c. 1 Ac 434 LON 55 REPORT OF THE MEDICAL OFFICER OF HEALTH OF THE CITY OF LONDON FOR THE YEAR 1929 LONDON. Printed by Drake, Driver & Leaver, Ltd., Rosebery Avenue E.C.I. 1930 REPORT OF THE MEDICAL OFFICER OF HEALTH OF THE CITY OF LONDON For the Year 1929. LONDON. Printed by Drake, Driver & Leaver. Ltd., Rosebery Avenue, E.C.I. 1930. INDEX. A. paGe. ANNUAL RATEABLE VALUE 7 APPENDICES 79 AREA 7 ARTIFICIAL CREAM ACT, 1929 43 ARTIZANS' DWELLINGS. STONEY LANE 58 ATMOSPHERIC POLLUTION AND SMOKE 25 B. BACTERIOLOGICAL EXAMINATIONS' 15 BIRTHS 8 INFANT WELFARE 11 NOTIFICATION 11 BUTTER FACTORIES 35 c. COURTS, SUMMER FLUSHING OF — 63 LIMEWASHING OF 63 CREMATIONS 29 CONGRESSES—ROYAL INSTITUTE OF PUBLIC HEALTH 25 —ROYAL SANITARY INSTITUTE 25 —NATIONAL ASSOCIATION FOR THE PREVENTION OF TUBERCULOSIS 25 —SANITARY INSPECTORS' ASSOCIATION 25 D. DENSITY 7 DIPHTHERIA—ANTI-TOXIN 15 DISINFECTANTS, SUPPLY OF 74 DISINFECTION OF SECOND-HAND CLOTHING 73 DRAINAGE PLANS 62 E. EXHUMATION AND REINTERMENT OF BODIES AT CITY OF LONDON CEMETERY 65 „ „ „ 102, FETTER LANE AND PLAYHOUSE YARD 64 F. FACTORY AND WORKSHOP ACT, 1901—ABOVEGROUND BAKEHOUSES 66 —FACTORIES. WORKSHOPS AND WORKPLACES 65 —OUTWORKERS 66,71 —SUMMARY OF INSPECTIONS 65 —SUMMARY OF WORK DONE 67 -UNDERGROUND BAKEHOUSES 66 FERTILIZERS AND FEEDING STUFFS ACT, 1926 72 FISH SUPPLIES AND SEIZURES 52 FLY NUISANCE 64 FOOD AT RIVERSIDE WHARVES, INSPECTION AND CONDEMNATION 56 FOOD AND DRUGS. SUPERVISION OF 32 G. GULLIES, STREET 63 H. HAIRDRESSERS AND BARBERS SHOPS 25 HOUSES LET IN LODGINGS 61 HOUSE, TRADE AND OTHER REFUSE REMOVAL 63 HOUSING 62 HUMAN REMAINS—EXHUMATION AND REINTERMENT AT CITY OF LONDON CEMETERY 65 102, FETTER LANE AND PLAYHOUSE YARD 64 I. ICE CREAM 73 INFANTILE MORTALITY 8 INFANT WELFARE 11 INFECTIOUS DISEASE 11 „ „-BACTERIOLOGICAL AND PATHOLOGICAL EXAMINATIONS 15 „ v—DIPHTHERIA ANTI-TOXIN . 15 „ „—MEASLES 14 „ „ —NOTIFICATION OF 11 „ „-NURSING PROVISION MEASLES, ENCEPHALITIS LETHARGICA, CEREBROSPINAL FEVER AND INFLUENZA 14 „ „—SMALLPOX 14 „ „-TEMPORARY ISOLATION ACCOMMODATION, 29, MIDDLESEX STREET 15 „ „—TUBERCULOSIS 15 to 31 „ „—VENEREAL DISEASES 22 INFLUENZA 14 VACCINE 15 INTRODUCTION 7 INDEX (continued). l. page. LEGAL PROCEEDINGS—SANITARY 63 LIMEWASHING OF COURTS 63 LODGING HOUSES, COMMON—116, MIDDLESEX STREET 62 REGISTERED 60 M. MARGARINE, REGISTRATION OF DEALERS IN MARGARINE AND MARGARINE CHEESE 35 MEASLES 14 MEAT INSPECTIONS 43 „ „-CASEOUS LYMPHADENITIS 46 „ „—DELIVERIES AT CENTRAL MARKETS 52 „ „—EXPORT OF MEAT 51 „ „—HOME-KILLED MEAT SEIZED 46 „ „—INSTRUCTION OF MEDICAL PRACTITIONERS 52 „ „—INSPECTION OF BRITISH MEAT 45 „ „—LEADEN HALL MARKET AND CITY SHOPS 50 „ „—PROSECUTIONS 51 „ „—PUBLIC HEALTH (MEAT) REGULATIONS, 1921 53 „ „—QUICK FREEZING OF MEATS 46 „ „—TUBERCULOSIS IN PIGS 45 „ „-UNSOUND MEAT REMOVED FROM COLD STORES 49 MEDICAL EXAMINATIONS 77 MIDDLESEX STREET, NO. 29. TEMPORARY ACCOMMODATION 15 MILK—BACTERIOLOGICAL AND CHEMICAL EXAMINATIONS FOR TUBERCULOSIS AND DIRT (RAILWAY STATIONS) 30 „—CHEMICAL EXAMINATION OF 33 „—PUBLIC HEALTH (DRIED MILK) REGULATIONS, 1923 35 „-MILK AND CREAM REGULATIONS P H. (CONDENSED MILK) REGULATIONS 35 „-MILK AND DAIRIES (AMENDMENT) ACT, 1922 34 „-MILK AND DAIRIES ORDER, 1926 34 MORTALITY 8 „—INFANTILE 8 „—MATERNAL 11 „—VIOLENCE 8 „—PHTHISIS 8 „—ZYMOTICS 8 MORTUARY—DISINFECTION OF CLOTHING FOR EXPORT, INQUESTS, Etc. 73 „—PRESERVATION OF BODIES OF UNKNOWN DEAD 73 N. NOTIFICATION OF BIRTHS ACT, 1907, AND INFANT WELFARE WORK 11 o. OFFENSIVE BUSINESSF:S— L.C.C. (GENERAL POWERS) BILL, 1930 65 OVERCROWDING 63 P. PIGEONS—L.C.C. (GENERAL POWERS) ACT, 1927 64 POPULATION 7 PUBLIC HEALTH (CONDENSED MILK) REGULATIONS, 1923 35 „ „—(DRIED MILK) REGULATIONS, 1923 35 „ „—(MEAT) REGULATIONS, 1924 53 „ „— (PREVENTION OF TUBERCULOSIS) REGULATIONS, 1925 21 „ „—(PRESERVATIVES, &c., IN FOOD) REGULATIONS, 1925-27 33 „ „-(TUBERCULOSIS) REGULATIONS, 1912-1924 21 PUERPERAL FEVER OR PUERPERAL PYREXIA 15 R. RAILWAY STATIONS—SAMPLES OF MILK 30 RATEABLE VALUE . 7 RAT REPRESSION 74 REFUSE REMOVAL 63 s. SALE OF FOOD AND DRUGS ACTS—ADMINISTRATIVE ACTION REGARDING SAMPLES REPORTED TO BE NOT GENUINE 36 „„ —PROSECUTIONS 42 „„—SUMMARY OF ARTICLES EXAMINED UNDER SALE OF FOOD AND DRUGS ACTS 40 SANITARY DEFECTS AND INFECTIOUS DISEASE 63 SANITARY INSPECTIONS 59 SEWER, DEFECTIVE CONNECTIONS 63 SEWER EMANATIONS 64 SHELTER FOR TEMPORARY ACCOMMODATION, 29, MIDDLESEX STREET 15 SMALLPOX 14 SMOKE AND ATMOSPHERIC SOLUTION 25 STAFF 5 STATISTICAL INFORMATION 10 STREET GULLIES 63 T. TUBERCULOSIS 15 to 21 „-PUBLIC HEALTH (PREVENTION OF TUBERCULOSIS) REGULATIONS, 1925 21 „—TRAINING OF HEALTH VISITORS 21 TYPHOID AND SHELLFISH 15 V. VACCINATION 10 VENEREAL DISEASES 22 VIOLENT DEATHS 8 VITAL STATISTICS 10 SANITARY STAFF. MEDICAL OFFICER OF HEALTH. Date of Appointment. willoughby, Willoughby Mason, B.A., M.D., B.C. (Cantab.), D.P.H. (Camb.) May, 1928 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. 2nd Class Assistant May, 1924 Lee, Wm. J. 3rd Class Assistant Oct., 1915 Spalding,C. A. (died 25/5/29) 3rd Class Assistant March, 1918 Threadgold, 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. Robbins, Francis Joseph Grade I. Sept., 1892 Ralph, William Holden Grade I. June, 1898 Robinson, Ernest S. Grade I. Feb., 1913 Fowler, George Henry Grade I. Oct., 1920 McGrath, William Richard Grade II. Mar., 1922 Harrington, George Edwin Grade II. Dec., 1925 Sillet, David Ernest Grade II. April, 1926 Fisher, Stanley G. Grade II. July, 1928 Neale, William G. C.Grade II. July, 1928 Tyler, Albert Grade II. July, 1928 Mayne, John W., Temporary Rat Officer Oct., 1916 SANITARY INSPECTORS AND MEAT INSPECTORS. Sharp, J. Owen, Senior Inspector May, 1892 Mettam, Harry Grade I. Dec., 1903 Bintcliffe, Charles E. Grade I. March, 1907 Matson, William S. Grade I. Dec., 1910 Mitchener. William E. Grade I. Dec., 1910 Jones, John Grade I. April, 1914 Slatter, Charles Grade II. May, 1908 King, George G. Grade II. April, 1910 Murray, Samuel B. Grade II. Sept., 1911 Mellish, Cyril E. Grade II. Jan., 1912 Thompson, Frederick Grade III. July, 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 Mann, Ernest V. Jan., 1928 Lawrence, Charles J. Feb., 1928 B annual report of the medical officer of health for the year 1929. To the Right Honourable the Lord Mayor, Aldermen and Commons of the Corporation of London. Public Health Department, Guildhall, E.C. July, 1930. My Lord Mayor and Gentlemen, I have the honour of presenting my Report on the work of this Department for 1929. I would refer to the absence, over some months, of your Veterinary Officer in Australia and New Zealand, and recall the useful report on his close observations which he presented on his return. I have to regret the death, in December, 1929, of Mr. E. A. Pinchin, B.Sc., F.I.C., Public Analyst for the City since June, 1923; for many years previously he had assisted the former Public Analyst, Dr. F. L. Teed, as also that of Mr. C. A. Spalding, third-class Assistant in the Meat Inspection Department, who was of eleven years' service. 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 (1928).—City of London, Registration District, at night, 17.3 persons to an acre; City of London, Registration District, during the day, *644.1 persons to an acre; Registration London, at night, 59.5 persons to an acre. Annual Rateable Value.—The rateable value of property within the administrative county of London (including the City) was £57,487,536 on April 6th, 1929, whilst on the same date the corresponding rateable value of property in the City of London was £8,333,539, or about one-seventh of the whole County. The sum receivable from a penny rate is £34,310. 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. Private Statute Families. Acres. 1911. 1921. 1911. 1921. 1921. City of London (Not including the Temple) 661 2,784 2,398 19,657 13,709 3,174 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. Night Population. City Census. Day Population. 1861 112,063 1866 170,133 1871 75,983 — 1881 51,405 261,061 1891 37,705 301,384 1901 26,923 — 1911 19,657 364,061 1921 13,709 436,721 (Imperial Census). There is only one registration district in tne City. The estimated population of the City for the year 1929 is 10,700. * 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 The day Census taken in 1911 showed that the day population was 364,061 persons, and also that 1,077,155 persons and 94,095 vehicles entered and left the City on the day the count was taken. Births.—During the year 1929, 424 births were registered in the City, 377 of which, however, did not belong thereto. To the remaining 47 must be added the births of 33 children born to citizens temporarily residing outside the City boundary. The number of births, therefore, on which the rate should be calculated is 80, one of which was a still birth. The annual birth-rate was 7.4 per 1,000 persons of all ages, compared with a quinquennial mean rate of 7.5 per 1,000. In the Metropolis the birth-rate in 1929 was 15.7 per 1,000. Mortality.—During the year under review, 721 deaths were registered in the District, including 657 persons dying in the City, but not belonging thereto. See table, p. 9, for details. Deducting these latter, 64 deaths remain, to which must be added those of 86 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 1929 was 14.0 per 1,000 per annum of the population (the previous year being 12.2), whilst that for the whole of the Metropolis was 15.7. Deaths from Violence.—Of the City deaths, 2.7 per cent. were caused by injuries or violence, as compared with 2.7 in 1927 and 2.8 in 1928. This is 1.8 below the average for the previous five years. PERCENTAGE OF REGISTERED DEATHS FROM VIOLENCE. Year. City of London. Per cent. Metropolis. Per cent.[/###} 1924 5.3 4.4 1925 4.4 4.6 1926 7.2 4.8 1927 2.7 5.1 1928 2.8 5.5 Average previous five years 4.5 4.9 1929 2.7 5.6 DEATH RATES, PER 1,000 PER ANNUM. Year. City of London. 107 Great Towns of England and Wales. Metropolis. 1924 11.3 12.3 12.1 1925 11.7 12.2 11.7 1926 10.4 11.6 11.6 1927 11.5 12.2 11.9 1928 12.2 11.6 11.6 Average previous five years 11.4 12.0 11.8 1929 14.0 13.7 13.8 The death rate from zymotic disease per 1,000 of the population was 0.19. The deaths from Phthisis correspond to a rate of 0.28 per 1,000 of the population, as compared with 0.96 in the Metropolis. Infantile Mortality.—The deaths of children under one year of age were at the rate of 62 per 1,000 births, as against 70 for the whole of London. 9 causes of, and ages at, death during the year 1929. Causes of Death. Nett Deaths at the sijbjoinf.d 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 5 .... 1 2 3 14 58 34 33 607 l. Enteric Fever .... .... .... .... .... .... .... .... .... .... 1 2. Small-pox .... .... .... .... .... .... .... .... .... .... .... 3. Measles .... .... .... .... .... .... .... .... .... .... 4. Scarlet Fever .... .... .... .... .... .... .... .... .... .... .... 5. Whooping Cough .... .... .... .... .... .... .... .... .... .... 1 6. Diphtheria 2 .... .... l 1 .... .... .... .... .... 1 7. Influenza 6 1 .... .... .... 1 1 3 .... .... 1 8. Encephalitis Lethargica .... .... .... .... .... .... .... .... .... .... .... 9. Meningococcal Meningitis .... .... .... .... .... .... .... .... .... .... 4 10. Tuberculosis of respiratory system 3 .... .... .... .... 1 1 1 .... .... 15 11. Other Tuberculous Diseases 1 .... .... .... .... .... 1 .... .... .... 8 12. Cancer, malignant disease 15 .... .... .... .... .... 1 8 4 2 81 13. Rheumatic Fever .... .... .... .... .... .... .... .... .... .... 7 14. Diabetes .... .... .... .... .... .... .... .... .... .... 10 15. Cerebral Haemorrhage, &c. 4 .... .... .... .... .... .... .... 3 1 7 16. Heart Disease 47 .... .... .... .... .... 3 15 14 15 51 17. Arterio-sclerosis 2 .... .... .... .... .... .... 1 1 .... 6 18. Bronchitis 7 .... .... .... .... .... .... 3 1 3 18 19. Pneumonia (all forms) 13 .... .... .... .... .... 1 9 3 .... 55 20. Other respiratory diseases 1 .... .... .... .... .... - .... .... .... 1 17 21. Ulcer of Stomach or Duodenum 2 .... .... .... .... .... 1 1 .... .... 16 22. Diarrhoea, &c .... .... .... .... .... .... .... .... .... 4 23. Appendicitis and Typhlitis 2 .... .... .... .... 1 1 .... .... 7 24. Cirrhosis of Liver 1 .... .... .... .... .... .... 1 .... .... 6 25. Acute and Chronic Nephritis 14 .... .... .... .... .... 1 3 4 6 21 26. Puerperal Sepsis .... .... .... .... .... .... .... .... .... .... 4 27. Other accidents and diseases of Pregnancy and Parturition .... .... .... .... .... .... .... .... .... .... .... .... 28. Congenital Debility and Malformation, Premature Birth 1 1 .... .... .... .... .... .... .... .... 15 29. Suicide 2 .... .... .... .... .... .... 2 .... .... 2 30. Other deaths from Violence 2 .... .... .... .... 1 .... 1 .... .... 48 31. Other Defined Diseases 25 3 .... .... 1 .... 3 9 4 5 199 32. Causes ill-defined or unknown .... .... .... .... .... .... .... .... .... .... 2 Totals 150 5 1 2 3 14 58 34 33 607 10 VITAL STATISTICS OF WHOLE DISTRICT DURING 1929 AND PREVIOUS YEARS. Name of District: CITY OF LONDON. [###3]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 3 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 1928 11,430 427 82 7.2 735 64.30 665 70 5 60 140 12.2 Average previous 5 years 12,868 400 99 7.5 725 56.56 657 79 8 81 147 11.4 1929 10,700 424 80 7.4 721 67.38 657 86 5 62 150 14.0 Area of City of London in acres (land and inland water) 661 Total population at all ages 13,706 Number of inhabited houses 2,922 Average number of persons per house 4.6 At Census 1921. Vaccination.—Of the 427 births notified to the Vaccination Officer during 1929, 109 had been successfully vaccinated by the end of the year, 12 had died before the age for vaccination. Vaccination was postponed by medical certificate in 3 cases, 172 had removed into other districts, or the vaccinations were pending at the end of the year. There were 131 instances of conscientious objection. The Public Vaccinator performed 2,520 re-vaccinations during the year, and in addition to the 109 successful vaccinations referred to above, 433 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. 1924 418 per cent. 27.3 per cent. 0.2 per cent. Nil. per cent. 3.3 per cent. 0.5 per cent. 50.3 per cent. 18.4 1925 330 26.9 Nil. „ 4.3 1.8 43.4 23.6 1926 390 26.4 „ „ 4.6 Nil. 49.2 19.7 1927 421 25.9 „ „ 4.7 „ 44.9 24.5 1928 432 31.1 „ „ 4.4 „ 38.4 26.1 Average previous 5 years. 398 27.5 0.04 „ 4.3 0.5 45.2 22.5 1929 427 25.5 Nil. „ 2.8 0.8 40.2 30.7 11 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, 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. 418 notifications of birth, made in accordance with the requirements of the Notification of Births Act, were received. Of these, 86 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 226 visits were made as a consequence of notifications received, and also that 337 special visits were made in connection with infant welfare. Five visits were also made in respect of cases coming within the scope of the Children Act, 1908, all in relation to nurse children and 10 in connection with verminous school children notified under the London County Council (General Powers) Act, 1904. MATERNAL MORTALITY. The investigation into maternal deaths which the Ministry of Health now require to be conducted has not called for any particular organisation in my department. There are very few deaths per annum among the City resident population, and such few maternal deaths as occur will be investigated by me. It may be of interest to note that, from 1900 to 1929 inclusive, only 14 maternal deaths have occurred among City residents. INFECTIOUS DISEASES. Few comments are necessary with reference to the incidence of infectious disease during the year 1929. Diphtheria was prevalent to the extent of 21 cases compared with 23 in 1928. The number of Scarlet Fever cases was 31, compared with 25 in 1928. There were 3 cases of Erysipelas. Measles and German Measles are not notifiable diseases and only 4 cases of the former illness were brought to my notice by medical practitioners and through the medium of the school medical service. Ten cases of Chicken-pox were notified, 10 of Acute Primary Pneumonia, 1 case of Acute Influenzal Pneumonia, 1 of Amoebic Dysentery, and 4 of Smallpox. No case of Ophthalmia Neonatorum was reported. 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 63. 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. 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 4 .... 3 l .... .... .... 4 Diphtheria 22 l 16 4 l 1 .... 21 Scarlet Fever 35 4 30 l .... 1 3 31 Enteric Fever (including Para-typhoid) .... .... .... .... .... .... .... .... Puerperal Fever .... .... .... .... .... .... .... .... Puerperal Pyrexia .... .... .... .... .... .... .... .... Erysipelas 3 1 .... .... 2 .... .... 3 Cerebro-spinal Meningitis .... .... .... .... .... .... .... .... Acute Polio-myelitis .... .... .... .... .... .... .... .... Ophthalmia Neonatorum .... .... .... .... .... .... .... .... Malaria contracted abroad .... .... .... .... .... .... .... .... Acute Primary Pneumonia 10 1 .... .... 9 .... .... 10 Acute Influenzal Pneumonia 1 1 .... .... .... .... .... 1 Encephalitis Lethargica .... .... .... .... .... .... .... .... Amoebic Dysentery 1 .... .... .... l .... .... 1 Totals 76 8 49 6 13 2 3 71 Chicken-pox 10 8 .... 1 l .... l 9 Measles 4 1 .... 1 2 .... .... 4 German Measles .... .... .... .... .... .... .... .... Totals 90 17 49 8 16 2 4 84 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 1929 compared with the figures for the previous five years:- In no case was it necessary to apply for an order for compulsory removal to hospital. Year. Number of cases reported. Per cent. of cases reported. ed to Hospital. Treated at home. 1924 22 95.5 .... .... 4.5 1925 49 89.8 .... .... 10.2 1926 91 97.8 .... .... 2.2 1927 61 90.2 .... .... 9.8 1928 51 96.0 .... ... 4.0 Average for the five years 55 93.8 .... .... 6.1 1929 60 90.0 .... .... 10.0 13 CASES OF INFECTIOUS DISEASE AND TUBERCULOSIS NOTIFIED DURING THE YEAR 1929. 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 years and under 4 years. 4 years and under 5 years. 5 years and under 10 years. 10 years and under 15 years. 15 years and under 20 years. 20 years and under 35 years. 35 years and under 45 years. 45 years and under 65 years. 65 years and over. Small-pox 4 .... .... .... .... .... .... 1 2 1 .... .... .... 4 Cholera .... .... .... .... .... .... .... .... .... .... .... .... .... .... Plague .... .... .... .... .... .... .... .... .... .... .... .... .... .... Diphtheria 21 .... .... 1 1 1 5 3 .... 9 1 .... .... 20 Erysipelas 3 .... .... .... .... .... .... .... 1 .... 2 .... .... 3 Scarlet Fever 31 .... .... 1 1 1 12 6 .... 9 1 .... .... 27 Typhus .... .... .... .... .... .... .... .... .... .... .... .... .... .... Enteric „ (including Para-typhoid) .... .... .... .... .... .... .... .... .... .... .... .... .... .... Relapsing „ .... .... .... .... .... .... .... .... .... .... .... .... .... .... Continued „ .... .... .... .... .... .... .... .... .... .... .... .... .... .... Puerperal „ .... .... .... .... .... .... .... .... .... .... .... .... .... .... Puerperal Pyrexia .... .... .... .... .... .... .... .... .... .... .... .... .... .... Polio-myelitis .... .... .... .... .... .... .... .... .... .... .... .... .... .... Cerebro-spinal Meningitis .... .... .... .... .... .... .... .... .... .... .... .... .... .... Pulmonary Tuberculosis 16 .... .... .... .... .... .... .... 2 8 1 4 1 9 Other forms of Tuberculosis 1 .... .... .... .... .... .... .... .... 1 .... .... .... .... Ophthalmia Neonatorum .... .... .... .... .... .... .... .... .... .... .... .... .... .... Measles 4 .... .... .... .... .... 1 .... .... 3 .... .... .... 3 Rubella .... .... .... .... .... .... .... .... .... .... .... .... .... .... Chicken Pox 9 .... .... .... .... .... 6 .... .... 2 1 .... .... 2 Malaria (contracted abroad) .... .... .... .... .... .... .... .... .... .... .... .... .... .... Acute Primary Pneumonia 10 .... .... .... .... .... 1 .... .... 2 .... 6 1 9 Acute Influenzal Pneumonia 1 .... .... .... .... .... .... .... .... .... .... 1 1 1 Encephalitis Lethargica .... .... .... .... .... .... .... .... .... .... .... .... .... .... Amoebic Dysentery 1 .... .... .... .... .... .... .... .... .... 1 .... .... 1 Totals 101 .... .... 2 2 2 25 10 5 35 7 11 2 79 * Metropolitan Asylums Board Hospitals, London Fever Hospital, City of London Infirmary, St. Bartholomew's Hospital, City Police Hospital, Sanatoria, &c. C SMALL-POX. The general incidence of Small-pox throughout London and its vicinity during 1929 made a very heavy demand upon the services of the staff, and in order to deal adequately with the control of the many contacts working in the City, it was necessary to make some temporary readjustment of duties, and matters which might be regarded as of a somewhat routine character have been allowed to remain in abeyance in order to avoid the necessity of engaging additional assistance. This rearrangement has, I feel, affected to some extent the figures reported under the Factories and Workshops Section of this Report. In all, 176 cases of Small-pox, either resident, working, or otherwise associated with the City, were notified. Of these, four only actually resided within the one square mile, and ten other cases, not resident, were diagnosed on City premises. It is not these cases, however, which call for special effort in the City, but the 162 other cases, who reside outside but were engaged within the City during the day time. These cases have almost invariably been in contact with a number of fellow-workers, and there were in all 8,370 persons ascertained as being contacts with City cases. It is the supervision of this large number which has necessitated the readjustment referred to above. Every effort is made to encourage immediate vaccination of each of these contacts, as it is recognised that this is the first and greatest public health measure in Small-pox control. The Corporation, during the year, expressed the opinion that this should be enforcible by law, and have also determined to make Chicken-pox, which is liable to be mistaken for the present mild type of Small-pox, temporarily notifiable in the City for a period of six months. A voluntary system of notification has been in force for some years, and has resulted in the notification of many cases, but, of course, not to the extent which would result from a Statutory obligation. RECEPTION AND TREATMENT OF MEASLES. During the course of every Measles Epidemic in London a time almost invariably arrives when the demand for hospital accommodation is greater than that which is available, and cases are then only accepted for admission on the recommendation of the appropriate medical officer of health, who bases his recommendation on— (1) The type of house and facilities therein available for the proper care of the patient; (2) The fact that the patient is under the age of two years when the case mortality is high; and (3) Whether broncho-pneumonia co-exists with the measles. By reason of the fact that measles is not a notifiable disease, medical practitioners are often not aware that hospital accommodation is available or the conditions under which patients are admitted, and I have therefore addressed an appropriate communication to members of the profession practising within the City, and inviting them to communicate with me in cases where hospital treatment is desired. NURSING PROVISIONS. 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 1929. INFLUENZA. In the early part of the year the very rapid spread of Influenza in the United States of America and Canada suggested the desirability of precautionary measures being instituted in this country, in order to minimise the incidence of the illness 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 the Banks, Insurance Companies, Railway Companies, Shipowners, Stock Exchange, etc. They were also circulated to City residents and exhibited at the Police Stations and other places in the City. A communication was also forwarded to medical practitioners in the City, enclosing a copy of the Ministry of Health's memorandum on the malady, and offering nursing assistance in such cases as came before their notice where difficulty was experienced in this direction. Copies of this pamphlet and posters are included in the Appendix to this Report. 14 15 PUERPERAL FEVER OR PUERPERAL PYREXIA. In the course of research work into the method of infection in women suffering from Puerperal Fever or Puerperal Pyrexia, evidence has been obtained which suggests that the contamination does not arise from the hands, but probably from the throat of the attendant, as an air-borne infection. In order that this theory may be further investigated the Metropolitan Asylums Board have asked medical practitioners to swab the throat of the nurse or midwife in attendance, and to forward the swab direct to the Board's Laboratory, for examination. The Board invited the assistance of your Medical Officer of Health in the direction of acquainting City medical practitioners with the proposal, and the consequent co-operation which I suggested was readily accepted by my professional City colleagues. TYPHOID FEVER AND SHELLFISH. Only one instance of suggested association of Typhoid Fever with shellfish was brought to my notice in 1929. A resident in one of the Metropolitan Boroughs was reported as suffering from Typhoid Fever, and upon inquiry it was ascertained that shortly before being taken ill, he-had consumed winkles purchased from a wholesale dealer in Billingsgate Market. It was not possible to identify the source of the suspected winkles as, upon arrival at the wholesaler's premises, all supplies were mixed. It was, however, ascertained that there was one unusual source of supply during the period affected, and the attention of the Fishmongers' Company was particularly directed to this point, when the matter was reported to them. The systematic examination of winkles on the same lines as obtains in the case of oysters was suggested, and the matter is now receiving the attention of the Fishmongers' Company. DISTRIBUTION OF DIPHTHERIA ANTI-TOXIN AND ANTI-INFLUENZA 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 1929. Examination for Pathogenic Bacteria.—During the year the following specimens were so dealt with. It will be seen that positive results were obtained in about 1 per cent. of these cases. Result. Specimen. Disease suspected. Positive. Negative. 30 Swabbings from throats Diphtheria 4 26 21 Sputa Tuberculosis 4 17 Of the 30 swabbings from throats, six were received from the Central Foundation School for Girls, Spital Square, E.C. 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. The Dispensary was open for the diagnosis and treatment of Tuberculosis through the year at the following hours:— Tuesdays 12.30 p.m.—2.30 p.m. 2.30 p.m.—4.30 p.m. For the Artificial Pneumothorax Clinic. Wednesdays 5.0 p.m.—7.0 p.m. Thursdays 11.30 a.m. (New cases only.) Fridays 2.0 p.m.—3.0 p.m. In all, 278 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 346, as compared with 403 last vear. 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. Non-Resident. Total. 22 146 168 „ Surgical „ 2 5 7 „ Dental „ 3 5 8 ,, Throat ,, 1 10 11 „ Pathological „ .... 5 5 „ Other „ — 20 20 28 191 219 16 Patients Admitted to the Hospital for Diagnosis.—The wards of the Hospital are available for the reception of cases presenting difficulties of diagnosis, which can only be overcome by observation as In-patients. Nine resident and 24 non-resident patients were admitted for this purpose. Examination of Sputum.—The following is a summary:— Positive City Residents. Non-Residents. Total. 8 34 42 Negative 42 99 141 Residential Treatment.—The number of patients for whom residential treatment was arranged was 75. Admitted to Poor Law Other St. Colvmbas Hosp. L.C.C. Institutions. Institutions. Institutions. Corpn. Expense. Total. Patients resident in the City 14 — 9 — 23 Patients non-resident 38 9 5 — 52 52 9 14 — 75 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.—(i.) 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 64. In addition, a large number of contacts are kept under observation. (ii.) 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 136. Total Attendances:— Total. Residents 322 Non-Residents 1,268 1,590 The total attendances for 1929 show an increase of 54 over those for 1928. In view of the fact that the 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. Columba's Hospital, Swiss Cottage. These facilities were not utilised in 1929. Artificial Pneumothorax.—Artificial pneumothorax treatment has been used again during the year. Artificial pneumothorax was induced in three cases and 225 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. Sixty-two homes have been visited, and 228 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. For this purpose 30 visits were made. General.—The following information is supplied in accordance with the requirements of the Ministry of Health:— (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. (ii.) Patients are referred to the Tuberculosis Dispensary from hospitals, school clinics and other institutions, with all of which there is close co-operation. The services of the Staff and all the resources of St. Bartholomew's Hospital are available for diagnosis and treatment. Many patients are referred to departments of the Hospital for these purposes. (iii.) 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. 17 (iv.) 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. (v.) 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. (vi.) 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, 18 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. (vii.) 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. (viii.) 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. (ix.) 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 about £30 has been expended. (x.) 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. (xi.) 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. (xii.) No local arrangements exist for providing employment for patients. (xiii.) No opportunity has arisen for the use of a shelter, but arrangements would be made for any suitable case if a site was available. (xiv.) 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. (xv.) The usual method for preventing the spread of infection is adopted, and pocket sputum flasks are provided free of cost. (xvi.) 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. (xvii.) 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 1929, 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. Non-Pulmonary. m. f. m. f. m. f. m. f. 0 .... .... .... .... .... .... .... .... 1 .... .... .... .... .... .... .... .... 5 .... .... .... .... .... .... .... .... 10 .... .... .... .... .... .... .... .... 15-20 .... 2 .... .... 1 .... .... .... 20-25 2 3 .... 1 .... .... .... .... 25-35 2 1 .... .... .... .... .... .... 35-45 1 .... .... .... 2 .... .... .... 45-55 3 .... .... .... 1 .... .... .... 55-65 1 .... .... .... .... .... .... .... 65 and upwards 1 .... .... .... .... .... .... .... Totals 10 6 .... 1 4 .... .... .... * The present lady members of the Committee are Lady Cooper, O.B.E., Miss Crosby, M.B.E., and Lady Smith. 18 RETURN SHOWING THE WORK OF THE DISPENSARY DURING THE YEAR 1929. 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 5 6 .... .... l 1 .... .... 6 7 .... .... (b) Doubtfully tuberculous .... .... .... .... .... .... .... .... .... 1 .... .... (c) Non-tuberculous .... .... .... .... .... .... .... .... 4 3 .... 1 B.—CONTACTS examined during the year:- (a) Definitely tuberculous .... .... .... .... .... .... .... .... .... .... .... .... (b) Doubtfully tuberculous .... .... .... .... .... .... .... .... .... .... .... .... (c) Non-tuberculous .... .... .... .... .... .... .... .... 3 9 8 6 C.—CASE written off the Dispensary Register as— (a) Cured .... .... .... .... .... .... .... .... .... .... .... .... (b) Diagnosis not confirmed or nontuberculous (including cancellation of cases notified in error) .... .... .... .... .... .... .... .... 7 12 8 7 D.—NUMBER OF PERSONS on Dispensary Register on Dec. 31st, 1929:— (a) Diagnosis completed 24 20 2 1 4 1 .... 1 28 21 2 2 (b) Diagnosis not completed .... 1 .... .... .... .... .... .... .... 1 .... .... 1. Number of persons on Dispensary Register on January 1st, 1929:— 45 2. Number of patients transferred from other areas and of " lost sight of"cases returned 2 3. Number of patients transferred to other areas and cases "lost sight of" 5 4. Died during the year 2 5. Number of observation cases under A (b) and B (b) above in which period of observation exceeded two months— 6. Number of attendances at the Dis- pensary (including Contacts) 322 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— 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 1 (b) Otherwise 6 11.Number of other visits by Tuberculosis Officers to Homes— 12. Number of visits by Nurses or Health Visitors to Homes for Dispensary purposes and Nursing 228 Nursing visits for Tuberculous Patients 30 13. Number of (a) Specimens of sputum, &c., examined 50 (b) X-ray examinations made in connection with Dispensary work 22 14. Number of Insured Persons on Dis- pensary Register on the 31st December 24 15. Number of Insured Persons under Domiciliary Treatment on the 31st December 7 16. Number of reports received during the year in respect of Insured Persons (a) Form G.P. 17— (b) Form G.P. 36— NON-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 88 77 5 4 9 8 l 1 97 85 6 5 (b) Doubtfully tuberculous .... .... .... .... .... .... .... .... 2 (c) Non-tuberculous .... .... .... .... .... .... .... .... 35 52 11 5 B.—Number of City workers attending Dispensary for treatment on Dec. 31st, 1929 50 C.—Number of Non-Resident and Non-Workers attending Dispensary for treatment on Dec. 31st, 1929 58 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 1929, ARRANGED ACCORDING TO THE YEARS IN WHICH THE PATIENTS FIRST 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. 1928. 1929. Class T.B. minus. 1 Class T.B. plus. Class T.B. minus. Class T.B. plus. Class T.B. minus. Class T.B. plus. Class T.B. minus. Class T.B. plus. j 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) 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. Adults. M 3 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... F 2 ... 1 .... 1 1 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Children. M 2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... F .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Disease not arrested. Adults. M 2 1 4 2 7 1 .... 1 .... 1 .... .... 1 .... 1 1 1 1 9 1 .... 2 1 3 F 1 2 .... 2 1 .... 1 1 1 .... 1 1 2 2 .... .... .... .... 3 2 1 .... 3 Children. M .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... F .... .... .... .... .... 1 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Condition not ascertained during the year 2 .... .... ... .... .... .... .... .... .... 1 .... .... .... .... .... .... .... .... .... .... .... .... .... .... Lost sight of or otherwise removed from Dispensary Register 14 2 12 3 17 2 .... 1 1 3 1 .... 3 2 5 5 .... .... 1 1 .... 1 .... .... 1 Dead. Adults. M 1 1 2 5 8 .... .... 1 3 4 .... .... .... 3 3 1 .... .... 2 2 .... .... .... .... .... F .... .... .... 3 3 .... .... .... .... .... .... .... .... 1 1 .... .... .... 1 1 .... .... .... .... .... Children. Ml .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... f| .... .... .... .... .... .... .... .... 1 1 .... .... .... ... .... .... .... .... .... .... .... .... .... .... .... Totals 29 4 21 13 38 6 .... 3 7 10 3 .... 5 7 12 9 1 1 4 1 6 4 3 3 1 7 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. 1928. 1929. 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. 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 l .... .... .... l .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Disease arrested. Adults. M l .... .... l .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... F .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Chil dren. M .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... F .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Disease not arrested. Adults. M .... .... .... .... .... .... .... .... .... .... 1 .... .... l 2 .... .... .... .... .... l .... .... .... l F l .... .... .... l .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Chil dren. M .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... F .... .... .... l 1 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Transferred to Pulmonary — .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Condition not ascertained during the year .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Lost sight of or otherwise removed from Dispensary Register 4 l l 2 8 2 .... .... 2 l .... 1 .... .... .... .... .... .... .... .... .... 1 Dead. Adults. M .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... F .... .... .... .... .... .... .... .... .... .... l .... .... 1 .... .... .... .... .... .... .... .... .... .... Children. M .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... ........ .... .... .... .... F .... .... .... .... .... .... .... .... .... ..... .... .... .... .... .... .... .... .... .... .... .... Totals 7 l l 3 12 2 .... .... .... 2 3 .... .... l 4 .... .... .... .... 0 l .... .... l 2 PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1912. Summary of Notifications during the period from the 1st January to the 28th December, 1929, in the City of London; Notifications on Form A. Notifications on Form B. † Number of Notifications on Form C AGE-PERIODS Number of Primary Notifications.* Total Notifications on Form A Number of Primary Notifications.* Total Notifications on Form B. Poor Law Institutions. sanatoria. 0 to 1 1 to 5 5 to 10 10 to 15 15 to 20 20 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 and upwards Total Primary Notifications. Under 5 5 to 10 10 to 15 Total Primary Notifications. Pulmonary Males .... .... .... .... .... 2 2 1 3 1 1 10 11 .... .... .... Nil. Nil. 1 3 „ Females .... .... .... .... 2 3 1 .... .... .... .... 6 8 .... .... .... „ „ .... 3 Non-pulmonary Males .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... „ „ „ ,, ,, Females .... .... .... .... .... 1 .... .... .... .... .... l 1 .... .... .... „ „ .... .... Col. (1 (2) (3) (4) (5) (6) (7) (8) (9) (10) 11) (12) (13) (14) (15) (16) (17) (18) (19) (20) (21) Patients notified as suffering from both pulmonary and non-pulmonarv disease have been included among the "pulmonary" returns only. All notifications on Form D have been disregarded in preparing this return. * Primary notifications relate to patients who have not previously been notified in this or former years, either on Form A or on Form B, in the area to which the return relates. Any additional notification of a case which has been previously notified in the area is regarded as duplicate. (Note,—No primary notifications should be made on Form C ) † A School Medical Inspector, or the Medical Officer of Health of a county, county borough, or other district, if acting as a School Medical Inspector, is required to notify on Form B all cases of tuberculosis discovered in the course of inspection of children attending public elementary schools whether or not these have previously been notified. Cols. 2-13. Only those cases which have been notified for the first time during the year on Form A in the area concerned, and which have never previously been notified in the area, either on Form A or on Form B, have been included in these columns. Col. 14. The object of this column is to show the extent to which duplicate notification of the same case occurs on Form A, and all notifications on Form A, whether duplicate or not, are included in this column. Cols. 15-18. Onlv those cases which have been notified for the first time during the year on Form B in the area concerned, and which have never previously been notified in the area, either on Form A or on Form B, have been included in these columns. Col. 19. All notifications which have been made during the year on Form B in the area concerned, whether the cases have previously been notified in the area, or not, either on Form A or on Form B, have been included in this column. (These figures agree with those furnished to the Ministry of Health for the period 1st January, 1929, to 29th December, 1929.) 20 21 PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1912 & 1924. New cases of Tuberculosis which have come to the knowledge of the Medical Officer of Health or Chief (Administrative) Tuberculosis Officer during the period from 1st January, 1929, to 28th December, 1929, otherwise than by notification on Form A or Form B. Age Periods. 0 to 1 1 to 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 Cases. Pulmonary Males .... .... .... .... .... .... l .... .... .... 1 Pulmonary Females .... .... .... .... .... .... .... .... .... .... .... .... Non-pulmonary Males .... .... .... .... .... .... .... .... .... .... .... .... Non-pulmonary Females .... .... .... .... .... .... .... .... .... .... .... .... The source or sources from which information as to the above-mentioned case was obtained is stated below:— Source of Information. No. of Cases. Pulmonary. Non-pulmonary. Death Returns (i.e., from Local Registrars, or transferable deaths from Registrar General) 1 .... "Transfers" from other areas (other than transferable deaths) .... .... Forms C and D (in respect of cases not previously known to the M.O.H.) .... .... Other Sources, e.g., posthumous notifications .... .... Number of cases of Tuberculosis remaining on the Register of Notifications on 31st December, 1929:— Males. PULMONARY. NON-PULMONARY. Females. Total. Males. Females. Total. Total Cases. 33 24 57 3 2 5 62 TUBERCULOSIS DISPENSARY.—TRAINING OF HEALTH VISITORS. Arrangements have been made that the facilities available at the Tuberculosis Dispensary shall be placed at the disposal of the College of Nursing, in order that that body can give to their Health Visitor Students a short course of practical experience in Tuberculosis work as undertaken by a Tuberculosis nurse. These will doubtless prove of considerable value in the future training of Health Visitors. 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 Tuberculous affections and who are engaged in certain occupations associated with the milk trade. d 22 VENEREAL DISEASES. The following is a brief summary of the work carried out at the Special Treatment Centre for Venereal Diseases during the year 1929:— At the beginning of the year 324 males and 98 females were registered on the books as being under treatment or observation, which compares with 392 males and 82 females at the beginning of the previous year. Of these patients 201 males and 70 females were under treatment for syphilis and 123 and 28 females for gonorrhoea. No patients were under treatment for conditions other than venereal disease. New patients admitted totalled 498 as compared with 476 in the previous year, and 425 in 1927 and 485 in 1926. 41 males and 6 females suffering from syphilis discharged themselves before completing the first course, and 20 males and 7 females after completing the first course, but before completion of treatment. 2 males and 1 female completed treatment, but failed to submit themselves to final test; 5 males and 2 females were transferred to other centres after treatment for syphilis, whilst 7 males and 1 female were discharged after completion of treatment and observation. In the case of gonorrhoea, 55 males and 23 females, out of the total of 377 and 68 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 14,095, which total is made up as follows:— Syphilis. Soft Chancre. Gonorrhoea. Non-Veneral Conditions. Total Attendances. Male. Female. Male. Female. Male. Female. Male. Female. Male. Female. 4,494 2,160 — — 6,223 1,104 84 30 10,801 3,294 In the interests of economy, In-patient treatment has been discontinued. In the laboratories associated with the Centre 6,834 specimens were examined, 24 for the detection of spirochetes, 941 for gonococci, 5,697 examinations for the Wassermann or Sigma test, and 172 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 W'assermann or Sigma test in respect of these patients:— London For Syphilis. No. of patients treated. For Gonorrhoea. For Non-Venereal Conditions. For Spirochetes. Examinations. For Wassermann or For Gonococci. Sigma Test. For Non-Venereal Reactions. Conditions. .... 124 246 108 24 906 5,689 212 Essex 2 1 3 — 4 3 — Herts — 1 — — 3 — — Surrey 2 3 1 — 16 4 — Kent 1 0 2 — 2 1 — Sussex — 2 — — 10 — — Totals .... 129 255 114 24 941 5,697 212 Included in the above total were *4,451 examinations for the Wassermann or Sigma test at the request of general practitioners. No 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. 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, 1929 Syphilis. Soft Chancre. Gonorrhoea. Conditions other than Venereal. Total Males Females Males Females Males Females Males Females Males Females I. Number of cases which— (a) at the beginning of the year under report were under treatment or observation for 201 70 .... .... 123 28 .... .... 324 98 (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 14 4 .... .... 36 3 .... .... 50 7 105 Total—Items 1 (a) and 1 (b) 215 74 .... .... 159 31 .... .... 374 2(a). Number of cases dealt with at the Treatment Centre during the year for the first time with infections of 1. less than one year's standing. 28 10 .... .... 154 37 .... .... 182 47 2. more than one year's standing. 66 25 .... .... 64 .... 84 30 214 55 Total*—-Items 1 (a), 1 (b) and 2 (a) 309 109 .... .... 377 68 84 30 770 207 2(6). Number of cases included in Item 2 (a) known to have received previous treatment at other Centres for the same infection 14 11 .... .... 27 7 .... .... .... .... 3. Number of cases which ceased to attend— (a) before completing the first course of treatment for 41 6 .... .... 55 23 .... .... 96 29 (b) after one or more courses but before completion of treatment for 20 7 .... .... .... .... .... .... 20 7 (c) after completion of treatment, but before final tests as to cure of 2 1 .... .... 14 .... .... .... 16 1 4. Number of cases transferred to other Treatment Centres after treatment for 5 2 .... .... 5 10 .... .... 10 12 5. Number of cases discharged after completion of treatment and observation for 7 1 .... .... 120 4 .... .... 127 5 6. Number of cases which, at the end of the year under report, were under treatment or observation for 234 92 .... .... 183 31 .... .... 417 84 123 30 Total*—Items 3, 4, 5. and 6 309 109 .... .... 377 68 .... .... 770 207 7. Out-patient attendances:- (a) For individual attention bv the Medical Officer 4,494 2,160 .... .... 2,649 756 .... .... 7,143 2,916 (b) For intermediate treatment, e.g., irrigation, dressings,etc. .... .... .... .... 3,574 348 84 30 3,658 378 Total Attendances 4,494 2,160 6,223 1,104 84 30 10,801 3,294 8. Aggregate number of "In-patient days" of treatment given to persons who were suffering from .... .... .... .... .... .... .... .... .... .... 9. Examinations of Pathological material:— (a) Specimens which were examined at, and by the Medical Officer of, the Treatment Centre For detection of Spirochetes. Gonococci. Other Organ isms For Wassermann Reaction. 24 12 C.S.F. W.R. 86 86 (b) Specimens from persons attending at the Treatment Centre which were sent for examination to an approved laboratory .... 929 941 W.R. 2,901 2,796 23 The total of 1tems 1 (a), 1 (6) 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. d 2 24 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. Kent. Sussex. Herts. Surrey. Total. A.* Number of cases from each area dealt with during the year for the first time and found to be suffering from:— Syphilis 124 2 1 .... .... 2 129 Soft Chancre .... .... .... .... .... .... Gonorrhoea 246 1 2 2 l 3 255 Conditions other than venereal 108 3 2 .... .... 1 114 Total 478 6 5 2 l 6 498 B * Total number of attendances of all patients residing in each area 13,753 77 54 24 5 182 14,095 C.*Aggregate number of "In patient days" of all patients residing in each area .... .... .... .... .... .... .... D. Number of doses of Arsenobenzene compounds given in the:— .... .... .... .... .... .... .... 1. Out-patient Clinic 1,549 10 7 .... .... 14 1,580 2. In-patient Dept to patients residing in each area. .... .... .... .... .... .... .... E. Give the names of Arsenobenzene compounds used in the treatment of syphilis and the usual initial and final dcses. Neosalvarsan. Novarsenobillon. Neokharsavan. Stabilarsen. 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. c Pot. Iod. 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 three occasions at weekly intervals. FEMALE. Films and sometimes cultures from cervic, urethra and Bartholin's glands (if necessary) after at least three successive menstrual periods, after cessation of treatment. 12/29. (Signed) KENNETH M. WALKER, Medical Officer of the Treatment Centre. •The totals in Item A should agree with the corresponding totals in Item 2 (a) on the previous page, and the totals in Items B and C should agree with the respective totals in Items 7 and 8 on the previous page. 25 Certain evidence indicated that the public were not sufficiently aware of the facilities which the Corporation provide for the treatment of venereal diseases. Appropriate posters have, therefore, been exhibited in the several underground conveniences in the City. A copy of the poster is appended (Appendix F). CONGRESSES. Royal Institute of Public Health, at Zurich, 15th-20th May, 1929. Royal Sanitary Institute, at Sheffield, 13th-20th July, 1929. National Association for the Prevention of Tuberculosis:— (1) Conference on Hygiene and Welfare of Merchant Seamen, at Geneva, 7th-9th October, 1929; (2) Fifteenth Annual Conference, at Newcastle-upon-Tyne, 10th-12th October, 1929. Sanitary Inspectors' Association, at Lowestoft, 2nd-7th September, 1929. The Corporation were represented at each of the first three of the Conferences referred to above, and the report of the delegates is contained in Appendix E of this Report. One of the Sanitary Inspectors was permitted to attend the Conference of the Sanitary Inspectors' Association at Lowestoft, and he reported that several interesting and instructive papers were read. Certain comprehensive resolutions upon the Housing question, and another on the administration of the Public Health (Meat) Regulations, were passed and forwarded to the appropriate authorities. 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. Price, 69, Fore Street. Samuel & Harry Cohen, trading as Cohen & Co., 120, Newgate Street. SMOKE AND ATMOSPHERIC POLLUTION. Thirteen 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. 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 theM eteorological 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 1929, 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. 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 four milligrammes per cubic metre of air ; this latter figure includes times when there has been a fog. 26 SMOKE ABATEMENT. Smoke and fog are to be understood from their chemistry of meteorology respectively. Given the chemistry of coal and of its combustion products and the chemistry of building stone and their mortars, certain inferences could easily be made as to possible and probable damage to buildings. It is noteworthy that such inferences are fully supported by the chemical facts in analysis of rotted building faces and stone tracery. The relative heats of combustion in factory and domestic fires, as well as a consideration of their respective types of coal, whether hard steam or caking coals, would lead to a suggestion that the domestic chimney might be a large offender in the matter of the soot-tar deposited on our buildings and occasionally in our nostrils. Again, accurate chemical analysis of the deposits in chimneys and parts of chimneys, and on buildings, supports the lines of general inference very fully and with such accuracy as to leave little of our more general observations unexplained. The floating about in air and the deposit of acid soot or acid tar (the acid being sulphuric acid) is more than half our difficulty as to damage and discomfort in smoke nuisance, and the domestic chimney is responsible for more than half this difficulty, even in the manufacturing towns of the north, and for more than half in the City of London. The withholding of light by the deposit of soot on the green leaf, which is the food factory of the plant, has occupied the chemical and biological experimenters, and again the effects are what might have been expected on general principles. The respiration of the plant is choked by soot, the green leaves are stunted and fall before their time, partly under the action of the acid, which is introduced into the myriad mouths of the leaf with the soot. Not all the acid is in soot, however; much is gaseous in the air, and when dissolved in rain, falls on herbage and soil; the herbage it destroys in proportion to the quantity of acid present, the soil it deteriorates by continuance of its mortal influences on the bacteria of the soil and interference with their particular duties in the economy of the community. Like soot, the free acid gas in the air can be carried to long distances and then thrown to earth by rain, but unlike soot, is much more rapidly diffused to larger distances, and, of course, does not interfere with light. The detail of all these considerations can be very readily found in Cohen and Ruston's book, "Smoke. or a Study of Town Air," together with so comparatively slight, but so sufficiently detailed figures and wealth of correlated experiment by the distinguished chemists who have applied themselves to the science of coal smoke, as makes the book at once popular and scientific, a difficult accomplishment, but of immense service to a community, because numbers must realise and realise accurately, the way in which modification may most reasonably be attempted, if adequate protection is to be afforded us. The tree, the blade of grass, the bacillus, are seen to be affected by tar and sulphuric acid—what of animal life ? Nobody in town but experiences in fog, which, apart from town, arises, and in the main is dissipated at a touch of sun, a sense of night running into night without natural light. The fog does not clear, and the less it clears the less its tendency to clear, because of the circlet of tar which prevents the vaporisation of the mist drop. The longer the fog hangs, the yellower it becomes, because it blankets the rising smoke and the more acid become its moist particles. To the sense of depression arising from an absence of that "pleasant thing it is to behold the day," is added a sense of discomfort to eyes and nostrils and that irritation of the throat which come from the acid tar, to say nothing of the grime of it. To get a true view of the above mere personal bodily discomforts of yellow fog, imagine the individual experience multiplied by millions: that constitutes a mass of comparative inefficiency and absolute and positive ill worth considerable thinking over if it can be avoided by taking thought. Not so striking, but none the less ever present in winter time, even in strong gales down the wind, is the grey to brown haze which is an effective heat and light screen. This hangs about on days which people will consider are reasonably fine days with plenty of light, but is really a dense pall. Coming from Holland towards the Straits of Dover and the Channel, from fifteen miles distant I have seen this pall streaming off England over the Channel: ourselves in bright sunshine, with the coast of Belgium and France in bright visibility at first, and then a gloom of smoke on entering the Channel. I have run up the East Coast in blazing sun, with a light summer easterly air holding a pall to the west of us throughout 100 miles of travel. Under that pall the day may be reckoned fine, but it is a dull day by comparison. This was industrial smoke mainly, for no householder who could avoid it would have lighted any fire that blazing day. 27 In the matter of light and the effect of deprivation thereof, I would suggest as a theoretical consideration which is probably not far from the truth, that the English, being a mixed race of northern and southern peoples, long blended and showing blond and dark children even in the same families, while different families trend to the predominating blond or the predominating dark have suffered, will suffer and are suffering to a vast extent from a smoky urbanisation. The southerner grows pale or tans to meet a variation in sunlight, the northerner used to less sun, can have too much of it. The past summer can have been very trying to some constitutions, but dull, dark winters can be more so to all, because of an unnatural cooping indoors which follows the general change of the race life to urbanisation. The point is, that in many diseases, and particularly tuberculosis, a little matter of heartening hygiene, such as natural sunlight and sun warmth, or even diffused daylight in winter, may turn the scale in favour of the patient's life. Nature could and would, of course, select, and according to thirty-five years' old information, has been selecting over a number of generations, whether a lighter or darker English race should predominate. but why should not human intelligence be thinkingly made, as it indeed is a part of Nature in this matter: it would be a better nature and one containing less struggle for the generations to come. Nor is the patient alone or chiefly to be considered; the preventive branch in medicine thinks of the prospective patient, who is turned back from the danger point before defined illness sets in. This is the truly economical treatment for the people. While on the subject of tuberculosis, one should emphasise that there is a very definite and well-known antecedent to the disease, a hardened fibre of lung, induced by inhalation of fine particles of silicious grit; it were good that complete combustion of tars be not effected with an increase in grit—a problem the engineers are setting themselves to solve for the forced draught chimney. But with these lengthy preliminaries, what is the root of the matter for London as to both cause and cure. The cause is the domestic chimney burning household coal, and for Central London more particularly the office chimney; the cure is smokeless heating, whether by electricity, gas, or a smokeless solid fuel. I think it will have been the experience of everybody that a still atmosphere in a room is oppressive, often the case with electric, gas or central heating, and does not occur in presence of an open fire, which extracts the air of a room through an open chimney, the fresh air finding its way in through every crevice, even though visible apertures be shut. The whole matter is involved in the eternal problem of ventilation; it should be well understood that a moving atmosphere is an essential to health and activity of brain or finger, and that the want of this is just the failure of electricity and gas in the heating of a room; to sneeze or cough into a still atmosphere means that bacteria are floating in the room for a definitely longer time than in the case of a moving atmosphere, and the cloud of bacteria is massed instead of spread. To inhale a few catarrhal bacteria may be a stimulant to the body's reaction, and is probably one of our protective mechanisms over the winter. Just as certainly to inhale a large number produces a cold; ventilation must be maintained on the counts of alertness and protection from illness in every office. It can be maintained by the open grate at a certain expense of fuel, for, of course, much heat goes up the chimney in carrying the air with it. The fog of the still winter's night is white; at nine o'clock a.m. it changes to yellow, to brown, to black over the metropolis. This is the expression of the lighting and maintaining of countless fires with smoky coal. The fog hangs and increases in density, and at long last, in the presence of a light westerly air, may drift, has drifted en masse above the river until, though the lower air be clear so that there is three miles of perfect visibility, even twenty-five miles away the overhead pall has produced there the darkness of midnight, causing incoming ships to put up port, starboard and masthead lights. This was an extreme phenomenon; the more usual is that the town and country to leeward are involved in the tarry mass and shipping is stopped completely. Will every ordinary fireplace burn a smokeless fuel such as low temperature carbonisation products? The answer is No! But many fireplaces, especially those with a long chimney, will. My experience with a ground floor office is that a low temperature carbonisation product, practically smokeless, is cheaper, cleaner, warmer and more regulable than coal: the fire is always bright, has its flicker to a certain extent; moreover, a slow combustion draught preventer had to be fitted. Where, on experiment, these products can be, they should be burned as a partial solution of London's great problem: that in winter the finest weather, i.e., the days of high barometer 28 and stillish air, is turned to murk and grime by the domestic hearth burning domestic coal. The very successful gas-and-coke fires are the variants with low temperature carbonised fuel, and these should be developed and made available. The time of turnover to the awaited perfect system of ventilation and heating is, in my opinion, most easily and satisfactorily filled in by gas and coke in combination, and by low temperature carbonisation products burned in the open hearth, which thus gives the cheer of a sufficient flicker, adequate movement of air ventilation in a room with closed doors, and a minimal quantity of smoke. It is grand to consummate a great scheme of change: it is more in the realm of practical evolution to proceed gradually along the lines which have been ingrained in English domestic economy where the household chimney is at fault. SUMMARY OF MONTHLY OBSERVATIONS AND REPORTS DURING THE YEAR 1929. Month of the Year 1929. 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 (S0a). Chlorine (CI). Ammonia (NH3). January Meteorological Office 22 0.20 2.82 5.42 0.97 2.68 12.09 0.94 0.74 0.06 Golden Lane 18 0.10 3.05 4.74 1.32 3.36 12.58 1.13 1.17 0.15 Victoria Park 22 0.07 1.68 2.21 1.10 1.75 6.81 1 .05 0.33 0.04 February Meteorological Office 15 0.14 1.79 4.60 0.83 3.87 11.23 0.71 0.40 0.02 Golden Lane 11 0.09 3.83 6.27 1.55 2.74 14.50 0.94 0.73 0.08 Victoria Park 11 0.07 1.43 2.31 0.53 1.36 5.70 0.64 0.22 0.03 March Meteorological Office 2 0.13 1.31 2.41 0.51 0.91 5.27 0.32 0.24 0.02 Golden Lane 2 0.04 1.43 2.63 0.82 1.68 6.60 0.66 0.99 0.02 Victoria Park 1 0.04 0.25 0.26 0-30 0.77 1.62 0.39 0.10 0.03 April Meteorological Office 25 0.15 1.18 2.41 1.43 2.99 8.16 0.82 1.14 0.09 Golden Lane 15 0.16 3.37 5.83 0.86 2.70 12.93 1.12 0.79 0.14 Victoria Park 27 0.20 2.61 5.75 0.87 1.78 11.21 0.74 0.31 0.08 May Meteorological Office 22 0.09 1.24 2.19 0.63 1.52 5.67 0.40 0.46 0.03 Golden Lane 31 0.09 2.00 3.57 1.76 2.39 9.81 0.82 0.80 0.19 Victoria Park 44 0.14 2.10 5.33 1.24 3.47 12.28 1.19 0.47 0.12 Tune Meteorological Office 18 0.13 1.30 1.90 0.99 1.56 5.88 0.64 0.38 0.04 Golden Lane 21 0.06 1.52 3.01 1.97 2.14 8.70 0.90 0.64 0.17 Victoria Park 23 0.10 1.28 2.12 0.42 1.17 5.09 0.50 0.18 0.05 July Meteorological Office 35 0.11 1.39 3.21 1.18 2.02 7.91 0.94 0.47 0.05 Golden Lane 51 0.10 2.27 3.83 2.89 3.88 12.97 1.12 0.94 0.28 Victoria Park 44 0.08 1.43 3.66 0.98 1.60 7.75 0.92 0.27 0.10 August Meteorological Office 44 0.06 0.77 1.68 0.98 1.69 5.18 0.88 0.27 0.05 Golden Lane 55 0.08 2.25 4.18 2.41 3.07 12.01 1.20 0.78 0.22 Victoria Park 44 0.08 1.08 2.37 0.62 1.24 5.39 0.64 0.19 0.08 September Meteorological Office 4 0.05 0.51 1.31 0.31 0.84 3.02 0.39 0.12 0.01 Golden Lane 5 0.07 1.15 2.19 0.09 1.05 5.15 0.37 0.27 0.05 Victoria Park 5 0.04 0.85 1.97 0.38 1.29 4.53 0.63 0.15 0.05 October Meteorological Office 70 0.14 1.19 2.74 1.26 2.25 7.58 1.11 0.53 0.11 Golden Lane 64 0.15 3.70 6.55 3.06 5.86 19.33 2.18 1.13 0.31 Victoria Park 68 0.08 1.26 2.11 0.41 2.33 6.19 0.74 0.30 0.09 November Meteorological Office 68 0.22 1.97 4.20 1.50 2.05 9.94 1.01 0.62 0.11 Golden Lane 109 0.15 2.54 3.97 5.22 2.61 14.49 1.79 1.55 0.30 Victoria Park 120 015 1.86 3.95 1.20 3.13 10.29 1.44 0.60 0.12 December Meteorological Office 81 0.22 1.64 3.83 1.61 3.87 11.17 1.16 1.42 0.11 Golden Lane 96 0.17 2.29 3.63 3.92 6.13 16.14 1.71 2.31 0.29 Victoria Park 86 0.11 2.14 2.50 1.54 3.95 10.24 1.42 1.08 0.09 29 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 48,385 cremations took place during 1928, 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. CREMATIONS IN THE UNITED KINGDOM. 45 YEARS—1885-1929. YEAR. Woking.* Manchester Glasgow. Liverpool. Hull. Darlington. Leicester. Golder's Green. Birmingham. Leeds. City of London. Sheffield. Bradford. W. Norwood. Hendon Park. Pontypridd. Bristol. Ipswich. Edinburgh. (Opened 3/10/29). No. of Cremations each year. 1885 3 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 3 1886 10 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 10 1887 13 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 13 1888 28 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 28 1889 46 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 46 1890 54 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 54 1891 99 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 99 1892 104 3 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 107 1893 101 30 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 131 1894 125 47 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 172 1895 150 58 1 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 209 1896 137 52 10 2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 201 1897 173 51 16 10 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 250 1898 240 62 12 27 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 341 1899 240 88 16 23 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 367 1900 301 83 20 40 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 444 1901 273 96 18 40 17 1 .... .... .... .... .... .... .... .... .... .... .... .... .... 445 1902 275 81 20 54 13 2 1 5 .... .... .... .... .... .... .... .... .... .... .... 451 1903 143 92 24 35 18 1 5 158 1 .... .... .... .... .... .... .... .... .... .... 477 1904 138 98 19 40 20 7 8 220 19 .... .... .... .... .... .... .... .... .... .... 569 1905 95 97 35 35 15 4 16 252 22 16 9 7 1 .... .... .... .... .... .... 604 1906 140 90 44 46 17 13 12 298 25 15 23 6 14 .... .... .... v .... 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 38 68 1,459 150 59 95 57 50 279 11 22 .... .... .... 3,265 1928 344 367 141 103 72 39 61 1,483 157 60 103 51 45 306 11 20 71 2 .... 3,436 1929 426 443 185 103 97 55 124 1,797 205 66 99 81 47 410 14 28 116 37 20 4,353 Totals 7,119 5,900 1,980 1,881 1,011 496 849 20590 1,865 745 1,294 725 520 3,042 72 101 187 39 20 48436 *"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 th? late Sir Henry Thompson at the opening of Golder's Green Crematorium, 22nd Nov"ember, 1902. Vide "Transactions of Cremation Society of England, 1903." p. 31. † Closed for reconstruction from August, 1913, to July, 1914. e 30 BACTERIOLOGICAL AND CHEMICAL EXAMINATIONS OF MILK. SAMPLES COLLECTED AT RAILWAY STATIONS. In accordance with the practice which was instituted many years ago, a further series of milk samples arriving in the City from country districts was obtained at Liverpool Street Station during the months of September and October last. The samples were sent to Sir Frederick Andrewes, K.B.E., the City Bacteriologist, for bacteriological examination and investigation as to the presence of dirt, and a duplicate of each sample was also submitted to Mr. E. A. Pinchin, B.Sc., the Public Analyst, for chemical examination. Special care was exercised in the collection of the 48 samples which were sent from different farms in the following counties:— Suffolk 15 Norfolk 22 Essex 3 Cambridgeshire 2 Buckinghamshire 1 Montgomeryshire 1 Shropshire 4 The following is a copy of Sir Frederick Andrewes' report:— MILK SAMPLES FROM CITY TAKEN SEPTEMBER, 1929. No. of Sample. DIRT. Date of inoculation of guinea pig. Date of Death. P.M. findings. Result qua tubercle. 1 Clean Sept. 13 Killed Oct. 16 Normal Negative. 2 „ „ „ „ .... „ 3 „ „ Dead Oct. 1 No sign of tubercle locally or elsewhere. B. Aertrycke abscesses in spleen. " 4 „ „ Dead Sept. 15 Wasted. No evident cause for death. A few B. coli in heart blood. Experiment frustrate. 5 „ „ Dying Oct. 2— killed. No sign of tubercle anywhere. No cause of death found. Negative. 6 Traces „ Died Oct. 5 Large abscess at site of inoculation. No T.B. found in pus. B. Aertrycke abscess in spleen. " 7 ,, Sept. 17 Died Oct. 6 „ „ „ „ 8 Clean „ Died Oct. 8 „ „ „ „ 9 Traces „ Killed Oct. 24 Normal „ 10 " „ Died Sept. 17 Large abscess at site of inoculation. No T.B. found. No glandular tubercle. B. Aertrycke abscess in spleen. Experiment frustrate. 11 Clean „ Died Oct. 10 No local signs of tubercle at site of inoculation or in glands. B. Aertrycke in spleen. Negative. 12 Traces „ Dead Sept. 29 „ Experiment frustrate. 13 Clean Sept. 20 Dead Sept. 22 Acute general infection with a virulent Bacillus coli. „ 14 Traces „ „ No apparent cause of death. Infection with B. Aertrycke. „ 15 Clean „ Dead Oct. 8 No sign of tubercle anywhere. Cause of death not found. Negative. 16 „ „ Dead Oct. 4 „ „ „ „ 17 „ „ Dead Sept. 27 Large local abscess; no tubercle bacilli found in pus. No sign of tubercle anywhere. Cause of death not found. Experiment frustrate. 18 „ „ Dead Sept. 30 No sign of tubercle anywhere. Infection with B. Aertrycke. „ 19 Daces Sept. 24 Killed Oct. 24 Normal Negative. 20 21 „ Clean „ „ Killed Oct. 23 Killed Oct. 31 No sign of tubercle anywhere; purulent pericarditis due to a hemolytic streptococcus. No sign of tubercle anywhere. Infection with B. Aertrycke. „ 22 Traces „ Dead Oct. 2 J „ „ „ Experiment frustrate. 23 „ „ Killed Nov. 3 Normal Negative. 24 Clean „ Dead Oct. 6 Wasted. No sign of tubercle. Some large abscesses due to a haemolytic streptococcus. „ 31 No. of Sample Date of inoculation ot DIRT. guinea pig. Date of Death. P.M. findings. Result qua tubercle. 25 Traces Sept. 27 Dead Oct. 20 No sign of tubercle anywhere. Cause of death uncertain. Negative. 20 „ „ Killed Nov. 7 Small quiescent abscess at site of inoculation. No T.B. found. Glands normal. B. Aertrycke abscesses in spleen. „ 27 „ „ No sign of tubercle anywhere „ 28 „ „ Killed Nov. 14 „ „ „ 29 Clean „ Dead Nov. 1 „ „ „ 30 Traces „ Killed Nov. 14 Early caseous regional glands—a few tubercle in spleen. T.B. microscopically and by culture. POSITIVE. 31 Clean Oct. 1 Killed Nov. 21 Normal Negative. 32 Mode-,, „ ,, ,, rately dirty. „ „ „ „ 33 Traces „ „ „ „ 34 „ „ „ .„ „ 35 Clean „ Killed Nov. 25 ,, „ 36 Traces „ Dead Oct. 6 No sign of tubercle anywhere. B. Aertrycke abscesses in spleen. Experiment frustrate. 37 Clean Oct. 8 Killed Nov. 25 Normal Negative. 38 „ „ „ „ „„ „ 39 „ „ Killed Nov. 28 No sign of tubercle anywhere. B. Aertrycke abscess in one testis. „ 40 Traces „ Killed Nov. 25 Normal „ 41 Clean „ Killed Nov. 28 ,, „ 42 Traces „ Dead Nov. 19 No sign of tubercle anywhere. Cause of death doubtful. „ 43 Clean Oct. 11 Killed Nov. 28 Normal „ 44 „ „ ,, „ .... .... .... .... .... „ 45 Traces „ Killed Dec. 2 ,, .... .... .... .... .... ,, 46 47 „ „ „ Local caseous abscess. Advanced tuberculous glands. Tubercle in spleen, liver and lung. T.B. abundant microscopically and by culture. Normal POSITIVE. Negative. 48 „ Died Nov. 3 No sign of tubercle anywhere. B. Aertrycke abscesses in spleen. „ Summary.—As regards dirt, 23 out of 48 samples could be classed as clean. 24 out of 48 samples contained small traces of dirt—i.e., a number of small blackish specks in the deposit. 1 out of 48 samples was dirty, but only moderately so. As regards tubercle: for one reason or another a number of the guinea pigs died prematurely, the chief cause being an epidemic of B. Aertrycke infection in the animal house. In 9 out of the 48 guinea pigs this premature death occurred so soon after inoculation as to prevent any conclusion from the experiment. But if the animal had lived 12 to 14 days or more after inoculation, and no evidence of tubercle was to be found, this has been returned as a negative result. On this basis only 2 out of 39 milks showed the presence of tubercle, or 5.1 per cent. St. Bartholomew's Hospital, (Signed) F. W. ANDREWES. January 6th, 1930. The details in connection with the two samples in which the tubercle bacilli was present were forwarded to the appropriate Medical Officers of Health, and the following are extracts from the reports which have been received, and indicate the presence of tuberculous cattle on the farms:— Sample No. 30.—" An investigation was carried out at this farm on the 21st November, 1929, by the Acting County Medical Officer of Health. "The herd consisted of forty-six cows. Two special samples were taken. One cow was tuberculin-tested, but no milk was taken from it. The result of the examination of the milk by animal inoculation was negative. Both mixed samples and both special samples showed no tubercle bacilli. The cow which was tuberculin-tested reacted positively and was slaughtered." The Pathologist's findings were as follows:— "There were very numerous lesions in lung tissue and substance of liver and also several lesions on the peritoneum. In addition, the bronchial mediastinal hepatic and several mesenteric lymphatic glands were affected. However, according to the wording of the Order it must be shown as ' not advanced.'" E 2 32 Sample No. 46.—" The above-named farm has been visited and the Veterinary Inspector has condemned one cow under the Tuberculosis Order. The post-mortem examination on this animal showed that it was suffering from advanced tuberculosis." The following summary for the purposes of comparison is inserted, and indicates the results obtained in the series of examination of milks on arrival in the City since 1904:— Year. Percentage showing Tuberculous Infection. Year. Percentage showing Tuberculous Infection. 1904 7.7 per cent. 19.21 24.2 per cent. 1st Series. 1905 9.1 „ „ .... 26.3 ,, „ 2nd Series. 1906 8.0 „ „ .... 12.5 ,, ,, 3rd Series. 1907 8.3 „ „ 1922 9.5 „ „ 1909 12.5 „ „ 1st Series. 1923 2.6 „ „ 4.7 ,, ,, 2nd Series. 1924 12.8 „ „ 1910 6.25 „ „ 1925 2.4 „ „ 1st Series. 1912 6.6 „ „ .... 2.4 „ „ 2nd Series. 1913 10.4 „ „ 1926 „ „ 1914 10.2 „ „ 1927 4.88 „ 1915 8.5 „ „ 1928 8.3 „ „ 1917 4.2 „ „ 1929 5.1 „ „ 1919 14.8 , „ .... The chemical examination showed that, with one exception, all the samples were samples of genuine milk. The exception was found to be adulterated to the extent of 2 per cent, of added water, and when an attempt was made to secure a further sample, it was learnt that the farm had been sold. SUPERVISION OF FOOD AND DRUGS. During the year 1929, 980 samples of Food and Drugs were submitted to the Public Analyst for examination. Of this number, 662 were taken as test samples without the formalities of the Act being observed. Sixteen of these informal samples were reported against, as follows:— 5 of Sausage Preservative Powder, out of 5 samples. 3 of Sausages, out of 28. 2 of Pickles and Sauces, out of 11. 2 of Liniment of Turpentine, out of 5. 1 of Butter, out of 58. 1 of Cream, out of 13. 1 of Crushed Linseed, out of 7. 1 of Iron and Quinine Citrate, out of 2. Of the formal samples, 22 out of 318 were reported against, as follows:— 11 of Milk, out of 263 samples. 2 of Sausage Preservative Powder, out of 2. 2 of Whisky, out of 10. 1 of Cream, out of 13. 1 of Crushed Linseed, out of 1. 1 of Liniment of Turpentine, out of 2. 1 of Pickles and Sauces, out of 1. 1 of Prescription Medicines, out of 4. 1 of Rum, out of 5. 1 of Sausages, out of 1. The above-mentioned samples, with the exception of Milk, Whisky, Rum and Prescription Medicines, were taken as the result of informal samples having been reported against. General Observations.—The percentage rate of adulteration of all foods and drugs sampled in the City was 3 -8, as compared with 2.4 in 1928. Butter.—Of the 64 samples, 46 were of butter with rolls, slices of bread or scone. One informal sample served on roll was certified as containing 40 per cent. of fat not derived from milk, the formal sample in connection therewith not being taken before the close of the year. The remaining samples were certified genuine. 33 Drugs.—Six samples were found not to comply with the standards of the British Pharmacopoeia, but in no case did the circumstances warrant any action being taken beyond that of cautioning the vendors. One prescription medicine was reported against and legal proceedings were successfully instituted. Spirits.—Of the 36 samples of spirits taken, 3 were certified to be slightly below the minimum strength of 35 degrees under proof, and each of the vendors were cautioned. Cream.—Twenty-six samples were procured and, with one exception, found genuine. This exception was with reference to an informal and formal sample taken of fruit salad with cream sold in carton, the fat of the "cream" being found to contain 95 per cent. of fat not derived from milk. The vendor was prosecuted and a penalty inflicted. Of the remaining samples, 19 were of ordinary cream which had an average fat content of 48.53 per cent., and five were of clotted cream with an average fat content of 59.16 per cent., all being free from thickeners, boric acid and other preservatives. One sample of artificial cream was taken and certified genuine. Sausages.—Twenty-nine samples were purchased and in four cases were certified to contain Sulphur Dioxide preservative without disclosure by label or notice, though the amount found did not exceed the permissible limit. In each instance the vendor was cautioned. None of the four samples of preserved sausages taken was reported against. Public Health (Preservatives, etc., in Food) Regulations.—Contraventions of these regulations were reported in connection with two different brands of Sauces. In one case 0.021 per cent. of Crystallised Copper Sulphate was discovered and legal proceedings were instituted both against the manufacturers and the vendor. On service of the summons, the manufacturers immediately enquired into the origin of the prohibited colouring matter and ascertained that it was due to defective copper pans in which the sauce was made. These were forthwith replaced and full details of the steps taken to remedy the matter submitted to this Authority. Application was accordingly made for the withdrawal of the summons, which was granted on payment of three guineas costs. The other brand of Sauce reported against contained 0.0069 per cent. of Crystallised Copper Sulphate. The attention of the manufacturers was called to the matter, and on investigation by them this was found also to arise from the boiling pans used. The manufacturers immediately undertook remedial measures and so rendered further action unnecessary. Seven samples of Sausage Preservative Powder were procured, each of which was reported against as containing considerably less preservative than the amount stated in the statutory declaration on the tin. The attention of the vendors and manufacturers was called to the matter. In one case the labelling of the tin was not in accordance in several respects with the requirements of the Regulations, and the manufacturers immediately complied by reprinting the label. EXAMINATION OF MILK. Chemical.—Of the 263 samples of milk, all of which were procured formally, 11 were certified as adulterated, giving a percentage of milk adulteration of 4.1, as compared with 5.1 for 1928. Legal proceedings were instituted regarding eight samples and penalties imposed in five cases, three being dismissed under the Probation of Offenders Act on payment of costs. None of the samples taken on Sundays was reported against. The following table shows the percentage of fat contained in each of the 263 samples of milk examined. Nine of this number contained fat in amounts below the point which 34 presumes adulteration, i.e., 3 per cent. The highest amount of fat contained in any sample was 5.6 per cent. The average percentage of fat was 3.4. Percentage of Fat. No. of Samples. Percentage of Fat. No. of Samples. 1.3 1 3.8 6 2.3 l 3.9 5 2.4 l 4.0 3 2.6 2 4.1 5 2.7 3 4.2 3 2.9 1 4.3 2 3.0 18 4.4 1 3.1 25 4.5 2 3.2 37 4.6 2 3.3 43 4.7 2 3.4 32 4.9 1 3.5 31 5.6 1 3.6 27 3.7 8 Total 263 It was observed that of the 11 samples where the percentage of fat exceeded 4.2, six were taken from churns in course of delivery at railway stations, the milk in the churns being thoroughly plunged, as usual, immediately prior to the samples being taken. The remaining five samples were taken from receptacles in shops or restaurants where the neglect to properly plunge the milk was probably the reason for the high amount of fat. By the provisions of the Food and Drugs (Adulteration) Act a purveyor of milk from whom a sample of milk has been taken, may, within 60 hours after such sample has been taken, serve a notice on the Local Authority giving particulars as regards his source of supply, place and time of delivery, and request the Authority to procure a sample in course of delivery to him. Twenty such requests were received, and in two instances it was necessary to ask another Authority to procure such samples, the place of delivery being outside the area of the City of London. These samples were certified to be genuine, but in both cases legal proceedings were successfully instituted against the retail purveyor, as the samples procured from him were certified to be not genuine. THE MILK AND DAIRIES ORDER, 1926, AND THE MILK AND DAIRIES (AMENDMENT) ACT, 1922. Sixteen new applications for registration as retail purveyors of milk were received during the year, 15 of which were approved. One application from a retailer who had no premises within the City was refused. The applicant failed to comply with the request to appear before the Sanitary Committee in support of his application. Legal proceedings were taken against him for filling bottles with milk in the street and for adulteration, and he was convicted, whereupon he sold his milk round and ceased purveying milk. Registration Statistics. Number of Retail Purveyors of Milk on the Register at end of 1928 277 New Applications for Registration received 16 Applications granted 15 Applications refused 1 Names of Retailers removed from Register 19 Number of Retail Purveyors of Milk on the Register at the end of 1929 273 Number of Milk sellers (other than Retail Purveyors of Milk) on the Register at the end of 1929 15 Licenses issued under the Milk (Special Designations) Order, 1923 7 Inspections of Premises where Milk is Retailed.—During the year 279 inspections were made in connection with the sale of milk. Routine inspections and visits were made to ascertain that the requirements for the proper conduct of the business were carried out. A copy of the Milk and Dairies Order, 1926, was supplied to each person newly registered during the year. 35 Observations have been continually kept on methods of distribution, and it was necessary to take legal proceedings in two instances with regard to the bottling of milk in the street. The defendants had been previously cautioned for a similar offence, and in one of these cases a total fine of £40 and £2 2s. costs was imposed, whilst in the other the employer was fined £5 and £2 2s. costs, and the employee £1. With regard to milk churns arriving at City railway stations, observations have been made from time to time in order to see that their construction complied with the Milk and Dairies Order. Where any neglect was noticed the owners were communicated with and improvements effected. THE PUBLIC HEALTH (CONDENSED MILK) REGULATIONS, 1923 AND 1927. Eight samples of seven different brands of condensed milk were taken and submitted to the Public Analyst, as follows:— Condensed Full Cream Milk, Sweetened 2 Condensed Full Cream Milk, Unsweetened 3 Condensed Skimmed or Machine-skimmed Milk—Sweetened 3 8 These samples were certified genuine as regards equivalent contents and composition. It was necessary to draw the attention of the manufacturers of one of the brands of milk to a contravention of the Regulations as regards the size of printing of the statutory declaration. THE PUBLIC HEALTH (DRIED MILK) REGULATIONS, 1923 AND 1927. Two samples of dried milk were submitted to the Public Analyst, as follows:— Dried Full Cream Milk 1 Dried Machine-skimmed Milk 1 These were found to conform to the required standard. REGISTERED PREMISES. Butter Factories.—One new application for registration was received during the year. Wholesale Dealers in Margarine and, Margarine Cheese.—Two new applications for registration were received during the year. 36 37 ADMINISTRATIVE ACTION REGARDING ADULTERATION OR OTHER IRREGULARITY. Serial No. Article. Whether Formal or Informal. Nature ot Adulteration or Irregularity. Observations. Results of Proceedings or other Action taken. 44 Margarine Informal Paper wrapper not in conformity with requirements of Food and Drugs (Adulteration) Act. .... Vendor cautioned. 73 Milk Formal 5% fat abstracted. .... Vendor cautioned. 74 Prescription Medicine Formal Deficient in Quinine Sulphate to the extent of 33% of the amount prescribed. .... Vendor prosecuted. Fined £3 3s. and £2 2s. Costs 79 Whisky Formal 36.6 degrees under proof. .... Vendor cautioned. 80 Whisky Formal 36.6 degrees under proof. .... Vendor cautioned. 88 Milk Formal 9% fat abstracted. .... Consignor cautioned. 111 Rum Formal 35.9 degrees under proof. .... Vendor cautioned. 135 Liniment of Turpentine Informal 50% deficient in Rectified Oil of Turpentine. Resampled formally—No. 249—genuine 147 Milk Formal 9% of added water. .... Vendor prosecuted. Fined £5 and £1 Is. Costs. 166 Milk Formal 27% fat abstracted. .... Vendor prosecuted. Fined £5 and £2 2s. Costs. 216 Sausages (Preserved) Informal Declaration on label not in conformity with the requirements of the Public Health (Preservatives, etc., in Food) Regulations. f ... .... .... .... .... .... .... Vendor cautioned. 230 Sauce Informal 0.021% Crystallised Copper Sulphate. Resampled formally—No. 289 .... 269 Milk Formal 14% fat abstracted. .... Vendor prosecuted. Summons dismissed under Probation of Offenders Act on payment of £2 2s Costs. 289 Sauce Formal 0.021 Crystallised Copper Sulphate. Taken in connection with informal sample No. 230. Vendor and manufacturer prosecuted. Defendants explanation accepted. Summons withdrawn on payment of £3 3s. Costs by the manufacturer. 303 Milk Formal 58% of added water Employee prosecuted under Milk and Dairies (Amendment) Act, 1922. Vendor and also employee prosecuted. Summons against Vendor dismissed under Probation of Offenders Act on payment of £2 2s. Costs. Employee fined £5. 377 Condensed Full Cream Milk—Sweetened Informal Printing of label not in conformity with the requirements of the Public Health (Preservatives, etc., in Food) Regulations. Importer cautioned. 382 Milk Formal 14% fat abstracted Vendor prosecuted. Fined £3 and £4 4s. Costs. 433 Margarine Informal Paper wrapper not in conformity with the requirements of the Food and Drugs (Adulteration) Act, 1928. .... Vendor cautioned. 468 Sauce Informal 0.0069 %Crystallised Copper Sulphate. .... Vendor cautioned. 510 Milk Formal 21% fat abstracted .... Vendor prosecuted. Fined £5 and £5 5s. Costs. 708 Milk Formal 2% of added water Resampling not possible—Consignor ceased to send milk—Farm sold. .... F 38 39 ADMINISTRATIVE ACTION REGARDING ADULTERATION OR OTHER IRREGULARITY—continued. Serial No. Article. Whether Formal or Informal. Nature of Adulteration or Irregularity. Observations. Results of Proceedings or other Action taken. 729 Beef Sausages Informal Contained Sulphur Dioxide to the extent of 82 parts per million without declaration. Resampled formally—No. 774 .... 739 Sausage Preservative Powder. Informal Deficient in Sulphur Dioxide to the extent of 21.60% of the declared amount. Declaration not in conformity with the requirements of the Public Health (Preservatives, etc., in Food) Regulations. .... Vendor and manufacturers communicated with. Old stock withdrawn from sale. 740 Sausage Preservative Powder. Informal Deficient in Sulphur Dioxide to the extent of 100.0% of the declared amount. Resampled formally—No. 790 .... 741 Sausage Preservative Powder. Informal Deficient in Sulphur Dioxide to the extent of 31.71% of the declared amount. .... Vendors communicated with and interviewed. Undertaking given to remedy matter. 742 Sausage Preservative Powder. Informal Deficient in Sulphur Dioxide to the extent of 25.57% of the declared amount. .... Vendors communicated with. Stock withdrawn from sale. Manufacturers interviewed. 743 Sausage Preservative Powder. Informal Deficient in Sulphur Dioxide to the extent of 61.5% of the declared amount. Resampled formally—No. 789 .... 746 Liniment of Turpentine Informal 15% deficient in Rectified Oil of Turpentine. Resampled formally—No. 788 .... 753 Cream with Fruit Salad Informal The fat of the "Cream" of the sample contained 95% of fat not derived from milk. Resampled formally—No. 784 0 .... 770 Pork Sausages Informal Contained Sulphur Dioxide to the extent of 109 parts per million without declaration. .... Vendor cautioned. 774 Beef Sausages Formal Contained Sulphur Dioxide to the extent of 54 parts per million without declaration. Taken in connection with informal sample, No. 729. Vendor cautioned. 779 Beef Sausages Informal Contained Sulphur Dioxide to the extent of 178 parts per million without declaration. .... Vendor cautioned. 784 Cream with Fruit Salad Formal The fat of the "Cream" of the sample contained 95% of fat not derived from milk. Taken in connection with informal sample, No. 753. Vendor prosecuted. Fined £15 and £2 2s. Costs. 788 Liniment of Turpentine Formal 23% deficient in Rectified Oil of Turpentine. Taken in connection with informal sample, No. 746. Vendor cautioned. 789 Sausage Preservative Powder. Formal Deficient in Sulphur Dioxide to the extent of 16.6% of the declared amount. .... Vendor communicated with. Manufacturer interviewed. Undertaking given to remedy matter. 790 Sausage Preservative Powder. Formal Deficient in Sulphur Dioxide to the extent of 100.0% of the declared amount. .... Vendor communicated with and interviewed. Material packed in error. Undertaking given to remedy matter. 792 Iron and Quinine Citrate Informal 14.9% deficient in Quinine. Resampled formally—No. 909—Certified genuine. 804 805 Milk Milk Formal Formal 9% fat abstracted 10% fat abstracted .... Consignor prosecuted. Summons dismissed under Probation of Offenders Act on payment of £5 5s. Costs. 814 Crushed Linseed Informal 12% deficient in Oil Resampled formally—No. 863 .... 863 Crushed Linseed Formal 7.3% deficient in Oil Taken in connection with informal sample, No. 814. Vendor cautioned. 948 Butter (on bread) Informal The fat of the "Butter" of the sample contained 40% of fat not derived from milk. Formal sample to be procured .... F 2 40 THE FOOD AND DRUGS (ADULTERATION) ACT, 1928, THE PUBLIC HEALTH (PRESERVATIVES, ETC., IN FOOD) REGULATIONS, THE PUBLIC HEALTH (CONDENSED MILK) REGULATIONS, 1923 AND 1927, THE PUBLIC HEALTH (DRIED MILK) REGULATIONS, 1923 AND 1927, AND THE ARTIFICIAL CREAM ACT, 1929. Formal and Informal Samples Submitted for Analysis. Article. Number Examined. Number Adulterated, etc. Percentage of Adulteration. Formal. Informal. Total. Formal. Informal. Total. Formal. Informal. Total. Almond Oil .... 7 7 .... .... .... .... .... .... Ammoniated Tincture of Quinine .... 9 9 .... .... .... .... .... .... Arrowroot .... 7 7 .... .... .... .... .... .... Bacon .... 2 2 .... .... .... .... .... .... Baking Powder .... 2 2 .... .... .... .... .... .... Bicarbonate of Soda .... 2 2 .... .... .... .... .... .... Black Pudding .... 3 3 .... .... .... .... .... .... Blancmange Powder .... 1 1 .... .... .... .... .... .... Borax (Purified) .... 8 8 .... .... .... .... .... .... Boracic Acid Powder .... 1 1 .... .... .... .... .... .... Brandy 3 2 5 .... .... .... .... .... .... Brawn .... 8 8 .... .... .... .... .... .... Bread .... 1 1 .... .... .... .... .... .... Butter 6 58 64 .... l 1 .... 1.7 1.5 Cakes, Pastries, etc .... 22 22 .... .... .... .... .... .... Cake Mixtures .... 2 2 .... .... .... .... .... .... Camphorated Oil .... 6 6 .... .... .... .... .... .... Castor Oil .... 1 1 .... .... .... .... .... .... Cayenne Pepper .... 1 1 .... .... .... .... .... .... Cheese .... 3 3 .... .... .... .... .... .... Cider .... 2 2 .... .... .... .... .... .... Cinnamon .... 3 3 .... .... .... .... .... .... Cocoa .... 3 3 .... .... .... .... .... .... Coffee .... 4 4 .... .... .... .... .... .... Coffee Extract .... 2 2 .... .... .... .... .... .... Coffee Mixture .... 1 1 .... .... .... .... .... .... Colourings .... 2 2 .... .... .... .... .... .... Compound Liquorice Powder .... 7 7 .... .... .... .... .... .... Compound Tincture of Rhubarb .... 2 2 .... .... .... .... .... .... Compound Tincture of Senna .... 1 1 .... .... .... .... .... .... Condensed Full Cream Milk— .... 2 2 .... .... .... .... .... .... Sweetened. .... .... .... .... .... .... .... .... .... Condensed Full Cream Milk— 2 1 3 .... .... .... .... .... .... Unsweetened. .... .... .... .... .... .... .... .... .... Condensed Machine-skimmed Milk— .... 3 3 .... .... .... .... .... .... Sweetened. .... .... .... .... .... .... .... .... .... Confectionery .... 24 24 .... .... .... .... .... .... Cornflour .... 1 1 .... .... .... .... .... .... Cream 13 13 26 .... 1 2 7.6 7.6 7.6 Cream (Artificial) 1 1 .... .... .... .... .... .... Cream of Tartar .... 6 6 .... .... .... .... .... .... Crushed Linseed 1 7 8 1 1 2 100.0 14.2 25.0 Crystallised Glace or Cured Fruit .... 4 4 .... .... .... .... .... .... (including Candied Peel). .... .... .... .... .... .... .... .... .... Currv Powder .... 3 3 .... .... .... .... .... .... Custard Powder .... 2 2 .... .... .... .... .... .... Desiccated Soup .... 1 1 .... .... .... .... .... .... Dried Fruit:— .... .... .... .... .... .... .... .... .... Apricots, Peaches, Nectarines, .... 4 4 .... .... .... .... .... .... Apples and Pears. .... .... .... .... .... .... .... .... .... Raisins and Sultanas .... 16 16 .... .... .... .... .... .... Currants, etc .... 13 13 .... .... .... .... .... .... Dried Milk—Full Cream .... 1 1 .... .... .... .... .... .... Dried Milk—Machine-skimmed .... 1 1 .... .... .... .... .... .... Dripping .... 10 10 .... .... .... .... .... .... Epsom Salts .... .... 1 1 .... .... .... .... .... .... Carried forward 26 286 312 2 3 5 .... .... .... 41 THE FOOD AND DRUGS (ADULTERATION) ACT, 1928, THE PUBLIC HEALTH (PRESERVATIVES, ETC., IN FOOD) REGULATIONS, THE PUBLIC HEALTH (CONDENSED MILK) REGULATIONS, 1923 AND 1927, THE PUBLIC HEALTH (DRIED MILK) REGULATIONS, 1923 AND 1927, AND THE ARTIFICIAL CREAM ACT, 1929.—Continued. Formal and Informal Samples Submitted for Analysis. Article. Number Examined. Number Adulterated, etc. Percentage of Adulteration. Formal. Informal. Total. Formal. Informal. Total. Formal. Informal. Total. Brought forward 26 286 312 2 3 5 .... .... .... Essence of Ginger .... 1 1 .... .... .... .... .... .... Essential Oil of Camphor .... 1 1 .... .... .... .... .... .... Eucalyptus Oil .... 3 3 .... .... .... .... .... .... Fish Paste .... 7 7 .... .... .... .... .... .... Flour .... 5 5 .... .... .... .... .... .... Flour (Self-raising) .... 6 6 .... .... .... .... .... .... Flowers of Sulphur .... 2 2 .... .... .... .... .... .... Friars Balsam .... 2 2 .... .... .... .... .... .... Fruit Salad .... 1 1 .... .... .... .... .... .... Gelatine .... 1 1 .... .... .... .... .... .... Gin 3 — 3 .... .... .... .... .... .... Ginger .... 1 1 .... .... .... .... .... .... Ginger Syrup .... 1 1 .... .... .... .... .... .... Ginger Wine Essence .... 1 1 .... .... .... .... .... .... Glauber's Salt .... 1 1 .... .... .... .... .... .... Glycerine .... 1 1 .... .... .... .... .... .... Grape Juice Gregory's Powder .... 1 1 .... .... .... .... .... .... .... 4 4 .... .... .... .... .... .... Ground Almonds .... 3 3 .... .... .... .... .... .... Ground Cloves .... 1 1 .... .... .... .... .... .... Ground Ginger .... 2 2 .... .... .... .... .... .... Ground Nutmeg .... 1 1 .... .... .... .... .... .... Ground Rice .... 5 5 .... .... .... .... .... .... Ham .... 11 11 .... .... .... .... .... .... Honey .... 1 1 .... .... .... .... .... .... Ice Cream .... 9 9 .... .... .... .... .... .... Ipecacuanha Wine .... 1 1 .... .... .... .... .... .... Iron and Quinine Citrate 1 2 3 .... 1 1 .... 50.0 33.3 Jam and Marmalade .... 5 5 .... .... .... .... .... .... Lard .... 7 7 .... .... .... .... .... .... Lemonade Powder .... 12 12 .... .... .... .... .... .... Liniment of Turpentine 2 5 7 1 2 3 50.0 40.0 42.8 Liquid Paraffin .... 1 1 .... .... .... .... .... .... Margarine .... 16 16 .... .... .... .... .... .... Meat .... 4 4 .... .... .... .... .... .... Meat Pies and Patties .... 16 16 .... .... .... .... .... .... Medicated Lozenges .... 3 3 .... .... .... .... .... .... Milk 263 .... 263 11 .... 11 4.1 4.1 Mincemeat .... 4 4 .... .... .... .... .... .... Mineral Waters .... 1 1 .... .... .... .... .... .... Mustard .... 9 9 .... .... .... .... .... .... Oatmeal .... 2 2 .... .... .... .... .... .... Oil of Cloves .... 1 1 .... .... .... .... .... .... Ointment, Boracic .... 1 1 .... .... .... .... .... .... Ointment, Calomel .... 2 2 .... .... .... .... .... .... Ointment, Red Precipitate .... 1 1 .... .... .... .... .... .... Ointment, Sulphur .... 5 5 .... .... .... .... .... .... Ointment, White Precipitate .... 5 5 .... .... .... .... .... .... Ointment, Zinc .... 2 2 .... .... .... .... .... .... Olive Oil .... 4 4 .... .... .... .... .... .... Pea Nuts .... 1 1 .... .... .... .... .... .... Pearl Barley .... 3 3 .... .... .... .... .... .... Pepper .... 15 15 .... .... .... .... .... .... Pickles and Sauces 1 11 12 1 2 3 100.0 18.1 25.0 Carried forward 296 497 793 15 8 23 .... .... .... 42 THE FOOD AND DRUGS (ADULTERATION) ACT, 1928, THE PUBLIC HEALTH (PRESERVATIVES, ETC., IN FOOD) REGULATIONS, THE PUBLIC HEALTH (CONDENSED MILK) REGULATIONS, 1923 AND 1927, THE PUBLIC HEALTH (DRIED MILK) REGULATIONS, 1923 AND 1927, AND THE ARTIFICIAL CREAM ACT, 1929 .—Continued.. Formal and Informal Samples Submitted for Analysis. Article. Number Examined. Number Adulterated, etc. Percentage of Adulteration. Formal. Informal. Total Formal. Informal. Total. Formal. Informal. Total. Brought forward 296 497 793 15 8 23 .... .... .... Prescription Medicines 4 .... 4 1 .... l 25.0 .... 25.0 Pressed Beef .... 1 1 .... .... .... .... .... .... Proprietary Foods .... 1 1 .... .... .... .... .... .... Rice .... 3 3 .... .... .... .... .... .... Rum 5 .... 5 l .... l 20.0 .... 20.0 Salad Cream .... 1 1 .... .... .... .... .... .... Salami .... 2 2 .... .... .... .... .... .... Sausages 1 28 29 l 3 4 100.0 10.7 13.7 Sausages (Preserved) .... 4 4 .... .... .... .... .... .... Sausage Preservative Powder 2 5 7 2 5 7 100.0 100.0 100.0 Sausage Seasoning .... 1 1 .... .... .... .... .... .... Seidlitz Powder .... 3 3 .... .... .... .... .... .... sherbet .... 5 5 .... .... .... .... .... .... Shrimps .... 1 1 .... .... .... .... .... .... Smoked Salmon .... 1 1 .... .... .... .... .... .... Spices .... 4 4 .... .... .... .... .... .... Sugar .... 19 19 .... .... .... .... .... .... Syrup of Senna .... 1 1 .... .... .... .... .... .... Tapioca .... 1 1 .... .... .... .... .... .... Tartaric Acid .... 2 2 .... .... .... .... .... .... Tea and Tea Fannings .... 6 6 .... .... .... .... .... .... Tincture of Iodine .... 4 4 .... .... .... .... .... .... Tinned Fruit .... 5 5 .... .... .... .... .... .... Tinned Meat .... 3 3 .... .... .... .... .... .... Tinned Vegetables .... 4 4 .... .... .... .... .... .... Tongue .... 1 1 .... .... .... .... .... .... Treacle .... 1 1 .... .... .... .... .... .... Tripe .... 2 2 .... .... .... .... .... .... Vinegar .... 4 4 .... .... .... .... .... .... Vinegar (Malt) .... 18 18 .... .... .... .... .... .... Whisky 10 13 23 2 .... 2 20.0 .... 8.6 Wines (Alcoholic) .... 11 11 .... .... .... .... .... .... Wines (Non-alcoholic) and Cordials .... 8 8 .... .... .... .... .... .... Wines (Medicated) .... 2 2 .... .... .... .... .... .... Totals 318 662 980 22 16 38 6.9 2.4 3.8 FOOD AND DRUGS (ADULTERATION) ACT, 1928, PUBLIC HEALTH (PRESERVATIVES, ETC., IN FOOD) REGULATIONS, PUBLIC HEALTH (CONDENSED MILK) REGULATIONS, 1923 AND 1927, PUBLIC HEALTH (DRIED MILK) REGULATIONS, 1923 AND 1927, AND ARTIFICIAL CREAM ACT, 1929. RESULTS OF PROSECUTIONS. Sample. Nature and extent of Adulteration. Result. 74 Prescription Medicine 33% deficient in Quinine Sulphate £3 3s. and £2 2s. Costs. 147 Milk 9% added water £5 and £1 1s. Costs. 166 Milk 27% deficient in fat £5 and £2 2s. Costs. 269 Milk 14% deficient in fat Dismissed under Probation of Offenders Act on payment of £2 2s. Costs. 289 Sauce 0.021% Crystallised Copper Sulphate Defendant's explanation accepted. Summons withdrawn on payment of £3 3s. Costs. 303 Milk 58% added water Dismissed under Probation of Offenders Act on payment of £2 2s. Costs. (Employee fined £5 under Milk and Dairies (Amendment) Act.) 382 Milk 14% deficient in fat £3 and £4 4s. Costs. 510 Milk 21% deficient in fat £5 and £5 5s. Costs. 784 Cream 95% fat not derived from milk £15 and £2 2s. Costs. 804 Milk 9% deficient in fat Dismissed under Probation of Offenders Act on payment of £5 5s. Costs. 805 Milk 10% deficient in fat j SUMMARY. Total Fines £36 3s. 0d. Total Costs £29 8s. 0d. 43 ARTIFICIAL CREAM ACT, 1929. The Artificial Cream Act came into operation on the 1st June, 1929. The substance whose sale and manufacture the Act is designed to regulate is a cream substitute, hitherto commonly known as reconstituted cream, and usually prepared by emulsifying butter, dried skimmed milk and water. The definition in the Act, however, is sufficiently wide to include any article of food resembling cream and containing nothing but the ingredients of cream. Artificial cream must be designated as such on every container or receptacle, and the place of manufacture must be registered with the Food and Drugs Authority who are charged with the enforcement of the provisions of the Act. The penalties for infringement vary from a maximum of £5 for a first offence to £50 for a second and subsequent offence. The measure is a useful one, and should secure the control of a material the commercial use of which is increasing. One registration was effected during the year. MEAT INSPECTION. The report under this heading has been prepared by your Veterinary Officer, Lt.-Col. T. D. Young. According to the Board of Trade Returns the imports of meat and bacon for the year ending 31st December, 1929, were as follows:— IMPORTS OF FRESH MEAT AND BACON FOR TWELVE MONTHS, 1929. Beef. Cwts. Mutton. Cwts. Pork. Cwts. Bacon. Cwts. United States 36,015 — 47,366 634,594 Uruguay 947,217 366,605 — — Argentina 9,060,324 1,545,162 69,697 — Australia 926,569 593,490 — — New Zealand 125,271 2,746,087 169,480 — Sweden — — — 379,866 Denmark — — — 4,977,026 Netherlands — — — 901,298 Irish Free State — — 296,217 497,139 Canada — — — 199,466 Other Countries 620,349 402,635 9,985 692,026 Total, 1929 11,715,745 5,653,979 592,745 8,281,415 Total, 1928 12,266,980 5,645,883 634,541 8,852,878 LIVE STOCK FOR THE TWELVE MONTHS, 1929. Cattle. No. Sheep. No. Pigs. No. Irish Free State 749,570 584,631 311,102 Other Countries 692 — — 750,262 584,631 311,102 The above figures show a decrease of 27,000 tons of beef compared with those for 1928, and consisted of approximately 80 per cent. chilled and 20 per cent. frozen. Argentina continues to head the list with supplies of 77 per cent., Australia 8 per cent., Uruguay 8 per cent., Other Countries 6 per cent., and New Zealand 1 per cent. The imports of tinned and canned beef tongues extracts, etc., amounted to nearly 50,000 tons. Mutton and Lamb.—The total of 282,699 tons was practically the same as last year. Argentina making good the decreases from New Zealand and Uruguay. New Zealand sent nearly 50 per cent., Argentina 27 per cent., Australia 10 per cent., Other Countries 7 per cent. and Uruguay 6 per cent. Offals consisted of tongues, livers, hearts, kidneys, etc., viz., 4,083 tons, with canned mutton and tongues amounting to 1,575 tons. Frozen Pork.—This class of food increased by 2,500 tons, chiefly from New Zealand and Argentina. The former sent over 50 per cent. of the total. Fresh Pork.—The Irish Free State is the only country from which this class of food is imported. Last year the amount decreased by 4,550 tons. The reason is obscure, as prices for fresh pork keep high. Bacon.—The amount of bacon imported decreased by 28,573 tons. Denmark sent 60 per cent., thus occupying first place, with Holland second and the United States of America third. The remainder is placed under the heading of "Other Countries." Hams.—50,000 tons were imported, of which 80 per cent. arrived from the U.S.A., the balance being from Other Countries, including Canada. Live Stock—With the exception of 692 cattle, which arrived from South Africa, consignments were all from Ireland. *SUPPLIES FOR THE YEAR 1929—465,851 TONS. Source of Supply. Beef and Veal. Mutton and Lamb. Pork and Bacon. Poultry and Game. Rabbits. Butter and Cheese. Eggs. Sundries. Totals. Ratio per cent. Tons. Tons. Tons. Tons. Tons. Tons. Tons. Tons. England 24,725 12,512 22,763 9,907 1,118 335 1,127 274 72,761 15.6 Scotland 14,653 17,632 81 528 39 1 4 8 32,946 7.1 Ireland 5,259 2,064 7,445 1,969 5 31 54 6 16,883 3.6 Totals—Home Produce 44,637 32,208 30,289 12,404 1,162 367 1,185 288 122,540 26.3 Australia 6,867 10,814 151 17 3,535 187 40 — 21,611 4.6 New Zealand 1,656 63,115 2,674 29 336 527 — 3 68,340 14.7 Canada and South Africa 135 — 79 79 — 63 79 2 437 01 Totals—Dominion Produce 8,658 73,929 2,904 125 3,871 777 119 5 90,388 19.4 Totals—Empire Produce 53,295 106,137 33,193 12,259 5,033 1,144 1,304 293 212,928 45.7 United States of America 1,330 102 978 88 — 1 — 121 2,620 0.6 Argentina 175,411 31,155 1,431 153 — 431 18 9 208,608 44.8 Uruguay 9,300 2,058 1 — — — — — 11,359 2.4 Brazil, Patagonia, Chili, etc. 7,164 441 7 — — — — — 7,612 1.6 Netherlands — — 5,759 1,263 341 282 498 87 8,230 1.8 Denmark — — 1,331 2 — 14 51 2 1,400 0.3 France, Italy, Russia, and — — — — — — — — — — other countries — 73 725 9,708 1,181 154 1,162 91 13,094 2.8 Totals—Foreign Produce 193,205 33,829 10,232 11,214 1,522 882 1,729 310 252,923 54.3 Grand Totals 246,500 139,966 43,425 23 743 6,555 2,026 3,033 603 465,851 100.0 *I am indebted to the Clerk and Superintendent of the Central Markets for the figures relating to the market supplies, sources and origin, &c. 44 45 INSPECTION OF BRITISH MEAT. As will be observed by the following table, the amount of "British" diseased meat discovered in the Markets rather increases than lessens. It was hoped that the introduction of the Public Health (Meat) Regulations, whereby (a) notice of intention to slaughter animals, and (b) notification of diseased or suspected carcases are required to be given by persons who slaughter animals, would result in better inspection in Rural Districts. It appears that the Regulations which, if properly administered, would protect the public, are not carried out. It must seem illogical to meat importers that, while inspection of their goods is rigorous, much of the meat produced in this country appears to be uninspected. If we may judge from observations in the markets, a considerable amount of diseased meat must, in some districts, pass into human consumption. From a Public Health point of view, the ideal would have been that all carcases and offal should be carefully inspected at the place of slaughter and stamped, the stamp indicating both home production and freedom from disease than, as at present, inspection on slaughter should be neglected and considerable effort devoted to mere grading of meat, some of which may not even have been thoroughly examined as to freedom from disease. A considerable amount of difficulty and work is being caused by deposit of pig carcases minus heads in the markets. There is no indication as to whether the head has been detached by or with the authority of a meat inspector at the place of slaughter and the diseased parts destroyed or detached by the owners; if the latter, whether the diseased parts were destroyed or passed into human consumption under circumstances in which little, if any, attention is given to inspection. This class of carcase requires the special and individual attention of section inspectors, and entails much work in that every carcase must be "split down" and the bones, serous membranes, kidneys and lymph glands examined. The remedy suggested is that, where the head has been detached by or under the authority of an inspector, an official stamp should be placed on the carcase. In such case, when unstamped carcases minus heads are received, it would suggest that the owner knew the carcases were diseased and notification had not been given to the Local Authority at the place of slaughter; such owner would be liable to prosecutions (a) for non-notification at the place of origin, and (b) for depositing diseased meat in the markets. Meat inspection in this country cannot be complete until all carcases and organs are examined at the places of slaughter and the meat passed officially stamped. TUBERCULOSIS IN PIGS. In previous reports (e.g., 1926 and 1927), mention was made as to the macroscopical appearance of the lesions in the lymph glands of pig carcases; as was ascertained from some owners, pigs which had never been fed on cow's milk or grazed in contact with cows still presented lesions. It was assumed that the source of infection was diseased fowls, and that investigation as to the correctness of this assumption would be an interesting and important piece of research work, both from a scientific and commercial point of view. Dr. A. Stanley Griffith, M.D., of the Field Laboratories, University of Cambridge, has typed the tubercle bacilli from the lesions taken from pig carcases. Dr. Griffith was assisted by Mr. R. L. Cornell, B.Sc., M.R.C.V.S., of the Institute of Animal Pathology, Cambridge. A full account of their work appears in the "Journal of Comparative Pathology and Therapeutics," Vol. XLIII., pp. 56-62, March, 1930. Briefly, out of 103 submaxillary lymph glands examined, on attempted culture, eight cases remained sterile; of the 95 cultures obtained 63, or over 66 per cent., were identical in characters with those of tubercle bacilli of bovine origin, 31, or 33 per cent., exhibited the characteristic, moist, slimy growths of the typical avian tubercle bacillus, and the remaining one presented the luxuriant, dry, coherent growths of the human type of tubercle bacillus. Dr. Griffith and Mr. Cornell form the following conclusions:— 1. Natural tuberculosis in swine may be the result of infection with bovine, avian or human tubercle bacilli. 2. The chief cause of swine tuberculosis is the bovine tubercle bacillus. 3. The avian tubercle bacillus is responsible for a considerable proportion of the cases in which the tuberculosis is apparently confined to the lymphatic glands of the alimentary tract. 4. These findings corroborate those of workers in America and on the Continent of Europe, and support their recommendation that pigs and poultry should not be allowed to run together over the same ground. G 46 Attention is now being given in Smithfield to the percentage of poultry affected with tuberculosis. It would be interesting to know to what extent, if any, avian tubercle bacilli are the cause of reactions in the testing of bovines. QUICK FREEZING OF MEATS. Improvements in the methods of freezing are constantly being developed. Lately, new systems, including the "Kolbe," "Zarotschenzeff" and "Birdseye," have come under observation. A small equipment of the "Z" system is shortly to be erected in the vicinity of the market to demonstrate its reputed advantages. The "Ottesen" process was tried some years ago at the market; this consisted of immersing the food to be frozen in a fluid of a very low temperature. The methods mentioned above are at base a vaporised or fog system, whereby the food is submitted directly or indirectly to the action of the "brine" at a temperature of—15 degrees. Experiments indicate that the more rapid the freezing of meat, especially beef, the better is the quality when prepared for consumption. A special new feature is that the food can be cooked directly from the frozen condition, and apparently is much more tender and palatable than when cooked after thawing out. Associated with rapid freezing, the packing of retail "cuts" of meat, etc., in special paper, and sealing in by a new and original method, are being tried. Small experimental consignments have been shown on the market, and from the hygienic and the economical points of view, are suggestive of a possible progress in the transport and handling of food. These methods are being kept under observation, and will be reported on when experiment has proceeded sufficiently to enable definite opinions to be formed. 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 Pork. Quarters of Pork. Carcases of Veal. Quarters of Veal. Heads. Tongues. Lungs. Livers. Mesenteries. Plucks.[/##] Abscess — — 9 — 43 4 l — 1 — — — — — Coenurus Cerebralis — — — — — — — — 2 — — — — — Distomatosis — — 47 — — — — — — — — — — — Emaciation and Hydraemia 7 3 73 — 1ll — 13 — — — — — — — Haemorrhages — — 1 — 3 — — — — — — — — — Injury — 3 — 1 — — — — — — — — — Jaundice 1 — — — 18 — 2 — — — — — — — Joint I11 — — — — — — 1 — — — — — — — Killed in Extremis — — 5 — 279 — — — — — — — — — Melanosis — — — — — — 1 — — — — — — — Myositis — — 1 — — — — — — — — — — — Nephritis — — 1 — 6 — 3 — — — — — — — Osteo Porosis — — — — 2 — 1 — — — — — — — Pleurisy and Peritonitis — — 5 — 112 — 3 — — — — — — — Pleurisy and Pneumonia — — 11 — 74 2 3 — — — — — — — Parasitic Mange — — — — 1 — — — — — — — — — Pseudo Leukaemia — — 1 — — — 1 — — — — — — — Pyaemia — — 1 — 2 — — 2 — — — — — — Rachitis — — 12 — 27 — — — — — — — — — Tuberculosis (Bov.) 39 52 — — — — 15 1 33 35 44 5 — — Tuberculosis (Porc.) — — — — 594 14 — — 5,044 — 12 3 20 1,936 Totals, 1929 47 58 167 — 1,273 20 44 3 5,080 35 56 8 20 1,936 Totals, 1928 27 120 157 4 1,016 11 30 4 5,077 29 10 7 55 2,090 CASEOUS LYMPHADENITIS. As this disease has caused a very considerable amount of extra work to the inspectors during 1928 and 1929, it may not be out of place to give a very brief sketch of how it has come into such prominence. The disease came under the notice of your Veterinary Officer in carcases of South American sheep slaughtered in the Deptford Markets nearly 30 years ago. As the importation of live animals from South America ceased, the extent to which sheep were affected could not be investigated. On taking up duties at Smithfield in 1910, he found that from time to time, when carcases were cut up, lesions of the disease were observed, and occasionally a leg or shoulder of mutton was returned from a buyer or a public institution with the statement that the meat was affected with "Tuberculosis." While in South America, in 1913, considerable attention was given by him to the incidence of the disease, but owing to the outbreak of the War in 1914, delay in investigation again occurred. 47 On termination of the War, on his resuming civil duty, attention was again directed to the disease specially because the inspectors had now become familiar with the appearance and location of the lesions, added to which lesions were occasionally found in muscular tissue Statistics were carefully kept, and in the Annual Report of the Medical Officer for 1926 the following words and figures appear:— " Attention has previously been directed to the increasing frequency of caseous lymphadenitis in sheep carcases. A further increase is noted in 1926 over 1925, thus:— Exporting Country. 1925. 1926. Argentine 263 267 Australia 9 143 Chile 10 93 New Zealand 7 30 Uruguay 62 91 351 624 It should be made an offence to cut out lymph glands from mutton and beef carcases, as it is to cut out lymph glands from pig carcases." The Consuls of the various countries were duly notified of the increased prevalence of the disease. Remarks were made by importers that in no other town or district, except the City of London, were such lesions discovered, or, if discovered, was any objection made to them. In 1925 a special article on the subject by the late Medical Officer of Health and Veterinary Officer of the City was published in the Medical Officer. In 1927 the number of diseased carcases arriving from one of the exporting countries was so high that it became necessary to detain and examine the whole of each consignment. This was specially necessary because it was ascertained that no organised system of Governmental or Local Authority meat inspection existed in the country of origin. It is worthy of mention that the importers at once sent, at their own expense, well qualified Veterinary Officers to act as meat inspectors, until the Government appointed qualified inspectors. In 1928, as the result of special tests, it was decided that, with the exception of carcases from one country, all imported mutton should be examined, and this was continued until July 1st, 1929, when, as the result of advice given as to certain alterations in the method of examination in the abattoirs of the exporting countries, a 10 per cent., instead of 100 per cent., examination, came into and continues to be in operation. This continued effort has resulted in (a) a more uniform examination of all imported carcases, (b) a special study of the disease in every exporting country, and (c) an increased and better organised system of inspection in those countries from which Great Britain receives mutton and lamb. During the year, approximately 1,250,000 carcases have been examined at Smithfield, nearly 13,000 carcases being surrendered as affected with the disease. Argentina.—From this country there were deposited in Smithfield Markets during the year 175,411 tons of beef, 31,155 tons of mutton and lamb, 1,431 tons of pork, 153 tons of poultry and game, 431 tons of butter, 18 tons of eggs and 9 tons of sundries. The total amount of unsound food taken from those consignments will be found under Tables Nos. 19 and 20. With reference to disease, it will be observed from the following Table that there was a marked increase in the amount of diseased meat discovered. The reason is given under the heading of Caseous Lymphadenitis. Under the new method of examination recommended, and now in operation in the Frigorificos, there has lately been a considerable decrease in the number of carcases found to contain lesions of disease, and it is anticipated there will be a continued improvement in 1930, as the Argentine Agricultural Department staff of meat inspectors has been further increased. Quarters of Beef. 1928. 1929. Carcases of Mutton. 1928. 1929. Quarters of Mutton, 1928. 1929. Carcases of Pork. 1928. 1929. Pieces. Sides. 1929. 1929. Abscess 24 5 7 — — — 63 66 10 — Caseous Lymphadenitis — — 1,624 7,097 56 243 — — 490 116 Cysticercus Bovis — 1 — — — — — — 1 Osteoporosis 2 3 — — — — — — — — Tuberculosis (Hinds) 54 121 — — — — — 11 Tuberculosis (Fores) 17 19 — — — — — — — — Totals 97 149 1,631 7,097 56 243 63 66 512 116 Australia.—The amount of food from this Dominion deposited in the Markets consisted of 6,867 tons of beef, 10,814 tons of mutton and lamb, 151 tons of pork, 17 tons of poultry, 3,535 tons of rabbits, 187 tons of butter and 40 tons of eggs. The amount found unfit for food is given in Tables Nos. 19 and 20. Reference to disease, it is worthy of note that the Federal Inspection staff were the first to adopt the recommendations as to an improved G 2 48 method of inspection and to increase the number of inspectors. The result will be observed in the following Table. The inspection is evidently being so carefully conducted in the meat works that it is anticipated there will be very few, if any, diseased carcases discovered in Australian consignments in the near future. Quarters of Beef. Carcases of Mutton. Quarters of Mutton. Pieces. 1928. 1929. 1928. 1929. 1928. 1929. 1929. Abscess 2 2 — — — — 1 Caseous Lymphadenitis — — 4,080 2,543 67 91 121 Tuberculosis 5 7 — — — — 1 Totals 7 9 4,080 2,543 67 91 123 New Zealand.—The amounts of food from this country deposited for sale in the Markets were: Beef, 1,656 tons; mutton and lamb, 63,115 tons; pork, 2,674 tons; poultry, 29 tons; rabbits, 336 tons; butter and cheese, 527 tons; and sundries, 3 tons. The quantities of those found unfit for food will be seen in Tables 19 and 20. With reference to disease in New Zealand supplies, examination of consignments show that caseous lymphadenitis, though present in some of the herds, does not appear to be so prevalent as in other countries; this may be due in a great measure to the disposal of the majority of the consignments as lambs, thus not keeping sheep which may contain lesions of the disease to spread it from open wounds. The staff of inspectors has been increased, and the effect is that, at the time of writing, consignments are being found much more satisfactory. Quarters of Beef. Carcases of Mutton. Quarters of Mutton. Carcases of Pork. Pieces. Sides. 1928. 1929. 1928. 1929. 1928. 1929. 1928. 1929. 1929. 1929. Abscess — — — 2 — — 78 93 3 — Caseous Lymphadenitis — — 102 763 22 16 — — 4 2 Cysticercus Ovis — — — 1 Haemorrhages — — — — — — — 1 — — Tuberculosis 11 — — — — — — 4 1 1 102 766 22 16 78 94 11 2 Uruguay.—Consignments from this country consisted of 9,300 tons of beef, 2,058 tons of mutton and lamb, 1 ton of frozen pork. For quantities of unsound food taken, see Tables 19 and 20. With reference to disease, a Veterinary Officer from Uruguay visited the Markets after advice had been received that an improved method of examination had been put in force there. He gave attention to the City Officers at work and stated that 15 additional veterinary officers had been appointed by his Government for meat inspection purposes. The effect can be observed in the following Table, viz.:— Quarters of Beef. Carcases of Mutton. Quarters of Mutton. Pieces. Sides. 1929. 1928. 1929. 1928. 1929. 1929. 1929. Abscess — 2 — — — 1 — Caseous Lymphadenitis — 1,866 339 7 5 149 183 Pleurisy — — 1 — — — — Tuberculosis 2 2 1,868 340 7 5 150 183 Chile.—The exact amount of mutton and lamb deposited in the markets from this country is not available, but the amount of unsound food discovered will be seen in Tables 19 and 20. A staff of veterinarians is now in the course of being trained and appointed for the inspection of meat. Advice as to the improved method of examination of carcases and organs was suggested. The new season's consignments will not come under examination until next year. Due to the sending of British Veterinary Officers by some of the agents in this country, a reduction in the number of diseased carcases will be observed in the following Tabel, viz .:- Carcases of Mutton. Quarters of Mutton. Pieces of Mutton. 1928 1929. 1929. 1929. Caseous Lymphadenitis 3,990 2,252 8 33 Other Countries.—Consignments from the following countries do not require any special observations:— Brazil. Quarters of Beef. Pieces. 19._,8 1929 1929 Abscess 11 2 — Tuberculosis 7 3 1 18 5 1 Manchuria. Carcases of Park. 1929 Abscess 17 Denmark. Side of Bacon. 1929. Abscess 3 Holland. Side of Bacon.1929. Abscess 1 Sweden. Siide of Bacon.1929. Abscess 1 49 UNSOUND MEAT, Etc., REMOVED FROM COLD STORES. Article. No. How Packed. Origin. Cause tor Destruction. Tons. Cwts. Qrs. lbs. Beef (Pieces) .... .... Argentina Decomposed 0 0 1 21 „ „ 11 .... Australia Bone Taint 0 13 1 23 „ 3 „ Brine Stained 0 0 2 7 ,, (Tongues) 1 Bag Argentina .... Mould Fungi 0 0 3 17 „ (Cheeks) 3 „ ,, .... Decomposed 0 1 0 18 „ (Tails) 2 „ .... „ •••• Vermin Damg. 0 0 3 26 ,, (Hearts) 1 „ .... „ •••• Decomposed 0 0 1 12 „ (Kidneys) 3 Cases „ .... „ •••• 0 0 3 12 „ „ 5 ,, .... Uruguay Mould Fungi 0 2 2 20 Fish .... Boxes Canada Decomposed 1 6 0 0 Lambs 1,225 .... Argentina *C.L.A 26 5 0 23 „ „ 39 .... Australia .... 0 16 3 14 „ „ 16 .... Chile „ •••• 0 6 0 25 „ „ 129 .... New Zealand „ •••• 1 19 0 21 „ „ 1 .... „ .... Mould Fungi 0 0 1 5 „ „ 44 .... „ •••• Brine Stained 0 12 3 11 „ „ 1 .... Australia .... 0 0 1 22 „ „ 2 .... Chile Transit Damg. 0 0 1 24 Liquid Eggs 1 Tin China Decomposed 0 0 1 10 Mutton (Carcases) 4,178 .... Argentina *C.L.A 123 2 1 24 „ „ 1,736 .... Australia „ .... 51 3 1 20 „ „ 1,209 .... Chile .... 38 4 0 16 „ „ 517 .... New Zealand .... 13 8 3 20 „ „ 41 .... Uruguay „ •••• 1 0 0 8 „ „ 1 .... New Zealand Transit Damg. 0 0 1 16 „ „ 2 .... Argentina „ •••• 0 0 2 11 „ „ 2 .... „ .... Store Damg 0 0 3 13 „ „ \ .... Chile Brine Stained 0 0 2 4 „ (Kidneys) 60 Cases .... Argentina .... Mould Fungi 1 7 3 0 (Legs) 36 .... Uruguay C.L.A 0 2 0 16 ,, ,, 386 .... Argentina .... „ .... 1 2 0 22 „„ .... 21 .... Australia .... „ •••• 0 1 0 1 „ „ •••• •••• 33 .... Chile „ .... 0 2 3 18 „ (Quarters) 221 .... Argentina .... „ •••• 1 1 3 2 „ „ •••• •••• 45 .... Australia .... „ •••• 0 6 2 2 „ „ •••• •••• 2 .... Chile „ .... 0 0 0 20 „ „ •••• •••• 4 .... Uruguay „ •••• 0 0 2 1 „ „ 6 New Zealand „ •••• 0 0 1 9 „ „ 2 .... ,, Brine Stained 0 0 0 22 ,, (Shoulders) 99 .... Uruguay *C.L.A 0 4 2 18 „ „ •••• •••• 22 .... Argentina .... 0 1 1 0 „ (Sides) 116 .... „ •••• „ •••• 1 10 1 18 183 .... Uruguay „•••• 2 10 0 20 „ „ •••• 2 .... New Zealand „ .... 0 0 1 25 „ (Pieces) .... .... Australia .... 0 7 0 20 „ „ .... .... Argentina „ •••• 0 17 0 15 „ „ .... .... .... ,, .... Decomposed 0 0 1 22 „ „ •••• •••• .... .... Australia Brine Stained 0 2 1 24 „„ •••• .. .... .... New Zealand „ •••• 1 10 2 26 Offal 1 Bag Argentina Decomposed 0 0 0 13 Pork (Pieces) .... .... Australia Abscess 0 0 0 13 ,, (Kidneys) 1 Cases Argentina Decomposed 0 0 0 25 .. (Legs) 5 „ .... U.S.A. Mould Fungi 0 5 0 17 ,, (Livers) 575 Boxes ..... „ .... 8 11 3 5 Sweetbreads .... „ .... Australia Decomposed 0 0 0 4 Tails 2 Bags Argentina 0 1 1 0 Tripe 120 „ .... .... „ .... 2 12 2 22 Turtles 2 .... .... .... 0 1 3 7 Veal (Kidneys) 37 Cases „ Mould Fungi 1 0 3 7 Cheese 12 „ •••• English Decomposed 0 10 2 0 Total for the Year 1929 .... .... 284 5 2 17 „ „ 1928 .... .... 216 12 3 0 Increase .... .... .... 67 12 3 17 * Caseous Lymphadenitis. 50 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) 20 Beef 34 ,, (Body) 1 „ (Tins) 134 Butter (lbs.) 70 Capercailzies 10 Cheese (lbs.) 278 Chickens and Pouissins 846 Cream (Tins) 438 Curlew 2 Ducks 822 Eggs (Chickens) 831 „ (Pheasants) 30 Fowls 3,067 Fruit (Tins) 182 Game (Black) 165 ,, (Unclassified) 16 Geese 119 Goats 34 Grouse 593 Guinea Fowls 29 Hares 388 Hazelhens 162 Heads (Ox) 12 (Pig) 20 Livers (Ox) 136 (Pig) 4 ,, (Sheep) 44 Lungs (Ox) 2 Milk (Tins) 92 Mushrooms (lbs.) 76 Mutton (Carcases) 8 „ (Pieces) 29 Partridges 1,276 Pheasants 719 Pigeons 1,437 Plovers 167 Plucks (Pig) 1 „ (Sheep) 10 Pork (Pieces) 11 Ptarmigan 34 Quail 809 Rabbits 5,809 Salmon (Tins) 26 „ (Cases) 4 Sausages (lbs.) 12 Snipe 605 Teal 12 Tongues (Ox) 7 Turkeys 246 Veal (Pieces) 17 „ (Carcase) 1 Venison (Pieces) 12 Widgeon 49 Woodcock 213 Total weight for the year 1929 — 21 tons 14 cwts. 2 qrs. 18 lbs. „ 1928 — 27 „ 4 „ 2 „ 21 „ Decrease 5 „ 10 „ 0 „ 3 „ SHOWING THE AMOUNT OF VARIOUS FOOD PRODUCTS SURRENDERED TO OR SEIZED BY MEAT INSPECTORS IN THE CITY OF LONDON FOR DISEASED CONDITIONS, 1929. Countries. Beef in lbs. Mutton in lbs. Pork in lbs. Veal in lbs. Offal in lbs. Bacon in lbs. Argentine 38,362 423,723 10,789 85 1,436 .... Australia 1,132 144,207 241 .... 60 .... Brazil 1,322 .... .... .... .... .... Britain 25,376 26,788 174,232 4,464 102,899 62 Chile .... 62,286 .... .... .... .... Denmark .... .... .... .... .... 295 Holland .... .... .... .... .... 278 Hungary .... .... .... .... .... 243 Ireland 10,803 748 29,743 1,900 34,991 .... Manchuria .... .... 294 .... .... .... New Zealand 564 46,025 9,041 .... 70 .... Poland .... .... .... .... .... 85 Russia .... .... .... .... .... 135 Uruguay 497 44,199 .... .... 60 .... Totals 1929 78,056 747,976 224,340 6,449 139,516 1,098 Totals 1928 65,332 636,016 220,828 3,624 181,393 175 51 SHOWING THE AMOUNT OF VARIOUS FOOD PRODUCTS SURRENDERED TO OR SEIZED BY MEAT INSPECTORS IN THE CITY OF LONDON FOR UNSOUNDNESS, 1929. Countries. Beef in lbs. Mutton in lbs. Pork in lbs. Veal in lbs. Venison in lbs. Offal in lbs. Game Bacon in lbs. Cheese in lbs. Tinned Fish in lbs. Furred. Feathered. Milk. Meat. Argentine 586,283 59,703 6,089 15 — 42,405 — — — 73 674 — Australia 6,834 45,465 182 50 — 3,788 1,349 — — — — — — Belgium — — — — — — 1,387 410 — — — — — Brazil 6,627 146 — — — 63 — — — — — — — Britain 22,610 30,216 61,466 10,836 1,072 39,873 22,302 25,892 4,031 1,270 789 149 — Canada — — — — — — — — 312 — — — 2,718 Chile — 4,373 — — — — — — — — — — — Denmark — — — — — — — 536 7,335 — 10 16 — Egypt — — — — — — — 250 — — — — — France — — — — — — 99 5,299 — — — — — Holland — — — — — — 593 1,681 7,791 23 3,571 672 — Hungary — — — — — — — 1.427 — — — — — Ireland 3,284 2,858 17,972 4,445 — 22,783 146 2,537 2,823 — 24 3 — Italy — — — — — — — 951 — — — — — Manchuria — — — — — — — — — — — — New Zealand 9,831 103,819 12,355 — — 13,052 66 — — — — — — Poland — — — — — — — — 1,324 — — — — Russia — — — — — — — 2,099 — — — — — U.S.A. — — — — — 16,565 — 706 130 — 826 178 — Uruguay 4,171 6,302 — — — 400 — — — — — — — Totals, 1929 639,640 252,822 98,064 15,346 1,072 138,929 25,942 41,788 23,746 1,293 5,293 1,682 2,718 Totals, 1928 908,981 354,357 107,881 18,094 2,137 151,015 26,802 53,624 33,517 20 4,909 3,037 1,426 SUMMARY OF UNSOUND FOOD DESTROYED. Tons. cwts. qrs. lbs. Central Markets 821 5 3 1 Cold Stores 284 5 2 17 Leadenhall Market and City Shops Shops 21 14 2 18 Total for the year 1929 1,127 6 0 8 Total for the year 1928 1,252 17 3 0 Total for the year 1929 1,127 6 0 8 Decrease 125 11 2 20 Twenty-eight Naval Officers received training in meat inspection at the Central Markets, Smithfield, during the year. EXPORT OF MEAT. During the year 93 certificates were issued at the request of merchants in connection with meat which it was proposed to export to other countries. PUBLIC HEALTH (LONDON) ACT, 1891.—UNSOUND MEAT—PROSECUTION. Serial No. Date. Business. Where heard. Before whom. Offence. Result. 1 13/5/29 Pig Guildhall. Ald. William Under the City of London Fined Breeders. P. Neal. (Various Powers) Act, 1911, £10 10s. 0d. section 39, being the persons Costs who consigned the diseased £6 6s. 0d. carcases of two pigs and ten pigs' plucks for sale for human consumption. *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. Country Killed. Per cent. Town Killed. Per cent. †Foreign Killed. Per cent. Home Killed. Per cent. American Killed.‡ Per cent. Australian and New Zealand. Per cent. 1925 14.4 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 1928 22.1 5.7 4.9 — 48.6 18.7 1929 20.8 5.5 4.9 — 49.4 19.4 The following figures supplied by the Superintendent of the Market are of interest :— 1925. 1926. 1927. 1928. 1929. Tons. Tons. Tons. Tons. Tons. Average daily delivery into the Markets 1,517 1,564 1,594 1,478 1,491 **Minimum delivery on any one day 147 144 286 256 288 Maximum delivery on anv one dav 5,160 5,259 4,278 3,699 3,179 The heaviest weight previously recorded on any one day (20th December, 1926) was— 5,259 tons. *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. † Includes "General Foreign Meat and Produce." ‡ Includes South American Imports. 52 Table showing Weight of Meat delivered, and Meat delivered to Contractors as unsound, during each Month of the Years 1928 and 1929. Month. Meat delivered at the Market, 1928. Unsound Meat delivered to Contractors, 1928. Meat delivered at the Market, 1929. Unsound Meat delivered to Contractors, 1929. Tons. cwts. qrs. Tons. cwts. qrs. Tons. c.wts. qrs. Tons. cwts. qrs. January 42,535 0 0 68 9 0 44,179 0 0 165 17 2 February 39,256 0 0 98 7 2 37,943 0 0 76 17 3 March 41,207 0 0 54 0 1 37,498 0 0 94 12 2 April 38,686 0 0 57 3 3 39,678 0 0 85 14 1 May 38,503 0 0 100 10 3 39,607 0 0 65 12 3 June 35,200 0 0 151 14 2 33,859 0 0 58 11 3 July 34,736 0 0 100 11 0 38,189 0 0 100 9 2 August 37,457 0 0 108 0 1 35,668 0 0 81 7 0 September 35,413 0 0 71 13 0 36,282 0 0 104 11 3 October 43,046 0 0 139 15 3 42,884 0 0 151 0 3 November 41,944 0 0 142 11 3 38,804 0 0 79 11 3 December 42,174 0 0 160 0 1 41,248 0 0 84 19 1 Totals 470,157 0 0 1,252 17 3 465,849 0 0 1,149 6 2 One ton in every 405 tons of meat paying toll in the Central Markets, Smithfield, was condemned last year, as compared with one ton in 375 in 1928. CENTRAL MARKETS, SMITHFIELD. *Table showing the average deliveries at the Central Meat Market, and other details for successive quinquennial periods during the past 56 years :— Quinquennium. Annual Average General Supply. Seizures by Inspectors % of Unsound Meat. 1874-1878 Tons. 178,373 cwts. 10 qrs. 0 Tons. 192 cwts. 18 qrs. 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 0 749 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 1924-1928 477,405 0 0 1,210 2 0 .253 1929 465,849 0 0 1,149 6 2 .246 * I am indebted to the Clerk and Superintendent of the Central Markets for the figures relating to the market supplies, sources of origin, &c. INSTRUCTION OF MEDICAL PRACTITIONERS IN MEAT INSPECTION. The Corporation is recognised to have valuable material and educational resources at its disposal at Smithfield Market, access to which is of great importance to students desiring to qualify for any of the public appointments requiring a knowledge of meat and its several affections. Facilities have already been granted to teaching institutions, and their number has now been increased by adding to the list the London School of Hygiene and Tropical Medicine, in whose course of instruction to medical practitioners qualifying for the Diploma in Public Health would exist a gap were this practical experience not available to their students. FISH SUPPLIES. 239,332 tons of fish, of which 216,936 were land-borne and 22,396 water-borne, were received at or near Billingsgate Market during the year. This was an increase of 2,510 tons in the land deliveries, and a decrease of 2,202 tons in the deliveries by water. 53 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 1929. 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 18,504 1 2 1,957 15 0 20,461 16 2 80 12 1 1 ton in 253 829 tons, or 0.394% February 16,103 9 0 1,307 8 2 17,410 17 2 18 16 3 „ 924.267 „ „ 0.108% March 18,722 10 3 1,857 9 2 20,580 6 1 89 15 2 „ 229.243 ,, ,, 0.436% April 17,728 5 1 1,828 8 2 19,556 13 3 112 16 0 „ 173.74 „ „ 0.76% May 20,391 15 2 1,632 17 0 22,024 12 2 167 13 0 „ 131.372 „ „ 0.761% June 18,275 6 1 1,472 9 0 19,747 15 1 83 12 1 „ 236.181 „ ,, 0.423% July 18,984 6 2 1,748 8 2 20,732 15 0 226 16 2 „ 91.404 ,, ,, 1.094% August 18,229 6 3 2,117 17 0 20,417 3 3 225 15 3 „ 90.426 ,, ,, 1.106% September 17,130 3 3 2,144 9 0 19,274 12 3 187 4 3 „ 102.942 „ „ 0.971% October 18,488 17 2 2,449 15 1 20,938 12 3 251 7 1 „ 83.300 ,, „ 1.200% November 18,851 7 3 2,364 19 3 21,216 7 2 67 3 1 „ 315.896 „ „ 0.316% December 15,526 9 3 1,514 10 2 17,041 0 1 75 13 0 „ 225.261 „ „ 0.443% Totals 216.936 4 1 22,396 9 2 239,332 13 3 1,587 6 1 „ 150.778 „ „ 0.663% * 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 1929 and the five years 1924—1928. 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. 1924 190,088 21,634 211,722 1,617 7 2 1 ton in 130.933 tons or 0.763% 1925 193,782 25,702 219,484 1,822 0 3 1 „ 113.601 „ 0.882% 1926 199,540 23,959 223,499 1,938 9 0 1 ,, 115.295 „ 0.867% 1927 207,056 22,904 229,960 2,070 1 0 1 „ 111.028 „ 0.900% 1928 Average (5 years) 214,426 24,598 239,024 2,241 12 1 1 „ 106.163 „ 0.903% 200,978 23,759 224,737 1,937 18 0 1 ton in 115.404 tons or 0.853% 1929 216,936 22,396 239,332 1,587 6 1 1 ton in 150.778 tons or 0.663% PUBLIC HEALTH (MEAT) REGULATIONS, 1924. There are two wholesale meat markets in the City of London, situated at Smithfield and Aldgate, and one retail meat market, situated at Leadenhall Street. Smithfield Market.—This market covers an area of nine acres and is the largest dead meat market in the world. Transport at Smithfield.—All classes of transport of meat to and from the markets operate :— (1) Meat Carriers. (2) Butchers, by means of their own vehicles. (3) Railway Companies. (1) Carriers.—The general condition of the vehicles used by the carriers is of a good standard, and the majority of carriers follow the Regulations. During the year it has not been necessary to take proceedings against any of them for non-compliance in respect of the condition of their vehicles. The class of carrier requiring supervision is that in which only one or two vehicles are owned, hence there is difficulty in sparing one of the vehicles for renovation, and painting or repair is generally of a hurried nature. (2) Butchers' Own Vehicles.—The type of vehicle used by retail butchers varies from hand-barrows and carrier cycles to horse traps and model meat vans, but the number of model vans is steadily increasing, thereby allowing more time for the supervision of other vehicles, many of which are far from realising a desirable standard. The use of private cars is still a source of trouble, and shows a tendency to increase in spite of prosecutions instituted against some of the offenders. It is found that the butcher using a private car is in a small way of business : in some cases the offenders are street butchers. H 54 (3) Railway Companies.—The conditions under which meat is conveyed by the Railway Companies varies, and any unsatisfactory transport can generally be traced to the negligence or carelessness of the employees. In such occurrence, by arrangement with the Railway Companies, the matter is reported to the representative of the particular Company concerned on duty at the Market, and is dealt with by him immediately. Handling.—(a) Licensed Porters.—This shows great improvement, the porter having realised the conditions which comply with the Regulations. The use and state of overalls and caps are more satisfactory ; sacking for shoulder wraps is discouraged. There are 1,545 licensed porters at Smithfield Market. (b) Retail Butchers and their Employees.—It is under this heading that the majority of contraventions of the Regulations occur, the butcher and his employees not being sympathetically inclined towards the Regulations. Some offences arise from wilful neglect on the part of the employee, but often from forgetfulness and carelessness. Sometimes upon enquiry being made as to the reason why an employee is not wearing his washable cap whilst carrying meat, the employee produces his cap, neatly folded, from his overall pocket. This is a matter which can only be dealt with by means of constant supervision and reminder, and in exceptional cases drastic measures. General Observations.—The question of the wet cleansing of the footways during the loading of meat into vehicles, which was the cause of dissatisfaction among the carriers, etc., attending the market, has now been remedied and has greatly assisted in the carrying out of the Regulations, owing to the spirit of goodwill founded by this action of the Cleansing Department. Complaints have been received with regard to various matters, including :— (a) Quantities of meat on barrows standing uncovered and exposed to contamination for prolonged periods. (b) Furred rabbits and feathered poultry in contact with meat. (c) Men walking over meat deposited in vans. These complaints and contraventions were made the subject of a circular letter which was issued to carriers and butchers, which has had the desired effect of checking these practices. A new offence has been observed and complained of in the immediate vicinity of Smithfield Market, over which there is at present no legal control, the preparation of chickens for sale by house-to-house hawkers, in places and under conditions likely to contaminate the articles prepared. So far this matter has been the subject of verbal objection, poultry being outside the Regulations. Aldgate Market.—This market, situated in a main thoroughfare, requires close supervision ; the class of vehicle used in transport is improving, and a few model vans are appearing there. Handling by persons not attired in washable overalls and caps is still met with, and is dealt with as suits the conditions in each case. Recently private cars have been in use in this Market for transporting meat, and have been strongly discouraged. Wholesale and Retail Butchers' Shops.—There are 64 establishments in the City of London used for the sale of dead meat, as follows :— Wholesale premises 21 Retail premises 41 Offal merchants 2 The general conditions existing in the above premises are of a high standard. The majority of the City shops are fitted with fixed glass fronts, and several also equipped with modern automatic refrigeration plants. The number of ice boxes in use is now small. The premises are subject to periodical visits of inspection, and in general any improvements or alterations required are readily carried out by the owner. The use of floor sawdust is diminishing, a matter which is regarded as a good indication. The majority of City butchers have now discontinued newspaper as wrapping for meat, although the use of either white or grease-proof paper entails some small expense in the business, it must thrust itself on the notice and appreciation of the purchaser. 55 The number of butchers who manufacture their own sausages is small, and where this business is carried on additional visits are made. Several butchers in the City render their own fat for dripping, and with the exception of one case, this process was carried on without any complaints being received from the premises in the near vicinity. With regard to the exception, this has now been effectively dealt with, and no further nuisance has been reported. A number of butchers have installed new electric digesters for fat melting, and the whole business is carried out with thorough cleanliness under supervision. Distribution Centres for Restaurants.—There are now three of these depots in the City, two having been established during the past year. Visited at frequent intervals, the only disadvantage of these depots is that, in every case, the premises are not sufficiently extensive to cope with the business carried on ; in spite of this decided drawback, meat and bacon is handled under hygienic conditions, and although in one case meat, poultry, fish and provisions are stored in the same premises and in close proximity. Premises Used for the Manufacture of Sausages and Meat Products.—The five factories in the City are subject to weekly inspection. The conditions existing at these premises are of a high standard as to efficiency and cleanliness. Many alterations and improvements have been carried out during the past year, in one case involving the expenditure of several hundreds of pounds. The class of employee engaged in these factories is on the whole high ; personal cleanliness and facilities thereto is made a point in improvement of working details. Premises Used for the Curing of Tongues and Boiling of Hams.— Five businesses of this type are in existence in the City, two being in basements ; the general conditions regarding storage and process are satisfactory. Bacon Shops.—There are 29 premises from which bacon is sold in the City; three of these are for wholesale trade only. The conditions met with under this class of business is only fair; this is due to the fact that the majority of shops selling bacon are also provision stores, and owing to the large number of various brands of other commodities of necessity stocked, the space devoted to the storage and selling of bacon is limited and in some cases unsatisfactory. Trouble has been experienced in some cases in having defects remedied, but it is expected that the conditions will continue to improve without any compulsory action being necessary. Bacon Stores and Curing Stoves.—There are three firms in the City who are included under this heading. The premises are well kept and clean. Recently a new warehouse and four new curing stoves have been erected by one firm ; these are reputed to be of the most modern type. Transport and Handling of Irish Meat.—The conditions mentioned in last year's report have not been improved to any appreciable extent. Prosecutions, etc.—Numerous verbal cautions have been given during the year, 685 cautionary letters written and 35 prosecutions ordered ; these last involved the issuing of 105 summonses. Fines totalling £122 10s. and costs £8 9s. have been imposed for offences under the Regulations. The number of cases during the past year shows an increase of 14 over last year ; and unavailing caution of a certain class of butcher by means of letters made it necessary to take further steps in obtaining adherence of the Regulations. It is only after repeated cautions have been given, that proceedings are taken, except in isolated cases, a serious offence necessitating immediate proceedings. SUMMARY OF CASES. No. of No. of No. of No. of No. of No. of No. of No. of Cases. Smithfield Cases. Aldgate Cases. Outside Butchers. City Butchers. Street Butchers. Smithfield Carriers. Smithfield Porters. 35 26 9 25 5 3 1 1 ANALYSIS OF OFFENCES. Private Clothing and Dirty Insufficient Protection, Car. Headcovering Offences. Vehicles. Dirty Cloths, etc. 7 27 14 9 General Observations.—There is a general improvement in all sections of the meat trade and less opposition is met with. In many cases the source of contraventions is want of consideration on the part of butchers and their employees; when occasion arises a short talk on the elementary rules of hygiene has proved quite effective. The mutual goodwill is highly appreciated by all the officers concerned in dealing with the meat trade and employees. H 2 56 INSPECTION OF FOOD AT CITY WHARVES. The duty of supervision of food at the Wharves is undertaken by Mr. D. E. Sillett, and the following is a summary of the chief products coming under observation :— SUMMARY OF FOOD DISCHARGED AT CITY WHARVES. Description of Total Number of General Range of Article. Where from. Packages. Packages. Weight of Packages. Butter Holland Packages 144,670 6 lbs.—1 cwt. Bacon Bales and Cases 95,200 1 cwt. 2 qrs.—3 cwts. Cheese (Loose) ,, 6,407 4 lbs.—56 lbs. Cheese ,, Packages 379,145 24 lbs.—1 cwt. Eggs Holland and Belgium Cases 74,303 84 lbs.—1 cwt. 2 qrs. Lard Holland Packages 3,625 28 lbs.—56 lbs. Compound „ „ 32,371 56 lbs. Margarine „ „ 927,874 12 lbs.—56 lbs. Cereals :— Barley ,, Bags 715 100 lbs.— 1 cwt. 2 qrs. Beans „ „ 1,879 1 cwt.—2 cwts. Peas „ „ 17,864 1 cwt.—1 cwt. 3 qrs. Semolina „ „ 50 1 cwt.—1 cwt. 2 qrs. Rice ,, & Japan „ 1,101 1 cwt.—1 cwt. 2 qrs. Tapioca ,, & E. Africa ,, 36 1 cwt.—1 cwt. 3 qrs. Cornflour „ „ 114 2 cwts. Coffee E. Africa, Costa Rica „ 89,016 1 cwt. 2 qrs. and Santos. Cocoa and Chocolate E. Africa and Holland 27,029 28 lbs.—2 cwts. Fruit (Soft) :— Apricots Holland and S. Africa Packages 133 14 lbs.—56 lbs. Apples Australia, New Zea- Casks and Boxes 99,994 28 lbs.—1 cwt. 2 qrs. land, Canada, U.S.A., Holland and Russia. Plums Holland Packages 1,013 7 lbs.—12 lbs. Pears Australia, S. Africa, „ 6,965 6 lbs.—28 lbs. Holland and Russia. Currants Holland ,, 11,411 6 lbs.—12 lbs. Strawberries „ ,, 7,908 7 lbs.—12 lbs. Peaches ,, „ 616 10 lbs.—14 lbs. Gooseberries „ ,, and Bags 154 40 lbs.—100 lbs. Rhubarb ,, Bundles 1,424 28 lbs. Cherries ,, Baskets 7,918 12 lbs.—40 lbs. Bilberries „ Chip Baskets 70 7 lbs.—12 lbs. Cranberries „ Boxes 8,108 28 lbs. Fruit (Dried) :— Currants Greece and Turkey Bags and Cases 227,450 28 lbs.—56 lbs. Raisins Greece, Turkey, Spain, Packages 231,925 8 lbs.—56 lbs. California and Russia. Sultanas Greece, Smyrna, Cali„ 384,718 24 lbs.—56 lbs. fornia. Plums California and Russia Boxes 172,286 24 lbs. Apricots „ ,, ,, 15,116 24 lbs. Peaches California „ 4,527 24 lbs. Pears „ „ 10,272 24 lbs. Figs Greece, Spain and Bags and Cases 115,592 28 lbs.—4 cwts. Smyrna. Dates Persia and Turkey Boxes 3,204 3 qrs. Evaporated Apples California and Russia Cases 8,616 56 lbs. Fruit Salad California „ 500 24 lbs.—56 lbs. Citrons Spain and Italy ,, 117 24 lbs.—56 lbs. Muscatels Spain Boxes 38,360 8 lbs.—24 lbs. Cherries Italy and Canada Cases 1,218 28 lbs.—2 cwts. Fruit (Green) :— Oranges Brazil, S. Africa, Italy Packages 366,839 3 qrs.—1 cwt. 1 qr. and Spain. Lemons Italy and Spain „ 444,426 1 cwt. Grapes Holland, Spain and „ 89,209 12 lbs.—40 lbs. Russia. Melons Holland, Spain and „ 36,302 12 lbs.—1 cwt. 1 qr. Russia. Pomegranates Spain „ 2,297 28 lbs.—1 cwt. 1 qr. Grape Fruit W. Indies and Cali„ 353 3 qrs. fornia. Pineapples St. Michael 3,140 1 cwt.—2 cwts. 57 Description of Total Number of General Range of Article. Where from. Packages. Packages. Weight of Packages. Vegetables :— Carrots Holland Packages 36,733 40 lbs.—1 cwt. 1 qr. Cauliflowers ,, „ 43,590 24 lbs.—40 lbs. Sprouts ,, „ 5,941 100 lbs. Cabbages „ „ 6,704 1 cwt. Parsnips „ Bags 2,613 1 cwt. Lettuces „ Packages 177,904 12 lbs.—56 lbs. Potatoes Holland, Spain, St. Bags and Packages 318,548 56 lbs.—1 cwt. 1 qr. Malo and Algiers. Onions Holland, Spain, Egypt „ „ 144,972 1 cwt.—1 cwt. 1 qr. and Russia. Tomatoes Holland and Spain Packages 508,356 12 lbs.—56 lbs. Radishes Holland „ 3,742 28 lbs.—1 cwt. Endives „ „ 113 12 lbs.—56 lbs. Cucumbers „ ,, 19,715 12 lbs.—40 lbs. Beetroots „ Bags 680 1 cwt. Beans „ Packages 526 28 lbs.—1 cwt. Peas „ „ 364 28 lbs. 1 cwt. Sugar „ Bags and Packages 100,280 28 lbs.—2 cwts. Tinned Goods :— Cherries Italy Cases 62,494 24 lbs.—48 lbs. Apricots Spain and California ,, 41,017 48 lbs. Pines Singapore and Hawaii ,, 148,141 48 lbs. Fruit Pulp and Holland, Spain and „ 44,652 48 lbs.—100 lbs. Salad. California. Loganberries California „ 30,733 48 lbs. Vegetables Holland, Spain, Italy „ 18,346 50 lbs.—100 lbs. and Russia. Pilchards California „ 5,500 1 cwt.—1 cwt. 3 qrs. Tomatoes Spain, Italy and Russia ,, 136,671 50 lbs.—100 lbs. Jellied Veal Holland „ 10,146 36 lbs. Pears California „ 53,581 48 lbs. Hams Holland „ 3,904 12 lbs.—1 cwt. Peaches California ,, 54,450 48 lbs. Tongues Holland „ 1,089 48 lbs.—1 cwt. Condensed Milk Italy, Ireland and Hoi- ,, and Casks 1,299,338 48 lbs.—3 cwts. land. Brawn Holland „ 11,901 36 lbs. Sardines Portugal „ 11,969 56 lbs.—1 cwt. Sausages Germany and Holland „ 1,583 56 lbs.—1 cwt. Salmon Canada and America „ 43,411 48 lbs. Apples Canada, America and „ 4,367 50 lbs.—60 lbs. Russia. Pork and Beans California „ 26,208 56 lbs. Anchovies Holland and Portugal „ 1,437 1 cwt.—2 cwts. Plums Canada and California „ 6,339 60 lbs. Sterilized Cream Holland Drums 3,874 14 lbs.—56 lbs. Grapes Spain Cases 250 56 lbs.—1 cwt. Lobsters California „ 636 48 lbs. Grape Fruit Florida ,, 6,840 50 lbs. Corned Beef Holland ,, 11,380 72 lbs. Blackberries Italy „ 99 40 lbs.—56 lbs. Chicken Holland „ 404 40 lbs.—56 lbs. Chicken and Ham „ „ 216 56 lbs.—1 cwt. Roll. Ham and Beef ,, „ 119 56 lbs.—1 cwt. Roll. Strawberries Italy „ 76 48 lbs. Prawns * California „ 2,315 48 lbs. Sugar Corn „ „ 500 48 lbs. Egg Yolk Holland „ 48 28 lbs.—56 lbs. Raisins Spain „ 20 48 lbs. Sturgeon Russia „ 400 56 lbs. Kidneys Holland 3 28 lbs. Pork 2 28 lbs. Soups „ „61 48 lbs. Macaroni Italy Packages 86,773 28 lbs. Nuts (Various) Italy, Spain and France Bags and Packages 73,776 28 lbs.—2 cwts. Milk Powder Holland Packages 31,648 50 lbs.—1 cwt. Ginger (Preserved) China Cases and Casks 11,661 30 lbs.—3 cwts. 58 Description of Total Number of General Range of Article. Where from. Packages. Packages. Weight of Packages. Vegetables in Brine Russia, Spain and HolCasks 7,210 3 cwts.—4 cwts. land. Miscellaneous :— Cocoa Butter Holland Packages 2,362 1 cwt.—2 cwts. Liquorice Italy and Holland „ 559 1 cwt.—2 cwts. Fruit Pulp Holland, Italy and Casks 9,772 4 cwts. Spain. Confectionery Holland, Turkey Packages 16,241 28 lbs.—1 cwt. Russia and Italy. Biscuits Holland „ 4,751 1 cwt.—1 cwt. 2 qrs. Sugar Candy „ „ 3,308 28 lbs.—56 lbs. Rabbits Holland and Belgium Cases 2,515 1 cwt. 2 qrs. Milk Sugar Holland Packages 150 28 lbs.—1 cwt. Honey Holland, Spain and Cases 578 1 cwt.—2 cwts. Bulgaria. Carraway Seeds Holland Bags 1,233 1 cwt. 1 qr. Drained Cherries Italy and Canada Packages 324 28 lbs.—1 cwt. Crispbread Sweden Cases 30,200 1 cwt.—2 cwts. Tongues (Salted) Holland Casks 6 1 cwt.—3 cwts. Fresh Cream „ Drums 234 56 lbs.—120 lbs. Candied Peel Italy and Spain Cases 100 56 lbs.—1 cwt. Citrons in Brine „ ,, Casks 52 4 cwts. Block Condensed Holland Packages 12 56 lbs. Milk. Orange Peel Spain and Italy Casks 120 2 cwts.—4 cwts. Lemon Skins „ „ „ 70 2 cwts.—4 cwts. Onion Powder Holland Cases 200 1 cwt. 2 qrs. Carrot Powder „ „ 54 1 cwt. 2 qrs. UNSOUND FOOD SURRENDERED AT RIVERSIDE WHARVES. As a result of the daily inspection of City wharves, 128 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 34 1 0 Condensed Milk (removed at request of owners) 2 9 2 Fruit (various) 42 1 2 Vegetables (various) 73 7 0 Fruit Pulp 3 4 3 Dried Fruit 4 12 3 Vegetables in Brine 2 0 0 Miscellaneous 10 16 3 Total 172 13 1 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 738 persons, compared with 751 in 1928. 80 per cent, are adults and 20 per cent, children (under 14 years). In addition to these Artizans' Dwellings, the Corporation, in connection with a slum clearance scheme, erected :— (1) In December, 1927, a block of buildings, Bearsted House, in Hutchison Street, which contains 88 rooms, arranged in 24 tenements, and housing at the end of 1929 106 persons (91 per cent, adults and 9 per cent, children). (2) In January, 1929, a similar block of buildings, Dutton House, in New Street, containing 52 rooms, arranged in 16 tenements, and housing at the end of 1929 66 persons (53 per cent. adults and 47 per cent. children). There are 7 shops, each with a basement, in Bearsted House, and 8 shops, similarly provided with a basement, in Dutton House. The number of births was 7, viz. : 4 males and 3 females. The birth-rate was 7.7 per 1,000, which is 1.5 per 1,000 above the average for the previous five years. The death rate for 1929 was 12.1 per 1,000 per annum. 59 TABLE OF BIRTHS AND DEATHS OCCURRING AT THE ARTIZANS' DWELLINGS, STONEY LANE, HOUNDSDITCH, BEARSTED HOUSE, HUTCHISON STREET, AND DUTTON HOUSE, NEW STREET, DURING THE YEAR 1929. Name of Block. Births. Mortality from all Causes at subjoined ages. Males. Females. At all ages. Under 1 year. 1 and under 5 5 and under 15 15 and under 25 25 and under 65 65 and upwards. NORTH BLOCK .... 1 1 .... .... .... .... .... 1 SOUTH „ .... .... 1 .... .... .... .... .... 1 KING'S „ 1 .... 4 .... .... .... .... 2 2 QUEEN'S „ .... .... 3 .... .... .... .... 2 1 PRINCE'S „ 2 1 1 .... .... .... .... .... 1 BEARSTED HOUSE .... .... .... .... .... .... .... .... .... DUTTON „ 1 1 1 .... .... .... .... .... 1 Totals 4 3 11 .... .... .... .... 4 7 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 7.7. The rate last year was 6.6. The baths, provided for the use of tenants of these Buildings, which were opened in May, 1904, continue to be extensively used, the number of persons bathing during 1929 being 14,058, of whom 5,397 were males and 8,661 were females. The accompanying table is compiled from the monthly records of attendances at the baths:— RECORD OF ATTENDANCES AT THE BATHS, ARTIZANS DWELLINGS. Month. Sex. Total. Males. Females. Children. Adults. Children. Adults. January 73 263 59 425 820 February 56 264 50 386 756 March 97 343 123 582 1,145 April 86 299 103 511 999 May 112 368 186 662 1,328 June 108 511 169 828 1,616 July 111 399 220 712 1,442 August 139 435 193 685 1,452 September 102 442 217 689 1,450 October 94 335 144 539 1,112 November 75 338 121 534 1,068 December 65 282 91 432 870 Totals 1,118 4,279 1,676 6,985 14,058 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 11 9 15 February 121 2 12 20 March 225 4 4 20 April 173 3 45 13 May 302 19 9 26 June 235 5 25 40 July 232 4 9 34 August 91 — 2 23 September 200 3 6 40 October 233 6 5 24 November 241 7 7 21 December 423 6 13 38 Totals 2,676 70 146 314 60 MIDDLE DISTRICT—Inspector G. H. Fowler. Month. Premises Inspected. Orders issued. Notices served. Improvements effected. January 245 4 20 22 February 227 6 8 20 March 240 6 13 16 April 233 4 12 21 May 252 4 6 17 June 226 5 8 14 July 30 7 9 10 August 215 5 3 25 September 203 5 11 19 October 238 3 7 18 November 284 4 5 19 December 232 3 5 10 Totals 2,625 56 107 211 EAST DISTRICT—Inspector W. H. Ralph. Month. Premises Inspected. Orders issued. Notices served. Improvements effected. January 157 4 3 10 February 195 2 2 19 March 237 8 28 25 April 215 9 11 29 May 289 13 10 21 June 125 7 11 35 July 243 7 9 18 August 238 3 4 14 September 119 5 8 24 October 185 10 10 25 November 257 4 8 26 December 371 6 12 35 Totals 2,631 78 116 281 THE FOREGOING ARE SUMMARISED AS UNDER :— District. Number of Inspections made. Orders issued. Notices served. Improvements effected. West 2,676 70 146 314 Middle 2,625 56 107 211 East 2,631 78 116 281 Totals 7,932 204 369 806 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 provision of handrails for staircases. For securing adequate lighting. For the taking of precautions in any case of infectious disease. 61 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 43 332 132 2.5 50 *Middle — — — — 3 East 17 116 67 1.7 29 Total 60 448 199 2.3 79 These houses are periodically inspected, and in April of each year the owners or tenants 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 79 notices during 1929. In addition to the foregoing, there are eleven blocks of Dwellings let out in tenements, but not placed on the Register for the reason that each holding is " self-contained," it having been decided in a Court of Law that in these circumstances they are not subject to the Byelaws for houses let in lodgings, or occupied by members of more than one family :— No. of Tenements. No. of Name and situation of Artizans' Block Dwellings. one Room. Two Rooms Three Rooms Four Rooms Five Rooms or over. No. of Inhabitants. WEST DISTRICT. Albion Buildings, No. 21, Bartholomew Close 10 22 Albion Buildings, No. 22, Bartholomew Close 10 16 Bartholomew House, Bartholomew Close 16 2 33 Dean Street Blocks, Fetter Lane— Block A 6 16 „ B 2 4 11 „ C 3 3 10 ,, D 6 1 1 21 „ E 7 1 1 15 „ F 4 4 16 St. Ann's Chambers, Ludgate Hill 3 14 1 26 Bloomfield House, Snow Hill 16 2 47 Total (Six " Blocks ") 41 71 1 4 233 MIDDLE DISTRICT. Bridgewater House, Fann Street 9 1 15 City Buildings, Moor Lane 21 11 79 Total (Two " Blocks ") 1 30 11 1 94 EAST DISTRICT. Harrow Alley and Stoney Lane— North Block 48 8 181 South 5 22 13 134 Prince's ,, 5 50 158 Queen's ,, 5 40 5 137 King's „ 8 16 16 121 Barker's Buildings, Catherine Wheel Alley, Bishopsgate 6 3 2 1 30 Bearsted House, Hutchison Street 8 16 109 Total (Three " Blocks ") 29 179 52 17 890 These eleven blocks contain 437 tenements, and are inhabited by 1,217 persons—an average of 2 - 8 persons to each tenement. * Premises demolished after service of Notices. I 62 The following table is included in this Report in accordance with the request contained in the letter from the Ministry of Health, dated 13th December, 1928, 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 Nil. Outside City Nil. (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) 753 (2) Number of dwelling houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 1,019 (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 37 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 136 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 125 (2) Number of dwelling houses in which defects were remedied after service of formal notices : (a) By owners 120 (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. 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 254 plans were submitted with regard to proposed reconstruction of water-closets or drains in the City. Of these, 227 were approved ; 16 revised and approved ; and 11 not approved. 63 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 no case was reported by your officers. 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 76 cases so investigated in 1929, it was found necessary to make amendments to soil and waste pipes, water-closets, &c., in 40 instances. House, Trade, and other Refuse Removal.—The City Engineer informs me that the refuse removed from the City in 1929 consisted of 22,482 cartloads of street sweepings and slops, and 48,588 loads of house and trade refuse, a total of 71,070 loads. The total for the year 1928 was 71,915. 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, 369 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 17,618,839 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 vicinity 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 1929, 19 were situated in the East District, 24 in the Middle District, and 17 in the West District. Defective Connections to Sewer.–During the year, 19 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, 16 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 17 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. I 2 64 SEWER EMANATIONS. Some little difficulty was experienced during the year in connection with ventilation of the sewers passing through the City area. Many complaints were received of offensive smells emanating from the surface ventilators of these sewers. The practice generally adopted in the past, of sealing them on receipt of such complaints, has not been practicable in view of the serious explosion which occurred in an adjoining area towards the end of 1928, and the subsequent recommendation of the Commission appointed by the Home Secretary, that all structures forming underground cavities should be adequately and continuously ventilated. The alternative practice of erecting upcast ventilating shafts against adjoining buildings has also presented difficulties by reason of the fact that the Corporation has no power to enforce this, and is dependent upon the owners' permission. In the past this permission was more often granted than refused, but now that architectural features are of such importance in new City buildings, owners are reluctant to consent to anything which may in any way interfere with the artistic aspect. The origin of the nuisance this year was the drought experienced during the summer, and as this was of an unusual nature, it is hoped that complaints will be less frequent in future. Where they are received, however, efforts will be made if the complaint is justified, to obtain permission of owners of adjoining property to erect an upcast ventilating shaft, failing which, if circumstances justify it, the City Engineer will temporarily seal the offending surface ventilator during the period of hot and dry weather. PIGEONS. The nuisance caused by the congregation of pigeons in the City has again been a cause for complaint by several influential property owners and private persons. A campaign on similar lines to that adopted in 1928 is being put into operation at the time of writing this Report, and will be referred to at greater length next year. THE FLY NUISANCE. Possibly because of the warm conditions which were experienced during the summer, many complaints were received as to the nuisance caused by the large number of flies which were invading certain residential and restaurant premises in the City. Special attention was given to this matter, especially with regard to the possibility of the spread of infection. Leaflets were distributed throughout the City directing attention to the fly nuisance, and indicating certain precautionary measures which should be taken in order to minimise the danger and nuisance so far as practicable, and drawing the attention of residents and others to the necessity for the strict observance of cleanliness, frequent removal of dust and other refuse, and particularly of waste food stuffs. The several stables existing in the City received special attention, but it was found in general that the persons responsible at these places appreciated the necessity of efficient control if the breeding of flies was to be kept at its minimum. I wish to acknowledge the assistance which has been rendered to me by the several Ward Beadles in bringing the suggestions which I have mentioned above to the notice of the residents in their districts. Their intimate knowledge of their areas was of considerable assistance. EXHUMATION OF HUMAN REMAINS. 102, FETTER LANE AND PLAYHOUSE YARD. During the course of excavation work at the above-mentioned premises several quantities of human remains were unearthed. In both instances they were very old bones and showed evidence of having been previously disturbed. Appropriate arrangements were made for their reverent reinterment. 65 EXHUMATION AND REINTERMENT OF BODIES. City of London Cemetery.—During the year the bodies of 11 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. LONDON COUNTY COUNCIL (GENERAL POWERS) BILL, 1930. OFFENSIVE BUSINESSES. As the law at present stands, it would appear that such sanction as may be given by the responsible Authority for the establishment anew of offensive businesses, has to be given, if given at all, without qualification or the imposition of conditions, except as regards limitation of period, and the above-mentioned Bill, sought to enable responsible Authorities to impose such conditions, restrictions, or limitation of period, as is considered necessary wher sanctioning the establishment anew of offensive businesses. This is a desirable addition to the powers possessed. FACTORY AND WORKSHOP ACT, 1901, &c. Factories, Workshops and Workplaces.—The premises upon the Register number 3,663, in which are included 7,908 workrooms, &c. There were served 1,878 notices during the year for various purposes under the Acts. The number of Factories, Workshops and Workplaces at follows :— present Registered is as Registered Places. Workrooms, &c., in Registered Places. FACTORIES 1,179 3,558 WORKSHOPS 1,410 2,035 WORKPLACES Kitchens of Restaurants and Tea Rooms 620 1,278 Kitchens of Licensed Premises 239 659 Stables 12 12 Other places 203 366 3,663 7,908 The following is a Summary of Inspections of separate workrooms, since 1919:— FACTORIES. Workshop Inspectors. Woman Inspector. Totals. 1920 866 — 866 1921 1,956 2 1,958 1922 1,763 — 1,763 1923 1,517 — 1,517 1924 1,050 — 1,050 1925 1,119 — 1,119 1926 1,419 — 1,419 1927 1,298 — 1,298 1928 1,383 — 1,383 1929 1,902 — 1,902 WORKSHOPS. Workshop Inspectors. Woman Inspector. Totals. 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 1927 1,242 7 1,249 1927 1,259 – 1,259 1928 1,093 1 1,094 1929 1,247 – 1,247 The following is a Summary of Inspections of separate workrooms, &c., during the year:— Workshop Inspectors. Woman Inspector. Totals. FACTORIES 1,902 – 1,902 WORKSHOPS 1,247 – 1,247 WORKPLACES 1,178 11 1,189 66 WORKPLACES. 1920 Workshop Inspectors. Woman Inspector. Totals. 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 1928 845 1 846 1929 1,178 11 1,189 Bakehouses.—Bakehouses are scheduled as Workshops (Part 2, Sixth Schedule), and are required to be registered by the Local Authority (Section 131). The following is a list of Bakehouses registered in the City :— ABOVEGROUND BAKEHOUSES. † 15/19, Artillery Lane. †*85, Middlesex Street. † 280, Bishopsgate. † 12 and 13, Widegate Street. † Great Eastern Railway Hotel. UNDERGROUND BAKEHOUSES. † 188, Aldersgate Street. †*37, Middlesex Street. 262, Bishopsgate. †*122, Middlesex Street. 8, Copthall Avenue. † 3, Pancras Lane. †*67, Farringdon Street. † 21, Stoney Lane. *93, Fetter Lane. 68, St. Mary Axe. 48, Knightrider Street. 194, Upper Thames Street. SUMMARY. Aboveground Bakehouses 5 Underground Bakehouses 12 17 * These have been established at least 43 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 10 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. One case of infectious disease was reported in connection with outworkers' premises in the City. The following figures show the number of Outworkers notified since 1902 :— Year. Number of Lists received. Outworkers Employed in City. Outworkers Employed outside City Total number of Outworkers. 1902 17 3,752 3,769 (Note.—First Notice issued to all employers at the end of 1904.) 1905 576 236 7,891 8,127 1908 1,506 624 16,909 17,533 1911 1,515 656 16,405 17,061 1912 1,481 709 15,777 16,486 1913 1,523 718 16,025 16,743 1914 1,581 739 15,941 16,680 1915 1,589 807 15,444 16,251 1916 1,481 661 14,766 15,427 1917 1,366 602 13,319 13,921 1918 1,395 607 12,802 13,409 1919 1,379 688 12,581 13,269 1920 1,359 802 13,102 13,904 1921 1,411 717 11,035 11,752 1922 1,493 783 11,956 12,739 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 1928 1,307 879 10,897 11,776 1929 1,263 861 10,478 11,339 67 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) 36 80 73 189 Do. Initial Inspections (Workrooms) 70 131 155 356 Do. Periodical Inspections (Tenancies) 119 192 243 554 Do. Periodical Inspections (Workrooms) 327 410 809 1,546 Do. Re-inspections (Sanitary Works, &c., in hand) 80 158 193 431 Workshops, Initial Inspections (Tenancies) 38 39 37 114 Do. Initial Inspections (Workrooms) 51 46 55 152 Do. Periodical Inspections (Tenancies) 187 271 291 749 Do. Periodical Inspections (Workrooms) 282 349 446 1,077 Do. Re-inspections (Sanitary Works, &c., in hand) 218 257 161 636 Workplaces, Initial Inspections (Tenancies) 2 14 11 27 Do. Initial Inspections (Workrooms) 18 24 12 54 Do. Periodical Inspections (Tenancies) 20 8 92 120 Do. Periodical Inspections (Workrooms) 54 10 160 224 Do. Re-inspections (Sanitary Works, &c., in hand) 59 81 65 205 Bakehouses, Initial Inspections (Tenancies) 1 — — 1 Do. Initial Inspections (Workrooms) 1 — — 1 Do. Periodical Inspections (Tenancies) 4 5 3 12 Do. Periodical Inspections (Workrooms) 5 9 3 17 Do. Re-insppctions (Sanitary Works. &c., in hand) 13 18 1 32 Kitchens of Restaurants, &c.— Initial Inspections (Tenancies) 6 21 10 37 Initial Inspections (Workrooms) 15 43 23 81 Periodical Inspections (Tenancies) 30 100 85 215 Periodical Inspections (Workrooms) 90 241 169 500 Re-inspections (Sanitary Works, &c., in hand) 78 266 78 422 Kitchens of Licensed Premises– Initial Inspections (Tenancies) — — 2 2 Initial Inspections (Workrooms) — — 5 29 5 106 Periodical Inspections (Tenancies) 19 58 Periodical Inspections (Workrooms) 57 201 56 314 Re-inspections (Sanitary Works, &c., in hand) 24 87 29 140 Workshops notified by H.M. Inspector 15 22 9 46 General Complaints received 14 9 8 31 Miscellaneous visits 1,139 349 326 1,814 DEFECTS FOUND. FACTORIES, WORKSHOPS, WORKPLACES. KITCHENS OF RESTAURANTS, &c. 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 137 54 21 27 46 19 15 21 6 346 Want of Ventilation 2 5 1 5 5 2 1 3 – 24 Overcrowding 1 1 – – – – – – – 2 Want of Drainage of Floors 6 — — 3 2 — 1 — – 12 Want of Lavatory Accommodation 1 – 1 Food improperly stored — — — 1 15 2 — 2 2 22 Storage Cistern defective 1 5 2 — 3 1 — 1 1 14 Accommodation for Refuse 1 2 1 3 2 1 3 1 – 14 Accumulation of Refuse 3 5 9 — 1 — — 1 – 19 Sanitary Accommodation. Insufficient (Tenancies) 1 8 — — 1 — — 1 – 11 Unsuitable (Do.) 12 — 5 — — — — — – 17 Defective (Do.) 139 87 95 5 8 3 2 6 2 347 Do. (No. of Conveniences)* 139 87 105 5 8 3 2 6 2 357 Not separate for Sexes (Tenancies) — 10 5 — 1 — — 1 – 17 Other Nuisances 126 16 17 34 40 5 17 12 3 270 Total Defects found 429 193 156 78 124 33 39 50 141 116 * Figures not included in total defects found or remedied. 68 DEFECTS REMEDIED. FACTORIES, WORKSHOPS, WORKPLACES. KITCHENS OF RESTAURANTS, &C. 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 81 56 20 38 40 17 11 22 6 291 Want of Ventilation 1 5 — 6 10 3 l 2 — 28 Overcrowding 2 1 — — — — — — — 3 Want of Drainage of Floors 2 — — 6 1 — l — — 10 Want of Lavatory Accommodation — — 1 — — — — 1 — 2 Food improperly stored — — — 4 14 2 — 3 2 25 Storage Cistern defective — 4 2 — 3 1 l 3 — 14 Accommodation for Refuse 1 2 2 3 2 — 3 1 — 14 Accumulation of Refuse 2 4 8 3 2 — — 2 1 22 Sanitary Accommodation. Insufficient (Tenancies) — 8 — — — — — — — 8 Unsuitable (Do.) 9 — 4 — — — — — — 13 Defective (Do.) 115 94 94 8 11 5 4 8 2 341 Do. (No. of Conveniences)* 115 94 99 8 11 5 4 8 2 346 Not separate for Sexes (Tenancies) 7 8 4 — 1 1 — 1 — 22 Other Nuisances 79 23 15 56 49 4 16 14 9 258 Total Defects remedied 299 205 150 124 133 33 37 57 13 1,051 ACTION TAKEN. East District Middle District. West District. Totals. Matters referred to H.M. Inspector— Nuisances remediable by H.M. Inspector 5 4 5 14 Failure to affix Abstract 19 7 22 48 Matters referred by H.M. Inspector— Notified by H.M. Inspector 13 52 19 84 Reports sent to H.M. Inspector 19 50 16 85 Notices served— Factories—Intimation 14 14 5 33 Statutory 5 — — 5 Workshops—Intimation 56 30 19 105 Statutory 5 2 2 9 Workplaces, &c.—Intimation 3 3 4 10 Statutory 3 1 — 4 Kitchens of Restaurants— Intimation 3 13 6 22 Statutory 4 — 6 10 Kitchens of Licensed Premises— Intimation 2 5 1 8 Statutory 1I — — 1 Orders required from Sanitary Committee 13 39 12 64 Certificates for Cleansing issued by Medical Officer of Health 3 17 5 25 Matters referred to District Inspectors 2 6 1 9 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 — — — 1,342 Names and Addresses, &c., received from other Authorities — — — 333 Names and Addresses transmitted to other Authorities — — — 9,883 Notices served on Employers — — — 1,671 Letters written, &c — — — 23 Firms visited 24 65 25 114 Outworkers Lists not kept — 8 2 10 Do. not sent — 8 2 10 Infectious Disease occurring in Outworkers' Premises — 1 — 1 Registered Factories and Workshops at which Outwork is received— Inspections 62 88 67 217 Defects found 115 22 19 156 Defects remedied 48 22 20 90 " Places from which work is given out"— Inspections — 6 33 39 Defects found — 1 — 1 Defects remedied — 1 — 1 * Figures not included in total defects found or remedied 69 In consequence of the prevalence of small-pox some portion of the time of the Workshop Inspectors has had to be devoted during the year to following up the many contacts employed in the City of London. The figures relating thereto are included under the heading miscellaneous visits. WOMAN INSPECTOR. , Total. Domestic Workshops at Inspections — which Outwork is received Defects reported and appropriate action taken — Domestic Workshops which Inspections — do not receive Outwork Defects reported and appropriate action taken — Domestic Premises receiving Inspections — Outwork (not registerable as Workshops). Defects reported and appropriate action taken — Underground Conveniences Inspections 36 for Women. Defects reported and appropriate action taken 6 Railway Stations (Ladies' Inspections 35 Rooms). Defects reported and appropriate action taken 5 Inspections 11 Kitchens Defects reported and attended to or referred to appropriate Inspector 3 L.C.C. (G.P.) Act, 1904. InNotifications received 7 spection of premises after Visits 10 cleansing of children Defects reported and appropriate action taken 1 Children Act, 1908 (Nurse Notifications received 4 Children) Visits 5 Defects reported and appropriate action taken — Births notified 86 Notification of Births Act, Home visits to infants 226 1907. Home visits to children between 1 and 5 years of age 159 Visits re Still Births — Deaths of Infants under 1 Number Notified 4 year of age. Visits 2 Expectant Mothers 31 Distribution of Milk (Free) Children under 6 months - Children over 6 months 38 Number of children in receipt of :— Distribution of Dried Milk Free Reduced or Cost Price 27 Number of Mothers attending Infant Welfare Centre 101 Total Attendances of Mothers at Infant Welfare Centre 898 Expectant Mothers visited at home 90 Special Visits 86 70 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) 743 38 – Workshops (including Workshop Laundries) 876 114 – Workplaces (other than Outworkers' premises) 507 55 – Total 2,126 207 – 2.—Defects Found in Factories, Workshops and Workplaces. Particulars. Number of Defects. Number of offences in respect to which Prosecutions were instituted. Found. Remedied. Referred to H.M. Inspectors. (1) (2) (3) (4) (5) Nuisances under the Public Health Acts :—* Want of cleanliness 346 291 11 — Want of ventilation 24 28 — — Overcrowding 2 3 l — Want of drainage of floors 12 10 — — Other nuisances 340 335 — — Sanitary accommodation insufficient 11 8 — — unsuitable or defective 364 354 — — not separate for sexes 17 22 — — 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 1,116 1,051 12 — •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 Factory and Workshop Act was reported. 71 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. (1) Lists† Outworkers.† Lists. Outworkers. Contractors. Workmen. Contractors. Workmen. (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) Wearing Apparel— making, &c 1,082 3,873 6,074 26 44 143 1,671 cleaning and washing Household Linen Lace, Lace Curtains and Nets Curtains and Furniture Hangings Furniture and Upholstery Electro Plate File making Brass and brass articles Fur pulling (Furriers) 84 215 235 9 2 9 Cables and Chains Anchors and Grapnels Cart Gear Locks, Latches and Keys Umbrellas, &c 42 6 299 3 — 7 Artificial Flowers 12 — 107 3 — 4 Nets, other than Wire Nets Tents Sacks Racquet and Tennis Balls Paper, &c., Boxes, Paper Bags 2 5 — — — — 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 1,222 4,099 6,715 41 46 163 1,671 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 G 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. The 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. K 2 72 4.—Registered Workshops. Workshops on the Register (S. 131) at the end of the year. Number. (1) (2) Important classes of workshops, such as workshop bakehouses, may be enumerated here. General Workshops 1,393 Bakehouses (including Factory Bakehouses) 17 Total number of Workshops on Register *1,410 * These were found to be 2,035 Workrooms, &c., in places Registered. 5.—Other Matters. Class. (1) Number. (2) Matters notified to H.M. Inspector of Factories :— Failure to affix Abstract of the Factory and Workshop Act (S. 133, 1901) 48 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 84 Reports (of action taken) sent to H.M. Inspector 85 Other — Underground Bakehouses (S. 101) :— Certificates granted during the year Nil. In use at the end of the year 12 Date, 31st December, 1929. (Signature) W. M. WILLOUGHBY, Medical Officer of Health. 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 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, tc the Secretary of State (Home 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 factories, workshops, workplaces, or homework. The duties of Local Authorities, and the Medical Officer of Health under the Act of 1901 are detailed in the Home Office Memorandum of March, 1912. FERTILISERS AND FEEDING STUFFS ACT, 1926. The provisions of this Act (which came into operation in 1928) have been carried out during the year. As the result of communications received from time to time from outside Authorities, &c., and of correspondence passing between the Corporation and the parties concerned, a number of visits were made to certain firms who were not complying with the terms of the Act. In most cases non-compliance was due to a lack of knowledge of the somewhat intricate clauses of the Act, and such visits were a means, therefore, not only of indicating clearly to the offenders the particular infringements, but also of advising on, and securing, prompt rectification and abatement of the offences. The quarterly returns have been forwarded to the Ministry of Agriculture and Fisheries. Mr. A. J. C. Lickorish was appointed Agricultural Analyst under the Act in the place of Mr. Pinchin, who died during the year. 73 SUPERVISION OF THE ICE CREAM TRADE. Inspections in connection with the manufacture or sale of Ice Cream within the City have been carried out. The barrows or stalls of itinerant vendors were visited from time to time during the summer season, and in any instance where lack of cleanliness or other defect was observed, the issue of a caution resulted in appropriate steps being taken to remedy the defect. Nine premises were registered during the year in accordance with the requirements of the London County Council (General Powers) Act, 1928. CITY MORTUARY. Bodies Received—Post-Mortems and Inquests :— Bodies received at the Mortuary to await burial 176 Post-Mortem examinations made 90 Inquests held on bodies 165 Inquests held on fires 2 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. 1924 481,391 160 145 0 1925 493,813 150 145 0 1926 305,970 155 139 4 1927 227,037 178 169 1 1928 180,530 159 147 2 Average for previous 5 years 337,748 160 149 1 1929 ... 515,375 176 165 2 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 Disinfecting Station during the year in connection with the export trade :— Number of Certificates issued. Number of articles disinfected. Fees received by the Corporation. 1,268 508,780 £1,306 Disinfection—Infectious Disease :— Articles disinfected after cases of infectious disease 5,151 Library Books disinfected 87 Public Vehicles—Electric Ambulance 4 Police Litter 4 Premises disinfected (including offices) 858 Lockers disinfected at request of General Post Office Authorities 146 There were also seven bags of letters which had been contaminated by Pathological specimens submitted to the process of disinfection at request of G.P.O. Cleansing of Persons Act, 1897 :— Number of verminous persons bathed 91 Cleansing of School Children :— Total number of children cleansed 981 77 Articles were destroyed at request of owners. In addition to the foregoing, some assistance was rendered to the Metropolitan Borough of Finsbury during a period when the disinfection apparatus operated by that authority was out of use. 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. It was, however, for the first time since the apparatus was installed, not necessary to take advantage of its utility. 74 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 1929 :— INQUESTS HELD UNDER THE CITY OF LONDON FIRE INQUESTS ACT, 1888. Date of Inquest. Premises Burnt. 3rd and 11th June, 1929 5, Lower Thames Street. 17th and 25th June, and 2nd July, 1929 Victoria Embankment, L.C.C. Subway. In addition to the above, the City Coroner personally inquired into 207 "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. RAT REPRESSION. The table set out on page 76 indicates the investigations and advisory work of your rat officer under the Rats and Mice (Destruction) Act, 1919. 1,094 buildings, occupied by 1,891 firms, were inspected. Of these, 376 were found to be infested. One or other of the rat-catchers working in the City was engaged by business firms in 168 instances, and poisons were laid down in 308. Break-back, wire and other traps were used in 410 premises. Varnish traps were relied on in 246 buildings. Cats or dog's were kept by 186 firms. Complaints or applications for advice numbered 132. In addition to the above palliative measures, preventive rat-proofing was carried out in 333 instances, and repair of drainage defects in 1,173. The Act lays the duty of disinfesting a premises found to harbour rats on the occupier ; this disinfesting is not the work of your officer who, however, knowing the habits of rats, is in a position to suggest measures to the occupiers which are likely to be effective. There are no figures, even approximate, obtainable of the total number of rats killed. The firm of Messrs. Wm. Dalton & Son inform me that they killed nearly 24,000 in the City during the year. A certain decrease of infestation is suggested by the number of buildings newly constructed, the demolition of old houses and constant attention to drainage and sewerage work. The brown, or wild rat, is not in evidence so much as is the black, or domestic species. With increasing confinement of the wild rat to the sewers, and an environment above ground increasingly unsuited to its habit of breeding, this is to be expected. Though proofing cannot entirely exclude rodents from buildings, the measure is of first importance in keeping down their numbers ; all new buildings should afford a reasonably rat-proof condition. In many old buildings proofing is practically impossible, and in some, where good might be effected, the owners, whose duty it would naturally become, are not responsible under the Act and cannot be called upon to incur the necessary expenditure. Demolition of old buildings liable to infestation should be preceded by poison baiting ; the usual objection to poison is not valid in this case, and the precaution may prevent the over-running of adjacent property hitherto uninfested. 75 The palliative, trapping, is most conveniently effected by the varnish trap, though every device found to be efficient should be used under circumstances suitable to its employment. The following figures have been supplied to me by the City Engineer :— Brick sewers reconstructed 6 Brick sewers constructed 2 Brick sewers being reconstructed (January, 1930) 2 Brick sewers being constructed (January, 1930) 1 Disused sewers filled in and abolished 7 Miscellaneous repairs to sewers and drains, etc 48 New drains constructed in connection with new buildings 28 Drains of existing buildings reconstructed 30 Drains reconstructed in connection with house reconstruction 68 Gulley drains reconstructed 72 Gulleys constructed 8 House and gulley drains repaired 236 Disused drains bricked up 411 Rats killed by sewer foreman and his men 1,007 No poison was used in the sewers during the year. The number of drain reconstructions carried out under the supervision of the Inspectors attached to this department is set out on page 76. Rat-catchers and poisoners are engaged on contract in many of the tea-shops, restaurants, hotels and business premises; several vacant building sites were dealt with, and all necessary information was given to representatives who called for advice. Rat-proofing was carried out in 333 buildings. This last consisted of the wiring of area gratings, ventilators and roof openings, and the stopping of rat holes in walls and floors, the removal of wooden floors from basements, with substitution of concrete and the stripping of internal walls of woodwork which affords breeding places. a: RATS AND MICE (DESTRUCTION) ACT, 1919. Summary Showing Investigations and Inspections Made and Details of Work Carried Out under the Above Act, for the Year ended December 31st, 1929. 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 Drainage and Sewerage Work carried out during the year. Special Observations. Rat-Catcher Employed. Poison Used. Wire Traps. Breakbacks. Varnish Traps. Other Traps. Cats or Dogs kept. Rat-holes stopped, &c. By City Engineer's Department. By M.O.H. Department. Complaints or Applications for Advice. January 112 2.1 42 236 10 32 8 33 27 1 14 32 919 254 10 February 22 1.7 10 39 4 7 2 6 7 — — 5 6 March 44 2.1 19 96 4 15 5 16 6 1 12 12 5 April 66 1.6 27 110 11 15 8 20 14 3 12 20 13 May 97 1.8 35 180 14 20 10 21 18 1 18 24 10 June 66 1.2 26 81 13 23 7 19 17 — 10 20 16 July 116 1.4 46 170 30 25 9 32 27 1 23 44 6 August 101 1.5 45 154 11 41 10 31 31 1 15 31 14 September 115 2.3 36 265 15 24 4 30 18 — 22 35 13 October 114 1.7 4 203 9 35 13 24 23 — 13 22 10 November 119 1.6 41 188 21 38 11 31 23 2 16 42 15 December 122 1.3 45 169 26 33 6 33 35 1 33 46 14 Totals 1,094 1.6 376 1,891 168 308 93 296 246 11 186 333 1,173 132 *Buildings systematically inspected 962 „ inspected in consequence of complaints 132 Totals 1,094 77 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, 66 persons were examined by the Medical Officer of Health during 1929. Four of these persons were reported as physically unfit for office. Twenty-one officers were also medically examined with a view to their retirement. With four exceptions, all were reported to be unfit for duty. I have the honour to be, Gentlemen, Your obedient Servant, W. M. WILLOUGHBY, Medical Officer of Health for the City of London. Public Health Department, Guildhall, E.C APPENDICES. PAGE Appendix A—Street Lists of Mortality 80 „ B— „ „ Infectious Diseases 85 „ C—Register of Houses let in lodgings or occupied by members of more than one family 87 „ D—List of Adoptive Acts, Orders, Bye-laws and Regulations in operation in the City 89 „ E—Congress : Royal Institute of Public Health, at Zurich 90 Royal Sanitary Institute, at Sheffield 90 National Association for the Prevention of Tuberculosis— (1) Geneva 91 (2) Newcastle-on-Tyne 91 „ F—Venereal Disease : Poster exhibited in Underground Conveniences 92 „ G—Leaflet issued relating to precautions which should be taken against Influenza 93 „ H—Poster issued relating to precautions which should be taken against Influenza 94 L 2 80 APPENDIX A.—STREET LISTS OF MORTALITY. STREET OR PLACE. No. of House. Sex. Age. Date of Death. Cause of Death. Remarks. Addle Street, Brewers' Hall. — M 61 18th Jan. la. Peritonitis b. Carcinoma of Stomach 2. Following operation for relief of obstruction Albion Buildings 21 F 81 17th Feb. la. Chronic Myocarditis Died in City of London Infirmary, Bow Road. b. Chronic Nephritis c. Chronic Endometritis Aldersgate Street, Manchester Hotel. — M 60 22nd Mar. la. Broncho-pneumonia Resided in Holland. Aldersgate Street 38 M 62 14th Sept. la. Cardiac Failure b. Hemiplegia–Cardiac Hypertrophy. c. Chronic Bronchitis—Emphysema " " 181 F 32 10th Sept. la. Acute Toxaemia of Pregnancy b. Degeneration of Liver 2. Instrumental delivery of twins, due to uterine inertia. Aldgate High Street 55 M 56 7th Oct. la. Secondary Carcinomatosis of Bone Died in London Hospital. b. Primary not found " " 62 F 45 12th Aug. la. Septicaemia Died in St. Bartholomew's Hospital. b. Acute Gangrenous Appendicitis Artillery Lane 7 M 6 months. 9th Feb. la. Broncho-pneumonia Died in Children's Hospital, Holborn. b. Infantile Dermatitis Barker's Buildings 22 F 83 27th Mar. la. Chronic Bronchitis b. Senile Debility—c. Syncope " 77 F 83 17th Feb. la. Myocardial Degneration Died in City of London Infirmary, Bow Road. Bartholomew Close 9 F 72 8th Mar. la. Bronchitis b. Myocarditis Bartholomew House 2 M 58 4th Mar. la. Disseminated Sclerosis Died in City of London Infirmary, Bow Road. b. Myocardial Degeneration " " 15 F 78 13th Feb. la. Syncope b. Chronic Myocarditis c. Chr. Nephritis 2. Chr. Bronchitis Bartlett's Buildings 8 M 78 8th May la. Cardiac Failure Died at Bournemouth. b. Myocardial Degeneration Basinghall Street 28a F 58 6th April 1 a. Cardiac Failure b. Valvular Disease of Heart. „ 66 F 67 6th July la. Carcinoma of Liver Died in City of London Infirmary, Bow Road. 2. Myocardial Degneration „ 69 M 77 3rd May la. Angina Pectoris b. Senility Bird-in-Hand Court 1 M 55 22nd April Shock due to bullet wound of the brain, self-inflicted—Suicide—No evidence to show state of mind Resided at Palmers Green. Bishopsgate (G.E. Hotel) — M 20 30th Jan. la. Sudden Cardiac Syncope b. Influenza „ 22 F 44 13th Sept. la. Lobar Pneumonia Died in St. Bartholomew's Hospital. „ 212 M 52 4th Feb. la. Myocardial Degeneration Died in Lambeth Hospital. b. Chronic Bronchitis. c. Asthma Blackfriars Bridge — M 20 8th July Instantaneous death—Multiple Injuries —Knocked down by lorry Resided in Southwark— Inq.—P.M. Blackfriars Railway Stn. — M 40 5th March Syncope and shock—Multiple Injuries —Fall in front of train Resided at Kilburn. Bloomfield House, King Street. 12 M 74 27th Jan. la. Chronic Bronchitis Died in City of London Infirmary, Bow Road. b. Myocardial Degeneration „ „ 14 F 77 31st May la. Diabetic Coma b. Diabetes 2. Carcinoma of Vagina „ „ 18 F 63 8th Jan. la. Chronic Endocarditis Died in City of London Infirmary, Bow Road. b. Chronic Bronchitis „ „ 18 M 69 13th Sept. la. Uraemia Died in St. Bartholomew's Hospital. b. Retention of Urine c. Enlargement of Prostate 2. Chronic Bronchitis Brushfield Street 10 M 57 22nd Dec. la. Chronic Bronchitis Inq.—P.M. b. Cardiac Debility c. Syncope Bucklersbury 1/2 F 2 weeks. 21st Nov. la. Toxaemia Died in Infants' Hospital, Westminster. b. Omphalitis 2. Malnutrition Cannon Street 64 M 56 4th Sept. la. Myocardial Failure Died at Yarmouth. b. Angina Pectoris „ 77 M 64 1st March la. Broncho-pneumonia c. Carcinoma of (Esophagus „ 83 F 7 27th Oct. la. Diphtheria Died in S.E. Hospital, Deptford. Carter Lane 6 M 45 22nd April la. Epileptic Convulsions 2. Valvular Disease of Heart Circus Minories 1 F 79 3rd July la. Cardiac Failure b. Myocarditis c. Senility 81 STREET LISTS OF MORTALITY–continued. STREET OR PLACE. No of House. Sex. Age. Date of Death. Cause of Death. Remarks Cloth Fair 45 F 45 20th Jan. 1a. Lobar Pneumonia b. Chronic Nephritis „ 45 F 80 11th March 1a. Bronchitis 2. Old Age Coleman Street 5 M 70 6th Dec. la. Cardiac Failure b. Hemiplegia „ 68 F 49 29th Oct. la. Mitral Stenosis b. Syncope Deans Court, Old Bailey 30 M 48 22nd Nov. la. Acute Heart Failure b. Influenza Dean Street, Fetter Lane 3d F 86 2nd March Syncope Enlarged Heart and Valve Disease— Degneration of Blood Vessels „ 3d M 68 17th May Syncope due to Sanguineous Apoplexy Devonshire Square 15 F 50 23rd May la. Bronchitis b. Pulmonary Congestion c. Syncope Dutton House, New Street 5 F 84 23rd May la. Myocardial Degeneration Exchange Buildings, Cornhill. F 44 31st May la. Cerebral Embolism b. Angina Pectoris c. Asthma 2. Myocarditis Falcon Square 7 M 43 17th June la. Heart Failure b. Aortic Incompetence c. Chr. Endocarditis 2. Acute Rheumatic Fever Fenchurch Street 118 M 53 22nd May la. Broncho-pneumonia b. Chronic Bronchitis c. Heart Failure Fenchurch Street Station – M 47 31st Aug. Haemorrhage Head severed by train —Suicide—Unsound Mind Inq.—Resided at Islington. Fleet Street 71 F 34 9th Nov. la. Cardiac Failure P.M.—Died in Royal Chest Hospital. b. Mitral Stenosis c. Rheumatic Fever Fore Street 19/ 21 M 70 27th Sept. la. Angina Pectoris Resided in Stepney. b. Morbus Cordis „ 112 M 59 20th Feb. la. Acute Bronchitis b. Myocardial Degeneration of Heart c. Cardiac Syncope Frederick's Place 4 F 51 15th May la. Hæmatemesis Died in St. Thomas's Hospital. b. Simple Chr. Gastric Ulcer Godliman Street 10 M 72 11th May la. Myocardial Degeneration Died in City of London Infirmary, Bow Road. b. Chr. Bronchitis Gracechurch Street 1/2 M 52 3rd Dec. Syncope due to mitral Stenosis, with Inq—P.M. Degeneration of Heart Muscle Great New Street 11 M 61 29th Sept. la. Cardiac Failure b. Myocardial Degeneration „ 13 F 82 31st Jan. la. Heart Disease (valvular) Died in Infirmary, Thavies Inn. b. Chronic Bronchitis c. Old Age „ 16 F 74 8th June la. Cerebral Thrombosis Died in City of London Infirmary, Bow Road. b. Chronic Endocarditis Gresham Street 32 F 65 23rd Feb. la. Carcinoma (Right Kidney) Died in Paddington. „ 77 M 53 29th July Asphyxia due to strangulation by hanging—Suicide—Unsound Mind Hosier Lane 30 M 44 7th July la. Gastric Carcinoma Hutchison Street 5 M 73 30th Jan. 1a. Cerebral Haemorrhage & Thrombosis Died in Home for Jewish Incurables. c. Paralysis Right Arm 2. Bronchitis iS: Myocardial Degeneration Jewry Street 12 F 85 16th Feb. Shock and Syncope—Chronic Bronchitis—Disease of Coronary Arteries, accelerated by shock of fire in adjoining house. Died in St. Bartholomew's Hospital. „ 31 M 61 3rd Sept. la. General Peritonitis Died in London Hospital. b. Operation for Acute Intestinal obstruction c. Peritoneal Obstruction 2. Carcinoma of Pelvic Colon John Street 12 M 71 21st July la. Syncope Died in City of London Infirmary, Bow Road. b. Myocardial Degneration 2. Asthma—Cystitis King's Bench Walk 4 M 63 29th June la. Cardiac Disease b. Chronic Nephritis King's Block, Stoney Lane 3 M 61 14th May la. Myocarditis b. Arterial High Tension „ 9 F 74 29th Dec. la. Acute Lobar Pneumonia b. Acute Nephritis 2. Myocardial Degeneration „ 29 F 74 15th Feb. la. Capillary Bronchitis b. Myocarditis 82 STREET LISTS OF MORTALITY—continued. STREET OR PLACE. No. of House Sex. Age. Date of Death. Cause of Death. Remarks. King Street, Cheapside 33 M 17 11th Nov. 1a. Pulmonary Tuberculosis Died in Consumption Hospital, Kensington. King William Street 46 M 47 28th Nov. la. G.P.I. Died in City of London Mental Hospital. „ 81 M 60 23rd Sept. Syncope due to Embolism of Left Coronary Artery. Lambs Buildings, Temple — F 89 1st Nov. la. Myocarditis Laurence Pountney Hill 6 F 56 23rd Jan. la. Myocardial Degeneration b. Intestinal Stasis 2. Chronic Nephritis Laurence Pountney Lane 5 F 69 17th March la. Bronchitis Leather Lane — M 68 20th Jan. la. Cardio Vasc. Degeneration Died in Epsom. Little Britain 26 F 45 1st July Syncope due to Valvular Heart Disease, with disease and narrowing of a coronary artery supplying heart with blood Inq.—P.M. Liverpool Street Rly. Stn. — F 58 27th March Syncope, due to Fatty Degeneration of the Heart Muscle Resided at Richmond. „ — F Newly born. 11th April Syncope, due to Congenital Defect of heart P.M. — Natural — (Unknown.) London Street 7 M 25 24th Oct. la. Cardiac Failure Died in London Hospital. b. Acute Intestinal Obstruction c. Acute Appendicitis, with Abscess Formation 2. Operation—Drainage of Abscess and division of bands London Wall 6 F 70 10th July la. Carcinoma of Vagina Died in City of London Mental Hospital, Stone. 2. Cardio Vascular Degeneration Ludgate Broadway 6 F 69 30th Oct. la. Coronary Embolism Died in Wimbledon. b. Fibrous Myocarditis 2. Bronchitis Ludgate Circus 4 M 72 7th Feb. la. Pneumonia Died in St. Bartholomew's Hospital. b. Auricular Fibrillation Ludgate Hill 11 M 3 21st Jan. Asphyxia due to Membraneous Diphtheria of Larynx Died on way to St. Bartholomew's Hospital. „ 34 F 75 7th Aug. la. Chr. Bronchitis Duration indefinite Died in Bethlem. Hospital. Mansell Street 26 F 88 14th Nov. la. Myocardial Degeneration Died in City of London Infirmary, Bow Road. b. Chronic Bronchitis Mark Lane 50 M 40 30th Jan. la. Pulmonary Tuberculosis 64 F 68 17th Feb. la. Asthenia Martin Lane 7 F 75 27th May la. Chronic Nephritis Died in City of London Infirmary, Bow Road. b. Chronic Myocarditis c. Carcinoma of Breast „ 8 F 69 30th Dec. la. Chronic Bronchitis „ „ b. Chronic Nephritis c. Chronic Myocarditis Middlesex Street 116 M 52 28th Dec., 1928 la. Heart Failure Died in St. Bartholomew's Hospital. b. Aortic Aneurism c. Myocarditis, Chronic Bronchitis and Empheysema „ 116 M 59 11th Jan. la. Tabes Dorsalis Died in St. Peter's Hospital. „ 116 M 49 24th Jan. la. Lobar Pneumonia Died in City of London Infirmary, Bow Road. „ 116 M 57 31st Jan. la. Lobar Pneumonia „ „ „ 116 M 50 14th Feb. la. Syncope „ „ b. Lobar Pneumonia c. Asthma „ 116 M 78 12th Feb. la. Chronic Bronchitis „ „ b. Myocardial Degeneration „ 116 M 73 27th Feb. la. Chronic Endocarditis „ „ b. Chronic Nephritis „ 116 M 73 11th March la. Chronic Bronchitis b. Myocardial Degeneration „ „ „ 116 M 81 15th March la. Uraemia „ „ b. Chronic Nephritis c. Myocardial Degeneration „ 116 M 69 15th March la. Cerebral Thrombosis „ „ b. Chronic Nephritis c. Arterio Sclerosis „ 116 M 52 11th May Lobar Pneumonia „ „ „ 116 M 55 24th May Fractured Skull—Knocked down by motor car—Inq.—Accidental Died in Metropolitan Hospital. „ 116 M 64 17th June la. Uraemia Died in St. Peter's Hospital. b. Chronic Nephritis „ 116 M 59 10th July la. Carcinoma of Larynx Died in City of London Infirmary, Bow Road. b. Asphyxia and Heart Failure „ 116 M 76 3rd Sept. la. Chronic Myocarditis „ „ b. Chronic Nephritis c. Chronic Bronchitis 83 STREET LISTS OF MORTALITY—continued. STREET OR PLACE. No. of House Sex. Age. Date of Death. Cause of Death. Remarks. Middlesex Street 116 M 73 4th Oct. la. Myocardial Degeneration Died in City of London Infirmary, Bow Road. b. Chronic Nephritis c. Chronic Bronchitis „ 116 M 51 22nd Oct. Syncope due to shock, due to Rupture of Thoracic Aneurysm of Aorta—cause of which, specific or otherwise, unknown P.M.—Inq. „ 116 M 67 19th Oct. la. Sarcoma of Sternum Died in St. Peter's Hospital, Stepney. „ 116 M 55 28th Oct. Lobar Pneumonia—Self-neglect—P.M. Inq. Died in City of London Infirmary, Bow Road. „ 116 M 53 8th Nov. 1a. Carcinoma of Liver „ b. Colitis „ 116 M 55 1st Dec. la. Chronic Endocarditis „ b. Chronic Nephritis c. Ascites „ 116 M 67 13th Dec. 1a. Myocardial Degeneration „ b. Chronic Nephritis Milk Street 1/2 M 52 31st Dec., 1928 la. Tubercular Laryngitis Died in St. Columba's Hospital. b. Tubercular Pneumonia „ 37 M 68 24th Feb. 1a. Lobar Pneumonia Died in City of London Infirmary, Bow Road. Montague Court 2 M 77 13th Sept. 1a. Chronic Nephritis „ „ b. Chronic Cystitis c. Myocardial Degeneration „ 5 M 31 7th Feb. 1a. Morbus Cordis 2. Pulmonary Catarrh Moorgate 119 M 48 10th Nov. 1a. Carcinoma of Bladder Died in St. Joseph's Hospice, Hackney. New Bridge Street 19 F 49 4th Feb. la. Heart Failure b. Acute Pneumonia c. Influenza New Broad Street 36 F 4 months. 17th March la. Acute Toxaemia Died in Infants' Hospital, Vincent's Square. b. Influenza Nicholas Lane 34 F 68 25th April 1a. Epidemic Catarrh b. Broncho-pneumonia c. Heart Failure 2. Chronic Rheumatoid Arthritis, general Noble Street 42a F 49 25th Feb. la. Auricular Fibrillation Died in Chelsea. b. Old Rheumatic Heart c. Influenza <-V Bronchitis North Block, Stoney Lane 42 M 82 9th March la. Asthma b. Senile Debility Norwich Street 261 F 68 24th Jan. la. Chronic Endocarditis Died in City of London Infirmary, Bow Road. b. Chronic Nephritis c. Rheumatoid Arthritis 2. Diabetes Mellitus Old Bailey, — M 43 26th Sept. la. Broncho-pneumonia " Bell " & " Three Tuns " Old Broad Street 19 M 53 8th May b. Pericarditis & Effusion Resided at Enfield. la. Aneurism of Aorta b. Arterio-Sclerosis „ Dashwood House – M 58 14th Jan. Syncope due to Sudden and Profuse Haemorrhage from Rupture of a Thoracic Aneurysm „ — M 55 9th June la. Gastric & Chronic Heart Disease Died at Falmouth. b. Syncope „ 117 M 38 6th May la. Tuberculous Peritonitis Died in St. Bartholomew's Hospital. b. Cirrhosis of Liver c. Chronic Nephritis 2. Eryseplas Philpot Lane 23 F 67 19th March la. Heart Failure Died in London Hospital. b. Broncho-pneumonia 2. Chr. Rheumatic Carditis Poppins Court 31 M 53 11th Dec. Syncope, due to Cirrhosis of Liver, consequent upon Chronic alcoholism and from excess Died in St. Bartholomew's Hospital—Inq.—P.M. Prince's Block, Stoney Lane. 42 M 70 1st Dec. Syncope due to Chronic Progressive Myocardial Degeneration of Heart Muscle, accelerated by Chronic Nephritis Pump Court, Temple 2 M 75 28th Feb. la. Senile Decay b. Bronchitis c. Heart Failure „ — M 79 13th March la. Broncho-pneumonia Queen's Block, Stoney Lane. 42 F 85 16th Aug. la. Chronic. Endocarditis Died in City of London Infirmary, Bow Road. b. Chronic Nephritis „ 48 F 47 14th Oct. la. Acute Bronchitis „ „" b. Fatty Degeneration of Heart c. Chronic Nephritis „ 49 M 63 20th Nov. Asphyxia due to acute poisoning by carbon monoxide from gas—Deceased killed himself—Found dead Inq—P.M. Queen's Court, Vine Street 3 M 47 26th June la. Broncho-pneumonia Died in City of London Mental Hospital, Stone. 84 STREET LISTS OF MORTALITY—continued. STREET OR PLACE. No. of House Sex. Age. Date of Death. Cause of Death. Remarks. Queen Street 28 F 67 6th Aug. la. Myocardial Degeneration Died in City of London Infirmary, Bow Road. b. Diseminated Sclerosis c. Gangrene of Foot „ 28 M 74 31st Dec. la. Cerebral Haemorrhage b. Arterio Sclerosis c. Myocarditis River Thames — M 32 29th July Asphyxia due to drowning P.M.—Open V erdict. „ — M 27 4th Aug. Asphyxia due to drowning Suicide—Unsound Mind Resided at Finsbury Park. „ F 40 28th Aug. „ „ „ Inq.—P.M.—Resided in Holborn. Rolls Buildings, Fetter Lane. — M 59 16th Oct. Syncope due to Degeneration of Heart Muscle, Aorta and Coronary Arteries P.M.—Natural. Salisbury Square 315 M 62 8th June Syncope due to Disease of the two Coronary Arteries of the Heart and of the Aorta Resided in Shoreditch. Sergeant's Inn 9 F 40 3rd Aug. Coma—Pneumonia and Sinus Thrombosis, conveyed by pus from Carbuncle after pricking with needle Died in St. Bartholomew's Hospital—P. M.—Inq. Shoe Lane 83 F 37 24th March la. Endocarditis Died in Hornsey. b. Congestion of Lungs c. Influenza Snow Hill, Saracen House — F 77 18th Feb. la. Senility and Cardiac Failure Died in Camberwell. „ 5 M 24 24th March Fracture of Left Frontal Bone, with laceration of Brain—Collision with motor cycle Accidental P.M.—Inq.—Died in Tendring R.D. South Block, Stoney Lane 37 F 74 12th Feb. la. Morbus Cordis b. Bronchitis St. Bartholomew's Hospital, Nurses' Quarters. F 26 3rd Oct. la. Addison's Disease Died in Kensington. St. Michael's Alley, Cornhill 1 M 48 16th Aug. la. Cachexia and Cardiac Failure Died in St. John's Hospital, Lewisham. b. Metastasis in Liver c. Carcinoma of Rectum Stoney Lane 13 F 75 6th Nov. la. Congestion of Lungs 2. Chlorosis Swan Lane 8 F 13 12th April la. Acute Lymphatic Leukæmia— P.M. Died in Charing Cross Hospital. Thavies Inn 18 F 82 31st Jan. la. Heart Failure (valvular) Resided at 13. Great New Street. b. Chronic Bronchitis c. Old Age „ 18 F 2 hrs. 19th Feb. la. Hæmorrhage from the Umbilical Cord at birth. „ 18 F 80 21st May la. Morbus Cordis Resided at 16, Wine Office Court. b. Arterio Sclerosis 2. Senile Decay. Throgmorton Avenue 3 F 56 4th Sept. la. Intestinal Obstruction Died in St. Bartholomew's Hospital. b. Strangulated Hernia Tudor Street 14 M 58 31st Oct. Coma—Corrosive poisoning by Spirits of salts—Deceased killed himself—Unsound mind P.M.—Inq.—Died in St. Pancras. Warwick Lane 22 F 74 12th March la. Cerebral Haemorrhage Watling Street 46 M 58 31st Dec., 1928 Cerebral Hæmorrhage—Chronic Arterio Sclerosis Widegate Street 20 M 42 20th Aug. la. Uraemia Died in London Jewish Hospital. b. Chronic Nephritis Wine Office Court 16 F 80 21st May la. Morbus Cordis Died at City of London Infirmary, Thavies Inn. b. Arterio Sclerosis 2. Senile Decay Whitecross Street 10 F 62 1st May la. Chronic Mitral Disease of Heart b. Nephritis Wood Street 56 M 49 3rd Dec. Syncope due to Diseased Coronary Arteries, with Aortic Valvular Disease of Heart and Fibroid and Fatty Degeneration of the Heart Muscle. Resided at Forest Gate. Wrestlers' Court 4 M 84 3rd Dec. la. Myocardial Degeneration b. Arterio Sclerosis c. Old Age 85 APPENDIX B.—LIST OF CASES OF INFECTIOUS DISEASE OTHER THAN TUBERCULOSIS, 1929. STREET LISTS.—COMPILED FROM NOTIFICATIONS RECEIVED. Street or Place. No. of House. Sex. Age. Disease. Date of Notification. Albion Buildings 21 F 6 Diphtheria 18th January. Aldersgate Street 187 F 13 Scarlet Fever 12th April. Barbican Court 4 M 15 Scarlet Fever 25th July. Basinghall Street 36 M 6 Diphtheria 19th December. Bearsted House 23 M 13 Scarlet Fever 25th May. Bishopsgate 262 F 11 Ditto 27th November. Blomfield House 14 M 7 Chickenpox 9th August. Brackley Street 5 M 21 Measles 18th January. Budge Row 22 M 21 Ditto 12th April. Cannon Street 83 F 7 Diphtheria 21st October. Cannon Street Hotel – F 42 Scarlet Fever 5th April. Carter Lane 22 M 20 Ac. Prim. Pneu. 21st August. Circus, Minories 4 M 43 Diphtheria 31st October. Clement's Lane 6 M 6 Scarlet Fever 22nd October. Cloth Fair 45 F 45 Ac. Prim. Pneu 21st January. Coleman Street 6 M 6 Scarlet Fever 11th November. Cornhill 77 M 25 Ditto 14th January. Crown Court – F 29 Smallpox 20th May. Crosby Square 2 F 44 Chickenpox 11th April. Crutched Friars 41 F 8 Ditto 1st October. Dean Street 3d M 5 Ditto 30th October. Devonshire Square 2 F 5 Scarlet Fever 15th October. Ditto 2 F 2 Ditto 22nd October. Ditto 4 M 24 Measles 15th March. East Harding Street 10 F 7 Chickenpox 7th January. Fleet Street 149 F 7 Ac. Prim. Pneu 8th January. Fore Street 37 M 12 Scarlet Fever 2nd October. Gracechurch Street 59 F 2 Diphtheria 27th December. Great New Street 23 M 22 Ac. Prim. Pneu 25th July. Guildhall Chambers 6 M 3½ Scarlet Fever 27th May. Houndsditch 137 F 5 Ditto 27th February. King's Block 23 M 5½ Chickenpox 29th November. Lawrence Lane 24 F 7 Scarlet Fever 16th November. Little Britain 25 M 7 Ditto 21st September. Long Lane 64 F 13½ Diphtheria 3rd October. Lower Thames Street 53 F 11½ Ditto 30th November. Ludgate Hill 11 M 14 Ditto 23rd January. Ditto 11 M 3 Ditto 23rd January. Middlesex Street 116 – – Ac. Pr. Pneu, 5 cases Various dates. (Salvation Army Hostel). Ditto ditto – – – Smallpox 3 cases Various dates. Milk Street 37 M 68 Ac. Prim. Pneu. 26th February. Minories 140 M 8 Scarlet Fever 11th October. Moorgate 36 F — Chickenpox 6th May New Bridge Street 19 F 50 Ac. Prim. Pneu. 4th February. New Street Square 12 M 27 Dysentery 15th November. North Block 25 F 8 Scarlet Fever 15th October. Old Bailey – M 9 Ditto 23rd April. Old Broad Street 42 F 5 Diphtheria 22nd October. Ditto 117 M 37 Erysipelas 6th May. Printing House Square 5 F 7 Measles 30th December. Queen's Block 8 F 7 Diphtheria. 21st September. Queen Victoria Street 71a M 12 Scarlet Fever 30th September. Rose Alley 9 M 6 Ditto 8th November. Ditto 21 M 6 Chickenpox 6th August. M 86 list of cases of infectious disease other than tuberculosis, 1929. street lists.—compiled from notifications received—continued. Street or Place. No. of House. Sex. Age. Disease. of Notification. Rose Street 11 M 8 Scarlet Fever 25th June. St. Andrew's Hill 7 F 25 Ditto 25th November. St. Bart.'s Hospital (Staff Quarters) – —. — Diphtheria, 9 cases Various dates. Ditto ditto — Scarlet Fever, 7 cases Ditto. St. Dunstan's Hill 14 M 41 Erysipelas 5th April. St. Mary Axe 31 M 19 Erysipelas 16th January. Serjeant's Inn 9 F 31 Chickenpox 2nd December. Shoe Lane 74 F 5 Diphtheria 27 th February. Swan Lane 10 M 6 Scarlet Fever 12th October. Widegate Street 18 M 5 Ditto 23rd July. 87 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 Owner or Tenant. Tenements. Lodgers. 20, Bride Lane E. Sharpe, 20, Bride Lane (o) 1 4 5, Britton's Court Mrs. Hurrel, 5 Britton's Court (t) 2 7 43, Cloth Fair Mr. C. Taylor, 6, Finsbury Square, E.C. (2 o) 2 5 45, do. W. F. Masters, 45, Cloth Fair (o) 3 10 12, Currier's Row W. G. Gallomel, 13, Currier's Row (t) 2 5 10, East Harding Street Eyre and Spottiswoode, East Harding Street (o) 2 8 11, do Do. do. (o) 3 8 12, do Do. do. (o) 4 9 2, Evangelist Court Morris & Co., 37, East Road, City Road (t) 1 2 93, Fetter Lane Friern Manor Dairy Co., 93, Fetter Lane (o) 3 10 29, Fleet Lane Messrs. Watney, Combe & Reid, Stag Brewery, Pimlico (o) 4 12 30, do. Do. do. do. (o.) 2 7 31, do. Do. do. do. (o) 3 8 10, Great New Street Mr. Lee, 10, Great New Street (t) 2 6 11, do. M. Quilty, 11, Great New Street (t) 2 6 12, do. Mr. A. E. Walker, 12, Great New Street (t) 2 9 13, do. F. Wilson, 51, Frankfort Road, Heme Hill (t) 8 19 14, do. Mrs. A. E. Jackson, 14, Great New Street (t) 4 9 16, do. J. Day, 16, Great New Street (t) 3 6 21, do. Goldsmiths' Company, Goldsmiths' Hall (o) 3 8 23, do. Mrs. J. Barnsley, 1, Great New Street (t) 5 9 25, do. Do. do. (t) 6 10 27, do. Do. do. (t) 3 9 7½, Gunpowder Alley T. Townsend, 259, Essex Road, N. (o) 2 6 8, do. Do. do. (o) 4 8 25, Little Britain Mr. Turner, 25, Little Britain (t) 2 4 79, Long Lane Robert Dyas & Sons, 63, Fore Street (o) 2 6 4 & 5, Middle Street J. Hull & Sons, Bartholomew Close (o) 5 10 1, Montague Court H. Tenant, 1, Montague Court (t) 2 9 2, do. R. Hutchins, 2, do. (t) 2 7 3, do. Mrs. Vincent, 3, do. (t) 3 5 4, do. Mrs. F. Smith, 4, do. (t) 3 3 5, do. Miss Saunders, 5, do. (t) 2 4 6, do. E. Jones, 6, do. (t) 2 6 8, Nevill's Court Moravian Mission, 32, Fetter Lane (o) 3 6 9, do. Do. do. (o) 3 8 10, do. Do. do. (o) 7 12 11, do. Goldsmiths' Company, Goldsmiths' Hall (o) 4 12 12, do. Do. do. (o) 6 14 14, Newbury Street J. W. Neighbour, 2, Ironmonger Row (o) 4 13 14, Wine Office Court Messrs. Reynolds & F.ason, 192, Bishopsgate (o) 2 4 16, do. Do. do. (o) 2 4 17, do. Do. do. (o) 2 2 Total 132 332 Average number of lodgers to each occupied tenement: 2.5 Houses demolished or closed as dwelling-houses — Tenement houses on Register 43 Cleansing Notices served 50 MIDDLE DISTRICT. Nil. Houses demolished or closed as dwelling-houses 3* (O) Owner. (T) Tenant. * Houses demolished after service of notices. M 2 88 EAST DISTRICT. Situation of Premises. Name and Address of Owner or Tenant. Tenemnets Lodgers. 7, Artillery Lane Clerk to Bishopsgate Institute, Bishopsgate (o) 3 9 9, do. Claude M. Leigh, 268, Bishopsgate (o) 3 6 21, do. Clerk to Bishopsgate Institute, Bishopsgate (o) 3 7 10, Brushfield Street Reynolds & Eason, 192, Bishopsgate (o) 6 7 12, do. Luke Cohen, 12, Brushfield Street (t) 2 3 14, do. Clerk to Bishopsgate Institute, Bishopsgate (o) 7 9 1, Circus, Minories S. Moses, 65, Mansell Street (o) 6 18 3, do. W. Lewis, 3, Circus, Minories (t) 3 7 4, do. W. Wisdom, 4. do. (t) 4 8 5, do. T. Groves, 5, do. (t) 4 4 3, Three Crown Court, Jewry Place. Mr. Martin, 14, Seething Lane (o) 3 5 18, Widegate Street S. Franks, 18, Widegate Street (t) 2 5 21, do. A. & A. Field, 95, Whitechapel Road (o) 6 6 24, do. W. I. Crane, 25, Widegate Street (t) 3 6 25, do. Do. do. (t) 3 4 2, Goodman's Yard Charrington, Brewers, Mile End Road (o) 3 3 5, Artillery Lane Clerk to Bishopsgate Institute, Bishopsgate (o) 6 9 Total 67 116 Average number of persons to each occupied tenement : 1.7 Houses demolished or closed as dwelling-houses Nil. Tenement houses on Register 17 Cleansing Notices served 29 (O) Owner. (T) Tenant. 89 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 above- ground 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. * This Trade was subsequently regulated by Acts of Parliament (L.C.C. (G.P.) Act, 1902 and 1928). 90 APPENDIX E.—REPORTS OF THE MEDICAL OFFICER OF HEALTH IN REGARD TO THE FOLLOWING CONGRESSES. Royal Institute of Public Health. Zurich. 15th to 20th May, 1929. Royal Sanitary Institute. Sheffield. 13th to 20th July, 1929. National Association for the Prevention of Tuberculosis. 1. Conference on Hygiene and Welfare of Merchant Seamen. Geneva. 7th to 9th October, 1929. 2. Fifteenth Annual Conference. Newcastle-upon-Tyne. 10th to 12th October, 1929. (Ordered to be circulated to Members of the Sanitary Committee, 22nd October, 1929.) 22nd October, 1929. To the Worshipful The Sanitary Committee. Gentlemen, CONGRESS OF THE ROYAL INSTITUTE OF PUBLIC HEALTH, ZURICH, 1929. This Congress was held from May l0th 20th, and the Corporation, as Sanitary Authority, was represented thereat by Mr. E. H. Dutton, Mr. Cyril Gamon and your Medical Officer. Of the varied papers presented and personalities displayed in them and their delivery, might be selected, because of the vivid impression conveyed, that of Professor Bloch, a master in the subject of " allergy," or that condition in which the body is rendered acutely sensitive to some substance which to the vast majority of people is quite harmless or even beneficial. Among other cases, Professor Bloch cited that of a man who presented a persistent and disfiguring eczema of the face which, when traced to its source, originated in a match constantly held between the teeth in the course of his employment. With the cessation of this habit of holding the match, the chronic eczema disappeared completely. Wood chips bound on the arm of this sensitized person produced a wheal and thus clinched the habit as the source of the disease. The professor is a pioneer in such experiment in and the cure of disease : one is honoured in having held the post of recording secretary in the section in which he spoke. Mr. Dunlop Young contributed and read a paper in the Veterinary section. To obtain the full benefit of this, as all congresses, it is good to be lodged in the immediate neighbourhood of the majority of the delegates. The situation of this town and the facilities given by its university afforded a useful combination in the success of this congress. I have the honour to be, Gentlemen, Your obedient Servant, (Signed) W. M. WILLOUGHBY, Medical Officer of Health. 22nd October, 1929. To the Worshipful the Sanitary Committee. Gentlemen, CONGRESS OF THE ROYAL SANITARY INSTITUTE, SHEFFIELD, JULY 13th—20th. During the whole week of the Congress the direction of a light air left the town open to the blaze of sun and clear skies of this summer—an unexpected event in Sheffield. The Corporation, as Sanitary Authority, was represented by your Chairman, Mr. H. J. Gower, Mr. Cyril Gamon, and your Medical Officer. The papers represented all that is best in the forward movement and consolidation of the sanitary position. Your Medical Officer acted as recording secretary of the Hygiene of Food Section. , The delegation was housed with the Council of the Society, and this alone would have ensured the success of a meeting which even otherwise was not in doubt as' to its utility. I have the honour to be, Gentlemen, Your obedient Servant, (Signed) W. M. WILLOUGHBY, Medical Officer of Health. 91 22nd October, 1929. To the Worshipful The Sanitary Committee. Gentlemen, NATIONAL ASSOCIATION FOR THE PREVENTION OF TUBERCULOSIS : (1) Conference on Hygiene and Welfare of Merchant Seamen, Geneva, 7—9th October, 1929. (2) Fifteenth Annual Conference, Newcastle-upon-Tyne, 10th-12th October, 1929. On Monday and Tuesday, 7th and 8th October, your Medical Officer duly attended at the Second Conference on the Health and Welfare of Merchant Seamen held at Geneva, under the International Committee of the Red Cross. The proceedings, mainly conducted in the French tongue, were made the more useful by a distribution of the papers read, in the English. Your Medical Officer contributed a statement on the facilities for medical treatment open to the seaman of whatever nationality who is found to be suffering from tuberculosis, or is stranded from the same disability in a British Port : these facilities being those afforded to the public in general, plus special sailors' dispensaries in large ports and preferential treatment for the homeless seaman in the matter of sanatorium benefit if the case is suitable for this. The deputations were entertained by the Town of Geneva and by the International Red Cross. By forced marches from Geneva to Newcastle (24 hours exactly) your Medical Officer was able to attend at the opening and all sittings of the Fifteenth Annual Conference of the National Association for the Prevention of Tuberculosis, on October the 10th and 11th. The subjects discussed showed the meeting of the irresistible and the immoveable in the almost universality of infection by the bacillus at an early age, and the escape unhurt of the vast majority of the people under some protective factor. The analogy with acute infective processes, e.g., in smallpox, has led to the emphatically announced campaign against spitting and for the careful disposal of infective saliva. Nobody was against this, but many suggested that there is some deeper and possibly more important factor than the mere infection : the vagaries of resistance to tuberculosis infection need close examination : the devoted wife may nurse a case of tuberculosis for years, exposed to repeated infection, only to go down herself as a case when cessation of her care and duties and, incidentally, of infection leaves a void in her life. " Worry " was suggested as the important factor in such cases. An attempt to elucidate tuberculosis was foreshadowed in a paper dealing with the Tyneside townships, which showed that there were different tuberculosis rates in these crowded communities, with different social conditions obtaining, and suggested a complete survey of these townships in order that some correlation may be established. This survey will probably be effected, the present state of our knowledge being unsatisfactory for the conduct of a comprehensive campaign on the soundest economic lines. Obviously the most potent factors inducing and protracting the disease should be the first attacked, when known. Mere overcrowding does not of necessity produce the large incidence. Sir Robert Philip held that tuberculosis is infective and it is universal, therefore measures must be applicable equally to every member of the community. Infection is for the most part contracted in childhood, nearly every child is tuberculised before puberty. The individual, once infected, is probably to some extent immune to fresh infection, but effects of the original infection may emerge at any time in life. The supreme effect of physiological (sanatorium) methods in raising individual resistance must be applied in the preventive sphere. Watch should be scientifically kept for the advent of the infection in the child, the date of its discovery registered, and the accredited sanatorium methods of de-tuberculisation practised, though not in a sanatorium, in a way which anticipates preventively the further budding of disease. With work on these lines in dispensary and family practice, Sir Robert Philip thinks one may justly expect that the need for curative institutions and places of segregation will correspondingly disappear. Broadly speaking, Sir Robert Philip means that every child must have adequate sunshine, fresh air, food, rest, exercise, and the other hygienic factors in a well-regulated life. From 1901-27 pulmonary tuberculosis mortality in Newcastle-on-Tyne has decreased 45 per cent. The broad survey of the field afforded by the Congress was of more than customary utility to the gathering of a true perspective in the subject. Colonel Blackham and your Medical Officer constituted the delegation of the City of London. I have the honour to be, Gentlemen, Your obedient Servant, (Signed) W. M. WILLOUGHBY, Medical Officer of Health. 92 APPENDIX F. CORPORATION OF LONDON. Public Health Department. The Effects of VENEREAL DISEASES are grave and far reaching DELAY IS DANGEROUS Arrangements have been made for FREE ADVICE AND TREATMENT under Conditions of Secrecy at the Special Treatment Centre ST. BARTHOLOMEW'S HOSPITAL (Out-patients' Department) on Males : Females : Mondays 5-7 p.m. Tuesdays 4-6 p.m. Thursdays 12-2 p.m. Fridays 12-2 p.m. Intermediate Treatment: Tuesdays 5-6.45 p.m. Intermediate Treatment: Thursdays 5-6.45 p.m. Fridays 5-6.45 p.m. Mondays 12-2 p.m. Saturdays - 9.30-10.30 a.m. Wednesdays 12-2 p.m. Medical Officer of Health, Guildhall, E.C. 2. 93 APPENDIX G. 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 tit 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 symptoms 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 ; (f) 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 lew 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. 94 APPENDIX H. 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 secretion 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.