AC 4345 1olly Gnara Dw 5B 2 Silrory CHE 53 Metropolilitan Borough of Chelsea Annual Report of the Medical Officer of Health J. H.WEI R, M.D., B.S., B.Hy., D.P.H. for the year 1955 1 METROPOLITAN BOROUGH OF CHELSEA PUBLIC HEALTH AND BATHS COMMITES (at 31st Deasmber, 1955). Chairman: Vice-Chairmans Councillor Lyall, Miss M. M.B.S. Councillor Duncan, It.-Col. R.C. C.I.E., M.V.O., O.B.E. Councillor Acland, Miss K. O.B.E., T.D. „ Baxter, Mrs. M. „ Beier, E.W. „ Bifiald, W.C. M.M. „ Budgett, F.G.P. „ Buxton, Mrs. G.K. Councillor Gough, A.E., T.D. „ Haanay, J. M.Ch.S. „ Henry, Mrs. A.F. „ Mblloy, Miss P.D.J. „ Tatton-Brown, J.S. „ Woolford, J.E. Ex-Officio Mambers His Workshop the Mayor (Councillor A.J. Sims, J. P.) The Deputy Mayor (Councillor Guy Edmistan, F.C.I.B., J.P.) 2 Representation by members of the Public Health and Baths Commettee on out side Commettees and other Organisations concerned with Public Health work. (at 31st December. 1955). Chelsea Cancer Commitee: Councillor Mrs. G.K. Buxton Chelsea Tubarculosis Care Committee: Councillor Mrs. G.K. Buxton Councillor Miss M. lyall Family Walfare Assocition: Councillor Miss M. Lyall Invalid Children's Ais Associations: Councillor Miss M. Lyall Londan County Council Divisional Health Commitee (Division I): Councillor Miss M. Lyall London County Council Divisional Tuberculosis Care Committee: Councillor Mrs. G.K. Buxton (Division 1) London and Home Counties Smoks Abatament Advisrw Council: Councillor J. Hannay National Smoke Abatement Society: Councillor J. Hannay Councillor Miss M. Lyall Old People's Walfare Committee: Councillor Lt.-Col. R.C. Duncan Councillor Miss M. Lyall Third Feathers Club Committee: Councillor Lt.-Col. R.C. Duncan Westminster and Chelsea District Nursing Associations: Councillor Miss M. Lyall 3 STAFF OF THE PUBLIC HEALTH DEPARTMENT at 31at Decanter, 1955. Medical Officer of Healths J.H. WEIR, M.D., B.S., B.Hy., D.P.H. Deputy Msdieal Officer of Healths W.C. TURNER, M.D., B.S., D.P.H., D.I.H. Chief Sanitary Inspectors H. HOYIAND. Deputy Chief Sanitary Inspector S.W. BAKER. and Senior Housing Inspectors: Sanitary Inspectors: J.T. HEALY (Resigned 28.8.55) H.F. LEACOCK. H.W. LUDLOW. A.J. WHITE. E.R. YOONG. Women Sanitary Inspectors: (Miss) A.C.C. KAY. (Miss) G.K. READER. Sanitary Inspectors' Assistant: F.G. RAWLINSON. Drainage Assistant: E. BOSLEY. Rodent Officers: J.F. COOKE. P. DRURY. Chief Disinfector: L.H. BERY. Disinfectors: F.W. HILL, R.J. WESTON. Cleansing Station Attendant: (Mrs.) J. LOBBAN. Chief Clerks J.C. BRYANT. Clerical Officerss I.M. THOMSON. H.G. HAMITON. L.A. POWELL. (Mrs.) W. BAAR. R.H. LITCHFIELD. P.M. MARGETTS. (Left for National Service on, 29.1.55) J. CHURCHILL. Social Worker: (Mrs.) O.M. BURKE. Public Analyst: Thos. McIACHIAN, A.C.G.F.C., F.R.I.C. 4 MEROPOLITAN BOROUGH OF CHELSEA Public Health Department, Town Hall, King's Road, CHELSEA, S.W.10. July, 1956. To the Mayor, Aldermen and Councillors of the Matropolitan Borough of Chelsea. Your Worship, My Lord, Ladies and Gentlemen, I have the honour to submit my annual report for the year ending 31st December, 1955. Vital Statistics. The population, as estimated by the RegistrarGeneral is 51,450, a decrease of 610 as compared with the return for 1954 (52,060). Deaths totalled 825, an increase of 91 wer those recorded in 1954 (734), and the death rate was 16.0, or 1.9 more than in the preceding year (14.1). Once again it is of interest to note that almost seventy-five per cent. of all deaths occurred in persons aged 65 years or ever. The average for the years 1950-1955 was slightly over seventy-one per cent. The Registrar-General has found it necessary to establish "Area Comparability Factors" to provide for adjustments of sex and age components of any one area as compared with England and Wales as a whole, and the results of the application of these factors to Births and Deaths rates will be found on Page 6. Births aggregated 745, and the rate was 14.5, 0.6 below the return for 1954. No deaths were found to be attributable to accidents or diseases associated with pregnancy or childbirth, In 1954 there were two, and in 1953, three. Infantile Mortality returns show a further rise in the number of deaths occurring amongst children under one year of age, the total being 25. In 1954 there were 21. The particular rate must, however, be contemplated with the actual number of births and deaths registered, when it will be clear that a greater proportionate reduction in the number of deaths is resulting when comparing them with the decline in births, as will be noted from the fallowing brief summary:- Year No. of births registered No. of deaths under 1 year. of age Percentage failing to attain to 1 year of age 1900 2,245 333 14.8 1910 1,376 141 10.2 1955 745 25 3.3 Infectious Diseases. Notifications received during the year totalled 1,218, as compared with 549 in the preceding year. This remarkable increase is almost entirely due to the incidence of M&aales - 736 cases were reported, representing approximately 60 per cent, of all notifications. In 1954 there were only 104 notifications of Maasles, so the current return represents an increase of 122 per cent. For the first time since 1949, Diphtheria appeared in the Infectious Diseases table, two cases being notified. A comprehensive report concerning this will be found in the section devoted to "Epidemiology" 5 Food Poisoning. Informtion as to twenty-seven cases was submitted to the Department. In 1954, nineteen notifications were received. The average for the five years 1951-1955 is slightly in excess of eighteen. Keen attention has been given to the supervision of all food premises in the borough, and endeavours are constantly being made to secure and maintain satisfactory hygienic Conditions. Jelfare of Old People. In 1950, the problem of providing elderly people with numerous facilities so that they might, as far as possible and despite disability or infirmity, continue to lead normal lives, was zealously investigated, and by the end of that year, 106 people were enjoying a not inconsiderable number of aids to their well-being. At the end of 1955 the number had swollen to 1,087, the great majority of whom were enjoying an aver expanding number of opportunities for maintaining social activities and obviating the perplexities so often attendant upon advanced age without surrendering their valued independence. Mr. T. McLachlan, Public Analyst to the Council, examined four hundred samples of foods and drugs during the year, and his findings and observations are incorporated in this report. It is with great pleasure that I acknowledge the support and encouragement it has been my privilege to receive from Chairmen of Committees and individual members of the Council. I am also most appreciative of the continued and friendly co-operation given me by other Chief Officers and their staffs, whilst the loyalty of all members of the Public Health Department has at all times been a matter of personal satisfaction. I am, Mr, Mayor, My- Lord, Ladies and Gentlemen, g. H. Wer. Medical Officer of Health. 6 METROPOLITAN BOROUGH OF CHELSEA. ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1955 AREA OF THE BOROUGH: 659.6 acres GENERAL RATE: 19s.6d. in the £ (At 31st March, 1955) PRODUCT OF A PENNY RATE (GROSS): £5,289. RATEABLE VALUE OF BOROUGH AS AT 31ST MARCH. 1955: £1,316,915. POPULATION: Registrar-General's estimate of the population of the Borough (mid-year, 1955) 51,450 LIVE BIRTHS: Total M. F. Legitimate 674 351 323 Birth rate per 1,000 of estimated population 14.5 Illegitimate 71 31 36 745 386 359 Adjustment of birth rate by area comparability factor 10.9 STILL BIRTHS: 15 8 7 Rate per 1,000 (live and still births) 19.7 DEATHS: 825 372 453 Death rate per 1,000 of estimated population (Males: 7.2: Females 8.8) 16.0 Adjustment of death rate by area comparability factor 14.1 MATERNAL MORTALITY: No deaths associated with pregnancy or childbirth occurred amongst Chelsea residents during the year. DEATH RATES OF INFANTS UNDER ONE YEAR OF AGE: All infants per 1,000 live births 33.5 Legitimate infants per 1,000 legitimate live births 31.1 Illegitimate infants per 1,000 Illegitimate live births 56.3 DEATHS FROM TUBERCULOSIS: Pulmonary 8 Other forms 1 Death rates per 1,000 of estimated pqpulation:- Pulmonary Tuberculosis: 0.15 Other forms: 0.019 7 summary of vital statistics 1942 - 1965 ( inclusive) Year Registrar-General's Estimate of Population births deaths deaths under ONE year MATERNAL dEAths No. + Rate No. + Rate No. + Rate No. + Rate 1942 27,430 342 12.5 502 18.3 17 50 1 2.8 1943 30,330 459 15.1 554 18.3 32 70 1 2.1 1944 30,990 416 13.4 572 18.4 21 50 1 2.4 1945 35,310 557 15.8 536 15.2 25 45 4 6.9 1946 45,740 816 17.8 550 12.0 36 44 1 1.2 1947 51,000 868 19.0 611 12.0 43 44 - - 1948 50,890 883 17 .4 597 11.7 35 40 - - 1949 51,990 875 16.8 588 11.1 23 26 - - 1950 52,490 829 15.8 638 12.2 21 25 - - 1951 52,430 819 15.6 686 13.1 19 23 - - 1952 52,140 787 15.1 669 12.8 16 20 - - 1953 52,150 787 15.1 694 13.3 15 19 3 3.7 1954 52,060 787 15.1 734 14.1 21 27 2 2.5 1955 51,450 745 14.5 825 16.0 25 34 - - Averages for the seven years 1949 -1955:- Births 804 Deaths 690 Deaths under one year of age 20 Maternal Deaths 0.7 *Totals arrived at after due allowance for inward and outward transfers. 8 DEATHS OF RESIDENTS DURING 1955 Causes of death At all ages Under 1 year 1 and under 5 5 and under 15 15 and under 25 25 and under 45 45 and under 65 65 and upward 1. Tuberculosis, respiratory 8 - - - - 1 2 5 2. Tuberculosis, other 1 - - 1 - - - - 3. Syphilitic disease 4 - - - - 1 - 3 4. Diphtheria - - - - - - - - 5. Whooping Cough - - - - - - - - 6. Meningococcal Infections - - - - - - - - 7. Poliomyelitis, acute 2 - - - - 2 - - 8. Measles - - - - - - - - 9. Infective and parasitic diseases 3 1 - - - - - 2 10. Malignant neoplasm, stomach 16 - - - - - 4 12 11. Malignant neoplasm, lung, bronchus 29 - - - - - 13 16 12. Malignant neoplasm, breast 13 - - - - - 5 8 13. Malignant neoplasm, uterus 5 - - - - 1 2 2 14. Malignant and lyngphatic neoplasms, other 90 - - - 3 31 56 15. Leukaemia, aleukaemia 3 - - - - 1 - 2 16. Diabetes 8 - - - - - 1 7 17. Vascular lesions of nervous system 98 - - - - - 10 88 18. Coronary disease, angina 96 - - - - 1 24 71 19. Hypertension, with heart disease 16 - - - - - - 16 20. Heart disease, other 105 - - - - 3 7 95 21. Circulatory disease,other 84 - - - - 1 8 75 22. Influenza 2 - - - - - 1 1 23. Pheumonia 53 2 - - - 1 5 45 24. Bronchitis 38 - - - - - 5 33 Carried forward 674 3 - 1 - 15 118 537 9 DEATHS OF RESIDENTS DURING 1955(Continued) Causes of death At all ages Under 1 year 1 and under 5 5 and under 15 15 and under 25 25 and under 45 45 and under 65 65 and towards Brought forward 674 3 - 1 - 15 118 537 25. Respiratory system, other diseases of 3 - - - - - 3 - 26. Ulcer of stomach and duodenum 13 - - - - - 2 11 27. Gastritis, enteritis and diarrhoea 6 1 - - - - - 5 28. Nephritis and nephrosis 8 - - - 1 - 1 6 29. Hyperplasia of prostate 3 - - - - - - 3 30. Pregnancy, childbirth, abortion - - - - - - - - 31. Congenital malformations 6 5 - - 1 - - - 32. Other defined and ill-defined diseases 73 16 - - 1 6 12 38 33. Motor vehicle accidents 10 - - - 3 2 1 4 34. All other accidents 19 - 1 - - 2 5 11 35. Suicide 10 - - - - 4 4 2 36. Homicide and operations of war - - - - - - - - TOTALS 825 25 1 1 6 29 146 617 Consideration of the following table clearly indicates the increase in longevity of sidents during the first half of this century. Year Number of deaths Deaths under 1 year of age Percentage of total deaths Deaths at 65 years and over Percentage of total deaths 1900 1,737 333 19.17 442 25.44 1925 883 64 7.24 433 48.01 1950 638 21 3.29 434 68.02 1951 686 19 2.76 483 70.40 1952 669 16 2.39 470 70,25 1953 694 15 2.16 488 70.31 1954 734 21 2.86 547 74.52 1955 825 25 3.03 617 74.78 10 ANALYSIS OF DEATHS The percentages of the total deaths attributable to particular causes during the years 1954 and 1955 are set out below. The figures in parentheses are to be read in association with those appearing in the main table of deaths shewn on the preceding pages. Coding Percentage 1954 1955 (1) 1.23 0.97 (2) - 0.12 (3) 0.14 0.48 (4) - - (5) - - (6) - - (7) - 0.24 (8) - - (9) 0.60 0.36 (10) 3.00 1.94 (11) 3.70 3.51 (12) 1.40 1.57 (13) 0.82 0.61 (14) 10.00 10.93 (15) 0.41 0.36 (16) 1.10 0.97 (17) 13.00 11.88 (18) 12.12 11.64 (19) 3.54 1.94 (20) 11.20 12.73 (21) 8.30 10.10 (22) - 0.24 (23) 5.70 6.42 (24) 4.40 4.61 (25) 0.82 0.40 (26) 0.70 1.60 (27) 0.41 0.73 (28) 1.09 0.97 (29) 0.82 0.40 (30) 0.30 - (31) 0.54 0.73 (32) 8.04 8.85 (33) 1.60 1.21 (34) 3.40 2.30 (35 1.23 1.21 (36) 0.14 - 11 CANCER OF THE LONG AND BRONCHUS Deaths from this disease during the years 1950-1955 (inclusive) show that it has accounted far for times as many males as females, thus giving a measure of support to the belief that cigarette smoking is a contributory cause. It would also appear that women are becoming increasingly devoted to this habit. CANCER OF THE LUNG AND BRONCHUS Year Males Females Totals 1950 18 4 22 1951 16 - 16 1952 27 6 33 1953 16 4 20 1954 20 7 27 1955 21 8 29 12 INFANT MORTALITY Twenty-five infants under the age of one year died during 1955, as compared with twenty-oie and nineteen in 1954- and 1953 respectively. Seventy-six per cent. of the deaths occurred under four weeks of age. The causes of deaths were attributed to:- Males Females Asphyxia 1 1 Atelectasis 1 - Cerebral haemmorhage 1 - Gastro-enteritis - 1 Intra-cranial haemmorhage 2 - Malformations, Congenital 4 2 Otitis Media 1 - Pneumonia 1 2 Prematurity 5 3 In 1954, for the first time since 1947, infant deaths rose, and an increase is again recorded this year. During the ten years 1925 to 1934, 465 infants under one year of age died, giving an annual average of 46.5 whilst in the period 1946 to 1955, 254. deaths occurred, representing an annual figure of 25.4. It will be noted that "Prematurity" was responsible for thirty-two per cent. of the deaths registered. The actual periods at which deaths occurred before infants attained to one year of age were as follows:- Under 4 weeks 4 weeks to 3 months 3 to 6 months 6 to 12 months Total under 1 year Males 12 - 2 2 16 Females 7 - 2 9 Totals: 19 - 2 4 25 13 INFANT MORTALITY RATES - ENGLAND AND MALES AND VARIOUS OTHER COUNTRIES Deaths under 1 year of age per 1,000 live births. Country 1949 1950 1951 1952 1953 1954 Average for six years ENGLAND & WALES 32 30 30 28 27 25 28.7 SWEDEN 23 20 21 20 19 19 20.3 NEW ZEALAND 24 23 23 22 20 22 22.3 AUSTRALIA 25 24 25 24 23 22 23.8 NETHERIANDS 27 25 25 23 22 21 23.8 UNITED STATES OF AMERICA 31 29 29 29 28 27 28.8 DENMARK 34 31 29 29 27 27 29.5 SCOTLAND 41 39 37 35 38 31 36.8 CANADA 43 41 38 38 35 32 37.8 REPUBLIC OF IRELAND 59 45 45 41 39 38 46.5 FRANCE 61 52 51 46 42 41 48.8 ITALY 74 64 67 64 59 53 63.5 The above table has been prepared from information made available by the Registrar-General. 14 NATIONAL ASSITANCE ACT. 1948. BURIAL OF THE DEAD (Section 50 of the above Act). A local authority is required ty the provisions of this Act to arrange the burial or cremation of the body of any person in respect of whom no other suitable action can be taken. This duty has been so delegated since 5th July, 1948, at which time the National Health Service Act of 1946 became operative. At first, all such arrangements were dealt with by the Borough Council, whether death occurred in local hospitals or the homes of residents. Subsequently, however, the Minister of Health decided that under certain circumstances Hospital Committees should arrange and pay for the burial or cremation of patients dying in hospitals. As will be seen from the summary set out below the degree of responsibility falling to the lot of the local authority markedly diminished. Year Interments arranged by Borough Council 1948 (approximately 6 months) 43 1949 25 1950 9 1951 10 1952 9 1953 12 1954 4 1955 6 The Borough Council has not, at any time, taken steps to arrange a cremation. It may well be that exhaustive enquiries have not resulted in the tracing of relatives; nevertheless the possibility exists that a member of a deceased person's family may contact the Council and challenge their right to have carried out a cremation. Wherever possible the Council endeavours to secure reimbursement of funeral expenses, either by proceeds from the disposal of an estate, or from a liable relative. In most instances, deceased persons are found to have lived in most unsatisfactory or insanitary conditions, generally brought about by a mis-applied sense of independence, or lack of friends. Procedure under the Act is not merely a matter of issuing an carder to an undertaker to carry out a funeral. The home of a deceased person has to be thoroughly searched for a Will, insurance policies, pension books, money and valuables, and for papers which may assist in establishing the existence, or otherwise, of relatives. Later it becomes necessary to prepare an inventory of goods and furniture, whilst in some cases there ensues considerable correspondence. A death grant is obtainable under the National Insurance Act, 1946, and the main provisions are - Grant £ (a) under the age of three years 6 (b) between three and six years 10 (c) between six and eighteen years 15 (d) over the age of eighteen years 20 15 A grant cannot be secured in the case of a man born before 5th July, 1883, or a woman born before 5th July, 1888, A further exception is made in the case of a child under the age of ten years who was born before 5th July, 1948. Grants as indicated above may only be paid in full to liable relatives; a local authority whilst assuming the role of a "liable relative" will olny receive three-fifths of an applicable grant, as stipulated by the National Insurance (Death Grant) Regulations, 1949. 16 HOSPITALS AND NURSING HOMES Excellent facilities for both general and special hospital treatment are available in the Borough, as will be seen from the following list:- HOSPITALS TYPE OF INSTITUTION Brompton Hospital, Fulham Road, S.W.3. Chest Diseases Chelsea Hospital for Women., General Dovehouse Street, S.W.3. Granard House, 98, Dovehouse Street, Malignant Disease S.W.3. (Part of Royal Marsden Hospital) Royal Marsden Hospital, Fulham Road, S.W.3. Malignant Disease Royal Hospital, Royal Hospital Road, S.W.3. Home for Pensioners St. George's Home, Milman's Street, S.W.10. Tuberculosis St. Luke's Hospital, Sydney Street, S.W.3. Chronic Sick St. Stephen's Hospital, Fulham Road, S.w.10. General Victoria Hospital for Children, Tite Street, Children's Diseases S.W.3. NURSING HOMES Royal Avenue Nursing Home, Private 39, Royal Avenue, S.W.3. Wilbraham Nursing Home Private 3, Wilbraham Place, S.W.1. 17 MATERNITY AND CHILD WELFARE SERVICES The London County Council has, since 5th July, 1948, been responsible for the day-to-day administration of these services, with the assistance of the Medical Officers of Health for the Boroughs of Chelsea, Fulham, Hammersmith and Kensington, Division 1 of the County Council comprises the above Boroughs, and Dr. V.I. Russell, Divisional Medical Officer, has kindly supplied the following information:— WELFARE CENTRES Attendances at Ante-natal and Post-natal Sessions 1,218 Attendances at Infant Welfare Sessions 8,304 HEALTH VISITING Premature infantas: First visits 3 Re-visits. 26 Children under 1 year: First visits 596 Re-visits 1,648 Children between 1 and 2 years: First visits 62 Re-visits 943 Children between 2 and 5 years: First visits 47 Re-visits 1,498 Expectant mothers: First visits 382 Re-visits 226 Still Births: First visits 11 Re-visits — Infectious disease: First visits 201 Re-visits 56 Follow-ur of hospital patients: First visits 5 Re-visits 11 Care of Old People: First visits 2 Re-visits 13 Other after-care: First visits _ Re-visits — Miscellaneous, inc. infestation: ... 409 Unsuccessful visits ... 1,643 TOTAL: 7,782 - 18 - MATERNITY AND CHILD WELFARE SERVICES (Continued) Number of children visited during year 2,329 Number of households involved 2,002 Foster Mothers: Number of registered foster mothers 7 Number of children fostered .. 13 Diphtheria Immunisation Number of children who completed a primary course of injections 513 Number of children who received reinforcing injections 375 Vaccination: Number of children vaccinated at the Violet Melchett Infant Welfare Centre 451 DIPHTHERIA IMMUNISATION It is disquieting to note the substantial decline in both the numbers of children presented for primary injections and reinforcing infections as compared with 1954. Year Primary Injections. Reinforcing Injections 1954 677 657 1955 513 375 Decreases: 164 282 Percentages: 24 43 Further data regarding an outbreak of Diphtheria towards the end of the year will be found in the section of this Report devoted to "Infections Diseases". 19 "PART III" ACCOMMCODATION The National Assistance Act, 1948 (Section 21) requires a local authority to provide - (a) residential accommodation for persons who by reason of age, infirmity or any other circumstances are in need of care and attention which is not available to them; and (b) temporary accommodation for persons who are in urgent need thereof, being need arising in circumstances which could not reasonably have been foreseen or in such other circumstances as the authority may in any particular case determine. The London County Council are, for the purposes of the above Act, the "local authority", and they maintain two institutions as "Part III" accommodation in this area, viz: 367, Fulham Road, (adjacent to St. Stephen's Hospital) and 'King's Mead', Dovehouse Street. It became necessary to arrange for the reception of 17 persons to 'King's Mead' during 1955. No occasion arose for enforced removal under Section 47 of the National Assistance Act, 1948, as amended by the National Assistance (Amendment) Act, 1951. At the same time as transfers are effected to London County Council premises, the persons concerned, are acquainted with the fact that their possessions automatically become the responsibility of the County authorities. 20 SPASTIC CHILDREN Cerebral palsy has, for some considerable time, been the subject of intensive research. The fact that little was known about it has made it difficult to cope with. The condition arises from an injury to the brain before, during or after birth, and from other causes which are somewhat in doubt, and may render it difficult for a child to either stand, walk, speak, or use its hands. The evident physical infirmity which is frequently very gross, has contributed to the belief, in the past, that the children concerned were mental defectives. When such an opinion was accepted, the mental anguish caused to adults unfortunately so afflicted, bearing in mind that in the majority of cases their intelligence was unimpaired, cannot be readily appreciated. As foreshadowed in my last Annual Report, the No. 4 (Chelsea) Group Hospital Management Committee opened an experimental non-resident treatment centre for Spastic Children at 6l, Cheyne Walk, S.W.3. In 1952 the need for the establishment of such a centre in south-western London was investigated, but for financial reasons it was not possible to go ahead with the work. It is most gratifying to record that funds for the foundation of the Centre were forthcoming from many directions, including the King Edward Hospital Fund for London, The London Parochial Charities, and the William Johnston Yapp Trust, as well as a large number of generous private donors. Ultimately approximately £20,000 was subscribed. The day-to-day financial maintenance is provided by the South-West Metropolitan Regional Hospital Board. The development of the Centre is planned in three phases, which are as follows:- Phase I - To establish on the ground floor of Cheyne Hospital for children, a 'Day out-patients diagnostic treatment centre' for children between the ages of 0 and 5 or 6 years suffering from cerebral palsy. The remaining phases cannot be achieved until the whole of Cheyne Hospital is returned to hospital use, and to some extent overlap each other and are not necessarily in chronological order. This particular phase came into operation on 5th April, 1955. Phase II - This is the duplication upon the first floor of the hospital of the facilities provided in Phase I. Phase III- This is the provision upon other floors of Cheyne Hospital of (a) some accommodation for mothers and babies for short periods of residence, and (b) the establishment of a research centre into the causes, treatment and prevention of cerebral palsy. From the first six-monthly report covering the period April to September, 1955, it has been ascertained that seventeen children were accepted for full treatment, i.e., Physiotherapy, Speech Therapy and Schooling, whilst eleven children are receiving treatment for Physiotherapy only. The latest figures indicate that there are twenty-eight full-time patients, and seventeen other patients attending by appointment. 21 spastic children - Contd. Consideration of the work carried out to date shows that the need is both obvious and urgent, and great encouragement is being received from the knowledge that the public is maintaining a steady interest in the efforts of all at the Centre. It is indeed pleasing to note that the centre is supported by a resolute and energetic voluntary body known as the Friends of the Centre for Spastic Children, the individual members of which are largely resident in Chelsea, including many well-known figures in the life of the Borough. CHILD POPULATION At mid-1955, it was estimated that 8,540 children under the age of fifteen years were residing in the Borough, constituted of the following age groups:- Under 1 year of age 710 1 to 4 years (inclusive) 2,640 5 to 14 years (inclusive) 5,190 8,540 a figure which represents approximately one-sixth of the whole population of the area (51,450). 22 WELFARE OF OLD PEOPLE As the year drew to a close, the register disclosed that one thousand and eighty-seven persons were, in one or more instances, availing themselves of the numerous services readily offered by the Old People's Welfare Committee which is representative of and co-ordinates the activities of voluntary organisations engaged in this sphere of public service. The Borough Council makes an annual grant of £450 to the Committee for its work. The problems and circumstances peculiar to people of advanced age are given every attention by the Council's Officers, and it is fully appreciated that whilst, in many instances, infirmity or ill-health would make it advisable for such persons to receive institutional care, the fact that they can remain in their homes does make for a measure of happiness, and wherever possible, their wishes are respected and necessary nursing arrangements mads. It is not possible to fully detail the facilities afforded, but the following comments will give an impression of the diversity of the aims of the Old People's Welfare Committee. Hot Meals. This service is efficiently administered by the Woman's Voluntary Services. Meals are supplied from Monday to Thursday in each week, and during the year delivery of 11,193 was made - a weekly average of 215. In 1954 the respective figures were 10,028, and 193. The provision of hot meals has always been greatly appreciated by the recipients. Chiropody. One hundred and thirty-eight persons were recommended for the services provided by two qualified chiropodists, as compared with 117 and 97 in the two preceding years. This facility is in great demand and there has been, for some time, a waiting list for treatment. During the year 429 treatments were carried out. Holidays. It has long been understood that elderly people do not feel able to make arrangements for holidays; it has to be recorded, however, that with the removal of such a responsibility, one hundred and eighteen persons enjoyed very pleasant and quiet holidays either by the sea or in the country during the year. The majority stayed at homes controlled by the Women's Holiday Fund, whilst others had one or two weeks' at the Lloyd Thomas Home of Rest at Highgate. On occasion they were transported to and from their homes, and not infrequently escorts accompanied them between their residences and railway stations. A. Library and Shopping scheme is operated by the British Red Cross Society whose weekly visits to persons unable to get out and about are eagerly anticipated. Where it becomes necessary for anyone to attend hospital for treatment every endeavour is made to provide escorts. The Women's Voluntary Services also assist with shopping facilities. The problem of securing Hospital accommodation for the chronic sick is fraught with difficulties, but the cordial and sympathetic relationship prevailing between helpers and hospital authorities has resulted in seventyeight men and women gaining admission to hospitals in the area. It was gratifying to learn that the patient consideration of hospital rehabilitation officers was rewarded by a number of persons being able to return to their homes and take up the threads of a normal life once again. 23 Issues of clothing were made in two hundred and seventy-five instances immediately it was established that need existed. The Women's Voluntary Services and other kind donors made available a variety of items of wearing apparel, whilst the National Assistance Board readily made grants which resulted in the provision of bedding, After careful consideration it was arranged for seventeen persons to be transferred to institutions, and in most cases it was found that they settled down to a communal life, although it was at first apparent that considerable tact and advice was necessary before the advantages were realised. The enfeebled condition of eight persons rendered it advisable to give them personal cleansing- Twenty-eight rooms were cleansed, and in some cases unwanted items disposed of. Boot and shoe repairs, at the rate of twenty-five pairs monthly, are dealt with by a local repairer, who kindly makes a reduction of twopence in the shilling from normal charges, an offer which is fully appreciated. At the beginning of November, a laundry service for incontinent persons was inaugurated by the Council with the valued co-operation of Fulham Borough Council. Soiled linen is collected twice weekly from the homes of these unfortunate persons and delivered to Fulham's disinfecting station where it is laundered and later collected for return to those using the scheme. By the end of the year four persons were so benefiting, and some 230 pounds of bedding, etc., had been laundered. No doubt as the facility becomes more publicised it will be made fuller use of. A total of two thousand, three hundred and forty-three visits were made to registered cases by the Council's Social Worker, either in their own homes, or whilst they were undergoing hospital treatment. 24 PUBLIC MORTUARY FACILITIES No mortuary premises have been maintained in the Borough during recent years. Under an agreement with Hammersmith Borough Council, facilities at their Mortuary in Fulham Palace Road, W.6, are readily available to this authority. During 1955, two hundred and twenty-one Post-Mortems without Inquests, and fifty-nine Post Mortems with Inquests were carried out in respect of Chelsea residents. DESTRUCTION OF PIGEONS Occasionally, complaints are received of nuisances caused by pigeons. An officer is not specifically employed to deal with such matters, and it is the practice to refer them to a firm who specialise in the trapping and despatching of these birds, for which no charge is made to the Council. A considerable number of pigeons were trapped and humanely despatched during the year. The Public Health (London) Act, 1936, section 123, empowers a local authority to take action to minimise the numbers of pigeons in its area, and to abate nuisances arising from concentrations of these birds. MEDICAL EXAMINATIONS Fifty examinations were performed to ascertain whether persons appointed to positions in the Council's employment were fit for admission to the authority's superannuation scheme, and all but three were found to be of a Satisfactory health standard. MASS RADIOGRAPHY It was not possible for a Mobile X-Ray Unit to visit Chelsea during the year, but facilities were constantly available at Grove Hospital, Tooting. Early in 1956 it is anticipated that the Mass X-Ray Service will be transferred from the above hospital to St. James' Hospital, Balham, where members of the public may attend from Mondays to Fridays for examination, without the necessity of making appointments. The HQ offices of the Service are also to be moved, and will eventually be located at Western Hospital, Seagrave Road, Fulham, and until these transfers and consequent re-organisations have been completed, no details as to visits to adjacent boroughs during 1956 can be give. 25 METEOROLOGY -1955 The following table gives brief details of temperatures, rainfall and sunshine recorded during the year, and has been compiled from information supplied by the Director of the Meteorological Office, based on data obtained at Kew Observatory. Quarter Daily Temperature of the Air Total Rainfall (inches) Total Sunshine (hours) Average of Highest Average of Lowest Average of Mean March 43.1° 33.2° 38.2° 4.84 280.4 June 61.2° 46.6° 53.9° 6.24 587.3 September 74.2° 54.7° 64.4° 2.87 601.9 December 52.0° 41.1° 46.5° 5.01 192.2 TOTALS: 18.96 1661.8 The highest and lowest temperatures recorded during each month of 1955 were as follows:- Highest Lowest January (llth) 52.5° (15th) 23.5° February ( 8th) 52.7° (18th) 22.3 March (25th) 63.1° ( 1st) 25.2° April (29th) 67.6° (20th) 33.8° May (27th) 64.0° (17th) 35.1° June ( 6th) 73.4° (10th) 40.6° July (17th) 86.2° ( 6th) 51.1° August (22nd) 86.2° ( 8th) 45.9° September ( 2nd) 77.4° (19th) 41.0° October ( 8th) 67.3 (31st) 29.7° N ovember ( 6th) 61.3° ( 1st) 29.1° December (27th) 57.0° (19th) 24.8° NOTE: All temperatures shown are Fahrenheit readings. Quarterly averages for south-eastern England as compared with normal anticipations. Rainfall. Sunshine. March 96 105 June 124 102 September 62 134 December 93 97 26 In conjunction with other local authorities and the Department of Scientific and Industrial Research, stations hare been established in the Borough. The following tables are based on (a) the examination of matter collected in a deposit gauge, and (b) the estimation of sulphur in milligrams of sulphur trioxide per day. (a) Deposit Gauze situated at Chelsea Polytechnic. Month Days exposed Rainfall (inches) Total deposits for period in tons per square mile Soluble Insoluble Total January 32 1.66 11.99 14.84 26.83 February 28 1.06 11.22 8.26 19.48 March 31 0.82 7.37 12.18 19.55 April 29 0.22 4.01 9.45 13.46 May 33 4.08 9.09 14.69 23.78 June 30 1.76 8.33 13.01 21.34 July 28 0.70 4.19 7.15 11.34 August 33 0.64 5.69 11.09 16.78 September 30 1.67 5.11 9.39 14.50 October 31 2.53 6.05 10.36 16.41 November 31 .50 6.65 12.89 19.55 December 22 1.69 __10.59_ 12.28 22.87 (b) Estimation, of atmospheric sulphur-chelsea Polytechnic. Estimation of sulphur in milligrams of sulphur trioxide per day. Month Days Exposed Daily Return January 32 3.71 February 28 4.46 March 31 4.08 April 28 2.13 May 33 3.02 June 30 2.15 July 28 2.06 August 33 2.33 September 30 3.52 October 31 3.03 November 31 4.7 December 32 3.64 27 SANITARY ADMINISTRATION OF THE BOROUGH SUMMARY OF WORK PERFORMED BY THE SANITARY INSPECTORS DURING THE YEAR 1955. Number of complaints received during the year 1,011 6,161 INSPECTIONS AND RE-VISITS DWELLINGS: Inspections after complaints 3,399 Inspections after Infectious Diseases 336 House-to-House inspections 2,022 Underground Rooms 201 Overcrowding and "Permitted Numbers" 153 (Housing Applications) Other visits 50 FOOD PREMISES: Butchers 140 2,190 Fishmongers and Fish Friers 41 General Provision Shops 169 Dairies 198 Ice Cream Vendors (Premises, Stalls, Vehicles, etc.) 204 Ice Cream Manufacturers 14 Bakehouses 103 Street Stalls and Barrows. 54 Food Factories (Mechanical) other than Bakehouses 19 Hotels, Restaurants and Dining Rooms 652 Premises in connection with Unsound Food 325 Premises in connection with sampling of Food and Drugs 192 Other Food Premises 79 FACTORIES AND CUTWORKERS: Factories - other than Food Factories (Mechanical) 258 322 Factories - other than Food Factories (Non-Mechanical) 49 Outworkers 14 Other visits (not classified) 1 DRAINAGE: Drains tested: (a) by water 401 573 (b) by smoke 99 (c) by air 73 Carried forwards 9,246 28 SANITARY ADMINISTRATION OF THE BOROUGH SUMMARY OF WORK PERFORMED BY THE SANITARY INSPECTORS DURING THE YEAR 1955. Brought forwards 9,246 INSPECTIONS AND RE-VISITS (Continued) 8,632 MISCELIANEOUS: Animals, poultry and birds 6 Open spaces, highways, allotments, fairgrounds, etc. 86 Office premises 2 Marine Stores and Second-hand Dealers 10 Premises registered under Pharmacy & Poisons Act, 1933 48 Premises to enforce requirements of Shops Act. 71 Premises re progress of voluntary works 4,690 Visits to offices of Owners, Agents, Builders, etc. 222 Smoke observations 29 Food Poisoning 47 Visits to Aged and Infirm Persons 190 Visits to Verminous Persons 16 Premises other than dwellings after Infectious Diseases 14 Premises under Pet Animals Act, 1951 12 Visits for Atmospheric Pollution recording 313 Premises under Rag Flock and Other Filling Materials Act,1950 11 Visits to premises resulting in "no access" 1,731 Other visits 1,134 TOTAL: 17,878 29 WORKS SUPERVISED BY THE SANITARY INSPECTORS FACTORIES ACT, 1937 HOUSING ACT, 1936 PUBLIC HEALTH (LONDON) ACT , 1936 FOOD & DRUGS ACT, 1938 TOTAL N. v. N. V. N. V. N. V. CLEANSING: Rooms: Walls & Cellings cleansed and redecorated _ _ 60 1 20 - - 1 82 Passages & Staircases: Walls & Ceilings cleansed and redecorated _ _ 30 _ 1 - - _ 31 Rooms and Contents cleansed by occupiers - - - 1 - - 1 Rooms where Food is manufactured stored or sold - - - - - - 3 14 17 Miscellaneous - - - - - 1 - 1 2 GENERAL IMPROVEMENTS AND REPAIRS: Roofs - - 54 1 82 — - 1 138 Eaves, Gutters — _ 9 2 44 1 — - 56 Rain-water pipes _ _ 26 1 6 _ _ _ 33 Yard and Area: Pavings - - 31 1 5 1 2 - 4O Walls rendered or repaired - - 39 - 3 - - - 42 Rooms: Wall & Celling plaster _ _ 186 2 133 _ 1 2 324 Passages & Staircases: Wall and Ceiling plaster - - 64 _ 17 - - _ 81 Floors — - 42 1 26 — — — 69 Stair Treads: Bannisters & Balustrades - - 37 1 4 - - 1 43 Window and Door Frames, fittings and sash cords - - 310 5 90 - - - 405 Dampness remedied - - 133 1 256 2 1 - 393 Horizontal damp proof course provided - - 4 - - _ _ _ 4 Vertical damp proof course provided - _ 4 _ _ _ _ _ 4 Fireplaces & Fire-ranges repaired _ - 60 2 26 1 _ _ 89 Washing Coppers repaired - - 4 - - - - - 4 Natural Ventilation provided or improved - - 43 1 12 - - - 56 Chimneys and Flues Natural Lighting provided or — — 24 1 3 — — — 28 improved - - 14 19 - - - - 33 Carried forward - - 1174 39 729 6 7 20 1975 30 WORKS SUPERVISED BY SANITARY INSPECTOR (Continued) FACTORIES ACT, 1937 HOUSING ACT, 1936 PUBLIC HEALTH (LONDON) ACT, 1936 FOCD & DRUGS ACT, 1938 TOTAL Brought forward N. V. N. V. N. V. N. V. - - 1174 39 729 6 7 20 1975 GENERAL IMPROVEMENTS AND REPAIRS (Continued) Obstructions to Natural Lighting removed - - 3 - - - - - 3 Subfloor ventilation provided - - 11 - - - - - 11 Miscallaneous — — 31 3 17 — 1 1 53 DRAINAGE: Total Reconstructions - - - - - 6 - - 6 Partial Reconstructions, repairs or alterations - 2 _ 1 _ 15 _ _ 18 Frontage Drains Reconstructed - - - - 15 6 - - 21 obstructions cleared — — 2 - 6 24 - - 32 Inspection Chambers provided - 1 - — - 33 - - 34 Inspection Chamber covers renewed — — 1 — 3 2 — - 6 Interceptors provided - - - - - 7 - - 7 Soil & Ventilation Stacks provided or reconstructed _ 1 - - - 43 1 - 45 Soil & Ventilation Stacks repaired - _ 3 - 4 3 - - 10 Waste & Ventilation Stacks provided or reconstructed - _ 3 - - 55 - - 58 Waste & Ventilation Stacks repaired - - - 1 - — — 1 Anti-Syphonage Stacks provided or reconstructed - - - - - 22 - - 22 Fresh Air Inlets provided - - - - — 8 - — 8 Fresh Air Inlets repaired or renewed - - 9 1 3 — _ - 13 Single Sinks provided - 5 9 _ - 134 5 — 153 Single Sinks renewed - - 2 — 2 — — - 4 Baths provided — - _ — _ 160 _ - 160 Wash-hand basins provided — 3 — _ _ 201 1 1 206 Miscellaneous — — 11 1 22 41 1 - 76 Carried forward - 12 1259 45 802 766 16 22 2922 31 WORKS SUPERVISED BY THE SANITARY INSPECTORS (Continued) factories act, 1937 HOUSING ACT, 1936 PUBLIC HEALTH (LONDON) ACT, 1936 FOOD & DRUGS ACT, 1938 TOTAL Brought forward n. V. N. V. n. V. N. V. - 12 1259 45 802 766 16 22 2922 SANITARY conveniences: Additional Water Closets provided - 4 - - - 170 - 3 177 Water Closet pans renewed - - 7 - 9 - - - 16 Water Waste preventers renewed or repaired -- - 3 _ 12 3 - _ 18 Water Waste preventers provided - 4 - - - 170 - 3 177 Roofs repaired or renewed - - 4 - 4 - - - 8 Walls & Ceiling plaster cleansed, repaired or redecorated - - 29 - 26 - _ 3 58 Natural Ventilation provided or improved - 1 32 - 5 28 - - 66 Natural or Artificial Light provided or improved - - 1 - - - - - 1 Ventilated Lobby provided 1 1 - — 1 2 1 — 6 Miscellaneous 1 - 20 1 18 1 — - 41 WATER SUPPLY: Supplies provided to Tenements _ _ 24 _ 1 - _ - 25 Taps supplied on main for drinking purposes - - 24 - 1 - - - 25 Cisterns cleansed, covered or repaired - - - - 8 - - - 8 MISCELLANEOUS SERVICES PROVIDED: Constant Hot Water - - - - - - 1 5 6 Bins, refuse - - - — 97 9 — — 106 Food Cupboards provided — - 60 1 - - - - 61 Food Cupboards - Ventilation provided - - 22 - - - - - 22 Covered Display & Counter Screens provided - - - - - - - 4 4 Carried forward 2 22 1485 47 984 1149 18 40 3747 32 WORKS SUPERVISED BY THE SANITARY INSPECTORS (Continued) FACTORIES ACT, 1937 HOUSING ACT, 1936 PUBLIC HEALTH (LONDON) ACT, 1936 FOOD & DRUGS ACT, 1938 TOTAL N. V. N. V. N. V. N. V. Brought forward 2 22 1485 47 984 1149 18 40 3747 MISCELLANEOUS NUISANCES ABATED, ARISING FROM: Offensive accumulations on open land and bomb sites - - - - 3 2 - - 5 Obstructions from Light and Air - - - - - 2 - - 2 GRAND TOTALS 2 22 1485 47 987 1153 18 40 3754 N = Mark carried out under Notice. V = Voluntary works. SHOPS ACT. 1950 The following voluntary works were carried out under the above Act. Inspections Chambers provided 2 Single Sinks presided 4 Wash-hand basins provided 5 Additional Water Closets provided 6 Water Waste preventers provided 6 Natural or Artifical Light provided or improved 1 33 INSPECTIONS, PROCEEDINGS. ETC. Total number of houses in the Borough 16,523 (approx.) PUBLIC HEALTH (LONDON) ACT, 1936 Number of houses inspected on account of complaints or illness 1,224 Number of statutory notices served 166 Number of houses repaired or nuisances remedied 300 HOUSING ACT, 1936 Number of houses inspected - house-to-house (Housing Consolidated Regulations, 1925) 102 Number of houses included by representations by the Medical Officer of Health under Section 25 of Housing Act, 1936 Nil Number of houses demolished following representation by Medical Officer of Health under Section 25 of Housing Act, 1936 Number of houses repaired under Sections 9 and 10 of Housing Act, 1936:- Nil (a) by owners 58 (b) by local authority in default of owners Number of houses demolished:- Nil (a) in pursuance of orders under Section 11 of the Housing Act, 1936 8 (b) voluntarily Nil Number of houses (wholly or in part) the subject of Closing Orders (excluding underground rooms) Nil Number of Closing Orders determined (i.e. houses made fit) Nil OVERCROWDlNG (HOUSING ACT, 1936) Number of families found to be living in overcrowded conditions 8 Number of overcrowded families who have obtained alternative accommodation 8 Number of houses erected by the Borough Council during the year 49 UNDERGROUND ROOMS Number found to be unfit 12 Number rendered fit for human habitation 2 Number closed by Closing Orders 10 HOUSES LET IN LODGINGS Number of inspections (see & above) _ Number of prosecutions Nil Number of complaints remedied under the bye-laws (not included under any other heading) 12 34 DETAILS OF NOTICES SERVED DURING THE YEAR UNDER VARIOUS ACTS 1. FACTORIES ACT, 1937 Health-General Provisions 4 2. FOOD AND DRUGS ACT, 1938 Section 13 - Defects at Food Premises 12 3. HOUSING ACT. 1936 Section 9 - Repair of Insanitary Houses 95 4. PUBLIC HEALTH (LONDON) ACT. 1936 (a) Intimation (Arising out of this item, 62. Nuisance Notices were served) 214 (b) Section 40 - Drainage 27 (c) Section 184 - Food Storage 75 5. L.C.C. (GENERAL POWERS) ACT, 1954 Section 12 - Provision of Dustbins - Intimation (Arising out of this item 25 Statutory Notices were served) 93 6. SHOPS ACT. 1950 Section 38 - Provision of suitable sanitary conveniences and ventilation 1 7. prevention of DAMAGE BY PESTS act. 1949 section 4 - Destruction of mice Nil TOTAL 521 Four hundred and fifty-seven notices were complied with during the year of which three hundred and four were served under the Public Health (London) Act, 1936. HOUSING REPAIRS AND RENTS ACT, 1954 Ten Certificates of Disrepair and four Certificates of Revocation were issued in accordance with the provisions of the above Act. 35 APPLICATIONS FOR RE-HOUSING To assist the Council's Property Manager in arriving at a just consideration of the merits of each application received a "pointing" system was evolved, and became effective in May, 1953. As applicable, points were awarded under the following headings: - Sub-standard accommodation; Ill-health (excepting Tuberculosis); Tuberculosis; Overcrowding; and Other circumstances. During the year, 58 applications were referred to the Public Health Department. 47 originated from Chelsea residents, and the remainder from applicants living in other areas. Each case was investigated - 42 in connection with ill-health, including Tuberculosis, and 16 in respect of sub-standard accommodation. Since May, 1953, the position is as follows:- Applicants re-housed by the Borough Council 77 Applicants re-housed by the London County Council 19 Applicants re-housed by other authorities 1 Applicants who secured alternative accommodation by their own efforts 16 113 Of this total, 86 of the cases re-accommodated had been dealt with under the heading of "ill-health". The policy of co-operative examination of each housing application under the headings mentioned is proving to be mutually satisfying by virtue of the accelerated period of enquiry and subsequent re-settlement. Points scheme for allocation of Permanent accommodation. The cases of 62 licensees in requisitioned premises were also referred to this department for pointing on medical grounds under the above scheme. 36 HOUSING ACT. 1936 - PART IV - OVERCROWDING New cases investigated and recorded 8 Number of families involved 8 Number of persons involved 42 Cases relieved by:- (a) Rehousing Authorities 5 (b) Informal or formal procedure 3 Such action resulted in 44 parsons being adequately housed. At the end of the year, 50 families were living in overcrowded conditions and every endeavour is being made to bring about an abatement of such conditions. WATER supply The provision of water for both commercial and domestic users is made by the Metropolitan Water Board. During the year, two complaints regarding the unsatisfactory condition of water supplies were received, and in both cases Notices were served requesting the satisfactory cleansing and covering of the water storage cistern. Twenty-seven samples of water were taken at the Council's Public Baths, and in every instance a satisfactory report was received. As a result of investigation by the Council's Sanitary Inspectors, the following provisions were made:- Supplies to tenements 25 Taps on main for drinking purposes 25 Cisterns cleansed, covered or repaired 8 37 FACTORIES ACT, 1937 Under Section 128 of the above Act, a Medical Officer of Health is required to report annually as to the administration of Factories, Workshops, and Workplaces in his district. The following three tables indicate the work carried out by the Sanitary Inspectors during the year. 1. INSPECTION OF FACTORIES, WORKSHOPS, AND WORKPIACES. Premises Number on Register Number of Inspections Written Notices Occupiers prosecuted (1) Factories in which Sections 1,2,3,4 and 6 are to be enforced by Local Authorities:- 72 49 3 - (2) Factories not included in (1) in which Section 7 is enforced by the Local Authority:- 266 306 2 - (3) Other premises in which + Section 7 is enforced by the Local Authority:- - - - - TOTALS 338 355 5 - Note:- Outworkers' premises are not included in (3) above. + i.e., Electrical Stations - Section 103(1), Institutions (Section 104) and sites of Building Operations and Works of Engineering Construction (Sections 107 and 108). 38 FACTORIES ACT, 1937 (Continued) 2. CASES IN WHICH DEFECTS WERE FOUND. Particulars Number of cases in which Defects were found Number of Cases in which prosecutions were Inspector Found Remedied Refer red To H.M. Inspector By H.M Inspector Want of cleanliness (Section 1) 3 3 - - - Overcrowding (Section 2) - - - - — Unreasonable temperature (Section 3) - - - - - Inadequate ventilation (Section 4) - - - - - Ineffective drainage of floors (Section 6) - - - - - Sanitary Conveniences (Section 7) (a) Insufficient 1 - — - _ (b) Unsuitable or defective 6 4 - 1 - (c) Not separate for sexes - - - - - Other offences against the Act (not including offences relating to Outwork) - - - - - TOTALS 10 7 - 1 - 39 FACTORIES ACT, 1937 (Continued) OUTWORK (Sections 110 and 111) Nature of Work No. of Outworkers in August List required by Section 110 (1)(c) No. of Cases of default in sending List to the Council No. of Prosecutions for failure to supply Lists No. of instances of work in unwholesome premises Notices served Prosecutions Wearing Apparel, Making etc. 14 - - 1 1 - Household linen 2 - - - - - Curtains and furniture hangings 3 - - - - - Furniture and upholstery 1 - - - - - Stuffed toys 3 _ - - - - Lampshades 16 - - - - - TOTALS 39 - - 1 1 - 40 LEGAL PROCEEDINGS The institution of legal proceedings, under the Public Health (London) Act, 1936, was necessary in two instances. Brief details of results of hearings are set out below. Premises Offence Result of Proceedings 35, Blantyre Street 23, Stadium Street Non-compliance with Statutory Notice. Non-compliance with Statutory Notice. Abatement order made for the work to be completed within 28 days. Council awarded £2. 2s. 0d. costs. Summons withdrawn - requirements of notice having been complied with at time of hearing. Council awarded £1. 1s. 0d. costs. PHARMACY AND POISONS ACT, 1933. The provisions of the Act and the Poisons Rules relating to the relating of poisons specified in Part II of the Poisons List wave administered throughout, the year. The number of listed sellers placed on the Council's register was 47. All applications are investigated to ensure that records are properly maintained, labelling efficiently performed, storage accommodation adsquste and that gales are made only by employees nominated on the application forms. In every instance it was found that the requirements of the Act and Poisons Rules were being complied with, whilst subsequent enquiries revealed that all cancerned, were well aware of their responsibilities in such matters. As a general rule the poisons retailed were insecticides, rodent exterminants, hair dyes, and household ammonia. Applications for inclusion aid/or retention in the Council's register are considered by the Public Health Committee each Spring. When approval has been expressed to applications, appropriate entries are made for a period of twelve months (1st May to 30th April). 41 BACTERIOLOGICAL EXAMINATIONS Daring the year, twenty-seven examinations were carried out for bacteriological findings, details of which are set out in the following summary:- Article Reported upon as- Total Satisfactory Unsatisfactory Dried full cream milk 1 - 1 Cream lolly 1 - 1 Luncheon Mb at 1 - 1 Hater 24 - 24 27 - 27 Reference to eight samples of Ice Cream will be found on Page 42 • 42 ICE CREAM Eight samples of Ice Cream were submitted to the Public Health Laboratory service for "Mathylene Blue" tests, with the following results:- Grade I 3 Grade II 3 Grade III 1 Grade IV 1 8 Grade 1953 1954. 1955 No. of samples Percentage of total No. of samples Percentage of total No. of samples Percentage of total I 32 62.7 22 30.4 3 37.5 II 8 15.6 23 32.0 3 37.5 III 6 11.8 17 23.6 1 12.5 IV 5 9.9 10 14.6 1 12.5 TOTAL 51 100.0 72 100.0 8 100.0 Traders whose products have been adversely reported upon are notified of the findings, whilst Medical Officers of Health are advised similarly concerning Ice Cream manufactured in their areas. 43 INSPECTION AND SUPERVISION OF FOOD As required by current legislation, registers are maintained of all persons carrying an trades connected with the manufacture, storage, and sale of food. Traders and their staffs are kept informed of the latest methods adopted for the hygienic handling, wrapping and delivery of food, and the great majority are appreciative of such information. The following summary gives details of the types of businesses receiving the attention of the Public Health Department:- Bakehouses 6 Butchers 29 Milk Retailers (including dairies) 46 Food Factories 4 Fried Fish Premises 2 Fruit and Vegetable Retailers 35 General Provision Merchants 56 Industrial Canteens. 7 +Miscellaneous Premises 31 Public Houses and Hotels 51 Restaurants 193 Wet Fish Retailers 9 Wet and Fried Fish Retailer 1 + Off-Licences, Bottling Stores, Cake Shops and Sweet Shops. As required under Section 16 of the Food and Drugs Act, 1955, or other local acts, the registrations of 108 premises for the storage and sale of Ice Cream, and 39 premises for the sale of Preserved Foods, are operative. 44 MILK SUPPLY Under the Milk and Dairies Regulations, 1949 to 1954, a local authority is required to keep a register of all persons carrying on the trade of milk distributor, and of all premises used as dairies (other than dairy farms) in their district, and to remove from the register the name of any person who ceases to trade as a milk distributor, and of any premise which ceases to be used as a dairy premise. On the 31st December, 1955, entries in the register were as follows:- (a) Number of registered distributors with premises in the Borough 36 (b) Number of registered distributors other than those included in (a) above 15 (c) Number of premises in the Borough registered as dairies 1 (d) Number of premises in the Borough, other than dairies, from which milk is distributed 45 During the year, 108 applications were received, and principal licences were granted under the Milk (Special Designation) (Raw Milk) Regulations, 1949 to 1954, and the Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 1949 to 1953, authorising the use of special designations in relation to milk sold at or from premises within the Borough, 41 supplementary licences were granted in respect of milk sold by retail within the Borough from 15 premises not situate in the area of this authority. Details of licences granted were as follows:- Type of Licence Tuberculin Tested Pasteurised Sterilised Total Principal 31 39 38 108 Supplementary 13 14 14 41 All retailers selling milk within the Borough have been licensed to use special designations in accordance with the provisions of the Milk (Special Designations) (Specified Areas) Order, 1951, which came into force on 1st October, 1951, for the whole of the County of London. 45 PET ANIMALS ACT. 1951. The Pet Animals Act, 1951, which came into operation on the 1st April, 1952, provides for a system of licensing and inspection by local authorities of pet shops, the main purpose being the enforcement of the Protection of Animals Acts in their application to the business of selling pets. Under Section 1 of the Act, no person may keep a pet shop unless he obtains a licence from the local authority on payment of a fee not exceeding Ten Shillings. In deciding whether to grant a licence, the local authority is required to have regard to the need for securing that there will be provided accommodation suitable as regards size, temperature, lighting, ventilation and cleanliness; that there will be an adequate supply of suitable food and drink; that the animals will not be sold at too early an age; that all reasonable precautions will be taken to prevent the spread of infectious diseases; and that appropriate steps will be taken in case of fire or other emergency. The local authority has, however, a discretion to withhold a licence on other grounds, and is given power to specify in the licence such conditions as they think necessary or expedient in a particular case. Any person aggrieved by the refusal of the local authority to grant such a licence or by the conditions imposed in the licence may appeal to a court of summary jurisdiction. During the year four persons were licensed to keep pert shops in the borough and in each case a fee of ten shillings was paid. 46 RAG FLOGK AND OTHER FILLING MATERIALS ACT. 1951 The Rag Block and Other Filling Materials Act, 1951, came into force on 1st November, 1951, and brought about the repeal of:- The Rag Block Acts of 1911 and 1928, and Section 136 of the Public Health (London) Act, 1936. The new Act represents a consolidation of the 1911 and 1928 Acts, and extends control to a large number of filling materials in order to ensure the cleanliness of same. Eleven premises in the Borough, used for upholstering and similar processes, have been registered since the Act came into force and in each case a fee of £1. 0s. 0d. was received. 47 RODENT CONTROL The Prevention of Damage by Pests Act, 1949, which became operative on 31st March, 1950, is more advantageous to a local authority in dealing with rodents than the Rats and Mice Destruction Act, 1919, which has been repealed. The new Act empowers a local authority to take all practicable measures to rid its area of rats and mice. Under the provisions of the Rats and Mice Destruction Act, 1919, the primary duty for the eradication of these particular pests rested upon the individual occupier. With the advent of this new legislation, an occupier is guilty of an offence if he fails to destroy rodents, or use his best endeavours to prevent infestation. There has always been co-operative action between owners, occupiers and the local authority in this Borough. Details of work carried out in this connection during the year are as follows:- 1. Treatment of Business and Private Premises. Business Premises Private Premises Number of visits made 441 2,798 Number of infestations found 30 274 Number of treatments undertaken 19 266 Number of pre-baits laid 1,775 Number of poison baits laid 585 Number of complaints received 306 2. Sewer Maintenance Treatments. No. of bait laid No. of Poisons baits laid Estimated kill No. 1 Treatment 870 360 3,522 No. 2 Treatment 909 343 2,076 48 UNSOUND FOOD When it has been established that food is unsound, it is surrendered to the Council's Officers, removed from the premises, and the necessary certificates issued. The food is subsequently disposed of via the Council's refuse disposal service, but prior to such action it is treated with carbolic acid. Approximately 8,926 pounds of unsound or diseased food were surrendered to and destroyed by the Council's Food Inspectors during the year, and for the purpose of comparison details of the foods which have largely contributed to the annual totals during the years 1952-1955 (inclusive) are set out in the following table:- UNSOUND FOOD SURRENDERED TO THE COUNCIL'S FOOD INSPECTORS DURING THE 1952-1955 (INCLUSIVE) Commodity 1952 lbs. 1953 lbs. 1954 lbs. 1955 lbs. Biscuits 505 - - Bread - 144 - - Cereals - 139 - - Cheese - - 110 137 Egg, dried - - - 180 Fish, Fresh 117 174 200 173 Fish, Tinned 88 - - - Fruit, Tinned 1,723 2,157 929 517 Fruit, juices 98 - - - Fruit, Fresh - - - 2,353 Fruit, Fresh 1,326 1,621 1,903 3,490 Meat, Tinned - 1,239 1,027 714 Milk, Tinned 95 - 90 - Preserves, - Jams, Marmalade, etc. 123 182 74 92 Sausages 858 435 359 72 Soups 40 93 88 304 Vegetables 1,127 436 254 639 Aggregates of all foods condemned annually 8,192 7,640 5,146 8,926 Average for the four years-7,476 lbs. 49 DISINFECTION AND DISINFESTATION The following is a summary of the work carried out by the staff of the Council's Disinfecting and Cleansing Station, 9a, Lots Road, Chelsea, during the past three years:- 1953 1994 1955 (a) SCABIES Treatments were carried out as follows:- ADULTS (Male) Cases 2 Nil Nil Treatments 3 Nil Nil ADULTS (Female) Cases 3 16 9 Treatments 7 20 9 Children Cases 1 13 6 Treatments 4 21 10 (In addition to the figures shown above, 10 children attending L.C.C. schools were given 12 treatments.) (b) VERMINOUS CONDITIONS Details of work in this connection are set out below:- ADULTS (Male) Cases 2 Nil Nil Treatments 2 Nil Nil ADULTS (Female) Cases 465 407 380 Treatments 465 407 380 Children Cases 304 284 193 Treatments 304 284 193 (194 treatments were given to L.C.C. schoolchildren.) DISINFECTION OF ROOMS AND CQJTENTS AFTER INFECTIOUS DISEASE 1953 1954. 1955 Number of Rooms Disinfected 220 112 130 Number of Articles Disinfected 6,138 3,334 4,462 Disinfection of Rooms and Contents2 Number of Rooms Disinfected 480 198 273 Number of Articles Disinfected 1,615 772 1,737 JfeelJLnwraa Dialect'i. on» Number of Rooms Disinfected 322 390 334 Number of Articles Disinfected 2,370 2,320 2,396 ANNUAL REPORT of the PUBLIC ANALYST for the year ended 31st December, 1955. THOMAS McLACHIAN, A.C.G.F.C., F.R.I.C. 50 To the Mayor, Aldermen and Councillors of The Metropolitan Borough of Chelsea. Mr. Mayor, Ladies and Gentlemen, During the year 1955, 400 samples of foods and drugs were examined. Of these 220 were taken formally and 180 informally. Adverse comments were made against 35 samples. The Incidence of adulteration or incorrect labelling may be classified as follows Number of samples examined. Number incorrect. Milk 200 0 Other foods 196 33 Drugs 4 2 These figures show that food in Chelsea is slightly better than last year. A sample of Canned Beef Steak with Gravy contained only 64 per cent. of total meat. Canned beaf steak with gravy must contain not less than 75 percent. of meat and this samples was, therefore, 14.6 per cent. deficient in meat. An interview was arranged in order to discuss the matter with the importers, who accepted our standard, and agreed that it is unnecessary for public analysts to rely on a Statutory Instrument when fixing a standard, In this particular case the standard for canned stewed steak with gravy was laid down in the Meat Products No. 2 Order, 1952, which was later revoked, but public analysts in this country are relying on most of the standards given in this Order, and propose to continue to rely on then where they believe them to be practicable. Another sample of Stewed Steak with Gravy contained only 69 per cent. of total meat and was therefore also deficient in meat. The manufacturers stated that no more of this product would be coming into the country from Australia. Some stuffed Pork Roll was considered to have a misleading label. It contained 54 per cent. of total meat and although the illustration on the label showed that the outer portion was a kind of Pork Luncheon Meat a purchaser would not expect to find such a high total percentage of filling material. It was considered that the total meat in a product of this type should be at least the same as that of a pork sausage, i.e., 65 per cent. The manufacturers agreed that the product should have been sold as a stuffed Pork and Meat Roll. A sample labelled "Beef Curry with Rice" was deficient in meat. It contained not more than 24 per cent. of meat,-assuming all the nitrogen in the rice and in the yeast extract added as a flavouring to be present as a meat constituent. The ingredients were also disclosed in the wrong order. The manufacturers replied that only a small quantity of this product had placed on the market for trial purposes, and agreed eventually to increase the meat content to approximately 40 per cent. and to amend the label. -51- A sample of Cheese with Ham Spread was declared to contain 20 per cent. of fat, bub contained only per cent., giving 17.3 per cent. of fat on the dry matter. This sample was, therefore, 13.5 per cent. deficient in fat if declared on the dry matter, but 83 per cent, deficient according to the label. The importers pointed out that the label bore the expression "Fett i.T." which means fat in the dry substance, but this does not inform the English purchaser that the fat is described as being on the dry matter, and still fails to account for the deficiency as calculated in the original product. The importers pointed out that all the labels on German cheeses must use the term "Fett i.T." but that they had discontinued the importation of the preparation. A sample labelled "Ham and Chicken" was thought to be incorrectly labelled as it implied that it was probably Ham and Chicken Roll. The manufacturers suggested that it might be called "Ham and Chicken, prepared for Slicing" but this was not acceptable and it was suggested that the product should be labelled "Ham and Chicken Luncheon Meat". There was no more of this pack available and when the new pack is ready for the market, samples were to be submitted for approval. A product labelled Pork and Liver Pate contained 29 per cent. of fat and 60 per cent. of defatted meat. Pork Liver was the principal ingredient and the product should have been labelled "Pork Liver Pate" and not "Pork and Liver Pate". The manufacturers agreed to amend their label accordingly. Some Stewed Veal was submitted for examination because the purchaser considered that it was mouldy and that the can was rusty. The tinplate was of poor quality and showed signs of very bad sulphur stain. What was probably thought to be mould consisted in reality of small pieces of fat and pieces of stain due to colour coming away from the sulphur stained tinplate. What was originally thought to be rust was probably sulphur stain, but once a can has been opened sulphur stained metal oxidizes very rapidly so that the top of the can had become rusty. The contents of the can would not have been unfit for consumption had they been eaten immediately after opening. A foreign body renoved from a meat pie and thought to be a tooth was examined and found to be a small fragment of bone. The matter was investigated by the manufacturers who informed the Council that the size of the piece of bone complained of was too small to be stopped by the normal meat mincing procedure, but that they would have expected it to be discovered by causing an obstruction in one of the pumps, or to have been crushed. This was the first complaint they had had. Some curried prawns were incorrectly labelled as the sample contained 6.7 per cent. of fat and only 2.4 per cent. of ash, but the addition of fat was not declared. Prawns like other crustaceans are low in fat and more fat must have been added than some of the other ingredients. Other ingredients included were garlic and tomato in this order, whereas more tomato than garlic was present. A can of curried mutton contained 9 per cent. of starch filler whose presence had not been declared an the label. Another, of curried beef, contained 4 per cent. of starch filler not declared on the label. The matter was taken up with the manufacturers who submitted further samples of their products and the sauce used in manufacture. They have agreed to have new labels printed showing the ingredients in the correct order. - 52 - Some vegetarian sausages bearing an illustration which implied that they were meat sausages were stated to be rich in protein, but contained only 13.3 per cent, of protein. Protein was declared as the principal ingredient. The disclosure of ingredients was considered to be incorrect. After lengthy correspondence and consultation with the manufacturers it was suggested that the sausages should be described as "Tasty Maatless Sausages" and that the declaration should be amended, but final agreement has not yet been reached. A sample of Salman Spread was considered to have an inferior flavour thought to be due to the use of herring with a small amount of 3almcn. It was, howrever, impossible to determine the quantity of herring present as compared with salmon. The manufacturers stated that the paste contained 70 per cent, of salmon, half of which is fresh and the other half canned, and the remainder of the ingredients were made up of herrings, rusk, and flavouring. It was suggested that there might be some defect in the blending technique, and the manufacturers promised to look into the matter. A product labelled "Fillets of Herring in Butter-Cream Sauce" was considered to be incorrect. The German description "Branded butter sauce" was quite clear and conforms to the illustration, but.the English translation "in Batter-Cream-Sauce" is incorrect. As the sauce contained 9 per cent. of butter the product could be described as "Fillets of Herring in Creamed Butter Sauce". The importers agreed to request the suppliers to change the label accordingly. A sample labelled "Fillets of Herring in Sparkling Wine Sauce" contained alcohol in the sauce 0.93° Proof and in the herrings 0.46° Proof. The use of a spaskling wine in the sauce appeared to be ridiculous as it imparts no special characteristics to the product, and in any case it was used in smaller quantity than still wine which had also been used. A description "Fillets of Herring in Vine Sauce" was suggested. The inqporters confirmed that their Principals were revising their whole range of cartons for canned fish specialities. A tomato soup containing only 0.71 per cent, of fat was stated to producs a cream of tomato soup when the contents were mixed with an equal quantity of milk. Cream of tomato soup containing such a mixture of fats must contain not less than 3 per cent, of total edible fat, so that the resulting cream soup made from the sample would be 38 per cent, deficient in fat. The inserters stated that they had ceased to stock this line. A sample of "Green Pea Soup" was reported as inferior because it contained only 8 per cent, total solid matter when prepared, whereas the Meat Products (Canned feat Control and Maximum Prices) Order, 1946, now revoked, required canned vegetable soup to contain not less than 10 per cent, of total solid matter. A "Veal and Mushroom Soup" cube contained 12.5 per cent, of salt, but salt was not declared among the ingredients. The manufacturers stated that this was a printer's error and they had not intended to omit the mention of salt cn the label. They had a stock of 18,000 labels and asked permission to use them up before reprinting new labels. A complaint was received that a sample of dried egg became green when reconstituted. The egg was examined, bufe it did not become green on reconstituting directly or when reconstituted with added alkali. The ether extract contained eight times the quantity of free fatty acids permitted by the - 53 - Ministry of Food during the war, so that the product was badly decomposed. A metal composition spoon used to reconstitute a further portion of the powder turned green an standing and it was later discovered that the original mix of which complaint was made had been prepared in a tinned copper pan. The green colour evidently resulted from a reaction between the acid of the dried egg and the copper of the pan. A "Cocktail Savoury" contained 14.2 per cent, of salt not declared on the label. The label of this product was reported as incorrect from this laboratory in June 1953, and the manufacturers had since changed the label, but the sample was found to be old stock. A Pepper Sauce was labelled as being made of Vinegar, Red Pepper, and Salt. As the result of a High Court Action, "Vinegar" in England, unless otherwise qualified, has been decided to mean malt vinegar, whereas this sample was made with spirit vinegar. The Sauce was imported from the U.SA. and the vinegar used was "grain vinegar", which in this country would be known as Spirit Vinegar. The manufacturers agreed to use the term "Spirit Vinegar" an new labels which they were having printed. The description and list of ingredients on. the label of an onion sauce tablet was illegible, but reference to the makers showed that the sale of this pack had been discontinued. A dried mixture for the preparation of Parsley Sauce was quite a good product, but failed to comply with the requirements of the Labelling of Food Order, as again the ingredients were not shown clearly on the packet. The manufacturers stated that they were trying oat this product and were using packing material they had in stock. If they continued to market the product the label would be redesigned in a mare suitable form. Two samples of "Macaroni with Cheese Sauce" preparations were examined and in the opinion of your Analyst they are inferior. It is claimed that the macaroni is cooked in 7 minutes, where els in the view of some people, macaroni which is merely boiled for 7 minutes is very far from cocked, and the cheese sauce flavouring left much to be desired. The packers had, however, gone to considerable trouble to make the packages attractive and if the public cares to bty this type of product they will doubtless do so, otherwise now that the market for food is so much frees? it will soon disappear. A sample of Gorgcnzola cheese contained 23 cheese maggots in 12.7 ozs. of cheese and was reported as inferior. Ideally maggots should be absent from cheese, but types of cheese such as Gorgonzola are apt to be contaminated with them. The cheese was well matured and there was therefore a tendency not only for infestation, but also far a large number of maggots to be present. A purchaser birring a whole Gorgonzola cheese should be able to judge what he is buying. This sample was submitted by a shop keeper following a complaint by a customer. Some "FLeur de Creme" cheese was labelled in French and on translation into English this read "60 per cent, of fatty matter". In reality it contained 63.3 per cent, of fat cn the dry matter, but only 26.5 per cent, of fat in the cheese as sold so that according to English law it was 55.8 per cent, deficient in fat. This description is permitted under French and various other continental laws. The importers agreed to take the matter up with the shippers. - 54 - A sample of Cream Cheese contained only 15.2 per cent, of fat. Cream cheese must not contain less than 52 per cento of milk fat, mid this sample was therefore considered to be a skim-milk cheese and nofc a cream cheese. The manufacturers stated that this mistake had already been brought to their notice and was dua to the fact that the word "cream" and the Italian word "crema" do not hare the same meaning. They were arranging to change the name of this cheese to "Pasteurised Cheesy Paste", which would be a correct description. Another sample of cheese labelled as containing 4.0 per cent, of fatty matter, contained only 21.1 per eent. of fat and, 34.9 per cent, of solids not fat. It was, therefore, 47 per cent, deficient in fat calculated on the cheese as sold and 8 per eent. deficient in fat when calculated an the dry matter. The fat content was declared on the dry matter and not on the cheese as sold. This continental method of labelling is not acceptable in this country as it is considered misleading. Some Rice was claimed to be high in mineral salts, phosphorus, and iron, but the label did not shew the quantities present as required by the Labelling of Food Order. The sanpla was satisfactory as rice but polished rice is not high in phosphorus, iron, or vitamins. The manufacturers stated that the wording of the label had been translated from Italian, and no more of the product would be imported without changing the pack. The importers were arranging for the paragraph in question to be cohered by a plain label. A sample of Baby Rice, a powdered cooked product to be mixed with cold milk and water, was satisfactory, but it was suggested to the manufacturers that the directions for use should include a warning that Baby Rice should be freshly prepared each tine before feeding a baby. The manufacturers felt, as do your Medical Officer of Health and your Analyst, that this remark should apply equally to all pre-cooked baby foods, and it was hoped that Public Analysts might arrange to discuss tbs matter with the Ministry. So far this has not been possible. A product described as Maize Flour was incorrectly labelled and should hawe been described as Maize Msal, Maize Grits, or Maize Semolina. Maize Flour must be milled and bolted, but the material was sold in a cellophane bag so that a purchaser could see what he was buying. The importers stated that the mistake was due to the Italian word "farina" being translated into English as "flour", and later agreed to describe their meal as "The famous Italian Maize for Polenta". A vegetarian Jelly Powder was incorrectly labelled as containing glucose, whereas in reality it contained Gluconic Delta Lactone which is an anhydride of gluconic acid. It was also claimed to contain real fruit flavour, whereas the flavour was artificial. The manufacturers had already had their attention drawn to the label a week earlier by another Authority, and were taking steps to amend it. A sample of Coffee Icing Sugar was examined because of the complaint that it contained brown particles. These particles were found to be water soluble particles of dried coffee and chicory extract. They were soluble in water but not in syrup said would note dissolve when the icing was made up. Their presence was considered to be due to improper manufacture. The label also showed an incorrect disclosure of the presence of flavouring arid of "phosphate" without stating which phosphate. The word "flavouring" was incorrect as coffee and chicory extracts are expressly excluded from being flavouring materials under - 55 - the Labelling of Food Order. The manufacturers later agreed that this particular sample was below standard due to the use of a coffee extract flaw our containing chicory. They also agreed to amend their label. A product called Festive Icing was reported as satisfactory, but as it was flavoured it was considered that it might be wise to state the flavour on the container since not everybody might wish to use icing of one particular flavour. A sample purchased as "Devil Nuts" by a child who ate four and became acutely ill with diarrhoea was examined. They appeared to be ordinary hazel nuts dipped in a tincture of capsicum or similar tincture, and there could be no reason why they should make a child ill. A produce described as Cumberland Rum and Butter Spread contained only 26.4 per cent, of total fat, including 4.2 Per cent, of butter, and 0.7 per cent, of rum. As most of the edible fat was not butter and the percentage of rum was exceedingly small it was incorrect to describe it as Rum and Butter Spread. After some correspondence with the manufacturers they stated that it was their intention to discontinue making a "Rum and Butter Spread" or "Cumberland Spread - Rum Flavour", and that in future only the genuine article would be manufactured. The label of a sample of Garlic Tablets bore two different declarations of composition, thus contravening the Pharmacy aid Medicines Act. This matter had previously been taken up by the Pharmaceutical Society and the manufacturers had already agreed to amend their label. Their present stock was almost exhausted and they hoped to have the new labels in a few days. Some Energy Tablets contained only 8.0 mgrms. of vitamin C per tablet, instead of 12.5 mgrms. claimed on the label. They were, therefore, 36 per cent, deficient in ascorbic acid, but the deficiency might have been due to deterioration during storage. The manufacturers agreed to affix a stick-on label with the warning that the tablets should be sold within four months to ensure that the Vitamin C content would have maintained its full standard0. Food and Drug Legislation during 1955, There has been little actual increase in the amount of food and drug legislation during the year, though much has been introduced, including the Pood and Drugs Act, 1955, and the Hygiene Regulations, 1955. The Food and Drugs Act is a Consolidation Act which came into operation in 1956, and it will not be discussed in this report, since the principal implications were mentioned in last year's report. Similarly the Hygiene Regulations only cams into force 1956 and it remains to be seen how some of its articles are to be interpreted from the public analyst's standpoint. The Food Standards (Butter and Margarine) Regulations, 1955, the Labelling of Food (Amendment) Order, 1955, also came into force in 1956. The Food Standards Committee issued a Supplementary Report on Colouring Matters in Foods. This list proposes the inclusion of titanium oxide and ultramarine as permitted dyes and also the deletion of one "coal-tar" dye, Baking Brown Aif, and the addition of Block EI to the List previously-proposed. The earlier Report proposed that the addition of added colours to foods should he declared to the purchaser, bait this Supplementary Report recognises that there are cases where this would be inadvisable. It is suggested that the presence of added colour to fish should fee declared, but that it should not be declared in - 56 - the case of bread, flour confectionery, butter, cheese, margarine, sugar confectionery, ice cream, and other frozen products. It is pointed out in the Report that the identification of colours in foods will not be straightforward, but it is hoped that with the introduction of modern techniques it may be possible for analysts to develop methods for their identification. Reports of this type, taken with those en the addition of anti-oxidants to foods, and limits far lead, arsenic, copper, zinc, addtin illustrate the increasing complexity of food analysis, when it is remembered that these are only cne facet of the work involved. 1 have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, THOMAS McIACHIAN, A.C.G.F.C., F.R.I.C., Public Analyst. 57 Taken Formally Adulterated Taken Informally Adulterated Total Samples Analysed Total sampales Adulterated Almonds, ground 0 0 2 0 2 0 Almond Marzipan 0 0 1 0 1 0 Beans, canned 1 0 1 0 2 0 Biscuits 0 0 1 0 1 0 Butter 1 0 1 0 2 0 Cake covering, chocolate 0 0 1 0 1 0 Cake mixture 1 0 0 0 1 0 Cassia 0 0 1 0 1 0 Cereal, baby 1 0 1 0 2 0 Cheese 0 0 1 1 1 1 Cheese, cream 110 0 11 Cheese, fancy 3 2 0 0 3 2 Cheese, Parmesan 1 0 0 0 1 0 Chicken liver 1 0 0 0 1 0 Chicken, minced 0 0 1 0 1 0 Cocktail Savoury 0 0 1111 Coffee 1 0 2 0 3 0 Coffee and Chicoiy Extract 0 0 1 0 1 0 Coffee Flavoured Beverage 1 0 0 0 1 0 Cooking Oil 1 0 0 0 1 0 Curry Powder 1 0 0 0 1 0 Custard Powder 1 0 0 0 1 0 Dessert Powder 2 0 1 0 3 0 Dripping 0 0 10 10 Egg, dried 0 0 1 1 1 1 Fish, bottled 0 0 3 0 3 0 Fishcakes 1 0 0 0 1 0 Fish, canned 6 1 7 2 13 3 Fish Paste 0 0 1 0 1 0 Fish potted 0 0 1 0 1 0 Fish, smoked, sliced 1 0 0 0 1 0 Fish sticks 1 0 0 0 1 0 lour, maize 0 0 1 1 1 1 orcemeat 1 0 0 0 1 0 Oreign matter from meat pie 0 0 1 1 1 1 Fruit, canned 0 0 3 0 3 0 Fruit dried 4 0 0 0 4 0 Fruit Juice 0 0 2 0 2 0 Pseradish, ground 0 0 1 0 10 ??? soft, flavoured 0 0 1 0 1 0 ??? 2 0 1 0 3 0 ??? vegetarian 0 0 1 1 1 1 Carried forward 3 3 4- 4-1 8 74 12 58 Taken Formally Adulterated Taken Informally Adulterated Total Samples Analysed Total Samples Adulterated Brought forward 33 4 41 8 74 12 Lard 0 0 1 0 1 0 Lemon Curd 1 0 0 0 1 0 Macaroni Products 0 0 2 0 2 0 Macaroons 0 0 1 0 1 0 Maize 0 0 1 0 1 0 Marmalade 1 0 0 0 1 0 Mayonnaise 1 0 1 0 2 0 Maat, canned 8 6 7 2 15 8 Meat Pie 1 0 1 0 2 0 Meat Pudding 1 0 0 0 1 0 Meat Tenderizes 0 0 1 0 1 0 Milk 117 0 83 0 200 0 Mincemeat 1 0 0 0 1 0 Mint Concentrate 1 0 0 0 1 0 Mushrooms, canned 1 0 0 0 1 0 Mushrooms,, dried ' 1 0 0 0 1 0 Mustard 1 0 0 0 1 0 Mustard, continental 1 0 0 0 1 0 Nuts 0 0 1 0 1 0 Olires, Stuffed 0 0 1 0 1 0 Parsley 0 0 1 0 1 0 Pastry, puff 0 0 1 0 1 0 Pate de Foie Truffe 1 0 0 0 1 0 Pate, Pork and Goose Liver 0 0 1 0 1 0 Pate, Pork and Liver 1 1 0 0 1 1 Pea Elour 1 0 0 0 1 0 Peas, canned 1 0 0 0 1 0 Peppers cayenne 0 0 1 0 1 0 Pepper, white 1 0 0 0 1 0 Popcorn, buttered 0 0 1 0 1 0 Prctein food 2 0 0 0 2 0 Puddings 1 0 1 0 2 1 Pulsess Lentils 0 0 10 1 Rarioli 1 0 0 0 1 0 Rice 1 1 0 0 1 0 Rice, baby 1 0 0 0 1 0 Rice, ground 1 0 0 0 1 0 Salad Oil, coconut 0 0 1 0 1 0 Sauce 1 0 4 2 5 0 Sauce tablet 1 1 0 0 1 1 Sausages 6 0 0 0 6 0 Carried forward 189 13 153 12 342 25 59 Taken Farmally Adulterated Taken Informally Adulterated Total Samples Analysed Total Samples Adulterated Brought forward 189 13 153 12 342 25 Sausages, vogetariew 0 0 1 1 1 1 Semolina Preparation 0 0 1 0 1 0 Soft Drinks 1 0 3 0 4 0 Soft Drink Powder 10 10 2 0 Soup, canned 4. 0 1 1 5 1 Soup Ponder 5 1 2 0 7 1 Soup, Tablets 1 0 1 1 2 1 Spice, piekling 1 0 0 0 1 0 Spirits 5 0 0 0 5 0 Spread, saroury 1 0 4 2 5 2 Spread, sweet 0 0 1 1 1 1 Stuffing 1 0 0 0 1 0 Suet 1 0 0 0 1 0 Suet, Shrsdded 1 0 0 0 1 0 Sugar, icingj, coffee 1 1 0 0 1 1 Tapieca, pearl 1 0 0 0 1 0 Tea 3 0 0 0 3 0 Tomaboes, canned 0 0 10 1 0 Tomato Concentrate 1 0 0 0 1 0 Turkey, bottled 1 0 0 0 1 0 Turkey, ad&ced 0 0 10 1 0 Vegetables, canned 0 0 2 0 2 0 Veggtables, piskled cauliflower 1 0 0 0 1 0 Vinegar, eider 0 0 10 1 0 Vinegar, wine 0 0 1 0 1 0 Whear product 1 0 0 0 1 0 Whippaag preparstios, 0 0 1 0 1 0 Yeast, dried 0 0 1 0 1 0 Drugs, Digestive Miaats 0 0 1 0 1 0 Energy Tablets 0 0 1111 Garlic Tablets 0 0 1 1 1 1 Tonis 0 0 10 1 0 TOTALS 220 15 180 20 400 35 EPIDEMIOLOGY Incidence and Notification of Jnfecbious Disease 60 NOTIFICATIONS. The following table shews the total (corrected) number of cases of Infectious Diseases received during the year. Disease Under 1 vear 1 and under 5 vrs. 5 and under 15 vrs. 15 and under 25 vrs. 25 and under A5 vrs. 45 and THider 65 vra. 65 yrs. and oYar TOTAlS Diphtheria - - 1 - 1 - - 2 Diphtheria (Carrier) - - 1 - - - - 1 Dysentery - 1 - - - - - 1 Dysentery (ilesner) - - - - - 1 - 1 Dysentery (Sonne) 25 118 42 9 20 - - 214 Erysipelas - - - - - 3 1 4 Food Poisoaing 5 2 7 A 5 3 1 27 Measles 45 410 267 5 7 2 - 736 Meningococcal Eifectian - 2 - - - - mm 2 Ophthalmia Neonatorum 1 - - - - - - 1 Paratyphoid Fever — — 1 - 1 - - 2 Pneumonias Ac. Influenzal 1 2 2 1 6 4c e Primary 2 1 4 3 4 2 2 18 Poliomyelitis! Paralytic 1 - - - 1 - - 2 Non-Paralytic 2 1 1 - — - 4 Puerperal lyrexia - - r 39 18 - - 57 Scabies - 2 2 2 4 2 - 12 Scarlet Fever - 17 25 1 a - - 43 Hlhoqping Cough 11 44 30 - - - - 85 TOTALS 90 599 381 65 63 35 5 1218 61 SUMMARY OF NCTIFICATIONS OF INFECTIOUS DISEASES RECEIVED DURING THE YEARS 1951 - 1955 (inclusivel) Diseases 1951 1952 1953 1954 1955 Average, for five years Diphtheria - - - - 2 0.4 Dysentery 95 139 260 196 216 181.2 Erysipelas 7 5 4 6 4 5.2 Food Poisoning 13 10 23 19 - 18.4 Malaria 1 - 1 - - 0.4 Measles 669 355 549 104 736 482.6 Mening ocoecal Infection 2 1 4 1 2 2 Ophthalmia Neonatorum - 3 2 - 1 1.2 Paratyphoid Ferrer 3 1 1 3 2 2 Pneumonia: Ac. Influenzal 16 13 4 6 7.8 Ac. Primary 5 16 16 24 18 15.8 Polionyelitiss Paralytic - 12 2 1 2 3.4 Ncn-Paralytic 1 2 3 - 4 2.0 Puerperal Pyrexia 7 67 29 36 57 39.2 Scabies 8 6 19 34 12 15.8 Scarlet Fever 29 61 49 26 43 41.6 typhoid 1 - - 1 - 0.4 Whooping Cough 174 87 257 93 85 139.2 - 62 - DIPHTHERIA Two cases of Diphtheria were notified and confirmed during the year (see report below), the only cases since 1949, when cue case was confirmed. Only one death has occurred during the past sixteen years. Immunisation, has played a major part towards the present excellent position, nevertheless it is constantly necessary to publicise the efficacy of such a service. Details of services provided during the year will be found an page 18. 4 local practitioner, visiting an adult woman patient, suspected clinical diphtheria. Her son, aged 5, had a heavy nasal discharge also considered to be diphtheritic; swabs taken confirmed the diagnosis, and both were admitted to a fever hospital. While in hospital the mother showed evideuce of a circulatory disturbance which suggested that the germ was capable of producing the heart trouble characteristic of diphtheria in susceptible subjects. The child bad been a pupil in a local infants' school, and as a precaution the teacher and all (32) children present in his class were swabbed. Fire children were found to be carrying the same germ, and swabbing of 8 children who were absent from school produced another 5 positives. Enqiry at the school showed that most of the children had been immunised, tat one of the children, unprotested and positive and who was absent from school, was removed to hospital. The family contacts of all positives were swabbed, disclosing two further positives - one a child attending another class of the same school, and the other a pupil the junior section of the same school which was housed in a different building some distance away. The husband of the first case was also found to be a carrier, and was admitted to hospital. Pending mors detailed bacteriological investigation of the germ, it was decided to warn Medical Officers of Health of adjoining Boroughs. All local general practitioners were apprised of the situation and given indications as to treatment, isolation and quarantine. The parents of the children excluded from school by reason of positive swabs were urged to seek medical attention and all parents of children attending the school were informed of the situation. The master was also brought to the notice of the Ministry of Health. By this tints the school had broken up for the Christmas holidays. Further bacteriology by three laboratories on this organism showed it to be an atypical diphtheria germ which was not virulent for guinea pigs. This was confirmed by Professor Robinson of the Liverpool Diphtheria Reference Laboratory, and the germ was labelled "Orchard Street" for local reference by Dr. Tomlinson of the Public Health Laboratory Service. (Loadon). In view of the apparent avirulense of the organism and the absence of notable symptoms or complications among the children affected, and having regard to the pressure an the Public Health Laboratory owing to the concurrent outbreak of dysentery in a nearby large institution, it was decided to await the re-opening of the school before undertaking further swabbing. - 63 - On the return to school swabbing of the 37 children present in Class I produced 8 symptomless positives. All family contacts of these and 5 children who were absent were negative. Because of this finding, as a matter of academic interest to determine the possible distribution of the organism, it was decided to swab the rest of the school by classes. 30 children present in Class III produced 6 positives, and 4 mare were found among 12 children missed in the previous two classes - 3 from Class III and 1 from Class I. Twenty-two children in Class II and all the family contacts of the previous positives were swabbed; with the exception of one child under school age, all were negative. A child previously absent from Class II returned to school and was found to be positive, also a report received from a neighbouring borough that a family contact, a child attending the Junior School, was positive. The last report concerning the outbreak was received from a Children's Hospital and noted that one of the positives had failed to respond to a full course of penicillin but was eventually cleared on aureomycin. This observation confirmed an impression that the carrier state did not tend to clear spontaneously without treatment, and that success with penicillin was variable. Erythromycin appeared to be the drug of choice. Of the 35 cases recorded, 30 occurred within the school (approximately 150 pupils), giving a carrier rate of 20% The remaining 5 cases were 2 adults (the first case and her husband), 2 children, attending the Junior School, and one child under school age. The six cases admitted to hospital included the first two cases (mother and son - the only cases considered to be notifiable), the father of the boy, and 3 children who were admitted because of varying home circumstances. COMMENT The chance finding, the presumptive avirulence, the apparent very local distribution and the high carrier rate of this germ, were matters of some epidemiological interest. The germ does not appear to have been isolated recently in London, nor was there any evidence of its spread to the local population, in spite of the alerting of local doctors. It was noted that nearly one half of the positives occurred in children who were absent from school, but enquiry into every case showed that such symptoms as were present were indefinite and so trivial that in no case had medical attention been sought, the majority being classed as "colds". Terminal disinfection was carried out in one case only (the original notified case). All positives were excluded from school until two, or in most cases, three negative swabs had been obtained. Close liaison was maintained throughout with all medical personnel involved - Dr. Ian Taylor, Epidemiological Officer, L.C.C., and Dr. Russell, Divisional Medical Officer, L.C.C.; Dr. Tomlinson, Public Health Laboratory Service (London); Dr. Kelleher, Western Hospital; Dr. Straker, St. Mary Abbot's Group Laboratory; Dr. Bloss, Ministry of Health; and Dr. Henderson, Ministry of Education. - 64 - Forty-three notifications of Scarlet Fever were received in the Public Health Department during 1955, as compared with 26 in 1954. MEASLES Seven hundred and thirty-six notifications of Measles were received during 1955, as compared with 104 and 549 in 1954 and 1953 respectively. During 1955, two hundred and sixteen notifications were submitted as compared with 196 in 1954 and 260 in 1953. It must again be stressed that 91% of the sufferers were residents of institutions not controlled by this authority. The premises concerned were such that it was difficult to prevent the spread of infection among this particular type of inmates. Nevertheless the Borough Council has been at great pains to bring about the eradication of the incidence of dysentery. - 65 - SMALLPOX No case of Smallpox has been notified to the Public Health Department as having occurred in the Borough since 1928, and there hare been no deaths from this disease for oyer fifty years. Information was received during the year regarding twelve contacts who had travelled to addresses in the Borough, and all were given advice on the precautionary action they should take. POLIOMYELITIS Eleven notifications of Poliomyelitis came to hand, and six of these were subsequently confirmed; four of the cases were of a non-paralytic type. One of the two paralytic cases, a male of 35 years died two days after admission to hospital. In 1954 there was one confirmed case, and in 1953 five confirmed cases. WHOOPING COUGH Eighty-five cases were notified during the year as against 93 in 1954. All cases were under 15 years of age and there were no deaths. PUERPERAL PYREXIA Puerperal Pyrexia means any febrile condition in a woman in whom a temperature of 100.4.0 Fahrenheit (38° Centigrade) or more has occurred within fourteen days after childbirth or miscarriage. Fifty-seven cases were notified during the year, of which only one ease occurred at home, the remainder being in hospital. Forty-one of the hospital notifications referred to patients residing outside the Borough. The Puerperal Pyrexia (Amendment) legislations, 1954, which came into operation on the 1st March this year prescribed a new form of certificate for the notification of cases of puerperal pyrexia by medical practitioners. The new form requires the cause of the disease, if known, to be stated. Herewith is a brief summary of the actual causes in the above cases. 16 cases were due to genital tract infection, 14 to breast involvement, 10 urinary tract infection, 8 respiratory tract infection, 3 associated with Caesarean section and causes not known 6. Ten other cases were brought to the notice of this Department by other local authorities; these concerned Chelsea residents whose confinements took place in hospitals situated in their areas. - 66 - FOOD POISONING Twenty-seven cases were notified as compared with 19 in 1954 and 23 in 1953. A summary of all cases occurring during the year under review is set out below in identical form to that supplied to the Ministry of Health, ANNUAL REPORT OF FOCD POISONING NOTIFICATIONS Notifications of the occurrence of Food Poisoning were received as fallows:- First Quarter Second Quarter Third Quarter Fourth Quarter Total 4 6 12 5 27 Outbreaks (other than family outbreaks) due to identified agents:- NIL Familv Outbreaks due to identified agents:- Total Outbreaks 2 (Salm. typhi-murium) Total Cases: 6 Outbreaks (other than family outbreaks) of undiscovered causes:- NIL Family Outbreaks of undiscovered cause: - Total Outbreaks 3 Total Cases: 7 Single Cases:- Agent identified: 7 Unknown causes: 7 14 (Salm. typhi-murium 6) (Salm. oranienburg 1) Total Cases: - 67 - ZYMOTIC DISEASES During 1955, the Registrar-General indicated that six deaths were attributable to "Gastritis, enteritis and diarrhoea", representing a death rate of 0.11 for such causes per 1,000 of the-population (51,450). Nowadays, the term "Zymotic" is considered to apply to such diseases as cholera, diarrhoea, diphtheria, measles, scarlet fever, smallpox, typhoid fever and typhus fever. Many years ago a considerable number of diseases which were looked upon as "epidemic, endemic, and contagious" received this doubtful distinction. How greatly deaths from these particular causes have declined during the twentieth century is apparant from the following figures:- Year Number of death 1900 219 1905 98 1910 66 1915 76 1920 41 1925 29 1930 22 1935 17 1940 1 1945 6 1950 3 1955 6 - 68 - TUBERCULOSIS 66 cases of Pulmonary Tuberculosis were notified during the year. These were made up of 40 notifications, 22 "inward transfers", 2 from Death Returns and 2 from other sources. There were also 8 nonpulmonary cases, of which 7 were primary notifications, and one from Death Returns. The accompanying tables present details of cases at present on the Tuberculosis Register,, VARIATIONS IN REGISTER DURING 1955. PULMONARI NON-PULMONARI TOTAL CASES M. P. M. F. (a) Number of cases remaining on register at 1st January, 1955 243 193 9 26 471 (b) Number of new cases notified 23 19 2 6 50 (c) Number of cases restored to register 1 1 - - 2 (&) Inward Transfers 11 11 - - 22 Removals (e) Outward Transfers 25 22 - 1 48 (f) Cases recovered 20 19 - 1 40 (g) Gases gone abroad 1 2 - - 3 (h) Cases lost sight of 12 4 - - 16 (i) Deaths 8 4 1 - 13 (j) Cases remaining on Register at 31st December, 1955 212 173 10 30 425 I <JN s£> I (A.) NEW CASES OF TUBERCULOSIS 1955 (B) DEATHS OF TUBERCULOSIS CASES 1955 Under 1 year 1 and under 2 years _ 2 and under 5 years 5 and under 10 years 10 and under 15 years 15 and under 20 years 20 and under 25 years 25 and under 35 years 35 and under 45 years 45 and under 55 years 55 and under 65 years 65 and under 75 years 75 years and upwards T0IAL (all ages) (A.) NEW CASES Pulmonary M - - - - 1 2 6 4 3 3 1 1 2 23 Pulmonary F - - - - 1 2 2 9 3 1 - 1 - 19 Ncn- Pulmonary M - - 1 1 - - - - - - - - - 2 Nan- Pulmonary F - — 1 - - 1 1 2 - - 1 — - 6 (B) DEATHS Pulmonary M - - - - - - - 1 - 1 1 3 2 8 Pulmonary F - - - - - - - - - - - 2 - 4 Non- Pulmonary M - - - - - - - - - _ - - - 1 Non- Pulmonary F - - - - - - - - - - — - - Nil - 70 - CHELSEA TUBERCULOSIS DISPENSARY. BROMPTON HOSPITAL. S.M.3. 1952 1953 1954 1955 Population served by Dispensary 52,140 52,150 52,060 51,450 Number of notified cases in Borough at end of year 429 440 471 425 Number of these who at the present do not attend Dispensary - 156 164 102 Total attendances during year 2,123 1,899 2,208 2,080 Total new patients seen 504 526 404 242 Number of these who were contacts 252 285 173 220 Number of contacts found to be tuberculous 7 18 2 1 Number of cases newly notified to Medical Officer of Health (i.e. excluding inward transfers) 99 107 68 42 Number of cases diagnosed as tuberculons (for the first time) at the Dispensary during the year 25 39 13 7 Number of X-rays 1,373 1,464 1,889 1,578 Number of Patients who received refills during the year 35 20 19 21 Number of Patients who received "Special treatment" at hone during the year 30 42 33 33 Number of Patients given B.C.G. 11 12 52 54 Number of home visits by medical staff 48 53 32 31 Number of visits paid by Dispensary Nurse 2,297 2,529 2,382 2,135 Number of Clinic Sessions per week 2 2 2 2 - 71 - BACTERIOLOGICAL EXAMINATIONS All bacteriological examinations are carried out at the Public Health Laboratory at County Hall under its Director, Dr. A.J.H. Tomlinsan. No charge is made to the Council for these examinations and during the year 485 were made as follows:- Throat/Nose Swabs Corynebacterium diphtherias (mitis) "Orchard Street" found 25 Haemolytic Streptococci found 15 Vincent's angina found 2 Coliform bacilli found 1 Pneumococci found 3 Monilia found 1 Normal throat flora found 5 Negative results 156 Ear Swabs Negative results 1 Eye Swabs Few colonies of micrococci found 1 Negative results 1 Faeces Shigella sonnei found 15 Salmonella typhi-murium found 11 Salmonella oranienburg found 1 Salmonella paratyphi B. found 1 Pathogenic Bact. coli 0119 found 1 Pathogenic Bact. coli 026 found 3 Negative results 240 Sputum Negative results 1 Foodstuffs Negative results 1 The following specimens which are included in the above were arranged and collected by this Department with the approval and co-operation of local practitioners and school authorities; Throat/Nose Swabs 113, Faecal specimens 166 and Eye Swabs 2. The Public Health Department has an arrangement with Chelsea doctors whereby specimens left at the offices by 3 p.m. Mondays to Fridays, and 11 a.m. on Saturdays are delivered by hand to the Laboratories the same day. This service is used extensively. INDEX Subject Page(s) Aged and Infirm Persons, Welfare of 22 & 23 Analyst, Public - Report of 50-59 Atmospheric Pollution 26 Bacteriological Examinations 41 & 71 Births 6 & 7 Child Welfare 17 & 18 Committee, Public Health & Baths: Members 1 Representation elsewhere by Members 2 Deaths 6-11 Diphtheria Immunisation18 Disinfection and Disinfestation 49 Factories Act, 1937 37 - 39 Foods Adulterated 50 - 59 Poisoning 66 Premises, Inspection and Supervision of 43 Unsound 43 Health Visiting 17 Hospitals 16 Housing 33-36 Ice Cream 42 Infant Mortality 6 & 7 12 & 13 Infectious Diseases 60 - 71 Introduction 4&5 Legal Proceedings 40 Mass Radiography 24 Maternity and Child Welfare Services 17 & 18 Maternal Mortality 6 & 7 Medical Examinations 24 Meteorology 25 Milk 42 Mortuary, Public 24 National Assistance Act, 1948: Burials 14 & 15 "Part III" Accommodation 19 Nursing Homes 16 Subject Page(s) Outworkers 39 Overcrowding 33 & 36 "Part III" Accommodation 19 Pet Animals Act, 1951 45 Poisons, Sale of 40 Population 6 & 7 Public Analyst - Report of 50-59 Radiography, Mass 24 Rag Flock 46 Rodent Control 47 Sanitary Inspectors - Work of 27 - 49 Shops Act, 1950 32 Spastic Children 20 & 21 Staff of Public Health Department 3 Stillbirths 6 Tuberculosis 2, 68 - 70 Underground Rooms 33 Vaccination 18 Vital Statistics 6-13 Water Supply 36 Welfare Centre, Attendances at 17 Welfare of Aged and Infirm Persons 22 & 23 Zymotic Diseases 67