AC 43 78 Library BER 51 (Duplicate) Borough of Bermondsey. REPORT ON THE SANITARY CONDITION OF THE BOROUGH OF BERMONDSEY For the Year 1938 BY D. M. CONNAN, M.D., D.P.H., Medical Officer of Health. BER 51 Borough of Bermondsey. REPORT ON THE SANITARY CONDITION OF THE BOROUGH OF BERMONDSEY For the Year 1938 BY D. M. CONNAN, M.D., D.P.H., Medical Officer of Health. TABLE OF CONTENTS. PUBLIC HEALTH 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 19 Scarlet Fever 20 Enteric Fever 20 Dysentery 20 Small-Pox 20 Ophthalmia Neonatorum 21 Puerperal Fever and Pyrexia 21 Acute Primary and Acute Influenzal Pneumonia 22 Measles 22 Whooping Cough 22 Anthrax 23 Disinfection 23 Cleansing Station 24 Shelter 24 Bacteriological Laboratory 24 Food Poisoning 25 Insulin for Diabetic Patients 25 Nursing 26 Cases Notified in 1938 27 Cases Notified for last ten years 28 TUBERCULOSIS— New Cases and Deaths 29 Period between Notifications and Deaths 29 Nursing, Extra Nourishment and Shelters 30 Lady Almoner 30 Work of the Tuberculosis Dispensary 31 Summary of Notifications 32 Cases on the Register 33 PAGE LIGHT TREATMENT, ELECTRO-THERAPY AND MASSAGE- Work done in the Solarium 34 Leysin Patients 35 MATERNITY AND CHILD WELFARE- Fairby Grange Convalescent Home 36 Midwifery Service 37 Obstetric and Puerperal Fever Consultants 37 Child Life Protection 37 Maternal Mortality 37 Work of the Health Visitors 38 Attendances at Centres 39 Extracts from Vital Statistics, 1938 40 DENTAL TREATMENT— Particulars of Children Treated 41 Particulars of Treatment and Work for 1938 42 CONSULTATION AND OTHER CLINICS- X-ray Department 43 Post-Infectious Disease Clinic 43 Post-Natal and Special Clinics for Women 44 Children's Clinic 45 Rheumatism Clinic 46 Foot Clinic 48 PROPAGANDA 49 SANITARY ADMINISTRATION- Housing 50 Housing Act, 1936—Overcrowding 52 Eradication of Bed Bugs 53 Inspections and Proceedings 53 Work of the District Inspectors 58 Factories and Workshops—Homework 59 Factories and Workshops—Inspections 60 Bakehouses 61 House, Trade and Market Refuse 61 Offensive Trades 61 Mortuary Street Markets 62 Drainage Work 62 Work of Factories and Shops Inspector 62 FOOD CONTROL- Imported Food Regulations—Samples taken 63 Unsound Food—Shops and Stalls 70 Work of the Wharves and Food Inspectors 71 Milk Premises 72 Milk Licences 72 Milk Sampling 72 Ice Cream 73 Pharmacy and Poisons Act, 1933 74 Food and Drugs—Samples Taken 75 Food and Drugs—Prosecutions 8 1 Unsound Food—Wharves, etc. 82 HEALTH SERVICES 88 PUBLIC HEALTH DEPARTMENT. PUBLIC HEALTH COMMITTEE, 1938. Chairman Councillor E. J. GIBSON 1937-38, 1938-39 Vice-Chairman „ S. R. WEIGHTMAN 1937-38, 1938-39 Councillor Mrs. F. Humphreys Alderman G.R.Balleine „ Mrs. L. M. Brown A. V. Kidd „ A. E. Hatcher „ Mrs. R. E. Laker „ M. Mahoney C. J. Lee „ A. V. Parker F. W. Love „ G. Loveland Councillor Mrs. S. C. Amos „ H. A. Beal „ Mrs. M. F. Lowery Mrs. W. L. Miller „ J.A.W.Douglas „ A.M.Downing „ J. W. Simmonds „ A. E. Smith F.J.W. Fielder „ Mrs. J. V. Snowdon „ Mrs. L. A. Glasson „ R. E. Goodwin „ A. E. Winch „ Miss K. Groves Ex-offficio: Councillor A. M. DOWNING, J.P., Mayor of Bermondsey, 1937-38 A. V. KIDD, J .P., Mayor of Bermondsey, 1938-39 MATERNITY AND CHILD WELFARE COMMITTEE, 1938. Chairman Councillor Mrs. D. A. GREEN, 1937-38 Mrs. W. L. MILLER, 1938-39 Vice-Chairman Alderman Mrs. L. JONES, 1937-38, 1938-39 Alderman Mrs. L. M. Brown Councillor Mrs. F. Humphreys Councillor D. Bradley „ Mrs. R. E. Laker Miss I. Condon Mrs. M. F. Lowery „ Mrs. M. Cushing „ Mrs. F. A. Powell „ E. J. Gibson „ Mrs. J. V. Snowdon Mrs. L. A. Glasson Co-opted Members: Mrs. E. R. Balman Miss M. I. Henrich „ E. B. Childs Rev. W. Spencer „ A. E. Gledhill Mrs. E. C. Starr „ A. M. Hatcher Ex-officio: Councillor A. M. DOWNING, J.P., Mayor of Bermondsey, 1937-38 „ A. V. KIDD, J.P., Mayor of Bermondsey, 1938-39 STAFF: — 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: W. Davis, Senior Inspector J. G. Frankson, Wharves and Food Inspector G. A. Hoskins, Wharves and Food Inspector (Retired, March, 1938) G. F. J. Toll, Wharves and Food Inspector. H. E. Butcher, Wharves and Food Inspector W. C. Tapsfield, Food and Drugs Inspector F.L. Richardson, Drainage and Markets Inspector H.J. Bailey, Factories and Shops Inspector District Inspectors. No. 1 — F.J. Carpenter No. 5 — A.W. Hancock No. 2 — L. T. Knott No. 6 — W.A. Pilson No. 3 — C.E. Lockley No. 7 — 0. W. R. Smart No. 4 — W.A. Campbell No, 8 — W.F. Smith 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— J. Marshall, M.B., Ch.B., D.P.H. Tuberculosis Nurse (Open-Air School) —Celia Clapson LADY ALMONER. Olive Pike. LIGHT TREATMENT CENTRE. Medical Officer in Charge—Florence L. Telfer, M.D., D.M.R.E. Nurse in Charge—Mrs. Dorothy Cottier. Solarium Nurses—Estelle Jagôt, Muriel Coleby, Joyce Hopkins, Gladys Warry, and Elsie Watkins. 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., D.M.R.E. Health Visitors. Rosa Bache Olive Oram Avis Baird Kathleen Parry Sarah Bowles Gwendolen Riches Lucy Brown Edith Riley Amy Carlton Florence Robson Florence Carter Florence Wadds Marie Helden Edith Wallis Elizabeth Lawrence Isabel White FAIRBY GRANGE CONVALESCENT HOME. Matron—Florence Child Sister—Ann O'Meara POST NATAL AND SPECIAL CLINICS FOR WOMEN Consultant Gynæcologist—Gladys Dodds, M.D., D.P.H., M.C.O.G., F.R.C.S. (Eng.) CHILDREN'S CLINIC Medical Officer —Ursula Shelley, M.D., M.R.C.P. (Lond.) RHEUMATISM CLINIC. Medical Officer —Ursula Shelley, M.D., M.R.C.P. (Lond) X-RAY SECTION. Radiologist —Florence L. Telfer, M.D., D.M.R.E. Radiographer—C. F. Lumley. DENTAL DEPARTMENT: Municipal Dental Surgeon—Grantley Smith, L.M.S.S.A., H.D.D., R.C.S. Edin., L.D.S., R.C.S. Eng. Assistant Dental Surgeon —W. H. Shapland, L.D.S., R.C.S.Eng. Half-time Assistant Dental Surgeons—G. B. Oliver, L.D.S., R.C.S.Eng. and D. G. Wigginton, M.R.C.S., L.R.C.P., L.D.S., R.C.S.Eng. Dental Nurses —Winifred Lambert, Mrs. Daisy Hodgson, and Winifred Lander. Prosthetic Assistants-G. W. Clarke, W. B. Monger and T. H. Baggott FOOT CLINIC: Chiropodists —Ethel Cook, Mrs. Florence Rock, Mary Bradley, 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.R.I.P.H.H. CLERICAL STAFF. A. I. Fair, Chief Clerk J.A. Blake, General Clerk J.F.M. Brooker, General Clerk F.W. Smith, Second Clerk C.W. Whye, General Clerk J.W.J. Saward, General Clerk A. Manning, General Clerk Alice Jones, General Clerk F.R. Parker, General Clerk F. Cornwell, General Clerk H. D. White, General Clerk C.F. Yaxley, General Clerk F. H. Mummery, Junior Clerk Rose Dutch, Clerk and Dispenser J. L. Springett, Junior Clerk H.J. Smith, General Clerk Joyce Field, Junior Clerk C.H. Harris, General Clerk S. R. Weightman, Junior Clerk DISINFECTING AND CLEANSING STATION : A. C. Davidson, Foreman in Charge. PUBLIC HEALTH DEPARTMENT. MUNICIPAL OFFICES, SPA ROAD, S.E.16 Borough of Bermondsey. ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH. To the Mayor, Aldermen and Councillors of the Borough of Bermondsey. Sir, Ladies and Gentlemen, I have the honour to submit my Annual Report for the year 1938. As a measure of economy comment has been strictly limited, but while this is so I am justified in drawing attention here to three record low rates which the statistics reveal. The Death Rate for the year is 11.0 as compared with 20.8 for the first year of the century (1901) ; the rate for 1938 is the lowest so far recorded. A similar low record has to be noted also in connection with Pulmonary Tuberculosis, the death rate for this disease being 0.68. The Infantile Mortality Rate for the year is 45 ; this is a most encouraging figure. Last year's rate was 59, and the lowest figure previously recorded was 56 in 1932, while in 1901 the rate was 169. I think the Council, and the Members of Committees in particular, should find cause for congratulation in this record, and I take the opportunity of thanking them again for the support accorded to the Department during the year. Perhaps I may also be permitted to record my regret at the untimely loss of Mrs Starr, who, though not a member of the Council, was for many years one of the most faithful and assiduous members of the Committee. 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 1938 according to the Rate Books was 19,134. The rateable value of the borough on the 31st December, 1938 was £874,329, the product of a penny rate being £3,440. POPULATION. Estimate of Registrar General Census to 30th June, 1937 to 30th June, 1938 1921 1931 97,420 119,452 111,542 98,790 BIRTHS. The total number of births belonging to the borough registered during 1938 was 1439, consisting of 758 males and 681 females. The number for 1937 was 1,421. The birth rate for 1938 was 14.8 per 1,000 persons living, compared with 14.4 for 1937. DEATHS. The total number of deaths belonging to the borough registered during 1938 was 1,072, consisting of 602 males and 470 females. The number for 1937 was 1,212. The death rate for 1938 was 11.0 per 1,000 persons living, compared with 12.3 for 1937. MARRIAGES. The total number of marriages in the borough in 1938 was 941, being 149 below the number for 1937, and 74 below the average for the last 10 years. The figures have been supplied by the Superintendent Registrar. This makes a marriage rate of 19.32 per 1,000 of the population, compared with a marriage rate last year of 22.07. Year No. Rate 1928 1,055 18.32 1929 994 17.47 1930 1,021 17.94 1931 17.81 1,001 1932 936 17.00 1933 1,007 18.77 1934 1,050 19.91 1935 1,027 20.00 1936 970 19.32 1937 1,090 22.07 18.86 Average for years 1928—1937 1,015 19.32 1938 941 (9) INFANTILE MORTALITY. Whole Borough London Year Rate per 1,000 Births No. of Deaths Rate per 1,000 Births No. of Deaths 85 4,879 1928 178 67 71 160 71 4,995 1929 59 1930 130 63 4,109 65 1931 112 57 4,270 1932 103 56 4,143 67 61 3,377 60 1933 92 3,832 67 1934 100 64 3,229 58 1935 103 69 66 3,691 1936 92 60 3,309 60 1937 59 84 3,983 64 Average for years 1928-1937 115 64 1938 * 65 45 * TUBERCULOSIS OF THE RESPIRATORY SYSTEM. In the following Table will be found particulars of deaths from Tuberculosis of the Respiratory System since the year 1928. Rotherhither St. Olave Whole Borough Bermond. sey London Sub-District No. Year No. Rate Rate No. No. No. 0.89 88 78 81 81 71 68 64 70 51 63 43 12 143 1.24 3985 1928 4230 1.03 0.96 1929 31 36 8 117 3826 132 1.16 0.87 1930 15 1.03 5 116 3907 0.90 1931 30 1.05 3564 0.82 1932 34 23 11 116 0.92 0.82 8 99 3530 1933 3227 0.76 1934 4 90 0.86 22 23 0.95 2847 0.68 5 98 1935 0.69 6 0.79 2848 1936 22 79 2888 0.71 22 2 87 0.89 1937 Averages for years 1928-1937 108 0.99 3485 0.81 71 29 76 23 1 66 0.68 * * 1938 42 * These figures are furnished by the Medical Officer of Health, London County Council, and were not available at the time of going to press—l2th June, 1939. INFANTILE MORTALITY RATE FOR 25 YEARS. VITAL STATISTICS OF WHOLE DISTRICT DURING 1938 AND PREVIOUS YEARS. Population estimated to Middle of each Year 2 Births Total Deaths registered in the District Total Deaths in Public Institutions in the District 9 Deaths of Non- Residents registered in Public Institutions, etc. in the District 10 Deaths of Residents registered in Public Institutions beyond the District 11 Net Deaths at all Ages belonging to the District No. 3 Rate 4 Under 1 Year of Age At all Ages No. 12 Rate 13 Year 1 No. 5 Rate per 1,000 Births registered 6 No. 7 Rate 8 115,200 2,086 143 69 1,230 10.7 67l 39 329 1,520 13.2 1928 18.1 1929 113,800 2,252 19.8 127 56 1,304 11.4 696 32 378 1,650 14.5 1930 113,800 2,059 18.1 90 44 1,169 10.3 686 46 365 1,488 13.1 112,400 1,958 17.4 91 46 1,169 10.4 596 92 331 1,408 12.5 1931 10.4 689 189 368 1,326 12.0 1932 110,100 1,831 16.6 81 44 1,147 1933 107,300 1,500 14.0 72 48 1,216 11.3 720 215 339 1,340 12.5 1934 105,060 1,557 14.8 77 49 1.223 11.6 784 229 310 1,304 12.4 1935 102,700 1,487 14.5 99 67 1,142 11.1 756 255 314 1,201 11.7 1936 100,400 1,545 15.4 76 49 1,136 11.3 723 175 328 1,289 12.8 98,790 1,421 14.4 61 43 1,148 11.6 741 245 309 1,212 12.3 1937 Averages for years 1928-1937 107,955 1,770 16.3 92 51 11.0 706 152 337 1,374 12.7 1,188 (12) OTHER INSTITUTIONS, Etc., Etc. I. Institutions, etc., within the District receiving sick and infirm persons from outside the District. II. Institutions, etc., outside the District, the Deaths in which have been distributed among the several localities in the District ] ] No. of Deaths No. of Deaths St. Olave's Hospital 186 Acton Hospital, Acton 1 All Saints' Hospital, Southwark 1 Ambulances on way to Hospital 8 Archway Hospital, Islington 1 Bermondsey Medical Mission Hospital Bexley Mental Hospital, Bexley 7 Brook Hospital, Shooters Hill 4 1 Camberwell House Mental Hospital, Peckham 1 9 Cancer Hospital, Chelsea 1 Deaths in River Thames, Surrey Commercial Docks, Wharves, etc. Caterham Hospital, Caterham 2 Catholic Nursing Institute, Lambeth 1 City Isolation Hospital, Droitwich 1 Claybury Mental Hospital, Woodford Bridge 1 Colindale Hospital, Hendon 2 County Hospital, Farnborough 1 Dulwich Hospital 2 Street 1 Eastern Hospital, Homerton 1 4 Evelina Hospital 2 1 Friern Hospital,friern Barnet Private Houses Golden Square Hospital, Westminster 2 Grove Park Hospital 4 201 Grove, The, Epsom 2 Total Guy's Hospital 53 Hackney Institution 1 Hammersmith Hospital 1 Hampstead General Hospital 1 High Wood Hospital, Brentwood 1 Home and Hospital for Jewish Incurables, Tottenham 1 Horton Hospital, Epsom 3 Hospital, The Coulsdon 4 Hospital of .St. John and St. Elizabeth, St. Marylebone 1 Hospital for Sick Children, Great Ormond Street 1 Hundred Acres, Banstead 2 Italian Hospital, Holborn 1 King's College Hospital 1 Ladywell Institution 5 Lambeth Hospital 6 Leavesden Hospital, Watford 2 Lewisham Hospital 15 Long Grove Hospital, Epsom 1 Lying-in Hospital, York Road 2 Maudsley Hospital, Denmark Hill 1 1 Middlesex Hospital (13) OTHER INSTITUTIONS, Etc., Etc.— continued Institutions, etc., within the District receiving sick and infirm persons from outside the District. Institutions, etc., outside the District, the Deaths in which have been distributed among the several localities in the District. No. of Deaths Newington Institution, Southwark . 1 Paddington Hospital 1 Park Hospital, Hither Green 10 Princes Elizabeth of York Hospital, Shadwell 1 Private Houses 1 Queen Mary's Hospital, Chislehurst 5 Queen Mary's Hospital, Sidcup 2 Radcliffe Infirmary, Oxford 1 River Thames 1 Royal Albert Dock 1 Royal East Sussex Hospital, Hastings 2 Royal Waterloo Hospital 1 St. Alfege's Hospital, Greenwich 16 St. Alfege's Institution, Greenwich 7 St. Andrew's Hospital, Willesden 1 St. Bartholomew's Hospital 3 St. Benedict's Hospital, Wandsworth 3 St. Bernard's Hospital, Southall 1 St. Clement's Hospital, Poplar 1 St. David's Hospital, Edmonton 1 St. Ebbas Hospital, Epsom 1 St. Francis Hospital, Camberwell 10 St. George-in-the-East Hospital, Stepney 3 St. Giles Hospital, Camberwell 1 St. John's Hospital, Battersea 3 St. Leonard's Hospital, Shoreditch 1 St. Matthews Hospital, Shoreditch 1 St. Nicholas Hospital, Woolwich 1 St. Pancras Hospital, St. Pancras 2 St. Peter's Hospital, Stepney 2 St. Thomas's Hospital 1 Sea at Margate 1 Seaman's Hospital, Greenwich 2 South Eastern Hospital, New Cross 8 Southend General Hospital, Southend-on- Sea 1 Southlands Hospital, Shoreham-by-Sea 1 Street 2 Tooting Bee Hospital 15 University College Hospital 1 Western Hospital, Fulham 1 Westminster Hospital 1 West Park Mental Hospital, Epsom 2 Total 271 CAUSES OF, AND AGES AT, DEATHS DURING THE YEAR 1938. Causes of Death Deaths at the subjoined ages of "Residents" whether occurring in or beyond the District. Under 1 2 and under 5 5 and under 15 15 and under 25 65 and up wards All Ages 1 and under 2 25 and under 45 45 and under 65 All Causes Certified 1072 65 8 15 20 33 96 277 558 Uncertified - - - - - - - - - - - - - - - - Typhoid and Paratyphoid Fever - - Measles 9 3 4 2 - - - - - (14) Scarlet Fever - - - - - - - - - Whooping Cough 4 3 - 1 - - - - - Diphtheria 4 - 1 3 - - - - - Influenza 3 - - 1 - - 1 1 - Encephalitis Lethargica - - - - - - - - - Cerebro-spinal Fever 2 1 - - 1 - - - - Tuberculosis of Respiratory System 66 - - 1 13 25 21 6 - Other Tuberculous Diseases 9 - 3 1 3 - 2 - - Syphilis 4 - - - - 3 1 - - General Paralysis of the Insane, tabes dorsalis 1 - - 1 - - - - - 173 - - 2 1 67 89 Cancer, Malignant Disease 14 - Diabetes 10 - 1 1 - - 2 6 - Cerebral Hæmorrhage, etc. 97 - - - - 3 25 69 - Heart Disease 221 - - - 3 4 8 57 149 2 - - - - - 1 Aneurysm 1 Other Circulatory Diseases 21 - - - - - 4 17 - Bronchitis 97 1 - 1 11 3 26 65 - CAUSES OF, AND AGES AT, DEATHS DURING THE YEAR 1938 — continued. Deaths at the subjoined ages of "Residents' whether occurring in or beyond the district. All Ages 5 and under 15 15 and under 25 25 and under 45 45 and under 65 65 and up wards Under 1 1 and under 2 2 and under 5 Causes of Death Pneumonia (all forms) 82 11 2 3 5 22 36 3 - 11 - - - 5 2 4 Other Respiratory Diseases - - - - 3 5 6 14 - - Peptic Ulcer - - - - 1 13 12 - - - Diarrhœa, etc. (15) 5 - 1 - - 1 3 Appendicitis - - 6 - - - - - 2 4 Cirrhosis of Liver - 6 - - - Other Diseases of Liver, etc, 6 - - - - - 1 3 5 11 Other Digestive Diseases 20 - - - - 2 5 8 47 62 - - Acute and Chronic Nephritis - - - - - - - Puerperal Sepsis - - - 4 - - 4 - - - - Other Puerperal Causes - Congenital Debility, Premature Birth, Malformations, etc, - - - - - - 32 30 2 10 10 - - - - - - Senility - - 1 1 4 1 7 - - Suicide - 3 2 5 7 15 Other Violence 35 1 1 2 1 2 11 8 14 Other Defined Causes 41 2 1 2 1 1 - - - - - - Causes ill-defined or unknown - ■ 1072 65 8 15 20 33 277 96 558 DEATHS FROM ZYMOTIC DISEASES, 1938. Year All Causes Principal Zymotic Diseases Smallpox Measles Scarlet Fever Diphtheria Whooping Cough Enteric Fever Diarrœa No. Rate No. Rate No. Rate No. Rate No. No. Rate No. Rate No. No. Rate Rate Rate 1928 1520 13.2 137 1.19 - - 77 .67 3 .03 16 .14 26 .23 1 14 .12 .01 1929 1650 14.5 62 - - .54 1 .01 2 .02 6 .05 33 .29 1 .01 19 1488 13.1 101 .89 - - .17 1930 61 .54 7 .06 8 .07 6 .05 2 .02 17 .15 1931 1408 12.5 24 .21 - 3 .03 1 .01 6 .05 - 5 .04 - - 9 .08 1932 1326 12.0 67 .61 1 .01 25 .23 - - 11 .10 16 .15 - - 14 .13 1933 1340 12.5 45 .42 - - 9 .08 4 .04 13 .12 5 .05 - - 14 .13 1304 12.4 87 .83 - 1934 38 .36 1 .01 10 .10 10 .10 - - 28 .26 - 1935 1201 11.7 54 .53 - - 4 .04 - - 10 .10 5 .05 - - 35 .34 1936 1289 12.8 56 .56 - - 20 .20 - - 8 .08 5 .05 4 .04 19 .19 1937 1212 12.3 36 .36 - - - - - 5 .05 7 .07 - - 24 .24 - Average for years 1928-1937 1374 67 - - .22 2 .02 9 .09 12 .11 1 .01 19 12.7 .61 24 .18 1938 30 - 9 - - .04 4 .04 - - 13 .13 1072 11.0 .31 .09 4 - INFANTILE MORTALITY. Deaths from Stated Causes at Various Ages under One Year of Age, 1938. 3—6 months 0—9 months 9—12 months Total under 1 year 2—3 weeks 3-4 weeks Total under 1 month 1—3 months Cause of Death Under 1 week 1—2 weeks Measles - - - - - - 2 3 1 - - - - - - - - - - Scarlet Fever - - 2 1 - 3 - - - - Whooping Cough - - - - - - - - - - Diphtheria - - - - - - - - - - - Influenza - - 1 1 - - - - - - Cerebro-spinal Meningitis - - - - - - - - - Tuberculous Meningitis - 1 - - - - 1 - - - Other forms of Meningitis - - - - - - - - - - - Tuberculosis of Respiratory System - - - - - - - - - Other Tuberculous Diseases - - - - - - - - - - - Syphilis - - 1 - 1 - - 1 - - Bronchitis 3 2 4 11 - - - - 2 Pneumonia (all forms) - - - - - - - - - - Other Respiratory Diseases - 3 3 4 2 12 - - - - Diarrhoea and Enteritis - Congenital Debility and Malformation, Premature birth 18 - - 19 23 2 1 1 1 - - 2 1 - - 1 2 - - - Injury at Birth 2 1 8 5 - - 5 - - - Other Causes Totals 24 2 - 1 27 7 14 9 8 65 II.— INFECTIOUS DISEASES, ETC. The following diseases are notifiable:— Anthrax Acute Poliomyelitis Acute Influenzal Pneumonia Cerebro Spinal Meningitis Diphtheria Enteric Fever and Typhoid Fever Glanders Malaria Membranous Croup Plague Puerperal Fever Relapsing Fever Small-pox Tuberculosis —all forms Acute Polioencephalitis Acute Primary Pneumonia Cholera Continued Fever Dysentery Encephalitis Lethargica Erysipelas Hydrophobia in Man *Measles Ophthalmia Neonatorum Puerperal Pyrexia Scarlet Fever and Scarlatina Typhus *Whooping Cough *Applies to the first case in the house; subsequent cases occurring in the same house within a period of two months from the date of first notification are not required to be notified. Owing to the housing conditions of the borough, it is the practice to remove to hospital nearly all cases of diphtheria and scarlet fever. Before referring to particular diseases under this heading it will be convenient to summarise the methods adopted in the Department for dealing with infectious diseases generally. Cases of infectious disease come to my notice either by notification or by report from various sources. The first step is taken by the District Sanitary Inspector who visits the premises immediately, either on the same day or the morning immediately following. He verifies the particulars already obtained, ascertains the names of contacts together with the names of the schools attended or the place of work. He also investigates the source of infection and arranges for the swabbing of contacts or the disinfection of bedding and premises where these measures are necessary. In appropriate circumstances the head teachers of schools are notified and the London County Council regulations with regard to exclusion of both patients and contacts are enforced. There are two exceptions to this general arrangement. All cases of tuberculosis are dealt with directly by means of the Tuberculosis Dispensary organisation, visits being paid at regular intervals to the homes of all notified patients, and in the case of measles and whooping cough, since so many of the patients are children, the visiting is done by the Health Visitors and not by the Sanitary Inspectors. Special enquiries of any kind in connection with infectious diseases are made by the Sanitary Inspector, and the body of a person who has died from any infectious disease is not allowed to remain at home or to return home from hospital, unless the Sanitary Inspector is able to satisfy me that this procedure would be absolutely safe and reasonable. DIPHTHERIA. The number of cases of this disease notified during the year was 187 ; this is an increase of twenty as compared with last year, in which year the number of cases of diphtheria was the lowest recorded for more than thirty years. In 33 cases the diagnosis was not confirmed, so that the actual number of cases of diphtheria which occurred in the borough last year was 154. There were four deaths, all of children of seven years or less, two from heart failure, one from toxaemia and one from diaphragmatic paralysis. The appended table records the attendances at the Schick Clinics during the year. One patient who was immunised and found to be Schick negative after immunisation in 1936, contracted diphtheria this year. Two Schick Clinics are held each week, one at the Public Health Centre on Mondays at 10 a.m. and one at 98 Rotherhithe New Road on Fridays at 11 a.m. The total number of children under school age immunised during the year was 132, and the number of school-children immunised was 139 We have used Burroughs Wellcome products only at the Schick Clinics; for the Schick Test —Toxin, and heated Toxin for the control; for immunisation —T.A.F. and A.P.T. No. of Sessions No. of new patients Total Attendances Clinic 49 992 Public Health Centre, Grange Road 98 Rotherhithe New Road 200 45 72 529 94 272 1,521 Totals SCARLET FEVER. There has been an increase in the number of cases of scarlet fever this year, but as the figure last year was the lowest ever recorded in the borough some increase was anticipated. The total number of cases notified was 200, and as the diagnosis was not confirmed in 19 cases, the net figure was 181. There were no deaths. ENTERIC FEVER. Two cases of this disease were notified and subsequently confirmed as being cases of paratyphoid "B"; both cases occurred in the same house, the second case being undoubtedly infected from the first. After a very careful investigation, the origin of the infection still remained unknown. Both patients made a complete recovery. DYSENTERY. Towards the end of 1937 a mild epidemic of dysentery occurred, chiefly amongst very young children, and the epidemic continued during the early part of this year, 26 cases being notified. One of these was inaccurately diagnosed and nine cases were sent to hospital. There were no deaths. SMALL-POX. There were no cases of small-pox and no re-vaccinations were made under the Public Health (Small-pox Prevention) Regulations 1917. NOTIFIED CASES OF DIPHTHERIA FOR 25 YEARS. NOTIFIED CASES OF SCARLET FEVER FOR 25 YEARS. OPHTHALMIA NEONATORUM. Ten cases of ophthalmia were notified during the year, a much larger number than usual; in two of these cases the sight was impaired; both infants were treated in St. Margaret's Hospital. Permanent impairment of vision is, I am afraid, to be expected in both cases, and in one of the infants the degree of impairment is unfortunately very severe. In the latter case the child is illegitimate and the mother is under treatment for venereal disease. Cases Vision Impaired Total Blindness Deaths Treated Vision Un- Impaired Notified In Hospital At home - 2 - 10 5 5 8 PUERPERAL FEVER AND PUERPERAL PYREXIA. Only one case of puerperal fever was notified during the year, but there were ten cases of puerperal pyrexia. Ten of these patients were treated in hospital and all made a complete recovery. The Council provides the services of a consultant obstetric surgeon or gynaecologist, and of a nurse where this is requested by the practitioner, and in addition all forms of bacteriological examination are also undertaken free of charge. No. of Cases Facilities Second Opinions Nil Nursing provided Nil Bacteriological examinations Nil Admitted to Hospital 10 ACUTE PRIMARY AND ACUTE INFLUENZAL PNEUMONIA. One hundred and twelve cases of acute primary and acute influenzal pneumonia were notified during the year ; of these 10 cases were of the influenzal variety. Home nursing was provided by the Council in 51 cases and 28 patients were sent to hospital. MEASLES. The County of London (Measles and Whooping Cough) Regulations, 1938, came into force on the Ist October, 1938, on which date the Bermondsey (Whooping Cough and Measles) Regulations, 1936, were rescinded. Under the latter regulations only cases under five years of age were notifiable, but the new regulations provide for the notification of cases irrespective of age. The number of cases of measles which occurred during the year was 1,574 ; of these 889 cases were notified under the regulations and an additional 685 cases were reported to me from various sources. In 245 cases the patient was removed to hospital for treatment, and home nursing was provided in 182 cases. There were 9 deaths; with one exception the deaths were all of children of two years and under. In seven cases broncho-pneumonia was the complication causing death, and in the remaining two cases measles was accompanied by gastro-enteritis. WHOOPING COUGH. The County of London Regulations referred to in the previous paragraph apply also to whooping cough and replaced the Bermondsey Regulations as from Ist October, 1938. One hundred and one cases of whooping cough were notified during the year, and an additional 38 cases of the disease came to my notice in various ways ; 42 cases were removed to hospital for treatment, and in 4 cases nursing was provided at home. There were unfortunately four deaths due in each case to pneumonia. ANTHRAX. During the year one case of anthrax was notified and subsequently proved fatal. The case was diagnosed clinically and confirmed bacteriologically, and the infection almost certainly was conveyed by pickled lamb skins imported from Alexandria. A shaving scratch on the side of the neck was apparently infected during the repacking of a cask which had broken. Another case of anthrax occurred in which the Public Health Departments of this borough and of Southwark were both concerned although the patient, who recovered, did not live in either borough. In this case the infection was traced to Manchurian horse hair which had been imported more than a year previously. The two departments co-operated most effectively, and were greatly assisted by the principals of the firm concerned who voluntarily tarily surrendered the incriminated horse hair for destruction. DISINFECTION. The figures showing the work done in the disinfecting station are set out below. For many years it has been the custom in this borough to insist on the disinfection of premises and articles exposed to infection in all cases of notifiable infectious disease, regard being had as far as possible to the convenience of the householder. Rooms are sealed for disinfection and beds, bedding clothes and other articles are brought into the station for treatment. Beds 843 Pillows (cases) 2,043 Quilts 1,573 Blankets 2,648 Bolsters 761 Sheets 2,098 „ (cases) 389 Furniture 3,531 Miscellaneous 9,037 Books 169 Cushions 214 Verminous Clothing 1,198 Mattresses 17 Bedding 18,222 Overlays 893 Scabies, Clothing 29,090 Pillows 2,230 42,348 new tabs were used to replace those taken off mattresses, palliasses, and cushions before disinfection. Number of rooms disinfected 3,104 Number of mattresses and other articles destroyed 1,899 Furniture, Floorcloth, etc. destroyed 69 Loads CLEANSING STATION. Verminous persons cleansed Adult Females 14 Adult Males 129 Children 2,868 Persons treated for Scabies: — Number treated Number of baths given Adult Females 146 289 Adult Males 86 160 Children, Females 236 1,042 Children, Males 269 1,337 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 11, 3 for scabies, 7 for verminous conditions and 1 for temporary insanitary condition of house, the total number of persons accommodated being 66. BACTERIOLOGICAL LABORATORY. To a large extent the work of the bacteriological laboratory consists in the examination of sputa for the tubercule bacillus and of throat swabs for K.L.B., and only about ten per cent. of the total number of investigations made were for other purposes. One or two of the practitioners in the borough do make considerable use of the facilities provided by the Council, but .generally speaking this source of assistance is rather neglected. 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 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 decrease this year. Results of Examination Total Examinations Examined for Positive Negative 1937 1938 1937 1938 1937 1938 Diphtheria (specimens taken by Medical Officer of Health) 290 281 19 16 271 265 Ditto (taken by general practitioners) 1246 1122 65 59 1181 1063 Diphtheria (total specimens taken) 1536 1403 84 75 1452 1328 Phthisis 1458 1042 188 123 1270 919 Various 258 303 41 29 217 274 Total specimens taken 3252 2748 313 227 2939 2521 FOOD POISONING. Seventeen cases of Food Poisoning were notified to me during the year under The Public Health (London) Act, 1936, Section 182. INSULIN FOR DIABETIC PATIENTS. Under Section 227 of the Public Health (London) Act, 1936 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. Twenty-six patients have been supplied during the year as compared with twenty patients in 1937. (26) NURSING. The following table shows the number of patients nursed under the Council's Scheme, the diseases from which these patients were suffering and the number of visits paid. Under this scheme the Council assists in the provision of nursing for expectant and nursing mothers, children under five, and for patients suffering from the following diseases: — Measles, German Measles, Whooping Cough, Puerperal Fever and Puerperal Pyrexia, Epidemic Diarrhoea, Dysentery, Influenza, Ophthalmia Neonatorum, Polio-myelitis, Encephalitis Lethargica, Malaria, Acute Primary and Acute Influenzal Pneumonia and Tuberculosis. The fee payable by the Borough Council to the Nursing Associations is Is. per visit. We are very much indebted to the authorities of both Nursing Associations for the valuable help received from them in connection with this scheme and particularly for their invaluable aid in nursing cases of measles and tuberculosis. St. Olave's District Nursing Association Totals whole Borough Rotherhithe Queen's Nursing Association Disease Cases Visits Cases Visits Cases Visits Pneumonia 40 860 11 219 51 1,079 Bronchopneumonia 7 1 147 2 35 9 182 Bronchitis 24 341 5 52 29 393 Influenza 28 417 3 25 31 442 Measles 116 1,474 66 746 182 2,220 Whooping Cough 3 61 1 8 4 69 Tuberculosis:— (a) Respiratory System 30 2,270 22 1,087 52 3,357 (b) Other Forms 8 370 4 66 12 436 Puerperal Pyrexia — — — — — — Puerperal Fever — — — — — — Pregnancy and Labour 49 763 5 106 54 869 Diseases of the Digestive System 28 223 14 109 42 332 Infantile Diarrhoea (under 2 years) — — — — — — Discharging Ears 11 316 — — 11 316 Discharging Eyes 9 184 4 74 13 258 Post-operative cases:— (a) Tonsils & Adenoids 10 43 3 12 13 55 (b)Other cases 5 99 2 19 7 118 Other diseases 44 615 6 71 50 686 Totals 412 8,183 148 2,629 560 10,812 CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR 1938. NOTIFIABLE DISEASE NUMBER OF CASES NOTIFIED BERMONDSEY ROTHERHITHE ST OLAVE At all Ages At Ages—Year 1 2 3 4 5 6 Total 1 2 3 Total St. John St. Olave St. Thomas Total Total Cases removed to Hospital 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 & up wards Diphtheria (including Membranous Croup) 187 3 82 25 5 2 1 - 22 16 18 96 26 22 30 78 6 4 3 13 11 16 60 5 4 13 186 - Erysipelas 57 1 6 - 2 2 5 13 6 9 13 6 8 5 12 6 3 40 7 5 4 16 - - 1 1 37 - 10 - - - 13 13 22 18 15 18 99 34 40 21 95 3 1 2 6 190 Scarlet Fever 200 6 85 69 17 5 6 2 Cerebro-Spinal Meningitis 3 2 - - - - - - - - 1 1 - - - 3 - - - - - - - - 1 1 3 - Ophthalmia Neonatorum 10 10 - - - - - - 1 1 2 1 1 - 6 - 3 1 4 - - - - - 5 - - - - - - - - - - 2 - - - 2 - - - - - - - 2 Enteric Fever 2 - 1 - 1 - - - 1 Puerperal Fever 1 - - - - - - - - - - - - - - - - - - 1 - 1 - - - - 1 Puerperal Pyrexia 10 - - - 1 4 3 2 - - 1 3 2 2 1 9 - - - - 1 - - 1 9 - - - Dysentery 26 2 7 2 1 2 2 5 - 1 3 1 1 2 5 - 1 10 1 11 3 15 - 1 - 1 1 9 Anthrax 1 - - - - - - 1 - - - - 1 - - - - 1 - - - - - - - 1 - - Acute Poliomyelitis 1 - - - 1 - - - - - - - - - - 1 - - 1 - - - - - - - - 1 Pneumonia (Acute Primary and Acute Influenzal) 112 6 22 4 5 5 11 2 14 7 20 16 12 9 11 75 9 10 32 4 1 - 5 23 7 13 13 28 Whooping Cough 101 17 70 14 - - - - - 15 2 17 11 10 4 59 20 17 3 40 - 1 1 2 36 - - - Measles 889 74 814 1 - - - - - - - 101 123 110 123 60 74 591 70 102 73 245 32 13 8 53 162 - Tuberculosis— 17 7 8 6 9 16 15 14 15 8 77 14 10 8 32 1 2 - 3 Respiratory System 112 1 2 6 19 25 21 - - Other forms of Tuberculosis 18 1 2 1 5 2 1 - 3 6 - 3 1 13 - 2 3 - 1 2 - 4 1 1 - 1 1 - Totals 1,730 121 1071 196 57 48 48 51 54 17 36 176 206 215 132 134 1082 182 224 155 47 24 16 87 31 670 219 561 CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEARS 1929-1938. Notifiable Disease. 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 46 47 3 16 21 7 - - - Small Pox - Diphtheria (including Membranous Croup) 463 462 263 263 386 372 273 207 167 187 Erysipelas 45 41 49 49 68 73 53 39 28 57 Scarlet Fever 584 507 310 446 640 597 367 266 167 200 Cerebro-Spinal Meningitis 4 5 9 9 4 2 2 4 10 3 Acute Polio-Myelitis and Acute Polio- Encephalitis 2 1 1 3 1 - - - 1 1 Ophthalmia Neonatorum 11 13 14 10 7 6 5 6 1 10 Anthrax 1 1 - - 1 - - 1 1 - Enteric Fever 2 5 1 2 2 2 3 15 5 2 (28) Puerperal Fever 12 14 13 8 6 2 3 6 1 1 Puerperal Pyrexia 20 19 37 27 24 13 19 9 13 10 Encephalitis Lethargica 1 4 1 2 2 - 2 - - - Dysentery - - - - 1 - 3 1 43 26 Malaria 2 - - - - - - - - - Malaria (induced) - - - - - - 1 - - - Pneumonia (Acute Primary and Acute Influenzal) 119 167 102 136 121 113 125 170 110 112 Whooping Cough 110 167 - 101 - - - 103 275 - Measles - - - - - 7 85 889 - - Tuberculosis:- Respiratory System 175 177 182 141 112 194 208 129 142 147 Other forms of Tuberculosis 40 46 40 35 34 32 34 34 31 18 Totals 1,536 1,494 1,083 1,149 1,512 1,371 1,004 966 1,145 1,730 (29) 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, 1938—NEW CASES AND DEATHS. AGE—PERIODS NEW CASES DEATHS Pulmonary Pulmonary Non- Pulmonary Non- Pulmonary M. M. F. M. F. F. M. F. 0 1 - - - - - - - 1 - 4 2 1 - 2 1 - 5 - 3 1 - 2 1 - - 10 4 1 - - 4 4 - - 15 15 3 1 2 1 6 2 - 20 2 - 8 2 1 13 14 - 25 2 - 9 9 - 17 11 - 35 14 4 1 1 5 2 - - 45 7 2 - 3 9 1 - 2 55 3 - - 10 1 - - 7 65 and upwards 5 2 - - 1 - - 5 77 54 16 12 48 18 6 3 TABLE II. TUBERCULOSIS, 1938—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 3 - 3 4.55 5 3 8 88·89 0-1 month 8 - 8 12·12 - - - - 1-3 months 1 1 2 3·03 - - - - 2 - 3·03 - - 3-6 months 2 - - 6-12 months 11 16 24·24 - - 5 - - 1-2 years 9 3 12 18·18 - - - - 2-5 years 7 5 12 18·18 1 11·11 - 1 Over 5 years 7 4 11 16·67 - - - - Totals 48 18 66 100·00 6 3 9 100·00 NURSING, EXTRA NOURISHMENT AND SHELTERS. As in previous years the District Nurses have been asked to visit many of our patients who are suffering from tuberculosis, and are being treated at home; 3,793 visits were paid by the nurses in 1938. A limited provision is made for the supply of extra nourishment to tuberculous persons, and this usually takes the form of eggs and milk; 142 patients received help in this way during the year. The scheme for the provision of shelters has been continued and thirteen shelters are at present in use. LADY ALMONER. The Lady Almoner has a variety of duties which are concerned chiefly in the after-care of tuberculous patients. She arranges for assistance to be given to patients in a number of different ways as for instance in the supply of extra nourishment, the provision of beds, bedsteads and nursing utensils. In a few cases she has been able to arrange for a period of rest in a convalescent home, or for a country holiday in the case of exhausted mothers. She regularly visits the homes of patients who are undergoing treatment in sanatoria in order to keep the relatives informed as to the patients' progress, and to see that proper provision is made for the patient's return. In addition to these duties the Lady Almoner acts as Child Protection Visitor under Part XIII of the Public Health (London) Act, 1936. RETURN SHOWING THE WORK Of THE DISPENSARY DURING THE YEAR 1638. Pulmonary Non-pulmonary Total Grand Total Diagnosis Adults Children Adults Children Adults Children M. F. M. F. M. F. M. F. M. F. M. F. A.—New Cases examined during the year (excluding contacts):- 51 38 3 1 4 5 3 55 38 8 4 105 (a) Definitely tuberculous - - - - - - - 1 2 1 4 (b) Diagnosis not completed - - - - - - - - - - 207 159 24 21 411 (c) Non-tuberculous - B.—Contacts examined during the year:— 1 - - 2 3 3 13 7 7 (a) Definitely tuberculous 3 1 - - - - - - - - - - (b) Diagnosis not completed - - - - - - - - - - 92 140 110 128 470 (c) Non-tuberculous - - - - II I C—Cases written off the Dispensary Register as 4 3 6 5 5 10 4 2 2 1 6 26 4 (a) Recovered (b) Non-tuberculous (including any such cases previously diagnosed and entered on the Dispensary Register as tuberculous) - - - - - - - 304 303 134 149 890 (31) - (D) .—Number of Cases on Dispensary Register on December 31st: — 294 39 32 34 48 47 328 288 86 72 240 40 774 (a) Definitely tuberculous - - - - - 1 2 1 - 4 (b) Diagnosis not completed - - - 1. Number of cases on Dispensary Register on January 1st 784 8. Number of visits by Tuberculosis Officers to homes (including personal consultations) 995 2. Number of cases transferred from other areas and cases returned after discharge under Head 3 in previous years 15 9. Number of visits by Nurses or Health Visitors to homes for Dispensary purposes *2,477 3. Number of cases transferred to other areas, cases not desiring further assistance under the scheme, and cases "lost sight of" 44 10. Number of:— (a) Specimens of sputum, etc., examined 1,068 4. Cases written off during the year as Dead (all causes) 64 (b) X-ray examinations made in connection with Dispensary work 1,158 5. Number of attendances at the Dispensary (including Contacts) 3,757 11. Number of "Recovered" cases restored to Dispensary Register, and included in A (a) and A (6) above 2 6. Number of Insured Persons under Domiciliary Treatment on the 31st December 110 12. Number of "T.B. plus" cases on Dispensary Register on December 31st 335 7. Number of consultations with medical practitioners: — (a) Personal 143 (b) Other *In addition to these visits 573 visits were made by the Lady Almoner and 158 visits by the School Nurse. PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1930. Summary of Notifications during the period from the Ist January, 1938, to the 31st December, 1938. Formal notifications Total Notifications Number of primary notifications of new cases of Tuberculosis 45 to 55 65 and upwards Total (all ages) 0 to 1 1 to 5 5 to 10 10 to 15 15 to 20 20 to 25 25 to 35 35 to 45 55 to 65 Age Periods Pulmonary, Males - 2 3 6 13 13 5 5 65 1 13 4 74 „ Female - - 3 13 12 8 4 2 3 2 47 55 - 1 3 - 1 1 1 - - 10 Non-Pulmonary Males 2 1 13 - „ Females - 1 1 4 1 - - 1 - 8 8 - - New cases of Tuberculosis coming to the knowledge of the Medical Officer of Health during the abovementioned period, otherwise than by formal notification. Age Periods 0 to 1 1 to 5 5 to 10 10 to 15 15 to 20 20 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 and upwards Total Pulmonary Males - - - 1 - 1 4 1 2 2 1 12 „ Females - - - 1 2 1 3 - - - - 7 Non-Pulmonary Males - 2 - - 2 1 1 - - - - 6 - 1 - - - - - 1 2 - - 4 Females (33) Returns rendered under the PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1930. 1st QUARTER, 1938 Respiratory System Other Forms M. F. M. Number of Cases on Register at commence- ment of Quarter 407 278 110 Number of Cases notified during Quarter 23 9 1 Inward Transfers, Un-notified Deaths, etc. 3 3 3 Number of Cases removed from the Register 32 8 8 Number of Cases remaining on the Register at end of Quarter 401 282 106 2nd QUARTER, 1938. I Respiratory System Other Forms M. F. M. Number of Cases on Register at commence- ment of Quarter 401 282 106 Number of Cases notified during Quarter 17 17 4 Inward Transfers, Un-notified Deaths, etc. 4 2 3 Number of Cases removed from the Register 18 13 3 Number of Cases remaining on the Register at end of Quarter 404 288 110 3rd QUARTER, 1938. Respiratory System Other Forms M. F. M. Number of Cases on Register at commence- ment of Quarter 404 288 110 17 13 3 Number of Cases notified during Quarter Inward Transfers, Un-notified Deaths, etc. 2 - - Number of Cases removed from the Register 18 11 5 Number of Cases remaining on the Register at end of Quarter 290 108 112 405 4th QUARTER, 1938. Respiratory System Other Forms M. F. M. Number of Cases on Register at commence- ment of Quarter 290 108 405 Number of Cases notified during Quarter 8 8 2 Inward Transfers, Un-notified Deaths, etc. 2 - 3 Number of Cases removed from the Register 46 21 19 Number of Cases remaining on the Register at end of Quarter 91 370 279 IV. LIGHT TREATMENT, ELECTROTHERAPY AND MASSAGE. The following table shows the work done in the Solarium during 1938:— Total Number of Attendances 49,343 Number of Individual Patients 2,102 Number of Treatments 99,111 Massage 8,011 Medical Electricity 3,350 Diathermy 8,514 Physical Exercises 2,552 Radiant Heat 22,249 Light 49,343 Ultra Violet Local 4,502 Mechanical Vibratory Massage 117 Q-Ray Pad 483 Number of Medical Examinations 4,445 Number of New Cases 1,208 During 1938, the alterations which were proposed in last year's Annual Report have been completed. The nurses' room has been fitted with radiant heat lamps and a new room has been built for the nurses. The extra radiant heat lamps have been a very great advantage, and many more patients have been able to have this as a preliminary to other forms of treatment. The number of radiant heat treatments given has been increased by 8,840. Several diathermy and medical electricity machines have been added to the equipment. All this apparatus has been in constant use, with the result that diathermy treatments have increased by nearly 5,000, and medical electricity treatments by 2,595. Four hundred more individual patients have attended during the year, and nearly 17,000 more treatments have been given. Massage has also increased by 2,000 treatments. Patients are now able to have more frequent treatment, with the result that they do not need to attend for such long periods as formerly. LEYSIN PATIENTS. In the following table will be found a complete list of patients who have been sent to Leys in by the Borough Council. Initials of Patient Age Sex Localisation of Disease Period previously under Medical Treatment prior to going to Leysin Date sent to Leysin Date returned from Leysin Result S.B. 12 M. Left Foot 5 years 28/7/24 5/7/27 Well and at work I.R. 10 F. 5 28/7/24 6/10/25 Removed from District Glands of Neck 6 „ 28/7/24 6/10/25 Well. Now married M.S. 15 F. Right Knee A.L. F. Glands of Neck 2 „ 1/10/24 6/10/25 Well. Now married 19 C.P. 37 F. Forearm and Peritoneum 2 „ 6/10/25 Well and at work 1/10/24 26/10/25 22/2/27 M.B. 28 F. Glands of Neck 15 „ „ „ E.C. 16 F. Right Knee 5 „ 26/10/25 8/7/27 „ „ 26/10/25 22/2/27 H.C. 10 M. Glands of Neck 2 „ „ „ 21 F. Left Hip 9 „ 17/5/26 29/6/28 „ „ A.H. E.W. F. Spine and Right Hip Left Ankle 18 „ 17/5/26 17/9/27 23 „ „ 2 „ 9/2/27 28/4/29 Removed from District G.B. 20 F. Left Ankle 2 „ 9/2/27 8/5/28 L.T. M. Abscess of Ribs „ „ 19 24 M. Spine 5/2/27 8/5/28 Keeping well C.P. 7 „ 5/2/27 8/6/29 Removed from District A.R. 26 F. Glands of Neck 3 „ 20/6/28 8/6/29 Well and at work E.G. 16 M. Lupus of Nose 4 „ 20/6/28 8/6/29 C.P. 26 M. 1 „ Tuberculide of Skin „ „ 20/6/28 26/9/30 H.S. 18 M. Right Hip 3 „ „ „ 31/5/29 5/8/32 8 „ I.S. 23 F. Right Hip „ „ 20/1/30 6/5/32 Removed from District C.C. 27 F. Mltiple Lupus 20 „ 20/1/30 20/3/31 Well and at work A. P. 16 F. Glands of Neck 4 months 15/4/30 1/2/33 E.W. 18 M. Left Knee 1 year „ „ 13/10/30 - Dead (Tuberculous Meningitis) G.L. 15 M. Spine 10 months 6/2/31 6/5/32 Well and at work V.B. 16 F. Lupus of Nose 1 year Dead (Cerebro-spinal Meningitis) 4 years 13/10/30 - D.R. 34 M. Spine Well 30/7/32 30/11/36 J.O.B 17 M. Right Knee 7 months Seen recently—keeping well E.B. 20 F. Left Knee - 10/5/33 14/6/35 17/5/36 13/9/38 Diagnosis not confirmed M.L. 11 F. Glands of Neck 3 months Keeping well 27/1/36 26/3/37 F.H. 22 F. Left Wrist 3 months 17/5/36 26/3/37 Well and at work H.H. 20 F. Glands of Neck 1 year 21/7/36 3/5/38 Well and at school 10 F. Glands of Neck 3 months J.H. Undergoingtreatmentfollowingoperation M.D. 25 Spine and Left Elbow 6 years 17/2/37 30/3/38 F. Still at Leysin 12/1/38 - H.S. 26 M. Spine 1 year V.—MATERNITY AND CHILD WELFARE. In my last report it was mentioned that proposals had been received both from the Reverend Walter Spencer and the Rev. Humphrey Richardson suggesting that the time had arrived for the Borough Council to assume full responsibility for the infant welfare centres hitherto operated on a voluntary basis at the Central Hall and at St. George's Hall. After full discussion it was finally decided that the Borough Council should take over both centres on terms which were mutually acceptable to both authorities, the Central Hall Centre being taken over as from Ist April, 1938, and the St. George's Hall Centre as from Ist July, 1938. With the exception of Salomon's Centre these were the only " voluntary " centres remaining in the borough, and with that exception the infant welfare centres are now all municipal. The Council also decided during the year to establish a panel of home helps and for this purpose framed a set of rules. The number of cases in which such help has been provided is 59. Under the auspices of the National Society of Day Nurseries Park Shelters a shelter was opened in Southwark Park for five weeks from July 21st. An average attendance of 69 children was recorded and the Committee have watched the experiment with great interest. FAIRBY GRANGE CONVALESCENT HOME. The total number of patients received into the home during the year, including mothers, babies, and toddlers, was 482, a slight increase on the figures for 1937. Number of women admitted 226 Number of babies admitted 91 Number of toddlers admitted 165 MIDWIFERY SERVICE. Under this scheme 213 patients "booked" during the year compared with 285 patients last year. In 145 of these cases the full fee of the midwife was paid by the Council and a proportion of the fee was paid in 63 other cases; the remaining 5 cases were assessed to pay full fee. OBSTETRIC AND PUERPERAL FEVER CONSULTANTS. The names of the lady and 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 Nil CHILD 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 10 fostermosthers with 12 children and 76 visits were paid by the visitor. MATERNAL MORTALITY. There were four maternal deaths during the year. In each case a careful investigation was made and a confidential report was submitted to the Ministry of Health. HEALTH VISITORS. The following table shows the work done by the Municipal and Voluntary Centres and Health Visitors during 1938:— District Visits to Expectant Mothers Visits to cases of Infectious Disease Unclassified or Special Visits Attendances at Centres & Clinics Births Notified Visits to Infants and Children Puerperal Pyrexia & Fever Ophthalmia Neonatorum Measles Whooping Cough Tuberculosis Post-Infectious Disease Re-visits Primary Visits Revisits First Visits Under 1 year 1-5 years 37 74 - 70 560 - 980 77 7 112 77 96 257 Miss Robson 76 - Miss Wallis 87 83 624 987 41 86 1 1 138 13 155 148 357 248 - Miss Bowles 7 6 81 158 4 10 - - 3 - 24 - 472 - - Miss Lawrence 72 71 448 604 21 47 - 4 199 4 304 259 330 246 1 Miss Oram 75 90 602 838 31 116 4 4 82 25 183 107 760 248 9 69 82 599 1059 45 108 Miss Riches 1 - 87 12 185 147 136 260 - Miss Brown 85 79 489 715 64 112 - 1 152 14 176 139 251 293 - Miss Riley 69 68 611 441 72 94 - 107 4 138 114 121 258 - - Miss Helden 111 114 680 837 60 150 3 - 115 4 190 462 136 271 - Miss Parry - - 94 40 212 108 69 216 24 94 86 660 851 52 146 Miss Carlton 86 88 704 934 72 139 - - 95 33 145 95 196 241 1 89 82 660 1386 82 271 5 137 5 158 142 45 160 - Miss White - Miss Wadds 154 151 987 968 82 134 - 1 192 9 146 205 42 266 - Miss Bache 124 644 879 71 146 - 9 115 145 33 - 116 9 232 279 Salomon's Centre 88 164 771 3024 322 307 - - 6 5 7 6 419 16 - 43 42 283 265 15 53 - - 125 10 63 40 1141 266 - Miss Baird Miss Carter 125 120 514 628 60 60 2 5 58 13 139 121 144 257 - Totals 11 30 1782 207 2482 2396 3863 4657 1440 1526 9917 15554 1131 2053 51 ATTENDANCES AT MATERNITY AND CHILD WELFARE CENTRES. The following table shows attendances at Maternity and Child Welfare Centres during 1938:— 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 Post- Natal Cases Total Attendances No. of Sessions No. of Attendances No. of Sessions New Cases Total Attendances New Cases Under 1 year 1-5 years 1-5 years Under 1 year Public Health Centre, Grange Road 193 301 76 4,162 4,625 46 132 60 708 13 202 46 394 5,911 140 98 Rotherhithe New Road 148 174 31 3,658 2,774 2,794 48 116 41 638 - 44 91 262 - Community Centre 50 64 42 1,041 1,174 1,200 - - - 41 489 - - - - Bermondsey Gospel Mission 96 128 32 2,041 1,638 2,279 - - - - - - - - - Roseberry Street 48 55 12 925 793 900 - - - - - - - - - Salomon's Centre 149 94 11 2,691 1,111 1,753 202 535 302 2,916 - - - - - Princess Club 144 134 20 2,505 2,448 3,338 40 84 24 424 42 519 - - - Fulford Street 97 115 21 1,682 1,400 2,039 49 80 60 547 - - - - - St. George's Hall 32 29 4 461 450 625 - - - - 25 496 - - - Central Hall 197 186 29 3,618 4,951 - - - - 13 217 - 4,153 - - Total 1,154 1,280 278 24,533 20,103 24,504 385 947 487 5,233 134 1,923 90 231 656 EXTRACTS FROM VITAL STATISTICS, 1938. Births. Registered— Total Males Females Live Births Legitimate 1,404 741 663 Illegitimate 35 17 18 Birth Rate per 1,000 of the estimated resident population 148 Total Males Females Stillbirths 36 20 16 Rate per 1,000 total (live and still) births 24 Notified within 36 hours of birth — (1) Live Births, 1,457. (2) Stillbirths, 35 (3) Total, 1,492 (1) By Midwives, 1,257*. (2) By Parents and Doctors, 235. * Including 887 births delivered by midwives in Hospitals. Total. Males. Females Deaths 1,072 602 470 Death Rate per 1,000 of the estimated resident population 11·0 Maternal Deaths. Deaths from puerperal causes: — Deaths. Rate per 1,000 total (live and still) births Puerperal Sepsis - - Other puerperal causes 4 2·71 Total 4 2·71 Death Rate of Infants under 1 year of age. All Infants per 1,000 live births 45 Legitimate infants per 1,000 legitimate live births 44 Illegitimate infants per 1,000 illegitimate live births 86 Health Visitors. Visits paid by Health Visitors during the year:— To Expectant Mothers (1) First Visits, 1,131. (2) Total Visits, 3,184 To Infants under 1 (1) First Visits, 1,526. (2) Total Visits, 11,443 To Children. 1—5 Total Visits, 15,554 Convalescent Homes for Children under 5. Number of Beds, 16. Number of Children under 5 received during the year, 256 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: — 11,957. Deaths from Cancer (all ages) 173 Deaths from Measles (all ages) 9 Deaths from Whooping Cough (all ages) 4 Deaths from Diarrhæa (under 2 years of age) 12 .. .. .. (41) VI. DENTAL TREATMENT. The attached tables summarise the work which has been done at the two dental centres during the year. TREATMENT OF CHILDREN DURING 1938 CENTRE Age Group Number Examined Number Treated Number of Extractions Anæsthetics Number of Fillings Number of Scalings Number of Attendances for Orthodontics Local General PUBLIC HEALTH CENTRE, GRANGE ROAD. Under 5 years 223 266 1136 18 241 12 - - Over 5 years 1400 448 338 460 5 59 625 571 Totals 794 2536 466 472 5 59 579 891 98, ROTHERHITHE NEW ROAD. Under 5 years 190 628 4 28 - - 189 141 608 623 1450 174 429 301 32 Over 5 years 2 798 812 2078 178 570 2 32 Totals 329 1592 1703 4614 644 801 7 (42) DENTAL TREATMENT CARRIED OUT DURING 1938 CENTRE 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 737 957 2520 129 26 227 84 670 231 2613 PUBLIC HEALTH CENTRE, GRANGE ROAD Women 1306 1619 2666 34 1242 112 336 196 177 2472 Men 2342 2565 5233 2597 127 446 148 4416 71 269 - Tuberculosis Cases 18 19 58 18 4 14 2 4 68 Children (Table I.) 794 891 2536 466 579 472 5 1 1 1991 Totals 6051 13013 1053 1397 138 5197 4993 697 410 11560 Maternity Cases 502 705 1786 255 64 25 202 261 24 1562 98, ROTHERHITHE NEW ROAD Women 494 544 1076 112 126 17 104 376 46 1201 Men 592 613 1365 562 70 76 17 92 20 1153 Tuberculosis Cases 10 6 25 3 6 5 - 2 18 - Children (Table I.) 798 812 2078 178 570 329 2 - - 1953 Totals 2396 2680 6330 1380 600 61 400 90 5887 1013 7593 8731 19343 6373 1997 1097 500 Totals both Centres 2066 199 17447 VII.—CONSULTATION AND OTHER CLINICS. X-RAY DEPARTMENT. During the year 1938 there has been a marked increase in the work of the X-ray Department. The total number of films taken was 2,682, nearly 1,000 more than in 1937. The total number of screen examinations was 1,490, 262 more than in 1937. The total number of patients examined was 1,287, 261 more than in 1937. The number of attendances made by these patients was 1,610. Thirty more chest cases were examined, but the increase in the number of patients was mainly due to the greater use of the department by the general practitioners in the borough. There have been twice as many bone cases, and four times as many examinations of the gastro-intestinal tract. It is very satisfactory to be able to record this increase in the number of patients sent by general practitioners. It seems to indicate that they are finding the department to be of real assistance to them in their work. The appointment system is working well and is much appreciated by the patients. POST-INFECTIOUS DISEASE CLINIC. During the past year 161 cases were seen for the first time at this clinic, many of whom were seen again, and occasionally more than once, so that 327 examinations were made in all. 109 of these were found to be suffering from some established defect, so that it was necessary to determine whether that defect was due to recent illness or to some previous ill-health, and this diagnosis could only be made after several examinations. In some cases the final diagnosis was helped by special investigations, such as X-rays or by reference to a special department of a hospital. As soon as the diagnosis was established the parents were recommended to seek the appropriate form of treatment from their private doctor or a hospital. In both cases an appointment or letter was given so that the minimum amount of delay should result. Only 52 children were found to be completely healthy and were consequently discharged; the defects discovered are classified in the following table:— Infectious Disease after which examined. Result of Examination Acute Pri- Scarlet Diph- Whoop- mary Measles Fever theria ing Cough Pneumonia Number of patients found to be suffering from: Malnutrition 16 3 3 2 — Bronchitis 5 — — — — Heart Affection 5 4 3 1 - Ear Affection 2 - 3 - 1 Eye Affection — — 2 — 1 Nose Affection 1 1 — 1 - Tonsils, enlarged or 22 5 6 2 3 septic Albuminuria 2 - - - 1 Dental Caries 6 1 2 — — Skin Disease 2 — — — — Speech Defect — — 1 — — Threadworms 1 — 1 — — POST-NATAL AND SPECIAL CLINICS FOR WOMEN. The total number of attendances at the Gynaecological Clinics was 656; of these 231 patients attended for the first time Twenty-three had inflammation of the genital tract. Most of these patients were treated at the clinic. Thirty-six had symptoms attributable to the menopause. These patients were kept under observation at the clinic, sent to hospital or referred to their own doctor. Thirty-two had disorders of menstrual function. Six of these had fibroids and were transferred to hospital for treatment; the others were kept under observation at the clinic. Twenty-two complained of genital displacements. Eight were referred to hospital for operation, and the remainder were treated at the clinic. Twenty-three were found to be pregnant. Seven complained of sterility. These were investigated and suitable lines of treatment suggested to them. Eleven had hyperpiesia. Thirteen had backache. The remaining sixty-four patients fall into the miscellaneous group —headaches, rheumatism, eye trouble and heart disease. These patients were either referred to their own doctor or to suitable places for treatment. There has been an increase in the number of patients attending with gynaecological complaints and a decrease of patients with other illnesses. There has also been an increase in the number of patients complaining of sterility; this complaint is often a source of unhappiness over many years and sometimes can be remedied by very simple measures, and it is therefore satisfactory that this type of patient is attending the clinic in increasing numbers. There have been no cases of malignant disease this year. CHILDREN'S CLINIC. One hundred and four new cases were seen in addition to those children referred under the Post-Infectious Disease Scheme. Some of these children were sent by other doctors who wished a more thorough examination than could be carried out in a Welfare Clinic, while others were children over five years of age whose parents wished to avail themselves of this clinic for advice. Many children, unfortunately, who have passed the age limit for Infant Welfare Clinics are frequently in need of help for physical or nervous defects. Others are brought up for some reason of management by mothers who have been trained to seek expert advice by their earlier use of the Infant Welfare Clinic. The necessary appointment can be made by reference to any Health Visitor who will arrange a visit as soon as possible. Two hundred and eighty-two examinations were made in all, and many of the children were referred to hospital for special treatment or to the Solarium for the tonic effect of ultra-violet light. When such treatment did not appear to be sufficient, the children were sent away to the country or seaside for a varying period of time. If the patient needed a doctor's care, enquiries were always made about the family doctor, and if the family possessed one a letter was sent to him giving details of the examination. RHEUMATISM CLINIC. Every case of rheumatism in a child, which has been reported in the borough, has been visited by one of the Health Visitors, who has made enquiries into the form of supervision which that child has been granted. To the large majority of such children, who have suffered from one or more attacks of acute rheumatism or chorea, supervision is provided by the London County Council at special Rheumatism Supervisory Clinics. Some parents, however, find it difficult to attend these Clinics and have been glad to avail themselves of the Borough Clinic. At this clinic, advice as to exercise, games, swimming, school and homework has been given, and close co-operation with the London County Council School Medical Service has been attained. When progress has not been satisfactory, or when a new acute attack has interfered with the normal life, rapid steps have been taken to send the child to a suitable hospital or home in the country. When parents have preferred to keep the child at home, the family doctor has been informed of the previous history, and the follow up convalescence has been carried out at the clinic. A number of young children have been brought for advice on account of indefinite pains in the limbs or back. Several of these children have been found to be suffering from established heart disease already, whereas some have been found to be suffering from some postural defect, such as flat feet or curved spine, which has caused the pain. Several children, who have been found to have a septic focus in the nose or throat, have been referred to the Ear, Nose and Throat Specialist at St. Olave's Hospital, where the necessary treatment has been carried out under ideal surgical conditions. No ill-effects have been produced by such operations. During the year 62 children have been seen for the first time, and 207 re-examinations have been carried out. It must be remembered that the special function of such a clinic is essentially one of supervision and not of treatment. The London County Council School Medical Service does not provide for the child once he has passed the age of fourteen years, or sixteen years in the case of those who have attended a physically defective school. The parents of these children, resident in the borough, have been visited by a Health Visitor, and advised to continue supervision; many of them have done so, and have repeated their visits. In order to make this service more useful to the adolescent, who has frequently started work, an evening clinic is held once a month. The boys and girls come to it alone, frequently on their way home from work. The attendance at this session makes it desirable that it should continue. Not only have children and adolescents been seen at the clinics, but also mothers and grandmothers. In the majority of such cases the rheumatism has been the type which attacks the joints and which is aggravated by hard manual work, or generalised backache which is due to rheumatism attacking the ligaments of the spine. In all cases lack of sufficient rest and persistent cares have added to the disability. Many of the cases have been referred to the Solarium, where they have found early temporary, and sometimes permanent relief. Each case is carefully searched for a septic focus, and if such a one is found the patient is advised to seek immediate treatment. An introductory letter is always provided. Seventy adolescents and adult new patients have been seen in the year, and among these a number have been re-examined, so that a total of 100 re-examinations have been made. FOOT CLINIC. The total number of patients treated during the year was 14,665. This is an increase of nearly one thousand compared with last year. As was anticipated it became necessary during the year to appoint an additional whole-time chiropodist, and there are now four whole-time and two part-time chiropodists employed at the two centres. Clinic Men Women Total Bermondsey 2,390 6,005 8,395 Rotherhithe 1,700 4,570 6,270 Totals 4,090 10,575 14,665 VIII.—PROPAGANDA. During the year 1938 lectures and demonstrations in every case illustrated by lantern and cinema films were given as follows:— Lectures. Audiences. Schools 84 20,030 Clubs and other Institutions 59 3,900 Open-air with Cinema Van 60 19,045 203 42,975 This is the largest number of lectures and demonstrations ever given in one year and is accounted for by the fact that, during the latter part of 1938, considerable help was given by the Propaganda Department in the training of First-Aid Volunteers. With; the object of keeping these volunteers interested, arrangements were made to give them lectures on physiology and hygiene after their recognised course had been completed, and as these lectures seemed to be very much appreciated they have been continued ever since. Two new films have been added to the film library, which now totals 39 films. The arrangements for the school lectures as set out in last year's annual report have been continued and these lectures, numbering 84, have been given to audiences of 20,000 school-children, as against 72 lectures and 12,000 school-children last year. IX.—SANITARY ADMINISTRATION. HOUSING. During the year 1938, ten areas were represented to the Council, comprising in all 459 dwelling houses, and 18 dwelling houses and shops. The Maze Pond Area No. 2, which was originally represented in June, 1936, was re-represented in October, 1938, and the latter representation included another 3 dwelling houses and 1 shop. The following are the areas represented:— Number of dwelling houses and shops Area in sq. ft. (Approx.) Number of dwelling houses Title of Clearance Area Date Tay Buildings 3,343 1/2/38 - 8 Wolseley Buildings 35,700 14/4/38 188 1 Staples Rents, No. 1 7/6/38 20,464 26 - 1 Staples Rents, No. 2 7/6/38 26,097 16 7/6/38 Staples Rents, No. 3 2,188 2 2 Staples Rents, No. 4 7/6/38 5,711 2 3 Enid Street 5/7/38 269,761 166 9 Tiger Bay 5/7/38 2 850 - Rotherhithe Street, Nos. 323—331 6/9/38 5 5,750 - 44 Maze Pond, No. 2 11/10/38 25,516 2 The following areas were declared by the Council, and the particulars of these are shown hereunder:— Date declared by Council Area in sq. ft. (Approx.) No. of dwelling houses Population Title of Clearance Area Families Persons Wolseley Buildings 35,700 188 180 757 24/5/38 Staples Rents, No. 1 and lands adjoining 20,981 30 41 157 26/7/38 Staples Rents No. 2 and lands adjoining 33,550 22 35 134 26/7/38 Staples Rents, No. 3 1,452 4 3 18 26/7/38 Staples Rents, No. 4 26/7/38 3,272 5 5 23 Enid Street and lands adjoining 276,536 178 326 1,049 27/9/38 Tiger Bay 850 2 2 9 27/9/38 Maze Pond, No. 2 22/11/38 20,100 46 61 223 Rotherhithe Street, Nos. 323—331 5,750 5 6 20 22/11/38 (50) The clearing of these areas will necessitate the demolition of 480 houses and the rehousing of 659 families, consisting of 2,390 persons. The housing activities of the Council have been continued as in the past, and 555 flats and 6 shops were erected during 1938. Particulars of these are given hereunder Number of Dwellings Position Adams Gardens Estate 16 flats 109 flats Arnold Estate Aylton Estate 17 flats Dhonau Estate 16 flats Holyoake House 1 flat Kirby Estate 70 flats and 1 shop 16 flats Lynton Estate 82 flats Meakin Estate 114 flats Neckingr Estate 15 flats Rotherhithe Street, Nos. 66 6—694 Redriff Estate 42 flats 13 flats and 4 shops Snowsfields Stansfeld Estate 22 flats 21 flats and 1 shop St. Mary's Estate Tyers Eatate 1 flat At the end of the year 1938, the following dwellings were in course of erection by the Council: — Position Number of flats and shops 1 flat Arnold Estate, Block 5 Arnold Estate, Block 2 62 flats and 3 shops 15 flats Arnold Estate, Block 4 40 flats and 2 shops Arnold Estate, Block 6 Arnold Estate, Block 7 43 flats Prospect Street, Block 1 3 flats and 2 shops Prospect Street, Block 2 49 flats 37 flats Neckinger Estate, Block 1 Lynton Mews, Block 1 5 flats Elephant Lane Site, Block 1 37 flats Alice Street, Block 2 24 flats Redriff Estate, Block 9 11 flats and 1 shop Sards Rents, Block 2 41 flats and 2 shops 31 flats Stansfeld Estate Extension Cherry Garden Street, Block 4 15 flats Kipling Street Site, Block 2 40 flats and 2 shops Private enterprise has been responsible for the erection of 12 flats. Altogether, therefore, 567 flats and 6 shops were erected in Bermondsey during the year. The houses demolished on insanitary areas number 541, and 14 houses have been demolished following the service of Demolition Orders. HOUSING ACT, 1936—OVERCROWDING. The following was the position at the end of 1938 in relation to overcrowding:— (a) (i) Number of dwellings overcrowded at the end of the year 1953 (ii) Number of families dwelling therein 1,953 (iii) Number of persons dwelling therein 11,647 (b) Number of new cases of overcrowding rereported during the year 311 (c) (i) Number of cases of overcrowding relieved during the year 931 (ii) Number of persons concerned in such cases 5,177 (d) No cases came to my notice during 1938 of dwelling houses again becoming overcrowded after the Local Authority had taken steps for the abatement of overcrowding. (e) Five cases of overcrowding were reported, in which I considered it necessary to take action. In two of these cases the accommodation offered had been refused. Notices under the Public Health (London) Act, 1936, were served in four instances, and one Summons was taken out in connection with a serious case, the tenant being rehoused finally by the Borough Council. As the appointed day, under the Housing Act, 1936, was fixed for October Ist, 1938, no further action has been taken in consequence, although another one of the families concerned has removed to other premises and abated the overcrowding. Thirty-eight cases of overcrowding in London County Council dwellings in Bermondsey have been abated, and nineteen cases in Borough Council dwellings; 136 cases have been relieved in connection with slum clearance operations. These cases are included in (c) (i) above. ERADICATION OF BED BUGS. As I stated in my last report, the use of Cimex-Azet Phume as a fumigant has been discontinued: for various reasons it has not been deemed advisable to use either H.C.N, or Heavy Naphtha and we have been thrown back upon the use of Sulphur Dioxide Gas. In a considerable proportion of the cases dealt with, however, we have used a proprietory agent, " Pyagra," applied by means of an electric sprayer, and this has given satisfactory results. This work is carried out by the staff of the Public Health Department, and the Senior Inspector, Mr. Davis, has himself devoted much of his time to the supervision of this work recently. The premises occupied by families who have been accepted as tenants for any of the Council's properties are inspected before removal. Where infestation is discovered fumigation of the house and effects is insisted upon before removal to a Council flat is permitted. Wherever vermin are discovered the Inspector is required as part of his duty to explain to the tenant the importance of preventing infestation and the means to be adopted by himself for this purpose. In addition, illustrated lectures are given upon this subject during the summer months. The following table shows the fumigations carried out during 1938 :— Infested Disinfested Council flats or houses 286 286 Council houses on Insanitary Areas during decanting 449 449 London County Council Removals 15 15 Houses disinfested prior to demolition — 380 Other houses or flats 96 96 INSPECTIONS. PROCEEDINGS, ETC. Hereunder will be found particulars of Inspections, Proceedings, etc., for the year 1938: — Inspection of Dwelling Houses during the Year:— Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 7,783 (6) Number of Inspections made for the purpose 39,727 (2) (a) Number of dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 3,877 (b) Number of Inspections made for the purpose 4,965 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 538 (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 828 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 2,887 Action under Statutory Powers during the Year: — (A) Proceedings under Sections 9, 10 and 16 of the Housing Act, 1936:— (1) Number of dwelling-houses in respect of which notices were served requiring repairs 828 (2) Number of dwelling-houses which were rendered fit after service of formal notices:— (a) By owners 930 (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 4,378 (2) Number of dwelling-houses in which defects were remedied after service of formal notices: — (a) By owners 1,491 (b) By Local Authority in default of owners Nil (C) Proceedings under Sections 11 and 13 of the Housing Act, 1936:— (1) Number of dwelling-houses in respect of which Demolition Orders were made 14 (2) Number of dwelling-houses demolished in pursuance of Demolition Orders 14 (D) Proceedings under section 12 of the Housing Act, 1936: — (1) Number of separate tenements or underground rooms in respect of which Closing Orders were made 6 (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit 1 Total number of houses in the Borough 19,559 Number of houses occupied by the working classes 19,415 REGISTERED PREMISES — Number on Register at end of 1938 Number of Inspections Premises Number of Prosecutions Common Lodging Houses 3 53 - Seamen's Lodging Houses 4 33 - Milkshops 256 575 - Houses let in lodgings 2,510 1,020 - Ice Cream Premises 253 - 175 - 206 Offensive Trades (including Poultry Slaughter-houses) 14 SMOKE NUISANCES— Number of observations 221 Number of notices 17 Number of complaints 12 Number of summonses 1 WATER SUPPLY TO TENEMENT HOUSES— Premises supplied 42 Prosecutions Nil SALE OF FOOD— Number of premises used other than ice-cream premises, milk shops and cowsheds 620 Number of inspections 1,975 RAG FLOCK ACT, 1911 AND PUBLIC HEALTH (LONDON) ACT, 1936:— There are four premises in the District where rag flock is used and nine inspections were made during the year. Ten samples of rag flock were taken, eight of which conformed with the regulations. The two remaining samples, which were taken from a man who did not usually use rag flock, were found to contain 240 parts and 112 parts per 100,000 of soluble chlorine respectively, but as it was doubtful whether the samples came strictly under the definition of rag flock, being a mixture of rag flock and hair, proceedings were not taken. A warning was sent to the vendor, who destroyed the remainder of the flock which was on his premises. RATS AND MICE (DESTRUCTION) ACT, 1919— No 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 42 tenement houses, after service of notices. WATER CLOSET ACCOMMODATION— Every inhabited house in the borough has one water-closet, which is, in many cases, shared by two or more families. Many of the flats have one water-closet to two families. SCHOOLS— The sanitary accommodation in each of the schools has been inspected twice during the year, and found to be satisfactory. SWIMMING BATHS AND POOLS. The swimming baths under the control of the Bermondsey Borough Council are four in number, two being at Central Baths, and two at Rotherhithe Baths. The baths at Central Baths are, 1st class, 124,000 gallons capacity, and 2nd class, 85,000 gallons. The Rotherhithe Baths have a capacity of 80,000 gallons each. No filtration plant is used. The baths are frequently emptied, the sides and bottoms thoroughly cleansed and the baths re-filled with water from the supplies of the Metropolitan Water Board. The Baths Committee and Council place no restrictions whatever on the amount of water used and the frequency with which the water is changed secures a high standard of cleanliness. The water in all four baths is chlorinated by the addition of liquid chlorine (sodium hypochlorite) to the extent of about .5 parts per million, and this is maintained at all times. There is also an Open-Air Swimming Pool in Southwark Park, which is under the control of the London County Council The Pool has a capacity of 360,000 gallons, and accommodation for 500 persons. The average number of swimmers is 58,500 per annum. The water is aerated and chlorinated through a chlorine gas filter, the whole passing through in eight hours. WORK OF DISTRICT INSPECTORS, 1938. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 House-to-House Complaints Infectious Diseases Offensive Trades Outworkers' Bi-Annual Inspection Underground Conveniences Drains Tested Other Calls and Visits Chimneys watched Bakehouses Common and Seamens Lodging Houses Fishmongers, Friers and Curers Food Stores Fruiterers and Greengrocers Ice Cream Markets Restaurants and Eating Houses Destruction of Food Various TOTALS Factories & Workshops Specially Inspected Special Inspections Butchers Visits Ints. District No. 1 505 1223 381 69 - - 14 - 21 1995 8 20 16 5 10 8 9 55 14 2 - 4380 25 380 „ No. 2 454 593 394 51 - - 28 - 34 3674 26 16 29 15 82 32 23 37 - - 5563 75 770 - „ No. 3 579 1533 502 148 - - 2 - 65 3757 37 15 10 41 35 48 23 7 74 17 - - 6893 652 „ No. 4 377 982 228 118 - - 22 - 26 2723 16 9 - 14 5 30 9 18 97 12 - - 4686 704 No. 5 339 860 344 102 - - 33 - 32 3539 46 20 6 51 54 73 22 37 87 53 4 5702 - 629 „ No. 6 442 719 611 108 - - 44 - 34 3183 17 24 25 8 17 89 16 28 78 18 1 1 5443 775 „ No. 7 648 1012 362 110 2 - 36 - 21 3135 17 10 1 36 14 96 23 10 52 35 1 - 5621 715 „ No. 8 533 952 306 72 3 1 52 - 5 2454 37 37 28 29 10 34 4 27 344 22 6 1 4957 578 3877 7874 3128 778 5 1 231 238 204 151 86 213 457 137 159 862 208 14 2 43245 5203 24460 160 - Total FACTORIES, AND OTHER PREMISES. HOMEWORK. NATURE OF WORK (1) Outworkers' Lists, Section 110 Outwork in Unwholesome Premises Section, 111 Lists received from Employers Outworkes resident in Bermondsey received From other Districts Notices served on Occupiers as to keeping or sending lists (8) Prosecutions Notices nerved (12) Instances (11) Prosecutions (13) Outworkers Lists (2) Failing, to keep lists (9) Failing to send lists (10) Resident in Bermondsey Resident in other Districts (5) Contractors (3) Workmen (4) Contractors (6) Workmen (7) Wearing Apparel:— I I I I .. I .. I [ . I . (1) Making, etc. 18 42 49 1 48 11 - 11 11 - - - (2) Cleansing and washing - - - - - - - - - - - - Fur pulling - - - - - - - - - - - - Umbrellas, etc. - - - - 2 - - - - - - - Sacks 8 - 12 8 - - 3 - 1 1 - - Paper, etc., Boxes, Paper Bags 2 - 6 4 - 6 2 - - 4 4 - Brush making - - - - - 3 - - - - - - Combs, etc. - - - - - - - - - - - - 3 Leather Goods 4 - 1 7 - - - - - - - Surgical Instruments 2 - 2 - - - - - - - - - Coathangers 2 - 13 - - - 7 7 10 8 2 - Carding of buttons, etc - - - - - 18 - - - - - - Onion Peeling - - - 2 - - - - - - - - Games and Toys - - - - - - - - - - - - Artificial Flowers - - - - - - - - - - - - Total 36 - 71 83 1 87 21 - - 23 23 - FACTORIES AND OTHER PREMISES. INSPECTION. Number of Premises Written Notices Occupiers Prosecuted Inspections Factories with mechanical power 5,612 64 Factories without mechanical power - 2,806 38 Other Premises under the Act (including works of building and engineering construction but not including outworkers' premises) - - 1,150 - - Total 9,568 102 DEFECTS FOUND. Number of defects in respect of which Prosecutions were instituted Number of Defects Particulars Found Remedied Referred to H.M. Inspector Want of Cleanliness (S.1.) 24 - 24 - Overcrowding (S.2.) - - - - 3 - Unreasonable Temperature (S.3 ) 3 - Inadequate Ventilation (S.4.) 6 6 - - Ineffective Drainage of Floors (S.6.) - - - - Sanitary Conveniences (S.7.) — Insufficient 2 - - 2 Unsuitable or Defective 43 43 - - Not separate for Sexes - 24 - - Other Offences (Not including offences relating to Home Work or offences under the Sections mentioned in the Schedule to the Ministry of Health (Factories and Workshops Transfer of Powers) Order, 1921, and re-enacted in the Third Schedule to the Factories Act, 1937) - 24 1 Total 102 102 1 - (60) BAKEHOUSES. The underground bakehouses in the borough were the subject of a report submitted to the Council on the 24th May, 1938. It was the view of the Council that none of these underground bakehouses could be made reasonably fit for use, and in accordance with the terms of the Act, notice was served on the owners that the bakehouses must in 5 cases be closed by December 31st, 1939, and in 8 cases by December 31st, 1942. In Use Not in Use Underground Above ground Above ground Underground 13 35 5 3 37 of these are Factory Bakehouses HOUSE, TRADE AND MARKET REFUSE. The following table shows the amount of house, trade and market refuse disposed of during 1938: — Disposal Loads tons cwts. qrs. House Refuse to Barge 17,481 20,637 9 0 Trade Refuse „ Barge 3,210 2,412 18 3 Street Markets Refuse to Barge 2,417 2,243 6 3 Totals 23,108 25,293 14 2 OFFENSIVE TRADES. The offensive trades on the Register are as follows: Fellmongers 3 Fatmelters 1 Glue and size makers 3 Dresser of Fur Skins 7 MORTUARY. The Public Health (London) Act, 1936, Section 234, requires the Borough Council to provide a proper place for the reception of dead bodies before interment. The London County Council acts as agent for the Borough Council in this matter and receives into the mortuary at St. Olave's Hospital those bodies for which it is the duty of the Borough Council to provide. A fee of one guinea per body is paid by the Borough Council for this service. Number of infectious bodies removed Nil Total number of bodies removed 22 STREET MARKETS. The market scheme continues to work smoothly and satisfactorily. Number of Licences in operation 465 Income £2,892 5s. 0d. There have been 9 prosecutions during the year. DRAINAGE WORK. Hereunder will be found particulars of drainage work, carried out by the Drainage Inspector during 1938: — Drains Tested 636 Visits to Underground Conveniences 377 Other Visits 3,014 WORK OF THE FACTORIES AND SHOPS INSPECTOR. Shops. Visits 1,232 Notices served under Shops Act, 1934 13 Notices served under Public Health (London) Act, 1936 28 Factories. Visits 927 Notices served 60 Workshops. Visits 539 Notices served 38 Visits to Offensive Trade premises 205 Various Visits 249 Chimneys watched 17 Drainage Visits 132 X—FOOD CONTROL. In January 1938, a District Sanitary Inspector had occasion to visit a food shop and found evidence of rat infestation. Some of the food bore evidence of being fouled by rats and the Inspector seized a quantity of butter beans, haricot beans rice, dried peas and packets of salt; the total weight being about ten cwt. The food was examined by the Magistrate that afternoon, and again upon the following morning, and a destruction order was granted. Legal proceedings were taken against the proprietors of the shop and the Magistrate inflicted a penalty of £21 with €2 costs. In August, 1938, another of the District Sanitary Inspectors upon receipt of a complaint visited a food shop and seized 15 tins of Herrings in Tomato Sauce. He also seized 20 tins of the same type at a stall in one of the street markets which was connected with the shopkeeper. These 35 tins were examined by a magistrate, and a destruction order was granted. Legal proceedings were taken against the shop-keeper and his supplier. The summons against the shopkeeper was withdrawn and that against the wholesaler was withdrawn upon payment of £3 3s. costs. PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1925, 1933 and 1937. One hundred and one samples have been taken during the year by the Wharves Inspectors. Of this number five samples were submitted to ascertain the composition, four to ascertain the composition and for the presence of preservative, 18 for the presence of preservative, ten for the presence of preservative and metals, one to ascertain the composition and whether contaminated, and the remaining 63 for the presence of metals. In addition, one sample of Beer was taken for bacteriological examination. PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1925, 1933 & 1937 Article Examined No. of Samples Purpose of Examination Result Action Anchovies in Oil (Italy) 2 For metallic contamination or preservative Negative Released Anchovies, Filets (Italy) 1 Ditto Tin 0.5 grains per lb. Preservative absent Released Apfelkraut (Germany) 1 Ditto Tin .84 grains per lb. Copper 25 parts per million Copper 36 parts per million on dry substance Released Apples, Dried (U.S.A.) 1 For presence of preservative Sulphur Dioxide 480 parts per million Released Bacon Rind and Sacking 1 To ascertain the composition of brown stain Stain due to iron, possibly from paint or anti-rust composition Bacon trimmed and released Trimmings destroyed (64) Beans, Haricots, Verts. (Italy) 1 For metallic contamination Copper in liquid 10 parts per million Copper in Beans, 130 parts per million Copper on dry substance 975 parts per million Re-exported under guarantee Copper 5 parts per million Copper 73 parts per million on dry substance Released after correspondence with importer and assurance that more care was to be taken to ensure that vegetables which had not been sprayed with copper solution would be used for this country. Subsequent sample satisfactory 1 „ „ „ „ „ „ „ „ 1 Negative Released Beans, Haricots, Verts (Belgium) „ „ „ 1 PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1925, 1933 & 1937.-continued No. of Samples Purpose of Examination Result Article Examined Action Bitten Brisling (Denmark) 1 For presence of preservative Benzoic Acid 1,000 parts per million Correspondence with importer and Danish Authorities. Mistake made by shipper, this parcel intended for tropics, but sent here in error. Subsequent samples satisfactory Brisling in Oil (Denmark) 1 „ „ Negative Released Brisling in Tomato (Denmark) 1 „ „ „ „ Butter 1 To ascertain composition and whether contaminated Moisture 13.38% „ Curd 0.51% Salt 1.65% Butter Fat 84.46% Genuine Butter—no contaminating substances 1 For presence of preservative and to ascertain composition of crystals covering the casings Casings, Sheep No action No preservative Crystals consisted of common salt Cherries, Drained 1 Still under detention For metallic contamination Copper, 90 parts per million Copper 115 parts per million on dry substance „ „ „ „ „ „ 1 Copper 55 parts per million Copper 6O parts per million on dry substance 2 „ „ „ „ Copper 40 parts per million Copper 47 parts per million on dry substance Released with warning to importer „ „ 1 „ „ Copper 25 parts per million Copper 33 parts per million on dry substance Released „ „ 1 „ „ Copper 20 parts per million Copper 27 parts per million on dry substance „ „ „ „ 1 „ „ Copper 10 parts per million Copper 13 parts per million on dry substance „ „ PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1925, 1933 & 1937.—continued. Article Examined No. of Samples Purpose of Examination Result Action Cream, Pure Thick (Denmark) 1 For presence of preservative and in ascertain composition No preservative Fat 23.2% Released Label stated contents equals fresh cream, but fresh cream usually contains about 50 per cent. of fat. Agreement with Danish authorities for phrase "in richness equals fresh cream" to be deleted from future labels Curry Powder 4 For metallic contamination Lead 20 parts per million Released after correspondence and interview with importer Lead 18 parts per million „ „ 1 „ „ Lead 16 parts per million „ „ 1 „ „ Lead 12 parts per million Madras authorities to take action to ensure no further lead contamination „ „ 1 „ „ (66) 1 „ „ „ „ Lead 9 parts per million Egg, Albumen, Liquid For presence of preservative Negative 1 Released No action Egg Yolk (Chine) 1 „ „ „ Egg Yolk (Japan) 1 „ „ „ „ „ Baker's Emulsion 1 For presence of preservative and to ascertain composition No preservative Released Glucose 45% Invert Sugar 31% Ash 5% Fat 12% Protein 7% Fat 1 To ascertain composition Fat of vegetable origin, probably Palm Kernel Stearin „ Grapefruit 1 For metallic contamination Tin 0.61 grains per lb. „ Jam 1 For presence of preservative Negative „ Kipper Snacks 1 „ „ „ Danske Hummer (Lobster-Denmark) 1 For metallic contamination or preservative Copper 10 parts per million No preservative „ PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1925, 1933 & 1937.— continued. Article Examined No. of Samples Purpose of Examination Result Action For metallic contamination Negative No action Mackerel Fillet 1 Milk Powder 1 For presence of preservative and to ascertain composition No preservative Released Water 8.6% Fat 1.25% Protein 35.19% Lactrose 47.66% Ash 7.3% Milk, Full Cream condensed (Estonia) 1 To ascertain whether complied with standards Still under detention Deficient in fat „ „ 2 „ „ Satisfactory No action Mushrooms 1 For presence of preservative Negative Released Mustard, Prepared (Germany) 2 For metallic contamination and presence of preservative „ „ (67) Mustard 1 For metallic contamination Lead 2 parts per million Tin 0.3 grains per lb. „ 1 For metallic contamination and presence of preserva tive Released after warning to Importer „ No preservative Lead 4 parts per million „ 2 For metallic contamination Lead not exceeding 4 parts per million I Mandarin Oranges 1 Negative No action „ „ Paprika Powder 1 „ „ Copper 10 parts per million copper 11 parts per million on dry substance Released Paprika Powder (Without Capsicum) 1 Copper 10 parts per million Copper 11 parts per million on dry substance „ „ „ Passion Fruit juice For presence of preservative Sulphur Dioxide 175 parts per million A volatile acid expressed as Benzoic Acid-600 parts per million Benzoic acid probably natural to the fruit. Cranberries for instance contain in their natural state quite as much Benzoic Acid No Action 1 PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1925, 1933 & 1937. -continued. Article Examined No. of Samples Purpose of Examination Result Action Peas For metallic contamination Copper 50 parts per million Copper 5 parts per million in juice Copper 280 parts per million on dry substance Still under detention The importer desired to dispose of these for ships stores, but permission was refused 1 1 „ „ Zinc 14 parts per million Zinc 70 parts per million on dry substance Released after correspondence with Importer and upon receipt of guarantee that apparatus would be thoroughly overhauled „ Raisins 1 For presence of preservatives Sulphur Dioxide 795 parts per million Stopped for treatment and subsequently released 1 Sulphur Dioxide 480 parts per million „ „ „ „ „ Raspberry Pulp 1 „ „ Sulphur Dioxide 1,080 parts per million Released „ „ 1 „ „ Sulphur Dioxide 1,055 parts per million „ Salmon 1 For metallic contamination Tin .08 grains per lb. „ Salmon, Smoked Sea (Denmark) 1 For presence of preservative No preservative „ Salmon Substitute (Denmark) 1 For metallic contamination and presence of preservative No preservative. Lead 4 parts per million Released after correspondence with importer, shipper and Danish authorities. Thorough examination of plant and tins to be made Sardines For metallic contamination Negative No action 21 Seatax, smoked 1 For metallic contamination and presence of preservative „ Released Sild (Norwegian) 1 For metallic contamination Lead 2 parts per million Tin 0.4 grains per lb. „ „ „ 1 „ „ Lead 3 parts per million Tin 0.36 grains per lb. „ Silver Fish in Tomato (Japan) 1 „ „ Tin 0.15 grains per lb. „ „ „ 1 „ „ Tin 0.23 grains per lb. „ Spinach (Belgium) 1 „ „ Negative „ PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1925, 1933 & 1937.—continued. Article Examined No. of Samples Purpose of Examination Result Action Strawberry Pulp For presence of preservative Sulphur Dioxide 1,090 parts per million 1 Released „ „ 1 „ „ Sulphur Dioxide 2,000 parts per million „ 1 For metallic contamination Tomatoes, Peeled (Italy) Tin 0.57 grains per lb. Copper 15 parts per million copper 262 parts per million on dry substance Released alter correspondence with importer who had raised the matter with the Italian exporter and had been promised that all steps would be taken to eradicate future metallic contamination Tomato Catsup (U.S.A) 1 „ „ Copper 20 parts per million Copper 83 parts per million on dry substance Released after correspondence with Importer who had drawn attention of American packers to this metallic contamination Tomato Puree (U.S.A.) 1 „ „ Copper 10 parts per million Copper 98 parts per million on dry substance T omato Puree 1 „ „ Copper 10 parts per million Released „ „ 1 Copper 15 parts per million „ „ „ Tomato Puree (Hungary) 1 Copper 18 parts per million copper 54 parts per million on dry substance „ „ „ Tomato Preparation 1 „ „ Copper 20 parts per million copper 40 parts per million on dry substance „ SAMPLE EXAMINED FOR SPECIAL PURPOSES Beer 1 Bacteriological 11,520 orgnisms in l.c.c. at 37 degree centigrade UNSOUND FOOD. The general inspection of food in shops and on stalls forms part of the duty of the District Sanitary Inspectors. Food, in the quantities stated, came under the notice of the Inspectors during the year, and being found unfit for human consumption was destroyed. Weight Description of Food tons cwts. lbs. qrs. Cabbage - - 18 1 - Chickens - 14 - Corned Beef - - 1 16 Ducks - 1 1 - - Fresh Fish - 1 14 - Ham - 10 - - - - Oranges 8 - - - 5 Pickles - - 1 - Prawns - Rabbits - 3 - - 2 Roes 5 Total - 12 3 26 (70) WORK OF THE WHARF AND FOOD INSPECTORS, 1938. 4 5 6 7 8 9 10 11 12 1 2 3 Food Factories Number of Samples taken Fish Curers Food Stores Food Wharves and Depots Milksellers Pharmacy & Poisons Nuisances Found Intimations Served Various Ice Cream Premises Food and Drugs Imported Food Regulations Milk (Special Designation) Order Samples of Milk for presence of Tubercle Bacilli Ice Cream (Bacteriological Examination) Samples of Milk for presence of Bacillus Abortus Raw Sugar (Bacteriological Examination) Pharmacy & Poison Jam Butter and Margarine Other Destruction of Food - 3 46 - 73 522 - - 62 1 - - - - 2 - - - - - - 18 1 34 1 169 1886 - - 188 1 1 5 - - 27 - - - - - 26 7 193 3 215 1882 - - 275 5 2 54 - 61 - - - - - - 35 13 139 8 175 177 124 206 9 3 181 4 410 49 2 - 4 13 1215 11 1 - 5 - - 5 398 109 - - 112 1074 - 150 6 105 3 - 67 62 - 5572 575 731 16 6 302 116 101 199 8 105 MILK PREMISES. MILK AND DAIRIES (AMENDMENT) ACT, 1922. Thirty-six milk sellers were registered under the above Act during 1938, and forty were removed from the Register, making a total of 256 milk sellers on the Register at the end of the year under report. MILK (SPECIAL DESIGNATIONS) ORDER, 1936. During the year under report the following licences were granted:— Dealers' Licences. To bottle and sell Tuberculin Tested Milk 4 To sell Tuberculin Tested Milk 22 To sell Pasteurised Milk 24 Supplementary Licences. To sell Accredited Milk 1 To sell Pasteurised Milk 16 To sell Tuberculin Tested Milk 8 All premises used for the sale of milk are regularly inspected to ensure that the standard of cleanliness laid down is maintained. MILK SAMPLING. In addition to the samples of milk taken from registered milksellers, arrangements are made for the sampling of milk supplied to all schools in the borough, both for bacteriological and chemical analysis. Fifty-six samples of milk have been taken from schools, the total number submitted for examination being 729. For Chemical (i.e., Fat and non-Fatty Solids) Examination, Liquid Milk, undesignated 327 Liquid Milk, undesignated (informal) 3 Sterilized Milk 79 Tuberculin Tested Milk 5 Accredited Milk (informal) 2 Pasteurised Milk 24 Pasteurised Milk (informal) 55 Condensed Milk (informal) 19 Sterilized Milk (informal) 1 Buttermilk (informal) 1 Malted Milk 1 Malted Milk (informal) 1 518 (72) For Bacteriological Examination. Tuberculin Tested Milk 81 Tuberculin Tested (Pasteurised) Milk 7 Pasteurised Milk (from schools) 56 Pasteurised Milk (other than from schools) 53 For tubercle bacilli 8 For brucella abortus 4 Accredited 2 211 ICE CREAM. One hundred and sixteen samples of ice cream have been examined with the following results:— 1. Bacterial Count. Up to 100 per 1 c.c. 2 Over 100 to 500 per 1 c.c. 7 Over 500 to 1,000 per 1 c.c. 1 Over 1,000 to 5,000 per 1 c.c. 16 Over 5,000 to 10,000 per 1 c.c. 12 Over 10,000 to 50,000 per 1 c.c. 34 Over 50,000 to 100,000 per 1 c.c. 8 Over 100,000 to 200,000 per 1 c.c. 12 Over 200,000 to 400,000 per 1 c.c. 4 Over 400,000 to 600,000 per 1 c.c. 2 Over 600,000 to 1,000,000 per 1 c.c. 2 Impossible to count 4 "More than a million" 1 105 (73) 2. Presence of B. Coli. B. Coli present in 1 c.c., 1 /10th c.c., and 1/100th c.c. 20 B. Coli present in 1 c.c., and l/10th c.c. 15 B. Coli present in 1 c.c. 11 B. Coli absent in 1 c.c., 1/10th c.c., and 1/100th c.c. 59 105 3. Chemical Analysis. Fat 0.70 per cent 1 Fat 2.55 per cent. 1 Fat 2.69 per cent. 1 Fat 2.84 per cent. 1 Fat 2.99 per cent. 1 Fat 4.08 per cent. 1 Fat 4.30 per cent. 1 Fat 6.49 per cent. 1 Fat 11.25 per cent. 1 Fat 11.82 per cent. 1 Fat 14.93 per cent. 1 11 PHARMACY AND POISONS ACT, 1933. Fifty-two premises were entered on the Council's list for the year under report; two premises were subsequently removed from the list. As a result of informal samples being purchased, it was found that five contraventions of the Act occurred, poisons being sold wrongly by both listed and unlisted vendors. Warning letters were sent in each case. (75) FOOD AND DRUGS. Articles submitted for Analysis Total Samples taken Percentages of Articles Adulterated Number Genuine Number Adulterated Acid Tablets 1 - - 1 Acid Tablets, Lemon 1 1 - - Almonds, Essence of (Informal) 1 1 - Almonds, Ground 6 6 - - - Almonds, Ground (Informal) 2 2 - - Almonds, Ground Substitute (Informal) 1 1 - - Ammoniated Tincture of Quinine 3 3 - Apricots, Tinned (Informal) - 1 1 - - Arrowroot 1 1 - 3 3 - - Aspirin Tablets - 1 1 - Barley Sugar - Barley, Pearl 6 6 - - Barley, Pearl (Informal) 1 1 - - Bailey, Pot 1 1 - - Bay rum 1 1 - - Beef Cubes (Informal) 2 2 - - Beer 3 3 - - Beer (Informal) 1 1 - - Bicarbonate of Soda (Informal) 2 2 - - Bismuth indigestion Tablets 1 1 - - Boracic Crystals 1 1 - - Boracic Powder 2 2 - - Brawn 9 9 - - Brawn, Pork 1 1 - - Brawn, Veal 3 3 - Brisling (Informal) - 1 1 - - Butter 56 56 - - Butter (Informal) 2 2 - - Cakes, Sponge 5 5 - - Calamine Lotion (Informal) 2 2 - - Calf's Foot Jelly 1 1 - - Calf's Foot Jelly (Informal) 1 1 - - Candied Peel 1 1 - Capers, French (Informal) - 2 2 - - Caraway Seeds (Informal) 1 1 - - Cascara Sagrada Tablets 1 1 - - Cheese 10 10 - - Cheese (Informal) 2 2 - - Cheese, Cheddar in Foil 1 1 - - Cheese, Cheddar in Foil (Informal) 2 2 - - Cheese, Dutch 3 3 - Cheese, Edam - 1 1 - Cheese, Full Cream - 1 1 - - Cheese, Goreonzola 1 1 - - Cheese, Lemon (Informal) 1 1 - - Cheese, in Foil - 1 1 - Cheese, in Foil (Informal) 3 3 - Cherries, glace - 1 1 - - Cherries, Glace (Informal) 2 2 - - Cherries, Preserved (Informal) 1 1 - Chicken and Ham Roll - 2 2 - - Chutney (Informal) 1 1 - - Chutney, Indian (Informal) 1 1 - - (76) FOOD AND DRUG— continued. Articles submitted for Analysis Total Samples Taken Number Genuine Number Adulterated 2 Clear Mints 2 - Cocoa 1 1 - Cocoa (Informal) 4 4 - 2 Cocoanut, Dessicated 2 - Cod Liver Oil and Emulsion 1 1 - Coffee 1 1 - Coffee (Informal) 1 1 - Coffee, Pure 1 1 - Coffee, French 1 1 - Coffee, French (Informal) 1 1 - 2 Coffee and Chicory Essence 2 - Coffee and Chicory Extract 1 1 - Coffee and Chicory Extract (Informal) 2 2 - Confectionery (Informal) 1 1 - 1 1 Cookeen - Cooking Fat 6 6 - 1 1 Cooking Fat (Informal) - 1 Cordial, Lime Juice 1 - Cordial, Raspberry Flavour 1 1 - 2 2 - Corned Beef Corned Beef (Informal) 1 1 - Crab, Dressed (Informal) 2 2 - Cream 1 1 - Cream, Fresh (Informal) 1 1 - Cream Slice, French (Informal) 1 1 - 1 Cream, Thick (Informal) 1 - Cream, Tinned (Informal) 10 10 - Currants 2 2 - Curry Powder 4 4 - 1 1 Custard Powder - Dripping 58 58 - 2 2 Dripping (Informal) - Dripping, Pork 1 1 - Egg Loaf 1 1 - 1 1 Egg Substitute - Egg Substitute (Informal) 1 1 - Eggs, Preserved 2 2 - 1 Epsom Salts 1 - Eucalyptus, Oil of (Informal) 1 1 - Figs, Dried 1 1 - Flour 2 2 - Flour, Pea 1 1 - Flour, Self-Raising 16 16 - Flour, Self-Raising (Informal) 1 1 - Gelatine (Informal) 1 1 - Gin 1 1 - 1 Ginger Beer 1 - Ginger, Ground 1 1 - Glycerine 2 2 - 1 1 - (77) FOOD AND DRUGS—continued Total Samples Taken Number Genuine Number Adulterated Percentages of Article Adulterated Articles submitted for Analysis - Glycerine, Lemon and Ipecac. Mixture (Informal) 1 1 - Glycerine of Thymol, Compound 2 - 2 - 1 - Grapes 1 - Herrings in Tomato Sauce, Canned (Informal) 1 - - 1 Honey 2 2 - - Honey (Informal) 4 4 - - Horseradish Cream (Informal) 1 1 - - Horseradish, Shredded (Informal) 1 1 - - 2 Hydrogen Peroxide 2 - - Ice Cream (Informal) 11 11 - - Ice Cream Mix 1 1 - - Influenza Mixture 1 1 - - Iodine 1 1 - - Iodine, Tincture of 2 2 - - Jam, Apricot 4 4 - - Jam, Black Currant 10 10 - - Jam, Plum 2 2 - - Jam, Plum, Red 5 5 - - Jam, Stoneless Plum 2 2 - - Jam, Quince (Informal) 1 1 - - Jam, Raspberry 17 17 - - Jam, Raspberry (Informal) 2 2 - - Jam, Strawberry 14 14 - - Jam, Strawberry (Informal) 2 2 - - Jelly, Apple 1 1 - - Jelly, Lemon 1 1 - - Jelly, Orange 2 2 - - Jelly, Orange (Informal) 1 1 - - Jelly, Raspberry 2 2 - - Jelly, Raspberry (Informal) 1 1 - - 3 Jelly, Strawberry Table (Informal) 3 - - Jelly, Table (Informal) 1 1 - - Jelly, Wincarnis (Informal) 1 1 - - Lard - 15 15 - Lard (Informal) 1 1 - - Lemon Barley Water 1 1 - - 2 Lemonade 2 - - Lemonade Powder 4 4 - - Lentils 1 1 - - Liniment, Mustard 1 1 - - Liniment, Wintergreen 1 1 - - Lozenges, Brompton 2 2 - - Lozenges, Linseed, Liquorice and Chlorodyne - 1 1 - Macaroni 2 - 2 - Malt, Extract of, with Halibut Liver Oil (Informal) 1 - 1 - Magnesia, Citrate of 3 3 - - (78) FOOD AND DRUGS—continued Total Samples Taken Number Genuine Number Adulterated Percentage of Articles Adulterated Articles submitted for Analysis 37 Margarine 37 - - - Margarine (Informal) 1 1 - Marmalade 3 3 - - Marmalade (Informal) 1 1 - - Marmalade, Ginger 2 3 1 66.66% 3 2 Medicinal Liquid Paraffin 3 - Medicinal Liquid Paraffin (Informal) 1 1 - - Milk 327 322 153% 5 Milk (Informal) 3 1 2 66.66% 2 Milk, Accredited (Informal) 2 - - 19 19 Milk, Condensed (Informal) - - Milk Multed 1 1 - - Milk Malted (Informal) 1 1 - - Milk Pasteurised 24 24 - - Milk Pasteurised (Informal) 55 55 - - Milk, Sterilised 79 79 - - Milk, Sterilised (Informal) 1 1 - - 3 2 40.00% Milk Tuberculin Tested 5 Buttermilk (Informal) 1 1 - - Mincemeat 5 5 - - 1 1 Mineral Water, Cream Soda - - Mineral Water, Cream Soda (Informal) 1 1 - - Mineral Water 1 1 - - Mineral Water (Informal) 2 2 - - 1 Mineral Water, Zesto 1 - - Mint, Dried 2 2 - - Mint, Dried (Informal) 2 2 - - 1 Mint jelly (Informal) 1 - - Mints 3 3 - - Mustard 5 5 - - Mustard, Compound (Informal) 2 2 - - Mustard, Dutch Table 1 1 - - Mustard, Prepared 1 1 - - Nutmeg, Ground (Informal) 1 1 - - Oats, Quick 1 1 - - 2 2 Oats, Rolled - - Oil, Castor 2 2 - - Oil, Castor (Informal) 1 1 - - Oil, Cod Liver and Malt Extract 3 3 - - 2 Oil, Cod Liver 2 - - 1 Oil, Frying 1 - - Oil, Lucca 1 1 - - 3 3 Oil, Olive - - Oil, Olive (Informal) 2 2 - - 1 1 Ointment, Basilicon - - Ointment, Boracic 2 2 - - Ointment, iodine (Informal) 1 1 - - Ointment, Sulphur 2 2 - - 1 1 Ointment, Sulphur (Informal) - - 1 1 Ointment, Wintergreen - - Ointment, Zinc 3 3 - - 1 Orange, Juice 1 - - 1 1 Orange Juice, Sweetened (Informal) - - (79) FOOD AND DRUGS —continued Total Samples Taken Percentages of Articles Adulterated Articles submitted for Analysis Number Genuine Number Adulterated 1 1 Orange Squash - - Paloney, Chicken and Ham 1 1 - - Parsley, Dried 1 1 - - Passion Fruit Juice (Informal) 1 1 - - Paste, Anchovy 1 1 - - Paste, Bloater 1 1 - - Paste, Bloater (Informal) 2 2 - - Paste, Chicken and Ham 1 1 - - Paste, Chicken and Ham (Informal) 1 1 - - Paste, Crab (Informal) 1 1 - - Paste, Crab and Lobster (Informal) 1 1 - - Paste, Fish 2 2 - - Paste. Lobster (Informal) 2 2 - - Paste, Salmon and Shrimp 2 2 - - Paste, Salmon and Shrimp (Informal) 3 3 - - Paste, Sardines and Tomato (Informal) 1 1 - - Parrish's Chemical Food 3 3 - - Peas, Dried Blue 1 1 - - Peas, English Green (Informal) 1 1 - - Peas, Tinned (Informal) 8 8 - - 23 Pepper 23 - - Pepper (Informal) 4 4 - - Pickle, Sweet (Informal) 1 1 - - Pickle, in Vinegar (Informal) 1 1 - - Pickle (Informal) 1 1 - - Pie, Pork 1 1 - - Prunes, Dried 1 1 - - Padding, Black 4 4 - - Pudding Mixture (Informal) 1 1 - - Puff Paste 1 1 - - Raspberries, Tinned (Informal) 1 1 - - Rennett, Essence of 1 1 - - Rice 10 10 - - Rice, Creamed ( Informal) 1 1 - - Rice, Flaked 2 2 - - Rice Ground 1 1 - - Rum (Informal) 1 1 - - Sago 1 1 - - Salmon (Informal) 5 5 - - Salmon, Pink (Informal) 1 1 - - Salts, Glauber 3 3 - - Sandwich Spread (Informal) 1 1 - - Sardines (Informal) 5 5 - - 3 3 Sauce - - Sauce (Informal) 3 3 - - Sauce, Chop (Informal) 3 3 - - Sauce, Mint (Informal) 6 6 - - Sauce, Tomato 1 1 - - Sauce, Tomato (Informal) 2 2 - - Sauce, Worcester 1 1 - - Sauce, Worcester (Informal) 1 1 - - Sausage, Breakfast 10 10 - - (80) FOOD AND DRUGS— Continued Articles submitted for Analysis Total Samples Taken Percentage of Articles Adulterated Number Adulterated Number Genuine Sausages - 5 5 - Sausages, Beef 50 50 - - Sausages, Cambridge 2 2 - - Sausages, Chipolata 4 4 - - Sausages, Devonshire 2 2 - - Sausages, Luncheon 3 3 - - Sausages, Parisien 1 1 - - Sausages, Pork 14 14 - - Sausages, Pork and Veal 1 1 - - 1 1 Semolina - - Semolina (Informal) 3 3 - - Sherbet 1 1 - - Shortening 3 3 - - 1 1 Shortening (Informal) - - Soup Mixture 1 1 - - Soup, Oxtail (Informal) 1 1 - - 1 1 Spice, Mixed (Informal) - - Sponge Mixture 1 1 - - Sponge Roll, Chocolate 1 1 - - 2 2 Stout - - Stuffing, Sage and Onion 4 4 - - Stuffing, Sage and Onion (Informal) 1 1 - - Stuffing, Veal 1 1 - - 1 Stuffing, Veal (Informal) 1 - - Suet, Chopped 5 5 - - Suet, Shredded 15 15 - - 1 1 Suet, Shredded (Informal) - - Suet, Shredded Beef 1 1 - - 2 2 Sugar - - 1 1 Sugar, Icing - - Sugar, Yellow 1 1 - - Sulphur and Yeast Tablets (Informal) 1 1 - - Sulphur Tablets, Compound 1 1 - - 1 Syrup, Golden (Informal) 1 - - Syrup of Figs 1 1 - - Syrup of Figs, Compound 1 1 - - Tapioca 5 5 - - Tapioca (Informal) 1 1 - - Tapioca, Flaked 2 2 - - Tea 8 8 - - Tomatoes, Tinned (Informal) 1 1 - - Tonic, Orange Quinine 1 1 - - Tooth, Essence (Informal) 1 1 - - Treacle, West Indian 1 1 - - Turtle Jelly 1 1 - - 2 2 Veal, Jellied - - Veal and Ham Roll 1 1 - - Vitacup 1 1 - - 56 Vinegar 56 - - Vinegar (Informal) 3 3 - - 3.22%, Vinegar, Malt 31 30 1 Vinegar, Malt (Informal) 4 4 - - Vinegar, Table (Informal) 1 1 - - FOOD AND DRUGS —Continued Total Samples Taken Percentages of Articles Adulterated Articles submitted for Analysis Number Genuine Number Adulterated - Wafer Oats 1 1 - 1 Whisky (Informal) 1 0 100.00% Wine, Australian (Informal) 1 1 - - - Wine, Ginger 3 3 - Wine, Ginger, Essence 1 1 - - 1 Wine, Red 1 - - 1 - Wine, Red Australian (Informal) 1 - - 2 2 - Wine, Red, Port Type (Informal) 1 1 - Wine, Ruby (Informal) - 13 0.876% Total 1,484 1,471 PROSECUTIONS IN CONNECTION WITH SAMPLES TAKEN DURING 1938. Adulteration or or Infringement No. Sample Remarks 182 Milk Soiling Milk 2.7% deficient in milk fat Fine £1 Costs £2 2s. Selling Milk 18.3% deficient in milk fat Selling Milk 30.0% deficient in milk fat 203 Milk Fine £l Costs £3 3s. Fine £1 Costs £3 3s. 216 Milk SUMMARY. £ 8. d. Fines 3 0 0 Costs 8 8 0 £11 8 0 PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1925 1933 & 1937. Quantity Unsound Exported Disposed of for Purposes other than Human Food Destroyed Removed for Sorting under S.A. Articles Quantity Weight Quantity Weight Quantity Weight Quantity Weight MEAT. • tons CWt qr lbs. tons cwt qr lbs tons lbs cwt qr tons cwt qr lbs Beef Various - - - - - 1 1 12 - - - - - - - - - - - 16 Corned 1,025 tins 2 4 0 832 tins 1 6 1 11 - - - - - - - - - - 1,830 bungs, 10 0 0 402 bungs - Casings - 7 0 0 2 casks 1 middle 0 17 8 runners 1 0 - - - - - 9 casks 5 cap end - - - - - - Tongue Roots 141 bags 3 10 2 0 - - - - - - - - - 15 Veal, Jellied 152 tins 8 0 14 65 cases 25 8 2 - - - - - - - - - - - 7,566 tins 29 tins - - - - - - - Veal, Cutlets - 2 1 4 - - - - - - - - FoLk 1 belly 1 carcase 7 sides 13 foreqtrs. - 1 4 2 8 - 3 legs - - - - - - - - - - - - - Bacon 7 sides 3 1 27 Various - 3 - 18 sides 12 2 5 - - - - - - - 22 Various 1 18 0 14 3 2 cases 4 27 Ham 4 cases 253 cases 13 3 0 0 - - - - - 880 tins 10 baskets - - 1 - 8 Pork, Jellied 6 tins - - - - - - - - - - - - - - Pork, Shoulders - - 35 tins - 2 3 0 - - - - - - - - - - - - - 4 Mutton - 3 19 - - 4 carcases - - - - - - - - - - - - - 73 tins - 0 0 Rabbits - - 5 crates 7 - - - - - - - - - - - - - Various Canned Meat Various 1 2 16 14 cases 1 27 Various 18 14 0 0 5 - - - - - - - 1 22 - Sausages, Salami - 2 cases 1 12 cases 12 0 0 - - - - - - - - - - - Sausages, Canned 14 tins 2 0 - - - - - - - - - - - - - - - - Sausages, Italian - - 1 basket - 1 0 0 - - - - - - - - - - - - - Sausages, Lunch - - - 7 tins - - - 21 - - - - - - - - - - - - PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1925 1933 & 1937-continued Quantity Unsound Destroyed Removed for Sorting under SA. Disposed of for Purposes other than Human Food Articles Exported Quantity Weight Quantity Quantity Weight Quantity Weight Weight tons lbs tons lbs cwt qr lbs I tons cwt qr - cwt qr tons cwt qr lbs 1 11 2 3 Tongues 203 tins 10 2 14 3 cases 501 tins 1 cask - - - - - 1 0 0 - Liver Paste 1 5 - 38 cases 282 tins 11 1,958 tins 17 2 20 3 - - - - - - - - - - 151 crates DAIRY PRODUCE - - 2 22 Cheese Various 7 11 0 0 - - - - - - - - - - 5,054 tins Eggs 130 5 3 2 - - - - - - - - - - - - - - - Lard Various 2,573 cases 409 tins 1 12 1 0 - - - - - - - - - - - - - - - Milk, Canned Various 2 3 12 - - - - - - - - - - - 35 2 2 10 FRUIT - Fresh and Canned 40 cases 14 Apples 1 6 - - - - - - - - - - - - - - - Apricots 1 tin - 0 16 - 2 cases - - - - - - - - - - - - - - 2 97 tins - Apricot Pulp 164 cases 11 2 20 casks - - 19 5 0 0 0 - - 4 - - - - 735 tins - Bananas 1 20 1 bundle - - - - - - - - - - - - - - - - Bilberries 13 tins - 6 - - - - - - - - - - - - - - - - - 31 tins - 3 Blackcurrants 0 0 - - - - - - - - - - - - - - - 5 0 Blackcurrant Pulp 64 tins - 15 - - - - - - - - - - - - - - - Cherries 16 cases - - - - - - - - - - - - - - - - - - - 761 tins 19 1 cask 3 19 - 1 - Citrons 18 casks 19 0 0 - - - - - - - - - - 0 - - - Dates Various 112 - - - 16 3 0 - - - - - - - - - - - PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1925, 1933 & 1937.— continued Quantity Unsound Articles Disposed of for Purposes other than Human Food Destroyed Removed for Sorting under S.A. Exported Quantity Weight Quantity Weight Quantity Weight Quantity Weight tons cwt lbs tons cwt qr lbs qr tons cwt qr lbs tons cwt qr lbs Figs - 1 case - - 1 1 9 - - - - - - - - - - - - - 4 tins Grapefruit - 123 cases 4 14 1 19 - - - - - - - - - - - - - - 12 tins 0 Grapefruit Juice - 1 case 1 0 - - - - - - - - - - - Grapes - - - - - 34 cases 1 4 2 2 - - - - - - - - - - - - - - 1 tin Lemons - 1,500 bags - - - - - - - - - - - - - - 253 cases 45 0 1 0 18 halfpipes - Lemon Juice 0 71 casks 31 9 0 - - - - - - - - - - - - - - - Melons 1 case 2 20 - - - - - - - - - - - - - - - - Oranges 8,233 cases - - - - - - - - - - - - - - - 42 packages 0 984 tins 329 14 21 Orange Pulp 1,543 tins 8 11 2 20 - - - - - - - - - - - - - - - 0 Peaches - 4 boxes 1 15 - - - - - - - - - - - - - - - 48 tins - Pears 292 boxes - - - - - - - - - - - - - - 58 tins 5 15 1 7 6 half barrels - Pineapple 86 cases - - - - - - - - - - - - - - - - - - 2,369 tins 3 12 6 1 Plums - 14 tins 1 0 - - - - - - - - - - - - - - - - Pulp 2 0 0 - - - - - 25 tins - - - - - - - - - - - Raspberries - - Various 5 6 2 1 - - - - - - - - - - - - - PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1925, 1933 & 1937-continued Quantity Unsound Articles Disposed of for Purposes other than Human Food Removed for Sorting under S.A. Destroyed Exported Weight Quantity Quantity Weight Weight Quantity Weight Quantity tons cwt qr lbs. tons cwt lbs tons cwt lbs qr tons cwt qr lbs qr Raspberry Juice 9 bottles 12 - - - - - - - - - - - - - - - - - - Raspberry Pulp 1 cask - - - - - - - - - - - - - - - 1 tin 4 0 12 - - Strawberry Pulp - 0 2 casks 3 0 - - - - - - - - - - - - - - 2 Tomatoes - 2,066 tins 1 11 18 - - - - - - - - - - - - - - Tomato Powder 2 tins - 20 12 cases 12 0 0 - - - - - - - - - - - - - Tomato Puree - 100 cases - - - - - - - - - - - - - - 2 1,619 tins 24 15 13 - Various, Canned 24 cases 17 0 16 - - - 1 - - - - - - - - - - - 800 tins DRIED - - Currants - - 400 boxes 5 0 0 0 - - - - - - - - - - - Various 3 Raisins 5 6 2 0 6 cartons 1 13 - - 0 - - - - - - - - CEREALS - Beans, Butter Various 50 0 0 0 - - - - - - - - - - - - - - Beans, Haricot 69 bags 5 11 0 8 - - - - - - - - - - - - - - - Beans, Soya Various 10 0 0 1 bag 1 2 0 - 0 - - - - - - - - - - 0 Biscuits 55 packages 2 0 0 - - - - - - - - - - - - - - - Barley Various 5 3 0 - - - - - - - - - - - - - - - Flour 9 bags 11 1 0 Various 2 15 555 bags 34 0 4 14 0 - - - - - - - 0 Macaroni 31 boxes 8 0 - - - - - 0 - - - - - - - - - - Maize Various 10 0 0 0 - - - - - - - - - - - - - - - Rice Various 8 16 3 21 Various 2 2 2 13 5 bags 5 1 18 - - - - - - Sago 30 bags 2 3 2 23 - - - - - - - - - - - - - - - Sugar Corn 26 tins 1 24 - - - - - - - - - - - - - - - - - Tapioca 2 6 0 20 28 bags - - - - - - - - - - - - - - - Wheat Various 143 11 2 0 - - - - - - - - - - - - - - - PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1925, 1933 & 1937—continued Quantity Unsound Articles Disposed of for Purposes other than Human Food Exported Destroyed Removed for Sorting under S.A. Quantity Weight Weight Quantity Weight Quantity Weight Quantity qr tons cwt lbs tons cwt qr lbs tons cwt lbs tons cwt qr lbs qr POULTRY Chickens 5 carcases 3 3 19 - - - - - - - - - - - - - - - - 1 case 304 tins - 1 10 Turkey 3 tins - - - - - - - - - - - - - - - - VEGETABLES Beans, Haricot Vert 1 case 1 0 0 40 eases 2 0 0 - - - - - - - - - - - Beans, Runner 319 crates 3 17 0 0 - - - - - - - - - - - - - - - 2 tins 1 14 Cucumbers - - - - - - - - - - - - - - - - - 10 casks 1 5 0 0 Gherkins - - - - - - - - - - - - - - - 22 tins Lettuce 112 crates 1 6 0 0 - - - - - - - - - - - - - - - 12 tins 6 Mushrooms - - - - - - - - - - - - - - - - - - 3,018 bags 119 19 Onions 100 bags 4 9 0 0 1 0 - - - - - - - - - - 1 keg Parsnips 150 bags 7 10 0 0 - - - - - - - - - - - - - - - 5 3 20 2 bags 1 20 Peas Various 3 - - - - - - - - - - - - Potatoes 33 boxes 15 0 0 8 1 0 0 - - - - - - 161 boxes - - - - - Vegetable Mixture 56 bags 2 16 0 0 - - - - - - - - - - - - - - - 24 tins 12 Vegetables, Various - - - - - - - - - - - - - - - - - FISH 1 tin 11 Anchovies - - - - - - - - - - - - - - - - - - 7 tins Brisling - 7 - - - - - - - - - - - - - - - - - Crab 1.190 tins 3 2 2 - - - - - - - - - - - - - - - - Lobster 10 tins 6 - - - - - - - - - - - - - - - - - - Pilchards 17 tins 14 - - - - - - - - - - - - - - - - - - Prawns 2 jars 1 3 0 26 - - - - - - - - - - - - - - - 133 cases 54 tins Salmon 21 - 18 cases 8 1 - - - - - - - - - - - - - - - 1,129 tins Sardines 9 tins 1 22 - - - - - - - - - - - - - - - - - 2 Sild 6 tins - - - - - - - - - - - - - - - - - - PUBLIC HEALTH (IMPORTED) FOOD REGULATIONS, 1925, 1933 & 1937—continued Quantity Unsound Exported Disposed of for Purposes other than human food Removed for Sorting under S.A. Destroyed Articles Quantity Weight Weight Quantity Weight Weight Quantity Quantity tons cwt qr lbs tons cwt qr ] lbs tons cwt qr -lbs cwt qr lbs tons NUTS J 3 Almonds 4 bags 5 0 - - - - - - - - - - - - - - - - - Cocoanut - 3 cases 3 0 0 - - - - - - - - - - - - - - 699 bags - Walnuts - 35 0 0 0 - - - - - - - - - - - - - - VARIOUS Canned Goods - Various 141 4 3 11 - - - - - - - - - - - - - Capers - - - barrel 1 0 - - - 0 - - - - - - - - - - Capsicum 1 - - - - 5 19 0 0 - - - - - - - - - - - - - - - 3 - - - Confectionery 1 case 0 - - - - - - - - - - - - 18 barrels 0 Fat 5 0 0 - - - - - - - - - - - - - - - 7 3 Gelatine 7 bags 2 15 Various 13 9 12 - - - - - - - - - - - Jam 2 tins - - - - - 4 - - - - - - - - - - - - - - 230 1 Sugar - - - - 2,727 bags 16 0 - - - - - - - - - - - Tallow - - - - - Various 3 2 0 28 drums 6 0 0 0 - - - - - Various 5 1 14 0 27 Various 6 24 2 0 Tea 1 Various 0 - - - - - - 955 - 326 1 3 5 - 30 12 2 0 0 10 5 Total - 415 10 3 7 - XI.—HEALTH SERVICES. MATERNITY AND CHILD WELFARE CENTRES Public Health Centre, Grange Road. Wednesday, 9.45 a.m.-12 noon Monday, 2.0 p.m.-4.30 p.m. Thursday, 2.0 p.m.-4.30 p.m. Wednesday, 2.0 p.m.-4.30 p.m. Ante-natal Clinic Tuesday, 2.0 p.m.-4.30 p.m. 98 Rotherhithe New Road, Tuesday, 9.45 a.m.-12 noon Wednesday, 2.0 p.m.-4.30 p.m. Friday, 2.0 p.m.-4.30 p.m. Ante-natal Clinic Tuesday 2.0 p.m.-4.30 p.m. Bermondsey Gospel Mission, 1-3, Jamaica Road. Monday, 2.0 p.m.-4.30 p.m. Friday, 2.0 p.m.-4.30 p.m. Manor Chapel, Roseberry Street. Monday, 2.0 p.m.-4.30 p.m. Community Centre, Redriff Estate. Thursday, 1.30 p.m.-4.0 p.m. Sewing Class Wednesday, 2.0 p.m.-4.30 p.m. Princess Club, Jamaica Road. Monday, 2.0 p.m.-4.30 p.m. Tuesday, 2.0 p.m.-4.30 p.m. Friday, 2.0 p.m.-4.30 p.m. Ante-natal Clinic Thursday, 2.0 p.m.-4.0 p.m. Sewing Class Wednesday, 2.0 p.m.-4.30 p.m. Alice Barlow House, Fulford Street. Thursday, 2.0 p.m.-4.30 p.m. Friday, 2.0 p.m.-4.30 p.m. Ante-natal Clinic Wednesday, 10.0 a.m.-12 noon. Central Hall, Bermondsey Street. Tuesday, Wednesday and Thursday, 2.0 p.m.-4.30 p.m. Sewing Class Friday, 2.0 p.m.-4.30 p.m. Toddlers Clinic First Friday in each month, 2.0-4.30 p.m. Salomons Centre, Newcomen Street. Monday 10.0 a.m.-12 noon and 2.0 p.m.-4.30 p.m. Thursday 2.0 p.m.-4.30 p.m. Ante-natal Clinics: — Monday, 9.30 a.m.-12 noon. Tuesday, 1.30 p.m.-4.30 p.m. Wednesday, 9.30 a.m.-12 noon. Friday, 9.30 a.m.-12 noon POST-NATAL AND SPECIAL CLINICS FOR WOMEN. Public Health Centre, Grange Road. Wednesday 5.0 p.m.-7.0 p.m. 98, Rotherhithe New Road. Monday 5.0 p.m.-7.0 p.m. CHILDREN'S CLINIC. Public Health Centre, Grange Road. Wednesday 2.0 p.m.-4.30 p.m. POST-INFECTIOUS DISEASE CLINIC. Public Health Centre, Grange Road. Wednesday 2.0 p.m.-4.30 p.m. RHEUMATISM CLINIC. Public Health Centre, Grange Road. Tuesday 2.0 p.m.-4.30 p.m. Evening Clinic once a month. PUERPERAL FEVER—CONSULTANTS. Mr. A. J. McNair, F.R.C.S., 9 Devonshire Place, W.l. (Telephone : Welbeck 6241.) Mr. G. F. Gibberd, F.R.C.S., 14 St. Thomas's Street, S.E.I. (Telephone : Hop 1010); and 20 Harley Street, W.l. (Telephone: Langham 4032.) Miss Gladys Dodds, F.R.C.S., 20 Upper Wimpole Street, W.l (Telephone: Welbeck 3640) and 27 Chenies Street Chambers, W.C.I. (Telephone: Museum 4659) Application should be made direct to the Consultant. OBSTETRIC CONSULTANTS. Mr. A. J. McNair, F.R.C.S., Mr. G. F. Gibberd, F.R.C.S:, and Miss Gladys Dodds, F.R.C.S., as above. Application should be made direct to the Consultant. 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. Public Health Centre, Grange Road. Monday to Friday (inclusive), 10.0 a.m.-7.30 p.m 98 Rotherhithe New Road. Monday, Thursday and Friday, 10.0 a.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, Public Health Centre, Grange Road. Patients are seen by appointment only. Evening sessions are held for patients at work. LIGHT TREATMENT CENTRE, The Solarium, Public Health Centre, Grange Road. Monday and Thursday 9.30 a.m.-8.0 p.m. Tuesday and Wednesday 930 a.m.-5.30 p.m. Friday 9.30a.m.-1.0 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. Public Health Centre, Grange Road. Monday at 10.0 a.m. 98 Rotherhithe New Road. Friday at 11.0 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. Cental Monday to Friday (inclusive), 9.0 a.m.- 4.30 p.m. (Monday afternoons and alternate Thursday afternoons excepted.) Ear, Nose and Throat Alternate Wednesdays, 2.0 p.m.-4.30 p.m. Bermondsey Medical Mission Hospital, 44 Grange Road. Minor Ailments Monday to Friday (inclusive), 10.30a.m.- 1.0 p.m. and 3.0 p.m.-6.0 p.m. Saturday, 9.30a.m.-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. Rotherhithe School Treatment Centre, Lady Gomm Dispensary, Hawkstone 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 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. Alternate Thursdays, 9.30 a.m.-12 noon Trinity School Treatment Centre, Redriff Lane. Minor Ailments Monday to Friday, 12 noon to 1 p.m Nightingale House Open-Air School, Fort Road. Headmistress Miss E. E. V. Webster Kintore Way Nursery School, Grange Road. Headmistress Miss D. E. May INVALID CHILDREN'S AID ASSOCIATION (Bermondsey Branch) Municipal Offices, Spa Road. Office hours Monday to Friday (inclusive), 9.30 a.m. to 5.30 p.m. Saturday, 9.30 a.m. to 12.30 p.m. Tuesday, 5.30 p.m. to 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. Public Health Centre, Grange 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 a.m. to 12 noon. 98 Rotherhithe New 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 a.m. to 12 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. to 8.0 p.m. Bank holidays, 10.0 a.m. to 12 noon. PUBLIC VACCINATOR. Dr. W. B. Pemberton, 50 Grange Road. 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., Printers, 4, Church Street Greenwich. S.E.10