CAC 4378 dupl. BER 44 Borough of Bermondsey REPORT ON THE SANITARY CONDITION OF THE BOROUGH OF BERMONDSEY For the Year 1931 BY D. M. CONNAN, M.B., B.S., D.P.H., Medical Officer of Health. 43 BER 44 Borough of Bermondsey REPORT ON THE SANITARY CONDITION OF THE BOROUGH OF BERMONDSEY For the Year 1931 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 Staff 5 VITAL STATISTICS — Area 8 Dwellings 8 Rateable Value 8 Population 8 Births 8 Deaths 9 Marriages 9 Infantile Mortality 10 Deaths from Tuberculosis 10 Vital Statistics of District 11 Causes of Deaths 14 Deaths from Zymotic Diseases 16 INFECTIOUS DISEASES — Diseases Notifiable 17 Diphtheria 17 Scarlet Fever 18 Small Pox 18 Measles 18 Ophthalmia Neonatorum 18 Puerperal Fever and Pyrexia 19 Disinfection 19 Cleansing Station 20 Shelter 20 Bacteriological Laboratory 21 Foot Clinic 21 Nursing 22 Cases Notified in 1931 23 Cases Notified for last ten years 24 TUBERCULOSIS- New Cases and Deaths 25 Period between Notifications and Deaths 25 Lady Almoner 27 PAGE Public Health (Prevention of Tuberculosis) Regulations, 1925 28 Work of the Tuberculosis Dispensary 29 Summary of Notifications 30 Cases on the Register 31 LIGHT TREATMENT— Work done in the Solarium 32 Leysin Patients 36 MATERNITY AND CHILD WELFARE— Fairby Grange Convalescent Home 38 Midwifery Service 39 Obstetric Consultants 39 Work of the Health Visitors 40 Attendances at Centres 41 Statistics for 1931 42 DENTAL TREATMENT- Particulars of Children Treated 44 Particulars of Treatment and Work for 1931 45 PROPAGANDA 46 SANITARY ADMINISTRATION- Housing 48 Inspections and Proceedings 59 Work of the District Inspectors 64 Factories and Workshops —Homework 65 Factories and Workshops —Inspections 66 Bakehouses 67 House, Trade and Market Refuse 68 Offensive Trades 68 Mortuary 68 Street Markets 68 Drainage Work 68 FOOD CONTROL— Unsound Food 71 Work of the Wharves and Food Inspectors 72 Milk Premises 73 Milk Licences 73 Milk Sampling 73 Food and Drugs—Samples Taken 76 Food and Drugs—Prosecutions 79 Public Health (Imported Food) Regulations, 1925 80 HEALTH SERVICES 86 PUBLIC HEALTH DEPARTMENT. PUBLIC HEALTH COMMITTEE, 1931. Chairman .. Councillor S. R. WEIGHTMAN Vice-chairman Councillor Mrs. M. NIX, 1930-31 Vice-chairman Councillor J. C. WAYNE, 1931-32 Alderman Miss A. Broughton Councillor A. V. Parker Councillor Mrs. S. C. Amos „ A. Ponsford „ F. H. Benfield „ Mrs. F. A. Powell „ W. T. Cockett „ W. Shearring, J.P. „ Mrs. J. Donovan „ E. J. Gibson „ G. H. Stean „ Mrs. A. M. Hatcher „ Mrs. E. A. Stokes „ Mrs. F. I. M. Husk „ I. Stokes „ A. V. Kidd J. Sullivan „ G. Loveland H. E. C. Webb „ M. E. McAleer „ W.F. Williams Ex-officio: Councillor G. S. TINGLE, J.P., Mayor of Bermondsey, 1930-31 Councillor J. LYNCH, J.P., Mayor of Bermondsey, 1931-32 MATERNITY AND CHILD WELFARE COMMITTEE, 1931 Chairman Councillor Mrs. E. F. GEORGE Vice-chairman Councillor Mrs. E. A. STOKES Alderman Miss M. I. Henrich Counciĺor Mrs. M. Nix Councillor Mrs. M. Nix Councillor Mrs. E. V. Coyle „ Mrs. F. A. Powell „ Mrs. A. M. Fortescue „ Mrs. J. E. Purser Mrs. L. F. M. Franklin „ Mrs. R. E. Reed „ Mrs. A. Salter, L.C.C. „ Mrs. A. M. Hatcher „ Mrs. M. Homewood „ I. Stokes „ Mrs. H. Jagger „ R. Wedden „ Miss J. Langley „ Mrs. L. L. White „ Mrs. A. M. Newton „ Mrs. M. E. Witham Co-opted Members: Mrs. E. R. Balman Miss D. Plummer Miss E. M. Haslam Lady Winifred Hawke Mrs. E. C. Starr Ex-officio: Councillor G. S. TINGLE, J.P., Mayor of Bermondsey, 1930-31 Councillor J. LYNCH, J.P., Mayor of Bermondsey, 1931-32 STAFF: — MEDICAL OFFICER OF HEALTH. D. M. Connan, M.B., B.S., D.P.H. SANITARY INSPECTORS: G. L. Scott, Wharves and Food Inspector. G. A. Hoskins, Wharves and Food Inspector. J. G. Francksen, Wharves and Food Inspector. W. Davis, Drainage Inspector. A. H. Merryman, Food and Drugs Inspector. E. J. Pitts, Market Inspector. District Inspectors. No. 1—H. E. Butcher No. 5—G. F. J. Toll No. 2—F. L. Richardson No. 6—0. W. R. Smart No. 3 —W. G. Luke No. 7 —H. J. Bailey No. 4—W. C. Tapsfield TUBERCULOSIS DISPENSARY. Deputy Medical Officer of Health and Clinical Tuberculosis Officer —C. H. C. Toussaint, M.R.C.S., L.R.C.P., D.P.H. Assistant Medical Officer of Health and 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—Constance Clarke and Estelle Jagot. 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. Ruth W. Plimsoll, M.B., B.S., D.P.H., Florence L. Telfer, M.D. Health Visitors. Lucy Brown Alice Lusty Isabel White Rosa Bache Marie Helden Mrs. Dorothy Cottier Florence Child Amy Carlton Sarah Bowles Florence Wadds Dental Treatment: Municipal Dental Surgeon —Grantley Smith, H.D.D. Edin., L.D.S. Eng. Assistant Dental Surgeon—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. R. Parker, General Clerk F. W. Smith, Second Clerk W. A. Campbell, General Clerk C. W. Whye, General Clerk H. J. Smith, General Clerk A. Manning, General Clerk Alice Jones, Solarium Clerk C. F. Yaxley, General Clerk L. T. Knott, General Clerk Rose Dutch, Clerk & Dispenser H. E. W. Ellery, General Clerk F. J. Carpenter, General Clerk A. W. Hancock, Junior Clerk C. H. Harris, General Clerk J. W. J. Saward, Junior Clerk C. F. Lumley. General Clerk MORTUARY KEEPER: J. C. Stockwell DISINFECTING AND CLEANSING STATION: A. C. Davidson, Foreman in Charge. PUBLIC HEALTH DEPARTMENT, MUNICIPAL OFFICES, 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 1931. I would like especially to draw attention to the fall in the number of cases of Diphtheria and Scarlet Fever which is recorded. In the case of Diphtheria the figure is the lowest for fifteen years, and in the case of Scarlet Fever the lowest for thirteen years. While I do not personally attach a vast importance to figures, I feel sure nevertheless that the Council will be pleased to know that there has been a substantial decline in these two common diseases. I feel justified also in drawing attention to the Infantile Mortality rate of 57 which is the lowest ever recorded in the borough, a fact which I am sure will be gratifying to the Council and to the Chairman and Members of the Maternity and Child Welfare Committee in particular. As in previous years my cordial thanks are due to the Chairmen and Members of Committees for their unfailing support and lively interest in the work of the Department. I desire at the same time to express my appreciation of the work of the staff, and to offer my thanks for their loyalty and willing co-operation in the work 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. The number of inhabited houses at the end of 1931 according to the Rate Books was 18,656. The rateable value of the Borough on the 31st December, 1931 was £834,441, the product of a penny rate being £3,315. POPULATION. Census Estimate of Registrar General to 30th June, 1930 1921 1931 to 30th June, 1931 111,526 113,100 112,400 119,452 BIRTHS. The total number of births belonging to the Borough registered during 1931 was 1958, consisting of 973 males and 985 females. The number for 1930 was 2,059. The birth rate for 1931 was 17.4 per 1,000 persons living, compared with 18.1 for 1930. DEATHS. The total number of deaths belonging to the Borough registered during 1931 was 1,408, consisting of 736 males, 670 females and 2in which the sex could not be determined. The number for 1930 was 1,488. The death rate for 1931 was 12·5 per 1,000 persons living, compared with 13.1 for 1930 MARRIAGES. The total number of marriages in the Borough in 1931 was 1,001, being 20 below the number for 1930, and 28 below the average for the last 10 years. The figures have been supplied by the Superintendent Registrar. This makes a marriage rate of 17 81 per 1,000 of the population, compared with a marriage rate last year of 17·94. Year No. Rate 1921 1,084 17.99 1,008 16.64 1922 1923 1,056 17.34 1924 1,015 16.62 1925 1,038 16.88 1926 994 16.15 1927 1,021 16.88 1928 1,055 18.32 1929 994 17.47 1930 1,021 17.94 Average for years 1921 —1930 1,029 17.22 1931 1,001 17.81 (9) (10) INFANTILE MORTALITY. Whole Borough London Year No. of Deaths Rate per 1,000 Births Rate per 1,000 Births No. of Deaths 1921 306 95 8,077 80 1922 324 102 7,089 75 1923 220 76 5,615 61 1924 229 78 5,904 69 1925 210 79 5,599 68 1926 146 60 5,067 64 1927 149 67 4,357 59 1928 178 85 4,879 67 160 71 4,995 71 1929 1930 130 63 4,109 59 78 5,569 67 Average for years 1921-1930 205 1931 57 4,270 112 65 TUBERCULOSIS OF THE RESPIRATORY SYSTEM. In the following Table will be found particulars of deaths from Tuberculosis of the Respiratory System since the year 1921. Bermondsey Rotherhithe St. Olave Whole Borough London Sub-District Year No. No. No. No. Rate No. Rate 1921 106 43 14 163 1·35 4813 1·07 1922 119 43 7 169 1·39 4888 1·08 1923 95 35 14 144 1·18 4432 0·97 1924 92 46 11 149 1·22 4486 0·98 1925 99 35 11 145 1·18 4361 0·95 1926 100 39 12 151 1·23 4066 0·88 1927 87 42 15 144 1·19 4140 0·91 1928 88 43 12 143 1·24 3985 0·89 1929 78 31 8 117 1·03 4230 0·96 1930 81 36 15 132 1·16 3826 0·87 Averages for years 1921-1930 94 12 146 4323 0·96 39 1·22 1931 81 5 1·03 3907 0·90 30 116 INFANTILE MORTALITY RATE FOR 25 YEARS. VITAL STATISTICS OF WHOLE DISTRICT DURING 1931 AND PREVIOUS YEARS. Year 1 Population estimated to Middle of each Year 2 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 Total Deaths registered in the District Births Total Deaths in Public Institutions in the District 9 Under 1 Year of Ago At all Ages No. 12 Rate 13 No. 3 Rate 4 Rate per 1,000 Births registered 6 No. 7 Rate 8 No. 5 1921 120,500 3,231 26·8 261 80 1,313 10·8 657 51 394 1,656 13·7 3·167 26·1 259 81 1,572 12·9 778 43 496 2,025 16·7 1922 121,100 1923 121,700 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 13·6 123,000 2,652 21·6 188 71 1,280 10·4 669 47 321 1,554 12·6 1925 1926 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 1929 113,800 2,252 19·8 127 56 1,304 11·4 696 32 378 1,650 14·5 1930 113,800 2,059 18·1 90 1,169 10·3 686 46 365 1,488 13·1 44 Averages for years 1921-1930 119,530 21·6 173 65 1,274 10·6 645 40 1·608 13·4 361 2,592 112,400 1,958 46 10·4 596 92 331 12·5 1931 17·4 91 1,169 1,408 (12) OTHER INSTITUTIONS, Etc., Etc. I. Institutions, etc., within the District receiving sick and infirm persons from outside the District. II. Institutions outside the District receiving sick and infirm persons from the District. III Other Institutions, etc., the Deaths in which have been distributed among the several localities in the District No. of Deaths No. of Deaths No. of Deaths St. Olave's Hospital Ladywell Institution Abergavenny Mental Hospital 1 79 87 Ambulances on way to Hospital 5 Babies Hospital, Albury St., Deptford 1 Bexley Mental Hospital 9 Bermondsey Mission Hospital Brentwood Colony 1 1 Brompton Hospital 1 Brook Hospital, Shooters Hill 1 Cancer Hospital, Chelsea 1 Deaths in River Thames, Surrey Commercial Docks, Wharves, etc. Cane Hill Hospital 6 Channel View, Lancing 1 Charing Cross Hospital 1 9 Chest Hospital, Bethnel Green 1 Children's Hospital, Gt. Ormond St. 3 Colindale Hospital, Hendon 5 Railway 1 Darenth Training Colony 2 Dulwich Hospital 2 East London Hospital for Children 2 Workplaces 1 Evelina Hospital 1 Forest, The—Epsom 1 Fountain Mental Hospital,Wandsworth 1 1 Private Houses 1 Glenhen Nursing Home, Deptford Grand Surrey Canal 1 Total 92 Grosvenor Sanatorium, Kennington, Kent 1 Grove, The—Epsom 2 Grove Hospital, Tooting 1 Guy's Hospital 78 Heatherwood Hospital, Ascot 1 Hendon Cottage Hospital 1 Hop Garden, Newton Vallence, Alton 1 Horton Hospital, Epsom 4 Hundred Acres, Epsom 7 Infants Hospital, Vincent Square 1 Kings College Hospital 3 Ladywell Institution 87 Lambeth Hospital 5 Leavesden Mental Hospital 1 Lewisham Hospital 2 London Hospital 1 Lying-in Hospital, York Road 1 Maudsley Hospital, Camberwell 1 Metropolitan Hospital, Caterham 1 Middlesex Hospital 2 Middlesex Hospital Annexe 1 Miller Hospital, Greenwich 1 Municipal Hospital, Boscombe 1 Newington Institution, Southwark 2 (13) 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. Northern Hospital, Winchmore Hill 1 North-Western Hospital, Hampstead 1 Park Hospital, Hither Green 7 Private Houses 6 Queen Mary's Hospital for Children, Carshalton 2 Queen Mary's Hospital, Chislehurst 2 Queen Mary's Hospital, Wandsworth 2 Queen Mary's Hospital, West Ham 1 Railway 1 Railway Carriage, Hitehin Station 1 River Thames 1 Royal Free Hospital 1 Sailors' Home, Well Street, Stepney 1 St. Alfege Hospital, Greenwich 2 St. George-in-the-Eaet Hospital, Stepney 1 St. Giles Hospital, Camberwell 3 St. John's Hospital, Lewisham 1 St. Joseph's Hospice, Hackney 2 St. Margaret's Hospital, St. Pancras 1 St. Marylebone Home 1 St. Peter's Hospital, Stepney 1 St. Thomas's Hospital 3 Sea at Ramsgate 1 Seamen's Hospital, Greenwich 1 South-Eastern Hospital, New Cross 4 s.s. Hull Trader, Free Trade Wharf, Shadwell 1 Street 6 Taken dead to Guy's Hospital in mother's arms 1 Tooting Bee Hospital 12 The Throat Hospital, Westminster 1 University College Hospital 2 Western Hospital, Fulham 1 West Kent General Hospital,Maidstone 1 West Park Mental Hospital, Epsom 3 Workplaces 1 Total 331 CAUSES OF, AND AGES AT, DEATHS DURING THE YEAR 1931. Deaths at the subjoined ages of " Residents " whether occurring in or beyond the District. Causes of Death 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 Age Unknown Under 1 All Ages 112 All Causes Certified 1408 162 22 21 27 91 413 558 2 Uncertified — — — — — — — — — — (14) Enteric Fever — — — — — — — — — — Small Pox — — — — — — — — — — Measles 1 — 3 2 — — — — — — Scarlet Fever 1 — — — — — — 1 — — Whooping Cough 3 1 — — — 5 1 — — — Diphtheria 6 — 5 1 — — — — — — Influenza 23 — 1 — 3 9 10 — — — Encephalitis Lethargica — — — — — — — — — — Meningococcal Meningitis — — 2 — 6 2 — 2 — — Tuberculosis of Respiratory System 116 — 3 32 41 6 — 34 — — Other Tuberculous Diseases 15 — 3 4 — — — 6 2 — Cancer, Malignant Disease 146 — — 60 71 1 — — 14 — Rheumatic Fever — 9 — — 2 3 1 — — 3 Diabetes 10 — — — 1 4 5 — — — Cerebral Hæmorrhage, etc. 90 — — — — 1 2 36 51 — Heart Disease — — — 16 — 197 1 24 102 54 Arterio-sclerosis 26 — — 14 — — — — 11 — CAUSES OF, AND AGES AT, DEATHS DURING THE YEAR 1931—continued. Deaths at the subjoined ages of " Residents " whether occurring in or beyond the district. Causes of Death All Ages 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 Age Unknown Under 1 Bronchitis 87 2 — — 2 2 7 32 — 42 Pneumonia (all forms) 169 36 11 6 3 3 20 57 33 — Other Respiratory Diseases 19 1 — 2 2 6 8 — — — Ulcer of Stomach or Duodenum 14 — — 1 5 6 2 — — — (15) Diarrhoea and Enteritis (under 2 years) 9 9 — — — - - - — — Appendicitis 6 - - - - 2 3 1 - - Cirrhosis of Liver 4 - - 4 - - - - - - Acute and Chronic Nephritis 65 - - 1 3 2 21 38 - - Puerperal Sepsis - - - - 3 4 - - 7 - Other Accidents and Diseases of Pregnancy and Parturition 5 - - - 2 - - - 2 1 - Congenital Debility and Malformation, Premature Birth - - - - - - 33 33 - - - Suicide 12 - - 1 4 5 2 - - - Other Deaths from Violence 1 1 10 14 52 2 5 4 15 - Other Defined Diseases 264 26 1 4 6 18 50 156 - 3 Diseases ill-defined or unknown 10 1 5 2 - - - - - 2 1408 21 112 22 27 91 413 558 2 162 DEATHS FROM ZYMOTIC DISEASES, 1931 Year Principal Zymotic Diseases Smallpox Measles Scarlet Fever Whooping Cough Diarrhoea All Causes Diphtheria Enteric Fever No. Rate Rate No. Rate No. Rate Rate Rate Rate No. No. No. Rate No. No. No. Rate 13·7 197 69 14 ·11 3 87 ·72 1656 18 - 1921 1·63 3 - ·15 ·57 ·03 - 1922 2025 16·7 292 2·41 - 101 11 ·09 90 65 1 - 24 ·83 ·74 ·53 ·19 - 1923 1480 12·1 125 1·02 - - 13 ·10 3 ·02 33 ·27 12 ·09 2 ·01 62 ·50 13·6 117 ·95 - ·04 ·20 ·09 1 ·01 1924 1657 48 ·39 6 25 11 26 ·21 - 1925 1554 12·6 96 - 20 29 27 - - 17 ·14 ·78 ·16 3 ·02 ·24 ·22 - 1926 12·1 24 ·19 42 - 21 ·17 1484 94 ·76 6 ·05 ·34 1 ·01 - - - 1927 1566 12·9 45 9 ·07 - - ·11 10 1 - 12 ·09 ·37 - 13 ·08 - 1928 1520 13·2 137 1·19 77 03 16 26 ·23 1 ·01 14 ·12 ·67 3 ·14 - - 1929 1650 14·5 62 ·54 - 1 ·01 2 ·02 6 ·05 33 ·29 1 ·01 19 ·17 - 1930 1488 13·1 101 ·89 61 ·54 7 ·06 8 ·07 6 ·05 2 ·02 17 ·15 — - Average for years 1921-1930 1608 127 1·05 6 33 ·17 1 ·01 30 ·25 13·4 ·30 ·05 ·27 - - 36 20 - - 3 1 6 ·04 1931 1408 24 ·21 ·03 ·01 ·05 5 - - 9 ·08 12·5 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 Typhus Tuberculosis—all forms 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. I am very glad to be able to record a pronounced fall in the number of cases of Diphtheria notified The number this year is 263, and of these 8 were returned from hospital as not suffering from Diphtheria, leaving a net total of 255 cases. As the number of cases last year was 431, this is a gratifying drop, and indeed this figure 255 is the lowest recorded for fifteen years There were 6 deaths During the year I have again directed the attention of practitioners to the value of early administration of Antitoxin in cases of Diphtheria I have also issued to practitioners a small booklet of blank forms for the removal of cases of infectious disease to hospital There are twenty-five forms in each booklet and on the paper covers of the booklet is printed information as to laboratory facilities, supply of Antitoxin, etc. The accompanying table shows the number of patients attending the Schick Clinic which is regrettably small in spite of judicious propaganda. There appears to be a widespread aversion in the borough to inoculation of any kind for preventative pur poses. No. of patients examined No. found to be positive and immunised No. found to be negative No. immunised without Test No. of sessions Total attendances 24 12 9 3 54 107 SCARLET FEVER. The number of cases notified this year is 310, of which 7 cases were returned as not suffering from Scarlet Fever. The net figure of 303 compares very favourably with that of 487 for last year and is the lowest figure recorded since 1918 There was only one death SMALL-POX. I am very pleased to be able to note that the number of cases of Small-Pox notified was only three. Five re-vaccinations were performed under the Public Health (Small-Pox Prevention) Regulations, 1917. MEASLES. This is not an epidemic year and the number of cases of Measles reported to me was only 216 as compared with 1,418 cases last year. Of these, 69 cases were removed to hospital and 15 patients were nursed at home. Three patients died. OPHTHALMIA NEONATORUM. The following table gives particulars of the number of cases of this disease. In four instances nursing was provided:— Cases Vision Impaired Notified Treated Vision UnImpaired Total Blindness Deaths At home In Hospital 14 8 6 14 - - - NOTIFIED CASES OF DIPHTHERIA FOR 25 YEARS. NOTIFIED CASES OF SCARLET FEVER FOR 25 YEARS. PUERPERAL FEVER AND PUERPERAL PYREXIA. The number of cases notified was, as follows:— Puerperal Fever 13 Puerperal Pyrexia 37 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. Facilities No. of Cases Second Opinions 2 Nursing provided 2 Bacteriological examinations Nil Admitted to Hospital 41 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 am very glad to be able to report that the new station is now open and in full working order, although a few details yet remain to be completed. By careful arrangement it was found possible to maintain a satisfactory disinfection service during the transition without recourse to outside help. The change over was complete early in September and the cleansing station was opened for the reception of school-children in the first week of October. In one respect the planning has been found to be defective, the accommodation provided for the school nurse was insufficient. It was understood that accommodation was required only for the storage of records and that all the clerical work of the nurses would be done in school at the time of examination of the children. This was a misapprehension and to meet this difficulty the female staff-room has been allotted to the nurses while the female staff have been provided with a mess-room adjacent to the mangling and ironing room. In addition to the ordinary disinfection work, all the staff laundry including white coats, overalls and towels, is now done in the station. The following table shows the number of articles disinfected during the year:— Beds 618 Pillows 1,572 Blankets 3,701 Pillows (cases) 1,162 Bolsters 480 Quilts 847 „ (cases) 194 Sheets 1,022 Books 277 Miscellaneous 5,909 Cushions 117 Verminous Clothing 4,312 Mattresses 60 ,, Bedding 779 Overlays 520 Scabies, Clothing 1,855 19,494 new tabs were used to replace those taken off mattresses, palliasses, and cushions before disinfection. Number of rooms disinfected 1,684 CLEANSING STATION. Verminous persons cleansed Adult Females 1 Adult Males 52 Children 620 Persons treated for Scabies: — Number treated Number of baths given Adult Females 2 4 Adult Males 3 8 Children—Females 26 132 Children—Males 13 72 SHELTER. Four flats are provided in The Neckinger for the temporary housing of families or persons while their premises are being disinfected. Three families were accommodated during the year, two for Small-Pox and one for Diphtheria, the total number of persons accommodated being 12. (21) BACTERIOLOGICAL LABORATORY. There is no special point to note in connection with the work of the laboratory which consists mainly 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 meantime 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 1930 1931 1931 1930 1931 1930 Diphthebia (specimens taken by Medical Officer of Health) 1010 798 89 85 925 709 Ditto (taken by general practitioners) 1028 186 1854 198 1668 1430 Diphtheria (total specimens taken) 2426 271 2864 287 2593 2139 Phthisis 1833 1897 326 260 1507 1637 Various 135 5 305 20 130 285 Total specimens taken 4832 4628 602 567 4230 4061 FOOT CLINIC. The clinic provides treatment for minor foot troubles such as corns, bunions and ingrowing toenails. The total number of attendances during the year was 9,021, consisting of 2,574 males and 6,447 females. In May the charge for treatment was increased from sixpence to one shilling, and for appointments the charge is now two shillings instead of one. Owing to the popularity of the clinic it was found necessary during the year to increase the number of sessions from five to nine sessions per week. The hours of attendance will be found on page 90. (22) NURSING. The following table shows the number of patients nursed under the Council's Scheme, the diseases from which these patients were suffering and the number of visits paid. Under this scheme the Council assists in the provision of nursing for expectant and nursing mothers, children under five, and for patients suffering from the following diseases : —Measles, German Measles, Whooping Cough, Puerperal Fever and Puerperal Pyrexia, Epidemic Diarrhoea, Dysentery, Influenza, Ophthalmia Neonatorum, Polio-myelitis, Encephalitis Lethargica, Malaria, Acute Primary and Acute Influenzal Pneumonia and Tuberculosis. Disease St. Olave's District Nursing Association Rotherhithe Queen's Nursing Association Totals whole Borough Visits Cases Cases Visits Cases Visits Pneumonia 42 1,018 24 667 66 1,685 Broncho pneumonia 251 9 254 23 505 Bronchitis 31 455 4 38 35 493 Influenza 36 779 11 154 47 933 Measles 12 166 3 48 15 214 Whooping Cough 1 23 1 12 2 35 Tuberculosis:— (a) Respiratory System 75 3,831 43 2,218 118 6,049 (6) Other Forms 7 316 1 127 8 443 Puerperal Pyrexia - - 1 10 1 10 Puerperal Fever 1 38 - - 1 38 Pregnancy and Labour 47 812 8 163 55 975 Diseases of the Digestive System 33 187 16 78 49 265 Infantile Diarrhoea (under 2 years) 3 29 2 14 5 43 Discharging Ears 11 397 1 8 12 405 Discharging Eyes 7 216 7 1 217 14 433 Post-operative cases:— (a) Tonsils & Adenoids 50 216 10 36 60 252 (6) Other cases 1 8 3 44 4 52 Other diseases 27 541 5 80 32 621 Totals 398 9,283 149 4.108 547 13,451 CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR 1931. NUMBER OF CASES NOTIFIED BERMONDBEY ROTHERHITHE ST OLAVE Total Cases removed to Hospital At Ages—Year St. Thomas Total St. John NOTIFIABLE DISEASE Under 1 year 1 and under 5 years 5 and under 15 years 15 and under 25 years 25 and under 45 years 45 and under 65 years 65 and upwards 2 4 5 1 2 3 St Olave Total At all Ages 1 3 6 Total 3 — — Small-pox — — 1 2 — — — — — — - 3 — — 3 - — 3 — — - Diphtheria (including Membranous Croup) 2 22 32 51 25 35 22 32 89 2 8 262 263 4 85 128 26 18 23 13 166 6 — — Erysipelas 49 3 3 5 5 9 21 3 9 3 8 5 6 4 35 3 10 1 14 — — — 14 — Scarlet Fever 5 112 162 25 6 41 33 43 54 30 23 224 29 26 13 68 12 1 5 18 306 310 — — 2 1 1 — 2 7 1 Cerebro-Spinal Meningitis 9 2 1 1 2 1 2 - — — 8 — 1 1 2 — — Acute Polio-Myelitis and Acute Polio Encephalitis. — 1 — — — — — — — 1 — — — — — — 1 1 1 — — — — — Ophthalmia Neonatorum — — 6 — 1 14 1 1 — 1 1 2 8 - — 1 — 5 4 2 1 14 — — Anthrax — - - - — - — — — — — - — — - — — — - — — — — — Enteric Fever 1 — — — 1 - — — — — — — - - — - 1 - — 1 1 — - — Puerperal Fever — 4 9 — — 1 3 3 1 1 10 - 1 2 3 - — 12 13 1 — — — — Puerperal Pyrexia 37 — — — 14 3 8 4 4 — 21 5 7 15 1 1 23 — 2 3 29 — — - Encephalitis Lethargica — — — 1 — — 1 1 - 1 - — — - — - — — - 1 — — — — Dysentery - - — — — — — — — — — — — — — — — — - - - — — — Malaria _ - - - — — — — - - — — — — — — — - — — — — - - Pneumonia (Acute Primary and Acute Influenzal) 167 45 14 25 31 14 16 17 17 19 18 9 96 24 23 16 63 3 4 1 8 — 10 28 Tuberculosis— 4 ... .J I .. 24 4 2 18 Respiratory System 175 — 8 67 57 39 4 18 19 18 20 17 116 24 12 5 41 12 — - Other forms of Tuberculosis 5 40 2 10 — 6 4 4 4 1 24 7 3 5 15 1 8 15 5 - 1 — — — 347 94 Totals 158 117 130 110 705 136 106 322 36 11 9 56 643 1083 40 254 169 21 115 153 71 80 CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEARS 1922-1931. 1922 1924 1925 1926 1927 1928 1929 1931 1930 Notifiable Disease. 1923 2 — 1 47 — — 46 — Small Pox — 3 Diphtheria (including Membranous Croup) 1,111 586 541 535 714 481 603 462 263 463 Erysipelas 50 19 42 35 30 25 43 45 41 49 Scarlet Fever 652 323 395 353 426 601 493 584 507 310 Cerebro-Spinal Meningitis 5 3 1 3 5 3 2 4 5 9 Acute Polio-Myelitis and Acute Polio- Encephalitis 2 2 1 4 2 2 1 2 1 1 Ophthalmia Neonatorum 12 18 12 15 10 13 8 11 13 14 Anthrax 1 - 2 3 4 2 1 1 - 1 (24) Enteric Fever 4 2 2 5 3 1 2 2 5 1 Puerperal Fever 7 4 2 9 9 9 7 12 14 13 Puerperal Pyrexia - - 11 21 20 20 19 37 - - Encephalitis Lethargica 8 5 4 1 4 1 2 1 21 8 — — — Dysentery — — 1 — — — - 1 2 — Malaria 1 1 — — — — — 1 Malaria (induced) — — — - — — — - - Pneumonia (Acute Primary and Acute Influenzal) 113 126 53 234 125 243 119 110 119 167 Tuberculosis 317 250 226 Respiratory System 245 206 231 184 194 208 175 Other forms of Tuberculosis 96 86 90 76 59 65 54 40 46 40 1,420 1,580 1,408 1,599 1,585 1,478 1,536 1,494 1,083 Totals 2,496 (25) III.—TUBERCULOSIS. In Table I are set out particulars of new cases and deaths during the year, and Table II shows the period elapsing between notification and death. TABLE I. TUBERCULOSIS, 1931—NEW CASES AND DEATHS. NEW CASES DEATHS Non- Pulmonary Non- Pulmonary Pulmonary Pulmonary AGE—PERIODS M. F. M. F. M. F. M. F. — 2 — — — — — 0 — — - 1 7 1 1 4 5 — 5 6 1 1 2 6 7 1 1 — 2 2 - 1 - 10 1 1 14 4 15 14 4 4 9 2 2 22 10 9 — 20 18 4 1 25 18 1 2 14 — 23 13 1 14 1 3 9 5 35 11 1 — 20 5 - 18 5 45 — — — 15 3 — - 2 — 55 9 — 3 2 — — 4 2 65 and upwards — — 117 75 27 23 68 48 5 10 TABLE 11. TUBERCULOSIS, 1931-PERIOD BETWEEN NOTIFICATION AND DEATH. Period Between Notification and Death Respiratory System Other Forms Males Females Percentage of Total Deaths Males Percentage of Total Deaths Total Females Total Not notified 5 2 7 6·03 2 6 8 53·34 0-1 month 6 3 9 7·76 1 2 3 20·00 1-3 months 8 6 14 12·07 1 1 2 13·33 3-6 months 10 3 13 11·20 - — — — 6-12 months 14 6 - — 20 17·24 — — 1-2 years 7 11 18 15·52 - — — — 2-5 years 10 13 23 19·83 - — — — Over 5 years 8 12 4 10·35 1 1 2 13·33 Totals 68 48 116 100·00 5 10 15 100·00 There has been a steady decline in the number of deaths from Tuberculosis throughout the country for a number of years, and the curve in this borough has been consistent with that for the country in general. This year there has been a fall of twenty in the total number of deaths from all forms of Tuberculosis, and deaths from Pulmonary Tuberculosis are sixteen less than last year. The death rate for Pulmonary Tuberculosis was 1.03, and apart from 1929 when the rate was the same it is the lowest ever recorded in Bermondsey. Table II. shows the period elapsing between notification and death. It will be noted that seven cases of Pulmonary Tuberculosis were not notified to me at all, the cause of death in these cases being ascertained from the death returns. This gives a percentage of 6.03 unnotified deaths from Pulmonary Tuberculosis as compared with fourteen deaths and a percentage of 10.61 last year. Turning to unnotified cases of the nonpulmonay forms of Tuberculosis we find a total of eight such cases this year, i.e., 53.34 per cent, as compared with eleven unnotified cases last year, i.e., 57.9 per cent. Thus there has been a drop in the number of unnotified cases this year in both categories. This fall is satisfactory as far as it goes, but it does not go far enough. Failure to notify may not be wholly the fault of practitioners. In many cases of non-Pulmonary Tuberculosis, notably those of Tuberculous Meningitis, the diagnosis is often obscure and of course in cases of Pulmonary Tuberculosis the patient may neglect to consult his doctor until forced to do so Notification of a case of Tuberculous Meningitis will often lead to the discovery of a case of Pulmonary Tuberculosis previously unsuspected. It is still necessary, however, to point out to practitioners that early diagnosis is the crux of the whole position, and to urge them to make fuller use of the facilities provided in connection with the Dispensary. The Tuberculosis Officers have continued to do artificial pneumothorax refills at the Dispensary, and the provision of this treatment appears to be of great assistance to patients who are fortunate enough to obtain work on return from sanatorium and are able on this account to attend for treatment in the evenings only. The arrangement with St. Olave's Hospital functions happily and is of great advantage to the Dispensary service in that it enables controlled rest in bed to be obtained for a patient at the earliest possible moment. The District Nursing Associations have also given very valuable help, not only in connection with the care of advanced cases, but also with regard to temperature records of cases under observation. LADY ALMONER. The total number of home visits made by the Lady Almoner this year has been exactly 1,000. Of these visits 958 were made to the homes of tuberculous patients, while 42 were in connection with other patients. A great many ether visits have been necessitated during the year in the effort to obtain employment for patients who have returned from sanatorium after treatment. This is difficult and trying work, particularly as the patients themselves often seem to have lost heart and are afraid of tackling a fresh job when it has been found. In spite of these difficulties quite a number of patients have successfully found employment. The handicraft class continues to meet on Friday afternoons except during the summer. The number attending varies from time to time and is not very large, there have been four new members during the year. Quite a number of patients have been successful in selling articles made by themselves. The class has been occupied mainly in leather, raffia and basket work. The Lady Almoner has also been able to arrange for treatment in convalescent homes for eleven non-tuberculosis patients, chiefly contacts or relatives of Dispensary patients. In addition, a short country or seaside holiday has been arranged for twenty women and five children during the year. Various articles of clothing have been provided to forty-five patients. It is part of the duty of the Lady Almoner to make assessments for the London County Council in the case of patients. going to Sanatorium, and to collect the payments, mostly in weekly instalments; 206 assessments have been made during the year and a total of £399 19s., collected on behalf of the London County Council. The Lady Almoner also visits the schools in the borough to arrange lectures on health subjects, and this year thirty-three visits have been made to schools and 54 lectures arranged. Our thanks are due to the Invalid Children's Aid Association, the Charity Organisation Society, the Public Assistance Committee and the various Relieving Officers for willing help in many cases, and to the Queen Mary's Needlework Guild for gifts of clothing. PUBLIC HEALTH (PREVENTION OF TUBERCULOSIS) REGULATIONS, 1925. It was not found necessary to take any action under these Regulations in 1931. RETURN SHOWING THE WORK OF THE DISPENSARY DURING THE YEAR 1931. Pulmonary Non-pulmonary Total Diagnosis Adults Children Adults Children Adults Children Grand Total M. F. M. F. M. M. F. M. M. F. F. F. A. —New Cases examined during the year (excluding contacts):— 1— (a) Definitely tuberculous 2 3 7 85 77 47 8 6 12 63 14 10 (b) Diagnosis not completed - 6 — — — 12 10 1 — — — - (c) Non-tuberculous — — — 122 169 69 52 603 — — — — — B.—Contacts examined during the year:— I . I (a) Definitely tuberculous 10 10 1 — 10 10 1 — — — — — (b) Diagnosis not completed — — — — 1 2 — 2 — — — - (c) Non-tuberculous — — — — 79 105 159 168 537 — — — — c.—Cases written oft the Dispensary Register as I (a) Recovered 12 20 15 7 6 6 12 8 18 26 27 15 (b) Non-tuberculous (including any such cases previously diagnosed and entered on the Dispensary Register as tuberculous) — — — —— 214 235 — — 281 224 — — 1010 (29) D.—Numher of Cases on Dispensary Register on December 31st: — I I 231 (a) Definitely tuberculous 328 50 56 72 72 43 89 371 287 161 122 12 (b) Diagnosis not completed — — — — — — — — 13 6 3 975 1. Number of cases on Dispensary Register on January 1st. 1,019 8. Number of visits by Tuberculosis Officers to homes (including personal consultations) 1,348 2. Number of cases transferred from other areas and cases returned after discharge under Head 3 in previous years 12 9. Number of visits by Nurses or Health Visitors to homes for Dispensary purposes *4059 3. Number of cases transferred to other areas, cases not desiring further assistance under the scheme, and cases "lost sight of" 40 10. Number of: — (a) Specimens of sputum, etc., examined 1,307 4. Cases written off during the year as Dead (all causes) 116 (6) X-ray examinations made in connection with Dispensary work 605 5. Number of attendances at the Dispensary (including Contacts) 4,085 11. Number of "Recovered" cases restored to Dispensary Register, and included in A (a) and A (6) above 2 6. Number of Insured Persons under Domiciliary Treatment on the 31st December 103 12. Number of " T.B. plus " cases on Dispensary Register on December 31st 344 7. Number of consultations with medical practitioners:— (a) Personal 113 (6) Other 185 * In addition to these visits 958 visits were made by the Lady Almoner and 231 visits by the School Nurse. PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1930. Summary of Notifications during the period from the 28th December, 1930, to the 2nd January, 1932. Formal notifications Age Periods Number of primary notifications of new eases of Tuberculosis 65 and upwards 1 to 5 5 to 10 10 to 15 15 to 20 20 to 25 25 to 35 35 to 45 45 to 55 55 to 65 Total Notifications Total (all ages) 0 to 1 Pulmonary, Males 5 — 14 22 19 12 18 14 2 — — 139 106 — — 2 1 14 3 2 17 16 10 4 69 Females 88 (30) Non-Pulmonar Males 2 3 7 2 3 4 1 2 — — 24 25 — „ Females — 5 1 1 16 5 1 - 2 1 — — 18 New cases of Tuberculosis coming to the knowledge of the Medical Officer of Health during the abovementioned period, otherwise than by formal notification. 0 to 1 1 to 5 5 to 10 10 to 15 15 to 20 20 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 and upwards Total Age Periods Pulmonary Males — — — — — — 4 2 2 1 — 11 1 — — — 1 2 1 1 — — 6 „ Females — Non-Pulmonary Males — 1 1 — — 1 — 3 — — - — — 2 1 1 2 — — — 1 — „ Females 7 — (31) Returns rendered under the PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1930. 1st QUARTER, 1931. Respiratory System Other Forms M. F. M. F. Number of Cases on Register at commencement of Quarter 626 463 220 201 Number of Cases notified during Quarter 24 19 5 3 Inward Transfers, etc. 2 — — — Number of Cases removed from the Register 33 29 11 5 Number of Cases remaining on the Register at end of Quarter 619 453 214 199 2nd QUARTER, 1931. Respiratory System Other Forms M. F. M. F. Number of Cases on Register at commencement of Quarter 453 199 619 214 Number of Cases notified during Quarter 26 22 8 4 Inward Transfers, etc. 2 1 1 — Number of Cases removed from the Register 75 59 21 14 Number of Cases remaining on the Register at end of Quarter 417 190 572 201 3rd QUARTER, 1931. Respiratory Svstem Other Forms M. F. M. F. Number of Cases on Register at commencement of Quarter 572 417 201 190 Number of Cases notified during Quarter 22 15 3 4 Inward Transfers, etc. — — — — Number of Cases removed from the Register 126 106 44 35 Number of Cases remaining on the Register at end of Quarter 468 326 160 159 4th QUARTER. 1531. Respiratory System Other Forms M. F. M. F. Number of Cases on Register at commencement of Quarter 468 326 160 159 Number of Cases notified during Quarter 34 13 8 5 Inward Transfers, etc. 1 2 1 1 Number of Cases removed from the Register 52 36 13 13 Number of Cases remaining on the Register at end of Quarter 451 305 156 152 IV. LIGHT TREATMENT. The following table shows the work done in the Solarium during 193: — Number of Attendances 25,015 „of Examinations 3,460 „of New Patients 677 „of Discharges 653 „ of Maternity and Child Welfare Cases under treatment during the year 317 Number of Tuberculous Patients under treatment during the year 81 Total number of other classes under treatment during the year 598 (The Maternity and Child Welfare patients formed 31.82 per cent of the total number under treatment and the tuberculosis patients 8.13 per cent) All patients attending for treatment are recommended by general practitioners or by medical officers of the Maternity and Child Welfare Centres, the Tuberculosis Dispensary or Hospitals. Every patient is examined by a member of the medical staff before and during treatment and a Medical Officer is on duty in the Solarium during nine of the sessions each week. A list of the principal diseases treated, together with the number of patients who completed treatment during the year is given below:— TUBERCULOSIS. Pulmonary .. 24 Glandular .. ~ 9 Spine 3 3 Hip 3 Skin (Lupus and Bazin's Disease) 9 Other non-pulmonary conditions 11 MATERNITY AND CHILD WELFARE. Ante-natal 13 Rickets 75 Marasmus, Debility, Malnutrition, etc. 39 Bronchitis 12 Septic Adenitis 6 Other conditions 1 OTHER DISEASES. Acne 4 Adenitis (non-tuberculous) 16 Alopecia .. 17 Bronchiectasis 2 Bronchitis (including chronic) 58 Chronic Rheumatic conditions .. 94 Eczema and Dermatitis 5 Emphysema 7 Fibroid Lung 5 Malnutrition, Debility, Anaemia, etc. 207 Miscellaneous conditions . 30 Psoriasis 8 Varicose Ulcers 3 During the year certain alterations were made in the male and female treatment rooms, and a considerable addition was made to the electrical equipment. The latter now comprises eight Jesionek mercury-vapour lamps, together with eight large radiant heat lamps, eight Alpine Sun mercury-vapour lamps, together with eight smaller radiant heat lamps, and one Kromayer lamp (for local treatment). Two carbon are lamps are also used for general treatment. A special table was introduced for the collective treatment of small infants, enabling four to be irradiated at one time by two Alpine Sun and two small radiant heat lamps. Cubicles were constructed in both treatment rooms and in each cubicle treatment is given with combined Alpine Sun and radiant heat lamps. School-children as a class, comprise a large part of the total numbers treated in the Solarium. The group system of irradiation was put into force during the year. Circles, surrounded by four Jesionek mercury-vapour lamps and four large radiant heat lamps, were marked out in each treatment room, one for boys and the other for girls. The children are timed to arrive in regular groups after the closure of school, and step round the circles, marching time being provided by gramophone music In warmer weather, each group, after the completion of irradiation, is put through a set of simple physical exercises by the nurse in charge. In a working-class district, particularly in times of economic distress, malnutrition and debility are not uncommon amongst children of school age. Many such cases are referred to the Tuberculosis Officer as possible cases of tuberculosis, and treatment in the Solarium is of great value in this class of case. Amongst such cases discharged during the year improvement was noted in seventy-five per cent. As pointed out previously, poor and overcrowded housing conditions invalidate the beneficial effects of treatment in some instances, and this accounts for failure in a proportion of the cases. Amongst the Maternity and Child Welfare cases results were encouraging Improvement was noted in the ante-natal cases, and of the rachitic infants completing treatment during the year the vast majority received great benefit. Improvements were also noted in the bronchitic type of infant and in those suffering from marasmus and debility. A considerable number of patients afflicted with chronic rheumatic affections were again referred for treatment. This type of illness constitutes a great problem amongst the older industrial population, and is the cause of much prolonged misery and incapacity. While artificial light treatment does not effect a cure, experience shows that, in a large number of cases there is decided relief from pain and in many an increase of mobility in affected joints. On these grounds alone it would seem that this form of treatment is justified in the absence of better methods. Cases of alopecia on the whole showed good results. With the object of tiding over the transitional period after return from sanatorium, selected cases of pulmonary tuberculosis were given treatment. The Tuberculosis Officer reports that the results in these cases were good. No cases of active or advancing disease were treated. We have been particularly unfortunate this year with regard to the nursing staff of the Solarium. In the early part of the year one of the nurses was given six months' leave, without pay, to take the Health Visitor's certificate. She was successful and almost immediately resigned from the Council's service. Later in the year the other nurse was granted three months' sick leave and is at present still away. Under the circumstances it was decided to transfer Mrs. Cottier, one of the Health Visitors, to be in charge of the Solarium. I feel that my personal thanks are due to Mrs. Cottier for the extremely efficient way in which she has stepped into the breach and carried on the work. The following table shows, as far as we know it, the present condition of the patients who have been sent to Leysin. 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 Ley sin Result 5 years S.B. M. Left Foot 12 28/7/24 5/7/27 Well and at Work I R. 10 F. Glands of Neck 5 „ 28/7/24 6/10/25 Removed from District MS. 15 28/7/24 6/10/25 Well and at Work F. Right Knee 6 A.L. 19 F. Glands of Neck 2 ,, 1/10/24 6/10/25 „ „ C.P. 37 F. Forearm & Peritoneum 2 1/10/24 6/10/25 „ „ M.B F. 28 Glands of Neck 15 „ 26/10/25 22/2/27 „ „ E.C. 16 F. Right Knee 5 „ 26/10/25 8/7/27 Seen recently. Keeping well H.C. 10 M. Glands of Neck 26/10/25 20/2/27 Well and at Work 2 „ 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 Seen recently. Keeping well G.B. 20 F. Left Ankle 2 „ 9/2/27 28/4/29 Well and at Work L.T. 19 M. Abscess of Ribs 2 9/2/27 8/5/28 Removed from District C.P. 24 M. Spine 7 5/7/27 8/5/28 Seen recently. Keeping well Glands of Neck 3 " 5/7/27 A.R. 26 F. 8/6/29 Well and at Work E.G 16 M. Lupus of Nose 4 20/6/28 8/6/29 „ „ C.P. 26 M. 20/6/28 Tuberculide of Skin 1 „ 8/6/29 Removed from District. Well &at Work H.S 18 M. Right Hip 3 „ 20/6/28 26/9/30 Well and at Work I.S 23 F. Right Hip 8 „ 31/5/29 - Still at Leysin C.C. 27 F. Multiple Lupus 20/1/30 - 20 „ „ „ A. P. 16 F. Glands of Neck 4 months 20/1/30 20/3/31 Seen recently. Keeping well E.W. 18 M. Left Knee 1 year 15/4/30 - Still at Leysin G.L. 15 M. Spine 10 months 13/10/30 Dead (Tuberculous Meningitis) V.B. F. 16 Lupus of Nose 1 year 6/2/31 Still at Leysin - Spine D.R. 34 M. 4 years 4 /7/31 - „ „ V.-MATERNITY AND CHILD WELFARE. The only change of note which has taken place this year is the transfer of one of the centres from Percy Hall to the neighbouring premises of the Time and Talents Club. This change was necessitated owing to the re-building of Percy Hall. There has been no alteration in the arrangements made for visiting children. The present scheme requires the Health Visitor to make a first visit as soon after the tenth day as possible. Visits are then made monthly for four months, then at six, eight, ten, twelve, fifteen and eighteen months and at the age of two, two-and-a-half, three, four and five years. The mouth is specially examined and the state of the teeth recorded at the visit between six and nine months, and again at the visits at two, three, four and five years. The Health Visitors have been carefully instructed in the use of the dental mirror by Mr. Grantley Smith. The attached tables show the work of the Health Visitors on their districts and at the centres. The three largest municipal centres are at 110 Grange Road, 98 Rotherhithe New Road and the Princess Club, Jamaica Road. The average attendanc e at these centres has been 44.7, 41 and 41.4 respectively, and the average number of children seen by the doctor at each session has been 26.2, 19 and 26. The two remaining municipal centres namely those held at Roseberry Street and Trinity Road are both comparatively small and have an average attendance of 35.4 and 28.4 respectively, the average number of children seen by the doctor being 19.4 and 21.6. I am very pleased to note that the attendances at the Trinity Road centre show a very substantial improvement over last year. This centre is situated "down town" and is the only centre available for most of Rotherhithe Street and Derrick Street area. Owing to the extensive activities of the Housing Department in this region a new centre is very urgently needed and it was hoped that the new clinic on the Silver Street site would have been ready by the time the new flats were erected. This, however, has unfortunately not been the case, but I trust that progress will be made with the Silver Street Clinic during the coming year; the need certainly is pressing as the Trinity Road centre is unattractive and badly situated. New buildings were opened by the authorities of the Central Hall during the year and the accommodation is now very much better than that previously provided. The total number of individual children under the age of one year who have attended a centre during the year was 1881. From a comparison with the total number of births during the year, i.e., 1958, this would indicate that a very high proportion of children born in the borough attend a centre and come under the influence of a trained Health Visitor, a most satisfactory state of affairs. The infantile mortality rate this year is 57, which is the lowest rate ever recorded in the borough. Considering the nature of the population, the state of housing, the degree of unemployment and the consequent under-nourishment in the borough, I regard this rate as being a very creditable one. I regret that the maternal mortality is not so creditable. There have been twelve deaths, seven from sepsis and five from other causes Each of these deaths has been investigated as carefully as possible by the Medical Officer of Health and in no case has it been possible to identify definite error or negligence or to indicate any precise means by which the death could have been prevented. FAIRBY GRANGE CONVALESCENT HOME. The number of admissions during 1931 shows an increase on the two preceding years, the details being as follows :— Number of women admitted 249 Number of babies admitted 133 Number of toddlers admitted 148 The majority of these patients were mothers requiring convalescence and rest, while a large number were cases recuperating after child-birth. With the exception of Christmas week, there were patients resident at the Home during the whole year. This indicates, I think, the extent to which it is appreciated. Only three cases were admitted free, the payments of the remainder varying from 2/6 upwards. MIDWIFERY SERVICE. The total number of patients booked under this scheme during 1931 was 685, an increase of 43 over the preceding year. In 327 of these cases the Council paid the midwife's fee, and a proportion of the fee in 165 others. Full details on this subject have been set out in previous reports, and in conjunction with the various ante-natal centres the scheme is working smoothly and satisfactorily. During the year the Bermondsey Medical Mission Hospital have entered into an arrangement whereby their maternity cases are attended at their own homes by midwives from that Hospital. The number of cases booked under the agreement with Guy's Hospital authorities is 104. This number is regrettably small and I trust that it will increase as the object of the scheme becomes more widely known in the borough. There are fifteen midwives practising in the borough and during the year I have been in frequent contact with them, and wish to thank them for their willing co-operation. OBSTETRIC CONSULTANTS. As an extension of the midwifery scheme the Council has authorised the payment of an obstetric consultant's fee in cases approved by the Medical Officer of Health. The names of the gentlemen who have agreed to act in this capacity will be found on page 87. The number of consultations during the year has been 10. HEALTH VISITORS. The following table shows the work done by the Municipal and Voluntary Centres and Health Visitors during 1931 :— District Births Notified First Visits Re-visits Ante-natal Puerperal Fever and Puerperal Pyrexia Ophthalmia Neonatorum Other Visits Attendances at Centres Health Talks Cases Visits Cases Visits 4 4 1 1 700 240 39 105 117 1787 189 No. 1 „ 2 143 160 1522 229 2 5 1 1 900 189 5 (40) „ 3 118 100 1105 254 2 2 - - 1227 228 36 256 1 75 52 „ 4 (St. George s Hall) 153 168 2518 1 - - 736 208 „ 5 124 139 1546 242 - 2 2 706 18 - 129 „ 6 118 1989 171 2 2 - 686 194 35 - 1 558 260 111 „ 7 148 139 2508 221 3 3 1 340 177 1 „ 8 198 194 3175 105 15 15 - - 35 „ 9 (Fulford Street) 221 210 1674 421 4 4 I 1 632 168 298 3 4 395 220 10 „ 10 156 176 3523 3 4 207 2331 7 1 1 169 235 „11 206 402 8 - 3 121 „12 142 143 2339 505 7 7 3 262 - 1281 342 120 61 Salomon's Centre 126 5368 - - - - - 209 Central Hall 84 61 - 335 - - 667 - - - 14 2866 403 Totals 7646 1958 2086 32052 4635 50 54 14 ATTENDANCES AT MATERNITY AND CHILD WELFARE CENTRES. The following table shows attendances at Maternity and Child Welfare Centres during 1931: — Name of Centre Children's Consultations Sewing Class Ante-natal Clinic No. of attendances No. seen by Doctor No. of Sessions No. of attendances No. of Sessions No. of attendances No. of Sessions 210 50 893 101 110 Grange Road 9,396 5,517 1,429 98 Rotherhithe New Road 149 6,122 48 390 2,869 99 1,173 - Trinity Road - - 52 1,477 1,126 - Percy Hall and Time and Talents 103 4,014 2,167 - - - - - - - Roseberry Street 49 1,736 955 - - Salomon's Centre 142 3,233 1,977 - 200 2,793 156 6,461 4,131 55 Princess Club 92 706 1,867 44 100 3,418 2,239 47 Fulford Street 347 531 - 53 1,090 St. George's Hall 2,274 45 - - 626 204 - - - Central Hall 18,388 - 1218 56,519 22,071 279 4,123 502 6,632 Totals Maternity and Child Welfare STATISTICS FOR THE YEAR, 1931. Borough Council of Bermondsey. POPULATION according to the Census of 1931.—111,526. Births. Registered— Live Births Total Males Females Illegitimate 1,913 950 963 Illegitimate 45 23 22 Birth Rate per 1,000 of the estimated resident population 1 17.4 Total Males Females Stillbirths 49 29 20 Rate per 1,000 total (live and stillbirths) births 24 Notified within 36 hours of birth— (1) Live Births, 1,896. (2) Stillbirths, 35. (3) Total, 1,931. (1) By Mid wives, 570. (2) By Parents and Doctors, 1,361. Total. Males. Females. Sex unknown. Deaths 1,408 736 670 2 Death Kate per 1,000 of the estimated resident population 12.5 Infant Deaths. Number— (1) Legitimate, 112. (2) Illegitimate, —. (2) Illegitimate, —. (3) Total, 112. (3) Total, 57. Rate per 1,000 births — (1) Legitimate, 57. Maternal Deaths. Number of deaths from diseases and accidents of pregnancy and childbirth:— From Sepsis 7 Other causes 5 Rate per 1,000 Live Births 6·l Rate per 1,000 total (live and stillbirths) births 5·9. Health Visitors. Visits paid by Health Visitors during the year:— To Expectant Mothers (1) First Visits, 1,912. (2) Total Visits, 4,635. To Infants under 1 (1) First Visits, 2,086. (2) Total Visits, 15,931. To Children, 1-5 Total Visits, 18,207. Convalescent Homes for Children under 5. Number of Beds, 16. Number of Children under 5 received during the year, 281. Day Nurseries. Total number of attendances of Children during the year— Municipal Whole Day - Half-day - Voluntary Whole Day 9,349. Half Day 1,475. Deaths from Measles (all ages) .. .. .. .. 3 Deaths from Whooping Cough (all ages) .. .. .. 5 Deaths from Diarrhoea (under 2 years of age) .. .. 9 VI. DENTAL TREATMENT. I have to report an increase in the number of patients treated compared with 1930. During this year 6,357 patients were treated entailing 12,771 attendances, an increase of 537 patients treated and 95 attendances. This is more gratifying since no locum tenens was provided during the holiday season. There is a fall in the number of school-children treated, due possibly to the opening of an additional L.C.C. School Dental Clinic near the Bermondsey Centre. The tuberculosis cases include 37 children from the Nightingale House Open-air School. Four visits were paid to the Rotherhithe Maternity and Child Welfare Centre to inspect toddlers in connection with an investigation into ear, nose and throat disease of children. A few patients unable to attend the centre have been treated in their homes. The X-ray apparatus continues to prove a great boon both to patient and dental surgeon. (44) TREATMENT Or CHILDREN DURING 1931 CENTRE Age Group Number examined Number Treated Number of extractions Number of Scalings Number of Attendances for Orthodontics Total Number of Attendances Number of Fillings Anæsthetics Local General 110, GRANGE ROAD. Under 5 years 399 402 1656 12 377 30 820 - - Over 5 years 500 1232 514 343 148 178 4 260 1332 902 2888 160 720 208 4 260 2152 Totals 913 98, ROTHERHITHE NEW ROAD. Under 5 years 222 220 775 20 174 16 429 - - Over 5 years 2211 266 679 18 37 168 79 2 489 Totals 443 486 1454 57 342 95 2 18 918 (45) DENTAL TREATMENT CARRIED OUT DURING 1931 CENTRE Type of Case Anæsthetics Number of Fillings Number of Soalings Number of Repairs to Dentures Number of Patients examined Number of Patients Treated Number of Dentures Fitted Number of Extractions Number of attendances Local General 110, GRANGE ROAD Maternity Cases 700 793 2104 765 193 133 26 168 75 1813 Women 1203 1263 2227 1170 132 253 19 139 76 1 2267 Men 1530 1577 2902 1635 42 194 36 230 92 2820 Tuberculosis Cases 103 78 173 45 43 61 6 11 187 — Children (Table I.) 913 902 2888 160 720 208 4 2152 - - 1449 4613 10294 3775 1130 849 91 548 243 9239 Totals Maternity Cases 515 465 1741 243 233 27 41 144 29 1198 98, ROTHERHITHE NEW ROAD. 330 Women 275 755 255 66 67 17 49 27 583 Men 362 460 895 407 38 76 23 63 29 817 Tuberculosis Cases 3 3 6 3 1 7 2 16 - - - Children (Table I.) 443 486 1454 57 342 95 2 918 - Totals 1598 1744 4851 965 680 272 83 256 87 3532 VII.—PROPAGANDA. The Propaganda Section of the Department has now com pleted its seventh year and the number of lectures given during 1931 were as follows:— Lectures Audiences Schools 51 11,115 Clubs and Other Institutions 58 5,810 Open Air with Cinema Van 42 29,000 151 45,925 Total Three new films were produced increasing the library to a total of 21. Ihe first was entitled "Germs" and deals in a popular way with the germ theory, with particular relation to diphtheria This film was produced as an attempt to popularise the Schick Test and Immunisation The second film was a simple treatise on the work of a Municipal Authority and the third, exercises and drill for groups of children. Nine new pamphlets were produced and published, and these, together with the 35 already in use, make a total of 44 now in circulation. During the past few years, cinema performances have been given to school children in the hall at the Central Baths, Grange Road. These were arranged through the "school organisation" with the sanction of the London County Council. Suitable films were hired and a small charge was made to the children to cover the cost. Owing to the fact, however, that "talkie" films are now almost universal we find it impossible to hire suitable silent films because they are not being produced. The cost of altering the cinema apparatus at the Baths to show sound films would be very heavy, and as the usefulness of this form of propaganda is limited, the expenditure is not justified. Consequently, for the time being this section of the work has been suspended. It was stated in my last Annual Report that the Council are granting, with the co-operation of the Head Teachers and teaching staffs of the schools, three classes of certificate by examination for Personal Hygiene, i.e., Elementary, Intermediate, and Advanced. During the past year 10 of the children who obtained the Elementary Certificate in 1930 were awarded the Intermediate Certificate, and 30 children obtained the Elementary Certificate. For the fourth year in succession, 2,000 copies of "Better Health" have been distributed each month in the borough. Owing to the smallness of the number of copies available, we find a certain amount of difficulty in supplying all the demands for copies, but we have endeavoured to share them out as evenly as possible. VIII.—SANITARY ADMINISTRATION. HOUSING. The section dealing with housing in my last annual report was confined almost entirely to figures, and no attempt was made to discuss the position with regard to housing generally. Later in the year I was asked by the Ministry of Health to amplify my report, particularly with regard to certain points. I, therefore, propose to discuss these points in this year's report. This is an industrial borough, and practically all the inhabitants earn their living by manual labour. It is also a riverside borough, and much of the labour is casual and uncertain, and there is a high rate of unemployment. Very few well-to-do people and few professional folk live in the borough, and such of these as dwell here do so only on account of the exigencies of their work. It is thus true that while there are still many large houses which were in former days inhabited by the comparatively well off, these houses are at the present time, occupied in almost every case by two or more families. This is quite often the case also with regard to four, five and six-roomed cottages, which constitute a large part of the property of the borough In many cases there is difficulty in securing proper provision for cooking and washing and adequate water closet accommodation. While the question of registering these houses as tenement houses and applying the bye-laws is always considered, yet in many cases it appears to me that such registration is hardly justified. It is the practice generally to register a house as a tenement house where it is inhabited by three or more families' and where no responsible person lives on the premises, but even then, the house is not registered if the property is in good condition and the tenants are respectable. The total number of houses on the register at present is 63; three have been removed and 11 have been registered during this year. A point which arises in this connection is that quite a number of houses are let out by an absent tenant, in single so-called "furnished rooms," at rents which are exorbitant and highly profitable to the tenant, although the actual owner may be charging the "tenant" a reasonable rent. Naturally, under such circumstances there are frequent changes of occupants, and in general the conditions of living in such houses are most unsatisfactory. The houses, so far as they are known, are all registered as tenement houses. In a somewhat similar category is the class of house in which the tenant lets off rooms to two or more families, charging sufficient rent to his sub-tenants to cover the whole, or nearly the whole rent of the house. These premises are practically always overcrowded, and in many cases the sub-letting arrangement is made without the knowledge or concurrence of the owner, and it is very probable that the conditions under which the subtenants live are often unsatisfactory, and in the absence of complaint remain unremedied until the Sanitary Inspector pays a "House to House" visit. It appears to me that these are instances of profiteering which ought not to be allowed, and which at present cannot be prevented. In addition to cottage property, there are many blocks of flats in the borough, including more than 4,000 separate tenements. Recently both the London County Council and the Borough Council have erected blocks of flats, but apart from these, quite a number of the older blocks are well designed, administered and maintained. On the other hand, one or two of these blocks of dwellings are very far from being satisfactory. A particularly bad example is to be found in Wolseley Buildings, Dockhead. At the request of the London County Council, who proposed to deal with this block as an improvement area under the Housing Act, 1930, these buildings were the subject of a special inspection made by Mr. H. E. Butcher. The block was built in 1883, and is, therefore, not very old. The design, planning and amenities are alike bad, but by abating overcrowding, replanning and doing necessary repairs the buildings could be rendered fit for human habitation. No doubt this was one of the reasons which actuated the London County Council in selecting this block as one of three areas in London to be dealt with as improvement areas under the new Act. There are, in all, 191 tenements, with 1 milkshop, an office, workshop and 1 hairdresser's shop. Of these, 163 tenements consist of two rooms, 14 of three rooms, 11 of four rooms, and l of one room. There are 207 families in the block, comprising 1,036 persons. The acreage covered is 5/8 of an acre, and the density per acre is 1,650 persons. One common yard is provided for the whole block. The surface is of tarmac , the yard is enclosed on every side, and is a dumping ground for all kinds of household refuse Great difficulty is experienced in keeping it even passably clean, and this in spite of continued effort on the part of both Sanitary Inspector and owner. There are nine common staircases lighted by gas. One w.c. is provided on the landings between two families, and one tap and sink between four families There are no sculleries and no baths. The dust shoots are inadequate, obselete and frequently out of order. There is a bi-weekly collection of refuse. Washing accommodation is provided on the roof, and consists of nine washhouses with four coppers in each; there is no drying room. Many of the inhabitants make use of the public washhouses maintained by the Borough Council. There is no doubt that this block of buildings is particularly bad, but there are other blocks in the borough which are not very much better At the present moment I understand that the question of proceeding with an Improvement Scheme for his area is in abeyance. Excluding new buildings and blocks of flats most of the property in the borough is between 70 and 150 years old, and a goodly proportion is frankly worn out, irreparable and scarcely habitable I suppose that the prime defect in most cases is dampness, followed closely by darkness and inadequate flow of air both inside and around the houses. Bad original design and the decrepitude of age, complete the picture The prevailing overcrowding accelerates the rate of deterioration, and necessitates the continual attention of the Sanitary Inspectors and the frequent service of notices. Rents range from 5s. for one room to 35s per week for 6 rooms. Having regard to the average wage in the borough, which cannot be more than from £2 2s. to £2 5s. per week, I regard the rents as being high. Taking into consideration the accommodation provided, the rent is often exorbitant. (51) With regard to the measures taken to meet the position, the following tables show the position so far as clearance areas are concerned, and the number of new houses and flats which have been built and the houses purchased, leased and converted by the Borough Council since the Housing Act of 1919 :— CLEARANCE AREAS. Area in sq. ft. (approx.) No. of dwelling houses Population Date declared by Council Title of Clearance Area families persons Bethel Place Prospect St. Leroy Street In abeyance 49 - 32,670 195 20/1/20 27,225 55 - 291 20/1/20 49,005 64 346 - 20/1/21 Vauban St. Clearance Area and Lands Adjoining 129 114,532 218 18/11/30 903 *Essex Place Clearance Area 7 7 9,512 35 18/11/30 *St. Paul's Lane Clearance Area and Lands Adjoining 57,695 34 49 180 18/11/30 *Be at son St. Clearance Area and Lands Adjoining 8 2/12/30 11,197 5 40 *Globe Stairs Clearance Area 12 67 1,606 13 2/12/30 *Lavender Lane Clearance Area and Lands Adjoining 28,355 26 48 172 2/12/30 *Mistears Buildings Clearance Area and Lands Adjoining 50,974 37 275 2/12/30 72 *Botherhjthe Street Nos. 334 and 336 Clearance Area and Lands Adjoining 7,030 5 2/12/30 9 40 *Botherhithe Street Nos. 382 to 390 Clearance Area and Lands Adjoining 6,657 2/12/30 6 12 47 *Rotherhithe Street Nos. 540 to 606 Clearance Area and Lands Adjoining 48 100 98,594 431 5/5/31 *Silver Street Nos. 7 to 10 Clearance Area and Lands Adjoining 12,171 10 15 74 5/5/31 CLEARANCE AREAS —continued. Title of Clearance Area Area in sq. ft. (approx.) No. of dwelling houses Population Date declared by Council families persons *Bryants Alley Clearance Area and Lands Adjoining 20,259 26 34 7/7/31 157 *Elgar St. Clearance Area 17,141 16 23 110 7/7/31 *Charlotte Place Clearance Area 2,530 4 4 17 7/7/31 *Odessa St. Clearance Area and Lands Adjoining 181,989 124 216 901 1/12/31 *Rotherhithe Street (West) Area. * Rotherhithe Street (East) Area. No. of families accommodated New premises erected. Salisbury Street Area 54 cottages 54 Rotherhithe Street 12 „ 12 „ (Surrey House) 9 flats 9 „ (Acorn Walk) 55 „ 55 Brunel Road 11 cottages 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 Grange Walk 2 cottages 2 Acorn Walk Site On this site, 57 flats are in course of erection. Grange House 32 flats are in course of erection Millpond Estate 30 flats „ „ Pages Walk 50 flats „ „ Horney Lane 14 flats „ „ Bermondsey Street 6 flats and 2 cottages are in course of erection. Rotherhithe Street, 254/262 32 flats and 2 shops are in course of erection. Elgar Street 24 flats are in course of erection. Premises purchased or leased and converted: No. of families accommodated 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 Street 5 flats 5 „ 5 houses 9 Rotherhithe Old Rd. (1 house) 4 flats. 4 Dartmouth Road 2 houses 5 Derrick Street 4 „ 5 Dockley Road 2 „ 3 Bermondsey Wall 5 „ 9 Clarence Street 1 „ 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 Millstream Road 3 „ 3 Neston Street 2 „ 2 Union Road 2 „ 4 Rock Grove 3 cottages 3 2 flats 2 The following blocks of flats have been erected in the borough since 1919 by the London County Council on the area known (54) as the Hickman's Folly area. The estate is called the Dickens Estate 28 flats, Dombey House, Dockhead ; 34 flats, Oliver House, Flockton Street ; 52 flats, Pickwick House, George Row. At the end of the year, two further blocks on this estate were practically completed, 6 flats at Dombey House and 31 flats at Copperfield House. In addition to the above, several blocks of flats and houses have been erected by private enterprise since 1919, and these comprise the following : — Year Situation of property No. of houses No. of flats 1921 28/29 George Row - 2 1922 11 Upper Russell Street 1 - - 50 Larnaca Street 1 - 1925 66/88 Tower Bridge Road — 12 1926 65a to 65e The Grange 6 - 171 Grange Road 1 — 1927 129 a to 129g Brunei Road 7 - 22/24 Pages Walk 2 - 1928 11/17 Boss Street — 4 56 Neptune Street 1 — 1929 69/69b Snowsfields - 3 1930 18a Lower Road 1 - 1931 1/12 Murdock House, Moodkee Street - 12 1/6 Clegg House, Moodkee Street - 6 1/12 Neptune House, Neptune Street - 12 1/8 Huxley Tenements, Paradise Street - 8 Empire House, Tooley Street - 1 Totals 22 58 At the end of 1930, the Housing Committee of the Borough Council had under consideration the following plan for the succeeding five years. They considered that the Rotherhithe Street (West) Area, the Vauban Street Area and Gilhams Court area should be completed. The general position at present with regard to these Areas is that the properties are being demolished by stages and the residents re-housed elsewhere. The Committee thought that considerable progress should also have been made with the following Areas, Rotherhithe Street (East), Leroy Street and Bethel Place. Work has already been begun on the first of these Areas, and I understand that Leroy Street and Bethel Place will be tackled this year. The Committee also felt that a number of smaller Areas should be dealt with as Clearance Areas, namely: — houses houses. Bala Place 10 Kintore Street 12 Clove Place 9 Mellicks Place 20 Cloyne Row 8 New Cottage Row 3 Cottage Row 4 Paradise Place 6 Coxson's Place 4 Queens Place 6 Cundall's Court 15 Rowleys Buildings 10 English Grounds 8 Sarnells Court 5 Epsom Court 6 Surrey Buildings 13 Fells Square 5 Ship & Mermaid Row 8 Finnemore Place 6 Truscott Court 5 Gibbons Rents 4 White Lion Court 4 No official representation has yet been made in any of these cases, but Closing Orders were placed on 9 houses in White Lion Court in 1919. Six of these houses are still standing, four of them being occupied, and these will be demolished within the course of the next few months. The following table shows the number of houses and estimated Population in the Areas mentioned in this report :— houses. persons Rotherhithe Street (West) 136 873 Vauban Street 129 903 Gilham's Court 22 190 Rotherhithe Street (East) 307 2,290 Leroy Street 64 346 Bethel Place' 49 195 Smaller Areas (as above) 171 900 The question of Improvement Areas has been left to the London County Council, and, so far as I am aware, only one Area in this borough has been considered, namely, Wolseley Buildings. The Committee also had under consideration a number of Insanitary Areas in different parts of the borough, which they felt could be dealt with by means of demolition orders, namely:— Bermondsey Wall and Rotherhithe Street 12 houses Blackman's Court 2 houses Phoenix Place 1 house Charlotte Place 4 Rose Court 3 houses Davis Buildings 3 „ Stanworth Street 1 house Fort Passage 3 „ Tidal Place 3 houses Musk Court 3 „ Wright's Buildings 4 „ It is hoped that these will be dealt with during the next five years Another considerable Area bounded by Long Lane, Weston Street, Alice Street and Rephidim Street has been under consideration, and the Committee took the view that this Area should be dealt with by the London County Council, but, so far as I am aware, no further action has been taken in the matter. On September 1st, 1931, I gave evidence at a Public Enquiry held at the Town Hall into the Council's application for confirmation of a Compulsory Purchase Order in connection with the Vauban Street Area. With regard to vacant sites suitable for housing accommodation, I believe that it is true to say that every available site in the borough has been brought to the notice of the Housing Committee. The following statement shows the sites which have been acquired, the number of houses or flats contemplated and the stage reached at present:— Site Houses and flats contemplated No erected No in course of erection 112 62 32 2 50 14 8 32 24 49 Acorn Walk Gilham's Court The Grange Grange Walk Pages Walk Horney Lane Bermondsey Street Rotherhithe Street (254/262) Elgar Street Fort Road 55 - - 2 - - - - - - 57 30 32 - 50 14 8 32 - - Overcrowding.—It is a matter of great difficulty to form a clear idea of the position with regard to overcrowding in the borough. The general impression of everybody in a position to speak is that overcrowding is übiquitous. In 1927 a special census was made, and, taking a standard of more than two persons to a room, it was found that nearly 3,000 families were living in overcrowded conditions. This standard is arbitrary and takes no account of cubic space; further it ignores sex and age, and many cases have been brought to my notice of young adults of opposite sex sleeping in the same room, under conditions which, while not strictly overcrowded, according to a standard of cubic space, are yet hopelessly wrong from every other point of view. In fact several cases have been reported to me in which the family has been split up, and the father and mother have had to separate on account of insufficient room. In last year s report, I stated that there were 1,102 overcrowded families, the vast majority of whom required local accommodation. The corresponding figures for this year are as follows:- Desiring local accommodation Willing to move to London County Council Estates 1,180 588 295 295 Overcrowded families Other families (not overcrowded) Totals 1,768 590 It will be seen that, although 300 families have been moved during the year, there are, at present, 1,475 families known to us who are living in overcrowded conditions. It appears from these figures that the position is getting worse rather than better. It must be borne in mind, however, that the figures are at best approximate, and probably contain a number of duplicates, and further that the building activities of the Council have led to an increase in the number of applications for local accommoda-tion. While this latter fact does not affect the actual number of overcrowded families in the borough, it probably has increased the number known to us. When a family has been removed, the house from which it went is visited at regular intervals by the Sanitary Inspector to prevent a recurrence of the nuisance. During the year we have been faced with this difficulty. A man in regular work and living in overcrowded conditions is accepted by the London County Council as a tenant on an outlying estate. The premises are regularly visited in the interval,and, on one of his visits, the Sanitary Inspector finds that the family has returned and the premises are again overcrowded. The father states that he has lost his work, fallen in arrears with rent, and has had to leave the estate. He returns to the home of his parents, the only home he has ever known both as a single man and the father of a family. More commonly perhaps he returns to other premises, and crowds his young family into one room. I do not know the immediate solution to this problem, and have left it to the wiser heads of the Public Health Committee. Underground Rooms. —The number of underground rooms in this borough is as follows: — Living only Living and sleeping Sleeping only Total 352 40 309 3 and the number of cases where the whole of the accommodation occupied by a family is underground is 13. Housing Act, 1930. —It has been the practice when extensive work are required under Section 17 and 18 of the Housing Act, 1930, to refer these houses to the Housing Department for action. Forty-one houses have been referred during the year,notices have been served in 13 cases, the work has been completed in 6 cases, and is in course of completion in the remaining 7. Demolition Orders were made in respect of 4 of the houses referred to the Housing Department, one house having been demolished and another closed for demolition. In other cases the owners have completed the work required by negotiation without the service of formal notices. Hereunder will be found particulars of Inspections, Proceedings, etc., for the year 1931 :— Inspection of Dwelling Houses during the Year:— (1) (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts') 9,302 (b) Number of Inspections made for the purpose 32,791 (2) (a) Number of dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Con-solidated Regulations, 1925 5,530 (b) Number of Inspections made for the purpose 5,530 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 403 (4) Number of dwelling-houses (exclusive of those referred to under the preceding subhead) found not 10 be in all respects reasonably fit for human habitation 41 Remedy of Defects during the Year without Service of Formal Notices: — Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their officers 3981 Action under Statutory Powers during the Year:— (A) Proceedings under Sections 17, 18 and 23 of the Housing Act. 1930:- (1) Number of dwelling-houses in respect of which notices were served requiring repairs 13 (2) Number of dwelling-houses which were rendered fit after service of formal notices: — (a) By owners (b) By Local Authority in default of owners Nil (B) Proceedings under Public Health Acts:— (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 5,416 (2) Number of dwelling-houses in which defects were remedied after service of formal notices:- (a) By owners 1,435 (b) By Local Authority in default of owners Nil (C) Proceedings under Sections 19 and 21 of the Housing Act, 1930:- (1) Number of dwelling-houses in respect of which Demolition Orders were made 4 (2) Number of dwelling-houses demolished in pursuance of Demolition Orders 1 (D) Proceedings under section 20 of the Housing Act, 1930:- (1) Number of separate tenements or under-ground rooms in respect of which Closing Orders were made Nil (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit Nil (E) Proceedings under section 3 of the Housing Act, 1925:- (1) Number of dwelling-houses in respect of which notices were served requiring repairs Nil (2) Number of dwelling-houses which were rendered fit after service of formal notices:- (a) By owners Nil (b) By local authority in default of owners Nil (3) Number of dwelling-houses in respect of which Closing Orders became operative in pursuance of declarations by owners of intention to close Nil (F) Proceedings under Sections 11, 14 and 15 of the Housing Act, 1925: — (1) Number of dwelling-houses in respect of which Closing Orders were made 6 (2) Number of dwelling-houses in respect of which Closing Orders were determined, the dwelling-houses having been rendered fit Nil (3) Number of dwelling-houses in respect of which Demolition Orders were made Nil (4) Number of dwelling-houses demolished in pursuance of Demolition Orders Total number of houses in the Borough 18,656 Number of houses occupied by the working classes 18,512 REGISTERED PREMISES— Premises Number on Register at end of 1931 Number of Inspections Number of Prosecutions Milkshops 290 641 - 63 357 - Houses let in lodgings 137 200 - Ice Cream Premises 15 47 - Offensive Trades (including Poultry Slaughter-houses) SMOKE NUISANCES— Number of observations 15 Number of notices 5 Number of complaints 3 Number of summonses Nil UNDERGROUND ROOMS— Number illegally occupied 13 Number closed or illegal occupation discontinued Nil WATER SUPPLY TO TENEMENT HOUSES— Premises supplied 4 Prosecutions Nil SALE OF FOOD— Number of premises used other than ice-cream premises, milk shops and cowsheds 659 Number of inspections 2,959 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. Water Supply.—A very large number of houses inhabited by more than one family have the water supply either on the ground floor or in the yard, and there are many houses without a direct supply from the rising main. Water Closet Accommodation.—Practically every house in the borough has one water-closet, which, of course is, in many cases shared by two or more families Many of the flats have one water-closet to two families. Schools. —The sanitary accommodation in every school in the borough is inspected at least twice a year. In some of the schools the provision is somewhat antiquated and might be improved. Attention has been drawn to these cases. Rats and Mice Destruction Act, 1919. —Complaints with regard to vermin are fairly numerous, but not more than would be expected in a riparian borough, where much of the property is of considerable age. Complaints are always investigated by the District Sanitary Inspectors. Where rat runs are traced to a drain, the latter is always tested and action taken when defects are found. Rat traps are loaned and rat biscuits given out when necessary, but the use of " sticky boards " has been discontinued. The sewers are baited annually during " Rat " Week, 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. — (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 — Number of prosecutions under the Milk and Dairies (Consolidation) Act, 1915 — Number of prosecutions under the Milk and Dairies Order, 1926 3 WORK OF DISTRICT INSPECTORS, 1931. 1 2 3 4 5 9 12 13 14 16 17 18 19 20 21 22 6 7 8 10 11 15 Outworkers' Bi-Annual Inspection Factories & Workshops Specially Inspected Drains Tested Markets Restaurants and Eating Houses Destruction of Food Ice Cream Other Calls and Visits TOTALS Special Inspections Infectious Diseases Fishmongers, Friers and Curers Chimneys watched Offensive Trades House-to-House Underground Conveniences Fruiterers and Greengrocers Food Stores Com plain to Bakehouses Butchers Visits Various Ints. 32 134 - 68 1681 4 39 61 44 77 3 5100 815 1183 397 168 3 111 36 72 170 2 651 796 1101 502 163 11l 9 28 - 40 2427 2 47 61 2 158 17 8 1 5783 69 151 50 972 788 766 327 106 125 6 - 35 101 2508 - 34 234 88 275 147 42 147 724 225; 1 14 5969 781 1781 35 398 151 100 26 48 2160 3 58 14 - 35 70 70 67 97 81 2 5978 3 979 795 971 504 184 149 3 74 42 2423 1 264 38 117 47 63 26 102 64 1 5877 1143 - 9 782 1055 263 156 129 24 48 48 2484 4 22 103 121 127 32 103 64 1 - - 5 5571 966 1221 773 366 121 78 38 21 2728 1 51 29 92 25 — - 25 33 96 53 2 - 5753 993 8078 2757 860 15 FACTORIES, WORKSHOPS, LAUNDRIES, WORKPLACES, AND HOMEWORK. HOMEWORK. NATURE OF WORK Outwork in Unwholesome Premises Section, 108 Outwork in Infected Premises (Sections 109, 110) Outworkers' Lists, Section 107 Lists received from Employers Outworkers re*i .ent in Bermondsey received from other Districts Instances (11) Prosecutions Notices served (12) Instances (14) Notices erved (15) Prosecutions (16) Notices served on Occupiers as to keeping or sending lists (8) Lists (2) Outworkers Prosecutions (13) Resident in Bermondsey Resident in other District (5) Failing to keep lists (9) Failing to send lists (10) Workmen (4) Contactors (6) Workmen (7) Contractors (3) I „ I . I I I Wearing Apparel:—- ! __ I „ I 62 7 7 6 9 1 (1) Making, etc. 25 — 30 53 - - — — - - — — — — — - — — — - (2) Cleansing and washing - — — - Fur pulling 1 — 1 - — — - - - — - - 2 — — 2 1 Umbrellas, etc. 1 5 — 3 — - — - - - — - — 3 Sacks 4 4 2 - - - - - - - - - - - Paper, etc., Boxes, Paper Bags 4 - 2 1 4 - - - - - - - - - - 1 1 1 Bush making - - - 5 - - — — - — - - Chocolates and Sweetmeats 1 - - 1 - - - - - - - - - - - Leather Goods 4 - 6 7 - - - - - - - - - - - Surgical Instruments 2 — - 4 — — - — - - — — — — — 1 Electro-plating 2 - 10 27 - - 1 - - 1 - 1 - - Carding of buttons, etc. - - 4 — — - - - - — — - — — — Total 44 — 53 109 8 69 12 — 11 — 3 — 11 — — (66) FACTORIES WORKSHOPS, LAUNDRIES, WORKPLACES AND HOMEWORK INSPECTION. Premises Number of Written Notices Prosecutions Inspections Factories (including Factory Laundries) 954 - 27 Workshops (including Workshop Laundries) 310 - 18 Workplaces (other than Out workers' Premises) 7 191 - Total 1455 52 - DEFECTS FOUND Number of Prosecutions Number of Defects Particulars Referred to H.M. Inspector Found Remedied Nuisances under the Public Health Acts — Want of Cleanliness 33 33 — — Want of Ventilation 1 1 — — Overcrowding — - — — Want of Drainage of Floors — — - — Other Nuisances 27 27 - — Sanitary Accommodation— Insufficient 6 — 6 — Unsuitable or Defective 18 18 — — Mot separate for Sexes — — - — Offences under the Factory and Workshop Act— I I I I Illegal Occupation of Underground Bakehouse (s. 101) - - - Breach of Special Sanitary Requirements for Bake-houses (ss. 97 to 100) 56 56 — — Other Offences 4 4 — - (67) OTHER MATTERS. Class Matters notified to H.M. Inspectors of Factories— Failure to affix Abstract of the Factory and Workshop Act (s. 133) Action taken in matters re ferred by H.M. Inspectors as remediable under the Public Health Acts, but not under the Factories Act (s. 7) Notified by H.M. Inspectors Reports (of action taken sent to H.M. Inspectors) Other Underground Bakehouses (s. 101) Certificates granted during 1931 In use at end of 1931 Workshop Bakehouses Workshops on the Register (s. 131) at the end of 1931 Total Number of Workshops on Register No. OF BAKEHOUSES IN THE BOROUGH. In Use Not in Use Underground Above ground Above ground 18 38 3 37 of these are Factory Bakehouses. HOUSE, TRADE AND MARKET REFUSE. The following table shows the amount of house, trade and market refuse disposed of during 1931 :— Disposal Loads tons cwts. qrs. House Refuse to Barge 1,398 2,948 18 1 „ „ „ Destructor 10,983 22,099 7 Trade Refuse „ Barge 1,514 1, 614 1 - 2 „ „ „ Destructor 1,862 2,130 14 Street Markets Refuse to Barge 951 1,179 9 - - „ „ „ Destructor 890 1,346 12 3 17,598 2 2 Totals 31,319 OFFENSIVE TRADES. The offensive trades on the Register are as follows: Fellfmongers 3 Fatmelters 2 Glue and size makers 3 Dresser of Fur Skins 7 MORTUARY Particulars of bodies removed to the Mortuary during the year are, as follows:— Total number of infectious bodies removed 12 Total number of bodies removed 75 STREET MARKETS. The market scheme continues to work smoothly and satis-factorily. Number of Licences in operation 624 Applications on waiting list 17 Income £2,637 12s. Od. There have been seven 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 1931: — Drains Tested 751 Intimation Notices served 12 Visits to Underground Conveniences 446 Other Visits 3,633 IX.—FOOD CONTROL. The information contained in this section of the Report is concerned mainly with the work done by the Wharves Inspectors and the Food and Drugs Inspector. One of the Wharves In-spectors is always present when a ship or barge is unloading a cargo of food. This often entails their presence on the wharves early in the morning or late at night, since the time of berthing varies with the tide. At one wharf bi-weekly boats regularly discharge cargo, generally at midnight, one of the Inspectors always being present. I pointed out in my last report that there seemed to have been a considerable increase in the amount of food coming into the Wharves in this borough and that this increase had been particularly noted with regard to bacon. I have no means of ascertaining even approximately the total amount of food which comes into the borough by water, but the general impression amongst the Inspectors engaged in the work is that the total volume of imported food is increasing year by year. On a number of occasions during the year as many as 14,000 to 16,000 bales of uncertified bacon (4 sides in a bale) have been delivered to the Wharves in a single day. On such occasions I have arranged for one of the district Inspectors to help in the work of inspection. On March 7th there was a serious fire at Butler's Wharf and much damage was done. As a large amount of food was stored at this Wharf a general " Stop " Notice was immediately placed on all wet and damaged foodstuffs. The damaged foodstuffs were disposed of in the following manner : — tons. cwts. qrs. Ibs. Disposed of for purposes other than human food 3 10 0 0 Destroyed 88 17 3 6 Removed for sorting under Supervision of Sanitary Authority 379 7 1 16 - 1 0 17 Exported 1 22 472 12 The samples taken on the Wharves under the Imported Food Regulations have numbered 41 consisting of the following:— Baking Powder 1 Butter 21 Butter Mixture 2 Canned Beef 2 Cheese 1 Egg Albumen 1 Fruit Pulp 1 Fruit Sweets 2 Gherkins 1 *Infusorial Earth 1 Lemon Juice 1 Oleine 1 Salt 1 Soya Bean Oil 2 Wafers 1 Yeast 2 41 (* An unknown mixture sampled to ascertain composition.) All the samples were genuine and the butter samples were also examined for preservatives with negative results; the water content in the latter was remarkably low being 11.35 per cent, against a standard of 16 per cent. This butter was all of Russian origin. With regard to the two samples of butter mixture mentioned above, this was found to be an illegal mixture and the parcels were consequently refused admission. 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. Ibs. Fresh Meat. - 2 0 12 Fresh Fish. - 2 2 16 Fresh Fruit 10 3 - 26 Bacon - 1 1 2 - Poultry 1 2 6 Vegetables. 4 2 - 5 Total 0 11 1 3 WORK OF THE WHARF AND FOOD INSPECTORS, 1931. 2 3 4 5 6 7 8 9 10 11 1 Visits Food Factories Number of Samples taken Jam Butter and Margarine Other Fish Curers Food Stores Milksellers Restaurants Destruction of Food Nuisances Found Intimations Served Various Food Wharves and Depots Milk (Special Designation) Order Imported Food Regulations Food and Drugs (72) Mr. Scott 5 56 8 2434 19 54 302 - - 201 - - 4 - - Mr. Hoskins 10 11 109 960 1767 248 16 2 63 - 3 - - - - 16 181 108 1 1700 1 Mr. Francksen 241 45 - - 7 - 34 - 1 80 Mr. Merryman - 2 - - - - - - 641 - - 2 233 1508 5 41 80 Totals 172 17 322 406 24 1307 5901 641 - 630 19 1508 MILK PREMISES. MILK AND DAIRIES (AMENDMENT) ACT, 1922. Fifty milksellers were registered under the above Act daring 1931, and 40 names were removed from the Register,making a total of 290 milksellers on the Register at the end of the year under report. MILK (SPECIAL DESIGNATIONS) ORDER, 1923. During the year under report, the following Licences were granted:— Dealers' Licences:— To bottle and sell Grade " A " (Tuberculin Tested) Milk 11 To sell Grade "A " (Tuberculin Tested) Milk 27 To sell "Pasteurised" Milk 5 Supplementary Licences:— 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. MILK SAMPLING. A total of 513 milk samples has been taken during the year. This is made up as follows: — " For chemical (i.e., Fat and non-Fatty Solids) Examination." Liquid milk undesignated 489 Condensed milk 1 Condensed full cream milk 2 Condensed machine skimmed milk 3 Evaporated milk 1 Separated milk 1 Skimmed milk 1 Sterilised milk 11 Grade 'A ' (T.T.) milk .. 1 Pasteurised milk 3 513 " For bacteriological examination." Grade ' A ' (T.T.) milk 69 Pasteurised milk 11 Liquid milk undesignated 1 For tubercle bacilli 9 90 The milk supply of every school in the borough is sampled at least once a quarter, bacteriological and chemical examinations being made alternately. These samples are included in the numbers, given above and all were found to be genuine. In addition samples have also been taken from St. Olave's Hospital and South Wharf Small-Pox Receiving Station. With regard to the designated milks mentioned above, 14 samples were found to be below standard. Of these only one sample showed a bacterial count above standard, the defect in the other cases being the presence of B.Coli. In every case where a sample has failed to reach the standard prescribed, I have made personal enquiries of the bottler and if necessary the actual farmer has been approached. In one or two cases the source of supply has been changed as a result of these enquiries. As will be seen from the figures given on page 73, 57 licences were granted during the year under the Milk (Special Designations) Order, 1923. The premises of these licensees are kept under continuous observation and on the whole the standard maintained is high. In one case the results of a sample showed so small a bacterial count that it appeared to me that the bacteriological technique must be at fault. After a somewhat prolonged inquiry which included a visit to the bottling premises by myself and our bacteriologist and an interview with the bacteriologist of the firm, we could find no fault with the process nor with our own bacteriological technique. Everything that we can do is being done in the borough to encourage the consumption of tuberculin tested milk, and on the whole our milksellers, par-ticularly the bottlers of designated milk, make real efforts to comply with our requirements. A great deal of the milk sold in the borough is pasteurised, but it is not of course all sold under that designation. There has been much controversy in the press on the question of the pasteurisation of all milk, and I have been asked a variety of questions on this subject more especially by mothers attending Maternity and Child Welfare centres with their children. While I fully appreciate the possible value of pasteurisation as a safeguard, its disadvantages are also apparent, and I cannot regard pasteurisation of the total milk supply as the ideal at which to aim. On the other hand it is true that the standards and designations prescribed under the Milk (Special Designations) Order, 1923, leave a good deal to be desired, and I have little doubt personally that the solution will be found ultimately in a compromise, whereby all milk will be required to comply with standards approximately those obtaining for Grade ' A' (Tuberculin Tested) Milk at present, or be pasteur-ised. Price is a factor of the utmost importance, and while the price at which Grade ' A ' (T.T.) Milk is sold is one which our people can pay, that of Certified Milk is prohibitive and renders this grade unsaleable in this borough. There appears to be a steadily increasing sale for sterilised milk in the borough which is, I think,to be regretted, since in my opinion this product is quite unfit for infants and young children. (76) FOOD AND DRUGS. Articles submitted for Analysis Total Samples Taken Number Genuine Number Adulterated Percentages of Articles Adulterated Acid Boric Crystals 1 1 - - Acid Tartaric 4 4 - - Almonds, Ground 4 4 - - Antelope 1 1 - - Apricots 4 4 - - Arrowroot 1 1 - - Bacon 1 1 - - Barley, Pearl 15 15 - - Barley, Pot 1 1 - - Beef, Corned 1 1 - - Beef, Pressed 1 1 - - Brawn 7 7 - - Brawn, Pork 2 2 - - Brawn Veal 2 2 - - Brimstone and Treacle 1 - - 1 Borax Refined 1 1 - - Borax Purified 2 2 - - Butter 233 232 1 0.4 Cake, Currant 1 1 - - Cake, Dessert 1 1 - - Cake, Seed 1 1 - - Cake, Genoa 1 - 1 - Cheese 11 11 - - Cheese, Cheddar 1 1 - - Cheese, Full Cream Pasteurised 1 1 - - Cherries, Glace 1 1 - - Cider 1 1 - - 7 - Cocoa - 7 Cocoanut, Desiccated 1 1 - - - Coffee 9 9 - Coffee, Creamia 1 1 - - Coffee Essence 1 1 - - Cold Cream 1 1 - - Collared Head 1 1 - - Cough Drops 1 1 - - Cream 6 6 - - Cream of Tartar 2 2 - - Cream and Raspberry Sandwich 1 1 - - Cyder 1 1 - - 76 Dripping 76 - - Eggs, Liquid 1 1 - - Fat 1 1 - 7 Fat, Baking 7 - - 1 Fat, Frying 1 - - Fat, White 1 1 - - Fat,' Compound White 1 1 - - Fish Paste 11 11 - - Flour 1 1 - - Flour, Self-raising 9 9 - - Friar's Balsam 1 1 - - Gherkins 1 1 - - 2 Ginger, Ground 2 - - 1 Golco Baking Fat 1 - - 2 Honey 2 - - 1 Jam, Apricot 1 - - Jam, Blackberry and Apple - 1 1 - (77) FOOD AND DRUGS—continued. Total Samples Taken Number Genuine Number Adulterated Percentages of Articles Adulterated Articles submitted for for Analysis Jam, Blackcurrant 5 5 - - Jam, Plum 1 1 - - Jam, Raspberry 7 6 1 14·3 Jam, Raspberry Flavour 1 1 - - Jam, Raspberry and Red Currant 1 1 - _ Jam, Strawberry 4 4 - - Kup Kakes 1 1 - - Lard 8 8 - - Lemon Curd 1 - 1 - Lemonade 1 1 - - Lemon Squash 2 2 - - Lentils 2 2 - - Lanseed, Crushed 2 2 - - Loganberries, Dessert (Informal) 1 1 - - Mace, Ground 1 1 - - Malted Milk Lunch Tablets 1 1 - - Margarine 95 95 - - Marmalade 2 2 - - Marmalade Orange 1 1 - - Milk 489 480 9 1·8 Milk, Condensed 1 1 - - Milk, Condensed, Full Cream 2 2 - - Milk, Condensed, Machine-Skimmed 3 3 - - Milk, Evaporated 1 1 - - Milk, Grade "A " (T.T.) 1 1 - — Milk, Pasteurised 3 3 - - Milk, Separated 1 1 - _ Milk, Skimmed 1 1 - - Milk, Sterilised 11 11 - - Mincemeat 3 3 - - Mustard 7 7 - - Nitre, Sweet Spirit of 4 2 2 50·0 Oil, Camphorated 4 4 - - Oil, Castor 1 1 - - Oil, Cod Liver 2 2 - - Oil, Eucalyptus 1 1 - - Oil, Nut 1 1 - - Oil, Olive 3 3 - - Oil, Soya Bean 1 1 - - Ointment, Boracic 2 2 - - Ointment, Zinc 3 3 - - Orange Squash 1 1 - - Paraffin Liquid 2 2 - - Parrish's Chemical Food 1 1 - - Paste, Fish 11 11 - - Paste, Lobster 1 1 - - Paste, Turkey and Tongue 1 1 - - Pears 1 1 - - Peas, Italian 1 1 - - Peel, Citron 1 1 - - Pepper 33 - 33 - Piccalilli 2 2 - - Pickles 2 2 - - Powder, Baking 3 3 - - Powder, Compound Liquorice 2 2 - - Powder, Custard 2 2 - - Powder, Egg Substitute 2 2 - - (78) FOOD AND DRUQS—continued Total Samples Taken Percentages of Articles Adulterated Articles submitted for Analysis Number Genuine Number Adulterated Powder, Gregory 1 1 - - Powder, Lemon 1 1 - - Powder, Lemonade 1 1 - - Powder, Milk 1 1 - - Powder, Seidlitz 1 1 - - Quinine, Ammoniated Tincture of 4 4 - - Quinine, Rhubard Compound . - - Tincture of 1 1 - - Raisins 2 2 - - Raisins (Stoned) 1 1 - - Rhubarb, Compound Tincture of 2 2 - - Rice 7 7 - - Rice, Ground 2 2 - - Roll, Swiss 1 1 - - Salts, Glauber 1 1 - - Sardines (Informal) 1 1 - - Sarsaparilla 1 1 - - Sauce 2 2 - - Sauce, Worcestershire 2 2 - - Sausage 3 3 - - Sausage, Breakfast 25 24 1 4·0 Sausage, Liver 3 3 - - Sausage, Luncheon 3 3 - - - Sausage, Luncheon Pork 1 1 - Sausage, Smoked 1 1 - - Sausages, Beef 42 42 - - Sausages, Parisian 2 2 - - Sausages, Pork 13 13 - - Semolina 3 3 - - Sherry 1 1 - - Spice, Mixed 1 1 - - Sponge Cakes 6 6 - - Sponge Fingers 2 2 - - Sponge Sandwich 1 1 - - Suet, Shredded 1 1 - - - Suet, Beef 1 1 - Sugar, Castor 1 1 - - Sugar, Demeraia 3 3 - - Sugar, Icing 3 - Sugar, Moist 1 1 - - Sugar, Pudding 1 1 - - Sultanas 5 5 - - Tablets, Aspirin 1 1 - - Tablets, Aspro 1 1 - - 1 Tartaric Acid 1 - - Tapioca 1 1 - - Tea 6 6 - - Tea Dust 4 4 - - Thymol, Compound Glycerine of 1 1 - - Tomato Ketchup 1 1 - - Tomatoes, Peeled 1 1 - - 4·3 Vinegar 92 88 4 Vinegar, Malt 38 36 2 5.3 Veal and Ham 2 1 - - Wine, Barley 1 1 - - Wine, Ginger 2 2 - - Wine, Ipecacuanha 1 1 - - Wine, Orange Quinine 1 1 - - 20 1·3 Total 1508 1488 (79) PROSECUTIONS IN CONNECTION WITH SAMPLES TAKEN DURING 1931. Adulteration or Infringement Remarks No. Sample 341 Margarine wrapper not marked. Dismissed on payment of 17s. 6d. costs. Margarine 427 Milk Dismissed on payment of 175.6 d. costs—first offence Deficient in milk fat, 16.0 per cent. Fined £5. Costs £2 2s. 739 Milk Deficient in milk fat, 26.0 per cent. 740 Deficient in milk fat, 29.7 per cent. Taken in with above Summons. Milk 801 Vinegar Deficient in acetic acid, 15.0 per cent. Dismissed on payment of 15s. Od. costs. 989 Sweet Spirit of Nitre Fined £10. Costs £10 10s. Deficient in Ethyl Nitrite to the extent of at least 43.5 per cent. Breakfast Sausage Containing Sulphurdioxide 4.0325 (equivalent to 325.0 parts per million). 90 Dismissed with caution. Summons against Wholesaler under Public Health (preservatives, etc., in food) Regulations dismissed with caution and ordered to pay 245. 6d. costs. Vinegar 225 Deficient in acetic acid, 8.5 per cent. Dismissed with caution, and ordered to pay 17s. 6d. costs. 471 Raspberry Jam Deficient in Raspberry fruit to the extent of 42.0 per cent. Dismissed. Warranty proved. Summons against wholesaler for false warranty. Fined £10. Costs £10 10s. 611 Malt Vinegar Deficient in acetic acid 90.0 per cent. Dismissed on payment of 17s 6d. costs. SUMMARY. £ d. s. Fines 25 0 0 Costs 28 11 6 £53 11 6 PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1925. Articles Quantity Unsound Disposed of for Purposes other than Human Food Removed for Sorting under S.A. Destroyed Weight Quantity Weight Quantity Weight Quantity tons cwt qr lbs tons cwt qr lbs tons lbs CWt qr Almond Substitute (Fire damaged) 6 boxes - - - - - - - 1 2 0 - - - - 8 tins Anchovies, Tinned - 1 3 4 - - - - - - - - - - Apples 264 boxes 5 7 0 0 - - - - - - - - - - Apples, Tinned 18 cases and 4 tins - 10 0 0 250 cases 10 0 3 16 - - - - - - Apricots, Tinned 11 0 0 - - 22 cases - - - - - - - - 8 - Apricot Pulp - 1 cask 31 cases and Various parcels 8 16 0 - - - - - - - - 2 bales Bacon 04 sides 95 gammons 3 fore-ends & 6 pieces 1 17 1 22 4 1 22 - - - - - - 1 10 3 2 Barley (Damaged) - - - - - - - - - - - 3 1 68 cases and 931 tins 17 4 - Beef, Corned - - - - - - - - - Beef, Bungs - - - - - 12 casks and 1 barrel 3 4 0 0 - - - - - Blackcurrant Pulp - 12 cases - 0 0 - 15 - - - - - - - - Brawn, Tinned - - - - - 5 cases and 203 tins - 10 0 27 - - - - - Butter 2 casks and 1 box - 2 2 0 Trimmings - 4 - - - - - - - PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1925. continued Quantity Unsound J Removed for Sorting under S.A. Disposed of for Purposes other than Human Food Destroyed Exported Articles Quantity Weight Quantity Weight Quantity Weight Quantity Weight tons cwt qr lbs tons CWt qr lbs tons cwt qr lbs tons cwt qr lbs Butter Mixture 100 casks - - - - 1 2 - 5 - - - - - - - - - - - Butter Beans(Fire damaged) - - 1 bag 1 2 0 - - - - - - - - - - - - - - Cake - - - 11 cases 11 0 0 - - - - - - - - - - - - - Canned Goods (Various) - - 104 17 0 10 - - - - - - - - - — - - - - Cardamons (Fire damaged) - - - - 5 cases 0 - - 2 2 - - - - - - - - - - Casings, Horse - 70 sets - 1 2 0 - - - - - - - - - - - - - - Casings, Salted - - - 1 cask - 3 2 0 - - - - - 3 casks - 12 0 0 - - - - - 97 bags 9 2 0 - - Cereals (Fire damaged) 7 - - - - - - - - - - - Various packages 4 9 1 11 8 crates 8 1 3 - Gheese - - - - - - - - - - - Cherries - 1 - - 346 baskets 11 2 14 - - - - - - - - - - - 1 basket - 1 0 - - - Chickens - - - - - - - - - - - - Chicken (Canned) - - 137 tins - 4 2 11 - - 1 case - 2- 7 - - - - - - - Cinnamon Quills (Fire damaged) 0 - - - - 5O bales 1 5 0 - - - - - - - - - - - Cloves (Fire damaged) - - 11 1 0 - - - - - - - - 6 bags and 9 bales - - - - - - Cocoa (Fire damaged) 0 - - - - - - 72 bags 0 3 26 - - - - - - - - - Cocoa Beans (Fire damaged) - - - - - - - - - - - - - - - 23 bags - 17 1 0 Cocoa, Desiccated (Fire damaged) 139 cases - - 0 - - 6 19 0 - - - - - - - - - - - Cocoanuts - - - - - 757 bags 34 18 5 0 _ - - - - - - - - - Cocoanuts (Fire damaged) - - - -- 218 cases 10 5 1 0 - - - - - - - - - - - Coffee (Damaged) - - 26 bags 2 0 0 0 - - - - - - - - - - - - - Cornflour - - - 3 bags - 3 0 0 - - - - - - - - - - - - 30 tins 15 Crab, Tinned - - 29 cases and 66 tins - 12 2 25 - - - - - - - - - - - PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1925—continued, Quantity Unsound Disposed of for Purposes other than Human Food Destroyed Removed for Sorting under S.A. Exported Articles Weight Quantity Weight Quantity Weight Quantity Quantity Weight tons cwt qr lbs tons cwt qr lbs tons cwt lbs tone cwt lbs qr qr Cream, Bottled 140 bottle 3 0 2 - - - - - - - - - - - - - - - - Cream, Tinned 2 3 11 - 9 cases and 491 tins - - - - - - - - - - - - - - - Dates (Fire damaged) 200 boxes 12 10 0 0 - - - - - - - - - - - - - - - Eggs 113 0 2 0 - - - - 2149 tins - - - - - - - - - - - Eggs (Frozen whole) 14711 tins 280 0 0 0 107 tins 1 6 0 0 - - - - - - - - - - Fat, Cooking 31 tierces 8 0 0 0 - - - - - - - - - - - - - - - Figs 70 bags 17 0 11 0 18 - - - 2 50 boxes - - - - - - - - - Figs (Fire damaged) 9 cases and 3 tins - 2 1 2 0 - - - - - - - - - - - - - - Fish, Fresh 13 cases and 2 trunks 13 0 0 - - - - - - - - - - - - - - - - Flour (Water damaged) 103 bags 1 14 3 0 - - - - - - - - - - - - - - - Gherkins 46 casks 11 8 0 0 - - - - - - - - - - - - - - - Ginger (Fire damaged) - - - 1 barrel and 109 bags 5 11 0 0 - - - - - - - - - - - - Ginger Root - 11 bags 13 2 0 - - - - - - - - - - - - - - - Gooseberries, Tinned 18 1 2 12 - - - - - - - - 450 cases - - - - - - - Hams, Salted - 15 hams - 1 3 18 35 cases 1 5 0 0 - - - - - - - - - Hams, Tinned 22 cases - 15 3 23 110 tins - 14 0 11 13 cases 13 2 0 5 cases 3 3 0 - - Herbs, Various (Fire damaged) 209 bales and 26 bags - - - - 5 17 2 0 - - - - - - - - - - - Lard 80 cases 2 0 0 0 - - - - - - - - - - - - - - - Lemons 1 case - 1 0 0 - - - - - Lemon Juice (Fire damaged) - - - - - - - - - - 155 half pipes - 65 5 1 12 - - - - - - - - - - - - - - PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1925—continued Quantity Unsound Articles Disposed of for Purposes other than Human Food Destroyed Removed for Sorting under S.A. Quantity Weight Quantity Weight Quantity Weight tons cwt qr lbs qr lbs qr lbs tons cwt tons cwt 1 puncheon 8 3 0 Lime Juice (Fire damaged) - - - - - - - - - - - 1509 boxes 22 9 3 0 Macaroni (Fire damaged) - - - - - - - - - - 1 1 14 Maize (Damaged) 2 - - - - - - - - - - - 425 cases 5 6 0 0 Margarine (Fire damaged) - - - - - - - - - - 1 case 14 Mayonnaise - - - - - - - - - - - - - 2702 tins 17 1 14 60 cases 1 5 2 24 Milk, Condensed - - - - - - 0 16 Milk, Tinned Evaporated 574 tins 5 - - - - - - - - - - - 12 trays Mincemeat 3- 2 6 - - - - - - - - - - - Nutmegs (Fire damaged) 83 bags and 48 boxes 6 0 0 0 - - - - - - - - - - 1 1 0 Oats (Fire damaged) 1 bag - - - - - - - - - - - 731 bags 32 16 0 0 Onions - - - - - - - - - - 0 0 Oranges 8 cases 8 - - - - - - - - - - - 11 cases 11 0 0 Oranges, Bitter - - - - - - - - - - - Orange Juice (Fire damaged) 39 half pipes 17 6 2 22 - - - - - - - - - - 1 cask 0 Ox Kidneys 5 0 - - - - - - - - - - - - 34 tins 1 0 11 Ox Tongue, Tinned - - - - - - - - - - 8 1 4 Pears 23 cases - - - - - - - - - - - 2 2 0 Peas, Green - - - - - - - - - - - - - 2 0 0 Peanuts (Fire damaged 2 bags - - - - - - - - - - 869 bags 84 15 0 0 - - - - - Pepper (Fire damaged) - - - - - 2 cases 4 0 Pigs, Fresh 0 - - - - - - - - - - - Pig Feet, Salted - - - - - - - - - - - - - - - 165 16 Pigs Rinds 15 tierces 104 barrels & 898 casks 0 0 - - - - - - - - - - 73 cases and 160 tins 2 10 2 24 Pines, Cubes and Slices - - - - - - - - - - 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. Weight Quantity Weight Quantity Weight Quantity tons cwt tons cwt qr lbs tons cwt qr lbs qr lbs Pineapples, Tinned 116 tins 1 2 2 - - - - - - - - - - - Plum Pulp 33 cases and 2 tins 1 5 3 12 - - - - - - - - - - Plums, Tinned 16 12 388 cases and 34 tins 10 1 200 cases 8 0 2 24 - - - - - Potatoes 274 bags 13 14 0 0 315 bags 15 15 0 0 3477 bags 173 17 0 0 Potatoes (Fire damaged) 0 0 2518 bags 70 bags 3 10 103 bags 5 3 0 0 125 18 0 0 Poultry 8 cases 3 14 - - - - - - - - - - - - Prunes (Fire damaged) 50 boxes 11 0 18 - - - - - - - - - - - Raisins 2 19 - 3 cases - - - - - - - - - - - Raspberries, Tinned 20 tins 1 12 - - - - - - - - - - - - Rice, Sweepings 12 18 0 25 - - - - - - - - - - - Salmon, Tinned 177 cases and 155 tins 4 0 6 - - - - - 5 - - - - - Sheep 3 carcases & 2 1 19 - - - - - - - - - - - 8 split sides Sauerkraut 1 cask 0 0 4 - - - - - - - - - - - Strawberries 704 boxes and 5 trays 2 2 1 19 - - - - - - - - - - Sultanas 200 boxes 2 4 2 16 - - - - - - - - - - Sultanas (Fire damaged) 12 bags and 9 cases 8 1 0 - - - - - - - - - - - Sugar (Fire damaged) 30 0 0 - - - - - - - - 300 bags 0 - - 180 11 1 8 Tallow, Unrefined 497 tierces, 48 pipes, 22 barrels,l86 casks & 1 case - - - - - - - - - - PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1925—continued Articles Quantity Unsound Destroyed Removed for Sorting under S. A. Disposed of for purposes other than Human Food Quantity Weight Quantity Weight Quantity Weight tons cwt qr lbs tons cwt qr lbs nil L l tons cwt qr lbs 1 Trotter Oil 5 10 0 - - - - - - 22 barrels - - - - 3 chests 5 2 0 Tea - - - - - - - - - - - 642 chests 43 4 3 0 Tea (Fire damaged) - - - - - - - - - - Tea Sweepings 47 14 1 12 - - - - - - - - - - - Tomato Puree 45 cases 10 2 0 27 - - - - - - - - - - & 2,122 tins - Tongues, Salted - - - - - - - - - - - - - - Tongue, Tinned 106 tins 3 3 15 - - - - - - - - - - - 43 bags 1 12 1 0 Turmeric (Fire damaged) - - - - - - - - - - 7 1 14 Veal, Jellied 136 tins - - - - - - - - - - - 4 0 0 4 cases Walnuts (Fire damaged) - - - - - - - - - - - 1 4 Wheat, damaged 141 14 - - - - - - - - - - - 25 barrels 12 2 0 Yeast (Fire damaged) - - - - - - - - - - - X.—HEALTH SERVICES. MATERNITY AND CHILD WELFARE CENTRES. 110 Grange Road. Monday, 2.0 p.m.-4.0 p.m. Tuesday, 9.45 a.m. to 12 noon Wednesday, 9.45 a.m.-12 noon Thursday, 2.0 p.m.-4.0 p.m. Ante-natal Clinics Tuesday, 4.30 p.m.-6.30 p.m. Wednesday, 2.0 p.m.-4.0 p.m. Sewing Class Friday, 1.45 p.m.-4.0 p.m. 98 Rotherhithe New Road. Tuesday, 9.45 a.m.-12 noon Wednesday, 2.0 p.m.-4.0 p.m. Friday, 2.0 p.m.-4.0 p.m. Ante-natal Clinics Thursday, 2.0 p.m.-4.0 p.m. and 5.30 p.m.-7.30 p.m. Sewing Class Monday, 1.45 p.m.-4.0 p.m. Time and Talents, 225 Abbey Street. Monday, 2.0 p.m.-4.0 p.m. Thursday, 9.45 a.m.-12 noon Roseberry Street. Monday, 2.0 p.m.-4.0 p.m. Trinity Road. Thursday, 2.0 p.m.-4.0 p.m. Princess Club, Jamaica Road. Monday, 2.0 p.m.-4.0 p.m. Tuesday, 9.45 a.m.-12 noon Friday, 2.0 p.m.-4.0 p.m. Ante-natal Clinic Thursday, 10.0 a.m.-12 noon Sewing Classes Tuesday and Wednesday, 2.0 p.m.-4.0 p.m. Alice Barlow House, Fulford Street. Thursday, 2.0 p.m.-4.0 p.m. Friday, 2.0 p.m.-4.0 p.m. Ante-natal Clinic First Wednesday in each month, 10.0 a.m.-12 noon, Sewing Class Wednesday, 2.0 p.m.-4.0 p.m. St. George's Hall, Old Kent Road. Tuesday 2.0 p.m.-4.0 p.m. Sewing Class Thursday, 2.0 p.m.-4.0 p.m. Salomons Centre, Newcomen Street. Thursday 10.0 a.m.-12 noon and 2.0 p.m.-4.0 p.m. Friday 2.0 p.m.-4.0 p.m. Ante-natal Clinics: — Monday, 10.0 a.m.-12 noon. Tuesday, 2.0 p.m.-4.0 p.m. Wednesday, 10.0 a.m.-12 noon. Friday, 10.0 a.m.-12 noon PUERPERAL FEVER CONSULTANTS. Mr. Frank Cook, F.R.C.S., 41 Harley Street, W.l. (Telephone: Langham 3816); and 51 South Street, W.l. (Telephone: Mayfair 4380). Mr. A. J. McNair, F.R.C.S., 10 Queen Anne Street, W.l. (Telephone: Langham 2861.) Applications for the services of a Consultant should be made to the Medical Officer of Health. OBSTETRIC CONSULTANTS. Mr. A. J. McNair, F.R.C.S., 10 Queen Anne Street, W.l. (Telephone: Langham 2861.) Mr. G. F. Gibberd 14 St. Thomas's Street, S.E.I. (Telephone: Hop 6618); and 44 Queen Anne Street, W.l. (Telephone: Welbeck 1608.) Applications for the services of a Consultant should be made to the Medical Officer of Health. DAY NURSERIES. Newcomen Day Nursery, 66-67 Snowsstields. Monday to Friday (inclusive), 7.0 a.m.-7.0 p.m. Saturday, 7.0 a.m.-1.0 p.m. "Alice Barlow " Social Welfare Centre, 14 Fulford Street. Monday to Friday (inclusive), 7.30 a.m.-6.30 p.m. Saturday, 7.30 a.m.-12.30 p.m. FAIRBY GRANGE CONVALESCENT HOME, Hartley, near Longfield, Kent. For mothers, and children under 5 only. Application Forms and full particulars can be obtained at any of the Maternity and Child Welfare Centres. DENTAL TREATMENT CENTRES. 110 Grange Road. Monday to Friday (inclusive), 10.0 a.m. to 8.0 p.m. 98 Rotherhithe New Road. Monday, Thursday and Friday, 2.0 p.m.-5.0 p.m Tuesday and Wednesday, 2.0 p.m.-8.0 p.m. From 5.0 p.m. to 8.0 p.m. the Centres are open only for patients who cannot attend during the day. TUBERCULOSIS DISPENSARY, 108 Grange Road. Patients are seen by appointment only. Evening sessions are held for patients at work. LIGHT TREATMENT CENTRE, The Solarium, 108 Grange Road. Monday to Thursday (inclusive), 9.30 a.m.-5.30 p.m. Friday, 9.30 a.m.-1 p.m. Monday and Thursday, 6.30 p.m.-8.0 p.m. Patients are seen by appointment only, and only patients who cannot attend during the day are seen at the evening sessions. SCHICK TEST CLINIC, Municipal Offices, Spa Road. Monday and Thursday at 9.30 a.m. DIPHTHERIA "CONTACTS" CLINIC, Municipal Offices, Spa Road. Monday and Thursday at 9.30 a.m. For school-children only. DIPHTHERIA "CARRIER" CLINIC, Guy's Hospital. Wednesday at 2.30 p.m. For school-children only by appointment. L.C.C. SCHOOL TREATMENT CENTRES. Bermondsey School Treatment Centre, Bermondsey Settlement, Farncombe Street. Minor Ailments Monday to Friday (inclusive), 9.30 a.m.- 1.0 p.m. and 3.0 p.m.-6.0 p.m. Saturday, 9.30 a.m.-12 noon. Dental Monday to Friday (inclusive), 9.0 a.m.- 4.30 p.m. Bermondsey Medical Mission Hospital, 44 Grange Read. Minor Ailments .. Monday to Friday (inclusive), 9.30 a.m.- 1.0 p.m. and 3.0 p.m.-6.0 p.m. Saturday, 9.30-12 noon. Dockhead School Treatment Centre, George Row. Minor Ailments Monday to Friday (inclusive), 9.30 a.m.- 1.0 p.m. and 3.0 p.m.-6.0 p.m. Rotherhithe School Treatment Centre, Lady Gomm Dispensary, Hawkstone Road. Minor Ailments Monday to Friday (inclusive), 9.30 a.m. 1.0 p.m. and 3.0 p.m.-6.0 p.m. Saturday, 9.30 a.m.-12 noon. 163 Abbeyfield Road. Ear, Nose and Throat, Dental Monday to Friday (inclusive), 9.0 a.m.-4.30 p.m. Trinity School Treatment Centre, Redriff Lane. Minor Ailments Monday to Friday (inclusive), 9.30 a.m.- 12 noon. INVALID CHILDREN'S AID ASSOCIATION (Bermondsey Branch) Municipal Offices, Spa Road. Office hours Monday to Friday (inclusive), 9.30a.m.-5.30 p.m Saturday, 9.30 a.m.-12.30 p.m. Tuesday, 5.30 p.m.-7.30 p.m. (by appointment only). NURSING ASSOCIATIONS. St. Olave's District Nursing Association, 13 Cherry Garden Street. Rotherhithe Queen's District Nursing Association, 149 Lower Road. FOOT CLINIC, 98 Rotherhithe New Road. Tuesday, 2.0 p.m.—4.30 p.m. (by appointment only). Monday, Wednesday, Thursday and Friday, 2.0 p.m. —4.30 p.m. Monday, Tuesday, Wednesday and Thursday, 5.30 p.m. 7.30 p.m. Only patients who cannot attend during the day are seen at the evening sessions. VENEREAL DISEASE CLINIC, Guy's Hospital. Monday to Saturday (inclusive), 9.0 a.m. to 8.0 p.m. Bank holidays, 10.0 a.m.-12 noon. PUBLIC VACCINATOR. Dr. V. A. Jaynes, 157 Jamaica Road. Monday to Friday (inclusive), 9.15 a.m.-11.0 a.m. AMBULANCE FACILITIES. Infectious Cases. L.C.C. (Special Hospitals) Dept. (Telephone—City 7200). At any hour of day or night. Non-Infectious Cases. L.C.C. (Special Hospitals) Dept. (Telephone—City 7200). At any hour of day or night. Minimum fee, 10s. Accident Cases. L.C.C. (Accident) Service. (Ask Telephone Operator for "Ambulance.") At any hour of day or night. Maternity Cases. L.C.C. (Special Hospitals) Dept. (Telephone—City 7200.) Urgent Cases At any hour of day or night on application by a doctor or certified midwife. Non-urgent Cases Between 11.0 p.m. and 8.0 a.m. —on application by a doctor or certified midwife, or on production of Letter of Admission to Hospital and L.C.C. Ambulance Card. Between 8.0 a.m. and 11.0 p.m.—by payment (minimum fee 10s.), or by application to Medical Officer of Health. Cases approved by Medical Officer of Health will be conveyed to Hospital free of charge.