Willesden Urban District Council. 1915. The 40th ANNUAL Health Report. GEORGE F. BUCHAN, Medical Officer. London: Hanbury, Tomsett & Co., Printers, Kensal Rise, N.W. 1916. WIL 16 54398 Willesden Urban District Council. 1915. The 40th ANNUAL Health Report. GEORGE F. BUCHAN, Medical Officer. London: Hanburv, Tomsett & Co., Printers, Kensal, Rise, N.W. 1916. 3 WILLESDEN URBAN DISTRICT COUNCIL, 1915-1916. Mr. Councillor J. ANDREWS. Mr. Councillor J. E. BALL. *Mr. Councillor J. J. BATE. *Mr. Councillor W. BLACKLOCK. Mr. Councillor C. H. BOLTON, M.A. †*Mr. Councillor W. M. BOLTON. Mr. Councillor P. BOND. †*Mr. Councillor S. BOWN. Mr. Councillor H. C. BROWN. Mr. Councillor S. D. BUMSTEAD. Mr. Councillor E. T. BUTTERISS. *Mr. Councillor J. COMBER, (Chairman). †*Mr. Councillor J. E. CONLON. Mr. Councillor W. II. DOBBS. Mr. Councillor A. E. DORAN. Mr. Councillor II. H. GRIMWOOD. Mr. Councillor J. E. HILL. Mr. Councillor W. A. HILL. *Mr. Councillor G. H. HISCOCKS. *Mr. Councillor C. W. HOGG, (Vice-Chairman). Mr. Councillor E. LANE. Mr. Councillor T. G. MATTHEWS. Mr. Councillor C. PINKHAM, J.P. Mr. Councillor H. B. PRATT. *Mr. Councillor W. C. RAPKIN. †*Mr. Councillor W. RILEY, J.P. (Chairman of the Health and Hospital Committees). *Mr. Councillor H. ROGERS. Mr. Councillor W. A. SAVILLE. †*Mr. Councillor The Rev. R. SILBY. Mr. Councillor A. SMITH. *Mr. Councillor C. E. P. TAYLOR. Mr. Councillor H. D. TURNER. Mr. Councillor W. WAY. *Member of the Health Committee. †Member of the Hospital Committee. 4 MEMBERS OF THE EDUCATION COMMITTEE, 1915-16. *Mr. Councillor J. ANDREWS (Vice-Chairman of the Education Committee). Mr. Councillor J. E. BALL. *Mr. Councillor W. BLACKLOCK. *Mr. Councillor W. M. BOLTON. Mr. Councillor P. BOND. Mr. Councillor S. D. BUMSTEAD. Mr. Councillor E. T. BUTTERISS. Mr. Councillor J. COMBER. Mr. Councillor H. H. GRIMWOOD. Mr. Councillor G. H. HISCOCKS. Mr. Councillor J. E. HILL. Mr. Councillor W. A. HILL. *Mr. Councillor C. W. HOGG. *Mr. Councillor E. LANE (Chairman of the Children's Care Committee). Mr. Councillor H. ROGERS. *Mr. Councillor The Rev. R. SILBY Mr. Councillor H. DAVEY TURNER. Mr. Councillor W. WAY. *Mr. J. CASH, J.P. Mr. W. J. DOWDELL. *Mr. E. W. ESSEL. *Miss M. A. LUPTON. *Mr. G. OSWIN. *Mr. H. E. SCOTT (Chairman of the Education Committee). *Mr. E. J. TOZER. Mr. A. E. WARREN. *Mr. D. T. WILLIAMS. *Member of the Children's Care Committee. 5 Municipal Offices, Dyne Road, Kilburn, N.W., 29th February, 1916. To the Willesden Urban District Council— The Local Sanitary Authority. The Local Education Authority. I beg to submit herewith the 40th Annual Health Report for Willesden for the year 1915. This report includes:— 1. The 40th Annual Report on the Health and Sanitary Condition of the District. 2. The 8th Annual Report on the Health of Children attending the Public Elementary Schools. 3. The 24th Annual Hospital Report. Owing to the large number of the staff of the Health Department on Military Service as shown in Appendix F this report has been curtailed, and only such tables are reproduced as are necessary for the continuity of the Health work of the Local Authority. Sanitary Work. The number of occupiable houses in Willesden at midsummer, 1915, was 23,533. The work of dust collection has been considerably hampered by the shortage of labour which has been experienced everywhere owing to the circumstances of the times. 9,861 loads have been removed in 1915 as compared with 10,083 in 1914. It is unsatisfactory to record that during the year in question 1,61-1 complaints have been received from householders as against 255 in 1914, and an average of 173 during the fourteen years, 1901 to 1914. 6 Vital Statistics. The population of Willesden, estimated at mid-summer, 1915, was 166,840, as compared with the census population, 154,344 in 1911. The Registrar General estimates the civil population of Willesden in 1915 at 160,778, which has been obtained by deducting the soldiers from the total population. The figure, however, of 166,840, is the figure used throughout this report. Particularly noteworthy is the fact that 1,666 marriages were recorded in Willesden during the year 1915, giving a marriage rate of 20 per 1,000, being the highest marriage rate recorded by no less than 4.3 per 1,000 of the population. On the other hand, the total number of births occurring in Willesden has fallen from 4,115 in 1914 to 3,775 in 1915, giving a birth-rate of 22.6 per 1,000, the lowest recorded by 2.1 per 1,000 of the population. The number of illegitimate births has not increased during 1915, being 137 as against 149 in 1914, and 132 in 1913. 2,030 deaths occurred during 1915, giving a death-rate of 12.2 per 1,000 as against 10.5 per 1,000 in 1914 and 9.8 in 1910, when the death-rate was lowest. This increase in the number of deaths is mainly due to Measles, Whooping Cough, Bronchitis, and Pneumonia, all of which conditions are closely associated. It is certain, as stated in my Annual Report for 1914, that Local Authorities in the near future will require to make provision for the treatment of these diseases which especially occur amongst young children. 334 deaths of infants occurred during the year 1915, giving an infant mortality rate of 91 as compared with 82 for the preceding year. 7 Infectious Diseases. 1,255 cases of compulsorily notifiable infectious diseases, including Tuberculosis, were notified during the year as compared with 1,665 in 1914. The diminution in number is mainly due to the diminished prevalence of Scarlet Fever and Diphtheria. 33 cases of Cerebro-spinal Meningitis were certified during the year, 4 occurring amongst soldiers and 29 in the civil population. Cerebro-spinal Meningitis is a disease in which the death-rate is very high, and under these circumstances it is satisfactory to record a recovery rate of 65 per cent. amongst all cases treated at the Willesden Isolation Hospital. In only one instance did a second case occur in a family, and this is no doubt due to the swabbing and isolation of contacts which was carried out where practicable in all cases coming to the notice of the Health Department. 1,947 cases of Measles were brought under notice during the year by Teachers, School Attendance Officers, Health Visitors and others, from which it is calculated that 7,204 cases of Measles occurred in Willesden during the year 1915. Recently the Local Government Board have, by order, made this disease notifiable, the order coming into operation on the 1st January, 191(3. The benefits to be derived from these notifications at 2s. 6d. or 1s. each, as the case may be, appear to be doubtful where no facilities exist for the treatment of the worst cases, amongst which the death-rate is very high. 798 notifications of Tuberculosis, relating to 425 new cases, were received during the year. 2,240 cases of Tuberculosis have now been notified since 1909, when the disease was first made notifiable, and of that number 838 were still residing in Willesden at the end of 1915. 8 Maternity and Child Welfare. The progress of the war and the decrease of Medical Staff has made it impossible for the Council to inaugurate a scheme for the care of expectant mothers and infants at the present time. There is, however, no subject of such great importance to the district and to the country than this, and with the cessation of hostilities, or when the personnel is available, all possible measures should be adopted by the Council with the object of saving infant life. The methods and measures to be adopted have been fully set out in Appendix D, page 225, of my Annual Report for 1914 as amended by Appendix C of the present report. The Local Government Board are now paying grants up to 50 per cent. on approved schemes of Local Authorities. Medical Inspection and Treatment. There were 24,178 children attending the Willesden schools in the middle of the year 1915. 5,315 were submitted to routine medical inspection during the year, and 2,700 parents attended the examinations. 5,144 children were specially referred to the Medical Staff on account of 6,456 defects, 206 of which related to the mental condition of children. Of the remaining 6,250 defects the Medical Service of the Authority has been able to deal with 4,114 at the school clinics or at home under the supervision of the Health Visitors as directed by the Medical Staff. 821 defects received treatment at voluntary hospitals or charitable institutions, 31 received treatment from the Poor Law, and 653 from private practitioners. In all 89.9 per cent. of the defects brought to notice received attention. It is to be observed that 5,674 attendances were registered during 1915 at the school clinics for the treatment of eyes and ringworm, as against 2,517 during 1914. 9 Provision of Meals. This section of the work of the Education Authority was taken over by the Medical Officer during the year under review. Administrative methods have been altered and the dietaries have been revised, two-course dinners now being general at the Centres provided or supported by the Committee. Owing to the shortage of Medical and Nursing Staff, it has not been possible to keep records of the effect of feeding upon the children. The maximum number of children fed on an average in any one week, was 1,402 for the week ending February 13th, and the minimum number 410 for the week ending December 25th, 1915. During the whole of the year the number has continuously fallen. For the year ending 31st March, 1915, the cost per meal for food only was 1.497d. under the pre-war contracts obtaining for that year. In June, 1915, the cost per meal for food only had risen to 2.416d., and at the present time, February, 1916, it is 2.675d. Table No. 67 on page 97 gives the costs of school meals, and incidentally shows the large proportion of expenditure attributable to administrative charges. This at once raises the question of the advantages of a central kitchen, which is a matter which will require the considered attention of the Authority when the times are favourable to the movement. Isolation Hospital. 706 patients were admitted to the Isolation Hospital during the year, as compared with 979 in 1914. The diminution in the number is mainly due to the diminished prevalence of Scarlet Fever and Diphtheria during the year under review. While the number of cases, however, of Scarlet Fever and Diphtheria has been smaller, the type of each disease has been more severe, and in consequence the fatality rate has been higher than in the previous year. 10 In addition to the cases of ordinary infectious diseases treated at the Hospital, two additional diseases, namely, Tuberculosis and Cerebro-spinal Meningitis, have also been treated. 55 cases of Tuberculosis were admitted during the year, and 34 cases of Cerebro-spinal Meningitis. Of the 34 cases of Cerebro-spinal Meningitis, 20 proved to be this disease and 14 other diseases. Of the 20 cases of true Cerebro-spinal Meningitis 13 recovered. The setting apart of beds for these two additional diseases has severely taxed the isolation accommodation in the Hospital, and but for the diminished number of cases of other diseases it would not have been possible to have dealt with the demands for isolation of Cerebro-spinal Meningitis made by the Military Authorities and the civilian population. I am, Your obedient servant, GEORGE F. BUCHAN, Medical Officer. WILLESDEN URBAN DISTRICT COUNCIL. THE 40th ANNUAL REPORT FOR THE YEAR 1915 on the HEALTH AND SANITARY CONDITION of the URBAN DISTRICT OF WILLESDEN. GEORGE F. BUCHAN, m.d., d.p.h. Medical Officer. 12 A.—NATURAL & SOCIAL CONDITIONS OF THE DISTRICT. Estimated Midsummer Populations.—The following Table, No. 1, shows the population estimated by the method in vogue in Willesden, at Midsummer of each year since 1901, together with the estimated annual increase and the natural increase as indicated by the excess of births over deaths:— Table No. 1. Year. Estimated Midsummer population. Estimated annual increase of population. Natural increase of population i. e. 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 1910 153,253 3,108 2,417 1911 156,572 3,319 2,151 1912 159,868 3,296 2,472 1913 163,644 3,776 2,360 1914 166,634 2,990 2,363 1915 166,840 206 1,745 166,840, the number appearing opposite 1915 above, is the figure which has been used throughout this Report as the Midsummer population for the calculation of the 1915 rates. The following Table, No. 2, gives certain particulars as to the estimated population of 166,840 at Midsummer, 1915:— 13 TABLE NO. 2.—POPULATION ESTIMATED AT MIDSUMMER, 1915. WARD. Population estimated on the number of rooms in occupation in each Ward as ascertained by enumeration. Occupiable Houses, including houses recently erected but not yet occupied. Occupiable rooms, including those of houses recently erected. Houses recently erected but unoccupied. Houses in course of erection. Houses demolished. Percentage of empty houses exclusive of houses recently erected Percentage of empty rooms inclusive of those in houses recently erected. Total. Empty Houses. Wholly unoccupied. Partly empty. No. having one or more empty tenements. Empty tenements, exclusive of those houses wholly unoccupied. 1 room 2 rooms 3 rooms over 3 rooms Total. No. occupied. No. empty. (l) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) (17) Met. Drain Area. 1. South Kilburn 14578 1311 45 76 3 62 16 7 10349 9897 452 ... ... ... 3.43 4.36 2. Mid Kilburn 14601 1762 62 22 3 10 7 3 13635 13095 540 ... ... 3 3.51 3.96 3. North Kilburn 12467 2047 75 31 1 1 12 17 17068 16318 750 ... ... ... 3.66 4.39 4. Brondesbury Park 9921 1421 17 5 ... ... 1 4 11463 11299 164 4 ... ... 0.91 1.43 5. Kensal Rise 14206 1893 19 27 8 2 9 8 12504 12310 194 1 4 ... 0.95 1.55 6. Harlesden 17369 2589 31 20 ... 3 6 11 18158 17851 307 6 3 ... 0.96 1.69 Total Met. Drain. Area 83142 11023 249 181 15 78 51 50 83177 80770 2407 11 7 3 2.16 2.89 Brent Drain Area. 7. Stonebridge 17711 2090 39 12 ... ... 12 ... 13895 13613 282 5 ... ... 1.63 2.02 8. Roundwood 15662 2196 32 13 2 ... 9 2 15631 15355 276 ... ... ... 1.45 1.76 9. Church End 14194 1980 27 20 ... ... 12 8 12382 12152 230 ... ... ... 1.36 1.85 10. Willesden Green 16768 2474 40 39 1 1 18 20 16546 16139 407 6 4 ... 1.37 2.45 11. Cricklewood 19363 3759 127 19 1 1 5 12 29209 28185 1O24 11 10 ... 3.09 3.50 Total Brent Drain, area 83698 12499 265 103 4 2 56 42 87663 85444 2219 22 14 ... 1.94 2.53 Total 166840 23522 514 284 19 80 107 92 170840 166214 4626 33 21 3 2.04 2.70 14 B.—SANITARY CIRCUMSTANCES OF THE DISTRICT. Scavenging.—In the following Tables, Nos. 3-7, are given the chief data relating to House Refuse removal. Table No. 3. 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. (1) (2) (3) (4) (5) (6) (7) (8) 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 i1905-6 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 1910-11 28 17 20 50 34 123 0.55 1911-12 29 12 21 50 23 204 0.90 1912-13 28 18 20 51 36 99 0.43 1913-14 27 13 19 44 26 178 0.77 1914 24 8 18 41 16 255 1.09 1915 41 6 19 78 12 1611 6.86 15 Table No. 4. REMOVAL OF HOUSE REFUSE. TABLE OF QUANTITIES. Year. Annual quantity collected. †Standard Quantities in cubic yards No. of Occupied 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. (1) (2) (3) (4) (5) (6) (7) (8) Cubic yds. Cubic yd. 1900-1 79,875 25,905 84,100 16,820 115,201 4.7 .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 76,719 20,735 140,692 4.3 .63 1906-7 79,137 25,666 78,103 21,109 142,772 3.7 .55 1907-8 80,100 25.978 79,494 21,485 144,912 3.7 .55 1908-9 86,062 27,912 80,830 21,846 149,744 3.9 .57 1909-10 80,558 26,127 81,655 22,069 151,000 3.7 .53 1910-11 80,417 26,081 82,824 22,385 154,298 3.6 .52 1911-12 84,367 27,362 83,912 22,679 157,717 3.7 .53 1912-13 87,106 28,250 84,815 22,923 161,188 3.8 .54 1913-14 79,450 25,767 85,870 23,208 164,538 3.4 .48 1914 76,002 24,649 86,132 23,279* 166,634* 3.3 .45 1915 74.621 24,201 86.909 23,489* 166,840* 3.2 .45 †Standard quantities are calculated upon the respective mean quantities of refuse collected per house (5.0 cubic yards during the quinquennium 1900-4 and 3.7 cubic yards during the eleven years 1905-15). 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 periods. The quantity in the respective periods rises steadily and proportionately to the number of new houses added to the district. *Midsummer. 16 Table No. 5.—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 £. Sub-Districts. Total. 1 2 3 (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) £ £ £ d. s. d. d. d. 1900-1 2,095 1,600 3,127 £6,822 £8,235 20 5 8 1 14.2 3.13 1901-2 2,475 1,895 3,452 £7,822 £8,449 22.5 9 0¾ l6.0 3.45 1902-3 2,725 2,495 3,752 £8,972 £8,905 23.6 9 10½ I7.4 3.69 1903-4 3,100 2,950 3,895 £9,945 £9,386 23.9 10 4½ 18.3 3.83 1904-5 3,445 3,489 3,995 £10,929 £9,796 26.4 10 11 19.3 3.99 1905-6 2,500 2,150 2,800 £7,450 £5,978 20.1 7 2¼ 12.8 2.60 1906-7 *1,930 *2,156 *2,258 £6.250 £6,085 19.0 5 11 10.5 2.10 1907-8 *2,300 *2,450 *2,250 £6,850 £6,194 20.5 6 4½ 11.3 2 .20 1908-9 *1,955 *1,925 *2,055 £5,855 £6,298 16.3 5 4¼ 9.4 1.84 1909-10 1,715 1,939 1,950 £5,604 £6,363 16.7 5 0¾ 8.9 1.73 1910-11 ... ... ... £6,547 £6,454 19.5 5 10¼ .02 1.99 1911-12 ... ... ... £6,547 £6,538 18.6 5 9¼ 10.0 1.97 1912-13 ... ... ... £6,547 £6,609 18.0 5 8½ 9.7 1.93 1913-14 ... ... ... £6,163 £6,691 18.6 5 3¾ 9.0 1.77 1914 ... ... ... £6,436 £6,711 20.3 5 6¼ 9.3 1.85 1915 ... ... ... £6,433 £6,844 18.9 5 5¾ 9.2 1.85 *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 1900-4 and 18.9d. during the eleven years 1905-15). 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 periods. The standard cost in each of the respective periods rises steadily and proportionately to the number of new houses added each year to the district. 17 Table No. 6. Total actual No. of loads removed. Average No. per day. Average cost per van load. Average capacity of van. (1) (2) (3) (4) 9,861 32.0 s. d. cubic yards. 13 0½ 7.57 Table No. 7. Month. No. of working days. Total cubic yards removed. Average quantity per day (cubic yards). (1) (2) (3) (4) 1915- January 26 7,383 284 February 24 6,283 262 March 27 6,899 256 April 25 6,501 260 May 25 6,072 243 June 26 6,496 258 July 27 6,005 222 August 25 5,566 223 September 26 5,800 223 October 26 5,708 220 November 26 6,087 234 December 25 5,821 233 Sanitary Work.—The following Table, No. 8, indicates the nature and amount of work accomplished by the Sanitary Officers during the year, and is in the form desired by the County Medical Officer of Health:— Table No. 8.—Sanitary Work. Local Acts in force in Willesden: Willesden Local Board Act, 1876. Willesden Local Board Act, 1887. Willesden Sewerage Act, 1896. Willesden Electric Lighting Order, 1898. Willesden Urban District Council Act, 1903. 18 Adoptive Acts in force in Willesden: *Public Health Acts Amendment Act, 1890, Part 111. *Public Health Acts Amendment Act, 1907, Parts II., *111., *IV., and X. Baths and Washhouses Acts, 1846-99. Burial Acts, 1852-1900. Public Libraries Acts, 1892-1901. Bye-laws in force in District: *Common Lodging Houses (P.H.A. 1875, s. 80). *Houses Let in Lodgings (P.H.A. 1875, 5. 90). *Slaughter Houses (P.H.A., 1875, 5. 169 and T.I.C.A., 1847, s. 128). *Prevention of Nuisances (P.H.A., 1875, s. 44). New Streets and Buildings (P.H.A., 1875, 5. 157 and P.H.A.A.A., 1890, s, 23). Pleasure Grounds (P.H.A., 1875, 5. 164). *Drainage of Buildings (P.H.A.A.A. 1890, 5. 23). *Rag and Bone Dealer (P.H.A., 1875, 5. 113). Regulations made by Local Authority in force in District: *Dairies, Cowsheds and Milkshops (D.C.M.O., 1885, 5. 13). Small Holdings and Allotment Act, 1908. *Underground Rooms (Section 17 (7) of the Housing, Town Planning, etc., Act, 1909). *These are administered wholly or partly by the Health Committee. The unstarred are administered by other Committees of the Council. Staff employed in Sanitary Department: 1 Chief Inspector of Nuisances. 8 District Inspectors of Nuisances. 1 Chief Health Visitor. (Also engaged in Medical Inspection.) 9 District Health Visitors. (Also engaged in Medical Inspection.) 1 Health Visitor. (Medical Treatment.) 1 Health Visitor. (School Meals.) 11 Clerks. (Also engaged in Medical Inspection.) 19 2 Disinfectors. 2 Drain Testers and Labourers. Inspections: Number of premises inspected on complaint 682 Number of premises inspected in connection with infectious diseases 66 Number of premises under periodical inspection 898 Houses inspected from House to House (Housing, Town Planning-, &c., Act, 1909) 651 Total number of inspections and re-inspections made 15,596 Action Taken (other than under Housing, Town Planning, &c., Act, 1909): Cautionary or Intimation Notices Issued 1,234 Number complied with 939 Statutory Orders issued 72 Number complied with 56 Summonses served 16 Number of convictions 16 Summonses withdrawn 0 ,, dismissed 0 Dwelling Houses and action under Housing, Town Planning, &c., Act, 1909: Notices under Section 36 of the Housing, Town Planning, &c., Act, 1909, issued 647 Number of houses dealt with under Section 15 0 Number of houses found to be in a state dangerous or injurious to health (Section 17) 6* Number of representations made by M.O.H. (Section 17) 6* Number of houses made habitable without closing orders 0 * Underground sleeping rooms. 20 Number of closing orders made by L.A. (Section 17) * 6* Number of houses closed voluntarily 0 Number of closing orders determined after repairs (Section 17) 9f Number of houses demolished— (a) by order of L.A. (Section 17) 2f (b) voluntarily 0 Illegal underground rooms vacated 12 Houses Let in Lodgings (Tenement Houses): Number registered under Bye-laws 0 Number of contraventions 0 Common Lodging Houses : Number registered under Bye-laws 2 Number of inspections made 16 Number of contraventions 2 Canal Boats used as Dwellings : Number inspected under' the Acts 65 Number of contraventions of Regulations 9 Movable Dwellings, Caravans, Tents, &c. : Number observed during the year 6 Number of nuisances therefrom abated 0 Number removed from district 0 Bakehouses: Number in district 66 Contraventions of Factory Acts 34 Slaughter-houses : Number on register 9 Number of inspections made 524 Frequency of inspection weekly Contraventions of Bye-laws 0 *Underground sleeping rooms. †Closed during the year 1914. 21 Cowsheds: Number on register 7 Number of inspections made 62 Frequency of inspection quarterly Contraventions of regulations 3 Number of milch cows in district 88 Dairies and Milkshops: Number on register 136 Number of inspections made 307 Frequency of inspection twice yearly Contraventions of regulations 33 Unsound Food: Meat (including organs) seized and surrendered 265 lbs. Poultry and game seized and surrendered 0 Fish seized and surrendered 426 lbs. Fruit and vegetables seized and surrendered 0 Other articles seized and surrendered 0 Method of disposal Incinerated in boiler furnace at Dust Destructor Adulterated Food: Samples taken 0 Found adulterated 0 Offensive Trades: Number of premises in district 11 Number of inspections made 26 Contravention of Bye-laws 6 Water Supply and Water Service: Wells- New sunk 0 Cleansed, repaired, etc. 0 Closed as polluted 0 22 Percentage of houses supplied from public water service 100 Cisterns—New provided 20 Cleansed, repaired, covered, etc. 143 Draw-taps placed on mains 179 Percentage of houses supplied on constant system 100 Number of samples obtained for analysis from— (a) Local wells 0 (b) Public supply 0 Drainage and Sewerage of existing Buildings: Water closets— Number of water closets substituted for dry receptacles 0 Repaired, supplied with water or otherwise improved 320 Percentage of houses provided with water closets 100 Drains— Examined, tested, exposed, etc. 419 Unstopped, repaired, trapped, etc. 195 Waste pipes, rain-water pipes, disconnected, repaired, etc. 299 New soil pipes or ventilating shafts fixed 12G Existing soil pipes or ventilating shafts repaired 65 Disconnecting traps or chambers inserted 68 Re-constructed 57 Cesspools— Rendered impervious, emptied, cleansed, etc. 0 Abolished and drain connected to sewer 0 Percentage of houses draining into sewers 100 23 Disinfection: Rooms disinfected— (a) ordinary infectious diseases 711 (b) Phthisis 66 Rooms stripped and cleansed 57 Articles disinfected or destroyed— (a) ordinary infectious diseases 12,554 (b) Phthisis 844 Dust: New bins provided 187 Periodical frequency of dust removal weekly. Number of complaints of non-removal received 1,611 Method of disposal. By tipping. Sundry Nuisances abated: overcrowding 24 Smoke 14 Accumulations of refuse 37 Foul ditches, ponds, etc., and stagnant water 13 Foul pigs and other animals 59 Dampness 210 Yards and forecourts paved, repaved or repaired 431 Walls and ceilings cleansed 1,284 Leaky roofs made watertight 335 Additional ventilation provided under floors 113 Flooring and other woodwork repaired 57 Damp-proof courses inserted 24 Water supply reinstated 22 Washhouse floors repaved 43 Fireplaces and stoves repaired 16 Decayed brickwork repaired and repointed 103 Additional sinks provided 76 Additional light and ventilation to staircases 23 24 Larders or food cupboards provided 54 Gutters and rainwater pipes repaired 75 Smoke observations 40 Additional water closets constructed 60 Miscellaneous 103 Inspection of Premises where Food is prepared: Butchers' shops 56 Fish shops 41 Eating houses 27 Greengrocers' shops 20 Ice-cream premises 25 25 Inspection of Manholes.—The following Table, No. 9, shows the results of inspection of manholes during a period of eleven years—1905-15:— Table No. 9. Date. Total Inspections. Drains choked at Interceptor. Percentage. Stoppers of raking arm missing. Percentage. october, 1905 6,745 288 4.3 654 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 3.4 83 1.5 „ „ 1909 6,144 158 2.6 110 1.8 „ „ 1910 6,739 181 2.7 73 1.1 „ „ 1911 9,735 202 2.1 161 1.7 „ „ 1912 9,739 209 2.1 143 1.5 „ „ 1913 4,710 112 2.4 61 1.3 „ „ 1914 835 38 4.6 31 3.8 „ „ 1915 601 63 10.4 41 6.5 Total 57,849 1,813 3.13 1,697 2.93 Exemptions from Inhabited House Duty.—Table No. 1o shows the number of applications made for certificates of exemption from Inhabited House Duty under section 26 of the Customs and Inland Revenue Act, 189o. Table No. 1o. Customs and Inland Revenue Act, 189o, Section 26. No. of applications received 55 No. granted 25 No. refused 15 No. under consideration at the end of the year 15 26 Canal Boats Acts, 1877 and 1884.—The following Table, No. 11, shows the contraventions observed and remedied during the year under these Acts:— Table No. 11. Infringements of the Acts and Regulations with respect to Carried forward from 1914. Found during 1915. Remedied during 1915. Carried forward from 1915. (a) Registration ... ... ... ... (b) Notification of change of Master ... ... ... ... (c) Certificates 1 6 7 ... (d) Marking ... ... ... ... (e) overcrowding ... ... ... ... (f) Separation of sexes ... ... ... ... (g) Cleanliness ... ... ... ... (h) Ventilation ... ... ... ... (i) Painting ... ... ... ... (j) Provision of Water Cask ... ... ... ... (k) Removal of Bilge Water ... ... ... ... (1) Notification of Infectious Disease ... ... ... ... (m)Admittance of Inspector ... ... ... ... (n) Habitable Condition ... 3 1 2 Totals 1 9 8 2 Veterinary Inspection of Milch Cows and Sampling of Milk for Detection of Tubercle Bacilli.—The quarterly examinations of milch cows at the farms in the district for the detection of animals suffering from tuberculosis of the udder, have been continued by the Council's veterinary surgeon. 27 The following Table, No. 12, shows the results of the examinations of samples of milk taken. Table No. 12. No. of samples taken. No. found to contain Tubercle Bacilli. No. found to be free from Tubercle Bacilli. Samples of Milk taken by Veterinary Surgeon from cows in the district suspected to be suffering with tuberculosis of the udder 27 2 25 Samples of milk taken from milkshops supplied by Cowkeepers outside the district 28 ... 28 Samples of milk taken from milkshops supplied by Agencies distributing from a London Depot 3 ... 3 Samples of milk taken from milkshops supplied by Cowkeepers in the district ... ... ... Totals 58 2 56 The following Table, No. 13, gives the results of examinations of samples of milk for tubercle bacilli in each completed year since the methods of sampling and examination indicated above have been in operation in Willesden:— Table No. 13. Year. No. of Samples taken. No. found to contain Tubercle Bacilli. Percentage found to contain Tubercle Bacilli. 1910 40 5 12.5 1911 48 3 6.2 1912 86 5 5.8 1913 149 9 6.0 1914 74 5 6.8 1915 58 2 3.4 Food Inspection.—In no instance during the year was it necessary to seize compulsorily any article of diseased or unsound food. 28 The following is a list of the foodstuffs voluntarily surrendered and destroyed:— Approximate Weights. 1 box of haddocks 36 lbs. 1 box of codling 36 lbs. 2 boxes of dabs 86 lbs. 1 box of plaice 44 lbs. 1 box of skate 44 lbs. 2 boxes of whiting 84 lbs. 1 box of plaice 44 lbs. 1 box of whiting 4o lbs. Total 414 lbs. Slaughterhouses.—There are nine slaughterhouses in the district. These were regularly visited when slaughtering was in operation. In all, 524 visits of inspection were made during the year. The carcases, organs, and offal, were all subjected to close inspection for the detection of disease. The following were found to be diseased and were surrendered:— Carcases or organs. Approximate weight in lbs. Disease. 1 liver (Bovine) 11 Pyaemic Abscess. 1 liver (Bovine) 11 Pyaemic Abscess. 1 liver (Sheep) 7 Cysticercus Tenuicollis. 1 lung (Bovine) 8 Tuberculosis. 1 liver (Bovine) 14 Pyaemic Abscess. 1 liver (Bovine) 14 Pyaemic Abscess. Portion of liver (Bovine) 5 Cirrhosis. 29 Sale of Food and Drugs Acts.—The administration of these Acts is in the hands of the Middlesex County Council, and the following Table, No. 14, showing the work done in Willesden, has been kindly supplied by Mr. Robinson, Chief of the Weights and Measures Staff. Table No. 14. Samples taken during the year ended December 31st, 1915. Article. Formal. Informal. Taken. Adulterated. Taken. Adulterated. Butter 12 5 324 44 Milk 263 51 97 30 oxo Cubes 1 ... 1 ... Margarine 1 ... ... ... Prescriptions 1 ... 1 ... Coffee ... ... 7 ... Tapioca ... ... 10 ... Arrowroot ... ... 4 ... Pepper ... ... 8 ... Pearl Barley ... ... 9 ... Egg Powder ... ... 2 ... Custard Powder ... ... 2 ... Whiskey ... ... 1 ... Rum ... ... 1 ... Brandy ... ... 1 ... Total 278 56 468 75 Housing, Town Planning, &c., Act, 19o9.—The following Table, No. 15, shows the action taken in respect of the houses brought forward from 1914, as well as the houses corning under review during the present year: 3o Table No. 15. Brought forward from 1914. 1915. Premises. No. of houses inspected and requiring notices which were not served during year ending 26/12/14. No. of houses with intimation notices outstanding at 26/12/14. No. of houses with statutory notices outstanding at 26/12/14. No. of houses inspected during the year ending 26/12/15. No. of houses in which no notices were required. No. of houses on which intimation notices were served during year ending 25/12,15. No. of houses on which intimation notices were complied with during year ending 25/12/15. No. of houses with intimation notices outstanding at year ending 25/12/15. No. of houses on which statutory notices were served during year ending 25/12/15. No. of houses on which statutory notices were complied with during year ending 25/12/15. No. o»" houses with statutory notices outstanding at year ending 25/12/15. No. of houses inspected and requiring notices which were not served during year ending 25/12/15. Canterbury Yard ... 1 ... ... ... ... 1 ... ... ... ... ... Granville Road, 32, 50, 98-108 14 48 ... 8 1 7 23 32 ... ... ... ... Peel Road, 2-14, 1-3 St. Mark's Terrace ... ... ... 10 ... 10 3 7 ... ... ... ... Percy Road, 7-13, 18-66 ... ... ... 29 8 21 4 17 ... ... ... ... Carlton Vale, 185 & 187 ... ... ... 2 ... 2 ... 2 ... ... ... ... Pembroke Mews, 1-10 ... ... ... 10 5 5 5 ... ... ... ... ... Park Road Mews, 1-7 ... ... ... 7 4 3 3 ... ... ... ... ... Albert Road, 1-113 ... 8 4 56 ... 56 35 29 ... ... 4 ... Salusbury Road, 6-24 ... 18 ... 10 ... 10 20 8 ... ... ... ... Bridge Street, 1-6, 8-13, 15 & 16 ... ... ... 14 ... 4 11 3 ... ... ... ... Greyhound Road ... ... 1 ... ... ... ... ... ... 1 ... ... Harrow Road ... 4 ... ... ... ... 3 1 ... ... ... ... Napier Road, 2-54 ... 3 ... 27 2 25 28 ... ... ... ... ... Lincoln Mews ... 15 ... ... ... ... 15 ... ... ... ... ... St. Julian's Road, 1-9 ... ... ... 9 9 ... ... ... ... ... ... ... Grange Road —1-3, Ebenezer Cottages ... ... ... 7 7 ... ... ... ... ... ... ... 1 & 2, Willesden Cottages 1 & 2, Maynes Cottages Poplar's Avenue, 13-18 ... ... ... 6 ... 3 3 ... ... ... ... ... Glengall Road, 1-35 ... ... ... 35 19 15 10 5 ... ... ... ... Priory Park Road, 9 ... ... ... 1 1 ... ... ... ... ... ... ... 31 Table No. 15—(continued). Brought forward from 1914. 1915. Premises. No. of houses inspected and requiring notices which were not served during year ending 26/12/14. No. of houses with intimation notices outstanding at 26/12/14. No. of houses with statutory notices outstanding at 26/12/14. No. of houses inspected during the year ending 25/12/15. No. of houses in which no notices were required. No. of houses on which intimation notices were served during year ending 25/12/15. No. of houses on which intimation notices were complied with during year ending 25/12/15. No. of houses with intimation notices outstanding at year ending 25/12/15. No. of houses on which statutory notices were served during year ending 25/12/15. No. of houses on which statutory notices were complied with during year ending 25/12/15. No. of houses with statutory notices outstanding at year ending 25/12/15. No. of houses inspected and requiring notices which were not served during year ending 25/12/15. Disraeli Road ... 5 ... ... ... ... 3 2 ... ... ... ... Steele Road ... 18 16 ... ... ... 12 ... 6 20 2 ... Shakespeare Avenue, 1-123, 114-134 ... ... ... 74 1 73 33 40 ... ... ... ... Barrett's Green Road, 97-101 ... 37 ... 3 ... 3 22 3 15 12 3 ... St. Mary's Terrace, 1-10 ... ... ... 10 ... 10 1 9 ... ... ... ... Ivy Cottages, 1, 1a, 2 ... ... ... 3 ... 3 3 ... ... ... ... ... Meyrick Road ... ... 5 ... ... ... ... ... ... ... 5 ... Cobbold Road ... 6 6 ... ... ... 6 ... ... 6 ... ... Chaplin Road, 1-75, 2-28 ... ... ... 51 7 44 3 41 ... ... ... ... Villiers Road, 62-210 ... 4 ... 69 8 61 30 30 5 1 4 ... Hazel Road, 2-56, 1-61 ... ... ... 59 2 57 29 28 ... ... ... ... St. Margaret's Road, 1-49 ... ... ... 26 ... 22 8 14 ... ... ... ... Rucklidge Avenue, 100-156 ... 36 28 29 ... 29 38 10 17 30 15 ... Ranelagh Road, 2-3, 9-23, 25, 40-44, 46-52, 39 ... 3 ... 31 ... 31 28 4 2 2 ... ... Honeywood Road, 1-4, 6-10, 12-14 ... 1 ... 12 ... 12 8 4 1 1 ... ... Taylor's Cottages, 1&2 ... ... ... 2 ... 2 2 ... ... ... ... ... Charlton Road, 3-9, 15-63, 2-48 ... ... ... 53 ... 53 2 51 ... ... ... ... Manor Villas ... 1 ... ... ... ... 1 ... ... ... ... ... Totals 14 208 60 653 74 561 393 340 46 73 33 4 32 Houses Unfit for Human Habitation.—The following Table, No. 16, shows the number of dwelling houses inspected under Section 17 of the Housing, Town Planning, etc., Act, 1909, and represented as unfit for human habitation, and action taken thereunder. Table No. 16. Total number of houses inspected 651 Number considered to be unfit for human habitation 6* Number represented by Medical officer of Health 6* Closing orders made by Local Authority 6* Appeals against Closing orders 0 Notices served on occupying tenants 23 occupying tenants summoned 3 orders made by Court requiring tenants to quit 3 Number of tenants ejected by order of Court 1 Closing orders determined 9† Demolition orders made 26 Appeals against Demolition orders o Demolition orders obeyed 2† Number of demolitions carried out without orders being made 0 *Underground sleeping rooms. †Closed during 1914. The following Table, No. 17, gives detailed information as to the action taken during the year in respect of houses represented as unfit for human habitation. 33 Table No. 17.—SECTIoN 17 (1) oF HoUSING, ToWN PLANNING, &c., ACT, 19o9. Dwelling Houses represented as Unfit for Human Habitation. Situation of Dwelling Houses. No. of Houses. Date of representation of M.o.H. Date of consideration of closing. Date of making closing orders. Date of service of closing orders. Date of operation of closing orders. Date of notice to occupying tenants. Date of determination of closing orders. Date of consideration of demolition. Date of making demolition orders. Date of service of demolition orders. Date of operation of demolition orders. Demolition orders obeyed. Demolition orders enforced. Canterbury Yard, 3-7 5 18/5/15 Rucklidge Avenue, 9-13 3 23/11/15 16/3/15 23/3/15 1/4/15 22/4/15 "Cottage," Willesden Paddocks 1 16/3/15 23/3/15 1/4/15 22/4/15 Harrow Road, 772 1 27/5/15 16/3/15 Harrow Road, 876, 880 2 11/1/15 25/1/15 28/1/15 18/5/15 27/5/15 1o/6/15 1/7/15 31/12/15 Wellington Road, 2 & 3 2 12/1/15 18/5/15 Harrow Road, 856 1 11/1/15 (Underground sleeping rooms) Avenue Close, 1-14 18 & 19 16 11/1/15 25/1/15 1/2/15 18/5/15 27/5/15 10/6/15 1/7/15 34 Table No. 17.—SECTIoN 17 (1) oF HoUSING, ToWN PLANNING, &c., ACT, 19o9.—Continued. Dwelling Houses represented as Unfit for Human Habitation. Situation of Dwelling Houses. No. of Houses. Date of representation of M.o.H. Date of consideration of closing. Date of making closing orders. Date of service of closing orders. Date of operation of closing orders. Date of notice to occupying tenants. Date of determination of closing orders. Date of consideration of demolition. Date of making demolition orders. Date of service of demolition orders. Date of operation of demolition orders. Demolition orders * obeyed. Demolition orders enforced. Avenue Close, 15-17 3 12/2/15 26/2/15 17/2/15 18/5/15 27/5/15 1o/6/15 1/7/15 Avenue Close, 20 & 21 2 11/3/15 25/3/15 7/9/15 Avenue Close, 23 & 24 2 12/4/15 26/4/15 7/9/15 Avenue Close, 25 1 11/1/15 25/1/15 1/2/15 22/6/15 18/5/15 27/5/15 1o/6/15 1/7/15 Avenue Close, 22-26 2 11/1/15 25/1/15 7/9/15 Lydia Terrace, Regent Street, 1 -4 4 11/1/15 25/1/15 17/2/15 27/5/15 Peel Road, 2-12 6 6/7/15 27/7/15 30/7/15 13/8/15 (Underground sleeping rooms) 35 Table No. 18. FACTORIES, WoRKSHOPS, LAUNDRIES, WoRKPLACES AND HOMEWORK. INSPECTION—Including Inspections made by Sanitary Inspectors or Inspectors of Nuisances. Premises. Number of Primary Inspections. Written Notices. Prosecutions. (1) (2) (3) (4) Factories (including Factory laundries) 155 19 ... Workshops (including Workshop laundries) 208 51 ... Workplaces (other than outworkers' premises included in Part 3 of this Report) 62 18 ... Total 425 88 ... Table No. 19. DEFECTS FoUND. Particulars. Number of Defects. Number of Prosecutions. Found. Remedied. Referred toH.M. Inspector (1) (2) (3) (4) (5) Nuisances under the Public Health Acts:— Want of Cleanliness 38 32 ... ... Want of Ventilation ... ... ... ... overcrowding 2 1 ... ... Want of drainage of floors 3 3 ... ... other Nuisances 81 50 ... ... Sanitary accommodation— Insufficient 4 3 ... ... Unsuitable or defective 24 16 ... ... Not separate for Sexes 2 1 ... ... 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) 30 24 ... ... other offences 11 5 ... ... (Excluding offences relating to out-work which are included in Part 3 of this Report). Total 195 135 ... ... 36 Table No. 2o. HoME WoRK. Nature of Work. outworkers Lists, Section 107. Notices served on occupiers as to keeping or sending lists. Prosecutions. outwork in Unwholesome Premises. Section 1o8. outwork in Infected Premises, Sections 1o9, 11o. Lists received from Employers. Sending twice in the Year. Sending once in the Year. Failing to keep or permit inspection of lists. Failing to send lists. Instances. Notices served. Prosecutions. Instances. orders made, S. 11o. Prosecutions, Section 1o9, 11o. Lists. outworkers. Lists. outworkers. Contractors. Workmen. tractors. men. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) Wearing Apparel— Making, &c. 17 28 30 8 13 1o 6o ... ... 9 9 ... ... ... ... Cleaning and Washing 1 2 ... 1 6 1 6 ... ... ... ... ... ... ... ... Household linen ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Lace, lace curtains, and nets 1 ... 2 1 ... ... 2 ... ... ... ... ... ... ... ... Furniture and upholstery 1 1 ... 1 ... 2 4 ... ... ... ... ... ... ... ... Umbrellas, &c. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Total 20 31 32 11 13 13 72 ... ... 9 9 ... ... ... ... 37 Table No. 21. REGISTERED WORKSHoPS. Workshops on the Register (s. 131) at the end of the year. Number. (1) (2). Factories 90 Factories, Laundries 46 Workshops, Laundries 38 Domestic Laundries 10 Bakehouses 58 Dressmakers 43 outworkers 215 Blouse Makers 10 Tailors 71 Bootmakers 49 Metal Workers 7 Wood Workers 5 Seamstresses 4 Motor and Cycle Makers 10 Upholsterers 5 Milliners 2 Miscellaneous 9 Total number of Workshops on Register 672 Table No. 22. oTHER MATTERS. Class. Number (1) (2) Matters notified to H.M. Inspector of Factories:— Failure to affix Abstract of the Factory and Workshop Act (s. 133) ... 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 3 Reports (of action taken) sent to H.M. Inspector ... other 1 Underground Bakehouses (s. 10l):— Certificates granted during the year ... In use at the end of the year 15 C.-PREVALENCE oF, AND CoNTRoL oVER, ACUTE INFECTIoUS DISEASES. Notifications.—The following Table, No. 23, shows the number of notifications of infectious diseases in Willesden each year since 1892:— 38 Table No. 23. Year. Small Pox. Cholera. Plague. Diphtheria (including Membranous Croup). Erysipelas. Scarlet Fever. Typhus Fever. Enteric Fever. Relapsing Fever. Continued Fever. Puerperal Fever. *Cerebral Spinal Meningitis. †Poliomyelitis. ** ophthalmia Neonatorum. ‡Pulmonary Tuberculosis. other forms of §Tuberculosis. Totals. Rate per 1,ooo of population. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) (17) (18) (19) 1892 5 1 ... 145 85 366 ... 28 ... ... 4 ... ... ... ... ... 634 9.4 1893 23 1 ... 229 139 589 1 47 ... ... 6 ... ... ... ... ... l035 15.0 1894 21 1 ... 129 63 268 ... 70 ... 2 4 ... ... ... ... ... 558 7.5 1895 5 ... ... 186 81 392 ... 69 ... ... 8 ... ... ... ... ... 741 9.3 1896 2 1 ... 173 101 475 ... 52 ... 1 10 ... ... ... ... ... 815 9.5 1897 ... 2 ... 275 107 510 ... 52 ... 1 9 ... ... ... ... ... 956 10.3 1898 1 ... ... 335 70 361 ... 66 ... ... 2 ... ... ... ... ... 835 8.4 1899 ... 1 ... 319 82 414 ... 79 ... ... 6 ... ... ... ... ... 901 8.3 1900 ... ... ... 226 89 335 ... 77 ... ... 8 ... ... ... ... ... 735 6.4 1901 10 ... 1 404 79 553 ... 57 ... ... 2 ... ... ... ... ... 1106 9.5 1902 88 ... ... 440 104 466 ... 73 ... ... 8 ... ... ... ... ... 1179 9.6 1903 7 ... ... 221 76 502 ... 45 ... ... 11 ... ... ... ... ... 862 6.7 1904 12 ... ... 353 73 326 ... 38 ... ... 5 ... ... ... ... ... 807 5.9 1905 ... ... ... 275 86 397 ... 41 ... ... 13 ... ... ... ... ... 812 5.8 1906 ... ... ... 286 103 637 ... 46 ... 1 9 ... ... ... ... ... 1082 7.6 1907 ... ... ... 254 77 641 ... 28 ... ... 13 3 ... ... ... ... 1016 7.0 1908 ... ... ... 215 78 737 ... 41 ... ... 7 3 ... ... ... ... 1081 7.3 1909 ... ... ... 207 94 638 ... 41 ... ... 8 ... ... ... 107 ... 1095 7.3 1910 ... ... ... 166 72 314 ... 23 ... ... 12 ... ... ... 61 ... 648 4.2 1911 ... ... ... 192 114 326 ... 13 ... ... 16 ... ... ... 230 ... 891 5.7 1912 1 ... ... 222 109 430 ... 13 ... ... 10 ... 4 ... 487 ... 1276 8.0 1913 ... ... ... 233 93 504 ... 18 ... ... 11 3 3 ... 368 146 1379 8.4 1914 ... ... ... 303 121 765 ... 13 ... ... 12 6 29 326 90 1665 10.0 1915 ... ... 231 81 453 ... 9 ... ... 4 29 3 27 335 83 1255 7.5 *Notifiable 5th August, 1907, to 4th August, 1908. Notifiable permanently 29th March, 1912. †Notifiable permanently from 1st March, 1912. ‡Poor Law Cases of this disease became notifiable on 1st January, 19o9. Hospital Cases became notifiable on 1st May, 1911, and all cases became notifiable on 1st January, 1912. §Became notifiable 1st February, 1913. ** Became notifiable 1st April, 1914. 39 Scarlet Fever.—The following Table, No. 24, shows the number of cases notified, the number and percentage removed to Hospital, and the Incidence and Fatality rates each year since 1892:— Table No. 24. Year. No. of Cases notified. No. of Cases removed to Hospital. Percentage of Cases removed to Hospital. Incidence Kate. Cases per 1,ooo population. Fatality Rate. Deaths per 1,ooo cases. 1892 366 49 13.3 5.5 22 1893 589 107 18.1 8.5 25 1894 268 83 30.9 3.6 26 1895 392 243 61.9 4.9 43 1896 475 282 59.3 5.5 35 1897 510 320 627 5.4 21 1898 361 209 57.8 3.6 28 1899 414 220 53.1 3.9 38 1900 335 188 56.1 2.9 35 1901 553 265 47.9 4.9 21 1902 466 282 60.5 3.8 27 1903 502 393 78.2 3.8 22 1904 326 242 74.2 2.4 6 1905 397 328 82.6 2.8 13 1906 637 543 85.2 4.5 17 1907 641 547 853 4.4 30 1908 737 651 88.3 5.0 19 1909 638 556 87.1 4.4 25 1910 314 265 84.3 2.0 0 1911 326 226 69.3 2.1 15 1912 430 373 86.7 2.7 2 1913 504 446 88.5 3.1 14 1914 765 682 89.1 4.6 7 1915 453 406 89.6 2.7 33 Return Cases of Scarlet Fever.—A "return case" of Scarlet Fever is defined for purposes of this report as a case which occurs in the same household after a case of Scarlet Fever has been set free from isolation at hospital or at home as the case may be. The latter case is called the "infecting case." The following Table, No. 25, gives certain particulars with regard to the occurrence of "return cases" since 1905. 4o Table No. 25. Year. Notifications of Scarlet Fever. Infecting Cases. 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. No. of Infecting Cases giving rise to 5 Return Cases. No. of Infecting Cases giving rise to 6 Return Cases. No. of Infecting Cases giving rise to 7 Return Cases. No. of additional cases occurring in houses secondary to Return Cases not necessarily themselves Return Cases. No. of Notifications. Incidence rate per 1,ooo of Population. No. of Infecting Cases. Percentage of Cases notified. No. of Return Cases. Percentage of Cases notified. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) 1905 397 2.8 14 3.5 18 4.5 12 1 ... 1 ... ... ... * 1906 635 4.5 23 3.6 26 4.1 20 3 ... ... ... ... ... * 1907 641 4.4 27 4.2 28 4.4 26 1 ... ... ... ... ... * 1908 737 5.0 51 6.9 70 9.5 37 11 1 2 ... ... ... * 1909 638 4.4 56 8.7 66 10.3 48 7 ... 1 ... ... ... 12 1910 3.4 2.0 15 4.7 21 6.7 10 4 1 ... ... ... ... ... 1911 326 2.1 11 3.4 15 4.6 9 ... 2 ... ... ... ... 3 1912 430 2.6 12 2.7 16 3.7 9 2 1 ... ... ... ... ... 1913 504 3.1 18 3.6 26 5.2 15 2 ... ... ... ... 1 ... 1914 765 4.6 34 5.0 42 5.5 29 4 ... ... 1 ... ... ... 1915 453 2.7 12 2.7 13 2.9 11 1 ... ... ... ... ... ... T0tals 5840 3.5 273 4.7 341 5.8 226 36 5 4 1 ... 1 15 *Rec0rds inc0mplete. 41 The following Table, No. 26, shows the number of days during which the 12 infecting cases shown in Table No. 25 were isolated in hospital or at home, and the number of days elapsing after release from isolation before the 13 "return cases" appearing in Table No. 25 occurred. Table No. 26. Initials of Infecting Cases. No. of days isolated. Initials of Return Cases. No. of days elapsing between release from isolation of infecting case and onset of illness of return case. 1 L.D. 44 L.D. 11 44 F.D. 13 2 *L.G. 47 M.G. 16 3 G.B. 33 N.B. 22 4 A.C. 54 F.C.. 6 5 A.W. 28 H.R.W. 93 6 H.C. 44 H.C. 8 7 J.G. 75 G.G. 35 8 A.B. 62 V.B. 29 9 D.H. 44 E.H. 18 1o D.P. 87 A. P. 36 11 G.M. 68 H.W. 4 12 B.G. 7o J.G. 8 *Treated in M.A.B. Hospital. Multiple Cases of Scarlet Fever.—The following Table, No. 27, shows the number of Scarlet Fever cases notified from each house in which Scarlet Fever occurred in the year 1915:— Table No. 27. 1915. No. of Houses. Per cent. of Houses. No. of Cases. Per cent. of Cases. Houses in which:— 1 case occurred 275 78.8 275 60.7 2 cases occurred 58 16.6 116 25.6 3 „ 9 2.6 27 6.0 4 „ 4 1.1 16 3.5 5 „ 1 .3 5 1.1 6 „ 1 .3 6 1.3 7 „ 0 ... 0 ... 8 „ 1 .3 8 1.8 Totals 349 100.0 453 100.0 42 Diphtheria and Membranous Croup.—The following Table, No. 28, shows the number of cases notified, the number and percentage removed to hospital, and the incidence and fatality rates each year since 1892. Table No. 28. Year. No. of Cases notified. No. of Cases removed to Hospital. Percentage of Cases removed to Hospital. Incidence Rate. Cases per 1,ooo population. Fatality Rate. Deaths per 1,000 cases. 1892 145 14 9.6 2.1 127 1893 229 0 0.0 3.1 199 1894 129 8 6.2 1.7 126 1895 186 66 35.4 2.2 190 1896 173 51 29.4 2.1 169 1897 275 132 48.0 2.9 250 1898 335 217 64.7 3.3 204 1899 319 183 57.3 2.9 148 1900 226 I20 53.1 1.9 124 1901 404 190 47.0 3.4 138 1902 440 222 50.4 3.5 122 1903 221 122 55.2 1.6 46 1904 353 290 82.1 2.6 54 1905 275 227 82.5 1.9 51 1906 286 222 77.6 2.0 57 1907 254 186 73.2 1.7 71 1908 215 175 81.3 1.4 65 1909 207 171 82.6 1.4 48 1910 166 142 85.5 1.l 66 1911 192 130 67.7 1.2 57 1912 222 191 86.0 1.4 45 1913 233 215 92.3 1.4 34 1914 303 258 85.2 1.8 79 1915 231 213 92.2 1.4 130 43 Small Pox.—The following Table, No. 29, shows the number of cases notified and the number and percentage removed to hospital each year since 1892:— Table No. 29. Year. No. of Cases notified. No. of Cases removed to Hospital. Percentage removed to Hospital. 1892 5 3 60.0 1893 23 21 91.3 1894 21 21 100.0 1895 5 5 100.0 1896 2 2 100.0 1897 ... ... ... 1898 1 ... 00.0 1899 ... ... ... 1900 ... ... ... 1901 10 7 70.0 1902 88 88 100.0 1903 7 7 100.0 1904 12 12 100.0 1905 ... ... ... 1906 ... ... ... 1907 ... ... ... 1908 ... ... ... 1909 ... ... ... 1910 ... ... ... 1911 ... ... ... 1912 1 1 100.0 1913 ... ... ... 1914 ... ... ... 1915 ... ... ... 44 Enteric Fever.—The following Table, No. 3o, shows the number of cases notified, the number and percentage removed to hospital, and the incidence and fatality rates each year since 1892:— Table No. 3o. Year. No. of Cases notified. No. of Cases removed to Hospital. Percentage of Cases removed to Hospital. Incidence Rate. Cases per 1,000 population. Fatality Rate. Deaths per 1,000 notifications. 1892 28 3 107 0.42 214 1893 47 ... ... 0.66 191 1894 70 4 57 0.96 157 1895 69 13 18.8 0.87 174 1896 52 5 9.6 0.66 211 1897 52 16 30.7 0.56 230 1898 66 38 57.5 0.66 136 1899 79 32 40.5 0.73 128 1900 77 32 41.5 0.68 181 1901 57 7 122 0.49 175 1902 73 14 19.1 0.60 205 1903 45 16 35.5 0.34 290 1904 38 12 31.5 0.27 211 1905 41 26 63.4 0.29 293 1906 46 33 717 0.32 152 1907 28 14 50.0 0.19 143 1908 41 27 65.8 0.27 195 1909 41 34 82.9 0.27 146 1910 23 16 69.5 0.15 87 1911 13 9 69.2 0.08 308 1912 13 6 46.1 0.08 231 1913 18 10 55.6 0.10 222 1914 13 12 923 0.07 231 1915 9 9 100.0 0.05 556 of the nine cases treated in hospital, four were treated in the Infirmary. There were five deaths from Enteric. Two occurred in the Middlesex County Asylum, and were not notified in this district. These are not included in number of cases notified, although they are reckoned for purpose of the last column in foregoing table. 45 Cerebro-spinal Meningitis.—Thirty-three cases of Cerebro-spinal Meningitis were notified during the year. Four occurred in the military population and 29 in the civil population. of the four military cases three were admitted to the Willesden Isolation Hospital and one was treated at home. of the three admitted to the Willesden Isolation Hospital, two recovered and one died. The case treated at home recovered. of the 29 civil cases, 16 were admitted to the Willesden Isolation Hospital, nine were admitted to other hospitals, and four were treated at home. of the 16 cases admitted to the Willesden Isolation Hospital, seven recovered and nine died. of the nine deaths, five were due to Cerebro-spinal Meningitis, one was due to Puerperal Septicaemia, one to Toxic Scarlet Fever, one to Tubercular Meningitis, and one to Non-tubercular Basic Meningitis. of the nine cases admitted to other hospitals, two recovered and seven died. of the four cases treated at home one recovered and three died, these three deaths occurring before the cases were notified. In only one instance did a second case occur in a family, the period elapsing between the date of removal to hospital of the first case which proved fatal and the date of onset of the second case being 51 days. Contacts.—In 16 of the 33 notified cases no bacteriological examination of contacts was made. In two of the remaining 17 cases no information is available, as all enquiries were made by the military authorities. In 15 of the remaining 17 cases bacteriological examinations of contacts were made, 66 contacts being swabbed. 46 In five instances the swabs were positive. Four of these positive contacts were admitted to the Willesden Isolation Hospital, and one was isolated at home under treatment until two negative bacteriological results had been obtained. ophthalmia Neonatorum.—Twenty-seven cases of this disease were notified during 1915. of these, 2o were cured, one died, and one was still under observation at the end of the year. In the case of the other five the result is not known. Seven of the cases attended the Eye Clinic, and of these five were cured, one was admitted to the Willesden Infirmary, and one was still under observation at the end of the year. Vaccination Statistics.—The following Table, No. 31, gives statistics of the Vaccination Returns in this district since 1898 :— Table No. 31. Years No. of Births on Register of Vaccination officer. Successfully Vaccinated. Insusceptible. Dead. Conscientious objectors. Postponed by Doctor. Gone Away. Unvaccinated. Percentage of Survivors unprotected by Vaccination. Conscientious objec2 tors per 100 Children Vaccinated. Cases of Small-pox 1 Notified. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) 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 2,3.4 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 6l 319 915 47 24.6 0 1910 3,810 1,742 8 206 607 24 277 946 52 34.8 0 1911 3.865 1,592 16 254 748 46 261 948 56 47.0 0 1912 3.955 1.804 10 227 1,020 53 247 594 52 56.0 1 1913 3,920 1,659 0 202 1,108 63 265 623 55 66.8 0 1914 3,974 1,745 16 241 1,092 118 260 502 53 62.6 0 1915 3,587 1,516 6 190 846 160 166 703 55 55.8 0 47 Measles.—The following Table, No. 32, shows in each year since 1907 the number of cases coming under the notice of the Health Department, and the number of deaths occurring among these cases; the number of deaths occurring among unknown cases, and the probable number of these cases assuming the fatality rate to have been the same in each class:— Table No. 32. Year. Total No. of Cases known before death. Cases unknown prior to death. Percentage of all probable Cases coming to knowledge. Total. Cases. Deaths. Fatality Rate per cent. Deaths. Estimated No. of Cases. 1907 1,442 25 1.75 20 1,153 55 2,595 1908 1,678 26 1.55 29 1,871 47 3,549 1909 1,445 17 1.17 24 2,040 41 3,485 1910 1,757 13 0.74 17 2,297 43 4,054 1911 1,845 26 1.40 25 1,774 51 3,619 1912 1,665 17 1.02 18 1,763 48 3,428 1913 1,656 21 1.26 48 3,785 30 5,441 1914 539 0 0.00 8 *664 *45 1,203 1915 1,947 20 1.03 54 5,257 27 7,204 Totals 13,974 165 1.18 243 20,604 40 34,578 *These figures are based on the average for the years 1907-1914. 48 D. PREVALENCE OF, AND CONTROL OVER, TUBERCULOSIS. Tuberculosis Notifications.—The total number of notifications received for the 53 weeks ending 1st January, 1916, was 798. During the year the actual number of persons notified as suffering from Tuberculosis was 125, the percentage of multiple notifications being 16.7. The following Table, No. 33, shows the number of notifications and the number of new cases each year since 19o9 : Table No. 33. Year. No. of notifications received. No. of new cases to which notifications refer. Pulmonary. other forms. Pulmonary. other forms. Total. *1909 (calendar year) 196 ... 107 ... 107 1910 („ „) 140 ... 61 ... 61 **1911 („ „) 241 ... 230 ... 230 †1912 (52 weeks) 851 ... 487 ... 487 ‡1913 („ „) 693 181 368 146 514 1914 ( „ ,, ) 613 122 326 90 416 1915 (53 „ ) 700 98 344 81 425 Total 3434 401 1923 317 2240 *Poor Law Cases of Pulmonary Tuberculosis notifiable from Ist january, 1909 **Hospital ,, ,, ,, ,, ,. ,, 1st May, 1911 †A11 ,, ,, ,, ,, ,, ,, 1st January, 1912 ‡All Cases of all forms of „ ,, ,, 1st February, 1913 838 of the 2,240 cases of Tuberculosis notified in Willesden since 19o9 were living in the area at the end of the year. The 344 new cases of Pulmonary Tuberculosis notified in 1915 include 15 in which the lung disease was associated with disease in other organs: glands 4, larynx 5, spine 3, intestines 1, peritoneum 1, abdomen and neck 1. 49 E. INVESTIGATION OF OTHER DISEASES. Death Rates from Certain Infectious Diseases.— The following Table, No. 34, shows the death rates per 100,000 of the population from scarlet fever, diphtheria, Enteric Fever, Measles and Wihooping Cough since 1875:— Table No. 34. Year. Scarlet Fever. Diphtheria. Enteric Fever. Measles. Whooping Cough. (1) (2) (3) (4) (5) (6) 1875 66 33 71 0 38 1876 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 24 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 65 52 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 1910 0 7 1 20 17 1911 3 7 3 33 54 1912 1 6 2 22 18 1913 4 5 2 42 14 1914 3 14 2 5 20 1915 9 18 3 44 33 *Infectious Diseases Notification compulsory in Willesden from this year. 50 Deaths from Tuberculosis.—The following Table, No. 35, shows the total number of deaths from Tuberculosis (all forms), and from Tuberculosis of the lungs, together with the death rates per 1,000 in Willesden as compared with England and Wales generally:— Table No. 35. Year. Tuberculosis (All Forms). Tuberculosis of the Lungs. Willesden. Total number of Deaths. Willesden. Death Rate per 1,000 of the population. England and Wales. Death Rate per 1,000 of the population. Willesden. Total number of Deaths. Willesden. Death Rate per 1,000 of the population. England and Wales. Death Rate per 1,000 of the population. 1875 53 2.92 2.99 37 2.03 2.20 1876 50 2.71 2.85 24 1.30 2.11 1877 56 2.87 2.84 32 1.64 2.07 1878 61 2.95 2.82 40 1.94 2.11 1879 57 2.54 2.76 35 1.56 2.02 1880 82 3.25 2.70 36 1.42 1.86 1881 † † 2.53 44 1.6o 1.82 1882 56 1.72 2.58 27 .83 1.85 1883 84 2.40 2.59 56 1.60 1.88 1884 61 1.68 2.57 35 .96 1.82 1885 77 1.99 2.43 55 1.42 1.77 1886 78 1.76 2.47 35 .79 1.73 1887 83 1.69 2.28 47 .95 1.61 1888 82 1.54 2.22 47 .87 1.56 1889 82 1.43 2.26 55 .96 1.57 1890 109 1.77 2.37 73 1.18 1.68 1891 100 1.60 2.30 67 1.07 1.59 1892 83 1.26 2.13 65 .98 1.46 1893 † † 2.14 73 1.05 1.46 1894 † † 1.97 72 .98 1.38 1895 † † 2.06 96 1.08 1.39 1896 † † 1.89 88 1.02 1.30 1897 † † 1.92 86 .92 1.33 1898 † † 1.91 100 1.00 1.31 1899 † † 1.90 135 1.25 1.33 1900 133 1.15 1.90 103 .89 1.33 1901 143 1.23 1.80 96 .81 1.26 1902 160 1.30 1.74 111 .91 1.23 1903 165 1.27 1.74 113 .87 1.20 1904 188 1.39 1.77 141 1.04 1.23 1905 194 1.37 1.63 146 1.04 1.14 1906 188 1.32 1.64 139 .98 1.15 1907 188 1.30 1.60 138 .961 1.14 1908 153 1.02 1.58 120 .81 1.11 1909 196 1.30 1.53 131 .87 1.09 1910 174 1.13 1.43 116 .76 1.01 1911 179 1.14 1.46 132 .84 1.08 1912 188 1.17 1.37 148 .93 1.04 1913 165 1.00 1.34 136 .83 1.00 1914 198 1.18 ... 147 .88 ... 1915 210 1.26 ... 168 1.01 ... †No record. 51 The following Table, No. 36, shows the age distribution of deaths from Tuberculosis in Willesden since 1877:— Table No. 36. Year. 0 to 1. 1 to 5. 5 to 15. 15 to 25. 25 to 65. 65 and upwards. Total. 1877 13 11 2 3 25 2 56 1878 10 12 1 4 31 3 61 1879 13 11 1 6 26 0 57 1880 24 16 5 6 30 1 82 *1881 ... ... ... ... ... ... ... 1882 13 14 3 8 17 1 56 1883 18 10 3 13 40 0 84 1884 16 12 5 7 21 0 61 1885 15 10 6 10 35 1 77 1886 27 20 3 2 25 1 78 1887 23 17 6 3 32 2 83 1888 19 14 5 5 37 2 82 1889 21 6 6 4 45 0 82 1890 20 18 2 ii 56 2 109 1891 21 8 14 12 44 1 100 1892 11 9 7 11 42 3 83 *1893-99 ... ... ... ... ... ... ... 1900 13 14 11 24 70 1 133 1901 20 24 15 i i 67 6 143 1902 19 22 14 20 81 4 160 1903 17 22 10 24 88 4 165 1904 19 20 16 16 111 6 188 1905 10 20 16 24 117 7 194 1906 22 19 13 35 97 2 188 1907 22 20 13 28 98 7 188 1908 11 14 11 21 87 9 153 1909 16 30 16 24 106 4 196 1910 17 25 14 20 91 7 174 1911 14 25 11 21 107 1 179 1912 8 13 12 32 113 10 188 1913 6 14 10 20 104 11 165 1914 7 29 12 21 126 3 198 1915 6 23 20 29 123 9 210 *Records incomplete. F. MEANS FOR PREVENTING MORTALITY IN CHILDBIRTH AND INFANCY. Maternity and Child Welfare.—This matter continued to receive the attention of the Council during the year 1915. 52 On the 31st May, 1915, Circular 906 was issued by the Local Government Board and Board of Education, relative to grants in aid of Maternity Centres and Schools for Mothers. On the 29th July, 1915, the Notification of Births (Extension) Act, 1915, was passed, and on the same date a Circular relative to the Act, was issued by the Local Government Board. On the 30th July, 1915, the Regulations under which grants are paid by the Local Government Board to Maternity Centres during the year ending 31st March, 1916, were issued. The Council fully recognise the need for adopting measures for the reduction of infant mortality and the care of expectant mothers and young children, and on 27th July, 1915, resolved to appoint one additional Assistant Medical Officer and four additional Health Visitors, and to establish two Maternity and Child Welfare Centres, at a capital cost of £100 and at an annual cost of £1,348, as shown in Appendix C of this report. Half of this expenditure would be borne by the grant payable by the Local Government Board. The difficulty, however, of finding the personnel to carry on this work during the war made it necessary for the Council to postpone its commencement at present. When the war is over, or as soon as the circumstances are favourable, it will be necessary for the Council to attack the problem of the care of expectant mothers and young children vigorously, as there is no work which the Council has to do which is of greater importance to the inhabitants and to the State. 53 Infant Mortality.—The following Table, No. 37, shows the number of deaths of infants under one year of age from all causes, and from Diarrhoea and Enteritis respectively together with the infant mortality rates per 1,000 births from 1875:— Table No. 37. Year. No. of deaths of Infants under 1 year of age from all causes. No. of Deaths of Infants under 1 year of age from Diarrhoea and Enteritis. Infant Mortality. Rate per 1,000 births. 1875 131 27 162 1876 120 * 149 1877 113 7 140 1878 167 19 201 1879 118 9 130 1880 168 24 173 1881 # * * 1882 202 27 186 1883 196 24 167 1884 203 36 164 1885 235 28 172 1886 265 28 164 1887 264 40 159 1888 290 32 170 1889 276 36 143 1890 287 34 158 1891 273 25 132 1892 333 30 159 1893 345 35 153 1894 299 * 132 1895 373 * 150 1896 460 * 167 1897 444 * 155 1898 427 * 136 1899 537 * 159 1900 497 124 139 1901 495 110 131 1902 436 100 130 1903 509 81 123 1904 509 135 115 1905 490 100 117 1906 493 133 115 1907 451 49 106 1908 397 62 97 1909 391 51 94 1910 313 39 80 1911 495 158 124 1912 328 22 80 1913 325 45 80 1914 337 73 82 1915 344 39 91 *Records incomplete. 51 The following. Table, No. 38, shows the infant mortality rate in Wards in Willesden since 1910:— Table No. 38. Wards. 1910 1911 1912 1913 1914 1915 (i) (2) (3) (4) (5) (6) (7) South Kilburn 9i 134 131 106 86 Mid. Kilburn 83 147 83 75 73 93 North Kilburn 77 83 75 56 65 108 Brondesbury Park 76 86 60 33 54 44 Kensal Rise 63 92 93 51 5° 89 Harlesden 73 95 68 57 7i 68 Stonebridge *3 165 73 118 116 94 Round wood 85 177 80 102 9' 113 Church End 83 119 85 117 109 90 Willesden Green ... 100 108 68 68 83 69 Cricklewood 52 93 42 63 76 56 Willesden U. D. ... 80 124 80 80 82 91 Infant Mortality of Legitimate Infants.—The following Table, No. 39, shows the number of deaths of legitimate infants and the infant mortality rate per 1,000 legitimate births in Willesden since 1904:— Table No. 39. year. No. of deaths of legitimate infants under one year of age. No. of deaths of legitimate infants under one year of age, per 1,000 legitimate births. 1904 459 106 I905 440 107 I906 471 114 1907 424 103 I908 359 90 1909 361 89 I9IO 293 77 19" 452 117 1912 306 78 1913 306 79 I9H 315 80 1915 318 88 55 Infant Mortality of Illegitimate Infants.—The following Table, No. 40, shows the number of deaths of illegitimate infants and infant mortality rate per 1,000 illegitimate births in Willesden since 1904:— Table No. 40. year. No. of deaths of illegitimate infants tinder one year. No. of deaths of illegitimate infants under one year per 1,000 illegitimate births. 1904 50 463 1905 50 467 1906 22 176 1907 27 216 1908 38 404 1909 30 231 1910 20 82 1911 43 312 1912 22 169 1913 19 204 1914 22 218 1915 26 190 Notification of Births Acts, 1907 and 1915.—The Notification of Births Act, 1907, was adopted in this district in 1908, and the following Table, No. 41, shows the number of births notified in each complete year since its adoption, together with certain other particulars:— Table No. 41. Total number of births notified. Number of stillbirths notified. Number of births registered. Attended by doctors. Attended by mid wives. Total. 1909 2220 1528 3748 95 4172 1910 2072 1318 3390 79 3923 1911 2266 1428 3694 88 4001 1912 2324 1347 3671 92 4075 1913 2273 1277 3550 104 4037 1914 2207 1232 3439 118 4115 1915 2067 1125 3192 83 3775 56 Births are visited after the expiry of ten days, and a booklet on Infant Care and Feeding is given and explained to the mother. 2,464 births were visited during 1915. Revisits are made in cases in which the condition of the child on the first visit appears unsatisfactory. Table No. 42 shows the number of revisits paid during each of the last four years. Table No. 42. Year. No. of re-visits made to cases requiring same under the Notification of Births Acts, 1907 and 1915. 1912 180 1913 976 1914 1,052 1915 926 Report of Health Visitor in Attendance at The Babies' Welcome, Lower Place.—Since October the Babies' Welcome has been held on Wednesday afternoons, in the Medical Inspection Room of Lower Place School, this being larger and more convenient than the small kitchen previously used. It is attended on an average by 28 mothers and 26 babies, and is much appreciated by the mothers, as is shown by the numbers being double those attending at the same time last year. With few exceptions, the babies attending are those whose mothers have been advised to give them Glaxo, which is sold to them. The work is limited, as formerly, to weighing the child, enquiring as to its condition since the last visit, and advising accordingly, selling the Glaxo required, and giving the mother a cup of tea and biscuits. Any mother whose baby shows signs of ill-health is advised to take it to a hospital or doctor. M. S. Wilkinson. 57 Infant Death Inquiries.—The following Table, No. 43, shows the number of infant death inquiries made during each of the past three years :— Table No. 43. Year. No. of Deaths of Infants under i year. No. of Infant Death Inquiries. 1913 325 300 1914 337 231 1915 344 266 G. VITAL STATISTICS OF THE DISTRICT. Marriages.—The following Table, No. 44, shows the total number of marriages in Willesden, and the marriage rate in Wiillesden as compared with England and Wales generally since 1900: Table No. 44. Year. Willesden. Total No. of Marriages. Willesden. Marriage-Rate per 1000 of the population. England and Wales. Marriage-Rate per 1000 of the population. 1900 622 10.8 16.0 1901 658 11.2 15.9 1902 760 12.4 15.9 1903 834 12.9 15.6 1904 840 12.4 15.2 1905 891 12.7 15.3 1906 926 13.1 15.6 1907 949 13.1 15.8 1908 971 13.0 14.9 1909 1036 13.8 14.6 1910 994 13.0 15.0 1911 1047 13.4 15.2 1912 1147 14.3 15.5 1913 1153 14.1 15.5 1914 1305 15.7 15.9 1915 1666 20.0 1913 58 Births.—The following Table, No. 45, shows the total number of births in Willesden and the birth rate in Willesden as compared with England and Wales generally since 1875:— Table No. 45. Year. Willesden. Total No. of Births. Willesden. Birth Rale per 1,000 of the population. England and Wales Birth Kate per 1,oco of the population Willesden. Birth Rate per 1,000 of female population between 15-45 years. England and Wales. Birth Rate per 1,000 of female population between 15-45 years. 1875 805 447 35.4 ... ... 1876 805 43.4 36.3 ... 157.5 1877 803 41.1 36.0 ... 155.9 1878 830 40.2 35.6 ... 154.5 1879 903 37.6 34.7 ... 150.5 1880 967 38.3 34.2 ... 148.3 1881 960 34.4 33.9 ... 147.0 1882 1083 33.3 33.8 ... I45.8 1883 1168 33.3 33.5 ... 144.1 1884 1233 34.1 33.6 ... 144.2 1885 1366 35.6 32.9 ... 140.7 1886 1584 35.7 32.8 ... 140,2 1887 1659 33.8 31.9 ... 135.5 1888 1701 32.1 31.2 ... 132.3 1889 1929 33.7 31.1 ... 131.7 1890 1811 29.4 30.2 ... 127.6 1891 2059 33.1 31.4 ... 132.1 1892 2085 31.7 30.4 ... 127.3 1893 2256 32.5 30.7 ... 127.9 1894 2264 30.7 29.6 ... 122.4 1895 2469 31.2 30.3 ... 124.8 1896 2749 32.2 29.6 ... 121.5 1897 2887 31.0 29.6 ... 120.7 1898 3142 31.5 29.3 ... 118.9 1899 3375 31.5 29.1 ... 117.7 1900 3559 31.2 28.7 ... 115.6 1901 3762 32.2 28.5 ... 114.2 1902 3916 31.3 28.5 ... 114.1 1903 4132 31.9 28.4 ... 113.8 1904 4421 32.9 27.9 116.5 111.8 1905 4201 29.8 27.2 107.4 108.9 1906 4272 30.1 27.0 107.6 108.3 1907 4247 29.4 26.3 105.8 105.1 1908 4095 27.5 26.5 98.8 106.1 1909 4172 27.8 25.6 99.9 103.2 1910 3923 25.6 24.8 95.0 100.6 1911 4001 25.6 24.4 94.9 97.8 1912 4075 25.5 23.8 94.6 95.6 1913 4037 24.7 23.9 91.6 ... 1914 4115 24.7 23.8 91.7 ... 1915 3775 22.6 21.8 84.0 ... 59 The following Table, No. 46, shows the births and birth rates per 1,000 of the population in each Ward in Willesden since 1911:— Table No. 46. Wards. 1911. 1912. 1913. 1914 1915. Total No. of Births. Birth Rate. Total No. of Births. Birth Rate. Total No. of Births. Birth Rate. Total No. of Births. Birth Rate. Total No. of Births Birth Rate. South Kilburn 425 30.5 419 29.77 405 28.58 444 30.11 418 28.67 Mid. Kilburn 380 26.4 397 26.77 361 24.73 343 23.51 332 22.73 North Kilburn 217 18.2 226 18.63 216 17.45 230 18.23 186 14.91 Brondesbury Park 175 18.7 200 20.92 182 18.79 149 15.15 158 15.92 Kensal Rise 357 25.9 355 25.94 315 22.56 396 27.94 325 22.87 Harlesden 398 25.8 383 23.74 421 25.36 393 22.96 396 22.80 Stonebridge 462 27.7 517 31.14 515 29.47 554 31.22 467 26.36 Round wood 424 28.1 443 29.21 401 25.75 440 28.10 380 24.26 Church End 404 30.1 388 28.04 369 26.38 368 26.06 378 26.63 Willesden Green 426 27.9 413 26.46 440 26.82 423 25.26 391 23.31 Cricklewood 323 18.7 334 18.28 351 18.64 315 16.31 319 16.47 Willesden U.D. 4001* 25.6 4075 25.5 4037† 24.7 4ti5** 24.7 3775†† 22.6 *Including 10 births (Wards unknown) received from Registrar General at end of year. † „ 61 „ „ „ „ „ „ „ ** „ 60 „ „ „ „ „ „ „ † † „ 25 „ „ „ „ „ „ „ 60 Illegitimate Births.—The following Table, No. 47, shows the number of illegitimate births and the illegitimate birth rates per 1,000 total births in Willesden since 1882:— Table No. 47. Year. No. of Illegitimate Births. Illegitimate Birth-Rate per 1000 Total Births. Year. No. of Illegitimate Births. Illegitimate Birth-Rate per 1000 Total Births. 1882 28 25.85 1899 56 16.59 1883 25 21.40 1900 56 I5.73 1884 23 18.65 1901 48 12.75 1885 43 31.47 1902 48 12.25 †1886 ... ... 1903 87 21.05 1887 53 31.94 1904 108 24.42 1888 31 1822 1905 107 25.47 1889 57 29.54 1906 125 29.26 1890 42 23.19 1907 125 29.43 1891 34 16.51 1908 94 22.95 1892 54 25.89 1909 130 31.16 1893 45 19.94 1910 122 31.09 1894 39 17.22 1911 138 34.49 1895 54 21.87 1912 130 31.90 1896 59 21.46 1913 132 32.69 1897 55 19.05 1914 149 36.20 1898 63 20.05 1915 137 36.28 †No record. 61 Deaths.—The following Table, No. 48, shows the total number of deaths in Willesden and the death rates in Willesden as compared with England and Wales generally since 1875:— Table No. 48. Year. Willesden. Total No of Deaths. Willesden. Death Rate per 1,000 of the population. England & Wales Death Rate per 1,000 of the population. Year. Willesden. Total No. of Deaths. Willesden. Death Rate per 1,000 of the population. England & Wales. Death Rate per 1,000 of the population. 1875 385 21.4 22.7 1896 1,312 15.3 17.1 1876 401 21.7 20.9 1897 1,343 14.4 17.4 1877 346 17.7 20.3 1898 1,388 13.9 17.5 1878 441 21.4 21.6 1899 1,643 15.2 18.2 1879 376 16.8 20.7 1900 1,577 13.6 18.2 1880 471 18.7 20.5 1901 1,529 13.2 16.9 1881 490 17.6 18.9 1902 1,709 13.9 16.3 1882 587 18.1 19.6 1903 1,655 12.8 15.5 1883 538 15.4 19.6 1904 1,645 12.2 16.3 1884 530 14.7 19.7 1905 1,744 12.4 15.3 1885 632 16.2 19.2 1906 1,672 11.8 15.5 1886 685 15.5 19.5 1907 1,704 11.8 15.1 1887 701 14.3 19.1 1908 1,623 10.9 14.8 1888 835 15.8 18.1 1909 1,678 11.2 14.6 1889 686 12.0 18.2 1910 1,506 9.8 13.5 1890 882 14.4 19.5 1911 1,848 11.8 14.6 1891 860 13.8 20.2 1912 1,603 10.0 13.3 1892 945 14.4 19.0 1913 1,677 10.2 13.8 1893 1,070 15.5 19.2 1914 1,752 10.5 14.0 1894 917 13.2 16.6 1915 2,030 12.2 15.1 1895 1,143 14.5 187 62 The following Table, No. 49, shows the total deaths in Willesden at different age periods since 1877:— Table No. 49. Year. 0 to 1 i to 5 5 to 15 15 to 25 25 to 65 65 and up. At all ages. 1877 113 75 15 10 90 43 346 1878 167 79 13 9 125 48 441 1879 118 50 20 15 109 64 376 1880 168 109 27 18 103 46 471 1881 ... ... ... ... ... ... 490 1882 202 145 26 18 120 76 587 1883 196 89 31 25 142 55 538 1884 203 87 31 20 122 67 530 1885 235 105 20 22 173 77 632 1886 265 163 15 13 145 84 685 1887 264 123 44 12 163 95 701 1888 290 175 42 26 194 108 835 1889 276 85 27 15 180 103 686 1890 287 170 42 24 222 137 882 1891 273 110 42 30 260 145 860 1892 333 152 37 33 251 139 945 1893 345 130 51 34 304 150 1014 1894 299 160 44 32 255 127 917 1895 373 132 48 38 295 198 1084 1896 460 240 46 28 280 156 1210 1897 444 160 63 37 302 167 1173 1898 427 199 69 26 276 200 1197 1899 537 178 64 46 383 240 1448 1900 497 190 67 71 476 276 1577 1901 476 203 95 57 437 270 1538 1902 536 200 72 58 501 348 1715 1903 509 260 69 58 484 286 l666 1934 509 187 66 58 522 303 1645 190s 490 212 66 63 563 350 1744 1906 493 189 59 67 518 346 1672 1907 451 251 57 59 526 360 1704 1908 397 175 69 60 545 377 1623 1909 391 167 70 63 589 398 1678 1910 313 155 68 59 535 376 1506 1911 495 241 61 64 584 403 1848 1912 328 126 56 78 564 451 1603 1913 325 171 66 63 592 460 1677 1914 337 144 62 62 641 506 1752 1915 344 234 113 79 700 560 2030 63 The following Table, No. 50, shows the total deaths in Willesden at different age periods since 1904:— Table No. 50. Year. 0 to 1 1 to 2 2 to 5 5 to 10 10 to '5 15 to 20 20 to 25 25 to 35 35 to 45 "5 to 55 55 to 65 65 to 75 75 to 85 85 and up. Total. 1904 509 101 86 43 23 26 32 102 120 124 176 148 121 34 1645 1905 490 I20 92 46 20 30 33 102 132 153 176 184 136 30 1744 1906 493 104 85 33 26 34 33 86 132 130 170 174 141 31 1672 1907 451 137 114 38 19 22 37 93 121 153 159 196 133 31 1704 1908 397 92 83 42 27 21 39 83 132 143 187 194 145 38 1623 1909 391 90 77 48 22 26 37 107 150 162 170 207 150 41 1678 1910 313 94 61 43 25 31 28 92 116 '53 174 188 145 43 1506 1911 495 144 97 38 23 28 36 111 137 151 185 197 153 53 1848 1912 328 60 66 35 21 40 38 101 128 144 191 235 172 44 1603 1913 325 94 77 43 23 34 29 99 135 165 193 238 175 47 1677 1914 337 73 71 37 25 34 28 94 146 180 221 263 198 45 1752 1915 344 125 109 74 40 34 44 123 150 189 238 278 203 79 2030 The following Table, No. 51, shows the death rates at different age periods per 1,000 of the population at these age periods in Willesden and England and Wales since 1904:— 64 Table No. 51. 0 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 and up Year. Willesden England & Wales Willesden England & Wales Willesden England & Wales Willesden England & Wales Willesden England & Wales Willesden England & Wales Willesden England & Wales Willesden England & Wales Willesden England & Wales Willesden England & Wales Willesden England & Wales Willesden England & Wales 1904 39.5 51.8 2.9 3.5 1.8 2.1 2.1 3.0 2.5 3.8 4.0 .53 6.7 8.8 11.9 15.1 29.7 29.3 52.3 62.5 126.8 131.9 217.9 284.7 1905 38.1 44.9 3.0 3.4 1.5 2.1 2.3 2.9 2.4 3.7 3.8 5.2 7.0 8.6 14.0 14.9 28.4 28.7 62.2 61.6 136.3 127.7 184.0 286.6 1906 36.8 45.6 2.1 3.5 1.9 2.1 2.6 2.9 2.4 3.6 3.2 5.1 7.0 8.7 11.9 14.9 27.2 29.2 58.4 62.1 140.3 129.8 189.0 301.1 1907 37.2 41.2 2.4 3.4 1.4 2.0 1.7 2.8 2.6 3.5 3.4 5.1 6.3 8.7 13.7 15.0 25.0 29.8 64.6 65.0 129.9 132.6 185.6 303.9 1908 29.3 40.9 2.6 3.2 1.9 1.9 1.5 2.6 2.7 3.4 2.9 4.9 6.6 8.3 12.4 14.6 28.4 28.9 61.9 63.8 137.2 131.1 219.7 295.2 1909 28.4 37.1 2.9 3.3 1.5 1.9 1.9 2.7 2.5 3.3 3.7 4.8 7.5 8.3 13.9 14.8 25.7 29.3 65.6 67.4 140.8 136.2 235.6 310.8 1910 23.3 34.2 2.6 2.9 1.7 1.8 2.2 2.5 1.9 3.1 3.1 4.5 5.7 7.8 12.9 13.9 25.7 27.3 58.3 62.3 133.4 124.7 241.6 285.4 1911 40.8 43.7 2.2 3.4 1.6 2.1 2.1 2.9 2.7 3.5 3.8 4.5 6.1 7.3 10.4 13.0 22.8 26.1 45.7 56.4 106.3 124.2 254.8 246.2 1912 24.6 32.4 2.0 3.1 1.4 1.9 3.0 2.8 2.8 3.3 3.4 4.3 5.6 7.2 9.6 12.9 23.1 26.1 53.3 57.1 117.0 126.7 207.5 252.9 1913 26.3 35.7 2.4 3.1 1.5 1.9 2.5 2.6 2.1 3.2 3.3 4.2 5.7 7.2 10.8 13.1 23.4 26.6 52.8 57.0 116.3 126.8 216.6 250.1 1914 25.1 ... 2.1 ... 1.6 ... 2.4 ... 2.0 ... 3.0 ... 6.1 ... 11.5 ... 25.6 ... 57.3 ... 129.2 ... 203.6 ... 1915 30.1 ... 4.1 ... 2.6 ... 2.4 ... 3.1 ... 4.0 ... 6.2 ... 12.1 ... 27.6 ... 60.5 ... 132.3 ... 355.9 ... WILLESDEN URBAN DISTRICT EDUCATION COMMITTEE. THE EIGHTH ANNUAL REPORT FOR THE YEAR ENDING 31st DECEMBER, 1915, ON THE HEALTH OF CHILDREN ATTENDING THE PUBLIC ELEMENTARY SCHOOLS IN WILLESDEN. GEORGE F. BUCHAN, m.d., d.p.h., Medical Officer. 67 A. GENERAL. School Accommodation.—There were 32 public elementary schools, with 79 departments and effective accommodation for 25,710 children, in Willesden on 3rd December, 1915. In addition, there were three special schools, maintained by the Local Education Authority, two for mentally defective and one for physically defective children. Children Selected for Medical Inspection.—At the beginning of the year 1915 the children examined were those of the same age groups as in the previous year, namely, children entering school life, and children who had attained the age of 12 years and who were classified as leavers. In April, 1915, the routine examination of a further age group was begun as required by the Board of Education, and children who had attained the age of eight years were examined as an intermediate group. In October, 1915, owing to the absence on military service of one of the Assistant Medical Officers, medical inspection in one area had to be abandoned, and on December 3rd, 1915, owing to further depletion of staff, routine medical inspection was discontinued, but arrangements were made, as required by the Board of Education, for the Assistant Medical Officers and Health Visitors to pay periodical visits to the schools to select and examine cases apparently needing medical attention. Such cases are, where necessary, followed up and re-examined in the ordinary way. Attendance of Parents at Medical Inspection.— During the year 5,315 children were examined, and in 2,700 cases, or 50.80 per cent., the parents attended the examination. 68 B. ROUTINE MEDICAL INSPECTION. Number of Children Inspected.—The total number of children on the roll in the Public Elementary Schools in Willesden in June, 1915, was 24,178. The following Table, No. 52, gives the number of children inspected during 1915, classified for age and sex, in the form required by the Board of Education:— Table No. 52. Age. Boys. Girls. Total. Entrants 5 and under 6 360 391 751 6 and under 7 612 594 1206 7 and under 8 130 149 279 2236 Intermediate Group 8 and under 9 422 448 870 9 and under 10 24 25 49 10 and under 11 35 27 62 11 and under 12 30 35 65 1046 Leavers 12 and under 13 501 488 989 13 and under 14 445 483 928 14 and over 62 54 116 2033 2621 2694 5315 The following Table, No. 53, shows the number of children inspected at each school and the number referred for treatment, together with certain other particulars:— 69 Table No. 53. School. No. examined. No. absent. No. of objections by parents. No. unable to be examined. No. notified to parent as requiring treatment. Acton Land (Mixed) 48 4 ... ... 9 Acton Lane (Infants) 124 22 2 ... 42 Bridge Road (Mixed and Infants) 123 10 ... ... 31 Chamberlayne Wood Road (Boys) 73 5 ... ... 22 Chamberlayne Wood Road (Girls) 62 5 4 ... 15 Chamberlayne Wood Road (Infants) 91 29 2 ... 32 Christchurch (Boys) 18 1 ... ... 7 Christchurch (Girls) 24 ... ... 7 8 Christchurch (Infants) 32 4 ... ... 10 Carlton Vale (Girls) 59 11 2 ... 17 Carlton Vale (Infants) 240 70 4 ... 54 College Road (Mixed and Infants) 98 11 1 ... 25 Disraeli Road (Infants) 39 10 ... ... 9 Dudding Hill (Boys) 55 4 ... ... 20 Dudding Hill (Girls) 44 1 ... ... 21 Dudding Hill (Infants) 74 19 ... ... 20 Furness Road (Senior Mixed) 93 4 2 ... 23 Furness Road (Junior Mixed) 42 7 ... ... 13 Furness Road (Infants) 156 28 ... ... 58 Gladstone Park (Mixed and Infants) 115 21 ... ... 36 Gibbons Road (Mixed) 159 24 1 ... 43 Gibbons Road (Infants) 117 17 ... ... 43 Gordon Memorial (Boys) 61 3 ... ... 20 Gordon Memorial (Girls) 41 7 ... ... 14 Gordon Memorial (Infants) 72 12 1 ... 30 Holy Trinity (Boys) 24 1 ... ... 8 Holy Trinity (Girls) 33 2 ... ... 13 Holy Trinity (Infants) 37 8 ... ... 15 Harlesden C. of E. (Boys) 44 1 ... ... 17 Harlesden C. of E. (Girls) 27 7 ... ... 8 Harlesden C. of E. (Infants) 46 9 ... ... 13 Harlesden R.C. (Mixed) 41 11 ... ... 17 Harlesden R.C. (Infants) 3i 4 ... ... 12 Keble Memorial (Boys) 19 6 ... ... 10 Keble Memorial (Girls) 42 13 ... ... 23 Keble Memorial (Infants) 55 13 ... ... 9 Kensal Rise (Boys) 67 5 ... ... 22 Kensal Rise (Girls) 66 4 ... ... 20 Carried forward 2592 413 19 7 809 70 Table No. 53—(continued). School. No. examined. No. absent. No. of objections by parents. No. unable to be examined. No. notified to parent as requiring treatment. Brought forward 2592 413 19 7 809 Kensal Rise (Infants) 178 23 ... ... 32 Kilburn Park (Girls) 52 5 ... ... 20 Kilburn Park (Infants) 34 5 1 ... 6 Leopold Road (Boys) 74 4 ... ... 27 Leopold Road (Girls) 85 1 1 ... 19 Leopold Road (Infants) 210 25 1 ... 67 Lower Place (Boys) 39 5 ... ... 6 Lower Place (Girls) 29 ... ... ... 9 Lower Place (Junior Mixed) 23 1 ... ... 8 Mora Road (Boys) 41 1 ... ... 9 Mora Road (Girls) 78 9 ... ... 23 Mora Road (Infants) 70 10 ... ... 27 Neasden National "Mixed) 44 2 ... ... 6 Neasden National (Infants) Oldfield Road (Boys) 73 9 ... ... 27 Oldfield Road (Girls) 64 4 ... ... 19 Oldfield Road (Infants) 139 22 ... ... 51 Percy Road (Boys) 81 4 ... ... 24 Pound Lane (Mixed) 125 26 ... ... 48 Pound Lane (Infants) 91 9 ... ... 31 Princess Frederica (Boys) 37 4 1 ... 25 Princess Frederica (Girls) 62 12 7 ... 24 Princess Frederica (Infants) 76 12 ... ... 21 Salusbury Road (Mixed) 101 23 ... ... 28 Salusbury Road (Infants) 129 27 1 ... 39 Stonebridge (Boys) 17 ... ... ... 4 Stonebridge (Girls) 80 3 ... ... 30 Stonebridge (Infants) 162 23 ... ... 52 St. Andrew's (Boys) 43 2 2 ... 22 St. Andrew's (Girls) 38 5 7 ... 15 St. Andrew's (Infants) 45 13 1 ... 10 St. John's (Boys) 32 1 ... ... 12 St. John's (Girls) 28 3 ... ... 11 St. John's (Infants) 52 6 ... ... 20 St. Mary's (Boys) 33 2 ... ... 14 St. Mary's (Girls) 22 20 3 ... 11 St. Mary's (Infants) 37 6 1 ... 22 St. Mary's R.C. (Mixed) 13 ... ... ... 5 St. Mary's R.C. (Infants) 35 8 1 ... 7 Wesley Road (Junior Mixed) 55 4 ... ... 19 Wesley Road (Infants) 96 13 i ... 32 Totals 5315 765 47 7 1691 71 Notice to Parents of Defective Conditions in Children Requiring Treatment.—From the foregoing Table, No. 53, it will be noted that 1,691 children medically inspected were referred for medical or dental treatment. In all these cases notices were sent to the parents calling their attention to the defects and advising them to seek remedial measures. Urgent cases were still further referred for home visitation with the view of assisting parents to secure treatment. Condition of the Children Inspected.—The following return, Table No. 54, gives details in respect of the condition of the 5,315 children submitted to routine medical inspection during the year:— 72 Table No. 54.—Return as required by the Board of Education showing the Condition of Children submitted to Routine Medical Inspection. ENTRANTS. LEAVERS. INTERMEDIATE. TOTAL. Boys. Girls. Total. Per cent. Boys. Girls. Total. Per cent. Boys. Girls. Total. Per cent. Boys. Girls. Total. Per cent. Total Inspected. 1102 1134 2236 1008 1025 2033 511 535 1046 2621 2694 5315 Clothing- Satisfactory 1075 1122 2197 98.26 974 1005 1979 97.34 498 526 1024 97.90 2547 2653 5200 97.84 Unsatisfactory 27 12 39 1.74 34 20 54 2.66 13 9 22 2.10 74 41 "5 2.16 Footgear- Satisfactory 1057 1092 2149 96.11 960 984 1944 95.62 482 514 996 95.22 2499 2590 5089 95.75 Unsatisfactory 45 42 87 3.89 48 41 89 4.38 29 21 50 4.78 122 104 226 4.25 Cleanliness of Head- Clean 943 802 1745 78.04 905 629 1534 75.45 431 327 758 72.47 2279 1758 4037 75.95 Nits 91 237 328 14.67 42 289 331 16.28 47 151 198 18.93 180 677 857 16.12 Pediculi 53 85 138 6.17 49 93 142 6.98 22 48 70 6.69 124 226 350 6.59 Other Dirty Conditions 15 10 25 1.12 12 14 26 1.28 11 9 20 1.91 38 33 71 1.34 Cleanliness of Body- Clean 1059 1105 2164 96.78 985 995 1980 97.39 481 511 992 94.84 2525 2611 5136 96.63 Dirty 4 1 5 .22 10 4 14 .69 4 2 6 .57 18 7 25 .47 Pediculi 4 2 6 .27 4 0 4 .20 3 1 4 .38 11 3 14 .26 Fleabitten 35 26 61 2.73 9 26 35 1.72 23 21 44 4.21 67 73 140 2.63 Nutrition— Excellent 995 1024 2019 90.30 895 916 1811 89.08 430 464 894 85.47 2320 2404 4724 88.88 Normal Below Normal 66 77 143 6.40 80 81 161 7.92 59 49 108 10.33 205 207 412 7.75 Bad 41 33 74 3.31 33 28 61 3.00 22 22 44 4.21 96 83 179 3.35 73 Nose and Throat- No Defect 875 932 1807 80.81 838 823 1661 8170 432 457 889 84.99 2145 2212 4357 81.98 Enlarged Tonsils 145 127 272 12.16 124 160 284 13.97 56 58 114 10.90 325 345 670 12.61 Adenoids 24 26 50 2.24 7 8 15 -74 13 9 22 2.10 44 43 87 1.64 Enlarged Tonsils and Adenoids 49 42 91 4.07 30 22 52 2.56 7 8 15 1.43 86 72 158 2.97 Other Conditions 9 7 16 .72 9 12 21 1.03 3 3 6 .57 21 22 43 .81 Cervical or Neck Glands- Normal 981 1046 2027 90.65 941 970 1911 94.00 462 491 953 91.11 2384 2507 4891 92.02 Enlarged 121 88 209 9.35 67 55 122 6.00 49 44 93 8.89 237 187 424 7.98 External Eye Disease- No Disease 1089 1123 2212 98.93 985 1011 1996 98.18 505 533 1038 99.24 2579 2667 5246 98.70 Blepharitis 12 8 20 .89 l6 9 25 1.23 4 1 5 .48 32 18 50 .94 Conjunctivitis 0 2 2 .09 i 1 2 .10 0 1 1 .10 1 4 5 .09 Corneal Opacities 0 1 1 .04 0 2 2 .10 1 0 1 .10 1 3 4 08 Other Disease 1 0 1 .04 6 2 8 .39 1 0 1 .10 8 2 10 .19 Ear Disease- No Disease 1067 1105 2172 97.14 985 997 1982 97.49 504 520 1024 97.90 2556 2622 5178 97.42 Chronic Suppuration of Middle Ear 24 16 40 1.79 13 14 27 1.33 5 8 13 1.24 42 38 80 1.51 Chronic Catarrh of Middle Ear 0 0 0 ... 0 0 0 ... 0 0 0 ... 0 0 0 ... Wax 2 3 5 .22 1 5 6 .30 0 2 2 .19 3 10 13 .24 Other Disease 9 10 19 .85 9 9 18 .89 2 5 7 .67 20 24 44 .83 Teeth- Sound 522 575 1097 49.06 570 631 1201 59.08 254 294 548 52.39 1346 1500 2846 53.55 Less than Four Decayed 285 269 554 24.77 322 292 614 30.20 156 144 300 28.68 763 705 1468 27.62 Four or More Decayed 293 289 582 26.03 113 99 212 10.43 99 97 196 18.74 505 485 990 18.63 Sepsis 2 1 3 .13 3 3 6 .30 2 0 2 .19 7 4 11 .21 Heart and Circulation— No Disease 1039 1080 2119 94.77 952 947 1899 93.41 473 500 973 93.02 2464 2527 4991 93.90 Organic Disease 31 26 57 2.55 28 32 60 2.95 17 16 33 3.I5 76 74 150 2.82 Functional Disease 8 5 13 .58 7 6 13 .64 2 4 6 .57 17 15 32 .60 Anaemia 24 23 47 2.10 21 40 61 3.00 19 15 34 3.25 64 78 142 2.67 Other Defect 0 0 0 ... 0 0 0 ... 0 0 0 ... O 0 0 ... Table No 54—(continued). ENTRANTS. LEAVERS. INTERMEDIATE. TOTAL. Boys. Girls. Total. Per cent. Boys. Girls. Total. Per cent. Boys. Girls. Total. Per cent. Boys. Girls. Total. Per cent. Total Inspected. 1102 1134 2236 1008 1025 2033 511 535 1046 2621 2694 5315 Lungs- No Disease 1072 1112 2184 97.67 994 1009 2003 98.52 505 527 1032 98.66 2571 2648 5219 98.19 Chronic Bronchitis and Bronchial Catarrh 21 15 36 1.61 3 1 4 .20 3 0 3 .29 27 16 43 .81 Tuberculosis 0 0 0 ... 2 4 6 .30 1 2 3 .29 3 6 9 .17 Tuberculosis Suspected 9 7 l6 .72 9 10 19 .93 2 5 7 .67 20 22 42 .79 Other Disease 0 0 0 ... 0 1 1 .05 0 1 1 .10 0 2 2 .04 Nervous System- No Disease 1100 1130 2230 99.73 1002 1021 2023 99.51 509 534 1043 99.7I 2611 2685 5296 99.64 Epilepsy I 2 3 .13 3 1 4 .20 2 0 2 .19 6 3 9 .17 Chorea 1 2 3 .13 3 2 5 .25 0 1 1 .10 4 5 9 .17 Other Disease 0 0 0 ... 0 1 1 .05 0 0 0 ... 0 1 1 .02 Skin- No Disease 1090 1118 2208 98.74 991 1012 2003 98.52 505 529 1034 98.85 2586 2659 5245 98.68 Ringworm: Body 4 6 10 .45 3 1 4 .20 2 0 2 .19 9 7 16 .30 Ringworm: Head Impetigo 4 5 9 .40 3 2 5 .25 2 0 2 .19 9 7 16 .30 Scabies 0 0 0 ... 2 0 2 .10 0 1 1 .10 2 1 3 .06 Other Disease 4 5 9 .40 9 10 19 93 2 5 7 .67 15 20 35 .66 Rickets- No Disease 1095 1128 2223 99.42 1004 1020 2024 99.56 5°7 532 1039 99.33 2606 2680 5286 99.45 Slight 1 0 1 •04 1 0 1 .05 0 0 0 ... 2 0 2 .04 Marked 6 6 12 .54 3 5 8 .39 4 3 7 .67 13 14 27 .51 74 75 Deformities- No Deformity 1087 1122 2209 98.79 971 985 1956 96.21 488 520 1008 96.37 2546 2627 5173 97.33 Deformity Present 15 12 27 1.21 37 40 77 379 23 '5 38 3.63 75 67 142 2.67 Tuberculosis, Non-pulmonary- No Disease 1101 1132 2233 99.87 1005 1024 2029 99.80 509 535 1044 99.81 2615 2691 53o6 99.83 Glandular 0 2 2 .09 1 0 1 .05 1 0 1 .10 2 2 4 .08 Bones and Joints 1 0 1 .04 2 1 3 .15 1 0 1 .10 4 I 5 .09 Other Forms 0 0 0 ... 0 0 0 ... 0 0 0 ... 0 0 0 ... Speech— Not Defective 1091 1128 2219 99.24 979 1016 1995 98.13 503 533 1036 99.04 2573 2677 5250 98.78 Defective Articulation 11 6 17 .76 19 8 27 1.33 7 2 9 .86 37 l6 53 1.00 Stammering 0 0 0 ... 10 1 11 .54 1 0 1 .10 11 I 12 .23 Mental Condition- Normal 1094 1127 2221 99.33 983 985 1968 96.80 496 521 1017 97.23 2573 2633 5206 97.95 Dull or Backward 7 4 11 .49 25 39 64 3.15 10 11 21 2.01 42 54 96 1.81 Mentally Defective (all grades) 1 3 4 .18 0 1 1 .05 5 3 8 .76 6 7 13 .24 Squint- No Squint 1078 1105 2183 97.63 991 1021 2012 98.97 505 529 i°34 98.85 2574 2655 5229 98.38 Squint Present 24 29 53 2.37 17 4 21 1.03 6 6 12 1.15 47 39 86 1.62 Vision Both Eyes Normal 677 668 1345 66.16 314 353 667 63.77 991 1021 2012 65.35 One Eye Normal 75 50 125 6.15 24 17 41 3.92 99 67 166 5.39 Both Eyes 6/9 127 135 262 12.89 120 117 237 22.66 247 252 499 16.21 One Eye 6/9, Other 6/12 or less 35 54 89 4.38 15 14 29 2.77 5° 68 118 3.83 Both Eyes 6/12 or less 94 118 212 10.43 3« 34 72 6.88 132 152 284 9.22 Other disease or defect- Not Present 1095 1126 2221 99.33 999 1020 2019 99.31 510 527 1037 99.14 2604 2673 5277 99.29 Present 7 8 15 .67 9 5 14 .69 1 8 9 .86 17 21 38 .71 76 C. SPECIAL CASES FOLLOWING-UP. Special Cases.—94 of the 5,315 children medically inspected were referred for further examination at the next medical inspection, or at the inspection clinic, without home visitation. These were cases where the diagnosis was doubtful, or where the child's state of health was low without any definite signs of disease being present. Special Cases—Following-up.—5,144 cases, including 206 cases of mental defect, were referred during the year 1915 with the view of medical treatment being obtained, remedial measures carried out, or other action taken. The following Table, No. 55, shows how the cases came under notice, and also gives corresponding figures for previous years:— Table No. 55. No. referred by Medical Inspection and Officers of Health Department. Head Teachers. Attendance Officers. Others. Total. 1915 1308 3429 109 298 5144 Including mental defects 1914 2322 2401 108 140 4971 1913 1092 1912 1102 1911 1030 1910 941 77 Remedial Measures — Medical Treatment — The Results of "Following-up."—The following Table, No. 56, shows, as required by the Board of Education, the nature and the number of the defects from which the 5,144 special cases referred to in the preceding paragraph were suffering, the number of visits and medical examinations made in connection with these cases, and the extent to which remedial measures or medical treatment were carried out during 1915:— 78 Table No. 56. CONDITIONS. No. of defects found for which treatment was considered necessary. No. of visits made on account of these defects. No. of Medical Examinations made on account of these defects. No. of defects for which no report is available. No. of defects treated. Results of Treatment. Percentage of defects treated. No. of defects not treated. Total No. of defects under observation at end of year and carried forward to succeeding year. Carried forward from previous year. New. Total. School Clinic. Home (i.e., under super1 vision of Medical staff of Authority). Voluntary Hospital or other charitable Institution. Infirmary or Poor Law. Private Practitioner. Total. Remedied. Improved. Unchanged. Under observation at end of year (result of treatment not known at end of year). Removed from observation. Still under observation at end of year. Total. Clothing- Unsatisfactory 0 8 8 40 2 0 0 8 0 0 0 8 7 I 0 0 100.00 0 0 0 0 Footgear- Unsatisfactory ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cleanliness of Head- Nits 51 217 288 1178 365 9 0 *279 0 0 0 279 223 50 0 6 96.87 0 0 0 6 Pediculi 42 680 722 3°49 1140 19 0 **697 3 0 3 703 554 136 0 13 97.36 0 0 0 13 Other Dirty Conditions ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cleanliness of Body Dirty 0 7 7 19 2 0 0 7 0 0 0 7 5 2 0 0 100.00 0 0 0 0 Pediculi 2 38 40 117 54 0 0 40 0 0 0 40 40 0 0 0 100.00 0 0 0 0 Fleabitten 0 2 2 5 1 0 0 2 0 0 0 2 2 0 0 0 100.00 0 0 0 0 Nutrition Below Normal 0 8 8 17 6 0 0 †6 2 0 0 8 4 4 0 0 100.00 0 0 0 0 Bad s 10 15 55 18 0 0 † † 12 I 0 1 14 0 12 0 2 93.33 I 0 1 2 *One of these was cleansed at the Willesden Isolation Hospital. † Four of these were provided with School Meals by the Willesden Education Authority. **Two „ were „ „ „ „ ‡Seven ,, ,, ,, ,, „ „ „ „ 79 Nose and Throat- Enlarged Tonsils 115 119 234 1183 87 5 0 6 86 0 21 113 74 18 6 15 48.29 97 19 116 34 Adenoids 16 50 66 313 46 3 0 2 38 0 3 43 25 5 0 13 65.15 13 7 20 20 Enlarged Tonsils and Adenoids 67 82 149 601 80 5 0 3 68 0 9 80 57 11 7 5 53.69 53 11 64 16 Other Conditions 15 184 199 497 48 0 0 108 27 1 58 194 176 12 3 3 97.48 5 0 5 3 Cervical or Neck Glands- Enlarged 18 123 141 464 55 2 0 58 25 1 47 131 102 23 1 5 92.90 8 0 8 5 External Eye Disease— Blepharitis 15 90 105 364 428 1 72 18 9 0 2 101 72 14 0 15 96.19 3 0 3 15 Conjunctivitis 49 205 2S4 741 862 1 185 46 11 0 6 248 189 35 0 24 97.71 5 0 5 24 Corneal Opacities 0 3 3 17 20 0 2 0 1 0 0 3 0 3 0 0 100.00 0 0 0 0 Other Diseases ... 10 33 43 159 88 1 22 5 10 0 3 40 22 14 3 1 93.02 2 0 2 1 Ear Disease- Chronic Suppuration of Middle Ear 19 67 86 380 69 1 0 25 30 0 22 77 54 16 3 4 89.53 6 2 8 6 Chronic Catarrh of Middle Ear ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Wax 0 2 2 7 3 0 0 2 0 0 0 2 1 1 0 0 100.00 0 0 0 0 Other Disease 9 31 40 158 43 0 0 9 15 0 5 29 15 9 2 3 72.50 8 0 11 6 Teeth- Irregular 0 1 1 2 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 Less than Four Decayed 0 7 7 31 8 0 0 0 5 0 0 5 5 0 0 0 71.43 2 0 2 0 l our or More Decayed 119 104 223 977 85 9 0 10 60 0 *31 101 69 25 2 5 45.29 89 24 113 29 Sepsis 1 2 3 8 2 0 0 1 2 0 0 3 2 1 0 0 100.00 0 0 0 0 Heart & Circulation- Organic Disease 2 8 10 38 8 0 0 0 5 0 3 8 0 5 1 2 80.00 2 0 2 2 Functional Disease 0 18 18 64 17 0 0 4 9 0 4 17 3 13 1 0 94.44 1 0 1 0 Anaemia 3 20 23 71 15 1 0 †4 8 1 7 20 8 10 0 2 86.95 1 1 2 3 Other Defect ? 5 8 21 11 0 0 0 4 0 4 8 3 5 0 0 100.00 0 0 0; 0 *Includes those treated by dentist. †Milk provided by Willesden Education Authority in one of these cases. 80 Table No. 56—(continued). CONDITIONS. No. of defects found for which treatment was considered necessary. No. of visits made on account of these defects. No. of Medical Examinations made on account of these defects. No. of defects for which no report is available. No. of defects treated. Results of Treatment. Percentage of defects treated. No. of defects not treated. Total No. of defects under observation at end of year and carried forward to succeeding year. Carried forward from previous year. New. Total. School Clinic. Home (i.e., under supervision of Medical staff of Authority). Voluntary Hospital or other charitable Institution. Infirmary or Poor Law. Private Practitioner. Total. Remedied. Improved. Unchanged. Under observation at end of year (result of treatment not known at end of year). Removed from observation. Still under observation at end of year. Total. Lungs- Chronic Bronchitis and Bronchial Catarrh 3 57 60 169 10 0 0 20 9 3 28 60 45 9 0 6 100.00 0 0 0 6 *Tuberculosis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Tuberculosis Suspected 7 28 35 139 38 1 0 0 13 10 8 31 4 20 3 4 88.57 3 0 3 4 Other Disease 3 16 19 43 6 0 0 3 5 0 11 19 15 2 1 1 100.00 0 0 0 1 Nervous System Epilepsy 1 6 7 21 4 0 0 1 3 0 0 4 2 2 0 0 57.14 3 0 3 0 Chorea 10 25 35 159 21 1 0 3 27 0 4 14 12 16 1 5 97.14 0 0 0 5 Other Disease 4 19 23 95 21 0 0 2 11 0 4 17 2 10 1 4 73.91 3 3 6 7 Skin- Ringworm—Body 122 316 438 1535 1249 10 293 54 21 0 48 416 334 6 4 72 94.97 2 10 12 82 Ringworm—Head Impetigo 16 557 591 2451 513 2 4 470 69 0 48 591 S45 14 0 32 99.66 0 0 0 32 Scabies 8 72 80 326 141 0 0 †41 15 1 21 80 69 1 0 10 100.00 0 0 0 10 Other Disease 17 168 185 585 147 0 14 100 22 2 34 172 136 20 7 9 92.97 13 0 13 9 Ricketts— Slight 1 2 3 18 4 0 0 0 3 0 0 3 0 3 0 0 100.00 0 0 0 0 Marked *Nine cases were notified by Assistant Medical Officers during the year, and were dealt with as notifiable infectious diseases †One of these was cleansed at the Willesden Isolation Hospital. 81 Deformities- Deformity Present 10 25 35 153 20 0 0 3 19 0 4 26 2 16 3 5 74.28 8 I 9 6 Tuberculosis (Non-pulmonary)— *Glandular ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... †Bones and Joints ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Forms ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Suspected—Glandular 0 2 2 3 4 0 0 0 1 1 0 2 0 1 1 0 100.00 0 0 0 0 ,, Bones & Joints 0 1 1 4 0 0 0 0 0 0 1 1 0 0 0 1 100.00 0 0 0 1 ,, Other Forms 0 2 2 8 2 0 0 0 2 0 0 2 0 2 0 0 100.00 0 0 0 0 Speech- Defective Articulation 1 1 2 7 3 0 0 1 1 0 0 2 0 2 0 0 100.00 0 0 0 0 Squint- Squint Present 30 105 135 456 434 4 102 1 7 0 1 111 12 81 8 10 82.22 17 3 20 13 Vision- Defect not ascertained 4 15 10 59 24 1 10 0 3 0 0 13 3 8 0 2 68.42 2 3 5 5 One Eye Normal 43 86 129 249 381 0 102 0 9 0 4 115 29 74 6 6 89.14 12 2 14 8 Both Eyes 6/6 0 8 8 16 20 1 6 0 0 0 0 6 S 0 1 0 75.00 1 0 1 0 Both Eyes 6/9 6 28 34 58 105 0 33 0 0 0 1 34 18 13 2 1 100.00 0 0 0 1 One Eye 6/9, Other 6/12 or less 73 109 182 374 526 1 143 0 14 0 2 159 47 103 2 7 87.36 21 1 22 8 Both Eyes 6/12 or less 153 372 525 1140 1585 7 412 0 5i 0 ‡5 468 121 328 5 14 89.14 47 3 50 17 Spectacles Broken 1 113 114 61 226 1 106 0 0 0 ‡2 108 106 0 0 2 94.73 2 3 5 5 Debility 9 53 62 192 34 1 0 25 11 3 21 60 36 17 2 5 96.77 0 1 1 6 Miscellaneous 27 790 817 1977 166 6 0 532 86 8 175 801 725 52 5 19 98.04 9 1 10 20 Grand Totals 1130 5120 6250 20874 9249 93 1506 2608 821 31 653 5619 3980 1225 81 333 89.90 440 98 538 431 Mental Condition- Dull or Backward 0 63 63 17 42 0 0 0 0 0 0 0 0 0 0 0 0 0 63 63 63 Mentally Defective (all grades) 0 143 143 15 111 0 §116 0 0 0 0 116 0 0 0 §116 81.11 16 11 27 127 *Three cases were notified by the Assistant Medical Officers during the \ear and were dealt with as notifiable infectious diseases, †One case was notified by the Assistant Medical Officers during the year and was dealt with a- a notifiable infectious disease. ‡Includes those treated by Optician. §In special schools for mentally defective children. 82 Prosecutions.—49 prosecutions were conducted by the Attendance Officers on the recommendation of the Medical Officer for non-attendance in respect of exclusion from school on account of dirty and verminous conditions. Five of these cases were withdrawn, as the children meanwhile had been cleansed. In the remaining 44 cases fines were inflicted by the Magistrate varying in amount from 2s. 6d. to 20s. D. CLINIC. The Clinic maintained by the Authority deals with Ringworm and Eye cases. The following Table, No. 57, shows the work that has been done at the Clinic during the year under review:— Table No. 57. Clinic.—(Ringworm and Eyes.) Ringworm. Eyes. Under 5 years. Over 5 years. No. of cases under treatment at 26th December, 1914 113 3 111 No. of cases coming under treatment 237 25 1070 Total No. of cases under treatment *350 †28 †1181 No. of cases cured or relieved:— (a) By X Rays 97 ... ... (b) By provision of Spectacles ... 2 730 (c) By other means 108 17 224 No. of cases previously attending Clinic cured by other agencies or removed 32 5 27 No. of cases not requiring treatment 57 1 112 Total No. of cases remaining under treatment at 1st January, 1916 56 3 88 Re-examinations of children previously treated at Eye Clinic ... 1 355 *Note that 57 of these cases were found upon examination not to be suffering from Ringworm. The actual number of cases of Ringworm coming under treatment therefore = 350 - 57 or 293. †Note that 1 of the cases under 5 years and 112 of the cases over 5 years were found upon examination not to require treatment. The actual number of cases coming under treatment is therefore 28-1 or 27 under 5 years, and 1181-112 or 1069 over 5 years, or a total of 1096—and of this number 1096, 7 were cases of Ophthalmia Neonatorum which would not appear in Table 56. 83 Ringworm Cases.—438 cases of Ringworm came under observation during the year, and it will be noted from the Table, No. 56, that 416 received treatment during the year, that no report was available in respect of 10 cases, and that 12 were not known to have received treatment. In respect of the 416 cases receiving treatment, 293 were treated at the School Clinic, 54 at home, 21 at Voluntary Hospitals, and 48 by private practitioners. In respect of the 293 cases treated at the School Clinic, 205 were cured at the Clinic and 56 were still under treatment there at the end of the year. The remaining 32 cases were cured by other agencies or removed from observation before treatment was completed, e.g., left Willesden, left school over school age. In no case treated by X rays has there been permanent baldness or other ill-effects from the treatment. The time elapsing on account of the long waiting list before it has been possible to apply X rays has been less this year than previously. At the end of the year no cases desiring X ray treatment were obliged to be kept waiting. The total number of attendances made by children at the Ringworm Clinic during the year was 1,097. The greatest number attending on any one day was 45, and the average attendance on each morning on which the Clinic was open throughout the year 24. Eye Cases.—Table No. 56 shows that 897 cases of Defective Vision, 135 cases of Squint, and 405 cases of External Eye Disease, or a total of 1,437, came under observation during the year as requiring treatment. Of this number 1,298 received treatment, including 1,089 cases which received treatment at the Eye Clinic. During the year 4,577 attendances were registered at the Eye Clinic. The greatest number attending on any one day was 51, and the average attendance during the period in question was 22 on each day on which the Clinic was open. 84 E. EXCEPTIONAL CHILDREN. Exceptional Children.—The following Table, No. 58, gives a classified list of exceptional children in the area. Table No. 58. Boys Girls Total Blind (including partially blind). Attending Public Elementary Schools ... — — — Attending Certified Schools for the Blind 21 9 30 Not at School 0 1 1 Deaf and Dumb (including partially deaf). Attending Public Elementary Schools ... 4 1 s Attending Certified Schools for the Deaf 9 3 12 Not at School 1 1 2 Mentally Deficient. Feeble Minded. Attending Public Elementary Schools ... 3 5 8 Attending Certified Schools for Mentally Defective Children ... ‡62 54 116 Notified to the Local (Control) Authority during the year ... 2 3 5 Not at School 5 3 8 Imbeciles. At School 1 1 2 Not at School 5 1 6 Idiots. 2 1 3 Epileptics. Attending Public Elementary Schools ... 3 2 S Attending Certified Schools for Epileptics 2 5 Not at School 2 2 4 Physically Defective. Pulmonary Tuberculosis. Attending Public Elementary Schools ... 53 46 99 Attending Certified Schools for Physically Defective Children ... 3 1 4 Not at School 21 9 30 Other Forms of Tuberculosis. Attending Public Elementary Schools ... 5 18 23 Attending Certified Schools for Physically Defective Children 16 4 20 Not at School 11 9 20 Cripples Other Than Tubercular. Attending Public Elementary Schools ... 10 8 18 Attending Certified Schools for Physically Defective Children 20 19 39 Not at School 8 3 11 Physically Defective other than Tubercular and other than Cripples. Attending Public Elementary Schools 4 5 9 Attending Certified Schools for Physically Defective Children 8 3 11 Not at School 0 15 15 Dull or Backward. Retarded i year 23 10 33 Retarded 2 years 13 10 23 Retarded 3 years 5 2 7 JTwo also partially blind. 85 Blind and Partially Blind Children.—A school for blind children is not maintained by the Authority, but children are sent to day or residential institutions as may be necessary. The following Table, No. 59, gives certain particulars with regard to the blind and partially blind children educated by the Education Committee during the year 1915. 86 Table No. 59. Initials of Child. Date of Birth Date Examined. Date reported by Medical Officer to Committee and Case No. Date entered Institution. Name of Institution. Date left Institution and remarks. F.H. 2-11-'93 ... ... 3- 7- 02 Royal Normal College (Scholarship Resident) 31-12- 15 W.L.W. ... 26- 5-'o1 ... ... 27- 1- 08 Swiss Cottage (Day) ... D.I.C. 2- 1-'01 ... ... 16- 3-'09 Edinborough Road, London (Day) ... 114- 1-'14 Swiss Cottage (Resident) R.S. 10- 9-'o1 ... ... 20- 9-'1o Royal Normal College (Resident) ... R.B. 21- 3-'02 ... ... 10-10-'10 Swiss Cottage (Resident) ... E.S. 11-11-'04 ... ... 10-10-'10 Edinborough Road, London ... Swiss Cottage (Resident) ... 27- 4-'l4 E.D. 31 -12-'02 ... ... 25- 4-'11 Royal Normal College (Resident) ... C.R.H. ... 16-11-'99 ... ... — 9-'11 Swiss Cottage (Resident) Reached 16 years Nov., 1915. (Education to be continued) F.L. 8- 6-'02 ... ... 8- 1 -'12 Barlby Road (Day) ... 10-11-'13 Swiss Cottage (Resident) W.G.G. ... 4-11-'04 ... ... 8- 1-'13 Swiss Cottage (Day) ... H.G. 5-10-'01 19- 6-'l2 23- 9-'l2 26- 3-'13 Swiss Cottage (Day) ... E.M.S. ... 11- 6-'O5 19- 2-'l3 31-3-'13 & 29- 3-'15 (35) 17-11-'13 Swiss Cottage (Day). In hospital 12-3-'15. Will require Resident Institution on discharge Removed from district 22-11-'15 A.S.Mc.I. 11- i-'o7 30-1-'14 4- 2-' 14 23- 2-'l4 Swiss Cottage (Day) Removed from district Jan., P.V.* 16- 8-'03 30- 9-'14 26-10-'14(23) 14- 9-'14 Leinster Road, M.D. School (Day) [1915 H.G.L. ... 27-3-'04 26- 9-'11 30-10-'11 23- 9-'14 Swiss Cottage (Resident) ... E.B. 25- 6-'99 3-10-'14 28- 9-'14 20-i0-'14 Swiss Cottage (Day) ... 25-6-'15 F.C.* ... 28-10-'03 27-11-'l4 29- 3-'15(36) 11- 1-'15 Leinster road M.D. School (Day) ... N.G. 4- 6-'O4 25-10-'i4 23-11-*14( 17) 22- 2-'l5 St. Anne's Ophthalmia School, Portobello Rd. ... M.G. 27- 3-'03 6- 3-'15 29- 3-'15(34) 21- 4-'15 St. Anne's Ophthalmia School, Portobello Rd. ... E.T. 27- 9-'03 14-12-'14 25- 1 -'15(12) 30- 4-'15 Swiss Cottage (Resident) ... G.E. 20 12-'06 26- 2-'15 28- 6-'15(56) 26- 5-'15 Swiss Cottage (Resident) St. John's (Baptist) Ophthalmic School ... R.W. 10- 7-'04 16- 4-'i5 19- 5-;15(32) 12- 6-'15 ... O.G. 27- 5-'04 13-7-'15 25-10-'15(14) 12- 7-'15 Barlby Rd. (Day) Awaiting admission to Royal Normal College E.T. 2-12-'00 14- 1-'15 22- 2-'l5(l2) 14- 8-'15 Barclay Home, Brighton ... S.H.* 1-11-'08 15- 9-'14 26-10-' 14(ll) ... Under school age. Was notified to Local Control Authority in 19l4,and removed from observation ... W.W. ... 16-1 i-'01 20-11-'14 2I-I2-'l4 (9) ... Awaiting admission ... F.M.B. ... 15-9-'03 6-11-'l4 21 -12-'14( 26) ... Awaiting admission Left district before admission *Also feeble-minded. Instruction given by Special Teacher. 87 Deaf and Partially Deaf Children.—A school for the deaf is not maintained by the local Education Authority, but certain children resident within the area of the Authority are educated by deaf methods at approved institutions. The following Table, No. 60, gives particulars of deaf . children being educated by the Education Committee during the year 1915. Table No. 60. Initials of Child. Date of Birth Date examined. Date reported by Medical Officer to Committee, and Case No. Date entered Institution. Name of Institution. Date left Institution and remarks.  e.m. 10-10-'02 ... 1- 6-'1o - 9-'1o Margate (Resident) Dec., 1915 Removed from t.h.b. 23- 7-'03 ... 5- 7-'11 31- 8-'11 do. ... [district H.A.H. 17- 6-'02 ... 5- 7-'11 31- 8-'11 do. ... E.G.S. 17- 5-'04 ... 5- 7-'11 31- 8-'11 do. ... a.r.n. 23- 5-'05 19- 3-'12 and 6-12-'13 29- 5-'12 and (27- 1-'13 14- 4-'13 do. ... W.S. 31-10-'06 16- 2-'12 1-10-'13 11-11-'13 do. ... LJ.T. 8- 8-'05 19- 3-'l2 29- 5-'12 11-11-'13 do. ... F.J.H. 30-10-'06 1- 7-'13 22- 9-'13 11-11 -'13 do. ... I.M.H. 9- 1-'09 1-10-'13 27-10-'13 27- 8-'14 do. ... s.n. 27- 7-'o2 6- 8-'14 7-10-'14 27- 8-'14 do. ... e.C.N. 18- 4-'09 6- 8-'14 7-10-'14 27- 8-'14 do. ... g.n.l.b. 19- 2-'09 1- 2-'15 29- 3-'15 11- 5-'15 Friar Gate, Derby (Resident) ... i.r. 3- 9-'04 12- 7-'15 25-10-'15 (13) 1-10-'15 do. Left Dec., 1915 d.b. 2- 7-'06 1- 7-'15 25-10-'15 3) 29-11-'15 Fitzroy Square (Day) ... *C.P. 13-5-'04 30- 9-'14 26-10-'14 (14) ... Taken over by London County Council H.H. 23-11-'09 28- 9-'15 25-10-'15 (59) ... Awaiting admission to Margate School h.r. 25- 3-'08 i2-10-'15 25-10-'15(64) ... Awaiting admission to Margate School *Partially deaf child attending a Willesden school, but residing in London. 88 89 The Mentally Defective.—Two schools for this class of children are maintained by the Education Authority, as under:— Name of School. Effective accommodation, 22-2-'l6 No. on roll, 22-2-' l6 No. awaiting admission, 22-2-'16 Leinster Road, Mentally Defective 8o 65 0 Leopold Road, do. 38 46 4 In addition, the following feeble-minded child is educated at a residential institution by the Willesden Education Authority as shown:— Table No. 61. Initials of Child. Date of Birth. Date Examined. Date reported by Medical Officer to Committee and Case No. Date entefed Institution Name of Institution. Date left Institution and remarks. L.W. 2-5-'01 2I-7-'14 28-9-'14 (28) 21-5*'15 Western Counties Asylum, Starcross, Devon. Epileptic Children.—Cases of severe epilepsy are best dealt with at residential institutions. The Willesden Education Authority does not maintain any such institution, but in certain cases pays for the maintenance of children at epileptic colonies or other recognised institutions. Mild cases sometimes only have fits during the night, and such children can attend an ordinary elementary school. 1 he following Table, No. 62, shows the cases of epileptic school children sent to institutions by the Willesden Education Authority:— 90 Table No. 62. Initials of Child. Date of Birth. Date examined. Date reported by Medical Officer to Committee, and Case No. Date entered Institution. Name of Institution. Date left Institution and remarks. K.B. 12- 2-'02 4-I2-'l2 4- 6-'13 12- 6-'13 Lingfield Epileptic Colony ... W.C.M. 15-10-'01 23-I2-'l3 4- 2-'14 11- 9-'13 Chalfont do. ... A.W. 27- 2-'01 18- 6-'13 1- 7-'I3 26- 8-'14 27-10-'13 28-I2-'14 Chalfont do. left 18-11 -'15 A.W. 17- 4-'01 15- 9-'14 26-10-'14 15- 6-'15 Maghull do. ... H.G.N. 2-11-'08 19- 3-'15 14- 4-'15 (37) 24- 6-'15 Lingfield do. ... The Physically Defective.—One school is maintained by the Authority for this class of children, viz.:— Effective No. No. awaiting Name of School. accommodation, on roll. admission. Furness Road, Physically Defective 69 63 31 The following Table, No. 63, shows the various conditions from which the above children are suffering:— Table No. 63. On Roll of Furness Road Physically Defective School. On Waiting List for Furness Road Physically Defective School or Open-air School. I. Tuberculosis— Pulmonary — 1 Non-Pulmonary 19 9 2. Paralysis 30 7 3. Deformities not included in 1 and 2 5 3 4. Heart Disease 4 11 5. Other Conditions 5 0 Total 63 31 91 The following Table, No. 64, shows the physically defective children maintained at institutions by the Willesden Education Authority:— Table No. 64. Initials of Child. Date of Birth. Date examined. Date reported by Medical Officer to Committee, and Case No. Date entered Institution. Name of Institution. Date left Institution and remarks. Pulmonary Tuberculosis G.O. 9-'02 ... ... 31-10-'14 Kensal House School Transferred from London A.T. 23-11 -'02 ... ... 12- 4-'15 Kensal House School Transferred from London. Left 10-9-'15 T.E.W. 21 - 8-'00 I9-2-'!5 29-3-'15(25) 26- 6- '15 East Anglian Sanatorium ... K.E.W. 13- 3-'03 ... ... 28- 6-'15 Kensal House School Transferred from London G.D.R.L. 20- 6-'03 14-1'I5 22-2-'15 (3) 18- 9-'15 East Anglian Sanatorium ... Other Forms of Tuberculosis J.B. 7- 6-'06 6-7-'14 28-9-'14 (34) 15-1o-'14 St. Vincent's Cripples' Home, Eastcote, Pinner ... PROVISION OF MEALS. Education (Provision of Meals) Acts, 1906 and 1914.—The Education Committee at its meeting on the 14th April, 1915, passed the following resolutions relative to the above:— (a) That the arrangements for the administration of the Education (Provision of Meals) Acts be placed in the charge of the School Medical Officer. (b) That, for the time being, the School Medical Officer be authorised to appoint temporarily a person to superintend the feeding centres. 92 (c) That the payment of wages and accounts and keeping of account books be carried out by the Accountant, in accordance with the existing system for other departments. (d) That the Secretary of the Education Committee carry out the usual duties of Clerk of the Committee, including the preparation of contracts for foodstuffs and other requirements, such as the necessary apparatus, utensils, crockery and other ware at the centres; and also arrange for recovery of cost of meals, when duly authorised by resolution of the Committee. Under resolution (b) above, Miss E. M. Carter was appointed supervisor of the feeding centres. There are five centres under the control of the Education Committee, one centre, the Kilburn Centre under the control of a voluntary body, and one coffee house at Cricklewood where children receive meals. Children may be fed on application to the Head Teachers or the Superintendents at the centres. The circumstances of all cases so added to the feeding lists are investigated within a few days of being put on. If the family circumstances show after deductions are made for rent, fares and insurance a net amount per head of the family of 3/6 or less, the children are retained on the feeding list. If the figure is above this amount, and the visitor, who is also a trained nurse, is of opinion that the children are well-nourished, the names are taken off the feeding list. If on the other hand the visitor is of opinion the children are ill-nourished, the children are referred to the Medical Officer for his decision as to whether or not the case should be retained on the feeding list. All cases struck off the feeding lists are reported to the Education Committee in due course. A register of the children fed is kept at each of the feeding centres. 93 The meals provided consist of dinners which are supplied on all days (school holidays included) except Saturdays and Sundays. Formerly one-course dinners only were supplied, but on the 12th July, 1915, two-course dinners were instituted and became general throughout the feeding centres controlled by the Committee. On the 25th October, 1915, when the charges for dinners at the voluntary centre at Kilburn were increased from 2½d. to 4d., the secretary of that centre agreed to the meals being made approximately equal to those given at the Committee's Centres. The following statement shows the dietaries in operation at the feeding centres on 14th February, 1916 Monday.—Meat and potato hash with beans and gravy, bread. Buttered rice. Tuesday.—Green peas and vegetable soup, bread. Baked jam roly-poly. Wednesday.—Shepherd's pie or minced meat and mashed potato, bread. Baked ginger pudding. Thursday.—Brown haricot soup and dumplings, bread. Cornflour and stewed fruit. Friday.—Fish and potato pie, green peas, parsley sauce, bread; or stewed fish and mashed potatoes. Suet pudding and treacle. Monday.—Lentil soup, dumplings, bread. Treacle tart. Tuesday.—Sailor's pie, cabbage, gravy, bread. Baked semolina pudding. Wednesday.—Savoury rice and cheese, peas, gravy, bread. Suet and jam roll. Thursday.—Scotch barley broth, bread. Baked bread and butter pudding. Friday.—Fish and potato pie, bread, green peas, parsley sauce or stewed fish and mashed potatq. Boiled apple roll. 94 Monday.—Boiled rabbit with rice and onion sauce. Currant bread. Tuesday.—Potato and onion soup with dried green peas, bread. Currant or fig pudding. Wednesday.—Cottage pie, green peas and gravy. Rice mould and jam. Thursday.—Irish stew, bread. Treacle tart. Friday.—Cheese and lentil savoury, bean gravy, bread. Ginger pudding baked. Monday.—(as alternative.) Roast mutton, potatoes, cabbage, gravy, bread. Currant bread and margarine. The following tables Nos. 65 and 66 show the total number of meals supplied, and the average daily number of individual children fed in each week of 1915, and corresponding weeks of the two previous years, so far as figures are available. 95 Table No. 65. Return of meals supplied. Week ending 1915 1914 1913 Week ending 1915 1914 1913 Jan. 2 Nil Nil Nil July 3 396I 2293 2880 „ 9 Nil Nil 5013 ,, 10 3885 2419 2953 „ 16 5842 4345 5197 .. 17 3570 2489 2944 .. 23 5933 4565 5464 „ 24 2925 1423 1760 (Schools closed 23-7-13) „ 30 6206 4785 5371 Feb- 6 6360 4854 5334 „ 13 6445 4616 5091 „ 20 6159 4548 5145 .. 31 1886 Holidays Holidays .„ 27 6027 4299 5287 Aug. 7 1236 Holidays Holidays Mar. 6 6065 4044 4919 » 14 1347 Holidays Holidays .. 13 5841 3950 (Approx.) 4692 ,, 21 1318 3651 Holidays 28 1247 5567 2319 ,, 20 556I 3905 (Approx.) 2310 (Easter Holidays) Sept. 4 1761 6771 2518 ,, 11 2306 7508 2720 » 18 2384 8175 2869 „ 27 5471 4000 Easter Holidays 25 2368 8553 2992 Oct. 2 2402 8981 3096 Apl. 3 4392 ... 4125 » 9 2445 8729 3018 „ 10 3096 ... 37 29 ,, 16 2377 8685 3173 „ 17 4845 Easter Holidays 3652 „ 23 2128 8688 2686 .. 30 1947 8066 2188 „ 24 4747 3172 3622 Nov. 6 2083 8385 3684 May 1 3521 3032 3387 .. 13 2340 8294 3738 ,, 8 3453 2972 3363 ,, 20 2216 8036 3996 „ 15 3253 3OI9 1981 (Whitsun Holidays) .. 27 2109 7810 4119 Dec. 4 1903 7429 4098 ,, 11 1914 7304 3954 „ 22 4273 2606 3'39 „ 18 1880 6888 3820 „ 29 2965 2867 3035 » 25 1643 39i8 June 5 4203 1917 2965 „ 12 4020 2844 2967 „ 19 4210 2774 2906 ,, 26 3991 2428 2395 96 Table No. 66. Return of children fed. Week ending 1915 1914 1913 Week ending 1915 1914 1913 Jan. 2 Nil Nil ... July 3 887 ... ... „ 9 Nil Nil ... „ 10 889 ... ... ,, 16 1333 956 ... „ 17 834 ... ... „ 23 1347 990 ... „ 24 784 ... ... „ 30 1404 1020 ... „ 31 484 Holidays Holidays Feb. 6 1412 1045 ... Aug. 7 382 Holidays Holidays .. 13 1432 1014 ... ,, 14 354 Holidays Holidays >> 20 1375 982 ... 21 325 ... ... ,, 27 1352 941 ... „ 28 315 1399 509 Mar. 6 1339 873 ... Sept. 4 479 1562 560 .. 13 1332 852 ... ,, 11 513 1724 579 „ 20 1254 849 ... „ 18 5H 1830 608 27 1198 858 ... 25 521 1917 640 Apr. 3 1117 824 ... Oct. 2 532 2007 639 „ 10 815 782 ... ,, 9 538 1950 642 17 1038 Easter Holidays ... ,, 16 509 1964 692 ... ,, 23 493 1945 722 24 954 687 ... „ 3° 496 1976 750 May 1 1017 642 ... Nov. 6 510 1890 774 ,, 8 997 633 ... .. 13 507 1850 814 .. 15 971 639 ... „ 20 491 1732 851 22 937 630 ... ,, 27 465 1762 875 .. 29 929 ... ... Dec. 4 418 1670 868 June 5 920 ... ... ,, 11 423 1628 871 „ 12 903 ... ... „ 18 417 1546 850 .. 19 881 ... ... ,, 25 410 1403 ... ,, 26 891 ... ... The following Table, No. 67, gives certain particulars as to the number of children fed and the cost of feeding for four-weekly periods since the four-weekly period ending 12th June, 1915:— 97 Table No. 67. 4 weeks ending 12-6-15 4 weeks ending 10-7-15 4 weeks ending 7-8-15 4 weeks ending 4-9-15 4 weeks ending 2-10-15 4 weeks ending 30-10-15 4 weeks ending 27-11-15 4 weeks ending 25-12-15 Average Number of children fed per week 921 894 620 406 518 505 491 416 Number of children receiving special meals ... 3 3 1 3 6 6 8 Number of meals provided 16139 16824 10166 606l 10045 9563 9414 7988 Number of special meals provided ... 43 24 3 68 109 139 143 Number of meals for children 15479 16047 9617 5673 9460 8883 8748 7340 Number of meals for assistants 660 Lunches 157 251 186 242 274 262 252 Dinners 377 274 199 275 297 265 253 Cost of food £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. *132 15 2¼ †166 4 5¼ ‡104 15 10¾ 62 7 10¼ 90 16 2½ §103 15 6¼ 112 1 1 95 4 1 Salaries and Wages **62 1 0 80 14 4½ 78 4 4¾ 72 12 9¾ 60 7 2½ 57 15 11½ 52 3 11¼ 50 8 10½ Other costs ***22 4 5¼ 65 8 4¾ 45 12 7¼ 50 19 5¾ 30 7 0¼ 22 18 6¾ 33 3 11 25 14 9 Total cost 217 0 7½ 312 7 2½ 228 12 10¾ 186 0 1¾ 181 10 5¼ 184 10 0¼ 197 8 11½ 171 8 2¾ Average cost for food per head in pence 210 2.39 2.37 2.47 2.16 2.60 2.85 2.86 Average total cost per meal in pence 3.16 4.45 5.39 7.36 4.33 4.63 5.03 5.15 Highest number of children paying ... 82 Wholly 88 75 100 113 94 69 Partly 1 Total amount received from children paying ... ††2 19 5 5 10 6 2 16 3 12 5 3 12 13 9½ 13 15 9½ 11 17 9 *Includes Kilburn meals at l|d. each and Cricklewood meals at 2½d. each. †Kilburn meals raised to 2¼d. on 14/6/15. ††For one week only. **Assistants' wages increased by 3/- per week, approximately equal to 20% on 7/6/15 ‡Approved 2-course menus used for first time during a complete 4-weekly period. ***Not including charges in respect of heating, lighting, rent. §Kilburn meals raised to 4d. on 25/10/15, Cricklewood meals raised to 3d. on 25/10/15. 98 It will be noted that, from the foregoing Table, although the number of meals provided has fallen from 16,139 for the four-weekly period ending 12th June, 1915, to less than half the number, namely, 7,988, for the four-weekly period 25th December, 1915, there has not been a corresponding reduction in the total cost of the meals. This is due mainly to the improved dietary and increased cost of food during this period, the increased wages paid to assistants, to the fact that the charges for the provision of premises remains constant irrespective of the number of meals supplied, and because with five separate feeding centres it is not possible to reduce the number of assistants in the same proportion as it would be if there was one central kitchen. It should also be noted that the charges for the meals supplied under contract at the voluntary centre (Kilburn) have gone up from l¾d. 10 4d. during the period under review, while the meals supplied at the Coffee House have gone up similarly from 2½d to 3d. per meal. Service of Meals.—The following rules for the service of meals have been drawn up and are in operation at each of the centres of the Committee:— Rules for the Serving of Meals at the Centres for the guidance of Superintendents and Monitors. Food to be apportioned by the Superintendent or an Assistant. Superintendent or Assistant to keep register, direct seating of children, and overlook monitors. Monitors to be selected from the elder boys and girls, one to every 20 children. Each monitor to serve for four weeks or longer. Monitors to be at centre as soon after 12 noon as possible. 99 Each monitor to set his or her own table with spoons and forks as required, and place a slice of bread for each child. Mugs and water to be arranged by monitors on a side table and given at the close of the meal when requested. A separate mug to be used for each child. Each monitor to wait on children at their allotted table. Monitors after each course to collect the plates, scrape the bits into a pail, pack the plates neatly together, and arrange the spoons and forks separately. Monitors to have dinner after the other children have finished. No food to be served before the entry of the children. As far as possible infants and small eaters to be served at separate tables. The children must eat the first course before being allowed any second course. The first course to be cleared away before the second course is served. No dirty plates or spoons to be left on the table. The children must understand that food asked for as a second helping must be eaten. The children must come with clean hands and faces and keep the tablecloth as clean as possible. Grace should be said or sung before and after the meal. Special Meals.—These consist of ½ pint of milk given at 11 a.m. daily by the Head Teachers to children specially selected by or brought to the notice of the Medical Staff. Millesden Urban District Conncil. 24th ANNUAL Hospital Report For the Year 1915. GEORGE F. BUCHAN, M.D., D.P.H., Medical Officer. 103 HOSPITAL REPORT FOR THE YEAR 1915. The number of patients admitted during the year 1915 was 706, as compared with 979 in 1914 and 721 in 1913. The following Table, No. 1, gives particulars of the cases under treatment at the Hospital during the year:— Table No. 1. Scarlet Fever. Diphtheria. Enteric Fever. Other Diseases. Tuberculosis. Total. No. of cases admitted, 1915 341 193 2 115 55 706 No. under treatment at 31/12/14 67 23 1 10 0 101 Total No. „ during 1915 408 216 3 125 55 807 No. discharged ” 1915 356 172 2 I08 15 653 No. died ” 1915 14 24 1 15 24 78 Mortality % ” 1915 3.4 11.1 33.3 I2.0 43.6 9.7 Remaining in Hospital 31/12/15 38 20 0 2 l6 76 On December 31st, 1914, 101 patients remained in Hospital, so that the total number of cases under treatment during 1915 was 807, as compared with 1,091 in 1914. The average number of patients under treatment each day during the year was 83.38, as compared with 102.17 in the previous year. Scarlet Fever patients remained in Hospital on an average 47.3 days, Diphtheria patients 24.9 days, and those suffering from other diseases, excluding Tuberculosis, 16.6 days. Table No. 2. Month. Scarlet Fever. Diphtheria. Enteric Fever. Other Diseases. Tuberculosis. Total Admissions. Total Deaths. Admissions. Deaths. Admissions. Deaths. Admissions. Deaths. Admissions. Deaths. Admissions. Deaths. January 29 1 17 1 - - 15 1 - - 6l 3 February 25 9 1 1 1 8 17 1 60 3 March 25 1 17 2 11 1 7 3 60 7 April 34 4 11 4 23 4 5 4 73 16 May 50 4 16 — 1 16 3 5 2 88 9 June 30 2 11 2 10 3 4 2 55 9 July 32 — 23 — 10 1 6 5 71 6 August 20 — 12 2 2 — 1 3 35 5 September 25 1 11 2 2 — 1 1 39 4 October 19 — 24 3 10 — 2 2 55 5 November 19 — 24 5 - 5 1 6 1 54 7 December 33 - 18 2 3 1 1 — 55 3 Total 341 13 193 24 2 1 115 15 55 24 706 77 104 105 Table No. 3. SCARLET FEVER. age. males. FEMALES. TOTAL. Admissions. Deaths. Admissions. Deaths. Admissions. s. Under i yr. - - 1 - 1 - 1 to 2 2 3 5 2 to 3 6 1 7 1 13 2 3 to 4 15 1 9 1 24 2 4 to 5 20 1 12 32 1 5 to 1o 72 1 70 2 142 3 1o to 15 35 3 35 1 70 4 15 to 20 10 — 14 24 — 20 to 25 4 — 3 7 — 25 to 30 3 — 6 9 — 3° to 35 3 — 6 1 9 1 35 to 4 2 — — 2 — 40 to — - - 3 - 3 - Total 172 7 169 6 341 13 Table No. 4. Chief Complications of Scarlct Fever. Number of Cases. Rheumatism 19 Albuminuria 48 Nephritis 21 Otorrhœa 38 Adenitis 94 „ Suppurative 7 Mastoiditis 2 Relapse 3 106 Table No. 5. D1PHTHER1A. age. males. FEMALES. TOTAL. Admissions. Deaths. Admissions. Deaths. Admissions. Deaths Under 1 yr - - - - - - 1 to 2 1 2 5 3 1 15 6 2 to 3 7 1 3 2 1O 3 3 to 4 12 2 10 1 22 3 4 to 5 7 1 6 1 13 2 5 to 1o 39 4 51 5 90 9 10 to 15 14 — l6 — 30 — 15 to 20 1 — 3 — 4 — 20 to 25 2 — 1 — 3 — 25 to 30 — — 2 — 2 — 3° to 35 1 — 1 — 2 — 35 to 40 - - - - - - 40 to — - - 2 1 2 1 Total 95 13 98 11 193 24 Table No. 6. Chief Complications of Diphtheria. No of Cases. Paralysis 1 1 Albuminuria 34 Otitis Media 2 Broncho-Pneumonia 3 39 cases suffered from laryngeal symptoms. Tracheotomy was performed on 17 patients, of whom 10 recovered. 107 Table No. 7. DIPHTHERIA. Day of Disease on Admission. Admissions. Deaths. Case Mortality. I St 7 - 0 2nd 46 5 1o.86 3rd 37 5 13.51 4th 30 2 6.66 5th 29 6 20.65 6th and over 44 6 13.63 Cerebrospinal Meningitis.—34 patients were admitted during the year as suffering from this disease. Of this number 20 were cases of Cerebro-spinal Meningitis, eight were Tuberculous Meningitis, and six were cases of other diseases. Of the 20 cases of Cerebro-spinal Meningitis 13, or 65 per cent., recovered, a very high proportion for this disease. 108 Table No. 8. Showing cases wrongly diagnosed and diseases for which they were mistaken. Certified as suffering from Diagnosed in Hospital as suffering from Cerebrospinal Meningitis Scarlet Fever. Diphtheria. Enteric Fever. 11 9 Tonsillitis 1 — — — Puerperal Septicæmia 1 — 1 Lobar Pneumonia — 11 1 — No apparent disease — 12 — — Erythema — — - 1 Pulmonary Tuberculosis — 2 — — Septic Rash — 5 1 — Measles — 3 — — Rotheln 1 — 1 — Scarlet Fever — 2 — — Dermatitis 8 — — 1 Tuberculous Meningitis — 1 — — Otorrhœa 1 — — — Influenza 2 — - — Mental Strain — 1 - — Rhinitis — 1 1 — Adenitis — 2 — — Urticaria 14 51 13 3 Total 81 109 Coexistent Diseases. Twenty-nine patients were, on admission, found to be suffering from more than one disease. The diseases were combined as follows:— Scarlet Fever and Diphtheria 13 Scarlet Fever and Chicken Pox 10 Diphtheria and Chicken Pox 5 Diphtheria and Rheumatic Fever 1 Other Diseases. 29 Fifty patients suffering from diseases not as a rule treated in this Hospital were admitted for special reasons. They were : Measles, 18; Meningitis, 28; Mastoid Disease, 2; Erysipelas, 5; Puerperal Fever, 1; Pneumonia, 2; while one infant was accommodated whose mother was admitted as a patient. Bacteriological Work. The number of examinations conducted in the Hospital laboratory was 1,038, as shown in the following Table, No. 9:— Table No. 9. Nature of Specimens examined. Positive Result. Negative Result. Total. 1. Throat and Nose Swabs for Diphtheria Bacilli, etc. 79 667 746 2. Sputum for Tubercle Bacilli 99 181 280 3. Blood for Widal Test 1 11 12 Total 179 859 1038 110 Sick Staff. A smaller number of members of the staff were incapacitated for duty for more than twenty-four hours at a time in 1915 than in 1914, the corresponding numbers being 17 in 1915 and 54 in 1914. The aggregate number of days they were ill was 467, 193 fewer than in 1914, and the average period off duty was 27.4 days, as against 12.2 days per person in the previous year. One nurse, two ward maids, and one laundry maid contracted Scarlet Fever, and two nurses Diphtheria, all of whom made good recoveries. One sister underwent an operation for Appendicitis. Hospital Buildings. No additions or alterations calling for comment were made during the year. Table No 1. VITAL STATISTICS OF WHOLE DISTRICT DURING 1915 AND PREVIOUS YEARS. Year. Population estimated to Middle of each Year. Births. Total Deaths Registered in the District. Transferable Deaths: Nett Deaths belonging to the District. Uncorrected Number. Nett. Under 1 Year of Age. At all Ages. Number. * Rate. of nonresidents registered in the District. † of residents not registered in the District. † Number. * Rate per 1, 000 Nett Births. Number. * Rate. Number. † Rate. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) 1910 153,253 ... 3,923 25.6 1,313 8.6 13 206 313 80 1,506 9.8 1911 156,572 3,863 4,001 25.6 1,6l8 10.3 10 240 495 124 1,848 11.8 1912 159,868 3912 4,075 25.5 1,307 8.7 27 233 328 80 1,603 10.02 1913 163,644 3,891 4,037 24.7 1,449 8.9 23 251 325 80 1,677 10.24 1914 166,634 3,971 4,115 24.7 1,501 9.0 32 283 337 82 1,752 10.51 1915 166,840 3,641 3,775 22.6 1,792 10.7 44 282 344 91 2,030 12.16 Ill APPENDIX A. LOCAL GOVERNMENT BOARD TABLES. Table Ia. VITAL STATISTICS OF THE WARDS—1915. WARDS. Population estimated to Middle of Year. Births. Total Deaths Registered in each Ward. Transferable Deaths: Nett Deaths belonging to each Ward. Uncorrected Number. Nett. of nonresidents registered in each Ward. † of residents not registered in each Ward. † Under 1 year of Age. At all Ages Number Rate. Number. * Rate. Number * Rate per 1000 Nett Births. Number. * Rate. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) South Kilburn 14,578 386 418 28.67 236 1618 1 39 64 153.11 274 18.79 Mid Kilburn 14,601 315 332 22.73 184 I2.6o ... 32 31 93.37 216 14.79 North Kilburn 12,467 170 186 14.91 136 10.90 2 30 20 107.52 164 13.15 Brondesbury Park 9,921 157 158 15.92 78 7.86 7 9 7 44.30 80 8.06 Kensal Rise 14,206 311 325 22.87 124 8.72 ... 30 29 89.23 154 10.84 Harlesden 17,369 386 396 22.8o 171 9.84 ... 22 27 68.18 193 11.11 Stonebridge 17,711 465 467 26.36 202 11.40 6 26 44 94.21 222 12.53 Roundwood 15,662 371 380 24.26 184 11.74 9 23 43 113.15 198 12.64 Church End 14,194 374 378 26.63 148 10.42 7 15 34 89.94 156 10.99 Willesden Green 16,768 388 391 23.31 176 10.49 6 25 27 69.05 195 11.62 Cricklewood 19,363 318 319 16.47 153 7.90 6 31 18 56.42 178 9.19 112 113 NOTES TO TABLES I. and la. Tables I. and Ia. are arranged to show the gross births and deaths in the District, and each ward, and the births and deaths properly belonging to them with the corresponding rates. The rates are calculated per 1,000 of the estimated gross population. *In Column 6 are included the whole of the deaths registered during the year as having actually occurred within the district, but excluding the deaths of soldiers and sailors. *In Column 12 is entered the number in Column 6, corrected by subtraction of the number in Column 8 and by addition of the number in Column 9. *In Column 10 the deaths are similarly corrected by subtraction of the deaths under 1 year, included in the number given in Column 8, and by addition of the deaths under 1 year, included in the number given in Column 9. †Column 4.—This number has been obtained by adding to the number shewn in Column 3 the number of births belonging to the district but occurring outside and subtracting the number occurring in the district but belonging to other districts. †Column 8.—This number is the number of deaths excluded from the returns of the local Registrar as transferable deaths defined below. †Column 9.—This number is the number of deaths transferred to the district by the Registrar-General. Transferable Deaths" are deaths of persons who, having a fixed or usual residence in England or Wales, die in a district other than that in which they resided. The deaths of persons without fixed or usual residence, e.g., casuals, are not included in Columns 8 or 9, except in certain instances under 3 (b) below. The following special cases arise as to Transferable Deaths:— (1) Persons dying in Institutions for the sick or infirm; such as hospitals, lunatic asylums, workhouses, and nursing homes (but not almshouses) must be regarded as residents of the district in which they had a fixed or usual residence at the time of admission. If the person dying in an Institution had no fixed residence at the time of admission, the death is not transferable. If the patient has been directly transferred from one such institution to another, the death is transferable to the district of residence at the time of admission to the first Institution. (2) The deaths of infants born and dying within a year of birth in an Institution to which the mother was admitted lor her confinement should be referred to the district of fixed or usual residence of the parent. (3) Deaths from Violence are to be referred (a) to the district of residence, under the general rule; (b) if this district is unknown, or the deceased had no fixed abode, to the district where the accident occurred, if known; (c) failing this, to the district where death occurred, if known; and (d) failing this, to the district where the body was found. Area of District in acres (land and inland water), 4,384. Total population at all ages 154,344 At Census, 1911 Total families or separate occupiers 35,478 114 MILITARY DEATHS NOT INCLUDED IN TABLES I. and Ia. No. of Deaths. Cause of Death. Age. Ward. 1 Compound shrapnel fracture, skull 18 1 1 Accidental—Thrown from horse 35 2 1 Accidental—Killed by train 62 7 1 Acute Cerebro-spinal Meningitis 21 10 1 Epidemic Cerebro-spinal Meningitis 20 10 1 Tubercle of Lungs 18 10 1 Appendicitis 46 1 1 Appendicitis 23 11 1 Pneumonia 56 11 1 Erysipelas 34 9 1 Cerebral Haemorrhage 53 10 1 Cerebral Haemorrhage 45 9 MILITARY CASES OF INFECTIOUS DISEASE NOT INCLUDED IN TABLE II. Register No Infectious Disease. Age. Ward. 643 Erysipelas 45 3 841 Erysipelas 34 9 652 Scarlet Fever 22 7 94 Typhoid Fever 20 3 150 Cerebro-spinal Meningitis 20 11 331 Cerebro-spinal Meningitis 30 8 229 Cerebro-spinal Meningitis 22 8 461 Cerebro-spinal Meningitis 20 8 1,197 Pulmonary Tuberculosis 25 3 1,355 Pulmonary Tuberculosis 45 9 1,412 Pulmonary Tuberculosis 22 9 1,422 Pulmonary Tuberculosis 22 2 1,440 Pulmonary Tuberculosis 33 10 TABLE II.—CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR 1915. Notifiable Disease. Number of Cases Notified. Total Cases Notified in each Ward. At all ages. At Ages—Years. South Kilburn.. Mid-Kilburn. North Kilburn. Brondesbury Park. Kensal Rise. Harlesden. Stonebridge. Roundwood. Church End. Willesden Green. Cricklewood. Total Cases removed to Hospital. Under 1 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 45. 45 and under 65. 65 and upwards. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) (17) (18) (19) (20) (21) Small-pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cholera (C) Plague (P) .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diphtheria (including Membranous croup) 231 1 78 128 12 9 2 1 37 24 15 8 14 23 17 39 19 18 17 213 Erysipelas 81 .. 2 4 7 34 25 9 13 10 9 3 3 7 9 6 7 7 7 11 Scarlet Fever 453 4 102 283 42 21 1 .. 39 38 36 19 65 62 51 33 26 49 35 406 Typhus Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric Fever 9 .. .. 3 2 4 .. .. 1 1 .. 1 1 .. 1 1 .. 2 1 9 Relapsing Fever (R) Continued Fever (C) .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever 4 .. .. .. .. 4 .. .. 1 .. .. 1 .. 1 .. .. 1 .. .. 1 Cerebro-spinal Meningitis 29 2 6 8 5 5 2 1 5 2 2 3 5 2 3 5 1 25 Poliomyelitis 3 1 1 1 .. .. .. .. 1 .. .. 1 .. 1 .. .. 1 .. .. 2 Ophthalmia Neonatorum 27 27 .. .. .. .. .. .. 7 1 1 3 3 5 3 3 1 .. 5 Pulmonary Tuberculosis 335 1 10 35 79 159 41 10 34 40 30 12 21 34 33 27 45 25 34 .. Other forms of Tuberculosis 83 5 29 26 13 9 1 .. 11 8 6 6 6 9 10 9 6 7 5 .. Totals 1255 41 228 488 160 245 72 21 149 123 99 52 116 140 131 120 111 114 100 672 The Willesden Isolation Hospital, Neasden, with 166 beds is Provided by the Willesden District Council for patients suffering with infectious diseases other than Small Pox. Cases of Infectious Disease occurring amongst soldiers or sailors are not included in this table. 115 116 TABLE III. CAUSES OF, AND AGES AT DEATH DURING THE YEAR 1915. Causes of Death. Nett Deaths at the subjoined ages of "Residents " whether occurring within or without the District, (a) Total Deaths whether of "Residents" or "NonResidents" in Institutions in the District. (6) All Ages. Under 1 year. 1 and under 2. 2 and under 5. 5 and under 15. 15 and under 25. 25 and under 45. 45 and under 65. 65 and upwards. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) All causes Certified (c) 2O30 344 125 109 113 79 273 427 560 421 Uncertified .. .. .. .. .. .. .. .. .. .. Enteric Fever 5 .. .. .. .. 2 2 1 .. 3 Small-pox .. .. .. .. .. .. .. .. .. Measles 74 13 33 22 6 .. .. .. .. 14 Scarlet Fever 15 .. 1 5 8 .. 1 .. .. 14 Whooping-cough 55 17 19 18 1 .. .. .. .. 9 Diphtheria and Croup 30 .. 7 12 10 .. 1 .. .. 25 Influenza 28 .. 1 .. 1 .. 6 6 13 1 Erysipelas 4 .. .. .. 2 .. 1 .. .. 3 Phthisis (Pulmonary Tuberculosis) 168 2 1 2 7 27 79 42 8 64 Tuberculous Meningitis 30 4 3 14 8 1 .. .. .. 4 Other tuberculous diseases 12 .. 2 1 5 1 1 1 1 6 Cancer, malignant disease 169 .. .. 1 .. 2 20 82 64 34 Rheumatic Fever 9 .. .. .. 3 1 3 2 .. 2 Meningitis (d) 26 5 1 2 7 4 3 2 2 6 Organic Heart Disease 187 .. .. 2 8 7 18 59 93 22 Bronchitis 190 42 15 5 .. 1 5 31 91 l8 Pneumonia fall forms) 177 51 26 12 12 2 23 26 25 27 Other diseases of Respiratory organs 43 3 2 1 2 3 7 10 15 2 Diarrhœa and Enteritis (e) 62 .. 6 3 3 1 3 4 3 4 Appendicitis and Typhlitis l6 .. .. 1 4 2 5 3 1 3 Cirrhosis of Liver 21 .. .. .. .. .. 4 13 4 6 Alcoholism 3 .. .. .. .. .. 2 1 .. 1 Nephritis and Bright's Disease 54 .. .. 1 .. 3 11 21 18 13 Puerperal Fever 4 .. .. .. .. .. 4 .. .. 3 Other Accidents and Diseases of Pregnancy and Parturition 9 .. .. .. .. 1 8 .. .. .. Congenital Debility and Malformation, including Premature Birth 126 125 .. 1 .. .. .. .. .. 12 Violent Deaths, excluding Suicide 66 9 4 3 9 7 10 18 6 16 11 .. .. .. .. .. 4 6 1 .. Other Defined Diseases 434 34 4 3 17 12 52 97 215 109 Diseases ill-defined or unknown 2 .. .. .. .. .. .. 2 .. .. Totals 2030 344 125 109 113 79 273 427 560 421 SubEntries. included in above figures. Cerebro-spinal Meningitis 17 3 .. 1 5 3 3 1 1 5 Poliomyelitis .. .. .. .. .. .. .. .. .. .. Pneumonia other than Broncho Pneumonia 88 10 5 5 5 1 21 23 18 19 117 NOTES TO TABLE III. The classification of Causes of Death are those of the "Short List" on page XXV. of the Manual of the International List of Causes of Death. (a) All "Transferable Deaths" of residents, i.e., of persons dent in the District who have died outside it, are included with the other deaths in columns 2-10. Transferable deaths of non-residents, i.e., persons resident elsewhere in England and Wales who have died an the District, are in like manner excluded from these columns. (b) All deaths occurring in Institutions for the sick and infirm situated within the district, whether 'on residents or nonresidents, are entered in the last column of Table III. (c) All deaths certified by registered Medical Practitioners and all Inquest cases are classed as "Certified"; all other deaths are regarded as " Uncertified." (d) Exclusive of "Tuberculous Meningitis" but inclusive of Cerebro-spinal Meningitis. (e) Includes deaths from Diarrhcea and Enteritis at all ages. N.B.—Deaths of soldiers and sailors are excluded from the total number of deaths registered in the district, and such deaths are in like manner excluded from column 11 of Table III. 118 TABLE No. Ill a. CAUSES OF DEATH CLASSIFIED IN WARDS. Causes of Death. Willesden u. D. South Kilburn. Mid-Kilburn. North Kilburn. Brondesbury Pk. Kensal Rise. Harlesden. StonebFidge. Roundwood. Church End. Willesden Green. CrLklewood. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (12) (13) All causes Certified 2030 274 2l6 164 80 154 193 222 198 156 195 178 Uncertified .. .. .. .. .. .. .. .. .. .. .. .. Enteric Fever 5 1 .. 1 .. 1 .. .. 1 1 .. .. Small Pox .. .. .. .. .. .. .. .. .. .. .. .. Measles 74 19 14 .. 1 4 5 9 4 6 6 3 Scarlet Fever 15 1 1 1 .. 3 1 3 2 2 .. 1 Whooping Cough 55 10 3 .. 1 3 2 17 10 5 2 2 Diphtheria and Croup 30 4 5 1 2 1 3 2 4 4 1 3 Influenza 28 4 3 3 1 1 2 3 1 4 3 3 3 Erysipelas 4 1 .. .. .. .. .. 1 2 .. .. .. Phthisis (Pulmonary Tuberculosis) 168 21 26 26 4 10 12 18 15 12 11 13 Tuberculous Meningitis 30 5 4 1 2 2 4 1 1 1 6 3 Other Tuberculous Diseases 12 .. 1 .. 1 1 1 1 3 3 1 .. Cancer, malignant disease 169 8 16 19 7 12 19 18 13 10 24 23 Rheumatic Fever 9 .. 1 .. .. .. 4 1 .. 2 .. 1 Meningitis 26 2 2 .. 1 2 .. 2 3 4 5 5 Organic Heart Disease 187 18 19 16 13 19 19 23 17 11 17 5 15 Bronchitis 190 33 18 9 8 13 14 21 25 20 21 8 Pneumonia (all forms) 177 38 16 11 7 11 11 39 13 7 16 8 Other Diseases of Respiratory Organs 43 7 6 1 .. 5 6 2 8 1 2 5 Diarrhœa and Enteritis 62 17 8 3 .. 7 2 6 7 6 2 4 Appendicitis and Typhlitis 16 .. 2 5 .. 2 4 .. .. 1 1 4 Cirrhosis of Liver 21 3 4 2 1 1 3 1 3 1 .. 1 Alcoholism 3 .. 1 .. .. .. .. .. 1 .. .. 1 Nephritis and Bright's Disease 54 3 8 5 2 3 5 .. 8 5 7 8 Puerperal Fever 4 1 .. .. .. .. .. .. .. 1 .. .. Other Accidents and Diseases of Pregnancy and Parturition 9 .. .. 1 1 .. 1 2 2 .. 1 1 Congenital Debility and Malformation, including Premature Birth 126 12 11 7 4 11 14 16 18 12 11 10 Violent Deaths, excluding Suicide 65 10 5 5 1 3 6 12 4 7 8 5 Suicide 11 .. .. 1 1 2 .. 1 1 2 1 5 Other Defined Diseases 434 56 42 42 22 36 54 23 31 28 49 51 Diseases ill-defined or unknown 2 .. .. 1 .. 1 .. .. .. .. .. .. Totals 2030 274 216 164 80 154 193 222 198 156 195 178 SubEntries, included in above figures Cerebro-spinal Meningitis 17 2 1 .. .. 1 .. 2 2 4 3 2 Poliomyelitis .. .. .. .. .. .. .. .. .. .. .. .. Pneumonia other than Broncho-Pneumonia . 88 14 8 8 4 5 10 18 7 2 6 6 119 TABLE IV.—INFANT MORTALITY. 191 5.—Nett Deaths from Stated Causes at various Ages wider 1 Year of Age. Causes of Death. Under 1 week. 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 4 Weeks. 4 Weeks and under 3 Months. 3 Months and under 6 Months. 6 Months and under 9 Months. 9 Months and under 12 Months. Total Deaths under One Year. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) All causes Certified 64 23 23 16 126 61 55 57 45 344 Uncertified .. .. .. .. .. .. .. .. .. .. Small-pox .. .. .. .. .. .. .. .. .. .. Chicken-pox .. .. .. .. .. .. .. .. .. .. Measles .. .. 1 .. 1 1 .. 7 4 13 Scarlet Fever .. .. .. .. .. .... .. .. .. .. Whooping Cough .. .. .. .. .. 2 3 4 8 17 Diphtheria and Croup .. .. .. .. .. .. .. .. .. .. Erysipelas .. .. .. .. .. .. .. .. .. .. Tuberculous Meningitis .. .. .. .. .. .. .. 3 1 4 Abdominal Tuberculosis (a) .. .. .. .. .. .. .. .. .. .. Other Tuberculous Dis. .. .. .. .. .. .. .. 1 1 2 Meningitis {not Tuberculous) .. .. .. .. .. 2 1 1 1 5 Convulsions .. .. 1 .. 4 4 1 3 .. 12 Laryngitis .. .. .. .. .. .. .. .. 1 1 Bronchitis 2 .. 2 2 6 9 9 13 5 42 Pneumonia (all forms) 2 .. .. 1 5 7 15 11 13 51 Diarrhoea .. .. .. 1 1 4 1 3 .. 9 Enteritis .. .. 1 1 2 9 9 7 3 30 Gastritis .. .. .. .. .. 1 2 .. 2 5 Syphilis .. .. 2 .. 2 1 .. .. .. 3 Rickets .. .. .. .. .. .. .. .. 1 1 Suffocation, overlying 3 .. .. .. 3 3 2 1 .. 9 Injury at birth .. .. .. .. .. .. .. .. .. .. Atelectasis 3 1 .. .. 4 .. .. .. .. 4 Congenital Malformations (b) 4 4 2 11 1 5 1 1 19 Premature birth 38 9 8 4 59 5 2 .. .. 66 Atrophy, Debility and v Marasmus 12 3 5 5 25 9 3 .. 3 40 Other Causes .. 1 1 1 3 3 2 2 1 11 Totals 64 23 23 16 126 61 55 57 45 344 Nett Births in ( legitimate 3,638 Nett Deaths in legitimate infants 318 the year illegitimate 137 the year illegitimate infants 26 (a) Under Abdominal Tuberculosis are included deaths from Tuberculous Peritonitis and Enteritis and from Tabes Mesenterica. (b) Want of Breast Milk is included under Atrophy and Debility. 120 TABLE IVA.—INFANT MORTALITY. 1915 — Nett Deaths from all Causes under one year of age classified in Wards. CAUSES OF DEATH. WARDS. South Kilburn. Mid Kilburn. North Kilburn. Brondesbury Park. Kensal Rise. Harlesden. Stonebridge. Roundwood. Church End. Willesden Green. Cricklewood. Total for District. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) All Causes Certified 64 31 20 7 29 27 44 43 34 27 18 344 Uncertified .. .. .. .. .. .. .. .. .. .. .. .. Small Pox .. .. .. .. .. .. .. .. .. .. .. .. Chicken Pox .. .. .. .. .. .. .. .. .. .. .. .. Measles 5 4 .. .. .. .. 1 1 .. .. .. .. Scarlet Fever .. .. .. .. .. .. .. .. .. .. .. 13 Whooping Cough 4 .. .. .. 3 1 5 2 1 1 .. .. Diphtheria and Croup .. .. .. .. .. .. .. .. .. .. .. I7 Erysipelas .. .. .. .. .. .. .. .. .. .. .. Tuberculous Meningitis .. .. 1 .. .. .. .. .. 1 .. 1 4 Abdominal Tuberculosis .. .. .. .. .. .. .. .. .. .. .. .. Other Tuberculous Diseases .. .. .. .. .. .. .. .. 2 .. .. 2 Meningitis (not Tuberculous) .. 1 .. .. .. .. 1 1 .. 1 .. .. Convulsions 3 .. .. .. 1 .. .. 1 3 .. 2 12 Laryngitis .. .. .. .. .. .. 1 .. .. .. .. .. Bronchitis 7 3 2 1 4 2 2 7 6 7 1 .. Pneumonia (all forms) 13 4 4 1 3 1 11 6 3 5 .. 42 Diarrhoea 6 1 .. .. 1 .. .. 1 .. .. .. 51 Enteritis 8 4 1 .. 4 .. 4 3 4 .. .. 9 Gastritis .. 1 1 .. .. .. 1 1 .. .. 2 30 Syphilis 1 .. 1 .. .. .. .. .. .. .. .. 5 Rickets 1 .. .. .. .. .. .. .. .. .. .. 3 Suffocation, overlying 2 1 2 .. .. .. .. .. .. .. .. 9 Injury at birth .. .. .. .. .. 1 .. 2 1 .. .. .. Atelectasis .. .. .. .. .. 2 .. .. .. .. .. 4 Congenital Malformations .. 2 3 .. 3 1 4 3 2 1 .. 19 Premature Birth 6 6 3 1 3 7 8 13 5 8 6 66 Atrophy, Debility and Marasmus 6 3 1 3 5 6 4 2 4 2 4 40 Other Causes 2 1 1 .. .. 1 2 .. .. .. 2 11 Totals 64 31 20 7 29 27 44 41 34 27 18 344 Deaths- Legitimate 57 31 19 7 28 23 41 40 31 26 15 318 Illegitimate 7 .. 1 .. 1 4 3 3 3 1 3 26 Births— Legitimate 399 322 181 158 320 389 455 367 367 373 312 3613 Illegitimate 19 10 5 .. 5 7 12 13 11 I8 7 137* Total Births 418 332 186 158 325 396 467 380 378 391 319 3750** Infant Mortality Rate— Legitimate 142.85 96.27 104.97 44.30 87.50 59.12 90.10 108.99 84.46 69.70 48.07 88'01 Illegitimate 368.42 o.oo 200.00 o.oo 200.00 571.42 250.00 230.76 273.72 55.55 428.57 189.78 Infant Mortality Pate 153.11 93.37 107.52 44.30 89.23 68.18 94.21 113.15 89.94 69.05 56.42 91.12 Population 14578 14601 12467 9921 14206 17369 17711 15662 14194 16768 19363 166840 *Includes 30 Illegitimate Births received from Registrar-General at end of year. *Does not include 25 Births received from Registrar-General at end of year, 6 of which were stated to be illegitimate—no addresses given. 121 APPENDIX B. Showing Acts, Circulars, Regulations, and Orders issued by the Local Government Board, and Board of Education during the year 1915, relating to Public Health and Medical Inspection. Circular 887, dated 25th January, 1915, of the Board of Education relative to payment of grant under Part 1 of the Medical Grant Regulations in cases of officers of the School Medical Service serving with the Naval or Military Forces. Minute of the Board of Education, dated the 3rd February, 1915, modifying the Regulations applicable to Schools for Blind, Deaf, Defective and Epileptic Children, dated the 19th July, 1909, as already modified by the minutes dated 27th June, 1910, and 17th July, 1914. The Public Health (Shell-Fish) Regulations, 1915, dated February 16th, 1915. Circular dated 17th February, 1915, relative to the Public Health (Shell-Fish) Regulations, 1915. Circular dated 22nd February, 1915, and memorandum on Cerebro-spinal Fever. Circular 899, dated 29th March, 1915, from the Board of Education relative to Temporary Employment of Members of the School Medical Staff in Military Hospitals. Circular dated 31st March, 1915, with reference to Compulsory Notification of Measles, German Measles (Rubeola), and Whooping Cough. Circular from the Local Government Board, dated April, 1915, w ith reference to Circulars and Papers relating to the co-operation of civil and military authorities in sanitary matters. Circular 912 of the Board of Education, being a memorandum on Class Instruction at Schools for Mothers, dated May, 1915. 122 Circular 906, dated 31st May, 1915, of the Local Government Board and Board of Education relative to Grants in Aid of Maternity Centres and Schools for Mothers. Milk and Dairies (Consolidation) Act, 1915. Notification of Births (Extension) Act, 1915. Circular dated 29th July, 1915, relative to Notification of Births (Extension) Act, 1915. Circular dated 30th July, 1915, relative to Regulations under which grants will be paid by the Local Government Board to Maternity Centres during the year ending 31st March, 1916. Circular dated 21st August, 1915, Order dated 18th August, 1915, and Memorandum of the Board of Agriculture and Fisheries with reference to Restriction of Slaughter of In-calf and In-pig Animals and of Calves. General Order dated 27th November, 1915, relating to Notification and Treatment of Measles and German Measles. Circular dated 29th November, 1915, relaling to Notification of Measles and German Measles. 123 APPENDIX C. MATERNITY AND CHILD WELFARE. Notes by Medical Officer. The Council at its meeting on 27th May, 1915, passed the following resolution:— “That it be an instruction to the Public Health Committee to prepare forthwith a scheme for the establishment of Maternity Centres and Baby Clinics." On the 1st April, 1915, the medical inspection of an additional group of school children, namely, children aged between eight and nine years, was undertaken. Having regard to the importance of Maternity and Child Welfare work and to the dearth of qualified medical men and nurses, 1 think it would be desirable at the present time to suspend the medical inspection of this group of school children. If this procedure is adopted all the other medical services of the Council can be maintained in the same state of efficiency as before the 1st April, 1915. Under these circumstances, at an estimated capital cost of £200 each for furniture, equipment, and alterations (half of which would be repayable by the Local Government Board), the Council would be enabled to open two local centres for Maternity and Child Welfare. One of these centres would be situated in the Kilburn area and another in the Church End-Roundwood area. These centres would be available daily except Saturday and Sundays as Maternity Centres and Baby Clinics for the expectant and nursing mother and for babies under one year of age. The estimated additional annual cost, half of which would be repayable by the Local Government Board in respect of the maintenance of these two centres, would be as follows:— 124 Additional Annual Cost: £ Temporary Assistant Medical Officer 438 Temporary Health Visitors 440 Temporary Clerk 80 Consultation Fees 50 Rent, Rates, Taxes 130 Heating, Lighting, Cleaning 50 Printing and Stationery 25 Postages, etc. 15 Drugs 40 Materials and Medical Requisites 30 Sundries 50 £1348 The estimated additional charges to the Council would therefore be:— £ Capital charge 200 Annual charge 674 GEORGE F. BUCHAN, Medical Officer. 9th June, 1915. APPENDIX D. MOTOR SERVICE. To the Chairman and Members of the Health Committee. On the 7th October, 1912, the Medical Officer submitted to the Public Health Committee a scheme for a Motor Ambulance Service for Willesden. This scheme, with some modilications, was passed by the Council on the 17th December, 1912. 125 On the 11th March, 1913, a Mechanic Superintendent was appointed, who commenced duties under the Council on the 31st March, 1913. Tenders for the vehicles required were duly considered by the Council at its meeting on the 27th May, 1913, and the tender of Messrs. Napiers, Ltd., was accepted. At the same meeting the Council decided upon the erection of a garage at the Isolation Hospital, and this was completed in due course. The dates of delivery of the several vehicles and the costs of each are shown in the following table:— Description of Car and No. Date ofDelivery. Date of being put into service. Cost of Vehicle. Disinfecting Van £ s. d. M.X. 1884 Dec. 2nd, 1913 Dec. 15th. 1913 445 0 0 Landaulette M.X. 2056 Dec. 17th, 1913 Dec. 17th, 1913 5S4 0 0 School 'Bus M.X. 2057 Dec. 24th, 1913 Tan. 5th, 1914 492 12 0 Infectious Ambulance M.X. 2058 Dec. 24th, 1913 Dec. 26th, 1913 486 0 0 School' Bus M.X. 2059 Dec. 22nd. 1913 Jan. 5th, 1914 492 12 0 Accident Ambulance M.X. 2060 Dec. 24th, 1913 Tan. 1st, 1914 489 0 0 School 'Bus M.X. 2061 Dec. 24th, 1913 Jan. 5th, 1914 492 12 0 Total £3,451 16 0 The garage at the Isolation Hospital was duly completed at a total cost of £1,033 10s. 8d. The following table shows the number of miles run by each vehicle during the first complete financial year, namely, from the 1st April, 1914, to 31st March, 1915, and since delivery to the latter date:— 126  Car Number. Miles run from April 1st, 1914 to March 31st, 1915. Miles run since delivery, to March 31st, 1915. Disinfecting Van, M.X. 1884 6440 9195 Landaulette, M.X. 2056 6385 7851 School 'Bus, M.X. 2057 7648 9449 Infectious Ambulance, M.X. 2058 5591 7009 School 'Bus, M.X. 2059 7176 9430 Accident Ambulance, M.X. 2060 3900 4625 School 'Bus, M.X. 2061 6958 9110 Totals 44,098 56,669 The following table shows the number of calls for the Disinfecting Van, Infectious Ambulance and Accident Ambulance respectively during the financial year April 1st, 1914, to March 31st, 1915, and since delivery to the latter date:— From April 1st, 1914, to March 31st, 1915. Since delivery to March 31st, I9I5. Number of calls for Disinfecting Van Number of calls for Infectious Diseases 1167 1537 Ambulance 940 1190 Number of calls for Accident Ambulance 372 412 The staff employed in connection with the Council's Motor Service is one Mechanic Superintendent and seven motor drivers. With one exception the motor drivers were previously employed in the Council's service, and have become proficient in motor driving; under the tuition of the Mechanic Superintendent. The motor drivers have a fixed wage of 35s. per week with 7d. per hour for overtime. The average working hours per week of the motor drivers is 61 l/3rd hours. One of the motor drivers is resident at the garage, and his hours are as follows:— 127 7.30 a.m. to 6 p.m., less two hours meals, Monday to Friday. 7.30 a.m. to 2 p.m., Saturday. And all night cases between 10 p.m. and 7.30 a.m. Annual leave, 14 days. The other six men are non-resident, and work in pairs, doing two short weeks and one long as below:— Short Week. Mon., 7.30 a.m. till 12.30 p.m., 1.30 p.m. till 5.30 p.m. I ues., ” ” ” ” Wed., ” ” ” ” Thurs., ” ” ” ” Friday ” ” ” ” Saturday, 7.30 a.m. till 1 p.m. Long Week. Mon., 7.30 a.m. till 12 noon, 2 p.m. till 10 p.m. Tues., ” ” ” ” Wed., ” ” ” ” Thurs., ” ” ” ” Friday ” ” ” ” Saturday, ” ” Sunday, 7.30 a.m. till 12 noon, ” ” Annual leave, 10 days. The following table shows the total cost of the Motor Service for the first complete financial year ending 31st March, 1915:— 128 Hxpenditure on Motor Service, April 1st, 1911, to March 31st, 1915. Cost. Total cost. Cost per mile. Interests and repayment of loan per annum £ s. d. £ s. d. 2.5 pence per mile. 459 15 6 459 15 6 Rent- Garage 175 0 0 1 .02 pence per mile. Messroom 12 0 0 187 0 0 Wages- Wages 875 6 9 War pay 41 14 2 5.02 pence per mile. 3. 18 pence per mile. State Insurance 5 4 0 922 4 11 Running Costs- Petrol 304 16 2 Tyres 253 15 6 Grease and oils 19 I 5 Sundries, including shock absorbers 45 12 9 Less refund for scrap and unrun miles, etc., £41 2 9 582 3 1 Fixed Charges- Insurance 77 2 9 Lighting 19 13 8 Coal, gas and water 34 17 8 Uniforms and Overalls 13 11 6 Licences (Drivers) 2 0 1 Rent of' Phone 9 8 2 Deposit on 'Phone 3 0 0 Alterations and Repairs 4 18 10 Petrol storage plant 6 0 0 Tax 6 6 0 Sundries- Including Tools 20 19 0 Bolts, Nuts, etc. 26 0 7 308 18 3 1 .68 pence per mile. £2,460 1 9 13.4 pence per mile. Mileage run by the seven vehicles April 1st, 1914, to March 31st, 1915—44,098. I am, Your obedient Servant, GEORGE F. BUCHAN, Medical Officer. October 2nd, 1915. 129 APPENDIX E. GRANTS IN AID. I. Maternity and Child Welfare (Local Government Board). Summary of expenditure incurred during the 12 months ended the 31st March, 1915, in respect of Maternity and Child Welfare work:— (a) Salaries or remuneration of— £ s. d. (1) Medical officers (2) Superintendents of midwives (3) Maternity and infant health visitors 143 9 6 (4) Other officers (clerical assistance) 13 19 6 (b) Payments to midwives or doctors (c) Drugs and other medical requisites 60 18 6 (d) Furniture and equipment 2 3 6 (e) Rent, rates and taxes 28 2 0 (f) Heating, lighting and cleaning (g) Printing, stationery, postage, etc. 43 4 8 (li) Other items of expenditure incurred (specifying them)— Treatment of Puerperal cases 3 3 0 Cost of conveyance of children to and from centres 0 5 0 Total 295 5 8 Deduct receipts, if any, specifying their sources. Sale of Glaxo (patent food) and half-cream milk (powder) 47 10 10 Total receipts 47 10 10 Net expenditure incurred £247 14 10 130 For purposes of the Grant the Board have deducted the sums spent on the provision of Glaxo (£42 6s.), half-cream dried milk (£13 12s. 6d.), teas (£1 13s. 6d.), less the receipts for the sale of same (£47 10s. 10d.). They have also deducted £28 2s. in respect of premises which they assume were already in the occupation of the Council, and did not, therefore, involve any additional expenditure under this heading. The Board have made a grant of £104 15s. 10d., or 50 per cent. of the remaining expenditure. Certain items in respect of the sum of £28 2s. are under discussion with the Board. II.—School Medical Service (Board of Education). Summary of payments made during the year ending 31st March, 1914:— 1. Salaries— £ s. d. (a) Salary of School Medical Officer 84 7 8 (b) Salaries of Assistant School Medical Officers 1,002 3 10 (c) Salaries of Specialist Officers (e.g., Ophthalmic Surgeon, Dental Surgeon), Specialist, X-ray Clinic 66 13 4 (d) Salaries of School Nurses 243 17 8 (i) Clerical assistance 229 7 3 2. Travelling expenses 89 19 9 3. Printing, stationery, postage, etc. 82 15 9 4. Drugs, materials, etc. 10 18 11 5. Apparatus (e.g., weighing machines, ophthalmoscopic, dental, X-ray apparatus) 152 6 8 6. Provision of spectacles 19 6 8 131  7. Contributions to external bodies (e.g., Hospitals, Infirmaries, Nursing Associations) 8. Cost of conveyance of children to centres for examination or treatment 9. Provision of premises, including payments in respect of loans 165 15 3 10. Maintenance of premises (e.g., rent, rates, heating, lighting, cleaning, upkeep of furniture) 141 0 11 11. Any expenditure not included in 1—10 above 12 18 5 Total 2,301 12 1 Total amount paid by, or recovered from, parents 1 5 3 Net Total £2,300 6 10 The whole of the items of the foregoing statement, with the exception of £84 7s. 8d., were taken into account by the Board of Education, and a grant of £997 3s. 7d., assessed at the rate of 45 per cent. of the expenditure, was made. The £84 7s. 8d. was not allowed as repayment of half the salary of the School Medical Officer had been obtained from other sources, and the deduction of five per cent. was made for the following reasons, as stated in the Board's letter to the Authority of the 11th May, 1915:— 1. During the greater part of the year in question the part-time system of Medical Inspection was in operation, as the whole-time Assistant Medical Officers did not take up their duties until March, 1914, 132 2. There was inadequate provision for co-ordination between the work of the School Medical Department and that of the School Attendance Department. 3. The provision during the year in question for following up cases of defect found on Medical Inspection was not systematic. 4. No provision was made during the year in question for a further examination of defects of vision. 5. No provision was made during the year in question for the treatment of dental defects. 6. No provision was made during the year in question for the treatment of adenoids and enlarged tonsils. 7. No provision was made during the year in question for the treatment of minor ailments with the exception of Ringworm. III.—Application for Grant during the year ending on the 31st March, 1916, in respect of the Provision of Meals under the Education (Provision of Meals) Acts, 1906 and 1914. Summary of payments actually made and sums actually received within the period from the 1st April, 1914, to the 31st March, 1915, in respect of the provision of meals for children in Public Elementary Schools:— 1. Payments— £ s. d. (1) Purchase of food 1,567 7 0¾ (2) Salaries and wages 872 0 8 (3) Provision of premises (4) Maintenance of premises (e.g., heating, lighting, cleaning, rent, rates, taxes) 334 1 10¼ (5) Furniture and equipment (a) Initial equipment of new premises (b) Annual repairs, replacements, etc. 25 7 9 133  (G) Printing, stationery, postage, etc 98 11 7 (7) Conveyance of children (8) Carriage of food, etc. (9) Any expenditure not included in (1)—(8) above 176 15 0 Total £3,074 3 11 2. Receipts— Amount paid or recovered from parents 21 8 8 Amount received from voluntary contributions — Miscellaneous receipts — Total 21 8 8 Net total expenditure £3,052 15 3 Total number of meals provided: Dinners, 251,123. Average total cost per meal, 2.938d. Average cost per meal for food only, 1.497d. Charge fixed under Section 2 of the Act of 1906 for each meal, l½d. Number of children whose meals were paid for by their parents—(a) wholly 76, partly 53. The Board have deducted from the Authority's claim the sum of £10 8s. 3d. in respect of employees' contributions for National Insurance, as they do not consider that this item can be regarded as expenditure on which grant is payable under the Provision of Meals Regulations. In view of the fact that no payment was actually made out of the rates for the rent of the centres at Gibbon's Road, 134 Furness Road, and Leopold Road Council Schools, the Board have also deducted the item of £120 from the claim submitted by the Authority. The Board have decided to pay a grant amounting to £1,461 3s. 6d., equal to 50 per cent. of the remaining expenditure. The Board state that, in determining the grant to be paid this year, they have taken into consideration the exceptional circumstances which prevailed during the greater part of the year 1914—1915, and that it must not be assumed that grant will necessarily continue to be paid at the same rate in future. 135 APPENDIX F. Staff on Military Duty—Health Department. Staff on War Service. Temporary Staff appointed. Name. Date com" menced War Service. Name. Date commenced duty for Council. Date ceasing duty for Council. Assistant Medical Officers— Dr. J. MacMillan 22- 9-14 Dr. T. S. Mcintosh* 28- 9-14 15- 4-15 *Dr. Mcintosh left for War service. „ Edith Shannon 15-4-15 „ G. R. Bruce 1-10-14 „ Estelle Atkinson 1-10-14 „ I. D. Eaton 16-10-15 Specialist Officers— Dr. Haldin Davis† 29- 8-14 Dr. II. MacCormac 29- 8-14 16- 1-15 †Dr. Davis resumed duty for Council 25-1-15. Mr. Oliver .. Hogg 23- 1-15 23- -15 31- 8-14 Mr. Hine 2-10-14 Sanitary Inspectors— A. W. Loughlin 13- 3-15 A. A. Waterhouse 28-10-15 P. Rees 28-10-15 Health Visitors Miss K. E. Baker (temporary) 28-10-14 Miss H. M. Bevis* 2-11-14 2- 6-15 *Miss Bevis left for War service „ H. G. Lenanton‡ 7-11-14 „ O. Andrews 9-11 14 23-10-15 ‡Miss Lenanton returned to duty 25-1-15. „ C. Johnston 27- 1-15 „ E. Dixon 5- 4-15 4-12-15 „ E. A. Bramall 21-10-15 „ D. E. Turner 25- 5-15 13-11-15 „ E. M. Carter 24-11-15 Mrs. E. A. Crawley 26- 5-15 17- 7-15 Miss H. Dean 4- 6-15 „ K. Cotton§ 19-10-15 4-12-15 §Miss Cotton „ N. Lewis 20-10-15 4-12-15 turned to duty „ V. Phillips 23-11-14 on 5-1-16. Clerks— A. A. Gibb 23- 9-14 Miss L. V. Timms 30- 9-14 L.J.White 23- 9-14 „ D. Bryceson 30- 9-14 F. H. Amor 19- 9-14 Mr. G. A. Bagwell 30- 9-14 4-12-15 S. E. Windsor 10-n-14 Miss K. Lloyd 16-11-14 L. H. Sommers 10-11-14 Mr. H. T. Woods 18-11-14 A. Paterson 29-10-15 Miss E. Deeks 13- 6-15 L. T. James 19-10-15 H. G. Andrews 29-10-15 Motor Drivers— G. Domone 1- 9-14 W. Stanley 14- 9-14 H. Mitchell 25- 1-15 J. Dean 4- 4-15 26-11-15 W. Cleaver 22-10-15 Miss Marston 13-12-15 E. Johnson 1-11-15 A. Dumbleton 10-11-15 H. Stanley 30-10-14 G. Yokes 23- 6-15 Labourer— J. Watkinson 14- 7-15 136  Staff on War Service. Temporary Staff Appointed. Name. Date commencing War Service. Position. Name. Date commencing duty for Council. Date ceasing duty for Council. Isolation Hospital— Dr. W. J. J. Stewart 1-12-14 Medical Supt. Dr. George F. Buchan 1-12-14 ” A. Romanes 6- 6-15 Assistant Medical Supt. Dr. A. R. H. Greig Miss K. Keen 1-12-14 Matron. Miss M. Morley I-I2-I4 G. Bourne 30- 8-14 Stoker. II. Vincett 5-12-14 J. Love 30- 8-14 11-10-14 E. Delderfield 20- 3-15 Porter. R. Champneys 5- 7-15 C. E. Turner 4- 5-14 Laundiy Porter. C. A. Goodwin 5- 7-15 J. Stewart 28-9-I4 Gate Porter. E. Phipp 25- 9-14 18 -5-15 A. Blachford 21- 5-15 C. Chantry 11-10-14 Engineer. J. Love 12-10-14 4-12-15 137 INDEX. Page Accommodation—Schools 67 Acts, Regulations, etc., in force—Willesden 17, 18 ” ” ” issued by L.G.B. and Board of Education 121, 122 Babies' Welcome 56 Bacteriological Department 109 Bakehouses 20 Births and Birth Rates 58 ” Illegitimate 60 ” Notification of Births Act, 1907 and 191 55 Blind Children 85 Body, Cleanliness of 72, 78 Bye-laws in Force 18 Canal Boats Acts, 1877 and 1884 20, 26 Caravans, Movable Dwellings, Tents, etc. 20 Cerebro-spinal Meningitis 45, 107 Childbirth and Infancy, Means of Preventing Mortality in 8, 51 Children, Exceptional 84-91 Children's Care Committee 4 Child Welfare, Maternity and 8, 51 Cleanliness of Head and Body 72, 78 Clinic 82 Clothing 72, 78 Coexistent Diseases 109 Common Lodging Houses 20 Condition of the Children Inspected 71-75 Councillors, 1915-16 3 Cowsheds 21 Cows, Veterinary Inspection of 26 Customs and Inland Revenue Act, 1890 25 138 Page Dairies and Milkshops 21 Death Inquiries, Infant 57 Deaths and Death Rates 61-64 ” of Legitimate and Illegitimate Infants 54-55 ” and Death Rates per 100,000, Scarlet Fever, Diphtheria, Enteric Fever, Measles, Whooping Cough 49 Deaths and Death Rates at Age Periods 62, 63, 64 Deaf Children 87 Debility 81 Deformities 75, 81 Diarrhoea and Enteritis, Deaths of Infants due to 53 Diphtheria and Membranous Croup 42 ” Cases admitted to Willesden Hospital 42, 103, 104, 106 ” Complications of 106 ” Day of Disease on Admission 107 ” Death Rate per 100,000 49 ” Incidence and Fatality Rates 42 Disinfection 23 Drainage and Sewerage of Existing Buildings 22 Dust, Removal of, etc. 14-23 Ear, Diseases of 73, 79 Education Committee, Members of 4 Enteric Fever 44 ” ” Cases Admitted to Willesden Hospital 44, 103, 104 ” ” Death Rate per 100,000 49 ” ” Incidence and Fatality Rates 44 Epileptic Children 89 Exceptional Children 84-91 Eye Diseases (External) 73, 79 Eye Clinic 82 Factory and Workshop Act, 1901 35 ” ” ” Inspections under 35 139 Page Following up 76 Food and Drugs Acts 29 Food, Adulterated 21 ” Inspection 24, 27 ” Unsound 21 Footgear 72, 78 Glands, Enlarged 73, 79 Grants in Aid 129-134 Head and Body, Cleanliness of 72, 78 Health Committee 3 Heart and Circulation, Diseases of 73, 79 Home Work 35 Hospital Buildings 110 Hospital Committee 3 Hospital Report 9, 103-110 Hospital, Sick Staff at 110 ” Cases Wrongly Diagnosed 108 House Refuse, Removal of 14, 23 Houses Let in Lodgings 20 ” Unfit for Human Habitation 32 Housing, Town Planning, &c., Act, 1909, Action taken under 19, 29 Housing Inspection 19, 29-31 Infant Death Inquiries 57 Infant Mortality—Rates since 1875 53 ” ” Illegitimate 55 ” ” Legitimate 54 ” ” Wards 54 Infectious Diseases 7, 37-51 ” ” Control over 37 ” ” Death Rates from certain 49 ” ” Notifications, Table of 37 ” ” Prevalence of 37 Inhabited House Duty, Exemption from 25 Inspections 19, 24, 25, 27, 35 140 Page Investigation of Other Diseases 49 Local Government Board Tables (Appendix A) 111-120 Table I—Population, Births and Deaths since 1910—District 1ll ” la—Population, Births and Deaths in Wards 112 Military Cases not included in Tables 1 and la 114 ” II—Infectious Diseases 115 Military Cases not included in Table 2 114 ” III—Causes of Deaths (Short Classification Table) 116 ” IIIa—Causes of Deaths—in Wards 118 ” IV—Infant Mortality under 1 year of age—Causes of Deaths 119 ” IVa—Infant Mortality under 1 year of age—Causes of Deaths—in Wards 120 Lungs, Diseases of 74, 80 Manholes, Inspection of 25 Marriages 57 Maternity and Child Welfare 8, 51 ” ” ” ” Notes by Medical Officer 123, 124 ” ” ” ” Grant 129 Measles 47 ” Death Rate per 100,000 49 ” Table of Known Cases since 1907 47 Meals, Provision of 9, 91 ” ” Grant 132 ” ” Dietaries 93 ” ” No. of Meals Supplied 94 ” ” No. of Children Fed 94 ” ” Cost of Feeding 96 ” ” Service of Meals—Rules 98 ” ” Special Meals 99 141 Page Medical Inspection and Treatment 8 Medical Inspection, Attendance of Parents at 67 ” ” Condition of Children 71 ” ” Children Selected for 67 ” ” Following up 76 ” ” Notice to Parents 71 ” ” Number Inspected 68 ” ” Routine 68-75 Medical Treatment 77 Meningitis, Cerebro-spinal 45, 107 Mentally Defective Children 89 Mental Condition 75, 81 Milch Cows, Veterinary Inspection of 26 Military Cases of Infectious Disease 114 Military Deaths 114 Milkshops 21 Milk Samples 26 Mortality in Child Birth and Infancy—Means of Preventing 8, 51 Motor Service 124-128 Movable Dwellings, Caravans, Tents, etc. 20 Natural and Social Conditions of the District 12 Neck Glands Enlarged 73, 79 Nervous System, Diseases of 74, 80 Nose and Throat, Diseases of 73, 79 Notification of Births Act, 1907 and 1915 55 Nuisances, Sundry, abated 23 Nutrition 72, 78 Offensive Trades 21 Ophthalmia Neonatorum 46 Physically Defective Children 90 Population—Midsummer, 1915 (in Wards)—Estimated at 13 ” Midsummer, Estimated 12, 13 142 Page Prevalence of and Control over Acute Infectious Diseases 37 Prevalence of and Control over Tuberculosis 48 Prosecutions 82 Provision of Meals—See Meals, Provision of. Regulations made by Local Authority in force in Willesden 18 Remedial Measures 77 Rickets 74, 80 Ringworm Clinic 82 Sale of Food and Drugs Acts 29 Sanitary Circumstances of the District 14 Sanitary Work 5, 17 Scarlet Fever, Cases admitted to Willesden Hospital 39, 103, 104, 105 ” ” Complications of 105 ” ” Death Rate per 100,000 49 ” ” Incidence and Fatality Rates in 39 ” ” Return Cases of 39 ” ” Multiple Cases 41 Scavenging, Removal of House Refuse—Statistics relating to 14 School Accommodation 67 School Medical Service—Grant 130 Sewerage and Drainage 22 Skin, Diseases of 74, 80 Slaughterhouses 20, 28 Small Pox, Cases Notified and Removed to Hospital 43 Social Conditions of District, Natural and 12 Special Cases 76 Speech 75, 81 Squint 75, 81 Staff 18 Staff on Military Duty 135 Teeth 73, 79 143 Page Throat, Nose and Ear, Diseases of 73, 79 Tuberculosis 48, 50, 75, 81 ” Cases Admitted to Willesden Hospital 103, 104 ” Non-Pulmonary 75, 81 ” Death Rates from 1875-1915 50 ” Deaths from and Age Distribution of 51 ” Detection of, in Milk 26 ” In Children Medically Inspected 75, 81 ” Prevalence of, and Control Over 48 ” Table of Notifications Received 48 ” Veterinary Inspection of Milch Cows and Sampling of Milk 26 Vaccination Statistics 46 Veterinary Inspection of Milch Cows 26 Vision 75, 81 Vital Statistics 6, 57 Water Supply 21 Whooping Cough 49 ” ” Death Rate per 100,000 49 Workshops on the Register 37 APPENDICES. Appendix. Page A — Local Government Board Tables 111-120 B — Acts, Circulars, Regulations and Orders issued by the Local Government Board and Board of Education 121-122 C — Maternity and Child Welfare—Notes by Medical Officer 123-124 D — Motor Service 124-128 E — Grants-in-Aid 129-134 I. Maternity and Child Welfare 129 II. School Medical Service 130 III. Provision of Meals 132 F — Staff on Military Duty 135-136