BER 48 CAC4378 Borough of Bermondsey. REPORT ON THE SANITARY CONDITION OF THE BOROUGH OF BERMONDSEY For the Year 1935 BY D.M. CONN AN, M.D., D.P.H., Medical Officer of Health. Borough of Bermondsey. REPORT ON THE SANITARY CONDITION OF THE BOROUGH OF BERMONDSEY For the Year 1935 BY D. M. CONNAN, M.D., 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 Rates 10 Deaths from Tuberculosis 10 Vital Statistics of District 11 Causes of Deaths 14 Deaths from Zymotic Diseases 16 Infantile Mortality, Causes of Deaths 17 INFECTIOUS DISEASES— Diseases Notifiable 18 Diphtheria 18 Scarlet Fever 19 Small Pox 19 Measles 19 Ophthalmia Neonatorum 19 Puerperal Fever and Pyrexia 20 Disinfection 20 Cleansing Station 21 Shelter 21 Bacteriological Laboratory 21 Food Poisoning 22 Foot Clinic 22 Insulin for Diabetic Patients 23 Nursing 24 Cases Notified in 1935 25 Cases Notified for last ten years 26 TUBERCULOSIS— New Cases and Deaths 27 Period between Notifications and Deaths 27 Nursing and Extra Nourishment 36 Shelters 36 Lady Almoner 37 PAGE Public Health (Prevention of Tuberculosis) Regulations, 1925 37 Work of the Tuberculosis Dispensary 38 Summary of Notifications 39 Cases on the Register 40 LIGHT TREATMENT— Work done in the Solarium 41 Leysin Patients 45 MATERNITY AND CHILD WELFARE— Changes in Scheme during 1935 46 Fairby Grange Convalescent Home 48 Midwifery Service 48 Obstetric and Puerperal Fever Consultants 48 Infant Life Protection 48 Maternal Mortality 48 Work of the Health Visitors 49 Attendances at Centres 50 Statistics for 1935 51 DENTAL TREATMENT— Particulars of Children Treated 53 Particulars of Treatment and Work for 1935 54 PROPAGANDA 55 SANITARY ADMINISTRATION— Housing 57 Housing Act, 1935 —Overcrowding Survey 59 Inspections and Proceedings 61 Work of the District Inspectors 65 Factories and Workshops —Homework 66 Factories and Workshops —Inspections 67 Bakehouses 68 House, Trade and Market Refuse 69 Offensive Trades 69 Mortuary 69 Street Markets 69 Drainage Work 70 Work of Factories and Shops Inspector 70 FOOD CONTROL— Unsound Food —Shops and Stalls72 Imported Food Regulations —Samples Taken 72 Work of the Wharves and Food Inspectors 75 Milk Premises 76 Milk Licences 76 Milk Sampling 76 Ice Cream 77 Food and Drugs—Samples Taken 78 Food and Drugs—Prosecutions 82 Unsound Food—Wharves, etc. 83 HEALTH SERVICES 88 PUBLIC HEALTH DEPARTMENT. PUBLIC HEALTH COMMITTEE, 1935. Chairman Councillor E. J. GIBSON, 1934-35, 1935-36 Vice-Chairman „ C. J. LEE, 1934-35 S. R. WEIGHTMAN 1935-36 Alderman A. E. Hatcher Councillor A. V. Kidd A. V. Parker „ Mrs. R. E. Laker Councillor Mrs. S. C. Amos „ Miss E. M. Nix H. A. Beal „ J. G. Page W. T. Cockett „ Mrs. F. A. Powell Mrs. E. V. Coyle „ J.W.Simmonds „ Miss K. Groves „ G. H. Stean „ Mrs. A. M. Hatcher „ W. A. Stocker Mrs. F. Humphreys „ J. A. Wright „ Mrs. F. I. M. Husk Ex-officio: Councillor S. R. WEIGHTMAN, J.P., Mayor of Bermondsey, 1934-35. Councillor G. LOVELAND, J.P., Mayor of Bermondsey, 1935-36. MATERNITY AND CHILD WELFARE COMMITTEE, 1935. Chairman Councillor Mrs. E. V. COYLE, 1934-35, 1935-36 Vice-Chairman „ Mrs.A. M. HATCHER, 1934-35,1935-36 Alderman G. R. Balleine, Councillor Mrs. F. I. M. Husk M.A. „ Mrs. R. E. Laker Mrs. D. A. Green „ W. S. McKay „ Miss M. I. Henrich „ Miss E. M. Nix Councillor Mrs. A. M. Fortescue „ Mrs. A. E. Pitt E. J. Gibson „ Mrs. F. A. Powell „ Mrs. L. A. Glasson Co-opted Members: Mrs. E. R. Balman Mrs. H. Richardson Miss E. M. Haslam Mrs. E. C. Starr Ex-officio: Councillor S. R. WEIGHTMAN,J.P., Mayor of Bermondsey, 1934-35. Councillor G. LOVELAND, J.P., Mayor of Bermondsey, 1935-36 MEDICAL OFFICER OF HEALTH. D. M. Connan, M.D., B.S. (Lond.), M.R.C.S., L.R.C.P., D.P.H. SANITARY INSPECTORS: J. G. Frankson, Wharves and Food Inspector. G. A. Hoskins, Wharves and Food Inspector. G. F. J. Toll, Wharves and Food Inspector. E. J. Pitts, Market Inspector. H. E. Butcher, Food and Drugs Inspector. W. C. Tapsfield, Factories and Shops Inspector. District Inspectors. W. Davis, Senior District Inspector and Drainage Inspector No. 1—F. J. Carpenter No. 5 —A. W. Hancock No. 2 —H. J. Bailey No. 6 —W. A. Pilson No. 3 —L. T. Knott No. 7—0. W. R. Smart No- 4—W. A. Campbell No, 8—F.8 —F. L. Richardson 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. O'Keeffe, M.R.C.S., L.R.C.P., D.P.H. Lady Almoner—Olive Pike. Tuberculosis Nurse—Celia Clapson Solarium Nurses—Mrs. Dorothy Cottier, Estelle Jagot and Muriel Coleby. 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. Rosa Bache Gwendolen Riches Sarah Bowles Edith Riley Lucy Brown Florence Robson Amy Carlton Florence Wadds Marie Helden Isabel White Elizabeth Lawrence Fairby Grange Convalescent Home: Matron —Florence Child Nurse—Ann O'Meara STAFF:— 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 FOOT CLINIC: Chiropodists—Ethel Cook, Mrs. Florence Rock and E. F. Part. PUBLIC ANALYST. A. Prideaux Davson, A.R.C.Sc., F.I.C., F.C.S PROPAGANDA AND ADMINISTRATIVE OFFICER: H. W. Bush, F.I.P.A., M.I.H. CLERICAL STAFF: A. I. Fair, Chief Clerk F. R. Parker, General Clerk C. H. Harris, General Clerk F. W. Smith, Second Clerk C. W. Whye, General Clerk J. W. J. Saward, General Clerk Alice Jones, General Clerk A. Manning, General Clerk C. F. Yaxley, General Clerk J. A. Blake, General Clerk J. F. M. Brooker, Junior Clerk Rose Dutch, Clerk & Dispenser C. F. Lumley, General Clerk F. Cornwell, Junior Clerk H. J. Smith, General Clerk H. D. White, Junior Clerk DISINFECTING AND CLEANSING STATION: A. C. Davidson, Foreman in Charge. PUBLIC HEALTH DEPARTMENT, MUNICIPAL OFFICES, SPA ROAD, S.E.16. INFANTILE MORTALITY RATE FOR 25 YEARS. Borough of Bermondsey. ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH. To the Mayor, Aldermen and Councillors of the Borough of Bermondsey. Sir, Ladies and Gentlemen I have the honour to submit my Annual Report for the year 1935. There are no points of outstanding interest upon which to comment, but I may perhaps be allowed to draw attention to the welcome, though slight decrease in the number of cases of infectious disease. Although it is unwise to attach too much importance to statistics, yet it may be noted that during this year there have been no maternal deaths and consequently the maternal mortality rate is nil. It is my very pleasant duty to thank the Chairmen and Members of Committees for their unfailing support. I desire also to offer my thanks to the staff in general for their loyalty and ungrudging industry during the year, and to Mr. F. W. Smith in particular who has, as in previous years, prepared the material for this report. A number of changes have taken place in the staff and I would like to make reference here to two of them. Dr. Turner, who has been a part-time Medical Officer in the Maternity and Child Welfare Department for many years, has resigned to the great regret of her colleagues. She will be missed by many of the mothers at the Princess Club Centre. Mr. G. L. Scott, Wharves Inspector, has also retired, having reached the age limit. Mr. Scott has been an Inspector in the borough for more than thirty-four years, and as a result of his long experience and high personal character he had achieved a position in the affection and esteem of his colleagues which it is the happy lot of few to attain. I am, Sir, Ladies and Gentlemen, Your obedient Servant D. M. CONNAN. I.—VITAL STATISTICS. GENERAL. The area of the Borough (exclusive of area covered by water) is 1,336 acres. The number of inhabited houses at the end of 1935 according to the Rate Books was 19,146. The rateable value of the Borough on the 31st December, 1935 was £877,181, the product of a penny rate being £3,452. POPULATION. Census Estimate of Registrar General 1921 1931 to 30th June, 1934 to 30th June, 1935 102,700 111,542 105,060 119,452 BIRTHS. The total number of births belonging to the Borough registered during 1935 was 1487, consisting of 771 males and 716 females. The number for 1934 was 1,557. The birth rate for 1935 was 14.5 per 1,000 persons living, compared with 14.8 for 1934. DEATHS. The total number of deaths belonging to the Borough registered during 1935 was 1,201, consisting of 670 males and 531 females. The number for 1934 was 1,304. The death rate for 1935 was 11.7 per 1,000 persons living, compared with 12.4 for 1934. MARRIAGES. The total number of marriages in the Borough in 1935 was 1,027, being 23 below the number for 1934, and 15 above the average for the last 10 years. The figures have been supplied by the Superintendent Registrar. This makes a marriage rate of 20.00 per 1,000 of the population, compared with a marriage rate last year of 19.91. Year No. Rate 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 1932 936 17·00 1933 1,007 18·77 1934 1,050 19·91 Average for years 1925—1934 1,012 17·71 1935 1,027 20·00 (10) INFANTILE MORTALITY. Whole Borough London Year Rate per 1,000 Births No. of Deaths Rate per 1,000 Births No. of Deaths 1925 210 79 5,599 68 1926 146 60 5,067 64 1927 149 67 4,357 59 1928 178 85 4,879 67 1929 160 71 4,995 71 1930 130 63 4,109 59 1931 112 57 4,270 65 1932 103 56 4,143 67 1933 92 61 3,377 60 1934 100 64 3,832 67 Average for years 1925-1934 } 138 4,463 66 65 1935 103 69 3,229 58 TUBERCULOSIS OF THE RESPIRATORY SYSTEM. In the following Table will be found particulars of deaths from Tuberculosis of the Respiratory System since the year 1925. Bermond sey Rotherhithe St. Olave Whole Borough London Sub-District Year No. No. No. Rate No. Rate No. 1925 99 35 11 145 1 · 18 4361 0·95 1926 100 39 12 151 1·23 4066 0·88 1927 87 42 15 144 1·19 4140 0·91 1928 88 43 12 143 1·24 3985 0·89 1929 31 8 117 1·03 4230 0·96 78 1930 81 36 15 132 1·16 3826 0·87 1931 81 30 5 1·03 0·90 116 3907 1932 71 34 11 116 1·05 3564 0·82 1933 68 23 8 99 0·92 3530 0·82 1934 64 22 4 90 0·86 3227 0·76 Averages for years 1925-1934 82 33 10 125 1·09 3884 0·88 1935 70 5 98 0·95 2847 23 0·68 VITAL STATISTICS OF WHOLE DISTRICT DURING 1935 AND PREVIOUS YEARS. Population estimated to Middle of each Year 2 Total Deaths in Public Institutions in the District 9 Deaths of NonResidents registered in Public Institutions, etc. in the District 10 Year 1 Deaths of Residents registered in Public Institutions beyond the District 11 Births Total Deaths registered in the District Net Deaths at all Ages belonging to the District No. 3 Rate 4 Under 1 Year of Age Rate 13 No. 12 At all Ages Rate per 1,000 Births registered 6 No. 5 No. 7 Rate 8 1925 123,000 2·652 21·6 188 71 1,280 10·4 669 47 321 1,554 12·6 1926 123,100 2,414 19·6 126 52 1,163 9·4 624 31 352 1,484 12·1 18·5 22 1927 121,000 2,233 119 53 1,236 10·2 616 352 1,566 12·9 1928 18·1 115,200 2,086 143 1,230 69 10·7 671 39 329 1,520 13·2 1929 113,800 2,252 19·8 127 56 1,304 11·4 696 32 378 1,650 14·5 1930 18·1 113,800 2,059 90 44 1,169 10·3 686 46 365 1,488 13·1 1,958 17·4 1931 112,400 91 46 1,169 10·4 596 92 331 1,408 12·5 110,100 1,831 16·6 44 1,147 1932 81 10·4 689 189 368 1,326 12·0 1933 1,500 107,300 14·0 72 48 1,216 11·3 720 215 339 1,340 12·5 1,223 1934 105,060 1,557 14·8 77 49 11·6 784 229 310 1,304 12·4 Averages for years 1925-1934 114,476 17·8 111 53 10·6 2,054 1,214 675 94 344 1,464 12·8 1935 102,700 1,487 14·5 99 67 1,142 11·1 756 255 314 1,201 11·7 (12) OTHER INSTITUTIONS, Etc., Etc. II. Institutions outside the District receiving sick and infirm persons from the District. III. Other Institutions, etc., the Deaths in which have been distributed among the several localities in the District I. Institutions, etc., within the District receiving sick and infirm persons from outside the District. No. of Deaths No. of Deaths No. of Deaths Ladywell Institution 42 All Saints' Hospital, Southwark 1 St. Olave's Hospital Ambulances on way to Hospital 5 236 Archway Hospital, Islington 1 Bexley Mental Hospital 4 Broadmoor Asylum, Crowthorne 1 Bermondsey Medical Mission Hospital Brook Hospital, Shooters Hill 2 Catholic Nursing Institute, Lambeth 1 2 Charing Cross Hospital 1 Children's Hospital, Great Ormond Street 1 Deaths in River Thames, Surrey Commercial Docks, Wharves, etc. Claybury Mental Hospital 1 Colindale Hospital, Hendon 1 Constance Road Institution, Camberwell 1 Darenth Training Colony 1 15 Downs Hospital, Sutton 1 Dulwich Hospital 2 East Sussex County Mental Hospital, Hellingley Grand Surrey Canal 1 1 East View, Rainham, Essex 1 Evelina Hospital 5 Private Houses 1 Farnborough Hospital, Orpington 1 General Hospital, Willesden 1 255 Total Golden Square Hospital, Westminster 1 Grove, The, Epsom 4 Grove Park Hospital, Mottingham 2 Guy's Hospital 65 Hanwell Mental Hospital, Southall 1 Hermitage Convalescent Home, Hastings 1 Holborn & Finsbury Institution, Shoreditch 1 4 Horton Hospital, Epsom Hospital, The, Chartham 1 Hospital, The, Coulsdon 7 Hundred Acres, Epsom 4 Infants' Hospital, Westminster 1 Isolation Hospital, East Malling 1 King's College Hospital 1 Ladywell Institution 42 Lambeth Hospital 9 Leavesden Mental Hospital 3 Lewisham Hospital 2 Manor, The, Epsom 2 Middlesex Hospital 2 Miller Hospital, Greenwich 2 Municipal Hospital, Hastings 1 National Hospital for Diseases of the Heart, St. Marylebone 1 Newington Institution, Southwark 1 (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. Normanhurst Nursing Home, Wandsworth 1 Norwood Children's Hospital 2 Papworth Village Settlement 1 Park Hospital, Hither Green 6 Peckham House Mental Hospital 1 Petersfield Lodge Nursing Home, Lewisham 1 Podkin Farm, Biddendon 1 Poplar Institution 1 Princess of Elizabeth of York Hospital, Shadwell 2 Private Houses 2 Queen Mary's Hospital, Bromley 1 Queen Mary's Hospital for Children, Carshalton 3 Queen Mary's Hospital, Chislehurst 1 Royal Waterloo Hospital 2 St. Alfege's Hospital, Greenwich 13 St. Alfege's Institution, Greenwich 10 St. Bartholomew's Hospital 3 St. Benedict's Hospital, Wandsworth 2 St. George-in-the-East Hospital, Stepney 3 St. Giles' Hospital, Camberwell 5 St. John's Hospital, Battersea 1 St. Joseph's Home, Edmonton 1 St. Joseph's Hospice, Hackney 2 St. Luke's Hospital, Paddington 1 St. Nicholas Hospital, Woolwich 2 St. Pancras Institution 1 St. Peter's Hospital, Hackney 1 St. Peter's Hospital, Westminster 1 St. Stephen's Hospital, Fulham 1 St. Thomas's Hospital 6 " Sandhill," Pembury, Kent 1 Seaman's Hospital, Greenwich 4 South-Eastern Hospital, New Cross 8 South London Hospital, Wandsworth 1 Southern Hospital, Dartford 2 Street 5 Tooting Bec Hospital 18 West Middlesex County Hospital, Isleworth 1 West Park Mental Hospital, Epsom 3 Workplaces 1 Total 314 CAUSES OF, AND AGES AT, DEATHS DURING THE YEAR 1935. 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 65 and up wards 15 and under 25 25 and under 45 45 and under 65 All {Certified 1200 103 17 22 29 52 120 307 550 Causes {Uncertified 1 - - - - - - 1 - - - Typhoid and Paratyphoid Fever - - - - - - - (14) Measles 4 - 2 2 - - - - - Scarlet Fever - - - - - - - - - Whooping Cough 5 2 2 1 - - - - - 5 Diphtheria 10 - - 5 - - - - Influenza 10 - 1 - — 1 1 3 4 Encephalitis Lethargica 1 1 - - - 1 - - - Cerebro-spinal Fever 3 - 1 1 - 1 - - - Tuberculosis of Respiratory System 98 - - - 22 42 28 6 - Other Tuberculous Diseases 9 - - 3 2 1 2 1 - Syphilis 1 - - - - 1 - - - General Paralysis of the Insane, tabes dorsalis 4 - - - 2 2 - - - Cancer, Malignant Disease 147 - 1 1 1 13 65 66 - Diabetes 11 - - - 1 1 - 3 6 Cerebral Hæmorrhage, etc. 111 5 - - - 1 3 28 74 Heart Disease 231 - - - 2 5 12 75 137 Aneurysm 4 - - - - - 2 2 - Other Circulatory Diseases 18 - - - - - 3 15 - Bronchitis 69 - - 15 48 3 - - 3 CAUSES OF, AND AGES AT, DEATHS DURING THE YEAR 1935—continued. Causes of Death Deaths at the subjoined ages of "Residents" whether occurring in or beyond the district. All Ages Under 1 1 and under 2 5 and under 15 15 and under 25 45 and under 65 2 and under 5 25 and under 45 65 and upwards 116 25 4 3 12 43 Pneumonia (all forms) 1 5 23 Other Respiratory Diseases 18 - 2 1 1 1 10 3 - Peptic Ulcer 16 - - - 1 3 7 5 - Diarrhœa, etc. 35 28 3 1 - 1 2 - - Appendicitis 8 - 1 - - 2 2 3 (15) - Cirrhosis of Liver 4 - - - - - 2 2 - Other Diseases of Liver, etc, 2 - - - - - - 2 - Other Digestive Diseases 10 - - - - - 1 9 - Acute and Chronic Nephritis 68 - - - 4 9 55 - - Puerperal Sepsis - - - - - - - - - Other Puerperal Causes - - - - - - - - - Congenital Debility, Premature Birth, Malformations, etc, - - - - - _ 35 - 35 Senility 42 - - - - - - 42 - Suicide 3 - - - - - 1 2 - Other Violence 41 1 2 7 7 6 6 12 1 Other Defined Causes 66 4 1 3 9 5 12 18 14 Causes ill-defined or unknown 1 - - - - - 1 - - 1201 103 17 22 29 52 120 307 551 DEATHS FROM ZYMOTIC DISEASES, 1935. Year All Causes Principal Zymotic Diseases Smallpox Measles Scarlet Fever Diphtheria Whooping Cough Enteric Fever Diarrhœa No. Rate No. Rate No. Rate No. Rate No. Rate No. Rate No. Rate No. Rate Rate No. 1925 96 1554 12·6 17 ·78 - - 20 ·16 3 ·02 ·22 ·14 29 ·24 27 - - 1926 1484 12·1 94 ·76 - 24 ·19 6 ·05 42 ·01 21 - ·34 1 - - ·17 45 1927 1566 12·9 ·37 - 9 - - ·07 - 13 ·11 10 ·08 1 - 12 ·09 1928 1520 13·2 137 1·19 - - 77 ·67 3 ·03 ·14 ·23 1 16 26 ·01 14 ·12 1929 1650 14·5 62 · 54 - 1 ·01 ·02 - 2 6 ·05 33 ·29 1 ·01 19 ·17 1930 1488 13·1 101 ·89 - - 61 ·54 7 ·06 8 ·07 6 ·05 2 17 ·15 ·02 1931 1408 12·5 24 ·21 - - 3 ·03 1 ·01 6 ·05 5 - 9 08 ·04 - 1932 1326 12·0 67 1 ·61 ·01 25 ·23 - - 11 .10 16 13 ·15 - - 14 1933 1340 45 12·5 .42 - - 9 ·08 13 4 ·04 .12 5 .05 - ·13 - 14 1934 1304 12·4 87 .83 - - 38 ·36 1 .01 10 .10 10 .10 - 28 ·26 - 1464 12·8 76 ·66 - - 27 ·23 3 .02 15 14 - - 16 ·14 Average for years 1925-1934 .13 .12 1201 54 ·53 - - .04 - - 10 ·10 5 .05 - - 35 11·7 .34 INFANTILE MORTALITY. Deaths from Stated Causes at Various Ages under One Year of Age, 1935. Cause of Death Under 1 week 1—2 weeks 2—3 weeks 3—4 weeks Total under 1 month 1—3 months 3—6 months Measles - - - - - - - Scarlet Fever - - - - - - - Whooping Cough - - - - - - - Diphtheria - - - - - - - Influenza - - - - - - - - Cerebro-spinal Meningitis - - - - - Tuberculous Meningitis - - - - - - - - Other forms of Meningitis - - - - - - - Tuberculosis of Respiratory System - - - - - - - - - - - - Other Tuberculous Diseases - - - - - - - Syphilis - - Bronchitis - - - - - - 1 Pneumonia (all forms) - 1 5 - 6 6 5 Other Respiratory Diseases 1 - - - - - - Diarrhoea and Enteritis - 1 2 1 4 4 11 Congenital Debility and Malformation, Premature Birth 12 5 3 1 21 3 1 Injury at Birth - - - - - - - Other Causes 10 3 1 1 15 3 1 22 10 11 3 46 16 19 Totals 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 Dysentery Enteric Fever and Typhoid Fever Encephalitis Lethargica Erysipelas Glanders Hydrophobia in Man Malaria Membranous Croup Ophthalmia Neonatorum Puerperal Fever Puerperal Pyrexia Relapsing Fever Scarlet Fever and Scarlatina Small Pox Typhus Tuberculosis—all forms Owing to the housing conditions of the Borough, it is the practice to remove to hospital nearly all cases of diphtheria and scarlet fever. DIPHTHERIA. There has been a fall of 98 in the number of cases of Diphtheria this year as compared with 1934, the number of cases for the year being 273. Of this number 27 cases were reported from hospital to be " not suffering " from Diphtheria, so that the net total for the year was 246 as against a net total last year of 344. Ten children died; five of these children were under five years of age, three were six years old, and the two remaining children were aged nine and thirteen respectively. Seven of these deaths were due to cardiac failure; one child died on the day of admission to hospital and one case was notified after death. In three cases tracheotomy was performed. From the attached table which shows the attendances at the Schick Clinic during the year, it will be observed that there has been a gratifying increase in the number of new patients and in the NOTIFIED CASES OF DIPHTHERIA FOR 25 YEARS. NOTIFIED CASES OF SCARLET FEVER FOR 25 YEARS. total number of attendances which are more than five times as many as in 1934. A second Schick Clinic was opened in November at 98 Rotherhithe New Road. No. of No. of new Total Clinic Sessions patients Attendances Municipal Offices, Spa Road 51 243 1,150 98 Rotherhithe New Road 6 46 110 Totals 57 289 1,260 SCARLET FEVER. The number of cases of this disease notified during the year was 367. This shows a substantial reduction compared with the figure of 597 in 1934. Thirty cases were returned from hospital as " not suffering " from Scarlet Fever, and there were no deaths. SMALL-POX. There were no cases of Small-pox, and only one re-vaccination was performed under the Public Health (Small-pox Prevention) Regulations, 1917. MEASLES. 361 cases of Measles were reported to me. This was not an epidemic year and the figures cannot therefore be usefully compared with those of my last report. Seventy-three patients were removed to hospital and nursing was provided for 23 patients at home. There were four deaths, two at home and two in hospital. OPHTHALMIA NEONATORUM. The subjoined table shows the number of cases of this disease notified during the year. The total number of cases last year was six. Cases Vision UnImpaired Notified Treated Vision Impaired Total Blindness Deaths At home In Hospital 5 2 3 - 5 - - PUERPERAL FEVER AND PUERPERAL PYREXIA. There were 3 cases of Puerperal Fever this year as compared with 2 last year and 6 in 1933, and 19 cases of Puerperal Pyrexia as compared with 13 last year and 24 in 1933. There were no deaths. 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 1 Nursing provided1 Bacteriological examinations 1 Admitted to Hospital 18 DISINFECTION. The following table sets out the work of the Disinfecting Station during the year. It will be noted that 287 houses were disinfected prior to the removal of families to new estates, and that 76 houses were disinfected prior to demolition. 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. Beds 868 Pillows 2,201 Blankets 2,269 Pillows (cases) 1,944 Bolsters 738 Quilts 1,284 „(cases) 315 Sheets 1,760 Miscellaneous 5,843 Books 219 Cushions 251 Verminous Clothing 2,981 „ Bedding 4,742 Mattresses 45 Scabies, Clothing 20,266 Overlays 839 32,668 new tabs were used to replace those taken off mattresses, palliasses, and cushions before disinfection. Number of rooms disinfected .. .. .. .. 2,955 Number of houses disinfected prior to families removing to new estates 287 Number of houses disinfected before demolition 76 Number of mattresses and other articles destroyed 2,644 Furniture, Floorcloth, etc. destroyed 85 Loads CLEANSING STATION. Verminous persons cleansed Adult Females 9 Adult Males 85 Children 3,566 Persons treated for Scabies:— Number treated Number of baths given Adult Females 59 134 Adult Males 35 79 Children—Females 228 1,463 Children—Males 186 959 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 75, 1 for Scarlet Fever, 4 for Scabies and 70 for verminous condition's the total number of persons accommodated being 362. BACTERIOLOGICAL LABORATORY. The work of the laboratory consists very largely in the examination of sputa for Tuberculosis and of throat swabs for K.L.B. We are called upon occasionally to do other pathological examinations tions such as blood counts, Widal or Wassermann tests and to examine urines, but general practitioners do not make as much use as they might of the facilities provided. Sterile outfits for throat swabs and sputum pots for the examination of sputa are supplied free on application to the Medical Officer of Health. All Diphtheria contacts of school age are excluded from school until the swab is negative. A positive result necessitates a further examination, treatment being provided in the meantime by the (22) general practitioner. Proved " carriers" are usually referred to the London County Council " Carrier " Clinic at Guy's Hospital. In addition to the examination of swabs and sputa other bacteriological investigations are undertaken on request, and it will be seen from the accompanying table that the number of these " various " investigations shows a slight increase this year. Total Examinations Results of Examination Nature of Specimen Positive Negative 1934 1935 1934 1935 1934 1935 Diphtheria (specimens taken by Medical Officer of Health) 537 21 23 430 516 407 Ditto (taken by general practitioners) 1826 1748 1687 1637 111 139 2363 2178 134 2044 Diphtheria (total specimens taken) 160 2203 Phthisis 193 1194 1244 192 1001 1052 Various 185 355 9 70 176 285 Total specimens taken 3777 362 3380 3742 396 3381 FOOD POISONING. Thirty-five cases of Food Poisoning were notified to me during the year under the London County Council (General Powers) Act, 1932, section 7. There was one death which occurred as the result of eating an imported duck's egg. FOOT CLINIC. Three whole-time chiropodists, two ladies and a gentleman, are employed in these clinics. The fee for treatment is two shillings per attendance, which is subject to reduction in the case of inability to pay the full fee. Patients are seen by appointment only. Treatment is given for corns, callosities, bunions, ingrowing and thickened toenails, warts and other similar affec- tions of the feet. Orthopaedic cases are not treated and are referred to private practitioners or to hospital. Particulars of the number of attendances during the year are given in the following table. Clinic Men Total Women Bermondsey 1,743 4,644 6,387 Rotherhithe 1,392 3,473 4,865 Totals 3,135 11,252 8,117 INSULIN FOR DIABETIC PATIENTS. Under Section 77 of the Public Health (London) Act, 1891 the Minister of Health has sanctioned the temporary supply of insulin for those poorer inhabitants of the borough who are suffering from Diabetes. Practitioners applying for supplies of insulin are required:— (a) To give the name, address, age and sex of the patient. (b) To supply a quarterly report to the Medical Officer of Health showing:— (1) The number of doses of insulin administered. (2) The results of blood and urine tests. (3) The progress of the patient. Nineteen patients have been supplied during the year as compared with nine patients in 1934. (24) 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. The fee payable by the Borough Council to the Nursing Associations is 1s. per visit. Disease St. Olave's District Nursing Association Rotherhithe Queen's Nursing Association Totals whole Borough Cases Cases Cases Visits Visits Visits Pneumonia 37 1,226 12 215 49 1,441 Broncho pneumonia 6 139 3 58 9 197 Bronchitis 19 470 4 35 23 505 Influenza 19 443 3 46 22 489 Measles 20 422 3 49 23 471 Whooping Cough 1 20 1 20 - - Tuberculosis:— :: (a) Respiratory System 42 1,757 26 2,696 68 4,453 (b) Other Forms 812 8 812 8 - - Puerperal Pyrexia 1 77 1 77 - - Puerperal Fever - - - - - - Pregnancy and Labour 33 1016 5 76 38 1,092 Diseases of the Digestive System 28 339 283 13 56 41 Infantile Diarrhoea (under 2 years) - - - - - - Discharging Ears 2 74 2 12 4 86 Discharging Eyes 10 235 2 23 12 258 Post-operative cases:— o (a) Tonsils & Adenoids 9 68 1 3 10 71 (b) Other cases 5 74 1 7 6 81 Other diseases 39 551 7 106 46 657 279 7,667 82 3.382 361 11,049 Totals CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR 1935. NOTIFIABLE DISEASE NUMBER OF CASES NOTIFIED BERMONDSEY ROTHERHITHE ST OLAVE Total Cases removed to Hospital At all Ages At Ages—Year St.Thomas Total 1 2 3 4 5 Total 3 Total 6 1 2 St.John St.Olave Under 1 year 1 and under 5 years 5 and under 15 years 25 and under 45 years 65 and upwards 15 and under 25 years 45 and under 65 years Small-pox - - - - - - - - - - - - - - - - - - - - - - - - Diphtheria (including Membranous Croup) 273 1 73 149 30 17 3 - 17 32 28 26 23 23 149 45 28 23 96 15 7 6 28 273 Erysipelas 53 2 - 4 2 9 23 13 3 5 9 10 1 32 4 9 3 16 1 2 2 5 28 4 Scarlet Fever 367 6 113 202 40 6 - - 41 38 47 36 30 23 215 49 38 36 123 14 13 2 29 360 Cerebro-Spinal Meningitis 2 - - 1 - - - - - 1 - - 1 - - - - - 1 - 1 2 1 - Acute Polio-Myelitis and Acute Polio Encephalitis. - - - - - - - - - - - - - - - - - - - - - - - - Ophthalmia Neonatorum 5 5 - - - - - - - - - 2 1 - 3 - 1 1 2 - - - 3 - Anthrax - - - - - - - - - - - - - - - - - - - - - - - - 3 - - 1 1 1 - - - 1 - - 1 1 - - - - - - - - 2 Enteric Fever 3 Puerperal Fever 3 - - - 1 2 - - 1 - - 1 - 1 - - - - - - - - 3 - Puerperal Pyrexia 19 - - - 9 10 - - 2 2 4 3 - 2 13 1 3 2 6 - - - - 15 Encephalitis Lethargica - - - - - - - - - - - - - - - - - - - - - - - - Dysentery 3 - 1 1 1 - - - - - 1 - - 1 1 1 - 2 - - - - 3 - Malaria - - - - - - - - - - - - - - - - - - - - - - - - Pneumonia (Acute Primary and Acute Influenzal) 113 5 29 21 10 20 15 11 16 14 15 7 80 15 8 5 2 - - 5 - 13 17 28 Tuberculosis— Respiratory System 129 - 2 4 45 24 6 10 14 23 21 6 8 82 15 13 10 38 3 4 2 9 - 48 Other forms of Tuberculosis - 5 12 7 3 1 1 4 3 6 4 22 6 2 1 9 1 1 1 3 — 34 6 4 1004 19 224 394 147 112 73 86 112 129 121 83 73 604 136 103 81 320 36 28 16 80 689 CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEARS 1926-1935. Notifiable Disease. 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 - - 1 46 47 3 16 21 7 - Small Pox Diphtheria (including Membranous Croup) 714 603 463 462 263 386 273 481 263 372 Erysipelas 30 25 43 4 5 41 49 49 68 73 53 Scarlet Fever 426 601 493 584 507 310 446 640 597 367 Cerebro-Spinal Meningitis 5 3 2 4 5 9 9 4 2 2 Acute Polio-Myelitis and Acute Polio- Encephalitis 1 4 1 3 - - 2 1 2 1 Ophthalmia Neonatorum 10 13 8 11 13 14 10 7 5 6 Anthrax 4 - 2 1 1 - 1 - - - 3 1 2 2 2 2 3 (26) Enteric Fever 2 5 1 Puerperal Fever 9 9 7 12 14 13 8 6 2 3 Puerperal Pyrexia 11 21 20 20 19 37 27 24 13 19 Encephalitis Lethargica 8 5 4 1 4 1 2 - 2 - Dysentery - - - - - 1 - 3 - - Malaria - - - 2 - - - - - - Malaria (induced) - - - 1 - - - - - - Pneumonia (Acute Primary and Acute Influenzal) 113 53 110 167 136 113 126 102 121 119 Tuberculosis:— Respiratory System 231 208 175 182 141 129 194 206 184 177 Other forms of Tuberculosis 59 65 54 40 46 40 35 34 32 34 Totals 1,599 1,585 1,478 1,536 1,494 1,083 1,149 1,512 1,371 1,004 (27) 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, 1935—NEW CASES AND DEATHS. AGE—PERIODS NEW CASES DEATHS Pulmonary NonPulmonary Pulmonary NonPulmonary M. F. M. F. M. F. M. F. 0 - - - - - - - - 1 - - - 2 3 2 2 1 2 - - 5 7 1 - - - 10 1 2 6 1 - 1 - - 15 10 8 3 4 1 4 1 - 11 9 20 20 1 2 8 - - 25 23 15 1 16 1 13 4 - 12 2 - 35 4 7 7 1 - 45 12 - - 8 8 1 4 - 55 8 2 3 11 1 - 1 - 65 and upwards 7 1 5 1 - - - - 81 62 21 21 60 38 5 4 TABLE II. TUBERCULOSIS, 1935—PERIOD BETWEEN NOTIFICATION AND DEATH. Period Between Notification and Death Respiratory System Other Forms Males Females Total Percentage of Total Deaths Males Females Total Percentage of Total Deaths Not notified 4 2 6 6·12 1 2 3 33·34 0-1 month 7 3 10 10·20 1 1 2 22·22 1-3 months 5 4 9 - 9·18 - - - 3-6 months 3 2 5 5·10 - - - - 6-12 months 9 3 12 12·25 - - - - 1-2 years 9 6 15 15·31 1 - 1 11·11 2-5 years 17 12 29 29·59 1 - 1 11·11 Over 5 years 6 6 12 12·25 1 1 2 22·22 Report by Dr. C. H. C. Toussaint, Clinical Tuberculosis Officer. During the year there was an increase of eight in the deaths from Pulmonary Tuberculosis, and a continued fall in the deaths from non-pulmonary forms of the disease. This has led to a slight increase in the death rate from respiratory tuberculosis, but the rate, .95, which had fallen to fresh low records during the two preceding years is below the average for the last ten years. The decline in the number of new cases has continued, and should lead to a further fall in the death rate. In Table 11. are reported six deaths from pulmonary disease, of patients who had not been notified during life. Of these, two were men, aged 81 and 63 respectively, whose deaths were sudden and were the subject of Coroners' enquiries. One death was that of a man, aged 41, who died from general peritonitis following a perforated gastric ulcer, together with lobar pneumonia, evidence of tuberculosis being found only on post-mortem examination. Of the other three cases, one a girl, aged 22, died from a sudden fatal haemoptysis, not having been under medical care previously, and the other two, one a man aged 28, and the other a woman aged 24, both died in local municipal hospitals, soon after admission, from acute forms of pulmonary tuberculosis. During the last few years there has been a slow but steady increase in the average period between notification and death, in pulmonary cases. During 1935 one to five years, or more, elapsed between notification and death in 57 % of fatal cases, as compared with 53% in 1934. This indicates an increase in the expectation of life in such persons. In view, however, of the fact that just over 40% of fatal cases die within one year of notification, still further efforts are needed to secure detection of the disease at the earliest possible moment. Pulmonary Tuberculosis, the most fatal form of the disease, affects, in the main, young members of the population aged 16 to 30 years. Prompt reference to the Tuberculosis Officer of such persons, disabled with influenza, debility, anaemia or similar complaints, would lead to a greater number of cases being diagnosed soon after the onset of the disease, which is too often mistaken, at first, for one or other of the disabilities mentioned.tioned. Five years ago a meeting of local practitioners was held at which a recognised consultant gave an address on the principles of early diagnosis in pulmonary tuberculosis. This was much appreciated and led to a close co-operation between the practitioners of the district and the tuberculosis dispensary service. It is hoped in the near future to hold a similar meeting with the object of acquainting practitioners with the most recent advances made in diagnosis and treatment of chest diseases. On page 38 are set out details of the work done in the dispensary during the year. During the year an alteration was made in the arrangements for home visiting. This is now undertaken by the Health Visitors, each one of whom attends a dispensary session at regular intervals. Efforts have been made to continue the intensive examination of contacts, both with a view to detecting cases at the earliest possible moment, and also in order to discover, if possible, the source of infection. In the report for the year 1928 was inserted a table showing the human sources of infection which had given rise to cases of meningeal or miliary tuberculosis in young children. This investigation has, since then, been continued firstly with the cooperation of Dr. E. J. Maclntyre and latterly of Dr. E. J. O'Keeffe, and, on pages 32—34 are set outparticulars of contact examination of the families of children aged 0-10, who have died from meningeal or miliary tuberculosis during the years 1928 to 1935 inclusive. Much has been said of the grave dangers of infection with the bovine type of tubercle bacillus, conveyed by infected milk. It would, however, appear that infection from the adult human, suffering from pulmonary tuberculosis, is of far greater importance. In the table on pages 32-34 the words " Refused examination refer to the contacts of the child and indicate that complete examination of themselves was not agreed to by both the father and the mother, although they may have agreed to examination of the other children in the family. "M" indicates municipal hospital and "V" voluntary hospital. Results may be summarised, as follows: — Deaths from Miliary Tuberculosis or Tuberculous Meningitis for the period 1928 to 1935 (inclusive) of children aged 0 to 10 years. Total cases 86 Contacts refused examination 26 Number of families investigated 54 Probable human source of infection found (father 26, mother 7, both 1, others 12) 46 (85.2%) Possible human source of infection 3 Human source not found 5 (9.3%) On page 35 is a further table, covering a similar period of years, indicating the probable sources of infection in cases of pulmonary tuberculosis (all sputum positive) occurring in children of school age at date of onset. Here again the important part played by human infection is emphasised. Artificial pneumothorax treatment has been continued by the Tuberculosis Officers, a special evening session being held for patients at work, and during the year 571 refills were given. The following table shows the condition of patients, on December 31st, 1935, of the patients treated by this method. Present condition Treatment commenced 1923 1927 1928 1929 1930 1931 1932 1933 1934 Total Number 1 1 1 5 14 26 17 20 9 Arrested 1 1 1 2 8 8 (1) 7 (I) - - Quiescent - - - - 1 6 5 (1) 14 (8) 9 (4) Stationary - - - - 1 3 (1) 3 (1) 2 (1) - Dead - - - 3 (2)* 4 (3) 9 (4) 2 (2) 4 (2) - * One of these three deaths was due to suicide in an arrested case. HUMAN SOURCES OF INFECTION IN PRIMARY TUBERCULOSIS OF CHILDHOOD. No. Initials Sex Age at Death Certified Cause of Death P.M. Exam. Notified before Death Human Contact Place of Death Year 1928 r 8012 A.G. M. 4 Tub. Meningitis No No Father: Pul. Tub. Sp. + M. 8028 M.C. F. 6 Tub. Meningitis No Two Sp.—cases in house M. No 8035 E.C. M. 4 Tub. Meningitis Yes N o Refused examination V. 8057 J.G. M. 4 Tub. Meningitis Yes No Father: Pul. Tub. M. 8059 E.C. M. 4 Tub. Meningitis No No Refused examination V. 8067 R.C. F. 4 m. Miliary Tuberculosis Yes No Father : Pul. Tub. Sp. + V. 8115 J.Y. M. 7 m. Miliary Tuberculosis No No Mother : Pul. Tub. M. 8161 S.H. M. 13 m. Miliary Tuberculosis Yes No Refused examination V. 8178 E.S. F. 4 Tub. Meningitis Yes No Father : Pul. Tub. Sp. + V. 8180 W.K. M. 1½ Tuberculosis of lungs No No Refused examination V. 8203 R.S. M. 3 Tub. Meningitis No No Refused examination M. (32) 8230 J.M. M. 13 m. Tub. Meningitis No No Father : Pul. Tub. Sp. + M. 8233 J.C. M. 7 m . Tub. Meningitis No No Mother : Pul. Tub. Sp. + M. 1929 Year 8285 A.B. M. 13 m. Tub. Meningitis No No Refused examination M. A.H. M. 14 m. Tub. Br. Pneumonia Yes No Refused examination H. 8298 8315 R.R. F. 4 Tub. Meningitis No No Sp. + cases in house M. 8338 E.N. F. 2 Tub. Meningitis No No Father : Pul. Tub. Sp. + H. 8341 M.B. F. 1 Tub. Meningitis Yes No Sp. + cases in house V. 8356 A.B. F. 8 Tub. Meningitis No No Refused examination M. 8357 R.R. M. 2 Tub. Meningitis No No Sp. + ca se in house M. 8181 R.H. M. .23 m. Tub. Meningitis and Dactylitis No Yes Father : Pul. Tub. Sp. + M. 8344 A.B. M. 17 m. Tub. Meningitis No No Father : Pul. Tub. Sp. + V. 8366 H.P. F. 6 Tub. Meningitis No Yes Refused examination M. 8368 G.S. M. 5 Tub. Meningitis No No Nil found M. 8376 H.D. M. 4 Tub. Meningitis No No Refused examination M. 8400 E.P. F. 10 m. Tub. Meningitis No No Father : Pul. Tub. Sp. + V. 8346 J.B. F. 16 m. General Tuberculosis No Yes Refused examination M. 8403 J.C. F. 8 m. Tub. Meningitis No No Mother : Pul. Tub. Sp. + M. 8492 I.W. F. 13 m. Tub. Meningitis No No Father : Pul. Tub. Sp. + M. 8499 D.H. M. 2 Tub. Meningitis Yes No Refused examination V. HUMAN SOURCES OF INFECTION IN PRIMARY TUBERCULOSIS OF CHILDHOOD —Contd. Initials Sex Age at Death Certified cause of Death P.M. Exam. Notified before Death Human Contact 1930 A.R. M. 10 Tub. Meningitis No Yes Refused examination R.F. F. 2 Tab. Meningitis No No Father : Pul. Tub. Sp. + S.H. M. 5 m. Tub. Meningitis Yes No Father : Pul. Tub. Sp. + K.F. F. 5 Tub. Meningitis No No Refused examination C.S. M. 20 m. Tub. Br. Pneumonia Yes No Father : Pul. Tub. D.R. F. 3 Tub. Meningitis Yes No Brother : Pul. Tub. Sp. + H.B. M. 10 m. Miliary Tuberculosis Yes No Refused examination L.S. F. 19 m. Tub. Meningitis Yes Yes Refused examination O.M. F. 19 m. Tub. Meningitis Yes No Refused examination A.T. M. 10 Tub. Meningitis No No Brother : Pul. Tub. Sp. + G.M. M. 7 Tub. Meningitis Yes No Refused examination R.L. M. 2 Acute Miliary Tub. No. Yes Father : Pul. Tub. Sp. + C.C. M. 14 m. Tub. Meningitis No No Father : Pul. Tub. Sp. + N.N. F. 13 m. Tub. Meningitis No Yes Father : Pul. Tub. Sp. + S.B. M. 3 Tub. Meningitis No Yes Mother : Pul. Tub. Sp. + P.T. F. 21 m. Tub. Meningitis No No Father and Mother: Pul. Tub. Sp. + 1931 W.G. M. 6 Tub. Meningitis No ? Hospital infection No M.J. F. 2 Miliary Tuberculosis No No Refused examination I.D. F. 10 Tub. Meningitis No No Nil found G.A. M. 8 Ac. Tub. Right Lung Yes No Father : Pul. Tub. Sp. + I.D. F. 5 Pul. Tuberculosis Lobar Pneumonia No Yes Sp. + case in house E.P. F. 2 Tub. Meningitis and Radius No Yes found R.K. F. 2 Tub. Meningitis Yes No Refused examination G.P. M. 3 Acute Miliary Tub. Refused examination Yes No D.W. F. 3 Tub. Meningitis Yes Yes Refused examination R.M. F. Tub. Toxaemia, Psoas abscess Yes No Grandfather : Pul. Tub. Sp. + 4 E.R. F. Tub. Meningitis and Spine No Yes Refused examination 6 HUMAN SOURCES OF INFECTION IN PRIMARY TUBERCULOSIS OF CHILDHOOD—Contd. No. Initials Sex Age at Death Certified Cause of Death P.M. Exam. Notified before Death Human Contact Place of Death 1932 Year 9121 W.G. No Sp. + ease in house M. M. 2 Tub. Meningitis No D.K. M. V. 9157 6 Tub. Meningitis Yes No Brother: Pul. Tub. Sp. + Tub. Meningitis Yes 9206 J.C. M. 10 No Refused examination M. 9212 E.H. M. 4 Miliary Tuberculosis No Yes Brother died. Sp. + 3 years ago M. Year 1933 9313 A.M. V. F. 10 m. Tub. Meningitis Yes No Refused examination J.L. M. 9399 F. 2 Tub. Meningitis No No Mother : Pul. Tub. Sp. + 9409 J.F. F. 19 m. Tub. Meningitis No No Father : Pul. Tub. Sp. + V. 9464 A.W. M. No Sister : Pul. Tub. Sp. + V. 2 Tub. Meningitis Yes (34) M. M. 9487 L.R. 10 m. Tub. Meningitis No Yes Father : Pul. Tub. Sp. + 9513 P.S. M. 12 m. Tub. Peritonitis No No Father : Pul. Tub. Sp. + H. 8556 G.T. M. 9 m. Tub. Br. Pneumonia Yes No Father : Pul. Tub. Sp. V. Year 1934 ' 9629 J.S. F. Tub. Meningitis Yes Yes Brother : Pul. Tub. Sp. + M. 2 9642 J.S. F. M. 3 m. Tub. of Abdomen Yes No Mother : Pul. Tub. Sp. + M. 9632 R.S. F. 23 m. Tub. Meningitis No Yes Father : Pul. Tub. Sp. + 9662 D.A. M. 22 m. Tub. Meningitis Yes No Nil found V. 9672 J.M. F. V. 23 m. Tub. Meningitis No No Father : Pul. Tub. (died) S.B. Tub. Meningitis Yes 9720 F. 4 Yes No family contact It 9748 p.p. F. 11 m. Tub. Meningitis No Yes Nil found M. M. 9757 T.R. M. 7 m. Miliary Tuberculosis No Yes Father : Pul. Tub. Sp. + Year 1935 $ 9819 D.C. F. 10 Miliary Tuberculosis Yes No Refused examination V. 9430 W.C. M. 3 Tub. Meningitis Yes Yes Father : Pul. Tub. Sp. + M. 9860 J.E. M. 2 Tab. Meningitis No Yes Mother : Pul. Tub. Sp. + M. 9864 B.S. F. 4 Miliary Tuberculosis No Yes Father : Pul. Tub. Sp. + V. PULMONARY TUBERCULOSIS (SPUTUM POSITIVE)—CHILDREN OF SCHOOL AGE AT DATE OF ONSET. Initials Hi Age at onset Sex Previous History Lungs affected R. or L. Source of infection Date onset No. 7849 G.C. 7¾ May 1927 M. Nil R. (Eff.) Father Sp. + 8267 H.A. 9 Deo. 1928 F. Nil R. Grandfather died P.T. same house 1927 8277 T.B. 11 Sep. 1928 M. Nil R. & L. Unknown 8372 M.M. 13 May 1929 F. Nil R. & L. Brother Sp. + 8551 S.B. 13¾ 21/10/29 Br. Pneum. at 2 ; Nil else R. & L. Nil in family ; 2 cases in next house Last died 19/9/27 F. 8580 E.C. 12 Oct. 1929 F. Nil R. Father Sp. + 8608 D.C. 9½ Mar. 1930 F. Nil L. Brother died P.T. January 1930 R. & L. 8665 G.P. 10½ 1/4/30 M. Nil Mother died P.T. 1925 8722 13 Mar. 1930 R. & L. A.E. F. Nil Brother died P.T. Dec. 1929 8755 F.H. 13 . 13/8/30 M. Nil R. & L. Sister died P.T. 1928 8877 R.C. 4½ May 1930 M. Nil R. Brother Sp. + Sister Sp. + 9178 J.B. 9 May 1932 F. Pneum. at 2½ ; Nil else L. Mother Sp. + 9199 E.W. 12 June 1932 F. Nil R. Brother died T.B. Meningitis. Aunt Pleural Effusion. Grandmother suspect 9253 M.R. 12 Mar. 1932 F. Nil R. Sister died P.T. April 1928. Mother Sp. + 9308 M.E. 12 Dec. 1932 F. Nil L. Brother died P.T. Dec. 1929. Sister died P.T. Aug. 1930 9429 F.C. 13 May 1933 F. Nil R. & L. Unknown 9660 E.W. 11¾ Aug. 1633 F. Nil R. Doubtful. Slept with grandmother-suspect 9808 B.S. 12 Feb. 1935 F. Nil R. Father Sp. + 9822 L.T. 13 Mar. 1935 F. Nil R. Mother Sp. + 19 cases. Human source of infection—Probable 14 cases —74% Possible 3 cases —15% Unknown 2 oases—11% NURSING AND EXTRA NOURISHMENT. The aid of the District Nursing Associations has been enlisted in 76 cases during the year. Much can be done by careful nursing to alleviate suffering and improve conditions, and as tuberculosis is notably a slow disease the average number of visits paid to each patient is high. During 1935 more than 5,000 visits were paid by the district nurses to patients suffering from tuberculosis. In advanced cases of tuberculosis where the patient is living at home, it has been our practice for a long time now to arrange for daily visits from the district nurse where the patient is willing for this to be done. By this means we are often enabled to help the patient and at the same time to reduce the risk of infection to other members of the household. The amount of extra nourishment which the scheme allows us to supply to tuberculous patients is very limited and it usually takes the form of milk and eggs, and is only supplied on the recommendation of the Tuberculosis Officer; a total of 167 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 17 shelters at present in use, 2 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. Forty-four beds are in use at present. LADY ALMONER. The work of the Lady Almoner is varied and arduous, and shows no sign of decreasing. She visits the homes of patients who are away in sanatoria or convalescent homes, and arranges for the supply of extra nourishment on the recommendation of the Tuberculosis Officer ; altogether 717 visits were paid during the year. She is also responsible for the loan of shelters, beds, bedding, bed-pans, air rings and other similar articles of invalid furniture. Much of her time is taken up in arranging holidays or periods of change in convalescent homes for contacts of tuberculosis cases. By the kindness of the Mayor, Councillor S. R. Weightman, 33 children were sent to the seaside this year ; holidays were also arranged for a number of other children and women. Articles of clothing were supplied to 60 patients during the year, and a large number of other patients were assisted in various ways. It is part of the work of the Almoner to assist patients to find employment, and a good deal of time is occupied in this endeavour, unfortunately but with scant success. In addition to these duties she interviews various mothers who are recommended for admission to Fairby Grange and receives payments for the first week's stay there. Another duty performed by the Lady Almoner is in connection with the supply of Insulin to diabetic patients ; she supplies the Insulin to such patients and visits them in their homes. She also acts as Infant Protection Visitor under the Children's Act, visiting the homes in which foster-children are received in order to see that foster-mothers comply with the conditions of the act. In some of these activities help is received from voluntary sources, and thanks are due to the Bermondsey United Charities, the Rotherhithe Consolidated Charities, the British Red Cross Society, Queen Alexandra Rose Day Fund, Queen Mary's Needlework Guild per Lady Ludlow, the Friends of the Poor, the Charity Organisation Society and the Invalid Children's Aid Association for help in various ways. PUBLIC HEALTH (PREVENTION OF TUBERCULOSIS) REGULATIONS, 1925. It was not found necessary to take any action under these Regulations in 1935. RETURN SHOWING THE WORK OF THE DISPENSARY DURING THE YEAR 1935. Grand Total Diagnosis Pulmonary Non-pulmonary Total Adults Children Adults Children Adults Children M. F. M. F. M. M. F. M. F. F. F. M. A.—New Cases examined during the year (excluding contacts): — —i- n I h -! I (a) Definitely tuberculous 59 47 3 3 4 12 8 3 63 59 11 6 Diagnosis not completed - - - - - - - - 5 5 1 2 (c) Non-tuberculous - - - - - 117 119 36 29 453 - - - B.—Contacts examined during the year : — T II I I , I I „ (a) Definitely tuberculous 2 4 2 3 - 1 2 - 2 5 4 3 (6) Diagnosis not completed - - - - - - - 1 1 1 - - (e) Non-tuberculous - - - 62 112 132 142 465 - - - - - .C—Cases written off the Dispensary Register as o rr \ I a I ~ '|| A O , 'I 1 I o ii „ 111 i (a) Recovered 9 8 6 4 2 1 7 8 11 9 13 12 (b) Non-tuberculous (including any such cases previously diagnosed and entered on the Dispensary Register as tuberculous) - - - - - - - 186 238 172 174 815 - (38) D.—Number of Cases on Dispensary Register on December 31st: — i — n ———— (a) Definitely tuberculous 288 220 50 43 36 56 70 56 324 276 120 99 (6) Diagnosis not completed - - - - - - - - 5 6 2 3 835 1. Number of cases on Dispensary Register on January 1st. 878 8. Number of visits by Tuberculosis Officers to homes (including personal consultations) 959 2. Number of cases transferred from other areas and cases returned after discharge under Head 3 in previous years 20 9. Number of visits by Nurses or Health Visitors to homes for Dispensary purposes 2,756 3. Number of oases transferred to other areas, cases not desiring further assistance under the scheme, and cases "lost sight of" 71 10. Number of :— (a) Specimens of sputum, etc., examined 880 4. Cases written off during the year as Dead (all causes) 95 (6) X-ray examinations made in connection with Dispensary work 584 6. Number of attendances at the Dispensary (including Contacts) 3,725 11. Number of "Recovered" cases restored to Dispensary Register, and included in A (a) and A (6) above — 6. Number of Insured Persons under Domiciliary Treatment on the 31st December 117 12. Number of " T.B. plus " oases on Dispensary Register on December 31st 326 7. Number of consultations with medical practitioners:— (a) Personal 92 (6) Other 208 la addition to these visits 717 visits were made by the Lady Almoner and 189 visit by the School Nurse. PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1930. Summary of Notifications during the period from the 1st January, 1935, to the 31st December, 1935. Age Periods Formal notifications Number of primary notifications of new cases of Tuberculosis Total Notifications 0 to 1 5 to 10 10 to 15 15 to 20 20 to 25 25 to 35 35 to 45 45 to 55 65 to 65 65 and upwards Total (all ages) 1 to 5 7 6 89 Pulmonary, Males - - 2 - 9 11 19 11 7 72 „ Females - 2 - 2 8 17 14 8 2 - 69 4 57 - 3 7 5 1 1 1 - - - - 18 20 Non-Pulmonary Males „ Females - 2 - - 3 2 3 2 1 2 1 16 19 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 9 Pulmonary Males - - - - 1 - 4 1 1 1 1 „ Females - - - - - 3 - - - 2 5 - Non-Pulmonary Males - - 1 2 - - - - - - 3 - - - 1 1 1 - 1 - - 1 „ Females - 5 (40) Return rendtrad under the PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1930. 1st QUARTER, 1935. Respiratory System Other Forms M. F. M. F. Number of Cases on Register at commencement of Quarter 431 302 138 131 Number of Cases notified during Quarter 19 18 5 5 Inward Transfers, Un-notified Deaths, etc. 2 - 2 - Number of Cases removed from the Register 23 15 5 7 Number of Cases remaining on the Register at end of Quarter 305 129 429 140 2nd QUARTER, 1935. Respiratory System Other Forms M. F. M. F. Number of Cases on Register at commencement of Quarter 429 305 140 129 Number of Cases notified during Quarter 20 16 7 2 Inward Transfers, Un-notified Deaths, etc. 3 - - 2 Number of Cases removed from the Register 28 7 7 23 Number of Cases remaining on the Register at end of Quarter 424 126 298 140 3rd QUARTER, 1935. Respiratory System Other Forms M. F. M. F. Number of Cases on Register at commencement of Quarter 424 126 298 140 Number of Cases notified during Quarter 21 15 2 4 Inward Transfers, Un-notified Deaths, etc. 2 2 1 2 Number of Cases removed from the Register 25 3 4 18 Number of Cases remaining on the Register at end of Quarter 422 297 140 128 4th QUARTER, 1935. Respiratory System Other Forms M. F. M. F. Number of Cases on Register at commencement of Quarter 422 297 140 128 Number of Cases notified during Quarter 12 8 4 5 Inward Transfers, Un-notified Deaths, etc. 2 1 3 9 Number of Cases removed from the Register 40 27 9 12 Number of Cases remaining on the Register at end of Quarter 396 281 135 122 IV. LIGHT TREATMENT. Report by Dr. E. J. O'Keeffe. Assistant Medical Officer of Health. During the year the old Solarium building was demolished to make way for the building of the new Health Centre, and since 4th September, 1935, the Light Clinic has been accommodated temporarily in the ground and first floors of that part of the new building which has been erected. The change to temporary quarters has been made smoothly and there has been no falling off in attendances or in the numbers of new cases accepted for treatment. The apparatus in use is the same as that used in the old building, except that, owing to limited accommodation, it is not at present possible to use the carbon arc lamp. An addition has been made to the Solarium staff by the appointment of a masseuse, Miss Coleby, who commenced duties on 30th April, 1935. Massage and remedial exercises are applied in suitable cases, and are an essential complement to light and heat therapy in many cases. The number of massage cases and general review of the results of treatment are given below: Number of attendances and General Treatments 27,068 Number of Local Treatments 4,232 Number of Examinations 1,934 Number of Massage Treatments 451 Number of New Patients 488 Number of Discharges 525 Number of Maternity and Child Welfare Cases under treatment during the year 303 Number of Tuberculous Patients under treatment during the year 26 Total number of other classes under treatment during the year 543 (The Maternity and Child Welfare patients formed 27.6 per cent. of the total number under treatment and the Tuberculosis patients 2.7 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 eight of the sessions each week. A list of the principal diseases treated, together with the number of patients who completed treatment during the year is given below: TUBERCULOSIS. Pulmonary 2 Glandular 6 Hip 4 Skin (Lupus and Bazin's Disease) 2 Other non-pulmonary conditions 11 MATERNITY AND CHILD WELFARE. Ante-natal 7 Rickets 42 Marasmus, Debility, Malnutrition, etc. 67 Bronchitis 38 Adenitis (non-tuberculous) 21 Other conditions 4 OTHER DISEASES. Acne 8 Adenitis (non-tuberculous) 10 Alopecia 25 Asthma 1 Bronchitis (including chronic) 36 Chronic Rheumatic conditions 74 Dermatitis 3 Emphysema 3 Fibroid lung 5 Malnutrition, Debility, Anaemia etc. 123 Miscellaneous conditions 33 Psoriasis 2 Light treatment has been found invaluable in cases of surgical tuberculosis following treatment in sanatorium. 23 cases of nonpulmonary tuberculosis completed treatment during the year with good results in all but one case. Of 74 cases of bronchitis who completed treatment during he year 53 showed marked improvement. Especially noticeable was the relief which the majority of cases of the "asthmatic" type got from the dyspnoeic attacks. As in previous years the numbers of infants and school children treated for nutritional disorders and debility following acute illness, and the numbers of adults treated for chronic rheumatic conditions formed the two largest groups of the total number of patients undergoing treatment. In the first group the most marked benefit from treatment was noticed in children suffering from debility following acute illness. Under "Malnutrition, Anaemia, Rickets, Marasmus" the majority of infants treated were referred from the Maternity and Child Welfare Centres, and from the Tuberculosis Dispensary and school in the case of older children. In these cases treatment provides a powerful stimulant to the metabolism, increasing the vital body functions and causing increase of appetite and muscular tone. The majority of children showed marked improvement in general condtion and increased weight. It must be born in mind that ultra-violet light therapy is but part of the treatment of cases of nutrition disturbances, and that other causal factors have to be remedied. In the case of infants these are fully investigated at the Maternity and Child Welfare Centres, whilst it is noted that most of the children referred from school for treatment have milk at school. A small proportion of children showed a little or no improvement following treatment. In many cases faulty nutrition at early, probably pre-natal, age results in a frail body framework, and later efforts to form a robust constitution end in failure. Good results were noted in the ante-natal cases treated during the year. These were later reflected in the health of the child at birth. In the second large group, those suffering from chronic rheumatic conditions, cases showed a varying degree of crippling due to pain and muscular spasm, in many cases there being a total incapacity to follow their usual occupations. This incapacity is bound to have far reaching effects on the patient's family as a whole, as it reduces the family income for long and recurring periods. Our results in the treatment of these cases have been excellent. In most cases, after a period of light and radiant heat treatment crippling disappears; and later, with treatment combined with massage in cases to promote absorption of fibrotic nodules or bands, functional capacity returns. It is realised that treatment is not a cure as has been emphasised in previous reports, but it does prevent more serious development in early cases, and it maintains functional capacity in the more advanced cases, which is important from the occupational point of view, as many of the sufferers from these maladies become totally unemployable. During the year 19 cases of alopecia completed treatment. Of these 7 cases were cured and 10 showed very definite improvement. Acne was found to respond well to treatment by ultra-violet light. Many of these cases had previously had prolonged treatment of varying forms, including vaccines, without apparent benefit; 6 cases completed treatment during the year, and of these 5 were greatly improved and 1 was cured. 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 returned from Leysin Initials of Patient A g e Localisation of Disease Date sent to Leysin Sex Result S.B. 12 M. Left Foot 5 years 28/7/24 5/7/27 Well and at work I.R. 10 F. Glands of Neck 5 „ 28/7/24 6/10/25 Removed from District M.S. 15 F. Right Knee 6 28/7/24 6/10/25 Well.Now married 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 Well and at work M.B. 28 F. Glands of Neck 15 „ 26/10/25 22/2/27 „ „ E.C. 16 F. Right Knee 5 „ 26/10/25 8/7/27 „ „ H.C. 10 M. Glands of Neck 2 „ 26/10/25 20/2/27 „ „ A.H. 21 F. Left Hip 9 „ 17/5/26 29/6/28 „ „ E.W. F. Spine and Right Hip 18 „ 17/5/26 17/9/27 Well 23 G.B 20 Left Ankle 2 „ 9/2/27 28/4/29 Removed from District F. L.T. 19 M. Abscess of Ribs 2 „ 9/2/27 8/5/28 „ „ „ M. Spine 7 „ 5/2/27 8/5/28 Keeping well C.P. 24 8/6/29 Removed from District A.R 26 F. Glands of Neck 3 „ 5/2/27 E G 16 M. 4 „ 20/6/28 8/6/29 Well and at work Lupus of Nose C.P. 26 M. Tuberculide of Skin 1 „ 20/6/28 8/6/29 „ „ H.S 18 M. Right Hip 3 „ 20/6/28 26/9/30 „ „ I.S 23 F. Right Hip 8 „ 31/5/29 5/8/32 „ „ F. Multiple Lupus 25 „ 20/1/30 6/5/32 Undergoing further treatment C C. 27 A P. 16 F. Glands of Neck 4 months 20/1/30 20/3/31 Well and at work E.W. 18 M. Left Knee 1 year 15/4/30 1/2/33 Well and working G.L. 15 M. Spine 10 months 13/10/30 Dead (Tuberculous Meningitis) - 16 F. Lupus of Nose 1 year 6/2/31 6/5/32 Well and at work V.B. D.R. 34 M. Spine 4 years 4/7/31 - Dead (Cerebro-spinal Meningitis) 17 7 months 30/7/32 - J O'B. M Right Knee Still at Leysin E.B. 20 F. Left knee - 10/5/33 14/6/35 Seen recently, keeping well. F.H. 22 F. Left wrist 3 months 27/1/36 - Still at Leysin V.-MATERNITY AND CHILD WELFARE. There have been several changes of importance during the year in the Maternity and Child Welfare Scheme to which it is necessary to call attention. I am very pleased to be able to record that a satisfactory arrangement has been arrived at with regard to the Maternity and Child Welfare Centre at the Central Hall. The number of Health Visitors employed by the Central Hall authority has been increased so that there are now one part-time and two whole-time Health Visitors. The part-time Medical Officers are employed and paid by the Borough Council and work under the direction of the Medical Officer of Health. Mothers and children are now seen by appointment so that the attendances are more evenly spread out over the whole of the sessions, and many other smaller points of difference have been adjusted to the satisfaction of both parties. In October following the resignation of one of the Tuberculosis Nurses, I submitted a report suggesting that the remaining nurse, Miss Riley, should be appointed as a Health Visitor and the work of visiting tuberculous patients should then be divided amongst all the Health Visitors. Both committees agreed to these proposals which are now in force and working satisfactorily. In the early part of the year the committee had under consideration the question of providing for the examination and treatment of women at the menopause. It was the intention to provide the services of an expert in diseases peculiar to women for three classes of patients:— 1. Post-Natal,—Women suffering from trouble following confinement. 2. Menopause.—Patients suffering from diseases associated with the "change of life." 3. Diseases of the Female Generative Organs, including, amongst other things, cancer and other tumours. After careful consideration the Council authorised the establishment of two such clinics weekly, one to be held at 110 Grange Road and one at 98 Rotherhithe New Road. These clinics were opened early in July and particulars of the attendances are appended. A report was approved by the Council in October authorising the establishment of two Health Centres, one in Rotherhithe and one in Bermondsey, the Housing Committee having kindly agreed to allocate two new flats to the Maternity and Child Welfare Committee or this purpose. It is intended to use these centres for a variety of purposes. 1. Infant Welfare Centres.—One Health Visitor will attend daily from 9.30 to 10.30 a.m. to see mothers and babies and weigh babies, if necessary, and to give such advice as is within her province and ordinarily given by her at any infant welfare clinic. When necessary she will make appointments for mothers to see the doctor at the next ordinary infant welfare centre in the district. She will also see and advise ante-natal patients and make appointments for such patients to see the doctor at the ante-natal clinic. 2. Toddlers' Play Centres.—These are intended to take up to a maximum of twelve children between the ages of one and five years, the object being to take care of these children for short periods not exceeding three hours, so as to free the mother. It is not intended to take care of children whose mothers go out to work. 3. Domestic Teaching.—Arrangements will be made for demonstrations in home management, budgetting and cookery to be given at these centres from time to time. 4. Foot Clinic.—One session each week will be held at each centre. 5. Invalid Children. —Many children suffer from sequelae following infectious diseases; a certain number of these children make very slow recoveries and require examination and sometimes prolonged convalescent treatment. Clinics for the examination of such children will be held at intervals. It is hoped that these centres will be opened by the end of February or the beginning of March next year, FAIRBY GRANGE CONVALESCENT HOME. The number of patients in the home of necessity remains about the same from year to year; particulars of admissions during 1935 are shewn hereunder: — Number of women admitted .. .. .. 222 Number of babies admitted .. .. .. 97 Number of toddlers admitted .. .. .. 153 MIDWIFERY SERVICE. Under this scheme 410 patients "booked" during the year compared with 301 patients last year. In 216 of these cases the full fee of the midwife was paid by the Council and a proportion of the fee was paid in 166 other cases; the remaining 28 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 89. The number of consultations during the year was as follows: — Obstetric Consultations Nil Puerperal Fever Consultations 1 INFANT LIFE PROTECTION. The number of foster-mothers and children in this borough is happily very small, and no difficulty has been experienced in dealing with these cases during the year. There were 15 fostermothers with 16 children and 76 visits were paid by the visitor and 2 by the Medical Officer of Health. MATERNAL MORTALITY. It gives me great pleasure to report that there were no maternal deaths during the year; the maternal death rate is therefore nil, HEALTH VISITORS. The following table shows the work done by the Municipal and Voluntary Centres and Health Visitors during 1935: — District Visits to Infants and Children Puerperal Fever and Puerperal Pyrexia Ophthalmia Neonatorum Attendences at Centres Births Notified Visits to Expectant Mothers Other Visits Re-visits First Visits Under 1 year Primary Visits Cases Visits Cases Visits 1-5 years Revisits Miss Robson 87 94 712 1225 48 136 2 2 - - 527 192 *Central Hall 13 84 7 6 - - - - 26 13 198 35 Miss Bowles 75 91 502 726 62 129 - - - - 613 239 Miss Lawrence 124 135 945 1172 49 110 3 3 - - 418 227 St. George's Hall 83 91 959 1231 53 201 1 1 - - 750 110 Miss Riches 61 72 618 978 44 140 2 2 - 620 241 - Miss Brown 51 75 295 815 117 - 1 1 570 216 52 - *Miss Riley 9 8 60 57 4 10 - - - - 74 19 235 95 800 Miss Helden 115 515 1124 70 195 2 2 - - Fulford Street 132 139 792 1092 106 180 - - - - 566 153 Miss Carlton 145 149 1181 1279 77 188 2 2 - - 320 221 Miss White 141 157 931 1164 94 217 4 4 2 3 481 174 Miss Wadds 89 90 889 1428 53 340 3 3 1 2 249 202 Miss Bache 134 760 990 60 141 3 3 1 3 128 242 125 Salomon's Centre 100 103 830 2394 542 537 - - - - 8 300 Totals 1330 1466 10073 15873 1321 2647 22 22 5 9 6159 2797 * From 16th November, 1936. ATTENDANCES AT MATERNITY AND CHILD WELFARE CENTRES. The following table shows attendances at Maternity and Child Welfare Centres during 1936: — Name of Centre Children's Consultations Ante-natal Clinic Sewing Class Gynaecological Clinic No. of Sessions New Cases Total Attendances No.seen by Doctor No. of Sessions New a Cases Total Attendances No. of Sessions No. of Attendences New Cases No. of Sessions Total Attendances Under 1 year 1-5 years Under 1 year 1-5 years 110 Grange Road 196 197 40 3,535 2,921 4,103 47 139 796 41 239 22 91 181 152 195 17 3,702 3,172 82 151 870 - - 23 77 98 Rotherhithe New Road 2,485 105 51 39 2 554 540 944 - - - - - - - - Trinity Road Bermondsey Gospel Mission 97 107 25 2,041 1,953 2,173 - - - - - - - - Roseberry Street 47 84 13 1,468 985 1,138 - - - - - - - - 151 96 4 2,482 1,278 200 476 3,015 - - - - Salomon's Centre 1,392 - Princess Club 159 102 10 2,032 1,891 2,922 51 71 408 85 1,392 - - - Fulford Street 99 151 24 1,968 1,541 2,360 50 135 646 - - - - - St. George's Hall 61 990 65 14 1,007 1,235 - - - 42 655 - - - *Central Hall 36 36 9 1,170 2,230 1,416 - - - - 155 - - - Totals 1,053 158 16,945 430 972 5,735 176 45 286 1,068 19,942 20,741 2,441 168 * Commencing 26th October, 1935. Maternity and Child Welfare. STATISTICS FOR THE YEAR, 1935 Borough Council of Bermondsey. POPULATION according to the Census of 1931.—111,542. Births. Registered— Total Males Females Live Births Legitimate 1,447 753 694 Illegitimate 40 18 22 Birth Rate per 1,000 of the estimated resident population 14.5 Total Males Females Stillbirths 41 15 26 Rate per 1,000 total (live and still) births 27 Notified within 36 hours of birth— (1) Live Births, 1,436. (2) Stillbirths, 37. (3) Total, 1,473 (1) By Midwives, 241. (2) By Parents and Doctors, 1,232. Total. Males. Females Deaths .. 1,201 670 531 Death Rate per 1,000 of the estimated resident population 11.7 Maternal Deaths. Deaths from puerperal causes:— Rate per 1,000 total (live and still) births. Deaths. Puerperal Sepsis Nil Nil Other puerperal causes Nil Nil Total Nil Nil Death Rate of Infant under 1 year of age. All Infants per 1,000 live births 69 Legitimate infants per 1,000 legitimate live births 66 Illegitimate infants per 1,000 illegitimate live births 175 Health visitors. Visits paid by Health Visitors during the year:— To Expectant Mothers (1) First Visits, 1,321. (2) Total Visits, 2,647 To Infants under 1 (1) First Visits, 1,466. (2) Total Visits, 10,073 To Children, 1-5 Total Visits, 15,873 Convalescent Homes for Children under 5. Number of Beds, 16. Number of Children under 5 received during the year, 250. 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:- 11,385. Deaths from Measles (all ages) 4 Deaths from Whooping Cough (all ages) 5 Deaths from Diarrhoea (under 2 years of age) 31 VI. DENTAL TREATMENT. One alteration in the time-tables of the dental centres has been made during the year. In the first week of May the Friday evening session at 110 Grange Road was closed and an additional session was added to those at 98 Rotherhithe New Road. The total number of patients treated during the year was 7,634, a very slight increase as compared with last year; the number of attendances has also risen and generally speaking every branch of the work shows a slight increase this year. Both centres are working almost to full capacity, and on one or two occasions prosthetic work has had to be sent out in order to avoid undue delay in the provision of dentures. The building operations do not seem to have interfered with the work of the centre at 110 Grange Road, and we are anticipating with pleasure the opening of the new building with its more commodious quarters. Alterations are contemplated also at 98 Rotherhithe New Road, and it is hoped that the accommodation of the dental clinic there will be increased, particularly with regard to the waiting-room for patients. (53) DENTAL TREATMENT CARRIED OUT DURING 1935 Type of Case Number of Patients Examined Number of Patients Treated Number of Extractions Anæsthetics Number of Fillings Number of Scalings Number of Dentures Fitted Number of Repairs to Dentures Number of Attendances Local General Maternity Cases 878 1014 2756 724 238 49 20 214 83 1997 Women 2290 1200 113 219 148 110 1325 1430 24 2432 3411 Men 1960 2085 3598 2100 47 267 37 209 140 Tuberculosis Cases 48 43 111 47 6 54 1 18 9 177 Children (Table I.) 896 844 2834 209 638 325 - - - 2079 Totals 5107 5416 11589 4280 1042 914 82 589 342 10096 Maternity Cases 494 500 1961 265 32 25 137 25 1221 253 Women 387 428 1007 268 60 8 56 30 882 134 Men 572 593 1085 544 52 59 19 65 24 1023 Tuberculosis Cases 5 5 13 1 3 - 1 - - 12 Children (Table I.) 708 692 2255 63 574 258 8 - - 1451 Totals 2166 2218 6321 1141 1016 409 258 79 61 4589 (54) TREATMENT OF CHILDREN DURING 1935 CENTRE Number Examined Number Treated Number of Extractions Anæsthetics Number of Fillings Number of Scalings Number of Attendances for Orthodontics Total Number of Attendances Age Group Local General 110, GRANGE ROAD. Under 5 years 309 319 1463 7 313 6 - - 598 Over 5 years 587 525 1371 202 325 319 - 301 1481 Totals 896 844 2834 209 638 325 - 301 2079 98, ROTHERHITHE NEW ROAD. Under 5 years 252 242 1033 26 234 45 - - 491 Over 5 years 456 450 1222 37 340 213 8 - 960 Totals 708 692 2255 63 574 258 8 - 1451 VII—PROPAGANDA. During the year 1935 the following lectures and demonstrations, each illustrated by lantern slides and cinema films, were given:— Lectures. Audiences. Schools 70 12,940 Clubs and other Institutions 36 1,867 Open-air with cinema van 64 29,360 170 44,167 During the same period 244 children attending schools in the Borough entered, after recognised training, for the Borough Council's examination in Personal Hygiene and Home Nursing, and the following certificates were granted:— Primary 141 Intermediate 36 Final 12 Four of the final passes also gained proficiency medals for obtaining over 70 per cent, of marks throughout the examination. Propaganda work in Bermondsey has been a recognised section of the Public Health Service for the past eleven years, and the experience gained shows that it is an essential part of any complete scheme of Preventive Medicine. The most valuable work in Health Publicity is that done in the schools, and it is the aim of the staff to steadily increase the number of lectures and demonstrations each year. During 1935 seventy such lectures were given, the lecturer on each occasion being a medical man or woman, and in every case the lecture was illustrated by lantern slides and films. Just recently a junior clerk was appointed in the Department and 23 applicants for the post, between the ages of 16 and 17, were given an educational test, part of which was to write an essay. A choice of subjects was given, one of them being one of the school lectures. Of the 23 candidates, 18 had attended Bermondsey Schools and of these, 17 chose the school lecture for the essay. In every case the writer showed an intimate knowledge of his subject and some really good essays were submitted. A steadily increasing number of children are taking the Bermondsey Hygiene Course at school, and during the past year a record number of Borough Council certificates were granted to successful candidates. The teachers responsible for this work are most enthusiastic and the children keenly interested. The examinations take two days, one for the theory and another for practical work, and are taken very seriously by the children. (57) VIII.—SANITARY ADMINISTRATION. HOUSING. During the year 1935 fourteen new areas were represented, comprising in all a total of 601 dwelling houses and 28 dwelling houses with shops attached. The following are the areas represented:- Title of Clearance Area Date Area in sq. ft. (approx.) No. of Dwelling Houses No. of Dwelling houses and Shops Adams Gardens 5/2/35 80,302 104 2 Tunnel Road 5/2/35 5,196 3 Nil 5/3/35 24,819 20 Nil Kintore Street Tyers Gateway 2/4/35 14,496 26 Nil Cloyne Row 2/4/35 3,640 8 Nil Arnolds Place 7/5/35 186,310 204 6 Rowley Buildings 4/6/35 17,685 19 7 Whites Grounds, No. 2 2/7/35 3,932 Nil 4 Prospect Street, No. 1 2/9/35 44,127 65 1 Prospect Street, No. 2 2/9/35 14,161 15 Nil Adams Gardens, No. 2 24/9/35 1,839 4 Nil Lynton Mews 1/10/35 13,213 12 Nil 8 Kipling Street 5/11/35 85,432 111 Queens Place 5/11/35 3,248 10 Nil Of the areas represented, eleven have been declared by the Council during the year and the particulars of these are given hereunder:— Title of Clearance Area Area in sq. ft. (Approx.) No. of dwelling houses Population Date declared by Council Families Persons 86,250 107 137 536 26/2/35 Adams Gardens and lands adjoining Tunnel Road 5,196 3 5 17 26/2/35 Kintore Street and lands adjoining 30,721 21 25 120 28/5/36 Tyers Gateway 14,496 26 28 112 28/5/35 Cloyne Row 3,640 8 8 30 28/5/35 Arnolds Place and lands adjoining 368 25/6/35 252 1481 301,230 Rowley Buildings 17,685 26 35 128 23/7/35 Whites Grounds No. 2 and lands adjoining 4,739 6 7 26 24/9/35 Prospect Street, No. 1, and lands adjoining 91,904 78 328 26/11/36 89 Prospect Street, No. 2 14,795 15 18 55 26/11/35 Lynton Mews 13,213 12 10 47 17/12/35 (88) The clearing of these areas necessitate the demolition of 554 dwelling houses, and the rehousing of 730 families consisting of 2,880 inhabitants. The building of new houses by the Council has been continued in accordance with the policy of the Council, and 459 cottages and flats have been erected during the year. Particulars of these are given hereunder: — Position No. of families accommodated Number of dwellings Whites Grounds Estate 55 flats 55 Albion Estate 4 „ 4 Irwell Estate 45 „ and 1 shop 45 Swan Mead 14 „ 14 West Lane (Cherry Garden Place) 19 „ 19 Amos Estate 28 „ 28 Cranbourn House 26 „ 26 Bethel Estate 23 „ 23 Elim Estate 27 „ and 1 shop 27 Purbrook Estate 79 „ and 1 shop 79 Crosby Row (Porlock Street) 2 cottages 2 Redriff Estate 26 flats 26 Rotherhithe Street West, Block No. 11 17 „ 17 20 „ 20 Neptune Street Creasy Estate (Leroy Street) 21 „ 21 Westfield House 21 „ 21 Fountain House 10 „ 10 Rothorhithe Street, Block No. 10 1 cottage 1 Bryan House 21 flats 21 The following dwellings were in course of erection at the end of the year:— Position. Number of fiats, cottages and shops Whites Grounds Estate 30 flats 61 „ Elim Estate Cherry Garden Place 21 „ Irwell Estate 24 „ Purbrook Estate 34 „ Rotherhithe Street, Block No. 10 5 cottages 18 flats and 1 shop Bryan House Alice Street site 34 flats Redriff Estate 51 „ Southwark Park Estate 58 „ and 4 shops 59 „ and 1 shop Adams Gardens HOUSING ACT, 1935—OVERCROWDING SURVEY. The overcrowding survey was made by the Housing Department, and the following report was submitted to the Council on the 25th February, 1936: — "The following information has been forwarded to the London County Council in connection with the recent overcrowding survey carried out by the Council:— Form A. Preliminary enumeration 18,350 houses visited. Form B. Doubtful overcrowding 5,027 houses revisited and all rooms in each house measured up Form C. This is a summary showing the result of the completed survey and a copy of the summary for the Borough of Bermondsey as submitted to the London County Council is attached to this report. This shows a total of 27,488 families included in the return, 3,142 families being overcrowded and 24,346 families not overcrowded. Dividing the Borough into its twelve electoral wards the results are as under:— Ward No. of families No. of families Total number overcrowded not overcrowded of families St. John 166 1,019 1,185 St. Olave 93 257 350 St. Thomas 47 246 293 B.1 493 1,799 2,292 8.2 481 2,635 3,116 B.3 337 3,518 3,855 B.4 148 3,849 3,997 B.5 122 2,339 2,461 B.6 391 1,435 1826 R.1 483 2,552 3,035 R.2 186 3,277 3,463 R.3 195 1,420 1,615 Totals 3,142 24,346 27,488 The 3,142 overcrowded families included in the return on Form C are contained in 2,734 separate dwelling-houses. It will be seen from Form C that no provision has been made for families of more than 13 persons or for houses which would accommodate. families of more than 13 persons. It has been pointed out to the London County Council that there are some families and houses in Bermondsey where the number of persons is higher than provided for on Form C., and they are considering the matter to see if the form can be amended to provide for these; if this is done there will be a very slight variation in the total number of families shewn on the form. "It has also been found that no provision was made on Form C. for families occupying one room only having a floor area of less than 50 or 70 sq. ft. In the first case no persons would be allowed to sleep in the room and in the second case only half a person (child under 10 years of age). It was found that in one case one adult person was sleeping in a room of less than 50 sq. ft. and in six cases single rooms of between 50 and 70 sq. ft. were being used for sleeping purposes by 1, 1½ or 2 persons. These have been included in the first downward column of Form C. showing permitted accommodation for one person and the matter has been mentioned to the London County Council. For the carrying out of the overcrowding survey, 30 enumerators and 20 survey assistants were engaged for a period of four weeks and ten survey assistants for a further period of one week. The total wages paid to these enumerators and survey assistants was £877 12s. 6d., and the agreed proportion of this to be met by the London County Council is £404 Is. 3d.; the net cost to the Borough Council, is, therefore, £473 lis. 3d." Form METROPOLITAN BOROUGH OF BERMONDSEY. HOUSING ACT, 1935, OVERCROWDING SURVEY-SUMMARY. NOTE.- The numbers of overcrowded families are shown below the stepped diagonal line. All numbers above the stepped diagonal line are families not overcrowded. INSPECTIONS. PROCEEDINGS, ETC. Hereunder will be found particulars of Inspections, Proceedings, etc., for the year 1935: — Inspection of Dwelling Houses during the Year;— (1) (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 8,507 (b) Number of Inspections made for the purpose 39,264 (2) (a) Number of dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 4,298 (b) Number of Inspections made for the purpose 4,298 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 643 (4) Number of dwelling-houses (exclusive of those referred to under the preceding subhead) found not to be in all respects reasonably fit for human habitation 63 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 3,474 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 63 (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 (B) Proceedings under Public Health Acts:— (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 5,772 (2) Number of dwelling-houses in which defects were remedied after service of formal notices: — (a) By owners 2,298 (b) By Local Authority in default of owners Nil (C) Proceedings under Sections 19 and 21 of the Housing Act, 1930:- (1) Number of dwelling-houses in respect of which Demolition Orders were made 4 (2) Number of dwelling-houses demolished in pursuance of Demolition Orders 4 (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 1 (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 Total number of houses in the Borough 19,146 Number of houses occupied by the working classes 19,002 REGISTERED PREMISES— Premises Number on Register at end of 1935 Number of Inspections Number of Prosecutions Common Lodging Houses 3 88 - Seamen's Lodging Houses 2 11 - 727 Milkshops 290 - Houses let in lodgings 1,205 4,278 - Ice Cream Premises 145 93 - 103 Offensive Trades (including Poultry Slaughter-houses) 15 - SMOKE NUISANCES— Number of observations 23 Number of notices 5 Number of complaints 4 Number of summonses Nil WATER SUPPLY TO TENEMENT HOUSES- Premises supplied 52 Prosecutions Nil SALE OF FOOD— Number of premises used other than ice-cream premises, milk shops and cowsheds 636 Number of inspections 2,930 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 daring the year, the total number of inspections being eight. RATS AND MICE (DESTRUCTION) ACT, 1919 — Two notices were served under this Act. 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, inhabitated by more than one family. Water supply has been installed on one of the storeys of 52 tenement houses, after service of notices. 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. 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. 8 (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 4 WORK OF DISTRICT INSPECTORS, 1935. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 Special Inspections Complaints Infectious Diseases Factories & Workshops Specially Inspected Offensive Trades Outworkers' Bi-Annual Inspection Underground Conveniences Drains Tested Other Calls and Visits Chimneys watched Bakehouses Common and Seamens Lodging Houses Butchers Fishmongers, Friers and Curers Food Stores Fruiterers and Greengrocers Ice Cream Markets Restaurants and Eating Houses Destruction of Food Various TOTALS House-to-House Visits Ints. District No. 1 616 1340 381 70 - 24 - 47 1623 2 26 35 54 30 160 52 36 45 138 3 - 4819 599 137 „ No. 2 575 1212 300 108 55 - 34 2 41 2898 2 24 - 109 21 81 35 26 80 25 1 13 5642 755 „ No. 3 593 1480 482 148 55 - 3 - 38 2582 1 33 1 97 100 196 50 51 60 85 2 - 6057 726 „ No. 4 493 966 335 130 - - 21 - 35 2785 1 29 - 53 20 61 25 39 61 42 2 9 5107 767 „ No. 5 472 966 537 110 - - 37 - 21 2725 6 39 1 77 12 146 14 25 88 10 3 11 5300 788 „ No. 6 459 1377 436 97 36 43 39 - - 2675 4 48 14 55 21 149 25 41 87 27 - 69 5738 734 603 „ No. 7 1312 334 151 142 2 43 - 62 2754 2 29 - 75 70 63 1 - 5979 743 28 232 35 41 „ No. 8 487 1396 424 99 17 11 36 5 65 2666 4 47 48 82 13 88 18 34 306 51 7 65 5969 698 Total 4298 10049 3229 980 375 56 237 7 345 20708 22 275 99 602 245 1113 s 293 797 19 167 44611 5810 441 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 Instances (11) Notices served (12) Prosecutions (13) Instances (14) Notices served (15) Prosecution (16) Liste (2) Outworkers Failing to keep lists (9) Failing to send lists (10) Resident in Bermondsey Resident in other Districts (5 Contractors (31) Workmen (4) Contractors (6) Workmen (7) Wearing Apparel:— I „ [ I i .. I ... I I _ I - I I I _ 1 .. I I I I I I I . I - 10 6 (1) Making, etc. 21 - 43 46 4 47 12 - - 10 - - (2) Cleansing and washing - - - - - - - - - - - - - - - Fur pulling - - - - 1 1 - - - - - - - - - Umbrellas, etc. - - - - 1 3 - - - - - - - - - Umbrellas, etc. - 5 1 - - 5 - - - - - - - - 6 Paper, etc., Boxes. Paper Bags 2 - 8 2 11 2 - - 2 2 - 3 - - 2 Brush making - - - - - 2 - - - - - - - - - Combs, etc. - - - - 2 - - - - - - - - - - Leather Goods 4 - 5 10 - - 1 - - - - - 1 - - Surgical Instruments 2 - - 2 - - - - - 1 - - - - - Coathangers 2 - 17 21 - - 1 - - 1 1 - 1 - - Carding of buttons, etc - - - - 1 - - - - - - - - - Onion Peeling - - - - - 2 - 1 1 - - - - - - Games and Toys - - - - 3 - - - - - - - - - Total 37 - 78 82 5 69 24 - - 14 14 - 11 - - (67) FACTORIES, WORKSHOPS, LAUNDRIES, WORKPLACES AND HOMEWORK. INSPECTION. Number of Premises Written Notices Inspections Prosecutions Factories (including Factory Laundries) 1,022 53 - Workshops (including Workshop Laundries) 542 53 - Workplaces (other than Out workers' Premises) 219 12 - 1,783 118 - Total DEFECTS FOUND. Number of Prosecutions Particulars Number of Defects Found Remedied Referral to H.M. Inspector Nuisances under the Public Health Acts— Want of Cleanliness 7 7 - - Want of Ventilation 1 1 - - Overcrowding - - - - Want of Drainage of Floors 1 1 - - 44 44 - Other Nuisances - Sanitary Accommodation— Insufficient 6 6 - - Unsuitable or Defective 57 57 - - Not separate for Sexes 1 1 - - Offences under the Factory and Workshop Act— I Illegal Occupation of Underground Bakehouse (s. 101) - - - - Breach of Special Sanitary Requirements for Bake-houses (ss. 97 to 100) 65 65 - - Other Offenes 1 1 - - Total 183 183 - (68) OTHER MATTERS. Class. Matters notified to H.M. Inspectors of Factories — Failure to affix Abstract of the Factory and Workshop Act (s. 133) Notified by H.M. Inspectors 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) Reports (of action taken sent to H.M. Inspectors) Other Underground Bakehouses (s. 101):- Certificates granted during 1935 In use at end of 1935 Workshop Bakehouses Workshops on the Register (s. 131) at the end of 1935 Total Number of Workshops on Register No. OF BAKEHOUSES IN THE BOROUGH. In Use Not in Use Underground Above ground Above ground 18 35 4 35 of these are Factory Bakehouses HOUSE, TRADE AND MARKET REFUSE. The following table shows the amount of house, trade and market refuse disposed of during 1935: — Disposal Loads tons cwts. qrs. - House Refuse to Barge 16,661 21,095 14 2,553 1,974 - Trade Refuse „ Barge - 2,099 2 2 Street Markets Refuse to Barge 2,243 21,457 25,168 16 2 Totals OFFENSIVE TRADES. The offensive trades on the Register are as follows: Fellmongers 3 Fatmelters 2 Glue and size makers 3 Dresser of Fur Skins 7 MORTUARY. During the year Mr. J. C. Stockwell, Mortuary Keeper, retired on account of ill-health, and owing to the difficulties in obtaining the services of a suitable temporary mortuary keeper, consideration was given by the Committee to the fact that the number of bodies received annually into the mortuary is so small as hardly to justify the employment of a whole-time official. It was finally decided that the London County Council should be approached with a view to ascertaining whether they would be prepared to act as agents for the Borough Council and receive into the newly constructed mortuary at St. Olave's Hospital, those bodies for which it is the duty of the Borough Council to provide accommodation under the Public Health (London) Act, 1891. The London County Council expressed willingness to assist in this matter, and at the present moment an agreement for this purpose is in course of preparation. Particulars of bodies removed to the mortuary during the year are, as follows: — Number of infectious bodies removed 22 Total number of bodies removed 70 STREET MARKETS. The market scheme continues to work smoothly and satisfactorily. Number of Licences in operation 551 Income £3,011 6s. 9d. There have been 6 prosecutions during the year. DRAINAGE WORK. Hereunder will be found particulars of drainage work, &c., carried out by the Drainage Inspector during 1935:- Drains Tested 615 Intimation Notices served - Visits to Underground Conveniences 429 Other Visits 3,444 WORK OF THE FACTORIES AND SHOPS INSPECTOR. (From 26th April, 1935.) Shops. Visits 747 Notices served under Shops Act, 1934 64 Notices served under Public Health (London) Act, 1891 39 Factories. Visits 343 Notices served 36 Workshops. Visits 456 Notices served 53 Visits to Offensive Trade premises 47 Various Visits 110 Chimneys watched 1 IX.—FOOD CONTROL. Early in the year Mr. A. H. Merryman resigned from the post of Food and Drugs Inspector after many years' service in the borough and was succeeded by Mr. H. E. Butcher, and in July Mr. G. L. Scott retired, having reached the age limit, his place being taken by Mr. G. F. J. Toll. Although the work of the food inspectors has the merit of variety, it is only occasionally that incidents occur of sufficient general interest to justify mention in the Annual Report. Under the Public Health (Preservatives in Food) Regulations a successful prosecution was undertaken by the Town Clerk against three firms implicated in the sale to Mr. Butcher, the Food and Drugs inspector, of " Drywite Potato Preparation" which was described in terms likely to lead to its being used as a preservative. Each of the defendant companies was also summoned for selling the preparation—not being labelled in accordance with the Second Schedule of the Regulations—as a preservative. These latter summonses were not dealt with separately by the magistrate. The preparation was intended to be added to water in which peeled potatoes could be soaked for several hours and then dried ready for frying. The label stated that "Drywite" is a most powerful deodouriser. A little added to the water when washing the fish will instantly remove any unpleasant odour." A sample examined by the Public Analyst was found to contain 3.5% of Sulphur Dioxide. A solution was prepared in accordance with the directions on the label. Potatoes, soaked in this solution and subsequently dried and fried, were found to contain no Sulphur Dioxide. Cod fillets dipped in the solution without being cooked, were found to contain 3.8 parts of Sulphur Dioxide per million, and when the fillets were dipped in the solution and then drained for two hours they were found to contain 4.7 parts of Sulphur Dioxide per million. Defending counsel said that he could not resist the submission that the label might lead to the sale of uncooked fish containing prohibited preservative and he therefore entered a plea of guilty and informed the magistrate that his clients would discontinue the use of the offending label. The use of preservative for fish and potatoes prior to frying does not appear to be prohibited by the Regulations, and the attention of the Ministry has been drawn to this point. UNSOUND FOOD. The general inspection of food in shops and on stalls forms part of the duty of the District Sanitary Inspectors and of the Market Inspector. Food, in the quantities stated, came under the notice of the Inspectors during the year, and being found unfit for human consumption was destroyed. Description of Food Weight Tons cwts. qrs. lbs. Cheese - 18 - - Fresh Fish 18 - 7 2 18 Shell Fish - - 2 - Fresh Fruit - 10 - - Canned Fruit - 3 - 18 Honey 1 - - - Poultry - - - 16 Vegetables - 7 3 20 Total 3 7 1 16 PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1925. Thirty-nine samples have been taken during the year by the Wharves Inspectors. Of this number, 1 sample was submitted to bacteriological examination; 14 were examined for the presence of metals, 7 were examined for preservative and 4 samples were examined for contamination. The remaining samples were taken in order to ascertain the composition. In addition, 2 samples have been taken by other officers for special purposes:— (73) PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1925.—continued Articles Examined No. of samples Examination Result Action taken Compound Roseline 1 To ascertain Composition Mixture of vegetable and Whale Oils Released Compound Lard 1 „ „ Mixture of Vegetable Oils Tomato Extract (Concentrated) 1 For the presence of Copper and Tin Tin—Nil Copper 30 parts per million „ Tomato Puree 1 Tin 2.9 grains per lb. Copper 38 parts per million Destroyed „ Tomato Puree 1 „ Tin 2.0 grains per lb. Copper 20 parts per million Destroyed Tomato Puree 1 „ Tin 1.52 grains per lb. Copper 10 parts per million Released Tomato Puree 1 „ Tin 1.60 grains per lb. Copper 30 parts per million „ Tomato Conserve 1 Tin 1.15 grains per lb. Copper 10 parts per million „ „ Peeled Tomatoes 1 „ Tin 0.4 grains per lb. Copper 5 parts per million „ Egyptian Butter (Ghee) 1 To ascertain composition Genuine „ Sild 5 For the presence of Tin Tin 0.20 grains per lb. „ Tin 0.50 grains per lb „ „ „ Tin 1.54 grains per lb. „ „ Tin 1.90 grains per lb. „ „ Tin 0.35 grains per lb. „ Red Currant Pulp 1 For preservative Sulphur Dioxide 220 parts per million „ Black Currant Pulp 1 „ Sulphur Dioxide 1050 parts per million „ Tomato Puree 1 For the presence of Copper and Tin Tin 0.41 grains per lb. Copper 20 parts per million „ Lard 6 To ascertain composition Released Genuine Vegetable Fat 1 „ „ „ (74) PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1925.—continued Articles examined No. of Samples Examination Result Action taken Mellamid (Impure Tallow) 1 To ascertain composition An emulsion-gum-my matter to hold moisture in mixture Released for technical purposes only Plastic Pastry Fat 1 „ „ Genuine Vegetable Fat Released Grape Fruit Juice 2 Contamination Unpleasant smell and fermenting Destroyed 1. Sulphur Dioxide 217 parts per million 2. Sulphur Dioxide 244 parts per million Tinned Cream 1 For the presence of metals Tin 0.20 grains per lb. Released Duck Eggs (12) 1 Bacteriological No pathogenic organisms „ Bacon Rind coloured green 1 Analysis of stain ? copper Harmless Smoked Samolax 1 For colouring matter Harmless I Smoked Samolax 1 For preservative Benzoic Acid 75 parts per million Still under detention Smoked Sealax 1 „ Benzoic Acid 100 parts per million Released Fish Conserves 1 „ „ Satisfactory „ Tunny Fish 1 „ „ „ „ „ Preserved Mushrooms 1 „ „ „ „ Samples Examined for Special Purposes. Drinking Water 1 Chemical Analysis Satisfactory Sausage 1 To ascertain composition and colouring matter „ WORK OF THE WHARF AND FOOD INSPECTORS, 1935. 11 1 2 4 5 6 7 8 9 10 3 Food Factories Various Number of Samples taken Fish Curers Food Stores Milksellera Food Wharves and Depots Restaurants Destruction of Food Nuisances Found Intimations Served Jam Butter and Margarine Other Food and Drugs Imported Food Regulations Milk (Special Designation) Order Samples of Milk for presence of Tubercle Bacilli Drinking Water Ice Cream (Bacteriological Examination) Samples of Milk for presence of I Bacillus Abortus Eggs for Bacillus Aertryeke 4 1 15 54 810 - - 66 - - - 6 - - - - - 8 - - 1 17 125 - 361 1508 - - 211 2 - 33 - 13 - - - - - 12 27 - 54 12 141 1618 201 1 1 4 16 - - - - - - - - - 36 1 147 16 95 483 - - 81 20 9 61 - 3 - - - - - - - 4 - - - 83 727 - - 3 246 - 218 8 1 4 8 3 1501 104 MILK PREMISES. MILK AND DAIRIES (AMENDMENT) ACT, 1922. Forty-two milksellers were registered under the above Act during 1935, and 50 names were removed from the Register, making a total of 290 milksellers on the Register at the end of the year under report. MILK (SPECIAL DESIGNATIONS) ORDER, 1923. During the year under report, the following Licences were granted: — Dealers' Licences: — To bottle and sell Grade "A" (Tuberculin Tested) Milk 9 To sell Grade "A" (Tuberculin Tested) Milk 27 To sell Grade "A" Pasteurised Milk 1 To sell "Pasteurised" Milk 20 To sell "Certified" Milk 1 Pasteuriser's Licence: — To sell Milk as "Pasteurised" 1 Supplementary Licences: — To sell "Certified" Milk 3 To sell Grade "A" (Pasteurised) Milk 4 To sell Grade "A" (Tuberculin Tested) Milk 7 n To sell "Pasteurised" Milk 7 All premises used for the sale of milk are regularly inspected to ensure that the standard of cleanliness laid down is maintained. MILK SAMPLING. Arrangements exist for the sampling of the milk supplied to all schools in the borough. Samples are taken for both bacteriological and chemical analysis; and so far a good standard has been maintained. Samples have been taken from 34 schools, and a total of 738 milk samples have been examined, as follows: — "For chemical (i.e., Fat and non-Fatty Solids) Examination." Liquid milk undesignated 414 Condensed milk (informal) 6 Dried milk (informal) 3 Grade A (Tuberculin Tested) milk 3 Pasteurised milk (informal) 49 Separated milk 1 Sterilised milk 32 508 MILK SAMPLING—continued "For bacteriological examination." Grade 'A' (T.T.) milk 139 Grade 'A' Pasteurised milk 6 Pasteurised milk 73 For tubercle bacilli 8 For bacillus abortus 4 230 ICE CREAM. One hundred and nine samples of ice cream have been examined with the following results:— 1. Bacterial Count. Below 100,000 per 1 c.c. 79 Over 100,000, but below 200,000 per 1 c.c. 6 Over 200,000, but below 400,000 per 1 c.c. 4 Over 400,000 but below 600,000 per 1 c.c. 3 Over 600,000, but below 1 million per 1 c.c. 5 Over 1 million 7 2. Presence of B. Coli. B.Coli present in 1 c.c. 1/10th c.c. and 1/100th c.c. 32 B. Coli present in 1 c.c. and 1/10th c.c. 23 B. Coli present in 1 c.c. 19 B. Coli absent in tests ranging from 1 c.c. to 1/100th c.c. 30 3. Chemical Analysis. Fat 12.70 per cent. 1 Fat 15.25 per cent. 1 Fat 17.75 per cent. 1 Fat 18.80 per cent. 1 Fat 19.35 per cent. 1 (78) FOOD AMD DRUQB. Articles submitted for Analysis Total Samples Taken Number Genuine Number Adulterated Percentages of Articles Adulterated Ale, draught 2 2 - - Ale, brown (informal) 1 1 - - I Ale, pale (informal) 1 - - Apricots, dried (informal) 1 1 - - Apricots, dried 1 1 - - Apples, dried (informal) 1 i - - 3 - 7 Almonds, ground - Aspirin Tablets 5 5 - - Aspirin Tablets (Informal) 2 2 - - 1 - - Aspro Tablets 1 Arrowroot 2 2 - - Baking Powder 1 1 - - Barley, Pearl 8 8 - - Barley, Pot 1 1 - - Barley, Flaked 1 1 - - Barley, puffed and toasted 1 1 - - Beef, Galantine 1 1 - - Bicarbonate of Soda 3 3 - - Bismuthated Magnesia Tablets 1 1 - - Bloater Creme 1 1 - - Borax, Powdered 6 6 - Balsam of Honey and Aniseed 1 1 - - Balsam of Glycerine, Honey and Lemon 1 1 - - Beer, bitter 3 1 - - Beer, ginger 1 1 - - Butter 98 98 - - Brawn 18 18 - - Brawn, Pork 2 2 - - Cabbage, Pickled Red 2 2 - - Cakes, Sponge 1 1 - - Candied Peel, Lemon (informal) 1 1 - - Candied Peel, Citron (informal) 1 1 - - Candied Peel, Citron 1 1 - _ Candied Peel, Orange 1 1 - - Castor Oil (informal) 1 1 - - Cheese 12 12 - - Cheese in foil, Crastless 6 6 - - Cheese in Foil, Cheddar 8 8 - - Cheese, Cheddar 1 1 - - Cheese, Dutch 2 2 - - Cherries, Glace 1 1 - - Cherries in Syrup 1 1 - - Chicken and Ham Galantine 1 1 - - Chicken and Ham Roll 2 2 - - 1 1 - Cider - Cinnamon and Quinine Mixture 1 1 - - Chocolate, Nut Milk 1 1 - - Chocolate, Milk 1 1 - - Cocoa 9 9 - - Cocoa, Malted Milk 1 1 - - Cocoa, Milk 1 1 - - Coffee 7 7 - - Coffee Essence 2 2 - - Coffee and Chicory 3 3 - - Coffee and Chicory Essence 2 2 - - Cornflour 2 2 - - (79) FOOD AND DRUQS—continued. Total Samples Taken Number Genuine Number Adulterated Articles submitted for Analysis Cocoanut, Desiccated 5 5 - Cream 5 5 - Cream, Fresh (Informal) 2 2 - Cream, Coffee 1 1 - Cream, Tinned 1 1 - Cream, Tinned (Informal) 9 9 - Cream, Devonshire 1 1 - Currants 1 - 1 Curry Powder 6 6 - Custard Powder 6 - 6 Devonshire Splits, Real Cream 1 1 - Dripping 73 73 - Egg Substitute Powder 3 3 - Epsom Salts 1 1 - Fish Fried (Informal) 2 2 - Fish, Boiled (Informal) 2 2 - Fish, Uncooked (Informal) 1 1 - Flour 5 5 - Flour, Pea 1 1 - Flour, Self-Raising 13 13 1 Flour, Self-Raising (Informal) 1 1 - Flour, Self-Raising—Egg Substitute 1 1 - Fruit-Ade 1 - 1 Fruit, Dried Mixed (Informal) 1 1 - Fruit, Dried Mixed with Peel) 1 1 - Gelatine (Informal) 1 1 - Gherkins, Pickled 1 1 - Ginger Beer Tablets 1 1 - Ginger Cordial 1 1 - Ginger, Ground 5 5 - Ginger, Preserved in Syrup 1 - 1 Glauber Salts (Informal) 1 I - Glycerine 3 3 - Glycerine of Thymol 2 - 2 Glycerophosphates, Syrup of 1 1 - Grape Fruit Crush 1 1 - Grape Fruit Powder - 1 - Gravy Thick 1 1 - Ham Plate 1 1 - Herbs, Mixed 3 3 - Honey, Glycerine and Lemon Mixture 1 1 - Hydrogen Peroxide—10 vols. 1 - 1 Ice Cream 2 2 - Ich Cream (Informal) 3 3 - lodine, Tincture of 2 - 2 Jam, Apricot 2 2 - Jam, Apricot (Informal) i I - Jam, Blackcurrant 3 2 1 Jam, Blackcurrant (Informal) 2 - 2 Jam, Grapefruit 1 1 - Jam, Plum 3 3 - Jam, Plum, Stoneless 3 3 - Jam, Raspberry 7 7 - Jam, Raspberry (Informal) 1 1 - Jam, Strawberry 5 5 - Jam, Strawberry (Informal) 1 1 - Jam, Strawberry and Apple 1 1 - (80) FOOD AND DRUGS—continued Articles submitted for Analysis Total Samples Taken Number Genuine Number Adulterated Percentages of Articles Adulterated Jelly, Grapefruit 1 1 - - Jelly, Raspberry Crystals 1 1 - - Jelly, Strawberry 2 2 - - 39 37 2 5.13 Lard Lard Substitute 1 1 - - Lemon Barley Powder 2 2 - - Lemon Barley Water 2 2 - - Lemon Cheese 2 2 - - Lemonade Powder and Crystals 8 8 - - Lentils 2 2 - - Lime Juice Cordial 1 1 - - Linctus, Lung 1 I - - Macaroni 2 2 - - Magnesia, Citrate of 3 3 - - Magnesia, Cream of 1 1 - - Margarine 60 60 - - Marmalade, Orange 1 1 - - Marmalade, Pineapple 1 1 - - Milk 414 402 12 2.9 6 6 - Milk, Condensed (Informal) - Milk, Dried (Informal) 3 3 - - Milk, Grade 'A' (Tuberculin Tested) 3 1 33.3 2 Milk, Pasteurised (Informal) 49 49 - - Milk, Separated 1 1 - - Milk, Sterilized 32 32 - - Mincemeat 1 1 - - Mint, Prepared Dried 6 6 - - Mints, Clear 1 1 - - Mustard 13 13 - - Nitre, Sweet Spirit of 1 1 - - Oil, Camphorated 2 2 - - Oil, Cod Liver 5 5 - - Oil, Cod Liver Cream Emulsion 1 1 - - 1 - - Oil, Ground Nut 1 3 - - Oil, Olive 3 - Oil, Soya Bean 1 1 - Ointment, Sulphur 1 1 - - Ointment, Wintergreen 1 1 - - Ointmenti Zinc 6 6 - - Orangeade Powder 1 1 - - Paraffin, Liquid 4 4 - - Paste, Chicken, Ham and Tongue 1 1 - - Paste, Fish 5 5 - - Paste, Salmon and Shrimp 10 10 - - Peas, Green 3 3 - - Peas, Split 3 3 - - 31 Pepper 31 - - - Pickle, Sweet 2 2 - 4 4 - - Potatoes (Informal) Potato Preparation 1 1 - - 2 2 - Potato Preparation (Informal) - Prawns in Jar 1 1 - - - Prunes, Dried 2 2 - Puff Pastry 1 1 - - Quinine, Ammoniated Tincture of 2 2 - - Raisins 1 1 - - (81) FOOD AND DRUGS—oontinued Articles submitted for Analysis Total Samples Taken Number Genuine Number Adulterated Percentage of Articles Adulterated Raspberry Crystals 1 1 - - Rice 18 18 - - Rice, Flaked 4 4 - - Rice, Ground 1 1 - - Roast Pork and Stuffing Roll 1 1 - - Sago 1 1 - - Sauce, Bostall 1 1 - - Sauce, Daddies 1 1 - - Sauce, Civil 1 1 - - Sauce, Lakedale 1 1 - - Sauce, Mint 1 1 - - Sauce, Mint Dry 1 1 - - - Sauce, Tomato 3 3 - Sauce, Worcestershire 1 1 - - Sausages, Beef 33 32 1 3.03 Sausages, Chipolata 8 7 1 12.5 Sausage, Breakfast 17 17 - - Sausages, Empire Meat 1 1 - - Sausage, Luncheon 9 9 - - Sausage, Liver 2 2 - - Sausages, Parisian 1 1 - - 4.35 Sausages, Pork 23 22 1 Sherbet Powder 2 2 - - Sherry, British 1 1 - - Spice, Mixed 3 3 - - Sponge and Cake Mixture 1 1 - - Squash, Grapefruit 1 1 - - Squash, Orange 1 1 - - Suet (Informal) 1 1 - - Suet, Shredded Beef 22 21 1 4.54 Sugar 4 4 - - Sultanas 1 1 - - Syrup, Catarrh 1 1 - - Syrup of Tigs 1 1 - - Syrup of Hypophosphites 1 1 - - Tapioca 7 7 - - Tapioca, Flaked 1 1 - - Tartaric Acid 1 1 - - Tea 15 15 - - Tonic, Adults Nerve 2 2 - - Tonic, Quinine and Iron 2 2 - - Veal and Ham Roll 2 2 - - Veal, Jellied 1 1 - - Vegetable Extract (Yeastral) 1 1 - - Vinegar 44 44 - - Vinegar, Malt 32 29 3 9.37 Vinegar, Mixed, Malt and Wood 1 1 - - Vinegar, Spiced 1 1 - - Wheat, Shredded 1 1 - - Whisky 2 - - 2 Whisky (Informal) 1 1 - - Whiskey, Irish 1 1 - - Wine and Cordial, Fruit 1 1 - - Wine, Ginger 2 2 - - Wine, Orange (non-alcoholic) 1 1 - - Wine, Orange Quinine 1 1 - - Wine, Port 2 2 - - - Wine, Raisin 1 1 - Wine, Ruby (Port Type) 1 1 - - Total 1501 1477 24 1.599 (82) PROSECUTIONS IN CONNECTION WITH SAMPLES TAKEN DURING 1935. No. Sample Adulteration or Infringement Remarks 74a Milk Carrying on trade of dairyman within Borough without being registered Fined 30/-. Costs £2 2s. „ Selling milk from van without having name and address conspicuously inscribed thereon 74b Fined 10/- 74c „ Filling with milk and closing bottles otherwise than on registered premises Fined 20/- 78a „ Sale of milk deficient in milk fat 9.3 percent. 8.0 per cent. 15.0 per cent. Dismissed under Probation of Offenders Act, 1907, on payment of £3 costs (Owner) 78b „ Fined 10/- on each of three summonses plus costs, £2 ss. Total, £6 15s. (Servant.) „ 79 Sale of milk deficient in milk fat; 22.7 per cent. Dismissed under Probation of Offenders Act, 1907, on payment of costs £1 Is. „ „ Filling with milk and closing bottle otherwise than on registered premises Fined £3. Costs £1 1s. 80 81 Sale of shredded suet deficient in fat 18.2 per cent. Fined £1. Costs £2 2s. Shredded Suet 87 Self-raising Flour Selling plain flour as selfraising flour to the prejudice of the purchaser Dismissed under Probation of Offenders Act, 1907, on payment of costs, £2 2s. 91 Lard Selling lard substitute instead of lard to the prejudice of the purchaser Fined £3. Costs £2 2s. 02 Lard „ Dismissed 95 Milk Selling milk deficient in milk fat 17.3 per cent. Dismissed under Probation of Offenders Act, 1907, on payment of costs, £3 3s. 97 "Drywite" Potato Preparation Selling article described or referred to in the label thereon in terms likely to lead to its being used as a preservative contrary to Regulation 4 (1) of the Public Health (Preservatives, etc., in Food) Regulations Manufacturers Fined £2. Costs £21 97 „ Selling a preparation as a preservative not being labelled in accordance with Rules in Second Schedule of the Regulations London Distributors and the Wholesalers in Bermondsey were each fined 20/- plus 30/- costs SUMMARY. £ s. d. Fines 15 10 0 Costs 42 18 0 £58 8 0 PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1926. Articles Quantity Unsound 1 1 1 Disposed of for Purposes other than Human Food Destroyed Removed for Sorting under S.A. Exported Quantity Weight Quantity Weight Quantity Weight Quantity Weigh MEAT. tons cwt lbs tons cwt lbs tons cwt qr lbs }l tons cwt lbs qr qr qr Beef. I. Fresh Beef 1 top bit 3 10 - - - - - - - - - - - - - - - - - Tinned and Corned Beef 3,807 tins 9 18 1 2 - - - - - - - - - - - - - - - Fresh Veal - - - - - - - - - - - - - 43 casks 2 3 - - - - Tinned Jellied Veal 12 cases and 1,409 tins 4 25 583cases and 271 tins 764 cases 14 - - 3 - 9 18 1 - - - - - - - Casings - - - 50 casks 11 10 4 - - - - - - - - - - - - - I Pork. Bacon 24 sides, 2 fore-ends 1 collar and pieces - 3 - 15 - 13 - - - - 17 4 - 18 - - - - 156 bales Fresh Pork - 1 carcase - 2 3 12 - - - - - - - - - - - - - - Sucking Pig - - - 1 carcase - 11 - - - - - - - - - - - - - - Tinned Hams and Shoulders 146 oases and 762 tine 2 casea and 865 tins 5 17 3 6 - - - 5 cases 24 12 3 17 3 3 - - - - Tinned Pork 10 tins 2 - - 4 - - - - - - - - - - - - - - - Tinned Tongues 484 tins 6 1 12 22 cases and 17 tins 12 23 - - - - - - - - - - - - Tinned Brawn 49 tins - 2 2 14 - - - - - - - - - - - - - - - Pig Skins - - 1 cask - 1 2 - - - - - - - - - - - - - - Tongues in Brine - - - - - - 2 1 1 cask 5 - - - - - - - - - - Rabbits 1 I Fresh Rabbits - - 7 cases 3 2 - - - - - - - - - - - - - - PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1925.—continued Articles Quantity Unsound Disposed of for Purposes other than Human Food Destroyed Removed for Sorting under S.A. Weight Quantity Weight Quantity Quantity Weight Various. tons cwt qr lbs tons cwt qr lbs tons cwt qr lbs - - Horse Casings - - - - - - - - - - - - - - Catameat 4 2 - - - - - - 4 bags - - - - - Kidneys in Brine - - 2 casks - 10 - - - - - _ - - - - Lambs Testicles - - 1 cask 5 - - - - - - - - - - - - - 19 - - Sausage Meat - - - - - - - - - - DAIRY PRODUCE Butter 1 cask and 2 boxes - - Trimmings 11 - 2 - 2 2 - - - - - 3 2 23 Cheese Trimmings - 11 1 11 Various 9 - - - - - Cream 749 cartons - - 5 1 7 - - - - - - - - - Eggs - 2 cases and 2,685 tins - - - - 111 - - - 17 1 - - - 2 boxes - Lard 1 - - - - - - - - - - - - Milk 4 cases - 2 11 cases 796 tins - - - - - 14 3 15 - - - - - - - - - - FRUIT. - - - - - - - - * Fresh. - - Apples - 50 bags 3 5 - - - - - - - - - - 1277 cases 57 17 3 - Grapefruit - - - - - - - - - - Lemons - - - - 4 boxes 3 - - - - - - - - 249 Oranges - - 6,755 cases 3 129 18 2 - - - - - 2,557 cases - Pears - 1 - - - - - 1 box - - - - - - - Tomatoes 3 - - - - - - - - PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1925—continued Articles 1 Quantity Unsound Destroyed Disposed of for Purposes other than Human Food Removed for Sorting under S.A. Quantity Weight Quantity Weight Weight Quantity tons cwt qr lbs Canned and Juice. tons cwt qr lbs. tons cwt qr lbs - - 2 cases and 1 tin 8 - Apple Pectin 1 - - - - - - - - - - - - Apricots 4 cases and 23 tins - - - - - 5 - - - - - - Apricot Pulp - 11 cases and 33 tins - - - - - - - - 14 3 17 - - Bilberries 25 cases 8 - - - - - - - - - - - - 10 cases Blackcurrants - 4 1 4 - - - - - - - - - - Cherries - - - - - 147 cases and 283 tins - - 4 1 - - 10 cases Damsons - 4 1 4 - - - - - - - - - - 12 cases and 45 tins Grapefruit - - - - - - 1 22 - - - - - Grapefruit Juice 10 casks 2 10 - - - - - - - - - - - - Lemon Skins 1 cask - - - - - 5 - - - - - - - - 34 tins - Loganberries 1 6 - - - - - - - - - - - Oranges 226 tins - - - - - - - 2 - - - - - - 80 cases and 78 tins Peaches - - - - - - - 1 6 7 - - - - Pineapple - - 67 cases and 202 tins - - - - - 2 6 3 8 - - - 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. Quantity Weight Weight Quantity Quantity Weight tons cwt qr lbs. tons lbs tons lbs cwt qr cwt qr Raspberry Pulp - - - - 5 tins - 1 22 - - - - - - - Red Currant Pulp - 1 cask - 4 - - - - - - - - - - - 504 cases and 69 53 11 22 - - Tomatoes - - - - - - - - - 377 cases Various - - tins Various 32 6 8 1 1 26 6 3 - - - Dried. Currants - 3 - 323 cases - - - 120 cases - - - - - 8 12 27 4 Dates 1,089 cases 2 - - - - - - - - - - - 2½ bags - 3 - Figs 1 - - - - - - - - - - 33 boxes - - Plums - 8 1 - - - - - - - - - 1 box - 1 - - - Sultanas - - - - - - - - - - CEREALS, etc. Barley - - - - - 7 11 - - - - - - - Cornflour 448 bags 28 - - - - - - - - - - - - - - 2 3 1 24 - - Rice - - - - - - - - Rice Sweepings 3 18 2 8 - - - - - - - - - - - Tea Salvaged - - - - - - - - - - - - - - - 109 - - - - Wheat - - - - - - - - - - Wheat Flour - - - - 2,396 bags 149 15 - - - - - - - - POULTRY. Chickens 147 cases 2 - - - - 19 1 - - - - - - - 1 case and 13 tins Tinned Chicken - - - - - - 8 - - 3 - - - - Turkeys 4 - 1 Turkey 12 4 cases - - - - - - - - - - PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1925.—continued. Articles Quantity Unsound Destroyed Removed for Sorting under S.A. Disposed of for Purposes other than Human Food Quantity Quantity Weight Weight Weight Quantity tons cwt qrl lbs 1 lbs - - tons cwt qr lbs tons cwt qr VEGETABLES. Canned Baked Beans 66 tins 23 tins 1 16 2 - - - - - - - - - - Cauliflowers 126 - - - - - - - 1 packages 194 tins - - - - - - - Canned Cucumbers 19 2 4 - - - - - - - - - - Horseradish 2 - - - - - - 2 bags - - - - - - - 274 bags Potatoes 11 4 110 bags 5 10 - - - - - - - - - Vegetables in Brine 3 casks 15 - - - - - - - - - - - - - FISH. 20 - Canned Crayfish 1 case 1 - - - - - - - - - - - 13 cases - Eels 17 2 - - - - - - - - - - - Canned Sild 330 tins - - - - - - - 3 - - - - - - Canned Sea Salmon - - - - - - - - - - - - - - SPICES. Ginger 1 22 - - - - - 1 bag - - - - - - - 34 bags Mustard Seed - 1 16 1 20 - - - - - - - - - - - - 3179 bags 25 8 2 25 Pepper - - - - - - - VARIOUS. Almonds - 63 bags 5 10 - - - - - - - - - - - Various 106 5 2 7 - Canned Goods - - - - - - - - - 5 casks 1 - Tallow 5 - - - - - - - - - - - - 363 7 - 3 692 11 3 10 198 6 3 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.-12 noon Wednesday, 9.45 a.m.-12 noon Thursday, 2.0 p.m.-4.0 p.m. Ante-natal Clinic Tuesday, 4.30 p.m.-6.30 p.m. Sewing Class Wednesday, 1.45 p.m.-4.0 p.m. 98 Rothsrhithe 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 Clinic Thursday, 4.30 p.m.-7.30 p.m. Sewing Class Monday, 2.0 p.m.-4.0 p.m. Bermondsey Gospel Mission, 1-3, Jamaica Road. Monday, 2.0 p.m.-4.0 p.m. Thursday, 9.45 a.m.-12 noon Manor Chapel, 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. 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. Toddlers Clinic Second and Fourth Wednesday in each month, 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 Wednesday, 10.0 a.m.-12 noon Sewing Class Wednesday, 2 p.m.-4 p.m. Central Hall, Bermondsey Street. Tuesday, Wednesday, Thursday and Friday, 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. Toddlers Clinic First Wednesday in each month 2.0 p.m.-4.0 p.m. Salomons Centre, Newcomen Street. Monday 2.0 p.m.-4.0 p.m. Thursday 10.0 a.m.-12 noon and 2.0 p.m.-4.0 p.m. Ante-natal Clinics:— Monday, 9.30 a.m.-12 noon. Tuesday, 1.30 p.m.-4.0 p.m. Wednesday, 9.30 a.m.-12 noon. Friday, 9.30 a.m.-12 noon SPECIAL CLINICS FOR WOMEN. 110, Grange Road. Wednesday 4.30 p.m.-6.30 p.m. 98, Rotherhithe New Road. Thursday 2.0 p.m.-4.0 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 20 Harley Street, W.l. (Telephone : Langham 4032.) 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 Thursday (inclusive), 10.0 a.m.-7.30 p.m. Friday 10.0 a.m.-5 p.m. 98 Rotherhithe New Road. Monday, Thursday and Friday, 2.0 p.m.-5.0 p.m. Tuesday 2.0 p.m.-7.30 p.m. Wednesday, 10 a.m.-7.30 p.m. From 5.0 p.m. to 7.30 p.m. the Centres are open only for patients who cannot attend during the day. TUBERCULOSIS DISPENSARY, 108 Grange Road. Patients are seen by appointment only. Evening sessions are held for patients at work. LIGHT TREATMENT CENTRE, The Solarium, 108 Grange Road. Monday to Thursday (inclusive), 9.30 a.m.-5.30 p.m. Friday, 9.30 a.m.-l p.m. Monday and Thursday, 6.0 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 CLINICS. Municipal Offices, Spa Road. Monday at 10.0 a.m. 98 Rotherhithe New Road. Friday at 10.0 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), 10.30 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 afternoons 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), 10.30 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), 10.30 a.m.- 1.0 p.m. and 3.0 p.m.-6.0 p.m. Rotherhifhe School Treatment Centre, Lady Gomm Dispensary, Hawkstone Road. Minor Ailments Monday to Friday (inclusive), 10.3 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, 1.30 p.m,-4.0 p.m. Wednesday, 9.30 a.m -4.0 p.m. Thursday and Friday, 9.30 a.m.-12 noon. Trinity School Treatment Centre, Redriff Lane. Minor Ailments Monday to Friday, 12 noon-1 p.m. 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. Town Hall, Spa Road. Monday to Friday (inclusive), 9.30 a.m. to 1.0 p.m. ; 2.0 p.m. to 5.0 p.m. and 5.30 p.m. to 8.0 p.m. Saturday, 9.30 p.m. to 12 noon. 98 Rotherhithe New Road. Monday, Tuesday, Wednesday and Friday, 9.30 a.m. to 1.0 p.m.; 2.0 p.m. to 5.0 p.m. and 5.30 p.m. to 8.0 p.m. Thursday, 2.0 p.m. to 5.0 p.m. and 5.30 p.m. to 8.0 p.m.; Saturday, 9.30 a.m. to 12.0 noon. Patients are seen by appointment only. Appointments can be made either by personal call or by letter. VENEREAL DISEASE CLINIC, Guy's Hospital. Monday to Saturday (inclusive), 9.0 a.m.-8.0 p.m. Bank holidays, 10.0 a.m.-12 noon. PUBLIC VACCINATOR. Dr. V. A. JAYNES, 149 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—Waterloo 3311 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—Waterloo 3311. 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 6301, 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 6301, or Regent 4000. 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 At any hour of the day or night —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. HENRY RICHARDSON LTD., 4, Church Street, Greenwich, S.E.10.