Berks United Sanitary Distriets INCLTXDING MAIDENHEAD and WOKINGHAM UEBvtN DISTRICTS, COOKHAM, EASTHAMPSTEAD, WINDSOR and WOKINGHAM RURAL DISTRICTS. r Annual Report OF THE MEDICAL OFFICER OF HEALTH for 1939 JAMES J. PATERSON, M.D. (Lond)., B.Sc., D.P.H. MEMBER OF THE ROYAL COLLEOE OF SURGEONS (ENG.) ; LICENTIATE OF THE ROYAL COLLEGE OF PHYSICIANS (LOND.) ; FELLOW OF THE SOCIETY OF MEDICAL OFFICERS OF HEALTH. East Berks United Sanitary Districts INCLUDING MAIDENHEAD and WOKINGHAM URBAN DISTRICTS, COOKHAM, EASTHAMPSTEAD, WINDSOR and WOKINGHAM RURAL DISTRICTS. Annual Report OF THE MEDICAL OFFICER OF HEALTH for 1939 BY JAMES J. PATERSON, M.D. (Lond)., B.Sc., D.P.H. MEMBER OF THE ROYAL COLLEGE OF SURGEONS (ENG.) ; LICENTIATE OF THE ROYAL COLLEGE OF PHYSICIANS (LOND.) ; FELLOW OF THE SOCIETY OF MEDICAL OFFICERS OF HEALTH. WINDSOR: LUFF AND SONS LTD., PRINTERS, 47, ST. LEONARD’S ROAD. 1940. To the CHAIRMAN and MEMBERS of the JOINT COMMITTEE for the UNITED SANITARY DISTRICTS OF EAST BERKS. Gentlemen, I have tlie privilege of presenting to you the 29th Annual Report of the Medical Officer of Health upon the Health and Sanitary Circumstances of the Districts constituting the East Berks United Sanitary Districts. ^ The Report this year has been greatly delayed, partly because of war work, but chiefly owing to the late arrival of the necessary statistics from the Registrar General, the latter not being received until the beginning of October, 1940. Several of the less important Statistical Tables have been omitted, also much of the reference matter, on the score of economy. So far as the health of the population as a whole is concerned and so far as it can be measured by the incidence of infectious and other diseases, the year 1939 may be described as being rather better than the average. The usual vital and mortal statistics do not vary much from the normal, but there is a distinct trend towards rise in the mortahty from Cancer and this is particularly noticeable in the two Urban Districts (Maidenhead and Wokingham) and in Windsor Rural District. The outbreak of war at the beginning of the last quarter of the year put a stop to the larger schemes for sanitary improvement, notably housing and sewerage. It is greatly to be regretted that the Bray and Cookham Sewerage scheme is again postponed, as it was by the previous war in 1914, and also that the rapidly growing “ urbanised ” portions of the Wokingham Rural District as well as the village of Twyford, where sewering is now so urgent, must, perforce, await a more convenient season. Many changes in the Sanitary Staffs of the Districts have occurred or are likely to occur in consequence of war conditions, but every effort should be made to fill vacancies so that the sanitary service as a whole shall not suffer, especially in view of the new problems arising out of evacuation. My grateful thanks are due to the cordial assistance afforded by the Senior Sanitary Inspectors and for their diligence in dealing with the mass of additional work that has been thrust upon them, and I have also to acknowledge the courtesy extended to me by the members of the various Councils I have to deal with. Copies of this Report will be supplied to each member of the several District Councils as soon as printed copies are available. I am, Gentlemen, Your obedient Servant, Medical Officer of Health. Guildhall, Maidenhead. November, 1940. East Berks United Sanitary Districts. CONSTITUTION AND HISTORY OF THE DISTRICTS. The combination of Districts in East Berks for Public Health purposes was originally ejected by an Order of the (then) Local Government Board dated 10th November, 1910, in pursuance of Section 286 of the Public Health Act, 1875. The combination then comprised Maidenhead Urban, Cookham, Easthampstead and Windsor Bural Districts, later, by a fresh Order dated 27th October, 1922, Wokingham Urban and Wokingham Kural Districts were added. The principal details of these two Orders and sundry other matters relating to the constitution of the combined districts as well as the geological formation and social conditions of the area were given in the Report for 1930 at pages 22-30. Subsequent alter- ations of boundries are described in the Report for 1938 at page 8. The area, population and rateable value of the several districts in the combination are given in the table below, while particulars of the populations in the Parishes will be found in the Appendix of previous Reports. East Berks United Sanitary Districts. District Area in Acres Estimated Population (1939) Rateable Value 1/4/40 Maidenhead Urban ... 5,026 24,340 £209,007 Wokingham Urban ... 3,403 7,810 53,672 Cookham Rural ... 24,901 11,180 92,859 Easthampstead Rural ... 27,034 20,160 146,678 Windsor Rural ... ... 8,665 9,821 112,723 Wokingham Rural ... 40,828 27,730 199,362 Totals ... 109,857 101,041 £814,301 ACCOUNTS FOR PAST YEAR. The Joint Committee, consisting of a proportionate number of members from the Councils of each of the Constituent Districts, as defined in the Order of 1922, meet, as a rule, once a year on the Thursday next after the 31st day of March for the purpose of examining and passing the accounts and for authorising the appor- tionment of salary and expenses amongst the Districts in the manner described in the Order. Public Health matters relating to the Districts in common are also discussed. At their meeting in Maidenhead on the 4th April, 1940, the following accounts ranking as expenses of office were passed for payment :— £ s. d. Printing of Annual Report ... 101 17 0 General Printing and Stationery • • « ... 16 4 9 M.O.H. Postages ... • • • ... 11 18 10 M.O.H. Petty Cash • • • ... 9 16 7 Clerk’s Salary and Expenses a • • ... 19 5 4 Total for 1939-40 . . . £159 2 6 Corresponding Total for 1938-9 . . . £142 7 1 „ . 1937-8 . . . £137 17 1 „ „ „ 1936-7 £130 17 3 OTHER INFORMATION. In former years it has been the custom to include in the Preface notes on such matters as are common to all the Districts in the combination, and also list of Hospitals, Clinics, Nursing Associations, Consultants, Specialists, Midwives, etc., whose services are available throughout the area dealt with in this Report. These services remain substantially the same, except in so far as they have been modified by war conditions, so that on the grounds of economy this portion of the Report has been omitted. For information on such subjects, reference may be made to the appropriate paragraph in previous Reports, or the enquiry may be directed to the Medical Officer of Health at the Guildhall, Maidenhead {Tel. Maidenhead 549). Members of the Joint Committee OF THE East Berks United Sanitary Districts for the Year 1940 Representing MAIDENHEAD Urban District: L. R. F. Oldersbaw, Esq., 15, St. Luke’s Road, Maidenhead. W. Archer, Esq., “ Dovercot,” The Crescent, Maidenhead. E. B. Norris, Esq., “ Grafton Lodge,” Belnaont Park Road, Maidenhead. Representing COOKHAM Rural District: F. H. C. S. Wood, Esq., “ Little Pickett,” Cookham Dean. J. C. Besley, Esq., “ Lewins,” Shurlock Row, nr. Twyford. Representing EASTHAMPSTEAD Rural District: M. Bolton, Esq., St. Mark’s Road, Binfield. Mrs. E. V. Bowman, “St. Enodoc,” Crowthorne. Lt.-Col. Lord J. A. N. Butler, “Nohhscrook Farm,” Winkfield. Representing WINDSOR Rural District: Mrs. M. Legge, Farm House, Old Windsor. J. H. Nelson, Esq., “ Woodcote,” Ascot. Representing WOKINGHAM Urban District: C. Goddard, Esq., Coppid House, Rectory Road, Wokingham. Representing WOKINGHAM Rural District: C. A. Mason, Esq., “ The Elms,” Grazeley, near Reading. F. T. Lee, Esq., “ Sandlea,” Buckhurst Hill, Wokingham. W. H. Geary, Esq., Red House, Lower Earley, nr. Reading. Clerh to the Joint Committee : H. E. Davies, Esq., Guildhall, Maidenhead. (Tel. 64). STAFF. Medical Officer of Health : James J. Paterson, M.D. (Lond.), B.Sc., D.P.H. ; Member of the Royal College of Surgeons (Eng.) ; Licentiate of the Royal College of Physicians (Lond.) ; Fellow of the Society of Medical Officers of Health. Date of appointment, 1st April, 1911. Office :—Guildhall, Maidenhead. Telephone, Maidenhead 549. Sanitary Inspectors and Assistants, 1940 : Maidenhead U.D. W. E. Harding (Cert.) R.S.I. and Meat and Other Foods Cert., Sanitary Insepctor, from 1st April, 1910. D. M. Jones (Cert.) R.S.I. and Meat and Other Foods Cert., Additional Sanitary Inspector from 1st January, 1939. Formerly Student Assistant from 11th February, 1935. Clerk : Miss W. Ellis, from 6th November, 1937. Office : Guildhall, Maidenhead. Telephone, Maidenhead 549. Wokingham U.D. R. R. Hole. (Cert) R.S.I. Chartered Surveyor and Sanitary Inspector, from 25th April, 1938. Two Clerical Assistants for combined office. Office : Town Hall, Wokingham. Telephone : Wokingham 323. COOKHAM R.D. J. H. JoYNT (Cert.) R.S.I. and Meat and Other Foods Cert., Sanitary Inspector and Building Surveyor from 1st July, 1934. Assistant: A. Swan, from 19th November, 1934. Office: “Oaklands,” Bath Road, Maidenhead. Telephone : Maidenhead 252. Easthampstead R.D. H. Charlesworth (Cert.) R.S.I. and Meat and Other Foods Cert., Sanitary Inspector and Building Surveyor, from 1st June, 1934. A. Furniss (Cert.) R.S.I. and Meat and Other Foods Cert., Second Sanitary Inspector, etc., from 1st March, 1937. A. E. Nixon (Cert.) R.S.I. and Meat and Other Foods Cert., Additional Sanitary Inspector, etc., from 8th February, 1937. Clerk : (Vacant) Office : Council Offices, Church Road, Bracknell. Telephone : Bracknell 500. Windsor R.D. W. H. Rowsell (Cert.) R.S.I. and Meat and Other Foods Cert., Sanitary Inspector and Building Surveyor, from 1st April, 1937. Address : West Lodge, Heather Drive, Sunningdale. Telephone : Ascot 663. Wokingham R.D. W. L. Longhurst (Cert.) R.S.I., Meat and Other Foods Cert., Sanitary Inspector. D. Evans (Cert.) R.S.I. and Meat and Other Foods Cert., Second Sanitary Inspector, from 3rd March, 1937. Office : The Rectory, Shute End, Wokingham. Telephone : Wokingham 833. Maidenhead Urban Sanitary District. SECTION A. GENERAL STATISTICS. Area (in acres) ... ... 5,026 Registrar General’s estimate of (а) Resident population at middle of 1939 ... ... 23,200 (б) Average population appropriate to calculation of Death Rates 24,340 Number of inhabited houses according to Rate Book at end of 1939 6,730 Rateable Value, 1st April, 1940 ... ... £209,007 Sum represented by Penny Rate, ditto £811 SOCIAL CONDITIONS AND UNEMPLOYMENT. There is nothing to add to the corresponding paragraph in the previous Report (p. 31), which describes Maidenhead as being chiefly residential in character without any large industrial undertakings. The chief forms of employment are Shop-keeping, Building, Transport, Personal and Domestic Service. The chief factories are Brewery, Garage, Laundry and Jam-making. Unemployment figures vary little from year to year and on the whole are maintained at a moderate level. EXTRACT FROM VITAL STATISTICS FOR THE YEAR, 1939. Total. Males. Females. Live Births * fLegitimate ... ... ... 296 V Illegitimate ... ... ... 23 161 13 135 10 Still Births 13 ••• ••• ••• JL 7 6 Deaths 275 127 00 Live Birtli Rate per 1,000 of the estimated resident population 13.75 Still Birtli Rate per 1,000 total (live and still) births ... 39.16 Death Rate per 1,000 of the estimated resident population ... 11.30 Rate per 1,000 Deaths from Puerperal Causes :— total (live and still) Deaths. Births. No. 29. Puerperal sepsis... 0 Nil No 30 Other Puerperal causes 1 3.03 TCotal ... ... ... ... ... 1 3.03 Death Rate of Infants under 1 year of age • • All infants per 1,000 live births » • • • 33.33 Illegitimate infants per 1,000 illegitimate live birhts 83.33 Legitimate infants per 1,000 legitimate live births 29.42 Number of Deaths from Other Causes :— Cancer (all ages) • • • • ... ... 49 Measles (all ages) 0 Whooping Cough (all ages) ... 0 Diarrhoea (under 2 years) . . • 2 Unusual or Excessive Mortality » • • « Nil POPULATION. Comments on the population of Maidenhead Urban District appeared in the corresponding paragraphs of the Reports for 1932 and subsequent Reports. For the year 1939 the Registrar General gives two figures, namely (a) 23,200 to represent the mid-year population upon which Birth Rates are calculated ; and (6) 24,340 upon which Death Rates and the incidence of Infectious Disease are calculated. The population as enumerated at Census periods was : 1901 12,980 1921 16,730 1911 15.219 1931 17,520 The estimated population for 1938 was 23,070. BIRTHS. This year the Registrar General has supplied two sets of figures to represent the Births attributable to this District, (a) the smaller for the purpose of calculating the local Birth Rate ; and (6) the larger for calculating Infant and Maternal Mortalities. These are given in the columns marked (a) and (6) respectively in the following Table. Births Table. Maidenhead, 1939. Male. Female. Total. Legitimate Births Illegitimate Births Total Live Births Total Still Births Total Registered (Live and Still) (a) ih) {a) 161 167 135 13 14 10 174 181 145 7 — 6 181 {h) {a) {h) 139 296 306 10 23 24 149 319 330 — 13 151 332 There were no illegitimates amongst the still births. The total Birth Rate (Live and Still) works out at 14.31 per 1,000 of population, and the Live Birth Rate (Live Births only) at 13.75 per 1,000 of population. DEATHS. As has been explained in previous Reports the gross number of deaths registered locally has to be corrected for residents dying elsewhere (inward transfers) and for non-residents dying in Insti- tutions, etc., in the District (outward transfers) ; also in order to make Death Rates in different districts comparable a correcting factor is applied to the death rate to compensate for age and sex differences in the population. The result is known as the Standard Death Rate. The net number of deaths attributed to this District is 275, comprising 127 males and 148 females. The net Death Rate works out at 11.30, which, multiplied by the comparability factor (0.88) gives a Standard Death Rate of 9.94. For the previous year the Net Death Rate was 12.74, while the average for the past two years is 12.26. The principal causes of deaths in this district during past years are :— Disease. 1939 1938 1937 1936 1935 1. Cancer ... 49 40 39 36 40 2. Heart Disease ... 72 83 96 76 72 3. Respiratory Diseases ... (Pneumonia, Bronchitis, etc.) 23 32 24 24 26 4. Influenza 3 3 16 2 4 5. Diseases of the Blood Vessels (including Cerebral Haemorrhage) 26 27 35 50 25 6. Disease of the Kidneys 5 7 8 6 8 7. Disease of the Digestive Organs 27 20 15 9 7 8. Tuberculosis (all forms) 10 22 15 12 11 9. All other Infectious Diseases ... 3 2 1 3 5 10. Suicide ... 5 0 2 3 3 11. Accidents, etc. ... 9 11 19 10 15 12. Senile Decay 4 6 5 1 5 INFANT AND MATERNAL MORTALITY. x4mongst infants under one year of age there were only 11 deaths, as against 22 in the preceding year. These referred to 9 legitimate infants and 2 illegitimate, in addition there were 13 still-births, of which none was illegitimate. Deaths from Diarrhoea under two years of age were 2 only. Maternal Mortality. There was 1 death from Puerperal Sepsis, which gives a Maternal Mortality Rate of 3.03 per 1,000 when calculated upon the 330 total births, or a rate of 0.04 per 1,000 when calculated upon the estimated population of 24,340. The respective rates work out as follows :— Infant Mortality Rate (average for past ten years) All infants per 1,000 live births (1939) Legitimate infants per 1,000 legitimate live births Illegitimate infants per 1,000 illegitimate live birhts Still-births per 1,000 total (live and still) births ... Maternal Mortality per 1,000 (live and still) births 50.77 33.33 29.42 83.33 39.39 3.03 The cause of, and age at, death of the infants referred to are set out in the following table :— Casue of JJnd. 1-2 2-3 3-i 1-3 3-6 6-9 9-12 Death 1 wk. whs. whs. ivks. mths. mths. mths. mths. Total Broncho- Pneumonia Cardiac — — — 1 1 — 2 failure Cerebral 2 — — — — — — 2 Haemorrhage General 1 — — — — — — — 1 Debility — — — — — 1 — — 1 Marasmus — — — — 1 — — — 1 Prematurity 3 — — — — — — — 3 Syncope — — — — 1 — — — 1 SECTION B. GENERAL PROVISION OF HEALTH SERVICES. PUBLIC HEALTH OFFICERS. In addition to the Medical Officer of Health the following are employed as members of the Public Health Staff: Two full-time Sanitary Inspectors, both of whom hold the qualifying certificate of the Royal Sanitary Institute and also the “ Meat ” Certificate. The senior Inspector also holds office as Inspector under the Shops Acts, 1912-1934, and Enforcement Officer under the Employment of Children Byelaws (Children and Young Persons Act, 1933). One Student Assistant preparing for qualifications as a Sanitary Inspector left to take up military duties and was replaced by a boy clerk. One full-time lady clerk who also acts for the East Berks Districts as a whole. One part-time Lady Doctor who is employed as assistant School Medical Officer and Medical Officer in charge of the Maternity and Child Welfare Service. One part-time Ophthalmic Surgeon. One part-time Dental Surgeon. One part-time Speech Therapist. Four Nurses who each hold the combined office of Health Visitor and School Nurse. All the above hold qualifications and certificates approved by the Ministry of Health and Board of Education. In connection with the Isolation Hospital which serves the whole of East Berks, the Staff consists of Matron, Deputy Matron and twelve Nurses together with appropriate domestic and out-door staff (see Annual Report, 1938, p. 47). LEGISLATION IN FORCE. A full list of the Adoptive Acts, Bye-laws and Regulations in force in this District was given in the Report for 1938 at pages 38-40. LABORATORY FACILITIES. The facilities for the examination of morbid specimens—swabs, etc., remain the same as described in previous Annual Reports and are the same for all the Districts in the combination. The Tables that appear below give a summary of the work done under this heading during the past year. (1) Specimens sent by Medical Practitioners for examination and report, to the Clinical Research Association, London : Material. Positive. Negative. Total. Swabs for Diphtheria ... ... 28 391 419 Sputum for Tubercle ... ... 7 49 56 Blood for Typhoid ... I 1 2 Other Specimens ... 4 3 7 40 444 484 (2) Swabs sent from the Borough Isolation Hospital to the Clinical Research Association for examination : Material. Positive. Negative. Total. Swabs for Diphtheria ... ... 148 618 766 Other Specimens ... 0 6 6 Grand Total ... 772 (3) Samples of Rag Flock taken by the Sanitary Inspector and examined by the Clinical Research Association, London : Number of Samples ... ... ... ... ... ... 5 Conforming to standard ... ... ... ... ... 5 Not so conforming ... ... ... ... ... ... 0 (4) Official samples of Milk taken by the Police : 49. One deficient in non-fatty solids to the extent of 2.94%. One sample was low in non-fatty solids and one was low in milk fat. (5) Formal samples taken by the County Inspectors (Weights and Measures Department) : Bloater Paste ... 1 Mustard • • • ... 2 Butter ... 2 Olive Oil ... • • • ... 1 Cream ... 2 Pearl Barley ... 3 Demarara Sugar ... 1 Rolled Oats • • • ... 1 Flour ... 3 Rum « • • ... 2 Gin ... 2 Semolina • t • ... 2 Ground Nutmeg ... 3 Sweet Spirits of Nitre ... 2 Lard ... 2 Vermicelli ... • • • ... 3 Macaroni • • • ... 1 Whisky ... . . . ... 3 All the samples proved to be genuine. (6) Samples and specimens examined and reported upon by the Medical Officer of Health : Milk (unofficial samples) ... ... 13 One of which proved to be low in fat content. Water : Samples taken by Medical Officer of Health from Swimming Baths and reported upon by Clinical Research Association— Chemical ... ... ... ... ... ... 4 Bacterial ... ... ... ... ... ... 4 The bacterial samples were satisfactory, but one of the chemical samples was high in chlorine and contained excess of solids in solution. In previous Reports it was the custom to give in the Preface a full list of Laboratories, Special Clinics, Consultants and other Special Services available for the respective Districts. As the former arrangements remain substantially the same, repetition of this list has been omitted, and in any case, should difficulty arise, appropriate facilities can be arranged on application to the Medical Officer of Health. AMBULANCE FACILITIES. Two Motor Ambulances maintained by the Maidenhead Town Council are available for general and accident cases arising in the Borough of Maidenhead and the neighbouring Rural District of Cookham. In addition, supplementary Trailer Ambulances have been acquired for use in the event of air raids. There is a special ambulance attached to the Isolation Hospital for cases of infectious disease. The service is quite adequate for the needs of this locality, and the extent of these services is indicated in the following Hst of journeys made during the year 1939 : Quarter ended. Accidents. Other. Total. 31st March, 1939 22 193 215 30th June, 1939 23 169 192 30th September, 1939 35 160 195 31st December, 1939 ... 33 205 238 113 727 840 HOME NURSING. Nursing in the home is carried out by the Maidenhead and District Nursing Association, 3-5, Castle Hill, Maidenhead (Tel. Maidenhead 651), a full account of which has been given in this corresponding paragraph of previous Reports. The following is a summary of the work done during the year ended 31st March, 1940. Superintendent : Mrs. A. M. Pantoll, Queen’s Nurse, Certified Midwife and certified Royal Sanitary Institute. Nursing Staff: Mrs. Glover, Queen’s Nurse, Certified Midwife. Miss Grigaitis, Queen’s Nurse, Certified Midwife. Miss Boydell, Queen’s Nurse, Certified Midwife. Mrs. Bond, Certified Midwife. Miss Bolt, State Registered Nurse and Certified Midwife (temporary). Report for Year ended 31st March, 1940. Cases. General (Cases) 307 Midwifery (District) 102 Maternity (District) 31 Midwifery Cases (House) 43 Maternity Cases (House) ... 59 Ante-Natal Clinic ... 46 *01d Age Pensioners 15 *Parish Relief 16 * School Children 1 *Children under School age 4 Total ... ... • •• ••• ••• (* Nursed Free) Previous year ^17 «•« KJ M 1 Attendances. Ante-Natal Clinic ••• ••• ••• • • • • • • 67 Sessions ••• • • • • • V 15 New Patients ... ••• ••• ••• Number of Yisits, 1939-40. 46 • •• ••• j-v April ... 1122 October 815 May ... 1224 November .,. ^ ... 819 June ... ... 1169 December 839 July ... 1269 January 1063 August ... 1295 February 1088 September ... 1165 March ... 1046 Total « . • . . * 12,914 Previous year 14,498 TREATMENT CENTRES AND CLINICS. In the Report for 1938 (pp. 42-44) a full list and general partic- ulars of the various Treatment Centres and Clinics in operation were given and need not he repeated, as that work is being carried on without any material change. In consequence of the numerous cases of skin diseases and minor ailments occurring amongst the evacuee children, a “ Sick Bay ” was established at 24, Craufurd Rise {Tel. Maidenhead 2110) for the purpose of providing treatment for such as could not be satisfactorily dealt with at home. This institution is under the charge of Sister Clarke (from Shirley Residential School, London), assisted by appropriate nursing and domestic stalf. The number of children dealt with since opening in the second week of September, 1939, to the 31st March, 1940, is shown below. September 30th to December 31st, 1939. (Maidenhead only.) Debility ... ... ... 2 Pemphigus ... ... 1 Enuresis 9 Scabies 39 Impetigo 7 Other Districts : 30. January 1st, to March Slst 1940. (Maidenhead and District.) Abscess ... o ^ Enuresis ... 10 Chilblains ... 3 Haematoma 1 Cut Lips ... 1 Impetigo ... 11 Debility 1 Influenza, etc. ... ... 13 Diarrhoea ... 1 Night Terrors ... 1 • • • Ear Trouble 1 Scabies ... ... 24 Total number treated : 157. HOSPITALS AND NURSING HOMES. Details of tlie Hospitals and Nursing Homes in this neighbourhood will be found in the Report for 1938, pages 44-49. Up to the begin- ning of September no changes had taken place, but since then various modifications owing to war conditions have been introduced in the General Hospitals and some of the smaller Private Nursing Homes have been closed, but these have not caused any serious difficulties to the resident population. The following particulars relating to the Maidenhead Borough Isolation Hospital, which serves the East Berks Districts and the Borough of Windsor as well, are reproduced below for the purpose of record. Staff. (1) Nursing.—Matron, Deputy-Matron and twelve permanent nurses. Additional temporary nurses employed as required. (2) Domestic.—Cook, kitchen maid, three ward maids, two housemaids (resident), one daily charwoman (non-resident), two laundresses (non-resident). (3) Out-door.—One porter, one gardener, one ambulance driver (all non-resident). Expenditure. The total expenditure of the Isolation Hospital, inclusive of capital, for the year to 31st March, 1939, was £5,962 8s. 6d., as detailed below. The average cost per patient, inclusive of capital and loan charges was £17 17s. Od., there having been 334 admissions during the financial year. Expenditure for year to 31st March, 1939 : Ambulance Clothing and Bedding Disinfectants Fuel, Light and Cleaning Furniture and Ironmongery... Medical Superintendent Medical Attendance (Consultations, etc.) Ditto, Treatment of Cases at other Hospitals Ditto, Analysis fees (Swabs, etc.) ... Medicines and Surgical Dressings ... Nursing and Staff (including Dress allowances) ... Provisions Kates, Taxes and Insurance Repairs and Upkeep of Buildings and Grounds ... Telephones AVages ... ... ... ... ... ... ... Miscellaneous ... Superannuation : Employers’ Contributions National Insurance ,, ,, Loan Charges— £ s. d. Principal ... ... ... ... 626 2 10 Interest ... ... ... ... 588 9 11 £ s. d. ... no 8 2 ... 41 2 7 ... 44 0 9 ... 530 18 3 ... 29 15 9 ... 150 0 0 ... 11 11 0 ... 198 3 0 ... 116 8 0 ... 224 9 9 ...1270 3 11 ... 910 9 4 ... 180 15 1 ... 147 1 9 ... 11 6 8 ... 606 7 4 ... 45 10 8 ... 95 19 10 ... 23 4 11 1,214 12 9 Total ... ... £5,962 9 6 Total for previous year (1938)—£6,049 11s. Od. MATERNITY AND CHILD WELFARE SERVICE. (i) The Berks County Council is the Local Supervising Authority for Midwives. Apart from mid wives attached to Institutions there is only one private midwive in active practice in the Borough. (ii) The Maternity Services of the Local Authority include a Welfare Centre conducted by Dr. E. Mary Bell at " The Wilderness,” Cookham Road, an account of which is given below, an Ante-Natal Clinic conducted at 3-5, Castle Hill, and a scheme by which all non- insured expectant mothers are examined by their own doctor as frequently as need be. The details of this latter scheme, which includes post-natal as well as ante-natal examinations, have appeared in previous Reports (see Report 1938, page 25). (hi) Institutional Provision for Mothers and Children is provided by various local agencies, an account of which will be found in the Report for 1938 at pages 51-52. (iv) Health Visiting, together with the work connected with the School Medical Service, is undertaken by three whole-time qualified nurses, and a fourth was added to the staff in September to cope with the additional duties consqeuent upon the influx of evacuees. (v) Child Life Protection and the duties connected therewith is undertaken by the Health Visitors as described in the Report for 1938, at page 53. The following is a summary of the work for 1939. Health Visiting. Three whole-time Health Visitors are employed, who also act as School Nurses, etc. A description of the work done by them in this connection was given in the Report for 1932 at page 42. The following is an abstract from Form M.C.W.96 relating to the foregoing services. Number of visits paid during the year by all Health Visitors :— (a) To expectant mothers : First visits, 62. Total visits, 96. (h) To children under 1 year of age : First visits, 324. Total visits, 1,304. (c) To children between the ages of 1 and 5 years : Total visits, 1,892. (d) The total attendances at the Welfare Centre during 1939 were : Children under 1 year of age ... ... ... ... 2,481 Children between 1 and 5 years of age ... ... 2,385 These included 200 children under 1 year of age, which represents 50 per cent, of the 409 local births ; and 102 between 1 and 5 years who attended the Centre for the first time. At the end of the year there were in attendance at the Centre : Children under 1 year of age ... ... ... ... 202 Children between 1 and 5 years of age ... ... 390 Free meals are not given at the Centre, but milk is supplied free of cost at home through the customary milk purveyor, to nursing and expectant mothers and to debilitated children for periods of one month at a time or longer if necessary. The quantity so supplied during 1939 was l,196i gallons. Vouchers are given in suitable cases to mothers enabling them to obtain dried milk and other baby foods at a reduced price from the local retailers. This service has been extended to include evacuee mothers and children. Child Life Protection. The Medical Officer of Health is nominated as the person to whom notices and communications relating to the reception of children for reward should be addressed. Visiting of the homes where children are so received is carried out by the three Health Visitors, who visit regularly at least once every three months, or oftener as occasion requires. The results of these visits are recorded and reported at the meetings of the Maternity and Child Welfare Committee. There are 12 Homes in Maidenhead where children are kept for payment and the number of children so kept is about 41. Each Home is visited regularly once a quarter, and additional visits are paid as required. Administration (Public Health Act, 1936, Sections 206 to 220). (a) Number of persons receiving children for reward on the Register at the end of the year ... ... ... ... 12 (h) Number of children on the Register : (1) At the end of the year 41 (2) Who died during the year 2 (3) On whom inquests were held during the year ... ... 0 Number of Infant Protection Visitors holding appointments under Section 209 (2) at the end of the year who were : (1) Health Visitors 4 (2) Female, other than Health Visitor 0 (3) Male ... ... ... ... ... ... ... ... 0 Legal proceedings taken during the year ... None (iv) Dental, Orthopaedic, etc.. Treatment. In this con- nection there is nothing to add to the description of the arrangement that appeared in the previous year’s Report (page 54). On account of lack of accommodation it has not been found possible to extend dental treatment to the mothers attending the Centre. During the year there were 272 attendances at the Dental Clinic of children of pre-school age. These included 93 inspections, 146 fillings and 149 extractions. i Cases requiring Orthopoedic treatment are referred to the local branch of the Wingfield-Morris Orthopoedic Hospital, which is held in the Out-Patient Department of the Maidenhead Hospital weekly, on Fridays at 2 p.m. During the past year 8 children under 5 years of age were so referred from the Welfare Centre, and in addition 62 children (all ages) attended the Classes for Remedial Exercises held twice weekly in connection with this Department. In previous Reports comment has been made upon the inadequacy and inconvenience of the premises at present used for Welfare work and Clinics, these being, in.fact, the “ temporary accommodation ” provided at the end of the last war. After much negotiation and many set-backs a scheme to provide a Municipal Health Centre worthy of the activities envisaged and adequate for present as well as future needs, was completed in 1939. By the irony of fate permission to proceed with the work at a cost of approximately £10,000 was received from the Government Departments concerned on the 4th of September—the day after War was declared. Needless to say, the Scheme is now in abeyance and the want of proper accommodation and convenience for the treatment and supervision of the numerous additional cases arising out of the influx of evacuees was keenly felt. SECTION C. SANITAKY CIRCUMSTANCES. WATER SUPPLY. The water supply of this district has been described in detail in previous Reports (see Report 1938, page 55). In regard to both quantity and quality this supply maintains a high standard. Frequent samples are taken for bacteriological analysis (about twice a week) and these have proved uniformly satisfactory during the past year. Extensions of the service are shown below. Connections New Total at Existing drivng end of 1938. 1939. year. Maidenhead (North Section) ... 4,390 35 4,425 Maidenhead (South Section) ... 2,358 15 2,373 Totals ... 6,748 50 6,798 The Company, which is a private one, derives its powers from an Act of 1875, and several subsequent Provisional Orders. The area of distribution covers the Borough of Maidenhead and practically the whole of the surrounding Rural District of Cookham. The popu- lation so served is approximately 34,000 persons. The total rainfall taken at Pond House reservior for 1939 was 26.52 inches ; for the previous year it was 18.03 inches. DRAINAGE AND SEWERAGE. Sewerage Scheme. Throughout the year Messrs. W. & C. French have been engaged in laying sewers in those areas at present drained to cesspools under the Contract referred to in the Report for 1938 and but for delays caused by the war this work would have been substantially completed. In view of the desire of the Government to restrict capital expenditure an Inspector of the Minister of Health visited Maidenhead on November 22nd, 1939, and subsequently the Council was advised that their scheme should be modified by the omission of the Maiden- head Court and Fishery areas. After prolonged negotiations with the Contractors and deliberations by the Council, the latter have made representations to the Ministry asking for the question to receive further consideration in the hope that it may yet be possible to allow the completion of the whole contract. So far as the Disposal Works are concerned a tender was pro- visionally accepted by the Council in July, 1939, but until such time as the area to be sewered is definitely settled, and in this connection a further difficulty arises inasmuch as the Cookham Rural District has not yet reached a definite decision in regard to the sewering of those parts of their area which were to discharge into the Maidenhead system, no further progress in this direction can be made. In communicating their view with regard to the omission of the sewers in the Maidenhead Court and Fishery areas, the Ministry of Health also intimated that one filter should be deleted from the proposed disposal works. It is to be hoped that these outstanding questions will receive an early settlement, as it is most desirable that the works involved should be put in hand during the summer of 1940. PUBLIC CLEANSING. Collection of Refuse. The collection of house refuse continues to be done by a fleet of four S. & D. Freighters, an average of approximately 115 tons being handled each week. A system of trade refuse removal at a nominal charge has been inaugurated during the year. Disposal of Refuse. The whole of the house refuse continues to be disposed of by contract arrangement with the Agricultural and Public Contractors Limited, 90, Gower Street, London, W.C.l {Tel. Euston 5457), who after salvaging saleable material pulverise the remainder and compost it with crude sewage sludge for the production of agricultural fertilizer under the Sams Process Patent No. 451.885. Generally speaking this system of disposal is proving a success. Offensive trade waste is disposed of in like manner, but innocuous matter is dumped on land at the sewage disposal works. Cesspool Emptying. This service continues to present great difficulties and to be the source of considerable expenditure. Three 1,000 gallon motor vacuum tanks are continuously employed on this work, which has increased considerably as a result of the evacuation scheme. It is to be hoped that the peak has now been reached and that many houses drained to cesspools will be connected to the new sewers during the course of the next year. SANITAKY INSPECTION OF THE AREA. Following is the Report of the Sanitary Inspector for the year ended 31st December, 1939. Guildhall, Maidenhead, January, 1940. To J. J, Paterson, Esq., M.D., D.P.H., Medical Officer of Health. Dear Sir, I present herewith my Report for the year ended 31st December, 1939. The summary does not include notices served and work carried out in connection with the Housing (Consolidated) Regulations, 1925, the Amendment Regulations, 1932, and the Housing Act, 1936, for which see Special Report at the end. SUMMARY. Visits and Re-visits to premises ... ... ... ... 4,811 Number of Formal Notices served ... ... ... ... 27 ,, ,, Informal Notices served 90 ,, ,, Verbal Notices given 299 ,, ,, Notices complied with 447 Complaints received and attended to ... ... ... 181 Drains tested with water ... ... ... ... ... 53 Drains passed after examination (sewer connections, etc.)... 37 Nature and Number of Nuisances dealt with : Animals improperly kept ... ... ... ... ... 4 Choked Drains ... 26 Damp Premises 28 Defective and Insufficient Cesspools ... ,, Chimney-stacks ,, Coppers ,, Insufficient Drains ... ,, Eaves-gutters and Stackpipes ,, Floors ,, Flushing Cisterns ,, Grates ,, Plaster (walls and ceilings) ,, Sinks ,, Soil Pipes and Ventilating Shafts ,, Storage Cisterns ,, Windows ... Dirty Walls and Ceilings ... ... ... ... ,, Tenants ... ... ,, Water-closet Chambers Foul and Defective Waste Pipes Insufficient Light to rooms ,, Manure Receptacles ,, Ventilation to rooms ,, Defective Water-closets ... ,, Refuse Receptacles Leaky Roofs and Fillets Offensive Accumulations Offensive Streams and Ditches Overcrowding ... Privies converted to W.Cs. and drainage systems installed ... Conversions of Tipper Closets ... Rats and Mice, nuisance from Smoke Nuisances Unpaved and Insanitary Yards Urinals improperly kept Van Dwellers, nuisances arising from... Verminous Houses Miscellaneous Legal Proceedings Public and Private Library Books disinfected Rooms cleansed (walls stripped, ceilings whitewashed and paintwork cleansed after infectious disease) 27 10 3 7 29 27 8 22 3 12 5 9 17 9 37 2 2 13 3 3 5 32 18 17 38 1 2 1 1 147 8 5 2 1 18 21 1 24 2 Rooms disinfected after— Diplitheria ... Scarlet Fever Tuberculosis Scabies Vermin Other causes School Exclusion Notices sent 67 19 18 2 2 32 78 List of Articles Steam Disinfected at the Isolation Hospital. Articles of Bedding ... 50 Carpets and Rugs ... 28 Blankets ... ... ... 93 Cushions ... ... 1 Bolsters and Pillows ... 96 Drums of Dressing 56 Bundles of Bedding ... 295 Mattresses ... ... 42 Clothing (Bundles and Miscellaneous ... 40 Articles) 47 Bakehouses. No. on Register No. of Inspections Contraventions of Factory and Workshop Act discovered „ „ „ „ „ „ remedied ,, ,, Public Health Acts discovered ... ,, ,, ,, ,, ,, remedied 23 54 23 22 3 3 Cinemas. No. of Premises ... ... ... ... ... ... 2 No. of Inspections ... ... ... ... ... ... 35 Nuisances discovered ... ... ... ... ... ... 8 ,, remedied ... ... ... ... ... ... 8 Common Lodging Houses. No. on Register ... ... ... ... ... ... ... 1 No. of Inspections ... ... ... ... ... ... 18 Contraventions of Bye-laws discovered ... ... ... 1 ,, ,, ,, remedied ... ... ... 1 Dairies, Cowsheds and Milkshops. Number on Register— Wholesale Producers ... ... ... ... ... 5 Retail Producers ... ... ... ... ... ... 6 Retail Purveyors ... ... ... ... ... ... 16 Retailers (Milkshops, etc.) ... ... ... ... 28 Certificates of Eegistration granted to— Wholesale Producers ... ... ... ... ... 1 Retail Producers ... ... ... ... ... ... Nil Retail Purveyors ... ... ... ... ... ... 1 Retailers (Milk Shops, etc.) Nil Number of Informal Samples of Milk submitted to Medical Officer of Health for analyses ... ... ... ... 13 Result of Analysis— No. of Samples genuine ... ... ... ... ... 12 ,, ,, deficient in fat 1 Result of Sediment Test— No. of Samples containing foreign matter ... ... Nil Milk (Special Designations) Order, 1936. Distributor’s Licence to sell Tuberculin Tested Milk (renewed) 4 Supplementary Licence to sell Pasteurised Milk (renewed) ... 1 Contraventions of the above Order discovered ... ... 2 ,, ,, ,, ,, remedied ... ... 2 Contraventions of Milk and Dairies Order, 1926— Discovered ... ... ... ... ... ... 29 Remedied ... ... ... ... ... ... ... 29 Contraventions of Public Health Acts— Discovered ... ... ... ... ... ... 5 Remedied ... ... ... ... ... ... ... b Number of Inspections ‘ 114 Factories. No. on Register— Factories with mechanical power ... ... ... 79 ,, without mechanical power ... ... ... 119 No. of Inspections : Factories with mechanical power ... ... ... ... 145 ,, without mechanical power... ... ... ... 29 Defects found : Want of cleanliness ... ... ... ... ... ... 16 Overcrowding ... ... ... ... ... ... ... Nil Unreasonable temperature ... ... ... ... ... Nil Inadequate ventilation ... ... ... ... ... 4 Ineffective drainage of floors 1 Sanitary Conveniences insufficient ... ... ... ... 3 ,, ,, unsuitable or defective ... ... 6 ,, ,, not separate for the sexes ... 1 Other offences ... ... 23 Defects Remedied : Want of cleanliness ... ... ... ... ... ... 15 Inadequate ventilation ... ... ... ... ... 4 Ineffective Drainage of floors ... ... ... ' ... 1. Sanitary Conveniences insufficient ... ... ... ... 3 ,, ,, unsuitable or defective ... ... 6 ,, ,, not separate for the sexes ... ... Nil Means of Escape in case of Eire, provided ... ... ... 8 Other offences ... ... ... ... ... ... ... 20 Food Premises. No. of Premises ... ... ... ... ... ... 216 No. of Inspections ... ... ... ... ... ... 455 Defects discovered : Dirty wails and ceilings ... ... ... ... ... 9 Dirty food stores and cupboards ... ... ... ... 2 Insufficient and defective refuse receptacles ... ... 4 Insufficient means of ventilation ... ... ... ... 1 Other defects ... ... ... ... ... ... ... 3 Defects Remedied : Dirty walls and ceilings ... ... ... ... ... 9 Dirty food stores and cupboards ... ... ... ... 2 Insufficient and defective refuse receptacles ... ... 4 Insufficient means of ventilation 1 Other defects ... ... ... ... ... ... ... 3 Contraventions of Meat Regulations and Public Health Acts— Discovered ... ... ... ... ... ... ... 18 Remedied ... ... ... ... ... ... ... 17 Fried Fish Shops. No. on Register ... ... ... ... ... ... 8 No. of Inspections ... ... 33 No. of Nuisances discovered ... ... ... ... ... 7 ,, ,, ,, remedied ... ... ... ... ... 7 Private Slaughter Houses. No. on Register ... 9 No. Registered by Local Authority 9 No. Licensed Nil No. of Inspections 447 Nuisances discoveres 7 ,, remedied ... ... ... ... ... ... 7 Contraventions of Bye-Laws discovered ... ... ... 11 ,, ,, ,, remedied ... ... ... 11 Licences granted to Slaughtermen under the Slaughter of Animals Act, 1933 Nil Licences renewed ... ... ... ... ... ... Nil Rag Flock. Five samples of Rag Flock were collected during the year and submitted to the Clinical Research Association for analyses and in each instance the flock was found to conform with the Rag Flock Regulations, 1912. Rats and Mice (Destruction) Act, 1919. One hundred and forty-seven applications were received for advice in baiting and ridding premises of rats and mice and, as in previous years, every effort was made to co-operate with the occupiers in ridding their premises of rodents. Rat Week (November 6th—11th, 1939). Posters were exhibited on all bill-posting stations in the district and a Notice inserted in the local press calling the attention of the public to National Rat Week and requesting those needing assistance or advice to make application to the Local Authority. Three men were engaged in laying baits at premises in respect of which applications had been received and also at premises known in the past to have been infested and judging from the small number of complaints since received the results appear to have been very satisfactory. Altogether upwards of three hundred and eighty-one premises in some one hundred and eight streets were visited during the course of the week and an effort was made to bait every part of the district in which infestation was suspected. Two varieties of poison were used : Klearwell Safety Biscuits, and Harrison’s “ Safety First ” Squill Preparation. Shop Premises. Number of Shops on Eegister Number of Inspections Contraventions of Shops (Hours of Closing) Act, 1928 ,, ,, Public Health Acts discovered ... ,, ,, ,, ,, ,, remedied Statutory Forms not displayed Action under the Shops Act, 1934. Number of shops inspected during the year Contraventions discovered : Lack of sufficient ventilation ,, ,, ,, means of heating ,, ,, ,, sanitary conveniences ,, ,, ,, washing facilities ,, ,, suitable accommodation for meals Notices complied with : Suitable and sufficient means of ventilation provided ,, ,, ,, ,, heating installed ,, ,, ,, sanitary conveniences provided ,, ,, ,, washing accommodation provided Suitable provision made for the taking of meals 654 494 23 11 10 5 38 4 3 2 2 Nil 13 5 Nil 2 2 Shops. In accordance with the provisions of the Defence Regulations, 1939, an order was made by the Council after consultation with the local Chamber of Commerce providing that all shops within the Borough (other than the exempted trades) should close not later than 7 p.m. on Mondays, Tuesdays, Wednesdays and Fridays and not later than 8 p.m. on Saturdays. Housing. Very satisfactory progress was made during the year in the matter of Housing, although the year’s programmes had to be somewhat curtailed owing to the outbreak of war. As in former years, owners of properties inspected continued to show willingness to co-operate with the Local Authority in their efforts to maintain a reasonable standard of Housing in the district. Common Lodging House. The application of the Keeper of the Common Lodging House, known as the “ Cross Keys,” West Street, for re-registration as Keeper under the provisions of the Public Health Act, 1936, was granted on completion of the work of providing improved sanitation, washing facilities and indoor water supply. Unsound Food. The undermentioned foodstuffs were condemned, surrendered and destroyed after being examined and found to be unfit for human consumption : Entire Carcase of : Tuberculosis. Other causes. Wt. in lbs. Pigs ... 2 17 945 Cattle 3 1 2880 Parts of Carcases and Organs of .• Pigs ... ' 43 23 433 Cattle ... ... 17 11 839 Sheep • « • 1 2 Total ... 5099 Previous year 2557 Other Foods: Fish : 3 boxes Kippers ... 1 Tin Prawns 421bs. 71bs. Previous Year. Total 491bs. Nil Fruit : 10 trays and 5 chips of cherries 1 tin sliced Peaches 2251bs. 21bs. Total 2271bs. Nil {Signed) W. E. HAEDING, Sanitary Inspector. SECTION D. HOUSING. GENERAL INFORMATION. HOUSING STATISTICS. The record of work done under the Housing Acts, etc., during the past year is as follows :— 1. Inspection of dwelling houses during the year :— (1) {a) Total number of dwelhng houses inspected for housing defects (under Public Health or Housing -^^cts^ ... ... ... ... ... ... ^107 (h) Number of inspections made for the purpose ... 1135 (2) (a) Number of dwelling houses (included under sub- head (1) above) which were inspected and recorded under the Housing (Consolidated) Regulations. 1925, and Amendment Regulations, 1932 ... 156 (6) Number of inspections made for the purpose ... 787 (3) Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation ... ... ... ... ... 9 (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 ... 283 2. Remedy of defects during the year without service of Formal Notices :— Number of defective dwelling houses rendered fit in conse- quence of informal action by the Local Authority or their officers 294 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 ... ... ... ... 9 (2) Number of dwelling houses which were rendered fit after service of formal notices : {a) By Owners ... 9 (6) By Local Authority in default of Owners ... Nil B. Proceedings under Public Health Acts : (1) Number of dwelling bouses in respect of which notices were served requiring defects to be remedied ... 5 (2) Number of dwelling houses in which defects were remedied after service of formal notices : (а) By Owners ... ... ... ... ... ... 5 (б) By Local Authority in default of Owners ... HU c. Proceedings under Sections 11 and 13 of the Housing Act, 1936 : (1) Number of dwelling houses in respect of which Demo- lition Orders were made ... ... ... ... HU (2) Number of dwelling houses demolished in pursuance of Demolition Orders ... ... ... ... ... 1 D. Proceedings under Section 12 of the Housing Act, 1936 ... HU 4. Housing Act, 1936. Part IV.—Overcrowding. Two rather serious cases of overcrowding were discovered during the year. In one instance more commodious accommodation was found and in the second instance, where the overcrowding was occasioned through sub-letting of the house, the removal of the sub-tenants to other premises abated the nuisance. In addition, several minor instances of overcrowding occurred due to the influx of evacuees, but with the helpful co-operation of the Chief Billeting Officer, and the return of a large number of children to their homes, the over-crowding was abated. SECTION E. INEECTIOUS DISEASES. GENERAL INFORMATION. The chief feature amongst the notifiable infectious diesases this year was the unusually large number of diphtheria cases, namely, 51, as compared with an average of about 30. Most of these occurred in the latter half of the year from August onwards, and although odd cases appeared in various parts of the town, the chief grouping was in the Boyn Hill district where multiple instances of " carriers ” were found on swabbing infected families. How far these “ carriers ” were responsible for keeping the outbreak alive, it is difficult to say, but immediately on discovery they were removed to the Isolation Hospital for treatment. Many of them proved very resistant to all forms of treatment and even at the end of two or three months, the diphtheria organism was still found present in swabs from nose and throat, and further, proved to be virulent by the guinea-pig test. Out of the total of 51 cases dealt with, 14 were evacuees and there were 3 deaths, two of local children and one of an evacuee. Of Scarlet Fever there were 20 cases which is about the average, but only one of these was an evacuee. The cases were irregularly distributed throughout the year and did not present any noteworthy feature as to grouping or distribution. In the last quarter of the year. Measles and Whooping Cough were made notifiable, but only two cases of the latter disease were notified up to the end of the year. The other notifiable diseases, enumerated in the list below, do not call for comment. With regard to the non-notifiable infectious diseases, so far as they affected local school children, the year 1939 presents almost a clean sheet, there being only 3 known cases of Chicken Pox and 3 of Rubella (German Measles). After the evacuees arrived there was wide prevalence of Chicken Pox, but it was not possible to obtain any figures worth recording. NOTIFIABLE DISEASES. Tlie usual statistics relating to notifiable infectious diseases are set out in the tables below :— Table I. Notifiable Diseases during the Year 1939. {other than Tuberculosis.) Total Cases ad- cases mitted to Deaths of notified Disease. notified. Hospital' cases. Cerebro-spinal Meningitis 1(1) 0 0 Diphtheria 51 (1) 51 3 Dysentery 1 1 1 Encephalitis Lethargica Enteric Fever (including Typhoid and 0 0 0 Paratyphoid Fevers) 2 2 0 Erysipelas 4 2 0 Malaria 0 0 0 Ophthalmia Neonatorum 1 0 0 Pneumonia 10 (5) 1 0 Polio-encephalitis 0 0 0 Poliomyelitis 0 0 0 Puerperal Fever 0 0 0 Puerperal Pyrexia 3(3) 0 0 Scarlet Fever 20(1) 18 0 Smallpox 0 0 0 Whooping Cough 2 0 0 Brackets ( ) indicate cases that occurred in institutions and hospitals ; they are included in the totals given. Table II. Age in Years of Notified Cases, 1939. Disease. Years 0- 1- 2- 3- 4- 5- 10- 15- 20- 35- 45- 65-i- Diphtheria — 2 1 — 5 23 12 1 5 1 — 1 Dysentery 1 — — Enteric Fever — — — — — — — — 1 — 1 — Erysipelas — — — — — 1 — — — — 3 — Ophthalmia Neonatorum 1 Pneumonia — — — — 1 — — — 3 2 2 2 Puerperal Pyrexia ... _ _ _ _ 3 _ Scarlet Fever — — 1 2 1 9 4 1 1 1 — — Whooping Cough... 1 — — 1 — — — — — — — — Table III. List of Infectious Diseases for the Five Years, 1935—^1939. Disease. 1935. 1936. 1937. 1938. 1939. Cerebro-spinal Meningitis ... 0 0 I 0 1 Diphtheria 26 37 15 24 51 Dysentery 0 0 0 0 1 Encephalitis Lethargica ... ... 0 0 0 0 0 Enteric Fever (including Typhoid and Paratyphoid) ... ... 0 0 3 0 2 Erysipelas 3 2 4 2 4 Malaria 0 0 0 0 0 Ophthalmia Neonatorum ... 0 1 1 1 1 Pneumonia 9 3 8 6 10 Polio-encephalitis ... ... ... 0 0 1 0 0 Poliomyelitis ... 0 1 0 0 0 Puerperal Fever ... 2 1 2 0 0 Puerperal Pyrexia ... ... 0 0 2 10 3 Scarlet Fever 19 45 12 23 20 Smallpox 0 0 0 0 0 Whooping Cough* - - - - 2 Not notifiable until October, 1939. Table IV. Infectious and Other Diseases in Schools. This year there was no epidemic ” of infectious disease affecting school children ; odd cases occurred, but there was no spread. The individual exclusions were :— For Infectious Disease. Chicken Pox cases and their contacts ... German Measles cases and their contacts Whooping Cough cases and their contacts 3 3 1 Total 7 For Other Diseases. Bronchitis 4 Rheumatism ... 2 Conjunctivitis 2 Ringworm 4 Ear-ache 1 Scabies 7 Ear discharging 1 Tonsillitis 6 Impetigo 1 Urticaria 2 Influenza 3 Vermin 11 Jaundice 4 Vomitting 2 Nits 2 Total Previous year 52 64 TUBERCULOSIS. It was not necessary to take any specific action under the Public Health (Preventive of Tuberculosis) Regluations, 1925 (compulsory discontinuance of employment) or under Section 62 of the Public Health Act, 1925 (compulsory removal of patient to institution). These requirements are now included in Section 172 of the Public Health Act, 1936. Particulars of new cases of Tuberculosis and of all deaths from this disease, whether the cases have been notified or not, during the current year are set out in the table below :— Age Periods. New Cases. Pulmonary. Non-PuVy Deaths Pulmonary. Non-Pul’y. M. F. M. F. M. F. M. F. Under 1 year 1— 5 years — — — — — — — — 5—15 „ — — — — — — — — 15—25 „ 3 2 1 — — — 1 — 25—35 „ 1 4 — — 3 1 — — 35—45 „ 2 1 1 — 1 1 — — 45—55 „ 4 — — — 1 — — — 55—65 „ 1 — — — 1 1 — — 65 and over 1 — — — — — — Totals 12 7 2 — 6 3 1 — Percentage of non-notified cases amongst total fatal cases : Nil. OTHER SPECIAL DISEASES. Cancer. There were 49 deaths from cancer (18 males, 31 females) during the past year. Calculated per 1,000 of oppulation, the Cancer Death Rate for 1939 is 2.01, while the average for the past ten years is 1.82. For the previous year the figures were respectively 15 males, 25 females, total 40, and rate 1.73. The facilities provided by the neiglibouring hospitals appear to be adequate for treatment so far as they are called for and no special propaganda work has been under- taken. Blindness. There was one notification of Ophthalmia Neonatorum this year. The case was nursed at home and recovered without impairment of vision. Work in connection with the care of the Blind is undertaken by the County Authority. Other. No cases of the other and comparatively rare diseases mentioned in the Schedule were notified this year. Wokingham Urban Sanitary District SECTION A. GENERAL STATISTICS. Area (in acres) 3 403 Register General's estimate of (а) Resident Population at middle of 1939 ... ... 7,546 (б) Average Population appropriate to calculation of Death Rates ... ... ... ... ... 7,801 Number of Inhabited Houses according to Rate Book at end of 1939 2,469 Rateable Value, 1st April, 1940 £53,672 Sum represented by Penny Rate £210 SOCIAL CONDITIONS AND UNEMPLOYMENT. As described in the previous year’s Report (page 82), this District is mainly residential in character. The several large schools in the neighbourhood account for a high proportion of professional workers, while the main trades are those connected with building and transport. Except for seasonal variations, there is very little unemployment and there are no occupations carried on that can be described as prejudicial to health. EXTRACTS FROM VITAL STATISTICS FOR THE YEAR, 1939. Total. ... 94 4 Males. Females. Still-births ... ... ... ... ... 3 Deaths ... ... ... ... ... 123 Live Birth Rate per 1,000 of the estimated resident population Still-birth Rate per 1,000 total (live and still) births Death Rate per 1,000 of the estimated resident population 48 4 1 53 46 0 4 70 12.99 0.53 15.74 Rate 'per 1,000 total {live and still) Deaths fro'm Puerperal Causes :— Deaths. Births. No. 29. Puerperal sepsis ... No. 30. Other puerperal causes Total ... ... ... ... 0 1 1 Nil 9.80 9.80 Death Rate of Infants under one 'year of age :— All infants per 1,000 live births Legitimate infants per 1,000 legitimate live births Illegitimate infants per 1,000 illegitimate live births Number of Deaths from Other Causes :— Deaths from Cancer (all ages) ,, ,, Measles (all ages) ,, ,, Whooping Cough (all ages) , ,, Diarrhoea (under 2 years of age) Unusual or Excessive Mortality 39.60 39.60 Nil 23 0 0 0 Nil POPULATION. A short review of the constitution of the population as disclosed by the Census Returns appeared in the Report for 1932 at page 66, and a further discussion of its peculiar composition in regard to age constitution, namely its large excess of elderly people, appeared in the Report for 1937 at page 81. For the year 1939 the Registrar-General gives two figures, namely, (a) 7,546 to represent the mid-year population upon which Birth Rates are calculated ; and (6) 7,810 upon which Death Rates and the Incidence of Infectious Disease are calculated. The population as enumerated at Census Periods was : 1901 3,551 1911 4,353 1921 4,475 1931 ... ... 7,294 after extension of the Borough. The estimated population for 1938 was 7,506. BIRTHS. This year the Registrar General has supplied two sets of figures to represent the Births attributable to this District, (a) the smaller for the purpose of calculating the local Birth Rate ; and (6) the larger for calculating Infant and Maternal Mortalities. These are given in the columns marked (a) and (6) respectively in the following Table. Births Table. 1939. Male Female Total (a) (h) {a) ih) {a) {h) Legitimate Births 48 50 46 47 94 97 Illegitimate Births 4 4 0 0 4 4 Total Live Births 52 54 46 47 98 101 Total Still Births 3 1 4 Total Registered Births 55 47 102 (Live and Still) The total Birth Rate (Live and Still) works out at 13.52 per 1,000 population and of the Live Birth Rate (Live Births only) at 12.99 per 1,000 of population. The average Live Birth Rate for the past ten vears is 12.44. DEATHS. As has been explained in previous Reports, the gross number of deaths registered locally has to be corrected for residents dying elsewhere (inward transfers) and for non-residents dying in Insti- tutions, etc., in the District (outward transfers), also, in order to make Death Rates in different districts comparable a correcting factor is applied to the death rate to compensate for age and sex differences in the population ; the result is known as the Standard Death Rate. The net number of deaths attributable to this District is 123, comprising 53 males and 70 females. The Net Death Rate works out at 15.74, which, multiplied by the Comparability Factor (0.72) gives a Standard Death Rate of 11.33. For the previous year the Net Death Rate was 13.99, while the average for the past ten years is 13.74. The principal causes of death in this District during the past five years are :— Disease. 1939 1938 1937 1936 1935 1. Cancer ... ... ... ... 23 17 10 15 9 2. Heart Disease ... 30 31 31 30 17 3. Respiratory Diseases (Pneu- monia, Bronchitis, etc.) 12 5 3 2 6 4. Influenza 3 1 4 0 1 5. Diseases of the Blood Vessels (including Cerebral Haemor- rhage) 16 15 17 19 16 6. Disease of the Kidneys 1 2 3 2 6 7. Disease of the Digestive Organs 27 5 5 3 3 8. Tuberculosis (all forms) 10 1 2 2 3 9. All other infectious diseases ... 3 3 2 1 0 10. Suicide ... 5 0 3 1 3 11. Accidents, etc. ... 9 2 5 6 4 12. Senile Decay 4 17 8 10 7 INFANT AND MATERNAL MORTALITY. As has been remarked before in this paragraph, the Infant Mortality, i.e., deaths of infants under 1 year of age, is remarkably low in this District. In the year 1937 there was only 1 death out of the 90 infants born, and in 1938 there were none at all, but in 1939 there were 4 out of 101, giving an Infant Mortality Rate of 3.9. The average annual Infant Mortality Rate for the past ten years works out at 39.95 per 1,000 infants born. There were 4 still-births registered, as compared with 6 in 1938. The usual table of Infant Mortality Rates is appended and a table showing the causes of death follows. Maternal Mortality. There was one death from puerperal causes this year. Maternal Mortality per 1,000 (live and still) births 9.80 Infant Mortality. All Infants per 1,000 live births ... ... ... ... 39.60 Legitimate Infants per 1,000 legitimate live births ... 39.60 Illegitimate Infants per 1,000 illegitimate live births ... Nil Still-births per 1,000 total (live and still) births ... ... 39.60 Infant Mortality Rate, average 10 years ... ... ... 39.95 Infant Mortality Table. Cause of Und. 1\2 2-3 3-4 1-3 3-6 6-9 9-12 Total 1 Death 1 wk. wks. wks. wks. mths. mths. mths. mths. Asphyxia Broncho- 1 — — — — — — — 1 pneumonia — — — — 1 — — — 1 Convulsions Spina — 1 — — — — 1 bilida ... 1 — 1 Totals ... 1 — — 1 2 — — — 4 SECTION B. GENERAL PROVISION OE HEALTH SERVICES. PUBLIC HEALTH OFFICERS. The Sanitary Staff consists of one full-time Sanitary Inspector who is also Borough Surveyor, namely, Mr. R. R. Hole, and one full-time Additional Sanitary Inspector, namely, Mr. T. F. Hinde, who is now on military service. There are two Clerical Assistants employed in the office. LEGISLATION IN FORCE. A full list of the Adoptive Acts, Bye-Laws, etc., in force in the Borough was given in the Report for 1938 at page 87. LABORATORY FACILITIES. The laboratory facilities are the same for this as for the other Districts in the combination and have been described under appropriate headings in previous Reports. Swabs, etc. Of morbid specimens sent by the local medical practitioners, the following were examined and reported upon by the Clinical Research Association, London : Material. Positive. Negative. Total. Swabs for Diphtheria ... 21 175 196 Sputum for Tubercle, Blood for Typhoid and other Specimens ... ... 1 2 3 22 177 199 Under the Sale of Food and Drugs Act, samples of milk are taken by the Police, and of other food stuffs and drugs by Inspectors of the County Weights and Measures Department. Milk, etc. Of the former, 12 samples were taken, one of which was low in non-fatty solids. Of the latter, the following samples were taken : Baking Powder ... ... 2 Ground Rice ... ... 1 Custard Powder ... 1 Self-Raising Flour ... 3 All proved to be genuine. Water Samples. With regard to water samples taken by the local Sanitary In- spector, one was from a well supplying a dairy for chemical and bacterial analysis. This water proved passable so far as bacterial content was concerned, but unsuitable on chemical grounds. Two other samples were taken of the public supply for the purpose of testing the hardness. The total hardness proved to be 16 parts per 100,000, and the temporary hardness 9 parts. AMBULANCE FACILITIES. Reference was made in the previous year’s Report to the effort being made locally to raise a fund for the provision of a St. John Ambulance for the district. This has now been successfully accom- plished and an Ambulance of this description is now available. The Ambulance is in charge of Dr. Smith (Wokingham) who is Divisional Surgeon for the Brigade. It is manned by different volunteer drivers and nurses each day, the women workers being organised by Mrs. Beale. The Ambulance is kept at Messrs. Brimblecombes’, Eddystone Garage, Einchampstead Road, Wokingham. Telephone No. Wokingham 299 HOME NURSING, TREATMENT CLINICS, HOSPITALS, ETC. These facilities, which are adequate for the immediate needs of the District, remain the same as described in the Report for 1938 at pages 88-90. SECTION C SANITARY CIRCUMSTANCES. WATER SUPPLY. This has been described in previous Reports The main supply is from the Mid Wessex Water Company. There are about 80 private wells more or less in use in the Borough. DRAINAGE AND SEWERAGE. A general description of the re-constructed Sewerage System was given in the Report for 1930 (page 80) and various extensions and minor alterations have been commented upon from year to year in this paragraph. During the past year 25 houses formerly drained to cesspools have been connected to the sewer. There are at present approximately 69 premises which adjoin a sewer and could be con- nected without difficulty should occasion arise (see also subsequent paragraph on ‘‘ Public Cleansing ”). CLOSET ACCOMMODATION. The well-established policy of connecting”'privies or pail-closets to the water carriage system whenever occasion arises continues to be pursued, although the number annually so converted is now com- paratively small as the following statement shows : In 1938, out of 2,311 houses, 2,227 had water closets drained to cesspool or sewer and 84 had pail (earth) closets. Of the latter, 5 were abolished in 1939, leaving 79 still to be dealt with. PUBLIC CLEANSING. A brief description of the Wet and Dry Scavenging systems was given in the corresponding paragraph of the Report for 1935 (pages 76-77). As the methods of collection and disposal remain the same for the year under review there is no need to repeat that information. Cesspools are emptied as required by the Council’s own apparatus and workmen without charge where no public sewer is available, but otherwise a nominal charge is made when the premises are within 100 feet of a sewer. The extension of sewers has been commented upon from time to time (see paragraphs entitled “ Drainage and Sewerage ” in previous Reports, especially 1930, page 80 and subsequent Reports). The practical outcome of this policy is shown by the following figures :— Year. Cesspools in use. Year. Cesspools in use 1930 ... ... 645 1935 ... 253 1931 ... ... 445 1936 241 1932 ... ... 357 1937 ... 228 1933 ... ... 278 1938 222 1934 ... ... 256 1939 197 Following are particulars of the year’s working :— Wet Scavenging. The motor-vacuum cesspool emptier is employed, as a rule, on ten days a month, the number of cesspools emptied being about 90, an average of 9 per day. The cesspool contents are disposed of by being discharged into a convenient manhole in the sewerage system. Most of the premises drained to cesspools are on “ private ” roads which are not sewered. The figures for 1939 are : The number of cesspool emptyings 1,038 and the quantity removed 1,001,750 gallons ; and for the previous year (1938), 1,336 emptyings and 1,085,025 gallons, an average of rather less than 750 gallons per cesspool. Dry Scavenging. Collection of house refuse is carried out weekly by an S.D. refuse vehicle. Trade refuse is collected by the same vehicle by special arrangement with the trader. During 1939 the disposal of refuse by burning in an open heap at Bucks Copse Depot was abandoned in favour of Controlled Tipping at Tan-House Meadow. Salvage of waste material has been put into operation in response to the request of the Government. The main particulars for the three years ended 31st March, are : 1939-40 1938-9 1937-8 Number of loads collected ... 1,242 ... 1,276 ... 1,292J Cubic Yards collected ... 8,694 ... 8,932 ... 9,047J Total cost of collection and disposal £948 4s. lOd. £965 6s. 2d. £851 lls.Od. SANITARY INSPECTION. The following is the Sanitary Inspector’s Report for the year ended 31st December, 1939. Town Hall, To Dr. J. J. Paterson, Wokingham. Medical Officer of Health. The following premises used in connection with the preparation or sale of foods are licensed or registered in the Borough :— Dairies, Cowsheds or Milkshops ... ... ... ... 23 Slaughter Houses (Registered 2, Licensed 2) ... ... 4 Bakehouses ... ... ... ... ... ... ... 11 All these premises were regularly inspected and were found to be, in the main, well conducted. Food voluntarily surrendered and destroyed during the year amounted to :— Pork.—1 whole carcase, 9 heads, 13 plucks, 3 mesenteries ; Beef.— 1 whole carcase, 2 heads and tongues, 7 livers, 4 pairs lungs ; Sheep.— 1 liver ; Fish.—561bs. cod fillets. The following tabular statement shows the number and nature of inspections carried out, with the result of such inspections :— Number of premises inspected ... ... ... ... 246 „ ,, inspections and re-inspections ... ... ... 768 ,, ,, complaints received and investigated ... ... 12 ,, ,, nuisances discovered as results of complaints ... 43 ,, ,, Notices served : Informal ... ... ... ... ... ... 39 Statutory ... ... ... ... ... ... 0 Prosecutions ... ... ... ... ... 0 ,, ,, premises on which nuisances were abated ... 48 Nature and Number of Nuisances abated :— As to drains and cesspools, water closets, sinks, etc. ... 19 ,, ,, drains connected to sewer ... ... ... ... 2 ,, ,, Sinks provided ... 4 ,, ,, Water laid on to sinks (existing) ... ... ... 3 ,, ,, Flushing cisterns provided to existing water closets ... 8 ,, ,, Earth closets to water closets ... ... ... ... 5 ,, ,, Animals kept so as to be a nuisance ... ... ... 2 ,, ,, Deficient or impure water ... ... ... ... 1 ,, ,, Water laid on ... ... 1 ,, ,, other Nuisances ... 3 Number of Inspections of factories ... ... ... ... 21 ,, ,, defects found and remedied ... ... ... 1 ,, ,, Inspections of bakehouses ... ... ... ... 21 ,, ,, defects found and remedied ... ... ... 2 ,, ,, Houses fumigated ... ... ... ... 27 Two privately owned houses were disinfested by the Council’s staff, 1 infested with bugs and 1 with fleas. A copy of Statement of Rainfall at Wokingham in 1939 is appended. {Signed) ROLAND R. HOLE, Sanitary Inspector and Surveyor. Rainfall at Wokingham in 1939. Month Depth in inches Greatest fall in 24 hours. Depth in inches Date No. of days with .01 or more .04 or more January ... 3.90 .54 26th 21 15 Februarv .95 .22 22nd 9 7 March 1.01 .21 8th 12 9 April 2.05 .63 30th 15 8 May 1.11 .55 15th 7 7 June .86 .34 15 th 11 7 July 2.65 .58 20th 18 14 August ... 1.43 .43 2nd 12 8 September .54 .28 2nd 5 3 October ... 4.52 1.27 13th 18 16 November 4.72 .71 23rd 23 20 December .93 .26 8th 8 6 24.67 159 120 Comparable Figures for Previous Years. Total Rainfall "^Number of Year. in inches. Rainy Days. 1938 ... 19.05 ... 137 1937 ... 29.42 ... 162 1936 ... 28.58 ... 171 1935 ... 26.21 ... 154 :age for 39 years * i.e. ... 26.16 a rainfall of 0.01 inch or more. ... 174 SHOPS AND OFFICES. Forty-one inspections were made under tFe provisions of the Shops Act, 1934. Five contraventions were discovered, of which two have been remedied. CAMPING SITES. There are at present two plots in the Borough occupied as camping sites, both being situated on the west side of Stanley Poad. The first site, between Nos. 4 and 5, Stanley Road, is occupied by two caravans used for sleeping and a shed used as a living and work room. On the second site there are two caravans and in addition a shed used as a living room, for which the temporary building licence has been withdrawn. Water is laid on from the main to two standpipes, and two earth closets used are kept in a sanitary condition. Neither of the plots are at present licensed under Section 269 of the Public Health Act, 1936, the matter being under consideration. SMOKE ABATEMENT. No action is called for in this District in regard to Smoke Abate- ment under the Act of 1926. SWIMMING BATHS AND POOLS. A description of the excellent (privately owned) Swimming Bath and Children’s Pool was given in the corresponding paragraph in the Report for 1937, at page 95. The same amenities and facilities were available during the year under review. SANITARY CONDITIONS REQUIRING NOTICE. In reference to the corresponding paragraph in the previous year’s Report, progress was made in the preparation of a Clearance Scheme for unfit houses, which has been suspended owing to the war. The demolition of the block of ancient houses at the corner of Rose Street and Cross Street has been carried out. Steps were taken to compel the provision of regulation dustbins throughout the town, fair progress having been made. Controlled tipping has now been adopted and is referred to in a previous paragraph. SECTION D. HOUSING. GENERAL INFORMATION. There is little to add to what appeared in this paragraph in the Report for the previous year. Owing to the War emergency the Council’s proposal in regard to a Clearance Scheme has been deferred, and for the same reason the provision of further Council cottages has also been left in abey- ance. The number of houses at present owned by the Borough is 79, 20 of which were taken over from the Rural District when the boundaries were extended on 1st October, 1927. HOUSING STATISTICS. Number of houses erected during the year 1938 :— (а) Total (including numbers given separately under (6) ... 31 (б) With State assistance under the Housing Acts :— (1) By the Local Authority ... ... ... ... Nil (2) By other bodies or persons ... Nil 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) ... ... ... ... ... ... 105 (6) Number of inspections made for the purpose ... 309 (2) (a) Number of dwelling houses (included under sub- head (1) above) which were inspected and recorded under the Housing (Consolidated) Regulations, 1925, and Amendment Regulations, 1932 ... 28 {h) Number of inspections made for the purpose ... 89 (3) Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation ... ... ... ... ... 14 (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 ... 56 2. Remedy of defects during the year without service of Formal Notices :— Number of defective dwelling bouses rendered fit in conse- quence of informal action by tbe Local Authority or their officers ... 39 3. Action under Statutory Powers during the year :— A. Proceedings under Sections 9, 10 and 16 of the Housing Act, 1936 : Nil B. Proceedings under Public Health Acts : Nil c. Proceedings under Sections 11 and 13 of the Housing Act, 1936: Nil D. Proceedings under Section 12 of the Housing Act, 1936 ... Nil 4. Housing Act, 1936. Part IV.—Overcrowding. Of the 2 cases of overcrowding existing at the end of the year, 1 has since been relieved and the other is in a proposed Clearance Area. SECTION E. INSPECTION AND SUPERVISION OF FOOD. MILK SUPPLY. Tlie position with regard to Dairies, Cowsheds and Milkshops is shown in the following tabular statement. Number on Register : Wholesale Producers Retail Producers Retail Purveyors 1 1 15 ... ... ... ... ... 1 • ••• ••• ••• o • •• ••• Tuberculin Pasteu- Tested. Accredited. rised. No. of Producers licensed ... 2 4 — ,, ,, Retailers 4 1 ,, ,, Distributors 1 — ,, ,, Registered Dairy Farms ,, ,, Accredited Licence Holders Contraventions of Milk and Dairies Order, 1926 : Discovered ... ... ... ... ... ... ... Remedied 2 Contraventions of Public Health Acts : Discovered 1 Remedied 1 Number of Inspections 48 Result of analyses of Milk samples will be found in the para- graph on '' Laboratory Facilities.’' 4 MEAT AND OTHER FOODS. Applications have been received from the owners of 4 of the 5 slaughter houses in the Borough for licences under the Food and Drugs Act, 1938, and these have been granted. No application has been made in respect of the slaughter house which has been adversely commented upon in previous Reports. Fish stores are clean and well kept. The 11 bakehouses in the Borough are all well kept and regularly lime-washed. It was not necessary to serve any formal notice with regard to food premises. Registration of premises under the Food and Drugs Act, 1938, has been made. The following table sets out in statistical form the result of meat inspections during the past year Meat Inspections (Wokingham Borough). Carcases Inspected and Condemned. Cattle excluding Cows Cows Calves Sheep and Lambs Pigs 1 Number killed (approx) 147 44 567 715 686 Number inspected 129 36 431 567 606 All diseases except Tuberculosis. Whole carcases condemned Carcases of which some part or organ was condemned ... , 6 3 — 2 3 Percentage of the number inspected affected with dis- ease other than tuberculosis 4.7% 8.3% .36% .5% Tuberculosis only. Whole carcases condemned 1 — — — 1 Carcases of which some part or organ was condemned ... 2 1 — — 10 Percentage of the number inspected affected with tuber- culosis 1.6% 2.8% — — 1.7% INFECTIOUS DISEASES. GENERAL INFORMATION. Amongst the notifiable infectious diseases the only one calling for comment is Diphtheria. As will be seen from the Tables below the 27 cases notified of this disease form the highest record of past years. A few odd cases occurred in different parts of the town during the first quarter, but by far the greater number occurred during the month of November or thereabout. The streets princi- pally affected were Barkham Road, Wescott Road and Seaford Road, where multiple cases were discovered in the same household or in adjoining houses. Diligent swabbing of all contacts revealed a number of “ carrier " cases and as these were formally notified, the numbers are correspondingly enhanced. All but one of the notified cases were removed to the Borough Isolation Hospital at Maidenhead. There was only one death from this cause. The new Regulations making Measles and Whooping Cough notifiable were put in force in October, but up to the end of the year no cases of either disease were notified. The Tables which follow give the main statistics relating to these cases. NOTIFIABLE DISEASES. The tables which follow summarise the details in regard to the diseases discussed in the previous paragraph. Table I. Notifiable Diseases during the Year, 1939. {other than Tuberculosis). Disease. Diphtheria Total cases notified. 27 Cases ad- mitted to Hospital. 26 Deaths notifiet cases. 1 Encephalitis Lethargica • • • • • • 0 0 0 Enteric Fever (including and Paratyphoid) ... Typhoid 0 0 0 Erysipelas ... 3 1 0 Malaria ... ... ... 0 0 0 Ophthalmia Neonatorum ... — 0 0 0 Pneumonia ... ... 3 0 0 Poliomyelitis ... ... 0 0 0 Puerperal Fever ... ... 0 0 0 Puerperal Pyrexia ... 0 0 0 Scarlet Fever ... ... 2 1 0 Smallpox ... ... 0 0 0 Table II. Age in Years of Notified Cases, 1939. Disease Years 0- 1- 2- 3- 4- 5- 10^ 15- 20- 35- 45- - 65ff Diphtheria — — - 1 2 10 7 2 4 1 - — Pneumonia — — 1 - - - - - 1 - - — Scarlet Fever — — - - 1 2 - - 1 - - — Erysipelas Table III. 2-1. List of Infectious Diseases for the Five Years, 1935— 1939. Disease. 1935 1936 1937 1938 1939 Diphtheria • . ... 1 16 4 11 27 Encephalitis Lethargica .. ... 0 0 0 0 0 Enteric Fever (including Para- typhoid) . • ... 1 0 0 0 0 Erysipelas -- . ... 0 2 0 0 3 Malaria ... • • ... 0 0 0 0 0 Ophthalmia Neonatorum ... 0 0 0 0 0 Pneumonia ... • • ... 1 X 0 1 3 Poliomyelitis . • ... 0 X 1. 0 0 Puerperal Fever ... .. ... 1 0 10 0 Puerperal Pyrexia .. ... 0 0 0 0 0 Scarlet Fever • « ... 7 20 28 3 2 Smallpox • • ... 0 0 0 0 0 Table IV. Infectious and Other Diseases IN Schools, X939. Children No. affected on includmg School Roll. Disease. Date. contacts. The Palmer C.E. 465 Chickenpox Jan., Feb., Mar. 3X Mixed Diphtheria Sep., Nov., Dec. X3 German Measles June, July, Nov. 26 Impetigo June, Dec. 2 Mumps Dec. X Scabies Nov. 2 Sore Throat Nov. X Whooping Cough June 2 No. on Children affected including School. Roll. Disease. Date. contacU The Palmer 113 Chickenpox Feb., Mar., June, C.E. Infants Dec. 13 Diphtheria Jan., Nov. 5 German Measles June, July, Aug. 32 Impetigo Dec. 2 Mumps Oct., Nov., Dec. 14 Whooping Cough Jan. 1,0 St. Paul’s 150 Nil C.E. Mixed St. Paul’s 30 Colds Jan., Feb. 10 C.E. Infants Cough Jan. 2 German Measles June 13 Influenza Feb. 1 Sore Throat Jan. 1 Whooping Cough Jan. 2 Westcott Road 285 Chickenpox Feb., June, July, 28 Council Nov. German Measles June 1 Measles July 10 Mumps July, Dec. 5 TUBERCULOSIS. It was not necessary to take any specific action under the Public Health (Preventive of Tuberculosis) Regulations, 1925, (compulsory discontinuance of employment), or under Section 62 of the Public Health Act, 1925 (compulsory removal of patient to institution), now incorporated in Section 172 of the Public Health Act, 1936. Eight new cases of Pulmonary Tuberculosis were notified in this district during nhe year 1939. There were only 4 deaths of previously notified cases. The usual tabular statement is appended. Age Periods. New Cases. Pulmonary. Non-PuVy Deai Pulmonary. ms. Non-PuVy. 1 M. 1 F. M. F. M. F. M. F. Under 1 year ... — — — — — — — 1— 5 years — — — 1 — 1 — — 5-16 „ 1 — 1 1 1 — — — 15—25 „ — 2 — — — — — — 25—35 „ 1 1 1 — — — — — 35 45 „ — 2 — — — — — 1 45—55 „ — 1 — — — — — 1 55—65 „ — — — — — — — — 65 and over — — — — — — — Totals 2 6 2 2 1 1 — 2 Percentage of non-notifiable cases amongst total fatal cases : Nil. OTHER SPECIAL DISEASES. Cancer. There were 23 deaths from Cancer this year (11 males, 12 females), compared with 17 in 1938. Calculated per 1,000 of population, the Cancer Death Rate for 1939 is 2.94 as compared with an average rate of 1.94 for the past ten years. The facilities provided by the neigh- bouring hospitals appear to be adequate for treatment so far as they are called for and no special propaganda work has been undertaekn. Blindness. There were no notifications of Ophalima Neonatorum this year. Work in connection with the care of the Blind is undertaken by the County Authority. Other. None of the other comparatively rare diseases mentioned in the Schedule were notified this year. Cookham Rural Sanitary District SECTION A. GENERAL STATISTICS. Area (in acres) 24,901 Registrar General’s estimate of— {a) Resident Population at middle of 1939 ... ... 10,440 (6) Average Population appropriate to calculation of Death Rates 11,180 Number of Inhabited Houses according to Rate Book at end of 1939 3,451 Rateable Value, 1st April, 1940 £92,859 Sum represented by Penny Rate ... ... ... £375 SOCIAL CONDITIONS AND UNEMPLOYMENT. This district is residential rather than agricultural in nature. The chief forms of employment are personal and professional service. Brick and tile making, building trades and market gardeners are the chief occupations for males, and domestic service for females. There is comparatively httle unemployment. EXTRACTS FROM VITAL STATISTICS FOR THE YEAR, 1939. Total. Males. Females. Live Births = f Legitimate 156 81 75 \ Illegitimate 8 1 9 Still-births ••• ••• ••• 2 5 7 Deaths ... ... ... ... 120 58 62 Live Birth Rate per 1,000 of the estimated resident population 15.80 Still-birth Rate per 1,000 total (live and still) births ... 40.70 Death Rate per 1,000 of the estimated resident population 10.73 Rate per 1,000 Deaths from Puerperal Causes :— (total (live and Deaths. still) Births. No. 29. Puerperal sepsis ... « • • 0 Nil No. 30. Other puerperal causes ... • • • 0 Nil ’I^ ^)t3jl ... ... ... ... ... • • « 0 Nil Death Rate of Infants under 1 year of age :— All infants per 1,000 live birtlis ... ... ... ... 35.09 Legitimate infants per 1,000 legitimate live britlis ... 35.09 Illegitimate infants per 1,000 illegitimate live birbts ... Nil Number of Deaths from Special Causes :— Cancer (all ages) ... ... ... ... ... ... ... 22 Measles (all ages) ... ... ... ... ... ... ... 0 Whooping Cough (ail ages) ... ... ... ... ... ... 0 Diarrhoea (under 2 years of age) ... ... ... ... ... 0 Unusual or Excessive Mortality ... ... ... ... ... Nil POPULATION. For the year 1939 the Kegistrar-General gives two figures, namely, {a) 10,440 to represent the Mid-year population upon which Birth Pates are calculated ; and (6) 11,180 upon which Death Rates and the Incidence of Infectious Disease are calculated. The population as enumerated at Census Periods was : 1901 10,584 1921 13,714 1911 12,311 1931 15,344 The estimated population for 1935 was 10,290, after the alteration of the boundary, while that for 1938 was 10,350. BIRTHS. This year the Registrar-General has supplied two sets of figures to represent the Births attributable to this District, {a) the smaller, for the purpose of calculating the local Birth Rate ; and (h) the larger, for calculating Infant and Maternal Mortalities. These are given in the columns marked (a) and (6) respectively in the following Table. Births Table. 1939. Male. Female, Total. (a) (h) {a) (b) (a) (b) Legitimate Births 81 84 75 78 156 162 Illegitimate Births 8 8 1 1 9 9 Total Live Births 89 92 76 79 165 171 Total Still Births 2 5 7 Total Registered Births 91 81 172 (Live and Still) The Total Birth Rate (Live and Still) works out at 16.47 per 1,000 of population and the Live Birth Rate (Live Births only) at 15.80 per 1,000 of population. DEATHS. As has been explained in previous Reports, the gross number of deaths registered locally has to be corrected for residents dying elsewhere (inward transfers) and for non-residents dying in Insti- tutions, etc., in the District (outward transfers), also, in order to make Death Rates in different districts comparable a correcting factor is applied to the death rate to compensate for age and sex differences in the population ; the result is known as the Standard Death Rate. The net number of deaths attributed to this District is 120, comprising 58 males and 62 females. The Net Death Rate works out at 10.73, which, multiplied by the Comparability Factor (0.88) gives a Standard Death Rate of 9.44. For the previous year the Net Death Rate was 12.27, while the average for the past ten years is 11.78. The principal causes of death in this district during the past and four preceding years are :— Disease. 1939 1938 1937 1936 1935 1. Cancer ... ... ... ... 22 14 16 21 22 2. Heart Disease ... 37 50 50 38 27 3. Respiratory Diseases ... (Pneumonia, Bronchitis, etc.) 6 10 10 9 6 4. Influenza 6 7 7 6 3 5. Diseases of the Blood Vessels ... (including Cerebral Haemorrhage) 14 17 16 11 16 6. Disease of the Kidneys 4 3 4 2 7 7. Disease of the Digestive Organs 5 5 3 9 8 8. Tuberculosis (all forms) 1 7 4 1 5 9. All other Infectious Diseases ... 0 0 1 3 2 10. Suicide ... 1 3 0 1 2 11. Accidents, etc. ... 3 5 5 4 7 12. Senile Decay 3 0 2 0 4 INFANT AND MATEKNAL MORTALITY. There were 6 deaths of infants under one year of age, none of which was illegitimate. The total was 10 in the preceding year. In addition there were 4 Still-births (none illegitimate). Maternal Mortality. There was 1 death from Other Puerperal Causes, which gives a Maternal Mortality Rate of 9.80 per 1,000 when calculated upon the 102 total (live and still) births, or a rate of 0.13 per 1,000 when calculated upon the estimated population of 11,180. The Infant Mortality rates work out as follow :— All infants per 1,000 live births Legitimate infants per 1,000 legitimate live births ... Still-births per 1,000 total (live and still) births Illegitimate infants per 1,000 illegitimate live births Infant Mortality Rate (average for fast 10 years) 39.60 39.60 39.22 Nil 39.95 The cause of, and age at, death of the infants referred to are set out in the following table — Cause of Death Und. 1 wk. 1-2 wks. 2-3 wks. 3-4 wks. 1-3 mths. 3-6 mths. 6-9 mths. 9-12 mths. Total Atelectasis 1 — — — — — — 1 Haemat emesis 1 — — — — — — — 1 Haemorrhagic Pneumonia 1 1 Heart Failure 1 1 Prematurity 1 — — — — — — — 1 Shock 1 — — — — — — — 1 Totals ... 4 — — 1 1 6 SECTION B. GENERAL PROVISION OF HEALTH SERVICES. PUBLIC HEALTH OFFICERS. The staff normally consists of one whole-time Sanitary Inspector (Mr. J. H. Joynt) who is also Building Surveyor and Superintendent of Scavenging, two outdoor assistants (unqualified) and a clerical assistant (Shorthand-typist). During the year, Mr. L. C. Stewart, the second assistant, has been called up for military service, and two temporary clerks have been engaged. There are three teams of two men each for operating the three cesspool emptiers and four men are employed in dry scavenging with two vehicles. In addition, four men are engaged at the dumps where the scavenged materials are deposited, and one supervising foreman, i.e., fifteen men in all. One of the vehicles has a “ dual- purpose chassis which can be converted for use as a cesspool emptier or a refuse lorry as required, with a corresponding change in the occupation of the men. LEGISLATION IN FORCE. In the Report for 1938 at pages 113-114 a full list of the Adoptive Acts, Bye-Laws, Regulations, etc., in force in this District was given. The only change is that the new Building Bye-Laws under the Public Health Act, 1936, came into operation on and after the 29th July, 1939. These Bye-Laws are based on Series IV of the Code of Model Bye-Laws issued by the Ministry of Health. LABORATORY FACILITIES. The laboratory facilities are the same for this as for the other Districts in the combination, and a summary of the work done in 1939 is given below. Swabs and other morbid specimens examined by the Clinical Research Association, London, on behalf of medical practitioners in the neighbourhood comprised the following :— Material. Positive. Negative. Total. Swabs for Diphtheria 9 • • • • • • XJ 31 33 Sputum for Tubercle ... • • • * • • 0 7 7 Blood for T37phoid 0 0 0 Others 0 1 1 2 39 41 Official samples of milk taken by the Police : 46. One was deficient in fat to the extent of 7.67%, 6 were deficient in milk fat, 2 were deficient in milk fat and non-fatty solids and 1 was deficient in non-fatty solids. The following samples were taken by Inspectors of the County Weights and Measures Department, all of which proved to be genuine : Cheese ... ... ... 1 Ground Nutmeg ... 1 Cream ... ... ... 1 Mustard ... ... 1 Plour 1 Pearl Barley 1 Ground Almonds ... 1 Tinned Cream ... 1 Ground Coffee ... ... 1 White Pepper ... 1 Twenty-one samples of water from private wells and other sources were taken for Chemical and Bacteriological analysis, with the result that 16 was classed as “ Good,” 1 as ” Passable,” and 4 as “Unfit.” AMBULANCE FACILITIES. These facilities have been described in previous Reports and are similar to those obtaining in Maidenhead. HOSPITALS, CLINICS AND HOME NURSING. Residents in Cookham Rural District have access to the Clinics, etc., in Maidenhead. A branch of the Maidenhead and District Nursing Association has been established at Pinkneys Green for the past five years, which serves a considerable portion of this District, while the rest is covered by the County Nurses. The Parish of Hurley enjoys the right of sending patients to Westminster Hospital by virtue of Willcock’s Charity, 1788. For details see Annual Report 1938, pages 115-116. SECTION C. SANITARY CIRCUMSTANCES. WATER SUPPLY. A full description of the water supply of the district was given in last year’s Reoprt (page 117). The number of premises supphed to date by the Maidenhead Water Company is shown in the following statement: Total at Existing New end of Parish. 1938. 1939. 1939. Bray ... 1037 28 1065 Cookham ... 1093 16 1109 Bisham ... 76 4 80 Shottesbrook 26 0 26 White Waltham ... 517 2 519 Waltham St. Lawrence ... 292 2 294 Hurley ... 264 0 254 3295 52 3347 Samples of water from private wells and other sources to the number of 21 w’ere taken for analysis during the year. Of these 16 were good, 1 passable and 4 unfit. In the locality known as Spade Oak adjoining the River Thames on the extreme northern boundary of the district, there have been at various times 42 samples of water taken from the wells, etc., supplying the dwellings there, which are mostly used as summer residences. The results were : Good 18, Passable 4, Unfit 20. Statutory Notices under Section 138 of the Public Health Act, 1936, were served on Owners of the 12 premises at which the water supplies were found to be unfit, 7 of whom objected to the require- ments and appealed to the Minister of Health. These appeals are now receiving consideration. DRAINAGE AND SEWERAGE. No further progress has been made in regard to the proposals for land drainage mentioned in the previous year’s Report, and in view of recent events this must now remain in abeyance. The scheme for sewering the villages of Bray and Cookham which received the approval of the Minister of Health in April, 1939, is for the same reason in abeyance, but it is hoped that it will be possible to proceed with at least a portion of the scheme. CLOSET ACCOMMODATION. At the beginning of the year, the figures representing the closet accommodation were approximately : Water Closets 3,303, Earth (Pail) Closets 286, Privies 61. During the year six Privies and seventeen Pail Closets were abolished and Water Closets provided. All new dwelling houses are provided with Water Closets. Taking these into consideration together with the conversions, the position at the end of the year is (approximately) : Water Closets 3,370, Earth (Pail) Closets 269, Privies 55. PUBLIC CLEANSING. The question of Public Cleansing, i.e., Wet and Dry Scavenging, was discussed at length in the Report for 1933 (pages 84-88) and an account of the projected scheme was given in the Report for 1934 (pages 92-93). That scheme is now in operation under the superin- tendence of Mr. J. H. Joynt (Sanitary Inspector), who has supplied the material for the following account. Wet Scavenging. Wet Scavenging, i.e., cesspool emptying, is carried on in four of the seven parishes in this District; the parishes which are not so scavenged are Waltham St. Lawrence, Shottesbrooke and Hurley. In the parishes of Bisham and White Waltham the work is done by a private contractor who undertakes the emptying of cesspools and the disposal of their contents. In the Parishes of Bray and Cookham, the Councirs own em- ployees do the work, the cesspool contents being disposed of by broad irrigation at two disposal sites, one in each parish. The emptying is carried out by the Council’s vehicles which consist of two 1,000 gallon and one 750 gallon Dennis vacuum machines. The latter is a dual purpose machine with interchangeable refuse collection and cesspool emptying bodies, and was taken into service on the 20th of June, 1939. During the financial year just ended, the cesspools emptied by the private Contractor in Bisham and White Waltham numbered 947 at the average contract price of £370, or at a rate of 7s. 7d. per cesspool. For the previous year (1938-39) the corresponding figures were 610 cesspools at £325, or 10s. 8d. per cesspool. In Bray and Cookham during the same period, and by direct labour, 4,833 cesspools were emptied of 7,192,000 gallons of sewage on 296 working days, at a cost of £2,669 or 7s. 5d. per 1,000 gallons, i.e., the nominal contents of one cesspool. The corres- ponding figures for the previous year are 4,974 cesspools, 7,062,000 gallons, 298 working days, total cost of £2,197 Os. Od., or 6s. 2id. per 1,000 gallons. The expenses of the above services for the year ended 31st March, 1940, are :— £ s. d. Kefuse Collection and Disposal ... ... ... 2150 0 0 (including Loan Charges) Cesspool Emptying by Contract for Bisham and White Waltham Parishes ... ... ... ... 370 0 0 Bray and Cookham Cesspool Emptying Expenses... 2334 0 0 (including Loan Charges) Sewage Works for disposal of cesspool contents (including Loan Charges) : Bray 188 0 0 Cookham 147 0 0 Dry Scavenging. Dry Scavenging, i.e., removal of house refuse, is carried out by the Council’s own employees and vehicles (three Dennis covered vans, each of 10 cubic yards capacity, one of these being a dual purpose machine, is employed part time only). In all seven parishes of the district the collection is carried out weekly. The refuse is disposed of by controlled tipping at three sites, these being disused pits. A further pit has been filled, making three since the scheme was commenced, and another site has been acquired at Switchback Road, Cookham. During the financial year ended the 31st March, 1940, 1,181 loads, or approximately 2,539J tons of refuse, were collected in 258 working days and disposed of at a total cost of £2,150 Os. Od,. or 16s. lid. per ton. In the previous year, the figures were 1,140 loads or 3,070 tons, total cost of £1,913 Os. Od., or at the rate of 12s. 7fd. per ton. On the 31st October, 1939, a system of salvage was commenced, whereby certain materials are recovered from the refuse and sold to dealers. So far, very little assistance has been received from householders in the district, although much publicity has been given to the matter and 4,000 handbills have been distributed requesting the co-operation of the public. To encourage further interest, consideration is being given to displaying posters, lecturing to branches of Women’s Institutes and the insertion of articles in the local press. From the date of commencement of the scheme to the 31st December, a sum of £5 9s. 6d. has been received for salvaged materials. SANITARY INSPECTION. The following is the Report of the Sanitary Inspector (Mr. J. H. Joynt) for the year ended 31st December, 1939 :— “ Oaklands,” Bath Road, Maidenhead. To Dr. J. J. Paterson, {Tel. Maidenhead 252). Medical Officer of Health. Dear Sir, I have the honour to submit my Sixth Annual Report since commencing my duties in the District on 2nd July, 1934. During the past year, my department has been delegated to prepare schemes or undertake duties with regard to the following Statutes :— Air Raid Precautions Act, 1937.—(A.R.P. Transport including Emergency Ambulances and Emergency Petrol Supplies ; prep- aration of Maps showing all Services, i.e., Water, Gas, Electricity, etc. ; Manning A.R.P. Report Centre for dealing with Air Raid Damage). Fire Brigades Act, 1938.—(Preparation of a scheme for Peace and War time, covering the whole of the Rural District; a scheme of improvements to Static Water Supplies was prepared and executed at a cost of £383 7s. 6d.). Civil Defence Act, 1939.—(Provision of Mortuaries, a separate room or building has been provided in each case for the receipt of gas contaminated bodies, the total cost of works, including stores, amounted to £350 12s. 4d. ; Commercial Buildings including approval of A.R.P. schemes, arranging training of personnel and attending at rehearsals). The above additional duties have to some degree interfered with the normal work of my Department, although, where possible, every endeavour has been made to deal with these matters outside normal office hours. May I record that during the period 5th September, 1939, to 13th January, 1940, my office was manned day and night. This was made possible only by the unfailing co-operation of my staff and other volunteers including one member of the Council and to them I render my profound thanks. A. Inspections and Visits. A total of 3,528 visits and inspections were carried out during the year and 49 complaints were received and investigated. B. Notices, Letters, Etc. Informal Verbal Statutory Notices comphed with Prosecutions Letters received ... Letters sent Persons interviewed at Office ... 159 84 21 206 Nil 4963 3628 1811 C. Index of Works. To economise both with paper and detailed work, the index of works executed during the year has been omitted. Improvements completed, defects remedied and nuisances abated during the year total 3,859. D. Factories. There are 49 Factories in the District. Twenty-four visits were paid during the year, four informal notices and one Statutory notice were served and three informal notices were complied with. E. Slaughter Houses. There are 4 registered and 2 licensed slaughter houses, making a total of 6. One hundred and twelve (112) visits were paid during the year to slaughter houses and butchers’ shops. A Table showing the meat found on inspection to be unfit for food is given at the end of paragraph F. Infectious Disease. Number of Cases Notified : Diphtheria ... ... ... ... ... ... ... 5 Erysipelas ... 1 Measles ... ... ... 1 Opthalmia Neonatorum ... ... ... ... ... 1 Pneumonia ... ... 5 Puerperal Pyrexia 4 Pulmonary Tuberculosis ... ... ... ... ... 9 Non-Pulmonary Tuberculosis 2 Scarlet Fever 12 Number of Houses disinfected 25 Number of Cases removed to Isolation Hospital ... 14 G. Dry Scavenging. H. Wet Scavenging. (See Special Eeport, Paragraph “ Public Cleansing.”) 1. Cowsheds and Dairies. Number of Registered Wholesale Producers ... ... ... 41 ,, ,, ,, Retail Producers ... ... ... 22 Retail Purveyors ... ... ... ... ... ... ... 29 Retailers (Milkshops, etc.) ... ... ... ... ... 8 Supplementary Licence to sell (T.T.) Milk ... ... ... 2 Dealer's Licence to sell (T.T.) Milk ... ... ... ... 1 Supplementary Licence to sell Pasteurised Milk ... ... 1 Ninety-seven visits were paid to these premises and many improvements were carried out after serving of notices. J. Drainage. One hundred and forty-three drainage systems to new buildings were inspected and approved during the year. Forty-four drainage systems were re-constructed or additional drains were provided during the alterations or additions to existing buildings. Six Privies were abolished and Water Closets with flushing cisterns were provided in their place. Seventeen Pail Closets were abolished and Water Closets with flushing cisterns were provided in their stead. Drainage systems to 50 existing dwelling houses were relaid, repaired or provided, after service of notice. K. Verminous Premises. Four Cottages were found to be infested. In two cases dis- infestation was carried out by the Owners and in two cases by this Council, the Owners of the premises bearing the cost. L. Housing (Rural Workers) Acts, 1926 and 1931. Housing (Rural Workers) Amendment Act, 1938. Considerable activity has taken place in the district during the year in connection with the above Acts. Twenty-nine premises were re-conditioned at a total cost of £4,937 15s. 8d., towards which this Council contributed £2,735 by way of grant. M. Shop Inspection. During the year, 31 visits were made to shops. N. Annual Report of Surveyor under New Streets AND Building Byelaws. Plans presented for approval ... ... ... ... ... 187 Dwelling Houses completed ... ... ... ... ... 44 Additions and alterations to existing dwellings completed... 56 Notices served, Contraventions of Byelaws, etc. ... ... 65 (Signed) J. H. JOYNT, Sanitary Inspector and Building Surveyor. CAMPING SITES. Under Section 269 of the Public Health Act, 1936, six applica- tions were received for approval of camping sites mostly in meadows adjoining the River Thames. All these were granted subject to certain conditions, namely :— (a) The tents and/or caravans shall be used for holiday camping purposes only and/or for occasional use at week-ends, but not for habitual human occupation. (h) Not more than eight caravans or tents to be placed on any one acre of land. (c) A clear space of not less than fifteen feet between each caravan and/or tent. (d) No caravan and/or tent to be sited nearer than 25 feet to the towing path. (e) Approved water supply and sanitary accommodation including refuse bin to be provided in each case. {/) The Bye-laws relative to Tents, Vans and Sheds to be strictly complied with. (g) The Licence to be for a limited period only and in any case to expire on the 30th September, of the current year. The Water Supply to the sites in question is by tube wells in four cases and Main Water Supply for the remainder. Samples of water, other than Main, were taken for bacteriological examination and found to be fit for domestic purposes, the applicant for licence bearing the cost of analysis. Generally speaking, Camping Sites were well maintained during the year and no complaints were made. At the village of Hurley, The Camping Club of Great Britain and Ireland are using a rather extensive area of land for camping purposes, and the Minister of Health has granted this organisation a Certificate of Exemption. A sample of well water from this site was found to be fit for domestic purposes on bacteriological examination. It is needless to say that conditions at this site were excellent, due generally to the rather strict code of camping instituted by the Club. List of Camping Sites. (R. Wallis.) Strande Castle, Cookham. (Major J. C. Walker.) Land situated at Rambler Cottage, Frogmill, Hurley; and known as ‘‘ Poisson de Due ”—locally " Poisoned Duck.” (Mr. W. Cook.) Land at rear of ” Royal Oak ” Inn, Knowl Hill. (Mr. C. W. Burfitt.) Riverside Meadows, Hurley. (Mr. W. Long.) Riverside Meadows adjoining Towing Path, Frogmill, Hurley. (The Thames Conservancy.) Plots adjoining Weir and Lock ; known as Upper and Lower Island, Hurley. (Camping Club of Great Gritain and Ireland.) Meadow, Mill Lane, Hurley. (Certificate of Exemption, Minister of Health.) SWIMMING BATHS AND POOLS. The four places in this district where provision is made for public bathing and swimming were enumerated and described in the corres- ponding paragraph in the previous year’s Report (page 130), to which there is nothing further to add except that the filter at the privately-owned pool has been improved and the owner advised to install a chlorinating plant. SANITARY MATTERS REQUIRING NOTICE. The Main Drainage Scheme for the parishes of Bray and Cookham is at present in abeyance pending decision as to whether that part of the Maidenhead Borough Scheme to which the Cookham section would be linked is to be proceeded with or not. The proposal to link up an outlying locahty (Oakley Green) in the Parish of Bray with the neighbouring sewer belonging to Windsor Borough is still under discussion. Preliminary investi- gation indicates that there is no serious difficulty in the way of effecting such linkage and the matter rests largely upon the question of appropriate charges as between the two Local Authorities con- cerned. The long discussed scheme for improving surface water drainage so as to prevent, or at least mitigate, the flooding of portions of Bray Village, has not made much progress. The lower portion of “ The Cut ” has been cleared and re-conditioned, but the subsidiary streams and ditches leading into it have not yet been dealt with. The position with regard to satisfactory water supply in the outlying locality known as Spade Oak has been greatly improved. The cost of providing a public supply to the dwellings—^mostly used as temporary residences in the summer—was considered prohibitive, being well over a thousand pounds. Most of the private wells from which unsatisfactory samples had been obtained have now been reconstructed, and further samples have shown that the water now obtainable is of satisfactory quality for drinking and domestic purposes. The few outstanding cases will be dealt with when it is possible to get into communication with the owners of the property. SECTION D. HOUSING. GENERAL INFORMATION. HOUSING STATISTICS. The record of work done under the Housing Acts, etc., during the past year is as follows :— 1. Inspection of dwelling houses during the year :— (1) (a) Total number of dwelling houses inspected for housing defects (under Public Health or Housing .^\.ctsl ... ... ... ... ... ... 02 (6) Number of inspections made for the purpose ... 750 (2) (a) Number of dwelling houses (included under sub- head (I) above) which were inspected and recorded under the Housing (Consolidated) Regulations, 1925, and Amendment Regulations, 1932 ... 43 (6) Number of inspections made for the purpose ... 567 (3) Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation ... ... ... ... ... Nil (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 ... 43 2. Remedy of defects during the year without service of Formal Notices :— Number of defective dwelling houses rendered fit in conse- quence of informal action by the Local Authority or their officers 98 3. Action under Statutory Powers during the year :— A. Proceedings under Sections 9, 10 and 16 of the Housing A-Cty 1936. ... ... ... ... ... ... B. Proceedings under Public Health Acts : c. Proceedings under Sections 11 and 13 of the Housing Act, 9 ••• ••• **• Nil Nil • • • * * • Nil D. Proceedings under Section 12 of the Housing Act, 1936 ... Nil 4. Housing Act, 1936. Part IT.—Overcrowding. (а) (i) Number of dwellings overcrowded at tbe end of the year ... ... ... ... ... ... 4 (ii) Number of families dwelling therein ... ... 4 (iii) Number of persons dwelling therein ... ... 34 (б) Number of new cases of overcrowding reported during the year ... ... ... ... ... 1 (c) (i) Number of cases of overcrowding relieved during the year ... ... ... ... ... ... 1 (ii) Number of persons concerned in such cases ... 10 (d) Particulars of any cases in which dwelhng hluses have again become overcrowded after the Local Authority have taken steps for the abatement of overcrowding Nil SECTION E. INSPECTION AND SUPEKVISION OE FOOD. MILK SUPPLY. The position with regard to milk supply is shown by the following tabular statement:— Daieies, Cowsheds and Milkshops. Number on Register : Wholesale Producers ... ... ... ... ... 31 Retail Producers 22 Retail Purveyors 29 Retails (Milk Shops, etc.) 8 Licences granted for the sale of Tuberculin Tested Milk ... 3 ,, ,, ,, ,, Pasteurised Milk ... ... 1 Dairy Farms licensed to produce Accredited Milk ... ... 25 ,, ,, ,, ,, Tuberculin Tested Milk ... 6 Total number of Registered Dairy Farms ... ... ... 63 Contraventions of Milk and Dairies Order, 1926 : Discovered ... ... ... ... ... ... ... 15 Remedied ... ... ... ... ... ... ... 13 Contraventions of Pubhc Health Acts : Discovered ... 6 Remedied ... ... ... ... ... ... ... 6 Number of Inspections ... ... ... ... ... ... 97 Notification of suspected infectious disease (Anthrax) amongst animals was received in respect of two farms in this District on the 17th of May and 10th of November respectively. In neither case was the preliminary diagnosis confirmed, and the notices were withdrawn. MEAT AND OTHER FOODS. Slaughtee Houses. There are 4 registered and 2 licensed slaughter houses in the District, and considering that most of them are old premises, their condition is reasonably good. One hundred and twelve visits were paid to slaughter houses and butchers’ shops during the year. The following Table sets out the carcases, etc., inspected and condemned :— Table of Meat Inspection (Cookham Parish). Carcases Inspected and Condemned. Cattle excluding Cows Cows Calves Sheep and Lambs Pigs Number killed (approx) 1 3 24 77 215 Number inspected 1 3 16 59 161 All diseases except Tuberculosis. Whole carcases condemned . t 1 Carcases of which some part or organ was condemned ... — 1 1 3 13 Percentage of the number inspected affected with dis- ease other than tuberculosis 5.1% 8.0% Tuberculosis only. Whole carcases condemned — — — — — Carcases of which some part or organ was condemned ... — •— — — 5 Percentage of the number | inspected affected with tuber- culosis ... ... ... — — 3.1% Total weight of meat condemned and destroyed, including decomposed meat: 1831bs. Bakehouses. There are 9 premises in the District where baking of bread is carried on. Generally speaking, it may be said that half of them are housed in rather old buildings, but as electricity becomes available power is obtained and machinery usually installed, thereby methods are more cleanly in character and further time is available for cleansing of premises. On the whole they are well kept and frequently inspected and in no instance was it necessary to issue a formal notice for cleansing, white washing or any other defect. OTHER ROOD SHOPS. Systematic inspections under the Rood and Drugs Act, 1938, of other premises where food is prepared or sold has been postponed for the time being owing to pressure of other work, but will be commenced in the coming year. Casual inspections, however, have been made and any matters of urgency have been attended to. INRECTIOUS DISEASES. GENERAL INRORMATION. There is very little to say about the notifiable infectious diseases in this District for the year 1939. Rive cases of Diphtheria and 12 of Scarlet Rever represent the average numbers for the past five years and none of the cases presents any noteworthy feature. The new Order making Measles and Whooping Cough notifiable produced only one case of Measles up to the end of the year. Rour cases of Puerperal Pyrexia and 1 of Ophthalmia in the new-born were notified, all of which recovered. The other cases, set out in the Table below, do not call for comment. NOTIRIABLE DISEASES. The usual statistics relating to notifiable infectious diseases are set out in the two table below :— Table I. Notifiable Diseases during the Year, 1939. {other than Tuberculosis). Total Cases ad- cases mitted to Disease. notified. Hospital. Diphtheria 5 5 Dysentery ... ... 0 0 Encephalitis Lethargica 0 0 Enteric Rever (including Typhoid and Paratyphoid) 0 0 Erysipelas 1 0 Malaria ... 0 0 Measles ... 1 0 Ophthalmia Neonatorum 1 0 Pneumonia 5 1 Poliomyelitis 0 0 Puerperal Rever 0 0 Puerperal Pyrexia 4 1 Scarlet Rever 12 9 Smallpox 0 0 Deaths of notified cases. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Table II. Age in Years of Notified Cases, 1939. Disease, Years 0- 1- 2- 3- 4- 5- 10- 15- 20- 35- 45- 65+ Diphtheria ... - --1-1 1 - 1 1 - - Erysipelas ... ______ _ _ - 1 ~ - Measles ... ... ! _____ _ _ _ _ _ _ Ophthalmia Neonatorum ... 1---- - - - - - - - Pneumonia ... -1-1-1 1 - 1 - - - Puerperal Pyrexia ______ _ _ 4 _ _ _ Scarlet Fever ... 1-11-6 - - 3 - - Table III. List of Infectious Diseases for the Five Years, 1935—1939. Disease. 1935 1936 1937 1938 1939 Diphtheria Dysentery Encephalitis Lethargica ... Enteric Fever (including Typhoid and Paratyphoid) Erysipelas Malaria Measles Ophthalmia Neonatorum Pneumonia ... Poliomyelitis Puerperal Fever Puerperal Pyrexia Scarlet Fever Smallpox 8 0 0 1 0 0 0 0 1 0 1 1 5 0 1 1 1 0 0 1 0 0 4 0 1 0 10 0 1 0 0 0 1 0 0 0 3 0 0 2 7 0 9 0 1 0 3 0 0 0 2 0 0 1 15 0 5 0 0 0 1 0 1 1 5 0 0 4 12 0 Table IV. NFECTIOUS AND OtHER DISEASES IN SCHOOLS, 1939. Children No. affected on including School. Roll. Disease. Date. contacts. Bisham Parish 84 Nil Bray, Braywood 74 Impetigo Nov., Dec. 2 C.E. Mumps Feb., March 2 Scarlet Fever Nov. 1 Whooping Cough March 2 Bray, Holyport no Chickenpox July 1 C.E. Ringworm July I Bray, Touchen End 88 Chickenpox June 3 C.E. Diphtheria Oct. 2 Impetigo Dec. I Cookham Dean C.E. 93 Nil Cookham Holy 134 Ringworm Nov. 1 Trinity Cookham Rise 93 Scarlet Fever Nov. 1 Council Hurley, Burchetts 14 Nil Green C.E. Hurley, Knowl 56 German Measles May 1 Hill Scarlet Fever Dec. 1 Whooping Cough April 2 Waltham St. 310 Chickenpox Aug., Sept., 41 Lawrence C.E. Oct., Nov. Mumps Oct. 1 Ringworm Oct. 1 White Waltham 120 Chickenpox March 9 C.E. Impetigo Feb., July, Oct. 4 Scarlet Fever Nov. 1 White Waltham 14 Nil Little wick C.E. TUBERCULOSIS. It was not necessary to take any specific action under tke Public Health (Prevention of Tuberculosis) regulations, 1925 (compulsory discontinuance of employment) or under Sec. 62 of the Public Health Act, 1925 (compulsory removal of patient to institution), now incor- porated in Section 172 of the Public Health Act, 1936. Particulars of new cases of tuberculosis and of all deaths from this disease whether the cases have been notified or not during the current year are set out in the table below. Tuberculosis Table. Age Periods. New Cases. Pulmonary. Non-PuVy. Deaths. Pulmonary. Non-Pid’y. M. F. M. F* M. F. M. F. Under 1 year ... 1— 5 years — — — — — . — — — 5—15 „ — 1 — — — — — 15—25 „ — — 1 — — — 25—35 „ 1 2 — — 1 — — — 35—45 „ 3 — — — — — — — 45—55 „ 1 1 — — 1 — — — 55—65 „ — — — — — — — — 65 and over — — — — — — Totals 3 3 1 1 2 — Percentage of non-notified cases amongst total fatal cases—Nil. ^ OTHER SPECIAL DISEASES. Cancer. The average cancer death rate for the past ten years is 1.85, and for the present year the net cancer deaths number 19 males and 10 females, giving a total of 22, which is equivalent to a rate of 1.97 per 1,000 population. In the previous year, the figures were 8 males 6 females, total 14, and rate 1.35. The facilities provided by the neighbouring Hospitals appear to be adequate for treatment so far as they are called for and no special propaganda work has been under- taken. Blindness. There was one case of Ophthalmia Neonatorum notified this year. The case was nursed at home and recovered without impairment of vision. Work in connection with the care of the Blind is undertaken by the County Authority. Other. Cases of the other and comparatively rare diseases mentioned in the Schedule were absent. Easthampstead Rural Sanitary District. SECTION A. GENERAL STATISTICS. Area (in acres) ... ... ... ... ... ... 27,034 Registrar General's estimate of— {a) Resident population at middle of 1939 ... ... 19,350 {h) Average population appropriate to calculation of Death Rates ... ... ... ... ... 20,160 Number of inhabited houses according to Rate Book at end of 1939 ... ... ... ... ... ... 5,355 Rateable Value, 1st April, 1940 ... ... ... ... £146,678 Sum represented by a penny Rate ... ... ... £574 SOCIAL CONDITIONS AND UNEMPLOYMENT. The social conditions were described in last year's Report (pages 144-145) and a discussion as to occupations in this District appeared in the Report for 1932 (pages 22-31). The chief features are building trades, brick-making and employment at the several large Institutions, Government, Military and Educational, situated in the neighbourhood. There is very little unemployment and there are no occupations that affect the health of the workers prejudicially. Evacuation. The chief alteration in the social circumstances of the District during the year was the putting into effect of the Government Evacuation Scheme in September, when 1,691 evacuees arrived at Bracknell Station in the course of three days and were billeted in the northern area of the District. Additional to this number were the staff and boys of St. Paul’s School, which was evacuated to the Crowthorne area under special private arrangements previously made by the School, their number amounting to 604. The official evacuation coincided with an influx of various business firms who took possession of some of the larger vacant country bouses in the District. There has been a continuous drift back of evacuees and the number officially billeted at the time of writing has been reduced to 459. Temporary sanitary accommodation in the form of latrines was provided near Bracknell Station, where the evacuees were first sorted into parties before being distributed to the various districts, and as a matter of urgency a disused building in Bracknell known as the Forest Hotel was requisitioned and fitted up as an emergency sick bay. This sick bay has now been put on a permanent basis serving several Districts in East Berkshire and although the building was derelict when taken over it has been put into a habitable state at a cost for the structural alterations of approximately £300. The Forest Sick Bay is serving a very useful purpose and the accommodation can be increased by putting the top floor of the building into commission. With the exception of the billeting arrangements for St. PauFs School in the Parish of Crowthorne, the whole of the district south of the Southern Railway line, comprising the Parishes of Crowthorne, Sandhurst, and parts of Easthampstead and Winkfield, has been reserved for mihtary billets. EXTRACTS FROM VITAL STATISTICS FOR THE YEAR 1939. Total. Males. Females. Live Births!- 252 119 119 J.J1 V KD JLIJ-X UIXD ^ Til • 1 • i b Illegitimate 9 * • • • « • 6 3 Still-births 12 6 6 Deaths 213 108 105 Live Birth Rate per 1,000 of the estimated resident population 13.49 Still-birth Rate per 1,000 total (live and still) births ... 45.98 Death Rate per 1,000 of the estimated resident population ... 10.56 Deaths from Puerperal Causes :— No. 29. No. 30. Total . Puerperal sepsis ... Other puerperal causes Rate per 1,000 total (live and Deaths. still) Births. . 0 mi . 0 0 • • • >} Death Rate of Infants under 1 year of age :— All infants per 1,000 live births ... ... ... ... 22.64 Legitimate infants per 1,000 legitimate live births ... 18.87 Illegitimate infants per 1,000 illegitimate live births ... 111.11 Deaths from Other Causes :— Cancer (all ages) 33 Measles (all ages) 0 Whooping Cough (all ages) 0 Diarrhoea (under 2 years of age) ... ... ... ... ... 0 Unusual or Excessive Mortality ... ... ... ... ... Nil POPULATION. For the year 1939 the Registrar General gives two figures, namely, (a) 19,350 to represent the mid-year population upon which Birth Rates are calculated ; and {h) 20,160 upon which Death Rates and the Incidence of Infectious Disease are calculated. The population as enumerated at Census Periods was : 1901 15,757 1921 18,757 1911 17,548 1931 18,010 The estimated population for 1938 was 19,240. BIRTHS. This year the Registrar General has supplied two sets of figures to represent the Births attributable to this District, (a) the smaller for the purpose of calculating the local Birth Rate ; and (h) the larger for calculating Infant and Maternal Mortalities. These are given in the column marked (a) and (h) respectively in the following Table. Births Table. 1939. Males. Females. Total. (a) (h) (a) (h) {a) (b) Legitimate Births 133 136 119 120 252 25( Illegitimate Births 6 6 3 3 9 ( Total Live Births 139 122 261 Total Still Births 6 6 12 Total Registered Births 145 128 273 (Live and Still) The Total Birth Rate (Live and Still) works out at 14.10 per 1,000 of population and the Live Birth Rate (Live Births only) at 13.49 population per 1,000 of population. DEATHS. As has been explained in previous Reports, the gross number of deaths registered locally has to be corrected for residents dying elsewhere (inward transfers) and for non-residents dying in Insti- tutions, etc. (in the District (outward transfers), also in order to make Death Rates in different districts comparable a correcting factor is applied to the death rate to compensate for age and sex differences in the population ; the result is known as the Standard Death Rate. The net number of deaths attributed to this District is 213, com- prising 108 males and 105 females. The Net Death Rate works out at 10.56, which, multiplied by the Comparability Factor (0.87), gives a Standard Death Rate of 9.19. For the previous year the Net Death Rate was 10.60, while the average for the past ten years is 11.04. The principal causes of death for the past five years are :— Disease. 1939 1938 1937 1936 1935 1. Cancer ... 33 26 35 27 31 2. Heart Disease ... 56 49 53 56 46 3. Respiratory diseases ... (Pneumonia, Bronchitis, etc.) 19 14 11 26 14 4. Influenza 4 5 6 3 0 5. Diseases of the Blood Vessels ... 24 19 23 24 20 (including Cerebral Haemorrhage) 6. Disease of the Kidneys 6 5 2 5 7 7. Disease of the Digestive Organs 13 11 15 10 13 8. Tuberculosis (all forms) 7 10 12 10 8 9. All other infectious diseases ... 0 4 0 2 0 10. Suicide 2 4 5 0 2 11. Accidents, etc. ... 9 13 7 6 7 12. Senile Decay 18 19 19 19 24 INFANT AND MATERNAL MORTALITY. There were 6 deaths amongst children under one year of age, as against 9 in the preceding year. One of these was illegitimate. In addition there were 12 still-births, none being illegitimate. The respective rates work out as follows :— All infants per 1,000 birth lives ... ... ... ... 22.64 Legitimate infants per 1,000 legitimate live births ... 18.87 Illegitimate infants per 1,000 illegitimate live births ... 111.11 Still-births per 1,000 total (live and still) births ... ... 45.98 Average Infant Mortality Rate (10 years) ... ... 43.10 The cause of, and age at, death of the infants referred to are set out in the following table : Cause of Death Und. 1 wk. 1-2 wks. 2-3 wks. 3-4 wks. 1-3 mths. 3-6 mths. 6-9 fuths. 9-12 mths. Total Cardiac Failure 1 1 Cranial Haemorrhage 1 _ _ „ 1 Hydro- cephaus _ _ 1 1 Malnutrition — 1 — — — — — — 1 Prematurity 1 — — — — — — — 1 Operation — — — — 1 — — — 1 Total 2 2 — • 1 — — 1 6 Maternal Mortality. There were no deaths this year from cases connected with chlid-birth, the Maternal Mortality Rate was therefore—Nil. SECTION B. GENERAL PROVISIONS OF HEALTH SERVICES. PUBLIC HEALTH OFFICERS. Various changes have taken place in the Public Health Staff during the year to which this Report refers. At present it consists of : One Chief Sanitary Inspector, who is also Building Surveyor and Superintendent of the Sewerage and Scavenging Schemes operated by the Council. One Second Sanitary Inspector, who is also nominated Building Surveyor. Both Sanitary Inspectors are guahfied Inspectors of Meat and Other Foods. (For names and qualifications see List of Staff, in Preface.) The Third Sanitary Inspector, who held similar offices, left in the beginning of August to take up a fresh appointment elsewhere. This vacant post has not yet been filled. One whole-time (male) typist and clerk to the Sanitary Department is employed. There is also an out-door staff of foremen and workmen employed at the Sewage Works and for removal and disposal of house refuse' who are under the control of the Sanitary Inspector. Since 25th January, 1937, when the whole of the CounciFs office staff moved into new premises in Church Road (Tel. Bracknell 500), the office accommodation for the Public Health Department has been adequate. LEGISLATION IN FORCE. In last year’s Report (pages 150-157) a full list was given of the Adoptive Acts, Sections, Bye-laws, etc., in force in this District. As this remains the same there is no need to repeat the list. LABORATORY FACILITIES. The general arrangements for supplying the local medical practitioners with swabs, etc., are as described in the Preface to previous Reports, where a list of the Laboratories, Consultants, etc., will also be found. Samples of Milk are taken by the County Police, and of other Foods and Drugs by the Inspectors of the County Department for Weights and Measures. These samples are submitted to the County Analyst. Samples of water for domestic use are taken from time to time by the local Sanitary Inspectors and sent to one or other of the well-known laboratories in London for analyses. The results of these investi- gations are given below. Swabs and other morbid specimens examined by the Clinical Research Association, London, on behalf of medical practitioners in the neigbourhood, comprised the Material. following :— Positive. Negative. Total Swabs for Diphtheria ... 10 105 115 Sputum for Tubercle ... 0 3 3 Blood for Typhoid * ... 0 0 0 Others ... 0 0 0 10 108 118 Official samples of milk taken by the Police during 1939 numbered 38. Of these 15.17% were deficient of non-fatty solids, two were low in non-fatty solids and one was low in milk fat. The following samples of Foodstuffs, etc., taken by the Inspectors of the Weights and Measures Department all proved to be genuine :— Arrowroot Butter Cheddar Cheese Cocoa Condensed Milk Corned Beef Cream Dried Sultanas Flour 1 1 1 1 1 1 1 1 2 Ground Coffee . Margarine Raspberry Jam Rice Sugar Tinned Cream . Tinned Peaches Tinned Sardines AMBULANCE AND MORTUARY FACILITIES. 1 1 1 I 1 I 1 1 For the transport of accident and other cases a St. John Ambulance is now available in Bracknell and neighbouring districts at any time upon application to : Supt. W. Green, Dubhn Cottage, Tel. Bracknell 27. Binfield Road, Bracknell. A description of the new Mortuary and Post-mortem Room adjoining the Council Offices in Church Street, was given in the Report for 1938 at page 152. HOME NURSING. TREATMENT CLINICS. HOSPITALS. MATERNITY AND CHILD WELFARE. The Services indicated by the above-mentioned headings remain as described in previous Reports. The scope and extent of their activities during the past year were similar to those recorded in the Report for 1938 at pages 153-154. SECTION C. SANITARY CIRCUMSTANCES. WATER SUPPLY. A brief description of the water supply and method of treatment in the area was included in the Annual Reports for 1937 at page 151 and for 1938 at pages 155-157. The Parishes of Binfield, Warfield, Easthampstead, Crowthorne and Sandhurst are supplied by the Mid-Wessex Water Co., and the Parish of Winkfield by the South-West Surburban Water Co., and practically the whole of the District is adequately supplied by the mains of these Companies. No further action has been taken with regard to the supply in the Westley Mill Area and this matter was reported upon fully in last year’s Report. In continuation of the record of extensions of the public water mains noted in former Reports, the following is to be added :— South-West Sufhurhan Water Co. 596 yards of 4in. main was laid in Winkfield Parish and 76 new supplies were afforded, these figures including connections to 32 houses at the Council’s Chavey Down Housing site. Mid-Wessex Water Co. 140 yards of 3in. main was laid at Moss End, Warfield, to serve a farm and three new cottages. A contract was let for the construction of an additional 2,000,000 gallon covered reservoir at Buckhurst Hill, Coppid Beach Lane, and by the end of the year work was well advanced. Automatic pressure actuated control of the electrically operated booster pumps serving Binfield, Bracknell, Warfield area was put into operation in the summer and has been continued since. This has resulted in a further improvement in the pressure and volume of supply at the peak hours of demand and during the evening. Contracts were let for the permanent pumping and softening plant at Beenham’s Heath and the buildings to house this are now being contrsucted. Four houses were supplied with Companies’ water in place of private well supply. Examination of Water Samples. The following arrangements for routine sampling of the water supplies in the District were in operation during the year. South-West Surburban Water Co. The Council has an arrange- ment with five other local authorities supplied by this Company under which each Council takes four samples per year and the results of all samples are circularised to the other districts participating in the scheme. The four samples taken in the Easthampstead District were all reported upon as being satisfactory bacteriologically, although the figure for hardness averaged 24.3 parts per 100,000. Mid-Wessex Water Co. The supplies of this Company were sampled monthly throughout the year and the Council has an arrangement with the Royal Institute of Public Health and Hygiene for a modified report on these samples and also a report as to hardness. The twelve samples taken were reported to be satisfactory bacterio- logically, but seven samples exceeded the statutory limit of 14° (Clark) imposed upon the Company in the Mid-Wessex Water Company’s Act, 1935. Representations have been made to the Company with regard to the hardness and the explanation given is that a greatly increased demand for water by the War Office in the Friniley and Farnborough area has so depleted the available supply that it has been necessary to put the new Beenham’s Heath supply into use to supplement other sources prior to the construction of the necessary softening plant at Beenham’s Heath. It will be noted that the contract for the construction of this plant has been let. Fire Protection. The District is well supplied with fire hydrants and on the outbreak of hostihties the Fire Brigade undertook the work of marking all hydrants with road line paint. Four new hydrants have been fitted during the year. The Mid-Wessex Water Company called a Conference of local authorities on 19th April, 1939, to discuss the necessary co-operation between the Company and the local authorities in the exercise of their respective duties under the Fire Brigades Act, 1938. The water supplies in the District can generally be described as satisfactory and in particular considerable improvement in supply has been effected in recent years in the area previously served by the Wokingham Water Company and now coming under the Mid-Wessex Water Company. DRAINAGE AND SEWERAGE. Drainage. There is nothing to add to the paragraph that appeared under this heading in the Report for 1938 at page 157, where references to previous Reports on this matter will be found. Sewerage. In continuation of the account of the Council’s Sewerage Under- takings that appear from year to year, the following extracts have been taken from the Surveyor’s Report for the past year. BINEIELD. The Amen Corner, Wokingham Road and Popeswood Road extensions to this Scheme which were described in last year’s Report were taken over by the Council on the 10th January and 59 properties have been connected to these sewers. The connection work slowed down considerably at the outbreak of War, but the Council is pressing for the remainder of the connections to be carried out where the existing drainage systems are unsatisfactory. The whole of the flow from the Amen Corner extensions is dealt with at the Bracknell Drainage Works and no alterations or extensions to the Binfield Works have been carried out during the year. The routine main- tenance of the Works has continued satisfactorily but a considerable amount of surface water finds access to the sewers and the Works is incapable of coping with the flow in times of storm. Valves are fitted which enable storm water in excess of the capacity of the Works to be diverted on to the land. Four samples of the final efiluent were taken by the Thames Conservancy during the year and proved to be satisfactory. 361 properties are now connected to the Binfleld sewers, including those connected to the Amen Corner scheme. BRACKNELL. The existing drainage scheme was described in detail in the Annual Report for 1937 and no alterations to the existing Works, Pumping Stations or sewers have been made during the year. The Works is now dealing with the additional flow from the Amen Corner, Binfield, extensions, the whole of this flow being pumped at the Out- fall Works Pumping Station. Ten connections have been made to the existing sewers during the year and there are now 1,153 properties connected to the Amen Corner, Binfield, scheme, making a total of 1,212 properties. It is impossible to give an accurate estimate of the population of the Bracknell Special Purpose area, which comprises parts of the Parishes of Easthampstead, Warfield and Winkfield, but the figure of 2,941 obtained in 1936 has been considerably increased by the occupation of new properties and the effect of the Government Evacution Scheme. The total flow at the Works during the year amounted to 67,510,000 gallons, equivalent to an average daily flow of 184,933 gallons. The flushing of sewers by hydrants in place of the watercart is now in full operation and giving satisfactory results. Four samples of the final effluent were taken by the Thames Conservancy during the year and proved to comply with the Conser- vator’s standards. The unsatisfactory conditions at the Bullbrook Pumping Station have been accentuated by the increased rainfall compared with the previous year and the influx of evacuees. Although it is appreciated that schemes involving considerable expenditure cannot readily be undertaken during the present emergency the provision of automatic electrical pumping apparatus at this Station has now become a necessity and at the time of writing a preliminary report on this matter from the Council’s Consulting Engineers is awaiting the consideration of the Bracknell Special Purposes Committee. The outstanding sewer extensions referred to in last year’s Report will now have to be deferred for the duration of the War, but it is hoped that the electrification of the (Bullbrook) Bracknell Pumping Station will be put in hand in the near future as a matter of urgency. The farming of the surplus land at the Outfall site is being continued and every effort is being made to produce the maximum amount of foodstuffs at the Works, thus turning the dried sludge produced to the best possible use. The value of crops sold during the year amounted to £233 14s. Id., the principal crops consisting of 150J cwts. of wheat, 14 cwts. of oats, 15 tons clover hay, 1| tons oat straw, 10 tons 8 cwts. wheat straw and 153J cwts. of potatoes. Other crops sold included cabbages, cauliflowers, osiers, sprouts, turnips, beetroots and peas. CROWTHOKNE AND SANDHURST. This drainage scheme was described in detail in the Annual Report of the Medical Officer of Health for 1933 and there have been no structural alterations to the Works during the year. The extensions to this Scheme, in the Owlsmoor area, were com- pleted at the outbreak of War with the exception of a length of the Owlsmoor Road sewer which was found to be unsatisfactory. The Engineers have refused to take this section over and the work was closed down pending the re-laying of the faulty section at a later date. The Branksome Hill Road extension has been completed and ten connections serving fifteen properties have been made to this sewer. The final cost of these extensions has not been ascertained, but the estimated cost was £4,536, and the length of sewers laid was 1,601 yards in the Owlsmoor Road and 521 yards at the upper end of Branksome Hill Road. During the year 23 connections were made serving 42 properties and the total figure since the inauguration of the scheme in June, 1933, is 833 connections, serving 1,269 properties. Ten of these connections serving 15 properties were made to the new Branksome Hill Road extension. The total flow recorded at the Works during the year amounted to 69,400,000 gallons compared with 62,846,000 gallons for the previous year, an increase of 9.5% and 4.5% in excess of the flow for the year 1937. This increase coincides with a large increase in rainfall as compared with the exceptionally dry year of 1938 and with the temporary increase in population following the outbreak of hostilities in September. The total rainfall recorded at the Outfall Works was 25.09 inches, compared with 14.20 inches for the previous year. Approximately 94% of the flow was pumped. The remaining gravity flow is from Wellington College and the Little Sandhurst area and is estimated as follows : Wellington College 8,000,000 gallons Little Sandhurst ... ... 3,000,000 gallons Total 11,000,000 gallons A considerable reduction in sewer flushing was effected during the year owing to the increased flow rendering many sections of sewer self-cleansing. 328,000 gallons of Company’s water were used for this purpose as against 575,000 gallons for the previous year. The new Sludge Digestor, particulars of which were given in the Report for last year, has functioned satisfactorily after the initial difficulty in seeding the raw sludge. During the year 2,286,300 cu. ft. of sludge gas was produced and a considerable surplus of gas was available over and above that consumed for heating the digestion tank. The resulting digested sludge dried satisfactorily and without odour and 38 drying beds were filled, this showing a reduction of 39% in the number of fillings in the corresponding period for 1937 prior to the installation of the digestion tank. 400 cubic yards of dried sludge was produced and the bulk of this was disposed of to local farmers free of charge. The only alteration to the equipment of the Pumping Stations consisted of the substitution of electrically operated floatless pump control at No. 6 Station in place of the existing float operation. It is satisfactory to be able to record that not a single complaint of nuisance has been received and the initial troubles experienced at this Works due to excessive odour appear now to have been definitely overcome. WINKFIELD. This sewerage scheme was completed and connections to the sewer commenced in October, 1937, and a full description of the scheme was included in the Annual Report for that year. At the end of the year there were 342 connections to the sewers serving 588 properties with an estimated population of 2,352, and as the sewers at present laid serve 632 houses with an estimated population of 2,500 it will be seen that connection work has now been substantially completed. The work of concreting the banks of the sludge drying beds has been completed and the road at the Works and the majority of the paths have been repaired and surface dressed with tar and shingle. Approximately 2| acres of the Outfall Works site has been cleaned, ploughed and cultivated and sown down to oats and a subsidy payment has been received in connection with the Government Scheme for ploiighing up of grassland. The Works and equipment have been functioning satisfactorily during the year and the effluent produced has been uniformly good. The three samples taken by the Thames Conservancy during the year proved to comply with the Conservator’s standards. The sludge digestion tanks have given excellent results and no difflculty has been experienced in disposing of dried sludge, an estimated quantity of 25 tons having been disposed of to local farmers free of charge. The digestion tanks are, however, working to capacity and it will be necessary to enlarge these tanks if and when further sewer extensions are put in hand. A total flow of 31,919,750 gallons was treated at the Works during the year, the whole of the flow being pumped at the Brockhill Bridge Pumping Station. The plant and equipment at the Pumping Station has given satisfactory service during the year and no major repairs or replace- ments have been necessary. On one occasion the flow exceeded the capacity of the pumping equipment for a short period and it has been decided to fit additional watertight manhole covers along the valley line where necessary to prevent the access of surface water during flooding. « The chlorination of sewage at the Pumping Station has now been discontinued as, owing to increased flow, the sewage arrives at the Pumping Station in a much fresher condition than formerly. It was found that chlorination of the sewage which was carried out for approximately nine hours per day at a strength of 8 parts per 1,000,000 considerably retarded the digestion of sludge in the digestion tanks. The extension to serve Mushroom Castle Lane and 36 new Council Houses was completed during the year at a total cost of £824 7s. 7d. KIVERS AND STREAMS. These were described at some length in the Survey Report for 1930 (page 136) and comments have been added from time to time in the corresponding paragraphs in subsequent Reports, e.g., that for 1934 (page 127). There is nothing further to add to the comments that have already appeared. There were no reports of pollution occurring during the past year. CLOSET ACCOMMODATION. As may be gathered from this and previous Reports, the whole of the Rural District will soon be served by sewers, the only exceptions being outlying areas where the cost is not justifiable. It has not been found practicable to enumerate the different types of closets in use at the end of the year and the former figures are unreliable on account of the sewering now in progress. PUBLIC CLEANSING. There is no scheme of cesspool emptying or emptying of pail closets in operation in the district and this service is not considered necessary at the moment owing to the extensive main drainage schemes undertaken by the Council during the last eight years. A weekly collection of household refuse is in operation throughout the district and the small portion of Owlsmoor previously scavenged by private contract is now being scavenged by the CounciTs vehicle, when the roads are in a safe condition. The disposal of refuse is by controlled tipping at the Longhill Road site, which was purchased last year and the development of this site has continued satisfactorily and without nuisance. It is now impossible to obtain fresh supplies of sleepers and experiments are being carried out with inter-locking concrete blocks to form temporary roads on the tip surface. 9,980 cubic yards of refuse was tipped at the site during the year and all covering material was excavated on the site. It was necessary to purchase a second collection vehicle during the year and after giving trials to two types it was decided to purchase a 10 yard sideloading vehicle manufactured by Messrs. Transport Engineering Co. Ltd., on a Karrier CK3 chassis, the cost of this vehicle being £455. The present collection and disposal arrangements are as follows : Collection by one yard Dennis Sideloading vehicle and one 10 yard " Karrier.’’ Collection Staff: One driver and one loader to each vehicle. Disposal Staff: Two men employed full-time on the tip. It has been possible to man the new lorry without addition to the existing staff and it is now possible to complete collection without incurring overtime or having vehicles on the road during the hours of “ black-out.” Salvage. At tlie request of tlie Ministry of Supply, a scheme of salvage of recoverable materials was put into operation in October commencing with the recovery and separate collection of waste paper. This scheme has now been developed to include other recoverables and materials salvaged and sold include in addition to paper, scrap iron, non-ferrous metals, rags and textiles, bones, jars and bottles. The salvage of tins was tried experimentally, but it was not found possible to carry this out economically, owing to the poor prices ruling for this commodity and the amount of labour involved in collection and loading on rail. Although no material recovered was sold during the year in question, at the time of writing this report. May, 1940, an amount of £100 15s. lid. has been realized from the sale of re- coverables. Prehminary sorting is carried out at the refuse tip and the salved materials are taken to the Bracknell Drainage Works on the last load of each lorry for final baling and sorting, which is carried out by employees at the Bracknell Drainage Works. SANITAKY INSPECTION. The following is a summary of the work performed by the Sanitary Inspectors for the year ended 31st December, 1939 :— Inspections. No. of visits. District Inspections 802 Eeinspections 277 Housing Inspections 192 ,, Eeinspections 371 Infected Houses 41 Slaughter-houses 310 Dairies ... ... ... 105 Cowsheds ... 89 Bakehouses 15 Factories 94 Interviews with Owners ... 134 Drains inspected 627 Visits on complaints 196 Tents, Vans and Sheds 92 Visits to Sewage Works 149 Foundations 106 Inspections during construction ... ... ... ... 621 Drains tested 382 Properties inspected on completion ... ... ... ... 93 Inspection of Council Houses 314 Market Inspections 31 Shops Inspections 29 Butchers'Shops inspections ... ... ... 66 SHOPS AND OFFICES. It was not found possible to carry out systematic inspection of shops and offices in the district during the year, but premises in High Street, Bracknell, taken over by the Head Office of the Inter- national (Tea Co.s’) Stores, Ltd., were dealt with by negotiation with the Company’s Surveyors and a satisfactory conversion was arrived at. CAMPING SITES. In the Keport for 1938 (pages 173-175) an account was given of the Kegulations pertaining to sites that might be used for summer camping in this district. There have been no applications this year. SMOKE ABATEMENT. The only factories in the district hkely to cause smoke nuisance are the brickfields in the Bracknell, Binfield and Winkfield areas, and in no case has it been found necessary to take any action with regard to smoke abatement. SWIMMIMG BATHS AND POOLS. There is one small privately-owned swimming pool situated in Martins Lane, Bracknell, which has now been used for two or three years. It consists of a concrete tank with sloping bottom, about 42 feet in length and 24 feet wide, in garden grounds, with the usual dressing boxes and sanitary conveniences. The pool has been inspected and the arrangements for the purification of the water were found to be satisfactory. DISINFESTATION. No case of infestation of bed-bugs occurred during the year, either in Council houses or other properties, and it was therefore unnecessary to carry out any disinfestation. The condition of the district in this respect is extremely satisfactory. SCHOOLS. A general survey of the Sanitary conditions of the Public Elemen- tary Schools in this District was given in the Report for 1932, at pages 125-126, and supplementary comments have been made from year to year in the corresponding paragraph. A disused house at Lily Hill, Bracknell, and a Parish Hall, Cranbourne, were taken over to provide additional school accommo- dation as a consequence of the Evacuation Scheme. The sanitary accommodation provided at the Hall at Cranbourne by the Education Authority is most unsatisfactory and is the subject of representations from the Council to the Berks County Council as the Education Authority responsible. SANITARY CONDITIONS REQUIRING NOTICE. The need for provision of a Pubhc Convenience in the village of Bracknell and certain extensions of the sewer have been commented upon in this paragraph in previous Reports, but under present conditions these matters must now remain in abeyance. The vacancy caused by one of the three Sanitary Inspectors leaving in August has not yet been filled, and as the Senior Sanitary Inspector is chiefly employed in Surveyor’s and other work arising out of working conditions, the lack of adequate staff is likely to have a prejudicial effect in the future on the standard of sanitary eflS.ciency that has been attained in this District. SECTION D. HOUSING. GENERAL INFORMATION. A summary of the work carried out under the Housing Acts is. given in the table in tbe next paragraph. Plans and Town Planning. The Planning Scheme for the District is still in course of prepar- ation and planning control is exercised under the protection of the Interim Development Order, 1933. New building developments have slowed down considerably since the outbreak of War and the following list gives details of plans submitted during the year under review. Houses and Bungalows ... ... ... ... ... 50 Alterations and Additions 29 Shops 1 Garages, Sheds, Workshops, Barns, etc 25 Estate Lay-outs ... ... ... ... ... ... 15 Electric Cables 6 Two appeals against the decision of the Council under the Interim Development Order, 1933, were the subject of Public Inquiries, the appellant being upheld in each case. The number of new houses built and entered in the rate books during the year are as follows :— By the By Private Rateable Value, Council. Enterprise. Up to £13 Nil 27 £13 to £26 Nil 59 £26 to £35 Nil 1 £35 to £52 Nil 1 £52 to £78 Nil 3 Over £78 Nil 4 95 Council Houses. Tlie construction of tlie 36 new Council Houses at Cliavey Down, Winkfield, referred to in last year’s Annual Report, is now completed and tlie houses were occupied on 18th March, 1940. This new Estate comprises two 5-bedroom houses, eight 4-bedroom, eighteen 3-bedroom and eight 2-bedroom houses, all of non-parlour type, and the development of the site when completed will provide for a playing ground at the rear of the houses. Seventeen of these houses were intended to replace houses scheduled for demolition or for the abatement of overcrowding and the remaining 19 were for general housing needs, but owing to the lapse of time since the scheme was first mooted and also the suspension of the demolition procedure under the Housing Act, it has been necessary to re- allocate the houses in accordance with current needs. HOUSING STATISTICS. The record of work done under the Housing Acts, etc., during the past year is as follows :— 1. Inspection of dwelling houses during the year :— (1) {a) Total number of dwelling houses inspected for housing defects (under Public Health or Housing A-Cts^ ... ... ... ... ... ... 233 (6) Number of inspections made for the purpose ... 384 (2) (a) Number of dwelling houses (included under sub- head (1) above) which were inspected and recorded under the Housing (Consolidated) Regulations. 1925, and Amendment Regulations, 1932 ... 192 (6) Number of inspections made for the purpose ... 223 (3) Number of dwelHng houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation ... ... ... ... ... 9 (4) Number of dweUing houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation ... 61 2. Remedy of defects during the year without service of Formal Notices :—• Number of defective dwelling houses rendered fit in conse- quence of informal action by the Local Authority or their officers 53 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 ... ... ... ... 2 (2) Number of dwelling houses which were rendered fit after service of formal notices : {a) By Owners 2 (b) By Local Authority in default of Owners ... Nil B. Proceedings under Public Health Acts : (1) Number of dwelhng houses in respect of which notices were served requiring defects to be remedied ... 2 (2) Number of dwelling houses in which defects were remedied after service of formal notices : {a) By Owners 2 (6) By Local Authority in default of Owners ... Nil c. Proceedings under Sections 11 and 13 of the Housing Act, 1936 : (1) Number of dwelling houses in respect of which Demo- htion Orders were made ... ... ... ... 1 (2) Number of dwelling houses demolished in pursuance of Demohtion Orders ... ... ... ... ... 1 D. Proceedings under Section 12 of the Housing Act, 1936 ... Nil ^ Housing Act, 1936. Part lY.—Overcrowding Nil SECTION E. INSPECTION AND SUPERVISION OF FOOD. Milk Supply. Owing to shortage of staff and pressure of urgent work arising from the present emergency it has not been possible to carry out the usual routine inspections of cowsheds and dairies in the District. The total number or registered premises is 72 and there are 11 producers of Accredited and 6 producers of Tuberculin Tested Milk. One Supplementary bottling licence for Tuberculin Tested Milk was issued for new premises erected in Bracknell and two dealer’s licences for the sale of Pasteurised Milk were issued. Meat and Other Foods. Ten licences have been issued in respect of nine slaughter-houses and one knacker’s yard under the Food & Drugs Act, 1938, but none of the slaughter-houses is now in use as under the Government Scheme for centralized slaughtering all meat intended for this District is slaughtered at Windsor or Maidenhead. The Scheme of centralized slaughtering has been strongly criticised by local butchers, as all cattle, sheep and pigs purchased at Bracknell Market are taken a distance of seven miles to Windsor for slaughtering and brought back to this District for distribution. Some cases of decomposition of meat owing to defective methods of handling and waste of time in delivery have already been discovered and it is feared that this trouble will increase in the summer. The routine inspection of meat and other foods in shops is being continued and the total number of premises requiring registration under Section 13 of the Food and Drugs Act, 1938, is 200. The following table shows the number of carcases inspected and all meat condemned was surrendered voluntarily and disposed of by the Council. Carcases Inspected and Condemned. Cattle excluding Cows Cows Calves Sheep and Lambs Pigs Number killed (if known) ... — — — — — Number inspected 79 — 58 302 463 All diseases except Tuberculosis, Whole carcases condemned Carcases of which some part or organ was condemned ... Percentage of the number inspected affected with dis- ease other than tuberculosis _ _ . . , . , 2 — •— — — 2.53 - Tuberculosis only. Whole carcases condemned Carcases of which some part or organ was condemned ... Percentage of the number inspected affected with tuber- culosis — — — — 2 1 — — — 9 1.26 — — 2.38 Weight condemned 471bs. — — — 2151bs. SECTION F. INFECTIOUS DISEASES. GENERAL INFORMATION. As usual, Scarlet Fever and Diplitlieria give the highest numbers amongst the notifiable infectious diseases, there being 13 of the former and 15 of the latter in the course of the year. For more than five years previously the notifications of Diphtheria in this District have not reached double figures, the annual average being about 7. The present number (15) is enhanced by 10 cases of carriers and mild clinical cases notified from The Forest Sick Bay, where the disease was introduced in November amongst the evacuees accommo- dated there for minor ailments ; thus, only 5 cases occurred amongst the native population. All of these, except one local case, were removed to the Maidenhead Isolation Hospital, and there were no deaths. The Scarlet Fever cases, namely 12, as against an average of about 32 per annum during the previous five years, hardly call for comment, as they were all of a mild type and occurred at odd times in different places. The new Order making Measles and Whooping Cough notifiable produced 24 notifications of the latter disease—16 of them at a Residential School—during the last quarter of the year. The odd cases of other notifiable diseases are enumerated in the Statistical Tables that appear below. NOTIFIABLE DISEASES. The following tables give the chief statistics relating to these diseases. Table I. Notifiable Diseases during the Year, 1939. (other than Tuberculosis,) Disease. Total Cases ad cases mitted to Cerebro-spinal Fever notified. Hospital. 0 0 Dysentery 0 0 Diphtheria 15(10) 14 Encephahtis Lethargica 0 0 Enteric Fever (including Typhoid Paratyphoid) and 0 0 Erysipelas 6 2 Malaria 0 0 Ophthalmia Neonatorum 0 0 Pneumonia 4 0 Poliomyelitis 2(1) 0 Puerperal Fever 0 0 Puerperal Pyrexia 1 0 Scarlet Fever 13 10 Smallpox 0 0 Whooping Cough 24 (16) 0 Total Deaths of notified cases. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 The figures in brackets ( ) refer to cases occurring in an institution and are included in the preceding number. Table II. Age in Years of Notified Cases, 1939. Disease. Years 0- 1- 2- 3- 4- 5- 10~ 15- 20- 35- 45- Diphtheria Erysipelas Pneumonia Poliomyehtis Puerperal Pyrexia Scarlet Fever Whooping Cough... -----7 6 - - ---1-1 - - 1 ______ _ 1 1 - - - 1 - 7 - 3 1 2 - 1 2 1 7 10 1 - 2 - - 1 5 - - 1 - - 1 - Table III. List op Infectious Diseases for the Five Years 1935-1939. Disease. 1935 1936 1937 1938 1939 Cerebro-spinal Fever 0 0 0 1 0 Dysentery 0 0 0 1 0 Diphtheria ... 9 7 8 7 15 Encephalitis Lethargica 0 0 0 0 0 Enteric Fever (including Typhoid and Paratyphoid) 0 0 0 0 0 Erysipelas 5 0 3 1 6 ^^lalaria ... ... ... ... 0 0 0 0 0 Ophthalmia Neonatorum 0 1 0 1 0 Pneumonia ... 12 26 14 12 4 Poliomyelitis 1 0 1 11 2 Puerperal Fever 0 0 1 0 0 Puerperal Pyrexia 1 1 0 3 1 Scarlet Fever 16 20 59 33 13 Smallpox 0 0 0 0 0 Whooping Cough* — — — — 24 Not notifiable, until October 1939. Table IV. Infectious and Other Diseases in Schools. Children No. affected on including School. Roll. Disease, Date. contacts. Binfield C.E. 157 Impetigo Dec. 1 Nits Dec. 2 Binfield Junior 42 Ringworm April 1 C.E. Scarlet Fever April 1 Crowthorne C.E. 241 Impetigo July 1 Mixed Mumps Feb., Mar., Apr. 109 May, June, July Poliomyelitis Jan. 2 Whooping Cough July 1 Crowthorne Broad- 109 Chickenpox Nov. 1 moor Council Mumps Jan., Feb., Mar., 21 Apr., May, June 3 Whooping Cough June Easthampstead C.E. 40 Nil. Easthampstead 221 Chickenpox April, Nov. 4 Priestwood Council Impetigo Dec. 1 Mixed Measles June 1 Whooping Cough Nov., Dec. 20 School. No. on Roll. Disease. Children affected including Date. contacts. Easthampstead ... 86 Whooping Cough March 1 Priestwood Council Infants Sandhurst C.E. 81 Diphtheria Sept. 3 Mumps Mar., Apr., May 20 June Sandhurst, Lower 263 Nil. Sandhurst Council Sandhurst Methodist 105 Diphtheria June, Oct. 2 German Measles June 1 Mumps Jan., Feb. 3 Scarlet Fever Jan. 1 Sore Throat June 1 Warfield C.E. 167 Chickenpox Nov. 6 Junior Diphtheria Nov. 1 German Measles May, June 20 Ringworm Jan. 1 Scabies Oct. 1 Winkfield, Ascot 94 Chickenpox Nov., Dec. 15 Heath C.E. Boys Impetigo July 1 Scabies Oct. 5 Winkfield, Ascot 181 Chickenpox Jan., Feb., June 18 Heath C.E. Girls Nov., Dec. Conjunctivitis Dec. 1 Impetigo Jan., Mar., Aug. 5 Oct., Nov. 5 Mumps March 1 German Measles Aug. 2 Pink eye May 1 Scarlet Fever Oct., Nov. 8 Sore Throat Oct. 4 Whooping Cough Jan., Feb. 23 Winkfield, Bracknell 224 Chickenpox Aug., Sept., Oct. 43 Council Nov., Dec. German Measles June, July, Sept. 15 Impetigo Apr., Oct., Nov. 12 Dec. Measles June 2 Whooping Cough March 20 Winkfield, Cran- 183 Nil. bourne Council Winkfield, St. 106 Whooping Cough March 15 Mary’s C.E. TUBEECULOSIS. It was not necessary to take any specific action under the Public Health (Prevention of Tuberculosis) Eegulations, 1925 (compulsory discontinuance of employment) or under Section 62 of the Public Health Act, 1925 (compulsory removal of patients to institutions). Particulars of new cases of tuberculosis and of all deaths from this disease, whether the cases have been notified or not during the current year, are set out in the table below. Age Periods. New Cases. Pulmonary. Non-PuVy. Deaths. Pulmonary. Non-PuVy. M. F. M. F. M. F. M. F Under 1 year — — — — — — 1— 5 years — — — 2 — — — — 5 15 „ — — — 4 — — — — 15—25 „ 1 1 — 1 — — — — 25 35 „ 1 4 1 — 1 1 — — 35—45 „ — 1 — — — 1 — — 45—55 „ 1 — — — 1 — — — 55—65 „ — — — — 1 — — — 65 and over — — 1 — — — — Totals 3 6 2 7 3 2 — — Percentage of non-notified cases amongst total fatal cases—Nil. OTHER SPECIAL DISEASES. Cancer. There were 33 deaths from cancer (14 males, 19 females) during the past year. Calculated per 1,000 of population the Cancer Death Rate for 1939 is 1.64, while the average for the past ten years is 1.47. Eor the previous year the figures were respectively 10 males, 16 females, total 26, and rate 1.35. The facilities provided by the neighbouring hospitals appear to be adequate for treatment so far as they are called for and no special propaganda work has been undertaken. Blindness. There was no notification of Ophthalmia Neonatorum this year. Work in connection with the care of the Blind is undertaken by the County Authotiry. Other. The other comparatively rare notifiable diseases that were notified during the year comprised 2 cases of Anterior Polio-myelitis, with no deaths. Windsor Rural Sanitary District SECTION A. GENERAL STATISTICS. Area (in acres) 8,665 Registrar General’s estimate of— (a) Resident population at middle of 1939 9,155 (b) Average population appropriate to calculation of Death. Rate ... ... ... ... ... 9,821 Number of inhabited houses according to Rate book at end of 1939 2,398 Rateable Value, 1st April, 1940 £112,723 Sum represented by penny Rate ... ... ... ... £446 SOCIAL CONDITIONS AND UNEMPLOYMENT. A considerable portion of this District is taken up by Crown Land, e.g., Windsor Forest, and much of the remainder by large private estates, especially in the neighbourhood of Ascot. The District is therefore residential rather than agricultural in nature. In the Report for 1925 (page 121) an analysis of, and comment upon, the Census Returns was given showing the nature of employment and general social characters of the District. Enquiry at the local Labour Exchange shows that there is very little unemployment in this neighbourhood. T • -o- xi. r Legitimate Live Births I EXTRACTS FROM VITAL STATISTICS FOR THE YEAR 1939. Total. oo >•« ••• ••• 4 !*• ••• ••• JL. Still-births ... ... ... ... ... 8 D eaths ... ... ... ... ...117 Live Birth Rate per 1,000 of the estimated resident population Still-birth Rate per 1,000 total (live and still) births Death Rate per 1,000 of the estimated resident population Males. Females. 53 2 3 56 35 2 55 61 9.61 83.33 11.91 Deaths from Puerperal Causes :— Rate per IflOO total {live and Deaths. still) births. No. 29. Puerperal sepsis ... 0 Nil No. 30. Other puerperal causes ... 0 Nil 1 -A. yj ucvi. ••• •** ••• ••• ••• 0 Nil Death Rate of Infants under 1 year of age All infants per 1,000 live births • • • 22.22 Legitimate infants per 1,000 legitimate live births 11.63 Illegitimate infants per 1,000 illegitimate live births 250.00 Deaths from Other Causes :— Cancer (all ages) 25 Measles (all ages) ... 0 • • • • • • w Whooping Cough (all ages) ... 0 • * • • • • Diarrhoea (under 2 years of age) ... • • • • • • Unusual or Excessive Mortality :— There were 25 deaths from Cancer this year (12 males and 13 females), which gives a death rate from this cause of 2.55 per 1,000 population. In the previous year the corresponding rate was 1.51, while, taken over the preceding ten years period, it was 1.46. POPULATION. The population of this District as estimated year by year by the Registrar-General shows comparatively little fluctuation and remains round about 9,500. For the year 1939 the Registrar-General gives two figures, namley, (a) 9,155 to represent the mid-year population upon which Birth Rates are calculated ; and (6) 9,821 upon which Death Rates and the Incidence of Infectious Disease are calculated. The population as enumerated at Census Periods was : 1901 8,103* 1921 9,690 1911 9,014* 1931 9,868 The estimated population for 1938 was 9,326. *Exclusive of the Parish of Clewer Without, which was incor- porated with the Borough of Windsor on the 9th day of November, 1920. BIRTHS. This year the Registrar-General has supplied two sets of figures to represent the Births attributable to this District, {a) the smaller for the purpose of calculating the local Birth Rate ; and (h) the larger for calculating Infant and Maternal Mortalities. These are given in the columns marked (a) and (6) respectively in the following Table. Births Table. 1939. Male. Female. Total {a) (h) (a) (h) (a) {h) Legitimate Births 51 51 33 35 84 86 Illegitimate Births ... 2 2 2 2 4 4 Total Live Births 53 53 35 37 88 90 Total Still Births Total Registered Births (Live and Still) 3 56 5 40 8 96 The Total Birth Rate (Live and Still) works out at 10.49 per 1,000 population and the Live Birth Rate (Live Births only) at 9.61 per 1,000 of population. DEATHS. As has been explained in previous Reports, the gross number of deaths registered locally has to be corrected for residents dying elsewhere (inward transfers) and for non-residents dying in Insti- tutions, etc., in the District (outward transfers), also, in order to make Death Rates in different districts comparable a correcting factor is applied to the death rate to compensate for age and sex differences in the population, the result is known as the Standard Death Rate. The net number of deaths attributed to this District is 117, comprising 56 males and 61 females. The Net Death Rate works out at 11.91 which, multiplied by the Comparability Factor (0.84) gives a Standard Death Rate of 10,00. For the previous year the Net Death Rate was 10.83, while the average for the past ten years is 10.94. The principal causes of death in this District during the past five years are :— Disease. 1939 1938 1937 1936 1935 1. Cancer ... ... ... ... 25 14 14 20 18 2. Heart Disease 40 38 32 20 29 3. Despiratory Diseases (Pneumonia, Bronchitis, etc.) 2 6 8 15 7 4. Influenza 0 1 6 0 0 5. Diseases of the Blood Vessels ... (including Cerebral Haemorrhage) 16 11 11 12 11 6. Disease of the Kidneys 3 2 '“2 2 ■5 7. Disease of the Digestible Organs 7 3 6 7 11 8. Tuberculosis (all forms) 6 6 4 2 3 9. All other infectious diseases ... 2 1 0 3 2 10. Suicide ... ... ... ... 0 0 2 0 1 11. Accidents, etc. ... 3 5 4 5 3 12. Senile Decay 8 6 6 3 1 INFANT AND MATEKNAL MOKTALITY. As in previous years Infant Mortality in Windsor Dural District is remarkably low ; out of a net total of 90 live births, there were only 2 deaths, there being 3 out of 112 in the proceeding year. In addition there were 8 still-births (none of which was an illegitimate child) as against 3 in 1938. The respective rates work out as follows : All infants per 1,000 hve births ... ... ... ... 22.22 Legitimate infants per 1,000 legitimate live births ... 11.63 Illegitimate infants per 1,000 illegitimate live births ... 250.00 Still-births per 1,000 total (live and still) births ... 83.33 Infant Mortality Date (average for past ten years) ... 36.13 The causes of, and age at, death of the infants referred to are set out in the following table :— Cause of Und. 1-2 2-3 3-4 1-3 3-6 6-9 9-12 Total Death. 1 wk. whs. whs. whs. mths. mths. mths. mths. Asphyxia 1 — — — — — — — 1 Prematurity 1 — — — — — — — 1 Totals 2 — — — — — — — 2 Maternal Mortality. There were no deaths this year arising from causes connected with child birth, the Maternal Mortality Date is therefore—Nil, SECTION B. GENERAL PROVISION OF HEALTH SERVICES. PUBLIC HEALTH OFFICERS. There is one whole-time Officer (W. H. Rowsell, West Lodge, Heather Drive, Snnningdale. Tel. Ascot 663), who holds the combined appointments of Sanitary Inspector and Building Surveyor for the whole District and who is also Superintendent of Scavenging for the parish of Old Windsor. The supervision of the CounciFs Sewerage Works and Scavenging Scheme for the two other parishes, Sunninghill and Sunningdale, is undertaken by E. J. Toy Mascal," Ascot. Tel. Ascot 357). LEGISLATION IN FORCE. A full list was published in the Annual Report for 1937, pages 190-192, of the Adoptive Acts, Byelaws and Regulations in force in this District previous to the Public Health Act (1936) coming into operation and the modification thereby effected was noted. The revision of the CounciFs Byelaws in respect to New Buildings, referred to in Section B of last year’s Report, was duly confirmed by the Minister or Health on May 24th of this year. The Minister’s attention was called to several clauses in the Model Series, which were deemed to be unsatisfactory, but in only two instances, a modified form of the CounciFs suggestions was allowed. The following information is required by the Public Health Act, 1936, Section 70, to be appended to the printed copies of Byelaws to be kept open for inspection and furnished to applicants. Sub-section (1) (a).—No Urban Powers under the Act of 1936 by reason of provisions of earlier Acts having been iffioperation. Sections 263 and 264 were put into force in the whole District by the Windsor Rural (Urban Powers) Order, 1938, on 13th April, 1938. Sub-section (1) (6).—Section 15 of the Public Health Acts Amend- ment Act, 1907, was put into operation in the whole District on 11th September, 1914, by Order of the Local Government Board dated 23rd July, 1914. Sub-section (1) (c).—No local Acts in force within the meaning of this paragraph. LABORATORY FACULTIES. The laboratory facilities are the same for this as for the other Districts in the combination, and are described under the appropriate heading in the Preface of previous Reports, where a list of Special Clinics, Consultants, etc., will also be found. A statement of specimens examined, analyses made, etc., is given below. Material. Positive. Negative. Total. Swabs for Diphtheria • • • • • • 6 6 Sputum for Tubercle * • • • • • 1 1 2 Blood for Typhoid ... • • • • • • 0 0 0 Other Specimens 2 1 3 3 8 11 Official milk sampling is done by the County PoHce, and in the course of the year 12 samples were taken, one of which was low in non-fatty solids. Sampling of other foods and drugs is done by the Inspectors of the County Weights and Measures Department. The following samples, all of which proved to be genuine, were taken during the past year : Anchovy Paste ... ... 1 Pork Sausages ... ... 1 Beef Saugases ... ... 1 Tinned Apricots ... 1 Bloater Paste 1 Tinned Pilchards ... I Chicken and Ham Paste 1 Tinned Pineapple ... 1 Ham and Tongue Paste 1 Tinned Salmon ... 1 Samples of water for drinking and domestic purposes are taken by the Sanitary Inspector. Four samples of water supplies were taken during the year and all proved satisfactory. Reports were received on 18 samples taken by other Authorities under the Six Districts Agreement ” (see para- graph on “ Water Supply including four samples taken in this District. These were all satisfactory. AMBULANCE FACILITIES. There is no local ambulance. For the removal of patients the ambulance belonging to the Hospital to which the patient is to be removed is employed. In case of emergency the St. John Ambulance stationed at Bracknell would be available on apphcation to : Supt. W. Green, Dublin Cottage, Binfield Road, Tel. Bracknell 27. Bracknell. HOME NURSING. TREATMENT CLINICS. HOSPITALS AND NURSING HOMES. MATERNITY AND CHILD WELFARE. These Services remain the same as described in the previous year’s Report at page 201. SECTION C. SANITARY CIRCUMSTANCES. WATER SUPPLY. A description of the Water Supply in this District was given at length in the Report for 1937 at page 94, which need not be repeated as the conditions remain unchanged, and further comments were added in the Report for 1938 at page 202. The chief source of supply if from the public mains of the South-West Suburban Water Company. By an arrangement with the six Districts in this neighbourhood on the same supply, samples from service pipes are taken periodically in rotation and the results of the analyses circulated. During the past year 22 of these samples were reported upon, including four from this District. All were satisfactory. DRAINAGE AND SEWERAGE. The drainage and sewerage of this District has been fully described in previous Reports under this heading and need not be repeated. The following report for 1939 has been received from Mr. E. J. Toy, Works Manager and Sanitary Superintendent. “ Mascal," Ascot. To Dr. J. J. Paterson, Medical Officer of Health. Dear Sir, There has been very little building in the District during 1939 and the total number of houses connected to the sewer is now 1,699 as compared with 1,685 a year ago. This total includes 81 houses outside the District, for which an annual charge is made by the Coucnil. The sewage all gravitates to the Pumping Station at Blacknest near the Western end of Virginia Water and is from there pumped to the Outfall Works half-way between Ascot and Bracknell, a distance of 4J miles with a rise of 120 feet. The rainfall for the year as registered at the Meterological Society’s gauge at the Pumping Station amounted to 29.39 inches, 3.39 inches above the average and an increase of 60 per cent, over that of the exceptionally dry preceding year. This had its effect upon the total amount of sewage dealt with, which rose from just under 94 miUion gallons in 1938 to 115,948,214 gallons in 1939. The greatly increased population of the District owing to the large number of Government and private evacuees also had a considerable bearing upon the total, and since September the plant at the Outfall Works has been working to full capacity, whilst at times of heavy rain a considerable strain has been placed upon the rising main ; the dry weather flow has increased from 260,000 gallons per diem to about 340,000 gallons. The monthly totals were as follow : January ... 12,616,409 July ... 8,129,333 February 8,224,653 August 7,506,218 March ... 8,270,952 September 9,303,118 April ... 8,499,173 October 11,036,293 May 8,603,204 November 14,067,436 June ... 8,051,989 December 11,639,436 The gas used in driving the powerful plant at the Pumping Station is made at the Station and the plant is very economical, as the cost of the anthracite coal used for the gas generation was only one penny for each 2,080 gallons of sewage pumped to the Outfall Works in 1939 ; each pound weight of coal was sufficient for 668 gallons. The total anthracite used during the year being 77J tons, costing £232. The gas plant was working for 8,124 hours and pumping was almost continuous night and day. Mr. C. Castle and his staff continue to keep the buildings and plant in first-class order. At the Outfall Works, in spite of the larger flow, Mr. F. Wallace, the Manager, continues to produce an effluent which is perfectly satisfactory to the Thames Conservators’ Inspectors. (Signed) EDMUND J. TOY, Manager. RIVERS AND STREAMS. The rivers and streams in this District have been described in previous Reports. They comprise :— (1) The Thames which forms the eastern boundary of the parish of Old Windsor. (2) The Blackmoor Stream which receives the efhuent from the Sewage Works at Whitmoor Bog and flows into the Cut, an artiflcial tributary of the Thames. (3) Virginia Water, a large lake in Windsor Forest adjacent to the receiving and pumping station of the Sewage Works at Blacknest. (4) Englemere Lake situated on the boundary between Ascot and Winkfleld (Easthampstead R.D.) (5) Several small unnamed streams which feed these lakes as well as other ornamental lakes and ponds within the grounds of the large private estates. There have been no cases of pollution reported during the past year. CLOSET ACCOMMODATION. The policy of substituting water carriage Closets for the Conser- vancy system is followed wherever practicable. Following this policy 23 premises were re-drained in 1939, including 14 where earth (pail) closets were in use. This reduces the number recorded in the previous year’s Keport from 60 to 46, so that there are now (approxi- mately) 2,309 premises with Water Closets and 46 with Earth (Pail) Closets. There are no Privies in this District. PUBLIC CLEANSING. Supplementary to what has appeared under this heading in previous Beports, the following account of the past year’s working has been supplied by the Superintendent of Scavenging for the Parishes of Sunninghill and Sunningdale. Wet and Dry Scavenging. About 20 houses which cannot be connected to any of the existing sewers continue to have their cesspools emptied every three weeks ; and the emptier is also used for occasional flushing of the sewers, and also for work outside the district, for which in 1939 charges amounting to £117 were paid to the Council. This machine is now over sixteen years old and the first dust freighter, which is still used three days each week, continues to give good service after eleven years of work. These are, however, kept in good mechanical order by Mr. T. H. Westmacott, the Council’s foreman ; but in spite of every care they are now reaching the end of their long and useful lives. TLe 7 cubic yard D and S ” freigbter bought two years ago is giving good service. The dust tip is still on the site of the marshy ground to the east of the Brockenhurst Road at South Ascot, and the layering and covering method adopted is very satisfactory and does not give rise to complaints by residents in the neighbourhood. Following are the details of the work done during 1939. The fact that occupiers of houses do not have to carry their dustbins to the road on the day the freighter is due to call, adds considerably to the cost of collection. Wet Scavenging. No. of cesspools emptied in Ascot, Sunninghill and Sunningdale and outside the District • • • • • • 281 No. of loads of approx. 1,000 gallons each • • • • • • 355 Weekly average of pail closets dealt with • • • • • « 6 Total cost of wet scavenging « • • • • • • £293 Dry Scavenging. Old lorry. New lorry. Mileage covered 2,575 5,542 No. of loads taken to tip 156 1,232 Bulk of ditto, in cubic yards 795 8,624 Weight of ditto, in tons 260 2,464 Loads of sand for covering 330 — Total cost of dry scavenging • • • • • • ... £1,408 (Signed) EDMUND J. TOY. With regard to scavenging in the parish of Old Windsor, this is now under the superintendence of Mr. W. H. Rowsell, Sanitary Inspector, and is carried out partly by the CounciFs employees (wet scavenging) and partly by a private contractor (dry scavenging), who is under obhgation to find a satisfactory disposal site. This arrange- ment can hardly be deemed satisfactory, but as the Council has so far been unable to acquire a site for controlled tipping it must continue. In May, 1937, a regular weekly collection of house refuse through- out the year was substituted for the weekly collection during summer months and fortnightly during winter months. Negotiations with an adjoining Local Authority regarding the burning in their incinerators of the collected dry refuse were con- cluded at the end of the year 1938 by an offer to burn for three years. at 5s. per ton. Alternative revised Scavenging schemes were sub- mitted in detail to the Council in June, 1938, and January, 1939, the final decision being to continue the existing scheme, but to make additional payment to the dry refuse contractor for the provision and maintenance of proper collecting vehicles. Owing to the War, it has not been possible to give full effect to the provisions, but a compromise has been made by the Contractor providing, without additional payment, an adapted lorry, having a tarpaulin cover. Following receipt of a further Report in December, 1939, the Council agreed to purchase a new dual-purpose refuse collection vehicle for the Parish of Old Windsor. After some delay, due to negotiations with the Parish Council, an order for this additional machine has now been placed. The existing machine was adapted during the year to receive the contents of Closet Pails, thus avoiding the necessity of hiring a horse and cart, with driver, for this purpose. During the calendar year 1939 a total of 1,510,000 gallons of sewage was removed in the course of 2,001 cesspool emptyings and, on an average, 30 pail closets were emptied weekly. As only one cess- pool emptying vehicle of 750 gallons capacity is employed it is practically impossible to keep pace with all the cesspools attached to the 500 odd houses in this parish. SANITARY INSPECTION. The Report of Mr. W. H. Rowsell, Sanitary Inspector for this District, for the year ended 31st December, 1939, is reproduced below. West Lodge, Sunningdale. To Dr. J. J. Paterson, Tel. Ascot 663. Medical Officer of Health. Dear Sir, Following are particulars relating to my duties during the past year :— Summary of Inspections and Re-inspections in connection with : Dwelling Houses (Public Health and Housing Acts) ... ... 309 Drainage work 98 Infectious Disease ... 28 Cowsheds and Dairies 39 Factories and Workshops 14 Shop Premises 32 Slaughter Houses and Butchers’ Shops 85 Food Stores (others) 21 Tents, Vans, Sheds, etc. ... 6 Water Courses 18 Miscellaneous (Interviews, etc.) 120 Notices. One hundred and fifty-one Informal Notices were given during the year (including verbal) and 14 Statutory Notices ; the majority were complied with by the year’s end, but owing to emergency work a complete check has not been possible. Items of Diseepaie, and Nuisances, etc., covered by Notices. Animals improperly kept 2 Damp Walls ... ... ... ... ... ... ... 53 Drains obstructed ... ... ... ... ... ... 12 ,, re-laid (whole systems) 23 Defective Kain Water Gutters and Pipes 10 ,, Brickwork of Walls, etc. ... ... ... ... 41 ,, Unpaved and Undrained Yard Surfaces ... ... 21 ,, or missing sub-fioor Ventilators 10 ,, or missing Dust Bins 14 ,, Firegrates (cooking stoves, coppers, etc.) ... 24 fi+OI-pQ 7 y y O ••• ••• ••• ••• ••• ••• I ,, Windows and Doors (including fastenings, sash- cords, etc.) ... ... ... ... ... ... 39 ,, Floors ... ... ... ... ... ... ... 31 ,, Drainage ... ... ... ... ... ... 11 ,, and insufiicient Cesspool accommodation (houses affected) ... ... ... ... ... ... 21 Factories needing cleansing ... ... ... ... ... 4 Food Premises needing cleansing 11 Foul or obstructed Water Courses 2 Insufficient Light and Ventilation (Rooms) „ or insanitary Sink accommodation ,, means of ventilation in Shops ,, means of maintaining reasonable temperature in Shops Leaky Roofs Lack of suitable and sufficient Water Supply Light and ventilation obstructed Rooms needing cleansing and decorating Untrapped Sink waste pipes Water Closets needing cleansing ,, ,, Apparatus defective Closets unsuitable and/or insufficient ... 27 14 2 Nil 27 5 Nil 139 21 15 16 17 Housing. During 1939, no houses were dealt with formally under Section 11, Housing Act, 1936, due, mainly, to the prevalence of '' emergency conditions,” and intimation from the Ministry of Health, that Demolition and Clearance Orders should be deferred, where possible. In two instances, demolitions carried over from the previous year were completed. Further details appear under '' Housing Statistics.” See also my Report as Building Surveyor. Drainage. Twenty-three premises were re-drained following Informal Notice, in 14 cases Pail Closets were previously in use. New sinks were provided in 6 instances. Meat and Other Foods. Premises where meat and other foods are prepared and sold are regularly inspected and details of these inspections are given in a later paragraph. Milk. Thirty-nine inspections were made during the year, at Farm and Dairy premises. Partial, and complete re-building of Dairy and Wash-house premises, following advice given, was completed in 3 instances. Notice to renew cooling apparatus was given and complied with at 1 Farm. A personal letter is sent to each cow- keeper in April and September, reminding him or her of the require- ments of Article 22, Milk and Dairies Order, 1926, as to Limewashing, etc. Generally speaking the Cowsheds and Dairies within the area are kept in a cleanly condition, and are reasonably well appointed. Factories. Compilation of a Eegister of premises affected by the Factories Act, 1937, was continued in accordance with Section 8 of the Act. 14 inspections were made under the Act, and cleansing was called for in 4 instances. Shops Act, 1934. For details of work under this heading, see special paragraph. Infectious Disease. With a view to determining the source of infection, and preventing the spread of Infectious Disease, enquiries were made concerning all notified cases. In 3 cases repair as well as cleansing of premises was called for. Disinfection of rooms and contents was carried out as under: After Scarlet Fever ... 8 (rooms). After Tuberculosis 10 (rooms). After Diphtheria ... 3 (rooms). (Signed) W. H. KOWSELL, Sanitary Inspector BUILDING SUKVEYOE’S EEPOET, 1939. The following is a summary of my work as Building Surveyor during the year ended 31st December, 1939 :— Plans deposited during 1939. Approved. Rejeeted. New Buildings 26 ... 8 Alterations and Additions ... ... 15 ... 2 Change of User 3 ... 4 Drainage 11 ... 0 Lay-out 2 ... 0 Inspections made ... ... ... ... 231 In 2 instances plans were referred to the Panel of Architects and their suggestions were adopted by the persons developing the Estates concerned. The repair and maintenance of 88 houses (comprising five Schemes) and 6 individual properties, owned by the Council, entails fairly constant supervision, and the investigation of many complaints, not all of which are justifiable. Repairs and decorations are, as far as possible, carried out on the basis of periodical surveys, for internal and external work at each house. This involves considerable inspectorial work, and the preparation of specifications, invitation of tenders, etc., but it is deemed to be a fairer and more economical procedure than haphazard response to complaints from tenants. During 1939, the following maintenance work was completed : External Painting at 52 houses. Making up and surfacing private road to 12 houses. Erection of boundary wall and fence to 12 houses. Paving of yard and path surfaces at 12 houses. Renewal of gutters to lead flat over Blacknest Pumping Station. Repairs and re-decorations at Warren House and Oakridge Bungalow, Bracknell. (Signed) W. H. ROWSELL, Building Surveyor. SHOPS AND OFFICES. Thirty-two inspections were made of premises under the Shops Act, 1934. The requirements of the Act as to Ventilation, Temper- ature and Sanitary Accommodation, are now generally observed in the District. In 2 cases, following prolonged correspondence and service of Statutory Notice under Section 10, means were provided for maintaining a reasonable temperature. General means of heating have not been called for in this District in the case of Meat or Fish Shops. The Shops Register now contains particulars of 72 premises. CAMPING SITES. There are two sites within the District occupied from time to time by moveable dwellings. In one case the dwelhngs comprise caravans used in connection with a travelling circus, the caravans themselves being therefore not subject to licence under Section 269 of the Public Health Act, 1936. A licence for the site was granted in 1938. In , the second case, an occasional caravan is sited in a large car park which has been laid out for use during Ascot Race Week. A licence has not yet been applied for in this instance, as negotiations are in hand for the erection of a cinema on the site. Both sites are provided with water from the public supply and sufficient sanitary accom- modation is available. SMOKE ABATEMENT. Improvement has been effected in the one case of smoke emission at Ascot, referred to in the Report for 1938, by the introduction of electrical power. Coal fired boilers are still in use, but the “ load ” has been considerably reduced. Complaint of “smoke and fumes” from plant at a pig farm at Old Windsor, has been investigated, and the owner advised that unless greater care is taken in the use of the plant, formal action to secure the abatement of the nuisance will be instituted. SWIMMING BATHS AND POOLS. There are no Public Swimming Pools in this District; there are, however, private ones in connection with St. George’s School, High Street, Ascot, and Earleywood School, Sunninghill. SANITARY CONDITIONS REQUIRING NOTICE. (1) Public Sewers.—Parish of Old Windsor. (See paragraphs 19 and 26 of Report for 1937.) No action has been taken in this matter. (2) Office Accommodation and Staff ioi Sanitary Inspector, Building Inspector and Superintendent of Scavenging for Old Windsor. (See paragraph 26 (2) of Report for 1937.) This matter is now receiving consideration. (3) Clearance Areas.—No further action has been taken in this matter. SECTION D. HOUSING. GENEEAL INEOEMATION. HOUSING STATISTICS. Tlie following is a statement of tlie Sanitary Inspector under tlie Housing and Public Health Acts during the past year :— 1. Inspection of dwelling houses during the year :— (1) (a) Total number of dwelling bouses inspected for housing defects (under Public Health or Housing Acts) ... ... ... ... ... ... 69 (6) Number of inspections made for the purpose ... 251 (2) (a) Number of dwelling houses (included under sub- head (1) above) which were inspected and recorded under the Housing (Consohdated) Eegulations, 1925, and Amendment Eegulations, 1932 ... 53 (h) Number of inspections made for the purpose ... 170 (3) Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation ... ... Nil (4) Number of dwelhng houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation ... 65 2. Remedy of defects during the year without service of Formal Notices :— Number of defective dwelling houses rendered fit in conse- quence of informal action by the Local Authority or their ofiicers 47 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 9 (2) Number of dwelhng houses which were rendered fit after service of formal notices : (a) By Owners 5 (b) By Local Authority in default of Owners ... Nil B. Proceedings under Public Health Acts : ... ... ... Nil c. Proceedings under Sections 11 and IS of the Housing Act, 1936 : (1) Number of dwelling bouses in respect of wbicb Demo- lition Orders were made ... ... ... ... Nil (2) Number of dwelling bouses demolished in pursuance of Demolition Orders 2 4^ D. Proceedings under Section 12 of the Housing Act, 1936 ... Nil 4. Housing Act, 1936. Part IV.—Overcrowding. (i) Number of cases of overcrowding relieved during tbe ^ear ... ... ... ... ... ... ... 2 (ii) Number of persons concerned in sucb cases ... ... 11 SECTION E. INSPECTION AND SUPERVISION OE FOOD. MILK SUPPLY. The particulars relating to the production and sale of milk in this District are summarised below :— Wholesale Producers 1 Retail Producers ... ... ... ... ... ... 6 Retail Purveyors (including Retail Producers) ... 10 Retailers (Milk Shops, etc.), excluding Purveyors ... 3 Accredited. T.T. Pasteurised. No. of Producers licensed ... 1 — — ,, ,, Retailers licensed ... ... — 4 1 ,, ,, Distributors licensed ... ^— — — Contraventions of Milk and Dairies Order, 1936 : Discovered 2 Remedied ... ... ... ... ... ... ... 2 Contraventions of Public Health Acts : Discovered ... ... ... ... ... ... ... Nil Remedied ... ... ... ... ... ... ... Nil Number of Inspections 39 There are 7 dairy farms in this District, of which 1 is licensed for “ Accredited ” milk. One notification of a suspected case of Anthrax at a farm in Sunningdale was received on 28th November, the diagnosis was not confirmed and the Notice subsequently withdrawn. Twelve official samples of milk were taken by the Police, one of which proved to be low in non-fatty solids. MEAT AND OTHER FOODS. There are 5 Registered Slaughter-houses and 6 Bakeries in the District. The premises are reasonably well maintained. Only 3 of the slaughter houses are in regular use. The quality of the animals slaughtered is of a regularly high standard. No whole carcases were condemned during the year. Arrangements have been made at each of the slaughter houses for a record to be kept of all the animals slaughtered during any one year. in compliance with the Ministry of Health Circular 1650. Thirteen visits were made in connection with occasional killing by cottagers. 106 inspections were made at premises where food is prepared or stored, including Slaughter-houses and Butchers’ Shops. In no instance was statutory action necessary to ensure compliance with the 11 Informal Notices given. 30lbs. of herring roe were surrendered and destroyed. There are no Food Stalls or Open Markets within the District. There is only one Fish Frying establishment at Sunninghill, the other in Old Windsor has been abandoned. A reasonable standard of cleanliness is maintained. Carcases Inspected and Condemned. Cattle excluding Cows Cows Calves Sheep and Lambs Pigs Number killed 108 ■—• 77 703 356 Number inspected 75 •— 70 601 281 All diseases except Tuberculosis. Whole carcases condemned r - - Carcases of which some part or organ was condenmed 3 — — 3 8 Percentage of the number inspected affected with dis- ease other than tuberculosis 4 L , — .49 2.8 Tuberculosis only. Whole carcases condemned — — — — — Carcases of which some part or organ was condemned 2 — — — 6 Percentage of the number inspected affected with tu- berculosis ... 2.6 • — — 2.1 IISTFECTIOUS DISEASES. GENERAL INFORMATION. There is very little to say about the notifiable infectious diseases in this District for the year 1939, except that the total number 16 is the lowest on record. There were 7 cases of Scarlet Fever of the usual mild type, none of which had any connection with each other, 2 cases of Diphtheria and the same number for Erysipelas and Puerperal Pyrexia, 1 each of Pneumonia, Whooping Cough and Polio-encephalitis, the last mentioned being that of a boy of 6 years at The Institution, Old Windsor. There were no deaths from any of these diseases. The usual Statistical Tables relating to them are set out below. Table I. Notifiable Diseases during the Year, 1939. (other than Tuberculosis.) Total Cases ad- Deaths of cases mitted to notified Disease. notified. Hospital. cases. Diphtheria 2 2 0 Encephalitis Lethargica 0 0 0 Enteric Fever (including Typhoid and Paratyphoid) ... 0 0 0 Erysipelas 2 (1) 0 0 Malaria ... 0 0 0 Ophthalmia Neonatorum 0 0 0 Pneumonia 1 0 0 Pohoencephalitis 1 (1) 0 0 Puerperal Fever 0 0 0 Puerperal Pyrexia 2 (2) 0 0 Scarlet Fever 7 (1) 3 0 Smallpox 0 0 0 Whooping Cough ... ... 1 0 0 The figures in brackets ( ) indicate cases which occurred at an institution; they are included in the totals given. Table II. Age in Years of Notified Cases, 1939. Disease. Years 0- 1~ 2- 3- 4- 5- 10- 15- 20- 35- 45- 65-}- Diphtheria Erysipelas Polio-enceplialitis Pneumonia Puerperal Pyrexia Scarlet Fever Wliooping Cougli ________ 1__1 1__ ----23-1---- Table hi. List of Infectious Diseases for the Five Years, 1935—1939. Disease. Diphtlieria ... Encephalitis Lethargica ... Enteric Fever (including Typhoid and Paratyphoid) Erysipelas ... Malaria Ophthalmia Neonatorum Pneumonia ... • Polio-encephalitis ... Poliomyelitis Puerperal Fever ... Puerperal Pyrexia Scarlet Fever Smallpox Whooping Cough* *iVoi notifiable until October, 1939. 1935 11 0 2 2 0 1 6 0 0 0 1 23 0 1936 11 0 1 3 0 0 9 0 0 1 0 10 0 1937 6 0 0 1 0 0 7 0 0 0 0 21 0 1938 20 0 2 4 0 2 7 0 0 0 4 29 0 1939 2 0 0 2 0 0 1 1 0 0 2 7 0 1 Table IV. Infectious and Other Diseases in Schools, 1939. Tlie following is a summary of the diseases affecting school children as obtained from returns sent to the County Medical Officer by the Head Teachers :•— Children No. affected on including School. Roll. Disease. Date. contacts. Old Windsor 79 Chickenpox Feb. 1 Mixed Impetigo Jan. 1 Mumps Feb., April 3 Whooping Cough May 1 Old Windsor 96 Mumps Mar., Dec., Oct. 7 Infants Scabies Oct. 1 Whooping Cough May, June 11 Old Windsor 74 Chickenpox Feb. 1 Park Royal Diphtheria Nov. 1 Whooping Cough Feb. Mar., 2 Sunningdale 145 Whooping Cough Feb. 6 Mixed Sunningdale 61 German Measles Jan. 1 Infants Impetigo April 2 Influenza Feb. 5 Whooping Cough Jan., Feb., Dec. 27 Sunninghill 105 Chickenpox Feb. 4 Infants Whooping Cough Feb., Mar., April May, June 20 Sunninghill 15 Scabies Nov. 2 Cheapside Sunninghill C.E. 188 Impetigo May 1 Mixed Sunninghill 59 Nil St. Francis TUBEKCULOSIS. No action was necessary under the Public Health (Prevention of Tuberculosis) Regulations, 1925, or under Section 62 of the Public Health Act, 1925, relating to discontinuance of employment and compulsory removal. These powers are now incorporated in Sec. 172 of tbeP ublic Health Act, 1936. The following table gives the required particulars of new cases of Tuberculosis and deaths from all forms of that disease during 1939. New Cases. Deaths. Age Periods. Pulmonary. Non-PuVy. Pulmonary. Non-PuVy. M. F. M. F. M. F. M. F. Under 1 year ... — — 1 — — — — — 1— 5 years — — — — — — — — 5-15 „ 2 — 1 — — — — — 15—25 „ — 1 — — — — — — 25—35 „ — 2 1 — — — — — 35—45 „ — 1 — — — — — — 45—55 „ 55—65 „ — 2 — — — — — — 65 and over 1 — — — — — — — Totals 3 6 3 — — — — Percentage of non-notified cases amongst total fatal cases—1 case out of 6==16.6%. OTHER SPECIAL DISEASES. Cancer. There were 25 deaths from Cancer (12 males, 13 females). The cancer death rate works out at 2.55 per 1,000 of population, which is considerably higher than the average rate of 2.06 for the past ten years. For the previous year the figures were 5 males, 9 females, total 14, and rate 1.50. Blindness. No cases of Ophthalmia Neonatorum (infectious inflamation of the eyes of a newly born) were notified this year. Work in connection with the Blind is undertaken by the County Authority. Other. Cases of other and comparatively rare diseases mentioned in the Schedule were entirely absent during 1939. Wokingham Rural Sanitary District. SECTION A. GENERAL STATISTICS. Area (in acres) Register General’s estimate of— {a) Resident Population at middle of 1939 (6) Average Population appropriate to calculation of Deatli Rates ... ... ... ... ... Number of Inhabited Houses according to Rate Book at end of 1939 Rateable Value, 1st April, 1940 £199,362 Sum represented by Penny Rate £787 40,828 26,210 27,730 8,528 SOCIAL CONDITIONS AND UNEMPLOYMENT. The chief characteristic of this District is the number of villages and large country residences which, if grouped together would form an important town, the District is, therefore, less rural in nature than its title suggests. From the Census returns (discussed in previous Reports) the chief occupations are personal service, brick and tile making, building and allied trades and, lately, factory workers. Enquiry at the local offices shows that unemployment is very small in amount, and it may be added that there are no noteworthy causes of sickness or invahdity arising out of occupation or environment. EXTRACTS FROM VITAL STATISTICS FOR THE YEAR, 1939. Total. Males. Females. Live Births f Legitimate 391 200 191 (^Illegitimate 12 7 5 Still-births ••• 13 ♦ « « » • • c/ 9 4 Deaths ••• ••• ••• ... 301 154 147 Live Birth Rate per 1,000 of the estimated resident population 15.37 Still-birth Rate per 1,000 total (live and still) births ... 31.25 Death Rate per 1,000 of the estimated resident population ... 10.85 Rate 'per 1,000 Deaths from Puerperal Causes :— total (live and Deaths. still) Births. No. 29. Puerperal sepsis 1 2.37 No. 30. Other puerperal causes 2 4.74 Total 3 7.11 Death Rate of Infants under 1 year of age :— All infants per 1,000 live births 31.78 Legitimate infants per 1,000 legitimate live births ... 22.67 Illegitimate infants per 1,000 illegitimate live births ... 333.33 Deaths from Other Causes :— Cancer (all ages) 48 Measles (all ages) 0 Whooping Cough (all ages) ... ... ... ... ... ... 0 Diarrhoea (under 2 years of age) 0 Unusual or Excessive Mortality Nil POPULATION. For the year 1939 the Registrar-General gives two figures, namely, (a) 26,210 to represent the mid-year population upon which Birth Rates are calculated ; and (b) 27,730 upon which Death Rates and the Incidence of Infectious Disease are calculated. The population as enumerated at Census Periods was : 1901 14,386 1921 18,469 1911 16,652 1931 20,268 The estimated population for 1938 was 25,210. Notes on the alteration to this and neighbouring Districts will be found in the Report for 1935, at page 8. BIRTHS. This year the Registrar-General has supplied two sets of figures to represent the Births attributable to this District, {a) the smaller for the purpose of calculating the local Birth Rate ; and (6) the larger for calculating Infant and Maternal Mortalities. These are given in the column marked {a) and (h) respectively in the following Table. Births Table. 1939. Male. Female. Total. (a) (h) (a) (h) (a) (6) Legitimate Births 200 202 191 195 391 397 Illegitimate Births 7 7 5 5 12 12 Total Live Births 207 209 196 200 403 409 Total Still Births 9 4 13 Total Registered Births 216 200 416 (Live and Still) The Total Birth Rate (Live and Still) works out at 15.87 per 1,000 population, and the Live Birth Rate (Live Births only) at 15.37 per 1,000 of population. DEATHS. As has been explained in previous Reports, the gross number of deaths registered locally has to be corrected for residents dying elsewhere (inward transfers) and for non-residents dying in Insti- tiutons, etc., in the District (outward transfers) ; also, in order to make Death Rates in different districts comparable a correcting factor is applied to the death rate to compensate for age and sex differences in the population, the result is known as the Standard Death Rate. The net number of deaths attributed to this District is 301, comprising 154 males and 147 females. The Net Death Rate works out at 10.85, which, multiplied by the Comparability Factor (0.84) gives a Standard Death Rate of 9.11. For the previous year the Net Death Rate was 10.43, while the average for the past ten years is 11.51. The principal causes of death in this district during the past five years are :— Disease. 1. Cancer 2. Heart Disease 3. Eespiratory Diseases (Pneumonia, Bronchitis, etc.) 4. Influenza 5. Diseases of the Blood Vessels ... (including Cerebral Haemorrhage) 6. Disease of the Kidneys 7. Disease of the Digestive Organs 8. Tubercluosis (all forms) 9. All other Infectious Diseases ... 10. Suicide ... 11. Accidents, etc 12. Senile Decay 1939 1938 1937 1936 1935 48 43 47 43 29 68 75 72 76 58 29 16 22 19 22 14 5 15 4 0 40 26 32 30 25 11 6 5 11 8 10 14 15 12 18 10 8 17 13 14 1 9 4 4 2 3 3 0 2 1 9 15 16 12 7 20 17 17 10 17 INFANT AND MATEKNAL MOETALITY. There were 13 deaths amongst infants under 1 year of age, as against 12 in the previous year, and of these deaths 4 referred to illegitimate infants. There were 13 Still-births (none illegitimate) as against 10 (one illegitimate) in the previous year. Maternal Mortality. There was one death from Puerperal Sepsis and two from other maternal causes, which gives a Maternal Mortality Eate of 7.11 per 1,000 when calculated upon the 422 total (live and still) births, or a rate of 0.11 per 1,000 when calculated upon the estimated population of 27,730. Infant Mortality. The various rates relating to the different groups are :— All infants per 1,000 live births Legitimate infants per 1,000 legitimate live births Illegitimate infants per 1,000 illegitimate live births Still-births per 1,000 total (live and still) births ... Infant Mortality Eate (average for the past 10 years) ... 31.78 22.67 333.33 31.23 45.88 The causes of, and age at, death of the infants referred to above are set out below :— Cause of Death. Und. 1 wk. 1-2 wks. 2-3 wks. 3-4 wks. 1-3 mths. 3-6 mths. 6-9 mths. 9-12 mths. Total Asphyxia Broncho- I — — — — — — — I Pneumonia — — — — — — — I I Influenza — — — — I — — — I Inanition I — — — — — — — 1 Marasmus — — — — 2 — — — 2 Pneumonia I — — — — — — — 1 Prematurity 4 — 4 Spina bifida Unascertain- — — — — — I — 1 able I — — — — — — — 1 Totals ... 8 — — — 3 — 1 I 13 SECTION B. GENEKAL PEOVISIONS OE HEALTH SERVICES. PUBLIC HEALTH OFFICERS. The normal staff consists of three whole-time Sanitary Inspectors, one of whom is now on military service, and one full-time Junior Clerk (female). The Council’s Undertakings, Le., Water Supply, Scavenging and Sewerage are under the control of a Manager with appropriate staff. The whole of the Council’s official employees are now housed in the new offices at the Rectory Buildings, Shute End, Wokingham. Tel. Wokingham 833. A list of the Laboratories, Consultants, etc., available in con- nection with the Pubhc Health Service has been given in the Preface in previous Reports. LEGISLATION IN FORCE. A full list of the Adoptive Acts, Bye-laws, etc., in force in this District was given in the Report for 1938 at pages 232-233 to which the only amendment is the new series of Building Bye-laws which became operative as from 1st July, 1939. LABORATORY FACILITIES. The arrangements for the examination of swabs, sputa, blood and other morbid materials are the same as for the other Districts in the combination. A brief description of these facilities as well as a list of the Laboratories, Consultants, etc., available for the work, has been given in the Preface in previous Reports and need not be repeated. A statement of specimens examined, analyses made, etc., is given below. For the convenience of Medical Practitioners practising in the western side of the District adjacent to Reading, swabs and other morbid specimens for examination may be sent to the Pathological Laboratory at the Royal Berks Hospital, Reading, to avoid delay in the post when the circumstances of the case are urgent. In this, as in other cases, the District Council defrays the cost of examination and report. By the Chnical Besearch Association, London : Material. Positive. Negative. Swabs for Diphtheria 33 294 Sputum for Tubercle 0 0 Blood for Typhoid 2 4 Other Specimens 7 5 Total. 327 0 6 12 42 303 345 By the Pathological Department, Eoyal Berks Hospital, Beading : Material. Swabs for Diphtheria Other Specimens Positive. Negative. Total. ... 1 29 30 ,3 0 3 4 29 33 Official samples of Milk are taken by the Police, and in this District 42 were tested during the year, of which the following were deficient in non-fatty solids : 1 to the extent of 2.12%, 2 to the extent of 16.94%, and 4 to the extent of 10.7%. One other sample was low in non-fatty solids and 3 had .000174% added Formic Aldehyde. Samples of other Food Stuffs and Drugs taken by Inspectors of the Weights and Measures Department are as follows Baking Powder... ... 2 Egg Substitute Butter Cornflour Custard Powder Dripping 2 2 2 2 Lard Margarine Oatmeal .. Bice 2 2 2 1 1 All samples proved to be genuine. AMBULANCE FACILITIES. The new Ambulance stationed in Wokingham Borough is available for work in this District (see corresponding paragraph in Wokingham Borough Section). The special ambulances attached to Hospitals serving this District are also available so that an adequate service for normal needs is maintained. HOME NUBSING. TBEATMENT CLINICS. HOSPITALS. MATEBNITY AND CHILD WELFABE. These services remain the same as described in the Beport for 1938 at pages 234-235. SECTION C. SANITARY CIRCUMSTANCES. WATER SUPPLY. The water supply of this District has been described in previous Reports ; for references see Report 1938, page 236. In continuation of these reports the following has been supplied by the Engineering and Waterworks Manager :— Engineer’s & Surveyor’s Ofl&ce, Shute End, Wokingham. Tel. : Office Nos.—^Wokingham 368 & 783. House No.—Reading 61820. During the year, the Water Tower at Earley has been completed and an 8in. Main laid in Langley Common Road to augment the supply to the Arborfield Camps and is now in use. The new Trunk Main from the Tower to Wargrave has been commenced, and work is proceeding satisfactorily. The consumption of water during the year amounted to 180,726,000 gallons, an increase of 31,366,000 gallons over last year and the greater part of this increase is attributed to the number of evacuees billeted in the district and to the demand of the Military Camps. During the year 2f miles of new Mains were laid, making the total mileage now in use approximately 100 miles and 254 new connections were made. {Signed) EDWIN A. HOSKINS, Engineer and Waterworks Manager. DRAINAGE AND SEWERAGE. Under this heading in previous Reports an account has been given of the drainage and sewerage work carried on by the District Council under the management of Mr. E. A. Hoskins. The following notes supplied by him are supplementary to what has already appeared. During the year, sewers on some of the estates in the Erleigh Court area were connected together and the sewage from about 250 houses is now being satisfactorily disposed of at the septic tank and irrigation area near Shepherds House Lane. Although the tender for the carrying out of the Main Drainage Scheme had been accepted and approved by the Ministry of Health, sanction to raise a loan was refused by the Government owing to the war, but as a result of strong representations made by the Council, a modified Scheme incorporating the built-up portions of the Earley, Woodley and Sonning parishes was approved by the Ministry of Health, and tenders for this work have been invited. It is to be regretted that the sewering of the Parish of Twyford, now long overdue, has been omitted from this modified scheme, and a strong representation has been made for its inclusion. PIVEES AND STEEAMS. There is nothing to add to what appeared under this heading in the Eeport for 1938 at page 238. CLOSET ACCOMMODATION. Pending the inauguration of the Councihs Scheme for the sewering of the more populous parishes, conversion of Pail Closets and Privies to Cesspool Drainage has been held over during the past year so that the position at the end of 1939 is much the same as recorded in the Eeport for 1938 at pages 239-240. PUBLIC CLEANSING. Under this heading a description has been given from year to year both of the Dry and of the Wet Scavenging that is carried out in this District under the superintendence of Mr. E. A. Hoskins, the Engin- eering Manager. In continuation of what has already appeared he has supplied the following Eeport:— Eefuse Collection and Disposal. The quantity of refuse collected and disposed of in the District during the year increased by 3,799 cubic yards, part of w^hich increase being due to the large number of evacuees billeted in the District since September last and additional work has also been placed on to this service in connection with the important work of the Salvage of Waste Materials. The following are details of the work done by the refuse collection vehicles during the year No. of: Bedford. Harrier. Dennis I. Dennis II Total. Days worked... — 284 294 297 875 Miles travelled 908 8,856 1,0853 10,426 31,043 Bins emptied 7,221 67,908 110,235 96,608 281,972 Cubic Yards collected ... 295 5,142 7,140 7,100J 19,677i Gallons of Petrol 92 1,632 2,012 1,940 5,676 Gallons of Lubricating Oil IJ 130i 39i 18J 190 Wet Scavenging. Owing to the outbreak of hostilities in September last, with the consequent imposition of the black-out, the cesspool emptiers have been unable to work double shift, as previously, and consequently, great difficulty has been experienced in carrying out this service satisfactorily, although an additional cesspool emptier was pur- chased in March, 1940, and two other cesspool emptiers had been purchased in May and August of last year. In spite of the diffi- culties mentioned, the total number of cesspools emptied during the year was 25,283, an increase of 6,929 over the previous year. (Signed) EDWIN A. HOSKINS, Engineering Manager. SANITARY INSPECTION. Following is the Report of the Senior Sanitary Inspector for the year 1939 :— Council Offices, Shute End, Dr. James J. Paterson, Wokingham. Medical Officer of Health, Guildhall, Maidenhead. Dear Sir, I have the honour of presenting herewith my Report of work carried out during the year ended 31st December, 1939. The total number or visits made during the year was 2,223, apportioned as follows :— No. of visits in connection with infectious diseases 138 ,, ,, ,, to dairy farms and dairies ... ... ... 210 ,, ,, ,, in connection with water supply 156 ,, ,, ,, to factories and workshops ... ... ... 33 ,, „ ,, to slaughter-houses, butchers’shops, etc. ... 423 „ ,, „ to dwelling houses ... ... ... ... ... 990 ,, ,, ,, to moveable dwellings ... ... ... ... 18 ,, ,, ,, to cafes, restaurants, etc. ... ... ... ... 1 ,, ,, ,, to schools ... ... ... ... ... ... 2 „ ,, ,, to shop premises under Shops Act, 1934 ... 14 ,, ,, miscellaneous visits ... ... ... ... ... 531 ,, ,, complaints received and attended to ... ... ... 108 ,, ,, Informal Notices issued 154 ,, ,, ,, „ complied with ... 130 The above figures include work carried out under the heading “ Housing Statistics,” which is submitted herewith on the prescribed form. Summary of Nuisances and Defects discovered and dealt WITH DURING THE YeAR. Offensive accumulations 2 Drains—insufiicient, obstructed or defective ... ... 14 Untrapped or unsatisfactory waste pipes ... ... ... 6 Dampness—general, of walls and floors 20 Cesspools—defective or insufiicient 44 Chimney stacks—defective or dangerous ... 4 Coppers—defective or inefficient ... 4 Stack pipes and gutters—insufiicient, defective or missing ... 10 Floors—defective or insanitary 12 Stoves and grates—defective or inefficient ... 16 Wall plaster—defective and unwholesome 19 Dirty walls and ceilings 26 Insanitary privies Nil Dooms insufficiently lighted ... 6 Windows—defective or without adequate fittings ... ... 10 Premises insufficiently ventilated ... 8 Polluted ditches ... ... ... 20 Yard paving—defective or insanitary ... 5 Verminous premises disinfested 3 Premises disinfected 56 Improvement to earth closets (pails, cleansing, floors, etc.) ... 1.1 Roofs and Flashings—defective or non-weather proof ... 11 Insanitary sinks 8 Staircases—defective treads and absence of hand-rail ... 9 Unsatisfactory water supply 20 Main supplies laid on 20 Premises liable to flooding Nil Walls—dangerous or defective ... ... ... ... ... 3 Premises without proper food stores ... ... ... ... 3 Cracked or otherwise defective ceiling plaster ... ... 12 Defective pointing of walls ... ... ... ... ... 9 W.C. apparatus defective ... ... ... ... ... 4 Steps or thresholds worn and defective ... ... ... 1 Defective hearths 2 Doors—defective or ill-fitting ... ... ... ... ... 4 Animals kept so as to be a nuisance 1 This list does not include defects in premises scheduled for formal action under the Housing Acts, or premises inspected with such action in view. Water Supply. Forty-three samples of water were taken from private wells in various parts of the District and were submitted to the Royal Institute of Public Health for bacteriological analysis. Fourteen samples were classified good, 10 passable and 19 bad. Appropriate action has been taken in regard to the bad samples. It was found necessary to serve 20 Statutory Notices under Section 138 of the Public Health Act, 1936, requiring owners to make proper provision for water supply on the sites. Twelve Notices were complied with. One appeal was lodged with the Ministry of Health, which was dismissed, and 1 pending at the end of 1938 was also dismissed. The Henley Regatta Committee were again kind enough to have a temporary water supply laid on from the main to the pubhc part of the course, for the convenience of refreshment caterers, occupiers of caravans and the public generally. This action of the Committee was very much appreciated by all concerned. Infectious Diseases. In addition to the usual routine enquiries being made on the occurrence of a case of Infectious Disease, Terminal Disinfection was carried out at 56 houses during the year. Number of School Exclusion Notices sent ... ... 30 Inspection and Supervision of Food. Slaughter Houses. There are 11 Slaughter houses in the District, 7 being licensed and 4 registered. These premises were frequently inspected and on the whole were kept in a clean condition. Public Health (Meat) Eegulations 1934. During the year the carcases of 884 pigs (including 19 killed by cottagers on their own premises), 34 calves, 181 sheep and 82 bullocks were inspected, and diseased and unsound meat was voluntarily surrendered for condemnation as follows :— Beef.—Carcases nil, 6 heads, 6 lungs, 2 livers and 1 mesentery for Tuberculosis ; 6 livers for Distomatosis ; 2 livers and I set of lungs for Abscesses ; 1 head for Actinomy- cosis ; 1 udder for Mastitis ; and 1 liver for Cavernous Angioma. Mutton.—1 carcase for decomposition ; 3 sets of lungs for Strongylus ; and 3 livers for Distomatosis. Veal.—1 set of lungs for Tuberculosis ; 1 set of lungs for Pleurisy. Porh.—Carcases nil; 25 heads, 10 plucks and 2 mesenteries for Tuberculosis ; 9 sets of lungs, etc., for Inflammatory conditions ; 8 livers for Cirrhosis ; 1 liver for Necrosis ; 2 kidneys for Hydronephrosis ; and about 121bs. of pork for Abscesses. Anthrax Order, 1928. Ten notifications of suspected cases were received during the year under this Order, but none of these was confirmed. Tuberculosis Order, 1938. Two notifications were received during the year under this Order. Bakehouses. There are 19 retail Bakehouses in the District. Informal Notices were issued in respect of the following matters :— Premises found to be in a defective condition ... 3 Defects remedied ... ... ... ... ... ... 3 Milk and Dairies Order, 1926. Two hundred and ten visits have been made to dairy farms and dairies, and in 28 cases it was found necessary to serve Preliminary Notices on the occupiers embodying the undermentioned matters :— Unsatisfactory floors ... ... ... ... ... 1.4 Insufflcient means of lighting ... ... ... ... 1 ,, ,, ,, ventilation... ... ... ... Nil Milkers not wearing clean clothing ... ... ... 3 Cows not being cleansed ... ... ... ... ... 4 Lime-washing overdue ... ... ... ... ... 9 Insanitary yards 7 Unsatisfactory water supply ... ... ... ... 3 Miscellaneous articles stored in dairy ... ... ... 4 Unsuitable premises ... ... ... ... ... 1 Milk stored in unsatisfactory places ... ... ... 2 Unsatisfactory drainage ... ... ... ... ... 2 Dirty conditions generally 4 Housing Act, 1936. During the year, 10 houses were offlcially represented as being unfit for habitation and incapable of being repaired at a reasonable cost. No Demolition Orders were made. Seven undertakings were received from owners of cottages and accepted by the Council to the effect that the properties would not be used for habitation until made fit. No cottages were demolished by the owners. Seven cottages were made fit after formal action taken. Housing (Kural Workers) Act, 1926. No applications were received during the year, but one house was completed under the scheme. 162 Housing. The eight Clearance Areas representing 36 houses mentioned in the Report for 1938, paragraph 21, should have been considered at a Ministry of Health Inquiry fixed for September, 1939, but the intervention of the War postponed all action regarding these areas. However, the owner of the three houses in Clearance Area No. 3 (Three Mile Cross, Shinfield) has voluntarily demolished these and in their place two semi-detached houses have been erected. Plans have been passed for a further two houses on this site, but these have so far progressed as far as the foundations only. {Signed) W. L. LONGHURST, Senior Sanitary Ins'pector. SHOPS AND OFFICES. During the year, 7 visits were made to shop premises under the Act of 1934. It was not found necessary to serve any Statutory Notices under the Act in relation to ventilation, temperature and sanitary conveni- ences. Minor defects were dealt with by informal notice. CAMPING SITES. The three sites mentioned in the previous year’s Report, page 248, are still in part use. At the Gipsy Encampment at Mole Road, Winnersh, 2 small bungalows have been built to replace caravans on the site. The Loddon Lido was not in use for a considerable part of the year during the time the premises were up for sale. SMOKE ABATEMENT. There was no need for any action to be taken with a view to the abatement of nuisance from smoke in this area. SWIMMING BATHS AND POOLS. An account of the Swimming Baths and Pools situate in this District, namely— California in England,” Nine Mile Ride ; Robinson Crusoe Holiday Camp, Longmoor ; Loddon Tea Gardens, Winnersh ; Henley Bathing Station, Remenham ; was given in the Report for 1937 at pages 237-8. As the conditions remain practically unchanged, there is no need to repeat the infor- mation then given. DISINFESTATION. Six visits were made to 3 houses to carry out disinfestation for bugs. None of these were Council Houses. The methods employed were described in the Report for 1938 at page 249. SCHOOLS. The conditions of the public elementary schools in this area, with an account of the water supply and sanitary arrangements, has already been given. See Survey Report, 1930, page 198 ; and Report for 1932, pages 176-7 ; also Report for 1937, page 239. The schools generally throughout this District are in a satisfactory condition both as regards water supply and sanitary arrangements. A new school is in course of erection in the parish of Wargrave. The new school at Woodley mentioned in last year’s Report was opened during the current year. SANITARY CONDITIONS REQUIRING NOTICE. The items that appeared under this heading in the previous year’s Report (page 250) were mostly concerned with drainage matters. Owing to the outbreak of war the proposed scheme for sewering the main parts of this District has been suspended, but as a result of a Special EncLuiry held on 11th January, 1940, it is hkely that a modified scheme will be proceeded with so as to relieve the more densely populated parishes (see paragraph on Drainage and Sewerage). Meanwhile, numerous complaints are being received in respect of nuisances arising from cesspools in parts of the parishes of Earley, Woodley and Twyford. SECTION D. HOUSING. GENERAL INFORMATION. The following particulars have been supplied by Mr. Edwin A. Hoskins, who is in charge of the Building Surveyor’s Department, through the absence of Mr. Tween on Military service — Up to September last, the largest amount of building development took place on the outskirts of the Borough of Reading, as in previous years, but owing to the war and the difficulties in obtaining supplies of building material, work on many of the estates has ceased, except for the completion of houses which were already under construction. Plans for 210 buildings of various categories and development were submitted for the Council’s consideration. Certificates of Habitation being issued for 199 houses and a further 55 houses and other buildings were completed during the year. The number of dwelling houses erected and owned by the District Council remains at 402. HOUSING STATISTICS. The record of work done under the Housing Acts, etc., during the past year is as follows :— 1. Inspection of dwelling houses during the year :— (1) (a) Total number of dwelling houses inspected for housing defects (under Public Health or Housing A L/O t ••• ••• ••• ••• ••• (6) Number of inspections made for the purpose (2) (a) Number of dwelling houses (included under sub- head (1) above) which were inspected and recorded under the Housing (Consolidated) Regulations, 1925, and Amendment Regulations, 1932 (h) Number of inspections made for the purpose (3) Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 108 639 62 111 10 (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 2. Remedy of defects during the year without service of Formal Notices :—• Number of defective dwelling houses rendered fit in conse- quence of informal action by the Local Authority or their officers 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 ... (2) Number of dwelling houses which were rendered fit after service of formal notices : {a) By Owners (b) By Local Authority in default of Owners B. Proceedings under Public Health Acts : ... c. Proceedings under Sections 11 and 13 of the Housing Act, 79^6 • '•A. V/ • ••• ••• ••• ••• ••• D. Proceedings under Section 12 of the Housing Act, 1936 ... 4. Housing Act, 1936. Part IV.—Overcrowding. {a) (i) Number of dwellings overcrowded at the end of the year ... ... ... ... ... ... (ii) Number of famihes dwelling therein (hi) Number of persons dwelling therein (b) Number of new cases of overcrowding reported during the year (c) (i) Number of cases of overcrowding relieved during the year ... ... ... ... ... ... (ii) Number of persons concerned in such cases {d) Particulars of any cases in which dwelling houses have again become overcrowded after the Local Authority have taken steps for the abatement of overcrowding (e) Any other particulars with respect to over- crowding conditions upon which the Medical Officer of Health may consider it desirable to report:— A small family reoccupied a hut, but when Statutory action was taken the overcrowding was abated almost immediately by the family removing to a house outside the District. Seven of the existing overcrowding cases consist of persons of the gipsy type occupying caravans, tents and sheds. All these families own their own plots of land. They are resident in the District for about six months in the year, when they leave for fruit and hop picking. It would be useless for the Council to offer them alternative accommodation in Council houses, as the majority have never slept in proper dwelling houses and they do not wish to do so. SECTION E. INSPECTION AND SUPEKVISION OE FOOD. MILK SUPPLY. As remarked in the Eeport for 1938 (page 255), this is a large milk producing District, there being at least 150 farms where milk is produced and over 50 are producing Designated Milk. An important item in this respect is the fact that the National Institute for Eesearch in Dairying has its headquarters in the Parish of Shinfield in this District. In pursuance of the Tuberculosis Order, 1938, the County Veter- inary Officer visited two Dairy Farms and ordered the slaughtering of one milch-cow at each farm. In one case the cow was sulfering from advanced tuberculosis and in the other from tuberculosis of the udder. The state of the Eegister, and statistical details relating thereto are shown on the tables which follow. Dairies, Cowsheds and Milkshops. Number on Eegister : Wholesale Producers—No. of Farms 97 Eetail Producers 55 Eetail Purveyors 29 Tuberculin Pasteu- Number Licensed: Tested. Accredited. rised. Producers 11 31 Nil Producers and Eetailers ... 4 7 Nil Distributors (Eetail Purveyors) 6 1 2 Total Number of Dairy Farms ... ... ... ... 152 Contraventions of Milk and Dairies Order, 1926 : Discovered ... ... ... ... ... ... ... 28 Eemedied ... ... ... ... ... ... ... 19 Contraventions of Public Health Acts : Discovered ... ... ... ... ... ... ... Nil Eemedied ... ... ... ... ... ... ... Nil Number of Inspections 210 The official samples taken by the Police in this District number 42. Of these, 7 were deficient in non-fatty solids, 1 was low in non-fatty solids and 3 had added Formic Aldehyde. MEAT AND OTHER FOODS. There are altogether 11 slaughter houses in this District, of which 4 are registered and 7 licensed. They are all reasonably well kept and are inspected as frequently as possible having regard to the other demands on the Sanitary Inspector’s time. Various parcels of un- sound meat were surrendered voluntarily, and these are enumerated in the Sanitary Inspector’s Report. The following table gives the details of meat inspection in this District:— Carcases Inspected and Condemned. Cattle excluding Cows Cows Calves Sheep and Lambs Pigs Number killed 100 3 70 450 1100 Number inspected 79 3 34 181 884 All diseases except Tuberculosis. Whole carcases condemned 1 Carcases of which some part or organ was condemned ... 11 — 1 6 27 Percentage of the number inspected affected with dis- ease other than tuberculosis 13.9% ■3% 3.8% 2.9% Tuberculosis ofily. Whole carcases condemned — — • — Carcases of which some part or organ was condemned ... 9 1 1 — 21 Percentage of the number inspected affected with tuber- culosis 11.4% 33.3% •3% — 2.4% There are 19 Bakehouses (retail) in use in this District, some of them very old and ill-adapted with regard to modern standards, but on the whole they are kept in a cleanly condition, 3 informal notices were served during the year for sanitary defects. INFECTIOUS DISEASES. GENEKAL INFORMATION. Numerically, Scarlet Fever occupies tlie premier place amongst the notifiable infectious diseases as it did in the previous year, there being 52 cases notified as compared with 71 in the previous year and an average of about 40 per annum during the preceding five years. This comparatively high figure is due chiefiy to a " hang- over ” from the outbreak affecting the parishes adjoining the County Borough of Reading which was commented upon in the previous year’s Report (page 260). There was nothing unusual or remarkable about the cases, which came mostly from the parishes of Woodley, Earley, Wargrave and Twyford as in the previous year. Diphtheria also reached an unusually high figure, namely, 38 cases as compared with 27 in 1938 and a five year average of about 20. Eighteen of these cases occurred in a large residential school and were mostly of the mild clinical or carrier type. As this was not the first time similar trouble had occurred at this school, after consultation between representatives of the School and the Medical Officer of Health, it was decided to enlist the aid of the Emergency Public Health Laboratory Service at present stationed at the School of Pathology, South Parks Road, Oxford. That Organisation kindly undertook to immunise gratuitously all the inmates of the school—about 500 altogether—and since then no further trouble has arisen. The Managers of the School have also undertaken to insist upon immuni- sation as a condition precedent to entry into the School, so that immunity from this dangerous disease shall be ensured for the future. The new Regulations as to notification of Measles and Whooping Cough were put into operation during the last quarter of the year, and so far only 9 cases of Whooping Cough have been received. The usual Statistical Tables relating to these and other notifiable diseases not specifically mentioned above are appended. NOTIFIABLE DISEASES. The following tables summarise the position in regard to notifiable and other infectious diseases during the year :— Table I. Notifiable Diseases during the Year, 1939. (other than Tuberculosis.) Total Cases ad- Deaths of cases mitted to notified Disease, notified. Hospital. cases. Diphtheria ... 38(18) 27 0 Dysentery ... 0 0 0 Encephalitis Lethargica ... 0 0 0 Enteric Fever (including Typhoid and Paratyphoid) ... 0 0 0 Erysipelas ... 5 0 0 Malaria 0 0 0 Ophthalmia Neonatorum ... 0 0 0 Pneumonia ... 17 0 5 Poliomyelitis ... 4 1 0 Puerperal Fever ... 0 0 0 Puerperal Pyrexia ... 0 0 0 Scarlet Fever ... 52 (24) 39 0 Smallpox ... 0 0 0 Polioencephalitis ... 0 0 0 Whooping Cough ... 9 0 0 Brackets ( ) indicate cases that occurred in institutions and hospitals ; they are included in the totals given. Table II. Age in Years of Notified Cases, 1939. Disease. Years 0- 1- 2- 3 - 4r- 5- 10- 15- 1 1 1 45- 65Y Diphtheria ... 1-11 - 8 19 2 5 - — _ Erysipelas ... _ _ _ _ - 1 - - 1 - 3 - Pneumonia ... - _ t - 1 - 1 - 1 7 6 - Poliomyelitis ... 1 - - - 1 1 1 - — — Scarlet Fever ... - - 1 1 1 17 21 6 4 - 1 - Whooping Cough 1 - 1 - 4 3 - - — — — — Table III. List oe Infectious Diseases for the Five Years 1935—1939. Disease. 1935 1936 1937 1938 1939 Diphtheria ... • • • • ... 22 16 12 27 38 Encephalitis Lethargica . ... 0 0 0 0 0 Enteric Fever (includine Para- typhoid) ... 3 0 4 3 0 Erysipelas ... • • • e ... 0 7 6 7 4 Malaria • • • « ... 0 0 0 0 0 Ophthalmia Neonatorum ... 1 1 3 1 0 Pneumonia ... • • • • ... 6 11 28 16 17 Poliomyelitis • . . ... 0 0 0 7 4 Puerperal Fever « . • ... 1 0 0 0 0 Puerperal Pyrexia • ... 0 0 0 3 0 Scarlet Fever • • • • ... 28 18 22 71 52 Smallpox . . . ... 0 0 0 0 0 Polioencephalitis • • • • . ... 0 0 0 2 0 Whooping Cough* • — _ _ _ 9 *Yo^ notifiable until October, 1939. Table IV. Infectious AND Other Diseases IN Schools, 1939. Children No. affected on including School. Roll. Disease. Date. contacts. Earley 293 Chickenpox Jan., April 3 German Measles Feb., Mar., April May, June, July 71 Impetigo Jan., Mar. 2 Measles Mar. 3 Mumps Mar. 1 Ringworm Mar. 1 Scarlet Fever Jan., Feb., Mar. 3 Vermin June 1 Whooping Cough Jan., Feb., Mar. 26 April Finchampstead 87 Mumps April, May 9 Children No. affected on including School. Roll. Disease. Date. contacts. Finchampstead 75 Chickenpox Feb., June, Oct. 4 Nine Mile Eide Nov. Council Impetigo Oct. 1 Mumps April, Oct. 2 Poliomyelitis Feb. 1 Eingworm Feb. 1 Scabies May 1 Whooping Cough Jan., Feb., April, 25 Newland Arbor- May, June, July field and 115 Chickenpox Mar. 3 Barkbam C.E. Diphtheria Nov., Dec. 9 Impetigo Mar., June, Dec. 3 Measles June 1 Mumps May, June 24 Scarlet Fever Sept. 2 Sore Throat Nov. 1 Sbinfield C.E. 154 Chickenpox Mar., June, Sep. Oct., Nov., Dec. 41 Impetigo April, Sept. 2 Shinfield, Gra^eley 110 Impetigo Oct. 4 Parockial Shinfield, Three 57 Chickenpox Mar., April, Oct., 15 Council Dec. German Measles May 1 Impetigo Dec. 2 Whooping Cough June, July 16 Sonning C.E. Boys 51 Chickenpox Mar. 2 Sonning C.E. Girls 45 Chickenpox Mar., April 7 St. Nicholas, Hurst 42 German Measles June 1 C.E. Boys St. Nicholas, Hurst 73 Chickenpox Jan. 1 C.E. Girls German Measles June, July 8 Impetigo Feb., Mar., April 5 Children No. affected on including School. Roll. Disease. Date. contacts. Swallowfield, 71 Cbickenpox Feb. 2 Farley Hill Council • Influenza Feb. 50 Swallowfield, 159 Cbickenpox Jan., Feb., Mar., 27 Lambs Lane Sept. Council German Measles Feb., Mar., April, 17 May Measles Mar. 2 Swallowfield, 130 Cbickenpox Oct. 1 Riseley Common German Measles Feb., July 5 C.E. Impetigo Jan., Mar., Dec., Nov. 13 Measles Mar., July 6 Twyford, Pole- 86 Cbickenpox Jan. 2 bampton Boys German Measles May, June, July 11 Measles May 1 Ringworm Feb. 1 Twyford, Pole- 192 Cbickenpox Jan., Feb., June 5 bampton Girls German Measles April, May, June July 61 Impetigo Feb. 1 Mumps Oct. 4 Scarlet Fever May 1 Wbooping Cougb Feb., May, June, 8 Oct. Wargrave, Crazies 51 Cbickenpox Feb., June, Oct. 3 Hill C.E. Wargrave, Piggot 125 Cbickenpox June, July, 34 C.E. Mixed German Measles Nov., Dec. April 1 Impetigo July 1 Scabies Dec. 2 Scarlet Fever April 4 Children No. affected on including School. Roll. Disease. Date. contacts. Wargrave, Piggot 33 Chickenpox June, July, Nov. 11 C.E. Infants German Measles June 1 Impetigo Jan., Feb. 2 Scarlet Fever April 1 Winnersh, Bear- 253 Chickenpox Jan., Feb. 14 wood Council German Measles May, July 9 Impetigo April 1 Measles May 1 Mumps Sept., Dec. 5 Scabies Oct. 1 Scarlet Fever Oct. 1 Wokingham With- 46 Measles July 4 out Forest Boad Kingworm April 1 C.E. Wokingham With- 66 Diphtheria June 3 out St. Sebastian’s German Measles June 1 C.E. Mumps June 3 Whooping Cough June 3 Woodley C.E. 194 Chickenpox June 5 German Measles May, June, Nov. 16 Impetigo April 2 Scabies Feb. 1 Scarlet Fever Feb., May 5 Whooping Cough April 1 Woodley Senior German Measles June, July, Aug. 9 Council Mumps June 1 Scabies Nov. 1 TUBERCULOSIS. It was not necessary to take any specific action under tke Public Health (Prevention of Tuberculosis) Regulations, 1925 (compulsory discontinuance of employment) or under Sec. 62 of the Public Health Act, 1925 (compulsory removal of patient to institution), now included in Sec. 172 of the Public Health Act, 1936. Particulars of new cases of tuberculosis and of all deaths from this disease whether the cases have been notified or not during the current year are set out in the table below. Tuberculosis Table. Age Periods. New Cases. Puhno7iary. Non-PuVy. Deaths. Pulmonary. Non-PuVy. M. F. M. F. M. F. M. F. Under 1 year ... — — — — — — — 1— 5 years ... — — — 1 — — — — 5-15 „ ... 2 3 2 2 — — — — 15—25 „ ... 1 4 — — 1 1 1 — 25—35 „ ... 2 1 — — — — — — 35—45 „ ... 2 2 — — 2 — — — 45—55 „ ... 1 1 — — 2 — — — 55—65 „ ... 1 2 1 — 2 — — — 65 and over ... 1 — — 1 — — — — Totals 10 11 3 3 7 1 1 — Percentage of non-notified cases amongst total fatal cases—2 out of 9=22.2%. OTHER SPECIAL DISEASES. Cancer. The average cancer death rate for the past ten years is 1.67, and for the present year the net cancer deaths number, Males 22, Females 26, total 48 ; giving a rate of 1.73 per 1,000 of population. In the previous year the corresponding figures were : Males 22, Females 25, total 48 ; and a rate of 1.89. The facilities provided by the neigh- bouring hospitals appear to be adequate for treatment so far as they are called for and no special propaganda work has been undertaken. Blindness. There were no notifications of Ophthalmia Neonatorum this year. Work in connection with the case of the Blind is undertaken by the County Authority. Other. Amongst the less usual notifiable infectious diseases there are to be noted 4 cases of Anterior Polio-myelitis. There were no deaths from this disease. GENERAL STATISTICAL TABLE. Birth Rates, Death Rates, Analysis or Mortality, Maternal Death Rates, and Case Rates for certain Infectious Diseases in THE Year 1939. England and Wales, London, 126 Great Towns and 148 Smaller Towns. (Provisional Figures supplied by Registrar-General based on Weekly and Quarterly Returns). Births— England and Wales 126 County Boro’s. and Great Towns including London. 148 Smaller Towns (Resident Pop’lat’ns 25.000 to 50.000 at 1931 Census). London Adminis- trative County. East Berks Districts (Combined) ' Population 101,041 Rates per 1,000 Population Total Number. Rate per 1,000 Live 15. 14.8 15.6 12.3 1334 13.10 Still ... 0.59 0.59 0.57 0.44 57 0.56 Deaths— All Causes ... 12.1 12.0 11.2 11.9 1149 11.38 Typhoid and \ 0.00 0.00 0.00 0.00 1 0.01 Paratyphoid Fevers f Smallpox — — — — — — Measles 0.01 0.01 0.01 0.00 — — Scarlet Fever 0.01 0.00 0.00 0.00 — — Whooping Cough ... 0.03 0.03 0.02 0.03 — ■— Diphtheria ... 0.05 0.05 0.04 0.02 4 0.04 Influenza 0.21 0.19 0.20 0.18 21 0.21 Notifications— Smallpox — — — — — — Scarlet Fever 1.89 1.96 1.78 1.53 106 1.05 Diphtheria ... 1.14 1.21 1.16 0.98 138 1.36 Enteric Fever 0.04 0.03 0.04 0.03 2 0.02 Erysipelas 0.34 0.40 0.31 0.37 21 0.21 Pneumonia ... 1.02 1.21 0.89 0.99 41 0.41 Number of Live Rate per 1,000 Live Births. Births 1,334 Number Rate Deaths under 1 year of age ... 50 53 40 48 42 31.48 Deaths from Diarrhoea 1 and Enteritis under 2 V 4.6 6. 3 3. 0 8. 2 2 1.50 years of age } Maternal Mortality— per 1000 Pop Puerperal Sepsis 0.77 2 1.44 Others 2.16 ^ Not available 3 2.16 Total 2.93 J 5 3.39 Rates per 1,000 Total Births (' i.e., Live Total Number for and Still) East Berks 1.391 ivi uicy'yiui' ivi OYt(xi%iy— Puerperal Sepsis 0.74 1 2 1.44 Others 2.08 > Not available. 3 2.16 Total ... ... 2.82 J 5 3.59 N otificati ons— Puerperal Fever ... 14 35 17.26 12.99 / 3.31 0 0.00 Puerperal Pyrexia ... j EAST BERKS UNITED SANITARY DISTRICTS. AVERAGE RATES FOR TEN YEARS 1929—1938. Corresponding Rates for 1939 in italics. Tuberculosis Cancer Birth Death Infantile Phthisis other than Death Rate. Rate. Mortality. Death Rate Phthisis. Rate. Maidenhead U.D. 14.06 12.26 50.77 0.58 0.14 1.82 1939- -13.75 11.30 ' 33.33 0.37 0.04 2.01 Wokingham U.D. 12.44 13.74 39.95 0.44 0.08 1.94 1939- -12.99 15.74 39.60 0.26 0.26 2.94 Cookkam R.D. 14.69 11.78 52.91 0.41 0.10 1.85 1939- -15.80 10.73 35.09 0.09 0.00 1.97 Eastkampstead R.D.... 12.80 11.04 43.10 0.50 0.10 1.47 1939- -13.49 10.56 22.64 0.35 0.00 1.64 Windsor R.D. 14.02 10.94 36.13 0.42 0.20 2.06 1939- - 9.61 11.91 22.22 0.41 0.20 2.55 Wokingham R.D. 14.70 11.51 45.88 0.37 0.15 1.67 1939- -15.37 10.85 31.78 0.32 0.04 1.73 ♦Including Typhoid and Paratyphoid. jThis Rate is calculated per 1000 Total Births (Live and Still). MATERNAL MORTALITY 1939. Puerperal Other Total District. Sepsis. Puerperal Causes. Deaths Maidenhead Urban ... 1 0 1 Wokingham Urban ... 0 1 1 Cookham Rural ... 0 0 0 Easthampstead Rural ... 0 0 0 Windsor Rural ... ... 0 0 0 Wokingham Rural ... 1 2 3 Totals—1939 2 3 5 1938 2 2 4 „ 1937 0 2 2 „ 1936 1 2 3 Death Rate per 1,000 TOTAL (live and still) Births. Puerperal Other District. Sepsis. Puerperal Causes. Total. Maidenhead Urban ... 3.03 0.00 3.03 Wokingham Urban ... 0.00 0.95 0.95 Cookham Rural ... 0-00 0.00 0.00 Easthampstead Rural ... 0.00 0.00 0.00 Windsor Rural ... ... 0.00 0.00 0.00 Wokingham Rural ... 2.37 4.74 7.11 England and Wales ... 0.74 2.08 2.82 INFANT MORTALITY. Death Rates (1) Still Birt District. Legitimate. Illegitimate. Total Rate (2 Maidenhead Urban 29.42 83.33 33.33 0.56 Wokingham Urban 39.60 0.00 39.60 0.53 Cookham Rural 35.09 0.00 35.09 0.67 Easthampstead Rural 18.87 111.11 22.64 0.59 Windsor Rural ... 11.63 250.00 22.22 0.81 Wokingham Rural 22.67 333.3 31.78 0.47 England and Wales ... — — 50.00 0.59 (1) Calculated per 1,000 births of each class. (2) Calculated per 1,000 of population. Deaths prom Infantile Diarrhoea. (under 2 years of age). Maidenhead U.D. ... ... ... 2 All Other Districts... 0 Total for East Berks ... ... 2 Rate per 1,000 Live Births: East Berks ... ... 1.5 England and Wales ... 4.6 MAIDENHEAD URBAN DISTRICT, 1939. Resident Population, 23,200. Comparability Factor 0.88. CAUSES OF DEATH. Males. Females. All Causes 127 148 1. Typhoid and paratyphoid fevers — 2. Measles — — 3. Scarlet Fever — — 4. Whooping Cough — — 5. Diphtheria 2 1 6. Influenza 2 1 7. Encephalitis Lethargica — — 8. Cerebro-spinal fever — •—■ 9. Tuberculosis of respiratory system ... 6 3 10. Other Tuberculous Diseases ... 1 — 11. Syphilis ... — — 12. General Paralysis of the insane. Tabes dorsalis 3 — 13. Cancer, malignant disease 18 31 14. Diabetes ... 1 6 15. Cerebral haemorrhage, etc. 7 9 16. Heart Disease 30 42 17. Aneurysm — — 18. Other circulatory diseases 3 7 19. Bronchitis 2 8 20. Pneumonia (all forms) 7 5 21. Other respiratory diseases 1 — 22. Peptic ulcer 7 1 23. Diarrhaea, etc. (under 2 years) 1 1 24. Appendicitis 3 — 25. Cirrhosis of liver — 1 26. Other diseases of liver, etc. 2 27. Other digestive diseases 2 2 28. Acute and chronic nephritis ... 2 3 29. Puerperal sepsis ... ■— 1 30. Other Puerperal causes 31. Congenital debihty, premature birth, malformations. - ■ etc. ... ... ... ... ... ... ... 4 4 32. Senility 1 3 33. Suicide 3 2 34. Other violence ... 7 2 35. Other defined diseases ... 13 10 36. Causes ill-defined or unknown 1 — Special causes (included in No. 35 above) : Small-pox ... ■— — Poliomyelitis -— — Pohoencephalitis — — Deaths of Infants Total 6 5 under 1 year Legitimate ... 5 4 Illegitimate 1 1 Live Births: Total 174 145 Legitimate ... 161 135 Illegitimate 13 10 Stillbirths: Total 7 6 Legitimate ... 7 6 Illegitimate WOKINGHAM URBAN DISTRICT, 1939. Resident Population, 7,546. Comparability Factor 0.72. causes of death. Males. Females All Causes 53 70 1. Typhoid and paratyphoid fevers — — 2. Measles — — 3. Scarlet Fever — •— 4. Whooping Cough — — 5. Diphtheria 1 •— 6. Influenza 2 1 7. Encephalitis Lethargica — — 8. Cerebro-spinal fever — •—■ 9. Tuberculosis of respiratory system ... — 2 10. Other Tuberculous Diseases ... 1 1 11. Syphilis 1 — 12. General Paralysis of the insane. Tabes dorsalis •— — 13. Cancer, malignant disease 11 12 14. Diabetes ... 2 — 15. Cerebral hgemorrhage, etc. 1 4 16. Heart Disease 14 16 17. Aneurysm — — 18. Other circulatory diseases 6 5 19. Bronchitis 1 — 20. Pneumonia (all forms) 1 9 21. Other respiratory diseases — 1 22. Peptic ulcer — — 23. Diarrbsea, etc. (under 2 years) — — 24. Appendicitis 1 — 25. Cirrhosis of liver — — 26. Other diseases of liver, etc. ... — 1 27. Other digestive diseases 1 — 28. Acute and chronic nephritis ... 1 •—• 29. Puerperal sepsis ... — — 30. Other Puerperal causes — 1 31. Congenital debility, premature birth, malformations. etc. ... ... ... ... ... ... 1 1 32. Senility 1 9 33. Suicide 1 — 34. Other violence ... 2 1 35. Other deflned diseases ... 4 6 36. Causes ill-deflned or unknown — — Special causes (included in No. 35 above) : Small-pox ... — — Poliomyelitis — — Polioencephalitis — — Deaths of Infants Total 2 2 under 1 year Legitimate ... 2 2 Illegitimate • — Live Births: Total 52 46 Legitimate ... 48 46 Illegitimate 4 — Stillbirths: Total 3 1 Legitimate ... 3 1 Illegitimate ' COOKHAM RURAL DISTRICT, 1939. Resident Population, 10,440. Comparability Factor 0.88. CAUSES OF DEATH. Males. Females. All Causes 58 62 1. Typhoid and paratyphoid fevers — — 2. Measles •— — 3. Scarlet Fever — — 4. Whooping Cough — — 5. Diphtheria — '— 6. Influenza 3 3 7. Encephalitis Lethargica — — 8. Cerebro-spinal fever •— — 9. Tuberculosis of respiratory system ... 1 — 10. Other Tuberculous Diseases ... —• — 11. Syphilis ... — — 12. General Paralysis of the insane, Tabes dorsalis — — 13. Cancer, malignant disease 12 10 14. Diabetes ... 1 — 15. Cerebral hsemorrhage, etc. 2 6 16. Heart Disease 16 21 17. Aneurysm — •— 18. Other circulatory diseases 2 4 19. Bronchitis 1 — 20. Pneumonia (all forms) 1 2 21. Other respiratory diseases 1 1 22 Peptic ulcer — — 23. Diarrhaea, etc. (under 2 years) —' — 24. Appendicitis 1 — 25. Cirrhosis of liver 1 — 26. Other diseases of liver, etc. — — 27. Other digestive diseases 2 — 28. Acute and chronic nephritis ... 1 3 29. Puerperal sepsis ... — — 30. Other Puerperal causes — — 31. Congenital debility, premature birth, malformations. etc. ... ... ... ... 3 1 32. Senility — 3 33. Suicide ... ... ... ... ... 1 — 34. Other violence ... 1 2 35. Other defined diseases ... 7 5 36. Causes ill-defined or unknown — — Special causes (included in No. 35 above) : Small-pox ... ... ... ^.. — — Poliomyelitis — — Polioencephalitis — — Deaths of Infants Total 5 1 under 1 year Legitimate ... 5 1 Illegitimate — Live Births: Total 89 76 Legitimate ... 81 75 Illegitimate 8 1 Stillbirths: Total 2 5 Legitimate ... 2 5 Illegitimate EASTHAMPSTEAD RURAL DISTRICT, 1939. Resident Population, 19,350. Comparability Factor 0.87. CAUSES OF DEATH. Males. Females. All Causes 108 105 1. Typhoid and paratyphoid fevers _ ..— 2. Measles — — 3. Scarlet Fever — — 4. Whooping Cough — 5. Diphtheria — — 6. Influenza ... ... ... ... ... ’ 2 2 7. Encephalitis Lethargica — ■— 8. Cerebro-spinal fever — — 9. Tuberculosis of respiratory system ... 5 2 10. Other Tuberculous Diseases ... '— — 11. Syphilis ... — — 12. General Paralysis of the insane, Tabes dorsalis — — 13. Cancer, malignant disease 14 19 14. Diabetes ... 2 1 15. Cerebral haemorrhage, etc. 6 9 16. Heart Disease 26 30 17. Aneurysm 1 — 18. Other circulatory diseases 5 3 19. Bronchitis 2 4 20. Pneumonia (all forms) 4 4 21. Other respiratory diseases 2 3 22. Peptic ulcer 3 — 23. Diarrhgea, etc. (under 2 years) — — 24. Appendicitis — — 25. Cirrhosis of liver — _ 26. Other diseases of liver, etc. ... 1 2 27. Other digestive diseases 2 2 28. Acute and chronic nephritis ... 3 3 29. Puerperal sepsis ... — — 30. Other Puerperal causes — — 31. Congenital debility, premature birth, malformations, etc. ... ... ... ... ... ... 5 1 32. Senility 7 11 33. Suicide 1 1 34. Other violence ... 7 2 35. Other defined diseases ... 10 6 36. Causes ill-defined or unknown ■— •— Special causes (included in No. 35 above) : Small-pox ... — — Poliomyelitis — — Polioencephalitis — — Deaths of Infants Total 5 1 under 1 year Legitimate ... 4 1 Illegitimate 1 — Live Births: Total 139 122 Legitimate ... 133 119 Illegitimate 6 3 Stillbirths; Total 6 6 Legitimate ... 6 6 Illegitimate ' WINDSOR RURAL DISTRICT, 1939. Resident Population, 9,155. Comparability Table 0.84. CAUSES OF DEATH. Males. 1 Females. All Causes 56 61 1. Typhoid and paratyphoid fevers • • « — 1 2. Measles • • • — — 3. Scarlet Fever • • • — 4. Whooping Cough • • • ■— — 5. Diphtheria • « • —' — 6. Influenza • • • — — 7. Encephalitis Lethargica • • « — 1 8. Cerebro-spinal fever • • • — — 9. Tuberculosis of respiratory system ... • • « 1 3 10. Other Tuberculous Diseases ... • • • 1 1 11. Syphilis ... • • • — — 12. General Paralysis of the insane. Tabes dorsalis « • • .— — 13. Cancer, mahgnant disease • • • 12 13 14. Diabetes ... • • ♦ 1 1 15. Cerebral haemorrhage, etc. • « • 3 1 16. Heart Disease • • • 23 17 17. Aneurysm • • • 1 ■— 18. Other circulatory diseases • • • 1 10 19. Bronchitis • • • — 1 20. Pneumonia (all forms) • • • — 1 21. Other respiratory diseases • > • ■— — 22. Peptic ulcer • . • — — 23. Diarrhaea, etc. (under 2 years) • • • — — 24. Appendicitis • • • 1 — 25. Cirrhosis of liver • • • — — 26. Other diseases of liver, etc. ... • • • — — 27. Other digestive diseases • • • 3 1 28. Acute and chronic nephritis ... • • • 2 1 29. Puerperal sepsis ... • • • — •— 30. Other Puerperal causes • • • — — 31. Congenital debility, premature birth, malformations. etc. • • • 1 32. Senility • • • 3 5 33. Suicide • • • ■— — 34. Other violence ... • • • 2 1 35. Other defined diseases ... • • * 1 3 36. Causes ill-defined or unknown ... — — Special causes (included in No. 35 above) : Small-pox ... . • • — — Poliomyelitis — •— Polioencephalitis ... — — Deaths of Infants Total 2 under 1 year Legitimate ... • . • 1 — Illegitimate ... 1 — Live Births: Total 53 35 Legitimate ... • • • 51 33 Illegitimate ... 2 2 Stillbirths: Total 3 5 Legitimate ... • • • 3 5 Illegitimate • • • WOKINGHAM RURAL DISTRICT, 1939. Resident Population, 26,210. Comparability Factor 0.84. CAUSES OF DEATH. Males. Females All Causes 154 147 ft 1. Typhoid and paratyphoid fevers _ 2. Measles — — 3. Scarlet Fever — — 4. Whooping Cough — — 5. Diphtheria — — 6. Influenza 6 8 7. Encephalitis Lethargica — — 8. Cerebro-spinal fever — — 9. Tuberculosis of respiratory system ... 8 1 10. Other Tuberculous Diseases ... 1 ■— 11. Syphilis ... 1 ■— 12. General Paralysis of the insane. Tabes dorsalis — 2 13. Cancer, malignant disease 22 26 14. Diabetes ... 1 3 15. Cerebral hsEmorrhage, etc. 4 11 16. Heart Disease 36 32 17. Aneurysm 2 — 18. Other circulatory diseases 11 12 19. Bronchitis 5 5 20. Pneumonia (all forms) 8 7 21. Other respiratory diseases 2 2 22. Peptic ulcer 3 ■— 23. Diarrhasa, etc. (under 2 years) — — 24. Appendicitis — — 25. Cirrhosis of liver — — 26. Other diseases of liver, etc. — — 27. Other digestive diseases 2 1 28. Acute and chronic nephritis ... 8 3 29. Puerperal sepsis ... — 1 30. Other Puerperal causes — 2 31. Congenital debility, premature birth, malformations. etc. 8 1 32. Senility 8 12 33. Suicide 2 1 34. Other violence ... 3 6 35. Other defined diseases ... 13 10 36. Causes ill-defined or unknown — 1 Special causes (included in No. 35 above) : Small-pox ... — — Poliomyelitis — — Polioencephalitis — • Deaths of Infants Total 10 3 under 1 year Legitimate ... 7 2 Illegitimate 3 1 Live Births: Total 207 196 Legitimate ... 200 191 Illegitimate 7 5 Stillbirths: Total 9 4 Legitimate ... 9 4 Illegitimate ' ' “ um^ \m: ,,, .-' "k '■ ■■'. 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