22 Bronchitis .. .. .. 1 1 5 1 2 1 3 2 3 2 .. .. 1 21 Laryngitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Pneumonia 2 .. .. .. 2 2 1 2 3 2 4 1 3 3 6 4 33 Suffocation, overlying 1 .. 1 .. 2 .. .. .. 1 .. .. .. .. .. .. .. 3 Other Causes 12 2 2 1 17 8 4 1 1 1 3 5 3 4 3 1 51 Totals 80 19 21 13 133 40 30 33 20 17 21 24 21 14 20 18 391 Percentage of total deaths 20.5 4.9 5.4 3.3 34.0 10.2 7.7 8.4 5.1 4.3 5.4 6.2 5.4 3.6 5.1 4.6 .. Births in the year legitimate 4,042 Deaths in the year of legitimate infants 367 illegitimate 130 illegitimate infants 4 Deaths from all Causes at all Ages, 1,678 Population, Estimated to middle of 1909 150,145 94 In concluding this report I desire to express my thanks to the Chairman and Members of the Public Health Committee for the support afforded me during the year. To the members of my staff I wish to say how fully I appreciate their unremitting and even strenuous efforts during a year in which great administrative changes have taxed their endeavours to the utmost. But for the sacrifice of a good deal of private convenience it would have been impossible in the press of new work to keep abreast of the normal routine, and for this willing sacrifice I have been, and am, extremely grateful. I am, Gentlemen, Your obedient servant, appendix i. Willesden Local Coucation Authority. ANNUAL REPORT OF THE SCHOOL MEDICAL OFFICER ON THE Medical Inspection of Children in Public Elementary Schools, 1909, BY william butler, Medical Officer of Health and School Medical Officer. MEMBERS OE THE SCHOOL HYGIENE COMMITTEE. Chairman— Mr. Councillor J. E. HILL. Mr. Councillor J. ANDREWS. Mr. Councillor W. R. DUNN. *Mr. E. VV. ESSELL, Vice-Chairman of Education Committee (ex-officio). Mr. Councillor F. HILBORN. Mr. Councillor W. H. LANSDELL. Mr. Councillor C. H. PARKER. Mr. Councillor VV. RILEY, J.P. Mr. Councillor G. T. SMITH, Chairman of Education Committee (ex-officio). * Co-optative Member. Clerk of the Council.—STANLEY W. BALL. Director of Education.—R. McKEE, M.A. Secretary of the Education Committee.—FREDERICK JOBBINS. INDEX. A Page. Abbreviations and Symbols used in Medical Inspection Tables 41 Acton Lane School 42—43 All Souls' School 72—73 Anthropological Investigations 32 Anthropometrical Observations, Table showing Results of 33 Appointments, etc., of Assistant School Medical Officers 4 Assistance given by the Teachers 5 Assistant School Medical Officers, Appointments of 4 ,, ,, ,, ,, Duties of 102 Attendance Officers in Relation to Medical Inspection 8 B Baths, School Shower 18 Blind Children, Methods for Dealing with 32 Boys and Girls Contrasted 25 c Cambridge Road (Temporary) School 44—45 Chamberlayne Wood Road School 46—47 Christ Church School 74—75 Closure of Schools 31 Contagious and Infectious Diseases Notified from Schools 30 D Deaf Children, Methods for Dealing with 32 Defects and Diseases 24 ,, Methods Available for Treatment of 35 ,, Methods Employed for Securing Treatment of 26 Degree of Uniformity Attained in Medical Inspection 20 Page. Dirt and Vermin 17 Diseases and Defects 24 „ Infectious and Contagious, notified from each School 30 ,, Precautions for Preventing the Spread of Infectious 27 ,, Non-Notifiable Infectious, intimated from Schools 29 Disraeli Road and Lower Place Schools 60—61 Dudden Hill School 48—49 Duties of Assistant School Medical Officers 102 ,, ,, School Medical Officer 101 F Forms used for Securing Presence of Parents at Inspection 103—105 Furness Road School 50—51 G Gibbons Road School 52—53 Girls and Boys Contrasted 25 Gordon Memorial School 76—77 H Harlesden R.C. School 78—79 Harvist Road School 54—55 Healthiness of Willesden Children 23 Heights of Scholars at Various Age Periods 99—100 Heights and Weights at each Trimester of each Year of Age 96 Holy Trinity School 80—81 Hygiene of the Skin 18 Hygienic Condition of School Buildings 38—40 I Infectious and Contagious Diseases Notified from Schools 30 ,, Diseases, Non-Notifiable, Intimated from Schools 29 ,, ,, Precautions for Preventing the Spread of 27 ,, ,, School Closures to Prevent the Spread of 31 K Keble Memorial School 82—83 Kilburn Park Road School 56—57 L Page. Lady Health Visitors and School Nurses 7 Leopold Road School 58—59 Lower Place and Disraeli Road Schools 60—61 M Medical Inspection, Attendance Officers in Relation to 8 ,, ,, Degree of Uniformity Attained in 20 ,, ,, Forms used to Secure the Presence of Parent at 103—105 „ „ General Results of 17 ,, ,, Parents and 9 ,, „ Principle on which Children have been Selected for 10 „ „ Results of, All Schools—all Ages 11—12 ,, ,, ,, of, at each of the Public Elementary Schools 42—95 ,, ,, ,, of, at Specified Ages 13—16 ,, Inspections, Nos. Completed at each of the Public Elementary Schools 30 Medically Inspected, Actual No. of Scholars, by each Assistant School Medical Officer 4 ,, ,, Average No. of Scholars, per School Week 4 ,, ,, Estimated No. of Scholars to be 4 ,, ,, No. of Scholars (Classified for Age at Date of Inspection and for Sex) 10 Mentally and Physically Defective Children, Methods for Dealing with 32 Miscellaneous Work 35 Mora Road School 62—63 N Neasden-cum-Kingsbury School 84—85 Non-Notifiable Infectious Diseases, Intimated from Schools 29 0 Objectors, No. and Percentage of 9 Oldfield Road School 64—65 P Page. Parents and Medical Inspection 9 Parents, Forms used for Securing Presence of, at Medical Inspection 103—105 Plans of Various Types of Schools in Willesden ... Following 40 Pound Lane School 66—67 Precautions for Preventing the Spread of Infectious Diseases 27 Princess Frederica School 86—87 R Racial Types, Table Showing, of all Children Observed 33 s St. Andrew's School 88—89 St. John's School 90—91 St. Mary's School 92—93 St. Mary's R.C. School 94—95 Salusbury Road School 68—69 Sanitary Condition of Schools 43—95 Scholars, Estimated No. to be Examined 4 ,, Examined by each Assistant School Medical Officer, Actual No. of 4 ,, ,, Actual No. of (Classified for Age at Date of Inspection and for Sex) 10 ,, ,, per School Week, Average No. of 4 ,, Healthiness of Willesden 23 ,, Heights and Weights of, at each Trimester of each Year of Age 96 ,, Heights of, at Various Age Periods 99—100 ,, Methods for Dealing with Blind, Deaf, Mentally or Physically Defective 32 ,, Principle on which, have been Selected for Inspection 10 ,, Racial Types of 33 ,, Result of Medical Inspection of, All Schools—all Ages 11—12 „ Results of Medical Inspection of, at Specified Ages 13—16 ,, Weights and Heights of, at each Trimester of each Year of Age 96 ,, ,, of,, at Various Age Periods 97—98 Page. School Buildings, Hygienic Conditions of 38—40 ,, Medical Officer, Duties of 101 ,, ,, Officers (Assistant), Appointments of 4 Duties of 102 ,, Nurses and Lady Health Visitors 7 ,, Shower Baths 18 Schools—('Provided)— Acton Lane 42—43 Cambridge Road (Temporary) 44—45 Chamberlayne Wood Road 46—47 Dudden Hill 48—49 Furness Road. Gibbons Road 52—53 Harvist Road 54—55 Kilburn Park Road 56—57 Leopold Road 58—59 Lower Place and Disraeli Road 60—61 Mora Road 62—63 Oldfield Road 64—65 Pound Lane 66—67 Salusbury Road 68—69 Stonebridge 70—71 (Non-Provided)— All Souls' 72—73 Christ Church 74—75 Gordon Memorial 76—77 Harlesden R.C. 78—79 Holy Trinity 80—81 Keble Memorial 82—83 Neasden-cum-Kingsbury 84—85 Princess Frederica 86—87 St. Andrew's 88—89 St. John's 90—91 St. Mary's, Church End 92—93 St. Mary's R.C. 94—95 Schools Closed with a view to Preventing Spread of Disease 31 ,, Day and Hour of Weekly Visit to, by Assistant School Medical Officers 4 Page. Schools, Sanitary Condition of 42—95 Skin, Hygiene of the 18 Stonebridge School 70—71 Symbols and Abbreviations used in Medical Inspection Tables 41 T Teachers, Assistance given by 5 Treatment of Defects, Methods Available for the 35 „ ,, „ ,, Employed for Securing 26 Types of Schools in Willesden 38—40 W Weights and Heights of Scholars at each Trimester of each Year of Age 96 Weights of Scholars at Various Age Periods 97—98 Willesden Children, Healthiness of 23 MEDICAL INSPECTION OF CHILDREN IN PUBLIC ELEMENTARY SCHOOLS. ANNUAL REPORT FOR THE YEAR 1909. To the Chairman and Members of the Local Education Authority. Gentlemen, I beg leave to submit my Annual Report for the year 1909. The Report for the year 1908 contained merely a statement of the arrangements made for carrying out the provisions of Section 13 Sub-section (b) of the Education (Administrative Provisions) Act, 1907. The work of medical inspection was not actually commenced until the month of February, 1909. It may be well, however, briefly to recapitulate what these arrangements were. In the month of December, 1908, the Medical Officer of Health was appointed also School Medical Officer, and in compliance with your instructions submitted alternative schemes for carrying out the work of medical inspection, (a) By the employment of all-time Assistant School Medical Officers, and (b) By the appointment of medical practitioners practising in the district to act in this capacity by devoting an hour or two each week to the work of medical inspection. Upon the submission of the Report you decided for one year, and as an experiment, to employ the part time services of the local medical practitioners, and the following statement shows in tabulated form the actual appointments made:— 4 No. SCHOOL APPOINTMENTS. No. of Scholars on Roll. Average for 1909. No. of Scholars estimated to Deexamined. See Special Report of 21 Dec., 1908. Actual No. of Scholars examined up to 31st Dec., 1909. Average No of Scholars examined per Schoo week. Name of School. Medical Officer. Departments. Day and hour of weekly visit to School, 1910. 1 Acton Lane Dr. R. T Jones B., G., and I. Mondays, 2—4 p.m 505 224 395 9.4 2 Stonebridge „ A. Bindlev B Wednesdays, 2—4 p.m 433 218 177 4.2 3 ,, „ D. V. Muller G Tuesdays, 2 p.m. Thursdays, 2 p.m.H 426 219 200 4.7 4 ,, ,, N. Greeves I. Wednesdays, 9.30 a.m 482 211 278 6.'6 5 Lower Place and Disraeli Road ,, Jessie D. G. Evans B., G., and I. Lower Place (B. and G.), Thursdays, 1.30 p.m. 444 638 123 209 2.9 5.0 Disraeli Road (Inf.), Thursdays, 1.30 p.m. 194 279 86 2.1 6 Leopold Road „ G. H. Mitchell B Wednesdays, 9.35 a.m 414 200 211 5.0 7 ,, ,, A. S. Grant G Thursdays, 3 — 4 p.m 405 189 221 502 8 ,, ,, J. S. Crone I Tuesdays, 2.30 p.m. 432 186 429 10.2 9 Gibbons Road „ C. W. Cooke Mixed Tuesdays, 3 p.m. Fridays, 3 pm 854 379 392 9.3 10 ,, ,, W. Bell I Thursdays, 2.45 p.m. 439 189 275 6.9 11 Dudden Hill P. Evans B. and G Tuesdays, 1.35.; Thursdays.il 1.35 p.m. 821 382 311 7.4 12 Neasden National and Dudden „ J. Mechan Mixed and I. Neasden National, 2.30 p.m.* Dudden Hill 210 652 291 93 343 2.4 8.4 Hill Infants (Inf.), 1.30 p.m., Wednesdays 442 250 6.0 13 Pound Lane ,, E. N. Smith G. and I Tuesdays, 3.15 p.m. (G), Thurs., 3.15 p.m. (Inf.) 727 324 208 4.9 14 „ B. and St. Andrews ,, R. C. Cruden B.and I Pound Lane (B.), Thursdays, 2.45 p.m 398 654 238 184- 331 4.3 7.8 St. Andrew's (Inf.), Wednesdays, 2.30 p.m. 256 147. 3.5 15 Kensal Rise „ T. Wilson B Mondays, 3pm 471 230 173 4.1 l6 ,, „ J. Spurway G Tuesdays, 2 p.m 433 203 209 4.9 17 ,, ,, J. C. Waithman I Wednesdays, 2 p.m 518 225 190 4.5 18 Chamberlayne Wood Road and „ W. W. Walker B. and B Chamberlayne Wd. Rd. (B), Mondays. 1.30 p.m. 401 815 169 315 137 247 3.2 5..8 Princess Frederica Princess Frederica, Mondays, 1.30 p.m. 414 182 110 2.6 19 Chamberlayne Wood Road ,, T. E. Smurthwaite G. and I Wednesdays, 1.30 p.m 752 323 246 5.8 20 Salusbury Road ,, H. J. Macevoy Mixed Afternoon, Tuesdays 883 420 330 7.8 21 ,, ,, J. Seymour† I Wednesdays, 2 p.m 496 215 300 7.1 22 Cambridge Road and Kilburn „ J. Macfarlane B., G., and I. ||Mondays, 2 p.m. 151 494 221 94 233 2.2 5.5 Park Road Kilburn Park Road, Thursdays. 2 p.m. 343 139 3.3 23 Mora Road ,, W. R. Soden B., G., and I. *Tues., 1.30 p.m.(B.& G.). Thurs. 2.30 p.m.'Inf.) 828 349 370 8.8 24 Oldfield Road ,, F. J. Beresford B.and G Wednesdays and Thursdays, 2 p.m. 742 305 274 65 25 ,, ,, J. C. Clayton I Thursdays (aft.) 427 192 316 7.4 26 Furness Road ,, B. G. Reynolds Senr. and Junr. Junr., Mondays, 3—4 ; Senr., Tuesdays, 3—4 677 259 379 9.0 27 „ and Harlesden R.C. ,, C. K. Rawes I. and B. G. and I. Furness Road (Inf.). Tuesdays, 2.30 p.m. 317 518 224 267 420 63. 10.0 Harlesden R.C., Fridays, 2.30 p.m 201 153 3.3 28 Princess Frederica „ H. R. Wilson G. and I Tuesdays, 2 p.m. 641 292 463 11.0 29 Keble Memorial ,, C. E. Armitage B., G., and I. Afternoon, Wednesdays 54i 238 280 6.6 3D Gordon Memorial ,, A. L. Saunders G. and I Inf. .Mondays, 2 p.m. 639 278 481 11.4 31 „ (B.) and St. John's ,, J. Snowman B.and I Gordon Mem. (B.), Thursdays, 3—4 p.m. 365 614 280 129 278 8.0 6.5 (Infants) St. John's (Inf.), Thursdays, 2—3 p.m. 249 149 3.5 32 Holy Trinity „ H. Knox B., G., and I. G. and Inf., 3 p.m.* B., Thursdays, 3 p.m. 555 242 239 5.6 33 Christ Church ,, J. F. Parr B., G.. and I. Tuesdays, 2.30 p.m 458 192 204 4.8 34 St. John's and Kilburn R.C. J. P. Cassidy B. and G., and Kilburn R.C., Mondays, 9 a.m 558 841 380 339 553 8.0 130 Mixed and I. St. John's Tuesdays and Thursdays 9 a.m. 283 214 5.0 35 St. Mary's ,, J. McD. Tudge B., G., and I. Tuesdays, 1.45 p.m 647 272 273 6.5 36 St. Andrew's ,, H. A. Seagrove B.and G Tuesdays. 2.30 p.m 678 304 211 5.0 37 Harlesden Ch. of England ,, O. Roberts B., G., and I. Tuesdays, 3 p.m 545 226 236 5.6 22,095 9.750 10,885 259.1 * Alternate Wednesdays. + Resigned March, 1909, and Dr. Moran appointed. J Or Thursdays. || Generally, ft If necessary. •! Or Tuesday. B—Boys. G. - Girls. I—Infants. 5 I am pleased to be able to report that, speaking generally, the scheme has worked well, with infinitely less friction than I had anticipated, and I think 1 may say, on the whole, with the most satisfactory results. In no single instance has complaint been made or has it come to my knowledge that any practitioner has felt himself aggrieved in any sense at the action of any of the Assistant Medical Officers, and it says much, not only for the " correctness " of their conduct, but for their tact, that there has been such uniform absence of complaint on this ground. Between myself and my colleagues the most harmonious relations have obtained. ASSISTANCE GIVEN BY THE TEACHERS. The essential co-operation of the teachers in the work, it was considered, would be better secured by mutual arrangement between the Assistant School Medical Officer and the Head Teacher of the school department to which he was appointed, rather than by the formulation of any hard and fast regulations. Almost without exception the Assistant School Medical Officers speak most highly of the hearty and warm response which the teachers have evinced, and of the valuable assistance which the teachers have ungrudgingly rendered. At the same time it is necessary to record that there have been exceptional instances in which it has been difficult to make a teacher realise that attention to the physical condition of the child is an essential element in its education ; and where, in consequence, there has not been that desire to co-operate, assist, and be assisted by the Medical Officer which has been a feature of the work throughout the schools generally. The notion has prevailed in these instances that other educational work had a prior and even exclusive claim upon a hardworked teacher's attention. This view, however, has never been pressed to its full conclusion, and has been in marked contrast 6 to the almost uniform enthusiasm with which the work has generally been taken up. The work undertaken by the teacher in pursuance of the supervision of the health of the children, it will be understood, has varied in different schools, but as the work progressed, and its importance and value were more and more appreciated, a broad uniformity of co-operation has been secured. The Head Teacher is generally present at the examination of the child, and next to securing medical treatment of the affections discovered, and the co-operation of the parent to this end, there is probably no more important circumstance than the presence of the teacher at the time of its examination by the Medical Officer. It is then and then only that the particular directions which the healthy physical and mental development called for by the peculiarities of individual children can be given. The regime of school life is for many of the children the most efficacious treatment of their defects; but that it may be so, this regime must take cognisance of the particular conditions which are sought to be modified. It is not sufficient, for instance, in the case of mouth breathers to remove the obstructions so commonly associated with their habit; the importance of systematic and sustained breathing exercises must be impressed upon the teachers and in turn these must be supervised and insisted upon as an element in the education of the child. Innumerable instances will suggest themselves where the co-operation of medicine and education can be secured only by the joint presence of their respective representatives at the medical inspection. In addition to the time given to this work, and in assisting to prepare the children for examination, the teachers have performed a large amount of clerical work in sending out notices and forms to parents and to the School Medical Officer, in weighing and measuring the 7 children, and in making the preliminary test of visual acuteness. The mental condition of the children, their normal state as regards cleanliness and clothing—in contradistinction to their appearance when presented for examination—and the standard and regularity of attendance are matters on which the knowledge of the teachers has necessarily had to be relied upon. Altogether medical inspection has brought a large amount of increased work to the teacher, and 1 desire to acknowledge, both on my own and on behalf of the Assistant School Medical Officers, our appreciation of the valuable assistance they have given. SCHOOL NURSES AND LADY HEALTH VISITORS. At the commencement of the work of medical inspection two additional Assistant Lady Health Visitors were appointed. For some years the duties of the Lady Health visitors already appointed had included much of the work of School Nurses. It was considered desirable rather than to appoint a separate staff of School Nurses to increase the staff of Health Visitors, and to include among the duties of all the Health Visitors those also of the School Nurse. The Health Visitor and School Nurse are alike concerned in one province of public health administration, that of domestic hygiene, and to distinguish as a separate concern of such administration the school children as apart from other members of the family is not only irrational but irritating and mischievous. In health and in sickness, the mother and the children occupy a province which it would be fatal to consign to possibly conflicting authorities. The Health Visitor is the friend and trained counsellor of the mother in the hygiene of the home, and it is when her services are most required, when the problems of infancy and the troubles of children's illnesses beset the mother that they are proffered. It has been urged in criticism of this arrangement that the health visitor is less of a nurse engaged in practical nursing, and 8 more of an adviser and instructor of a mother, who may have little skill in these specialised duties. And this is true, yet 1 think the objects of medical inspection are better served by this arrangement. As was pointed out in the first Memorandum on the subject, "one of the objects of the new legislation is to stimulate a sense of duty in matters affecting health in the homes of the people, to enlist the best services anj interests of the parents, and to educate their sense of responsibility for the personal hygiene of their children. The increased work undertaken by the State for the individual will mean that the parents have not to do less for themselves and their children, but more." In this spirit at all events the Health Visitors have worked, I know, with excellent results. Much of their work is very disheartening. Many of the parents who attend the medical inspection of their children act upon the advice of the Medical Officer given at the time, and seek the skilled advice and treatment which the morbid conditions discovered require. But there is a considerable residue of parents who accumulate on the lists of the Health Visitors, on whom neither the sense of duty to their children nor the appeals and warnings made on behalf of the sufferers, have any effect. The health of their children is neglected, the morbid conditions remain untreated, and the considerable sums publicly spent in the endeavour to educate these unfortunate waifs is wasted, due to the incorrigible indifference and brutal insensibility of the parents. I regard it as a serious handicap of the efforts of the Local Education Authority, that in such cases they are not empowered to put into operation the provisions of Sections 12 and 34 of the Children Act. ATTENDANCE OFFICERS IN RELATION TO MEDICAL INSPECTION. Perhaps the least satisfactory part of the organisation of school hygiene is its lack of correlation with the work of the 9 Attendance Officers. The Attendance Officers individually 1 have always found most willing and even zealous to assist and work in harmony with the School Medical Officer's department, but their work has not yet been correlated with that of school hygiene. The Attendance Officers' concern should rest exclusively with those whose absence from school is in no way related to officially recognised illness or its prevention. The prompt discovery of the cause of absence from school, and where that cause is illness its notification to the School Medical Officer should be the immediate and first duty of the Attendance Officer; the regulation of school attendance during illness, both of the patient and of other inmates of the house, should be the responsibility of the School Medical Officer, and his staff trained to enquire into cases of sickness should be adequate for this purpose. A system of notification to the attendance officers of cases whose further exclusion from school on ground of health has become unnecessary should be set up. In a word, absenteeism should be classified into that which is due to illness and so is no concern of the Attendance Officer, and absenteeism due to other causes which it is his duly to prevent. PARENTS AND MEDICAL INSPECTION. Parents have appreciated the value and importance of medical inspection to an unexpected extent. There have, of course, been objectors who have refused to submit their children to examination, and others who, without raising specific objection, have obstructed by keeping their children from school on the day appointed for their medical inspection. The number of definite refusals received amounts to 193, or 1.8 per cent, of the total number of children examined, and by far the greater pumber of parents have shown themselves appreciative of the advantages to their children which medical inspection provides. In the case of girls and infants the mothers usually 10 attend at the schools at the time appointed for examination, and even in the case of boys it is quite common for one or other parent to be present. The following table shows the principle on which children have been selected for inspection:— 1. Children five years of age and under. 2. Children of other ages admitted to school for the first time—not transfers. 3. Children aged 7 but not yet 8 years of age. 4. Children aged 10 but not yet 11 years of age. 5. Children aged 13 years and over. 6. Children of other ages " leaving school —not transfers. 7 . Children (at any age) specially referred by school teachers. Table showing actual number of children inspected (classified for age at date of inspection and for sex). Age. Boys. Girls. 4 145 108 5 880 759 6 394 390 7 1.199 1,200 8 365 255 9 198 154 10 926 995 11 343 254 12 102 104 13 912 883 14 178 115 15 13 11 16 - 2 Totals 5,655 5,230 RESULTS OF MEDICAL INSPECTION. Totals—All Schools, All Ages. Degree. ♦ Ref. No. ot Note Attendance. Clothing. Footgear. Nutrition. Cleanliness of Skin and Head. Do. Body. Mental Condition. Vision—R. Do. —L. Tonsils. Nose and Throat. Adenoids. Submax and Cervical Glands External Eye Disease. 'Temp. Teeth defect. No., & No. of Children affected. Perm. Teeth defect. No., & No. of - Children affected. Ear Disease. Hearing. Speech. Heart and Circulatory. Lungs. Nervous Diseases. Tuberculosis. Rickets. Deformities, Spinal Dis., etc. Infectious and Contagious Dis. Other Defects. Tuberculosis in 1 Family. ' 4 6 9 10 18 14 12 13 a 13 16 17 20 21 22 23 24 25 26 27 BOYS—Number Examined, 5,655. 1 Cases A. R. M.B. A. A. 11.301 2,099 O.&c. 4.805 3.539 3.773 2,324 5.028 4,926 3,008 2.795 2,823 2,765 1,021 488 783 1,504 S. 69 B. 2,918 B. 839 92 294 357 268 146 92 58 178 124 35 206 148 Per cent. 87.1 62.3 66.8 41.1 88.9 87.1 64.9 60.3 63.7 62.4 18.1 8.6 13.0 26.6 1.2 C. 3.9 C. 2.5 1.6 5.2 6.3 4.7 2.6 1.6 1.0 3.1 2.2 0.6 3.6 2.6 2 b O.D. O.D. Combined B O.D. 2 Cases 453 1,886 1,585 2.637 641 549 644 1,413 1.573 1,284 1,311 652 640 98 3.552 72 Per cent. 8.2 33.3 28.0 46.6 11.3 9.7 11.4 30.5 33.9 29.0 29.6 11.3 11. 3 1.7 62.8 1.3 3 Cases 257 230 297 53 78 85 209 262 321 352 179 SYMBOLS and ABBREVIATIONS. Per cent. 4.6 4.1 5.2 1.0 1.4 1.3 4.5 5.6 7.2 7.9 3.2 * Corresponds to Reference No. of Note. (Notes for Inspecting Officer—Circular 582.) Degree 1 Good In columns corresponding to reference Nos. 4, 6, 9, 10, 18 Cases I.R.C. I.R. Anaemic V. 241 V. 59 O.D. 2 Average or normal .. 3 lad 594 318 13 13 ,, 2b Below normal. An additional Class in the case of Nutrition. Per cent. 10.3 5.6 0.2 4.2 1.0 0.2 ,, 1 6/5 & 6/6 In columns corresponding to reference Nos. 14 ,, 2 6/9 & 6/12 ,, ,, ,, ,, ,, ,, ,, 3 6/18 to D/60 ,, ,, ,, ,, ,, ,, Cases O.D. 106 O.D. 30 ,, 1 (Tonsils) 12 Represents d'gree 1 of enlargm't ,, 2 ,, Per cent. 1.9 0.5 ,, 3 ,, GIRLS—Number Examined, 5,230. * Ref. No. of Note 4 6 9 10 18 14 12 13 11 15 16 17 20 21 22 23 24 25 26 27 1 Cases A. A. M.B. 9.970 2,102 0. &c. 4,183 3,617 3,608 2,502 4,726 4,746 2,712 2.555 2,202 2,138 869 323 615 1,164 S. 43 B. 2,715 B. 902 61 212 155 24b 13b 62 23 72 77 26 125 146 Per cent. 81. 6 69.1 69.0 47.8 90. 4 90.7 61.8 58.2 53.8 52.2 16.6 6.1 11.8 22.3 0.8 C. 3.7 C. 2.3 1.16 4.0 2.9 4.7 2.6 1.1 0.4 1.4 1.5 0.5 2.4 2. 8 2 Cases 2 b O.D. O.D. Combined B O.D. 586 1,511 1,464 2,225 448 433 1.497 1,600 1.529 1,571 533 310 90 3.367 56 468 Per cent. 11.4 28.9 27. 9 42.5 8. 9 8.6 8.3 34.1 36.5 37.3 38.3 10.0 5.9 1.7 64.4 1.07 3 Cases 323 102 158 35 56 51 177 231 363 385 138 SYMBOLS and ABBREVIATIONS—Continued. Per cent. 6.3 1.9 3.0 0.6 1.0 1.0 4.0 5.2 8.8 9.4 2.6 I Insufficiency In columns corresponding to reference Nos 6 R. Need of Repair ,, ,, ,, ,, ,, ,, C. Uncleanliness ,, ,, ,, ,, ,, ,, Cases I.R.C. I.R. Anaemic V.1,414 V, 46 O.D. V. Verminuus condition ,, ,, ,, ,, ,, 10 O.D. Other Diseases ,, ,, ,, ,, ,, ,, 10, 12,13,15 150 157 4 8 A. Attention ,, ,, ,, ,, ,, ,, 18 Per cent. 2.8 3.0 0.08 27.0 0.8 0 1 R. Response ,, ,, ,, ,, ,, ,, M.B. Mouth Breathers ,, ,, ,, ,, ,, ,, 12 S. Squlint ,, ,, ,, ,, ,, ,, 13 Cases O.D.67 O.D. 12 O. &c. Discharging Ear Disease ,, ,, ,, ,, ,, ,, 15 A. Total No. of Teeth found to be defective ,, ,, ,, ,, 11 B. No. of Children in which defective Teeth were found ,, ,, Per cent. 1.3 0.2 C. Average No. of defective Teeth per affected child ,, ,, tl RESULTS OF EXAMINATION OF CHILDREN AT SPECIFIED AGES.—Children Aged 5 Years. BOYS -Number Examined, 88o. Degree. Ref. No. of Note Attendance. Clothing. Footgear. Nutrition. Cleanliness of Skin and Head. Do. Body. Mental Condition. Vision—R. Do. —L. Tonsils. Nose and Throat. Adenoids. Submax. and Cervical Glands External Eye Disease. Temp. Teeth defect. No., «S: No. of Children affected. Ferm. leetn defect No.. & No. of Children afferted Ear Disease. Hearing. Speech. Heart and Circulatorv. Lungs. Nervous Diseases. Tuberculosis. Rickets. Deformities, Spinal Dis., etc. Infectious and Contagious Dis. | Other defects. Tuberculosis in Family. 4 6 9 10 18 14 12 13 11 IS 16 17 20 21 22 23 24 25 26 27 1 M.B. S. A.1,881 Cases 6 77 534 545 423 776 768 A. R. i74 86 123 265 13 B. 474 41 45 64 ~9 26 9 8 34 17 8 50 17 Per cent 84.4 60.7 61.9 48.1 83.2 87.3 19.8 9.8 14.0 30.1 1.3 C. 4.0 4.7 3.1 7.3 3.3 3.0 1.0 1.0 3.9 1.9 1.0 3.7 1.9 2 2b O.D. O.D. Cases 64 304 286 357 91 95 110 57 13 Per cent 8.0 34.5 42 32.5 40.6 10.4 10.3 10.8 12.3 6.5 1.3 54.0 3 Cases 61 49 8 17 31 Per cent 7.6 4.8 5.6 0.9 1.5 1.9 3.5 I.R.C. I.R. Anaemic V V O.D. Cases 48 35 2 34 7 3 Per cent 3.3 4.0 0.2 3.9 0.8 0.3 O.D. O.D. Cases 9 3 Per cent 1.0 0.3 GIRLS Number Examined, 759. 1 M.B. S. A- 1.735 Cases 584 507 496 369 688 687 108 40 80 201 10 B. 442 17 21 27 23 27 6 4 20 7 3 15 14 Per cent 83.5 66.8 65.4 48.6 90.6 90.3 14.2 5.3 10.5 26.5 1.3 C. 3.9 2.2 2.8 3.6 3.0 3.6 0.8 0.b 2.6 0.9 0.4 2.0 1.8 2 2b O.D. O.D. Cases 60 243 244 322 68 68 82 41 6 66 Per cent 8.6 32.0 32.1 42.4 8.7 9.1 9.1 10.8 5.4 0.8 58.2 3 Cases 55 9 19 2 3 4 18 Per cent. 7.9 1.2 2.3 0.3 0.3 0.4 2.4 I.R.C I.R. V. V. 14 20 134 4 Per cent 1.8 2.6 17.7 0.4 O.D. O.D. Cases 5 12 Per cent 0.6 1.6 For Symbols and Abbreviations used in this Table, see Table on page 41. VI RESULTS OF EXAMINATION OF CHILDREN AT SPECIFIED AGES.—Children Aged 7 Years. BOYS—Number Examined, 1,199. Degree. Ref. No. of Note Attendance. Clothing. Footgear. Nutrition. Cleanliness of Skin and Head. Do. Body. Mental Condition. Vision—R. Do. —L. Tonsils. Nose and Throat. Adenoids. Submax. and Cervical Glands External Eye Disease. Temp. Teeth defeet. No., & No. of Children affected. Perm, leeth defect No.. tV No. of -Children affected. Ear Disease. Hearing. Speech. Heart and Circulatory. Lungs. Nervous Diseases. Tuberculosis. Rickets. Deformities, Spinal Dis., etc. Infectious and Contagious Dis. Other defects. Tuberculosis in ! Family. 4 6 9 10 18 14 12 13 11 13 16 17 20 21 22 23 24 25 26 27 1 A. R. M.B. S. A. 3,962 A. 12.S Cases 983 721 773 441 1,038 1,006 759 686 676 679 232 116 222 306 12 B. 867 B. 64 30 47 61 43 35 18 13 36 27 5 49 37 Per cent 82.8 60.1 64.5 36.8 86.6 83.9 63.3 57.2 37.4 57.6 19.3 9.7 18.5 23.5 1.0 C. 4.6 C. 2.0 2.3 4.0 3.1 3.6 2.9 1.3 l.1 3.0 2.3 0.4 4.1 3.1 2 2b O.D. O.D. Combined B Cases 137 429 351 580 146 175 381 439 438 442 138 114 18 898 Per cent. 11.5 35.8 29.3 18.4 13.3 12.2 14.6 31.8 36.6 37.2 37.5 11.5 9.5 1.3 74.9 3 Cases 68 18 15 18 59 64 57 46 Per cent. 5.7 4.1 6.2 1.3 1.2 1.3 4.9 6.2 5.4 4.9 3.8 I.R.C. I.R. V. I V. O D Cases 33 9 4 Per cent 8.3 6.1 2.8 0.8 0.3 O.D. O.D. 18 Per cent 1.5 0.8 GIRLS—Number Examined, 1,200. 1 M.B. S. A. 3,629 A. 117 Cases 972 825 821 504 1.073 1.078 824 785 658 656 235 73 161 274 6 B. S52 B. 4i 33 28 43 32 7 * 21 ??, 5 27 36 Per cent 82.0 68.8 68.4 42.0 89.4 89.8 68.7 65.4 56.0 35.8 19.6 6.1 13.4 22.8 0.5 C. 4.3 C. 2.4 3.4 2.7 2.3 3.6 2.7 0.6 0.5 1.7 1.7 0.4 2.2 3.0 2 O.D. O.D. Combined B Cases 147 346 337 554 109 106 342 375 456 455 124 74 29 873 Per cent 12.4 28.8 28.1 46.2 11.4 9.1 8.8 28.5 31.3 38.8 38.7 10.3 6.2 2.4 72.7 3 Cases 66 29 42 18 16 34 40 61 64 31 Per cent 5.6 2.4 3.5 0.4 1.5 1.4 2.8 3.3 5.2 5.5 2.6 I.R.C I.R. V. V. I O.D. Cases 39 1 37 3i5 11 1 Per cent 3.2 3.1 26.2 0.9 0.1 O.D. O.D. Cases 9 Per cent 0.7 0.2 For Symbols and Abbreviations used in this Table, see Table on page 41. Si RESULTS OF EXAMINATION OF CHILDREN AT SPECIFIED AGES.-Children Aged 10 Years. BOYS—Number Examined, 926. Degree. Ref. No. of Note Attendance. Clothing. Footgear. Nutrition. Cleanliness of Skin and Head. Do. Body. Mental Condition. Vision—R. Do. —L. Tonsils. Nose and Throat. Adenoids. Subm.ix. and Cervical Glands External Eye Disease. Temp. Teeth de feet. No., & No. of Children affected. Perm, leetn cte feet No., & No. of Children affected. Ear Disease. Hearing. Speech. Heart and Circulatory. Lungs. Nervous Diseases. Tuberculosis. Rickets. Deformities, Spinal Dis., etc. Infectious and Contagious Dis. Other defects. Tuberculosis in Family. 4 6 9 1 10 13 14 12 13 11 13 1 16 17 20 21 22 23 24 25 26 27 1 A. R. M.B. S. A. 1.426 A. 490 Cases 846 555 627 319 840 821 629 591 5^9 582 135 64 81 193 H B. 433 B. 199 20 44 48 •>4 26 18 11 28 26 2 26 20 Per cent 91.6 59.9 67.7 34.4 90.7 88.6 67.9 63.8 63.8 63.0 14.6 6.9 8.7 20.8 1.5 C 3.3 C. 2.5 2.2 4.8 5.2 5.8 2.8 1.9 1.2 3.0 2.8 0.2 2.8 2.2 2 2b OD. O.D. Combined B. Cases 55 334 252 481 73 96 257 292 260 249 78 123 14 116 586 Per cent 5.9 36.1 27.2 52.2 12.5 7.9 10.4 27.8 31.3 28.1 26.9 8.4 13.3 1.5 63.3 3 Cases 23 37 47 8 13 9 40 43 75 93 21 Per cent. 2.5 4.0 5.1 0.9 1.4 1.0 4.3 4.7 8.1 10.1 2.3 I.R.C. R.I. V. V. O.D Cases 119 62 38 10 1 Per cent 12.9 6.7 4.1 1.1 0.1 O.D. O.D. Cases 21 2 Per cent 2.3 0.2 GIRLS—Number Examined, 995. 1 M.B. S. A. 1.331 A. 612 Cases 823 671 667 496 924 930 573 539 545 523 138 50 87 195 7 B. 470 B. 264 17 47. 30 44 11 17 6 17 6 21 3i Per cent 83.5 67.4 67.0 49.8 92.9 93.5 57.6 54.2 54.9 32.7 13.9 5.9 8.7 19.6 0.7 C. 2 .8 C. 2.3 1.7 4.7 3.0 4.4 1.2 1.7 0.5 0.6 1.7 0.b 2.1 3.1 2 2b O.D. O.D 308 291 61 Combined B. 81 628 Per cent 11.9 31.0 29.3 41.1 8.1 6.7 6.1 37.7 40.8 35.3 37.0 10.3 5.3 1.5 63.1 3 Cases 46 16 37 9 4 4 47 50 97 102 27 Per cent 4.6 1.6 3.7 1.0 0.4 0.4 4.7 5.0 9.8 10.3 2.7 I.R.C I.R. Anaamic V. V. 28 1 1 275 8 Per cent 2.8 2.7 1.0 27.6 0.8 O.D. Cases 9 Per cent 0.9 For Symbols and Abbreviations used in this Table, see Table on page 41. 91 RESULTS OF EXAMINATION OF CHILDREN AT SPECIFIED AGES.—Children Aged 13 Years. BOYS Number Examined, 912. Degree. Ref. No. of Note Attendance. Clothing. Footgear. Nutrition. Cleanliness of Skin and Head. Do. Body. Mental Condition. Vision—R. Do. —L. Tonsils. Nose and Throat. Adenoids. Submax. and Cervical Glands External Eye Disease. Temp. Teeth defect. No., & No. of Children affected. Perm. Teeth defect No., & No. of Children affected. Ear Disease. Hearing. Speech. Heart and Circulatory. Lungs. Nervous Diseases. Tuberculosis. Rickets. Deformities, Spinal Dis., etc. Infectious and Contaeious Dis. Other defects. Tuberculosis in Family. 4 6 9 10 18 14 12 13 11 13 16 17 20 21 22 23 24 23 26 27 1 A R M.B. S. A. 489 A. 835 Cases 820 622 671 427 836 823 655 622 649 627 144 49 60 164 4 B. 204 B. 342 20 43 40 60 20 24 8 17 15 7 25 29 Percen 90.3 68.2 73.6 46.8 91.6 90.2 71.8 68.2 71.3 69.0 15.8 3.4 6.6 18.0 0.4 C. 2.4 C. 2.4 2.2 4.7 5.4 6.6 2.2 2.6 0.9 1.9 1.6 0.8 2.7 3.2 2 2b O.D. O.D. Cases 54 260 203 389 68 82 231 253 187 191 89 117 17 Combined B 90 5.8 Percent 6.0 28.5 22.2 42.6 9.9 7.5 9.0 25.3 27.7 20.6 74 21.0 92 9-8 12-8 1-9 56.8 3 Cases 34 30 38 6 8 7 26 37 17 Per cent 3.7 3.3 4.2 0.7 0.9 0.8 2.9 1.1 8.1 10.0 1.9 I.R.C. I.R. Anaemic V. V. Cases 129 69 4 25 8 Per cent 14.1 7.6 0.4 2.7 0.9 O.D. O.D. Cases 23 4 Per cent 2.8 0.4 GIRLS—Number Examined, 883. 1 M.B. S. A. 470 A. 870 Cases 698 623 646 446 827 827 529 489 474 441 135 51 72 108 8 B. 1,4 B. 355 6 38 17 40 20 9 4 1 11 3 25 23 Per cent 79.2 70.6 73.2 50.5 93.6 93.6 59.9 55.4 54.5 30.7 15.3 5.8 8.1 12.2 0.9 C. 2.4 C. 2.3 0.7 4.3 2.0 3.3 2.3 1.0 0.3 0.1 1.2 0.3 2.8 2.6 2 2b O.D. O.D. Cases HI 244 212 379 51 51 316 333 290 321 71 40 6 Combined B 521 Per cent 126 27.6 24.0 42.9 5.8 5.8 5.8 35.8 37.7 33.3 36.9 8.0 4.3 0.7 59.0 3 Cases 72 16 25 7 5 5 38 61 106 108 16 Per cent 8.2 1.8 2.8 0.8 0.6 0.6 4.3 6.9 12.2 12.4 1.8 I.R.C. I.R. V. V. Cases 36 37 264 1 Per cent. 4.1 4.2 29.9 0.1 O.D. Per cent. 1.3 For Symbols and Abbreviations used in this Table, see Table on page 41. 7 GENERAL RESULTS OF MEDICAL INSPECTION. DIRT AND VERMIN. Not unexpectedly one of the first results of medical inspection was to brings into prominence the prevalence of dirty and verminous conditions among the children. A few of the public elementary schools in Willesden would probably rank among the cleanest and freest from vermin of any such schools in the kingdom, and, take them altogether, they are certainly not worse in this respect than the general run of schools administered by Local Education Authorities. Having said this, it remains to say that the condition of the heads and persons of children attending your public elementary schools as ascertained by medical inspection was deplorable. It was found that the girls were verminous to a much larger extent than the boys, and, taking the results for all the schools throughout the district, no fewer than 27 per cent, of all the girls examined were found to be harbouring vermin. The earlier examinations showed results much worse than this, for, owing to the publicity given to the disgraceful conditions discovered, and to the efforts made to secure improvement, great amelioration of the condition was effected before the end of the year reported on. At one of the schools, the Assistant School Medical Officer, Dr. Granger Evans, examined the head of every child in the school, and as a result it was ascertained that no fewer than 63 per cent, of the girls were infested with vermin. Impressed with the serious extent of the evil, and with the need for securing an elementary and decent degree of cleanliness in schools where compulsory attendance is for a large number of children the only alternative, I seized the opportunity afforded by the summer vacation of circularising the parents with a view to securing their co-operation in eradicating the evil. 18 The issue of this circular, in which was advocated the common-sense practice among school children of keeping the hair short, irrespective of sex, attracted a considerable amount of public attention, and in consequence was instrumental less perhaps in effecting a change in custom in respect of girls' hair than in quickening the public conscience as to the disgraceful prevalence of the evil and the need for remedy. At all events, a marked improvement followed upon the agitation which was aroused. I fear, however, that there is little chance of securing anything like permanent freedom from vermin a^iong school children until the prevailing fashion of children of the female sex wearing long hair is recognised as ill-adapted to the existing conditions of school life. Were the custom of wearing short hair during school life universally to prevail it would be possible in a very short time absolutely to eradicate vermin from our schools. THE HYGIENE OF THE SKIN. SCHOOL SHOWER BATHS. There is probably no better educational influence than the systematic and routine cleansing of the body. Unfortunately for large numbers of the children attending public elementary schools in Willesden this is at present impracticable. In a special Report made to the School Management Committee on this subject I wrote as follows:— "School shower baths are much less costly to provide than public baths; they may, if desired, be made to subserve all the purposes of public baths so far as public provision for cleansing is concerned, and they supply not only a pressing need of the school child but an instrument of education in one of the most important although one of the most rudimentary conditions of civilised life, namely in cleanliness. It is a deplorable fact that the great majority of the houses of the working classes are unprovided with 19 baths or any adequate means by which the cleansing of the skin can be effected; it may be considered even more deplorable that, in many houses in which they have been installed, they are used for quite other purposes than those for which they are intended, and are not at all or rarely used for bathing. "You cannot teach an old dog new tricks, and people who all their lives have been without the means of cleansing their bodies and have acquired the habit of a dirty skin, can hardly be expected to change a life-long custom merely because the opportunity occurs. "If people so unfortunately situated are to become cleanly in person it must be by means of a practical education commencing in childhood; and for a large number of children nowhere, and by no means can this be accomplished save at the school. 'I'o instil in the rising generation the virtue of cleanliness in such a manner that it becomes a habit would be an accomplishment greater in its moral and humanising effects than any particular achievement of our educational system. " However unpalatable the fact may be it has to be recognised that a very large number of people, through no fault that can properly be accredited to them, are dirty in their habits and persons, and every medical man knows that in this, more than in any other particular condition, lies the cause of a vast amount of disease and a hopeless bar to its remedy. " School shower baths should be supplied with hot and cold water. They should preferably be in sufficient number to enable a whole class of either boys or girls to be bathed simultaneously. Ry this means a whole school may be bathed regularly not less than once a week without dislocation of school work. It is estimated that half-an-hour is ample time in which to bath a class, where sufficient number of shower baths is provided. The bathing may very properly take the place of physical exercise on the occasion on which it is given. Soap and towels and the supervision of the teacher are necessary. It follows that where ample A 20 provision is made the shower baths of one school may be used as a centre available for other schools in the neighbourhood by a careful adjustment of the time table. Moreover, the Committee might well consider whether bathing facilities might not be afforded out of school hours to that section of the public which stands in need of some public provision of this kind. By so doing, the scheme might be made partly self-supporting." I wish to re-affirm the opinions expressed in this Report. I can conceive no more important item in the equipment of the school building than the school shower bath. The moral and physical benefit of a systematic education in personal cleanliness will rival among the poorer and dirtier of the children almost any of the benefits which the present measure of their education confers. I venture to hope that the Local Education Authority will take the matter into consideration at an early date. DEGREE OF UNIFORMITY ATTAINED IN MEDICAL INSPECTION. In the tables will be found summaries of the results of medical inspection respectively of boys and of girls. For the most part the same Medical Officer has not examined both girls and boys, and a comparison of the percentage of defects found under each heading of the Board's Schedule may thus be taken as in some degree a measure of the uniformity of standard to which the Assistant Medical Officers have as a whole attained. One item which I have abstracted from the medical inspection cards, and in respect of which there can be no question of variation due to differences of sex, is that of children giving a family history of tuberculosis. In the case of boys, the recorded observations of the Assistant School Medical Officers in which this history was elicited amount to 2.6 per cent, of all the bovs examined, in the case or girls 2.8 per cent. This figure is certainly low, and it may be objected as a measure of the standard of 21 formity that the fact recorded is one not dependent upon the direct observation of the Medical Officer; but while this is so it does show that for the same kind of observation there is a very close approximation of results in records which, if correctly noted should so approximate. The same conclusion is suggested by consideration of another result which is dependent upon the direct observation of the examining officer, namely, that of the relative number of defective teeth in mouths harbouring teeth not wholly sound. There is no reason to suppose that in this respect girls are better or worse than boys. Taking the total number of decayed teeth found and dividing them by the number of children found to be the possessors of such undesirable defects, we find that they average for each child affected 3.8 temporary teeth and 2.4 permanent teeth. For boys the figures are respectively 3.9 and 2.5; for girls 3.7 and 2.3. Such insignificant differences in the results of two sets of arbitrarily selected examining officers, where only minor differences in the actual results are reasonably to be expected, are reassuring when considering the reliability of the records in respect of uniformity of standard. There can, of course, be no question that absolute uniformity of standard is unattainable. Even the same observer will differ from time to time in his estimate of the degree of minor departures from the normal, and no two men are likely to attain, even in standardised observations, exact agreement. But I think that, taken as a whole, the returns of the Assistant School Medical Officers may be said to reflect fairly accurately average medical opinion as to the degree and extent of abnormalities and diseases to be found among school children, and this is perhaps for practical purposes more valuable than the more uniformly exact observations and specialised opinion of an expert exclusively devoted to pedagogic medicine. In speaking of the general results of medical inspection, I shall assume, then, that the errors of the personal equation are neutralised in the aggregate, and that, in the general results, we are dealing with as reliable data as A 2 22 may, under the circumstances, reasonably be expected in investigating the physical condition of the children attending public elementary schools. It would at the same time be incorrect not to notice that while the averaged results may as a whole be thus regarded, there are in some few instances wide departures from the general standard in the observation, or lack of observation, of particular officers. It is difficult to believe, for instance, that while for all the children examined affections of the heart and circulatory system amount to only 4.7 per cent., this same class of affections should in the boys' department of an otherwise healthy school rise to 38 per cent, of all the boys examined, or that affections of the nervous system chiefly of one form should in the same department of boys amount to 10 per cent, of all the boys examined, when the combined observations of all the Medical Officers have succeeded in discovering something less than one and a half per cent, of all the children exhibiting evidence of this class of disease. This is by far the most marked aberrance I have been able to discover in the comparative results of the different Medical Officers on what I may call the positive side, but on the side of omission there are instances quite as marked. These occur chiefly in respect of affections of the nose and throat, the presence or suspected presence of adenoids, and the existence of enlarged cervical or submaxillary glands. They are obviously instances of failure to record abnormalities which careful observation could scarcely fail to have discovered. In a few cases enlargement of the lymphatic glands have in no instance been recorded, in others no mouth breathers have been detected and adenoids have remained wholly unsuspected. It is clear from what I have said that the standardisation of what by consensus of opinion is the normal state, and of the degree of departure from this which is to be accepted as pathological, and so to be recorded, still leaves much to be desired. 23 A careful consideration of all the facts, however, leaves me unshaken in the view that the main general results are a reliable expression of average medical opinion on the conditions recorded. The anomalies to which I have referred are so exceptional as to leave the general soundness of the results but little affected. To speak figuratively, a strange team has been employed to do work in which uniform results are to be desired. 1 he pulling on the whole has been good, and the progress measured in the gross results is not less certain because here and there one of the team has fallen out of step or on occasion ceased to pull. With further experience I do not doubt the discipline will improve, and the flaws and blemishes that mar the first essays will disappear. HEALTHINESS OF WILLESDEN CHILDREN. Most of the Assistant School Medical Officers have expressed themselves as struck with the general healthiness and good physical condition of the children, and with the comparative absence of serious disease among them. I do not doubt when comparison with the results in other towns is possible, that Willesden children will take a place accordant with what available comparative vital statistics would lead one to expect, namely, one high in the scale that measures the national health. Willesden has few slums, and although for the greater part it consists of a better working class population, it is one living on the whole under satisfactory sanitary conditions. Nevertheless, the tale told by the results of medical inspection is not so rosy or by any means so satisfactory as the recurring examination of a large number of healthy children must naturally suggest to the observer. Apart from the acute diseases of childhood, in the discovery of which systematic medical inspection can play but an insignificant part, the affections of childhood are chiefly of an incipient character. They are on this account of more importance from the point of view of preventive medicine than the grosser lesions, which are past repair. 24 DEFECTS AND DISEASES. That in something fewer than 11,000 inspections over 21,000 defective temporary, and more than 4,000 decayed permanent teeth should be found, is an appalling revelation to those who understand the significance of this widespread unsoundness of a particular tissue in reference to permanent bodily health and sound, resistant physical structure. About 2.5 per cent, of the children examined were found to be suffering from inflammatory affections of the ear, mostly of a chronic character, while between 4 and 5 per cent, in addition suffered from defective hearing. Over 12 per cent, were diagnosed or suspected of suffering from adenoids, while nearly one-third were found to have in greater or less degree enlargement of the tonsils, and about onefourth to possess enlarged submaxillary or cervical glands. These for the most part are affections in themselves not of a deadly character, but their neglect means a vast amount of physical and even mental incapacity, and in later life a crippling of efficiency which, reduced to terms of mere earning capacity, may safely be said immeasurably to outweigh the immediate cost of remedying the conditions. That about 7 per cent, of the children are mouth breathers may not sound very formidable, but the part which this habit plays in the more serious diseases of later life makes its removal a matter of medical and educational concern of no insignificant moment. The large proportion of children shown in the tables to be suffering from seriously defective vision, can barely have affected our mortality rates, by which the public health has hitherto been mainly judged, but if the public could realise the personal loss and suffering entailed by, but not necessarily ascribed to these remediable defects, it would not be permitted that the cruel injustice of their neglect should continue. When we turn to affections of the more vital organs, classified under columns Nos. 20-27 of the Board's Schedule—see tables—the proportion of 25 children affected is small, it is true, but by no means insignificant. Many of the conditions recorded, moreover, fortunately represent the effects of arrested disease. But all may be said to call for a modified regime in the life of the child, a regime most fittingly introduced as part of and integral to its educational routine. BOYS AND GIRLS CONTRASTED. Contrasting the results of inspection of boys and of girls, it is to be observed that girls are better clothed and shod, better nourished, and, apart from the harbouring of vermin, cleaner in person and clothing than are boys. With the exception of defects of vision, and of affections of the heart and lungs, girls come out better than boys in respect of every item of the Board's Schedule. Doubtless in these facts is to be found an explanation, in part at least, of the higher mortality among boys than among girls. Girls are the objects of a more fostering care. Better clothed, cleaned and nourished, they are less exposed to the agencies destructive of health and life than are boys who, where the struggle for life is keenest, or at least more primitive, must naturally make shift. It is well that chivalry should show at the more primal levels of human effort. If medical inspection at its inception in Willesden has revealed much that is satisfactory, it has also exhibited more than enough, not only to justify itself, but to demonstrate the imperative necessity of the measure as an essential and urgently needed step in the protection of the national health. To prate about it as a " doctor's fad " will not be possible to those who study the mere bald facts in which it issues. With a little imaginative understanding of these facts they will be seen to range themselves among those intrusive phenomena to ignore the significance of which is impossible in any sane endeavour at social amelioration or rational attempt to improve the public health. 26 METHODS EMPLOYED FOR SECURING TREATMENT OF THE DEFECTS. Where the parents themselves attended the medical inspection of their children, the Assistant School Medical Officers personally instructed the parents as to the need for having the defects discovered attended to. This is not the least valuable result of the attendance of the parents at the schools; the interview with the Medical Officer is an occasion on which the parent can be impressed with the importance of following the instructions which the condition of the child's health dictates. Should the examining Medical Officer consider it desirable that the School Nurse should visit the house of the child, or in any case should he deem the case one calling for the exclusion of the child from school, intimation of the name, age and address of the child, the disease and period of exclusion, is made to the School Medical Officer on a small card known as the Health Visitor's Card. All such cases are made the subject of domiciliary visits by the Lady Health Visitors, the importance of securing medical treatment of the condition is urged where necessary upon the parents, and supervision of the extent to which the treatment recommended by the doctor or hospital is carried out, is exercised until the child is well enough to return to school. The following table summarises the main results of this work during the year. It conveys but a poor impression, however, of the nature and character of the work. The administrative measures alone arising out of this work involve an immense amount of time and trouble. Each case is the subject of systematic record and report. Many of the cases involve frequent and continued re-visiting, and are the occasion of a great variety of communications with numerous institutions and agencies, the more frequently recurring of which have been reduced to suitable forms issued from the office of the Health Department. 27 Cases dealt with as a result of reference from Assistant School Medical Officers of children suitable for domiciliary visitation by the Lady Health Visitors, 1909. Condition needing attention. Number notified on H V. Card. Number Visited. Number Receiving Treatment at First Visit. Number Receiving Treatment as a direct result of Visiting. Number untreated at end of year. No. on Med. In. Schedule. Medical. Domestic. Medical. Domestic. 9 Nutrition 2 2 — 1 1 — 10 Vermin and want of cleanliness 407 407 1 112 2 285 7 11 Teeth 17 17 5 — 8 — 4 12 Nose & Throat 134 134 11 — 80 — 43 13 Eyes 47 63 10 6 35 6 6 14 Vision 71 27 2 — 19 — 6 15 Ear discharge 5 20 3 1 10 5 1 16 Hearing 1 1 — — 1 — — 18 Mental condition 8 8 - - 3 - 20 Heart 4 6 3 — 1 1 1 21 Lungs 5 6 4 — 2 — — 22 Nervous disorders 3 3 2 1 23 Tuberculosis 16 16 7 — 9 — — 25 Deformities 10 10 3 — 3 — 4 26 Infectious and contagious diseases 286 307 45 84 130 43 5 27 Other defects 12 20 9 3 7 - 1 Totals 978 *1047 103 207 3i3 340 79 *The number visited, it will be observed, slightly exceeds the number notified. This is accounted for by the fact that some cases not notified by the A.S.M.O. were, judged by the returns on the medical inspection card, deemed to be cases calling for home visits by the School Nurse. It will be observed that, after deducting cases of verminous and uncleanly conditions, 27 per cent, of the total cases notified by the Assistant School Medical Officers received no medical treatment. This is a very much smaller proportion of untreated cases of illness than has been found in cases of sickness occurring among school children coming to knowledge otherwise than by intimation from the A.S.M.O. (See Tables). PRECAUTIONS FOR PREVENTING THE SPREAD OF INFECTIOUS DISEASES. A number of the cases thus dealt with are brought to notice by intimations from the Head Teachers made on the Teacher's Notification Card. These are cases of infectious disease coming 28 to the knowledge of the teacher either as affecting the scholars or other children in the homes from which the scholars come. Further details relating to these cases will be found in Tables on pages 29 and 30, and in the tables issued in the quarterly statistics appended. It is one of the great advantages of the system of medical inspection adopted that each department of each school is visited once a week by a medical man to whom questions of readmission or continued exclusion from school may be referred in respect of children whose condition raises these questions. This system of notification by teachers and Attendance Officers of cases or infectious disease occuring among scholars has been in operation since 1903, and has proved of the utmost value in controlling the spread of these diseases. The tables show the number of cases coming to knowledge in this way. 6? NON-NOTIFIABLE INFECTIOUS DISEASES—-INTIMATED FROM THE SCHOOLS. Number of Cases for year ended December 31st, 1909. Disease. Visited. Suffering. Con tacts. Re-visited. Suffering upon re-visit. Doctor in attendance. Isolated. Total No. Suffering. H.T. S.M.O. H.T., S.M.O. H.T. S.M.O. H.T. S.M.O H.T. S.M.O. H.T. S.M.O, H.T. S.M.O. H.T. S.M.O. Measles 713 1 1026 4 2556 5 590 1 415 — 803 — 409 3 1441 4 German Measles 31 — 80 — 225 — 51 — 25 — 55 — 29 — 105 — Whooping Cough 468 27 758 27 1172 25 214 5 110 11 411 10 144 3 868 38 Mumps 152 13 112 14 - — 6 — — — 46 2 31 4 112 14 Chicken Pox 300 2 283 2 - - - - - - 77 1 92 2 283 2 Ringworm 253 97 286 109 - — 176 117 — — 128 30 125 53 286 109 Consumption 6 15 6 15 - — 2 9 — — 6 12 1 2 6 15 Influenza 30 — 34 - - — 1 — — — 19 - 1 — 34 — Coughs and Colds 82 5 87 5 - — 16 2 4 — 22 3 3 — 87 5 Other Diseases 443 577 545 584 - - 205 399 - - 137 70 78 54 400 584 Totals 2478 737 3217 760 3953 30 1261 533 554 11 1704 128 913 121 3622 771 H.T.—F igures in these columns represent cases notified by the Head Teachers. S.M.O.—Figures in these columns represent cases notified by the Assistant School Medical Officers. 30 Number of Medical Inspections Completed, and Infectious and Contagious Diseases Notified from Public Elementary Schools during 1909 :— NAME OF SCHOOL (Provided). No. ot Medical Inspections completed. No. of Cases of Illness primarily visited. Infectious and Contagious Diseases notified as occurring among Scholars attending Public Elementary Schools. Scarlet Fever. Diphtheria. Measles. Whooping Cough. Mumps. Chicken-pox. Other Non-notifiable Infectious Diseases. Ringworm. Ophthalmia. Other Contagious Diseases Acton Lane Mixed 395 34 ... 2 10 2 4 8 ... 2 ... 9 Do Infants 31 3 3 5 2 1 11 ... 3 ... 9 Cambridge Road (Temp.) 94 9 2 ... 2 2 1 1 ... 1 ... ... Chamberlayne Wood ... ... Road Boys & Girls 383 160 8 ... 60 6 21 13 20 5 ... ... Do Infants 232 7 1 131 20 15 21 5 7 ... 5 Dudden Mill Boys & Girls 311 26 9 3 5 1 1 5 ... 1 ... ... Do Infants 250 125 18 2 40 8 ... 13 ... 14 ... 16 Furness Road Mixed 379 113 11 3 24 4 8 20 5 18 ... 20 Do. Infants 267 93 12 2 30 6 1 ... 1 2 ... 6 Granville Road Special ... 4 ... ... 2 ... ... ... ... 1 ... 2 Gibbons Road Mixed 392 142 4 3 42 7 7 19 ... 3 ... 8 Do. Infants 275 144 3 5 20 11 5 23 ... 2 ... 17 Kcnsal Rise Boys & Girls 382 26 10 ... 10 ... 3 ... ... 5 ... ... Do Infants 190 181 11 2 22 44 49 9 5 29 ... 19 Kilburn Park Road Girls 139 30 5 1 5 ... 5 2 ... 1 ... 13 Do. Infants 49 ... ... 31 ... 2 3 ... 2 ... 15 Leopold Road Boys & Girls 432 161 2 2 87 8 2 7 1 8 ... 16 Do. Infants 429 282 7 1 111 59 ... 9 1 14 ... 18 Do. Special ... 6 ... ... 5 ... ... ... ... ... ... 1 Lower Place ... Boys & Girls 123 73 4 1 5 1 ... 10 ... 6 ... 5 Disraeli Road Infants 86 66 5 1 8 5 1 18 ... 6 ... 4 Mora Road Boys & Girls 370 29 8 2 6 14 1 4 ... 1 ... 3 Do. Infants 102 13 ... 10 66 2 7 ... 1 ... 3 Oldfield Road Boys & Girls 274 99 3 1 41 2 3 2 ... 7 ... 2 Do Infants 316 102 10 1 51 5 ... 10 ... 2 ... 1 Pound Lane Mixed 392 43 11 5 15 1 1 1 ... 2 ... 6 Do Infants 111 11 4 27 21 21 8 ... 7 ... 12 Salusbury Road Mixed 330 56 32 ... 19 2 2 ... ... ... ... 1 Do. Infants 300 231 14 1 78 45 21 15 ... 20 ... 31 Stonebridge Boys & Girls 377 101 12 2 23 2 2 9 ... 5 ... 20 Do Infants 278 117 10 2 41 18 1 1 ... 10 ... 18 NON-PROVIDED SCHOOLS. Christ Church Boys & Girls 204 47 1 ... 18 ... 3 2 ... 1 ... 1 Do. Infants 70 1 2 41 9 14 18 ... 2 ... 8 Gordon Memorial Boys & Girls 610 45 9 ... ... 1 ... 1 ... ... ... 16 Do. Infants 33 13 1 6 3 ... 3 1 1 ... 3 Marlesden National Boys & Girls 236 26 4 8 ... ... 8 ... 2 ... 4 Do. Infants 72 1 2 19 3 ... 31 ... 4 ... 6 Harle-den R.C Mixed 153 51 ... 1 6 4 ... 1 ... 5 ... 2 Do. Infants 35 ... ... 7 7 ... ... ... 3 ... 1 Holy Trinity Boys & Girls 239 22 3 ... 3 ... 1 2 ... 4 ... ... Do Infants 23 6 2 ... 13 ... 1 ... ... ... ... Keble Memorial Boys & Girls 280 3 ... ... ... ... ... ... ... 1 ... ... Do.Infants 43 5 1 1 17 ... 11 ... 3 ... ... Neasden National Mixed 93 4 2 ... ... ... ... ... ... ... ... Do. Infants 6 ... ... 1 ... ... 16 ... 1 ... ... Princess Frederica Boys & Girls 573 111 3 ... 53 9 3 3 ... 4 ... 3 Do. Infants 142 1 3 58 21 17 12 ... 15 ... 7 St. Andrews Boys & Girls 211 19 2 7 14 ... 1 ... ... 1 ... 1 Do. Infants 147 92 3 2 45 2 ... 19 ... 3 ... 4 St. Johns Boys & Girls 339 88 ... ... ... ... ... 2 ... ... ... ... Do Infants 149 21 7 2 2 4 ... 3 ... 1 ... 1 St. Mary's, W'sden. Boys&Giris 273 31 4 1 3 1 1 ... ... 3 4 12 Do. Infants 26 1 ... 2 8 ... 1 ... 2 ... 1 St. Mary's R.C Mixed 214 25 ... ... 2 1 ... 1 1 1 ... ... Do. Infants 44 7 1 3 8 ... 2 ... ... ... ... Schools outside Willesden ... 160 72 8 54 34 8 7 ... 8 1 2 Totals 10,885 4,17 386 87 1,312 507 228 393 40 250 18 352 31 I have submitted a draft of new regulations amending those at present in operation, but although experience has shown the desirability of effecting the changes indicated in the draft, the Regulations Committee to which they were referred has not yet dealt with them. The presence in the schools of the Assistant School Medical Officers provides an additional safeguard in the control of communicable diseases. Intimation is sent to the Assistant Medical Officer of the school department affected of all cases of infectious disease occurring among the children in the department to which he is attached. The intimation gives the data on which to base appropriate action. Thus, when a child has attended school subsequently to the onset of infectious illness, the Assistant School Medical Officer knows when to expect, having regard to the incubative period of the disease, the occurrence of other cases in the affected class, and the presence in the school of a medical man under these circumstances is invaluable. It has been found necessary to close the infants' departments of the following schools during the course of the year to prevent the spread of measles. Schools closed during year 1909 with a view to preventing spread of disease. Name of School. Dept. Date closed, from Re-open. Reason for Closure. Gibbons Road Infants Feb. 15 March 2 Outbreak of Measles Gibbons Road ,, April 2 April 9 ,, Chamberlayne Wood Road ,, Feb 26 March 15 ,, ,, ,, ,, April 2 April 9 ,, All Souls ,, March 18 ,, 9 ,, ,, ,, ,, Sept. 30 Oct. 18 ,, Dudden Hill ,, March 18 April 9 ,, Lower Place ,, ,, 19 March 29 ,, Kensal Rise ,, ,, 27 April 9 ,, Pound Lane ,, April 2 ,, ,, Mora Road ,, ,, ,, ,, Princess Frederica ,, ,, ,, ,, Keble Memorial ,, Oct. 25 Nov. 1 ,, 32 METHODS FOR DEALING WITH BLIND, DEAF, MENTALLY OR PHYSICALLY DEFECTIVE CHILDREN UNDER THE ACTS OF 1893 and 1899. There are three special schools in the district, one for physically and two for mentally defective children. Two Medical Officers have been appointed, but their relationship to the School Medical Officer has not yet been determined. There is need for this work being co-ordinated with the rest of the work relating to school hygiene, and I venture to hope the Education Committee will give this question their early attention. ANTHROPOLOGICAL INVESTIGATIONS. Dr. Thomas Smurthwaite has carried out at Chamberlayne Wood Road School a series of anthropological investigations, with the results of which he has kindly furnished me, together with copious notes, reports, diagrams, and photographs. I can only summarise the results, which are a valuable instalment of a survey which, could it be carried out so as to be representative of all the school children in the district, would form an interesting contribution to our knowledge of the physical characteristics which are so important an element in the health of our population. Dr. Smurthwaite is an enthusiastic and well-known worker in Anthropology, and I merely reproduce in condensed form the methods and results of his investigation. In the diagram are shown the different shapes of head and face on which the classification into six racial types is based, and the brief description below renders their identification easy. LONG-HEADED TYPES. Irerian.—The Iberian facial contour is oval, egg-shaped, or somewhat lozenge-shaped ; the contour of skull oval. Teutonic.—The Teutonic facial contour is oblong, or kev-stone shaped ; the skull contour oblong. 33 BROAD-HEADED TYPES. Remian.—Facial contour conical, pear-shaped, or wedge-shaped; skull contour somewhat pear-shaped. Ligurian.—Facial contour pentagonal or five-pointed; skull contour pentagonal. Magian.—Facial contour round, or roundish; skull contour roundish. Celtic.—Facial contour square, or squarish; skull contour squarish. Dr. Smurthwaite observes:— " There is a remarkable difference between boys and girls in respect of the frequency of recurrence of the respective racial tvpes. 20(1 girls give fii Celtic, 35 Magian, 31 Iberian, 29 Ligurian, 28 Remian, and 22 Teutonic types respectively. Thus, more than one fourth of the girls are Celtic, and only one-tenth Teutonic. The prevailing type among the boys is Ligurian, of which there were 54 cases, or between one-third and one-fourth of the whole number, while of the remainder there were observed respectively 35 Celtic, 28 Iberian, 27 Magian, 25 Teutonic, and 24 Remian types. The following table shows these results for all children observed:— Racial Type. No. observed. Percentage of Total No. examined. Celtic 96 24.0 per cent Ligurian 83 20.8 ,, Magian 62 15.5 ,, Iberian 59 14.8 ,, Remian 52 13.0 ,, Teutonic 47 11.7 ,, 399 34 TABLE SHOWING RESULTS OF ANTHROPOMETRICAL OBSERVATIONS. BOYS. Racial Types. School Dept. Long. Medium. Broad. Total number Exd. Cephalic Index. No. Cephalic Index. No. Cephalic Index. No. Iberian Boys 70 to 75 13 76 to 79 5 80 I 28 Infants 72 ,, 75 6 76 ,,79 3 — — Teutonic .. Boys 71 „ 75 !4 76 ,, 79 2 80 I 25 Infants 71 ,, 75 6 76 ,, 79 2 — — Remian Boys 75 2 76 „ 79 5 80 to 87 8 24 Infants - — 76 ,, 79 4 80 „ 86 5 Ligurian Boys 73 ,, 75 3 76 ,, 79 '5 80 „ 83 4 54 Infants 70 ,, 75 4 76 ,, 79 15 80 „ 82 13 Magian Boys — 76 ,, 79 7 80 „ 86 4 27 Infants — — 76 ,, 79 6 80 „ 88 10 Celtic Boys — — 76 ,, 79 7 80 ,, 85 11 35 Infants 75 2 76 ,, 79 8 80 „ 84 7 Long 500 Medium 79 Broad.. 64 193 GIRLS. Racial Types. School Dept. Long. Medium. Broad. Total number Exd. Cephalic Index. No. Cephalic Index. No. Cephalic Index. No. Iberian Girls 71 to 75 9 76 to 79 8 80 to 84 6 31 Infants 73 to 75 4 76 ,, 79 4 — — Teutonic .. Girls 70 to 75 6 76 ,, 79 11 80 - 22 Infants 72 to 75 3 76 ,, 79 1 — 1 Remian Girls 75 2 76 „ 79 4 80 ,, 90 14 28 Infants - - 76 ,, 79 2 80 ,, 90 6 Ligurian Girls 70 to 75 5 76 ,, 79 5 80 ,,85 10 29 Infants - - 76 ,, 79 7 80 „ 83 2 Magian Girls - — 76 ,, 79 5 80 „ 85 17 35 Infants 74 1 76 ,, 79 3 80 „ 85 9 Celtic Girls — 76 ,, 79 20 80 ,, 88 22 61 Infants — — 76 ,, 79 9 81 „ 84 10 Long 30 Medium 79 Broad 97 206 35 MISCELLANEOUS WORK. During the year 70 teachers were medically examined by the School Medical Officer as to medical fitness for appointment. In addition to these, a number of tfuant children were certified foe admission to institutions to which they were committed by the magistrates, and a few persons were examined for minor staff appointments. METHODS AVAILABLE FOR THE TREATMENT OF DEFECTS. It is obvious that the chief value of medical inspection lies in remedying the defects found. Many of these defects are of minor character, and important chiefly because they are the earliest indications of incipient disease or weak points in the physical resistance to a disease which may later invade the tissues through the channel known to be exposed to possible attack. Against such risks unquestionably the best defence lies in the continuous presence and sustained attention of the school doctor. The modifications of regime to meet the peculiar requirements of particular cases can be secured where the Medical Officer is constantly revisiting his charge throughout the year, and in this the scheme which provides for weekly visits of the doctor to each department of a school, has manifest advantages. The actual treatment of cases, however, as distinguished from preventive supervision is not met or attempted to be met by the appointment of medical inspectors. Willesden is unprovided with any general hospitals or hospital out-departments. The provision for medical attendance is for the most part such as is embraced in an ample supply of general medical practitioners who in their private practices deal with the bulk of medical treatment in the district. There is, of course, the Poor Law provision, which is of the same essentially unsatisfactory character, inherent in the system, B 36 which the Report of Royal Commission has recently laid bare. There is a Cottage Hospital which is unprovided with an outdepartment. There are two Provident Dispensaries which might meet the needs of two relatively small areas in the district, and several private clubs. In addition to this the proximity of the London hospitals enables advantage to be taken of the facilities they afford, and they are used extensively for affections of the eye, operative and other cases. Nevertheless, the existing provision for medical treatment is hopelessly inadequate to meet the needs of the district. The tabulated results of investigation into cases of illness coming to knowledge during the last six years, and published in my Annual Reports, show that nearly one half of the cases of illness occurring among school children go untreated. The many thousands of cases investigated leave no doubt as to the size and seriousness of the problem. It is not that there is an insufficient supply of medical men on the one hand, or any limit to the number of possible patients on the other, that the skill and knowledge which is available is not utilised in the cure of the cases in which attention is so urgently needed. The anomaly lies in the lack of any organised provision. That such organised provision is an urgent necessity is becoming increasingly appreciated. That the problem will be solved, no one knowing the facts can doubt. It would be scandalous were so grave a situation to continue. It is perhaps fortunate that there are many competing schemes in the field to remedy the evil. But the evil is so much greater than has been or is appreciated that they do not receive the impetus to materialise that the urgency of the case demands. Pending statutory effect being given to the alternative .ecommendations of the Majority or Minority Reports of the Royal 37 Commission on the Poor Laws, several interesting experiments and suggestions claim attention. School Clinics have been suggested as an immediate solution of the problem of dealing with the defects discovered by medical inspection. Without pronouncing an opinion on their general utility I think that at the present time Willesden does not present a favourable field for the experiment. The Provident Dispensaries and the Public Medical Service which serves the eastern part of the district offer a more promising relief of our immediate necessities. It would perhaps be premature to enter into details of systems which, however appropriately they may lend themselves to local requirements, have not so far extended their operations so as to cover the whole of the district. As, however, it has been publicly announced that a neighbouring Local Education Authority is considering a scheme approved by the Hampstead Public Medical Service for the treatment of school children found at the statutory medical inspection to be defective, I think it desirable to call attention to the organisation in question. Section 13 Sub-section (b) of the Education (Administrative Provisions) Act, 1907, includes among the powers and duties of a Local Education Authority "the power to make such arrangements as may be sanctioned by the Board of Education for attending to the health and physical condition of the children educated in public elementary schools." Whether the Local Education Authority will avail themselves of this power to deal with a problem which the figures show to be of urgent importance, they must in their wisdom and with the facts before them decide. In considering the question, I think the agencies to which I have referred should receive attention, possessing as they do the approval of local organised medical opinion. B 2 38 HYGIENIC CONDITIONS OF SCHOOL BUILDINGS. The main facts relating to school buildings are given in detail in the tables. For the better understanding of the general character of the buildings I have classified them under six types, to one or other of which the respective schools generally conform. The sketch plans (single line, to scale) which the sanitary inspectors have kindly made for me from the data ascertained in the course of systematic inspection, will better illustrate my meaning than a lengthier description. I have selected from these sketch plans those of schools which may be taken as most typical of their class. Type I. The simplest form of school building consists of a single room, usually of oblong shape. Such a barn-like building in its purest form has the advantage of having its four walls exposed to the air, thus permitting of the most ample provision for lighting and through ventilation. On both educational and hygienic grounds it is found necessary, however, to subdivide the room for the purpose of separating the different classes in the school. This subdivision into rooms introduces difficulties of intercommunication, and so of supervision, while it fails in the case of glass or low partitions to remove the very grave defects which the single room imposes in respect of the direction of the source of light in relation to the position of the scholar. Practically all the schools classified as Type I. present examples of desks so arranged that the children sit with the light directly in front of them or coming directly from behind or from the right side, each of these faulty sources of direction being injurious to eyesight and the occasion of unnecessary fatigue. It is very important that these faulty positions of the desks should be rectified, and in many of the schools this could be done without any structural alterations whatever. 39 Type II. In schools of this class the principle of subdivision of the class rooms has been carried further than in schools of Type I. Instead of a single row of class rooms open on two sides to the outer air, the class rooms are arranged in a double row without special provision for intercommunication, so that one class room opens directly into another without posessing the advantage of windows opening on opposite sides of the room to the outer air. Type III. Schools classified as belonging to Type III. show an increase in complexity of school structure. Provision is made for separation of classes by subdivision into classrooms, and to facilitate intercommunication, they are arranged so as to open on to a common corridor. This permits of the removal of some of the chief objections to Types I. and II. Type IV. Schools of Type IV. differ from those of Type III. only in the fact that class rooms are arranged on either side of the common corridor. The main objection to this type of school building is that ventilation is obviously less perfectly provided for. The double row of class rooms is separated by a corridor which, at the best, can only open to the outer air at its extremities. Type V. Type V. may be looked upon as a modification of Type IV. The central corridor has become expanded into a central hall round which on two sides are ranged the class rooms. Here again the objection urged against Type IV. holds good. The ideal from the point of view of ventilation is to have the class room walls exposed on opposite sides to the open air. Not only with the increasing complexity of structure have the class rooms been reduced to having one wall only so exposed, but, as will be 40 seen, they now open directly into a central hall, which itself has throughout its length, no direct communication with the outer air. It will, of course, be appreciated that I am dealing here with specific objections to the respective types. The admirable manner in which, with increase in size and complexity, these schools have been designed to meet educational, administrative and general hygienic requirements is beyond praise fitting to this report. Type VI. Type VI. stands in relation to Type V. very much as Type III. does to Type IV. The evils of a central hall giving to class rooms ranged on either side have been mitigated by arranging for the windows of the hall to open throughout the length of one side directly to the outer air. % Types I. and II., III. and IV., V. and VI. respectively represent different stages of evolution in the necessarily increasing complexity and size of school buildings. In Types I. and II. the class rooms, if separated at all, intercommunicate directly; in Types III. and IV., intercommunication is secured by the provision of corridors giving access to the separate class rooms; in Types V. and VI. the intercommunicating corridor has been expanded, and in addition to providing for intercommunication serves the purpose of an assembly room. LETTERS USED IN TYPE PLANS. A to P = Classrooms. X = Cloakrooms. Y = Staircases. TYPE II ST. MARy's (non-provided) School BOYS & GIRLS SCHOOL TYPE I. & II. Combined. TYPE III. TYPE IV. PBINCESS FREDEBICA (NON-PROVIDED) SCHOOL. TYPE V DUDDEN HILL (PROVIDED) SCHOOL. TYPE IV&VI (TRANSITION) OLDFIELD ROAD (PROVIDED) SCHOOL. TYPE VI. hakvist road (provided) school. 41 SYMBOLS and ABBREVIATIONS. * Corresponds to Reference No. of Note. (Notes for Inspecting Officer— Circular 582.) Degree 1 =Good In columns corresponding to reference Nos. Averageor ,, 2= 1 normal ,, ,, 4.6,9,10,18 ,,3=Bad ,, ,, ,, „ 2b=Belownormal An additional Class in the case of Nutrition. „ 1=6/5&6/8 In columns corresponding to reference Nos. 1 ,, 2=6/9 &6/12 ,, ,, ,, 14 ,, 3 — 6/18 to^D/60 „1 (Tonsils) ,, „ ,, 2 „ „ „ sents d'gree lofenlargm't st 3 „ ,, ,, ,, 1.=Insufficiency „ „ „ R.=Need of Repair „ „ 6 C.= Uncleanliness „ „ „ V.=Verminous condition „ „ 10 O.D.=Other diseases „ „ 10,12,13.15 A.=Attention „ „ R.=Response ,, ,, 18 M.B.=Mouth Breathers „ „ 12 S.=Squint „ ,,13 O. &c.=Discharging Ear Disease „ „ 15 A.=Total No. of Teeth found to be defective „ j B.=No. of Children in which defective Teeth were found „ 11 C.=Average No. of defective Teeth per affected child „ 42 ACTON LANE SCHOOL. ??? Attendance. Clothing. Footgear. . Nutrition. leaiihness of Skin. Do. Head. Do. Body. Mental Condition. Vision—R. Do. —L. Tonsils. Nose and Throat. Adenoids. Submax.. and Cervical Glands External Eye Disease. Temp. Teeth defect. No., & No. of Children affected. Perm. Teeth defect No., & No. of Children affected. Ear Disease. Hearing. Speech. Heart and Circulatory. Lungs. Nervous Disease. Tuberculosis. Rickets. Deformities, Spinal Dis., etc. Infectious and Contagious Dis. Other defects. Tuberculosis in Family. 4 6 9 10 18 14 12 13 11 13 16 17 20 21 22 23 1 24 29 26 27 BOYS—Number Examined, 198. 1 178 126 123 113 107 104 A. 98 R. 97 83 87 15 1 A. 593 B. 158 A. 14 B. 5 1 1 7 2 2 8 1 1 2 14 71 72 85 2b 94 94 48 49 60 54 20 Combined B 161 3 6 1 3 11 11 14 16 7 R.I.C. 1 R.I. 1 GIRLS—Number Examined, 197. 1 174 154 153 136 138 137 96 93 100 94 12 M.B. 4 A. 598 B. 153 A. 8 B. 4 1 1 3 1 6 2 18 43 44 60 2b 1 59 60 66 68 60 57 13 Combined B 155 3 5 2 3 4 13 3 For Symbols and Abbreviations used in this Table, see Table on page 41. 43 School—ACTON LANE (Provided). Average number of Children on Roll 505 No. of Children medically inspected 395 No. of Parents objecting 4 INFANTS. BOYS. GIRLS. Assistant School Medical Officer Mixed Departmer.. Rees T. Jones, L.R.C.P Head Teacher Miss J. Henderson W. D. Lloyd Accommodation 1909 1910 176 170 1909 296 1910 No Alt. Average No. on Roll 196 153 156 Time per Inspection ... ten minutes. ten minutes. ten minutes. No. referred for subsequent examination 13 ( Department not stated) No. to whom directions for treatment given 15 (Department not stated) No referred to S.M.O. as suitable for visiting by L.H. Visitor 1 1 6 Comments of A.S.M.O.—None offered. Type—I. and II. (combined). L shape, single storey building with separate class-roomsSite—Open, on slope of hill. Playground—Tar paved, well drained, good condition. Sanitary Conveniences— Boys 3 separate W.C.s, automatic flushing. Girls 8 separate W.C.s, automatic flushing. Infants 3 separate W.C.s, automatic flushing. Urinals—Senior Boys 27-ft. lineal, Infant Boys 17-ft. lineal. Lavatory Basins—Boys 4, Girls 5, Infants 5. c Drinking Water—Boys drinking fountain, two cups. Girls from tap over lavatory basin. Class Room Walls and general Cleanliness of School—Match-boarded dado, brickwork above—clean. Desks—Modern double desks. Lighting—Good. Heating—Closed stoves. Ventilation—Good. Cloak Rooms—Well lighted and ventilated. 44 CAMBRIDGE ROAD SCHOOL (Boys). Degree. Attendance. Clothing. Footgear. Nutrition. Cleanliness of Skin. Do. Head. Do. Body. Mental Condition. Vision—R. Do. —L. Tonsils. Nose and Throat. Adenoids. Submax. and Cervical Glands External Eye Disease. Temp. Teeth defeet. No., & No. of Children affected. Perm. Teeth defect No., & No. of -Children affected. Ear Disease. Hearing. Speech. Heart and Circulatory. Lungs. Nervous Disease. Tuberculosis. Rickets. Deformities, Spinal Dis., etc. Infectious and Contagious Dis. Other defects. Tuberculosis in Family. 4 6 9 10 18 14 12 13 11 15 16 17 20 21 22 23 24 26 26 27 BOYS—Number Examined, 94. 1 59 31 32 11 79 78 A. 43 R. 46 32 27 13 M.B. 4 1 33 A. 23 B. 8 A. 33 B. 15 2 5 2 2 1 2 14 58 45 2b 76 6 15 16 48 45 49 52 O.D. 3 Combine. B 22 3 6 5 17 0 0 3 3 13 15 6 R.I C. 12 V. 5 V. 3 GIRLS—Number Examined, 1 2 3 For Symbols and Abbreviations used in this Table, see Table on page 41. 45 School—CAMBRIDGE ROAD TEMPORARY (Provided). Average number of Children on Roll 150 Number of Children medically inspected 94 Number of Parents objecting 1 BOYS. Assistant School Medical Officer J. Macfarlane Head Teacher A. Thacker. Accommodation 1909 1910 150 No Alt. Average No. on Roll 150 Time per Inspection nine minutes. No. referred for subsequent examination None. No. to whom directions for treatment given None No referred to S.M.O. as suitable for visiting by L.H. Visitor 2 Comments of S.M.O.—This building is altogether unsuitable for school premises, it is dark, insufficiently ventilated, a semi-basement under a Chapel which ought not to be used for the purpose of a school. Comments of A.S.M.O.—None offered. Type—II. Semi-basement under Chapel, large room for several classes. not separated. Site—Shut in by houses. Playground—Gravel. Sanitary Conveniences— Boys 3 syphonic latrines, automatic flushing. Urinals—Boys 9-ft. lineal. Lavatory Basins—Three. Drinking Water—From taps over lavatory basins. Class Room Walls and general Cleanliness of School—Match boarded dado, plaster above—fairly clean. Desks—Modern double desks. Lighting—Execrable. Heating—Warmed air (convected). Ventilation—Indifferent. Cloak Rooms—Lighting and ventilation fail 46 CHAMBERLAYNE WOOD ROAD SCHOOL. Degree. Attendance. Clothing. Footgear. Nutrition. Cleanliness of Skin. Do. Head. Do. Body. Mental Condition. Vision—R. Do. —L. Tonsils. Nose and Throat. Adenoids. Submax. and Cervical Glands External Eye Disease. Temp. Teetn defeet. No., & No. of Children affected. Pern 1. Teetn defect No.. & No. of Children affected. Ear Disease. Hearing. Speech. Heart and Circulatorv. Lungs. Nervous Disease. Tuberculosis. Rickets. Deformities, Spinal Dis., etc. Infectious and Contagious Dis. Other defects. Tuberculosis in Family. 4 6 9 10 18 14 12 13 11 15 16 17 20 21 22 23 24 25 26 27 BOYS—Number Examined, 229. 1 205 105 201 16 218 222 A. 103 R. 90 101 107 40 M.B. 41 1 59 S. 2 A. 300 B. 84 A. 86 B.26 8 26 7 5 12 & i, sus. 5 3& 3 sus. 15 13 1 14 16 2 22 34 27 52 2b 14 9 5 64 73 66 56 30 O.D. 62 O.D. 3 Combined B 101 3 2 1 2 2 12 16 12 16 12 R.I.C. 17 R.I. 4 V. 4 V. O.D. 1 O.D. 4 O.D. 1 GIRLS—Number Examined, 154. 1 136 152 153 2 153 154 101 98 34 52 25 M.B. 8 1 16 S. A. 293 B. 112 A. 1 B. 1 6 13 2 2 2 sus. 1 3 9 2 15 2 1 11 2b 1 15 18 70 53 17 O.D. 3 O.D. 2 Combined B 112 3 3 1 2 2 11 10 5 R.I.C 20 V. 4 O.D. 1 O.D. 3 For Symbols and Abbreviations used in this Table, see Table on page 41. :k School—CrtAMBERLAYNE WOOD ROAD (Provided). Average number of Children on Roll 1,153 Number of Children medically inspected 383 Number of Parents objecting 26 INFANTS. BOYS. GIRLS. Assistant School Medical Officer T. Smurthwaite, L.M.S.S.A. W. Walker, m.r.C.S., ETC. T. Sunurthwaite, L.M.S.S.A. Head Teacher Miss A. L. King C. F. Sykes. Miss I. Webster Accommodation 1909 1910 424 No Alt. 1909 1910 400 No alt. 1909 1910 400 No alt. Average No. on Roll 358 401 394 Time per Inspection 10 to 15 minutes 10 minutes. 10 to 15 minutes No. referred for subsequent examination 4 10 4 No. to whom directions for treatment given 35 82 75 No. referred to S.M.O. as suitable for visiting by L.H. Visitor 6 16 2 Comments of A.S.M.O.—Dr. Smurthwaite makes many valuable suggestions in regard to the specific items of medical inspection, and insists on the importance of instilling into parents' minds the necessity of making their children eat more fats; he adds, "I am perfectly aware that city children do not require the amount of fatty material that country children do, but it is necessary to stop the children rejecting every form of fat. They require more than they generally consume." Type—Transition IV. and VI. Modern school, central hall, three storeys. Site—Open, elevated. Playground—Tar paved, well drained, good condition. Sanitary Conveniences— Boys 9 syphonic latrines, automatic flushing. Girls 10 syphonic latrines, automatic flushing. Infants 14 syphonic latrines, automatic flushing. Urinals—Senior Boys 72-ft. lineal, Infant Boys 35-ft. lineal. Lavatory Basins—Boys 12, Girls 12, Infants 12. Drinking Water—Four water fountains with metal cups. Class Room Walls and general Cleanliness of School—Glazed brick dado, hard plaster above—clean. J Desks—Modern double desks. Light i ng—Good. Heating—Hot water radiators. Ventilation—Good. Cloak Rooms—Well lighted and ventilated. Comments of A.S.M.O.—Dr. Walker is struck with the number of children with enlarged tonsils and adenoids, and notes the difficulty of getting parents to have these conditions treated. These throat affections, he adds, lead to throat deafness, and obviously affect the intelligence of the children, by producing mouth breathing; he thinks they lead also to irregularity of the teeth, and are responsible for a large amount of dental caries. 4.8 DUDDEN HILL SCHOOL. Degree. Attendance. Clothing. Footgear. Nutrition. leannness of Skin. Do. Head. Do. Body. Mental Condition. Vision—R. Do. —L. Tonsils. Nose and Throat. Adenoids. Submax. and Cervical Glands External Eye Disease. Temp. Teeth defeet. No., & No. of Children affected. Perm. Teeth defect No., cS: No. of Children affected. Ear Disease. Hearing. Speech. Heart and Circulatory. Lungs. Nervous Disease. Tuberculosis. Rickets. Deformities, Spinal Dis., etc. Infectious and Contagious Dis. Other defects. Tuberculosis in Family. 4 6 9 10 18 14 12 13 11 15 16 17 20 21 22 23 24 25 26 27 BOYS—Number Examined, 279. 1 236 i43 168 9« 239 237 A. 186 R. 171 163 i55 62 M.B. 36 59 20 S. 4 A. 398 B. 138 A. 311 B. 122 2 10 15 4& 2 sus. 2 2 1 sus. 4 8 2 28 124 102 155 2b 20 37 38 75 90 89 96 11 O.D. 11 O.D. 4 Combined B 214 3 10 12 9 14 3 4 13 13 18 19 4 R.I.C. 16 R.I. 4 V. 4 O.D 1 O.D. 1 GIRLS—Number Examined, 282. 1 204 179 198 109 236 243 176 178 125 120 43 M.B. 19 45 & I sus. 35 S. 2 A. 525 B. 150 A. 199 90 4 7 4 5 5& 3 sus. 1 i & i sus 1 10 12 2 48 99 81 136 2b 35 42 36 j 88 81 133 136 19 O.D. 14 O.D. 3 Combined B 206 3 22 4 3 2 4 3 11 16 17 19 2 R.I.C 5 V. 89 V. O.D. 2 O.D. 2 1 For Symbols and Abbreviations used in this Table, see Table on page 41. 49 School—DUDDEN HILL (Provided). Average number of Children on Roll 1.263 Number of f hildren medically inspected 561 No of Parents objecting 6 INFANTS. BOYS. GIRLS. Assistant School Medical Officer J. Mechan, m.e. P. Evans, M.d. Head Teacher Miss L. K. Finch J. Kelly Miss M. Platts. Accommodation 1909 1910 45° 400 1909 1910 400 No alt. 1909 1910 400 No alt. Average No. on Roll 422 410 411 Time per Inspection eight minutes fifteen minutes fifteen minutes No. referred for subsequent examination 12 38 65 No. to whom directions for treatment given 53 60 102 No referred to S.M.O. as suitable for visiting by L.H. Visitor 15 5 5 Comments of A.S.M.O.—Dr. Evans says that "the scheme seems to be very well planned and to be working well, and I think it is doing a great deal of good to the children." Dr. Evans makes several suggestions which have received consideration. Type—V. Modern school, central hall, three storeys. Site—Open, elevated position. Playground—Tar paved, well drained, good condition. Sanitary Conveniences— Boys 8 syphonic latrines, automatic Hushing. Girls 10 syphonic latrines, automatic flushing. Infants 9 syphonic latrines, automatic flushing. Urinals—Senior Boys 52-ft. lineal, Infant Boys 28-ft. lineal. Lavatory Basins—Boys 6, Girls 6, Infants 8. ^ Drinking Water—Three water fountains with metal cups. Class Room Walls and general Cleanliness of School—Glazed brick dado, hard plaster above—clean. Desks—Modern double desks Lighting—Good. Heating—Hot water pipes and radiators. V entilation—Good. Cloak Rooms—Lighting and ventilation good. -O FURNESS ROAD SCHOOL. Degree. Attendance. Clothing. Footgear. Nutrition. leanliness ot Skin. Do. Head. Do. Body. Mental Condition. Vision—R. Do. —L. Tonsils. Nose and Throat. Adenoids. Submax. and Cervical Glands External Eye Disease. Temp. Teeth defect. No., & No. of Children affected. Perm. Teeth defect No., & No. of Children affected. Ear Disease. Hearing. Speech. Heart and Circulatory. Lungs. Nervous Disease. Tuberculosis. Rickets. Deformities, Spinal Dis., etc. Infectious and Contagious Dis. Other defects. Tuberculosis in Family. 4 6 9 10 18 14 12 13 11 15 16 17 20 21 22 23 24 25 26 27 BOYS—Number Examined, 354. 1 315 253 287 179 34i 324 A. 80 R. 65 144 130 47 M.B. 23 20 53 S. 4 A. 674 B. 143 A. 181 B. 70 4 11 15 9 9&2 sus. 3 3&6 sus. 9 T5 4 9 2 15 100 64 2b 141 32 10 27 208 212 124 17 15 O.D. 33 O.D. 7 Combined B 208 3 21 1 3 2 3 3 5 16 24 25 3 R.I.C. 15 R.I. 17 V. 23 V. 1 O.D. 1 GIRLS—Number Examined, 292. 1 240 24® 220 164 284 282 68 53 101 105 48 M.B. 20 19 & 2 sus. 40 S. 1 A. 507 B. 115 A. 97 B. 40 2 sus. 2 3 13 ii & 2 sus. 4 2& 2 sus. 2 4 3 10 2 25 51 67 2b 105 1 21 6 7 173 '85 122 117 25 O.D. 14 O.D. 2 Combined B 152 3 23 i 5 2 2 3 1 4 17 18 7 R.I.C 1 R.I. 9 V. 90 V. 2 For Symbols and Abbreviations used in this Table, see Table on page 41. *-n N* School—FURNESS ROAD (Provided). Average number of Children on Roll 994 Number of Children medically inspected 646 Number of Parents objecting 33 INFANTS. SENIOR. JUNIOR. Assistant School Medical Officer C. K. Rawes, m.b. B. G. Reynolds, L.R.c.P. Head Teacher Miss B. Martin W. Daniell MissE.A.McKenzie Accommodation 1909 1910 456 No Alt. 1909 1910 400 No Alt. 1909 19x0 400 No Alt. Average No. on Roll 3*7 307 370 Time per Inspection ten minutes. eight minutes eifcht minutes No. referred for subsequent examination 33 20 8 No. to whom directions for treatment given ... 45 65 74 No referred to S.M.O. as suitable for visiting by L.H. Visitor 3* 5 none Comments of A.S.M.O.—Dr. Gore Reynolds reports that the impression he has gained " Is that the public greatly appreciate the efforts that are being made to protect the interests and general welfare of their children ; the objectors are very few, and will become less. The public are gaining more confidence in the schools, for they begin to realise that the Medical Inspection is really a great protection to their children, and a direct encouragement to them to send their little ones clean and Cared for to the school, knowing the chances of contamination from others are being eliminated." For Dr. Rawes' comments, see Harlesden R.C. School, page 79. f Type—IV. and VI. (combined). Modern school, two storeys. Site—Open. Playground—Tar paved, well drained, good condition. Sanitary Conveniences—- Boys ... 7 syphonic latrines, automatic flushing. Girls ... 16 syphonic latrines, automatic flushing. Infants ... 7 syphonic latrines, automatic flushing. Urinals—Senior Boys 37-ft. lineal, Infant Boys 20-ft. lineal. Lavatory Basins—Boys 10, Girls 12, Infants 12. Drinking Water—Three fountains with metal cups. Class Room Walls and general Cleanliness of School—Glazed brick dado, hard plaster above—clean. Desks—Modern double desks. Lighting—Good. Heating—Hot water pipes and radiators. Ventilation—Good. Cloak Rooms—Infants' lighting and ventilation defective. 52 GIBBONS ROAD SCHOOL. Degree. Attendance. Clothing. Footgear. Nutrition. Cleanliness of Skin. Do. Head. Do. Body. Mental Condition. Vision—R. Do. —L. Tonsils. Nose and Throat. Adenoids. Submix. and Cervical Glands External Eye Disease. Temp. Teeth defect. No., & No. of Children affected. Perm. Teeth defect No., & No. of Children affected. Ear Disease. Hearing. Speech. Heart and Circulatory. Lungs. Nervous Disease. Tuberculosis. Rickets. Deformities, Spinal Dis., etc. Infectious and Contagious Dis. Other defects. Tuberculosis in 1 Family. 4 6 9 10 18 14 IS 13 11 19 16 17 20 21 22 23 24 25 26 27 BOYS—Number Examined, 323. 1 223 218 208 168 273 264 A. R. 186 177 216 218 60 M.B. 8 43 8 S. 5 A. 418 B. 129 A. 17b B. 85 5 12 6 6& 1 sus. 2 us. 1 5 2 2 41 95 87 2b 137 18 48 56 92 96 27 24 19 O.D. 5 O.D. 1 Combined B 188 3 25 10 28 2 3 1 6 14 15 4 R.I.C 6 R.I. 6 V. 3 V. 6 O.D. 2 GIRLS—Number Examined, 344. 1 247 276 267 200 301 287 214 214 | 206 205 5° M.B. 9 41 7 S. ,4 A. 442 B. 130 A. 219 112 10 9 1 8 1 >us. 4 2 3 2 50 63 1 2b 124 18 40 55 i 82 8t 49 51 26 O.D. 1 O.D. 5 Combined B 219 3 23 5 16 2 3 2 11 11 19 18 2 R.I.C 2 R.I. 2 V. 79 O.D. 2 For Symbols and Abbreviations used in this Table, see Table on page 41. 53 School—GIBBONS ROAD (Provided). Average number of Children on Roll 1,293 Number of Children medically inspected 667 Number of Parents objecting 9 INFANTS. BOYS. GIRLS. Assistant School Medical Officer W. Bell, l.r.c.p. Mi xed. C. W. Cooke, m.d. Head Teacher Miss Houghton E. J. Sai nsbury. Accommodation 1909 1910 418 No Alt. 1909 800 1910 No Alt. Average No. on Roll 439 457 397 Time per Inspection eight minutes nine minutes nine minutes. No. referred for subsequent examination 1 26 (sex not stated) No. to whom directions for treatment given 22 114 (sex not stated) No referred to S.M.O. as suitable For visiting by L.H. Visitor 47 5 36 Comments of A.S.M.O.—Dr. Cooke says that " in addition to the nine minutes per child which his inspection occupies, the teacher spends about ten minutes per child in measuring, weighing, examining eyes, and clerical work." In addition, he has inspected at least 200 children referred to him by the head teacher, who do not appear in the returns. He has been agreeably surprised to find what a particularly healthy lot of children he has had to inspect. He says, "I think the matter which requires most urgent attention is that of the teeth, I have seen a few perfect mouths, but not many. The children's heads have improved in cleanliness to a very great extent during the last few months. I find that very little attention is paid to one's recommendations as to taking advice in such cases as adenoids, defective eyes, etc. A certain number of parents who take an interest in their children have already found out their defects, and have had them treated, the others take absolutely no notice at all " Type—V. Modern school, two storeys. Site—Open, low lying. Playground—Tar paved, well drained, good condition. Sanitary Conveniences— Boys 8 svphonic latrines, automatic flushing. Girls 18 syphonic latrines, automatic flushing. i Infants 4 syphonic latrines, automatic flushing. Urinals—Senior Boys 42-ft. lineal, Infant Boys 22-ft. lineal. Lavatory Basins—Boys 10, Girls 12, Infants 10. Drinking Water—Three Water fountains with metal cups. Class Room Walls and general Cleanliness of School—Glazed brick dado, hard plaster above—clean. Desks—Modern double desks. Ligh ting—Good. Heating—Hot water radiators. Ventilation—Good. Cloak Rooms—Lighting and ventilation good. HARYIST ROAD SCHOOL. Degree. Attendance. Clothing. Footgear. Nutrition. Cleanliness of Skin. Do. Head. Do. Body. Mental Condition. Vision—R. Do. —L. Tonsils. Nose and Throat. Adenoids. Subm.ax. and Cervical Glands External Eye Disease. Temp. Teeth defect. No., & No. of Children affected. Perm. Teeth defect No., & No. of -Children affected. Ear Disease. Hearing. Speech. Heart and Circulatory. Lungs. Nervous Disease. Tuberculosis. Rickets. Deformities, Spinal Dis., etc. Infectious and Contagious Dis. Other defects. Tuberculosis in 1 Family. 4 r 6 9 10 18 14 12 13 11 15 16 17 20 21 22 23 24 28 26 27 BOYS—Number Examined, 277. 1 246 150 155 92 265 267 A. R. 183 176 128 130 29 M.B. 15 22 & 1 sus. 73 S. 3 A. 466 B. 123 A. 57 B. 29 8 15 12 73 6 20 9 4 9 7 2 20 125 120 2b 77 102 11 10 34 41 77 82 28 O.D. 84 Combined B 148 3 8 2 2 6 1 6 6 18 11 12 R.I.C 4 R.I. 1 V. 1 V. O.D. O.D. GIRLS—Number Examined, 295. 1 267 250 244 185 292 1 291 166 159 1136 1 130 59 M.B. 33 20 142 S. 1 A. 657 B. 196 A. 178 B. 94 6 7 6 15 4 5 4 3 12 22 2 18 45 5i 1 2b 87 20 3 4 71 78 72 75 18 O.D. 11 O.D. 10 Combined B 244 3 9 3 4 4 21 1 24 2 R.I.C 5 V. 30 O.D. r For Symbols and Abbreviations used in this Table, see Table on page 41. 54 bright, intelligent and well nourished. The proportion of verminous heads is astonishingly small. The greatest trouble I have to deal with is defective eyesight and teeth, but even in these cases I find the parents willing and anxious to do the best they can for their children's welfare." Type—VI. Modern school, central hall, three storeys. Site—Open. Playground—Tar paved, well drained, good condition. Sanitary Conveniences— Boys 7 syphonic latrines, automatic flushing. Girls 10 syphonic latrines, automatic flushing. Infants 9 syphonic latrines, automatic flushing. Urinals—Senior Boys 32-ft. lineal, Infant Boys 32-ft. lineal. 1 Lavatory Basins—Boys 9, Girls 10, Infants 8. Drinking Water—Two water fountains with metal cups. Class Room Walls and genera} Cleanliness of School—Glazed brick dado, hard plaster above—clean. Desks—Modern double desks. Lighting—Good. Heating—Hot water pipes and radiators. V entilation—Good. Cloak Rooms—Lighting and ventilation good. Comments of A.S.M.O.—Dr. Waithman reports the condition of the school as regards clothing and cleanliness to be excellent. He says: "The parents have fully appreciated and keenly made use of all suggestions that have been made with regard to the welfare of their children, and have been wishful to follow out the same." Ul tn School HARVIST ROAD (Provided). Average number of Children on Roll 1,422 Number of Children medically inspected 572 Number of Parents objecting 13 INFANTS. BOYS. GIRLS. Assistant School Medical Officer J. Waithman, m.a., m. d. T. Wilson, f.r.c.s., Ireland. J. Spurway, m.b. Head Teacher Mrs. E. Morrall W. Dowel ell. Miss S. Gledhill. Accommodation 1909 1910 470 440 1909 1910 460 No alt. 1909 1910 400 No alt. Average No. on Roll 518 471 433 Time per Inspection ten minutes ten minutes ten minutes No. referred for subsequent examination 5 2 2 No. to whom directions for treatment given ... 7o MS 54 No. referred to S.M.O. as suitable for visiting by L.H. Visitor 6 3 none Comments of A.S.M.O.—Dr. Wilson remarks: "The boys are clean, and almost free from skin disease, and suitably clad in warm garments. The boots are of good quality. The following diseases are prevalent in the school, heart disease, chorea, adenoids, and enlarged tonsils. In each case suitable act'on has been taken and the parents Informed, either verbally or by letter, of the condition of the child." Dr. Spurwav says: "The parents on the whole seem very interested in this work and pleased to have their children examined. The school is a remarkably healthy one, the girls rosy and well developed, 56 KILBURN PARK ROAD (Girls and Infants). Degree. Attendance. Clothing. Footgear. Nutrition. Cleanliness of Skin. Do. Head. Do. Body. Mental Condition. Vision—R. Do. —L. Tonsils. Nose and Throat. Adenoids. Submax. and Cervical Glands External Eye Disease. Temp. Teeth defect. No., & No. of Children affected. Perm. Teeth defect No., & No. of Children affected. Ear Disease. Hearing. Speech. Heart and Circulatory. Lungs. Nervous Disease. Tuberculosis. Rickets. Deformities, Spinal Dis., etc. Infectious and Contagious Dis. Other defects. Tuberculosis in Family. 4 6 9 10 18 14 12 13 11 15 16 17 20 21 22 23 24 28 26 27 BOYS—Number Examined, 31. 1 26 14 13 2 29 29 A. R. 7 6 3 3 3 M.B. 4 9 S. 1 A. 5 3 1 1 1 i 2 3 16 17 2b 27 2 1 6 7 10 9 21 O.D. 1 3 2 1 1 2 1 1 1 1 2 R.I.C R.I. 1 V. 1 V. 1 GIRLS—Number Examined, 108. 1 95 61 59 22 103 IOI 56 58 24 22 17 M.B. 5 24 S. 1 A. 25 B. 6 A. 21 B. q 1 2 3 1 1 2 2 44 47 2b 80 6 5 7 26 22 45 49 58 O.D. 3 Combined B 15 3 11 3 2 1 3 14 12 7 R.I.C 1 V. 11 O.D. 1 For Symbols and Abbreviations used in this Table, see Table on page 41. 57 School—KILBURN PARK ROAD (Provided). Average number of Children on Roll 344 Number of Children medically inspected 139 Number of Parents objecting 7 INFANTS. GIRLS. Assistant School Medical Officer J. Macfarlane, M.B. Head Teacher Mrs. Brougham. Mrs. Brougham. Accommodation 1909 1910 150 No alt. 1909 1910 174 No alt. Average No. on Roll 344 Infants and Girls Time per Inspection nine minutes. nine minutes. No. referred for subsequent examination none none No. to whom directions for treatment given 48 (Department not stated) No. referred to S.M.O. as suitable for visiting by L.H. Visitor none 4 Comments of A.S.M.O.—None offered. Type—II. arW III. (combined), two storey building. Site—Shut in. Playground—Tar paved, well drained, good condition. Sanitary Conveniences— Girls 4 separate W.C.s with flushing cisterns Infants 3 separate W.C.s with flushing cisterns. Urinals—Infant Boys 9-ft. 6-in. lineal. Lavatory Basins—Infants 3, Girls 3. Drinking Water—One water fountain, two metal cups. Class Room Walls and general Cleanliness of School—Hard plaster, painted dado—clean. Desks—Long desks, unsatisfactory. Lighting—Good, but direction of source faulty in several rooms Heating—Open fireplaces and hot water pipes. Ventilation—Good. Cloak Rooms—Lighting and ventilation good. 58 LEOPOLD ROAD SCHOOL. Degree. Attendance. Clothing. Footgear. Nutrition. Cleanliness of Skin. Do. Head. Do. Body. Mental Condition. Vision—R. Do. —L. Tonsils. Nose and Throat. Adenoids. Submax. and Cervical Glands External Eye Disease. Temp. Teeth defect. No., & No. of Children affected. Perm. Teeth defect No., & No. of Children affected. Ear Disease. ' j Hearing. Speech. Heart and Circulatory. Lungs. Nervous Disease. Tuberculosis. Rickets. Deformities, Spinal Dis., etc. Infectious and Contagious Dis. Other defects. Tuberculosis to Family. 4 6 9 10 16 14 12 13 11 15 16 17 20 21 22 23 21 29 26 27 BOYS—Number Examined, 423. 1 383 302 312 120 401 395 A. R. 255 252 172 174 44 M.B. 15 10 & 1 sus. 65 S. 1 A. 950 B. 234 A. 205 B. 79 12 2 21 9 5& 1 sus. 4 2& I sus. 22 14 3 56 5 2 26 112 103 2b 228 74 15 23 50 52 119 119 42 O.D. 29 O.D. 6 Combined B 296 3 9 9 8 1 7 5 14 15 28 26 17 R.I.C 57 R.I. 19 V. 15 V. 2 O.D. 1 O.D 16 O.D. 1 GIRLS—Number Examined, 438. 1 339 285 286 158 393 395 205 180 169 147 38 M.B. 8 23 & sus. 55 S. A 1011 B. 241 A. 400 B. 151 9 22 17 18 13 7 2 sus. 20 16 2 19 2 2 59 147 146 2b 194 77 43 39 116 123 138 l6o 36 O.D. 30 O.D. 3 Combined B 345 3 24 6 6 9 2 4 14 32 28 28 20 R.I.C 34 R.I. 31 V. 160 V. 5 For Symbols and Abbreviations used in this Table, see Table on page 41. 59 School—LEOPOLD ROAD (Provided). Average number of Children on Roll 1,251 Number of Children medically inspected 86l Number of Parents objecting 7 INFANTS. BOYS. GIRLS. Assistant School Medical Officer J. S. Crone, L.R.C.P G. H. Mitchell, M.B A. S. Grant, M.R.C.S Head Teacher Miss Irvin E. Eyles. Miss E. Slape Accommodation 1909 1910 450 400 1909 1910 400 No alt. 1909 1910 400 No alt. Average No. on Roll 432 414 405 Time per Inspection eight minutes ten minutes ten minutes No. referred for subsequent examination 30 none 2 No. to whom directions for treatment given 127 31 59 No referred to S.M.O. as suitable for visiting by L.H. Visitor 64 4 24 Comments of A.S.M.O.—Dr. Crone has been surprised to find that 99 per cent, of the parents were willing, and even anxious, to have their children medically examined. He adds: "I have been personally thanked by the parents on several occasions, long after the examination, for calling their attention to some easily remediable defects, which would have been attended to long before if they had only known of its existence, attention to which rendered their children's lives healthier and happier. There is not the least doubt these examinations have conduced to greater cleanliness and better care of the children. A year ago, scarcely a girl in the school but had a verminous head, true, ' only nits,' but still verminous. Now to see a girl with such a head is the exception, whereas, before, it was the rule, and the same applies to the boys." Type—V. Modern school, central hall, three storeys. Site—Open, low lying. Playground.—Tar paved, well drained, good condition. Sanitary Conveniences— Boys 8 syphonic latrines, automatic flushing. Girls 10 syphonic latrines, automatic flushing. Infants 8 syphonic latrines, automatic flushing. Urinals—Senior Boys 28-ft. 6-in. lineal, Infant Boys 27-ft. lineal. Lavatory Basins—Boys 12. Girls 12, Infants 10. Drinking Water—Three water fountains with metal cups. Class Room Walls and general Cleanliness of School—Glazed brick dado, hard plaster above—clean. Desks—Modern double desks. Lighting—Good. Heating—Hot water radiators. Ventilation—Good. Cloak Rooms—Lighting and ventilation good. Comments of A.S.M.O.—Dr. Mitchell says: "The boys I examined came up to a fairly even standard, the chief thing noted was the very high percentage of children who had suffered from measles. It was quite the exception to find a child who had not had it." 6o LOWER PLACE & DISRAELI ROAD SCHOOLS. Degree. Attendance. Clothing. Footgear. Nutrition. Cleanliness of Skin. Do. Head. Do. Body. Mental Condition. Vision—R. 1 Do. —L. Tonsils. Nose and Throat. Adenoids. Subm.ix. and Cervical Glands External Eye Disease. Temp. Teeth defect. No., & No. of Children affected. Perm. Teeth defect No., & No. of -Children affected. Ear Disease. Hearing. Speech. Heart and Circulatory. Lungs. Nervous Disease. Tuberculosis. Rickets. Deformities, Spinal Dis., etc. Infectious and Contagious Dis. Other defects. Tuberculosis in Family. 4 1 6 9 10 18 14 12 13 11 15 16 17 20 21 22 23 24 25 26 27 BOYS—Number Examined, q8. 1 78 60 77 5 92 68 A. R. 81 70 68 65 29 M.B. 9 1 8 24 S. 3 A. 113 B. 38 A. 95 B.36 2 2 6 1 10& 1 sus. 9 2 5us. 16 4 3 3 2 18 35 19 2b 63 27 6 29 6 16 6 8 8 O.D. 2 O.D. 10 Combined B 70 3 2 3 2 3 1 1 2 6 7 R.I.C 23 . R.I. 8 Anaemic r V. 3 V. 7 O.D. 1 O.D 1 GIRLS—Number Examined, III 1 89 72 87 16 7i 85 97 84 61 61 22 M.B 6 6 19 S. 3 1 A. 84 ! A. 85 B. 41 6 5 4 4& 2 sus. 6 i sus. 5 2 11 2 17 39 24 2b 67 24 38 26 3 *6 20 19 10 O.D. 4 Combined B 69 3 4 4 2 9 1 10 R.I.C 16 . R.I. 17 Anaemic 4 V. 38 v. 7 O.D 1 For Symbols and Abbreviations used in this Table, see Table on page 41. 61 School LOWER PLACE AND DISRAELI ROAD TEMPORARY (Provided). Average number of Children on Roll 638 Number of Children medically inspected 209 Number of Parents objecting 2 INFANTS. BOYS. GIRLS. Assistant School Medical Officer Jessie D. Granger . Evans, m.b. Head Teacher Miss Richardson C. Barton. Miss A. Mellor Accommodation 1909 1910 190 No alt. 1909 1910 1909 1910 230 No alt. 210 209 Average No. on Roll 194 234 210 Time per Inspection fifteen minutes fifteen minutes fifteen minutes No. referred for subsequent examination 3 (Department not stated) No. to whom directions for treatment given 55 (Department not stated) No. referred to S.M.O. as suitable for visiting by L.H. Visitor 46 5 55 Comments of A.S.M.O.—Dr. Granger Evans reports that she found very little serious disease. "The chief morbid conditions have been carious teeth, verminous heads, defective eyesight, and, in a few cases, enlarged tonsils and adenoids. As regards the dirty heads, I have made great efforts at improving the general conditions at the school, and, on the whole, have had some success, though the want of the attendance officers this term, and the lack of legal power to deal with persistent offenders, have minimised the effect." Type—Boys and Girls V., Infants I. and II. (combined). Galvanised iron, temporary buildings, with separate class rooms. Site—Open. Playground—Tar paved, fair condition. Sanitary Conveniences— Boys 7 stoneware latrines, automatic flushing. Girls 8 stoneware latrines, automatic flushing. Infants 7 stoneware latrines, automatic flushing. Urinals—Corrugated iron, tarred, automatic flushing. Lavatory Basins—Eight enamelled iron basins. Drinking Water—Two fountains with metal cups. Class Room Walls and general Cleanliness of School—Lined with matchboarding, varnished—clean. Desks—Modern double desks. Lighting—Good. Heating—Closed stoves. V entilation—Good. Cloak Rooms—Fairly good. 62 MORA ROAD SCHOOL. Degree. Attendance. Clothing. Footgear. Nutrition. Cleanliness ot Skin. Do. Head. Do. Body. Mental Condition. Vision—R. Do. —L. Tonsils. Nose and Throat. Adenoids. Submax. and Cervical Glands External Eye Disease. Temp. Teeth defeet. No., & No. of Children affected. Perm. Teeth defect No., & No. of Children affected. Ear Disease. Hearing. Speech. Heart and Circulatory. Lungs. Nervous Disease. Tuberculosis. Rickets. Deformities, Spinal Dis., etc. Infectious and Contagious Dis. Other defects. Tuberculosis in Family. 4 6 9 10 18 14 12 13 1 11 15 16 17 20 21 22 23 1 24 25 26 1 27 BOYS—Number Examined, 199. 1 184 186 184 131 193 192 A. 119 R. 104 91 92 62 M.B. 21 14 and 26 sus. 111 S. 2 A. 46s B. 112 a. 103 B. 46 3 5 9 2 2 &1 sus. 1 1 10 2 9 13 13 61 2b 7 5 6 17 31 21 18 33 O.D. 4 O.D. 3 Combined B 143 3 5 1 1 2 3 8 10 6 R.I. 3 N. 4 GIRLS—Number Examined. 171. 1 157 167 169 129 166 167 108 107 76 7i 52 M.B. 5 f and 17 sus. 70 S. 2 a. 491 B. 106 A. 97 b.44 4 2 6 2 2 1 i 1 7 2 3 8 4 2 32 2b 10 4 3 20 20 27 30 17 O.D. 1 O.D. 4 Combined b 33 6 i 1 2 3 10 12 11 V. 29 1 For Symbols and Abbreviations used in this Table, see Table on page 41. 6.3 School MORA ROAD (Provided). Average number of Children on Roll 829 Number of Children medically inspected 370 Number of Parents objecting 6 INFANTS. BOYS. GIRLS. Assistant School Medical Officer W. R. Soden, m.d. Head Teacher Miss E. Dive J. Hinde. Miss M. Fielding Accommodation 1909 1910 400 No alt. 1909 1910 400 No alt. 1909 1910 400 No alt. Average No. on Roll 279 272 278 Time per Inspection eleven minutes eleven minutes eleven minutes No. referred for subsequent examination 1 none none No. to whom directions for treatment given 43 22 22 No. referred to S.M.O. as suitable for visiting by L.H. Visitor none none z Comments of A.S.M.O.—None offered. Type—Transition IV. and VI. Modern school, central hall, two storeys. Site—Open. Playground—Tar paved, good condition, well drained. Sanitary Conveniences— Boys 8 syphonic latrines, automatic flushing. Girls 16 syphonic latrines, automatic flushing. Infants 7 syphonic latrines, automatic flushing. Urinals—Senior Boys 70-ft. lineal, Infant Boys 33-ft. lineal. Lavatory Basins—Boys and Girls 22, Infants 10. Drinking Water—Three water fountains with metal cups. Class Room Walls and general Cleanliness of School—Glazed brick dado, hard plaster above—clean. Desks—Modern double desks. Lighting—Good. Heating—Hot water pipes and radiators. I entilation—Good. Cloak Rooms—Lighting and ventilation good. 64 OLDFIELD ROAD SCHOOL. Degree. Attendance. Clothing. Footgear. Nutrition. Cleanliness of Skin. Do. Head. Do. Body. Condition. Vision—R. Do. —L. Tonsils. Nose and Throat. Adenoids. Subm.ix. and Cervical Glands External Eye Disease. Temp. Teeth defeet. No., & No. of Children affected. Perm. Teeth defect No., & No. of Children affected. Ear Disease. Hearing. Speech. Heart and Circulat ry. Lungs. Nervous Disease. Tuberculosis. Rickets. Deformities, Spinal Dis., etc. Infectious and Contagious Dis. Other defects. Tuberculosis in Family. 4 6 9 10 18 14 12 13 11 15 16 17 20 21 22 23 24 25 26 27 BOYS—Number Examined, 298. 1 267 272 272 9 295 287 A. 126 R 111 154 151 66 52 87 68 3 A. 713 B. 171 A. 9 4 8 15 3 4 5& 3 sus 2 1 10 10 2 12 11 2 25 25 25 2b 245 44 2 8 102 117 54 54 27 O.D. 2 O.D. 5 Combined B 171 3 5 1 1 1 3 5 5 20 23 8 R.I.C 23 R.I. 20 V. 6 V. 5 O.D. 1 O.D. 4 O.D. 4 GIRLS—Number Examined, 2Q2. 1 243 200 206 25 276 287 131 111 149 149 61 M.B. 32 47 39 S. 4 A. 682 B. 167 A. 20 B. 5 8 9 2 6 6& 1 sus. 1 1 & 1 sus. 5 8 I 7 15 2 33 82 74 2b 227 39 14 5 118 136 79 79 25 O.D. 3 O.D. 7 Combined B 170 3 12 10 12 1 2 4 1 6 21 21 4 R.I.C 5 R.I. 7 V. 87 V. 4 O.D. O.D. For Symbols and Abbreviations used in this Table, see Table on page 41. 6* School OLDFIELD ROAD (Provided). Average number of Children on Roll 1,169 Number of Children medically inspected 590 Number of Parents objecting 2 INFANTS. BOYS. GIRLS. Assistant School Medical Officer J. C. Clayton, L.R.c.P. F. J. Beresford, l.r.C.S. Head Teacher Miss E. Dowling. T. kills Miss A. Acock Accommodation 1909 1910 400 No alt. 19o9 1910 400 No alt. 1909 1910 400 No alt. Average No. on Roll 427 383 359 Time per Inspection ten minutes ten minutes No. referred for subsequent examination 27 8 18 No. to whom directions for treatment given 96 16 40 No referred to S.M.O. as suitable for visiting by L.H. Visitor 14 19 39 Comments of A.S.M.O.—Dr. Clayton says: "Undoubtedly the greatest defects in the school come under the headings of eyes, enlarged tonsils, adenoids, decayed teeth, and dirty heads." Dr. Beresford says: "I have found the health of both boys and girls uniformly good. Verminous heads have been comparatively few among the boys, among the girls they have occurred only too frequently; defective vision has occurred frequently among boys and girls, and parents have recognised that the defect may cripple the child in after life, and have taken measures to remedy the same. Cutaneous diseases have been few, and mentally deficient children very few. I think that inspection at this school has done good, and many cases of filthy children would have been allowed to roam at large had it not been for the constant inspection by the officials." I Type—IV. and VI. transition. Modern School, central hall, two storeys. Site—Open. Playground—Tar paved, well drained, good condition. Sanitary Conveniences— Boys 8 syphonic latrines, automatic flushing. Girls 16 syphonic latrines, automatic flushing. Infants 12 syphonic latrines, automatic flushing. Urinals—Senior Boys 63-ft. lineal, Infant Boys 40-ft lineal. Lavatory Basins—Boys 10, Girls 10, Infants 10. Drinking Water—Three water fountains with metal cups. Class Room Walls and general Cleanlinescs of School—Glazed brick dado, hard plaster above—clean. Desks—Modern double desks. Ligh ti ng—G ood. Heating—Hot water radiators. Ventilation—Good. Cloak Rooms—Lighting and ventilation good 66 POUND LANE SCHOOL. Degree. Attendance. Clothing. Footgear. Nutrition. Cleanliness of Skin. Do. Head. Do. Body. Mental Condition Vision—R. Do. — L. Tonsils. Nose and Throat. Adenoids. Subm.ix. and Cervical Glands External Eye Disease. Temp. Teeth defeet. No., & No. of Children affected. Perm. Teeth defect No., & No. of Children affected. Ear Disease. Hearing. Speech. Heart and Circulatory. Lungs. Nervous Disease. Tuberculosis. Rickets. Deformities, Spinal Dis., etc. Infectious and Contagious Dis. Other defects. Tuberculosis in Family. 4 6 9 10 18 14 12 13 11 15 16 17 20 21 22 23 24 25 26 27 BOYS—Number Examined, 276. 1 252 232 240 122 226 232 A. 218 1 R. 214 180 176 80 M.B. 15 11&23 sus. 200 S. 7 A. 653 B. 144 A. 330 B 95 2 7 14 66 1 1 11 8 1 sus. 5 5 2 14 44 35 2b 120 34 46 41 24 28 46 43 20 O.D. 7 O.D. 6 Combined B 233 3 10 1 4 3 2 2 13 20 2 R.I.C 19 . R.I. 21 V. 11 V. O.D 4 O.D. 1 GIRLS—Number Examined, 116. 1 J 102 1x2 92 96 "5 112 90 88 69 66 1 46 M.B 5 2 & 2 sus. 99 S. |A. 280 B. 75 A. 84 B. 31 1 1 1 58 2 4 5 2 1 13 4 24 2b 16 4 1 4 2 10 13 8 O.D. 2 O.D. 3 Combined B 93 a I 1 5 5 R.I.C 2 :. R.I 1 24 V. 27 V O.D 2 O.D 1 For Symbols and Abbreviations used in this Table, see Table on page 41. , ON ck School—POUND LANE (Provided). Average number of Children on Roll 1,125 Number of Children medically inspected 392 Number of Parents objecting 10 INFANTS. BOYS. GIRLS. Assistant School Medical Officer E. N. Smith, m.d. R. E. Cruden, m.a., m.b. E. N. Smith, m.d. Head Teacher Miss M. Palmer H. Earl 1 H. Earl Accommodation 1909 1910 418 No alt. Mi 1909—860. xed 1910—856 Average No. on Roll 345 396 384 Time per Inspection six minutes . ten minutes six minutes No. referred for subsequent examination 6 (2 depts.) 27 No. to whom directions for treatment given 60 45 52 No. referred to S.M.O. as suitable for visiting by L.H. Visitor 21 none 12 Comments of A.S.M.O.—Dr. Cruden reports that in respect of the boys he has been struck with the absence of serious disease amongst them. Where such does occur, however, he feels how difficult it is to insure that the child shall have adequate treatment. The great majority of the children are well clothed, well fed, and well up to the average in intelligence. The chief defects found have been in regard to teeth, enlarged tonsils, and adenoids, and enlarged submaxillary and cervical glands. He has been much impressed by the presence of these enlarged glands, even in the absence often of enlarged tonsils and adenoids. Type—VI. Modern school, central hall, three storeys. Site—Open, elevated position. Playground—Tar paved, well drained, good condition. Sanitary Conveniences— Boys 8 syphonic latrines, automatic flushing. Girls 12 syphonic latrines, automatic flushing. Infants 11 syphonic latrines, automatic flushing. Urinals—Senior Boys 37-ft. lineal, Infant Boys 46-ft. lineal. Lavatory Basins—Boys 12, Girls 12, Infants 12. 1 Drinking Water—Three taps in playground with metal cups. Class Room Walls and general Cleanliness of School—Glazed bricks dado, hard plaster above—clean. Desks—Modern double desks. Lighting—Good. Heating—Hot water radiators. Ventilation—Good. Cloak Rooms—Well lighted and ventilated. Comments of A.S.M.O.—Dr. Newlyn Smith says: "It appears to me that it is much to be desired that some suitable means should be found whereby the defects, etc., noted in the course of inspection may be satisfactorily dealt with; at present it seems to me that even where a recommendation to seek advice is given it is quite doubtful whether any steps are taken by the parents ; notably in the case of post-nasal growths and defective teeth, neglect may be of serious moment to the child." 68 SALUSBURY ROAD SCHOOL. Degree. Attendance. Clothing. Footgear. Nutrition. Cleanliness of Skin. Do. Head. Do. Body. Mental Condition Vision—R. Do. —L. Tonsils. Nose and Throat. Adenoids. Submax. and Cervical Glands External Eye Disease. Temp. Teeth defect. No., & No. of Children affected. Perm. Teeth defect No., & No. of Children affected. Ear Disease. Hearing. Speech. Heart and Circulatory. Lungs. Nervous Disease. Tuberculosis. Rickets. Deformities, Spinal Dis., etc. Infectious and Contagious Dis. Other defects. Tuberculosis in Family. 4 6 9 10 18 14 12 13 11 15 16 17 20 21 22 23 24 28 28 27 BOYS—Number Examined, 366. 1 323 209 249 227 336 337 A. 216 R. 164 206 192 108 M.d. 41 66&29 sus. 118 b. 10 A 1171 B. 267 A. 14 B. 9 »5 19 35 25 8 3 1 sus. 27 & 1 sus. 2 1 13 11 2 30 147 113 2b 119 20 28 28 no 152 97 104 56 O.D. 55 O.D. 16 Comb 26 ned B 8 3 7 10 4 2 1 5 15 20 27 21 R.I.C 47 R.I. 7 V. 3i V. 2 O.D. 1 O.D. O.D. GIRLS—Number Examined, 264. 1 227 188 196 158 250 257 157 131 130 114 72 M.B. 22 41 & 9 sus. 76 S. 3 A. 869 B.215 A. 6 B. 4 3 6 12 35 1 5 3 4 , 1 1 7 8 2 11 76 66 | 2b 91 15 10 5 78 99 81 9i 43 O.D. 23 O.D. 9 Combined B 213 f 3 11 2 4 2 i 6 14 20 19 R.I.C. 5 R.I. 2 V. 93 V. O.D. 28 O.D. 3 For Symbols and Abbreviations used in this Table, see Table on page 41. 69 School SALUSBURV ROAI) (Provided). Average number of Children on Roll 1,378 Number of Children medically inspected 630 Number of Parents objecting 11 INFANTS. MIXED. Assistant School Medical Officer A. J. Moran, l.r.c.p.i., d.p.h. H. J. Macevoy, m.d., b.sc. Head Teacher Miss A. Butler J. Mellor Accommodation 1909 1910 460 No Alt. 1909 1910 860 No Alt. Average No. on Roll 496 883 Time per Inspection nine minutes ten minutes No. referred for subsequent examination £ hour weekly re inspection. 212 No. to whom directions for treatment given 138 149 No referred to S.M.O. as suitable for visiting by L.H. Visitor 10 3 Comments of A.S.M.O.—Dr. Macevoy says: "I find that the majority of the children are quite ignorant of Hygiene, care of the teeth, etc., and I feel sure that some instruction on such subjects given to them periodically by a medical man, would be decidedly beneficial. With few exceptions, the children are adequately clothed; speaking generally, they are more sensibly shod than clothed. I have rarely found the skin of the body dirty, but there is a great prevalence of nits among the girls. Dental caries is fearfully prevalent. I have endeavoured to seek for a cause or causes of this ; I am not satisfied at present that I can account for it at all. Very few children have perfectly sound teeth. Moderate enlargement of the tonsils is often present, I find, without any history of sore throat, without any accompanying nasal obstruction, without arching of the palate, without ear trouble, in short, without any sign or sympton which seems to call for treatment." Type—IV. and VI. (combined). Modern School, three storeys. Site—Open. Playground—Tar paved, well drained, good condition. Sanitary Conveniences— Boys 7 syphonic latrines, automatic flushing. Girls 10 syphonic latrines, automatic flushing. Infants 10 syphonic latrines, automatic flushing. Urinals—Senior Boys 40-ft. lineal, Infant Boys 24-ft. lineal. Lavatory Basins—Boys 8, Girls 7, Infants 8. Drinking Water—Three water fountains with metal cups. Class Room Walls and general Cleanliness of School—Glazed brick dado, hard plaster above—clean. Desks—Modern double desks. Lighting—Good. Heating—Hot water pipes and radiators. Ventilation—Good. Cloak Rooms—Lighting indifferent, ventilation good. Comments of A.S.M.O.—Dr. Moran forwards a report on the sanitary condition of the school premises, and interesting tabulated results and analysis of the cases he has inspected. Space, however, does not permit of their reproduction. 7° STONE BRIDGE SCHOOL. Degree. Attendance. Clothing. Footgear. Nutrition. Cleanliness of Skin. Do. Head. Do. Body. Mental Condition. Vision—R. Do. —L. Tonsils. Nose and Throat. Adenoids. Submax. and Cervical Glands External Eye Disease. 'Temp. Teeth defect. No., & No. of Children affected. Perm. Teeth defect No., & No. of Children affected. Ear Disease. Hearing. Speech. Heart and Circulatory. Lungs. Nervous Disease. Tuberoulosis. Rickets. Deformities, Spinal Dis., eto. Infectious and Contagious Dis. Other defects. Tuberculosis in Family, 4 0 0 10 18 14 12 15 11 15 16 17 20 21 22 23 24 25 26 27 BOYS—Number Examined, 302. 1 263 183 178 85 236 235 A. K. 173 168 193 192 51 M.D. 1 23 112 S. 2 A. 305 B. 120 A. 140 B. 67 3 4 16 3 6 1 us. 2 1 2 2 26 76 78 2b 176 32 59 60 76 8l 20 18 4 O.D. 15 O.D. 5 Combi 16 ned B 3 *3 43 46 9 7 7 5 5 9 12 1 R.I.C 43 R.I. 5i V. 39 V. 6 O.D. 4 GIRLS—Number Examined, 353. 1 283 86 89 117 292 189 145 147 113 94 51 M.B. 26 16 & 9 sus. 13 S. 5 A. 181 B. 99 A. 221 B. 94 5 13 3 20 o& 1 us. 1 I 1 s & 1 us. 1 6 2 49 239 242 2b 208 27 50 53 138 130 107 122 n O.D. 3 O.D. 6 Combi 19 ned B 2 3 21 28 22 1 11 11 27 33 37 41 2 R.I.C I 10 R.I. 21 V. 78 O.D. 5 For Symbols and Abbreviations used in this Table, see Table on page 41. 71 School—STONEBRIDGE (Provided). Average number of Children on Roll 1,341 Number of Children medically inspected 655 Number of Parents objecting 11 INFANTS. BOYS. GIRLS. . 'distant School Medical Officer N. Greeves, m.r.c.s. A. Bindley, m.b. D. V. Muller, l.s.a. Head Teacher Miss B. Emerson. W. Buck. Miss E. Buck. Accommodation 1909 1910 440 430 1909 1910 400 No alt. 1909 1910 400 No alt. Average No. on Roll 482 433 426 Time per Inspection nine minutes. fifteen minutes fifteen minutes. No. referred for subsequent examination 3 22 93 No. to whom directions for treatment given 61 S3 136 No. referred to S.M.O. as suitable for visiting by L.H. Visitor 3 12 27 Comment of A.S.M.O.—Dr. Muller makes many suggetions, and is of opinion that proper and efficient instruction should be given in each class with regard to breathing exercises, as he finds that very few children know how to expand or contract the chest properly. Type—V. Modern school, three storeys. Site—Open. Playground—Tar paved, well drained, good condition. Sanitary Conveniences— Boys 7 syphonic latrines, automatic flushing. Girls 12 syphonic latrines, automatic flushing. Infants 10 syphonic latrines, automatic flushing. Urinals—Senior Boys 49-ft. lineal, Infant Boys 27-ft. lineal. Lavatory Basins—Boys 10, Girls 10, Infants 8. Drinking Water—Three water fountains with metal cups. Class Room Walls and general Cleanliness of School—Glazed brick dado, hard plaster above—clean. Desks—Modern double desks. Lighting—Good. Heating—Hot water pipes and radiators. V entilation—Good. Cloak Rooms—Lighting and ventilation good. Comments of A.S.M.O.—Dr. Greeves also makes many suggestions with regard to the problems arising out of the work of medical inspection. He has been surprised at the general good health of the Stonebridge infants, which, he thinks, in some measure is probably due to the fact that more care is taken of younger children by the parents than is later the case. Dr. Greeves is of opinion that it is the best mothers who attend at the medical inspection of their children, neglected children being unaccompanied by the parents. 7* ALL SOULS' SCHOOL. Degree. Attendance. Clothing. Footgear. Nutrition. Cleanliness of Skin. Do. Head. Do. Body. Mental Condition. Vision—R. Do. —L. Tonsils. Nose and Throat. Adenoids. Submax. and Cervical Glands External Eye Disease. Temp. Teeth defect. No., & No. of Children affected. Perm. Teeth defect No., & No. of Children affected. Ear Disease. Hearing. Speech. Heart and Circulatory. Lungs. NYrvous Disease. Tuberculosis. Rickets. Deformities, Spinal Dis., etc. Infectious and Contagious Dis. Other defects. Tuberculosis in Family. 4 6 9 10 18 14 12 13 11 13 16 17 20 21 22 23 24 29 2fi 27 BOYS—Number Examined, 113. 1 72 50 68 52 1 98 88 A. R. 70 61 52 53 8 M.B. 17 7 & 8 sus. S. 2 A. 131 B. 32 A. 10 B. ~5 6 14 3 2 4 3 2&1 sus. 1 1 5 11 2 26 49 36 2b 48 10 ! 15 25 12 21 23 23 5 O.D. 4 O.D. 1 Combined B 37 •3 15 14 9 3 2 2 8 7 R.I.C 11 R.I. 13 v. 1 O.D. 2 GIRLS—Number Examined, 123. 1 108 94 108 59 HI 107 85 | 76 69 65 8 M.B. 10 5 & 4 sus. s. 4 A. 149 B. 44 A. 6 B. 3 9 19 2 1 12 &11 SUS 1 2 10 15 2 6 26 10 2b 49 15 8 13 11 20 24 1 28 4 O.D. 8 O.D. 2 Combined B 46 3 9 3 5 4 3 4 4 7 7 R.I.C 1 R.I. 3 V. 6 O.D. 2 For Symbols and Abbreviations used in this Table, see Table on page 41. 73 School—ALL SOULS (Non-provided). Average number of Children on Roll 545 Number of Children medically inspected 236 Number of Parents objecting none INFANTS. BOYS. GIRLS. Assistant School Medical Officer 0. Roberts, m.r.c.s., etc. Head Teacher Miss M. Bevan J. Anderson Miss L. Baker Accommodation 1909 19x0 192 175 1909 1910 192 160 1909 1910 187 148 Average No. on Roll 151 188 206 Time per Inspection 15 to 20 mins. 15 to 20 mins. 15 to 20 mins. No. referred for subsequent examination 1 none none No. to whom directions for treatment given 30 8 28 No. referred to S.M.O. as suitable for visiting by L.H. Visitor 3 none none Comments of A.S.M.O.—Dr. Oswald Roberts speaks highly of the cleanly and healthy condition of the children, and says : " It is quite the exception to meet with any child who has anything seriously wrong "beyond adenoids, etc. The few cases of nits I have met with, he adds, "have chiefly occurred among newly admitted Infants." Type—1, Girls' main room with two partitions, several classes in eacl division. Boys' main room with two partitions, several classes i each division. Infants' main and small room, no partition betweei classes. Site—Shut in. Mews on one side. Playground—-Small and inadequate, oyershadowed by Church, tar paved fairly well drained. Sanitary Conveniences— Boys 4 separate W.C.s, automatic flushing. Girls 4 separate W.C.s, automatic flushing. Infants 5 separate W.C.s, automatic flushing. Urinals—Senior Boys 10-ft. lineal, Infant Boys 13-ft. lineal. Lavatory Basins—Boys none. Girls and Infants 3 enamelled basins. Drinking Water—Girls and Infants obtain water from lavatory taps No cups. Class Room Walls and general Cleanliness of School—Matchboarde dado, smooth plaster above—clean. Desks—Old type, long and unsatisfactory. Lighting—U nsatisfactory. Heating—Open fireplaces, closed stoves, and gas heated radiators, I'entilation—Unsatisfactory. Cloak Rooms—Unsatisfactory. 74 CHRIST CHURCH SCHOOL. Degree. Attendance. Clothing. Footgear. Nutrition. 'Cleanliness of Skin. Do. Head. Do. Body. Mental Condition. Vision—R. Do. —L. Tonsils. Nose and Throat. Adenoids. Submax. and Cervical Glands External Eye Disease. Temp. Teeth defect. No., & No. of Children affected. Perm. Teeth defect No., & No. of Children affected. Ear Disease. Hearing. Speech. Heart and Circulatory. Lungs. Nervous Disease. Tuberculosis. Rickets. Deformities, Spinal Dis., etc. Infectious and Contagious Dis. Other defects. Tuberculosis in Family. 4 6 9 10 18 14 12 13 11 15 16 17 20 21 22 23 24 25 26 27 BOYS—Number Examined, no. 1 104 26 34 14 101 100 R. 68 63 77 76 25 M.B. 10 1 and 10 sus 2 A. 446 B. 93 A. 9 B. 5 3 3 1 10 2 4 81 71 1 2b 87 1 9 9 10 35 40 21 23 6 O.D. 6 Combined B 94 3 2 3 5 4 3 1 R.I.C 3 R.I. 1 V. 4 V. O.D. 2 O.D. 1 GIRLS—Number Examined. Qa. 1 77 4i 42 15 82 83 68 59 51 4* 26 M.B. 9 3 anc II sus 2 A. 285 B. 74 A. 4 B. 2 4 1 1 12 2 11 52 48 2b 70 9 11 11 18 27 28 30 7 O.D. 3 Combined B 74 3 6 1 R.I.C 2 4 . R.I. 2 1 V. 17 V. 1 5 6 5 O.D 1 For Symbols and Abbreviations used in this Table, see Table on page 41. 75 School—CHRIST CHURCH (Non-provided). Average number of Children on Roll 458 Number of Children medically inspected 204 Number of Parents objecting 6 INFANTS. BOYS. GIRLS. Assistant School Medical Officer J. F. Parr, l.s.a., etc. Head Teacher Mrs. Gillingham C. Wreford Miss L. Banting Accommodation 1909 1910 128 no 1909 1910 152 No alt. 1909 1910 152 No alt. Average No. on Roll 139 162 158 Time per Inspection eleven minutes eleven minutes eleven minutes No. referred for subsequent examination 6 (Department not stated) No. to whom directions for treatment given 41 (Department not stated) No. referred to s.M.o. as suitable for visiting by L.H. Visitor 6 » 18 Comments of A.S.M.O.—Dr. Parr has been struck with the state of a great number of the children's teeth. The many other troubles for which carious teeth are responsible, make it remarkable that so many parents seldom give a thought to the condition of the teeth of their children. Type—I. and IV. (combined). Two storey building, four class rooms on each floor, one teacher to each class room. Site—Abuts on houses. Playground—Boys' and Girls' department tar paved, well drained, good condition, Infants, not paved, in bad condition. Sanitary Conveniences— Boys 5 trough closets, automatic flushing. Girls 8 trough closets, automatic flushing. Infants 3 trough closets, automatic flushing. Urinals—Senior Boys 8-ft. 6-in. lineal, Infants, angle basin. Lavatory Basins—None. Drinking Water—One tap for boys and one for girls. Class Room Walls and general Cleanliness of School—Matchboarded dado, brickwork above—fairly clean. Desks—Long desks, unsatisfactory. Lighting—Direction of source of light faulty. Heating—Open fireplaces. Ventilation—Good. Cloak Rooms—Lighting and ventilation good. 76 GORDON MEMORIAL SCHOOL. Degree. Attendance. Clothing. Footgear. Nutrition. Cleanliness of Skin. Do. Head. Do. Body. Mental Condition Vision—R. Do. —L. Tonsils. Nose and Throat. Adenoids. Submax. and Cervical Glands External Eye Disease. Temp. Teeth defect. No., & No. of Children affected. Perm. Teeth defect No., & No. of Children affected. Ear Disease. Hearing. Speech. Heart and Circulatory. 1 Lungs. Nervous Disease. Tuberculosis. Rickets. Deformities, Spinal Dis., etc. Infectious and Contagious Dis. Other defects Tuberculosis in Family. 4 6 9 10 18 14 12 13 11 15 16 17 20 21 22 23 24 25 26 27 BOYS—Number Examined, 271. 1 186 104 135 162 237 242 A. 166 R. 159 99 98 23 M.B. 28 38 &; sus 75 S. A. 762 B. 19c A. 54 B. 23 29 14 13 10 12 & 1 sus. 6 4 sus. 3 12 4 17 3 2 14 132 86 2b 81 25 24 21 34 38 62 65 31 O.D. 44 O.D. 2 Combined B 210 3 24 35 50 3 10 8 4 7 12 10 9 R.I.C 61 . R.I. 47 Anaemic 10 V. 22 V. 10 O.D O.D GIRLS—Number Examined, 339. 1 22a 230 227 265 323 320 153 159 138 140 33 M.B 19 54 176 S. A. 869 B. 223 A. 187 B. 63 8 3 1 12 14 3 i 3 3 4 3 2 2 59 102 90 2b 4 27 - 13 14 102 89 76 73 30 O.D. 59 O.D. 4 Combined B 260 3 14 7 22 3 3 5 16 23 20 21 16 R.I.C 5 . R.I 3 V. 200 V. 14 O.D 1 O.D 1 O.D 1 For Symbols and Abbreviations used in this Table, see Table on page 41. 77 School—GORDON MEMORIAL (Non=provided). Average number of Children on Roll 1,004 Number of Children medically inspected 6lO Number of Parents objecting none INFANTS. BOYS. GIRLS. Assistant School Medical Officer A. L. Saunders, m.r.c.s. J. Snowman, m.r.c.p., Lond. A. L. Saunders, m.r.c.s., etc. Head Teacher Miss M. Parnell Mrs. Ulph Miss E. Meyler 1909 1910 1909 1910 1909 1910 Accommodation 387 338 410 333 439 354 Average No. on Roll 316 36 5 323 Time per Inspection ten minutes ten minutes ten minutes No. referred for subsequent examination 18 7 34 No. to whom directions for treatment given 170 38 89 No. referred to S.M.O. as suitable for visiting by L.H. Visitor 16 3 49 Comments of A.S.M.O.—Dr. Snowman finds the scheme of medical inspection working satisfactorily, he says: "We are applying the clinical experience gained by general practice to the medical needs of school children; the outstanding feature of the work is the conviction forced upon one that the remedying of the defects pointed out ought to be made obligatory." Type—III. Three storey, class rooms open on to corridors, six class rooms on each floor. In several class rooms, classes not separated. Site—Shut in. Playground—Small, tar paved, well drained, good condition, provides access to private houses. Sanitary Conveniences— Boys 4 trough closets, automatic flushing. Girls 8 trough closets, automatic flushing. Infants 4 trough closets, automatic flushing. Urinals—Senior Bovs 10-ft. lineal, Infant Boys 8-ft. lineal. Lavatory Basins—Boys 3, Girls 3, Infants 4. Drinking Water—Two taps, no cups. Class Room Walls and general Cleanliness of School—Hard plaster, painted dado—clean. Desks—Modern double desks. Lighting—Fair, direction of source of light faulty. Heating—Hot water radiators and open fire places. V entilation—Fair. Cloak Rooms—Badly ventilated, offensive, indifferently lighted. Comments of A.S.M.O.—Dr. Saunders says: "Most of the children of this school belong to the very poor. I have been much struck by the very few cases of children who one could say are under fed, and also with the great care with which the mothers' have clothed them. The heads, especially in the girls who have very long hair, are found to be full of nits. Great improvement has taken place with this trouble, as I make a point of seeing every infected head at least once a week. In several instances, children, desquamating from scarlet fever, have been found—this, in my opinion, must more than pay the expenses of the Act." 78 HARLESDEN R.C. SCHOOL. Degree. Attendance. Clothing. Footgear. Nutrition. Cleanliness of Skin. Do. Head. Do. Body. Mental Condition. Vision—R. Do. —L. Tonsils. Nose and Throat. Adenoids. Submax. and Cervical Glands External Eye Disease. Temp. Teeth defeet. No., & No. of Children affected. Perm. Teeth defect No., & No. of Children affected. Ear Disease. Hearing. Speech. Heart and Circulatory. Lungs. Nervous Disease. Tuberculosis. Rickets. Deformities, Spinal Dis., etc. Infectious and Contagious Dis. Other defects. Tuberculosis in Family. 4 6 9 10 18 14 12 13 11 15 16 17 20 21 22 23 24 29 26 27 BOYS—Number Examined, 80. 1 76 18 21 21 66 65 A. 35 R. 34 42 40 24 M.B. 3 33 S. A. 226 B. 61 A. 5 B. 3 2 5 5 3 3& 1 sus. 2 2 sus 3 2 4 3 3 2 2 5i 40 41/2b/15 12 13 22 25 12 15 4 O.D. 10 O.D. 5 Combined B 64 3 2 11 19 3 2 2 7 5 3 2 2 R.I.C. 19 R.I. 23 V. 10 O.D. 1 GIRLS—Number Examined, 73. 1 64 29 24 9 67 62 20 14 29 29 12 M.B. 1 8 22 S. A. 168 B. 53 A. 18 B- 7 1 2 2 4 2 2 2 2 6 2 5 41 41 44 2b/20 6 10 28 32 15 16 7 O.D. 4 O.D. 1 Combined B 58 3 4 3 8 1 4 6 5 4 5 R.I.C. 8 R.I. 10 V. 25 For Symbols and Abbreviations used in this Table, see Table on page 41. 79 School—HARLESDEN ROMAN CATHOLIC (NonProvided). Average number of Children on Roll 201 Number of Children medically inspected 153 Number of parents objecting 5 INFANTS. BOYS. GIRLS. Assistant School Medical Officer C. K. Rawes, m.b. Head Teacher Miss Hulhoven. Accommodation 1909 1910 37 No Alt. 1909 1910 88 No alt. 1909 1910 76 No alt. Average No. on Roll Mixed & Infants 201 Time per Inspection six minutes six minutes six minutes No. referred for subsequent examination 52 (Department not stated) No. to whom directions for treatment given 57 (Department not stated) No. referred to S.M.O. as suitable for visiting by L.H. Visitor 19 7 52 Comments of A.S.M.O.—Dr. Rawes, after expressing an opinion on several administrative points in which I concur, says, " y inspection so far, tends, I think, to show that the proportion of well nourished children is larger amongst the ill-clad than amongst the better cared for, and that the ailments the ill-clad suffer from are not usually traceable to innutrition. The prevalence of enlarged tonsils and adenoids is, I think, partly due to the overheating of the kitchens, in which they live, and their bad ventilation, causing constant catarrhal attacks when going into the open air." Type—I. L-shaped single storey building, partly new, separate class rooms. Site—Partially shut in. Playground—Tar paved, well drained, good condition. Sanitary Conveniences— Boys 3 separate W.C.s with flushing cisterns. Girls 4 separate W.C.s with flushing cisterns. Infants 4 separate W.C.s with flushing cisterns. Urinals—Senior Boys 15-ft. lineal, Infant Boys 9-ft. lineal. Lavatory Basins—Six glazed stoneware. Drinking Water—Two water fountains with metal cups. Class Room Walls and general Cleanliness of School—Hard plaster, —clean. Desks—Mixed, double and long. Lighting—Good, but direction of source of light faulty. Heating—Closed stoves. V entilation—Good. Cloak Rooms—Well lighted and ventilated. 8o HOLY TRINITY SCHOOL. Degree. Attendance. Clothing. Footgear. Nutrition. Cleanliness of Skin. Do. Head. Do. Body. Mental Condition. Vision—R. Do. -L. Tonsils. Nose and Throat. Adenoids. Submax. and Cervical Glands External Eye Disease. 'Temp. Teeth defect. No., & No. of Children affected. Perm. Teeth defect No.,S No. of Children affe ted. Ear Disease. Hearing. Speech. Heart and Circulatory. Lungs. Nervous Disease. Tuberculosis. Rickets. Deformities, Spinal Dis., etc. Infectious and Contagious Dis. Other defects. Tuberculosis in Family. 4 6 9 10 18 14 12 13 11 15 16 17 20 21 22 23 2 i 25 26 27 BOYS—Number Examined, 144. 1 113 72 74 76 122 99 A. 43 R. 39 101 100 3 M.B. 2 3 and 1 sus. 3 A. 402 B. 113 A. 5 B. 2 1 2 3 7 4 4 1 sus. 4 5 3 2 13 56 4i 57/2b/11 16 30 43 44 4 3 23 O.D. 7 Combined B 114 3 9 16 29 6 15 32 35 5 7 9 R.I.C. 33 R.I. 8 V. 4 V. O.D. 8 O.D. 5 GIRLS—Number Examined, 95. 1 59 53 56 60 52 70 27 28 27 30 3 M.B. 5 8 3 A. 226 B. 72 A. 21 B. 6 1 8 4 3. 4 2 1 2 1 2 16 39 29 2b 29 6 36 15 28 27 30 3i 11 O.D. 8 Combined B 77 3 8 3 10 7 10 11 11 8 4 3 R.I.C. 3 V. 28 O.D. 1 O.D. 2 For Symbols and Abbreviations used in this Table, see Table on page 41. 81 School—HOLY TRINITY, HIGH ROAD, AND CANTERBURY ROAD (Non-provided). Average number of Children on Roll 555 Number of Children medically inspected 239 Number of Parents objecting 2 INFANTS. BOYS. GIRLS. Assistant School Medical Officer H. Knox, l.r.c.p. Head Teacher Miss C. Harris G. Chappie Miss R. Thompson 1909 1910 1909 1910 1909 19io Accommodation 180 204 180 166 180 No alt. Average No. on Roll 173 195 187 Time per Inspection seven minutes seven minutes seven minutes No. referred for subsequent examination none 7 7 No. to whom directions for treatment given ... 14 45 53 No referred to S.M.O. as suitable for visiting by L.H. Visitor 1 none 3 Comments of A.S.M.O.—Dr. Knox has been particularly impressed by the lack of treatment, especially of cases of defective teeth and eyes, ringworm, enlarged tonsils, and dirty conditions of the head. Dr. Knox reports a marked improvement in respect of verminous conditions in the Girls' School, "due in a very great measure to the publicity given to the S.M.O.'s request to parents to keep their children's hair short," and also to the continuous weekly reinspection of children found to be verminous. Type—I. Boys, single storey, three class rooms, classes not separated in main room ; Girls and Infants, two storeys, classes in main rooms not separated, no corridor, class rooms open one into another. Site—Shut in (Girls and Infants). Playground—Tar paved, well drained, good condition. Sanitary Conveniences— Boys 4 syphonic latrines, automatic flushing. Girls 8 syphonic latrines, automatic flushing. Infants 3 syphonic latrines, automatic flushing. Urinals—Senior Boys 19-ft. lineal, Infant Boys 15-ft. lineal. Lavatory Basins—Boys 4, Girls 4, Infants 3. Drinking Water—Boys, Girls and Infants, one tap each over lavatory basins. Class Room Walls and general Cleanliness of School—Brickwork painted dado—clean. Desks—Mixed, majority long desks, unsatisfactory. Lighting—Indifferent. Direction of source of light faulty. Heating—Closed stoves and open fireplaces. Ventilation—Bad. Cloak Rooms—Lighting and ventilation good. 82 KEBLE MEMORIAL SCHOOL. Degree. Attendance. Clothing. Footgear. Nutrition. Cleanliness of Skin. Do. Head. Do. Body. Mental Condition. Vision—R. Do. —L. Tonsils. Nose and Throat. Adenoids. Submax. and Cervical Glands External Eye Disease. Temp. Teeth defeet. No., iV No. of Children affected. Perm. Teeth defect No., & No. of Children affected. Ear Disease. Hearing. Speech. Heart and Circulatory. Lungs. Nervous Disease. Tuberculosis. Rickets. Deformities. Spinal Dis., etc. Infectious and Contagious Dis. Other defects. Tuberculosis in Family. 4 6 9 10 18 14 12 13 11 IS 16 17 20 21 22 23 24 25 26 27 BOYS—Number Examined, 145. 1 137 145 143 143 145 145 A. 94 R. 87 79 72 48 M.B. 4 &3 sus. 42 A. 247 B. 79 A. 36 B.13 6 4 4 5 1 1 sus. 2 i 9 2 3 2 2/2b 40 44 38 5i 18 O.D. 10 Combined B 90 3 5 1 4 18 12 1 R.I.C 6 R.I. 11 O.D. 3 GIRLS—Number Examined, 135. 1 101 135 135 135 134 134 108 94 47 47 47 M.B. 1 11 40 A. 196 B. 56 A. 93 B. 36 9 3 7 1 3 2 sus. 4 i 2 7 2 18 2b 1 1 19 33 53 52 22 O.D. 10 Combined B 92 3 16 12 13 2 R.I.C. 1 R.I. 1 V. 5 O.D. 1 For Symbols and Abbreviations u»ed in this Table, see Table on page 41. 83 School KEBLE MEMORIAL (Non-provided). Average number of Children on Roll 540 Number of Children medically inspected 280 Number of Parents objecting 4 INFANTS. BOYS. GIRLS. Assistant School Medical Officer C. E. A. Armitage, m.a., m.b. Head Teacher Miss E. Turnbull. Miss S. Rose. Miss E. Clifford. 1909 1910 1909 1910 1909 1910 Accommodation 130 No alt. 175 No alt. 227 No alt. Average No. on Roll 164 159 217 Time per Inspection ten minutes. ten minutes. ten minutes. No. referred for subsequent examination 15 (Department not stated) No. to whom directions for treatment given 33 (Department not stated) No. referred to S.M.O. as suitable for visiting by L.H. Visitor 4 none none Comments of A.S.M.O.—Dr. Armitage says, "I have been struck by the number of children with badly decayed teeth and consequent glandular infection. In many cases, nothing is done for this condition in spite of advice. Again, in many cases of enlarged tonsils, I refer to those so enlarged as to be prejudicial to the child's health, in spite of repeated notice the parents have declined to W take any steps in the matter. On the whole, I think there has been a general absence of any serious disease, and I have been much impressed by the all-round cleanliness of the children." Type—III. Three storey block, with separate classrooms, opening into through ventilated corridor. Site—Open on three sides, one side closely abuts on houses. Playground—Small portion tar paved, remainder earth, bad condition. Sanitary Conveniences— Boys 4 separate W.C.s with 2 gallon flushing cisterns. Girls 13 separate W.C.s with 2 gallon flushing cisterns. Infants 4 separate W.C.s with 2 gallon flushing cisterns. Urinals—Senior Boys 21-ft. lineal, Infant Bovs 8-ft. lineal. Lavatory Basins—Boys 5, Girls 5, Infants 5. Drinking Water—Taps in each department, but no drinking cups. Class Room Walls and general Cleanliness of School—Internal surface rough brickwork, lower part painted, upper coloured. Desks—Modern double desks. Lighting—Good. Heating—Hot water pipes and radiators. Ventilation—Good. Cloak Rooms—Light and ventilation good. NEASDEN-CD M-KINGSBURY SCHOOL. Degree. Attendance. Clothing. Footgear. Nutrition. Cleanliness of Skin. Do. Head. Do. Body. Mental Condition. Vision—R. Do. —L. Tonsils. Nose and Throat. Adenoids. Subm.ix. and Cervical Glands External Eye Disease. Temp. Teeth defect. No., & No. of Children affected. Perm. Teeth defect No., &. No. of Children affected. Ear Disease. Hearing. Speech. Heart ano Circulatory. Lungs. Nervous Disease. Tuberculosis. Rickets. Deformities, Spinal Dis., etc. Infectious and Contagious Dis. Other defects. Tuberculosis in Family. 4 6 9 10 18 14 12 13 11 15 16 17 20 21 22 23 24 25 26 27 BOYS—Number Examined, 50. 1 37 24 23 r5 46 43 A. 3i R. 3i 18 X4 5 M.B. 9 5 A-73 B. 22 A. 38 B. 14 1 2 1 2 10 26 26 2b 27 8 4 7 8 8 17 19 2 O.D. 1 Combined B 32 3 I 1 3 3 3 5 2 R.I.C. 2 R.I. 1 V. 0 O.D. 1 GIRLS—Number Examined, 43. 1 34 18 20 17 37 42 33 30 10 9 1 M.B. 1 8 7 A.53 B.15 A. 29 B. 12 6 2 1 2 7 24 21 2b 20 6 5 1 2 5 21 20 2 O.D. 1 Combined B 27 3 2 1 2 1 2 4 R.I. 5 V. 5 O.D. 2 For Symbols and Abbreviations used in this Table, see Table on page 41. J? 85 School— NEASDEN-CUM-KINGSBURY (Non-provided). Average number of Children on Roli 210 Number of Children medically inspected 93 Number of Parents objecting none INFANTS. BOYS. GIRLS. Assistant School Medical Officer Mixed and J. Mechan, m.b , Infants g.m. Head Teacher D. S. Garner 1909 1910 Accommodation 274 259 Average No. on Roll 58 80 72 Time per Inspection eight minutes eight minutes eight minutes No. referred for subsequent examination (Department not stated) No. to whom directions for treatment given ... 14 15 No referred to S.M.O. as suitable for visiting by L.H. Visitor 4 (Department not stated) Comments of A.S.M.O.—None offered. Type—I. and II. (combined). Single storey building, main class room sub-divided by single partition, and two smaller class rooms, classes not separated. Playground—Not paved. Sanitary Conveniences— Boys 3 syphonic latrines, automatic flushing. Girls 3 syphonic latrines, automiatic flushing. Infants 2 syphonic latrines, automatic flushing. Urinals—Senior Boys 8-ft. lineal, Infant Boys 10-ft. lineal. Lavatory Basins—Five. Drinking Water—From taps over lavatory basins, metal cups. Class Room Walls and General cleanliness of School—Brickwork distempered—fairly clean. Desks—Modern double desks. Lighting—Light good. In main room desks badly arranged respecting direction of light. Heating—Closed stoves. Ventilation—Fair. Cloak Rooms—Well ventilated, badly lighted. PRINCESS FREDERICA SCHOOL. Degree. Attendance. Clothing. Footgear. Nutrition. Cleanliness of Skin. Do. Head. Do. Body. Mental Condition. Vision—R. Do. —L. Tonsils. Nose and Throat. Adenoids. Submax. and Cervical Glands External Eye Disease. Temp. Teeth defect. No., & No. of Children affected. Perm. Teeth defect No., & No. of Children affected. Ear Disease. Hearing. Speech. Heart and Circulatory. Lungs. Nervous Disease. Tuberculosis. Rickets. Deformities, Spinal Dis., etc. Infectious and Contagious Dis. Other defects. Tuberculosis in Family. 4 6 9 18 14 12 13 11 15 16 17 20 21 22 23 24 25 26 27 BOYS—Number Examined, 262. 1 244 128 137 120 245 250 A. 60 R. 59 63 61 28 M.B 30 5 and 3 sus. 67 S. 6 A. 222 B. 68 A. 84 B.44 14 9 15 6 14& 1 sus. 5 3&3 sus. 12 12 2&1 sus. 7 13 2 7 127 118 114/2b/26 17 12 84 85 45 40 24 O.D. 64 O.D. 4 Combined B 104 3 11 7 7 2 4 4 10 17 6 R.I.C. 49 R.I. 13 V. 13 V. O.D. 5 O.D. 1 GIRLS—Number Examined, 311. 1 260 172 162 89 308 309 81 80 99 105 30 M.B. 4 4& 3 sus. 23 S. 4 A. 214 B. 85 A. 49 B. 22 8 17 8 5 9 1 4 10 2 5 4 2 36 137 147 199/2b/22 3 2 164 166 9i 90 11 O.D. 10 O.D. 8 Combined B 106 3 15 2 2 1 3 2 23 18 1 R.I. 1 V. 34 O.D. 1 For Symbols and Abbreviations used in this Table, see Table on page 41. CX! Ov 87 School PRINCESS FREDERICA (Non provided). Average number of Children on Roll 1,055 Number of Children medically inspected 573 Number of Parents objecting 18 INFANTS BOYS. GIRLS. Assistant School Medical Officer H. Wilson, m.b. W. Walker, m.r.c.s. H. Wilson, m.b. Head Teacher Miss E. Slaughter. Miss A. Tozen. Miss E. Fletcher 1909 1910 1909 1910 1909 1910 Accommodation 266 238 527 432 S27 434 Average No. on Roll 268 4 4 373 Time per Inspection eight minutes ten minutes. eight minutes No. referred for subsequent examination 3 12 3 No. to whom directions for treatment given 23 86 39 No. referred to S.M.O. as suitable for visiting by L.H. Visitor 10 14 22 Comment by A.S.M.O.—Dr. H. Wilson has found that the scheme has worked very well, and that the inspection has resulted in a generally improved condition of the children. "Tuberculosis has been markedly absent, one unsuspected case was detected, although attending a children's hospital for a discharge from the ear. This case shows the utility of the general school examination. Through the kindness of the teachers, this case was sent to Eastbourne and Broadstairs, and is greatly improved (chronic tubercular pleurisy). Two other suspected cases (one following measles, the other a case of haemoptysis after violent vomiting) were also sent away by subscriptions raised by the teachers, and returned (i) much better, but with chronic bronchitis, and (2) apparently cured. Eye cases are the most unsatisfactory, many mothers not allowing their daughters to wear glasses in spite of my repeated protest. Deafness, leading to inattention and apparent stupidity, has, in several cases, been found due to impacted wax. Heart disease (serious) was detected in one unsuspected case. Enlarged tonsils, adenoids, etc., occurred fairly frequently, and enlarged glands in the neck were so common at the change of dentition, and so rare in the older girls, as to suggest that they might be partly physiological. For Dr. W. Walker's comments, see page 47. Type—IV. Three storied buildings, separate classrooms opening to internal corridors, terminating on each floor in offices separated by cross ventilation. Site—Open, elevated. Playground—Tar paved, fairly good condition. Sanitary Conveniences— Boys 7 syphonic latrines, automatic flushing. Girls 10 syphonic latrines, automatic flushing. Infants 6 syphonic latrines, automatic flushing. Urinals—Senior Boys 68-ft. lineal, Infant Boys 29-ft. lineal. Lavatory Basins—Boys 4, Girls 4, Infants 2. Drinking Water—One tap for Boys, one tap for Girls and Infants. Class Room Walls and general Cleanliness of School—Painted dado, brickwork above distempered—clean. Desks—Modern double desks. Lighting—Desks badly arranged respecting direction of light in several classrooms, light good. Heating—Hot water pipes, radiators, and open fireplaces. Ventilation—Fair. Cloak Rooms—Lighting and ventilation good. 88 ST. ANDREW'S SCHOOL. Degree. Attendance. Clothing. Footgear. Nutrition. Cleanliness of Skin. Do. Head. Do. Body. Mental Condition. Vision—R. Do. —L. Tonsils. Nose and Throat. Adenoids. Submax. and Cervical Glands External Eye Disease. Temp. Teeth defect. No., & No. of Children affected. Perm. Teeth defect No., & No. of -Children affected. Ear Disease. Hearing. Speech. Heart and Circulatory Lungs. Nervous Disease. Tuberculosis. Rickets. Deformities, Spinal Dis., etc. Infectious and Contagious Dis. Other defects. Tuberculosis in Family. 4 6 9 10 18 14 12 13 11 15 16 17 20 21 22 23 24 25 26 27 BOYS—Number Examined, 200. 1 150 131 141 4 183 177 A. 144 R. M4 105 98 52 M.B. 4 1 & 12 sus. 64 S. 3 A. 333 B. 87 A. 57 B.26 6 8 11 7 3&1 sus. 2 i ii 2 4 2 41 67 57 128 2b 30 15 21 19 19 46 52 34 O.D. 27 O.D. 1 Combined B 112 3 9 2 2 2 2 2 2 2 14 »5 5 R.I.C. 9 R.I. 4 V. 7 O.D. 2 GIRLS—Number Examined, 158. 1 146 105 109 49 145 '45 107 106 73 69 28 M.B. 3 1 and 6 sus. 5i S. 2 A. 268 B. 67 A. 33 B.15 6 4 7 3 2 1 3 2 4 53 49 2b/91/14 11 13 3 4 26 29 17 O.D. 12 O.D. 1 Combined B 80 3 8 4 2 1 1 10 11 2 R.I.C. 3 R.I. 2 V. 28 O.D. 2 For Symbols and Abbreviations used in this Table, see Table on page 41. «9 School -ST. ANDREW'S (Non-provided). Average number of Children on Roll 934 Number of Children medicallv inspected 358 Number of Parents objecting 6 INFANTS. BOYS. GIRJLS. Assistant School Medical Officer R. Cruden, m.a., m.b. H. Seagrove, l.r.c.p., m.r.c.s. Head Teacher Mrs. Kent R. J. Kent Mrs. Peachey 1910 1910 Accommodation 236 207 425 379 334 No alt. Average No. on Roll ... 256 347 33* Time per Inspection ten minutes thirteen minutes thirteen minutes No. referred for subsequent examination 30 36 (department 11 ot stated) No. to whom directions for treatment given ... 58 none none No. referred to S.M.O. as suitable for visiting by L.H. Visitor 12 none none Comments of A.S.M.O.—Dr. Cruden reports that with respect to verminous heads, that he thinks it would be a good thing if, before a holiday period, each A.S.M.O. were to pass in review at least all the girls of the school, and give instructions to the parents of all those found to be infected to have treatment carried out during the holidays. Type—I. and II. (combined). Infants' school separate building (type I.) situated apart from Boys' and Girls' department. Boys' and Girls' department, main room divided by glass partitions. Infants, four class rooms opening one into the other, in two rooms, classes not separated. Site—Boys' and Girls' open to street two sides, abuts on houses one. Infants' shut in. Playground—Tar paved, well drained, good condition. Sanitary Conveniences— Boys 5 latrines stoneware, automatic flushing. Girls 5 latrines stoneware, automatic flushing. Infants 5 latrines stoneware, automatic flushing. Urinals—Senior Boys 30-ft. lineal, Infant Boys 15-ft. lineal. Lavatory Basins—Boys 4, Girls 4, Infants none. Drinking Water—Five taps, no cups provided. Class Room Walls and general Cleanliness of School—Wood dado, varnished, brickwork above distempered—dirty. Desks—Boys and Girls, majority long desks, unsatisfactory. Lighting—Infants, very defective, mullions and lead glazing further obscuring the deficient light. Boys and Girls fair. Heating—Close stoves. Ventilation—Inadequate. Boys, Girls and Infants. Cloak Rooms—Infants' good, Girls' department inadequate. Comments of A.S.M.O.—Boys' and Girls' department—none offered. 90 ST. JOHN'S SCHOOL. Degree. Attendance. Clothing. Footgear. Nutrition. Cleanliness of Skin. Do. Head. Do. Body. Mental Condition. Vision—R. Do. —L. Tonsils. Nose and Throat. Adenoids. Submax. and Cervical Glands ; External Eye Disease. Temp. Teeth defeet. No., & No. of C hildren affected. Perm. Teeth defect No., & No. of Children affected. Ear Disease. Hearing. Speech. Heart and Circulatory. Lungs. Nervous Disease. Tuberculosis. Rickets. D :formities, Spinal Dis., etc. Infectious and onr:»?!ous Dis. Other defects. Tuberculosis in Family. 4 6 9 10 18 14 12 13 11 F) 16 17 ?0 21 ?2 24 25 27 BOYS—Number Examined, 305. 1 279 161 182 5 256 255 A. 91 R. 79 162 155 65 M.B. 75 85 & 74 sus. 189 S. 7 A. 765 B. 179 A. 27 B. 12 20 76 90 4 13 & 5 sus. 10 8 sus. IO 9 7 21 5 2 12 109 86 188 2b 58 35 35 113 113 78 84 86 O.D. 108 O.D. 13 Combined B l8l 3 14 35 37 1 14 15 60 72 17 18 21 R.I.C. 89 R.I. 29 Anæmic 2 V. 27 V. 16 O.D. 2 O.D. 8 O.D. 6 GIRLS—Number Examined, 183. 1 126 126 "5 34 165 158 A. 54 R. 46 74 7i 35 M.B. 42 44 & 50 sus. 115 S. 2 A. 378 B. 108 A. 13 B. 10 6 3i 46 5 9 & 2 sus. 10 i & i sus. 4 3 1 6 8 2 30 42 39 117/2b/31 16 22 61 66 61 67 52 O.D. 47 O.D. 7 Combined B no 3 27 15 29 1 2 3 43 46 19 16 12 R.I.C. 9 R.I. 16 Anaemia V. 118 V. 13 O.D For Symbols and Abbreviations used in this Table, see Table on page 41. 91 School—ST. JOHN'S, KILBURN (Non provided). Average number of Children on Roll 807 Number of Children medically inspected 488 Number of Parents objecting 2 INFANTS. BOYS. GIRLS. Assistant School Medical Officer J. Snowman, m.r.c.p. J. Cassidy, l.r.c.p. Head Teacher Miss S. Trapp. T. Sandford Miss M. Noble 1909 1910 1909 1910 1909 1910 Accommodation 249 220 3i4 254 226 184 Average No. on Roll 249 315 243 Time per Inspection fifteen minutes fifteen minutes fifteen minutes No. referred for subsequent examination 8 30 (dept. not stated) No. to whom directions for treatment given ... 77 260 (dept. not stated) No. referred to S.M.O. as suitable for visiting by L.H. Visitor 6 80 50 Comments of A.S.M.O.—Dr. Cassidy found the majority of parents desirious of rectifying, by medical treatment, the many defects or diseases found on inspection. Many children, however, suffering from defective vision, are unable to procure the glasses prescribed, through poverty of the parents. " The heads of children have shown a marked improvement, and I have noticed that a good many of the girls have had their hair cut, with very beneficial results." Dr. Snowman says All the girls, without exception, are infected with nits ; defective and insufficient clothing is a marked condition in this school, and I suggest that the children ought to be supplied with clean overalls in school. The premises are wholly unsuitable for school, both the class rooms and playground." Type—II. Two storey building, no central hall or through corridor, classrooms open direct one into another, classes not separated as a rule. Site—Shut in. Playground.—Girls and Infants tar paved, Boys gravel. Inadequate. Sanitary Conveniences— Boys 5 separate W.C.s, 2 gallon flushing cistern. Girls 7 separate W.C.s, 2 gallon flushing cistern. Infants 4 separate W.C.s, 2 gallon flushing cistern. Urinals—Senior Boys 24-ft. lineal, Infant Boys 13-ft. lineal. Lavatory Basins—Boys 6, Girls 4, Infants 3. Drinking Water—One tap to each department over lavatory basin. Class Room Walls and general Cleanliness of School—Brickwork painted dado—fairly clean. Desks—Mixed, long and modern. Lighting—Very unsatisfactory, in Infants' department execrable. Heating—Closed stoves and open fireplaces. V entilation—Bad. Cloak Rooms—Lighting and ventilation good. 93 ST. MARY'S SCHOOL. Degree. Attendance. Clothing. Footgear. Nutrition. Cleanliness of Skin. Do. Head. Do. Body. Mental Condition. Vision—R. Do. —L. Tonsils. Nose and Throat. Adenoids. Submax. and Cervical Glands External Eye Disease. Temp. Teeth defect. No., & No. of Children affected. Perm. Teeth defect No., & No. of; -Children affected. Ear Disease. Hearing. Speech. Heart and Circulatory. Lungs. Nervous Disease. Tuberculosis. Rickets. Deformities, Spinal Dis., etc. Infectious and Contagious Dis. Other defects. Tuberculosis in Family. 4 6 9 10 18 14 12 13 11 15 16 17 20 21 22 23 24 25 26 27 BOYS—Number Examined, 136. 1 113 38 44 87 130 127 A. 116 R. 112 80 88 15 M.B. 1 4 8 S. 1 A. 325 B. 88 A. 13 B. 4 1 2 1 5 1 2 1 3 1 2 15 96 89 2b/43/5 6 9 10 14 38 28 7 O D. 5 Combined B 92 3 2 3 1 8 10 R.I.C 6 R.I. 4 V. 2 O D. 5 GIRLS—Number Examined, 137. 1 103 87 86 80 126 125 121 121 72 74 25 M.B. * 17 S. 2 A. 283 B. 89 A. 12 B. 5 i 3 1 3 1 1 1 1 2 3 2 12 47 50 51/2b/5 11 12 3 3i 26 11 O.D. 6 O.D. 1 Combined B 92 3 15 3 1 1 2 2 16 19 R.I.C. 4 R.I 2 V. 65 O.D. 2 For Symbols and Abbreviations used in this Table, see Table on page 41. 93 School—ST. MARY S, CHURCH END (Non-provided). Average number of Children on Roll 647 Number of Children medically inspected 273 Number of Parents objecting None INFANTS. BOYS. GIRLS. Assistant School Medical Officer J. McD. Tudge, m.r.c.s., d.p.h. Head Teacher Miss L. Stevens. J. Pickworth. Miss M. Greening. 1909 1910 1909 1910 1909 1910 Accommodation 239 208 360 3m 264 219 Average No. on Roll 130 264 253 Time per Inspection ten minutes. ten minutes. ten minutes. No. referred for subsequent examination 30 10 38 No. to whom directions for treatment given ... 38 34 67 No referred to S.M.O. as suitable for visiting by L.H. Visitor 9 none none Comments of A.S.M.O. Dr. Tudge remarks that the special "clean up" which children get in consequence of the intimation of date of medical inspection throws the cleanliness of the skin and clothes into marked contrast with the condition of their heads. He says, "In the boys school I do not remember having seen a dirty head, but in the girls nits are only too frequent, especially among the older girls. I can only attribute this to the different mode of wearing the hair. I am glad to say that the percentage of nits has much decreased since the earlier inspections. Much of the benefit that would be derived from the inspections is discounted by the inability of the parents to carry out the suggestions of the Medical examiner, in a very few cases from indifference, but mostly from poverty. Many of the mothers have stated that they are not in a position to consult a medical man, and cannot afford the fares to go to a hospital." Type—II. Infants' department small, single storey block of three rooms, classes not separated. Boys' and Girls' department single storey building without corridor, class rooms opening directly one into another, classes in main rooms not separated. Site—Open in both cases. Playground—Tar paved, well drained, good condition. Sanitary Conveniences— Boys 6 trough closets, automatic flushing. Girls 8 trough closets, automatic flushing. Infants 8 separate W.C.s with 2 gallon flushing cisterns. Urinals—Senior Boys 37-ft. lineal, Infant Boys 13-ft. lineal. Lavatory ttasitis—Boys 2, Girls 3, Infants 2, no water supply. Drinking Water—Three taps in playground, metal cups in boys. Class Room Walls and general Cleanliness of School—Boys and Girls department painted dado, brickwork above—clean. Infants, matchboarded dado, brickwork above—clean. Desks—Infants, majority long desks unsatisfactory, Boys' and Girls' department, majority modern double desks. Lighting—Boys and Girls' department very bad. Infants' fair, direction of source of light faulty. Heating—Closed stoves and open fireplaces. I'entilation—Very defective. Cloak Rooms—Infants' defective, lighting and ventilation boys' and girls' good. 94 ST. MARY'S R.C. SCHOOL. Degree. Attendance. Clothing. Footgear. Nutrition. Cleanliness of Skin. Do. Head. Do. Body. Mental Condition. Vision—R. Do. —L. Tonsils. Nose and Throat. Adenoids. Submax. and [Cervical Glands External Eye Disease. 'Temp. Teeth defect. No., & No. of Children affected. Perm. Teeth defect No., & No. of Children affected. Ear Disease. Hearing. Speech. Heart and Circulatory. Lungs. Nervous Disease. Tuberculosis. Rickets. Deformities, Spinal Dis., etc. Infectious and Contagious Dis. Other defects. Tuberculosis in Family. 4 6 9 10 18 14 12 13 11 13 16 17 20 21 22 23 24 25 26 27 BOYS—Number Examined, 92. 1 56 68 72 20 69 64 A. 16 R. 16 11 11 16 M.B. 34 39& 20 sus. 63 S. 3 A. 119 B. 34 A. 2 B. 2 4 27 37 4 2 & 1 sus. 2 3 sus. 3 3 3 6 9 2 16 17 13 59/2b/12 14 19 33 32 35 34 26 O.D. 41 O.D. 6 Combined B 35 3 18 7 7 1 9 9 8 9 2 3 18 R.I.C. 22 R.I. 1 V. 5 V. O.D. 3 O.D. 1 GIRLS—Number Examined, 122. 1 80 105 105 33 106 104 45 4i 20 21 25 M.B. 26 40& 20 sus. 73 S. 3 A. 236 B. 57 A. 1 B. 1 5 19 25 2 2 3 2 sus. 2 4 6 6 2 16 10 10 73 /2b/16 11 15 64 68 60 57 33 O.D. 35 O.D. 8 Combined B 57 3 24 7 7 5 3 13 13 9 11 8 R.I.C. & V. 68 V. O.D. 8 O.D. 2 For Symbols and Abbreviations used in this Table, see Table on page 41. 95 School—ST. MARY'S ROMAN CATHOLIC (Nonprovided). Average number of Children on Roll 283 Number of Children medically inspected 214 Number of Parents objecting 3 INFANTS. BOYS GIRLS. Assistant School Medical Officer J-Cassidy, l.r.c.p. Head Teacher Miss M. McCarthy Mixed.—Miss M. Wilkes 1909 1910 1909 1910 1909A1910c«ommodation 160 142 132 No alt. Average No. on Roll i43 64 76 Time per Inspection fifteen minutes fifteen minutes fifteen minutes No. referred for subsequent examination 20 (Department not stated) No. to whom directions for treatment given ... 235 (Department not stated) No. referred to S.M.O. as suitable for visiting by L.H. Visitor 27 10 17 Comments of A.S.M.O.—For Dr. Cassidy's comments see St. John's School, page 91. Type—II. Two storey building, three class rooms on each room in main room, classes not separate. Site—Shut in. Playground—Tar paved, well drained, good condition. Sanitary Conveniences— Boys 7 trough closets, automatic flushing. Girls 7 trough closets, automatic flushing. Infants No separate provision. Urinals—Senior Boys and Infant Bovs 12-ft. 9-in. lineal. Lavatory Basins—Senior and Infant Boys 3, Senior and Infant Girls 3. Drinking Water—From taps over lavatory basins, Boys 1, Girls 1. Class Room Walls and general Cleanliness of School—Matchboarded dado, hard plaster above—clean. Desks—Mixed, long and modern. Lighti ng— Fair. Heating—Hot water pipes. Ventilation—Fair. Cloak Rooms—Light and ventilation good. 96 TABI.E SHOWING AVERAGE HEIGHTS (CENTIMETRES) AND WEIGHTS (KILOGRAMMES) AT EACH TRIMESTER OF EACH YEAR OF AGE FOR BOYS AND FOR GIRLS. No. Exd Height. Weight. No. Exd Height. Weight. No. Exd Height. Weight No Exd Height. Weight. Age Periods 4.0 4.25 4.50 4.75 Boys 14 95.4 15.6 29 98.6 15.8 38 98.4 15.8 64 98.4 16.9 Girls 8 95°9 15.8 17 95.6 15'3 28 98.4 i6'o 53 98.4 15.8 Age Periods 5.0 5.25 5.50 5.75 Boys 227 1020 17.0 213 103.5 17.5 213 103.0 17.9 212 106.7 18.2 Girls 188 101.6 17.7 163 103.3 17.1 210 105.3 177 191 105.6 17.4 Age Periods 6.0 6.25 6 .50 6.75 Boys 127 107.1 18.0 84 108.6 19.2 75 109.9 18.8 120 111.6 20.0 Girls 14.1 107.8 18.3 7 5 109.1 18.2 69 109.4 19.1 99 113.0 19.9 Age Periods 7.0 7.25 7.50 7.75 Boys 340 114.1 20.6 290 115.4 21.0 300 112.1 211 272 119.4 21.7 Girls 346 113.2 19.9 289 115.3 20.9 275 115.6 207 268 117.0 20.9 Age Periods 8.0 8.25 8 .50 8.75 Boys 162 117.6 21.9 92 120.4 23.3 67 121.3 23.8 41 123.7 24.1 Girls 112 119.4 22.5 67 118.9 21.2 53 120.9 22.5 27 123.9 23.5 Age Periods 9.0 9 .25 9.50 0.75 Boys 40 126.0 25.5 54 125.9 25.5 50 124.6 25.2 53 127.5 26.1 Girls 44 122.2 ,22'S 34 122.6 23.3 42 122.8 23.6 32 129.1 26.9 Age periods 10.0 10.25 10.50 10.75 Boys 203 130.1 27.3 202 129.3 27.1 256 130.2 27.6 266 132.6 28.4 Girls 219 129.5 26.3 281 1303 26.7 232 131.3 27.3 250 131.8 27.4 Age Periods 11.0 11.25 11.50 11.75 Boys 161 132.6 28.7 89 134.8 29.7 48 134.7 29.8 45 137.3 31.2 Girl 109 135.8 29.1 66 134.8 29.4 38 134.5 28.9 36 138.1 30.2 Age Periods 12.0 12.25 12.50 12.75 Boys 1 139.8 31.8 20 142.6 35.3 25 139.4 31.3 34 140.5 33.9 Girls 6 1371 30.6 13 140.2 32.1 22 143.1 34'9 31 142.6 33.5 Age Periods 13.0 13.25 13.50 13.75 Boys 194 141.1 33.8 254 143.2 34.9 237 145.1 36.5 217 145.7 36.7 Girls 240 144.8 36.5 233 146.2 37'2 230 147.0 37.4 167 148.9 40.0 Age Periods 14.0 14.25 14.50 14.75 Boys 78 148.1 40.1 56 150.4 40.2 22 155.2 44.8 16 155.7 44.4 Girls 48 150.9 40.4 23 151.0 41.4 19 153.6 43.9 13 157.1 477 97 TABLE SHOWING AVERAGE WEIGHTS (in Kilogrammes) OF SCHOLARS ATTENDING WILLESDEN SCHOOLS AT VARIOUS AGE PERIODS. Age Periods ... 4—5 5—6 6—7 7.8 8.9 9—10 Schools. Boys. Girls. Boys. Girls. Boys. Girls. Boys. Girls. Boys. Girls. Boys. Girls. No. Exd. Aver. No. Exd Aver. No. Exd. Aver. No. : Exd. Aver. No. Exd. Aver. No. Exd. Aver. No. Exd. Aver. No. Exd. Aver. No. Exd. Aver. No. Exd. Aver. No. Exd. Aver. No. Exd. Aver. 1 Acton Lane 1 17.0 39 19.4 33 18.5 21 20.5 23 20.8 58 23.0 41 21.4 12 23.8 14 23.8 4 28.6 7 26.1 I II All Souls 2 15.4 26 17.6 23 166 18.1 6 167 18 20.8 10 20.3 2 24.5 7 20.8 3 27.4 II III Cambridge Road 1 22.3 12 21.4 12 22.5 2 28.2 III VI Cham.. Wood Rd 1 17.8 50 18.6 35 l8.2 11 18.6 9 21. I 32 21.8 20 21.5 24 23.1 4 26.3 28.2 IV V Christchurch 7 20.6 9 19.2 1 195 54 21.4 33 20.9 4 24.3 5 21.5 3 25.4 10 26.4 V VI Disraeli Road 1 16.5 10 16.7 10 17.3 5 17.1 7 18.1 24 20.6 29 21.0 10 VI VII Dudden Hill 4 17.7 6 18.0 57 20.9 26 19.7 99 21.6 69 20.8 13 22.7 42 22.9 1 21.6 20 24.3 VII VIII Furness Road 61 17.0 50 17.5 94 21.1 85 20.5 8 23.7 2 24.4 25 26.0 32 24.5 VIII IX Gibbons Road 3 15.5 3 16.8 41 17.1 34 16.8 21 18.9 29 18.0 103 20.8 91 19.5 16 19.9 11 21.2 4 25.0 0 23.0 IX X Gordon Memorial 13 14.8 10 14.6 54 17.3 58 16.4 28 18.3 32 17.9 56 19.6 72 18.9 15 21.4 18 20.6 10 23.2 J4 20.8 x XI Harlesden R.C. 1 15.3 16 17.2 20 16.9 4 18.7 6 19.3 16 20.1 11 20.2 1 23.1 2 22.2 33 23.9 1 25.4 XI XII Holy Trinity 15 16.0 11 153 11 17.3 10 i6.9 8 18.9 8 15.6 26 20.4 19 19.3 15 15.4 9 21.6 20 E 15 24.1 OR. 1 21 3 XII YTTT XIII Keble Memorial 1 16.5 i 167 9 16.9 7 17.6 17.2 11 20.8 6 22.4 21 21.5 . q 00 u 2 20.8 11 20.1 2 30 0 XIII XIV Kensal Rise 54 19.0 54 17.8 25 19.8 12 19.8 29 21.7 55 22.3 3 23.9 13 23.3 27.7 11 24.9 XIV XV Kilburn Park Rd 15.1 15 17.4 25 17.2 2 18.1 5 18.3 12 19.8 24 20.3 1 21.5 XV XVI Leopold Road 20 15.9 16 15.1 85 16.7 87 16.8 39 19.9 30 18.5 68 20.8 95 20.4 21.8 16 22.4 7 24.2 XV XVII Lower Place 1 17.6 6 20.9 7 24.0 1 26.5 1 27.0 XVII XVIII Mora Road 3 15.5 50 18.6 29 17.4 22 19.4 21 187 14 21.8 25 21.1 32 23.5 20 22.5 1 32.0 XVIII XIX Neasden National 8 17.0 8 17.5 2 14.1 1 17.6 6 19.9 12 21.9 10 25.1 2 24.3 3 24.9 XIX XX Oldfield Road 31 17.3 15 16 4 34 17.8 24 17.2 11 17.7 9 18.4 115 21.2 140 21.2 1 26.5 5 23.5 25.5 24.0 XX XXI Pound Lane 13 16.0 9 16.1 19 18.0 17 16.6 13 18.9 13 18.1 54 21.0 41 20.6 31 22.8 8 21.5 28.1 4 20.8 XXI XXII Pr. Frederica 5 16.2 5 15.1 107 17.4 58 16.8 29 17.3 35 17.1 21 19.2 66 20.3 2 21.6 24.7 1 20.4 XXII XXIII St. Andrew.s 35 18.0 47 17.5 8 18.1 22.l 39 22.5 16 21.8 8 23.0 10 22.5 XXIII XXIV St. John.s 3 16.0 7 4.5 38 17.5 18 16.9 22 19.8 9 18.4 46 21.3 25 19.6 38 23.0 11 21.0 24.8 3 25.0 XXIV XXV St. Mary.s 2 14.8 1 177 8 16.2 10 15.8 22 19.7 8 19.6 28 20.9 24 207 2 22.0 9 18.6 25.7 XXV XXVI St. Mary.s, R.C. 9 14.9 7 15.2 26 17.2 24 16 .7 7 19.1 11 17 .8 11 20.0 22 19.3 3 20.5 5 22.2 23.2 7 21.9 XXVI XXVII Salusbury Road 25 16.3 15 16.3 10 16.8 13 15.8 16 19.5 18 191 105 21.2 67 2I.0 51 22.9 41 23.3 28.0 2 217 XXVII XXVIII Stonebridge 48 17.6 43 17.8 26 17.5 50 17.2 50 20.7 65 203 21 22.3 3 22.4 24.4 6 25.4 XXVIII All Schools 145 16.0 106 15.9 865 17.7 752 17.2 406 19.2 384 18.5 1202 20.9 1178 20.5 362 23.0 259 22.3 25.4 152 239 98 TABLE SHOWING AVERAGE WEIGHTS (in Kilogrammes) OF SCHOLARS ATTENDING WILLESDEN SCHOOLS AT VARIOUS AGE PERIODS Age Periods 10.11 11—12 12—13 13—14 14—15 Schools. Boys. Girls. Boys. Girls. Boys. Girls. Boys. Girls. Boys. Girls. No. Exd. Aver. No Exd. Aver. No. Exd. Aver. No. Exd. Aver. No. Exd Aver. No. Exd. Aver. No. Exd. Aver. No. Exd. Aver. No. Exd. Aver. No. Exd. Aver. I Acton Lane 25 30.5 33 20 .0 8 29.3 7 32.3 4 37.4 7 31.1 23 40.1 39.7 2 40.8 4 41.4 I II All Souls 26 29.3 26 28.5 5 30.3 6 297 3 3..5 26 37.7 30 38.2 3 45.8 5 487 II in Cambridge Road 25 26.4 11 28.6 1 38.5 26 36.5 4 40.8 III IV Cham.. Wood Rd 25 28.2 21 28.6 22 30.5 9 33.0 1 31.2 34 39.7 42 39.0 18 40.9 14 43.4 IV V Christchurch 29 29.4 15 26.6 6 31.1 7 28.3 3 28.3 7 35.0 11 37.0 V VI Disraeli Road VI VII Dudden Hill 45 27.4 17 277 17 30.2 16 30.3 3 28.0 13 32.6 39 38.2 50 39.4 12 39.2 2 47.6 VII VIII Furness Road 67 27.5 54 27.0 21 29.6 16 29.2 5 32.1 7 307 69 34.7 37 36.9 1 40.0 4 46.3 VIII IX Gibbons Road 78 26.9 93 25.9 5 27.7 17 2 76 3 33.3 7 307 49 33.8 50 367 1 31.8 IX X Gordon Memorial 41 26.0 76 25.6 9 27.6 7 26.2 5 35.3 4 32.1 34 31.7 46 35.1 1 41.0 1 35.0 X XI Harlesden R.C. 20 27.0 11 267 1 27.3 1 27.0 1 39.0 3 32.1 18 33.7 16 36.2 1 39.9 XI XII Holy Trinity 20 26.2 12 26.0 10 28.5 4 28.3 2 32.9 3 31.5 22 34.2 13 34.2 XII XIII Kebie Memorial 27 26.3 20 29.2 27 29.8 7 28.5 21 33.9 2 34.8 20 35.9 28 40.4 15 43.6 13 43.5 XIII XIV Kensal Rise 76 39.2 86 28.9 17 31.5 6 31.9 65 38.7 25 40.5 22 40.9 12 40.7 XIV XV Kilburn Park Rd 32 26.1 1 297 15 38.3 1 50.2 XVI XVI Leopold Road 49 27.8 83 267 17 29.6 19 27.6 9 32.0 8 32.4 91 35.4 71 37.0 14 40.1 3 35.1 XVI XVII Lower Place 18 26.8 24 27.0 9 28.6 11 28.1 3 31.5 15 33.5 25 34.2 XVII XVIII Mora Road 10 29.8 23 27.6 25 30.3 19 31.8 1 41.0 18 37.5 21 39.9 14 39.9 8 45.0 XVIII XIX Neasden National. 17 29.1 8 26.8 1 25.2 1 33.5 8 35.7 io 39.2 XIX XX Oldfield Road 59 28.6 55 28.2 3 307 1 38.0 3 35.5 43 35.5 3i 36.1 2 54.o XX XXI Pound Lane 44 27.7 6 27.2 21 28.4 5 32 8 1 31.1 60 37.3 11 40.3 10 40.0 2 377 XXI XXII Pr. Frederica 48 26.3 86 265 1 33.5 1 25.0 1 36.1 43 36.2 54 36.1 2 46.7 1 34 8 XXII XXIII St. Andrew.s 28 29.2 29 27.5 15 29.9 4 29.9 2 35.9 40 36.6 38 363 23 39.0 8 40.9 XXIII XXIV St. John.s 32 26.7 42 25.1 41 28.1 18 27.6 25 31.5 20 32.0 16 33.0 30 36.0 1 40.0 XXIV XXV St. Mary.s 26 26.5 35 25. 2 3 28.3 4 28.5 2 32.0 25 32.6 45 34.8 1 34.0 XXV XXVI St. Mary.s R.C. 7 24.5 17 24.0 2 32.0 10 27.3 4 30.4 3 33.1 14 33.8 13 309 3 317 XXVI XXVII Salusbury Road 48 27.9 24 28.5 39 31.5 33 28.5 2 30.9 2 30.3 44 37.8 33 41.5 21 42.0 14 447 XXVII XXXVIII Stonebridge 37 28.0 64 25.0 27 29.3 8 277 5 33.1 4 36.3 53 34.1 100 36.4 8 39.9 4 41.2 XXVIII All Schools 927 28.5 992 26.8 343 29.4 249 292 100 32.7 102 32.1 902 35.9 870 37.0 172 40.7 103 42.8 99 TABLE.SHOWING.AVERAGE.HEIGHTS.(in.Centimetres).OF.SCHOLARS.ATTENDING.WILLESDEN.SCHOOLS AT.VARIOUS.AGE.PERIODS. Age.Periods. 4—5 5—6 6—7 7.8 8.9 9—10 Schools. Boys. Girls. Boys. Girls. Boys. Girls. Boys. Girls. Boys. Girls. Boys. Girls. No..Exd. Aver. No. Exd. Aver. No..Exd. Aver. No. Exd Aver. No..Exd. Aver. No..Exd Aver. No..Exd. Aver. No..Exd. Aver. No..Exd. Aver. No..Exd. Aver. No..Exd. Aver. No..Exd. Aver. I Acton.Lane 1 103.0 39 106.8 33 106.9 21 111.9 23 113.0 58 116.3 41 1l6.2 12 121.1 14 121.6 4 131.5 7 126.6 I II All.Souls. 2 96.5 26 103.4 23 101.9 4 106.4 6 103..8 18 114.7 10 114.2 2 119.8 7 115.4 3 127.0 II III Cambridge.Road. 1 113.0 12 116.2 12 118.7 2 132.5 III IV Cham..Wood.Rd. 1 101.0 50 107.5 35 107.3 11 109.2 9 112.8 32 116.5 20 115.6 24 122.0 4 129.1 2 130.0 IV V Christchurch 7 106.2 9 102..I 1 115.s 54 115.8 33 115.3 4 119.8 5 119.5 3 123.0 10 129.1 V VI Disraeli.Road 1 95.0 10 98.8 10 100.5 5 104.6 7 104.0 24 112.6 29 112.0 VI VII Dudden.Hill 4 106.9 6 106.3 57 114.1 26 113.3 99 115.7 69 115.2 13 120.5 42 121.1 1 115.0 20 126..1 VII VIII Furness.Road 61 104.1 50 105.1 94 117.5 85 115.2 8 122.2 2 123.0 25 128.2 32 126.2 VIII IX Gibbons.Road 3 99.2 3 102.5 41 102.5 34 1027 21 108.9 29 108.6 103 114.7 91 113.7 16 114.5 11 117.2 4 123.2 8 120.8 IX X Gordon.Memorial 13 94.8 10 94.2 54 101.2 58 101.4 28 107.0 32 1o6.4 56 112.8 72 113.1 15 116.1 18 117.4 10 122.6 14 120.2 X XI Harlesden.R.C 1 98.0 16 101.5 20 102.9 4 106.6 6 110.1 16 113.7 11 113.2 1 117.5 2 114.3 3 122.9 1 123.0 XI XII Holy.Trinity 15 103.8 11 99.3 11 107.8 10 104.7 8 110.5 8 100.5 26 112.4 19 112.8 15 116.0 9 119.9 15 122.8 6 123.1 XII XIII Keble.Memorial 1 99.5 1 106.0 9 107.1 7 1118 1 119.5 11 115.5 6 122.2 21 118.9 4 122.0 2 121.2 11 129.9 2 136.2 XIII XIV Kensal.Rise 54 110.0 54 108.4 25 113.3 12 114.4 29 118.2 5.5 120..1 3 120.1 13 123.7 1 125.0 11 120.0 XIV XV Kilburn.Park.Road 96.5 15 102.2 25 102.3 2 108.3 5 109.4 12 113.7 24 115.5 1 122.0 XV XVI Leopold.Road 20 98.5 16 95.3 85 102.9 87 103.3 39 111.5 30 110.5 68 115.0 95 115.0 29 119.1 16 120.7 7 123.6 XVI XVII Lower.Place 1 110.5 6 115.6 7 115.9 1 128.0 1 124.5 XVII XVIII Mora.Road 3 96.0 50 107.2 29 105.0 22 109.4 21 109.7 14 119.7 25 118.1 32 123.7 20 120.0 6 135.8 XVIII XIX Neasden.National 8 105.4 8 1060 2 103.3 1 104.5 6 115.7 12 117.8 10 122.3 2 127.5 1 120.0 XIX XX Oldfield.Road 31 100.8 15 100.1 34 104.0 24 104.4 11 106.0 9 109.2 115 115.3 140 .5.5 1 138.0 5 123.4 3 125.8 5 126.8 XX XXI Pound.Lane 13 99.5 9 98.8 19 104.9 17 103.2 13 109.8 13 108.6 54 115.6 41 116.6 31 120.0 8 5.3 8 129.8 4 113.1 XXI XXII Pr..Frederica 5 99.5 5 945 107 104.4 58 103.8 29 104.9 35 107.1 21 115.8 66 115.0 2 120.5 1 126.5 1 112.0 XXII XXIII St..Andrew.s 35 107.6 47 106.4 8 111.3 4 117.6 39 119.7 16 119.4 8 120.7 10 121.6 XXVIII XXIV St..John.s 3 95.7 7 923 38 101.6 18 100.6 22 110.4 9 109.2 46 116.1 25 iii.5 38 121.5 11 114.4 42 125.8 3 127.2 XXIV XXV St..Mary.s 2 93.8 1 100.5 8 100.9 10 986 22 107.8 8 1127 28 113.2 24 114.1 2 116.5 9 117.1 18 126.3 XXV XXVI St..Mary.s.R.C 9 95.2 7 973 26 102.9 24 102.4 7 108.6 11 106.2 11 112.5 22 111.9 3 117.3 5 119.6 123.0 7 120.1 XXVI XXVII Salusbury.Road 25 100.4 15 100.5 10 101.0 13 100.6 16 111.8 18 111.5 105 116.5 67 115.3 51 120.2 41 122.9 0.00 132.1 122..1 XXVII XXVIII Stonebridge 48 105.2 43 106.4 26 105.0 50 105.3 50 112.9 65 3.4 21 119.1 3 I20.7 23 123.3 0 123.8 XXVIII All.Schools 145 99.3 106 97.6 865 104.3 752 104.3 406 109.7 384 109.1 1202 115.5 1178 1167 362 120.0 259 120.4 197 126.1 152 124.9 F loo TABLE SHOW1NG AVERAGE HE1GHTS (1n Cent1metres) OF SCHOLARS ATTEND1NG W1LLESDEN SCHOOLS AT VAR1OUS AGE PER1ODS. Age Per1ods 10.11 11—12 12—13 13—14 14—15 Schools. Boys. G1rls. Boys. G1rls. Boys. G1rls. Boys. G1rls. Boys. G1rls. No. Exd. Aver. No. Exd. Aver. No. Exd. Aver. No. Exd. Aver. No. Exd. Aver. No. Exd. Aver. No. Exd. Aver. No. Exd. Aver. No. Exd. Aver. No. Exd. Aver. 1 Acton Lane 25 134.2 33 133.9 8 131.4 7 138.4 4 143.2 7 136.3 23 149.3 25 152.1 2 151.2 4 154.1 1 11 All Souls 26 130.8 26 130.4 5 132.9 6 136.1 3 137.0 26 145.0 30 146.4 3 150.8 5 158 6 11 111 Cambr1dge Road 25 128.6 11 133.0 1 151.0 26 144.2 4 147.6 111 1V Cham.. Wood Rd 25 132.6 21 133.3 22 135.3 9; 142.9 1 137.0 34 146.2 42 148.6 18 149.8 14 153.2 1V V Chr1stchurch 29 132.8 15 128.8 6 138.9 7 136.1 3 137.2 7 144.8 11 143.3 V V1 D1srael1 Road V1 V11 Dudden H1ll 45 130.4 17 132.4 17 134.5 16 135.4 3 131.8 13 140.9 39 146.2 50 148.1 12 150.9 2 151.7 V11 V111 Furness Road 67 131.0 54 132.3 21 134.8 16 135.1 9 141.1 7 138.2 69 143.5 37 146.3 155.7 4 156.3 V111 1X G1bbons Road 78 128.6 93 128.4 5 131.1 17 131.3 3 142.5 7 139.1 49 139.2 50 146.7 1 132.5 1X X Gordon Memor1al 41 127.6 76 127.1 9 128.7 7 131.4 5 143.5 4 138.5 34 138.5 46 144.9 1 152.0 1 141.5 X X1 Harlesden R.C. 20 128.1 11 131.1 1 127.5 1 131.5 1 145.0 3 139.3 18 139.9 16 144.5 1 151.5 X1 X11 Holy Tr1n1ty 20 125.5 12 131.8 10 129.0 4 133.5 2 135.2 3 140.2 22 140.9 13 147.5 X11 X111 Keble Memor1al 27 134.0 20 131.8 27 139.9 7 133.6 21 145.1 2 141.0 20 147.8 28 150.0 15 153.0 13 153.9 X111 X1V Kensal R1se 76 133.4 86 134.6 17 139.8 6 141.5 65 147.9 25 151.4 22 150.4 12 153 .5 X1V XV K1lburn Park Rd 32 1272 1 130.5 15 148.6 1 164.1 XV XV1 Leopold Road 49 132.0 83 130.4 17 135.2 19 131.3 9 139.5 8 141.8 91 144.9 71 146.4 14 150.4 3 145.0 XV1 XV11 Lower Place 18 126.6 24 129.4 9 132.2 n 132.1 3 138.5 15 139.6 25 143.0 XV11 XV111 Mora Road 10 136.0 23 133.3 25 135.1 19 139.1 1 152.0 18 146.4 21 149.2 14 149.9 8 155.3 XV111 X1X Neasden Nat1onal 17 132.9 8 133.7 1 125.0 1 148.0 8 150.6 10 148.1 X1X XX Oldf1eld Road 59 132.0 55 132.3 3 139.7 1 158.0 3 145.0 43 141.6 31 144.3 2 155.2 XX XX1 Pound Lane 44 131.3 6 131.5 21 134.8 5 138.8 1 135.5 60 146.4 11 148.3 10 149.3 2 146.7 XX1 XX11 Pr. Fredr1ca 48 130.8 86 129.8 1 145.5 1 126.0 1 141.0 43 144.8 54 144.5 2 147.8 1 141.5 XX11 XX111 St. Andrew.s 28 132.1 29 131.2 15 134.5 4 137.4 2 147.2 40 145.5 38 146. 1 23 149.9 8 148.7 XX111 XX1V St. John.s 32 128.9 42 125.8 41 132.9 18 132.3 25 139.3 20 139.4 16 140.1 30 143 3 1 155.0 XX1V XXV St. Mary.s 26 131.3 35 131.9 3 134.0 4 140.2 2 135.0 25 141.4 45 144.3 1 149.0 XXV XXV1 St. Mary.s R.C. 7 124.3 17 127.6 39 137.9 10 132.5 4 140.2 3 141.7 14 140.9 13 139.5 3 143.7 XXV1 XXV11 Salusbury Rord 48 135.4 24 134.1 27 132.4 33 136.4 2 139.6 2 134.7 44 147.4 33 152.5 21 152.9 14 155.1 XXV11 XXV111 Stonebr1dge! 37 128.8 64 126.8 2 137.3 8 132.4 8 138.7 4 139.6 53 141.9 100 143.9 8 149.0 4 150.6 XXV111 All Schools 927 131.0 992 130.4 343 134.6 249 135.4 100 141.0 102 139.7 902 144.2 870 146.4 172 150.5 103 152.9 101 I cannot conclude this report without acknowledging my indebtedness for the support afforded me by the School Hygiene and School Management Committees. What is largely a new and extensive department had to be organised in an extremely limited time, intricate administrative machinery had to be evolved and forces to be directed, which only tact and discretion could keep from jarring. To the wise action of these Committees and to their Chairman it is due that so successful a result has been achieved. To them and to all the officers of my department and the teaching staff I desire to express my warmest thanks. I am, gentlemen, Your obedient Servant, APPENDIX. The duties of the School Medical Officer and of the Assistant School Medical Officers were defined as follows— Duties of School Medical Officer. (a) The School Medical Officer to act under the direction and instructions of the Education Committee, and be responsible to them for carrying out the provisions of the Education (Administrative Provisions) Act, 1907, section 13 (b) and of the duties imposed in pursuance of that Act in circulars 576, 582, and 596 of the Board of Education. (b) The duties of the School Medical Officer include— (i) The examination of, and granting of certificates in respect of Officers and Teachers prior to appointment. (ii) The examination of, and granting of certificates in respect of scholars committed to truant schools. (iii) When required, the examination of and reporting on teachers and scholars absent from school for prolonged periods. (iv) The attendance at such committee meetings as the Education Committee may require. 102 Duties of Assistant School Medical Officers. 1.—Assistant School Medical Officers will be required by the Local Education Authority to act under the immediate superintendence of the School Medical Officer, and to carry out the duties in regard to medical inspection imposed by section 13 (b) of the Education (Administrative Provisions) Act, 1907; the requirements of the Board of Education as set out in the Memoranda, Circulars 576, 582 and 596; and such other duties as may from time to time be determined by the Local Education Authority. 2.—Each Assistant School Medical Officer will be expected to visit his school or department not less than once during each week of the school year. 3.—In addition to the systematic inspections to be made in accordance with the instructions of the Board of Education, the Assistant School Medical Officers shall advise the Head Teacher on any matter necessary to the general health of the scholars and as to cases specially referred to them by the school teachers. Questions requiring medical knowledge for their answer are constantly arising in connection with the scholars attending public elementary schools, and these can fittingly be dealt with during the school visits. 4.—All communications to parents other than those arising out of actual interviews at the schools will be made by the Chief School Medical Officer. 5.—Particular directions as to duties will be furnished from time to time as occasion requires, but in general terms these have already been defined in the Memoranda of the Board of Education already referred to. 6.-—The Local Education Authority reserve to themselves the right, should occasion arise, to withhold the whole or part of the salary of or to forthwith determine the appointment of any 103 Assistant School Medical Officer who shall have failed to discharge to their satisfaction the duties of his office. The Local Education Authority desire that each School Medical Officer should feel that his charge, though designed so as to avoid exacting demands on his time, should be viewed as embracing a wide responsibility for the health of all the children under his care. Any narrowing of interest to the specified routine is to be deprecated : it is hoped that all the resources of medical knowledge will be broadly exercised in the interest of school health. The Local Education Authority wish to feel that they have enlisted not only the knowledge but the sympathy of the Medical Profession in the hygienic and medical aspects of the problems with which elementary education is beset. The following forms show the methods adopted for securing the presence of the parents at the inspection :— S.M.O.D. Form. A. Willesden Local Education Authority. SCHOOL, 191 Dear Sir, or Madam, In accordance with the requirements of the Education (Administrative Provisions) Act, 1907, it will be necessary during the course of this year medically to inspect children attending public elementary schools. If you desire to be present when your child is examined by the school physician and will let me know on the enclosed form, I will arrange in due course to acquaint you with the day and probable hour when you may attend at the 104 school. If you do not desire, or find it inconvenient to attend I shall in any case be greatly obliged if you will kindly inform me from which (if any) of the diseases, set out in the form (c) your child has suffered. You will, I am sure, appreciate that this duty which has been thrown by Parliament upon the Local Authorities is one which is conceived in the interests of the health of school children, and I venture to express the confident hope that in carrying out the provisions of the Act I can rely on the hearty co-operation of the parents. I am, dear Sir, or Madam, Your obedient servant. School Medical Officer. S.M.O.D. Form B. FORM TO BE FILLED IN BY PARENTS WISHING TO BE PRESENT. 191 Dear Sir, It is my desire to be present when my child (name) is medically inspected and I shall be glad if you will acquaint me in due course when the medical inspection is likely to take place. Yours faithfully, S.M.O.D. Form C. 105 FORM TO BE FILLED UP BY PARENTS UNABLE OR NOT WISHING TO BE PRESENT. 191 Dear Sir, I do not propose to be present when my child is medically examined. I have to inform you that my child (name) has suffered from the following diseases: * Scarlet Fever * Diphtheria * Measles * German Measles * Mumps * Whooping Cough * Chicken Pox * Rheumatism Yours faithfully, * Cross out if child has not suffered from this disease. S.M.O.D. Form D. Dear Sir or Madam, In accordance with your request I have to inform you that the medical inspection of your child (name) has been arranged to take place on the about o'clock. The inspecting medical officer will be glad to see you at the school on that day. Will you kindly arrange to be present at the hour mentioned. Yours faithfully, School Medical Officer. APPENDIX II. WILLESDEN Urban District Council. HOSPITAL REPORT FOR THE YEAR 1909. BY WILLIAM J. J. STEWART, M.D.. C.M. lEdin.), D.P.H. ICamb.l, MEDICAL SUPERINTENDENT. S oniinu: Morton & Hurt, Ltd., 187, Edgware Koad, W. 1910. Members of the Hospital Visiting Committee, 1909. Councillor J. E. HILL (Chairman). ,, J. ANDREWS. ,, C. BIDDISCOMBE. ,, E. T. BUTTERISS. ,, W. R. DUNN. ,, F. HILBORN. ,, J. W. INGLEDEW. ,, C. H. PARKER. ,, W. RILEY (Chairman of the Council) ex-officio. HOSPITAL REPORT for 1909. To the Chairman and Members of the Willesden Urban District Council. Gentlemen, I have the honour to submit to you the Hospital Report for 1909. The number of patients admitted during the year was 775, or 79 less than in the previous year. I11 January, it will be within your recollection, owing to the lack of accommodation, a number of patients had to be transferred to the Mary Wardell Convalescent Hospital at Stanmore ; it was not, however, necessary to send more than one batch, the diminished number of admissions later on in the year not being beyond the capacity of your own Hospitals. The Kingsbury Hospital during the year remained open for a longer period than has been the case for many years, and it was not until May 17th that it was finally closed down. In the past it has been customary to re-open this hospital each autumn 4 for two or three months, but, owing to the nonappearance of what is called the Autumnal Rise, there was no necessity for doing so. The failure of this Autumnal Rise is a somewhat unusual circumstance, and was quite unexpected. To understand what is meant bv the term it may be explained that almost invariably each autumn there is a pronounced increase in the .incidence of infectious disease throughout the country, due it is believed, amongst other things, to seasonal and climatic influences. Last year, however, no such increase took place, which may have been due to the unusual cold and wet; if anything, there was a decrease in the number of cases, as may be gathered from the fact that the number of admissions during the last quarter was actually less than at any other period of the year. To illustrate this further it is necessary only to refer to the table of monthly admissions, when it will be seen that the admissions per month range from a maximum in January of 120, almost regularly down each month to a minimum of 45 in December. If we take the admissions per quarter and compare them with those of the previous year it is 6 even more strikingly shown. Thus in 1908 the admissions for the last quarter averaged 110 per month, and for the other three quarters of the same year 58.0 per month. But last year the average for the last quarter was only 46.0 per month, whilst the average for the remaining three quarters was no less than 70.7 per month—an almost complete reversal of the usual state of affairs. As alreadv mentioned, the total number of patients admitted during the year was 775, made up as follows:— Scarlet Fever, 524 ; in 1908 there were 625 Diphtheria, 160; „ ,, 169 Enteric Fever, 29; ,, ,, 20 Other Diseases 62 ; ,, ,, 40 775 854 Amongst these 775 patients there were 33 deaths, Thus 16 patients died from Scarlet Fever, 8 from Diphtheria, 4 from Enteric Fever, and 5 from diseases other than those usually notified. In 1908 there were 31 deaths. 6 The average daily number of patients under treatment throughout the year still keeps up to the high level of recent years. The following figures show how steadily the number is rising :— 1909 10475 1908 108.0 Average daily number 1907 98.6 of patients in Hospital 1906 103.5 1905 73.6 1904 69.2 It should be noted that the bed accommodation in the hospital, which at times now is sorely strained, is the same to-day as it was in 1904. As regards the duration of stay in hospital of each patient, this varies according to the disease from which the patient is suffering. In this, as in other hospitals, a minimum period for isolation is fixed for each disease. Thus for Scarlet Fever the patient is detained until the end of the sixth week of disease, for Diphtheria until the end of the third week, for Enteric Fever until one month has elapsed from the date on which the temperature became 7 normal, and for the other diseases admitted, a variable period, depending mainly upon the physical fitness of the patient. It is only possible, however, in the case of the mildest forms of attack, and not in all of them, to discharge the patient on the expiry of the minimum period. The more severe cases, and those in which complications develop, are detained for a much longer period, in a few instances for as long as three months, and in exceptional cases double that period. The result is that the average duration of stav in hospital of each patient is considerably above that of the minimum period fixed. These prolonged cases occur most frequently amongst the Scarlet Fever patients, in which disease inflammation of the kidneys is a not unusual complication, and although the majority of cases recover from the condition in a few weeks, a number do not resolve so readily, but drag on for two months or more, by which time there is great risk of the condition becoming incurable, or passing on to a state of Bright's disease, as it is termed. With such a possibility ahead, in the interests of the patients themselves, even though infectiousness 8 may have long since lapsed, it is only right that everything possible in the way of detention under medical supervision should be undertaken in order to prevent, if possible, the occurrence of such a dire result. In the case of Scarlet Fever where the minimum period of detention is until the termination of the sixth week of disease, infectiousness in most of the cases has passed off by that time. It is a regrettable fact however, that it does not pass off in all within that period, a small percentage retaining their infectiousness with greater persistence. In the majority of these cases evidence of infectiousness is quite obvious, but in a small number nothing abnormal is to be detected, they are to all appearances cured and well, and in consequence are discharged to their homes. There, unfortunately, they set up secondary cases, or "return cases," as they are called, amongst the members of their own family. With a few exceptions these return cases occur within a month of the date of discharge of the primary (and as it turned out to be the infectious) case from the hospital. 9 It is unlikely that these return cases will be preventible until the special germ of Scarlet Fever is definitely known. In that event it will possiblv be an easy matter to demonstrate microscopically whether a patient, at the time of discharge from the hospital, retains the infection or not. Diphtheria patients are detained in hospital until the expiry of the third week of their attack, and are then discharged, provided a negative bacteriological examination is obtained from the throat or other affected part, and provided that they are physically fit and not likely to develop paralysis subsequently. The persistence with which the diphtheria bacillus clings to some patients is well recognised, so that it is not surprising to find that for this reason alone a patient has to be detained for several weeks beyond the minimum period. With regard to Enteric Fever most patients are usually detained in hospital until they are fit and able to get about daily, and undertake with safety the journey home. It is possible, however, that in the near future other points will have to occupy the attention of hospital authorities. I 10 refer to the fact that it is now well recognised that a small percentage of enteric fever patients retain their infectiousness, that is, the specific organisms of the disease may be retained in their tissues, for it would seem, an almost indefinite period. Well authenticated cases in which the organism has been detected after 20 or 30 years from the date of the attack have recently been reported. It is not known at present how these cases can best be freed from their infection. 11 TABLE No. 1. Disease. Remaining in Hospital, December 31st, 1908 Admitted during 1909. Total uuder Treatment during 1909. Discharged during 1909. Died during 1909. Mortality per cent. Remaining in Hospital, " December 31st, 1909. Scarlet Fever 136 524 660 610 16 2.78 34 Diphtheria 15 160 175 151 8 5.03 16 Enteric 3 29 32 22 4 14.54 6 Total 154 718 867 783 28 3.67 56 Other Diseases 2 62 64 54 5 8.26 5 Grand Total 156 775 931 837 33 4.01 61 12 TABLE No. 2. Month. Scarlet Fever. Diphtheria. Enteric Fever. Other Diseases. Total Admissions. Total Deaths. Admissions. Deaths. Admissions. Deaths. Admissions. Deaths. Admissions. Deaths. January 90 2 15 - 8 1 7 - 120 8 February 45 2 18 3 — - 6 1 69 6 March 66 2 23 — — — 4 1 93 3 April 48 2 11 1 1 — 2 - 62 3 May 48 — 15 1 1 - 9 - 73 1 June 30 — 15 — 4 2 6 — 55 2 July 47 8 14 — 4 — 5 — 70 3 August 31 — 7 — — — 4 2 42 2 September 38 1 4 - 2 — 9 — 53 1 October 42 — 12 1 1 - 4 1 59 2 November 21 4 8 1 5 1 2 - 36 6 December 18 — 18 1 3 — 4 — 43 1 Total 524 16 160 8 29 4 62 5 775 33 18 SCARLET FEVER. Of this disease 660 cases were treated during the year, as compared with 709 in 1908. The fatality rate is 2.78 per cent. As regards the type of attack, nothing specially is to be noted except the large number of purulent rhinitis cases which complicated the convalescent stages. This condition seems to be of frequent occurrence in this district, and affects not only hospital patients but also cases treated at home. It would appear to be most frequently associated with the presence of a diphtheroid organism readily enough found in the nasal discharge. 14 TABLE No. 3. SCARLET FEVER. AGE. males. females. total. Admitted. Died. Admitted. Died. Admitted. Died. Under 1 2 1 1 ... 3 1 1 to 2 11 1 9 .. 20 1 2 to 3 12 1 15 2 27 3 3 to 4 20 2 17 1 37 3 4 to 5 22 1 18 1 40 2 5 to 10 109 3 149 1 258 4 10 to 15 39 1 41 .. 80 1 15 to 20 8 ... 9 ... 17 ... 20 to 25 9 ... 10 ... 19 25 to 30 4 ... 11 1 15 1 30 to 35 3 ... 1 ... 4 ... 35 to 40 2 ... 2 ... 1 ... Total 241 10 283 6 521 16 15 TABLE No. 4. COMPLICATIONS OF SCARLET FEVER. Complication. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Total. Rheumatism 17 13 6 3 39 Albuminuria 9 16 9 12 46 Nephritis 16 10 3 3 32 Otorrhoea 35 24 10 9 78 Adenitis 18 30 15 7 70 Do. (suppurative) 2 3 1 2 8 Rhinitis 20 24 12 10 66 Mastoid Abscess 3 8 ... 1 12 Stomatitis 2 ... 1 ... 3 16 DIPHTHERIA. 175 cases of this disease were treated. In 1904 as many as 298 cases were treated, whilst in 1907 there were 198 cases, and in 1908 182 cases. The case mortalitv of 5.05 per cent, is a low one. Before antitoxin was introduced in 1894 a mortality rate of 30 per cent, was by no means unusual. Antitoxin was administered to all cases on admission, except in six instances. TABLE No. 5. DIPHTHERIA. age. males. females. TOTAL. Admitted. Died. Admitted. Died Admitted. Died. Under 1 2 ... 1 ... 3 1 to 2 8 ... 2 2 10 2 2 to 3 4 1 4 ... 8 1 3 to 4 8 ... 5 1 13 1 4 to 5 5 1 11 ... 16 1 5 to 10 35 1 30 2 65 3 10 to 15 9 ... 12 ... 21 ... 15 to 20 1 ... 7 ... 8 ... 20 to 25 ... ... 4 ... 4 ... 25 to 30 1 ... 3 ... 4 ... 30 to 35 3 ... 2 ... 5 ... 35 to 40 ... ... ... ... ... ... 40 and over ... 2 ... 1 ... 3 ... Total 78 3 82 5 160 8 17 Tracheotomy was performed on nine patients, and of that number seven recovered. TABLE No. 6. COMPLICATIONS OF DIPHTHERIA. Complication. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Total. Paralysis 2 5 3 3 13 Albuminuria ... ... 2 3 5 Relapse ... 1 ... ... 1 Otorrhoea l ... 1 ... 2 Adenitis 3 1 ... ... 4 18 ENTERIC FEVER. As usual only a small number of cases suffering from this disease was admitted. Three cases remaining over from the previous year bringing the total treated up to 32. Amongst these 32 cases there were 4 deaths. TABLE No. 7. ENTERIC FEVER. AGE. males. FEMALES. TOTAL. Admitted. Died. Admitted. Died. Admitted. Died. Under 5 1 ... 1 ... 2 ... 5 to 10 3 ... 3 ... 6 ... 10 to 15 4 ... 1 ... 5 ... 15 to 20 2 ... 5 ... 7 ... 20 to 25 1 1 ... ... 1 1 25 to 30 ... ... 1 ... 1 ... 30 to 35 1 1 2 ... 3 1 35 to 40 2 2 ... ... 2 2 40 to 45 2 ... ... ... 2 ... Total 16 4 13 ... 29 4 19 COEXISTENT DISEASES. Coexistence of more than one disease in the same patient was by no means uncommon. As stated in previous reports, these cases take up a great deal of valuable room, especially in a hospital like this with a somewhat limited accommodation, for, unless there happens to be other cases of an exact nature under treatment at the same time, each case takes up an entire separation ward. In times of pressure this causes great inconvenience, and it is mainly in consequence of this that there is periodically so much difficulty in accommodating all the patients awaiting admission. MISCELLANEOUS DISEASES. Other diseases than those usually admitted to hospital were 8 in number, 6 of these being cases of Erysipelas and 2 of Measles. It is not customary to admit these diseases except under special circumstances decided upon by the Medical Officer of Health at the time when the case is notified to him. Cases wrongly diagnosed numbered 54, or 6.9 per cent. of the total admissions. This is quite a satisfactory percentage. In the Metropolitan area 10 per cent. is a not unusual rate. 20 TABLE No. 8. Table showing the cases wrongly diagnosed and the diseases for which they were mistaken. Certified as suffering from Diagnosed in Hospital as suffering from Scarlet Fever. Diphtheria. Enteric Fever. 6 ... ... Measles 8 ... ... Rothelm 1 ... ... Urticara 1 ... ... Septic Eruption 9 6 ... Tonsillitis 2 ... l Bronchitis 2 ... ... Gastric Catarrh 1 ... ... Burn 1 ... l Meningitis 2 ... ... Erythema ... ... l Cerebral Haemorrhage ... 1 ... Septicaemia 5 ... 1 Nil ... ... l Melancholia ... ... l Tuberculosis 2 ... ... Glandular Abscess 40 7 7 21 RINGWORM. A somewhat smaller number (121) of patients were treated during the year as out-patients for ringworm and diseases of a like nature. In 1908 there were 200 patients. These patients attend twice a week, they are then examined and advised as to the method of treatment to be adopted. BACTERIOLOGY. During the year 783 pathological specimens were examined. These specimens are mostly of the nature of throat and nose swabbings, but they also include sputum, blood, and various discharges, &c., &c., which are sent in for bacteriological examination and report. A large proportion of these specimens were taken from patients in hospital, but a considerable number, i.e., 345, were sent in by medical practitioners in the district. The work entailed in connection with the examination of all these specimens is necessarily very great, and at times, when the wards are full and so much other work is on hand, it is a matter of extreme difficulty to get it done expeditiously. 22 SICK STAFF. Fifty-six members of the Staff were off duty through illness for periods exceeding twenty-four hours at a time. The total number of days these members were off duty amounted to 781, or an average of 13.9 days per sick person, as compared with 13.1 days in 1908. Four members of the Staff contracted an infectious ailment, one nurse developed Diphtheria, and another Scarlet Fever, whilst one wardmaid contracted Scarlet Fever, and a second Enteric Fever. All of these attacks, I am glad to say, ended in recovery. HOSPITAL EXPENDITURE. As in previous years I append a Statement of the Total Expenditure for the year, in connection with the Hospital. Owing to the fact that so much outside or district work is done by the hospital staff, in addition to their ordinary duties, it is always a difficult matter to allocate the charges exactly so as to obtain an estimate of the real cost of upkeep 23 of the hospital. I have, however, this year estimated the hospital expenditure proper as explained in my last year's Report, that is, charging all expenses to the hospital after deducting onethird of the amount incurred in respect to steam coal ,two-thirds of the disinfecting porter's wages, one half as regards stable forage, and the wages of one laundry maid and one stable help. If these items (amounting to £536 12s. 2d.) be deducted from the gross hospital expenditure which amounts to .£15,285 2s. 2d., the net cost of the hospital for the year is £14,748 10s., and if that be divided up amongst the 931 patients treated during the year, the cost per head is £15 16s. 9|d. for the average stay of 39.4 days which each patient remains under treatment. In conclusion I beg to tender my thanks to the Chairman (Mr. J. E. Hill), and to the Members of the Hospital Committee for th'e assistance and support rendered to me in the administration of the hospital work throughout the year. I would also express my appreciation of the work done by all Members of the Hospital Staff. 24 That their work is beyond question, I think is testified to by the innumerable letters of thanks that are received throughout the year from patients themselves, and, from the parents of patients who have been treated in the hospital. I remain, Gentlemen, Your obedient Servant, W. J. J. STEWART. 25 HOSPITAL EXPENDITURE FOR THE YEAR 1909. £ s. d. Salaries of Staff 3,201 17 7 Provisions 2,549 5 8 Drugs, Surgical Appliances, etc. 233 5 4 Coals, Gas, Electricity, Water, etc. 1,486 4 7 Domestic and Establishment Expenses (including repairs, etc.) 1,873 10 4 Instalments and Interest on Loans, Rates, Taxes, and Insurance 5,404 6 6 £14,748 10 0 Estimated cost of work done by Hospital in connection with outside Disinfection 536 12 2 Cost of Maintenance—(Food only). s. d. Average weekly, per head—Patients 3 8¼ Staff 7 8¾ appendix III. Millesden Urban District Council. PUBLIC HEALTH QUARTERLY STATISTICS. First Quarter, 1909. To the Chairman and Members of the Public Health Committee. METEOROLOGICAL OBSERVATIONS. 1909. Week ending. Highest by Day. Lowest by Night. Range in week. Mean of all—Highest. Mean of all—Lowest. 4-ft. Earth Thermometer. Mean Degree of Humidity. Rainfall in Inches. No. of Days on which Rain was measured. Total No. of Hours of Bright Sunshine. Hours of Bright Sunshine Registered at Greenwich. Max. Min. deg. Jan. 2 42.00 10.50 31.5° 35.96 24.71 49.00 48.00 91 .24 2 4.5 5.7 " 9 47.50 32.75 14.75 44.11 36.46 48.00 47.25 91 .13 2 8.5 8.1 ,, 16 50.25 32.50 17.75 46.79 37.11 47.00 46.75 88 .42 4 22.7 22.7 " 23 49.50 25.75 23.75 43.14 33.54 46.50 46.25 87 .03 1 9.3 10.9 " 30 42.00 19.00 23.00 36.79 24.43 46.25 46.00 85 .03 1 13.7 18.9 Feb. 6 56.00 27.25 28.75 48.00 32.32 46.00 45.25 87 .06 1 10.3 7.7 " 13 45.25 24.00 21.25 40.75 31.29 45.25 45.00 88 .15 3 15.2 21.1 " 20 48.75 23.00 25.75 43.82 27.89 45.00 44.75 76 - — 23.0 36.3 " 27 51.75 15.00 36.75 43.71 25.21 44.50 44.00 85 - — 20.5 22.4 Mar 6 40.00 11.00 29.OO 35.39 23.86 44.00 43.75 93 .67 1 9.0 16.2 " 13 47.00 33.50 13.50 41.07 34.00 43.75 42.75 89 .44 4 14.5 17.0 " 20 54.00 21.50 32.50 42.96 32.86 42.50 42.50 85 .44 5 18.0 17.7 " 27 55.00 29.75 25.25 50.50 39.39 42.50 42.00 82 .38 4 20.0 20.7 Total Ttl. Total Total Means 1st Qr„ 1908 48.38 23.50 24.88 42.54 31.01 45.40 44.94 87 2.99 28 189.2 225.4 50.52 26.48 24.04 44.72 33.47 44.65 44.18 84 5.07 34 20.73 197.5 2 BIRTHS for First Quarter, 1909 WARDS. Total. Boys. Girls. Rate per 1000. Corresponding period last year. Illegitimate Births. I. Church End 2 18 104 114 35.6 37.7 ... 2. Harlesden 196 115 81 34.3 35.1 ... 3 Kensal Green 202 107 95 26.1 32.4 ... 4 South Kilburn 120 64 56 32.3 31.1 ... 5 Mid Kilburn 80 48 32 25.8 32.6 .... 6. North Kilburn 57 26 3i 22.5 23.6 ... 7 Willesden Grn. 224 122 102 26.2 25.3 ... Willesden U.D. 1097 586 511 28.6 31.2 28 Willesden U.D. 4th quarter '08 945 504 441 23.9 20 1st quarter '08 1095 533 562 31.2 15 • Including Births of Willesden Infants in Queen Charlotte's Hospital. DEATHS.—1st Quarter, ending April 3rd, 1909. 3 WARDS Deaths of Willesden residents dying within the district. Deaths of Willesden residents dying outside the district. Total. Willesden residents dying within the district. Deaths under 1 year, inclusive of infants dying outside district. Infantile Mortality Rate. Standard Death Rate. Mean Annual Death Rate last five years corrected for age and sex distribution. Rate per 1,000 for 1st Quarter, 1909. Corresponding Qtr.,1908. Illegitimate. Not certified. Inquests. Recorded. Corrected. Corrected. 1. Church End 100 11 Ill 2 ... 2 28 131.5 16.91 13.9 18.1 18.9 16.7 2. Harlesden 84 7 91 1 ... 9 28 157.3 15.74 14.3 15.9 17.9 20.1 3. Kensal Green 84 19 103 ... 1 1 24 125.7 16.22 10.6 13.3 14.5 12.7 4. South Kilburn 53 6 59 1 ... 7 16 155.3 16.98 15.7 15.9 16.6 18.3 5. Mid Kilburn 41 10 51 1 ... 3 9 104.7 17.13 16.1 16.4 16.9 15.3 6. North Kilburn 24 3 27 ... ... 3 6 130.4 16.00 10.9 10.6 11.7 12.4 7. Willesden Green 97 6 103 ... ... 2 18 86.5 15.60 11.0 12.1 13.7 14.3 Ward unknown ... ... ... ... ... ... ... ... ... ... ... ... ... Willesden U. D. 483 62 545 5 1 27 , 129 125.9 16.38 12.7 14.2 15.2 15.4 4th Quarter, 1908 385 42 427 7 ... 26 116 113.3 10.8 11.6 1st Quarter, 1908 453 52 505 7 4 25 110 104.2 14.4 15.4 4 DEATHS of WILLESDEN RESIDENTS during the FIRST QUARTER, ending April 3rd, 1909. (Inclusive of Residents Dying Outside the District.) CAUSES OF DEATH. DEATHS AT SUBJOINED AGES. DEATHS IN LOCALITIES. (At all Ages.) At all Ages 0 to 1 1 to 5 5 to 15 15 to 25 25 to 65 65 & Up. Church End. Harlesden. Kensal Green. S. Kilburn. Mid-Kilburn. N. Kilburn. Willesden Green. Ward Unknown. Small Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 28 8 18 2 ... ... ... 14 2 4 ... ... ... 7 ... Scarlet Fever 6 ... 5 1 ... ... ... 2 ... ... 2 2 ... ... ... Whooping Cough 15 9 6 ... ... ... ... 2 5 2 4 2 ... ... ... Diph and Memb. Croup 4 ... 3 1 ... ... ... . 2 ... ... ... ... 1 1 ... Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever 4 ... ... ... 1 3 ... 2 ... 1 ... 1 ... ... ... Other continued ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Epidemic Influenza 12 2 1 ... 1 5 ... 3 2 2 1 2 ... 1 ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cerebro Spinal Meningitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhoea 7 6 ... ... ... ... 1 3 1 2 ... 1 ... ... ... Enteritis 3 2 1 ... ... ... ... 1 ... 1 1 ... ... ... ... Puerperal Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas 1 ... ... ... ... ... 1 ... ... 1 ... ... ... ... ... Other Septic Diseases 2 1 1 ... ... ... ... 1 ... ... 1 ... ... ... ... Phthisis 45 1 ... 1 5 38 ... 7 7 13 5 4 ... 9 ... Other Tubercular Diseases 19 5 9 3 1 1 ... 2 4 6 1 3 ... 3 ... Cancer 26 ... 1 ... 1 15 9 5 1 8 0 2 3 7 ... Bronchitis 66 3 ... ... ... 17 46 12 12 12 7 6 4 13 ... Pneumonia 54 17 10 ... 1 22 4 10 9 8 10 4 2 11 ... Pleurisy 1 ... ... ... ... 1 ... ... ... ... 1 ... ... ... ... Other Dis. Resp. Organs 8 ... ... 1 ... 6 1 1 3 2 1 ... ... 1 ... Alcoholism (Acute) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cirrhosis of I.iver 8 ... ... ... ... 6 2 ... 2 1 1 1 ... 3 ... Venereal Disease 1 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... Premature Birth 26 26 ... ... ... ... ... 3 7 7 2 1 1 5 ... Accidents and Diseases of Parturition 3 ... ... ... 1 2 ... 1 ... 2 ... ... ... ... ... Heart Disease 37 ... ... 4 2 19 12 6 7 8 3 2 3 8 ... Accidents 14 1 1 2 1 5 4 2 3 1 3 3 1 1 ... Suicide 2 ... ... ... ... 1 1 ... ... 1 ... ... 1 ... ... Murder ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Congenital Defects 14 14 ... ... ... ... ... 3 2 4 1 2 1 1 ... Want of Breast Milk, Marasmus 15 15 ... ... ... ... ... 5 4 1 1 1 ... 3 ... Diseases of Nervous System 46 9 1 2 2 16 16 10 9 3 4 5 3 12 ... Dis. of Digestive System 12 1 ... 1 ... 6 4 2 ... 2 2 2 ... 4 ... Diseases of Urinary System 13 ... ... ... 1 6 5 3 1 1 3 ... 2 3 ... All other causes 53 7 2 ... 3 12 29 9 10 10 5 7 3 9 ... Totals 545 125 59 18 20 181 138 111 91 103 59 51 27 103 NOTIFICATIONS.—First Quarter ending April 3rd, 1909. 5 Wards. Small Pox. Scarlet Fever Diphtheria. Typhoid Fever. Erysipelas. Membranous Croup. Puerperal Fever. Cerebro Spinal Meningitis Total. Estimated Population. Xmas, 1908. Rate per 1,000 Population. Pulmonary * Phthisis. Scarlet Fever. Diphtheria. Notified under 15 years of age. Notification rate per 1,000 population under 15 years of age. Last Report. Notified under 15 years of age Notification rate per 1,000 population under 15 years of age. Last Report. Church End ... 39 14 8 3 ... ... ... 64 24050 10.4 13 33 13.6 10.5 11 4.6 4.0 Harlesden ... 27 17 ... 7 ... ... ... 51 22440 8.9 12 22 12.1 10.6 10 5.5 3.2 Kensal Green ... 43 9 ... 5 ... 2 ... 59 30422 7.6 5 38 13.9 21.7 8 2.9 5. South Kilburn 32 3 2 3 40 14565 10.8 13 29 21.0 48-4 3 2-2 4'2 Mid Kilburn ... 33 1 2 2 ... ... ... 38 12150 12.3 8 31 31.1 30.1 1 1.0 1.9 North Kilburn ... 7 2 ... ... ... ... ... 9 9963 3.5 1 6 10.o 25.9 2 3.3 ... Willesden Green ... 66 ... 1 5 ... ... ... 91 33574 10.7 6 56 21.5 22.7 19 7.3 9.3 Willesden U. D. 247 65 l3 25 ... 2 ... 352 150453 9.2 58 215 16.7 21.4 54 4.2 4.8 4th qtr. '08 ... 311 67 18 22 2 ... ... 420 150453 10.6 ... 284 21.4 ... 63 4.8 ... 1st qtr. '08 ... 121 58 11 23 1 3 1 218 145449 6.2 ... 98 8.3 ... 47 4.0 ... * Notified from 1st January, 1909, under Public Health (Tuberculosis) Regulations, 1908. NON-NOTIFIABLE INFECTIOUS DISEASES. —Coming to knowledge from Schools and 6 other sources of information. Number of Cases for First Quarter ending April 3rd, 1909. DISEASE. Families Visited. Total Nos. Suffering. (FirstVisit). Contacts. Families Re-visited. Secondary Cases discovered upon Re-visit. Doctor in Attendance. Total Cases. Isolated. Total No. Suffering. Measles 431 453 965 I40 126 346 126 579 German Measles 4 3 ... ... 3 Whooping Cough J55 297 484 53 32 124 11 329 Mumps 21 16 ... I 11 6 16 Chicken Pox ... 34 38 ... 9 3 38 Ringworm 9i 95 IO 29 25 95 Consumption ... 4 4 4 1 4 Influenza 23 28 ... i 16 28 Coughs and Colds ... 32 34 5 2 Proved Measles 6 34 Other Diseases i39 '59 16 ... 40 15 159 Totals 934 1127 H49 226 160 585 187 1285 1 NUMBER OF MEDICAL INSPECTIONS COMPLETED, and INFECTIOUS AND CONTAGIOUS DISEASES NOTIFIED from the PUBLIC ELEMENTARY SCHOOLS. NAME OF SCHOOL. No. of Medical Inspections completed. No. of Cases of Illness primarily visited. Infectious and Contagious Diseases notified as occurring among scholars attending public Elementary Schools. Scarlet Fever. Diphtheria. Measles. Whooping Cough. Mumps. Chicken Pox. Other Nonnotifiable Infectious Diseases. Ringworm. Other Contagious Diseases. Acton Lane—Mixed ... 4 ... 1 ... ... ... 2 ... 2 3 Ditto Infants ... 13 ... 1 1 2 ... 6 ... 2 6 Cambridge Road (Temp.) 24 3 2 ... 2 1 ... ... ... ... ... Chamberlayne Wood Rd. Boys and Girls 64 109 2 ... 51 2 18 ... 20 3 ... Ditto Infants 154 3 ... 1O7 17 4 2 3 2 2 Dudden Hill—B. & G. 50 3 6 I 2 ... ... ... ... 1 ... Ditto Infants ... 37 15 I 15 2 ... 5 ... 5 5 Furness Road—Mixed ... 17 ... 2 4 1 3 2 ... 4 ... Ditto Infants ... 33 3 1 20 1 1 ... 1 1 3 Granville Road ... 1 ... ... ... ... ... ... ... ... 1 Gibbons Road—Mixed 12 32 3 2 21 5 1 1 ... 1 3 Ditto Infants ... 37 1 2 14 7 ... 3 ... 1 8 Kensal Rise—B. & G. 41 17 3 ... 10 ... 2 ... ... 5 ... Ditto Infants ... 35 3 1 10 ... 2 6 ... 13 5 Lower Place -B. & G. 3 9 2 ... 2 ... ... 9 ... 1 1 Kilburn Lane—Infants ... 1 ... ... ... ... ... 4 ... 1 ... Ditto B. & G. ... 2 ... ... ... ... ... ... 1 ... ... Leopold Road—B. & G. 62 24 ... ... 8 ... ... 4 ... 1 11 Ditto Infants ... 41 ... ... 4 27 ... 4 1 3 8 Ditto Special ... 4 ... ... 3 ... ... ... ... ... 1 Disraeli Road—Infants 6 17 ... ... 6 2 ... 18 ... 3 ... Oldfield Road—B. & G. 53 14 ... ... 6 2 ... 1 ... 3 2 Ditto Infants 53 14 2 ... 1 5 ... 10 ... 1 ... Pound Lane—Mixed ... 16 7 5 12 ... ... ... ... 2 2 Ditto Infants ... 14 3 4 10 ... ... ... ... 1 3 Salusbury Road—Mixed ... 4 10 ... ... ... 1 ... ... ... 1 Ditto Infants ... 36 4 ... 15 7 13 2 ... 6 6 Mora Road—B. & G. ... 5 6 1 4 ... ... ... ... ... 1 Ditto Infants ... 10 8 ... 7 ... ... 1 ... 1 1 Stonebridge—B. & G. ... 15 7 ... 2 1 2 6 ... 3 6 Ditto Infants 69 33 5 2 3 16 ... 1 ... 6 7 8 Number of Medical Inspections completed, and Infectious and Contagious Diseases notified from the Public Elementary Schools—(Continued). NON-PROVIDED SCHOOLS. NAME OF SCHOOL. No. of Medical Inspections completed. No. of Cases of Illness primarily visited. Infectious and Contagious Diseases notified as occurring among scholars attending public Elementary Schools. Scarlet Fever. Diphtheria. Measles. Whooping Cough. Mumps. Chicken Pox. Other Nonnotifiable Infectious Diseases. Ringworm. Other Contagious Diseases. Christ Church—B. & G. ... 6 ... ... 4 ... 3 1 ... 1 ... Ditto Infants ... 5 ... ... 3 ... 12 17 ... ... ... Gordon Mem.—B. & G. 103 ... 2 ... ... 1 ... 1 ... ... 4 Ditto Infants 6 3 ... 1 3 ... 2 ... 1 ... Harlesden Nat.—B. &G. ... 3 ... ... 2 ... ... ... ... 2 1 Ditto Infants ... 22 1 ... 17 3 ... ... ... ... 1 Harlesden R. C.—Mixed 26 9 ... 1 2 1 ... ... ... 3 1 Ditto Infants 11 ... ... 1 7 ... ... ... 2 ... Holy Trinity—B. & G. 60 7 ... ... 1 ... 1 1 ... 3 ... Ditto Infants 13 3 1 ... 13 ... 1 ... ... ... Keble Mem.—B. & G. ... ... ... ... ... ... ... ... ... ... ... Ditto Infants ... 8 1 ... ... 3 ... 5 ... ... ... Kilburn Park Rd.—Evan 15 1 ... ... ... ... ... 4 ... ... ... Neasden—Mixed ... ... 1 ... ... ... ... ... ... ... ... Ditto Infants ... 1 ... ... ... ... ... 3 ... 1 ... Princess Fred.—B & G. 87 32 ... ... 21 5 ... ... ... 2 ... Ditto Infants 64 1 1 34 19 ... 9 ... 9 4 St. Andrew's—B. & G. 47 16 1 ... 14 ... 1 ... ... 1 1 Ditto Infants ... 47 2 ... 44 ... ... ... ... ... ... St. John's—B. & G. 1 ... ... 11 ... ... ... ... ... ... ... Ditto Infants 13 3 5 ... 2 ... ... ... ... ... ... St. Mary's, Wil.—B.&G. ... 6 1 1 ... 1 ... ... ... 1 ... Ditto Infants ... 10 ... ... 1 8 ... ... ... 1 ... St. Mary's, R.C.—Mixed 20 2 ... ... 2 ... ... ... ... ... ... Ditto Infants 13 4 ... ... 7 ... ... ... ... ... Schools outsideWillesden ... 48 26 2 26 11 4 2 ... ... 2 Totals 809 1087 150 30 515 180 68 133 26 99 100 The following Schools have been closed during the First Quarter of the year, 1909, to prevent the spread of Infectious Disease :— Gibbons Road—Infants, February 15th to March 2nd (Measles). Chamberlayne Wood Road—Infants, Feb. 26th to March 15th (Measles). All Souls'—Infants, March 18th to April 9th (Measles). Dudden Hill—Infants. March 18th to April 9th (Measles). Lower Place—Infants, March 19th to March 29th (Measles). Kensal Rise—Infants, March 27th to April 9th (Measles). 9 Summary of principal items of Work for 1st Quarter, ending April 3rd, 1909. Description of Work. Laoy Hlth. Vis. Sanitary Districts. Total No. 2 No, 3 No.4 No. 5 No. 6 Inspection of Houses- Number inspected on complaint 15 35 6l 11 41 52 215 ,, ,, for special inquiry 7 3 10 ,, ,, from house to house 16 50 63 64 31 224 „ „ „ (Housing of the Working Classes Act, 1890) 4 4 Number inspected and measured for Inland Revenue Certificate 45 4 38 8 95 Re-inspection of Houses- Number re-inspected 11 42 45 58 15 171 Number of visits to premises where works of amendment are in operation 536 561 305 263 571 2236 Number of Birth Enquiries 188 188 ,, Infantile Death Enquiries 113 113 Cases of Infectious disease visited 344 344 ,, ,, „ re-visited .. 104 104 ,, ,, ,, removed 287 Number of visits re miscellaneous matters 23 23 „ cases of Consumption visited 85 85 ,, Midwives disinfected.. 3 3 ,, rooms disinfected 391 391 Cases of illness notified from schools, visited 1067 1667 " ,, re-visited 300 300 Number of rooms disinfected after Consumption 4 4 Cancer 2 2 Other Diseases 7 7 Inspection of Mews, Stables, etc. 6 7 5 15 11 44 ,, of Dairies, Milkshops, etc. 22 24 19 19 17 101 ,, of Slaughterhouses 12 28 18 3 11 72 ,, re Miscellaneous matters 54 47 29 130 ,, of Canal Boats 22 22 Observations re Smoke Nuisance 3 1 4 Nuisances abated— Number of new drains constructed 4 1 2 6 13 ,, drains amended 10 17 3 4 8 42 „ tested 23 18 17 23 15 96 „ drains inspected .. 12 5 13 5 11 46 ,, nuisances of various descriptions abated 57 80 67 40 87 331 Sanitary notices issued 57 57 74 541 72 314 Statutory ,, „ 23 19 17 10 23 92 ,, ,, ,, under the Housing of the Working Classes Act, 1890 4 4 Number of letters received 1510 ,. written 863 Number of Summonses issued 3 1 4 IO Statement of principal items of work done under the Factory and Workshop Act, 1901, for the 1st Quarter ending April 3rd, 1909. Description of Defects, &c. Factories— Miscellaneous. Factory Laundries. FactoriesDomestic. Workshop Laundries. Domestic Laundries. Dressmakers. Miscellaneous Workshops. Bakehouses. Outworkers. Total. Number inspected .. 17 .. 7 7 14 31 24 17 117 Want of cleanliness .. 1 .. .. 1 .. 6 9 .. 17 Want of ventilation .. .. .. .. .. .. .. .. .. •• Overcrowding .. .. .. .. .. 1 .. .. .. 1 Sanitary Accommodation'— Insufficient .. .. .. .. .. .. .. .. .. .. Unsuitable or defective.. .. .. .. .. 1 6 .. .. .. 7 Not separate for sexes .. .. .. .. .. 1 .. .. .. 1 Other nuisances .. .. .. .. .. 2 3 .. .. 5 Failure to affix abstract .. .. .. .. 1 6 .. .. .. 7 Number of males employed .. 34 .. 13 5 2 76 30 4 161 Number of females employed .. 217 .. 67 27 121 14 .. 18 464 Total number of persons employed .. 251 .. 80 32 123 90 30 22 628 Number of Workshops discontinued .. 1 .. 5 7 8 2 .. 3 26 Number of Workshops reinspected .. .. .. 15 .. .. .. .. .. 15 Re-Visited .. .. .. .. .. .. 3 • • 1 4 Rooms measured .. .. .. .. .. .. .. .. .. .. Space notices issued .. .. .. .. .. 1 .. .. 1 2 WILLIAM BUTLER, Medical Officer of Health. 30th April, 1909. 11 To the Chairman and Members oj the Public Health Committee. Gentlemen, The following figures show the number of Patients treated during the quarter ended March 31st:— Disease. Remaining in Hospital, Dec .31,1908. Admitted. Discharged. Died. Remaining in Hospital, mar. 31,1909. Scarlet Fever 136 20i 217 8 1 12 Diphtheria 15 56 45 4 22 Enteric Fever 3 8 8 1 2 Other Diseases 2 17 13 2 4 Total 156 282 283 15 140 As compared with the corresponding quarter of last year the number of admissions is greatly in excess ; in other words 282 cases were admitted as against 163 cases in 1908. The average daily number of patients in Hospital for the quarter was 158.6, which will give some idea of the great and constant strain upon the Hospital accommodation, which as you are aware numbers some 164 beds. The cost of maintenance for the quarter is Patients, 3/5¾; Staff, 7/8½. I am, Gentlemen, Your obedient servant, W. J. J. STEWART, May 11th, 1909. Willesden Urban District Council. PUBLIC HEALTH QUARTERLY STATISTICS. Second Quarter, 1909. To the Chairman and Members of the Public Health Committee. METEOROLOGICAL OBSERVATIONS. 1909Week ending. Highest by Day. Lowest by Night. Range in week. Mean of all—Highest. Mean of all—Lowest. 4-ft. Earth Thermometer. Mean Degree of Humidity. Rainfall in Inches. No. of Days on which Rain was measured. Total No. of Hours of Bright Sunshine. Hours of Bright Sunshine Registered at Greenwich. Max. Min. deg. April 3 59.50 26.50 33.00 51.71 39.07 43.00 42.00 82 .66 5 20.5 23.8 " 10 71.75 27.50 44.25 53.18 33.14 44.25 43.00 66 — — 72.5 83.7 " 17 69.50 27.50 42.00 61.11 38.29 44.75 44.50 74 .13 3 47.0 42.2 " 24 66.75 30.75 36.00 61.96 40.82 45.25 44.75 76 .71 4 50.8 53.4 May 1 65.75 34.50 31.25 59.14 41.25 46.50 45.50 76 1.18 5 63.8 64.0 8 66.00 31.25 34.75 59.54 40.64 46.75 46.50 62 .04 1 85. 0 92.4 " 5 70.75 31.00 39.75 61.07 35.82 47.50 47.00 69 .12 2 61.8 62.7 " 22 73.75 30.50 43.25 64.89 37.25 48.25 47.75 71 .13 3 69.5 75.9 29 81.75 42.00 39.75 68.36 47.36 49.25 48.25 72 — — 50.0 55.9 June 5 75.50 42.75 32.75 63.18 47.07 50.00 49.25 85 1.12 4 21.5 31.2 "12 65.75 37.75 28.00 58.39 42 .64 50.50 50.25 78 .26 4 24.8 25.4 " 19 71.00 44.50 26.50 65.71 47.25 50.75 50.50 75 .08 1 46.5 37.4 " 26 71.00 48.00 23.00 65.36 52 .00 51.50 50.75 79 14.2 5 312 30.1 Means 2nd Qr., 1908 Total Ttl. Total Total 69.90 34.96 34.94 61.43 41.74 47.56 46.92 74 5.85 37 638.9 678.1 69.67 36.83 32.85 61.58 44.16 47.85 47.13 75 7.70 33 591.0 587. 5 2 POPULATION ESTIMATED TO MIDSUMMER, 1909. NAME OF WARD. Drainage Areas. Population estimated on the number of houses in occupation in each Ward as ascertained by enumeration. Houses in Occupation. Total Number of Empty Tenements. No. of Houses recently erected but unoccupied. No. of Houses in course of erection. Per centage of empties exclusive of houses recently erected. Per centage of empties inclusive of houses recently erected. Per centage of Houses empty at Census. Population in Drainage Areas. Wards. 1 Room. 2 Rooms. 3 Rooms. Over 3 Rooms. Population. 1908-9. Houses. No. of Empty Houses. Church End Met. ... 24043 Mids'r 3679 169 6 5 172 84 4 12 4.6 4.7 5.96 Brent. 24043 Xmas 3680 169 1 1 214 40 3 — 4.6 4.7 Harlesden Met. 8245 22509 Mids'r 3774 161 2 4 102 67 10 15 4.3 4.5 3.88 Brent. 14260 Xmas 3755 153 1 5 103 65 24 8 4.1 47 Kensal Green Met. 30117 30154 Mids'r 4178 125 8 14 129 64 6 9 3.0 3.1 2.92 Brent. 37 Xmas 4172 83 1 5 103 53 4 2 2.0 2.1 S. Kilburn Met. 14622 14622 Mids'r 1316 50 4 119 52 9 - - 3.8 - 1.26 Brent. ... Xmas 1316 55 - 41 100 12 — - 4.2 . Mid Kilburn Met. 12150 12150 Mids'r 1586 97 4 33 53 37 - - 61 — 4.16 Brent. ... Xmas 1595 106 8 30 59 23 - - 6.6 — N. Kilburn Met. 9787 9787 Mids'r 1687 131 - 1 52 50 11 - 7.8 8.4 2.62 Brent. Xmas 1685 101 4 9 32 17 8 5 6.0 6.7 Willesden Green Met. 2875 33611 Mids'r 5777 294 1 1 77 101 162 51 5.1 7.9 7.37 Brent. 30736 Xmas 5725 248 3 4 124 71 155 58 4.3 7.0 Willesden U. D. aggregate of the Wards Met. 77800 146876 Mids'r 21997 1027 25 177 637 412 193 87 4.7 5.'5 4.02 Brent. 69076 Xmas 21928 915 18 95 735 281 194 73 4.2 5.2 Population as estimated to Midsummer, 1909, by the Registrar-General, 160,424 Population estimated on the assumption that the average number of persons per house at census has remained constant for the whole of Willesden—150,118, Midsummer, 1909. 150,453, Christmas, 1908. 3 BIRTHS for Second Quarter, 1909.* WARDS. Total. Boys. Girls. Rate per 1000. Corresponding period last year. Illegitimate Births. 1. Church End 209 109 100 34.9 38.5 ... 2. Harlesden 185 104 81 33.0 36.2 ... 3. Kensal Green 179 82 97 23.8 25.6 ... 4. South Kilburn 110 61 49 30.2 25.7 ... 5. Mid Kilburn 97 46 51 32-0 32.4 ... 6. North Kilburn 50 27 23 20.5 16.5 ... 7. Willesden Grn. 205 109 96 24.5 26.4 ... Willesden U.D. 1035 538 497 27.7 28.8 39 Willesden U.D. 2nd quarter '08 1071 527 544 28.8 30.7 35 1 st quarter '09 1097 586 511 28.6 31.2 28 • Including Births of Willesden Infants in Queen Charlotte's Hospital 4 DEATHS.—2nd Quarter, ending July 3rd, 1909. WARDS Deaths of Willesden residents dying within the district. Deaths of Willesden residents dying outside the district. Total. Willesden residents dying within the district. Deaths under 1 year, inclusive of infants dying outside district. Infantile Mortality Rate. Standard Death Rate. Mean Annual Death Rate last five years corrected for age and sex distribution. Rate per 1,000 for 2nd Quarter, 1909. Corresponding Qtr.,1908. Illegitimate. Not certified. Inquests. Recorded. Corrected. Corrected. 1. Church End 52 3 55 2 2 4 18 87.0 16.91 13.9 9.2 9.6 12.6 2. Harlesden 58 7 65 ... ... 2 15 85.7 15.74 14.3 11.6 13.0 12.4 3. Kensal Green 69 10 79 ... ... 2 18 96.0 16.22 10.6 10.5 11.5 10.6 4. South Kilburn 44 14 58 ... 1 6 12 112.1 16.98 15.7 15.9 16.6 12.4 5. Mid Kilburn 39 6 45 ... ... 1 8 93.6 17.3 16.1 14.9 15.4 17.8 6. North Kilburn 22 1 23 1 ... ... 1 20.8 16.00 10.9 9.4 10.4 11.2 7. Willesden Green 65 8 73 ... ... 6 15 73.2 15.60 11.0 8.7 9.9 7.7 Ward unknown ... ... ... ... ... ... ... ... ... ... ... ... ... Willesden U. D. 349 49 398 3 3 21 87 857 16.38 12.7 10.6 11.4 11.0 1st Quarter, 1909 483 62 545 5 1 27 129 125.9 14.2 15.2 2nd Quarter, 1908 339 45 384 9 2 29 83 79.2 10.3 11.0 5 DEATHS of W1LLESDEN RESIDENTS during the SECOND QUARTER ending July 3rd, 1909. (Inclusive of Residents Dying Outside the District.) CAUSES OF DEATH. DEATHS AT SUBJOINED AGES. DEATHS IN LOCALITIES. (At all Ages.) At all Ages 0 to 1 1 to 5 5 to 15 15 to 25 25 to 65 65 & Up. Church End. Harlesden. Kensal Green. S. Kilburn. Mid-Kilburn. N. Kilburn. Willesden Green. Ward Unknown. Small Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 8 1 7 ... ... ... ... ... ... 5 2 1 ... ... ... Scarlet Fever 2 ... 1 1 ... ... ... 1 ... ... ... ... ... 1 ... Whooping Cough 23 11 11 1 ... ... ... 1 4 4 6 7 1 ... ... Diph. and Memb. Croup 2 ... 2 ... ... ... ... ... 1 ... ... ... 1 ... ... Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever 2 ... ... ... 1 1 ... ... ... 2 ... ... ... ... ... Other continued ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Epidemic Influenza 17 ... 1 ... ... 7 9 ... 4 7 ... 5 1 ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Tentanus 1 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... Diarrhœa 1 1 ... ... ... ... ... ... 1 ... ... ... ... ... ... Enteritis 1 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... Puerperal Fever 1 ... ... ... ... 1 ... ... 1 ... ... ... ... ... ... Erysipelas 1 ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... Other Septic Diseases 6 ... ... ... ... 6 ... ... 1 2 1 ... ... 2 ... Phthisis 34 ... 1 4 4 25 ... 6 9 7 0 1 ... 5 ... Other Tubercular Diseases 19 4 9 2 ... 4 ... 4 2 4 1 4 1 3 ... Cancer 24 ... 1 ... ... 13 10 2 2 5 3 4 3 5 ... Bronchitis 15 4 1 ... ... 5 5 2 5 1 2 2 ... 3 ... Pneumonia 40 5 6 1 ... 19 9 6 5 7 7 4 2 9 ... Pleurisy 1 ... ... ... ... ... 1 ... ... 1 ... ... ... ... ... Other Dis. Resp. Organs 1 ... ... ... ... ... 1 1 ... ... ... ... ... ... ... Alcoholism (Acute) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cirrhosis of Liver 7 ... ... ... ... 5 2 ... 1 1 2 ... 2 1 ... Venereal Disease 2 2 ... ... ... ... ... 1 ... 1 ... ... ... ... ... Premature Birth 14 14 ... ... ... ... ... 6 2 2 2 1 ... 1 ... Accidents and Diseases of Parturition 3 ... ... ... ... 3 ... ... 1 1 ... ... ... 1 ... Heart Disease 37 ... 1 1 1 23 11 6 4 4 8 2 ... 9 ... Accidents 11 4 1 2 ... 3 1 1 2 1 1 2 ... 4 ... Suicide 1 ... ... ... ... 1 ... ... 1 ... ... ... ... ... ... Murder ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Congenital Defects 13 12 1 ... ... ... ... 2 2 3 1 ... ... 4 ... Want of Breast Milk Marasmus 13 11 2 ... ... ... ... 3 3 ... 3 ... ... 4 ... Diseases of Nervous System 39 9 5 ... 1 14 10 6 3 8 9 5 2 6 ... Dis. of Digestive System 18 4 ... 1 ... 9 4 2 2 5 1 1 2 5 ... Diseases of Urinary System 9 ... ... 1 ... 3 5 2 2 ... ... 2 ... 3 ... All other causes 32 3 2 2 1 5 19 3 6 7 3 3 3 7 ... Totals 398 87 52 16 8 147 88 55 65 79 58 45 23 73 ... 2nd Quarter, 1908 384 83 24 18 13 156 90 72 60 73 43 52 25 56 3 6 NOTIFICATIONS.—Second Quarter ending July 3rd, 1909. Wards. Small Pox. Scarlet Fever Diphtheria. Typhoid Fever. Erysipelas. Membranous Croup. Puerperal Fever. Cerebro Spinal Meningitis. Total. Estimated Population. M dsr., 1909. Rate per 1,000 Population. Pulmonary Phthisis. Scarlet Fkvkr. Diphtheria. Notified under 15 years of age. Notification rate per 1,ooo population under 15 years of age. 1 Last Report. Notified 1 under 15 years of age Notification rate per 1,000 ! population under 15 years of age. Last Report. Church End ... 33 12 1 3 ... ... ... 49 24043 8.2 3 31 13.2 13.6 10 4.2 4.6 Harlesden ... 24 13 ... 3 ... 1 41 22509 7.3 4 21 11.8 12.1 9 5.1 5.5 Kensal Green ... 28 11 6 1 ... ... ... 46 30154 6.1 1 26 9.9 13.9 10 3.8 2.9 South Kilburn ... 9 4 ... 3 ... ... ... 16 14622 4.4 3 8 5.9 21.0 4 3.0 2.2 Mid Kilburn ... 18 5 ... 4 ... ... ... 27 12150 8.9 2 17 17.4 31.1 3 3.1 1.0 North Kilburn ... 10 1 ... 4 ... 1 ... 16 9787 6.5 1 10 17.5 10.0 1 1.8 3.3 Willesden Green ... 32 7 1 1 ... 1 ... 42 33611 5.0 2 24 9.4 21.5 7 2.8 7.3 Willesden U. D. ... 154 53 8 19 ... 3 ... 237 150145 6.3 16 137 10.9 16.7 44 3.5 4.2 1st qtr. '09 ... 247 65 13 25 ... 2 ... 352 150453 9.2 58 215 16.7 ... 54 4.2 ... 2nd qtr. '08 ... 145 43 3 15 1 4 2 213 149035 5.7 ... 123 9.9 ... 38 3.1 ... NON-NOTIFIABLE INFECTIOUS DISEASES. Intimated from the Schools. Number of Cases for Second Quarter ending July 3rd, 1909. Disease. Visited. Suffering. Contacts. Re-visited. Suffering upon Re-visit Doctor in Attendance. Isolated. Total No. Suffering. H.T. S.M.O. H.T. S.M.O. H.T. S.M.O. H.T. S.M.O. H.T. S.M.O. H.T. S.M.O. H.T. S.M.O. H.T. S.M.O. Measles 435 3 327 3 86c 5 224 ... 146 ... 267 ... 127 3 473 3 German Measles 53 ... 124 ... 20 ... 12 ... 29 ... 18 ... 65 ... Whooping Cough 191 25 279 25 467 22 80 4 53 11 165 10 44 3 332 36 Mumps 79 4 47 4 ... ... ... ... ... ... 18 1 12 ... 47 4 Chicken Pox 131 1 93 1 ... ... ... ... ... ... 27 1 24 1 93 1 Ringworm 86 58 99 58 ... ... 42 39 ... ... 41 13 43 22 99 58 Consumption 1 7 1 7 ... ... ... ... ... ... 1 5 ... 1 1 7 Influenza 2 ... 2 ... ... ... ... ... ... ... 2 ... ... ... 2 ... Coughs and Colds *30 ... 30 ... ... ... 5 ... ... ... 10 ... 1 ... 30 ... Other Diseases 110 179 161 179 ... ... 28 89 ... ... 33 27 18 13 16 179 Totals 1065 277 1092 277 1451 27 399 132 211 11 593 57 287 43 13.3 288 * Three proved Whooping Cough. H.T.—Figures in these columns represent cases notified by the Head Teachers. S.M.O.—Figures in these columns represent cases notified by the Assistant School Medical Officers. 7 8 NUMBER OF MEDICAL INSPECTIONS COMPLETED, and INFECTIOUS AND CONTAGIOUS DISEASES NOTIFIED from the PUBLIC ELEMENTARY SCHOOLS. NAME OF SCHOOL. No. of Medical Inspections completed. No. of Cases of Illness primarily visited. Infectious and Contagious Diseases notified as occurring among scholars attending public Elementary Schools. Scarlet Fever. Diphtheria. Measles. Whooping Cough. Mumps. Chicken Pox. Other Nonnotifiable Infectious Diseases. Ringworm. Ophthalmia Other Contagious Diseases. Acton Lane—Mixed 246 9 ... ... ... ... 4 2 ... ... ... 3 Ditto Infants 3 ... 1 ... ... ... 3 ... ... ... ... Cambridge Road (Temp.) 39 3 ... ... ... ... 1 1 ... ... ... ... Chamberlayne Wood Rd. Boys and Girls 151 29 1 ... 8 1 3 3 ... 1 ... ... Ditto Infants 43 1 1 23 3 7 7 2 ... ... ... Dudden Hill—B. & G. 100 10 1 1 2 ... ... ... ... ... ... ... Ditto Infants 104 41 2 ... 22 ... ... 1 ... 2 ... 3 Furness Road—Mixed 129 28 ... 1 12 1 ... 8 ... 8 ... 2 Ditto Infants 113 30 2 ... 6 5 ... ... ... 1 ... 1 Gibbons Road—Mixed 145 36 1 ... 10 1 4 3 ... 1 1 3 Ditto Infants 118 68 ... ... 1 3 4 15 ... 1 ... 3 Granville Road—Special ... 1 ... ... 2 ... ... ... ... ... ... ... Kensal Rise—B. & G. 123 5 1 ... ... ... 1 ... ... ... ... ... Ditto Infants 36 119 1 ... 10 43 33 ... ... 13 ... 10 Kilburn Park—Mixed 37 15 ... ... 5 ... ... 2 ... ... ... 5 Ditto Infants 29 ... ... 30 ... ... 3 ... 1 ... ... Leopold Road—B. & G. 206 63 ... 1 18 8 1 2 1 2 ... 2 Ditto Infants 210 84 3 1 13 32 ... 4 ... 9 1 5 Ditto Special ... 2 ... ... 2 ... ... ... ... ... ... ... Disraeli Road—Infants 28 23 4 ... ... 2 1 ... ... 1 ... 2 Lower Place —B. & G. 55 13 ... 1 ... 1 ... ... ... 3 ... 3 Mora Road—B. & G. 142 5 ... 1 ... 2 1 ... ... ... ... ... Ditto Infants 18 3 ... 2 5 ... ... ... ... 5 1 Oldfield Road—B. & G. 104 45 2 ... 11 ... 3 ... ... 4 ... ... Ditto Infants 123 35 6 1 14 ... ... ... ... 1 ... 1 Pound Lane—Mixed 132 9 1 ... 2 ... ... ... ... ... ... 1 Ditto Infants 28 1 ... 14 ... 4 1 ... 5 ... 4 Salusbury Road—Mixed 198 44 16 ... 17 2 1 ... ... ... ... ... Ditto Infants 81 172 3 1 63 33 5 7 ... 11 ... 19 Stonebridge—B. & G. 167 15 3 ... 3 1 ... 1 ... ... ... 3 Ditto Infants 103 20 3 ... 1 2 ... ... ... 3 ... 6 9 Number of Medical Inspections completed, and Infectious and Contagious Diseases notified from the Public Elementary Schools—(Continued). NON-PROVIDED SCHOOLS. NAME OF SCHOOL. No. of Medical Inspections completed. No. of Cases of Illness primarily visited. Infectious and Contagious Diseases notified as occurring among scholars attending public Elementary Schools. Scarlet Fever. Diphtheria. Measles. Whooping Cougn. Mumps. Chicken Pox. Other Nonnotifiable Infectious Diseases. Ringworm. Ophthalmic. Other Contagious Diseases. Christ Church—B. & G. 99 27 ... ... 14 ... ... 1 ... ... ... 1 Ditto Infants 57 ... ... 38 7 2 1 ... ... ... 7 Gordon Mem.—B. & G. 274 23 ... ... ... ... ... ... ... ... ... ... Ditto Infants 7 ... 1 5 ... ... ... ... ... ... ... Harlesden Nat.—B. & G. 102 14 ... 2 ... ... ... 8 ... ... ... ... Ditto Infants 41 ... 2 1 ... ... 31 ... 3 ... 3 Harlesden R. C.—Mixed 75 7 ... ... ... ... ... 1 ... 1 ... ... Ditto Infants 11 ... ... 6 ... ... ... ... ... ... ... Holy Trinity—B. & G. 102 14 3 ... 2 ... ... 1 ... 1 ... ... Ditto Infants 9 2 1 ... ... ... ... ... ... ... ... Keble Mem.—B. & G. 49 3 ... ... ... ... ... ... ... 1 ... ... Ditto Infants 20 4 ... 1 11 ... 3 ... 2 ... ... Kilburn Park Rd.—Evan ... ... ... ... ... ... ... ... ... ... ... ... Neasden—Mixed 13 ... ... ... ... ... ... ... ... ... ... ... Ditto Infants 5 ... ... 1 ... ... 13 ... ... ... ... *PrincessFred.—B. & G. 198 41 ... ... 28 3 1 2 ... ... ... 1 Ditto Infants 47 ... 2 22 1 2 ... ... 4 ... 2 St. Andrew's—B. & G. 78 3 ... 1 ... ... ... ... ... ... ... ... Ditto Infants 45 6 1 1 ... ... ... ... ... ... ... ... St. John's—B. & G. 173 39 ... ... ... ... ... 2 ... ... ... ... Ditto Infants 58 11 2 1 ... 4 ... 3 ... ... ... 1 St. Mary's, Wil.—B.&G. 93 11 3 ... 1 ... 1 ... ... 1 4 5 Ditto Infants 46 9 1 ... ... ... ... ... ... 1 ... 1 St. Mary's, R.C.—Mixed 83 8 ... ... ... 1 ... ... ... 1 ... ... Ditto Infants 22 3 ... 3 1 ... ... ... ... ... ... Schools outside Willesden Mixed ... 75 18 ... 3 1 ... ... ... 2 ... ... Infants ... 19 22 ... 1 ... 2 1 ... Totals 4378 1556 92 24 435 191 79 131 7 86 12 98 * One case of Typhoid Fever. The following Schools have been closed during the Second Quarter of the year, 1909, to prevent the spread of Infectious Disease. Pound Lane—Infants, April 2nd to April 9th (Measles). Mora Road—Infants, April 2nd to April 9th (Measles). Princess Frederica—Infants, April 2nd to April 9th (Measles). Gibbons Road—Infants, April 2nd to April 9th (Measles). Chamberlayne Wood Road—Infants, April 2nd to April 9th (Measles). 10 Summary of principal items of Work for 2nd Quarter, ending July 3rd, 1909. Description of Work. Lady Hlth. Vis. Sanitary Districts. Total No. 2 No. 3 No. 4 No. 6 No. 6 Inspection of Houses— Number inspected on complaint 7 52 6l 19 56 53 248 „ „ for special inquiry 2 7 6 15 „ „ from house to house 42 88 81 10 48 269 „ „ „ „ (Housing of the Working Classes Act, 1890) 2 2 Number inspected and measured for Inland Revenue Certificate 26 1 2 29 Re-inspection of Houses— Number re-inspected 6 17 63 60 28 34 208 Number of visits to premises where works of amendment are in operation 475 496 314 578 649 2512 Number of Birth Enquiries 260 260 „ Infantile Death Enquiries 124 124 Cases of Infectious disease visited 237 237 „ „ „ re-visited 113 113 „ „ „ removed 190 Number of visits re miscellaneous matters 46 46 „ cases of Consumption visited 76 76 „ Midwives disinfected 2 2 „ rooms disinfected 284 284 Cases of illness notified from schools, visited 1905 1905 „ „ „ „ re-visited 663 663 Number of rooms disinfected after Consumption 21 21 Cancer 2 2 Other Diseases 12 12 Inspection of Mews, Stables, etc. 12 7 8 12 21 60 „ of Dairies, Milkshops, etc. 23 24 21 19 27 114 „ of Slaughterhouses 7 21 16 8 5 57 „ premises where ice-cream is made 7 19 17 20 9 72 „ re Miscellaneous matters 15 120 116 22 15 288 „ of Canal Boats 20 20 Observations re Smoke Nuisance 23 4 13 40 Nuisances abated— Number of new drains constructed 4 1 1 3 5 14 „ drains amended 12 5 2 4 9 32 „ tested 20 22 14 51 28 135 „ drains inspected 10 27 11 8 9 65 „ nuisances of various descriptions abated 73 93 71 65 91 393 Sanitary notices issued 74 109 133 33 61 410 Statutory „ „ 13 15 30 19 18 95 „ ,, „ under the Housing of the Working Classes Act, 1890 2 2 Number of letters received 804 written 1059 Number of Summonses issued 11 Statement of principal items of work done under the Factory and Workshop Act, 1901, for the 2nd Quarter ending July 3rd, 1909. Description of Defects, &c. Factories— Miscellaneous. FactoryLaundries. FactoriesDomestic. Workshop Laundries. Domestic Laundries. Dressmakers. Miscellaneous Workshops. Bakehouses. Outworkers. Total. Number inspected .. 4 .. 11 4 40 23 56 28 166 Want of cleanliness .. .. .. 1 .. .. 4 22 .. 27 Want of ventilation .. .. .. .. .. .. .. .. .. .. Overcrowding .. .. .. .. .. 1 1 .. .. 2 Sanitary Accommodation:— Insufficient .. .. .. .. .. .. .. .. .. .. Unsuitable or defective .. 1 .. 2 1 2 .. 6 .. 13 Not separate for sexes .. .. .. .. .. .. .. .. .. .. Other nuisances .. .. .. 2 1 5 1 8 .. 17 Failure to affix abstract .. .. .. 2 .. 1 2 .. .. 5 Number of males employed .. 16 .. 15 3 .. 58 117 1 210 Number of females employed .. 117 .. 62 21 169 9 .. 31 409 Total number of persons employed .. 133 .. 77 24 169 67 117 32 619 Number of Workshops discontinued .. .. .. .. .. 8 .. 4 19 31 Number of Workshops reinspected .. .. .. 17 .. 7 5 14 .. 43 Re-Visited .. .. .. 1 .. 3 3 .. 10 17 Rooms measured .. .. .. 3 1 2 4 .. .. 10 Space notices issued .. .. .. .. 2 .. 4 .. 4 10 WILLIAM BUTLER, Medical Officer of Health. July, 1909. 12 To the Chairman and Members of the Public Health Committee. Gentlemen, I beg to submit the Hospital Statistics for the quarter ending June 30th. The following. Table shows the number of Patients treated during that time:— Disease. Remaining in Hospital, Mar. 31,1909. Admitted. Discharged. Died. Remaining in Hospital, June 30,1909. Scarlet Fever 112 126 61 2 63 Diphtheria 22 41 29 1 11 Enteric Fever 2 6 0 2 4 Other Diseases 4 17 14 1 2 Total 140 190 104 6 80 For the quarter the cost of maintenance of Patients is 3/5½. and Staff 7/5½. July 12th, 1909. Your obedient servant, W. J. J. STEWART. Millesden Arban District Council. PUBLIC HEALTH QUARTERLY STATISTICS. Third Quarter, 1909. To the Chairman and Members of the Public Health Committee. METEOROLOGICAL OBSERVATIONS. 1909. Week ending. Highest by Day. Lowest by Night. Range in week. Mean of all—Highest. Mean of all—Lowest. 4-ft. Earth Thermometer. Mean Degree of Humidity. Rainfall in Inches. No. of Days on which Rain was measured. Total No. of Hours of Bright Sunshine. Hours of Bright Sunshine Registered at Greenwich. Max. Mill. July 3 70.50 39.75 30.75 63.21 45.75 52.00 51.75 deg. 79 1.17 3 42.2 37.0 „ 10 72.75 46.75 26.00 68.07 52.18 52.25 52.00 73 .91 5 35.5 31.2 „ 17 73.50 46.25 27.25 67.43 52.64 52.75 52.50 79 .60 6 26.3 25.2 „ 24 75.75 45.00 30.75 72.64 53.39 53.50 53.00 70 .31 1 64.3 63.0 „ 31 68.75 46.75 22.00 65.96 53.29 54.00 53.75 74 1.54 5 36.0 34.4 Aug. 7 74.25 43.50 30.75 68.82 49.50 54.50 54.00 72 .21 1 51.0 54.4 „ 14 85.50 50.00 35.50 79.68 52.79 55.00 54.50 71 — - 77.5 81.5 „ 21 84.75 49.00 35.75 73.61 54.39 55.75 55.00 78 .72 5 38.5 40.2 „ 28 68.25 42.75 25.50 66.18 49.32 56.25 55.75 79 .75 4 26.7 30.2 Sept. 4 70.75 34.75 36.00 64.57 44.50 56.25 55.75 72 .14 1 40.3 41.7 „ 11 68.50 35.00 33.50 62.00 46.46 55.75 55.25 80 .90 7 41.0 35.0 „ 18 68.25 43.50 24.75 63.00 51.64 55.25 55. 00 79 .34 4 16.5 20.9 „ 25 69.00 39.00 30.00 65.11 51.14 55.00 54.75 80 .46 3 30.8 27.7 Total Ttl. Total Total Means 73.11 43.23 29.88 67.71 50.54 54.48 54.08 76 8.05 45 526.6 522.4 3rd Qr., 1908 76.69 44.08 32.61 68.89 50.55 56.29 55.77 74 8.58 37 534.7 591.0 2 BIRTHS for Third Quarter, 1909.* WARDS. Total. Boys. Girls. Rate per 1000. Corresponding period last year. Illegitimate Births. 1. Church End 201 115 86 33.5 32.1 ... 2. Harlesden 188 96 92 33.6 29.9 ... 3. Kensal Green 200 103 97 26.6 25.7 ... 4. South Kilburn 95 44 51 26.1 29.1 ... 5. Mid Kilburn 88 42 46 29.1 29.4 ... 6. North Kilburn 47 24 23 19.2 16.1 ... 7. Willesden Grn. 189 97 92 22.6 24.4 ... Willesden U.D. 1008 521 487 26.9 26.5 28 Willesden U.D. 2nd quarter '09 1035 538 497 27.7 28.8 39 1st quarter '09 1097 586 511 28.6 31.2 28 3rd quarter '08 984 492 492 26.5 29.1 17 • Including Births of Willesden Infants in Institutions outside the District. 3 DEATHS.—3rd Quarter, ended October 2nd, 1909. WARDS Deaths of Willesden residents dying within the district. Deaths of Willesden residents dying outside the district. Total. Willesden residents dying within the district. Deaths under 1 year, inclusive of infants dying outside district. Infantile Mortality Rate. Standard Death Rate. Mean Annual Death Rate last five years corrected for age and sex distribution. Rate per 1,000 for 3rd Quarter, 1909. Corresponding Qtr.,1908. Illegitimate. Not certified. Inquests. Recorded. Corrected. Corrected. 1. Church End 44 5 49 4 ... 1 20 95.7 16.91 13.9 8.2 8.6 10.8 2. Harlesden 45 5 50 2 1 3 18 99.4 15.74 14.3 8.9 10.0 10.9 3. Kensal Green 38 12 50 1 ... 2 10 52.9 1622 10.6 6.7 7.3 7.9 4. South Kilburn 34 7 41 ... ... 3 15 142.9 16.98 15.7 11.3 11.8 10.9 5. Mid Kilburn 3.5 11 46 1 1 4 10 117.7 17.13 16.1 15.2 15.7 8.6 6. North Kilburn 10 4 14 ... ... ... 1 20.2 16.00 10.9 5.7 6.3 5.3 7. Willesden Green 55 9 64 ... ... 2 10 49.5 15.60 11.0 7.6 8.6 8.4 Ward unknown ... 2 2 ... ... ... ... ... ... ... ... ... ... Willesden U. D. 261 55 316 8 2 15 84 82.3 16.38 12.7 8.4 9.0 8.9 2nd Quarter, 1909 349 49 398 3 3 21 87 85.7 10.6 11.4 11.0 1st Quarter, 1909 483 62 545 5 1 27 129 125.9 14*2 15-2 3rd Quarter, 1908 265 42 307 5 ... 16 88 85.3 8.3 8.9 4 DEATHS of WILLESDEN RESIDENTS during the THIRD QUARTER, ending October 2nd, 1909. (Inclusive of Residents Dying Outside the District.) CAUSES OF DEATH. DEATHS AT SUBJOINED AGES. DEATHS IN LOCALITIES. (At all Ages.) At all Ages 0 to 1 1 to 5 5 to 15 15 to 25 25 to 65 65 & Up. Church End. Harlesden. Kensal Green. S. Kilburn. Mid-Kilburn. N. Kilburn. Willesden Green. Ward |Unknown. Small Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 1 ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... Scarlet Fever 4 ... 2 ... ... ... ... ... 1 2 1 ... ... ... ... Whooping Cough 3 3 ... ... ... ... ... 1 ... 1 ... 1 ... ... ... Diph. and Memb. Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other continued ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Epidemic Influenza 3 ... ... ... ... 1 ... ... 1 1 ... 1 ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Tentanus ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhœa 23 20 1 2 ... ... ... 7 4 4 6 ... ... 2 ... Enteritis 9 6 2 ... ... 1 ... 3 4 ... 1 1 ... ... ... Puerperal Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Septic Diseases 3 ... ... ... ... 2 ... ... ... ... 2 ... ... 1 ... Phthisis 18 ... 1 ... 4 13 ... 2 1 1 3 2 2 7 ... Other Tubercular Diseases 16 2 7 4 1 2 ... 4 1 2 3 2 1 3 ... Cancer 37 ... ... ... ... 22 15 4 5 9 4 3 3 9 ... Bronchitis 9 7 ... ... ... 2 5 ... 1 3 ... 1 ... 4 ... Pneumonia 10 2 1 ... ... 4 3 1 1 2 ... 5 1 ... ... Pleurisy 1 ... ... ... ... 1 ... ... ... ... ... 1 ... ... ... Other Dis. Resp. Organs 1 ... 1 ... ... ... ... ... 1 ... ... ... ... ... ... Alcoholism (Acute) 1 ... ... ... ... 1 ... ... ... ... ... 1 ... ... ... Cirrhosis of Liver 3 ... ... ... 1 1 1 ... ... ... 1 1 ... ... ... Venereal Disease 2 2 ... ... ... ... ... ... 1 ... ... ... ... 1 ... Premature Birth 19 19 ... ... ... ... ... 1 4 3 4 3 ... 4 ... Accidents and Diseases of Parturition 2 ... ... ... ... 2 ... ... ... ... ... ... ... 2 ... Heart Disease 30 ... 1 2 3 15 9 3 6 7 5 1 ... 8 ... Accidents 8 1 2 1 1 2 1 3 1 1 ... 2 ... 1 ... Suicides 5 ... ... ... ... 4 1 1 2 ... 1 1 ... ... ... Murder ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Congenital Defects 7 7 ... ... ... ... ... 1 ... 1 3 1 ... 1 ... Want of Breast Milk, Marasmus 14 11 2 ... ... ... ... 2 ... ... 3 5 ... ... ... Diseases of Nervous System 32 2 4 ... ... 19 7 7 4 3 2 3 3 9 1 Dis. of Digestive System 11 2 1 1 ... 4 3 1 1 1 ... 2 1 4 1 Diseases of Urinary System 14 ... ... ... ... 10 4 1 2 3 ... 4 ... 4 ... All other causes 30 5 1 ... ... 13 11 1 5 6 1 5 2 4 ... Totals 316 84 27 13 10 120 62 49 50 50 41 46 14 64 2 3rd Quarter, 1908 307 88 21 9 14 104 71 62 53 54 38 25 12 61 2 5 NOTIFICATIONS.—Third Quarter ended October 2nd, 1909. Wards. Small Pox. Scarlet Fever Diphtheria. Typhoid Fever. Erysipelas. Membranous Croup. Puerperal Fever. Cerebro Spinal Meningitis. Total. Estimated Population. M'dsr., 1909. Rate per 1,000 Population. Pulmonary Phthisis. Scarlet Fever. Diphtheria. Notified under 15 years of age. Notification rate per 1,000 population |under 15 years of age. Last Report. Notified under 15 years of age Notification rate per 1,000 population under 15 years of age. Last Report. Church End ... 12 8 2 2 ... ... ... 24 24043 40 2 9 3.8 13.2 6 2.5 4.2 Harlesden ... 21 13 1 6 ... ... ... 41 22509 7.3 2 20 11.2 11.8 11 6.2 5.1 Kensal Green ... 26 1 4 7 ... ... ... 38 30154 5.1 2 25 95 9.9 1 .4 3.8 South Kilburn ... 27 4 ... 5 ... ... ... 36 14622 9.9 3 23 17.0 5.9 3 2.2 3.0 Mid Kilburn ... 10 3 1 1 ... ... ... 15 12150 5.0 2 8 8.2 17.4 3 3.1 3.1 North Kilburn ... 10 1 1 2 ... ... ... 14 9787 5.7 ... 9 15.7 17.5 1 1.8 1.8 Willesden Green ... 31 5 2 5 ... ... ... 43 33611 5.1 5 29 11.4 9.4 3 1.2 2.8 Ward unknown ... ... ... ... ... ... ... ... ... ... ... 2 ... ... ... ... ... ... Willesden U. D. ... 137 35 11 28 ... ... ... 211 150145 5.6 18 123 9.8 10.9 28 2.2 3.5 2nd qtr. '09 ... 154 53 8 19 ... 3 237 150145 6.3 16 137 10.9 ... 44 3.5 ... 1st qtr. '09 ... 247 65 13 25 ... 2 352 150453 9.2 58 215 16.7 ... 54 4.2 ... 3rd qtr. '08 ... 160 43 9 18 ... ... ... 230 149035 6.2 ... 146 11.7 ... 35 2.8 ... 6 NON-NOTIFIABLE INFECTIOUS DISEASES.—Intimated from the Schools. Number of Cases for Third Quarter ending October 2nd, 1909. Disease. Visited. Suffering. Contacts. Re-visited. Suffering upon Re-visit Doctor in Attendance. Isolated. Total No Suffering. H.T.. S.M.O. H.T. S.M.O. H.T. S.M.O. H.T. S.M.O. H.T. S.M.O. H.T. S.M.O. H.T. S.M.O. H.T. S.M.O. Measles 107 ... 66 ... 257 ... 62 ... 27 ... 53 ... 52 ... 93 ... German Measles 24 ... 22 ... 95 ... 29 ... 13 ... 24 ... 9 ... 35 ... Whooping Cough 96 1 139 1 158 3 51 1 17 ... 96 ... 77 ... 156 1 Mumps 22 7 21 8 ... ... 2 ... ... ... 9 1 4 4 21 8 Chicken Pox 49 1 47 1 ... ... ... ... ... ... 11 ... 20 1 47 1 Ringworm 33 17 33 17 ... ... 71 40 ... ... 29 3 27 17 35 17 Consumption 1 2 1 2 ... ... 1 7 ... ... 1 2 ... ... 1 2 Influenza 1 ... 1 ... ... ... ... ... ... ... ... ... 1 ... 1 ... Coughs and Colds 5 1 5 1 ... ... 2 1 *2 ... 1 ... ... ... 5 1 Other Diseases 81 255 86 256 ... ... 73 167 ... ... 21 22 14 '7 86 256 Totals 419 284 423 286 510 3 291 216 59 ... 245 28 204 39 480 286 • Proved Whooping Cough. H.T.—Figures in these columns represent cases notified by the Head Teachers. S.M.O.—Figures in these columns represent cases notified by the Assistant School Medical Officers. 7 NUMBER OF MEDICAL INSPECTIONS COMPLETED, and INFECTIOUS AND CONTAGIOUS DISEASES NOTIFIED from the PUBLIC ELEMENTARY SCHOOLS. NAME OF SCHOOL. No. of Medical Inspections completed. No. of Cases of Illness primarily visited. Infectious and Contagious Diseases notified as occurring among scholars attending public Elementary Schools. Scarlet Fever. Diphtheria. Measles. Whooping Cough. Mumps. Chicken Pox. Other Nonnotifiable Infectious Diseases Ringworm. Ophthalmia Other Contagious Diseases. Acton Lane—Mixed 29 14 ... ... 2 ... ... 4 ... ... ... 3 Ditto Infants 7 ... ... ... ... 1 2 ... 1 ... 3 Cambridge Road (Temp.) 15 1 ... ... ... ... ... ... ... 1 ... ... Chamber layne Wood Rd. Boys and Girls 93 11 2 ... 1 3 ... 4 ... ... ... ... Ditto Infants 15 1 ... 1 ... ... 11 ... ... ... ... Dudden Hill—B. & G. 58 1 ... 1 ... 1 ... ... ... ... ... ... Ditto Infants 66 20 1 ... 1 4 ... ... ... 4 ... 1 Furness Road—Mixed 136 23 8 ... 4 ... 1 4 ... 5 ... 3 Ditto Infants 59 11 1 ... ... ... ... ... ... ... ... ... Gibbons Road—Mixed 107 50 ... ... 4 1 2 9 ... 1 ... 2 Ditto Infants 83 20 1 ... ... 1 1 1 ... ... ... 1 Granville Road—Special ... 1 ... ... ... ... ... ... ... ... ... 1 Kensal Rise—B. & G. 110 2 1 ... ... ... ... ... ... ... ... ... Ditto Infants 41 12 1 ... 1 ... 14 ... ... 2 ... ... Kilburn Park—Mixed 40 4 ... ... ... ... ... ... ... 1 ... 2 Ditto Infants 2 ... ... 1 ... ... ... ... 1 ... 1 Leopold Road—B. & G. 79 54 2 1 40 ... ... 1 ... 2 ... 2 Ditto Infants 135 127 ... ... 82 ... ... ... ... 2 ... 5 Ditto Special ... ... ... ... ... ... ... ... ... ... ... ... Lower Place - B. & G. 10 40 1 ... ... ... ... ... ... 1 ... 1 Ditto Infants 4 15 1 1 ... 1 ... ... ... 2 ... 2 Mora Road—B. & G. 95 12 1 ... ... 11 ... ... ... ... ... 2 Ditto Infants 68 2 ... ... 61 2 1 ... ... ... ... Oldfield Road—B & G. 56 15 1 ... 1 ... ... ... ... ... ... ... Ditto Infants 63 8 2 ... 4 ... ... ... ... ... ... ... *Pound Lane—Mixed 120 5 2 ... 1 ... ... ... ... ... ... 2 Ditto Infants 30 7 ... 3 2 12 ... ... 1 ... 2 Salusbury Road—Mixed 123 2 6 ... ... ... ... ... ... ... ... ... Ditto Infants 79 12 6 ... ... ... 2 4 ... 2 ... 5 Stonebridge—B. & G. 36 22 2 ... 1 ... ... 1 ... 1 2 6 Ditto Infants 29 10 1 ... ... ... ... ... ... ... ... 4 * One case of Typhoid Fever. 8 Number of Medical Inspections completed, and Infectious and Contagious Diseases notified from the Public Elementary Schools—(Continued). NON-PROVIDED SCHOOLS. NAME OF SCHOOL. No. of Medical Inspections completed. No. of Cases of Illness primarily visited. Infectious and Contagious Diseases notified as occurring among scholars attending public Elementary Schools. Scarlet Fever. Diphtheria Measles. Whooping Cough. Mumps. Chicken Pox. Other Non notifiable Infectious Diseases. Ringworm. Ophthalmic. Other Contagious Diseases. Christ Church—B. & G. 40 4 ... ... ... ... ... ... ... ... ... ... Ditto Infants 5 1 2 ... 2 ... ... ... 1 ... 1 Gordon Mem.—B. & G. 122 9 6 ... ... ... ... ... ... ... ... 2 Ditto Infants 11 6 ... ... ... ... 1 ... ... ... 3 Harlesden Nat.—13. & G. 6o 3 ... 1 1 ... ... ... ... ... ... 2 Ditto Infants 4 ... ... 1 ... ... ... ... ... ... 2 Harlesden R. C.—Mixed 1 29 ... ... 3 ... ... ... ... ... ... 1 Ditto Infants 12 ... ... ... ... ... ... ... ... ... 1 *Holy Trinity—B. & G. 44 1 ... ... ... ... ... ... ... ... ... ... Ditto Infants 1 1 ... ... ... ... ... ... ... ... ... Keble Mem.—B. & G. 135 ... ... ... ... ... ... ... ... ... ... ... Ditto Infants 13 ... 1 ... 3 ... 3 ... 1 ... ... Kilburn Park Rd.—Evan ... ... ... ... ... ... ... ... ... ... ... ... Neasden—Mixed 44 4 ... ... ... ... ... ... ... ... ... ... Ditto Infants ... ... ... ... ... ... ... ... ... ... ... *PrincessFred.—B & G. 162 20 ... ... 4 ... ... ... ... ... ... 2 * Ditto Infants 10 ... ... 1 1 6 ... ... ... ... 1 St. Andrew's—B. & G. 39 ... 1 ... ... ... ... ... ... ... ... ... Ditto Infants 60 11 ... ... ... ... ... ... ... ... ... ... St. John's—B. & G. 118 19 ... ... ... ... ... ... ... ... ... ... Ditto Infants 37 5 ... 1 ... ... ... ... ... ... ... ... St. Mary's, Wil—B.&G. 10 8 ... ... 2 ... ... ... ... 1 ... 4 Ditto Infants 20 4 ... ... 1 ... ... 1 ... ... ... ... St. Mary's, R.C.—Mixed 50 6 ... ... ... ... ... ... ... ... ... ... Ditto Infants 6 ... ... ... ... ... 1 ... ... ... ... Schools outside Willesden Mixed ... 6 17 1 2 ... 1 ... ... 2 ... ... Infants 4 ... ... ... 1 ... ... ... ... Totals 6o8 809 82 9 162 94 42 49 1 32 2 67 * One case of Typhoid Fever in each of these Schools. The following School was closed during the Third Quarter of the year, 1909, to prevent the spread of Infectious Disease. All. Souls'—Infants, September 30th to October 18th (Measles). 9 Summary of principal items of Work for 3rd Quarter, ending Oct. 2nd, 1909. Description of Work. Lady Hlth. Vie. Sanitary Districts. Total No. 2 No. 8 No. No. 6 No. 6 Inspection of Houses- Number inspected on complaint 10 64 48 21 69 61 273 „ „ for special inquiry 23 7 8 7 11 56 „ „ from house to house 20 14 40 61 32 167 „ „ „ „ (Housing of the Working Classes Act, 1890) Number inspected and measured for Inland Revenue Certificate Re-inspection of Houses— Number re-inspected 8 10 32 26 48 20 144 Number of visits to premises where works of amendment are in operation 504 493 329 387 470 2163 Number of Birth Enquiries 974 974 „ Infantile Death Enquiries 75 75 Cases of Infectious disease visited 214 214 „ „ „ re-visited 96 96 „ „ „ removed 159 Number of visits re miscellaneous matters 17 17 „ cases of Consumption visited 64 64 „ Midwives disinfected „ rooms disinfected 253 253 Cases of illness notified from schools, visited 979 979 „ „ „ „ re-visited 847 847 Number of visits to Schools 8 8 „ children cleansed 27 27 Number of rooms disinfected after Consumption 21 21 Cancer 2 2 Other Diseases 10 10 Inspection of Mews, Stables, etc. 17 13 9 14 15 68 of Dairies, Milkshops, etc. 23 22 22 19 17 103 „ of Slaughterhouses 5 15 12 5 2 39 „ premises where ice-cream is made „ re Miscellaneous matters 16 101 57 12 27 213 „ of Canal Boats 22 22 Observations re Smoke Nuisance 5 5 Nuisances abated— Number of new drains constructed 2 2 3 7 6 20 „ drains amended 7 5 4 6 3 25 „ tested 28 13 15 24 17 97 „ drains inspected 20 16 5 15 10 66 „ nuisances of various descriptions abated 73 113 70 67 81 404 Sanitary notices issued 53 64 59 91 85 352 Statutory „ „ 12 12 13 30 25 92 „ „ „ „ under the Housing of the Working classes Act, 1890 Number of letters received 1383 „ written 650 Number of Summonses issued 1 1 10 Statement of principal items of work done under the Factory and Workshop Act, 1901, for the 3rd Quarter ending October 2nd, 1909. Description of Defects, &c. Factories— Miscellaneous. Factory Laundries. FactoriesDomestic. Workshop Laundries. Domestic Laundries. Dressmakers. Miscellaneous Workshops. Bakehouses. Outworkers. Total. Number inspected .. 47 3 51 19 48 26 1 17 212 Want of cleanliness .. 7 11 17 2 .. .. 2 1 40 Want of ventilation .. 1 .. .. .. .. .. .. .. 1 Overcrowding .. 1 .. 1 .. 1 1 .. .. 4 Sanitary Accommodation:— Insufficient .. .. .. .. .. .. .. .. .. .. Unsuitable or defective .. 6 4 3 .. .. 1 1 .. 15 Not separate for sexes .. .. .. .. .. .. .. .. .. .. Other nuisances .. 7 9 11 1 .. 3 1 .. 32 Failure to affix abstract .. 1 .. 3 .. 3 1 .. .. 8 Number of males employed .. 115 .. 53 6 .. 29 1 3 207 Number of females employed .. 816 .. 347 38 190 82 .. 24 1497 Total number of persons employed .. 931 .. 400 44 190 111 1 27 1704 Number of Workshops discontinued .. 1 .. 7 2 14 .. .. 10 34 Number of Workshops reinspected .. 1 16 45 .. 24 9 9 .. 104 Re-Visited .. 3 .. 16 1 9 6 .. 3 38 Rooms measured .. 1 .. 2 .. 5 6 .. .. 14 Space notices issued .. 3 .. 5 .. 14 5 .. .. 27 WILLIAM BUTLER, Medical Officer of Health. 8th October, 1909. 11 To the Chairman and Members of the Public Health Committee. Gentlemen, The following figures deal with the number of patients treated during the Quarter ending September 30th:— Disease. Remaining in Hospital, June 30,1909. Admitted. Discharged. Died. Remaining in Hospital, Sep. 30,1909. Scarlet Fever 63 116 112 5 62 Diphtheria 11 25 30 ... 6 Enteric Fever 4 6 8 ... 2 Other Diseases 2 18 14 1 5 Total 80 165 164 6 75 During the Summer months I have had all the wards in the hospital thoroughly washed down and disinfected. This has been accomplished with the aid of the ordinary hospital Staff, and without engaging any extra hands. The hospital is now well prepared for the coming winter's work. I am, Gentlemen, Your obedient servant, W. J. J. STEWART. October 12th, 1909. Millesden Arban district Council. PUBLIC HEALTH QUARTERLY STATISTICS. Fourth Quarter, 1909. To the Chairman and Members of the Public Health Committee. METEOROLOGICAL OBSERVATIONS. 1909. Week ending. Highest by Day. Lowest by Night. Range in week. Mean of all—Highest. Mean of all - Lowest. 4-ft. Earth Thermometer. Mean Degree of Humidity. Rainfall in Inches. No. of Days on which Rain was measured. Total No. of Hours of Bright Sunshine. Hours of Bright Sunshine Registered at Greenwich. Max. Min. Oct. 2 64.25 41.50 22.75 60.00 47.71 54.75 54.50 deg. 93 .85 7 6.0 6.0 „ 9 65.75 35.75 30.00 63.39 48.50 54.50 54.25 80 .34 5 28.3 33.7 „ 16 63.75 33.50 30.25 61.79 49.46 54.25 54.00 83 .73 6 16.0 22.5 „ 23 64.50 40.75 23.75 61.43 51.29 54.00 54.00 90 .36 4 16.5 16.7 „ 30 62. 00 26.25 35.75 50.07 37.82 54.00 53.00 86 1.95 7 17.5 13.9 Nov. 6 54.75 30.75 24.00 50.11 40.57 52.75 51.75 91 .11 2 7.3 20.1 „ 13 55.75 26.50 29.25 49.46 35.43 51.75 51.00 81 .04 1 28.8 22.2 „ 20 47.50 28.75 18.75 43.39 33.71 51.00 49.75 81 .29 5 19.2 I4.0 „ 27 45.75 26.00 19.75 41.54 29.32 49.50 48.75 84 - - 10.5 14.7 Dec. 4 52.75 35.51 17.25 48.82 33.68 48.75 47.50 91 1.33 5 15.0 13.2 „ 11 48.50 24.50 24.00 42.79 32.11 47.50 40.50 90 .46 5 6.8 16.7 „ 18 46.75 33.50 13.25 42.04 36.32 46.50 46.00 89 .47 5 .8 0.4 „ 25 53.00 19.00 34.00 46.36 29.18 45.75 45.00 94 .48 5 13.0 18.1 Means 55.77 30.94 24.83 50.86 39.24 51.15 50.46 87 Total Ttl. Total Total 7.41 57 19.1 7 21.22 4th Qr., 1908 62.00 33.75 28.25 53.50 41.81 53.04 52.59 89 3.44 29 15.90 249.2 2 POPULATION ESTIMATED TO CHRISTMAS, 1909. NAME OF WARD. Drainage Areas. Population estimated on the number of houses in occupation in each Ward as ascertained by enumeration. Houses in Occupation. Total Number of Empty Tenements. No. of Houses recently erected but unoccupied. No. of Houses in course of erection. Per centage of empties exclusive of houses recently erected. Per centage of empties inclusive of houses recently erected. Per centage of Houses empty at Census. Population in Drainage Areas. Wards. No. of Empty Houses. 1 Room. 2 Rooms. 3 Rooms. Over 3 Rooms. Population. 1909. Houses. Church End Met. ... 24359 Xmas 3689 133 1 1 172 70 7 8 3.6 3.8 5..96 Brent. 24359 Mids'r 3679 169 6 5 172 84 4 12 4.6 4.7 Harlesden Met. 8423 22777 Xmas 3811 155 1 — 147 50 10 7 4.1 4.3 3.88 Brent. 14354 Mids'r 3774 161 2 4 102 67 10 15 4.3 4.5 Kensal Green Met. 30348 30385 Xmas 4194 110 3 6 192 37 11 6 2.6 2.9 2.92 Brent. 37 Mids'r 4178 125 8 14 129 64 6 9 3.0 3.1 S. Kilburn Met. 14518 14518 Xmas 1316 59 2 88 78 — — — 4.5 - 1.26 Brent. ... Mids'r 1316 50 4 119 52 9 — — 3.8 — Mid Kilburn Met. 12085 12085 Xmas 1586 105 8 11 85 13 — — 6.6 — 4.16 Brent. ... Mids'r 1586 97 4 33 53 37 — — 6.1 — N. Kilburn Met. 9856 9856 Xmas 1687 120 2 1 32 22 11 1 7.1 7.8 2.62 Brent. ... Mids'r 1687 131 — 1 52 50 11 — 7.8 8.4 Willesden Green Met. 2887 34469 Xmas 5874 251 1 2 54 91 191 38 4.3 7.5 7.37 Brent. 31582 Mids'r 5777 294 1 1 77 101 162 51 5.1 7.9 Willesden U. D. aggregate of tbe Wards Met. 78117 148449 Xmas 22157 933 18 109 760 283 230 60 4.2 5.2 4.02 Brent. 70332 Mids'r 21997 1027 25 177 637 412 193 87 4.7 5.5 Population as estimated to Midsummer, 1910, by the Registrar-General, 166,088. Population estimated on the assumption that the average number of persons per house at census has remained constant for the whole of Willesden—151,964, Christmas, 1909. 150,145, Midsummer, 1909. 3 BIRTHS for Fourth Quarter, 1909.* WARDS. Total. Boys. Girls. Rate per 1000. Corresponding period last year. Illegitimate Births. 1. Church End 205 115 90 34.1 32.9 ... 2. Harlesden 181 88 93 32.2 26.5 ... 3. Kensal Green 181 100 81 24.2 22.0 ... 4. South Kilburn 114 62 52 31.9 24.6 ... 5. Mid Kilburn 95 46 49 31.8 23.8 ... 6. North Kilburn 44 25 19 18.1 17.2 ... 7. Willesden Grn. 212 106 106 24.9 21.5 ... Willesden U.D. 1032 542 490 27.6 23.9 35 4th quarter '08 Willesden U.D. 945 504 441 23.9 26.1 20 3rd quarter '09 1008 521 487 26.9 26.5 28 2nd quarter '09 1035 538 497 27.7 28.8 39 1st quarter '09 1097 586 511 28.6 31.2 28 W.U.D., year '09 4172 2187 1985 27.8 27.5 130 • Including Births of Willesden Infants in Institutions outside the District. 4 DEATHS.—4th Quarter, ended December 31st, 1909. WARDS Deaths of Willesden residents dying within the district. Deaths of Willesden residents dying outside the district. Total. Willesden residents dying within the district. Deaths under 1 year, inclusive of infants dying outside district. Infantile Mortality Rate. Standard Death Rate. Mean Annual Death Rate last five years corrected for age and sex distribution. Rate per 1,000 for Illegitimate. Not certified. Inquests. 4th Quarter, 1909. sponding Qtr.,1908. Net. Corrected. Corrected. 1. Church End 57 10 67 ... ... 2 19 91.3 16.91 13.9 11.2 11.7 13.3 2. Harlesden 46 6 52 2 1 3 11 587 15.74 14.3 9.3 10.6 15.3 3. Kensal Green 66 10 76 2 ... 4 21 110.2 16.22 10.6 10.2 11.1 9.7 4. South Kilburn 41 6 47 2 ... 1 8 72.7 16.98 15.7 13.2 13.8 12.3 5. Mid Kilburn 35 5 40 ... ... 2 11 122.2 17.13 16.1 13.4 13.8 14.3 6. North Kilburn 27 5 32 ... ... 2 5 101. 16.00 10.9 13.2 14.6 8.8 7. Willesden Green 70 11 81 1 1 10 16 77.1 15.60 11.0 9.5 10.8 10.8 Ward unknown 1 1 2 ... ... ... ... ... ... ... ... ... ... Willesden U. D. 343 54 397 7 2 24 91 87.2 16.38 12.7 10.6 11.4 11.6 4th Quarter, 1908 385 42 427 7 ... 26 116 113.3 10.8 11.6 3rd Quarter, 1909 261 55 316 8 2 15 84 82.3 8.4 9.0 2nd Quarter, 1909 349 49 398 3 3 21 87 85.7 10.6 11.4 1st Quarter, 1909 483 62 545 5 1 27 129 125.9 14.2 15.2 Year, 1909 436 220 1656 23 8 87 391 93.7 11.0 11.8 5 DEATHS of WILLESDEN RESIDENTS during the FOURTH QUARTER, ending December 31st, 1909. (Inclusive of Residents Dying Outside the District.) CAUSES OF DEATH. DEATHS AT SUBJOINED AGES. DEATHS IN LOCALITIES. (At all Ages.) At all Ages 0 to 1 1 to 5 5 to 15 15 to 25 25 to 65 65 & Up. Church End. Harlesden. Kensal Green. S. Kilburn. Mid-Kilburn. N. Kilburn. Willesden Green. Ward Unknown. Small Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 4 ... 4 ... ... ... ... 1 2 ... ... 1 ... ... ... Scarlet Fever 4 1 2 ... ... ... ... ... 1 1 1 ... ... ... ... Whooping Cough 2 2 ... ... ... ... ... ... 2 ... ... ... ... ... ... Diph. and Memb. Croup 4 ... 1 3 ... ... ... 1 ... 1 ... ... ... 2 ... Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other continued ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Epidemic Influenza 4 ... ... ... ... 1 3 ... ... 2 1 1 ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Tentanus 1 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... Diarrhoea 16 15 1 ... ... ... ... 4 ... 5 3 3 ... 1 ... Enteritis 2 ... 1 ... ... ... 1 ... ... 1 ... ... ... 1 ... Puerperal Fever 1 ... ... ... ... 1 ... ... 1 ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Septic Diseases 4 ... ... ... ... 3 1 ... ... 1 ... 1 ... 2 ... Phthisis 34 1 1 1 8 20 3 4 4 4 9 5 2 6 ... Other Tubercular Diseases 11 3 2 1 1 3 1 2 2 1 ... 2 2 1 ... Cancer 33 ... ... ... ... 16 17 4 4 9 3 1 4 8 ... Bronchitis 32 11 3 ... ... 7 11 6 6 8 3 3 3 3 ... Pneumonia 37 10 7 2 4 10 4 9 5 5 2 4 4 8 ... Pleurisy 2 ... 1 ... 1 ... ... 1 1 ... ... ... ... ... ... Other Dis. Resp. Organs 7 ... ... ... ... 6 1 2 1 1 ... 1 1 1 ... Alcoholism (Acute) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cirrhosis of Liver 3 ... ... 1 ... ... 2 ... 1 1 ... ... ... 1 ... Venereal Disease 4 2 ... ... ... 2 ... 1 ... 2 ... ... 1 ... ... Premature Birth 13 13 ... ... ... ... ... 3 1 1 ... 3 3 2 ... Accidents and Diseases of Parturition 2 ... ... ... 1 1 ... ... ... ... ... ... ... 2 ... Heart Disease 40 ... ... 5 4 15 16 5 ... 9 7 3 6 10 ... Accidents 11 1 ... 2 ... 4 4 1 1 1 2 3 ... 3 ... Suicides 1 ... ... ... ... 1 ... ... 1 ... ... ... ... ... ... Murder ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Congenital Defects 7 7 ... ... ... ... ... 1 2 1 ... ... 1 2 ... Want of Breast Milk, Marasmus 10 10 ... ... ... ... ... 3 2 1 3 ... ... 1 ... Diseases of Nervous System 43 9 2 2 1 15 14 8 5 8 4 2 1 15 ... Dis. of Digestive System 10 1 2 1 ... 4 2 1 1 2 1 1 2 2 ... Diseases of Urinary System 14 ... ... ... ... 7 7 1 3 5 3 1 1 ... ... All other causes 41 4 2 3 2 10 20 9 6 5 5 5 1 9 1 Totals 397 91 29 21 22 127 107 67 52 76 47 40 32 81 2 4th Quarter, 1908 427 116 52 19 9 139 92 80 80 71 45 44 21 84 2 6 NOTIFICATIONS.—Fourth Quarter ended December 31st, 1909. Wards. Small Pox. Scarlet Fever Diphtheria. Typhoid Fever. Erysipelas. Membranous Croup Puerperal Fever. Cerebro Spinal Meningitis. Total. Estimated Population. Mdsr., 1909. Rate per 1,000 Population. Pulmonary Phthisis. Scarlet Fkver. Diphtheria. Notified under 15 years of age. Notification rate per 1,000 population under 15 years of age. Last Report. Notified under 15 years of age Notification rate per 1,000 population under 15 years of age. Last Report. Church End ... 10 10 4 2 ... ... ... 26 24359 4.3 4 8 3.4 3.8 8 3.4 2.5 Harlesden ... 17 14 1 3 ... 2 ... 37 22777 6.6 1 15 8.4 11.2 11 6.2 6.2 Kensal Green ... 36 3 1 10 ... ... ... 50 30385 6.7 ... 34 13.0 9.5 3 1.1 .4 South Kilburn ... 14 2 ... 1 ... ... ... 17 14518 4.8 4 12 9.0 17.0 2 1.5 2.2 Mid Kilburn ... 6 3 ... 1 ... ... ... 10 12085 3.4 3 6 6.2 8.2 2 2.1 3.1 North Kilburn ... 4 1 3 1 ... ... ... 9 9856 3.7 ... 3 5.2 15.7 1 1.7 1.8 Willesden Green ... 13 21 ... 4 ... 1 ... 39 34469 4.6 1 10 3.9 11.4 21 8.1 1.2 Ward unknown ... ... ... ... ... ... ... ... ... ... ... 2 ... ... ... ... ... ... Willesden U. D. ... 100 54 9 22 ... 3 ... 188 151964 5.0 15 88 7.0 9.8 4.8 3.8 2.2 4th qtr. '08 ... 311 67 18 22 2 ... ... 420 150453 10.6 ... 284 21.4 ... 63 4.8 ... 3rd qtr. '09 ... 137 35 11 28 ... ... ... 211 150145 5.6 18 123 9.8 ... 28 2.2 ... 2nd qtr. '09 ... 154 53 8 19 ... 3 ... 237 150145 6.3 16 137 10.9 ... 44 3.5 ... 1st qtr. '09 ... 247 65 13 25 ... 2 ... 352 150453 9.2 58 215 16.7 ... 54 4.2 ... Year 1909 ... 638 207 41 94 ... 8 ... 988 150145 6.6 107 563 11.2 ... 174 3.5 ... 7 NON-NOTIFIABLE INFECTIOUS DISEASES.—Intimated from the Schools. Number of Cases for Fourth Quarter ending December 31st, 1909. Disease. Visited. Suffering. Contacts. Re-visited. Suffering upon Re-visit Doctor in Attendance. Isolated. Total No. Suffering. H.T. S.M.O H.T. S.M.O. H.T. S.M.O. H.T. S.M.O. H.T. S.M.O. H.T. S.M.O. H.T. S.M.O. H.T. S.M.O. Measles 175 1 180 1 474 ... 164 1 116 ... 137 ... 104 ... 296 1 German Measles 3 ... 2 ... 6 ... 2 ... ... ... 2 ... 2 ... 2 ... Whooping Cough 26 1 43 1 63 ... 30 ... 8 ... 26 ... 12 ... 51 1 Mumps 30 2 28 2 ... ... 3 ... ... ... 8 ... 9 ... 28 2 Chicken Pox 86 ... 105 ... ... ... ... ... ... ... 30 ... 45 ... 105 ... Ringworm 43 32 37 34 ... ... 53 38 ... ... 29 14 30 14 57 34 Consumption ... 6 ... 6 ... ... 1 2 ... ... ... 5 ... 1 ... 6 Influenza 4 ... 3 ... ... ... ... ... ... ... 1 ... ... ... 3 ... Coughs and Colds 15 4 18 4 ... ... 4 1 ... ... 5 3 2 ... 18 4 Other Diseases 113 143 139 149 ... ... 88 143 ... ... 43 21 31 24 139 149 Totals 495 189 575 197 543 ... 345 185 124 ... 281 43 235 39 699 197 * Proved Whooping Cough. H.T.—Figures in these columns represent cases notified by the Head Teachers. S.M.O.—Figures in these columns represent cases notified by the Assistant School Medical Officers. 8 NUMBER OF MEDICAL INSPECTIONS COMPLETED, and INFECTIOUS AND CONTAGIOUS DISEASES NOTIFIED from the PUBLIC ELEMENTARY SCHOOLS. NAME OF SCHOOL. No. of Medical Inspections completed. No. of Cases of Illness primarily visited. Infectious and Contagious Diseases notified as occurring among scholars attending public Elementary Schools. Scarlet Fever. Diphtheria. Measles. Whooping Cough. Mumps. Chicken Fox. Other Nonnotifiable Infectious Diseases Ringworm. Ophthalmia Other Contagious Diseases. Acton Lane—Mixed 120 7 ... 1 8 2 ... ... ... ... ... Ditto Infants 8 3 1 4 ... ... ... ... ... ... ... Cambridge Road (Temp.) 16 2 ... ... ... 1 ... ... ... ... ... ... Chamberlayne Wood Rd. Boys and Girls 75 11 3 ... ... ... ... 6 ... 1 ... ... Ditto Infants 20 2 ... ... ... 4 1 ... 5 ... 3 Dudden Hill—B. & G. 103 12 2 ... 1 ... 1 5 ... ... ... ... Ditto Infants 80 27 ... 1 2 2 ... 7 ... 3 ... 7 Furness Road—Mixed 142 45 3 ... 4 2 4 6 5 1 ... 15 Ditto Infants 95 19 6 1 4 ... ... ... ... ... ... 2 Gibbons Road—Mixed 128 24 ... 1 7 ... ... 6 ... ... 1 ... Ditto Infants 86 19 1 3 5 ... ... 4 ... ... ... 5 Granville Road—Special ... 1 ... ... ... ... ... ... ... 1 ... ... Kensal Rise—B. & G. 108 2 5 ... ... ... ... ... ... ... ... ... Ditto Infants 113 15 6 1 1 1 ... 3 ... 1 ... 4 Kilburn Park—Girls 51 11 5 1 ... ... 5 ... ... ... 1 6 Ditto Infants 18 ... ... 2 ... ... ... ... 14 Leopold Road—B. & G. 90 20 ... ... 21 ... 1 ... ... ... ... 1 Ditto Infants 108 30 ... ... 12 ... ... 1 ... ... ... ... Ditto Special ... ... ... ... ... ... ... ... ... ... ... ... Disraeli Road 20 11 ... ... 2 ... ... ... ... ... ... ... Lower Place—B. & G. 35 11 1 ... 3 ... ... 1 ... 1 1 ... Mora Road—B. & G. 138 7 1 ... 2 1 ... 4 ... 1 ... ... Ditto Infants 6 ... ... 1 ... ... 5 ... ... ... 1 Oldfield Road—B & G. 61 25 ... 1 23 ... ... 1 ... ... ... ... Ditto Infants 84 44 ... ... 32 ... ... ... ... ... ... ... Pound Lane—Mixed 164 13 1 ... ... 1 1 1 ... ... ... 1 Ditto Infants 39 ... ... ... 19 5 7 ... ... ... 3 Salusbury Road—Mixed 9 6 ... ... 2 ... ... ... ... ... ... ... Ditto Infants 140 11 1 ... ... ... 1 2 ... 1 ... 1 Stonebridge—B. & G. 179 49 ... 2 17 ... ... 1 ... 1 ... 5 Ditto Infants 77 54 1 ... 37 ... 1 ... ... 1 ... 1 9 Number of Medical Inspections completed, and Infectious and Contagious Diseases notified from the Public Elementary Schools—(Continued). NON-PROVIDED SCHOOLS. NAME OF SCHOOL. No. of Medical Inspections completed. No. of Cases of Illness primarily visited. Infectious and Contagious Diseases notified as occurring among scholars attending public Elementary Schools. Scarlet Fever. Diphtheria. Measles. Whooping Cough. Mumps. Chicken Pox. Other Nonnotifiable Infectious Diseases. Ringworm. Ophthalmic. Other Contagious Diseases. Christ Church—B. & G. 54 10 1 ... ... ... ... ... ... ... ... ... Ditto Infants 3 ... ... ... ... ... ... ... 1 ... ... Gordon Mem.—B. & G. 111 13 1 ... ... ... ... ... ... ... ... 10 Ditto Infants 9 4 ... ... ... ... ... ... ... ... ... Harlesden Nat.—B. & G. 70 6 ... 1 5 ... ... ... ... ... ... 1 Ditto Infants 5 ... ... ... ... ... ... ... 1 ... ... Harlesden R. C.—Mixed 51 6 ... ... ... ... ... ... ... 1 ... ... Ditto Infants 1 ... ... ... ... ... ... ... 1 ... ... Holy Trinity—B. & G. 33 ... ... ... ... ... ... ... ... ... ... ... Ditto Infants ... ... ... ... ... ... ... ... ... ... ... Keble Mem —B. & G. 95 ... ... ... ... ... ... ... ... ... ... ... Ditto Infants 2 ... ... ... ... ... ... ... ... ... ... Neasden—Mixed 36 ... 1 ... ... ... ... ... ... ... ... ... Ditto Infants ... ... ... ... ... ... ... ... ... ... ... Princess Fred. B & G. 126 18 3 ... ... 1 2 1 ... 2 ... ... Infants 21 ... ... 1 ... 9 3 ... 2 ... ... St. Andrew's—3 & G. 47 ... ... 6 ... ... ... ... ... ... ... ... Ditto Infants 42 28 ... 1 ... ... ... 19 ... 3 ... 4 St. John's—B. & G. 47 30 ... ... ... ... ... ... ... ... ... ... Ditto Infants 41 2 ... ... ... ... ... ... ... 1 ... ... St. Mary's, Wil.—B.&G. 70 6 ... ... ... ... ... ... ... ... ... 3 Ditto Infants 21 3 ... ... ... ... ... ... ... ... ... ... St. Mary's, R.C.—Mixed 61 9 ... ... ... ... ... ... ... ... ... ... Ditto Infants 3 ... 1 ... ... ... 1 ... ... ... ... *Schls. outside Willesden Mixed ... 12 11 5 3 ... 3 ... ... 1 ... ... Infants 15 1 ... ... 3 ... 1 ... ... Totals 3127 769 59 29 200 32 39 88 7 34 3 87 • Two cases of other notifiable diseases. The following school was closed during the fourth quarter of the year 1909, to prevent the spread of Infectious disease, Keble Memorial Infants, Oct. 20th, Nov. 1st (Measles). 10 Summary of principal items of Work for 4th Quarter, ending Dec. 31st, 1909. Description of Work. Lady Hlth Vis. Sanitary Districts. Total No. 2 No. 3 No. No. No. Inspection of Houses— Number inspected on complaint 12 38 33 18 46 35 182 „ „ for special inquiry 5 6 9 20 „ „ from house to house 26 40 26 64 27 183 „ „ „ „ (Housing of the Working Classes Act, 1890) Number inspected and measured for Inland Revenue Certificate 8 6 1 1 16 Re-inspection of Houses— Number re-inspected 12 8 27 48 81 8 184 Number of visits to premises where works of amendment are in operation 697 504 305 595 611 2712 Number of Birth Enquiries 779 779 „ Infantile Death Enquiries 116 116 Cases of Infectious disease visited 180 180 „ „ „ re-visited 118 118 „ „ „ removed 138 138 Number of visits re miscellaneous matters 26 26 „ cases of Consumption visited 58 58 „ Midwives disinfected 2 2 „ rooms disinfected 228 228 Cases of illness notified from schools, visited 929 929 „ „ „ „ re-visited 859 859 Number of visits to Schools 31 31 „ children cleansed 3 3 Number of rooms disinfected after Consumption 44 44 Cancer 2 2 Other Diseases 22 22 Inspection of Mews, Stables, etc. 15 7 9 17 13 61 „ of Dairies, Milkshops, etc. 26 28 22 28 36 140 „ of Slaughterhouses 3 15 15 7 5 45 „ premises where ice-cream is made „ re Miscellaneous matters 26 118 32 16 192 „ of Canal Boats 18 18 Observations re Smoke Nuisance 8 8 Nuisances abated— Number of new drains constructed 5 3 3 1 8 20 „ drains amended 17 9 3 12 5 46 „ tested 15 23 17 26 11 92 „ drains inspected 6 2 8 20 5 41 „ nuisances of various descriptions abated 73 113 39 114 56 395 Sanitary notices issued 51 39 79 112 31 312 Statutory „ „ 22 13 49 31 27 142 „ „ „ under the Housing of the Working Classes Act, 1890 1 1 Number of letters received 465 written 747 Number of Summonses issued 1 1 11 Statement of principal items of work done under the Factory and Workshop Act, 1901, for the 4th Quarter ending December 31st, 1909. Description of Defects, &c. Factories— Miscellaneous. Factory Laundries. FactoriesDomestic. Workshop Laundries. Domestic Laundries. Dressmakers. Miscellaneous Workshops. Bakehouses. Outworkers. Total. Number inspected .. .. .. 3 .. 3 41 6 24 77 Want of cleanliness .. .. .. .. .. .. .. 9 1 13 Want of ventilation .. .. .. .. .. .. 1 .. .. 1 Overcrowding .. .. .. .. .. 1 .. .. .. 1 Sanitary Accommodation:— Insufficient .. .. .. .. .. .. 2 .. .. 2 Unsuitable or defective .. .. .. .. .. .. 2 3 .. 5 Not separate for sexes .. .. .. .. .. .. .. .. .. .. Other nuisances .. .. .. .. .. .. 1 2 .. 3 Failure to affix abstract .. .. .. .. .. .. 4 .. .. 4 Number of males employed .. .. .. .. .. .. 112 49 16 177 Number of females employed .. .. .. 2 .. 20 20 .. 15 57 Total number of persons employed .. .. .. 2 .. 20 132 49 31 234 Number of Workshops discontinued .. .. .. .. .. .. 2 .. .. 2 Number of Workshops reinspected .. 4 11 19 9 3 8 24 5 83 Newly discovered .. .. .. .. .. .. 3 .. .. 3 Rooms measured .. 4 .. 4 .. 2 12 .. 6 28 Re-Visited .. .. .. .. .. .. 2 7 1 10 Space notices issued .. 4 .. 4 .. 2 1 .. 4 15 WILLIAM BUTLER, Medical Officer of Health. 11th January, 1910. 12 To the Chairman and Members of the Public Health Committee. Gentlemen, I submit figures showing the number of patients treated during the three months ending December 31st, 1909. The admissions for the quarter, it will be seen was 138, as compared with 330 in the corresponding period of 1908, and 244 in 1907. In spite of this small number, the total admissions for the year was 775. In 1908, 854 patients were admitted. Disease. Remaining in Hospital, Sep. 30,1909. Admitted. Discharged. Died. Remaining in Hospital, Dec. 31, 1910. Scarlet Fever 62 81 105 4 6l Diphtheria 6 38 25 3 16 Enteric Fever 2 9 3 1 7 Other Diseases 5 10 10 1 4 Total 75 138 143 9 88 !3 Owing to the fact that Mr. Annal, the Steward, has been seriously ill during the last four weeks and is not yet able to resume his duties, and to the fact that his clerk is suffering from an attack of Diphtheria, I am unable to give the usual figures for the quarter relating to cost of maintenance of patients and staff. These, however, will be included in my report for the whole year. I am, Gentlemen, Your obedient servant, W. J. J. STEWART. January 11th, 1910.