AC. 4378 e.I. BER 52 Don. 10369 Borough of Bermondsey REPORT ON THE SANITARY CONDITION OF THE BOROUGH OF BERMONDSEY For the Year 1939 BY D. M. CONNAN, M.D., D.P.H., Medical Officer of Health Borough of Bermondsey REPORT ON THE SANITARY CONDITION OF THE BOROUGH OF BERMONDSEY For the Year 1939 BY D. M. CONNAN, M.D., D.P.H., Medical Officer of Health TABLE OF CONTENTS PUBLIC HEALTH DEPARTMENT — page Public Health Committee 4 Maternity and Child Welfare Committee 4 Staff 5 VITAL STATISTICS— Area 9 Dwellings 9 Rateable Value 9 Population 9 Births 9 Deaths 10 Marriages 10 Infantile Mortality Rates 11 Deaths from Tuberculosis 11 Vital Statistics of District 12 Causes of Death 15 Deaths from Zymotic Diseases 17 Infantile Mortality, Causes of Deaths 18 INFECTIOUS DISEASES— Diseases Notifiable 19 Diphtheria 19 Scarlet Fever 20 Acute Poliomyelitis 20 Small-pox 20 Acute Primary and Acute Influenzal Pneumonia 20 Ophthalmia Neonatorum 20 Puerperal Fever and Pyrexia 21 Measles 21 Whooping Cough 21 Anthrax 21 Disinfection 22 Cleansing Station 22 Shelter 23 Bacteriological Laboratory 23 Food Poisoning 23 Insulin for Diabetic Patients 23 Nursing 24 Cases Notified in 1939 25 Cases Notified for last ten years 26 TUBERCULOSIS- New Cases and Deaths 27 Period between Notifications and Deaths 27 Nursing, Extra Nourishment and Shelters 28 Lady Almoner 28 Work of the Tuberculosis Dispensary 29 Summary of Notifications 30 Cases on the Register 31 PAGE LIGHT TREATMENT, ELECTRO-THERAPY AND MASSAGE — Work done in the Solarium 32 MATERNITY AND CHILD WELFARE- Fairby Grange Convalescent Home 33 Midwifery Service 33 Obstetric and Puerperal Fever Consultants 33 Child Life Protection 33 Work of the Health Visitors 34 Attendances at Centres 35 Extracts from Vital Statistics, 1939 36 DENTAL TREATMENT— Particulars of Children Treated 37 Particulars of Treatment and Work for 1939 38 CONSULTATION AND OTHER CLINICS— X-ray Department 39 Rheumatism, Children's and Post-Infectious Disease Clinics 39 Post-Natal and Special Clinics for Women 40 Foot Clinic 41 PROPAGANDA 42 SANITARY ADMINISTRATION— Housing 43 Housing Act, 1936 —Overcrowding 44 Eradication of Bed Bugs 45 Inspections and Proceedings 46 Work of the District Inspectors 49 Factories and Workshops—Homework 50 Factories and Workshops —Inspections 51 Bakehouses 52 House, Trade and Market Refuse 52 Offensive Trades 52 Mortuary 52 Street Markets 53 Drainage Work 53 Work of Factories and Shops Inspector 53 FOOD CONTROL — Imported Food Regulations—Samples taken 54 Unsound Food —Shops and Stalls 55 Milk Premises 55 Milk Licences 55 Milk Sampling 56 Ice Cream 56 Pharmacy and Poisons Act, 1933 57 Food and Drugs—Samples Taken 57 Food and Drugs—Prosecutions 58 Unsound Food —Wharves, etc. 59 Work of the Wharves and Food Inspectors 60 HEALTH SERVICES 61 PUBLIC HEALTH DEPARTMENT PUBLIC HEALTH COMMITTEE, 1939. Chairman Councillor E. J. GIBSON 1938-9, 1939-40 Vice-Chairman „ S. R. WEIGHTMAN 1938-9, 1939-40 Alderman M. Mahoney. Councillor A. V. Kidd. Councillor Mrs. S. C. Amos. „ C. J. Lee. „ H. A. Beal. „ F. W. Love. „ J. A. W. Douglas. „ G. Loveland. „ A. M. Downing. „ Mrs. M. F. Lowery. „ F. J. W. Fielder. „ Mrs. W. L. Miller. „ Mrs. L. A. Glasson. „ A. E. Smith. „ R. E. Goodwin. „ Mrs. J. V. Snowdon. „ Mrs. F. Humphreys. „ A. E. Winch. Ex-officio. Councillor A. V. KIDD, J.P., Mayor of Bermondsey, 1938-9. „ A. G. R. HENLEY, J.P., Mayor of Bermondsey, 1939-40. MATERNITY AND CHILD WELFARE COMMITTEE, 1939. Chairman Councillor Mrs. W. L. MILLER, 1938-9, 1939-40. Vice-Chairman Alderman Mrs. L. JONES, 1938-9, 1939-40. Alderman Mrs. L. M. Brown. Councillor Mrs. D. A. Green. Councillor D. Bradley. „ Mrs. F. Humphreys. „ Miss I. Condon. „ Mrs. R. E. Laker. „ Mrs. M. Cushing. „ Mrs. M. F. Lowery. „ E.J.Gibson. „ Mrs. F. A. Powell. „ Mrs. L. A. Glasson. „ Mrs. J. V. Snowdon. Co-opted Members. Mrs. E. R. Balman. Mrs. A. P. Henley. Mrs. E. B. Childs. Miss M. I. Heinrich. Rev. L. Davidson. Rev. W. Spencer. Mrs. D. Downing. Mrs. E. C. Starr. Mrs. A. M. Hatcher. Ex-officio. Councillor A. V. KIDD, J.P., Mayor of Bermondsey, 1938-9. „ A. G. R. HENLEY, J.P., Mayor of Bermondsey, 1939-40. 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. 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. (resigned June, 1939). *H. T. Levi, M.B., Ch.B. (commenced July, 1939). 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 Jagot, Muriel Coleby, Joyce Hopkins, Gladys Warry, and Elsie Watkins. MATERNITY AND CHILD WELFARE. Assistant Medical Officers for Maternity and Child Welfare — Florence L. Telfer, M.D., D.M.R.E. Aileen A. Nicol, M.B., Ch.B., D.P.H. (commenced May, 1939). Health Visitors. Barbara Anderson (com- Edith Crundwell (com- Kathleen Parry. menced Ap. 1939). menced July, 1939). Gwendolen Riches. Rosa Bache. Marie Helden (retired Edith Riley. Avis Baird. July, 1939). Florence Robson. Sarah Bowles. Phyllis Hesketh (com- Florence Wadds. Lucy Brown. menced June, 1939). Edith Wallis (resigned Amy Carlton (retired Elizabeth Lawrence. March, 1939). March, 1939). Olive Oram. Isabel White. Florence Carter. FAIRBY GRANGE CONVALESCENT HOME. Matron —Florence Child. Sister—Ann O'Meara. * At present serving in H.M. Forces. POST-NATAL AND SPECIAL CLINICS FOR WOMEN. Consultant Gynaecologist—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.). 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. F. M. Brooker, General Clerk. F. W. Smith, Second Clerk. *J. W. J. Saward, General Clerk. C. W. Whye, General Clerk. Alice Jones, General Clerk. A. Manning, General Clerk. F. Cornwell, General Clerk. F. R. Parker, 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. J. A. Blake, General Clerk. DISINFECTING AND CLEANSING STATION. A. C. Davidson, Foreman in Charge. PUBLIC HEALTH DEPARTMENT, MUNICIPAL OFFICES, SPA ROAD, S.E.16. * At present serving in H.M. Forces. 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 1939. For reasons of economy the report consists virtually only of statistics. The outbreak of war, as members very well know, has led to tremendous changes in the work of the Department. Without a single exception, every member volunteered to do any kind of war work connected with the Department which might be assigned to them. Although the normal work has been in many directions much reduced, it has been, and is, the deliberate policy of the Council to maintain all the normal services as far as possible. Some of the clinics have been suspended entirely, notably the Children's Clinic and the Post-Infectious Diseases Clinic, others have been much reduced in size, and in some cases Infant Welfare Clinics have been amalgamated. In general, it is true to say that for those who remain in the borough the ordinary peace time services have been maintained. Additional war work placed upon the Department has been enormous, particularly, of course, in the direction of the maintenance and operation of the First Aid and Stretcher Party Posts, and in connection with evacuation schemes and food control. Many duties have been imposed for which the Medical Officer of Health and the staff could not be supposed to have had any previous training, and which were quite outside the scope of their ordinary work. I take this opportunity of recording my gratitude to the members of the staff, and my admiration for the many unsuspected talents which have been displayed. There have been several changes of staff during the year, and these have been noted in the Department; in addition, several members have joined the Forces. Shortly after the outbreak of war this Department shared with other Departments the very great honour of a visit from the King and Queen, when His Majesty was pleased to express his approval of our work. The visit was greatly appreciated and gave much encouragement to the staff. This report relates to the year 1939 only. I am confident that when the story of the borough for the year 1940 comes to be related, the heroism and endurance, confidence and courage displayed by humble and great alike —and there aren't any " great" in that sense in this borough so far as I know —have been altogether beyond any words which I command. It is not possible for any power, however ruthless and however near to omnipotence, to defeat such a spirit. Finally, may I take this opportunity as in other years, but very specially in this year, of thanking members of the Council, but particularly the Mayor and the two Chairmen, for their cheerful and unfailing encouragement and help in every difficulty. I am, Sir, Ladies and Gentlemen, Your obedient Servant, D. M. CONNAN. 1.-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 1939 according to the Rate Books was 19,019. The rateable value of the borough on the 31st December, 1939, was £879,238, the product of a penny rate being £3,445. POPULATION. Census Estimate of Registrar-General 1931 1921 to 30th June, 1938 to 30th Tune, 1939 †95,500 ‡90,210 119,452 111,542 97,420 †For calculation of Birth Rate. †For calculation of Death Rate. BIRTHS. The total number of births belonging to the borough registered during 1939 was 1,275, consisting of 670 males and 605 females. The number for 1938 was 1,439. The birth rate for 1939 was 13.4 per 1,000 persons living, compared with 14.8 for 1938. DEATHS. The total number of deaths belonging to the borough registered during 1939 was 1,010, consisting of 559 males and 451 females. The number for 1938 was 1,072. The death rate for 1939 was 11.2 per 1,000 persons living, compared with 11.0 for 1938. MARRIAGES. The total number of marriages in the borough in 1939 was 1,258, being 317 above the number for 1938, and 254 above the average for the last 10 years. The figures have been supplied by the Superintendent Registrar. This makes a marriage rate of 26.35 per 1,000 of the population, compared with a marriage rate last year of 19.32. Year No. Rate 1929 994 17.47 1930 1,021 17.94 1931 1,001 17.81 1932 936 17.00 1933 1,007 18.77 1934 1,050 19.91 1935 1,027 20.00 1936 970 19.32 1937 1,090 22.07 1938 941 19.32 Average for years 1929 1938 1,004 18.96 1939 1,258 26.35 (10) INFANTILE MORTALITY. The Infantile Mortality Rate for the year 1939 has been calculated on the figure of 1,223 live births furnished by the Registrar-General. Whole Borough London Year No. of Deaths Rate per 1,000 Births No. of Deaths Rate per 1,000 Births 4,995 71 1929 160 71 1930 130 63 4,109 59 1931 112 57 4,270 65 1932 103 56 4,143 67 1933 92 61 3,377 60 1934 100 64 3,832 67 1935 103 69 3,229 58 1936 92 60 3,691 66 1937 84 59 3,309 60 1938 45 65 3,130 57 60 Average for years 1929-1938 104 63 3,808 1939 45 37 2,409 47 TUBERCULOSIS OF THE RESPIRATORY SYSTEM. In the following Table will be found particulars of deaths from Tuberculosis of the Respiratory System since the year 1929. Sub-District Bermondsey Rotherhithe St. Olave Whole Borough London Year No. No. No. No. Rate No. Rate 1929 4230 0.96 78 31 8 117 1.03 1930 81 36 15 132 1.16 3826 0.87 1931 81 30 1.03 5 116 3907 0.90 1932 71 34 11 116 1.05 3564 0.82 1933 68 23 99 8 0.92 3530 0.82 1934 64 22 4 90 0.86 3227 0.76 1935 70 23 5 98 0.95 2847 0.68 1936 51 22 79 6 0.79 2848 0.69 1937 63 22 2 87 0.89 2888 0.71 1938 42 23 1 66 0.68 2590 0.64 27 Averages for years 1929-1938 6 100 0.94 67 3346 0.78 1939 38 65 0.72 2650 21 6 0.70 VITAL STATISTICS OF WHOLE DISTRICT DURING 1939 AND PREVIOUS YEARS. Births Total Deaths registered in the District Deaths of Non-Residents registered in Public Institutions, etc., in the District 10 Deaths of Residents registered in Public Institutions beyond the District 11 Net Deaths at all Ages belonging to the District Total Deaths in Public Institutions in the District 9 Population estimated to Middle of each Year 2 Under 1 Year of Age At all Ages Year 1 Rate per 1,000 Births registered 6 No. 3 Rate 4 No. 12 Rate 13 No. 5 No. 7 Rate 8 113,800 2,252 127 11.4 696 378 1,650 14.5 1929 19.8 56 1,304 32 44 1,169 10.3 686 46 365 1,488 13.1 1930 113,800 2,059 18.1 90 1931 112,400 1,958 17.4 91 46 1,169 10.4 596 92 331 1,408 12.5 44 1,147 10.4 689 189 368 1,326 12.0 1932 110,100 1,831 16.6 81 215 339 1,340 12.5 1933 107,300 1,500 14.0 72 48 1,216 11.3 720 1934 105,060 1,557 14.8 77 49 1,223 11.6 784 229 310 1,304 12.4 67 1,142 11.1 756 255 314 1,201 11.7 1935 102,700 1,487 14.5 99 49 1,136 11.3 723 175 328 1,289 12.8 1936 100,400 1,545 15.4 76 1937 98,790 1,421 14.4 61 43 1,148 11.6 741 245 309 1,212 12.3 42 1,002 10.3 488 201 271 1,072 11.0 1938 97,420 1,439 14.8 60 Averages for years 1929-1938 106,177 15.9 83 49 11.0 688 168 1,329 12.5 331 1,166 1,705 1939 1,275 40 31 445 201 243 1,010 11.2 *95,500 13.4 968 10.7 ╪90,210 ‡ For calculation of Death Rate. * For calculation of Birth Rate. (13) 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 189 All Saints' Hospital, Eastbourne 3 All Saints' Hospital, Southwark 1 Ambulances on way to Hospital 9 Deaths in River Thames, Surrey Commercial Docks, Wharves, etc. Archway Hospital, Islington 1 Belgrave Hospital, Lambeth 1 Bexley Mental Hospital, Bexley 5 Brook Hospital, Shooter's Hill 1 Caterham Hospital, Caterham 1 8 Cathloic Nursing Institute, Lambeth Road 1 Charing Cross Hospital 1 Church Street Hospital, Eastbourne. Private Houses 4 3 Colony, The, Chalfont St. Peter 1 3 Total 201 County Hospital, Farnborough Downs Hospital for Children, Sutton 1 East Surrey Hospital, Redhill 1 Evelina Hospital 3 German Hospital, Hackney 1 Grand Surrey Canal 2 Grove Hospital, Tooting 1 Grove, The, Epsom 3 Guy's Hospital 37 Hammersmith Hospital 1 Highfield Camp, Udian Farm, Ewhurst 1 Home, The, Nunnery Fields, Canterbury 1 Horsham Hospital, Horsham 2 Horton Hospital, Epsom 2 Hospital, The, Coulsdon 2 Hundred Acres, Banstead 2 Joyce Green Hospital, Dartford 2 Kingston County Hospital, Kingston 1 Lambeth Hospital 11 Leavesden Hospital, Watford 4 Lewisham Hospital 15 Marillac Sanatorium, Brentwood 1 Metropolitan Convalescent Home, Cooden 1 New End Hospital, Hampstead 1 Newington Institution, Southwark 2 Northern Hospital, Southgate 1 Orchard Hospital, Dartford 3 Orsett Lodge, Orsett 1 Park Hospital, Hither Green 3 Police Station, Borough High Street 1 (14) OTHER INSTITUTIONS, Etc., Etc.- continued. 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 Poplar Hospital 1 Princess Alice Hospital, Eastbourne 1 Princess Mary's Hospital, Margate 1 Private Houses 6 Queen Mary's Hospital, Carshalton 1 Queen Mary's Hospital, Chislehurst 5 Queen Mary's (Roehampton) Hospital, Roehampton 1 Royal Sussex County Hospital, Brighton 1 St. Alfege's Hospital, Greenwich 16 St. Bartholomew's Hospital 3 St. Benedict's Hospital, Wandsworth 10 St. Clement's Hospital, Poplar 2 St. David's Hospital, Edmonton 1 St. Ebbas Hospital, Epsom 3 St. Francis Hospital, Camberwell 10 St. George-in-the-East Hospital, Stepney 1 St. Giles` Hospital, Camberwell 4 St. James's Hospital, Battersea 1 St. John's Hospital, Lewisham 1 St. Mary Abbots Hospital, Kensington 1 St. Matthew's Hospital, Shoreditch 1 St. Pancras Hospital 1 St. Peter's Hospital, Stepney 3 St. Peter's House, Lambeth 1 St. Richard's Hospital, Chichester 1 St. Thomas's Hospital 1 Seaman's Hospital, Greenwich 1 South Eastern Hospital, New Cross 8 South London Hospital, Wandsworth 1 Stanborough's, The, Watford 1 Stone House, Stone, Dartford 1 Street 1 Tooting Bec Hospital 10 West Ashford House, Westwell 1 Western Hospital, Fulham 1 Workplaces 1 Yeovil District Hospital, Yeovil 1 Total 243 CAUSES OF, AND AGES AT, DEATHS DURING THE YEAR 1939. Causes of Death Deaths at the subjoined ages of Residents whether occurring in or beyond the District. All Ages Under 1 1 and under 2 2 and under 5 5 and under 15 15 and under 25 25 and under 45 45 and under 65 65 and upwards All Causes Certified 1,010 45 2 9 25 89 289 530 21 Uncertified - - - - — - - - - Typhoid and Paratyphoid Fever - - - - - - - - - Measles - - - - - - - - - Scarlet Fever - - - - - - - - - Whooping Cough 2 2 - - - - - - - Diphtheria 7 3 4 - - - - - - Influenza 10 1 4 5 - - - - - Encephalitis Lethargica 1 - - 1 - - - - - Cerebro-spinal Fever 1 1 - - - - - - - Tuberculosis of Respiratory System 65 3 7 24 26 5 - - - Other Tuberculous Diseases 4 - - - - 2 2 Syphilis - - 2 2 - - - - - - - General Paralysis of the Insane, tabes dorsalis 4 3 1 - - - - - - Cancer, Malignant Disease 140 12 61 67 - - - - - Diabetes 9 1 2 6 - - - - - Cerebral Hæmorrhage, etc. 98 1 2 1 27 67 - - - Heart Disease 221 - 1 1 7 48 164 - - Aneurysm 1 1 - - - - - - - Other Circulatory Diseases 20 - 1 3 16 - - - - Bronchitis 87 4 33 50 - - - - - Pneumonia (all forms) - 4 2 4 87 10 23 44 - Other Respiratory Diseases 15 2 5 8 - - - - - 3 9 1 Peptic Ulcer - 3 - - - - 5 8 - 2 Diarrhœa,etc. 1 2 - - - 2 6 1 1 Appendicitis - - - - 2 2 3 1 Cirrhosis of Liver - - - - - - 1 - 1 Other Diseases of Liver, etc. - - - - - - 1 18 1 3 4 9 Other Digestive Diseases - - - Acute and Chronic Nephritis 56 2 1 8 45 - - - - - Puerperal Sepsis - - - - - - - - Other Puerperal Causes 3 2 1 - - - - - - Congenital Debility, Premature Birth, Malformations, etc. 22 22 - - - - - - - 12 Senility - 1 11 - - - - 6 2 1 3 Suicide - - - - 46 2 1 6 5 10 17 5 Other Violence - 3 3 4 2 8 12 14 Other Defined Causes 46 - - - Causes ill-defined or unknown — - - - - - - 1,010 45 9 21 25 289 530 2 89 1650 14.5 62 .54 - 1 6 .05 33 .29 1 19 .17 1929 .01 2 .02 .01 - 7 17 .15 1930 1488 13.1 101 .89 61 .54 .06 8 .07 6 .05 2 .02 - - 12.5 24 .21 3 .03 1 .01 6 .05 .04 9 1931 1408 - - 5 .08 25 - - 1932 1326 12.0 67 .61 1 .01 .23 11 .10 16 .15 - 14 .13 - - - 1933 .42 14 1340 12.5 45 9 .08 4 .04 13 .12 5 .05 - .13 - - - 1934 1304 12.4 87 .83 38 .36 1 .01 10 .10 10 .10 - 28 .26 - - - 10 1935 1201 11.7 54 .53 4 .04 .10 5 .05 - 35 .34 - - - - - .56 19 1936 1289 12.8 56 20 .20 8 .08 5 .05 4 .04 .19 - - - - 1937 1212 12.3 36 .36 5 .05 7 .07 24 .24 - - - .09 - - - - .31 1938 1072 11.0 30 9 .09 4 .04 4 .04 - 13 .13 - - - - - Average for years 1929-1938 .53 19 .18 1 1329 12.5 56 17 .16 1 .01 8 .08 10 .09 .01 - - 1939 1010 11.2 .08 - 17 .19 2 .02 - - - - - - 7 - 8 .09 Cause of Death Under 1 week 2 — 3 weeks 3 — 4 weeks Total under 1 month 6 — 9 months Total under 1 year 1 — 3 months 3 — 6 months 9 — 12 months 1 — 2 weeks Measles - - - - - - - - - - - 1 1 - - 7 1 7 16 - - - - - - - - - Scarlet Fever - - - - - - - - - Whooping Cough 1 1 2 - - - - - - - Diphtheria - - - - - - - - - Influenza - - - - - - - - Cerebro-spinal Meningitis - 1 1 - - - - - - Tuberculous Meningitis - - - - - - - - - Other Forms of Meningitis - - - - - - - - - Tuberculosis of Respiratory System Other Tuberculous Diseases - - - - - - - - - - - - - - - - - - Syphilis - - - - - - - - - Bronchitis - - - - - - - - - Pneumonia (all forms) 1 2 1 1 4 10 - - 2 Other Respiratory Diseases - - - - - - - - - 1 2 3 Diarrhoea and Enteritis Congenital Debility and Malformation, Premature Birth - - - - - - 3 1 12 1 - 11 - - - Injury at Birth - 1 1 - - - - - - - 1 Other Causes 8 1 5 2 16 - - Totals 3 2 8 5 4 1 22 6 45 (18) II.—INFECTIOUS DISEASES. 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 DIPHTHERIA. One hundred and thirty-five cases of diphtheria were notified as compared with 187 cases last year; in 24 cases the diagnosis was not confirmed ; there were seven deaths. The appended table shows the attendances at the Schick Clinics during the year; since the 2nd September no clinic has been held at 98, Rotherhithe New Road. No. of No. of New Total Clinic Sessions Patients Attendances Public Health Centre, Grange Road 49 145 684 98, Rotherhithe New Road 33 79 439 Totals 82 224 1,123 SCARLET FEVER. The total number of cases notified was 112, and of these 14 were returned as not suffering from the disease, giving a net figure of 98. This compares with net figure of 143 cases in 1937, which was the lowest figure recorded in this borough. ACUTE POLIOMYELITIS. Seven cases of acute anterior poliomyelitis were notified during the year; exhaustive enquiries were made without disclosing any definite link of infection. Medical practitioners were warned and requested to report all doubtful cases. SMALL-POX. There were no cases of small-pox and no re-vaccinations were made under the Public Health (Small-pox Prevention) Regulations, 1917. ACUTE PRIMARY AND ACUTE INFLUENZAL PNEUMONIA. One hundred and twenty-one cases of acute primary and acute influenzal pneumonia were notified during the year; of these 18 cases were of the influenzal variety. Home nursing was provided by the Council in 32 cases and 54 patients were sent to hospital. OPHTHALMIA NEONATORUM. Five cases of ophthalmia were notified during the year, as compared with ten last year. Vision was unimpaired in every case. Cases Treated Vision Vision Total Deaths Notified Un- Impaired Blindness In Impaired At home Hospital 5 4 1 5 PUERPERAL FEVER AND PUERPERAL PYREXIA. There were no cases of puerperal fever notified during the year, but there were nine cases of puerperal pyrexia. Six 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. Facilities No. of Cases Second Opinions 1 Nursing provided 2 Bacteriological examinations Nil Admitted to Hospital 6 MEASLES. The County of London (Measles and Whooping Cough) Regulations, 1938, were amended by new regulations on the 23rd October, 1939, which require all cases of measles and whooping cough to be notified. Thirty-nine cases of measles were notified, while a further five cases were reported to me, making a total of 44 cases. WHOOPING COUGH The new regulations which require all cases of whooping cough to be notified came into force on the 23rd October, 1939. Three hundred and eighty-three cases were notified during the year, while information regarding 157 other cases reached me from various sources, making a total of 540 cases during the year. Eighty-seven patients were removed to hospital, and in nine of these cases the diagnosis was not confirmed; nursing was provided for seven patients at home. Two patients died. ANTHRAX. One case of anthrax was notified in the borough during the year : infection was apparently due to horse hides from South America, and the patient died. The Department also assisted a neighbouring borough in the investigation of two other cases. 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 551 Pillows (cases) 1,197 Blankets 3,790 Quilts 963 Bolsters 458 Sheets 1,197 „ (cases) 202 Furniture 3,783 Books 56 Miscellaneous 4,490 Cushions 163 Verminous Clothing 1,363 Mattresses 3 „ Bedding 12,381 Overlays 1,211 Scabies, Clothing 19,959 Pillows 1,385 64,495 new tabs were used to replace those taken off mattresses, palliasses, and cushions before disinfection. Number of rooms disinfected 2,261 Number of mattresses and other articles destroyed 1,097 Furniture, Floorcloth, etc., destroyed 138½ Loads CLEANSING STATION. Verminous persons cleansed Adult Females 16 Adult Males 106 Children 2,016 Persons treated for Scabies: — Number treated Number of baths given Adult Females 127 244 Adult Males 58 98 Children, Females 185 1,119 Children, Males 155 950 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 four, two for scabies and two for verminous conditions, the total number of persons accommodated being 32. BACTERIOLOGICAL LABORATORY. The work done in the Laboratory during the year is set out in the appended table. Total Examinations Results of Examination Positive Negative Examined for 1939 1938 1939 1938 1938 1939 Diphtheria (specimens taken by Medical Officer of Health 281 149 16 3 265 146 Ditto (taken by general practitioners) 793 59 759 1,122 1,063 34 905 Diphtheria (total specimens taken) Phthisis 1,403 942 75 37 1,328 939 146 919 1,042 123 793 Various 303 229 29 18 274 211 2,748 1,909 Total specimens taken 2,110 227 201 2,521 FOOD POISONING. Ten 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. Thirty-three patients have been supplied during the year as compared with twenty-six patients in 1938. 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 1s. 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. Disease St. Olave's District Nursing Association Rotherhithe Queen's Nursing Association Totals whole Borough Cases Visits Cases Visits Cases Visits Pneumonia 23 455 9 209 32 664 Broncho-pneumonia 3 35 2 80 5 115 Bronchitis 12 151 3 32 15 183 Influenza 46 476 4 42 50 518 Measles - - - - - - Whooping Cough 5 61 2 26 7 87 Tuberculosis :— (a) Respiratory System 19 752 11 424 30 1,176 (b) Other Forms 5 267 - - 5 267 Puerperal Pyrexia . 1 3 1 12 2 15 Puerperal Fever — — — — — — Pregnancy and Labour 34 361 5 53 39 414 Diseases of the Digestive System 15 120 8 39 23 159 Infantile Diarrhoea (under 2 years) 1 17 — — 1 17 Discharging Ears 7 153 4 43 11 196 Discharging Eyes 6 65 6 92 12 157 Post-operative cases :— (a) Tonsils & Adenoids 2 8 1 4 312 (b) Other cases 2 31 2 18 4 49 Other diseases 16 176 6 160 22 336 Totals 197 3,131 64 1,234 261 14,365 CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR 1939. NUMBER OF CASES NOTIFIED Bermondsey ROTHERHITHE St. Olave Total Cases removed to Hospital At Ages—Year St.Olave St.Thomas Total At all Ages St.John 1 5 6 Total 1 2 Total NOTIFIABLE DISEASE 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 & upwards 2 3 4 3 Diphtheria (including Membranous Croup) 135 1 42 57 14 9 8 3 1 - - 11 15 14 11 8 24 83 19 18 5 - 8 - 7 44 3 135 Erysipelas 35 - 2 1 1 2 4 7 5 7 6 1 4 7 7 3 - 22 7 3 2 12 1 - 1 15 - - Scarlet Fever 112 1 54 30 13 9 2 2 1 - - 16 8 15 23 7 3 72 5 19 12 36 3 1 - 4 109 - Cerebro-Spinal Meningitis 8 1 1 3 2 1 - - 2 3 1 - 6 1 1 - - - — - 2 7 - - - - - - Ophthalmia Neonatorum 5 5 - — - - - 1 - 1 - 1 3 4 - - - - - - - - - - 1 - - - Malaria (Induced) 2 - - - - 1 - 1 - 1 1 - - 2 - - - - - - 2 - - - - - - - Puerperal Pyrexia 9 - - - 1 3 4 1 - - - - 1 1 1 - 3 1 2 3 2 1 - 3 6 - - - Dysentery 2 1 - 1 - - - - - 1 - - 1 - 1 1 - 1 - - 1 - - - - - - - Anthrax 1 - - - - - 1 - - - - 1 1 - - - - - - 1 - - - - - 6 - - Acute Poliomyelitis 7 - 2 1 2 2 - - - - 6 6 - 6 - 1 1 - - - 7 - - - - - - - Pneumonia (Acute Primary and Acute Influenzal) 121 9 19 10 10 9 6 13 9 15 13 8 5 18 19 13 8 9 72 18 14 13 45 2 2 - 4 54 Whooping Cough 383 46 273 60 1 2 1 - - - - 22 24 - 44 93 29 15 227 40 69 38 147 4 4 1 9 72 Measles 39 9 25 3 2 - - - - - 6 2 3 3 2 - 16 1 6 14 21 1 2 14 - - 1 - Tuberculosis — Respiratory System 94 1 2 3 2 23 13 13 11 10 8 8 7 13 12 10 8 10 60 11 6 22 5 1 12 5 6 - Other forms of Tuberculosis - 1 3 4 4 1 - - 13 2 2 7 - - - 20 2 3 2 3 1 4 3 2 3 - - - 973 74 171 61 43 36 29 74 68 585 105 143 23 43 424 Totals 421 50 35 31 22 86 122 173 62 97 345 17 3 CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEARS 1930-1939 1931 Notifiable Disease. 1930 1932 1933 1934 1935 1936 1937 1938 1939 Small Pox 47 3 16 21 7 - - - - - Diphtheria (including Membranous Croup) 462 263 263 386 372 273 207 167 187 135 73 53 39 28 57 35 Erysipelas 41 49 49 68 Scarlet Fever 507 310 446 640 597 367 266 167 200 112 Cerebro-Spinal Meningitis 5 9 9 4 2 2 4 10 3 8 Acute Polio-Myelitis and Acute Polio-Encephalitis 1 - - - 1 1 7 1 1 3 6 5 6 1 10 5 Ophthalmia Neonatorum 13 14 10 7 1 - - 1 1 1 Anthrax 1 - - - Enteric Fever 5 1 2 2 2 3 15 5 2 - (26) 3 Puerperal Fever 14 13 8 6 2 6 1 1 - Puerperal Pyrexia 19 37 27 24 13 19 9 13 10 9 4 1 2 - 2 - - Encephalitis Lethargica - 2 - Dysentery - - 1 3 1 43 26 2 - - Malaria 2 - - - - - - - - - Malaria (Induced) - - - - - - - - 2 - Pneumonia (Acute Primary and Acute Influenzal) 119 167 102 136 121 113 125 170 112 121 Whooping Cough 103 275 101 383 - - - - - - Measles 7 85 889 39 - - - - - - Tuberculosis — Respiratory System 208 175 177 182 141 129 142 147 112 94 34 32 34 34 31 18 20 Other forms of Tuberculosis 46 40 35 Totals 1,494 1,083 1,149 1,512 1,371 1,004 966 1,145 1,730 973 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, 1939 —NEW CASES AND HEATHS. NEW CASES DEATHS AGE PERIODS Pulmonary Non-Pulmonary Pulmonary Non-Pulmonary M. F. M. F. M. F. M. F. 0 1 - - - - - - - 1 1 2 - - - - - - 5 1 3 2 1 - - - - 10 1 2 3 1 1 1 - - 15 14 9 3 3 - - 1 1 20 10 6 1 2 3 1 - - 25 12 5 2 3 11 3 2 - 35 10 2 1 3 9 1 - - 45 9 2 1 8 4 - - - 55 8 1 12 2 - - - - 65 and upwards 6 3 5 - - - - - 74 33 11 49 12 16 1 3 TABLE II. TUBERCULOSIS. 1939-PERIOD BETWEEN NOTIFICATION AND DEATH. Period Between Notification and Death Respiratory System Other Forms Males Percentage of Total Deaths Males Total Percentage of Total Deaths Females Total Females Not notified 2 6 9.23 3 4 - 3 75.00 5 0-1 month 2 7 10.77 1 25.00 - 1 1-3 months 6 1 7 10.77 - - - - 3-6 months 4 1 5 7.69 - - 6-12 months 2 - - - 2 3.08 - - - - 1-2 years 10 3 13 20.00 2-5 years 5 - - - - 5 10 15.38 - - - Over 5 years 13 2 15 - 23.08 - - - - Totals 1 16 100.00 49 65 3 4 100.00 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; 1,443 visits were paid by the nurses in 1939. A limited provision is made for the supply of extra nourishment to tuberculous persons, and this usually takes the form of eggs and milk; 114 patients received help in this way during the year. The scheme for the provision of shelters has been continued, and 12 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 patients' 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 1939. Pulmonary Non-Pulmonary Total Children Adults Children Grand Total Diagnosis Adults Children Adults M. F. M. F. F. M. F. M. M. F. M. F. A. —New Cases examined during the year (excluding contacts): — I I (a) Definitely tuberculous 45 20 4 1 5 5 2 2 50 25 6 3 84 (b) Diagnosis not completed - - 2 1 1 4 - - - - - - (c) Non-tuberculous - - - 181 104 11 308 - - - - - - 12 B.—Contacts examined during the year:— I [ ■ I II I I I I II I (a) Definitely tuberculous 7 1 - 1 - 7 1 1 - - - 9 - (b) Diagnosis not completed - - - - - - - - - - - - - (c) Non-tuberculous - - - - 66 88 57 92 303 - - - - C.—Cases written off the Dispensary Register as:— 1! ! I 3 5 (a) Recovered 12 4 5 1 11 3 6 15 7 6 39 (6) Non-tuberculous (including any such cases previously diagnosed and entered on the Dispensary Register as tuberculous) 194 615 - (29) - - 248 69 104 - - - - - D.—Number of Cases on Dispensary Register on December 31st:— I I! h II- I I I I I I I I (a) Definitely tuberculous 282 227 35 32 34 41 271 76 68 44 36 316 731 - (b) Diagnosis not completed - - - - - 2 1 1 - - 4 - 8. Number of visits by Tuberculosis Officers to homes (including personal consultations) 790 1. Number of cases on Dispensary Register on January 1st 778 2. Number of cases transferred from other areas and cases returned after discharge under Head 3 in previous years 13 9. Number of visits by Nurses or Health Visitors to homes for Dispensary purposes 1,987 3. Number of cases transferred to other areas, cases not desiring further assistance under the scheme, and cases "lost sight of" 55 10. Number of:— (a) Specimens of sputum, etc., examined 939 (b) X-ray examinations made in connection with Dispensary work 1,061 4. Cases written off during the year as Dead (all causes) 55 5. Number of attendances at the Dispensary (including Contacts) 2,017 11. Number of "Recovered" cases restored to Dispensary Register, and included in A (a) and A (b) above — 6. Number of Insured Persons under Domiciliary Treatment on December 31st 106 12. Number of "T.B. plus" cases on Dispensary Register on December 31st 301 7. Number of consultations with medical practitioners:— (а) Personal 135 (b) Other 220 * In addition to these visits 520 visits were made by the Lady Almoner and 106 visits by the School Nurse. PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1930. Summary of Notifications during the period from the 1st January, 1939, to the 31st December, 1939. Formal Notifications Number of Primary Notifications of New Cases of Tuberculosis 65 and upwards Total Notifications 0 to 1 1 to 5 5 to 10 10 to 15 15 to 20 20 to 25 25 to 35 35 to 45 45 to 55 55 to 65 Total (all ages) Age Periods 1 - 14 9 8 9 8 7 5 64 72 Pulmonary, Males 2 1 „ Females - 2 2 9 4 5 2 2 1 3 30 35 - Non-Pulmonary Males 1 2 3 2 1 1 - - 10 11 - - - - - 1 2 2 2 3 - 10 11 „ Females - - - New cases of Tuberculosis coming to the knowledge of the Medical Officer of Health during the above-mentioned period, otherwise than by formal notification: — 0 to 1 1 to 5 5 to 10 10 to 15 15 to 20 35 to 45 45 to 55 65 and upwards Total 20 to 25 25 to 35 55 to 65 Age Periods Pulmonary Males - 1 - 1 4 1 1 1 1 10 - - „ Females - 1 - 2 - - - - 3 - - - Non-Pulmonary Males - 1 - 1 - - - 2 - - - - - - - 1 - 1 „ Females - - - - - - (31) Returns rendered under the PUBLIC HEALTH (TUBEBCULOIS) REGULATIONS, 1930. 1st QUARTER, 1939. Respiratory System Other Forms M. F. M. F. Number of Cases on Register at commencement of Quarter 370 102 279 91 Number of Cases notified during Quarter 19 13 5 4 Inward Transfers, Un-notified Deaths, etc. 2 1 - - Number of Cases removed from the Register 23 10 5 3 Number of Cases remaining on the Register at end of Quarter 368 282 91 104 2nd QUARTER, 1939. Respiratory System Other Forms M. F. M. F. Number of Cases on Register at commencement of Quarter 104 368 282 91 Number of Cases notified during Quarter 17 10 2 5 Inward Transfers, Un-notified Deaths, etc. 2 2 — — Number of Cases removed from the Register 19 10 2 3 Number of Cases remaining on the Register at end of Quarter 368 284 91 106 3rd QUARTER, 1939. Respiratory System Other Forms M. F. M. F. Number of Cases on Register at commencement of 368 284 91 106 Number of Cases notified during Quarter 16 1 3 1 Inward Transfers, Un-notified Deaths, etc. 4 1 2 - 6 Number of Cases removed from the Register 26 8 4 Number of Cases remaining on the Register at end of Quarter 90 362 278 103 4th QUARTER, 1939. Respiratory System Other Forms M. F. M. F. Number of Cases on Register at commencement of Quarter 362 278 90 103 Number of Cases notified during Quarter 12 6 - - Inward Transfers, Un-notified Deaths, etc. 2 - - - Number of Cases removed from the Register 25 13 3 8 Number of Cases remaining on the Register at end of Quarter 351 271 87 95 IV.—LIGHT TREATMENT, ELECTRO-THERAPY AND MASSAGE. The following table shows the work done in the Solarium during 1939. The figures given are practically those for the first seven m6nths of the year. The department was closed for holidays in August and owing to the war did not re-open until December. Total Number of Attendances 30,693 Number of Individual Patients 1,482 Number of Treatments 67,278 Massage 6,113 Medical Electricity 3,057 Diathermy 7,723 Physical Exercises 1,184 Local Treatments — Radiant Heat and Ultra Violet Light 17,732 General Ultra Violet Light 30,693 Mechanical Vibratory Massage 18 Q-Ray Pad 758 Number of Medical Examinations 3,411 Number of New Cases 805 V.—MATERNITY AND CHILD WELFARE. FAIRBY GRANGE CONVALESCENT HOME. The total number of patients received into the home during the year, including mothers, babies and toddlers, was 357, a decrease on the figures for 1938. Number of women admitted 173 Number of babies admitted 65 Number of toddlers admitted 119 MIDWIFERY SERVICE. During the year 1939 domiciliary midwifery practice, so far as it concerns midwives, came under the control of the London County Council, and all midwives practising privately in this borough surrendered their certificates. Prior to this change, which took place in the middle of the year, the Borough Council under their own scheme then existing paid the whole of the midwives' fees in 75 cases and a portion of the fees in 36 other cases. OBSTETRIC AND PUERPERAL FEVER CONSULTANTS. The number of consultations during the year was as follows: — Obstetric Consultations Nil Puerperal Fever Consultations 1 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 7 foster-mothers with 8 children and 39 visits were paid by the visitor. HEALTH VISITORS. The following table shows the work done by the Municipal and Voluntary Centres and Health Visitors during 1939 :— Births Notified Visits to Infants and Children Visits to Expectant Mothers Visits to Cases of Infectious Disease Unclassified or Special Visits Attendances at Centres & Clinics Health Talks Puerperal Pyrexia and Fever Ophthalmia Neonatorum Measles Whooping Cough Tuberculosis Post-Infectious Disease First Visits Re-visits District Under 1 year Primary Visits Revisits 1—5 years Miss Anderson 50 42 303 673 18 44 17 142 15 15 133 - - - - Miss Bache 118 114 551 874 96 136 1 5 74 106 29 261 71 - - 104 121 481 600 59 90 38 236 Miss Baird 6 59 133 87 - - - 485 Miss Bowles 1 - - - - - - - - - - - - - Miss Brown 71 71 286 530 28 58 4 46 125 42 167 200 - - - Miss Carter 115 96 465 553 59 72 2 94 59 229 222 47 - - - 48 564 18 6 Miss Crundwell 45 322 37 10 79 43 97 - - - - 51 14 76 Miss Hesketh 10 8 23 2 3 6 309 - - - - - 32 Miss Lawrence 81 83 438 672 48 1 2 29 262 250 35 303 - - Miss Oram 94 99 30 92 33 231 617 863 5 5 164 53 428 4 - Miss Parry 74 68 435 582 19 96 44 131 57 65 220 10 - - - 557 32 Miss Riches 72 82 271 80 3 1 24 103 60 113 225 - - Miss Riley 48 65 473 317 25 32 101 229 94 45 11 - - - - Miss Robson 16 46 63 360 761 33 61 1 82 15 75 190 - - - Miss Wadds 50 51 315 403 19 40 5 9 46 36 30 176 - - - Miss White 54 74 597 63 219 22 67 136 88 163 1154 - 7 42 - Salomon's Centre 39 514 1281 128 91 58 2 3 1 217 18 - - - - 1074 1140 6451 10435 661 1262 2 15 55 524 1710 574 1993 3611 32 Totals ATTENDANCES AT MATERNITY AND CHILD WELFARE CENTRES. The following table shows attendances at Maternity and Child Welfare Centres during 1939: — Children's Consultations Ante-natal Clinic Sewing Class Gynæcological Clinic No. of Sessions No. of Attendances New Cases Total Attendances No. seen by Doctor No. of Sessions New Cases Total Attendances No. of Sessions New Cases Total Attendances Name of Centre No. of Sessions Post Natal Cases Under 1 year 1-5 years Under 1 year 1-5 years Public Health Centre, Grange Road 170 279 46 4,868 3,860 4,197 43 159 24 727 - - 39 95 269 98 Rotherhithe New Road 122 180 22 2,746 2,549 2,915 52 155 24 654 - - 36 53 134 Community Centre 70 61 22 1,088 1,384 1,257 - - - - 41 833 - - - Bermondsey Gospel Mission 85 90 26 1,691 1,528 1,877 - - - - - - - - - Roseberry Street 31 29 2 527 469 621 - - - - - - - - - Salomon's Centre 93 41 4 1,351 515 767 129 289 155 1,729 - - - - - Princess Club 98 87 7 1,807 1,491 2,209 20 25 5 126 28 321 - - - 1,863 100 7 508 - - - - Fulford Street 86 128 19 1,598 1,241 46 - Central Hall 133 159 31 2,894 2,569 3,334 - - - 15 307 - - - - EXTRACTS FROM VITAL STATISTICS, 1939. Births. Registered— Total Males Females Live Births Legitimate 1,234 649 585 Illegitimate 41 21 20 Birth Rate per 1,000 of the estimated resident population 13.4 Total Males Females Stillbirths 44 17 27 Rate per 1,000 total (live and still) births 33 Notified within 36 hours of birth— (1) Live Births, 1,244. (2) Stillbirths, 35. (3) Total, 1,279. (1) By Midwives, 1,112*. (2) By Parents and Doctors, 167. * Including 705 births delivered by midwives in Hospitals. Total Males Females Deaths 1,010 559 451 Death Rate per 1,000 of the estimated resident population 11.2 Maternal Deaths. Calculated on the figure of 1,267 (live and still) births furnished by the Registrar-General. Rate per 1,000 total (live and still) births Deaths from puerperal causes:— Deaths. Puerperal Sepsis - - Other puerperal causes 3 2.37 Total 3 2.37 Death Rate of Infants under 1 year of age. Calculated on the figure of 1,223 live births furnished by the Registrar-General. All Infants per 1,000 live births 37 Legitimate infants per 1,000 legitimate live births 35 Illegitimate infants per 1,000 illegitimate live births 49 Health visitors Visits paid by Health Visitors during the year:— To Expectant Mothers (1) First Visits, 661. (2) Total Visits, 1,923 To Infants under 1 (1) First Visits, 1,140. (2) Total Visits, 7,591 To Children, 1—5 Total Visits, 10,435 Convalescent Homes for Children under 5. Number of Beds, 16. Number of Children under 5 received during the year 184 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:— 8,593. Deaths from Cancer (all ages) 140 Deaths from Measles (all ages) Nil Deaths from Whooping Cough (all ages) 2 Deaths from Diarrhoea (under 2 years of age) 8 (37) 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 1939. Number of Attendances for Orthodontics Anæsthetics Number of Extractions CENTRE Age Group Number of Scalings Number Examined Number of Fillings Number Treated General Local PUBLIC HEALTH CENTRE, GRANGE ROAD. Under 5 years 215 210 764 7 182 4 - - Over 5 years 445 464 1006 254 281 310 10 21 Totals 660 674 1770 261 463 314 10 21 Under 5 years 141 175 597 2 140 16 - - 98, ROTHERHITHE NEW ROAD. Over 5 years 424 406 945 181 293 230 5 30 Totals 565 581 1542 183 433 246 5 30 896 Totals both Centres 1225 1255 3312 444 560 15 51 (38) DENTAL TREATMENT CARRIED OUT DURING 1939. Anæsthetics Number of Repairs to Dentures Number of Patients Examined Number of Patients Treated Number of Dentures Fitted Number of Attendances Number of Extractions Type of Case Number of Scalings CENTRE General Number of Fillings Local PUBLIC HEALTH CENTRE, GRANGE ROAD Maternity Cases 752 752 2411 500 244 83 16 206 85 2037 Women 1240 1203 2039 998 147 208 30 177 113 2566 Men 2060 2024 4061 1982 109 339 59 264 149 4135 Tuberculosis 20 22 44 11 8 7 - 10 1 74 Cases Children (Table I.) 660 674 1770 261 463 314 10 3 I 1496 Totals 4732 4675 10325 3752 971 951 115 660 348 10308 Maternity Cases 365 421 1437 332 286 47 25 118 31 1212 98, ROTHERHITHE NEW ROAD Women 289 361 599 252 119 64 10 43 22 719 355 507 1022 457 79 60 20 120 26 1050 Men Tuberculosis Cases 1 1 9 3 - - - 2 6 - Children (Table I.) 565 581 1542 183 433 246 5 - 1303 - Totals 1575 4609 1227 917 417 60 281 81 1871 4290 Totals both Centres 6307 6546 14934 4979 1888 1368 175 941 429 14598 VII.—CONSULTATION AND OTHER CLINICS. X-RAY DEPARTMENT. During the first six months of the year the work of the X-Ray Department showed a considerable increase over the first six months of 1938, but as the department was closed for two months after the outbreak of war the figures for the whole year are less than those of 1938. Number of Attendances 1,558 Number of New Cases 1,069 Number of Screenings 1,333 Number of Films 2,182 Analysis of Films: — Bones 243 Barium Meals 68 Barium Enemas 12 Tuberculous Chests 1,061 Non-Tuberculous Chests 31 Kidneys 5 Antrums 2 Gall Bladder 5 Urinary Tract 2 Parotid Gland 1 Sinus 2 Hearts 10 Abdome 16 RHEUMATISM. CHILDREN'S AND POST-INFECTIOUS DISEASE CLINICS. These three clinics were closed during most of the month of August on account of the school holiday, and they have not been re-opened. Thirty-one new patients were referred for examination to the Childrens Clinic, and there were 69 re-examinations in the Rheumatism Clinic at which the new cases numbered 12 adults and 15 children and there were 224 re-examinations. The attached table sets out the work of the Post-Infectious Disease Clinic:— Number of New Cases 55 Number of Examinations 172 Number of Re-Examinations 117 Number of Defects found 40 Infectious Disease after which examined. Result of Examination Acute Primary Pneumonia Whooping Cough Measles Scarlet Fever Diphtheria Number of patients found to be suffering from 2 2 5 Malnutrition 2 2 1 3 Heart Affection - - - - Ear Affection - 1 1 - - 2 - Nose Affection 1 - 1 Throat Affection - - 1 - Tonsils, enlarged or septic 2 - 2 2 - 4 - Albuminuria 2 - - 1 Dental Caries 1 - - - 1 - Spine Defect - - - - Mental Defect 1 - - - POST-NATAL AMD SPECIAL CLINICS FOR WOMEN. The total number of attendances at the Gynaecological Clinic was 416; of these 170 patients attended for the first time. The major portion of the patients seen at the clinic had a gynæcological or menopausal complaint. The few patients who were found to be suffering from some condition unsuitable for treatment were transferred either to their own doctor or to hospitals. The majority of the new patients complained of menstrual irregularities (36 cases). Only one of these had a carcinoma of the cervix and this was fortunately in an early stage. Seven patients came for examination on account of sterility and all of these were given advice or treatment —three subsequently became pregnant. The treatment of uterine inflammations and displacements formed, as in previous years, a major part of the work of this clinic. FOOT CLINIC. Attendances during the year are shown in the following table:— Clinic Men Women Total Bermondsey 1,932 6,990 5,058 Rotherhithe 1,597 4,310 5,907 Totals 3,529 9,368 12,897 VIII.—PROPAGANDA. During the year 1939 lectures and demonstrations, in every case illustrated by cinema films, were given as follows: — Schools 19 Clubs and other Institutions 33 Open Air (with Cinema Van) 30 A.R.P. 141 j — i— 223 Audiences numbered 25,250. This is the largest number of lectures and demonstrations ever given in one year, and the increase is entirely due to the help given by the Propaganda Department in the training of First Aid volunteers. From the outset of war in September to the present date the whole of the energies of the Propaganda Department have been devoted to A.R.P. work. IX.—SANITARY ADMINISTRATION HOUSING. During the year 1939, eight areas were represented to the Council, comprising in all 143 dwelling-houses, and 4 dwelling-houses and shops. The following are the areas represented:— Title of Clearance Area Area in sq. ft. (Approx.) Number of dwellinghouses Number of dwellinghouses and shops Date Epsom Court 3/1/39 6 2,230 - East Lane, No. 1 7/2/39 16,921 13 2 East Lane, No. 2 7/2/39 14,307 8 East Lane, No. 3 7/2/39 - 4,995 3 - East Lane, No. 4 7/2/39 12,584 9 - Donne Place 7/2/39 7,047 14 Wormald Place 7/2/39 - 3,427 7 - Larnaca Street 14/3/39 95,193 83 2 The following areas were declared by the Council, and the particulars of these are shown hereunder:— Date declared by Council Title of Clearance Area Area in sq. ft. (Approx.) No. of dwellinghouses Population Families Persons East Lane, No. 1, and lands adjoining 16,921 20 48 155 25/4/39 Donne Place 7,047 14 23 81 23/5/39 Wormald Place 3,427 7 8 36 23/5/39 Larnaca Street and lands adjoining 95,193 88 129 432 23/5/39 The clearing of these areas will necessitate the demolition of 129 houses and the rehousing of 208 families, consisting of 704 persons. Two hundred and fifty-four flats and four shops were erected during 1939. Particulars of these are given hereunder: — Number of Dwellings. Position. Arnold Estate 64 flats. Cherry Garden Street 15 flats. Kirby Estate 1 flat and 1 shop. 17 flats and 1 shop. Lockyer Estate 24 flats. Meakin Estate 37 flats. Neckinger Estate Redriff Road 10 flats and 1 shop. St. John's Estate 41 flats and 1 shop. Stansfeld Estate 31 flats. Tyers Estate 14 flats. At the end of the year 1939, the following dwellings were in course of erection by the Council: — Position. Number of flats and shops. Arnold Estate, Block 2 40 flats and 3 shops. Arnold Estate, Block 6 28 flats and 2 shops. 26 flats and 1 shop. Arnold Estate, Block 7 Prospect Street, Block 1 1 flat and 1 shop. 49 flats. Prospect Street, Block 2 Neckinger Estate Extension, Block 1 13 flats. Neckinger Estate Extension, Block 2 8 flats. 5 flats. Lynton Mews, Block 1 Elephant Lane Site, Block 1 1 flat. 17 flats. Elephant Lane Site, Block 2 1 flat. Redriff Estate, Block 9 Kipling Street Site, Block 2 23 flats and 1 shop. 4 cottages. Adams Gardens, Block 4 St. Olave's Buildings Site 59 flats. Private enterprise has been responsible for the erection of 34 flats. Altogether, therefore, 279 flats and 4 shops were erected in Bermondsey during the year. The houses demolished on insanitary areas number 300, and 9 houses have been demolished following the service of Demolition Orders. HOUSING ACT, 1936 —OVERCROWDING. The following was the position at the end of 1939 in relation to overcrowding: — (a) (i) Number of dwellings overcrowded at the end of the year 1,778 (ii) Number of families dwelling therein 1,778 (iii) Number of persons dwelling therein 10,512 (b) Number of new cases of overcrowding reported during the year 68 (included in (a) (i) above) (363 persons) (c) (i) Number of cases of overcrowding relieved during the year 243 (ii) Number of persons concerned in such cases 1,498 (d) No cases came to my notice during 1939 of dwelling-houses again becoming overcrowded after the Local Authority had taken steps to abate the overcrowding. (e) No cases of overcrowding were reported in which I considered it necessary to take statutory action. Eight cases of overcrowding in London County Council dwellings in Bermondsey have been abated, and 47 cases in Borough Council dwellings; 92 cases have been relieved in connection with slum clearance operations. These cases are included in (c) (i) above. ERADICATION OF BED BUGS. Sulphur Dioxide Gas, and the proprietary agent "Pyagra," the latter to the largest extent, are used as fumigants. The work devolves upon the staff of the Public Health Department, and premises occupied by families accepted as tenants by the Council are inspected before removal. Where rooms and effects are infested, fumigation is insisted upon before removal is permitted. The Sanitary Inspectors, as part of their duty, explain to the tenants the importance and means of preventing infestation. The following table shows the fumigations carried out during 1939:— Infested Disinfested Council houses or flats 254 254 Council houses on Insanitary Areas during decanting 283 283 London County Council Removals 117 117 Houses disinfested prior to demolition 267 — Other houses or flats 86 86 INSPECTIONS, PROCEEDINGS, ETC. Hereunder will be found particulars of Inspections, Proceedings, etc., for the year 1939: — Inspection of Dwelling-Houses during the Year: — (1) (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 5,900 (b) Number of Inspections made for the purpose 29,345 (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 2,645 (b) Number of Inspections made for the purpose 3,225 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 156 (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 557 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 1,888 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 557 (2) Number of dwelling-houses which were rendered fit after service of formal notices:— (a) By owners 510 (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 3,212 (2) Number of dwelling-houses in which defects were remedied after service of formal notices:— (a) By owners 1,324 (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 9 (2) Number of dwelling-houses demolished in pursuance of Demolition Orders 9 (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 1 (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit Nil Total number of houses in the Borough 19,529 Number of houses occupied by the working classes 19,385 REGISTERED PREMISES- Premises Number on Register at end of 1939 Number of Inspections Number of Prosecutions 3 Common Lodging Houses 56 - Seamen's Lodging Houses 3 15 - Milkshops 253 602 - Houses let in lodgings 955 1,876 - Ice Cream Premises 299 180 - Offensive Trades (including Poultry Slaughter-houses) 13 156 - SMOKE NUISANCES Number of observations 281 Number of notices 4 Number of complaints 8 Number of summonses Nil WATER SUPPLY TO TENEMENT HOUSES— Premises supplied 16 Prosecutions Nil SALE OF FOOD- Number of premises used other than ice-cream premises, milk-shops and cowsheds 586 Number of inspections 1,392 RAG FLOCK ACT, 1911, and PUBLIC HEALTH (LONDON) ACT, 1936:— There are four premises in the District where rag flock is used and eight inspections were made during the year. 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 inhabited by more than one family. Water supply has been installed on one of the storeys of 16 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. (48) WORK OF DISTRICT INSPECTORS, 1939. 4 5 6 10 11 12 13 14 15 16 18 20 21 22 3 7 8 9 17 19 23 1 2 Complaints Factories & Workshops Specially Inspected Offensive Trades Outworkers' Bi-Annual Inspection Other Calls and Visits Common and Seamen's Lodging Houses Butchers Fruiterers and Greengrocers Restaurants and Eating Houses Destruction of Food Chimney Watched Fishmongers, Friers and Curers Underground Conveniences Special Inspections Infectious Diseases TOTALS House-to-House Drains Tested Food Stores Bakehouses Ice Cream Markets Various Ints. Visits District No. 1 309 682 284 44 - 4 6 1769 21 4 14 13 2 10 5 28 25 15 1 3236 336 - - - „ No. 2 308 776 431 54 - 17 - 26 3089 92 14 - 22 11 55 19 14 36 21 - - 4985 614 - „ No. 3 282 668 425 94 5 - 14 2125 21 9 7 4 9 25 53 21 - - 24 14 - - 3810 442 „ No. 4 309 737 199 65 - - 11 - 20 1502 5 10 19 4 17 4 12 29 7 - - 2950 351 - „ No. 5 179 810 362 43 - - 22 - 27 2730 29 6 3 28 18 39 9 33 57 21 - - 4416 526 „ No. 6 333 1039 585 68 - - 24 - 27 1700 22 10 22 1 4 12 3962 587 15 13 42 27 18 1 - „ No. 7 476 801 258 78 - - 58 - 9 2343 44 8 44 12 116 21 37 44 25 1 - 4375 479 - „ No. 8 458 494 220 36 - - 47 - 11 2180 28 29 25 16 6 19 2 36 137 18 2 2 3766 436 Total 2654 6007 2764 482 - - 188 140 17438 262 90 71 170 79 285 82 227 408 146 5 2 31500 3771 - FACTORIES AND OTHER PREMISES. HOMEWORK. NATURE OF WORK (1) Outwork in Unwholesome Premises, Section 111 Outworkers' Lists, Section 110 Lists received from Employers Prosecutions Instances (11) Notices served (12) Prosecutions (13) Outworkers resident in Bermondsey received from other Districts Notices served on Occupiers as to keeping or sending lists (8) Outworkers Failing to keep lists (9) Failing to send lists (10) Resident in Bermondsey Resident in other Districts (5) Lists (2) Workmen (4) Contractors (3) Contractors (6) Workmen (7) Wearing Apparel— F—4 ! 1 I (1) Making, etc. 7 10 - 87 54 - 24 6 - 7 - - (2) Cleansing and washing - - - - - - - - - - - - Fur pulling - - - - - - - Umbrellas, etc. - - - - - - - 2 - - - - - - - - - Sacks 6 27 18 - - 2 - - - 3 3 - Paper, etc., Boxes, Paper Bags 2 11 3 - - 5 2 - - - - - Brush making 1 2 - - 2 - - - 1 1 - - Combs, etc. - - - - - - - - - - - - Leather Goods 2 1 3 - - - 1 - - - - - Surgical Instruments 2 - 4 - - - - - - - — - Coathangers 2 5 8 4 - - 1 - - - - - Carding of buttons, etc. - 22 - - - - - - 2 2 - - Onion Peeling - - - - - - - - - - - - Games and Toys - - 1 - - - - - - - - Artificial Flowers - - - - - - - - - - - - Total 25 - 133 90 60 12 - - 13 13 - - FACTORIES AND OTHER PREMISES. INSPECTION. Number of Premises Inspections Written Notices Occupiers Prosecuted 4,219 79 - Factories with mechanical power.. Factories without mechanical power Other Premises under the Act (in cluding works of building and engineering construction but not including outworkers' premises) 2,301 26 - 1,165 - - Total 7,685 - 105 DEFECTS FOUND. Number of Defects Number of defects in respect of which Prosecutions were instituted Particulars Found Remedied Referred to H.M. Inspector Want of Cleanliness (S.I.) - - 69 69 - Overcrowding (S.2.) - - - Unreasonable Temperature (S.3.) - - - - Inadequate Ventilation (S.4.) 4 4 - - - Ineffective Drainage of Floors (S.6.) - - - Sanitary Conveniences (5.7.)— Insufficient 7 7 - - Unsuitable or Defective 93 93 - - 2 Not separate for Sexes 2 - - 31 6 - 31 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.) 206 Total 206 6 - BAKEHOUSES. In Use Not in Use Above ground Underground Above ground Underground 32 10 13 3 38 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 1939: — Disposal Loads tons cwts. qrs. 16,473 19,582 7 1 House Refuse to Barge Trade Refuse to Barge 3,127 2,245 14 - Street Markets Refuse to Barge 2,236 2,104 4 1 21,836 23,932 5 2 Totals OFFENSIVE TRADES. The offensive trades on the Register are as follows: — Fellmongers 3 Fatmelters 1 Glue and size makers 3 Dresser of Fur Skins 6 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 28 STREET MARKETS. The market scheme continues to work smoothly and satisfactorily. Number of Licences in operation 459 Income £2,622 14s. 9d. There have been no prosecutions during the year. DRAINAGE WORK. Hereunder will be found particulars of drainage work, etc., carried out by the Drainage Inspector during 1939: — Drains Tested 673 Visits to Underground Conveniences 225 Other Visits 2,320 WORK OF THE FACTORIES AND SHOPS INSPECTOR. Shops. Visits 627 Notices served under Shops Act, 1934 4 Notices served under Public Health (London) Act, 1936 28 Factories (with mechanical power). Visits 652 Notices under Factory Act, 1937 68 Notices under Public Health (London) Act, 1936 7 Factories (without mechanical power). Visits 301 Notices under Factory Act, 1937 17 Notices under Public Health (London) Act, 1936 9 Workplaces. Visits 429 Notices served 33 Visits to Offensive Trade premises 156 Various Visits 112 Chimneys watched 19 (54) X.-FOOD CONTROL. PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1931. Ninety-six samples were taken during the year by the Wharves Inspectors, special action being required in connection with the following:— Article Examined Result Action Anchovy Paste, in metal tubes, Jugoslavia Tin 4.67 grains per lb. Re-exported. „ 1.10 „ „ „ 1.54 „ „ „ 1.77 „ „ Tin 0.22 grains per lb. Owner agreed to cease importing in metal tubes. Lead 2 parts per million Still under detention. Curry Powder, Madras Lead 40 parts per million .. „ 38 „ „ „ 32 „ „ „ 35 „ „ Fish Roe, Caviar Style, Denmark Benzoic Acid, 360 parts per million Re-exported. Greengage Pulp, Holland Copper 480 parts per million Re-exported. Sild, Norway Tin 2.52 grains per lb. Stocks destroyed. Re-exported. Tomato Puree, France Copper 140 parts per million Tin 0.66 grains per lb. Re-exported. Tomato Puree, Italy Copper 165 parts per million „ 160 „ „ „ 125 „ „ Three samples, two of prawns and one of Chinese eggs, were submitted for bacteriological examination, with satisfactory results. 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. Description of Food Weight tons cwts. qrs. lbs. 2 3 14 Fish - Fruit 4 - 10 Meat - 3 2 14 Milk - - - 5 Poultry - - - 4 Vegetables - - - 24 Total - 3 15 10 MILK PREMISES. MILK AND DAIRIES (AMENDMENT) ACT, 1922. FOOD AND DRUGS ACT, 1938. Twenty-one milk sellers were registered under the above Acts during 1939, and 24 were removed from the Register, making a total of 253 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 18 To sell Pasteurised Milk 28 Supplementary Licences. To sell Accredited Milk 1 To sell Pasteurised Milk 15 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. Samples of milk, both for bacteriological and chemical examination, are taken from milksellers, and special arrangements are made for the sampling of the milk supplied to all schools in the borough. The total number of samples submitted for analysis during 1939 was 756, of which number 74 were taken from schools. For Chemical (i.e., Fat and non-Fatty Solids Examination. Liquid Milk, undesignated 401 Liquid Milk, undesignated (informal) 2 Sterilized Milk 92 Tuberculin Tested Milk 4 Accredited Milk (informal) 2 Pasteurised Milk 11 Pasteurised Milk (informal) 35 Condensed Milk (informal) 30 Sterilized Milk (informal) 1 578 For Bacteriological Examination. Tuberculin Tested Milk. 64 Tuberculin Tested (Pasteurised) Milk 8 Pasteurised Milk (from schools) 37 Pasteurised Milk (other than from schools) 59 For tubercle bacilli 5 For brucella abortus 3 Accredited 2 178 ICE CREAM. Seventy-eight samples of ice cream have been examined, with the following results: — 1. Bacterial Count. Up to 500 per 1 c.c. 7 Over 500 to 1,000 per 1 c.c. 2 Over 1,000 to 5,000 per 1 c.c. 11 Over 5,000 to 10,000 per 1 c.c. 10 Over 10,000 to 50,000 per 1 c.c. 22 Over 50,000 to 100,000 per 1 c.c. 7 Over 100,000 to 200,000 per 1 c.c. 5 Over 200,000 to 400,000 per 1 c.c. 1 Over 400,000 to 600,000 per 1 c.c. 1 Over 600,000 to 1,000,000 per 1 c.c. 1 Impossible to count 4 " More than fifteen million " 1 (56) 2. Presence of B. Coli. B. Coli present in 1 c.c., 1 10th c.c. and 1 100 th c.c. 14 B. Coli present in 1 c.c. and 1 10th c.c. 6 B. Coli present in 1 c.c. 10 B. Coli absent in 1 c.c., 1 10th c.c., and 1 100 th c.c. 42 72 3. Chemical Analysis. Fat 2.45 per cent. 1 Fat 2.51 per cent. 1 Fat, 2.61 per cent. 1 Fat 3.85 per cent. 1 Fat, 11.78 per cent. 1 Fat 12.86 per cent. 1 6 PHARMACY AND POISONS ACT, 1933. Fifty-two premises were entered on the Council's list for the year under report, one being removed later. As a result of informal samples being purchased, it was found that fourteen contraventions of the Act occurred, poisons being sold wrongly by both listed and unlisted vendors. Warning letters were sent in each case. FOOD AND DRUGS. During the year 1,421 articles were submitted for analysis, of which number the following 21 were found to be adulterated. Adulterated samples taken during the four months of war numbered 14. Eucalyptus 1 Gin 2 Lard 2 Milk 3 Sausages 5 Sild 2 Vinegar 2 Whisky 4 21 PROSECUTIONS IN CONNECTION WITH SAMPLES TAKEN DURING 1939. No. Sample Adulteration or Infringement Remarks Sausages Selling Sausages containing preservative without causing them to be labelled. Selling Sausages to the prejudice of the purchaser. 238 Sausages Fine £5. Fine £3. Costs £3 3s. Ditto 239 Dismissed under Probation of Offenders Act, 1907, upon payment of £2 2s. costs. Selling Whisky to the prejudice of the purchaser. Whisky 240 Fine £15. Costs £3 3s. Sausages 241 Selling Sausages containing preservative without causing them to be labelled. Selling Sausages to the prejudice of the purchaser. Dismissed under Probation of Offenders Act, 1907, upon payment of £1 1s. costs. Selling Milk 38.6 per cent. deficient in milk fat. 242 Milk Fine £2. Costs £2 2s. SUMMARY. £. s. d. Fines 25 0 0 Costs 11 11 0 £36 11 0 (59) PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1937. Quantity Unsound Articles Disposed of for purposes other than human food Removed for sorting under S.A. Destroyed Exported Weight Weight Weight Weight Tons cwts. Tons CWts. Tons cwts. Tons cwts. qrs. lbs. qrs. lbs. qrs. lbs. qrs. lbs. Meat 24 12 0 24 2 3 0 23 67 0 0 0 3 19 2 25 7 17 3 24 Dairy Produce 112 19 0 0 5 0 0 - - - - - Fruit 124 7 0 14 - - - - 45 0 0 0 6 10 0 0 Fish 14 12 0 21 2 14 0 0 - - - - - - - - Nuts 1 18 0 0 8 5 2 18 - - - - - - - - Vegetables 89 3 0 15 - - - - 4 1 11 - - - - - Confectionery 1 5 0 0 1 2 25 - - - - - - - - - Cereals 63 14 3 12 - - - - - - - - - - - - Various - - - - 44 4 1 0 - - - - - - - - 99 395 112 13 8 0 4 16 1 4 9 1 11 3 2 25 WORK OF THE WHARF AND FOOD INSPECTORS, 1939. 1 2 3 4 5 6 7 8 9 10 11 12 Food Factories Number of Samples taken Butter and Margarine Fish Curers Food and Drugs Milk (Special Designation) Order Samples of Milk for presence of Tubercle Bacilli Samples of Milk for presence of Bacillus Abortus Imported Food Regulations Pharmacy and Poisons Ice Cream Premises Food Wharves and Depots Ice Cream (Bacteriological Examination) Imported Food (Bacteriological Examination) Destruction of Food Nuisances Found Pharmacy and Poison Visits Intimations Served Various Milksellers (60) Food Stores Other Jam Mr. Frankson 9 4 25 2 60 1278 - 157 2 2 17 - - - - - - - - - - Mr. Toll 6 152 - 333 2512 - - 311 1 1 46 - 62 - - - - - - - - Mr. Butcher 44 20 129 12 133 1305 - - 135 6 1 1152 - 14 - - - - - — - Mr. Tapsfield - 1 - - 82 602 213 3 - - 84 74 1421 3 175 5 72 3 3 65 • I 72 3 65 Totals 53 30 307 14 526 5177 602 213 606 9 4 282 74 1421 96 175 5 3 XI.—HEALTH SERVICES. The detailed list of health services shown in previous Annual Reports has not been published this year, owing to the frequent changes in the services necessitated by war conditions. All services will be maintained as fully as possible, and up-to-date information regarding the time-tables of all Centres and Clinics, the Ambulance Facilities afforded by the London Ambulance Service of the London County Council, Obstetric and Puerperal Fever Consultants and other services will be supplied on application to the Medical Officer of Health, Telephone No. BERmondsey 2109.