AC434 LON48 REPORT OF THE MEDICAL OFFICER OF HEALTH OF THE CITY OF LONDON FOR THE YEAR 1922 LONDON. Printed by Drake, Driver & Leaver. Ltd., Rosebery Avenue, E C. 1. 1923. REPORT OF THE MEDICAL OFFICER OF HEALTH OF THE CITY OF LONDON For the Year 1922. LONDON. Printed by Drake, Driver & Leaver, Ltd., Rosebery Avenue, E C. 1. 1923. INDEX. A. pace. ANNUAL RATEABLE VALUE 7 ANTHRAX AND BRISTLES 18 ANTHRAX AND THE MILK SUPPLY 54 AREA 7 ARTIZANS' DWELLINGS, STONEY LANE 66 ATMOSPHERIC POLLUTION AND SMOKE 26 B. BACTERIOLOGICAL EXAMINATIONS 22 BARBERS' SHOPS 22 BIRTHS 8 BORIC ACID IN CAKE AND EGG YOLK 56 BOTULISM 45 c. CAKE, BORIC ACID IN 56 CANADA, IMPORT OF FOOD PRODUCTS 45 CHILDREN, CRUELTY TO—(VERMINOUS) 14 COCAINE, DESTRUCTION OF 23 COMMON LODGING HOUSE, 116, MIDDLESEX STREET 71 CONNECTIONS TO SEWERS 72 COURTS, SUMMER FLUSHING OF 72 „ LIMEWASHING OF 72 CREMATIONS 28 D DAIRIES, COWSHEDS AND MILKSHOPS ORDERS 48 DENSITY 7 DISINFECTION OF PART WORN POLICE UNIFORMS 68 DISINFECTANTS, SUPPLY OF 68 DRAINAGE PLANS 71 E EGG YOLK, BORIC ACID IN 56 EXAMINATIONS FOR PATHOGENIC BACTERIA 22 EXHUMATION AND REINTERMENT OF BODIES AT CITY OF LONDON CEMETERY 29 EXPORT OF FOOD PRODUCTS TO CANADA 45 F, FACTORY AND WORKSHOP ACT, 1901—ABOVEGROUND BAKEHOUSES 73 „ „ „ —FACTORIES, WORKSHOPS AND WORKPLACES 72 „ „ „ —OUTWORKERS 75 „ „ „ —SUMMARY OF INSPECTIONS 77 „ „ „ —SUMMARY OF WORK DONE 74 „ „ „ —UNDERGROUND BAKEHOUSES 73 FISH SUPPLIES AND SEIZURES 42 FLY NUISANCE 72 FOOD AT RIVERSIDE WHARVES, INSPECTION AND CONDEMNATION 46 FOOD POISONING 43 FOOD PRODUCTS FOR EXPORT TO CANADA 45 FOOT AND MOUTH DISEASE (AMENDMENT) ORDER, 1922 29 G. GULLIES, STREET 71 H HAIRDRESSERS' ESTABLISHMENTS 22 HOUSES LET IN LODGINGS 70 HOUSE, TRADE AND OTHER REFUSE REMOVAL 71 HOUSING—ANNUAL RETURN 14 „ —HUTCHISON STREET IMPROVEMENT SCHEME 14 „—QUEEN'S COURT AREA 13 HUMAN REMAINS—EXHUMATION AND REINTERMENT AT CITY OF LONDON CEMETERY 29 „ „ —REMOVAL OF ST. KATHERINE COLEMAN CHURCH, FENCHURCH STREET 28 HUTCHISON STREET IMPROVEMENT SCHEME 14 I. ICE CREAM—MANUFACTURED IN UNSUITABLE PREMISES 57 ,, „ —SALE BY ITINERANT VENDORS 57 INFANTILE MORTALITY 10 INFANT WELFARE 10 INFECTIOUS DISEASE 15 „ „ —ANTHRAX BRISTLES 18 „ „ —ISOLATION ACCOMMODATION, 6, BRIDGEWATER SQUARE 18 „ „ —TUBERCULOSIS 18 „ „ —SANITARY DEFECTS 71 „ „ —VENEREAL DISEASES 23 INDEX (continued). l. page LEGAL PROCEEDINGS 71 LODGING HOUSES, REGISTERED 70 M. MARGARINE ACT, 1887 49 MEAT INSPECTION—ALDGATE MARKET AND SLAUGHTERHOUSES 37 „ ,, —ARGENTINE MEAT 38 „ „ —AUSTRALIAN BEEF AND ONCHOCERCOA GIBSONI 30 „ „ —AUSTRALIAN MEAT 34 „ „ —COLD STORES 38 „ „ —DUTCH MEAT 35 „ „ —FOOT AND MOUTH DISEASE OUTBREAK 31 „ „ —HANDLING OF MEAT (DEPUTATION TO MINISTRY OF HEALTH) 32 „ „ —LEADENHALL MARKET AND CITY SHOPS 35 „ „ —NEW ZEALAND MEAT 35 „ „ —SUMMARY OF UNSOUND FOOD DESTROYED 39 „ „ —TUBERCULOUS MEAT SEIZED IN CENTRAL MARKET 33 „ „ —WORM NEST IN AUSTRALIAN BEEF 30 MEDICAL EXAMINATIONS 85 MILK AND DAIRIES (AMENDMENT) ACT, 1922 50 MILK AND SOPHISTICATION, LETTER MINISTRY OF HEALTH 54 MILK SUPPLY AND ANTHRAX 54 MORTALITY 8 „ —INFANT 10 MORTUARY—DISINFECTION OF CLOTHES FOR EXPORT, INQUESTS, Etc 67 „ —DESTRUCTION OF QUANTITY OF COCAINE 23 N. NOTIFICATION OF BIRTHS ACT, 1907 10 o. OVERCROWDING 71 P. PATHOLOGICAL EXAMINATIONS 22 POISONING FOOD 43 POLICE UNIFORMS, DISINFECTION 68 POPULATION 7 PRESERVATION OF BODIES 68 PUBLIC HEALTH (MILK AND CREAM) REGULATIONS, 1912 TO 1917 56 and 82 Q. QUEEN'S COURTJAREA, HOUSING 13 R. RATEABLE VALUE 7 RAT REPRESSION 80 REGISTERED LODGING HOUSES 70 RIVERSIDE WHARVES, INSPECTION AND CONDEMNATION OF FOOD 46 s. SALE OF FOOD AND DRUGS ACT 48 „ „ „ —ADMIN'ISTRATI VE ACTION REGARDING SAMPLES REPORTED TO BE NOT GENUINE 58 „ „ ,, —OBSERVATIONS, GENERAL 49 „ „ ,, —PRESCRIPTIONS 50 „ „ ,, —PROSECUTIONS OF MILK SELLERS, LETTER MINISTRY OF HEALTH 54 „ „ ,, —RESULTS OF PROSECUTIONS 88 „ „ ,, —SUMMARY OF ARTICLES EXAMINED UNDER THE SALE OF FOOD AND DRUGS ACT, AND PUBLIC HEALTH (MILK AND CREAM) REGULATIONS 62 SANITARY DEFECTS AND INFECTIOUS DISEASES 71 SANITARY INSPECTIONS 69 SANITARY STAFF 5 SEWER CONNECTIONS 72 SMOKE, ATMOSPHERIC POLLUTION 26 SPITTING 22 SUMMER FLUSHING OF COURTS 72 T. TUBERCULOSIS 18 „ —AND SPITTING 22 V. VACCINATION 13 VENEREAL DISEASES 23 VERMINOUS CONDITION OF CHILDREN 14 VITAL STATISTICS 10 w. WHARVES, INSPECTION AND CONDEMNATION OF FOOD 46 WATER CLOSET BYE-LAWS, NEGLECT TO COMPLY WITH 71 SANITARY STAFF. MEDICAL OFFICER OF HEALTH. Apointment. Howarth, Wm. J., C.B.E., M.D., D.P.H Dec., 1912 VETERINARY SURGEON. Young, T. Dunlop, O.B.E., M.R.C.V.S., D.V.S.M. Nov., 1909 CLERICAL STAFF. Lowe, George Sanitary Clerk Nov., 1902 Gray, Charles M. March, 1911 Baldwin, Harold J. March, 1921 Lee, Wm. J. Oct., 1915 Pallett, Frank J. Nov., 1914 Spalding, C. A. March, 1918 Naylor, Robert William. Jan., 1922 Chapman, Miss B. R. Feb., 1920 Tunbridge, Mrs. Jan., 1917 Jarvis, Miss E. S., M.B.E. May, 1921 WOMAN SANITARY INSPECTOR. Wilkinson, Miss Annie M. July, 1909 SANITARY INSPECTORS. Hills, Arthur Reginald April, 1888 Gathercole, Wm. Henry Joseph May, 1891 Simmons, Edward John June, 1892 Robbins, -Francis Joseph Sept., 1892 Ralph, William Holden June, 1898 Robinson, Ernest S. Feb., 1913 Fowler, George Henry Oct., 1920 McGrath, William Richard Feb., 1922 SANITARY INSPECTORS AND MEAT INSPECTORS. Sharp, J. Owen, Senior Inspector May, 1892 Kelland, William C. May, 1899 Mettam, Harry Dec., 1903 Davies, Thos. L. Dec., 1903 Bintcliffe, Charles E. March, 1907 Matson, William S. Dec., 1910 Mitchener, William E. Dec., 1910 Jones, John April, 1914 Slatter, Charles May, 1908 King, George G. April, 1910 Murray, Samuel B. Sept., 1911 Penman, Thomas July. 1913 INSPECTOR OF SLAUGHTERHOUSES AND MEAT. Eglin, William July, 1896 ASSISTANT INSPECTOR OF SLAUGHTERHOUSES AND MEAT. Mellish, Cyril E. Jan., 1912 KEEPER OF THE MORTUARY. Oakley, J. E. Feb., 1909 DISINFECTOR. McDonnell, R. J. April, 1903 MESSENGERS. Pinkney, Robert W. Oct., 1921 Peacock, Percy L. Oct., 1921 LABOURERS. Steggles, T. (General Duties at Mortuary) Dec., 1918 Powis, B. (Do. do.) Feb., 1920 Hastings, T.(Do. do.) June, 1920 Collins, W. (Gatekeeper at City Mortuary) Nov., 1920 Adams, T. C. (Meat Shed) May, 1905 Ludgate, G. (Meat Shed) Oct., 1906 PORTERS, CENTRAL MEAT MARKET. Potter, R. March, 1914 Strong, S. R. March, 1914 b b annual report of the medical officer of health for the year 1922. To the Right Honourable the Lord Mayor, Aldermen and Commons oj the Corporation of London. Public Health Department, Guildhall, E.C. 6th February, 1923. My Lord Mayor and Gentlemen, I beg to present herewith the report of the Medical Officer of Health for the Corporation of the City of London for the year 1922. AREA. The City of London (excluding The Temple) comprises an area of 661 acres (excluding tidal water and foreshore), or 1032 square miles, equal to a square of L016 miles to a side. The area of "Registration London" is 74,817 acres (excluding tidal water and foreshore), or 1169 square miles, equal to a square of 1081 miles to a side. DENSITY (1922). City of London, Registration District, at night 20.2 persons to an acre. „ „ „ during the day ...*578.5 „ „ Registration London, at night 60.3 ,, „ ,, * This figure refers only to persons "actively engaged in the City during the daytime," and is based upon a Census taken in May, 1911. ANNUAL RATEABLE VALUE. The rateable value of property within the administrative county of London (including the City) was £48,924,070 on 6th April, 1922; whilst on the same date the corresponding rateable value of property in the City of London was £6,227,124 or about one-eighth of the whole County. POPULATION. The undermentioned figures are extracted from the Preliminary Report of the Registrar-General on the Census of England and Wales, 1921:— Area, Inhabited Houses Population. Statute Acres 1911. 1921. 1911. 1921 City of London (Not including the Temple) 661 2,784 — 19,657 13,527 These figures represent the population on the nights of the 3rd April, 1911, and the 19th June, 1921. B2 8 The following table shows the progressive decline which has taken place since 1861 in the number of inhabitants who reside within the City boundaries, and the progressive increase in the number of workers who are daily employed in the City :— Year. Imperial Census. Night Population. City Census. Day Population 1861 112,063 — 1866 — 170,133 1871 75,983 — 1881 51,405 261,061 1891 37,705 301,384 1901 26,923 — 1911 19,657 364,061 1921 13,706 — There is only one registration district in the City. The estimated population of the City for the year 1922 is 13,363. The day Census taken in 1911 showed that the day population was 364,061 persons, and also that 1,077,155 persons and 94,095 vehicles entered and left the City on the day the count was taken. BIRTHS. During the year 1922, 360 births were registered in the City, 240 of which however, did not belong thereto. To the remaining 120 must be added the births of 28 children born to citizens temporarily residing outside the City boundary. The number of births, therefore, on which the rate should be calculated is 148. The annual birth rate was 11.1 per 1,000 persons of all ages, compared with a quinquennial mean rate of 9.8 per 1,000. In the Metropolis the birth rate in 1922 was 21.0 per 1,000. MORTALITY. During the year under review, 809 deaths were registered in the District, including 719 persons dying in the City, but not belonging thereto. See Table, p. 9, for details. Deducting these latter, 90 deaths remain, to which must be added those of 98 persons who died in Institutions in outside districts, where they were registered; the total, therefore, on which the City death rate is calculated is 188. The death rate for 1922 was 14T per 1,000 per annum of the population (the previous year being 11.5), whilst that for the whole of the Metropolis was 13.4. DEATHS FROM VIOLENCE.—Of the City deaths, 3.2 per cent, were caused by injuries or violence, as compared with 7.8 in 1920 and 5.7 in 1921. This is 3.7 below the average for the previous five years. PERCENTAGE OF REGISTERED DEATHS FROM VIOLENCE. Year. City of London. Metropolis. Per cent. Per cent. 1917 6.2 5.9 1918 4.2 5.6 1919 10.4 5.7 1920 7.8 4.7 1921 5.7 4.2 Average previous five years 6.9 5.2 1922 3.2 3 .3 DEATH RATES, PER 1,000 PER ANNUM. 105 Great Towns Year. City of London. of England and Metropolis. Wales. 1917 156 14.6 15.0 1918 20.9 18.2 18.9 1919 14.4 13.8 13.4 1920 15.6 12.5 12.6 1921 11.5 12.3 12.4 Average previous five years 156 143 14.5 1922 14 .1 13.0 13.4 The death rate from zymotic disease per 1,000 of the population was 0.59 compared with 1.14 in the Metropolis. The deaths from Phthisis correspond to a rate of 14 per 1,000 of the population, as compared with 1.04 in the Metropolis. 9 CAUSES OF, AND AGES AT, DEATH DURING THE YEAR 1022. Causes of Death. Nett Deaths at the subjoined ages of "Residents" Whether Occurring within or within the District (a) Total Deaths whether of "Residents" or "Nonresidents" in Institutions in the District (fc). All ages. Under 1 year. 1 and under years. 2 and under 5 years. 5 and under 15 years. 15 and under | 25 years. 25 and under 45 years 45 and under 65 years. 65 and up wards. 1 2 3. 4. 5. 6. 7. 8. 9. 10. 11. All causes Certified (c) 188 9 3 6 8 6 15 53 88 695 1 Uncertified 1. Enteric Fever ... ... ... ... ... ... ... ... ... 1 2. Small-pox ... ... ... ... ... ... ... ... ... ... 3. Measles 1 ... 1 ... ... ... ... ... ... 3 4. Scarlet Fever ... ... ... ... ... ... ... ... ... ... 5. Whooping Cough 2 ... 1 1 ... ... ... ... ... 1 6. Diphtheria and Croup 5 1 ... 2 2 ... ... ... ... 9 7. Influenza 3 ... ... ... ... ... ... ... 3 8 8. Erysipelas ... ... ... ... ... ... ... ... ... ... 9. Phthisis (Pulmonary Tuberculosis) 19 1 1 1 2 4 6 4 22 10. Tuberculous Meningitis 1 ... ... ... ... 1 ... ... ... 11 11. Other Tuberculous Diseases ... ... ... ... ... ... ... ... ... 12 12. Cancer, malignant disease 21 ... ... ... ... 1 1 12 7 89 13. Rheumatic Fever 2 ... ... ... ... ... 1 ... I 4 14. Meningitis (See Note (d) ) ... ... ... ... ... ... ... ... ... 13 15. Organic Heart Disease 39 ... ... ... ... ... 2 11 26 60 16. Bronchitis 22 1 ... ... ... ... 1 4 16 18 17. Pneumonia (all forms) 14 3 1 2 ... ... ... 5 3 63 18. Other diseases of respiratory organs 2 ... ... ... 1 ... ... ... 1 5 19. Diarrhoea and Enteritis (See Note (e) ) ... ... ... ... ... ... ... ... ... 6 20. Appendicitis and Typhlitis ... ... ... ... ... ... ... ... ... 21 21. Cirrhosis of Liver 1 ... ... ... ... ... 1 ... ... 3 21a. Alcoholism ... ... ... ... ... ... ... ... ... 22. Nephritis and Bright's Disease 4 ... ... ... ... ... ... 2 2 20 23. Puerperal Fever ... ... ... ... ... ... ... ... ... 3 24. Other accidents and diseases of Pregnancy and Parturition ... ... ... ... ... ... ... ... ... 6 25. Congenital Debility and Malformation, including Premature Birth 2 2 ... ... ... ... ... ... ... 26 26. Violent Deaths, excluding Suicide 5 ... ... ... ... ... ... 2 3 56 27. Suicide 1 ... ... ... ... ... 1 ... ... 6 28. Other Defined Diseases 44 1 ... ... 4 2 4 11 22 229 29. Diseases ill-defined or unknown ... ... ... ... ... ... ... ... ... ... Totals 188 9 3 6 8 6 15 53 88 695 10 INFANTILE MORTALITY. The deaths of children under one year of age were at the rate of 61 per 1,000 births, as against 74 for the whole of London. The table of infantile mortality on page 11 shows the deaths under one year of age according to monthly age periods. From this it will be seen that IT per cent, of these deaths occurred in the first month, 33 per cent, within the first three months and 44 per cent, during the first six months of existence. The figures in the City are so small that it is undesirable to use them as a basis for any definite conclusions, but it is of interest to note that these percentages show an extraordinary reduction compared with those reported in any previous year. For example, last year 66 per cent, of infant deaths occurred during the first month and during the year under review the percentage was only 11. These figures rather suggest that the great saving in infant mortality which has been a feature of recent years is as pronounced in the dangerous first month as in subsequent months. NOTIFICATION OF BIRTHS ACT, 1907, AND INFANT WELFARE WORK. No new work has been undertaken in connection with Infant Welfare Work. Care has, of course, continued to be given to the City infants and the usual clinic has been held every Wednesday at St. Bartholomew's Hospital. Supplies of milk, in some cases at cost price and in others free, have been provided in accordance with the scheme outlined in my last annual report. 383 notifications of births, made in accordance with the Notification of Births Act, were received. Of these only 110 belonged to the City, and the balance were transferred to the appropriate Authorities. VITAL STATISTICS. In the subjoined table comparisons are made between the vital statistics as recorded in the City of London and those recorded in the Metropolis for the year 1922 and the previous five years. No reliable conclusions can be drawn from these comparisons, and they are inserted merely as matters of interest. CITY OF LONDON COMPARED WITH THE METROPOLIS FOR THE YEAR 1922 AND THE PREVIOUS FIVE YEARS. City of London. Birth Rate Death Rate. Deaths of Children under 1 year to 1,000 Births. Violent Deaths, per cent, of Deaths Registered Deaths from principal Zymotic Disease per 1,000 of the Population. Estimated Night Population (Imperial Census). Estimated Day Population (Corporation Census). City. Metropolis. City. Metropolis. City. Metropolis. City. Metropolis City. Metropolis. 1917 14,720 $74,459 7.9 17.5 15.6 15.0 69 103 6.2 5.9 0.24 1.02 1918 13,900 376,186 7.3 16.1 20.9 18.9 148 107 4.2 5.6 0.50 1.31 1919 13,893 377,931 9.6 18.3 14.4 13.4 108 85 104 5.9 0.29 2.37 1920 12,200 379,694 14.9 26.4 15.6 12.6 66 76 7.8 4.7 0.49 1.45 1921 13,706 381,083 9.4 22.3 11.5 12.4 93 80 5.7 4.2 0.22 0.14 Average previous 5 years. 13,684 377,871 9.8 20.1 15.6 14.5 97 90 6.9 5.3 0.35 1.26 1922 13,360 382,408 11.1 210 141 13.4 61 74 3.2 3.3 0.59 1.14 11 CITY OF LONDON. INFANTILE MORTALITY DURING THE YEAR 1922 Nett Deaths from stated Causes at Various Ages under One Year of Age. causes of death. Under 1 Week. 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 4 Weeks. 1 Weeks and under 3 Months. 3 Months and under 6 Months 6 Months and under 9 Months. 9 Months and under 12 Months Total Deaths under 1 Year. All Causes. Certified 1 ... ... ... 1 2 1 4 1 9 Uncertified ... ... ... ... ... ... ... ... ... ... Small-pox ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... Scarlet Fever ... ... ... ... ... ... ... ... ... ... Whooping Cough ... ... ... ... ... ... ... ... ... ... Diphtheria and Croup ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... Tuberculous Meningitis ... ... ... ... ... ... ... ... ... ... Abdominal Tuberculosis ... ... ... ... ... ... ... ... ... ... Other Tuberculous Diseases ... ... ... ... ... ... ... 1 ... 1 Meningitis (not Tuberculous) ... ... ... ... ... ... ... ... ... ... Convulsions ... ... ... ... ... ... ... ... ... ... Laryngitis ... ... ... ... ... ... ... 1 ... 1 Bronchitis ... ... ... ... ... 1 ... ... ... 1 Pneumonia (all forms) ... ... ... ... ... ... ... 2 ... 2 Diarrhcea ... ... ... ... ... ... ... ... ... ... Enteritis ... ... ... ... ... ... ... ... ... ... Gastritis ... ... ... ... ... ... ... ... ... ... Syphilis ... ... ... ... ... ... ... ... ... ... Rickets ... ... ... ... ... ... ... ... ... ... Suffocation (overlying) ... ... ... ... ... ... ... ... ... ...... Injury at Birth 1 ... ... ... 1 ... ... ... ... 1 Atelectasis ... ... ... ... ... ... ... ... ... ... Congenital Malformations ... ... ... ... ... ... ... ... ... ... Premature Birth ... ... ... ... ... 1 ... ... ... 1 Atrophy, Debility and Marasmus ... ... ... ... ... ... ... ... ... ... Other Causes ... ... ... ... ... ... ... ... 1 2 1 ... ... ... 1 2 1 4 1 9 Nett Births in the year legitimate 136 Nett Deaths in the year of legitimate infants 9 illegitimate 12 illegitimate infant 0 12 VITAL STATISTICS OF WHOLE DISTRICT DURING 1922 AND PREVIOUS YEARS. Name of District: CITY OF LONDON. Year. Population estimated to Middle of each Year Births. Total Deaths Registered in the District. Transferable Deaths ‡ Nett Deaths belonging to the District. Uncorrected number. Nett. of Nonresidents registered in the District.† of Residents not registered in the District. † Under 1 Year of Age. At all Ages. Number. † Rate. Number. * Rate. Number. Rate per 1,000 nett Births. Number. * Rate. 1 3 4 5 6 7 8 9 10 11 12 13 1917 14,720 253 115 7.9 705 47.88 602 126 8 69 229 15.6 1918 13,900 314 101 7.3 637 45.82 517 171 15 148 291 20.9 1919 13,893 453 139 9.6 780 56.14 681 101 16 108 200 14.4 1920 12,200 470 182 14.9 842 69.01 728 77 12 66 191 15.6 1921 13,706 336 129 9.4 785 57.27 705 78 12 93 158 11.5 1922 13,363 360 148 11.1 809 60.54 719 98 9 61 188 14.1 Notes.—This Table is arranged to show the gross births and deaths in the district, and the births and deaths properly belonging to it with the corresponding rates. For years before 1911 some of the corrected rates probably will not be available. The rates should be calculated per 1,000 of the estimated gross population. In a district in which large Public Institutions for the sick or infirm seriously affect the statistics, the rates in Columns 5and 13 may be calculated on a nett population, obtained by deducting from the estimated gross population the average number of inmates not belonging to the district in such institutions. *In Column 6 are to be included the whole of the deaths registered during the year as having actually occurred within the district. In Column 12 is to be entered the number in Column 6, corrected by subtraction of the number in Column 8 and by addition of the number in Column 9. Deaths in Column 10 are to be similarly corrected by subtraction of the deaths under I, included in the number given in Column 8, and by addition of the deaths under 1 included in the number given in Column 9. †The Medical Officer of Health will be able from the returns made to him by the local Registrar of Deaths, as well as from the quarterly lists furnished by the Registrar.General, to fill in Column 8 in accordance with the rule in the next paragraph below. The Registrar.General, either directly or through the County Medical Officer of Health, will supply the Medical Officer of Health with the particulars of deaths to be entered in Column 9 ; and all such deaths must be included in this Column, unless an error is detected, and its correction has been accepted by the Registrar-General. For Column 4 the Registrar-General will furnish to the Medical Officer of Health a Statement of the number of births needing to be added to or subtracted from the total supplied by the local Registrar. ‡"Transferable Deaths" are deaths of persons who, having a fixed or usual residence in England or Wales, die in a district other than that in which they resided. The deaths of persons without fixed or usual residence, e.g., casuals, must not be included in Columns 8 or 9, except in certain instances under 3 (6) below. The Medical Officer of Health will state in Column 8 the number of transferable deaths of "non-residents" which are to be deducted, and will state in Column 9 the number of deaths of "residents" registered outside the district which are to be added in calculating the nett death-rate of his district. The following special cases arise as to Transferable Deaths:— (1) Persons dying in Institutions for the sick or infirm, such as hospitals, lunatic asylums, workhouses, and nursing homes (but not almshouses) must be regarded as residents of the district in which they had a fixed or usual residence at the time of admission. If the person dying in an Institution had no fixed residence at the time of admission, the death is not transferable. If the patient has been directly transferred from one such Institution to another, the death is transferable to the district of residence at the time of admission to the first Institution. (2) The deaths of infants born and dying within a year of birth in an Institution to which the mother was admitted for her confinement should be referred to the district of fixed or usual residence of the parent. (3) Deaths from Violence are to be referred (a) to the district of residence, under the general rule ; (b) if this district is unknown, or the deceased had no fixed abode, to the district where the accident occurred, if known; (c) failing this, to the district where death occurred, if known ; and (d) failing this, to the district where the body was found. Total population at all ages 13,706 Area of City of London in acres (land and inland water) 661 Number of inhabited houses 2,922 Average number of persons per house 4.6 At Census 1921. 13 VACCINATION. Of the 365 births notified to the Vaccination Officers during 1922, 102 had been successfully vaccinated by the end of the year, 19 had died before the age for vaccination, and in no case was a child reported as insusceptible. Vaccination was postponed by medical certificate in 1 case, 178 had removed into other districts, or the vaccinations were pending at the end of the year. There were 65 instances of conscientious objection. The Public Vaccinators performed 5,421 re-vaccinations during the year, and in addition to the 102 successful vaccinations referred to above, 991 persons were vaccinated for the first time, chiefly during the period of smallpox prevalence in London. VACCINATION STATISTICS IN THE CITY OF LONDON. Year. Number of Births notified to Vaccination Officer Successfully Vaccinated. Insusceptible. Had Small-pox. Died before Vaccination. Vaccination postponed. Cases pending or removed at the end of the year. Conscientious objections. 1917 per cent. per cent. per cent. per cent. per cent. per cent. per cent. 254 39.3 Nil. Nil. 5.9 0.8 37.1 16.9 1918 312 22 .7 „ „ 10.5 0.7 54.5 11.6 1919 460 23.7 „ „ 10.0 0.7 50.6 15.0 1920 471 31.4 „ „ 4.6 1.2 42.2 203 1921 341 19.6 „ „ 9.4 0.6 49.9 20.5 Average previous 5 years. 369 27.3 „ „ 81 0.8 46.9 16.9 1922 365 27.9 „ „ 53 0.3 48.7 17.8 HOUSING. QUEEN'S COURT, MINORIES AREA. In November, 1921, I submitted to the Sanitary Committee of the Corporation a representation that houses numbered 1, 2, 3 & 4, Queen's Court, 3 & 5, Vine Street and No. 7, The Circus, Minories, constituted an area which should be dealt with under Part II. of the Housing of the Working Classes Act, 1890. The Sanitary Committee approved this recommendation and a scheme was prepared and a local enquiry held at the Guildhall by the Ministry of Health on the 18th May, 1922. On the 19th October last, the City of London (Queen's Court, Minories Area Improvement Scheme) Order, was issued approving the scheme. In brief, the scheme, which affects 72 residents, provides that the Corporation shall, except so far as the Minister may otherwise direct, demolish all the buildings in the area, provided that they shall not demolish any occupied house until accommodation for the occupants is available in new dwellings to be erected by the Corporation unless the Corporation are satisfied that suitable alternative accommodation for the occupants is available elsewhere. Further, the Corporation has to provide on an approved site and in accordance with approved plans, dwellings suitable for the accommodation of 72 persons of the working classes. The Corporation acquired possession of the property by private treaty before the scheme was approved. As the tenements become empty they are not re-let, and in this way it is hoped that in a short time the whole property will be available for demolition. At the time of writing this report the occupants have vacated Nos. 1, 3 & 4, Queen's Court and these premises have therefore been closed and not re-let. c 14 HUTCHISION STREET AREA IMPROVEMENT SCHEME. The above-mentioned improvement scheme was the subject of an enquiry at the Guildhall by the Ministry of Health in March, 1920. The scheme received the approval of the Ministry on the 10th August last, and negotiations are now in progress between the Corporation and the several owners with a view to the former acquiring possession of the properties within the area covered by the scheme. The scheme makes it obligatory on the Corporation to provide on a site or sites and in accordance with plans to be approved by the Ministry, dwellings suitable for the accommodation of 885 persons of the working classes, of which persons 250 shall be provided with accommodation within the area of the scheme. The details relating to this scheme are now regularly receiving the attention of the Sanitary Committee. HOUSING STATISTICS. Number of new houses erected during the year:— (a) Total Nil. (b) As part of a municipal housing scheme Nil. 1. Unfit Dwelling Houses. Inspection—(1) Total number of dwelling houses inspected for housing defects (under Public Health or Housing Acts) 771 (2) Number of dwelling houses which were inspected and recorded under the Housing (Inspection of District) Regulations, 1910 163 (3) Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation Nil. (4) Number of dwelling houses (exclusive of those referred to under the preceding heading) found not to be in all respects reasonably fit for human habitation Nil. 2. Remedy of Defects without Service of formal Notices. Number of defective dwelling houses rendered fit in consequence of informal action by the Local Authority or their Officers 150 3. Action under Statutory Powers. A.—Proceedings under Section 28 of the Housing, Town Planning, etc., Act, 1919. (1) Number of dwelling houses in respect of which notices were served requiring repairs Nil. (2) Number of dwelling houses which were rendered fit:— (a) by owners Nil. (b) by Local Authorities in default of owners Nil. (3) Number of dwelling houses in respect of which Closing Orders became operative in pursuance of declarations by owners of intention to Nil. B.—Proceedings under Public Health Acts. (1) Number of dwelling houses in respect of which notices were served requiring defects to be remedied 294 (2) Number of dwelling houses in which defects were remedied:— (a) by owners 282 (b) by Local Authorities in default of owners Nil. C.—Proceedings under Sections 17 and 18 of the Housing, Town Planning, etc., Act, 1909. (1) Number of representations made with a view to the making of Closing Orders Nil. (2) Number of dwelling houses in respect of which Closing Orders were made Nil. (3) Number of dwelling houses in respect of which Closing Orders were determined, the dwelling houses having been rendered fit Nil. (4) Number of dwelling houses in respect of which Demolition Orders were made Nil. (5) Number of dwelling houses demolished in pursuance of Demolition Orders Nil. The majority of the houses occupied by people of the working classes have been inspected and recorded. VERMINOUS CONDITION OF CHILDREN. During the course of investigation into housing conditions in a block of premises at the western end of the City, the Inspector found three young children in an exceedingly neglected and filthy condition. The circumstances were reported to the National Society for the Prevention of Cruelty to Children who were successful in securing the removal of all the children to the Infirmary, and who subsequently prosecuted the parents for cruelty and neglect. 15 On the statement of the Society that there was evidence of improved conditions and that some attempt at cleansing was being made the case was adjourned for one month to see whether such improvement was maintained. At the adjourned hearing the Magistrate was satisfied that the conditions were then satisfactory and permitted the parents to receive the children back from the Infirmary. The mother was bound over for six months and the father acquitted. Further complaints during the present year (1923) were necessary in respect of this family and proceedings resulted in both parents being imprisoned and the children removed to a residential institution. INFECTIOUS DISEASES. Few comments are necessary with reference to the incidence of infectious disease during the year 1922. Diphtheria was prevalent to the extent of 40 cases as compared with 33 in 1921. The number of Scarlet Fever cases was 32 compared with 89 in 1921. Erysipelas showed a decrease from six to four. No case of Measles was brought to my notice, measles and rubella not being notifiable diseases. Two cases only of Chicken-pox were notified and one of Ophthalmia Neonatorum. The percentage of cases removed to hospital for treatment continues satisfactory, viz. : 94 8. During 1922 anxiety was caused on account of the cases of Small-pox reported at different times in various neighbourhoods. In several instances of illness where the medical practitioners suspected Small-pox the patients were personally visited and examined by your Medical Officer of Health who found them to be suffering from other ailments which were perhaps difficult of diagnosis in their early stages of development. As is not unusual, however, numerous contacts with cases occurring outside the City were reported. These were visited and kept under observation and where necessary, vaccination advised. No cases of Small-pox occurred within the City. In each instance of notified disease a detailed examination is made of the sanitary condition of the premises where the case occurred and a summary of defects found by the District Inspector is given on page 69. NOTIFICATION OF INFECTIOUS DISEASES.—In the following tables will be found particulars of certificates relating to cases of infectious disease, forwarded to the Medical Officer of Health under Sections 55 and 56 of the Public Health (London) Act, 1891, and information as to the removal of patients to hospitals, infirmaries, &c. 16 NAME OF DISEASE. Number of Certificates received. Treated at Home. Removed to the Metropolitan Asylums Board Hospitals. Removed to the London Fever Hospital. Treated at other Hospitals and Infirmaries. Duplicate Certificates received. Diagnosis subsequentlyfound to be incorrect. Net number of Cases. Small-pox .... .... .... .... .... .... .... .... Diphtheria 44 .... 33 l 6 l 3 40 Scarlet Fever 36 .... 28 4 .... 3 1 32 Enteric Fever .... .... .... .... .... .... .... .... Puerperal Fever .... .... .... .... .... .... .... .... Erysipelas 4 3 .... .... 1 .... .... 4 Cerebro-spinal Meningitis .... .... .... .... .... .... .... .... Acute Polio-myelitis .... .... .... .... .... .... .... .... Ophthalmia Neonatorum 2 l .... .... .... 1 .... 1 Measles .... .... .... .... .... .... .... .... Rubella .... .... .... .... .... .... .... .... Malaria contracted abroad 1 .... .... .... 1 .... .... 1 Acute Primary Pneumonia 7 l .... .... 6 .... .... 7 Acute Influenzal Pneumonia 1 l .... .... .... .... .... 1 Totals 95 6 61 5 14 5 4 86 Chicken-pox .... 2 2 .... .... .... .... .... 2 Totals 97 8 61 5 14 5 4 88 The following is a return of infectious diseases which have occurred in the City of London, exclusive of Tuberculosis, Measles, Rubella, Malaria, Pneumonia and Chicken-pox, with the percentages of such cases removed to hospitals for treatment or nursed at home during 1922 compared with the figures for the previous five years:— Number of Per cent, of cases reported. Year. cases reported. Removed to Hospital Treated at home 1917 51 94.1 .... .... 5'9 1918 42 88.1 11-9 1919 41 90.2 9 8 1920 74 91.9 8-1 1921 131 95.4 4 6 Average for the five years 67.8 91.9 8.1 1922 77 94.8 5.2 17 CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR 1922. NUMBER OF CASES NOTIFIED. DISEASES. At Ages—Years. No. of Cases Removed Hospital. * At all ages. Under 1 year. l year and under years. 2 years and under 3 years. 3 years and under 4 years. 4 years and under 5 years. 5 years and under 10 years. 10 years 'and under 15 years. 15 years and under 20 years. 20, years and under 35 years. 35 years and under 45 years. 45 years and under 65 years. 65 years and over. Small-pox .... .... .... .... .... .... .... .... .... .... .... .... .... Cholera .... .... .... .... .... .... .... .... .... .... .... .... .... .... Plague .... .... .... .... .... .... .... .... .... .... .... .... .... .... Diphtheria 40 l l 4 .... 2 13 3 2 12 2 .... .... 40 Erysipelas 4 .... .... .... .... .... .... .... .... .... .... 3 1 1 Scarlet Fever 32 .... 1 .... 2 3 10 6 l 9 .... .... .... 32 Typhus .... .... .... .... .... .... .... .... .... .... .... .... .... .... Enteric „ .... .... .... .... .... .... .... .... .... .... .... .... .... .... Relapsing „ .... .... .... .... .... .... .... .... .... .... .... .... .... .... Continued „ .... .... .... .... .... .... .... .... .... .... .... .... .... .... Puerperal „ .... .... .... .... .... .... .... .... .... .... .... .... .... .... Polio-myelitis .... .... .... .... .... .... .... .... .... .... .... .... .... .... ....Cerebro-spinal Meningitis .... .... .... .... .... .... .... .... .... .... .... .... .... .... Pulmonary Tuberculosis 28 .... .... .... .... 1 2 1 3 7 5 9 .... 18 Other forms of Tuberculosis 2 .... .... .... .... .... 1 1 .... .... .... .... .... 1 Ophthalmia Neonatorum 1 l .... .... .... .... .... .... .... .... .... .... .... .... Measles .... .... .... .... .... .... .... .... .... .... .... .... .... .... Rubella .... .... .... .... .... .... .... .... .... .... .... .... .... .... Malaria (contracted abroad) 1 .... .... .... .... .... .... .... .... 1 .... .... .... 1 Acute Primary Pneumonia 7 .... .... .... .... .... 2 .... .... 2 1 1 1 5 Acute Influenzal Pneumonia 1 .... .... .... .... .... .... .... .... .... .... 1 .... .... Totals 116 2 2 4 2 6 28 11 6 31 8 14 2 98 * Metropolitan Asylums Board Hospitals, London Fever Hospital, City of London Infirmary, St. Bartholomew's Hospital, City Police Hospital, Sanatoria, &c. 18 ISOLATION ACCOMMODATION —6, BRIDGEWATER SQUARE. In view of the prevalence of Small-pox it was considered desirable to make some additions to the equipment at the Isolation Centre established by the Corporation at 6, Bridgewater Square. The equipment of this Centre has for economic reasons been kept as low as possible, as it was considered that the probability of it being required for use was somewhat remote. Only such apparatus as could not be provided immediately had been installed, and it was the intention to obtain whatever else was necessary when the circumstances demanded it. The Corporation has received notice to vacate this building in March, 1924, and enquiries are now being instituted to discover alternate accommodation. ANTHRAX AND BRISTLES. The City was associated during the year with a neighbouring Borough concerning the investigation of a case of Anthrax occurring in the person of a man working in Shoreditch who had been handling bristles from China and horse hair from Russia. Examination of the bristles and horsehair at the place of employment revealed the presence of anthrax in both. It was ascertained that the Chinese bristles had been obtained from a firm of City merchants. Samples of these bristles still unsold and remaining in the City were bacteriologically examined by Sir Frederick Andrewes, who reported as follows:— Re Chinese Bristles and Anthrax. "The three samples were emulsified in broth and a very dirty fluid obtained, which "was heated to 80 degrees C for 15 minutes. One c.c. was injected, from each fluid, into a "guinea pig. The animals are unharmed (8 day's). "Cultures were also made from the heated fluids and anthrax-like colonies grew, but "none of these on further examination proved to be B. anthracis. "These bristles are therefore apparently free from anthrax spores." A subsequent examination made of an unopened case of the bristles at the premises where the patient worked yielded negative results so far as anthrax was concerned, and in all probability the infection of both the patient and the sample of Chinese bristles found contaminated was due to the stock of Russian horse hair on the premises. TUBERCULOSIS. Dr. H. B. Gibbins, who has been associated with the tuberculosis dispensary since its inception, resigned on April 30th, 1922, and was succeeded by Dr. F. H. Young, O.B.E., on July 1st, 1922. The following particulars have been furnished by Dr. Young:— TUBERCULOSIS DISPENSARY.—The Tuberculosis Dispensary has been open for the diagnosis and treatment of tuberculosis of various types on Tuesdays and Fridays, 12-30 to 3-30; Mondays 5 to 7-30 and Thursdays 6 to 7-30. In all 202 sessions have been held. In addition, the Tuberculosis Officer visits cases in their own homes when necessary. NEW' PATIENTS.—The number of new patients examined was 351. Tliev mav be summarised as follows:— A.—PATIENTS RESIDENT IN THE CITY, 133. Number of Under observation at the Dispensary on Jan. 1st, pending diagnosis. Examined for the first time during the year. Found to be Lender observation at the Dispensary on Dec. 31st, pending diagnosis. Ceased attendance before completion of diagnosis. Total. Suffering from Tuberculosis. Not suffering from Tuberculosis. Pulmonary. NonPulmonary. (a) All persons (including contacts) Adults M 10 29 39 13 .... 24. .... 9 F 16 16 32 5 l 25 l .... Children under 15 M 11 23 34 1 l 31 l F 14 14 28 2 25 l .... Total *51 82 133 21 2 105 0 3 (b) "Contacts" (included in (a)) Adults M 6 7 13 .... .... 12 .... 1 F 12 8 20 2 .... 18 .... .... Children under 15 M 14 21 1 .... 19 1 .... F 8 12 20 .... .... 19 1 .... (c) Insured persons (included in (a)) i M 5 14 19 6 .... 13 .... .... F 3 2 5 1 .... 4 .... .... * This includes all patients attending on January 1st, 1922, who had not been diagnosed or notified as Tuberculous. 19 B.—PATIENTS RESIDENT OUTSIDE THE CITY OF LONDON, 218. Number of Under observation at the Dispensary on Jan. 1st. pending diagnosis. Examined for the first time during the year. Total. Found to be Under observation at the Dispensary on Dec. 31st, pending diagnosis. Ceased attendance before completion of diagnosis. Suffering from Tuberculosis. Not suffering from Tuberculosis. Pulmonary. NonPulmonary. (a) All persons (including contacts) Adults | M 27 72 99 35 2 56 2 4 F 26 57 83 30 2 49 2 Children under 15 M .... 10 10 .... 2 5 2 l F 10 16 26 3 1 21 1 .... Total *63 155 218 68 7 131 7 5 (b) "Contacts" (included in (a)) Adults M .... .... .... .... .... .... .... .... F .... .... .... .... .... .... .... .... Children under 15 M .... .... .... .... .... .... .... .... F .... .... .... .... .... .... .... .... (c) Insured persons (included in (a)) M 18 41 59 24 .... 29 2 4 F 15 25 40 12 .... 27 1 .... PATIENTS REFERRED TO THE HOSPITAL.—The following is the summary of patients referred to the various departments of St. Bartholomew's Hospital for help in diagnosis or treatment: Resident. Non-Resident. Total. Referred to X-Ray Department 18 24 42 „ Surgical „ — 4 4 ,, Dental ,, 8 4 12 ,, Throat „ 6 6 12 „ †Pathological „ 12 3 ,, Other „ 3 3 6 36 43 79 PATIENTS ADMITTED TO THE HOSPITAL FOR DIAGNOSIS.—The wards of the Hospital are open for the reception of cases presenting difficulties of diagnosis which can only be overcome by observation as In-patients. One resident and 4 non-resident patients were admitted for this purpose. EXAMINATION OF SPUTUM.—The following is a summary :— City Residents. Non-Resident. Total. Positive 11 20 31 Negative 38 157 195 RESIDENTIAL TREATMENT.—The number of patients for whom residential treatment was arranged was 27. They are summarised as follows:— Admitted to Poor Law Other L.C.C. Institutions. Institutions. Institutions. Total. Patients resident in the City 10 2 5 17 Patients non-resident but working in the City 5 — 5 10 15 2 10 27 Persons neither resident or working in the City are transferred immediately to their own Tuberculosis Officer and arrangements are made by him. This system has worked satisfactorily. PERSONS TREATED.—(A) Patients resident in the City. All persons suffering from tuberculosis who are resident in the City are supervised and treated at the Dispensary. The total number of cases so treated was 50. (B) Patients non-resident in the City. (a) Who work in the City. * This includes all patients attending on January 1st, 1922, who had not been diagnosed or notified as Tuberculous. † This does not include examination of sputum. 20 On diagnosis these patients are informed that they can be treated and advised at the Dispensary or transferred to the Tuberculosis Officer of their own Borough. The majority decide to remain patients at the Dispensary. The number so treated was 67. (b) Who do not work in the City. On diagnosis these patients are transferred to the Tuberculosis Officer of their own Borough, so none are treated here. TOTAL ATTENDANTE— Insured. Non-Insured. Total. Residents 288 517 805 Non-Residents 650 626 1,276 2,081 THE TUBERCULOSIS NURSE.—The work of the Tuberculosis Nurse has been continued on the same lines as former years. 72 homes have been visited and 591 visits made in connection with after care and following up. In addition to the above, patients, some of whom were in an advanced stage of the disease, have been nursed in their own homes. Three of these cases terminated fatally. For nursing purposes 15 visits were paid. (These figures are lower than usual as the official Tuberculosis Nurse was away on sick leave for three months and in addition no cases at home needed daily visits over long periods). The following information is supplied in accordance with the requirements of the Ministry of Health. The paragraph numbers correspond with those in Circular 168, and where a number is omitted the subject matter does not concern City work:- (i.) The Tuberculosis Dispensary is at St. Bartholomew's Hospital; the Tuberculosis Officer is Dr. F. H. Young, O.B.F. ; one Tuberculosis Nurse is engaged in the work. Treatment in residential institutions is provided for insured and uninsured persons by the London County Council. (iii.) Patients are referred to the Tuberculosis Dispensary from hospitals, school clinics and other institutions, with all of which there is close co-operation. The services of the Staff and all the resources of St. Bartholomew's Hospital are available for diagnosis and treatment. Many patients are referred to departments of the Hospital for these purposes. (iv.) The Tuberculosis Officer is in constant consultation and communication with general practitioners, so that there is close co-operation between them and the Dispensary. He reminds them when reports are due on insured patients under domiciliary treatment and provides them with copies of the form with names and addresses inserted. (v.) When the diagnosis is in doubt and the patient is under the care of a practitioner, arrangements are made with him for re-examination ; in other cases arrangements are made with the patient, but should he fail to attend, either the Tuberculosis Nurse calls upon him or he is reminded of the appointment in writing. (vi.) The Tuberculosis Officer explains to the patients the importance of the examination of home contacts, and in addition to the necessary visits of the Sanitary Inspectors the Tuberculosis Nurse visits the homes of City residents periodically for the same purpose, and arranges for the attendance of the contacts at the Dispensary at times convenient to them. The supervision of these contacts and the re-examination of suspects among them, is secured by the home visits periodically made by the Nurse. (vii.) X-ray photographs of 42 patients have been taken during the year, and have proved of value as an addition to the usual methods of diagnosis. The usual methods of treatment have been continued in the Dispensary. Tuberculin has been used in a few cases. In addition, two cases of pulmonary tuberculosis are attending for the continuation of their treatment by artificial pneumothorax. It is hoped to use this very promising method of treatment in suitable cases as they arise. (viii.) Experience shows that when the disease is active, residence in an institution more quickly and certainly brings about arrest than when treatment is attempted at home on sanatorium lines, and that the lessons learnt in the sanatorium are sometimes put into practice by the patient on his return home to his permanent advantage. (ix.) Dental treatment is provided by the Dental Department of St. Bartholomew's Hospital, and the Corporation defrays the whole or part of the cost of artificial dentuies . for necessitous cases. (x.) Nursing in their own homes of patients resident in the City is one of the duties of the Tuberculosis Nurse. Milk has been provided for necessitous persons requiring extra nourishment and in this connection the sum of £20 has been expended. (xi.) Patients suffering from Non-pulmonary Tuberculosis receive advice and treatment from the Surgeons of St. Bartholomew's Hospital, to whom they are referred from the Dispensary. Treatment in residential institutions is provided as for pulmonary cases. The Corporation supplies surgical apparatus free of cost for necessitous residents in the City. to y—i TUBERCULOSIS. PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1912. Summary of Notifications during the period from the 1st January to the 31st December, 1922, in the City of London. AGE-PERIPDS Notifications on Form A- Notifications on Form B t Number of Notifications on Form c Number of Primary Notifications.* Total Notifications on Form A Number of Primary Notifications.* Total Notifications on Form B. Poor Law Institutions Sanatoria. 0 to 1 1 to 5 5 to 10 10 to 15 15 to 20 20 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 and upwards Total Primary Notifications Under 5 5 to 10 10 to 15 Total Primary Notifications Pulmonary Males .... .... 2 .... 2 4 2 4 7 1 .... 22 33 .... .... .... Nil. Nil. 2 15 „ Females .... .... 1 1 1 .... 1 1 1 .... .... 6 10 .... .... .... „ „ .... 5 Non-pulmonary Males .... .... 1 .... .... .... .... .... .... .... .... 1 l .... .... .... „ „ .... 1 „ ,, Females .... .... .... .... 1 .... .... .... .... .... .... I l .... .... .... „ „ .... 1 Col. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) (17) (18) (19) (20) (21) Patients notified as suffering from both pulmonary and non-pulmonarv disease have been included among the " pulmonary " returns only. All notifications on Form D have been disregarded in preparing this return. *Primary notifications relate to patients who have not previously been notified in this or former years, either on form A or on Form B. in the area to which the return relates. Any additional notification of a case which has been previously notified in the area is regarded as duplicate. (Note.—No primary notifications should be made on Form C.) †A School Medical Inspector, or the Medical Officer of Health of a county, county borough, or other district, if acting as a School Medical Inspector, is required to notify on Form B all cases of tuberculosis discovered in the course of inspection of children attending public elementary schools whether or not these have previously been notified. Cols. 2-13. Only those cases which have been notified for the first time during the year on Form A in the area concerned, and which have never previously been notified in the area, either on Form A or on Form B, have been included in these columns. Col. 14. The object of this column is to show the extent to which duplicate notification of the same case occurs on Form A, and all notifications on Form A, whether duplicate or not, are included in this column. Cols. 15-18. Only those cases which have been notified for the first time during the year on Form B in the area concerned, and which have never previously been notified in the area, either on Form A or on Form B, have been included in these columns. Col. 19. All notifications which have been made during the year on Form B in the area concerned, whether the cases have previously been notified in the area, or not, either on Form A or on Form B, have been included in this column. 22 (xii.) The arrangements for "care" and "after care" are carried out by a subcommittee of the Sanitary Committee, on which two ladies are co-opted as members. It receives detailed reports on all cases of Tuberculosis occurring among City residents. (xiii.) No local arrangements exist for providing employment for patients. (xiv.) No opportunity has arisen for the use of a shelter, but arrangements would be made for any suitable case if a site were available. (xv.) No special points have been noted as to the incidence of Tuberculosis ; the records do not show that the disease is specially prevalent among any class of workers in the City. (xvi.) The usual methods for preventing the spread of infection are adopted, and pocket sputum flasks are provided free of cost. (xvii.) The principal difficulty encountered occurs on the discharge of a patient from a sanatorium with the disease arrested. The home environment to which he returns is often unsatisfactory; suitable occupation near his home may be practically unobtainable, even when remuneration is not the main consideration, and the very considerable benefit gained is in some cases soon lost and the treatment in the sanatorium largely wasted. CONSUMPTION—SPITTING.—The objectionable habit of spitting in the streets and other public places, and also the corridors of large buildings occupied by a number of different firms, is still a source of nuisance. Precautionary notices issued by the Corporation drawing attention to this practice are distributed to bona-fide applicants. EXAMINATION FOR PATHOGENIC BACTERIA. Any medical practitioner desiring examinations of specimens for Pathogenic Bacteria in cases of suspected infectious disease occurring amongst their patients residing in the City, should forward them to the Medical Officer of Health at the Guildhall. Arrangements have been made for free examination, and the results obtained are communicated as speedily as possible. During the year the following specimens were so dealt with. It will be seen that positive results were obtained in 17 8 per cent, of these cases. Result. Specimen. Disease suspected. Positive. Negative. 88 Swabbings from throats Diphtheria 16 72 13 Sputum Tuberculosis 2 11 Of the 88 swabbings from throats, 42 were received from the Central Foundation School for Girls, Spital Square, E.C. These swabs were sent to the City Pathologist in accordance with the arrangements between the City Corporation and the London County Council. This school is situate partly in the City and partly in the Metropolitan Borough of Shoreditch, and pupils attend from many parts of the East and North-East of London, and also Boroughs and Urban districts in Essex and Middlesex. HYGIENE OF HAIRDRESSERS' AND BARBERS' SHOPS. The Registered Hairdressers establishments throughout the City remain under the supervision of your officers, and there are now six proprietors of these places who hold certificates, and have undertaken to comply with the Regulations of the Corporation for the conduct of their business. The following is a list of those proprietors at present on the Register:— Kingston and Hubbard, 8 and 10, Ludgate Arcade. Chas. Lehman, 8 and 9, Aldermanbury Postern. Martin Longman, 75, Mark Lane. Thos. W. Monk, 5, Angel Court. Marsh and Prince, 36, Coleman Street. Harry G. Wicks, trading as Arthur and Co., 42a, Old Broad Street. The Hairdressers establishment formerly conducted at No. 16, Lawrence Lane, has been discontinued and at No. 35, Bucklersbury there has been a change of proprietorship. 23 DESTRUCTION OF A QUANTITY OF COCAINE. At the request of the Commissioner of the City Police I undertook the destruction of a small quantity of cocaine which had been seized in the City of London. The cocaine was destroyed by being burnt in the furnace at the City Disinfecting Station in the presence of the representative of the Police Authorities. VENEREAL DISEASES. I have already referred to the fact that the Centre for the treatment of venereal diseases requires to be extended. The scheme which I referred to last year as having been prepared cannot yet be proceeded with, and for a further twelve months the Centre will continue on existing lines. When financial conditions are less urgent, doubtless, the necessary improvements will be revised and reconsidered. The cost of the Centre during the year under review exceeded £3,000. At the beginning of the year, 452 males and 150 females were registered on the books as receiving treatment, which compares with 661 males and 212 females in the previous year. Of these patients, 254 males and 98 females were under treatment for syphilis and 198 males and 52 females for gonorrhoea. The decrease of patients is pronounced in connection with both diseases. New patients admitted totalled 583 as compared with 758 in the previous year and 1,053 in 1920. 40 males and 24 females, suffering from syphilis, discharged themselves before completing the first course, and 17 males and 4 females after the first course but before completing treatment; 14 males and 2 females completed treatment but no final tests were applied; 13 males and 3 females were transferred to other centres, whilst 10 males and 4 females were discharged after completion of treatment and observation. In the case of gonorrhoea, 104 males and 28 females out of the total of 261 and 59 of the respective sexes coming under treatment discharged themselves before completion of the first course of treatment. The total number of attendances of all persons at the Clinic was 16,702, which total is made up as follows .- Syphilis. Soft Chancre. Gonorrhoea. Non-Venereal Conditions. Total Attendances. Male. Female. Male. Female. Male. Female. Male. Female. Male. Female. 5,603 2,534 7,292 1,264 28 12,895 3,807 A few beds are provided at the Centre for in-patient treatment and the number of days of such treatment totalled 117 for males and 53 for females. In the laboratories associated with the Centre, 4,774 specimens were examined, 91 for the detection of spirochetes and 1,717 for gonococci. 2,951 examinations for the Wassermann reaction were undertaken, also 15 other examinations. The following tabulation indicates the number of patients coming under treatment from the Counties stated and also the examinations which were made for Gonococci and Wassermann reaction in respect of these patients:— No. of patients treated. Examinations. For Syphilis. For Gonorrhoea. For Non-Venereal For Gonococci. For Wassermann. Conditions. London 123 233 28 1,522 1,354 Essex 37 34 Nil 50 81 Hertfordshire 5 3 Nil 10 11 Surrey 5 4 Nil 6 9 Kent 12 9 Nil 4 10 Middlesex 53 40 Nil 98 109 Total 235 323 28 1,690 1,574 Included in the above total were 27 examinations for gonococci and 1,377 examinations for the Wassermann reaction at the request of general practitioners. d 2 24 RETURN RELATING TO ALL PERSONS WHO WERE TREATED AT THE TREATMENT CENTRE AT 20, GOLDEN LANE, E.C. 1, DURING THE YEAR ENDED THE 31st DECEMBER, 1922. Syphilis. Soft Chancre. Gonorrhœa. Conditions other than Venereal. Total. Males Females Males Females Males Females Males Females Males Females 1. Number of persons who, on the 1st January, 1922, were under treatment or observation for:— 254 98 .... .... 198 52 .... .... 452 150 2. Number dealt with during the year in the out-patient Clinic for the first time and found to be suffering from:- Syphilis only 177 58 .... .... .... .... .... .... 177 58 Soft chancre only .... .... .... .... .... .... .... .... .... .... Gonorrhœa only .... .... .... .... 261 59 .... .... 261 59 Syphilis and soft chancre .... .... .... .... .... .... .... .... .... .... Syphilis and gonorrhœa 21 2 .... .... 21 2 .... .... 21 2 Gonorrhœa and soft chancre .... .... .... .... .... .... .... .... .... .... Syphilis, soft chancre and gonorrhœa .... .... .... .... .... .... .... .... .... .... Conditions other than venereal .... .... .... .... .... .... 28 .... 28 .... Total—Item 2 177 58 .... .... 261 59 28 .... 466 117 Total*—Items 1 and 2 431 156 .... .... 459 111 28 .... 918 267 3. Number of persons who ceased to attend the out-patient Clinic (a) before completing the first course of treatment for 40 24 .... .... 104 28 .... .... 144 52 (b) after one or more courses but before completion of treatment for 17 4 .... .... .... .... .... .... 17 4 (c) after completion of treatment, but before final tests as to cure of 14 2 .... .... 98 14 .... .... 112 16 4. Number of persons transferred to other Treatment Centres after treatment for 13 3 2 1 15 4 5. Number of persons discharged from the out-patient Clinic after completion of treatment and observation for:— 10 4 .... .... 19 8 .... .... 29 12 6. Number of persons who, on the 1st January, 1923, were under treatment or observation for:— 337 119 .... .... 236 60 28 .... 601 179 Total*—Items 3, 4, 5, & 6 431 156 .... .... 459 111 28 .... 918 267 7. Total attendances of all persons at the out-patient Clinic who were suffering from:— 5,603 2,543 .... .... 7,292 1,264 .... .... 12895 3,807 8. Aggregate number of "In-patient days" of treatment given to persons who were suffering from:— 46 17 .... .... 71 36 .... .... 117 53 For detection of For Wassermann Reaction. Spirochetes. Gonococci. Other Organisms. 9. Examinations of Pathological material:— (a) Specimens which were examined at, and by the Medical Officer of, the Treatment Centre 91 1,690 15 1,574 =3,370 (b) Specimens from persons attending at the Treatment Centre which were sent for examination to an approved laboratory .... 27 .... 1,377 = 1,404 = 4,774 25 Statement showing the services rendered at the Treatment Centre during the year, classified according to the areas in which the patients resided. Name of County or County Borough (or Country in the case of persons residing elsewhere than in England and Wales) to be inserted in these headings. London. Essex. Herts. Middlesex. Surrey. Kent. Total. A. Number of persons from each area dealt with during the year at or in connection with the out-patient Clinic for the first time and found to be suffering from:— Syphilis 123 37 5 53 5 12 .... .... .... .... .... 235 Soft chancre .... .... .... .... .... .... .... .... .... .... .... .... Gonorrhœa 233 34 3 40 4 9 .... .... .... .... .... 323 Conditions other than venereal 28 .... .... .... .... .... .... .... .... .... .... 28 Total 384 71 8 93 9 21 .... .... .... .... .... 586 B. Total number of attendances at the out-patient Clinic of all patients residing in each area 15,084 629 38 832 49 70 .... .... .... .... .... 16,702 C Aggregate number of "Inpatient days" of all patients residing in each area 106 6 40 9 3 12 .... .... .... .... .... 170 D. Number of doses of Salvarsan substitutes given in the:— 1. Out-patient Clinic 1,782 204 22 567 19 32 .... .... .... .... .... 2,626 2. In-patient Dept. to patients residing in each area. 6 .... .... .... 2 3 .... .... .... .... .... 11 E. Give the names of Salvarsan substitutes used in the treatment of syphilis and the usual initial and final doses. F. State the amount and kind of treatment usually administered to a case of Syphilis of each of the types usually dealt with at the Treatment Centre. G. State the nature of tests applied in deciding as to discharge of patients referred to in Item 5 on previous page. Nov.-Arsenobenzol. Corbiere .45 to .9 Nov.-Arsenobillon .45 to .9. Routine, 8 N.AB. +12 to 15 Hyd. alternately. 3 to 4 courses with periods of rest from 4 to 12 wks., with H.I. courses. W.R. every 3 mths. for 1 yr., every 6 mths. 2nd yr. after cessation of treatment; these yearly as long as patient attends. Gonorrhœa.—Female. Films (cultures in some cases) from urethra, cervix and, if necessary, Bartholin's glands, on at least 3 occasions, immediately after successive menstrual periods treatment having ceased. Males. After cessation of treatment and urethroscopy, patient put on alcohol for 3 wks., films, and in some cases, cultures are made from urethral discharge, if any, from urinary threads, if any, and from prostatic and vesicular secretions, after massage. Date 7 /2 /23. (Signed) KENNETH M. WALKER, Medical Officer of the Treatment Centre, 26 SMOKE AND ATMOSPHERIC POLLUTION. Eleven instances of smoke nuisance or annoyance from chimneys were dealt with during the year. Some of these were of a temporary character and did not recur, others were abated upon service of the usual form of notice upon the offenders and there has been no occasion to take further action. As mentioned in previous Reports, the annoyance and the evil from coal smoke cannot satisfactorily be dealt with by law until the enactments at present in force are strengthened or amended. Much dirt and discomfort from smoke continues, although to a distinctly lesser degree than in former years, and for which the enormous number of the chimneys, domestic and otherwise, in surrounding Greater London are largely responsible. Difficulties in the way of obtaining suitable coal are still stated to be a source of trouble. A critical examination of the air in the City was commenced in the year 1914, in conjunction with the Committee for the Investigation of Atmospheric Pollution, appointed by the International Exhibition and Conference in London, 1912, and an apparatus consisting of a large rain gauge is mounted upon the roof of one of the Corporation's buildings in Golden Lane, and the rain-water from a known area of surface is collected monthly. This rain-water, containing the soot, grit and dust washed from the air, has been submitted for examination to the Public Analyst and the results tabulated. For comparison the results obtained from similar observations made at the Archbishop's Park, Lambeth, by the London County Council are added. SUMMARY OF MONTHLY OBSERVATIONS AND REPORTS DURING THE YEAR 1922. Month of the Year 1922. Place. 3 4 5 6 7 8 9 10 11 12 Rainfall in millimetres. Metric tons of deposit per square kilometre during month. Insoluble matter Soluble matter. Total solids. Included in soluble matter. Tar. Carbonaceous other than tar. Ash. Loss on ignition. Ash. Sulphate as (SO3). Chlorine (CI) Ammonia (NH3). January City of London 62 0.08 3.34 3.99 2.48 3.47 13.35 1.70 1.41 0.37 Lambeth (Archbishop's Park) 56 0.11 1.55 1.84 1.67 3.10 8.27 1.39 0.72 0.23 February City of London 50 0.04 2.12 2.90 1.80 3.41 10.28 1.24 1.03 0.18 Lambeth 51 0.23 5.38 9.22 1.52 4.24 20.59 2.39 0.69 0.ll March City of London 37 0.04 2.06 3.48 2.34 2.05 9.98 1.00 1.17 0.18 Lambeth 40 0.13 1.60 2.40 1.13 2.37 7.63 1.23 0.67 0.10 April City of London 68 0.06 3.73 4.39 2.46 3.00 13.64 1.69 1.36 0.24 Lambeth 73 0.13 2.13 2.82 2.47 3.40 10.95 2.11 0.77 0.17 May City of London 18 0.05 2.52 3.81 0.66 1.77 8.82 0.66 0.55 0.11 Lambeth 31 0.19 4.17 7.49 1.25 2.50 15.60 0.90 0.50 0.10 June City of London 15 0.06 4.48 9.60 1.38 5.64 21.17 1.81 1.07 0.15 Lambeth 20 0.12 2.30 3.68 0.80 1.52 8.42 0.59 0.35 0.08 July City of London 92 0.04 3.50 4.40 1.83 3.66 13.44 2.14 1.10 0.37 Lambeth 90 0.19 4.34 7.36 0.90 3.29 16.08 1.56 0.70 0.20 August City of London 67 0.04 4.34 4.25 1.87 3.73 14.23 1.92 0.76 0.29 Lambeth 59 0.15 2.81 4.80 1.28 2.81 11.85 1.38 0.39 0.08 September City of London 29 0.10 6.18 6.50 1.39 4.41 18.58 1.95 0.49 0.25 Lambeth 51 0.07 1.39 2.29 1.22 3.11 8.08 1.55 0.42 0.16 October City of London 36 0.06 3.78 5.65 2.02 4.47 15.98 2.18 0.84 0.29 Lambeth 23 0.03 0.39 0.38 2.15 5.34 8.29 2.17 0.76 0.11 November City of London 31 0.04 2.26 3.16 1.63 2.64 9.73 1.29 0.62 0.23 Lambeth 29 0.17 1.98 4.85 1.05 3.09 11.14 1.24 0.46 0.14 December City of London 68 0.05 2.99 4.30 2.44 4.61 14.39 2.70 1.21 0.40 Lambeth 73 0.11 2.13 2.77 1.67 4.61 11.29 1.76 0.83 0.28 The foregoing table shows the rainfall for the months of January to December of the year 1922, and the amounts found of insoluble matter, tar, soot and dust, also the soluble matter, together with the sulphates, ammonia and chlorine in the volume collected. The results as given by the Public Analyst have been re.calculated into metric tons per square kilometre during each month. 27 One metric ton per square kilometre is equivalent approximately to 9 lbs. per acre, or 2 56 tons per square mile. Although the presence of much impurity in the atmosphere has been long known the figures given represent a definite record of the facts. In examining the foregoing table it will be appreciated that in the month of June only, the amount of deposit registered as falling in the City amounted to 21 17 tons per square kilometre, which is equal (estimating the City as having an area of one square mile) to no less than about 54 tons avoirdupois. Of this mass of dirt, approximately 18 tons were soluble, and included the chemicals mentioned, and 36 tons were insoluble and consisted of tar, carbon and grit. In addition to the foregoing, a daily observation has been made at mid-day at the Guildhall of the purity of the air by a modern dry method, by which the suspended matter can be readily demonstrated. From the 1st January until the 31st December the amount of the impurity at noon has varied from half a milligramme to three milligrammes per cubic metre of air ; this latter figure includes times when there has been a fog. It is interesting to compare the results of similar observations made at other places, as for example, Malvern and Sheffield, where results are widely divergent. The value of the work being carried on in connection with the examination of the atmosphere in the City is evident, and the details recorded indicate the necessity of its continuation. At the beginning of the year the Bishopsgate Ward Club forwarded to the Corporation the following resolution unanimously passed by their members "That the Bishopsgate Ward Club after hearing a lecture on 'Coal Smoke Curse' "by Dr. Caleb William Saleeby, with descriptions of the curative and hygienic properties "of sunlight, commends the object of the Smoke Abatement Committee which has now "published its final report and asks the Prime Minister and the Minister of Health to promote "the legislation asked for in the report." The Sanitary Committee were in general sympathy with the terms of the above resolution, although some of the proposals of the Smoke Abatement Committee are such as will doubtless promote controversy among local authorities. For example, one recommendation (4) suggests that the duty of enforcing the law with regard to the pollution of the air by smoke should be transferred from local sanitary authorities to county authorities leaving minor authorities with power to take proceedings should they so decide. Another (5) proposes that the Minister of Health should be empowered to form joint Committees and another (6) suggests that the Minister of Health should assign to one or more competent officers the duty of advising and assisting local authorities in this matter. The Sanitary Committee gave very careful consideration to the entire report, a copy of which was circulated to each member, and on their recommendation the Court of Common Council recommended that the Ministry of Health be urged to give effect to the report, particularly in regard to the following recommendations, viz.:— That the Minister of Health should be given clearly-defined power to compel or act in place of any defaulting authority which refuses to perform its duty in administering the law with regard to smoke. That the general legal obligation on all manufacturers, users and occupiers of any business premises or processes, engines or plant of any description whatever, should be to use the best practicable means, having regard to all the circumstances of the case, for avoiding the pollution of the air by smoke, grit or any other noxious emissions ; that the same law should also apply to all Government establishments and all rail and road locomotives and motor cars of whatever weight or type, and to steamers on rivers, estuaries and lakes. It ought clearly to be understood that questions of cost must be taken into account in determining what is practicable. That the Minister of Health should be empowered to fix standards from time to time, and in any case, in which the emission exceeds the standard so fixed, the onus of the proof that the manufacturer is using the best practicable means should be on the manufacturer. That the law should enable much larger fines to be imposed than at present. That legislation should be introduced at an early date with a view to consolidating in one measure the various existing statutory provisions with regard to the pollution of the air by smoke, and providing for their amendment where necessary to give effect to the above recommendations. 28 CREMATIONS IN THE UNITED KINGDOM. 38 YEARS—1885-1922. YEAR. Woking.* Manchester. Glasgow. Liverpool. Hull. Darlington. Leicester Golder's Green Birmingham. Leeds. City of London. Sheffield. Bradford. W. Norwood. Abney Park. No. of Cremations each year. 1885 3 .... .... .... .... .... .... .... .... .... .... .... .... .... .... 3 1886 10 .... .... .... .... .... .... .... .... .... .... .... .... .... .... 10 1887 13 .... .... .... .... .... .... .... .... .... .... .... .... .... .... 13 1888 28 .... .... .... .... .... .... .... .... .... .... .... .... .... .... 28 1889 46 .... .... .... .... .... .... .... .... .... .... .... .... .... .... 46 1890 54 .... .... .... .... .... .... .... .... .... .... .... .... .... .... 54 1891 99 .... .... .... .... .... .... .... .... .... .... .... .... .... .... 99 1892 104 3 .... .... .... .... .... .... .... .... .... .... .... .... .... 107 1893 101 30 .... .... .... .... .... .... .... .... .... .... .... .... .... 131 1894 125 47 .... .... .... .... .... .... .... .... .... .... .... .... .... 172 1895 150 58 1 .... .... .... .... .... .... .... .... .... .... .... .... 209 1896 137 52 10 2 .... .... .... .... .... .... .... .... .... .... .... 201 1897 173 51 16 10 .... .... .... .... .... .... .... .... .... .... .... 250 1898 240 62 12 27 .... .... .... .... .... .... .... .... .... .... .... 341 1899 240 88 16 23 .... .... .... .... .... .... .... .... .... .... .... 367 1900 301 83 20 40 .... .... .... .... .... .... .... .... .... .... .... 444 1901 273 96 18 40 17 1 .... .... .... .... .... .... .... .... .... 445 1902 275 81 20 54 13 2 1 5 .... .... .... .... .... .... .... 451 1903 143 92 24 35 18 1 5 158 1 .... .... .... .... .... .... 477 1904 138 98 19 40 20 7 8 220 19 .... .... .... .... .... .... 569 1905 95 97 35 35 15 4 16 252 22 16 9 7 l .... .... 604 1906 140 90 44 46 17 13 12 298 25 15 23 6 14 .... .... 743 1907 108 98 30 34 29 8 12 290 33 16 18 18 13 .... .... 707 1908 119 116 28 32 37 6 14 364 18 24 19 12 6 .... .... 795 1909 105 106 30 46 15 9 19 421 30 19 24 18 13 .... .... 855 1910 106 114 28 37 21 9 16 415 38 12 22 8 14 .... .... 840 1911 114 124 39 50 25 12 13 542 44 17 20 10 13 .... .... 1,023 1912 125 149 44 52 27 15 14 591 40 24 32 12 9 .... .... 1,134 1913 128 172 49 66 23 11 11 602 59 16 21 15 15 .... .... 1,188 1914 124 184 57 48 16 11 7† 671 53 28 42 20 18 .... .... 1,279 1915 153 165 63 53 34 16 22 730 45 20 45 21 12 10 .... 1,389 1916 125 179 65 58 25 9 23 633 63 22 44 13 11 70 .... 1,340 1917 129 178 65 62 22 14 30 719 50 17 68 25 10 118 .... 1,507 1918 142 197 74 69 43 17 42 820 64 34 70 50 20 153 .... 1,795 1919 181 235 84 89 46 26 36 919 76 30 68 41 31 169 .... 2,031 1920 149 203 80 69 30 18 32 851 72 26 58 32 20 156 .... 1,796 1921 159 228 87 75 43 20 36 893 78 31 57 29 24 162 .... 1,922 1922 193 189 75 74 45 17 23 939 98 31 70 38 25 186 6 2,009 Totals 5,048 3,665 1,141 1,267 583 248 396 11333 927 398 709 374 269 1,063 6 27,427 * "Viscount Cross in the year 1879 forbade the practice of cremation there (Woking) under the threat of passing an Act to make it "illegal But in 1884 appeared the well-known judgment of Mr. Justice Stephen, which, in the case of a child's body having been ''burned by its father contrary to the order of the coroner, determined cremation to be a legal act, provided no nuisance be caused there"by to others."—Extract from speech made by the late Sir Henry Thompson at the opening of Golder's Green Crematorium, 22nd Nov"ember, 1902. Vide" Transactions of Cremation Society of England, 1903." p. 31. † Closed for reconstruction from August, 1913, to July, 1914. REMOVAL OF HUMAN REMAINS. ST. KATHERINE COLEMAN CHURCH, FENCHURCH STREET. The Home Secretary in June last granted a Licence to the Vestry Clerk of St. Katherine Coleman Church, Fenchurch Street, for the removal of the remains of all persons buried in or beneath that Church. One of the conditions attaching to the Licence was to the effect that the removal of the remains was to be carried out under the supervision and to the satisfaction of the Medical Officer of Health. The removals which were commenced on the 14th July were not completed until the 5th October. The remains were taken from the Crypt and from two vaults in the Crypt. The whole of the earth in the crypt and vaults was sifted by hand to an average depth of 11 ft. 6 ins., until the solid clay was reached. The earth under the flagstones of the Church floor was also sifted down to the crown of the arches beneath. In all, 124 lead coffins and 94 boxes of loose bones were removed and re-interred in a special enclosure at Ilford Cemetery. The whole work was carried out with the greatest regard to reverence and decency. 29 EXHUMATION AND REINTERMENT OF BODIES AT THE CITY OF LONDON CEMETERY. During the year the bodies of 12 persons buried at the City of London Cemetery at Ilford have been exhumed and subsequently re-interred in other graves in the same Cemetery. In accordance with the terms of the Licenses issued by the Home Secretary in respect of these cases, the work of removal and re-interment was carried out in the early morning under the supervision of your Medical Officer of Health. FOOT AND MOUTH DISEASE (AMENDMENT) ORDER, 1922. The above-mentioned Order was made by the Minister of Agriculture and Fisheries by virtue of the powers vested in him under the Diseases of Animals Acts, 1894—1914. Among other things it provides for the notification to the Medical Officer of Health of a sanitary district of cases or suspected cases of foot and mouth disease in the animal or carcase. The Minister of Agriculture and Fisheries whilst continuing in general the policy of slaughter of affected animals or animals directly in contact therewith, decided in future to consider in each case whether local circumstances are peculiarly favourable to the adoption of isolation in lieu of slaughtering. It is not, I understand, anticipated that this procedure will be followed in many instances but it will nevertheless be seriously considered. Hitherto the invariable practice of slaughtering all affected and suspected animals has generally automatically disposed of the question as to the use of milk from infected cows. In the new circumstances, however, if isolation of animals is practised, cases may arise of the distribution of milk from such animals for human consumption unless steps are taken to prevent it. Powers already exist in Section 15 of the Dairies, Cowsheds and Milkshops Order, 1885, which provides that milk from a diseased cow shall not be mixed with other milk and shall not be sold or used for human food. The duty of enforcing the Foot and Mouth Disease (Amendment) Order rests with the Sanitary Authority through their Medical Officer of Health, and in order that that official shall be aware of the possibility of the presence of milk from diseased cows in his district provision is made, as already stated, for the Medical Officer of Health to be notified of every case or suspected case of foot and mouth disease in his district. The Medical Officer of Health will then take such steps as will ensure that so long as the animal is diseased its milk shall not be used for human consumption. The question of the disposal of meat of affected animals is one of some moment, and in this connection it should be observed that carcases of suspected animals may be derived from two sources:— (1) From the farm where affected animals and their contacts have been slaughtered by order of the Ministry of Agriculture and Fisheries, and (2) From slaughter-houses where animals have developed the disease whilst being kept for slaughter. In the first case the carcases will be disposed of under the supervision of the Ministry of Agriculture and Fisheries, but in the second case no such responsibility will be accepted by that Authority. It will therefore be necessary for the local Medical Officer of Health to exercise particular vigilance as to the disposal of such carcases and the notification above referred to will afford him an opportunity for making the necessary inspection of the animals slaughtered in such slaughterhouses whilst the various organs are available. The question of right of entry into the affected slaughter-houses is one to which consideration must be given. The Foot and Mouth Disease (Amendment) Order expressly provides that "no person (except the person attending the animal) "shall unless authorised in writing by an inspector or officer of the Ministry, or "by an inspector of the local authority enter any field, shed or other place being "part of an infected place." It is not at all clear as to whether this clause over-rides the right of entry to a slaughter-house granted by the Public Health (London) Act and, in the City of e 30 London, by the City of London Sewers Act, 1848, but in the event of this being the case the Cattle Markets Committee, who are the authority under the Diseases of Animals Act for the City, have granted a general authorisation for your Medical Officer of Health and Meat Inspectors to enter any place within the area of the City which may be declared an infected place. There are seven slaughter-houses in the City of London which are situated at Aldgate, and officers of this Department are on continuous duty during the time slaughtering is in progress. The amount of slaughtering carried out therein is considerable and animals arrive there from all parts of the country. MEAT INSPECTION. On page 32 is a report by Mr. T. Dunlop Young, O.B.E., M.R.C.V.S., the veterinary surgeon at the Meat Markets. In that report is contained details of routine inspections shewing the amount of meat which comes under observation and the amount which has been condemned. The amount of meat passing through the Markets is higher this year than in any previously reported and it is also of interest to note that the condemnations record a decrease of 800 tons. This is probably due to the fact that the war accumulations have now been worked off and supplies are of the normal pre-war character. I would direct your attention to the new incisions which it is proposed to substitute for the previous grevious mutilation of the stifle joint which has always been an objectionable feature of Australian hind quarters. In connection with Australian beef I attach herewith a report, dated January 23rd, 1923, which I prepared on the instructions of the Sanitary Committee and which has been forwarded to the High Commissioner for the Commonwealth of Australia. The subject requires no further elaboration. "In accordance with your instructions I beg to submit herewith the following brief report on the subject of Australian meat. The High Commissioner for Australia recently forwarded to the Lord Mayor a request that I should be instructed to furnish him with a memorandum dealing in general terms with the subject of Australian meat, particularly as regards its infection with Onchocerca Gibsoni. This letter was referred to the Sanitary Committee and my instructions followed as a consequence. Australian meat is received in this country invariably in the frozen state. The actual freezing of the meat results in its physical characteristics being changed to the detriment of the product from the point of view of sale since the frozen carcase cannot be placed on the market possessing the same attractive appearance as a chilled carcase. In transportation a certain amount of rubbing is unavoidable since frozen carcases are close packed. This fact also reduces the attractiveness of the quarter. In addition, careless thawing depreciates the value of frozen carcases when exposed for sale in the retail shops. This circumstance, however, is a deficiency common to any frozen carcase and much can be done to minimise it by instructing retailers in the most efficient method of defrosting before cutting up. It is obvious therefore that frozen meat even of equal quality must be at a disadvantage when compared with the chilled, but when there is super-added certain mutilations of the carcase, the market handicap of frozen beef is further increased. This is the present position of Australian carcase meat for it is so frequently affected with the disease known as onchocerciasis that definite regulations have had to be agreed upon and adopted to enable this meat to be put on the market in this country. The mutilations follow as a consequence of these regulations which inter alia require the removal of the brisket from the fore-quarter and certain well-defined incisions in the region of the stifle joint. As regards these latter incisions I have had an opportunity recently of witnessing the modified incision which it was agreed should be attempted, and I can say that this incision is much less objectionable than the previous one, and, provided adequate care is taken at the place of slaughter, some improvement at any rate will result in the appearance of the hind quarters by its adoption. Permission to continue this incision—if it is ultimately adopted—will depend upon strict observance at the place of slaughter of the necessity to remove those tissues which are likely to be affected with onchocerciasis in this area. Notwithstanding this improvement, incisions will still be necessary, and further, no matter what degree of care is exercised, there will be no positive certainty that all nodules will be removed by the methods adopted. This risk, together with the continuance of mutilations, will continue to depreciate Australian beef. The position, therefore, presents two aspects—(a) the objectionable characteristics which are the result of importing meat in the frozen state and which are dependent upon the physical changes consequent upon freezing, the effects of transportation and the carelessness which is displayed by retailers in regard to the thawing process, and (b) the condition which is peculiar to Australian carcases, viz., onchocerciasis. In connection with this latter condition it is argued that no known ill-effects have resulted from the consumption of meat containing nodules, and that therefore sentiment rather than danger prompts the present so called protective measures. It may be true to assert that human beings are not harmfully affected by the consumption of such meat, but surely an animal severely affected with 31 this condition cannot be regarded as normal, and I am not altogether certain that some constitutional change prejudicial to the value of the animal as human food does not result. In any event a country such as this which is dependent in a very large measure for its food supply on imported products must take the stand that only sound and non-diseased products shall be admitted. If any variation from this attitude is permitted it becomes a matter of the greatest difficulty to decide the line of demarcation. This simple statement of the position requires no elaboration. Solution of the problem must be sought in the country of origin and the real administrative solution is not to temporise by attempting to reduce the objectionable appearances, but to make every effort to remove the cause. This cannot be done until the life history of the infecting organism has been elucidated. When such has been with certainty decided, the circumstances will require to be considered and preventive measures based on such knowledge attempted. Much excellent work I know has been done in Australia in relation to this aspect of the subject, but I very much doubt whether any scientist would accept the statement that the life history of this worm has been worked out without a shadow of doubt. I am quite aware that work of this character is costly, but on the other hand depreciation of Australian meat as a consequence of the presence of this disease must be expensive to all persons interested in the various aspects of the cattle trade in Australia. It would not be a difficult matter to estimate the capital sum which is represented by depreciation of all Australian carcases as represented by actual reduced selling value, not to mention the reduction in weight consequent upon removal of the briskets ; in fact the economic loss has already been prominently mentioned in official reports. In my opinion I consider that further research work should be organised in connection with onchocerciasis. Such work involves the labour almost of a team of workers, comprising among others, the skilled helminthologist, the expert entomologist, the experienced epidemiologist, and possibly the modern veterinarian. The labours of such people must extend over more than a season, that is to say, more than over the different seasons of one year, possibly over a continuous period of years to enable experience to be gained of different annual variations. It must of necessity be expensive work because men who are competent to undertake this particular class of research are probably men who are gaining a place in the forefront of science. To limit their activities for a prolonged period means that they are removed from general to detailed work with possible crippling of their future careers. True it is that if a satisfactory solution results from their labours, the reward will be great, but there must be permanent adequate remuneration during this period of isolation from other work. The annual expenditure therefore should not be on parsimonious lines, and personally I feel that the effort could be arranged if financial considerations do not prove prohibitive. In this connection perhaps £10,000 a year would be a nearer estimate than £1,000, but again I can only suggest that the effort would be worth the expenditure, and more than worth it if successful. There are in Australia efficient and excellent scientific centres which if conditions and circumstances are, as in this country, only require financial encouragement. If the men at the home centres are not available there are those, I think, in this country who would be more than willing to assist provided the attractions as suggested were sufficiently bright. There are two other aspects of the case I might mention. One is that the Meat Committee of the Food Investigation Board in conjunction with the Low Temperature Research Station at Cambridge so ably presided over by Mr. W. B. Hardy, Secretary of the Royal Society, and on which Committee I have the honour of a seat, is devoting a considerable time to the investigation of new methods in connection with the freezing of meat. Improvement in freezing methods is by no means outside the realm of probability, and if so, other things being equal, the disadvantage of freezing might be reduced somewhat. In the interests therefore of traders if such improvement be attained, it would seem equally desirable that the objectionable mutilations should be limited or done away with so that advantage may be taken of any improvements which may be discovered. The matter is perhaps also of international importance. The intermediate carrier in the life history of infections such as that to which Australian bovines are subjected need not necessarily be the same in every country, and if infection is transmitted from one country to another a suitable intermediate host might be found to exist in the country into which it was introduced. The above is the position as it appears to me. Temporisations simply mean continued depreciation of the Australian product ; the discovery of the life history of the organism, particularly if such can be associated with effective preventive measures, would prove a real remedy and it might easily result in the Australian product being regarded in the market as of equivalent value to similar products from other countries. I therefore strongly recommend that the scientific bodies in the Commonwealth be consulted, that their recommendations be received and if thought desirable, acted upon with a spirit of generosity. I feel I ought to express an apology for making any recommendation on a subject which is outside my province, particularly' in view of the work done by Cleland, Dickinson, Dodd, Gilruth, Hill, Johnston, McEachran, Miss Sweet, and others in Australia. Had this been a scientific report I should have mentioned the part these investigators had played in the elucidation of the problem, as it is I may have made statements which further acquaintance with local conditions and work would have proved to be inadvisable, and if so, I trust that the fact that I received an instruction to report will be regarded as an adequate excuse." During February it will be remembered that there was an extensive outbreak of foot and mouth disease in this country and that active measures had to be taken by the Ministry of Agriculture and Fisheries to bring the spread under control. Special veterinarv surgeons were detailed off for this work in different parts of the e 2 32 country and with the approval of the Sanitary Committee, Mr. Young accepted temporary service for this particular work and was detailed to an area in Yorkshire. He was absent for this purpose for a period of one month. The subject of the handling of meat has been before the Sanitary Committee on many occasions during the last few months and in view of the recommendations of the Departmental Committee on Meat Inspection the Committee decided to approach the Ministry of Health by means of a deputation to emphasise the urgency of regulations being devised to control the methods of transportation and handling of meat between the markets and the shops of the retail dealers. The Ministry arranged for a meeting and the Chairman, Mr. D. Haydon, accompanied by Mr. W. Leuw, Mr. W. H. Savery, J.P., the late Mr. B. T. Swinstead and Mr. M. J. Lindsey, had the honour of an interview with Lord Onslow, Parliamentary Secretary, Ministry of Health. The Chairman of the Committee set out the circumstances and at the close of the conference the deputation were informed that the Minister would give serious consideration to the matter and that draft proposals with the above objects in view were in course of preparation. The following report has been prepared by Mr. Dunlop Young, Veterinary Sureeon of the Corporation. The Board of Trade Returns for 1922 show the following importations of meat:- Origin. Beef. Cwts. Mutton. Cwts. Pork. Cwts. Argentina 7,608,968 1,430,277 101,984 Australia 1,166,590 984,110 — Denmark 78,663 — — Netherlands — 138,662 461,332 New Zealand 580,335 3,016,063 — Other Countries 159,676 163,126 25,507 United States 65,756 — 80,341 Uruguay 1,146,017 116,525 — Total for 1922 10,806,005 5,848,763 669,164 Total for 1921 11,630,176 6,829,906 650,640 Decrease 824,171 981,143 - Increase — — 18,524 Of the beef 55 per cent. was chilled, 44 per cent. frozen and 1 per cent. fresh. Of the mutton 52 per cent. arrived from New Zealand, 24 per cent. from Argentina, 16 per cent. from Australia and the balance of 8 per cent. from "Other Countries" including Uruguay. The pork figures show a "Record" due chiefly to a great increase in the Dutch trade. The following table* shows that nearly half of the total amount of meat imported passed through the City Markets at Smithfield:— Origin. 1922. 1921. Difference. Ratio. Tons. Tons. Tons. per cent. Britain and Ireland 87,820 80,130 + 7,670 9.6 Australasia 128,007 130,586 — 2,579 1.9 Canada and U.S.A. killed 8,274 9,470 — 1,196 12.6 English killed 7,980 8,783 - 803 9.1 South America 186,189 165,212 + 20,977 12.6 Holland and other countries 44,804 28,232 + 16,572 58.7 Totals 463,074 422,433 + 40,641 9.6 Those figures, viz.:—463,074 tons constitute a "Record" and show that nearly 9,000 tons of food passed through the Central Markets every week, or an average of nearly 1,800 tons per day; quantities unapproached by any other markets in the world. When we add to the above the amount of food supervised in the City Cold Stores, Leadenhall Market, Aldgate Market and the City Shops, it will be observed what a field there exists in the City for gaining experience in meat and food inspection. The work necessary to supervise the above quantities of meat has taxed the efforts of the staff to the utmost to cope with it. It is regrettable to observe that * Kindly supplied by the Market Superintendent. 33 out of the total amount of meat passing through the markets only 87,820 tons, viz.: 154 per cent. of the beef, 142 per cent. of the mutton and 30 3 per cent. of the pork were from home-bred animals. Those figures explain the high price demanded for home killed meat. When we observe that South American supplies increased by 20,977 tons or 12.6 per cent. and "Holland with Other Countries "increased by 16,572 tons or 58.7 per cent., we can understand the competition the British farmer has to contend against. It is interesting to note that 303 per cent. of the pork was supplied by British feeders but the amount could be greatly increased as pig feeding is at present the best paying part of farming. This fact is being realised and pig farming is considerably on the increase due to good prices being obtained for pork, the lower price of feeding stuffs, the greater attention paid to scientific feeding and out-door life of pigs. Schemes for co-operation in pig feeding are being evolved and we expect shortly that more home-fed pork will appear on the markets to the benefit of feeders and consumers. It may not be out of place here to again advise the pasteurisation of all food which could convey tubercle bacilli to pigs in order to avoid the destruction of carcases or portions of carcases on the market. For example, in the year 1915 in the Central Markets 5,141 pig carcases were found to contain lesions of tuberculosis. Under the old system of meat inspection the whole of those carcases would have been destroyed causing an estimated loss of £40,000. Under the present scientific system only the heads of those pigs were destroyed, the above money saved and the price of pork affected in favour of the public. The amount of diseased British meat which is found on the markets shows that as yet the Recommendations of the Departmental Committee on Meat Inspection have not received the attention of many Local Authorities it deserved. The lesions observed in some carcases show that no examination by an inspector had taken place and that the senders were entirely ignorant of disease. Thus not only is a better system of inspection necessary, but feeders of animals intended for food require educating on the subject of disease. It is remarkable that our Foreign Food Regulations are so stringent while the attention given to the inspection of carcases in many parts of the country appears to be nil. The Butchers' Federation is urging for a better system of inspection throughout England in the interests of traders and the public. TUBERCULOSIS MEAT SEIZED AT THE CENTRAL MARKETS DURING 1922. Carcases BEEF. Qrs. Pieces Carcases. PORK. Qrs. Pieces. Carcases. VEAL. Qrs. Pieces. 1922 29 71 52 325 .... 78 4 .... .... 1921 40 39 66 312 6 66 12 .... 3 Increase .... 32 .... 13 .... 12 .... .... .... Decrease 11 .... 14 .... 6 .... 8 .... 3 OFFAL. Heads. Tongues. Lungs. Hearts. Livers. Stomachs. Spleens. Mesenteries. Intestines. Kidneys 1922 31 35 3 4 12 .... 1 .... .... 4 Oxen. 1,072 .... 9 3 81 .... .... .... .... .... Pigs. .... .... .... .... .... .... .... .... .... .... Calves. 1921 45 40 16 13 13 2 .... .... .... .... Oxen. 2,005 1 147 84 105 2 2 4 2 6 Pigs. 4 1 .... .... .... .... .... .... .... .... Calves Total Weight for 1922 = 39 tons 6 cwts. 2qrs. 2 lbs. „ ,, ,, 1921 = 33 „ 0 „ 1 „ 12 „ Increase — 6 „ 6 „ 0 „ 18 „ ARGENTINE MEAT.—The quality, grading, dressing and cleanliness of meat from Argentina and Uruguay were generally up to the usual high standard, and the show at Christmas was that of meat marketed in almost perfect condition. The inspection was good considering the great quantity exported, but from time to time we have found lesions of disease in the lymphatic glands of quarters of beef while the meat was being cut up in the markets. Most of those lesions were 34 found in the ischiatic and the precrural lymphatic glands which had not been incised at the place of slaughter. There is no difficulty in making a neat incision into those glands without spoiling the appearance of the carcase, and where evidence of disease, no matter how slight, is observed in a carcase or its organs, those glands should in the course of examination, be incised. If this had been done, those quarters of beef would not have arrived here. It would be interesting to know how many quarters of beef with similar lesions are observed by butchers in the process of cutting up and not reported to the Sanitary Authorities. We would again urge the adoption of Inspection labels similar to those used by the Dutch Government which are found so useful in reporting disease. Towards the end of the year a quantity of very thin sheep carcases arrived which were much below the Argentine standard. They did not support the freezing and thawing and were only fit for the Digestors. Argentine lamb continues to improve in competition with that from New Zealand and Australia. In the month of December it sold at 6/8 per 8-lb. stone compared with 3/8 per 8-lb. stone in 1921. ARGENTINE OX TONGUES. Owners. No. of Tongues Examined. Percentage Examined. No. of Tongues Seized. Percentage. A 199,666 5% 200 2.7% ,, 1,476 100% 59 4.0% B 16,930 5% 10 1.1% C 4,356 100% 35 .8% D 600 16% 2 2.08% E 600 5% 1 3.3% EXAMINED AT DOCKS AND RELEASED HERE AFTER RECEIVING A REPORT FROM THE M.O.H., PORT OF LONDON. C D F 93,936 Tongues. 7,500 1,248 53 quarters of beef (40 hind and 13 fore) were found affected with tuberculosis. For total quantities of diseased and unsound food destroyed vide Summary. AUSTRALIAN MEAT.—The quality, grading and dressing of Australian meat generally was similar to that of former years. Many visitors from Australia have discussed with us why their meat is sold at so low a price and asked for observations thereon. As it appears to us the remedy exists in following the lines adopted by Argentina, viz.:— 1. Improvement of breed. 2. Younger beef. 3. Better dressing and grading. 4. As soon as better quality beef is produced endeavour to bring it in the "Chilled" condition. The inspection in Australia is good as judged by the meat passing under our supervision. Attention has frequently been directed to the disfiguring results which follows as a consequence of the mutilations necessary to examine Australian meat as to freedom or otherwise from onchocerciasis. The Australian authorities have been anxious to reduce these mutilations if possible and certain suggestions have been made which appear to have the effect desired. Without discussing the matter too minutely a reference to the accompanying photographs will give a fair general idea of the improvements which will result if the new incisions are adopted. Figure 1 shows the condition of the hind quarter as a consequence of the present mutilation and figure 2 illustrates the results of the proposed new incisions. Two hindquarters were found to be affected with tuberculosis. For details of diseased and unsound meat destroyed see Summary on page 40. 35 NEW ZEALAND.—New Zealand mutton and especially the lamb has maintained its high reputation and obtained good prices. In December, lamb sold at 7/10 per 8-lb. stone against 5/4 for 1921. New Zealand beef deserves the same criticism as applies to Australian beef. It is remarkable that a country which has attained so high a standard in marketing lamb seems to devote little attention to attaining an equal high standard in beef. The inspection of New Zealand meat has always been good and maintains that reputation. Four hind quarters of beef were found affected with tuberculosis. For total quantities of diseased and unsound food destroyed vide Summary. DUTCH MEAT.—The quality and cleanliness of Dutch meat has been good and as the figures in the "Supplies Tables" indicate, in great demand. The inspection has generally been good, occasionally unsuitable carcases are observed and reported on. The Chief Veterinary Inspector (Dr. Remelts) has sent a representative and also personally visited the markets in order to observe any defects in their own inspection work. Any criticism offered by us is always accepted in a good spirit and we are certain every endeavour is made to export only that class of meat which reaches the standard required at Smithfield. 22 pig carcases were found affected with tuberculosis. For total quantities of diseased and unsound food destroyed vide Summary. LEADENHALL MARKET AND CITY SHOPS. The Leadenhall Market and City Shops have been carefully inspected during the year, and the following table shows the amount and variety of unsound food dealt with :— Bacon (Pieces) 6 Offal (Baskets) 2 Beef (Pieces) 6 „ (Heads—Pigs) 20 Calves 1 Partridges 454 Cheese (Cases) 24 Pheasants 325 Chickens 17 Pigeons 575 Ducks 739 Plovers 69 Deer 4 Pork (Carcases) 119 Fowls 2,585 ,, (Pieces) 8 Fruit (Cases) 2 Ptarmigan 661 Goats 6 Quail 156 Geese 157 Rabbits 17,601 Grouse 196 Snipe 153 Game (Black) 4 Tails (Bags) 3 Hares 242 Teal 34 Kids 33 Turkeys 1,042 Milk (Cases) 11 Venison (Carcases) 2 Mutton (Pieces) 1 Widgeon 73 Meat (Barrels) 1 Woodcock 22 Total Weight for the year 1921 = 103 Tons, 17 Cwts., 3 Qrs., 25 lbs. „ 1922 = 25 „ 17 „ 1 „ 15 „ Decrease 78 „ 0 „ 2 „ 10 „ 36 COLD STORES. Article No. How Packed Origin. Cause for Destruction. Tons Cwts. Qrs 1bs Bacon (Pieces) .... .... Denmark Decomposed 0 l 0 27 Beef (Quarters) 2 .... Argentine ,, 0 4 3 16 ,, ,, 40 .... New Zealand ,, 3 8 0 7 ,, ,, 63 .... Australia ,, 4 6 2 8 ,, (Pieces) .... .... ,, ,, 13 3 1 9 ,, ,, .... .... New Zealand ,, 1 17 1 9 ,, ,, .... .... Argentine ,, 11 11 3 26 ,, ,, .... .... South Africa ,, 0 0 3 12 „ (Tinned) .... Boxes U.S.A ,, 0 0 1 8 ,, ,, .... ,, Argentine ,, 0 2 2 11 ,, ,, 13 ,, British ,, 0 13 3 22 Calves (Carcases) 1 .... ,, ,, 0 0 2 13 Eggs (Liquid) 13 Cases China ,, .... .... .... .... Fish (Various) .... .... Argentine ,, 1 6 3 4 ,, ,, .... .... Canada ,, 2 13 2 0 ,, ,, .... .... Australia ,, 1 15 3 4 „ (Salmon) 25 Cases Canada ,, 2 15 2 18 Geese 1 ,, Argentine ,, 0 1 1 10 Glands 213 ,, ,, ,, 2 15 0 10 Hearts (Ox) 614 Bags ,, ,, 15 17 2 2 ,, 67 ,, Australia ,, 2 8 3 5 „ (Sheep) 24 ,, New Zealand ,, 0 0 1 2 Kidneys (Ox) 1,242 Cases Argentine ,, 28 2 0 21 ,, (Sheep) 19 ,, Australia ,, 0 9 3 0 Lambs (Carcases) 180 .... New Zealand ,, 2 4 1 13 ,, ,, 176 .... Australia ,, 2 10 2 27 ,, ,, 15 .... Uruguay Emaciated 0 1 3 9 ,, ,, 259 .... Chili ,, 3 1 0 18 ,, ,, 3 .... Patagonia ,, 0 0 3 13 „ (Pieces) .... .... ,, Decomposed 0 6 0 22 Lard 21 Tins China ,, 0 6 1 11 Livers (Ox) 162 Cases Argentine ,, 4 8 2 22 Mutton (Carcases) 106 .... ,, Emaciated 1 10 0 1 ,, ,, 238 .... ,, Decomposed 4 17 0 18 ,, ,, 2,768 .... New Zealand ,, 60 8 3 7 ,, ,, 8 .... ,, Brine Stain 0 3 0 1 ,, ,, 7 .... Australia ,, 0 2 2 5 ii ii 484 .... ,, Decomposed 7 10 0 16 ,, ,, 10 .... Patagonia ,, 0 4 0 7 ,, ,, 82 .... Chili ,, 1 11 0 24 „ (Pieces) .... .... Argentine ,, 1 15 2 8 ,, ,, .... .... Australia ,, 5 7 2 22 ,, ,, .... .... New Zealand ,, 3 16 2 10 Offal (Various) .... .... ,, ,, 0 8 3 20 ,, ,, .... .... Argentine ,, 1 13 2 23 ,, ,, .... .... British ,, 0 8 0 4 Pork (Carcases) 3 .... Argentine ,, 0 1 2 27 ,, ,, 2 .... ,, Brine Stain 0 2 0 16 ,, ,, 6 .... Esthonia Decomposed 0 10 1 20 „ (Pieces) .... .... Argentine ,, 1 3 0 14 Poultry (Various) .... .... British ,, 1 4 3 21 ,, ,, 6 Cases U.S.A ,, 0 4 1 14 Rabbits 198 ,, Australia ,, 6 13 1 27 Sausages .... .... British Vermin eaten 0 1 3 24 Tails (Ox) 15 Bags Argentine Decomposed 0 6 2 22 Tongues „ 277 .... ,, Diseased 0 14 2 12 ,, ,, 10 .... Madagascar ,, 0 0 2 12 Tripe 13 Cases U.S.A Decomposed 0 4 2 16 Venison .... .... Russia ,, 0 2 0 0 208 7 2 14 Total for the Year 1921 = 420 tons, 9 cwts., 0 qrs., 18 lbs. 1922 = 208 „ 7 „ 2 „ 14 „ Decrease 212 „ 1 „ 37 ALDGATE MARKET AND SLAUGHTER-HOUSES. Although the outbreak of Foot and Mouth Disease in 1922 disorganised the movement of live stock the numbers of animals killed at the Aldgate Slaughterhouses during the year show an increase of 2,067. The Departmental Committee on Meat Inspection in their Summary of Conclusions recommend:— "(5) Adequate notice should be given to the Local Authority of inten"tion to slaughter so as to facilitate inspection of the carcase at the time of "slaughter or shortly afterwards. In connection with the above it may be useful to here quote Bye-law No. 19 of the Slaughter-house Regulations of the City of London, which provides that "Every occupier of a slaughter-house who shall intend to slaughter any "animal in such slaughter-house, or to cause or to permit any animal to be "slaughtered therein, at any time other than between the hours of seven "o'clock in the forenoon and three o'clock in the afternoon on a Sunday, "or between the hours of six o'clock in the forenoon and nine o'clock in the "afternoon on any other day, shall give to the Corporation at least three "hours' notice in writing of such intention, which shall be delivered or sent " to their Veterinary Inspector at his office." The following table shows the result of this Bye-law during the year 1922 :— Extra hours of duty performed by the Inspectors— Weekdays. Sundays. Before 6 a.m. After 9 p.m. Before 7 a.m. After 3 p.m. Hours. Hours. Nil. 1301 Nil. 10½ Number of animals killed during the above hours:— Bulls 10 Calves 1,262 Cows 5 Heifers 2 Oxen 290 Sheep 412 Goats 1 Total 1,982 Those figures support the Recommendations of the Departmental Committee by showing the number of animals killed after the inspectors' official hours. The following table shows the number of animals killed in the houses compared with the figures for 1921 :— 1922. 1921. Bulls 145 161 Calves 23,826 17,613 Cows 51 19 Heifers 71 216 Oxen 6,250 5,804 Sheep 11,384 15,844 Various (Goats) 56 59 41,783 39,716 The principal disease which rendered carcases or portions of carcases unfit for food was as in former years, tuberculosis. A total of 126 animals showed lesions of the disease. On analysis of the figures it is found that the percentages in the various animals were as follows:— Bulls 6 or 4.00 per cent. affected. Calves 22 „ 0.09 ,, „ „ Cows 21 „ 41.00 „ „ „ Heifers 9 „ 12.80 „ ,, Oxen 68 ,, 1.00 ,, „ „ F 38 Percentage of carcases and quarters destroyed for tuberculosis :— Carcases. Quarters. Bulls 16. per cent. — percent. Calves 59. „ ,, — ,, ,, Cows 57. ,, ,, 5. „ ,, Heifers 33. ,, „ — ,, „ Oxen 10.3 „ „ 13.2 „ „ 12 of the calves affected with generalised tuberculosis were tinder six months old and 1 under nine months old. 9 were affected in the lungs or lungs and liver only and in a very slight degree. 3 of the heifers and 1 bull affected with generalised tuberculosis were only two years of age. Of the cows affected with generalised tuberculosis 10 were over four and under six years of age and 2 were ten years old. Of the 6 oxen totally destroyed, their ages were as follows:—2 between one and two years, 1 between two and three years and 3 between three and four years. INSPECTION AT ALDGATE.—The above details are obtained and classified by the help of records which have been put into operation in the present year for the first time. A record of the inspections of the carcases of all animals which deviate from the normal is kept on the card, a copy of which is submitted below. Records so obtained will be of increasing value each year for statistical purposes. DIRECTIONS TO INSPECTORS. To show how the Serous Membranes are affected. Mark the extent of the affected area on the diagram of the side. To show which Lymphatic Glands are affected. Draw pencil through the names of the glands affected on each side. To show which organs are affected. Draw pencil through the names of the organs affected. Special Observations and result of the Examination. 39 BREEDS.—Of the animals affected with tuberculosis the breeds were as follows:— Animals. Red Poll. Devon. Crossbred Hereford. Shorthorn. Longhorn. Fresian. Bulls — — 2 — 1 — Calves 1 1 7 — 11 — 2 Cows — 5 8 — 4 2 2 Heifers — — 1 — 6 — 2 Oxen 5 — 30 3 30 — — The following tables show the total number of carcases, portions of carcases and organs destroyed in the slaughter-houses with the cause for destruction. NUMBER OF CARCASES AND QUARTERS SEIZED AND DESTROYED AT ALDGATE. BEEF. MUTTON. VEAL. Cause for Destruction. Carcases. Quarters. Carcases. Quarters Carcases. Quarters. Asphyxia .... .... 4 .... .... .... Decomposition 1 .... 12 .... 1 .... Fibroma Carcinoma .... .... 1 .... .... .... Hydraemia and Emaciation .... .... 15 .... 2 .... Injury .... .... .... .... 2 8 Jaundice .... .... .... .... 1 .... Pleurisy and Pneumonia .... .... 8 .... 8 .... Pyaemia l .... .... .... 1 .... Tuberculosis 22 9 .... .... 13 .... Unsound .... .... .... .... 15 .... Totals for year 1922 24 9 40 .... 43 8 Totals for year 1921 17 2 19 43 25 5 D OF ORGANS SEIZED AT ALDGATE FOR THE YEAR 1922. Cause for Destruction. OXEN. CALVES. Heads. Tongues. Lungs. Hearts. Livers. Stomachs. Spleens. Mesenteries Intestines. Kidneys. Heads. Tongues. Lungs. Hearts. Livers. Stomachs. Spleens. Mesenteries. Intestines. Kidneys Abscess 32 ... 19 ... 188 ... ... ... ... ... 1 ... 30 ... 168 ... ... ... ... ... Actinomycosis 99 126 ... ... ... ... ... ... ... ... 5 3 ... ... ... ... ... ... ... ... Distomatosis ... ... 27 ... 1045 ... ... ... ... ... ... ... ... ... 9 ... ... ... ... ... Parasitic Disease ... ... 138 ... ... ... ... ... ... ... ... ... ... ... 46 ... ... ... ... ... Pleurisy ... ... 604 ... ... ... ... ... ... ... ... ... 207 ... ... ... ... ... ... ... Tuberculosis 55 40 75 ... 66 29 ... 61 61 6 13 13 21 ... 21 13 3 13 13 6 Unsound 1 1 8 43 3 17 54 93 93 64 28 28 20 119 34 27 93 28678 28678 74 Totals for the year 1922 187 167 871 43 1302 46 54 154 154 70 47 44 278 119 278 40 96 28691 28691 80 Totals for the year 1921 220 179 1552 61 1800 101 46 82 82 44 62 43 615 124 368 98 86 25567 25567 60 SHEEP GOATS. Abscess ... ... ... ... 33 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Actinomycosis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Distomatosis ... ... 2 ... 140 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Parasitic diseases ... ... 1859 ... 1225 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Pleurisy ... ... 109 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Tuberculosis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Unsound 28 28 19 102 28 10177 109 288 288 56 ... ... ... ... ... 19 ... 2 2 ... Totals for the year 1922 28 28 1989 102 1426 10177 109 288 288 56 ... ... ... ... ... 19 ... 2 2 ... Totals for the year 1921 89 89 1550 167 1798 8144 190 206 206 38 ... ... 1 ... 1 13 ... 10 10 ... 40 AMOUNT OF VARIOUS FOOD PRODUCTS SURRENDERED OR SEIZED IN THE CITY, IMPORTED OR RECEIVED FROM THE COUNTRIES INDICATED. DISEASED. Countries. Beef in lbs. Mutton in lbs. Pork in lbs. Veal in lbs. Offal in lbs. Total in lbs. Argentina 33,129 10,799 14,364 ... 2,140 60,432 Australia 898 1,298 ... ... ... 2,196 Britain 40,433 28,590 41,119 8,941 50,959 170,042 Canada ... ... ... ... ... ... Chili ... ... ... ... ... ... China ... ... ... ... ... ... Denmark ... ... ... ... ... ... France ... ... ... ... ... ... Holland 2,124 8,071 14,535 2,584 736 28,050 New Zealand 777 568 ... ... ... 1,345 Patagonia ... ... ... ... ... ... U.S.A. ... ... ... ... ... ... Totals 77,361 49,306 70,018 11,525 53,835 262,065 UNSOUND. Countries. Beef in lbs. Mutton in lbs. Pork in lbs. Veal in lbs. Offal in lbs. Bacon in lbs. Lard in lbs. Cheese in lbs. Venison in lbs. Meat in Tins. No. Argentina 678,963 132,440 25,908 ... 299,442 ... ... ... ... 3,151 Australia 179,091 152,332 ... 8,166 16,739 ... ... ... ... ... Britain 45,065 36,889 55,267 7,401 306,548 3,837 ... 490 1,520 ... Canada 318 ... ... 20 793 332 ... ... ... ... Chili ... 5,102 ... ... ... ... ... ... ... ... China ... ... ... ... ... ... 711 ... ... ... Denmark 3,078 ... 1,526 ... 6,246 3,029 ... ... ... ... France ... ... ... ... ... ... ... ... ... ... Holland 8,779 19,631 126,754 ... 35,861 1,710 ... ... ... ... New Zealand 184,060 447,507 112 ... 11,402 ... ... ... ... 196 Patagonia ... 40 ... ... ... ... ... ... ... ... U.S.A. ... ... 8,286 ... 5,047 106 ... ... ... 439 Totals 1,099,354 793,941 217,853 15,587 682,078 9,014 711 490 1,520 3,786 UNSOUND. Countries. Milk in Tins. No. Fish in Tins. No. Fish Whole No. Eggs. Whole No. Eggs in cases. No. Eggs, Liquid. No. of cases. Poultry. No. Game Furred. No. Game Feathered. No. Fruit. No. of Tins. Argentina ... ... ... ... 6 ... ... ... ... ... Australia ... ... ... ... ... ... ... 20,362 ... ... Britain 2,783 ... 50 10,435 ... ... 12,339 21,810 3,307 ... Canada 4,023 646 6,260 ... ... ... ... ... ... ... Chili ... ... ... ... ... ... ... ... ... ... China ... ... ... ...... ... 92 ... ... 866 ... Denmark 228 ... ... ... ... ... ... ... ... ... France ... ... ... ... ... ... 48 ... 481 ... Holland 3,185 ... ... ... ... ... ... 597 1,878 ... New Zealand ... ... ... ... ... ... ... 60 ... ... Patagonia ... ... ... ... ... ... ... ... ... ... U.S.A. 7,233 4 ... ... ... ... 102 ... ... 988 Totals 17,542 650 6,310 10,435 6 92 12,489 42,829 6,532 988 SUMMARY OF UNSOUND FOOD DESTROYED. Tons. Cwts. Qrs lbs. Central Markets, Smithfield . 1,070 18 2 22 Cold Stores 208 7 2 14 Leadenhall Market and City Shops 25 17 1 15 Aldgate Market and Slaughter-houses 109 0 0 8 Total 1,414 3 3 3 Total for the year 1921 2,238 4 3 0 Total for the year 1922 1,414 3 3 3 Decrease 824 0 3 25 Fifteen Naval Officers received Markets, Smithfield, during the year. training in meat inspection at the Central 41 CENTRAL MARKETS, SMITHFIELD. *Table showing the average deliveries at the Central Meat Market, and other details for successive quinquennial periods during the past 49 years:— Quinquennium. Annual Average General Supply. Seizures by-Inspectors % of Unsound Meat Tons. cwts qrs. Tons. cwts. qrs. 1874-1878 178,373 10 0 192 18 2 .108 1879-1883 218,200 12 3 282 11 2 .129 1884-1888 249,580 19 2 248 1 2 .099 1889-1893 304,986 5 1 461 15 1 .151 1894-1898 372,440 12 2 749 3 3 .201 1899-1903 410,456 18 1 1,082 13 2 .263 1904-1908 414,906 11 1 1,584 19 3 .382 1909-1913 427,146 0 0 1,520 2 3 .356 1914-1918 324,715 0 0 1,370 11 2 .422 1919-1922 386,605 10 0 1,961 7 3 .508 *The sources of origin of the Central Markets Supplies during the past five years are here expressed in terms per cent. of the total annual deliveries. British. American. American Killed.‡ Australian and New Zealand Country Killed. Town Killed. † Foreign Killed. Home Killed. Per cent. Per cent. Per cent. Per cent. Per cent. Per cent. 1918 31.8 1l.l 0.6 - 43.9 12.6 1919 24.8 11.4 0.5 - 41.9 21.4 1920 17.6 6.7 2.6 - 39.0 34.1 1921 14.1 4.9 6.7 2.1 41.3 30.9 1922 14.7 4.3 9.7 1.7 42.0 27.6 † Includes "General Foreign Meat and Produce." ‡ Includes South American Imports. *Some idea of the amount of the work of your Inspectors of Slaughter-houses and Meat may be obtained from the following figures supplied by the Superintendent of the Market— 1918. 1919. 1920. 1921. 1922. Tons. Tons. Tons. Tons. Tons. Average daily delivery into the Markets 688 964 1,192 1,389 1,513 J Minimum delivery on any one day 61 107 101 101 142 Maximum delivery on any one day 1,668 2,101 3,103 3,537 3,659 The heaviest weight previously recorded on any one.day (22nd December, 1913) was.— 4,398 tons. ‡ The minimum deliveries relate to Saturdays when practically no wholesale business at the Market is carried out. One ton in every 320 tons of meat paying toll in the Central Markets, Smith. field, was condemned last year, as compared with one ton in 169 in 1921. Table showing Weight of Meat delivered, and Meat delivered to Contractors as unsound, during each Month of the Years 1921 and 1922. Month. Meat delivered at the Market, 1921. Unsound Meat delivered to Contractors, 1921. Meat delivered at the Market, 1922. Unsound Meat delivered to Contractors, 1922. Tons cwts. qrs. Tons cwts qrs. Tons cwts. qrs. Tons cwts. qrs. January 33,604 0 0 122 2 0 42,201 0 0 188 2 l February 32,071 0 0 89 1 l 35,551 0 0 115 19 0 March 34,037 0 0 139 7 0 42,448 0 0 143 16 0 April 34,002 0 0 111 17 1 35,198 0 0 104 17 3 May 33,970 0 0 186 8 3 37,895 0 0 185 1 1 June 33,935 0 0 233 7 0 38,351 0 0 104 18 0 July 30,865 0 0 238 15 0 37,644 0 0 71 8 0 August 34,329 0 0 224 5 0 37,228 0 0 94 8 2 September 37,009 0 0 195 19 0 36,431 0 0 121 2 3 October 39,279 0 0 255 14 1 41,191 0 0 117 14 3 November 39,986 0 0 241 18 3 40,655 0 0 119 15 2 December 39,295 0 0 199 9 2 38,281 0 0 78 11 0 Totals 422,382 0 0 2,238 4 3 463,074 0 0 1,445 14 3 * I am indebted to the Clerk and Superintendent of the Central Markets for the figures relating to the market supplies, sources of origin, &c. 42 FISH SUPPLIES. 242,385 tons of fish, of which 210,914 were land-borne and 31,471 water-borne, were received at or near Billingsgate Market during the year. This was a increase of 12,075 tons in the land deliveries, and an increase of 2,813 tons in the deliveries by water. MONTHLY FISH RETURNS. Table showing Weight of Fish, Delivered, Fish seized as Unsound, and Percentage of Fish Condemned to that Delivered, at or near Billingsgate Market, and on board boats lying off that place, during each month of the year 1922. Month. Weight of Fish Delivered. Total. Weight of Fish Condemned. Ratio of Fish Condemned to that Delivered. By Land. By Water Tons. cwts. Tons. cwts. Tons. cwts. Tons. cwts. qrs. Per Cent. January 14,754 12 1,508 0 16,262 12 71 10 1 1 ton in 227.409 tons or 0.439 February 16,196 13 2,536 0 18,732 13 111 17 3 1 ,, 167.423 ,, 0.596 March 19,293 9 3,288 0 22,581 9 204 6 2 1 „ 110.517 ,, 0.904 April 15,570 11 2,882 0 18,452 11 128 6 0 1 ,, 143.823 ,, 0.695 May 18,750 4 2,426 10 21,176 14 410 7 0 1 „ 51.606 „ 1.937 June 17,468 13 2,225 18 19,694 11 203 9 0 1 „ 96.802 ,, 1.033 July 17,698 16 2,814 0 20,512 16 321 5 3 1 ,, 63.845 ,, 1.566 August 18,288 0 3,184 5 21,472 5 202 19 1 1 „ 105.794 ,, 0.945 September 17,681 15 3,017 0 20,698 15 221 19 2 1 „ 93 248 ,, 1.072 October 19,712 0 3,284 0 22,996 0 232 16 2 1 ,, 98.769 ,, 1.012 November 18,904 1 2,255 15 21,159 16 62 6 1 1 „ 339.577 ,, 0.293 December 16,595 0 2,049 5 18,644 5 88 6 1 1 „ 211.116 ,, 0.473 Total 210,913 14 31,470 13 242.384 7 2259 10 0 1 „ 107.273 ,, 0.932 * Compiled from the Monthly Returns furnished to the Corporation by the Fishmongers' Company. Monthly Deliveries of Fish at London Central Markets, Smithfield, 1922. Tons. cwts. qrs. January 78 15 0 February 68 14 0 March 92 18 0 April 82 5 0 May 97 0 0 June 85 12 0 July 86 6 0 August 75 0 0 September 75 18 0 October 80 19 0 November 81 10 0 December 71 11 0 Total 976 8 0 Of the above, 4 tons 8 cwts. 0 qrs. 16 lbs. were seized as unsound by your Officers and those of the Fishmongers' Company. This equals .45 per cent. of the whole, or 1 ton in 222 tons. Weight of Fish Delivered, Fish seized as Unsound, and percentage of Fish Condemned to that Delivered, at or near Billingsgate Market during 1922 and the five years 1917—1921. Year. Weight of Fish Delivered. Total. Weight of Fish Condemned. Ratio of Fish Condemned to that Delivered. By Land. By Water. Tons. Tons. Tons. Tons. cwts. qrs. 1917 111,548 3,623 115,169 1,750 6 3 1 ton in 66 tons, or 1.520% 1918 121,270 154 121,424 2,166 9 1 1 „ 56.047 „ 1.784 „ 1919 158,326 9,360 167,686 3,079 16 2 1 „ 54.444 „ 1.837 „ 1920 231,866 19,622 251,488 2,720 17 2 1 „ 92.425 „ 1.081 „ 1921 198,839 28,658 227,497 2,580 17 1 1 „ 88.089 „ 1.134 „ Average (5 years) 164,370 12,283 176,653 2,459 13 2 1 ton in 71.819 tons or 1.392% 1922 210,914 31,471 242,385 2,259 10 0 1 ton in 107.273 tons or 0.932% 43 FOOD POISONING. Unusual publicity in the Press was given during the year to the numerous outbreaks of illness attributed to food poisoning. In the City one case only was reported and the following are the facts associated therewith:— In September a City medical practitioner reported that he was attending a family of three persons who presented symptoms of food poisoning. Enquiry was instituted and the following information obtained:— Mrs. L. purchased on Saturday, the 2nd September, from an offal shop in the South-eastern area of London, 1 lb. of ox-cheek, a half cow's heel and 2 lbs. of skirt beef. These were taken home and stewed the same evening (without addition of pre-existing stock) in an enamel saucepan over a gas-stove for about two hours. It was left in the saucepan after cooking, and on the following day was stewed for a further three hours in the same saucepan. The mixture then, with boiled potatoes, constituted the Sunday's dinner and was supplemented by stewed damsons and blancmange, the latter being prepared from a proprietary blancmange powder. The family consisted of husband, wife and daughter, and all partook of the meal. Scraps of the stewed meat were also given to the dog. The portion of the stewed meat which was not consumed on the day was made into a pie by Mrs. L. and baked soon after the conclusion of the mid-day meal. The pie was stored in a clean pantry and on the next day, Monday, it was warmed up and eaten by all three members of the family, and also by a Miss H., a boarder. This meal was supplemented by a baked rice pudding. The remaining portion of the pie was eaten at night-time on the same day by Mr. L. for supper, scraps being given to the dog. No portion of the food eaten during the 2nd, 3rd and 4th was available for examination. The dish in which the pie was made was of china and nothing peculiar was noticed by any of the persons consuming the pie. The house is a clean one and all utensils appeared to be kept in a satisfactory condition. Other foods consumed in the household between the 2nd and 5th September are as under :— 2nd September Boiled cod for supper. 3rd „ Fresh fruit, apples, pears and plums. 4th „ Fried bacon and eggs. 5th „ Fried bacon and tomatoes. Mrs. and Miss L. also partook of tea at the home of Mrs. L. Senior on the 4th, where they consumed haddock, tomatoes and buns. The following is a table of the articles consumed by the different persons concerned:— Date. Food. Mr. L. Mrs. L. Miss L. Miss H. September, 1922. 2nd Boiled cod (supper) X X X — 3rd Tea and bread and butter for breakfast X X X — 3rd Fresh fruit during day, stewed meat with potatoes, damsons and blancmange (dinner) X X X — 4th Fried bacon and eggs (breakfast) X X X — 4th Meat pie, potatoes, stewed damsons and rice pudding (dinner) X X X X 4th Haddock, tomatoes and buns (tea) — X X — 5th Fried bacon and tomatoes (breakfast) X X X — The food given to the dog was as under:— September 3rd Morning Bread and milk. Mid-day Spratt's dog biscuit. Evening Scraps left from family's dinner. September 4th Morning Bread and milk. Mid-day Spratt's dog biscuit. Evening Scraps from family's dinner. It is interesting to note that Miss H., the boarder referred to above, who although partaking of the mid-dav meal on the 4th September, suffered from no illness of any description. The dog suffered from distinct diarrhoea and general uneasiness on I uesday, the 5th. 44 As none of the suspected food was available for examination, the faeces of the three patients were examined bacteriologically and the blood of Mr. and Mrs. L. tested serologically by Sir Frederick Andrewes, the City Bacteriologist. A sample of the proprietary blancmange powder referred to above was also examined. The following is a copy of Sir Frederick Andrewes's report:— "HISTORY. "September 2nd, 1922.—Ox-cheek and beef-skirt bought and stewed together. "September 3rd.—Ox-cheek eaten by family and given to dog. "September 4th.—Beef-skirt eaten by family and given to dog. "September 5th.—MRS. L. seized at mid-day with epigastric pain, followed by vomiting "and diarrhoea. Temperature 100° F. on two following days. Severe diarrhoea persisted "for a week or more. "MR. L. on night of 5th, had pain and nausea, followed by diarrhoea for two days, "but no vomiting or fever. "MISS L. had epigastric pain and nausea but no vomiting or diarrhoea. *THE DOG had diarrhœa. "On September 7th, I received stools from the three cases. These were examined (a) "by direct plating on lactose litmus agar, and (b) by inoculation into brilliant green broth of "3 strengths in each case, the resulting growth being plated next day on lactose litmus agar. "THE DIRECT PLATING was successful only in the case of Mr. L.—colonies of a "Salmonella being obtained. "THE BRILLIANT GREEN METHOD was" readily successful in all three cases"Salmonella colonies being obtained from all. "CULTURALLY the bacillus presented the classical character of the Paratyphoid "B Group. It was mobile, actively reduced neutral red, formed no indol, fermented glucose. "mannite and vulcite with formation of gas, failed to ferment lactose and saccharose, and "formed alkali in litmus milk. "SEROLOGICALLY the bacillus proved to be a B. Aertrycke (the so-called ' Mutton "type which is the commonest cause of food-poisoning in this country). (In determining "this fact I made use of methods now in course of publication, based on the fact that in all "old Salmonella cultures there exist side by side bacilli of highly specific, and of almost "unspecific character, but mutually convertible on subculture. I have sera of each type, "in the case of all common food-poisoning bacilli and also a stock of already absorbed sera, "reacting each with its own type alone). "IN THE CASES OF MRS. L. AND MISS L., I found, amongst a majority of unspecific "colonies, one colony yielding the specific agglutinations of B. Aertrycke, in each case, which "is sufficient to identify the nature of the bacillus. In the case of Mr. L., all of the ten "colonies tested proved unspecific. I therefore put the strain through daily broth culture "to allow of mutation and this procedure was successful. The fourth broth sub-culture was "plated on agar and ten colonies were picked and tested; 6 colonies proved specific Aer"tryckes and 4 unspecific. The evidence is, therefore, complete in all three cases, that the " infecting organism was B. Aertrycke. "TESTS OF THE PATIENTS' SERUM.—Dr. White provided me on September 12, "7 days from onset, with blood from Mr. and Mrs. L. but not from Miss L., who had gone "away. The sera were put up against a long series of specific and unspecific emulsions "of food poisoning and other bacilli, and yielded unspecific results corresponding to the "unspecific nature of the bacillus from the stools. The titres for my standard Aertrycke "emulsion were Mr. L., 1: 440 =92 units; Mrs. L., 1: 250 =52 units. But these were "also agglutinated unspecific strains of Paratyphoid B, Paratyphoid C, and B. Newport, "as well as unspecific Aertrycke, though not to quite so high a titre. They failed to agglutinate "specific strains of any, not even of B. Aertrycke. If I had not known the infecting agent, "I should have been in doubt to which of these salmonellas infection was due. I should "add that Mr. L.'s serum (and not Mrs. L.'s) agglutinated B. Typhosus to 1: 150 and specific "B. Paratyphosus B. to 1: 30, suggesting former T.A.B. inoculation, concerning which I "am making enquiries. "SOURCE OF INFECTION.—The ox-cheek, which Dr. White suspects as the cause, "had all been used up, as had the beef-skirt. " A sample of pink blancmange powder which had been used, was sent to me on September "8th. Cultures in brilliant green broth were negative, and two mice fed on it exclusively for "three days were unharmed. "(Signed) F. W. ANDREWES." "St. Bartholomew's Hospital, "September 16th, 1922." It is difficult to incriminate any special article of food, principally on account of the fact that Miss H. escaped attack, although she partook of the meal which would appear to be the only food consumed in common by the whole household 45 (including the dog). Notwithstanding these difficulties, however, the pie, in view of the known circumstances in relation to food poisoning outbreaks, was probably the source of infection. BOTULISM. It will probably be remembered that during the year an outbreak of botulism received considerable publicity in the press and elsewhere, and that an anti-toxic serum was produced for use in cases of the disease. The anti-toxin appears to have been used with some success and the Ministry of Health made arrangements for a supply to be available at several centres throughout the country for Medical Officers and medical men in case of need. In accordance with the suggestions of the Ministry of Health these facilities were made known to the medical men practising in the City and each was furnished with a leaflet issued by the Ministry containing instructions as to the use of the Botulinus anti-toxic serum. EXPORT OF FOOD PRODUCTS TO CANADA. In consequence of the requirements of the food laws in operation in the Dominion of Canada, a system of certification of certain food products prepared and packed in England and Wales for export to Canada is now in operation. Officials, designated "Certifying Officers" are now appointed in this country by the Minister of Health and their duties are to keep themselves informed by personal enquiry and in any other available manner as to— (i.) The Sanitary conditions, structure and character of the premises on which the food products are prepared, stored or packed, with special regard to the possibility of contamination of food products at any stage : (ii.) The cleanliness and wholesomeness of the materials employed in the preparation, storing and packing of the food products, and (iii.) The precautions taken to avoid the utilisation for food purposes of diseased, unsound or unwholesome materials in any portion of the premises, and arrangements for the safe deposit of any material which on account of disease, unsoundness or unwholesomeness or any other reason is unfit for human food. In the case of products derived from the flesh of cattle, sheep, swine or goats, the Certifying Officer must also satisfy himself that the animals from which the products are prepared have been subject to an ante mortem and post mortem veterinary inspection and found free from disease and suitable for human food. When the products are prepared from animals slaughtered in the United Kingdom the Certifying Officer must, before certification as to Veterinary examination— (a) Be satisfied that the animals were subject to ante mortem and post mortem veterinary examination by an officer of the Local Authority for which he himself acts ; (b) Be satisfied that the animals were slaughtered in a public abbatoir under official veterinary inspection, or (c) Be furnished by the applicant with a declaration, signed by a qualified Veterinary Surgeon, appointed by the firm, with the approval of the Certifying Officer, to the effect that an ante mortem and post mortem examination was made by him, and that the animals so examined were found to be free from disease. Where the products are prepared from material imported from overseas, the Certifying Officer must satisfy himself that such material was accompanied by a certificate as to ante mortem and post mortem Veterinary inspection, signed by an official from the Government of the exporting country, being a country whose certificate the Canadian Authorities are prepared to accept. These countries, in addition to Canada, are Australia, New Zealand, Argentina and the United States of America. The Certifying Officer is authorised to withold the Certificate if in his view the information obtained is not entirely satisfactory. Information and details of such refusal is required to be forwarded to the Ministry of Health. Your Medical Officer of Health has been appointed by the Ministry of Health to act as the Certifying Officer for the City of London. g 46 INSPECTION OF FOOD IN CITY WHARVES. The duty of supervision of food at the Wharves is undertaken by Mr. T. L. Davies, and the following is a summary of the chief matters coming under observation:— SUMMARY OF FOOD DISCHARGED AT CITY WHARVES. Article. Where from. Description of Packages. Total number of Packages. General Range of Weight of Packages. General Farm Produce— Butter Holland Cases and Casks 80,551 12 lbs.—100 lbs. Bacon ,, Bales 41,058 2 cwts.—3 cwts. Cheese Holland and Italy Single Cheeses 280,817 4 lbs.—14 lbs. ,, Holland, Italy and Denmark Packages 220,963 48 lbs.—1 cwt. Eggs Holland Cases 34,589 1 cwt.—1 cwt. 2 qrs. Lard ,, ,, 26,008 28 lbs.—56 lbs. Compound ,, ,, 12,963 28 lbs. Margarine ,, ,, 312,180 12 lbs.—56 lbs. Cereals— Barley ,, Bags 10,382 100 lbs.—1 cwt. 2 qrs. Beans ,, ,, 1,191 1 cwt. 3 qrs. Peas ,, ,, 8,605 1 cwt.—2 qrs. Farina ,, ,, 3,301 2 cwts. Rice Italy ,, 850 1 cwt.—2 qrs. Tapioca Holland ,, 116 1 cwt. Beverage Products- Coffee Africa and Costa Rica ,, 40,424 1 cwt. 2 qrs. Cocoa & Chocolate Ceylon, N. Africa and Holland Bags and Cases 24,771 28 lbs.—2 cwts. Fruit (Soft)— Apples Holland Packages 18,342 40 lbs.—1 cwt. 2 qrs. Plums ,, ,, 492 40 lbs. Pears ,, ,, 17,918 14 lbs.—40 lbs. Cranberries ,, ,, 1,011 28 lbs. Currants ,, ,, 14,989 7 lbs.—40 lbs. Gooseberries ,, ,, 11,880 14 lbs.—100 lbs. Strawberries ,, ,, 32,045 7 lbs.—28 lbs. Bilberries ,, ,, 1,582 7 lbs. Cherries ,, ,, 13,519 12 lbs.—40 lbs. Blackberries ,, ,, 57 7 lbs. Rhubarb ,, Bundles 23,338 1 cwt. Fruit (Dried)— Currants Australia, S. Africa and Greece Packages 594,653 40 lbs.—56 lbs. Raisins Australia, S. Africa Spain & California ,, 246,185 8 lbs.—56 lbs. Sultanas Australia, S. Africa Greece, Afganistan, Smyrna, and California ,, 442,009 28 lbs.—56 lbs. Plums Bosnia and California ,, 118,135 24 lbs.—56 lbs. Apricots Australia & California ,, 8,702 24 lbs.—56 lbs. Evaporated Apples California ,, 8,979 56 lbs. Pears Australia & California ,, 3,300 24 lbs.—56 lbs. Peaches ,, ,, ,, 400 24 lbs.—56 lbs. Dates Australia & Egypt ,, 3,727 28 lbs. Figs Greece, Smyrna and Spain Cases and Bags 60,915 14 lbs.—3 cwts. Fruits (Green)— Oranges Italy and Spain Packages 535,792 56 lbs.—1 cwt. 2 qrs. Lemons ,, ,, ,, 217,777 56 lbs.—1 cwt. 1 qr. Grapes Holland and Spain ,, 32,245 12 lbs.—40 lbs. Melons ,, ,, ,, 17,225 56 lbs.—1 cwt. Pomegranates Spain ,, 372 1 cwt. Vegetables— Cauliflowers Holland ,, 16,764 24 lbs.—40 lbs. Cucumbers ,, ,, 113,793 15 lbs.—40 lbs. Cabbages ,, ,, 34,489 1 cwt. Carrots ,, ,, 9,970 30 lbs.—1 cwt. 2 qrs. Lettuce ,, ,, 76,732 14 lbs.—28 lbs. Potatoes ,, Bags 270,850 100 lbs. Parsnips ,, ,, 7,104 100 lbs. Onions Holland and Spain Bags and Cases 329,981 100 lbs.—1 cwt. 2 qrs. 47 Article Where from Description of Total Number of General Range of packages. Packages. Weight of Packages. Vegetables—contd. Radishes Holland Packages 2,606 50 lbs. Tomatoes Italy and Holland „ 204,709 12 lbs.—40 lbs. Beetroots Holland Bags 10,008 100 lbs. Spinach ,, „ 401 40 lbs. Horseradish „ Packages 125 56 lbs. Sprouts „ „ 3,312 56 lbs. Sugar „ Bags and Cases 96,764 1 cwt.—2 cwts. Tinned Goods— Apricots Australia & California Cases 4,286 48 lbs. Fruit Pulp Australia, Holland and Spain Casks and Cases 39,612 60 lbs.—3 cwts. Vegetables Holland and Italy Cases 5,492 50 lbs.—1 cwt. 2 qrs. Tomatoes Italy ,, 46,921 50 lbs.—100 lbs. Pines Singapore „ 1,000 48 lbs. Pears Australia & California ,, 3,250 48 lbs. Peaches California ,, 11,000 48 lbs. Cherries Italy ,, 13,493 50 lbs. Condensed Milk Holland ,, 875,413 48 lbs. Tangerines Spain ,, 550 50 lbs. Sardines Portugal ,, 9,853 50 lbs.—1 cwt. Anchovies Spain „ 318 56 lbs.—1 cwt. 1 qr. Salmon Italy and Canada „ 521 48 lbs.—56 lbs. Crab Japan „ 340 48 lbs. Jam Australia ,, 1,000 48 lbs. General Products— Macaroni Italy „ 128,921 28 lbs. Nuts (Various) France, Italy, Spain and Turkey Cases & Bags 58,541 28 lbs.—2 cwts. Milk Powder Holland ,, „ 2,353 50 lbs.—1 cwt. Milk Sugar „ Cases 830 100 lbs. Ginger (Preserved) China Cases & Casks 5,045 30 lbs.—3 cwts. Vegetables (in Brine) Holland Casks 5,696 3 cwts. Miscellaneous— Carraway Seeds Holland Bags 2,062 1 cwt. 1 qr. Liquorice Italy Cases 2,051 1 cwt.—3 cwts. Confectionery Holland „ 1,460 56 lbs.—1 cwt. Anchovies Spain Barrels 175 1 cwt.—1 cwt. 2 qrs. Liquid Egg Yolk China Casks 2,902 3 cwts.—4 cwts. Cinnamon India Cases 10 56 lbs. Sugar Candy Holland „ 1,763 28 lbs. Cocoa Butter „ „ 2,472 1 cwt.—1 cwt. 2 qrs. Olives Spain Casks 127 2 cwts. Cocoanuts Ceylon Bags 972 1 cwt. 2 qrs. Chillies India „ 56 1 cwt.—1 cwt. 2 qrs. Peel in Brine Italy Casks 276 2 cwts. 2 qrs.—2 cwts. 3 qrs. Lemon Juice „ ,, 130 3 cwts. Desiccated Cocoanut Ceylon Cases 1,510 1 cwt. 2 qrs.—2 cwts. Salt Germany Bags 400 1 cwt. CONDEMNATION OF FOOD INSPECTED AT RIVERSIDE WHARVES. As a result of the daily Inspection of City Wharves 207 loads of unsound food were removed from these places during the year by the Cleansing Department. The material so disposed of comprised:— Tons. cwts. qrs. Tinned Fruit, Vegetables, and Fish 70 7 3 Condensed Milk (removed at request of owners) 17 2 Fruit Pulp 27 16 2 Fruit (Various) 6 18 3 Vegetables (Various) 218 1 2 Miscellaneous 13 6 0 Total 337 8 0 A portion of the above was removed at the request of the owners. 48 FOODS AND DRUGS. During the year 1922. 942 samples of food or drugs were submitted to the Public Analyst for examination. Of this number 830 were taken as test samples without the formality of the Act being observed; of these 82 were found to be adulterated, made up as follows:— 16 of Coffee Essence or Extract out of 17 samples taken. 10 of Milk out of 148 samples taken. 9 of Borax out of 22 samples taken. 7 of Butter out of 112 samples taken. 6 of British Wines out of 6 samples taken. 5 of Margarine out of 37 samples taken. 5 of Tinned Spinach out of 7 samples taken. 3 of Honey out of 3 samples taken. 3 of Gelatine out of 8 samples taken. 3 of Lemon Curd and Lemon Cheese out of 9 samples taken. 3 of Cyder out of 3 samples taken. 2 of Gregory Powder out of 10 samples taken. 2 of Whiskey out of 6 samples taken. 2 of Preserved Cream out of 6 samples taken. 2 of Sauce out of 5 samples taken. 1 of Mustard out of 24 samples taken. 1 of Rum out of 3 samples taken. I of Cream out of 5 samples taken. 1 of Table Jelly out of 4 samples taken. Of the formal samples, 24 out of 112 were found to be adulterated, made up as follows:— 5 of Whiskey out of 7 samples taken. 4 of Prescriptions out of 9 samples taken. 3 of Butter out of 8 samples taken. 3 of Coffee Extract and Coffee Essence out of 3 samples taken. 3 of Margarine out of 4 samples taken. 2 of Milk out of 71 samples taken. 2 of Gin out of 3 samples taken. 1 of Cream out of 1 sample taken. 1 of Rum out of 1 sample taken. The percentage of milk adulteration for both formal and informal samples together is 5 4, as compared with 6 7 for 1921. Of the 12 adulterated samples, 10 were informal samples and 2 formal samples. There were two prosecutions. BUTTER.—The cases of adulteration of Butter were all in respect of butter sold on bread or rolls. There were two prosecutions. Cautions were given in the remaining 5 instances. WHISKEY.—In three instances the vendors of Whiskey sold at a strength slightly below the statutory limit of 35 degrees under proof, were cautioned. There were two prosecutions. GIN.—There were two prosecutions resulting from the two cases of adulteration. RUM.—The vendor of the adulterated sample of Rum was prosecuted. CREAM.—The vendor of the adulterated sample was cautioned. REGISTRATION OF MANUFACTORIES AND PREMISES OF WHOLESALE DEALERS IN MARGARINE AND MARGARINE CHEESE. Two applications for registration were received under the Order of the Local Government Board, dated February 26th, 1900. The premises were inspected and the applications granted. DAIRIES, COWSHEDS AND MILKSHOPS ORDERS, 1885, 1886 & 1899.— During the year twenty applications were received from persons or firms desirous of being registered under these orders. All the applications were approved. Routine inspections of Milk Retailers' premises have been carried out with a view to the maintenance of cleanly conditions therein, and in three instances structural improvements were found necessary and duly carried out. 49 MARGARINE ACT, 1887.—Three samples of Margarine were supplied in unmarked or improperly marked wrappers. Cautions were issued in two instances and there was one prosecution. TABULATION OF WORK.—Tables setting out in detail the various purchases in each quarter, and the results of analysis are appended to this section of the report on pages 62 to 65. GENERAL OBSERVATIONS. The percentage rate of adulteration of all foods sampled in the City is ll-2. This might at first appear to indicate that adulteration in the City is more prevalent than in other areas. Such assumption is incorrect for I believe that food sold within the City area compares favourably with that in the rest of the country. Haphazard selection of samples would probably result in a very low rate of adulteration being recorded, due in great measure to the prevalence of multiple shops and the method of trading under common control. In such businesses due regard is paid to the requirements of the Food and Drugs Acts, and although occasionally a lapse is discovered, supplies furnished from a common source result in the bulk being subjected to careful supervision. Occasionally this supervision fails, more from accident than intention, a notable illustration of which was recently made public in another district in connection with the sale of a product used for the preparation of a popular beverage. Even the small shops which are not associated with any central organisation less frequently sell adulterated food to-day than formerly, for the reason that a great amount of food is sold in the packet form. These packets are supplied by wholesalers, where again there is central control. An increased percentage of adulteration is due to some extent to the method of sampling and recording results. It has been the practice in the past to purchase a considerable number of informal samples and when any such is discovered to be adulterated, another informal sample is taken to ascertain whether sophistication was accidental or persistent, and if further adulteration is discovered a formal sample is purchased so that proceedings may be instituted if necessary. It follows therefore that in the majority of instances of adulteration, two and sometimes three or even more samples of the same product from the same shop have been taken and these being added to the aggregate of adulterated samples there must obviously result an increase in the percentage rate of adulteration. In addition, special attention is given to group sampling. Illustrations have been before the Sanitary Committee in considerable numbers in recent months. Take borax as an example. Samples of this commodity have been purchased with a view of ascertaining the position borax occupies in everyday sales, and in this connection purchases have been made which it was expected would be found to be contaminated but in respect of which a purchase would hardly have been regarded as one in which proceedings could be taken under the Food and Drugs Acts. Again, when a commodity has been found unexpectedly to contain preservative, all other examples of that commodity supplied by other traders have been purchased for examination with the result that the practice has been found to be followed in others. If only an odd sample, for example, of a sauce containing salicylic acid had been purchased, the percentage rate of adulteration would not have been so great as it is in consequence of the methods adopted. I could state other reasons but the above are sufficient to indicate that the method of purchase and enquiry in the City does tend to show a greater percentage of sophistication than would be the case were mere routine purchases of foods made, particularly of many which before purchase and before submission to analysis could be unhestitatingly stated to be free from adulteration. I hope in the very near future to present a special report dealing with the necessity for a larger number of official standards being established in respect of food products and the want of uniformity which exists throughout the country in respect of decisions in connection with the addition of preservatives. During the year group sampling has been carried out in respect of the following : COFFEE EXTRACT.—With a view of ascertaining the preservative used (Report No. 250). CONDENSED MILK.—To compare the fat contents of the different products now on the market with the object of ascertaining the necessity of standardising such milks (Report No. 250). 50 GELATINE.—To ascertain the preservatives used in both loose gelatine and gelatine prepared for domestic use, and in jellies prepared from gelatine (Report No. 253). BUTTER AND MARGARINE.—To ascertain the frequency of the use of boric acid and the amount so used, and the percentage of moisture contained in each sample (Report No. 253). BORAX.—As to the contaminations contained in the product as sold by the grocer and the chemist (Report No. 253). LEMON CURD AND LEMON CHEESE.—To ascertain the preservatives used (Report No. 253). COPPER IN TINNED SPINACH.—Samples were examined which included products prepared in America, France, Belgium and Holland. The American samples (two) were free from copper but the Continental products each contained copper varying from 0.022 per cent. to 0049 per cent. (See Report No. 254). PRESCRIPTIONS.—Eight which were prepared for panel patients by panel practitioners and submitted for dispensing to chemists on the roll of the London Insurance Committee have been examined. The prescriptions were taken from the Pharmacopoeia of the London Insurance Committee. Of these, four were returned by the Analyst as being precisely in accordance with the terms of the prescription. In the remaining four there was some variation. In one there was a deficiency of potassium bromide to the extent of 8 per cent., together with a deficiency of ammonium carbonate to the extent of 5 per cent., as in another there was excess of potassium bromide and also ammonium carbonate to the extent of 9 per cent. In a further sample ammonium carbonate was deficient to the extent of 34 per cent. In none of these instances was action taken and in respect of the first two careless dispensing rather than wilful addition or abstraction was thought to have been the cause. A communication was forwarded to the Pharmaceutical Society of Great Britain enquiring what in the opinion of the Society is the limit of error to be accepted as permissible in prescribing work. The matter is under consideration by the Society as is also the question of variation in sizes of bottles. In the third case, namely, that of deficiency in ammonium carbonate, Dr. Teed submitted the following note:— "Ammonium carbonate has no very definite composition. "The ammonium carbonate of the British Pharmacopoeia is a mixture of acid carbonate "of ammonium and ammonium carbonate, and should contain 30 6 per cent. of Ammonia. "Exposed to the air it becomes covered with a white efflorescence which is only super"ficial; this efflorescence should be scraped off before the salt is used for dispensing.' "As a matter of fact if sufficiently exposed to the air the whole mass is converted into "this efflorescence, which contains much less ammonia, as low as some 24 per cent. "Previous British Pharmacopoeias required lower percentages of ammonia than 30.6." In the fourth case in which sodium salicylate was deficient to the extent of 19 per cent., and potassium bicarbonate to the extent of 23 per cent., proceedings were ordered to be taken and a conviction obtained against the defendant who was fined £5 and one guinea costs by the Alderman presiding (Report No. 253). In addition, sampling of spirits has been recommenced and the usual routine examination of all other foodstuffs has been continued. The nature and number of such samples is set out in the table appended. THE MILK & DAIRIES (AMENDMENT) ACT, 1922. The Milk and Dairies (Amendment) Act, 1922, became operative on 1st September, 1922. It contains several clauses which strengthen the position of local authorities responsible for the supervision of the milk supply. It will enable them to secure the removal of some difficulties which, in the past, have retarded improvements in the methods of supply and distribution of milk, and so permit of some progress being made. The Milk and Dairies (Consolidation) Act, 1915, which deals even more comprehensively with the several aspects of the milk problem, has never been put 51 into operation. Presumably there are considerations which render it expedient for this Act to remain in abeyance, for Section 1 of the Act of 1922 again postpones the commencement of the Consolidation Act until 1st September, 1925. Some important changes of routine administration are required by the new Act, the most important of which, from a departmental point of view, are contained in Section 2. This Section confers on local authorities the power, under certain circumstances, to refuse to register a retail purveyor of milk, or to remove such person from the Register. Hitherto the Dairies, Cowsheds and Milkshops Orders have required all cowkeepers, dairymen and purveyors of milk to be registered with the local authority, but no power was given to the authority to refuse to register any applicant however unsatisfactory or unsuitable the conditions under which the business was carried on. Furthermore no provision was made for either the withdrawal or termination of registration, except such as are contained in the London County Council (General Powers) Act, 1908. It is now possible for any local authority to exercise this power which is given by Section 2 "if they are satisfied that the public health is, or is likely to be endangered by any act or default of any person . . in relation to the quality storage or distribution of milk." Various powers of appeal against a decision to refuse to register or to remove from the register are given to any person aggrieved thereby. Another useful clause in the Section gives a Court power, on the application of the Local Authority, to order the removal from the Register of any person convicted of any offence under the Acts and Regulations relating to Milk and Dairies. Up to the present one register only has been kept by the local authority of persons carrying on the business of cowkeeper, dairyman or purveyor of milk. Two registers are now required, one of persons trading as retail purveyors of milk, and the other of all other persons registerable under the Dairies, Cowsheds and Milkshops Orders. This latter will consist of wholesale traders, producers and others who do not sell milk by retail. It is apparently unnecessary for persons already registered under the Dairies, Cowsheds and Milkshops Orders to apply for reregistration. I suggested that the new registers should take the form of a card index, the cards being similar to those set out below. The two classes of registration would be indicated by the use of cards of a different colour. A small check register of names and addresses would also be kept as a protection against the loss of any card. A local authority, may presumably, fix minimum local standards and requirements to guide it in its decisions relating to the quality, storage and distribution of milk sold within the area over which it has control. New applicants for registration as retail purveyors of milk might well be required to comply with these requirements, but for the purpose of securing uniformity of administration it will be necessary to carry out an inspection of the premises in the occupation of milksellers already registered, paying particular attention to the methods and general conditions obtaining in order to ascertain whether the local authority is prepared to permit the registration to stand without requiring some alterations or improvements as far as the powers of Section 2 allow. In deciding requirements to regulate the storage and distribution of milk the likelihood of contamination will be the paramount consideration. The regulations of the City Corporation made under the Dairies, Cowsheds, and Milkshops Orders already contain comprehensive provisions for this purpose, but in reconsidering the question under the powers provided by the new Act of Parliament some additional features might be examined. This aspect of the case may advisably be left over for the present and I would suggest that strict compliance with the present regulations form the standard of registration. Section 3 foreshadowed the additional responsibilities to be placed upon local authorities in respect of the issue of licences for the sale of milk of superior quality under special designations such as "Certified," "Grade A" and "Pasteurised," etc. The duty of the local authority will not end with the granting of the licences for supervision will have to be exercised to ensure that the terms under which the licences were granted are being complied with. An order giving effect to these powers and conditions has now been issued and has formed the subject of a further report. 52 Section 4 continues and extends the provisions of an existing order of the Food Controller. It prohibits the addition of any colouring matter or water or reconstituted milk or skimmed or separated milk to milk intended for sale. The Section also prohibits the sale of reconstituted milk as milk. The practice of " toning " milk by the addition of skimmed or separated milk to whole milk to increase the bulk and lower the percentage of fat to the minimum standard of three per cent, is therefore an offence under the Act. Section 5 prohibits under heavy penalty the sale of milk of a cow suffering from tuberculosis of the udder. It is made no defence to plead ignorance, for the Section is specifically made to apply equally to a person guilty and to one who could by the exercise of ordinary care have ascertained that the cow was suffering from disease. This enactment should assist in preventing the distribution of tuberculous milk though it does not apparently place any responsibility on a person selling tuberculous milk after the first transaction, i.e., in the capacity of distributor or retailer if he is not the producer. It would be a considerable advance if retailers and distributors obtained a guarantee from the farmer or producer that the milk supplied by him is from certified healthy animals. Such a procedure would materially improve the prospect of the elimination of tuberculous milk. Section 8 requires the Minister of Health to make regulations as to imported milk under the Public Health (Regulations as to Food) Act, 1907. It also empowers him to make regulations prescribing standards for dried and condensed milks and the manner in which receptacles containing dried, condensed, skimmed or separated milk are to be labelled or marked. The draft of certain proposals as to the standardisation of condensed milk has been made public but it has not yet been before the Sanitary Committee. Section 9 provides for the prosecution of the servant or agent of a purveyor of milk in certain circumstances if the local authority are satisfied that the offence is not within the knowledge, consent or connivance of the purveyor. This Section also protects a person against conviction in respect of a sample of milk taken after the milk has left his custody and control, if it is proved that the churn or other receptacle in which the milk was contained was effectively closed when it left his custody, but was not closed and sealed when it reached the person by whom the sample was taken. At present it is not usual effectively to close and seal churns or milk receptacles during transit. The fastening, if any, is mostly of a very simple character and undoubtedly milk is tampered with at times. It will, however, be of interest to see whether those engaged in milk production and distribution will avail themselves of the protection of this clause by sealing the vessels in which the consignments are forwarded, and so deprive themselves of the excuse which the unsealed churn or receptacle always provides in cases which are the subject of legal proceedings. In arriving at a decision as to whether a person should be placed on the Register or not certain additional considerations will require attention, such as the following:— The desirability of permitting basements to be used for the storage of milk and if so, what conditions should be observed. The practice of permitting churns to stand on the footway outside milkshops and how to safeguard churns and lids. The practice which is found to be followed of small milk receptacles containing a reserve supply standing on shop floors. It seems to me to be desirable that some further experience in considering whether or not a person shall be registered is required before too strict a set of requirements is laid down, and I have, therefore, suggested the following procedure. 1.—Two Registers shall be kept, viz.: (a) of "Retail Purveyors of Milk" and (b) of all other milk sellers. 2.—These Registers to be prepared in card index form; the cards to be as those submitted, but of two different colours. 3.—Milk sellers on the present register to be regarded as now being registered, but at each meeting of the Committee a certain number of milk sellers to be reported upon with a view to transferring their names, or otherwise, to the new Register. This method of registration will bring the circumstances up to date and enable detailed consideration to be given to each case. 4.—The cards to form the index to be of the following character:— 53 Obverse. MILKSELLER (OTHER THAN RETAIL PURVEYOR). Licensed No. on Reg. Date of Registration distributor of Address Daily average quantity of milk Occupier Registered as Owner Owner's Address Source of milk supply Accommodation for Storage. Position Receptacles Covered Condition of floor Walls Ceiling How lighted Ventilated Method of distribution Is skimmed milk received Sanitary Conditions. Drainage Water Closets Water supply Ablution Facilities for cleansing Cistern milk receptacles Remarks Date Inspector Reverse. INSPECTIONS. Date Matters noted Action taken Inspector Obverse RETAIL PURVEYOR OF MILK. Licensed No. on Reg. Date of Registration distributor of Address Daily average quantity of milk Occupier Source of milk supply Owner Owner's Address Accommodation for Storage. Position Receptacles Covered Condition of floor Walls Ceiling How lighted Ventilated Conditions of Retail Sale. Position Receptacle Position Covered Other business carried on Cleanliness of Shop Lighting Ventilation Method of Skimmed milk received outside delivery * Sanitary Conditions. Drainage Water Closets Water supply Ablution Facilities for cleansing Cistern milk receptacles Remarks Date Inspector Reverse. INSPECTIONS. Date Matters noted Action taken Inspector • 54 SOPHISTICATED MILK. In July the Ministry of Health issued a circular letter outlining a policy in relation to the institution of prosecutions in connection with the sale of adulterated milk. Briefly, the circular suggests that prosecutions should only be instituted in cases of milk adulteration where a series of tests have shown repeated default. It would appear that the Minister of Health has had his attention directed to a case in which a milk vendor of good reputation was prosecuted for selling milk deficient in fat. During the course of the hearing it was shown that special circumstances existed to account for the deficiency on the occasion when the sample was purchased. Whilst I am aware of the fact that conditions of a temporary character may on occasions cause the milk from cows, which normally give milk of the proper fat content, to be below that required by the Sale of Milk Regulations, I can only view with concern the issue of an official circular such as that under consideration. In the practical administration of the Sale of Food and Drugs Acts I fear that it will have an effect contrary to the interests of the general public. In the past every opportunity has been given to milk sellers to submit proof to a magistrate that the milk yielded by the cows on the day on which the sample was taken was not tampered with by the seller, and that whatever deficiency of fat there may have been was the result of natural and temporary circumstances such as those suggested in the circular. Further, one must not overlook the fact that the major portion of the milk supply, at any rate to large towns, is the product not of one cow, or one herd of cows, but frequently is the product of a number of different herds. It is very rarely indeed that this mixed milk is found below the official standard. Moreover, the honest trader rarely has any difficulty in satisfying the local authority of his bona fides, and so far as I, personally, am concerned I should always refrain from suggesting the institution of a prosecution in the case of the first deficient sample taken from a tradesman whose goods had been frequently sampled and found to be satisfactory. The unscrupulous trader, however, will, if the suggestion of the Ministry is put into practice, recognise a way of enriching himself at the expense of the public and his honest rival, with less risk of punishment than has hitherto been the case. It is obvious that the probability of the local authority being able to secure repeated default from a series of tests is remote, as the vendor could forestall the authority by the adoption of systematic adulteration on certain days ; the consequent intermittency in results would, undoubtedly, prejudice the case of the local authority. It seems difficult to understand why such a concession should be granted to the sellers of one of the most important items of food unless similar concessions are granted to vendors of other commodities, and, after consideration of the subject, the Sanitary Committee passed a resolution regretting the issue of the circular and expressing the opinion that it should be withdrawn. ANTHRAX AND THE MILK SUPPLY. In the month of May information was received from the Medical Officer of Health of one of the rural areas outside London that a cow on one of the farms in his area had died from anthrax and that milk from the farm had been sent to a City dairyman for two days after the death of the affected cow. The supply was then stopped and on the same day I was notified of the circumstances. On enquiry in the City it was found that all the milk from the farm in question had been disposed of and that the churns in which it had arrived had been returned. The milk, which was described as "Farm Milk," was not bulked with other milkbut kept separately and delivered to customers who specially desired milk which had not been pasteurised. Instructions were given for efficient sterilisation of every receptacle used in connection with the milk and the proprietor was informed that any case of illness 55 amongst his staff or customers must be reported to me immediately it came to his notice. No case was so reported. The herd at the farm was later examined by a Veterinary Surgeon and declared to be healthy, and the supply of milk to the City was consequently resumed. No further case of a similar nature came to my notice during the year. PUBLIC HEALTH (MILK AND CREAM) REGULATIONS, 1912 AND 1917. REPORT FOR THE YEAR ENDED 31st DECEMBER, 1922. From the subjoined table it will be noted that of the 219 samples of milk purchased within the City in no instance did the Analyst report that a preservative had been added, neither did he indicate the addition of any colouring matter. In no instance were " appeal to cow " samples obtained. 13 samples of cream were purchased in addition to the milk samples for examination under the Milk and Cream Regulations, 1912 and 1917. Six of these samples were purchased as cream (not preserved cream). On examination it was found that in two instances such cream did actually contain preservative, namely, boric acid. The purchases were made from the same shop, the first one having been purchased informally, and in consequence of the small amount of preservative discovered a second formal sample was taken. One of these contained 0.18 per cent. and the other half that amount. The explanation submitted by the vendor was accepted and no proceedings resulted. Seven samples of preserved cream were obtained and in all instances the cream was found to contain above 35 per cent. of fat. In two instances, however, the amount of preservative was found to exceed that permitted by the Regulations but not to any very serious extent. In both instances it was below 0.5 per cent., which was the former standard. In one of these instances the seller still retained on his announcements the percentage 05 per cent. which was permitted by previous regulations. It will be remembered that the amount now permissible is 0.4 per cent. Explanations were sought and were accepted by the Committee. In no instance was evidence discovered of the addition of a thickening substance to cream. 1. MILK; AND CREAM NOT SOLD AS PRESERVED CREAM. (a) (b) Number of Samples examined Number in which Preservative was for the presence of reported to be present and percentage Preservative. of Preservative found in each Sample. Milk 219 None. Cream 6 2 0.09 per cent. 0.18 per cent. Nature of preservative in each case in column (b) and action taken under the Regulations in regard to it. (1) Boric Acid. Informal sample. Formal sample taken. (2) Boric Acid. Formal sample from the same vendor as in previous case. The vendor was asked to furnish an explanation. The circumstances were reported to the Sanitary Authority, and, as a result, the vendor was cautioned. 2. CREAM SOLD AS PRESERVED CREAM. (a) Instances in which samples have been submitted for analysis to ascertain if the statements on the labels as to preservatives were correct. (i.) Correct statements made 5 (ii.) Statements incorrect 2 Total 7 (iii.) Percentage of Percentage preservative 10.48 stated on 0.5 found in each 0.46 Statutory 0.4 sample Label (b) Determinations made of milk fat in cream sold as preserved cream. (i.) Above 35 per cent 7 (ii.) Below 35 per cent 0 Total 7 h 2 56 (c) Instances where (apart from analysis) the requirements as to labelling or declaration of preserved cream in Article V (1) and the proviso in Article V (2) of the Regulations have not been observed. Nil. (d) Particulars of each case in which the Regulations have not been complied with, and action taken. (1) Preserved Cream. Described on tariff card of Refreshment Room as being Preserved Cream, containing Boric Acid not exceeding 0.5 per cent. Sample on analysis contained 0.48 per cent. Boric Acid. Vendor cautioned. (2) Preserved Cream. Contained an excess of Boric Acid preservative. A subsequent formal sample complied with the Regulations. Vendor cautioned as to the informal sample. THICKENING SUBSTANCES.-Any evidence of their addition to Cream or Preserved Cream. Action taken where found. None. OTHER OBSERVATIONS, IF ANY. The figure of incorrect statements given under heading No. 2 (ii.) includes one instance where the advertised amount of preservative, though in excess of that permitted by the Regulations, did not exceed the amount actually found in the sample. BORIC ACID IN CAKE AND EGG YOLK. From time to time I have had occasion to report upon the presence of boric acid in egg yolk and have referred to the danger of the use of this product when heavily loaded with this preservative. Steps have been taken to limit the use of boracised egg yolk, but that these are not sufficient is indicated by the following facts:— Sixteen samples of slab cake were obtained and submitted to the Public Analyst for examination as to the boric acid content and his report shows that in 3 only was this preservative absent. In the remaining 13, boric acid was present in amounts varying from 0.03 per cent. to 0.37 per cent. Later, 22 samples of sponge cakes and fingers were similarly examined and boric acid found in amounts varying from nil to 0.42 per cent. So far as I am aware, cake requires no addition of boric acid for any purpose and its presence is doubtless due to the use of boracised egg yolk as an ingredient in the cakes. Enquiries were made and it was ascertained that the cakes had been made at Westminster, Islington, St. Marylebone and, in one case, in the City. Analysis of the egg yolk used in the City case showed boric acid to be present in the amount of 1.10 per cent. Two samples of the yolk used in cakes manufactured in Westminster were examined and one found to be free from boric acid and the other to contain 1.32 per cent. boric acid. Of two samples from Islington, one was free and the other contained 1.75 per cent. of boric acid. Two yolks examined by the Medical Officer of Health for St. Marylebone proved to contain 0.248 per cent. and 22 per cent. of boric acid respectively. Until quite recently boracised egg yolk has been regarded entirely as an imported product and unofficial regulations with regard to distribution and the use to which it could be put could be imposed before allowing the product to be distributed throughout the country. I understand, however, that there are now in this country, firms preparing boracised liquid eggs. A copy of the report which I presented to the Corporation on this subject was forwarded to the Ministry of Health, who fully appreciate the necessity for the exercise of greater control. Subsequently, the Ministry informed me that a communication in the following terms had been received from the Bakery and Allied Traders' Association,* stating that it was unanimously agreed— "That Sponge Fingers, Sponge Biscuits and small Sponge Cakes, should not contain "Boric Acid and that the Trade as a whole should sign a Bond that, in future, when sending "out Liquid Eggs:— "(1) Sale will only be made on the understanding that Liquid Whole Egg must not "be used in the manufacture of Sponge Fingers, Biscuits, and 1d., 1½d., and 2d. Sponge "Cakes. "(2) That our Invoice bears a statement to the Buyer that Liquid Egg cannot be "used in the manufacture of Sponge Fingers, Biscuits and 2d. Sponge Cakes. "And when sending out Liquid Yolks:— "(1) Sold only as an ingredient in the manufacture of Liquid Whole Egg and the "Liquid Whole Egg not to contain more than 50 per cent. of the Yolks." * A further letter, Circular 381, has since been issued by the Ministry of Health, dealing with this subject and dated March 20th, 192; 57 The above policy, if faithfully adhered to, should result in the almost complete elimination of boric acid from sponge fingers, sponge cakes and biscuits. At a later date further samples will be taken with a view to ascertaining to what extent conditions are improved. SALE OF ICE CREAM BY ITINERANT VENDORS. At the beginning of what might be termed the Ice Cream season an inspection was made of the barrows of the itinerant vendors of Ice Cream in the City. These barrows are provided with receptacles with more or less close fitting covers, to contain the ice cream, to which little practical exception could be taken. Another receptacle is, however, invariably carried which contains the water for washing the ice cream glasses, and metal frames in which the ice cream wafers are made up. These receptacles were without covers and were in most cases found to be in an unsatisfactory condition. Examination of the wafer frames showed that the parts not exposed to view were in a dirty condition, and likely to contaminate the water in which they were rinsed as well as to provide a nidus for the development of objectionable and dangerous organisms. The water, too, in which these frames were washed was, especially in the late afternoons, very dirty and on hot days quite warm. I found that the water with which the vendors set out on their morning round was made to last the whole day. When spoken to on the point all the vendors agreed as to the desirability of periodically changing the water, but stated that they were unable to obtain a fresh supply at suitable places. On my recommendation arrangements have now been made by the City Engineer for these traders to obtain clean water at the several men's underground conveniences throughout the City, and also at Aldgate Pump. In order that all the vendors might be made aware of these facilities a circular letter was distributed to them on the subject, and in this circular letter their attention was also directed to the necessity for frequent and adequate washing of the glasses and all utensils, especially the wafer frames which it was suggested should be taken to pieces frequently, scalded, and cleaned before being reassembled. ICE CREAM. In two instances during the year it was necessary to direct the attention of the Sanitary Committee to the manufacture of Ice Cream in basement premises which were wholly unsuited for the purpose to which they were put. It was not necessary to institute legal proceedings as the manufacture was ceased when the occupiers' attention was called to the unsatisfactory nature of the premises. 58 59 ADMINISTRATIVE ACTION REGARDING SAMPLES N0T REPORTED TO BE GENUINE. Name of Article. Identification No. given to the sample in the Quarterly Report. Result of Analysis. If any legal proceedings were instituted under the Sale of Food & Drugs Acts, state result, showing fines and costs separately. If any legal proceedings were instituted under Acts other than the Sale of Food & Drugs Acts, state result, showing fines and costs separately. If no legal proceedings were instituted, state briefly the course adopted in regard to each sample. Information, if any, as to previous convictions. Remarks on any point of special interest. Quarter ending 31st March, 1922. Milk l 11% of the original fat abstracted .... .... .... .... Resampled .... .... .... Subsequent sample genuine. ,, 189 8% of added water .... .... .... .... ,, .... .... .... ,, 238 10% „ „ Fined £5 and 17/6 Costs. .... Same Vendor as No. 189. Gregory Powder 114 55.2% of Magnesium Carbonate and 18.4% of Magnesia instead of 66% of Magnesia. .... .... .... .... Vendor cautioned. ,, 115 71.6% of Magnesium Carbonate instead of 66% of Magnesia. .... .... .... .... ,, Margarine 211 100% of Margarine .... .... .... .... ,, .... .... .... Wrapper not properly marked. Quarter ending 30th June, 1922. Butter 251 100% „ .... .... .... .... Resampled .... .... .... Subsequent sample genuine. „ 288 100% „ .... .... .... .... ,, ,, 292 100% „ .... .... .... .... ,, .... .... .... ,, ,, ,, ,, 295 100% „ .... .... .... .... ,, ,, 385 60% „ Fined £2 and £2 2s. Costs. .... 26th April, 1912, Same Vendor as No. 288. ,, 387 90% Fined £7 7s. and £1 1s. Costs. Fined £5 and 17/6 Costs for similar offence. ,, ,, 295. ,, 527 100% „ .... .... .... .... Resampled Milk 260 4% of the original fat abstracted .... .... .... .... ,, ,, 282 10% ,, ,, Summons dismissed. Warranty proved. .... .... .... .... ,, ,, 260. ,, 427 10% ,, ,, .... .... .... .... Resampled .... .... .... Subsequent sample genuine. ,, 433 8% ,, ,, .... .... .... .... ,, .... .... .... ,, ,, ,, ,, 437 6% ,, ,, .... .... .... .... ,, .... .... .... ,, ,, ,, ,, 460 23% ,, ,, .... „ .... .... .... ,, ,, ,, ,, 462 3% of added water .... .... .... .... ,, .... .... .... ,, ,, ,, 4% of the original fat abstracted 7% deficient in fat ,, 514 5% of the original fat abstracted .... .... .... .... ,, .... .... .... ,, ,, ,, ,, 517 4% ,, ,, .... .... .... .... ,, .... .... .... ,, ,, ,, Extract of Coffee and Chicory 261 Faint trace of Salicylic Acid .... .... .... .... Reported to Sanitary Committee .... .... .... Letter forwarded to all these manufacturers, on the instructions of the Sanitary Committee, stating that the Committee did not consider that coffee extract or essence required the addition of any preservative. Coffee Extract 262 4.9 grains of Salicylic Acid per lb. .... .... .... .... Essence of Coffee with Chicory 264 Faint trace of Salicylic Acid .... .... .... .... Coffee Extract with Chicory 265 7.0 grains of Salicylic Acid per lb. .... .... .... .... Essence of Coffee with Chicory 266 7.0 ,, ,, .... .... .... .... Extract of Coffee 364 3.5 „ „ .... .... .... .... ,, 365 5.8 ,, „ .... .... .... .... Extract of Coffee with Chicory 372 4.5 ,, ,, .... .... .... .... Essence of Coffee 373 Faint trace of Salicylic Acid .... .... .... .... Essence of Coffee with Chicory 374 1.2 grains of Salicylic Acid per lb. .... .... .... .... ,, ,, ,, 375 Trace of Salicylic Acid .... .... .... .... Extract of Coffee 376 ,, ,, .... .... .... .... Essence of Coffee and Chicory 377 1.1 grains of Salicylic Acid per lb. .... .... .... .... Extract of Coffee 388 5.25 ,, ,, .... .... .... .... ,, 389 10.5 grains of Sulphur Dioxide per .... .... .... .... ,, 390 Trace of Salicylic Acid [lb. .... .... .... .... ,, 391 ,, ,, .... .... .... .... ,, 392 1.05 grains of Salicylic Acid per lb. .... .... .... .... Coffee Essence with Chicory 410 2.1 ,, ,, .... .... .... .... Margarine 269 30% of Butter fat .... .... .... .... Resampled .... .... .... Subsequent sample genuine. Mustard 289 26% of Wheat Flour and coloured with Turmeric. .... .... .... .... ,, .... .... .... ,, ,, ,, Honey 400 Faint trace of Salicylic Acid .... .... .... .... Reported to Sanitary Committee. Extracted Honey 402 ,, ,, .... .... .... .... Honey 403 ,, ,, .... .... .... .... Gelatine 404 9.1 grains of Sulphur Dioxide per .... .... .... .... Reported to Sanitary Committee. „ 414 2.8 „ „ [lb. .... .... .... .... ,, 415 4.2 ,, ,, .... .... .... .... Whiskey 420 40.6 degrees under proof .... .... .... .... Resampled. „ 422 38.1 „ „ .... .... .... .... ,, .... .... ,, ,, ,, Rum 457 44.4 „ „ .... .... .... .... .. Quarter ending 30th September, 1922. Cream Jelly 542 0.026% of Sulphur Dioxide .... .... .... .... Reported to Sanitary Committee. 60 61 Administrative Action Regarding Samples Not Reported to be Genuine.—Cont. Name of Article. Identification No. given to the sample in the Quarterly Report. Result of Analysis. If any legal proceedings were instituted under the Sale of Food & Drugs Acts, state result, showing fines and costs separately. If any legal proceedings were instituted under Acts other than the Sale of Food & Drugs Acts, state result, showing fines and costs separately. If no legal proceedings were instituted, state briefly the course adopted in regard to each sample. Information, if any, as to previous convictions. Remarks on any point of special interest. Margarine 548 100% of Margarine Fined £2 and £1 1s. Costs. .... .... .... .... Sold in a plain wrapper. ,, 598 0.56% of Boric Acid .... .... .... .... Resampeld. Vendor cautioned .... .... .... Subsequent sample genuine. ,, 604 0.49% .... .... .... .... Reported to Sanitary Committee. .... .... .... ,, 711 0.41% .... .... .... .... ,, 718 100% of Margarine .... .... .... .... Vender cautioned .... .... .... Sold in an improperly marked wrapper. Butter 549 100% „ .... .... .... .... ,, .... .... .... Same Vendor as No. 527. ,, 599 17.85% of Moisture .... .... .... .... Resampeld. Vendor cautioned Subsequent sample genuine. ,, 700 0.68% of Boric Acid .... .... .... Vendor cautioned. Lemon Curd 560 2.1 grains of Boric Acid per lb. .... .... .... .... Reported to Sanitary Committee. Lemon Cheese 608 1.4 grains of Salicylic Acid per lb .... .... .... .... ,, 615 1.75 ,, ,, .... .... .... .... Borax 582 150 parts of Arsenic per million .... .... .... .... ,, ,, ,, 584 100 „ ,, .... .... .... .... ,, 585 100 ,, ,, .... .... .... .... Whiskey 666 43.4 degrees under proof Fined £2 and £1 1s. Costs. .... Same Vendor as No. 420. ,, 712 36.6 „ „ .... .... .... .... Vendor cautioned. Rum 667 37.6 „ „ Summons dismissed on payment of £1 3s. Costs. .... ,, ,, 457. Chop Sauce 674 Copper equal to 1.4 grains of crystallised copper sulphate per lb. .... .... .... .... Reported to Sanitary Committee. Sauce 675 Copper equal to 0.7 grains of crystallised copper sulphate per lb. .... .... .... .... Quarter ending 31st December, 1922. Whiskey 770 52.1 degrees under proof Fined £2 and £1 1s. Costs. .... Vendor cautioned ,, 771 35.6 „ „ .... .... .... .... ,, ,, 772 36.4 „ ,, .... .... .... .... Borax 822 150 parts of Arsenic per million .... .... .... .... Reported to Sanitary Committee. ,, 823 34 ,, ,, .... .... .... .... ,, 824 34 ,, ,, .... .... .... .... ,, 825 14 ,, ,, .... .... .... .... ,, 830 30 ,, ,, .... .... .... .... Gin 834 42.2 degrees under proof Summons dismissed on payment of £1 3s. Costs. .... ,, 835 42.3 ,, ,, Fined £2 and £1 1s. Costs. .... Vendor cautioned Margarine 844 16.14% of water .... .... .... .... Prescriptions— .... Mist. Sodii Sal. 886 19% deficiency in Sodii Sal Fined £5 and £1 1s. Costs. .... Reported to Sanitary Committee. .... .... .... Letter sent to Pharmaceutical Society. 23% deficiency in Pot. Bicarb Mist. Pot. Brom. 889 8% deficiency in Pot. Brom. .... .... .... .... 5% deficiency in Ammon. Carb .... .... .... .... Vendor cautioned ,, 890 34% „ „ .... .... .... .... Reported to Sanitary Committee. .... .... .... ,, 891 9% stronger both in Pot. Brom. and Ammon. Carb. than prescribed. .... .... .... .... .... .... .... ,, ,, ,, Tinned Spinach 894 Copper equal to 1.54 grains of Crystallised Copper Sulphate per lb. .... .... .... .... ,, ,, ,, The question of copper in tinned vegetables to be reported upon further. ,, 895 ,, ,, .... .... .... .... ,, 896 Copper equal to 3.43 grains of Crystallised Copper Sulphate per lb. .... .... .... .... ,, 897 ,, ,, .... .... .... .... ,, 898 ,, ,, .... .... .... .... Resampled Subsequent sample conformed to B.P. standard. Borax 923 15 parts of Arsenic per million .... .... .... .... Orange Wine 925 1.1 grains Salicylic Acid per pint 0.84 grains Sulphur Dioxide per pt. .... .... .... .... Reported to Sanitary Committee. Raisin Wine 926 0.84 ,, ,, .... .... .... .... Orange Wine 927 2.2 grains Salicylic Acid per pint .... .... .... .... Ginger Wine 928 0.9 ,, ,, .... .... .... .... Raisin Wine 929 0.98 grains Sulphur Dioxide per pint .... .... .... .... Ginger Wine 930 0.84 ,, ,, .... .... .... .... Cyder 938 0.76 ,, ,, .... .... .... .... ,, 940 1.06 ,, ,, .... .... .... .... ,, 941 0.45 ,, ,, .... .... .... .... 62 63 SALE OF FOOD AND DRUGS ACTS, and the PUBLIC HEALTH (MILK AND CREAM) REGULATIONS. Articles examined during each Quarter of the year 1922. Articles submitted for Analysis. Quarter ending 31st March Quarter ending 30th June. Quarter ending 30th September. Quarter ending 31st December. Total for 1922. No of Samples taken. No. Genuine. No. Adulterated. Percentage of Adulteration. No. of Samples taken. No. Genuine. No. Adulterated. Percentage of Adulteration. No. of Samples taken. No. Genuine. No. Adulterated. Percentage of Adulteration. No. of Samples taken. No. Genuine. No. Adulterated. Percentage of Adulteration. No. of Samples taken. No. Genuine. No. Adulterated. Percentage of Adulteration Milk 2 l l 50.0 7 6 l 14.2 7 7 .... .... 55 55 .... .... 71 69 2 14-0 Butter .... .... .... .... 4 2 2 50.0 3 2 l 33.3 1 1 .... .... 8 5 3 37.5 Coffee Essence and Extract .... .... .... .... 3 .... 3 100.0 .... .... .... .... .... .... .... 3 .... 3 100.0 Margarine .... .... .... .... l 1 .... .... 3 3 100.0 .... .... .... .... 4 1 3 75.0 Mustard .... .... .... .... l 1 .... .... .... .... .... .... .... .... .... 1 1 .... Whiskey .... .... .... .... .... .... .... .... 4 2 2 500 3 .... 3 100.0 7 2 5 71.4 Preserved Cream .... .... .... .... .... .... .... .... 1 1 .... .... .... .... .... .... 1 1 .... Cream * .... .... .... .... .... .... .... .... 1 1 100.0 .... .... .... .... 1 .... 1 100.0 Rum .... .... .... .... .... .... .... .... 1 1 100.0 .... .... .... .... 1 .... 1 100.0 Brandy .... .... .... .... .... .... .... .... .... .... .... 3 3 .... .... 3 3 .... Gin .... .... .... .... .... .... .... .... .... .... .... 3 1 2 66.6 3 1 2 66.6 Prescriptions .... .... .... .... .... .... .... .... .... .... .... 9 5 4 44.4 9 5 4 44.4 Total formal samples 2 l 1 50.0 16 10 6 37.5 20 12 8 40.0 74 65 9 12.1 112 88 24 21.4 Informal:— Milk 55 53 2 3.6 57 49 8 14.0 36 36 .... .... .... .... .... .... 148 138 10 6.7 Butter 42 42 .... .... 47 42 5 10.6 22 20 2 9.0 1 1 .... .... 112 105 7 6.2 Margarine 14 13 1 7.1 8 7 1 12.5 10 8 2 20.0 5 4 1 20.0 37 32 5 13.5 Coffee 13 13 .... .... 9 9 .... .... 2 2 .... .... 2 2 .... .... 26 26 .... .... Cheese 12 12 .... .... 1 1 .... .... 2 2 .... .... 6 6 .... .... 21 21 .... .... Lard 10 10 .... .... 5 5 .... .... .... .... .... .... 5 5 .... .... 20 20 .... .... Cocoa 9 9 .... .... 2 2 .... .... 3 3 .... .... 2 2 .... .... 16 16 .... .... Rice 9 9 .... .... 1 1 .... .... 3 3 .... .... 1 1 .... .... 14 14 .... .... Pepper 9 9 .... .... 4 4 .... .... 8 8 .... .... 3 3 .... .... 24 24 .... .... Sugar (Granulated) 8 8 .... .... .... .... .... .... 1 1 .... .... .... .... .... .... 9 9 .... .... Mustard 7 7 .... .... 6 5 1 16.6 8 8 .... .... 3 3 .... .... 24 23 1 4.1 Vinegar 6 6 .... .... 12 12 .... .... .... .... .... .... 6 6 .... .... 24 24 .... .... Sugar (Yellow Crystals) 6 6 .... .... 1 1 .... .... .... .... .... .... .... .... .... .... 7 7 .... .... Ground Cinnamon 6 6 .... .... .... .... .... .... 1 1 .... .... .... .... .... .... 7 7 .... .... Gregory Powder 6 4 2 33.3 .... .... .... .... .... .... .... .... 4 4 .... .... 10 8 2 20.0 Grape Nuts 4 4 .... .... .... .... .... .... .... .... .... .... .... .... .... .... 4 4 .... .... Force 4 4 .... .... .... .... .... .... .... .... .... .... .... .... .... .... 4 4 .... .... Curry Powder 4 4 .... .... .... .... .... .... 1 .... .... .... .... .... .... .... 5 5 .... .... Shredded Wheat 3 3 .... .... .... .... • ••• .... .... .... .... .... .... .... .... .... 3 3 .... .... Ground Rice 3 3 .... .... 1 1 .... .... .... .... .... .... .... .... .... .... 4 4 .... .... Ground Ginger 3 3 .... .... .... .... .... .... 4 4 .... .... 2 2 .... .... 9 9 .... .... Tapioca 3 3 .... .... 3 3 .... .... .... .... .... .... 2 2 .... .... 8 8 .... .... Cayenne Pepper 1 1 .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1 1 .... .... Condensed Milk .... .... .... .... 20 20 .... .... .... .... .... .... .... .... .... .... 20 20 .... .... Coffee Essence and Extract .... .... .... .... 16 .... 16 100.0 .... .... .... .... 1 1 .... .... 17 1 16 94.1 Epsom Salts .... .... .... .... 6 6 .... .... 3 3 .... .... .... .... .... .... 9 9 .... .... Olive Oil .... .... .... .... 6 6 .... .... 1 1 .... .... .... .... .... .... 7 7 .... .... Whiskey .... .... .... .... 6 4 2 33.3 .... .... .... .... .... .... .... .... 6 4 2 33.3 Baking Powder .... .... .... .... 5 5 .... .... .... .... .... .... 3 3 .... .... 8 8 .... .... Compound Liquorice Powder .... .... .... .... 4 4 .... .... .... .... .... .... .... .... .... .... 4 4 .... .... Boric Acid Ointment .... .... .... .... 4 4 .... .... 3 3 .... .... .... .... .... .... 7 7 .... .... Demerara Sugar .... .... .... .... 3 3 .... .... 2 2 .... .... .... .... .... .... 5 5 .... .... Oatmeal .... .... .... .... 3 3 .... .... .... .... .... .... .... .... .... .... 3 3 .... .... Sago .... .... .... .... 3 3 .... .... .... .... .... .... .... .... .... .... 3 3 .... .... Jam .... .... .... .... 3 3 .... .... .... .... .... .... .... .... .... .... 3 3 .... .... Honey .... .... .... .... 3 .... 3 100.0 .... .... .... .... .... .... .... .... 3 .... 3 100.0 Gelatine .... .... .... .... 3 .... 3 100.0 .... .... .... .... 5 5 .... .... 8 5 3 37.2 Flour (Self Raising) .... .... .... .... 3 3 .... .... .... .... .... .... 1 1 .... .... 4 4 .... .... Brandy .... .... .... .... 3 3 .... .... .... .... .... .... .... .... .... .... 3 3 .... .... Gin .... .... .... .... 3 3 .... .... .... .... .... .... .... .... .... .... 3 3 .... .... Rum .... .... .... .... 3 2 1 33.3 .... .... .... .... .... .... .... .... 3 2 1 33.3 Carried forward 64 1 65 SALE OF FOOD AND DRUGS ACTS, and the PUBLIC HEALTH (MILK AND CREAM) REGULATIONS.—Continued. Articles submitted for Analysis. Quarter ending 31st March, Quarter ending 30th June. Quarter ending 30th September. Quarter ending 31st December. Total for 1922. No. of Samples taken. No. Genuine. No. Adulterated. Percentage of Adulteration. No. of Samples taken No. Genuine. No. Adulterated. Percentage of Adulteration. No. of Samples taken. No. Genuine. No. Adulterated. Percentage of Adulteration. No. of Samples taken. No. Genuine. No. Adulterated. Percentage of Adulteration. No. of Samples taken. No. Genuine. No. Adulterated . Percentage of Adulteration. Brought forward Custard Powder .... .... .... .... 3 3 .... .... .... .... .... .... 2 2 .... .... 5 5 .... .... Ipecacuanha Wine .... .... .... .... 2 2 .... .... .... .... .... .... .... .... .... .... 2 2 .... .... Calomel Ointment .... .... .... .... 2 2 .... .... .... .... .... .... .... .... .... .... 2 2 .... .... Beef Extract (cubes) .... .... .... .... 2 2 .... .... .... .... .... .... .... .... .... .... 2 2 .... .... Soup (cubes) .... .... .... .... 2 2 .... .... .... .... .... .... .... .... .... .... 2 2 .... .... Arrowroot .... .... .... .... 2 2 .... .... .... .... .... 9 2 .... .... 4 4 .... .... Dripping .... .... .... .... 2 2 .... .... .... .... .... .... 2 2 .... 4 4 .... .... Citric Acid .... .... .... .... 2 2 .... .... .... .... .... .... .... .... .... .... 2 2 .... .... Tartaric Acid .... .... .... .... 2 2 .... .... .... .... .... .... .... .... .... .... 2 2 .... .... Cream of Tartar .... .... .... .... 2 2 .... .... .... .... .... .... .... .... .... .... 2 2 .... .... Semolina .... .... .... .... 1 1 .... .... .... .... .... .... .... .... .... .... 1 1 .... .... Salt .... .... .... .... 1 1 .... .... 3 3 .... .... .... .... .... .... 4 4 .... .... Preserved Cream .... .... .... .... 1 .... 1 100.0 5 4 l 20.0 .... .... .... .... 6 4 2 33.3 Borax .... .... .... .... .... .... .... .... 8 5 3 37.5 14 8 6 42.8 22 13 9 40.9 Lemon Curd and Lemon Cheese .... .... .... .... .... .... .... .... 8 5 3 37.5 1 1 .... .... 9 6 3 33.3 Cream .... .... .... .... .... .... .... .... 5 4 1 20.0 .... .... .... .... 5 4 1 20.0 Sauce .... .... .... .... .... .... .... .... 5 3 2 40.0 .... .... .... .... 5 3 2 40.0 Sulphur Ointment .... .... .... .... .... .... .... .... 4 4 .... .... .... .... .... .... 4 4 .... .... Camphorated Oil .... .... .... .... .... .... .... .... 3 3 .... .... .... .... .... .... 3 3 .... .... Table Jelly .... .... .... .... .... .... .... .... 4 3 1 250 .... .... .... .... 4 3 1 25.0 Jelly (Crystals and Powder) (and concentrated) .... .... .... .... .... .... .... .... 3 3 .... .... 4 4 .... .... 7 7 .... .... Desiccated Cocoanut .... .... .... .... .... .... .... .... 3 3 .... .... .... .... .... .... 3 3 .... .... Bread .... .... .... .... .... .... .... .... 3 3 .... .... .... .... .... .... .... 3 .... .... Glycerine .... .... .... .... .... .... .... .... 3 3 .... .... .... .... .... .... 3 3 .... .... Light Magnesium Carbonate .... .... .... .... .... .... .... .... 3 3 .... .... .... .... .... .... 3 3 .... .... Table Cream .... .... .... .... .... .... .... .... 1 1 .... .... .... .... .... .... 1 1 .... .... Fruit Jelly .... .... .... .... .... .... .... .... 1 1 .... .... .... .... .... .... 1 1 .... .... Castor Sugar .... .... .... .... .... .... .... .... 1 1 .... .... .... .... .... .... 1 1 .... .... Ground Allspice .... .... .... .... .... .... .... .... 1 1 .... .... .... .... .... .... 1 1 .... .... Ground Nutmeg .... .... .... .... .... .... .... .... 1 1 .... .... .... .... .... .... 1 1 .... .... Blanc Mange Powder .... .... .... .... .... .... .... .... 1 1 .... .... 1 .... .... .... 2 2 .... .... Flour .... .... .... .... .... .... .... .... 1 1 .... .... .... .... .... .... 1 1 .... .... Crushed Linseed ' .... .... .... .... .... .... .... .... .... .... .... 7 7 .... .... 7 7 .... .... Tinned Spinach .... .... .... .... .... .... .... .... .... .... .... 7 2 5 71.4 7 2 5 71.4 British Wines .... .... .... .... .... .... .... .... .... .... .... 6 .... 6 100.0 6 .... 6 100.0 Castor Oil Compound Rhubarb Pills .... .... .... .... .... .... .... .... .... .... .... 5 5 5 5 .... .... 5 5 5 5 .... .... Mincemeat .... .... .... .... .... .... .... .... .... .... .... 5 5 .... .... 5 5 .... .... Malt Vinegar .... .... .... .... .... .... .... .... .... .... .... 4 4 .... .... 4 4 .... .... Flowers of Sulphur .... .... .... .... .... .... .... .... .... .... .... 4 4 .... .... 4 4 .... .... Bicarbonate of Soda .... .... .... .... .... .... .... .... .... .... .... 4 4 .... .... 4 4 .... .... Tea .... .... .... .... .... .... .... .... .... .... .... 3 3 .... .... 3 3 .... .... Cyder .... .... .... .... .... .... .... .... .... .... .... 3 .... 3 100.0 3 .... 3 100.0 Cornflour .... .... .... .... .... .... .... .... .... .... .... 2 2 .... .... 2 2 .... .... Egg Substitute .... .... .... .... .... .... .... .... .... .... .... 2 2 .... .... 2 2 .... .... Seidlitz Powder .... .... .... .... .... .... .... .... .... .... .... 1 1 .... .... 1 1 .... .... Marmalade .... .... .... .... .... .... .... .... .... .... .... 1 1 .... .... 1 1 .... .... Mineral Water .... .... .... .... .... .... .... .... .... .... .... 1 1 .... .... 1 1 .... .... Total Informal Samples 237 232 5 2.1 278 237 41 14.7 177 162 15 8.4 138 117 25 18.1 830 748 82 9.8 Totals 239 233 6 2.5 294 247 47 15.9 197 174 23 11.6 212 182 34 16.0 942 836 106 11.2 66 SALE OF FOOD AND DRUGS ACTS, 1875 TO 1907. RESULTS OF PROSECUTIONS, 1922. First Quarter. Sample. Nature and Extent of Adulteration. Result. Nil. Second Quarter. 238 Milk 10 per cent. added water £5 and 17/6 costs. 282 Milk 10 per cent. of original fat abstracted Summons dismissed. Warranty proved. 385 Butter (on bread) 60 per cent. margarine £2 and £2 2s. costs. 385 Butter (on bread) 60 per cent. margarine Withdrawn. 387 Butter (on bread) 90 per cent. margarine £7 7s. and £1 1s. costs. Third Quarter. 548 Margarine Sold in a plain wrapper £2 and £1 1s. costs. Fourth Quarter. 666 Whiskey 43.4 degrees under proof £2 and £1 1s. costs. 667 Rum 37.6 degrees under proof Ordered to pay £1 3s. costs. 770 Whiskey 52.1 degrees under proof £2 and £1 1s. costs. 834 Gin 42.2 degrees under proof Ordered to pay £1 3s. costs. 835 Gin 42.3 degrees under proof £2 and £1 1s. costs. 886 Prescription— Deficient in sodium salicylate to the Mist Sodii Sal. extent of 19 per cent. and in potassium bicarbonate to the extent of 23 per cent. £5 and £l 1s. costs. SUMMARY. £ s. d. £ s. d. First Quarter: Fines — Costs — Second Quarter ,, 14 7 0 „ 4 0 6 Third Quarter „ 2 0 0 ,, 1 1 0 Fourth Quarter ,, 11 0 0 „ 6 10 0 Total Fines £27 7 0 Total Costs £11 11 6 ARTIZANS' DWELLINGS, STONEY LANE, HOUNDSDITCH. These Buildings, erected by the late Commissioners of Sewers and opened in January, 1885, stand upon ground formerly the site of several courts and alleys in the Ward of Portsoken. There are five "blocks" of Dwellings, severally named King's, Queen's, Prince's, North, and South, designed for occupation by persons of the artizan class, some of the ground floors being let as shops. The Buildings contain 501 rooms, arranged in 241 tenements, and are occupied by 785 persons, compared with 775 in 1921. 73 per cent. are adults and 27 per cent. children (under 14 years). The number of births was thirteen, viz., six males and seven females. The birth rate was 16.5 per 1,000, which is 1.9 per 1,000 below the average for the previous five years. The death rate for 1922 was 11.4 per 1,000 per annum. The number of deaths of children under one year, per 1,000 births, was 77, as against 61 for the City generally. TABLE OF BIRTHS AND DEATHS OCCURRING AT THE ARTIZANS' DWELLINGS, STONEY LANE, HOUNDSDITCH, DURING THE YEAR 1922. Name of Block. Births. Mortality from all Causes at subjoined ages. Male. Female. At all ages. Under 1 year. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. NORTH BLOCK 2 3 3 l .... .... l l .... SOUTH ,, 1 .... .... .... .... .... .... .... .... KING'S ,, .... 1 4 .... .... .... .... l 3 QUEEN'S „ 2 2 .... .... .... .... .... .... .... PRINCE'S „ 1 1 2 .... l .... .... l .... Totals 6 7 9 l l .... l 3 3 67 The birth rate in these Dwellings reached a maximum of 46 9 per 1,000 in 1896, and has since been falling, as shown by the following figures:— BIRTH RATE, ARTIZANS' DWELLINGS. 1896 46.9 1910 32.9 1897 40.3 1911 29.5 1898 43.1 1912 33.4 1899 37.5 1913 ______ 29.7 1900 38.4 1914 36.3 1901 33.8 1915 28.8 1902 45.8 1916 22.6 1903 31.2 1917 29.3 1904 30.1 1918 13.8 1905 29.1 1919 18.7 1906 26.1 1920 19.8 1907 35.0 1921 10.3 1908 31.5 1922 16.5 1909 29.6 The baths provided for the use of tenants of these Buildings, which were opened in May, 1904, continue to be extensively used, the number of persons bathing during 1922 being 12,214, of whom 4,476 were males and 7,738 were females. The accompanying table is compiled from the monthly records of attendances at the baths:— RECORD OF ATTENDANCES AT THE BATHS, ARTIZANS' DWELLINGS. Month . Sex. Total. Males. Females. Children. Adults Children. Adults. January 47 235 134 331 747 February 60 230 151 327 768 March 87 217 189 350 843 April 164 439 337 733 1,673 May 107 264 222 429 1,022 June 110 293 213 469 1,085 July 114 292 181 483 1,070 August 106 267 221 439 1,033 September 105 318 213 497 1,133 October 98 267 157 436 958 November 74 226 178 382 860 December 91 265 196 470 1,022 Totals 1,163 3,313 2,392 5,346 12,214 CITY MORTUARY. DISINFECTION—TRADE.—In accordance with the requirements of the South African Government, the disinfection of second-hand clothing prior to export to that country has been carried on as usual. The Corporation was asked to assist the Metropolitan Borough of Finsbury in the work during 1922 as the apparatus used by that authority was out of order. Assistance was given as requested until the new apparatus was installed in August. The following table gives the details of the work of disinfection carried out at the Disinfection Station during the year in connection with the export trade Number of Number of articles Fees received Certificates issued. disinfected. by the Corporation. 652 760,860 £1,457 DISINFECTION—INFECTIOUS DISEASES Articles disinfected after cases of infectious disease 13,207 Public Vehicles 1 BODIES RECEIVED POST-MORTEMS AND INQUESTS Bodies received at the Mortuary to await burial 135 Post-mortem examinations made 53 Inquests held on bodies 114 Inquests held on fires 15 CLEANSING OF PERSONS ACT, 1897 Number of verminous persons bathed 27 CLEANSING OF SCHOOL CHILDREN Total number of children cleansed 1,084 68 NUMBER OF ARTICLES DISINFECTED, BODIES RECEIVED AT THE MORTUARY, AND INQUESTS HELD AT THE CORONER'S COURT IN THE CITY DURING 1922, COMPARED WITH THE PREVIOUS FIVE YEARS. Year. Articles disinfected. Bodies received at the Mortuary. Inquests held on bodies. Inquests held on Fires. 1917 295,144 234 213 l 1918 179,990 158 130 0 1919 207,935 170 150 4 1920 549,829 172 158 9 1921 579,304 153 140 25 Average for previous 5 years 362,440 177 158 8 1922 760,860 135 114 15 DISINFECTION OF PART WORN POLICE UNIFORMS. In March last I was approached by the Commissioner for the City of London Police and asked whether it would be possible for the Corporation to undertake the disinfection of part worn police uniforms. It was explained that the uniforms which it was desired to disinfect were uniforms which had been very little used and were fit for re-issue and would in all probability not exceed more than 60 to 100 outfits per annum. The Sanitary Committee acceded to the request and during the year 500 garments were so treated. PRESERVATION OF BODIES OF UNKNOWN DEAD.—The De Rechter apparatus for the preservation of the dead, installed at the City Mortuary in March, 1909, was fully described in the Annual Report for that year. It has proved of considerable assistance in connection with the identification of persons found drowned in the river Thames. FIRE INQUESTS.—Dr. F. J. Waldo, J.P., Coroner for City of London and Southwark, has kindly furnished me with the following list of places in the City which were the subject of Fire Inquests held by him during 1922:— INQUESTS HELD UNDER THE CITY OF LONDON FIRE INQUESTS ACT, 1888. Date of Inquest. Premises burnt. 26th January, 1922 24, Aldgate. 6th February, 1922 5, New Union Street. 17th February, 1922 167, Upper Thames Street. 2nd March, 1922 9 and 10, Australian Avenue. 2nd March, 1922 7, Carter Lane. 21st March, 1922 39, Redcross Street. 30th March, 1922 11, Poultry. 30th March, 1922 41 and 43, Moor Lane. 21st April, 1922 17, Little Trinity Street. 21st April, 1922 110, Cannon Street. 10th July, 1922 12 and 13, Noble Street. 10th July, 1922 12 and 13, Noble Street. 17th July, 1922 4, Dorset Buildings, Salisbury Square. 4th and 18th July, 1922 Sub-Station of Metropolitan Railway, Moor Lane. 25th and 28th July 72 and 73, Fore Street. In addition to the above the City Coroner personally inquired into 189 "non-fatal" City fires reported to him during the year. DISINFECTANTS.—As heretofore, all the disinfectants used in the Public Health Department were obtained through your Medical Officer of Health. They are used for the following purposes:—Deodorising and "denaturalising" condemned meat, disinfecting public conveniences, disinfecting roadways, street gullies, disinfecting premises, &c., after infectious disease, drain testing and sundries. 69 SANITARY INSPECTIONS. The following is a statement of the work of the Sanitary Inspectors in their several Districts during each month of the year:— WEST DISTRICT— Inspector F. J. Robbins. Month Premises Inspected. Orders issued. Notices served. Improvements effected. January 112 9 24 8 February 100 — — — March 104 2 15 22 April 154 5 73 16 May 292 37 10 13 June 351 — 57 50 July 100 3 20 15 August 200 — 10 50 September 260 7 7 28 October 224 3 10 25 November 303 13 9 28 December 328 3 15 18 Totals 2,528 82 250 273 MIDDLE DISTRICT— Inspector E. J. Simmons. Month. Premises Inspected. Orders issued. Notices served. Improvements effected. January 271 3 20 19 February 111 l 17 20 March 236 8 5 38 April 262 5 17 25 May 256 15 5 30 June 397 14 15 48 July 201 6 12 20 August 203 7 8 21 September 112 — 4 21 October 243 6 18 27 November 280 12 10 31 December 324 10 14 35 Totals 2,896 87 145 335 EAST DISTRICT— Inspector W. H. Ralph. Month. Premises inspected. Orders issued. Notices served. Improvements effected. January 129 9 10 18 February 236 8 9 9 March 245 43 24 28 April 256 6 69 29 May 245 21 14 43 June 457 23 58 59 July 147 3 19 27 August 195 2 8 18 September 145 1 7 9 October 253 3 11 40 November 287 9 12 29 December 286 8 16 40 Totals 2,881 136 257 349 THE FOREGOING ARE SUMMARISED AS UNDER:— District. Number of inspections made. Orders issued. Notices served. Improvements effected. West 2,528 82 250 273 Middle 2,896 87 145 335 East 2,881 136 257 349 Totals 8,305 305 652 957 70 REGISTERED LODGING HOUSES. Public Health (London) Act, 1891, Sec. 94. The Corporation, as the Sanitary Authority in the City, are required, under the provisions of Sec. 94 of the Public Health (London) Act, 1891, to make and enforce Bye-laws applying to houses let in lodgings or occupied by members of more than one family for the following purposes:— For regulating the number of persons and separation of the sexes. For the registration and inspection of such houses. For enforcing drainage and promoting cleanliness and ventilation. For the cleansing and limewashing of the premises at stated times. For the taking of precautions in any case of infectious disease. The Bye-laws now in force in the City for this class of property were made by the Court of Common Council on 24th November, 1904, and confirmed by the Local Government Board on the 20th January, 1905. Unfurnished lodgings, when the rent is not less than 10s. a week, and furnished lodgings when the rent is not less than 12s. 6d. a week are exempt from the operations of the Bye-laws. Particulars relating to the registered Lodging-houses in the City now on the Register are given in the accompanying table:— REGISTERED LODGING-HOUSES. District. Number of Houses on Register. Number of Lodgers. Number of Tenements. Average Number of Persons per Tenement. Cleansing Notices Served. West 75 480 208 2.3 91 Middle 4 25 17 1.5 4 East 61 316 155 2.0 81 Total 140 821 380 1.9 176 These houses are periodically inspected, and in April of each year the landlords are called upon to carry out a thorough cleansing of them, in accordance with the provisions of Bve-laws. This necessitated the service of 176 Notices during 1922. In addition to the foregoing, there are eleven blocks of Dwellings let out in tenements, but not placed on the Register for the reason that each holding is "selfcontained," it having been decided in a Court of Law that in these circumstances they are not subject to the Bye-laws for houses let in lodgings, or occupied by members of more than one family:— Name and situation of Artisans' Block Dwellings. No. of Tenements. No. of tants. One Room. Two Rooms. Three Rooms. Four Rooms. Five Rooms or more. WEST DISTRICT. Albion Buildings, No. 21, Bartholomew Close .... 9 .... .... .... 20 Albion Buildings, No. 22, Bartholomew Close .... 10 .... .... .... 20 Bartholomew House, Bartholomew Close 14 3 .... .... .... 33 Dean Street Blocks, Fetter Lane— Block A .... 6 .... 1 .... 19 ,, B 4 2 .... 1 .... 12 „ c 4 2 .... 1 .... 16 „ D 6 2 .... .... .... 11 „ E 8 2 .... .... .... 22 „ F 4 4 .... .... .... 11 St. Ann's Chambers, Ludgate Hill 6 13 .... 1 .... 33 Bloomfield House, Snow Hill .... 14 .... 3 .... 45 Total (Six "Blocks") 46 67 .... 7 .... 242 MIDDLE DISTRICT. Bridgewater House, Fann Street .... 12 .... .... .... 13 City Buildings, Moor Lane .... 20 12 .... .... 78 Total (Two "Blocks" .... 32 12 .... .... 91 EAST DISTRICT. Harrow Alley and Stoney Lane— North Block .... 48 8 .... .... 217 South „ 5 22 13 .... .... 178 Prince's „ 5 50 .... .... .... 167 Queen's „ 5 40 5 .... .... 160 King's 8 16 16 .... .... 158 Barker's Buildings, Catherine Wheel Alley, Bishopsgate 11 5 2 2 .... 42 Total (Two "Blocks") 34 181 44 2 .... 922 These ten blocks contain 425 tenements, and are inhabited by 1,255 persons— an average of 295 persons to each tenement. 71 COMMON LODGING-HOUSE, 116, MIDDLESEX STREET.—The above premises, which are known as the "Salvation Army Working Men's Hotel and Shelter," and is the only common lodging-house in the City, was opened on the 7th February, 1906. It was utilised during the War as a Soldiers' Hostel, but is now again in use as a common lodging-house. The premises are periodically inspected, and always found to be well kept and in a generally satisfactory condition. NEGLECT TO COMPLY WITH WATER-CLOSET RYE-LAWS.—In accordance with the Bye-laws with respect to water-closets, &c., made under Section 54 of the City of London (Various Powers) Act, 1900, every person who shall intend to construct a water-closet, or to connect or disconnect any water-closet from any soil pipe or drain, shall, at least seven days before the work is to be commenced, deliver or send to the Corporation at the Guildhall, a plan showing the situation of such water-closet, drawn to scale, together with a section showing the proposed means of ventilation. Under Section 17, every person who shall offend against these Bye-laws renders himself liable to a penalty of £5 for every such offence, and in the case of a continuing offence, to a further penalty of 40s. for each day after written notice of this offence from the Corporation. Any infringement of such Bye-law is a serious matter, and may lead to considerable trouble and expense to the owner of the property, inasmuch as it may necessitate the condemnation of a system installed in contravention of the Corporation requirements. One instance of neglect in this respect has occurred during the year under review. DRAINAGE PLANS.—In the course of the year 234 plans were submitted with regard to proposed reconstruction of water-closets or drains in the City. Of these, 211 were approved, 14 revised and approved, and 9 not approved. STREET GULLIES.—The gradual substitution of properly trapped gullies for those formerly existing has greatly reduced the number of complaints received of offensive smells arising from those appliances, especially in warm weather. In some cases this nuisance was doubtless due to want of flushing, but in the majority faulty construction was the cause of the trouble. The City Engineer has given special attention to this matter for several years past, and his action in replacing the old pattern gullies with those of a more up-todate design will, I hope, eventually lead to a complete abatement of the evil. OVERCROWDING.—Overcrowding is a nuisance to be dealt with summarily under Section 2, Sub-section 1 (e) of the Public Health (London) Act, 1891, and during the year 1 case was reported by your officers. On the service of the statutory notice of abatement the overcrowding was discontinued. SANITARY DEEECTS AND INFECTIOUS DISEASE.—In every case of notification of infectious disease, the premises involved were inspected with regard to the drainage system, water supply, ventilation, &c.; and of the 95 cases so investigated in 1922, it was found necessary to reconstruct the sanitary system in two instances, and to make amendments to soil and waste pipes, water-closets, &c., in 58 others. HOUSE, TRADE AND OTHER REFUSE REMOVAL.—The City Engineer informs me that the refuse removed from the City in 1922 consisted of 19,837 cartloads of street sweepings and slops, and 43,493 loads of house and trade refuse, a total of 63,330 loads. The total for the year 1921 was 64,360. The use of the Destructor was discontinued in September, 1905, since which date all refuse has been removed by barge from Lett's Wharf to the Corporation land on Hornchurch Marshes, where it is dealt with. The horse manure collected from the street orderly bins is not included in the above, but is dealt with by a contractor, who sells it to market gardeners and others. LEGAL PROCEEDINGS.—During the year 652 notices have been served by the District Inspectors at the order of the Sanitary Committee, and in five gases K 2 72 only was it found necessary, in consequence of non-compliance therewith, to refer the matters to the City Solicitor with a view to such steps being taken as he deemed necessary. SUMMER FLUSHING OF COURTS.—There are 279 courts and narrow passages throughout the City which were regularly flushed during the Summer months under the direction of the City Engineer, who informs me that in this service and the flushing of the main streets, no less than 18,336,013 gallons of water were used. Of these courts and alleys, 20 were flushed six times a week, 10 five times a week, 2 four times a week, 27 three times a week, 126 twice a week, and 94 once a week. Disinfectants are also freely applied where desirable. The condition of the approaches to Billingsgate Market and the Customs House, as heretofore, required special attention. There has always been a difficulty in keeping the thoroughfares in the immediate vicinity of these places free from the nuisance caused by the drippings from the fish carts, especially during hot weather. LIMEWASHING OF COURTS.—There are 89 courts and narrow passages situated in various parts of the City, the walls of which, unless cleansed frequently, become dirty and unsightly through the constant traffic of passengers or vehicles, together with the action of the smoke-laden atmosphere. These are cleansed or limewashed twice a year under the direction of the City Engineer. Of the places so dealt with during 1922, 24 were situated in the East District, 33 in the Middle District, and 32 in the West District. DEFECTIVE CONNECTIONS TO SEWER.—During the year, 159 reports were received from the City Engineer respecting the condition of connections between the drains of certain City houses and the public sewer. Investigations shewed that it was necessary to reconstruct 148 of the connections referred to. Of these, 104 have been completed and the remainder are, at the time of writing this report, in process of reconstruction. In the majority of cases these drains were brick-barrel drains, in which rats had their breeding places, and were, undoubtedly, a source of much annoyance to the occupiers of the houses to which they were connected. FLY NUISANCE. In accordance with the practice instituted some few years ago, leaflets calling attention to the nuisance and danger created by the fly were distributed throughout the City. Special reference was made to the precautionary measures which should be taken to minimise the danger, and every effort was made by your officers to impress on householders in the City the necessity for the observance of cleanliness, frequent removal of house and other refuse, and the prevention of access of flies to foodstuffs, especially milk. FACTORY AND WORKSHOP ACT, 1901, &c. FACTORIES, WORKSHOPS AND WORKPLACES.—The premises upon the Register number 3,739, in which are included 7,788 workrooms, &c. There were served 2,226 notices during the year for various purposes under the Acts. The number of Factories, Workshops and Workplaces at present Registered is as follows:— Registered Workrooms, &c , in Places. Registered Places. FACTORIES 1,027 3,494 WORKSHOPS 1,790 2,723 WORKPLACES Kitchens of Restaurants, Tea Rooms, &c. 793 1,264 Stables 20 31 Other places 109 276 3,739 7,788 73 The following is a Summary of Inspections of separate workrooms, &c., during the year:— Workshop Inspectors. Women Inspectors. Totals. FACTORIES 1,763 - 1,763 WORKSHOPS 1,598 1,598 WORKPLACES 957 l 958 The following is a Summary of Inspections of separate workrooms since 1914 Workshop Inspectors. Women Inspectors. Totals. FACTORIES. 1914 3,025 237 3,262 1915 1,438 319 1,757 1916 1,264 406 1,670 1917 1,501 234 1,735 1918 904 3 907 1919 995 7 1,002 1920 866 — 866 1921 1,956 2 1,958 1922 1,763 — 1,763 WORKSHOPS. 1914 2,053 658 2,711 1915 1,411 751 2,162 1916 1,224 799 1,960 1917 1,308 347 1,655 1918 783 11 794 1919 1,069 18 1,087 1920 731 — 731 1921 1,958 — 1,958 1922 1,598 — 1,598 WORKPLACES. 1914 672 138 810 1915 512 164 676 1916 469 173 642 1917 760 124 884 1918 713 72 785 1919 445 41 486 1920 618 — 618 1921 979 38 1,017 1922 957 1 958 BAKEHOUSES.—Bakehouses are scheduled as Workshops (Part 2, Sixth Schedule), and are required to be registered by the Local Authority (Section 132). The following is a list of Bakehouses registered in the City:— ABOVEGROUND BAKEHOUSES. †*37, Middlesex Street. *63 to 65, Middlesex Street. † 280, Bishopsgate. † *122, Middlesex Street. †45, Fish Street Hill. - 3, Pancras Lane. † Great Eastern Railway Hotel. 21, Stoney Lane. *61, Middlesex Street. 68, St. Mary Axe. *85, Middlesex Street *75, St. Paul's Churchyard. 194, Upper Thames Street. UNDERGROUND BAKEHOUSES. 188, Aldersgate. SUMMARY. 262, Bishopsgate. *4, Broadway. Aboveground Bakehouses 5 8, Copthall Avenue. Underground Bakehouses 16 15, Cornhill. †*67, Farringdon Street. 21 *93, Fetter Lane. 48, Knightrider Street. * These have been established at least 36 years. † Factory Bakehouses (power is used). 74 SUMMARY OF WORK DONE UNDER THE FACTORY AND WORKSHOP ACT, 1901, AND THE PUBLIC HEALTH (LONDON) ACT, 1891, &c., FOR THE YEAR 1922. Men Inspectors. Women Inspectors. Special. Inspector Gathercole. East District. Inspector Robinson. West District. Inspector McGrath. West District. Miss East District. Miss Wilkinson. Totals. INSPECTIONS. Factories, Initial Inspections (Tenancies) .... 66 33 .... .... 99 Do. Initial Inspections (Workrooms) .... 130 97 .... .... 227 Do. Periodical Inspections (Tenancies) .... 225 232 .... .... 457 Do. Periodical Inspections (Workrooms) .... 616 920 .... .... 1,536 Do. Re-inspections (Sanitary Works, &c., in hand) .... 322 142 .... .... 464 Workshops, Initial Inspections (Tenancies) .... 147 88 .... .... 235 Do. Initial Inspections (Workrooms) .... 210 140 .... .... 350 Do. Periodical Inspections (Tenancies) .... 459 319 .... .... 778 Do. Periodical Inspections (Workrooms) .... 676 529 .... .... 1,205 Do. Re-inspections (Sanitary Works, &c., in hand) .... 400 195 .... .... 595 Workplaces, Initial Inspections (Tenancies) 29 .... .... .... .... 29 Do. Initial Inspections (Workrooms) 36 .... .... .... .... 36 Do. Periodical Inspections (Tenancies) 499 .... 3 .... 1 503 Do. Periodical Inspections (Workrooms) 908 .... 13 .... 1 922 Do. Re-inspections (Sanitary Works, &c., in hand) 573 .... 1 .... 1 575 Bakehouses, Inspections 43 .... .... .... .... 43 Do. Re-inspections (Sanitary Works, &c., in hand) 7 .... .... .... .... 7 DEFECTS FOUND. Factories, Workshops and Workplaces, &c.— Want of Cleanliness 175 47 27 .... .... 249 Want of Ventilation 18 4 6 .... .... 28 Overcrowding .... 5 .... .... .... 5 Want of Drainage of Floors .... .... .... .... .... .... Other Nuisances, &c. 53 174 38 .... .... 265 Kitchens Storage Cistern defective 3 .... .... .... .... 3 Accommodation for Refuse 7 .... .... .... .... 7 Accumulation of Refuse 4 .... .... .... .... 4 Sanitary Accommodation Insufficient (Tenancies) .... .... .... .... .... 2 Unsuitable (Do.) 4 3 14 .... .... 21 Defective (Do.) 58 153 123 .... .... 334 Do. (No. of Conveniences)* 72 300 312 .... .... 684 Not separate for Sexes (Tenancies) 9 25 8 .... .... 42 Total Defects found 333 411 216 .... .... 960 DEFECTS REMEDIED. Factories, Workshops and Workplaces, &c.— Want of Cleanliness 182 41 34 .... .... 257 Want of Ventilation 9 6 6 .... .... 21 Overcrowding .... 5 .... .... .... 5 Want of Drainage of Floors .... .... 1 .... .... 1 Other Nuisances, &c. 39 189 33 .... .... 261 Kitchens Storage Cistern defective 4 .... .... .... .... 4 Accommodation for Refuse 5 .... .... .... .... 5 Accumulation of Refuse 2 .... .... .... .... 2 Sanitary Accommodation Insufficient (Tenancies) .... .... .... .... .... .... Unsuitable (Do.) 2 3 17 .... .... 22 Defective (Do.) 53 157 110 .... .... 320 Do. (No. of Conveniences)* 61 309 271 .... .... 641 Not separate for Sexes (Tenancies) 2 23 10 .... .... 35 Total Defects remedied 298 424 211 .... .... 933 OUTWORKERS. Lists received from City Firms 1,488 .... .... .... .... 1,488 Names and A ddresses, &c., received from other Authorities 322 .... .... .... .... 322 Names and A ddresses transmitted to other Authorities 11,956 .... .... .... .... 11,956 Notices served on Employers 1,934 .... .... .... .... 1,934 Letters written, &c. 57 .... .... .... .... 57 Firms visited 167 .... .... .... .... 167 Workshops notified by H.M. Inspector .... 50 10 .... .... 60 General complaints received 5 5 1 .... .... 11 Miscellaneous Visits .... .... .... .... .... .... * Figures not included in total defects found or remedied. 75 ACTION TAKEN. Men Inspectors. Women Inspectors. Special. Inspector Gathercole. East District. Inspector Robinson. West District. Inspector McGrath. West District. Miss East District. Miss Wilkinson. Totals. Matters referred to H.M. Inspector— Want of Cleanliness .... 1 3 .... .... 4 Want of Ventilation .... .... .... .... .... .... Overcrowding .... .... .... .... .... .... Want of Drainage of Floors .... .... .... .... .... .... Failure to affix Abstract .... 32 25 .... .... 57 Other Nuisances .... .... 1 .... .... 1 Action taken in matters referred by H.M. Inspector— Notified by H.M. Inspector .... 52 7 .... .... 59 Reports sent to H.M. Inspector .... 52 7 .... .... 59 Other matters .... .... .... .... .... .... Notices served— Factories—Intimation .... 11 13 .... .... 24 Statutory .... 12 8 .... .... 20 Workshops—Intimation .... 56 18 .... .... 74 Statutory .... 42 3 .... .... 45 Workplaces, &c.—Intimation 109 .... .... .... .... 109 Statutory 20 .... .... .... .... 20 Orders required from Sanitary Committee 75 43 10 .... .... 128 Certificates for Cleansing issued by Medical Officer of Health 58 10 .... .... .... 68 Matters referred to District Inspectors 22 8 2 .... .... 32 Matters referred to Women Inspectors .... .... .... .... .... .... Matters referred to Workshop Inspectors .... .... .... .... .... .... Cases reported for Legal Proceedings .... .... .... .... .... .... Legal Proceedings taken .... .... .... .... .... .... SPECIAL INSPECTION WORK. Domestic Workshops—Inspections (Tenancies) .... .... 1 .... 9 10 Do. Defects found .... .... .... .... 1 1 Do. Defects remedied .... .... .... .... 1 1 Outworkers' Premises, Inspections (Tenancies) not registered as Work shops .... .... 14 .... .... 14 Do. Defects found .... .... .... .... .... .... Do Defects remedied .... .... .... .... .... .... WOMEN INSPECTORS. Offices, Inspections (Tenancies) .... .... .... .... .... .... Do. Defects found .... .... .... .... .... .... Do. Defects remedied .... .... .... .... .... .... London County Council (General Powers) Act, 1904, Inspections of Premises after Cleansing of Children .... .... .... .... 10 10 Do. Do. Defects found .... .... .... .... .... .... Do. Do. Defects remedied .... .... .... .... .... .... Children Act, 1908 (Nurse Children), Inspections of Premises .... .... .... .... 10 10 Do. Do. Defects found .... .... .... .... .... .... Do. Do. Defects remedied .... .... .... .... .... .... Underground Conveniences for Women, Inspections .... .... .... .... 24 24 Do. Do. Defects found .... .... .... .... 27 27 Do. Do. Defects remedied .... .... .... .... 2 2 Railway Stations (Ladies' Rooms), Inspections .... .... .... .... 29 29 Do. Do. Do. Defects found .... .... .... .... 5 5 Do. Do. Do. Defects remedied .... .... .... .... .... .... Notification of Births Act, 1907, Visits .... .... .... .... 240 240 Number of Mothers attending Welfare Centre for advice .... .... .... .... 367 367 Special Visits .... .... .... .... 5 5 OUTWORKERS AND HOMEWORKERS.—The provisions of the Act relating to "Outworkers" were carried out as heretofore, and the lists of the names and addresses of workers receiving work from the City firms were duly received without the necessity of legal proceedings. In 85 cases employers neglected to keep lists at their premises and to send copies of the same to the Corporation as required by the Act. Notice in each case was served upon the offender and in all cases complied with. 76 No case of infectious disease was reported in connection with premises occupied by outworkers in the City. The following figures show the number of Outworkers notified since 1902:— Year. Number of Lists received. Outworkers Employed in City. Outworkers Employed outside City. Total number of Outworkers. 1902 17 3,752 3,769 (Note.—First Notice issued to all employers at the end of 1904.) 1905 576 236 7,891 8,127 1908 1,506 624 16,909 17,533 1911 1,515 656 16,405 17,061 1912 1,481 709 15,777 16,486 1913 1,523 718 16,025 16,743 1914 1,581 739 15,941 16,680 1915 1,589 807 15,444 16,251 1916 1,481 661 14,766 15,427 1917 1,366 602 13,319 13,921 1918 1,395 607 12,802 13,409 1919 1,379 688 12,581 13,269 1920 1,359 802 13,102 13,904 1921 1,411 717 11,035 11,752 1922 1,493 783 11,956 12,739 77 FACTORIES, WORKSHOPS, WORKPLACES AND HOMEWORK. 1 922. 1—INSPECTION OF FACTORIES, WORKSHOPS AND WORKPLACES. Including Inspections made by Sanitary Inspectors or Inspectors of Nuisances. Premises. Number. (1) Inspections. Written Notices. Prosecutions (2) (3) (4) Factories (including Factory Laundries) 556 44 Workshops (including Workshop Laundries) 1,056 119 Workplaces (other than Outworkers' premises included in Part 3 of this Report) 532 129 Total 2,144 292 2.—DEFECTS FOUND IN FACTORIES, WORKSHOPS AND WORKPLACES. Particulars. Number of Defects. Number of Found. Remedied. Referred to H.M. Inspectors. Prose cutions. (1) (2) (3) (4) (5) Nuisances under the Public Health Acts :—† Want of cleanliness 249 257 4 — Want of ventilation 28 21 — — Overcrowding 5 5 — — Want of drainage of floors — 1 — — Other nuisances 279 272 3 — Sanitary accommodation insufficient 2 — — — unsuitable or defective 355 342 — — not separate for sexes 42 35 — — Offences under the Factory and Workshop Act:— Illegal occupation of underground bakehouse (S. 101) — — — — Breach of special sanitary requirements for bakehouses (SS. 97 to 100) — — — — Other offences (excluding offences relating to outwork which are included in Part 3 of this Report) — — — — Total 960 933 7 — t Including those specified in Sections 2, 3, 7 and 8 of the Factory and Workshop Act, 1901, as remediable under the Public Health Acts. 78 I 79 3.—HOME WORK. NATURE OF WORK.* OUTWORKERS LISTS, SECTION 107 Notices served on occupiers as to keeping or sending Lists. Prosecutions. OUTWORK IN UNWHOLESOME PREMISES, SECTION 108. OUTWORK IN INFECTED PREMISES, SECTIONS 109, 110. Lists received from Employers. Instances. Notices served. Prosecutions. Instances Orders made (S. 110). Prosecutions (Sections 109, 110). Sending twice in the year. Sending once in the yean Failing to keep or permit inspection Failing to send lists. Lists.† Outworkers, † Lists. Outworkers. Contractors. Workmen. Contractors. Workmen. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) Wearing Apparel— 1 1,934 making, &c 1,264 3,718 7,368 22 33 41 cleaning and washing Household Linen Lace, Lace Curtains and Nets Curtains and Furniture Hangings Furniture and Upholstery Electro Plate File making Brass and brass articles Fur pulling (Furriers) 102 190 317 3 16 1 Cables and Chains Anchors and Grapnels Cart Gear Locks, Latches and Keys Umbrellas, &c 54 41 230 — — — Artificial Flowers 34 — 433 — — — Nets, other than Wire Nets Tents • Sacks Racquet and Tennis Balls Paper, &c., Boxes, Paper Bags 8 8 18 1 — 3 Brush making Pea picking . Feather sorting Carding, &c., of Buttons, &c Stuffed Toys Basket making Chocolates and sweetmeats Cosaques, Christmas Crackers, Christmas Stockings, &c Textile Weaving Total 1,462 2,957 8,366 26 49 45 1,934 Nil. Nil. Nil. Nil. Nil. Nil. Nil. Nil. * It an occupier gives out work of more than one of the classes specified in column 1, and subdivides his list in such a way as to show the number of workers in each class . . . 4 (or 6 and 7) into their respective classes. A footnote should be added to show that this has been done. of work, the list should be included among those in column 2 (or 5 as the case may be) against the principal class only, but the outworkers should be assigned in columns 3 and † The figures required in columns 2. 3 and 4 are the total number of the lists received from those employers who comply strictly with the statutory duty of sending two lists some previous returns odd numbers have been inserted. The figures in columns 3 and 4 will usually be (approximately) double of the number of individual outworkers whose each year and of the entries of names of outworkers ... those lists. The entries in column 2 must necessarily be even numbers as there will be two lists for each employer—in names are given, since in the February and August lists of the same employer the same outworker's name will often be repeated. 4.—REGISTERED WORKSHOPS. Workshops on the Register (S. 131) at the end of the year. (1) Number. (2) Important classes of workshops, such as workshop bakehouses, may be enumerated here. General Workshops 1,769 Bakehouses (including Factory Bakehouses) 21 Total number of Workshops on Register *1,790 5.—OTHER MATTERS. Class. Number. (1) (2) Matters notified to H.M. Inspector of Factories :— Failure to affix Abstract of the Factory and Workshop Act (S. 133, 1901) 57 Action taken in matters referred by H.M. Inspector as remediable under the Public Health Acts, but not under the Factory and Workshop Act (S. 5, 1901). ' Notified by H.M. Inspector 59 Reports (of action taken) sent^to H.M. Inspector.... 59 Other 1 Underground Bakehouses (S. 101):— Certificates granted during the year NiL In use at the end of the year 16 Dale, 31st December, 1922. (Signature) W. J. HOWARTH, * These were found to be 2,744 Workrooms, &c., in places Registered. Medical Officer of Health. Note:- The Factory Workshop Act, 1901 (S. 132), requires the Medical Officer of Health in his Annual Report to the District Council to report specifically on the administration of that Act in workshops and workplaces, and to send a copy of his Annual Report, or so much of it as deals with this subject, to the Secretary of State (Home Office). If the Annual Report is presented otherwise than in print, it is unneccessary to include in factories, workshops, workplaces, or homework. The duties of Local Authorities, and the Medical Officer of Health under the Act of 1901 are detailed in the Home Office Memorandum of March, 1912. L 2 l 2 80 RAT REPRESSION. The table set out on page 84 indicates the number of investigations and inspections made and details of work carried out under the Rats and Mice (Destruction) Act, 1919, during the year ended December 31st, 1922. From this summary it will be seen that 1,076 buildings were inspected and that those buildings were occupied by some 2,500 firms. Of the premises no fewer than 855 were rat infested. Various methods were employed by occupiers to destroy rats. One or other of the ratcatchers working in the Gity were engaged by business firms in 82 instances; poisons were laid down by 463 firms and traps of the break- back character were used in 459 premises and wire traps in 146. Varnish traps which are used in special circumstances were relied upon in 259 premises. Cats and dogs were found to be kept by 271 firms. Complaints have been received at the office or applications for advice in 155 instances. The work done in addition to poisons and traps and the keeping of animals included rat proofing in 255 instances and drainage defects repaired in 150 instances. Mr. Engineer further informs me that during the year following the sewerage and drainage works, all of which tended to reduce the number of breeding places for rats, were carried out by his Department:— Pipe Sewers reconstructed 7 „ „ in course of reconstruction 2 „ ,, substituted for old brick sewers 3 Brick sewers re-inverted 7 „ „ in course of being re-inverted 1 „ „ reconstructed 1 Sewers repaired 12 Disused sewers filled in 7 Disused gulley and drain abolished 1 Existing drains reconstructed 120 „ „ repaired 9 Gulley drains reconstructed 57 Disused drains bricked up 373 Total 600 It was not found necessary in any case either to serve statutory notices or to take legal proceedings. I am indebted to Messrs. Dalton & Sons, professional rat catchers, for the information that they have during the year caught 20,358 rats in the City area. During the year in accordance with the instructions of the Court of Common Council I presented a report on this subject, which appeared in printed report No. 249 of the Medical Officer of Health. I then made the following suggestions " 1.—That rat investigation and repression should be regarded as coming under the head" ing of general sanitary work, and be referred to the district and factory and workshop " inspectors* who will report on rat infested premises. There should be attached to the de" partment an inspector competent to supervise the execution of the remedial measures " necessary. " 2. Remedial measures should be the responsibility not of the occupier alone but of " both the occupier and the owner. Of the owner when structural defects exist such as " favour the harbouring of rats and prevent the occupier dealing effectually with infestation. " The occupier should be responsible for ridding his premises of casual infestation when " structural conditions are such as enable him with reasonable care to rid the premises of " casual rats. " 3. Rat catchers, for reasons stated, should be registered with the Local Authority, " and controlling regulations should be framed. " 4. In view of the difficulties of the problem and the practical impossibilities of ex" terminating rats by present known methods, research work should not only be encouraged, " but should be a function of the central department." As regards the first of these suggestions, I am satisfied increasing experience will justify the recommendation. It is somewhat unfortunate, in my opinion, that the Act under which rat repression is carried out does not recognise that there *" Since writing this report I observe that the recently issued Sanitary Officers' Order, " 1922, provides that a Sanitary Inspector shall ' if so directed by the Local Authority " under the Rats and Mice (Destruction) Act, 1919, and under any orders or " regulations made thereunder. " 81 is a difference in the nature of the work to be performed in rural and urban districts. The problems whilst being similar in minor respects are totally dissimilar in major respects. Rat repression in urban districts in so far as the vermin infest separate buildings, resolves itself into a consideration of whether the sanitary conditions of that building, particularly as regards drains, are satisfactory ; whether refuse is properly stored and whether the construction of the building is such that renders difficult the ingress of the vermin to the premises and the vermin having gained entry, whether life is rendered difficult by the absence of suitable nesting places and by the reduction of available food supplies to a minimum. Similar principles apply in a rural district, particularly as regards what might be termed common harbourage, but the application of preventive measures is a different problem to what is presented in urban areas. In dealing with separate premises one of the primary considerations is to render those premises proof against ingress of rats from the sewers. This entails two considerations:— (i) careful inspection of existing sanitary fittings and (ii.) adequate supervision of such fittings as it is proposed shall be put out of use. As regards the first of these, the drainage work done by all the inspectors as well as the special work done by the rat inspectors may be included as work against rat infestation. The City Engineer is constantly investigating the sewers, and as far as opportunity presents, it appears that sewers are being improved. In his investigations of the sewers he directs my attention to defective connections, many of which are the result of the circumstance that years ago drains and connections to the sewers were made under regulations which are not acceptable to-day. As regards the second requirement, the bye-laws of the Corporation now require that before any structural alterations are carried out to existing sanitary appliances, notice of the proposal should be sent to the Medical Officer of Health. In this way control is obtained of drains which it is proposed shall be cut off from existing drainage. It enables supervision to be made of the closing of open ends and if necessary defective drains which are thrown out of use may be required to be dug out or stopped up in some adequate manner. In the City the disused drains of the past must provide a certain amount of suitable harbourage. The proposals of the London County Council contained in the following resolution of the General Purposes Committee must be reviewed with satisfaction:— " (a) That legislation be promoted in the Session of Parliament 1923, to place upon " owners or occupiers of property an obligation to notify the local authority on ceasing to " use any drain or similar sanitary fitting, and to make it an offence to cease to use any " such drain or sanitary fitting without efficient sealing off." Apparently the Ministry of Health regard rat repression as being closely related to general sanitation. For that reason the Sanitary Officers' Order, 1922, now provides that a sanitary inspector shall " if so directed by the Local Authority, " act as an officer of the Local Authority under the Rats and Mice "(Destruction) Act, 1919, and under any orders or regulations made thereunder." Under this instruction all the sanitary inspectors have been appointed officers under this Act and approval of the Ministry has been made to the temporary appointment of Mr. Mayne as officer co-ordinating the work of the different inspectors in connection with rat repression. It is also perhaps of interest briefly to mention the standpoints from which rat repression is viewed by the owner and occupier of a building since the Act came into operation. Before January, 1920, the date of the Act coming into force, if rats became a nuisance the occupier usually complained to the owner who took the necessary steps to abate the nuisance, either by calling in professional ratcatchers or by instructing his builder to see to the drains if necessary and to stop up all holes and places of ingress. Poisons also were used, chiefly by the ratcatcher and the building was dealt with as a whole. The chief poison in those days was generally phosphorous and from it reasonably good results were obtained. Viruses of more or less efficiency have also been in use for some years. The dangers to be apprehended from the use of bacterial preparations and their limited application were fully 82 discussed in my report to the Corporation dated February 24th, 1920. When the Act came into force, however, the occupier of a building or part of a building, became solely responsible for rat riddance, the owner being under no obligation whatever to carry out any structural works which might be shown to be necessary to repress rats. This is the weak point of the Act for it becomes exceedingly difficult in a large building occupied by a large number of tenants to get joint action. Owing to circumstances connected with the business, infestation say of a five-storey building may only be noted on three or four of the stories. The fourth and fifth occupiers who are not affected are extremely reluctant to spend money in bringing about improvement which is of no benefit to themselves. Even though premises may be only partially infested the necessary alterations are such in some cases that they can only be regarded as a charge which should be equally distributed over the whole of the occupiers. This brief illustration indicates clearly the necessity for the landlord or owner having responsibility where premises present difficulties which only structural alterations can remedy. If, however, the premises structurally are sound and separate tenancies are either accidentally infested or the nature of the business is such as to encourage infestation or render de-infestation difficult, then the occupier should shoulder the responsibility. Rat infestation is furthermore perhaps rendered more difficult to-day by the fact that accommodation in increasing amount for consuming food on the premises is frequently being provided for employees. This may have arisen from the fact that more women and girls are employed than formerly and the provision ranges from a satisfactory kitchen and dining room to a simple room which is set apart for meals. One finds that buildings which were rat free before this accommodation was introduced are now rat infested, food being the attraction. This is probably not a serious matter, but still it is one of those minor developments which have perhaps resulted in more rats being observed to-day inside premises than formerly was the case. Again, I have some doubt whether the poisons used are as effective as is supposed. I am afraid that many of the proprietary products, of which a large number exist on the market, are by no means as efficacious as they are reputed to be. Strychnine, arsenic, phosphorous are discouraged owing to the dangers attaching to their use and recipes have appeared containing other agents which appear to do little more than irritate the majority of the rats consuming it. I am not sure that barium carbonate is worthy of the prominent position which it occupies. Again, the City rat population is constantly being reinforced by importations from the docks. I am aware that considerable improvements have been effected at the docks and much useful work is there being carried out, but there is evidence throughout the City that the ship rat is now appearing in greater proportion to the total rat population than formerly. These rats are often brought into the City in crates or skeleton cases, and as some warehouses receive large stocks of cases and as some of them are only moved at long intervals these rats have both space for movement and time and harbourage for multiplication. Another suggestion that has frequently been made is that a ratcatcher should be appointed bv each municipality. This appears to me to be an almost useless suggestion. A ratcatcher is useful for dealing with individual premises but as a means for dealing with the problem as a whole his value is only proportionate to the information which he conveys to the Health Department of rat infested premises or of the reasons why certain premises are rat infested. A local authority would be better advised in increasing its inspectorial staff, if additional officers are necessary, rather than involving itself in liability for rat catching work by the appointment of a ratcatcher. As stated ratcatchers are worthy of their place as aids for controlling infestation in any particular premises, but their work should be encouraged by private firms, and should also be subject to some simple control by the local authority, such control being limited to matters in which the local authority is directly interested. The appropriate storage of garbage and refuse is a subject which cannot be disregarded in connection with rat repression and it is satisfactory to note that the 83 Sanitary Committee have instructed the City Engineer to submit a report in connection with this matter. I made the following recommendation to the Sanitary Committee on November 28th, which was attached — " I am of opinion that it is desirable that the type of ashbin which is used in the City " should be definitely stated, and I would suggest that the matter be referred to Mr. Engineer " with a view to his deciding the size and material of a bin which would meet City require" ments and at the same time prove acceptable in the work of refuse collection, since it is " perfectly clear that if the provision of rat-proof bins of a satisfactory type were made an " essential requirement some progress would be effected. At the present time your inspec" tors obtain provision of these bins by the somewhat roundabout process of regarding an " unsuitable bin as a potential nuisance." It is my practice to record any matters of interest which Mr. Mayne discovers in the matter of rat repression work and the following two items are of interest:— 1. There is a material known as vegetable ivory which is used for the manufacture of buttons. This vegetable ivory is prepared from at least two nuts, namely, the Dum nut of Northern Africa and the Corozo nut of Mexico. The appearance of buttons made from these nuts is clearly distinctive. The former does not appear to be quite so hard and does not take the polish of the Corozo, and manufacturers of these buttons have noted that rats will gnaw and consume buttons made from the Dum nut and not those made from the Corozo nut. The explanation given is that the former buttons contain more fat, but it seems to me equally probable that it is a physical reason. A material with the polished surface and the hard texture of the Corozo nut may result in its being a material which the rat does not care to tackle. 2. As I have previously reported, varnish is frequently used in the City for rat catching purposes, and is found to be of increasing value. Difficulties have arisen in the past owing to the fact that varnishes on the market are not of equal "tackiness," in fact some varnishes are useless for the purpose. Enquiries would appear to indicate that this varnish, which is prepared from flax seeds, varies according to the country of origin of the seeds. It is stated that seeds obtained from sub-Tropical or Tropical regions do not yield a product equal in tackiness to that manufactured from seeds obtained from temperate or colder places. This information has not been confirmed and is submitted as an expression of opinion which has been obtained by Mr. Mayne. For the information of your Honourable Court a copy of the card used in connection with rat repression work is reproduced herewith:— Obverse. Card No RATS AND MICE DESTRUCTION. No. in Register Situation, Name, Descrip- tion of Land or Premises, - Ship. Occupier ,Prevalence of Rats or Mice Name & Address of Ower Inspection or Action taken. By Materials used Expenses Charged up Reverse. Foodstuffs Stored (Animal & Human) General Observations Other edible products Defects in Building & Roof or Paving Defects in Sanitary Fittings Defects in Drains Presence of rats in vicinity What attraction to rats in vicinity Portion of premises most infested f Means of rat ingress to building Date of report on drainage to M.O.H. Date drains certified satisfactory by Dist. Inspector Date notice served Inspector. 84 RATS AND MICE (DESTRUCTION) ACT, 1919. Summary Showing Investigations and Inspections Made and Details of Work Carried Out under the Above Act, for the Year ended, December 31st, 1922. Months 1922. No. of Buildings Inspected. Average No. of Firms in building. No. of premises Rat Infested. Total No. of Firms interested. Steps taken to destroy Rats. Rat Proofing done, Rat-holes stopped, &c. Drainage and Sewage Work carried out • during the year. Special Observations. Rat-Catcher Employed. Poison Used. Wire Traps. Breakbacks. Varnish Traps. Other Traps. Cats or Dogs kept. By City Engineer's Department. By M.O.H Department. Complaints or Applications for Advice. January 103 2.0 138 209 7 71 15 82 23 — 47 8 600 150 22 February 66 3.4 125 223 3 86 27 81 17 1 33 8 12 March 74 4.5 128 336 4 63 12 73 26 1 58 48 7 April 114 2.5 109 292 6 51 32 67 31 6 22 12 19 May 153 21 139 331 11 58 37 61 52 — 32 33 32 June July 103 11 50 114 14 37 8 18 36 — 48 50 21 August September 106 1.8 47 195 5 29 5 21 32 — 3 21 14 October 118 1.6 57 196 15 35 5 24 15 1 3 39 11 November 163 1.2 39 199 14 21 3 18 8 1 24 18 9 December 76 3.5 23 272 3 12 2 14 19 — 1 18 8 Totals 1,076 2.2 855 2,367 82 463 146 459 259 10 271 255 600 150 155 *Buildings systematically inspected 921 „ Inspected as a consequence of complaints 155 Totals 1,076 85 MEDICAL EXAMINATIONS. In accordance with the Standing Order of the Court that no person shall enter the employ of the Corporation or any of its Committees without previously passing a medical examination to the satisfaction of the Committee having cognizance of the appointment, 36 persons were examined by the Medical Officer of Health during 1922, two of these persons were reported as physically unfit for office. Fifteen officers were also medically examined with a view to their retirement, thirteen of whom were reported to be unfit for duty. I have the honour to be, Gentlemen, Your obedient Servant, Briliam Howarth. Medical Officer of Health for the City of London. Puri.ic Health Department, Guildhall, E.C. m APPENDICES. page Appendix A—Street Lists of Mortality.. 88 „ B— „ „ Infectious Diseases 92 „ C—Register of Houses let in lodgings or occupied by members of more than one family 94 M 2 88 APPENDIX A.—STREET LISTS OF MORTALITY. STREET OK PLACE. No. of House Sex. Age. Date of Death. Cause of Death. Remarks. Albion Buildings 22 M 64 19 Jan. Chronic Bronchitis Died in City of London Infirmary, Bow Road. Aldersgate Street 53 F 90 12 July Cerebral Haemorrhage „ „ 72 F 55 27 July Carcinoma of Breast „ „ 93 F 12 8 March Empyema Died in Royal Waterloo Hospital. ... 181 F 65 9 March Carcinoma of Ovary -12 months Aldgate High Street 32 M 50 13 April Asphyxia from Drowning. No evidence to show how he entered the water. Inquest. Verdict— Drowned in Thames. „ „ 34 M 68 9 Jan. Broncho-pneumonia Died in City of London Infirmary, Bow Road. „ „• 36 F 2 1 Nov. Diphtheria Died in Eastern Hospital. Angel Court 11 M 54 25 April Pulmonary Tuberculosis Died in City of London Infirmary, Bow Road. Artillery Lane 9 F 69 25 Feb. Valvular Disease of Heart „ „ 21 M 51 18 Feb. Mitral Stenosis Died in Chest Hospital, Victoria Park. „ „ 23 F 40 20 Jan. Pulmonary Tuberculosis „ „ 23 M 2 27 Oct. Broncho-pneumonia Bank Station M 70 11 April Syncope—Disease of Coronary Arteries Resided at Reading. Inquest, P.M. Barker's Buildings 28 M 2 mths. 21 April Prematurity City of London Maternity Hospital. Bartlett's Buildings, Holb. 16 F 50 13 March Osteo Arthritis Died at City of London „ „ „ 20 F 73 14 Jan. Chronic Interstitial Nephritis Infirmary, Bow Road. Died at City of London Asylum, Stone. Bishopsgate 173 M 66 13 Nov. Chronic Bronchitis „ 191 M 10 25 Oct. Rheumatic Endocarditis Died in Charing Cross Hospital. Blomfield House, King St. 14 M 4 19 Dec. Broncho-pneumonia Died in Fountain Mental Hospital. Botolph Alley 4 F 75 16 March Bronchitis Bouverie Street 17 F 5 13 Feb. Diphtheria Died at Eastern Hospital. Bow Lane—Williamson's Hotel. — M 8 mths. 5 June Broncho-pneumonia Bridewell Place 3 M 76 26 Sept. Arterio Sclerosis Bridgewater House, Charles Street 1 M 70 30 Oct. Asphyxia caused by impaction of full set of artificial teeth of lower jaw in pharynx. Inquest—Misadventure. Bridgewater Street 3 M 39 18 Dec. Pulmonary Tuberculosis Died in Chest Hospital, Bethnal Green. Broad Street Place 4 F 21 11 April Heart failure due to fainting attack P.M.—Inquest. Broad Street 112 M 74 27 Dec. Morbus Cordis Resided at Buxton. Brushfield Street 10 F 68 11 Oct. Tuberculosis of Lungs Bucklersbury 23 M 78 20 Nov. Influenza Budge Row 22 F 14 19 Feb. Pulmonary Tuberculosis Died at Hackney. Chapel Place, Fetter Lane 1 F 63 30 Dec. Carcinoma of left Breast Chapel Place, Fetter Lane 2 F 4 15 June Bronchitis Cheapside 89 M 58 24 June Arterio Sclerosis Clement's Lane ... 6 M 54 12 May Broncho-pneumonia Clifford's Inn 14 M 75 29 Jan. Abdominal Haemorrhage Died in Royal Sussex Hospital. Cloth Fair... — F 89 16 May Myocardial degeneration. Arterio Sclerosis Died in City of London Infirmary, Bow Road. Crescent, Minories 10 M 57 2 Dec. Cardiac Dilatation Crown Court, Jewry St. ... 3 M 72 7 April Bronchitis „ ,, Warwick Lane — F 34 6 Nov. Cerebral Haemorrhage Cursitor Street ... 14 M 52 24 Oct. Pulmonary Tuberculosis Died in Kensington. Dean's Court 3c M 6 10 May Diphtheria Died in North Eastern Hospital. Dean Street, Fetter Lane 6b F 82 12 Jan. Senile Gangrene .. 7A.c F 82 21 March Cardiac Failure Died at City of London Infirmary, Thavies Inn. 8d F 70 14 Dec. Tuberculosis of Lungs. 6e M 58 1 July Syncope—Perforated duodenal ulcer and geneial peritonitis. Died in St. Bartholomew's Hospital. Duke Street 10 M 65 24 July Arterio Sclerosis—Cerebral Haemorrhage East Harding Street 10 F 74 12 Feb. Valvular Disease of Heart Eldon St., St. Mary's Rectory. — F 56 10 May Cerebral Haemorrhage Farringdon Street 27a F 82 15 Jan. Epithelioma of Orbit „ 83 M 67 6 July Cerebral Thrombrosis Died in City of London Infirmary, Bow Road. Fenchurch Avenue 3 F 62 5 July Carcinoma of Rectum . 7 M 80 15 Aug. Morbus Cordis Died in City of London Infirmary, Bow Road. Fenchurch Street Station — M 57 27 April Valvular Disease of Heart Resided at Westclitfe-on- Caa Fenchurch Street 34 F 44 2 June Cerebral Tumour Died in Shoreditch Infirmary. 41 F 73 25 Feb. Morbus Cordis 155 F 71 3 Feb. Carcinoma of Breast and Mediastinum Died at Clapham. Fenton's Buildings 2 F 88 19 Feb. Old Age—Exhaustion Fetter Lane 41 M 82 28 Feb. Senile Decay Died in City of London Asylum, Stone. Finch Lane 18 F 49 2 Jan. Cancer of Uterus Died in Fulham. Fleet Street 43 F 82 8 Oct. Myocardial Degeneration Died in City of London Infirmary, Bow Road. 89 STREET LISTS OF MORTALITY—continued. STREET OR PLACE. No. of House Sex. Age. Date of Death. Cause of Death. Remarks. Fleet Street 66 M 21 15 Dec. Pulmonary Tuberculosis Died in Colindale Hospital. ,, ,, 143 F 64 12 Sept. Carcinoma of Breast ,, ,, 158 F 67 27 Jan. Myscoedema ,, ,, 160 F 68 31 Dec.-21 Bronchitis Died in City of London Infirmary, Thavies Inn. Furnival Street 36 M 68 5 June Fibroid Disease of Heart Garden Place 5 F 83 27 Oct. Myocardial Degeneration Died in City of London Infirmary, Bow Road. George Street 1/2 M 50 20 Feb. Pulmonary Tuberculosis Godliman Street .. 16 M 80 18 Feb. Bronchitis Goring Street 11 M 77 13 Jan. Epidemic Catarrh Gough Square 8 F 84 2 Jan. Arterio-Sclerosis—Chronic Bronchitis Gracechurch Street 19 M 74 12 Feb. Chronic Bronchitis Died in City of London Infirmary, Bow Road. Great New Street 14 F 4 23 May Pulmonary Tuberculosis Died in Royal Waterloo ,, ,, 14 M 50 7 Dec. Pneumonia, Lobar Hospital. ,, ,, 16 F 57 1 Oct. Carcinoma Recti Great Tower Street 17 M 69 3 Nov. Cerebral Thrombosis—Arterio Sclerosis Died in City of London Infirmary, Bow Road. Gresham Street 95 M 50 17 Feb. Morbus Cordis Greystoke Place 9 F 8 mths. 27 Jan. Syncope—Pneumonia Inquest—P.M. Holborn Viaduct Rly. Stn. — M 43 7 Feb. Heart Disease Resided at Bromley, Kent. Houndsditch 56 F 6 10 May Spinal Curvature, 5 years Huggin Court 2 F 75 7 Feb. Chronic Bronchitis Died in City of London Infirmary, Bow Road. Huggin Lane 10 F 80 2 April Incompetent Disease Mitral Valve Hutchison Avenue 17 M 19 mths. 17 Sept. Pneumonia Died at North Eastern Hospital. Hutchison Street 14 M 64 15 Feb. High Blood Pressure—Arterio Sclerosis Resided in Stepney. ,, ,, 14 M 6 mths. 4 June Acute Miliary Tuberculosis Died in Children's Hospital, Gt. Ormond Street. ,, ,, 14 M 63 27 July Diabetes Meltitus—Broncho-pneumonia ,, ,, 20 M 55 27 Feb. Pulmonary Tuberculosis Died in City of London Infirmary, Bow Road. Jewry Street 7 F 65 15 Feb. Chronic Bronchitis f» »» Kings Block, Stoney Lane 5 F 72 20 Dec. Aneurism of Aorta Died on way to Hospital. ,, ,, 28 F 52 1 Feb. Cerebral Apoplexy Died in London Hospital. ,, ,, 35 F 71 27 Jan. Acute Bronchitis ,, ,, 35 M 75 23 Jan. Chronic Bronchitis King Street, Snow Hill, — M 84 17 Jan. »» Died in City of London 5, Bloomfield House. Infirmary, Bow Road. King Street, Snow Hill, Bloomfield House. — F 84 22 Aug. Morbus Cordis ,, ,, King William Street, — F 75 23 Sept. Myocardial Degeneration Resided at Wandsworth. Monument Tavern. Knightrider Street 15 M 78 2 Jan. Arterio Sclerosis Died in City of London Infirmary, Bow Road. Leadenhall Street 138 F 77 7 Jan. Myocardial Degeneration Died in City of London Infirmary, Bow Road. Little Britain 11 M 35 15 July Heart Failure—Delirium Tremens Little Montague Court 5 F 65 6 Nov. Chronic Bronchitis Died in City of London Infirmary, Bow Road. Liverpool St., G.E. Hotel — F 57 13 Aug. Syncope. Fatty Heart. Administration ol Chloroform for Operation. Misadventure—P. M. Liverpool Street Station — M 61 2 OU. Coronary Arteries ,, ,, Offices — M 43 25 Nov. Syncope due to Arterio Sclerosis Resided at Ponders End. ,, ,, — M 48 15 Dec. Haemorrhage from Cut Throat Resided at Shoreditch. Inquest—Felo-de-se. London Wall 60 M 55 4 Jan. Cirrhosis of Liver Long Lane, Central London Hotel. — F 47 16 March Carcinoma of Breast Died in St. Columba's Hospital. Long Lane 23 M 53 18 Dec. Pernicious Anaemia Died in City of London Tnfirmarv Bow Road Love Lane 3 M 49 6 June Atheroma of Coronary Arteries iiiiiiiiiai y , i-'v v* a . P.M. Lower Thames Street 54 M 77 22 May Disseminated Sclerosis—Fall out of bed Dislocated Femur—Accidental. Died in City of London Infirmary, Bow Road. Inquest. Ludgate Circus Buildings 2 M 54 6 June Epithelioma of Penis Died in City of London Infirmary, Bow Road. Mansion House Station — M 55 22 Jan Extensive Peritonitis with obliteration o left coronary artery. Resided at Wembley. P.M.—Inquest. Mark Lane 72 F 65 25 Sept. Large Ovarian Tumour Middlesex Street, Salvation Army Shelter. — M 72 25 Jan. Syncope due to Heart Disease, accelerated by Influenza. Inquest—-P.M. ,, ,, ,, — M 54 30 Dec. 21 Acute Bronchitis Died in City of London Infirmary, Bow Road. ,, ,, ,, M 67 7 Jan. Carbuncle-neck—Broncho-pneumonia ,, ,, ,, ,, — F 2 10 Feb. Pertussis Died in Homerton Infirmary. ,, ,, ,, — M 2 mths. 13 Feb. Bronchitis ,, ,, ,, ,, M 17 mths. 12 Feb. Measles ,, ,, ,, ,, — M 31 23 March Pulmonary Tuberculosis Died in City of London Infirmary, Bow Road. ,, ,, ,, — M 65 3 April ,, ,, Died in City of London Asylum, Stone. ,, ,, ,, — M 70 3 May Myocardial Degeneration Died in City of London Infirmary, Bow Road. ,, ,, ,, — M 68 12 May Chronic Bronchitis ,, ,, 90 STREET LISTS OF MORTALITY—continued. STREET OR PLACE. No. of House Sex. Age. Date of Death. Cause of Death. Remarks. Middlesex Street,Salvation Army Shelter — M 74 15 June Locomotor Ataxy Died in City of London Infirmary, Bow Road ,, ,, ,, — M 48 2 Nov Tuberculosis of Right Lung ,, ,, ,, ,, ,, M 68 31 Oct. Pernicious Anaemia.Perinephritic Abscess „ „ ,, ,, ,, M 71 4 Dec. Chronic Bronchitis „ „ ,, ,, ,, — M 61 10 Dec. Tuberculosis of Right Lung „ „ ,, ,, ,, — M 64 11 Dec. Locomotor Ataxy „ „ ,, ,, ,, — M 71 7 Dec. Acute Bronchitis „ „ Middlesex Street 125 M 49 2 Nov. Aortic Regurgitation Died in National Heart Hospital. Middle Street 6 M 71 30 April Myocarditis Died in City of London Infirmary, Bow Road. Milk Street 1/2 F 56 10 Feb. Heart Failure—Bronchitis ,, ,, 16 F 63 16 March Bronchial-pneumonia Monument Station — M 36 6 Feb. Run over by train Inquest. Suicide, Unsound Mind. Resided in St. Moorgate Street ... 36 F 71 12 June Fatty Degeneration of Heart Marylebone. Died in City of London Asylum, Stone. It It 91 F 69 5 May Senility—Bronchitis Moor Lane Chambers 8 M 42 17 Nov. Tuberculosis of Right Lung. Died in City of London Infirmary, Bow Road. ,, ,, ,, 14 F 69 27 Nov. Carcinoma of Stomach—18 months ,, ,, ,, 17 M 24 28 Nov. Carcinoma of Liver Nevill's Court 8 F 61 10 March Chronic Bronchitis and Asthma Died in City of London Infirmary, Bow Road. New Bridge Street, Bridewell Royal Hospital — M 50 27 Sept. Syncope from Heart Failure, following hypertrophy of thyroid gland. Inquest. Died in Eaton Socon R.D. Newbury Street 14 F 79 29 March Myocardial Degeneration Died in City of London Infirmary, Bow Road. New Court.St.Swithin'sLa. — F 64 19 Oct. Intestinal Obstruction Died in St. Marylebone. Newgate Street— — M 48 4 Feb. Shock, Laceration of Brain. Fracture of P.M. Suicide — Unsound Post Office Station City London Rly. Skull and Fractured Spine. Caused by train. mind. Resided at Chelsea. New Street, Bishopsgate 6 F 75 12 Feb. Chronic Bronchitis Died in City of London Infirmary, Bow Road. ,, ,, 6 F 62 23 Feb. Acute Bronchitis ,, ,, 24 M 86 2 June Myocardial Degeneration Died in City of London Arterio Sclerosis Infirmary, Bow Road. ,, ,, 35 F 63 14 April Diabetes—Gangrene of Foot „ „ New Street, „ 5 M 75 17 Jan. Stricture of Oesophagus New Street, „ 29 F 75 7 April Cerebral Tumour Died in Hospital for Jewish Incurables, Tottenham. ,, ,, ,, 30 F 75 8 April Rheumatoid Arthritis New Street Square 1 M 32 9 Feb. Fracture of Cervical Vertebrae. Fall from window. Resided at Hampstead. Inquest. Accidental. P.M. North Block, Stoney Lane 8 F 17 13 Jan. Pulmonary Tuberculosis ,, ,, ,, 23 M 62 16 March Uraemia ,, ,, ,, 48 M 5 mths. 16 Feb. Wasting and Inanition Old Bailey 18 F 54 4 Dec. Morbus Cordis Paper Buildings, Temple 3 M 57 1 July Heart Failure Paper Street 6 M 32 3 Dec. Carbon Monoxide Poisoning. Found Dead. Inquest. Did kill himself whilst of Patnernoster Row 17 F 90 17 Sept. Myocardial Degeneration sound mind. Phil's Buildings, Houndsditch. 7 F 75 10 April Cardiac Valvular Disease and Cardiac Dilation and Arterio Sclerosis. Priest's Court 3 M 74 31 July Cancer of Liver Temporary Resident. Resided in N. Zealand. Prince's Block,Stoney Lne. 16 M 12 mths 17 March Pertussis ,, ,, ,, 50 M 33 2 Sept. Morbus Cordis Providence Place 8 M 45 18 Oct. Carcinoma of Stomach Died in Queen Mary's Hospital, Stratford. ,, ,, 16 M 42 11 March Heart Failure- General Septicaemia Died in St. Bartholomew's Hospital. Pudding Lane 15 F 77 15 June Chronic Bronchitis Died in City of London Infirmary, Bow Road. Queen's Court, Minories 4 F 42 21 April Rheumatoid Arthritis „ „ Queen Street 83 M 65 1 Sept. Carcinoma—Rectum Died in Charing Cross Hospital. River Thames — M 50 3 Jan. Asphyxia—Drowning. No evidence to Inquest. show how he came into the water. „„ — M 46 5 Feb. „ „ „ Inquest—P.M. „ „ — M 48 16 Dec. Asphyxia from Drowning Resided in Southwark Inquest. No evidence. „ „ — M 9 23 Nov. Asphyxia—Drowning. Accidental Inquest—P.M. Rose Alley 43 M 2 10 April Diphtheria St. Bartholomew's Hosp'l, — F 21 13 Dec Tuberculous Meningitis Nurses' Home. Sergeant's Inn 3 M 60 19 June Carcinoma Gastric Thavies Inn, Infirmary ... 18 F 24 8 Jan. Lues Veneria „ „ „ 18 F 64 16 Oct. Valvular Disease of Heart Died in Leavesden Asylum „ „ „ 18 M 81 19 Dec. Senile Decay and Chronic Bronchitis Died in Caterham Asylum. „ „ „ 18 M 87 26 Dec. Cerebral Haemorrhage „ „ „ 18 M 65 28 Dec. Syncope. (Edema of Lungs and Bronchitis P.M.—Natural. Threadneedle Street 37 F 58 19 April Croupous Pneumonia Tower Hill 2 F 53 15 Oct. Syncope due to Chronic Valvular Disease Inquest—P.M. Natural of Heart. 91 STREET LISTS OF MORTALITY—continued. STREET OR PLACE. No. of House Sex. Age. Date of Death Cause of Death. Remarks. Upper Thames Street— - M 60 9 Feb. Fracture of Skull. Fall from Scaffold. Resided in St. Marylebone. In Street. Accidental. P.M. Union Place, Aldersgate St 6 F 13 9 April Chronic Supperative Otitis Media Walbrook 27 F 73 16 Feb. Chronic Rheumatism Died in City of London Infirmary, Bow Road. Watling Street 16 M 55 19 July Epithelioma of Tongue and Lower Jaw „ „ „ „ 49 F 57 19 Jan. New growth of Lung „ „ 64 F 75 14 Jan. Influenza West Smithfield 30 F 10 mins. 20 June White Asphyxia „ „ 57 F 74 24 Jan. Bronchitis Whitecross Street 12 M 7 mths. 18 June Croupous Laryngitis Whitefriars Street 25 F 65 5 May Valvular Disease of Heart Whistler's Court 1 F 17 3 Dec. Pulmonary Tuberculosis White Lion Court, Cornhill 2 M 48 15 Oct. Chronic Nephritis Died in Seamen's Hospital, Greenwich. Widegate Street 21 M 57 17 Jan. Chronic Bronchitis „ „ 21 F 70 21 July Chronic Nephritis Wood Street 34 F 47 15 June Syncope—Incompetent Valves Resident in Southwark. „ „ 76 M 42 6 June Cerebral Haemorrhage P.M. 92 APPENDIX B.—LIST OF CASES OF INFECTIOUS DISEASE OTHER THAN TUBERCULOSIS, 1922. STREET LISTS.—Compiled from Notifications received. Street or Place. No. of House. Sex. Age. Disease. Date of Notification. 1922. Aldersgate Street 93 M 9 Scarlet Fever 6th October. Ditto 181 F 4 Diphtheria 10th February. America Square 14 F 13 Scarlet Fever 17th August. Bishopsgate 184 F 9 Ditto 15th February. Ditto The Fire Station — M 9 Ditto 20th October. Ditto 310 M 8/12 Diphtheria 12th April. Bouverie Street 17 F 5 Ditto 6th February. Ditto 17 M 8 Ditto 17th February. Budge Row 19 M 4/365 Ophthalmia Neonatorum 9th October. Cannon Street 54 F 13 Scarlet Fever 11th March. Cannon Street Fire Station 8 F 8 Diphtheria 13th March. Ditto 8 F 11 Ditto 22nd May. Ditto 8 M 12 Ditto 17th July. Cannon Street Hotel — F 23 Ditto 24th July. Cheapside 129 M 6 Ditto 8th April. City of London Union — M 6 Acute Primary Pneumonia 7th January. Ditto — M 33 Ditto 11th March. Ditto — M 81 Ditto 9th March. City Police Hospital — M 23 Ditto 5th August. Ditto — M 21 Diphtheria 16th May. Crown Place 6 F 6 Scarlet Fever 11th February. Dean's Court 30 M 41 Diphtheria 18th April. Ditto 30 M 6 Ditto 31st March. Ditto 30 F 10 Ditto 10th April. Ditto 30 M 14 Scarlet Fever 16th November. Dean Street 4d M 50 Erysipelas 16th May. Eastern Hospital — F 8 Scarlet Fever 18th April. Eldon Street 15 F 4 Ditto 5th October. Fenchurch Street 24 M 20 Malaria 27th December. Ditto 63 F 58 Erysipelas 7 th December. Fleet Street 1 F 29 Diphtheria 17 th July. Ditto 1 M 19 Ditto 20th July. Fleur-de-Lys Court 6 F 4 Scarlet Fever 27 th December. Great Tower Street 54 F Scarlatina 5th January. High Street, Aldgate 36 F 2 Diphtheria 21st October. Holborn Circus 7 M 22 Scarlet Fever 15th May. Holborn Infirmary — M 52 Erysipelas 7th January. Huggin Court 2 F 2 Diphtheria 13th April. Ditto 2 M 2 Ditto 27th June. Hutchison Avenue 17 M 1 Scarlet Fever 3rd September. King's Block 20 M 72 Erysipelas 27 th December. Ditto 27 M 9 Scarlatina 16th May. King Street, Snow Hill 18 F 8 Diphtheria 4th May. Long Lane 77 F 8 Ditto 8th May. Ditto 79 M 3 Chicken-pox 8th March. Lower Thames Street 55 F 49 Acute Influenzal Pneum'ia 16th February. Mason's Avenue 12 M 5 Diphtheria 6th May. Ditto 12 M 9 Scarlet Fever 1st October. Mansell Street 32 F 4 Diphtheria 2nd February. Montague Court 1 M 3 Scarlet Fever 1st November. Ditto 1 M 6 Ditto 1st November. Moor Lane Chambers 8 F 3 Chicken-pox 11th December. Nevill's Court 12 M 40 Acute Primary Pneumonia 18th January. Ditto 12 F 9 Diphtheria 5th June. New Street, Gravel Lane 17 M 1 Ditto 10th May. North Block 25 F 8 Ditto 6th October. 93 STREET LISTS.—Compiled from Notifications received.—continued. Street or Place. No. of House. Sex. Age. Disease. Date of Notification. 1921. Providence Place 2 M 17 Scarlatina 29th Dec. 1922. Ditto 13 M 5 Scarlet Fever 12th Sept. Queen Victoria Street 71a M 7 Ditto 15th October. Ditto 73a F 7 Diphtheria 5th August. Ditto 73a F 32 Ditto 10th August. Ditto 174 M 5 Ditto 1st April. Ditto 174 F 32 Ditto 10th April. Ditto 174 F 10 Scarlet Fever 29th June. Ditto 174 F 25 Ditto 1st July. Rose Alley 43 M 2 Diphtheria 1st February. St. Bartholomew's Hospital Scarlet Fever, 10 cases ; Diphtheria, 9 cases and Acute Primary Pneumonia, 1 case. Shoe Lane 109 F 8 Diphtheria 21st March. Whitechapel Infirmary — M 58 Acute Primarv Pneumonia 17th January. 94 APPENDIX C—REGISTER OF HOUSES LET IN LODGINGS OR OCCUPIED BY MEMBERS OF MORE THAN ONE FAMILY. WEST DISTRICT. Situation of Premises. Name and Address of Landlord. Tenements. Lodger 6, Bartholomew Place Veil, 6, Bartholomew Place l 20, Bride Lane A. G. Bodenham, 46 Carter Lane 2 3 5, Britton's Court Mrs. Hurrel, 5, Britton's Court 1 6 9, Broadways, Ludgate Hill F. J. Wells, 9, Broadways 2 4 1, Chapel Place Moravian Mission, 32, Fetter Lane 2 8 2, do. Do. do. 2 6 43, Cloth Fair Mr. C. Taylor, 6, Finsbury Square, E.C. 2 2 4 44, do Do. do. 1 2 45, do W. F. Masters, 45, Cloth Fair 3 10 5, Currier's Row T. Simmons, 5, Currier's Row 2 5 6, do. A. Bedford, 6, do. 2 5 7, do. W. Bampton, 7, do. 1 12, do. R. Edwards, 12, do. 2 3 13, do. J. Pringle, 13, do. 2 9 4, Dorset Street E. King, 23, Whitefriars Street 1 1 7, do E. King, 23, Whitefriars Street 1 9 10, East Harding Street Eyre and Spottiswoode 3 7 11, do. Do. 3 7 12, do. Do. 4 8 2, Evangelist Court Morris & Co., 37, East Road, City Road 3 5 1, Fenton's Buildings Evans, Lescher, Webb, 60, Bartholomew Close 1 7 2, do. Do. do. do. 3 5 3, do. Do. do. do. 1 2 41, Fetter Lane Mrs. Vaughan, Railway Hotel, Bishops Stortford 4 8 42, „ W. Read, 102, Fetter Lane 3 6 93, do L. B. Hayward, 93, Fetter Lane 5 11 29, Fleet Lane Messrs. Watney, Combe & Reid, Stag Brewery, Pimlico 4 13 30, do. Do. do. do. 3 9 31, do. Do. do. do. 4 9 1, Great New Street Mrs. J. Barnsley, 1, Great New Street 5 8 2, do. Do. do. 4 9 3, do. Do. do. 7 9 4, do. Goldsmith Company 3 6 13, do. Mrs. Lee, 12, East Harding Street 4 4 14, do. Mr. A. E. Walker, 14, Great New Street 3 10 15, do. Mrs. A. E. Castleneau, 15, Great New Street 4 9 16, do. J. Day, 16, Great New Street 3 5 20, do. F. Wilson, 51, Frankfort Road, Heme Hill 6 15 21, do. M. Quilty, 21, Great New Street 2 7 5, Green Dragon Court J. Pringle, 58, Chancery Lane 1 6 6, do. Do. do. 2 6 7, do. Do. do. 2 5 6, Grevstoke Place W. G. Cuss, 6, Greystoke Place 1 4 7, do. Solicitors' Law Stationery Society, 104 Fetter Lane 4 4 8, do. Do. do. do. 4 10 9, do. Do. do. do. 4 13 2, Gunpowder Alley T. Richardson, 2, Gunpowder Alley 1 6 7½, do. T. Townsend, 259, Essex Road, N. 2 6 8, do. Do. do. 4 6 25, Kinghorn Street W. B. Hallett, 11, Queen Victoria Street Empty. 25a, do. Do. do. do. 54, Little Britain J. Boni, 54, Little Britain 1 2 25, do. . Mrs. Davis, 25, Little Britain 3 4 79, Long Lane Robert Dyas & Sons, 63, Fore Street 2 9 2, Middle Street F. B. Westacott, 74, Camden Road, N.W. 1 4 3, do. Do. do. 1 5 4 & 5, do J. Hull & Sons, Bartholomew Close 6 12 6, do. Mr. Crook, 6, Middle Street 3 4 20, do. T. Green, 20, Middle Street 1 1, Montague Court H. Tenant 1, Montague Court 3 7 2, do. Mr. G. Hanlan, 2, do. 2 5 3, do. Mrs. Vincent 3, do. 2 4 4, do. Mrs. F. Smith 4, do. 3 4 5, do. Mr. E. Hutchins, 5, do. 2 8 Carried forward 164 388 95 WEST DISTRICT—continued. Situation of Premises. Name and Address of Landlord. Tenements. Lodgers. Brought forward 164 388 6, Montague Court Mr. F. J. Swain, 6, Montague Court 4 6 7, Nevill's Court Moravian Mission, 32, Fetter Lane 2 5 8, do. Do. do. 2 9 9, do. Do. do. 3 9 10, do Do. do. 6 14 11, Nevill's Court Goldsmiths' Company, Goldsmiths' Hall 6 9 12, do. Do. do. 5 9 14, Newbury Street J. W. Neighbour, 2, Ironmonger Row 3 12 57, West Smithfield T. A. Allen, 57, West Smithfield 6 7 13, Wine Office Court Messrs. Reynold & Eason, 192, Bishopsgate 1 4 14, do. Do. do. 2 5 16, do. Do. do. 2 5 17, do. Do. do. 2 2 Total 208 484 Average number of lodgers to each occupied tenement: 2.3. Houses demolished:—Nil. Tenement houses on Register 77 Cleansing Notices served 91 MIDDLE DISTRICT. 1 and 2, Huggin Court City Parochial Charities Trustees, 3, Temple Gardens 6 14 9, Huggin Lane H. Belcher, 8, Martin's Lane, E.C. 5 2 10, do. H. Willis, 10, Huggin Lane 5 8 15, Swan Lane H. Postlewaithe, 15, Swan Lane 1 1 Total 17 25 Average number of lodgers to each occupied tenement 1-5 Houses demolised:—Nil. Cleansing Notices served 4 Houses on Register 4 EAST DISTRICT. 7, Artillery Lane Clerk to Bishopsgate Institute, Bishopsgate 4 12 9, do. Claude M. Leigh, 268, Bishopsgate 2 6 20, do. A. Woolf, 20, Artillery Lane 1 4 21, do. Clerk to Bishopsgate Institute 3 9 10, Brushfield Street J. Shepherd, 106, Eastern Road, Brighton 6 10 12, do Luke Cohen, 12, Brushfield Street 4 4 14, do. Clerk to Bishopsgate Institute 6 7 1, Circus, Minories S. Moses, 65, Mansell Street 7 15 2, do. T. Shaw, 2, Circus, Minories 2 5 3, do. W. Lewis, 3, do. 3 8 4, do. W. Wisdom, 4, do. 3 6 5, do. T. Grover, 5, do. 6 7 7, do City Corporation 6 11 3, Crown Place, Aldgate W. Harper, 3, Crown Place 2 5 5, Duke Street Imbert Terry & Co., 28a, Basinghall Street 2 4 6, India Street, Minories B. Marks, 6, India Street 1 1 1, Hutchison Avenue A. J. Hollington, 8, Middlesex Street 1 3 3, do. B. Ereira, 3, Hutchison Avenue 1 1 4, do. Morris Cohen, 4, Hutchison Avenue 2 3 6, do. J. Sietta, 51, New Road, Whitechapel 1 3 7, do. Do. do. 1 2 9, do. Barnet Barnet, 9, Hutchison Avenue 1 1 10, do. C. Zeffie, 10, do. 1 2 12, do. A. Cohen, 11, do. 3 4 13, do. B. Levy, 13, do. 3 5 14, do. P. Sugarman, 14, do. 1 1 21, do. A. Fuglar, 21, do. 1 1 do. B. Dubowski, 22, do. 3 3 23, do. J. Cronie, 23, do. 2 6 24, do. S. Ereira, 24, do. 2 2 25, do. L. Lazarus, 25, do. 1 1 26,do Lewis Joseph 26, do. 2 2 Carried forward 84 154 96 EAST DISTRICT—continued. Situation of Premises. Name and Address of Landlord. Tenements. Lodgers. Brought forward 84 154 5, Hutchison Street J. Silver, 5, Hutchison Street 1 3 6, do. J. Soloman, 6, do. 2 6 10, do. I. Levy, 10, do. 2 5 12, do. N. Webber, 12, do. I 2 17, do. A. Cohen, 17, do. 1 3 18, do. A. Solomon, 18, do. 1 2 20, do. I. Edwards, 20, do. I 4 Janes Buildings, 2, Hutchison Messrs. Moore & Moore, 7, Leadenhall Street Street. 3 7 14, New St., Gravel Lane J. Panyer, 14, New Street, Gravel Lane ... 1 2 15, do. H. Norden, 15, do. 1 3 16, do. H. Lifman, 16, do. 1 2 22 do. B. Levy, 22, do. 1 3 23, do. E. Dickson, 23, do. 1 4 27, do. E. Marks, 27, do. 2 3 30, do. E. Hassan, 30, do. 3 6 32, do. E. Douglas, 32, do. 1 2 34, do. R. Cohen, 34, do. 2 4 40, do. M. Roche, 40, do. 2 4 2, Queen's Court, Vine Street City Corporation 2 8 3, Three Crown Court, Jewry Place Mr. Martin, 14, Seething Lane 3 5 3, Vine Street, Minories City Corporation 6 17 5, do. Do. 5 19 17, Widegate Street A. Cohen, 17, Widegate Street 3 8 18, do. S. Franks, 18, do. 2 4 21, do. A. Field, 182, Hanbury Street 4 4 24, do. W. I. Crane, 25, Widegate Street 4 8 25, do. Do. do. 5 8 2, Goodman's Yard Charrington, Brewers, Mile End Road 3 4 5, Artillery Lane Clerk to Bishopsgate Institute, Bishopsgate 7 12 Total 155 318 Average number of persons to each occupied tenement: 2.1 Houses demolished or closed in 1922 3 Tenement houses on Register 61 Cleansing Notices served 81