AC 4378 dupl. BER 42 Borough of Bermondsey REPORT ON THE SANITARY CONDITION OF THE BOROUGH OF BERMONDSEY For the Year 1929 BY D. M. CONNAN, M.B., B.S., D.P.H., Medical Officer of Health. BER 42 Borough of Bermondsey REPORT ON THE SANITARY CONDITION OF THE BOROUGH OF BERMONDSEY For the Year 1929 BY D.M. CONNAN, M.B., B.S., D.P.H., Medical Officer of Health. TABLE OF CONTENTS. PUBLIC HEALTH DEPARTMENT— PAGE Public Health Committee 4 Maternity and Child Welfare Committee 4 Housing Committee 5 Staff 6 VITAL STATISTICS— Area 9 Dwellings 9 Rateable Value 9 Population 9 Births 9 Deaths 9 Marriages 10 Infantile Mortality 11 Deaths from Tuberculosis 11 Vital Statistics of District 12 Causes of Deaths 15 Deaths from Zymotic Diseases 17 INFECTIOUS DISEASES— Diseases Notifiable 18 Diphtheria 18 Scarlet Fever 19 Small Pox 19 Measles 19 Ophthalmia Neonatorum 20 Puerperal Fever and Pyrexia 20 Disinfection 21 Shelter 22 Bacteriological Laboratory 22 Special Report on Treatment Clinic 23 Nursing 23 Cases Notified in 1929 25 Cases Notified for last ten years 26 TUBERCULOSIS— New Cases and Deaths 27 Period between Notifications and Deaths 28 X-Ray arrangements 28 Lady Almoner 29 PAGE Public Health (Prevention of Tuberculosis) Regulations, 1925 30 Work of the Tuberculosis Dispensary 31 Summary of Notifications 32 Cases on the Register 33 LIGHT TREATMENT— Work done in the Solarium 34 Leysin Patients 40 MATERNITY AND CHILD WELFARE— Midwifery Service 41 Fairby Grange Convalescent Home 47 Work of the Health Visitors 48 Attendances at Centres 49 Statistics for 1929 50 DENTAL TREATMENT— Particulars of Children Treated 52 Particulars of Treatment and Work for 1929 53 PROPAGANDA 54 SANITARY ADMINISTRATION- Housing 56 Inspections and Proceedings 58 Work of the District Inspectors 63 Factories and Workshops —Homework 64 Factories and Workshops —Inspections 65 Bakehouses 66 House and Trade Refuse 67 Offensive Trades 67 Mortuary 67 Street Markets 67 Drainage Work 67 FOOD CONTROL— Unsound Food 70 Milk Premises 70 Milk Licenses 70 Work of the Wharves and Food Inspectors 71 Food and Drugs—Samples Taken 72 Food and Drugs—Prosecutions 76 Public Health (Imported Food) Regulations, 1925 77 PUBLIC HEALTH DEPARTMENT. PUBLIC HEALTH COMMITTEE, 1929. Chairman—Councillor WEIGHTMAN. Alderman Miss Broughton Councillor Meadows Councillor Mrs. Amos „ Mrs. Nix „ Benfield „ Mrs. Powell „ Gibson „ Roberts „ Harding „ Stean „ Miss Henrich „ Mrs. Stokes, „ Howard „ Stokes, I. „ Mrs. Husk „ Sullivan „ Kidd „ Wayne „ Loveland „ Webb Ex-officio : Councillor G. A. HORWOOD, J.P., Mayor of Bermondsey, 1928-29. Councillor A. C. STARR, J.P., Mayor of Bermondsey, 1929-30. MATERNITY AND CHILD WELFARE COMMITTEE, 1929. Chairman—Councillor NIX Councillor Mrs. Amos Councillor Mrs. Newton Mrs. Fortescue „ Ponsford „ Mrs. George „ Mrs. Powell „ Miss Henrich „ Mrs. Purser „ Mrs. Homewood „ Stokes, I. „ Mrs. Husk „ Wayne „ Miss Langley „ Mrs. Witham Co-opted Members: Miss E. M. Haslam Miss D. Plummer Lady Hawke Miss A. Wardle Ex-officio : Councillor G. A. HORWOOD, J.P., Mayor of Bermondsey, 1928-29. Councillor A. C. STARR, J.P., Mayor of Bermondsey, 1929-30. HOUSING COMMITTEE, 1929. Chairman, 1928-29 Councillor STARR Chairman, 1929-30 Councillor TINGLE Alderman Amos, M.A. Councillor Harding „ Douglas „ Henley „ Kirby, „ Miss Henrich „ Salter, „ Horwood M.D., J.P., M.P. Councillor Bench „ Miss Langley „ Bradley „ Mrs. Newton „ Mrs. Fortescue „ Ponsford Franklin „ Mrs. Purser „ Mrs. George „ Mrs. Salter, L.C.C. „ Glasson „ Smith Ex-officio : Councillor G. A. HORWOOD, J.P., Mayor of Bermondsey, 1928-29. Councillor A. C. STARR, J.P., Mayor of Bermondsey, 1929-30. STAFF:- MEDICAL OFFICER OF HEALTH. D. M. Connan, M.B., B.S., D.P.H., CHIEF SANITARY INSPECTOR. E. C. Freeman, M.S.I.A. SANITARY INSPECTORS : G. L. Scott, Wharves and Food Inspector. G. A. Hoskins, Wharves and Food Inspector. H. J. Toogood, Housing Inspector. W. Davis, Drainage Inspector. J. G. Francksen, Markets Inspector A. H. Merryman, Food and Drugs Inspector. District Inspectors: No. 1.—O. W. R. Smart No. 5.—G. F. J. Toll No. 2.-E. J. Pitts No. 6.—H. E. Butcher No. 3.— W. G. Luke No. 7.—R. E. Helden No. 4.—W. C. Tapsfield TUBERCULOSIS DISPENSARY. Clinical Tuberculosis Officer—C. H. C. Toussaint, M.R.C.S. L.R.C.P., D.P.H. Assistant Tuberculosis Officer—E. J. MacIntyre, M.B., Ch.B., D.P.H. Lady Almoner—Olive Pike. Tuberculosis Nurses—Celia Clapson, Louise Colbeck and Edith Riley. Solarium Nurses—Sarah Bowles and Constance Clarke. Caretaker—H. J. Madasa. MATERNITY AND CHILD WELFARE: Assistant Medical Officers for Maternity and Child Welfare— Ruth W. Plimsoll M.B., B.S., D.P.H.; Florence L. Telfer, M.D. Health Visitors: Lucy Brown Rosa Bache Isobel White Mrs. Dorothy Cottier Marie Helden Amy Carlton Florence Child Florence Wadds Dental Treatment: Municipal Dental Surgeon—Grantley Smith, H.D.D. Edin., L.D.S. Eng. Assistant Dental Surgeon (part-time) —W. H. Shapland, L.D.S. Eng. Dental Nurses —Winifred Lambert and Mrs. Daisy Hodgson Prosthetic Assistants—G. W. Clarke, W. B. Monger and T. H. Baggott. Fairby Grange Convalescent Home: Matron—Alice Sewell. Nurse —Mrs. Mary Barden. PUBLIC ANALYST. A. Prideaux Davson, A.R.C.Sc., F.T.C., F.C.S. PROPAGANDA AND ADMINISTRATIVE OFFICER: H. W. Bush, M.I.H. CLERICAL STAFF : A. I. Fair, First Clerk F. J. Carpenter, General Clerk F. W. Smith, Second Clerk C. H. Harris, General Clerk E. F. Walsh, Third Clerk C. F. Lumley, General Clerk A. Manning, M. and C.W. Clerk F. R. Parker, General Clerk C. W. Whye, General Clerk W. A. Campbell, Junior Clerk C. F. Yaxley, General Clerk A. W. Hancock, Junior Clerk Rose Dutch, Clerk & Dispenser J. W. J. Saward, Junior Clerk MORTUARY KEEPER: J. C. Stockwell FOREMAN DISINFECTOR: 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. Sir, Ladies and Gentlemen, I have the honour to submit the Annual Report for the year 1929. The Report is divided into nine sections. I wish again to express my thanks to the Chairmen and Members of the three Committees, and to the staff of the Department. I am, Sir, Ladies and Gentlemen, Your obedient Servant, D. M. CONNAN. I. —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, 1929, was £1,102,028, the product of a penny rate being £4,432. POPULATION. Census Estimate of Registrar General 1911 1921 to 30th June, 1928 to 30th June, 1929 125,903 119,452 115,200 113,800 I : BIRTHS. The total number of births belonging to the Borough registered during 1929 was 2,252, consisting of 1,138 males and 1,114 females. The number for 1928 was 2,086. The birth rate for 1929 was 19.8 per 1,000 persons living, compared with 18.1 for 1928. DEATHS. The total number of deaths belonging to the Borough registered during 1929 was 1,650, consisting of 895 males and 755 females. The number for 1928 was 1,520. The death rate for 1929 was 14.5 per 1,000 persons living, compared with 13.2 for 1928. MARRIAGES. The total number of marriages in the Borough in 1929 was 994, being 61 below the number for 1928, and 96 below the average for the last 10 years. The figures have been supplied by the Superintendent Registrar. This makes a marriage rate of 17.47 per 1,000 of the population, compared with a marriage rate last year of 18·32 of the population, 115,200. Year No. Rate 1919 1,242 19.19 1920 1,383 21.40 1921 1,084 17·99 1922 l ,008 16 · 64 1923 1,056 17·34 1924 1,015 16·62 1925 1,038 16 · 88 1926 9 94 16 ·15 1927 1,021 16 · 88 1928 1,055 18 · 32 Average for years 1919 —1928 1,090 17·74 1929 994 17 · 47 (10) INFANTILE MORTALITY RATE FOR 25 YEARS. (11) INFANTILE MORTALITY. Whole Borough London Year No. of Deaths Rate per 1,000 Births No. of Deaths Rate per 1,000 Births 1919 262 99 7,039 85 76 1920 337 83 9,141 1921 306 95 8,077 80 1922 324 102 7,089 75 61 1923 220 76 5,615 1924 229 78 5,904 69 1925 210 79 5,599 68 1926 60 146 5,067 64 59 1927 149 67 4,357 178 85 4,879 67 1928 Average for years 1919-1928 236 82 6,277 70 71 4,995 71 1929 160 TUBERCULOSIS OF THE RESPIRATORY SYSTEM. In the following Table will be found particulars of deaths from Tuberculosis of the Respiratory System since the year 1919. Sub-District Bermondsey St. Olave Whole Borough London Rotherhithe Year No. Rate No. Rate No. Rate No. Rate No. Rate 12 1.39 1.22 1919 104 1.28 58 1.66 174 1.40 5332 4791 81 0.96 46 1.27 10 1.12 137 1.05 1920 1.06 - - 14 - 4813 1921 106 43 163 1.35 1.07 1922 - - 7 - 1.39 4888 1.08 119 43 169 1923 95 - 14 - 144 1.18 4432 0.97 35 - 92 - 46 - 11 149 1.22 4486 0.98 1924 - - 1.18 4361 0.95 99 - 35 - 11 145 1925 100 151 1926 - 39 - 12 - 1.23 4066 0.88 87 - 42 - - 144 1.19 4140 0.91 1927 15 88 43 143 3985 0.89 1928 - 12 - 1.24 - 43 - Averages for years 1919-1928 97 - 12 - 152 1.24 4529 1.00 1.03 1929 78 - - 8 - 117 4230 0.96 31 VITAL STATISTICS OF WHOLE DISTRICT DURING 1929 AND PREVIOUS YEARS. Year 1 Population estimated to Middle of each Year 2 Births Total Deaths registered in the District Total Deaths in Public Institutions in the District 9 Deaths of Non- Residents registered in Public Institutions, etc. in the District 10 Deaths of Residents registered in Public Institutions beyond the District 11 Net Deaths at all Ages belonging to the District No. 3 Rate 4 Under 1 Year of Age At all Ages No. 12 Rate 13 No. 5 Rate per 1,000 Births registered 6 No. 7 Rate 8 124,239 2,637 20.4 212 80 1,600 12.8 709 165 313 1,748 14.1 1919 1920 129,189 4,038 31.2 280 69 1,466 11.3 689 105 281 1,642 12.7 1921 120,500 3,231 26.8 261 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 43 337 1,657 13.6 1925 123,000 2,652 21.6 188 71 1,280 10.4 669 47 321 1,554 12.6 1920 123,100 2,414 19.6 126 52 1,163 9.4 624 31 352 1,484 12.1 1927 121,000 2,233 18.5 119 53 1,236 10.2 616 22 352 1,566 12.9 1928 115,200 2,086 18.1 143 69 1,230 10.7 671 39 329 1,520 13.2 23.0 201 1,333 10.9 346 Averages for years 1919-1928 122,114 2,828 70 646 59 1,633 13.4 127 56 1,302 11.4 696 32 113,800 2,252 1,650 (13) OTHER INSTITUTIONS, Etc., Etc. 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 I. Institutions, etc., within the District receiving sick and infirm persons from outside the District. No. of Deaths No. of Deaths No. of Deaths Ambulances on way to Hospital 3 Bermondsey and Rotherhithe Hospital Ladywell Institution 100 Belgrave Hospital 1 18 Bexley Mental Hospital 6 Birmingham General Hospital 1 Brook Hospital, Shooters Hill 3 Cane Hill Mental Hospital 9 Colindale Hospital, Hendon 4 Deaths in River Thames, Surrey Commercial Docks, Wharves, etc. Croydon General Hospital 1 Cyril Henry Treatment Centre, Woolwich 1 9 Darenth Training Colony 1 M.A.B. South Wharf Derbyshire Royal Infirmary 1 Downs Hospital, Sutton 2 1 East London Hospital for Children 1 Private Houses 4 Elm Grove Institution, Brighton 1 Evelina Hospital 6 Total 32 Foreshore, Bar Point, Mudeford 1 Forest Gate Sick Home, West Ham 1 Fountain Mental Hospital, Wandsworth 1 Greenwich and Deptford Hospital 4 Grove, The, Epsom 3 Grove Hospital, Tooting 2 Grove Park Hospital, Mottingham 1 Guy's Hospital 94 Heart Hospital, West Wiekham 1 Hill House, Minster 1 Horton Hospital, Epsom 3 Hundred Acres, Epsom 3 Italian Hospital, Queen's Square 1 King's College Hospital 1 Ladywell Institution 100 Lambeth Hospital 4 Leavesden Mental Hospital 1 Lewisham Hospital 1 Livingstone Hospital 1 London Hospital 3 Lying-in Hospital, York Road 1 Metropolitan Hospital, Catcrham 1 Miller Hospital, Greenwich 2 Mount Vernon Hospital, Northwood 1 Park Hospital, Hither Green 6 Poplar Hospital 1 Princess Louisa Hospital, Kensington 1 Princess Mary's Hospital for Children, Margate 1 Private Houses 13 (14) OTHER INSTITUTIONS, Etc., Etc.—continued Institutions, etc., within the District receiving sick and infirm persons from outside 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. Queen Mary's Hospital, Carshalton 3 Queen Mary's Hospital, Wandsworth 1 Queen's Hospital, Chislehurst 3 Risebridge Farm, Goudhurst 1 River Thames 2 Royal East Sussex Hospital, Hastings 1 St. Bartholomew's Hospital 2 St. George's Home, Chelsea 1 St. Joseph's Hospice, Hackney 3 St. Luke's Hospital, Paddington 1 St. Mary's Hospital, Paddington 1 St. Michael's Home, Axbridge 1 St. Peter's Home, Hampstead 1 St. Thomas's Hospital 2 Seamen's Hospital, Greenwich 3 South Eastern Hospital, New Cross 22 South Western Hospital, Stockwell 2 Street 4 Tooting Bec Hospital 22 University College Hospital 1 Warkworth House Institution, Isleworth 1 West Hill Institution, Dartford 1 West Park Mental Hospital, Epsom 3 Woolwich Memorial Hospital, Shooters Hill 1 Total 378 CAUSES OF, AND AGES AT, DEATHS DURING THE YEAR 1929. Causes of Death Deaths at the subjoined ages of "Residents" whether occurring in or beyond the District. 1 and under 2 5 and under 15 25 and under 45 45 and under 65 2 and under 5 15 and under 25 65 and upwards All Ages Under 1 162 474 639 All Causes Certified 1648 160 66 35 45 67 Uncertified - 2 - - - - - - 2 - - - - 1 - Enteric Fever 1 - - - - - Small Pox - - - - - - Measles 1 1 - - - - - - - - 2 - - - Scatrlet Fever 2 - - - 19 5 2 - Whooping Cough 33 7 - - - Diphtheria 6 1 2 - 3 - - - - 3 11 10 Influenza 27 1 1 - - 1 - - - - 1 - Encephalitis Lethargica 1 - - - - - - 1 - - Meningococcal Meningitis 5 4 1 - 3 21 Tuberculosis of Respiratory System 117 - 43 42 7 - - 1 Other Tuberculous Diseases 21 2 6 5 5 - Cancer, Malignant Disease 145 - - - 11 76 58 - - Rheumatic Fever 6 - - 3 2 - 1 - - - - - Diabetes 12 2 9 1 - - 4 29 71 Cerebral Hæmorrhage, etc. 106 2 - - - - Heart Disease 194 1 - 5 10 16 60 102 - - - - - Arterio-sclerosis 38 33 CAUSES OF, AND AGES AT. DEATHS DURING THE YEAR 1929—continued Deaths at the subjoined ages of "Residents" whether occurring in or beyond the district. Causes of Death All Ages Under 1 1 and under 2 2 and under 5 5 and under 15 15 and under 25 25 and under 45 45 and under 65 65 and upwards 234 3 1 - - - 3 73 154 Bronchitis pneumonia (all forms) 222 36 25 20 3 7 58 54 19 39 3 - - - 2 23 6 Other Respiratory Diseases 5 Ulcer of Stomach or Duodenum 8 - - - 5 2 1 - - Diarrhoea and Enteritis (under 2 years) 19 17 - - 2 - - - - Appendicitis 8 - - - 2 2 1 2 1 - - 1 - - - - 4 Cirrhosis of Liver 5 Acute and Chronic Nephritis 44 - 2 3 8 - 20 11 - Puerperal Sepsis - 2 2 - - - - - - Other Accidents and Diseases of Pregnancy and Parturition 3 - - 1 2 - - - - 59 - - - - Congenital Debility and Malformation, Premature Birth 59 - - - Suicide - - - - 5 12 - 6 1 Other Deaths from Violence 64 7 3 7 12 11 8 1 15 20 2 10 20 33 120 Other Defined Diseases 213 2 6 - Diseases ill-defined or unknown .. .. .. 3 - - - - 2 1 - I 1650 160 66 35 45 67 162 474 641 DEATHS FROM ZYMOTIC DISEASES, 1929. All Causes Principal Zymotic Diseases Smallpox Measles Scarlet Fever Diphtheria Whooping Cough Enteric Fever No. Rate No. Rate No. Rate No. Rate No. Rate No. Rate No. Rate No. Rate No. Rate 1919 1748 14.1 113 .91 - 18 5 .04 21 .17 4 .03 3 .02 62 .49 .14 - 1920 1642 12.7 163 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 1923 1480 12.1 125 1.02 - - 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 36 .78 - - 20 .16 3 .02 29 .24 27 .22 - - 17 .14 1926 1484 12.1 94 .76 - - 24 .19 6 .05 42 .34 1 .01 - - 21 .17 1927 1566 12.9 45 .37 - 9 .07 - - 13 .11 10 1 - - .08 12 .09 1928 1520 13.2 137 1.19 - - 77 .67 3 .03 16 .14 26 .23 1 .01 14 .12 Average for years 1919-1928 1633 13.4 138 1.13 - - 37 .30 6 .05 36 .30 21 .17 1 .01 36 .29 1650 14.5 62 .54 - - 1 .01 2 .02 6 .05 33 .29 1 .01 19 1929 II.—INFECTIOUS DISEASES, ETC. The following diseases are notifiable:— Anthrax Acute Polioencephalitis Acute Poliomyelitis Acute Primary Pneumonia Acute Influenzal Pneumonia Cholera Cerebro Spinal Meningitis Continued Fever Diphtheria Encephalitis Lethargica Enteric Fever and Typhoid Fever Erysipelas Hydrophobia in Man Glanders Membranous Croup Malaria Puerperal Fever Ophthalmia Neonatorum Relapsing Fever Puerperal Pyrexia Small Pox Scarlet Fever and Scarlatina Tuberculosis —all forms Typhus Owing to the housing conditions of the Borough, it is the practice to remove to hospital nearly all cases of diphtheria and scarlet fever. DIPHTHERIA. Reference was made in last year's report to the prevalence of diphtheria in this Borough, and the hope was expressed that Schick Testing and Immunising would soon be available. The Public Health Committee has agreed to the establishment of a Clinic for this purpose and the table below gives the number of cases dealt with since the opening of the Clinic on 18th April, 1929. It will be seen that the numbers attending have been very small. No doubt as the existence of the Clinic becomes more widely known the numbers availing themselves of this form of protection will increase. No. of patients examined No. found to positive and immunised No. found to be negative No. of sessions Total attendances 45 16 29 46 148 NOTIFIED CASES OF DIPHTHERIA FOR 25 YEARS. NOTIFIED CASES OF SCARLET FEVER FOR 25 YEARS. The number of cases notified during 1929 was 463, which is the lowest number recorded in any year during the last ten years, with the exception of 1920. Ido not think, however, that this figure is a matter for congratulation, it is still far too high, especially as experience proves the efficacy of modern methods of prevention and treatment. The number of deaths from this disease was 6 as compared with an average of 36 for the last ten years; 23 cases were returned from hospital as not suffering from diphtheria. SCARLET FEVER. The number of cases notified during the year was 584 and 2 patients died. The number of cases returned as not suffering was 23. SMALL POX. Forty-six cases of smallpox have been notified during the year. Compared with neighbouring Boroughs, this Borough has been extremely fortunate in having so small a number of cases. The general epidemic in which we have shared to such a relatively small extent has been the cause of an enormous increase of work. Every case is reported to the Ministry of Health and to the London County Council, and. all contacts living or working in the Borough, whether they are contacts of a Bermondsey patient or of a case occurring elsewhere, are kept under supervision for sixteen days. In several instances there have been more than a hundred contacts to a single case and as the number of notifications in London during the year has approximated 2,000, the increased amount of work entailed by the epidemic is obvious. We have had no severe cases during the year and only one case has been returned as not suffering from small-pox. MEASLES. In anticipation of the occurrence of an epidemic of this disease during the latter months of the year, special arrangements have been made with the School Medical Officer of the London County Council, by which it is hoped to obtain earlier knowledge of suspected cases. Measles is not at present notifiable in the Borough and information about cases is received from various sources, chiefly from the schools and Health Visitors. Hospital treatment can be obtained by the doctor in charge, on application, either direct to the Metropolitan Asylums Board or to the Medical Officer of Health. The number removed to hospital during the year was 12. A nurse will be provided, where necessary, by either of the District Nursing Associations, free of charge—the number of cases nursed last year was 11. OPHTHALMIA NEONATORUM. The following table gives particulars of this disease. In no case was vision impaired. The death reported was due to meningitis. Cases Vision Unimpaired Total Blindness Vision Impaired Deaths Notified Treated At home In Hospital 1 3 10 - - 11 8 PUERPERAL FEVER AND PUERPERAL PYREXIA. The number of cases notified will be found in the accompanying table. Facilities are provided by the Council for assistance in the diagnosis and treatment of these cases. These facilities include the provision of the services of a consultant and of a nurse where necessary. We also undertake bacteriological examinations and arrange for the admission of patients to hospital where this is desired. The total number of cases is small, and these facilities have been utilised during the year, as follows . Facilities No. of Cases Second Opinions 1 Nursing provided 3 Bacteriological examinations Nil Admitted to Hospital 24 DISINFECTION. Disinfection of premises and of articles exposed to infection is insisted upon in all cases of notifiable infectious disease. Respect is always had as far as possible to the convenience and comfort of the householder. Rooms are sealed up for disinfection and beds, bedding, clothes and other articles are removed and disinfected at the station. I regret to report that very little headway has been made in connection with the new disinfecting station. Various suggestions from the Ministry of Health have been considered, and in all probability work on the new station will begin in the near future. Fortunately, although the disinfecting staff are working under great difficulties; they have been quite able to cope with the work up to the present. The new station is to include special provision for the cleansing of verminous children attending elementary schools. The number of adults cleansed during the year was 73, being 6 females and 67 males. All library books are disinfected before being returned to the library. The following table shows the number of articles passed through the steam disinfector during the year under report:— Beds 1,279 Pillows (cases) 2,228 Blankets 3,794 Quilts 1,688 Bolsters 890 Sheets 2,253 ,, (cases) 303 Miscellaneous 13,514 Books 1,369 Verminous Clothing 698 Carpets 50 Bedding 115 Cushions 303 Hair (Bundles) Nil Mattresses 243 „ (cases) Nil Overlays 870 Pillows 2,621 27,101 new tabs were used to replace those taken off mattresses, palliasses, and cushions before disinfection. Number of rooms disinfected 2,346 (22) On the whole the general volume of disinfecting work shows a tendency to increase and there have been some five thousand more articles through the machines than there were last year. SHELTER. Four flats are provided in The Neckinger for the temporary housing of families or persons while their premises are being disinfected. There were 177 persons so accommodated during the year, the increase being almost entirely due to smallpox. BACTERIOLOGICAL LABORATORY. The work of the bacteriological laboratory consists mainiy in the examination of sputa for tubercle bacilli and the examination of throat swabs for diphtheria bacilli. Many of the throat swabs are sent by general practitioners and sterile outfits for this purpose are supplied free on application to the Medical Officer of Health. All diphtheria contacts of school age are excluded from school until the throat swab is negative. A positive result of course necessitates a further examination, and treatment in the mean" time by the private practitioner. Proved "Carriers" are usually referred to the London County Council "Carriers'" Clinic at Guy's Hospital. In addition to the examination of swabs and sputa, other bacteriological investigations are undertaken when requested. Total Examinations Results of Examination Nature of Specimen Positive Negative 1928 1929 1929 1928 1929 1928 Diphtheria (specimens taken by Medical Officer of Health) 1171 875 102 56 1069 819 Ditto (taken by general practitioners) 1366 1229 180 146 1186 1083 Diphtheria (total specimens taken) 2537 2104 282 202 2255 1902 Phthisis 1300 1451 237 253 1063 1198 Various 79 90 3 3 76 87 Total specimens taken 3916 3645 522 458 3394 3187 SPECIAL REPORT ON TREATMENT CLINIC. A special report on the provision of facilities for the early diagnosis, supervision and treatment of Acute Rheumatoid Arthritis and Cancer, was submitted to the Public Health Committee in November, 1928. This has been discussed and accepted with certain modifications, and steps are being taken at present to proceed with the scheme outlined in the report. I hope that it will be possible to include a full account of the scheme in my next Annual Report. NURSING. There are two District Nursing Associations at present established in Bermondsey:— St. Olave's District Nursing Association, 13 Cherry Garden Street. Rotherhithe Queen's District Nursing Association, 149 Lower Road. St. Olave's District Nursing Association has a staff consisting of a superintendent and an assistant superintendent, together with twelve qualified nurses who are training as district nurses. Rotherhithe Queen's District Nursing Association employs a senior nurse and two assistant nurses. No. of Cases, 1928. No. of Visits, 1928. St. Olave's District Nursing Association 1,080 22,638 Rotherhithe Queen's Nursing Association 495 11,426 In the case of both associations the nurses work under the direction of the medical man in attendance and the services of a nurse are available for any resident in the Borough on appliction. No definite charge is made, but voluntary contributions are received. A rule observed by both Associations is that no nurse shall act as a midwife. On July 2nd, after negotiations with the nursing associations, an agreement was arrived at for the provision of nursing assistance (24) to residents of the Borough, where such assistance is certified by a medical practitioner to be necessary, at a fee of lOd. per visit. This scheme was put into operation on July 3rd and the following table shows the number of cases attended and the number of visits made during the year. Disease St. Olave's District Nursing Association Rotherhithe Queen's Nursing Association Totals whole Borough Cases Visits Cases Visits Cases Visits Pneumonia 111 25 136 3,182 2,550 632 Broncho pneumonia 299 10 134 29 433 19 6 148 19 370 Bronchitis 13 222 12 242 3 144 9 98 Pleurisy 1 34 1 34 Asthma - - 6 53 21 288 Influenza 15 235 49 11 159 8 110 3 Measles 3 58 58 - 3 Whooping Cough - Tuberculosis :— I ..\ T> : I (a) Respiratory System 25 1,049 15 738 10 311 1 11 1 11 (b) Other Forms - I Rheumatism :— I I I .. I 5 149 15 521 (a) Acute 10 372 11 251 (b) Chronic 8 215 3 36 2 9 1 8 3 17 Puerperal Pyrexia Puerperal Fever - - - - - - 25 19 240 17 215 2 Pregnancy and Labour Cancer, malignant disease 822 5 178 24 1,000 19 6 147 20 443 Heart disease 14 296 Diseases of the Digestive System (excluding malignant disease) 18 163 58 487 40 324 283 3 7 819 4 536 Diabetes Infantile Diarrhoea (under 2 years) - - - - - - Diseases of the Urinary System 3 92 10 123 31 7 6 8 159 121 2 38 Discharging Ears 7 Discharging Eyes 5 208 2 7 215 Post-operative cases : — | I I i ! ... 457 (a) Tonsils & Adenoids 60 | 401 14 56 74 14 6 (b) Other cases 4 65 2 79 Diseases of the Nervous System 11 8 138 19 653 515 3,255 658 143 110 2,597 33 Other diseases Totals 181 3,704 682 14,545 501 10,841 CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR 1929. NUMBER OF CASES NOTIFIED NOTIFIABLE DISEASE BERMONDSEY ROTHERHITHE ST. OLAVE Total Cases removed to Hospital At Ages—Year 1 2 3 4 5 6 Total 1 2 3 Total St. John St.Olave St. Thomas Total At all Ages Under 1 year 1 and under 5 years 5 and under 15 years 25 and under 45 years 45 and under 65 years 65 and upwards 15 and under 25 years Small-pox 46 - 2 16 9 8 11 - 10 13 - 1 3 3 31 1 2 10 13 1 1 - 2 46 Diphtheria (including Membranous Croup) 463 7 153 247 33 21 2 - 65 81 40 51 30 45 312 62 43 14 119 21 5 6 32 462 Erysipelas 45 - - 5 4 11 19 6 5 1 3 5 5 2 22 5 7 8 20 - 1 2 3 3 Scarlet Fever 584 8 183 333 38 19 3 - 70 85 57 62 45 364 58 70 48 176 25 7 12 44 578 45 Cerebro-Spinal Meningitis 4 - 4 - - - - - 2 - - - - 2 - - 1 1 - - 1 4 - 1 Acute Polio-Myelitis and Acute Polio Encephalitis 2 - 2 - - - - - 1 - - - - 1 2 - - - - - - - - 2 Ophthalmia Neonatorum 11 11 - - - - - - 1 2 — 2 1 - 6 1 2 1 4 1 - - 1 8 Anthrax 1 - - - 1 - - - - - 1 - - - 1 - - - - - - - - 1 Enteric Fever 2 - - 1 1 - - - - - - - 1 1 1 - - 1 - - - - 2 - Puerperal Fever 12 - - 3 9 - - 1 2 3 - 2 1 9 2 - 2 - 1 - 1 11 - - Puorperal Pyrexia 20 - - - 5 15 - - 2 2 3 3 2 2 14 3 1 1 5 1 - - 1 13 Encephalitis Lethargica 1 - 1 - - - - - - - - - - - 1 - - 1 - - - - - - Dysentery - - - - - - - - - - - - - - - - - - - - - - - - Malaria (induced) 1 1 1 - - - - - - 1 - - - - - - - - - - - - - Pneumonia (Acute Primary and Acute Influenzal) 110 6 26 11 19 16 7 10 10 15 12 12 3 62 21 15 11 47 1 - - 1 25 - Tuberculosis— 11V u _< > 11 1C IV I X\J ' X\J ' I ■' I I _ 1 — ' O I \ii. *jl l>) I 11 ** J 1 . — 1 Respiratory System 2 12 66 43 7 25 60 6 2 104 64 24 18 26 19 11 123 25 19 16 3 11 - Other forms of Tuberculosis 40 3 4 16 8 7 2 - 4 4 5 2 5 3 23 8 4 15 - 2 - 2 - 3 Totals 1536 35 376 656 180 173 96 20 193 221 154 163 125 117 973 188 163 ll3 464 57 19 23 99 1130 CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEARS 1920-1929. Notifiable Disease. 1920 1921 1922 1923 1924 1925 1926 Small Pox - - 2 - - - - Diphtheria (including Membranous Croup) 268 741 1,111 586 541 535 714 Erysipelas 59 54 50 19 42 35 30 Scarlet Fever 976 1,164 652 323 395 353 426 Cerebro-Spinal Meningitis 6 1 5 3 1 3 5 Acute Polio-Myelitis and Acute Polio- Encephalitis - - 2 2 2 1 1 Ophthalmia Neonatorum 37 15 12 18 12 15 10 Anthrax 5 1 1 - 2 3 4 Enteric Fever 7 8 4 2 2 5 3 Puerperal Fever 21 7 7 4 2 9 9 Puerperal Pyrexia - - - - - - 11 Encephalitis Lethargica 4 4 2 1 21 8 8 Dysentery 3 - - - 1 - - Malaria 18 3 1 - 1 - 1 Malaria (induced) - - - - - - - Continued Fever 1 - - - - - - Pneumonia (Acute Primary and Acute Influenzal) 81 234 125 243 119 37 113 Tuberculosis:— I ... I ... Respiratory System 339 376 317 226 245 250 206 Other forms of Tuberculosis 99 79 96 86 90 76 59 1,924 2,490 2,496 (21) III.—TUBERCULOSIS. The number of deaths from all forms of tuberculous disease in 1929 was 138, being 26 lower than in the previous year. The number of deaths from tuberculosis of the respiratory system was 117, and the death rate from this form of the disease, 103, was the lowest recorded since the war. In spite of this improvement much remains to be done before the tuberculosis death rate in the borough will compare favourably with that of other districts. In Table I. is shown an analysis of new cases notified and of deaths classified by sex and age groups. TABLE I. TUBERCULOSIS, 1929—NEW CASES AND DEATHS. NEW CASES DEATHS AGE—PERIODS Pulmonary Non Pulmonary Pulmonary Non- Pulmonary M. F. F. M. M. F. M. F. - - 1 2 - - - 2 0 2 1 6 5 1 - 6 5 1 5 3 6 4 - - 1 2 5 1 3 6 6 1 2 1 1 10 15 14 12 4 1 4 2 - - 27 17 3 1 7 8 - - 20 24 29 2 4 15 9 - 25 - 35 15 6 1 - 10 9 - - 12 6 - 2 15 - 2 45 5 55 24 7 1 1 17 5 - - 55 and upwards 7 1 1 1 6 1 1 - (28) TABLE II. TUBERCULOSIS, 1929—PERIOD BETWEEN NOTIFICATION AND DEATH. Period Between Notification and Death Respiratory System Other Forms Males Females Total Percentage of Total Deaths Males Females Total Percentage of Total Deaths Not notified 10 1 11 9.40 6 7 13 61.91 0-1 month 9 2 11 9.40 1 5 6 28.57 1-3 months 8 8 16 13.68 - - - - 3-6 months 6 3 9 7.69 1 - 1 4.76 6-12 months 3 7 10 1 - 1 4.76 8.55 1-2 years 13 6 19 16.24 - - - - 2-5 years 14 10 24 20.51 - - - - Over 5 years 13 4 17 14.53 - - - - Totals 76 41 117 100.00 9 12 21 100.00 In January 1929, fresh arrangements were made for radiological examination of cases attending the Dispensary. The Borough Council concluded an agreement with the Board of Guardians, whereby patients could be X-rayed at the Bermondsey and Rotherhithe Hospital at an inclusive charge of 7s. 6d. per patient. One of the major objects of Tuberculosis Dispensary work is the thorough investigation and diagnosis of every new case and the increased facilities in the way of X-ray work have been of inestimable value. During the year 418 cases were X-rayed compared with 91 in 1928. In addition to an afternoon session there has been an evening session, enabling patients, who are still at work, to be X-rayed without interference with their employment. This is undoubtedly of the greatest benefit to patients. The Tuberculosis Officers attend personally at the X-ray sessions. Screening is employed in every case and the films are later filed and stored at the Tuberculosis Dispensary. It is hoped that this arrangement will continue when the London County Council takes over Bermondsey and Rotherhithe Hospital under the Local Government Act. LADY ALMONER. A separate short section of the Report was devoted last year for the first time to the work of the Lady Almoner, and I find that a number of Councillors are under a slight misapprehension as to the nature of her work, believing it to consist almost entirely in the collection of money. Primarily, her work is in connection with tuberculosis, and as a part of the Tuberculosis Scheme; she does collect money in the form of the contributions of patients towards the cost of sanatorium treatment. The amount which a patient is required to pay is assessed according to ability to pay and the assessment is made by Miss Pike and approved or revised by the London County Council. The amount approved by the London County Council is then collected, in most cases in weekly instalments: — Number of cases assessed 223 Total sum collected £416 5s. 6d. The sum collected is small and in no way represents the cost of treatment, but the principle that the patient should pay something towards the cost of treatment is one which has been adopted by the London County Council, and it therefore forms a definite part of the Tuberculosis Scheme. I do not dissent from this principle so far as certain services are concerned, but I personally consider that its application in the case of tuberculosis is unfortunate for two reasons. Tuberculosis is a disease of poverty, promoted by poverty and only too frequently leading to poverty. The poor financial resources of most of our patients are ill able to stand the strain of even a small assessment, especially when the payments have to be kept up over a comparatively long period. The amount collected from those who are in a somewhat better financial position is so small as to render collection only worth while as an object lesson in self-help, and this I imagine, is the idea underlying insistence on this form of contribution There is a second objection, however, which I regard as being of greater importance. The removal of a patient to sanatorium certainly benefits the patient, but it also removes a source of infection from the home. In this latter aspect the removal of a patient to sanatorium is a direct measure of prevention designed to protect the community against a risk and the community should be prepared to pay for this protection. Other assessments such as those in connection with the Maternity and Child Welfare Milk Scheme and Fairby Grange are on a different footing, and these also are made by Miss Pike. The Lady Almoner visits the homes of patients for various purposes mainly in connection with tuberculosis. During the year she has visited a number of cases of rheumatism which have been discovered through the agency of the nursing scheme. She also assists in the propaganda work, and for this purpose has visited most of the schools in the Borough. Total number of visits 664 A great many other visits have been made which are not included in the above figure. These have been made to various factories, businesses, etc., and to the Labour Exchange, in attempts to find work for tuberculous patients. Great difficulty is experienced in finding such work and only 9 persons have been successfully placed during the year. Twenty-nine patients have been assisted with clothing from various sources and in this connection thanks are due to the Queen Mary's Needlework Guild for a gift of 100 garments and to the Charity Organisation Society and the Guardians for unfailing help. Eight adult non-tuberculous patients have been sent to Convalescent Homes, and holidays have been arranged for 11 other adults. The handicraft class which was mentioned in last year's report has been continued during the year, meeting on Friday afternoons in the Solarium. A large number of articles have been made in leather, basket work and raffia work—the sum received for the sale of these articles amounting to just over £60. PUBLIC HEALTH (PREVENTION OF TUBERCULOSIS) REGULATIONS, 1925. It was not found necessary to take any action under these Regulations in 1929. RETURN SHOWING THE WORK OF THE DISPENSARY DURING THE YEAR 1929. Diagnosis Pulmonary Total Non-pulmonary Adults Children Adults Adults Children Children M. F. M. F. M. F. M. F. M. F. M. F. A.—New Cases examined during the year (excluding contacts): — n a O A aa in I 5 (a) Definitely tuberculous 77 56 2 3 7 10 8 2 84 66 10 (b) Doubtfully tuberculous - - - - - - - - 11 11 4 6 - - - - - - 124 130 66 38 (c) Non-tuberculous - - B. —Contacts examined during the year:— . 1 I _ I I I I 1 1 I I I I . II n I 1 (a) Definitely tuberculous 6 5 - - - - - 1 6 5 - 1 (b) Doubtfully tuberculous - - - - - - 5 4 4 4 - - - - - - - - - 69 102 126 140 (c) Non-tuberculous - I f I . I 1-1 T - 1 r~~1 T~T i i i „ ii ii i I I I ftft I IF c.—Cases written off the Dispensary Register as 13 2 1 4 11 3 4 8 6 16 6 22 17 (a) Cured (b) Diagnosis not confirmed or non-tuberculous (including cancellation of cases notified in error) - - - - - - - - 249 272 196 211 (31) D.—Number of Persons on Dispensary Register on December 31st: — 1/\C rn 345 144 (a) Diagnosis completed 307 238 91 72 38 61 105 72 299 197 - 6 4 3 (b) Diagnosis not completed - - - - - - - 8 10. Number of consultations with medical practitioners:— 1. Number of persons on Dispensary Register on January Ist 1107 2. Number of patients transferred from other areas and of " lost sight of " oases returned 15 (a) At Homes of Applicants 127 (b) Otherwise 130 11. Number of other visits by Tuberculosis Officers to Homes 1077 3. Number of patients transferred to other areas and cases "lost sight of" 50 12. Number of visits by Nurses or Health Visitors to Homes for Dispensary purposes 4826 4. Died during the year 93 5. Number of observation cases under A (b) and B (b) above in which period of observation exceeded 2 months 2 13. Number of: — (a) Specimens of sputum, etc., examined 1003 6. Number of attendances at the Dispensary (including Contacts) 3295 (b) X-ray examinations made in connection with Dispensary work 418 14. Number of Insured Persons on Dispensary Register on the 31st December 448 7. Number of attendances of non-pulmonary eases at Orthopaedic Out-stations for treatment or supervision - 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 102 (a) "Light" treatment 16. Number of reports received during the year in respect of Insured Persons: — (b) Other special forms of treatment - (a) Form G.P. 17 4 9. Number of patients to whom Dental Treatment was given, at or in connection with the Dispensary 39 (b) Form G.P. 36 PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1912. Summary of Notifications during the period from the 30th December, 1928, to the 28th December, 1929. Age Periods Notifications on Form A. Notifications on Form B. No. of Notifications on Form C. Number of Primary Notifications n No. of Primary Notifications J 0 to 1 1 to 5 5 to 10 10 to 15 15 to 20 35 to 45 45 to 55 55 to 65 Total Primary Notifications Total Notifications on Form A Under 5 5 to 10 10 to 15 Total Primary Notifications Total Notifications on Form B Poor Law Institutions Sanatoria 20 to 25 25 to 35 65 and upwards Pulmonary Males - 1 4 1 14 23 20 14 11 19 6 113 145 - - 1 1 1 34 108 - 1 3 3 12 17 24 6 6 7 1 80 104 - - - - - „ Females 12 64 1 1 6 4 3 3 2 1 - 1 - 22 24 - - - - - 3 22 Non-Pulmonary Males „ „ Females 2 3 3 3 1 1 4 - 1 18 25 - - - - - 1 13 - - New cases of Tuberculosis coming to the knowledge of the Medical Officer of Health during the period from the 30th December, 1928, to 28th December 1929 otherwise than by notification on Form A or Form B under the Public Health (Tuberculosis) Regulations, 1912. Age Periods 0 to 1 5 to 10 15 to 20 20 to 25 35 to 45 45 to 55 55 to 65 65 and upwards Total Cases 25 to 35 1 to 5 10 to 15 Pulmonary Males - 1 1 - - 4 4 1 1 5 1 18 - - - - - - 5 - - - - „ Females 5 Non-Pulmonary Males - 5 - 2 1 - - - 1 9 - - „ „ Females - 2 1 3 - 2 - 1 - - 9 (33) Returns rendered under the PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1924. 1st QUARTER, 1929. Respiratory System Other Forms M. F. M. Number of Cases on Register at commencement of Quarter 1230 1046 459 Number of Cases notified during Quarter 30 25 3 Notified Cases Removed to Bermondsey from other Districts 2 - - Number of Cases removed from the Register 87 73 2 Number of Cases remaining on the Register at end of Quarter 1175 998 460 2nd QUARTER, 1929. Respiratory System Other Forms M. M. F. 1175 998 460 Number of Cases on Register at commencement of Quarter Number of Cases notified during Quarter 21 23 3 Notified Cases removed to Bermondsey from other Districts - 1 1 Number of Cases removed from the Register 114 167 32 Number of Cases remaining on the Register at end of Quarter 854 432 1083 3rd QUARTER, 1929. Respiratory System Other Forms M. F. M. Number of Cases on Register at commencement of Quarter 1083 854 432 Number of Cases notified during Quarter 37 15 7 Notified Cases removed to Bermondsey from other Districts 2 1 2 Number of Cases removed from the Register 65 24 62 Number of Cases remaining on the Register at end of Quarter 1057 809 416 4th QUARTER, 1929. Respiratory System Other Forms M. F. M. Number of Cases on Register at commencement of Quarter 1057 809 416 Number of Cases notified during Quarter 26 17 9 Notified Cases removed to Bermondsey from other Districts 2 1 3 Number of Cases removed from the Register 59 53 31 Number of Cases remaining on the Register at end of Quarter 1027 775 395 IV. LIGHT TREATMENT. The following table shows the work done in the Solarium during 1929: — No. of attendances 22,060 No. of Examinations 2,110 No. of New Patients 498 No. of Discharges 410 No. of Maternity and Child Welfare Patients under treatment during the year 403 Total No. of Tuberculous Patients under treatment during the year 86 Total No. of all other classes under treatment during the year 451 (The Maternity and Child Welfare patients formed 42.9% of the total number under treatment and the tuberculous patients 9.1%.) All the patients coming for treatment are recommended by general practitioners or by medical officers of the Maternity and Child Welfare Centres, the Tuberculosis Dispensary or the local hospitals. Each patient is examined by a member of the medical staff before and during treatment. During the year Miss Pearce and Miss Henniker resigned within a short time of each other, and in July Miss Clarke and Miss Bowles were appointed as nurses for duty in the Solarium. A list of the principal diseases treated, together with the number of new patients for 1929 is given below: — TUBERCULOSIS. Knee 1 Cervical Glands 12 Bazin's Disease (Skin) 3 Hip 3 Lungs 4 Lupus 4 MATERNITY AND CHILD WELFARE CASES. Ante-natal 9 Rickets 63 Marasmus, Debility, Malnutrition, etc. 122 Bronchitis 40 Septic Adenitis 6 OTHER DISEASES. Chronic Rheumatoid conditions 20 Alopecia 25 Furunculosis 4 Cervical Adenitis (non-tuberculous) 17 Emphysema 4 Eczema 2 Fibroid Lung and unresolved pneumonia 5 Asthma 2 Bronchitis (including chronic) 75 Bronchiectasis 2 Malnutrition, debility, anaemia, etc. 141 Dermatitis 6 Varicose Ulcers 4 Pyorrhoea 5 Of the tuberculosis cases who had been under treatment and were discharged during the year, the majority had already received institutional treatment (in some cases combined with ultra-violet light) and treatment was continued in the Solarium to maintain their general condition and to prevent any chance of a relapse on return to poor home conditions. Cases of tuberculous adenitis showed improvement, though this was slow in comparison with cases where suppuration had already occurred. The following two cases are illustrative of this class: — D.O. (female, aged 15). Had a tuberculous gland the size of a walnut at the right angle of the jaw. Onset, August 1928. Teeth and tonsils had been treated with no improvement in the glandular condition. General condition pale and thin. After 101 exposures to mercury vapour lamp the gland had decreased in size and was small and firm. Her general condition improved considerably, and patient was able to start work. E.M. (female, aged 12). Had a large gland under the left sternomastoid. After 209 exposures to mercury vapour lamp the condition was arrested. The gland was small and hard, and her general condition was good. As was reported last year cases of non-pulmonary tuberculosis in which the part affected has "broken down," with consequent sinus formation, show marked improvement, and good results with ultra-violet light. This is well illustrated by the following cases: E.S. (female, aged 42). Had a tuberculous abscess of sternum, with a tender swelling over the sternum and two discharging sinuses. After four months' treatment with the mercury vapour lamp, the swelling had subsided, tenderness was gone and the sinuses were healed. I.M. (female, aged 11). Had tuberculous dacro-cystitis (left eye). An operation had already been performed at a general hospital, but a sinus persisted. Ultra-violet light was started and in three months the sinus had healed. Treatment was continued till there was no further likelihood of relapse. In the cases of lupus and of Bazin's Disease improvement in the diseased conditions were also obtained. As was reported last year the number of cases of Pulmonary Tuberculosis put on treatment was small and gradual insolation was again practised. None of these cases showed any marked improvement In the Maternity and Child Welfare section 238 new cases began treatment; 172 were discharged and 7,333 attendances were made. Nearly half the children were suffering from anaemia, debility and malnutrition, and all those who attended regularly for a period of two to three months showed considerable improvement in their general condition. Most of the bronchitis cases were babies who suffered from bronchitis during teething. The 000majority continued to have a certain amount of bronchitis, but showed a decrease in the number and severity of the attacks. Several of the babies had no attacks during treatment, and cut the remaining teeth without further trouble. The cases of rickets which attended regularly over a long period all showed great improvement, and were discharged cured. The cure of rickets if necessarily a slow process, and it is an unfortunate fact that many of the mothers will not realise that if the disease is at all advanced it entails regular attendance for a considerable period. Many of the most severe cases ceased attending after a few treatments. Of the nine ante-natal mothers who attended for treatment all showed improvement in general health and had normal confinements and healthy babies. One mother, who had been in poor health for some years and had suffered from post-partum hemorrhage at all her previous confinements had a normal and easy labour after three months' treatment with ultra-violet light. The baby was much stronger than any of the earlier children. It will be noticed that fewer patients suffering from chronic rheumatoid conditions were referred for treatment in 1929 than in 1928. Out of 49 cases discharged during the year improvement was shown in 25 cases, and no relief was obtained in 24. It does not seem that lasting benefit can be obtained in this group from ultra-violet light alone, though there may, in certain cases, be great alleviation of suffering for the time being. In alocepia better results were obtained than in the previous year. Of 14 cases discharged during the year 3 were cured, 5 others were improved and in 6 there was no marked improvement. The following two cases are worthy of record:— J.H.S. (male, aged 28). Christmas 1928, small patch started on right frontal region. First attended in February 1929 when he had 10 small patches all over head. Original patch was about 2 inches in diameter. After 54 exposures to local and general mercury vapour lamp, his hair had completely regrown and it was impossible to distinguish the affected from the unaffected areas. W.L. (male, aged 31). When he first attended he had a patch, of three months standing, 2 inches by 3 inches, on the right side of the vertex. After 112 exposures to local and general mercury vapour lamp, the condition was quite cured. The majority of cases of bronchitis showed improvement. It was, however, noticed that in extreme bronchitis and emphysema, such as occurs in old age, no material improvement was obtained. Three cases of seborrhaeic dermatitis were treated and discharged during the year, all of them having shown marked improvement. The cases of malnutrition, debility and anaemia were mostly children of school age. Of 92 such cases discharged during the year, 63 had shown improvement after ultra-violet light treatment. This improvement was in the nature of an increase in appetite and general liveliness with a consequent gain in nutrition. In 29 cases no material improvement was recorded. It was reported last year that bad housing conditions might well be the cause of failure in such cases. During 1929 some of these children, who had shown no response to ultra-violet light, were referred to the Invalid Children's Aid Association for convalescence. Almost without exception they then improved and these results seem to point to the deleterious effect of poor home environment. It appears that due regard to the housing conditions should always be paid in the recording of such cases. It must again be noted that some patients, and parents of children, do not realise the value of regular attendance. As was stated earlier the best results of treatment, in any group, are always obtained in those cases which attend regularly. Of four cases of varicose ulcers discharged during the year, one was cured, two were greatly improved and one showed no improvement. On the utility of ultra-violet light in dental sepsis Mr. Grantley Smith reports that "in cases of gum inflammation which have not gone on to pocket formation or the loosening of the teeth (pyorrhoea), I have found the ultra-violet ray useful as an adjunct to oral treatment. After the mouth has been rendered thoroughly clean, body baths, together with the local application of the ray to the gums, have been of benefit, in many cases restoring the normal pink colour." A separate table shows the particulars of patients who have undergone treatment at Dr. Rollier's Clinics at Leysin. The final results have been good in every case and, up to date, there have been no relapses. LEYSIN PATIENTS. In the following table will be found a complete list of patients who have been sent to Leysin by the Borough Council. 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 12 M. Left Foot 5 years 28/7/24 5/7/27 Seen recently. Keeping well. S.B. L.R. 10 F. Glands of Neck 5 „ 28/7/24 6/10/25 Removed from District M.S. 15 F. Right Knee 6 „ 28/7/24 6/10/25 Seen recently. Keeping well A.L. 19 F. Glands of Neck 2 „ 1/10/24 6/10/25 „ „ „ „ C.P. 37 F. Forearm and Peritoneum 2 „ 1/10/24 6/10/25 „ „ „ „ M.B. 28 F. Glands of Neck 15 „ 26/10/25 22/2/27 „ „ „ „ E.C. 16 F. Right Knee 5 „ 26/10/25 8/7/27 „ „ „ „ H.C. 10 M. Glands of Neck 2 „ 26/10/25 20/2/27 „ „ „ „ A.H. 21 F. Left Hip 9 „ 17/5/26 29/6/28 „ „ „ „ E.W. 23 F. Spine and Right Hip 18 „ 17/5/26 17/9/27 „ „ „ „ G.B. 20 F. Left Ankle 2 „ 9/2/27 28/4/29 „ „ „ „ L.T. 19 M. Abscess of Ribs 2 „ 9/2/27 8/5/28 Removed from District 24 M. 7 „ 5/7/27 8/5/28 Seen recently. Keeping well C.P. Spine A.R. 26 F. Glands of Neck 3 „ 5/7/27 8/6/29 „ „ „ „ E.G. 16 M. Lupus of Nose 4 „ 20/6/28 8/6/29 „ „ „ „ 26 M. Tuberculide of Skin 1 „ 20/6/28 8/6/29 Removed from District C.P. H.S. 18 M. Right Hip 3 „ 20/6/28 - Still at Leysin I.S. 23 F. Right Hip 8 „ 31/5/29 - „ „ C.C. 27 F. Multiple Lupus 20 „ 20/1/30 - „ „ A.P. 16 F. Glands of Neck 4 months 20/1/30 - „ „ v.—MATERNITY AND CHILD WELFARE. There have been one or two features of special interest in connection with this section of the work during the year. For a number of years a very successful clinic has been maintained by voluntary effort at the Princess Marie Louise Club at 110 Jamaica Road. Owing partly to augmented expenditure and partly to the demands upon the time of Lady Hawke, the Honorary Secretary, it was found increasingly difficult to maintain this organisation on a voluntary basis. After somewhat lengthy negotiations, it was finally decided that the centre should be taken over by the Borough Council and conducted in future as a Municipal Centre. The change took place on January Ist, 1930. The Committee expressed their appreciation of the very valuable work which had been done by the voluntary organisation under the guidance of Lady Hawke. No other change of importance has taken place in the general work of the Clinics, but it is to be noted that there has been a general increase in every branch of the work. This has necessitated an additional Infant Clinic at 110 Grange Road, and it is probable that additional Ante-Natal Clinics will be required at 110 Grange Road and at 98 Rotherhithe New Road in the near future. The scale of assessment for free and half-price milk supplied under the Maternity and Child Welfare Scheme was revised on 8th October, 1929, with the approval of the Ministry, and the new scale came into operation on 22nd October, 1929. Under this new scale there will, of course, be an increase in the number of persons receiving milk. MIDWIFERY SERVICE. The Maternity and Child Welfare Committee at its meeting on the 14th May considered an application from the Treasurer of the St. Olave's District Nursing Association for a grant towards expenses in connection with the proposed addition to their staff of a Maternity Nurse. I was instructed to report to the Committee on the advisability of paying such a grant. The proposal of the St. Olave's District Nursing Association was that a qualified Maternity Nurse should be appointed to attend confinement cases in company with a medical man or in conjunction with a senior student working in connection with the Guy's Charity. It was definitely understood that the Maternity Nurse, although qualified to do so, should not attend cases as a midwife. In preparing my report I had to consider carefully, the whole question of the midwifery service at present available in this Borough. For the purpose of confinement the prospective mother has one of two alternatives. She may decide to enter hospital or she may desire to have the baby born at home. The total number of births in 1928 was 2,086, and with regard to hospital cases I have to submit the following figures for the year 1928:— Number of Maternity Cases received into— Guy's Hospital 216 Bermondsey and Rotherhithe Hospital 550 General Lying-in Hospital 19 St. Thomas's Hospital 2 If the mother decides to have the baby at home the arrangements made may fall into any one of the four following groups. The mother may be attended by:- (1) A general practitioner and a handy woman. (2) A general practitioner and a qualified maternity nurse. (3) A midwife with or without a handy woman. (4) A senior student in connection with Guy's Charity. With regard to (1), (2) and (3) I have been unable to obtain definite figures as to the number of mothers so attended. Under heading (4) I am informed that 1,018 Bermondsey women were confined in connection with Guy's Charity during 1928, and that the maternal mortality rate of all cases treated by the hospital including both in-patients and cases on the district was .56 per 1,000. It will be seen that out of 2,086 births in 1928, 1,805 took place either in hospital or in connection with Guy's Charity. This leaves 281 births in the Borough which were attended by a medical man or by a midwife. I think it will be agreed that treatment is adequate:— (1) When a confinement takes place in hospital. (2) When a doctor attends at home accompanied by a properly qualified maternity nurse. (3) When the labour is conducted by a midwife, who is bound, should necessity arise, to call in a medical man. There is little doubt also that members of the Committee would subscribe to the following observations: — (1) That the prospective mother should be freed as far as possible from worry, either financial or in connection with the conduct of the home while she is incapacitated. (2) That there should be careful ante-natal supervision. (3) That only qualified persons (i.e. a doctor or a nurse holding a C.M.B.), should be allowed to attend the mother and baby. The handy woman serves a useful purpose when she confines her activities to cooking, cleaning and generally assisting in the house. When an unqualified woman exceeds these duties and helps in the actual conduct of the labour, there is always an increased risk both to mother and baby. At present financial considerations play a considerable part in the decision of the mother as to where and by whom the labour shall be conducted. The maternity benefit is £2, but it may on occasion, i.e., when both parents are insured be £4. Guy's Hospital makes no charge either for hospital treatment or for attendance on the district. The maximum charge made by the Bermondsey and Rotherhithe Hospital is one guinea per week. Patients treated by other hospitals are assessed according to their means. The fee of the general practitioner is usually about two guineas and that of the midwife 25s. to 35s., while the handy woman makes a charge of anything up to 15s. or £1, if she can get it. It should be borne in mind that the midwife will not do and should not be expected to do, housework, cleaning and cooking. If, therefore, a mother desires to have her baby born at home she may book up with a doctor and employ an unqualified handy woman as nurse, for the simple reason that to pay a doctor and a qualified nurse is more than she can afford, seeing that she is bound to have some kind of help in the home as well. It thus comes about that the handy woman may usurp the function of the maternity nurse to the detriment of the security of both mother and baby. I feel sure the Committee will agree that while a "home help" is necessary, a woman so employed should not be allowed to act as a nurse in any fashion whatsoever. In order to eliminate such unqualified practice and to provide a qualified nurse for every confinement case I beg to submit the following suggestions: (1) That the authorities of Guy's Hospital be asked to make it a rule that every confinement dealt with under the Charity shall be attended by a maternity nurse as well as by a student. (2) That the fees of approved midwives (whether practising as midwives or as maternity nurses) charged for attending residents in the Borough should be paid by the Borough Council. This payment of fees would apply also to maternity nurses employed by Guy's Hospital as suggested above, if the Hospital authorities agree to the suggestion. Taking the annual number of births as 2,000 the payment of midwives' fees would involve a maximum additional annual expenditure of £2,500 if the fee were 25s. or £3,500 if the fee were 35s. less any grant received from the Ministry if the scheme is approved. There are certain advantages to be expected from this course: (1) I am sure the Committee would not desire to interfere with the training of medical students at Guy's, especially as the results of the scheme at present in operation have been so good. Every mother receiving treatment is seen personally at least once before confinement by Mr. McNair or Mr. Frank Cook, and is under regular ante-natal supervision at the Clinic; the maternal mortality rate at present is 56 per 1,000. On the other hand, the employment of the handy woman who works in conjunction with the student does not seem to be an ideal arrangement, and it certainly helps to bolster up the position of the handy woman. I do not see any reason to fear that the payment of midwives by the Council would interfere with the work of the Guy's Charity provided that maternity nurses were employed directly by the hospital authorities and that payment was made to the same authorities. (2) The payment of such fees would ease the financial situation for many families and with the aid of the Maternity Benefit would enable the mother to employ a doctor if she desired to do so as well as a "home help." (3) Interference in the conduct of the labour on the part of the handy woman would be entirely eliminated in every case where a maternity nurse was employed, and it is unlikely that her services would be refused if these were free. Such interference cannot effectually be prevented in any other way. (4) Ante-natal supervision could be secured in every case by making this a condition of payment. There are certain possible disadvantages which require consideration:— (1) Patients who at present go into hospital might prefer to remain at home. This is not likely to happen except in connection with Bermondsey and Rotherhithe Hospital, and we are not in a position yet to say whether the maternity work of this hospital will be continued when the Hospital comes under the control of the London County Council. (2) The number of patients who retain the services of a doctor might be reduced. This is unlikely to be the case, and as the number of cases who have a doctor at present is small and the number of doctors anxious to do midwifery is also small, I think this objection carries little weight. (3) The payment of fees might result in an influx of midwives into the Borough. This could not increase the expenditure falling upon the Council, and is, I think an unlikely contingency. Conditions for Payment of Midwives. (1) Must be on approved list. (2) Must submit a notice of booking to the Medical Officer of Health as soon as made. (3) Must arrange for ante-natal supervision and for at least one ante-natal examination by a medical practitioner— the latter may be made either by a general practitioner or at one of the Borough Ante-natal Clinics or at Guy's, and the records should show that this examination has been made. (4) Must not allow any handy woman to undertake nursing duties. (5) A midwife on the list must not make any other charge to a patient, whose fee has been paid by Council. In connection with the maternity service in the Borough, I beg to submit two further suggestions for consideration:— (1) That maternity outfits (towels, water-proofs, etc.) should be supplied free of charge at the request of the medical practitioner or the midwife, for every confinement taking place at home. (2) That arrangements be made with the two lady doctors on the staff of the Borough Council to attend at intervals a specialist course on ante-natal work, and as a condition of grant payable by the Borough Council in aid of any Voluntary Ante-Natal Centre, the Medical Officer in charge of that particular Voluntary Ante-Natal Centre be required to produce evidence of special training. The scheme is now in partial operation. The final arrangements with Guy's Hospital have not yet been completed and the full approval of the Ministry has not yet been obtained. I have had a number of meetings with the midwives on the subject, and am satisfied that they will co-operate with us in working the scheme. I would like to emphasise three main points in the scheme, which I regard as being of the utmost importance:— (1) That adequate ante-natal supervision from the earliest possible moment up to the date of confinement should be secured for every mother. (2) That the handywoman should not be allowed to undertake any nursing duties whatsoever. (3) That the midwives should work in close and amicable relations with the Health Visitors. FAIRBY GRANGE CONVALESCENT HOME. The home continues to function quietly and efficiently. There has been a slight increase in the number of women admitted during the year, and I am glad to be able to report that there has been an increasing tendency to seek admission during the winter months. Number of women admitted 249 Number of babies admitted 115 Number of toddlers admitted 103 HEALTH VISITORS. The following table shows the work done by the Municipal and Voluntary Centres and Health Visitors during 1929:- District Births Notified First Visits Re-visits Ante-natal Puerperal Fever and Puerperal Pyrexia Other Visits Ophthalmia Neonatorum Attendances at Centres Health Talks Cases Visits Cases Visits No. 1 193 187 1977 139 3 1 5 176 8 3 242 (48) „ 2 206 229 2401 181 4 6 - - 328 182 7 „ 3 134 154 1987 327 2 4 1 1 494 197 43 154 2836 241 5 5 - - 641 96 40 „ 4(St. George's Hall) 155 „ 5 (Princess Club) 171 177 1977 228 1 1 - - 201 533 29 „ 6 163 204 1951 302 2 4 1 3 469 218 152 „ 7 212 2853 65 5 5 1 10 34 181 15 195 „ 8 (Fulford Street) 266 236 2532 309 6 1 2 506 148 36 „ 9 181 213 - 2692 195 1 1 - 97 208 33 „ 10 175 201 2323 79 2 2 4 11 111 200 3 „ 11 150 158 2596 74 - - 1 1 22 238 34 Salomon's Centre 135 128 4404 1424 1 1 1 1 - 352 - Central Hall - 292 201 - 711 41 - - - - - Totals 2124 2253 31240 3605 31 38 11 34 3437 2930 400 No. attending No. of Sessions No. of Sessions No. attending No. of Sessions Nos. attending Children 110 Grange Road 47 50 150 7,712 898 592 98 Rotherhithe New Road 147 48 5,110 892 49 422 49 - Trinity Road 1,217 - - - Oxley Street and Percy Hall 96 - - - 3,322 - Roseberry Street 1,535 46 49 397 - - - Salomon's Centre 150 2,410 - 202 2,686 Maternity and Child Welfare. STATISTICS FOR THE YEAR, 1929. Borough Council of Bermondsey. POPULATION according to the Census of 1921.—119,452. Registered— 1. Legitimate (a) Live Births 2,216 (b) Still Births 61 2. Illegitimate (a) Live Births 36 (b) Still Births 5 3. Total (a) Live Births 2,252 (b) Still Births 66 Birth Rate: —19.8 Notified within 36 hours of birth— (1) Live Births, 2,137. (2) Still Births, 51. (3) Total, 2,188. (1) By Midwives, 475. (2) By Parents and Doctors, 1,713. Total. Males. Females. Deaths 1,650 895 755 Death Rate 14.5 Infant Deaths. Number- (1) Legitimate, 160. (2) Illegitimate, - (3) Total, 160. Rate per 1,000 births- (1) Legitimate, 71. (2) Illegitimate, - (3) Total, 71. Maternal Deaths. Number of Women dying in, or in consequence of Childbirth - (1) From Sepsis, 2. (2) Other causes, 3 Health Visitors. Visits paid by Health Visitors during the year:- To Expectant Mothers (1) First Visits, 3,605. (2) Total Visits, 3,605 To Infants under 1 (1) First Visits, 2,253. (2) Total Visits, 15,639 To Children 1—6 Total Visits, 17,854 Municipal Homes and Hospitals for Children under 5. Number of Beds, 16. Number of children under 5 received during the year, 218. Total number of weeks spent in the Homes by such cases, 467. Municipal Day Nurseries. Total number of attendances of Children under 5 during the year- (a) Whole:- (6) Half:- Deaths from Measles (all ages) 1 Deaths from Whooping Cough (all ages) 33 Deaths from Diarrhæa (under 2 years of age) 19 Births. VI. DENTAL TREATMENT. I have again to report an increase in the work of the dental department, compared with 1928. At the Bermondsey Centre there has been an increase of 65 children and of 587 adults and at the Rotherhithe Centre an increase of 79 children and 133 adults. These figures refer to the number of patients treated and represent a total increase of 864 for both centres. The average attendance at the Bermondsey Centre is 11.2 per session, an increase of .8 compared with last year, and at the Rotherhithe Centre the average is 7.7, an increase of 2.5. In view of the fact that 7 patients per session is considered a reasonable number for a fully occupied dental surgeon to attend during one session, it appears to me that a further increase in the number of sessions has already become necessary. A large amount of educational work has been done in the department, and I have again to thank Mr. Grantley Smith and Mr. Shapland for their help in the general propaganda work of the Department. (52) TREATMENT OF CHILDREN DURING 1929 Age Group Number examined Number Needing Treatment Number Treated Number of extractions Anaesthetics Number of Fillings Number of Scalings Number treated for Orthodontics Number of Attendances Local General 2 years and under 24 24 23 101 - 23 - - - 48 3 years 95 95 95 440 2 72 - - - 183 4 years 182 181 172 817 11 15 - - 151 363 5 years 107 107 104 4 5 - - 181 373 85 Over 5 years 483 540 1238 120 308 123 2 1051 494 16 Total 902 934 2969 137 639 143 2 16 890 1826 2 years and under 11 11 11 12 4 2 - - - 17 3 years 26 26 18 80 4 - - - 44 14 4 years 69 51 196 6 40 5 - - 120 66 5 years 89 89 82 310 17 59 6 - - 171 Over 5 years 157 155 355 4 3 83 27 2 4 158 317 Total 353 349 317 953 74 198 38 4 2 669 (53) DENTAL TREATMENT CARRIED OUT DURING 1929 CENTRE Type of Case Number of Dentures Fitted Number of Repairs to Dentures Number of Patients examined Number of Patients Treated Number of Extractions Anæsthetics Number of Fillings Number of Scalings Number of attendances Local General Maternity Cases 172 171 343 120 30 7 4 22 6 262 Women 1082 975 2635 871 179 118 33 170 184 2406 Girls (14-21) 420 495 510 358 12 97 10 - 1 510 110, Men 1029 1080 2021 996 30 143 34 139 60 1857 GRANGE Tuberculosis Cases 32 38 133 34 4 10 5 21 4 131 ROAD. Children (Table I.) 902 934 2969 137 639 143 2 - 1826 - Total 3637 3693 8611 2516 894 518 88 352 255 6992 Maternity Cases 93 111 390 49 51 7 15 24 2 234 Women 318 298 921 238 60 43 62 42 846 98, 103 Girls 14-21 69 92 72 41 8 27 5 1 - 142 ROTHERHITHE NEW Men 252 226 481 244 20 87 35 57 11 653 Tuberculosis Cases 1 - - - 2 - - ROAD. 2 2 - Children (Table I.) 353 317 953 74 198 38 2 - 669 - 1087 1045 2817 646 380 221 100 144 2546 Total 55 VII.—PROPAGANDA. The Propaganda Section of the Department has now completed its fifth year of work, and the amount of teaching done has steadily increased each year during this period. The outstanding item of interest during the year was the second Health Exhibition, held at the Central Baths, Grange Road, from November 4th to the 16th. The Council as an experiment decided to continue the exhibition for two weeks, and the attendance showed that the extended time was justified. The number of people attending during the first week was 29,139, and during the second week 21,984. The total for the whole period was 51,123. In addition, 2,600 were present at health lectures given in "Woodlands" Place during the time the Exhibition was open. The mornings were reserved for children, and by permission of the London County Council, the senior children attending elementary schools in the Borough were brought to the exhibtion, in charge of teachers, during school hours. Each party was conducted by a member of the staff who explained the exhibits. The number of school children attending was 4,016. As on the previous occasion the whole of the ground floor of the hall was devoted to exhibits entirely connected with public health, and firms renting stalls were placed in the gallery. Whilst all the stalls were interesting, and each claimed a great deal of attention, those devoted to Food and the "Babies of all Nations," seemed to provide the biggest attraction for the public. The food stall was quite small, and exhibited tinned foods, cereals and eggs, but the Food Inspectors who had charge were kept very busy, and always had a large audience. It is proposed on the next occasion to make a much bigger feature of this subject. The "Babies of all Nations" consisted of 32 dolls dressed in their national baby costumes. The whole of the dresses were made by Health Visitors, and a great deal of time and thought was given to the work. We have had a number of applications from other local authorities to borrow this exhibit, and arrangements have been made to lend it to them. The enthusiasm of the staff was again one of the main factors of the success of the exhibition. The number of lectures given during the year is as follows:— Schools 48 Audience 10,550 Clubs and other Institutions, 62 Audience 4,950 Open-air demonstrations, 45 Audience 15,300 Health Visitors' talks to audiences of not less than 10 for 10 minutes 400 This number of lectures is an increase on any previous year, and is probably the maximum number that can be done with the present staff. One hundred and seven of the lectures were given in the evening mostly between 8 and 10 p.m. The number of pamphlets have been increased by seven to thirty-five. The additional ones published during the year were on:- Clothing, Eye-sight, Food, Rheumatism in Children, Smallpox, Smoke Abatement and Tuberculosis. The number of films in use now is 17, and of these 7 are our own production. The monthly edition of "Better Health" has been distributed during the year, and we still have a great demand for copies. Unfortunately, it has not yet been possible to increase the supply of 2,000 copies per month. On the night of the General Election a screen was fixed on the cottages opposite the Town Hall, and the opportunity was taken to show a number of health films to a large crowd of people gathered to hear the Election Results. The Medical Officer addressed them on several health subjects. (56) VIII.—SANITARY ADMINISTRATION. HOUSING. A review of the housing conditions in the Borough was submitted in last year's Report. The tables included last year have been brought up to date in the present Report. From the following figures showing the number of applicants on the register at the end of the year it will be seen that, in spite of all the work which has been done both by the Borough Council and by the London County Council, there is no improvement at all in the situation:- Desiring local accommodation Willing to move to London County Council Estates 614 218 Overcrowded families Other families (not overcrowded) 279 219 Totals 437 893 The position with regard to insanitary areas is set out in the following table:- Area Acreage No. of Premises Population (approx.) Date of Represenation Present position Bethel Place 0.75 49 195 In abeyance 20/1/20 Prospect St. 0.625 55 291 20/1/20 In abeyance Leroy St. 1.125 64 346 20/1/20 In abeyance Rotherhithe St. (West) 4.91 150 990 4/12/28 Scheme prepared and awaiting approval of Ministry of Health 2.98 134 914 2/7/29 Scheme submitted to Ministry of Health Awaiting Inquiry Vauban St. 11.29 311 2290 17/12/29 Details in course of preparation with a view to fresh representation Rotherhithe St. (East) Particulars of housing work carried out by the Borough Council since 1919:- New premises erected. No. of families accommodated Salisbury Street Area 54 cottages 54 Rotherhithe Street 10 „ 10 Brunel Road 11 „ 11 „ 4 bungalows 4 Albion Street 5 cottages 5 „ 1 bungalow 1 Paulin Street 5 cottages 5 Orange Place 3 „ 3 Corbett's Lane 4 bungalows 4 Silver Street 30 flats 30 At the end of the year there were 2 cottages and 9 flats in course of erection at Rotherhithe Street for the accommodation of 11 families. Premises purchased or leased and converted. Parish Street Institution 47 flats 47 Grange Walk (1 factory) 8 „ 8 Swan Mead (1 factory) 8 „ 8 Gomm Road Fire Station 10 „ 10 The Grange (6 empty cottages) 4 cottages 4 The Grange 2 flats 2 Maze Pond (1 house) 3 „ 3 Maze Pond Terrace (1 house) 2 „ 2 Old Kent Road (1 house) 4 „ 4 Rotherhithe St. (5 houses) 8 „ 8 „ 2 houses 4 Rotherhithe Old Rd. (1 house) 4 flats 4 Dartmouth Road 2 houses 5 Derrick Street 4 „ 5 Dockley Road 2 „ 3 Bermondsey Wall 1 house 1 Clarence Street 1 „ house 1 Esmeralda Road 1 „ 1 Fendall Street 1 „ 1 Freda Street 1 „ 1 Neptune Street 1 „ 1 Odessa Street 1 „ 2 Paradise Street 1 „ 1 Reverdy Road 1 „ 2 Ridge Street 1 „ 1 St. James's Road 1 „ 2 Silver Street 1 „ 2 Millstream Road 3 houses 3 Neston Street 2 „ 2 Union Road 2 „ 4 Rock Grove 3 cottages 3 „ 2 flats 2 Hereunder will be found particulars of Inspections, Proceedings, etc., for the year 1929: — Number of new houses erected during the year:- (a) Total (including numbers given separately under (b)) 51 (b) With State assistance under the Housing Acts:- (i.) By the Local Authority Nil (ii.) By other bodies or persons 28 (1) Unfit Dwelling Houses:- Inspection— (i.) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 9,870 (ii.) Number of dwelling-houses (included under sub-head (i.) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 4,313 (iii.) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 118 (iv.) Number of dwelling-houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 3,808 (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 2,420 (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 3,808 (ii.) Number of dwelling-houses which were rendered fit after service of formal notices:- (a) By owners 1,384 (b) By Local Authority in default of owners 4 (iii.) Number of dwelling-houses in respect of which Closing Orders became operative in pursuance of declarations by owners of intention to close 1 (B) Proceedings under Public Health Acts:- (i.) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 2,872 (ii.) Number of dwelling-houses in which defects were remedied after service of formal notices:- (a) By owners 2,872 (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 Nil (iv.) Number of dwelling-houses in respect of which Demolition Orders were made Nil (v.) Number of dwelling-houses demolished in Clearance of Insanitary Areas 21 Total number of houses in the Borough 18,202 Number of houses occupied by the working classes 18,052 REGISTERED PREMISES— Number on Register at end of 1929 Premises Number of Inspections Number of Prosecutions 268 Milkshops - 537 Houses let in lodgings 220 440 - Ice Cream Premises 117 274 - 15 55 Offensive Trades (including Poultry Slaughter-houses) - SMOKE NUISANCES- Number of observations 94 Number of notices 23 Number of complaints 22 Number of summonses 5 UNDERGROUND ROOMS- Number illegally occupied 2 Number closed or illegal occupation discontinued 2 WATER SUPPLY TO TENEMENT HOUSES- Premises supplied 13 Prosecutions Nil SALE OF FOOD- Number of premises used other than ice-cream premises, milk shops and cowsheds 570 Number of inspections 2,940 RAG FLOCK ACTS, 1911 AND 1928- There are three premises in the District where rag flock is used. All premises were inspected during the year, the total number of inspections being six. There were no prosecutions. NUMBER OF PROSECUTIONS UNDER BY-LAWS UNDER PUBLIC HEALTH ACT, 1891:- (a) For prevention of nuisance arising from offensive matter running out of any manufactory, etc. - (b) For the prevention of keeping of animals in such a manner as to be injurious to health - (c) As to paving of yards, etc., of dwelling houses - (d) In connection with the removal of offensive matter, etc. 2 (e) As to removal and disposal of refuse, etc. - (f) For securing the cleanliness of tanks, cisterns, etc. - (g) With respect to water closets, etc. - (h) With respect to sufficiency of water supply to water closets - (i) With respect to drainage, etc. (Metropolis Management Act, Sec. 202) - (j) 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 1 Number of prosecutions under the Milk and Dairies (Consolidation) Act, 1915 Nil Number of prosecutions under the Milk and Dairies Order, 1926 2 WORK OF DISTRICT INSPECTORS, 1929. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 House-to-House Special Inspections Complaints Infectious Diseases Factories & Workshops Specially Inspected Offensive Trades Outworkers' Bi-Annual Inspection Underground Conveniences Drains Tested Other Calls and Visits Chimneys watched Bakehouses Butchers Fishmongers, Friers and Curers Food Stores Fruiterers and Greengrocers Ice Cream Markets Restaurants and Eating Houses Destruction of Food Various TOTALS Visits Ints. 644 1108 368 212 65 17 41 - 37 2355 - 17 195 30 16 59 41 80 94 - - 5379 967 533 1060 762 265 12 30 21 - 6 2219 12 4 226 47 128 30 34 138 8 - 5588 775 53 695 606 510 212 25 1 37 1 65 2799 2 37 178 54 233 90 83 158 116 1 17 5920 708 317 305 270 111 37 2 16 12 1546 31 31 54 13 34 11 36 41 16 - - 2883 520 - 325 927 397 153 12 2 17 - 13 1751 3 7 135 17 10 31 6 26 37 3 1 3873 684 644 911 596 296 47 3 83 - 40 2480 1 24 86 29 161 45 29 109 45 2 5 5636 1150 433 97 710 913 198 83 - 28 - 188 2272 3 38 18 19 56 17 71 49 1 1 5195 967 432 358 324 174 12 - 13 - 60 2504 1 7 22 9 43 12 32 70 33 1 - 4107 743 13 341 206 70 1 - 5 10 720 41 10 2 3 18 - - 26 3 1 - 1470 175 - 4313 6529 3866 169l 294 55 261 1 431 18646 94 156 936 220 740 357 274 615 17 24 40051 531 6689 FACTORIES, WORKSHOPS, LAUNDRIES, WORKPLACES, AND HOMEWORK. HOMEWORK. NATURE OF WORK (1) 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) Sending twice in the year Sending once in the year Failing to keep or permit inspection of lists (9) Failing to send lists (10) Lists (2) Lists (5) Outworkers Outworkers Workmen (4) Contractors 6) Workmen (7) Contractors (3) Wearing Apparel:- I I I [ I I I I I I I I I I I - 7 7 - - - 2 - (1) Making, etc. 22 5 90 - - - - (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 - 4 - - - - - - — - - - - Artificial flowers - - - - - - - - - - - - - - - - - - Nets, other than wire nets - - - - - - Tents 2 2 - - — - - - - - — — - - - - - - Sacks 4 14 - - - - - - - - - - Racquets and Tennis Balls - - - - - - - - - - - - - - - 1 1 9 - - - - - - Paper, etc., Boxes, Paper Bags 2 - - - - - 1 1 Brush making - 5 - - - - - - - - - - - Pea Picking - - - - - - - - - - - - - - - Feather Sorting - - - - - - - - - - - - - - - - - - - Carding, etc., of Buttons, etc. - 3 - - - - - - - - - - - - - - Surgical Instruments 2 - - - - - - - - - - - - - - Basket making - - - - - - - - - - - - - - Chocolates and Sweetmeats - - - - - - - - - - - Cosaques, Christmas Crackers, Christmas Stockings, etc. - - - - - - - - - - - - - - - - - - - - - Textile Weaving - - - - - - - - - 1 1 - - - - Leather Goods 4 - 5 - - - - - - - - - - - Coat hangers - - - - - - - - - - - Total 38 5 132 - - 2 - - 10 10 - - - - (66) FACTORIES WORKSHOPS, LAUNDRIES, WORKPLACES AND HOMEWORK. INSPECTION. Number of Premises Inspections Written Notices Prosecutions Factories (including Factory Laundries) 115 13 1 Workshops (including Workshop Laundries) - 14 95 Workplaces (other than Out workers' Premises) 84 - 11 Total 294 38 1 DEFECTS FOUND. Particulars Number of Defects Number of Prosecutions Found Remedied Referred to H.M. Inspector Nuisances under the Public Health 5 5 - - Want of Cleanliness Want of Ventilation 2 2 - - Overcrowding - - - - Want of Drainage of Floors - - - - Other Nuisances 16 16 - - Sanitary 1 Insufficient 4 3 - Unsuitable or Defective 7 7 - - Not separate for Sexes - - - - Offences under the Factory and Workshop Illegal Occupation of Underground Bakehouse (s. 101) - - - - Breach of Special Sanitary Requirements for Bake houses (ss. 97 to 100) 21 21 - - Other Offences 2 2 - - 57 56 - 1 (66) OTHER MATTERS. Number Class. Matters notified to H.M. Inspectors of 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 11 Reports (of action taken sent to H.M. Inspectors) 11 Other 1 Underground Bakehouses (s. 101):- 1 Certificates granted during 1929 - In use at end of 1929 17 Workshop Bakehouses 27 Workshops on the Register (s. 131) at the end of 1929 413 440 Total Number of Workshops on Register No. OF BAKEHOUSES IN THE BOROUGH. In Use Not in Use Underground Above ground Above ground Underground 17 42 1 1 34 of these are Factory Bakehouses. HOUSE AND TRADE REFUSE. The following table shows the amount of house and trade refuse disposed of during the year ended December, 1929:— Disposal Loads tons cwts. qrs. 2,566 House Refuse to Barge 14 2 4,957 „ „ „ Destructor 10,024 17,643 6 2 Trade Refuse „ Barge 3,201 3,622 11 0 „ „ „ Destructor 927 581 3 2 16,718 15 Totals 2 26,804 OFFENSIVE TRADES. The offensive trades on the Register are as follows:- Fellmongers 3 Fatmelters 3 Glue and size makers 3 Dresser of Fur Skins 6 MORTUARY. Total number of infectious bodies removed 16 Total number of bodies removed 64 STREET MARKETS. The market scheme continues to work smoothly and satisfactorily. Number of Licences in operation 681 Applications on waiting list 20 Income £2,435 17s. 0d There have been eight prosecutions during the year for infringements of the Act. DRAINAGE WORK. Hereunder will be found particulars of drainage work, &c., carried out by the Drainage Inspector during 1929: — Drains Tested 482 Intimation Notices served 35 Visits to Underground Conveniences 386 Other Visits 3,299 IX.—FOOD CONTROL. The undermentioned report was made by me to the Public Health Committee on the 10th December, 1929, and following my report the Public Health Committee recommended the appointment of a third Wharves Inspector, Mr. Francksen being promoted to fill this post:— "At the Public Health Committee on 26th November, 1929, the question of the adequacy of the inspection of food at the wharves was raised, and I was instructed to report on the present arrangements, and especially as to whether the appointment of an additional inspector is necessary. The two inspectors at present employed on this work are Mr. Scott and Mr. Hoskins, and in addition to their duties at the wharves they are also responsible for inspecting wholesale food premises. There are about 3½ miles of river frontage in the Borough, much of which is occupied by wharves importing food, and there are about 150 wholesale food premises. This work is highly skilled, and the position of these officers is a very responsible one, and both Mr. Scott and Mr. Hoskins have been occupied solely with food inspection for the last twenty years. All cargoes of food landed in this Borough are examined by the inspectors. It is quite clear, however, that only a certain proportion of each cargo can actually be examined by the inspector. If the proportion examined is found to be in a satisfactory condition, the whole parcel is released. If on the other hand the percentage examined is unsatisfactory, a more stringent examination is made, including, if necessary, the whole parcel. The completeness of this examination depends upon the number of inspectors engaged gaged on this work and the appointment of an additional inspector would ensure the examination of a larger percentage of the goods, It is the practice at present for an inspector to do the work of his colleague when the latter is away for any reason (holiday or sickness). This may entail considerable additional work for the remaining inspector and naturally leads to a lower percentage examination of cargoes. In connection with a number of wholesale food premises there is a great increase of work at certain seasons, and at these seasons the inspectors must devote more time to these premises, to the possible detriment of their wharf work. There are two further reasons for considering the appointment of an additional Food Inspector. During the last two or three years there has been a steady increase in the number of wholesale food premises in the Borough, and there has also been an increase in the amount of food imported. When trading relations are officially re-established with Russia, the amount of food imported from that country will greatly increase. As the Committee mittee is also aware recent legislation has greatly increased the powers and duties of the food inspectors, notably in connection with the Imported Food Regulations and the various grading and marking Acts. It must be also be borne in mind that although there has been considerable re-construction and new building in connection with both wharves and wholesale premises, there has been no increase in the number of officers employed in this work since 1908. Neither Mr. Scott nor Mr. Hoskins at present come under the supervision of the Chief Inspector, and if the Committee agrees to the recommendations set out below, I think this would be a suitable occasion for bringing the work of these Inspectors under the general supervision of the Chief Inspector. Taking into consideration the above reasons, I am of the opinion that the appointment of an additional Food Inspector is advisable." UNSOUND FOOD. The general inspection of food in shops and on stalls forms part of the duty of the District Sanitary Inspector. The following quantities of food came under the notice of the Inspectors during the year, and being found unfit for human consumption was destroyed:— Weight Description of Food Tons cwts. qrs. lbs. - 7 0 Fresh Meat 2 Fresh Fish - 5 3 20 1 16 26 Fresh Fruit 2 Poultry - 6 3 26 - 6 24 Vegetables 1 Total 3 3 2 12 MILK PREMISES. MILK AND DAIRIES (AMENDMENT) ACT, 1922. Ninety-nine milksellers were registered under the above Act during 1929, and 27 names were removed from the Register, making a total of 268 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 10 To sell Grade "A" (Tuberculin Tested) Milk 27 To sell "Pasteurised" Milk 5 Supplementary Licenses: — To sell "Certified" Milk 3 To sell Grade "A" Milk 3 To sell Grade "A" (Tuberculin Tested) Milk 5 To sell "Pasteurised" Milk 3 All premises used for the sale of milk are regularly inspected to ensure that the standard of cleanliness laid down is maintained. WORK OF THE WHARF AND FOOD INSPECTORS, 1929. 1 2 3 4 5 6 7 8 9 10 11 Food Factories Fish Curers Food Stores Food Wharves and Depots Milksellers Restaurants Destruction of Food Nuisances Found Intimations Served Various Number of Samples taken Jam Butter and Margarine Other Food and Drugs Imported Food Regulations Milk (Special Designation) Order 113 - 94 7 218 2519 - - 240 - - 85 - 5 - 300 20 460 35 869 2053 - 8 229 17 5 - 2 - 110 - - - - - - 537 - - 10 10 390 1507 - 71 20 (72) FOOD AND DRUGS. Articles submitted for Analysis Total Samples Taken Number Genuine Number Adulterated Percentages of Articles Adulterated Almonds, Ground 1 1 - - Arrowroot 1 1 - - Aspirin Tablets 1 1 - - Aspro Tablets 2 2 - - Bacon 3 3 - - Baking Powder 3 3 - - Barley, Pearl 13 13 - - Barley, Prepared 1 1 - - Barley, Scotch 1 1 - - Beef, Corned 1 1 - - Beef, Pressed 2 2 - - Bismuth Compound Tablets 1 - - 1 Bloater Paste 1 1 - - Boracic Ointment 1 1 - - 4 Boric Acid Crystals 4 - - 11 - Brawn 11 - Brawn, Pork 6 6 - - Brawn, Veal 1 1 - - Breakfast Relish 1 1 - - Brisket, Pressed 1 1 - - Brynite 1 1 - - 0.5 Butter 204 203 1 1 1 Cake, Currant - - Cake, Dundee 1 1 - - Cake, Fruit 1 1 - - Cake, Madeira 1 - - 1 Cake, Ruby 1 1 - - 1 1 Cake, Russian - - 1 1 - Cakeoma - 10 10 - - Cakes, Sponge Camphorated Oil 4 4 - - 15 15 Cheese - - 1 Cheese, Cheddar 1 - - 1 Cheese, Gorgonzola 1 - - Chicken and Ham Roll 1 1 - - 1 Cider 1 - - Cocoa 9 - - 9 Cocoanut, Desiccated 1 1 - - Cod Liver Oil 2 2 - - 15 15 - Coffee - 3 3 Coffee Essence - - Coffee and Chicoiy Essence 1 1 - - Collared Head 1 1 - - Cordial, Lime Fruit 1 1 - - Cordial, Lime Juice 1 1 - - 1 1 - - Cough Drops Crab Paste 1 1 - - Cream 2 2 - - 1 1 - - Cream, Clotted 3 3 - - Cream of Tartar Cream Salad Oil 1 1 - - 1 1 - Curry Powder - 3 3 - - Custard Powder Dripping 65 65 - - 1 1 Eggs, Frozen - - 1 1 Epsom Salts - - Farina 1 1 - - (73) FOOD AND DRUGS—continued. Articles submitted for for Analysis * Total Samples Taken Number Genuine Number Adulterated Percentages of Articles Adulterated Fat 1 1 - - Fat, Cooking 1 1 - - Fat, White 2 2 - - Fish Paste 20 20 - - Flour 5 5 - - Flour, Self-raising 8 8 - - Friar's Balsam 1 1 - - Fruit, Mixed 1 1 - - Fruit, Mixed Pudding 1 1 - - Fruit, Mixed Salad 2 2 - - Fruit Sauce 1 1 - - Ginger Brandy Flavour 1 1 - - Ginger, Crystallized 1 1 - - Ginger, Ground 3 3 - - Glycerine 3 3 - - Ham 1 1 - - Ham, Cooked 1 1 - - Ham, Tinned 1 1 - - Ham Roll 1 1 - - Honey 2 2 - - Jam, Apricot 2 2 - - Jam, Blackcurrant 4 4 - - Jam, Raspberry 4 4 - - Jam, Raspberry Flavour 1 1 - - Jam, Raspberry containing other - - 1 1 Fruit Juice - 1 1 - Jam, Sto neless Plum - - Jam, Strawberry 1 1 - - Jam, Strawberry and Gooseberry 1 1 - - Jam Sandwich 2 2 - - Jelly, Blackcurrant Flavour 1 1 - - Jelly, Calves Feet 1 - - 1 Jelly, Loganberry 1 1 - - Jelly Crystals 1 1 - - Lard 4 4 - - Lard Compound 2 2 - - Lemon Cheese 2 2 - - Lemon Curd 2 2 - - Lemon Squash 2 2 - - Lemonade Powder 2 2 - - Lemonade Syrup 1 1 - - Linseed, Crushed 1 1 - - Linseed Meal 2 2 - - liquorice Powder Compound 2 2 - - Lobster Paste 2 2 - - Lung Syrup 1 1 - - Margarine 73 - - 73 Marmalade 1 1 - - Marmalade, Ginger 1 1 - - Marmalade, Orange 3 3 - - Marmalade, Scotch 1 1 - - Mayonnaisse 1 1 - - Menthol and Eucalyptus Tablets 1 1 - - 487 472 15 Milk 3.1 Milk, Condensed Skimmed 1 1 - - Milk, Full Cream Evaporated 2 2 - - 18 Milk, Sterilised 19 1 5.3 (74) FOOD AND DRUGS—continued. Articles submitted for Analysis Total Samples Taken Number Genuine Number Adulterated 1 1 - Milk of Sulphur Mincemeat 3 3 - Mushroom Ketchup 1 1 - Mustard 10 10 - Nuts and Raisins 1 1 - Oatmeal, Fine 1 - 1 Ointment, Zinc 2 2 - Olive Oil 1 1 - Orange Curd 1 1 - Orange Squash 1 1 - Parriah's Chemical Food 2 2 - Pears, Dried 1 1 - Peas, Tinned 1 1 - Peel, Candied 1 1 - Pepper 38 36 2 Piccalilli 2 2 - Pickled Cabbage 2 2 - Pickled Onions 1 1 - Pickles, Mixed 1 1 - Pilchards 1 1 - Pork Pie 1 1 - Quinine, Ammon., Tincture of 1 1 - Quinine and Iron Tonic 1 1 - Raisins 1 1 - Raisins, Seedless 1 1 - Rice 4 4 - Rice Flour 1 1 - Rose Pink Colouring 1 1 - Rum and Butter Caramels 1 - 1 Sal Volatile 2 2 - Salmon and Shrimp Paste 1 1 - Sauce 6 6 - Sauce, Chop 1 1 - Sauce, Mint 1 1 - Sauce, Tomato 1 1 - Sausage, Breakfast 17 16 1 Sausage, Liver 1 1 - Sausage, Luncheon 18 18 - Sausage, Pork Luncheon 1 1 - Sausages, Beef 34 33 1 Sausages, Cambridge 1 1 - Sausages, Beef and Pork 1 1 - Sausages, Pork 16 15 1 Sausages, Parisian 1 1 - Seasoning 1 1 - 2 2 Sponge Fingers - Steak 2 2 - Sueflakes 1 1 - Suet 1 1 - Suet, Beef 2 2 - Suet, Shredded 5 5 - Sugar 7 7 - Sugar, Demerara 3 3 - Sugar, Yellow Crystals 2 2 - (75) FOOD AND DRUGS— continued. Number Genuine Number Adulterated Percentages of Articles Adulterated Articles submitted for for Analysis Total Samples Taken 1 1 - - Sugar, Icing Sulphur and Limefruit Lozenges 1 1 - - Sulphur and Yeast Tablets 1 1 - - Sultanas 4 4 - - Tarragona 1 1 - - Tartaric Acid 3 3 - - Tea 3 3 - - Tea, small leaf 1 1 - - Treacle, Black 1 1 - - Turkish Rhubarb Powder 1 1 - - Veal, Jellied 1 1 - - Vinegar, Malt 35 32 3 8.6 Vinegar, Table 1 1 - - Vinegar, Wood 108 104 4 3.7 Vintaroo (Port Type) 1 1 - - Walnuts 1 1 - - Wine, Blackcurrant Flavour 1 1 - - Wine, Ginger 9 9 - - Wine, Green Ginger 1 1 - - Wine, Ipecacuanha 1 1 - - Wine, Orange 1 1 - - Wine, Orange Flavour 1 1 - - Wine, Orange and Quinine 1 1 - - Wine, Peppermint 1 1 - - Wine, Port 1 1 - - Wine, Raisin 3 3 - - Wine, Raisin Flavour 1 1 - - Wine, White 1 1 - - Wine and Fruit Cordial 1 1 - - 1507 1477 30 2.0 Total (76) PROSECUTIONS IN CONNECTION WITH SAMPLES TAKEN DURING 1929. Sample Adulteration or Infringement No. Remarks Beef Sausages Containing Sulphur dioxide 0.0400 per cent. Dismissed under Probation of Offenders Act. Ordered to pay costs, 38s. 6d. 298 425 Milk Deficient in milk fat, 50.0 per cent. Fined £5 443 Milk Deficient in milk fat, 11.0 per cent. Fined £1 459 Vinegar Deficient in acetic acid, 11.5 per cent. Fined 5s. Costs, 17s. 6d. 463 Milk Deficient in milk fat, 13.0 per cent. Fined £1 550 Milk Deficient in milk fat, 26.0 per cent. Dismissed on payment of 5s. costs 612 Vinegar Deficient in acetic acid, 16.0 per cent. Fined 10s. 649 Milk Deficient in milk fat, 12.0 per cent. Fined 40s. Costs £10 10s. Milk Deficient in milk fat, 12.7 per cent. Fined 20s. 669 670 Milk Deficient in milk fat, 9.3 per cent. Fined 10s. 687 Pepper Containing foreign starch (ground rice), 50.0 per cent. Dismissed. Warranty proved Pepper 789 Containing foreign starch (ground rice), 50.0 per cent. Two Summonses against wholesalers for selling to prejudice of purchaser and false warranty respectively. Dismissed Warranty proved 25 Pork Sausages Containing Sulphur dioxide, 0.0088 per cent. Dismissed under Probation of Offenders Act. Ordered to pay costs, 17s. 6d. 55 Vinegar Deficient in acetic acid, 35.5 Per cent. Fined 10s. Costs, 17s. 6d. Milk 196 Added water, 5.5 per cent. Dismissed under Probation of Offenders Act. Ordered to pay costs, 17s. 6d. 416 Deficient in acetic acid, 45.0 per cent. Malt Vinegar Fined 40s. 428 Breakfast Sausage Containing Boric Acid, 0.05 percent. Summons against Wholesalers under preservatives, etc., in Food Regulations. Dismissed under Probation of Offenders Act. Ordered to pay £5 5s. costs SUMMARY. £ s. d. Fines 13 15 0 Costs 21 8 6 £35 3 6 PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1925. Quantity Unsound Articles Destroyed Removed for Sorting under Disposed of for Purposes other than Human Food Quantity Weight Quantity Weight Quantity Weight tons lbs lbs tons cwt lbs tons cwt qr Cwt qr qr 70 cases and 4887 tins - - 36 11 1 2 - Apricot Pulp - - - - - - - Apricots, Dried - 5 boxes - 1 1 0 - - - - - - - - - Bacon 14 sides 1 gammon and pieces - 7 1 0 3911 sides 445 10 0 0 - - - - - 1 13 tins - 2 24 - - - Beef, Corned 2643 tins 5 0 2 - - - Beetroots - - 55 bags 2 15 0 0 - - - - - - - - Bilberries - 36 baskets - 5 2 0 - - - - - - - - - Blackcurrant Pulp - - 29 cases and 549 tins 5 5 1 10 - - - - - - - - - - 549 una 21 squares and 2 boats - 16 - - 3 2 Blackcurrants - - - - - - Brawn 71 cases and 127 tins 1 17 0 18 - - - - - - - - - - Brisket 4 tins - 16 - - - - - - - - - - - - Butter Various trimmings - 9 0 0 - - - - - - - - - - Butter Beans 42 bags 2 0 0 0 - - - - - - - - - - Cabbages - 201 bags 10 2 3 0 - - - - - - - - - Canned Goods (various) - - - 75 5 0 15 - - - - - - - - Cereals, Fire Damaged - - - - - 21,753 bags and various packages 1633 0 0 - - - - - PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1925.—continued Articles Quantity Unsound Disposed of for Purposes other than Human Food Destroyed Removed for Sorting under S.A. Exported Quantity Weight Quantity Weight Quantity Weight Quantity Weight tons — cwt. qr tons cwt qr lbs cwt qr lbs ~n tons cwt qr lbs lbs tons Cheese Various packages - - - 12 0 10 - - - - - - - - - - - - - Chestnuts - - - 1,337 bags 66 0 - - 17 0 - - - - - - - - - - 213 cases and 9 tins 5 - - - 85 cases and 2 tins Cherries, Tinned 14 0 0 2 4 0 0 - - - - - - - Chickens - - 1 case - 3 7 baskets 3 14 - - 0 - - - - - - - - - Cocoanuts - 85 bags and 21 nets 5 11 3 0 - - - - - - - - - - - - - - Confectionery - Various boxes - 4 2 0 - - - - - - - - - - - - - - - - 1 liver - - - - - Cow Liver 13 - - - - - - - - - - - Crab - - 1 case - 1 20 - - - - - - - - - - - - - - Cranberries - 22 casks 1 10 0 0 - - - - - - - - - - - - - - Cream - - 3 cases and 60 tins - 1 1 9 - - - - - - - - - - - - - Dates - - 1 case - 2 0 - - - - - - - - - - - - - - Eggs - - 2749 tins and 186 eggs 141 4 3 24 - - - - - - - - - - - - - 1 Fat 5 casks 10 0 0 - - - - - - - - - - - - - - - Fat, Animal 60 casks 15 0 0 0 - - - - - - - - - - - - - - - Flour 214 bags 13 7 2 0 - - 935 bags 58 15 0 0 - - - - - - - - Flour Sweepings 10 1 2 - - - - - - - - - - - - - - - - - Garlic - - 6 0 0 0 - - - - - - - - - - - - - - Gherkins, Salted - - 62 casks 13 3 0 0 - - - - - - - - - - - - - Glucose - - - - - 1 cask - 5 2 27 - - - - - - - - - - - - Grape Fruit - - 1 case - 1 2 - - - - - - - - - - - - PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1925—continued Articles Quantity Unsound Disposed of for Purposes other than Human Food Destroyed Removed for Sorting under S.A. Exported Quantity Weight Quantity Weight Quantity Weight Quantity Weight Hams - tons cwt qr lbs tons cwt qr lbs tons cwt qr lbs 54 oases 10 boxes and 5 cases tons cwt qr lbs 5 cases 3 6 13 0 10 0 0 - - - - - - - - - 21 ting Hams, Tinned 1 case and 438 tins 2 8 0 1 2 1 9 1 9 0 604 tins 3 4 2 16 - 0 - - - - Horse Radish - 7 casks 6 1 0 - - - - - - - - - - - - - Lamb 113 carcases and pieces 2 tins 2 16 2 24 - - - - - - - - - - - - - - - - - Lamb Tongues 12 - - - - - - - - - - - - - - - 4 pipe Lemon Skins - - 1 0 0 0 - - - - - - - - - - - - Lobster, Tinned - 1 1 - - - 169 tins 2 - - - - - - - - - - - - Melons - 16 cases 16 0 0 - - - - - - - - - - - - - - - 18 cases Milk, Condensed 84 cases and 43 tins 1 16 1 14 1 3 0 23 - - - - - - - - - - and 2307 tins - Milk, Tinned Evaporated - - 11 cases and 1523 tins 16 2 12 - - - - - - - - - - - - - - - - - 1 barrel 2 0 0 Mushrooms - - - - - - - - - - - - - Mutton 259 carcases 8 legs and 5 pair Fore ¼'s 6 10 0 20 - - - - - - - - - - - - - - - - 4 bags - Offal - 3 0 14 - - - - - - - - - - - - Onions - 545 bags, 30 12 3 0 - - - - - - - - - - - - - - and 2 loads - - - - Orange Pulp 4 cases 2 2 8 - - - - - - - - - - - - 0 Oranges - - 56 cases and 5 17 0 - - - - - - - - - - - - - - 78 boxes - 1 heart - - Ox Heart 4 - - - - - - - - - - - - - Ox Livers 3 16 - - - - - - - - - - - - - PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1925— continued Articles Quantity Unsound Removed for Sorting under S.A. Exported Disposed of for Purposes other than Human Food Destroyed Weight Quantity Quantity Weight Quantity Weight Weight Quantity Ox Kidneys 1 box and 5 kidneys tons cwt qr - lbs lbs Ibs tons cwt qr tons cwt qr lbs tons cwt qr 1 9 - - - - - - - - - - - - - - - - 4 5 tins 51 casks, 26 barrels and 96 tins 12 barrels and 9 casks 0 Ox Tongues 12 8 0 2 1 3 3 0 - - - - - - - - - 5 casks 15 0 0 Pig Tongues 38 casks and 1 bag 5 11 2 14 - - - - - - - - - 26 cases and 10 tins 10 - 16 2 80 Pineapples, Tinned - - - - - - - - - - - - - - - 0 Pines, Cubes and Slices 1132 cases and 45 tins 3 16 2 - - - - - - - - - - - - - - - - 2 tins 12 - Pork, Corned - - - - - - - - - - - - - - - - - 10 casks 1 10 0 0 Pork Rinds - - - - - - - - - - - - - - 0 - 19 casks and 2 baskets 2 9 2 Potatoes - - - - - - - - - - - - - - - 14 4 birds Poultry, Frozen - - - - - - - - - - - - - - - - - 47 tins 10 - 2 0 Rabbits - - - - - - - - - - - - - - - 7 - 24 rabbits 1 Rabbits, Frozen - - - - - - - - - - - - - - - - 32 cases and 9 tins 1 6 3 14 Raspberry Pulp - - - - - - - - - - - - - - - - - Rice, Damaged 4 1 9 - - - - - - - - - - - - - - - Rice, Sweepings Various packages 3 16 3 1 - - - - - - - - - - - - - - - - Sheep 1 carcase - 1 19 - - - - - - - - - - - - - - - - - - - 38 casks 7 15 0 0 Soupstock - - - - - - - - - 9 4 tube 1 3 Strawberries - 1 0 I Sultanas ~~ - PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1925—continued Articles Quantity Unsound ! 1— 1 Disposed of for Purposes other than Human Food Destroyed 1 Removed for Sorting under S.A. ■I ! Exported 1 Quantity Weight Quantity Weight Quantity Weight Weight Quantity Tallow lbs lbs 339 barrels and 398 casks tons cwt lbs 1,U25 barrels, 448 casks ancl ! tons cwt 1 lbs tons cwt qr tons cwt qr qr qr 529 7 0 0 2i7 9 0 0 5S tierces ! Various parcels 20 9 2 10 Tea Sweepings j 3 cases and 4 tins 4 Tomato Puree 3 0 0 10 trays 2 0 Tomatoes . . 0 Tomatoes, Tinned 65£ cases and ! 32 tins 1 17 3 49 tins 2 2 11l Tongues Trotter Oil .. 21 tierces 7 7 0 0 — 6 birds 2 15 Turkeys 5 tins i 2 Veal, jellied - 1 11 2 o ! Vegetables, Various - — Wheat, damagecl .. Various parcels 157 12 0 27 - 1 basket 1 0 0 Yeast PRINTED BY HENRY RICHARDSON. LIMITED, 4, CHURCH STREET, GREENWICH, S.E. 10.