AC 4378 BER 53 Borough of Bermondsey. REPORT ON THE SANITARY CONDITION OF THE BOROUGH OF BERMONDSEY For the Year 1940 BY D. M. CONNAN, M.D., D.P.H., Medical Officer of Health. BER 53 Borough of Bermondsey. REPORT ON THE SANITARY CONDITION OF THE BOROUGH OF BERMONDSEY For the Year 1940 BY D. M. CONNAN, M.D., D.P.H., Medical Officer of Health. TABLE OF CONTENTS. PUBLIC HEALTH DEPARTMENT— PAGE Public Health Committee 4 Maternity and Child Welfare Committee 4 Staff 5 VITAL STATISTICS— Area 8 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 12 Deaths from Zymotic Diseases 14 Infantile Mortality, Causes of Deaths 15 INFECTIOUS DISEASES— Diseases Notifiable 16 Diphtheria Prevention 16 Disinfection 17 Cleansing Station 17 Shelter 17 Bacteriological Laboratory 18 Food Poisoning 18 Insulin for Diabetic Patients 18 Nursing 19 Cases Notified in 1940 20 Cases Notified for last ten years 21 TUBERCULOSIS- New Cases and Deaths 22 Period between Notifications and Deaths 22 Nursing, Extra Nourishment and Shelters 23 Lady Almoner 23 Work of the Tuberculosis Dispensary 24 Summary of Notifications 25 Cases on the Register 26 LIGHT TREATMENT, ELECTRO-THERAPY AND MASSAGE— Work done in the Solarium 27 PAGE MATERNITY AND CHILD WELFARE— Fairby Grange Convalescent Home 28 Obstetric ansd Puerperal Fever Consultants 28 Child Life Protection 28 Work of the Health Visitors 29 Attendances at Centres 30 Extracts from Vital Statistics, 1940 31 DENTAL TREATMENT— Particulars of Children Treated 32 Particulars of Treatment and Work for 1940 33 CONSULTATION AND OTHER CLINICS- X-ray Department 34 Post-Natal and Special Clinics for Women 35 Foot Clinic 35 PROPAGANDA 36 SANITARY ADMINISTRATION— Housing 37 Housing Act, 1936 —Overcrowding 37 Eradication of Bed Bugs 37 Inspections and Proceedings 38 Work of the District Inspectors 41 Factories and Workshops—Homework 42 Factories and Workshops—Inspections 43 Bakehouses 44 House, Trade and Market Refuse 44 Offensive Trades 44 Mortuary 44 Street Markets 45 Drainage Work 45 Work of Factories and Shops Inspector 45 FOOD CONTROL— Imported Food Regulations—Samples taken 46 Unsound Food—Shops and Stalls 46 Milk Premises 47 Milk Licences 47 Milk Sampling 47 Ice Cream 48 Pharmacy and Poisons Act, 1933 48 Food and Drugs—Samples Taken 49 Food and Drugs—Prosecutions 49 Unsound Food—Wharves, etc. 50 Work of the Wharves and Food Inspectors 51 HEALTH SERVICES 52 PUBLIC HEALTH DEPARTMENT. PUBLIC HEALTH COMMITTEE, 1940. Chairman Councillor E. J. GIBSON .. 1939-40, 1940-41 Vice-Chairman „ S. R. WEIGHTMAN 1939-40, 1940-41 Alderman M. Mahoney Councillor C. J. Lee Councillor Mrs. S. C. Amos „ F. W. Love „ H. A. Beal „ G. Loveland „ J.A.W.Douglas „ Mrs. M. F. Lowery „ A.M.Downing „ Mrs. W. L. Miller „ F.J.W.Fielder „ A. E. Smith „ Mrs. L. A. Glasson „ Mrs. J. V. Snowdon Mrs. F. Humphreys A. E. Winch A. V. Kidd Ex-officio: Councillor A. G. R. HENLEY, J.P., Mayor of Bermondsey, 1939-40, 1940-41 MATERNITY AND CHILD WELFARE COMMITTEE, 1940. Chairman .. Councillor Mrs. W. L. Miller, 1939-40 Chairman .. Alderman Mrs. L. Jones, 1940-41 Vice-Chairman Alderman Mrs. L. Jones, 1939-40 Vice-Chairman Councillor Mrs. F. A. Powell, 1940-41 Alderman Mrs. L. M. Brown Councillor Mrs. L. A. Glasson Councillor D. Bradley „ Mrs. F. Humphreys Miss I. Condon „ Mrs. R. E. Laker Mrs. M. Cushing „ Mrs. M. F. Lowery „ E. J. Gibson „ Mrs. J. V. Snowdon Co-opted Members: Mrs. L. J. Benwell Mrs. D. Downing Mrs. E. B. Childs Mrs. A. M. Hatcher Rev. L. Davidson Mrs. A. P. Henley Ex-officio: Councillor A. G. R. HENLEY, J .P., Mayor of Bermondsey, 1939-40, 1940-41 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 (Retired May, 1940) J. G. Frankson, Senior Inspector G. F. J. Toll, Wharves and Food Inspector H. E. Butcher, Wharves and Food Inspector W. C. Tapsfield, Wharves and Food Inspector F. L. Richardson, Drainage and Markets Inspector H. J. Bailey, Food and Drugs Inspector W. A. Campbell, Factories and Shops Inspector District Inspectors. F. J. Carpenter W. A. Pilson A. W. Hancock O. W. R. Smart L. T. Knott W. F. Smith C. E. Lockley (Resigned May, 1940) 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—*H. T. Levi, M.B., Ch.B. 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 (Resigned August, 1940) and Elsie Watkins (Resigned August, 1940) 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. Health Visitors. Barbara Anderson Elizabeth Lawrence Rosa Bache Olive Oram Avis Baird Kathleen Parry Sarah Bowles Gwendolen Riches Lucy Brown Edith Riley Florence Robson Florence Carter (Resigned July, 1940) Edith Crundwell) Florence Wadds Phyllis Hesketh Isabel White 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 Gynæcologist—Gladys Dodds, M.D.,D.P.H., M.C.O.G. F.R.C.S. (Eng.) 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.1.C., F.C.S. PROPAGANDA AND ADMINISTRATIVE OFFICER : H. W. Bush, F.I.P.A., M.R.I.P.H.H. CLERICAL STAFF. H. J. Smith, General Clerk A. I. Fair, Chief Clerk (Retired August, 1940) C. H. Harris, General Clerk F. W. Smith, Chief 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 J. A. Blake, General Clerk *J. L. Springett, General Clerk J. F. M. Brooker, General Clerk *F. H. Mummery, Junior Clerk C. F. Yaxley, General Clerk Joyce Field, Junior Clerk Rose Dutch, Clerk and Dispenser *S. R. Weightman, Junior Clerk (Retired November, 1940) Nellie Simms, Junior Clerk (Commenced August, 1940) 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 1940. In accordance with the instructions of the Minister the Report has been made as brief as possible and therefore consists almost solely of statistics. During the year the two Committees which are mainly concerned with the work of this Department, namely, the Public Health Committee and the Maternity and Child Welfare Committee, have continued to meet though with less frequency than usual. lam grateful for the support and encouragement which I have received from the members and wish particularly to express this gratitude to the two Chairmen. It is always the privilege of a chief official to come into close contact with the Mayor, and in war-time this relationship is closer than at other times. I may therefore be permitted to say how greatly we have missed the friendly, cheerful and encouraging presence of the late Mayor, Councillor A. G. Henley, J.P,, who was killed by enemy action on the 11th May, 1941. 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 rateable value of the borough on the 31st December, 1940 was £873,847, the product of a penny rate being £3,445. POPULATION. Census Estimate of Registrar General 1931 to 30th June, 1940 1921 to 30th June, 1939 71,590 119,452 111,542 †95,500 ‡90,210 † For calculation of Birth Rate. ‡ For calculation of Death Rate. BIRTHS. The total number of births belonging to the borough registered during 1940 was 1,232, consisting of 615 males and 617 females. The number for 1939 was 1,275. The birth rate for 1940 was 17.2 per 1,000 persons living, compared with 13.4 for 1939. DEATHS. The total number of deaths belonging to the borough registered during 1940 was 1,551, consisting of 795 males and 756 females. The number for 1939 was 1,010. The death rate for 1940 was 21.7 per 1,000 persons living, compared with 11.2 for 1939. MARRIAGES. The total number of marriages in the borough in 1940 was 1,186, being 72 below the number for 1939, and 156 above the average for the last 10 years. The figures have been supplied by the Superintendent Registrar. This makes a marriage rate of 33.13 per 1,000 of the population, compared with a marriage rate last year of 26.35. Year No. Rate 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 1939 1,258 26·35 Average for years 1930 —1939 1,030 19·85 1940 1,186 33·13 INFANTILE MORTALITY. The Infantile Mortality Rate for the year 1940 has been calculated on the figure of 1,146 live births furnished by the Registrar-General. Year Whole Borough London No. of Deaths Rate per 1,000 Births No. of Deaths Rate per 1,000 Births 1930 130 63 4,109 59 1931 112 57 4,270 65 1932 103 56 4,143 67 61 3,377 60 1933 92 1934 100 64 3,832 67 69 3,229 1935 103 58 1936 92 60 3,691 66 84 1937 59 3,309 60 1938 65 45 57 3,130 1939 45 37 2,409 47 Average for years 1930-1939 93 57 3,550 61 1940 40 35 2,062 48 TUBERCULOSIS OF THE RESPIRATORY SYSTEM. In the following Table will be found particulars of deaths from Tuberculosis of the Respiratory System since the year 1930. Sub-District Bermondsey Rotherhithe St. Olave Whole Borough London Year No. No. No. Rate No. No. Rate 1930 36 15 3826 81 132 1·16 0·87 81 30 5 116 1·03 3907 0·90 1931 116 1932 71 34 11 1·05 3564 0·82 68 23 8 99 0·92 3530 0·82 1933 0·86 1934 64 22 4 90 3227 0·76 70 23 5 98 0·95 2847 1935 0·68 1936 51 22 6 79 0·79 2848 0·69 87 0·89 2888 0·71 1937 63 22 2 1938 42 23 1 66 0·68 2590 0·64 38 2650 1939 21 6 65 0·72 0·70 3188 Averages for years 1930-1939 6 0·76 26 9 63 0·90 1940 43 21 4 0·95 68 2687 0·87 VITAL STATISTICS OF WHOLE DISTRICT DURING 1940 AND PREVIOUS YEARS. Population estimated to Middle of each Year 2 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 Year 1 Under 1 Year of Age At all Ages No. 3 Rate 4 Rate per 1,000 Births registered 6 No. 5 No. 12 Rate 13 No. 7 Rate 8 1930 44 1,169 10·3 686 46 365 1,488 13·1 113,800 2,059 18·1 90 46 1,169 10·4 596 92 331 1,408 12·5 1931 112,400 1,958 17·4 91 1,831 16·6 81 44 1,147 10·4 689 189 368 1,326 12·0 1932 110,100 107,300 72 48 1,216 11·3 720 215 339 1,340 12·5 1933 1,500 14·0 11·6 784 229 1,304 1934 105,060 1,557 14·8 77 49 1,223 310 12·4 1,142 1,201 102,700 1,487 14·5 99 67 11·1 756 255 314 11·7 1935 15·4 76 49 1,136 11·3 723 175 328 1,289 12·8 1936 100,400 1,545 1,148 741 245 309 1,212 12·3 1937 98,790 1,421 14·4 61 43 11·6 1,072 1938 97,420 1,439 14·8 60 42 1,002 10·3 488 201 271 11·0 * 95,500 1,010 1,275 13·4 40 31 968 10·7 445 201 243 11·2 1939 ‡90,210 Averages for years 1930-1939 185 46 1,132 10·9 1,607 15·3 318 104,347 75 12·1 663 1,265 71,590 1940 17·2 28 1,483 20·7 829 304 373 1,551 21·7 1,232 35 * For calculation of Birth Rate, ‡For calculation of Death Rate. CAUSES OF, AND AGES AT, DEATHS DURING THE YEAR 1940. Deaths at the subjoined ages of "Residents" whether occurring in or beyond the District. Causes of Death All Ages Under 1 1 and under 2 2 and under 5 5 and under 15 15 and under 25 25 and under 45 45 and under 65 65 and upwards All Causes Certified 40 13 21 47 106 205 412 1551 707 Uncertified - - - - - - - - - Typhoid and Paratyphoid Fever - - - - - - - - - 2 Cerebro-spinal Fever 2 - - - - - - - Scarlet Fever - - - - - - - - - Whooping Cough 1 1 - - - - - - - Diphtheria - - - - - - - - - Tuberculosis of Respiratory System 68 1 13 19 30 5 - - - 2 1 Tuberculous — other forms 3 - - - - - - 3 2 Syphilitic Disease 10 1 4 - - - - Influenza 7 1 2 4 - - - - - Measles - - - - - - - - - Acute Poliomyelitis and Polioencephalitis - - - - - - - - - Acute Infectious Encephalitis - - - - - - - - - Cancer of Buccal Cavity and Oesophagus (Males only) 5 13 18 - - - - - - Cancer of Uterus - - - - - - - - - Cancer of Stomach and Duodenum 38 1 19 18 - - - - - Cancer of Breast 10 8 2 - - - - - - Cancer of all other sites 72 1 1 4 29 37 - - - Diabetes 6 1 5 - - - - - - 63 1 2 25 Intra-cranial Vascular Lesions 91 - - - - 67 201 Heart Disease 279 1 4 6 - - - CAUSES OF, AND AGES AT, DEATHS DURING THE YEAR 1940 — continued. Deaths at the subjoined ages of " Residents " whether occurring in or beyond the district. Causes of Death All Ages Under 1 1 and under 2 2 and under 5 5 and under 15 15 and under 25 45 and under 65 65 and up wards 25 and under 45 Other Diseases of the Circulatory System 34 2 7 25 - - - - - Bronchitis 140 1 1 1 41 91 - - 5 3 Pneumonia 90 7 3 2 3 6 26 40 Other Respiratory Diseases 15 3 1 1 7 3 - - - Ulceration of the Stomach or Duodenum 19 4 6 9 - - - - - Diarrhœa (under 2 years of age) 2 2 - - - - - - - Appendicitis 4 1 2 1 - - - - - 30 Other Digestive Diseases 2 1 3 10 - - - 14 Nephritis 104 11 6 87 - - - - - Puerperal and Post-abortive Sepsis 1 1 - - - - - - - 3 Other Maternal Causes 3 - - - - - - - Premature Births 12 12 - - - - - - - Congenital Malformations, Births, Injury, Infantile Diseases 6 5 1 - - - - - - Suicide 4 - - 3 1 - - - - 4 Road Traffic Accidents 1 1 1 1 - - - - Other Violent Causes 417 7 5 16 39 77 122 95 56 All Other Causes 61 1 1 1 3 14 - 11 30 40 21 47 106 205 I 1551 13 412 707 DEATHS FROM ZYMOTIC DISEASES, 1940. All Causes Principal Zymotic Diseases Smallpox Measles Scarlet Fever Diphtheria Whooping Cough Enteric Fever Diarrhœa Year Rate Rate No. No. Rate No. No. Rate No. Rate Rate No. No. No. Rate Rate Rate No. 1488 13.1 7 1930 101 ·89 61 ·54 ·06 8 ·07 6 ·05 2 ·02 17 ·15 - - 12·5 24 3 1931 1408 ·21 ·03 1 ·01 6 ·05 5 ·04 9 08 - - - - 25 1932 1326 12·0 67 ·61 1 01 - ·10 16 ·15 14 ·13 ·23 11 - - - 1933 1340 12·5 45 4 5 ·13 ·42 9 ·08 ·04 13 ·12 ·05 14 - - - - 1304 87 38 1 1934 12·4 ·83 ·36 ·01 10 ·10 10 ·10 28 ·26 - - - - 1935 1201 11·7 54 ·53 4 ·04 - 10 ·10 5 ·05 35 ·34 - - - - - 1289 20 1936 12·8 56 ·20 8 ·08 5 ·05 4 ·04 ·19 ·56 - 19 - - - 1937 36 - 7 1212 12·3 ·36 - 5 ·05 ·07 24 ·24 - — - - - - 11·0 4 1938 1072 30 ·31 9 ·09 - 4 ·04 ·04 13 ·13 - - - - - 1939 1010 11·2 17 ·19 7 ·08 2 ·02 8 ·09 - - - - - - - - Average for years 1930-1939 52 1 - 6 1265 18 12·1 1 ·08 ·49 - 17 8 ·06 ·01 ·17 ·16 ·01 1940 - 1 - - - - - 3 - - 2 21·7 1551 ·04 - ·01 ·03 - INFANTILE MORTALITY. Deaths from Stated Causes at Various Ages under One Year of Age, 1940. Under 1 week 2-3 weeks 3—4 weeks Total under 1 month 1-3 months 6-9 months 9—12 months Total under 1 year 3—6 months Cause of Death 1—2 weeks Measles - - - - - - - - - - Scarlet Fever - - - - - - - - - - 1 1 Whooping Cough - - - - - - - - Diphtheria - - - - - - - - - - (15) Influenza - - - - - - - - - - 2 2 Cerebro-spinal Meningitis - - - - - - - - Tuberculous Meningitis - - - - - - - - - - Other forms of Meningitis - - - - - - - - - - Tuberculosis of Respiratory System - - - - - - - - - - Other Tuberculous Diseases - - - - - - - - - - Syphilis 1 1 - - - - - - - - 1 1 Bronchitis - - - - - - - - 7 Pneumonia (all forms) 2 1 1 3 - - - - - Other Respiratory Diseases - - - - - - - - - - 1 1 1 3 Diarrhoea and Enteritis - - - - - - Congenital Debility and Malformation, Premature Birth 10 2 12 - - - - - - - 1 4 Injury at Birth 3 - - - - - - - 2 2 9 Other Causes 1 4 - - - - - Totals 13 2 - - - 3 7 6 9 40 II.- INFECTIOUS DISEASES, ETC. The following diseases are notifiable: — Anthrax Acute Polioencephalitis Acute Poliomyelitis Acute Primary Pneumonia Acute Influenzal Pneumonia Cholera Cerebro-Spinal Meningitis Continued Fever Diphtheria Dysentery Enteric Fever and Typhoid Encephalitis Lethargica Fever Erysipelas Glanders Hydrophobia in Man Malaria Measles Membranous Croup Ophthalmia Neonatorum plague Puerperal Pyrexia Puerperal Fever Scarlet Fever and Scarlatina Relapsing Fever Typhus Small-pox Whooping Cough Tuberculosis —all forms DIPHTHERIA PREVENTION. The appended table shows the attendances at the Schick Clinics during the year Clinic No. of new patients Total Attendances No. of Sessions Public Health Centre, Grange Road 37 79 461 2 50 Public Air Raid Shelters 50 39 129 511 Totals 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 566 Pillows (cases) 1,312 Blankets 5,481 Quilts 925 Bolsters 455 Sheets 1,155 ,, (cases) 257 Furniture 1,192 Books 51 Miscellaneous 4,747 Mattresses 2 Verminous Clothing 642 Overlays 1,427 „ Bedding 6,603 Pillows 1,651 Scabies, Clothing 6,157 26,044 new tabs were used to replace those taken off mattresses, palliasses, and cushions before disinfection. Number of rooms disinfected 1,798 Number of air raid shelters disinfected 96 Number of mattresses and other articles destroyed 774 Furniture, Floorcloth, etc. destroyed 101½ Loads CLEANSING STATION. Verminous persons cleansed Adult Females 121 Adult Males 51 Children 1,664 Persons treated for Scabies: — Number treated Number of baths given Adult Females 152 305 Adult Males 75 153 Children, Females 195 1,049 Children, Males 173 1,027 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 three, one for scarlet fever, one for scabies and one for temporary insanitary condition of house, the total number of persons accommodated being 19. BACTERIOLOGICAL LABORATORY. The work done in the Laboratory during the year is set out in the appended table. Examined for Total Examinations Results of Examination Positive Negative 1939 1940 1939 1940 1940 1939 149 34 3 Diphtheria (specimens taken by Medical Officer of Health) 34 - 146 Ditto (taken by general practitioners) 793 388 34 759 371 17 Diphtheria (total specimens taken) 942 422 37 905 17 405 Phthisis 939 510 146 80 793 430 Various 229 94 18 7 211 87 Total specimens taken 1026 201 104 1909 922 2110 FOOD POISONING. Five 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-nine patients have been supplied during the year as compared with thirty-three patients in 1939. (19) NURSING. The following table shows the number of patients nursed under the Council's Scheme, the diseases from which these patients were suffering and the number of visits paid. Under this scheme the Council assists in the provision of nursing for expectant and nursing mothers, children under five, and for patients suffering from the following diseases : —Measles, German Measles, Whooping Cough, Puerperal Fever and Puerperal Pyrexia, Epidemic Diarrhœa, Dysentery, Influenza, Ophthalmia Neonatorum, Polio-myelitis, Encephalitis Lethargica, Malaria, Acute Primary and Acute Influenzal Pneumonia and Tuberculosis. The fee payable by the Borough Council to the Nursing Associations is 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 Rotherhithe Queen's Nursing Association Totals whole Borough Disease Cases Visits Cases Visits Cases Visits Pneumonia 26 423 7 110 33 533 Broncho pneumonia 5 92 2 28 7 120 Bronchitis 10 115 13 11 128 Influenza 31 408 2 15 33 423 Measles 7 140 2 38 9 178 Whooping Cough Tuberculosis:— (a) Respiratory System 27 2,325 8 241 35 2,566 (6) Other Forms 1 106 — — 1 106 Puerperal Pyrexia 1 36 2 44 3 80 Puerperal Fever — — — — — — Pregnancy and Labour 25 390 7 67 32 457 Diseases of the Digestive System 14 127 — — 14 127 Infantile Diarrhoea (under 2 years) — — — — — — Discharging Ears 3 49 — — 3 49 Discharging Eyes 1 10 2 41 3 51 Post-operative cases (a) Tonsils & Adenoids — — — — — — (6)other cases 3 19 3 24 6 43 Other diseases 20 222 3 30 23 252 Totals 174 4,462 39 651 213 5,113 CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR 1940. Total Cases removed to Hospital BERMONDSEY ROTHERHITHE ST OLAVE NUMBER OF CASES NOTIFIED NOTIFIABLE DISEASE At all Ages St. John St. Olave St. Thomas Total At Ages—Year 1 5 6 Total 1 2 3 Total 2 3 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 4 10 16 7 6 1 5 - 7 - 3 Diphtheria (including Membranous Croup) 3 45 2 5 1 4 55 19 17 9 2 2 1 56 3 - - - 6 6 1 29 5 - 11 2 1 3 27 1 3 9 9 8 8 3 11 2 3 6 - Erysipelas 43 1 1 - - 19 31 13 11 10 2 12 230 116 10 1 1 39 51 40 9 18 176 55 243 3 59 26 19 7 1 - Scarlet Fever - 3 3 19 9 Cerebro-Spinal Meningitis 2 6 3 3 1 4 2 4 - 1 27 3 1 11 4 2 2 1 - 29 3 - - - Ophthalmia Neonatorum - - 2 - 1 - - 2 - 2 2 - - - - - - - - - - - - - - - - - - - - 2 2 - - 1 1 2 - - - - - Puerperal Fever 2 - - - - - - - - - - - - 4 2 4 - 1 - 1 6 3 5 2 1 1 1 1 6 - Puerperal Pyrexia 11 1 - - - — - - - - - 1 2 1 1 1 - - 2 1 1 - - - - - - - Enteric Fever - - - - - - - - - - - - - 1 2 - 4 - 4 1 1 3 1 - 1 - - - Dysentery 6 1 - - - - - - - - - Pneumonia (Acute Primary and Acute Influenzal) 5 14 6 2 22 11 77 25 35 18 2 5 1 1 104 6 23 3 2 4 5 11 11 11 10 18 19 - 2 14 2 7 1 3 4 17 16 4 1 5 2 - 3 2 — Whooping Cough 25 9 - - - - - - - - - 12 15 36 10 20 184 70 29 31 18 13 173 17 4 10 Measles 229 23 167 33 4 2 - - - - - - - 3 64 8 1 Tuberculosis — Respiratory System 10 16 12 5 8 29 4 11 10 - 2 2 1 14 16 28 11 12 8 3 13 - 97 - 5 - Other forms of Tuberculosis - 1 1 2 - 2 - 2 1 - - - 6 - 1 1 1 1 - - - - - - - - 82 62 49 193 27 22 2 51 141 133 66 52 52 611 587 Totals 51 347 115 44 56 43 71 39 37 28 24 855 167 CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEARS 1931-1940. 1931 1933 1934 1935 1937 Notifiable Disease. 1932 1936 Small Pox 3 16 21 7 - - - 263 372 Diphtheria (including Membranous Croup) 263 386 273 207 167 49 73 28 Erysipelas 49 68 53 39 266 Scarlet Fever 310 446 640 597 367 167 Cerebro-Spinal Meningitis 9 9 4 2 2 4 10 Acute Polio-Myelitis and Acute Polio- Encephalitis 1 1 3 1 - - - 14 Ophthalmia Neonatorum 10 7 6 5 6 1 Anthrax 1 1 - - - - - 2 2 15 Enteric Fever 1 2 3 5 Puerperal Fever 13 8 6 2 3 6 1 13 Puerperal Pyrexia 37 27 24 19 9 13 2 2 Encephalitis Lethargica 1 2 - - - Dysentery 1 3 1 43 - - - Malaria - - - - - - - Malaria (induced) - - - - - - - Pneumonia (Acute Primary and Acute Influenzal) 167 102 136 121 113 125 170 103 275 Whooping Cough - - - - - Measles 7 85 - - - - - Tuberculosis:— 141 129 147 Respiratory System 175 177 182 142 Other forms of Tuberculosis 40 35 34 32 34 34 31 1,083 1,149 1,512 1,371 1,004 966 1,145 Totals 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, 1940—NEW CASES AND DEATHS. AGE—PERIODS NEW CASES DEATHS Pulmonary Non- Pulmonary Non- Pulmonary Pulmonary M. F. M. F. M. F. M. F 0 - - - - - - - - 1 2 - - 1 - - 1 - 5 1 1 - - 1 - - - - 1 10 - 1 - - - - 15 4 - 2 2 - 1 10 6 20 - 7 16 2 1 1 2 3 19 - 25 13 - 2 1 7 3 9 35 4 - - - - 6 3 45 10 - - - 2 - 8 2 55 6 - - - 3 15 5 - 65 and upwards - - 2 2 - 2 3 - 3 6 60 42 26 53 - 3 TABLE II. TUBERCULOSIS, 1940—PERIOD BETWEEN NOTIFICATION AND DEATH. Period Between Notification and Death Respiratory System Other Forms Males Females Total Percentage of Total Deaths Males Total Percentage of Total Deaths Females Not notified 7 2 9 13·23 - 1 1 33·33 6 2 8 11·77 1 1 0-1 month - 33·33 1-3 months 2 4 6 8·82 - 1 1 33·34 3-6 months - 1 1 1·47 - - - - 6-12 months 4 4 8 - - 11·77 - - 1-2 years 3 3 6 8·82 - - - - 2-5 years 9 7 16 23.53 - - - - 9 Over 5 years 5 14 20·59 - - - - Totals 42 68 100·00 26 - 3 3 100·00 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; 2,672 visits were paid by the nurses in 1940. A limited provision is made for the supply of extra nourishment to tuberculous persons, and this usually takes the form of eggs and milk ; 68 patients received help in this way during the year. The scheme for the provision of shelters has been continued, and 5 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 1940. Grand Total Pulmonary NOn pulmonary Total Adults Children Adults Adults Children Children Diagnosis M. F. M. F. M. F. M. F. M. F. M. F. A.—New Cases examined during the year (excluding contacts):— i (a) Definitely tuberculous 34 29 1 4 2 2 35 33 2 2 72 - - (b) Diagnosis not completed 3 2 5 - - - - - - - - - - 280 (c) Non-tuberculous 162 104 8 6 - - - - - - - - B.—Contacts examined during the year:— I I I I I I —ii il 1 I I I I I II II I I I I I I - (o) Definitely tuberculous 6 6 1 6 6 1 13 - - - - - - (6) Diagnosis not completed - - - - - - - - - - - - - (c) Non-tuberculous 15 26 15 16 72 - - - - - - - - .C-Cases written off the Dispensary Register as I I I I ■ Il Il I — I II II I I I I I I I — 14 - 48 (a) Recovered 9 5 4 6 5 5 14 15 10 9 (b) Non-tuberculous (including any such cases previously diagnosed and entered on the Dispensary Register as tuberculous) (24) - - 177 130 352 - 23 22 - - - - - D.—Number of Cases on Dispensary Register on December 31st:— I I I I ! II I I I I r I 37 (a) Definitely tuberculous 263 217 29 28 31 37 30 294 254 66 58 672 (6) Diagnosis not completed - - - 3 2 5 - - - - - - - 1. Number of cases on Dispensary Register on January let 731 8. Number of visits by Tuberculosis Officers to homes (including personaconsultations) 715 2. Number of cases transferred from other areas and cases returned after discharge under Head 3 in previous years 9 9. Number of visits by Nurses or Health Visitors to homes for Dispensary purposes *1,048 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 510 4. Cases written off during the year as Dead (all causes) 61 (b) X-ray examinations made in connection with Dispensary work 790 6. Number of attendances at the Dispensary (including Contacts) 2,353 11. Number of "Recovered" cases restored to Dispensary Register, and included in A (a) and A (6) above 6. Number of Insured Persons under Domiciliary Treatment on the 31st December 110 12. Number of "T.B. plus" cases on Dispensary Register on December 31st 275 7. Number of consultations with medical practitioners : — (a) Personal 109 (b) Other 230 * In addition to these visits 480 visits were made by the Lady Almoner. PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1930. Summary of Notifications during the period from the 1st January, 1940, to the 31st December, 1940. Formal Notifications Number of primary notifications of new cases of Tuberculosis Age Periods 1 to 5 5 to 10 15 to 20 20 to 25 25 to 35 35 to 45 45 to 55 65 to 65 65 and upwards Total Notifications Total (all ages) 0 to 1 10 to 15 8 62 Pulmonary, Males 2 1 4 3 16 10 6 1 51 - - 1 12 - - 1 10 13 3 2 2 2 46 50 „ Females - - 1 1 - - - 2 - - - - 2 Non-Pulmonary Males 4 - - 1 1 1 1 - - „ Females - - 4 - 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 10 to 15 15 to 20 25 to 35 35 to 45 45 to 55 55 to 65 65 and upwards 5 to 10 20 to 25 Total Pulmonary Males 4 3 1 1 9 - - - - - - - „ Females - 1 - - - 3 1 1 - 1 - 7 - - - - - 1 - - - - 1 Non-Pulmonary Males - - - - - 1 - 1 - - - - „ Females 2 (26) Returns rendered under the PUBLIC HEALTH (TUBEROULOIS) REGULATIONS, 1930. 1st QUARTER, 1940. Respiratory System Other Forms M. F. F. M. Number of Cases on Register at commencement of Quarter 87 95 351 271 Number of Cases notified during Quarter 19 12 2 - 3 2 1 Inward Transfers, Un-notified Deaths, etc. - 10 3 Number of Cases removed from the Register 25 5 Number of Cases remaining on the Register at end of Quarter 348 275 85 92 2nd QUARTER, 1940. Respiratory System Other Forms M. F. M. F. Number of Cases on Register at commencement of Quarter 348 275 85 92 1 2 Number of Cases notified during Quarter 17 14 Inward Transfers, Un-notified Deaths, etc. 3 1 - - 28 22 6 8 Number of Cases removed from the Register Number of Cases remaining on the Register at end of Quarter 80 86 340 268 3rd QUARTER, 1940. Respiratory System Other Forms M. F. M. F. Number of Cases on Register at commencement of Quarter 340 268 80 86 7 10 Number of Cases notified during Quarter - - 3 1 2 Inward Transfers, Un-notified Deaths, etc. - Number of Cases removed from the Register 6 10 2 - Number of Cases remaining on the Register at end of Quarter 80 86 345 268 4th QUARTER, 1940. Respiratory System Other Forms M. M. F. F. Number of Cases on Register at commencement of Quarter 345 268 80 86 Number of Cases notified during Quarter 5 13 1 - 2 1 Inward Transfers, Un-notified Deaths, etc. - - 1 3 Number of Cases removed from the Register 7 12 Number of Cases remaining on the Register at end of Quarter 345 270 80 83 IV. LIGHT TREATMENT, ELECTRO-THERAPY AND MASSAGE. The following table shows the work done in the Solarium during 1940. No diathermy treatments have been given since September, as Defence Regulations do not permit the use of the apparatus without adequate screening. This screening is now completed and the machines will be in use again shortly. Total Number of Attendances 11,943 Number of Treatments 23,504 Massage 2,104 Physical Exercises 392 Medical Electricity 904 Diathermy 1,557 Q-Ray Pad 230 Mechanical Vibratory Massage 14 Local Treatments — Radiant Heat and Ultra Violet Light 6,360 Number of Medical Examinations 1,117 Number of New Cases 494 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 206, a decrease on the figures for 1939. Number of women admitted 101 Number of babies admitted 58 Number of toddlers admitted 47 OBSTETRIC AND PUERPERAL FEVER CONSULTANTS. The number of consultations during the year was as follows: — Obstetric Consultations Nil Puerperal Fever Consultations Nil CHILD LIFE PROTECTION. During the year 15 visits were paid by the visitor to 4 fostermothers with 4 children. These children were subsequently evacuated and at the end of the year there were no fosterchildren in the borough. HEALTH VISITORS. The following table shows the work done by the Municipal and Voluntary Centres and Health Visitors during 1940 :— District 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 Puerperal Pyrexia & Fever Ophthalmia Neonatorum Measles Whooping Cough Tuberculosis Post-Infectious Disease First Visits Re-visits Under 1 year 1-5 years Primary Visits Revisits Miss Anderson 113 86 76 347 527 34 41 1 5 1 127 11 - - 72 85 483 665 57 145 5 2 2 1 64 161 219 Miss Bache - 61 213 174 25 27 9 53 2 65 101 Miss Baird 73 7 - - Miss Bowles 505 - - - - - - - - - - - - - Miss Brown 70 50 112 382 25 30 2 82 103 132 - - - - 62 37 150 195 5 59 62 Miss Carter 8 16 - - - - - 285 Miss Crundwell 54 74 415 32 22 4 2 48 52 94 - - - Miss Hesketh 10 29 51 2 2 201 81 - 3 - - - - - 115 259 11 1 2 144 148 127 Miss Lawrence 103 392 2 - - - Miss Oram 68 67 389 614 24 49 28 1 101 340 196 - - - 58 Miss Parry 71 367 567 41 133 1 63 68 209 - - 27 - 65 67 98 1199 27 6 2 27 47 66 Miss Riches 1 - - - Miss Riley 40 40 213 309 11 23 53 4 61 18 92 - - - 23 36 Miss Robson 66 50 278 540 1 63 22 103 - - - - 77 62 284 31 40 4 42 23 352 Miss Wadds 364 - - - - 208 Miss White 51 62 846 1354 61 1 8 86 4 131 72 144 - 27 Miss Williams 16 23 114 31 3 24 33 - - - - - - Salomon's Centre 61 45 - - - - - - - - - - - - 961 Totals 950 4380 6862 473 815 10 12 249 28 1048 2 1390 2629 ATTENDANCES AT MATERNITY AND CHILD WELFARE CENTRES. The following table shows attendances at Maternity and Child Welfare Centres during 1940 :— Ante-natal Clinic Sewing Class Gynaecological Clinic Children's Consultations New Cases Total Attendances No.seen by Doctor No. of Sessions No. of Sessions Post- Natal Cases Total Attendances No. of Sessions No. of Attendances Total Attendances Name of Centre No. of Sessions New Cases 1-5 years Under 1 year New Cases Under 1 year 1-5 years Public Health Centre, Grange Road 234 3,929 160 35 2,718 2,863 102 207 6 1,128 47 91 291 - - 98 Rotherhithe New Road 159 2,520 1,669 105 16 2,383 65 131 6 767 4 3 14 - - Community Centre 49 50 12 762 840 914 4 35 532 - - - - - - Bermondsey Gospel Mission 87 93 6 1,553 1,333 1,791 2 - - - - - - - - Salomon's Centre - 152 336 159 1,825 - - - - - - - - - - Fulford Street 100 142 34 1,765 958 1,683 76 129 1 - - 779 - - - Central Hall - - 177 186 41 2,491 1,798 2,616 - - - - - - - Totals 13,020 9,316 12,250 678 864 144 401 803 172 4,499 35 532 51 94 305 Births EXTRACTS FROM VITAL STATISTICS, 1940. Registered— Legitimate Illegitimate Total Males Females 1,200 600 600 32 15 17 Live Births Birth Rate per 1,000 of the estimated resident population 17.2 Total Males Females Stillbirths 48 22 26 Rate per 1,000 total (live and still) births Notified within 36 hours of birth— 37 (1) Live Births, 977. (1) By Midwives, 890*. (2) Stillbirths, 36. (3) Total, 1,013 (2) By Parents and Doctors, 123. * Including 368 births delivered by midwives in Hospitals. Total Males. Females. Deaths 1,551 795 756 Death Rate per 1,000 of the estimated resident population 21.7 Maternal Deaths. Calculated on the figure of 1,194 (live and still) births furnished by the Registrar-General. Deaths from puerperal causes:— Deaths. Rate per 1,000 total (live and still) births. Puerperal Sepsis 1 0,84 Other puerperal causes 3 2·51 Total 4 3·35 Death Rate of Infants under 1 year of age. Calculated on the figure of 1,146 live births furnished by the Registrar- General. All Infants per 1,000 live births 35 Legitimate infants per 1,000 legitimate live births 34 Illegitimate infants per 1,000 illegitimate live births 62 Health Visitors. Visits paid by Health Visitors during the year:— To Expectant Mothers (1) First Visits, 473. (2) Total Visits, 1,288 To Infants under 1 (1) First Visits, 950. (2) Total Visits, 5,330 To Children, 1-5 .. Total Visits, 6,862 Convalescent Homes for Children under 5. Number of Beds, 16. Number of Children under 5 received during the year, 105 Day Nurseries. Number of day nurseries Nil. Deaths from Cancer (all ages) 138 Deaths from Measles (all ages) Nil Deaths from Whooping Cough (all ages) 1 Death from Diarrhœa (under 2 years of age) 2 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 1940 Number Examined Number of Extractions Anæsthetics Number of Fillings Number of Scalings Number of Attendances for Orthodontics CENTRE Age Group Number Treated Local General PUBLIC HEALTH CENTRE, GRANGE ROAD. 170 157 463 7 141 1 - Under 5 years - 364 332 902 125 242 128 2 - Over 5 years 534 489 1365 383 129 2 Totals 132 - 104 421 102 4 Under 5 years 86 98, ROTHERHITHE NEW ROAD. - - 177 63 437 113 Over 5 years 113 59 1 - 281 199 858 63 215 63 1 Totals 815 688 2223 195 598 192 3 Totals both Centres - (33) DENTAL TREATMENT CARRIED OUT DURING 1940 Number of Patients Examined Number of Extractions Anæsthetics Number of Scalings Number of Fillings Number of Patients Treated CENTRE Type of Case Local General 713 666 195 94 17 433 Maternity Cases 1910 880 PUBLIC HEALTH CENTRE, GRANGE ROAD 698 188 20 819 1329 94 Women 1438 112 2825 176 1294 33 1488 Men Tuberculosis Cases 9 22 6 5 1 12 2 534 489 383 129 Children (Table.I) 132 2 1365 Totals 3627 3421 2563 786 592 73 7451 195 885 89 130 8 98, ROTHERHITHE NEW ROAD Maternity Cases 243 28 164 6 221 551 68 63 Women 242 234 48 677 7 216 40 Men 304 1 281 215 63 858 63 Children (Table I.) 199 Totals 931 988 2971 532 461 194 22 Totals both Centres 4558 4409 10422 3095 1247 786 95 VII.—CONSULTATION AND OTHER CLINICS. X-RAY DEPARTMENT. The number of patients examined in this Department was much smaller than in 1939. This was mainly due to the reduction in the population since September. Total number of Attendances 1,263 Number of Individual Cases 1,096 Number of New Cases 843 Number of Screenings 1,037 Number of Films 1,653 Analysis of Films :— Chests 790 Bones 148 Barium Meals 72 Barium Enemas 9 Hearts 50 Kidneys 8 Abdomens 12 Gall Bladders 2 Sinus 1 Oesophagus 1 Urinary Tract 3 POST-NATAL AND SPECIAL CLINICS FOR WOMEN. The total number of attendances at the Gynaecological Clinic was 305 ; of these 94 patients attended for the first time. The majority of the patients were suffering from some gynaecological disorder and were either treated at the clinic or recommended to their own doctor or hospital. The sixteen patients who were not suitable for the clinic were referred back to their own doctor. Seven patients sought advice for sterility. Twenty-four patients attended on account of menstrual irregularities, and the remainder were suffering from some minor disorder due to menopause, such as backache, high blood pressure, and displacements. FOOT CLINIC. Attendances during the year are shown in the following table :— Clinic Men Women Total Bermondsey 3,757 5,191 1,434 Rotherhithe 1,089 2,979 4,068 Totals 6,736 9,259 2,523 VIII.- PROPAGANDA. During the year 1940 lectures and demonstrations illustrated by cinema films were given as follows: — Lectures 70 Persons attending 4,320 Since the beginning of the war the whole of the activities of the Propaganda Section have been devoted to A.R.P. work. Open air illustrated demonstrations have had to be abandoned, and school lectures cannot take place under existing conditions. Early in 1941 arrangements were made through the Bermondsey Shelter Council for Film Shows to be given as a regular feature in the Public Shelters during the winter evenings, and a report on this will be given next year. IX.—SANITARY ADMINISTRATION. HOUSING. During the year 1940, no areas were represented or declared by the Council. One hundred and forty-two flats were erected during the year. Particulars of these are given hereunder:— Redriff Estate 1 flat Arnold 30 flats Neckinger„ 22 „ Kirby„ 50 „ Lockyer„ 22 „ St. Mary's„ 17 „ HOUSING ACT, 1936—OVERCROWDING. Owing to changes in the occupation of houses, due to war damage, London County Council and private evacuation, it is impossible to give any reliable figures relative to overcrowding. ERADICATION OF BED BUGS. Sulphur Dioxide Gas, and the proprietary agent "Pyagra," 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 explain to the tenants the importance and means of preventing infestation. The following table shows the fumigation carried out during 1939 Infested Disinfested Council houses or flats 183 183 Council houses on Insanitary Areas during decanting 171 171 Houses disinfested prior to demolition — 40 Other houses or flats 86 126 INSPECTIONS. PROCEEDINGS, ETC. Hereunder will be found particulars of Inspections, Proceedings, etc., for the year 1940 :— Inspection of Dwelling Houses during the Year : — (1) (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 3,791 (b) Number of Inspections made for the purpose 21,769 (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 .. 1 752 (b) Number of Inspections made for the purpose 2,049 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation Nil (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 Nil Remedy of Defects during the Year without Service of Formal Notices:— Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their officers 700 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 Nil (2) Number of dwelling-houses which were rendered fit after service of formal notices :— (a) By owners 47 (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 1,339 (2) Number of dwelling-houses in which defects were remedied after service of formal notices :— (a) By owners 639 (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 Nil (2) Number of dwelling-houses demolished in pursuance of Demolition Orders Nil (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 Nil (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit Nil Total number of houses in the Borough 18,258 Number of houses occupied by the working classes 18,014 REGISTERED PREMISES— Premises Number on Register at end of 1940 Number of Inspections Number of Prosecutions Common Lodging Houses 3 20 - 2 6 Seamen's Lodging Houses - 210 503 Milkshops - 748 1,260 Houses let in lodgings - 151 201 Ice Cream Premises - 13 115 Offensive Trades (including Poultry Slaughter-houses) - SMOKE NUISANCES— Number of observations 23 Number of notices - Number of complaints 2 Number of summonses Nil WATER SUPPLY TO TENEMENT HOUSES— Premises supplied 2 Prosecutions Nil SALE OF FOOD— Number of premises used other than ice-cream premises, milk shops and cowsheds 489 Number of inspections 1,092 RAG FLOCK ACT, 1911 AND PUBLIC HEALTH (LONDON) ACT, 1936:— There are four premises in the District where rag flock is used and six 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 inhabitated by more than one family. Water supply has been installed on one of the storeys of two 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. WORK OF DISTRICT INSPECTORS, 1940. 8 2 3 4 6 9 10 11 12 13 14 15 16 17 18 19 1 5 7 20 House-to-House Special Inspections Infectious Diseases Outworkers' Bi-Annual Inspection Other Calls and Visits Chimneys watched Common and Seamens Lodging Houses Fishmongers, Friers and Curers Fruiterers and Greengrocers Ice Cream Restaurants and Eating Houses Destruction of Food TOTALS Complaints Drains Tented Bakehouses Butchers Food Stores Markets Various Ints Visits 1623 155 11 5 2 1 1 2565 District No. 1 156 44 1 556 3 3 2 - 2 98 - - - 287 1803 377 60 7 6 5 No. 2 19 4 2035 3 7 - 1 2 28 16 11 1 4681 275 - 64 222 1 649 6 6 3 1 No.3 192 32 9 2 7 2 3 5 1 1205 193 - - „ No. 4 10 116 86 24 1 5 617 861 - - - - 1 - 1 149 - - - - - 315 1704 174 36 - 1224 3 18 1 „ No. 5 19 6 2 4 8 - 3514 127 - - - - 29 13 6 1 „ No. 6 305 1557 238 17 657 4 4 6 3 3 4 4 3 - 2854 154 - 70 „ No. 7 342 1912 190 100 41 2 1044 2 1 19 3 10 17 6 12 2 3781 167 8 - 273 1493 198 7 8 2939 „ No. 8 104 22 766 2 6 11 6 1 4 - 35 3 - 176 - Total 1752 10430 1610 429 105 56 7548 11 45 25 56 24 132 28 48 57 35 8 1 22400 1339 FACTORIES AND OTHER PREMISES. HOMEWORK. Outwork in Unwholesome Premises Section, 111 Outworkers' Lists, Seetion 110 Lists received from Employers Notices served on Occupiers as to keeping or sending lists (8) Prosecutions Instances (11) Notices served (12) Prosecutions (13) Outworkers resident in Bermondaey received from other Districts NATURE OF WORK (1) Outworkers Failing to keep lists (9) Failing to send lists (10) Resident in Bermondsey Resident in other Districts (5) Lists (2) Contractors (3) Workmen (4) Contractors (6) Workmen (7) Wearing Apparel:— 1 . I I I r I I I I I I I - I I I I I I - I [ - I 41 2 3 3 (1) Making, etc. 4 25 45 6 - - - - (2) Cleansing and washing - - - - - - - - - - - - 3 3 Fur pulling - - - - - - - - - - 2 Umbrellas, etc. - - - - - - - - - - - Sacks 4 42 38 4 4 - - - - - - - Paper, etc., Boxes, Paper Bags 8 - - - - - - - - - - - 1 Brush making - - - - - - - - - - - Combs, etc. - - - - - - - - - - - - Leather Goods 3 5 5 1 - - - - - - - - Surgical Instruments 2 4 - - - - - - - - - - Coathangers 1 2 6 5 - - - - - - - - Carding of buttons, etc 10 - - - - - - - - - - - Onion Peeling - - - - - - - - - - - - Games and Toys 1 - - - - - - - - - - - Artificial Flowers 1 - - - - - - - - - - - Total 14 - 74 98 9 73 2 - - 7 7 - FACTORIES AND OTHER PREMISES. INSPECTION. Premises Number of Inspections Written Notices Occupiers Prosecuted 3,661 11 - Factories with mechanical power Factories without mechanical power 1,668 6 Other Premises under the Act (including works of building and engineering construction but not including outworkers' premises) - 189 - - 5,518 - Total 17 DEFECTS FOUND. Particulars Number of Defects Number of defects in respect of which Prosecutions were instituted Found Remedied Referred to H.M. Inspector Want of Cleanliness (S. 1.) 4 4 - - Overcrowding (S.2.) - - - - Unreasonable Temperature (S.3 ) - - - - Inadequate Ventilation (S.4.) - - - - Ineffective Drainage of Floors (S.6.) - - - - Sanitary Conveniences (S.7.)— 2 - Insufficient 2 - 29 Unsuitable or Defective 29 - - Not separate for Sexes - - - - 7 2 7 - 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) - 42 42 2 Total (43) BAKEHOUSES. Not in Use In Use Underground Underground Above ground Above ground 11 27 9 3 34 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 1940:— Loads tons cwts. qrs. Disposal House Refuse to Barge 14,842 2 12,807 17 Trade Refuse to Barge 3,134 2,147 4 2 Street Markets Refuse to Barge 1,395 1,035 0 3 Totals 17,336 18,025 2 3 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 26 STREET MARKETS. The market scheme continues to work smoothly and satisfactorily. Number of Licences in operation 379 Income £1,802 11s. 6d. There have been 3 prosecutions during the year. DRAINAGE WORK. Hereunder will be found particulars of drainage work, &c., carried out by the Drainage Inspector during 1940: — Drains Tested 405 Visits to Underground Conveniences 168 Other Visits 1,029 WORK OF THE FACTORIES AND SHOPS INSPECTOR Shops. Visits 454 Notices served under Shops Act, 1934 1 Notices served under Public Health (London) Act, 1936 23 Factories (with mechanical power). Visits 302 Notices under Factory Act, 1937 7 Notices under Public Health (London) Act, 1936 4 Factories (without mechanical power). Visits 162 Notices under Factory Act, 1937 — Notices under Public Health (London) Act, 1936 2 Workplaces. Visits 200 Notices served 5 Visits to Offensive Trade premises 115 Various Visits 76 Chimneys watched 12 X.—FOOD CONTROL. PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1937. Twenty-three samples were taken during the year by the Wharves Inspectors, action being taken in connection with the following cases: — Article Examined Result Action Lead 8 parts per million Lead 8 parts per million Lead 10 parts per million Tin 0.2 grams per pound Lead 8 parts per million Portuguese Sardines A warning was given to the merchant in all cases to communicate with shipper to eradicate metallic contamination, Portuguese Sardines Chinchards Portuguese Sardines 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. qrs. lbs. Fish — 2 3 2J Fruit — — 4 8 Meat 1 15 1 2] Poultry — — — 6 Total 1 19 2 0 MILK PREMISES. MILK AND DAIRIES (AMENDMENT) ACT, 1922. FOOD AND DRUGS ACT, 1938, Nineteen milk sellers were registered under the above Acts during 1940, and 62 were removed from the Register, making a total of 210 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 sell Tuberculin Tested Milk 17 To sell Pasteurised Milk 26 Supplementary Licences. To sell Pasteurised Milk 11 To sell Tuberculin Tested Milk 6 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 1940 was 618 of which number 52 were taken from schools. For Chemical (i.e., Fat and non-Fatty Solids) Examination. Liquid Milk, undesignated 372 Liquid Milk, undesignated (informal) 6 Sterilized Milk 68 Pasteurised Milk 24 Pasteurised Milk (informal) 15 Condensed Milk (informal) 20 505 For Bacteriological Examination. Tuberculin Tested Milk 42 Tuberculin Tested (Pasteurised) Milk 7 Pasteurised Milk (from schools) 26 Pasteurised Milk (other than from schools) 32 For tubercle bacilli 4 For brucella abortus 2 113 (47) 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. 3 Over 500 to 1,000 per 1 c.c. 1 Over 1,000 to 5,000 per 1 c.c. 7 Over 5,000 to 10,000 per 1 c.c. 6 Over 10,000 to 50,000 per 1 c.c. 25 Over 50,000 to 100,000 per 1 c.c. 15 Over 100,000 to 200,000 per 1 c.c. 6 Over 200,000 to 1,000,000 per 1 c.c. 1 Over 1,000,000 to 2,000,000 2 "More than five million" 5 71 2. Presence of B. Coli. B. Coli present in 1 c.c., 1/10th c.c., and 1/100th c.c. 26 B. Coli present in 1 c.c., and 1 1/10th c.c. 4 B. Coli present in 1 c.c. 3 B. Coli absent in 1 c.c., 1/10th c.c., and 1/100th c.c. 38 71 3. Chemical Analysis. Fat 1.75 per cent. 1 Fat 3.03 per cent. 1 Fat 3.80 per cent. 1 Fat 6.35 per cent. 1 Fat 7.09 per cent. 1 Fat 8.84 per cent. 1 6 PHARMACY AND POISONS ACT, 1933. Thirty-eight premises were entered on the Council's list for the year under report. As a result of informal samples being purchased, it was found that two contraventions of the Act occurred, poisons being sold wrongly by listed vendors. A warning was given in both cases. FOOD AND DRUGS. During the year 1383 articles were submitted for analysis, of which number the following 20 were found to be adulterated: — Camphorated Oil 1 Curry Powder 1 Gin 5 Lard 1 Milk 6 Sausages 1 Shredded Suet 1 Rum 2 Vinegar 1 Whisky 1 20 PROSECUTIONS IN CONNECTION WITH SAMPLES TAKEN DURING 1940. Sample Adulteration or or Infringement No. Remarks 243 Milk 52.6% deficient in fat Fine £2 Costs £2 2s. (Taken in conjunction with previous sample) 244 Gin 4.0% excess water Fine £3 Costs £3 3s. 245 Gin 11.4% excess water Fine £5 Costs £3 3s. 246 Rum 16.0% excess water Fine £6 Costs £3 3s. 5.4% added water 247 Sterilized Milk Fine £2 Cost £3 3s. 248 Milk 43.0% deficient in fat Case dismissed —first offence SUMMARY. £ s. d. Fines 18 0 0 Costs 14 14 0 £32 14 0 (50) PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1937 Quantity Unsound Disposed of for purposes other than human food Removed for sorting under S.A. Exported Destroyed Weight Weight Weight Weight lbs. Tons cwts, lbs. Tons cwts. Tons cwts, Tons cwts. qrs. qrs. qrs. lbs. qrs. 10 103 11 2 23 14 2 11 049 9 1 14 - - - 27 13 0 20 278 18 3 164 18 0 5 8 - - - 0 73 6 3 16 134 8 3 6 56 4 0 - - - 2 98 5 25 3 6 3 6 0 - - 0 0 - - 3 5 183 11 2 - 4 6 1 - - - - - - 17 - 2 6 2 94 12 1 19 - - - - - - 11 0 3505 11 1 10 0 3 3 7 9 0 - - - 2 13 8 2 1 119 5 3 10 31 8 3 62 0 0 3907 25 3 12 0 746 7 1 313 15 2 87 0 0 13 WORK OF THE WHARF AND FOOD INSPECTORS, 1940. 7 12 2 3 4 5 6 8 9 10 11 13 1 Number of Samples taken Food Factories Food Stores Food Wharves and Depots Milksellers Pharmacy & Poisons Food Control Various Ice Cream Premises Nuisances Found Destruction of Food Jam Intimations Served Milk (Special Designation) Order Fish Curers Samples of Milk for presence of Tubercle Bacilli Ice Cream (Bacteriological Examination) Samples of Milk for presence of Bacillus Abortus Imported Food (Bacteriological Examination) Pharmacy & Poison Butter and Margarine Other Imported Food Regulations Food and Drugs 30 411 352 2113 - - - - 302 2 2 153 14 - - - - - - - - - - 38 56 105 6 199 1142 - - 132 13 - 207 — — 9 - - - - 2 - 738 78 2 10 1 12 14 10 - 14 57 58 - 69 59 20 - - 140 375 310 - 5 - - 193 - 976 40 646 - 29 2 61 1 - 7 - - 45 248 284 61 - 107 96 6 849 3630 503 102 740 15 4 1045 459 81 1384 23 4 71 2 - 19 52 661 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 and Puerperal Fever Consultants and other services will be supplied on application to the Medical Officer of Health, Telephone No. BERmondsey 2109.