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(b) Ophthalmic Clinic:— Central Clinic, Vicarage Drive, Ripple Road Woodward Clinic, Woodward Road Tuesdays and Fridays, 10 a.m. Thursdays, 2 p.m. Modern clinic premises with inspection, waiting and treatment rooms, etc. do. do. do. (c) Dental Clinics:— Central Clinic, Vicarage Drive, Ripple Road Daily, 9 a.m. and 2 p.m. do. do. Woodward Clinic, Woodward Road do. do. do. East Street Clinic do. Inspection, waiting and treatment rooms do. (d) Orthopaedic Clinic:— (i) Specialist's Clinic, Manor School First Thursday in each month, 9 a.m. Three rooms do. (ii) Remedial Exercises Clinic, Ultra Violet Light Therapy, etc.:— Faircross School Daily, 9 a.m. and 2 p.m. One room do. Manor School do.
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Three rooms do. (e) Ear, Nose and Throat Clinic:— Woodward Clinic, Woodward Road Tuesdays and Fridays, 2 p.m. Modern clinic premises with inspection, waiting and treatment rooms, etc. do. 3. Immunisation Clinic (Diphtheria, Scarlet Fever and Whooping Cough) Central Clinic, Vicarage Drive, Ripple Road Mondays, 10.30 a.m. Modern clinic premises with inspection, waiting and treatment rooms. do. Woodward Clinic, Woodward Road Mondays, 9 a.m. do. do. 4. FooT Clinic. Central Clinic, Vicarage Drive, Ripple Road By appointment do. do. Woodward Clinic, Woodward Road By appointment do. do. 5. Tuberculosis. 37, Linton Road Mondays, 3-5 p.m. Tuesdays, 7-8 p.m.
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Thursdays, 10.30 a.m.-12.30 p.m. Three rooms Essex County Council. G. Venereal Diseases. Oldchurch Hospital and London hospitals, etc. – – By arrangement with Essex County Council 203 Ophthalmic Service.—Refraction Clinics are held at the Central and Woodward Clinics, and the scheme includes the provision of spectacles at a very low charge, and, in some cases, where the family income is below a certain scale, at no charge. Provision is also made for training the eyes of children suffering from squint. Orthopædic Treatment.—Orthopædic treatment—including the provision of splints and any necessary hospital treatment—is provided through the Orthopaedic Clinic, Hulse Avenue and at the Manor School Clinic. Prevention of Diphtheria, Scarlet Fever and Whooping Cough.—Immunisation against Diphtheria, Scarlet Fever and Whooping Cough is carried out at the Central Clinic and at the Woodward Clinic.
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No charge is made for this treatment. Special School.—The Faircross Special School is divided into three sections—a Physically Defective Section, a Mentally Defective Section and a Section for Delicate Children. When considered desirable, the children are conveyed to and from school by motor ambulance. Tonsils and Adenoids.—Surgical treatment for tonsils and adenoids is carried out at two local hospitals under an agreement with the Corporation. A small charge is made to the parents, except in certain necessitous cases, when no charge is made. Ultra-Violet Light Treatment.—Ultra-violet light treatment is given at the Orthopaedic Clinic, Hulse Avenue, and at the Manor School Clinic. X-Ray Treatment of Ringworm of the Scalp.—Where necessary, Ringworm is treated by X-Ray at the London Hospital. No charge is made for this treatment. 204 REPORT OF SENIOR DENTAL OFFICER. To the School Medical Officer, May, 1939. Barking Borough Council.
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Sir, I have the honour to present the Annual Report of the Dental Service for the year ending December 31st, 1938. The figures for the year are shown on a separate page and it is to be noted that the number of fillings show progressive increase over past years and is accompanied by a corresponding increase in acceptances. It is relevant at this point to examine what factors most assist in obtaining a Dental Service which functions over the minimal standard that reasonably might be expected. The first essential is a good type of building together with equipment, well maintained, for members of a community need some visible expression of the services they hope to utilize, and the stubborn resistance of those who are prejudiced is furthered by a service environment which may be below civic standard. A surgery which is regarded with distaste by parents is no place to instruct children in dental hygiene. In this respect the design, appearance and maintenance of the Dental Clinics of this Authority can be regarded as a model which any Authority might well adopt.
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The frequency with which the School Dental Surgeon is able to establish routine contact with his prospective patients has a direct relation to the probable acceptance rate, and it is well within reason to aim at two routine inspections of all schools in a school year. The 205 numerical staffing of a service on this basis would mean an increase in most cases, but it has been established that an increase in staff is invariably accompanied by an increased acceptance rate, and if the ideal of one Dental Surgeon to 2,500/3,000 school children be achieved (as was urged by Sir George Newman) the acceptance rate may well be so universal as to make a refusal the greatest rarity. This has been demonstrated by the Borough of Cambridge where such a ratio has been in force for some years. A Dental Surgeon who attends mainly to the dental needs of children should endeavour to visualize the outlook of his patients on their own particular interests.
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To have a knowledge of the literature of the young and the very young, to be able to discuss from folk dancing to the orthodoxy of the Test batsmen is quite as useful with a patient as the deftness of technique which minimises pain. If these can be accomplished, all or in part, then the operator is well on the way to that relationship in which the patient knows and speaks to the operator as Mr.—, for such a relationship usually indicates that the problems of dental treatment are purely professional and never personal. The orthodontic treatment carried out at the Clinics is well to the fore and it may be regarded as a sign of the advancement in dental education that parents not only consent to such treatment for their children with great willingness but seek advice and treatment of their own accord. The dental condition of those children attending the nursery schools is being watched with considerable attention.
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Dental cleanliness, which is part of the nursery school routine, and the influence of the teachers in advising early treatment where necessary should have a marked beneficial effect, and the first dental inspection as pupils proper should furnish interesting results. 206 I have to acknowledge the invaluable assistance given by the teaching staff of the Barking Schools and also to the Medical and Health Visiting Staff for their interest and willing co-operation. To the Dental Staff—operative nursing and administrative—I wish to record the manner in which their team work has contributed so much to the success of the Dental Scheme. I have the honour to be, Sir, Your obedient Servant, W. H. FOY, (l.d.s., r.c.s., eng.), Senior Dental Officer. 207 REPORT ON THE WORK OF THE OPHTHALMIC CLINICS. To the School Medical Officer, May, 1939. Barking Borough Council.
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Dear Sir, During 1938 the number of spectacles prescribed at the clinics was much smaller than in 1937 but there was practically no diminution in the number of children tested. As all of these children had some visual defect it follows that a considerable proportion of them were told that they did not require glasses. This seems to merit some explanation. All the cases referred to can be said to form a definite group which has the following characteristics. They are slightly longer sighted and do not have standard vision—it varies within narrow limits and is just short of normal. They are able to read their ordinary school work without complaining provided their general health is good. This is due to the ability of the eye to overcome the minor degrees of defect by means of its internal muscular mechanism. The condition of this mechanism depends on the state of the general health and, if the latter is satisfactory, no ocular trouble is experienced.
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Any condition which lowers body health such as want of suitable food, fresh air, or the presence of decayed teeth, produces early fatigue ; the eye is no longer able to counterbalance its own inherent defect and headaches or blurred vision results. When this condition exists, glasses will relieve the child but they will not cure. In fact, it is not the eyes which require treatment so much as the causes of the lowering of body well-being, for once these are remedied glasses will be found to be no longer necessary. 208 As the school health in Barking is good, it can be understood why in many cases of slight longsight defect, spectacles were not advised. Further evidence of improvement in nutrition is afforded by the complete disappearance during 1938 of Phlyctenular inflammation. It will be remembered that a special system was instituted to remedy this vitamin deficiency disease. As school leaving time approaches it is often asked whether spectacles are still required.
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In many cases of longsight it is possible to dispense with glasses for the eye has outgrown its disability. The age-old fallacy of once having worn glasses one need always wear them is simply not true. Enough has been said to show the intimate relation which exists between the eyes and the degree of general health. Adequate nutrition, the elimination of any diseased condition which retards the general well-being and all these other factors which make for good health will also reduce the need for and the number of glasses worn in some types of visual defect. STATISTICS RELATING TO THE WORK OF THE OPHTHALMIC CLINICS IN CONNECTION WITH ORDINARY ELEMENTARY SCHOOL AND FAIRCROSS SCHOOL CHILDREN DURING 1938. TABLE I. No. of refractions under atropine 781 No. of post-mydriatic tests 21 No. of spectacles prescribed 387 No.
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of cases listed for squint training 70 All spectacles were checked before being issued at the Clinics. 209 TABLE II. MYOPIA. TABLE SHOWING WORK CARRIED OUT DURING 1938 IN CONNECTION WITH ALL SCHOOL-CHILDREN SUFFERING FROM MYOPIA. Individual cases No. of attendances Spectacles No. of attendances of cases reviewed in:— Recommendations to Head Teachers for:— Notprescribed on first visit Ordered for first time Changed No change Months Ordinary Routine Easy Treatment" "Special Treatment" 3 4 6 9 12 229 305 6 91 86 122 10 4 280 9 2 294 9 2 TABLE III.
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External Diseases of the Eye treated at the Clinics Conjunctivitis and Blepharitis 35 Cellulitis 1 Injury 7 Meibomiam Cyst 7 Foreign body in eye 1 Dacrocystitis 1 Hordeolum 5 Keloid of lower lid 1 TABLE IV. Total No. of Attendances 2,539 Percentage attendance of appointments made 83.5 210 TABLE V. TREATMENT OF ELEMENTARY SCHOOL CHILDREN AT THE ORTHOPTIC (SQUINT TRAINING) CLINIC. No. of sessions given to Squint Training 182 (1) Cases treated:— (a) Cured 15 (b) Under treatment at end of year 71 (c) Treatment commenced but discontinued for various reasons, i.e., left district, left school, etc. 6 Total 92 (2) Treatments:— Cases cured—average length of treatment 11 months. Cases still under treatment:— After treatment for Over 12 mths.
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9-12 mths. 6-9 mths. 3-6 mths. Under 3 mths. No. of cases 55 7 2 1 6 Average fusion 5.0° 4.0° 4.0° – 0.6° No. showing definite diminution of squint 48 3 1 – – No. showing improvement 53 5 2 1 2 Percentage showing improvement 96 71.4 100 100 33 No. showing no improvement 2 2 – – 4 No. of treatments given 1,264 WM. A. GRAY, F.R.C.S., Ophthalmic Surgeon. 211 REPORT ON THE WORK OF THE ORTHOPÆDIC CLINIC. To the School Medical Officer, May, 1939. Barking Borough Council.
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Dear Sir, The Statistical Returns show in general the scope of the work undertaken during the past year. The increase in personnel and equipment has greatly added to the efficiency of the Clinic. A few minor additions are still required, after which the Clinic will become one of the most efficient in the district. The diagnosis and treatment of the patients have proceeded along normal lines. The major disabilities have been, as in the past, cases of acute and chronic anterior poliomyelitis. A number of the latter have been seen in the first instance at the Barking Hospital in consultation with the medical staff. My personal thanks are due to the members of the Massage and Clerical staffs, and in particular to Miss Roe, the head masseuse, to whose energy and foresight much of the success of the Clinic is due. The following tables, which are prepared on lines similar to those previously used, show the work which has been carried out at the Orthopaedic Clinic amongst children of school age:— No.
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of primary examinations by Orthopaedic Surgeon 217 No. of re-examinations by Orthopaedic Surgeon 229 212 The cases dealt with for the first time during 1938 were referred for the following conditions:— (a) Deformities of Bones and Joints. 1. Congenital: Additional digit—feet 1 Congenital dislocation hip 1 Deformity—foot 1 Deformity—digit 1 Digitus varus 1 Mid-tarsal varus 1 Talipes 2 2.
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Acquired: Bowed tibiæ 5 Deformed chest 27 Exostosis 3 Genu valgum 58 Genu varum 11 Hallux valgus 2 Hallux rigidus 1 Hammer toes 3 Harrison's sulcus 1 Injury—foot 1 Injury—thumb 1 Injury—ankle 1 Injury—finger 2 Kohler's disease 1 Left shoulder higher than right 1 Perthe's disease 1 Pes planus 22 Valgus ankles 9 Von Schlatter's Disease 1 ? Arthritis—hip and knee 1 ? Internal Derangement knee 1 161 213 (b) Deformities—Muscular. 1. Congenital: Scoliosis 1 Torticollis 2 2.
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Acquired: Bad posture 12 Contracted extensors 1 Intoeing 7 Kyphosis 7 Kypho-lordosis 1 Lordosis 4 Pes planus 67 Round shoulders 13 Scoliosis 2 117 (c) Paralysis. A.P.M 3 3 (d) Miscellaneous. Cleft palate 1 Ganglion—hand 2 Onychogryphosis—foot 1 Pain in hip 1 ? Bursitis superficial T.A. 1 6 Total defects found ... 287 214 During the year, eleven children were admitted to Hospital, ten for operations and one for observation, as follows:— Operations: Amputation extra digit—feet R. and L. 1 Arthrodesis—base of metacarpal I and plaster 1 Arthrode is—proximal joint—foot 2 Scaphoid Arthrodesis R.
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& L. and plaster 1 Manipulation—feet and plaster 1 Open elongation T. A. R. & L. and plaster 1 Plaster bed 1 Tenotomies adductors and plaster 1 Tenotomies Tendo Achillis 2 Transposition Tendon flexor longus pollicis and plaster 1 12 Observation 1 Total 13 215—216 PARTICULARS OF THE WORK DONE IN CONNECTION WITH THE ORTHOPÆDIC CLINIC DURING 1938. No. of sessions held by Orthopaedic Surgeon No. of sessions held by Masseuses ATTENDANCES.
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Primary Examination Re-examination For Treatment Totals School Children Toddlers and Expectant & Nursing Mothers School Children Toddlers and Expectant & Nursing Mothers School Children Toddlers and Expectant & Nursing Mothers School Children Toddlers and Expectant & Nursing Mothers 11 1,058 217 178 229 174 7,366 4,813 7,812 5,165 TREATMENTS. Massage Electricity Remedial Exercises Ultra-Violet Therapy Radiant Heat Dressings and Splintage Totals. No. of Children No. of Treatments No. of Children No. of Treatments No. of Children No. of Treatments No. of Children No. of Treatments No. of Children No. of Treatments No. of Children No. of Treatments No. of Children No.
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of Treatments School Children 33 937 10 308 269 1,824 317 3,995 21 473 300 1,563 950 9,100 Toddlers and Expectant and Nursing Mothers 69 1,102 27 181 167 1,002 232 2,827 31 182 268 1,666 771 6,960 Admissions to Hospitals On Waiting List for Admission 31/12/38 School Children Toddlers Total School Children Toddlers Total 11 (Under Council's Orthopaedic Scheme) – 11 – – – 217 REPORT ON THE WORK OF THE EAR, NOSE & THROAT CLINIC. To the School Medical Officer, May, 1939. Barking Borough Council.
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Dear Sir, The opening of an Ear, Nose and Throat Clinic in September of the year under review for the Borough of Barking has made provision for certain treatments which hitherto were somewhat difficult to obtain locally, such as zinc ionisation for discharging ears and diastolisation for certain nasal conditions. It was noted, shortly after the time of the Political Crisis in September, 1938, that there was an increase amounting almost to an epidemic in the number of cases of Acute Suppurative Otitis Media with, in several cases, Mastoiditis. This effect was felt at the newly established Clinic, and may be ascribed to different factors. Some patients reported that they had caught a chill waiting in queues for Gas Mask fittings. In other cases it seemed attributable to a slight lowering of the general standard of health and resistance to infection following upset of normal routine, and mental upset. Further, I have noted, as compared with comparable Clinics, a marked absence of cases of Hayfever and Asthma.
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Whether these cases are not yet reaching me, whether provision for them is supplied elsewhere, or whether such cases are numerically small in Barking— and these diseases notoriously vary from one district to another—are points to be elucidated by further enquiry and observation. 218 There has been, since Christmas, an epidemic of acute ear conditions coincident with the influenzal outbreak, and mostly due to a Haemolytic Streptococcal infection. Arrangements have been made for keeping under supervision at the clinic all those cases which had ear trouble whilst in-patients in the Barking Hospital, thus enabling any relapse to which such type of patient is prone to be dealt with at the beginning. C, R. SANDIFORD, f.r.c.s., Ear, Nose and Throat Surgeon. 219 SCHOOL MEDICAL SERVICE. Statistical Tables—Public Elementary Schools, 1938. TABLE I. RETURN OF MEDICAL INSPECTIONS. A.—Routine Medical Inspections.
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Number of Inspections in the prescribed Groups:— Entrants 1,639 Second Age Group 1,419 Third Age Group 1,249 Total 4,307 Number of other Routine Inspections 409 Grand Total 4,716 B,—Other Inspections. Number of Special Inspections 12,492 Number of Re-Inspections 26,126 Total 38,618 220 C.—Children found to require Treatment. Number of individual children found at Routine Medical Inspection to require Treatment (excluding Defects of Nutrition, Uncleanliness and Dental Diseases). Group For defective vision (excluding squint) - For all other conditions recorded in Table II A Totals. Entrants 10 431 440 Second Age Group 84 235 301 Third Age Group 83 115 190 Totals (Prescribed Groups) 177 781 931 Other Routine Inspections 27 72 97 Grand Totals 204 853 1.028 221—222 TABLE II.
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(A)—RETURN OF DEFECTS FOUND BY MEDICAL INSPECTION IN THE YEAR ENDED 31ST DECEMBER, 1938. Defect or Disease Routine Inspections Special Inspections No. of Defects No. of Defects Requiring Treatment Requiring to be kept under observation, but not requiring Treatment Requiring Treatment Requiring to be kept under observation, but not requiring Treatment Skin (1) Ringworm—Scalp – – 5 – (2) Body 2 – 34 – (3) Scabies 7 1 125 – (4) Impetigo 11 2 379 – (5) Other Diseases (Non-Tuberculous) 52 29 363 18 Totals (Heads 1-5) 72 32 906 18 Eye (6) Blepharitis 25 13 122 4 (7) Conjunctivitis 11 4 251 1 (8) Keratitis – – 3 –
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(9) Corneal Opacities 1 – – – (10) Other Conditions (excluding Defective Vision and Squint) 13 6 122 3 Totals (Heads 6-10) 50 23 498 8 (11) Defective Vision (excluding Squint) 204 103 167 36 (12) Squint 32 5 25 14 Ear (13) Defective Hearing 9 5 6 2 (14) Otitis Media 2 4 23 – (15) Other Ear Diseases 60 5 224 9 Nose and Throat (16) Chronic Tonsillitis only 122 423 150 80 (17) Adenoids only 2 2 3 3 (18) Chronic Tonsillitis and Adenoids 11 4 20 1 (19) Other Conditions 28 28 208 19 (20) Enlarged Cervical Glands (Non-Tuberculous)
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35 75 59 41 (21) Defective Speech 17 20 16 16 Heart and Circulation Heart Disease: (22) Organic 4 31 3 13 (23) Functional 6 103 3 47 (24) Anaemia 40 34 77 17 Lungs (25) Bronchitis 30 57 69 13 (26) Other Non-Tuberculous Diseases 12 38 29 15 223—224 TABLE II. (A)—continued. Defect or Disease Routine Inspections Special Inspections No. of Defects No. of Defects Requiring Treatment Requiring to be kept under observation, but not requiring Treatment Requiring Treatment Requiring to be kept under observation,
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but not requiring Treatment Tuberculosis Pulmonary: (27) Definite 1 1 — — (28) Suspected 1 — — 1 Non-Pulmonary: (29) Glands — 2 — 4 (30) Bones and Joints — — — — (31) Skin — — — — (32) Other Forms Totals (Heads 29-32) — 2 — 4 Nervous System (33) Epilepsy — 2 1 2 (34) Chorea 3 3 11 22 (35) Other Conditions 46 37 67 45 Deformities (36) Rickets 4 5 1 1 (37) Spinal Curvature 13 11 5 6 (38) Other Forms 219 161 109 37 (39) Other Defects and Diseases (excluding Defects of Nutrition, Uncleanliness and Dental Diseases) 121 221 4,689 222 Total number of defects 1,
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144 1,435 7,369 692 225 table ii. (b) classification of the nutrition of children inspected during the year in the routine age groups. Age-groups Number of Children Inspected A (Excellent) B (Normal) C (Slightly subnormal) D (Bad) No. % No. % No. % No.
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% Entrants 1,639 400 24.40 1,122 68.46 115 7.02 2 0.12 Second Age-group 1,419 413 29.11 897 63.21 106 7.47 3 0.21 Third Age-group 1,249 261 21.00 949 76.00 39 3.00 — — Other Routine Inspections 409 107 26.16 275 67.24 27 6.60 — — Totals 4,716 1,181 25.04 3,243 68.76 287 6.09 5 0.11 226 TABLE III. RETURN OF ALL EXCEPTIONAL CHILDREN IN THE AREA. Blind Children. At Certified Schools for the Blind At Public Elementary Schools At other Institutions At no School or Institution Total 3 — — — 3 Partially Sighted Children.
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At Certified Schools for the Blind At Certified Schools for the Partially Sighted At Public Elementary Schools At other Institutions At no School or Institution Total — 5 — — 1 6 Deaf Children. At Certified Schools for the Deaf At Public Elementary Schools At other Institutions At no School or Institution Total 12 — — — 12 227 TABLE III.—continued. Partially Deaf Children. At Certified Schools for the Deaf At Certified Schools for the Partially Deaf At Public Elementary Schools At other Institutions At no School or Institution Total — — — — — — Mentally Defective Children. Feeble-Minded Children. At Certified Schools for Mentally Defective Children At Public Elementary Schools At other Institutions At no School or Institution Total 57 — — — 57 Epileptic Children. Children Suffering from Severe Epilepsy. At Certified Special Schools At Public Elementary Schools At other Institutions At no School or Institution Total 1 — — — 1 228 TABLE III.—continued.
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Physically Defective Children. A.—Tuberculous Children. I.—Children Suffering from Pulmonary Tuberculosis. (Including pleura and intra-thoracic glands.) At Certified Special Schools At Public Elementary Schools At other Institutions At no School or Institution Totals — (i) — (2) 6 (—) 2 (—) 8 (3) II.—Children Suffering from Non-Pulmonary Tuberculosis. (This category includes tuberculosis of all sites other than those shown in I above.) At Certified Special Schools At Public Elementary Schools At other Institutions At no School or Institution Totals 1 (6) 4 (16) 4 (—) 2 (—) 11 (22) Explanatory Note. Physically Defective Children—Tuberculous. Attendance at a Tuberculosis Dispensary, subsequent to active treatment, has been looked upon as preventive treatment and therefore treatment within the meaning of the Table.
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The figures in brackets under this section denote children who are notified cases of Tuberculosis and are therefore attending a Tuberculosis Dispensary, but in whose case the disease has been declared "arrested" although the children cannot yet be said to be "recovered." B—Delicate Children. At Certified Special Schools At Public Elementary Schools At other Institutions At no School or Institution Total 62 2 — 1 65 229 TABLE III.—continued. C.—Crippled Children. At Certified Special Schools At Public Elementary Schools At other Institutions At no School or Institution Total 16 — — 2 18 D.—Children with Heart Disease. At Certified Special Schools At Public Elementary Schools At other Institutions At no School or Institution Total 28 4 — 2 34 Children Suffering from Multiple Defects.
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Combination of Defect At Certified Special Schools At Public Elementary Schools At other Institutions At no School or Institution Totals Mental Defect (feebleminded) and Crippling 1 — — — 1 Mental Defect (feebleminded) and Heart Disease — — — Deafness and Crippling 1 — — — 1 230 FORM 307M.—STATEMENT OF THE NUMBER OF CHILDREN NOTIFIED DURING THE YEAR ENDED 31ST DECEMBER, 1938, BY THE LOCAL EDUCATION AUTHORITY TO THE LOCAL MENTAL DEFICIENCY AUTHORITY. Total No. of Children Notified 7 Analysis of the above Total. Diagnosis Boys Girls 1.
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(i) Children incapable of receiving benefit or further benefit from instruction in a Special School: (a) Idiots — —— (b) Imbeciles 1 — (c) Others — 2 (ii) Children unable to be instructed in a Special School without detriment to the interests of other children: (a) Moral defectives — — (b) Others — 1 2. Feeble-minded children notified on leaving a Special School on or before attaining the age of 16 2 1 3. Feeble-minded children notified under Article 3, i.e., "special circumstances" cases — — 4. Children who in addition to being mentally defective were blind or deaf —— — GRAND TOTALS 3 4 231 TABLE IV. RETURN OF DEFECTS TREATED DURING THE YEAR ENDED 31st DECEMBER, 1938. Group I.—Minor Ailments (excluding Uncleanliness, for which see Table VI).
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Defect or Disease Number of Defects treated, or under treatment during the year Under the Authority's Scheme Otherwise Totals Skin— Ringworm—Scalp: (i) X-Ray Treatment 1 — 1 (ii) Other 3 — 3 Ringworm—Body 33 — 33 Scabies 114 4 118 Impetigo 370 3 373 Other skin disease 293 31 324 Minor Eye Defects (External and other, but excluding cases falling in Group II). 410 24 440 Minor Ear Defects 209 21 230 Miscellaneous {e.g., minor injuries, bruises, sores, chilblains, etc.). 3,370 133 3,503 Totals 4,809 210 5,025 232 TABLE IV.—continued. Group II.—Defective Vision and Squint (excluding Minor Eye Defects treated as Minor Ailments— Group I).
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Number of Defects dealt with Under the Authority's Scheme Otherwise Totals Errors of Refraction (including Squint) 1,045 21 1,066 Other Defect or Disease of the Eyes (excluding those recorded in Group I) — — — Totals 1,045 21 1,066 Number of children for whom spectacles were prescribed:— (a) Under the Authority's Scheme 387 (b) Otherwise 18 Total 405 Number of children who obtained spectacles:— (a) Under the Authority's Scheme 394 (b) Otherwise 18 Total 412 233—234 TABLE IV.—continued. Group III.—Treatment of Defects of Nose and Throat. Number of Defects.
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Defect Received Operative Treatment Received other forms of Treatment Total number treated Under the Authority's Scheme, in Clinic or Hospital By Private Practitioner or Hospital, apart from the Authority's Scheme Totals Tonsils only — 30 30 230 497 Adenoids only 2 1 3 Tonsils and Adenoids 230 1 231 Other 3 — 3 Totals 235 32 267 230 497 Group IV.—Orthopaedic and Postural Defects. Under the Authority's Scheme . Otherwise Total number treated Residential treatment with education Residential treatment without education Non-Residential treatment at an orthopaedic clinic Residential treatment with education Residential treatment without education Non-Residential treatment at an orthopaedic clinic Number of children treated ... 5 1 359 — 1 2 363 235 TABLE V. DENTAL INSPECTION AND TREATMENT.
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(1) Number of Children who were:— (a) Inspected by the Dentist:— Aged: Routine Age Groups 5 515 6 627 7 606 8 564 9 657 10 599 11 621 12 885 13 550 14 151 Total 5,775 (b) Specials 1,375 (c) Grand Total (Routine and Specials) 7,150 (2) Found to require treatment 5,917 (3) Actually treated 4,666 (4) Attendances made by children for treatment 12,647 (5) Half-days devoted to:— Inspection 27 Treatment 1,123 Total 1,150 (6) Fillings:— Permanent teeth 6,623 Temporary teeth 91 Total 6,714 236 TABLE V.—continued.
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(7) Extractions:— Permanent teeth 1,559 Temporary teeth 8,443 Total 10,002 (8) Administration of general anaesthetics for extractions 3,844 (9) Other Operations:— Permanent teeth 4,744 Temporary teeth Total 8,588 TABLE VI. UNCLEANLINESS AND VERMINOUS CONDITIONS. (i) Average number of visits per school made during the year by the School Nurses 3 (ii) Total number of examinations of children in the schools by School Nurses 39,521 (iii) Number of individual children found unclean 1,008 (iv) Number of individual children cleansed under Section 87 (2) and (3) of the Education Act, 1921 4 (v) Number of cases in which legal proceedings were taken:— (a) Under the Education Act, 1921 7 (b) Under School Attendance Byelaws — 237 SCHOOL MEDICAL SERVICE. Statistical Tables—Secondary Schools in Barking, 1938.
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(i.e., BARKING ABBEY SECONDARY SCHOOL AND THE DAY SCHOOL OF THE SOUTH-EAST ESSEX TECHNICAL COLLEGE). TABLE I. RETURN OF MEDICAL INSPECTIONS. (Secondary Schools only.) A.—Routine Medical Inspections. Number of Inspections in the prescribed Groups:— Entrants 363 Second Age Group 202 Third Age Group 100 Total 665 Number of other Routine Inspections — Grand Total 665 B.—Other Inspections. Number of Special Inspections 148 Number of Re-Inspections 643 Total 791 238 C.—Children to require Treatment. Number of individual children found at Routine Medical Inspection to Require Treatment (excluding Defects of Nutrition, Uncleanliness and Dental Diseases.) Group. For defective vision (excluding squint) For all other conditions recorded in Table IIA Totals.
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Entrants 45 64 102 Second Age Group 23 13 34 Third Age Group 16 9 22 Totals (Prescribed Groups) 84 86 158 Other Routine Inspections — — — Grand Totals 84 86 158 239—240 TABLE II. (A)—RETURN OF DEFECTS FOUND BY MEDICAL INSPECTION IN THE YEAR ENDED 31st DECEMBER, 1938. (Secondary Schools only.) Defect or Disease Routine Inspections Special Inspections No. of Defects No. of Defects Requiring Treatment Requiring to be kept under observation, but not requiring Treatment Requiring Treatment Requiring to be kept under observation, but not requiring Treatment Skin (1) Ringworm—Scalp — — 1 — (2) Body — — 4 — (3) Scabies 1 — — — (4) Impetigo — — 1 — (5) Other Diseases (Non-Tuberculous) 8 3
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2 — Totals (Heads 1-5) 9 3 8 — Eye (6) Blepharitis 3 (7) Conjunctivitis 1 — 1 — (8) Keratitis — — — — (9) Corneal Opacities — 1 — — (10) Other Conditions (excluding Defective Vision and Squint) 2 — 3 — Totals (Heads 6-10) 6 1 4 — (11) Defective Vision (excluding Squint) 84 16 5 — (12) Squint — — — — Ear (13) Defective Hearing 1 — — — (14) Otitis Media — — — — (15) Other Ear Diseases 3 1 1 — Nose and Throat (16) Chronic Tonsillitis only 2 6 7 — (17) Adenoids only — — — — (18) Chronic Tonsillitis and Adenoids 1 1 — —
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(19) Other Conditions 9 4 — — 241—242 TABLE II. (A)—continued. (Secondary Schools only.) Defect or Disease Routine Inspections Special Inspections No. of Defects No. of Defects Requiring Treatment Requiring to be kept under observation, but not requiring Treatment Requiring Treatment Requiring to be kept under observation, but not requiring Treatment (20) Enlarged Cervical Glands (Non-Tuberculous) 1 3 — — (21) Defective Speech 1 — — — Heart and Circulation Heart Disease: (22) Organic — 2 — — (23) Functional — 4 — — (24) Anaemia — — — — Lungs (25) Bronchitis — 1 1 — (26) Other Non-Tuberculous Diseases — 3 — — Tuberculosis Pulmonary: (27) Definite — — — — (28) Suspected — — — — Non-Pulmonary: (29) Glands —
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— — — (30) Bones and Joints — — — — (31) Skin — — — — (32) Other Forms — — — — Totals (Heads 29-32) — — — — Nervous System (33) Epilepsy (34) Chorea — — — — (35) Other Conditions — 4 — 1 Deformities (36) Rickets — — — — (37) Spinal Curvature 4 2 — — (38) Other Forms 46 2 1 — (39) Other Defects and Diseases (excluding Defects of Nutrition, Uncleanliness and Dental Diseases) 12 24 32 10 Total number of defects 180 97 59 11 243 TABLE II. (B)—CLASSIFICATION OF THE NUTRITION OF CHILDREN INSPECTED DURING THE YEAR IN THE ROUTINE AGE GROUPS. (Secondary Schools only.)
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Age-groups Number of Children Inspected A (Excellent) B (Normal) C (Slightly) subnormal) D (Bad) No. % No. % No. % No. % Entrants 363 50 13.77 299 82.37 14 3.86 — — Second Age-group 202 40 19.80 155 76.73 7 3.47 — — Third Age-group 100 38 38.00 61 61.00 1 1.00 — — Other Routine Inspections — — — — — — — — — Totals 665 128 19.25 515 77.44 22 3.31 — — 244 TABLE III. RETURN OF ALL EXCEPTIONAL CHILDREN IN THE AREA. (Secondary Schools only.) NONE. 245 TABLE IV. RETURN OF DEFECTS TREATED DURING THE YEAR ENDED 31st DECEMBER, 1938.
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(Secondary Schools only.) Group I.—Minor Ailments (excluding Uncleanliness, for which see Table VI). Defect or Disease Number of Defects treated, or under treatment during the year Under the Authority's Scheme Otherwise Totals Skin— Ringworm—Scalp: (i) X-Ray Treatment — — — (ii) Other 1 1 2 Ringworm—Body 1 4 5 Scabies — 1 1 Impetigo 1 — 1 Other skin disease 2 1 3 Minor Eye Defects (External and other, but excluding cases falling in Group II.) 2 — 2 Minor Ear Defects 1 — 1 Miscellaneous (e.g., minor injuries, bruises, sores, chilblains, etc.). 28 2 30 Totals 36 9 45 246 TABLE IV.—continued. (Secondary Schools only.)
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Group II.—Defective Vision and Squint (excluding Minor Eye Defects treated as Minor Ailments— Group I). Number of Defects dealt with Under the Authority's Scheme ' Otherwise Totals Errors of Refraction (including Squint) 90 4 94 Other Defect or Disease of the Eyes (excluding those recorded in Group I) — — — Totals 90 4 94 Number of children for whom spectacles were prescribed:— (a) Under the Authority's Scheme 53 (b) Otherwise 4 Total 57 Number of children who obtained spectacles:— (a) Under the Authority's Scheme 50 (b) Otherwise 4 Total 54 247 TABLE IV.—continued. (Secondary Schools only.) Group III.—Treatment of Defects of Nose and Throat. Number of Defects.
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Defect Received Operative Treatment Received other forms of Treatment Total number treated Under the Authority's Scheme, in Clinic or Hospital By Private Practitioner or Hospital, apart from the Authority's Scheme Totals Tonsils only 1 — 1 6 6 Adenoids only — — — Tonsils and Adenoids — — — Other — — — Totals 1 — 1 5 6 Group IV.—Orthopaedic and Postural Defects. Under the Authority's Scheme Otherwise Total number treated Residential treatment with education Residential treatment without education Non-Residential treatment at an orthopaedic clinic Residential treatment with education Residential treatment without education Non-Residential treatment at an orthopaedic clinic Number of children treated — 56 — — — 56 249 TABLE V. DENTAL INSPECTION AND TREATMENT. (Secondary Schools only.)
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(1) Number of Children who were:— (a) Inspected by the Dentist:— Aged: Routine Age Groups 10 — 11 67 12 59 13 67 14 68 15 57 Total 318 (b) Specials 64 (c) Grand Total (Routine and Specials) 382 (2) Found to require treatment 284 (3) Actually treated 263 (4) Attendances made by children for treatment 909 (5) Half-days devoted to:— Inspection 2 Treatment 101 Total 103 (6) Fillings:— Permanent teeth 701 Temporary teeth — Total 701 (7) Extractions:— Permanent teeth 120 Temporary teeth 59 Total 179 250 TABLE V.—continued. (8) Administration of general anæsthetics for extractions 109 (9) Other Operations:— Permanent teeth 255 Temporary teeth Total 255 TABLE VI. UNCLEANLINESS AND VERMINOUS CONDITIONS. (Secondary Schools only.)
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(i) Average number of visits per school made during the year by School Nurses (ii) Total number of examinations of children in the schools by School Nurses 665 (iii) Number of individual children found unclean — (iv) Number of individual children cleansed under Section 87 (2) and (3) of the Education Act, 1921 — (v) Number of cases in which legal proceedings were taken:— (a) Under the Education Act, 1921 — (b) Under School Attendance Byelaws — 251 MEDICAL INSPECTION. (Secondary Schools only.) The following table shows the number of medical examinations conducted at school at routine and special inspections during 1938 classified according to the schools, the number of inspections held in each school, and the number of parents or guardians present:— School. No. of Inspection Sessions. Numbers Inspected. No. of Parents present (Routine and Special Exams.) Routines and Specials. Re-Exams.
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Barking Abbey Boys 7 113 46 54 Barking Abbey Girls 5 109 46 60 South-East Essex Technical College Boys 14 286 62 167 South-East Essex Technical College Girls 9 209 94 161 Totals 35 717 248 442 252 FINDINGS OF MEDICAL INSPECTION. (Secondary Schools only.) Table II (A) on pages 239 and 240 gives in detail a return of defects found during the course of routine and special inspections at ordinary elementary schools and at the clinics. The following table is similar to Table I (C) of the Returns to the Board of Education (given on page 238 of this report), except that it shows the percentage of children found to require treatment:— Group. Number of Children. Percentage of children found to require Treatment. Inspected. Found to require Treatment.
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PRESCRIBED GROUPS : Entrants 363 102 28.1 Second age group 202 34 16.8 Third age group 100 22 22.0 Totals (prescribed groups) 665 158 23.7 OTHER ROUTINE INSPECTIONS — — — 253 FOLLOWING-UP. (Secondary Schools only.) A summary of the following-up work by your School Nurses is given herewith:— Number of visits to schools re medical inspection 39 Total number of visits to schools 39 Number of home visits in connection with:— (a) Routine medical inspections 15 (b) Cleanliness inspections 2 (c) Infectious disease 1 (d) Non-attendance for treatment at Minor Ailments Clinics, etc. — (e) Miscellaneous 21 (/) After operations for removal of enlarged tonsils and/or adenoids — (g) Non-access visits — 254 ARRANGEMENTS FOR TREATMENT. (Secondary Schools only.)
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A summary of the work of the Clinics is included in the following table:— All Clinics. Clinic. No. of first attendances of school children. Total No. of attendances of school children. Minor Ailments:— (a) Central 60 175 (b) Woodward 23 109 (c) Porters Avenue 9 26 Ophthalmic 93 219 Dental 263 969 Orthopaedic FOR EXAMINATION 34 52 FOR TREATMENT 46 183
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PUBLIC HEALTH DEPARTMENT mr. H. illiet. BARK 33 BOROUGH OF BARKING. THE ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH. FOR THE YEAR 1939 (War Edition) C. LEONARD WILLIAMS, B.Sc., H.R.C.S., L.R.C.P., D.P.H. BOROUGH of BARKING. ANNUAL REPORT of the Medical Officer of Health for the Borough of Barking? in the County of Essex, for the Year ended 31st December, 1939. (War Edition). Public Health Department, Barking, Essex. August, 1940. To the Mayor, Aldermen and Councillors of the Borough of Barking. Mr. Mayor, Ladies and Gentlemen, I have pleasure in submitting my report as Medical Officer of Health for the year ended 31st December, 1939.
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At the suggestion of the Ministry of Health an interim report only is being issued this year, although suitable arrangements are being made for the preservation of all records in order that, at the termination of the war, a report could be issued dealing more fully with the period from the beginning of 1939. This report is confined mainly to essential and urgent matters which have affected the public health during the year; it deals inter alia with matters arising from, or connected with, the war. I am, Mr. Mayor, Ladies and Gentlemen, Your obedient servant, C. LEONARD WILLIAMS, Medical Officer of Health. - 2 - ANNUAL REPORT of the MEDICAL OFFICER of HEALTH for the YEAR 1959 (War Edition). STAFF. The following indicates the many changes that have taken place in the staff of the Public Health Department during the year 1939:- Deputy Medical Officer of Health and Deputy School Medical Officer.
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J. Mervyn Thomas, M.D., B.Sc., D.M.R.E., L.R.C.P., D.P.H. (Resigned 9th December, 1939). Assistant Medical Officers of Health and Assistant School Medical Officers. T. M. Clayton, M.B., B.S., B.Hy., D.P.H. (Resigned 23rd September, 1939). Margaret A. Glass, B.Sc., M.B., Ch.B., D.P.H. (Resigned 31st March, 1939). Muriel M. Osborn, M.R.C.S., L.R.C.P. (Resigned 28th August, 1939). T. A. Cockburn, M.D., D.P.H. (Commenced 13th March, 1939). Phoebe I. McKernan, L.R.C.P., L.R.C.S., L.L.M.
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(Commenced 28th August, 1939). Resident Medical Officer, Barking Hospital. Phoebe I. McKernan, L.R.C.P., L.R.C.S., L.L.M. (Commenced 15th March, 1939). - Transferred to post of Assistant Medical Officer, 28th August, 1939). Resident Medical Officer, Upney Hospital. C. P. Bampfylde Wells, M.R.C.S., L.R.C.P. (Resigned 28th August, 1939). Dental Surgeons. R. O. Borgars, L.D.S., R.C.S. (Resigned 31st January, 1939). Eileen F. Gawn, L.D.S., R.C.S. (Resigned 20th May, 1939). J. Angelman, L.D.S. (Commenced 1st July, 1939).
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J. R. Watson, L.D.S., R.C.S. (Commenced 10th July, 1939). Sanitary Inspectors. Miss J. Urquhart, (h and t). (Commenced 28th August, 1939). Health Visitors etc. + Miss E. Fisher, (g, h and i). (Resigned) 30th November, 1939). + Miss R. Hobbs, (g, h and i). (Resigned 2nd November, 1939). + Miss M. McAlister, (g, h, i and j). (Resigned 14th March, 1939). Miss S. E. Ware, (Chiropodist) (s). (Commenced 2nd January, 1939. Resigned 13th November, 1939). - 3 - District Municipal Midwives. Mrs.
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L. Back, (h and i). (Resigned 31st July, 1939). Miss G. Thomas, (h). (Transferred to Hospital Staff 28th January, 1939). Mrs. W. Wild, (h and i). (Commenced 1st August, 1939). Clerical Staff. Mr. E. A. Ellis, (c and m). (Resigned 26th May, 1939). Miss D. Foulsham. (Resigned 29th July, 1939). Miss I. Cast, (Resigned 31st August, 1939). Mr. L. J. Dexter. (Military Service as from 1st September, 1939). Mr. G. Stokes. (Commenced 28th February, 1939). Mr. H. Garrod.
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(Commenced 23rd May, 1939). Miss D. House. (Commenced 14th August, 1939). Miss E. Clark. (Commenced 28th August, 1939). (c) Meat etc., Inspector's Certificate of the Royal Sanitary Institute. (g) Health Visitor's Certificate of the Royal Sanitary Institute. (h) Certificate of the Central Midwives' board. (i) General Hospital Training. (j) General Fever Training. (m) Sanitary Inspector's Certificate of the Royal Sanitary Institute and Sanitary Inspectors' Examination Joint Board. (s) Certificate of Chiropody of the Chelsea School of Chiropody, (t) Sanitary Inspector's Certificate and Certificate of Meat Inspection, (Scotland). + Combined appointment - Health Visitor and School Nurse.
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At the outbreak of war your four district midwives went to Bishops Stortford with those expectant mothers whose confinements were imminent; by the end of the year two of these midwives had returned and the others came back early in 1940. No other staff was transferred to reception areas. During the latter months of 1939 members of the staff were designated to posts in connection with Civil Defence, but, when things became more settled, the staff were for the most part released from Civil Defence work and returned to their normal duties; the majority, however, continue to take part in the Civil Defence Scheme on a voluntary basis. 4 SECTION A. STATISTICS AND SOCIAL CONDITIONS OF THE AREA. (See also Page 26) (1) GENERAL STATISTICS.
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Area (acres) 4,174 Population (1931 Census) 51,277 + Population (June, 1938) (Registrar- General's Estimate) 76,790 Number of Inhabited Houses, March, 1940, according to Rate Books;- Houses 18,906 Shops 1,377 Total 20,283 Rateable Value - General £732,526 0 0 Sum represented by a penny rate £2,984 11 4 General Rate 15s. 6d. + This figure has been affected considerably by evacuation, etc. (2) VITAL STATISTICS.
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Net deaths belonging to the district 569 Death Rate 7.41 Net live births belonging to the district 1,009 Birth Rate 13.14 Net still-births belonging to the district 34 Still-birth rate per 1,000 total births 32.6 Number of deaths of infants under one year of age 38 Infantile Death Rate 37.66 Number of maternal deaths 2 Maternal Mortality Rate 1.92 N. B. The official figures had not been received from the Registrar-General at the time this report was prepared. The figures quoted are purely local figures and may be subject to correction. 5 (3) DEATHS. (a) General. There were 303 deaths registered in Barking during 1939. Of these, 10 were deaths of non-residents. Barking residents to the number of 276 died elsewhere during the year. Including the latter and excluding the deaths of visitors, the net number of deaths was as follows Males. Females.
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Total. 323 246 569 The following table shown the principal causes of death during 1939:- (Net Deaths). Causes of Death. Total Diphtheria 2 Influenza15 Pulmonary Tuberculosis 48 Non-Pulmonary Tuberculosis 3 Syphilis 1 Cancer 90 Diabetes 4 Cerebral Haemorrhage 23 Heart Disease 138 Other Circulatory Diseases 23 Bronchitis 23 Pneumonia (all forms) 33 Other Respiratory Diseases 9 Peptic Ulcer 7 Diarrhoea (under 2 years) 7 Appendicitis 3 Cirrhosis of Liver 1 Other Digestive Diseases 2 Acute and Chronic Nephritis 22 Other Puerperal Causes 2 Congenital Debility, Premature Birth, etc. 22 Senility 10 Suicide 13 Other Violence 18 Other Defined Diseases 50 Total 569 (b) Infant Mortality.
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Once again I have pleasure in drawing your attention to the infant mortality rate, which at 37.66 is the lowest figure yet reported to you. That such a splendid result should be obtained in so difficult a year reflects much credit on your health visiting staff. The following table gives the actual causes of death of the 38 children who died under one year of age 6 0-1 mth. 1-3 mths. 3-6 mths. 6-9 mths. 9-12 mths.
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Total under 1 year Acute Bronchitis 1 I 1 2 Acute Influenzal BronchoPneumonia 1 1 Acute Primary Broncho-pneumonia 1 1 Asphyxia (Natural) due to Acute Suppurative Bronchitis 1 1 Atelectasis Neonatorum & Premature Birth 1 1 Bronchitis & Marasmus 1 1 Broncho-Pneumonia & Infantile Eczema 1 1 Broncho-Pneumonia & Suprarenal Haemorrhage 1 1 Cerebral Haemorrhage, Birth Injury & Congenital Heart Disease 1 1 Convulsions, Cerebral Injury,
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Instrumental Delivery 1 1 Gastro-Enteritis 1 Gastro-Enteritis & Maternal Eclampsia 1 1 Haemorrhagic Diathesis of Newborn 1 1 Heart Failure & Multiple Congenital Deformities incompatible with life 1 1 Hydrocephalus & Spina Bifida Inanition & Premature Birth Induction & Prematurity 4 1 1 1 4 1 Intercranial Haemorrhage due to Birth Tears of the Dura Mata 1 1 Intercranial Haemorrhage 1 1 Meningitis & Acute Lobar Pneumonia 1 1 Pneumonia 1 1 Pneumococcal Peritonitis,
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Pneumococcal Pyaemia & Broncho-Pneumonia 1 1 Prematurity 5 Prematurity & Atelectasis of the Lungs 1 1 Prematurity & Toxaemia of Pregnancy 1 1 Purulent Meningitis & Hydrocephalus 1 1 Septicaemia & Cerebral Haemorrhage. Infected Haematoma of Scalp 1 1 Toxaemia & Gastro-Enteritis 1 2 3 Totals 21 8 5 1 3 38 (c) Maternal Mortality. At the time of preparing this report the official maternal mortality figures had not been received, but we think we are advised sufficiently of the situation to afford you some information. 7 There were four deaths of Barking women associated with pregnancy or childbirth. Two women died in the early months of pregnancy, before they came under your Maternity and Child Welfare Scheme; one only of these can be classified strictly as a maternal death.
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One woman was evacuated and died out of the town and her death is not allocated to Barking; of all the cases delivered under your schemes, numbering approximately 960, one only died. Though it cannot be said statistically, I am persuaded the damage due to childbirth is today slight indeed compared with a generation ago. (4) SOCIAL CONDITIONS. (a) General. The outbreak of hostilities considerably affected the social conditions of the Borough during 1939 5 many women and children were evacuated to reception areas. A large proportion of these, particularly the women, returned to Barking before the end of the year. A serious thing I have noticed since the outbreak of war is that the public is less and less interested in preventive medicine than they have been heretofore.
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Curative medicine captures the public imagination; it is difficult for parents to think seriously of conditions such as defective teeth, eyes, tonsils, etc., which are detrimental to their children or more likely will be detrimental to them some years hence, when their immediate concern is that they may be safe say for the next 24 hours. War of necessity limits ones vision to the immediate future; this, so far as I can see, is a most harmful influence at the present time. (b) Schemes of Relief. There is no doubt that in drawing up schemes of relief, Public Assistance Committees must have had in their minds other forms of relief which are available. For necessitous persons such forms of relief include, among many others, free meals for children of school age. Children in necessitous households will almost invariably be living on a diet which is deficient in the necessary protective food stuffs and a certain number of them will share with other children the danger of eating foods which have been improperly cooked and thereby less digestible than they otherwise would be.
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If such children be given one proper meal a day, the appetite of these children will be increased because it has been found that one good meal deserves another. Not only will the appetite be increased, as such, but the proper meal a day will increase the rate of growth so that consequently from this standpoint also the child would require more food. Households, therefore, where the family income is less than the standard rate and whose children are given a well balanced, properly prepared meal, should be subsidised by an allowance, rather than the free meal provided being regarded as a form of relief which may be taken into account when assessing scales of relief. 8 (c) Unemployment. Barking is a dormitory town and the employment has "been changed considerably by the war. The following table shows a comparative statement of local unemployed by industries as at December, 1938, and December, 1939 Dec. 1939. Dec. 1938. Men Women Men Women Pood 14 12 8 3 Electrical
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and Wireless 33 29 2 1 Building Trade and Painters 147 1 179 1 Works of Construction 100 - 145 - Engineering 41 7 31 2 Domestic 9 77 18 50 Rubber Workers 9 13 34 19 Commercial 3 6 3 3 Road and Water Transport 27 2 43 1 Clothing 11 53 12 35 Distributive Trades 141 90 133 52 Government and Professional 7 8 1 - Tin Box Manufacture 5 5 7 9 Matches 3 9 3 3 Chemicals 22 8 26 4 Printing 22 21 17 13 Asbestos 8 21 7 14 Woodworking and French Polishing 53 4 7 2 Agriculture 6 19 7 25 General Labourers and Factory Hands 334 65 633 185 Mineral Water Manufacture 4 7 - 1 Leather Trades - 2
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4 - Gas and Water 51 2 42 - 1,050 1+61 1,363 423 (d) Travelling Facilities. Once again I regret to report that there has been no improvement in the standard of travelling conditions to and from Barking; in fact the reduction in the number of trains and buses at the beginning of the war meant that the travelling facilities deteriorated. Black-out conditions, too, tended to make travelling more irksome. - 9 - SECTION B. GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. (1 ) GENERAL HEALTH SERVICES. (a) Laboratory Facilities. Our laboratory facilities have suffered considerably from the absence, owing to illness, of Dr. E. M. Hill, the Scientist. During the time Dr. Hill was in Barking, not only ourselves,but other organisations and authorities she contacted, learned to value highly the way in which she undertook her work in the Laboratory in the Barking Hospital precincts.
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(b) Ambulance Facilities. On the outbreak of War your ambulance service became virtually a part of the Air Raid Precautions Service, and has so continued. (c) Hospitals (Public and Voluntary). Not only your Hospitals, but certain voluntary and County Hospitals were taken over wholly or in part, and became emergency hospitals at the beginning of September; some two months later your Maternity Hospital reverted to its normal use. As in previous years you allocated a sum of £300 to be distributed to certain voluntary hospitals catering specially for the needs of the people of Barking. Your proposal to build a second maternity pavilion has had to be deferred on account of the war. (d) Clinics and Treatment Centres. On the outbreak of war both the Central and the Woodward Clinics were taken over and adapted for use as First Aid Posts.
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For a few weeks clinic sessions were curtailed, but, by the end of the year, a more normal programme of work was being carried out at all Clinics, excepting Porters Avenue, where the Minor Ailment Sessions were cancelled. The number of sessions at the Foot Clinic were reduced. (e) Nursing in the Home. In consequence of the outbreak of war many patients were discharged from hospitals and many hospitals reduced their out-patient activities. This of necessity led to the utmost demands being made on the Home Nursing Services which have been provided in the Borough. This work is at present done by the Plaistow Maternity Hospital and District Nurses' Home and the East Barking District Nursing Association, both of whom now receive substantial grants from the Corporation. (2) MATERNITY AND CHILD WELFARE SERVICES. (a) Ante-Natal and Post-Natal Supervision.
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Although the ante-natal clinics were interrupted at the commencement of the war, by the end of the year our - 10 - programme was again normal. In spite of the evacuation of many expectant mothers the number of attendances at your clinics amounted to 6,726, a slight increase on the figure for the previous year; the number of post-natal attendances (392) and gynaecological attendances (332) were much the same as for the previous year. (b) Midwifery. (1) Supervision. There were 18 midwives practising in the Borough at the end of the year, seven of which were employed at the Upney Maternity Pavilion. During the year 1939s midwives sought medical assistance in 261 cases; 65 of these were on behalf of babies, (2) Midwives Act, 1936.
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The arrangements made by the Council pursuant to the Midwives Act, 1936, worked very smoothly until the outbreak of war when some 240 expectant mothers were evacuated under the Council's Scheme. About 170 of these were sent to various reception areas in the West of England; the remaining 70, whose confinements were imminent, were sent to Bishops Stortford. A large house was converted for use as an emergency maternity hospital; your four district midwives were temporarily transferred. The arrangements at Bishops Stortford were most successful, and it is hoped to use the same emergency hospital should evacuation again be ordered for expectant mothers. Upwards of six-hundred mothers were delivered in Barking under your district midwifery scheme during the year 1939. (c) Upney Maternity Pavilion.
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The Maternity Hospital became part of the Emergency Hospital Scheme just prior to the outbreak of war and those patients who were fit for discharge were discharged on the order of the Ministry; some two months later it was re-opened as a Maternity Hospital. As a result of this temporary closure, the evacuation scheme and the policy of limiting the number of admissions, there was a reduction in the number of cases dealt with. Pour-hundred and four patients were admitted, 50 of which were for ante-natal treatment; the corresponding figures for the year 1938 were 504 and 44 respectively. (d) Infant Welfare Centres. The number of attendances at infant welfare centres decreased on account of evacuation and also because at the outbreak of hostilities some of the clinic sessions were curtailed. 32,163 attendances were made during 1939s compared with 37,925 during 1938. (e) Home Visiting.
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The gradual return of many evacuated mothers and babies made home visiting all the more important and difficult since the outbreak of war. Your Health Visitors were unable to devote so much time to this work during 1939, and the number of visits paid was 17,696, as compared with 21,936 in the previous year. - 11 - - SECTION C SANITARY CIRCUMSTANCES OF THE AREA. (1) RAINFALL. The rainfall for the year ended 31st December, 1939s was 24.05 inches, as compared with 14.42 inches for the previous year. Rain fell on 172 days in the year 1939. (2) DRAINAGE AND SEWERAGE. Drainage arrangements continue as heretofore. (3) RIVERS AND STREAMS. The rivers and streams running through the area are tidal in character and are not controlled by the Corporation.
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Attention is directed to the continued unsatisfactory condition' obtaining in the River Roding. (4) CLOSET ACCOMMODATION. At the end of the year there remained a total of 16 premises unconnected with the sewer, nine of which 'ere factory premises. (5) PUBLIC CLEANSING. During the year, 9,190 loads of refuse were collected, with an average weight of 1 ton 19 cwts. (6) REFUSE DISPOSAL. All the refuse collected in the Borough was deposited at the Corporation tip which is situated on the North Bank of the Roding, near the Kingsbridge Wharf. (7) SANITARY INSPECTION OF THE AREA. Emergency and war conditions have interfered seriously. with the routine work of the Department. (a) WORK OF SANITARY INSPECTORS. (1) Inspection of Dwelling-Houses.
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Total Houses Inspected under Public Health or Housing Acts 1,680 Total Number of Inspections made 4,350 Housing (Consolidated) Regulations 545 After Infectious Disease 727 Overcrowded Premises 63 Defects Found 2,066 Notices Served (preliminary) 925 Re-inspections re Notices Served 2,670 Inspection of Works in Progress 1 60 Slum Clearance Property 1 44 - 12 - (2) Premises Controlled "by Byelaws and Regulations. Inspections. Contraventions. Notices served.
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Houses Let in Lodgings — — — Common Lodging Houses 3 1 1 Offensive Trades 25 15 6 Tents, Vans and Sheds 28 5 2 Dairies, Cowsheds and Milkshops 39 9 5 Slaughter-houses 69 — — Hairdressers' & Barbers' Premises 19 4 3 Smoke Observations 61 1 2 12 (3) Factories, Workshops and Workplaces. Inspections. Defects. Notices. Factories 70 — — Bakehouses 11 — — Workplaces 73 9 7 Outworkers' Rooms 54 — — Butchers' Premises 106 41 25 Fishmongers 19 17 8 Restaurants and Dining Rooms & Canteens 72 43 19 Stables and Stable Yards 10 4 3 Piggeries 2 — — (4) Miscellaneous. Inspections. Defects.
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Notices. Rats and Mice (Destruction) Act, 1919 34 8 7 Vacant Land and Refuse Dumps 72 8 4 Public Lavatories 30 1 1 Schools 23 1 1 Markets and General Shops 136 4 3 Ice-Cream Vendors 32 13 7 Petroleum and Celluloid Stores 30 3 1 Drainage Inspections 99 — — Milk Sampling 47 — — Other Miscellaneous 41 — — Inspection of Meat from Outside District 74 — — Shops Act, 1934 231 36 26 Water Sampling 8 — — Food Manufacturers — — — Street Traders 5 — — Food Byelaws 10 7 6 - 13 - (b) NOTICES SERVED.
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Informal Notices 925 Statutory Notices:- Public Health Act, 1936 :- Section 39 6 Section 45 28 Section 83 8 Section 93 239 Housing Act, 1936 :- Sections 9 & 10 40 Section 24 2 Section 32 1 324 (c) FACTORIES ACT, 1937. (1) Inspections (including inspections made by Sanitary Inspectors). Premises. Number of Inspections. . Written Notices. Prosecutions. Intimations. Statutory. Factories 70 — — — Workplaces 73 7 — — Totals 143 7 — — (2) Defects found. Particulars. Number of Defects. Number of Prosecutions. Found Remedied Referred to H.M. Inspector.
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+Nuisances under the Public Health Acts :Want of cleanliness 3 3 — — Inadequate ventilation — — — — Overcrowding — — — — Want of drainage of floors — — — — Sanitary accommodation Insufficient 1 1 — — Unsuitable or defective 5 5 — — Not separate for sexes — — — — Other offences 1 1 — — Totals 10 10 — — 4- Including those specified in Sections of the Factories Act, 1937, as remediable under the Public Health Acts. - 14 - ( 3) Home Work. Sight notices were issued to the occupiers of premises in the district where outworkers are employed, who supplied lists twice during the year of 30 workpeople engaged on making wearing apparel, etc. , in their homes. (4) Other Matters. Class Number. Matters notified to H.1-.
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Inspector of Factories :- Failure to affix Abstract of the Factory and Workshop Act — Action taken in matters referred by H.M. Inspector as remediable under the Public Health Acts, but not under the Factory and Workshop Act 1 Other — Underground Bakehouses Certificates granted during the year —- In use at the end of the year — (5) Outworkers. The Register of Outworkers contains the names and addresses of 67 persons carrying out work at their homer on "behalf of other people. (d) PREMISES AND OCCUPATIONS WHICH ARE CONTROLLED BY BYELAWS OR REGULATIONS. The following is a list of the above type of premises:- (1) Houses Let in Lodgings. (2) Common Lodging Houses. (3) Tents, Vans and Sheds. (4) Underground Sleeping Rooms. (5) Offensive Trades. (61 Piggeries. (7) Stables.
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(e) RATS AND MICE DESTRUCTION ACT, 1919. There were 34 visits made to premises under this Act, and any necessary work arising has been carried out. (f) REMOVE OF INFIRM AND DISEASED PERSONS. Three eases were reported during the year. In two cases arrangements were made for the persons to have institutional treatment, and in the third case it was found that suitable arrangements were in force for the person to have the necessary medical and nursing attention at home. (8) ERADICATION OF BED BUGS. The following houses have been disinfested Barking Council Houses 37 London County Council Houses 9 Privately Owned Houses 6 Total .52 - 15 - SECTION D. HOUSING. (1 ) STATISTICS. (a) General. Number of new houses erected during the year;- (1) Total 501 (2) As part of a municipal housing scheme;- (a) Barking 178 (b) L.C.C.
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56 (3) Others (including private enterprise and subsidy houses) 267 (b) Unfit Dwelling-Houses. 1. Inspection of Dwelling-Houses during the Year:- (1) (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 1,680 (b) Number of inspections made for the purpose 4,350 , (2) (a) Number of dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations 545 (b) Number of inspections made for the purpose 1,154 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 51 (4) Number of dwelling-houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 925 2.
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Remedy of Defects during the Year without Service of formal Notices;- Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their officers 700 3. Action under Statutory Powers during the Year; - A. - Proceedings under sections 9, 10 and 16 of the Housing Act, 1936; (1) Number of dwelling-houses in respect of which notices were served requiring repairs 40 - 16 - (2) Number of dwelling-houses which were rendered fit after service of formal notices:- (a) By owners 95 (b) By local authority in default of owners 1 B. - Proceedings under Public Health Acts: (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 281 (2) Number of dwelling-houses in which defects were remedied after service of formal notices:- (a) By owners 86 (b) By local authority in default of owners Nil C.
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- Proceedings under sections 11 and 13 of the Housing Act, 1936: (1) Number of dwelling-houses in respect of which Demolition Orders were made, 3 (2) Number of dwelling-houses demolished in pursuance of Demolition Orders, 3 D. - Proceedings under section 12 of the Housing Act, 1936: (1) Number of separate tenements or underground rooms in respect of which Closing Orders were made Nil (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit Nil E. - Proceedings under section 114-8, Barking Corporation Act, 1933: Number of dustbins supplied by local authority in default of owners 165 - 17 - SECTION E. INSPECTION AND SUPERVISION OF FOOD. (1 ) MILK SUPPLY AND ICE-CREAM. (a) Milk Supply.
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There are no cowkeepers in the district and we have only one dairy where milk is handled or treated. The remaining 77 premises on the register retail pre-packed supplies. In addition there are 15 milk purveyors who occupy premises in other districts, but retail in Barking. The following table sets out the results of the bacteriological examination of various samples, from which it will be seen that, of the total of 36, all were satisfactory- Type of Sample. Satisfactory. Unsatisfactory. Totals. "Sterilised" Milk — — — "Pasteurised" Milk 18 — 18 Raw Milk 14 — 14 "Homogenised" Milk 2 — 2 Tuberculin Tested Milk 2 — 2 Totals 36 — 36 There were during the year 6 samples of milk submitted to biological examination for the presence of tubercle, none of which were found to be infected.
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The following table shows the number of licences granted during the year for the sale of graded milks under the Milk (Special Designations) Order, 1936:- Tuberculin Tested 6 Pasteurised 13 (b) Ice-Cream - Barking Corporation Act, 1933 - Section 160. There are 113 manufacturers and vendors registered, in accordance with this Act. This is a decrease of four in the number of registered premises. Many of the shops are supplied from one source with pre-packed containers and sampling is therefore directed to control the main supplies, rather than the individual vendors. The general standard of cleanliness has been good. Six samples were submitted for bacteriological examination, one of which was unsatisfactory. (2) MEAT AND OTHER FOODS. (a) Meat. There is one licensed slaughterhouse in the district, the licence of which is renewable annually. - 18 - - 19 - Statistics show the work carried out in this slaughterhouse during the year.
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The following table gives particulars of notifications received, and the animals slaughtered, during the twelve years ended December 31st, 1939. Year. 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 Notifications Received 126 72 61+ 39 57 34 205 236 195 179 184 112 Cattle 40 64 80 12 10 41 350 447 340 365 340 234 Pigs 409 137 93 200 84 18 502 1,131 474 457 212 77 Sheep 815 426 332 173 270 241 1038 1,346 748x 500+ 936* 545# Calves 71 10 11 1 9 1 140 157 11 38 3 2 Totals 1,
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335 637 516 386 373 301 2030 3081 1,639 1,360 1,491 857 x Includes 404 lambs. + Includes 199 lambs. x Includes 597 lambs. # Includes 257 lambs.
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The following additional table gives information as to carcases inspected and condemned during the year 1939 — Cattle excluding Cows Cows Calves Sheep and Lambs Pigs Number Killed 209 25 2 545 77 Number Inspected 209 25 2 545 77 All diseases except Tuberculosis:- Whole carcases condemned — — — — — Carcases of which some part or organ was condemned 31 3 — 8 — Percentage of Number inspected affected with disease other than Tuberculosis 14.83 12.0 — 1.46 — Tuberculosis only:- Whole carcases condemned 6 3 — — — Carcases of which some part or organ was condemned 55 12 — — — Percentage of the number inspected affected with Tuberculosis 26.31 48.0 — — — - 20 - (b) Supervision of Food Preparing Premises.
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The number of premises in the district at the end of the year at which the following foods are prepared were:— Sausages 26 Potted Meat and Brawn 4 Roast and/or Boiled Ham 6 Pressed, Pickled, Cooked, etc., Beef and Tongue 39 Roast Pork 5 Bacon 1 Boiled Crabs and Lobsters 1 Pickled Fish 8 Pickled Onions 1 Smoked Fish 7 Bakehouses 9 (c) Unsound Food. The following list gives particulars of unsound food destroyed during the year;- 70 Ibs. Frozen Ox Cheeks. 70 lbs. Kippers (5 boxes @ 14 lbs.) 7 lbs. Cooked Gammon Bacon. 1 lb. 2 ozs. Pears. 200 lbs. Chicken. 265 lbs. Beef. 195 lbs. Mutton and Lamb. 5 stone Coley. 20 lbs. Lambs Livers.
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203 lbs. Beef. 60 lbs. Beef. 60 lbs. Ox Livers. (3) FOOD POISONING. There were 5 cases of food poisoning notified during the year. These were investigated and any necessary action taken. (4) ADULTERATION, ETC. I am indebted to Mr. A. Horsnell, Chief Food and Drugs Officer for the Metropolitan Area of the Essex County Council, for the particulars of Samples purchased and submitted for analysis during the period 1st January to 30th September, 1939. These samples were submitted for chemical examination to Dr. Bernard Dyer, the County Analyst Great Tower Street, London, with the following results - Milk 15 Butter 24 Other 102 Total 141 At the 1st October, 1939, the Council became the administrative authority for the purposes of the Food and Drugs Act (1938).
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The first quarterly report of the Public Analyst, who continues to be Dr. Bernard Dyer, as - 21 - above mentioned, shows that the following action was taken;- Samples examined. Milk 1 Butter 2 Other 27 Total 30 all of which were found to be unadulterated, and no case was found of any infringement of the regulations relating to the use or the presence of preservatives in any of the samples submitted. (5) CHEMICAL AND BACTERIOLOGICAL EXAMINATION OF FOOD. The bacteriological examination of all milk, ice-cream and water samples is carried out for this Authority by the Counties' Public Health Laboratories, of 91, Queen Victoria street, London, whilst the examination of samples of milk for the presence of tubercle is carried out by Dr. S. R. Gloyne, of the Victoria Park Hospital, Hackney.
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- 22 - SECTION F. PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES. (1) Notification. The evacuation scheme meant that we had a smaller population vulnerable to infectious diseases after the outbreak of war, and the notification figures show a significant decline. In October the Measles and Whooping Cough (Provisional) Regulations, 1939, were introduced, making these diseases notifiable. The following table shows the number of notifications of infectious diseases (other than Tuberculosis) received during 1939 Disease Total Total cases removed to Hospital Deaths Smallpox — — Scarlet Fever 192 170 — Diphtheria 91 91 — Enteric Fever (including Para-Typhoid Fever) 2 2 — Puerperal Pyrexia 10 4 — Pneumonia Acute Influenzal (18) 34 4 Acute Primary (59) 3 Following Measles (—) — Erysipelas