65920 Borough of Bermondsey REPORT ON THE SANITARY CONDITION OF THE BOROUGH OF BERMONDSEY For the Year 1926 BY R. KING BROWN, B.A., M.D., D.P.H., Medical Officer of Health. TABLE OF CONTENTS. VITAL STATISTICS PAGE Area 9 Dwellings 9 Rateable Value 9 Population 9 Births 9 Marriages 10 Deaths 10 Infantile Mortality 11 Deaths from Zymotic Diseases 11 Deaths from Measles 11 Deaths from Whooping Cough 12 Deaths from Enteric Fever 12 Deaths from Tubercular Diseases 12 Deaths from Phthisis 12 NOTIFICATION OF INFECTIOUS DISEASE— Attack Rate 13 Diphtheria 13 Scarlet Fever 13 Small Pox 13 Enteric Fever 13 Erysipelas 13 Ophthalmia Neonatorum 14 Puerperal Fever 14 Puerperal Pyrexia 14 Cerebro-Spinal Meningitis 14 Acute Polio-Encephalitis 14 Encephalitis Lethargica 14 Anthrax 14 Pneumonia 14 Bacteriological Laboratory 15 SANITARY ADMINISTRATION- Inspections and Proceedings 15 District Inspectors' Work 20 Wharves and Food Inspectors' Work 21 PAGE Unsound Food 22 Milk Premises 22 Milk Licenses 22 Food and Drugs 22 House and Trade Refuse 23 Offensive Trades 23 Disinfection 23 Cleansing of Persons 24 Mortuary 24 Street Markets 24 TUBERCULOSIS- Tuberculosis Dispensary 26 Light Treatment 29 Leysin Patients 36 Work of the Tuberculosis Dispensary 37 Summary of Notifications 38 Cases on the Register 39 New Cases and Deaths 40 PROPAGANDA 40 MATERNITY AND CHILD WELFARE- Fairby Grange Convalescent Home 43 Work of the Health Visitors 44 Attendances at Centres 45 DENTAL TREATMENT 46 APPENDIX TABLES- Vital Statistics of District 50 Causes of Deaths 53 Deaths from Zymotic Diseases 55 Cases of Infectious Diseases Notified 56 Factories and Workshops—Homework 57 Factories and Workshops —Inspections 58 Bakehouses 59 Maternity and Child Welfare 60 Food and Drugs 61 Public Health (Imported Food) Regulations, 1925 64 PUBLIC HEALTH DEPARTMENT. PUBLIC HEALTH COMMITTEE, 1926. Chairman —Councillor WEIGHTMAN. Councillor Loveland Alderman Gledhill „ Wallsgrove „ Maskell „ Powell Councillor Amos „ Stokes, E. A. „ Burgess „ Stokes, I. „ Heather „ Henrich „ Sweeney „ Horwood „ Virgo „ Howard „ Wayne „ Kidd Ex-officio : Councillor I. STOKES, J.P., Mayor of Bermondsey, 1925-26. Councillor G. CATCHPOLE, J.P., Mayor of Bermondsey, 1926-27. MATERNITY AND CHILD WELFARE COMMITTEE, 1926. Chairman —Councillor NIX Councillor Amos Councillor Powell „ Salter, L.C.C. „ Dye Stokes, E. A. „ George „ Stokes, I. „ Jagger „ Langley „ Virgo „ Wayne „ Loveland „ Newton Co-opted Members: Mrs. E. Campbell Mrs. J. A. Hawke Miss D. Plummer Miss E. M. Haslam Ex-officio : Councillor I. STOKES, J.P., Mayor of Bermondsey, 1925-26 Councillor G. CATCHPOLE, J.P., Mayor of Bermondsey, 1926-27 STAFF : Medical Officer of Health —R. KING BROWN, B.A., M.D., D.P.H. SANITARY INSPECTORS: Mr. E. C. Freeman, Chief Sanitary Inspector Mr. G. L. Scott, Wharves and Food Inspector. Mr. G. A. Hoskins, Wharves and Food Inspector. Mr. W. Davis, Drainage Inspector. Mr. H. J. Toogood, Food and Drugs Inspector. Mr. J. G. Francksen, Markets Inspector District Inspectors : No. 5.—Mr. G. F. J. Toll No. 1.—Mr. O. W. R. Smart No. 2. —Mr. E. J. Pitts No. 6.—Mr. H. E. Butcher No. 7.—Mr. A. H. Merryman No.3. —Mr. W. G. Luke No. 4. —Mr. J. W. Wood TUBERCULOSIS DISPENSARY. Clinical Tuberculosis Officer and Deputy Medical Officer of Health —Dr. D. M. Connan, M.B., B.S., D.P.H. Assistant Tuberculosis Officer—Dr. A. H. Kynaston, M.R.C.S., L.R.C.P. Tuberculosis Nurses —Miss O. Pike, Miss M. Stevens and M. Wells. Caretaker —Mr. H. J. Madasa. MATERNITY AND CHILD WELFARE : Assistant Medical Officers for Maternity and Child Welfare — Dr. Maud C. Cairney, M.B., Ch.B., D.P.H.; Dr. Ruth W. Plimsoll, M.B., B.S., D.P.H. Health Visitors : District. District. No.1. —Miss F. Mercer No. 5.—Miss R. Bache No. 2. —Miss I. White No. 6.—Mrs. D. Cottier No. 3. —Miss M. Helden No. 7.—Miss A. Carlton No. 8.—Miss F. Wadds No. 4. —Miss J. Child Dental Treatment : Municipal Dental Surgeon —Mr. Grantley Smith, H.D.D. Edin., L.D.S. Eng. Assistant Dental Surgeon (part-time) —Mr. C. O. Gray, L.D.S. Glas. Dental Nurses—Miss W. Lambert and Mrs. D. Hodgson Prosthetic Assistants—Mr. G. W. Clarke and Mr. W. B. Monger Fairby Grange Convalescent Home : Matron —Miss A. E. Sewell Nurse —Mrs. M. A. Barden PUBLIC ANALYST. Mr. A. Prideaux Davson, A.R.C.Sc., F.I.C., F.C.S. CLERICAL STAFF : Mr. H. W. Bush, Chief Clerk and Assistant Administrative Officer Mr. C. F. Yaxley, General Clerk Mr. A.I. Fair, First Clerk Mr. F. W. Smith, Second Clerk Miss R. Dutch, Clerk and Dispenser Mr. E. F. Walsh, Third Clerk Mr. W. C. Tapsfield, General Clerk Mr. A. Manning, M. and C.W. Clerk Mr. F. J. Carpenter, Junior Clerk Mr. F. R. Parker, Junior Clerk Mr. C. W. Whye, General Clerk MORTUARY KEEPER : Mr. J. C. Stockwell FOREMAN DISINFECTOR: Mr. F. Delacour PUBLIC HEALTH DEPARTMENT, TOWN HALL, SPA ROAD, S.E.16. Borough of Bermondsey. ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH. To the Mayor, Aldermen and Councillors of the Borough of Bermondsey. Ladies and Gentlemen, — I have the honour to submit my Twenty-sixth Annual Report on the sanitary condition of the Borough of Bermondsey for the year 1926. The death rate was 12.1, compared with 12.6 in 1925, and 13.6 in 1924, and it is the same figure as that for 1923, which I pointed out as the lowest reported death rate in Bermondsey. When one gets a low record of this kind, one always has a little doubt whether the lowering is permanent, but, in this case, one may consider that the period of probation is past, and that the general death rate will either remain at the present figure or go lower, unless we are visited by some very malignant epidemic. In infectious diseases generally, the attack rate has gone up to 10.84 against 8.84 in 1925. This is practically wholly due to diphtheria, which was prevalent in the autumn of 1926. There is a movement among some Sanitary Authorities at the present time, not only to find out children who are specially susceptible to diphtheria, but also to provide immunity against attack for those who are susceptible, and this is known as the "Schick" test. I hope to make a report on this matter at an early date, as this is the most fatal of our present infectious diseases, and although the case mortality has been enormously reduced since the introduction of anti-toxins, the general prevalence of the disease seems to be on the increase. I have to report again a reduction in the birth rate, which was 19.6 against 21.6 in the previous year. This is somewhat unexpected, especially in a district like Bermondsey, which is almost entirely inhabited by the industrial classes. When I first came to Bermondsey, the birth rate was round about 28 to 30, but the reduction has been specially marked since the War period. This is looked upon askance by many persons, but I think that those who are acquainted with the enormous difficulties that the working class mother has to contend with, will not look upon the reduction of the birth rate as an unmitigated evil. There were several minor changes in the staff during the year. We took over charge of the whole of the drainage, which necessitated the appointment of a special drainage inspector. The new Regulations for puerperal fever and puerperal pyrexia came into force during the year 1926, and necessitated the appointment of consultants who would be available for the general practitioner requiring a second opinion, especially in cases of puerperal pyrexia, and also facilities were provided under the Regulations for bacteriological examination for these cases. Before closing these general remarks, I would like to thank first of all the Chairman of the Public Health Committee and the Maternity and Child Welfare Committee for their unfailing courtesy and support on all measures which were introduced for the benefit of the public health. These measures always received the unstinted support of the Committees and the Council. As regards the way my staff have carried out their duties I have nothing but praise. In my last year's annual report I specified the heads of the various sections into which the Public Health Department is divided, and I not only say generally that I do' not believe that there is another Medical Officer of Health who is better served, not only by the ladies and gentlemen in charge of these various departments, but by the subordinate staff. I am, Ladies and Gentlemen, Your obedient Servant, R. KING BROWN. 1.—VITAL STATISTICS. GENERAL. The area of the Borough (exclusive of area covered by water) is 1,336 acres. At the 1921 Census there were 18,266 structurally separate dwellings in the Borough, which were inhabited by 28,610 families or separate occupiers. The rateable value of the Borough on the 31st December, 1926, was £1,081,287, the product of a penny rate being £4,335. POPULATION. The population of the Borough of Bermondsey, as enumerated in the Census of 1911 and 1921, and the estimate of the year under report are as follows :— 1911 1921 Estimated to June 30th, 1926 125,903 119,452 123,100 The population of Bermondsey for 1926 has been estimated by the Registrar-General as 123,100, and this figure has been utilised in estimating the birth and death rates. BIRTHS. The total number of births registered in the Borough for the 52 weeks ended January 1st, 1927, was 2,414, consisting of 1,226 males, and 1,188 females. This is 571 below the average for the last 10 years, and 238 below the figure for 1925. The birth rate for 1926 was 19.6 per thousand persons living, which is 2.0 below that for 1925 and 4.6 below the average for the last 10 years. The birth rate is unusually low for Bermondsey, but the same may be said of the death rate, and subtracting the latter from the former, leaves us with a net increase of population of 7.5. MARRIAGES. The total number of marriages in the Borough in 1926 was 994, being 44 below the number for 1925, and 122 below the average for the last 10 years. The figures have been supplied by the Superintendent Registrar. This makes a marriage rate of 16.15 per 1,000 of the population, compared with a marriage rate last year of 16.88 of the population, 123,000. Year No. Rate 1916 1,215 19.65 1917 1,015 16.92 1918 1,106 18.21 1919 1,242 19.19 1920 1,383 21.40 1921 1,084 17.99 1922 1,008 16.64 1923 1,056 17.34 1924 1,015 16.62 1925 1,038 16.88 Average for years 1916 —1925 1,116 18.08 1926 994 16.15 DEATHS. In Tables I. and II. of Appendix will be found tables dealing with deaths in the Borough. The total number of deaths registered in the Borough for the year ended December 31st, 1926, was 1,163, which is 117 less than in 1925 and 353 below the average for the last 10 years. When this figure is corrected by exclusion of deaths of nonparishioners occurring in the district, and the inclusion of deaths of parishioners occurring outside the district, the number is raised to 1,484. This is 70 less than in 1925, and 330 less than the average for the last 10 years. The death rate for the Borough in 1926 was 12.1 per thousand living inhabitants, being 0.5 below that recorded in 1925, and 3.3 below the average for the last 10 years. In column 1, foot of Table 1. of the Appendix, will be found a list of places where deaths of non-parishioners occurred in the district. There were 31 such deaths in all, against 47 in 1925 and 43 in 1924. 352 persons belonging to this Borough died in outlying institutions, against 321 in 1925, and 337 in 1924. The names of the various places where the deaths occurred will be found in columns 2 and 3 at foot of Table I. of Appendix. INFANTILE MORTALITY. The figure for this is 60 deaths under one year to every 1,000 births. TABLE A.-INFANTILE MORTALITY. Year Whole Borough London No. of Deaths Rate per 1,000 Births Rate per 1,000 Births No. of Deaths 364 108 1916 8,819 88 1917 335 125 8,273 103 322 7,965 107 139 1918 262 99 7,039 85 1919 337 1920 83 75 - 80 1921 306 95 - 324 102 1922 - - 220 76 1923 - - 229 78 - 1924 - 210 79 - 1925 - - Average for years 1916-1925 291 - 98 1926 60 - 146 - DEATHS FROM ZYMOTIC DISEASES. There has been a decrease in the deaths from these diseases, the figures being 94 against 96 in the previous year, and 171 the average for the last 10 years. This gives a zymotic death-rate of .76. MEASLES. There were 24 deaths due to this disease, which is 20 below the average for the last 10 years, and 4 above the number for 1925. WHOOPING COUGH. One death was due to this cause, against 27 in 1925. ENTERIC FEVER. There were no deaths due to this cause in 1926 and 1925. TUBERCULAR DISEASES. The number of deaths from all forms of tubercular disease in 1926 was 170, against 170 in 1925. PHTHISIS. In Table B will be found particulars of deaths from phthisis since the year 1916. There were 151 deaths due to this cause, which is 6 more than the number recorded in the previous year. TABLE B.-PHTHISIS. Sub-District Bermondsey Rotherhithe St. Olave Whole Borough London Year No. Rate No. Rate No. Rate No. Rate No. Rate 1916 126 1.70 44 1.38 14 1.78 184 1.61 6288 1.45 2.02 1.88 1917 123 1.75 61 14 198 1.83 6658 1.57 1.66 1918 117 43 1.42 9 1.20 169 1.56 7048 1.78 1919 1.28 58 1.39 104 1.66 12 174 1.40 5332 - 1920 81 0.96 46 1.27 10 1.12 137 1.06 - - 1921 106 43 14 163 - - - 1.35 - - 1922 119 43 7 169 1.39 - - - - - 95 35 1923 - - 14 - 144 1.18 - - 1924 92 - 11 - 46 - 149 1.22 - - 1925 99 35 11 145 1.18 - - - - - Averages for years 1916-1925 - 45 - - 1.38 106 12 163 - - 1926 39 12 - 1.23 100 - - 151 - - II.—NOTIFICATION OF INFECTIOUS DISEASE. In Table IV. of Appendix will be found particulars of infectious diseases notified during the year under report. The number of cases of infectious diseases notified, exclusive of notifications of tuberculosis, which numbered 265, was 1,334, compared with 1,087 in 1925 and 1,264 in 1924. The attack rate per thousand inhabitants was 10.84 against 8.84 in 1925. 83 cases were returned from hospital as not suffering from the disease for which they were notified, but, if allowance is made for mild unreported cases, the recorded notifications would, if anything, understate the actual number of cases. DIPHTHERIA. There were 714 cases of diphtheria notified in 1926 as against 535 cases in 1925. The attack rate per thousand inhabitants was 5.80, against 4.35 in 1925. The case mortality was 5.9 per cent., against 5.4 per cent. in 1925 and 4.6 per cent. in 1924. Fifty cases were returned as not suffering from this disease. SCARLET FEVER. The notifications of scarlet fever in 1926 were 426, against 353 in 1925. This is an increase of 73. The distribution of the disease in the various Wards, as shown in Table IV. of Appendix, was fairly uniform. Thirty-two cases were returned from hospital as not suffering from scarlet fever. There were 6 deaths, which gives the very low case mortality of 1.4 per cent., against .85 per cent. in 1925. The disease, as in recent years, was of a very mild type. The attack rate per thousand inhabitants was 3.46 against 2.87 in 1925. SMALL POX. There were no cases notified during 1926 and 1925. ENTERIC FEVER. Three cases were notified during 1926 as against 5 in 1925. One case was returned from hospital as not suffering from this disease. ERYSIPELAS. Thirty cases were notified during 1926 as against 35 in 1925. OPHTHALMIA NEONATORUM. There were 10 cases of this disease notified during 1926, as against 15 in 1925. Under this heading is included every kind of "sore eyes" occurring in the newly born. They were all visited by the Health Visitors, who instructed the mother in each case to immediately seek medical advice. Cases Vision Un- Impaired Vision Impaired Total Blindness Deaths Treated 1 Notified At home In Hospital 10 7 3 10 - - - It will be observed from the above table, that in no case was vision impaired, which is very satisfactory. PUERPERAL FEVER. Nine cases were notified during 1926, as against the same number in the previous year. PUERPERAL PYREXIA. This disease was made notifiable on the Ist October, 1926, and from that date until the end of the year 11 cases were notified. CEREBRO-SPINAL MENINGITIS. Five cases were notified in 1926 as against 3 cases in 1925. ACUTE POLIO-ENCEPHALITIS. One case was notified in 1926. ENCEPHALITIS LETHARGICA. Eight cases were notified in 1926 as against the same number in the previous year. ANTHRAX. Four cases were notified in 1926 as against three cases in 1925. ACUTE PRIMARY AND ACUTE INFLUENZAL PNEUMONIA. 113 cases were notified in 1926 as against 119 cases in 1925. BACTERIOLOGICAL LABORATORY. The total number of specimens examined in 1926 was 4,048, as compared with 3,936 in 1925, and 3,624 in 1924. TABLE C. Total Examinations Results of Examination Nature of Specimen Positive Negative 1925 1926 1925 1926 1925 1926 Diphtheria (specimens taken by Medical Officer of Health) 23 884 1155 19 861 1136 Ditto (taken by general practitioners) 1213 93 119 1335 1120 1216 2097 138 Diphtheria (total specimens taken) 2490 116 1981 2352 Phthisis 1806 1497 279 234 1527 1263 Various 33 61 4 12 29 49 Total specimens taken 3936 4048 399 384 3537 3664 CONTACTS. We still keep very busy in the laboratory, as the above table shows. There was an increase of 271 in the number of school contacts examined, and out of a total of 1,155, 19 were positive. These children came up for re-examination in a week, and were not allowed to return to school until the examination proved negative. 111.- SANITARY ADMINISTRATION. INSPECTIONS. In the following Tables D. and E., will be found particulars of the general sanitary work by the District Inspectors during 1926. The house-to-house inspections numbered 5,405. This is 832 above the total for the previous year. 6,048 intimation notices were served, compared with 5,297 in the previous year. TABLE D.-PROCEEDINGS DURING 1926. Number on Register at end of 1926 Premises Number of Inspections Number of Prosecutions Cowsheds - - - 206 761 Milkshops - Houses let in lodgings 223 446 - 197 Ice Cream Premises 92 - Slaughter-houses - - - Offensive Trades (including Poultry Slaughter-houses) 13 26 - SMOKE NUISANCES- Number of observations 13 Number of notices 7 Number of complaints 2 Number of summons Nil HOUSING— Number of new houses erected during the year:— (a) Total (including numbers given separately under (b)) Nil (b) With State assistance under the Housing Acts:— (i.) By the Local Authority Nil (ii.) By other bodies or persons Nil (1) Unfit Dwelling Houses : — Inspection—(i.) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 6,039 (ii.) Number of dwelling-houses which were inspected and recorded under the Housing Consolidated Regulations, 1925 5,405 (iii.) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 164 (iv.) Number of dwelling-houses (exclu-sive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 3,946 (2) Remedy of Defects without Service of Formal Notices. Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their officers 3,169 (3) Action under Statutory Powers. (A) Proceedings under Section 3 of the Housing Act, 1925: — (i.) Number of dwelling-houses in respect of which notices were served requiring repairs 3,946 (ii.) Number of dwelling-houses which were rendered fit after service of formal notices:— (a) By owners 772 (b) By Local Authority in default of owners 5 (iii.) Number of dwelling-houses in respect of which Closing Orders became operative in pursuance of declarations by owners of intention to close Nil (B) Proceedings under Public Health Acts :— (i.) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 1,733 (ii.) Number of dwelling-houses in which defects were remedied after service of formal notices :— (a) By owners 322 (b) By Local Authority in default of owners Nil (C) Proceedings under Sections 11, 14 and 15 of the Housing Act, 1925 :— (i.) Number of representations made with a view to the making of Closing Orders 1 (ii.) Number of dwelling-houses in respect of which Closing Orders were made 1 (iii.) Number of dwelling-houses in respect of which Closing Orders were determined, the dwelling-houses having been rendered fit 5 (iv.) Number of dwelling-houses in respect of which Demolition Orders were made Nil (v.) Number of dwelling-houses demolished in pursuance of Demolition Orders Nil Total number of houses in the Borough 18,252 Number of houses occupied by the working classes 18,102 UNDERGROUND ROOMS— Number illegally occupied 1 Number closed or illegal occupation discontinued 1 OVERCROWDING— Number of rooms overcrowded Nil Number remedied Nil Prosecutions Nil CLEANSING Number of adults cleansed 182 Number of children cleansed Nil Number of rooms or premises cleansed 2,229 WATER SUPPLY TO TENEMENT HOUSES— Premises supplied 8 Prosecutions Nil SALE OF FOOD— Number of premises used other than ice-cream premises, milk shops and cowsheds 592 Number of inspections 4,051 DISINFECTION SHELTER— Persons accommodated 25 OPHTHALMIA NEONATORUM REGULATIONS- Number of notifications received during the year from certified midwives Nil NUMBER OF PROSECUTIONS UNDER BY-LAWS UNDER PUBLIC HEALTH ACT, 1891 :- (a) For prevention of nuisance arising from snow, ice, salt, filth, etc. (b) For prevention of nuisance arising from offensive matter running out of any manufactory, etc. — (c) For the prevention of keeping of animals in such a manner as to be injurious to health — (d) As to paving of yards, etc., of dwelling houses — (e) In connection with the removal of offensive matter, etc. — (f) As to cesspools and privies, removal and disposal of refuse, etc. (g) For securing the cleanliness of tanks, cisterns, etc. (h) With respect to water closets, earth closets, etc. (i) With respect to sufficiency of water supply to water closets (j) With respect to drainage, etc. (Metropolis Management Act, Sec. 202) (k) With respect to deposit of plans as to drainage, etc. (Metropolis Management Acts Amendment (By-laws) Act, 1899) Number of prosecutions under the Public Health (Meat) Regulations, 1924 Number of prosecutions under the Milk and Dairies (Consolidation) Act, 1915 TABLE E.—WORK OF DISTRICT INSPECTORS, 1926. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 Special Inspections Complaints Restaurants and Eating Houses Infectious Diseases Fishmongers, Friers and Curers Food Stores Ice Cream Markets Factories and Workshops Specially Inspected Outworkers' Bi-Annual Inspection Underground Conveniences Offensive Trades Other Calls and Visits Various Drains Tested Chimneys watched Bakehouses Butchers Destruction of Food Fruiterers and Greengrocers TOTALS House-to-House Visits Ints. 757 692 257 9 1 33 151 40 16 86 52 5 429 77 33 167 23 3453 62 92 3 6438 1024 718 444 308 6 22 78 50 5 28 148 153 54 7 148 67 6 11 5646 688 492 20 2835 46 866 383 496 296 40 - 24 78 93 2797 - 48 99 471 189 62 112 129 1 13 6505 708 308 312 9 - 47 7 6080 800 330 522 119 35 43 3411 2 50 80 110 41 22 75 65 893 - 1 59 50 165 4 1 5674 993 793 26l 551 351 79 62 2688 1 48 135 72 189 83 31 50 74 109 27 332 117 65 59 4 647 710 403 379 22 - 12 3120 4 38 168 49 1 6340 935 133 19 47 6247 824 349 355 26 - 19 76 3890 - 14 230 37 112 44 10 61 1 - 807 5405 3001 3194 575 248 197 965 498 16 42930 2258 383 25 207 22194 13 1117 401 1243 562 41 6048 387 Mr. Davis, Drainage Inspector (October 1st to December 31st): —Nuisances, 2 ; Drains tested, 201 Totals —Visits, 702; Ints., 2 TABLE F.-WORK OF THE WHARF AND FOOD INSPECTORS, 1926. 1 2 3 4 5 6 7 8 9 10 11 Visits Food Factories Fish Curers Food Stores Food Wharves and Depots Milksellers Restaurants Nuisances Found Intimations Served Various Number of Samples taken Other Unsound Food Regulations Food and Drugs Butter and Margarine Destruction of Food Jam 8 628 2069 - 315 - - 84 3 Mr. Scott 90 - 90 - - - 12 339 15 59 849 2015 15 214 5 7 Mr. Hoskins 492 115 - 1185 571 - 8 30 2 Mr. Davis - 1 27 - 238 30 - - 24 24 Mr. Toogood - - - - 190 - 54 - 388 - - - 59 761 66 16 67 1715 4084 15 255 1573 10 Total Visits 429 609 537 (21) UNSOUND FOOD. The following were brought to the notice of the Department, found to be unfit for human food, and destroyed :— Tons cwts. qrs. lbs. Fresh Meat 1 10 0 6 Fresh Fish - 1 3 19 Fresh Fruit 1 18 2 5 Tinned Goods - - 2 0 Total 4 1 0 2 MILK PREMISES. MILK AND DAIRIES (AMENDMENT) ACT, 1922. Twenty milksellers were registered under the above Act during 1926, and 27 names were removed from the Register, making a total of 206 milksellers on the Register at the end of the year under report. MILK (SPECIAL DESIGNATIONS) ORDER, 1923. During the year under report, the following Licenses were granted :— Dealers' Licenses :— To bottle and sell Grade " A " (Tuberculin Tested) Milk 9 To sell Grade "A" (Tuberculin Tested) Milk 23 Supplementary Licenses : — To sell " Certified " Milk 4 To sell Grade "A" Milk 4 To sell Grade "A" (Tuberculin Tested) Milk 6 To sell "Pasteurised" Milk 4 FOOD AND DRUGS. In Table IX. of Appendix will be found a list of the samples taken in 1926, and the action taken; 1,566 samples were taken, compared with 1,553 in 1925, and 1,330 in 1924. Of these 4.1 per cent. were found adulterated, compared with 2.8 per cent. in the previous year, and 2.2 per cent. in 1924. HOUSE AND TRADE REFUSE. The following table shows the amount of house and trade refuse disposed of during the year ended December, 1926 : — Loads tons cwts. qrs. House Refuse to Barge 13,343 21,774 8 2 „ various Shoots 289 466 0 0 Trade Refuse to Barge 1,962 1,937 19 2 „ „ various Shoots - - - - Totals 15,594 24,178 8 0 OFFENSIVE TRADES. The offensive trades on the Register are as follows : — Tripe boiler 1 Glue and size makers 4 Fellmongers 3 Fatmelters 4 Manure Manufacturer 1 DISINFECTION. The following table shows the number of articles passed through the steam disinfector during the year under report:— Beds 1,341 Pillows (cases) 2,074 Blankets 2,949 Quilts 1,522 Bolsters 910 Sheets 1,890 „ (cases) 321 Books 548 Carpets Nil Miscellaneous 6,999 Cushions 276 Verminous Clothing 1,753 Mattresses 292 „ Bedding 325 Overlays 754 Hair (Bundles) Nil Pillows 2,636 „ (cases) Nil 25,032 new tabs were used to replace those taken off mattresses, palliasses, and cushions before disinfection. Number of rooms disinfected 2,229 CLEANSING OF PERSONS' ACT, 1897. During the year under report 163 male and 19 female adults used the Verminous Baths, and had their clothing disinfected. The total number of articles disinfected for this purpose was 1,753. MORTUARY. Total number of infectious bodies removed 5 Total number of bodies removed 73 STREET MARKETS. Full details of the staff, with the various reports made on the above to the Council, were given in my last annual report for 1925. There is very little to add, except that the Bermondsey Borough Council (Street Trading) Act, 1926, came into force in November, 1926, and hereunder will be found the various details concerning applications for licences, finance, etc. At the present time the Act is working very smoothly, and the experience gained, not only in our voluntary market scheme, but in the scheme as it is under the Act, has formed the basis of legislation for London generally by the London County Council (General Powers) Bill. Of the various public health measures which have been brought forward of late years, this is one of the most useful, but it is a case in which much more depends on the good-will displayed, not only by the Borough Council, but the trader himself in carrying out the provisions of the Act, than in merely trying to enforce the provisions of the Act. Those who take a superficial view of it look upon it as one of the simplest things in the world to get an Act to regulate the markets, and then simply sit down to regulate them on paper, but anybody who gains a little practical experience in the working will find that this is an entirely erroneous view, and that the question of street trading, from the point of view of both the street trader and the Borough Council, is a very complicated affair, and the question of pleasing the traders themselves, who may be presumed to know their own business best, is one requiring an immense amount of patience, knowledge and general goodwill on the part of the officials who are charged with carrying out the Act. We have been very fortunate in Bermondsey in this respect, since we have in the Chief Inspector, Mr. E. C. Freeman, a man who has not only the necessary knowledge but the goodwill and patience, the result being that the amount of friction in the working of the Act is practically nil. I would like to mention that Mr. Freeman is very ably backed up by the Market Inspector, Mr. Francksen. Applications received for licenses 680 Applications refused 74 Applications withdrawn 2 Licenses granted 581 Licenses revoked 2 Licenses cancelled or given up 12 Licenses in operation on 31st December, 1926 567 Fees collected from commencement of the Act, Ist November, 1926 to 2nd January, 1927 £393 1 0 Fees for Licenses £147 5 0 Fees collected under the voluntary system from Ist January, 1926 to 31st October, 1926 £1245 3 0 The total amount of refuse collected from the Street Markets during 1926 was:- 805 van loads 1,006 5 Tons cwt. 203 barrow loads 30 9 Total 1,036 14 TUBERCULOSIS DISPENSARY. SCHEME FOR THE TREATMENT OF TUBERCULOSIS FOR THE FINANCIAL YEAR COMMENCING Ist APRIL, 1927. The Ministry of Health and the County Council have requested this Council to submit a scheme for the treatment of tuberculosis for the financial year commencing Ist April, 1927. The Medical Officer has submitted the following report, which embodies all the points alluded to in the letter from the County Council. The following is the staff concerned with the work of Tuberculosis in the Borough Name Qualifications and Degrees Remuneration per Annum Duties Date of Appointment Richard King Brown £ s. Administrative and Supervisory M.D., D.P.H. 1911 - Donald M. Connan M.B., B.S., M.R.C.S., L.R.C.P., D.P.H. 750 0 Clinical 1st April, 1921 Clinical A. H. Kynaston M.R.C.S., L.R.C.P 350 0 (half-time) 275 0 1st May, 1925 Olive Pike Visiting and assisting at Dispensary Fully Trained Nurse 1st April, 1921 Celia Clapson Ditto 200 0 Ditto 7th December, 1926 Solarium Nurse May Wells Ditto 225 0 7th October, 1924 Ditto Gladys Pearce Ditto 200 0 16th November, 1926 Rose Dutch Clerk and Dispenser Apothecaries' Hall Dispenpensing Qualification 235 1st April, 1921 Frederick W. Smith Clerk - 20th January, 1920 - Caretaker Various; Weighing patients, etc. 182 0 (fire, lodging, and light) 7th March, 1922 - Mr. F. W. Smith is a Clerk in the Public Health Department, who devotes about six hours weekly to the Tuberculosis Dispensary. The above staff is a part of the Public Health Department and the duties comprise the following : — (1) Receiving notifications of Tuberculosis on Forms A, B, C and D, and keeping a register of these. (2) Keeping administrative and clinical records of all cases and suspected cases of Tuberculosis in the Borough. (3) Supervision and periodical examinations of all cases of Tuberculosis, including regular visitation of the homes by a Dispensary Nurse, the giving of advice on hygiene, and reporting insanitary conditions to the Medical Officer of Health. (4) Assisting general practitioners in the diagnosis of Tuberculosis, and advising them as to treatment, both in insured and non-insured cases. (5) Examination of "contacts." (6) Special examinations of ex-sailors and ex-soldiers for the Local Pensions Committee and the Medical Boards of the Ministry of Pensions. (7) Giving special treatment, such as "Tuberculin," and light treatment, and giving medicinal treatment in cases where, for special reasons, they are not being treated by general practitioners, Poor Law doctors, or other medical men. (8) Making recommendations to the London County Council regarding treatment in residential institutions, and making progress reports to the London County Council of cases that have been treated in a sanatorium. (9) Co-operating with general practitioners in the examination, supervision and treatment of insured persons. (10) Acting as tuberculosis consultant to Bermondsey and Rotherhithe Hospital. The Tuberculosis Officer visits the hospital once a week. Special Facilities at Hospitals, etc. —The Tuberculosis Dispensary has been linked up with Guy's Hospital for the purpose of providing observation beds and special facilities for treatment and diagnosis. The authorities and medical staff at Guy's have agreed to undertake this work free of charge. Arrangements have also been made for the taking of X-ray photographs at a charge of 7s. 6d. each, and pneumothorax treatment at Brompton Hospital at 10s. 6d. per refill. Tuberculosis subjects attend at our Municipal Dental Clinic at 110 Grange Road. A special fortnightly session is set aside for these patients. The following is the scheme for the distribution of extra nourishment:— Supply of Extra Nourishment to Tuberculous Persons :— (1) Extra nourishment comprises milk, eggs, butter, oatmeal. (2) It is supplied only to necessitous tuberculous persons of the borough. (3) Extra nourishment is only supplied on the recommendation of the Tuberculosis Officer, after investigation of the conditions by the Dispensary Nurse. (4) The period for which extra nourishment is given is fixed by the Tuberculosis Officer and decided on medical grounds. It is estimated that the expenditure for next year will be as follows :— £ s. d. 1. Salaries of Medical Staff 1,100 0 0 2. Nurses 483 0 0 3. Salaries of other staff employed at the Dispensary 439 0 0 4. Loan charges, rates, taxes, insurance and telephone 245 0 0 5. Heating and lighting and repairs 500 0 0 6. Drugs and medical appliances 100 0 0 7. Special Treatment, etc., e.g., X-ray examinations 75 0 0 8. Dental treatment 175 0 0 9. Extra nourishment 240 0 0 10. Travelling expenses of staff 5 0 0 11. Printing and stationery 55 0 0 12. Laundry 25 0 0 13. National Insurance Act 7 0 0 14. Workmen's compensation 6 0 0 15. Superannuation contributions 56 0 0 16. Provision of shelters 150 0 0 17. Beds and bedding for shelters 40 0 0 ]8. Beds and bedding for patients 10 0 0 19. Post-Graduate Course 30 0 0 20. Refresher course for nurses 10 0 0 21. Solarium 855 0 0 22. Patients to Leysin, Switzerland 900 0 0 £5,506 0 0 LIGHT TREATMENT. In the following report by Dr. D. M. Connan will be found a full account of the new solarium. I need not say very much about it except just to state generally that light treatment has come to stay. We have only touched the fringe of its possibilities , and what the future will bring forth it would be bold to prophesy. There is one thing, however, I think may be said and that is that it is going to be of very much more benefit to the people of northern countries, where the natural sun is deficient, than to the people from the climates of southern Europe and the tropics who are much more accustomed to plentiful sunlight. It has been found, for instance, that fair skinned Europeans benefit much more by artificial sunlight in the treatment of wounds than the dark skinned Turks of Asia Minor, and this, no doubt, will apply generally. Further developments probably will be in the direction of allowing those domestic animals, useful to man, such as cows, to benefit from the ultra-violet rays. I need only restate that the Bermondsey solarium is the first of its kind on any considerable scale in the country. Lamps have been installed, of course, in many places, but the general planning of the building and the methods used are quite original. Dr. D. M. Connan's Report :— "During the first six months of 1926 light treatment was continued as before in the temporary Light Clinic in the Tuberculosis Dispensary. The new Solarium was opened by the Mayor in June, 1926, when a large number of Councillors and other persons of prominence in the Borough, were present. Addresses were given by Professor Leonard Hill, F.R.S., and Dr. Salter, M.P., and by the Medical Officer of Health. The building is constructed upon a small site, 73ft. by 80ft., and at the rear of the Tuberculosis Dispensary in Grange Road. The site originally formed the gardens of the two houses, 108 and 110 Grange Road. There are separate entrances in Alscot Road, one for males and one for females, and there is easy access to the Dispensary. The building is constructed of corrugated iron, lined with matchboarding; the roof is also of corrugated iron, with lantern lights. The accompanying plan gives a clear idea of the arrangement of the rooms. The building is divided into two by the nurses' and doctors' rooms, which occupy the centre. There are two large rooms for light treatment, one for males, and the other for females, each measuring 32ft. by 25ft. Corresponding to each room there is a small dressing room, with lockers and pegs, and a w.c. Two concreted courtyards are provided, 36ft. by 36ft. The mercury vapour lamps are supplied with specially long leads, so that they can be taken out into these yards, when the weather is propitious, thus enabling treatment to be given actually in the open air. On that side of the treatment rooms, which is adjacent to the courtyard there is a large folding door, which extends the whole width of the room. Except in very inclement weather, this door is kept open, so that the maximum amount of fresh air and natural light may enter the room. This prevents overheating, which seems to be a common defect of many clinics. The "male" half of the building, including entrance, dressing room, treatment room, and courtyard, is entirely separated from the female half. In each treatment room there is one carbon arc lamp, suspended in the centre of the room. From eight to ten patients can be treated simultaneously at these lamps. Each room further has four mercury vapour lamps. Three of these, the Jesionek lamps, fixed on moveable stands which can be wheeled into any desired position in the room or the courtyard. Three patients can be treated at a time with these lamps. The fourth lamp is of the type known as the Hanovia Alpine Sun lamp. This also is a moveable lamp, but is adapted for local rather than general treatment, and is also used for treating infants lying prostrate on a stretcher. The arc lamps are controlled from the consulting room, the mercury vapour lamps by means of a local switch. There is a lamp plug in the consulting room, to which any of the mercury vapour lamps may be attached, thus providing seclusion for those cases in which complete nudity may be necessary during treatment. The Kromayer lamp, which requires a supply of water for cooling purposes, is generally operated in this room. As will be seen from the plan, the middle of the building is occupied by the nurses' room, and the doctors' consultation room. The patients are weighed in the nurses' room, where also any necessary dressings are done; they are thus examined in the consultation room. This brief description of the building will suffice to explain the size and arrangements of the clinic. If the accommodation were taxed to its utmost, approximately 300 to 350 patients could be treated in one day. At present, the maximum number is 170. During the year 1926 the total number of individual patients treated has been 341, and the total number of attendances has been 10,416, giving an average of 30 attendances per patient. Each patient attends twice or three times a week, according to the prescription of the doctors, and the length of exposure begins in all cases with a short period. With the mercury vapour lamps the beginning exposure is from 20 sees, to 1 min., and the maximum exposure from 10-15 mins., at a distance of 3ft. With the carbon arc, the beginning exposure is five minutes, going up to a maximum of one hour. In addition, all the patients of school age, with the exception of one or two children are put through a course of physical exercises based on the Board of Education syllabus after the light treatment has been given. Patients come from various sources; many are sent from the Tuberculosis Dispensary and from the Maternity and Child Welfare Clinics —both municipal and voluntary. Private practitioners have made great use of the clinic, and have sent up a large number of patients, and a smaller number attend voluntarily, having heard from various sources of the existence of the clinic. Patients suffering from many different diseases have been sent up for treatment. Thus we have had many varieties of Tuberculosis, e.g., Tuberculosis of bones and joints and glands, Tuberculosis, enteritis, Tuberculous abdominal glands, and many cases of enlarged bronchial glands, numerous cases of Lupus, and a few cases of Pulmonary Tuberculosis have also been treated. Alopœcia, Acne, Aortic Disease, Asthma, and Bronchitis, Dermatitis of various sorts, Psoriasis, Neuritis, and Sciatica, various forms of Rheumatism, Rickets, and Malnutrition are among the more prominent types sent up for treatment. Cases of Definite Tuberculosis of all forms comprise 27 per cent, of the total number treated, while cases of Debility and Malnutrition form 37 per cent. of the total. The great majority of this latter class —debilitated children—come from the Dispensary as "contacts," which are likely to develop Tuberculosis later on, in the absence of prophylactic treatment. Thus, approximately 64 per cent. of the cases treated are connected with the Tuberculosis scheme for the Borough. A list of the principal diseases and the number of cases treated is given below : — Tuberculosis of Spine 5 „ Ankle 2 „ Hip 3 „ Knee 3 „ Wrist 1 „ Abdomen 2 „ Skin 7 „ Glands 18 „ Bronchial Glands 39 „ Lungs 12 „ Pleura 3 Debility, Malnutrition, Scrofula, etc. 127 Rickets 32 Sciatica and Neuritis 9 Chronic Rheumatism, Rheumatoid Arthritis, etc. 11 Varicose Ulcers 6 Alopœcia 10 Acne 5 Aortic Disease 1 Asthma 1 Bronchitis 9 Bronchiectasis 2 Dermatitis—trade 2 Eczema 1 Fragilitas Ossium 1 Haemophilia 1 Psoriasis 2 It is obviously impossible and unnecessary to give details of all these cases, and the more important classes only will be dealt with in this report. Every patient sent up for treatment is examined carefully by the doctor at the first attendance, and the exact treatment prescribed. Three sessions a week are devoted to examination by myself and Dr. Cairney and Dr. Plimsoll, each do one session a week, at which they see children sent up from the Maternity and Child Welfare Clinics for treatment. Subsequent examinations are made at intervals, which vary with the nature of the case and the progress made. Some general observations should be made at this point :— (1) Regular attendance for treatment is an absolute essential if the treatment is to be carried out properly and effectively. Progress is often delayed because this fact is not appreciated. (2) Children who come from very overcrowded homes, and many such attend the clinic, make slow progress. Light treatment is, no doubt, of special value in such cases; but it will only counteract in part the results of bad housing conditions and overcrowded homes. (3) Many patients will not believe that they are getting treatment of any value unless it is conveyed to the mouth from a bottle. If all the bottles in Bermondsey were melted up and converted into Grade A T.T. milk bottles, the health of the Borough would be much improved. (4) Improvement is slow, and prolonged treatment is necessary in most cases. Patients too often look for dramatic results, forgetful of the fact that the treatment requires the exercise of patience and courage on their own part. Most of the cases of surgical Tuberculosis come to the Solarium having had treatment previously in an institution. The object of light treatment under such circumstances is to prevent relapse, which had hitherto been all too frequent, or to improve the results obtained by institutional treatment. Insufficient time has elapsed to speak with confidence of the results of light treatment from a prophylactic point of view. So far only one patient has been sent away for institutional treatment because progress under light treatment was unsatisfactory. With regard to the improvement of the end results of previous institutional treatment, one case has been of considerable interest. This patient had Tuberculosis of the knee, and on discharge from Sanatorium the knee was antrylosed, there was considerable muscular wasting, and the patient could only get about with the aid of crutches and a splint. This patient can now walk without any adventitious support, and there is a steadily increasing degree of movement in the joint. On the whole, there has been a very satisfactory improvement in those cases, which have been diagnosed as Tuberculous Bronchial Glands. With regard to the treatment of Pulmonary Tuberculosis, the number of cases is too small to allow of the expression of definite opinion. In one instance, where the patient suffered from advanced Pulmonary Tuberculosis, a secondary Tuberculous ulceration of the cheek healed after a few exposures, although it had previously resisted all other forms of treatment for months. All the Lupus cases have done well; a particularly gratifying result was obtained by "general light treatment" only, in a case of Lupus of the Nasal Septum. The lesion healed in a few weeks, and has remained healed ever since, a matter now of about five months. Striking improvement was noted in the cases of Pleurisy. With regard to the patients included under the heading Debility, Malnutrition and Scrofula, the results on the whole have been good. Some of these patients have done very well indeed; others have not made so much improvement. In general those patients who do not do well are just those ones who attend irregularly, feed irregularly, live in bad home conditions, and keep late hours. In some cases of this class the results of light treatment seem to be delayed. That is to say, treatment does not produce manifest results at once, but after a time, and sometimes after treatment has ceased, the child makes steady and obvious improvement. One or two very striking cases of this kind have been noted. Thirty-two cases of Rickets have been treated, and on the whole improvement has been satisfactory. The remarkable thing is that not a single case of active Rickets has yet been seen in the clinic. All of these cases showed clinical evidence of Rickets, but in those cases which appeared clinically to be active X-ray examination did not bear out the clinical findings. With regard to the other diseases treated there is not yet sufficient evidence to justify definite conclusions. Two cases of Rheumatoid Arthritis were greatly relieved by the treatment, sufficiently so to make the difference between misery and comparative happiness; in others the degree of improvement has been less marked, but in no case has harm resulted. The case of aortic disease in the list above calls for special mention. This man, suffering from a severe heart lesion, complained of insomnia and bad dreams which awakened him every night. The improvement in- his general condition was very striking after a few exposures, and he was delighted with the result, though, of course, there was no change in the physical signs." LEYSIN PATIENTS. In the following table will be found a full account of the Leysin patients. The main question in all these sun cures is one of permanence, and it will be seen that, so far, the experiment of sending patients to Leysin has been fully justified. There is no doubt that an occasional visit to our solarium, especially in the winter time, is most useful in preventing relapses. Initials of Patient Age Sex Localisation of Disease Period previously under Medical Treatment prior to going to Leysin Date sent to Leysin Date returned from Leysin Result M. Left Foot 5 years 28/7/24 - S.B. 12 Still at Leysin 10 F. Glands of Neck 5 „ I.R. 28/7/24 6/10/25 Returned home cured. Remains quite well 15 F. 6/10/25 Right Knee 6 „ M.S. 28/7/24 „ „ „ F. Glands of Neck 2 „ 6/10/25 A.L. 19 1/10/24 „ „ „ Forearm and Peritoneum 37 F. C.P. 2 „ 6/10/25 1/10/24 „ „ „ 28 F. 15 „ M.B. Glands of Neck 26/10/25 - Still at Leysin 16 5 „ F. E.C. Right Knee 26/10/25 - „ „ 10 2 „ M. H.C. Glands of Neck 26/10/25 - „ „ 21 F. A.H. Left Hip 9 „ 17/5/26 - „ „ 23 E.W. F. Spine and Right Hip 18 „ 17/5/26 - „ „ RETURN SHOWING THE WORK OF THE DISPENSARY DURING THE YEAR 1926. PULMONARY NON-PULMONARY TOTAL Adults Children Adults Children Adults Children DIAGNOSIS M. F. M. F. M. F. M. F. M. F. M. F. A.—New Cases examined during the year (excluding contacts) :— (a) Definitely tuberculous 71 45 5 4 2 18 9 75 47 23 9 - (b) Doubtfully tuberculous 69 62 33 25 - - - - - - - - (c) Non-tuberculous 28 40 26 35 - - - - - - - - B.—CONTACTS examined during the year : — (a) Definitely tuberculous 1 1 1 1 - - - - - - - - (b) Doubtfully tuberculous 2 12 4 7 - - - - - - - - 24 62 141 122 (c) Non-tuberculous - - - - - - - - C. —CASES written off the Dispensary Register as — (a) Cured 9 16 12 26 5 5 2 7 14 21 14 33 (b) Diagnosis not confirmed or non-tuberculous (including cancellation of cases notified in error) 88 180 191 180 - - - - - - - - (37) D.—NUMBER OF PERSONS on Dispensary Register on December 31st: — (a) Diagnosis completed 363 261 136 124 40 45 113 74 403 306 249 198 12 14 (b) Diagnosis not completed 6 10 - - - - - - - - 1. Number of persons on Dispensary Register on January 1st 1233 10. Number of consultations with medical practitioners :— 2. Number of patients transferred from other areas and of " lost sight of " cases returned 36 (a) At Homes of Applicants 42 (b) Otherwise 284 11. Number of other visits by Tuberculosis Officers to Homes 119 3. Number of patients transferred to other areas and cases " lost sight of" 95 12. Number of visits by Nurses or Health Visitors to Homes for Dispensary purposes 3913 4. Died during the year 103 5. Number of observation cases under A (b) and B (b) above in which period of observation exceeded 2 months 7 13. Number of :— (a) Specimens of sputum, etc., examined 968 6. Number of attendances at the Dispensary (including Contacts) 4680 (b) X-ray examinations made in connection with Dispensary work 138 7. Number of attendances of non-pulmonary cases at Orthopaedic Out-stations for treatment or supervision — 14. Number of Insured Persons on Dispensary Register on the 31st December 605 8. Number of attendances, at General Hospitals or other Institutions approved for the purpose, of patients for 15. Number of Insured Persons under Domiciliary Treatment on the 31st December 458 (a) " Light" treatment - 16. Number of reports received during the year in respect of Insured Persons: — (b) Other special forms of treatment - 9. Number of patients to whom Dental Treatment was given, at or in connection with the Dispensary 255 (a) Form G.P. 17 58 (b) Form G.P. 36 225 PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1912. Summary of Notifications during the period from the 3rd January, 1926, to the 1st January, 1927. No. of Notifications on Form C. Notifications on Form A. Notifications on Form B. No. of Primary Notifications Number of Primary Notifications 0 to 1 5 to 10 10 to 15 25 to 35 55 to 65 65 and upwards Total Primary Notifications Total Notifications on Form A Total Primary Notifications Total Notifications on Form B Poor Law Institutions 20 to 25 1 to 5 15 to 20 35 to 45 45 to 55 Under 5 5 to 10 10 to 15 Sanatoria Age Periods 25 100 Pulmonary Males - 11 8 18 18 20 20 17 15 3 130 154 - - - - - - (38) „ Females - 5 3 8 13 22 16 3 4 1 75 87 - - 18 45 - - - - 1 Non-Pulmonary Males 4 9 4 6 3 2 1 - 30 38 - - - 4 11 19 — — - „ „ Females - 9 6 2 2 3 4 1 2 - 29 33 1 6 9 - - - - - New cases of Tuberculosis coming to the knowledge of the Medical Officer of Health during the period from the 3rd January, 1926, to 1st January, 1927, otherwise than by notification on Form A or Form B under the Public Health (Tuberculosis) Regulations, 1912. 65 and upwards Age Periods 0 to 1 1 to 5 5 to 10 10 to 15 15 to 20 20 to 25 25 to 35 35 to 45 45 to 55 55 to 65 Total Cases - - - 1 4 2 Pulmonary Males 1 2 4 4 18 - - - 2 1 2 2 7 „ Females - - - - - 1 4 2 Non-Pulmonary Males 2 - - - - - 3 - 12 11 „ „ Females 1 3 2 3 1 - - 1 - - - (39) Returns rendered under the PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1924. 1st QUARTER, 1926. Respiratory System Other Forms M. F. M. F. Number of Cases on Register at commencement of Quarter 1227 1122 449 397 Number of Cases notified during Quarter 27 15 9 10 Notified Cases removed to Bermondsey from other Districts 1 1 - - Number of Cases removed from the Register 5 23 29 6 Number of Cases remaining on the Register at end of Quarter 1231 1109 453 402 2nd QUARTER, 1926. Respiratory System Other Forms M. F. M. F. Number of Cases on Register at commencement of Quarter 1109 402 1231 453 Number of Cases notified during Quarter.. 37 23 5 2 Number of Cases removed from the Register 20 28 5 2 Number of Cases remaining on the Register at end of Quarter 1104 1248 453 402 3rd QUARTER, 1926. Respiratory System Other Forms M. F. M. F. Number of Cases on Register at commencement of Quarter 1248 1104 453 402 Number of Cases notified during Quarter.. 39 20 8 5 Notified Cases removed to Bermondsey from other Districts - - 1 - Number of Cases removed from the Register 23 21 7 4 Number of Cases remaining on the Register at end of Quarter 1264 1103 454 404 4th QUARTER, 1926. Respiratory System Other Forms M. F. M. F. Number of Cases on Register at commencement of Quarter 1264 454 1103 404 Number of Cases notified during Quarter.. 28 17 8 12 33 Number of Cases removed from the Register 29 4 3 Number of Cases remaining on the Register at end of Quarter 1259 1091 413 458 TUBERCULOSIS, 1926. AGE—PERIODS NEW CASES DEATHS Pulmonary Non. Pulmonary Pulmonary Non- Pulmonary M. F. M. F. M. F. F. M. 0 - — 2 1 - 1 1 1 - 2 8 12 3 1 1 1 - 11 11 - 5 8 1 3 2 5 9 5 3 5 - 10 3 6 1 3 6 8 15 19 8 6 1 - 3 3 20 9 14 - 20 13 1 4 10 25 24 22 2 14 - - 1 13 13 22 1 35 18 - - 19 3 6 45 21 4 - 1 - 3 19 - 55 6 3 16 4 - 3 3 65 and upwards 3 4 - - - - 148 42 40 63 12 82 88 7 V.-PROPAGANDA. As I have emphasised, not only in previous annual reports, but in various lectures which I have given and articles I have written, there is no more important public health matter than the question of propaganda. By propaganda I mean the education of the general public in the laws of health. Repressive legislation has practically gone as far as it is advisable to have it enacted at present, and further developments can only proceed properly on the question of general education, with a view to co-operation of the general population in all health measures. The staff of the Propaganda Department, under Dr. D. M. Connan, with the able assistance of Mr. H. W. Bush, has now had 3½ years' experience in this particular branch of work, and they have embodied this most ably in a small book which has just been published under the title of "Better than Cure," and those who desire to get all available information on this subject up to date, cannot do better than read this little volume. Dr. Connan's report speaks for itself, and all their efforts have not only my unstinted approval, but my best wishes for their good. Dr. D. M. Connan's Report:— "A very full description of the propaganda scheme was given in the Annual Report for 1925, and it is not, therefore, necessary to go into the same details in this year's report. In general, the work has followed the lines set out in the previous report. The most important, and at the same time, the most arduous part of the work is the lecturing. It is, perhaps, not generally realised what a large amount of work this entails. At least one, and very often two, personal visits have to be made before a lecture can be arranged. As we have to comply strictly with the London County Council Regulations as to precautions against fire, such visits as these take up a considerable amount of time, and require a good deal of tact. In one case this year a lecture was arranged in a school, and I had already begun to address the children, when a telephone message was received from the London County Council forbidding the lecture on account of a trivial irregularity in the arrangements. The fault was our own, and of course, the lecture was stopped, but the example illustrates the difficulties which have to be faced and overcome. The arrangements for lectures are in the hands of Mr. Bush, who also attends all the lectures, and superintends the running of the lantern and the cinematograph. During the year a total of fifty-nine indoor lectures has been given. This is an average of considerably more than one per week, and I do not think that a higher average than this can be aimed at under the present arrangement, whereby much of the work is done after office hours. A definite attempt has been made to concentrate upon the schools in order to teach the children, since they are more likely to be influenced by the lectures and to profit by them. Without exception we have had good audiences and excellent attention. The number of outdoor lectures was twenty-eight. This is less than was given last year, the reduction being chiefly due to the bad weather. The total attendance numbered 18,000. As further experience is gained in this form of propaganda, its value becomes more and more evident. Intelligent interest is always displayed by the audience in the form of question and comment, the latter being far more often flattering than otherwise. We now have five series of pictures for the electric sign, which unfortunately, has not been fully in use during the year owing to the restrictions on lighting, which have been in force. Instructions have been given for the sign to be removed from time to time, so that it may be displayed in various parts of the Borough. The pictures are changed at regular-intervals. Only one poster has been in use during the year, but we have made considerable use of pamphlets for distribution at the lectures, and, altogether, there are eleven pamphlets in use, most of them prepared in our own department on the Multigraph machine. During the year we have also prepared two bookmarks for use in connection with library. Most of our attention has been given to the propaganda by means of the spoken word, as opposed to that by the printed word. It becomes increasingly clear as the work goes on, that the spoken word carries far more weight than does any other form of propaganda, and that the main use of pamphlets and posters is to reinforce and repeat the advice already given by the lecturer. I have to thank Dr. Cairney for giving two lectures, and Mr. Grantley Smith for giving two indoor lectures and one lecture in the street." VI. —MATERNITY AND CHILD WELFARE. It gives me great pleasure to report that the infantile mortality for 1926 went down to 60 per thousand births. This is the lowest we have ever had, and looking back a quarter of a century's work in Bermondsey, I can honestly say that had anyone prophesied a reduction from nearly 200 deaths per thousand births to 60 in that time, I would have looked upon him as an optimist of the first water, for at that period I think I would have been quite content to cut it down somewhere between 110 and 120 per thousand births. The causes of this reduction are extremely complicated, and although I would be perfectly within my rights in claiming it as a large part due to the efficiency of the Maternity and Child Welfare Department, still, in the interests of scientific truth, one must admit that there are other factors, such as the reduction in the birth rate, various climatic factors, general improvement in education and so on, which have all played their part in bringing about this most desirable end. The work of the Doctors and Health Visitors is, of course, largely educational in itself, and I have no doubt that we are reaping the benefit from their unceasing and devoted work. The scheme mentioned in the last annual report of having two lady doctors has thoroughly justified itself, especially as one of the great difficulties is that the large majority of the mothers are anxious to get in personal touch with the medical officers direct, but, of course, the numbers who do so must be restricted, because if the lady doctors see too many mothers and infants in one session, the giving of advice becomes a mere matter of routine and consequently much less impressive. Full details of the work of the Health Visitors and attendances at Centres will be found in Tables G and H. The work of the Voluntary Centres has gone on very satisfactorily, and is very much appreciated, not only by the mothers themselves, but by the Maternity and Child Welfare Committee. FAIRBY GRANGE CONVALESCENT HOME, HARTLEY, KENT. Fairby Grange continues to be appreciated by the mothers of Bermondsey. During 1926, the number of mothers admitted was 247, the number of babies 133, and the number of toddlers 119. I would like to say a word of appreciation of the way the home is managed by the matron, Miss Sewell, and her staff. This home is one of the most economical institutions that the Borough Council has under its care. There is accommodation for sixteen mothers and sixteen children with a staff of six, and it provides an immense amount of happiness at a total cost of less than ¼d. rate. During the year, the Mayor, Councillor I. Stokes, provided a wireless set, which has proved a great boon. The only difficulty we have is filling the home during the months of November, December, January, and February. Special efforts were made by the Committee to advertise it, and also gave facilities to allow women who were convalescent from various illnesses to go down, but, notwithstanding this, the country is not very attractive during the winter for towns people. Possibly we may be able to devise some additional attraction for the coming winter. TABLE G.—HEALTH VISITORS. The following table shows the work done by Health Visitors during the year 1926 :— Births Notified Subsequent Visits Various Calls and Visits Attendances at Centres Ophthalmia neonatorum Reports to M.O.H. First Visits Puerperal Fever Lost Visits Health Visitors Antenatal No. of District Under 1 year 1 to 5 years Miss Mercer 1 278 294 897 1235 54 1 1 51 298 278 52 Miss White 2 252 271 782 2324 139 9 11 65 506 192 33 (44) Miss Helden 3 277 240 504 1621 92 6 296 197 52 - - 4 297 292 270 Miss Child 309 300 934 147 5 8 - 71 11 Miss Bache 5 259 263 334 818 42 3 4 150 364 18 Mrs. Cottier 6 276 256 596 1235 9 8 97 75 248 39 — Miss Carlton 7 318 299 681 1409 10 - 4 125 104 255 23 Miss Wadds 8 288 276 310 860 35 3 5 110 153 255 14 Salomon's Centre 141 180 1724 3619 999 - 1017 24 - - - - Princess Club 48 136 22 47 1279 25 105 2 - - - - Fulford Street 1103 111 14 1073 294 - - - — - - - St. George's Hall 1127 1418 223 66 - - — - - - - - Central Hall 39 346 322 42 182 147 - - - - - - Totals 2386 2475 8840 16890 *2133 *21 *47 3730 1307 2311 318 - * Includes Re-visits. TABLE H.— ATTENDANCES AT M. AND C. W. CENTRES FOR THE YEAR 1926. Ante-Natal Clinic Evening Clinic Class for Mothers Sewing Class Name of Centre No. attending No. attending Nos. attending children No. of Sessions No. of Sessions No. of Sessions No. of Sessions No. attending Under 1 year 1 to 5 years 110 Grange Rd. 169 3656 2463 48 1422 686 48 443 46 98 Rotherhithe New Road 169 3204 1537 50 826 49 402 48 455 Trinity Road 50 885 670 - - - - - - Oxley Street 101 1654 1197 - - - - - - Roseberry St. 47 1719 836 42 366 - - - - Salomon's Centre 151 1459 843 215 3352 - - - - Princess Club 175 3558 3386 74 2111 46 516 - - Fulford Street 2085 1219 86 1191 12 105 98 - - St. George's Hall 48 826 689 41 517 - - - - Central Hall 194 8355 9526 - - - - - - 6433 Totals 1202 27401 22366 341 370 4818 94 1141 VII.—DENTAL TREATMENT. In my report for the year 1925, reasons were given why the question of the care of the teeth is of such great importance. It was pointed out there that poisons are manufactured by carious and pyorrhoeic teeth and these poisons get into the system, causing rheumatism and many other diseases. Mr. Grantley Smith has given a very full dental report, and the number of patients attending the clinic is steadily increasing. Probably, the greatest difficulty to be encountered is to get parents to bring up the very young children. There is an idea prevalent that it does not matter what happens to the milk teeth, but these, although they are not permanent, require just as much care as the others, because an enormous amount of mischief may be done in the first six or seven years of life through defective primary teeth. An important development in the Dental Department was the re-opening of the clinic at 98 Rotherhithe New Road. It has been found that patients from Rotherhithe were often unwilling to undertake the long journey up to the Grange Road clinic. As the former clinic has only just restarted, I shall reserve any further remarks on the subject for the next annual report. Mr. Grantley Smith's Report:— "I have the honour to submit the sixth annual report for the work carried out at the Dental Treatment Centre. "I have to record that, with the exception of maternity cases and tuberculosis patients, the numbers treated have increased. "The new centre at 98 Rotherhithe New Road was opened on November 17th, its staff consisting of a half-time dental surgeon and nurse. The progress of this centre is slow at first, but at the moment of writing, it is showing considerable signs that its existence is justified. Its existence, too, does not affect the amount of work coming in at the centre at 110 Grange Road. Here the staff is very fully occupied, and an additional dental mechanic is necessary. "The number of adolescents treated during the year has increased, especially the number of young girls of the age group 16 —21. This category is of great importance, since here the good work done by the school dental service may be followed up. These patients show great prejudice to conservative work, but its terror is being abolished by the wider use of local anæsthesia. Treatment carried out for this category is of a preventive nature, since the greater the number of young people who are kept dentally fit and dentally wise, the lesser will be the number of adults who are usually found to require drastic treatment, whether they be maternity patients or otherwise. I am, Sir, Your obedient Servant, GRANTLEY SMITH, Municipal Dental Surgeon. (48) TABLE I.—TREATMENT OF CHILDREN DURING 1926. Number Examined Number Needing Treatment Number refusing Treatment Number Treated Number of Extractions Number of Administrations of Anæsthetics Number of Other Operations Number of Children Treated for Orthodontics Number of Visits Number of Fillings Age. Group Local General 2 years and under 39 38 6 32 145 - 28 - - - 67 113 1 99 5 3 years 120 8 105 489 - 223 - 4 years 167 161 8 153 899 5 149 12 - 326 - 5 years 97 95 6 89 518 3 88 12 - - 189 203 199 11 188 64 103 45 2 3 Over 5 years 512 315 39 73 2 3 1120 626 606 567 2563 467 74 (49) TABLE II.—DENTAL TREATMENT DURING 1926. Number of Patients Examined Number of Patients Treated Number of Administrations of Anæsthetics Number of Repairs to Dentures Number of Extractions Number of Scalings Number of Dentures Fitted Number of Fillings, including Root Fillings Local General 254 173 81 21 17 10 Maternity Cases 106 189 865 Women 826 686 2732 551 231 105 48 243 106 220 208 309 176 20 37 6 8 - Unmarried Girls (16-20) Men 638 566 2129 90 43 600 74 44 201 Tuberculosis Cases 78 47 172 27 22 14 2 15 3 Children (Table I.) 567 2563 73 74 - 626 467 - - Total, including Children Table I. 2642 2263 1600 911 117 162 325 573 8770 TABLE I.—VITAL STATISTICS OF WHOLE DISTRICT DURING 1926 AND PREVIOUS YEARS. Population estimated to Middle of each Year 2 Deaths of Non-Residents registered in Public Institutions, etc. in the District 10 Total Deaths in Public Institutions in the District 9 Deaths of Residents registered in Public Institutions beyond the District 11 Year 1 Births Total Deaths registered in the District Net Deaths at all Ages belonging to the District No. 3 Rate 4 At all Ages Under 1 Year of Age No. 12 No. 5 Rate per 1,000 Births registered 6 Rate 8 VIII.—APPENDIX. No. 7 Rate 13 1916 123,665 3,361 27.1 364 108 1,507 13.2 608 155 453 1,960 17.2 1917 119,983 2,613 21.7 329 125 1,807 18.8 840 186 411 2,032 18.8 1918 121,465 2,323 19.1 322 139 2,142 19.8 1,007 191 439 2,390 22.0 1919 124,239 2,637 20.4 212 80 1.600 12.8 709 165 313 1,748 14.1 1920 129,189 4,038 31.2 280 69 1,466 11.3 689 105 281 1,642 12.7 120,500 3,231 26.8 1921 261 80 1,313 10.8 657 51 394 1,656 13.7 1922 121,100 3,167 26.1 259 81 1,572 12.9 778 43 496 2,025 16.7 1923 121,709 2,912 23.9 220 76 1,192 9.7 330 42 288 1,480 12.1 1924 122,100 2,913 23.8 200 68 1,277 10.4 720 337 1,657 43 13.6 123,000 21.6 188 1925 2,652 71 1,280 10.4 669 47 321 1,554 12.6 Averages for years 1916-1925 122,695 2,985 24.2 264 90 1,516 701 103 373 1,814 15.4 13.0 2,414 19.6 52 1,163 9.4 624 31 352 1,484 12.1 1926 123,100 126 (51) OTHER INSTITUTIONS, Etc., Etc. I. Institutions, etc., within the District receiving sick and infirm persons from outside the District. II. Institutions outside the District receiving sick and infirm persons from the District. III Other Institutions, etc., the Deaths in which have been distributed among the several localities in the District. No. of Deaths No. of Deaths No. of Deaths Bermondsey and Rotherhithe Hospital Ladywell Institution Ambulances on way to Hospital 7 82 Banstead Mental Hospital 5 11 Bexley Mental Hospital 10 Brompton Hospital 1 Brompton Hospital Sanatorium, Frimley 1 Deaths in River Thames, Surrey Commercial Docks, Wharves, etc. Brook Hospital, Shooters Hill 5 Cane Hill Mental Hospital 12 Central London Throat, Nose and Ear Hospital 17 1 Charing Cross Hospital 1 Children's Hospital, Holborn 1 Chilworth Road Institution, Southampton Private Houses 3 1 City Mental Hospital, Leicester 1 Total 31 City of London Institution, Poplar 1 City of London Mental Hospital, Dartford 1 Claybury Mental Hospital 2 Colindale Hospital, Hendon 3 Cottage Hospital, Margate 1 Downs Hospital, Sutton 1 Eastern Hospital, Homerton 1 East London Hospital 1 Elizabeth Garratt Anderson Hospital 1 Empire Nursing Home, Westminster 1 Evelina Hospital 2 General Hospital, Tunbridge Wells 1 Grand Surrey Canal 1 Grosvenor Sanatorium, Kennington, Kent 3 Grove Hospital, Tooting 1 Grove Park Hospital, Mottingham 3 Guy's Hospital 66 Hanwell Mental Hospital 2 Hawthorne Dene, Bonchurch 1 Heigham Hall, Norwich 1 Holy Cross Sanatorium, Shottermill 1 Honorton Farm, Brenchley 1 Horton Mental Hospital, Epsom 1 Hospital for Men, Westminster 1 Isolation Hospital, Logmore, Dorking 1 Joyce Green Hospital, Dartford 3 King George's Sanatorium, Bramshott 1 King's College Hospital 1 Ladywell Institution 82 Lambeth Hospital 3 Leavesden Mental Hospital 1 (52) OTHER INSTITUTIONS, Etc., Etc.—continued Institutions, etc., within the District receiving sick and infirm persons from outsiďe the District. Institutions outside the District receiving sick and infirm persons from the District. Other Institutions, etc., the Deaths in which have been distributed among the several localities in the District. London Fever Hospital 3 London Hospital 3 Long Grove Mental Hospital 2 Lying-in Hospital, York Road 2 Metropolitan Mental Hospital, Caterham 1 Middlesex Hospital 1 Mildmay Mission Hospital, Bethnal Green 1 Miller Hospital, Greenwich 1 National Hospital for Diseases of the Heart, St. Marylebone 1 National Hospital, Holborn 1 Newington Institution 1 North Middlesex Hospital, Edmonton 1 Oast Garden Udiam Farm, Ewhurst 1 Park Hospital, Hither Green 10 Peckham House 2 Princess Alice Hospital, Eastbourne 1 Princess Mary's Hospital for Children, Margate 1 Private Houses 9 Queen Mary's Hospital for Children, Carshalton 1 Queen's Hospital, Chistlehurst 2 Railway Station, Huntingdon 1 River Thames 3 Royal Waterloo Hospital 1 St. Andrew's Hospital, Dollis Hill 1 St. Bartholomew's Hospital 4 St. Thomas's Hospital 4 Seaman's Hospital, Greenwich 2 Ship in River Thames 1 South Eastern Hospital, New Cross 24 South London Hospital, Wandsworth 2 South Western Hospital, Stockwell 2 Southwark Hospital 1 Street 1 Tooting Bee Hospital 17 University College Hospital 1 Western Hospital, Fulham 1 Westminster Hospital 1 West Park Mental Hospital, Epsom 4 Total 352 TABLE II. CAUSES OF, AND AGES AT DEATHS, DURING THE YEAR 1926. Deaths at the subjoined ages of " Residents " whether occurring in or beyond the District. Causes of Death 1 and under 2 5 and under 15 15 and under 25 25 and under 45 2 and under 5 45 and under 65 65 and upwards All Ages Under 1 All Causes Certified 1483 146 51 57 74 69 177 392 517 Uncertified 1 - - - - - _ 1 - (53) Enteric Fever - - - - - - - - - Small Pox - - - - - - - - - Measles 24 5 11 7 1 - - - Scarlet Fever 6 - - 2 3 1 - - - - Whooping Cough 1 - 1 - - - - - - Diphtheria and Croup 42 1 4 16 21 - - - - Influenza 16 - - 2 - 1 8 5 Erysipelas - 3 - 3 - - - - - - Phthisis (Pulmonary Tuberculosis) 151 1 1 2 9 37 50 44 7 Tuberculous Meningitis 11 2 4 4 - - 1 Other Tuberculous Diseases - 8 - - 2 2 - 4 - - Cancer, Malignant Disease 158 - 16 80 62 - - - - Rheumatic Fever 3 - 2 1 _ - - Meningitis 11 - - 2 2 1 1 1 1 2 1 Organic Heart Disease 159 - - 8 17 16 56 72 - Bronchitis 148 8 1 - — 1 9 42 87 Pneumonia 128 32 20 8 4 2 14 25 23 TABLE II.—CAUSES OF AND AGES AT DEATHS, DURING THE YEAR 1926—continued. Deaths at the subjoined ages of " Residents " whether occurring in or beyond the district. Causes of Death 2 and under 5 5 and under 15 15 and under 25 25 and under 45 45 and under 65 65 and upwords 1 and under 2 All Ages Under 1 Other Diseases of Respiratory Organs 16 1 1 1 1 4 8 - - - - Diarrhoea and Enteritis under 2 years 21 18 3 - - - - 1 5 1 2 2 Appendicitis and Typhlitis 11 - - (54) - 3 1 Cirrhosis of Liver 5 - - 1 - - - Alcoholism - - - - - — - - - 1 - 2 1 5 13 9 Nephritis and Bright's Disease 31 - Puerperal Fever 4 - - - 1 3 - - - Other Accidents and Diseases of Pregnancy and Parturition - - - 2 - 4 2 - - Congenital Debility and Malformation, including Premature Birth - - - - - _ 52 52 - Violent Deaths, excluding Suicide 48 1 2 3 5 2 8 12 15 Suicide 19 - - - 2 5 9 3 - Encephalitis Lethargica 2 - - 1 - - 1 - - 9 44 84 221 Other Defined Diseases 399 23 3 7 8 - 2 1 Diseases ill-defined or unknown 3 - - - - - All Causes 146 51 57 74 69 177 392 518 1484 TABLE III.-DEATHS FROM ZYMOTIC DISEASES, 1926. All Causes Principal Zymotic Diseases Smallpox Measles Scarlet Fever Enteric Fever Pyrexia (origin uncertain) Diarrhoea Diphtheria Whooping Cough Typhus Fever Year Rate No. Rate No. Rate No. Rate No. Rate No. No. Rate No. Rate No. Rate No. Rate No. Rate No. Rate 1916 1960 17.2 155 1.36 - 42 .36 5 .04 29 •25 16 •14 - 2 .01 - - 61 •53 - - 1917 2032 18.8 218 2.02 - 72 .66 1 •01 18 •16 32 •29 - 6 •05 - - 89 •82 - - 1918 2390 22.0 229 2.11 23 . 21 84 •78 - 48 •44 - - 71 .66 3 .03 — - - — - 1919 1748 14.1 113 •91 18 .14 5 •04 21 - .17 4 •03 - - 3 .02 - - 62 •49 - 1642 163 1920 12.7 1.26 - 56 .44 7 •06 25 .19 41 •32 - - 1 .01 - - 33 .26 - 1921 1656 13.7 197 1.63 - 3 - 18 •15 - 69 •57 14 •11 - - 3 •03 - - 87 •72 1922 2025 16.7 292 2.41 - 101 •83 11 .09 90 •74 65 .53 - - 1 - - 24 •19 - - 1480 12.1 125 1.02 1923 - 13 .10 3 •02 33 •27 12 .09 2 •01 - 62 •50 - - - - 1924 1657 13.6 117 •95 - 48 .39 6 •04 25 .20 11 .09 - - - 1 - - - 26 •21 1925 1554 12.6 96 •78 - - 20 .16 3 •02 29 •24 27 •22 - - - 17 •14 - - - Average for years 1916-1925 •30 31 - 2 - 51 . 26 1814 15.4 171 1.45 - 44 6 .05 .43 •37 36 •01 - - - 1484 12.1 94 •76 - - 24 6 42 •34 1 •01 - - - 21 - 1926 .19 •05 - •17 - TABLE IV.-CASES OF INFECTIOUS DISEASES NOTIFIED DURING THE YEAR 1926. NUMBER OF CASES NOTIFIED BERMONDSEY ROTHERHITHE ST.OLAVE At all Ages At Ages—Year Total Cases removed to Hospital Total Total NOTIFIABLE DISEASE St. Thomas 15 and under 25 years 25 and under 45 years 45 and under 65 years 1 2 3 4 5 6 1 2 3 St. John St. Olave Total Under 1 year 1 and under 5 years 5 and under 15 years 65 and upwards Small-pox - - - - - - - - - - - - - - - - - - - - - - - - Diphtheria (including Membranous Croup) 9 237 388 47 28 99 77 65 99 63 500 93 38 187 16 6 5 27 714 5 97 56 713 - Erysipelas 30 - 1 2 7 10 9 1 1 3 3 4 2 4 17 6 3 3 12 1 - - 1 1 Scarlet Fever 426 5 160 236 20 5 - - 25 32 50 33 36 26 202 81 56 63 200 14 7 3 24 418 Relapsing Fever - - - - - - - - - - - - - - - - - - - - - - - - Cerebro-Spinal Meningitis 1 1 1 - - - 1 - 2 1 - 4 5 2 - - - - 1 - - 1 5 — Acute Polio- Encephalitis - - - - - 1 - - 1 - 1 - - - - - - 1 - - - — - - Ophthalmia Neonatorum 10 - - - - 2 2 1 6 1 1 1 3 1 - - 1 10 - 1 - 3 - - Anthrax 4 - - - - 4 - - 1 2 - - 3 - - - - 1 - - 1 4 - - Enteric Fever 3 - 1 - 1 1 - - 1 1 - - - 2 1 - - 1 - - - - 2 - Puerperal Fever 9 - - - 1 8 - 1 - 1 - 4 - 6 2 1 3 - - - - - 8 - Puerperal Pyrexia 11 - - - 1 10 2 3 2 - 2 - 9 - - - - 2 - - 2 6 - - Encephalitis Lethargica 8 - - 2 2 1 3 - - 1 1 1 2 - 5 1 1 - 2 - 1 - 1 2 Dysentery - - - - - - - - - - - - - - - - - - - - - - - - Malaria - - - - - - - - - - - - - - - - - - - - - - - - Continued Fever - - - - - - - - - - - - - - - - - - - - - - - - Pneumonia (Acute Primary and Acute Influenzal) 5 46 19 14 18 1 17 21 6 6 8 69 5 13 11 29 10 3 2 15 113 10 11 - Tuberculosis— Respiratory System 206 - - 26 58 79 39 4 29 21 22 13 130 23 28 13 64 9 1 2 12 15 30 - Other forms of Tuberculosis 59 1 13 21 14 8 2 5 8 9 5 5 7 39 9 6 3 18 - 1 1 2 - - Totals 1599 31 459 696 165 168 74 6 159 196 199 139 179 121 993 220 166 133 519 55 19 13 87 1162 TABLE V. —FACTORIES, WORKSHOPS, LAUNDRIES, WORKPLACES, AND HOMEWORK. HOMEWORK. Outworkers' Lists, Section 107 Outwork in Unwholesome Premises Section, 108 Outwork in Infected Premises (Sections 109, 110) Lists received from Employers Notices served on Occupiers as to keeping or sending lists (8) Prosecutions Instances (11) Notices served (12) Prosecutions (13) Instances (14) Order made (S. 110) (15) Prosecutions (Sections 109, 110) (16) NATURE OF WORK (1) Sending twice in the year Sending once in the year Failing to keep or permit inspection of lists (9) Failing to Rend lists (10) Lists (2) Outworkers Lists (5) Outworkers Con- tractors (3) Workmen (4) Contractors 6) Workmen (7) Wearing Apparel:— I I I I I I I .. I I I I I I I (1) Making, etc. 34 10 164 - 11 - - - - - - - - - - (2) Cleansing and washing - - - - - - - - - - - - - - - Household linen - - - - - - - - - - - - - - - Lace, lace curtains and nets - - - - - - - - - - - - - - - Curtains and furniture hangings - - - - - - - - - - - - - - - Furniture and upholstery - - - - - - - - - - - - - - - Electro plate - - - - - - - - - - - - - - - File making - - - - - - - - - - - - - - - Brass and brass articles - - - - - - - - - - - - - - - Fur pulling - - - - - - - - - - - - - - - Cables and chains - - - - - - - - - - - - - - - Rubber and Waterproof sundries - - - - - - - - - - - - - - - Cart gear - - - - - - - - - - - - - - - Locks, latches and keys - - - - - - - - - - - - - - - Umbrellas, etc. 2 - 6 - - 1 - - - - - - - - - Artificial flowers - - - - - - - - - - - - - - - Nets, other than wire nets — — — - - - - - - - - - - - - Tents 4 - 21 - - 1 - - - - — - - - - Sacks 6 - 17 - - - 3 - - - - - - - - Racquets and Tennis Balls - - - - - — - — — — — — — — - Paper, etc., Boxes, Paper Bags 4 - 8 - - - 2 - — — — - - - - Brush making - - - - - - - - — — - - - - - Pea Picking - - - - - - - - — — - — — — - Feather Sorting - - - - - - - - — — - - - - - Carding, etc., of Buttons, etc. - - - - - - - - - - - - — - - Surgical Instructions 2 - - - - - - - - - — - — — - Basket making - - - - - - - - — — - - - - - Chocolates and Sweetmeats - - - - - - - - - - - - - - - Cosaques, Christmas Crackers, Christmas Stockings, etc. - - - - - - - - - - - - - - - Textile Weaving - - - - - - - - - - - - - - - Leather Goods 2 - 8 - - - 2 - - - - - - - - Coat hangers - - - 1 - - - - - - - - - - - Total 54 10 224 1 - - 20 - - - - - - - - TABLE VI. FACTORIES, WORKSHOPS, LAUNDRIES, WORKPLACES AND HOMEWORK. INSPECTION. Number of Premises Inspections Written Notices Prosecutions 130 Factories (including Factory Laundries) .. .. .. .. 7 - Workshops (including Workshop Laundries) .. .. .. .. 434 27 Workplaces (other than Out workers' Premises) .. .. .. .. 34 2 598 Total 36 DEFECTS FOUND. Particulars Number of Defects Number of Prosecutions Referred to H.M. Inspector Found Remedied Nuisances under the Public Health Acts— 7 Want of Cleanliness 7 - - 1 1 Want of Ventilation - - Overcrowding - - - - Want of Drainage of Floors - - - - Other Nuisances 29 29 - - Sanitary Accommodation— 2 2 Insufficient - - Unsuitable or Defective 10 10 - - Not separate for Sexes - - - - Offences under the Factory and Workshop Act — Illegal Occupation of Underground Bakehouse (s. 101) - - Breach of Special Sanitary Requirements for Bake houses (ss. 97 to 100) 25 25 - - - Other Offences - - - 74 - Total 74 - OTHER MATTERS. Number Class. Matters notified to H.M. Inspectors of Factories— Failure to affix Abstract of the Factory and Workshop Act (s. 133) - Action taken in matters re ferred by H.M. Inspectors as remediable under the Public Health Acts, but not under the Factories Act (s. 7) Notified by H.M. Inspectors - Reports (of action taken sent to H.M. Inspectors) - Other - Underground Bakehouses (s. 101) :- Certificates granted during 1926 - 19 In use at end of 1926 Workshop Bakehouses 27 Workshops on the Register (s. 131) at the end of 1926 .. .. 413 440 Total Number of Workshops on Register TABLE VII.—No. OF BAKEHOUSES IN THE BOROUGH. In Use Not in Use Underground Above ground Above ground Underground 2 42 1 19 34 of these are Factory Bakehouses. TABLE VIII. Maternity and Child Welfare. STATISTICS FOR THE YEAR, 1926. Borough Council of Bermondsey. POPULATION according to the Census of 1921. —119,452. Births. Registered.— (3) Total, 2,414. (1) Legitimate, 2,369. (2) Illegitimate, 45. Notified within 36 hours of birth— (1) Live Births, 2,412. (2) Still Births, 34. (3) Total, 2,446. (1) By Midwives, 575. (2) By Parents and Doctors, 1871. Infant Deaths. Number — (2) Illegitimate,— (3) Total, 146. (1) Legitimate, 146. Rate per 1,000 births — (1) Legitimate, 60. (2) Illegitimate,— (3) Total, 60. Maternal Deaths. Number of Women dying in, or in consequence of Childbirth — (1) From Sepsis, 4. (2) Other causes, 4. Health Visitors. Vißits paid by Health Visitors during the year : — To Expectant Mothers (1) First Visits, 2,120. (2) Total Visits, 2,133. To Infants under 1 (1) First Visits, 2,475. (2) Total Visits, 11,315. To Children 1—5 Total Visits, 16,890. Municipal Homes and Hospitals for Children under 5. Number of Beds, 16. Number of children under 5 received during the year, 252 Total number of weeks spent in the Homes by such cases, 533. Municipal Day Nurseries. Total number of attendances of Children under 5 during the year — (a) Whole (b) Half:— Deaths from Measles (all ages) 24 Deaths from Whooping Cough (all ages) 1 Deaths from Diarrhæa (under 2 years of age) 21 (61) TABLE IX.—FOOD AND DRUGS. Articles submitted for Analysis Total Samples Taken Number Genuine Percentages of Articles Adulterated Number Adulterated Almonds, Ground 3 3 - - Apples 1 1 - - Arrowroot 12 12 - - 25.0 Aspirin Tablets 8 6 2 Baking Powder 3 3 - - Balsam of Aniseed 1 1 - - Barley, Pearl 10 10 - - Beans, Tinned 1 1 - - Bicarbonate of Soda 7 7 - - Black Pudding 1 1 - - Boracic Powder 4 4 - - Borax 1 1 - - Butter 129 128 1 0.8 Cake 6 6 - - Cake, Currant 2 2 - - Cake, Lemon 2 2 - - Cake, Plain 1 1 - - Cake, Sponge 20 19 1 5.0 Cake, Sultana 1 1 - - Cake, Sultana and Cherry 1 1 - - Camphorated Oil 8 8 - - 1 1 - Carbonate of Magnesia - Castor Oil 1 1 - - Cheese 21 21 - - Cherry Brandy Flavour 1 1 - - Cinnamon, Ground 1 1 - - Citrate of Magnesia 8 8 - - 1 - Citric Acid 1 - Cocoa 24 24 - - Cocoanut, Dessicated 5 5 - - Cod Liver Oil 1 1 - - Coffee 17 17 - - Cordial, Raspberry Flavour 1 1 - - Corn Flour 1 1 - - Crab Paste 1 1 - - Cream 2 2 - - Cream of Tartar 8 8 - - Custard Powder 3 3 - - 62 - Dripping 62 - 1 100.0 Egg Powder 1 - Eucalyptus Oil 1 1 - - Fat (Nusu) 1 1 - - 21 21 - Fish Paste - Flour 1 1 - - Flour, Self-raising 26 26 - - Flowers of Sulphur 2 2 - - 1 Ginger 1 - - 2 2 - Ginger, Ground - Glycerine 6 6 - - Golden Syrup 1 1 - - Gravy Salt 1 1 - - 3 3 - Ice Cream - Jam, Black Currant 7 7 - - Jam, Greengage 1 1 - - Jam, Plum 1 1 - - Jam, Raspberry 4 4 - - (62) TABLE IX.—FOOD AND DRUGS—continued. Articles submitted for for Analysis Total Samples Taken Number Genuine Number Adulterated Percentages of Articles Adulterated Jam, Strawberry 8 8 - - Lard 22 22 - - Lemon Curd 1 1 - - Lemonade 1 1 - - Lemonade, Crystals 5 5 - - Lemonade Powder 9 9 - - Lemon Squash 1 1 - - Lime Water 1 1 - - Linseed, Crushed 3 3 - - 1 1 - Linseed Meal - Liquorice Powder, Compound 1 1 - - Margarine 72 72 - - Marmalade 6 6 - - Milk 498 477 21 4.2 Milk, Condensed Evaporated 1 1 - - Milk, Condensed Full Cream 6 6 - - Milk, Condensed Skimmed 8 8 - - Milk, Grade "A" (Tuberculin Tested) 38 40.6 64 26 Milk, Separated 3 3 - - Milk, Sterilised 5 5 - - Mincemeat 4 4 - - Mustard 50 50 - - Oatmeal 1 1 - - Olive Oil 1 1 - - Pea Flour 3 3 - - Pepper 52 52 - - Quinine, Ammon., Tincture of 6 4 2 33.3 Rice 24 24 - - 1 1 - Rice, Flaked - Rice, Ground 2 2 - - Roll, Ham and Chicken 1 1 - - 2 2 - Sago - Salmon and Shrimp Paste 3 3 - - 1 1 - Salts, Epsom - 4 4 - Salts, Glauber - 7 7 - Sausages - 2 2 - - Sausages, Beef Sausages, Breakfast 4 4 - - 1 1 - Sausages, Pork - 1 1 - - Semolina Spirits of Nitre (Sweet) 2 2 - - Suet, Beef, Flaked 1 1 - - 7 6 1 14.3 Suet, Beef, Shredded Sugar, Demerara 6 6 - - 1 1 - Sugar, Granulated White - 1 1 - Sulphate of Magnesia - 7 7 - Tapioca - Tapioca Flakes 2 2 - - 3 3 - Tartaric Acid - 1 1 - Tea Dust - Treacle 1 1 - - Vermicelli 1 1 - - 4.9 Vinegar, Malt 41 39 2 142 135 7 4.9 Vinegar, Wood Zinc Ointment 2 2 - - Total 1566 1502 64 4.1 (63) PROSECUTIONS IN CONNECTION WITH SAMPLES TAKEN DURING 1926. Sample Adulteration or Infringement No. Remarks 311 Vinegar Deficient in acetic acid, 7 per cent. Dismissed on payment of costs, 17s. 6d. Deficient in acetic acid, 35.5 per cent. 498 Vinegar Summons withdrawn. £2 2s. costs paid by wholesaler Margarine Wrapper not marked Fined 2s. 6d. Costs 17s. 6d. 578 662 Milk Deficient in fat, 8.3 per cent. Fined 40/-. Costs 17s. 6d. Egg Powder 705 Contained no egg Fined 20s. Costs 21s. 829 Milk 2 per cent, excess of water Fined 20s. Costs 17s. 6d. 867 Milk 2.1 per cent, excess of water Fined 20s. Costs 17s. 6d. Milk 1.3 per cent, excess of water 868 Fined 20s. Costs 17s. 6d. Vinegar Deficient in acetic acid, 17.5 per cent. Fined 40s. 61 94 Vinegar Deficient in acetic acid, 7 per cent. Fined 2s. 6d. Costs 17s. 6d. Dismissed. Warranty proved. 130 Milk Deficient in fat, 20 per cent. Vinegar Deficient in acetic acid, 14.5 per cent. Fined 10s. Costs 17s. 6d. 191 Sponge Cake Boric acid 0.30 per cent. Dismissed on payment of costs, 17s. 6d. 255 337 Vinegar Deficient in acetic acid, 27.0 per cent. Dismissed on payment of costs, 17s. 6d. 423 Vinegar Deficient in acetic acid, 27.0 per cent. Summons withdrawn. £2 2s. costs paid by wholesaler 428 Milk Added water, 1.9 per cent. Fined 40s. 430 Milk Added water, 1.3 per cent. Fined 40s. 434 Milk Added water, 3.2 per cent. Fined £5 435 Milk Added water, 1.0 per cent. Fined 40s. 451 Milk Added water, 3.3 per cent. Fined £10. Costs 21s. 6d. 474 Vinegar Deficient in acetic acid, 28.0 per cent. Fined 20s. Costs 17s. 6d. 612 Milk Deficient in fat, 11.0 per cent. Fined 40s. SUMMARY. £ s. d. Fines 32 15 0 Costs 15 19 0 £48 14 0 TABLE X PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1925. Articles Quantity Unsound Disposed of for Purposes other than Human Food Removed for Sorting under S.A. Exported Destroyed Quantity Quantity Quantity Weight Quantity Weight Weight Weight tons cwt lbs tons cwt lbs tons cwt lbs tons cwt lbs qr qr qr qr Anchovies 17 cases 11 1 15 - - - - - 45 tins 2 3 0 - - - - - - - Apples - 1,618 boxes and 3 cases 29 2 11 - - 3 - - - - - - - - - - - - Apple Jelly 244 cases 6 1 3 0 - - - - - - - - - - - - - - - Apricots, Canned 23 cases 1 4 0 0 - - - - - - - - - - - - - - - Apricots, Dried 33 cases 5 3 16 - - - - - - - - - - - - - - - - Apricot Pulp 77 cases and 68 tins 3 13 2 24 - - - - - - - - - - - - - - - Bacon 70 bales and trimmings 8 14 3 2 20 sides, pieces and trimmings 3 9 0 0 92 sides and various parcels 4 17 3 14 - - - - - Beef Cubes - - - - 47 cases and 87 tins. 235 jars, 105 cups - - - - - - - - - - - - - - - 46 cases and 6 tins Blackcurrant Pulp 1 3 2 2 - - - - - - - - - - - - - - - Butter 1 box 2 0 - - - - - - - - - - - - - - - - - Butter Beans 7 19 0 0 - - - - - - - - - - - - - - - - Canned Goods, Various 2289 tins and various packages 42 1 2 9 - - - - - - - - - - - - - - - Caviare - - 21 casks and 34 cases 4 0 0 0 21 casks and 34 cases 4 0 0 0 - - - - - - - - TABLE X.—PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1925.—continued Quantity Unsound Removed for Sorting under S.A. Disposed of for Purposes other than Human Food Articles Destroyed Exported Weight Quantity Quantity Weight Quantity Weight Quantity Weight tons cwt lbs tons cwt lbs tons cwt qr lbs tons cwt qr lbs qr qr 375 cases 1225 boxes 755 bundles Cheese various packages 1 19 0 0 various packages - 15 3 14 - - - - — 26 13 3 0 Cherries - 16 boats and 22 tins 8 1 16 - - - - - - - - - - - - - - - 6 barrels and 3 kegs 320 gallons Cherries, Crushed - - - - - - - - - - - - - - - Chicken, Boned 79 tins 1 0 0 - - - - - - - - - - - - - - - - Christmas Pudding various packages 2 7 2 21 - - - - - - - - - - - - - - - Cocoa Powder 89 cases 4 9 0 0 - - - - - - - - - - - - - - - Coffee - - - - - 1 bag - - 24 - - - - - - - - - - - Condensed Milk 35 cases and 864 tins 1 9 3 19 5 casks 1 8 0 0 107 cases 1 13 2 0 - - - - - Crab, Tinned 30 cases and 244 tins 14 2 12 - - - - - - - - - - - - - - - - - Dates 11 packages 16 2 0 - - - - - - - - - - - - - - - Ducks 29 clucks - 1 1 14 - - - - - - - - - - - - - - - 226 Eggs 3339 tins 0 3 13 - - - - - - - - - - - - - - - Egg Yolk 2 cases 2 0 0 19 cases 1 3 3 0 - - - - - - - - - - - Extract of Beef 2 cases 58 boxes and various packages 9 2 7 - - - - - - - - - - - - — - - - 1 Tierce 3 2 0 - Fat - - - - - - - - - - - - - - - Figs 616 bags and 199 boxes 9 18 0 0 - - - - - - - - - — - - - - - TABLE X.—PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1925—continued Quantity Unsound Disposed of for Purposes other than Human Food Destroyed Exported Removed for Sorting under S.A. Articles Quantity Weight Quantity Weight Quantity Quantity Weight Weight tons cwt lbs tons cwt lbs tons cwt lbs tons cwt lbs qr qr qr qr Fig Paste 2 cases 3 25 - - - - - - - - - - - - - - - - - Fish, Canned 22 cases and various packages 8 1 14 - - - - - - - - - - - - - - - - Fish, Fresh 97 cases 4 19 0 0 - - - - - - - - - - - - - - - Flour 1 2 0 - - - - - - - - - - - - - - - - - Fruit, Canned, Various 1 0 277 cases and 77 tins 4 11 0 13 - - - - - various packages 6 1 - - - - - Fruit, Various 72 cases, 19 boxes and various packages 4 6 3 7 - - - - - - - - - - - - - - - Fruit Pulp various packages 8 10 1 0 - - - - - - - - - - - - - - - Glucose - 1 cask 6 0 0 - - - - - - - - - - - - - - - Grapes 18 boxes and 1 crate 1 1 0 - - - - - - - - - - - - - - - - Hams - - - - 1 case and 9 hams 2 0 5 24 cases, 35 hams, and 2,634 tins 14 5 0 14 75 cases, 29 tins and 25 hams 4 6 2 1 - - Horseradish 3 barrels and 27 bags 0 - 1 0 0 - - - - - - - - - - - - - - Haricot Beans - - - - - - - - - - - - 1 12 - - - - - - Ice Wafers 19 cases 1 3 0 0 - - - - - - - - - - - - - - - Kidneys, Pig 8 casks - 8 3 7 - - - - - - - - - - - - - - - Kidneys, Sheep 1 box 7 - - - - - - - - - - - - - - - - - - TABLE X. —PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1925—continued Quantity Unsound Disposed of for Purposes other than Human Food Removed for Sorting under S.A. Articles Destroyed Exported Quantity Weight Quantity Weight Quantity Weight Quantity Weight tons cwt qr lbs tons cwt qr lbs tons cwt qr lbs tons cwt qr lbs Lamb and Mutton - - 1 carcase 1 7 8,569 carcases 138 10 0 0 - - - - - - - - - - 10 cases Lard - - 5 3 23 - - — - - - - - - — - - - - Lemon Curd - - 5 0 17 - - - - - - - 26½ boxes - - - - - - - 2 0 0 - Lime Pickle - - 2 cases - - - - - - - - - - - - - Mandarines - - - 2 crates 1 1 0 - - - - - - - - - - - - - Margarine - - 1 box 2 3 - - - - - - - - - - - - - - - Meat, Canned, Various 2,365 tins 5 13 1 23 55 cases and 587 tins 3 0 3 12 - - - - - - - - - - Meat, Fresh various pieces - 13 3 18 83 pieces 11 2 13 - - - - - - - - - - - Melons 74 cases 3 4 0 0 - - - - - — - - - - - - - - - Offal - - 18 bags 14 2 9 - - - - - - - - - - - - - - Onions 128 cases and various packages 6 17 3 0 - - - - - — 2 1 4 - - - - - - Ox Cheeks - - - - - - 24 - - - - - - - - - — - - - 11 2 barrels - Ox Tongues - - 116 tongues 7 1 - - - - - - - - - - - - Oranges - - 456 cases and 718 x ½ cases 76 14 0 0 - - - - - - - - - — - - - Orange Juice - - - 3 tierces and 4 casks 188½ gallons - - - - - - - - - - - - 2 19 Orange Pulp - - - - - - - - - - - - - - - - - - Peaches, Tinned - 2 cases - 1 1 4 28 cases 14 0 0 - - - - - - - - - - Pears - 18 barrels and various packages 4 0 2 3 - - - — - - - - - - - - - - TABLE X.—PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1925—continued Quantity Unsound Destroyed Disposed of for Purposes other than Human Food Removed for Sorting under S.A. Articles Exported Quantity Weight Quantity Weight Quantity Weight Quantity Weight tons cwt qr lbs tons cwt qr lbs tons cwt qr lbn tons cwt qr lbs Pigs Heads 3 3 - - - - - - - - - - - - - - - - - - Pigs Plucks 1 case 1 0 0 - - - - - - - - - - - - - - - - Pigs Tongues 15 casks 2 5 0 0 - - - - - - - - - - - - - - - Pines, Grated 10 cases 5 1 12 - - - - - - - - - - - - - - - - Pineapples, Tinned 60 cases and various packages 4 2 2 20 - - - - - - - - - - - - - - - Plums - - - - - 280 cases 3 2 2 0 - - - - - - - - - - (68) Pork trimmings 2 2 5 707 carcases 42 0 0 0 - - - - - - - - - - - Pork Loins 2 cases 2 24 - - - - - - - - - - - - - - - - - Potatoes 999 bags 49 19 0 0 6 bags, 1 basket and 24 boxes 1 6 0 0 - - - - - - - - - - Poultry - 21 cases 5 1 14 - - - - - - - - - - - - - - - Prunes 4 bags 6 3 6 - - - - - - - - - - - - - - - - Quaker Oats 44 cases 15 3 0 - - - - - - - - - - - - - - - - Raisins 1 box 14 - - - - - - - - - - - - - - - - - - Raspberry Pulp - 2 tins 20 - - - - - - - - - - - - - - - - - various parcels 116 11 2 7 - - Rice - - - - - - - - - - - - - Sage - 1 1 14 - - - - - - - - - - - - - - - - 20 0 0 0 Salmon - - - - - - - - - 970 cases - - - - - - Salmon, Salted 1 cask 8 0 0 - - - - - - - - - - - - - - - - Sardines 6 cases and 56 tins 7 0 7 - - - - - - - - - - - - - - - - 2 12 Sheep 2 carcases - - - - - - - - - - - - - - - - - Shrimps 1 barrel - - - - - - - - - - - - - - - - - - - TABLE X.— PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1925—continued Quantity Unsound Articles Disposed of for Purposes other than Human Food Removed for Sorting under S.A. Exported Destroyed Weight Quantity Weight Quantity Weight Quantity Weight Quantity lbs lbs tons cwt lbs tons cwt qr lbs tons cwt tons cwt qr qr qr 769 baskets and 2 tubs 1 0 2 9 - - - - Strawberries - - - - - - - - - - - 2 bags and sweepings 1 3 2 7 42 bags 1 19 1 0 Sugar - - - - - - - - - - 5 boxes and 3 tins 3 8 Sweet Breads - - - - - - - - - - - - - - - - - 6 kegs 30 gallons - - - - - Syrup - - - - - - - - - - 3,712 casks 1304 4 0 0 336 14 0 0 Tallow 962 casks - - - - - - - - - - Tapioca 749 bags 48 0 0 0 - - - - - - - - - - - - - - - 5 Tomatoes - 61 packages, 10 cases and 40 tins 3 1 8 - - - - - - - - - - - - - - Tomatoes, Peeled 324 tins 8 2 20 - - - - - - - - - - - - - - - - Tomato Pulp 9 cases and 8 tins 8 0 0 - - - - - - - - - - - - - - - - 12 cases 6 2 0 6 tins 1 5 Tomato Puree - - - - - - - - - - - - - 5 3 4 - - - - - Tongues - - - - - 1 case and 85 tongues - - - - - - Tripe 4 bags 2 2 13 - - - - - - - - - - - - - - - - Wheat various packages 738 6 1 25 various packages 1 12 0 0 - - - - - - - - - - Whortleberries 5 barrels 1 0 0 0 - - - - - - - - - - - - - - -