C . dupe . BER 45 Borough of Bermondsey REPORT ON THE SANITARY CONDITION OF THE BOROUGH OF BERMONDSEY For the Year 1932 BY D. M. CONNAN, M.B., B.S., D.P.H., Medical Officer of Health. BER 45 Borough of Bermondsey REPORT ON THE SANITARY CONDITION OF THE BOROUGH OF BERMONDSEY For the Year 1932 BY D. M. CONNAN, M.B., B.S., D.P.H., Medical Officer of Health. TABLE OF CONTENTS. PUBLIC HEALTH DEPARTMENT— PAGE Public Health Committee 4 Maternity and Child Welfare Committee 4 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 17 Small Pox 18 Measles 18 Ophthalmia Neonatorum 18 Puerperal Fever and Pyrexia 18 Disinfection 19 Cleansing Station 19 Shelter 20 Bacteriological Laboratory 20 Food Poisoning 21 Foot Clinic 21 Nursing 22 Cases Notified in 1932 23 Cases Notified for last ten years 24 TUBERCULOSIS— New Cases and Deaths 25 Period between Notifications and Deaths 25 Nursing and Extra Nourishment 28 Shelters 29 Lady Almoner 29 PAGE Public Health (Prevention of Tuberculosis) Regulations, 1925 30 Work of the Tuberculosis Dispensary 31 Summary of Notifications 32 Cases on the Register 33 LIGHT TREATMENT— Work done in the Solarium 34 Leysin Patients 36 MATERNITY AND CHILD WELFARE— Fairby Grange Convalescent Home 37 Midwifery Service 37 Obstetric and Puerperal Fever Consultants 37 Work of the Health Visitors 38 Attendances at Centres 39 Statistics for 1932 40 DENTAL TREATMENT— Particulars of Children Treated 42 Particulars of Treatment and Work for 1932 43 PROPAGANDA 44 SANITARY ADMINISTRATION— Housing 46 Inspections and Proceedings 48 Work of the District Inspectors 53 Factories and Workshops—Homework 54 Factories and Workshops—Inspections 55 Bakehouses 56 House, Trade and Market Refuse 57 Offensive Trades 57 Mortuary 57 Street Markets 57 Drainage Work 57 FOOD CONTROL— Unsound Food —Shops and Stalls 58 Imported Food Regulations —Samples Taken 59 Work of the Wharves and Food Inspectors 60 Milk Premises 61 Milk Licences 61 Milk Sampling 61 Food and Drugs—Samples Taken 62 Food and Drugs—Prosecutions 65 Unsound Food—Wharves, etc. 66 HEALTH SERVICES 70 PUBLIC HEALTH DEPARTMENT. PUBLIC HEALTH COMMITTEE, 1932. Chairman Councillor S. R. WEIGHTMAN, 1931-32. Chairman Councillor Mrs. F. I. M. HUSK, 1932-33. Vice-Chairman Councillor J. C. WAYNE, 1931-32. Vice-Chairman Councillor Mrs. A. M. HATCHER, 1932-33. Alderman Miss A. Broughton Councillor M. E. McAleer J. A. W. Douglas „ A. Ponsford „ Mrs. D. A. Green „ Mrs. F. A. Powell Councillor Mrs. S. C. Amos „ W.Shearring, W. T. Cockett J.P. „ Mrs. J. Donovan „ G H. Stean „ Miss K. Groves „ Mrs. E. A. Stokes „ G. H. Horwood „ J. Sullivan A. V. Kidd „ Mrs. L. L. White , G. Loveland „ W. F. Williams Ex-officio: Councillor J. LYNCH, J.P., Mayor of Bermondsey, 1931-32. Councillor Mrs. E. F. GEORGE, J.P., Mayor of Bermondsey, 1932-33. MATERNITY AND CHILD WELFARE COMMITTEE, 1932 Chairman Councillor Mrs. E. F. GEORGE, 1931-32 Chairman „ Mrs. M. NIX, 1932-33 Vice-Chairman „ Mrs. E. A. STOKES, 1931-32 Vice-Chairman „ Mrs. A. M. FORTESCUE, 1932-33 Alderman Miss M. I. Henrich Councillor Mrs. A. M. Hatcher Councillor Mrs. E. V. Coyle „ Mrs. F. A. Powell „ Mrs. J. Donovan „ Mrs. R. E. Reed „ Mrs. L. F. M. Franklin „ R. Wedden „ C. Harding „ Mrs. L. L. White Co-opted Members: Mrs. E. R. Balman Miss D. Plummer Miss E. M. Haslam Mrs. E. C. Starr Ex-officio: Councillor J. LYNCH, J.P., Mayor of Bermondsey, 1931-32 Councillor Mrs. E. F. GEORGE, J.P., Mayor of Bermondsey, 1932-33 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. Frankson, Wharves and Food Inspector. A. H. Merryman, Food and Drugs Inspector. E. J. Pitts, Market Inspector. District Inspectors. W. Davis, Senior District Inspector and Drainage Inspector No. 1—H. E. Butcher No. 2—F. L. Richardson No. 3—W. G. Luke No. 4—W. C. Tapsfield No. 5—G. F. J. Toll No. 6—O. W. R. Smart No. 7—H. J. Bailey 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.D., D.P.H. Lady Almoner —Olive Pike. Tuberculosis Nurses— Celia Clapson, Louise Colbeck and Edith Riley. Solarium Nurses—Constance Clarke and Estelle Jagôt. Caretaker—H. J. Madasa. MATERNITY AND CHILD WELFARE. Assistant Medical Officers for Maternity and Child Welfare— Ruth W. Plimsoll, M.B., B.S., D.P.H. ; Florence L. Telfer, M.D. Health Visitors. Lucy Brown Alice Lusty Rosa Bache Isabel White Marie Helden Mrs. Dorothy Cottier Florence Child Amy Carlton Sarah Bowles Florence Wadds Fairby Grange Convalescent Home: Matron—Alice Sewell. Nurse —Ann O'Meara. DENTAL DEPARTMENT : Municipal Dental Surgeon— Grantley Smith, L.M.S.S.A., 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 PUBLIC ANALYST. A. Prideaux Davson, A.R.C.Sc., F.I.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. Madam, Ladies and Gentlemen, I beg to submit my Annual Report for the year 1932. There are no special points to which it is necessary to draw attention this year. The work of the Department has proceeded smoothly, and I trust, with efficiency during the year, and I have to thank both the Chairmen and Members of Committees, and the staff, for their very willing co-operation at all times. Perhaps I may be allowed also to express my own personal sense of loss occasioned by the death of Mrs. Nix, lately the Chairman of the Maternity and Child Welfare Committee—a real friend—an ideal Chairman. I am, Madam, 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 1932 according to the Rate Books was 18,711. The rateable value of the Borough on the 31st December, 1932 was £871,361, the product of a penny rate being £3,415. POPULATION. Census Estimate of Registrar General to 30th June, 1931 to 30th June, 1932 1921 1931 119,452 112,400 110,100 111,542 r BIRTHS. The total number of births belonging to the Borough registered during 1932 was 1831, consisting of 961 males and 870 females. The number for 1931 was 1,958. The birth rate for 1932 was 16.6 per 1,000 persons living, compared with 17.4 for 1931. (9) DEATHS. The total number of deaths belonging to the Borough registered during 1932 was 1,326, consisting of 750 males and 576 females. The number for 1931 wag 1,408. The death rate for 1932 was 12.0 per 1,000 persons living, compared with 12.5 for 1931. MARRIAGES. The total number of marriages in the Borough in 1932 was 936, being 65 below the number for 1931, and 84 below the average for the last 10 years. The figures have been supplied by the Superintendent Registrar. This makes a marriage rate of 17.00 per 1,000 of the population, compared with a marriage rate last year of 17.81. Year No. Rate 1922 1,008 16.64 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 1931 1,001 17.81 Average for years 1922 —1931 1,020 17.20 1932 936 17.00 (10) INFANTILE MORTALITY. Year London Whole Borough No. of Deaths Rate per 1,000 Births No. of Deaths Rate per 1,000 Births 1922 324 102 7,089 75 1923 76 61 220 5,615 1924 229 78 5,904 69 1925 210 79 5,599 68 146 5,067 64 1926 60 149 67 59 1927 4,357 1928 178 85 4,879 67 1929 160 71 4,995 71 63 4,109 1930 130 59 1931 112 57 4,270 65 74 66 186 5,188 Average for years 1922-1931 56 4,143 67 1932 103 TUBERCULOSIS OF THE RESPIRATORY SYSTEM. In the following Table will be found particulars of deaths from Tuberculosis of the Respiratory System since the year 1922. Bermondsey Rotherhithe St. Olave Whole Borough London Sub-District Year No. No. No. No. Rate No. Rate 1922 119 43 7 169 1.39 4888 1.08 95 14 4432 0.97 1923 35 144 1.18 1924 92 46 11 149 1.22 4486 0.98 99 1925 35 11 145 1.18 4361 0.95 1926 100 39 12 151 1.23 4066 0.88 1927 87 42 1.19 15 144 4140 0.91 88 43 12 1928 143 1.24 3985 0.89 1929 78 31 8 117 1.03 4230 0.96 1930 81 36 15 1.16 3826 0.87 132 1931 81 116 0.90 30 5 1.03 3907 Averages for years 1922-1931 92 38 11 141 1.18 4232 0.93 1932 71 34 11 1.05 3564 0.82 116 INFANTILE MORTALITY RATE FOR 25 YEARS. VITAL STATISTICS OF WHOLE DISTRICT DURING 1932 AND PREVIOUS YEARS. Year 1 Population estimated to Middle of each Year 2 Births Total Deaths registered in the District Total Deaths in Public Institutions in the District 9 Deaths of Non- Residents registered in Public Institutions, etc. in the District 10 Deaths of Residents registered in Public Institutions beyond the District 11 Net Deaths at all Ages belonging to the District No. 3 Rate 4 Under 1 Year of Age At all Ages No. 12 Rate 13 No. 5 Rate per 1,000 Births registered 6 No. 7 Rate 8 1922 1,572 3,167 26.1 121,100 259 81 12.9 778 43 496 2,020 16.7 1,480 1923 121,700 2,912 23.9 220 76 1,192 9.7 330 42 288 12.1 43 1924 122,100 2,913 23.8 200 68 1.277 10.4 720 337 1,657 13.6 1925 123,000 2,652 21.6 188 71 1,280 10.4 669 47 321 1,554 12.6 1926 52 1,163 9.4 624 31 352 12.1 123,100 2,414 19.6 126 1,484 352 1,566 1927 121,000 2,233 18.5 119 53 1,236 10.2 616 22 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 14.5 378 1,650 1930 113,800 2,059 18.1 90 44 1,169 10.3 686 46 1,488 13.1 365 1931 112,400 1,958 17.4 91 46 1,169 10.4 596 92 331 1,408 12.5 Averages for years 1922-1931 118,720 2,465 156 62 1,259 10.6 639 20.7 44 355 1,583 13.3 (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 Lady well Institution All Saints' Hospital, Southwark 1 171 101 Ambulances on way to Hospital 6 Belgrave Hospital, Lambeth 1 Bexley Mental Hospital 6 Bermondsey Mission Hospital Borough Sanatorium, Brighton 1 3 Bow Institution, Poplar 2 Brook Hospital, Shooters Hill 3 Cane Hill Hospital 5 Catholic Nursing Institution, Lambeth Road Deaths in River Thames, Surrey Commercial Docks, Wharves, etc. 1 Charing Cross Hospital 2 13 Claybury Mental Hospital 1 Colindale Hospital, Hendon 6 Darenth Training Colony 1 Railway 1 Dartford Institution 1 Downs Hospital, Sutton 4 Dulwich Hospital 1 Workplaces 1 East London Hospital for Children 2 Edmonton Colony 1 Elizabeth Garrett Anderson Hospital, St. Pancras 1 Total 189 Epsom Cottage Hospital 1 Evelina Hospital 5 Forest, The, Epsom 1 Fountain Mental Hospital, Wandsworth 1 Friern Barnet Infirmary 1 Grosvenor Sanatorium, Kennington, Kent 1 Grove, The, Epsom 4 Grove Hospital, Tooting 1 74 Guy's Hospital High Wood Hospital, Brentwood 1 Home and Hospital for Jews, Tottenham 1 Horton Hospital, Epsom 1 Hospital of St. John and St. Elizabeth, St. Marylebone 1 Hundred Acres, Epsom 2 Infants' Hospital, Vincent Square 1 Ipswich Sanatorium, Foxhall 1 1 Islington Institution Isolation Hospital, Loose 1 Joyce Green Hospital, Dartford 1 Kings College Hospital 1 Kneller Road Institution, Lewisham 1 Ladywell Institution 101 Lambeth Hospital 9 Leavesden Mental Hospital 3 (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. Lewisham Hospital 2 London Docks 1 Long Reach Hospital, Dartford 1 Lying-in Hospital, York Road 1 Mental Hospital, Uxbridge Road, Uxbridge 1 Metropolitan Hospital, Caterham 3 Middlesex Hospital Annexe 2 Miller Hospital, Greenwich 2 National Hospital, Queen's Square 1 New End Hospital, Hampstead 1 North Devon Children's Convalescent Home, Lynton 1 North Western Hospital, Hampstead 4 Northumberland House, Green Lanes, Stoke Newington 1 Park Hospital, Hither Green 13 Preston Hall, Aylesford 1 Private Houses 8 Queen Mary's Hospital, Chislehurst 2 Queen Mary's Hospital, Putney 1 Queen Mary's Hospital, Wandsworth 1 Railway Carriage at Battle 1 Railway Hotel, Braintree 1 River Thames 3 Royal East Sussex Hospital, Hastings 1 Royal Waterloo Hospital 1 St. Alfege's Hospital, Greenwich 2 St. Andrew's Hospital, Thorpe 1 St. Columba's Hospital, Hampstead 2 St. George's Hospital, Westminster 2 St. Giles' Hospital, Camberwell 2 St. James's Hospital, Balham 1 St. John's Hospital, Battersea 1 St. Joseph's Hospice Hackney 2 St. Thomas's Hospital 4 South-Eastern Hospital, New Cross 9 South-Western Hospital, Stockwell 2 s.s. Beaverbrae, off Gravesend 1 Stone House, Stone 1 Street 3 Tooting Bee Hospital 15 Waterloo House Institution, Bethnal Green 1 Western Hospital, Fulham 1 West Kent General Hospital, Maidstone 1 West Park Mental Hospital, Epsom 2 Total 368 CAUSES OF, AND AGES AT, DEATHS DURING THE YEAR 1932. Causes of Death Deaths at the subjoined ages of "Residents" whether occurring in or beyond the District. Under 1 1 and under 2 2 and under 5 5 and under 15 15 and under 25 25 and under 45 45 and under 65 65 and upwards All Ages All Certified 1325 103 44 25 43 78 130 353 549 Causes Uncertified 1 - - - - - - 1 - Typhoid and Paratyphoid Fever - - - - - - - - - Measles 25 4 16 5 - - - - - Scarlet Fever - - - - - - - (14) 17 - - Whooping Cough 5 16 7 3 1 - - - - Diphtheria 11 - 3 - - 2 6 - - Influenza 9 - - - 1 3 - - 5 Encephalitis Lethargica 2 - - 5 - - - 1 1 Cerebro-spinal Fever 3 - 1 - - 1 1 - - Tuberculosis of Respiratory System 116 - - 3 31 41 35 6 - Other Tuberculous Diseases 11 - - 2 2 2 - 4 1 Syphilis 1 - - 1 - - - - - 1 General Paralysis of the Insane, tabes dorsalis - 6 - - - - - 5 Cancer, Malignant Disease 179 - - 1 3 19 75 - 81 Diabetes 6 - - - 3 - - 3 Cerebral Hæmorrhage, etc - - - 96 - - - 4 27 65 - Heart Disease 177 13 62 - - 3 8 91 Aneurysm 2 - - 1 1 - - - - Other Circulatory Diseases 23 - - 3 20 - - - - Bronchitis 2 1 3 31 CAUSES OF, AND AGES AT, DEATHS DURING THE YEAR 1932—continued Deaths at the subjoined ages of "Residents" whether occurring in or beyond the district. Causes of Death All Ages Under 1 1 and under 2 2 and under 5 5 and under 15 15 and under 25 25 and under 45 45 and under 65 65 and up wards Pneumonia (all forms) 129 14 17 2 6 15 31 41 3 2 Other Respiratory Diseases 35 3 1 1 - 1 11 16 Peptic Ulcer 22 - - 1 15 - 6 - - Diarrhœa, etc. 14 11 - - - 1 2 1 - (15) Appendicitis 7 - 1 2 - 1 - - 3 Cirrhosis of Liver 6 - - - - 1 5 - - Other Diseases of Liver, etc, 2 - - - - 1 - 1 - Other Digestive Diseases 27 1 - 1 1 1 7 16 - Acute and Chronic Nephritis 72 2 5 9 55 - 1 - - Puerperal Sepsis 1 - - - - 1 - - - Other Puerperal Causes 3 - 1 2 - - - - - Congenital Debility, Premature Birth, Malformations, etc, 51 - - - - - - 51 - Senility 77 - - - - 1 76 - - Suicide 12 - - 10 7 5 - 3 - Other Violence 55 3 - 3 11 10 10 9 9 Other Defined Causes 68 9 - 1 10 7 7 18 16 Causes ill-defined or unknown 13 - - 1 1 - 7 4 - 103 44 25 43 78 130 549 1326 354 DEATHS FROM ZYMOTIC DISEASES, 1932. Year All Causes Principal Zymotic Diseases Scarlet Fever Diphtheria Enteric Fever Smallpox Measles Whooping Cough Diarrhœa No. Rate No. No. Rate Rate Rate Rate No. No. No. Rate No. No. Rate No. Rate Rate 2025 292 - 101 11 .09 90 .74 65 1 - 24 1922 16.7 2.41 .83 .53 .19 - 1923 1480 12.1 1.02 .10 3 12 2 .01 62 .50 125 - 13 .02 33 .27 .09 - 1924 1657 13.6 117 .95 48 .39 6 25 .20 11 .09 1 26 .21 - - .04 - 1554 96 - - 20 3 .02 .24 27 - 17 1925 12.6 .78 .16 .22 .14 29 - 1926 1484 12.1 94 .76 .19 6 .05 42 1 - 21 .17 - 24 .34 .01 - - 1927 1566 12.9 45 .37 - - 9 - - 13 10 1 12 .09 .07 .11 .08 - 1520 137 77 .67 .23 1 14 1928 13.2 1.19 3 16 .14 26 .01 .12 - - .03 1650 62 - - 1 .01 2 .02 .05 .29 1 .01 19 .17 1929 14.5 .54 6 33 1930 1488 13.1 101 .89 61 .06 8 .07 6 .05 .02 17 .15 .54 7 2 - - 1408 3 1 6 5 .04 08 1931 12.5 24 .21 .03 .01 .05 9 - - - - Average for years 1922-1931 1583 13.3 109 .91 - - 36 .30 4 .03 27 .22 20 .16 1 .01 22 .18 1932 1326 12.0 67 .61 1 .01 25 .23 - - 11 .10 16 .15 - - 14 .13 NOTIFIED CASES OF DIPHTHERIA FOR 25 YEARS. NOTIFIED CASES OF SCARLET FEVER FOR 25 YEARS. 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 Erysipelas Fever Hydrophobia in Man Glanders Membranous Croup Malaria Puerperal Fever Ophthalmia Neonatorum Relapsing Fever Puerperal Pyrexia Small Pox Scarlet Fever and Scarlatina Tuberculosis—all forms Typhus Owing to the housing conditions of the Borough, it is the practice to remove to hospital nearly all cases of diphtheria and scarlet fever. DIPHTHERIA. The number of cases notified was exactly the same as last year, namely 263. Six cases were returned as not suffering from Diphtheria, and there were eleven deaths. Very little use is being made of the provision for immunisation against the disease, and the total number of attendances for the whole year was only 55. 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 12 3 6 3 30 55 SCARLET FEVER. There has been a rise in the number of cases of Scarlet Fever, the number being 446, with a net total of 432 as 14 cases were returned as not suffering from the disease. The mild form of the disease still prevails and there were no deaths. SMALL-POX. There were 16 cases of Small-pox during the year. This is an increase as compared with 3 last year, but on the whole this borough has been exceptionally fortunate as compared with other metropolitan boroughs, in having so few cases. No re-vaccinations were performed under the Public Health (Small-pox Prevention) Regulations, 1917. MEASLES. The number of cases reported was 1,730 as compared with 1,418 in the last epidemic year (1930) and 216 last year. Of these, 240 cases were removed to hospital and nursing was provided for 68 cases at home. There were 25 deaths, 7 at home and 18 in hospital. OPHTHALMIA NEONATORUM. The following table gives particulars of the number of cases of this disease. In five instances nursing was provided:— Cases Vision Un- Impaired Vision Impaired Total Blindness Deaths Notified Treated At home In Hospital 10 5 5 9 - - - The subsequent history of one case which was treated in hospital could not be ascertained owing to the removal of the family to an unknown address. PUERPERAL FEVER AND PUERPERAL PYREXIA. The number of cases notified was, as follows:- Puerperal Fever 8 Puerperal Pyrexia 27 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 4 Bacteriological examinations Nil Admitted to Hospital 30 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. The following table shows the number of articles disinfected during the year:— Beds 934 Pillows 2,162 Blankets 4,208 Pillows (cases) 1,991 Bolsters 666 Quilts 1,448 „ (cases) 298 Sheets 1,750 Miscellaneous 5,290 Books 283 Cushions 292 Verminous Clothing 3,645 Mattresses 103 „ Bedding 280 Overlays 724 Scabies, Clothing 13,021 24,098 new tabs were used to replace those taken off mattresses, palliasses, and cushions before disinfection. Number of rooms disinfected 2,597 Number of mattresses and other articles destroyed 2,829 CLEANSING STATION. Verminous persons cleansed Adult Females 4 Adult Males 82 Children 1,772 Persons treated for Scabies:— Number Number of treated baths given Adult Females 32 69 Adult Males 24 58 Children —Females 148 930 Children —Males 103 646 (20) SHELTER. Four flats are provided in The Neckinger for the temporary housing of families or persons while their premises are being disinfected. The number of families accommodated during the year was 17, 7 for Small-pox, 3 for Diphtheria, 3 for Scarlet Fever, and 4 for verminous conditions, the total number of persons accommodated being 54. BACTERIOLOGICAL LABORATORY. As in previous years the work of the laboratory has consisted very largely in the examination of sputa and throat swabs. 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 Nature of Specimen Results of Examination Negative Positive 1932 1931 1931 1931 1932 1932 Diphtheria (specimens taken by Medical Officer of Health) 798 496 89 23 473 709 Ditto (taken by general practitioners) 198 1430 1271 1628 1390 119 Diphtheria (total specimens taken) 2426 1886 287 142 2139 1744 Phthisis 1897 1883 260 261 1637 1622 Various 305 188 20 9 285 179 Total specimens taken 4628 3957 567 412 4061 3545 FOOD POISONING. Section 7 of the London County Council (General Powers) Act, 1932, provides that every registered medical practitioner shall send to the Medical Officer of Health a notification for every case, or suspected case, of Food Poisoning. Number of cases notified during 1932 10 FOOT CLINIC. The total number of sessions per week is as it was last year, viz., 9, but on the 16th August this year a new clinic was opened in Bermondsey Town Hall for two sessions a week and the number of sessions at Rotherhithe was reduced by two. In spite of the fact that the fee for treatment is now 1/- instead of 6d., there has been no falling off in the number of attendances which were 10,145 as against 9,021 last year. Quite a large number of patients now attend regularly for treatment every three or four weeks, and there is no doubt that these clinics render a very valuable service in this borough. (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 Diarrhœa, 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 Cases Visits Cases Visits Cases Visits Pneumonia 16 546 22 534 38 1,080 Broncho pneumonia 5 156 8 116 13 272 Bronchitis 14 292 — — 14 292 Influenza 18 354 5 124 23 478 Measles 55 993 13 290 68 1,283 Whooping Cough 7 202 5 162 12 364 Tuberculosis: — (a) Respiratory System 56 4,267 36 1,301 92 5,568 (6) Other Forms 6 420 3 657 9 1,077 Puerperal Pyrexia 1 25 3 20 4 45 Puerperal Fever — — — — Pregnancy and Labour 28 551 5 101 33 652 Diseases of the Digestive System 37 375 18 116 55 491 Infantile Diarrhoea (under 2 years) — — 1 10 1 10 Discharging Ears 15 409 4 69 19 478 Discharging Eyes 14 379 9 245 23 624 Post-operative cases:— (a) Tonsils & Adenoids 19 99 8 60 27 159 (b) Other cases 5 92 2 14 7 106 Other diseases 44 894 10 172 54 1,066 CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR 1932. NOTIFIABLE DISEASE NUMBER OF CASES NOTIFIED BERMONDSEY ROTHERHITHE ST OLAVE Total Cases removed to Hospital At all Ages At Ages—Year 2 3 4 5 6 1 2 3 Total St. John St Olave St. Thomas Total 1 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 Total Small-pox 16 - 1 6 5 1 3 - 5 - - 6 - - 12 - 4 - 4 - - - - 16 25 43 18 1 Diptheria (including Membranous Croup) 263 4 74 141 30 12 2 44 41 28 13 13 164 32 93 5 6 262 - - Erysipelas 49 3 3 2 15 17 3 4 9 3 2 26 8 8 1 17 5 1 6 15 2 7 5 - Scarlet Fever 446 7 157 251 19 12 - 62 60 48 18 38 286 56 57 21 134 18 1 7 26 - 60 440 Cerebro-Spinal Meningitis Acute Polio-Myelitis and Acute Polio Encephalitis 3 8 1 - - 1 - - - - 9 1 9 - 3 2 1 1 - - 1 4 1 - phalitis. 3 - 3 - - - - 1 - 1 - 2 - 1 - 1 - - - - 3 - - - Ophthalmia Neonatorum 10 - - - - - 2 1 1 - 1 2 6 - - - - 6 - 10 4 3 - - Anthrax - - - - - - - - - - - - - - - - - - - - - - - - Enteric Fever 2 - - - 1 - 1 1 - - - 1 2 - - - - - - - - 2 - - Puerperal Fever 8 - - 3 5 - - 2 1 1 - 3 7 - 1 - 1 - - - - 7 - - Puerperal Pyrexia 27 - - - 7 17 3 - 3 1 5 2 3 14 6 6 1 13 - - - - 23 - Encephalitis Lethargica - 1 - - - - 2 2 - - - - - 1 - - 2 - - - - - 2 - Dysentery - - - - - - - - - - - - - - - - - - - - - - - - Malaria - - - - - - - - - - - - - - - - - - - — - - - - Pneumonia (Acute Primary and Acute Influenzal) 29 14 16 22 6 4 35 - 14 4 102 16 8 58 11 13 4 4 6 12 11 1 9 9 Tuberculosis— Respiratory System 177 - 3 58 59 37 7 22 20 24 33 13 20 132 13 13 5 31 9 3 2 14 - 13 Other forms of Tuberculosis 35 1 6 8 11 6 3 - 3 3 6 4 2 2 20 9 2 3 14 - - 1 1 - 1149 32 277 435 153 145 83 24 149 125 153 162 60 86 735 148 139 65 352 41 9 12 62 CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEARS 1923-1932. 1923 1924 1925 1926 1927 1928 1929 1931 1932 Notifiable Disease. 1930 Small Pox - - - - - 1 46 47 3 16 Diphtheria (including Membranous Croup) 586 541 481 463 535 714 603 462 263 263 Erysipelas 25 45 19 42 35 30 43 41 49 49 Scarlet Fever 323 395 353 426 601 493 584 507 446 310 Cerebro-Spinal Meningitis 3 1 3 5 3 2 4 5 9 9 Acute Polio-Myelitis and Acute PolioEncephalitis 2 2 2 1 1 4 1 1 2 3 Ophthalmia Neonatorum 18 12 15 10 13 8 13 10 11 14 Anthrax - 2 3 4 2 1 1 - 1 - (24) Enteric Fever 2 2 5 3 1 2 2 5 1 2 Puerperal Fever 4 2 9 14 9 9 7 12 13 8 Puerperal Pyrexia - - 21 20 11 20 19 37 27 - Encephalitis Lethargica 1 1 2 21 8 8 5 4 4 1 Dysentery - 1 - - - - - - - - Malaria 1 - 1 - 2 - - - - - Malaria (induced) - - 1 - - - - - - - Pneumonia (Acute Primary and Acute Influenzal) 113 126 53 167 119 102 125 243 110 119 Tuberculosis: — Respiratory System 206 184 245 175 177 250 226 231 194 208 Other forms of Tuberculosis 86 90 59 65 54 40 46 40 35 76 1,580 1,408 1,585 1,478 1,530 1,494 1,083 1,149 Totals 1,420 1,599 (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, 1932—NEW CASES AND DEATHS. AGE—PERIODS NEW CASES DEATHS Pulmonary Non Pulmonary Pulmonary Non Pulmonary F. M. F. M. F. M. F. M. 0 - - - 1 - - - - 1 3 1 2 5 2 - - - 5 1 - 5 1 4 6 - - 10 1 1 1 4 2 1 2 - 15 4 3 5 11 2 13 12 - 14 24 20 3 3 9 6 2 - 22 25 21 6 1 18 9 1 - 35 - 14 10 5 9 - - - 45 23 1 12 4 1 5 - - 9 1 55 5 2 14 5 1 - - 65 and upwards 5 3 - 1 5 - - 13 47 107 90 30 69 10 1 - TABLE II. TUBERCULOSIS, 1932—PERIOD BETWEEN NOTIFICATION AND DEATH. Respiratory System Other Forms Period Between Notification and Death Total Males Females Total Percentage of Total Deaths Males Females Percentage of Total Deaths Not notified 9 2 11 - 4 36.37 4 9.48 0-1 month 5 2 5 10 8.62 2 18.18 - 1-3 months 12 3 15 12.93 1 1 9.09 - 3-6 months 9 11 20 17.24 - - - - 6-12 months 6 - 7 13 11.21 - - - 1-2 years 7 6 13 11.21 - 1 1 9.09 2-5 years 13 7 20 17.24 1 1 9.09 - Over 5 years 8 12.07 6 14 2 2 18.18 - In Table II. it will be noted that eleven cases of pulmonary tuberculosis were not notified to me before death, an actual increase of four over the number of such cases in 1931. Of these 11 cases 4 males and 1 female were aged 56 years or over at death and had been admitted to the local general hospital only a short time before death. Another female, aged 32, died out of the district and had not been resident in the borough for a considerable period before death. With regard to the 5 remaining males (aged 16—37), on 2 of whom inquests were held, death occurred suddenly or the diagnosis remained in doubt until the end. Thus, although there has been a small increase in the number of unnotified deaths there is no evidence to suggest that there has been any relaxation amongst medical practitioners in their efforts to comply with the notification regulations. I am pleased to report that there was a decline in the number of deaths due to miliary or meningeal tuberculosis, amongst children aged 10 and under. In 1932 these numbered only 4 compared with 16 in 1930 and 11 in 1931. It is difficult to account precisely for this decline. Advantage is taken of the London County Council's scheme for the boarding out of children from homes where there is an infectious case of tuberculosis in the family and approximately 15 children are sent away each year. Difficulty, however, is always experienced in persuading parents to part from infants, who are of course the most susceptible to the disease, and the majority of children "boarded out" are of school age. It seems possible that one of the deciding factors in the decline is the increased use of the local hospital for the admission of active and advanced cases. The Tuberculosis Officers, who are known to the patients and their families, visit the hospital regularly and this has, without doubt, helped to keep in the institution many who would otherwise return home and remain a source of infection to others. Attention was drawn, in a previous report, to the importance of human infection in cases of miliary tuberculosis. Of the 4 children, all males, who died in 1932, 3 had been in contact during their lifetime with cases of active pulmonary tuberculosis, but in the fourth case it was impossible to discover the source of infection as the contacts refused to be examined. On page 31 is a return showing the work done at the Tuberculosis Dispensary during the year. There has been a slight increase both in the number of new cases of tuberculosis seen at the Dispensary and in the number of cases referred for investigation. The majority of the latter are sent by medical practitioners who are making good use of the services of the Tuberculosis Officers and of the auxiliary facilities, such as X-rays, provided for the diagnosis of obscure cases. The periodical examination and supervision of contacts is being maintained, and there has been a slight increase in the number of adult contacts examined. It is always easier to secure the examination of children, but the supervision of adults, and especially of adolescents, is of equal importance in our attempt to prevent the disease or to check it at its onset. The number of X-ray examinations shows a decline, due solely to an increase in the charges made by the London County Council for this work. These charges, however, have now been revised and the number of X-ray examinations made will not be determined primarily by expense. In my last report, I mentioned that the Tuberculosis Officers were now giving artificial pneumothorax refills at the Dispensary to the great advantage of the patients. The number of "refills" this year has reached a total of 453 and in view of the fact that a charge of 10/6 for each "refill" is sanctioned when these are done at hospital, this work of the Tuberculosis Officers has meant a considerable saving to the borough. An evening clinic is held for those who work during the day. The following Table shows the present condition of patients who have had artificial pneumothorax treatment. The small figures in brackets indicate the number of patients (in each group) in whom the disease was already bilateral when the treatment was started. Results in such cases are not expected to be as good as in those patients with early unilateral disease. Treatment begun Arrested Quiescent Stationary Dead 1923 1 — — — 1928 1 — — — 1929 3 — — 2 (2) 1930 8 2 2 3 (2) 1931 4 12 10 (4) — (The cases started during 1932 are not shown in this table.) The total numbers are too small, and sufficient time has not yet elapsed to enable a comparison to be drawn between this and other forms of treatment. The results so far achieved, however, are encouraging, and the benefits of the treatment in early cases of pulmonary tuberculosis in an industrial district are undoubted. It is of interest to note that in ten of the arrested and quiescent cases shown above, the treatment was started in St. Olave's Hospital, where a close association and co-operation has been maintained between the Tuberculosis Officers and the Medical Officers of the Hospital. NURSING AND EXTRA NOURISHMENT. The Nursing Associations have been of the very greatest assistance to us during the year and their work has been of value in two ways. In quite a number of cases a daily record of temperature (morning and evening) is of assistance in diagnosis, and the Tuberculosis Officer often makes use of the services of the district nurse for this purpose. In other cases where the patient is bedridden, the nurse can do much to alleviate suffering and to see that the patient carries out instructions so that the risk of infection for other members of the household is lessened. In addition to the services of the district nurses, the Tuberculosis Officer has authority to supply a small amount of extra nourishment to tuberculous patients, which takes the form of milk and eggs or Virol and milk; a total of 212 patients have been thus assisted during the year. SHELTERS. For many years the Council has loaned shelters free for the use of patients suffering from tuberculosis. The shelters are built by the Works Department and are of the ordinary sanatorium fixed type, so constructed that even when completely closed, ample ventilation through louvres is provided. The use of a shelter diminishes the risk of infection which is so serious in an overcrowded home, but the instances in which a shelter can be erected are few, since the garden space available is usually either insufficient or unsuitable. Beds and bedding are supplied with the shelter and in some cases arrangements have been made for electric light to be installed. There are 21 shelters at present in use, 6 new ones having been erected during the year and 7 dismantled owing to the death or removal of the patient. In addition to the supply of shelters, beds and bedding are supplied on loan for the use of patients at home where suitable use can be made of them. By this means we are often enabled to arrange for a patient to sleep alone and so lessen the risk of infection. Twenty-three beds are in use at present. LADY ALMONER. The social side of tuberculosis work is of the utmost importance. Practically all tuberculous patients in this borough require assistance of some sort beyond the mere diagnosis of the disease and provision of sanatorium treatment. The Lady Almoner is the connecting link between the needy patient and the source of assistance. During this year Miss Pike has made 966 visits to homes of patients in connection with this side of the Tuberculosis Scheme, and a great deal of very varied assistance has been given to patients. In many cases clothing has been found for needy patients going to sanatoria. In other cases help has been given by way of providing surgical boots, belts, artificial limbs and elastic bandages. Convalescent treatment and seaside holidays have been arranged in a number of non-tuberculous cases, and in others assistance has been given in the matter of fares. Continuous attempts have been made to find work for ex-sanatorium patients, in a few cases with some degree of success. The Lady Almoner continues the work of assessment for the London County Council in connection with sanatorium treatment and for patients for admission to Fairby Grange. She also conducts the handicraft class on Friday afternoons at the Dispensary. Many articles in leather and pewter have been made, and in spite of the difficulties of the year, all these have been sold. Our grateful thanks are due to the following societies for their kind assistance on many occasions—Metropolitan Convalescent Institution, Surgical Aid Society, Friends of the Poor, United Services Fund, Royal Red Cross Society, Charity Organisation Society, Woman's Holiday Fund, Queen Mary's Needlework Guild per Lady Ludlow for grant of clothing and the Public Assistance Committee. PUBLIC HEALTH (PREVENTION OF TUBERCULOSIS) REGULATIONS, 1925. It was not found necessary to take any action under these Regulations in 1932. RETURN SHOWING THE WORK OF THE DISPENSARY DURING THE YEAR 1932. Diagnosis Pulmonary Non-pulmonary Total Grand Total Adults Children Adults Children Adults Children M. F. M. F. M. F. M. F. M. F. M. F. A.—New Cases examined during the year (excluding contacts):- 1 — 1 (a) Definitely tuberculous 75 63 4 12 6 3 87 69 9 4 7 5 (b) Diagnosis not completed - - - - - - - 6 9 1 - - (c) Non-tuberculous - - - - - - - - 144 141 78 75 626 B.—Contacts examined during the year:— (a) Definitely tuberculous 6 9 2 5 1 1 7 2 10 2 7 (b) Diagnosis not completed - - - - - 2 - - - - - - - (c) Non-tuberculous - - - - - - - - 141 165 595 88 175 C. —Cases written off the Dispensary Register as I I II ! (a) Recovered 9 8 5 9 4 3 5 13 19 10 10 11 (b) Non-tuberculous (including any such cases previously diagnosed and entered on the Dispensary Register as tuberculous) - - 299 259 - 247 - - - 242 1100 - - (31) D. —Number of Cases on Dispensary Register on December 31st:— (a) Definitely tuberculous 319 227 63 55 45 53 127 79 364 72 280 142 (b) Diagnosis not completed - - - - - - - - 6 9 1 - 929 1. Number of cases on Dispensary Register on January 1st 975 8. Number of visits by Tuberculosis Officers to homes (including personal consultations) 2. Number of cases transferred from other areas and cases returned after discharge under Head 3 in previous years 15 9. Number of visits by Nurses or Health Visitors to homes for Dispensary purposes *4,335 3. Number of cases transferred to other areas, cases not desiring further assistance under the scheme, and cases "lost sight of" 66 10. Number of:— (a) Specimens of sputum, etc., examined 1,387 4. Cases written off during the year as Dead (all causes) 116 (b) X-ray examinations made in connection with Dispensary work 526 6. Number of attendances at the Dispensary (including Contacts) 4241 11. Number of "Recovered" cases restored to Dispensary Register, and included in A(a) and A (b) above 1 6. Number of Insured Persons under Domiciliary Treatment on the 31st December 110 12. Number of "T.B. plus" cases on Dispensary Register on December 31st 345 7. Number of consultations with medical practitioners:- (a) Personal 120 (6) Other 197 * In addition to these visits 966 visits were made by the Lady Almoner and 245 visits by the School Nurse. PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1930. Summary of Notifications during the period from the 3rd January, 1932, to the 31st December, 1932. Formal notifications Number of primary notifications of new cases of Tuberculosis Total Notifications 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 (all ages) Age Periods Pulmonary, Males 1 - 5 1 11 13 19 12 22 6 4 94 130* 22 10 5 4 3 83 102 (32) „ Females 2 3 12 18 4 - 5 1 2 5 - 1 1 - 23 23 Non-Pulmonary Males 1 3 4 2 „ Females - 1 - 12 14 3 1 1 3 1 - - New cases of Tuberculosis coming to the knowledge of the Medical Officer of Health during the abovementioned period, otherwise than by formal notification. Age Periods 0 to 1 1 to 5 5 to 10 10 to 15 15 to 20 20 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 and upwards Total Pulmonary Males - — - - 2 1 3 2 1 3 1 13 1 - - 2 3 - - 1 - 7 „ Females - - 2 1 - 1 1 - - 1 - 7 Non-Pulmonary Males 1 - „ Females - - 1 - - - - - - 1 - - * Includes 2 re-notifications of cases originally notified as Non-Pulmonary. These cases have been transferred to the Pulmonary side of the Register. (33) Returns rendered under the PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1930. 1st QUARTER, 1932. Respiratory System Other Forms F. F. M. M. Number of Cases on Register at commencement of Quarter 305 156 152 451 Number of Cases notified during Quarter 27 5 3 21 Inward Transfers, Un-notified Deaths, etc. 1 - - 1 Number of Cases removed from the Register 26 21 16 2 Number of Cases remaining on the Register at end of Quarter 447 312 145 153 2nd QUARTER, 1932. Respiratory System Other Forms M. F. M. F. Number of Cases on Register at commencement of Quarter 447 145 153 312 25 Number of Cases notified during Quarter 25 7 7 Inward Transfers, Un-notified Deaths, etc. 1 1 - - 32 4 Number of Cases removed from the Register 23 7 Number of Cases remaining on the Register at end of Quarter 156 145 441 315 3rd QUARTER, 1932. Respiratory System Other Forms M. F. M. F. Number of Cases on Register at commencement of Quarter 441 315 156 145 Number of Cases notified during Quarter 24 14 6 1 Inward Transfers, Un-notified Deaths, etc. 2 1 - Number of Cases removed from the Register - 13 42 29 11 Number of Cases remaining on the Register at end of Quarter 301 140 425 144 4th QUARTER, 1932. Respiratory System Other Forms F. M. M. F. Number of Cases on Register at commencement of Quarter 140 144 425 301 Number of Cases notified during Quarter 24 17 5 1 Inward Transfers, Un-notified Deaths, etc. 7 11 4 1 Number of Cases removed from the Register 27 15 13 33 Number of Cases remaining on the Register at end of Quarter 295 137 133 427 IV. LIGHT TREATMENT. The following table shows the work done in the Solarium during 1932:- Number of Attendances 31,344 „ Examinations 3,748 „ New Patients 759 „ Discharges 696 „ Maternity and Child Welfare Cases under treatment during the year 358 „ Tuberculous patients under treatment during the year 58 Total number of other classes under treatment during the year 685 (The Maternity and Child Welfare patients formed 32.5 per cent, of the total number under treatment and the tuberculosis patients 5.3 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. During the year there has been a considerable increase in the amount of work done in the Solarium, and the number of attendances shows an increase of 6,000 compared with last year. These figures are gratifying when it is remembered that the light clinic is situated in a temporary corrugated iron building which in many respects is unsatisfactory, particularly in the matter of dressing room accommodation. In previous years the Solarium has not been closed at all during the year, except for a day or two at Christmas, This year the staff took their holidays at the same time, and the Solarium was closed for three weeks in August. This arrangement has worked well, and as many patients, especially school children, become irregular in their attendances during the holiday months of August, there has been little or no disadvantage to patients. There was no change in the general equipment of the apparatus, and maintenance in this direction was limited to the rejuvenation of quartzburners, the output of which deteriorates when subjected to prolonged usage. Individual treatment is conducted in cubicles and the group system has been maintained for school children and toddlers. This Clinic is of great value to the Tuberculosis Officers, who report improvement in many cases. Good results, previously noted, have been achieved in cases of tuberculosis, particularly, in suppurative or non-pulmonary conditions. The treatment is also of high value in helping to maintain a patient's condition after his return home from Sanatorium. Uniformly good improvement was obtained in the Maternity and Child Welfare section, both in ante-natal cases and amongst children suffering from rickets and from malnutrition and debility. As stated last year many patients were referred for treatment for chronic rheumatism conditions, and, in approximately twothirds of these cases, an improvement is noted with amelioration of suffering. LEYSIN PATIENTS. In the following table will be found a complete list of patients who have been sent to Leysin by the Borough Council. Period previously under Medical Treatment prior to going to Leysin Date sent to Leysin Date returned from Leysin Initials of Patient Age Sex Localisation of Disease Result S.B. M. Left Foot Well and at work 12 5 years 28/7/24 5/7/27 I. R. 10 F. Glands of Neck 5 „ 28/7/24 6/10/25 Removed from District M.S. 15 F. Right Knee 6 „ 28/7/24 6/10/25 Well and at work 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. 28 F. Glands of Neck 15 „ 26/10/25 22/2/27 „ „ E.C. 16 F. Right Knee 5 „ 26/10/25 8/7/27 „ „ H.C. 10 M. Glands of Neck 26/10/25 20/2/27 „ „ 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 9/2/27 2 „ 8/5/28 Removed from District C.P. 24 M. Spine 7 „ 5/7/27 8/5/28 Seen recently. Keeping well A.R. 26 F. Glands of Neck 3 „ 5/7/27 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. Tuberculide of Skin 1 „ 20/6/28 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 31/5/29 Seen recently. Keeping well 8 „ 5/8/32 C.C. 27 F. Multiple Lupus 6/5/32 20 „ 20/1/30 Well and at work 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 - Still at Leysin 15/4/30 G.L. M. Spine 13/10/30 15 10 months Dead (Tuberculous Meningitis) V.B. 16 F. Lupus of Nose 1 year 6/2/31 6/5/32 Well and at work D.R. 34 M. Spine 4/7/31 Dead (Cerebrospinal Meningitis) 4 years J O'B. 17 M. Right Knee 7 months 30/7/32 - Still at Leysin V.—MATERNITY AND CHILD WELFARE. There has been no material alteration in the Maternity and Child Welfare Scheme during the year. I reported last year that, owing to re-building operations in connection with Percy Hall, it had been necessary to find temporary accommodation at the Time and Talents Club. The new building in Jamaica Road was completed in the early part of this year, and the clinic has now removed from the Time and Talents Club to the new premises of the Bermondsey Gospel Mission. Changes have also been made with regard to the child welfare work at the Central Hall in Tower Bridge Road, so as to bring this centre more directly into line with the general scheme. There are six clinics held each week, at two of which Dr. Telfer now attends. In addition, three municipal health visitors are now helping at each session, and a district has been allocated to the health visitor employed by the Central Hall for systematic home visiting. It is anticipated that these alterations will result in a considerable improvement in the quality of the work done at this centre. FAIRBY GRANGE CONVALESCENT HOME. There has been a slight decrease in the total number of admissions to the home as compared with last year, the figures being:— Number of women admitted 224 Number of babies admitted 107 Number of toddlers admitted 147 MIDWIFERY SERVICE. Under this scheme 498 patients "booked" during the year. In 313 of these cases the full fee of the midwife was paid by the Council and a proportion of the fee was paid in 169 other cases; the remaining 16 cases were assessed to pay the full fee. OBSTETRIC AND PUERPERAL FEVER CONSULTANTS. The names of the gentlemen who have agreed to act in this capacity will be found on page 71. The number of consultations during the year was as follows: — Obstetric Consultations Nil Puerperal Fever Consultations 2 HEALTH VISITORS. The following table shows the work done by the Municipal and Voluntary Centres and Health Visitors during 1932:— District Health Talks Births Notified Visits to Infants and Children Visits to Expectant Mothers Puerperal Fever and Puerperal Pyrexia Ophthalmia Neonatorum Other Visits Attendance at Centres First Visits Re-visits 1-5 years Under 1 year Primary Visits Re-visits Cases Visits Cases Visits No. 1 87 93 805 1052 46 139 - - - - 236 27 848 „ 2 87 108 448 860 69 93 1 1 - 1273 208 - - (38) 76 83 433 538 56 143 6 7 - - 1290 232 46 „ 3 „ 4 (St. George's Hall) 152 151 1202 1499 73 1 1 1 1 1112 61 55 218 „ 5 79 81 385 722 51 95 - - - 608 120 12 — 1 „ 6 133 134 687 910 44 137 - 964 210 31 1 - „ 7 157 146 1337 859 14 3 3 1 1 853 217 99 220 79 9 „ 8 192 194 1170 1066 22 9 1 1 452 233 20 „ 9 (Fulford Street) 175 175 934 1305 134 285 2 2 I 1 762 153 33 „ 10 136 165 1306 1107 64 237 6 6 2 5 471 198 24 1 3 „ 11 164 165 1108 1121 59 245 4 6 272 233 23 431 60 „ 12 139 143 1177 1299 22 451 2 2 3 4 180 Salomon's Centre 105 103 1358 3870 650 623 - - - 255 - - - Central Hall 5 44 - 156 199 - 83 326 325 11 - - - 1824 16533 3009 38 10 16 9492 2735 430 Totals 1687 12676 1315 35 ATTENDANCES AT MATERNITY AND CHILD WELFARE CENTRES. The following table shows attendances at Maternity and Child Welfare Centres during 1932:— Children's Consultations Ante-natal Clinic Sewing Class Name of Centre New Cases Total Attendances No. seen by Doctor No. of Sessions New Cases Total Attendances No. of Sessions No. of Sessions No. of Attendances Under 1 year 1-6 years Under 1 year 1-5 years 110 Grange Road 200 247 123 5,591 4,804 5,511 81 1,123 48 203 845 98 Rotherhithe New Road 153 249 4,437 2,964 213 1,082 258 19 3,393 101 35 Trinity Road 52 46 11 876 1,180 - - - 762 - - Percy Hall and Time and Talents 1,781 115 100 20 2,137 - 2,149 - - - - 47 882 842 Roseberry Street 62 11 590 - - - - - Salomon's Centre 153 113 2,368 1,720 2,267 495 - 8 163 1,577 - Princess Club 165 186 29 3,521 2,985 4,234 51 696 1,667 112 90 Fulford Street 101 172 15 2,357 2,025 2,721 51 162 640 34 223 St. George's Hall 93 24 1,244 1,147 1,213 46 52 719 - - - 204 55 16 7,538 10,100 Central Hall - - - - - - Maternity and Child Welfare. STATISTICS FOR THE YEAR, 1932. Borough Council of Bermondsey. POPULATION according to the Census of 1931. — 111,542. Births. Registered— Total Males Females Live Births Legitimate Ille gitimate 1,798 33 940 21 858 12 Birth Rate per 1,000 of the estimated resident population 16.6 Total Males Females Stillbirths 65 35 30 Rate per 1,000 total (live and still) births 34 Notified within 36 hours of birth— (1) Live Births, 1,730. (2) Stillbirths, 48. (3) Total, 1,778. (1) By Midwives, 594. (2) By Parents and Doctors, 1,184. Total. Males. Females Deaths 1,326 750 576 Death Rate per 1,000 of the estimated resident population 12.0 Maternal Deaths. Deaths from puerperal causes:— Deaths. Rate per 1,000 total (live and still) births. Puerperal Sepsis 1 0·53 Other puerperal causes 3 1·58 Total 4 2·11 Infant Deaths. Number— (1) Legitimate, 96. (2) Illegitimate, 7. (3) Total, 103. Rate per 1,000 live births— (1) Legitimate, 52. (2) Illegitimate, 4. (3) Total, 56. Health Visitors. Visits paid by Health Visitors during the year:— To Expectant Mothers (1) First Visits, 1,315. (2) Total Visits, 3,009. To Infants under 1 (1) First Visits, 1,824. (2) Total Visits, 12,676. To Children, 1-5 Total Visits, 16,533. Convalescent Homes For Children under 5. Number of Beds, 16. Number of Children under 5 received during the year, 254. Day Nurseries. Number of day nurseries 2 (both voluntary). Number of places for children under 5 in the nurseries:— Summer months 60. Winter months 56. Total number of attendances of children at these nurseries during the year:— 9,065. Deaths from Measles (all ages) 25 Deaths from Whooping Cough (all ages) 16 Deaths from Diarrhœa (under 2 years of age) 11 VI. DENTAL TREATMENT. I have to report an increase of 933 in the number of patients treated during 1932. This figure includes an increase of 231 in the number of children treated. Generally speaking there has been an increase in the amount of surgical work carried out, and a slight decrease of prosthetic work. This decrease is due partly to trade depression and partly to restriction of dental benefit under the National Health Insurance. It has been found possible to dispense with one gas session at the Bermondsey Centre. (42) TREATMENT OF CHILDREN DURING 1932 Age Group Number Examined Number Treated Number of Extractions Anæsthetics Number of Scalings Number of Attendances for Orthodontics CENTRE Number of Fillings Total Number of Attendances Local General 110, Under 5 years 423 587 1658 22 406 23 - - 788 Over 6 years 524 499 1115 152 310 241 2 94 1103 GRANGE ROAD. r Totals 947 1086 2773 174 716 264 2 94 1891 98, ROTHERHITHE 192 221 826 6 189 6 - 369 Under 5 years - NEW ROAD. Over 5 years 285 740 226 86 2 2 312 50 575 Totals 477 533 1566 56 415 92 2 2 944 (43) DENTAL TREATMENT CARRIED OUT DURING 1932 CENTRE Type of Case Number of Patients Examined Number of Extractions Number of Fillings Number of Dentures Fitted Number of Repairs to Dentures Number of Attendances Number of Scalings Anæsthetics Number of Patients Treated Local General Maternity Cases 773 1153 2358 73 29 183 75 1733 220 630 Women 1117 1214 1050 93 186 94 1836 1838 23 67 Men 1768 1898 3236 1920 40 252 43 228 101 3189 110, GRANGE ROAD Tuberculosis Cases 91 3 72 149 58 29 92 8 5 224 Children (Table I.) 1086 174 947 716 264 2773 2 - - 1891 Totals 5442 10354 3832 1098 867 100 248 8873 4677 513 Maternity Cases 434 462 1721 231 229 19 21 121 34 1112 98, ROTHERHITHE NEW ROAD. Women 365 353 258 69 7 46 19 756 65 684 Men 492 22 65 21 56 16 498 956 500 857 Tuberculosis Cases 2 7 3 - 4 - - - 7 3 Children (Table I.) 533 1566 56 415 2 - - 477 92 944 1771 5006 245 223 69 1848 1048 VII—PROPAGANDA. During the year 1932, the following lectures and demonstrations, each illustrated by lantern slides and cinema films, were given:— Lectures. Audiences. Schools 40 10,350 Clubs and other Institutions 46 3,880 Open-air, with cinema van 62 29,550 148 43,780 The total of 148 is three less than for the previous year, when the number of 151. A new film of 2,000 ft. entitled "Consumption," was written and produced, the general theme being that "Consumption is Curable, Consumption is Preventable." The film strikes a cheery note throughout, and has been very useful in helping to remove from the public mind the dread of the disease, and the feeling of hopelessness which so commonly seizes those who suffer from pulmonary tuberculosis. We now have a total of 22 films and 47 pamphlets in our library. The annual examination for school children in Personal Hygiene was held in June. This is the third year of this scheme, which is worked in co-operation with the Head Teachers and Teaching Staff of the schools. Three classes of certificates are given, i.e., Elementary, Intermediate and Final. The Final Certificate also entitles the holder to a Proficiency Badge. The successful pupils at the June Examination were as follows:— Final Certificate and Proficiency Badge 4 Intermediate Certificate 19 Elementary Certificate 66 It is proposed during the year 1933 to hold similar examinations for nursing. During the year an attempt was made to bring our films more into line with the "Talkies" at present in general use, and for this purpose, it was proposed to prepare gramophone records with running comments synchronised with the films. The film selected for the experiment is about 1,500 feet long, and entitled "Our Food Supplies." After deducting the captions there remained about 1,000 feet of the picture for which the speaking part had to be written. It was necessary so to time the words that they fitted in exactly with the portion of the picture being described, and so that the last word was spoken as each section of the picture finished. After a good deal of careful thought, this was managed without any alteration at all in the photography. The next step was to get the records made, and, for this purpose, the wellknown gramophonecampanies were asked to give quotations. The cost of this work, however, was so high that it became impracticable. In fact, the records for the film would have cost almost as much as the film itself. We then endeavoured to obtain an apparatus to make our own records, but, so far, have not been successful. There are a number of self-recording machines on the market, but they are really only toys, and quite unsuitable for our purpose. Many enquiries have been made during the year, but, as far as we can ascertain, no British manufacturer can supply a suitable apparatus, and it seems that eventually we shall be compelled to purchase abroad. (46) VIII. SANITARY ADMINISTRATION. HOUSING. Work has proceeded actively in connection with the areas which were set out in my last annual report, and I anticipate that, before the end of 1933, these areas will have been entirely cleared, and the population rehoused in modern dwellings. Three new areas have been declared by the Council during the year. With regard to the Leroy Street Area, it is necessary to point out that part of the area has been excluded, and the remainder has now been divided into two smaller areas. The following are the areas declared: — Title of Clearance Area Area in sq. ft. (approx.) No. of dwelling houses Population Date declared by Council families persons Porlock Place 12 11,282 21 90 19/4/32 14,985 217 21/6/32 Bethel Place 49 56 67,518 111 176 762 22/11/32 Leroy Street During the year the following new premises have been erected by the Council: — Position No. of Flats No. of families accommodated Grange House, Grange Walk 32 32 Bermondsey Street 6 and 2 cottages 8 Harold Estate, Pages Walk 50 50 Horney Lane 14 14 Amos Estate, Rotherhithe Street 56 and 2 shops 56 Lavender House, Rotherhithe St. 15 15 Redriff Estate, Rotherhithe Street 24 24 Aylwin Estate, Grange Walk 14 14 Silver Street Flats 14 14 Acorn Walk 57 57 Millpond Estate, Gilhams Court 38 38 Vauban Street 5 5 and 3 shops 2 cottages As there are no vacant sites in the Borough suitable for working class houses, there is no prospect of building by private enterprise, and so far as I am aware only six houses were erected during 1932 by private individuals. The London County Council have completed the erection of Dombey House and Copperfield House, providing 65 flats in all, and two further blocks are in course of erection. The following premises are in course of erection by the Council:— Position. Acorn Walk Extension No. of Flats 22 Amos Estate, Rotherhithe Street 48 and 5 shops Lavender House, Rotherhithe Street 29 Redriff Estate, Rotherhithe Street 42 Aylwin Estate, Grange Walk 14 Silver Street Flats 36 Millpond Estate, Gilhams Court 16 Vauban Street 18 and 3 shops Fort Road (Stansfeld Estate) 49 Crosby Row 36 No new premises have been purchased, leased or converted. OVERCROWDING. So far as overcrowding is concerned, I have no fresh facts to report. The position does not seem to me to improve, and the number of overcrowded families known to us in the Borough is practically the same as last year. The figures are as follows:— Overcrowded families desiring local accommodation 1,100 Other families desiring local accommodation 806 Total 1,906 Underground Rooms. —The number of underground rooms in the Borough is shown in the following table:— Living only Living and sleeping Sleeping only Total 317 32 3 352 and the number of rooms where the whole of the accommodation of families is underground is 5. During the year 8 underground rooms used for sleeping purposes have been closed. One Closing Order was made under the Housing Act, 1925. The house has now been demolished and the inhabitants rehoused elsewhere. Seven Demolition Orders have been made under Section 19 of the Housing Act, 1930. One of these houses has been demolished, and eight houses, including two on which Orders were made in 1931, are now closed for demolition. No notices have been served under Section 17 of the Housing Act, 1930. Hereunder will be found particulars of Inspections, Proceedings, etc., for the year 1932:— Inspection of Dwelling Houses during the Year:- (1) (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 8,741 (b) Number of Inspections made for the purpose 34,225 (2) (a) Number of dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 5,014 (b) Number of Inspections made for the purpose 5,014 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 178 (4) Number of dwelling-houses (exclusive of those referred to under the preceding subhead) found not to be in all respect; reasonably fit for human habitation Nil 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 4,667 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 Nil (2) Number of dwelling-houses which were rendered fit after service of formal notices:— (a) By owners 7 (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 6,587 (2) Number of dwelling-houses in which defects were remedied after service of formal notices:— (a) By owners 1920 (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 7 (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 underground rooms in respect of which Closing Orders were made 7 (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 became operative 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 became operative 1 (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 became operative 1 (4) Number of dwelling-houses demolished in pursuance of Demolition Orders 1 Total number of houses in the Borough 18,711 Number of houses occupied by the working classes 18,567 REGISTERED PREMISES — Premises Number on Register at end of 1932 Number of Inspections Number of Prosecutions 511 Milkshops 296 - Houses let in lodgings 76 460 - 145 Ice Cream Premises 155 - Offensive Trades (including Poultry Slaughter-houses) 62 14 - SMOKE NUISANCES — Number of observations 49 Number of notices 14 Number of complaints 8 Number of summonses Nil UNDERGROUND ROOMS— Number illegally occupied 5 Number closed or illegal occupation discontinued 8 WATER SUPPLY TO TENEMENT HOUSES- Premises supplied 6 Prosecutions 1 SALE OF FOOD— Number of premises used other than ice-cream premises, milk shops and cowsheds 649 Number of inspections 3,470 RAG FLOCK ACTS, 1911 AND 1928— There are four premises in the District where rag flock is used, and each of these premises was inspected twice during the year, the total number of inspections being eight. There were no prosecutions. Water Supply.—Most of the houses in the Borough have the water supply either on the ground floor or in the yard, and many of these houses are, of course, inhabited by more than one family. Quite a number of houses are without a direct supply from the rising main. Water Closet Accommodation. —Practically every house in the Borough has one water closet, which 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 each of the schools has been inspected twice during the year, and the attention of the London County Council has been drawn to the accommodation in one of these schools, 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. 4 (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- WORK OF DISTRICT INSPECTORS, 1932. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 House-to-House Special Inspections Complaints Factories & Workshops Specially Inspected Outworkers' Bi-Annual Inspection Underground Conveniences Other Calls and Visits Chimneys watched Bakehouses Butchers Fishmongers, Friers and Curers Fruiterers and Greengrocers Markets Restaurants and Eating Houses Various TOTALS Destruction of Food Infectious Diseases Offensive Trades Drains Tested Food Stores Ice Cream Visits Ints. Mr. Butcher 793 1501 483 209 181 9 31 - 73 1937 3 39 57 54 108 104 21 65 174 - 1 5843 897 Mr. Richardson 709 1541 460 195 41 7 25 - 27 2473 8 44 20 155 19 9 - 5939 51 20 105 30 1002 Mr. Luke 720 835 356 84 58 6 24 - 83 2686 1 24 225 57 191 113 38 137 84 2 13 5637 783 Mr. Tapsfield 716 1799 416 157 14 37 33 - 70 2234 9 42 73 37 83 52 5 79 66 5923 1058 1 - Mr. Toll 727 1062 - 76 - 29 2208 21 41 123 44 290 79 26 137 68 4 6 5673 486 179 67 1092 Mr. Smart 713 1121 212 154 67 3 11 42 2551 4 20 122 61 266 141 20 123 61 3 4 5699 - 872 1304 234 8 28 Mr. Bailey 636 102 - - 40 2332 3 32 49 31 102 30 25 139 58 1 - 5154 935 FACTORIES, WORKSHOPS, LAUNDRIES, WORKPLACES, AND HOMEWORK. HOMEWORK. NATURE OF WORK (1) Outworkers' Lists, Section 107 Outwork in Unwholesome Premises Section, 108 Outwork in Infected Premises (Sections 109, 110) Lists received from Employers Outworkers resident in Bermondsey received from other Districts Notices served on Occupiers as to keeping or sending lists (8) Prosecutions Notices served (12) Prosecutions (13) Instances (14) Notices served 5) Prosecutions 16 Lists (2) Outworkers Failing to keep lists (9) Failing to send lists (10) Resident in Bermondsey Resident in other Districts (5) Instances (11) Contractors Workmen (4) Contractors (6) Workmen (7) Wearing Apparel:— ] „ I I I „ I I I . I I .. I I . I I i I I I _ I I _ I I T - 1 1 —i I 48 42 7 5 (1) Making, etc. 25 - 36 6 - - 5 1 - - - (2) Cleansing and washing - - - - - - - - - - - - - - - 1 - Fur pulling - - - - - - - - - - - - - 1 1 - Umbrellas, etc. - 2 - - - - - - - - - - Sacks 5 - 3 1 2 - - - - - - - - - - Paper, etc., Boxes, Paper Bags 4 - 2 2 8 1 - 2 2 - - - - - - 5 2 Brush making - - 2 - - - - - - - - - - Chocolates and Sweetmeats - - - - - - - - - - - - - - - Leather Goods 4 - 4 5 2 1 3 3 2 - - - - - - Surgical Instruments 2 - - 4 - - - - - - - - - - - - 12 - 2 Coathangers 2 30 1 2 - - - - - - - Carding of buttons, etc - - 2 - - - - - - - - - - - - Onion Peeling - - - - - - 2 - - - - - - - - - - Total 43 14 - 3 - 63 90 7 12 - - 14 58 (55) FACTORIES, WORK8HOPS, LAUNDRIES, WORKPLACES AND HOMEWORK INSPECTION. Premises Number of Inspections Written Notices Prosecutions Factories (including Factory Laundries) 610 14 - Workshops (including Workshop Laundries) 137 17 - Workplaces (other than Out workers' Premises) 152 17 - Total 899 48 - DEFECTS FOUND. Particulars Number of Defects Number of Prosecutions Found Referred to H.M. Inspector Remedied Nuisances under the Public Health Acts— 4 4 - Want of Cleanliness - Want of Ventilation - - - - Overcrowding - - - - Want of Drainage of Floors - - - - Other Nuisances 17 17 - - Sanitary Accommodation— Insufficient 1 1 - - Unsuitable or Defective 17 17 - - Not separate for Sexes - - - - Offences under the Factory and Workshop Act— I I I Workshop Act — Illegal Occupation of Underground Bakehouse (s. 101) - - - - Breach of Special Sanitary Requirements for Bake-houses (ss. 97 to 100) 33 33 - - 3 Other Offences 3 - - 75 (56) OTHER MATTERS. Number Class. Matters notified to H.M. Inspectors of Factories— Failure to affix Abstract of the Factory and Workshop Act (s. 133) - Action taken in matters re ferred by H.M. Inspectors as remediable under the Public Health Acts, but not under the Factories Act (s. 7) Notified by H.M. Inspectors 4 Reports (of action taken pent to H.M. Inspectors) 4 2 Other Underground Bakehouses (s. 101):- Certificates granted during 1932 - 17 In use at end of 1932 Workshop Bakehouses 18 417 Workshops on the Register (s. 131) at the end of 1932 435 Total Number of Workshops on Register No. OF BAKEHOUSES IN THE BOROUGH. In Use Not in Use Underground Above ground Underground Above ground 3 1 17 38 37 of these are Factory Bakehouses (57) HOUSE, TRADE AND MARKET REFUSE. The following table shows the amount of house, trade and market refuse disposed of during 1932:— Disposal Loads tons cwts. qrs. House Refuse to Barge 14,525 6 2 10,192 „ „ „ Destructor 3,151 6,690 11 2 3 15 „ Shoot 3 - Trade Refuse „ Barge 2,302 1,869 2 1 425 10 „ „ Destructor 520 - „ „ „ Shoot 29 36 5 - 1,567 Street Markets Refuse to Barge 1,681 18 3 „ „ „ Destructor 227 326 16 - „ „ „ Shoot 22 10 27 - Totals 17,918 25,681 15 - OFFENSIVE TRADES. The offensive trades on the Register are as follows: Fellmongers 3 Fatmelters 2 Glue and size makers 3 Dresser of Fur Skins 6 MORTUARY. Particulars of bodies removed to the Mortuary during the year are, as follows: — Total number of infectious bodies removed 33 Total number of bodies removed 97 STREET MARKETS. The market scheme continues to work smoothly and satisfactorily. Number of Licences in operation 631 Income £2,855 There have been 67 prosecutions during the year. DRAINAGE WORK. Hereunder will be found particulars of drainage work, &c., carried out by the Drainage Inspector during 1932:— Drains Tested 721 Intimation Notices served 10 Visits to Underground Conveniences 410 Other Visits 3,620 IX—FOOD CONTROL. In this section of my report is given tabulated information concerning the work of the three Wharves Inspectors and of the Food and Drugs Inspector. There have been no unusual features in their work this year and there is therefore no need for any special comments. UNSOUND FOOD. The general inspection of food in shops and on stalls forms part of the duty of the District Sanitary Inspector. The following food, in the quantities stated, 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. bs. Fresh Meat 1 2 3 14 Fresh Fish — 1 1 14 Fresh Fruit — 14 — 12 Hams, Tinned — 3 2 22 Poultry — — 2 6 Vegetables — 3 3 — Total 2 6 1 12 (59) PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1925. Under these Regulations, 24 samples were taken during the year by the Wharves Inspectors. Of this number, 2 samples were taken in order to ascertain the composition of an unusual product; 11 were examined for preservatives ; 6 samples were bacteriologically examined and 4 were examined for the presence of tin. The remaining sample was taken from a consignment of broken worm-eaten nutmegs and in this case the attention of the Ministry of Health was drawn to the matter with a view to further investigation in other districts. No. of Samples Examination Result Action taken Article Examined Sardine' Oil 1 To ascertain composition Genuine Released Mace Butter Pork Brawn 1 1 „ For presence of tin „ o*o3 grain of tin per pound „ Released for rendering down Fruit Salad 1 0*77 grain of tin per per pound Re-exported to packers „ Canned Salmon 2 0-55 and 0*33 grains of tin per pound respectively Taken at request of Ministry of Health „ Bacon 1 For preservative Genuine - Butter 1 „ „ - Caviare 2 „ 1 Genuine 1 contained 0*41 per cent. Boric Acid Transferred to another district under the supervision of Medical Officer of Health 6 „ 5 Genuine contained Sulphur Dioxide 2360 parts Warned Fruit Pulp 1 „ per million Sulphur Dioxide 1200 parts Under "stop" notice Must (unfermented grape juice) 1 per million Released Nutmegs Bacteriological 6 „ — Gherkins Made "Full and Sound" WORK OF THE WHARF AND FOOD INSPECTORS, 1932. 1 2 3 4 5 6 7 8 9 10 11 Number of Samples taken Food Factories Food Stores Nuisances Found Jam Butter and margarine Other Restaurants Milksellers Food and Drugs Milk (Special Designation) Order Imported Food Regulations Food Wharves and Depots Destruction of Food Intimations Served Fish Curers Various - 2 38 2 2574 - 213 - 17 17 19 287 - - - 4 19 95 - 228 1711 179 1 46 - 5 - - - 7 101 163 - - 185 20 1912 - 1 160 - - 26 - 11 87 - - - - - - 2 2 627 511 - 1502 - - 124 21 318 22 678 511 9 3 716 33 87 6197 1 552 1502 MILK PREMISES. MILK AND DAIRIES (AMENDMENT) ACT, 1922. Forty-seven milksellers were registered under the above Act daring 1932, and 41 names were removed from the Register, making a total of 296 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 29 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 6 To sell "Pasteurised" Milk 4 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 511 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 479 Condensed milk 6 Condensed full cream milk 1 Condensed machine skimmed milk 2 Separated milk 3 Sterilised milk 9 Pasteurised milk 11 511 " For bacteriological examination." Grade 'A' (T.T.) milk 70 Pasteurised milk 17 Liquid milk undesignated 50 For tubercle bacilli 7 144 (62) FOOD AND DRUGS. Articles submitted for Analysis Total Samples Taken Number Genuine Number Adulterated Percentages of Articles Adulterated 1 Almond, Block 1 - - Almonds, Ground 7 7 - - Antelope Phosphate-Powder 1 1 - - 2 Aspirin Tablets 2 - - 1 Aspro Tablets 1 - - 3 3 Baking Powder - - 13 13 Barley, Pearl - - 1 Barley, Small Pearl 1 - - Beef, Brisket 1 1 - - Bicarbonate of Soda 1 1 - - 2 2 Black Pudding - - Blancmange Powder 1 1 - - Bloater Creme 1 1 - - 2 Boracic Powder 2 - - 1 Borax Purified 1 - - 10 10 Brawn - - 223 223 Butter - - 1 Cake, Currant 1 - - Cake, Fruit 1 1 - - 1 Cake, Seed 1 - - 4 4 Cake, Sponge - - Candied Peel 1 1 - - Cheese 14 14 - - 2 2 Chicken and Ham Roll - - 1 1 Chocolate Compound - - Chutney, Indian 1 1 - - Cinnamon, Ground 1 1 - - 3 Cocoa 3 - - Cocoanut, Desiccated 1 1 - - Coffee 10 10 - - 1 1 Coffee and Chicory Essence - - 1 Compound Glycerine-of-Thymol 1 - - 1 1 Cream - - 1 1 Cream Powder - - 1 1 Cream, Tinned - - 6 Cream of Tartar 6 - - 1 1 - Currants - 1 1 Currie Powder - - 2 Custard Powder 2 - - 1 Cyder 1 - - 65 Dripping 65 - - 1 Egg Substitute Flour 1 - Egg Substitute Powder 1 1 - - Eggs, Vapo 1 1 - - 8 8 Fat, Cooking - - 3 Fish Paste 3 - - Flour 2 2 - - 9 9 - - Flour, Self-raising 2 2 - - Fruit, Mixed 3 Fruit Salad 3 - - Ginger, Brandy-flavour 1 1 - - 2 Ginger, Ground 2 - - Glauber Salts 2 2 - - 3 3 Glycerine - - 1 1 Golden Syrup - - Grape Fruit Squash 1 1 - - (63) FOOD AND DRUGS—continued. Number Genuine Number Adulterated Articles submitted for for Analysis Total Samples Taken 1 1 Hock Yalumla - 3 3 Honey - 1 1 Horseradish Cream - 1 1 Ice Cream - 5 4 1 Jam, Blackcurrant 1 1 Jam, Mixed Fruit - 1 1 Jam, Plum - 1 1 Jam, Red Plum - Jam, Red Plum Stoneless 1 1 - 11 10 1 Jam, Raspberry 1 1 Jam, Raspberry Flavour (Informal) - 1 1 Jam, Raspberry and Gooseberry 2 6 6 Jam, Strawberry - 1 1 Jam, Strawberry and Gooseberry - Jam, Victoria Plum 1 1 - Jam Sandwich 1 1 - 1 1 Jellies - 10 10 Lard - Lemon Cheese 1 1 - 3 3 Lemon Curd - 3 3 Lemonade Powder - Lemon Squash 2 2 - 1 1 Limejuice Cordial - 1 Linseed 1 - Linseed, Crushed 2 2 - 4 4 Liquorice Powder Compound - 1 1 Loganberries (Informal) - 1 Malt Extract and Cod Liver Oil 1 - 103 103 Margarine - 1 1 - Margarine Cake Margarine Pastry 1 1 - 3 3 Marmalade - 1 1 Marmalade Jelly - Milk 479 457 22 6 6 Milk, Condensed - 1 Milk, Condensed, Full Cream 1 - Milk, Condensed, Machine-Skimmed 2 2 - 11 11 Milk, Pasteurised - 3 2 1 Milk, Separated Milk, Sterilised 9 9 - 1 1 Mincemeat - 5 Mustard 5 - Oats, Flaked 1 1 - 2 2 Oatmeal - 2 Oil, Camphorated 2 - 1 1 Oil, Castor - 1 1 Oil, Cod liver - 3 Oil, Olive 3 - 2 Oil, Olive (Informal) 2 - Oil of Wintergreen 1 1 - 2 2 Oil, Soya - Ointment, Boric 2 2 - 1 Ointment, Mercury 1 - 4 4 Ointment, Zinc - Orange Squash 1 1 - Paraffin Liquid 2 2 - Paste, Dressed Crab (Informal) 1 1 1 (64) FOOD AND DRUGS—continued Number Adulterated Articles submitted for Analysis Total Samples Taken Number Genuine Percentages of Articles Adulterated 19 Paste, Fish 19 - - 1 Paste, Cheese and Tomato 1 - - 2 Peas, Green 2 - - Peas, Mixed 2 2 - - 27 - Pepper 27 - 1 Permanganate of Potash 1 - - 1 - Pickle 1 - - Pickled Cabbage 1 1 - Pickled Walnuts 1 1 - - - - Pilchards (Informal) 1 1 3 - Quinine, Ammoniated Tincture of 3 - - Raisins 4 4 - - Raisins (Seedless) 1 1 - 1 - Raspberry Compound 1 - - Relish 1 1 - Rice 3 - - 3 Sal Volatile (Informal) 1 1 - - 1 - Saline, Health 1 - Sauce 2 2 - - 2 2 - - Sauce, Worcester 1 12.5 Sausages 8 7 Sausages, Beef 36 36 - - - 40 40 - Sausages, Breakfast Sausages, Beef Chipolata 1 1 - - 1 - Sausages, Chicken, Ham and Tongue 1 - 2 - 2 - Sausages, Liver - 7 - - Sausages, Luncheon 1 Sausages, Ham 1 - - - Sausages, Pork 23 23 - - 1 1 - Semolina 1 1 - - Sherry - - Sugar 3 3 Sugar, Castor 1 1 - - 1 1 - - Sugar, Demerara 1 1 - - Suet, Shredded 5 - Sultanas 5 - 1 1 - - Swiss Roll 5 Tartaric Acid 5 - - 5 - Tea 5 - Tea Dust 1 1 - - 1 1 - - Tincture of Iodine - - Tomato Ketchup 1 1 1 - - Tomato Sauce 1 1 1 - - Veal Loaf 1 1 - - Veal Savoury - Veal and Ham 1 1 - 1.5 67 66 1 Vinegar 41 - - Vinegar, Malt 41 1 - Walnuts, Pickled 1 - Wine, Australian 1 1 - - Wine, Blackcurrant 2 2 - - 1 1 - Wine, Blackcurrant Flavour - 7 - Wine, Ginger 7 - 1 1 - - Wine, Orange 1 - Wine, Orange Quinine 1 - - Wine, Peppermint 1 1 - 1 1 - - Wine, Raisin 1.9 1502 1473 29 Total (65) PROSECUTIONS IN CONNECTION WITH SAMPLES TAKEN DURING 1932. Adulteration or Infringement Remarks Deficient in acetic acid, 8.5 per cent. Dismissed on payment of 17s. 6d. costs. Deficient in milk fat, 8.7 per cent. Dismissed under Probation of Offenders' Act on payment of 17s 6d costs Deficient in milk fat, 9.6 per cent, and containing 5.8 per cent, of added water. Fined £3. Deficient in milk fat, 10.7 per cent. Fined £2. Containing Sulphurdioxide 0.023 per cent, (equivalent to 230.0 parts per million). Two Summonses under Public Health (Preservatives, etc., in Food) Regulations, 1925-1927. Dismissed on payment of £1 1s. costs by retailer and £3 3s. costs by the wholesale dealer. Deficient in milk fat 18.3 per cent. Dismissed on payment of 17s. 6d. costs. Containing 7.6 per cent, of added water Dismissed on payment of £2 2s. costs. Deficient in milk fat 10.0 per cent. Dismissed on payment of 17s 6d. costs. SUMMARY. £ s. d. Fines 5 0 0 Costs 9 16 0 £14 16 0 PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1925. Quantity Unsound Articles Destroyed Disposed of for Purposes other than Human Food Removed for Sorting under S.A. Quantity Weight Quantity Weight Quantity Weight lbs i I lbs tons cwt lbs tons cwt tons cwt qr qr qr Anchovies, Tinned 3 tins - 3 0 - - - - - - - - - - - - 7223 crates 45 5 3 Apricots - 14 - - - - - - - - - - 30 cases and 4 tins 10 1 12 Apples, Tinned - - - - - - - - - 0 4 13 Bacon 5 2 bales, 2 gammons & 3 pieces 4 3 184 bales 20 6 2 0 67 sides 1 gammon & 1 fore-end 1 - 1 16 22 - - Barley Sweepings 8 bags - - - - - - - - - 1 6 Beef - - 1 clod and sticking - - - - - - - - - 22 - - 1 tierce and 1 barrel 8 3 Beef, Bungs - - - - - - - - - 9 2 Beef, Corned 1008 tins 3 27 - - - - - - - - - - - 1 tin 14 Beef Extract - - - - - - - - - - - - 2 casks 10 0 0 Blackcurrant Pulp - - - - - - - - - - - 0 79 tins Brawn, Tinned 30 cases 9 0 1 2 15 - - - - - - - 14 Butter 29 boxes 2 0 1 box 2 0 - - - - - - - - - 30 bags - 18 0 Cabbage, Red 0 - - - - - - - - - Canned Goods (Various) - - - 83 8 2 3 - - - - - - - - Various parcels - 2 7 3 22 Cheese - - - - - - - - - - - Chicken (Tinned) 3 tins 20 - - - - - - - - - - - Chicory - - - 26 - - - - - - - - - - - PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1925 . —continued Articles Quantity Unsound Disposed of for Purposes other than Human Food Destroyed Removed for Sorting under S.A. Exported Quantity Weight Quantity Weight Quantity Weight Quantity Weight - tons cwt qr lbs tons cwt qr lbs tone cwt qr lbs tons cwt lbs qr Chocolate 2 cases 4 0 0 - - - - - - - - - - - - - Cocoanuts 439 bags - - - - - 32 19 0 0 - - - - - - - - - - - - - Cucumbers - 7 bags 7 - - 0 0 - - - - - - - - - - - - - Currants 4 boxes 2 - - 0 0 - - - - - - - - - - - - - - Various parcels 15 Dates 150 0 0 - - - - - - - - - - - - - - - 1 Duck - 46 birds - - 3 8 - - - - - - - - - - - - - 2329 tins Eggs - - - - 121 8 0 18 - - - - - - - - - - - Eggs, Liquid - - 110 cases and 15 tins 10 8 - - - - 0 - - - - - - - - - - - 9 - - - - - - - Fruit Salad, Tinned - - - - 248 cases 6 1 2 - Various packages - - Fruit Pulp - - - 2 - - 2 2 0 - - - - - - - - - - - - - - - - - - Game 48 cases 2 2 0 0 - - - - - - - Geese - - - 60 birds 1 5 - - - 0 22 - - - - - - - - - Gherkins - - - - - 40 casks 8 0 2 0 - - - - - - - - - - 1 Hams, Tinned 1 case - 0 7 451 tins 2 9 0 4 5 cases and 112 tins 10 2 19 29 tons 1 2 0 - - Hazelnut Kernels - - - - - 1 bag - - 2 0 0 - - - - - - - - - Lard - - - - - 3 boxes scrapings 1 2 0 1 0 8 2 boxes & 2 cases 3 0 0 - 3 boxes - - Lemon Peel in Brine - - - 1 keg - - - - 1 0 - - - - - - - - - - 5 Maize (damaged) - 27 1 4 - - - - - - - - - - - - - - - Meat (Tinned) - 12 cases 9 21 - - - - 3 - - - - - - - - - - - Milk Condensed 10 0 - 26 cases & 16 tins 16 10 cases and 2814 tins 1 3 1 10 - - - - - PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1925 -continued Quantity Unsound Disposed of for Purposes other than Human Food Destroyed Removed for Sorting under S.A. Articles Weight Quantity Weight Quantity Quantity Weight - - lbs , lbs tons cwt qr lbs tons cwt qr tons cwt qr Milk, Tinned Evaporated - - - 5 cases and 185 tins - 3 3 25 - - - - - - - 0 3 - - - - 2 Mustard 22 cases - - - - - - - 0 0 0 - - - Oil, Sardine 13 casks 2 - - - - - - - 2 1 1 - Oranges, Mandarin (Tinned) - - 7 cases & 17 tins - - - - - - - - - 6 - - - - 0 0 - Ox Kidneys 2 casks - - - - - 0 2 0 Partridges - - - 9 cases and 17 tins - 3 1 18 boxes 0 - - - 3 - 5 25 - - - - - Pig Shoulders (Tinned) 4 cases & 20 tins - - - - - - - - 2 14 1 22 - - Pineapples, Tinned 81 cases and 272 tins - - - - - - 7 - 2 22 - - - - Plums 19 baskets - - - - - 108 Potatoes 1157 bags 17 0 0 1701 bags 10 baskets & various 4 2 0 339 bags 16 19 0 0 57 - - 2 - - - - 1 2 Poultry 6 cases - - - - - 12 15 0 26 - - Rice (Damaged) - - - - - - - - - 67 ewe sides 6 wethers 3 hoggets 17 23 - Sheep 3 - - - - - - - - - - - 1 13 - - - - - - Sugar, Sweepings - - - - - - 10 0 - Tallow 46 casks 11 2 - - - - - - - - - 3 2 Tapioca (Damaged) - - - - - 3 bags - 3 - - - - - 565 bags 14 3 22 - - - - Tea Sweepings 26 - - - - - - 3 3 0 Tomatoes - - - - 30 boxes - - - - - - - PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1325—continued Quantity Unsound Disposed of for purposes other than Human Food Destroyed Removed for Sorting under S. A. Articles Exported Quantity Weight Weight Weight Quantity Quantity Quantity Weight cwt qr lbs tons cwt qr lbs cwt lbs tons qr tons tons cwt q r lbs Tomatoes, Canned - - - 130½ cases & 22 tins 3 19 0 18 - - - - - - - - - - - - - - - - 14 - 3 - Tomato Cream 180 tins - - - - - - - - - - - Tomato Puree - 1 2 1 - - 17 cases and 81 tins 18 - - - - - - - - - - - - - - 16 3 11 - - - - 6 Tongues, Lunch, Tinned 21 cases & 331 tins - - 6 tins - - - - - - 7 - - 1 - 4 - - - - Tongues, Ox, Tinned - 80 tins - - - - - - - - Tongues, Salted - - - - - 15 0 - - - - - 5 casks 0 - - - - - - Turkeys - - 7 18 24 - 2,396 birds 3 - - - - - - - - - - - - 10 cases 3 0 Veal, Jellied 0 272 tins - 14 3 13 - - - - - - - - - - - Vegetables, Preserved - - 3 tins - - 3 0 - - - - - - - - - - - - - Walnuts - 1 7 0 - - 17 casks 0 - - - - - - - - - - - - 0 Wheat, damaged 3 0 0 - - - - - - - - Yeast - 2 baskets 0 - - - - 2 ■ I - - - i J - 8 Total Weights 300 12 436 10 1 16 37 0 8 4 0 19 12 3 27 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, Percy Hall, 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, 2.0 p.m.-4.0 p.m. 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 Central Hall, Bermondsey Street. Tuesday, Wednesday, Thursday and Friday, 2.0 p.m.-4 p.m. PUERPERAL FEVER —CONSULTANTS. Mr. A. J. McNair, F.R.C.S., 10 Queen Anne Street, W.l. (Telephone: Langham 2861.) Mr. G. F. Gibberd, F.R.C.S., 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. OBSTETRIC CONSULTANTS. Mr. A. J. McNair, F.R.C.S., and Mr. G. F. Gibberd, F.R.C.S., as above. Applications for the services of a Consultant should be made to the Medical Officer of Health. DAY NURSERIES Newcomen Day Nursery, 66-67 Snowsfields. 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.-5.50 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. (Monday and alternate Thursday afternoons excepted.) Ear, Nose and Throat Alternate Mondays, 2.0 p.m.-4.30 p.m. Bermondsey Medical Mission Hospital, 44 Grange 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, 9.30-12 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. Dental Monday, 9.30 a.m.-12 noon. Tuesday, 2.0 p.m,-4.30 p.m. Wednesday, 9.0 a m -4.30 p.m. Thursday and Friday, 9.30 a.m.-12 noon 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 CLINICS, 98 Rotherhithe New Road. Monday, Wednesday and Thursday, 2.0 p.m. —4.30 p.m. and 5.30 p.m.—7.30 p.m. Friday, 2.0 p.m.—4.30 p.m. Town Hall, Spa Road. Tuesday, 2.0 p.m.—4.30 p.m. and 5.30 p.m.—7.30 p.m. Friday, 2.0 p.m.—4.30 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. The following facilities are afforded by the London Ambulance Service of the London County Council. Ambulances are provided free of cost except where otherwise stated. Infectious Cases. Telephone—City 7200. At any hour of the day or night Patients will not be removed to hospital unless a medical certificate stating definitely the nature of the disease is handed to the ambulance nurse. Infectious cases are conveyed to hospitals other than the L.C.C. hospitals for infectious diseases at a minimum fee of 12/6. Non-Infectious Cases. Telephone—City 7200. At any hour of the day or night Minimum fee 12/6. Accident Cases. Ask telephone operator for "Ambulance." At any hour of the day or night. Serious Illness. Telephone—Hop 6000, New Cross 2645, Central 6300-1, or Regent 4000. At any hour of the day or night. Ambulances are provided for persons suffering from illnesses in their homes if a medical practitioner certifies that the case is one of life or death, and that arrangements have been made for the reception of the patient in a hospital. Maternity Cases. Telephone—Hop 6000, New Cross 2645, Central 6300-1, or Regent 4000 except where otherwise stated. Urgent Cases At any hour of the day or night on application by a doctor or certified midwife, provided that either a doctor or midwife accompanies the case and that arrangements for the reception of the patient in a hospital have been made. Non-urgent Cases Between 11.0 p.m. and 8.0 a.m.—provided that admission to a maternity bed has been previously arranged and a card (issued by the London County Council to hospitals, maternity homes, etc.) for such admission obtained. This card must be handed to the ambulance attendant at the time of removal. The husband or a female friend must accompany the patient. Between 8.0 a.m. and 11.0 p.m. (Telephone City 7200) —by payment (minimum fee 12/6) or by application to the Medical Officer of Health, provided that arrangements for the reception of the patient in a hospital have been made. Cases approved by the Medical Officer of Health will be conveyed to hospital free of charge. The husband or a female friend must accompany the patient. Henry Richardson Ltd.. Printers, 4, Church Street, Greenwich, S.E.10