AC 434 LON 58 REPORT OF THE MEDICAL OFFICER OF HEALTH OF THE CITY OF LONDON FOR THE YEAR 1932 LONDON. Printed by Drake, Driver & Leaver Ltd., Rosebery Avenue, E.C.1. 1933. REPORT OF THE MEDICAL OFFICER OF HEALTH OF THE CITY OF LONDON For the Year 1932. LONDON. Printed by Drake, Driver & Leaver. Ltd., Rosebery Avenue, E.C.1. 1933. INDEX. A. page. AMBULANCE SERVICE 16 ANNUAL RATEABLE VALUE 7 APPENDICES 81 AREA 7 ARTIFICIAL CREAM ACT, 1929 53 ARTIZANS' DWELLINGS, STONEY LANE 62 ATMOSPHERIC POLLUTION AND SMOKE 27, 28 AGRICULTURAL PRODUCE (GRADING AND MARKING) ACT, 1928 50 B. BACTERIOLOGICAL EXAMINATIONS 15 BASEMENT ROOMS, CLOSING OF 68 BIRTHS 8 „ INFANT WELFARE 11 „ NOTIFICATION 11 BUTTER FACTORIES 53 c. COURTS, SUMMER FLUSHING OF 67 LIMEWASHING OF 67 CREMATION 28, 30 COMMON LODGING HOUSES 66 CONGRESSES—ROYAL INSTITUTE OF PUBLIC HEALTH 27 ROYAL SANITARY INSTITUTE 27 „ SANITARY INSPECTORS' ASSOCIATION 27 D. DENSITY 7 DIPHTHERIA—ANTI-TOXIN 15 DISINFECTANTS, SUPPLY OF 77 DISINFECTION OF SECOND-HAND CLOTHING 77 DRAINAGE PLANS 67 E. EXHUMATION AND REINTERMENT OF BODIES AT CITY OF LONDON CEMETERY 68 2, KING EDWARD STREET; 57/9, CHARTERHOUSE STREET; AND 78, NEWGATE STREET 68 F. FACTORY AND WORKSHOP ACT, 1901—ABOVEGROUND BAKEHOUSES 70 „ „ —FACTORIES, WORKSHOPS AND WORKPLACES 69 „ „ —OUTWORKERS 73-75 „ „ —SUMMARY OF INSPECTIONS 74 „ „ —SUMMARY OF WORK DONE 71 „ „ —UNDERGROUND BAKEHOUSES 70 FERTILIZERS AND FEEDING STUFFS ACT, 1926 50 FISH SUPPLIES AND SEIZURES 42 FOOD AT RIVERSIDE WHARVES, INSPECTION AND CONDEMNATION 47-50 FOOD AND DRUGS—ADMINISTRATIVE ACTION 54-57 „ „ —PROSECUTIONS 60 „ „ —SUMMARY OF ARTICLES EXAMINED 58, 59 „ „ —SUPERVISION OF 61 G. GULLIES, STREET 67 H. HOUSES LET IN LODGINGS 65 HOUSE, TRADE AND OTHER REFUSE REMOVAL 67 HOUSING 66 HUMAN REMAINS—EXHUMATION AND REINTERMENT AT CITY OF LONDON CEMETERY 68 2, KING EDWARD STREET; 57/9, CHARTERHOUSE STREET; AND 78, NEWGATE STREET 68 L ICE CREAM 76 INFANTILE MORTALITY 8 INFANT WELFARE 11 INFECTIOUS DISEASE 11 „ „ —BACTERIOLOGICAL AND PATHOLOGICAL EXAMINATIONS 15 „ „ —DIPHTHERIA ANTI-TOXIN 13 „ „ —NOTIFICATION OF 12, 13 „ „ —NURSING PROVISION—MEASLES, ENCEPHALITIS LETHARGICA, CEREBROSPINAL FEVER AND INFLUENZA 15 „ „ —SMALLPOX 14, 15 „ „ —TUBERCULOSIS 20-26 „ „ —VENEREAL DISEASES 16-19 INQUESTS 77 INSULIN, PROVISION OF 16 INTRODUCTION 7 INDEX (continued). L. page. LEGAL PROCEEDINGS—SANITARY 67 LIMEWASHING OF COURTS 67 LOCAL GOVERNMENT ACT, 1929—TRANSFER OF POWERS 27 L.C.C. (G.P.) ACT, 1932—PREPARATION OF PRESERVED MEAT, &c. 47 LODGING HOUSES COMMON—116, MIDDLESEX STREET 66 „ „ REGISTERED 65 M. MARGARINE, REGISTRATION OF DEALERS IN MARGARINE AND MARGARINE CHEESE 63 MEASLES 15 MEAT INSPECTIONS 31 „ „ —CASEOUS LYMPHADENITIS 37 „ „ —DELIVERY AT CENTRAL MARKETS 41 „ „ —DEMONSTRATIONS AND INSTRUCTION 40 „ „ —EXPORT OF MEAT 32-40 „ „ —HME-KILLED MEAT SEIZED 34 „ „ —INSPECTION AT SLAUGHTERHOUSES 43 „ „ —LEADENHALL MARKET AND CITY SHOPS 38 „ „ —LIVESTOCK IMPORTED 32 ,, „ —PROSECUTIONS 41 „ „ —PUBLIC HEALTH (MEAT) REGULATIONS, 1924 44-46 „ „ —SEIZURES OF IMPORTED MEAT 40 „ „ —UNSOUND MEAT REMOVED FROM COLD STORES 38 MEDICAL EXAMINATIONS 80 MERCHANDISE MARKS ACT, 1926 60 MILK—BACTERIOLOGICAL AND CHEMICAL EXAMINATIONS FOR TUBERCULOSIS AND DIRT (RAILWAY STATIONS) 60-62 „ —CHEMICAL EXAMINATION OF 52 „ —PUBLIC HEALTH (CONDENSED MILK) REGULATIONS, 1923 & 1927 53 „ —PUBLIC HEALTH (DRIED MILK) REGULATIONS, 1923 & 1927 53 „ —MILK AND DAIRIES (AMENDMENT) ACT, 1922 53 „ —MILK AND DAIRIES ORDER, 1926 53 MORTALITY 8 „ —INFANTILE 8 „ —MATERNAL 11 „ —VIOLENCE 8 „ —PHTHISIS 8 „ —ZYMOTICS 8 MORTUARY—DISINFECTION OF CLOTHING FOR EXPORT, INQUESTS, Etc 77 „ —PRESERVATION OF BODIES OF UNKNOWN DEAD 77 N. NOTIFICATION OF BIRTHS ACT, 1907, AND INFANT WELFARE WORK 11 NURSING PROVISIONS 16 O. OUTWORKERS 73-75 OVERCROWDING 67 P. PIGEONS—L.C.C. (GENERAL POWERS) ACT, 1927 68 POPULATION 7 PRESERVED MEAT, &c., PREPARATION OF—L.C.C. (G.P.) ACT, 1932 47 PUBLIC HEALTH—(CLEANSING OF SHELLFISH) ACT, 1932 50 „ „ —(CONDENSED MILK) REGULATIONS, 1923 & 1927 53 „ „ —(DRIED MILK) REGULATIONS, 1923 & 1927 53 „ „ —(MEAT) REGULATIONS, 1924 44-46 „ „ —(PREVENTION OF TUBERCULOSIS) REGULATIONS, 1926 16 „ „ —(TUBERCULOSIS) REGULATIONS, 1930 26 R. RAILWAY STATIONS—SAMPLES OF MILK 60-62 RATEABLE VALUE 7 RAT REPRESSION 78, 79 REFUSE REMOVAL 67 s. SANITARY DEFECTS AND INFECTIOUS DISEASE 67 SANITARY INSPECTIONS 64 SEWER, DEFECTIVE CONNECTIONS 67 SLAUGHTERHOUSE INSPECTION 43 SMALLPOX 14, 15 SMOKE AND ATMOSPHERIC POLLUTION 27, 28 STAFF 5 STATISTICAL INFORMATION 10 STONE CRUSHING 68 STREET GULLIES 67 T. TUBERCULOSIS 20-26 „ —PUBLIC HEALTH (PREVENTION OF TUBERCULOSIS) REGULATIONS, 1926 16 „ —TRAINING OF HEALTH VISITORS 16 V. VACCINATION 10-14 VENEREAL DISEASES 16-19 VIOLENT DEATHS 8 VITAL STATISTICS 10 w. WRAPPING OF FOODSTUFFS 44 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 Stout, James Erl 3rd Class Assistants July, 1930 Lee, Wm. J. Oct., 1915 Bernhardt, D. R. May, 1931 Threadgold, Arthur W. Unclassified Nov., 1923 Lee, W. R. June, 1930 Tunbridge, Mrs. Jan., 1917 Holdrup, F. A. March, 1932 SANITARY INSPECTORS. Robinson, Ernest S. Grade I. Feb., 1913 Fowler, George Henry Oct., 1920 McGrath, William Richard Mar., 1922 Harrington, George Edwin Grade II. Dec., 1925 Sillet, David Ernest April, 1926 Fisher, Stanley G. July, 1928 Neale, William G. C. July, 1928 Tyler, Albert July, 1928 Thorpe, Robert C. March, 1930 Webber, G. A. July, 1932 (1 Vacancy) (Rat Officer) Johnson, E. A., Inspector and Official Sampler under Fertilizers and Feeding Stuffs Act, 1926 ; and Officer under Agricultural Produce (Grading and Marking) Act, 1928, etc. March, 1931 SANITARY INSPECTORS AND MEAT INSPECTORS. Sharp, J. Owen, Senior Inspector May, 1892 Mettam, Harry (Retired Feb., 1932) Dec., 1903 Bintcliffe, Charles E. Grade I. March, 1907 Matson, William S Dec., 1910 Mitchener. William E. Dec., 1910 Jones, John April, 1914 Slatter, Charles May, 1908 Murray, Samuel B. Grade II. Sept., 1911 Mellish, Cyril E. Jan., 1912 Thompson, Frank E. July, 1924 Perris, G. A. Dec., 1923 Cann, S. W. Grade III. May, 1927 Cole, E. May, 1924 Peyton, H. R. Sept., 1932 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. Oct., 1906 Strong, S. R. March, 1914 Morris, W. F. March, 1925 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 1932. To the Right Honourable The Lord Mayor, Aldermen and Commons of the Corporation of London. Public Health Department, Guildhall, E.C. May, 1933. My Lord Mayor and Gentlemen, I have the honour to present my sixth Annual Report on the work of the Department of the Medical Officer of Health for the City of London. I deeply regret to have to record the death of Sir Frederick William Andrewes, who has been the Bacteriologist for the City Corporation since 1912, when he succeeded the late Professor Klein. Sir Frederick's outstanding ability, together with his peculiar personal charm, raised him to a high level in his profession, and his passing will be felt by all who knew him. The City has been fortunate in securing the services of Dr. Ronald Canti, the senior Bacteriologist and Pathologist at St. Bartholomew's Hospital, as Sir Frederick's successor. I have also to record the retirement of Mr. H. Mettam, on age limit, after nearly thirty years' service. Mr. Mettam was an efficient officer and his services will be missed. 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. The area of "Registration London" is 74,817 acres (excluding tidal water and foreshore), or 116.9 square miles. Density (1928).—City of London Registration District, at night, 17.3 persons to an acre; City of London Registration District, during the day, *664.1 person 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 £59,742,654, on April 6th, 1932, whilst on the same date the corresponding rateable value of property in the City of London was £8,767,460, or about one-seventh of the whole County. The annual sum receivable from a penny rate is £34,500. Population.—The undermentioned figures are extracted from the Report of the Registrar-General on the Census of England and Wales, 1921:— Area, Statute Acres. Inhabited Houses. Population. Private Families. 1921. 1911. 1921. 1911. 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 Tune. 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 1931 10,808 — Census.) There is only one registration district in the City. *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. BZ 8 The estimated population of the City, for the year 1932, is 9,990. 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 1932, 397 live births were registered in the City, 363 of which, however, did not belong thereto. To the remaining 34 must be added the births of 31 children born to citizens temporarily residing outside the City boundary. The number of births, therefore, on which the rate should be calculated is 65. There were four still births. The annual birth-rate was 6.5 per 1,000 persons of all ages, compared with a quinquennial mean rate of 7.4 per 1,000. In the Metropolis the birth-rate in 1932 was 14.3 per 1,000. Mortality.—During the year under review, 650 deaths were registered in the District, including 593 persons dying in the City, but not belonging thereto. Deducting these latter, 57 deaths remain, to which must be added those of 71 persons who died in outside districts, where they were registered; the total, therefore, on which the City death-rate is calculated is 128. See table, p. 9 for details. The death-rate for 1932 was 12.8 per 1,000 per annum of the population (the previous year being 12.5), whilst that for the whole of the Metropolis was 12.3 Deaths from Violence.—Of the City deaths, 10.2 per cent. were caused by injuries or violence, as compared with 8.5 in 1930 and 5.9 in 1931. This is 5.7 above the average for the previous five years. PERCENTAGE OF REGISTERED DEATHS FROM VIOLENCE. Year. City of London. Per cent. Metropolis. Per cent. 1927 2.7 5.1 1928 2.8 5.5 1929 2.7 5.6 1930 8.5 5.5 1931 5.9 5.7 Average previous five years 4.5 5.5 1932 10.2 4.6 DEATH RATES, PER 1,000 PER ANNUM. Year. City of London. 118 Great Towns of England and Wales. Metropolis. 1927 11.5 12.2 11.9 1928 12.2 11.6 11.6 1929 14.0 13.7 13.8 1930 12.0 11.5 11.4 1931 12.5 12.3 12.4 Average previous five years 12.4 12.3 12.2 1932 12.8 12.2 12.3 The death rate from zymotic disease per 1,000 of the population was 0.3. The deaths from Phthisis correspond to a rate of 0.7 per 1,000 of the population, as compared with 0.8 in the Metropolis. Infantile Mortality.—The deaths of children under one year of age were at the rate of 46 per 1,000 births, as against 67 for the whole of London. 9 CAUSES OF, AND AGES AT, DEATH DURING THE YEAR 1932. Causes of Death. Nett Deaths at the subjoined ages of "Residents" whether occurring within or without the district. Total Deaths whether of "Residents" or "NonResidents" in Institutions in the District. All Ages Under 1 year. 1 and under 2 years. 2 and under 5 years. 5 and under 15 years. 15 and under 25 years. 25 and under 35 years. 35 and under 45 years. 45 and under 55 years. 55 and under 65 years. 65 and under 75 years. 75 and upwards. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. All Causes. 128 3 l ... 3 4 6 10 25 25 26 25 550 1. Typhoid and Paratyphoid Fevers ... ... ... ... ... ... ... ... ... ... ... ... ... 2. Measles 1 1 ... ... ... ... ... ... ... ... ... ... ... 3. Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... ... ... 4. Whooping Cough 1 1 ... ... ... ... ... ... ... ... ... ... ... 5. Diphtheria 1 ... l ... ... ... ... ... ... ... ... ... 1 6. Influenza 3 ... ... ... ... ... ... ... 1 1 ... ... 1 7. Encephalitis Lethargica ... ... ... ... ... ... ... ... ... ... ... ... ... 8. Cerebro-spinal Fever ... ... ... ... ... ... ... ... ... ... ... ... 3 9. Tuberculosis of Respiratory System 7 ... ... ... ... ... ... 1 3 1 ... ... 15 10. Other Tuberculous Diseases 2 ... ... ... 1 ... ... l ... ... ... ... 8 11. Syphilis 1 ... ... ... ... ... ... ... ... ... 1 ... ... 12. General Paralysis of the Insane, Tabes Dorsalis ... ... ... ... ... ... ... ... ... ... ... ... 1 13. Cancer, Malignant Disease 19 ... ... ... ... ... ... ... 4 7 7 1 108 14. Diabetes ... ... ... ... ... ... ... ... ... ... ... ... 9 15. Cerebral Haemorrhage, &c. 3 ... ... ... ... ... ... ... ... ... 2 1 9 16. Heart Disease 30 ... ... ... ... ... ... 3 3 2 7 13 31 17. Aneurysm ... ... ... ... ... ... ... ... ... ... ... ... 3 18. Other Circulatory Diseases 8 ... ... ... ... ... ... 1 1 1 1 4 14 19. Bronchitis ... ... ... ... ... ... ... ... ... ... ... ... 6 20. Pneumonia (all forms) 9 ... ... ... 1 ... ... 1 4 3 ... ... 37 21. Other Respiratory Diseases 1 ... ... ... ... ... ... ... 1 ... ... ... 14 22. Peptic Ulcer 2 ... ... ... ... ... ... ... 1 1 ... ... 32 23. Diarrhoea, &c. ... ... ... ... ... ... ... ... ... ... ... ... 9 24. Appendicitis ... ... ... ... ... ... ... ... ... ... ... ... 15 25. Cirrhosis of Liver ... ... ... ... ... ... ... ... ... ... ... ... 2 26. Other Diseases of Liver, &c. ... ... ... ... ... ... ... ... ... ... ... ... 6 27. Other Digestive Diseases 4 ... ... ... ... ... ... ... 1 1 2 ... 4 28. Acute and Chronic Nephritis 5 ... ... ... ... ... ... ... 1 3 ... 1 26 29. Puerperal Sepsis ... ... ... ... ... ... ... ... ... ... ... ... ... 30. Other Puerperal Causes ... ... ... ... ... ... ... ... ... ... ... ... ... 31. Congenital Debility, Premature Birth, Malformations, &c. 2 1 ... ... ... ... ... ... ... 1 ... ... 16 32. Senility 3 ... ... ... ... ... ... ... ... ... 1 2 ... 33. Suicide 5 ... ... ... ... ... 1 1 1 ... 1 1 4 34. Other Violence 8 ... ... ... 1 ... 1 1 2 1 1 1 29 35. Other Defined Causes 13 ... ... ... ... ... 2 1 2 3 3 1 146 36. Causes ill-defined or unknown ... ... ... ... ... ... ... ... ... ... ... ... 1 Totals 128 3 l ... 3 4 6 10 25 25 26 25 550 10 VITAL STATISTICS OF WHOLE DISTRICT DURING 1932 AND PREVIOUS FIVE YEARS. Name of District: CITY OF LONDON. Year. Population estimated to Middle of each Year. Births. Total Deaths Registered in the District. Transferable Deaths Nett Deaths belonging to the District. Uncorrected number. Nett. of Nonresidents registered in the District. of Residents not registered in the District. Under 1 Year of Age. At all Ages. Number. Rate. Number. Rate. Number. Rate per 1,000 nett Births. Number. Rate. 1 2 3 4 5 6 7 8 9 10 11 12 13 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 1929 10,700 424 80 7.4 721 67.38 657 86 5 62 150 14.0 1930 10,700 436 89 8.3 667 62.33 598 64 4 89 133 12.0 1931 10,808 413 61 5.6 680 62.91 620 60 5 81 135 12.5 Average previous 5 years 11,329 423 85 7.4 713 63.09 646 71 6 79 142 12.4 1932 9,990 397 65 6.5 650 65.06 593 71 3 46 128 12.8 Area of City of London in acres (land and inland water) 661 Total population at all ages 13,709 Number of inhabited houses 2,922 Average number of persons per house 4.6 At Census 1921. Vaccination.—Of the 413 births notified to the Vaccination Officer during 1932, 170 had been successfully vaccinated by the end of the year, 14 had died before the age for vaccination and 3 were reported as insusceptible. Vaccination was postponed by medical certificate in 1 case, 137 had removed into other districts, or the vaccinations were pending at the end of the year. There were 88 instances of conscientious objection. The Public Vaccinator performed 310 re-vaccinations during the year, and in addition to the 170 successful vaccinations referred to above, 95 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. Conseientious objections. per cent. per cent. per cent. per cent. per cent. per cent. per cent. 1927 421 25.9 Nil. Nil. 4.7 Nil. 44.9 24.5 1928 432 31.1 „ „ 4.4 „ 38.4 26.1 1929 427 25.5 „ „ 2.8 0.8 40.2 30.7 1930 436 22.1 „ „ 2.3 0.5 48.9 26.2 1931 413 24.7 „ „ 2.6 0.2 53.1 19.4 Average previous 5 years. 426 25.8 „ „ 3.4 0.3 45.1 25.4 1932 413 41.2 0.7 „ 3.4 0.3 33.1 21.3 11 INFANT WELFARE WORK. Although no new work has been undertaken in connection with infant welfare during 1932, a scheme has been approved by the Corporation, resulting in a very much improved procedure and control at the Infant Welfare Centre, which isheld weekly at St. Bartholomew's Hospital. This scheme, which came into operation on 1st January, 1933, provides for the attendance of a medical officer and a qualified health visitor, who is also a trained and State registered nurse and certified midwife. This latter officer is also responsible to me for the whole of the infant welfare work in the City. There is ample evidence already that the improved facilities are much appreciated by City mothers. Supplies of milk and dried milk at cost price, or 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 desirable. In no case was home help necessary during 1932. 420 notifications of birth, including 22 still births, made in accordance with the requirements of the Notification of Births Act, were received. Of these, 52 referred to City mothers, and the balance were transferred to the appropriate authorities. 289 visits were made as a consequence of notifications received, and 490 special visits were made in connection with infant welfare. Two visits were also made in respect of cases coming within the scope of the Children Act, 1908, all in relation to nurse children. Two verminous school children were notified under the London County Council (General Powers) Act, 1904. This does not, however, represent the number of births to 64 mothers, some of whom were confined outside the City area. The actual number of births for which this Department has to accept the responsibility of control will be found to be 65, and is referred to on page 8. 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. With the small City resident population, few deaths in this category are reported. When such do occur, the investigations are conducted by me. No cases were reported during 1932. It may be of interest to note that, from 1900 to 1932 inclusive, only 15 maternal deaths have occurred among City residents. INFECTIOUS DISEASES. One hundred and four cases of notifiable infectious diseases were notified or reported during the year 1932. Notification of Chicken-pox.—In consequence of the presence of the mild type of small-pox which has been more or less prevalent in London for the past few years, chicken-pox was made notifiable in the City of London on the 17th March, 1930. The obligation has since been extended and is still in operation, the latest extension carrying it to 17th day of March, 1933. Appropriate notice to interested parties was given, a copy of which is reproduced in Appendix E of this Report. Twenty-two of the cases reported were Diphtheria, compared with 14 in 1931. The number of Scarlet Fever cases was 29, compared with 17 in 1931. There were 7 cases of Erysipelas. Measles and German Measles are not notifiable diseases, but 14 cases of the former illness were brought to my notice by medical practitioners and through the medium of the school medical service. Twenty-five cases of Chicken-pox were notified, 3 of Acute Primary Pneumonia, 2 of Typhoid Fever and 2 cases of suspected food poisoning. No case of Ophthalmia Neonatorum was reported. The percentage of cases removed to hospital for treatment continues to be 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 67. In the following tables will be found particulars relating to cases of infectious disease, and information as to the removal of patients to hospitals. 12 STATISTICS OF NOTIFICATIONS AND REMOVALS TO HOSPITAL. NAME OF DISEASE. Number of Notifications received. Treated at Home. Removed to the L.C.C. Special Hospitals. Removed to the London Fever Hospital. Treated at other Hospitals and Institutions. Duplicate Certificates received. Diagnosis subsequently found to be incorrect. Net number of Cases. Small-pox ... ... ... ... ... ... ... ... Diphtheria 22 1 20 1 ... ... l 21 Scarlet Fever 29 1 27 ... l ... 2 27 Enteric Fever (including Para-typhoid) 2 ... ... ... 2 ... ... 2 Puerperal Fever ... ... ... ... ... ... ... ... Puerperal Pyrexia ... ... ... ... ... ... ... ... Erysipelas 7 3 ... ... 4 ... ... 7 Cerebro-spinal Meningitis ... ... ... ... ... ... ... ... Acute Polio-myelitis ... ... ... ... ... ... ... ... Ophthalmia Neonatorum ... ... ... ... ... ... ... ... Malaria contracted abroad ... ... ... ... ... ... ... ... Acute Primary Pneumonia 3 ... ... ... 3 ... ... 3 Acute Influenzal Pneumonia ... ... ... ... ... ... ... ... Encephalitis Lethargica ... ... ... ... ... ... ... ... Food poisoning or suspected food poisoning 2 2 ... ... ... ... ... 2 Amoebic Dysentery ... ... ... ... ... ... ... ... Chicken-pox 25 23 2 ... ... ... ... 25 Totals 90 30 49 l 10 ... 3 87 Measles 14 10 3 l ... ... ... 14 German Measles ... ... ... ... ... ... ... ... Totals 104 40 52 2 10 ... 3 101 The following is a return of infectious diseases which have occurred in the City of London, exclusive of Tuberculosis, Measles, Pneumonia, Chicken-pox, and Food Poisoning, with the percentages of such cases removed to hospitals for treatment or nursed at home during 1932 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 actual cases. Per cent. of actual cases reported. Removed to Hospital. Treated at home. 1927 61 90.2 9.8 1928 51 96.0 4.0 1929 60 90.0 10.0 1930 58 93.1 6.9 1931 38 94.7 5.3 Average for the five years 53.6 92. 8 7.2 1932 57 91.2 8.8 13 CASES OF INFECTIOUS DISEASE AND TUBERCULOSIS NOTIFIED DURING THE YEAR 1932. DISEASES. NUMBER OF ACTUAL CASES NOTIFIED. At Ages—Years. No. of Case s Removed to 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 ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria 21 ... 1 1 1 5 2 2 5 3 1 ... 20 Erysipelas 7 ... ... ... ... ... ... 2 ... 2 1 1 1 4 Scarlet Fever 27 1 1 1 3 5 5 ... 1 10 ... ... ... 26 Typhus „ ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric „ (including Para-typhoid) 2 ... ... ... ... ... ... ... ... 1 ... 1 ... 2 Relapsing „ ... ... ... ... ... ... ... ... ... ... ... ... ... ... Continued „ ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal ,, ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Pyrexia ... ... ... ... ... ... ... ... ... ... ... ... ... ... Polio-myelitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cerebro-spinal Meningitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... Pulmonary Tuberculosis 22 ... ... ... ... ... ... ... 1 10 5 5 l 20 Other forms of Tuberculosis 2 ... ... ... ... ... ... ... ... 1 ... 1 ... 2 Ophthalmia Neonatorum ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 14 2 l l 2 1 6 ... ... 1 ... ... ... 4 Rubella ... ... ... ... ... ... ... ... ... ... ... ... ... ... Chicken-pox 25 ... ... l 2 1 13 4 1 3 ... ... ... 2 Malaria (contracted abroad) ... ... ... ... ... ... ... ... ... ... ... ... ... ... Acute Primary Pneumonia 3 ... ... ... ... ... ... ... 1 1 ... 1 ... 3 Acute Influenzal Pneumonia ... ... ... ... ... ... ... ... ... ... ... ... ... ... Encephalitis Lethargica ... ... ... ... ... ... ... ... ... ... ... ... ... ... Amoebic Dysentery ... ... ... ... ... ... ... ... ... ... ... ... ... ... Food Poisoning 2 ... ... ... ... ... ... ... ... 1 ... 1 ... ... Totals 125 3 3 4 8 7 29 8 6 35 9 11 2 83 * L.C.C. Hospitals, London Fever Hospital, St. Bartholomew's Hospital, City Police Hospital, Sanatoria, &c. C 14 SMALL-POX AND PUBLIC VACCINATION. The repeal of the Vaccination Acts and the introduction of a voluntary system was advocated by one of the large provincial towns during the year, and representations with this end in view were made to the Ministry of Health. The advocacy was based upon a thesis which, put briefly, was as follows:— Endemicity of small-pox remained to the date of compulsory vaccination of infants, and has since been abolished by that measure. In 1898 and 1907, conscientious objection and further ease in obtaining exemption were provided for, leading to a fall to 40 per cent. of vaccinations in infants in 1929. The fear of sleepy sickness has produced modified technique conferring immunity which is less in duration and intensity than before. Thus, with an infant vaccination rate which has dropped to about one-third of the birth-rate, the protection of those vaccinated is diminished. The present administration through the Vaccination Officer is costly and cumbrous, and requires reconsideration. The work is done on voluntary lines, but follows the almost obsolete " compulsory " routine, which is needlessly complicated. The replacement of the various notices required and the disabilities the Public Vaccinator suffers under the present conditions of home vaccinations, by a scheme worked through the Health Visitors and Welfare Centres (touching three-quarters of the new births) and through pamphlet (touching the remainder) is suggested. The vaccination would take place at an infant welfare clinic. The foreseen advantages are:— 1. As great or even greater efficiency. 2. A saving in cost, estimated at £100,000 for England and Wales. Legislation would be necessary to repeal the Vaccination Acts and to introduce the voluntary system. The following considerations on the subject of retention or abrogation of the Vaccination Acts present themselves:— The Vaccination Acts are limited, for all practical purposes, to vaccinations of infants under two years of age as to the compulsory clauses. Other vaccinations and re-vaccinations are practised as a general public health measure under the public health authorities. The Acts, as at present administered, secure approximately 9 per cent. immunity, which is a material safeguard, and this especially against foci of infection in schools. It may be assumed that no further attempts at compulsion are possible in this country, so that the lessons from the efficacy of extensive compulsion in other countries are only of educative use by way of popularising vaccination and re-vaccination here. The Acts secure that, in times of threatened epidemic, there is a Public Vaccinator at hand. He is not limited by this contract to infant work. The Public Vaccinator, in his routine, using one definite technique and recording his results, is of use to the government, in that he teaches students and enables an assessment to be made of the value of batches of lymph sent out from the central establishment. The above advantages are at present less in that the technique of vaccination has been simplified. Any medical practitioner should be familiar with vaccination, as with other inoculations similar in principle and practice: to this end special schools for the sole teaching of vaccination are not necessary or advisable; the duty of teaching need not be limited to those familiar with a technique which is no longer advised, and efficient records can be kept by any medical man with clerical ability or assistance. Moreover, the present one-mark vaccination should properly be followed by re-vaccinations, to ensure immunity through life: this is the end to be arrived at, and it is not promulgated by Acts dealing with infant vaccination. The machinery of the Vaccination Act is too complicated to be of use in vaccination of later life. The Vaccination Register was initiated when the Vaccination Act constituted almost the sole public health activity; now the Medical Officer of Health has an independent register of all births, and a separate register for vaccination as one of many health activities seems unnecessary. Vaccination might well become a matter for advice in the routine of Infant Welfare work, and Public Vaccinators 15 be retained to vaccinate on lists supplied them by the Medical Officers of Health. The Public Vaccinator would be in reserve also in case of epidemic rush. The central authority, the Ministry of Health, would issue calf lymph to medical officers of health from the Government lymph establishment, and these officers would undertake the collecting and forwarding of any information the Central Authority might require. I have, so far, in these remarks condensed some considerations set out in the Review on Small-pox Prevention (Ministry of Health), 1931. It appears that different sanitary authorities could proceed in the direction indicated in the report, with differences in practice suited to their circumstances, without any recourse to immediate change in the present law. The present administration of the Acts in the City of London shows a 78.5 per cent. efficiency in securing primary infant vaccinations. The present infant welfare organisation is used in the education of mothers as to vaccination and re-vaccination, as is indicated by the Ministry of Health in the above Review. If and when it be shown that such a use of welfare centres generally throughout the country not only supplements, but supplants, procedure under the Acts, changes in the Acts could be advocated in accordance with the request proferred. There appears to be no sufficient data on which to urge this matter at present. In all the circumstances, the Corporation were not able to support the proposed abrogation of the Vaccination Acts. SUMMARY OF SMALL-POX FOR THE YEAR ENDING 31st DECEMBER, 1932. The customary disinfection, where necessary, was carried out, and those persons, resident or employed in the City, who had been in contact with cases of Small-pox, were supervised. The total number of cases (including missed cases) notified or reported to this Department during the period ended 31st December, 1932, was 61. The total number of persons in contact with cases ascertained or notified during the period ended 31st December, 1932, was 920. 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 1932. DISTRIBUTION OF DIPHTHERIA ANTI-TOXIN AND ANTI-INFLUENZA VACCINE. Although City medical practitioners are well aware of the facilities available, only one application for supplies of diphtheria anti-toxin was received during 1932. No applications in regard to anti-influenza vaccine were received. EXAMINATION OF PATHOGENIC BACTERIA. Any medical practitioner desiring examination of specimens for pathogenic bacteria in cases of suspected infectious disease occurring amongst their patients residing in the City may forward them to me at the Guildhall. Arrangements have been made for free examination, and the result obtained is communicated immediately to the medical practitioner in attendance. During the year, the following specimens were so dealt with. It will be seen that positive results were obtained in 18.4 per cent. of these cases. Specimens. Disease Suspected. Result. Positive. Negative. 42 Swabbings from throats Diphtheria 9 33 23 Sputa Tuberculosis 3 20 PROVISION OF INSULIN. In accordance with the request made by the Authorities of the University College Hospital, Insulin has been supplied to one patient resident in the City, and in attendance at that hospital. The Corporation have power to make this provision under Section 77 of the Public Health (London) Act, 1891, with the approval of the Ministry of Health, but, so far as I am aware, this is the first patient in regard to whom such powers have been put into operation. The arrangement has worked satisfactorily c 2 16 AMBULANCE SERVICE. Certain modifications in the existing practice of the London County Council, in regard to the use of their ambulances by public authorities and private persons in cases of illness, were made during the year. These revisions do not affect the existing scale of charges agreed upon between the Corporation and the London County Council in regard to the City's duties under the Maternity and Child Welfare Act. They were, however, of considerable importance to City medical men and City residents, and copies of a pamphlet giving details of the facilities afforded by the London Ambulance Service, together with a statement of the new charges, were forwarded to doctors practising within the City area. Copies are included in the Appendices to this report (Appendix F). 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. TUBERCULOSIS DISPENSARY.—TRAINING OF HEALTH VISITORS. The facilities available at the Tuberculosis Dispensary are 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. This should prove of considerable value in all future training of health visitors. VENEREAL DISEASES. The Special Centre for the Treatment of Venereal Diseases, which, in accordance with the powers under the Public Health (Venereal Diseases) Regulations, 1916, the City Corporation established at 20/21, Golden Lane—previously occupied as a shelter, and specially altered to meet the requirements—was transferred to St. Bartholomew's Hospital on the 17th February, 1930. This step was deemed expedient for economic and other reasons, and it is satisfactory to note that the number of persons availing themselves of the opportunity afforded has, since that date, shown steady average increase, the total number of new cases in the year being 981. The following is a brief summary of the work carried out during 1932:— At the beginning of the year 563 males and 220 females were registered on the books as being under treatment or observation, which compares with 510 males and 186 females at the beginning of the previous year. Of these patients, 374 males and 198 females were under treatment for syphilis, and 189 males and 22 females for gonorrhoea. No patients were under treatment for conditions other than venereal disease. New patients admitted totalled 981, as compared with 1,075 in the previous year, the total attendances were 26,069. Unfortunately, 278 cases discharged themselves before completion of treatment, and 153, although completing treatment, failed to submit themselves to final test. Twenty-seven males and 17 females were transferred to other centres after treatment, whilst 486 males and 127 females were discharged after completion of treatment and observation. There were 5 in-patients. The total number of attendances is made up as follows:— Syphilis. Soft Chancre. Gonorrhoea. Non-Venereal Conditions. Total Attendances. Male. Female. Male. Female. Male. Female. Male. Female. Male. Female. 11,500 4,835 — — 8,623 622 384 105 20,507 5,562 In the laboratories associated with the Centre, 8,282 specimens were examined, 42 for the detection of spirochetes, 1,182 for gonococci, 6,730 examinations for the Wassermann or Sigma test, and 228 for 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 17 detection of Spirochetes, of Gonococci, and for the Wassermann or Sigma test in respect of these patients:— For Syphilis. No. of patients treated. For Gonorrhoea. For Non-Venereal Conditions. For Spirochetes. Examinations. For Gonococci. For Wassermann or Sigma Test Reactions. London 228 259 430 42 1,132 7,034 Essex 5 13 8 — 19 14 Herts. 2 4 4 — 8 2 Surrey 1 10 5 — 18 2 Kent 3 2 7 — 5 6 Middlesex — — — — — — Sussex — — — — — — Totals f239 †288 454 42 1,182 7,058 The following summary shows the work carried out during each year that the Centre has been in operation. Year. Men. Women. Total. Total Attendances. "606." Bismuth. Mercury. In-Pts. Path. Ex. 1917 207 87 294 2,340 1,193 ... 339 22 372 1918 304 176 480 8,353 1,406 ... 1,391 71 421 1919 606 201 807 15,269 1,763 ... 1,782 45 2,485 1920 799 254 1,053 21,689 3,690 ... 2,800 41 6,005 1921 570 188 758 18,216 3,584 ... 2,859 52 5,241 1922 469 117 586 16,702 2,637 ... 2,851 23 4,774 1923 367 98 465 14,710 2,049 ... 2,130 9 6,832 1924 301 116 417 10,890 1,510 1,368 1,503 1 7,040 1925 314 88 402 10,541 1,782 1,198 1,192 1 5,835 1926 399 86 485 11,656 1,869 1,539 764 3 6,351 1927 340 80 420 12,501 1,723 2,124 362 2 6,266 1928 395 81 476 13,051 1,785 2,781 2 0 6,932 1929 396 102 498 14,095 1,580 3,042 ... 0 6,822 1930 816 257 1,073 20,694 2,601 5,509 ... 11 8,212 1931 853 209 1,062 26,378 4,175 6,860 ... 24 8,555 1932 785 196 981 26,069 4,916 7,021 ... 5 8,282 Totals 7,911 2,327 10,307 243,154 38,263 31,442 17,975 310 90,425 † Including 14 patients who are known to have received treatment at other Centres and referred to in Item 4 of annual return. 18 RETURN RELATING TO ALL PERSONS WHO WERE TREATED AT THE TREATMENT CENTRE AT ST. BARTHOLOMEW'S HOSPITAL DURING THE YEAR ENDED THE 31st DECEMBER, 1932. Syphilis. Soft Chancre. Gonorrhoea. Conditions other than venereal. Totals. M. F. M. F- M. F- M. F- M. F. Totals. 1. Number of cases on 1st January under treatment or observation 374 198 ... ... 189 22 ... ... 563 220 783 2. Number of cases removed from the register during any previous year which returned during the year under report for treatment or observation of the same infection 6 ... ... ... 26 ... ... ... 32 ... 32 3. Number of cases dealt with for the first time during the year under report (exclusive of cases under Item 4) suffering from:— Syphilis, primary 28 1 ... ... ... ... ... ... 28 1 29 „ secondary 43 28 ... ... ... ... ... ... 43 28 71 ,, latent in 1st year of infection 48 37 ... ... ... ... ... ... 48 37 85 „ all later stages 26 5 ... ... ... ... ... ... 26 5 31 „ congenital 5 7 ... ... ... ... ... ... 5 7 12 Soft Chancre ... ... ... ... ... ... ... ... ... ... ... Gonorrhoea, 1st year of infection ... ... ... ... 200 18 ... ... 200 18 218 ,, later ... ... ... ... 35 ... ... ... 35 ... 35 Conditions other than venereal ... ... ... ... ... ... 354 100 354 100 454 4. Number of cases dealt with for the first time during the year under report known to have received treatment at other Centres for the same infection 5 ... ... ... 9 ... ... ... 14 0 14 Total of Items 1, 2, 3 and 4 535 276 ... ... 459 40 354 100 1,348 416 1,764 5. Number of cases discharged after completion of treatment and final tests of cure (see Item 15) 31 11 ... ... 101 16 354 100 486 127 613 6. Number of cases which ceased to attend before completion of treatment and were, on first attendance, suffering from:— Syphilis, primary 34 2 ... ... ... ... ... ... 34 2 36 „ secondary 40 19 ... ... ... ... ... ... 40 19 59 „ latent in 1st year of infection 46 24 ... ... ... ... ... ... 46 24 70 „ all later stages 5 ... ... ... ... ... ... ... ... ... 5 „ congenital 3 8 ... ... ... ... ... ... 3 8 11 Soft Chancre ... ... ... ... ... ... ... ... ... ... ... Gonorrhœa, 1st year of infection ... ... ... ... 60 ... ... ... 60 ... 67 „ later ... ... ... ... 29 1 ... ... 29 1 30 7. Number of cases which ceased to attend after completion of treatment but before final tests of cure (see Item 15) 26 24 ... ... 103 ... ... ... 129 24 153 8. Number of cases transferred to other centres or to institutions, or to care of private practitioners:— 16 14 ... ... 11 3 ... ... 27 17 44 9. Number of cases remaining under treatment or observation on 31st December 334 174 ... ... 155 13 ... ... 489 187 676 Totals of Items 5, 6, 7, 8 and 9 (These totals should agree with those of Items 1, 2, 3 and 4.) 535 276 ... ... 459 40 354 100 1,348 416 1,764 10. Number of cases in the following stages of syphilis included in Item 6 which failed to complete one course of treatment:— Syphilis, primary 23 1 ... ... ... ... ... ... 23 1 24 „ secondary 29 12 ... ... ... ... ... ... 29 12 41 ,, latent in 1st year of infection 41 20 ... ... ... ... ... ... 41 20 61 „ all later stages 2 ... ... ... ... ... ... ... 2 ... 2 „ congenital 1 8 ... ... ... ... ... ... 1 8 9 11. Number of attendances:— (a) for individual attention of the medical officers 11,500 4,835 ... ... 3,014 473 384 105 14,898 5,413 20,311 (b) for intermediate treatment, e.g., irrigation, dressing ... ... ... ... 5,609 149 ... ... 5,609 149 5,758 Total Attendances 11,500 4,835 ... ... 8,623 622 384 105 20,507 5,562 26,069 12. In-patients:— (a) Total number of persons admitted for treatment during the year 1 ... ... ... 1 3 ... ... 2 3 5 (b) Aggregate number of "inpatient days" of treatment given 58 ... ... ... 10 88 ... ... 68 88 156 19 Return relating to all persons who were treated at the Treatment Centre at St. Bartholomew's Hospital during the year ended the 31st December, 1932.—continued. Under 1 year. 1 and under 5 years. 5 and under 15 years. 15 years and over. Totals. m. F. m. F. m. F. m. f. m. F. 13. Number of cases of congenital syphilis in Item 3 above classified according to age periods 3 2 .... 1 .... .... 2 4 5 7 Arsenobenzene Compounds. Mercury. Bismuth. 14. Chief preparations used in treatment of Syphilis:— (a) Names of preparations Neosalvarsan. Sil. Salvarsan. Neokharsavan.Novarsenobillon. Stabilarsan. .... Bis. Oxychloride in 5% glucose sol. and Collosol metal Bismuth 10%. (b) Total number of injections given (out-patients and in-patients) 4,916 .... 7,021 (c) Number of injections included in (b) given to patients who on first attendance at this Centre were suffering from primary and secondary syphilis 249 .... 352 15. Are the tests recommended in Memo. V21 as amended by Memo. V21a followed in deciding as to the discharge of the patient after treatment and observation for syphilis and gonorrhoea ? Yes. If not, in what way are they modified ? — Microscopical Serum Tests 16. Pathological Work:— (a) Number of specimens examined at and by the medical officer of the treatment centre. for Spirochetes. for Gonococci. Wassermann. Others for Syphilis. for Gonorrhœa. 42 1,182 1,192 Sigma 1,170 .... (b) Number of specimens from patients attending at the centre sent for examination to an approved laboratory .... .... .... .... .... 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. Surrey. Herts. Kent. Total. a. Number of cases in Items 3 and 4 from each area found to be suffering from:— Syphilis 228 5 1 2 3 .... .... .... 239 Soft Chancre .... .... .... .... .... .... .... .... .... Gonorrhoea 259 13 10 4 2 .... .... .... 288 Conditions other than venereal 430 8 5 4 7 .... .... .... 454 Total 917 26 16 10 12 .... .... .... 981 B. Total number of attendances of all patients residing in each area 24,963 553 277 123 153 .... .... .... 26,069 C. Aggregate number of "In-patient days" of all patients residing in each area 156 .... .... .... .... .... .... .... 156 D. Number of doses of arsenobenzene compounds given in the out-patient Clinic and In-patient Department to patients residing in each area 4,825 62 .... 10 19 .... .... .... 4,916 Jan., 1933. [Signed) KENNETH M. WALKER, Medical Officer of the Treat ment Centre. 20 TUBERCULOSIS. The hours at which the Dispensary was open for diagnosis and treatment of Tuberculosis were:— 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. Fridays 11.30 a.m. (New cases only.) ,, 2.0 p.m.—3.0 p.m. In all, 254 sessions have been held. New Patients.—The number of new patients examined was 318, as compared with 362 last year :— Patients Referred to the Hospital.—The following is the summary of patients referred to the various departments of St. Bartholomew's Hospital for help in diagnosis or treatment:— Resident. Non-Resident. Total. Referred to X-ray Department 58 154 212 „ Surgical „ 0 0 0 „ Dental „ 1 0 1 ,, Throat „ 7 10 17 „ Pathological „ 1 1 2 „ Other „ 3 24 27 70 189 259 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. No resident and 9 non-resident patients were admitted for this and other purposes. Examination of Sputum.—The following is a summary:— City Residents. Non-Residents. Total. Positive 4 38 42 Negative 15 67 82 Residential Treatment.—The number of patients for whom residential treatment was arranged was 129. Admitted to L.C.C. Institutions. Hospitals of Local Authorities. Other Institutions. St. Columbas Hospital Corpn. Expense. Brompton Corpn. Expense. Total. Patients resident in the City 4 5 20 1 5 35 Patients non-resident 55 11 28 — — 94 59 16 48 1 5 129 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 and referred to as patients on the register in Table on page 23 was 51. In addition, 39 contacts were 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. (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 222. Total Attendances:— Residents 392 Non-Residents 975 1,367 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. One case was admitted in 1932. 21 During past years a certain amount of difficulty has arisen with cases who were residing at the place at which they were employed, when diagnosed as having pulmonary tuberculosis. The provision of Residential treatment by the L.C.C. usually entails the patient waiting two or three weeks before admission; under ordinary circumstances this does not cause any difficulty, but with this particular type of case more prompt action is desirable. The Corporation have now an arrangement with the Brompton Hospital whereby cases of this type can be admitted within 48 hours under Dr. Young's personal care, under a Certificate from the Medical Officer of Health. Five cases have been admitted under this scheme during the year. Artificial Pneumothorax.—Artificial pneumothorax treatment has been used again during the year. Artificial pneumothorax was induced in two cases and 27 City and 289 non-City Refills done in connection with the Dispensary. The Tuberculosis Sister.—As an adjunct to the work at the Tuberculosis Clinic, the outside work of the Tuberculosis Sister has been continued on the same lines as former years. Sixty-eight homes have been visited, and 297 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 21 nursing 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 Sister 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. (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 Sister 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 Sister 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 Sister. (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, 3 City and 15 non-City cases of pulmonary tuberculosis attended for the continuation of their treatment by artificial pneumothorax 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 the 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 Sister. Milk has been provided for necessitous persons requiring extra nourishment and in this connection the sum of about £35 has been expended. d 22 (x.) Patients suffering fron 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 in 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 were 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 1932, 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 — — — — — — — — l — — — — — — — — 5 — — — — — — — — 10 — — — — — — — — 15 — 1 — — — — — — 20 2 2 — — — — — — 25 4 2 — 1 — — — — 35 2 3 — — — — — — 45 3 — 1 — — — — — 55 2 — — — — — — — 65 and upwards 1 — — — — — — — Totals 14 8 1 1 — — — — † The present lady members of the Committee are Miss Crosby, M.B.E. and Lady Smith. 23 return showing the work of the dispensary during the year 1932. city residents. Diagnosis. Pulmonary. Non-Pulmonary. Total. Grand 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 8 6 ... .... l 1 ... ... 9 7 ... ... 16 (b) Diagnosis not completed ... ... ... ... ... ... .... .... ... .... ... ... — (c) Non-tuberculous ... ... ... ... ... ... ... ... 3 2 2 ... 7 B.—CONTACTS examined during the year:— ... ... ... ... ... ... ... ... ... ... ... ... ... (a) Definitely tuberculous 1 ... ... ... ... ... ... ... 1 ... ... ... 1 (b) Diagnosis not completed ... ... ... ... ... ... ... ... ... ... ... ... — (c) Non-tuberculous ... ... ... ... ... ... ... ... 4 17 8 9 38 C.—CASE S written off the Dispensary Register as— (a) Recovered ... ... l ... ... ... ... ... ... ... 1 .... 1 (b) Non-tuberculous (including any such cases previously diagnosed and entered on the Dispensary Register as tuberculous) ... ... ... ... ... ... ... 7 20 10 9 46 D.— NUMBER OF CASES on Dispensary Register on December 31st:— (a) Definitely tuberculous 27 14 l 1 5 2 ... l 32 16 1 2 51 (b) Diagnosis not completed ... ... ... ... ... ... ... ... ... ... ... ... - 1. Number of cases on Dispensary Register on January 1st, 1932:— 58 2. Number of cases transferred from other areas and cases returned after discharge under Head 3 in previous years - 3. Number of cases transferred toother areas, cases not desiring further assistance under the scheme, and cases "lost sight of" 16 4. Cases written off during the year as Dead (all causes) 6 5. Number of attendances at the Dispensary (including Contacts). 392 6. Number of Insured Persons under Domiciliary Treatment on the 31st December - 7. Number of consultations with medical practitioners:— (a) Personal (bj Other 13 8. Number of visits by Tuberculosis Officers to homes (including personal consultations) .... — 9. Number of visits by Nurses or Health Visitors to Homes for Dispensary purposes Nursing 297 21 10. Number of (a) Specimens of sputum, etc., examined (b) X-ray examinations made in connection with Dispensary work 19 58 11. Number of "Recovered" cases restored to Dispensary Register, and included in A (a) and A (b) above 12. Number of "T.B. plus" cases on Dispensary Register on December 31st 22 non-residents. Diagnosis. Pulmonary. Non-Pulmonary. Total. Grand 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 78 49 4 4 9 5 i 1 87 54 5 5 151 (b) Doubtfully tuberculous ... ... ... ... ... ... ... ... 4 3 ... ... 7 (c) Non-tuberculous ... .... ... ... ... ... ... ... 53 35 2 4 94 B.—Number of Tuberculous City workers attending Dispensaryfor treatment on Dec.31st, 1932 33 C - Number of Non-Resident and Non-Workers attending Dispensary for treatment on . Dec. 31st, 1932 23 308 D 2 24 supplementary annual return showing in summary form (A) the condition at the end of 1932 of all patients remaining on the dispensary register; and (B) the reasons for the removal of all cases written off the register. the table is arranged according to the years in which the patients were first entered on the dispensary register as definite cases of pulmonary tuberculosis, and their classification at that time. A.—pulmonary tuberculosis. Condition at the time of the last record made during the year to which the Return relates. Previous to 1926. 1920. 1927. 1928. 1929. 1930. 1931. 1932. Class T.B. minus. 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. Class T.B. minus. 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. 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). 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).[/### (a) Remaining on Dispensary Register on 31st December. Disease arrested. Adults. M 2 1 2 1 4 1 .... .... .... .... 1 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... F 1 1 1 1 1 1 .... Chil- den. 1 .... .... .... .... 1 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Disease not arrested. Adults. M .... .... 1 1 2 .... .... .... .... .... .... .... .... .... .... 1 .... .... .... .... 1 .... 1 .... 1 .... .... .... 1 1 2 .... 1 1 2 3 1 1 2 4 F .... .... 1 .... 1 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1 .... 1 1 2 .... .... 1 1 2 2 1 .... .... 1 Children. .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Condition not ascertained daring the year 3 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Total on Dispensary Register at 31st December 7 1 5 2 8 3 .... .... .... .... 1 .... 1 .... 1 1 .... .... .... .... 1 .... 1 .... 1 1 .... 1 2 3 2 .... 2 2 4 5 2 1 2 5 (b) Not now on Dispensary Register and reasons for removal therefrom. Discharged as Recovered Adults. M 1 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... F .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Children. 1 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Lost sight of, or otherwise removed from Dispensary Register 19 2 14 3 19 3 .... 2 3 5 2 .... 3 2 5 8 1 .... 1 2 3 3 2 .... 5 3 1 2 1 4 4 1 .... 2 3 1 .... .... 2 2 Dead. Adults. M 1 1 2 5 8 .... .... 1 3 4 .... .... 1 3 4 1 .... 1 2 3 .... .... .... 1 1 .... .... .... 1 1 .... .... 1 2 3 1 .... .... .... .... F .... .... .... 3 3 .... .... .... .... .... .... .... .... 2 2 .... .... .... 1 1 .... .... .... .... .... .... .... .... 1 1 .... .... .... .... .... 1 .... .... .... .... Children. .... .... .... .... .... .... .... .... 1 1 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Total written off Dispensary Register 22 3 16 11 30 3 .... 3 7 10 2 .... 4 7 11 9 1 1 4 6 3 3 2 1 6 3 1 2 3 6 4 1 1 4 6 3 0 0 2 2 Grand Totals 29 4 21 13 38 6 .... 3 7 10 3 .... 5 7 12 10 1 1 4 6 4 3 3 1 7 4 1 3 5 9 6 1 3 6 10 8 2 1 4 7 25 b.—non-pulmonary tuberculosis. supplementary annual return showing in summary form (a) the condition at the end of 1932 of all patients remaining on the dispensary register; and (b) the reasons for the removal of all cases written off the register. Condition at the time of the last record made during the year to which the Return relates. Previous to 1926. 1926. 1927. 1938. 1929. 1930. 1931. 1932. Bones and Joints. Abdominal. Other Organs. Peripheral Glauds. Total. Bones and Joints. Abdominal. Other Organs. Peripheral Glands.1 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. Bones and Joints. Abdominal. Other Organs. Peripheral Glands. Total. Bones and Joints. Abdominal. Other Organs. Peripheral Glands. Total. (a) Remaining on Dispensary Register on 31st December. Disease arrested. Adults M 1 .... .... .... 1 .... .... .... .... .... 1 .... .... .... 1 .... .... .... .... .... 1 .... .... .... 1 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... F .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Children. .... .... .... 1 1 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Disease not arrested. Adults M .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1 .... .... .... 1 .... .... .... .... .... .... .... 1 .... 1 F 1 .... .... .... 1 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1 1 Children. .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Condition not ascertained during the year .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Total on Dispensary Register at 31st December 2 .... .... 1 3 .... .... .... .... .... 1 .... .... .... 1 .... .... .... .... .... 1 .... .... .... 1 1 .... .... .... 1 .... .... .... .... .... .... .... 1 1 2 Transferred to Pulmonary .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... (b) Not now on Dispensary Register and reasons for removal therefrom. Discharged as Recovered Adults j M F .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Children. 1 .... .... .... 1 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Lost sight of or otherwise removed from Dispensary Register 4 1 1 2 8 2 .... .... .... 2 1 .... .... 1 2 .... .... .... .... .... .... .... .... 1 1 1 .... .... .... 1 .... .... .... .... .... .... .... .... .... .... Dead. Adults M F .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Children. .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1 .... 1 .... .... .... .... .... .... .... .... .... .... Total written off Dispensary Register 5 1 1 2 9 .... .... .... .... .... 2 .... .... 1 3 .... .... .... .... .... .... .... .... 1 1 1 .... 1 .... 2 .... .... .... .... .... .... .... .... .... .... Grand Totals of (a) and (b) (excluding those transferred to Pulmonary). 7 1 1 3 12 2 .... .... .... 2 3 .... .... 1 4 .... .... .... .... .... 1 .... .... 1 2 2 .... 1 .... 3 .... .... .... .... .... .... .... 1 1 2 26 public health (tuberculosis) regulations, 1930. part I. Summary of Notifications during the period from the 3rd January, 1932, to the 31st December, 1932. Age Periods Formal Notifications. Number of Primary Notifications of now cases of Tuberculosis. Total Notifications. 0- 1. 5- 10. 15- 20- 25- 35- 45- 55- 65- Total (all apes) Pulmonary Males ... ... ... ... ... 2 4 2 3 2 1 14 24 „ Females ... ... ... ... 1 2 2 3 ... ... ... 8 10 Non-Pulmonary Males ... ... ... ... ... ... ... ... 1 ... ... 1 2 „ „ Females ... ... ... ... ... ... 1 ... ... ... ... 1 2 Col. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) part ii. supplemental return. New cases of Tuberculosis coming to the knowledge of the Medical Officer of Health during the above-mentioned period otherwise than by formal notification. Age Periods 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65- Total Pulmonary Males ... ... ... ... ... .... ... ... 1 ... ... 1 ,, Females ... ... ... ... ... ... ... .... ... ... ... ... Non-Pulmonary Males ... ... 1 ... ... ... ... ... ... ... ... 1 Females ... ... ... ... ... ... ... ... 1 ... ... ... The source or sources from which information as to the above-mentioned cases was obtained should be stated below:— Source of Information. No. of Cases. Pulmonary. NonPulmonary. Death Returns from local Registrars l 1 transferable deaths from Registrar General ... ... Posthumous notifications ... ... " Transfers " from other areas (other than transferable deaths) ... ... Other sources, if any (specify) ... ... part iii. notification register. Pulmonary. Non-Pulmonary. Total Cases. Males Females Total Males Females Total Number of cases of Tuberculosis remaining at the 31st December, 1932, on the Registers of Notifications kept District Medical Officers of Health in the County by the Medical Officer of Health of the CountyBorough, or Metropolitan Borough ..) 37 16 53 3 3 6 59 Number of cases removed from the Register(s) during the year by reason inter alia of :— 1. Withdrawal of notification ... ... ... ... ... ... ... 2. Recovery from the disease 1 ... 1 1 ... 1 2 3. Death 8 1 9 1 ... 1 10 NOTES. PA RT I (f) Forma/ Notifications are notifications which are made in pursuance of Article 5 of the Public Health (Tuberculosis) Regulations, 1930, or by Naval, Military or Air Force Medical Authorities, in pursuance of Section 5 (b) of the Local Government (Emergency Provisions) Act, 1916. (b) Primary Notifications for the purpose of columns (2) — (13) relate to patients who have never previously been formally notified in the area to which the Return relates. A patient who changes his residence from one Sanitary District to another in the same County may properly be the subject of Primary Notification in each such District. Only the first of such notifications, however, should be recorded in columns (2) — (13) of the Return for the County concerned, the subsequent notification(s) being included in column (14). (c) Column (14). All formal notifications, whether duplicate or not, should be included in this column. General. Patients notified as suffering from combined pulmonary and non-pulmonary tuberculosis should be included among the "pulmonary" returns only. If a patient, already notified as suffering from one form of tuberculosis, is subsequently notified to the Medical Officer of Health of the same Sanitary District as suffering from another form of tuberculosis, the fact should be noted in the Notification Register, but such notification should be recorded as a duplicate notification. PART II. (a) New cases of tuberculosis first coming to knowledge otherwise than by formal notification may, in some instances, afterwards be formally notified under the Regulations. Should such formal notification be received within the same year as that in which the case first came to the knowledge of the Medical Officer of Health, it should be recorded as a "Primary Notification," and excluded from the Supplemental Return. If the formal notification is received in a subsequent year, such notification should be regarded as duplicate, as the case has already been included in the Supplemental Return for a previous year. (b) A formal notification which is not received until after the death of the patient should be included in the Supplemental Return as a " posthumous notification." (c) Particulars of cases coming to knowledge through the Death Returns, as well as of cases notified posthumously, are required by Article 10(2) of the Regulations to be entered in the Notification Register. It follows that such cases will also be duly included in the number of cases removed from the Register during the year by reason of "death " (cf. Head 3 of the second section of Part III. of the Form overleaf). (d) No case should be included both in the Summary of Notifications and in the Supplemental Return for the same year. (e) In Counties, the particulars for the purposes of this Return should be obtained by the procedure suggested in paragraph 2 of Part II. of Circular 549. ... PART III. In Counties the information should be compiled from the quarterly statements for the year 1932, which are required to be furnished to the Cpuntv Medical Officer of Health by the Medical Officer of Health of each District in the County, in pursuance of Article 10 (8) of the Regulations, and should represent the surn of the figures relating to each District in the County. If any of these quarterly statements has not been duly received by the County Medical Officer of Health, the Ministry should be furnished with particulars, including the name of the District concerned. Further, if the County Medical Officer of Health is in any doubt as to the accuracy of the figures included in his Return, he should record the fact, giving reasons. 27 local government act, 1929. transfer or delegation of powers. As a result of a joint application made to the Minister of Health under Section 64, Local Government Act, 1929, by the London County Council and the Metropolitan Boroughs Standing Joint Committee, a draft order has been issued authorising the transfer or delegation from the County Council to the City Corporation and Borough Councils of such powers as the Minister might think fit within the limits of certain principles. This draft order has little practical effect on the Department of the Medical Officer of Health for the City. The public health services to which it relates are the following:— (1) Common Lodging Houses and Seamen's Lodging Houses. (2) Cow Houses. (3) Knackers' Yards. (4) Slaughter Houses. (5) Offensive Trades. (6) Smoke Nuisances. (7) Maternity and Child Welfare. (8) Infant Life Protection. (9) Maternity and Nursing Homes. (10) Supervision of Midwives and (11) Medical Inspection of School Children. The control of the foregoing, with the exception of the Supervision of Midwives and Medical Inspection of School Children, is already the responsibility of the City Corporation. With regard to the Supervision of Midwives, there are very few such practising in the City of London, but if powers of control are to be exerciseable by the Metropolitan Boroughs in their areas, there does not appear to be any reason why such powers should not be exercised in the City by the Corporation. In regard to the delegation of Inspection of School Children, I am of opinion that this is work in which centralisation would appear to be essential, and not one where delegation would result in increased efficiency or economy. CONGRESSES. Royal Sanitary Institute, Brighton, 9th July to loth July, 1932 ; Royal Institute of Public Health, Belfast, 9th to 14th May, 1932 ; Sanitary Inspectors' Association, Colwyn Bay, 5th to 10th September, 1932 ; Public Health Congress, London, 14th to 19th November, 1932 ; Central Council for Health Education, London, 17th November, 1932 ; National Association for Prevention of Tuberculosis, London, 21st to 23rd July, 1932 ; National Association for Prevention of Infant Mortality, London, 4th to 6th July, 1932. The Congresses organised by the above-mentioned Institutes and Associations were attended by representatives of the City Corporation, and evidence of the utility of attendance was amply afforded. Current thought was developed and intelligent anticipation of the lines on which public health will advance was given free opportunity for expression. Curtailment of these opportunities for intimate discussion of the details of public health work is much to be deprecated. SMOKE AND ATMOSPHERIC POLLUTION. Nineteen complaints of smoke nuisance or annoyance from chimneys were dealt with during the year, and in connection with these 166 observations were made. Many of the offences 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 the Meteorological Office, South Kensington, on the west, and Victoria Park, on the east of the rain gauge at Golden Lane, are shown in the attached table. 28 The table also shows the rainfall for the months of January to December of the year 1932, 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. SUMMARY OF MONTHLY OBSERVATIONS AND REPORTS DURING THE YEAR 1932. Month of the Year 1932. Place 3 4 5 6 7 8 9 10 11 12 Rainfall mm. Metric tons per square kilometre. Insoluble matter. Soluble matter. Total solids. Included in soluble matter. Tar. Carbonaceous other than tar. Ash. Loss on ignition. Ash. Sulphates (SO3). Chlorine (Cl). Ammonia (NH3), January Meteorological Office 37 0.25 2.25 4.74 1.32 3.54 12.08 1.64 0.58 0.06 Golden Lane 28 0.22 1.21 2.21 1.66 2.12 7.43 0.62 0.67 0.15 Victoria Park 33 0.07 1. 00 1.51 0.39 1.82 4.79 0.60 0.28 0.05 February Meteorological Office 4 0.20 0.96 2.14 0.53 1.26 5.09 0.43 0.37 0.05 Golden Lane 5 005 0.01 005 1.54 212 3.77 1.04 0.61 0.03 Victoria Park .... .... .... .... .... .... .... .... .... .... March Meteorological Office 35 0.31 1.58 3.15 1.12 2.30 8.46 0.91 0.64 0.05 Golden Lane 28 0.31 2.95 5.43 2.11 3.00 13.81 1.18 1.14 0.21 Victoria Park 35 018 215 4.92 0.92 1.84 10.01 0.78 0.40 0.05 April Meteorological Office 61 0.22 0.82 1.69 1.09 1.57 5.39 0.71 0.35 0.03 Golden Lane 68 0.18 1.69 2.78 3.80 9.76 18.22 3.12 1.40 0.22 Victoria Park 60 0.14 1.66 2.97 1.81 2.41 8.99 1.12 0.51 0.09 May Meteorological Office 105 0.33 2.92 4.08 1.26 2.11 10.70 1.08 0.40 0.01 Golden Lane 83 0.28 2.98 6.98 0.95 6.89 18.09 2.23 1.89 0.22 Victoria Park 65 0.14 1.78 4.06 1.29 2.98 10.25 1.15 0.35 0.08 June Meteorological Office 17 0.22 0.63 1.91 0.47 1.62 4.85 0.51 0.13 0.00 Golden Lane 16 0.07 0.79 1.72 0.76 1 .18 4.52 0.59 0.25 0.09 Victoria Park .... .... .... .... .... .... .... .... .... .... July Meteorological Office 68 0.12 1.13 1. 91 0.96 1.78 5.90 0.78 0.16 0.03 Golden Lane 78 0.14 1.37 3.45 1.39 2.48 8.84 1.49 0.49 0.31 Victoria Park 95 0.11 1.37 3.01 0.57 1.71 6.77 1.05 0.23 0.13 August Meteorological Office 47 0.21 1.05 1.91 0.66 1.24 5.07 0.58 0.12 0.00 Golden Lane 39 0.07 0.94 2.38 2.35 1.80 7.54 0.55 0.39 0.10 Victoria Park 27 0.06 0.98 2.31 0.48 1.18 5.01 0.01 0.11 0.05 September Meteorological Office 53 0.20 0.71 1.18 0.74 1.49 4.32 0.69 0.17 0.01 Golden Lane 52 0.16 1.15 2.84 1.98 2.72 8.86 1.36 0.45 0.21 Victoria Park 48 0.08 1.50 4.51 0.58 2.32 8.99 1.00 0.22 0.08 October Meteorological Office 107 0.22 1.40 2.07 0.64 1.49 5.82 0.87 0.20 003 Golden Lane 142 0.24 2.20 3.25 4.56 3.98 14.23 2.54 101 0.46 Victoria Park 132 0.11 1.25 1.12 1.05 2.11 6.44 1.36 0.35 0.10 November Meteorological Office 31 0.29 1.42 212 1.30 2.41 7.54 0.81 0.38 0.05 Golden Lane 27 0.23 1 .37 3.03 3.62 3.35 11.61 1.87 0.84 0.13 Victoria Park 27 0.09 0.44 0.61 0.64 1.39 3.17 0.66 0.31 0.14 December Meteorological Office 10 0.16 0.79 1.03 0.84 1.38 4.20 0.59 0.41 0.03 Golden Lane 11 0.07 0.15 0.21 1.35 1.59 3.39 0.74 0.48 0.04 Victoria Park 11 0. 05 0.43 0.73 0.57 1.31 3.09 0.63 0.15 0.05 29 CREMATION. Pass the place where the stocks long stood open to the weather outside the gate; trip over the open granite stile, a simple device against the straying of cattle from the meadow; turn south from the appropriate door of the church, capturing or enriching the correct spirit of entry to this acre from the legend beneath its sundial, "Sicut Umbra"; turn east, past memorials to some of the most gracious and noble patricians who, from out their hereditary store of noblesse oblige, ever helped their fellow-beings, until the boundary is reached. And there, on your left, against the wall of old red sandstone greyed by lichen and green with little black-stemmed ferns, lovers of a west aspect and the mists of the Western channel, stands a slate slab. At Easter time, the primroses are in profuse and grateful response to a want of any undue care of the turf at its foot—mounds make care difficult. " Reader, pass on nor spend your time In reading o'er this rugged rhyme ; What I am this humble stone ensures, And what I was is no affair of yours." Looking away south again, a blue heaven meets earth and sea. Less than 100 years have passed since the persons in whom this philosopher (also gunner in the senior service) vested as care and property after death, laid him not so far south of the church, in a place which is no longer commemorated by the slab. They may have expected, with every right the circumstances of the place could afford—a scattered population and a scene of utterest repose, that ages could not change the dispositions they had made. Yet mounds sink in and tumbled tombstones are once more erected (if at all) by those rather remote persons who reverently make "their" affairs "ours." There are few persons in the London Metropolis to-day who can count on physical remembrance at their place of repose over a space of one hundred years, under the process of sepulture. The density of the population would necessitate too great a reservation of space for each ultimate mere handful of dust; and this dust is precisely of the same composition, under whatever agency it is brought to its final state. The conditions of change under the customary method of sepulture are indescribable to a shocked laity ; they will not be described here. Rather is attention drawn to a process of change not differing, except in its utter purity and hastening of the final result, from that of earth-burial. It would seem that our choice in the Metropolis—or, indeed, elsewhere—is that of fouling the air and subsoil over large acreages situated in the midst of dwellings, in sepulture, or immediate and unnoisome reduction to the same dust, in cremation. If a few moments be given to thought, the position of cremation must stand as the more thinkable, as it is the more unselfish though far-sighted procedure, with regard to those we shall have honoured and shall still honour. A comparison of figures given in the following table indicates the steady progress which is made in cremation. During last year, 6,315 cremations took place in the 24 crematoria operating in Great Britain. This is the largest number recorded in any one year, and shows an increase of more than 21 per cent, over 1931, by far the largest increase yet seen. Comparing this figure with that of ten years ago, when the total was 2,009, an increase of 200 per cent, on the 1922 total is shown. Yet this figure represents only a little more than 1 per cent, of the total deaths, a percentage very much below that of certain Continental countries. In Czecho-Slovakia, for instance, with a population of about one-third of that of this country, and with only ten crematoria, 5,441 cremations took place during 1932. Two new crematoria have been opened in Great Britain during the last year, and it is hoped, with the growing request, facilities will be provided and will contribute to an acceleration in the increase of cremation. The Corporation are doing what is possible to forward this method of disposal of the dead. The interior of the Crematorium at Ilford has recently been redecorated throughout, the seating accommodation enlarged and improved, and important alterations effected in the position of the catafalque. A portion of the catacombs has been altered to provide a columbarium for the storage of urns, and a special enclosure provided adjacent to the Crematorium, in which ashes can be scattered if so desired. During 1932, 158 people were cremated at Ilford, which is an increase of 46 per cent, on the previous year's total, and is the largest in any one year since the opening in 1904. E 30 CREMATIONS IN THE UNITED KINGDOM. 48 YEARS—1885-1932. YEAR. Woking.* Manchester. Glasgow. Liverpool Hull. Darlington. Leicester. Golder's Green. Birmingham. Leeds. City of London. Bradford. W. Norwood. Hendon Park. Pontypridd. Bristol. Ipswich. Edinburgh. Brighton. Guernsey. Nottingham. Reading. (Opened Aug., 1932) Southampton. (Opened July, 1932) 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 .... .... .... .... .... .... .... .... .... .... .... 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 1930 446 442 121 160 84 52 119 1,787 180 73 112 59 49 390 12 40 143 55 125 78 6 .... .... .... 4,533 1931 476 508 158 163 128 62 89 1,866 257 109 112 87 77 415 13 43 177 68 169 144 4 70 .... .... 5,195 1932 446 626 165 171 126 77 94 2,245 307 116 158 84 123 480 13 51 237 94 266 263 9 74 13 77 6,315 Totals 8,487 7,476 2,411 2,375 1,349 688 1,151 26488 2,609 1043 1,676 955 769 4,327 110 235 744 256 580 485 19 144 13 77 64467 * "Viscount Cross in the year 1879 forbade the practice of cremation there (Woking) under the threat of passing an Act to make it "illegal... But in 1884 appeared the well-known judgment of Mr. Justice Stephen, which, in the case of a child's body having been "burned by its father contrary to the order of the coroner, determined cremation to be a legal act, provided no nuisance be caused there" by to others."—Extract from speech made by the late Sir Henrv Thompson at the opening of Golder's Green Crematorium, 22nd Nov"ember, 1902. Vide "Transactions of Cremation Society of England, 1903." p. 31. † Closed for reconstruction from August, 1913, to July, 1914. 31 MEAT INSPECTION. The report under this heading has been prepared by your Veterinary Officer, Lt.-Col. T. Dunlop Young. Reference to the Board of Trade Returns shows the undermentioned imports of fresh meat and bacon for the year 1932. 1932. Beef. Cwts. 1931. Beef. Cwts. 1932. Mutton and Lamb. Cwts. 1931. Mutton and Lamb. Cwts. Argentina 7,462,063 8,570,077 1,385,720 1,553,309 Australia 957,589 1,141,333 1,156,034 1,532,041 Brazil 481,090 600,453 — — Canada — — — — Denmark — — — — Irish Free State — — — — Netherlands — — — — New Zealand 578,881 382,849 3,915,865 3,469,460 Poland — — — — Sweden — — — — United States 47,466 60,367 — — Uruguay 699,849 1,017,561 163,690 283,922 Other Countries 142,455 224,088 350,187 289,497 Totals 10,369,393 11,996,728 6,971,496 7,128,229 1932. Pork. Cwts. 1931. Pork. Cwts. 1932. Bacon. Cwts. 1931. Bacon. Cwts. Argentina 108,934 81,220 - - Australia - - - - Brazil - - - - Canada - - 182,683 49,555 Denmark - - 7,672,030 7,339,095 Irish Free State 262,151 382,849 199,530 296,841 Netherlands — — 971,567 1,000,880 New Zealand 131,142 121,803 — — Poland — — 1,142,524 — Sweden — — 430,248 578,423 United States 32,542 62,208 63,318 189,027 Uruguay — — — — Other Countries 67,986 100,230 744,032 1,684,008 Totals 602,755 748,310 11,405,932 11,137,829 Beef.—The imports, contrary to the opinion so often expressed as to our supplies from overseas, shows a decrease of over 31,000 tons, 77 per cent, of this article of food was received in the chilled condition, and 22 per cent, frozen, the former being 24,393 tons, and the latter 6,340 tons, less than the previous year. Tinned beef extracts, etc., amounted to 40,700 tons. Mutton and Lamb.—Imports consisted of 348,574 tons or over 8,000 tons less than last year. Tinned mutton, etc., amounted to 1,950 tons, against 2,850 tons for the year 1931, and sheep's offals were imported to the extent of 7,100 tons, compared with 5,800 tons last year. Fresh Pork.—The Irish Free State was the only sender of this article of food, and the figures show a reduction of 6,000 tons compared with 1931. Frozen Pork.—The total amount imported shows a reduction due to small consignments from Other Countries, including the U.S.A., but imports from New Zealand and Argentina showed increases. Bacon.—This article of food continues to be of considerable importance, especially to pig producers and bacon curers in this country, the total amount imported was 520,296 tons, an increase of 13,612 tons compared with 1931. Hams.—This trade was previously in the hands of U.S.A. shippers, but appears to be gradually changing, due to increased consignments from Other Countries and Canada, the former increased from 19 per cent, to 24 per cent., and the latter sent 17 per cent, of the total. E 2 32 LIVE STOCK IMPORTED. 1932. Cattle. 1931. Cattle. 1932. Sheep. 1931. Sheep. 1932. Pigs. 1931. Pigs. Irish Free State 625,906 738,967 440,871 561,165 302,760 478,941 Canada 16,724 26,991 — — — - 1932 1931. Average prices Irish Cattle . Stores included £13 14 8 £16 6 1 „ „ Canadian Cattle „ „ £20 14 0 £20 10 3 „ „ Irish Sheep and Lambs „ „ £1 10 8 — „ „ Irish Pigs „ „ £3 8 5 — EXPORTS OF HOME-GROWN FOODSTUFFS. Fresh meat 6,987 tons. Bacon and hams 2,368 „ Offal 2,293 „ EXPORTS OF IMPORTED FOOD. Fresh beef 8 cwts. Chilled beef 724 tons. Frozen beef 7,347 „ Mutton and lamb 1,527 „ Bacon 10,082 „ Hams 613 „ Pork (frozen) 69 „ EXPORT OF ANIMALS TO IMPROVE BREEDS. Cattle 1,345 Sheep and lambs 1,017 Pigs 538 LONDON CENTRAL MARKETS. Analysis and Comparison of Supplies in Tons. Twelve Months. Description and Country of Origin. 1932. 1931. Difference. Beef and Veal: England and Wales 120,082 21,742 — 1,660 Scotland 13,971 13,548 + 423 Ireland †2,316 1,929 + 387 Australia 7,484 7,693 — 209 New Zealand 3,312 3,086 + 226 Canada 1,299 1,512 213 South Africa 243 154 + 89 U.S. of America 1,852 2.537 — 685 Argentina 163,613 168,540 — 4,927 Uruguay 5,765 7,157 — 1,392 Brazil, etc. 7,463 13,053 — 5,590 Netherlands — — — Denmark — — — Other Countries 3 — + 3 Totals : Beef and Veal Tons 227,403 240,951 — 13,548 Totals : Carried forward Tons 227,403 240,951 13,548 † Amended Figure. 33 Description and Country of Origin. Twelve Months. 1932. 1931. Difference. Totals : Brought forward Tons 227,403 240,951 — 13,548 Mutton and Lamb : England and Wales †12,763 11,648 + 1,115 Scotland 21,499 17,951 + 3,548 Ireland 1939 1,720 — 781 Australia 17,821 17,943 — 122 New Zealand 78,115 70,902 + 7,213 Canada 6 — + 6 South Africa 2 — + 2 U.S. of America 14 65 — 51 Argentina 20,942 26,528 — 5,586 Uruguay 601 1,015 — 414 Brazil, etc. 394 1,184 — 790 Netherlands — — — — Denmark — — — Other Countries 217 206 + 11 Totals : Mutton and Lamb Tons 153,313 149,162 + 4,151 Pork and Bacon : England and Wales †28,155 21,871 + 6,284 Scotland 39 56 — 17 Ireland †8,650 13,301 — 4,651 Australia 2,009 2,269 — 260 New Zealand 2.006 2,105 — 99 Canada 31 28 + 3 South Africa — — — U.S. of America 347 566 — 219 Argentina 679 829 — 150 Uruguay — — — Brazil, etc. 56 50 + 6 Netherlands *899 *1,795 — 896 Denmark Bacon *1,296 *1,490 — 194 Other Countries *3,708 *3,205 + 503 Totals : Pork and Bacon Tons 47,875 47,565 + 310 Poultry and Game : England and Wales †9,647 9,783 — 136 Scotland 633 594 + 39 Ireland 11,740 1,333 + 407 Australia 125 39 + 86 New Zealand 7 4 + 3 Canada 282 6 + 276 South Africa — 9 — 9 U.S. of America 42 340 — 298 Argentina 247 291 — 44 Uruguay — 6 — 6 Brazil, etc. — — — Netherlands 1,303 1,798 — 495 Denmark 9 10 — 1 Other Countries 10,615 11,635 — 1,020 Totals : Poultry and Game .... Tons 24,650 25,848 — 1,198 Rabbits : England and Wales †895 1,279 — 348 Scotland 33 25 + 8 Ireland †5 5 — Australia 6,889 5,678 + 1,211 New Zealand 341 268 + 73 Canada — — — South Africa — — — U.S. of America — — — Argentina 1 — + 1 Uruguay — — — Brazil, etc. — — — Netherlands 189 395 — 206 Denmark 2 7 — 5 Other Countries 650 664 — 14 Totals: Rabbits Tons 9,005 8,321 + 684 Totals: Carried forward Tons 462,246 471,847 — 9,601 † Amended Figures. 34 Description and Country of Origin. Twelve Months. 1932. 1931. Difference. Totals: Brought forward Tons 462,246 471,847 — 9,601 Eggs : England and Wales †1,519 1,289 + 230 Scotland 2 8 — 6 Ireland †223 94 + 129 Australia 136 44 + 92 New Zealand 3 — + 3 Canada — 1 — 1 South Africa 116 124 — 8 U.S. of America 1 2 — 1 Argentina 13 6 + 7 Uruguay 2 2 — Brazil, etc. — — — Netherlands 305 590 — 285 Denmark 174 145 + 29 Other Countries 142 254 — 112 Totals: Eggs Tons 2,636 2,559 + 77 Butter and Cheese: England and Wales 376 430 — 54 Scotland — — — Ireland †5 9 — 4 Australia 151 189 — 38 New Zealand 311 369 — 58 Canada 25 17 + 8 South Africa 10 3 + 7 U.S. of America 2 4 — 2 Argentina 97 93 + 4 Uruguay — — — Brazil, etc. — — — Netherlands 78 188 — 110 Denmark 6 2 + 4 Other Countries 15 81 — 66 Totals : Butter and Cheese Tons 1,076 1,385 — 309 Sundries : England and Wales †526 329 + 197 Scotland — — — Ireland †2 2 — Australia 3 1 + 2 New Zealand 2 1 + 1 Canada 1 3 — 2 South Africa 2 1 + 1 U.S. of America 27 32 — 5 Argentina 6 6 — Uruguay — — — Brazil, etc. — — — Netherlands 97 88 + 9 Denmark 171 67 + 104 Other Countries 485 434 + 51 Totals: Sundries Tons 1,322 964 + 358 Grand Totals Tons 467,280 476,755 — 9,475 †Amended Figure. GREAT BRITAIN. The following table of diseased meat seized or surrendered in the Markets shows no improvement in inspection at the places of slaughter, but rather a relaxation. This confirms remarks made in the previous reports and emphasised in the report of the Slaughtering of Live Stock Committee of the Economic Advisory Council, which states: "Meat inspection in private slaughterhouses in England and Wales is admittedly unsatisfactory. There is no uniformity in the standards of inspection or the rigour with which they are applied." Meat traders in general reply: "This is the fault of local authorities and cannot be laid at our doors, because we have for years pleaded for rigid inspection by properly qualified persons." 35 great britain.—1932. Beef. Mutton. Pork. Veal. Carcases. Quarters. Carcases. Quarters. Carcases. Quarters. Carcases. Quarters. Goats. Tongues. Lungs. Meeenterlee. Plucks. Heads.[/### Abscess - - 19 6 55 - 8 5 1 3 - - - 2 Actinomycosis - - - - - - - - - 1 - - - - Arthritis - - 1 — 26 - 1 — - — - - - — Decomposition - - 1 — 3 - 1 — - — - - - — Distomatosis - - 169 — — - — — - — - - - — Dropsy - - — — — - 1 — - — - - - — Emaciation and Hydraemia 5 - 86 — 120 - 15 — 1 — - - 2 — Fevered 1 2 — — 23 - — — - — - - — — Hemorrhagic — 3 — — 56 3 — — - — - - — — Injury - - 1 - - - 1 - - - - - - - Jaundice — — 2 — 23 — 15 — - — - - — — Joint III — — — - — 2 — - — - - — — Killed Inextremis 1 — 10 2 11 — 18 - - - - - - - Leukaemia (Pseudo) - - 1 - - - - - - - - - - — Melanosis — — — — — — — 4 - — - - 1 — Myositis - - - - - - 1 - - - - - - - Nephritis (Septic) 1 — 9 — 9 — 4 — - — - - — — Parasitic Disease — — 2 — — — — — - — - - 1 — Peritonitis and Pleurisy — — 41 3 419 18 7 - - - - - - - Rachitis — — 5 — 18 — 3 — - — - - — — Tuberculosis (Bovine) 9 16 — — — — 8 — - 32 17 - 8 17 Tuberculosis (Porcine) — — — — 728 118 - - - - - 145 575 6,133 Urticaria — — — — 9 — — — - — — — — — Totals for 1932 17 21 347 11 1,500 139 85 9 2 36 17 145 587 6,152 Totals for 1931 24 33 339 10 1,062 38 53 7 1 22 13 15 342 2,973 IRELAND (SOUTHERN). Consignments of food received in the Market from this country consisted, in tons, of beef, 2,316 ; mutton and lamb, 939 ; pork and bacon, 8,650 ; poultry and game, 1,740 ; rabbits, 5 ; eggs, 223 ; butter, 5 ; and sundries, 2. The quality of the meat was good, and the inspection at the places of slaughter continues to improve, as will be seen by the following figures. The amount of unsound food surrendered is shown in Tables Nos. 18 and 19, and the amount of diseased meat in the following table :— [### Beef. Pork. Quarters. Carcases. Sides. Pieces. Heads. Plucks.[/### Abscess - 2 4 - - - Emaciation - 1 6 - - - Erysipelas - 1 — - - - Jaundice - 1 — - - - Killed Inextremis - 2 — - - - Minus Lymph Glands - — 7 — - - Pleurisy and Peritonitis - 17 15 - - - Rheumatoid Arthritis - 4 — - - - Tuberculosis 1 19 112 18 4 14 Total for 1932 1 47 144 18 4 14 Total for 1931 - 100 134 40 18 28 Argentina.-The following table shows the amount of food, in tons, sent from this country to Smithfield Market during 1932, compared with 1931 :- Beef and Veal. Mutton and Lamb. Tork and Bacon. Fcultry and Game Eggf. Butter.[/### Sundries. 1932 163,613 20,942 679 247 13 97 6 1931 168,540 26,528 829 291 6 93 6 From these consignments the amount of food taken for unsoundness is given on page 40. 36 The following table shows the amount of food taken for disease, viz. :— Beef Quarters Mutton Carcases Mutton Quarters Pork Carcases Mutton Pieces 1931. 1932. 1931. 1932. 1931. 1932. 1931. 1932. 1931. 1932. Abscess 39 27 24 9 - - 7 1 - - Caseous Lymphadenitis — — 371 215 142 19 — - 115 8 Cysticercus Bovis — 4 - - - - - - — — Emaciation — — 7 5 — — — - — — Nephritis — 2 - - - - - - - - Pleurisy 2 - - - - - - - - - Peritonitis — — — 3 — — — - — — Tuberculosis (Hinds) 64 84 - - - - - - - - „ (Fores) 13 18 - - - - - - - - „ (Pore.) - - - - - - - 1 - - Totals 118 135 402 232 142 19 7 2 115 8 Australia.—This country exported to Smithfield Market during 1932, the following amount of food in tons, viz. :— Beef and Veal. Mutton and Lamb. Pork. Poultry and Game. Rabbits. Eggs. Butter. Sundries. 7,484 17,821 2,009 125 6,889 136 151 3 The amount of unsound food taken from these quantities is shown on page 40, and the amount taken for disease in the following table, viz. :— Beef. Quarters. Mutton. Carcases. Mutton. Quarters Pork. Carcases. Mutton. Pieces. 1931. 1932. 1931. 1932. 1931. 1932. 1931. 1932. 1931. 1932. Abscess - 3 17 5 - - - 2 - - Caseous Lymphadenitis - — 241 171 38 25 - — 162 24 Emaciation - — 5 5 — — - — — — Tuberculosis 5 7 - - - - - - - - Totals 5 10 263 181 38 25 - 2 162 24 New Zealand.—From this country the total amount of food deposited in the Central Markets during 1932 consisted of beef, 3,312; mutton and lamb, 78,115; pork, 2,006; poultry, 7 ; rabbits, 341 ; eggs, 3 ; butter and cheese, 311 ; and sundries, 2 tons respectively. The amount of unsound food discovered in those consignments is given in Tables Nos. 18 and 19, and the amount of diseased meat in the following Table :— Beef. Quarters. 1931. 1932. Mutton. Carcases. 1931. 1932. Mutton. Quarters. 1931. 1932. Pork. Carcases. 1931. 1932. Mutton. Pieces. 1931. 1932. Abscess l — 13 9 — 44 33 — Caseous Lymphadenitis Parasitic Disease — — 201 5 157 15 4 12 — — 6 Pleurisy Tuberculosis.... l 1 2 — — — 1 6 — — Totals 2 1 221 181 4 12 45 39 6 Uruguay.—The amount of meat sent from this country consisted of 34,992 tons of beef and 8,184 tons of mutton, compared with 7,157 tons of beef and 1,015 tons of mutton for 1931. Some of the beef reached a high standard of quality and showed improved breeding. Improvement in meat inspection continues as the following figures show, viz. :— Beef. Quarters. 1931. 1932. Mutton. Carcases. 1931. 1932. Pork. Carcases. 1931. 1932. Mutton. Pieces. 1931. 1932. Abscess .... .... .... .... .... 5 — 3 1 1 — — — Caseous Lymphadenitis — — 40 3 — — 48 — Emaciation — — — 2 — — — — Tuberculosis 1 — — — — — — — Totals 6 — 43 6 1 — 48 — Chile.—The inspection in this country continues to show improvement. Only 10 carcases were seized for disease, compared with 148 in 1931. 37 Brazil.—This country sent to the Central Markets the following amount of food, in tons, viz. : Beef and veal, 7,463 ; mutton and lamb, 394 ; and pork, 56. There was a considerable improvement in the quality of some of the beef. For the quantities of unsound food surrendered, vide Tables Nos. 18 and 19. The amount of diseased food seized was :— Beef Quarters. 1932. 1931. Abscess 5 10 Sarcoma — 1 Tuberculosis 8 6 — — Totals 13 17 South Africa.—This country is at present attempting to supply small quantities of chilled beef. The average quality of the beef is not of a high standard, but great interest is being taken in the experiment by the African Government so that by improved breeding and more experience in transportation a useful class of meat may be supplied to British consumers. Only one quarter of beef was found diseased. Other Countries.—There is nothing of importance to report as to the undermentioned countries except to continue to urge that all bacon should bear a stamp showing that it has been derived from pigs found free from disease by Government Inspectors. Denmark. Bacon. bides, rieces. Abscess 8 1 Pleurisy 2 — Tuberculosis 1 — Holland. Pleurisy 1 — Lithuania. Abscess 7 — Poland. Abscess 4 1 Pleurisy 5 — CASEOUS LYMPHADENITIS. The following table shows as during the last two years a continued improvement in the inspection of carcases at the places of slaughter, but no or little improvement in the inspection of quarters and pieces, thus necessitating a continuation of 100 per cent, examination of the two latter articles prior to sale in this country. Countries. Carcases. Sides. Quarters. Pieces. 1930. 1931. 1932. 1930. 1931. 1932. 1930. 1931. 1932. 1930. 1931. 1932. Argentina 918 371 483 — 76 4 24 142 36 2 39 47 Australia 222 241 187 — — — 20 38 101 10 162 111 Brazil 26 30 — 1 — — — — — — — — Chile 160 147 105 217 98 169 6 — 79 — — 284 New Zealand 311 201 246 33 23 — — 4 18 10 139 393 South Africa 43 — — — — — — — — — — — Uruguay 152 40 3 6 — — — — — — 48 — Totals 1,832 1,030 1,024 257 197 173 50 184 234 22 388 835 38 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) 35 Lamb (Plucks) 6 Beef (Pieces) 13 Milk (Tins) 80 „ (Livers) 14 Mutton (Carcases) 6 „ (Tongues) 6 „ (Pieces) 13 Butter (Case) 1 (Quarters) 2 Calf (Carcases) 4 Offal (lbs.) 1,430 „ (Head) 2 Partridges 1,452 „ (Liver) 1 Pheasants 915 „ (Quarters) 4 Pigeons 1,267 „ (Pieces) 8 Plover 300 „ (Plucks) 7 Pork (Carcases) 1 Capercailzies 17 „ (Heads) 13 Chickens 953 „ (Kidneys) 1 Cream (Tins) 505 „ (Livers) 27 Curlew 1 „ (Pieces) 11 Ducks 1,427 „ (Plucks) 15 Eggs 1,378 Ptarmigan 90 Fowls 5,746 Quail 593 Game (Black) 25 Rabbits 11,441 „ (Unclassified) 900 Snipe 73 Geese 148 Squirrel 1 Grouse 1,281 Teal 23 Guinea Fowls 422 Turkeys 1,547 Hams 6 Venison (Carcases) 3 Hares 756 „ (Pieces) 8 Hazelhens 280 „ (Quarters) 12 Lamb (Livers) 28 Widgeon 48 „ (Pieces) 5 Woodcock 73 Tons. Cwts. Qrs. Lbs. Total for 1932 36 2 3 3 1931 26, 8 1 5 Increase 9 14 1 26 UNSOUND MEAT, ETC., REMOVED FROM COLD STORES. Article. No. How Packed. Origin. Cause for Destruction. Tons. Cwts. Qrs. Lbs. Beef (Pieces) .... .... Argentina Injury 0 0 l 26 „ .... „ Peritonitis 0 0 l 12 „ .... „ Decomposed 0 0 3 5 ,, (Livers) 4 .... „ „ 0 0 l 21 „ 37 Boxes „ Brine Stain 0 3 l 27 „ (Tongues) 2 Bags „ Decomposed. 0 0 3 18 „ (Tripe) 4 „ „ Brine Stain 0 2 1 8 „ (Kidneys) 6 Boxes „ „ 0 0 2 8 „ (Pieces) .... Australia Decomposed 0 2 3 5 „ .... „ Bone Taint 0 1 1 5 „ (Livers) .... „ Decomposed 0 0 0 21 „ (Tails) 1 .... „ „ 0 0 0 2 „ (Tins) 704 Tins Gt. Britain „ 1 17 2 18 Blood (Defibrinated) 1 „ Argentina. „ 0 0 1 19 Fish 2 Cases Gt. Britain. „ 0 2 1 9 Hams 2 Tins Holland „ 0 0 1 2 Hearts 10 Bags Argentina Brine Stain 0 3 0 16 „ 1 „ Australia Decomposed. 0 0 2 14 „ 8 „ „ Brine Stain 0 3 0 0 Kidneys .... New Zealand Decomposed 0 0 3 8 „ 13 Crates Australia Brine Stain 0 3 2 11 „ 198 Boxes Argentina Decomposed 1 11 3 20 Carried forward 4 17 1 23 39 Unsound Meat, Etc., Removed from Cold Stores.—continued. Article. No. How Packed. Origin. Cause for Destruction. Tons. Cwts. Qrs. Lbs. Brought forward 4 17 1 23 Mutton (Carcases) 398 .... Argentina *C.L.A 5 13 2 0 „ „ 30 .... „ Mould Fungi 0 4 2 7 „ (Pieces) .... „ *C.L.A 0 1 1 10 „ „ 2 .... „ Injury 0 0 0 15 „ (Shoulders) 12 .... „ *C.L A 0 0 3 9 ,, (Sides) 4 .... „ „ 0 0 2 9 (Quarters) 17 .... „ „ 0 1 3 18 „ (Carcases) 17 .... Australia „ 0 8 0 3 16 .... „ Brine Stain 0 5 2 2 „ „ 1 .... „ Transit damage 0 0 1 9 „ (Pieces) 1 .... „ Abscess 0 0 0 4 „ 1 .... „ Brine Stain 0 0 0 10 „ „ 1 .... *C.L.A 0 0 0 24 „ „ .... „ Decomposed 0 0 0 20 (Quarters) 76 .... „ *C.L.A 0 10 1 11 (Legs) 160 .... „ „ 0 9 1 3 „ „ 8 .... „ Mould Fungi 0 0 2 3 „ (Carcases) 75 .... Chile *C.L.A 1 12 3 22 (Quarters) 79 .... „ „ 0 9 1 19 (Legs) 17 .... „ „ 0 1 1 6 „ (Shoulders) 38 .... „ „ 0 2 0 22 „ (Sides) 169 .... „ „ 1 11 0 20 „ (Carcases) 993 .... Iceland Mould Fungi 13 15 2 8 „ (Pieces) .... „ „ 5 1 2 16 „ (Carcases) 73 .... New Zealand *C.L.A 1 13 0 11 9 .... „ Brine Stain . 0 4 0 0 „ „ 6 .... „ Mould Fungi 0 1 3 16 „ 2 .... „ Transit damage 0 0 2 4 (Legs) 290 .... „ *C.L.A 0 18 1 3 „ (Pieces) .... „ Decomposed 0 0 1 12 „ „ .... „ Mould Fungi 0 10 2 6 (Quarters) 6 .... „ *C.L.A 0 0 2 13 „ (Shoulders) 1 .... „ „ 0 0 0 6 (Sides) 9 .... „ ii 0 1 2 10 (Livers) 1 Pack „ Decomposed. 0 0 0 5 Offal .... Gt. Britain Parasitic Disease 0 0 1 12 Pork (Carcases) 2 .... Argentina Abscess 0 1 2 17 Quail 10 Bundles Egypt Mould Fungi- 0 1 3 4 Rabbits .... Australia Decomposed. 0 4 2 18 Sweetbreads 136 Boxes Argentina Brine Stain 0 19 0 10 Turkeys 1 .... „ Decomposed 0 0 0 12 Veal 4 Bags Australia ... ii 0 2 0 10 „ (Livers) 64 Cases New Zealand ii 2 19 1 8 Total for 1932 43 9 0 22 „ 1931 37 14 2 12 Increase 5 14 2 10 * Caseous Lymphadenitis. F2 40 SHOWING THE AMOUNT OF VARIOUS FOOD PRODUCTS SURRENDERED TO OR SEIZED BY MEAT INSPECTORS IN THE CITY OF LONDON FOR DISEASED CONDITIONS, 1932. Countries. Beef in lbs. Mutton in lbs. Pork in lbs. Veal in lbs. Venison in lbs. Bacon in lbs. Offal in lbs. Poultry in lbs. Rabbits in lbs. Argentine 46,783 47,683 5,224 296 — — 4,683 Australia 1,784 14,737 2,276 — — 1,820 Brazil 2,173 1,787 — — Britain 22,616 20,548 128,688 4,785 184 907 103,829 2,102 4,073 Chile — 6,981 — — — Denmark — — — — — 517 Holland — — — — — 631 Hungary — — — — — — 16 Ireland 1,127 1,478 26,784 762 — 176 55,921 1,371 2,754 Manchuria — ' — 578 — — New Zealand 1,737 21,090 4,309 1,238 387 Poland — — 439 — 893 South Africa — — — — 63 Uruguay 4,283 6,980 83 — — U.S.A — — — — — — 80 — — Totals for 1932 80,503 121,284 168,381 7,081 184 3,187 166,720 3,489 6,827 Totals for 1931. 64,322 97,233 147,326 5,244 116 2,800 119,924 164 SHOWING THE AMOUNT OF VARIOUS FOOD PRODUCTS SURRENDERED TO OR SEIZED BY MEAT INSPECTORS IN THE CITY OF LONDON FOR UNSOUND CONDITIONS, 1932. Countries. Beef in lbs. Mutton in lbs. Pork in lbs. Veal in lbs. Venison in lbs. Goat in lbs. Bacon in lbs. Offal in lbs. Furred Game in lbs. Feathered Game in lbs. Tinned Milk in lbs. Tinned Meat in lbs. Cheese in lbs. Fish in lbs. Argentine 456,896 43,871 3,178 3,371 30,784 127 173 173 7,081 Australia.... 10,743 26,839 2,784 — — — — 3,684 3,978 2,784 107 Austria .... — — — — — — — — — 463 Belgium .... — — — — — — 784 8,764 468 Brazil 6,874 — 600 — — 117 — Britain .... 24,880 23,318 75,405 15,645 2,550 434 7,323 .''.4,784 23,088 70,408 1,802 1 lfi'2 Canada ... — — — — — — 84 83 295 Chile 874 4,783 Czechoslovakia — — — — 784 Denmark — — — — «— — 3,978 73 211 774 Esthonia .... — — — — — — 2,908 France .... — — — — — — — 37 4,051 Finland .... — — — — — 73 Germany.... — — — — — — — — 1,290 607 Holland .... — — — — — — 3,684 — 12,784 33,784 1,537 1,083 Huneary — — — — — — — — 12 Iceland .... — 48,348 — — — Ireland .... 178 10,784 16,737 568 160 z 873 125,775 381 3,922 20 Italy — — — — — — — — 381 3,781 60 Lithuania — — — — — 784 Manchuria — — — — — — 62 New Zealand 19,148 233,138 5,764 784 — — — 3,581 4,787 7.251 16 Norway .... — — — — — — — 87 Poland .... — — — — — — 2,876 - Uruguay .... 13,732 — 1,857 375 74 197 — — U.S.A — — — — — — — 37,843 825 271 Russia .... — — — — — — 381 7,858 South Africa 167 Sweden .... — — — — 187 Syria — — — — — - — 4,783 — — Totals for 1932 533,492 384,981 106,325 20,743 2,784 748 23,481 236,451 54,793 141,544 5,000 11,184 60 295 Totals for 1931 525,011 37,845 98,718 18,436 3,196 625 20,944 65,365 76,011 70,002 5,512 7,049 59 2,300 SUMMARY OF UNSOUND FOOD DESTROYED* [### Tons. Cwts. Lbs. Central Markets (Smithfield) 848 15 1 18 Cold Stores 43 9 0 22 Leadenhall Market and City Shops 36 2 3 3 Total for year 1932 928 7 1 15 Total for year 1931 762 8 2 11 Increase 165 18 3 4 EXPORT OF MEAT. During the year 153 Certificates were issued at the request of various firms, in connection with the export of meat to other countries. DEMONSTRATIONS AND INSTRUCTION IN MEAT INSPECTION. Ninety-nine persons from various Inspector and other Training Centres received instruction during the year. In accordance with arrangements of long standing, 24 Naval Officers received training in meat inspection at the Central Markets, Smithfield, during the year. 41 PUBLIC HEALTH (LONDON) ACT, 1891 —UNSOUND M EAT— PROSECUTIONS. Serial No. Date. Business. Where heard. Before whom. Offence. Result. l 17/3/32 Farmer and Dealer. Guildhall Aid. Sir D. George Collins. Under the City of London (Various Powers) Act, 1911, Sec. 39, being the person who consigned the diseased carcases of four sheep and one breast of mutton. Fined £20 ; Costs, £10 2s. 6d. 2 27/4/32 Coal Merchant. „ Aid. Sir W. Burton. Under the City of London (Various Powers) Act, 1911, Sec. 39, being the person who consigned the diseased carcase of a boar pig. Fined £10 ; Costs, £6 8s. 6d. 6 16/6/32 Dealer „ Aid. Sir W. Jacobs. Under the City of London (Various Powers) Act, 1911, Sec. 39, being the person who consigned the diseased carcases of two pigs. Fined £25; Costs, £3 6s. 6d. At the invitation of the Argentine Government, Mr. T. D. Young was permitted by the Corporation to visit the Sixth International Cold Storage Congress, held at Buenos Aires, in August. Opportunity was taken of this visit to accept invitations from the Governments of Uruguay and Brazil, to see the system of meat inspection in operation in those two countries. These visits were of considerable value to Mr. Young, and through him, to the Corporation. Table showing Weight of Meat delivered, and Meat delivered to Contractors as unsound, during each Month of the Years 1931 and 1932. Month. Meat delivered at the Market, 1931. Unsound Meat delivered to Contractors, 1931. Meat delivered at the Market, 1932. Unsound Meat delivered to Contractors, 1932. Tons. cwts. qrs. Tons. cwts. qrv Tons. cwts. Qrs. Tons. cwts. qrs. January 43,236 0 0 57 15 1 39,806 0 0 71 0 0 February .... 37,498 0 0 61 5 1 41,297 0 0 51 18 0 March 41,799 0 0 56 18 3 39,654 0 0 60 16 1 April 40,831 0 0 64 12 2 38,223 0 0 56 3 3 May 37,334 0 0 60 2 1 37,451 0 0 54 0 0 June 35,646 0 0 61 15 3 35,399 0 0 64 10 3 July 38,814 0 0 76 11 0 35,443 0 0 91 9 0 August 33,527 0 0 67 17 3 35,417 0 0 149 18 2 September 38,981 0 0 88 18 0 39,477 0 0 106 18 2 October 43,213 0 0 83 8 2 42,540 0 0 86 16 1 November 40.809 0 0 60 17 0 41,022 0 0 92 15 2 December 45,067 0 0 79 8 3 41,037 0 0 135 2 2 Totals 476,755 0 0 819 10 3 466,766 0 0 1,021 9 0 One ton in every 457 tons of meat paying toll in the Central Markets, Smithfield, was condemned last year, as compared with one ton in 582 in 1931. ♦Table showing the average deliveries at the Central Meat Market, and other details for successive quinquennial periods during the past 58 years :— Quinquennium. Annual Average General Supply. Seizures by Inspectors. % of Unsound Meat. Tons. cwts. qrs. Tons. cwts. qrs. 1874-1878 178,373 10 0 192 18 2 •108 1879-1883 218,200 12 3 282 11 2 •129 1884-1888 249,580 19 2 248 1 2 •099 1889-1893 304,986 5 1 461 15 1 •151 1894-1898 372,440 12 2 749 3 3 •201 1899-1903 410,456 18 1 1,082 13 2 •233 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 1929-1932 467,835 0 0 960 0 0 •205 • I am indebted to the Clerk and Superintendent of the Central Markets for the figures relating to the market supplies, sources of origin, &c. 42 *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. South Africa . Per cent. 1928 22.1 5.7 4.9 - 48.6 18.7 1929 20.8 5.5 4.9 - 49.4 19.4 1930 20.5 4.6 4.8 - 49.2 20.9 1931 21.1 3.8 4.9 0.3 46.6 23.2 0.1 1922 22.9 3.6 4.4 0.1 43.5 25.4 0.1 The following figures supplied by the Superintendent of the Market are of interest:— 1928. 1929. 1930. 1931. 1932. Tons. Tons. Tons. Tons. Tons. Average daily delivery into the Markets 1,478 1,491 1,502 1,554 1,511 **Minimum delivery on any one day 256 288 208 523 368 Maximum delivery on any one day 3,699 3,179 3,694 4,524 3,877 The heaviest weight previously recorded on any one day (20th December, 1926) was— 5,259 tons. *1 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. t Includes " General Foreign Meat and Produce." X Includes South American Imports. FISH SUPPLIES. 192,485 tons of fish, of which 176,494 were land-borne and 15,991 water-borne, were received at or near Billingsgate Market during the year. This was an decrease of 17,327 tons in the land deliveries and of 714 tons in deliveries by water. MONTHLY FISH RETURNS. * Table showing Weight of Fish Delivered, Fish seized as Unsound, and Percentage of Fish Condemned to that delivered, at or near Billingsgate Market, and on board boats lying off thatplace, during each month of the year 1931. Month. Weight of Fish Delivered. Total. Weight of Fish Condemned. Ratio of Fish Condemned to that Delivered. By Land. By Water. Tons. :wts. qrs. Tons. cwts. qrs. Tons. cwts. qrs. Tons. cwts. qrs. January 15,049 1 3 794 9 0 15,843 10 3 49 8 0 1 ton in 320 719 tons, or 0.311% February 15,396 17 1 1,179 14 2 16,576 11 3 107 19 3 153.504 „ „ 0.651% March 15,747 10 3 1,541 17 2 17,289 8 1 104 19 1 164.719 „ „ 0.607% April 15,408 17 1 1,334 19 0 16,743 16 1 153 13 3 108.947 „ 0.917% May 14,982 14 3 1,293 5 0 16,275 19 3 137 14 0 118.198 ,, „ 0.846% June 14,351 16 2 1,088 10 2 15,440 7 0 128 6 0 120.345 ,, ,, 0.830% July 14.336 19 0 1,253 9 2 15,590 8 2 170 5 1 ,, 91.566 ,, ,, 1.092% August 14,018 8 0 1,594 17 3 15,613 5 3 377 17 0 41.321 „ „ 2.420% September 13.946 14 1 1,719 5 0 15,665 19 1 152 0 0 103.065 „ 0.970% October 13,950 15 1 1,690 9 0 15,641 4 1 65 7 3 239.207 „ 0.418% November 15,188 2 3 1,432 1 2 16,620 4 1 67 7 0 246.773 ,, „ 0.405% December 14,116 13 3 1,068 6 3 15,185 0 2 43 3 1 351.810 „ 0.284% Totals 176,494 11 1 15,991 5 0 192,485 16 1 1,558 1 0 123.546 „ „ 0.809% Weight of Fish Delivered, Fish Seized as Unsound, and percentage of Fish Condemned to that Delivered, at or near Billingsgate Market during 1932 and the five years 1927—1931. 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. 1927 207,056 22,904 229,960 2,070 1 0 1 ton in 111- 028 tons or 0. 900% 1928 214,426 24,598 239,024 2,241 12 1 1 „ 106.163 „ 0.903% 1929 216,936 22,396 239,332 1,587 6 1 1 „ 150.778 „ 0.663% 1930 207,121 21,586 228,707 2,111 15 0 1 „ 140.902 „ 0.710% 1931 193,821 16,705 210,526 1,581 19 3 1 „ 133.077 „ 0.751% Average (5 years) 207,872 21,638 229.510 1,918 10 3 1 ton in 119.661 tons or 0.830% 1932 176,494 15,991 192,485 1,558 1 0 1 ton in 123.546 tons or 0-809% • Compiled from the Monthly Returns received from the Fishmongers' Company. 43 MEAT INSPECTIONS AT SLAUGHTERHOUSES. The Sanitary Committee of the City Corporation gave very careful consideration, during 1932, to the possibility of strengthening the existing powers of Local Authorities in connection with the slaughtering of animals for human food and subsequent inspection of the carcase. The general law relating to the inspection and destruction of unsound meat is contained in Section 47 of the Public Health (London) Act, 1891, and under the powers conferred by that Act, responsible officials may inspect and examine any article intended for the food of man, and sold or exposed for sale, or deposited in any place for the purpose of sale, or of preparation for sale, and if he finds it to be diseased, unsound, unwholesome or unfit, he is required to take it before a justice, who in turn examines it, condemns it and orders that it shall be destroyed or so disposed of as to prevent it from being used for human consumption, and the person to whom the same belongs at the time of sale or in whose possession or on whose premises the same is found is liable to heavy penalties. The City of London (Various Powers) Act, 1911, gave further powers to the Corporation, rendering any person sending, consigning or delivering, or causing to be sent, consigned or delivered, such meat, liable to similar penalties. The question with regard to actual slaughtering of animals for sale for human consumption is dealt with by the Public Health (Meat) Regulations, 1924. Under these Regulations, except where the slaughter takes place in a slaughterhouse under the management of a local authority, a person may not slaughter an animal for sale for human consumption unless he has, at least three hours before the time of slaughter, notified the local authority of the district in which the place of slaughter is situated. Where, however, it is the regular practice in any slaughterhouse to slaughter animals at fixed times on fixed days, and written notice of this practice has been given, special notice is not required in respect of any animal slaughtered in accordance with such practice. The Regulations also deal with emergency slaughter, and they further require the person by, or on whose behalf, an animal is slaughtered, forthwith to notify the local authority where it appears that any part of the carcase or internal organs is or may be diseased. The carcase of such animal and certain internal organs may not be removed until after inspection or until its removal has been authorised. This regulation, however, does not apply in the case of sheep or any animal in respect of whose slaughter special notice is not required to be given, unless some part of the carcase or organs appears to be diseased or unsound. The Regulations, however, authorise removal at the expiration of three hours from the time of slaughter or six hours from the delivery of any notice in relation thereto, whichever is the later. The Regulations are so framed as to make it difficult for the slaughterman or the person on whose behalf the diseased animal was slaughtered to explain how any meat which is seized or surrendered on deposit for sale on account of obvious disease or unsoundness was despatched without the inspection of the local authority at the place of slaughter, and the slaughterman is expected to know in general the appearance of a carcase and offal which is sound and free from disease. The evidence obtained as a result of investigation in the seizures in Smithfield Market may show either (1) that the local authority has provided insufficient inspection, or (2) as it more often happens, that evasion has been attempted. In all the circumstances, the present Regulations have certainly been effective in securing a general improvement in meat inspection conditions. Their limitation, however, at present lies in the paucity of competent meat inspectors, and in the disinclination of local authorities to increase the burden of local taxation by the appointment of such additional inspectors as will be necessary to ensure that every carcase slaughtered in their area is seen before dispatch to market. The obvious and complete solution of the whole question seems to be in the provision of centralised lairages and abattoirs, where sufficient inspection would be a much more simple matter. The closing of scattered slaughterhouses would then not be the impossible task that it is at present. Advocacy of this, however, the City Corporation quite recognises, is untimely at the present moment, but when, at some future date, circumstances permit, appropriate steps will doubtless be taken to further the improvement of meat inspection this indicates. 44 WRAPPING OF FOOD STUFFS. From time to time local authorities have given consideration to the possible danger to public health associated with the delivery of bread to customers' houses unprotected by suitable wrappings and of other food stuffs wrapped in newspaper or similar waste paper, and a number of representations have been made with the object of securing statutory powers to control these practices. During 1932, the council of one of the larger residential metropolitan boroughs expressed the opinion that it should be compulsory to wrap bread before delivery and that newspapers or waste paper should not be used for the wrapping of food stuffs of any description, and the Corporation were asked to support this view, and the subsequent application to the London County Council for the inclusion of appropriate clauses in the next General Powers Bill. Although the City Corporation is not directly interested to anything like the same extent in a practice which is very common in the more thickly-populated and poorer metropolitan area, they were of opinion that the suggested powers were desirable and had no hesitation in offering the support asked for. PUBLIC HEALTH (MEAT) REGULATIONS, 1924. The above Regulations continue to require constant administration on the part of my department to ensure due obedience and compliance in the various businesses concerned situated within the City of London. Smithfield Market.—I am pleased to be able to report that the improvements of last year have been maintained, and this market is now nearing that standard of cleanliness aimed at with regard to the handling and transport of meat. Leadenhall Market.—The shops are clean and well kept, and this condition is greatly encouraged by a Local Traders' Association, of which the majority of the shopkeepers are members. Periodical cleansing is carried out by the Corporation. Aldgate Market.—A marked improvement ; a new shop has been erected on modern lines, which should, in emulation, improve the few shops now remaining. Market Carriers.— There is an increase in the number of offences under this heading in respect of dirty vehicles and the use of dirty cloths for the covering of meat. I am unable to give any reason for this increase but carelessness on the part of the owner-drivers of these vehicles ; in practically every case it was found the vehicle was used for such other purposes as the transport of printing machines, furniture, etc., when not engaged in carrying meat. Market Porters.—No legal proceedings have been taken against the licensed market porters during the year 1932 ; this indicates that the co-operation of this body, which is essential, has now been obtained. Multiple Butchers.—The marked decrease in the number of prosecutions under this heading is due to the increased number of modern, hygienic vehicles now placed upon the market ; these vehicles, though costly, should repay the firms, owing to their clean appeal to the consuming public. Small Butchers.—The decline in the number of summonses issued under this heading, though not great, shows an improvement over 1930. Considerable supervision is still necessary with regard to the degree of cleanliness of the vehicles attending the market, and it is still found that once-a-week washing is considered adequate by some of the butchers. Street Butchers.—No proceedings have been taken against this class of trader during the past year, the small number attending the market having complied with the conditions for clean conveyance through the streets on barrows. Private Cars.—The number of private cars in use for the conveyance of meat has increased It has been observed that the conditions set out in an instruction dealing with private cars have been complied with in the majority of cases. Summary of Number of Cases and Summonses issued :— 1930. 1931. 1932. No. of Cases .... .... .. . 39 32 15 No. of Summonses issued 120 103 50 Total Fines £131 17 G £71 10 0 £116 13 0 Total Costs .... £17 10 0 £4 8 0 £3 3 0 No. of Cautions issued 925 788 967 45 Butchers' Shops.—Improvements have been made during the past year, especially in connection with the rendering of fats, several electric digesters having been installed which, whilst eliminating the offensive smell, improve the conditions usually connected with this business. Distribution Centres for Restaurants.—These premises require constant supervision, owing to the great variety of commodities dealt with in a space generally inadequate for the amount of business carried on. Premises used for the Manufacture of Sausages and Meat Products.—These are of a high standard of cleanliness and efficiency, and every effort is being made on the part of proprietors to improve their premises where possible. Bacon Shops.—Improvement is slow ; the businesses concerned are general provision dealers and it is found that the large amount of stock necessarily carried is not conducive to cleanliness. Bacon Stoves and Curing Stoves.—No complaints have been received concerning these, and improvements continue to be carried out which tend to raise the high standard already in existence. Transport and Handling of Irish Meat.—There has been a great improvement in this trade during the last few months, due to a more definite understanding between the responsible department in Ireland and the Corporation. General Observations.—I am glad to report that there is a decided improvement in all matters connected with the Public Health (Meat) Regulations. The continued co-operation of the many persons and associations concerned has largely made this possible. 46 SUMMARY OF SUMMONSES AND OFFENCES.—PUBLIC HEALTH (MEAT) REGULATIONS, 1924. Section of Regulations. OFFENCES. Market Carriers. Market Porters. Multiple Butchers. Small Butchers. Street Butchers. Private Cars. Hotel and Restaurant Proprietors.[/### 1930 1931 1932 1930 1931 1932 1930 1931 1932 1930 1931 1932 1930 1931 1932 1930 1931 1932 1930 1931 1932] Part VI, Clause 21, Section (1) (a). Dirty Vehicle 8 4 6 - - - 4 7 4 19 12 11 3 4 - 4 1 1 2 - - Part VI, Clause 21, Section (1) (b). Meat in contact with other commodities (furred rabbits, poultry, spare tyres, etc.). 2 - 1 - 1 - - 3 - 1 - - - - - - - - 1 - - Part VI, Clause 21, Section (1) (c). Live animals carried in vehicle with meat - - - - - - - - - - 2 - - - - - - - - - - Part VI, Clause 21, Section (2) (b). No front sheet - - - - - - - - - 2 1 - - - - - - - - - - Part VI, Clause 21, Section (2) (a). Meat in contact with ground - - - - - - - - - - - 1 - - - - - - - - - Part VI, Clause 21, Section (3). Head covering Offence 8 5 1 1 7 - 3 6 2 14 6 1 - 1 - - 2 - 1 - - Part VI, Clause 21, Section (3). Overall Offence 2 4 1 - - - 2 - 1 5 4 6 - 2 - - 1 - 1 - - Part VI, Clause 21, Section (2) (b). Meat in contact with floor mat of a Private Car. - - - - - - - - - - - - - - - 3 4 - 2 - - Part VI, Clause 21, Section (2) (b). Meat contaminated with visible dirt - - - - - - 2 6 - 9 - 1 1 1 - - 1 - 1 - - Part VI, Clause 21, Scction (2) (b.) Dirty and stinking cloths used for protecting the meat. 5 2 3 - 2 - 5 - 2 3 3 7 2 2 - - 3 - 1 - - Part VI, Clause 21, Section (1) (b). Meat being conveyed uncovered - 1 - - - - 1 1 - 1 2 - - - - - 2 1 - - - Part I, Section 5 Obstruction of an Inspector - - - - - - - - - 1 - - - - - - - - - - - Totals 25 16 12 l 10 - 17 23 9 55 30 27 6 10 - 7 14 2 9 - - 47 THE LONDON COUNTY COUNCIL (GENERAL POWERS) ACT, 1932. Part II. Under this Act premises for the preparation or manufacture of potted, pressed, pickled or preserved meat, fish, or other food intended for sale shall be registered. As to meat or fish, the word " preserved " includes preparation by any process of cooking. This is new and useful in the sanitary control of food premises. Registration has been actively pursued, and has led to much alteration and improvement to hygienic ends in the premises inspected for the purpose. A few of the premises were utterly unsuitable for the work carried on in them, and it was recommended that registration be refused. I have found that the proprietors of the many businesses very readily see the necessity for alterations as a preliminary to registration, and the standard of cleanliness is generally raised throughout, sometimes at large but necessary expense. Further, the Common Council may make bye-laws for promoting sanitary and cleanly conditions in the manufacture, preparation, storage, transport, or exposure for sale of any article intended to be sold for food. These bye-laws would, I presume, follow the lines of those proposed by the London County Council, who promoted the Act. The number of premises inspected and registered are 25 and 5 respectively. Those in which alterations were carried out before registration numbered 14. Control of premises for the preparation, etc., of ice-cream is transferred from the 1928 Act to this Act. INSPECTION OF FOOD AT CITY WHARVES. The following is a summary of the chief products coming under the observation of the Inspector charged with the supervision of food at the City Wharves :— SUMMARY OF FOOD DISCHARGED AT CITY WHARVES. Article. Description of Packages. Where from. General Range of Weight of Packages. Quantity. Butter Packages Holland 6 lbs.—1 cwt. 86,116 Bacon Bags, Cases ,, 1 cwt. 2 qrs.—3 cwts. 135,411 Cheese (Loose) Single ,, 1 lb.—8 lbs. 6,459 Cheese Packages ,, 24 lbs.—1 cwt 392,044 Eggs (Fresh) Cases ,, 84 lbs.—1 cwt. 2 qrs. 62,857 Egg Yolk Casks ,, 56 lbs.—4 cwts. 187 Compound Packages ,, 56 lbs. 2,095 Lard ,, ,, 28 lbs.—56 lbs 23,112 Margarine ,, ,, 12 lbs.—56 lbs 101,822 Cereals— Barley Bags ,, 100 lbs.—1 cwt. 2 qrs 860 Beans ,, ,, 1 cwt.—2 cwts 2,515 Peas ,, ,, 1 cwt.—1 cwt. 3 qrs. 40,832 Rice ,, ,, Spain and Italy 1 cwt.—1 cwt. 2 qrs. 16,253 Semolina ,, — 1 cwt. 400 Tapioca ,, — 1 cwt. 41 Cocoa Bags, Packages Holland, Ceylon and E. Africa. 28 lbs.—2 cwts. 14,603 Coffee Bags Africa, Costa Rica, 1 cwt. 2 qrs. 89,108 Ceylon and Jamaica. Fruit (Soft)— Apples Packages Holland, Australia, 28 lbs.—1 cwt. 2 qrs 12,143 New Zealand, Canada, and U.S.A. Apricots ,, Holland 12 lbs. 6,536 Black Currants ,, ,, 6 lbs.—12 lbs. 357 Cherries ,, ,, 12 lbs.—40 lbs. 1,305 Citrons ,, Spain 56 lbs. 49 Cranberries ,, Holland 28 lbs. 11,844 Gooseberries ,, ,, 40 lbs.—100 lbs. 132 Greengages ,, ,, 14 lbs.—28 lbs. 526 Peaches ,, ,, 10 lbs.—14 lbs. 206 Pears ,, ,, 6 lbs.—28 lbs. 855 Plums ,, ,, 7 lbs.—28 lbs. 5,238 Raspberries ,, ,, 12 lbs.—28 lbs. 9 Red Currants ,, ,, 6 lbs.—12 lbs. 245 Rhubarb ,, ,, 6 lbs.—12 lbs. 267 Strawberries ,, ,, 6 lbs.—14 lbs. 39,785 Fruit (Dried)— Apricots ,, Persia, Russia, South Africa and U.S.A. 24 lbs.—56 lbs. 37,991 Currants ,, Greece, Turkey, South Africa and U.S.A. 28 lbs.—56 lbs. 274,916 G2 48 Article. Description of Packages. Where from. General Range of Weight of Packages. Quantity. Fruit (Dried)—(continued)— Dates Packages Mesopotamia, Turkey and Egypt. 3 qrs. 18,337 Evaporated Apples >> .... California and South 56 lbs. 6,049 Africa. Figs „ Turkey, Spain and Greece. 28 lbs.—4 cwts. 57,908 Fruit Salad tt S. Africa and America 28 lbs.—56 lbs 2,950 Peaches S. Africa and U.S.A. 24 lbs. 8,700 Pears ,, tf It 24 lbs. 6,152 Plums tt ft tt 24 lbs. 282,879 Preserved Fruit tt Holland and Canada 10 lbs.—56 lbs 2,461 Raisins „ S. Africa, America, Turkey and Greece. 6 lbs.—56 lbs 364,978 Sultanas „ S. Africa, U.S.A., Turkey, Greece and Cypru 24 lbs.—56 lbs 409,932 Fruit (Green)— Grape Fruit Florida and Jaffa 56 lbs.—1 cwt 3,870 Grapes Holland and Spain .... 12 lbs.—1 cwt 40,494 Lemons tt .... Italy and Spain 1 cwt. 392,360 Mandarines Spain 3 qrs.—1 cwt. 1 qr 1,142 Melons ,, and Holland .... 12 lbs.—1 cwt. 1 qr 44,690 Oranges „ and Brazil 3 qrs.—1 cwt. 1 qr 222,571 Pines St. Michaels 1 qr. 16 lbs.—2 qrs. 18 lbs 14,682 Pomegranates Spain 28 lbs.—1 cwt. 1 qr 2,861 Vegetables— Artichokes ,, Holland 14 lbs.—56 lbs 20 Beetroots ,, ,, 1 cwt. 6,129 Cabbages ,, ,, 1 cwt. 10,632 Carrots ,, ,, 40 lbs.—1 cwt. 1 qr 44,779 Cauliflowers ,, ,, 24 lbs.—40 lbs 13,421 Celery ,, ,, 28 lbs. 20 Cress ,, ,, 10 lbs. 62 Cucumbers ,, ,, 12 lbs.—40 lbs 12,317 Lettuce ,, ,, 12 lbs.—28 lbs 271,568 Onions ,, ,, Spain, Italy 1 cwt.—1 cwt. 1 qr 260,854 and Egypt. Potatoes ,, Holland, Spain, St. 56 lbs.—1 cwt. 1 qr 739,517 ,, Malo and Cyprus. Radishes ,, Holland 28 lbs.—1 cwt 12,839 Spinach ,, ,, 14 lbs.—56 lbs 20 Tomatoes ,, ,, 12 lbs.—56 lbs 527,236 Sugar Bags, Cases ,, 1 cwt.—2 cwts 5,803 Tea Packages India, Ceylon, China and Java. 1 cwt. 104,855 Tinned Goods— Anchovies Cases Holland and Portugal 2 cwts.—3 cwts. 907 Apples ,, Australia and U.S.A. 50 lbs.—1 cwt. 10,879 Apricots ,, ,, ,, 48 lbs. 25,638 Asparagus ,, America 56 lbs.—1 cwt. 610 Beans ,, Spain and Italy 1 cwt. 815 Beef Brisket ,, South America 90 lbs. 423 Boiled Mutton ,, ,, 90 lbs. 570 Brawn ,, Holland 36 lbs. 2,029 Brisling ,, Norway 56 lbs.—1 cwt. 300 Cherries ,, Italy and Canada 28 lbs.—48 lbs. 13,025 Condensed Milk ,, Holland 48 lbs. 1581,536 Corned Beef ,, South America 72 lbs. 7,590 Crab ,, America 56 lbs. 250 Eggs (frozen) ,, Holland 1 cwt. 260 Figs ,, ,, 1 cwt. 98 Fish ,, ,, 1 cwt. 11 Fruit Pulp ,, „ Spain and America. 72 lbs.—100 lbs. 19,676 Fruit Salad ,, Australia, S. Africa and 56 lbs.—100 lbs. 15,400 U.S.A. Grape Fruit ,, America 50 lbs. 11,924 Hams ,, Holland 20 lbs.—1 cwt. 1 qr. 3,069 Kidneys ,, America 56 lbs. 50 Loganberries ,, ,, 1 cwt. 5,165 Lobster ,, ,, 50 lbs. 1,141 49 Article. Description of Packages. Where from. General Range of Weight of Packages Quantity. Tinned Goods—(continued)— Meat Cases Holland 56 lbs.—1 cwt ill Meat Roll ,, 56 lbs.—1 cwt 737 Oranges ,, Japan .... .... 56 lbs.—1 cwt 300 Peaches ,, Australia and California. 48 lbs. 47,721 Peas ,, Spain and Italy 56 lbs.—72 lbs 3,005 Pears ,, Australia and California. 48 lbs. 35,867 Pickles ,, Australia 1 cwt. 1 qr 45 Pines ,, Singapore and Hawaii 48 lbs. 162,693 Pilchards ,, U.S.A. 60 lbs. 3,286 Plums ,, Canada and U.S.A 60 lbs. 4,900 Pork and Beans ,, America 56 lbs.—1 cwt 1,750 Prawns ,, t> 56 lbs. 3,883 Salmon ,, Canada and U.S. A 48 lbs. 15,481 Sardines ,, Portugal 56 lbs.—1 cwt 39,708 Sausages ,, Holland 56 lbs.—1 cwt 1,475 Soup ,, America 56 lbs. 20 Sterilised Cream ,, Holland 14 lbs.—56 lbs 845 Strawberries ,, Canada 48 lbs. 319 Sugar Corn ,, America and Canada 56 lbs. 2,235 Tomatoes ,, Italy .... _ .... 1 cwt.—1 cwt. 3 qrs 84,354 Tongues ,, Holland and America 48 lbs.—1 cwt 2,888 Tripe ,, America 56 lbs. 30 Veal ,, Holland 56 lbs.—100 lbs 26,475 Vegetables ,, Spain, Italy and Holland. 50 lbs.—100 lbs 12,331 Bottled Foods— Meat — 56 lbs.—84 lbs 349 Macaroni Packages Italy 28 lbs. 32,034 Milk Powder ,, Holland 50 lbs.—1 cwt 48,477 Nuts (Various) ,, Spain, Italy, China and 50 lbs.—1 cwt. 1 qr 62,389 Brazil. Vegetables in Brine Casks Spain and Holland .... 3 cwts.—4 cwts. 12,399 Vegetables (Dried) Packages Holland 56 lbs. 245 Ginger (Preserved) Cases, Casks China 30 lbs.—3 cwts. 37,452 Miscellaneous— Anchovies (in Brine) Casks Holland 1 cwt.—3 cwts. 12 Biscuits Packages ,, 1 cwt.—1 cwt. 1 qr. 39 Carraway Seeds Bags ,, 1 cwt. 1 qr. 1,868 Caviare Packages Russia 3 cwts.—4 cwts. 8 Cherries (in Brine) Casks Italy 2 cwts.—3 cwts. 887 Chocolate Packages Holland 50 lbs.—1 cwt. 1 qr. 969 Citrons (in Brine) Casks Spain 4 cwts. 172 Cocoa Butter Packages Holland 1 cwt.—2 cwts 3,295 Condensed Milk Casks ,, 3 cwts.—4 cwts. 8,829 Confectionery Packages ,, 28 lbs.—1 cwt. 4,406 Crispbread ,, Sweden 56 lbs. 31,723 Desiccated Cocoanut „ Ceylon 28 lbs.—1 cwt. 18 lbs. 1,600 Drained Cherries ,, Italy and Canada 28 lbs.—1 cwt. 1,544 Fresh Cream Drums Holland 56 lbs.—130 lbs. 186 Fruit (in Brine) Casks Spain, Italy and 3 cwts.—4 cwts. 122 Holland. Fruit and Lemon ,, Spain and Italy 3 cwts.—4 cwts. 1,173 Juice. Fruit Pulp ,, Spain, Italy and 4 cwts. 6,909 Holland. Honey ,, California and Holland 1 cwt.—2 cwts. 887 Jams Cases Australia 3 qrs. 9 lbs. 150 Liquorice Packages Italy 1 cwt.—2 cwts. 754 Pepper — West Indies 1 cwt.—1 cwt. 1 qr. 210 Milk Sugar — Holland 2 cwts. 166 Peel (in Brine) Casks Spain and Italy 4 cwts.—5 cwts. 1,423 Prawns ,, California 28 lbs.—38 lbs. 10 Poultry — Holland 24 lbs.—56 lbs. 495 Spaghetti — Italy 28 lbs. 97 Sugar Candy Packages Holland 28 lbs.—56 lbs. 1,892 Casings Casks, Cases Holland, Persia, America and Turkey. 56 lbs.—3 cwts. 265 Rabbits Cases Holland 1 cwt. 2 qrs. 1,596 Vegetable Powder Packages ,, 1 cwt. 2 qrs. 1,585 Yeast ,, ,, 28 lbs.—56 lbs. 9,275 50 UNSOUND FOOD SURRENDERED AT RIVERSIDE WHARVES. As a result of the daily inspection of City wharves, 39J 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. Condensed Milk 4 10 2 Dried Fruit 5 2 1 Fresh Fruit 5 0 Fruit Pulp 1 1 0 Nuts (various) 3 4 1 Tinned Fruit, Vegetables and Fish 16 18 3 Vegetables 11 3 1 Miscellaneous 3 3 3 Total 45 8 3 The following were placed under embargo and subsequently removed for destruction by private contractors under adequate supervision :— Tons. Cwts. Qrs. Lbs. Coffee 4 1 0 Condensed Milk 6 0 0 Dried Fruit l 5 1 3 Fruit Pulp and Fruit Juice l 4 0 0 Tinned Fruit and Vegetables 1 4 2 Tinned Meat and Casings 8 0 0 20 Vegetables 188 11 0 0 Miscellaneous 13 1 11 Total 200 6 0 8 PUBLIC HEALTH (CLEANSING OF SHELLFISH) ACT, 1932. The above-mentioned Act enables the Corporation to provide apparatus for shellfish cleansing or to make contributions to another local authority undertaking such cleansing. Prolonged practical experiment has demonstrated that cleansing of shellfish can be carried out successfully, but it is obvious that such cleansing could be most effectively applied directly the fish were taken from their beds rather than after transport to such markets as Billingsgate. It is, of course, appreciated that some foreign shellfish are received in the City for distribution, but in all the circumstances the Sanitary Committee decided to take no action in the matter at the present time. AGRICULTURAL PRODUCE (GRADING AND MARKING) ACT, 1928. MERCHANDISE MARKS ACT, 1926. Administration of the above-mentioned Acts has been attended with very little difficulty other than the persuasion of the affected parties to conform to the requirements. Casual street vendors, as a general rule, appear to have little knowledge of the requirements of the law on this matter, but those regularly engaged in this kind of work, having once been acquainted by the Inspector of their obligations, very readily remedy any omission. When neglect is found in shops and stores, it is almost invariably due to assistants having failed to carry out the instructions of the proprietors. It is satisfactory to report that there is a marked improvement in the packing and grading of produce coming within the scope of the Agricultural Produce (Grading and Marking) Act. During the year, 2,263 shops and stores and 688 street vendors have been visited, and 12 minor offences in the former and 14 in the latter thus found were remedied without delay. Seven new orders were issued, each of which received the attention of the Inspector appointed for the purpose. FERTILISERS AND FEEDING STUFFS ACT, 1926. During the year, 150 visits have been made in connection with the above-mentioned Act, and 24 special enquiries instituted in connection with reports by other authorities of neglect to comply with the requirements. Such offences as have been discovered have nearly always been due to ignorance of the somewhat intricate clauses, and the assistance which my officer has been able to give in explaining the points of difficulty which are experienced has been much appreciated, and has resulted in prompt rectification and abatement of offences. The quarterly returns required by the Ministry of Agriculture and Fisheries have been made. 51 SUPERVISION OF FOOD AND DRUGS. During the year 1932, 1,022 samples of Food and Drugs were submitted to the Public Analyst for examination. Of this number, 745 were taken as informal or test samples, without the formalities of the Act being observed. Nineteen of these informal samples were reported against, as follows :— Samples. 6 Butter 23 3 Spices and Herbs 39 2 Cream 14 2 Sausages 34 1 Butter (on bread) 17 1 Glycerine of Alum 1 1 Lozenges and Tablets (Medicated) 17 1 Magnesia Oil 1 1 Mustard 14 1 Tincture of Iodine 6 19 Of the formal samples, 26 out of 277 were reported against, as follows :— Samples. 16 Milk 222 3 Cream 3 2 Rum 12 2 Spices and Herbs 3 1 Butter 5 1 Lozenges and Tablets (Medicated) 1 1 Magnesia Oil 1 26 The above-mentioned samples, with the exception of Milk and Rum, were taken as the result of informal samples having been reported against. General Observations.—The percentage rate of adulteration of all food and drugs sampled in the City was 4.-4, as compared with 4.7 in 1931. Butter.—Twenty-eight samples of butter were taken, and 7 were reported against. Eighteen samples of butter (on bread or scone) were also submitted for analysis, one of which was certified to contain margarine to the extent of 40 %. In this case, six informal samples were taken of the butter supplied on different days by the wholesaler, and all of these proved to be adulterated with margarine in amounts varying from 35% to 45%, showing that it was a regular practice. Whilst in course of delivery from the wholesaler to the retailer a formal sample was accordingly taken, and this was found to contain 45% margarine. Legal proceedings were instituted against the wholesaler, who was fined £10, with £5 5s. 0d. costs. A fine of £5 was also imposed for delivering margarine in a package not branded. Cream.—Seventeen samples of cream were taken, five of which were reported against. In connection with three of the samples, it was found that, although they possessed a fat content of about 50 %, they contained from 5.3 % to 8.6 % extraneous water. The definition of cream is " that portion of milk rich in milk-fat which has been separated by skimming or otherwise and is intended for human consumption." The added water found in the cream is not any portion of the original milk, therefore, the alleged cream containing something more than "that portion of milk rich in milk-fat" does not conform to the definition of cream. It is sophisticated. A representative of the company concerned informed me that it was the custom of his company to water down cream as received from the separators, to a consistency permitting of more than less ready flow from a jug. The danger of sophistication of this sort lies in the fact that there are no cream standards, and a ready source of profit, at the consumers' expense, is to hand in the addition of either water or milk to cream. I intimated to the company concerned in the above-mentioned samples that the article sold as cream did not conform to the definition and that any finding of a like sophistication would be considered with a view to magisterial proceedings. Later samples proved that the practice had ceased. Two other samples of cream, contained in hermetically sealed tins and labelled "Devonshire Cream," were found to only have a milk-fat content of 21% and 22.9%. The vendors were communicated with and cautioned, with the result that the description on the label of the tins was altered. 52 Spices.—Of the 42 samples of spices submitted for analysis, five were reported against, three being with regard to ground cinnamon, and two rubbed thyme. One prosecution was taken with reference to ground cinnamon, when the warranty defence was successfully pleaded and the summons dismissed. Owing to the vendor having had the article in stock for more than six months from the time the warranty was given until the sample was taken, it was not possible to institute proceedings against the wholesalers for having given a false warranty. Legal action was also taken with regard to a sample of rubbed thyme, which was certified to contain extraneous mineral matter to the extent of 11.5%, with the result that the vendor was fined £1, with £3 3s. 0d. costs. Sausages.—Thirty-five samples of sausages were taken, two of which did not comply with the requirements relating to preservatives. On re-sampling, they were found to be genuine. Drugs.—Of the 113 samples of drugs taken, six were reported against as not complying with the requirements of the British Pharmacopoeia, or not in conformity with the formulas on the containers. In two instances the formula, which contained an error, was immediately rectified on the attention of the manufacturers being called to the matter. In connection with two other samples, the manufacturers were successfully summoned, and with regard to one sample procured informally, a formal sample had not been taken at the close of the year. Spirits.—Thirty-nine samples of spirits were purchased formally and, with the exception of two samples of rum, found to be genuine or above the standard of 35 degrees under proof. Successful prosecutions ensued in the two instances. EXAMINATION OF MILK. Chemical.—Of the 222 samples of milk, all of which were taken formally, 16 were certified to be below the standards which presume adulteration, giving a percentage figure of 7.2, as compared with 5.8 for 1931. In connection with six of the samples reported against, where the figures of analysis did not justify legal proceedings, further samples were taken which proved to be genuine ; in another case the consignor ceased business. It was found necessary to take legal action against six vendors or consignors with reference to nine of the samples reported against, when penalties were imposed in two instances, the summonses dismissed under the Probation of Offenders Act, with costs, in two others, and in the remaining two cases the summonses were dismissed, the magistrates being of opinion that the milk supplied was as delivered by the cow. In this connection, I submit that the position with regard to the law is extremely unsatisfactory, in that there is no absolute or legal standard of genuineness for milk. The Sale of Milk Regulations of 1901 provide that milk containing less than 3% of milk-fat, or less than 8.5% of milk solids other than milk-fat, is to be presumed not to be genuine until the contrary is proved. The onus of proof is thus placed upon the defence in a prosecution. It must be admitted that individual cows on occasion give milk below the figures mentioned, but it should not be possible for persons to take advantage of this position and be indifferent to their methods of dairying. It can reasonably be contended that this is extremely unfair to the farmer who takes every means to ensure that his milk supply is in accordance with the standard and who usually obtains the same price for his product as the farmer who produces quantity without quality. It is true to say that, provided cows are suitably fed and milked at regular intervals, the butter-fat content cannot be altered appreciably. Fortunately, the majority of farmers produce milk well above the presumptive standard figure. The following table shows the percentage fat-content in each of the 222 samples of milk procured in the City during the year, and it is interesting to note that the average fat-content is 3.6%, only nine samples falling below the standard figure of 3%. Percentage of Fat. No. of Samples. Percentage of Fat. No. of Samples. Percentage of Fat. No. of Samples. 2.2 l 3.4 21 4.3 4 2.4 l 3.5 42 4.4 l 2.6 2 3.6 39 4.5 l 2.8 2 3.7 19 4.7 2 2.9 3 3.8 ,20 4.8 1 30 4 3.9 10 5.4 1 31 9 40 8 5.7 1 3.2 8 41 4 7.7 1 3.3 12 4.2 5 - Total 222 53 It will be seen that one sample contained as high a percentage of fat as 7.7. This sample was purchased at a small shop where, on enquiry, it was ascertained, as expected, that the milk had been standing in reserve and had not been plunged before sale. In all such cases, it is customary for the Officer to explain in detail the necessity for continual plunging as sales proceed. Nine purveyors of milk, from whom samples had been taken, served notices upon the Authority, requesting samples of milk to be procured from their suppliers in course of delivery to them, in accordance with the provisions of the Food and Drugs (Adulteration) Act. In this connection it was necessary on one occasion to request an adjoining Authority to obtain 21 samples, and in another instance six " appeal to the cow " samples were required. THE MILK AND DAIRIES ORDER, 1926, AND THE MILK AND DAIRIES (AMENDMENT) ACT, 1922. Thirteen new applications for registration as retail purveyors of milk were received during the year, and none was refused. Six of these were from persons who have no City premises, but purvey milk within the area. Registration Statistics. Number of Retail Purveyors of Milk on the Register at end of 1931 278 New Applications for Registration received 13 Applications granted 13 Applications refused — Names of Retailers removed from Register 5 Number of Retail Purveyors of Milk on the Register at end of 1932 286 Number of Milk Sellers (other than Retail Purveyors of Milk) on the Register at end of 1932 24 Licences issued under the Milk (Special Designations) Order, 1923 17 Inspection of Premises where Milk is Retailed.—During the year, 230 inspections were made in connection with the sale of milk, and the statutory requirements were found, with minor exception, generally to be observed. From time to time observations have been kept upon distributors, and I am able to state that no legal action was necessary for such offences as milk bottling in the street. The proper construction of milk churns has, also, engaged attention, and steps taken to have defects remedied where necessary. THE PUBLIC HEALTH (CONDENSED MILK) REGULATIONS, 1923 AND 1927. THE PUBLIC HEALTH (DRIED MILK) REGULATIONS, 1923 AND 1927. Six samples of various brands of condensed milk were purchased for analysis, and all were found to conform to the standards for composition and equivalent contents. One brand did not fully comply with the requirements as regards labelling, and the attention of the manufacturers was called to the matter. The two samples of dried milk taken were reported satisfactory in all respects. REGISTERED PREMISES. Butter Factories.—One butter factory became unoccupied during the year, the business being transferred to another district. Samples taken at irregular intervals at the factories have been certified genuine. Wholesale Dealers in Margarine and Margarine Cheese.—One new application for registration was received during the year. Artificial Cream Act, 1929.—No additions have been made to the register. H 54 ADMINISTRATIVE ACTION REGARDING ADULTERATION OR OTHER IRREGULARITY. [###Serial No. Article. Whether Formal or Informal. Nature of Adulteration or Irregularity. Observations. Results of Proceedings or other Action taken. 6 Cream Informal Extraneous water, 5.37%. Taken in connection with sample No. 957 (1931). Re-sampled formally—Nos. 76 and 80. ... ... ... ... ... ... ... ... 46 Milk Formal Milk fat deficient, 5%. ... ... ... ... ... ... ... ... Vendor cautioned. 47 Milk Formal Milk fat deficient, 12%. ... ... ... ... ... ... ... ... Vendor prosecuted. Summons dismissed under the Probation of Offenders Act on payment of £2 costs. 76 Cream Formal Extraneous water, 8.6%. Formal sample—No. 80—procured from wholesaler in course of delivery ... ... ... ... ... ... ... ... 80 Cream Formal Extraneous water, 7.68%. Taken in connection with sample No. 76 Vendor cautioned. 90 Cinnamon (Ground) Informal Extraneous mineral matter (sand, etc.), 5.5%. Re-sampled formally—No. 125. ... ... ... ... ... ... ... ... 108 Milk Formal Extraneous water, 1.5%. Re-sampled—genuine ... ... ... ... ... ... ... ... 110 Rum Formal Proof spirit deficient, 19 degrees. ... ... ... ... ... ... ... ... Vendor prosecuted. Fined £2, with £3 3s. 0d. Costs. 119 Magnesia Oil Informal Magnesia deficient, 77.48%. Re-sampled formally—No. 142 ... ... ... ... ... ... ... ... 125 Cinnamon (Ground) Formal Extraneous mineral matter (sand, etc.), 5%. Taken in connection with sample No. 90 Vendor prosecuted. Summons dismissed. Warranty defence. 131 Cinnamon (Ground) Informal Extraneous mineral matter (sand, etc.), 4%. Re-sampled formally—genuine ... ... ... ... ... ... ... ... 142 Magnesia Oil Formal Magnesia deficient, 77%. Taken in connection with sample No. 119 Manufacturers submitted explanation showing error in formula on label, which was accepted. 171 Margarine Informal Printing of wrapper not in accordance with requirements of Sec. 6 of the Food and Drugs (Adulteration) Act. Vendor communicated with ... ... ... ... ... ... ... ... 297 Milk Formal Extraneous water, 3.5%. ... ... ... ... ... ... ... ... Vendor prosecuted. Fined £1. 298 Milk Formal Extraneous water, 15.2%. ... ... ... ... ... ... ... ... Vendor prosecuted. Fined £5, with £21 Costs. 373 Milk Formal Extraneous water, 2%. Re-sampled—genuine ... ... ... ... ... ... ... ... 374 Milk Formal Extraneous water, 2%. Re-sampled—genuine ... ... ... ... ... ... ... ... 398 Glycerin of Alum Informal Alum deficient, 32.7%. Re-sampled formally—genuine ... ... ... ... ... ... ... ... 407 Butter (on bread) Informal Margarine, 40%. Re-sampled formally—genuine. See sample No. 465 ... ... ... ... ... ... ... ... 410 Devonshire Cream (Tinned). Informal Only 21% milk fat. Re-sampled formally—No. 429 ... ... ... ... ... ... ... ... 419 Butter Informal Margarine, 40%. Taken in connection with sample No. 407. Re-sampled formally—No. 465. ... ... ... ... ... ... ... ... 420 Bismuth Dyspepsia Tablets. Informal Bismuth Oxycarbonate deficient, 32%. Sodium Bicarbonate deficient, 30%. Re-sampled formally—No. 450 ... ... ... ... ... ... ... ... 429 Devonshire Cream (Tinned). Formal Only 22.94% milk fat. Taken in connection with sample No. 410. Vendor cautioned. 430 Butter Informal Margarine, 35%. Taken in connection with sample No. 407 ... ... ... ... ... ... ... ... 436 Butter Informal Margarine, 45%. Taken in connection with sample No. 407 ... ... ... ... ... ... ... ... 448 Butter Informal Margarine, 35%. Taken in connection with sample No. 407 ... ... ... ... ... ... ... ... 449 Butter Informal Margarine, 40%. Taken in connection with sample No. 407 ... ... ... ... ... ... ... ... 55 hz 56 57 ADMINISTRATIVE ACTION REGARDING ADULTERATION OR OTHER IRREGULARITY—continued. Serial No. Article. Whether Formal or Informal. Nature of Adulteration or Irregularity. Observations. 1 Results of Proceedings or other Action taken. 450 Bismuth Dyspepsia Tablets. Formal Bismuth Oxycarbonate deficient, 32%. Sodium Bicarbonate deficient, 30%. Taken in connection with sample No. 420 Vendors and manufacturers prosecuted. Summons against retailer withdrawn. Manufacturers fined £5, with £8 8s. 0d. Costs. 464 Butter Informal Margarine, 40%. Taken in connection with sample No. 407 465 Butter Formal Margarine, 45%. Taken in course of delivery from wholesaler in connection with sample No. 407. Wholesaler prosecuted. Fined £10, with £5 5s. 0d. Costs, for selling adulterated butter, and £5 for delivering Margarine in a package not branded. 501 Pork Sausages (Preserved). Informal Printing of statutory declaration not of required size. ... ... ... ... ... ... ... ... Vendors cautioned. 546 Milk Formal Extraneous water, 3%. Re-sampled—genuine ... ... ... ... ... ... ... ... 566 Beef Sausages (Preserved). Informal Excess Sulphur Dioxide, 175 parts per million. Printing of statutory declaration not of required size. Re-sampled—genuine Vendors cautioned with regard to printing of label. 577 Condensed Full Cream Milk (Sweetened). Informal Label not in conformity with the Public Health (Condensed Milk) Regulations. Vendors cautioned. 608 Thyme (Rubbed) Informal Extraneous mineral matter, 12.3%. Re-sampled formally—No. 640 ... ... ... ... ... ... ... ... 640 Thyme (Rubbed) Formal Extraneous mineral matter, 11.5%. Taken in connection with sample No. 608 Vendor prosecuted. Fined £1, with £3 3s. 0d. Costs. 643 Beef Sausages Informal Sulphur Dioxide, 113 parts per million. Re-sampled formally—genuine ... ... ... ... ... ... ... ... 652 Milk Formal Milk fat deficient, 26%. Consignor prosecuted. Summons dismissed. Magistrate satisfied milk delivered as given by the cow. 653 Milk Formal Milk fat deficient, 2%. Re-sampled—genuine ... ... ... ... ... ... ... ... 664 Milk Formal Milk fat deficient, 5%. Consignor ceased business ... ... ... ... ... ... ... ... 675 Margarine Informal Wrapper not in conformity with requirements of Sec. 6 of the Food and Drugs (Adulteration) Act. ... ... ... ... ... ... ... ... Vendor cautioned. 685 Milk Formal Milk fat deficient, 7%. Appeal to Cow " samples taken in ... ... ... ... ... ... ... ... 687 Milk Formal Milk fat deficient, 5.7%. tion with sample No. 652. 721 Milk Formal Extraneous water, 6.9%. Consignor prosecuted. Fined £5, with £3 3s. 0d. Costs. 775 Milk Formal Milk fat deficient, 20%. Vendors prosecuted. Summons dismissed under Probation of Offenders Act, with £2 2s. 0d. Costs. 803 Mustard Informal Starch, 6%. To be re-sampled formally ... ... ... ... ... ... ... ... 868 Milk Formal Milk fat deficient, 12%. ... ... ... ... ... ... ... ... Consignor prosecuted. Summons dismissed. Magistrate satisfied milk delivered as given by the cow. 969 Rum Formal Proof spirit deficient, 6 degrees. ... ... ... ... ... ... ... ... Vendor prosecuted. Summons dismissed under Probation of Offenders Act, with £2 2s. 0d. Costs. 999 Tincture of Iodine Informal Iodine deficient, 22%. To be re-sampled formally ... ... ... ... ... ... ... ... 58 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. Beer — 10 10 — — — — — — Bread — 2 2 — — — — — — Butter 5 23 28 l 6 7 20.0 26.0 25.0 Butter (on bread) 1 17 18 — 1 1 — 5.8 5.5 Cheese — 11 11 — — — — — — Cocoa — 5 5 — — — — — — Coffee — 5 5 — — — — — — Confectionery — 27 27 — — — — — — Cream 3 14 17 3 2 5 100.0 14.2 29.4 Flour — 1 1 — — — — — Flour (Self-raising) — 6 6 Jam and Marmalade — 13 13 Lard — 14 14 — — — — Margarine — 11 11 — — Milk 222 — 222 16 — 16 7.2 — 7.2 Milk, Condensed — 6 6 — — — — Mustard — 14 14 — 1 1 — 7.1 7.1 Sugar — 20 20 — — — — — Tea — 7 7 — — — — — Vinegar — 25 25 — — — — — Wine — 2 2 — — — — — Spirits 39 — 39 2 — 2 51 — 5.1 Drugs 3 110 113 2 4 6 66.6 3.6 5.3 Other Articles 4 402 406 2 5 7 50.0 1.2 1.7 Totals 277 745 1022 26 19 45 9.3 2.5 4.4 Spirits— Brandy 3 — 3 — — — — — Gin 6 — 6 — — — — Rum 12 — 12 2 — 2 16.6 16.6 Whisky 18 — 18 — — — — — — Totals 39 39 2 2 51 51 Drugs— Acid, Boric — 1 1 — — — Acid, Tartaric — 3 3 — — — Borax — 3 3 — — — Camphorated Oil — 2 2 — — — — — — Cascara Sagrada — 1 1 — — — — — — Cream of Tartar — 7 7 — — — Epsom Salts — 3 3 — — — — — Friar's Balsam — 3 3 — — — — Ground Ginger — 3 3 — — — — — — Glycerine — 6 6 — — — — — — Glycerine of Alum 1 1 2 — 1 1 — 100.0 50.0 Linseed, Crushed — 5 5 — — — — — — Lozenges and Tablets 1 17 18 1 1 2 100.0 5.8 11.1 Magnesia Oil 1 1 2 1 1 2 100.0 100.0 100.0 Oil, Almond — 7 7 — — — — — — Oil, Castor — 1 1 — — — — — — Oil, Cod Liver — 1 1 — — — — — — Oil, Eucalyptus — 3 3 — — — — — — Ointment, Boric — 2 2 Ointment, Calomel — 1 1 — — — — — — Ointment, Sulphur — 2 2 — Ointment, White Precipitate — 2 2 — — — — — — Ointment, Zinc — I 1 — — — — — — Paraffin, Liquid — 2 2 — — — — — Powder, Gregory's — 1 1 — — — — — — Powder, Liquorice Compound — 6 6 — — — — — — Sal Volatile — 1 1 — — — — — — Soda Bicarbonate — 2 2 — — — — — — Glauber's Salt — 2 2 — — — — — — Carried forward 3 90 93 2 3 5 6.66 3.3 5.4 59 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. Drugs (continued)— Brought forward 3 90 93 2 3 5 6.66 3.3 5'4 Sulphur, Flowers of — 4 4 — — — — — — Syrup of Figs — 1 1 — — — — — — Tincture of Iodine — 6 6 — 1 1 — 16.6 16.6 Tincture of Ammoniated Quinine — 4 4 — — — — — — Turpentine, Liniment — 2 2 — — — — — — Wines, Medicated — 2 2 — — — — — — Sundries — 1 1 — — — — — — Totals 3 110 113 2 4 6 66.6 3.6 5.3 Other Articles— Arrowroot — 1 1 — — — — — — Baking Powder — 2 2 — — — — — — Barley, Pearl — 4 4 — — — — — — Beverages, &c. — 22 22 — — — — — — Cake and Bicuits — 11 11 — — — — — — Chocolate Powder — 5 5 — — — — — — Coffee Essence — 2 2 — — — — — — Cornflour — 1 1 — — — — — — Cyder — 1 1 — — — — — — Dried Milk — 2 2 — — — — — — Dripping — 3 3 — — — — — — Essences — 3 3 — — — — — — Fish — 2 2 — — — — — — Fish Cakes — 2 2 — — — — — — Fish, Canned — 7 7 — — — — — — Fish, Potted — 3 3 — — — — — — Fish, Other — 1 1 — — — — — — Fruit, Bottled and Canned — 7 7 — — — — — — Fruit, Dried — 66 66 — — — — — Gelatine, Ground — 1 1 — — — — — — Honey — 6 6 — — — — — — Ice Cream — 15 15 — — — — — — Jellies — 2 2 — — — — — — Lemonade Powder — 3 3 — — — — — — Lemon Curd — 3 3 — — — — — — Meat — 35 35 — — — — — — Meat, Canned — 3 3 — — — — — — Meat, Potted — 2 2 — — — — — — Meat Extracts — o 2 — — — — — — Meat Pies and Rolls — 24 24 — — — — — — Mincemeat — 5 5 — — — — — — Mineral Waters, etc. — 3 3 — — — — — — Oatmeal — 3 3 — — — — — — Olive Oil — 6 6 — — — — — — Pepper — 14 14 — — — — — — Pickles and Sauces — 19 19 — — — — — — Powder, Custard — 3 3 — — — — — — Preservative for Sausages — 2 2 — — — — — — Preserved Vegetables — 12 12 — — — — — — Puddings — 1 1 — — — — — — Rice — 3 3 — — — — — — Sausages, etc. 1 34 35 — 2 2 — 5.8 5.7 Soup — 1 1 — — — — — — Spices, etc 3 39 42 2 3 5 66.6 7.6 11.9 Suet — 4 4 — — — — — — Tapioca — 2 2 — — — — — — Treacle, etc — 3 3 — — — — — — Wines (Non.alcoholic) — 7 7 — — — — — — Totals 4 402 406 2 5 7 50. 1.2 1.7 60 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. RESULTS OF PROSECUTIONS. Sample. Nature and extent of Adulteration. Result. 47 Milk 12% deficient in fat Dismissed under Probation of Offenders Act, with 40s. Costs. 110 Rum 54 degrees under proof £2 and £3 3s. Costs. 125 Ground Cinnamon 5% extraneous mineral matter (sand) Dismissed. Warranty proved. 297 Milk 3.5% extraneous water £1. 298 Milk 15.2% extraneous water £5 and £21 Costs. 465 Butter 45% Margarine £10 and £5 5s. Costs. 465 Margarine Package not branded £5. 450 Bismuth Dyspepsia Tablets. 32% deficient in Bismuth Oxy-carbonate and 30% in Sodium Bi-carbonate. £5 and £8 8s. Costs. 640 Thyme 11.5% extraneous mineral matter £1 and £3 3s. Costs. 652 Milk 26% deficient in fat Dismissed. Magistrate satisfied milk was delivered as given by the cow. 721 Milk 6.9% extraneous water £5 and £3 3s. Costs. 775 Milk 20% deficient in fat Dismissed under Probation of Offenders Act, on payment of £2 5s. Costs. 868 Milk 12% deficient in fat Dismissed. Magistrate satisfied milk was delivered as given by the cow. 969 Rum 41 degrees under proof Dismissed under Probation of Offenders Act, on payment of £2 2s. Costs. SUMMARY. Total Fines £34 0s. 0d. Total Costs £50 9s. 0d. BACTERIOLOGICAL AND CHEMICAL EXAMINATION OF MILK. SAMPLES TAKEN AT RAILWAY STATIONS. In accordance with the practice instituted in 1904, a further series of samples of milk arriving in the City of London from the country was collected at Liverpool Street Station and submitted to Dr. R. G. Canti, the City Bacteriologist, for bacteriological examination and for investigation as to the presence of dirt. A duplicate of each sample was submitted to Mr. A. J. C. Lickorish, F.I.C., the Public Analyst, for chemical examination. Forty-eight samples were collected, and these were sent from different farms situated in the following counties :— Norfolk 23 Hertfordshire 3 Suffolk 12 Cambridgeshire 2 Essex 8 The following is a copy of the report which Dr. Canti has submitted on the result of his investigations :— '' No. of Sample. Date of inoculation of Guinea Pig. Date of Death. Post Mortem Findings. Result qua Tubercle.[/##] 1 15th Sept Killed 31st Oct Normal Negative. 2 15th Sept Killed 31st Oct Right inguinal glands and lumbar glands show abscess formation. Spleen enlarged and tuberculous. Liver tuberculous. Tubercle bacilli demonstrated in pus. Positive. 3 15th Sept Killed 31st Oct Normal Negative. 4 15th Sept Killed 31st Oct Normal Negative. 5 15th Sept Killed 31st Oct Normal Negative. 6 15th Sept Killed 31st Oct Normal Negative. 7 20th Sept Died 26th Sept Animal much wasted Frustrate. 8 20 th Sept Killed 3rd Nov Normal Negative. 9 20th Sept Killed 3rd Nov Normal Negative. 10 20 th Sept Killed 3rd Nov Normal Negative. 11 20 th Sept Killed 3rd Nov Normal Negative. 12 20 th Sept Killed 3rd Nov Normal Negative. 13 24th Sept Killed 7th Nov Normal Negative. 14 24th Sept Killed 7th Nov Normal Negative. 61 No. of Sample. Date of inoculation of Guinea Pig. Date of Death. Post Mortem Findings. Result qua Tubercle. 15 24th Sept. Killed 7th Nov. Normal Negative. 16 . 24th Sept. Killed 7th Nov. Normal Negative. 18 24th Sept. Died 12th Oct. Animal undergrown and wasted Frustrate. 19 27th Sept. Killed 10th Nov. Normal Negative. 20 27th Sept. Killed 10th Nov. Normal Negative. 21 27th Sept. Died 28th Sept. No cause of death found Frustrate. 22 27th Sept. Died 30th Oct. No tuberculous lesions found Negative. 23 . 27th Sept. Killed 10th Nov. Normal Negative. 24 27th Sept. Killed 10th Nov. Normal Negative.. 25 30th Sept. Killed 14th Nov. Normal Negative. 26 30th Sept. Killed 14th Nov. Normal Negative. 27 . 30th Sept. Killed 14th Nov. Normal Negative. 28 . 30th Sept. Killed 14th Nov. Normal Negative. 29 . 30th Sept. Killed 14th Nov. Normal Negative. 30 30th Sept. Killed 14th Nov. Normal Negative. 31 4th Oct. Killed 17th Nov. Normal Negative. 32 4th Oct. Killed 17 th Nov. Normal Negative. 33 4th Oct. Killed 17th Nov. Normal Negative. 34 4th Oct. Killed 17th Nov. Normal Negative. 35 4th Oct. Killed 17th Nov. Caseous lumbar glands in right side. Spleen tuberculous. Tubercle bacilli demonstrated in pus. Positive. 36 4th Oct. Killed 17th Nov. Normal Negative. 37 8th Oct. Killed 21st Nov. Normal Negative. 38 8th Oct. Killed 21st Nov. Normal Negative. 39 8th Oct. Killed 21st Nov. Normal Negative. 40 8th Oct. Died 22nd Oct Evidence of marked wasting Frustrate. 41 8th Oct. Killed 21st Nov. Normal Negative. 42 .. 8th Oct. Killed 21st Nov. Normal Negative. 43 11th Oct. Killed 24th Nov. Caseous glands in right inguinal region and lumbar region. Tuberculous spleen. Tubercle bacilli demonstrated in pus. Positive. 44 11th Oct. Killed 24th Nov. Large mass of tuberculous inguinal gland on right side. Tuberculous lumbar glands and spleen. Tubercle bacilli demonstrated in pus from inguinal glands. Positive. 45 11th Oct. Killed 24th Nov. Normal Negative. 46 11th Oct. Killed 24th Nov. Normal Negative. 47 11th Oct. Killed 24th Nov. Normal Negative. 48 11th Oct. Killed 24th Nov. Normal Negative. "As regards dirt, many of the samples contained traces, but only sample No. 18 was found "to contain a moderate amount of dirty deposits on centrifugalization. "As regards tubercle, four animals died within one month of inoculation—three of wasting, " and one from unknown causes. These have been excluded from the calculations. One animal "which died 33 days after inoculation, and the remaining 43, which were killed six weeks after inoculation, making 44 in all, are included. Of these 44 animals, four were found to be tuberculous. On this basis, therefore, 9.1 per cent. of the samples of milk have been found to "contain living tubercle bacilli." The details in connection with the samples from which the guinea-pigs found to be affected with tubercle were inoculated, were forwarded to the medical officers of health for the areas in which the farms responsible for the samples were situated, and the following are extracts from reports which have been received indicating the conditions ascertained. Sample No. 2. The County Council's Veterinary Surgeon inspected the dairy herd at the above-mentioned farm, on 16th December, 1932. He found three cows markedly affected with induration of the udder, and reported to me as follows :— " I have collected a sample of milk from each of the above cows and forwarded Same to County Bacteriologist, East Suffolk County Laboratories, Ipswich, for biological examination. " Two cows have gone dry since the positive sample was taken (15-9-32), i.e., black-and-white cow, No. 1 ; Red-roan cow, ' Endore.' " No cows have been sold since the positive sample was taken (15-9-32). " Included in the total number inspected are five cows which are dry at present." A later report revealed the presence of two tuberculous cows in the herd. Sample No. 35. There were 47 cows ; of these, three were dry, No. 4 and No. 32, and one cow with no number Four special samples of milk were taken and eight mixed milk samples ; these have been submitted to the County Laboratory for bacteriological examination. Tuberculin test was performed upon two animals. I should have written to you sooner, giving the above information, only I hoped to be able to include a copy of the post-mortem results of the two cows which were tuberculin-tested, as these re-acted ; however, the valuation has not yet been settled, and, meanwhile, these two animals are isolated. I 62 Sample No. 43. The herd of cows has been examined. One cow in the herd was found with an indurated udder, and on making a microscopical examination of a sample of milk, tubercle bacilli were found. The milk from this cow has, therefore, been stopped, and the animal will be slaughtered as early as possible. Sample No. 44. The County Council's Veterinary Surgeon examined 18 dairy cows at the above-mentioned farm, on 17th December, 1932. He found two suspected cows, which he submitted to the tuberculin test, but neither of the cows re-acted. He concludes his report as follows :— " On October 30th a cow died, which was stated to be badly affected with tuberculosis. I have no doubt that she was the source of the trouble." Appropriate action has been taken in each case by the responsible authority. I have received a report from the local Medical Officer of Health, who was notified of the dirty condition of Sample No. 18, and he states that he will arrange for a cleanliness examination to he made. For purposes of comparison, the following summary of results obtained since the examination of milk on these lines was first commenced is here inserted :— Year. Percentage showing Tuberculous Infection. Year. Percentage showing Tuberculous Infection. 1904 7.7% 1921 24.2% 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% 1927 4.88% 1914 10.2% 1928 8.3% 1915 8.5% 1929 5.1% 1917 4.2% 1930 4.2% 1919 14.8% 1931 1932 9.5% 9.1% The chemical examination showed that five of the samples gave evidence of sophistication. The following are the details :— Sample No. 9. 26 per cent. deficient in milk fat. Consignor prosecuted. Case dismissed, as the magistrate was satisfied that the milk was delivered as given by the cow. Sample No. 10. 2 per cent. deficient in milk fat. Re-sampled at a later date and found to be a genuine milk. Sample No. 15. 5 per cent. deficient in milk fat. Consignor ceased sending milk to Liverpool Street as from 30th September, 1932. Sample No. 24. " Poor quality." Re-sampled and legal proceedings instituted for a fat deficiency of 12 per cent. Case dismissed. Magistrate satisfied milk was delivered as given by the cow. Sample No. 48. 6 9 per cent. extraneous water. Consignor prosecuted. Fined £5, with £3 3s. Costs. 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 680 persons, compared with 705 in 1931. 86 per cent. are adults and 14 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 "1932, 98 persons (96 per cent. adults and 4 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 1932 65 persons (63 per cent. adults and 37 per cent. children). There are 7 shops, each with a large and well-lighted basement, in Bearsted House, and 8 shops, similarly provided with a basement, in Dutton House. The total population of these dwellings is 843. 63 The number of births was 6, viz. : 2 males and 4* females. The birth-rate, omitting the still-birth, was 5.9 per 1,000, which is 0.4 per 1,000 above the average for the previous five years. 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 death rate for 1932 was 10.6 per 1,000 per annum. For the purposes of comparison of birth and death rates, the population in the whole of these dwellings has been included in the calculation, as probably representing a class homogeneity. 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 1932. 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 l 3* l ... ... ... 1 ... ... SOUTH „ l ... i ... ... ... ... ... l KING'S „ ... ... ... ... ... ... QUEEN'S „ 1 3 ... ... ... ... 2 l PRINCE'S „ ... ... ... ... ... ... ... BEARSTED HOUSE ... 2 ... ... ... ... 2 ... DUTTON „ ... 2 ... ... ... ... 2 ... Totals 2 4 9 ... ... ... 1 6 2 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 1932 being 13,384, of whom 5,390 were males and 7,994 were females. The accompanying table is compiled from the monthly records of attendances at the baths :— RECORD OF ATTENDANCES AT THE BATHS, ARTIZANS' DWELLINGS. Month. Sex. Males. Females. Total. Children. Adults. Children. Adults. January 104 375 78 565 1,122 February 84 273 72 488 917 March 80 387 64 539 1,070 April 80 331 93 592 1,096 May 85 342 113 560 1,100 June 90 377 122 655 1,244 July 123 407 159 696 1,385 August 113 376 131 514 1,134 September 89 352 159 582 1,182 October 80 365 84 512 1,041 November 78 343 89 492 1,002 December 87 369 85 550 1,091 Totals 1,093 4,297 1,249 6,745 13,384 * One still birth. I 2. 64 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 A. Tyler. Month. Premises Inspected. Orders issued. Notices served. Improvements effected. January 123 l ... 12 February 149 ... ... 8 March 218 ... 9 11 April 188 ... 33 9 May 210 10 2 12 June 186 ... ... 11 July 160 ... 1 10 August 207 ... 2 13 September 155 ... 1 14 October 145 l 1 11 November 144 3 1 7 December 175 ... 1 8 Totals 2,060 15 51 126 MIDDLE DISTRICT—Inspector G. H. Fowler. Month. Premises Inspected. Orders issued. Notices served. Improvements effected. January 176 2 2 16 February 183 4 4 13 March 203 5 6 19 April 243 9 10 12 May 166 8 7 20 June 178 5 6 21 July 200 1 4 14 August 93 ... 3 5 September 150 4 4 22 October 155 1 2 20 November 190 2 4 16 December 163 1 2 23 Totals 2,100 42 54 201 EAST DISTRICT—Inspector G. E. Harrington. Month. Premises Inspected. Orders issued. Notices served. Improvements effected. January 215 7 7 17 February 179 2 4 11 March 163 2 22 13 April 184 5 1 10 May 210 19 4 14 June 162 ... ... 11 July 232 ... 2 15 August 235 ... 2 17 September 133 10 5 17 October 151 4 6 12 November 110 2 1 20 December 157 ... ... 14 Totals 2,131 51 54 171 THE FOREGOING ARE SUMMARISED AS UNDER District. Number of Inspections made. Orders issued. Notices served. Improvements effected. West 2,060 15 51 126 Middle 2,100 42 54 201 East 2,131 51 54 171 Totals 6,291 108 159 498 65 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. 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 lenement. Cleansing Notices Served. West 35 281 137 2.0 37 Middle — — — — — East 16 Ill 66 1.7 16 Total 51 392 203 1.9 53 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 Bve-laws. This necessitated the service of 53 notices during 1932. In addition to the foregoing, there are twelve 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 :— Name and situation of Artizans' Block Dwellings. No. of Tenements. No. of Inhabitants One Room. Two Rooms. Three Rooms. Four Rooms. Five Rooms or over. WEST DISTRICT. Albion Buildings, No. 21, Bartholomew Close .... 10 .... .... .... 23 Albion Buildings, No. 22, Bartholomew Close .... 10 .... .... .... 14 Bartholomew House, Bartholomew Close 20 .... .... .... .... 35 Dean Street Blocks, Fetter Lane— Block A .... 7 .... .... .... 22 B 3 3 1 .... .... 13 „ C 4 4 .... .... .... 16 „ D 6 1 .... l .... 13 „ E 6 1 1 .... .... 14 „ F 4 4 .... .... .... 16 St. Ann's Chambers, Ludgate Hill 3 13 .... l .... 30 Bloomfield House, Snow Hill 17 .... 2 .... 55 Total (Six " Blocks ") 46 70 4 .... 235 MIDDLE DISTRICT. Bridgewater House, Fann Street .... 9 .... .... 1 16 City Buildings, Moor Lane 1 20 10 .... 1 74 Total (Two " Blocks ") 1 29 10 .... 2 90 EAST DISTRICT. ^Harrow Place and Stoney Lane— North Block 52 8 .... .... 166 South ,, 5 22 13 .... .... 113 Prince's „ 5 50 .... .... 138 Queen's ,, 5 40 5 .... .... 123 King's 8 18 16 .... .... 108 Barker's Buildings, Catherine Wheel Alley, Bishopsgate 5 6 .... l .... 28 Bearsted House, Hutchison Street .... .... 8 16 .... 98 Dutton House, New Street .... .... 13 2 1 65 Total (Four " Blocks ") 28 188 63 19 1 839 These twelve blocks contain 463 tenements, and are inhabited by 1,164 persons—an average of 2.5 persons to each tenement. 66 The following table is included in this Report in accordance with the request contained in the letter from the Ministry of Health, dated 24th June, 1932, and relating to contents of annual reports of Medical Officers of Health :— 1. Inspection of Dwelling-houses during the year :— (1) (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 335 (b) Number of inspections made for the purpose 567 (2) (a) Number of dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 51 (b) Number of inspections made for the purpose 143 (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 72 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 69 3. Action under Statutory Powers during the Year :— A.—Proceedings under sections 17, 18 and 23 of the Housing Act, 1930 : (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. B.—Proceedings under Public Health Acts : (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 40 (2) Number of dwelling-houses in which defects were remedied after service of formal notices :— (a) By owners 40 (b) By local authority in default of owners Nil. C.—Proceedings under sections 19 and 21 of the Housing Act, 1930 : (1) Number of dwelling-houses in respect of which Demolition Orders were made Nil. (2) Number of dwelling-houses demolished in pursuance of Demolition Orders Nil. D.—Proceedings under section 20 of the Housing Act, 1930 : (1) Number of separate tenements or underground rooms in respect of which Closing Orders were made Nil. (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit.Nil. E.—Proceedings under section 3 of the Housing Act, 1925 : (1) Number of dwelling-houses in respect of which notices became operative 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. F.—Proceedings under sections 11, 14, and 15 of the Housing Act, 1925 : (1) Number of dwelling-houses in respect of which Closing Orders became operative Nil. (2) Number of dwelling-houses in respect of which Closing Orders were determined, the dwelling-houses having been rendered fit Nil. (3) Number of dwelling-houses in respect of which Demolition Orders became operative Nil. (4) 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. 67 Neglect to comply with Water-closet Bye-laws.—One instance of neglect in this respect has occurred during the year under review. Drainage Plans.—In the course of the year 184 plans were submitted with regard to proposed reconstruction of water-closets or drains in the City. Of these, 157 were approved, 20 revised and approved ; and 7 not approved. Street Gullies.—-The gradual substitution of properly trapped gullies for those formerly existing has greatly reduced the number of complaints received of offensive smells arising from these 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 three cases were reported by your officers. Sanitary Defects and Infectious Diseases.—In cases of notification of infectious disease, the premises involved were inspected with regard to the drainage system, water supply, ventilation, &c. ; and of the 93 cases investigated in 1932, it was found necessary to make amendments to soil and waste pipes, water-closets, &c., in 26 instances. House, Trade and other Refuse Removal.—The City Engineer informs me that the refuse removed from the City in 1932 consisted of 23,497 cartloads of street sweepings and slops, and 47,085 loads of house and trade refuse, a total of 70,582 loads. The total for the year 1931 was 73,356. 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, 108 notices have been issued by the Sanitary Committee, and in one case it was found necessary, in consequence of non-compliance therewith, to refer the matter to the City Solicitor. Slimmer 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 24,974,729 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 Custom 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 1932, 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 16 of the connections referred to. As a result of the inspection of the internal drainage system of these premises, reconstruction or alteration was found necessary in 13 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. 68 HOUSING ACT, 1930. Improvement Areas, Closing of Parts of Houses (Basement Rooms). The London County Council gave consideration to the question of amendment of Section 20 of the Housing Act, 1930, so that a Local Authority, in dealing with an improvement area under Part I. of that Act, should be able to make a closing order in relation to any part of a building which it deems to be unfit for human habitation, notwithstanding that it may not be occupied as a separate tenement. Such an amendment would enable individual rooms and houses in an improvement area to be dealt with, and would conduce to economical conservation of existing housing accommodation. The Corporation would be prepared to support the London County Council, provided that the position and powers of the Corporation as the existing authority for the City of London under the Act are maintained. STONE CRUSHING. Certain local authorities in the Greater London area have experienced considerable difficulty in controlling the nuisance created by stone crushing or mixing, or by such trades as create a nuisance by emission of dust from the plant used on the premises. Unloading coal, cement and materials of a similar description have also caused nuisance, and it is doubtful whether any of these could be dealt with by the powers conferred by the Public Health (London) Act, 1891. As a consequence, it has been suggested that powers should be obtained in the next London County Council (General Powers) Bill, enabling control to be exercised over these businesses, and although the City have not experienced any of the troubles of some other areas surrounding it, the Corporation are prepared to support the London County Council in any legislation which would remove the difficulty. PIGEONS. Complaints of the nuisance and damage caused by the congregation of pigeons in the City have again been numerous, and continual attention has been necessary in order to attempt to keep the number of these birds within reasonable limits. The practice of feeding adopted by so many visitors, together with the ideal nesting facilities readily available at such places as St. Paul's Cathedral and other City Churches, renders the problem of adequate reduction difficult. Some 574 birds have been caught by the expert engaged by the Corporation, and all destroyed under my supervision, with the exception of two ringed birds, which were sent to the Secretary of the Homing Union for return to their owners. I should add here that every precaution is taken by those responsible to ensure that the work is not attended by any element of cruelty. DISCOVERY OF HUMAN REMAINS. 2, King Edward Street. 57 /59, Charterhouse Street. 78, Newgate Street. During the course of building operations at each of the above-mentioned premises, a small quantity of human remains was unearthed. The bones were of great age, and in each instance bore evidence of a previous disturbance. The customary notification to the Coroner and the City Police was made, and the remains subsequently reverently reinterred on the sites. EXHUMATION AND RE-INTERMENT OF BODIES. City of London Cemetery. During the year the bodies of five persons buried in the City of London Cemetery, at Ilford, have been exhumed and subsequently re-interred in other graves in the same cemetery. These exhumations are carried out at the request of members of the deceased's family under licence issued by the Home Secretary, and the work of removal and re-interment is supervised by one of my representatives. The greatest care is exercised by the Cemetery Staff and other responsible persons to ensure that the operations are carried out with proper reverence. 69 FACTORY AND WORKSHOP ACT, 1901, &c. Factories, Workshops and Workplaces.—The premises upon the Register number 3,670, in which are included 8,281 workrooms, &c. There were served 1,616 notices during the year for various purposes under the Acts. The number of Factories, Workshops and Workplaces at present Registered is as follows :— Registered Places. Workrooms, &c., in Registered Places. FACTORIES 1,366 3,799 WORKSHOPS 1,174 1,812 WORKPLACES Kitchens of Restaurants and Tea Rooms 702 1,550 Kitchens of Licensed Premises 240 717 Stables 5 41 Other places 183 362 3,670 8,281 The following is a Summary of Inspections of separate workrooms, &c., during the year :— Workshop Inspectors. Woman Inspector. Totals. FACTORIES 1,872 - 1,872 WORKSHOPS 878 - 878 WORKPLACES 1,079 77 1,156 The following is a Summary of Inspections of separate workrooms, since 1923 Workshop Inspectors. Woman Inspector. Totals. FACTORIES. 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 1930 1,649 - 1,649 1931 2,144 - 2,144 1932 1,872 - 1,872 Workshop Inspectors. Woman Inspector. Totals. WORKSHOPS. 1923 1,387 - 1,387 1924 .1,159 - 1,159 1925 1,219 - 1,219 1926 1,242 7 1,249 1927 1,259 - 1,259 1928 1,093 1 1,094 1929 1,247 - 1,247 1930 855 - 855 1931 1,044 - 1,044 1932 878 - 878 Workshop Inspectors. Woman Inspector. Totals. WORKPLACES. 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 1930 704 48 752 1931 1,248 95 1,343 1932 1,079 77 1,156 k 70 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. 4*85, Middlesex Street. †280, Bishopsgate. †12 and 13, Widegate Street. † Great Eastern Railway Hotel. UNDERGROUND BAKEHOUSES. † 188, Aldersgate Street. 262, Bishopsgate. 8, Copthall Avenue. †*67, Farringdon Street. 48, Knightrider Street. †*37, Middlesex Street. †*122, Middlesex Street, †3, Pancras Lane, †21, Stoney Lane, †68, St. Mary Axe. 194, Upper Thames Street. SUMMARY. Aboveground Bakehouses 5 Underground Bakehouses 11 16 * These have been established at least 46 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 37 cases employers neglected to keep lists at their premises and to send copies of the same to the Corporation, as required by the Act. Notice in each case was served upon the offender and in all cases complied with. No cases of infectious disease were reported in connection with outworkers' premises in the City. 71 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) 72 92 38 202 Do. Initial Inspections (Workrooms) 111 125 81 317 Do. Periodical Inspections (Tenancies) 197 152 214 563 Do. Periodical Inspections (Workrooms) 482 348 713 1,543 Do. Re-inspections (Sanitary Works, &c., in hand) 322 265 160 747 Workshops, Initial Inspections (Tenancies) 37 77 35 149 Do. Initial Inspections (Workrooms) 50 101 51 202 Do. Periodical Inspections (Tenancies) 176 142 162 480 Do. Periodical Inspections (Workrooms) 245 198 229 672 Do. Re-inspections (Sanitary Works, &c., in hand) 185 183 76 444 Workplaces, Initial Inspections (Tenancies) 11 6 3 20 Do. Initial Inspections (Workrooms) 27 6 4 37 Do. Periodical Inspections (Tenancies) 33 9 38 80 Do. Periodical Inspections (Workrooms) 79 12 61 152 Do. Re-inspections (Sanitary Works, &c., in hand) 69 23 34 126 Bakehouses, Periodical Inspections (Tenancies) 17 10 6 33 Do. Periodical Inspections (Workrooms) 21 10 6 37 Do. Re-inspections (Sanitary Works, &c., in hand) 37 7 10 54 Kitchens of Restaurants, &c.— Initial Inspections (Tenancies) 41 8 17 66.' Initial Inspections (Workrooms) 107 17 32 156 Periodical Inspections (Tenancies) 74 31 74 179 Periodical Inspections (Workrooms) 220 96 133 449 Re-inspections (Sanitary Works, &c., in hand) 146 81 190 417 Kitchens of Licensed Premises— Initial Inspections (Tenancies) 3 3 6 12 Initial Inspections (Workrooms) 11 11 11 33 Periodical Inspections (Tenancies) 27 12 36 75 Periodical Inspections (Workrooms) 84 43 84 211 Re-inspections (Sanitary Works, &c., in hand) 33 16 47 96 Workshops notified by H.M. Inspector 10 36 12 58 General complaints received 5 12 5 22 Miscellaneous visits 293 202 174 669 FACTORIES, WORKSHOPS, WORKPLACES. KITCHENS OF RESTAURANTS, &c. KITCHENS OF LICENSED PREMISES. DEFECTS FOUND. East District. Middle District. West District. East District. Middle District. West District. East District. Middle District. West District. Totals. Want of Cleanliness 117 61 14 35 25 21 9 5 3 290 Want of Ventilation 7 9 — 4 2 5 1 — — 28 Overcrowding 1 — 3 — — — — — — 4 Want of Drainage of Floors 1 — — — — — — — — 1 Want of Lavatory Accommodation — — — — — — — — — — Food improperly stored 1 — — 6 3 5 — — 2 17 Storage Cistern defective 17 17 4 2 2 4 — 1 2 49 Accommodation for Refuse 6 — — 5 — 3 1 — — 15 Accumulation of Refuse 21 4 5 6 — 4 — — — 40 Sanitary Accommodation. Insufficient (Tenancies) 1 1 2 1 — — — — — 5 Unsuitable (Do.) 18 11 11 3 — 2 — — 1 46 Defective (Do.) 169 129 76 20 13 10 7 — 3 427 Do. (No. of Conveniences)* 169 129 76 20 13 10 7 — 3 427 . Not separate for Sexes (Tenancies) 3 10 6 1 — 1 — — 1 22 Other Nuisances 38 24 19 32 15 25 6 4 4 167 Total Defects found 400 266 140 115 60 80 24 10 16 1,111 * Figures not included in total defects found or remedied. K2 72 FACTORIES, WORKSHOPS, WORKPLACES. KITCHENS OF RESTAURANTS, &c. KITCHENS OF LICENSED PREMISES. DEFECTS REMEDIED. East District. Middle District. West District. East District. Middle District. West District. East District. Middle District. West District. Totals. Want of Cleanliness ill 75 15 33 21 17 3 3 4 282 Want of Ventilation 8 9 — 4 2 5 1 — 1 30 Overcrowding 1 — 3 4 Want of Drainage of Floors Want of Lavatory Accommodation Food improperly stored — — — 5 8 3 — — 2 18 Storage Cistern defective 17 14 4 8 2 5 — 1 3 54 Accommodation for Refuse 7 2 3 — 3 1 — — 16 Accumulation of Refuse 22 6 4 5 — 4 — — — 41 Sanitary Accommodation. Insufficient (Tenancies) 1 1 — 1 3 Unsuitable (Do.) 19 11 10 4 — 4 1 — 1 50 Defective (Do.) 169 135 85 20 13 9 8 — 2 441 Do. (No. of Conveniences)* 169 135 85 20 13 9 8 — 2 441 Not separate for Sexes (Tenancies) 4 11 6 1 — 1 — — 1 24 Other Nuisances 48 32 16 33 22 23 6 4 3 187 Total Defects remedied 407 296 143 117 68 74 20 8 17 1,150 ACTION TAKEN. East District. Middle District. West District. Totals. Matters referred to H.M. Inspector— Nuisances remediable by H.M. Inspector 4 l — 5 Failure to affix Abstract 23 28 4 55 Matters referred by H.M. Inspector— Notified by H.M. Inspector 1 16 3 20 Reports sent to H.M. Inspector 1 16 3 20 Notices served— Factories—Intimation 31 41 7 79 Statutory 3 — 2 5 Workshops—Intimation 8 12 5 25 Statutory 3 — — 3 Workplaces, &c.—Intimation 4 — — 4 Statutory — — — — Kitchens of Restaurants— 1 2 5 8 Intimation — — — — Statutory Kitchens of Licensed Premises— — — 4 4 Intimation — — 1 1 Statutory Orders required from Sanitary Committee 7 2 3 12 Certificates for Cleansing issued by Medical Officer of Health — — — — Matters referred to District Inspectors 9 2 — 11 Matters referred to Woman Inspector — — — — Matters referred to Workshop Inspectors — — — — Cases reported for Legal Proceedings — — 1 1 Legal Proceedings taken — — 1 1 OUTWORK, AND THE INSPECTION OF OUTWORKERS' PREMISES, &c. Lists received from City Firms — — — 1,238 Names and Addresses, &c., received from other Authorities — — — 399 Names and Addresses transmitted to other Authorities — — — 8,768 Notices served on Employers — — — 1,487 Letters written, &c — — — 16 Firms visited 23 49 19 91 Outworkers' Lists not kept 4 2 — 6 Do. not sent 19 26 — 45 Infectious Disease occurring in Outworkers' Premises — — — — Registered Factories and Workshops at which Outwork is received— Inspections 71 88 39 198 Defects found 54 37 5 96 Defects remedied 54 37 5 96 ''Places from which work is given out "— Inspections 32 27 23 82 Defects found 11 7 1 19 Defects remedied 11 7 1 19 *Figures not included in total defects found or remedied. 73 WOMAN INSPECTOR. . Domestic Workshops at which Outwork is received Inspections — Defects reported and appropriate action taken — Domestic Workshops which do not receive Outwork Inspections — Defects reported and appropriate action taken — Domestic Premises receiving Outwork (not registerable as Workshops). Inspections — Defects reported and appropriate action taken — Underground Conveniences for Women Inspections 28 Defects reported and appropriate action taken 2 Railway Stations (Ladies' Rooms) Inspections 15 Defects reported and appropriate action taken 6 Inspections 77 Kitchens Defects reported and attended to or referred to appropriate Inspector 31 L.C.C. (G.P.) Act, 1904. Inspection of premises after cleansing of children Notifications received 2 Visits 1 Defects reported and appropriate action taken 1 Children Act, 1908 (Nurse Children) Notifications received 2 Visits 2 Defects reported and appropriate action taken — Notification of Births Act, 1907 Births notified 52 Home visits to infants 289 Home visits to children between 1 and 5 years of age 411 Visits re Still Births — Deaths of Infants under 1 year of age Number Notified 3 Visits — Distribution of Milk (Free) Expectant and Nursing Mothers and Children 106 Distribution of Dried Milk Number of children in receipt of:— Free 1 Reduced or Cost Price 8 Number of Mothers attending Infant Welfare Centre 101 Total Attendances at Infant Welfare Centre 689 Expectant Mothers visited at home 76 Special Visits 43 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 1930 1,229 1,019 9,603 10,622 1931 1,202 996 9,105 10,101 1932 1,182 1,006 8,758 9,764 74 FACTORIES, WORKSHOPS, WORKPLACES AND HOMEWORK. 1.—Inspection of Factories, Workshops and Workplaces. Including Inspections made by Sanitary Inspectors. Premises. Number of Inspections. Written Notices. Occupiers Frosccuted. (1) (2) (3) (4) Factories (including Factory Laundries) 777 84 † Workshops (including Workshop Laundries) 633 28 — Workplaces (other than Outworkers' premises) 501 17 — Total 1,911 129 — 2.—Defects Found in Factories, Workshops and Workplaces. Particulars. Number of Defects. Number of offences in respect of which Prosecutions were instituted. Found. Remedied. Referred to H.M. Inspectors. (i) (2) (3) (4) (5) Nuisances under the Public Health Acts:- Want of cleanliness 298 287 5 — Want of ventilation 38 39 — Overcrowding 4 4 — — Want of drainage of floors 1 — — — Other nuisances 299 323 — — Sanitary accommodation insufficient 5 3 — — unsuitable or defective 475 493 — 1† not separate for sexes 22 24 — — 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 1,142 1,173 5 1 •Including those specified in Sections 2, 3, 7 and 8 of the Factory and Workshop Act, 1901, as remediable under the Public Health Acts. fProsecutions instigated against owner. No instance of outwork in unwholesome premises under Section 108 of the factory and Workshop Act was reported. 75 3.—Home Work. nature of work.* OUTWORKERS' LISTS, SECTION 107. OUTWORK IN UNWHOLESOME PREMISES, SECTION 10b. OUTWORK IN INFECTED PREMISES, SECTIONS 109, 110. Lists received from Employers. Notices served on occupiers as to keeping or sending Lists. Prosecutions. Instances. Notices served. Prosecutions. Instances. Orders made (S. 110). Prosecutions (Sections 109, 110). Sending twice in the year. Sending once in the year. Failing to keep or permit inspection of lists. Failing to send lists. Lists.f Outworkers.f Lists. Outworkers. Contractors. Workmen. Contractors. Workmen. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) at) (12) (13) (14) (15) ###] Wearing Apparel— making, &c 1,002 3,180 5,201 31 27 127 1,487 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) 88 287 139 6 16 6 Cables and Chains Anchors and Grapnels Cart Gear Locks, Latches and Keys Umbrellas, &c 40 6 264 1 — 3 Artificial Flowers 6 — 48 — — — Nets, other than Wire Nets Tents Sacks Racquet and Tennis Balls Paper, &c., Boxes, Paper Bags 2 — 2 — — — Brush making 4 — 56 — — — Pea picking Feather sorting Carding, &c., of Buttons, &c Stuffed Toys 2 — 8 — — — Basket making Chocolates and sweetmeats Cosaques, Christmas Crackers, Christmas Stockings, &c Textile Weaving Total 1,144 3,473 5,718 38 43 136 1,487 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 6 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 arc the total numl er of the lists received from those employers who comply strictly with the statutory duty of sending tuo 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. 76 4.—Registered Workshops. Workshops on the Register (S. 131) at the end of the year. Number. (1) ##] Important classes of workshops, such as workshop bakehouses, may be enumerated here. General Workshops 1,170 Bakehouses (including Factory Bakehouses) 16 Total number of Workshops on Register < *1,186 * These were found to be 1,824 Workrooms, &c., in places Registered. 5.—Other Matters. Class. Number. (1) (2) Matters notified to H.M. Inspector of Factories:— Failure to affix Abstract of the Factory and Workshop Act (S. 133, 1901) 55 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 20 Reports (of action taken) sent to H.M. Inspector 20 Other — Underground Bakehouses (S. 101):— — Certificates granted during the year Nil. In use at the end of the year 11 Date, 31s* December, 1932. (.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, to 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. 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. One additional premises was registered during the year in accordance with the requirements of the London County Council (General Powers) Act, 1928, now repealed and replaced, as regards ice cream by the London County Council (General Powers) Act, 1932. 77 CITY MORTUARY. Bodies Received—Post-Mortems and Inquests:— Bodies received at the Mortuary to await burial 142 Post-Mortem examinations made. 91 Inquests held on bodies 90 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. PostMortem Examinations. Inquests held on Fires. 1927 227,037 178 169 81 l 1928 180,530 159 147 93 2 1929 515,375 176 165 90 2 1930 203,909 145 135 73 1 1931 155,324 133 127 77 1 Average for previous 5 years 256,435 158 148 83 1 1932 234,170 142 90 91 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. 319 226,266 £296 Other disinfection and cleansing work carried out during the year is as follows:— Disinfection—Infectious Disease:— Articles disinfected after cases of infectious disease 7,904 Library Books disinfected 11 Public Vehicles—Electric Ambulance and Police Litters 3 Cells at Police Stations 2 Premises disinfected (including offices) 229 Lockers disinfected at request of General Post Office Authorities 77 Horsehair (cases) 4 Cleansing of Persons Act, 1897:— Number of verminous persons bathed 120 Cleansing of School Children:— Total number of children cleansed 1,395 509 articles of clothing were destroyed at request of owners. Preservation of Bodies of Unknown Dead.—The De Rechter apparatus for the preservation of the dead, installed at the City Mortuary, in March, 1909, was fully described in the Annual Report of that year. It has proved of considerable assistance in connection with the identification of persons found drowned in the River Thames. During 1932 four bodies were placed in the apparatus, three being subsequently identified. 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, street gulleys, 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. In the interests of economy the practice of using a disinfectant fluid in conjunction with general street watering has been discontinued. l 78 RAT REPRESSION. Rat repression work in the City has been carried on during 1932 by the Sanitary Inspectors. In the interests of economy the position of City Rat Officer, rendered vacant by the death of Mr. J. W. Mayne, in 1931, has not yet been filled, and it has consequently not been possible to devote as much attention to rat problems as one might wish. Rat infestation of premises, when brought to my notice, has, of course, been dealt with without delay, and no urgent problems have been neglected. I think that one of the reasons for the large number of complaints that we continue to receive is the many empty premises in the City, some of which undoubtedly afford nesting and breeding places from which the rats forage at night for food. The tables set out on page 79 indicate the number of investigations made, and the details of the work carried out under the Rats and Mice (Destruction) Act, 1919. From this summary, it will be seen that 86 buildings, occupied by 124 firms, were inspected, and that 110 of these occupancies were found to be rat-infested. One or other of the rat-catchers working in the City was engaged by eight firms. Poisons were laid down in 53 cases, varnish traps were used in 29 cases, break-backs, wire, and other traps in 118 cases. Eight firms kept cats or dogs on the premises. In all, 86 complaints or applications for advice have been received. Rat-proofing was put into operation in 159 instances. This is the most important means of dealing with the rat problem in an area such as the City. When this is carried out in combination with elimination of hiding places, invariably marked improvement is experienced. It is not, however, possible, even with the most expensive or efficient methods of proofing, to exclude rodents from the buildings, ingress to which they obtain as opportunity occurs through open doors and windows. One of the difficulties experienced in connection with rat-proofing which so often involves structural alterations, is the fact that the duty of disinfesting premises devolves upon the occupiers, who are often loath to spend the necessary money. The owner might reasonably be expected to deal with the structure in the matter, but is not legally responsible. It is not possible to report even approximately the total number of rats killed. Messrs. William Dalton & Sons, one of the firms principally engaged in this work in the City, inform me that they killed 16,586 rats in the City during 1932. The substitution of old buildings by modern structures, and the constant attention to drainage and sewage work, have probably resulted in a decrease in the rat population. So far as palliative measures are concerned, we have continued to obtain very satisfactory results from the Varnish Trap. The following figures have been supplied to me by the City Engineer:— Brick sewers reconstructed Nil. Brick sewers constructed 2 Brick sewers in course of reconstruction (1st Jan., 1933) Nil. Disused sewers filled in and abolished 7 Brick sewers reinverted, pointed and repaired 30 Pipe sewers reconstructed 1 Miscellaneous repairs to sewers, drains, etc 66 House drains constructed in connection with new buildings 16 Drains of existing buildings reconstructed 18 House drains reconstructed in connection with the reconstruction and reinverting of certain sewers Nil. Gulley drains constructed and reconstructed in connection with the struction and reinverting of certain sewers Nil. New gullies and drains constructed 4 Gulley drains reconstructed 66 House and gulley drains repaired 198 Disused drains bricked up 123 Rats killed by sewer foreman and his men 1,117 One cwt. of poison was used in the sewers during the year, and subsequently 105 dead rats were found. A larger number of dead rats were doubtless carried away by the flow of water. The number of drainage reconstructions carried out under the supervision of inspectors of this Department is set out on page 79. 79 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, 1932. Months. No. of Buildings Inspected. Average No. of Firms in building. No. of premises Rat Infested. Total No. of Firms interested. Steps taken to destroy Rats. Rat Proofing done, Rat-holes stopped, &c. Drainage and Sewerage Work carried out during the year. Legal Proceedings. Special Observations. Complaints or Applications for Advice. Rat-Catcher Employed. Poison Used. Wire Traps. Breakbacks. Varnish Traps. Other Traps. Cats or Dogs kept. By City Engineer's Department. By M.O.H. Department. January 4 2.7 4 5 — 3 3 5 5 — 2 5 531 f 96 1 — 4 February 4 2.2 4 6 1 2 3 l — — — 5 — 4 March 5 1.8 5 9 1 3 3 2 — — l 7 — 5 April 6 1.5 7 9 — 7 2 8 — — — 13 — 6 May 5 2.0 5 6 — 4 10 — — — 2 16 — 5 June 21 2.2 32 31 2 13 13 9 7 l 1 41 — 21 July — August — September 13 1.7 16 18 — 9 9 5 1 — 1 22 — 13 October 13 2.2 16 18 2 5 23 6 8 — — 26 — 13 November December 15 2.6 21 22 2 7 6 9 8 — 1 24 — 15 Totals 86 21 110 124 8 53 72 45 29 l 8 159 627 — 86 80 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, 95 persons were examined by the Medical Officer of Health during 1932. Four of these persons were reported as physically unfit for office, and the decision in regard to three is pending. Twenty officers were also medically examined with a view to their retirement. With one exception, 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 „ B— „ „ Infectious Diseases 86 „ C—Register of Houses let in lodgings or occupied by members of more than one family 88 „ D—List of Adoptive Acts, Orders, Bye-laws and Regulations in operation in the City 90 „ E—Compulsory Notification of Chicken-pox. Form of Notice 91 „ F—London Ambulance Service—Facilities 91 82 APPENDIX A.—STREET LISTS OF MORTALITY. STREET OR PLACE. No. of House Sex. Age. Date of Death. Cause of Death. Remarks. Albion Buildings 1 F 34 8th Feb. Coma. Injury to brain. Murdered. P.M. Inq. Aldgate 9 M 43 18th Aug. la. Addison's disease b. Tumour of Suprarenals Died in St. Peter's Hospital. „ 23 F 72 31st Aug. la. Cancer of Splenic Flexure Died in Leicester City Mental Hospital. P.M. Aldersgate Street, Manchester Hotel. M 67 7th Aug. Fractured skull. Laceration of brain and other injuries. Fall from landing on to stone floor P.M. Suicide. Unsound mind. „ „ M 54 18th Aug. Syncope. Enlarged heart, with myocardial degeneration. Accelerated by heat Resident of Germany. Inq. P.M. Accidental. Basinghall Street, St. Michael's House. — M 48 25th May la. Pulmonary Tuberculosis Died in Colindale Hospital. Bearsted House 13 M 50 25th Feb. Drowned in River Thames „ 16 M 60 6th Nov. Carcinoma of Pharynx Died in St. Marylebone. Billingsgate Market, The Residence. — M 64 20th April Coronary disease. Syncope. Natural Died in St. Marylebone. Inq. Bishopsgate 191 F 10 18th June la. Lobar Pneumonia Died at Ipswich. Botolph Alley 1 M 56 18th June la. Oedema of Lungs b. Acute Dilatation of Heart c. Opn. for removal of Enlarged tate Died in Guy's Hospital. Bridgewater House, Charles Street. 4 F 72 19th Nov. la. Syncope b. Senile decay Cannon Street 7 M 53 11th July Lobar Pneumonia „ 84 M 63 18th Aug. Heart failure (Syncope). Rupture of an Aneurism of the Aorta. Atheroma of large vessels Resided at Streatham. „ 143 M 75 15th June Angina Pectoris Resided at Worthing. „ 145 M 62 30th Mar. la. Congestive Cardiac failure 2. Pulmonary Tuberculosis Died in Fairlight Sanatorium, Hastings. Carter Lane, G.P.O. South Telephone Exchange. M 65 10th May Asphyxia. Inhalation of coal gas from gas ring connection P.M. Inquest. Misadventure. Resided at Edmonton. Carter Lane 46 F 31 19th June Failure of respiration, due to Emphysema, following Asthma and Bronchitis. Church Passage 3 F 51 7th Jan. la. Acute Lobar Pneumonia b. Pelvic Carcinoma, with Ascites Died in Homoeopathic Hospital. Circus, Minories 5 M 56 22nd April la. Broncho-pneumonia 2. Pericarditis Died in St. Peter's Hospital, Stepney. Clifford's Inn 12a M 65 9th Feb. la. Bronchial Pneumonia b. Senile Gangrene Died in Charing Cross Hospital. „ 12a M 8 20th Nov. la. Respiratory failure b. Tubercular Meningitis " Coleman Street 5 F 64 25th June Pyelo-nephritis Died in St. Bartholomew's Hospital. College Street 26 M 73 5th Nov. Shock. Haemorrhage. Multiple injuries. Run over by motor van Died in ambulance on way to hospital. Copthall Avenue 15 M 53 9th Aug. la. Hepatic insufficiency b. Actinomycosis of Liver Died in St. Bartholomew's Hospital. „ 15 M 27 29th Jan. Asphyxiation. Crushed between lift roof and ceiling Resided at Brixton. Inq. Misadventure. Cowper's Court, Cornhill. 2 M 25 24th Mar. Shock and Syncope. Internal haemorrhage from blood vessels in stomach Coma and failure of respiration, due to Cerebral Haemorrhage, accelerated by Arterio-sclerosis, Valvular Heart disease and Granular Kidney P.M. Dean Street, D Block 5a F 79 28th May „ „ 5b M 76 5th Jan. Chr. Gastric Ulcer. Gastric Haemorrhage. Epithelioma of Penis Died in St. Peter's Hospital, Stepney. „ „ 5e 6d F M 59 54 27th Mar. 27th Mar. Asphyxiation due to inspiration of contents of Abscess in throat, which burst la. Pulmonary Tuberculosis Died in St. Peter's Hospital. „ „ 7e F 11 mos. 8th Mar. la. Broncho-pneumonia b. Measles Died in Western Hospital, Fulham. Dean Street 8a M 68 25th Feb. Syncope. Coronary Thrombosis. Myocardial degeneration Died in ambulance on way to hospital. „ 8e M 65 4th Mar. la. Ulceration of neck Died in St. Peter's Hospital, Stepney. Doctor Johnson's Bldgs., Temple. 3 F 76 10th Oct. la. Mitral disease of heart Died at Wandsworth. Dutton House, New Street. 8 F 34 15th Jan. la. Cardiac failure b. Recurrent Haemorrhage Died in Hospital for Women, Westminster. „ „ 10 M 41 26th July Shock. Multiple injuries. Knocked down in street by motor lorry Died in London Hospital. P.M. Inq. Accidental. Dyers' Buildings 6 F 68 29th April Syncope. Diseased Mitral valves. Broncho-pneumonia Died in ambulance. P.M. East Passage, Cloth Fair 27 M 76 4th July Suffocation. Strangulation by cord round neck. Suicide. Unsound mind Died in ambulance on way to hospital. P.M. Inq. Eastcheap 40 F 57 31st Jan. Carcinoma rt. breast. Died in St. Luke's Hospital. 83 STREET LISTS OF MORTALITY—continued. STREET OR PLACE. No. of House Sex. Age. Date of Death. Cause of Death. Remarks. Essex Court 4 M 39 25th June Syncope from Myocardial Degeneration, due to Atheroma of Coronary Arteries Resided in Bloomsbury. P.M. Exchange Buildings 4 M 85 8th Dec. la. Myocardial degeneration Died in St. Peter's Hospital. Fenchurch Buildings 6 M 67 2nd Jan. Cerebral Haemorrhage Fenchurch Street 65 65a F M 47 62 20th April 20th Feb. la. Broncho-pneumonia b. Septicaemia c. Agranulocytosis Carcinoma of tonsil Died in St. Peter's Hospital. Fetter Lane 98 M 61 10th June Syncope. Myocardial degeneration. Chronic Bronchitis and Kidney degeneration Resided at Lewisham. Fleet Street 154 M 11 19th May Asphyxia and shock and other injuries caused when deceased was squeezed in a lift Inquest. P.M. Misadventure. Fore Street 103 F 30 26th Jan. Syncope from loss of blood, due to cutting of main vessels of neck Murdered. P.M. Resided at Clapton. Goodman's Yard 2 F 72 25th Mar. 1. Auric Fibrilation Died in St. Peter's Hospital, Stepney. Gough Square 17 M 67 12th May la. Carcinoma Bronchus. Toxaemia b. Empyema Died in Charing Cross Hospital. Gracechurch Street 42 M 51 14th Sept. Atheroma and Thrombosis of the left Coronary Artery of the Heart Resided at Ilford. „ 79 M 56 3rd Jan. la. Acute Peritonitis b. Perforated Duodenal Ulcer 2. Operation Died in Guy's Hospital. Gresham Street 23/ 25 M 25 5th May Shock and Haemorrhage and Multiple Fractures. Fall from window P.M. Inq. Suicide. Died in ambulance. „ 46 F 73 6th Sept. la. Carcinoma of Colon Died in St. Peter's Hospital, Stepney. Gunpowder Alley 8a M 77 21st Mar. Asphyxiation. Pleurisy. Inflammation of lungs. Chronic Heart Disease Holborn Circus 4/5 F 59 22nd June Carcinoma of stomach Holborn Viaduct 52 M 84 17th Oct. la. Cerebral Anaemia b. Senile arteries King Edward Street, G.P.O. — M 54 12th Dec. Syncope. Myocardial degeneration. Thrombosis of the Coronary arteries Resided at Romford. P.M. King's Bench Walk 13 F 68 23rd May la. Coronary Thrombosis b. Arterio-sclerosis Knightrider Street 61 F 54 24th May la. Syncope b. Portal Thrombosis 2. Hepatic Cyst Died in St. Bartholomew's Hospital. Leadenhall Street 53 M 52 10th Sept. Disease of Heart muscle. Myocarditis, causing Cardiac failure and Syncope Resided at Wimbledon. Lindsey Street, Central Hotel. — M 67 14 th Feb. la. Cardiac failure b. Myocardial degeneration 2. Chronic Interstitial Nephritis Died in St. Bartholomew's Hospital. Liverpool Street, Great Eastern Hotel. — M about 43 31st Oct. Shock. Laceration of brain. Passage of bullet from revolver Inq. P.M. Unsound mind. Liverpool Street, Met. Station. — M 52 26th Oct. Shock. Multiple injuries. Falling in front of train Resided at Oakleigh Park. Inq. P.M. Accidental. „ M 47 21st Dec. Shock and multiple injuries. Run over by train Resided at Walthamstow. Inq. Suicide. Unsound mind. Lloyd's Avenue 4 M 68 6th April la. Cerebral Haemorrhage Died in Archway Hospital, Islington. Love Lane, Eastcheap 5 M 51 14th Aug. la. Oedema of lungs Ludgate Circus, Bank Buildings. F 51 16th Dec. la. Thrombosis of Cerebral vessels b. Carcinoma of Cervix Ludgate Hill 62 M 67 18th July la. Myocardial degeneration b. Arterio-sclerosis Resided at Acton. Maidenhead Court 2a F 81 26th Feb. Senile decay Died in Tooting Bee Hospital. Mark Lane, Railway Station. — M 65 8th June Shock. Fractured spine and other injuries. Fall in front of train P.M. Inq. Accidental. Resided at Kensington. Hark Lane 5 F 2 mos. 9th Nov. la. Broncho-pneumonia b. Whooping cough Died in Tottenham. Martin Lane 7 F 69 3rd Aug. la. Peritonitis b. Perforation. Intestinal obstruction Died in City of London Mental Hospital. Middlesex Street 116 M 59 3rd Feb. la. Cardiac failure b. Myocardial degeneration c. Chronic Bronchitis Died in St. Peter's Hospital. „ 116 M 63 6th Feb. la. Broncho-pneumonia „ „ „ 116 M 77 1st Mar. la. Chronic Myocarditis b. Chronic Bronchitis Died in City of London Infirmary, Bow Road. „ 116 M 50 10th Mar. la. Pulmonary Tuberculosis Died in Bancroft Lodge, Stepney „ 116 M 70 24th April Cardiac Valvular disease Died in Poplar. „ 116 M 81 6th May la. Chronic Myocarditis b. Chronic Bronchitis Died in City of London Infirmary, Bow Road. „ 116 M 62 21st May la. Carcinoma of liver Died in St. Peter's Hospital. 84 STREET LISTS OF MORTALITY—continued. STREET OR PLACE. No. of House Sex. Age. Date of Death. Cause of Death. Remarks. Middlesex Street 116 M 72 21st May la. Myocardial degeneration b. Arterio-sclerosis Died in City of London Infirmary, Bow Road. „ 116 M 44 20th May la. Chronic Myocarditis b. Asthma c. Chronic Bronchitis „ „ 116 M 57 8th Aug. la. Myocardial degeneration b. Chronic Nephritis „ „ 116 M 38 25th Aug. la. Broncho-pneumonia b. Bronchitis and Emphysema Died in St. Peter's Hospital. „ 116 M 60 25th Sept. la. Chronic Myocarditis b. Chronic Nephritis Died in City of London Infirmary, Bow Road. „ 116 M 63 26th Nov. la. Perforation of colon b. Hirschspreng's disease Died in Friern Barnet Infirmary. „ 116 M 51 25th Dec. Lobar Pneumonia Died in St. Peter's Hospital. Minories 47 M 66 18th Jan. Cardio-hypertrophy Coronary Atheroma Resided in Kensington. „ 60 M 22 2nd June la. Haemorrhage b. Lung Abscess 2. Acute Mastoid Died in St. Bartholomew's Hospital. „ 85 M 82 7th Feb. la. Chronic Myocarditis b. Chronic Bronchitis Died in City of London Infirmary, Bow Road. „ 150 M 75 3rd Mar. Sclerosis. Stenosis of left Coronary Artery, causing failure of Cardiac muscle Montague Court 1 F 81 30th Sept. la. Chronic Endocarditis b. Chronic Nephritis Died in City of London Infirmary, Bow Road. „ 5 M 64 22nd Dec. la. Carcinoma Hepatis 2. Cirrhosis Hepatis Died in St. Bartholomew's Hospital. Monument Station — M 58 2nd Jan. Shock and Haemorrhage. Multiple injuries. Run over by train Resided at Chiswick. Inq. P.M. Accidental. Monument Street 24 F 19 22nd Jan. la. Influenzal Pneumonia b. Complication—localised abscess Died in St. Bartholomew's Hospital. Moor Lane 29 F 67 14th Oct. la. Gangrenous Cystitis 2. Operation 2 weeks ago Died in St. Peter's Hospital. Moor Lane Chambers 5 M 65 29th Mar. la. Cardiac failure b. Acute Bronchitis 2. Cellulitis of face „ Moorfields 21 M 49 5th May la. Unemia b. Chronic Nephritis 2. Hypertension Died in Middlesex Hospital. Moorgate 52 M 39 8th Sept. la. Malignant Endocarditis Died in St. Peter's Hospital, Stepney. Britannic House. — M 47 21st Nov. la. Haemorrhage b. Gastric Ulcer Died at Worthing. Neville's Court 12 F 87 23rd Feb. la. Myocardial degeneration b. Chronic Bronchitis Died in City of London Infirmary, Bow Road. „ 12 F 81 19th Mar. la. Myocardial degeneration b. Chronic Bronchitis „ New Bridge Street 28 F 19 10th Jan. Pulmonary Tuberculosis New Street Square 14 F 50 23rd Jan. la. Carcinoma of stomach b. Secondary Carcinoma of abdominal and pelvic glands Died in Empire Nursing Home, Westminster. Newgate Street, Cent. London Rly., P.O. Station. — F 31 23rd June Shock and multiple injuries. Run over by train. Resided at Maida Vale. P.M. Accidental. North Block, 1 F 22 26th Jan. Pulmonary Tuberculosis Stoney Lane. Old Bailey 7/10 M 48 16th Feb. la. Cardiac failure b. Acute Broncho-pneumonia c. Influenza Old Broad Street, Winchester House. — M 52 1st July la. Angina Pectoris b. Arterio-sclerosis c. Dilatation of aorta „ 94 F 50 4th Feb. la. Pneumonia b. Syncope Old Change Buildings — M 76 15th Feb. Enlarged heart. Diseased arteries Paper Street 3 M 57 29th Jan. la. Coronary Thrombosis b. Myocardial degeneration Died in Hackney. Police Buildings, Bishopsgate. 27 F 21 mos. 12 Jan. la. Cardiac failure b. Faucial and Laryngeal Diphtheria Died in Eastern Hospital, Hackney. Primrose Street 1 F 82 16th Dec. la. Arterio-sclerosis Died in St. Peter's Hospital. Queen Victoria Street, College of Arms. — F 37 10th April la. Pulmonary Tuberculosis Died in Brompton Hospital. „ 11 M 68 24th Nov. la. Peritonitis b. Carcinoma of Oesophagus 2 (1). Operation for Gastrectomy „ 71 a M 44 16th Jan. la. Cerebral Haemorrhage b. Arterio-sclerosis Died in St. Bartholomew's Hospital. „ 136 M 62 15th Sept. Sudden heart failure, consequent upon Myocardial degeneration Resided at Wandsworth. 85 STREET LISTS OF MORTALITY—continued. STREET OR PLACE. No. of House Sex. Age. Date of Death. Cause of Death. Remarks. Queen's Block, Stoney Lane. 12 F 41 18th Oct. la. Valvular disease of heart (aortic b. Rheumatic Fever 2. Hemiplegia „ 38 F 69 13th April la. Carcinoma of stomach „ 42 M 25 22nd Sept. la. Heart failure b. Aplastic Anaemia Died in Seamen's Hospital, Greenwich. Railway Place, Fenchurch Street. - M 65 14th Aug. Heart failure (Syncope), due to Valvular disease of heart (Aortic regurgitation) and Myocardial degeneration, due to disease of both Coronary arteries Inq. P.M. River Thames - M 49 19th Jan. Asphyxia. Drowning Resided at Bethnal Green. Inq. P.M. „ - M 62 8th May Asphyxia by drowning Suicide. Unsound mind. P.M. Inq. Resided at Norwich. „ - M 67 5th Sept. Suffocation by drowning. Suicide. Unsound mind Resided at Nunhead. Inq. P.M. „ - M 73 24th Oct. Asphyxia. Drowning. Suicide. Unsound mind Resided at Palmers Green. P.M. „ - M about 45 23rd Oct. Asphyxia from drowning Name and address unknown. Inq. P.M. Robinhood Court 5/6 F 35 17th Jan. 1. Influenza Pleuro-pneumonia 2. Confinement Resided at Finsbury. St. Bartholomew's Hospital, Nurses' Home. - F 28 29th Dec. la. Acute Broncho-pneumonia b. Complicated by paroxysma Tachycardia Died in St. Bartholomew's Hospital. St. Bartholomew's Hospital, The Great Hall. - F 56 30th Sept. la. Lobar Pneumonia Died in City of London Mental Hospital, Stone. St. Mary Axe 37 F 70 20th Dec. la. Cerebral Embolism b. Auricular Fibrilation Died in St. Peter's Hospital. „ 57/ 59 F 1 day 27th Dec. Intestinal Obstruction. Imperforate anus P.M. Died in East London Children's Hospital. St. Paul's Churchyard 22 M 69 22nd April Syncope. Myocardial degeneration, due to disease of the Coronary arteries Resided at Deptford. P.M. St. Swithin's Lane 28/ 29 M 49 27th Jan. la. Cardiac failure b. Aortic Stenosis, with Coronary disease Died in Royal Free Hospital. Salisbury Court 8 F 47 11th Sept. la. Heart failure b. Carcinoma of Cervix Uteri Died in St. Marylebone. Salisbury Square 3 F 95 25th July la. Myocarditis b. Senility Serjeants' Inn 14 M 72 27th April la. Multiple Gummata of liver and spleen b. Syphilis Spital Yard, Bishopsgate. 7 F 85 25th Jan. la. Broncho-pneumonia b. Cerebral Haemorrhage c. Hyperpiesis S. Block, Stoney Lane 6 F 78 10th July Acute Pulmonary Oedema. Atheroma of cerebral vessels Died in Shoreditch. Swan Lane 11 M 49 28th May la. Cerebral Haemorrhage b. Atheroma, Cerebral Arteries Died in St. Peter's Hospital, Stepney. 11 F 63 12th Aug. la. Carcinoma of splenic flexure of colon „„ Thavies Inn 5 F 54 19th Aug. la. Pneumonia b. Stenosis of right upper Bronchus „ 18 M 77 22nd Mar. Asphyxia. Ch. Bronchitis. Tumour of Prostate gland Tokenhouse Buildings 4 M 79 11th Dec. Injury of head. Knocked down by motor van Died in Memorial Hospital, N. Finchley. P.M. Accident. Upper Thames Street, Vintners' Hall. 68½ M 60 12th Nov. la. Broncho-pneumonia b. Influenza Victoria Embankment, Unilever House. — M 49 11th June Heart failure due to Anaemia and Gastritis. Emphysema Resided at Fulham. P.M. Walbrook 32 F 58 25th Jan. Coma. Blood poisoning. Streptococcal infection. Cut thumb whilst sharpening a knife Died in St. Bartholomew's pital. Inq. Accidental. Widegate Street 12 F 39 24th Aug. la. Cardiac failure b. Exophthalmic Goitre 2. Large Fibro-myoma of Uterus Wormwood Street 14 M 63 27th Oct. la. Cardiac muscular disease b. Chronic Interstitial Nephritis Wrestlers' Court 4 F 87 28th Mar. la. Cerebral Embolism b. Cardiac muscular disease „ 5 M 68 11th Dec. la. Carcinoma of bladder Died in St. Columba's Hospital, Hampstead. m 86 APPENDIX B.—LIST OF CASES OF INFECTIOUS DISEASE OTHER THAN TUBERCULOSIS, 1932. street lists.—compiled from notifications received. Street or Place. No. of House. Sex. Age. Disease. Date of Notification. Aldersgate Street — F 25 Diphtheria 8th April. Ditto — F 23 Ditto 20th June. Aldgate High Street 53 M 9 Chicken-pox 25th January. Artillery Lane 20 M 6½ Scarlet Fever 29th December. Austin Friars 26 F 1¾ Measles — Bartholomew House 7 M 3/12 Ditto — Ditto 7 F 3 Ditto — Basinghall Street 31 M 11 Chicken-pox 14th December. Bear Alley 17 M 8 Measles — Ditto 17 F 6 Ditto — Bearstead House 14 M 57 Ac. Prim. Pneu 16th October. Billiter Street 14 M 23 Chicken-pox 6th April. Bucklersbury 35 F 1½ Measles — Coleman Street 20 M 20 Diphtheria 11th January. Creechurch Lane 41 M 6 Chicken-pox 1st November. Crown Court, Warwick Lane — M 21 Measles — Ditto — M 22 Chicken-pox 11th January. Crutched Friars 29 M 44 Erysipelas 4th October. Dean Street 6a F 60 Susp. food pois 20th September. Ditto 7a M 6 Measles — Ditto 7a M 2½ Ditto — Ditto 8a M 6 Ditto — Ditto 4b M 10 Diphtheria 7th December. Ditto 8b F 2 Scarlet Fever 5th October. Ditto 5d F 22 Ditto 9th October. Devonshire Square 2 F 8 Diphtheria 2nd March. Dowgate Hill 4 F 6 Ditto 25th January. Dutton House 9 M 5 Ditto 26th October. Ditto 10 F 10 Chicken-pox 22nd August. Ditto 11 F 6 Ditto 22nd July. Ditto 15 F 35 Diphtheria 25th October. Fleet Lane 29 M 5 Scarlet Fever 29th March. Ditto 29 F 3 Ditto 15th May. Ditto 72 F 8 Measles — Fleet Street 184a M 4 Scarlet Fever 16th May. Ditto 184a M 11 Diphtheria 6th September. Golden Lane 20 F 5 Chicken-pox 31st March. Ditto 20 F 4 Ditto 12th April. Ditto 20 F 9 Ditto 12th April. Gracechurch Street 79 F 6 Scarlet Fever 1st June. Ditto 79 F 6 Ditto 1st April. Harrow Place 39 M 3 Chicken-pox 20th June. Idol Lane 9 F 5 Ditto 16th November. Ditto 3 F 3 Ditto 29th November. Ironmonger Lane 18 M 21 Ditto 29th March. John Carpenter Street — F 21 Susp. food pois 30th September. King Street — M 4 Scarlet Fever 13th June. Ditto — M 37 Diphtheria 19th January. Ditto 26 M 61 Enteric Fever 3rd December. King's Block 21 M 3¼ Scarlet Fever 14th June. Knightrider Street 39 M 15½ Ac. Prim. Pneu 15th March. London Wall Buildings 1 F 7 Diphtheria 15th July. Mansell Street 3 F 2 Chicken-pox 19th December. Ditto 3 F 15 Ditto 19th December. Ditto 3 F 5 Ditto 9th December. Mark Lane 36 M 4 Scarlet Fever 2nd February. Middlesex Street 95 F 4 Measles — Ditto 116 M 27 Erysipelas 10th February. Milk Street Buildings 2 F 22 Ditto 4th November. 87 list of cases of infectious disease other than tuberculosis, 1932. street lists.—compiled from notifications received—continued. Street or Place. No. of House. Sex. Age. Disease. Date of Notification. Minories 76 M 2£ Diphtheria 23rd June. Montague Court 1 M 3 Ditto 4th August. Moor Lane Chambers 16 F 4 Scarlet Fever 23rd July. Moorgate 7 F 5 Chicken-pox 26th October. Ditto 58 F 44 Diphtheria 21st April. Ditto — F 59 Ditto 6th July. Old Broad Street 10 M 9 Ditto 5th October. Primrose Street 1 F 4 Measles — Prince's Block 21 M 5 Scarlet Fever 26th March. Ditto 28 M 51 Erysipelas 23rd March. Ditto 53 F 6 Scarlet Fever 11th October. Rose Alley 37 F 2 Diphtheria 11th January. Ditto 45 M 5 Chicken-pox 4th May. Ditto 56 F 3 Scarlet Fever 17th June. Ditto 56 M 2 Ditto 20th June. Ditto 56 F 33 Ditto 23rd June. Ditto 56 F 1 Ditto 23rd June. St. Bartholomew's Hospital — M 23 Enteric Fever 10th December. Ditto — Vari ous Scarlet Fever (8 cases). Various. Ditto — dit to Diphtheria (3 cases) Various. St. Dunstan's Alley 4 F 28 Ac. Prim. Pneu 25th September. St. Dunstan's Hill 10 F 13 Erysipelas 21st March. Salisbury Court 13 M Scarlet Fever 6th April. Shoe Lane 83 F 20 Diphtheria — Snow Hill .— M 24 Scarlet Fever 20th June. South Block 25 F 7 Chicken-pox 21st June. Ditto 29 F 6£ Ditto 8th July. Ditto 33 F 9 Ditto 5th July. Ditto 40 F 13 Ditto 6th July. Three Nuns' Court — F 68 Erysipelas 1st March. Upper Thames Street 129 M 71 Diphtheria 3rd November. Victoria Embankment — F 9 Measles — Warwick Lane — M 19 Scarlet Fever 3rd August. Watling Street 64 F 7 Chicken-pox 20th January. Widegate Street 19 M 10 Erysipelas 4th October. Wood Street 47 M 18 Chicken-pox 11th January. M 2 88 APPENDIX C.—REGISTER OF HOUSES LET IN LODGINGS OR OCCUPIED BY MEMBERS OF MORE THAN ONE FAMILY. WEST DISTRICT. Situation of Premises. Name and Address of Owner or Tenant. Tenements. Lodgers. 5, Britton's Court Mr. Hurrel, 26, Triscon Road,'Peckham Rye (t) 2 9 43, Cloth Fair The Mitchell Estates, c /o Herbert Smith & Co., 62, London Wall, E.C. (o) 2 3 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 93, Fetter Lane Friern Manor Dairy Co., 93, Fetter Lane (o) 2 5 29, Fleet Lane Messrs. Watney, Combe & Reid, Stag Brewery, Pimlico (o) 4 14 30, do. Do. do. do. (o) 2 7 31, do. Do. do. do. (o) 3 8 11, Great New Street M. Quilty, 11, Great New Street (t) 4 6 13, do F. Wilson, 39, Holmedene Avenue, Heme Hill (o) 9 11 14, do. Mrs. A. E. Jackson, 14, Great New Street (t 6 7 16, do. J. Day, 16, Great New Street (t) 3 5 21, do. Goldsmiths' Company, Goldsmiths' Hall (o) 5 15 23, do. Mrs. J. Barnsley, 27, Great New Street (o) 4 14 25, do. Do. do. (o) 6 10 27, do. Do. do. (t) 4 7 7½, Gunpowder Alley Mrs. C. Townsend, 259, Essex Road, N. (o) 2 6 8, do. Do. do. (o) 4 8 4 & 5, Middle Street J. Hull & Sons, Bartholomew Close (o) 10 12 1, Montague Court H. Tenant, 1, Montague Court (t) 2 8 2, do. R. Hutchins, 2, do. (t) 2 8 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) 3 5 6, do. E. Jones, 6, do. (t) 2 6 8, Nevill's Court Moravian Mission, 32, Fetter Lane (o) 4 8 9, do. Do. do. (o) 6 10 10, do Do. do. (o) 6 7 11, do Goldsmiths' Company, Goldsmiths' Hall (o) 8 17 12, do Do. do. (o) 6 11 14, Newbury Street Page & Steward, 2, Ironmonger Row (o) 4 10 14, Wine Office Court Messrs. Reynolds & Eason, 192, Bishopsgate (o) 2 3 16, do. Do. do. (o) 2 2 2, Pemberton Row Mr. J. O'Shea, 2, Pemberton Row (o) 3 6 Total 137 281 Average number of lodgers to each occupied tenement: 2.0 Houses demolished or closed as dwelling-houses — Tenement houses on Register 35 Cleansing Notices served 37 MIDDLE DISTRICT. Nil. (O) Owner. (T) Tenant. 89 EAST DISTRICT. Situation of Premises. Name and Address of Owner or Tenant. Tenements. Lodgers. 5, Artillery Lane Clerk to Bishopsgate Institute, Bishopsgate (o) 5 9 7, do Do. do. (o) 4 11 9, do. I. J. & J. Mendes, Ltd., 16/18, Middlesex St. (o) 3 6 21, do Clerk to Bishopsgate Institute, Bishopsgate (o) 3 7 10, Brushfield Street Reynolds & Eason, 192, Bishopsgate (o) 6 6 12, do Luke Cohen, 12, Brushfield Street (t) 3 6 14, do. Clerk to Bishopsgate Institute, Bishopsgate (o) 6 7 3, The Circus, Minories W. Lewis, 3, Circus, Minories (t) 4 5 4, do. W. Wisdom, 4, do. (t) 5 13 5, do. T. Groves, 5, do. (t) 6 9 3, Three Crown Court, Jewry Place. Mr. Martin, 14, Seething Lane (o) 3 3 18, Widegate Street S. Franks, 18, Widegate Street (t) 3 7 21, do. A. & A. Field, 95, Whitechapel Road (o) 5 8 24, do. W. I. Crane, 25, Widegate Street (t) 4 6 25, do. Do. do. (t) 3 5 2, Goodman's Yard Charrington, Brewers, Mile End Road (o) 3 3 Total 66 111 Average number of persons to each occupied tenement: 1.7 Houses demolished or closed as dwelling-houses — Tenement houses on Register 16 Cleansing Notices served 16 (O) Owner. (T) Tenant. 90 APPENDIX D.— LIST OF ADOPTIVE ACTS, LOCAL BYE-LAWS AND 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, brewers, 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. 39 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. Kitchens of Restaurants and aboveground Bakehouses ditto ditto ditto Jan., 1904. Common Lodging Houses City of London Sewers Act, 1851 & 1897 Oct., 1902. House Drainage Regulations adopted by the Corporation Sept., 1898. 91 APPENDIX E. Corporation of Ilonbon. public health department. THE PUBLIC HEALTH (LONDON) ACT, 1891. Compulsory Notification of Chicken-pox. J^JOTICE IS HEREBY GIVEN that the Mayor and Commonalty and Citizens of the City of London, as the Sanitary Authority for the City of London, Do hereby by virtue of the powers vested in them by Section 56 of the Public Health (London) Act, 1891, and with the approval of the Minister of Health, Order that the provisions of the said Act, with respect to infectious disease, shall apply in the City of London to the disease known as Chicken-pox, in addition to the diseases specifically mentioned in Section 55 of the said Act (or any Order extending or amending the same) and that for a period of twelve months from the 18th day of March, 1932, Chicken-pox shall be a compulsorily notifiable disease within the City of London. BELL. Guildhall, London, E.C.2. 26th February, 1932. APPENDIX F. Honbon Countp Council. public health department. LONDON AMBULANCE SERVICE. NOTICE. A revised pamphlet, giving particulars of the facilities afforded by the London Ambulance Service, together with details of the revised charges for the hire of the Council's ambulances and ambulanceomnibuses (when not required for public purposes) by public authorities and private persons in cases of illness, is forwarded herewith. The revised charges will take effect as from and including ls< October, 1932. Attention is drawn to the regulation that removals for private persons between addresses, both of which are outside the administrative County of London, cannot be undertaken, unless in circumstances of exceptional emergency. Additional copies may be obtained, if required, on application to the Officer-in-Charge, London Ambulance Service, Public Health Department, Victoria Embankment, E.C.4. It is anticipated that the Headquarters of the London Ambulance Service will be transferred to the County Hall, S.E.I, on or about 16th October, 1932. F. N. KAY MENZIES, Medical Officer of Health. The County Hall, S.E.I. September, 1932. 92 APPENDIX F.—continued. [.Previous issues hereby cancelled.] London County Council. public health department. LONDON AMBULANCE SERVICE. {Headquarters, The County Hall, S.E. 1.] Facilities afforded by the London Ambulance Service with instructions for obtaining the help of the service. I. Ambulances Supplied Without Payment. The Council provides, within the Administrative County of London, ambulances, free of cost, for the conveyance to :— A.—Hospitals or private residences of:— (i) Persons meeting with accidents or suffering from sudden illnesses in the streets, public places, places of employment, etc.; (ii) Persons meeting with accidents in their homes ; (iii) Persons suffering from illnesses in their homes if a medical practitioner certifies that the case is one of life or death, and that arrangements have been made for the reception of the patient in a hospital ; (iv) Parturient women, if the case is one of urgency, whether from the home, place of business or elsewhere, on the application of a qualified medical practitioner or certified midwife, provided that either a doctor or midwife accompanies the case; and (v) Non-urgent cases of parturition if the call is made between the hours of 11 p.m. and 8 a.m. In such cases admission to a maternity bed must have previously been arranged and a card (issued by the Council to hospitals, maternity homes, etc.) for such admission obtained. This card must be handed to the ambulance attendant at the time of removal. In these cases the husband or a female friend must accompany the patient. (Note.—The Corporation of the City of London maintains its own ambulance service for dealing with cases of accident and illness occurring in the streets within the City area.) How to obtain an ambulance for :— Cases coming under classes (i) and (ii). No telephone number is required; ask the operator merely for "Ambulance." Cases coming under classes (iii), (iv) and (v). Ask the telephone operator (or dial) for one of the headquarters telephone numbers, namely : HOP 6000, NEW Cross 2645, CENtral 6300-1 or REGent 4000. In either case, when communication has been effected, particulars should be clearly given in this order : Locality of accident or illness, name of the caller. B.—The Council's hospitals for infectious cases :— Patients can only be removed if the following conditions have been fulfilled : A medical certificate must be handed to the ambulance nurse stating definitely the nature of the disease, and this disease must be one of those admissible to hospital. The nurse, on removing the patient, will leave at the house a notice stating the hospital to which the patient is to be taken, together with a copy of the regulations as to enquiries about, and visiting of, patients. The diseases admissible to hospital are the following :— Anthrax. Cerebro-spinal meningitis. Cholera. Continued fever. Diphtheria. Dysentery (a). Encephalitis lethargica. Enteric (or Typhoid or Para-typhoid) fever. Glandular fever. Malaria. Measles (or Morbilli). Membranous croup. Ophthalmia neonatorum (b). Plague. Polio-encephalitis. Polio-myelitis. Puerperal fever and Puerperal pyrexia. Relapsing fever. Scarlet fever (or Scarlatina). Smallpox (or Variola). Typhus. Whooping cough (or Pertussis) (a). Zymotic enteritis (or Infantile diarrhoea) (a). Notes.—In special circumstances, cases of chickenpox, german measles and mumps may be admitted. (a) Admitted only on application of medical officers of health of metropolitan boroughs. (b) Admitted on application of either a medical practitioner or a certified midwife (medical certificate not essential). C.—The Council's hospitals and institutions for non-infectious cases when application is made— (i) Through the Council's Public Assistance Department ; and (ii) By, or on behalf of, the Council's special, general and mental hospitals. 93 APPENDIX F.—continued. II. Ambulances Supplied on Payment. D.—Ambulances and ambulance-omnibuses are also provided by the Council, when not required for the purposes stated above, on payment of charges, as laid down from time to time by the Council, for the conveyance of infectious and non-infectious cases between private houses, hospitals (other than to the Council's hospitals, etc., under the provisions of Section I), nursing homes and for examinations, consultations and treatment by specialists or at special establishments. The conveyance of private persons between addresses both of which are outside the administrative county of London, cannot be undertaken, unless in circumstances of exceptional urgency. Arrangements for the reception of an infectious case must be made by or on behalf of the patient before application for an ambulance is sent to the Council, and a medical certificate as to the nature of the infection must be handed to the ambulance driver before the patient is removed. The charges as from and including 1st October, 1932, are as follows :— (a) Within the Administrative County of London (private cases), 12s. 6d. for the removal of one patient from one place to another within the administrative county of London, this charge to include, if necessary, the services of a male attendant. A doctor and one friend to be allowed to accompany the patient free of charge. Additional charges to be made as follows :— (i) 5s. if two patients are conveyed together; (ii) 2s. 6d. if the friend accompanying the patient wishes to return in the ambulance during the whole or some part of its journey to the ambulance station ; (iii) 5s. for a journey back to the first address or, on to further addresses, at 5s. plus the prescribed waiting fee, for each address ; (iv) 2s. 6d. a head for each additional person who desires to accompany the patient, together with 2s. 6d. for the return journey, if used; (v) 5s. for the services of a nurse for a period up to two hours and thereafter at an extra charge of 2s. an hour or part of an hour ; (vi) 5s. an hour or part of an hour for keeping an ambulance waiting more than 15 minutes. (b) For journeys extending outside the county and for work carried out for public authorities within and without the county :— For one or two persons, Is. 6d. a mile up to 50 miles and thereafter Is. 3d. a mile. For three or four persons, Is. 10\d. a mile up to 50 miles and thereafter Is. (id. a mile. For five to eight persons, 2s. 3d. a mile up to 50 miles and thereafter Is. 10^. a mile. For over 8 persons, particulars of charges may be obtained on application to the medical officer of health at the address given below. The mileage is reckoned on the total distance travelled by the ambulance from ambulance station back to ambulance station. The highest number of persons at one time on the journey to be charged for on the total mileage reckoned to and from the ambulance station. For a journey occupying over eight hours, an additional charge to be determined by the medical officer of health, to be made to cover drivers' expenses, and where the journey extends to a second day, the person ordering the vehicle to be required to arrange for garaging, and also for lodging and subsistence for the staff. Additional charges to be made as under (a), (v) and (vi) above. No charge will be made in respect of the conveyance by ambulance of patient's doctor who accompanies the patient in the ambulance. (Note.—The Council has entered into agreements with certain Metropolitan borough councils to hire to those councils, on reduced terms, ambulances for the conveyance of non-urgent maternity cases between the hours of 8 a.m. and 11 p.m. How to Obtain an Ambulance (or Ambulance-Omnibus) for:— Cases coming under classes (B) (C) and (D). Application should be made by telephone to Headquarters—telephone number, CITy 7200 (12 lines). III. General Notes. The vehicles are available at any hour of the day or night, including Sundays and public holidays, subject, in the case of private hire, to their not being required for the work of the Council. Applications may be made by telephone, as stated above, to the Headquarters, which is open continuously. Applications for vehicles may also be made by letter, telegraph, or personal call at the Headquarters or at any of the ambulance stations. Letters should be addressed to the :— Medical Officer of Health, London Ambulance Service, London County Council, The County Hall, S.E.I. 94 APPENDIX F.—continued. Except in the case of ambulances called for accidents, etc., under Section I.A., the following particulars are generally required in connection with applications for vehicles :— (a) Name, sex and age of patient and the address from which to be removed. (b) Certified disease. (c) Full address of the destination when it is other than one of the Council's hospitals or institutions. (d) Date and time when removal desired. (e) In appropriate cases the name and address of the person who accepts responsibility for payment of the charges. Ambulances (except those provided for the accident section of the service, which are staffed and equipped specially for that work) are equipped with stretcher, carrying-chair, blankets and pillow. A male attendant accompanies the driver, if required to assist with stretcher or chair. Ambulance-omnibuses are equipped for recumbent or sitting cases as required. In cases of private hire the charge should be paid to the driver before the patient enters the ambulance. The driver will give an official receipt for all sums received. Only light hand luggage can be carried in the vehicles. Infants in arms are not considered as additional passengers. Associations, authorities and others requiring repeated services may enter into special arrangements with the Council as regards payment. IV. Ambulance Stations. The Headquarters and the stations are open always, except those shown in italics, which are open on week-days from 7.30 a.m. to 11.30 p.m. Name of Station. Address. Battersea 119, Battersea Rise, S.W.I 1. Bloomsbury 15, Herbrand Street, Tavistock Square, W.C.I. Brook Shooter's Hill, S.E.18. Eastern Brooksby's Walk, E.9. Elephant and Castle 15, St. George's Market, London Road, S.E.I. Hackney Paragon Road, Mare Street, Hackney, E.9. Highbury Corsica Street, Highbury, N.5. Lee 142, High Road, Lee, S.E.13. North Kensington Silchester Mews, North Kensington, W. 10. North Western Lawn Road, N.W.3. Old Kent Road Canterbury Road, S.E.I5. Paddington Lyons Place, St. John's Wood, N.W.8. Poplar 7, Woolmore Street, E.14. Shoreditch 5, Montclare Street, E.l. South Eastern New Cross Road, S.E.14. South Western Landor Road, S.W.9. Streatham Mountearl Gardens, Wandsworth, S.IF.16. Western Seagrave Road, S.W.6. Westminster 93, Regency Street, S.W.l. Woolwich High Street, Woolwich, S.E.18.