# \v REPORT OF THE MEDICAL OFFICER OF HEALTH - JJ- OF THE CITY OF LONDON For the Year 1927. LONDON. Printed by Drake, Driver & Leaver, Ltd., Rosebery Avenue, E.C. I. 1928. s3 A. page. ANNUAL RATEABLE VALUE 7 APPENDICES 81 AREA 7 ARTIZANS DWELLINGS, STONEY LANE ATMOSPHERIC POLLUTION B. BIRTHS 8 INFANT WELFARE 10 NOTIFICATION 11 CONGRESSES—BRITISH SOCIAL HYGIENE COUNCIL, LONDON 24 —R.S.I. CONGRESS, HASTINGS 24 —ROYAL INSTITUTE OF PUBLIC HEALTH, GHENT 24 —NATIONAL ASSOCIATION FOR PREVENTION OF TUBERCULOSIS, LONDON 24 —WORLD'S DAIRY CONGRESS 24 COURTS AND ALLEYS, FLUSHING 64 LIMEWASHING 64 CREMATIONS 27, 28 D. DENSITY 7 DIPHTHERIA—SCHICK TEST AND ANTI-TOXIN INOCULATION 14 DISINFECTION OF SECOND-HAND CLOTHING 74 DRAINAGE PLANS 64 E. EXHUMATION AND REINTERMENT OF HUMAN REMAINS AT— CITY OF LONDON CEMETERY 74 F. FACTORY AND WORKSHOPS ACT, 1901—ABOVEGROUND BAKEHOUSES 67 „ „ „ —FACTORIES, WORKSHOPS, WORKPLACES AND KITCHENS 66, 68 —OUTWORKERS 67, 72 —SUMMARY OF WORK DONE 68 —UNDERGROUND BAKEHOUSES 67 FISH—SUPPLIES AND SEIZURES 55 FLY NUISANCE 65 FOOD AND DRUGS, SUPERVISION OF 29 FOOD AT RIVERSIDE WHARVES—INSPECTIONS AND CONDEMNATIONS 57 H. HAIRDRESSERS' AND BARBERS' SHOPS 25 HOUSE AND TRADE REFUSE REMOVAL 64 HOUSING 62 L ICE CREAM 44 INFANTILE MORTALITY 8 INFANT WELFARE 10 INFECTIOUS DISEASE 11 „ „ —BACTERIOLOGICAL AND PATHOLOGICAL EXAMINATIONS 11 —DIPHTHERIA ANTI-TOXIN 11 —NOTIFICATION OF 11 —NURSING PROVISION — MEASLES, ENCEPHALITIS LETHARGICA, CEREBROSPINAL FEVER AND INFLUKNZA 15 —TEMPORARY ISOLATION ACCOMMODATION, 29, MIDDLESEX STREET 15 —TUBERCULOSIS 15 —VENEREAL DISEASES 21 INFIRM PERSONS, REMOVAL OF 66 INFLUENZA 14 INTRODUCTION 7 L. LEGAL PROCEEDINGS—SANITARY 64 LIMEWASHING OF COURTS 64 LODGING HOUSES, COMMON—116, MIDDLESEX STREET 63 „ REGISTERED 61 INDEX (continued) iy1 page MARGARINE, REGISTRATION OF DEALERS IN MARGARINE AND MARGARINE CHEESE 31 MEASLES 14, 15 MEAT INSPECTIONS 44 „ „ —DELIVERIES AT CENTRAL MARKETS 54 —DISEASED MEAT FROM VARIOUS COUNTRIES 48, 53 —EXPORT OF MEAT 53 —HOME KILLED MEAT SEIZED 47 —LEADENHALL MARKET AND CITY SHOPS 52 —LIVE ANIMALS IMPORTED 45 —PROSECUTIONS 54 —PUBLIC HEALTH (MEAT) REGULATIONS, 1924 55 —SUPPLIES AT CENTRAL MARKETS 45 —UNSOUND MEAT REMOVED FROM COLD STORES 51 MEDICAL EXAMINATIONS 79 MIDDLESEX STREET, NO 29 TEMPORARY ACCOMMODATION 15 MILK—BACTERIOLOGICAL AND CHEMICAL EXAMINATIONS FOR TUBERCULOSIS AND DIRT (RAILWAY STATIONS) 28 „ —CHEMICAL EXAMINATION OF 31 „ —PUBLIC HEALTH (DRIED MILK) REGULATIONS, 1923 33 „ —MILK AND CREAM REGULATIONS PH (CONDENSED MILK) REGULATIONS 32, 33 , —MILK AND DAIRIES (AMENDMENT) ACT, 1922 31 „ —MILK AND DAIRIES ORDER, 1926 31 MORTALITY 8 „ —INFANTILE 8 —VIOLENCE 8 —PHTHISIS 8 —ZYMOTICS 8 MORTUARY—DISINFECTION OF CLOTHING FOR EXPORT, INQUESTS, Etc 74 „ —PRESERVATION OF BODIES OF UNKNOWN DEAD 74 N NOTIFICATION OF BIRTHS ACT, 1907, AND INFANT WELFARE WORK 11 o OVERCROWDING 84 P PIGEONS—LCC (GENERAL POWERS) ACT, 1927 66 POPULATION 7 PUBLIC HEALTH (CONDENSED MILK) REGULATIONS, 1923 33 —(DRIED MILK) REGULATIONS, 1923 33 —(MEAT) REGULATIONS, 1924 56 —(MILK AND CREAM) REGULATIONS, 1912 & 1917 32 — (PRESERVATIVES, &c, IN FOOD) REGULATIONS, 1925-27 30 —(SMOKE ABATEMENT) ACT, 1926 26 R RAG AND BONE DEALERS' BYE-LAWS 66 RAILWAY STATIONS—SAMPLES OF MILK 28 RATEABLE VALUE 7 RAT REPRESSION 75, 78 REFUSE REMOVAL 64 s SALE OF FOOD AND DRUGS ACTS—ADMINISTRATIVE ACTION REGARDING SAMPLES REPORTED TO BE NOT GENUINE 34 ,, —PROSECUTIONS 44 „ —SUMMARY OF ARTICLES EXAMINED UNDER SALE OF FOOD AND DRUGS ACTS AND PUBLIC HEALTH (MILK AND CREAM) REGULATIONS 42 SANITARY DEFECTS AND INFECTIOUS DISEASE 64 SANITARY INSPECTIONS 60 SEWER, DEFECTIVE CONNECTIONS 65 SHELTER FOR TEMPORARY ACCOMMODATION, 29, MIDDLESEX STREET 15 SMOKE AND ATMOSPHERIC POLLUTION 26 STAFF 5 STATISTICAL INFORMATION 7 STREET GULLIES 64 T TUBERCULOSIS 16 21 V VACCINATION 10 VENEREAL DISEASES 21, 24 VIOLENT DEATHS 8 VITAL STATISTICS 10 SANITARY STAFF. MEDICAL OFFICER OF HEALTH. Date of Appointment. 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 Principal Assistant Nov., 1902 Gray, Charles M. 1st Class Assistant March, 1911 Blunt, Harold F ) May, 1924 Lee, Wm. J 3rd Class Assistants Oct., 1915 Spalding, C. A March, 1918 Thredgold, Arthur W. Nov., 1923 Cole, Ernest May, 1924 Cann, S. W Unclassified May, 1927 Tunbridge, Mrs. Jan., 1917 Jarvis, Miss E. S., M.B.E. May, 1921 SANITARY INSPECTORS. Hills, Arthur Reginald , April, 1888 Simmons, Edward John | June, 1892 Robbins, Francis Joseph - Grade I. Sept., 1892 Ralph, William Holden June, 1898 Davies, Thos. L. Dec., 1903 Robinson, Ernest S Feb., 1913 Fowler, George Henry Oct., 1920 McGrath, William Richard Grade II. Mar., 1922 Harrington, George Edwin j Dec., 1925 Sillet, David Ernest April, 1926 SANITARY INSPECTORS AND MEAT INSPECTORS. Sharp, J. Owen, Senior Inspector May, 1892 Mettam, Harry Dec., 1903 Bintcliffe, Charles E. March, 1907 Matson, William S ' Grade I. Dec., 1910 Mitchener, William E. I Dec., 1910 Jones, John April, 1914 Slatter, Charles May, 1908 King, George GradeII April, 1910 Murray, Samuel B Grade Sept., 1911 Mellish, Cyril E Jan., 1912 Thompson, Frederick Tuly, 1924 Perris, G. A Grade III Dec., 1923 WOMAN SANITARY INSPECTOR. Wilkinson, Miss Annie M July, 1909 KEEPER OF THE MORTUARY. Oakley, J. E Feb., 1909 DISINFECTOR. Steggles, T Dec., 1918 MESSENGERS. Tierney, T. E. (Temporary) Dec., 1926 Betts, Charles (Temporary) April, 1926 LABOURERS. McDonnell, R. J. (General Duties at Mortuary) April, 1903 Powis, B. ( Do. do. ) Feb., 1920 Hastings, T.( Do. do. ) June, 1920 Collins, W. (Gatekeeper at City Mortuary) Nov., 1920 Ludgate, G. (Meat Shed) Oct., 1906 Morris, W. F. (Meat Shed) March, 1925 Strong, S. R March, 1914 Prevost, A. C Feb., 1926 B annual report of the medical officer of health for the year 1927. To the Right Honourable the Lord Mayor, Aldermen and Commons of the Corporation of London. Public Health Department, Guildhall, E.C. 22nd March, 1928. My Lord Mayor and Gentlemen, As Acting Medical Officer of Health for the City of London, I have the honour to present the Report on the work of the Department for the year 1927. Dr. Howarth's ill-health and resignation are to me a matter of the deepest regret, the more particularly that in other circumstances, in this Report he would, as it were, have sealed the work of the rehousing scheme, in the inception of which he took so prominent a part. STATISTICAL INFORMATION. Area.—The City of London (excluding The Temple) comprises an area of 661 acres (excluding tidal water and foreshore), or 1 -032 square miles, equal to a square of 1 -016 miles to a side. The area of " Registration London " is 74,817 acres (excluding tidal water and foreshore), or 116 -9 square miles, equal to a square of 10 -81 miles to a side. Density (1927).—City of London, Registration District, at night, 19-8 persons to an acre; City of London, Registration District, during the day, *644-1 persons to an acre; Registration London, at night, 60'6 persons to an acre. Annual Rateable Value.—The rateable value of property within the administrative county of London (including the City) was £56,200,358 on 6th April, 1927, whilst on the same date the corresponding rateable value of property in the City of London was £8,044,594 or about one-seventh of the whole County. The sum receivable from a penny rate is £32,894. Population.—The undermentioned figures are extracted from the 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 2,398 19,657 13,709 These figures represent the population on the nights of the 3rd April, 1911, and the 19th June, 1921. 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. City Census. Night Population. 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 13,706 436,721 (Imperial Census). There is only one registration district in the City. The estimated population of the City for the year 1927 is 13,010. 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. * This figure refers only to persons " actively engaged in the City during the daytime," and is based upon the Imperial Census taken in June, 1921. b 2 8 Births.—During the year 1927, 417 births were registered in the City, 355 of which, however, did not belong thereto. To the remaining 62 must be added the births of 52 children born to citizens temporarily residing outside the City boundary. The number of births, therefore, on which the rate should be calculated is 114. The annual birth.rate was 8 .7 per 1,000 persons of all ages, compared with a quinquennial mean rate of 7 .8 per 1,000. In the Metropolis the birth.rate in 1927 was 16 .1 per 1,000. Mortality.—During the year under review, 762 deaths were registered in the District, including 688 persons dying in the City, but not belonging thereto. See table, p. 9, for details. Deducting these latter, 74 deaths remain, to which must be added those of 76 persons who died in institutions in outside districts, where they were registered ; the total, therefore, on which the City death.rate is calculated is 150. The death.rate for 1927 was 11.5 per 1,000 per annum of the population (the previous year being 10 .4), whilst that for the whole of the Metropolis was 11 .9. Deaths from Violence.—Of the City deaths, 2.7 per cent, were caused by injuries or violence, as compared with 4.4 in 1925 and 7.2 in 1926. This is 2.5 below the average for the previous five years. PERCENTAGE OF REGISTERED DEATHS FROM VIOLENCE. Year. City of London. Metropolis. Per cent. Per cent. 1922 3.2 3.3 1923 5.8 4.5 1924 5.3 4.4 1925 4.4 4.6 1926 7.2 4.8 Average previous five years 5.2 4.3 1927 2.7 5.1 DEATH RATES, PER 1,000 PER ANNUM. 107 Great Towns Year. City of London. of England and Metropolis. Wales. 1922 14 1 13 0 13.4 1923 11.5 11.6 11.2 1924 11.3 12.3 12.1 1925 11.7 12.2 11.7 1926 10.4 11.6 11.6 Average previous five years 11.8 12.1 .... .... 12.0 1927 11.5 12.2 11.9 The death rate from zymotic disease per 1,000 of the population was 0 .23 compared with 0 27 in the Metropolis. The deaths from Phthisis correspond to a rate of 0 92 per 1,000 of the population, as compared with 0 91 in the Metropolis. Infantile Mortality.—The deaths of children under one year of age were at the rate of 105 per 1,000 births, as against 59 for the whole of London. 9 CAUSES OF, AND AGES AT, DEATH DURING THE YEAR 1927. Causes of Death. Nett Deaths at the subjoined ages of " Residents " whether occurring within or without the district. Total Deaths whether of " Residents or "NonResidents " in Institutions in the District. All ages. Under 1 year. 1 and under 2 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 under 75 years. 75 and upwards. 1 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. All causes. 150 12 2 2 2 4 13 55 32 28 643 l. Enteric Fever .... .... .... .... .... .... .... .... .... .... .... 2. Small-pox .... .... .... .... .... .... .... .... .... .... .... 3. Measles .... .... .... .... .... .... .... .... .... .... .... 4. Scarlet Fever 1 .... .... 1 .... .... .... .... .... .... .... 5. Whooping Cough .... .... .... .... .... .... .... .... .... .... .... 6. Diphtheria 1 .... 1 .... .... .... .... .... .... .... 1 7. Influenza 2 .... .... .... .... .... 1 .... 1 .... 2 8. Encephalitis Lethargica 1 .... .... 1 .... .... .... .... .... .... .... 9. Meningococcal Meningitis .... .... .... .... .... .... .... .... .... .... .... 10. Tuberculosis of respiratory system 12 .... .... .... .... 2 5 5 .... .... 9 11. Other Tuberculous Diseases .... .... .... .... .... .... .... .... .... .... 24 12. Cancer, malignant disease 24 .... .... .... .... .... 2 13 9 .... 57 13. Rheumatic Fever .... .... .... .... .... .... .... .... .... .... 12 14. Diabetes 2 .... .... .... .... .... .... 2 .... .... 3 15. Cerebral Haemorrhage, &c. 5 .... .... .... .... .... .... 3 1 1 12 16. Heart Disease 30 .... .... .... 1 .... 2 5 8 14 40 17. Arterio-sclerosis 7 .... .... .... .... .... .... 3 1 3 15 18. Bronchitis 4 .... .... .... .... .... .... 1 3 .... 13 19. Pneumonia (all forms) 12 1 1 3 6 78 20. Other respiratory diseases .... .... .... .... .... .... .... .... .... .... 20 21. Ulcer of Stomach or Duodenum 3 .... .... .... .... .... .... 3 .... .... 17 22. Diarrhoea, &c 1 1 .... .... .... .... .... .... .... .... 6 23. Appendicitis and Typhlitis 2 .... .... .... .... 1 .... 1 .... .... 9 24. Cirrhosis of Liver 2 .... .... .... .... .... .... 2 .... 8 25. Acute and Chronic Nephritis 2 .... .... .... .... .... .... 1 .... 1 33 26. Puerperal Sepsis 1 .... .... ... .... .... 1 .... .... .... 3 27. Other accidents and diseases of Pregnancy and Parturition .... .... .... .... .... .... .... .... .... .... 1 28. Congenital Debility and Malformation, Premature Birth 6 6 .... .... .... .... .... .... .... .... 19 29. Suicide 1 .... .... .... .... .... 1 .... .... .... 13 30. Other deaths from violence 3 1 .... .... .... .... 1 1 .... .... 69 31. Other Defined Diseases 28 4 .... .... .... .... .... 12 3 9 171 32. Causes ill-defined or unknown .... .... .... .... .... .... .... .... .... .... 8 Totals 150 12 2 2 2 4 13 55 32 28 643 10 VITAL STATISTICS OF WHOLE DISTRICT DURING 1927 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. Number. Rate. 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 per 1,000 nett Births. Number. Rate. 1 2 3 4 5 6 7 8 9 10 11 12 13 1922 13,363 360 148 1l.l 809 60.54 719 98 9 61 188 14.1 1923 13,480 381 111 8.2 714 52.96 641 82 9 81 155 11.5 1924 13,330 413 94 7.1 719 53.93 656 88 11 117 151 11.3 1925 13,340 360 100 7.5 705 52.92 633 84 6 60 156 11.7 1926 13,230 383 106 7.1 703 53.14 644 79 7 66 138 10.4 1927 13,010 417 114 8.7 762 58.51 688 76 12 105 150 11.5 Area of City of London in acres Total poputltion at all ages 13.706 At census 1921. (land and inland water) 661 Number of inhabited houses 2,922 Average number of persons per house 4.6 Vaccination.—Of the 421 births notified to the Vaccination Officer during 1927, 109 had been successfully vaccinated by the end of the year, 20 had died before the age for vaccination. Vaccination was postponed by medical certificate in no cases, 189 had removed into other districts, or the vaccinations were pending at the end of the year. There were 103 instances of conscientious objection. The Public Vaccinator performed 87 re.vaccinations during the year, and in addition to the 109 successful vaccinations referred to above, 7 adult persons were vaccinated for the first time. 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 1922 365 per cent. 27.9 per cent. Nil. per cent. Nil. per cent. 53 per cent. 03 per cent. 48.7 per cent. 17.8 1923 387 26.4 „ „ 4.4 1.1 55.5 12.6 1924 418 27.3 0.2 „ 3.3 05 50.3 18.4 1925 330 26.9 Nil. „ 4.3 1.8 43.4 23.6 1926 390 26.4 11 M 4.6 — 49.2 19.7 Average previous 5 years. 378 26.9 0.04 »> 4.5 0.8 494 18.4 1927 421 25.9 — — 4.7 — 44.9 24.5 INFANT WELFARE WORK. No new work has been undertaken in connection with Infant Welfare Work, as it is found that the needs of the City are amply filled by the arrangements already in operation. The small resident population of the City and the consequent few births enables a close personal touch to be maintained between my staff and the City mothers. The Infant Welfare Centre administered by the Corporation at St. Bartholomew's Hospital has had a satisfactory attendance at the weekly Wednesday session, and supplies of milk and dried milk, at cost price, under cost price, and free, according to circumstances, 11 have been provided in accordance with the practice which has been in operation for some years. Cod Liver Oil Emulsion is also given where its administration appears to be advisable. 459 notifications of birth, made in accordance with the requirements of the Notification of Births Act, were received. Of these, 94 referred to City mothers, and the balance were transferred to the appropriate authorities. The Woman Inspector, who undertakes the work arising from these notifications, reports that 275 visits were made as a consequence of notifications received, and also that 331 special visits were made in connection with infant welfare. Three visits were also made in respect of cases coming within the scope of the Children Act, 1908, all in relation to nurse children, and ten in connection with verminous school children notified under the London County Council (General Powers) Act, 1904. THE HEALTH OF CHILDREN UNDER 5 YEARS. Some controversy was caused during the year by a suggestion of one of the Metropolitan Borough Councils that the Ministry of Health should increase the age period from three years to five years for children to receive milk without the formalities of the production of a special medical certificate, as is required by the Maternity and Child Welfare Act. This suggestion was made in consequence of an indication in the Annual Report of the Chief Medical Officer of the Board of Education for 1925 that the health of children up to five years of age necessitated greater attention and improved facilities for treatment of disease prior to and during school life, and the stress of the importance of food, air, exercise, rest, and the practice of hygiene. The Ministry of Health were unable to agree to this suggestion, and in view of the necessity for the exercise of economy and also for the maintenance of the desirable spirit of independence and responsibility of the individual, one can only view this decision with satisfaction, especially as no hardship is caused by the restriction in question. INFECTIOUS DISEASES. Few comments are necessary with reference to the incidence of infectious disease during the year 1927. Diphtheria was prevalent to the extent of 16 cases compared with 47 in 1926. The number of Scarlet Fever cases was 37 compared with 38 in 1926. There were 4 cases of Erysipelas. Measles and Rubella are not notifiable diseases and only a few cases of illness of this type were brought to my notice through the medium of the school medical service. Twenty-nine cases of Chicken-pox were notified and one of Ophthalmia Neonatorum. The percentage of cases removed to hospital for treatment continues satisfactory. 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 60. Notification of Infectious Diseases.—In the following tables will be found particulars of certificates relating to cases of infectious disease, and information as to the removal of patients to hospitals, infirmaries, etc. Examination for Pathogenic Bacteria.—During the year the following specimens were so dealt with. It will be seen that positive results were obtained in 2 4 per cent, of these cases. Result. Specimen. Disease suspected. Positive. Negative. 68 Swabbings from throats Diphtheria 1 67 16 Sputa Tuberculosis 1 15 Of the 68 swabbings from throats, 44 were received from the Central Foundation School for Girls, Spital Square, E.C. 12 STATISTICS OF NOTIFICATIONS AND REMOVALS TO HOSPITAL. 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 subsequently found to be incorrect. Net number of Cases. Small.pox .... .... .... .... .... .... .... .... Diphtheria 18 .... 18 .... .... .... 2 16 Sjarlet Fever0 39 l 33 2 l 2 .... 37 Enteric Fever (including Para.typhoid) .... .... .... .... .... .... .... .... Puerperal Fever .... .... .... .... .... .... .... .... Puerperal Pyrexia 2 l .... .... l .... .... 2 Erysipelas 4 4 .... .... .... .... .... 4 Cerebro.spinal Meningitis .... .... .... .... .... .... .... .... Acute Polio.myelitis .... .... .... .... .... .... .... .... * Ophthalmia Neonatorum 1 .... .... .... l .... .... 1 Measles .... .... .... .... .... .... .... .... Rubella .... .... .... .... .... .... .... .... Malaria contracted abroad .... .... .... .... .... .... .... .... Acute Primary Pneumonia 10 2 .... .... 8 .... .... 10 Acute Influenzal Pneumonia 1 .... .... .... 1 .... .... 1 Encephalitis Lethargica 2 .... .... .... 2 .... .... 2 Totals 77 8 51 2 14 2 2 73 Chicken.pox 29 29 .... .... .... .... .... 29 Totals 106 37 51 2 14 2 2 102 The following is a return of infectious diseases which have occurred in the City of London, exclusive of Tuberculosis, Measles, Rubella, Malaria, Pneumonia, Ophthalmia Neonatorum and Chicken.Pox, with the percentages of such cases removed to hospitals for treatment or nursed at home during 1927 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. 1922 77 94.8 5'2 1923 64 95.3 4.7 1924 22 95.5 4 5 1925 49 89.8 10 2 1926 91 97.8 2.2 Average for the five years 61 94.6 5.4 1927 61 90.2 9.8 *This was a prematurely born child (6J months). Vision unimpaired, but child died. 13 CASES OF INFECTIOUS DISEASE AND TUBERCULOSIS NOTIFIED DURING THE YEAR 1927. NUMBER OF CASES NOTIFIED. DISEASES. At Ages—Years. No. of Cases Removed toHos- pital. At all ages. Under 1 year. 1 year and under 2 years. 2 years and under 3 years. 3 4 years , years and and under under 4 ; 5 years. | 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 16 .... 1 .... 2 .... 3 3 .... 6 l .... .... 16 Erysipelas 4 .... .... .... .... .... 1 .... .... 1 .... 2 .... .... Scarlet Fever 37 .... .... 2 1 4 13 5 5 7 .... .... .... 36 Typhus „ .... .... .... .... .... .... .... .... .... .... .... .... .... Enteric „ (including Para-typhoid) .... .... .... .... .... .... .... .... .... .... .... .... .... .... Relapsing „ .... .... .... .... .... .... .... .... .... .... .... .... .... .... Continued „ .... .... .... .... .... .... .... .... .... .... .... .... .... .... Puerperal ,, .... .... .... .... .... .... .... .... .... .... .... .... .... .... Puerperal Pyrexia 2 .... .... .... .... .... .... .... .... 1 l .... .... 1 Polio-mvelitis .... .... .... .... .... .... .... .... .... .... .... .... .... .... Cerebro-spinal Meningitis .... .... .... .... .... .... .... .... .... .... .... .... .... .... Pulmonary Tuberculosis 18 .... .... .... .... ... .... .... 3 5 3 7 .... 16 Other forms of Tuberculosis 5 .... .... .... .... .... .... .... 2 1 1 1 .... 5 Ophthalmia Neonatorum 1 1 .... .... .... .... .... .... .... .... .... .... .... 1 Measles .... .... .... .... .... .... .... .... .... .... .... .... .... .... Rubella .... .... .... .... .... .... .... .... .... .... .... .... .... .... Malaria (contracted abroad) .... .... .... .... .... .... .... .... .... .... .... .... .... .... Acute Primary Pneumonia 10 .... .... .... .... .... .... .... .... 1 3 3 2 8 Acute Influenzal Pneumonia 1 .... 1 .... .... .... .... .... .... .... 1 .... .... 1 Encephalitis Lethargica 2 .... .... .... .... .... .... .... 1 1 .... .... .... 2 Totals 96 1 2 2 3 4 17 8 11 23 10 13 2 86 * Metropolitan Asylums Board Hospitals, London Fever Hospital, City of London Infirmary, St. Bartholomew's Hospital, City Police Hospital, Sanatoria, &c. 14 PREVENTION OF DIPHTH ERIA.—SCHICK TEST AND ANTI-TOXIN INOCULATION. During the year some consideration has been given to the prevention of Diphtheria in London by means of the Schick Test and preventive inoculation. One of the metropolitan borough councils proposed to approach the Ministry of Health and the London County Council with a view to financial assistance being granted to such councils as adopted a scheme for carrying out such treatment. The Schick test has a very definite merit in the practice of preventive medicine. Introduction of the test was attempted some time since at one of the City Schools, but was not proceeded with mainly in consequence of the opposition of the pupils' parents. Since then, however, much experience has been gained and a generous publication of the facts concerning resulting immunity will do much to remove the apprehension current in the mind of that section of the public who regard with misgiving the introduction of scientific protective measures of this nature. Cumulative and world-wide experience of diphtheria immunisation suggests that it is efficient and harmless and the period of immunity appears to be of considerable duration, sufficiently long indeed to tide the child over the age period during which circumstances most expose him to infection. The measure is of most utility among children, since the advance of years seems to give to the individual some naturally acquired immunity from Diphtheria. The establishment of any scheme for the practice of the Schick test and subsequent immunisation of the susceptible, would in my opinion be a sound public health measure in schools and among children generally, and if the measure develops as one would hope, into a scheme which may well have the effect on diphtheria comparable to inoculation on smallpox, the subject will doubtless again be brought to the notice of the City Corporation in the form of concrete proposals for the establishment of an appropriate organisation and an accompanying campaign of education among the general public. DISTRIBUTION OF DIPHTHERIA ANTI-TOXIN AND ANTI - IN FLU ENZA VACCINE. Although City medical practitioners are well aware of the facilities available, no applications for supplies of diphtheria anti-toxin or anti-influenza vaccine were received during 1927. INFLUENZA. The prevalence of Influenza abroad during the early part of the year suggested the desirability of precautionary measures being instituted in this country in order to minimise as far as possible the incidence of the disease should it become epidemic. Leaflets and posters setting out the precautions which should be adopted were prepared and issued to the larger employers of labour such as Banks, Insurance Companies, Railway Companies, etc. They were also circulated to City residents and exhibited at the Police Stations and other places within the City boundary. A communication was also forwarded to medical men practising within the City enclosing a copy of the Minister of Health's memorandum on the malady, and offering assistance with reference to nursing in such cases as came before their notice where difficulty was experienced in this direction. A copy of the pamphlet and poster are included in the appendices to this Report. MEASLES. In view of the biennial epidemic of Measles which is due at the end of 1927 and the early part of 1928, those responsible for the public health work of London gave consideration to the steps which could usefully be taken to modify the measles scheme which has been in operation since 1921, in order that the machinery for securing through the school organisations earlier information of cases of measles might be improved. This early information is more than ever desirable, in view of the recent decision of the Metropolitan Asylums Board to increase in their hospitals the number of beds available for measles. It is obvious that the fullest co-operation of parents is essential if the maximum advantage of any scheme is to be obtained, and with this object, therefore, the following leaflet was circulated to the parents of children through the agency of (1) Head teachers of City schools. (2) Superintendents of City Sunday schools. (3) The Infant Welfare Centre. 15 Up to the time of writing this report there has been nothing more than the normal incidence of measles in the City. MEASLES WARNING. Measles has appeared in your neighbourhood, and there is a possibility that tne disease may become prevalent. Measles is ahighly infectious disease, especially in the early stages of illness before the rash appears. The early symptoms are those of a cold, which may be at tirst slight ; there is generally running at the eyes and nose, sneezing and possibly a dry cough, followed by a rash about tne fourth day after the first appearance of illness. Measles should always be treated, as a Serious Disease, especially in Young Children. As soon as it is suspected the child should be put to bed in a well-ventilated room (as far as possible away from other children) and be kept warm. A doctor should be called in at once, for many children lose their lives, or suffer from ill-health for years as a result of the after-effects ot the disease, mainly because the disease is neglected in the early stages. Tne child should on no account be exposed to chill or draughts or allowed to run about until tne doctor or nurse gives consent. Immediately Measles occurs in your family you should inform the Head Teacher of the School attended by your children, or the Health Visitor at the Infant Welfare Centre, or send, word to the Medical Officer of Health at the Guildhall, E.C. A child showing signs of sickening or suffering from measles must not attend Sunday School, cinemas, public baths or any place of entertainment, nor mix with other children. Arrangements for the Removal of a Measles Patient to Hospital or for Nursing Assistance in the Home may be made in Special Cases when the need for this is known to the Medical Officer of Health. The sooner you send word of the existence of measles in the home the sooner will the Medical Oxficer of Health know, and the sooner will help be forthcoming. Do not wait until bronchitis or pneumonia develops—it may then be too late. w. M. wllloughby, Acting Medical Officer of Health. NURSING PROVISION. Measles, etc.—The Corporation has approved of the expenditure of £25 per annum in respect of the nursing of complicated cases of Measles, Encephalitis Lethargica and Cerebrospinal Fever, and have also agreed to expend the sum of £30 on provision of medical assistance and nursing attendance in necessitous cases of Influenza. No action was necessary under this heading during 1927. TEMPORARY ISOLATION ACCOMMODATION. 29, MIDDLESEX STREET. Suitable accommodation for isolation and observation of Small Pox Contacts is provided by the Corporation at 29, Middlesex Street, but it has not been found necessary to use the accommodation during the year. TUBERCULOSIS. Acting on the suggestion of the Ministry of Health, special attention of medical men practising in the City, and of large employers of labour, such as Banks and Insurance offices, has been directed to the facilities which are available at the Tuberculosis Dispensary established by the City Corporation at St. Bartholomew's Hospital. As in past years, the Dispensary has been open for the diagnosis and treatment of tuberculosis of various types on Tuesdays and Fridays, from 12.30 to 2.30 ; on Mondays, from 5 to 7 ; on Thursdays, from 6 to 7 ; and on Wednesdays, 11.30, for new cases only. In all, 253 sessions have been held, and in addition the Tuberculosis Officer has visited cases at their homes when necessary. New Patients.—The number of new Patients examined was 435, as compared with 410 last year. 62 16 RETURN SHOWING THE WORK OF THE DISPENSARY DURING THE YEAR 1927. CITY RESIDENTS. Diagnosis. Pulmonary. Non-Pulmonary. Total. Adults. Children. Adults. Children. Adults. Children. M. F. M. F. M. F. M. F. M. F. M. F. A.—NEW CASES examined during the year (excluding contacts):— (a) Definitely tuberculous 10 4 ... ... 3 1 ... ... 13 5 ... ... (b) Doubtfully tuberculous ... 1 ... ... ... ... ... ... ... 1 .... ... (c) Non-tuberculous ... 4 1 2 ... .... ... ... ... 4 l 2 B.—CONTACTS examined during the year (a) Definitely tuberculous ... ... ... ... ... ... ... ... ... ... ... ... (b) Doubtfully tuberculous ... ... ... ... ... ... ... ... ... ... ... ... (c) Non-tuberculous 5 16 8 10 ... ... ... ... 5 16 8 10 C.—CASES written off the Dispensary Register as— (a) .Cured 1 1 ... ... ... ... ... 1 1 1 ... 1 (b) Diagnosis not confirmed or nontuberculous (including 1 4 1 2 ... ... ... ... ... ... ... ... cellation of cases notified in error) 5 20 9 12 .... .... .... .... 6 24 10 .... D.—NUMBER OF PERSONS on Dispensary Registeron Dec. 31st, 1927:— (a) Diagnosis completed 25 16 2 1 3 2 .... 2 28 18 2 3 (b) Diagnosis not completed .... 1 .... .... .... .... .... .... .... 1 .... .... NON-RESIDENTS. Diagnosis. Pulmonary. Non-Pulmonary. Total. Adults. Children. Adults. Children. Adujts. Children.[/##] M. F. 11. F. M. F. M. F. M. F. M F. A-—NEW CASES examined during the year (excluding contacts) :— (a) Definitely tuberculous 110 73 4 2 10 11 8 3 120 84 12 5 (b) Doubtfully tuberculous 8 10 .... .... .... .... .... .... 8 10 .... .... (r) Non-tuberculous 55 45 13 18 .... .... .... .... 55 45 13 18 B.—Number of City workers attending Dispensary for treatment on Dec. 31st, 1927.... .... 29 C.—Number of Non-Resident and Non-Workers attending Dispensary for treatment on Dec. 31st, 1927 61 26th January, 1928. 1. Number of persons on Dispensary Register on January 1st, 1927 87 2. Number of patients transferred from other areas and of " lost sight of" cases returned — 3. Number of patients transferred to other areas and cases "lost sight _ of" 34 4. Died during the year 9 5. Number of observation cases under A (b) and B (b) above in which period of observation exceeded 2 months — 6. Number of attendances at the pensary (including Contacts) 509 7. Number of attendances of non-pul- monary cases at Orthopaedic Outstations for treatment or supervision — 8. Number of attendances, at General Hospitals or other Institutions approved for the purpose, of patients for (a) " Light " treatment — (b) Other special forms of treatment 1 9. Number of patients to whom Dental Treatment was given, at or in connection with the Dispensary .... 3 10.—Number of consultations with medical practitioners:— (a) At Homes of Applicants 4 (b) Otherwise — 11. Number of other visits by culosis Officers to Homes — 12. Number of visits by Nurses or Health Visitors to Homes for Dispensary purposes and Nursing 591 13. Number of (a) Specimens of sputum, &C., examined 26 (b) X-ray examinations made in connection with Dispensary work 19 14. Number of Insured Persons on pensary Register on the 31st December 29 15. Number of Insured Persons under Domiciliary Treatment on the 31st December 2 16. Number of reports received during the year in respect of Insured Persons (a) Form G.P. 17 — (b) Form G.P. 36 — 17 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 Referred to X-Ray Department Resident. 19 Non-Resident. 147 Total. 166 Surgical „ 3 4 7 ,, Dental ,, 3 4 7 ,, Throat „ 5 10 15 ,, f Pathological ,, 0 4 4 „ Other „ 2 3 5 † This does not include examinations of sputum. 33 172 204 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. Five resident and 23 non-resident patients were admitted for this purpose. Examination of Sputum.—The following is a summary :— City Residents. Non-Residents. Total. Positive 3 23 26 Negative 33 152 185 Residential Treatment.—The number of patients for whom residential treatment was arranged was 78. They are summarised as follows :— Admitted to Poor Law Other St. Columbus Hosp. L.C.C. Institutions. Institutions. Institutions. Corpn. Expense. Total. Patients resident in the City 11 0 7 2 20 Patients non-resident 56 0 2 0 58 67 0 9 2 78 Persons neither resident nor working in the City are usually transferred immediately to their own Tuberculosis Officer and subsequent arrangements are made by him. This system has worked satisfactorily. Persons Treated and Supervised at the Dispensary.—(A) Patients resident in the City. All persons suffering from tuberculosis who are resident in the City may be supervised and treated at the Dispensary. The total number of cases so treated was 87. In addition a large number of contacts are kept under observation. (B) Patients non-resident in the City. (a) Who work in the City. 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. (b) Who do not work in the City. On diagnosis these patients are usually transferred to the Tuberculosis Officer of their own Borough. The total number of cases so transferred was 147. Total Attendances . Insured. Non-Insured. Total. Residents 255 254 509 Non-Residents 618 776 1,394 1,903 In view of the fact that cases in the last stages of the disease are extremely infectious, especially in crowded houses, the Corporation have made arrangements to pay for the maintenance of selected City cases at St. Columbia's Hospital, Swiss Cottage. Two such cases were admitted in 1927. Artificial Pneumo-thorax.-—Artificial pneumo-thorax treatment has been used to a larger extent during the year. Artificial Pneumo-thorax was induced in 9 cases, and 182 Refills done in connection with the Dispensary. The Tuberculosis Nurse.—As an adjunct to the work at the Tuberculosis Clinic, the outside work of the Tuberculosis Nurse has been continued on the same lines as former years. Eighty-three 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. Two of these cases terminated fatally. For nursing purposes 66 visits were paid. General.—The following information is supplied in accordance with the requirements of the Ministry of Health. The paragraph numbers correspond with those in Circular 648, 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.E. ; 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. 18 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.) Considerable use is made of X-rays from the point of view of diagnosis and decision as to method of treatment to be recommended. The usual methods of treatment have been continued in the Dispensary. Tuberculin has been used in a few cases. In addition ten cases of pulmonary tuberculosis are attending for the continuation of their treatment by artificial pneumo-thorax and inductions of the treatment have been performed in several cases in the wards of the Hospital. (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 dentures 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 £50 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 for as pulmonary cases. The Corporation supplies surgical apparatus free of cost for necessitous residents in the City. (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 method 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 quiescent. 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. (xviii.) Difficulties also arise with regard to advanced cases. These are usually very infectious and do not care to go to the Infirmary. This has been largely remedied by the arrangement made by the Corporation already referred to. The following table sets out the number of cases both of Pulmonary and Non-Pulmonary Tuberculosis, which were brought to my notice during the year 1927, and also the total number of deaths from Tuberculosis among City residents during the same period :— Age Periods. New Cases. Deaths. Pulmonary. Non-Pulmonary. Pulmonary. Nod Pulmonary. M. F M. F. M. F. M. F. 0 .... .... .... .... .... .... .... .... 1 .... .... .... .... .... .... .... .... 5 .... .... .... .... .... .... .... .... 10 .... .... .... .... .... .... .... .... 15-20 2 1 2 .... .... .... .... .... 20-25 .... .... .... .... 1 .... .... .... 25-35 5 .... .... 1 2 1 .... .... 35—45 4 .... .... 1 2 .... .... .... 45-55 2 1 .... 1 4 .... .... .... 55-65 3 .... .... .... .... 1 .... .... 65 an Upwards .... .... .... .... .... .... .... .... Totals 16 2 2 3 9 2 .... .... * The present lady members of the Committee are Lady Cooper, O.B.E,, and Miss Crosby, M.B.E* 19 RETURN SHOWING IN SUMMARY FORM THE CONDITION OF ALL PATIENTS WHOSE CASE RECORDS ARE IN THE POSSESSION OF THE DISPENSARY AT THE END OF 1927, ARRANGED ACCORDING TO THE YEARS IN WHICH THE PATIENTS FlRST CAME UNDER PUBLIC MEDICAL TREATMENT FOR PULMONARY TUBERCULOSIS, AND THEIR CLASSIFICATION AS SHOWN ON FORM A. A.—PULMONARY TUBERCULOSIS. Condition at the time of the last record made during the year to which the Return relates. Previous to 1926. 1926. 1927. Class T.B. minus. Class T.B. plus. Class T.B. minus. Class T.B. plus. Class T.B. minus. Class T.B. plus. Group 1. Group 2. Group 3. Total (Class T.B. plus). Group 1. Group 2. Group 3. Total (Class T.B. plus). Group. 1. Group 2. Group 3. Total (Class ' T.B. plus). Alive. Discharged as cured. ADULTS. M 1 .... .... .... .... .... .... .... .... .... .... .... .... .... .... F 1 .... .... .... .... .... .... .... .... .... .... .... .... .... .... Children. M .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... F .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Disease arrested. idults. M 5 .... .... l l .... .... .... .... .... .... .... .... .... .... F 3 1 .... .... l l .... .... .... .... .... .... .... .... .... Chil- , dren. M 2 ....| .... .... .... .... .... .... .... .... .... .... .... .... .... F .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Disease not arrested. \dults. M 4 2 4 l 7 l .... 2 .... 2 l .... 2 .... 2 F 1 .... 4 .... 4 l .... .... 1 1 .... .... 2 l 3 Children. M .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... F .... .... .... .... .... l .... .... .... .... .... .... .... .... .... Condition not ascertained during the year 2 .... .... .... .... .... .... .... .... .... .... .... 1 1 Lost sight of or otherwise removed from Dispensary Register 8 1 8 1 10 l .... 1 2 3 1 .... .... 2 2 Dead. Adults. M .... .... 2* 1 3 .... .... .... .... .... .... .... .... 3 3 F .... .... .... 2 2 .... .... .... .... .... .... .... .... 1 1 Children. M .... .... .... .... .... .... .... .... .... | .... .... .... .... .... .... F .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Totals 27 4 18 6 28 5 .... 3 3 6 2 .... 5 7 12 *1 Died, not from T.B. T.B. arrested at P.M. B.~NON-PULMONARY TUBERCULOSIS. Condition at the time of the last record made during the year to which the Return relates. Previous to 1926. 1926. 1927. Bones and Joints. Abdominal. Other Organs. Peripheral Glands. Total. Bones and Joints. Abdominal. Other Organs. Peripheral Glands. Total. Bones and Joints. Abdominal. Other Organs. Peripheral Glands. Total. Alive. Discharged as cured. Adults. M .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... F .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Chil dren. ' M .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... F 1 .... .... .... 1 .... .... .... .... .... .... .... .... .... .... Disease arrested. Adults. M 1 1 .... .... 2 .... .... .... .... .... .... .... .... .... .... F 1 .... .... .... 1 .... .... .... .... .... .... .... .... .... .... Chil dren. M .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... f .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Disease not arrested. Adults. M .... .... .... .... .... .... .... .... .... .... 1 .... .... 1 2 F .... .... .... .... .... .... .... .... .... .... 1 .... .... .... 1 Children. ' M .... .... .... .... .... .... .... .... .... .... .... .... .... .... F .... .... .... 1 1 1 .... .... .... 1 .... .... .... .... .... Transferred to Pulmonary .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Condition not ascertained during the year .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Lost sight of otherwise removed from Dispensary Register 4 .... 1 2 7 1 .... .... .... 1 1 .... .... .... 1 Dead. Adults. M .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... F .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Chil dren. M .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... F .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Totals 7 l l 3 12 2 .... .... .... 2 3 .... .... 1 4 30th January, 1928. bs o PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1912. Summary of Notifications during the period from the 1st January to the 31st December, 1927, in the City of London; AGE-PERIODS 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 toS 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 .... 5 3 3 2 .... 15 19 .... .... .... Nil. Nil. l 9 „ Females .... .... .... 1 .... .... .... .... 1 1 .... 3 5 .... .... .... „ „ .... 2 Non-pulmonary Males .... .... .... .... 2 .... .... .... .... .... .... 2 4 .... .... .... „ „ .... 2 „ „ Females .... .... .... .... .... .... 1 1 1 .... .... 3 4 .... .... .... „ „ l 3 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, nnd which have never previously been notified in the area, either on Form A or on Form B, have been included in these cclumns. Col. 19. All notifications which have been made during the year on Foim B in the area concerned, whether the cases have previously been notified in the area, < r not, either on Form A or on Form B. have been included in this column. (These figures agree with those furnished to the Ministry of Health for the period 2nd January, 1927, to 31st December, 1927.) 21 TUBERCULOSIS. Some consideration has been given to the question of the possibility of the introduction of legislation which would entitle to some portion of sickness benefit under the National Health Insurance Scheme those tuberculous patients who could only participate in a parttime occupation by reason of their affliction. It is, of course, undesirable for a tuberculous patient who has been undergoing treatment, say in a Sanatorium, to be plunged direct into full-time arduous work, and certain workshops do exist where graduated labour is arranged. It is felt, however, that, desirable as it may appear, that the wages earned by this part-time work should be supplemented by some proportion of the sickness benefit, such a policy would only tend to postpone the introduction of a scheme to deal with the employment of the tuberculous in a comprehensive manner. The City Tuberculosis Officer has expressed the opinion on more than one occasion, and this opinion is one with which I am in complete accord, that for a large proportion of tuberculous patients employment in a factory specially devoted to them is the only solution. The problem, however, is one which must ultimately be dealt with on a very large scale. PUBLIC HEALTH (PREVENTION OF TUBERCULOSIS) REGULATIONS, 1925. It has not been necessary during the year to take any action in regard to the abovementioned regulations, which provide for the exercise of some control over persons suffering from certain Tuberculous affections and who are engaged in certain occupations associated with the milk trade. VENEREAL DISEASES. The following is a brief summary of the work carried out at the Special Treatment Centre for Venereal Diseases during the year 1927 :— At the beginning of the year 399 males and 115 females were registered on the books as being under treatment or observation, which compares with 276 males and 105 females at the beginning of the previous year. Of these patients 202 males and 82 females were under treatment for syphilis and 197 and 33 females for gonorrhoea. No patients were under treatment for conditions other than venereal disease. New patients admitted totalled 425 as compared with 485 in the previous year, and 402 in 1925 and 417 in 1924. 30 males and 17 females suffering from syphilis discharged themselves before completing the first course, and 27 males and 13 females after completing the first course, but before completion of treatment. 24 males and 26 females completed treatment, but failed to submit themselves to final test ; 4 males and 1 female were transferred to other centres, whilst 9 males and 1 female were discharged after completion of treatment and observation. In the case of gonorrhoea, 127 males and 21 females, out of the total of 189 and 33 of the respective sexes coming under treatment during the year for the first time, discharged themselves before completion of the first course of treatment. The total number of attendances of all persons at the clinic was 12,501, 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. 4,969 1,320 — — 5,261 951 — — 10,230 2,271 A few beds are provided at the Centre for in-patient treatment and the number of days of such treatment totalled : males, 0 ; and females, 17. It is intended, however, to discontinue this in-patient treatment. In the laboratories associated with the Centre 6,266 specimens were examined, 45 for the detection of spirochetes, 1,011 for gonococci, 4,984 examinations for the Wassermann reaction, and 226 other examinations. The following tabulation indicates the number of patients coming under treatment for the first time from the Counties stated and also the examinations which were made for the detection of Spirochetes, of Gonococci and for the Wassermann reaction in respect of these patients . \0. of patients treated. Examinations. For Syphilis. For Gonorrhoea. For Non-Venerea I For Spirochetes. For Gonococci. For Wassermann For Non-Venereal Conditions. Reactions. Conditions. London 147 214 43 45 976 4,972 226 Essex — 3 2 — 20 Herts — 11 — 2 Surrey 12 2 — 8 4 Kent 2 1 2 — 3 8 — Middlesex — 1 . 3 — 2 Totals 150 222 53 45 1,011 4,984 226 Included in the above total were *3.997 examinations for the Wassermann reaction at the request of general practitioners. Eleven specimens were submitted by general practitioners for examination for gonococci. No specimens were submitted by general practitioners for examination for spirochetes *Includes tests made for St. Bartholomew's Hospital and the Metropolitan Asylums Board. d 22 RETURN RELATING TO ALL PERSONS WHO WERE TREATED AT THE TREATMENT CENTRE AT ST. BARTHOLOMEW'S HOSPITAL TREATMENT CENTRE, 20, GOLDEN LANE, E.C.1, DURING THE YEAR ENDED THE 31st DECEMBER, 1927. Syphilis. Soft Chancre. Gonorrhoea. Conditions other than Venereal. Total Males Females Males Females Males Females Males Females Males Females 1. Number of cases which— (a) at the beginning of the year under report were under treatment or observation for 202 82 .... .... 197 33 .... .... 399 115 (b) had been marked off in a previous year as having ceased to attend or as transferred to other Centres, and which returned to the Treatment Centre during the year under report suffering from the same infection 3 1 .... .... 7 .... .... .... 10 1 Total—Items 1 (a) and 1 (b) 205 83 .... .... 204 33 .... .... 409 116 2(a). Number of cases dealt with at the Treatment Centre during the year for the first time 113 37 .... .... 189 33 43 10 345 80 Total*—Items I (a), 1 (b) and 2 (a) 318 120 .... .... 393 66 43 10 754 196 2(b). Number of cases included in Item 2 (a) known to have received previous treatment at other Centres for the same infection 5 1 .... .... 18 2 .... .... 23 3 3. Number of cases which ceased to attend (a) before completing the first course of treatment for 30 17 .... .... 127 21 .... .... 157 38 (b) after one or more courses but before completion of treatment for 27 13 .... .... .... .... .... .... 27 13 (c) after completion of treatment, but before final tests as to cure of 24 26 .... .... 72 15 .... .... 96 41 4. Number of cases transferred to other Treatment Centres after treatment for 4 1 .... .... 9 5 .... .... 13 6 5. Number of cases discharged after completion of treatment and observation for 9 1 .... .... 17 5 .... .... 26 6 6. Number of cases which, at the end of the year under report, were under treatment or observation for 224 62 .... .... 168 20 .... .... 392 82 Total*—Items 3, 4, 5 & 6 318 120 .... .... 393 66 43 10 754 196 7. Out-patient attendances: - (a) For individual attention by the Medical Officer 4,969 1,320 .... .... 1,376 832 .... .... 6,345 2,152 (b) For intermediate treatment, e.g., irrigation, dressings, etc. .... .... .... .... 3,885 119 .... .... 3,885 119 Total Attendances 4,969 1,320 .... .... 5,261 951 .... .... 10,230 2,271 8. Aggregate number of In-patient days" of treatment given to persons who were suffering from .... 17 .... .... .... .... .... .... .... 17 For detection of For Wassermann Reaction. Spirochetes. Gonococci OtherOrganisms Sigmas. 9. Examinations of Pathological material :— (a) Specimens which were examined at, and by the Medical Officer of, the Treatment Centre .... 11 C.S.F. W.R. 113 Sig. 113 W.R. 2,126 Sig. 1,871 (b) Specimens from persons attending at the Treatment Centre which were sent for examination to an approved laboratory 45 1,000 W.R. 501 Sig. 486 * The total of Items 1 (a), 1 (b) and 2 (a) in the vertical columns headed Syphilis, Soft Chancre and Gonorrhoea should agree with the corresponding total of Items 3, 4, 5, and 6. 26 23 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. Middlesex. Herts. Surrey. Kent. Total. A. Number of cases from each area dealt with during the year for the first time and found to be suffering from:— Syphilis 147 .... .... .... l 2 150 Soft chancre .... .... .... .... .... .... .... Gonorrhœa 214 3 l l 2 1 222 Conditions other than venereal 43 2 3 l 2 2 53 Total 404 5 4 2 5 5 425 B. Total number of attendances of all patients residing in each area 12,294 129 8 2 45 23 12,501 C. Aggregate number of "In patient days" of all patients residing in each area 17 .... .... .... .... .... 17 D. Number of doses of Arsenobenzol compounds given in the:— 1. Out-patient Clinic 1,719 .... .... .... .... .... 1,719 2. In-patient Dept. to patients residing in each area. 4 .... .... .... .... .... 4 E. Give the names of Arsenobenzol comp0ounds used in the treatment of syphilis and the usual initial and final doses. Neo.- Salvarsan. Nov-Arsenobillon. Neo.-KharsavanStabilarsen. Silver Salvarsan. Sulfarsenol. MALE. Initial dose, 6 to 9. FEMALE. „ .45 to 75. 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. Usual course, 8 to 10 injections of Arsenical compounds, with 10 to 20 Mercurial or Bismuth injections. 3 to 4 courses in the 1st year, 2 to 3 courses in the 2nd year, according to Wassermann Reaction. Hydrag. Perchlor. with Pot. Iodide between the courses. Mercury Cream, Mercurosal, or Bismuth, in conjunction with or without Arsenical compounds. G. State the nature of tests applied in deciding as to discharge of patients referred to in Item 5 on previous page. MALE. Urethroscopy. Cessation of treatment. Alcohol. Films and cultures from urethral discharge, and from threads, if any, and from prostatic and vesicular secretions on 3 occasions at weekly intervals. FEMALE. Films and sometimes cultures from cervix, urethra and Bartholin's glands (if necessary) after at least 3 successive menstrual periods, after cessation of treatment. 18/1 /28. (Signed) KENNETH M. WALKER, Medical Officer of the Treatment Centre. 24 VENEREAL DISEASE EDUCATIONAL AND PROPAGANDA WORK. On the application of the British Social Hygiene Council, the City Corporation made a grant of fifty guineas per annum towards expenses incurred in connection with educational and propaganda work which that Council carry out as part of their campaign against the incidence of venereal disease. It is, of course, highly desirable that public enlightenment should continue, and the Corporation recognise readily the able manner in which this delicate and difficult task has been carried out by the Council for some years past. CONGRESSES. Royal Sanitary Institute, Hastings The Congress of the Royal Sanitary Institute for 1927, at which the City Corporation was represented, was held at Hastings, from July 11th to July 16th. Your Acting Medical Officer of Health had the honour of reading a paper entitled "Tuberculosis: A Note on the Health of Crews and Ships' Hygiene," in the Conference of Medical Officers of Health, and also a paper on "Canned Foods," in the Hygiene of Food Section. The success of the Congress was due largely to the facilities afforded and arrangements made by the Mayor and Corporation of Hastings, to the convenient nature of the Town as a Congress centre, and from the City point of view, to the fact that the Corporation's delegates were lodged under the same roof with the Council of the Institute and many delegates from other parts of the country. ROYAL INSTITUTE OF FUBLIC HEALTH, GHENT. The City Corporation were, in accordance with custom, represented at the Congress of the Royal Institute of Public Health, held at Ghent from the 1st to the 6th June, 1926. The Congress, which had as its Patron, His Majesty the King of the Belgians, was a very successful one, and many useful and instructive papers were read. NATIONAL CONVENTION FOR THE PREVENTION OF TUBERCULOSIS, LONDON. The National Convention for the Prevention of Tuberculosis, which was founded thirty years ago, held their Annual Congress in London on June 30th, July 1st, and July 2nd. The Corporation were represented and the delegates heard discussions of particular interest. All speakers were agreed that the incidence of tuberculosis is falling, and there was a general agreement that this was due to two factors. The first, and the most important, is the improvement in the surroundings, the education and the social conditions of the people. The other is the adoption of definite measures for the prevention and the treatment of the disease. The Conference insisted on the need for the continuance of educative effort. BRITISH SOCIAL HYGIENE COUNCIL, LONDON. The Third Imperial Social Hygiene Congress, organised by the British Social Hygiene Council, was held in London from the 3rd to the 7th October, inclusive. The Corporation, at the request of this organisation, appointed delegates. As the title of the Congress indicates, the subjects dealt with were, in the main, relative to Social Hygiene. Interesting and instructive papers were read, followed by discussions by social and other workers. WORLD'S DAIRY CONGRESS. The World's Dairy Congress is to be held in July, 1928. The City Corporation has always been interested in any project which has in view the production of clean milk and clean milk products available for the public, and has signified its support of the Congress by making a grant of fifty guineas towards the expenses incurred. The Congress will be the subject of a reference in the Annual Report for the year 1928. 25 HYGIENE OF HAIRDRESSERS' AND BARBERS' SHOPS. A system of voluntary registration of hairdressers' establishments with the Department of the Medical Officer of Health was instituted in 1904. The following is a list of establishments at present on the register :— Alfred Kingston, 8 and 10, Ludgate Arcade. Charles Lehman, 8 and 9, Aldermanbury Postern. Thos. W. Monk, 5, Angel Court. Ed. Hy. Prince, 69, Fore Street. Harry C. Wicks, trading as Arthur & Co., 42a, Old Broad Street. Einar P. Eilert, 75, Mark Lane. Samuel & Harry Cohen, trading as Cohen & Co., 120, Newgate Street. 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. 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. 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 Meteorological Office, South Kensington, on the west, and Victoria Park, on the east of the rain gauge at Golden Lane, are shown in the attached table. The table also shows the rainfall for the months of January to December of the year 1927 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. 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 table, it will be appreciated that in the month of August the amount of deposit registered as falling in the City amounted to 30.52 tons per square kilometre, which is equal (estimating the City as having an area of one square mile) to no less than about 78 tons avoirdupois. Of this mass of dirt, approximately 29 tons were soluble, and included the chemicals mentioned, and 49 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 six milligrammes per cubic metre of air ; this latter figure includes times when there has been a fog. 26 SUMMARY OF MONTHLY OBSERVATIONS AND REPORTS DURING THE YEAR 1927. Month of the Year 1927. Place. 3 4 5 6 7 8 9 10 11 12 Rainfall mm. Metric tons per square kilometre. Insoluble matter. Soluble matter. Total solids. Included in soluble matter. Tar. Carbonaceous other than tar. Ash. Loss on ignition. Ash. Sulphates (SO3). Chlorine (Cl). Ammonia (NH3). January Meteorological Office 38 0.18 2.57 5.04 1.28 3.08 12.15 1.29 0.78 0.08 Golden Lane 44 0.08 7.87 6.47 2.49 6.57 23.48 2.86 1.35 0.18 Victoria Park 26 0.06 1.02 1.40 0.72 1.94 5.14 0.90 0.37 0.07 February Meteorological Office 86 0.18 2.87 4.67 2.37 4.47 14.55 2.15 o.76 0.06 Golden Lane 76 0.04 3.38 5.64 3.04 4.25 16.35 2.29 0.91 0.24 Victoria Park 76 0.1 1.80 2.82 0.86 3.36 8.95 1.47 0.34 0.15 March Meteorological Office 52 0.13 1.69 3.26 1.06 3.13 9.26 1.06 0.55 0.04 Golden Lane 47 0 .08 6. 03 8.50 2.70 7.38 24.69 2.77 1. 01 1.92 Victoria Park 56 0 .09 0.79 2.23 0.42 2.48 6.02 0.90 0.42 0.06 April Meteorological Office 37 0.11 1.39 1.83 0.70 1.54 5.8 0.66 0.24 0.03 Golden Lane 18 0.06 6.21 8.83 2.55 4.62 22.77 2.53 0.60 0.10 Victoria Park 47 0.05 0.78 2.04 1.01 1.73 5.61 0.76 0.32 0.07 May Meteorological Office 11 0.06 0.93 1.31 0.87 2.13 5.31 0.89 0.31 0.01 Golden Lane 33 0 .03 2.68 4.04 1.83 2.87 11.45 1 .61 0.58 013 Victoria Park 43 0.05 127 307 031 1.83 6.53 0.67 0.26 0.05 June Meteorological Office 52 0.17 1.79 4.67 1.25 2.70 10.58 1.21 0.37 0.07 Golden Lane 47 0.04 402 714 2.26 5.08 18.54 2.06 0.80 0.32 Victoria Park 57 0.07 1.47 3.48 0.46 2.24 7.73 0.85 0.24 0.06 July Meteorological Office 58 0.17 1.65 2.76 1.04 3.28 8.90 1.06 0.29 0.03 Golden Lane 47 0.04 4.60 6.44 3.40 4.73 19.22 2.21 0.84 0.30 Victoria Park 78 0 07 1.16 2.61 0.47 2.50 6.80 0.86 0.22 0.11 August Meteorological Office 77 0.15 1.31 2.17 1.39 3.40 8.42 1.32 0.31 0.09 Golden Lane 47 0.05 7.46 11.74 3.76 7 . 51 30.52 4.00 0.76 0.32 Victoria Park 102 0.07 0.96 1.72 0.86 2.50 6.11 1.12 0.33 0.12 September Meteorological Office 84 0.13 1 . 41 216 1.54 2.58 7.82 1.51 0.40 0.07 Golden Lane 94 0.05 5.37 7.09 5.25 9.00 26.76 3.99 0.79 0.37 Victoria Park 117 0.07 1.24 2.22 0.89 2.71 7 .13 1.23 0.37 0.09 October Meteorological Office 26 0.21 1.21 2.29 0.50 2.39 6.60 1.20 0.32 0.04 Golden Lane 24 0.04 3.59 5.10 1.93 3.76 14.42 1.92 0.67 0.09 Victoria Park 28 0 .05 0.88 1.48 0.49 1.40 4.39 0.30 0.22 0.06 November Meteorological Office 54 0.21 2.70 3.40 1.74 3.59 11.64 1.29 0.65 0.08 Golden Lane 59 0.05 2.92 4.54 2.81 4.45 14.77 2.09 0.95 0.21 Victoria Park 52 0.07 1.33 2.24 0.34 2.33 6.31 0.93 0.31 0.09 December Meteorological Office 79 0.20 3.02 4.68 1.49 5.11 14.50 1 .55 0.95 0.10 Golden Lane Bottle burst by fros t. Victoria Park 55 0.06 1.03 1.43 0.72 3.28 6.52 0.97 0.66 0.08 PUBLIC HEALTH (SMOKE ABATEMENT) ACT, 1926. A valuable addition to the Public Health laws, the Public Health (Smoke Abatement) Act, 1926, came into operation on the 1st July of this year. The Act increases in one important direction the powers already possessed by local authorities for controlling nuisances which arise from smoke. In the past the greatest difficulty in dealing with complaints of smoke nuisance has been due to the fact that "black" smoke only was referred to in the Smoke Clauses of the Public Health (London) Act, 1891. In the new Act, however, the word "black" has been omitted, and action can now be taken in the case of a chimney, not being the chimney of a private dwelling.house, which 27 sends forth smoke in such quantities as to be a nuisance, notwithstanding that the smoke is not black smoke. Further, the expression smoke includes soot, ash, grit and gritty particles. There is, however, a new defence for the person charged with an offence under the Act, i.e., if such person is able to prove that he has used the best practical means for preventing the nuisance having regard to all the circumstances. This defence does not apply if the smoke emitted is black smoke. Power is given the local authority to make bye-laws, but the City Corporation do not at this juncture propose to take advantage of this power. The appropriate Committee of the London County Council, who had before them the question of such bye-laws, invited the views of the City Corporation on the suggestion that:— "emission of black smoke for two minutes in the aggregate within any continuous "period of thirty minutes should be deemed to be an offence." Such a bye-law would permit without penalty the continuous emission, during any half-hour of the day, of smoke for any period under two minutes, and it is clear that this would, in a congested area such as the City, constitute a very real nuisance. In my opinion it is not desirable to set up any hard-and-fast rule as to how long any particular chimney shall be permitted to send forth smoke. The law now enables local authorities to deal with this question, and in my view each infringement can best be dealt with on its merits. The proposal to establish a permanent Committee of representatives of the London County Council, the City Corporation, the Metropolitan Borough Councils, the neighbouring authorities within the area of Greater London, and important industrial associations intimately concerned with smoke consumption, is one with which I am in hearty accord. It is intended that this Committee will act in an advisory capacity. The advantages of cooperation between local authorities and industrial associations are manifest, and this cooperation will doubtless ensure that the maximum benefit is derived from the Public Health (Smoke Abatement) Act, 1926. CREMATION. Although cremation is not gaining ground so rapidly as in the case of Continental countries like Czecho-Slovakia, Scandinavia, Switzerland or Germany, in which latter country there are 81 Crematoria in operation and a total of 45,000 cremations carried out during 1926, the figures inserted in the following table of cremations carried out in Great Britain indicate that this method of disposal of the dead is gradually appealing to a wider circle, and I am sure that it is only a question of appropriate educative action before it will be very much more largely adopted. Among prominent persons in public life whose bodies were cremated in the past year may be included Sir Edward Marshall Hall, K.C., Sir Thos. Granger, the Earl Amherst, Israel Zangwill and others. 28 CREMATIONS IN THE UNITED KINGDOM. 43 Years—1885-1927. YEAR. Woking.* Manchester. Glasgow. Liverpool. Hull. Darlington Leicester. Golder's Green. Birmingham. Leeds. City of London. Sheffield. Bradford. W. Norwood. Hendon Park. Pontypridd. 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 l 5 .... .... .... .... .... .... .... .... 451 1903 143 92 24 35 18 1 5 158 l .... .... .... .... .... .... .... 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 54 34 16 22 730 45 20 45 21 12 30 .... .... 1,410 1916 125 179 71 58 25 10 23 633 63 22 43 14 11 89 .... .... 1,366 1917 129 178 67 62 24 15 34 719 49 17 68 25 10 118 .... .... 1,515 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 1923 170 227 90 62 45 21 36 920 75 27 69 37 23 178 6 .... 1,986 1924 235 251 82 74 47 28 40 1,114 97 47 68 32 24 240 7 4 2,390 1925 271 287 116 75 41 32 57 1,214 126 48 66 48 32 266 7 14 2,700 1926 305 303 98 96 55 33 70 1,270 128 40 84 43 32 299 8 13 2,877 1927 320 357 129 101 70 39 68 1,459 150 59 95 57 50 279 11 22 3,266 . _ Totals 6,349 5,090 1,654 1,675 842 402 664 17310 1,503 619 1992 593 128 2,326 47 53 40,647 * " 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 Henrv 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. BACTERIOLOGICAL AND CHEMICAL EXAMINATIONS OF MILK. Samples Collected at Railway Stations. During the latter part of September and the early part of October, samples of milk arriving in the City of London from the country were collected at Liverpool Street Station and submitted to Sir Frederick Andrewes, K.B.E., City Bacteriologist, for bacteriological examination and investigation as to the presence of "dirt." A duplicate of each sample was also submitted to Mr. E. A. Pinchin, B.Sc., Public Analyst for the City, for chemical examination. In all, 42 samples from different farms situate in the following counties were examined:— Essex 9 Suffolk 11 Norfolk 19 Cambridgeshire 9 Lincolnshire 1 29 The samples were collected with the customary regard to cleanliness. The following is a summary of Sir Frederick Andrewes' report on the result of the bacteriological examinations:— " Dirt.—Out of the 42 samples:— 17 were recorded as clean—i.e., no blackish material visible in deposit on standing. 20 had traces of dirt—i.e., small blackish particles were visible in deposit. 2 had rather more than mere traces of dirt. 3 were definitely dirty—though only moderately so—i.e., just over 7%. "Tubercle.—One inoculated guinea pig (No. 15) died of an acute infection and must be excluded from the series, but No. 7 may, I think, safely be included, as ten days had elapsed between inoculation and death, and there were no signs of local inflammation. This leaves 41 guinea pigs, of which two died with tubercle. "The percentage of tuberculous milk is thus 4.88, not quite so good a result as several in recent years. The total absence of tubercle in last year's series was exceptional. (Signed) F. W. ANDREWES. The details in connection with the two cases in which the tubercle bacillus was found were forwarded to the appropriate Medical Officers of Health. The following are extracts from reports which have been received indicating unsatisfactory conditions at the farms of origin:— Sample No. 24.—" Samples have been taken from three cows which, in the opinion of the Veterinary Surgeon, were suspicious, and have been sent for biological examination. Should this examination prove that the cows are suffering from tuberculosis, they will be dealt with by the County Council under the Tuberculosis Order of 1925." Sample No. 31.—"Two samples of milk received from you on the 13th instant have been examined microscopically for the presence of acid-fast organisms, and the result in each case has proved positive." I am informed that action was taken by the Council of the County in which the farm was situate, to deal with the affected cows under the Tuberculosis Order, 1925. The details with regard to the three samples which Sir Frederick Andrewes describes as "definitely dirty" were also communicated to the appropriate Medical Officers of Health in order that investigations at the farms might be made. In one case conditions which might account for the dirt in the milk were found. For purposes of comparison, the following summary of results obtained since the examination of milk on arrival in the City was first commenced in 1904, is here inserted. Year. Percentage showing Tuberculous infection. Year. Percentage showing Tuberculous infection. 1904 7 .7 per cent. 1919 14.8 per cent 1905 9.1 „ „ 1921 124.2 „ „ (1st series) 1906 8.0 „ „ 26.3 „ „ (2nd „ ) 1907 8.3 „ „ 12.5 „ „ (3rd „ ) 1909 12.5 „ ,, (1st series) 1922 9.5 „ „ 4.7 „ „ (2nd „ ) 1923 2.6 „ „ 1910 6.25 „ 1924 12.8 „ „ 1912 6.6 „ 1925 2.4 „ „ (1st series) 1913 10.4 „ 2.4 „ „ (2nd „ ) 1914 10.2 „ 1926 —„ „ 1915 8.5 „ 1927 4.88 „ „ 1917 4.2 „ ,, The chemical examination showed that, with one exception, all the samples were samples of genuine milk. The exception was found to be sophisticated to the extent of 5% added water and 8% fat abstracted. The consignor was fined £1 and £3 11s. 6d. costs. All the samples were free from boracic acid and formalin. SUPERVISION OF FOOD AND DRUGS. During the year 1927, 1,006 samples of Food and Drugs were submitted to the Public Analyst for examination. Of this number, 727 were taken as test samples without the E 30 formalities of the Acts being observed; of these, 17, which comprised the following, were found adulterated:— 3 of Sausage Preservative Powder, out of 9 samples taken. 3 of Malt Vinegar, out of 19 samples taken. 3 of Calomel Ointment, out of 10 samples taken. 2 of Liniment of Turpentine, out of 6 samples taken. 1 of Butter, out of 48 samples taken. 1 of Dried Machine Skimmed Milk, out of 2 samples taken. 1 of Margarine, out of 26 samples taken. 1 of Sausage Seasoning, out of 3 samples taken. 1 of Tinned Vegetables, out of 15 samples taken. 1 of Smelts, out of 1 sample taken. Of the formal samples, 26 out of 279 were found to be adulterated, as follows:— 15 of Milk, out of 238 samples taken. 2 of Liniment of Turpentine, out of 2 samples taken. 2 of Malt Vinegar, out of 3 samples taken. 1 of Butter, out of 7 samples taken. 1 of Calomel Ointment, out of 1 sample taken. 1 of Preservative Powder for Sausages, out of 1 sample taken. 1 of Rum, out of 5 samples taken. 1 of Tinned Vegetables, out of 1 sample taken. 1 of Unfermented Grape Juice, out of 1 sample taken. 1 of Whisky, out of 8 samples taken. The above-mentioned samples, in all cases except Milk, Rum, Whisky and Unfermented Grape Juice, were taken as the result of informal samples having been certified as adulterated. General Observations.—The percentage rate of adulteration of all foods and drugs sampled in the City was 4 -2, the same rate as in 1926. Butter.—Of the 55 samples of butter taken, 30 were of butter served with bread or scone. Legal proceedings were successfully instituted in connection with one sample which was certified to consist of Margarine. Drugs.—Eight samples of drugs were found not to comply with the standards of the British Pharmacopoeia. There were three prosecutions (informal samples having previously been procured) and penalties imposed in each case. A caution was issued to the Vendor of one sample, and in the remaining instance it was not deemed desirable to take further action by reason of a declaration at the time of sale. Seer.—None of the 10 samples of Beer was reported against. Spirits.—Of the 24 samples of Spirits taken, two were found to be below the statutory minimum strength of 35 degrees under proof, and the Vendors were cautioned as legal proceedings were not warranted considering the circumstances. Public Health (Preservatives, etc., in Food) Regulations, 1925 to 1927.—These Regulations, with certain exceptions, became operative on the 1st January, 1927. Consequently the list of articles of food purchased for analysis in the past has been considerably extended, and samples of the articles mentioned in the First Schedule to the Principal Regulations, which may contain one of two added preservatives, viz., Sulphur Dioxide or Benzoic Acid, in specified amounts, have been procured. Sausages.—Thirty-nine samples of Sausages and six samples of sausages labelled as containing preservative were taken and all certified to be genuine. Eleven samples of Preservative Powders and Liquids for sausages were taken. Powders purchased from two Vendors were found to contain Boric Acid, and one of these was the subject of successful legal proceedings. The attention of the Vendor was called to the matter in the other case, and the stock was withdrawn from sale. The declaration on the labels of receptacles containing sausage preservative powder or liquid in most cases were not found to conform to the requirements of the Regulations in various respects, but on the attention of the Makers or Vendors being drawn to the defects, the necessary amendments were made. 31 Six samples of colourings and seasonings for sausages were also procured. One informal sample of seasoning was certified to contain Boric Acid, but a formal sample of the same article was certified free of this preservative, the old stock having been withdrawn from sale. One sample of Margarine, at the beginning of the year, was found to contain Boric Acid, and on resampling a few weeks later, it was found that the old stock had been disposed of. Similarly, with regard to tinned peas certified to contain crystallised sulphate of copper, the Vendor was cautioned and allowed time to dispose of the small balance of his stock. SUPERVISED AND REGISTERED PREMISES. Wholesale Dealers in Margarine and Margarine Cheese.—One new application for registration was received during the year. THE MILK AND DAIRIES ORDER, 1926, AND THE MILK AND DAIRIES (AMENDMENT) ACT, 1922. Ten new applications for registration as retail purveyors of milk were received during the year, eight of which were approved. Two applicants were refused registration, as the conditions obtaining at the premises were unsatisfactory. In accordance with the procedure laid down by the Milk and Dairies (Amendment) Act, 1922, one of these persons appeared before the Sanitary Committee, but no appeal was made by the applicant from their decision to refuse to register him. Registration Statistics. Number of Retail Purveyors of Milk on the Register at end of 1926 334 New Applications for Registration received 10 Applications granted 8 Applications refused 2 Names of Retailers removed from the Register 71 Number of Retail Purveyors of Milk on the Register at the end of 1927 271 Number of Milksellers (other than Retail Purveyors of Milk) on the Register at the en Nil Licenses issued under the Milk (Special Designations) Order, 1923 Nil Inspection of Premises where Milk is Retailed.—During the year, 284 inspections were made in connection with the supervision of the sale of milk. In the course of such inspections it was occasionally necessary to make suggestions for improvement in methods of storage, cleansing of vessels, etc., and these suggestions were readily complied with. Considerable improvements were made by one retail milk distributor by the installation of a cleansing plant comprising a boiler, wash-up tank, churn block and steam sterilizing cabinet. A copy of the Milk and Dairies Order, 1926, was supplied to each person newly registered during the year. In addition to the inspection of premises where milk is retailed, observation has been kept on the barrows whereby milk is purveyed in the streets, to ensure that the requirements of the Order were complied with. Legal proceedings were instituted on two occasions against the same person for permitting bottles to be filled with milk elsewhere than on registered premises. On the first occasion the case was dismissed under the Probation of Offenders Act on payment of two guineas costs; and on the second, the defendant was fined £2 and one guinea costs. Observation has also been made at railway stations with regard to the condition of churns being returned empty to the senders. Generally speaking, they have been found to have been cleansed before dispatch, but in one case, which was the subject of complaint from a Rural District, it was found that churns were being returned in a dirty condition. The firm concerned had no premises within the City area, but the Local Authority in whose district the business was situated was communicated with and the cause of the •complaint removed. EXAMINATION OF MILK. Chemical.—Fifteen samples, all of which were procured formally, were certified as adulterated, giving a percentage of milk adulteration of 6.3, as compared with 4.4 for 1926. There were eight prosecutions and penalties were imposed in each instance. In the seven cases in which proceedings were not deemed advisable, the vendors were cautioned- e 2 32 The following table shows the percentage of fat contained in each of the 238 samples of milk examined. Nine of this number contained fat in amounts below the point which presumes adulteration, i.e., 3 per cent. The highest amount of fat contained in any sample was 7 .1 per cent. Percentage of Fat. No. of Samples. Percentage of Fat. No. of Samples. 22 l 4.0 11 2.3 l 4.1 8 2.4 l 4.2 9 2.5 2 4.3 6 2.6 2 4.4 8 2.8 1 4.5 6 2.9 1 4.6 2 3.0 6 4.7 1 3.1 12 4.8 1 3.2 19 4.9 1 3.3 20 5.0 1 3.4 21 5.3 1 3.5 24 5.4 1 3.6 22 5.5 1 3.7 17 6.0 1 3.8 13 7.1 1 3.9 15 Total 238 In the 32 cases where the percentage of fat exceeded 4 - 2 it was observed that 15 of these samples were taken from milk vessels in shops and very probably the neglect to efficiently plunge the milk accounted for the excessive fat content; 15 were taken from churns in course of delivery at Railway Stations, which, of course, were thoroughly plunged previous to the sample being taken, and one of these was from Jersey cows ; the remaining two samples were taken in transit, where it was specially noted that the milk had not been plunged before delivery. Thirty-six requests were received from purveyors of milk, from whom samples of milk had been taken, asking for samples to be procured in course of transit or delivery from the respective suppliers, in accordance with the Milk and Dairies (Consolidation) Act, 1915. PUBLIC HEALTH (MILK AND CREAM) REGULATIONS, 1912 & 1917. During 1927, 238 samples of Milk were examined under these Regulations, and all were found to be free from preservative. Nine samples of cream (not preserved) were purchased, none of which was certified to contain Boric Acid. Ten samples of Preserved Cream were obtained and found to comply with the Regulations as to labelling and the amount of preservative permitted. In no instance did the fat content of Preserved Cream fall below 35 per cent. No contravention of the other requirements relating to preserved cream was found. All the samples of Cream and Preserved Cream were certified to be free from thickening substances. 1. Milk; and Cream not sold as Preserved Crea 'Ml. («) <») Number of samples examined tor the presence of Preservative. Number in which Preservative was reported to tic present and percentage of Preservative found in each sample. Milk 238 None. Cream 9 None. 2. Cream sold as Preserved Cream. (a) Instances in which samples have been submitted for analysis to ascertain if the statement on the labels as to preservatives were correct. (i.) Correct statements made 10 (ii.) Statements incorrect 0 Total 10 33 (iii.) Percentage of preservative found in each sample 0.28 Percentage stated on Statutory Label 0.4 0.33 0.4 0.31 0.4 0.20 0.4 0.01 0.4 0.13 0.4 0.29 0.4 0.31 0.4 0.23 0.4 0.26 0.4 (b) Determinations made of milk fat in cream sold as preserved cream. (i.) Above 35 per cent 10 (ii.) Below 35 per cent 10 Total 10 (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. Nil. Thickening Substances.—Any evidence of their addition to cream or preserved cream. Action taken where found. Nil. Other observations, if any. Nil. THE PUBLIC HEALTH (CONDENSED MILK) REGULATIONS, 1923. Nine samples of different brands of condensed milk were taken and submitted to the Public Analyst, as follows:— Condensed Full Cream Milk, Sweetened4 Condensed Skimmed or Machine Skimmed Milk, Sweetened 5 Condensed Skimmed Milk, Unsweetened — Condensed Full Cream Milk, Unsweetened — Total 9 In no instance was there a breach of the Regulations either with regard to the equivalent contents, composition or declaration on the labels. THE PUBLIC HEALTH (DRIED MILK) REGULATIONS, 1923. Four samples of dried milk were taken and submitted to the Public Analyst, as follows Dried Full Cream Milk 2 Dried Machine Skimmed Milk that one sample of Dried Machine Skimmed Milk was deficient as regards equivalent contents. This brand was resampled and found satisfactory. The printing on the labels of the tins, however, did not conform to the Regulations. The importers, whose premises were within the City area, were communicated with, and they immediately took steps to effectively remedy the errors. 34 35 ADMINISTRATIVE ACTION REGARDING SAMPLES NOT REPORTED TO BE GENUINE. Name of Article. Identification No. given to :he 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, 1927. Margarine 68 0.41% of Boric Acid .... .... .... .... .... .... .... .... .... .... .... .... .... .... Tinned Peas 82 1.94 grains per lb. Crystallized Sulphate of Copper. .... .... .... .... .... .... Informal sample. Subsequent formal sample genuine. .... .... .... .... .... .... .... .... Liniment of Turpentine 125 44% deficient in Rectified Oil of Turpentine. .... .... .... .... .... .... Informal sample. Resampled formally. .... .... .... .... .... .... .... .... Liniment of Turpentine 168 44% deficient in Rectified Oil of Turpentine. Fined £5 and £1 1s. costs. .... .... .... Informal sample. Resampled formally. .... .... .... Same Vendor as No. 125. Tinned Peas 172 1.568 grains per lb. Crystallized Sulphate of Copper. .... .... .... .... .... .... .... .... .... .... .... Same Vendor as No. 82. Milk 243 3% added water .... .... .... .... .... .... Vendor permitted to dispose of small balance of Stock and cautioned as to future purchases. .... .... .... Milk 261 4% added water .... .... .... .... .... .... Resampled .... .... .... .... .... .... .... .... Milk 291 3% added water .... .... .... .... .... .... Re-sampled .... .... .... .... .... .... .... .... .... .... .... .... .... .... Vendor cautioned Fined £5 and 17s. 6d. Costs, 25th Nov., 1924, for selling Milk containing 10% added water. .... .... .... .... .... Milk Quarter ending 30th June, 1927. 300 3% added water and 5% fat abstracted. .... .... .... .... .... .... Vendor cautioned .... .... .... Same Vendor as No. 243. Milk .... .... .... .... .... .... Unfermented Grape Juice. 342 Sulphur Dioxide, 92 parts per million. .... .... .... .... .... .... Consignor cautioned .... .... .... Supplier to Vendor of Nos. 243 and 300. Milk 380 3% added water .... .... .... .... .... .... Vendor cautioned. Label on bottle altered. .... .... .... .... .... .... .... .... Milk 399 2% added water .... .... .... .... .... .... Vendor cautioned .... .... .... .... .... .... .... .... Butter (on bread) 419 93% Margarine .... .... .... .... .... .... Vendor cautioned .... .... .... Same Vendor as No. 261. Butter (on bread) 454 93% Margarine Fined £2 and £1 1s. costs. .... .... .... Informal sample. Resampled .... .... .... .... .... .... .... .... Malt Vinegar 506 50% deficient in Acetic Acid .... .... .... .... .... .... .... .... .... .... .... .... .... .... Same Vndor as No. 419. Milk 512 14% fat abstracted Fined £3 3s. & £2 2s. costs .... .... .... Informal sample. Resampled .... .... .... .... .... .... .... .... Milk 513 27% fat abstracted Fined £3 3s. & £2 2s. costs. .... .... .... .... .... .... .... .... .... .... .... Sample taken in course of delivery from churn at Railway Station. Milk 516 20% fat abstracted Fined £3 3s & £2 2s. Costs. .... .... .... .... .... .... .... .... .... .... .... Sample taken in course of delivery from churn at Railway Station. Milk 518 17% fat abstracted Fined 10 /- & £1s. Costs. .... .... .... .... .... .... .... .... .... .... .... Sample taken in course of delivery from churn at Railway Station. Malt Vinegar 522 70% deficient in Acetic Acid Fined £2 2s. & £1s. Costs. .... .... .... .... .... .... .... .... .... .... .... Same Vendor as No. 506. Liniment of Turpentine 534 87% deficient in Rectified Oil of Turpentine. .... .... .... .... .... .... Informal sample. Resampled .... .... .... .... .... .... .... .... Milk 547 15% fat abstracted Fined £1 and £1 1s. Costs. .... .... .... 36 37 ADMINISTRATIVE ACTION REGARDING SAMPLES NOT 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. Sausage Preservative Powder. 551 Defective label .... .... .... .... .... .... Attention of Vendor drawn to the breach of the Regulations and the error rectified. .... .... .... .... .... .... .... .... Liniment of Turpentine 572 89% deficient in Rectified Oil of Turpentine. Fined £2 and £2 2s. Costs. .... .... .... .... .... .... .... .... .... .... .... Same Vendor as No. 534. Quarter ending 30th September, 1927. Sausage Preservative Powder. 575 Defective label .... .... .... .... .... .... Attention of Vendor drawn to the breach of the Regulations and the error rectified. .... .... .... .... .... .... .... .... Smelts 576 3.1 % Boric Acid .... .... .... .... .... .... Informal sample. Consignment destroyed. Importers ceased importing. Reported to Ministry of Health. .... .... .... .... .... .... .... .... Sausage Preservative Powder. 614 0.90% Sulphur Dioxide, 0.56% Boric Acid. .... .... .... .... .... .... Informal sample. Vendor communicated with. Stock withdrawn from sale. .... .... .... .... .... .... .... .... Sausage Preservative Liquid. 617 Defective label .... .... .... .... .... .... Informal sample. Vendor written to. Error rectified. .... .... .... .... .... .... .... .... Sausage Preservative Powder. 618 Defective label .... .... .... .... .... .... Informal sample. Vendor written to. Error rectified. .... .... .... .... .... .... .... .... Calomel Ointment 666 63% excess of Calomel .... .... .... .... .... .... Declaration at time of sale. No action necessary. .... .... .... .... .... .... .... .... Calomel Ointment 670 79% deficient in Calomel .... .... .... .... .... .... Informal sample. Resampled .... .... .... .... .... .... .... .... Sausage Preservative Powder. 674 0.37 Boric Acid .... .... .... .... .... .... Informal sample. Resampled .... .... .... .... .... .... .... .... Milk 678 22% fat abstracted Fined £2 and £2 2s. Costs. Sausage Preservative Powder. 714 Defective label .... .... .... .... .... .... Informal sample. Vendor written to. Error rectified. .... .... .... .... .... .... .... .... Sausage Preservative Powder. 715 31% deficient in Sulphur Dioxide. Defective label. .... .... .... .... .... .... Informal sample. Vendor written to. Error rectified. .... .... .... .... .... .... .... .... Beef Sausage Seasoning 716 0.18% Boric Acid .... .... .... .... .... .... Informal sample. Subsequent formal sample genuine. .... .... .... .... .... .... .... .... Calomel Ointment 717 4.6% Ammoniated Mercury and no Calomel Fined £2 and £2 2s. Costs. .... .... .... .... .... .... .... .... .... .... .... Same Vendor as No. 670. Malt Vinegar 723 10% deficient in Acetic Acid .... .... .... .... .... .... Informal sample. Subsequent formal sample genuine. .... .... .... .... .... .... .... .... Malt Vinegar 724 Vinegar other than Malt Vinegar .... .... .... .... .... .... Informal sample. Resampled formally .... .... .... .... .... .... .... .... Calomel Ointment 734 50% excess of Calomel .... .... .... .... .... .... No action necessary .... .... .... .... .... .... .... .... Sausage Preservative Powder. 741 0.30% Boric Acid Fined £1 and £2 2s. Costs. .... .... .... .... .... .... .... .... .... .... .... Same Vendor as No. 674. Quarter ending 31st December, 1927. Malt Vinegar 767 Vinegar other than Malt Vinegar .... .... .... .... .... .... Vendor cautioned .... .... .... Same Vendor as No. 724. Milk 779 5% of added water and 8% of fat abstracted. Fined £1 and £3 11s. 6d. Cost. .... .... .... .... .... .... .... .... .... .... .... Sample taken in course of delivery from churn at Railway Station. Sausages (Preserved) 784 Defective label .... .... .... .... .... .... Informal sample. Vendor written to. Error rectified. .... .... .... .... .... .... .... .... Milk 859 11 % added water Fined £2 and £2 12s. 6d. Costs. Rum 871 36.6 degrees under proof .... .... .... .... .... .... Vendor cautioned .... .... .... .... .... .... .... .... Whisky 910 36.1 degrees under proof .... .... .... .... .... .... Vendor cautioned .... .... .... .... .... .... .... .... Dried Machine Skimmed Milk. 951 Equivalent contents, 7.5 pints in place of 8.0, as stated. Defective label. .... .... .... .... .... .... Informal sample. Manufacturers communicated with. Resampled and found satisfactory. .... .... .... .... .... .... .... .... 38 39 SALE OF FOOD AND DRUGS ACTS, THE PUBLIC HEALTH (PRESERVATIVES ETC., IN FOOD REGULATIONS, THE PUBLIC HEALTH Milk AND CREAM REGULATIONS, AND THE PUBLIC HEALTH (DRIED MILK) REGULATIONS. THE PUBLIC HEALTH (CONDENSED MILK) REGULATIONS Quarter of the Year 1927. Articles Examined During Each Articles submitted for Analysis. Quarter en ding 31st March. Quarter en ding 30th June. Quarter ending 30th September. Quarter ending 31st December. Total lor 1927. No of Samples taken. No. Genuine. No. Adulterated. Percentage of Adulteration. No. of Samples taken. No. Genuine. No. Adulterated. j 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. Formal:— Beef Sausage Seasoning .... .... .... .... .... .... .... .... 1 1 .... .... .... .... .... .... 1 1 .... .... Brandy .... .... .... .... .... .... .... .... .... .... .... .... 8 8 .... .... 8 8 .... .... Butter 3 3 .... .... 1 .... 1 100.0 3 3 .... .... .... .... .... .... 7 6 1 14.2 Calomel Ointment .... .... .... .... .... .... .... .... 1 .... 1 100.0 .... .... .... .... 1 .... 1 100.0 Gin .... .... .... .... 1 1 .... .... .... .... .... .... 1 1 .... .... 2 2 .... .... Liniment of Turpentine 1 .... 1 100.0 1 .... 1 100.0 .... .... .... .... .... .... .... .... 2 .... 2 100.0 Malt Vinegar .... .... .... .... 1 .... 1 100.0 .... .... .... .... 2 1 1 50.0 3 1 2 66.6 Margarine 1 1 .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1 1 .... .... Milk 67 63 4 5.9 68 60 8 11.7 44 43 1 2.2 59 57 2 3.3 238 223 15 6.3 Preservative Powder for Sausages .... .... .... .... .... .... .... .... 1 .... l 100.0 .... .... .... .... 1 .... 1 100.0 Rum .... .... .... .... .... .... .... .... .... .... .... .... 5 4 1 20.0 5 4 1 20.0 Tinned Peas 1 .... 1 100.0 .... .... .... .... .... .... .... .... .... .... .... .... 1 .... 1 100.0 Unfermented Grape Juice .... .... .... .... 1 .... 1 100.0 .... .... .... .... .... .... .... .... 1 .... 1 100.0 Whisky .... .... .... .... 2 2 .... .... .... .... .... .... 6 5 1 16.6 8 7 1 12.5 Total formal samples 73 67 6 8.2 75 63 12 16.0 50 47 3 6.0 81 76 5 6.1 279 253 26 9.3 Informal:— Almond Oil 1 1 .... .... 1 1 .... .... 1 1 .... .... 5 5 .... .... 8 8 .... .... Ammoniated Tincture of Quinine .... .... .... .... .... .... .... .... .... .... .... .... 1 1 .... .... 1 1 .... .... Arrowroot 1 1 .... .... 2 2 .... .... .... .... .... .... 2 2 .... .... 5 5 .... .... Bacon .... .... .... .... .... .... .... .... 1 1 .... .... .... .... .... .... 1 1 .... .... Baking Powde 4 4 .... .... 1 1 .... .... .... .... .... .... .... .... .... .... 5 5 .... .... Beer .... .... .... .... .... .... .... .... 10 10 .... .... .... .... .... .... 10 10 .... .... Bicarbonate of Soda .... .... .... .... .... .... .... .... 1 1 .... .... .... .... .... .... 1 1 .... .... Black Pudding .... .... .... .... 1 1 .... .... .... .... .... .... .... .... .... .... 1 1 .... .... Brawn .... .... .... .... 5 5 .... .... 1 1 .... .... 2 2 .... .... 8 8 .... .... Brawn Seasoning .... .... .... .... 1 1 .... .... .... .... .... .... .... .... .... .... 1 1 .... .... Butter 18 18 .... .... 19 18 1 5.2 6 6 .... .... 5 5 .... .... 48 47 1 2.0 Cake and Buns (various) 1 1 .... .... .... .... .... .... 2 2 .... .... .... .... .... .... 3 3 .... .... Camphorated Oil 3 3 .... .... 1 1 .... .... .... .... .... .... 5 5 .... .... 9 9 .... .... Caramel .... .... .... .... .... .... .... .... 1 1 .... .... .... .... .... .... 1 1 .... .... Castor Oil .... .... .... .... .... .... .... .... 1 l .... .... 4 4 .... .... 5 5 .... .... Cayenne Pepper 2 2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... 2 2 .... .... Cheese 2 2 .... .... .... .... .... .... .... .... .... 2 2 .... .... 4 4 .... .... Chicory .... .... .... .... 2 2 .... .... .... .... .... .... .... .... .... .... 2 2 .... .... Chutney 2 2 .... .... .... .... .... .... .... .... 3 3 .... .... 5 5 .... .... Citric Acid .... .... .... .... 1 1 .... .... .... .... .... .... .... .... .... 1 1 .... .... Cocoa 4 4 .... .... .... .... .... .... .... .... 1 1 .... .... 5 5 .... .... Cod Liver Oil 1 1 .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1 1 .... .... Coffee 1 1 .... .... 1 1 .... .... 1 l .... .... .... .... .... .... 3 3 .... .... Coffee Mixture .... .... .... .... 1 1 .... .... .... .... .... .... .... .... .... .... 1 1 .... .... Coffee and Chicory, Extract of 3 3 .... .... .... .... .... .... 1 1 .... .... .... .... .... .... 4 4 .... .... Colorings .... .... .... .... .... .... .... .... 2 2 .... .... .... .... .... .... 2 2 .... .... Compound Liquorice Powder 1 1 .... .... 1 1 .... .... .... .... .... .... 1 1 .... .... 3 3 .... .... Condensed Full Cream Milk— Sweetened 2 2 .... .... .... .... .... .... 1 l .... .... 1 1 .... .... 4 4 .... .... Condensed Full Cream Milk Unsweetened .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Condensed Machine Skimmed Milk—Sweetened 2 2 .... .... 2 2 .... .... .... .... .... .... 1 1 .... .... 5 5 .... .... Condensed Machine Skimmed Milk—Unsweetened .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Cordials and Fruit Juices .... .... .... .... .... .... .... .... 3 3 .... .... .... .... .... .... 3 3 .... .... Cornflour 1 1 .... .... 4 4 .... .... .... .... .... .... .... .... .... .... 5 5 ........ .... Cream of Tartar 4 4 2 2 .... .... .... .... .... .... 1 1 .... .... 7 7 .... .... Carried forward 53 53 .... .... 45 44 1 .... 32 32 .... .... 34 34 .... .... 164 163 1 .... F 2 40 41 SALE OF FOOD AND DRUGS ACTS, THE PUBLIC HEALTH (PRESERVATIVES, ETC., IN FOOD) REGULATIONS, THE PUBLIC HEALTH (MILK AND CREAM) REGULATIONS, THE PUBLIC HEALTH (CONDENSED MILK) REGULATIONS AND THE PUBLIC HEALTH (DRIED MILK) REGULATIONS.—Continued. Articles submitted for Analysis. Quarter ending 31st March. Quarter ending 30th June. Quarter ending 30th September Quarter ending 31st December. Total for 1927. 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. Informal.—Continued. Brought forward 53 53 .... .... 45 44 1 .... 32 32 .... .... 34 34 .... .... 164 163 1 .... Cream (Not Preserved) 2 2 .... .... 6 6 .... .... .... .... .... .... 1 1 .... .... 9 9 .... .... Cream (Preserved) .... .... .... .... 8 8 .... .... 2 2 .... .... .... .... .... .... 10 10 .... .... Crushed Linseed 6 6 .... .... .... .... .... .... 1 1 .... .... 2 2 .... .... 9 9 .... .... Crushed Wheat 1 1 .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1 1 .... .... Crystallized Glace or CuredFruit (including Candied Peel) 6 6 .... .... 3 3 .... .... .... .... .... .... 7 7 .... .... 16 16 .... .... Curry Powder 3 3 .... .... .... .... .... .... 1 1 .... .... .... .... .... .... 4 4 .... .... Custard Powder .... .... .... .... .... .... .... .... .... .... .... .... 1 1 .... .... 1 1 .... .... Cyder 2 2 .... .... 1 1 ..... .... 1 1 .... .... 1 1 .... .... 5 5 .... .... Desiccated Cocoanut Dried Fruit:— .... .... .... .... 1 1 .... .... ..... .... .... .... .... .... .... .... 1 1 .... .... Apricots, Peaches, etc. 10 10 .... .... 2 2 .... .... .... .... .... .... 1 1 .... .... 13 13 .... .... Raisins and Sultanas 10 10 .... .... 4 4 .... .... ..... .... .... .... 15 15 .... .... 29 29 .... .... Dried Milk—Full Cream .... .... .... .... .... ..... .... .... ..... .... .... .... 2 2 .... .... 2 2 .... .... Dried Milk—Machine Skimmed .... .... .... .... .... .... ..... .... .... .... .... .... 2 1 1 50.0 2 1 1 50.0 Dried Parsley .... .... .... .... 1 1 .... .... .... .... .... .... .... .... .... .... 1 1 .... .... Dripping 5 5 .... .... 4 4 .... .... 2 2 .... .... 1 1 .... .... 12 12 .... .... Essence of Anchovies .... .... .... ..... 1 1 .... .... .... .... .... .... .... .... .... .... 1 1 .... ..... Eucalyptus Oil .... .... .... .... .... .... .... .... .... .... .... .... 4 4 .... .... 4 4 .... .... Extract of Malt and Cod Liver Oil .... .... .... .... ..... .... .... .... .... .... .... .... 1 1 .... .... 1 1 .... .... Fish Paste 5 5 .... .... 2 2 .... .... .... 2 2 .... 1 1 .... .... 10 10 .... .... Flour 1 1 .... .... 1 1 .... .... .... .... .... .... .... .... .... .... 2 2 .... .... Flour (Self-raising) 3 3 .... .... 3 3 .... .... ..... .... .... .... 2 2 .... .... 8 8 .... .... Friars Balsam .... .... .... ..... 1 1 .... .... .... .... .... .... 3 3 .... .... 4 4 .... .... Gelatine 3 3 .... ..... 4 4 .... .... 2 2 .... .... .... .... .... .... 9 9 .... .... Ginger Bread .... .... .... .... .... .... .... .... .... .... .... .... 1 1 .... .... 1 1 .... .... Ginger, Stem .... .... ..... .... .... .... .... .... .... .... .... .... 1 1 .... .... 1 1 .... .... Glaze .... .... .... .... .... .... .... .... .... .... .... .... 1 1 .... .... 1 1 .... .... Glacial Acctic Acid .... .... .... .... .... .... .... .... .... .... .... .... 2 2 .... .... 2 2 .... .... Glycerine .... .... .... .... 1 1 .... .... .... .... .... .... 1 1 .... .... 2 2 .... .... Glycerine of Borax 1 1 .... .... 1 1 .... .... .... .... .... .... .... .... .... .... 2 2 .... ..... Golden Syrup 1 1 .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1 1 .... .... Grape Juice 1 1 .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1 1 .... .... Ground Allspice .... .... .... ..... .... .... .... .... 1 1 .... .... .... .... .... .... 1 1 .... .... Ground Almonds .... .... .... ..... .... .... .... .... 1 1 .... .... 2 2 .... .... 3 3 .... .... Ground Ginger .... .... .... ..... .... .... .... .... .... .... .... .... 2 2 .... .... 2 2 .... .... Ground Nutmeg .... .... .... .... 1 1 .... .... .... .... .... .... .... .... .... .... 1 1 .... .... Ground Rice 2 .... .... .... 1 1 .... .... 1 1 .... .... .... .... .... .... 4 4 .... .... Guava Jelly .... .... .... .... .... ..... .... .... 1 1 .... .... .... .... .... .... 1 1 .... .... Ham .... .... .... .... .... .... .... .... 4 4 .... .... .... .... .... .... 4 4 .... .... Honey 2 .... .... .... 1 1 .... .... 2 2 .... .... 5 5 .... .... 10 10 .... .... Ice Cream .... .... .... .... .... .... .... .... 3 3 .... .... .... .... .... .... 3 3 .... .... Ipecacuanha Wine .... .... .... .... .... .... .... .... 2 2 .... .... .... .... .... .... 2 2 .... .... Jam and Marmalade 3 .... .... .... 5 5 ..... .... 4 4 .... .... 2 2 .... .... 14 14 .... .... Junket Powder .... .... .... .... .... .... .... .... 1 1 .... .... .... .... .... .... 1 1 .... .... Lard 5 5 .... .... 3 3 .... .... 2 2 .... .... 2 2 .... .... 12 12 .... .... Lemon Curd 1 1 .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1 1 .... .... Lemon Squash .... .... .... .... 1 1 .... .... 1 1 ..... .... .... .... .... .... 2 2 .... .... Lemonade Powder .... .... .... .... 5 5 .... .... 4 4 .... .... .... .... .... .... 9 9 .... .... Lime Crush .... .... .... .... .... .... .... .... 1 1 .... .... .... .... .... .... 1 1 .... .... Liniment of Turpentine 2 1 1 50.0 4 3 1 25.0 .... .... .... .... .... .... .... .... 6 4 2 33.3 Malt Vinegar 10 10 .... .... 7 6 1 14.2 2 .... 2 100.0 .... .... .... .... 19 16 3 15.7 Margarine 14 13 1 7.1 7 7 .... .... 2 2 .... .... 3 3 .... .... 26 25 1 3.8 Meat Paste 3 3 .... .... .... .... .... .... 1 1 .... .... .... .... .... .... 4 4 .... .... Meat Pies 1 1 .... .... 2 2 .... .... 1 1 .... .... .... .... .... .... 3 3 .... .... Medicated Wine .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1 1 .... .... Medicated Tablets .... .... .... .... .... .... .... .... .... 1 1 .... 2 2 .... .... 2 2 .... .... Mincemeat .... .... .... .... .... .... .... .... ..... .... .... .... 7 7 .... .... 7 7 .... .... Mineral Waters 3 3 .... .... 3 3 .... .... 1 1 .... .... .... .... .... .... 7 7 .... .... Carried forward 159 157 2 .... 129 126 3 .... 78 76 2 .... 109 108 1 .... 475 467 8 .... 42 43 SALE OF FOOD AND DRUGS ACTS, THE PUBLIC HEALTH (PRESERVATIVES, ETC, THE PUBLIC HEALTH (CONDENSED MILK) REGULATIONS IN FOOD) REGULATIONS, THE PUBLIC HEALTH (MILK AND CREAM) REGULATIONS, AND THE PUBLIC HEALTH (DRIED MILK) REGULATIONS—Continued Articles submitted for Analysis No of Samples taken Quarter ending 31st March Quarter ending 30th June Quareter ending 30th September Quarter ending 31th September Total for 1927 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 Informal—Continued Brought forward 159 157 2 .... 129 126 3 .... Mustard 2 2 .... .... 1 1 .... .... 78 76 2 .... 109 108 1 .... 475 467 8 .... Mustard Condiment .... .... .... .... .... .... .... .... 1 1 .... .... .... .... .... .... 4 4 .... .... Nut Paste .... .... .... .... .... .... .... .... .... .... .... .... 1 1 .... .... 1 1 .... .... Oatmeal 1 1 .... .... .... .... .... .... .... .... .... .... 1 1 .... .... 1 1 .... .... Ointment, Boracic .... .... .... .... 1 1 .... .... .... .... .... .... 2 2 .... .... 3 3 .... .... Ointment, Calomel .... .... .... .... 3 3 .... .... .... .... .... .... .... .... .... .... 1 1 .... .... Ointment, Gall and Opium 2 2 .... .... 1 1 .... .... 6 3 3 50.0 1 1 .... .... 10 7 3 30.0 Ointment, Iodine .... .... .... .... 1 1 .... .... 1 1 .... .... .... .... .... .... 4 4 .... .... Ointment, White Precipitate .... .... .... .... 2 2 .... .... .... .... .... .... 1 1 .... .... 2 2 .... .... Ointment, Zinc 1 1 .... .... 1 1 .... .... 2 2 .... .... 2 2 .... .... 6 6 .... .... Olive Oil 1 1 .... .... 1 1 .... .... .... .... .... .... .... .... .... .... 2 2 .... .... Paregoric 2 2 .... .... .... .... .... .... 3 3 .... .... 2 2 .... .... 7 7 .... .... Pearl Barley 1 1 .... .... .... .... .... .... .... .... .... .... .... .... .... .... 2 2 .... .... Peas (Dried) 1 1 .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1 1 .... .... Pepper 1 1 .... .... 3 3 .... .... .... .... .... .... .... .... .... .... 1 1 .... .... Pickles 2 2 .... .... 2 2 .... .... .... .... .... .... 1 1 .... .... 5 5 .... .... Potted Shrimps 1 1 .... .... .... .... .... .... 1 1 .... .... 1 1 .... .... 6 6 .... .... Prawns .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1 1 .... .... Preserved Ginger 1 1 .... .... .... .... .... .... 1 1 .... .... .... .... .... .... 1 1 .... .... Prunes 1 1 .... .... .... .... .... .... .... .... .... .... 3 3 .... .... 4 4 .... .... Purified Borax 3 3 .... .... 4 4 .... .... 1 1 .... .... l 1 .... .... 3 3 .... .... Rice 1 1 .... .... .... .... .... .... 2 2 .... .... 1 1 .... .... 10 10 .... .... Rum .... .... .... .... .... .... .... .... 1 1 .... .... .... .... .... .... 2 2 .... .... Salad Dressing .... .... .... .... 1 1 .... .... .... .... .... .... 1 1 .... .... 1 1 .... .... Salami .... .... .... .... 2 2 .... .... .... .... .... .... .... .... .... .... 1 1 .... .... Sauces 8 8 .... .... 3 3 .... .... 1 1 .... .... .... .... .... .... 3 3 .... .... Sausages (Not Preserved) 7 7 .... .... 7 7 .... .... 1 1 .... .... .... .... .... .... 12 12 .... .... Sausages (Preserved) .... .... .... .... 2 2 .... .... 12 12 .... .... 13 13 .... .... 39 39 .... .... Sausage Preservative Liquid .... .... .... .... .... .... .... .... 2 2 .... .... 2 2 .... .... 6 6 .... .... Sausage Preservative Powder .... .... .... .... 1 1 .... .... 2 2 .... .... .... .... .... .... 2 2 .... .... Sausage Seasoning .... .... .... .... .... .... .... .... 8 5 3 37.5 .... .... .... .... 9 6 3 33.3 Semolina .... .... .... .... 1 1 .... .... 3 2 1 33.3 .... .... .... .... 3 2 1 33.3 Sherbet .... .... .... .... 2 2 .... .... .... .... .... .... .... .... .... .... 1 1 .... .... Shredded Suet 1 1 .... .... 1 1 .... .... 1 1 .... .... .... .... .... .... 3 3 .... .... Smelts .... .... .... .... .... .... .... .... .... .... .... .... 1 1 .... .... 3 3 .... .... Soup Seasoning .... .... .... .... .... .... .... .... 1 .... 1 100.0 .... .... .... .... 1 1 1 100.0 Spice (Mixed) .... .... .... .... .... .... .... .... .... .... .... .... 1 1 .... .... 1 1 .... .... Spirit of Sal Volatile .... .... .... .... .... .... .... .... .... .... .... .... 1 1 .... .... 1 1 .... .... Sponge Cake 5 5 .... .... 2 2 .... .... 1 1 .... .... .... .... .... .... 9 9 .... .... Sugar (Granulated) 6 6 .... .... 2 2 .... .... 1 1 .... .... 1 1 .... .... 9 9 .... .... Sugar (Demerara) 2 2 .... .... 1 1 .... .... .... .... .... .... 1 1 .... .... 6 6 .... .... Sugar (Caster) 1 1 .... .... .... .... .... .... 1 1 .... .... 2 2 .... .... 1 1 .... .... Sweet Spirit of Nitre .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1 1 .... .... Sweets 2 2 .... .... .... .... .... .... 1 1 .... .... .... .... .... .... 4 4 .... .... Table Jellies .... .... .... .... 1 1 .... .... .... .... .... .... 2 2 .... .... 2 2 .... .... Tapioca .... .... .... .... 1 1 .... .... 1 1 .... .... .... .... .... .... 2 2 .... .... Tartaric Acid 1 1 .... .... .... .... .... .... .... .... .... .... 1 1 .... .... 1 1 .... .... Tea and Tea Sittings 1 1 .... .... 2 2 .... .... .... .... .... .... .... .... .... .... 5 5 .... .... Tincture of Iodine (Weak) .... .... .... .... .... .... .... .... 1 1 .... .... 1 1 .... .... 2 2 .... .... Tinned Fish 1 1 .... .... .... .... .... .... .... .... .... .... 2 2 .... .... 1 1 .... .... Tinned Fruit 2 2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... 5 5 .... .... Tinned Vegetables 9 8 1 11.1 2 2 .... .... 1 1 .... .... 2 2 .... .... 15 15 .... .... Treacle .... .... .... .... .... .... .... .... 2 2 .... .... 2 2 .... .... 1 1 1 6.6 Vinegar 4 4 .... .... 4 4 .... .... .... .... .... .... 1 1 .... .... 10 10 .... .... Wines (Alcoholic) 4 4 .... .... 3 3 .... .... 1 1 .... .... 1 1 .... .... 11 11 .... .... Wines (Non-Alcoholic) 2 2 .... .... .... .... .... .... .... .... .... .... 4 4 .... .... 2 2 .... .... Yellow Crystals .... .... .... .... 1 1 .... .... .... .... .... .... .... .... .... .... 1 1 .... .... Total informal samples 236 233 3 1.2 188 185 3 1.5 138 128 10 7.2 165 164 1 0.6 727 710 17 2.3 Totals 309 300 9 2-9 263 248 15 5.7 188 175 13 6.9 246 240 6 2.4 1,006 963 43 4.2 44 SALE OF FOOD AND DRUGS ACTS, PUBLIC HEALTH (PRESERVATIVES, ETC., IN FOOD) REGULATIONS, PUBLIC HEALTH (MILK AND CREAM) REGULATIONS, PUBLIC HEALTH (CONDENSED MILK) REGULATIONS AND PUBLIC HEALTH (DRIED MILK) REGULATIONS. RESULTS OF PROSECUTIONS. First Quarter. Sample. Nature and Extent of Adulteration. Result. 168 Liniment of Turpentine 44 per cent. deficient in Rectified Oil £5 and £1 1s. Costs. of Turpentine. Second Quarter. 454 Butter (on bread) Selling as butter on bread a substance £2 and £1 1s. Costs. containing 93% Margarine. 512 Milk 14 per cent. of original fat abstracted £3 3s. and £2 2s. Costs. 513 Milk 27 per cent. of original fat abstracted £3 3s. and £2 2s. Costs. 516 Milk 20 per cent. of original fat abstracted £3 3s. and £2 2s. Costs. 518 Milk 17 per cent. of original fat abstracted 10s. and £1 1s. Costs. 522 Malt Vinegar 70 per cent. deficient in Acetic Acid £2 2s. and £1 1s. Costs. 572 Liniment of Turpentine 89 per cent. deficient in Rectified Oil £2 and £2 2s. Costs. of Turpentine. 547 Milk 15 per cent. of original fat abstracted £1 and £1 1s. Costs. Third Quarter. 678 Milk 22 per cent. of original fat abstracted £2 and £2 2s. Costs. Fourth Quarter. 717 Calomel Ointment Entirely deficient in Mercurous Chloride £5 and £2 2s. Costs. and containing 4.6 per cent. Ammoniated Mercury. 741 Preservative Powder 0.3 per cent. Boric Acid £1 and £2 2s. Costs. for Sausages. 779 Milk 5 per cent. added water and 8 per cent. £1 and £3 11s. 6d. Costs. of the original fat abstracted. 859 Milk 11 per cent. added water £2 and £2 12s. 6d. Costs. SUMMARY. £ s. d. £ s. d. First Quarter, Fines 5 0 0 Costs 1 1 0 Second Quarter „ 17 1 0 „ 12 12 0 Third Quarter „ 2 0 0 „ 2 2 0 Fourth Quarter ,, 9 0 0 „ 10 8 0 Total Fines £33 1 0 Total Costs £26 3 0 SUPERVISION OF THE ICE CREAM TRADE. The usual inspections in connection with the manufacture or sale of Ice Cream within the City have been carried out. In all cases where manufacture took place in other areas, the appropriate local authority was informed of the circumstance and requested to state if the premises and process of manufacture were satisfactory. Replies to these enquiries show that in practically every instance the conditions were found to be satisfactory. In those few instances where this was not the case, sanitary improvements were ultimately effected. The Barrows or Stalls of itinerant vendors were inspected periodically, and in those instances where lack of cleanliness of the utensils was observed, the administration of a caution invariably resulted in appropriate steps being taken to remedy the defect. MEAT INSPECTION. The following tabulated report has been prepared by Mr. T. Dunlop Young, Veterinary Surgeon:— 1. Beef.—According to the Board of Trade statistics for the year 1927, the total amount of beef imported was 671,797 tons, of which over 77 per cent. arrived in a chilled condition and 23 per cent. frozen. Those figures show the increasing demand for chilled against frozen, there being an increase of 36,000 tons in the quantity of the former and a decrease of 25,000 tons in the latter. Imported tinned and canned beef, tongues, extracts, etc., derived from bovines amounted to 50,000 tons. 45 2. Mutton and Lamb.—The importation of mutton and lamb increased by 8,427 tons, compared with the quantity for 1926. Sheep offals (frozen) amounted to 3,535 tons, and tinned or canned food derived from sheep and lambs amounted to over 2,535 tons. 3. Pork.—The imports of fresh pork consisted of 15,000 tons less than in 1926, and the quantity of frozen pork was 4,300 tons less. The following table shows the total imports of meat and bacon from the various countries:— Countries. Beef. Mutton. Pork. Bacon. Argentina 577,916 76,824 2,233 — Australia 32,137 31,398 — — Canada — — — 25,154 China — — 33 — Denmark — — — 254,080 Irish Free State — — 15,867 22,544 New Zealand 16,543 136,866 — — Other Countries 11,882 15,894 5,158 89,624 U.S.A. 3,901 — 1,938 32,054 Uruguay 29,417 15,863 — — Tons 671,796 276,845 25,229 423,456 4. live stock.— The importation of live cattle from soutn Africa, Canada and the U.S.A., appears to be gradually diminishing to the stage of extinction. During the year under review only 7,669 animals arrived from Canada, compared with over 79,000 for the year 1926. The increasing demand for cattle and the high prices obtained in the U.S.A. is the explanation. If that demand continues and the U.S.A. opens its ports to chilled beef from South America, there would follow a marked effect on the supplies of that class of meat to Smithfield Market, with in all probability an increase in the price of beef. This would be an incentive to the British and Irish farmers to produce more home-fed animals. LIVE FOOD ANIMALS IMPORTED 1927. Countries. Cattle No. Sheep No. Pigs No. Canada 7,669 Irish Free State 629,001 584,397 394,740 South Africa 198 — — Totals 636.868 584.397 394,740 Re-Exportation of Meat.—From the same source of information it appears that this country re-exported 1,245 tons of chilled beef, 21,110 tons of frozen beef, 111 tons of frozen pork, 1,503 tons of frozen mutton and lamb and 1,242 tons of bacon and hams. In addition to 16,079 tons of fresh meat, 2,869 tons of home-produced bacon and hams and 6,684 tons of offal. SMITHFIELD MARKETS. The following table* shows comparison in tonnage of the supplies for 1927 with those for 1926, by which it will be observed that 1927 was another record supply year, there being a total increase of 9,052 tons over the record of 1926: — LONDON CENTRAL ANALYSIS AND COMPARISONS OF SUPPLIES IN MARKETS. TONS.—A RECORD YEAR'S SUPPLIES. Description and Country of Origin. 1027. 1926. Difference. Beef and Veal:— Britain and Ireland 47,558 38,225 + 9,333 Australia 2,758 7,093 — 4,335 New Zealand 1,292 1,473 — 181 Canada 827 4,413 — 3,586 United States of America 1,314 1,583 — 269 Argentina 201,064 191,566 + 9,498 Uruguay, etc. 6,997 12,312 — 5,315 Netherlands 4,250 — 4,250 Other Countries — 2,342 — 2,342 Totals—Beef and Veal 261,810 263,257 — 1,447 Description and Country of Origin. 1927. 1926. Difference. Mutton and Lamb :— Britain and Ireland 39,921 33,199 + 6,722 Australia 18,582 16,109 + 2,473 New Zealand 65,660 66,836 — 1,176 Canada — — — United States of America 93 54 + 39 Argentina 21,155 21,986 — 831 Uruguay, etc. 4,696 2,645 + 2,051 Netherlands 1,641 — 1,641 Other Countries 150,107 104 142,574 — 104 + 7,533 * We are indebted to the Superintendent for those figures. 46 Description and Country of Origin. 1927. 1826. Difference. Pork and Bacon:— Britain and Ireland 30,268 15,723 + 14,545 Australia 192 208 — 16 New Zealand 495 378 + 117 Canada 242 931 — 689 United States of America 975 1,317 — 342 Argentina 1,190 1,918 — 728 Uruguay, etc. 8 112 — 104 Netherlands (*) Bacon *3,380 15,762 — 12,382 Other Countries — *2,215 4,186 — 1,971 Totals—Pork and Bacon 38,965 40,535 — 1,570 Description and Country of Origin. 1927. 1926. Difference. Poultry and Game:— Britain and Ireland 12,836 12,030 + 806 Australia 57 68 11 New Zealand 48 21 + 27 Canada 11 131 — 120 United States of America 652 546 + 106 Argentina 81 213 — 132 Uruguay, etc. 28 13 + 15 Netherlands 1,221 1,098 + 123 Other Countries 8,234 6,603 + 1,631 Totals—Poultry and Game 23,168 20,723 + 2,445 Description and Country of Origin. 1927. 1926. Difference. Rabbits, Butter, etc.:— Britain and Ireland 4,808 4,354 + 454 Australia 4,080 3,435 + 645 New Zealand 797 789 + 8 Canada 97 132 — 35 —United States of America 131 127 + 4 Argentina 126 194 — 68 Uruguay, etc. — — — Netherlands 1,225 966 + 259 Other Countries 3,976 3,152 + 824 Totals—Rabbits, Butter, etc. 15,240 13,149 + 2,091 Grand Totals 489,290 480,238 + 9,052 It is interesting to note that Britain and Ireland increased the food supplied by Mutton and Lamb .... .... „ 6,722 Pork and Bacon „ 14,545 Poutry and Game „ 806 Rabbits, Butter, etc .... ,, 454 Total 31,860 At present consignments of dressed beef are coming direct from Ireland into Smithfield Market, chiefly from Drogheda. Some very excellent beef has been delivered, which entered into keen competition with Scotch beef. Not only was the quality good, but the dressing and cleanliness of the meat reflected credit on those responsible, as did also the freedom from disease. Considerable activity was observed during the year in the supply of fresh pork from Ireland. Consignees in Smithfield Market have with commendable enterprise been at considerable trouble to educate Irish consignors as to the right type of pig carcase required, the best method of dressing, packing and transport. The consignors have also taken a great interest in this work, as have also the officials of the Ministry of Agriculture for the Irish Free State, who have repeatedly visited the Central Markets making observations and also obtaining from the salesmen and meat inspectors useful information. The Department of Local Government and Public Health Secretary has taken great interest in the meat inspection branch of the supplies, and the Department appears anxious to ensure that no doubtful meat is exported from Ireland. Enquiries have been received from Veterinary Inspectors in charge of meat inspection in Ireland as to the standard adopted here in judging as to the fitness for human food of carcases. All this activitv noints to Droeress in the rierht direction. 47 In the report for 1926, reference was made to the large numbers of pig carcases in which lesions of tuberculosis were found, also the variation in the macroscopic appearances of the lesions in the lymph glands. Enquiries had been made as to the feeding of many of the diseased pigs, and it had been ascertained that they had never received as food any cows' milk ; this led us to suggest fowls as the source of the disease. It was further stated that an investigation as to the percentage of pigs found affected with Avian tuberculosis would prove, not only of scientific interest, but of considerable value commercially to the breeders and feeders of pigs, and lead to measures of prevention that should be taken as to infection of pigs. During 1927 we were fortunate in co-operating with Dr. Stanley Griffith, who very kindly undertook to type the bacilli found in the tubercular submaxillary glands of pigs' heads ; fresh glands were cut out and sent to the Field Laboratories at Cambridge, and Dr. Griffith, with Mr. Cornell, B.Sc., M.R.C.V.S., of the Comparative Pathology Department, Cambridge, has for some time been carrying out the interesting investigation. The results will, no doubt, form the subject of a special report by Dr. Griffith, but it is possible to state here that 30.0 per cent. of the lesions sent contained tubercle bacilli of the Avian type. This investigation should be a warning to pig feeders not to allow poultry and pigs to run or be fed together, also that the danger of tubercular infection of pigs arises from at least four sources—(1) feeding on cows' milk containing the bacilli, (2) suckling a sow with diseased mamma, (3) feeding in pastures with cows which are infected, and (4) feeding with fowls, many of which may be tubercular. Judging from the amount of diseased meat which continues to be deposited in the Central Markets, Smithfield, there appear to be many local authorities who do not enforce the Public Health (Meat) Regulations, 1924. It is, doubtless, impossible for many Sanitary Inspectors to carry out efficient meat inspection in their districts in addition to their other duties. An Inspector who called at the markets some time ago, stated he had to supervise twenty-nine private slaughterhouses in his district in addition to his other duties and no assistance given. As long as this obtains, there will always be a risk of the public consuming some diseased meat. The National Federation of Meat Traders recognise this and continue to urge for a systematic form of inspection throughout the country, because at present very strict inspection is in force in towns and some districts, while in others there is practically no inspection, with the result that honourable traders are the losers by calling in Inspectors to see carcases that are doubtful. All traders should be treated equally. The following table shows that, compared with 1926, instead of there being a reduction in the quantities of unsound food deposited on the markets, there is actually an increase, especially in beef and pork AMOUNTS OF HOME-KILLED MEAT SEIZED AT SMITHFIELD ON ACCOUNT OF DISEASE, AND THE NATURE OF THE DISEASE. CAUSE OF SEIZURE. Carcases of Beef. Quarters of Beef. Carcases of Mutton. Quarters of Mutton. Carcases of Veal. Quarters of Veal. Carcases of Pork. Quarters of Pork. Heads. Tongues. Lungs. Kidneys. Livers. Plucks. Abscesses — — 2 — — — 14 4 4 — — — — — Actinomycosis 1 — — — — — — — 5 16 — — — — Arthritis — — — — — — 9 — — — — — — — Asphyxia — — 1 — — — 1 — — — — — — — Blackquarter — — — — — 6 — — — — — — — — Diphtheria — — — — — — — — 3 — — — — — Distomatosis — — 14 — — — — — — — — — — — Dropsy — — — — — — 2 — — — — — — — Emaciation and 1 2 70 — 4 — 13 — — — — — — — Hydraemia Erysipelas (Swine) — — — — — — 2 — — — — — — — Haemorrhages — 1 — — — — 23 — — — — — — — (Muscular). Jaundice — — — — 4 — 2 — — — — — — — Joint ill — — — — 1 — — — — — — — — — Killed in Extremis 3 — 2 — 1 — 37 — — — — — — — Metritis (Septic) 1 — 1 — — — — — — — — — — — Myositis — — 2 — 2 — 1 — — — — — — — Nephritis (Acute) — — 1 — — — — — — — — — — — Osteoporosis — — — — — — 1 — — — — — — — Carried forward 6 3 93 — 12 6 105 4 12 16 — — — — G 2 CAUSE OF SEIZURI . Carcases of Beef. Quarters of Beef. Carcases of Mutton. Quarters of Mutton. Carcases of Veal. Quarters of Veal. Carcases of Pork. Quarters of Pork. Heads. Tongues. Lungs. Kidneys. Livers. Plucks. Brought forward 6 3 93 — 12 6 105 4 12 16 — — — — Pleurisy and Peritonitis. 2 — 3 — 4 — 125 4 — — — — — — Pseudo-leukaemia — — — — 1 — — — — — — — — — Pyaemia — — — — — — 2 — — — — — — — Rachitis — — — 4 — — 6 — — — — — — — Sarcoma 1 — — — — — 1 — — — — — — — Sarcosporidia — — 1 — — — — — — — — — — — Tuberculosis Bov. 12 19 — — 4 2 — — 63 49 4 6 22 — Tuberculosis Pore. — — — — — — 403 8 4292 — — — — 2101 Totals, 1927 21 22 97 4 21 8 642 16 4367 65 4 6 22 2101 Totals, 1926 7 3 176 4 18 — 353 7 1691 37 80 1 83 — Argentina.—It will be observed from the Board of Trade's figures that 577,916 tons of beef, 76,824 tons of mutton and lamb, and 2,233 tons of pork were imported from Argentina. Of those quantities 201,064 tons or 34.8 per cent. of the beef, 21,155 tons or 27.5 per cent. of the mutton and lamb, and 1,190 tons or 53.3 per cent. of the pork passed through Smithfield Market. Compared with 1926, there was an increase of 9,498 tons of beef, and a decrease of 831 tons of mutton and lamb imported. For a period of the year under review the quality of the beef which arrived was scarcely up to the usual high standard, and lately some of the mutton was not of a very high quality. Considering the very large quantities of meat imported from this country, the amount found diseased or unsound was very small. Some anxiety has existed as to the possibility of the virus of Foot and Mouth Disease being conveyed in or with South American meat. With a view to adopting precautions, the Ministry of Agriculture during the year sent to Argentina one of its Senior Veterinary Officers, who will keep observations on the system of inspection at the Frigorificos, and the freedom of contagious disease of animals sent to the packing plants for slaughter. (A recommendation to this effect was made by your Veterinary Surgeon in 1913.) The Argentine Government has greatly increased its staff of Veterinary Inspectors, and apparently everything is being done by co-operation between the two Governments to prevent any possibility of the virus being introduced into this country. As will be seen from the following table, there has been an increase in the Australia.—Eight-and-a-half per cent. of the beef, fifty-nine per cent. of the mutton and lamb, with 192 tons of the pork imported from Australia, passed through Smithfield Markets. Two consignments of chilled beef were received, the last was perhaps the most successful of the few attempts that have been made to bring chilled beef from Australia. There seems to be a diversity of opinion as to whether, under present conditions, it will pay to bring this class of meat over so long a distance. If this can be done it appears to be worth trying, judging by the great demand for chilled beef and the continued diminution in numbers of retailers who ask for frozen beef. For example, in 1925 the number of quarters of frozen beef imported from all countries was approximately 2,174,000, and in 1927 the number had fallen to 992,432, much of which went for contract supplies. Those figures will doubtless give food for thought on the part of Australian shippers. There were considerable quantities of poor quality lamb from this country placed on the market during the year. From a meat inspection point of view the meat imported was satisfactory, although there is an increase in the number of sheep carcases found to contain lesions of Caseous Lymphadenitis. 48 country. As will be seen from the following table, there has been an increase in the amount of diseased Argentine meat observed in the Central Markets :— Disease. Quarters of Beef. Carcases of Mutton. Quarters of Mutton. Pig Carcases. 1926 1927 1926 1927 1926 1927 1926 1927 Abscesses 12 15 — 3 — — 69 95 Caseous Lymphadenitis — — 267 475 — 48 — — Injury — 1 — — — — — — Nephritis (Acute) — — — — — — — 1 Pleurisy (Acute) — — — — — — — 1 Pseudo-leukaemia — — — 2 — — — — Tuberculosis (Hinds) 142 172 — — — — — — Tuberculosis (Fores) 25 41 — — — — — — Totals 179 229 267 480 — 48 69 97 49 Disease. Quarters of Beef. Carcases of Mutton. Quarters of Mutton. Pig Carcases. 1926 1927 1926 1927 1926 1927 1926 1927 Abscesses 1 — — 1 — — — 2 Caseous Lymphadenitis — — 143 71 — 10 — — Tuberculosis 2 — — — — — — — Totals 3 — 143 72 — 10 — 2 New Zealand.—There was a considerable decrease in the amount of mutton and lamb imported from this country, nearly eight per cent. of the beef, forty-eight per cent. of the mutton and lamb, with 495 tons of pork imported from New Zealand, passed through Smithfield Markets. The quality of the mutton and lamb was, as usual, very good, but as noted in former reports, the appearance of many lamb carcases consigned was unsatisfactory, there being a lack of "bloom" on them. This important feature has been carefully considered by those responsible in New Zealand, and several interesting and educative experiments have been made with a view to finding the cause. With so much energy being devoted to finding where the fault exists in the various stages from the slaughterhouses to the markets, doubtless a remedy will eventually be found. There has been an increase in the number of carcases found affected with Caseous Lymphadenitis, but considering the quantity of carcases received, the inspection in the Abattoirs has been very good. Disease. Quarters of Beef. Carcases of Mutton. Quarters of Mutton. Pig Carcases. 1926. 1927. 1926. 1927. 1926. 1927. 1926. 1927. Abscesses 1 — — 2 — — — 20 Caseous Lymphadenitis — — 30 94 — 27 — — Pseudo-leukaemia — — — 1 — — — — Sarcoma — — — 1 — — — — Tuberculosis 1 — — — — — — — Totals 2 — 30 98 — 27 — 20 Uruguay.—This country exported to Britain during the year 29,417 tons of beef and 15,863 tons of mutton ; of those quantities 6,997 tons of beef and 4,696 tons of mutton passed through Smithfield Market. The improvement in the breed of cattle and the finish of the animals have not been so marked as in the Argentine products; this is the reason for Uruguayan beef being sold at a lower figure on the market. The mutton sent was generally of a type too heavy, and therefore not so great in demand as even light third-grade quality carcases from other countries. Heavy fat mutton is not wanted on the market from any country, and the sooner breeders and feeders recognise that small joints, e.g., legs and shoulders, are what is desired, the better it will be for all concerned. Though there was a slight increase in the number of carcases found to contain lesions of disease, the inspection at the Frigorificos reflected credit on those responsible. Disease. Carcases of Mutton. Quarters of Mutton. 1926. 1927. 1926. 1927. Caseous Lymphadenitis 91 110 — 2 Chili.—Towards the end of the year considerable numbers of carcases and sides of mutton were found to contain lesions of Caseous Lymphadenitis. As a result, it was necessary to detain in City Cold Stores several consignments and make a thorough examination of them. As diseased carcases were still being observed on the market, it was ascertained that they were being sent from a Cold Store in a neighbouring Borough, and an intimation to that effect was communicated to the Health Officers; this resulted in an embargo being placed on all carcases from the country in question and a careful examination made of them. The Agents in this country promptly convened a meeting with the Chilean Consul at which it was suggested that the Chilean Government establish a Veterinary Meat Inspection Service and stamp or label all carcases passed as having been inspected. This suggestion was at once accepted and would be communicated to the Government. The Agents, in order to render every assistance to the Health Authorities and protect the public health, offered to appoint and pay a number of selected British Veterinary Officers to act as meat inspectors at the Frigorificos in Chili for the next season and until the Chilean Officers were appointed. Four highly qualified Veterinary Officers were selected, and are now in Chili making a careful examination of all carcases prior to their export to Britain. Disease. Carcases of Mutton. Sides of Mutton. 1926. 1927. 1926. 1927. Caseous Lymphadenitis 93 1,535 — 402 50 Consignments from the following countries do not call for any special remarks:— Manchuria. Disease. Carcases of Mutton. Quarters of Mutton. Pig Carcases. 1926 1927 1926 1927 1926 1927 Abscesses — 3 — — 1 2 Caseous Lymphadenitis — 1 — 2 — — Emaciation 9 — — — — — Totals 9 4 — 2 1 2 Brazil. Disease. Carcases of Mutton. Quarters of Mutton. Pig Carcases. 1926 1927 1926 1927 1926 1927 Abscesses — — — — 2 1 Caseous Lymphadenitis — 3 — — — — Pleurisy (Acute) — — — — — 1 Totals — 3 — — 2 2 South Africa. Disease. Carcases of Mutton. Quarters of Mutton. Pig Carcase*. 1926 1927 1926 1927 1926 1927 Abscesses - — — — 5 4 United Stales of America. Disease. Carcases of Mutton. Quarters of Mutton. Pig Carcases. 1926 1927 1926 1927 1926 1927 Abscesses — — — 2 4 Denmark. Disease. Abscesses 4 Sides of Bacon. Holland. Disease. Abscesses 3 Sides of Bacon. 51 UNSOUND MEAT, Etc., REMOVED FROM COLD STORES. Article. No. How Packed. Origin. Cause for Destruction. Tons. Cwts. Qrs. lbs. Beef (Pieces) .... .... Argentine Bone Taint l 19 2 14 11 ll •••• •••• .... .... ,, Decomposed 2 6 0 0 11 ll •••• •••• .... .... ,, Injury 0 0 0 24 M II •••• .... .... ,, Mould Fungi 21 12 3 24 •) 11 . . . . •••• .... .... ,, Vermin Eaten 0 0 1 5 M II • ••• .... .... .... Australia Bone Taint 0 9 2 14 ,, yy .... •••• .... .... ,, Decomposed 0 3 0 18 ........ .... ,, Mould Fungi 1 1 1 20 Brawn 36 Cases Holland Decomposed 0 11 2 20 Butter .... Denmark Rancid 0 8 0 4 Caviare 12 Cases Russia Decomposed 0 12 0 6 Cheese .... .... Denmark Mould Fungi 0 8 0 4 Deer 1 .... British Decomposed 0 0 3 16 Fish (Various) .... .... ,, ,, 5 7 1 10 Game (Black) 100 Cases Russia ,, 8 9 2 20 Glands 1 Case Argentine ,, 0 0 1 22 10 Tins New Zealand ,, 0 1 3 25 Kidneys (Ox) .... .... Argentine Mould Fungi 0 10 2 0 (Sheep) .... .... ,, ,, 0 1 0 14 (Ox) .... .... Australia Decomposed 0 0 2 4 (Sheep) .... .... New Zealand ,, 0 4 1 24 Lambs (Carcases) 2 .... Argentine Brine Stain 0 0 2 4 II ll 19 .... ,, Mould Fungi 0 4 1 14 1 .... Australia Brine Stain 0 0 1 23 1 .... ,, Vermin Eaten 0 0 1 10 II ll •••• •••• 12 .... New Zealand Mould Fungi ,, 0 2 3 15 „ (Pieces) .... .... Argentine,, 0 4 0 26 .... .... New Zealand ,, 0 8 2 11 Livers (Lambs) .... .... Argentine Decomposed 0 2 2 0 „ (Ox) .... .... ,, Mould Fungi 0 0 2 14 Mutton (Carcases) 9 .... ,, Brine Stain 0 5 2 18 1,121 .... Chili *C.L.A 22 15 3 16 7 .... New Zealand Brine Stain 0 3 0 12 „ (Pieces) .... .... Argentine Decomposed 0 4 0 22 II II •••• •••• .... .... ,, Mould Fungi 0 4 3 1 il II •••• .... .... Australia ,, 0 1 0 12 .... .... New Zealand ,, 0 1 1 14 (Sides) 106 .... Chili *C.L.A 1 1 3 7 Offal .... .... Argentine Decomposed 0 4 3 25 Pork (Pieces) .... .... Manchuria Mould Fungi 0 2 1 26 Poultry (Various) .... .... British Decomposed 0 7 3 10 .... .... Italy ,, 0 1 0 8 Rabbits 24 .... Australia ,, 0 0 1 20 Tails (Ox) .... .... Argentine ,, 0 0 3 7 Tongues (Ox) 8 Bags „ ,, 0 7 0 16 Venison .... .... .... British ,, 0 5 1 12 ,, .... .... Argentine ,, 0 1 3 4 72 4 1 19 Total for the Year 1927 = 72 tons 4 cwts. 1 qrs. 19 lbs. 1926 = 66 . „ 1 „ 0 „ 26 „ Increase 6 „ 3 ,, 0 ,, 21 „ *Caseous Lymphadenitis. 52 LEADENHALL MARKET AND CITY SHOPS. The Leadenhall Market and City Shops have been systematically inspected during the year, and the following table shows the amount and variety of unsound food dealt with:— Bacon (Pieces) 15 Mutton (Pieces) 11 Beef „ 14 „ (Carcases) 2 ,, (Tins) 246 Plucks (Calves) 1 Capercailzies 17 „ (Sheep) 5 Cheese (lbs.) 115 Partridges 484 Chickens and Pouissins 1,372 Pheasants 241 Cream (Tins) 993 Pigeons 2,479 Curlew 8 Plovers 460 Ducks 1,216 Ptarmigan 470 Eggs 13,127 Pork (Pieces) 4 „ (Plovers) 248 „ (Carcase) 1 Fowls 3,520 Quail 185 Fruit 2,017 Rabbits 9,100 Game (Black) 132 Salmon 59 ,, (Box) 1 Sardines (Tins) 48 „ (Unclassified) 139 Sausages (lbs.) 12 Geese 170 Snipe 729 Grouse 687 Soup (Tins) 96 Guinea Fowl 31 Teal 45 Hares 721 Tomatoes (Tins) 180 Hazelhens 62 Tongues (Beef) 7 Heads (Beef) 5 Turkeys 625 ,, (Pigs) 12 Tripe (lbs.) 68 Kidneys (Beef) 9 Udders (Cows) 30 Livers (Calves) 2 Veal (Pieces) 2 ,,(Pigs) 2 Venison (Pieces) 22 ,, (Ox) 315 Whelks (Bags) 1 „ (Rabbits) 4 Widgeon 69 „ (Sheep) 10 Woodcock 38 Milk (Tins) 521 Total weight for the year 1926 = 27 tons 14 cwts 3 qrs. 12 lbs. „ 1927 = 25 „ 18 „ 2 25 „ Decrease 1 ,, 16 ,, 0 ,, 15 ,, SHOWING THE AMOUNT OF VARIOUS FOOD PRODUCTS SURRENDERED TO OR SEIZED BY MEAT INSPECTORS ON ACCOUNT OF DISEASED CONDITIONS. 1927. Countries. Beef in lbs. Mutton in lbs. Pork in lbs. Veal in lbs. Goat in lbs. Offal in lbs. Bacon in lbs. Total in lbs. Argentine 43,277 41,373 12,006 .... .... 431 .... 97,087 Australia 106 4,825 970 .... .... 25 .... 5,926 Brazil .... 180 230 .... .... .... .... 410 Britain 10,885 7,251 118,892 1,583 57 107,390 57 246,115 Canada .... .... 155 .... .... .... .... 155 Chile .... 68,815 .... .... .... .... .... 68,815 Denmark .... .... .... .... .... .... 283 283 Holland .... .... .... .... .... .... 318 318 Iceland .... 13,023 .... .... .... .... .... 13,023 Ireland (Southern) 204 .... 7,552 .... .... 4,219 73 12,048 Manchuria .... 190 230 .... .... .... .... 420 New Zealand .... 5,367 1,450 .... .... .... .... 6,817 South Africa .... .... 210 .... .... .... .... 210 Sweden .... .... .... .... .... .... 60 60 U.S. A .... .... 384 .... .... .... .... 384 Uruguay .... 1,136 .... .... .... 5 .... 1,141 Totals, 1927 54,472 142,160 142,049 1,583 57 112,070 791 453,212 Totals, 1926 62,410 59,128 102,059 6,589 675 98,331 77 329,269 53 SHOWING THE AMOUNT OF VARIOUS FOOD PRODUCTS SURRENDERED TO OR SEIZED BY THE MEAT INSPECTORS IN THE CITY OF LONDON FOR UNSOUNDNESS. 1927. Countries. Beef in lbs. Mutton in lbs. Pork in lbs. Veal in lbs. Venison in lbs. Goat in lbs. Offal in lbs. Bacon in lbs. Cheese in lbs. Furred Game. No. Feathered Game. No. Argentine 1,194,535 73,344 4,489 1,161 .... .... 24,414 59 .... 45 55 Australia 16,590 58,680 923 30 .... .... 2,355 .... .... 14 079 597 Austria .... .... .... .... .... .... .... .... .... .... 708 Belgium .... .... .... .... .... .... .... .... .... 2,708 580 Brazil 2,932 54 .... .... .... .... .... .... .... .... Britain 23,133 50,946 97,488 9,427 3,543 249 118,896 9,296 115 22,662 26,491 Canada .... .... 10 .... .... .... 8 666 56 .... Chile 400 501 4,665 .... .... .... .... .... .... .... Denmark .... .... .... .... .... .... .... 9,857 1,800 .... France .... .... .... .... .... .... .... 90 .... 632 813 Holland .... .... .... .... .... .... 1,423 5,005 .... 1,153 413 Iceland .... 31 .... .... .... .... .... .... .... .... Italy .... .... .... .... .... .... .... .... .... 60 303 Ireland (Southern) 16 43 13,464 15 .... 80 20,311 698 .... 208 248 Manchuria .... 181 753 .... .... .... .... .... .... .... New Zealand 10,920 82,869 988 384 .... .... 2,579 .... .... 80 Poland .... .... .... .... .... .... .... 556 .... 12 Rumania .... .... .... .... .... .... .... 4,000 .... 357 305 Russia .... .... .... .... .... .... .... 1,077 .... .... 10,994 South Africa 1,155 .... 91 .... .... .... 7,137 60 .... .... Sweden .... .... .... .... .... .... .... 788 .... .... U.S.A .... .... .... .... .... .... 64 81 36 12 68 Uruguay .... 567 .... .... .... .... 33 .... .... .... .... Totals, 1927 1,249,681 267,216 122,871 11,017 3,543 329 177,220 32,233 2,007 42,008 41,575 Totals, 1926 1,407,184 403,599 120,089 22,839 4,768 675 530,912 48,992 234 55,285 34,688 SHOWING THE AMOUNT OF VARIOUS FOOD-STUFFS SEIZED BY THE INSPECTORS AT SMITHFIELD IN THE YEAR, 1927. Countries. Eggs. Tinned Milk. | Tinned Meat. Fish. Butter. No. No. of Tins. No. of Tins. lbs. lbs. Argentine .... 350 844 .... .... Belgium .... 39 .... .... .... Britain 13,375 3,979 1,757 8,212 50 Canada .... 6 .... .... .... Denmark .... 97 10 .... .... France .... .... 2 .... .... Holland .... 2,837 892 .... .... Ireland (Southern) .... 23 14 .... .... U.S.A .... 568 128 .... .... Totals, 1927 13,375 7,899 3,647 8,212 50 Totals, 1926 2,023 11,273 1,406 5,545 190 SUMMARY OF UNSOUND FOOD DESTROYED. Tons. Cwts. Qrs. lbs. Central Markets, Smithfield 1,042 10 0 26 Cold Stores 72 4 1 19 Leadenhall Market and City Shops 25 18 2 25 Total for the year 1927 1,140 13 1 14 Total for the year 1926 1,340 9 3 0 Total for the year 1927 1,140 13 1 14 Decrease 199 16 1 14 Twenty-four Naval Officers received training in meat inspection at the Central Markets, Smithfield, during the year. EXPORT OF MEAT. During the year 56 certificates were issued at the request of merchants in connection with meat which it was proposed to export to other countries. H 54 PUBLIC HEALTH (LONDON) ACT, 1891 .—UNSOUND MEAT PROSECUTIONS. Date. Name. Business. Address. Where heard. Before whom. Offence. Result. 13/10/27 Mathew Henry Blight. Farmer. Whimbles, Holsworthy, Devon. Guildhall. Aid. Josiah Gunton. For being the owner of a diseased calf carcase and offal deposited for the purpose of sale. Fined, £50 0 0 and £12 12 0 Costs. Paid. 13/10/27 Sydney Tucker. Farmer. Whimbles, Holsworthy, Devon. Guildhall. Aid. Josiah Gunton. Caused to be sent for sale threequarters of a diseased calf carcase and offal. Fined, £25 0 0 and £12 12 0 Costs. Paid. CENTRAL MARKETS, SMITHFIELD. *Table showing the average deliveries at the Central Meat Market, and other details for successive quinquennial periods during the past 54 years :— Quinquennium. Annual Average Supply. Tons. cwts. General qrs. Seizures by Inspectors Tons. cwts. qrs. % of Unsound % Meat. 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 1919.1923 403,364 10 0 1,849 19 0 .459 1924.1927 477,454 0 0 1,240 0 0 .259 *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. Australian and New Zealand Per cent. Country Killed. Pet cent. Town Killed. Per cent. tForeign Killed. Per cent. Home Killed. Per cent. American Killed. X Per C4fit. 1923 1.7 5.1 9.6 0.6 47.7 22.3 1924 16.6 5.2 10.6 0.3 48.4 18.9 1925 1.4 4.9 13.7 1.0 47.5 18.5 1926 16.1 5.4 8.4 0.9 49.1 20.1 1927 21.1 6.6 4.1 0.2 48.8 19.2 The following figures supplied by the Superintendent of the Market are of interest. 1923. 1924. 1925. 1926. 1927. Tons. Tons. Tons. Tons. Tons. Average daily delivery into the Markets 1,532 1,560 1,517 1,564 1,594 **Minimum delivery on any one day 169 181 147 144 286 Maximum delivery on any one day 3,411 4,775 5,160 5,259 4,278 The heaviest weight previously recorded on any one day (20th December, 1926) was— 5,259 tons. One ton in every 404 tons of meat paying toll in the Central Markets, Smithfield, was condemned last year, as compared with one ton in 358 in 1926. Table showing Weight of Meat delivered, and Meat delivered to Contractors as unsound, during each Month of the Years 1926 and 1927. Month. Meat delivered at the Market, 1926. Unsound Meat delivered to Contractors, 1926. Meat delivered at the Market, 1927. Unsound Meat delivered to Contractors, 1927. Tons. cwts qrs. Tons. cwts. qrv Tons. cwts. qrs. Tons. cwts. qrs. January 41,527 0 0 75 14 2 42,719 0 0 108 6 3 February 39,789 0 0 111 10 1 38,456 0 0 91 14 2 March 45,883 0 0 136 15 1 44,395 0 0 174 13 2 April 41,131 0 0 99 13 3 39,564 0 0 67 14 0 May 34,844 0 0 110 15 2 46,191 0 0 90 17 2 June 37,717 0 0 104 4 3 39,227 0 0 112 16 0 July 37,963 0 0 119 15 1 36,756 0 0 81 12 2 August 35,232 0 0 93 19 1 38,875 0 0 114 15 3 September 38,979 0 0 148 12 1 40,258 0 0 95 12 1 October 40,581 0 0 110 17 3 41,819 0 0 85 13 1 November 41,916 0 0 121 5 0 42,147 0 0 135 12 2 December 44,674 0 0 107 6 1 42,885 0 0 59 14 1 Totals 480,236 0 0 1,340 !) 1 493,292 0 0 1,219 2 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. ** The minimum deliveries relate to Saturdays when practically no wholesale business at the Market is carried out. f Includes "General Foreign Meat and Produce"‡ Includes South American Imports. 55 FISH SUPPLIES. 229,960 tons of fish, of which 207,056 were land-borne and 22,904 water-borne, were received at or near Billingsgate Market during the year. This was an increase of 7,516 tons in the land deliveries, and a decrease of 1,055 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 1927. Month. Weight of Fish Delivered- Total. Weight of Fish Condemned. Ratio of Fish Condemned to that Delivered. By Land. | By Water. Tons. cwts. qrs Tons. cwts. qrs. Tons. cwts. qrs. Tons cwts. qrs. January 17,093 15 2 1,614 0 0 18,707 15 2 102 4 3 0.546% or 1 ton in 182 983 tons. February 15,890 15 3 1,565 10 0 17,456 5 3 109 12 0 0.627 159.272 „ March 17,1)71 10 0 2,208 0 0 19,879 10 0 217 13 3 1.095 ,, 91.320 ,, April 16,802 5 3 1,898 0 0 18,700 5 3 74 19 1 0.400 „ 249.461 ,, May 18,279 16 2 1,626 10 0 19,906 6 2 198 10 2 0.997 100,271 ,, June 17,198 10 1 1,491 18 0 18,690 8 1 98 12 2 0.527 189.509 July 17,789 16 o 1,988 0 0 19,777 16 2 325 11 3 1.646 ,, 60.745 ,, August 17,464 11 0 2,291 0 0 19,755 11 0 308 4 2 1.560 ,, 64.094 ,, September 17,725 17 3 2,226 0 0 19,951 17 3 191 11 1 0.960 104.153 ,, October 17,299 4 2 2,166 0 0 19,465 4 2 275 8 1 1.414 70.676 ,, November 17,023 6 1 1,891 0 0 18,914 6 1 113 10 2 0.600 166.609 „ December 16,816 12 3 1,938 0 0 18,754 12 3 54 2 0 0.288 346.897 ,, Totals 207,056 2 L' 22,903 18 (1 229,960 0 2 2,070 1 0 0.900 111.028 „ * Compiled from the Monthly Returns received from the Fishmongers' Company. Weight of Fish Delivered, Fish seized as Unsound, and percentage of Fish Condemned to that Delivered, at or near Billingsgate Market during 1927 and the five years 1922—1926. 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. 1922 210,914 31,471 242,385 2,259 10 0 1 ton in 107.273 tons or 0-932% 1923 211,736 27,479 239,215 2,007 3 3 1 „ 119.178 „ 0.839 „ 1924 190,088 21,634 211,722 1,617 7 2 1 ,, 130.933 ,, 0.763 „ 1925 193,782 25,702 219,484 1,822 0 3 1 „ 113.601 „ 0.832 „ 1926 199,540 23,959 223,499 1,938 9 0 1 „ 115.295 „ 0.867 „ Average (5 years) 201,212 26,049 227,261 1,926 18 1 1 ton in 117.935 tons or 0.848% 1927 207,056 22,904 229,930 2,070 1 0 1 ton in 111.028 tons or 0.900% THE PUBLIC HEALTH (MEAT) REGULATIONS, 1924. Continued progress was made under these Regulations during the year. In addition to the improvement secured by the ordinary routine administration, some important matters which affected the conditions of meat transport within the City area received attention. The results were generally satisfactory. Transport by Railway Road Vehicles.—Early in the year a conference was arranged with representatives of one of the Railway Groups engaged in the delivery of meat. At this meeting various matters were discussed which had hitherto been the cause of numerous complaints at Smithfield Market. The following undertakings were given:— (1) Overall clothing to be supplied to and worn by all carmen handling meat. (2) The use of straw in meat delivery vans to be discontinued, all meat in future to be loaded on linen sheets on clean floors. (3) All lining and covering sheets to be changed daily. (4) Boot and blood stains necessarily incurred in the performance of delivery during the day not to be treated as a contravention of the Regulations. (5) Infringements to be reported immediately to the Market Representative of the Railway Company. Matters of sufficient importance to be referred by the Medical Officer of Health to the Goods Manager. Failing agreement as to any steps necessary to secure observance friendly action to be taken in the Courts for an interpretation of the Regulations in the particular circumstance. The foregoing agreement was submitted subsequently to the other Railway Companies through their own organization, and the procedure was accepted for adoption by them in London. H 2 56 Transport of Meat by Carriers.—In February a conference was held with representatives of the London Cartage and Haulage Contractors' Association, to which several of the largest firms of meat carriers belong. The adequate covering of meat while in transit, the carriage of offals and the use of straw in meat vans were discussed, arid general principles laid down for the guidance of meat carriers and others ; these were communicated by the Secretary to the members of the Association with beneficial results. There is no doubt that the increased care shown by the large carrying organizations proved a useful reminder to others of the existence of the Regulations ; moreover, it tends to remove the erroneous impression that large businesses are permitted gfeater latitude than smaller concerns. One assumes that the marked improvement in cleanly transport is a reliable indication that, through example, the underlying principles of the Regulations are more and more understood generally. Local Conditions : (a) Smithfield Market.—As the result of a somewhat prolonged period of observation, certain avoidable conditions leading to accidental contamination of meat during handling and porterage were found. The following matters were referred to the Committees concerned by the Sanitary Committee :— That the Byelaws be amended so as to include such offences as :— (1) dirty overall clothing worn by meat porters ; (2) men urinating in the vicinity of meat vans ; (3) appropriation of waste straw by unauthorized persons ; (4) dirty market trucks ; and as to general recommendations :— (5) the kerbstones at certain points at Smithfield Market to be sloped to enable laden meat trucks to run without shock from the footway to the road, and vice versa ; (6) the washing down of footways at the market be delayed until the loading of meat into carrier vans had been completed ; (7) the vehicles used for the collection of street sweepings be lower, so as to minimise the diffusion of dust during lifting and loading. (b) Aldgate.—The closing of the Aldgate Slaughterhouses at the end of 1926 materially affected the local conditions there. The disused premises, after cleansing, have since been utilized to extend the wholesale meat shops which they adjoined. The increased area thus available for storage and display of meat has proved beneficial. The environment of Aldgate Market is now much more cleanly, and the condition of the wholesale shops has substantially improved. Transport of Meat.—Improvement in the vehicles used for meat traffic has been slow. This has been due, in part, to the absence of any specific requirements. There is still a tendency to repeat unsatisfactory structural details when vehicles are sent for repair or refitting. There is a lack of appreciation of the essentials by some builders of meat vans. The adapted vehicle is seldom without fault. Some guidance is desirable-both to makers and users, in order that defects in van design may be eliminated. Some meat traders are realizing that clean and efficient hired transport is a business asset; they are no longer satisfied with dirty-looking and dilapidated vans. Unfortunately, this cannot be said of a proportion of traders who use their own vehicles for market work, although it might be thought that they, too, would see the value of possessing transport obviously hygienic and maintained at a high standard of structural condition and cleanliness. Gross infringements of the clause relating to transport were fewer, but minor offences continued numerous. There is still much room for improvement in the methods employed and the care exercised in handling and transport. Overall Clothing worn by Persons carrying Meat.—This requirement has continued to present a serious difficulty. On two occasions it has received the special consideration of the Sanitary Committee. It has not been thought desirable to proceed with the proposed cooperative scheme for the supplying and washing of overall clothing, owing to administrative and other difficulties ; a recommendation has been made, however, for the Market Bye laws to be amended in so far as the licensed porters are concerned. In addition, an authorization was given to send a circular letter to all licensed porters, numbering 1,600, urging them in their own interests to avoid an infringement of the law relating to the wearing of an overall and head covering while carrying meat. It is hoped that considerable improvement will result from these measures. 57 In view of the absence of uniformity as to the wearing of the head covering amongst the employees of the stall holders at Smithfield Market, a circular letter on the subject was forwarded to the employers, and immediate good effects were observed. Persons in other categories, such as those employed to do market work by individual butchers or carriers, cannot be dealt with collectively, but they are influenced by the conditions which they find prevailing at the markets, and by cautionary letters sent to them personally. At present the licensed porters appear to be the key to the overall situation, and their failure to comply with requirements is conducive to carelessness on the part of others Retail Shops.—These premises continue to improve. As the result of suggestions or requests made during routine inspections, the following alterations have been made :—New or reconditioned cold storage rooms, improved fittings and furniture, improved means of ventilation, the provision of impermeable surfaces where such were desirable, and the arrangement of staff cloak rooms. By these means the tone of the shops has been raised. Particular attention has been given to the conditions under which sawdust and wrapping paper were stored, and to fat rendered for subsequent sale as dripping. General Observations.—The embargo placed upon the importation of fresh meat from the Continent, in 1926, was still in operation. The deficiency has been met by increased supplies from Ireland and this country, the majority of the transport having been done by the Railway Company. During the year 64 summonses were issued for offences under the Regulations, and Fines totalling £145 and Costs amounting to £11 3s. 6d. were imposed. Many conditions exist, the amelioration of which will not be easy to accomplish. The most fruitful method of advancement will be by co-operation by the varied interests with the administrative Authority. It has been shown that the Regulations are not permitted to remain inoperative in the City and that compliance can and will be enforced if necessary. Loyal observance of them will not only reduce the liability to any official action, but produce conditions favourable to the growth and expansion of business. INSPECTION OF FOOD AT 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 products coming under observation :— SUMMARY OF FOOD DISCHARGED AT CITY WHARVES. Article. Where from. Description of Total Number of General Range of Packages. Packages. Weight of Packages. Butter Holland Packages .. 188,419 6 lbs.—1 cwt. Bacon ,, Bales and Cases 115,722 1 cwt. 2 qrs.—3 cwts. Cheese, loose ,, Single Cheeses . 18,901 4 lbs.—56 lbs. ,, ,, Packages .. 453,008 24 lbs.—1 cwt. Eggs ,, ,, .. 80,402 84 lbs.—1 cwt. 2 qrs. Lard ,, Boxes and Cases 8,556 28 lbs.—56 lbs. Compound ,, Cases .. 21,345 56 lbs. Margarine ,, Boxes and Cases 891,946 12 lbs.—56 lbs. Cereals— Barley ,, Bags 2,482 100 lbs.—1 cwt. 2 qrs. Beans ,, ,, 2,468 1 cwt.—2 cwts. Peas ,, ,, 10,229 1 cwt.—1 cwt. 3 qrs. Rice Japan ,, 660 1 cwt.—1 cwt. 2 qrs. Cornflour Holland ,, 1,538 2 cwts. Coffee E. Africa, Costa Rica ,, 110,840 1 cwt. 2 qrs. and Santos. ,, Cocoa and Chocola Fruit (Soft):— te E. Africa, Ceylon and Holland. Bags and Cases 23,464 28 lbs.—2 cwts. Apples Australia, New Zealand, Canada, U.S.A. and Holland. Boxes, Baskets and Barrels. 60,963 40 lbs.—2 cwts. Peaches Holland Baskets 1,056 10 lbs. Plums Italy, Germany and Holland. ,, 14,943 7 lbs.—12 lbs. Pears Australia, Italy, U.S.A. Baskets and Cas es 14,453 6 lbs.—28 lbs. Currants Holland Packages 155,875 6 lbs.—12 lbs. Gooseberries ,, ,, 11,103 40 lbs.—100 lbs. Strawberries ,, ,, 95,835 7 lbs.—12 lbs. Cranberries Boxes 4,319 28 lbs. Bilberries Chip Baskets 4,376 7 lbs.—12 lbs. Cherries ,, Baskets 8,685 12 lbs.—40 lbs. Rhubarb ,, Bundles 3,177 28 lbs. Article. Where from. Description of Packages. Total Number o Packages. General Range of Weight ol Packages. Fruit (Dried) :— Currants Raisins Australia and Greece Bags and Cases .... 476,616 28 lbs.—56 lbs. Australia, S. Africa, Greece, California & Spain. Packages 396,754 8 lbs.—56 lbs. Sultanas Australia, California, Greece & Smyrna. 253,679 24 lbs.—56 lbs. Plums .... California Cases 33,050 24 lbs. Apricots 4,145 24 lbs. Peaches 5,095 24 lbs. Pears .... 4,450 24 lbs. Figs Greece, Spain & Smyrn i Packages 150,953 28 lbs.—4 cwts. Evaporated Apples. California Cases 4,600 56 lbs. Dates .... Persia Boxes 45 3 qrs. Green Fruit :— Oranges Italy and Spain Packages 418,670 3 qrs.—1 cwt. 1 qr. Lemons 450,456 1 cwt. Grapes .... Holland and Spain ... 149,157 12 lbs.—40 lbs. Melons >> )t „ .... .... 11,350 12 lbs.—1 cwt. 1 qr. Pomegranates Spain 2,336 1 cwt.—1 qr. Grape Fruit W. Indies Cases 750 3 qrs. Vegetables:— Celery .... Holland Bundles 25 28 lbs. Cucumbers Packages.... 23,017 12 lbs.—40 lbs. Cauliflowers ,, „ 17,138 24 lbs.—40 lbs. Cabbages ,, .... Bags 7,410 1 cwt. Carrots „ Packages.... 34,886 40 lbs.—1 cwt. 2 qr Lettuce.... tt .... tt .... .... 117,568 12 lbs.—28 lbs. Parsnips Bags 579 l.cwt. Potatoes Holland, Spain, St. Malo, Algiers. Packages.... 349,647 56 lbs.—1 cwt. 1 qr. Spinach Holland Bags 44 100 lbs. Onions .... Holland, Spain and Egypt. Bags and Cases .... 377,462 1 cwt.—1 cwt. 1 qr. Beetroot Holland Bags 2,075 1 cwt. Tomatoes Holland and Spain ... Packages 412,241 12 lbs.—56 lbs. Radishes Holland 8,969 28 lbs.—1 cwt. Sprouts 662 100 lbs. Sugar ,, ,, 117,066 1 cwt.—2 cwts. Tinned Goods :— Fruit Salad California Cases 450 48 lbs. Apricots 17,262 48 lbs. Apples Canada 12,000 50 lbs. Fruit Pulp Australia, Holland and Spain. 12,882 72 lbs.—100 lbs. Cherries Italy 36,535 24 lbs.—48 lbs. Vegetables Italy and Spain 4,129 50 lbs.—100 lbs. Grape Fruit California 501 50 lbs. Tomatoes Italy and Spain 77,913 50 lbs.—100 lbs. Pines .... Singapore 50,800 48 lbs. Pears O I California 22,620 48 lbs. Loganberries 2,500 48 lbs. Peaches 29,241 48 lbs. Corned Beef Argentine & Holland 1,087 72 lbs. Condensed Milk Holland Cases and Casks 968,575 48 lbs.—3 cwts. Salmon Canada and U.S.A. ... Cases 30,725 48 lbs. Sardines Portugal 7,230 56 lbs.—1 cwt. Brawn Holland 4,128 36 lbs. Veal 790 36 lbs. Lunch Tongues 626 48 lbs. Hams 30 12 lbs.—20 lbs. Macaroni .... Italy 131,016 28 lbs. Nuts (Various) .... Italy, Spain, China & Turkey. Packages 33,802 28 lbs —2 cwts. Milk Powder .... Holland )> •••• 15,580 50 lbs.—1 cwt. Milk Sugar ,, .... .... Cases 724 100 lbs. Preserved Ginger China .... Cases and Casks 9,075 30 lbs.—3 cwts. Vegetables in Brine. Holland Casks 4,268 3 cwts.—4 cwts. 58 Article. Where from. Description of Packages. Total Number of Packages. General Range of Weight of Packages. Miscellaneous :— Carraway Seeds Holland • Bags 978 1 cwt. 1 qr. Confectionery .... Holland and Turkey Packages.... 3,943 28 lbs.—1 cwt. Liquorice Italy 1,178 1 cwt.—2 cwts. Block Condensed Milk. Holland . Cases 644 48 lbs. Biscuits tt ...» ... • ft .... .... 18,779 1 cwt.—1 cwt. 2 qrs. Sugar Candy Packages 3,372 28 lbs.—56 lbs. Peel in Brine .... Italy Casks 87 4 cwts.—5 cwts. Honey Holland Cases and Casks 137 1 cwt.—2 cwts. 2 qrs. Fruit Pulp Casks 3,120 4 cwts. Frozen Eggs .... China Tins 590 50 lbs. Cocoa Butter .... Holland Packages.... 3,355 1 cwt.—2 cwt. Citrons in Brine Italy .... Casks 81 4 cwts.—5 cwts. Fresh Cream .... Holland Churns & Drums 241 50 lbs. —120 lbs. Fresh Milk Churns .... 1,921 170 lbs. 59 UNSOUND FOOD SURRENDERED AT RIVERSIDE WHARVES. As a result of the daily inspection of City wharves, 76 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 .... .... .... .... 63 11 3 Condensed Milk (removed at request of owners) .... .... 1 0 3 Fruit Pulp 1 18 0 Fruit (various) .... .... .... .... .... .... .... 6 13 2 Vegetables (various) 8 19 2 Miscellaneous .... .... .... .... .... 9 0 1 Total 91 3 3 GENERAL SANITARY WORK. 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 773 persons, compared with 743 in 1926. 75 per cent, are adults and 25 per cent, children (under 14 years). The number of births was 6, viz. : 3 males and 3 females. The birth-rate was 7 -8 per 1,000, which is 2-1 per 1,000 below the average for the previous five years. The death-rate for 1927 was 10-4 per 1,000 per annum. TABLE OF BIRTHS AND DEATHS OCCURRING AT THE ARTIZANS' DWELLINGS, STONEY LANE, HOUNDSDITCH, DURING THE YEAR 1927. Births. Mortality from all Causes at subjoined Ages. Name of Block. 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 ina upwards. NORTH BLOCK . 1 2 1 l SOUTH 1 1 3 2 l KING'S 2 1 l QUEEN'S „ PRINCE'S „ l 2 1 l Totals 3 3 8 5 3 The birth-rate in these Dwellings reached a maximum of 46 *9 per 1,000 in 1896, and has since been falling irregularly, but almost progressively. The present rate is 7'8. The rate last year was 2-7, the lowest on record. 60 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 1927 being 10,442, of whom 3,929 were males and 6,513 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. Males. Females. Total Children. Adults. Children. Adults. January 100 214 96 353 763 February 109 195 83 285 672 March 118 217 112 364 811 April 110 255 129 434 928 May 115 233 159 453 960 June 143 207 173 447 970 July 148 280 201 493 1,122 August 96 191 181 409 877 September 99 242 169 482 992 October 80 259 118 436 893 November 67 190 103 344 704 December 80 181 111 378 750 Totals 1,265 2,664 1,635 4,878 10,442 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 200 7 7 6 February 129 4 8 20 March 102 4 8 12 April 219 2 66 25 May 232 15 4 34 June 295 6 35 59 July 130 2 5 13 August 200 2 5 20 September 200 3 5 20 October 216 6 16 23 November 239 6 9 19 December 410 4 9 35 Totals 2,572 61 177 286 MIDDLE DISTRICT—Inspector E. J. Simmons. Month. Premises Inspected. Orders issued. Notices served. Improvement effected. January 210 l 7 27 February 161 2 8 15 March 243 4 5 16 April 316 7 10 29 May 188 5 10 33 June 281 6 7 29 July 198 5 4 25 August 192 5 5 24 September 178 4 5 24 October 225 4 21 25 November 244 6 8 19 December 392 6 12 40 Totals 2,828 55 102 306 61 EAST DISTRICT—Inspector W. H. Ralph. Month. Premises Inspected. Orders issued. Notices served. Improvements effected. January 197 2 5 19 February 156 2 4 15 March 93 4 11 26 April 343 7 28 37 May 175 6 12 29 June 287 5 14 33 July 166 3 14 18 August 240 2 6 23 September 229 1 5 19 October 127 2 11 25 November 283 3 7 22 December 420 8 8 42 Totals 2,716 45 125 308 THE FOREGOING ARE SUMMARISED AS UNDER:— District. Number of inspections made. Orders issued. Notices served. Improvements effected. West Middle East 2,572 2,828 2,716 61 55 45 177 102 125 286 306 308 Totals 8,116 161 404 900 REGISTERED LODGING HOUSES. Public Health (London) Act, 1891, Sec. 94. and Housing Act, 1925, Sec. 6. The Corporation, as the Sanitary Authority in the City, are required, under the provisions of Sec. 94 of the Public Health (London) Act, 1891, and Section 6 of the Housing Act, 1925, to make and enforce Bye-laws with respect to houses intended or used for occupation by the working classes and 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 requiring adequate and accessible and, where necessary, separate provision of closet accommodation, washing accommodation, and accommodation for the storage, preparation and cooking of food. For the keeping in repair and adequate lighting of any common staircase. For the cleansing and redecorating of the premises, and for the paving of the courts and courtyards. For the provisions of handrails for staircases. For securing adequate lighting. For the taking of precautions in any case of infectious disease. Particulars relating to the registered Lodging-houses in the City now on the Register are given in the accompanying table :— District. Number of Houses on Register. Number of Lodgers. Number of Tenements. Average Number of Persons per Tenement. Cleansing Notices Served. West 48 370 157 2.3 75 Middle 3 21 14 1.5 3 East 23 156 84 1.8 39 Total 74 547 255 21 117 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 the Bye-laws. This necessitated the service of 117 notices during 1927. 62 In addition to the foregoing, there are ten blocks of Dwellings let out in tenements, but not placed on the Register for the reason that each holding is " self-contained," it having been decided in a Court of Law that in these circumstances they are not subject to the Bye- Laws tor houses let in lodgings, or occupied by members ol more than one lamily :— Name and situation of Artizans' Block Dwellings. No. of Tenements. No. of Inhabitants. One Room. Two Rooms. Three Rooms. Four Rooms. ' Five Rooms or more. WEST DISTRICT. Albion Buildings, No. 21, Bartholomew Close 10 21 Albion Buildings, No. 22, Bartholomew Close 10 15 Bartholomew House, Bartholomew Close 14 3 38 Dean Street Blocks, Fetter Lane— Block A 2 2 16 „ B 2 3 l 15 „ C 4 2 l 18 ,, D 6 1 l 17 ,, E 7 1 l 13 ,, F 4 3 13 St. Ann's Chambers, Ludgate Hill 5 15 "l 39 Bloomfield House, Snow Hill 14 3 43 Total (Six " Blocks ") 44 64 l 7 250 MIDDLE DISTRICT. Bridgewater House, Fann Street 9 l 18 City Buildings, Moor Lane 20 12 73 Total (Two "Blocks") 29 12 l 91 EAST DISTRICT. /Harrow Alley and Stoney Lane— North Block .... 48 8 .... .... 191 South „ 5 22 13 .... .... 131 Prince's ,, 5 50 .... .... 159 Queen's ,, 5 40 5 .... .... 144 King's „ 8 16 16 .... .... 118 Barker's Buildings, Catherine Wheel Alley, Bishopsgate 12 6 2 1 .... 49 Total (Two "Blocks") 35 182 44 1 .... 792 These ten blocks contain 410 tenements, and are inhabited by 1,133 persons—an average of 2.7 persons to each tenement. HOUSING OF THE WORKING CLASSES. During the year, the opening of Windsor House, Shepherdess Walk, brought to fruition the energetic efforts of Dr. W. J. Howarth, who, so far back as 1919, reported on the necessity for the clearing of the unsatisfactory housing area in the vicinity of Hutchison Street. Although much progress has been made in clearing the area, it is not yet entirely free from unsatisfactory property. It is satisfactory to observe, however, that no nuisance now exists on the site, and it is hoped that in a short while the additional block of new dwellings now in course of erection in the area will be available for the accommodation of the remaining residents, thus enabling the entire site to be cleared. The Vine Street area is now cleared with the exception of two houses which will probably be vacated before this Report is circulated. Windsor House, referred to above, was erected in accordance with plans prepared by the City Engineer, Mr. E. E. Finch, M.I.C.E., F.S.I., and is a building of pleasing architecture containing all the latest improvements, and the site covers an area of two acres. The centre of the square is a big garden reserved for the use of adult residents. Every living room looks down on this garden, while round the whole of the site is a spacious playground for the children. The total cost of the building, including the land, will be about £116,000, which is being entirely borne by the Corporation without assistance 63 from the Exchequer. There are 104 flats consisting of 2, 3, 4 and 5 rooms, and containing in all 344 rooms, which should provide accommodation for about 600 persons. The weekly rents, which include rates and taxes, vary from lis. 6d. to 14s. for 2-room tenements, 16s. to 18s. 6d. for 3-room tenements, 18s. 6d. to 20s. 6d. for 4-room tenements, and 21s. 6d. to 22s. 6d. for 5-room tenements. In the course of a visit paid by His Royal Highness, the Prince of Wales, to the City on the 18th October, His Royal Highness took the opportunity of inspecting the buildings, and graciously planted a tree in the gardens. The following table is included in this Report in accordance with the request contained in the letter from the Ministry of Health, dated 15th December, 1927, and relating to contents of annual reports of Medical Officers of Health:— Number of New Houses erected during the year— [a) Total (including numbers given separately under (b) ) In City 24 Outside City 104 (b) With State Assistance under the Housing Acts : (i.) By the Local Authority Nil. (ii.) By other bodies or persons Nil. 1. Inspection of Dwelling Houses during the Year : (1) Total number of dwelling houses inspected for housing defects (under Public Health or Housing Acts) 881 (2) Number of dwelling houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 1,104 (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 sub-head) found not to be in all respects reasonably fit for human habitation 68 2. Remedy of Defects during the Year without Service of Formal Notices : Number of defective dwelling houses rendered fit in consequence of informal action by the Local Authority or their officers 138 3. Action under Statutory Powers during the Year : A.—Proceedings under Section 3 of the Housing Act, 1925 : (1) Number of dwelling houses in respect of which notices were served requiring repairs Nil. (2) Number of dwelling houses which were rendered fit after service of formal notices : (a) By owners Nil. (b) By Local Authority 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 close Nil. B.—Proceedings under Public Health Acts : (1) Number of dwelling houses in respect of which notices were served requiring defects to be remedied 179 (2) Number of dwelling houses in which defects were remedied after service of formal notices : (a) By owners 163 (b) By Local Authority in default of owners Nil. C.—Proceedings under Sections 11, 14, and 15 of the Housing Act, 1925 : (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. 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 lodginghouse 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. i 2 64 Neglect to comply with Water-closet Bye-laws.—No instance of neglect in this respect has occurred during the year under review. Drainage Plans.—In the course of the year 216 plans were submitted with regard to proposed reconstruction of water-closets or drains in the City. Of these, 210 were approved ; 3 revised and approved ; and 3 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-to-date 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 one case was reported by your officers. On the service of the statutory notice of abatement the overcrowding was discontinued. Sanitary Defects 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 111 cases so investigated in 1927, it was found necessary to make amendments to soil and waste pipes, water-closets, &c., in 44 instances. House, Trade, and other Refuse Removal.—The City Engineer informs me that the refuse removed from the City in 1927 consisted of 20,393 cartloads of street sweeping sand slops, and 47,571 loads of house and trade refuse, a total of 67,964 loads. The total for the year 1926 was 67,554. 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, 404 notices have been served by the District Inspectors at the order of the Sanitary Committee, and in no case was it found necessary, in consequence of non-compliance therewith, to refer the matter to the City Solicitor. Summer Flushing of Courts.—There are 161 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 20,566,042 gallons of water were used. Of these courts and alleys, seven were flushed four times a week, six three times a week, three twice a week, 21 once a week, five once a month, and 119 every two months. 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 vicinty of these places free from nuisance caused by the drippings from the fish carts, especially during hot weather. Limewashing of Courts.—There are 60 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 smokeladen atmosphere. These are cleansed or limewashed twice a year under the direction of the City Engineer. Of the places so dealt with during 1927, 19 were situated in the East District, 24 in the Middle District, and 17 in the West District. 65 Defective Connections to Sewer.—During the year, 11 reports were received from the City Engineer respecting the condition of connections between the drains of certain City houses and the public sewer. Investigations showed that it was necessary to reconstruct all of the connections referred to. Of these, nine have been completed and the remainder are, at the time of writing this Report, in process of reconstruction. As a result of the inspection of the internal drainage system of these premises, reconstruction or alteration was found necessary in nine instances. In the majority of cases these external 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. PIGEONS. The powers conferred by the London County Council (General Powers) Act, 1927, enabling local authorities in London to take the steps necessary to reduce the number of pigeons infesting the metropolis have been exercised by the City Corporation so far as the City is concerned, and although it was only possible to commence operations a few days before the close of the year, a definite reduction in the number of birds has been effected. The scheme adopted, of which the following are the main principles, has as its basis the engagement of an expert trapper, who undertakes for an agreed sum to destroy a given number of birds:— 1. That the pigeons be trapped in the early hours of the morning, when there is little likelihood of interruption by pedestrians and others. 2. That the pigeons be removed alive in pigeon baskets to a suitable centre. 3. That all ringed birds be separated and returned to the National Homing Union. 4. That the remainder be killed at the centre in the customary way in which pigeons are killed, under the supervision of an officer of the Corporation. 5. That the carcases be at the disposal of the contractor or burned by the Corporation. The clause relating to the return of ringed birds was included, to meet the very natural anxiety of the National Homing Union that private and perhaps valuable pigeons should not be destroyed in the general round-up. An undertaking was also given when the Bill was before the House of Commons that the birds would not be shot at or maimed. Thus the method of catching was for practical purposes reduced to netting or trapping with such appliances as would not inflict injury on the birds. I am pleased to report that no allegations of cruelty have been received. A very careful control will be maintained over the trapping, and action modified from time to time as circumstances indicate, as it is not intended that the City shall be entirely cleared of pigeons, but rather that a proper balance between hygienic necessity and aesthetic beauty be preserved. FLY NUISANCE. As in past years, attention has been given to the possibility of the spreading of infection by flies during the summer months. Leaflets were distributed throughout the City calling attention to the danger created by the fly and making special reference to the precautionary measures which should be taken to minimise such dangers. Your officers, where opportunity offered, made a special point of directing attention of householders to the necessity for the strict observance of cleanliness, frequent removal of dust and other refuse, and particularly of foodstuffs, especially milk. Following a practice adopted for the first time last year, the service of the several Ward Beadles were utilized in directing attention to this subject. They were all furnished with a supply of leaflets, and I wish to acknowledge the assistance they rendered, which by reason of their intimate knowledge of their districts was of considerable value. 66 RAG AND BONE DEALERS' BYE-LAWS. An important addition to Public Health powers has been made during 1927 in the form of bye-laws respecting the business of a rag and bone dealer. The bye-laws, a copy of which is included in the appendix to this report (Appendix G) are made under Section 9 of the London County Council (General Powers) Act, 1908, which empowered the Corporation to make Bye-laws for regulating the conduct within the City of London of the business of a fish frier, a fish curer, and a rag and bone dealer. The Byelaws with regard to the two former trades were completed and put into operation some years ago, but the latter were delayed on account of certain trade difficulties. REMOVAL OF INFIRM AND DISEASED PERSONS. The new power which the London County Council are seeking to obtain for London, which will authorize the compulsory removal to an infirmary or similar institution of infirm and diseased persons who, by virtue of advanced years or infirmity, are unable to take such steps as they doubtless otherwise would to secure cleanliness for themselves and their surroundings, will be of very considerable assistance to public health authorities in some of the more congested areas of London. When the City Corporation were asked for views on the proposal, appreciation of its functions was expressed, although no difficulty had then been experienced in the direction at which control was sought. Very shortly afterwards, however, a case did occur in which these powers would have been of very material assistance. FACTORY AND WORKSHOP ACT, 1901, &c. Factories, Workshops and Workplaces.— The premises upon the Register number 3,875 in which are included 8,371 workrooms, &c. There were served 2,016 notices during the year for various purposes under the Acts. The number of Factories, Workshops and Workplaces at present Registered is as follows :— Registered Places. Workrooms, &c., in Registered Places. FACTORIES 1,126 3,611 WORKSHOPS 1,684 2,647 WORKPLACES Kitchens of Restaurants and Tea Rooms 599 1,083 Kitchens of Licensed Premises 242 617 Stables 15 15 Other places 209 398 3,875 8,371 The following is a Summary of Inspections of separate workrooms, &c., during the year:— Workshop Inspectors. Woman Inspector. Totals. FACTORIES 1,298 - 1,298 WORKSHOPS 1,259 - 1,259 WORKPLACES 1,041 l 1,042 The following is a Summary of Inspections of separate workrooms since 1917:— FACTORIES. Workshop Inspectors. Woman Inspector. Totals. 1918 904 3 907 1919 995 7 1,002 1920 866 — 866 1921 1,956 2 1,958 1922 1,763 — 1,763 1923 1,517 — 1,517 1924 1,050 — 1,0£0 1925 1,119 — 1,119 1926 1,419 — 1,419 1927 1,293 — 1,298 67 wriRi'SHnPs Workshop Inspectors. Woman Inspector. Totals. 1918 783 1l 794 1919 1,069 18 1,087 1920 731 — 731 1921 1,958 — 1,958 1922 1,598 1,598 1923 1,387 — 1,387 1924 1,159 — 1,159 1925 1,219 — 1,219 1926 1,242 7 1,249 1927 1,259 — 1,259 WORKPLACES. 1918 713 72 785 1919 445 41 486 1920 618 — 618 1921 979 38 1,017 1922 957 1 958 1923 675 33 708 1924 730 2 732 1925 613 — 613 1926 821 42 863 1927 1,041 1 1,042 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. † 280, Bishopsgate. † 3, Pancras Lane. † Great Eastern Railway Hotel. † 21, Stoney Lane. †* 85, Middlesex Street. 68, St. Mary Axe. † 12 and 13, Widegate Street. 194, Upper Thames Street. †*122, Middlesex Street. UNDERGROUND BAKEHOUSES. † 188, Aldersgate Street. 262, Bishopsgate. 8, Copthall Avenue. SUMMARY. †*67, Farringdon Street. Aboveground Bakehouses 4 *93, Fetter Lane. Underground Bakehouses 12 48, Knightrider Street. — †*37, Middlesex Street. 16 *These have been established at lsast 41 years. † Factory Bakehouses (power is used). 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 for legal proceedings. In 40 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. 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 68 Year. Number of Lists received. Outworkers Employed in City. Outworkers Employed outside City. Total number of Outworkers. 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 1923 1,406 701 12,114 12,815 1924 1 426 848 12,234 13,082 1925 1,391 874 12,061 12,935 1926 1,352 889 11,514 12,403 1927 1,338 846 11,230 12,076 SUMMARY OF WORK DONE UNDER THE FACTORY AND WORKSHOP ACT, 1901, AND THE PUBLIC HEALTH (LONDON) ACT, 1891, &c. INSPECTIONS. East District. Middle District. West District. Totals. Factories, Initial Inspections (Tenancies) 17 53 22 92 Do. Initial Inspections (Workrooms) 25 80 55 160 Do. Periodical Inspections (Tenancies) 121 144 112 377 Do. Periodical Inspections (Workrooms) 256 434 448 1,138 Do. Re-inspections (Sanitary Works, &c., in h; ind) 134 263 134 531 Workshops, I nitial Inspections (Tenancies) 49 57 41 147 Do. Initial Inspections (Workrooms) 56 73 69 198 Do. Periodical Inspections (Tenancies) 280 275 142 697 Do. Periodical Inspections (Workrooms) 382 365 278 1,025 Do. Re-inspections (Sanitary Works, &c., in h ind) 220 274 202 696 Workplaces, Initial Inspections (Tenancies) 13 9 27 49 Do. Initial Inspections (Workrooms) 20 9 42 71 Do. Periodical Inspections (Tenancies) 23 11 30 64 Do. Periodical Inspections (Workrooms) 57 16 61 134 Do. Re-inspections (Sanitary Works, &c., in h and) 46 20 76 142 Bakehouses, Periodical Inspections (Tenancies) 10 10 6 26 Do. Periodical Inspections (Workrooms) 15 15 6 36 Do. Re-inspections (Sanitary Works, &c., in h and) 4 11 1 16 Kitchens of Restaurants, &c.— Initial Inspections (Tenancies) 6 28 20 54 Initial Inspections (Workrooms) 7 63 36 106 Periodical Inspections (Tenancies) 69 81 67 217 Periodical Inspections (Workrooms) 153 196 144 493 Re-inspections (Sanitary Works, &c. in h and) 118 237 180 535 Kitchens of Licensed Premises— Initial Inspections (Tenancies) 2 - — 2 Initial Inspections (Workrooms) 2 - — 2 Periodical Inspections (Tenancies) 27 32 28 87 Periodical Inspections (Workrooms) 79 108 48 235 Re-inspections (Sanitary Works, &c., in h and) 103 79 43 225 Workshops notified by H.M. Inspector — - — — General Complaints received 20 5 11 36 Miscellaneous visits 168 93 169 430 DEFECTS FOUND. FACTORIES, WORKSHOPS, WORKPLACES. KITCHENS OF RESTAURANTS, & KITCHENS OF LICENSED :. PREMISES. East District. Middle District. West District. East District. Middle District. West District. East District. Middle District. West District. Totals. Want of Clear lliness 40 23 58 20 31 28 11 14 238 Want of Vent ilation 2 7 1 8 22 8 2 5 2 57 Overcrowding — 1 — — — — — — - 1 Want of Draii aage of Floors - 1 - - 1 - - - - 2 Want of Lava tory Accommodation - - 3 - - 4 - 3 3 13 Food imprope rly stored - - - - 9 10 - - - 19 Storage Cister n defective 1 13 24 5 31 - 3 10 87 Accommodati on for Refuse .— 6 - - 2 3 - 1 1 13 Accumulation of Refuse 1 22 7 - 8 7 - - - 45 Sanitary Accommodation. I Insufficient (Tenancies) 2 1 1 2 3 6 1 1 17 Unsuitable (Do.) 14 2 27 2 - 6 1 - - 52 Defective (Do.) 87 118 137 4 18 22 4 3 5 398 Do. (No. of Conveniences)* 152 132 355 5 18 37 6 5 9 719 Not separate for Sexes (Tenancies) 11 7 17 1 - 1 2 - - 39 Other Nuisances 83 26 42 20 37 22 7 13 8 258 Total Defects found 241 227 317 57 136 148 28 42 43 1,239 * Figures not included in total defects found or remedied. 69 DEFECTS REMEDIED. FACTORIES, WORKSHOPS, WORKPLACES. KITCHENS OF RESTAURANTS, Sec. KITCHENS OF LICENSED PREMISES. East District Middle District West District East District Middle District West District East District Middle District West District Totals. Want of Cleanliness 41 23 52 14 27 22 10 12 12 213 Want of Ventilation 3 5 1 8 22 5 2 5 3 54 Overcrowding - 1 - - - - - - - 1 Want of Drainage of Floors — 1 — — 1 — — — — 2 Want of Lavatory Accommodation - - 3 - - 4 - 2 3 12 ?ood improperly stored - - - - 11 7 - - - 18 Storage Cistern defective .... 1 14 21 - 5 24 — 2 9 76 Accommodation for Refuse — 4 — — 1 2 — 1 1 9 Accumulation of Refuse — 24 7 — 6 8 — — — 45 Sanitary Accommodation. 1 Insufficient (Tenancies) 2 1 1 1 4 2 1 — 1 13 I Unsuitable (Do.) 13 3 25 1 - 4 2 - - 48 Defective (Do.) 81 131 126 4 19 16 4 3 3 387 Do. (No. of Conveniences)* 139 144 318 5 19 22 6 5 6 664 v Not separate for Sexes (Tenancies) 15 7 12 1 — — 1 — — 36 Other Nuisances 72 27 37 17 40 17 11 10 6 237 Total Defects remedied 227 241 285 47 136 111 31 35 38 1,151 ACTION TAKEN. East District. Middle District. West District. Totals. Matters relcrrccl to ii.M. Inspector— Nuisances remediable by H.M. Inspector l 3 3 7 Failure to affix Abstract 16 24 20 60 Matters referred by H.M. Inspector— Notified by H.M. Inspector 14 12 6 32 Reports sent to H.M. Inspector 14 12 6 32 Notices served— Factories—Intimation 5 18 12 35 Statutory 7 1 4 12 Workshops—Intimation 29 30 33 92 Statutory 30 — 8 38 Workplaces, &c.—Intimation 4 1 8 13 Statutory 5 — - 5 Kitchens of Restaurants— Intimation 11 14 22 47 Statutory 11 3 8 22 Kitchens of Licensed Premises- Intimation 3 6 5 14 Statutory 4 — 2 6 Orders required from Sanitary Committee 70 38 52 160 Certificates for Cleansing issued by Medical Officer of Health 15 4 13 32 Matters referred to District Inspectors 5 12 1 18 Matters referred to Woman Inspector — — — — Matters referred to Workshop Inspectors — — — — Cases reported for Legal Proceedings — — — — Legal Proceedings taken — — — — OUTWORK AND THE INSPECTION OF OUTWORKERS' PREMISES, &c. Lists received from City Firms — — — 1,415 Names and Addresses, &c., received from other Authorities — — — 3 22 Names and Addresses transmitted to other Authorities — — — 10,037 Notices served on Employers — — — 1,732 Letters written, &c. — — — 17 Firms visited 66 54 10 130 Outworkers Lists not kept 4 22 13 39 Do. not sent 4 23 13 40 Infectious Disease occurring in Outworkers' Premises — — — — Registered Factories and Workshops at which Outwork is received— Inspections 107 62 31 200 Defects found 18 24 20 62 Defects remedied 18 22 4 44 " Places from which work is given out "— Inspections 1 11 8 20 Defects found — — 4 4 Defects remedied — — 1 1 * Figures not included in total defcets found or remedied. K 70 WOMAN INSPECTOR. Total. Domestic Premises receiving Inspections l Outwork (not registerable as Workshops) Defects reported and appropriate action taken — Underground Conveniences Inspections 32 for Women Defects reported and appropriate action taken 2 Railway Stations (Ladies' Inspections 26 Rooms). Defects reported and appropriate action taken 3 L.C.C. (G.P.) Act, 1904. Notifications received 7 spection of premises after Visits 10 cleansing of children Defects reported and appropriate action taken — Children Act, 1908 (Nurse Notifications received 2 Children) Visits 3 Defects reported and appropriate action taken — Notification of Births Act, Births notified 85 1907 Home visits to infants 275 Home visits to children between 1 and 5 years of age 153 Visits re Still Births 1 Deaths of Infants under 1 Number Notified 6 year of age Visits 2 Distribution of Milk (Free) Expectant Mothers 21 Nursing Mothers 54 Children under 6 months 1 Children over 6 months 32 iNumber of children in receipt of:— Distribution of Dried Milk Free — Reduced or Cost Price 20 Number of Mothers attending Infant Welfare Centre 97 Total Attendances of Mothers at Infant Welfare Centre 742 Expectant Mothers visited at home 88 Special Visits 87 71 FACTORIES, WORKSHOPS, WORKPLACES AND HOMEWORK. 1.—Inspection of Factories, Workshops and Workplaces. Including Inspections made by Sanitary Inspectors. Premises. Number of (1) Inspections. (2) Written Notices. (3) Occupiers Prosecuted. (4) Factories (including Factory Laundries) 469 47 — Workshops (including Workshop Laundries) 870 130 — Workplaces (other than Outworkers' premises) 473 107 - Total 1,812 284 — 2.—Defects Found in Factories, Workshops and Workplaces. Particulars, (i) Number of Defects. Number of offences in re pect to whicn Prosecutions were instituted. (5) Found. (2) Remedied. (3) Referred to H.M. Inspectors, (4) Nuisances under the Public Health Acts:—* Want of cleanliness 238 213 7 Want of ventilation 57 54 — — Overcrowding 1 1 — - Want of drainage of floors 2 2 — - Other nuisances 435 397 - - Sanitary accommodation insufficient 17 13 — — unsuitable or defective 450 435 — — . not separate for sexes 39 36 — — Offences under the Factory and Workshop Act:— Illegal occupation of underground bakehouse (S. 101) — - — — Other offences (excluding offences relating to outwork and offences under the Sections mentioned in the Schedule to the Ministry of Health (Factories and Workshops Transfer of Powers) Order, 1921) Total ' 1,239 1,151 7 — *Including those specified in Sections 2, 3, 7 and 8 of the Factory and Workshop Act, 1901, as remediable under the Public Health Acts, No instance of outwork in unwholesome premises under Section 108 of the Fact'ory and Workshop Act was reported. K 2 72 73 3.—Home Work. Nature of work. OUTWORKERS LISTS, SECTION 107. OUTWORK IN UNWHOLESOME PREMISES, SECTION 108. outwork in infected premises, sections 109, 110. Lists received from Employers. Notices served on occupiers as to keeping or sending Lists. Prosecutions. Instances. Notices served. Prosecutions. Instances. Orders made (S. 110). Prosecutions (Sections 109, 110). Sending twice in the year. Sending once in the year. Failing to keep or permit Inspection of lists. 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— making, &c 1,112 3,878 6,653 37 121 74 cleaning and washing 1,732 / 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) 96 218 218 9 6 9 Cables and Chains Anchors and Grapnels Cart Gear Locks, Latches and Keys Umbrellas, &c 56 22 414 1 — 1 Artificial Flowers 20 — 111 2 — 21 Nets, other than Wire Nets Tents Sacks Racquet and Tennis Balls Paper, &c., Boxes, Paper Bags 4 9 2 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 1,288 4,127 7,398 50 127 108 1,732 Nil. Nil. Nil. Nil. Nil. Nil. Nil. Nil. * If 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 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 4 (or C> and 7) into their respective classes. A footnote should be added to show that this has been done. †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 each year and of the entries of names of outworkers in those lists. 1 he entries in column 2 must necessarily be even numbers as there will be two lists for each employer-in 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 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. Number. (1) (2) Important classes ot workshops, such as workshop bakehouses, may be enumerated here. General Workshops 1,668 Bakehouses (including Factory Bakehouses) 16 Total number of Workshops on Register *1,684 * These were found to be 2,047 Workrooms, &c., in places Registered. Note.—The Factory and Workshop Act, 1901 (S. 132), requires the Medical Officer of Health in his Annual Report to the District Council to report specifically on the Office). If the Annual Report is presented otherwise than in print, it is unnecessary to include in the copy sent to the Home Office, the portions which do not relate to Memorandum of March, 1912. 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) 60 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 32 Reports (of action taken) sent to H.M. Inspector 32 Other — Underground Bakehouses (S. 101) :— Certificates granted during the year Nil. In use at the end of the year 12 Date, 31st December, 1927. (Signature) W. M. WILLOUGHBY, Acting Medical Officer of Health. 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 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 74 EXHUMATION AND REINTERMENT OF BODIES. City of London Cemetery.—During the year the bodies of six persons buried at the City of London Cemetery at Ilford have been exhumed and subsequently re-interred in the same Cemetery. In accordance with the terms of the licences 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. CITY MORTUARY. Bodies Received—Post-Mortems and Inquests :— Bodies received at the Mortuary to await burial 178 Post-Mortem examinations made 81 Inquests held on bodies 169 Inquests held on fires 1 The following tabulation shows the work carried out at the Mortuary and Coroner's Court during the past five years :— Year. Articles disinfected. Bodies received at the Mortuary. Inquests held on bodies Inquests held on Fires. 1922 760,860 135 114 15 1923 355,657 149 128 1 1924 481,391 160 145 0 1925 493,813 150 145 0 1926 305,970 155 139 4 Average for previous 5 years 479,538 150 133 4 1927 227,037 178 169 1 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 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. 556 221,957 £777 Disinfection—Infectious Diseases:— Articles disinfected after cases of infectious disease 5,080 Public Vehicles—Electric Ambulance 4 Police Litter 1 Cleansing of Persons Act, 1897:— Number of verminous persons bathed 40 Cleansing of School Children:— Total number of children cleansed 1,008 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 of that year. It has proved of considerable assistance in connection with the identification of persons found drowned in the River Thames. During the year, six bodies were placed in the apparatus, and of these five were subsequently identified. Fire Inquests.—Dr. F. J. Waldo, J.P., Coroner for the 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 1927:— INQUESTS HELD UNDER THE CITY OF LONDON FIRE INQUESTS ACT, 1888. Date of Inquest. Premises Burnt. 3rd, 11th and 13th May, 1927 5 and 6, Well Court. In addition to the above, the City Coroner personally inquired into 170 " non-fatal" City fires reported to him during the year. DISINFECTANTS. The disinfectants and other chemicals in use in the Public Health Department and in other branches of the Corporation's service, have, as in the past, been supplied under a contract prepared by your Medical Officer of Health. They are used for deodorising and denaturising unsound meat, disinfecting public conveniences, streets and roadways, premises after infectious diseases, etc. Special attention was given to the thoroughfares in the vicinity of the Billingsgate and Smithfield Markets, the former of which presents certain difficulties in the matter of deodorisation in the summer months. Very few complaints were, however, received of offensive odours necessarily associated with the fish trade. 75 RAT REPRESSION. The table set out on page 76 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, 1927. From this summary it will be seen that 1,153 buildings, occupied by 4,329 firms, were inspected. Of these, 479 were found to be rat infested. One or other of the rat catchers working in the City was engaged by business firms in 168 instances, poisons were laid down and traps of the break-back variety were used in 632 instances, and wire traps in 122. Varnish traps, which were used in special circumstances, were relied upon in 306 buildings. Cats and dogs were found to be kept by 195 firms. Complaints have been received at the Office, or applications for advice, in 141 instances. The work done in addition to poisons and traps, and the keeping of rodentdestroying animals, include rat-proofing in 441 instances, and the repair of drainage defects in 521 others. In this relationship it should be stated that rat-proofing cannot be relied upon absolutely to exclude rodents from buildings, for reasons which have been pointed out from time to time,e.g., the importation of rats into buildings in cases and crates from the dock and ingress through open doors and windows, especially through roof doors provided for exit in case of fire. The value of properly carried out rat-proofing should not be under-estimated, for by this means food is protected, the domestic water supply is guarded, fire risk is lessened, insanitary defects are remedied which might otherwise remain undiscovered, and rats are more easily reduced in numbers, since hiding places are eliminated and absence of hiding places results in a decrease of the rat population. It has been pointed out in previous reports that the construction of many City buildings is such as to render rat-proofing practically impossible ; and, further, that the owners who are the only persons competent to deal structurally with the buildings, are not responsible under the Act. A large number of old buildings have been demolished throughout the City during the year, and in the course of demolition rats which were disturbed found harbourage in neighbouring buildings, many of which had not been previously infested. But in many old buildings poison baits in large numbers have been laid before the work of pulling down has been started. This has resulted in the destruction of large numbers of rats. Mr. Engineer informs me that, during the year, the following sewerage and drainage works, all of which tended to reduce the breeding places for rats, were carried out by his Department:— Pipe sewers reconstructed 3 Brick sewers reconstructed 4 Brick sewers in course of reconstruction 4 Disused sewers filled in 5 Miscellaneous repairs to sewers damaged by rats, etc 13 Brick-barrel drain filled in or abolished 6 New drains constructed in connection with new buildings 42 Drains of existing buildings reconstructed 58 New gulley drains constructed 4 Gulley drains reconstructed 54 House and gulley drains repaired 19 Gulley drains reconstructed 13 Disused drains bricked up 83 Amount of poisons used in sewers during year 98 lbs. Amount of poison varnish for rat-catching year 14 lbs. No. of rats killed in sewers, not including those which died from poisoning 882 The number of drains reconstructed carried out under the supervision of the Inspector, attached to my own department, is set out on page 64. It was not found necessary in any case either to serve Statutory Notices nor to take legal proceedings. I am indebted to Messrs William Dalton & Sons, rat-catchers, for the information that, during the year, they caught 29,014 rats in the City. It is, of course, impossible to estimate the total number of rats destroyed in the City area during the year ; the impr acticabilitv of giving even an approximate estimate was pointed out in a special report presented to the Sanitary Committee on the 26th September, 1922. Rat-catchers and poisoners are engaged on contract in many of the multiple tea-shops, restaurants, hotels, and business premises ; several vacant building sites in the City were 76 dealt with under the supervision of the Department, and all necessary information was given to representatives who called for advice. The attached table shows that of the 1,153 buildings visited during the year, 479 were found to be rat infested, and in these rat proofing work was carried out at 441. This work chiefly consisted of wiring area gratings, ventilators, roof openings, and the stopping of rat holes in walls and floors. Other necessary work, such as the removal of wooden floors from basements and substituting concrete, the stripping of internal walls of the woodwork, such as matchboarding, wainscoting and panelling—behind which rats nest and breed—the cementing of walls and the removals of ceilings in certain cases, could only be done to a very limited extent, because it would not be considered a reasonable request to ask an occupier to carry out this expensive work in a building which he does not own. Rat Week.—No special effort was put forward during Rat Week. Rat repression work in the City being continuous, it is difficult to see what advantage can be gained by distributing circulars to firms who are doing their utmost (in their own interests) to deal adequately with the rat nuisance. Moreover, in previous years, some of these firms have expressed their irritation on receipt of those circulars. Virus.—The subject of virus received attention in 1913, when the virus in use by certain tenants at the Central Meat Market was examined by the City bacteriologist, who reported that the particular virus was inert, though it was stated to contain a modified Lœffler’s bacillus (possibly the bacillus typhi murium, of Lœffler). The virus question was again enquired into in 1920, when three samples were obtained. One proved to be identical with Gærtner’s B. enteritidis, the second resembled Gaertner's bacillus and the third was similar to the first. The conclusion arrived at, after considering the subject at some length, was that Gærtner’s bacillus was not a natural inhabitant of the intestine of either rats or mice, but that both these animals might be infected by these organisms, and the result might be death or recovery ; the animals might survive as carriers, and it was suggested there was a possibility of a carrier animal gaining access to food and contaminating it. The question, therefore, arose whether the use of virus should be prohibited. It has been the practice of this Department not to encourage the use of bacterial preparations in City premises, but no power exists which would enable the Corporation to prohibit their use. Traps.—Various kinds of traps have been used, the ordinary cage trap, the eel-pot, the round wire and other types of wire traps. None of them are very successful, and some are constructed of wire so fine that captured rats are able to force the wires apart and escape. Better results have been obtained with break-back traps and varnish traps, the latter being now in general use and the most successful of all. Poisons.—Many kinds of poisons are used in the City by the poisoners employed by City firms, e.g., Strychnine, Arsenic, Plaster of Paris, Magnesium Sulphate, Squill, Phosphorus, Barium Carbonate, etc. There is no law to control the use of many deadly raticides, but the dangers of Strychnine, Arsenic, Phosphorus, are pointed out to the users. Red Squill Extract is the poison chiefly recommended on account of its being extremely toxic to rodents and its comparative harmlessness to domestic animals. In April, 1920, a lengthy report on rat repression was submitted in printed form to the Corporation. This dealt in a fairly comprehensive manner with the natural history of the rat, the circumstances which contribute to the prevalence of rats in the City, and the available methods for attacking the problem. Several other reports have been submitted at different times, and the chief conclusions arrived at are as follows:— (1) Rat infestation, if uncontrolled, will depend upon the amount of food which is available. Rats increase to the limits of the means of subsistence. Available food is, therefore, an important factor in rat increase. (2) The increase can be to some extent prevented by— (a) Rendering premises rat-proof and thereby preventing casual infestation. Such means include satisfactory construction of drains and adequately guarded openings of basements, and doors; also internal improvements in premises, 77 with the object of doing away with conditions which provide the rat with shelter and suitable nesting places. (b) Efforts to catch or kill rats which have infested premises by means of traps, poisons, varnish, or by the use of suitable animals. (3) In the presence of the black rat and its capacity for climbing, preventive measures against ingress are not to be limited to the ground floor, but extend to the highest floor of a building. These rats may enter buildings by travelling along telephone cables. If the methods indicated are diligently pursued, rats can be very largely reduced in numbers, but the experience of Copenhagen tends to shew that even if, with such measures, there be combined rewards for rats killed (which apparently would encourage a large number of persons to be rat-catchers), the reduction can only reach a certain limit. If energies are relaxed, the rat being very prolific, the previous maximum, dependent upon the means of subsistence, will again rapidly be reached. L 78 RATS AND MICE (DESTRUCTION) ACT, 1919. Summary Showing Investigations and Inspections Made and Details of Work Carried Out under the Above Act. Months. 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 Sewerage Work carried out during the year. Special Observations. Complaints or Applications for Advice. 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. January 102 2.3 36 240 10 29 9 25 23 l 15 33 308 213 13 February 103 2.8 36 290 18 19 9 28 21 3 17 40 12 March 114 2.7 48 309 11 30 8 25 31 — 13 41 11 April 93 3.7 34 344 14 25 7 22 28 1 8 33 11 May 122 3.7 46 460 16 26 10 34 32 — 19 40 12 June 91 3.3 37 306 9 25 13 17 21 2 16 31 12 July 96 5.0 37 481 14 26 10 26 27 1 12 33 15 August September 106 4.7 52 504 17 33 6 35 43 — 22 48 17 October 115 6.0 60 791 27 47 25 44 28 — . 23 62 12 November 105 4.2 55 446 13 36 18 34 24 — 29 47 15 December 106 1.4 38 158 19 20 7 26 28 1 21 33 11 Totals * 1,153 2.8 479 4,329 168 316 122 316 306 9 195 441 521 141 *Buildings systematically inspected 1,012 ,, inspected in consequence of complaints 141 Totals 1,153 79 MEDICAL EXAMINATIONS. In accordance with the Standing Order of the Court that no person shall enter the employ of the Corporation or of any of its Committees without previously passing a medical examination to the satisfaction of the Committee having cognizance of the appointment, 108 persons were examined by the Medical Officer of Health during 1927. One of these persons was reported as physically unfit for office. Seven officers were also medically examined with a view to their retirement. All were reported to be unfit for duty. I have the honour to be, Gentlemen, Your obedient Servant, W. M. WILLOUGHBY, Acting Medical Officer of Health for the City of London. Public Health Department, Guildhall, E.C. l 2 APPENDICES. page Appendix A—Street Lists of Mortality 82 „ B— „ „ Infectious Diseases 86 C—Register of Houses let in lodgings or occupied by members of more than one family 88 „ D—List of Adoptive Acts, Orders, Bye-laws and Regulations in operation in the City 90 „ E—Leaflet issued relating to precautions which should be taken against Influenza 91 „ F—Poster issued relating to precautions which should be taken against Influenza 91 „ G—Bye-laws with respect to the business of a Rag and Bone Dealer 92 82 APPENDIX A.—STREET LISTS OF MORTALITY. STREET OR PLACE. No. of House Sex. Age. Date of Death. Cause of Death. Remarks. Albion Buildings 22 M 64 11th May Arterio Sclerosis Myocardial Degeneration Died at Stone House, Stone. Aldgate, Three Nuns Hotel. — M 48 16th July Diabetes Mellitus Fibrosis of Liver Died in London Hospital. ” ” — M 38 30th Oct. (a) (Edema of Lungs Resided at Hull. (b) Cirrhosis of Liver Aldgate High Street 23 F 62 8th Dec. Syncope from infarction of heart muscle due to Coronary Atheroma— Inquest—P.M. Died in Ambulance on way to Hospital. „ 41 M 55 10th June Carcinoma of Pancreas—Exhaustion Amen Court 8 M 57 28th May Syncope Myocarditis Coronary Disease. Died in St. George's Hospital—P.M.—Inquest— Natural. Austin Friars 6 M 53 18th Feb. Syncope Myocardial Disease Resided at Cobham. ” 12 F 58 5th Jan. 1. Multilolobular Cirrhosis of Liver 2. Ascites ” 13 F 71 24th Jan. 1. Acute Bronchitis 2. Asthenia ” 15 M 49 31st March Pulmonary Tuberculosis Died in St. Luke's Hospital, Paddington. Barbican 50 M 73 18th Jan. 1. Osteo-arthritis Died in City of London Infirmary, Bow Road. 2. Congestion of Lungs Barker's Buildings 26 F 43 16th Aug. Tuberculosis of Lung and Bowel. Died in St. Columba's Hospital. Bartholomew House 3 M 18 1st Jan. Pulmonary Tuberculosis Died in St. Joseph's Hospital, Hackney. Bartholomew Place 6 M 61 25th July Cerebral Haemorrhage Myocardial Degeneration Died in City of London Infirmary, Bow Road— P.M. Basinghall Street 65 F 42 11th April Sarcoma of Kidney Died in City of London Infirmary, Bow Road. Bevis Marks 17 M 4 13th Nov. Syncope due to Bronchitis, with suspicion of Encephalitis Lethargica Billiter Street 5 M 74 21st Aug. Syncope, Degenerated Heart and Aortic Disease P.M.—Inquest. Billiter Square 8a M 54 10th Aug. Arterio Sclerosis—Hypcrpiesis—Bronchitis—Asphyxia—Early Cirrhosis of Liver Died in Guy's Hospital— P.M. Birchin Lane 7 F 54 6th Dec. la. Carcinoma of Bieast Died at Acton. 2. Bronchitis Bishopsgate, 213 F 38 24th Nov. la. Auricular Fibrillation. Died in German Hospital. "King’s Arms." Bloomfield House, Snow Hill. 6 M 67 14th Feb. b. Chronic Rheumatic Heart Disease Cerebral Haemorrhage Arterio Sclerosis Died in City of London Infirmary, Bow Road. Botolph Alley I F 51 17th May Carcinoma of Stomach ” 8 M 47 28th Feb. Pulmonary Tuberculosis Botolph Lane 39 F 78 16th April Myocardinal Degeneration Arterio Sclerosis Died in City of London Infirmary, Bow Road. Bride Lane .... 20 F 56 2nd Nov. General Paralysis of Insane Died in City of London Mental Hospital, Stone. Broadway, Ludgate Hill 5 M 73 15th Jan. Bronchitis ” 9 F 69 22nd Jan. 1. Bronchitis 2. Heart Failure Broken Wharf, Upper Thames Street. 3 M 75 1st March Senile Decay Died in City of London Mental Hospital. Brushfield Street 3a M 58 26th April Gastric Ulcer-Hæmorrhage and Cardiac Failure Died in City of London Infirmary, Bow Road. ” 10 M 82 6th May Chronic Endocarditis Chronic Bronchitis ” 10 F 73 12th Oct. Chronic Myocarditis and Hypostatic Congestion of Lungs .. ” 12 F 80 25th June 1. Myocardial Degeneration Died at Poplar. 2. Arterio Sclerosis ” 14 F 81 3rd Feb. Senile Decay Tooting Bee Hospital. Bucklersbury 5/6 M 58 10th Oct. a. Angina Pectoris b. Myocardial Degeneration Cannon Street 50 M 54 12th July Syncope due to Haemorrhage consequent on self-inflicted wound with razor Resided Rotherhithe— Inq.— P.M. — Unsound Mind. ” 81 F 78 5th Feb. 1. Mitral Stenosis 2. Bronchitis Castle Court — M Newly born 12th July Suffocation due to want of attention at birth Address not known—Inq. Chancery Lane 5 F 71 14th June Intersusception—Intestinal Obstruction and Toxoemia Died in Southwark. Church Row, Houndsditch. 2 M 69 31st Jan. Influenzal Broncho-pneumonia Circus, Minories 4 M 71 28th July Carcinoma of Rectum—Exhaustion Clark’s Place, Bishopsgate. 9 F 63 13th Feb. 1. Arterial High Tension 2. Apoplexy Clothier Street 2 F 64 27 th May 1. Diabetes Mellitis—Coma 2. Heart Failure Crooked Lane, Crooked Billet." — F 55 22nd Nov. la. Peritonitis Gangrene of Abdominal Wall Died in London Hospital. b. Perforated Gangrenous Appendix 83 STREET LISTS OF MORTALITY—continued. STREET OR PLACE. No. of House Sex. Age. Date of Death. Cause of Death. Remarks. Cursitor Street 3 M 62 11th July Asphyxia due to C.O. in coal gas, selfadministered by gas ring P.M.—Inquest—No evidence as to state of mind. 8 Dean Street C M 56 21st May Cirrhosis of Liver Died in City of London Infirmary, Bow Road. B’k Myocardial Degeneration Devonshire Square 7 M 79 18th Nov. 1a. Cerebral Embolism b. Aortic Incompetence c. Myocardial Degeneration Dowgate Hill 12 F 67 29th Dec. 1a. Acute Bronchitis 2. Myocarditis ” 13 M 52 16th May Syncope — Gastritis —Enlarged Heart —Bronchitis Inq.—Natural. East Harding Street 8 F 58 26th Nov. Chronic Locomotor Ataxia Ellison Street 9 F 42 15th Oct. Carcinoma of rt. Breast—Secondary Deposit in Pelvic Bones and Intestines Died in City of London Infirmary, Bow Road. Evangelists' Court 3 F 73 29th May Cerebral Thrombosis —Myocardial Degeneration Died in City of London Infirmary, Bow Road. Fenchurch Avenue 9/11 M 61 10th Aug. Cerebral Apoplexy Fenchurch Street, Fenton House. — F 25 20th Dec. Pulmonary Tuberculosis Resided in Islington. Fenchurch Street 59 F 66 5th April Syncope due to internal Haemorrhage consequent upon Rupture of Dissecting Aneurysm of Aorta Inquest — P.M. —Natural Fetter Lane 42 M 63 2nd Jan. Lobar Pneumonia— Myocardial Degeneration Died in City of London Infirmary, Bow Road. 75 M 75 17th Feb. Arterio Sclerosis Finch Lane 3 M 42 7th March 1. Pneumonia 2. Active Phthisis Founder's Court, Lothbury. — M 61 26th April Valvular Disease of Heart—Mitral Fleet Street 18 M 47 1st Sept. 1. Sarcoma of rt. Lung Exhaustion George Alley, Upper Thames Street. 98 M 79 31st Jan. 1. Chronic Prostatis Died in City of London Infirmary, Bow Road. 2. Arterio Sclerosis Gracechurch Street 3 M 68 1st Oct. Intestinal Obstruction—Carcinoma of Sigmoid Colon—Pericarditis ” 59 F 4 2nd March Scarlet Fever—Broncho-pneumonia— Empyema Died in South-Eastern Hospital. Great New Street 13 F 78 8th Nov. Fatty Degeneration of HeartChronic Bronchitis Died in City of London Infirmary, Bow Road. ” 13 F 70 25th Jan. 1. Acute Lobar Pneumonia 2. Cardiac Failure ” 16 F 19 mos. 6th Feb. Broncho-pneumonia Died in St. Bartholomew's Hospital. Great Tower Street 98 F 82 17th Jan. 1. Chronic Myocarditis Died in City of London Infirmary, Bow Road. 2. Chronic Bronchitis ” 98 F 28 8th April Puerperal Septicaemia Endocarditis and Cardiac Failure Died in City of London Maternity Hospital. Green Arbour Court 14 F 73 26th May Cancer of Breast Died in Tooting Bee Hospital. Gutter Lane, " Goldsmith's Arms." — M 58 27th June Carcinoma—Mesenteric Gland Died in St. Bartholomew's Hospital—P.M. Heneage Lane — M Newly born 17th April Congenital Heart Disease— Inattention at Birth Inq.—P.M.—Found dead in Heneage Lane. Hosier Lane 2 M 42 3rd Dec. la. Cardiac Failure Died in St. Joseph's Hospice, Hackney. b. Phthisis Houndsditch 21 M 62 14th June Lymphadenoma ” 154 F 58 26th March Sarrhus Care, of Transverse Colon— Intestinal Obstruction—Operation Exhaustion German Hospital, Hackney. Hutchison Avenue 4 M 78 26th March Ileus Paralyticus—Laparotomy Gidema of Lungs Died in London Hospital. ” 9 F 10 5th Feb. Bacterial Endocarditis Died in East London Children's Hospital. Hutchison Street 18 M 2 weeks 20th July Prematurity Died Infant's Hospital, Vincent Square. Idol Lane 5 M 20 12th Dec. Hæmoptysis— Died in St. Columba's Hospital. Pulmonarv Tuberculosis Idol Lane, Gt. Tower St. 6 F 85 30th Oct. a. Pulmonary Congestion b. Myocarditis Ingram Court, " Thomas Chambers " — F 55 1st Jan. 1. Spastic Paraplegia City of London Infirmary, Bow Road. 2. Congestion of Lungs Ironmonger Lane 17 M 68 10th June 1. Pneumonia 2. Heart Failure Ivy Lane, " Ship Inn " — F 52 16th Aug. Pulmonary Tuberculosis Colindale Hospital. King's Block, Stoney Lane. 5 M 79 19th Sept. Chr. Cystitis—Enlargement of Prostate Gland—Chr. Mitral Regurgitation ” 37 M 55 1st Jan. Syncope—General Peritonitis, under influence of Anaesthetic for operation St. Bartholomew's—Inq. —Misadventure. Liverpool St. Station — M 65 17th June Syncope due to Valvular Disease of the heart—Mitral Stenosis and Athenoma of Coronary Arteries of the Heart Inq.—Resided at Romford —P.M.—Natural. ” * M Newly born 24th Aug. Asphyxiation during Birth and inattention thereat Inq.—P.M. Lower Thames Street 88 F 46 7th Dec. la. Lympho Sarcoma of Lungs Prematurity Died in Walthamstow. LudgateHill," KingLud." — M 1½ hrs. 2nd Jan. Died at 5, Brunswick Sq. * Found dead in railway carriage. 84 STREET LISTS OF MORT ALITY—continued. STREET OR PLACE. No. of | House, Sex. Age. Date of Death. Cause of Death. Remarks. Ludgate Hill, " King Lud." 11 F 3 days 3rd Feb. Congenital Defect of Heart Died in Lying-in Hospital, York Road. Mark Lane, Dunster House. — M 45 26th July Carcinoma of Liver On Mark Lane Station railway- F Newly born 20th Jan. Inattention at Birth Inq.—P.M. Mark Lane 7 M 13 22nd Oct. Broncho-pneumonia Died in London Hospital. Mansion House Street — M 19 2nd Feb. Crushed Skull—Fall from bicycle Resident Old Ford—P.M. Martin’s Lane 28 F 31 7th Jan. 1. Influenzal Broncho-pneumonia 2. Heart Failure Middlesex Street 110 M 59 25th Aug. Chronic Endocarditis—Chronic Bronchitis City of London Infirmary, Bow Road. ” 116 M 70 20th Oct. Syncope—Fatty Disease of Heart Died on way to Hospital— Inq..—P.M.—Natural. ” 116 M 82 25th Jan. Chr. Bronchitis—Arterio Sclerosis Died in City of London Infirmary, Bow Road. ” 116 M 74 12th Feb. Carcinoma of Pharynx and (Esophagus with Metastasis in Cervical Gland ” ” 116 M 81 17th Feb. Chr. Bronchitis Chronic Nephritis ” ” 116 M 80 16th Feb. Chronic Bronchitis— Myocardial Degeneration ” Middle Street 24 M 62 22nd Dec. In. Chr. Nephritis City of London Infirmary, Bow Road. b. Myocarditis c. Chr. Cystitis Middle Temple 6 M 73 5th June Broncho-pneumonia Heart Failure Charing Cross Hospital. Milton Street 31 M 57 21st Sept. 1. Acute Dilitation of Stomach 2. Partial Gastrectomy for Gastric Ulcer Minories 124 M 29 5th Sept. 1. Myocardial Failure Died in Stepney. 2. Mitral Stenosis ” 152 M 65 27th Feb. Myocardial Degeneration —Angina Pectoris Montague Court 2 F 65 23rd Nov. la. Carcinoma of Stomach ” 6 M 62 6th Oct. Myocardial Degeneration — Chronic Nephritis Glycosuria-Arterio Sclerosis City of London Infirmary, Bow Road. Monument Street 10 F 76 29th June Paralysis Agitans—Coma Died at I.evton. Moorgate 141 F 69 10th April 1. Cerebral Embolism St. Bartholomew's Hospital. 2. Hemiplegia Moorgate Court — M 60 2nd Feb. Acute Pneumonia Moor Lane Chambers 1 F 75 21st Dec. In. Chr. Endocarditis City of London Infirmary, Bow Road. b. Chr. Bronchitis c. Arterio Sclerosis Neville's Court, Fetter Lane. 11 M 76 9th Jan. Chronic Bronchitis with Endocardial Degeneration New Bridge Street 28 M 72 4th Feb. Malignant Disease of Stomach New Street 20 F 73 26th Aug. Acute Bronchitis—Chr. Myocarditis City of London Infirmary, Bow Road. ” 24 M 45 11th Jan. 1. Cellulitis of Foot City of London Infirmary, Thavies Inn. 2. Septicemia and Pericarditis New Street Hill 11 F 102 14th Oct. a. Cerebral Hemorrhage b. Old Age. North Block 4 M 52 17th Feb. Perforated Gastric Ulcer London Hospital. Paternoster Row 63 M 62 27th June Cerebral Haemorrhage St. Bartholomew's Hospital. Phils Buildings 7 F 77 11th July a. Gangrene of Leg b. Septic Infection c. Varicose Ulcer Police Buildings, New Street 16 M 23 mos. 1st April Diphtheria South-Eastern Hospital. Prince's Blk., Stoney Lane 6 F 92 18th Sept. Myocardial Degeneration— Hypostatic Congestion of Lungs City of London Infirmary, Bow Road. „ ,, 54 F 31 28th Jan. Asphyxiation by Coal Gas Poisoning Inq.—Unsound mind. Providence Place 3 F 84 22nd Feb. Senile Gangrene of Feet— Myocardial Failure ” 15 F 24 hrs. 5th Sept. 1. Bronchitis 2. Premature Birth Queen Street 64 F 56 14th May Carcinoma of rt. Breast—Bronchitis Died in Rochford R.D. Queen Victoria Street 120 F 48 30th Nov. Malignant Growth in the Mediastinum ” 136 M 64 22nd July Syncope due to Myocardial Degeneration of Heart Muscle, consequent upon Disease of Coronary Arteries of the Heart Resided in Holborn. River Thames (near Blackfriars). — M 28 5th Aug. Asphyxia due to Drowning- Suicide— Unsound Mind P.M. River Thames (Foreshore). — F Newly born 16th June Asphyxia by Drowning—No evidence —Open verdict Inquest. River Thames (off London Bridge). — M 45-50 25th July Asphyxia from Drowning—No evidence —Open verdict P.M.—Inquest. River Thames (Puddle Dock). — M Newly born 7th Aug. Asphyxia — Deprivation of Air to Lungs—Inattention at birth—-No evidence. Inq.—P.M. Salisbury Square 8 F 62 5th Feb. Acute Bronchitis ” 8 M 23 20th March 1. Appendicitis St. Bartholomew's Hospital. 2. Bronchial-penumonia Serjeant's Inn 17 F 48 22nd Dec. 1a. Double Lobar Pneumonia City of London Infirmary Bow Road. South Block, Stoney Lane 3 F 56 14th June Cerebral Haemorrhage 85 STREET LISTS OF MORTALITY—continued. STREET OR PLACE. No. of House Sex. Age. Date of Death. Cause of Death. Remarks. South Block, Stoney Lane 17 M 48 9th June 1. Hydated Cyst of Liver. P.M. 2. Myocarditis and Heart Failure ” ” 33 F 66 10th June 1. Syncope—Myocardial Failure 2. Myocardial Degeneration and Flatulent Dyspepsia Swan Lane 11 M 67 11th Jan. 1. Pneumonia 2. Bronchitis—Heart Failure Thavies Inn 18 F 54 8th Nov. 1 a. Cerebral Haemorrhage, b. Aneurism Resided City of London College, White Street. c. Arterio Sclerosis 2. Chr. Nephritis 18 M 6 hrs. 24th Nov. 1 a. Inanition Resided in Kensington. b. Premature Birth Trump Street 10 F 45 30th March 1. Quinsey and Cellulitis of Neck Died in St. Bartholomew's Hospital. 2. Post Tracheotomy—Cardiac Failure Tudor Street 28 M 27 13th Feb. 1. Tuberculosis—Broncho-pneumonia 2. Mastoiditis Upper Thames Street 9 M 56 17th July 1. Carcinoma of Rectum 2. Heart Failure ” 98 M 49 24th May 1. Myocardial Degeneration 2. Cardiac Failure Walbrook 27 M 50 23rd Nov. la. Pulmonary Tuberculosis ” 37 M 62 14th April 1. Carcinoma of Stomach 2. Haematemesis Wardrobe Place 3 F 65 30th Aug. Carcinoma of Bladder— City of London Infirmary, Bow Road. Cerebral Haemorrhage West Smithfield 12 M 74 30th Aug. 1. Carcinoma of Prostate 2. Uraemia following operation for removal. White Street, City of London College. F 54 8th Nov. 1 a. Cerebral Haemorrhage, b. Aneurism Died at 18, Thavies Inn. c. Arterio Sclerosis 2. Chr. Nephritis Widegate Street 21 F 55 15th Aug. 1. Heart Failure 2. Pulmonary Tuberculosis M 86 APPENDIX B.—LIST OF CASES OF INFECTIOUS DISEASE OTHER THAN TUBERCULOSIS, 1927. STREET LISTS.—COMPILED FROM NOTIFICATIONS RECEIVED. Street or Place. No. of House. Sex. Age. Disease. Date of Notification. 1927 Aldersgate Street 181 F 3½ Diphtheria 14th January. Ditto 181 F 40 1/1 0/2 Ditto 29th January. Ditto 181 M 7 Ditto 11th February. Aldgate High Street 9 M 20 Scarlet Fever 12th February. Ditto 9 M 16 Ditto 2nd February. Ditto 55 M 8 9/12 Chicken Pox 24th November. Ditto 60 M 4 7/12 Scarlet Fever 20th December. Arthur Street 8 M 21 Ditto 3rd May. Barbican Court 4 M 7 6/12 Chicken Pox 15th November. Ditto 4 M 11 Ditto 16th November. Ditto 4 M 13 Ditto 28th November. Barnet Mansions 6 F 2½ Scarlet Fever 3rd June. Billiter Square 8a F 18 Ditto 30th July. Bishopsgate 180 F 9 1/1 ½ Chicken Pox 16th July. Ditto 180 F 48 Ditto 2nd August. Ditto 180 M 12 Ditto 2nd August. Ditto 262 F 8| Ditto 16th December. Brackley Street 5 M 18 Scarlet Fever 12th October. Brushfield Street 3 M 59 Diphtheria 9th March. Ditto 6 F 8 Scarlet Fever 27th February. Cannon Street 90 F 16 1/1 0/2 Chicken Pox 13th May. Ditto 94 M 5½ Scarlet Fever 5th October. Ditto 103 F 5 Ditto 13th February. Ditto 103 M 8 Diphtheria 18th December. Charterhouse Street 8 F 11 9/12 Scarlet Fever 10th September. City of London Union — M 63 Acute Primary Pneumonia 3rd January. Ditto — M 38 Ditto 13th January. Ditto — M 40 Ditto 24th January. Ditto — M 48 Ditto 24th January. Ditto — M 74 Ditto 8th February. Ditto — M 65 Ditto 8th February. Ditto — M 58 Ditto 27th February. Ditto — M 37 Ditto 7 th November. Crutched Friars 39 M 39 Erysipelas 29th November. Devonshire Street 4 F 2 9/12 Scarlet Fever 30th November. Duke Street 7 F 15 Ditto 11th June. Garden Place 6 F 15 Ditto 31st May. Gracechurch Street 59 F 4½ Ditto 27th January. Ditto 59 F 5 8/12 Ditto 24th January. Great Tower Street 98 F 28 Puerperal Pyrexia 23rd March. Houndsditch 16 F 14½ Erysipelas 5th November. Hutchison Street 18 M 5/365 Ophthalmia Neonatorum 12th July. Ditto 19 M 4 Scarlet Fever 24th June. Ditto 20 F 30 Encephalitis Lethargica 11th August. London Fever Hospital — M 18 Scarlet Fever 12th October. Ditto — M 20 Ditto 1st February. Long Lane 83 F 8 Ditto 25th November. Middlesex Street 116 M 34 Ditto 8th August. Ditto 116 M 64 Erysipelas 26th July. Ditto 125 M 2 4/12 Diphtheria 24th March. Minories 152 M 3 1/1 ½ Scarlet Fever 24th September. Montague Court 6 F 5 Chicken Pox 13th March. Moorgate 83 M 21 Scarlet Fever 29th December. Moor Lane Chambers 10 M 62 Erysipelas 15th March. Ditto 8 F 44 Puerperal Pyrexia 24th November. Neville's Court 12 M 1 Lobar Pneumonia 13th January. New Street Square 9 M 9 1/1 0/2 Scarlet Fever 6th May. North Block 6 F 7 Ditto 25th April. Ditto 9 M 10 Diphtheria 11th February. Ditto 9 F 3 8/12 Ditto 14th March. Ditto 21 M 4 Scarlet Fever 2nd May. Ditto 38 F 10 Diphtheria 8th January. Old Jewry 26 M 11 Ditto 4th November. 87 LIST OF CASES OF INFECTIOUS DISEASE OTHER THAN TUBERCULOSIS, 1927.—continued. Street or Place. No. of House. Sex. Age. Disease. Date of Notification. 1927 P.L.A. Buildings — M 13½ Scarlet Fever 20th February. Providence Place 2 F 13 Ditto 25th April. Ditto 2 F 11 Ditto 25th April. Rose Alley 16 M 1 1/1 ½ Diphtheria 29th March. Ditto 16 M 5 7/12 Scarlet Fever 25th January. Ditto 14 M 5 Ditto 21st January. St. Bartholomew's Hospital — — — Scarlet Fever, 3 cases — Ditto — — — Diphtheria, 6 cases — Ditto — — — Encephalitis Leth., 1 case — St. Peter's Hospital — M 36 Ac. Influenzal Pneumonia 19th January. St. Paul's Cathedral, Choir House — — — Chicken Pox, 17 cases — Silver Street 13 F 13 Chicken Pox 7th March. St. Mary Axe 22 F 5 8/12 Scarlet Fever 19th January. Swan Lane 10 F 5 6/12 Ditto 18th January. Swan Street 1 M 4 Chicken Pox 15th January. South Block 11 M 13 Scarlet Fever 18th October. South-Eastern Hospital — M 5 8/12 Diphtheria 19th February. Water Lane 21 F 5 Ditto 18th January. Whistler's Court ' F 7 Ditto 4th January. M 2 88 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. Lodgers. 20, Bride Lane E. Sharpe, 20, Bride Lane 2 5 5, Britton's Court Mrs. Hurrel, 5, Britton's Court 1 6 43, Cloth Fair Mr. C. Taylor, 6, Finsbury Square, C.E. 2 2 5 45, do. W. F. Masters, 45, Cloth Fair 3 10 12, do. J. Rider, 12, Currier's Row 2 3 10, East Harding Street Eyre and Spottiswoode, East Harding Street 2 8 11, do. Do. do. 2 7 12, do Do. do. 4 9 2, Evangelist Court Morris & Co., 37, East Road, City Road 2 5 42, Fetter Lane W. Read, 102, Fetter Lane 3 6 93, do Friern Manor Dairy Co., 93, Fetter Lane 3 10 29, Fleet Lane Messrs. Watney, Combe & Reid, Stag Brewery, Pimlico 4 12 30, do. Do. do. do. 3 9 31, do. Do. do. do. 4 10 10, Great New Street Mr. Lee, 10, Great New Street 2 6 11, do. M. Quilty, 11, Great New Street 2 7 12, do. Mr. A. E. Walker, 12, Great New Street 2 9 13, do. F. Wilson, 51, Frankfort Road, Herne Hill 9 20 14, do. Mrs. A. E. Jackson, 14, Great New Street 4 9 16, do. J. Day, 16, Great New Street 3 5 21, do. Goldsmiths' Company, Goldsmiths' Hall 3 8 23, do. Mrs. J. Barnsley, 1, Great New Street 5 9 25, do. Do. do. 6 10 27, do. Do. do. 3 9 7, Green Dragon Court Gale, Heath & Sneath, 15, New Bridge Street 3 9 7, Greystoke Place Solicitors' Law Stationery Society, 104 Fetter Lane 4 4 8, do. Do. do. do. 3 7 9, do. Do. do. do. 4 13 Gunpowder Alley T. Townsend, 259, Essex Road, N. 2 6 8, do. Do. do. 4 8 25, Little Britain Mr. Turner, 25, Little Britain 3 4 79, Long Lane Robert Dyas & Sons, 63, Fore Street 2 6 4 & 5, Middle Street J. Hull & Sons, Bartholomew Close 5 10 1, Montague Court H. Tenant, 1, Montague Court 3 9 2, do. Mr. G. Hanlan, 2, do. 2 5 3, do. Mrs. Vincent, 3, do. 3 7 4, do. Mrs. F. Smith, 4, do. 3 4 5, do. Miss Saunders, 5, do. 2 8 6, do. Mr. F. J. Swain, 6, do. 3 6 8, Nevill's Court Moravian Mission, 32, Fetter Lane 3 6 9, do. Do. do. 3 8 10, do. Do. do. 7 12 11, do. Goldsmiths' Company, Goldsmiths' Hall 6 10 12, do. Do. do. 6 14 14, Newbury Street J. W. Neighbour, 2, Ironmonger Row 4 13 14, Wine Office Court Messrs. Reynolds & Eason, 192, Bishopsgate 2 5 16, do. Do. do. 2 4 17, do. Do. do. 2 2 Total 157 370 Average number of lodgers to each occupied tenement: 2.3. Houses demolished or closed as dwelling-houses 3 Tenement house on Register 48 Cleansing Notices served 75 MIDDLE DISTRICT. 1 and 2, Huggin Court City Parochial Charities Trustees, 3, Temple Gardens 5 9 9, Huggin Lane H. Belcher, 8, Martin's Lane, E.C. 5 5 10. do. H. Willis, 10, Huggin Lane 4 7 Total 14 21 Average number of lodgers to each occupied tenement : 1.5 Houses demolished or closed as dwelling-houses Tenement houses on Register 3 Cleansing Notices served 3 89 EAST DISTRICT. Situation of Premises. Name and Address of Landlord. Tenements. Lodgers. 7, Artillery Lane Clerk to Bishopsgate Institute, Bishopsgate 3 10 9, do. Claude M. Leigh, 268, Bishopsgate 3 6 21, do. Clerk to Bishopsgate Institute, Bishopsgate 3 7 10, Brushfield Street Reynolds & Eason, 192, Bishopsgate 6 7 12, do. Luke Cohen, 12, Brushfield Street 2 3 14, do. Clerk to Bishopsgate Institute, Bishopsgate 7 9 1, Circus, Minories S. Moses, 65, Mansell Street 6 21 3, do. W. Lewis, 3, Circus, Minories 3 7 4, do. W. Wisdom, 4, do. 4 8 5, do. T. Groves, 5, do. 4 4 7, do. City Corporation, Guildhall 7 8 5, Hutchison Street J. Silver, 5, Hutchison Street 1 2 6, do. J. Soloman, 6, do. 4 5 10, do. I. Levy, 10, do. 1 1 Janes Buildings, 2, Hutchison Street. City Corporation, Guildhall 3 16 3, Three Crown Court, Jewry Place. Mr. Martin, 14, Seething Lane 3 5 3, Vine Street, Minories City Corporation, Guildhall 1 4 18, Widegate Street S. Franks, 18, Widegate Street 2 5 21, do. A. & A. Field, 95, Whitechapel Road 6 6 24, do. W. I. Crane, 25, Widegate Street 3 6 25, do. Do. do. 3 4 2, Goodman's Yard Charrington, Brewers, Mile End Road 3 3 5, Artillery Lane Clerk to Bishopsgate Institute, Bishopsgate 6 9 Total 84 156 Average number of person to each occupied tenement : 1.8. Houses demolished or closed as dwelling-houses 25 Tenement houses on Register 23 Cleansing Notices served 39 90 APPENDIX D.—LIST OF ADOPTIVE ACTS, BYE-LAWS AND LOCAL REGULATIONS, RELATING TO PUBLIC HEALTH, IN FORCE IN THE CITY OF LONDON. ADOPTIVE ACTS.—Nil. ADOPTIVE ORDERS. Subject. Date adopted. Sanitary Accommodation Sanitary Accommodation Order, 1903 Sept., 1904. BYE-LAWS. Vendors of Fried Fish London County Council (General Powers) Act, 1908, Sec. 9 Jan., 1914. Fish Curers ditto ditto ditto. Slaughtering of Cattle Public Health (London) Act, 1891, Sec. 19 May, 1911. Prevention of Nuisances arising from Snow, Ice, Salt, Dust, Ashes, Rubbish, Offal, Carrion, Fish or Filth, or other matter or thing in any street City of London Sewers Act, 1897 ; Public Health (London) Act, 1891, Sec. 16 Feb., 1894. Prevention of nuisance arising from offensive matters running out of any manufactories, breweries, slaughterhouses, knackers' yard, butchers, or fishmongers' shop, or dunghill ditto ditto ditto. Prevention of keeping of animals on any premises in such a manner as to be a nuisance ditto ditto ditto. As to the paving of yards or open spaces in connection with dwelling houses ditto ditto ditto. Keeping W.C.'s supplied with a sufficient supply of water ditto ditto Sec. 37 Feb., 1894. Cleansing of Cisterns ditto ditto Sec. 50 ditto. Water Closet, Earth Closet, &c City of London (Various Powers) Act, 1900 Sept., 1909. Houses Let in Lodgings Public Health (London) Act, 1891, Sec. 94 and Housing Act, 1925, Sec. 6 Sept., 1926. Demolition of Buildings City of London (Public Health) Act, 1902, Sec. 5 July, 1904. Ash Pits City of London (Various Powers) Act, 1900, Sec. 54 June, 1925. Business of Slaughterer of Poultry Public Health (London) Act, 1891 July, 1925. Rag and Bone Dealer London County Council (General Powers) Act, 1908, Sec. 9 Jan., 1927. REGULATIONS. Soda Water Agreed regulations to control trade 1908. Hairdressers ditto ditto ditto Nov., 1904. Kitchens of Restaurants and aboveground Bakehouses ditto ditto ditto Jan., 1904. Milk Stores and Milk Shops Dairies, Cowsheds & Milkshops Order, 1885 July, 1903. Ice Cream Regulations adopted by the Corporation Nov., 1902. Common Lodging Houses City of London Sewers Act, 1851 & 1897 Oct., 1902. House Drainage Regulations adopted by the Corporation Sept., 1898. 91 APPENDIX E.—LEAFLET ISSUED RELATING TO PRECAUTIONS WHICH SHOULD BE TAKEN AGAINST INFLUENZA. Corporation of London. PUBLIC HEALTH DEPARTMENT. PRECAUTIONS AGAINST INFLUENZA. 1. The golden rule is to keep fit, and avoid infection as much as possible. 2. The way to keep fit is to cultivate healthy and regular habits, to eat good food, and to avoid fatigue, chill and alcoholism. Healthy living does not of itself ensure against attack, but it makes the patient better able to withstand the complications which kill. 3. The early symptons of influenza are usually those of a severe feverish cold. Though the actual cause of the disease is unknown, we do know that it is rapid in onset, that it is most infectious in its early stages, and that it is spread by discharges from the mouth and nose, and that it kills mainly by its complications. Every person suffering from the disease, no matter how mild the form, is a danger to others. 4. It is not always possible to avoid infection, but the risks can be lessened by— (a) healthy living ; (b) working and sleeping in well-ventilated rooms ; (c) avoiding crowded gatherings and close, ill-ventilated rooms ; (d) wearing warm clothing ; (e) gargling the throat and washing out the nostrils ; * (f) by wearing a †mask and glasses when nursing or in attendance on a person suffering from influenza ; 5. Do not waste money on drugs in the false hope of preventing infection. 6. Those attacked should— (a) go home, go to bed, and keep warm ; (b) call in a doctor ; (c) occupy, if possible, a separate bedroom or a bed that is screened off from the rest of the room ; (d) when coughing or sneezing hold a handkerchief in front of the mouth ; the handkerchief should be boiled, or burnt if of paper ; (e) use a gargle as described ; (/) be careful during convalescence in order to avoid relapse or complications ; (g) avoid meetings and places of entertainment for at least one week after the temperature has become normal. Any further information may be obtained by applying to— THE MEDICAL OFFICER OF HEALTH, Public Health Department, Guildhall, E.C.2. * The following may be used as a gargle : —A solution of common salt (one teaspoonful to a pint of warm water) to which a few crystals of potassium permanganate are added—enough to make the solution pink. † The mask, which may be made of gauze (4 layers) or butter muslin (3 layers) should cover the mouth and nose. To protect the eyes it is advisable to wear goggles. *APPENDIX F.—POSTER ISSUED RELATING TO PRECAUTIONS WHICH SHOULD BE TAKEN AGAINST INFLUENZA. Corporation of London. PUBLIC HEALTH DEPARTMENT. INFLUENZA. In view of the fact that there may possibly be a recrudescence of Influenza during the forthcoming months, employers and employees are requested to observe the precautionary measures which are set out in the pamphlet recently distributed in the City. Workers attacked with Influenza should at once be sent home. When Influenza becomes prevalent it is desirable :— (a) That workers suffering from even a slight attack of the disease, or from any form of feverish cold, should remain at home, and (b) That special care should be taken to ensure the adequate ventilation of workrooms and living rooms. Draughts, however, which chill the body surface should be avoided. There does not appear to be any necessity to disinfect rooms which have been occupied by patients suffering from Influenza. Thorough flushing of the rooms with air and the generous use of soap and water, and the washing of all articles which can be washed will suffice. Useless litter should be burnt. Infection is conveyed from the sick to the healthy by the secretions of the respiratory surfaces. In the act of coughing or sneezing, or even in loud talking, this infection may be transmitted through the air for considerable distances in the form of a fine spray. Precautionary handbills for distribution among employees may be obtained on application as below. Any further information may be obtained by applying to— THE MEDICAL OFFICER OF HEALTH, Public Health Department, Guildhall, E.C.2. * The size of the poster was 22-in. by 17-in. 92 APPENDIX G. Corporation of London. BYE-LAWS RESPECTING THE BUSINESS OF A RAG AND BONE DEALER. BYE-LAWS made by the Mayor and Commonalty and Citizens of the City of London (hereinafter called " the Corporation ") under Section 9 of the London County Council (General Powers) Act, 1908, for regulating the conduct, within the City of London, of the business of a rag and bone dealer, and with respect to the premises in or upon which such business is carried on, and the apparatus, utensils and appliances used for the purposes of or in connection with such business. 1. A person carrying on the business of a rag and bone dealer shall not use for the reception, storage or manipulation of rags, bones, fat, rabbit skins or other like articles any part of his premises in or upon which may be any article intended for human food. Provided that this Bye-law shall not apply where any such article for consumption by such dealer or any person employed by him is in or upon any part of his premises in which the sorting, dusting or grinding of rags is not carried on. 2. A person carrying on the business of a rag and bone dealer shall not knowingly bring, or cause or suffer to be brought, upon his premises any rags, bones, fat or other like articles which have been collected or obtained by any person from any dust wharf, dust or refuse heap, dust bin, dust cart, or premises wherein any infectious disease exists. Provided that this Bye-law shall not apply in respect of any article which has been obtained from any premises used by a sanitary authority for the treatment of refuse, and which has been disposed of by such sanitary authority in the ordinary course of business. 3. A person carrying on the business of a rag and bone dealer shall cause all rags, bones, fat, rabbit skins or other like articles brought on his premises in connection with his business, and which may be in an offensive condition, to be removed from the premises within twelve hours. 4. A person carrying on the business of a rag and bone dealer shall not cause or suffer rags, bones, fat, rabbit skins or other like articles to be stored or manipulated in any room or place upon his premises other than a room or place constructed and maintained in accordance with the following requirements : (a) Such room or place shall be enclosed and shall be provided with a rainproof ceiling or roof. The inner surfaces of the walls or enclosures shall be lined or covered in such a manner as will prevent effectually the harbouring of vermin and will render them capable of ready and effective cleansing. (b) Such room or place shall be provided with windows or other openings for the purposes of lighting, and the aggregate area of such windows or openings shall be not less than onetenth of the floor area of such room or place. (c) Such room or place shall have permanent openings to the external air for ventilation suitably protected by wire gauze against the entry of any article likely to ignite the contents of such room or place, and the aggregate area of such openings independent of wire gauze shall be not less than one-hundredth of the floor area of such room or place, and such openings shall be so placed as to secure efficient ventilation of the whole of such room or place. (d) The surface of the floor of such room or place shall be finished or covered in such a manner as will prevent effectually the harbouring of vermin and will render it capable of ready and effective cleansing. Provided always that this Bye-law shall not apply to the storage of rags in bales or sacks in any room or place solely used for the purpose of such storage, or to any room or place where the manipulation of rags is limited to the examination and weighing of rags at the time of purchase, and which is not used for the storage of such rags, except in sacks of small quantities, for a period not exceeding six weeks. Provided also that this Bye-law shall not until after the expiration of twelve months 93 from the date of the confirmation of these Bye-laws apply to any room or place which was on such date used for the storage or manipulation of rags, bones, fat, rabbit skins or other like articles ; nevertheless, if at any time during such period of twelve months any alteration of any such room or place shall be effected, such alteration shall be carried out in conformity with the requirements of this Bye-law. 5. A person carrying on the business of a rag and bone dealer shall not cause or suffer any rags or other materials to be stored so as to obstruct the lighting or ventilation of any receiving, sorting or storing room or place upon his premises. Provided that this Bye-law shall not apply to the storage of rags in bales or sacks in any room or place solely used for the purpose of such storage. 6. A person carrying on the business of a rag and bone dealer shall not cause or suffer any rags, bones, fat, rabbit skins or other like articles to be stored or manipulated in any room or place upon his premises used as a sleeping room or place. He shall not cause or suffer any rags, bones, fat, rabbit skins or other like articles to be stored or manipulated in any room or place upon his premises which communicates directly, otherwise than by means of a close-fitting and self-closing door, with any sleeping apartment or with any staircase or passage leading to any sleeping apartment. 7. A person carrying on the business of a rag and bone dealer— (a) Shall, except as hereinafter provided, provide upon his premises a sufficient number of vessels or receptacles properly constructed of galvanised iron or other non-absorbent material and furnished with closely fitting covers for the purpose of receiving, storing, and conveying away from his premises bones and fat and the dust and refuse resulting from rag sorting on his premises. Provided that with respect to the receiving, storing and conveying away of bones the vessels or receptacles to be provided may consist of well-tarred bags kept closed at all times when such bags are not being emptied or filled. (b) Shall cause all bones and fat brought on his premises in connection with his business to be placed and stored in such vessels or receptacles and to be removed from the premises at least once in every seventy-two hours either in such vessels or receptacles or in like vessels or receptacles provided by the person removing such bones and fat. (c) Shall at the close of every working day cause all dust and refuse resulting from rag sorting on his premises to be gathered up and either burned in a suitable fireplace or put into such vessels or receptacles. If such dust and refuse be put into such vessels or receptacles he shall at least once a week cause such dust and refuse to be removed from such vessels or receptacles and forthwith burned in a suitable fireplace, or he shall cause such dust and refuse to be removed from the premises at least once a week either in such vessels or receptacles or in like vessels or receptacles provided by the person removing such dust and refuse. 8. A person carrying on the business of a rag and bone dealer shall cause all floor surfaces, yards, hauling ways, fittings and window lights of the premises in or upon which his business is carried on, and all utensils and appliances used for the purposes of or in connection with his business, to be cleansed as often as may be necessary to ensure thorough cleanliness and to prevent the harbouring of vermin. 9. A person carrying on the business of a rag and bone dealer shall cause the inner surfaces of the walls and the ceilings or inner surfaces of the roofs of such parts of his premises as are used for the purpose of his business to be thoroughly limewashed as often as may be necessary to ensure effective cleanliness and to prevent the harbouring of vermin. Provided always that this Bye-law shall not apply in the case of any such ceilings and inner surfaces of walls and roofs painted with oil and varnished if such ceilings and surfaces be thoroughly cleansed as often as may be necessary to ensure effective cleanliness and to prevent the harbouring of vermin. Provided also that this Bye-law shall not apply to any part of the premises used solely for the storage of rags in bales or sacks or to any room or place where the manipulation of rags is limited to the examination and weighing of rags at the time of purchase, and which is not used for the storage of such rags, except in sacks of small quantities, for a period not exceeding six weeks. 10. A person carrying on the business of a rag and bone dealer shall keep and maintain the premises in or upon which his business is carried on, and the apparatus, utensils and appliances therein used for the purposes of or in connection with his business, in a proper state of repair, so as to ensure thorough cleanliness and to prevent the harbouring of vermin. 11. A person carrying on the business of a rag and bone dealer shall cause the surface of every yard and hauling way in or upon which his business may be carried on and upon which any rags, bones, fat, rabbit skins or other like articles may be deposited to be properly paved with impervious material. He shall cause every such yard and hauling way to have a proper slope and channel towards a trapped drain inlet, and to be effectually drained by adequate drains communicating with a public sewer. 94 Provided that this Bye-law shall not until after the expiration of twelve months from the date of the confirmation of these Bye-laws apply to any such yard or hauling way in or upon which on such date the business of a rag and bone dealer may have been carried on ; nevertheless, if at any time during such period of twelve months any alteration of such yard or hauling way shall be effected, such alteration shall be carried out in conformity with the requirements of this Bye-law. 12. A person carrying on the business of a rag and bone dealer who shall offend against any of the foregoing Bye-laws shall be liable for every such offence to a penalty of five pounds. Provided, nevertheless, that the Court before whom any information may be laid, or any proceedings may be taken in respect of any such offence, may, if the Court think fit, adjudge the payment as a penalty of any sum less than the full amount of the penalty imposed by this Bye-law. Examined, A. F. I. PICKFORD, City Solicitor. The Common Seal of the Mayor and Commonalty and Citizens of the City of London was affixed to these Bye-laws at a duly constituted Meeting of the Court of Common Council held on the 3rd day of February, 1927, and in my presence. JAMES BELL, Town Clerk. Allowed by the Minister of Health this 5th day of April, 1927. E. H. RHODES, Assistant Secretary, Ministry of Health. In pursuance of the powers conferred on me by Section 9 (5) of the London County Council (General Powers) Act, 1908, as regards any business carried on in any factory or workshop to which the Factory and Workshop Act, 1901, applies, I hereby allow the foregoing Bye-laws. W. JOYNSON-HICKS, One of His Majesty's Principal Secretaries of State. Whitehall, 14th April, 1927.