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ea727787-dd12-4404-9868-28e2fc6be078 | Some necessary improvements were made during the year, and noxious conditions are now at a minimum. During hot weather, frequent inspections are necessary to ensure the proper covering and disposal of waste matters. (/) OIL BOILER. Bye-laws controlling this business did not, although confirmed, become operative during the year. The owner carried out certain alterations which, although remedying offensive conditions within the factory, have in no way minimized the nuisance without. After constant pressure, negotiations are now in hand for the installation of an efficient oil fume condenser. COMMON LODGING HOUSES. There are two registered Common Lodging Houses, providing accommodation for 30 and 27. male lodgers respectively. These houses are of the dormitory type, and received 84 visits, excluding night inspections, during the year.. Five notices were served in respect of l4 infringements of the bye-laws, and 2 notices for structural defects. There was one change of keeper during the year. |
330a9fc0-9050-48c3-894d-feb2fbc60cc3 | The habitues of these houses are not of the usual vagrant type, but more or iess regular customers, and the premises, on the whole, are well conducted. 37 TENTS. VANS, SHEDS, Etc. There are 16 such. premises in the district, which received visits during the year. The defects discovered were mainly: want of proper water supply and sanitary accommodation in 4 instances; absence of proper refuse accommodation in 3; and a filthy condition of the premises also in 3 instances. It was necessary to institute proceedings in the case of one -family, who were in occupation of a hut without provision of water supply, sanitary or refuse provision. A Magistrate's Order was obtained for closure of the premises. HOUSES LET IN LODGINGS. It has so far been found impracticable to register all houses coming within the scope of these Bye-laws. |
3cbc1c56-f5f0-438a-80fa-40a6231a7fae | Technically, somewhere between two and three hundred such houses are in occupation within the district, though never intended for the purpose, and with about nine exceptions, totally unsuited therefor. These houses are frequently inspected to secure their being maintained in as good sanitary condition as possible. FOOD. Dairies, Cowsheds and Milkshops.βThe number of registered dairies and milkshops is 28. Three dairies and milkshops were registered for the first time during the year, while 8 were removed from the register. In addition to my own inspections, 274 visits were paid by the inspectors, and 3 notices served for defects. In one instance only was milk so stored as to become liable to contamination. At the end of the year one cowshed remained in occupation only, but, although belonging to the old type, I found at the time of my inspection, little to which exception might be taken. The occupier of these premises keeps an average of some 30 cows. |
50d8f0a8-dcd6-419c-9549-dd6cceaab59a | The present tendency for distributors to form combines, rather than working as separate units (enabling to a great extent better and more efficient methods of distribution to be 38 adopted, together with the gradual elimination of the small retailer), constitutes in my opinion a decided change for the better. Milk (Spccial Designations) Order, 1923.βUnder the above Order licences require to be granted for the sale of milk designated as " Certified," " Grade A Tuberculin Tested," " Grade A," or " Pasteurised." Licences granted expire on 31st December of each year, which, in the case of producers, are issued by the Ministry of Health and County Councils, whilst distributors are licensed by the local sanitary authorities. |
8d30b057-3998-4d9a-b1d8-84e04b0b5a49 | At the end of the year licences for the sale of designated milk in this area were as follows :β Grade A (Tuberculin Tested) Milk 3 Grade A Milk 1 Grade A (Bottling Licence) 1 Bakehouses.βAt the end of the year there were 16 bakehouses on the register, 7 of which were factory bakehouses. In addition to my own inspections, bakehouses received 123 visits, while two informal notices were served. There are no underground bakehouses. Premises where Food is Prepared for Sale.βExcluding bake houses, the number of such places is :β Eating Houses 16 Slaughter Houses 2 Meat Shops and Cooked Meat Shops 36 Fried Fish Shops 17 Fish Shops (wet), additional 3 Ice Cream 38 During the year these premises received 137 visits, whilst 19 notices were served for defects found. |
a8653238-ad71-4331-92eb-628efb1a8d37 | It will be recognised that the conditions under which food is sold or prepared for sale is of importance, in order to secure the wholesomeness of the same and the cleanliness of both premises and utensils. Efficient control will only be established 39 Where all premises engaged in the preparation, storage, sale or distribution of food are compulsorily registered throughout the country, controlled by regulations, and provision made for de-registration, a system already adopted in New York. βThe Public Health (Meat) Regulations, 1924, came into force on April 1st, 1925. Every butcher in the district was supplied with a copy of these regulations. and advised as to the appropriate manner of their application to his premises. From April 1st to the end of the year 110 notices to daughter were received, and 102 beasts, 519 sheep and 74 pigs emamined. The following parts were found diseased :β Description. Weight. Disease. lbs. 2. |
712d9c7a-a232-4b13-adcd-70c99359b7ee | Fore Quarters of Beef 400 Tuberculosis 1 Beast's Head 28 Tuberculosis 5 IV asts' Lungs 40 Tuberculosis 3 Beasts' Lungs 24 Congestion 1 Beast's Lung 8 Echinococcus 3 Beasts' Livers 43 Tuberculosis 7 Beasts' Livers 98 Distoma Hepaticum 67 Sheeps' Lungs 201 Strongylus Rufcscens 10 Sheeps' Livers 40 Distoma Hepaticum 3 Sheeps' Livers 12 Cirrhosis 10 Pigs' Heads 140 Tuberculosis 10 Pigs' Plucks 75 T uberculosis Diseased meat, whether surrendered or seized, is destroyed by the Authority. Following the issue of Circular 604 by the Ministry of Health, a conference was held between the Chairman of the Public Health Committee, representatives of the Butchers' Federation and myself. |
ef4f6d0b-1b41-472b-9324-95f1cdf47d63 | As a result, it was decided inter alia that when side and overhead screens were provided it would ke presum'ed that meat so exposed would be in accordance with Regulations. 40 The somewhat ambiguous phraseology of the Regulations and the practice in adjoining districts, did not strengthen my endeavours to arrange that all meat should be exposed behind glass fronts only, although during the latter part of the year there was a distinct tendency on the part of butchers to provide their shop windows with hygienic fronts. The two slaughter houses in the district are not employed to their full capacity. The licensed slaughter house is mainly used for the slaughtering of calves and sheep, and an occasional bullock, whilst there has been no slaughtering on the registered premises during the past six months. Markets.βThe open and closed markets were regularly inspected during the year, receiving 133 visits. In general the market stalls are fairly well conducted, and the stall holders willing to comply with requirements. |
e78fa692-dfd4-4ce0-9932-1a1148b9054d | Fried Fish Shops.βThere are 17 fried fish shops in the district. 14 notices were served during the year, mainly with respect to cleansing. In addition to enforcing the provisions of the Bye-laws, a careful look-out is kept on the wholesomeness of the fish and of the oils., etc., used in frying. Ice Cream.βDuring the year 38 premises where ice cream is manufactured were inspected. Prior to the passing of the Public Health Act, 1925, the powers of Local Authorities for dealing with this commodity were not entirely adequate. It is now, however, possible to secure that ice cream is manufactured under hygienic conditions, Section 72 of the above Act providing that no room shall be used for selling, preparing, storing or keeping in vessels, any foodstulls (which would include ice cream), unless such room is suitable. There has recently been opened in the district an ice cream factory with a capacity for turning out some 500 gallons a day. |
f0a8b920-11c9-4722-836a-a0814c462820 | These premises are constructed on modern and up-to-date lines, and the manufacture of the commodity is carried on under idea! conditions. 41 UNSOUND FOOD. The following is a list of unsound food destroyed during the year:β Commodity. Quantity. Condition. Result of Action Taken. Meat 68 lbs. Decomposed Surrendered Fish βDabs 12 st. ,, ,, Haddock 12 st. ,, ,, Skate 6 st. ,, ,, Roker 6 st. ,, ,, Whelks 3 bush. ,, " Winkles 2 bush. " " fruitβApples 400 lbs. ,, " Apples 28 lbs. ,, ,, Tomatoes 8 lbs. ,, ,, Bating Houses.βThe number of eating houses is 16, being of the type usually frequented by carmen and others. 154 visits were paid during the year and 3 notices served for sanitary defects. |
6e229882-de7e-400a-8c34-8076e131fb20 | SALE OF FOOD & DRUGS ACTS. I am indebted to Mr. H. C. Card, Chief Food and Drugs Officer of the Essex County Council for the following particulars of samples purchased and submitted for analysis during the year;β Milk. Butter. Miscellaneous. Total. Prosecutions. Fines. 83 58 23 164 3 Β£22 Proceedings were taken in the case of 2 samples of margarine from bulks not labelled as required, the vendors being each fined Β£l. Of 4 samples of butter found adulterated proceedings were instituted against the vendor, who was fined Β£'20 Β£1 costs. RATS & MICE (DESTRUCTION) ACT, 1019. In accordance with the suggestions of the Ministry of Agriculture and Fisheries, a National Rat Campaign was observed locally from November 2nd to 14th. |
748f6e06-f54a-4d3f-baf0-fc4597153ea5 | To emphasise the 42 importance of concerted efforts for the extermination of rats, publicity to the campaign was given in the local press, while special circulars were addressed to all likely to be affected, the occupiers of infested premises being also asked to notify same to the Public Health Department. In order to discover the efficiency of different raticides, various preparations were employed in different wards of the district. As a result, it was found that liquid preparations entailed considerable trouble in preparation, baits being not infrequently improperly laid, and that for all practical purposes paste raticidcs were the more effective. During the period 63 premises were treated with 848 baits, 737 of which were consumed. The occupiers of 24 premises reported total clearance of rats, 26 an improvement, whilst in 13 instances there was no change. (I) GENERAL HOUSING CONDITIONS IN THE AREA. It is with regret that I am unable to report any appreciable improvement in the housing shortage. |
0c7599ee-0d64-4c7d-870d-186961a312d1 | During the year no houses were erected for letting purposes. A beginning was made by the Authority during the year upon 59 houses, to be erected on Eastbury Estate by direct labour. These may shortly be ready for tenancy, and will, I hope, be immediately followed by many more. (II) OVERCROWDING. As an indication of the present housing shortage I have extracted the following information from the list of applications for houses as on December 1st, 1925. 208 applications appear from families living in one room divided as follows:β No. in Family. Instances. 2 33 3 72 4 73 5 32 6 10 7 1 8 1 9 1 Representing a population of 788. 43 250 applications from families living in 2 rooms were received as foilows :β No. in Family. Instances. |
074efcdb-c382-4fac-91d7-c7923e5111a0 | 2 33 3 79 4 83 5 33 6 9 7 7 10 1 Representing a population of 910 persons. There were also 246 applications from families occupying three or more rooms. These 706 applications do not represent the total shortage, as, in many instances, owing to inability to pay higher rents, many of the poorer families do not trouble to apply. It is unnecessary to further emphasise the question of overCrowding. Under such conditions as, unfortunately, too frequently exist, the ideals of Preventive Medicine are impossible, and I am led to wonder how, in many instances, the occupants keep fit at all in their sordid atmospheres of social and moral destitution. The causes of overcrowding appear to be threefold:β (a) Rate of building not consistent with increase of population; (b) Gradual encroachment of surplus population from adjoining districts. |
a9b594f0-da62-4a25-bf32-ae6ec5180c9b | This is unavoidable in the , extension of the greater London area; (c) Poverty. (III) FITNESS OF HOUSES. (a) The general standard of housing in the district is, on whole, only fair. Of an estimated number of 7,613 dwellings, 630 are unfit in that they are worn out and beyond reconditioning, Surroundings faulty, structures bad, rooms damp and insufficiently lighted and ventilated, with an almost general 44 absence of food cupboard accommodation. In addition, many of the houses are dirty, infested with rats and vermin, and, did circumstances permit, fit only to be closed. A reference to the summary of work carried out during the year in the case of defective houses generally will show that they are chiefly in connection with roofs, eavesgutters, rain, waterpipes, floors, internal walls and woodwork. (b) MEASURES TAKEN FOR THE ABATEMENT OF OVERCROWDING. |
d73999c3-9567-4890-8933-26eef6768718 | This question received the serious consideration of the Council during the year, and the erection of 59 houses was commenced by direct labour as an experiment. Others are contemplated. (IV) UNHEALTHY AREA. At the December meeting of the Public Health Committee I submitted a Representation in accordance with Section 35 of the Housing Act, 1925, that the area known as the " Island Site was an unhealthy one, and should be dealt with under an Improvement Scheme. This question will be more fully dealt with in my next Report. FACTORY AND WORKSHOP ACT, 1901. Factories, Workshops, Laundries, Workplaces and Homework. 1. Inspections (including inspections made by Sanitary Inspectors). Premises. Number of Inspections. Written Intimations. Notices. Statutory. Prosecutions. |
b9768131-e090-4d05-9f26-d7bf1111e91c | Factories 72 8 β β Workshops 154 10 1 - Workplaces 926 5 - - Total 1152 23 1 β 45 2. DEFECTS FOUND. Particulars. Number of Defects. Number of Prosecutions. Found Remedied Referred to H.M. Ins. Nuisances under the Public Health Acts :β Want of cleanliness 9 9 - - Want of ventilation β β β β Overcrowding β β β β Want of drainage of floors 1 1 β β Other nuisances 4 4 β β Sanitary accommodation:β Insufficient 3 3 Unsuitable or Defective 9 9 β - Not separate for sexes - β - Offences under the Factory and Workshop Acts :β Illegal occupation of underground bakehouse (S.101) β - - - Breach of special sanitary requirements for bakehouses (SS. |
6ecc7b78-ae3e-4bed-a92d-b31de484b553 | 97 to 100) - - - - Other offences (excluding offences relating to outwork which are included m Part 3 of this Report) - - - - Total 26 26 - β Including those specified in Sections 2, 3, 7 and 8, of the Factory and workshop Act as remediable under the Public Health Acts. HOME WORK. Nature of Work. Outworkers' Lists (Section 107). Outwork in Unwholesome Premises (Section 108). Outwork in Infected Premises (Sees. 109. 110). List received from Employers. Notices served on occupiers as to keeping or sending lists. Prosecutions. Instances. Notices served. Prosecutions. Instances. Orders made (Sec. 110). Prosecutions (Secs. 109. 110). Sending twice in the year. Sending once in the year. Failing to keep or permit inspection of lists. |
e35177aa-3470-4181-bd51-22fadda2b7e8 | Failing to send list. Lists. Outworkers. Lists. Outworkers. Contrac tors. Workmen. Contrac tors. Workmen. Wearing Apparel:β Making, etc. 1 - 3 1 β 6 3 β - - - - - β β Total 1 3 1 6 3 46 47 REGISTERED WORKSHOPS. Workshops on the Register (Sec. 131) at the end of the year. Number. (1) (2) Bakehouses (including seven factory bakehouses) 16 Other Workshops 64 Total number of Workshops on Register 80 OTHER MATTERS. Class. N umber. (1) (2) Matters notified to H.M. Inspector of Factories:β Failure to affix Abstract of the Factory and Workshop Act (Sec.133) - Action taken in matters referred by H.M. |
19d52bc2-3242-4cf4-ae57-0c6abd19a71f | Inspector as remediable under the Public Health Acts, but not under the Factory and Workshop Acts (Sec. 5) 6 Other β Underground Bakehouses (Sec. 101):β Certificates granted during the year - In use at the end of the year - OUT-WORKERS. The following list shows the nature of the homework carried out in this district by 24 out-workers :β Wearing apparel 7 Ties 4 Umbrella makers 3 Collar makers 1 Boot makers 1 Paper bag makers 2 Life belt covering 6 During the year 20 lists of out-workers were received from other Authorities in respect of addresses in Barking. 3 lists were received from employers within the district. In all instances the premises of out-workers were kept in a satisfactory state. 18 SECTION 3 NOTIFIABLE INFECTIOUS DISEASES. The following table shows the number of notifications of infectious disease received during 1925 :β TABLE 1. Males. Females. |
42d27339-f2c6-4f4b-80cd-c4218833224e | Total Total cases rem'd to Hos. Deaths Scarlet Fever 29 31 60 58 1 Diphtheria 29 46 75 70 2 Puerperal Septicemia . β 4 4 4 β Pneumonia (Acute primary and influenzal) 37 21 58 25 (All Forms) Erysipelas 10 8 18 3 1 Ophthalmia Neonatorum 8 4 12 *1 β Encephalitis Lethargica β β β β β Enteric β β β β β Cerebro Spinal Fever 2 β 2 1 2 Anterio Poliomyelitis 1 β 1 β β Totals 116 114 230 137 31 * Baby born in maternity ward of hospital. |
2033fcfb-2297-48f6-9c2b-d42f8214459b | The following table i;ives particulars of the various infectious diseases notified during the preceding 5 years, together with the notification rate per 1,000 population, and the average for the quinquennium ending the 31st December, 1925. 49 Disease. 1921. 1922. 1923. 1924. 1925. Average for five years. No. Notified. Rate. No. Notified. Rate. No. Notified. Rate. No. Notified. Rate. No. Notified. Rate. No. Notified. Rate. Scarlet Fever 150 4.1 53 1.4 18 0.4 40 1.0 60 1.5 64 1.68 Diphtheria 118 3.2 51 1.3 30 0.8 50 1. |
7a29c07e-ece1-4ca3-8f12-7723d5a6c6ed | 3 75 1.9 65 1.7 Pneumonia 101 2.7 103 2.8 92 2.4 50 1.4 58 1.5 82 2.16 Puerperal Fever β β 2 0.05 4 0.1 3 0.07 4 0.1 3 0.06 Erysipelas 60 1.6 36 0.9 36 0.9 18 0.4 18 0.4 34 0.84 Ophthalmia 9 0.2 10 0.2 10 0.2 7 0.1 12 0.3 10 0.2 no The average annual death rate of notifiable infectious disease per 1,000 population during the quinquennium ending December 31st, 1925 was 0.88. |
bf8622c1-5a21-46ca-9476-c0310f58d368 | The following diseases were notifiable in 1925 under the original Infectious Disease (Notification) Act, 1889 and 1899:- Smallpox, diphtheria, relapsing fever, cholra, erysipelas, typhus, plague, puerperal fever, enteric fever Strict fever and continued fever, and by Orders or Regulations framed under Section 180, Public Health Act, 1875 :β Tuberculosis (all forms), ophthalmia neonatorum, cerebrospinal fever, acute polio-myelitis, encephalitis lethargic. influenzal pneumonia, acute primary pneumonia, malaria, dysentery, trench fever. The Barking Town (Pneumonia) Regulations, 1924. provides for the notification of Pneumonia supervening upon Measles. The total notifications of infectious disease numbered 230 exclusive of tuberculosis, compared with 179 the previous year. |
462e7e70-fdf7-4ea8-9e6d-2f17bf2c952b | During 1025 the number of notifications of Tuberculosis (all forms) was 80 compared with 97 in 1924. 51 TABLE II. Notifiable Disease. No. of cases notified at age groups. Cases classified according to Wards. Under one year. 1 to 2 years. 2 to 3 years. 3 to 4 years. 4 to 5 years. 5 to 10 years. 10 to 15 years. 15 to 20 years. 20 to 35 years. 35 to 45 years. 45 to 05 years. Over 65 years. Abbey. Gascoigne. Central. Ripple. Long bridge Westbiiry. |
eea816a9-e6f4-4248-9847-d9ec38a9308a | Scarlet Fever β 3 3 1 1 20 11 2 2 β β β 10 6 0 14 14 10 Diphtheria β 2 6 5 7 27 10 5 10 2 1 β 12 23 2 14 9 15 β β β. 4 β 2 1 1 Pneumonia (primary and influenzal) 3 6 5 5 1 9 2 4 4 5 12 2 19 7 16 2 8 6 Erysipelas β β β β β β β 1 3 3 8 3 3 1 4 β β 5 Ophthalmia Neonatorum 12 β β β β β β β β β β 2 5 2 β 1 2 Encephalitis Lethargic β β β β β β β β β β β β β |
810466fd-f0aa-46bf-aafc-c6b156686bce | β β β β β Enteric β β β β β β β β β β β β β β β β β β Cerebral Spinal Fever β β β β β 1 β 1 β β β β β 1 β β 1 Anterio Poliomyelitis β β β β 1 β β β β β β β β β 1 β β Totals 15 10 14 13 20 63 23 13 23 10 21 5 48 44 31 33 35 39 52 TABLE III. Monthly summary of notifications of infectious disease : , Month. Scarlet Fever. Diphtheria. Puerperal Fever. Pneumonia. Erysipelas. Ophthalmia Neonatorum. Enteric Fever. Anterio Poliomyelitis Cerebro Spinal Meningitis. Encephalitis Lethargica. Totals. January 7 |
b9761fd1-f798-4d11-84a1-e5f37ac60104 | 11 1 3 5 2 - - - - 29 February 3 4 - 3 - - - - - - 10 March 3 5 - 8 1 2 - - - - 19 April 3 5 - 14 1 - - - - - 23 May 1 2 l 2 1 - - - - - 7 June 5 4 - - 2 1 - - 1 - 13 July 3 5 - 7 - 2 - - 1 - 18 August 10 2 1 - 1 4 - - - β 18 September 2 9 - 4 1 - - - - - 16 October 10 5 - 4 1 - - 1 - - 21 November 5 7 - 6 2 1 - - - - 21 December 8 16 1 7 3 - - - - - 35 Totals 60 |
70fae5ba-98fe-48e4-a42e-66a5c255c568 | 75 4 58 18 12 - 1 2 - 230 53 (a) Scarlet fiver.βThe number of coses notified was 60, Compared with 40 the previous year. One fatal case occurred. 58 cases were isolated at the Infectious Hospitnl. The average day of scarlet fever cases in hospital was 40.6 days, compared with 3d."J days in 1024. .The longest period of detention was 105 days and the shortest 19 days. |
9db75412-41b2-422f-a71c-91c375dbedad | Twenty-nine cases treated in hospital developed complications as follows:β OtorrhΕa 4 Albuminuria 1 KhinorrhΕa 5 Bronchitis 1 Mastoiditis 1 Impetigo 1 Arthritis 1 Septic Sores 2 Adenitis 13 Of all cases notmed, five were found to be mistaken diagnoses as follows :β Measles 2 OtorrhΕa 1 Pneumonia 1 Nil diagnosed 1 Of cases treated in hospital, the age incidence was as follows:β 1β2 years 2 5β10 years 25 2β3 years 3 10β15 years 11 3β4 years 3 15β20 years 1 4β5 years 11 20β35 vears 2 Sex.β29 cases were male and 31 female. (b) Small Pox.βNo case of Small Pox occurred in 1925. |
98331e3d-bf61-4ff6-b5e5-01f9ed451f2b | Notifications of two persons who had been in contact with cases of Small Pox were received and kept under supervision for the usual periods. The following particulars are appended of vaccinations during 1920 :β Certificates of successful vaccinations 299 Postponed 20 Conscientious objections 489 Left District 21 The vaccination rate per 1,000 births was therefore 394.8, Compared with 452.1 fot the preceding year. (c) Diphtheria.β75 cases were notified, compared with 50 the preceding vear. Of cases notified, 70 were removed and treated in hospital. Two deaths occurredβone in hospital and one amongst cases treated at home. The average stay of diphtheria cases in hospital was 38.3 days, the longest stay being 86 and the shortest 20 days, excluding one case removed from hospital after only seven days' stay. The duration of the one fatal case was 66 days. |
144e9871-df7a-43d5-9409-1142f7022791 | Three cases of laryngeal diphtheria were admitted to hospital, but in only one instance was the performance of tracheotomy necessary, the patient making a somewhat prolonged but otherwise satisfactory recovery. The type of diphtheria present on examination was as follows :β Faucial 53 Naso-Pharyngeal 5 Laryngeal 3 Of all cases notified as diphtheria and removed to hospital, nine on examination were found to be mistaken diagnoses. Three cases of diphtheria admitted to hospital developed complicationsβtwo paralysis and one albuminuria. |
7289ccf5-045c-4d33-a39b-a0fb45603993 | Of diphtheria patients treated in hospital, the age incidence was as follows 1 to 2 years 2 10 to 15 years 10 2 to 3 years 5 15 to 20 years 5 3 to 4 years 4 20 to 35 years 10 4 to 5 years 7 35 to 45 years 2 5 to 10 years 24 45 to 65 years 1 Sex.β 29 cases were male and 46 female. (d) Enteric Fever.β No notification of enteric fever was received throughout the year. (e) Puerperal Fever.βFour cases were notified during the year, all of which were admitted to hospital. One case, however, so notified being found to be pulmonary tuberculosis only was transferred elsewhere. All of the other cases recovered. (f) Malaria and Trench Fever.βNo cases were notified during the. year. |
bc76c721-b85b-4857-a4dc-ed72333b96d6 | (g) Acute Primary Pneumonia and Acute Inpucnral Pneumonia.β-58 cases were notified during 1925, compared with 55 85 for the preceding year. The case mortnlity from pneumonia (all forms) was 45.4 per cent. (i) Encephalitis Lethargica.βOne case of encephalitis was notified: (ii) non-notifiable infectious diseases. The most important of these are measles, whooping cough and summer diarrhoea. There were no serious epidemics of these diseases, and the deaths registered were as follows:β Measles 1 Whooping Cough 13 Summer Diarrhoea 9 Measles ami Whooping Cough.βCases amongst school children are reported to the School Medical Officer by school teachers, attendance officers and nurses, appropriate action being taken as regards exclusion and supervision of contacts. Further particulars of action taken will be found on page 10 of the School Medical Officer's Report. |
5c199ad6-7214-49c1-9f15-8fb900bbc2a1 | ISOLATION HOSPITAL. The following is the table of admissions, etc., in rcspect of infections diseases during 1925 :β Disease. In Hospital January, 1st, 1924. Admitted during the year. Died. charged In Hospital Dec. 31st. 1924 Scarlet Fever 7 58 1* 54 10 Diphtheria 3 70 2β 50 15 Pneumonia β β β β Puerperal Fever β 4 β 3 1β‘ Measles β 2 β 2 Chicken Pox β β β β β Mumps β β β β β Whooping Cough β β β β β Enteric Fever β β β β β Ophthalmia Neonatorum β 1 β 1 β Erysipelas β 3 1 2 β Cerebrospinal Meningitis β 1 1 β β *Case diagnosed as Pneumonia. |
441ac1b9-b659-4fce-a31d-e513385ee3ba | β One Case diagnosed as Scarlet Fever. β‘ Case diagnosed as Phthisis. 56 One case of mixed infection was admitted to hospital, and one instance of cross-infection occurred during the year. The ward buildings and other appurtenances comprising the isolation accommodation of the district are now inadequate and inefficient, lacking more or less all of the essential requirements of the modern Infectious Hospital, while the steady development of the district would appear to render necessary the formulation of some definite scheme providing sufficient and efficient accommodation for the segregation and treatment of infectious disease Including a ward reserved for maternity work, the actual number of beds available, based on modern standards, for infectious disease is only 30. While several different schemes present themselves for consideration, it is necessary to remember that at least one bed per 1,000 is required as a hospital district basis for infectious disease, and that this proportion should be provided according to whatever population area would necessarily be served. |
28c9d660-bacb-47aa-b74e-6dbe3763ec75 | The present hospital site in Upney Lane, if considered sufficiently central and otherwise suitable lor further building operations, could be extended, or, alternatively, a more suitable site selected elsewhere. A "squaring off" of the present site, however, by an extension of certain boundaries would be a sine qut non of any scheme affccting that particular site. The present hospital buildings are unsuitable and unsatisfactory for the treatment of the infectious sick and could be satisfactorily reconstructed, re-planned and extended only at considerable expense, while entirely new buildings to be erect on the same or some other site on modern and up-to-date linesβ in my opinion, the only satisfactory solution to the problem βwould mean still greater expenditure. A further alternative presents itself, which deserves some. consideration in so far as capital commitments could be to some extent avoided and upkeep charges lessened, by the formation of a Joint Hospital Board with one or more neighbouring districts, the policy of the large centrally-placed hospital commending itself or. |
6fe4252f-232e-4536-b9a6-db0249bd4bcb | other lines than those merely of finance. The present hospital, however, could be rendered suitable for treating advanced tuberculosis only, from Barking and by 57 arrangement probably also from neighbouring districts, at considerable less expense than it could be reconstructed tor the treatment of infectious disease. The continued use for maternity work of part of the limited space at the district's disposal forr the treatment of infectious disease should, of course, be remedied as soon as circumstances permit. TUBERCULOSIS. Administrative Arrangements.β Under the Essex County Council (the responsible authority for the treatment of tuberculosis), the Medical Officer of Health of Barking continued 2& Tuberculosis Officer for the district during the year. |
de6a6229-ec8e-4709-a988-24e399d9b6e6 | The administrative arrangements for dealing with tuberculosis in the area include:β (a) A dispensary used on two half-days per week, (b) Garden shelters for suitable cases, (c) Sanatorium accommodation for surgical tuberculosis, (d) Sanatorium accommodation for suitable early pulmonary cases, and in some instances the more advanced, (e) Accommodation for a number of bedridden and advanced cases at St. Joseph's Hospice, Hackney. A suggestion was made towards the end of the vear that certain cubicles at the Infectious Hospital he set apart by arrangement with the County Council for the segregation of advanced cases of pulmonary tuberculosis where home conditions were unsatisfactory and not conducive to the best interests of the patient's family. This question, an urgent one as concerns this district, was under consideration at the end of the year. I he number of notified cases on the register on December 3lst, 1925, was 793, compared with 746 for the corresponding Period of the preceding year. |
d490321c-ed60-45bf-86d6-ea48b040ac26 | During the year 1925 80 notifications were received of all forms of tuberculosisβpulmonary 57, and non-pulmonary 23β representing a notification rate of 2.08, compared with an average notification rate of 2.5 for the quinquennium ending December, 1925. Information was received of the removal into the district of wee tuberculous persons, whilst one case not counted the previous year was traced in the district. 58 Thirty-five deaths of notified cases occurred (including one certified due to bronchiectasis!. Two cases left the district or could not otherwise be traced, leaving 793 on the register on December 31st, 1925, 384 being male and 409 female. Particulars of new cases of tuberculosis notified and of deaths from the disease during 1925 is afforded by the following table :β New Cases. Deaths. Pulmonary. NonPulmonary. Pulmonary. N'onPulmonary Male. |
8a0303f8-687b-45cb-813b-e164bcd28a93 | Female Male. Female. Male. Female- Male. Female Under 1 Year β β 1 1 β β 1 l 1 to 5 years β β 3 2 β β 1 1 5 to 10 years 3 2 3 2 β β β β 10 to 15 years β β _ 2 β β 1 β 15 to 20 year 5 o β 3 2 β β β 20 to 25 years. 3 8 β 1 2 β β 25 to 35 years 3 5 β β 2 2 β β 35 to 45 years 6 5 β β 5 7 1 β 45 to 55 years 5 3 β β 2 1 β β 55 to 65 years 2 1 β β 4 β β β 65 yrs. |
2f38be5b-f907-46e8-a9a1-d1b828dacce1 | & upwards β 1 β β 1 β β β Totals 27 30 12 11 18 18 4 2 PUBLIC HEALTH (PREVENTION OF TUBERCULOSIS REGULATIONS, 1925. 1 hese regulations, which came into force on July 31st, 1*526, give power to a local authority to prevent any person sulTrnn| from tuberculosis of the respiratory tract entering upon any employment or occupation in connection with a dairy whi"1 would involve the milking of cows, the treatment of milk, or the handi ng of vessels used for containing milk. An) person vvbo deems himself aggrieved by a requirement under these regutot*** mav appeal to a Court of Summary Jurisdiction,"and may urtk/ certain circumstances bo compensated for any damage sustained- In one ease only was it found necessary to take action u dC these regulations, the affected person ceasing his employ*!^ as a milk roundsman upon request. |
bf8ead29-471c-4271-82d3-2b9d0d85c249 | No appeal or claim made. 59 PUBLIC HEALTH ACT. 19-25, SECTION 62. In no instance was it found necessary to take action under this section to secure the compulsory removal to hospital of it tuberculous person in an infective state. |
66c5eac9-0d3c-42a5-a6a2-ae0a8c8e9909 | As regards the occupations of notified cases during the year, the following table is of interest:β Retired Policemen 1 Milliners 1 Nophtha Distillers 1 Packers 2 Asbestos workers 3 Steel Erectors 1 Salesmen 1 Bricklayers 1 Machinist 1 Carpenters 2 School Children 10 Gatekeepers 1 Labourers 8 Clerks 2 Housewifery 16 Insurance Agents 1 "^op-lauys ... 1 Barmen 1 Typists 1 Painters and Decorators 1 Factory hands ... 6 Nil 10 Warehousemen 2 The following figures indicate for the four quarters of the year the percentage attendances of cases per 10,000 population at the Tuberculosis Dispensary and of those admitted to sanatoria undo the County Council :β Attendances at Dispensary. Admission to Sanatoria. No. Kate per 10,000 population. No. Rate per 10,000 population. |
3d102bc9-a404-4a77-af3d-1fc674750041 | 1st Quarter 425 110.5 15 3.9 2nd Quarter 307 79.8 12 3.1 3nl Ouarter 270 70.2 20 5.2 4th Quarter 424 110.2 20 5.2 the average for the year being 92.6 and 4.3, compared with 100.9 and 4.92 for the preceding year, and 83.31 and 3.41 respectively for 1923. 60 The proportion of sanatoria admissions to cases notified was 83.7 per cent., and the incidence of tuberculosis per 10,000 population in respect of notified cases 206.2. The following are particulars of cases notified under Forms C and D during the year :β Form C. Form D. Pulmonary. Non-Pulmonary Pulmonary. Non-Pulmonary. Male. Female. Male. Female. Male. Female. |
9ffddcc1-c763-42aa-a018-d585f539baea | Male. Female 31 24 3 5 18 19 6 1 Forty-two deaths occurred from tuberculosis (all forms), 36 of these being pulmonary cases. The number of deaths in institutions was 16. The death rate for tuberculosis (all forms) during ]925 was 1.09, compared with 1.02 for the previous year, and an average death rate of 1.1 during the preceding five years. During 1925 eight deaths from tuberculosis were registered of persons not previously notified as suffering from the disease. The importance of notification is that the necessary steps car be taken with regard to the care of patients and contacts and the prevention of spread of the disease. Delay in notification is bad for both patients and public. |
1abbdf20-4b3c-4515-a2f3-8dbaaef49122 | Of deaths registered due to tuberculosis, notifications received by the Medical Officer of Health were as follows:β Number not notified at time of death 8 Number notified less than 3 months before death 12 Number notified 3 to 6 months before death 2 Number notified 6 to 9 months before death 3 Number notified 9 to 12 months before death 2 Number notified 12 to 18 months before death 4 Number notified 18 to 24 months before death β Number notified more than 21 months before death 11 61 The incidence of tuberculosis amongst cases attending the Tuberculosis Dispensary is shown from the following table:β Insured. Not Insured. Ex-Service Men. Pulmonary M 70 60 58 F 34 90 β Non-Pulmonary M 5 37 1 F 7 27 β Five hundred and four patients made 1,426 attendances at the dispensary during the year for the purpose of medical examination, 179 being new cases. |
85301caf-904c-4c25-b93c-f1f43ca45c99 | Of new cases attending during the year, 50 were notified as suffering from tuberculosis. At the end of the year 342 cases on the Dispensary Register Mere definitely diagnosed as suffering from tuberculosis, whilst in 162 C;ises the diagnosis still remained in abeyance. MEMORANDUM 37/T (TUBERCULOSIS). In accordance with the requirements of the above Memorandum, all patients on the Dispensary Register at the end of the year were classified in the following manner :β Pulmonary Cases.βThese cases were divided into two classes, viz.( T.B. Minus and T.B. Plus, the former class including those in whom tubercle bacilli had never been demonstrated in the sputum, and the latter class those in whom tubercle bacilli had been tound. The latter class (T.B. |
bf694916-184a-4b97-810a-bdab9f0e5e66 | Plus) was further sub-divided into three groups as follows:β Group 1.βCases with slight constitutional disturbance, if viz., those cases with no marked acceleration of pulse nor elation of temperature except of very transient duration. Group 2.βAll cases which could not be placed in Groups 1 and 3. 62 Group 3.βCases with profound systematic disturbance or constitutional deterioration; with marked impairment of function either local or general, and with little or no prospect of recovery Son-Ptihnouary Cases.βThese cases were classified accordir g to the site of the lesion as follows:β (1) Tuberculosis of bones and joints. (2) Abdominal tuberculosis (i.e., tuberculosis of peritoneum, intestines or mesenteric glands). (3) Tuberculosis of other organs. (4) Tuberculosis of peripheral glands. |
db91070e-db0d-41d1-9927-afd211b26128 | In addition, each case was classified as to whether disease was "arrested" or "not arrested," an "arrested" case being one whose condition had been "quiescent" for a period of two years. It is of interest to here note that no "arrested" case should be discharged as "cured" until the arrest of the disease had been maintained for a period of three years after the period of two years "quiescence," and that in non-pulmonary cases the term "arrested" may be used as soon as there is rtaspn to believe that the disease is unlikely to recur. The following tables give in tabulated form details of the above classification of patients at the Barking Dispensary:β (a) Number of persons on Dispensary Register on 31st December, 1925. Pulmonary. Non-Pulmonary Totals. Adults. Children. Adults. Children. |
c1cfb01c-4bf4-4c5b-b545-644f30b84e88 | Adults Children M. F. M. F. M. F M. F. M. F. M. F. (i) Diagnosis completed 97 88 39 42 8 12 34 22 105 100 73 64 (ii) Diagnosis not completed 0 14 62 74 β 1 β 2 9 15 62 76 63 Summary showing the condition of all patients whose records are in the session of Barking Dispensary at the end of December, 1925. ??? at the time the last record made ??? the year to which ??? Return relates. Pulmonary. Non-Pulmonary Class T. B. Plus Other Organs. Class T. B. Minus. Group 1. Group 2. Group 3. Total (class T. B. plus). Bones and Joints. Abdominal. |
cbb2a687-b0cb-45ac-a0a8-445c61644235 | Peripherialil Glands Total Adults M 1 β β β β β β β β β ???charged as ??? F β β β β β β β β β β Chldn. M β β β β β β β β β β F β β β β β β β β β β Adults M 52 4 6 β 10 1 2 β 1 4 ??? F 39 4 2 1 7 4 β 1 3 8 Chldn. M 18 β β β β β 1 β 6 12 F 20 β β β β 1 2 β 10 13 Adults M 17 7 11 β 18 2 β 1 1 4 ??? not arrested F 31 3 5 3 11 β β 1 1 4 Chldn. |
57385453-afa8-4a0b-a38c-dc709082bc93 | M 21 β β β β 13 2 1 6 22 F 13 β β β β 6 β β 3 9 Adults M 3 β β 8 8 β β β β β F β β β 9 9 β β β β - C hldn. M β β β β β β β β β β F β β β β β β β β β β ??? M β β β β β β β β β β F 3 β β β β 1 β β β - Totals 227 18 24 21 63 35 7 4 31 β Number of Insured persons on Register at 31st December,1925 116 Number of insured persons receiving Domiciliary treatment en 31st Dec. 1925 9 64 AFTER-CARE. |
32c59883-abef-4023-9118-cabae22d1f96 | Tuberculosis in the great majority of instances is a curable infection provided the patient is seen sufficiently early, undergoes sanatorium treatment and subsequently is able to pass his life under reasonably hygienic conditions. It is with regard to the latter that the activities of the Aftercare Association in this district particularly exist consisting inter alia in providing special splints, clothing, boots, nourishment, etc., for necessitous cases and in obtaining if possible suitable homes and employment for the tuberculous. During the year 16 new cases were so assisted, whilst 23 old cases were further assisted from the previous year. The funds of the Association are mainly dependent upon :β (a) Essex Insurance Committee. (b) Romford Board of Guardians. (c) Annual donations from certain Friendly Societies and Trade Unions. (d) Donations from various local Sports Clubs. (e) Donations from private individuals and from proceeds raised at Whist Drives and Dances organised by the Social Sub-Committee. |
43b010dc-9912-4322-bf04-cc6d206bd6f0 | Equally important in the matter of after-care is that of dealing with the large number of advanced cases who are, in the majority of instances, in a highly infectious condition and net infrequently living under overcrowded home conditions. for these practically no remedy hitherto existed, except the workhouse, but by virtue of Section 62 of the Public Health Act, 1925, local health authorities have become vested with powers where, in the opinion of the Medical Officer of Health the conditions of a tuberculous patient at home are inimical to the best interests of a his or her dependents, to secure such patient's removal compulsorily pr otherwise to a suitable institution and to there detain 65 him or her until circumstances have changed. It only remains to point out that where such steps become necessary, local institutional arrangements should be available. Compulsory disinfection of all houses after death from tuberculosis is now practised throughout the district under Section 5 of the Infectious Disease (Prevention) Act, 1890. |
f715677e-8bf5-4acb-9a15-cf360095b8c7 | DISINFECTION. This subject was discussed at considerable length in my report for last year. 66 SECTION 4. MATERNITY AND CHILD WELFARE. The Local Supervisory Authority for the district under the Midwives Acts, 1902 and 1918 is the Essex County Council. B\ arrangement a number of inspections and investigations were carried out by the Medical Officer of Health regarding- the work of 7 midwives who had notified the Local Supervisory Authority of their intention to practice within the district during the year. It is gratifying to report that there has been an increasing tendency amongst local midwives to co-operate in the Authority's Ante-natal and Infant Welfare schemes as regards the care of expectant and nursing mothers not under the supervision of a medical practitioner. Reference was made in my Report for last year to the practic e of unqualified women acting in the capacity of maternity nurses during the lying-in period, an undesirable arrangement, and one which falls considerably short of the ideal. |
b0493894-458d-452d-99e2-4fe0804175d4 | Although definite figures are not available, it might be stated that in Barking during 1925 23 per cent, of confinements were nursed by unqualified women. NOTIFICATION OF BIRTH ACTS, 1907 and 1915. The above Acts require all live births and still births of seven months and over to be notified to the Medical Officer of Health within 30 hours, being an additional requirement to the Registration Act of 1836, by which all live births must be registered within six weeks. 67 Of the total live births which occurred during the year all except 33, or 3.9 per cent., were notified, particulars of from whom notifications were received being supplied by the following table:β By whom notified. Live Births. Still Births Medical Practitioners 136 ??? 4 ??? Certified Midwives 555 ??? 20 ??? Parents and Others 106 ??? 4 ??? |
9f042511-b57c-411d-892d-557b14a98334 | The actual number of births within the district during the year was 830, the net total of 825 being reached by adjustment of inward and outward transfers, etc. Of the total live births during the year 519, or 66.1 per cent., were attended by midwives, the remainder being attended by medical practitioners. The percentage of still births was 3.2. The actual number of all births registered included 411 males and 414 females, of which number 23, or 2.7 per cent, were illegitimate. On comparison with 1024, 21 fewer births were registered during 1925, a fall equivalent to 2.4 per cent. There can be little doubt that a considerable proportion of this fall is intentional, though partly resulting from industrial distress and the housing shortage, factors which have ever prolonged the mean age at carriage, and have in turn paved the way to the now growing practice of birth control. MATERNITY WARD. |
7f95373e-7971-462e-9e43-415829b4a908 | One ward at the Infectious Hospital continued to be used for maternity work during the year. 206 cases were admitted and 167 babies born (compared with 143 and 124 respectively in 19241 or 20.1 per cent. of the total births of the district. Although the percentage number of occupied beds during the year showed an increase, there is still matter for regret, considering the over- 68 crowded state of the district generally, and the undesirable conditions under which in many cases confinements take place that more advantage is not taken of the facilities in this respect placed at the district's disposal. It has to be remembered, however, in drawing comparisons, that as present situated the Maternity Ward cannot cater for cases other than what would generally be considered "straight-forward," little local facilities existing for dealing efficiently with more than minor deviations from the normal. |
b923a9ea-3a99-44b3-8937-cfd8173b99dc | The following return required by the Ministry of Health for the year ended 31st December, 1925 is included as under, the comparative freedom from the more usual complications of childbirth and necessity for the intervention of outside aid being partly explainable from the preceding context. (1) Number of cases admitted (39 of which Ante-natal.) 206 (2) Average duration of stay 14.5 days (3) Number of cases delivered by:β (a) Midwives 166 (b) Doctors 1 (4) Number of cases in which medical assistance was sought by the midwife with reason for requiring assistance:β (a) Ante-natal Nil (b) During Labour 1 (c) After Labour 10 (d) For Infant 6 (5) Number of cases notified as puerperal sepsis with result of treatment in each caseβNil. (6) Number of cases in which temperature rose above 100.A for 24 hours with rise of pulse rate.βNil. |
86a75900-a2a6-45e5-8ccb-54d786a568be | (7) Number of cases of pemphigus neonatorum.βOne. (8) Number of cases notified as ophthalmia neonatorum with result of treatment in each case.βOne (recovered). (9) Number of cases of " inflammation of the eyes," however slight.βOne. 69 (10) Number of infants not entirely breastfed while in the Institution, with reasons why they were not breastfed.β Four. (a) Weakness of mother 1 (b) Prematurity 2 (c) Depressed nipples 1 (11) Number of maternal deaths.βNil. |
604392c8-0a9d-410c-b2c4-96446ea6b84c | (12) Number of foetal deaths (a) stillborn, and (b) within 10 days of birth and their causesβand the results of the post mortem examination if obtainable:β (a) Stillborn 6 (b) Prematurity 1 As in previous years advantage was taken of the above Ward for the treatment of suitable cases referred from the Ante-natal Clinics, 39 cases being admitted compared with 31 in 1924. PUEPERAL SEPSIS. Four cases of puerperal sepsis were notified compared with 3 in 1924, all of which were admitted to the Infectious Hospital. Three of these had been attended by midwives. A case notified on the 31st December as "puerperal sepsis" was on admission found suffering from advanced pulmonary tuberculosis, and transferred to another institution. |
5ff6fb53-4c3c-49ef-ac9b-88c36071a8f0 | As in previous years special investigations were carried out by health visitors in all notified cases, though in no instance was it possible to arrive at any specific cause for the disease. MATERNAL DEATHS. One death occurred attributable to the puerperal state, giving a maternal mortality rate of 1.2, compared with 3.54 for the previous year, and 3.90 for the country as a whole. Maternal mortality is a question occupying the serious consideration of the Ministry of Health, it being evident that the mortality rate of England and Wales has remained practically stationary during 70 the past quarter of a century, amounting to approximately four maternal deaths in every 1,000, without taking- account of tinamount of injury, disability and subsequent illhealth resulting from child bearing. |
bf5c6786-f83e-47b3-ab9d-7619ded68970 | It is satisfactory to note the increasing inteiesi taken respecting this problem, with which is so closely allied the one feature of infant welfare in which very little orogress has hitherto been made, viz., deaths due to ante-natal conditions and occuring during the first month of life, and where disease of the mother has been variously estimated as being responsible for the occurrence in some 50 per cent, of cases. BIRTHS. The birth rate is calculated on the number of births registered per 1,000 population and during 1925 was 21.4 compared with 18.3 for England and Wales, the lowest figure yet recorded for the country as a whole. Attention was directed to the main causes of our falling Birth Rate in the opening paragraphs of this Section of my Report. |
728a2a86-093a-40a8-9cc4-bbf02313465e | Of (he total births recorded, 23 or 2.7 per cent, were illegitimate compared with 2.3 per cent, in 1924 Primary visits were paid to 829 of the total births during the year. STILL-BIRTHS. Of the total notifications received under the Notification of Births Act, still-births formed 3.2 per cent., compared with 1.5 per cent, in 1924: and 2.6 in 1923. The actual number of still births notified for the year was 28, of which 20 were attended by midwives. Of these 3 referred to non-residents, while 2 Barking women had still births outside the district in addition to the 28 which occurred in the district. |
12dc6b8e-1c3b-48ff-ae4e-f8d8227843aa | 71 Special visits of investigation in all still-births were paid, and the following details elicited as far as accurately could be established:β (1) Duration of pregnancy:β (a) Less than seven months 1 (b) More than seven months 29 (2) Presentation:β (a) Vertex 22 (b) Breach 3 (c) Footling 1 (d) Not elicited 4 (3) Supposed cause of still-birth:β (a) Abnormal presentation 1 (b) Overwork 2 (c) Accident, etc. 7 (d) Not known 14 (e) Ill health, etc. 4 (f) Malformation 2 (4) Occupation of mother:β (a) Household duties 22 (b) Factory hand 4 (c) Shop assistant 2 (d) Flower seller 1 (e) Machinist 1 Of the mothers who had still-born babies 9 had worked up to the time of confinement. |
ee5cbb75-0055-4c78-bb26-6a5a3b9a8b22 | Of the total number of mothers who had still-births 10, or 35.7 per cent, had attended the Ante-natal Clinic once or oftener. As already pointed out disease of the mother probably accounts for some 50 per cent, of still-births throughout the country. 72 OPHTHALMIA NEONATORUM. The number of cases notified was 12 compared with 7 in 1924. Of these 7 occurred in the practices of mid wives, the remainder having- been attended by medical practitioners. One mother whose infant suffered from ophthalmia neonatorum had attended the ante-natal clinic. Particulars of these cases are afforded from the following table:β Age . Group. Cases. Vision Unimpaired. Vision Impaired. Total Blindness. Deaths. Treated. Notified. At Home. |
ec9c25b8-904f-4171-ac7a-ace4d9d8abfa | At Hospital Under 3 weeks 12 11 1 12 β β β ANTE-NATAL CENTRES. Owing to the increasing' number of expectant mothers avail ing themselves of ante-natal supervision during the year, an additional session was opened on the 1st May, 1925, at the Central Clinic in East Street. The average number of new cases seen per session was 3.8 while on an average the number of subsequent attendance per session was 7.5, making an average attendance of 11.3 expectant mothers per session. During 1924 the average attendance of expectant mothers per session was 14.8. Ante-natal measures continued to be adopted locally where possible in venereal complications, otherwise arrangements were made for treatment being carried out at neighbouring hospitals. Syphilis remains the great cause of still-birth and abortion. |
75481d07-1635-4432-846e-4616832debc8 | Gonorrhoea causes sterility in both male and female, being at the same time causative of many of the more serious obstetrical and gynaecological complications. The following table affords particulars of cases referred from the ante-natal clinic for hospital and other treatment:β 73 Cause. No. of Cases. Contracted Pelvis 2 Syphilis 1 GonorrhΕa 1 Heart Disease 1 Phthisis 3 Threatened Abortion 4 ToxΓ¦mias of Pregnacy 5 Hyperemesis 1 Pelvic Peritonitis 2 The foregoing; total does not include patients who received ante-natal treatment in the Maternity Ward of the Infectious Hospital, 39 of whom were admitted during the year. The number of primigravidΓ¦ attending the ante-natal clinic during the year was 114, and the number of ante-natal visits paid by the Health Visitors 128. WORK OF THE HEALTH VISITORS. |
c74600c1-4c1e-4532-a60a-80e20b623e04 | The number of health visitors was increased from 2 to 3 by the appointment of an additional visitor, who commenced on 14th April, but who ceased work on the 5th October, leaving two health visitors to carry on for the rest of the year. The number of weekly sessions was increased from three to six, an additional afternoon session being first held at each of the three welfare centres on the following dates:β Abbey Hall6/5/1925 Empress Hall 5/5/1925 Central Clinic, East Street 7/5/1925 The premises used as a Welfare Centre in Abbey Road, long considered unsuitable for the purpose, were vacated on 25-11-25 when new premises, known as the Alexandra Centre, which had been erected by the Authority, were officially opened by the Chair- 74 man of the Public Health Committee on 26-11-1925. The first session at the new Centre following the opening- ceremony was held on 2-12-1925. |
2b7d2f71-34d0-408d-9d0f-953f0070d342 | Kennedy Hall, which had been used as a Centre since 1920 was vacated on 16-2-25 and another Centre opened on lease of the Empress Hall, Ripple Road, for use on two afternoons per 1 week, the first session at Empress Hall being held 23-2-25. Duri.ig the year it was proposed to devote a number of these extra sessions to sewing and knitting classes, demonstrations in model garments, and the sale of wool, the earlier part of the meeting to be given up to baby-weighing, health talks, etc. It was found, however, that the unavoidable absence of a mcdical officer at many of these sessions was not followed by the success which had been originally anticipated. Eight hundred and twenty-nine births were visited and 2,990 re-visfts paid, being on an average 4.6 visits per child.during the first year of life, while 1,242 visits were paid between 1 and 5 years. |
3312e3ff-92f4-4f21-8fef-f5a34a604db6 | To some extent the relatively fewer visits paid to older children was due to diminished staff, a circumstance which it is hoped will be rectified when the full number of health visitors is again restored. Kennedy and Empress Halls. Clinic premises. Abbey Hall and Alexandra Centre. Total attendances:β 1 to 12 months 1,833 2,195 2 322 1 to 5 years 1,536 1,648 1,991 Average No. of attendances per session 41.5 47.4 53.2 No. of new cases 173 175 179 No. of old cases 3,196 3,668 4,134 Average No. of attendances per mother 33.4 36.6 42.6 The addresses of 44 children who left the district were sent to the Medical Officers of Health for the districts to which' they had gone. |
98dc2a67-e095-4044-8bd0-179c1546c964 | During the year the number of births and deaths of children up to one year of age occurred as follows:β 75 LIVING IN 1 room. 2 rooms. 3 rooms. 4 or more rooms. Births. Deaths. Births. Deaths. Births. Deaths. Births. Deaths. 131 12 104 18 91 11 439 25 DEATH RATE PER THOUSAND BIRTHS. 91.0 109.7 120.8 50.9 76 Particulars of the work of the Health Visitors and Centres will be found from the following table:β No. of ante-natal visits 128 No. of first visits to children under one year 829 No. of subsequent visits to children under one year:β (a) Attending a Centre 446 (b) Not Attending a Centre 2.544 No. |
fbd4d70d-47fe-47c3-be18-49ff5c6e3c2a | of visits to children 1 to 5 years of age:β (a) Attending a Centre 97 (b) Not Attending a Centre 1,145 No. of special visits in connection with Ophthalmia Neonatorum 20 Ditto Deaths of children up to 3 years of age 79 Ditto Still-births 22 Ditto Puerperal sepsis 4 Ditto Foster Children 20 Other visits (not specified) 104 The following table is of interest respecting infant feeding:β Ureast Fed. Mixed. Artificial. No. of children under supervisionβ feeding at the end of first month 501 47 29 Children who died during first year of lifeβfeeding during firet month (where elicited) 37 10 1 Children who died from diarrhoeal diseasesβfeeding at time of death 1 2 6 Special visits were made to all deaths up to 3 years of age by Health Visitors. |
c7d0c2ce-8814-4008-a901-c8b210044e5a | 77 DEATHS AMONG NOTIFIED AND UN-NOTIFIED BIRTHS. 92.4 per cent, of the deaths under one year of age were notified, the remainder being un-notified. SEX. The death rate among male children was 87.5 per thousand births, and among females 72.4, the excessive male death rate during the year being noteworthy. NEONATAL MORTALITY. The neonatal mortality rate is calculated on the number of deaths of children under four weeks per thousand births, and (luring 1925 was equal to a rate of 30.3 compared with 36.6 for the previous year. From the following table it will be seen that out of a total of 25 deaths during the first four weeks of life 13 occurred during the first seven days and 8, or 61.5 per cent, of these resulted frcm prematurity or debility. |
d13458ba-da66-4d0a-a5af-b0adb0e9b880 | The question of further ante-natal care was emphasised in my Report for the previous year as an important factor in further reducing the disproportionate incidence of infantile deaths during the neonatal period. 78 Deaths Under Four Weeks. Under seven days. Under fourteen days. Under twentyone days. Under twentyeight days. Total. |
1f0079d3-c020-4c59-8361-4b6e9695dfbc | Bronchitis β β β 1 1 PiarrhΕa β 1 β β 1 Injury at Birth β 2 β β 2 Atelectasis 1 β β β 1 Congenital Malformation β β β 1 1 Premature Birth 8 2 β β 10 Debility 3 β β β 3 Intestinal Obstruction β 1 β β 1 Nephritis β 1 β β 1 Pemphigus Neonatorum β 1 β β 1 Absces (PyΓ¦mia) β β β 1 1 Want of proper attention at Birth 1 β β β 1 Icterus Neonatorum β 1 β β 1 79 dental treatment of mothers, and children UNDER 5 YEARS. This question has been discussed in the Dental Surgeon's Report, which appears on page 27 of the School Medical Officer's Report. Eighteen mothers were supplied with dentures during the year. |
5da8c197-db81-4dab-9392-566a88ef5b5b | PROVISION OF MEALS TO EXPECTANT AND NURSING MOTHERS. This provision is not valued probably for sentimental reasons as much as it ought to be, only 12 mothers availing themselves of its advantages during the year, 381 dinners being supplied. FOSTER CHILDREN. Cases of foster children received in the district are notified to the Mcdical Officer of Health by the Guardians under Part 1 of the Children Act, 1908, 20 children being so notified during flic year. Special visits in all cases were made by the Health Visitors, and the foster-mothers as far as possible induced to attend a Welfare Centre regularly with the children. As a general rule the care of these foster children continues to be satisfactory, it being only necessary in one instance to make any complaint during the year. 80 CONVALESCENT TREATMENT. |
d32de555-cda2-4d56-b615-80132d06c3a1 | Seven mothers with young babies, and two children received convalescent treatment during the year, particulars of length of stay, patients' contributions, net cost to Council, etc., being afforded by the following table: Cass No. Description of Patient. Situation of Convalescent Home. Charge made by Home, (per week) Length of Patient's stay. Patient's contribution. Council's net responsibility. Rly. Fares Home. Total. f. s. d. f, s. d. 747 Mother & Baby Limps field, Surrey 15/- 1 week Own travelling expenses only β 0 15 0 0 15 0 776 Mother & Baby Limpsfield, Surrey 15/- 3 weeks Ditto β 2 5 0 2 5 0 801 Child- St. |
43c70ccb-8613-4255-a61a-1a2b5ff9d02f | Leonards-on-Sea 25/- 2 weeks 5/- per week 7/6 2 0 0 2 7 6 819 Mother & Baby Limpsfield, Surrey 15/6 4 weeks Nil 7/1 3 2 0 3 9 1 889 Mother & Baby Birchington-on-Sea 25/- 2 weeks 15/- per week β 1 0 0 1 0 0 893 Child Arkley, Barnet 12/6 8 weeks 5/- per week 3/- 3 0 0 3 3 0 892a Mother & Baby Birchington-on-Sea 25/- 3 weeks 10/- per week β 2 5 0 2 5 0 907 Mother & Baby Limpsfield, |
974c4a08-f63b-404b-bd64-d5f645ff6b6f | Surrey 15/6 2 weeks 5/- per week 7/1 1 1 0 1 8 1 OH) Mother & Baby Limpsfield, Surrey 15/6 2 weeks Nil 7/1 1 11 0 1 18 1 81 ILLEGITIMACY. Twenty-three illegitimate children were born during the year, giving an illegitimate birth rate of 0.59 per thousand population, illegitimacy thus forming 2.7 per cent, of the total birth rate compared with 2.3 per cent, for the previous year. While the infantile death rate among legitimate children was 76.05, that among illegitimate children was equal to 217.39. INFANTILE MORTALITY. While the birth rate for the district in 1925 was 21.4, the infantile mortality rate was 80 compared with 22.3 and 85.1 repectively in 1924. |
ca125f31-54b3-4bf3-8070-9e9161e39dba | The number of deaths from diarrhΕal diseases under two years of age per 1,000 births was 10.9, forming 34.6 per cent, of the zymotic death rate, which was 0.67. The actual number of deaths from all causes under one year was 66, 30 being , female and 36 male children. During the same period the infantile mortality rate for England and Wales was 75, for the 105 Great Towns 79, for the 157 smaller towns 74, while in London it was 67. Deaths during the neonatal period have been considered in a previous section. Sixteen children died over a month and under three months, 9 over three months and under six months, 8 over six months and under nine months, and the remainder between the ages of nine months and one year. |
def96b50-5358-42fc-9433-b241d9f4cf56 | In 6 cases death was due to debility and marasmus, in 1 case to convulsions, in 9 cases to diarrhoea, and in 13 cases to bronchitis and pneumonia. From July to September 10 eases of summer diarhΕa were visited. The preponderance of artificial feeding among fatal eases is noteworthy. The infantile mortality rates for 1924 of 85.1 and of 80 for 1925 cannot be considered otherwise than high, and are attributable partly to defective environment and sanitary conditions, but it is well known that given the above conditions and a big percentage of breast fed babies the infantile mortality rate will be 82 low, breast feeding protecting the infant against one of its most deadly contingenciesβinfection through the milk, while further a known protection against various infections (which is probably quite specific) is afforded by the mother's milk. |
e86a4a77-0be7-4f39-8658-db7f25da5c97 | In Berlin from 1900-1904 only 10 per cent, of infants' deaths occurred in breast fed babies while Laling analysing over 13,000 infants in Baudeloque's Clinic found that of the total deaths 14 per cent, occurred in breast fed compared with 85 per cent, in bottle fed babies. Without further stressing this important point, of 1,000 fatal cases investigated by the Health Department of New York City in 1908 it was found that fatal cases in breast fed infants numbered only 9 per cent, of the total number of deaths. ORTHOPAEDIC TREATMENT FOR CHILDREN UNDER 3 YEARS OF AGE AND CO-ORDINATION OF WORK WITH THE SCHOOL MEDICAL SERVICE. This has been discussed at length in the report on the School Medical Service on pages 1, 2 and 16. MEASLES, WHOOPING COUGH AND DIARRHOEA. |
50d80461-caf1-4139-a8d1-cf0fb1210e75 | During the year 105 visits were paid in connection with the incidence of the above diseases as under:β Disease. No. of Visits. Measles and German Measles 9 DiarrhΕa 10 Whooping Cough 86 PROVISION OF FRESH AND DRIED MILK. The three brands of dried milk in use, "Glaxo," "Cow and Gate." and "Ambrosia," arc generally recognised as being amongst the best, and experience of them locally justifies this opinion. 83 Particulars of amounts used are provided by the following table:β Cost Price, (lbs.) Reduced Price, (lbs.) Free, (lbs.) Total, (lbs.) |
a7a41b59-0726-4492-9279-fb1efd91cd91 | Glaxo (Full Cream) 3,331 45 265 3,641 Gtaxo (Half Cream) 2 β β 2 Glaxo (Humanised) 50 β β 50 Ambrosia 2,728 45 203 2,976 Cow and Gate 10,048 75 935 11,058 frufood 12 β β 12 Fresh milk is supplied free and at reduced price to necessitous mothers and children, particulars of which are supplied by the following table:β No. of pints supplied at reduced price. No. of pints supplied free. Total. Total cost of milk supplied. Council's liability in respect of fresh milk supplied. Β£ 9. d. Β£. s d. |
2938aef8-122e-4518-98ff-0835ec46f59b | 2,050 16,373 18,423 249 9 7 235 12 0 Although it is gratifying to record the general increase in natural as distinct from bottle feeding throughout the country, there is still a great deal of unnecessary bottle feeding practiced. There are, however, many formidable obstacles in the path of natural feeding advocates, and one of the most serious is that commonly known as vested interests. The manufacture of dried milk has become an extensive and lucrative one in which much capital is invested and one of the principal sources from which interest on this capital can accrue is the mother of the family of one or more children. No time in many instances is lost in bringing to the notice of a young mother after the birth of her child the virtues of one or more brands of dried milk. |
d4c93459-8034-4ac6-a5b8-de5cc2b4f08b | A circular 84 letter by post or a carefully worded advertisement in the public press can be very convincing to the wife of an unemployed man especialiy when accompanied or followed quickly by the receipt of some alluring sample, when to use the women's own words "She is not getting her proper support" and who there[???] cannot see how she can possibly naturally feed her offspring successfully, and in many such cases the damage is done before the opportunity is given to interfere. If to this commercialisation of the diet of infants there were no counteracting influence in the shape of Maternity and Child Welfare Centres it can readily be imagined that the day would soon come when artificial feeding would be a national custom to be quickly followed by the day when women, through neglect to use it, would be unable to perform one of their most essential functions. BAR 19 1 ANNUAL REPORT OF THE SCHOOL MEDICAL OFFICER. (1) STAFF. During the year Dr. |
40dbf41d-0484-4400-b93e-30ae77d67923 | Simpson continued as School Medical Officer. Mr. W. W. Dawe commenced his duties as full-time Dental Surgeon in January, and Miss F. Young those of Dental Nurse in April. The remaining personnel of the School Medical Service suffered no change throughout the year. (2) CO-ORDINATION. (a) Infant and Child Welfare. The School Medical Officer and Assistant School Medical Officer arc also Medical Officer of Health and Assistant Medical Officer of Health respectively. The nursing staff of the Education Authority is not engaged in the work of the Sanitary Authority, so that co-ordination in the fullest sense of the word is not complete. Although the present position is unavoidable, a distinct gain would result were the school nurses employed also as part-time health visitors, so that the care of children of ail ages up to 14, and in some cases even titer, could be carried out by the same nursing staff. |
899197e0-ac23-4d1d-babf-ce2007cc6e6e | The School Medical Service is run in close touch with the Maternity and Child Welfare schemes of the district, the Tuberculosis Dispensary, and the Barking Tuberculosis After-care Committee. 2 (b) Nursery SchoolsβThere are no nursery schools in the district, but in certain selected cases children between 4 and 5 years of age were admitted to the Infants' Departments of certain elementary schools during the year. (c) Care of Debilitated Children under School Age.β Orthopaedic treatment where necessary is available for children under school age, joint arrangements existing therefor between the Education and Public Health Committees, any treatment required being given at the Orthopaedic Clinic of the Special School. Dental trertment and that for enlarged tonsils and adenoids is provided, the former, by arrangement with the Education Committee and available at the School Dental Clinic, the latter under similar arrangements to those for children of school age. |
0aae2926-f1c6-4bdb-8b00-cb3d1af256fc | No children under school age were admitted to the open air classes of the Special School, but sanatorium or hospital treatment was arranged for tuberculous cases through the Harking Dispensary. THE SCHOOL MEDICAL SERVICE IN RELATION TO PUBLIC ELEMENTARY SCHOOLS. (3) SCHOOL HYGIENE. Excepting the Roman Catholic and Church of England Schools, the general hygienic conditions of the remaining elementary schools can be considered satisfactory, the two excepted being the oldest schools in the district. Hygienic defects are more keenly felt in the case of the Roman Catholic School, which has been considerably overcrowded of late. Both schools lack, to some extent, open surroundings, and from the points of view of lighting, ventilation and heating leave something to be desired. 3 A site has been secured for an additional Roman Catholic School which, on completion, will go some way in minimising existing overcrowding. |
fe78a060-6b49-4f54-982c-980429f3da5a | The question of types of desks, blackboards, sanitary conveniences, water supply, etc., were dealt with at some length in my Report for 1923 With the exception of the Special School, no facilities exist at any of the others for the drying of children's clothes or boots. PROVISION OF MEALS. (i) A hot mid-day meal of two courses is provided for children attending the Special School, parents contributing to the cost thereof according to means. Meals are served in the Dining Hall of the School under the supervision of certain teachers, who, at the close of the children's dinner, are supplied with meals at a nominal charge. Pood is cooked in the Municipal Kitchen, arrangements existing for keeping food hot during transit and at the school before service. The actual service of meals is in the hands of assistants, although selected children take part in its distribution. (ii) It is possible for children in attendance at all other of the elementary schools to return home for the mid-day meal. |
088db1f7-77dc-47bc-9d05-9fa262648061 | (4) MEDICAL INSPECTION. The first table in the appendix shows the number of children inspected and ages at inspection, the Board's scheme being followed throughout. Every child is submitted to routine, medical inspection three times during its school life as one of the fundamental functions of the School Medical Service, the system employed ensuring that no child is omitted. 4 The number of children examined as entrants, intermediates and leavers, besides those examined otherwise than during routine inspection, together with the percentage of defectives found, is furnished by the subjoined table :β Entrants. Intermediates Leavers. Specials. Other Routine Examinations. Total. No. of children examined 1015 437 640 49 205 2,346 No. referred for treatment 265 124 141 34 27 591 No. |
c959f262-a3fd-4e94-929c-e9cf9a6f12dc | referred for observation 82 40 22 10 11 165 Percentage of defective children 34.1 37.5 25.4 89.7 18.5 32.2 The proportion of children, whose parents were present at school examination, was 65.5 per cent., compared with 53.1 per cent. during the preceding year. The number of children ou the school register on 31st December, 1925, was 6,791, compared with 6,539 oil 31st December, 1924. From a large series of general examinations of over a million children throughout the country it has been found that 19.4 per cent, required treatment, compared with the figure which for Burking in 1925 was 25.1 per cent. During the year, the Medical Officer paid 114 visits to 22 departments for inspection purposes, examinations being conducted throughout the year on the various school premises. |
45328ee1-9db4-4ef2-bc20-059dce9429be | Curtain cases of defect were, as in previous years, referred to the School Clinic for further examination and treatment. Very little disturbance of school routine is occasioned by these inspections, the convenience of teachers being followed as far as possible. 5 The following table shows the number of children examined at routine and special inspections during 1925, classified according to the schools attended, the number of inspections held in each school and the number of parents or guardians present :β COUNCIL SCHOOLS. School. No. of inspections. Numbers inspected. No. of parents present. Boys. Girls. Gascoigne 24 276 282 367 North St 23 220 198 292 Castle 3 35 17 29 Creeksmouth 1 3 3 6 Westbury 18 180 197 269 Ripple 17 181 163 246 Faireross 7 107 08 127 VOLUNTARY SCHOOLS. |
82f48ad2-1090-48bb-bf29-affebc14d1c2 | Church of England 13 132 111 127 Roman Catholic 8 69 74 75 (5) FINDINGS OF MEDICAL INSPECTIONS. Table II., Appendix (a), gives a return of defects found during the course of routine examination. Of those examined at routine and special inspections, 756, or 32.2 per cent., had some defect, and the actual percentage requiring treatment was 25.1. t (a) Malnutrition.βTwenty-one cases were found on inspection sufficiently serious to require treatment, and 23 others were specially watched, most of the cases found being already in attendance at the open-air classes of the Special School. The main causes of malnutrition are probably environmental in origin, followed to a minor extent by improper or insufficient food. The belief is gaining ground that one of the principal causes of malnutrition in young children, apart from other obvious cause, is tuberculosis, usually contracted at an earlier period of 6 life. |
02b296e9-71c7-40db-9501-4b69604581ef | The value of an open-air school for such cases is very great, playing, as it does, the part of a preventorium where children while attending usually remain remarkably free from further evidence of activity of the disease. (b) Uncleanliness.βThis defect in more recent years has shown a constant and satisfactory decline. Owing to the condition of some of the homes from which the children come, and of the other inmates, this defect cannot be stamped out by the School Medical Service alone. In this connection, close cooperation with the sanitary authority is valuable. Surveys under the above heading were carried out at (a) routine medical inspections, and (b) special inspections conducted oy the school nurses. (a) At the former, 305 children out of a total of 2,316, or 13 per cent., had nits in their hair, while 6 of 0.25 per cent. had head or body vermin. |
f09ed49b-af0c-43e4-b707-db874ee25ac4 | As formerly, cases were seen at the School Clinic after exclusion by nurses or teachers, of which number 108 had nits and 58 head or body vermin. (b) During the vear the school nurses made 17,504 individual investigations, compared with 13,632 in 1924, of which number 2,170 children were found to have nits in the hair only, 170 harboured nits and head vermin, whilst 21 had verminous bodies and clothing. 7 Every school in the area covered by each school nurse is fully inspected during each term, the results of these examinations being as follows :-r- School. Dept. Nits only. Nits and Vermin (head). Body and clothing verminous. Gascoigne Infants 139 15 1 Boys 58 7 1 Girls 304 15 2 North St. |
3a7d2e6c-f204-4a7b-b173-b991467dee6d | Infants 100 8 β Boys 39 4 1 Girls 159 6 β Castle Infants Boys Girls 44 6 10 Creeksmouth Infants Boys Girls 20 2 β Westbury Infants 138 22 β Boys 21 2 β Girls 211 7 β Ripple Infants 91 8 2 Boys 26 3 1 Girls 146 7 β C. of E Infants 120 17 β Boys 46 19 1 Girls 257 9 β R.C Infants 43 3 2 Boys Girls 138 5 β Faircross β 67 6 β Printed instructions are in all cases sent to parents or guardians of children excluded from school as result of verminous conditions, cleansing of the verminous person and clothing being subsequently undertaken at the School Cleansing Station. During 1925, 169 cases were so dealt with. |
25c7f105-70f6-45fa-a62f-82a50be74d57 | (c) Clothing.βChildren with dirty clothing numbered 10 or 0.47 per cent., compared with 47 or 2.11 per cent. in 1924. Children with defective footgear numbered 14 or 0.66. Cases of children with defective footgear were as heretofore referred 8 to the Boots Minor Sub-Committee, who considered applications for the provision of boots in 133 cases, compared with 19 in 1924. (d) Heights and Weights.βThe following table gives the average heights and weights of children examined at the three undermentioned age periods in four of the schools, compared with the results at similar age periods in 1924. Age Period. Average Height in inches. Average Weight in pounds. 1924. 1925. 1924. 1925. |
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