Metropolitan Borough of Chelsea Annual Report of the Medical Officer of Health J. H. WEIR, M.D., B.S., B.Hy., D.P.H. for the year 1956 1 METROPOLITAN BOROUGH OF CHELSEA PUBLIC HEALTH AND BATHS COMMITTEE (at 31st December 1956.) Chairmans Councillor Lyall, Miss M. ,M.B.E. Vice-Chairman: Councillor Tatton-Brown, J.S. Councillor Bates, A. ,, Birdwood, Vere Lady " Budgett, F.G.P. " Buxton, Mrs. G.K. " Croslegh, M.C. Councillor Gough, A.E. , T.D. '' Hannay, J. , M.Ch.S. " Paterson-Morgan, J.A. " Wills, Dr. L. " Woolford, J.E. Ex-Officio Members His Worship the Mayor (Councillor A.J. Sims, J.P.) The Deputy Mayor (Councillor G.H. Evans) - 2 - Organisations concerned with Public Health work,, at 31st December, 1956) Chelsea Tuberculosis Care Councillor Mrs. G.K. Buxton Committee: Councillor Miss M. Lyall Family Welfare Associations: Councillor Miss M. Lyall Invalid Children' s Aid Councillor Miss M. Lyall London County Council Councillor Mrs. G.K. Buxton Divisional Health Councillor Miss M. Lyall Committee (Division I): London County Council Councillor Mrs. G.K. Buxton Tuberculosis Care Committee (Division I): London and Home Counties Councillor J. Hannay Smoke Abatement Advisory Council: National Smoke Abatement Councillor J. Hannay Society: Councillor Miss M. Lyall Old People's Welfare Councillor J.S. Tatton-Brows Committee: Councillor Miss M. Lyall Third Feathers Club Councillor M.C. Groslegh Committees Westminster and Chelsea Councillor Miss M. Lyall. District Nursing Association: 3 STAFF OF THE PUBLIC HEALTH DEPARTMENT at 31st December, 1956. Medical Officer of Healths J.H. WEIR, M.D. ,B.S. ,B.Hy. ,D.P.H. Deputy Medical Officer of Health; Hastings E.A. CARSON, M.D. ,M.B. ,B.S. ,D.P.H. Chief Public Health Inspector: H. H0YLAND. Deputy Chief Public Health Inspector and Senior Housing Inspectors S.W. BARKER,, Public Health Inspectors: H.F. LEACOCK, H.W. LUDLOW, A.J. WHITE, E.R. YOUNG. Women Public Health Inspectorss (Miss) A.C.C. KAY, (Miss)G.K. READER. Drainage Assistants E. B0SLEY. Rodent Officerss J.F. COOKE, P. DRURY. Public Health Inspectors' Assistant: F.G. RAWLINGS0N. Chief Disinfector: L.H. BERRY. Disinfectors: F.W. HILL, R.J. WESTON. Cleansing Station Attendant: (Mrs.) J.L0BBAN. Chief Clerk: J.C. BRYANT. Clerical Officers: I.M. THOMSON, H.G. HAMILTON, L.A. POWELL, (Mrs.) W. BAAR, R.H. LITCHFIELD, F. BARR. Social Worker: (Mrs.) O.M. BURKE. Public Analyst: Thos. McLACHLAN, A.C.G.F.C. , F.R.I.C. - 4 - METROPOLITAN BOROUGH OF CHELSEA Public Health Department, Town Hall, King' s Road, CHELSEA, S.W.3. July, 1957. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Chelsea. Your Worship, My Lord, Ladies and Gentlemen, I have much pleasure in presenting my annual report for the year ending 31st December, 1956, which has been prepared in the manner desired by the Minister of Health as indicated in circular No. 19 of 1956. The population of the Borough has been estimated by the Registrar-General to be 51,070. In 1955 it was recorded as 51,450, so that a reduction of 380 (or 0.74%) has occurred. Births. For the first time since 1949, the number of annual births has risen, 837 being registered, giving a rate of l6.4. Stillbirths. These numbered 15 - Males 7: Females 8, representing a rate of 17.6 per 1,000 live and still births. Deaths. The death rate (l6.0) remains unchanged compared with 1955. The number of deaths (815) is ten less than the number registered in 1955 (825). Almost 79 per cent. of the current deaths were of persons aged 65 years and over. As recently as 1950 this particular percentage was 68. Infant Mortality. Twenty-one infants died before attaining to the age of one year, and the mortality rate was 25.1 per 1,000 live births. The implementation of "Area Comparability Factors" by the Registrar-General continues. This provides for the adjustments of sex and age components of a particular area as compared with England and Wales as a whole. The Birth and Death rates given above are, by these calculations, found to be 12.5 and 11.2 respectively. Infectious Diseases. 863 notifications were received by the Public Health Department during the year; the total in 1955 was 1,218, Whilst Measles cases decreased by 553, the incidence of Dysentery and Food Poisoning rose by 133 and 58 respectively, A detailed review of infectious diseases is included in this report. Atmospheric Pollution. Close attention has always been paid to the problem of reducing atmospheric pollution, and with the advent of the Clean Air Act, 1956, it is felt that much will be done to effect a marked improvement in conditions. It has been estimated that the damage to property from the discharge of smoke, grit, and gases, and the consequent losses to efficiency in industry from this caus - 5 - may well amount to £250 million annually, whilst ten million tons of fuel are wasted each year as a result of imperfect combustion,, Analysis of Food and Drugs. Four hundred samples were submitted to Mr. T. McLachlan, Public Analyst to the Council, for his examination, and in twenty-two instances (5.5%) he reported upon such matters as adulteration, labelling inaccuracies or misdescriptions. In such cases, thorough investigations were pursued to ensure that offences did not recur. It was not found necessary to have recourse to legal action,, Mr. McLachlan's report on his work during the year presents a comprehensive picture of the action taken to safeguard the health and interests of consumers. Food Hygiene. Inspections of all premises at which food is prepared, stored, and/or sold, has for very many years been carried out with the utmost regularity by the Council's Public Health Inspectors, and no opportunities are lost to secure immediate, and lasting, improvements. The Food Hygiene Regulations, 1955, the provisions of which are set out in this report, will undoubtedly secure the establishment of sound protective measures. It is again my pleasure to acknowledge my indebtedness to Chairmen of Committees and individual members of the Council for the consideration they have extended to me, and to express my appreciation of the helpful and consistent co-operation of other Chief Officers and their staffs. Finally, I thank all members of my Department for their continued and loyal help. I am, Mr. Mayor, My Lord, Ladies and Gentlemen, Your obedient Servant, Medical Officer of Health. - 6 - ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1956 AREA OF THE BOROUGH: 659.6 acres GENERAL RATE: 19s.10d in the £ (At 31st March, 1956) PRODUCT OF A PENNY RATE (GROSS): £5,357, RATEABLE VALUE OF BOROUGH AS AT 31ST MARCH, 1956: £1,332,811 POPULATION: Registrar-General's estimate of the population of the Borough (mid-year 1956) 51,070 Density of population per acres: 77.42 LIVE BIRTHS: Total M. F. Birth rate per 1,000 of estimated population Legitimate Illegitimate 738 366 372 16.4 99 51 48 837 417 420 Adjustment of birth rate by area comparability factor 12.5 STILL BIRTHS s 15 7 8 Rate per 1,000 (live and still births) 17.6 DEATHS s 815 361 454 Death rate per l,000 of estimated population 16.0 (Males 7.l 8 Females 8.9) Adjustment of death rate by area comparability factor 11.2 MATERNAL MORTALITYg No deaths associated with pregnancy or childbirth occurred amongst Chelsea residents during the yearQ DEATH RATES OF INFANTS UNDER ONE YEAR OF AGE 8 All infants per l,000 live births 25.1 Legitimate infants per l,000 legitimate live births 23.0 Illegitimate infants per 1,000 illegitimate live births 40.4 DEATHS FROM TUBERCULOSIS: Pulmonary 1 Other forms Nil Death rates per 1,000 of estimated populations: Pulmonary Tuberculosis: 0.019 Other forms of Tuberculosis Nil - 7 - SUMMARY OF VITAL STATISTICS 1943-1956 (inclusive) Year Registrar General's Estimate of Population BIRTHS DEATHS DEATHS UNDER ONE YEAR MATERNAL DEATHS No. + Rate No. + Rate No. + Rate No, + Rate 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 - - 1956 51,070 837 16.4 815 16.0 21 25 - - Averages for the seven vears 1950-1956 :- Births 798 Deaths 723 Deaths under one year of age 20 Maternal Deaths 0.7 + Totals arrived at after due allowance for inward and outward transfer. - 8 - DEATHS OF RESIDENTS DURING 1956 Causes of Death At all ages Under 1 yr. 1 and under 5 5 and under 15 15 and under 25 25 and under 45 45 and under 65 65 and upwards l.Tuberculosis, respiratory 1 — — — — — — 1 2.Tuberculosis, other - — — — — — — — 3.Syphilitic disease A — — — — — 2 2 4.Diphtheria — - — — — — — — 5.Whooping Cough - - — — — — — — 6.Meningococcal Infections — — — — — — — — 7.Poliomyelitis, acute — — — — — — — — 8.Measles — — — — — — — — 9.Infective and parasitic diseases 1 — — — — — 1 — 10.Malignant neoplasm, stomach 18 — — — — — 4 16 ll.Malignant neoplasm, lungj, bronchus 31 — — — — 3 12 12.Malignant neoplasms, breast 21 — — — — 2 7 12 13.Malignant neoplasm, uterus 7 — — — — — 2 5 l4.Malignant and lymphatic neoplasms, other 81 — 1 — — 1 — 65 15.Leukaemia, aleukaemia 5 — — — 1 3 — — 16.Diabetes 6 — — — — — — 5 17.Vascular lesions of nervous system 109 — — — 1 3 8 97 18.Coronary disease, angina 86 — — — — 1 20 65 19.. Hypertension with heart disease 18 — — — — — — 14 20.Heart disease, other 118 — — — — 1 6 111 21.Circulatory disease, other 68 — — — — 1 2 65 22.Influenza — — — — — — — — 23.Pneumonia 63 2 1 — —— — 2 58 24.Bronchitis 39 — — — —- — 9 30 Carried forward 676 2 2 — 2 15 95 560 - 9 - DEATHS OF RESIDENTS DURING 1956 (Continued) Causes of death At all ages I Under 1 vear | 1 and under 5 5 and under 15 15 and under 25 25 and under A5 4-5 and under 65 65 and upwards Brought forward 676 2 2 - 2 15 95 560 25.Respiratory system, other diseases of 10 — — — — — 1 9 26.Ulcer of stomach and duodenum 11 — — — — 1 4 6 27.Gastritis, enteritis and diarrhœa — —_ — — — — — — 28.Nephritis and nephrosis 3 — — — — — — 3 29.Hyperplasia of prostate 5 — — — — — — 5 30.Pregnancy, childbirth, abortion — — — — — — — — 31.Congenital malformations 7 5 — — — 2 — — 32.Other defined and ill-defined diseases 77 13 — — 1 2 13 48 33.Motor vehicle accidents 5 — — — — — 2 3 34.All other accidents 12 1 1 — — 1 3 7 35.Suicide 7 — — - — 4 2 1 36.Homicide 2 - - - - 1 - 1 TOTALS 815 21 2 - 3 26 120 643 Consideration of the following table clearly indicates the increase in longevity of residents during the first half of this century. Year No0 of Deaths Deaths under 1 year of age Percentage of total deaths Deaths at 65 years and over Percentage of total deaths 1900 l,737 333 19.l7 442 25.44 1925 883 64 7.24 433 480.01 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 1956 815 21 2.58 643 78.89 - 10 - ANALYSIS OF DEATHS The percentages of the total deaths attributable to particular causes during the past three years 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 1956 Average for three vears (1) 1.23 0.97 0.12 0.74 (2) — 0.12 — 0.04 (3) 0.14 0.48 0.49 0.37 (4) — — — — (5) — — — — (6) — — - — (7) — 0.24 — 0.08 (8) - - - - (9) 0.60 0.36 0.12 0.36 (10) 3.00 1.94 2.21 2.38 (11) 3.70 3.51 3.81 3.67 (12) 1.40 1.57 2.60 1.86 (13) 0.82 0.61 0.86 0.76 (14) 10.00 10.93 9.96 10.29 (15) 0.41 0.36 0.61 0.46 (16) 1.10 0.97 0.73 0.93 (17) 13.00 11.88 13.41 12.76 (18) 12.12 11.64 10.60 11.45 (19) 3.54 1.94 2.21 2.56 (20) 11.20 12.73 14.51 12.81 (21) 8.30 10.10 8.36 8.92 (22) — 0.24 — 0.08 (23) 5.70 6.42 7.75 6.62 (24) 4.40 4.6l 4.80 4.60 (25) 0.82 0.40 1.23 0.82 (26) 0.70 1.60 1.35 1.22 (27) 0.41 0.73 — 0.38 (28) 1.09 0.97 0.37 0.81 (29) 0.82 0.40 0.61 0.61 (30) 0.30 — — 0.10 (31) 0.54 0.73 0.86 0.71 (32) 8.04 8.85 9.47 8.79 (33) 1.60 1.21 0.61 1.14 (34) 3.40 2.30 1.48 2.39 (35) 1.23 1.21 0.86 1.10 (36) 0.14 — 0.24 0.13 -11 - CANCER OF THE LUNG AND BRONCHUS For a considerable time, research has progressed to ascertain definitely if cigarette smoking is responsible for increasing mortality from this cause. Nicotine and tar which are present in cigarette smoke are believed to be cancer-producing agents, and in some quarters it is felt that there should be regulations passed to ensure that cigarettes are manufactured with filters, and that such filters must effectively prevent the entry of harmful tars into the respiratory system. Investigation is also proceeding as to the possibility of Diesel exhaust fumes increasing the risk of lung cancer, and from a preliminary study carried out by a senior medical officer of the London Transport Executive it emerged that the incidence of lung cancer amongst their employees was actually lower than for the general population. Oddly enough, the highest rate occurred amongst men employed in the trolley-bus engineering section, a body which is the least exposed to exhaust fumes. In Chelsea, during the period 1950 to 1956 (inclusive) it is apparent that the ratio of mortality is one woman to every four men. The following table gives in detail the number of deaths of residents:- CANCER OF THE LUNG AND BRONCHUS Percentage of deaths registered Year Males Females Totals 1950 18 4 22 3.4 1951 16 — 16 2.3 1952 27 6 33 5.0 1953 16 4 20 2.9 1954 20 7 27 3.7 1955 21 8 29 3.5 1956 25 6 31 3.8 143 35 178 21.2 Averages: 20.4 5.0 25.4 3.0 - 12 - INFANT MORTALITY During the year, twenty-one infants died under the age of one year, as compared with twenty-five and twenty-one in 1955 and 1954- respectively. Sixty per cento of the deaths now under review occurred before the age of four weeks was attained. Deaths were attributable to:- Males Females Asphyxia 1 - Atelectasis 3 1 Erythroblastosis - 1 Inattention at birth 1 - Intra-ranial haemorrhage - 3 Malformations, Congenital 4 1 Pneumonia - 2 Prematurity 1 3 It will be observed that the number of infant deaths has decreased by four as compared with 1955o 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 1947 to 1956, 239 deaths occurred - an annual average of 23.9. Deaths from "Prematurity" accounted for nineteen per cento of total registered (21). The actual periods at which all deaths occurred were as follows:- under 4 weeks 4 weeks to 3 months 3 to 6 months 6 to 12 months Total under 1 year Males 7 1 1 1 10 Females 8 2 - 1 11 Totals: 15 3 1 2 21 - 13 - INFANT MORTALITY RATES - ENGLAND AND WALES AND VARIOUS OTHER COUNTRIES Deaths under 1 vear of age per 1,000 live births. Country 1950 1951 1952 1953 1954 1955 Average for six years ENGLAND & WALES 30 30 28 27 25 25 27.5 SWEDEN 20 21 20 19 19 17 19.3 NEW ZEALAND 23 23 22 20 22 22 22.0 NETHERLANDS 25 25 23 22 21 20 22.7 AUSTRALIA 24 25 24 23 22 22 23.3 DENMARK 31 29 29 27 27 25 28.0 UNITED STATES OF AMERICA 29 29 29 28 27 27 28.2 SCOTLAND 39 37 35 38 31 30 35.0 CANADA 41 38 38 35 32 31 35.8 REPUBLIC OF IRELAND 45 45 41 39 38 37 40.8 FRANCE 52 51 46 42 41 39 45.2 ITALY 64 67 64 59 53 49 59.3 The above table has been prepared from information made available by the Registrar-General. - 14 - NATIONAL ASSISTANCE ACT, 1948. Section 50 of the above Act empowers a local authority to arrange the burial or cremation of any person in respect of whan no other suitable action can be taken. The Borough Council has,, however, only carried out interments,, In certain instances it has not been found possible to trace any surviving relatives, but if a cremation was arranged and ultimately a member of the deceased's family was contacted, it might well be that the Council would be challenged as to their right to have so proceeded. The National Insurance Act, 1946, provides that under certain circumstances, death grants may be obtained as follows:- (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 Grants as indicated above are only payable to liable relatives; a local authority whilst assuming the role of a "liable relative" will only receive reimbursement to the extent of three-fifths of an applicable grant, as stipulated by the National Insurance (Death Grant) Regulations, 1949. Since this particular Act became operative, interments have been carried out as follows:- 1943 (approximately 6 months) 43+ 1949 25 1950 9 1951 10 1952 9 1953 12 1954 4 1955 6 1956 11 + During 1948, the Borough Council arranged the interments of persons dying in local hospitals as well as at their homes. Subsequently the Minister of Health transferred this responsibility to the hopsital authorities when deaths occurred on their premises. - 15 - 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, Dovehouse Street, S.W.3. General Granard House, 98, Dovehouse Street, S.W.3. (Part of Royal Marsden Hospital) Malignant Disease Royal Marsden Hospital, Fulham Road, S.W.3. Malignant Disease Royal Hospitals, Royal Hospital Road, S.W.3. Home for Pensioners 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, S.W.3. Children's Diseases NURSING HOMES Royal Avenue Nursing Home, 39, Royal Avenue, S.W.3. Private - 16 - MATERNITY, CHILD WELFARE AND OTHER SERVICES The London County Council is 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.B.E.A. Sharpe, Divisional Medical Officer, has kindly supplied the following information:- WELFARE CENTRES Attendances at Ante-natal and Post-natal Sessions 1,338 Attendances at Infant Welfare Sessions 8,728 HEALTH VISITING No. of visits carried out by Health Visitors; Expectant mothers: First visits 327 Total, visits ... 556 Children under 1 year: First visits (including visits paid to Premature Infants) 758 Total visits ... 2,702 Children between 1 and 2 years: Total visits ... 1,232 Children between 2 and 5 years: Total visits ... 1,784 Still Births: Total visits ... 11 School Children: Total visits ... 71 Care of old people: Total visits ... 12 Care of other peoples: Total visits ... 6 Miscellaneous: Total visits ... 594 Unsuccessful: Total visits ... 1,507 No. of children under 5 visited during the year ... 2,932 No. of households visited during the year ... 2,074 Foster Mothers: Number of registered foster mothers 6 Number of children fostered 8 - 17 - MATERNITY, CHILD WELFARE & OTHER SERVICES(Continued) Diphtheria Immunisations: Number of children who completed a primary course of injections 645 Number of children who received reinforcing injections 595 Vaccinations: Number of children vaccinated at the Violet Melchett Infant Welfare Centre 416 Child Population: Registrar General's estimate of child population at 30 June 1956: Under 1 year 790 1-4 years 2,550 5-14 years 4,300 7,640 DIPHTHERIA IMMUNISATION During 1956, 645 children received primary injections whilst another 595 were given reinforcing injections, representing respective advances of 132 and 220 as compared with 1955. Bearing in mind that no cases of Diphtheria came to the knowledge of the Public Health Department in 1956, it is particularly encouraging to observe that public interest in this service has been intensified,, Details of this work for the past three years are as follows:- Year Primary Injections Reinforcing Injections 1954 677 657 1955 513 375 1956 645 595 - 18 - "PART III" ACCOMMODATION Section 21 of the National Assistance Act, 1948, 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. During the year arrangements were made for the reception of twenty-two persons at "King's Mead", but occasion did not arise for enforced removal under Section 47 of the Act, as amended by the National Assistance (Amendment) Act, 1951. When such transfers were effected, those concerned were advised that their possessions would be held in the safe keeping of the County authorities. - 19 - SPASTIC CHILDREN In April, 1955, the No. 4 (Chelsea) Group Hospital Management Committee opened an experimental non-resident treatment centre for Spastic Children at 61, Cheyne Walk, S.W.3. The establishment of such a centre had been under consideration since 1952, and with the overcoming of financial difficulties the project became actual fact,, With the help of a generous bequest from the Sir William Coxen Fund it has been possible to acquire expensive electronic apparatuses and many accessories measuring brain and muscle tone. Moreover the establishment of a modern electro-encephalograph department should provide hospitals in the South-west of London with additional facilities of this kind which have long been needed,, Cerebral palsy has, for some considerable time, been the subject of intensive research, and 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. The original plan was divided into five phases, of which the first four or more immediate ones were as follows s:- Phase I - Establishment of a day diagnostic and treatment centre for young spastic children. This phase is completed. Phase II - Opening of a ward for resident patient. This phase is in abeyance as the day nursery is still occupying the upper storeys of the hospital, and is likely to remain there until 196. Phase III - Accommodation of mothers of patients under observation. Accommodation for a few mothers and children is now available at St. Stephen's Hospital, Chelsea. Phase IV - Establishment of a research centre into causes, treatment, and prevention of cerebral palsy in all its forms. Phase I - diagnosis and treatment - has gradually merged into Phase IV research. - 20 - SPASTIC CHILDREN - Continued. Numbers under treatment The following tabular statement shows numbers of patients (0-5 years) under various categories:- Period ending Total Screened Awaiting Screening School patients attending daily Out-patients attending for treatment only Total attending April 1955 29 30 9 12 21 October 1955 55 16 18 20 38 April 1956 84 47 25 17 42 October 1956 113 4 31 22 53 Transition from diagnosis and treatment to research Daily contact with this baffling disease provokes research in an active mind, and the idea that the centre should undertake research into causes and treatment was emphasized in the terms of the medical officer's appointment. It is an experimental centre, and the medical officer's sessions were paid far out of the regional research funds. The idea that the centre should undertake research came about gradually, and at a crucial moment the bequest mentioned earlier made it a practical possibility in so far as space and equipment were concerned. In the meantime the very gradual increase in the number of screenings to well over 100 is equipping the medical officer with the necessary fundamental experience. Quality of treatment The emphasis has been on giving adequate treatment to fewer patients rather than less adequate treatment to more. Shortening the time under treatment or increasing the intervals between successive treatments due to increased numbers has been avoided even if it means starting a waiting list. If treatment is to achieve results and inspire confidence, quality is of paramount importance. King Edward's Hospital Fund for London The King Edward's Hospital Fund, by their generous donations at the outset, made the establishment of this centre a possibility. In October 1956, the visiting committee of the Fund reported that "A visit to the Spastic Centre in Cheyne Walk is a most stimulating experience,, This is a pioneer effort operating in a new field. We feel that the Committee of Management should have the support of all those who are interested in the Cerebral Palsy problem. We think that the size of the unit might be increased, but to not more than double its present numbers. We hope that the research work and the development of therapeutic and educational methods will be supported by sufficient funds for the purpose". - 21 - WELFARE OF OLD PEOPLE. At the close of the year, 1,038 persons were on the registers of the Public Health Department. In investigating the circumstances and conditions peculiar to each aged person, the Council's Officers at all times exercise commendable tact, and fully appreciate that despite ill-health in many cases, people are perfectly contented if they can remain in familiar surroundings, and at the same time be aware that every effort will be made to ensure their well-being. The Borough Council makes a grant of £450 annually to the Chelsea Old People's Welfare Committee, which is representative of and co-ordinates the activities of voluntary organisations working in this sphere of public service. It is impossible to refer to all the facilities offered, but the following matters will illustrate the variety of assistance available for the well-being of those in need:- Provision of Hot Meals. This service is efficiently administered by the Women's Voluntary Services. Meals are supplied from Monday to Friday, and during the year delivery of 12,570 was made - weekly average of 241. In 1955 the respective figures were 11,193, and 215. The provision of hot meals has always been greatly appreciated by the recipients. Chiropody. 130 persons were recommended for the services provided by two qualified chiropodists, as compared with 138 and 117 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 493 treatments were carried out. Holidays. The continuance of this scheme resulted in 116 persons having pleasant stays either at the sea or in the country. 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, In some instances, transport was provided to convey people to and from holiday centres, and quite frequently escorts travelled to and from railway stations. Library and Shopping Facilities continued to be maintained by the British Red Cross Society, and the weekly visits by their officers are eagerly awaited by those whose disabilities prevent them getting out and about. This Society also provides escorts, when necessary,to accompany persons attending hospital for treatment. Shopping facilities are provided by the Women's Voluntary Services. Difficulty in securing hospital accommodation for the chronic sick continues, but the good relationship between the Council's officers and hospital authorities brought about the admission of 95 men and women during the year. It is pleasing to record that the patient efforts of hospital - 22 rehabilitation officers resulted in a number of people returning to their homes ready to live normal lives again. Institutional care became necessary for 22 persons, most of whom settled down quite readily to a communal life. However, it must be stressed that a change of environment frequently entails considerable effort and tact. Issues of clothing were made in 308 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. The National Assistance Board also gives every sympathy to persons in distress, and makes grants which ensure the securing of essential items. The enfeebled condition of 13 persons rendered it advisable to give them personal cleansing. 12 rooms were cleansed, and in some cases superflous items disposed of. A local boot-repairer is now carrying out boat and shoe repairs to the extent of 25 pairs monthly. The charge for this work is subject to a reduction of twopence in the shilling from normal costs, an offer which is fully appreciated. At the beginning of Novembers 1955, 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 hemes 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 26 persons had so benefited, and some 3,648 pounds of bedding, etc, had been laundered. A total of 2,102 visits were made to registered cases by the Council's Social Workers, either in their own homes, or whilst they were undergoing hospital treatment. It must be pointed out that very many visits are of a protracted nature, and lead to the making of a variety of enquiries, the prosecution of which cannot be duly recognised in this report. - 23 - PUBLIC MORTUARY FACILITIES No mortuary premises have been maintained in the Borough for some years. Under an agreement with Hammersmith Borough Council, excellent facilities are readily available at their Mortuary in Fulham Palace Road, W.6. During the year, one hundred and fiftynine Post-Mortems without Inquests, and forty-one Post-Mortems with Inquests were performed in respect of Chelsea residents. MEDICAL EXAMINATIONS During 1956, sixty-nine persons were examined to ascertain whether they were fit to be admitted to this authority's employment and to participate in the superannuation scheme. Only one was found not to be in a satisfactory state of health. In addition, three examinations were undertaken on behalf of other local authorities as a result of the transfer of employees. MASS RADIOGRAPHY The detection of unsuspected Tuberculosis of the lungs, at the earliest possible stage, may well result in the avoidance of a lengthy illness as a result of immediate treatment. To this end X-ray facilities are readily available to Chelsea residents at the following Centres:- 1. The Central Mass-X-Rav Centre, Western Hospital, Seagrave Road, Fulham, S.W.6. Programme Women Men Mondays 2.00 - 3.00 3.00 - 4.00 Tuesdays 9.30 -10.30 10.45 -12.30 Wednesdays 3.00 - 4.00 2.00 - 3.00 Thursdays 10.45 -12.30 9.30 -10.30 Wednesday Evenings - Men and Women 5.30 - 7.15. 2. The Mass X-Ray Centre, St. James' Hospital, St. James' Drive, Balham. S.W.12. Programme Women Men Mondays 9.30 - 10.30 10.45 - 12.30 Tuesdays 10.45 - 12.30 9.30 - 10.30 Wednesdays 9.30 - 10.30 10.45 - 12.30 Thursdays 10.45 - 12.30 9.30 - 10.30 Monday Evenings - Men and Women 5.00 - 7.00 - 24 - METEOROLOGY - 1956 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, Daily Temperature of the Air Total Rainfall (inches) Total Sunshine (hours) Quarter Average of Highest Average of Lowest Average of Mean March 44.6° 34.2° 39.4° 3.67 257.1 June 60.9° 45.1° 53.0° 3.02 549.7 September 66.5° 54.0° 60.2° 11.61 438.9 December 50.9° 41.2° 46.0° 4.60 188.0 TOTALS: 22.90 1433.7 As compared with 1955, there was an excess of 8.74 inches of rain, and a deficiency of 439 hours of sunshine during the September quarter, which was notable for exceptional thundery conditions. The highest and lowest temperatures recorded during each month of the year were as follows:- Highest Lowest January (26th) 53.8° (31st) 22.8° February (28th) 53.6° ( 2nd) 17.1° March (26th) 61.7° ( 9 th) 27.9° April (10th) 64.6° (16th) 31.1° May (28th) 76.3° (19th) 37.2° June (25th) 74.8° (15th) 44.6° July (27th) 81.7° (22nd) 48.6° August ( 8th) 71.4° (29th) 44.6° September (23rd) 75.2° ( 1st) 48.7° October (16th) 62.6° (26th) 33.8° November ( 8th) 56.3° (23rd) 24.8° December (12th) 55.6° (27th) 29.3° NOTE: All temperatures shown are Fahrenheit readings. Quarterly averages for south-eastern England as compared with normal anticipations. Rainfall Sunshine March 96% 116% June 68% 99% September 150% 85% December 68% 89% - 25 - ATMOSPHERIC POLLUTION In conjunction with other local authorities and the Department of Scientific and Industrial Research, stations have been established within the Borough for the recording of atmospheric pollution,, Three stations have been in operation throughout the year, and are sited at l. The Victoria Hospital for Children, Tite Street; 2. Civil Defence Headquarters, Carlyle Square; and 3. Chelsea Polytechnic, Manresa Road. Data regarding the amount of smoke, sulphur, rainfall, etc., is collected daily by the Public Health Inspectors, and monthly returns are submitted to the Department of Scientific and Industrial Research for collation on a nation-wide basis. From readings taken at the stations, it emerges that there is a total annual deposit of approximately 225 tons per sq. mile, and of this pollution it is estimated that between fifty and sixty-five per cent. of the smoke is emitted from domestic chimneys. The Clean Air Act. 1956. parts of which came into force during the year will grately encourage local authorities in their efforts to reduce this serious nuisance. Briefly, the Act aims to prohibit the emission of dark smoke from chimneys of all buildings, and when the whole of the Act becomes operative, if infringements occur, the responsible person or persons will be liable, on summary conviction,, to (a) a fine of £10 if dark smoke is emitted from the chimney of a private dwelling, or (b) to a fine not exceeding £100 when an offence occurs in respect of a chimney emitting smoke from any other buildings. In due course, regulations will be issued by the Minister of Health specifying certain periods during which emissions of smoke will be permitted. When offences are established, the responsible persons will be called upon to give sound reasons for their inability to prevent nuisances. Frequently, a great deal of structural alteration will be unavoidable if the emission of dark smoke is to cease, and exemption from prohibitory provisions will be permitted for a reasonable period, during which industrial and private buildings will have to be subjected to required works of alteration and adaptation Such exemptions will depend upon local authorities issuing the relevant certificates. Practical means will have to be adopted to prevent the issue of dark smoke from railway locomotives, and failure to take every reasonable precaution will constitute an offence. Where industrial furnaces are scheduled for installation, it must be ensured that when burning fuels recommended, they emit a minimum of smoke. When a local authority considers plans and specifications submitted to them, and subsequently expresses approval of same, it will be considered that adequate precautions will be maintained. It must also be borne in mind that serious atmospheric pollution arises from the emission of dust and grit from furnaces, and occupiers of buildings operating furnaces which consume solid fuels or solid wastes will be expected to explore every possible means of minimizing the emission of dust and grit, and if it is apparent that due care is not being exercised, proceedings will be instituted. - 26 - The Act is also concerned with ensuring that chimneys to be erected in new or extended industrial buildings must be of such a height to prevent, as far as practicable, smoke, grit, or fumes becoming prejudicial to health, and in considering plans placed before them local authorities will reject proposed works if they are satisfied the heights of chimneys are inadequate for the prevention of nuisances as indicated. The disastrous effects of atmospheric pollution on the health of the nation will be quite apparent from a contemplation of the following brief statistics:- (a) Lung cancer deaths rose from approximately 11,000 in 1949 to over l6,000 in 1955. In this borough deaths from this cause have, in the past six years, risen from 16 to 31. (b) Bronchitis is, in England and Wales, annually responsible for 30,000 deaths. It is also estimated that 26,000,000 days absence from employment by insured persons occurs yearly, and without doubt, this particular disease is the greatest single cause of sickness. (c) 4,000 deaths from respiratory diseases were a direct result of the smog incident of December, 1952. - 27 - SANITARY ADMINISTRATION OF THE BOROUGH SUMMARY OF THE WORK PERFORMED BY THE PUBLIC HEALTH INSPECTORS DURING THE YEAR 1956. Number of complaints received during the year 980 INSPECTIONS AND RE-VISITS DWELLINGS: Inspections after complaints 3,556 Inspections after Infectious Diseases 954 House-to-House inspections Underground Rooms 118 Overcrowding and "Permitted Numbers" (Housing Applications) 97 Other visits 9 6,263 FOOD PREMISES: Butchers 299 Fishmongers and Fish Friers 49 General Provision Shops 10 Dairies 207 Ice Cream Vendors (Premises, Stalls, Vehicles, etc,) 251 Ice Cream Manufacturers 15 Bakehouses 101 Street Stalls and Barrows 134 Food Factories (Mechanical) other than Bakehouses 33 Hotels, Restaurants, and Dining Rooms 533 Premises in connection with Unsound Food 197 Premises in connection with Food Sampling 102 Other Food Premises 113 2,044 FACTORIES AND OUTWORKERS: Factories other than Food Factories (Mechanical) 195 Factories other than Food Factories (Non-Mechanical) 26 Outworkers 50 Other visits (not classified) — 271 DRAINAGE: Drains tested: (a) by water 472 (b) by smoke 93 (c) by air 86 651 Carried Forward: 9,229 - 28 - SANITARY ADMINISTRATION OF THE BOROUGH SUMMARY OF THE WORK PERFORMED BY THE PUBLIC HEALTH INSPECTORS DURING THE YEAR 1956 Brought forward: 9,229 INSPECTIONS AND RE-VISITS (Continued) MISCELLANEOUS : Animals, Poultry, and Birds 21 Open Spaces, Highways 90 Office premises 8 Marine Stores and Second-hand Dealers 6 Premises registered under Pharmacy & Poisons Act, 1933 54 Premises to enforce requirements of Shops Act 5 Premises re progress of voluntary works 4,615 Visits to Owners,Agents and Builders Offices 297 Smoke observations 46 Food Poisoning 15 Visits to aged and infirm persons 200 Visits to Verminous persons 1 Premises under Pet Animals Act, 1951 4 Visits for Atmospheric Pollution recording 373 Visits to premises resulting in "no access" 1,540 Other Visits 1,153 8,428 17,657 - 29 - WORKS SUPERVISED BY THE PUBLIC HEALTH INSPECTORS. FACTORIES ACT' 1937 HOUSING ACT' 1936 PUBLIC HEALTH (LONDON) ACT' 1936 FOOD & DRUGS ACT, 1955 TOTAL N. V. N. V. N. V. N. V. CLEANSING: Rooms: Walls & Ceilings cleansed and redecorated 2 - 55 - 12 - 4 1 74 Passages & Staircases: Walls & ceilings cleansed and redecorated - - 12 - 1 2 2 1 18 Yard and area walls cleansed and colour-washed - - - - 1 - 1 - 2 Rooms and Contents cleansed by occupiers - - - - 1 - - - 1 Rooms where Food is manufactured stored or sold - - - - - - 22 8 30 Coffee Stalls, Street Barrows etc. - - - - - - 1 - 1 Miscellaneous - - - - 1 - 1 - 2 GENERAL IMPROVEMENTS AND REPAIRS: Roofs - - 93 - 74 7 - - 174 Eaves, Gutters - - 31 - 33 2 - - 66 Rain-water pipes - 1 47 - 11 3 - - 62 Yard and Areas Pavings - - 47 - 6 - - - 53 Walls rendered or repaired - - 65 - 12 3 - - 80 Rooms Wall & Ceiling plaster - - 304 - 123 9 1 - 437 Passages & Staircases: Wall and Ceiling plaster - - 89 - 18 1 - - 108 Floors - - 57 - 22 2 2 - 83 Stair Treads: Bannisters & Balustrades - - 33 - 7 3 - - 43 Window and Door Frames, fittings and sash cords 1 - 530 - 82 20 - - 633 Dampness remedied - - 203 - 212 9 2 - -426 Horizontal damp proof course provided - - 3 - - - - - 3 Vertical damp proof course provided - - 7 - - - - - 7 Fireplaces & Fire-ranges repaired - 93 - 44 4 - - 141 Washing Coppers repaired - - 1 - - - - - 1 Natural Ventilation provided or improved - - 84 - 7 1 1 - 93 Chimneys and Flues - - 28 - 8 - - - 36 Carried forward 3 1 1782 - 675 66 37 10 2574 - 30 - WORKS SUPERVISED BY THE PUBLIC HEALTH INSPECTORS (Continued) FACTORIES ACT, 1937 HOUSING ACT, 1936 PUBLIC HEALTH (LONDON) ACT, 1936 FOOD & DRUGS ACT, 1955. TOTAL N. V. N. V. N. V. N. V. Brought forward 3 1 1782 _ 675 66 37 10 2574 GENERAL IMPROVEMENTS AND REPAIRS (Continued) Natural Lighting provided or Unproved - - 21 - - - - - 21 Obstructions to Natural Lighting removed - - 9 - - - - - 9 Subfloor ventilation provided - - 16 - - - - - 16 Miscellaneous - - 36 - 27 3 - - 66 DRAINAGE: Total Reconstructions - 1 - - 16 16 - - 33 Partial Reconstructions, repairs or alterations - - - - - 11 - - 11 Frontage Drains Reconstructed - 2 - - - 17 - - 19 Obstructions cleared l - 5 - 32 19 - 1 58 Inspection Chambers provided - 1 - - - 43 - - 44 Inspection Chamber covers renewed - - - - 7 1 - - 8 Interceptors provided - 7 - - 3 11 - - 21 Petrol Interceptors provided - 1 - - - - - - 1 Soil & Ventilation Stacks provided or reconstructed - 2 5 - - 48 - - 55 Soil & Ventilation Stacks repaired - - - - 2 1 - - 3 Waste & Ventilation Stacks provided or reconstructed - 2 6 - 1 52 - - 61 Waste & Ventilation Stacks repaired - - 1 - - - - - 1 Fresh Air Inlets provided - - - - 2 4 - - 6 Fresh Air Inlets repaired or renewed - - 10 - 10 - - - 20 Single Sinks provided - 12 17 - - 170 3 3 205 Single Sinks renewed - - - - 1 - 5 - 6 Baths provided - - - - - 221 - - 221 Wash-hand basins provided - - - - - 226 6 - 232 Miscellaneous - 2 8 - 21 34 2 67 Carried forward 4 31 1916 - 797 943 51 16 3758 - 31 - WORKS SUPERVISED BY THE PUBLIC HEALTH INSPECTORS (Continued) FACTORIES ACT, 1937 HOUSING ACT, 1936 PUBLIC HEALTH (LONDON) ACT, 1936. FOOD & DRUGS ACT, 1955 TOTAL N. V. N. V. N. V. N. v. Brought forward 4 31 1916 797 943 51 16 3758 SANITARY CONVENIENCES: Additional Water Closets provided — 6 — — — 210 — 1 217 Water Closet pans renewed — — 8 — 7 3 — — 18 Water Closet pans cleansed 1 — — — 1 — 1 — 3 Water Waste preventers renewed or repaired 1 — 5 14 2 — — 22 Water Waste preventers provided — 6 — — — 210 — 1 217 Roofs repaired or renewed — — 5 — 6 — — — 11 Floors repaired or renewed — — 4 — — — — — 4 Walls & Ceiling plaster cleansed repaired or redecorated 1 1 48 — 12 2 5 2 71 Natural Ventilation provided or improved — — 74 — 2 18 1 — 95 Natural or Artificial Light provided or improved — 1 — — — — — — 1 Ventilated Lobby provided Miscellaneous — 1 — 1 — 27 — — — 14 3 3 — 1 — — 3 47 WATER SUPPLY: Supplies provided to Tenements — — 53 — 1 3 — — 57 Taps supplied on main for drinking purposes — — 53 — — 3 — — 56 Burst Pipes repaired — — — 1 19 4 — — 24 Cisterns cleansed, covered or repaired — — — — 3 — — — 3 MISCELLANEOUS SERVICES PROVIDED : Soap and Towels for staff — — — — — — 2 — 2 Constant Hot Water — — — — — — 16 2 18 Bins, refuse — — 6 1 64 17 — — 88 Food Cupboards provided — — 134 — — — — — 134 Carried forward 8 46 2333 2 940 1421 77 22 4849 - 32 - WORKS SUPERVISED BY THE PUBLIC HEALTH INSPECTORS (Continued) FACTORIES ACT, 1937 - HOUSING ACT, 1936 PUBLIC HEALTH (LONDON) ACT, 1936 FOOD & DRUGS ACT, 1955 TOTAL N. V. N. V. N. V. N. v. Brought forward 8 46 2333 2 940 1421 77 22 4849 MISCELLANEOUS SERVICES PROVIDED: (Continued) Food Cupboards - Ventilation provided - - 23 - - - - - 23 Covered Display & Counter Screens provided - - - - - - 3 1 4 MISCELLANEOUS NUISANCES ABATED. ARISING FROM: Animals or Birds - - - - 1 - - - 1 Offensive accumulations on open land and bomb sites - - - - 13 4 - - 17 GRAND TOTALS 8 46 2356 2 954 1425 80 23 4894 N - Work carried out under Notice. V = Voluntary Works. - 33 - INSPECTIONS, PROCEEDINGS, ETC. Total number of houses in the Borough 15,929 (approx.) PUBLIC HEALTH (LONDON) ACT, 1936 Number of houses inspected on account of complaints or illness 1,658 Number of statutory notices served 133 Number of houses repaired or nuisances remedied 394 HOUSING ACT, 1936 Number of houses inspected - house-to-house (Housing Consolidated Regulations, 1925) 64 Number of houses included by representations by the Medical Officer of Health under Section 25 of the Housing Act, 1936 Nil Number of houses demolished following representation by the Medical Officer of Health under Section 25 of the Housing Act,1936 Nil Number of houses repaired under Sections 9 and 10 of the Housing Act, 1936:- (a) by owners 104 (b) by local authority in default of owners Nil Number of houses demolished:- (a) in pursuance of orders under Section 11 of the Housing Act, 1936 4 (b ) voluntarily 2 Number of houses (wholly or in part) the subject of Closing Orders (excluding underground rooms) 5 Number of Closing Orders determined (i.e. houses made fit) Nil OVERCROWDING (HOUSING ACT, 1936) Number of families found to be living in overcrowded conditions 7 Number of overcrowded families who have obtained alternative accommodation 13 Number of houses erected by the Borough Council during the year 8 UNDERGROUND ROOMS Number found to be unfit 9 Number rendered fit for human habitation Nil Number closed by Closing Orders 9 - 34 - DETAILS OF NOTICES SERVED DURING THE YEAR 1. HOUSING ACT, 1936 Section 9 - Repair of insanitary houses 64 2. PUBLIC HEALTH (LONDON) ACT, 1936 (a) Intimation 304 (b) Nuisance Notices 72 (c) Section 40 - Drainage 9 (d) Section 184 - Food Storage 60 L.C.C. (General Powers) Act. 1954 (a) Section 12 - Provision of dustbins - Intimation 48 (b) Section 12 - Provisions of dustbins - Statutory Notices 10 L.C.C. (General Powers) Act. 1955 (a) Section 25 - Stopped up drains 5 (b) Section 26 - Supply of water to premises 1 3. FACTORIES ACT. 1937 Health - general provisions 4 4. FOOD AND DRUGS ACT. 1955 Defects at food premises 68 5. SHOPS ACT, 1950 Provision of suitable sanitary conveniences and ventilation 2 TOTAL Six hundred and forty-four notices were complied with during the year, of which four hundred and ninety-one were served under the Public Health (London) Act, 1936. HOUSING REPAIRS AND RENTS ACT, 1954 Three 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; Over crowding; and Other circumstances. During the year, 29 applications were referred to the Public Health Department. 19 originated from Chelsea residents, and the remainder from applicants living in other areas. Each case was investigated - 21 in connection with ill-health, including Tuberculosis, and 8 in respect of sub-standard accommodation,, Since May, 1953, the position is as follows:- Applicants re-housed by the Borough Council 80 Applicants re-housed by the London County Council 22 Applicants re-housed by other authorities 1 Applicants who secured alternative accommodation by their own efforts 17 120 Of this total, 91 of the cases re-accommodated had been dealt with under the heading of "ill-health". Points scheme for allocation of permanent accommodation. The cases of 192 licensees in requisitioned premises were also referred to this Department during the year for pointing on medical grounds under the above scheme. _ 36 - HOUSING ACT, 1936 - PART IV - OVERCROWDING New cases investigated and recorded 7 Number of families involved 7 Number of persons involved 50 Cases relieved by (a) Rehousing Authorities 3 (b) Informal or formal procedure 10 Such action resulted in 67 persons being adequately housed At the end of the year, 44 families (involving 269 persons) 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,, one complaint regarding the unsatisfactory condition of the water supply was received. Samples of the water were taken from the tap and from a hydrant on the main. The results of these samples showed that the water was of satisfactory hygienic quality and fit for human consumption. Twenty-six 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 Public Health Inspectors, the following provisions were made:- Supplies to tenements 57 Taps on main for drinking purposes 56 Cisterns cleansed, covered or repaired 3 - 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 Public Health Inspectors during the year:- 1. INSPECTION OF FACTORIES, WORKSHOPS, AND WORKPLACES. Premises Number on Register Number of Inspections Written Notices Occupiers Prosecuted (l) Factories in which Sections 1, 2, 3, 4, and 6, are to be enforced by Local Authorities:- 84 26 3 - (2) Factories not included in (l) in which Section 7 is enforced by the Local Authorities:- 248 179 11 - (3) Other premises in which + Section 7 is enforced by the Local Authorities:- TOTALS 332 205 14 - NOTE:- Outworkers' premises are not included in (3) above. + i.e. Electrical Stations - Section 103 (l), 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 instituted Found Remedied Referred To H.M. Inspector By H.M. Inspector Want of Cleanliness (Section l) 8 5 — — — Overcrowding (Section 2) — — — — — Unreasonable temperature (Section 3) — — — — — Inadequate ventilation (Section 4) — — — — — Ineffective drainage of floors (Section 6) — — — — — Sanitary Conveniences (Section 7) (a) Insufficient — — — — _ (b) Unsuitable or defective 8 6 — — — (c) Not separate for sexes — — — — — Other offences against the Act (not including offences relating to Outwork) 2 1 — — — TOTAL 18 12 — — — - 39 — FACTORIES ACT, 1937 (Continued) OUTWORK Sections 110 and 111 Nature of Work No. of Outworkers in August List as required by Section 110 (l)(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 Prosecu tions Wearing Apparel making etc. 7 - - - - - Household Linen - - - - - - Curtains and furniture hangings 4 - - - - - Furniture and upholstery 1 - - - - - Stuffed toys - - - - - - Lampshades 14 - - - - - TOTALS 26 - - - - - - 40 - LEGAL PROCEEDINGS The institution of legal proceedings, under the Public Health (London) Act, 1936, was necessary in three Instances. Brief details of results of hearings are set out below. Premises Offence Result of Proceedings 15, Blantyre Street Noncompliance with Statutory Notice Abatement Order made for the work to be completed within 28 day. Council awarded £3. 3. 0d. costs. 17, Dartrey Road Non-compliance with Statutory Notice Abatement Order made for the work to be completed within 28 days. Council awarded £1. ls. 0d. costs. 3, Tetcott Road Non-compliance with Statutory Notice Summons withdrawn requirements of notice having been complied with at time of hearing. Council awarded £1. ls.0d. costs - 41 - BACTERIOLOGICAL EXAMINATIONS During the year, 53 samples were submitted for bacteriological examination, details of which are set out in the following table:- Article Reported upon as Total Satisfactory Unsatisfactory Meat Pie - 1 1 Stewed Steak and Kidney 1 - 1 Prawns 1 - 1 Roast Beef 1 - 1 Milks Pasteurised 10 T.T. 4 14 - 14 Cream 9 - 9 Water 26 - 26 52 1 53 Reference to 81 samples of Ice Cream will be found on Page 42. - 42 - ICE CREAM 81 samples of Ice Cream were submitted to the Public Health Laboratory Service. 80 of these were tested by the Methylene Blue method, with the following results:- Grade I 23 Grade II 29 Grade III 13 Grade IV 15 80 Grade 1954 1955 1956 No. of samples Percentage of total No. of samples Percentage of total No. of samples Percentage of total I 22 30.6 3 37.5 23 28.8 II 23 31.9 3 37.5 29 36.2 III 17 23.6 1 12.5 13 16.2 IV 10 13.9 1 12.5 15 18.8 TOTALS 72 100.0 8 100.0 80 100.0 Notifications are forwarded to traders when ice cream samples are unfavourably reported upon. Other local authorities are also advised of unsatisfactory reports concerning ice cream prepared in their areas. - 43 - FOOD HYGIENE On January lst, 1956, changes in the law relating to food and drugs came into force, and the Food and Drugs Act. 1955, is the principal Act for controlling the composition, labelling, fitness, and hygienic handling of food; with the advent of this new legislation the Food and Drugs Act of 1938 was repealed. At the same time the Food Hygiene Regulations ,1955, became operative. From their title it will be obvious that these Regulations stress the great importance which is placed on clean food handling and safe food. The main requirements of the Regulations are as follows:- Requirments affecting food handlers Personal cleanliness Persons handling food musts (a) keep their hands and clothing (including overalls) clean; (b) cover open cuts and abrasions with a waterproof dressing; (c) refrain from spitting, and (d) refrair from smoking or taking snuff when handling food, or when in any room where there is open food. Protection of food from contamination (e) food shall not be so placed as to involve risk of contamination. Wrapping of food (f) unclean or printed wrapping material must not be allowed to come into contact with food. (g) any person engaged in the handling of food who is suffering from, or is a carrier of, certain infectious conditions must inform (i) the occupier of the food premises and (ii) the owner of the food business. (h) the owner or occupier when given this information must notify the Medical Officer of Health immediately. - 44- FOOD HYGIENE (Continued) Requirements relating to food premises. Sanitary Conveniences (i) no room which communicates with a sanitary convenience may be used for - (i) the handling of foods, or (ii) the cleaning of equipment. (j) a notice requesting users to wash their hands must be displayed at every sanitary convenience. Water Supply (k) a constant, clean, and wholesome water supply must be provided. Washbasins (l) suitable and sufficient washbasins must be provided,, together with a supply of hot and cold water,, soap,, nailbrush and clean towels. First-aid materials (m) suitable and sufficient bandages, dressings and antiseptic must be provided and maintained. Accommodation for clothing (n) sufficient and suitable cupboard or locker accommodation for clothing and footwear must be provided. Facilities for washing food and equipment (o) suitable and sufficient sinks, together with an adequate supply of hot and cold water, soap or other suitable detergent, and of clean cloths must be provided, and in addition adequate and suitable cleaning and drying facilities,, (p) lighting and ventilation of food rooms must be adequate and satisfactory. Cleanliness and repair_of_food_rooms (q) walls, floors, doors, windows, ceiling, woodwork, and all other parts of structure of every food room must be kept clean, and in such good order, - 45 - FOOD HYGIENE (Continued) Cleanliness and repair of food rooms (Continued) repair and condition, as to enable them to be effectively cleaned and prevent risk of infestation by rats, mice, insects and birds . Temperatures at which certain foods are to be kept (r) food consisting of meat, fish, gravy or imitation cream, or prepared from or containing these substances, or any egg or milk, must be kept in accordance with the temperatures set out in Regulation 25. Requirement relating to stalls General Requirements (s) every stall must bear conspicuously the name and address of the person carrying on the business, and (t) stalls must be kept clean and in good repair. receptacles for waste (u) meat and fish stalls must be covered over and screened at the sides and back, and a covered metal refuse bin must be provided for all waste trimmings. SuppIy of water for stalls (v) stalls used for the supply of open food for immediate consumption must be provided with suitable and sufficient sinks for washing food and equipment, together with a supply of hot and cold water, soap, nailbrush, clean towels and drying cloths. (w) food in or about any forecourt, yard, market or stall must not be placed lower than 18 inches from the ground. - 46 - FOOD HYGIENE (Continued) Penalties (x) aperson guilty of an offence against any of these Regulations shall be liable to a fine not exceeding £100, or to imprisonment for a term not exceeding three months, or to both, and in the case of a continuing offence, to a further fine not exceeding £5 for each day during which the offence continues after conviction. This new legislation has placed additional duties on the Council,, In the early part of the year, 14.6 food premises were on the Council's Register, but information as to rooms or accommodation used in connection with the varied trades was not available. The traders concerned were, therefore, sent letters explaining the requirements of the Food Hygiene Regulations, and requesting the completion of forms upon which they would give the additional data required. Following consideration of the information provided;, the Council's Inspectors visited the traders and in each case fully discussed the action appropriate, when it was generally found that a spirit of co-operation prevailed. There are also a further 344 food premises which are not registered, in respect of which considerable progress has been made in implementing the Regulations , and a more detailed report will appear in my next annual review of food hygiene in the Borough. -47- INSPECTION AND SUPERVISION OF FOOD As required by current legislation, registers are maintained of all persons engaged in carrying on trades connected with the manufacture, storage and sale of food. Traders and their staffs are kept well informed of the latest methods adopted for the hygienic handling, wrapping and delivery of food, and the great majority are appreciative of such advice. The following summary gives details of the types of businesses receiving the attention of the Public Health Department:- Bakehouses 5 Butchers 29 Milk Retailers (including Dairies) 52 Food Factories 5 Fried Fish Premises 3 Fruit and Vegetable Retailers 37 General Provision Merchants 44 Industrial Canteens 7 + Miscellaneous Premises 33 Hotels and Public Houses 52 Restaurants 198 Wet Fish Retailers 9 Wet and Dry Fish Retailers 1 + Off Licences, Bottling Stores , Cake and Sweet Shop. As required under Section 16 of the Food & Drugs Act. 1955, or other local Acts, the registration of 118 premises for the storage and sale of Ice Cream, and 35 premises for the sale of Preserved Foods, is operative. - 48 - 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 premises which ceases to be used as a dairy premise. On the 31st December, 1956, entries in the register were as follows:- (a) Number of registered distributors with premises in the Borough 43 (b) Number of registered distributors other than those included in (a) above 18 (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 51 During the year, 128 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 Borougho 59 supplementary licences were granted in respect of milk sold by retail within the Borough from 18 premises not situated in the area of this authority. Details of licences granted were as follows:- Type of Licence Tuberculin Tested Pasteurised Sterilised Total Principal 37 47 44 128 Supplementary 19 20 20 59 All retailers selling milk within the Borough have been licenced 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. - 49 - PET ANIMALS ACT, 1951 During the year four licences were applied for and granted, and in each case a fee of 10/- was paid. Regular inspections were carried out to ensure that all animals were being cared for and maintained in accordance with the conditions attaching to the licences. PHARMACY & POISONS ACT. 1933. The provisions of the Act, and the Poisons Rules relating to the retailing of poisons specified in Part II of the Poisons List, were administered throughout the year. The number of listed sellers placed on the Council's register was 49. All applications are investigated to ensure that records are properly maintained, labelling efficiently performed;, storage accommodation is adequate, and that sales are only made by employees nominated on application forms. In every instance it was found that the requirements of the Act and the Poison Rules were being complied with, whilst it was apparent that all concerned were fully aware of their particular responsibilities,, As a general rule the poisons retailed were insecticides, rodent exterminants, hair dyes, and household ammonia,, Applications for inclusion and/or retention in the Council's register are considered by the Public Health and Baths Committee each Spring, and when approval has been expressed, appropriate entries are made for a period of twelve months (1st May to 30th April). RAG FLOCK AND OTHER FILLING MATERIALS ACT, 1951 Eleven premises in the Borough, used for upholstering and similar processes, have been registered since the Act came into force on 1st November, 1951. There are no premises in the Borough where rag flock is manufactured. - 50 - 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:- l. Treatment of Business and Private Premises. Business Premises Private Premises Number of visits made 2,972 684 Number of infestations found 38 255 Number of treatments undertaken 31 246 Number of pre-baits laid 1,862 Number of poison baits laid 586 Number of complaints received 313 2. Sewer Maintenance Treatments. Non of pre- No. of poison baits laid baits laid Estimated kill No. 1 Treatment 980 363 2,760 No. 2 Treatment 860 325 2,315 - 51 - 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 3,296 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 1953-1956 (inclusive) are set out in the following table:- UNSOUND FOOD SURRENDERED TO THE COUNCIL'S FOOD INSPECTORS DURING THE YEARS 1953-1956 (INCLUSIVE) Commodity 1953 1954 1955 1956 lbs lbs lbs lbs Biscuits 505 - - - Bread 144 - - - Cereals 139 — - - Cheese — 110 137 86 Egg, dried - - 180 - Fish, Fresh 174 200 173 - Fish, Tinned — - - 66 Fruit, Tinned 2,157 929 517 829 Fruit, juices - - - 60 Fruit, Fresh - - 2,353 - Meat, Fresh 1,621 1,903 3,490 1,287 Meat, Tinned 1,239 1,027 714 310 Milk, Tinned - 90 - 33 Preserves, - Jams, Marmalade, etc 182 74 92 45 Sausages 435 359 72 - Soups 93 88 304 - Vegetables 436 254 639 214 Aggregates of all foods condemned annually 7,640 5,146 8,926 3,296 Average for the four years - 6,252 lbs. - 52 - DISINFECTION AND DISINFESTATION The following summary shows the amount of work carried out by the staff of the Council's Disinfecting and Cleansing Station, 9a, Lots Road, Chelsea, during the past year. (a) SCABIES During the past year there were no cases of Chelsea residents suffering from Scabies referred to the Cleansing Station for treatment, but under an arrangement with the London County Council 17 children attending L.C.C. schools were given 20 treatments. (b) VERMINOUS CONDITIONS Details of work in this connection are set out below:- Cases Treatments ADULTS (male) Nil Nil ADULTS (Female) 307 307 CHILDREN 176 176 (In addition to the figures shown above, 211 treatments were given to children attending L.C.C. Schools) DISINFECTION OF ROOMS AND CONTENTS AFTER INFECTIOUS DISEASE Number of Rooms Disinfected 113 Number of Articles Disinfected 3,697 DISINFESTATION OF ROOMS AND CONTENTS Number of Rooms Disinfested 235 Number of Articles Disinfested 1,561 MISCELLANEOUS DISINFECTION Number of Rooms Disinfected 415 Number of Articles Disinfected 3,364 EPIDEMIOLOGY Incidence and Notification of Infectious Disease -53- NOTIFICATIONS. The following table shows the total (corrected) number of Infectious Diseases received during the year. Disease Under 1 year 1 and under 5 yrs. 5 and under 15 yrs. 15 and under 25 yrs 25 and under 45 yrs. 45 and under 65 yrs. 65 yrs and over TOTAL Dysentery - - - - - 3 - 3 Dysentery (Sonne) 38 174 78 11 38 4 3 346 Erysipelas - - - - - 2 3 5 Food Poisoning - 3 4 4 13 22 38 85+ Measles 12 108 60 1 2 - - 183 Meningococcal Infection 2 - 1 - - - - 3 Pneumonia: Ac. Influenzal Ac. Primary -1 -1 -2 1 1 4 4 3 5 4 10 12 24 Poliomyelitis: Paralytic Non-Paralytic - - 3 2 2 3 3 1 - - - - 8 6 Puerperal Pyrexia - - - 36 27 - - 63 Scabies - 3 2 3 7 - - 15 Scarlet Fever - 17 20 1 - - - 38 Whooping Cough 11 42 18 - 1 - - 72 TOTALS 64 353 190 62 96 39 58 863+ * + Total includes one case - Age unknown. - 54 - SUMMARY OF NOTIFICATIONS OF INFECTIOUS DISEASES RECEIVED DURING THE YEARS 1952-1956 (Inclusive) Diseases 1952 1953 1954 1955 1956 Average for five years Diphtheria - - - 2 - 0.4 Dysentery 139 260 196 216 349 232 Erysipelas 5 4 6 4 5 4.8 Food Poisoning 10 23 19 27 85 32.8 Malaria _ 1 - - - 0.2 Measles 355 549 104 736 183 385,4 Meningococcal Infection 1 4 1 2 3 2.2 Ophthalmia Neonatorum 3 2 - 1 - 1.2 Paratyphoid Fever 1 1 3 2 - 1.4 Pneumonia: Ac. Influenzal - 13 4 6 12 7 Ac. Primary 16 16 24 18 24 19.6 Poliomyelitis: Paralytic 12 2 1 2 8 6 5 3 Non-Paralytic 2 3 - 4 Puerperal Pyrexia 67 29 36 57 63 50.4 Scabies 6 19 34 12 15 17.2 Scarlet Fever 61 49 26 43 38 43.4 Typhoid Fever - - 1 - - 0.2 Whooping Cough 87 257 93 85 72 118.8 - 55 - DIPHTHERIA Four notifications wars received during the year, but were not confirmed. Two cases were confirmed in 1955, being the first cases since 1949. Only one death has occurred during the past seventeen 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 on page 7 SMALLPOX No case of Smallpox has been notified to the Public Health Department as having occurred in the Borough since 1928, and there have been no deaths from this disease for over fifty years. POLIOMYELITIS Fourteen notifications of Poliomyelitis came to hand, and all were subsequently confirmed; six of the cases were of a non-paralytic type. One of the eight paralytic cases, a female of 18 years, died six days after admission to hospital. None of the above cases had been vaccinated} against poliomyelitis. DYSENTERY During 1956, three hundred and forty-nine notifications were submitted as compared with 216 in 1955 and 196 in 1954. 68% of the sufferers were residents of institutions not controlled by this authority. The premises were such that it was difficult to prevent the spread of infection among the particular type of inmates. Nevertheless the Borough Council has been at great pains to bring about the eradication of the incidence of dysentery. MEASLES One hundred and eighty-three notifications of Measles were received during 1956, as compared with 736 and 104 in 1955 and 1954 respectively. - 56 - PUERPERAL PYREXIA Puerperal Pyrexia means any febrile condition in a woman in whom a temperature of 100.4° Fahrenheit (38° Centigrade) or more has occurred within fourteen days after childbirth or miscarriage. Sixty-three cases were notified during the year, of which only one case occurred at home, the remainder being in hospital. Forty-eight of the hospital notifications referred to patients residing outside the Borough. The Puerperal Pyrexia (Amendment) Regulations, 1954, which came into operation on the 1st March last year prescribed a 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. 5 cases were due to genital tract infection, 17 to breast involvement, 1 associated with Phlebitis, 17 urinary tract infection, 1 respiratory tract infection, 1 bowel infection, 1 associated with Caesarean section and causes not known 20. Eight 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. WHOOPING COUGH Seventy-two cases were notified during the year against 85 in 1955. SCARLET FEVER Thirty-eight notifications of Scarlet Fever were received in the Public Health Department during 1956, as compared with 43 in 1955. -57- FOOD POISONING Eighty-five cases were notified as compared with 27 in 1955 and 19 in 1954. 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 FOOD POISONING NOTIFICATIONS Notifications of the occurrence of Food Poisoning were received as follows:- First Quarter Second Quartet Third Quarter Fourth Quarter Total 27 4 2 52 85 identified agents:- Total Outbreaks 1 (Salm. oranienburg) Total Cases: 6 Total Outbreaks 2 (Salm. typhi-murium 4) (Clostridium welchii 2) Total Case: 6 Outbreaks (other than family outbreaks) of undiscovered cause:- Total Outbreaks 2 Total Cases: 61 Total Outbreaks 1 Total Cases: 2 Single cases:- Agent identified: 4 Unknown causes: 6 (Salm. Eastbourne l) (Salm. typhi-murium l) (Salm. enteritidis l) (Salm. London l) Total Cases: 10 - 58 - ZYMOTIC DISEASES During the year, no deaths occurred which were considered by the Registrar-General to be attributable to causes which came under this heading. Currently, diseases such as cholera, diarrhoea, diphtheria., measles, scarlet fever, smallpox, typhoid fever and typhus fever are considered to be zymotic in origin, having occurred by reason of the multiplication of germs from without. It is interesting to note how sharply the number of deaths has fallen during this century: Year Number of deaths from Zymotic causes. 1900 219 1905 98 1910 66 1915 76 1920 41 1925 29 1930 22 1935 17 1940 1 1945 6 1950 3 1955 6 1956 - -59 - TUBERCULOSIS 73 cases of Pulmonary Tuberculosis were notified during the year. These were made up of 35 primary notifications, 29 "inward transfers", 1from Death Returns and 8 from other sources. There were also 5 non-pulmonary cases of which 4 were primary notifications, and one from "inward transfers". The accompanying tables present details of cases at present on the Tuberculosis Register. VARIATIONS IN REGISTER DURING 1956. PULMONARY NON-PULMONARY TOTAL CASES M. F. M. F. (a) Number of cases remaining on register at 1st January, 1956. 212 173 10 30 425 (b) Number of new cases notified. 18 18 1 3 40 (c) Number of cases restored to register 2 4 - - 6 (d) Other cases added 2 - - - 2 (e) Inward Transfers 16 13 1 - 30 Removals (f) Outward Transfers 17 12 - 1 30 (g) Cases recovered 3 1 - 1 5 (h) Cases gone abroad - 1 - - 1 (i) Deaths 3 - - - 3 (j) Cases remaining on Register at 31st December, 1956 227 194 12 31 464 60 (A) NEW CASES OF TUBERCULOSIS 1956 (B) DEATHS OF TUBERCULOSIS CASES 1956 TOTAL (all ages) 18 18 1 3 3 Nil Nil Nil 75 years and upwards 2 - - - 2 - - - 65 and under 75 years 1 1 - - - - - - 55 and under 65 years 4 1 1 - - - - 45 and under 55 years 3 4 - - 1 - - - 35 and under 45 years 2 3 - 1 - - 25 and under 35 years 3 7 - - - - - - 20 and under 25 years 1 2 - 1 - - - - 15 and under 20 years 2 1 - - - - - - 10 and under 15 years - - - - - - - - 5 and under 10 years - - - - - - - - 2 and under 5 years - - - - - - - - - 1 and under 2 years - - - - - - - - Under 1 year - - - - - - - - M F M F M F M F (A) NEW CASES Pulmonary Pulmonary Non- Pulmonary Non- Pulmonary (B) DEATHS Pulmonary Pulmonary Non- Pulmonary Non- Pulmonary - 6l - CHELSEA TUBERCULOSIS DISPENSARY, BROMPTON HOSPITAL. S.W.3. 1953 1954 1955 1956 Population served by Dispensary 52,150 52,060 51,450 51,070 Number of notified cases in Borough at end of year 440 471 425 468 Number of these who at the present do not attend Dispensary 156 164 102 115 Total attendances during year 1,899 2,208 2,080 1,984 Total new patients seen 526 404 242 149 Number of these who were contacts 285 173 220 106 Number of contacts found to be tuberculous 18 2 1 - Number of cases newly notified to Medical Officer of Health (i.e. excluding inward transfers) 107 68 42 43 Number of cases diagnosed as tuberculous (for the first time) at the Dispensary during the year 39 13 7 18 Number of X-rays 1,464 1,889 1,578 1,417 Number of Patients who received "Special treatment" at home during the year 42 33 33 30 Number of Patients given B.C.G. 12 52 54 65 Number of home visits by medical staff 53 32 31 50 Number of visits paid by Dispensary Nurse 2,529 2,382 2,135 2,027 Number of Clinic Sessions per week 2 2 2 2 -62- BACTERIOLOGICAL EXAMINATIONS All bacteriological examinations are carried out at the Public Health Laboratory at County Hall under its Director, Dr. A.J.H. Tomlinson. No charge is made to the Council for these examinations and during the year 1601 were made as follows:- Throat/Nose Swabs Corynebacterium diphtheriae (mitis) "Orchard Street" found 24 Haemolytic Streptococci found 10 Vincent's angina found 2 Pneumococci found 2 Mixed growth of proteus and Staph. aureus found 1 Staphylococcus aureus found 1 Streptococcus veridans and Neisseria catarrhalis found 1 Normal throat flora found 4 Negative results 317 Faeces Shigella sonnel found 229 Salmonella enteritidis found 1 Salmonella pensacola found 1 Salmonella typhi-murium found 18 Salmonella paratyphi B. found 1 Pathogenic Bact. coli 0119 found 2 Pathogenic Bact. coli found 2 Pathogenic Bact. coli 055 found 3 Pus cells found 1 Ova of Trichuris trichiura found 4 Female Ascaris lumbricoides found 1 Negative result 973 Foodstuffs Very large number of gram positive bacilli and heavy growth of Clostridium welchii found 1 Negative results 2 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 297 and Faecal specimens 1019. 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. ANNUAL REPORT of the PUBLIC ANALYST for the year ended 31st December, 1956. THOMAS McLACHLAN, A.C.G.F.C.,.F.R.I.C., M.I.Biol. - 63 - To the Mayor, Aldermen and Councillors of The Metropolitan Borough of Chelsea. Your Worship, My Lord, Ladies and Gentlemen, During the year 1956, 400 samples of foods and drugs were examined. Of these 2 were taken formally and 398 informally. Adverse comments were made against 22 samples and the incidence of adulteration or incorrect labelling may be classified as follows:- Number of samples examined. Number incorrect. Milk 207 0 Other foods 188 22 Drugs 5 0 These figures again indicate that during 1956 food was slightly better than the previous year. A sample of egg macaroni contained a weevil. No other packets were found to be infested and it was thought probable that the infestation had occurred at the time of packing in Italy. This was the first complaint of this type the importers had received. Some caviar contained 2300 parts per million of hexamine per million parts of caviar. Benzoic acid was also present, but the sample was not large enough for the quantity to be determined. Caviar is not allowed to contain any preservative other than salt. or salt and vinegar. The importers stated that as the commodity did not come up to standard the whole consignment had been returned to the agents, and they did not propose to handle any more of this brand in future. Later the importer called to see your analyst and informed him more of this product was on the way and that Chelsea had given him permission to sell ito This statement was, of course, incorrect. A sample of Italian butter contained 16.9 per cent of water, whereas under the Butter and Margarine Regulations, 1955, butter must not contain more than 16 per cent of water. The importers informed the Council that butter is permitted to contain 17 per cent of water in Italy. They held only a small stock of this butter in tubes, and for future shipments would see that the water content did not exceed 16 per cent. Sane brewers' yeast powder contained 3.5 parts per million of arsenic and 78 parts per million of copper, whereas the British Pharmaceutical Codex requires the arsenic to be less than 1 part per million and the copper to be less than 50 parts per million. As yeast - 64 - removes the bulk of poisonous metals from the wort in the brewing of beer, the figures which were found by your analyst were not surprising. The manufacturers submitted a certificate from a firm of consulting chemists which did not contradict your analyst's certificate, but it was felt that as the manufacturers were alive to the situation no further action was necessary. A sample labelled as "Caffeine-free Coffee Extract" was found to contain 0.4 per cent of caffeine and was therefore not quite caffeine free, After correspondence and discussions with the importers it was agreed that the product might be described as "Decaffeinated". A product was sold as "Biochemical salt which was perfectly balanced for human requirements", and containing quantities of minor constituents. Analysis showed that it was not a perfectly balanced salt, and the minor constituents were not present in the quantities shown on the label. When contacted the manufacturers claimed that it was common salt to which was added the necessary ingredients to make it biochemically balanced, and that it was difficult evenly to distribute the finely powdered ingredients. They were, however, installing new machinery and hoped for better results. A complaint about a small black object in a loaf of bread was investigated and the offending matter found to consist of a semi-burnt wheat grain. A sample of Canadian wheat flour was submitted by a flour mills for an opinion regarding its suitability for human consumption. The hydrogen-ion concentration was found to be about 4.0 compared with that of a newly milled flour 5.5, but the acidity as lactic acid was only 0.074 per cent which is relatively low. The flour had a rather strong odour and with the low pH it could probably only be satisfactorily employed for human consumption by blending. The composition and labelling of a cake mixture were satisfactory, but a newspaper advertisement of this product was considered to be misleading. The advertisement to which objection was taken gave the impression that a fresh egg was in the cake mixture, whereas the egg had to be added by the user. The manufacturers stated that their endeavour was to stress in all advertising material the need for a fresh egg to be added by the housewife, and that they were grateful for the opinion that this particular advertisement might in some way by some people be considered to mislead. The advertisement had only appeared for two months and would be amended. An apple tart was submitted for examination by a purchaser who complained that it was unfit to eat. The fat in the crust was found to contain only 0.4 per cent of free fatty acids, calculated as oleic acid, but it gave a strongly positive test for rancidity by the Kreis reaction. The manufacturers stated that they did not hold more than a week's supply of fat at a time. They made at that particular bakery 200-300 tarts and other goods daily and had received no other complaints, but they had recently dismissed the manageress as they had reason to believe that she had on occasions sold goods that were not - 65 - fresh. The matter was also taken up with the suppliers of the margarine. A sample of canned cucmbers was sent for examination because of green stains on the skins. Analysis showed the copper content of the skins to be about 100 times the quantity normally found. This amount of copper may have been due to the use of copper spray or to the use of copper vats for the fermentation during the pickling process. It was not considered to be harmful and the cucumbers could be sold for manufacturing purposes. A jelly-jam was stated on the label to be not standard, and not to conform to the Ministry of Food Standards, nor was the fruit from which it was prepared mentioned on the label. It is impossible for manufacturers to contract out of a Food Standards Order. The manufacturers' solicitors called to discuss the label and agreed to recommend its amendment. A description "apricot special fruit product" was considered to be incorrectly labelled and to be an evasion of the Food Standards (Preserves) Order. The product was formerly called jam, but did not comply with the requirements of the Order. On the other hand, as it contained about 40 per cent of sugar it is not properly a "Jam for Diabetics" and your analyst feels that it should be sold as a "Sugar Reduced" jam in the same manner as certain breads are sold as "Proteinenriched" bread. The manufacturers stated that some years ago the Ministry had issued them with a licence to sell this product as a variety of jam, but that another public analyst had objected to the name. The order of the ingredients of a mint jelly was incorrect. The manufacturers agreed, and informed the Council that this sample must have been old stock distributed prior to the introduction of a revised label which had been in use for some months. A sample of pear juice contained added citric and ascorbic acids whose presence was declared in Italian, whilst the English portion of the label stated that it consisted entirely of pear juice with 5% of added sugar. Your analyst had already reported on this mistake to another Authority. The importers stated that no more of this pear juice was being imported at the present time. They added, however that they had been advised not to mention the addition of ascorbic and citric acids in English in view of the possible deterioration of ascorbic acid and because this part of the Italian label was spelt almost the same as in English. Their intention had been to indicate that no artificial ingredients were used to increase the volume of the product. A sample labelled "Natural Lemon Juice" and with the words "Here in a bottle is the clear undiluted juice and rind oils of a basketful of Sicilian lemons" was examined, and it was found that the ascorbic acid content was only 1034 ago per 100 mls. whereas it should be approximately the same as that of fresh lemon juice. Blatant descriptions are inappropriate for juice which contains only about one- - 66 - twentieth the natural content of vitamin C. After discussion with the manufacturers they agreed to amend their label. A liver sandwich spread was considered quite satisfactory, but the order of declaration of ingredients was incorrect, and a constituent described as "glutamate" should have read "sodium glutamate". The matter was taken up with the importers who consulted the Swiss manufacturers. Fresh labels were submitted giving the product a new name, but these labels were not considered satisfactory. After lengthy consultations and correspondence further suggestions for a new label were made and the importers offered to bring a Swiss representative to England for discussion, but as your analyst will be in Switzerland early next year he "has offered to see the manufacturers in Switzerland should they so desire. Insufficient directions were given on the label of a sample of liver puree for babies. It is generally recognized that instructions for infant feeding should give some guidance to the mother of the quantity to be served. The manufacturers acting on this advice arranged to insert leaflets into each carton giving hints to mothers based on the advice of their nutrition adviser. In conjunction with other public analysts your analyst carried out an investigation into the composition of sausage rolls, and of 46 samples examined by your analyst, Chelsea kindly provided 6. The six samples taken in Chelsea contained 19.4, 18.83, 16.1, 13.4, 13.l, and 5.l per cent. respectively of Ministry of Agriculture, Fisheries and Food "Lean Meat" as suggested for calculating the meat content of sausages. If the sample containing only 5.l per cent of meat is omitted, the average meat content of all the samples examined by your analyst is 16.9 per cent so that the sausage rolls obtained in Chelsea are inferior in quality to those submitted generally to your analyst. It was felt that there might be a lower percentage of meat in large rolls than in smaller ones and that price might affect the quantity of meat present, but this was found not to be the case. There can be no doubt that general examinations of this type must serve a useful purpose and enable one to obtain a clearer picture of market conditions. Food Legislation and recommendations during 1956. On the 1st, January the new Food and Drugs Act, 1955, came into operation and it was anticipated that this would bring about many changes in Food and Drug administration generally, but these changes are taking place gradually by a process of evolution rather than revolution. The Act is in itself a Consolidating Act and repeals The Food and Drugs Act, 1938, The Food and Drugs (Milk, Dairies and Artificial Cream) Act, 1950, and The Food and Drugs Amendment Act, 1954, this last Act having been passed with the knowledge that it would never come into force as such, but that it would provide material for consolidation into the present Act. Whether such a procedure was wise or not is doubtful; if the Food and Drugs Act, 1954, had been allowed to operate for a few years before the whole Act was consolidated an opportunity would have been provided to discover whether all its provisions were workable. From the public analyst's standpoint there are several weaknesses. The definition of food is not as good as in the Food and Drugs Act, 1938, with the new - 67 - Act one finds that a food includes an "article and substance used as an ingredient in the preparation of food or drink", but sections 91 and 92 of the Act also provide for "substances capable of being used in the preparation of food", and it remains for the High Court to decide what is the difference, if any, between an article or substance used as an ingredient in the preparation of food and a substance capable of being used in the preparation of food. This point could have been resolved quite easily during the course of the Bill through Parliament and, in your analyst's opinion, it should have been settled. Although the first Food and Drugs Act was passed in 1860, there is still no legal definition of a medicine, although the definition of a drug states that it includes medicine for internal or external use. The definition of a "substance recommended as a medicine" given in the Pharmacy and Medicines Act, 1941, is unsatisfactory, as it is difficult to know exactly what constitutes an ailment, infirmity, or injury affecting the human body. The new Act states that a food does not include articles or substances used only as drugs, but whilst this may be comprehensive it is far from clear. The new Act has endeavoured to give clear definitions of cream, reconstituted cream, and imitation cream, but whether it will be possible to enforce these is doubtful, because, unfortunately, tradesmen with the best intentions in the world will contravene the law owing to the ignorance of the publico It is doubtful whether the public expect to find genuine cream in a cream bun unless it is labelled to that effect, in general they expect to find reconstituted cream in such an article. In any case, whatever the filling, they ask for a cream bun. Again one is doubtful about the position of sweetened whipped cream in an eclair or a cream bun, since the addition of the sugar produces a mixture which is really no longer cream. If one or two of these minor points could be cleared up it will be seen that the public is now protected from some of the frauds which have been growing and which it has been almost impossible to stop. Had firm action been taken some half century ago, when "custard powders", "egg powders", and other products first came onto the market, the position would have been greatly simplified. The Local Authority will now have to be advised by its medical officer of health and public analyst regarding the possible cumulative effect of any substance or substances used as additions to foods. Patent and proprietary medicines are no longer exempt from the provisions of the Food and Drugs Act. A milk dealer who bought his milk as milk derived from more than one farm and has warranties justifying him in believing that the milk was genuine, need not ask for the "appeal to cow" procedure to be put into force, but may plead the warranties as a defence. From the public analyst's point of view one of the chief advantages of the new Act is that a part-time public analyst now enjoys the protection of the local authority, when acting in his capacity as a public analyst. It may not be generally recognised that previously a part-time public analyst had been personally liable to penalties, in - 68 - the event of a mistake having been made by him either in his analysis or in his recommendations or actions to support his views. One point entirely new to Food and Drug administration is that provision has been made whereby the public analyst for the area. who is unable to carry out an effective analysis of a sample because he lacks the necessary apparatus or knowledges, may pass it to the public analyst for another area who possesses such apparatus and knowledge. Unfortunately expensive physical apparatus is being introduced at such a rate that in the not far distant future it may be impossible to carry out the whole analysis of a sample in one laboratory, but as the Act has been worded the whole analysis must be carried out under the control of one analyst only. From the general administrative angle the length of time during which proceedings may be commenced for samples other than milk has been extended from 28 days to two months, and the period during which proceedings for giving a false warranty may be commenced has been increased to twelve months. One points which is not made clear in the Act and which may cause some confusion, is that the Food and Drugs Amendment Act, 1954, repealed "The Defence (Sale of Food) Regulations, 1943, As this Act never came into force as such, but only in the consolidated Act of 1955, many people have overlooked the repeal of numerous Orders made as a result of this repealo It would have been useful had the 1955 Act re-enumerated repeals brought about by the Act of 1954. The Food Hygiene Regulations, 1955, except for enforcement of certain minor parts, came into force with the new Food and Drugs Act, These Regulations are not, in the main, the concern of the public analyst, but of the medical officer of health and public health inspectors. The public analyst, is, however, frequently asked for his opinion on complaint samples, which may be the subject of offences against the general provisions of the Act or of the Regulations, In your analyst's opinion these regulations will prove of the greatest assistance to local authorities in dealing with certain backward traders and manufacturers, but care will have to be exercised over complaints from the general public. For some years there has been a growing tendency for the public to look to the local authority for guidance and action when foods of inferior, dubious, or really unsaleable quality have been supplied and this is a symptom, which your analyst welcomes, and he hopes that, with the progress of time, the manufacturer and the tradesman will also welcome them. The good manufacturer is apt to feel aggrieved when complaints are taken to the local authority instead of being returned to the shop where the article was purchased, but many of the public feel that their justifiable complaints are ignored, even by many of the large companies. which deny that the article is inferior, or even accuse the purchaser of allowing a product to deteriorate before making the complaint. Manufacturers feel that their good names and reputations are impugned when complaints are taken to the local authority instead of to the shop, but it is the opinion of your analyst that the local authority and the public analyst are in a better position to give an unbiased opinion. It cannot be denied that there is a growing tendency - 69 - on the part of a few members of the public to engage in a type of legal blackmail against food manufacturers and your analyst has been perturbed at being asked to give certificates for nails in cut bread, when the nails must have been inserted after cutting the loaf. On another occasion a bottle of milk was contaminated with cat's urine and possessed a most objectionable odour, but careful examination proved that the contamination must have been introduced after the milk had been bottled and the cream layer had become so firm that the contaminant did not penetrate the cream layer. One sees convictions reported in the press at the present time which give cause for grave anxiety, and your analyst is firmly of the opinion that the present tendency for complaints to be dealt with by the local authority will be found to serve the interests of the manufacturers as well as those of the consumer. In general the manufacturer can usually arrange for his own expert to examine the suspected article in conjunction with the public analyst in the event of there being any doubt. Such joint consultation must be to his advantage as it provides him with an insight into the general administyration of the Food and Drugs Act. Several Statutory Instruments controlling the composition of foods under the new Food and Drugs Act came into force during the year. The Food Standards (Butter and Margarine) Regulations, 1955, prescribed standards for butter and margarine similar generally to those previously given in the Food and Drugs Act, 1938, by which it was forbidden to sell butter or margarine containing more than 16 per cent of water, or margarine containing more than 10 per cent of butter fat. The Labelling of Food (Amendment) Regulations, 1955, re-enacted the provisions of Sections 32 and 33 of the Food and Drugs Act, 1938, regarding the labelling of margarine and margarine-cheese and for the amendment of the Regulations by substituting the words "Imitation Cream" for "Synthetic Cream" wherever they appeared in the 0rder. At the same time this amendment made provision for the labelling of margarine making claims for cream or milk fat and requiring these to be stated as "milk-fat equivalent to (y)% of butter%" where "y" represents the actual butter equivalent to the milk or cream. Your analyst is unhappy about these last provisions. At one time it was common to advertise that margarine contained butter, so that it became necessary with the Butter and Margarine Act, 1907, to stipulate that a road must separate factories used for the manufacture of butter and margarine. Later in the Food and Drugs (Adulteration) Act, 1928, it was made illegal to label margarine except with the word "margarine" together with a descriptive name approved by the Minister of Agriculture and Fisheries. With the advent of the Food and Drugs Act, 1938, a retrograde step was made by permitting the label to state the percentage of butter fat present. Advantage of this was first taken by an overseas importer some four or five years ago, when the permission granted by the 1938 Act had been completely forgotten by most food and drug authorities. Shortly after, vendors of margarine began to claim the presence of cream in margarine and instead of suppressing this the Ministry has attempted to regularise the position. In consequence there are now on the market cheese spreads and processed cheeses containing cheese made from separated milk with claims for the presence of "cream" although the total milk fat is less than the quantity of milk fat which would be present naturally if a full-cream milk cheese had been employed for their manufacture. The position has become even - 70 - worse with the introduction of shortenings, which claim to "be enriched with 10% of butter" and to be "richer", so that one can use less. The Mineral Oil in Food (Amendment) Regulations, 1955, permit any chewing compound to contain up to 12.5 per cent of microcrystalline wax, but public analysts do not approve this order, especially since only a few years ago the Ministry of Food pressed them to endeavour to suppress completely the use of paraffin wax in chewing gum. There is no real difference between paraffin wax and microcrystalline wax from the food aspect or that of detection. The Bread (Amendment No. 2) Order, 1956, abolished all price control on bread, and also abolished definitions of national flour, national bread, national brown bread, and national milk bread. With this Order came the Floor (Composition) Order, 1956, which prescribes requirements for calcium, iron, vitamin B1 and nicotinic acid in all types of flour and it is left to Food and Drug Authorities to enforce the Order. The Milk and Dairies (Channel Islands and South Devon Milk) Order, 1956, now made under the Food and Drugs Act, requires such milk to contain not less than 4 per cent of milk fat. Previously no action could be taken under the Food and Drugs Act if such milk did not contain 4 per cent of fat. The Sale of Food (Weights and Measures? Bacon and Ham) Regulations, 1956, and the Pm-Packed Food (Weights and Measures s Marking) (Amendment No, 2) Regulations require bacon and ham to be sold only by weight and any pre-packed bacon and ham to have a mark on the outer container showing the weight contained in the package,, The Food Standards (Curry Powder) (Amendment) Regulations,, 1956, and the Food Standards (Tomato Ketchup) (Amendment) Regulations , 1956, permit curry powder to contain up to 20 parts per million of lead, and permit tomato ketchup, catsup, sauce or relish to contain up to 20 parts per million of copper instead of 50 parts per million calculated on the dry solidso These small quantities are hardly likely to have an adverse effect on the health of the consumers,. During the year the Food Standard® Committee of the Ministry issued several Reports §= The Report on processed cheese and cheese spread recommends that processed Cheddar or Cheshire cheese shall contain not more than 42 per cent of moisture and that the butter fat content of the dry matter shall not be less than 48 per cento In the case of other processed cheese it is recommended that the moisture shall be not more than 45 per cent and the butter fat not less than 45 per cent on the dry matter,. For cheese spreads it is recommended that the maximum moisture content shall be 60 per cent and that the minimum butter fat content of the product as sold shall be not less than 20 per eent„ The Report on Sausages recommends that pork sausages shall contain not less than 65 per cent of meat, whilst sausages made from beef, mutton, bacon, ham, lamb, veal, edible offals, poultry, game, rabbit, - 71 - hare and venison shall contain not less than 50 per cent of meat and that the quantity of fat shall be not more than 50 per cent of the total meat in any type of sausage. A majority of the Committee recommended that with pork and beef sausages the pork or beef content of the meat portion shall be not less than four-fifths of the total meat. A minority thought that the meat should be solely that by which the sausage is named. Your analyst agrees with the minority view especially as with both pork and beef the religious susceptibilities of members of the Commonwealth may be grievously offended at the idea of unwittingly eating prohibited meats. It is doubtful whether the Committee even considered this aspect of the matter. The Report on the addition of emulsifying and stabilising agents is comprehensive and recommends that some twenty substances, which may or may not occur naturally in foods, are so commonly used that they do not require legislation and further recommends that legislation be introduced to control the use of super-glycerinated fats, synthetic lecithin, propylene glycol or stearate, methyl cellulose,, methylethylcellulose, sodium carboxymethyl cellulose, stearyl tartrate, the diacetyl tartaric acid esters of super-glycerinated fats, monostearin sodium sulphoacetate, or sorbitan esters of fatty acids. Other substances, such as brominated oils and silicones, it is recommended, should be banned. Finally a revised Report was issued giving recommendations for limits of the copper contents in foods, The general recommendations are that ready-to-drink beverages should contain not more than 2 parts per million of copper, other beverages 10 parts per million, and that foods generally should contain not more than 20 parts per million. There are, however, certain recommended exceptions, which need not be mentioned in this report. It will suffice to mention that some authorities have been pressing to introduce legislation to prohibit the use of any chemicals in food. whose presence cannot be detected. Your analyst feels that the Council will offer him their sympathy should such legislation be enacted. In conclusion it may not be out of place to mention that it is extremely rare for the Council to be forced to take legal action in the administration of the Food and Drugs Act. Your analyst is very grateful to the medical officer of health and to his staff for the patient manner in which they deal with points raised by him. Much time is consumed and careful negotiations are required, but it is seldom that manufacturers disagree eventually with our recommendations and they are generally grateful for the help given to them. Food administration in this country has changed entirely during the last few years. Complaints from the public are generally submitted to the public analyst through the Local Authority, and manufacturers and caterers are learning that they act impartially in the public interest. As the chairman of the Standards Committee of the Association of Public Analysts your analyst has had the opportunity to see much behind the scenes and he looks forward to the not far distant future when most matters regarding the compositions, description, and advertising of foods will be arranged by friendly negotiation with trade organisations, and when the threat of legal action will be a thing of the past except - 72 - for the few, who think only of themselves. Most manufacturers and caterers are honest and they realise that food administration protects them from frivolous and even wrongful complaints, because after all, the real aim of society, whatever be one's walk in life, is to serve the public interest. I am, Mr. Mayor, My Lord, Ladies and Gentlemen, Your obedient Servant, thomas mclachlan, a.c.g.f.c., f.r.i.c., m.i.biol. Public Analyst. - 73 - Taken Formally Adulterated etc. Taken Informally Adulterated etc. Total samples Analysed Total samples Adulterated etc. Baby Food 0 0 1 1 1 1 Baking Powder 0 0 1 0 1 0 Biscuits 0 0 1 0 1 0 Bread 0 0 2 0 2 0 Butter 0 0 2 1 2 1 Cake Mixture 0 0 1 1 1 1 Capers 0 0 1 0 1 0 Caviar 0 0 1 1 1 1 Cheese 0 0 1 0 1 0 Cheese, milk 0 0 1 0 1 0 Cheese, Parmesan 0 0 1 0 1 0 Chicken 0 0 3 0 3 0 Cloves, ground 0 0 1 0 1 0 Coffee and Chicory 0 0 1 0 1 0 Coffee Extracts caffeine free 0 0 1 1 1 1 Compound Food 0 0 1 0 1 0 Confectionery 0 0 2 0 2 0 Conserve, fig 0 0 1 0 1 0 Cooking Fat 0 0 1 0 1 0 Cooking Fat, Vegetable 0 0 1 0 1 0 Cornflour 0 0 1 0 1 0 Cream 0 0 4 0 4 0 Cream, Cashew Nut 0 0 1 0 1 0 Cucumber, Pickled 0 0 2 1 2 1 Dessert Powder 0 0 2 0 2 0 Fish, bottled 0 0 1 0 1 0 Fish, Cakes 0 0 1 0 1 0 Fish, canned 0 0 11 1 11 1 Fish, smoked snaithe 0 0 1 0 1 0 Fish Pasts 0 0 4 0 4 0 Flour 0 0 1 1 1 1 Flour, chestnut 0 0 1 0 1 0 Flour, pea 0 0 1 0 1 0 Flour, potato 0 0 1 0 1 0 Fruit, canned 0 0 3 0 3 0 Fruit, dried 0 0 1 0 1 0 Fruit, Juice 0 0 5 2 5 2 Fruit, Puree 0 0 1 0 1 0 Fruit, Tart 0 0 1 1 1 1 Garlic Powder 0 0 1 0 1 0 Gelatine, powdered 0 0 1 0 1 0 Gravy Powder 0 0 1 0 1 0 Gravy Salt 0 0 1 0 1 0 Carried forward 0 0 72 11 72 11 -74 - Taken Formally Adulterated etc. Taken Informally Adulterated etc. Total samples Analysed Total samples Adulterated etc. Brought forward 0 0 72 11 72 11 Honey 0 0 4 0 4 0 Horseradish, grated 0 0 1 0 1 0 Ice Cream 0 0 1 0 1 0 Icing 0 0 1 0 1 0 Jam 0 0 3 0 3 0 Jam, sugar reduced 0 0 1 1 1 1 Jelly-Jam 0 0 1 1 1 1 Jelly-redcurrant 0 0 2 0 2 0 Macaroni, egg 0 0 1 1 1 1 Macaronis, Egg & Vegetable 0 0 1 0 1 0 Marmalade 0 0 1 0 1 0 Meat, canned 0 0 10 2 10 2 Meat & Egg canned 0 0 1 0 1 0 Meat Puddings canned 0 0 1 0 1 0 Milk 2 0 205 0 207 0 Milk Condensed 0 0 2 0 2 0 Mincemeat 0 0 2 0 2 0 Mincemeat Tart 0 0 1 0 1 0 Mint in Vinegar 0 0 1 0 1 0 Mint Jelly 0 0 1 1 1 1 Mono Sodium Glutamate Crystals 0 0 1 0 1 0 Mushrooms, Canned 0 0 1 0 1 0 Mushrooms, dried 0 0 1 0 1 0 Mustard 0 0 2 0 2 0 Mustard, Continental 0 0 1 0 1 0 Nutmeg Powder 0 0 1 0 1 0 Olive Oil 0 0 1 0 1 0 Paprika 0 0 1 0 1 0 Pate de Foie 0 0 1 0 1 0 Pepper, cayenne 0 0 1 0 1 0 Pepper, white 0 0 2 0 2 0 Pickles 0 0 1 0 1 0 Pie Filling 0 0 2 0 2 0 Potato Salad, canned 0 0 1 0 1 0 Pudding Mixture, (suet) 0 0 1 0 1 0 Rissoles, ham and beef 0 0 1 0 1 0 Salts biochemical 0 0 1 1 1 1 Salt, vegetable 0 0 1 0 1 0 Sauce 0 0 6 0 6 0 Sausages 0 0 4 0 4 0 Sausage Rolls 0 0 5 2 5 2 Savoury Rolls 0 0 1 0 1 0 Carried forward 2 0 350 20 352 20 - 75 - taken formally adulterated etc. taken informally adulterated etc. total samples analysed total samples adulterated etc. Brought forward 2 0 350 20 352 20 Semolina 0 0 1 0 1 0 Soft drinks 0 0 4 0 4 0 Soups 0 0 7 0 7 0 Spread, savoury 0 0 8 1 8 1 Suet, shredded 0 0 1 0 1 0 Sugar, demerara 0 0 1 0 1 0 Syrup for flavouring milk 0 0 1 0 1 0 Tapioca, prepared 0 0 1 0 1 0 Tomatos, canned 0 0 2 0 2 0 Treacle 0 0 1 0 1 0 Turkey paste 0 0 1 0 1 0 Vegetables, canned 0 0 9 0 9 0 Vinegar 0 0 2 0 2 0 Vinegar, cider 0 0 1 0 1 0 Vinegar, wine 0 0 2 0 2 0 Yeast powder 0 0 1 1 1 1 Drugs: Asthmatic & Bronchitic Mixture 0 0 1 0 1 0 Aspirin Tablets 0 0 1 0 1 0 Cough Mixture 0 0 1 0 1 0 Glucose Tablets 0 0 1 0 1 0 Ointment 0 0 1 0 1 0 totals 2 0 398 22 400 22 INDEX Page (s) Analyst, Public - Report of 63-75 Atmospheric Pollution 25 & 26 Bacteriological Examinations 41 & 62 Births 6 & 7 Child Welfare 16 & 17 Committee, Public Health & Baths: Members 1 Representation elsewhere by Members 2 Deaths 6 - 11 Diphtheria Immunisation 17 Disinfection and Disinfestation 52 Factories Act, 1937 37 - 39 Food: Adulterated 63 - 73 Hygiene Regulations 43 - 46 Poisoning 57 Premises, Inspection & Supervision of 47 Unsound 51 Health Vislting 16 Hospitals 15 Housing 33-36 Ice Cream 4-2 Infant Mortality 6 & 7 12 & 13 Infectious Diseases 53- 62 Introduction 4 & 5 Legal Proceedings 40 Mass Radiography 23 Maternal Mortality 6&7 Maternity Services 16 Medical Eixammations 23 Meteorology 24 Milk, Licensing of distributors 48 Mortuary, Public 23 National Assistance Act, 1948: Burials 14 "Part III" Accommodation 18 Nursing Homes 15 Page (s) Outworkers 39 Overcrowding 33 - 36 "Part III" Accommodation 13 Pet Animals Act, 1951 49 Pharmacy & Poisons Act, 1933 49 Population 6 & 7 Public Analyst, Report of 63-75 Public Health Inspectors, Work of 27-52 Radiography, Mass 23 Rag Flock & Other Fillings Act, 1951 49 Rodent Control 50 Spastic Children 19 - 20 Staff of Public Health Department 3 Statistics, Vital 6 Tuberculosis 59 - 61 Underground Rooms 33 Water Supply 36 Welfare of Old People 21 - 22 Zymotic Diseases 58