AC 434 LON 59 LONDON. Printed by Drake. Driver & Leaver, Ltd., Rosebery Avenue, E.C.I. 1934. REPORT OF THE MEDICAL OFFICER OF HEALTH OF THE CITY OF LONDON FOR THE YEAR 1933 REPORT OF THE MEDICAL OFFICER OF HEALTH OF THE CITY OF LONDON For the Year 1933. LONDON. Printed by Drake, Driver & Leaver, Ltd., Rosebery Avenue, E.C.I 1934. index. A. PAGE. ANNUAL RATEABLE VALUE 7 APPENDICES 81 AREA 7 ARTIFICIAL CREAM ACT, 1928 52 ARTIZANS' DWELLINGS, STONEY LANE 62, 63 ATMOSPHERIC POLLUTION AND SMOKE 28 AGRICULTURAL PRODUCE (GRADING AND MARKING) ACT, 1923 49 B. BACTERIOLOGICAL EXAMINATIONS 17 BIRTHS 8 „ INFANT WELFARE 11, 12 „ NOTIFICATION 12 BLIND, WELFARE OF THE 12 BUTTER FACTORIES 52 c. CHILDREN AND YOUNG PERSONS ACT, 1932 12 CLEANSING OF PERSONS ACT, 1897 76 CLEANSING OF SCHOOL CHILDREN 76 COURTS, SUMMER FLUSHING OF 67 „ LIMEWASHING OF 67 CREMATION 29 COMMON LODGING HOUSES 66 CONGRESSES—ROYAL INSTITUTE OF PUBLIC HEALTH 23 —ROYAL SANITARY INSTITUTE 23 —SANITARY INSPECTORS' ASSOCIATION 23 D. DENSITY 7 DIPHTHERIA—ANTI-TOXIN 17 DISINFECTANTS, SUPPLY OF 76 DISINFECTION—INFECTIOUS DISEASES 76 DISINFECTION OF SECOND-HAND CLOTHING 76 DRAINAGE PLANS 67 E. EXHUMATION AND REINTERMENT OF BODIES AT CITY OF LONDON CEMETERY 68 „ „ „ HOUNDSDITCH AND BACK GRAVEL LANE, AND BANK OF ENGLAND 68 F. FACTORY AND WORKSHOP ACT, 1901—ABOVEGROUND BAKEHOUSES 69 „ „ „ —FACTORIES, WORKSHOPS AND WORKPLACES 68-73 „ „ „ —OUTWORKERS 69-74 „ „ „ —SUMMARY OF INSPECTIONS 73 „ „ „ —SUMMARY OF WORK DONE 70 „ „ „ —UNDERGROUND BAKEHOUSES 69 FERTILISERS AND FEEDING STUFFS ACT, 1926 50 FISH SUPPLIES AND SEIZURES 42 FOOD AT RIVERSIDE WHARVES, INSPECTION AND CONDEMNATION 47-49 FOOD AND DRUGS—ADMINISTRATIVE ACTION 54-57 „ „ —PROSECUTIONS 60 „ „ —SUMMARY OF ARTICLES EXAMINED 58, 59 „ „ —SUPERVISION OF 50 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 OK LONDON CEMETERY 68 „ „ „ HOUNDSDITCH AND BACK GRAVEL LANE, AND BANK OF ENGLAND 68 I. ICE CREAM 75 INFANTILE MORTALITY 8 INFANT WELFARE 11 INFECTIOUS DISEASE 14 „ „ —BACTERIOLOGICAL AND PATHOLOGICAL EXAMINATIONS 17 „ „ —DIPHTHERIA ANTI-TOXIN 14, 15 „ „ —NOTIFICATION OF 15,16 „ „ —NURSING PROVISION—MEASLES, ENCEPHALITIS LETHARGICA, CEREBROSPINAL FEVER AND INFLUENZA 17 „ „ —SMALLPOX 17 „ „ —TUBERCULOSIS 21-27 „ „ —VENEREAL DISEASES 18-20 INQUESTS 76 INSULIN, PROVISION OF 17 INTRODUCTION 7 INDEX (continued). L. page. LEGAL PROCEEDINGS—SANITARY 67 LIMEWASHING OF COURTS 67 L.C.C. (G.P.) ACT, 1932—PREPARATION OF PRESERVED MEAT, &c. 45 LODGING HOUSES, COMMON—116, MIDDLESEX STREET 66 „ „ REGISTERED65 M. MARGARINE, REGISTRATION OF DEALERS IN MARGARINE AND MARGARINE CHEESE 52 MATERNITY AND CHILD WELFARE 11, 12 MEASLES 17 MEAT INSPECTIONS 30 „ „ -CASEOUS LYMPHADENITIS 37 „ „ —DELIVERY AT CENTRAL MARKETS 41 „ „ —DEMONSTRATIONS AND INSTRUCTION 40 „ „ —EXPORT OF MEAT 40 „ „ —HOME-KILLED MEAT SEIZED 34 „ „ —(IMPORTED FOOD) REGULATIONS. 1933 43 „ „ —LEADENHALL MARKET AND CITY SHOPS 37 „ „ —LIVESTOCK IMPORTED 31 „ „ —PRODUCTION IN S. AMERICA 42 „ „ —PROSECUTIONS 40 „ „ —PUBLIC HEALTH (MEAT) REGULATIONS, 1924 44-46 „ „ —SEIZURES OF IMPORTED MEAT 39 „ „ -UNSOUND MEAT REMOVED FROM COLD STORES 37 MEDICAL EXAMINATIONS 79 MERCHANDISE MARKS ACT, 1926 49 MILK—BACTERIOLOGICAL AND CHEMICAL EXAMINATIONS FOR TUBERCULOSIS AND DIRT (RAILWAY STATIONS) 53-55 „ —CHEMICAL EXAMINATION OF 51 „ —PUBLIC HEALTH (CONDENSED MILK) REGULATIONS, 1923 & 1927 52 „ —PUBLIC HEALTH (DRIED MILK) REGULATIONS, 1923 & 1927 52 „ —MILK AND DAIRIES (AMENDMENT) ACT, 1922 52 „ —MILK AND DAIRIES ORDER, 1926 52 MORTALITY 8 „ —INFANTILE 8 „ —MATERNAL 12 „ —VIOLENCE 8 „ — PHTHISIS 8 „ —ZYMOTICS 8 MORTUARY—CHAPEL 76 „ —DISINFECTION OF CLOTHING FOR EXPORT, INQUESTS, Etc. 76 „ —PRESERVATION OF BODIES OF UNKNOWN DEAD 76 N. NOTIFICATION OF BIRTHS ACT, 1907, AND INFANT WELFARE WORK 11, 12 NURSING PROVISIONS 17 O. OUTWORKERS 69-74 OVERCROWDING 67 P. PIGEONS—L.C.C. (GENERAL POWERS) ACT, 1927 68 POPULATION 7 POST GRADUATE NURSING COURSE 17 PRESERVED MEAT, &c., PREPARATION OF—L.C.C. (G.P.) ACT, 1932 45 PUBLIC HEALTH—(CONDENSED MILK) REGULATIONS, 1923 & 1927 52 „ „ — (DRIED MILK) REGULATIONS, 1923 & 1927 52 „ „ —(IMPORTED FOOD) AMENDMENT REGULATIONS, 1933 43 „ „ —(MEAT) REGULATIONS, 1924 44-46 „ „ —(PREVENTION OF TUBERCULOSIS) REGULATIONS, 1925 17 „ „ —(TUBERCULOSIS) REGULATIONS, 1930 27 R. RAILWAY STATIONS—SAMPLES OF MILK 60-62 RATEABLE VALUE 7 RAT REPRESSION 77, 78 REFUSE REMOVAL 67 s. SANITARY DEFECTS AND INFECTIOUS DISEASE 67 SANITARY INSPECTIONS 64 SEWER, DEFECTIVE CONNECTIONS 67 SMALLPOX 17 SMOKE AND ATMOSPHERIC POLLUTION Z 28 STAFF 5 STATISTICAL INFORMATION 10 STREET GULLIES 67 T. TUBERCULOSIS 21-27 „ —PUBLIC HEALTH (PREVENTION OF TUBERCULOSIS) REGULATIONS, 1925 17 „ —TRAINING OF HEALTH VISITORS 17 V. VACCINATION 10 VENEREAL DISEASES 18-20 VIOLENT DEATHS 8 VITAL STATISTICS 10 STAFF. MEDICAL OFFICER OF HEALTH. Date of Appointment. Willoughby, Willoughby Mason, B.A., M.D., B.C. (Cantab.), D.P.H. (Camb.) May, 1928 CLERICAL STAFF. Lowe, George Principal Assistant and Vaccination Officer 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 Threadgold, Arthur W. Nov., 1923 Lee, W. R. June, 1930 Tunbridge, Mrs. Unclassified Jan., 1917 Bernhardt, D. R. May, 1931 Holdrup, F. A. March, 1932 SANITARY INSPECTORS. Robinson, Ernest S. Feb., 1913 Fowler, George Henry Grade I. Oct., 1920 McGrath, William Richard Mar., 1922 Harrington, George Edwin Dec., 1925 Sillet, David Ernest April, 1926 Fisher, Stanley G. July, 1928 Neale, William G. C. Grade II. 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 MEAT INSPECTION STAFF. Young, T. Dunlop, O.B.E., M.R.C.V.S., D.V.S.M., Veterinary Surgeon Nov., 1909 Sharp, J. Owen, Senior Inspector May, 1892 Bintcliffe, Charles E. March, 1907 Matson, William S. Dec., 1910 Mitchener, William E. Grade I. Inspector Dec., 1910 Jones, John April, 1914 Slatter, Charles May, 1908 Murray, Samuel B. Sept., 1911 Mellish, Cyril E. Grade II. Inspector Jan., 1912 Thompson, Frank E. July, 1924 Perris, G. A. Dec., 1923 Cann, S. W. May, 1927 Cole, E Grade III. Inspector 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 1933. To the Right Honourable The Lord Mayor, Aldermen and Commons of the Corporation of London. Public Health Department, Guildhall, E.C. June, 1934. My Lord Mayor and Gentlemen, I have the honour to present my seventh Annual Report on the work of the Department of the Medical Officer of Health for the City of London. 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 £60,384,592, on April 6th, 1933, whilst on the same date the corresponding rateable value of property in the City of London was £8,893,115, or about one-seventh of the whole County. The annual sum receivable from a penny rate is £34,750. 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. 1911. 1921. 1911. 1921. 1921. City of London (Not including the Temple) 661 2,784 2,398 19,657 13,709 3,174 These figures represent the population on the nights of the 3rd April, 1911, and the 19th June, 1921. The following table shows the progressive decline which has taken place since 1861 in number of inhabitants who reside within the City boundaries, and the progressive increase 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. B 2 8 The estimated population of the City, for the year 1933, is 9,830. 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 1933, 396 live births were registered in the City, 353 of which, however, did not belong thereto. To the remaining 43 must be added the births of 40 children born to citizens temporarily residing outside the City boundary. The number of births, therefore, on which the rate should be calculated is 83. There were seven still births. The annual birth-rate was 8.4 per 1,000 persons of all ages, compared with a quinquennial mean rate of 7.0 per 1,000. In the Metropolis the birth-rate in 1933 was 13.2 per 1,000. Mortality.—During the year under review, 572 deaths were registered in the District, including 521 persons dying in the City, but not belonging thereto. Deducting these latter, 51 deaths remain, to which must be added those of 57 persons who died in outside districts, where they were registered; the total, therefore, on which the City death-rate is calculated is 108. See table, p. 10 for details. The death-rate for 1933 was 10.9 per 1,000 per annum of the population (the previous year being 12.8), whilst that for the whole of the Metropolis was 12.2. Deaths from Violence.—Of the City deaths, 4.6 per cent. were caused by injuries or violence, as compared with 5.9 in 1931 and 10.2 in 1932. This is 1.4 below the average for the previous five years. PERCENTAGE OF REGISTERED DEATHS FROM VIOLENCE. Year. City of London. Metropolis. Per cent. Per cent. 1928 2.8 5.5 1929 2.7 5.6 1930 8.5 5.5 1931 5.9 5.7 1932 10.2 4.6 Average previous five years 6.0 5.4 1933 4.6 4.7 DEATH RATES, PER 1,000 PER ANNUM. Year. City of London. 118 Great Towns of England and Wales. Metropolis. 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 1932 12.8 12.2 12.3 Average previous five years 12.7 12.3 12.3 1933 10.9 12.2 12.2 The death-rate from zymotic disease per 1,000 of the population was 0.2. 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 60 per 1,000 births, as against 59 for the whole of London. 9 CAUSES OF, AND AGES AT, DEATH DURING THE YEAR 1933. 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. 108 5 ... ... ... 4 2 7 18 12 27 33 471 1. Typhoid and Paratyphoid Fevers .... .... .... .... .... .... .... .... .... .... .... .... .... 2. Measles .... .... .... .... .... .... .... .... .... .... .... .... .... 3. Scarlet Fever .... .... .... .... .... .... .... .... .... .... .... .... .... 4. Whooping Cough .... .... .... .... .... .... .... .... .... .... .... .... .... 5. Diphtheria .... .... .... .... .... .... .... .... .... .... .... .... 1 6. Influenza 6 .... .... .... .... 1 .... 1 .... 1 3 .... 2 7. Encephalitis Lethargica .... .... .... .... .... .... .... .... .... .... .... .... .... 8. Cerebro-spinal Fever .... .... .... .... .... .... .... .... .... .... .... .... 2 9. Tuberculosis of Respiratory System 7 .... .... .... .... 1 1 .... 1 1 2 1 7 10. Other Tuberculous Diseases 1 1 .... .... .... .... .... .... .... .... .... .... 13 11. Syphilis .... .... .... .... .... .... .... .... .... .... .... .... .... 12. General Paralysis of the Insane, Tabes Dorsalis 1 .... .... .... .... .... .... .... 1 .... .... .... .... 13. Cancer, Malignant Disease 12 .... .... .... .... .... .... 2 3 1 5 1 89 14. Diabetes 1 .... .... .... .... .... .... .... .... .... 1 .... 10 15. Cerebral Haemorrhage, &c. 3 .... .... .... .... .... .... .... .... .... 1 2 7 16. Heart Disease 30 .... .... .... .... 1 .... .... 4 3 7 15 30 17. Aneurysm 1 .... .... .... .... .... 1 .... .... .... .... .... 4 18. Other Circulatory Diseases 4 .... .... .... .... .... .... .... 2 1 .... 1 9 19. Bronchitis 5 .... .... .... .... .... .... .... 1 .... 1 3 5 20. Pneumonia (all forms) 7 1 .... .... .... 1 .... 1 1 2 .... 1 39 21. Other Respiratory Diseases 4 .... .... .... .... .... .... 1 .... 1 1 1 3 22. Peptic Ulcer 3 .... .... .... .... .... .... 1 .... 1 .... 1 21 23. Diarrhœa, &c. 2 1 .... .... .... .... .... .... 1 .... .... .... 10 24. Appendicitis .... .... .... .... .... .... .... .... .... .... .... .... 18 25. Cirrhosis of Liver 1 .... .... .... .... .... .... .... .... 1 .... .... 5 26. Other Diseases of Liver, &c. .... .... .... .... .... .... .... .... .... .... .... .... 4 27. Other Digestive Diseases 1 .... .... .... .... .... .... .... .... .... 1 .... 1 28. Acute and Chronic Nephritis 5 .... .... .... .... .... .... .... 3 .... .... 2 22 29. Puerperal Sepsis 1 .... .... .... .... .... .... 1 .... .... .... .... 2 30. Other Puerperal Causes .... .... .... .... .... .... .... .... .... .... .... .... .... 31. Congenital Debility, Premature Birth, Malformations, &c. 1 1 .... .... .... .... .... .... .... .... .... .... 15 32. Senility 2 .... .... .... .... .... .... .... .... .... .... 2 .... 33. Suicide 1 .... .... .... .... .... .... .... .... .... .... 1 3 34. Other Violence 4 1 .... .... .... .... .... .... 1 .... 1 1 24 35. Other Defined Causes 5 .... .... .... .... .... .... .... .... .... 4 1 122 36. Causes ill-defined or unknown .... .... .... .... .... .... .... .... .... .... .... .... 3 Totals 108 5 .... .... .... 4 2 7 18 12 27 33 471 10 VITAL STATISTICS OF WHOLE DISTRICT DURING 1933 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 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 1932 9,990 397 65 6.5 650 65.06 593 71 3 46 128 12.8 Average previous 5 years 10,726 419 75 7.0 691 64.40 627 70 3 68 137 12.7 1933 9,830 396 83 8.4 572 58.18 521 57 5 60 108 10.9 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 396 births notified to the Vaccination Officer during 1933, 145 had been successfully vaccinated by the end of the year, 18 had died before the age for vaccination and 3 were reported as insusceptible. Vaccination was postponed by medical certificate in 1 case, 140 had removed into other districts, or the vaccinations were pending at the end of the year. There were 89 instances of conscientious objection. The Public Vaccinator performed 6 re-vaccinations during the year, and in addition to the 145 successful vaccinations referred to above, 9 adult persons were vaccinated for the first time. VACCINATION STATISTICS IN THE CITY OF LONDON. Year. Number of Births notified to Vaccination Officer. Successfully Vaccinated. Insusceptible. Had Small-pox. Died before Vaccination. Vaccination postponed. Cases pending or removed at the end of the year. Conscientious objections 1928 432 per cent. 31.1 per cent. Nil. per cent. Nil. per cent. 4.4 per cent. Nil. per cent. 38.4 per cent. 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 1932 413 41.7 0.7 „ 3.4 0.3 33.1 21.3 Average previous 5 years. 424 29.0 0.1 „ 3.1 0.4 42.7 24.7 1933 396 36.7 0.7 „ 4.5 0.2 35-4 22-5 11 MATERNITY AND CHILD WELFARE. Three hundred and seventy notifications of births, including 20 still births, made in accordance with the requirements of the Notification of Births Act, were received. Of these, 67 only referred to City births, and the balance were transferred to the appropriate authorities. Sixty-seven initial visits were made as a consequence of these notifications, and 1,138 subsequent visits in connection with infant welfare and ante-natal work, in addition to 11 special nursing visits. One visit was made in connection with a case which came within the scope of the Children Act, 1908, and one in respect of a nurse child. Supplies of milk and dried milk, at cost price or free, according to circumstances, have been provided, according to the practice which has been in operation for some years. Cod Liver Oil is also given if its administration appears to be desirable. In no case was home help necessary during 1933. There were no notifications of verminous school children under the London County Council (General Powers) Act, 1904. One visit was made in connection with infant life protection and two in connection with cases of Ophthalmia. The lying-in accommodation provided by the City Corporation at St. Bartholomew's Hospital, in accordance with the provisions of the Local Government Act, 1929, was utilized by two mothers during 1933. Dr. Charles F. Harris, who is in charge of the Corporation Clinic held at St. Bartholomew's Hospital, has kindly prepared the following brief report on the working of the Clinic during 1933 :— THE CITY OF LONDON WELFARECENTRE, HELD AT ST. BARTHOLOMEW'S HOSPITAL. The Welfare Centre was reorganised at the beginning of 1933. It will be recalled that the innovations then introduced were the appointment of a medical officer to attend at the sessions and the appointment of a trained health visitor to visit the infants in their homes and to carry out the non-medical duties at the weekly sessions of the centre. The medical officer seeing the children during 1933 was Dr. A. W. Franklin, and the health visitor was Miss S. A. Backhouse. Of the total number of 219 infants under 5 years of age in the City, 164 attended the centre during 1933. The total attendances during the year numbered 1,800. It is a matter of congratulation that so high a proportion of the infant population made use of the centre, a proportion that compares favourably with any other area within my knowledge. The number of home visits carried out by Miss Backhouse was 1,043, and this undoubtedly contributed largely to this satisfactory result. The average monthly attendances of infants rose during the course of the year from 77 in January to 227 in November (the figure 150 for December is not comparable because of the holiday). It seems probable that one of the most satisfactory features of the welfare centre is its close association with the children's department of the Hospital. Although it is run as an entirely separate enterprise for the management of healthy infants, it is possible for the mothers to get advice at the Hospital, if their babies should fall sick between the sessions of the centre; also the transfer of an ill child for treatment from the centre to the children's department of the Hospital is an extremely simple matter. The point is illustrated by the fact that in 1933 six of the babies attending the centre were admitted to the children's ward of the Hospital for the treatment of diseases discovered at the centre. Furthermore, in the course of the year, over 2,000 bottles of medicine of one sort or another were issued by the Hospital dispensary to babies attending the centre. It goes without saying that the City of London Welfare Centre is capable of still further development; yet it can be said with confidence that it has as great possibilities of usefulness as any similar enterprise in the country. (Signed) CHARLES F. HARRIS, M.D., F.R.C.P., Physician to the Children's Department, St. Bartholomew's Hospital. 12 The following is a tabulated statement of the work carried out by your Health Visitor in the above connection:— MATERNITY AND CHILD WELFARE, 1933. Birth Notifications received 67. Infant Welfare Centre. 50 Sessions:— Under 1 year 993 Total 1,800 Over 1 year 807 attendances. Mothers attended during year 157 „ left City „ „ 14 No. Children becoming over 5 during year 32 Total visits 1,138:— Under 1 year 393 Over 1 to 5 years 640 Ante-Natal 94 Ophthalmia 2 Deaths under 1 year 3 Still Births 5 Infant Life Protection 1 MATERNAL MORTALITY. The enquiries into maternal deaths, which the Ministry of Health has required to be conducted, has not called for any particular organisation in my Department. With a small City resident population, few deaths in this category are reported. Where such cases do occur, investigations are conducted by me. One case was reported during 1933. It may be of interest to note that, from 1900 to 1933 inclusive, only 16 maternal deaths have occurred amongst City residents. CHILDREN AND YOUNG PERSONS ACT, 1932. Section 65 of the above-mentioned Act makes it obligatory upon any person residing in the City, undertaking for reward the nursing and maintenance of an infant under the age of 9 years, apart from its parents, to give notice to the Corporation— (a) In the case of an infant not already in his care, being the first infant proposed to be received for reward, not less than seven days before he receives the infant. (b) In the case of any other infant not already in his care, not less than 48 hours before he receives the infant. (c) In the case of an infant already in his care without reward, within 48 hours after entering into the undertaking for reward. The Corporation are empowered by Section 66 to fix the number of infants under the age of 9 years who may be kept in any dwelling in which there is an infant in respect of whom notice is required, and to impose conditions where the number may be exceeded. Power is given for removal of infants kept in unsuitable premises or by unsuitable persons. The foregoing are amendments and extensions of obligations empowered by the Children Act, 1908. The number of cases in which the legislation applies in the City is very small, but in view of the fact that important alterations were made in the responsibilities of foster-parents, appropriate advertisements were made in the form attached to the Schedule in the Memorandum on the subject issued by the Ministry of Health. Your Tuberculosis Sister and Health Visitor, Miss S. A. Backhouse, was appointed Protection Visitor under Part 2 (2) of the Children Act, 1908. WELFARE OF THE BLIND. Paragraph 3 of the Memorandum 162 B.D., issued by the Ministry of Health, suggests that blind children under school age have escaped inclusion on the Register of the Blind because of confusion as to which department of the local authority is responsible for their welfare. Co-operation between the Blind Persons Act Committee and the Infant Welfare Act Committee is deemed to be of importance in this connection, and this co-operation has now been established in the City. 13 The causes of blindness are such as to suggest much of this disability in children as a matter for prevention. Prominent causes are accident, syphilis, purulent conjunctivitis, congenital defects, and ophthalmia neonatorum. Half of the blindness due to purulent conjunctivitis is deemed avoidable, at least two-thirds of the syphilis, and almost all the ophthalmia neonatorum. It is considered that only one child in five is born in a clean home in England, hence purulent conjunctivitis, but feeding may have influence in this matter. As regards gonococcal infection of the eyes, this can be nearly obviated by proper attention to the child at birth. Syphilis can be largely prevented according to the use made by the syphilitic pregnant woman of the facilities for cure of her disease. A syphilitic pregnant person, treated from the early months of pregnancy, will bear a normal child. Children born syphilitic, with persistent treatment from early birth, are rendered normal. It, therefore, appears that gonococcal and syphilitic blindness should be reduced under systems of ante-natal and post-natal care in properly arranged clinics. Congenital syphilis, untreated, shows itself in the eyes at any time between the ages of 2 and 35, and 2 to 10 years of treatment is then necessary before even a quiescent stage in the disease is reached. There remain many diseases of the eye which are truly hereditary in nature, and which are handed on inevitably from generation to generation in more or less well-known mendelian ways; these can be but registered, prevention in them is a matter of eugenics. The country, however, is turning over in its sleep on this subject. The Memorandum of the Advisory Committee recognises the difficulty of determining whether a child under the school age is a blind person within the meaning of the Blind Persons Act, and that it requires discretion on the part of the registering body to determine whether a child is suitable for registration; but where there is doubt, it is deemed preferable to register a child under the school age as blind, in order to keep it under observation, rather than run risk of the lapse of a number of years before steps are taken to provide the special education it may require. The close liason now established with St. Bartholomew's Hospital in the matters of infant welfare and the treatment of venereal disease is an agency well calculated to do a large preventive work and to make early note of the cases which arise. Circular 1353 of the Ministry of Health on the certification of blindness draws attention to the following points:— (1) A person should not be registered as blind until satisfactory medical evidence of blindness is produced. (2) Local Authorities should consider the desirability of the examination and certifying of a blind person by a medical practitioner with special experience in ophthalmology—i.e., a medical practitioner in charge of the ophthalmic department of a General Hospital, or one holding a recognised diploma in ophthalmology, or one who, by reason of special experience in the practice of ophthalmology, is fully competent to secure a correct and just certification. (3) A form of certification designed to be at once a certificate and a record for compilation of statistics of scientific value, which should be used in every case of blindness placed upon the register. The Minister and Board of Education have authorised the Prevention of Blindness Committee to collate and tabulate the statistics for the use of local authorities. An appendix to the circular gives intimate technical directions for the use of the certifying ophthalmologist and a definition of blindness for the purposes of the Blind Persons Act, 1020. For registration the person must be "so blind as to be unable to perform any work for which eyesight is essential"—i.e., not his ordinary or any particular work, but any work. It is recognised in this stringency, however, that a person with recent defect is less able to adapt himself to his environment than a person whose defect in acuity of vision is of long standing; and an old person with recent failure of sight, so readily as a young person with equal defect. The Metropolitan Society for the Blind, who are the agents for the Corporation, report for the year 1932-33 that the City of London blind number only 15, of whom in seven blindness occurred below the age of 50, in four below 30, and in two below 20. No one of the City blind is now below age 30. The services of an ophthalmologist have been obtained through the medium of St. Bartholomew's Hospital, at a fee of two guineas for examination and certification. C 14 INFECTIOUS DISEASES. One hundred and six cases of infectious disease were notified or reported during the year 1933. 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 18th day of March, 1934. Appropriate notice to interested parties was given, a copy of which is reproduced in Appendix E of this Report. Fifteen of the cases reported were Diphtheria, compared with 22 in 1932. The number of Scarlet Fever cases was 39, compared with 29 in 1932. There were 10 cases of Erysipelas. Measles and German Measles are not notifiable diseases, but 21 cases of the former illness were brought to my notice by medical practitioners and through the medium of the school medical service. Seventeen cases of Chicken-pox were notified, 1 of Enteric Fever, 1 case of suspected food poisoning, 1 of Ophthalmia Neonatorum, and 1 of Cerebro-Spinal Meningitis. 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 (56. In the following tables will be found particulars relating to cases of infectious disease, and information as to the removal of patients to hospitals. 15 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 15 .... 15 .... .... .... 4 11 Scarlet Fever 39 4 30 3 .... 2 3 34 Enteric Fever (including Para-typhoid) l .... .... .... l .... .... 1 Puerperal Fever .... .... .... .... .... .... .... .... Puerperal Pyrexia .... .... .... .... .... .... .... .... Erysipelas 10 3 .... .... 5 2 .... 8 Cerebro-spinal Meningitis l .... 1 .... .... .... .... 1 Acute Polio-myelitis .... .... .... .... .... .... .... .... Ophthalmia Neonatorum l .... .... .... 1 .... .... 1 Malaria contracted abroad .... .... .... .... .... .... .... .... Acute Primary Pneumonia .... .... .... .... .... .... .... .... Acute Influenzal Pneumonia .... .... .... .... .... .... .... .... Encephalitis Lethargica .... .... .... .... .... .... .... .... Food poisoning or suspected food poisoning l 1 .... .... .... .... .... 1 Amoebic Dysentery .... .... .... .... .... .... .... .... Chicken-pox 17 13 2 .... 1 1 .... 16 Totals 85 21 48 3 8 5 7 73 Measles 21 6 14 1 .... .... .... 21 Totals 106 27 62 4 8 5 7 94 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 1933 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 1928 51 96.0 4.0 1929 60 90.0 10.0 1930 58 93.1 6.9 1931 38 94.7 5.3 1932 57 91.2 8.8 Average for the five years 52.8 93.0 7.0 1933 56 87.5 12.3 C 2 16 CASES OF INFECTIOUS DISEASE AND TUBERCULOSIS NOTIFIED DURING THE YEAR 1933. NUMBER OF ACTUAL CASES NOTIFIED. DISEASES. At Ages—Years. No. of Cases Removed toH ospital. * 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 11 1 .... .... .... .... 4 .... .... 3 2 .... l 11 Erysipelas 8 .... .... .... .... .... .... .... .... 2 2 4 .... 5 Scarlet Fever 34 .... .... .... 2 .... 13 6 3 10 .... .... .... 30 Typhus „ .... .... .... .... .... .... .... .... .... .... .... .... .... .... Enteric „ (including Para-typhoid) 1 .... .... .... .... .... .... .... .... 1 .... .... .... 1 Relapsing „ .... .... .... .... .... .... .... .... .... .... .... .... .... .... Continued ,, .... .... .... .... .... .... .... .... .... .... .... .... .... .... Puerperal „ .... .... .... .... .... .... .... .... .... .... .... .... .... .... Puerperal Pyrexia .... .... .... .... .... .... .... .... .... .... .... .... .... .... Polio-myelitis .... .... .... .... .... .... .... .... .... .... .... .... .... .... Cerebro-spinal Meningitis 1 .... .... .... .... .... .... .... 1 .... .... .... .... 1 Pulmonary Tuberculosis 22 .... .... .... .... .... .... .... 1 11 7 3 .... 22 Other forms of Tuberculosis 4 1 .... .... .... .... 1 .... .... 2 .... .... .... 3 Ophthalmia Neonatorum 1 1 .... .... .... .... .... .... .... .... .... .... .... 1 Measles 21 .... 3 2 3 3 8 .... .... 1 1 .... .... 15 Rubella .... .... .... .... .... .... .... .... .... .... .... .... .... .... Chicken-pox 16 .... .... 2 1 .... 9 3 .... 1 .... .... .... 3 Malaria (contracted abroad) .... .... .... .... .... .... .... .... .... .... .... .... .... .... Acute Primary Pneumonia .... .... .... .... .... .... .... .... .... .... .... .... .... .... Acute Influenzal Pneumonia .... .... .... .... .... .... .... .... .... .... .... .... .... .... Encephalitis Lethargica .... .... .... .... .... .... .... .... .... .... .... .... .... .... Amœbic Dysentery .... .... .... .... .... .... .... .... .... .... .... .... .... .... Food Poisoning 1 .... .... .... .... .... .... .... .... .... 1 .... .... .... Totals 120 3 3 4 6 3 35 9 5 31 13 7 l 92 * L..C.C. Hospitals, London Fever Hospital, St. Bartholomew's Hospital. City Police Hospital, Sanatoria, &c. 17 MEASLES. The customary arrangements were made for dealing with the bi-annual epidemic of measles in schools, and in Appendix F will be seen a copy of a communication which was handed, through the head teachers, to parents of all children entering Infants' Departments of schools where measles was reported, directing attention to the importance of early treatment of the malady. At the same time all mothers attending the Infant Welfare Centre were similarly advised. SUMMARY OF SMALL-POX FOR THE YEAR ENDING 31st DECEMBER, 1933. 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, 1933, was 34. The total number of persons in contact with cases ascertained or notified during the period ended 31st December, 1933, was 490. 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 1933. 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 1933. 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 7.5 per cent. of these cases. Disease Suspected. Result. Specimens. Positive. Negative. 28 Swabbings from throats Diphtheria 2 26 12 Sputa Tuberculosis 1 11 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. 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. POST-GRADUATE NURSING COURSE. With the approval of your Committee, your Tuberculosis Sister and Health Visitor attended a special post-graduate course of nursing organised by the College of Nursing in June last. 18 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 1,023. The following is a brief summary of the work carried out during 1933:— At the beginning of the year 489 males and 187 females were registered on the books as being under treatment or observation, which compares with 563 males and 220 females at the beginning of the previous year. Of these patients, 334 males and 174 females were under treatment for syphilis, and 155 males and 13 females for gonorrhoea. No patients were under treatment for conditions other than venereal disease. New patients admitted totalled 1,023, as compared with 981 in the previous year, the total attendances were 30,377. Unfortunately, 204 cases discharged themselves before completion of treatment, and 204, although completing treatment, failed to submit themselves to final test. Twelve males and 10 females were transferred to other centres after treatment, whilst 442 males and 90 females were discharged after completion of treatment and observation. There were 6 in-patients. The total number of attendances is made up as follows:— Syphilis. Soft Chancre. Gonorrhœa. Non-Venereal Conditions. Total Attendances. Male. Female. Male. Female. Male. Female. Male. Female. Male. Female. 14,301 6,025 - - 8,347 1,214 309 70 23,068 7,309 The following summary shows the work carried out during each year that the Centre has been in operation. Year. New Patients. Total. Total Attendances. " 606." Bismuth. Mercury. In-Pts. Path. Ex. Men. Women. 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 1933 845 178 1,023 30,377 4,155 8,532 .... 6 8,314 Totals 7,756 2,505 2,330 273,531 42,418 39,974 17,975 316 98,739 † Including 30 patients who are known to have received treatment at other Centres and referred to in Item 4 of annual return. In the laboratories associated with the Centre, 8,314 specimens were examined, 28 for the detection of spirochetes, 1,712 for gonococci, 6,370 examinations for the Wassermann or serum test, and 204 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 detection of Spirochetes, of Gonococci, and for the Wassermann or Serum test in respect of these patients No. of patients treated. Examinations. For Wassermann or Serum Test Reactions. For Syphilis. For Gonorrhœa. For Non-Venereal Conditions. For Spirochetes. For Gonococci. London 256 387 355 28 1,704 6,366 Essex 1 — 6 — — 4 Herts. — — 1 — - — Surrey — 4 7 — 4 — Kent — 1 5 — 4 — Middlesex — — — — — Sussex — — — — — — Totals †257 †392 374 28 1,712 6,370 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, 1933. Syphilis. Soft Chancre. Gonorrhœa. 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 334 174 .... .... 155 13 .... .... 489 187 676 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 28 4 .... .... 24 .... .... .... 52 4 56 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 25 3 .... .... .... .... .... .... 25 3 28 „ secondary 43 26 .... .... .... .... .... .... 43 26 69 ,, latent in 1st year of infection 49 26 .... .... .... .... .... .... 49 26 75 „ all later stages 51 3 .... .... .... .... .... .... 51 3 54 ,, congenital 11 10 .... .... .... .... .... .... 11 10 21 Soft Chancre .... .... .... .... .... .... .... .... .... .... .... Gonorrhœa, 1st year of infection .... .... .... .... 263 41 .... .... 263 41 304 later .... .... .... .... 67 1 .... .... 67 1 68 Conditions other than venereal .... .... .... .... .... .... 309 65 309 65 374 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 7 3 .... .... 20 .... .... .... 27 3 30 Total of Items 1, 2, 3 and 4 548 249 .... .... 529 55 309 65 1,386 369 1,755 5. Number of cases discharged after completion of treatment and final tests of cure (see Item 15) 23 4 .... .... 123 23 296 63 442 90 532 6. Number of cases which ceased to attend before completion of treatment and were, on first attendance, suffering from:— Syphilis, primary 24 .... .... .... .... .... .... .... 24 .... 24 „ secondary 22 16 .... .... .... .... .... .... 22 16 38 „ latent in 1st year of infection 33 20 .... .... .... .... .... .... 33 20 53 „ all later stages 18 10 .... .... .... .... .... .... 18 10 28 ,, congenital 1 4 .... .... .... .... 1 4 5 Soft Chancre .... .... .... .... .... .... .... .... .... .... .... Gonorrhœa, 1st year of infection .... .... .... .... 74 6 .... .... 74 6 80 „ later .... .... .... .... 32 .... .... .... 32 .... 32 7. Number of cases which ceased to attend after completion of treatment but before final tests of cure (see Item 15) 91 10 .... .... 113 .... .... .... 204 10 214 8. Number of cases transferred to other centres or to institutions, or to care of private practitioners:— 2 8 .... .... 10 2 .... .... 12 10 22 9. Number of cases remaining under treatment or observation on 31st December 334 177 .... .... 177 24 13 2 524 203 727 Totals of Items 5, 6, 7, 8 and 9 (These totals should agree with those of Items 1, 2, 3 and 4.) 548 249 .... .... 529 55 309 65 1,386 369 1,755 10. Number of cases in the following stages of syphilis included in Item 6 which failed to complete one course of treatment:— Syphilis, primary 12 .... .... .... .... .... .... .... 12 .... 12 „ secondary 11 3 .... .... .... .... .... .... 11 3 14 ,, latent in 1st year of infection 14 9 .... .... .... .... .... .... 14 9 23 ,, all later stages 10 3 .... .... .... .... .... .... 10 3 13 „ congenital .... 3 .... .... .... .... .... .... .... 3 3 11. Number of attendances:— 1 (a) for individual attention of the medical officers 14,301 6,025 .... .... 3,267 828 420 70 17,988 6,923 24,911 (b) for intermediate treatment, e.g., irrigation, dressing .... .... .... .... 5,080 386 .... .... 5,080 386 5,466 Total Attendances 14,301 6,025 .... .... 8,347 1,214 420 70 23,068 7,309 30,377 12. In-patients:— (a) Total number of persons admitted for treatment during the year .... .... .... .... 4 2 .... .... 4 2 6 (b) Aggregate number of "inpatient days "of treatment given .... .... .... .... 167 101 .... .... 167 101 268 20 Return relating to all persons who were treated at the Treatment Centre at St. Bartholomew's Hospital during the year ended the 31st December, 1933.—continued. Under 1 year. 1 and under 5 years. 5 and under 15 years. 15 year 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 2 .... 3 1 4 5 2 4 11 10 14. Chief preparations used in treatment of Syphilis:— (a) Names of preparations Arsenobenzene Compounds. Mercury. Bismuth. Neosalvarsan. Sil. Salvarsan. Neokharsavan. Novarsenobil. .... Bis. Oxychloride 5% glucose sol. and Collosal Metal Bismuth 10%. (b) Total number of injections given (out-patients and in-patients) 4,155 .... 8,532 (c) Number of injections included in (b) given to patients who on first attendance at this Centre were suffering from primary and secondary syphilis 780 .... 1,309 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 forsyphilis and gonorrhœa? Yes. If not, in what way are they modified? — Microscopical Serum Tests for Spirochetes. for Gonococci. Wassermann. Others for Syphilis. for Gonorrhœa. 16. Pathological Work:— (a) Number of specimens examined at and by the medical officer of the treatment centre. 28 1,709 1,077 1,016 .... (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. Kent. Surrey. Herts. Total. a. Number of cases in Items 3 and 4 from each area found to be suffering from:— Syphilis 256 1 .... .... .... .... .... .... 257 Soft Chancre .... .... .... .... .... .... .... .... .... Gonorrhœa 387 .... 1 4 .... .... .... .... 392 Conditions other than venereal 355 6 5 7 1 .... .... .... 374 Total 998 7 6 11 1 .... .... .... 1,023 b. Total number of attendances of all patients residing in each area 30,142 49 142 43 1 .... .... .... 30,377 C. Aggregate number of "In-patient days" of all patients residing in each area 268 .... .... .... .... .... .... .... 268 d. Number of doses of arsenobenzene compounds given in the out-patient Clinic and In-patient Department to patients residing in each area 4,136 19 .... .... .... .... .... .... 4,155 Jan., 1934. (Signed) KENNETH M. WALKER, Medical Officer of the Treatment Centre. 21 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. 5.0 p.m.—7.0 p.m. Fridays 12.30 p.m. (New cases only.) 3.30 p.m.—4.30 p.m. In all, 240 sessions have been held. New Patients.—The number of new patients examined was 312, as compared with 318 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 94 198 292 „ Surgical „ 3 2 5 „ Dental „ 2 3 5 Throat „ 10 23 33 „ Pathological,, 2 4 6 „ Other „ 0 6 6 111 236 347 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. Five residents and one non-resident patient were admitted for this and other purposes. Examination of Sputum.—The following is a summary:— City Residents. Non-Residents. Total. Positive 4 5 9 Negative 25 53 78 Residential Ireatment.— The number of patients tor whom residential treatment was arranged was 88. 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 12 5 8 l 3 29 Patients non-resident 47 10 2 — — 59 59 15 10 l 3 88 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 26 was 57. In addition, 54 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 183. Total Attendances:— Residents 389 Non-Residents 754 1,143 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 1933. d 22 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. Three cases have been admitted under this scheme during the year. Artificial Pneumothorax.—Artificial pneumothorax treatment has been used again during the year. Artificial pneumothorax refills were done in 32 City and 260 non-City patients, 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. 74 homes have been visited, and 344 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 17 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, and 62 homes were visited in this connection. Milk has been provided for necessitous persons requiring extra nourishment, and in this connection the sum of about £35 has been expended. 23 (x.) Patients suffering from Non-Pulmonary Tuberculosis receive advice and treatment from the Surgeons of St. Bartholomew's Hospital, to whom they are referred from the Dispensary. Treatment in residential institutions is provided for as 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 1933, and also the total number of deaths from Tuberculosis among City residents during the same period :— Age Periods. New Cases. Deaths. Pulmonary. Non-Pulmonary. Pulmonary. Non-Pulmonary. M F. M. F. M. F. M. F. 0 - - - - - - - - 1 - — - - - - - - 5 - — - 1 - - - - 10 - — - 1 - - - - 15 - — - - - - - - 20 - — - - - - - - 25 1 — - - - 2 - - 35 2 1 - - - — - - 45 3 — - - - — - - 55 3 — - - - — - - 65 and upwards 1 — - - - — - - Totals 10 1 - 2 — 2 - - † The present lady members of the Committee are Miss Crosby, and Lady Smith. CONGRESSES. The Congress of the Royal Institute of Public Health, at Eastbourne, from 30th May to the 4th June; the Congress of the Royal Sanitary Institute, at Blackpool, from 18th to the 24th June; and the Congress of the National Association for the Prevention of Tuberculosis, at Cardiff, on the 13th, 14th and 15th July last, were all attended by representatives of the City Corporation, and again provided ample evidence of the value of these meetings. One of my staff also attended the Congress of the Sanitary Inspectors' Association, held at Clacton-on-Sea, from the 4th to the 9th September. d 2 24 SUPPLEMENTARY ANNUAL RETURN SHOWING IN SUMMARY FORM (A) THE CONDITION AT THE END OF 1933 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. 1926. 1927. 1928. 1929. 1930. 1931. 1932. 1933. 1 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. 1 Class T.B. minus. Class T.B. plus. Group 1. Group 2. Group 3. 1 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. 1 Total (Class T.B. plus). 1 Group 1. Group 2. Group 3. Total (Class T.B. plus). 1 Group 1. 1 Group 2. Group 3. Total (Class T.B. plus). (a) Remaining on Dispensary Register on 31st December. Disease arrested. Adults. M 2 I 1 ... 2 1 ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... F 1 ... 1 ... 1 1 ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Children. ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Disease not arrested. Adults. M ... ... 1 1 2 ... ... ... ... .... ... ... ... ... ... 1 ... ... ... ... 1 ... 1 ... 1 ... ... ... 1 1 ... ... ... 1 1 2 ... 1 1 2 1 3 3 2 8 F ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 1 2 ... ... 1 1 2 1 1 ... .... 1 2 1 ... ... 1 Children. 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... .... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... .... ... ... ... ... .... ... Condition not ascertained during the year 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... Total on Dispensary Register at 31st December 7 1 4 1 6 3 ... ... ... ... 1 ... 1 ... 1 1 ... ... ... ... 1 ... 1 ... 1 1 ... 1 2 3 2 ... 1 2 3 3 1 1 1 3 3 4 3 2 9 (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 15 3 20 3 2 3 5 2 3 2 5 8 1 ... 1 2 3 3 2 ... 5 3 1 2 1 4 4 1 1 2 4 3 ... ... 2 3 2 ... ... ... ... Dead. Adults. M 1 1 2 6 9 ... ... 1 3 4 ... ... 1 3 4 1 ... ... ... ... ... ... 1 1 ... ... ... 1 1 ... ... 1 2 3 1 ... ... 1 1 2 ... ... ... ... F ... ... ... 3 3 ... ... ... ... .... ... ... ... 2 2 ... .... ... 1 1 ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... 1 ... ... ... ... ... ... ... 2 2 Children. ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... .... ... Total written off Dispensary Register 22 3 17 12 32 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 2 4 7 5 1 0 3 4 2 ... ... 2 2 Grand Totals 29 4 21 13 | 38 | 6 ... 3 | 7 10 31 ... 51 71 12 10 1 | 1 4 6 4 13 3 1 7 4 1 3 15 9 6 1 3 161 10 18 2 1 4 7 5 4 3 4 11 SUPPLEMENTARY ANNUAL RETURN SHOWING IN SUMMARY FORM (A) THE CONDITION AT THE END OF 1933 OF ALL PATIENTS REMAINING ON THE DISPENSARY REGISTER; AND (B) THE REASONS FOR THE REMOVAL OF ALL CASES WRITTEN OFF THE REGISTER. B.—NON-PULMONARY TUBERCULOSIS. Condition at the time of the last record made during the year to which the Return relates. Previous to 1926. 1926. 1927. 1928. 1929. 1930. 1931. 1932. 1933. 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. 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 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... F ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Children. ... ... ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Disease not arrested. Adults M ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... ... ... 1 ... 1 ... ... ... 1 1 F ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... 1 1 Children. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 Condition not ascertained during the year ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Total on Dispensary Register at 31st December ... ... ... 1 1 ... ... ... ... ... 1 ... ... ... 1 ... ... .... ... ... 1 ... ... ... 1 1 ... ... ... 1 ... ... ... ... ... ... ... 1 1 2 ... ... ... 3 3 Transferred to Pulmonary ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (b) Not now on Dispensary Register and reasons for removal therefrom. Discharged as Recovered Adults. M ... ... ... ... ... ... ... ... ... ... .... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... F ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Children. 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Lost sight of or otherwise removed from Dispensary Register 6 1 1 2 10 2 ... ... ... 2 1 ... ... 1 2 ... ... ... ... ... ... ... ... 1 1 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Dead. Adults M ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... F ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Children. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Total written off Dispensary Register 7 1 1 2 11 ... ... ... ... ... 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 ... ... ... 3 3 25 26 RETURN SHOWING THE WORK OF THE DISPENSARY DURING THE YEAR 1933. 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 5 5 ... ... 1 ... ... 1 6 5 ... 1 12 (b) Diagnosis not completed 1 ... ... ... ... ... ... ... 1 ... ... ... 1 27 (c) Non-tuberculous 5 5 2 2 ... ... ... ... 5 5 2 2 14 B.—CONTACTS examined during the year:— (a) Definitely tuberculous. 2 ... ... ... ... 1 ... ... 2 1 ... ... 3 (b) Diagnosis not completed ... ... ... ... ... ... ... ... ... ... ... ... - 54 (c) Non-tuberculous 8 28 7 8 ... ... ... ... 8 28 7 8 51 C.—CASES written off the Dispensary Register as— (a) Recovered .... ... 1 ... ... ... ... ... ... ... 1 ... ... 1 (b) Non-tuberculous (including any such cases previously diagnosed and entered on the Dispensary Register as tuberculous).... .... ... ... ... ... ... ... ... 13 33 9 10 65 D.—NUMBER OF CASES on Dispensary Registeron December31st:— (a) Definitely tuberculous 30 16 1 1 4 2 l 2 34 18 2 3 57 (b) Diagnosis not completed 1 ... ... ... ... ... ... ... 1 ... ... ... 1 1. Number of cases on Dispensary 2. Number of cases transferred from Register on January 1st, 1933:— 51 other areas and cases returned after discharge under Head 3 in previous years 4 3. Number of cases transferred toother 4. Cases written off during the year as areas, cases not desiring further Dead (all causes) 4 assistance under the scheme, and cases “lost sight of” 9 5. Number of attendances at the 6. Number of Insured Persons under Dispensary (including Contacts) 389 Domiciliary Treatment on the 31st December — 7. Number of consultations with med- 8. Number of visits by Tuberculosis ical practitioners:— Officers to homes (including (a) Personal 12 personal consultations) 1 (b) Other 9. Number of visits by Nurses or 10. Number of Health Visitors to Homes for Dis- (a) Specimens of sputum, etc., pensary purposes 344 examined 29 (b) X-ray examinations made in connection with Dispensary work 94 1. Number of “Recovered” cases re- 12. Number of “T.B. plus” cases on stored to Dispensary Register, and Dispensary Register on December included in A (a) and A (b) above 31st 26 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 67 54 3 3 9 8 ... l 76 62 3 4 145 (b) Doubtfully tuberculous ... ... ... ... ... ... ... ... 6 3 ... ... 9 231 (c) Non-tuberculous ... ... ... ... ... ... ... ... 33 36 6 2 77 1 B.—Number of Tuberculous City workers attending Dispensary for treatment on Dec. 31st, 1933 22 C — Number of Non-Resident and Non-Workers attending Dispensary for treatment on Dec. 31st, 1933 ... ... ... ... ... ... ... ... ... ... .... 30 283 27 PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1930. PART I. Summary of Notifications during the period from the 1st January, 1933, to the 31st December, 1933. Age Periods Formal Notifications. Total Notifications. Number of Primary Notifications of new cases of Tuberculosis. 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65- Total (all ages) Pulmonary Males 3 2 4 1 2 ... 12 20 „ Females ... ... ... ... 1 4 2 3 ... ... ... 10 16 Non-Pulmonary Males 1 ... ... ... ... ... 1 ... ... ... ... 2 4 ,, „ Females ... ... 1 ... ... ... 1 ... ... ... ... 2 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 ... ... ... ... ... ... ... .... ... 1 1 Non-Pulmonary Males ... ... ... ... ... ... ... ... ... ... ... „ ,, Females ... ... ... ... ... ... ... ... ... ... 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 Registers 2 ... 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, 1933, on the Register of Notifications 38 19 57 4 5 9 66 Number of cases removed from the Register(s) during the year by reason inter alia of:— 1. Withdrawal of notification ... 1 1 ... ... ... 1 2. Recovery from the disease ... ... ... ... ... ... ... 3. Death 5 3 8 1 ... 1 9 notes. PART I. (a) Formal 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 eases 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 1933, which are required to be furnished to the County 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 sum 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. 28 SMOKE AND ATMOSPHERIC POLLUTION. Twenty-six complaints of smoke nuisance or annoyance from chimneys were dealt with during the year, and in connection with these 208 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. The table also shows the rainfall for the months of January to December of the year 1933, 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 19333. Month of the Year 1933. Place. 3 4 5 6 7 8 9 10 11 12 Metric tons per square kilometre. Insoluble matter. Soluble matter. Included in soluble matter. Rainfall mm. Tar. Carbonaceous other than tar. Ash. Loss on ignition. Ash. Total solids. Sulphates (S0,). Chlorine (CI). Ammonia (NH3). January Meteorological Office 30 0.28 2.12 3.80 0.65 1.78 8.63 0.75 0.47 0.03 Golden Lane 24 0.34 3.39 6.57 2.62 3.67 16.59 1.77 1.24 0.23 Victoria Park 25 0.06 0.80 1.46 0.91 2.07 5.30 0.78 0.32 0.06 February Meteorological Office 48 0.25 1.36 3.22 0.96 2.11 7.90 0.72 0.52 0.05 Golden Lane 29 0.13 0.91 1.54 2.18 3.48 8.24 1.70 1.03 0.22 Victoria Park 32 0.12 1.44 3.09 0.83 1.99 7.47 0.66 0.33 0.07 March Meteorological Office 54 0.12 0.93 1.22 1.19 1.74 5.20 0.89 0.41 0.01 Golden Lane 40 0.25 3.16 5.80 1.61 3.77 14.59 0.41 0.80 0.12 Victoria Park 55 0.14 1.63 3.21 0.98 2.30 8.26 0.94 0.23 0.07 April Meteorological Office 18 0.08 0.29 0.51 0.74 0.96 2.58 0.30 0.17 0.01 Golden Lane 27 0.15 1.56 3.45 1.95 2.39 9.50 1.04 0.64 0.09 Victoria Park 18 0.05 0.74 3.23 0.61 1.22 5.85 0.64 0.17 0.04 May Meteorological Office 41 0.18 0.70 1.00 0.96 1.31 4.17 0.70 0.22 0.02 Golden Lane 40 0.18 2.90 4.56 1.50 2.45 11.60 1.03 0.53 0.15 Victoria Park 47 0.12 2.15 6.35 0.75 1.68 11.05 0.80 0.23 0.07 June Meteorological Office 47 0.13 1.02 1.13 1.23 1.61 5.12 0.88 0.20 0.03 Golden Lane 40 0.21 0.84 2.64 1.60 0.65 5.94 0.47 0.26 0.06 Victoria Park 44 0.09 1.74 5.32 0.53 1.85 9.53 0.94 0.20 006 July Meteorological Office 52 0.08 0.62 3.16 3.16 7.02 1.08 0.49 0.05 Golden Lane 28 0.16 0.84 2.33 1.51 1.85 6.69 0.55 0.26 0.06 Victoria Park ... ... ... ... ... ... ... ... ... ... August Meteorological Office 13 0.12 0.66 1.26 2.15 1.61 5.80 0.83 0.41 0.01 Golden Lane 0 ... ... ... ... ... ... ... ... ... Victoria Park 13 0.06 0.61 1.24 0.37 0.98 3.26 0.48 0.13 0.06 September - Meteorological Office 82 0.16 1.08 2.46 0.65 2.77 7.12 1.12 0.30 0.05 Golden Lane 128 0.93 4.12 6.71 6.90 7.38 26.04 3.37 1.05 0.59 Victoria Park 61 0.05 0.93 1.83 1.09 1.45 5.35 0.91 0.27 0.10 October Meteorological Office 34 0.18 0.71 2.24 0.89 1.31 5.33 0.64 0.33 0.04 Golden Lane 38 0.29 2.12 5.49 1.80 2.58 12.28 1.14 0.54 0.10 Victoria Park 35 0.16 2.93 4.63 0.70 1 .83 10.25 1 .01 0.21 0.09 November Meteorological Office 22 0.21 1.36 2.63 0.94 1.72 6.86 0.63 0.55 0.05 Golden Lane 21 0.25 1.87 2.96 1.75 1.83 8.67 0.85 0.58 0.11 Victoria Park 22 0.06 0.73 1.04 0.69 1.17 3.69 0.61 0.24 0.05 December Meteorological Office 10 0.21 1.48 2.79 0.92 2.72 8.12 0.93 0.84 0.06 Golden Lane 8 0.62 2.71 6.35 12.46 12.49 34.63 4.92 0.27 0.14 Victoria Park 7 0.02 0.33 0.50 0.53 1.21 2.59 0.55 0.20 0.06 29 CREMATIONS IN THE UNITED KINGDOM. 49 Years—1885-1933. YEAR. Woking.* Manchester. Glasgow. Liverpool. Hull. Darlington. Leicester. Golder's Green. Birmingham Leeds. City of London. Sheffield. Bradford. W. Norwood. Hendon Park. Pontypridd. Bristol. Ipswich. Edinburgh. Brighton. Guernsey. Nottingham. Reading. (Opened Aug., 1932) Southampton. (Opened July, 1982) 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 .... ... 5,196 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 6,316 1933 447 674 202 247 148 128 122 2,396 395 153 192 108 101 624 10 84 300 120 359 300 20 90 67 193 7,480 Totals 8,934! 8,150 2,613 2,622 1,497 816 1,273 28884 3,004 1196 1,868 1063 870 4,951 120 319 1044 376 939 785 39 234 80 270 71947 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 I884 appeared the well-known judgment of Mr. Justice Stephen, which, in the case of a child's body having been “burned by its father contrary to the order of the coroner, determined cremation to be a legal act, provided no nuisance be caused there“by to others.”—Extract from speech made by the late Sir Henry Thompson at the opening of Golder's Green Crematorium, 22nd November, 1902. Vide "Transactions of Cremation Society of England, 1903." p. 31. †Closed for reconstruction from August, 1913, to July, 1911. CREMATION. The Sanitary Committee of the City Corporation, acting as the Burial Board for the City of London, had before them, in the early part of the year, the question of enlarging the use of the Crematorium which they had established at the City of London Cemetery, which is situated at Manor Park, E. It was felt that the excellent provision which it had made for this the most desirable method of disposal of the dead was not sufficiently known 30 in the neighbouring areas to either the general public or to medical practitioners. Accordingly, with this object in view, I communicated with the medical officers of health of 98 local authorities which might be regarded as coming within the geographical orbit of the Crematorium at Manor Park, suggesting that the local authority might see its way, through their medical officer of health, to bring the uses of the Crematorium to the notice of doctors practising in their area, and to such other persons as might be induced to consider its advantages. I also suggested that a paragraph drawing attention to the sanitary and economic conditions might be included in the annual report of the Medical Officer of Health. The particularly attractive booklet, “The Garden of Rest,” which has been prepared by the Burial Board, was also sent, and attention especially directed to the amenities associated with the Crematorium, which are arranged on an ideal which has no regard to the question of financial advantage to the Board. I am pleased to say that this communication met with a very favourable reception, and that more than one thousand copies of the booklet were distributed in consequence. In many cases, too, the medical officers of health expressed their willingness to include in their next annual report some reference to the advantages of cremation and to the facilities afforded at Manor Park. There may be some significance in the fact that cremations this year reached the figure of 192, as against 158 of last year, and are the highest yet recorded at the Corporation Crematorium. MEAT INSPECTION. According to the Board of Trade Returns the imports of fresh meat and bacon for the twelve months 1933, were:— 1933. Beef. Cwts. 1932. Beef. Cwts. 1933. Mutton and Lamb. Cwts. 1932. Mutton and Lamb. Cwts. Argentina 7,645,174 7,462,063 1,146,601 1,385,720 Australia 1,164,035 957,589 1,306,666 1,156,034 Brazil 517,022 481,090 — — Canada — — — — Denmark — — — — Irish Free State — — — — Lithuania — — — — Netherlands — — — — New Zealand 706,750 578,881 3,734,462 3,915,865 Poland — — — — Sweden — — — — United States 50,130 47,466 — — Uruguay 673,471 699,849 171,958 163,690 Other Countries 361,916 142,455 338,756 350,187 Totals 11,118,498 10,369,393 6,698,443 6,971,496 1933. Pork. Cwts. 1932. Pork. Cwts. 1933. Bacon. Cwts. 1932. Bacon. Cwts. Argentina 166,356 108,934 - - Australia — — - - Brazil — — - - Canada — — 506,113 182,683 Denmark — — 5,524,497 7,672,030 Irish Free State 194,695 262,151 204,303 199,530 Lithuania — — 415,526 — Netherlands — — 871,950 971,567 New Zealand 278,082 131,142 — — Poland — — 783,758 1,142,524 Sweden — — 402,634 430,248 United States 83,322 32,542 62,931 63,318 Uruguay — — — — Other Countries 95,369 67,986 313,221 744,032 Totals 817,824 602,755 9,084,933 11,405,932 Beef.—The figures show a decrease of 12,354 tons on the previous year. 73 per cent. of the beef was imported as chilled, being over 31,301 tons less than in 1932, and 27 per cent. arrived in the frozen condition, being 17,530 tons more than the previous year. Argentina shipped 68 per cent. of the total amount, Australia sent 10 per cent., New Zealand and 31 Uruguay each sent 5 per cent., and Brazil sent 4 per cent. Other countries, 3 per cent. The figures for 1934 should show increases from other countries, as the Union of South Africa and Southern Rhodesia are now amongst the exporters to Great Britain. The imports of beef in the form of tinned beef, extracts, etc., amounted to over 46,177 tons. Mutton and Lamb.—Under this heading there is shown a decrease of 11,794 tons compared with the previous year. New Zealand, as usual, sent the largest proportion, viz., 55 per cent. Australia sent 19 per cent., Argentina 17 per cent., and other countries 4 per cent. Sheep and lamb offals and preserved by-products amounted to 9,238 tons. Fresh Pork.—The Irish Free State is practically the only sender of fresh pork, and the amount sent decreased 3,950 tons compared with 1932. Frozen Pork.—The amount of this article of food has markedly increased from New Zealand, Argentina, United States and other countries. New Zealand sent 33 per cent. of the total. Bacon.—The imports of bacon decreased considerably; this is due, no doubt, to the quota. Denmark continues to be the chief sender, having exported to Britain 60 per cent. of the total. Holland takes second place, Poland third, Canada fourth, followed closely by Lithuania and Sweden. In value, quality and demand the products of those countries appear to be respectively : Denmark, Sweden, Canada, Holland, Irish Free State, other countries, Poland, Lithuania and United States. Hams.—The U.S.A. continues to be the most important sender, her contributions amounting to 65 per cent, of the total ; 5,000 tons more arrived from this country than in 1932. Canada also sent 2,000 tons more. Live Cattle.—Canada greatly increased her shipments of live cattle—51,433, against 16,724 in the previous year. A depot has been opened for the reception of cattle at Tilbury, the proprietors of which anticipate a further increase of imports. Forty-three thousand seven hundred and thirteen fewer cattle arrived from the Irish Free State, which was the only country to send sheep and pigs. Average prices were given as follows:— Cattle. Sheep. Pigs. Canada £16 17 7 — — Irish Free State, including stores 989 £116 £2 18 LONDON CENTRAL MARKETS. Analysis and Comparison of Supplies in Tons. Twelve Months. Description and Country of Origin. 1933. 1932. Difference. Beef and Veal: England and Wales 19,999 20,082 -83 Scotland 14,521 13,971 + 550 Ireland 2,557 2,316 + 241 Australia 11,607 7,484 + 4,123 New Zealand 3,525 3,312 + 213 Canada 2,945 1,299 + 1,646 Un. of S. Africa & S. Rhodesia 3,325 243 + 3,082 U.S. of America 1,901 1,852 + 49 Argentina 154,577 163,613 — 9,036 Uruguay 6,508 5,765 + 743 Brazil, etc. 7,593 7,463 + 130 Netherlands — — — Denmark — — — Other Countries - 3 3 Totals: Beef and Veal Tons 229,058 227,403 + 1,655 Totals: Carried forward Tons 229,058 227,403 + 1,655 E2 32 Description and Country of Origin. Twelve Months. 1983. 1932. Difference. Totals: Brought forward Tons 229,058 227,403 +1,655 Mutton and Lamb: England and Wales 13,447 12,763 +684 Scotland 18,366 21,499 —3,133 Ireland 2,331 939 +1,392 Australia 19,281 17,821 +1,460 New Zealand 72,234 78,115 —5,881 Canada 19 6 +13 Un. of S. Africa & S. Rhodesia 6 2 +4 U.S. of America 36 14 + 2 Argentina 19,357 20,942 —1,585 Uruguay 672 601 +71 Brazil, etc. 369 394 —25 Netherlands — — — Denmark — — — Other Countries 320 217 +103 Totals: Mutton and Lamb Tons 146,438 153,313 —6,875 Pork and Bacon: England and Wales 24,370 28,155 —3,785 Scotland 40 39 + 1 Ireland 6,471 8,650 —2,179 Australia 2,596 2,009 +587 New Zealand 4,200 2,006 +2,194 Canada 283 31 +252 Un. of S. Africa & S. Rhodesia — — — U.S. of America 536 347 +189 Argentina 762 679 +83 Uruguay — — — Brazil, etc. 90 56 +34 Netherlands Bacon *844 *899 55 Denmark *872 *1,296 424 Other Countries *3,059 *3,708 649 Totals: Pork and Bacon Tons 44,123 47,875 —3,752 Poultry and Game: England and Wales 9,703 9,647 +56 Scotland 650 633 +17 Ireland 1,717 1,740 23 Australia 87 125 —38 New Zealand 12 7 +5 Canada 153 282 —129 Un. of S. Africa & S. Rhodesia 7 — +7 U.S. of America 180 42 +138 Argentina 377 247 +130 Uruguay — — — Brazil, etc. — — - Netherlands 1,339 1,303 +36 Denmark 25 9 +16 Other Countries 9,431 10,615 —1,184 Totals: Poultry and Game Tons 23,681 24,650 969 Rabbits: England and Wales 1,025 895 +130 Scotland 32 33 1 Ireland 1 5 4 Australia 6,363 6,889 —526 New Zealand 330 341 —11 Canada — — — Un. of S. Africa & S. Rhodesia — — — U.S. of America — — — Argentina — 1 —1 Uruguay — — — Brazil, etc. — — — Netherlands 108 189 81 Denmark 2 2 — — Other Countries 382 650 —268 Totals: Rabbits Tons 8,243 9,005 762 Totals: Carried forward Tons 451,543 462,246 —10,703 33 Description and Country of Origin. Twelve 1933. Months. 1932. Difference. Totals: Brought forward Tons 451,543 462,246 —10,703 Eggs: England and Wales 1,568 1,519 +49 Scotland — 2 —2 Ireland 177 223 —46 Australia 115 136 —21 New Zealand 3 3 — Canada 8 — +8 Un. of S. Africa & S. Rhodesia 189 116 +73 U.S. of America 2 1 +1 Argentina 11 13 —2 Uruguay 1 2 —1 Brazil, etc. — — — Netherlands 95 305 —210 Denmark 50 174 —124 Other Countries 311 142 +169 Totals: Eggs Tons 2,530 2,636 106 Butter and Cheese: England and Wales 264 376 —112 Scotland — — — Ireland 8 5 +3 Australia 164 151 +13 New Zealand 270 311 41 Canada 2 25 —23 Un. of S. Africa & S. Rhodesia — 10 10 U.S. of America 6 2 +4 Argentina 70 97 —27 Uruguay 1 — +1 Brazil, etc. — — — Netherlands 117 78 +39 Denmark — 6 —6 Other Countries 93 15 +78 Totals: Butter and Cheese Tons 995 1,076 -81 Sundries: England and Wales 530 526 +4 Scotland — — — Ireland 3 2 +1 Australia 6 3 +3 New Zealand 12 2 +10 Canada 7 1 +6 Un. of S. Africa & S. Rhodesia 3 2 +1 U.S. of America 41 27 +14 Argentina 1 6 —5 Uruguay — — — Brazil, etc. — — — Netherlands 63 97 —34 Denmark 94 171 77 Other Countries 585 485 +100 Totals: Sundries Tons 1,345 1,322 +23 Grand Totals Tons 456,413 467,280 —10,867 Beef and Veal.—The figures show a decrease of home-produced supplies in England and Wales, but an increase in consignments from Scotland and Ireland. Mutton and Lamb.—There was a considerable increase in the amount of mutton and lamb from England and Wales, but a large decrease from Scotland. Bacon and Pork.—The figures show considerable decrease in home-produced supplies. Poultry, Game, Rabbits, Eggs, Butter, Cheese and Sundries.—There was very little difference between the amounts of those home-produced articles and those of 1932. Of the 456,413 tons, Home Produce consisted of 25.8 per cent., Dominion 28.0 per cent. and Foreign 46.2 per cent. 34 Farmers still complain of Foreign competition, but much of the beef, mutton, lamb and pork compared very unfavourably with imported articles of the same kind. In general, beef lacked finish, mutton was heavy and pork very uneven in quality. GREAT BRITAIN. The following table shows the amount of British diseased meat discovered in the markets, a small diminution compared with former years.:— GREAT BRITAIN.—1933. Beef. Mutton. Pork. Veal. Goat. Carcases. Quarters. Carcases. Quarters. Carcases. Quarters. Carcases. Quarters. Carcases. Tongues. Lungs. Mesenterlee. Plucks. Heads. Abscesses - - 53 - 71 4 9 3 - 1 - 15 37 Actinomycosis - - — - — — — — - 3 - - — 2 Adenitis - - — - — — 2 — - — - - — — Arthritis - - 33 - 15 — - — - — - - — — Cirrhosis - - - - - - - - - - - - 14 — Distomatosis - - 46 - — — — — - — - - — — Dropsy - - 4 - 8 — 4 — - — - - — — Emaciation 5 4 757 - 53 — 38 — 3 — - - — — Hemorrhagic Musculature 1 — 1 - 96 — 1 — — — - - — — Injury — — 2 - 2 — 3 — — — - - — — Jaundice — — — - 8 — 7 — — — - - — — Joint 111 — - - - - - 5 - - — - - — — Killed in Extremis — — 22 - 10 — 12 — — — - - — — Leukaemia (Pseudo) — — 1 - — — 2 — — — - - — — Melanosis - - - - - - 1 - - 1 - - 1 1 Myositis — — — - 1 — 1 — — — - - — — Nephritis 1 4 3 1 8 — 12 - - - - - - - Oedema — — 1 - — — — — — — - - — — Osteoporosis — — — - — — 2 — — — - - — — Parasitic Disease — 2 1 - - - - - - - 2 - - - Pleurisy and Peritonitis — 1 73 1 296 6 9 - - - - - 7 — Pneumonia and Pericarditis — — 1 - 2 — 3 — — — — - 7 — Pyaemia - - - - - 2 - - - - — - — — Rachitis — — 2 - 9 — - — — — — - — — Swine Erysipelas and Fever — — - - 10 — - — — — — - — — Tuberculosis (Bovine) 15 7 - - — — 12 2 — 26 — - — 17 Tuberculosis (Porcine) — — - - 492 22 - — — — 56 152 785 3,710 Urticaria - - - - 1 - - - - - - - - - Totals for 1933 22 18 1,000 2 1,082 34 123 5 3 31 58 152 829 3,767 Totals for 1932 . 17 21 347 11 1,500 139 85 9 2 36 17 145 587 6,152 IRELAND (SOUTHERN). The consignments of food received from this country, compared with those of 1932, were as follows, viz.:— Tons of Beef. Tons of Mutton. Tons of Pork and Bacon. Tons of Poultry and Game. Tons of Rabbits. Tons of Butter and Cheese. Tons of Eggs. Tons of Sundries. 1933 2,557 2,331 6,471 1,717 l 8 177 3 1932 2,316 939 8,650 1,740 5 5 223 2 The amount of unsound food surrendered is shown in Tables Nos. 18 and 19. Beef. Mutton. Pork. Sides. Quarters. Carcases. Quarters. Carcases. Sides Abscess - - 2 - 2 2 Arthritis - - - - 6 — Emaciation - - 4 - 1 2 Haemorrhagic Musculature - - 1 - 2 — Killed while exhausted - - 1 - 1 2 Pleurisy and Peritonitis - - — 2 5 5 Tuberculosis 2 3 — — 15 24 Total for 1933 2 3 8 2 32 35 Total for 1932 - 1 - - 47 144 35 Argentina.—The following table shows the amount of food, in tons, received from this country, compared with the amount for 1932:— Beef and Veal. Mutton and Lamb. Pork and Bacon. Poultry and Game. Eggs. Cheese and Butter. Sundries. 1933 154,577 19,357 762 377 11 70 l 1932 .... 163,613 20,942 679 247 13 97 6 The amount of diseased meat surrendered from this year's consignments are shown in the following table, and the amount of unsound food surrendered in tables Nos. 18 and 19. Beef. Quarters. Mutton. Carcases. Mutton. Quarters. Mutton, Pieces. Pork. Carcases. 1932. 1933. 1932. 1933. 1932. 1933. 1932. 1933. 1932. 1933. Abscess 27 38 9 34 - 5 - 1 l 3 Caseous Lymphadenitis — — 215 161 19 12 8 11 — — Cysticercus Bovis 4 6 - - - - - - - - Emaciation — — 5 — — — — - — — Leukaemia — 1 - - - - - - - - Melanotic Tumour — 1 - - - - - - - - Nephritis 2 - - - - - - - - - Osteomalacia — 1 - - - - - - - - Peritonitis — — 3 — — — — - — — Tuberculosis (Hinds) 84 45 - - - - - - - - ,, (Fores) 18 9 - - - - - - - - (Pork) - - - - - - - - l 1 - - - - - - - - — - Totals 135 101 232 195 19 17 8 12 2 4 Australia.—This country sent to the markets during the year the following amounts of food, in tons, compared with those for 1932:— Beef and Veal. Mutton and Lamb. Pork. Poultry and Game. Rabbits. Eggs. Butter. Sundries. 1933 11,607 19,281 2,596 87 6,363 115 164 6 1932 7,484 17,821 2,009 125 6,889 136 151 3 The following table shows the amounts of meat surrendered as diseased and the quantities of unsound food are shown in tables Nos. 18 and 19:— Beef. Quarters. Mutton. Carcases. Mutton. Quarters. Mutton. Pieces. Pork. Carcases. 1932. 1933. 1932. 1933. 1932. 1933. 1932. 1933. 1932. 1933. Abscess 3 4 5 19 - - - 1 2 3 Caseous Lymphadenitis — — 171 122 25 41 24 9 — — Emaciation — — 5 — — — — — — — Tuberculosis 7 3 - - - - - - - - TotalS 10 7 181 141 25 41 24 10 2 3 New Zealand.—From this country the total amounts of food, in tons, deposited in the markets during the year 1933, compared with those for 1932:— Beef and Veal. Mutton and Lamb. Pork. Poultry and Game. Rabbits. Eggs. Butter and Cheese. Sundries. 1933 3,525 72,234 4,200 12 330 3 270 12 1932 3,312 78,115 2,006 7 341 3 311 2 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. Mutton. Carcases. Mutton. Quarters. Mutton. Pieces. Pork. Carcases. 1932. 1933. 1932. 1933 1932. 1933. 1932. 1933. 1932. 1933. Abscess - 3 24 34 - 8 - 2 33 55 Caseous Lymphadenitis - — 157 103 12 41 6 13 — — Nephritis - - - - - - - - - 1 Pleurisy - - - 1 - - - - - 2 Tuberculosis l 1 - - - - - - 6 — Totals l 4 181 138 12 49 6 15 39 58 Uruguay.—The amount of food sent to the markets from Uruguay was 7,182 tons, consisting of:— Beef and Veal. Mutton and Lamb. Pork and Bacon. Poultry and Game. Rabbits. Butter and Cheese. Eggs. Sundries. 1933 .... 6,508 672 — — — 1 1 — The quantity of diseased meat surrendered is given herewith, and the amount of unsound food is shown in Tables 18 and 19 :— Beef. Quarters. Mutton. Carcases. Mutton. Pieces. 1932. 1933. 1932. 1913. 1932. 1933. Abscess - 5 l - - - Caseous Lymphadenitis - — 3 7 - 1 Cysticercus Bovis - 1 — — - - Emaciation - — 2 — - - Totals 6 6 7 1 36 Chile.—This country sends mutton and lamb only, and the trade is seasonal. The following table shows the amount of diseased meat surrendered, viz.:— Mutton. Carcases. Mutton. Quarters. Mutton. Pieces. 1932. 1933. 1932. 1933. 1932. 1933. Abscess - 7 - - - - Caseous Lymphadenitis 10 29 - 4 - 2 Totals 10 36 - 4 - 2 Brazil.—This country sent to the markets 7,593 tons of beef, 369 tons of mutton and lamb, and 90 tons of pork, compared with 7,463 tons of beef, 394 tons of mutton and lamb, and 56 tons of pork in 1932. The amount of diseased meat surrendered was:— Beef. Quarters. Mutton. Carcases. Mutton. Pieces. Pork. Carcases. 1932. 1933. 1932. 1933. 1932. 1933. 1932. 1933. Abscess 5 3 - 3 - - - 21 Tuberculosis 8 8 - - - - - - Totals 13 11 - 3 - - - 21 South Africa, including Rhodesia.—The amounts of meat were as follows : 3,325 tons of beef, 6 tons of mutton and lamb, 7 tons of poultry and game, 189 tons of eggs and 3 tons of sundries, compared with those for 1932, which were, in tons—beef 243, mutton 2, poultry and game nil, eggs 116, butter and cheese 10, sundries 2. The attempts to introduce chilled beef from South Africa have continued and the transport condition of the meat has been excellent. The quality of some of the consignments was quite good, but in other shipments it was evident that improvement in breeding to Smithfield requirements is wanted. The amount of meat surrendered due to disease was:— Beef. Quarters. Beef. Quarters. 1932. 1933. 1932. 1933. South Africa. Southern Rhodesia. Abscess - 6 Abscess - 14 Hemorrhagic Glands - 1 Tuberculosis - 16 Tuberculosis - 3 Total - 10 Total - 30 Other Countries.—In my last report it was suggested that all imported bacon should bear a stamp showing that it has, by ante-mortem and post-mortem examination, been found free from disease by Government Inspectors. United States of America. Pork Carcases. 1932. 1933. Abscess — 1 Lithuania. Bacon Sides Pieces Abscess 5— Canada. Abscess 1— Pleurisy 2— 3 — Denmark. Abscess 4 2 Holland. Abscess 1 1 Poland. Abscess 5 1 Ukrania. Abscess 1— 37 CASEOUS LYMPHADENITIS. The following table shows the amount of mutton taken on account of Caseous Lymphadenitis during the last three years:— Countries. Carcases. Sides. Quarters. Pieces. 1931. 1932. 1933. 1931. 1932. 1933. 1931. 1932. 1933. 1931. 1932. 1933. Argentina 371 483 238 76 4 3 142 36 - 39 47 3 Australia 241 187 132 — — — 38 101 30 162 111 86 Brazil 30 — — — - - — - - — — — Chile 147 105 36 98 169 85 — 79 7 — 284 93 New Zealand 201 246 154 23 — 19 4 18 12 139 393 27 Uruguay 40 3 22 - - - - - - 48 — 32 Totals 1,030 1,024 582 197 173 107 184 234 49 388 835 241 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) 44 Heads (Pigs) 37 Beef (Pieces) 26 Livers ,, 1 „ (Livers) 111 Meat (Tins lbs.) 40 „ (Sweet Breads) 14 Milk (Tins) 240 „ (Hearts) 2 ,, (Tins lbs.) 1,200 „ (Tongues) 4 Mutton (Carcases) 10 „ (Kidneys) 1 „ (Pieces) 25 Butter (lbs.) 17 Offal (lbs.) 576 Calf (Liver) 1 Partridges 2,008 „ (Heads) 5 Pheasants 1,034 Capercailzies 46 Pigeons 1,669 Chickens and Poussins 1,189 Pork (Pieces) 1 Cream (Tins) 1,181 Plover 443 Curlews 5 Plucks (Pigs) 25 Deer (Carcases) 10 „ (Sheep) 4 Ducks 1,396 Ptarmigan 48 „ (Eggs) 84 Quail 424 Eggs (Hens) 930 Rabbits 10,871 (Gulls) 7,412 Sausages (lbs.) 30 Fish (Tins) 114 Sheep (Plucks) 4 Fowls 6,367 Spleens 326 Fruit (Tins) 186 Snipe 132 Game (Black) 89 Teal 118 „ (Unclassified) 259 Turkeys 1,001 Geese 334 Veal (Pieces) 6 Grouse 1,927 Venison (Pieces) 27 Guinea Fowls 882 Widgeon 91 Hares 2,317 Woodcock 80 Hazelhens 178 Tons. Cwts. Qrs. Lbs. Total for 1933 ... 42 15 2 0 1932 .... 36 2 3 3 Increase .... 6 12 2 25 UNSOUND MEAT, ETC., REMOVED FROM COLD STORES. Article. No. How Packed. Origin. Cause for Destruction. Tons. Cwts. Qrs. Lbs. Beef (Sweet Breads) 1 Box Argentina Mould Fungi 0 0 0 22 „ (Cheeks) 76 Bags ,, Decomposed 1 18 2 10 „ (Heads) 3 „ ... Gt. Britain Store Perished 0 0 3 16 ,, (Hearts) 1 „ ... Argentina Decomposed 0 0 1 13 „ (Kidneys) .... .... „ ... „ ... 2 1 0 12 „ „ 83 Boxes Canada „ ... 0 11 2 24 „ „ „ ... Gt. Britain „ ... 0 0 1 17 „ (Livers) ... ... Argentina Unsound 0 11 1 25 „ „ 4 Cases Brazil Decomposed 0 2 0 26 Carried forward 5 6 3 25 F 38 Unsound Meat, Etc., Removed from Cold Stores.—continued. Article. No. How Packed. Origin. Cause for Destruction. Tons. Cwts. Qrs. Lbs. Brought forward 5 6 3 25 Beef (Pieces) Argentina Decomposed 3 2 3 3 „ „ ... ... Australia Bone Taint 0 6 3 7 „ „ 8 ... „ Brine Stained 0 6 2 6 „ „ ... ... Gt. Britain Decomposed 13 13 1 21 „ (Stomach) 3 Bags Argentina „ 0 1 1 10 „ (Tails) ... ... U.S.A. „ 8 19 0 11 „ (Tongues) 7 ... Argentina „ 0 0 1 6 „ „ 2 Bags Uruguay „ 0 1 0 6 Chicken ... ... Russia Unsound 0 2 0 17 Fat (Caul) ... ... Argentina Decomposed 0 9 0 2 Glands ... ... „ „ 0 0 0 7 Mutton (Carcases).... 71 ... „ *C.L.A. 1 3 2 12 „ (Sides) 3 ... „ „ 0 0 2 12 „ (Pieces) ... ... „ „ 0 3 1 6 „ (Kidneys) 14 Cases „ Decomposed 0 8 1 24 „ (Livers) 4 Bags „ „ 0 1 3 27 ,, (Carcases) 17 ... Australia *C.L.A. 0 5 2 24 „ „ 28 ... „ Brine Stained 0 11 3 23 „ „ 46 ... „ Decomposed 0 12 2 11 „ (Quarters) 30 ... „ C.L.A. 0 3 1 26 „ „ 4 ... „ Decomposed 0 0 0 14 „ „ 2 ... „ Injury 0 0 1 0 „ (Kidneys) 39 Bags ... Decomposed 1 12 3 12 „ (Livers) 10 „ „ „ 0 3 0 24 „ (Pieces) ... ... „ „ 0 1 1 3 „ „ ... ... „ *C.L A 0 1 1 8 „ (Shoulders) 49 ... „ „ 0 2 1 20 „ (Carcases) 12 ... Chile „ 0 3 3 15 „ (Sides) 85 ... „ „ 0 18 0 7 „ (Quarters) 7 ... „ „ 0 0 3 7 (Legs) 7 ... „ „ 0 0 1 25 „ (Shoulders) 18 ... „ „ 0 1 0 4 „ (Hearts) 3 Bags „ Transit damage 0 1 1 10 „ (Kidneys) 3 Cases „ Decomposed 0 1 2 13 „ (Carcases) 52 ... New Zealand *C.L.A. 1 6 3 2 „ „ 50 ... „ Store Perished 0 11 0 11 „ „ 5 ... „ Brine Stained 0 2 1 1 „ „ 1 ... „ Vermin damage 0 0 1 2 „ (Sides) 19 ... „ *C.L.A. 0 4 0 18 „ „ 1 ... „ Decomposed 0 0 1 0 „ 1 ... „ Brine Stained 0 0 0 16 (Quarters) 12 ... „ *C.L.A 0 1 3 25 „ „ 2 ... „ Store damage 0 0 0 16 „ „ 2 ... „ Injury 0 0 0 9 „ „ 1 ... „ Brine Stained 0 0 0 9 „ (Pieces) 1 ... „ „ 0 7 1 10 „ ... ... „ Decomposed 6 16 1 10 „ „ ... Bags „ Mould Fungi 0 5 3 22 „ „ ... ... .... *C.L.A 0 0 0 22 „ (Kidneys) 20 Crates „ Decomposed 0 13 3 20 (Legs) 7 ... „ C.L.A 0 0 1 26 „ „ 15 ... „ Decomposed 0 0 3 27 „ „ 1 ... „ Abscess 0 0 0 6 „ (Livers) 1 Tin „ Decomposed 0 0 0 19 „ (Carcases) 15 ... Uruguay C.L.A 0 5 2 9 „ (Pieces) ... ... „ „ 0 1 3 23 „ (Shoulders) 6 Bags Gt. Britain Decomposed 0 2 0 25 „ (Livers) 10 ... „ „ 0 0 0 14 Pack Meat ... ... Australia „ 0 0 1 10 Pork (Carcases) 1 ... Gt. Britain „ 0 1 0 16 „ „ 17 ... New Zealand Mould Fungi 0 10 3 10 „ (Pieces) ... ... „ „ 0 0 3 24 (Legs) 2 ... „ Abscess 0 0 0 15 „ (Livers) ... ... „ Decomposed 0 3 0 1 Carried forward 51 8 3 26 *Caseous Lymphadenitis. 39 Unsound Meat, Etc., Removed from Cold Stores.—continued. Article. No. How Packed. Origin. Cause for Destruction. Tons. Cwts. Qrs. Lbs. Brought forward 51 8 3 26 Poultry (Mixed) ... ... Gt. Britain Decomposed 0 3 2 4 Rabbits ... ... Australia „ 1 1 3 10 „ 7 Cases New Zealand „ 0 4 0 24 Salmon 12 „ U.S.A. „ 0 12 1 9 Suet 4 ,, Argentina Mould Fungi 0 2 3 27 Turkeys 4 „ Gt. Britain Store Perished 0 3 1 3 „ 59 „ Canada Mould Fungi 3 1 2 25 Veal (Pieces) ... .... Argentina Decomposed 0 0 0 24 „ (Side) ... .... „ Vermin damage 0 0 2 11 Total for 1933 56 19 2 23 „ 1932 43 9 0 22 Increase 13 10 2 1 SHOWING THE AMOUNT OF VARIOUS FOOD PRODUCTS SURRENDERED TO OR SEIZED BY MEAT INSPECTORS IN THE CITY OF LONDON FOR DISEASED CONDITION, 1933. 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. Argentina 35,192 33,780 6,273 689 — — 3,780 — — Australia 2,315 18,327 2,492 — — — 1,270 — — Brazil 1,396 2,092 — — — — — — — Britain 25,673 15,340 95,438 4,807 376 1,183 65,349 5,722 9,525 Canada — — — — — 170 — — — Chile — 8,340 — — — — — — — Denmark — — — — — 382 — — — Holland — — — — — 117 — — — Hungary - — — — — — — 326 — Ireland 576 488 9,487 — — — 64,839 1,981 112 New Zealand 2,450 17,486 3,384 893 — — 584 — — Poland — — 209 — — 713 — — — South Africa 2,271 — — — — 116 — — — Southern Rhodesia 1,803 — — — — 102 — — — Uruguay — 4,847 — — — — — — — U.S.A. — - — - - - 1,022 - — Totals for 1933 71,676 100,700 117,283 6,389 376 2,783 136,844 8,029 9,637 Totals for 1932 80,503 121,284 168,381 7,081 184 3,187 166,720 3,489 6,827 SHOWING THE AMOUNT OF VARIOUS FOOD PRODUCTS SURRENDERED TO OR SEIZED BY MEAT INSPECTORS IN THE CITY OF LONDON FOR UNSOUND CONDITION, 1933. 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. Feathered Game. Tinned Meat. Tinned Milk. Fish in lbs. Cheese in lbs. 421,883 38,218 4,872 1,250 - - - 27,834 - - 4,281 203 - - Australia. 20,784 27,220 2,103 — — — — 9,382 3,209 1,782 270 - — — Austria — — — — — — — — 2,911 263 — — — — Belgium — — — — — — 587 — 10,296 — — — — — Brazil 5,329 — — — — — — 900 — — — — — — Britain 22,920 26,007 73,308 11,411 1,197 642 7,864 50,507 21,799 79,562 872 3,704 693 636 Canada 1,237 - - — — — 201 — — — 23 - - - Chile 192 3,792 - - - - - - - - - - - - Denmark — — — — — — 5,348 — 773 — - 1,357 — — France — — — — — — — — 271 5,022 — — — Finland — — — — — — — — — 142 — — — Germany — — — — — — — — 635 1,701 — 691 — — Holland — — — — — — 4,739 — 15,234 29,965 1,217 1,329 — — Ireland 572 15,783 11,359 1,947 — — — 110,451 2,341 4,727 — — — — Italv — — — — — — — — 1,083 2,930 — — — — New Zealand 26,183 256,27? 7,022 1,870 — — — 12,329 — 2,683 — — 839 — Norway — — — — — — — — 6,829 — — — — — Poland — — 247 — — — 2,742 — — — — — — — Uruguay 9,764 — 2,372 342 — — — 3,228 — — — — — — U.S.A. 210 — — — — — — 43,470 — — 1,318 470 — — Russia — — — — — — — — — 6,282 — — — — South Africa 8,747 - - - - - - - - - - - - - S. Rhodesia 6,902 - - - - - - - - - - - - - Sweden — — — — — — — — — 58 — — — — Syria — — — — — — — — — 3,679 — — — — Totals for 1933 524,723 367,293 101,283 16,820 1,197 642 21,481 258,101 65,387 138,796 7,981 7,754 1,532 636 Totals for 1932 533,492 384,981 106,325 20,743 2,784 748 23,481 236,451 54,793 141 544 11,184 5,000 295 60 40 SUMMARY OF UNSOUND FOOD DESTROYED. Tons. Cwts. Qrs. Lbs. Central Markets (Smithfield) 778 10 1 12 Cold Stores 56 19 2 23 Leadenhall Market and City Shops 42 15 2 0 Total for year 1933 878 5 2 7 Total for year 1932 928 7 1 15 Decrease 50 1 3 8 EXPORT OF MEAT, ETC. Seventy-seven certificates were issued during the year. DEMONSTRATIONS AND INSTRUCTION IN MEAT INSPECTION. One hundred and twenty-six persons from various Training Centres received instruction. In accordance with arrangements of long standing, 30 Naval Officers received training in meat inspection at the Central Markets, Smithfield. PUBLIC HEALTH (LONDON) ACT, 1891—UNSOUND M EAT—PROSECUTIONS. Serial No. Date. Business. Where heard. Before whom. Offence. Result. 9 1 /3 /33 Dealer Guildhall Ald. Sir S. Killick. Under the City of London (Various Powers) Act, 1911, Sec. 39, being the person who consigned 52 plucks which were diseased and unfit. Fined £5; Costs, £10 10s. 0d. 8 3/4/33 Butcher „ Aid. Sir P. Vincent. Under the City of London (Various Powers) Act, 1911, Sec. 39, being the person who consigned one cow carcase which was diseased. Fined £50; Costs, £10 10s. 0d. 2 24/5/33 „ „ Aid. P. J. C. Pollitzer. Under the City of London (Various Powers) Act, 1911, Sec. 39, being the owners of two pig carcases which were diseased. Fined £20; Costs, £5 5s. 0d. 24 /5 /33 Butcher’s „ Employee. „ Person who consigned the above carcases. Fined £3. 3 24/5/33 Poultry „ Dealer. „ Under the City of London (Various Powers) Act, 1911, Sec. 39, being the owner of one pig carcase and pluck which were diseased. Fined £2; Costs, £2 2s. 0d. 30/5/33 Licensed „ Slaughterer. „ Person who consigned pig carcase and pluck. Fined £3; Costs, £2 2s. 0d. 4 24/5/33 Dealer „ „ Under the City of London (Various Powers) Act, 1911, Sec. 39, being the owner of one pig carcase. Fined £5; Costs, £5 5s. 0d. 5 29/8/33 Coal „ Merchant. Aid. Sir D. G. Collins. Under the City of London (Various Powers) Act, 1911, Sec. 39, being the owner of one pig carcase. Fined £30; Costs, £3 3s. 0d. 41 Table showing Weight of Meat delivered, and Meat delivered to Contractors as unsound, during each Month of the Years 1932 and 1933. Month. Meat delivered at the Market, 1932. Unsound Meat delivered to Contractors, 1932. Meat delivered at the Market, 1933. Unsound Meat delivered to Contractors, 1933. Tons. cwts. qrs. Tons. cwts. qrs. Tons. cwts. qrs. Tons. cwts. qrs. January 39,806 0 0 71 0 0 41,911 0 0 51 9 3 February 41,297 0 0 51 18 0 35,287 0 0 50 11 3 March 39,654 0 0 60 16 1 40,054 0 0 75 9 3 April 38,223 0 0 56 3 3 36,463 0 0 52 9 3 May 37,451 0 0 54 0 0 39,328 0 0 75 0 3 June 35,399 0 0 64 10 3 35,037 0 0 70 2 0 July 35,443 0 0 91 9 0 35,065 0 0 94 16 0 August 35,417 0 0 149 18 2 35,013 0 0 141 19 1 September 39,477 0 0 106 18 2 36,603 0 0 98 18 0 October 42,540 0 0 86 16 1 41,061 0 0 107 19 2 November 41,022 0 0 92 15 2 40,645 0 0 76 18 3 December 41,037 0 0 135 2 2 39,945 0 0 58 8 3 Totals 466,766 0 0 1,021 9 0 456,412 0 0 954 4 0 One ton in every 478 tons of meat paying toll in the Central Markets, Smithfield, was condemned last year, as compared with one ton in 457 in 1932. Table showing the average deliveries at the Central Meat Market, and other details for successive quinquennial periods during the past 59 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 1929-1933 465,550 0 0 958 0 0 •206 *I am indebted to the Clerk and Superintendent of the Central Markets for the figures relating to the market supplies, sources of origin, &c. *The sources of origin of the Central Markets Supplies during the past five years are here expressed in terms per cent, of the total annual deliveries. British. American. Australian Country Killed. Per cent. Town Killed. Per cent. †Foreign Killed. Per cent. Home Killed. Per cent. American Killed.‡ Per cent. and New Zealand. Per cent. South Africa. Per cent. 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 1932 22.9 3.6 4.4 0.1 43.5 25.4 0.1 1933 22.3 3.5 3.8 0.3 42.8 26.5 0.8 The following figures supplied by the Superintendent of the Market are of interest:— 1929. 1930. 1931. 1932. 1933. Tons. Tons. Ions. Tons. Tons. Average daily delivery into the Markets 1,491 1,502 1,554 1,511 1,491 **Minimum delivery on any one day 288 208 523 368 627 Maximum delivery on any one day 3,179 3,694 4,524 3,877 4,061 The heaviest weight previously recorded on any one day (20th December, 1926) was— 5,259 tons. *Iam 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.” ‡Includes South American Imports 42 FISH SUPPLIES. 196,887 tons of fish, of which 181,888 were land-borne and 14,999 water-borne, were received at or near Billingsgate Market during the year. This was an increase of 5,394 tons in the land deliveries and a decrease of 992 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 that place, during each month of the year 1933. Month. Weight of Fish Delivered. Total. Weight of Fish Condemned. Ratio of Fish Condemned to that Delivered. By Land. By Water. Tons. cwts. qrs. Tons. cwts. qrs. Tons. cwts. qrs. Tons. cwts. qrs. January 15,048 7 1 1,014 3 0 16,062 10 1 29 18 2 1 ton in 536'758 tons, or 0186% February 14,556 8 3 649 18 2 15.206 7 1 63 19 1 237.738 „ 0.420% March 17,119 2 0 1,191 1 3 18,310 3 3 124 15 3 146.730 ,, „ 0.681% April 14,165 19 1 1,250 7 2 15,416 6 3 126 11 3 121.784 ,, 0.821% May 15,516 17 2 1,389 18 3 16,906 16 1 118 11 0 142.613 ,, „ 0.701% June 13,995 5 0 1,146 17 2 15,142 2 2 84 15 1 178.641 ,, 0.559% July 14,810 3 3 1,286 8 1 16,096 12 0 201 16 0 79.765 ,, „ 1.253% August 15,784 15 2 1,589 3 1 17,373 18 3 127 2 1 136.681 „ „ 0.731% September 15,846 15 0 1,619 8 1 17,466 3 1 87 8 1 199.813 ,, ,, 0.500% October 14,722 12 1 1,578 15 0 16,301 7 1 84 8 0 193.144 ,, „ 0.517% November 16,245 17 1 1,315 7 3 17,561 5 0 85 16 3 204.587 „ „ 0.488% December 14,075 19 0 968 2 3 15,044 1 3 33 3 3 453.300 „ 0.220% Totals 181,888 2 2 14,999 12 1 196,887 14 3 1,168 6 2 155.726 „ 0.642% Weight of Fish Delivered, Fish Seized as Unsound, and percentage of Fish Condemned to that Delivered, at or near Billingsgate Market during 1933 and the five years 1928—1932. 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. 1928 214,426 24,598 239,024 2,241 12 1 1 ton in 106.163 tons or 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% 1932 176,494 15,991 192,485 1,558 1 0 1 „ 123.546 „ 0.809% Average (5 years) 201,759 20,256 222.015 1,816 2 3 1 ton in 130.892 tons or 0.767% 1933 181,888 14,999 196,887 1,168 6 2 1 ton in 155.726 tons or 0.642% •Compiled from the Monthly Returns received from the Fishmongers' Company. MEAT PRODUCTION IN SOUTH AMERICA. On the invitation of a number of South American States, Mr. T. D. Young, the Corporation Veterinary Surgeon, was permitted by the Sanitary Committee to visit South America in the latter part of 1932 and the early part of 1933. The report, which is here reproduced, shows a satisfactory betterment of conditions in meat production and examination for export, and touches upon vital points in the economics of meat production. Visit to South America. “I visited the frigerificos in Argentina, Uruguay, and some of those in Brazil. Special attention was given to the meat inspection systems in operation in each country, and I am glad to report that a considerable all-round improvement has taken place since my last visit in 1913. “The number of veterinary surgeons has considerably increased. All animals arriving at the meat works must be accompanied by a veterinary certificate that, when the consignment left the estancios, the animals had been carefully examined and found free from any clinical evidence of contagious disease. On arrival at the frigerificos the animals are again examined ; any suspected of disease are placed aside and specially observed when slaughtered. If Aftosa (Foot and Mouth Disease) is discovered, none of the animals are killed for export to Britain. They are used for local consumption. Instead of coloured skewers being used on carcases to indicate where the lesions of disease exist, discs of various colours are affixed with hooks to the carcase, so that, at the final examination, the veterinary officer has full details in front of him, in order that he can form a definite decision. Caseous Lymphadenitis. “The carcases of lambs have the lymphatic glands palpated, and any glands which feel enlarged are incised and examined. The carcases of all sheep have the available lymphatic glands incised. “I understand that countries on the Continent will accept a carcase of mutton with one lymphatic gland, which had been affected with Caseous Lymphadenitis, cutout. Those more extensively affected have the lymphatic glands cut out and are sold locally. If there is a generalised condition in the 43 carcase, the whole of it is condemned as unfit for human food. No carcase showing any evidence of the disease is knowingly passed for export to Britain. “Many of the frigerificos have been partly rebuilt and, as the result of advice which I gave on my previous visit, most of the canning and digester departments are entirely separate from each other and from the slaughtering section. Three of the older frigerificos have been closed, and one new works (the Anglo), belonging to the Union Cold Storage Company, has been built. This establishment, in which 4,000 to 6,000 cattle and over 6,000 sheep can be slaughtered daily, is the best equipped and most hygienic I have seen in any part of the world. As we occasionally find quarters of beef and carcases of mutton showing lesions of disease in the lymphatic glands, I gave particular attention to this defect, and believe I have ascertained how it occurs. All carcases of mutton and sides of beef are examined by the veterinary inspectors as they are suspended on a “moving chain.” Each inspector examines a given area as the beef, mutton or pork passes him. If the carcases, etc., are passing along quicker than the inspector can incise the area for which he is responsible, or if his attention is directed from his duty for even a few seconds, or he has to absent himself for a short period, then carcases or sides may pass his post uninspected. Such omissions should be checked by the final inspecting veternarian, but apparently even there some carcases, etc., may escape minute observation, depending on the rapidity of the numbers passing him. “The regulations, as framed, and the system are very good, but the human element plays, and always will play, an important part in the result. The chief veterinary officer in each frigorificos is held responsible, but it is evident that where up to forty inspectors are working under his charge, it must be difficult to keep each inspector work perfect. “The preserved food sections are well supervised, and there is no inducement or temptation offered to any inspector to pass any unsound food, as the officers are all employed and paid by the Department of Agriculture of the Government. The owners of the frigorificos pay a fixed sum per animal to the Government, out of which the meat inspection staff is paid. Killing can begin only when the chief inspector gives his permission, and must cease if he thinks his staff has done enough work and are fatigued. Office, laboratory and lavatory accommodation are provided by the proprietors for the inspection staff, who are in complete control of everything in the frigorificos. The system of dividing the vertebrae in beef carcases is now done by an electric saw. It was, on my first visit, done by a crosscut saw operated by two men. There are two types of these saws in operation: (1) The circular saw ; the other, a saw similar to that used by a carpenter, but more powerful. In short, the whole system of meat inspection is such as to form a model which I should like to see adopted in this country, as in many rural districts, judged from consignments of meat received in Smithfield, meat inspection is in a most unsatisfactory condition. “The same system of meat inspection and control exists in Uruguay as in Argentina, and, as far as I could see and ascertain, also in Brazil; but, due to a revolution existing when in the latter country, I was unable to visit every frigorificos. There is no scarcity of beef in South America, especially in Argentina, where cattle can be bred and fed ready for killing in first-class condition at 1 year 3 months to 1 year 10 months old. Improvement in the breeding of cattle has continued in all the three countries. Improvement in the breeding of sheep and lambs has not received the same attention, but the production of pigs has made extraordinary progress—e.g., I visited estancios where up to 80,000 pigs were being bred and fed in the open in the same manner as cattle and sheep, never indoors, the feeding being alfalfa, wheat, rye in the green state, and, as an addition, maize. Great attention is being given to producing a “standard pig, “the principal breeds being the Duroc-Jersey (Red) and the Poland-China (Black). “The tour made throughout the breeding and feeding grounds showed me that British farmers can never hope to compete with South American producers—e.g., a first-class ox under two years old can be delivered at the frigorificos for the sum of £10, at a profit to the feeder, whilst at £12 he would be making a very good living. British farmers cannot produce the same type of ox under double this price, and even then it is doubtful whether it would leave any profit. “The experience gained during the tour as to production cost and method of feeding, transport of live animals and meat inspection, has again proved invaluable, and certainly added to my knowledge, making me, I hope, a more efficient meat inspector. “I am deeply grateful to the Corporation of the City of London for permitting me to accept the kind invitations of the Governments of Argentina and Uruguay, also to all their officers and the managers of the frigorificos for their courtesy and kindness, also to the Brazilian Government which, under the circumstances prevailing, did all it could, through its officers, to show me the system of meat inspection in operation. " Where so many officers were so kind it would be invidious to mention names, but I could not omit to specially refer to the great kindness of Dr. J. Richelet, late Attache to the Argentine Embassy in London." PUBLIC HEALTH (IMPORTED FOOD) AMENDMENT REGULATIONS, 1933. These Regulations came into force on September 1st, 1933. Considering the farreaching effect and nature of the regulations, the application of them must of necessity be tempered for a while until a full measure of running order is possible. The principal purpose of the Amendments is the extension of the system of certification of meat exported to England in the country of origin, from edible parts of pigs to that of cattle, sheep and goats also. 44 An “official certificate” is a label, mark, stamp, or other voucher affixed to oversea meat or its containing package by a competent authority in the country of origin and recognised by the Minister of Health as evidence of freedom from disease and careful dressing, preparation and packing. The recognition of an official certificate is effected by notice published by the Minister of Health in the London Gazette. Several new forms of official certificate are already recognised by the Minister and copies are in the hands of your officers. Meat prohibited from importation comprises scrap meat (meat not identifiable with a definite part of a carcase), meat from which pleura or peritoneum is stripped, a carcase not having several specified lymphatic glands in position, and a part of a carcase not having the specified glands appropriate to the part in position. The glands, pleura and peritoneum frequently give good indication of disease, if present, as of its absence. Conditionally admissible meats—that is, meat which must have “official certification” for importation into this country—is (1) A severed part of the carcase of an animal with the specified glands proper to the part in position. (2) Lard, dripping, etc. (3) All edible parts of an animal other than the above (e.g., heart and liver). Sausage casings and meat which has been prepared for human consumption before importation— e.g., sausage and tinned food—are excepted. A part of the carcase of a pig which has been salted, cured, pickled, dried or smoked, or prepared as bacon, is unconditionally admitted as before the amending regulations. In the former regulations these embargoes on and conditions to importation applied mainly to pigs ; they now apply to the chief food animals, cattle, sheep and pigs. The official certificate is largely a guarantee of efficient examination of the live animal and its carcase in the exporting country. It should be an assurance of the possibility of examining that examination, as also the meat itself, in this country, but is not of necessity so. Nothing in these regulations prevents the exercise of the powers of examination already possessed in the case of imported food, as of food in general, and the solid extension of the guarantee with regard to freedom from disease in imported meat conveyed by them will be recognised, especially having regard to the large trade in imported meat at Smithfield Market through the Port of London. PUBLIC HEALTH (MEAT) REGULATIONS, 1924. Constant supervision shows that the object of the Regulations has not yet been obtained to as great a degree as is desirable. The need for cleanliness in the handling and transport of meat is not always realised by the persons concerned. The conditions at Smithfield with regard to meat vehicles continues to improve, but a number of cautions have been necessary with regard to the use of dirty lining cloths, upon which the meat is placed. This year the use of metal-lined meat vehicles has increased among market carriers. One of the aluminium alloys has proved very satisfactory, especially where the sheets of metal are placed on a hard background. The great advancement which has been made by some carriers sets off the cases of carelessness. It has not been necessary to institute proceedings against any of the market porters, although several cautionary letters have had to be sent. The butchers who engage a market porter are responsible for him with regard to the Regulations while he is in their employ— a point not generally recognised. Many butchers now employ the regular market carriers to convey their meat, and some have vehicles which are a good practical advertisement, but considerable supervision is necessary where private cars are used, and where “once-a-week” washings are still considered sufficient. The use of private cars for transport is rapidly increasing, and one feels that this method of conveyance is thoroughly bad practice. Of course, there is no objection if reasonable precaution protects the meat from contamination. 45 Details of the cases heard are as follows:— 1931. 1932. 1933. No. of Cases 32 15 6 No. of Summonses issued 103 50 20 Total Fines £71 10 0 £116 13 0 £17 10 0 Total Costs £4 8 0 £3 3 0 — Six hundred and seventy-four cautionary letters were issued in 1933. The butchers' shops are reaching a high standard of cleanliness. Some distribution centres for restaurants carry too much business for the space available which militates against strict cleanliness. Considerable improvements in premises used for the manufacture of sausages and meat products have been made, some being of a costly nature, and the trade has shown a willingness to work in close co-operation with your officers. In general, I am conscious that the improvements effected during the past year are due to the cordial co-operation of the persons and associations who have met the officers of my department. L.C.C. (GENERAL POWERS) ACT, 1932, PART II. SUMMARY OF TYPES OF PREMISES REGISTERED DURING 1933. Sausage and Cooked Meat Manufacturers 17 Ham Boilers 5 Shellfish Boilers 2 Jellied Eel Merchants 3 Pickling of Olives 1 „ Meats 27 Manufacture of Packet Cheese 1 Preparation of Bacon 4 „ Sausage Casings 4 Note.—Some premises are registered for more than one of the above processes. The number of applications for registration received in 1933 is 56. Twenty premises were immediately registrable, and 32 after alterations. In four, registration was refused. G 46 SUMMARY OF SUMMONSES AND OFFENCES.—PUBLIC HEALTH (MEAT) REGULATIONS, 1924. on of Regulations. OFFENCES. Market Carriers. Market Porters. Multiple Butchers. Small Butchers. Street Butchers. Private Cars. Hotel and Restaurant Proprietors. 1931 1932 1933 1931 1932 1933 1931 1932 1933 1931 1932 1933 1931 1932 1933 1931 1932 1933 1931 1932 1933 Part VI, Clause 21, Section (1) (a). Dirty Vehicle 4 6 3 - — — 7 4 12 11 3 4 - 1 1 1 - — — — Part VI, Clause 21, Section (1) (b). Meat in contact with other commodities (furred rabbits, poultry, spare tyres, etc.). — 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 - - - - - - - - - 1 - - - - - - - - - - - Part VI, Clause 21, Section (2) (a). Meat in contact with ground - - - - - - - - - - 1 - - - - - - - - - - Part VI, Clause 21, Section (3). Head covering Offence 5 1 5 7 - - 6 2 - 6 1 2 1 - 1 2 - - - - - Part VI, Clause 21, Section (3). Overall Offence 4 1 - — - - — 1 - 4 6 — 2 - - 1 - - - - - Part VI, Clause 21, Section (2) (b). Meat in contact with floor mat of a Private Car. - - - - - - - - - - - - - - - 4 - - - - - Part VI, Clause 21, Section (2) (b). Meat contaminated with visible dirt - - - - - - 6 - - - 1 - - 1 - 1 - - - - - Part VI, Clause 21, Section (2) (b.) Dirty and stinking cloths used for protecting the meat. 2 3 1 2 - - — 2 - 3 7 1 2 - - 3 - - - - - Part VI, Clause 21, Section (1) (b). Meat being conveyed uncovered 1 - - - - - 1 - - 2 - - - - - 2 1 - - - - Part I, Section 5 Obstruction of an Inspector - - - - - - - - - - - - - - - - - - - - - Totals 16 12 9 10 - - 23 9 - 30 27 6 10 - 2 14 2 - - - - 47 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 153,146 Bacon Bags „ 1 cwt. 2 qrs.—3 cwts. 101,822 Cheese (Loose) Cases „ 1 lb.—8 lbs 46,588 Cheese Single Packages „ 24 lbs.—1 cwt 290,188 Eggs (Fresh) Cases „ 84 lbs.—1 cwt. 2 qrs. 65,992 Eggs (Dried) Packages „ 56 lbs.—1 cwt 26 Egg Yolk Casks Holland and China 56 lbs.—4 cwts. 438 Compound Packages Holland 56 lbs. 10 Beef Dripping Casks South America 56 lbs.—1 cwt 600 Lard „ South America and Holland. 28 lbs.—56 lbs 20,022 Margarine „ Holland 12 lbs.—56 lbs 22,541 Cereals— Barley Bags „ 100 lbs.—1 cwt. 2 qrs. 749 Beans „ „ 1 cwt.—2 cwts 10,882 Peas „ „ 1 cwt.—1 cwt. 3 qrs. 19,919 Rice „ Italy and Spain I cwt.—1 cwt. 2 qrs. 1,591 Semolina „ Holland 1 cwt. 100 Cocoa „ Holland, East Africa and Ceylon. 28 lbs.—2 cwts. 14,463 Coffee „ East Africa, Costa 1 cwt. 2 qrs 89,191 Rica and Holland. Fruit (Soft):— Apples Packages Holland and Australia 28 lbs.—1 cwt. 2 qrs. 9,618 Cherries „ Holland 12 lbs.—40 lbs 289 Cranberries „ 28 lbs. 12,556 Currants „ „ 6 lbs.—12 lbs 5 Gooseberries „ „ 40 lbs.—100 lbs. 59 Loganberries „ „ 6 lbs.—12 lbs 800 Peaches „ „ 10 lbs.—14 lbs 104 Pears „ „ 6 lbs.—28 lbs 8,355 Plums „ „ 7 lbs.—28 lbs 1,391 Red Currants „ „ 6 lbs.—12 lbs 2 Rhubarb „ „ 6 lbs.—12 lbs 25 Strawberries „ „ 6 lbs.—14 lbs 36 Fruit (Dried):— „ Apricots „ America, S. Africa and 28 lbs.—56 lbs 60,592 „ Persia. Currants „ America, Greece and Turkey. 28 lbs.—56 lbs 278,704 Dates „ Mesopotamia and Egypt- 3 qrs. 25,992 Evaporated Apples „ E. Africa, Canada 56 lbs. 98,732 „ and America. Figs „ Turkey and Spain 28 lbs.—4 cwts. 102,434 Fruit Salad „ Canada, America and S. Africa. 28 lbs.—56 lbs 1,300 Nectarines „ America and S. Africa 56 lbs. 1,769 Peaches „ S. Africa, Canada and America. 24 lbs. 5,250 Pears „ „ „ „ 24 lbs. 6,022 Plums „ S. Africa and California. 24 lbs. 195,461 Preserved Fruit „ Holland 10 lbs.—56 lbs 478 Raisins „ Spain, Turkey, Greece and America. 6 lbs.—56 lbs 253,767 Sultanas „ S. Africa, Persia, Greece, Turkey and U.S.A. 24 lbs.—56 lbs 266,343 Fruit (Green):— „ Grape Fruit Packages Florida and Jaffa 56 lbs.—1 cwt 964 Grapes „ Holland and Spain 12 lbs.—1 cwt 62,363 Lemons „ Italy and Spain 1 cwt. 356,577 Melons „ Holland and Spain 12 lbs.—1 cwt. 1 qr. 79,308 Oranges „ Spain, Italy and Jaffa 3 qrs.—1 cwt. 1 qr. 75,368 Pines „ St. Michaels 1 qr. 16 lbs.—2 qrs. 18 lbs. 5,755 Pomegranates „ Spain 28 lbs.—1 cwt. 1 qr. 15 g 2 48  Description of Generall Range of Article. Packages. Where from. Weight of Packages. Where from. Vegetables— Beans Packages Holland 40 lbs. 16,489 Beetroots „ „ 1 cwt. 42 Cabbages „ „ 1 cwt. 13,768 Carrots „ „ 40 lbs.—1 cwt. 1 qr. 49,490 Cauliflowers „ „ 24 lbs.—40 lbs 18,050 Celery „ „ 28 lbs. 19 Cucumbers „ „ 12 lbs.—40 lbs 6,973 Lettuce „ „ 12 lbs.—28 lbs 360,664 Onions „ „ 1 cwt.—1 cwt. 1 qr. 102,853 Parsnips „ „ 1 cwt. 916 Potatoes „ „ 56 lbs.—1 cwt. 1 qr. 208,875 Radishes „ „ 28 lbs.—1 cwt 12,737 Sprouts „ „ 100 lbs. 157 Tomatoes „ „ 12 lbs.—56 lbs 351,906 Turnips „ „ 1 cwt.—2 cwts 10 Sugar Bags „ 1 cwt.—2 cwts 500 Tea Chests India, China, Tava and 1 cwt. 100,943 Ceylon. Tinned Goods— Anchovies Cases Portugal 2 cwts.—3 cwts. 272 Apples „ Canada, Australia and 50 lbs.—1 cwt 13,583 America. Apricots „ Australia and California 48 lbs. 33,955 Asparagus „ Canada and America 56 lbs.—1 cwt 2,380 Beans „ Spain and Italy 1 cwt. 1,241 Beef Brisket „ South America 90 lbs. 5,081 Beef Extract „ „ 1 cwt.—1 cwt. 2 qrs. 2,400 Blueberries „ Holland 1 cwt. 5 Boiled Beef „ South America 90 lbs. 1,899 Brawn „ Holland 36 lbs. 3,125 Cherries „ Italy 28 lbs.—48 lbs 28,465 Chicken „ Holland 1 cwt. 155 Condensed Milk „ „ 48 lbs. 1,081,635 Corned Beef „ South America 72 lbs. 35,949 Crab „ Japan and America 56 lbs. 350 Figs „ America 1 cwt. 603 Fish „ Holland and Portugal 1 cwt. 60 Fruit Pulp „ Spain, Italy, Holland 72 lbs.—100 lbs. 17,887 and Australia. Fruit Salad Australia and California 56 lbs.—100 lbs. 8,935 Glands „ South America 1 cwt.—2 cwts 9 Grape Fruit „ Florida 50 lbs. 13,290 Hams „ Holland 20 lbs.—1 cwt. 1 qr. 372 Kidneys „ South America 56 lbs. 75 Loganberries „ California 1 cwt. 5,225 Lobster „ „ 50 lbs. 14,952 Mandarines „ Japan 56 lbs.—1 cwt 150 Meat Roll „ Holland 56 lbs.—1 cwt 500 Oranges „ Japan 56 lbs.—1 cwt 5,380 Ox Tripe „ South America 56 lbs. 120 Peaches „ Australia, Canada and 48 lbs. 73,455 California. Peas „ Spain, Italy and 48 lbs. 11,908 America. Pears „ Australia, Canada and 48 lbs. 39,689 California Pines „ Hawaii and Singapore 60 lbs. 126,673 Pilchards „ California 60 lbs. 2,800 Plums „ Canada and America 60 lbs. 870 Pork and Beans „ America 60 lbs. 755 Pressed Beef „ South America 90 lbs. 694 Prawns America 56 lbs. 7,322 Rhubarb „ Holland 1 cwt. 65 Salmon „ America and Canada 56 lbs.—1 cwt 8,019 Sardines „ Portugal 56 lbs.—1 cwt 20,770 Sausages „ Holland 56 lbs.—1 cwt 925 Soup „ Canada and S. America 56 lbs. 260 Sterilised Cream „ Denmark and Holland 14 lbs.—56 lbs 1,424 Strawberries „ America and Canada 48 lbs. 37 Sugar Corn „ „ „ 56 lbs. 3,017 Tomatoes „ Italy and Canada 56 lbs. 53,388 49 Description of General Range of Article. Packages. Where from. Weight of Packages. Quantity. Tinned Goods—(continued)— Tongues Cases Holland and S. America; 48 lbs.—1 cwt 6,482 Veal „ Holland 56 lbs.—100 lbs 11,676 Vegetables „ Holland, Spain and Italy 50 lbs.—100 lbs 2,083 Macaroni Packages Italy 28 lbs. 21,756 Milk Powder „ Holland 50 lbs.—1 cwt 34,361 Nuts (Various) Bags, Packages Spain, China, Holland and Russia. 50 lbs.—1 cwt. 1 qr 34,130 Vegetables (in Casks Brine). Spain, Italy and Holland. 3 cwts.—4 cwts. 10,888 Vegetables (Dried) Packages Holland 56 lbs. 10 Ginger (Preserved) Casks, Cases China 30 lbs.—3 cwts. 54,843 Nuts (in Brine) Casks Spain, Italy and Holland. 3 cwts.—4 cwts. 224 Miscellaneous— Aniseed Packages Italy 1 cwt. 13 Biscuits „ Holland 1 cwt.—1 cwt. 1 qr 744 Carraway Seeds ,, „ 1 cwt. 1 qr 1,505 Cherries (in Brine) Casks Italy 2 cwts.—3 cwts. 992 Chocolate Packages Holland 50 lbs.—1 cwt. 1 qr 669 Citrons (in Brine) Casks Spain 4 cwts. 44 Cocoa Butter Packages Holland 1 cwt.—2 cwts 2,583 Chutney Casks India 1 cwt.—3 cwts 10 Condensed Milk „ Holland 4 cwts.—6 cwts. 5,843 Confectionery Packages „ 28 lbs.—1 cwt 774 Crispbread „ Sweden 56 lbs. 17,430 Desiccated Cocoanut „ Ceylon 28 lbs.—1 cwt. 18 lbs 4,452 Drained Cherries „ Italy and Canada 28 lbs.—1 cwt 1,189 Drained Citrons „ Spain 56 lbs.—1 cwt. 1 qr 110 Fresh Cream Drums Holland 56 lbs.—130 lbs 211 Fruit and Lemon Casks Spain and Italy 3 cwts.—4 cwts. 2,628 Juice. Fruit Pulp ,, Spain, Italy and 4 cwts. 6,946 Holland. Honey ,, Holland and America 1 cwt.—2 cwts 1,129 Glands ,, Holland 1 cwt.—2 cwts 60 Glucose „ „ 56 lbs.—1 cwt 26 Jam Australia 3 qrs. 9 lbs 48 Liquorice Packages Italy 1 cwt.—2 cwts 516 Marmalade Casks Florida 1£ cwts.—2 cwts. 1 qr. 7 Peel (in Brine) ,, Spain and Italy 4 cwts.—5 cwts. 1,135 Poultry Packages Holland 24 lbs.—56 lbs 638 Sugar Candy „ „ 28 lbs.—56 lbs 385 Casings Casks „ 56 lbs.—3 cwts. 354 Rabbits Packages „ 1 cwt. 777 Vegetable Powder ,, „ 1 cwt. 2 qrs 1,570 Yeast ,, „ 28 lbs.—56 lbs 6,610 Potato Flour „ „ 1 cwt. 20 Turtle Meat ,, South America 56 lbs. 8 Rice Flour „ Holland 1 cwt. 64 Cloves ,, West Indies 1 cwt. 106 Beef Powder „ South America 56 lbs.—2 cwts. 367 AGRICULTURAL PRODUCE (GRADING AND MARKING) ACT, 1928. MERCHANDISE MARKS ACT, 1926. The administration of the above-mentioned Acts has been attended with little difficulty in persuading affected parties to conform to the requirements. Casual street vendors, as a rule, still appear to have little knowledge of the requirements of the law, but those regularly engaged in this kind of work, having once been acquainted by the Inspector of their obligations, very readily remedy any omission. In shops and stores defect is almost invariably due to the failing of assistants to carry out the proprietors' instructions. The marked improvement in packing and grading of produce is very evident. During the year 2,261 shops and 685 street vendors were visited, and 14 minor offences in connection with the former, and 18 in the latter, were remedied without delay. Twenty new orders were issued under the Agricultural Produce (Grading and Marking) Act, 1928. 50 FERTILISERS AND FEEDING STUFFS ACT, 1928. During the year 150 visits have been made in connection with the above-mentioned Act, and 25 special enquiries instituted in connection with reports by other Authorities of neglect to comply with requirements. Offences disclosed have nearly always been due to ignorance of the somewhat difficult clauses of the Act, and the assistance which your Officer has been able to give in explaining the points of difficulty has been much appreciated. The Quarterly Returns to the Ministry of Agriculture and Fisheries have been made in the usual way. SUPERVISION OF FOOD AND DRUGS. During the year 1933, 1,012 samples of food and drugs were submitted to the Public Analyst for examination, 807 of which were taken as informal or test samples without the formalities of the Food and Drugs (Adulteration) Act, 1928, being observed. Seventeen of these informal samples were reported against, as follows:— Samples. 3 Sausages 43 3 Spices, Herbs and Condiments 49 2 Soups 6 2 Pickles and Sauces 19 2 Wines, Non-Alcoholic 11 1 Camphorated Oil 4 1 Glycerin of Alum 2 1 Glycerin of Phenol 2 1 Magnesia Preparation 1 1 Grey Powder 1 17 Of the formal samples, 21 out of 205 were reported against, as follows:— Samples. 11 Milk 165 2 Pickles and Sauces 2 2 Spices and Herbs 2 1 Mustard 1 1 Rum 12 1 Camphorated Oil 1 1 Glycerin of Alum 1 1 Glycerin of Phenol 1 1 Tincture of Iodine 1 21 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 3.7, as compared with 4.4 in 1932. Butter, Cream and Cheese.—It is interesting to note that none of the 63 samples of these dairy products was reported against. Spices, etc.—Of the 72 samples of spices, herbs, condiments, pickles and sauces taken, 9 were reported against, 8 of which related to adulterated mint. This mint, originally imported, was found to be an admixture of dried mint with quantities of leaves of Ailanthus (Tree of Heaven), varying from 20 per cent. to as much as 50 per cent. These leaves are practically tasteless and odourless, and are used for packing, and have been in use in Italy for feeding certain types of silkworm. They are, of course, quite useless for the purpose of flavouring, for which mint is employed. Three prosecutions were taken in connection with the sale of this article. Sausages.—By the Public Health (Preservatives, etc., in Food) Regulations, sausages is one of the articles in which Sulphur Dioxide preservative is permitted to be used to a limited amount, provided that the presence of preservative is declared by notice or label in a specified manner. Of the 43 samples of sausages purchased, 14 were sold as containing preservative, and, on examination, the actual amount in no case exceeded the maximum permitted. Three samples were reported against as containing preservative, though no 51 declaration had been made by label or notice, and in each case the vendors were cautioned and the requirements of the regulations brought to their notice. Ice Cream.—The consumption of this important commodity has greatly increased during the past few years, and it is to be regretted that no legal definition or standard of quality exists for ice cream. Analyses of the 28 samples taken in the City showed a very wide range in the percentage fat content, which bore little relationship with the prices charged. Thirteen of the samples, purchased at restaurants, had a fat content of 8 per cent, or more, ranging from 8.5 per cent. to 24.4 per cent., with an average of 13.5 per cent. Fifteen samples, taken principally from itinerant vendors, had a fat content ranging from 0.6 per cent. to 4.6 per cent., with an average of 2.6 per cent. It may reasonably be submitted that ice cream should have a milk fat content of at least 8 per cent., and consist only of butter fat, milk solids-not-fat, sugar, gelatine and water. Mixtures which principally consist of milk, sugar, cornflour, eggs, etc., should not be permitted to be sold as ice cream, but under an appropriate designation such as Ice or Ice Custard. Spirits.—Twenty-seven samples of spirits were purchased formally and, with one exception, found to be above the standard of 35 degrees under proof. Legal proceedings were taken and a conviction obtained against a licensed victualler in connection with the sale of a sample of rum. A fine of £10, with £3 3s. 0d. Costs, was imposed after proof of a previous conviction. Non-Alcoholic Wines.—Eleven samples were taken and 2 were found to contain salicylic acid, a preservative the use of which is prohibited by the Public Health (Preservatives, etc., in Food) Regulations, and one which the Public Analyst states he has not found in any article of food for some years past. Enquiries revealed that the bottles were of very old stock and had been supplied by the wholesaler or manufacturer prior to the Preservative Regulations coming into operation. Permission was given to the retailers to withdraw the unsold stock from sale. Drugs.—Of the 120 samples of drugs taken, 9 were reported against as not complying with the requirements of the British Pharmacopoeia or not being in accordance with the formula on the container. Legal proceedings were instituted and fines imposed in two instances, and in the other cases, where the discrepancy or deficiency was small, the vendors were communicated with. EXAMINATION OF MILK. Chemical.—Eleven of the 165 samples of milk which were taken formally were certified to be below the standards which presume adulteration, equivalent to a percentage figure of 6.6, as compared with 7.2 in 1932. In most cases the deficiency was small, and further samples were taken which were certified to be genuine. The low fat figure was probably due to the absence of, or neglect to use, a proper plunger, in order to keep the milk constituents uniform. In such cases the attention of the vendors or consignors was directed to the necessity of taking precautions to see that the milk was sold in the same state as when it was received. Fifty-five of the samples were purchased from milk roundsmen in the streets. The only case of legal action was in reference to a sample purchased from a milk roundsman and certified to contain 7.2 per cent. of extraneous water. The vendor was fined £4, with £1 0s. 6d. Costs. The following table shows the percentage fat-content in each of the 165 samples of milk procured in the City during the year, the average fat-content being 3.4 per cent., only 9 samples falling below the standard figure of 3 per cent.:— Percentage of Fat. No. of Samples. Percentage of Fat. No. of Samples. Percentage of Fat. No. of Samples. 2.5 l 3.3 26 4.0 5 2.7 l 3.4 27 4.1 2 2.8 l 3.5 18 4.2 2 2.9 6 3.6 19 4.3 2 3.0 6 3.7 8 4.6 2 3.1 8 3.8 12 5.0 1 3.2 9 3.9 9 Total 165 52 Six 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, 1928. THE MILK AND DAIRIES ORDER, 1926, AND THE MILK AND DAIRIES (AMENDMENT) ACT, 1922. Ten new applications for registration as retail purveyors of milk were received during the year, and none was refused. Five 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 1932 286 New Applications for Registration received 10 Applications granted 10 Applications refused — Names of Retailers removed from Register 5 Number of Retail Purveyors of Milk on the Register at end of 1933 291 Number of Milk Sellers (other than Retail Purveyors of Milk) on the Register at end of 1933 25 Licenses issued under the Milk (Special Designations) Order, 1923 16 Inspection of Premises where Milk is Retailed.—During the year 187 inspections were made in connection with the sale of milk, and the statutory requirements were found generally to be complied with. Observations have been made from time to time in order to ensure that milk distribution has been conducted in accordance with the requirements of the Milk and Dairies Order, 1926, and no instances, such as the bottling of milk elsewhere than in a dairy, have been recorded. THE PUBLIC HEALTH (CONDENSED MILK) REGULATIONS, 1923 AND 1927. THE PUBLIC HEALTH (DRIED MILK) REGULATIONS, 1923 AND 1927. Fourteen 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 and the requirements respecting labelling. The one sample of dried milk taken was reported satisfactory in all respects. REGISTERED PREMISES. Butter Factories.—One butter factory is registered in the City. Samples taken at irregular intervals at these premises 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 55 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. 3 Desiccated Soup Informal Sulphite Preservative equivalent to 124 parts of Sulphur Dioxide per million. ... Manufacturers communicated with. Method of manufacture altered. 4 Desiccated Soup Informal Sulphite Preservative equivalent to 49 parts of Sulphur Dioxide per million. ... Manufacturers communicated with. Method of manufacture altered. 13 Tincture of Iodine Formal Iodine in excess to 78% and Potassium Iodide deficient to 100%. Taken in connection with sample No. 999 (1932) Vendors prosecuted. Fined £5, with £1 0s. 6d. Costs. 35 Mustard Formal Starch, 4%. Taken in connection with sample No. 803 (1932) Manufacturers and Vendors communicated with Containers marked as containing a mixture. 39 Milk Formal Milk fat deficient, 4%. Re-sampled—genuine ... 183 Milk Formal Milk fat deficient, 5%. Re-sampled—genuine ... 235 Glycerin of Phenol Informal Phenol deficient, 36.2%. Re-sampled formally—No. 333 ... 237 Grey Powder (2 grains) Informal Mercury deficient, 27.2%, and Chalk deficient, 18.6%. Re-sampled formally—genuine ... 252 Milk Formal Extraneous water, 2.2%. Re-sampled. See sample No. 420 ... 253 Milk Formal Extraneous water, 1.9%. Re-sampled. See sample No. 420 ... 273 Magnesia Oil Informal Magnesia deficient, 77.3%. ... Manufacturers communicated with. Error found to exist in formula on container. 285 Glycerin of Alum Informal Alum deficient, 13.3%. Re-sampled formally—No. 334 ... 304 Dried Mint Informal Leaves foreign to genuine Mint, 32%. Re-sampled formally—No. 331 ... 313 Milk Formal Milk fat deficient, 16.3%. Two of five churns consigned. Consignor cautioned. 316 Milk Formal Milk fat deficient, 7.6%. Remainder genuine. ... 318 Milk Formal Milk fat deficient, 3.3%. Two churns consigned, one genuine Consignor cautioned. 326 Rum Formal Proof Spirit deficient, 4.5 degrees. ... Vendor prosecuted. Fined £10, with £3 3s. 0d. Costs. Previous conviction. 331 Dried Mint Formal Leaves foreign to genuine Mint, 38%. Taken in connection with Sample No. 304 Retailer prosecuted. Summons dismissed under Probation of Offenders Act on payment of £3 3s. 0d. Costs. Suppliers prosecuted. Summons dismissed under Probation of Offenders Act on payment of £5 5s. 0d. Costs. 333 Glycerin of Phenol Formal Phenol deficient, 17.8%. Taken in connection with Sample No. 235 Vendor cautioned. 334 Glycerin of Alum Formal Alum deficient, 15%. Taken in connection with Sample No. 285 Vendor cautioned. 339 Sausages Informal Sulphur Dioxide, 85 parts per million. ... Vendor cautioned. Use of preservatives discontinued. 420 Milk Formal Extraneous water, 7.2%. ... Vendor prosecuted. Fined £4 and £1 0s. 6d. Costs 436 Sausages Informal Sulphur Dioxide, 240 parts per million. ... Vendor cautioned. 438 Camphorated Oil Informal Camphor deficient, 12.3%. Re-sampled formally—No. 468 ... 461 Sausages Informal Sulphur Dioxide, 285 parts per million. ... Vendor cautioned. 468 Camphorated Oil Formal Camphor deficient 11% Taken in connection with sample No. 438 Vendor prosecuted. Fined £1, with £1 1s. 0d. Costs. 538 Mint Sauce Informal Leaves foreign to genuine Mint, 40%. Re-sampled formally—No. 668 ... H 2 56 57 ADMINISTRATIVE ACTION REGARDING ADULTERATION OR OTHER IRREGULARITY—continued. Serial No. Article. Whether Formal or Informal. Nature of Adulteration or Irregularity. Observations. Results of Proceedings or other Action taken. 612 Dried Mint Informal Leaves foreign to genuine Mint, 28% Re-sampled formally—No. 667 ... 615 Mint Sauce Informal Leaves foreign to genuine Mint, 40% Re-sampled formally—No. 666 ... 666 Mint Sauce Formal Leaves foreign to genuine Mint, 50% Taken in connection with sample No. 615 Vendor prosecuted. Summons dismissed under Probation of Offenders Act on payment of £1 1s. 0d. Costs. 667 Dried Mint Formal Leaves foreign to genuine Mint, 20% Taken in connection with sample No. 612 Vendor prosecuted. Summons dismissed. Warranty proved. 668 Mint Sauce Formal Leaves foreign to genuine Mint, 40% Taken in connection with sample No. 538 Vendor prosecuted. Fined £1, with £5 5s. 0d Costs. 741 Milk Formal Milk fat deficient, 4% Re-sampled—genuine. ... 758 Milk Formal Extraneous water, 2.3% Further sample not obtainable as consignor ceased to send milk. ... 807 Cowslip Wine (Non-Alcoholic). Informal Salicylic Acid, 250 parts per million ... Manufacturers communicated with. Old stock, withdrawn from sale. 829 Raisin Wine (Non-Alcoholic). Informal Salicylic Acid, 20 parts per million ... Manufacturers communicated with. Old stock, withdrawn from sale. 957 Milk Formal Milk fat deficient, 9% ... Vendor cautioned. 1010 Curry Powder Informal Lead, 96 parts per million 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 — l l — — — — — — Bread — l l — — — — — — Butter 3 7 10 — — — — — — Butter (on bread) — 18 18 — — — — — — Cheese — 19 19 — — — — — — Cocoa — 4 4 — — — — — — Coffee — 6 6 — — — — — — Confectionery — 37 37 — — — — — — Cream — 26 26 — — — — — — Flour — 1 1 — — — — — — Flour (Self-raising) — 1 1 — — — — — — Jam and Marmalade — 18 18 — — — — — — Lard — 7 7 — — — — — — Margarine — 14 14 — — — — — — Milk 165 — 165 11 — 11 6.6 — 6.6 Milk, Condensed — 14 14 — — — — — — Mustard 1 12 13 1 — l 100.0 — 7.6 Sugar — 7 7 — — — — — — Tea — 14 14 — — — — — — Vinegar — 29 29 — — — — — — Wines — 4 4 — — — — — — Spirits 27 — 27 l — l 3.7 — 3.7 Drugs 5 115 120 4 5 9 80.0 4.3 7.5 Other Articles 4 452 456 4 12 16 100.0 2.6 3.5 Totals 205 807 1012 21 17 38 10.2 2.1 3.7 Spirits— Gin 4 — 4 — — — — — — Rum 12 — 12 1 — 1 8.3 — 8.3 Whisky 11 — 11 — — — — — — Totals 27 — 27 1 — 1 3.7 — 3.7 Drugs— Acid, Acetic — 2 2 — — — — — — Camphorated Oil 1 4 5 1 1 2 100.0 25.0 40.0 Cream of Tartar — 1 1 — — — — — — Epsom Salts — 1 1 — — — — — — Essences, Various — 8 8 — — — — — — Ginger, Ground — 4 4 — — — — — — Glycerine of Alum 1 2 3 1 1 2 100.0 50.0 66.6 „ „ Borax — 3 3 — — — — — — „ „ Phenol 1 2 3 1 1 2 100.0 50.0 66.6 Hydrogen Peroxide — 3 3 — — — — — — Liniment of Turpentine — 3 3 — — — — — — Linseed, Crushed — 4 4 — — — — — — Lozenges and Tablets — 27 27 — — — — — — Magnesia Preparation — 1 1 — 1 1 — 100.0 100.0 Oil, Almond — 4 4 — — — — — — Oil, Cloves — 1 1 — — — — — — Oil, Eucalyptus — 1 1 — — — — — — Ointment, Calomel — 3 3 — — — — — — Ointment, Gall and Opium — 1 1 — — — — — — Ointment, White Precipitate — 7 7 — — — — — — Ointment, Zinc — 3 3 — — — — — — Paraffin, Liquid — 5 5 — — — — — — Paregoric — 4 4 — — — — — — Powder, Grey 1 1 2 — 1 1 — 100.0 50.0 Powder, Liquorice Compound — 5 5 — — — — — — Powder, Seidlitz — 1 1 — — — — — — Sal Volatile — 4 4 — — — — — — Carried forward 4 105 109 3 5 8 75.0 4.3 7.3 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 4 105 109 3 5 8 75.0 4.3 7.3 Soda Bicarbonate — 1 1 — — — — — — Sulphur, Flowers of — 2 2 — — — — — — Tincture, Iodine 1 5 6 l — 1 100.0 — 16.6 Tincture, Quinine — 2 2 — — — — — — Totals 5 115 120 4 5 9 80.0 4.3 7.5 Other Articles— — — — — — Arrowroot — 2 2 — — — — — — Baking Powder — 2 2 — — — — — — Barley, Pearl — 2 2 — — — — — — Beverages, etc. — 41 41 — — — — — — Cake and Bicuits — 15 15 — — — — — — Chocolate Powder — 1 1 — — — — — — Coffee Mixtures, etc. — 4 4 — — — — — — Cornflour — 2 2 — — — — — — Dried Milk — 2 2 — — — — — — Dripping — 5 5 — — — — — — Egg Powder Substitute — 1 1 — — — — — — Fish — 7 7 — — — — — — Fish, Canned — 12 12 — — — — — — Fish, Potted — 9 9 — — — — — — Fruit, Bottled and Canned — 10 10 — — — — — — Fruit, Dried — 33 33 — — — — — — Fruit Crystallised — 15 15 — — — — — — Fruit Flavouring — 1 1 — — — — — — Honey — 6 6 — — — — — — Ice Cream — 28 28 — — — — — — Jellies — 9 9 — — — — — — Lemonade Powder, etc. — 17 17 — — — — — — Lemon Curd, etc. — 7 7 — — — — — — Meat — 32 32 — — — — — — Meat, Canned — 4 4 — — — — — — Meat, Potted — 5 5 — — — — — — Meat Pies — 11 11 — — — — — — Mincemeat — 6 6 — — — — — — Oatmeal — 1 1 — — — — — — Olive Oil — 6 6 — — — — — — Pepper — 7 7 — — — — — — Pickles and Sauces 2 19 21 2 2 4 100.0 10.5 19.0 Powder, Custard — 1 1 — — — — — — Preserved Vegetables — 8 8 — — — — — — Rice — 6 6 — — — — — — Sago — 1 1 — — — — — — Sausages, etc. — 43 43 — 3 3 — 6.9 6.9 Soups — 6 6 — 2 2 — 33.3 33.3 Spices, Herbs, and Condiments 2 49 51 2 3 5 100.0 6.1 9.8 Tapioca — 1 1 — — — — — — Treacle, etc. — 1 1 — — — — — — Water, Aerated — 1 1 — — — — — — Wines (Non-alcoholic) — 11 11 — 2 2 — 18.1 18.1 Yeast — 2 2 — — — — — — Totals 4 452 456 4 12 16 100.0 2.6 3.5 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. 13 Tincture of Iodine 78% excess of Iodine and 100% deficient in Potassium Iodide. £5 and £1 0s. 6d. Costs. 326 Rum 39.5 degrees under proof £10 and £3 3s. 0d. Costs. 331 Dried Mint 38% leaves foreign to genuine Mint Dismissed under Probation of Offenders Act on payment of £3 3s. Costs. 331 Dried Mint Label falsely described Mint, which contained 38% leaves foreign to genuine Mint. Dismissed under Probation of Offenders Act on payment of £5 5s. Costs. 420 Milk 7.2% extraneous water £4 and £1 0s. 6d. Costs. 468 Camphorated Oil 11% deficient in Camphor £1 and £1 1s. Costs. 666 Mint Sauce 50% leaves foreign to genuine Mint Dismissed under Probation of Offenders Act on payment of £1 1s. Costs. 667 Dried Mint 20% leaves foreign to genuine Mint Dismissed. Warranty proved. 668 Mint Sauce 40% leaves foreign to genuine Mint £1 and £5 5s. Costs. SUMMARY. Total Fines £21 0s. 0d. Total Costs £20 19s. 0d. BACTERIOLOGICAL AND CHEMICAL EXAMINATION OF MILK. SAMPLES COLLECTED 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. Precautions were taken during the collection of the samples to ensure that they were not contaminated during the process. Fifty samples were collected and these were sent from different farms situated in the following counties:— Norfolk 24 Hertfordshire 2 Suffolk 19 Cambridgeshire 1 Essex 4 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. Dirt. Date of Death. Post Mortem Findings. Result qua Tubercle. l 11th March Trace 24th April Caseating right inguinal glands. Tuberculous liver and spleen. Tubercle bacilli demonstrated in pus from gland. Positive. 2 11th March Trace 24th April Normal Negative. 3 11th March Trace 12th April Perisplenitis and perihepatitis. No evidence of tuberculosis. Negative. 4 11th March Trace 24th April Normal Negative. 5 11th March Trace 15th March Normal Frustrate. 6 11th March Trace 24th April Normal Negative. 7 14th March Nil 26th April Normal Negative. 8 14th March Nil 18th March Normal Frustate. 9 14th March Nil 26th April Normal Negative. 10 14th March Trace 24th June Caseating right inguinal lumbar glands. Massive tuberculosis of spleen and liver. Tubercle bacilli demonstrated in pus from gland. Positive. 11 14th March Nil 24th June Caseous right inguinal lumbar glands. Moderate degree of tuberculosis of spleen. Slight degree of tuberculosis of liver. Tubercle bacilli demonstrated in pus from gland. Positive. 12 14th March Trace 24th March Normal Negative. 13 16th March Nil 3rd May Normal Negative. 61 No. of Sample. Date of inoculation of Guinea Pig. Dirt. Date of Death. Post Mortem Findings. Result qua Tubercle. 14 16th March Trace 3rd May Normal Negative. 15 16th March Trace 3rd May Normal Negative. 16 16th March Trace 3rd May Normal Negative. 17 16th March Trace 3rd May Normal Negative. 18 16th March Trace 3rd May Normal Negative. 19 22nd March Trace 5th April Miliary nodules in spleen and liver. Caseous right inguinal glands. No tubercle bacilli found. Culture grows gram negative bacilli. Pus from gland inoculated into another guineapig. (See 19a.) 19a 13th April Nil 16th June Normal Frustrate. 20 22nd March Trace 4th May Normal Negative. 21 22nd March Trace 4th May Normal Negative. 22 22nd March Nil 4th May Normal Negative. 23 22nd March Trace 4th May Small caseous glands in right inguinal and lumbar regions. Tuberculosis of spleen. Early tuberculosis of liver. Tubercle bacilli demonstrated in spleen. Positive. 24 22nd March Trace 4th May Normal Negative. 25 7th Oct. Nil 22nd Nov. Tuberculous glands in right inguinal region. Early tuberculosis of spleen and liver. Tubercle bacilli demonstrated in spleen. Positive. 26 7th Oct. Nil 22nd Nov. Normal Negative. 27 7th Oct. Nil 22nd Nov. Normal Negative. 28 7th Oct. Trace 22nd Nov. Normal Negative. 29 7th Oct. Nil 22nd Nov. Normal Negative. 30 7th Oct. Nil 22nd Nov. Normal Negative. 31 10th Oct. Nil 27 th Nov. Normal Negative. 32 10th Oct. Trace 27th Nov. Normal Negative. 33 10th Oct. Trace 27th Nov. Normal Negative. 34 10th Oct. Nil 27th Nov. Normal Negative. 35 10th Oct. Nil 27th Nov. Normal Negative. 36 10th Oct. Nil 27th Nov. Normal Negative. 37 10th Oct. Nil 1st Dec. Normal Negative. 38 12 th Oct. Trace 1st Dec. Normal Negative. 39 12th Oct. Nil 1st Dec. Normal Negative. 40 12th Oct. Nil 1st Dec. Normal Negative. 41 12th Oct. Nil 1st Dec. Normal Negative. 42 12 th Oct. Nil 1st Feb. Tuberculous glands in right inguinal and lumbar regions. Early tuberculosis of liver and advanced tuberculosis of spleen. Tubercle bacilli demonstrated in inguinal glands. Positive. 43 17th Oct. Trace 6th Dec. Large abscess in right inguinal region, containing coliform bacilli and streptococci. No other lesions. Negative. 44 17th Oct. Nil 6th Dec. Normal Negative. 45 17th Oct. Trace 6th Dec. Normal Negative. 46 17th Oct. Nil 30th Oct. Normal Frustrate. 47 17th Oct. Nil 6th Dec. Normal Negative. 48 17th Oct. Nil 27th Nov. Normal Negative. 49 8th Nov. Nil 19th Dec. Normal Negative. 50 8th Nov. Nil 19th Dec. Normal Negative. "Dirt.— As regards dirt, about half the samples were clean, and half contained a trace, but none could be considered objectionable. "Tuberculosis.— Two samples (Nos. 8 and 11) were repetitions of samples found positive in September last (viz., Nos. 2 and 43, 1932, respectively). In the first, the animal died within one week of inoculation, and the experiment was therefore frustrate, and the second was again found to be positive. As these samples were collected with bias, they have been excluded from the calculations. "Three other animals died within one month, and have also been excluded. One of these (No. 19) died 14 days after inoculation, and was found to have extensive disease of the internal organs. The condition did not resemble tuberculosis, no tubercle bacilli could be demonstrated, and a second animal inoculated with pus from a lymphatic gland, failed to develop tuberculosis in six weeks. "Forty-four samples have, therefore, to be considered, and of these, five were found to contain living tubercle bacilli, namely, 11.1 per cent." I 62 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 for such action as they considered desirable. I have received a report from the local Medical Officer of Health who was notified of the dirty condition of Sample No. 33, and he states that he will arrange for a cleanliness examination to be 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% 1922 9.5% 1905 9.1% 1923 2.6% 1906 8.0% 1924 12.8% 1907 8.3% 1925 2.4% 1st Series. 1909 12.5% 1st Series. 2.4% 2nd Series. 4.7% 2nd Series. 1927 4.88% 1910 6.25% 1928 8.3% 1912 6.6% 1929 5.1% 1913 10.4% 1930 4.2% 1914 10.2% 1931 9.5% 1915 8.5% 1932 9.1% 1917 4.2% 1933 11.1% 1919 14.8% 1921 24.2% 1st Series. 26.3% 2nd Series. 12.5% 3rd Series. The chemical examination showed that three of the samples gave evidence of sophistication. The following are the details:— Sample No. 13. 5 per cent. deficient in fat. Re-sampled and found to be genuine. Sample No. 30. 4 per cent. deficient in milk fat. Re-sampled and found to be genuine. Sample No. 42. 2.3 per cent. extraneous water. Unable to re-sample as consignor ceased to send milk to the City. 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 656 persons, compared with 680 in 1932. 85 per cent. are adults and 15 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 1933 100 persons (94 per cent. adults and 6 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 1933, 63 persons (69 per cent. adults and 31 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 819. 63 The number of births was 8, viz.: 8* males and 0 females. The birth-rate, omitting the still-births, was 7.3 per 1,000, which is 0.5 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 1933 was 14.6 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 1933. 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 2 .... 3 .... .... .... .... 1 2 SOUTH „ 2 .... 2 .... .... .... .... l 1 KING'S „ .... .... 2 .... .... .... .... l 1 QUEEN'S „ 2 .... 1 .... .... .... .... l .... PRINCE'S „ 2 .... 1 .... .... .... .... l .... BEARSTED HOUSE .... .... 3 .... .... .... l l 1 DUTTON „ .... .... .... .... .... .... .... .... .... Totals 8 .... 12 .... .... .... l 6 5 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 1933 being 12,959, of whom 5,141 were males and 7,818 were females. The accompanying table is compiled from the monthly records of attendances at the baths:— RECORD OF ATTENDANCES AT THE BATHS, ARTIZANS' DWELLINGS. Month. Sex. Total. Males. Females. Children. Adults. Children. Adults. January 56 279 50 401 786 February 57 288 51 443 839 March 88 366 111 585 1,150 April 91 341 79 549 1,060 May 102 351 105 616 1,174 June 116 397 100 727 1,340 July 117 441 98 687 1,343 August 116 339 94 621 1,170 September 92 350 120 609 1,171 October 61 335 65 548 1,009 November 76 313 59 548 996 December 73 296 35 517 921 Totals 1,045 4,096 967 6,851 12,959 * Two still births. 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 159 .... .... 12 February 167 .... l 26 March 211 .... l 16 April 209 .... 37 10 May 215 4 1 23 June 207 3 1 17 July 184 .... .... 12 August 148 2 1 12 September 164 1 2 14 October 193 1 1 9 November 205 1 1 24 December 140 .... .... 12 Totals 2,202 12 46 187 MIDDLE DISTRICT—Inspector G. H. Fowler. Month. Premises Inspected. Orders issued. Notices served. Improvements effected. January 125 l 2 14 February 168 2 1 11 March 157 2 2 12 April 156 1 2 16 May 187 2 4 11 June 179 3 2 18 July 161 7 7 20 August 123 .... 1 9 September 249 .... 4 14 October 171 7 6 8 November 186 2 2 15 December 143 8 7 10 Totals 2,005 35 40 158 EAST DISTRICT—Inspector G. E. Harrington. Month. Premises Inspected. Orders issued. Notices served. Improvements effected. January 167 .... .... 16 February 177 4 9 10 March 192 12 7 12 April 172 .... 20 11 May 182 1 9 18 June 197 2 .... 20 July 160 .... .... 16 August 174 .... .... 18 September 218 4 3 12 October 167 3 4 19 November 161 .... 1 18 December 163 .... .... 14 Totals 2,130 26 53 184 THE FOREGOING ARE SUMMARISED AS UNDER District. Number of Inspections made. Orders issued. Notices served. Improvements effected. West 2,202 12 46 187 Middle 2,005 35 40 158 East 2,130 26 53 184 Totals 6,337 73 139 529 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 nrecautions in anv case, of infectious disease. Particulars relating to the registered Lodging-houses in the City now on the Register are given in the accompanying table:— District. Number of Houses on Register. Number of Lodgers. Number of Tenements. Average Number of persons per Tenement. Cleansing Notices Served. West 30 247 120 20 37 Middle — — — — — East 16 121 68 1.7 16 Total 46 368 188 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 1933. 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 16 1 .... .... .... 33 Dean Street Blocks, Fetter Lane— Block A .... 7 .... .... .... 22 „ B 3 3 1 .... .... 13 „ C 4 4 .... .... .... 15 „ D 3 1 1 l .... 17 „ E 7 1 1 l .... 14 „ F 4 4 .... .... .... 15 St. Ann's Chambers, Ludgate Hill 3 13 .... l .... 33 Bloomfield House, Snow Hill .... 17 .... 2 .... 55 Total (Six "Blocks") 40 71 3 5 .... 254 MIDDLE DISTRICT. Bridgewater House, Fann Street .... 9 .... .... l 15 City Buildings, Moor Lane 1 20 10 .... l 76 Total (Two "Blocks") 1 29 10 .... 2 91 EAST DISTRICT. Harrow Place and Stoney Lane— North Block .... 52 8 .... .... 169 South „ 5 22 13 .... .... 117 Prince's „ 5 50 .... .... .... 133 Queen's „ 5 40 5 .... .... 123 King's „ 8 18 16 .... .... 114 Barker's Buildings, Catherine Wheel Alley, Bishopsgate 3 2 1 2 .... 22 Bearsted House, Hutchison Street .... .... 8 16 .... 100 Dutton House, New Street .... .... 13 2 1 63 Total (Four "Blocks") 26 184 64 20 1 841 These twelve blocks contain 456 tenements, and are inhabited by 1,186 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) 296 (b) Number of inspections made for the purpose 540 (2) (a) Number of dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 190 (b) Number of inspections made for the purpose 397 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 11 (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 40 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 100 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 28 (2) Number of dwelling-houses in which defects were remedied after service of formal notices:— (a) By owners 28 (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 formcil 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 202 plans were submitted with regard to proposed reconstruction of water-closets or drains in the City. Of these, 182 were approved, 19 revised and approved ; and 1 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 eight 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, etc; and of the 76 cases investigated in 1933, it was found necessary to make amendments to soil and waste pipes, water-closets, &c., in 30 instances. House, Trade and other Refuse Removal.—The City Engineer informs me that the refuse removed from the City in 1933 consisted of 16,812 tons of street sweepings and slops, and 41,167 tons of house and trade refuse, a total of 57,979 tons. The total for the year 1932 was 70,582 loads. 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, 73 notices have been issued by the Sanitary Committee, and in no case was it found necessary, in consequence of non-compliance therewith, to refer the matter to the City Solicitor. Summer Flushing of Courts.—There are 161 courts and narrow passages throughout the City, which were regularly flushed during the summer months, under the direction of the City Engineer, who informs me that in this service, and the flushing of the main streets, no less than 26,884,859 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 1933, 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, 15 reports were received from the City Engineer respecting the condition of connections between the drains of certain City houses and the public sewer. Investigations showed that it was necessary to reconstruct all 15 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 five 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 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 and public buildings, renders the problem of adequate reduction difficult. Some 529 birds have been caught by the expert engaged by the Corporation, and all destroyed under my supervision, with the exception of one ringed bird, which was sent to the Secretary of the Homing Union for return to its owner. One hundred and thirty-four other pigeons were destroyed at request. 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. EXHUMATION AND RE-INTERMENT OF BODIES. City of London Cemetery. During the year the bodies of nine 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. DISCOVERY OF HUMAN REMAINS AT (i.) Houndsditch and Back Gravel Lane, and (ii.) Bank of England. During the course of rebuilding operations at each of the above-mentioned premises, human remains were unearthed. In the case of Houndsditch and Back Gravel Lane, the quantity was very small and bore obvious evidence of age and previous disturbance. The customary notification to the Coroner and City Police was made, and the remains subsequently reverently reinterred on the site. In regard to the discovery at the Bank of England, the quantities here were very much larger, and the work of exhumation covered a period of 4½ months. Arrangements had been made by the Bank of England Authorities to reinter such remains as were found in a special vault purchased at Nunhead Cemetery. The total number of cases removed was 98, which represented approximately 800 bodies. Supervision of this work on behalf of this Department was entrusted to one of your sanitary inspectors, Mr. G. H. Fowler, who was assisted by Mr. G. E. Harrington. FACTORY AND WORKSHOP ACT, 1901, &.C. Factories, Workshops and, Workplaces.—The premises upon the Register number 3,744, in which are included 8,385 workrooms, &c. There were served 1,702 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 1,421 3,825 WORKSHOPS 1,145 1,718 WORKPLACES:- Kitchens of Restaurants and Tea Rooms 691 1,605 Kitchens of Licensed Premises 249 744 Stables 5 44 Other places 233 449 3,744 8,385 The following is a Summary of Inspections of separate workrooms, &c., during the year:— Workshop Inspectors. Woman Inspector. Totals. FACTORIES 2,121 — 2,121 WORKSHOPS 1,051 — 1,051 WORKPLACES 1,350 514 1,864 69 The following is a Summary of Inspections of separate workrooms, since 1924:— Workshop Inspectors. Woman Inspector. Totals. FACTORIES. 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 1933 2,121 — 2,121 Workshop Inspectors. Woman Inspector. Totals. WORKSHOPS. 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 1933 1,051 — 1,051 Workshop Inspectors. Woman Inspector. Totals. WORKPLACES. 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 1933 1,350 514 1,864 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 L?.ne. †*85, Middlesex Street, † 280, Bishopsgate. † 12 and 13, Widegate Street, † Great Eastern Railway Hotel. UNDERGROUND BAKEHOUSES, † 188, Aldersgate Street. † 3, Pancras Lane. 262, Bishopsgate. † 21, Stoney Lane. 8, Copthall Avenue. † 68, St. Mary Axe. †*67, Farringdon Street. 194, Upper Thames Street, †* 122, Middlesex Street. SUMMARY. Aboveground Bakehouses 5 Underground Bakehouses 9 14 * These have been established at least 47 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 42 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. K 70 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) 45 130 81 256 Do. Initial Inspections (Workrooms) 61 189 165 415 Do. Periodical Inspections (Tenancies) 166 269 328 763 Do. Periodical Inspections (Workrooms) 306 495 894 1,695 Do. Re-inspections (Sanitary Works, &c., in hand) 99 318 231 648 Workshops, Initial Inspections (Tenancies) 17 65 72 154 Do. Initial Inspections (Workrooms) 20 82 97 199 Do. Periodical Inspections (Tenancies) 141 214 241 596 Do. Periodical Inspections (Workrooms) 195 277 377 849 Do. Re-inspections (Sanitary Works, &c., in hand) 73 197 105 375 Workplaces, Initial Inspections (Tenancies) 38 12 15 65 Do. Initial Inspections (Workrooms) 74 15 17 106 Do. Periodical Inspections (Tenancies) 13 16 59 88 Do. Periodical Inspections (Workrooms) 20 20 93 133 Do. . Re-inspections (Sanitary Works, &c., in hand) 502 46 40 588 Bakehouses, Periodical Inspections (Tenancies) 16 10 2 28 Do. Periodical Inspections (Workrooms) 25 10 2 37 Do. Re-inspections (Sanitary Works, &c., in hand) 33 15 9 57 Kitchens of Restaurants, &c.— Initial Inspections (Tenancies) 14 17 10 41 Initial Inspections (Workrooms) 30 39 21 90 Periodical Inspections (Tenancies) 64 97 133 294 Periodical Inspections (Workrooms) 146 234 275 655 Re-inspections (Sanitary Works, &c., in hand) 106 213 234 553 Kitchens of Licensed Premises— Initial Inspections (Tenancies) — 10 4 14 Initial Inspections (Workrooms) — 25 9 34 Periodical Inspections (Tenancies) 12 37 51 100 Periodical Inspections (Workrooms) 43 123 122 288 Re-inspections (Sanitary Works, &c., in hand) 4 51 78 133 Workshops notified by H.M. Inspector 11 17 7 35 General complaints received 5 17 7 29 Miscellaneous visits 249 259 88 596 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 56 87 17 25 54 32 4 14 10 299 Want of Ventilation 3 5 — 3 1 — — 1 — 13 Overcrowding — — 1 — — — — — — 1 Want of Drainage of Floors 10 — — — — — — — — 10 Want of Lavatory Accommodation 1 — — — — — — — — 1 Food improperly stored — — — 1 3 4 — 1 l 10 Storage Cistern defective 4 69 13 1 2 17 — 2 18 126 Accommodation for Refuse 4 2 1 2 2 3 — — 1 15 Accumulation of Refuse 37 2 9 2 5 4 — — 2 61 Sanitary Accommodation. Insufficient (Tenancies) 1 6 3 — — — — 2 — 12 Unsuitable (Do.) 5 6 10 2 2 2 — — — 27 Defective (Do.) 101 168 133 12 17 13 2 9 5 460 Do. (No. of Conveniences)* 101 168 134 12 17 13 2 9 5 461 Not separate for Sexes (Tenancies) 2 8 6 1 — 1 — 3 — 21 Other Nuisances 61 25 23 16 31 36 1 9 10 212 Total Defects found 285 378 216 65 117 112 7 41 47 1,268 * Figures not included in total defects found or remedied. 71  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 49 86 14 28 48 36 8 13 11 293 Want of Ventilation 3 7 — 3 2 1 — — — 16 Overcrowding — — 1 — — — — — — 1 Want of Drainage of Floors 11 — — — — — — — — 11 Want of Lavatory Accommodation 2 — — — — — — — — 2 Food improperly stored 1 — — 2 4 5 — — l 13 Storage Cistern defective 4 67 13 1 2 17 — 2 18 124 Accommodation for Refuse 4 2 1 4 2 2 — — 1 16 Accumulation of Refuse 31 1 7 4 5 6 — — 2 56 Sanitary Accommodation. Insufficient (Tenancies) 1 7 3 — — — — 2 — 13 Unsuitable (Do.) 5 6 7 1 2 2 — — — 23 Defective (Do.) 100 169 130 8 19 12 2 8 5 453 Do. (No. of Conveniences)* 100 169 131 8 19 12 2 8 5 454 Not separate for Sexes (Tenancies) 2 8 4 1 — 1 — 2 — 18 Other Nuisances 53 22 17 15 32 38 4 8 11 200 Total Defects remedied 266 375 197 67 116 120 14 35 49 1,239 ACTION TAKEN. East District. Middle District. West District. Totals. Matters referred to H.M. Inspector— Nuisances remediable by H.M. Inspector l 6 — 7 Failure to affix Abstract 10 32 16 58 Matters referred by H.M. Inspector- Notified by H.M. Inspector 3 4 — 7 Reports sent to H.M. Inspector 3 4 — 7 Notices served— Factories—Intimation 11 35 11 57 Statutory — 1 1 2 Workshops—Intimation 19 16 4 39 Statutory 1 3 3 7 Workplaces, &c.—Intimation 29 4 1 34 Statutory — 3 — 3 Kitchens of Restaurants— Intimation 3 8 6 17 Statutory — 3 1 4 Kitchens of Licensed Premises- Intimation — 1 — 1 Statutory — — — — Orders required from Sanitary Committee 17 10 4 31 Certificates for Cleansing issued by Medical Officer of Health 1 3 3 7 Matters referred to District Inspectors 17 6 2 25 Matters referred to Women Inspectors — — — — Matters referred to Workshop Inspectors — — — — Cases reported for Legal Proceedings — — — — Legal Proceedings taken — — — — OUTWORK, AND THE INSPECTION OF OUTWORKERS' PREMISES, &c. Lists received from City Firms — — — 1,253 Names and Addresses, &c., received from other Authorities — — — 445 Names and Addresses transmitted to other Authorities — — — 8,401 Notices served on Employers — — — 1,538 Letters written, &c. — — — 30 Firms visited 19 61 31 111 Outworkers' Lists not kept — 2 7 9 Do. not sent — 2 7 9 Infectious Disease occurring in Outworkers' Premises — — — — Registered Factories and Workshops at which Outwork is received— Inspections 67 83 36 186 Defects found 34 39 5 78 Defects remedied 34 39 5 78 "Places from which work is given out"— Inspections 2 — 37 39 Defects found — — 6 6 Defects remedied — — 6 6 *Figures not included in total defects found or remedied. K 2 72 WOMAN INSPECTOR. Total. Domestic Workshops at which Outwork is received Inspections — Defects reported and appropriate action taken — Domestic Workshops which do not receive Outwork Inspections 4 Defects reported and appropriate action taken 6 Domestic Premises receiving Outwork (not registerable as Workshops). Inspections 43 Defects reported and appropriate action taken 1 Underground Conveniences for Women Inspections 152 Defects reported and appropriate action taken 33 Railway Stations (Ladies Rooms) Inspections 114 Defects reported and appropriate action taken 24 Kitchens of Restaurants, &c. Initial Inspections (Tenancies) 7 Initial Inspections (Workrooms) 10 Periodical Inspections (Tenancies) 387 Periodical Inspections (Workrooms) 504 Re-inspections (Sanitary Works, &c., in hand) 164 Defects found 245 Notices Intimation (Verbal) 106 Statutory — Matters referred to District Inspectors 49 Matters referred to Workshop Inspectors 1 Certificates for Cleansing issued by Medical Officer of Health — Orders required from Sanitary Committee — Cases reported for Legal Proceedings — Legal proceedings taken — 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 1933 1,189 1,069 8,495 9,564 73 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 Prosecuted. (1) (2) (3) (4) Factories (including Factory Laundries) 1,030 59 — Workshops (including Workshop Laundries) 753 46 — Workplaces (other than Outworkers' premises) 1,001 59 — Total 2,784 164 — 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. (1) (2) (3) (4) (5) Nuisances under the Public Health Acts:—* Want of cleanliness 328 321 4 — Want of ventilation 31 32 2 — Overcrowding 1 1 — — Want of drainage of floors 10 11 1 — Other nuisances 538 504 — — Sanitary accommodation insufficient 12 13 — — unsuitable or defective 610 582 — — not separate for sexes 21 18 — — 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 1,551 1,482 7 — *Including those specified in Sections 2, 3, 7 and 8 of the Factory and Workshop Act, 1901, as remediable under the Public Health Acts. No instance of outwork in unwholesome premises under Section 108 of the Factory and Workshop Act was reported. 74 3.—Home Work. NATURE OF WORK.* OUTWORKERS' LISTS, SECTION 107. OUTWORK IN UNWHOLESOME PREMISES, SECTION 108. OUTWORK IN INFECTED PREMISES, SECTIONS 109, 110. Lists received from Employers. Notices served on occupiers as to keeping or sending Lists. Prosecutions. Instances. Notices served. Prosecutions. Instances. Orders made (S. 110). Prosecutions (Sections 109, 110). Sending twice in the year. Sending once in the year. Failing to keep or permit inspection of lists. Failing to send lists. Lists.† Outworkers.† Lists. Outworkers. Contractors. Workmen. Contractors. Workmen. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) Wearing Apparel— making, &c 1,006 3,346 4,825 44 93 135 1,538 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) 92 281 166 2 3 — Cables and Chains Anchors and Grapnels Cart Gear Locks, Latches and Keys Umbrellas, &c. 34 11 187 — — — Artificial Flowers 2 — 3 1 — 1 Nets, other than Wire Nets Tents Sacks Racquet and Tennis Balls Paper, &c., Boxes, Paper Bags 2 — 4 — — — Brush making 4 — 54 — — — Pea picking Feather sorting Carding, &c., of Buttons, &c. Stuffed Toys 2 — 10 — — — Basket making Chocolates and sweetmeats Cosaques, Christmas Crackers, Christmas Stockings, &c. Textile Weaving Total 1,142 3,638 5,249 47 96 136 1,538 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 are the total number of the lists received from those employers who comply strictly with the statutory duty of sending two lists each year and of the entries of names of outworkers in those lists. The entries in column 2 must necessarily be even numbers as there will be two lists for each employer—in some previous returns odd numbers have been inserted. The figures in columns 3 and 4 will usually be (approximately) double of the number of individual outworkers whose names are given, since in the February and August lists of the same employer the same outworker's name will often be repeated. 75 4.—Registered Workshops. Workshops on the Register (S. 131) at the end of the year. Number. (1) (2) Important classes of workshops, such as workshop bakehouses, may be enumerated here. General Workshops 1,142 Bakehouses (including Factory Bakehouses) 14 Total number of Workshops on Register *1,156 * These were found to be 1,729 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) 58 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 7 Reports (of action taken) sent to H.M. Inspector 7 Other — Underground Bakehouses (S. 101):— Certificates granted during the year Nil. In use at the end of the year 9 Date, 31st December, 1933. (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. No additional premises were 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. 76 CITY MORTUARY. Bodies Received.—Post-Mortems and Inquests:— Bodies received at the Mortuary to await burial 114 Post-Mortem examinations made 77 Inquests held on bodies 71 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. 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 1932 234,170 142 90 91 2 Average for previous 5 years 257,861 151 133 85 2 1933 233,821 114 71 77 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. 447 229,210 £359 1s. Other disinfection and cleansing work carried out during the year is as follows:— Disinfection—Infectious Disease:— Articles disinfected after cases of infectious disease 4,566 Library Books disinfected 45 Public Vehicles—Electric Ambulance and Police Litters 4 Cells at Police Stations 4 Premises disinfected (including offices) 98 Lockers disinfected at request of General Post Office Authorities 100 Horsehair (cases) 26 Cleansing of Persons Act, 1897:— Number of verminous persons bathed 100 Cleansing of School Children:— Total number of children cleansed 1,067 10 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 1933 one body was placed in the apparatus. Mortuary Chapel.—I have felt for some time that the equipment of the chapel which is provided at the City Mortuary, for the reception of citizens dying in the City, whose homes are not altogether suitable for the retention of the bodies whilst waiting for burial, has left something to be desired. The Corporation have now equipped this building with an altar and the customary altar ornaments. There is already indication that greater use will now be made of the Chapel than has been the case in the past. 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. 77 RAT REPRESSION. Rat repression work in the City has been carried on during 1933 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. An additional Sanitary Inspector has, however, at the time of writing this Report, been appointed, who will commence his duties on the 1st June, 1934. 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 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. A special communication was sent to all licencees, restauranteurs, grocers, butchers, etc., etc. The tables set out on page 78 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 105 buildings, occupied by 117 firms, were inspected, and that 108 of these occupancies were found to be rat-infested. One or other of the ratcatchers working in the City was engaged by eleven firms. Poisons were laid down in 46 cases, varnish traps were used in 35 cases, break-backs, wire and other traps in 96 cases. Ten firms kept cats or dogs on the premises. In all, 105 complaints or applications for advice have been received. Rat-proofing was put into operation in 242 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 disinfecting 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 14,563 rats in the City during 1933. 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:— Sections of brick sewers constructed for the purpose of linking-up 4 Brick sewers reconstructed 2 Disused sewers filled in and abolished 4 Brick sewers reinverted, pointed and repaired 15 Pipe sewers constructed, reconstructed and repaired 4 Miscellaneous repairs to sewers, drains, etc. 44 House drains constructed in connection with new buildings 12 Drains of existing buildings reconstructed 17 House drains partially reconstructed in connection with the part reconstruction and reinverting of certain sewers 23 Gully drains partially reconstructed in connection with the part reconstruction and reinverting of certain sewers 9 New gullies and drains constructed 3 Gullies reconstructed 14 Gully drains reconstructed 26 Gully and house drains repaired 98 Disused gully and house drains bricked off 105 Number of rats destroyed by sewermen during year 797 Eighty-five lbs. of poison was used in the sewers during the year, and subsequently 157 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 78. L 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 30th, 1933. 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. Hand-bills delivered. 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 the City Engineer's Department. By the M.O.H's. Department. January 7 16 7 7 l 4 2 - - - - 19 380 167 6 - 7 February 7 12 8 10 2 2 1 3 - 2 - 16 7 - 7 March 4 15 4 4 — 4 5 6 — — — 11 4 - 4 April 4 6 4 5 — 3 1 1 2 — — l 4 - 4 May 8 10 9 10 — 6 1 3 10 1 3 21 9 - 8 June 8 12 9 9 1 2 1 2 9 — 1 20 8 - 8 July 19 34 20 26 3 7 2 18 8 — 1 47 17 — 19 August September 16 20 16 16 1 5 4 8 2 1 — 31 10 - 16 October 11 13 11 9 — 5 1 2 — — 2 16 6 - 11 November 21 41 20 21 3 8 10 20 4 1 3 60 34 - 21 December Totals 105 1.7 108 117 11 46 28 63 35 5 10 242 547 105 - 105 78 79 MEDICAL EXAMINATIONS. In accordance with the Standing Order of the Court that no person shall enter the employ of the Corporation or of any of its Committees without previously passing a medical examination to the satisfaction of the Committee having cognizance of the appointment, 94 persons were examined by the Medical Officer of Health during 1933. Five of these persons were reported as physically unfit for office. Fifteen officers were also medically examined with a view to their retirement. With four exceptions, all were reported to be unfit for duty. I have the honour to be, Gentlemen, Your obedient Servant, W. M. WILLOUGHBY, Medical Officer of Health for the City of London. Public Health Department, Guildhall, E.C. L 2 APPENDICES. page Appendix A—Street Lists of Mortality 82 „ B— „ „ Infectious Diseases 86 „ C—Register of Houses let in lodgings or occupied by members of more than one family 88 „ D—List of Adoptive Acts, Orders, Bye-laws and Regulations in operation in the City 89 „ E—Compulsory Notification of Chicken-pox. Form of Notice 90 „ F—Measles Warning 90 82 APPENDIX A.—STREET LISTS OF MORTALITY. STREET OR PLACE. No. of House Sex. Age. Date of Death. Cause of Death. Remarks. Albion Buildings, Flat 7 21 M 73 15th Oct. Syncope. Atheroma of coronary arteries „ 24 M 74 18th Jan. Heart failure consequent upon acute pleural effusion and oedema of lungs Syncope. Myocardial degeneration Syncope. Complete occlusion of left coronary artery by atherina and fatty degeneration of heart muscle. Aldersgate Street 31 F 51 19th July P.M. 180 M 65 23rd Oct. Resided at Seven Kings. P.M. ,, Manchester Hotel. - M 34 3rd Nov. Aneurism of Aorta. Rupture of pericardium into bronchus. Œdema of lungs Died in ambulance on way to St. Bartholomew's. Aldgate, Three Nuns Hotel. — F 59 10th Mar. la. Myocardial disease b. High blood pressure Resided at Liverpool. Angel Court 1 M 48 18th Mar. la. Uraemia b. Chronic arteriosclerotic kidney 2. Pyonephrosis, due to renal stone Died in St. Bartholomew's Hospital. Artillery Lane 9 F 83 27th July la. Chronic myocarditis b. Old age Barbican 21a M 50 5th April Poisoning by cyanide of potassium. Inq. P.M. Resided at Hendon. Self-administered. Suicide. Unsound mind. Barker's Buildings 9 M 53 13th Nov. la. Secondary Carcinoma of brain b. Carcinoma bronchus 2. Secondary Carcinoma suprarenals Died in St. Peter's Hospital. Bartholomew Close 61a F 68 2nd Feb. Heart Failure following embolism of the Coronary Artery Bartholomew House, Cloth Fair. 2 F 72 25th Jan. la. Broncho-pneumonia and Influenza Died in Islington. „ „ 5 M 64 29th Aug. la. Carcinoma of Stomach (Gastrectomy) b. General Peritonitis c. Broncho-pneumonia Died in St. Bartholomew's Hospital. Basinghall Street 22 F 83 20th June la. Senile decay; ascites b. Morbus Cordis „ 39 F 74 15th April la. Cardiac failure b. Hemiplegia Bearsted House, Middlesex Street. 1 M 68 19th Feb. la. Coronary Thrombosis b. Arterio-sclerosis c. Senile Gangrene Died in London Hospital. „ „ 1 F 47 4th Sept. la. Asthenia b. Cerebral Embolism c. Valvular disease of Heart „ „ 8 M 20 3rd Jan. la. Influenzal Pneumonia Died in London Hospital. Bishopsgate 121 M 39 8th Mar. Syncope. Myocardial degeneration, probably accelerated by pressure of large clot in right ventricle Resided in Stepney. „ 192 M 5 wks. 30th Dec., 1932 Asphyxia. Pneumonia „ 280 M 23 8th May la. Septicaemia b. Ulcerative Endocarditis „ 306 F 50 11th Dec. Toxaemia. Bilateral Pyonephritis. Chr. Cystitis. Tabes Dorsalis Died in St. Peter's Hospital. Bread Street - M 87 28th April la. Myodegeneration b. Chronic Nephritis Died in City of London Infirmary, Bow Road. Broad Street Railway Station. - M 40 4th March Thrombosis of Cerebella vein. Subarachnoid Haemorrhage Resided at Manor Park. Broadway, Ludgate Hill 9 F 24 5th Nov. la. Pulmonary Tuberculosis Died in St. Joseph's Hospital. Bucklersbury 25 M 78 27th June la. Senile decay b. Cardio vase, degeneration c. Broncho-pneumonia Died in City of London. Mental Hospital, Stone. Bury Street 5 F 66 3rd Aug. la. Asthenia b. Secondary Carcinoma of Liver and Stomach. Chancery Lane 122 F 82 12th Nov. la. Myodegeneration b. Arterio-sclerosis Died in City of London Infirmary, Bow Road. Circus, Minories 3 M 73 25th Jan. Carcinoma of (Esophagus. Secondary Carcinoma of brain Died in St. Peter's Hospital, Stepney. Cowper's Court, Cornhill - M 59 19th Feb. Shock. Fractured skull and other injuries caused by fall from window sill P.M. Inq. Resided at Brixton. Cullum Street 24 F 33 29th Apr. la. Laryngeal T.B. b. Pulmonary T.B. Died in Brompton Hospital. Dean Street 5c M 76 10th Jan. Multiple injuries. Threw himself from window. Suicide while of unsound mind Died in St. Peter's Hospital, Stepney. Dove Court 14 F 66 1st Jan. Carcinoma of rectum Died in St. Joseph's Hospice, Hackney. Fenchurch Avenue 2 M 72 9th Jan. la. Influenza 2. Myocardial degeneration Fenchurch Street 3 M 62 30th Sept. Syncope. Myocardial degeneration. Occlusion of right coronary artery and Resided at Dunton Green, Kent. „ 19 F 62 27th Dec. Arterio-sclerosis la. Cardiac Syncope b. Pneumonia 83 STREET LISTS OF MORTALITY—continutd. STREET OR PLACE. No. of House Sex. Age. Date of Death. Cause of Death. Remarks. Fenchurch Street 22 F 62 3rd June 1a. Myocardial failure b. Myocardial degeneration c. Chronic Bronchitis and Asthma ,, Railway Station. - M 73 6th Mar. la. Chronic Myocarditis b. Old age c. Adiposity 2. Bronchitis and Gastric Influenza Resided at Goodmayes. Fetter Lane 101 M 66 29th Dec. la. Pulmonary Tuberculosis Died in Archway Hospital. Fish Street Hill 37 F 68 26th July 1a. Cardiac Syncope b. Fatty infiltration of heart muscle Fleet Street 138 M 43 9th Oct. Syncope. Pulmonary Tuberculosis P.M. Fleur-de-Lis Court 4 F 67 16th Jan. la. Acute Bronchitis b. Carcinoma Mammae (operation) and Secondary Metastases Friday Street 6/7 M 34 28th Feb. Shock. Multiple injuries. Crushed between lift and floor Resided at Edenbridge. Gracechurch Street 3 F 43 26th Jan. 1a. Hæmatemesis 2. Gastric ulcer Died in St. Bartholomew's Hospital. „ 78 M 39 19th April 1a. Lobar Pneumonia Died in Guy's Hospital. Great New Street 2 F 76 24th Mar. la. Cerebral Thrombosis b. Arterio-sclerosis Died in City of London Infirmary, Bow Road. „ 13 F 84 17th Dec. la. Myocardial degeneration b. Senility 2. Bronchitis Great Tower Street 74 F 36 2nd Jan. la. Cardiac Syncope b. Influenza 2. Graves' disease 48 F 92 28th Feb. la. Bronchitis 2. Valvular disease of heart Gresham Street 34/36 M 55 26th June la. Apoplexy b. Arterio-sclerosis c. Chronic Nephritis „ 46 F 71 28th Jan. la. Acute Bronchitis and Influenza „ 99 M 58 24th Nov. la. Syncope b. Angina Pectoris Resided at Finchley. Gunpowder Alley 24 F 8 hrs. 24th Oct. la. Premature birth b. 25th week of pregnancy Harrow Place 39 F 6 mos. 17th Jan. la. Acute catarrhal Gastro-enteritis b. Acute Stomatitis Holborn Viaduct 39 F 53 12th Mar. la. Metastatic Carcinoma liver b. Carcinoma left breast Huggin Lane 4a F 47 14th Sept. Syncope. Mitral Stenosis. Myocardial degeneration and Emphysema Died in ambulance on way to hospital. P.M. Natural. Hutchison Street 12 F 79 23rd Sept. (a) Myocardial degeneration (b) Senile decay Died in Jewish Home of Rest at Wandsworth. King's Block, Stoney Lane. 16 F 80 29th Jan. Syncope, supervening on Acute Pulmonary Congestion, with (Edema of both lungs P.M. „ 33 M 55 29th May la. Cerebral Thrombosis b. Arterio-sclerosis Died in Prince of Wales' Hospital, Tottenham. Leadenhall Market — M 58 7th Nov. la. Myocardial degeneration Resided in Shoreditch. Leadenhall Street 65 F 48 20th June la. Acute Ulcerative Colitis Died in St. Peter's Hospital, Stepney. „ 122 M 66 24th Jan. la. Syncope b. Chronic Myocardial degeneration Resided at Hampstead. „ Great Eastern Hotel. — F 55 2nd July la. Myocardial degeneration Died in Chest Hospital in Bethnal Green. Liverpool Street, Great Eastern Hotel. - M 56 6th Sept. la. Myocarditis b. Fatty degeneration of heart 2. Ascites Resided in Yorkshire. „ — F 49 18th July Cerebral haemorrhage. Atheroma of Arteries. Died in St. Bartholomew's Hospital. P.M. Liverpool Street Station - M Newly born. 12th July Asphyxiation and inattention at birth. No evidence to determine whether intentional or otherwise P.M. Inquest. Name unknown. Liverpool Street 36 F 78 29th Nov. la. Asthenia b. Senility Resided in Chelsea. Lloyds Avenue 6 M 70 2nd Sept. la. Acute Myocardial degeneration b. Prostatectomy c. Cystitis 2. Ascites Died in Guy's Hospital. Long Lane - M 18 19th Dec. Shock. Fractured skull and severe internal injuries. Fall under motor Resided in Canning Town. Inq. P.M. Love Lane, Eastcheap 4 M 82 26th July lorry la. Broncho-pneumonia Died in St. Bartholomew's Hospital. Lower Thames Street 82 M 74 11th Dec. la. Uraemia and Myocardial degeneration b. Enlarged prostate Died in St. Peter's Hospital. H.M. Custom House. - M 62 29th Jan. Syncope. Myocardial degeneration, following blocking of left coronary artery Resided at Balham. 84 STREET LISTS OF MORTALITY—continued. STREET OR PLACE. No. of House Sex. Age. Date of Death. Cause of Death. Remarks. Ludgate Circus 4 F 79 1st Jan. la. Myocardial degeneration b. Senility Ludgate Hill 59 F 90 23rd May la. Myocarditis b. General Arterio-sclerosis Died at Hackney. Mansell Street 18 M 75 10th May Chronic Bronchitis and Myocardial degeneration P.M. „ Stern's Hotel - M 55 7th Sept. la. Myocarditis b. Heart failure and bilateral hydrothorax Died in Holborn. Mansion House — F 63 2nd Nov. la. Cerebral Haemorrhage b. Arterio-sclerosis Resided in Herts. Mansion House Chambers 148 M 64 25th May Syncope, due to rupture of the heart and Haemorrhage into the pericardium Resided at Chingford. P.M. Middle Street 1 M 9 mos. 5th Nov. la Tubercular Meningitis Died in Children's Hospital, Great Ormond Street. „ 5 M 87 20th Jan. la. Myocardial degeneration 2. Paralysis Agitans Middlesex Street 110 M 56 5th March la. Cirrhosis of liver b. Chronic alcoholism Died in Stepney. „ 112 M 70 31st Dec., 1932. Syncope. Acute Pericarditis. Myocardial degeneration „ 116 M 44 11th Jan. la. Broncho-pneumonia b. Asthma c. Chronic Bronchitis Died in City of London Infirmary, Bow Road. „ 116 M 73 11th Jan. la. Broncho-pneumonia b. Myocardial degeneration c. Epilepsy Died in City of London Infirmary, Bow Road. „ 116 M 84 29th Jan. la. Chronic Myocarditis b. Chronic Nephritis „ 116 M 48 9th Feb. Pulmonary Tuberculosis Died in Bancroft Lodge, Stepney. „ 116 M 54 1st Mar. Syncope due to Myocardial degeneration, consequent upon obliteration of left coronary artery „ 116 M 50 5th Aug. la. Cerebral Thrombosis b. Arterio-sclerosis Died in St. Peter's Hospital. „ 116 M 80 21st Aug. la. Heart failure b. Car. vase. Hypertrophy c. Hyperpiesia Died in London Hospital. „ 116 M 56 31st Aug. la. Pulmonary Tuberculosis Died in Shoreditch. „ 116 M 79 2nd Oct. la. Myocardial degeneration 6. Chronic Bronchitis Died in City of London Infirmary, Bow Road. ,, 120 M 64 26th Nov. Lobar Pneumonia Died in London Hospital. Mincing Lane 38 F 38 9th May Pyaemia. Purulent Cervicitis. Paracervicitis Died in London Hospital. Mitre Street — F 92 8th Feb. la. Myocardial degeneration b. Chronic Bronchitis Died in City of London Infirmary, Bow Road. Moor Lane Chambers 27 M 75 24th Aug. la. Broncho-pneumonia b. Perforated Gastric Ulcer and Peritonitis Died in St. Bartholomew s Hospital. Moorgate Street Station, C. & S.L.R. - M 34 28th July Fractured skull. Laceration of brain. Run over by train. Suicide. Unsound mind Inq. P.M. Resided at Edgware. Nevill's Court 9 F 82 24th Jan. la. Cardiac failure b. Cachexia c. Carcinoma of face „ 11 F 78 7th Feb. la. Senile decay c. Syncope „ 12 M 53 18th Dec. la. Broncho-pneumonia 2. Heart failure New Bridge Street 19 M 66 6th Dec. Syncope. Disease of Coronary Arteries. Coroner's P.M. Natural Resided at Westminster. North Block, Stoney Lane. 44 F 83 8th Mar. Cerebral Thrombosis. Fractured neck of femur. Fall from bed Died in St. Peter s Hospital, Stepney. „ 50 F 79 21st Jan. la. Acute Pulmonary congestion b. Bronchitis acute 2. Progressive Myocardial failure „ 52 F 44 28th Aug. la. Carcinoma of liver b. Carcinoma of gall bladder 2. Gall stones Died in Guy's Hospital. Old Broad Street 18 19 M 74 8th Oct. la. Pulmonary Tuberculosis Died in St. Peter's Hospital. Paternoster Row 17 F 70 23rd Mar. la. Cerebral Haemorrhage b. Hyperpiesia 2. Ovarian cyst Died in St. Peter's Hospital, Stepney. Philpot Lane 5 M 65 23rd May la. Moist Gangrene of arm b. Embolism of brachial artery c. Atheroma Coronary Arteries 2. Congestive Cardiac failure Died in St. Peter's Hospital, Stepney. Prince's Block, Stoney Lane. 51 F 64 12th Feb. la. Broncho-pneumonia, supervening on Influenza 2. Diabetes Mellitus 85 STREET LISTS OF MORT ALITY—continued. STREET OR PLACE. No. of House Sex. Age. Date of Death. Cause of Death. Remarks. Prince's Street 8 F 69 1st July la. Carcinoma of colon b. (Verified by laparotomy before death.) Queen's Block, Stoney Lane. 40 M 53 15th Feb. la. Acute Cardiac dilatation b. Chronic Bronchitis Died in London Jewish Hospital. Queen Victoria Street .... 136 M 58 2nd Aug. Syncope due to disease and narrowing of left coronary artery P.M. Resided at Kingston, Surrey. River Thames M About 50 19th Mar. Asphyxia from drowning. No evidence to determine how deceased came in water Unknown man. Found dead. Inq. P.M. — M 49 8th May Asphyxia by self-immersion in Thames. Suicide unsound mind Resided at Roehampton. P.M. Inq. " M 56 18th June Asphyxiation by drowning Resided at Kensington. P.M. Inq. Suicide. Unsound mind. Roman Bath Street Gen. P.O. M 18 21st May Shock. Syncope following a blow on body from another boy Inq. P.M. St. Ann's Chambers, Ludgate Circus. 10 M 75 24th Jan. la. Acute Bronchitis .. 40 F 73 28th Feb. la. Cardiac failure b. Chronic Bronchitis Died in St. Peter's Hospital, Stepney. St. Paul's Churchyard ... 22 M 23 22nd April la. Myocardial failure b. Empyema c. Lobar Pneumonia Died in London Hospital. Salisbury House, Finsbury Circus. * M 70 4th April Syncope. Gas and oxygen anaesthesia. Operation for tumour (papilloma) of bladder. Misadventure Died in hospital, in St. Marylebone. Snow Hill 4 M 32 11th July la. Morbus Cordis b. Syncope c. Infantile Paralysis Resided at West Norwood. South Block, Stoney Lane. 13 F 46 6th Nov. la. General Carcinomatosis b. Carcinoma of lung Died in London Hospital. ,, 27 F 75 14th July la. Cerebral Thrombosis Tokenhouse Buildings .... 1 F 79 25th Aug. la. Hypostatic Pneumonia b. Chronic Bronchitis Tower Hill 3 M 64 3rd Mar. la. Peritonitis b. Perforated duodenal ulcer Died in Bancroft Lodge, Stepney. Upper Thames Street 9 F 48 11th Nov. Aortic Stenosis. Syncope. P.M. " 29 M 54 20th April Fractured pelvis and skull. Wall falling on deceased at his place of employment P.M. Inq. Accidental. Upper Thames Street, The Black Bull. 97 M 41 26th Dec. la. Carcinoma of lung 2. Cystitis Died in Hornchurch. Water Lane, Gt. Tower Street. 9 M 80 1st March la. Cardio vascular degeneration Died in City of London Mental Hospital, Dartford. Widegate Street 12 F 69 22nd Dec. la. Cardiac Syncope b. Myocardial degeneration 2. Diabetes Mellitis Chronic Interstitial Nephritis (Flat 3) .... 12/ 13 F 76 6th June Syncope. Myocardial degeneration. Phthisis " 23 F 82 23rd Oct. la. Cerebral Haemorrhage b. Hyperpiesis 2. Senility Died in St. Peter's Hospital. " 25 F 95 24th July la. Chronic Myocarditis b. Chronic Bronchitis Died in City of London Infirmary, Bow Road. M 86 APPENDIX B.—LIST OF CASES OF INFECTIOUS DISEASE OTHER THAN TUBERCULOSIS, 1933. STREET LISTS.—COMPILED FROM NOTIFICATIONS RECEIVED Street or Place. No. of House. Sex. Age. Disease. Date of Notification. Aldersgate Street F 23 Diphtheria 4th March. Ditto 153 F 40 Erysipelas 17th March. Austin Friars 24 M 6 Scarlet Fever 6th June. Barker's Buildings 18 F 10 Chickenpox 8th August. Ditto 19 M 9 Ditto 17th July. Bartholomew House 15 F 7 Scarlet Fever 10th October. Basinghall Street 9 M 45 Food Poisoning 29th March. Bearsted House 8 M 6 Chickenpox 17th July. Billingsgate Market M 53 Erysipelas 2nd February. Bishopsgate 242 F 13½ Scarlet Fever 4th December. Bloomfield House 9 M 1½ Measles 8th May. Ditto 23 M 1 Ditto 6th May. Bucklersbury 35 F 2½ Chickenpox 11th March. Bush Lane 23 M 3 Measles 14th August. Cannon Street 123 M 76 Diphtheria 9th March. Clothier Street 6 M 5 Chickenpox 4th July. College Street — F 5 Measles 30th November. Crown Court — F 21 Scarlet Fever 6th January. Ditto — M 20 Measles 19th December. Crutched Friars 52 M 4 Ditto 3rd November. Dean Street 5 F 12 Chickenpox 24th February. Ditto 7 M 6 Scarlet Fever 13th January. Devonshire Square 2 F 6 Chickenpox 7th April. Dutton House 3 F 12 Scarlet Fever 29th June. Ditto 9 M 5 Chickenpox 4th July. Ditto 12 M 7 Ditto 14th June. Fleet Street 1 M 20 Scarlet Fever 5th September. Gracechurch Street 78 M 7 Ditto 11th December. Great Tower Street 34 M 5 Diphtheria 25th October. Gresham Street 23 M 17 Scarlet Fever 6th April. Houndsditch 141 M 25 Erysipelas 16th October. Jewry Street 12 M 50 Ditto 29th April. John Street 12 M 17 Cerebro-spinal Meningitis 31st March. King Street — M 2 Measles 3rd May. Ditto 24 F 6 Diphtheria 2nd November. Liverpool Street — F 44 Erysipelas 2nd November. Long Lane 74 M 9 dys Ophthalmia Neonatorum 23rd February. Ludgate Circus Buildings 2 M 12 Scarlet Fever 5th September. Ludgate Circus 56 F 5 Chickenpox 10th May. Mark Lane 5 F 7 Diphtheria 19th August. Martin's Lane 7 F 51 Erysipelas 29th September. Middle Street 2 M 8 Measles 21st May. Middlesex Street 116 M 47 Erysipelas 6th March. Mincing Lane — M 3 Measles 23rd May. Minories 95 F 7/12 Diphtheria 8th August. Ditto 97 M 3 Scarlet Fever 10th June. Ditto 97 M 5 Ditto 9th June. Ditto 97 F 8 Ditto 12th June. Mitre Street 7 F 9 Ditto 27th February. Moor Lane — M 28 Chickenpox 15th September. Moor Lane Chambers 8 M 6 Diphtheria 24th November. Ditto 25 F 5 Scarlet Fever 2nd October. Moorgate 141 M 4 Measles 2nd August. Nevill's Court 8 F 3 Ditto 11th May. Ditto 11 F 5 Ditto 6th May. Ditto 11 F 5 Ditto 2nd May. Ditto 11 M 2 Ditto 29th April. Ditto 11 M 3 Ditto 29th April. Ditto 11 F 7 Ditto 29th April. 87 LIST OF CASES OF INFECTIOUS DISEASE OTHER THAN TUBERCULOSIS, 1933. STREET LISTS.—COMPILED FROM NOTIFICATIONS RECEIVED —continued. Street or Place. No. of House. Sex. Age. Disease. Date of Notification. Nevill's Court 11 F 8 Measles 29th April. Ditto 11 M 6 Ditto 29th April. New Broad Street 53 F 11 Scarlet Fever 26th June. North Block, Stoney Lane 31 F 10 Chickenpox 16th June. Old Bailey 22 F 7 Scarlet Fever 4th November. Old Broad Street 19 M 35 Diphtheria 4th July. Primrose Street 1 F 2 Chickenpox 3rd January. Queen's Block, Stoney Lane 8 F 11 Scarlet Fever 5th December. Ditto 27 F 30 Erysipelas 29th September. Ditto 28 F 8 Chickenpox 15th June. Rose Alley 38 F 5 Measles 21st March. Ditto 41 M 3 Scarlet Fever 12th December. St. Bartholomew's Hospital — — — Diphtheria (two cases) Various. Ditto — M 4 Chickenpox 26th April. Ditto — — — Scarlet Fever Various. (seven cases). Serjeant's Inn 13 M 40 Measles 1st May. South Block, Stoney Lane 7 F 44 Diphtheria 6th February. Ditto 29 F 6 Measles 20th March. Ditto 33 M 31 Scarlet Fever 31st July. Swan Lane 8 M 8½ Chickenpox 16th March. Trinity Square 14 M 33 Enteric Fever 6th September. Upper Thames Street 104 F 9 Scarlet Fever 7th February. Water Lane 3 M 15 Ditto 29th June. Watling Street 64 F 7 Ditto 19th June. Widegate Street 12 F 10 Ditto 19th April. Ditto 14 F 20 Ditto 26th October. Ditto 23 M 5 Ditto 28th September. 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. 43, Cloth Fair Messrs. J. Seeley & P. Paget, 41, Cloth Fair, E.C. (o) 2 3 10, East Harding Street Eyre and Spottiswoode, East Harding Street (o) 2 8 12, do. Do. do. (o) 4 6 93, Fetter Lane Friern Manor Dairy Co., 93, Fetter Lane (o) 3 8 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 6 11, Great New Street M. Quilty, 11, Great New Street (t) 4 6 13, do. F. Wilson, 39, Holmedene Avenue, Heme Hill (o) 9 12 14, do. Mrs. A. E. Jackson, 14, Great New Street (t) 6 8 16, do. J. Day, 16, Great New Street (t) 3 5 21, do. Goldsmiths' Company, Goldsmiths' Hall (o) 5 12 23, do. Mrs. J. Barnsley, 27, Great New Street (o) 4 14 25, do. Do. do. (o) 5 11 27, do. Do. do. (t) 4 9 7½, Gunpowder Alley Mrs. C. Townsend, 259, Essex Road, N. (o) 2 4 8, do. Do. do. (o) 3 10 4 & 5, Middle Street J. Hull & Sons, Bartholomew Close (o) 6 10 3, Montague Court Mrs. Vincent, 3, Montague Court (t) 3 5 4, do. Mrs. F. Smith, 4, do. (t) 3 3 5, do. Mr. W. V. Luff, 80, Sydney Street, Chelsea,S.W.3 (0) 2 4 8, Nevill's Court Moravian Mission, 32, Fetter Lane (o) 4 7 9, do. Do. do. (o) 9 10 10, do. Do. do. (o) 6 10 11, do. Goldsmiths' Company, Goldsmiths' Hall (o) 7 19 12, do. Do. do. (o) 4 10 14, Newbury Street Page & Steward, 2, Ironmonger Row (o) 3 12 14, Wine Office Court Messrs. Reynolds & Eason, 192, Bishopsgate (o) 2 3 16, do. Do. do. (o) 2 3 2, Pemberton Row Mr. J. O'Shea, 2, Pemberton Row (t) 4 8 30 Total 120 247 Average number of lodgers to each occupied tenement: 2.0 Houses demolished or closed as dwelling-houses — Tenement houses on Register 30 Cleansing Notices served 37 MIDDLE DISTRICT. Nil. EAST DISTRICT. Situation of Premises. Name and Address of Owner or Tenant. Tenements. Lodgers. 5, Artillery Lane Clerk to Bishopsgate Institute, Bishopsgate (o) 5 8 7, do. Do. do. (o) 4 12 9, do. I. J. & J. Mendes, Ltd., 113-125, Grove Street, E.l(o) 3 6 21, do. Clerk to Bishopsgate Institute, Bishopsgate (o) 3 6 10, Brushfield Street Reynolds & Eason, 192, Bishopsgate (o) 6 7 12, do. Luke Cohen, 12, Brushfield Street (t) 3 11 14, do. Clerk to Bishopsgate Institute, Bishopsgate (o) 7 7 3, The Circus, Minories W. Lewis, 3, Circus, Minories (t) 4 5 4, do. W. Wisdom, 4, do. (t) 5 16 5, do. T. Groves, 5, do. (t) 6 5 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) 5 9 25, do. Do. do. (t) 3 8 2, Goodman's Yard Charrington, Brewers, Mile End Road (o) 3 3 Total 68 121 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. 89 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. 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. 90 APPENDIX E. Corporation of London. PUBLIC HEALTH DEPARTMENT. THE PUBLIC HEALTH (LONDON) ACT, 1891. Compulsory Notification of Chicken-pox. NOTICE 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, 1933, Chicken-pox shall be a compulsorily notifiable disease within the City of London. BELL. Guildhall, London, E.C.2. 23rd February, 1933. APPENDIX F. Corporation of London. PUBLIC HEALTH DEPARTMENT. MEASLES WARNING. Measles has appeared in your neighbourhood, and there is a possibility that the disease may become prevalent. Measles is a highly infectious disease, especially in the early stages of illness before the rash appears. The early symptoms are those of a cold, which may be at first slight; there is generally running at the eyes and nose, sneezing and possibly a dry cough, followed by a rash about the fourth day after the first appearance of illness. Measles should always be treated as a serious disease, especially in Young Children. As soon as it is suspected the child should be put to bed in a well-ventilated room (as far as possible away from other children) and be kept warm. A doctor should be called in at once, for many children lose their lives, or suffer from ill-health for years as a result of the after-effects of the disease, mainly because the disease is neglected in the early stages. The child should on no account be exposed to chill or draughts or allowed to run about until the doctor or nurse gives consent. Immediately Measles occurs in your family you should inform the Head Teacher of the School attended by your Children, or the Health Visitor at the Infant Welfare Centre, or send word to the Medical Officer of Health at the Guildhall, E.C.2. If children are absent for more than two days, parents are specially asked to send a note to the Head Teacher stating the reason for such absence. A child showing signs of sickening or suffering from measles must not attend Sunday School, play centres, cinemas, public baths or any place of entertainment, nor mix with other children. If you are not in a position to obtain the services of a private doctor, you should apply to the Relieving Officer of your district for the services of a District Medical Officer. Arrangements for the Removal of a Measles Patient to Hospital or for Nursing Assistance in the Home may be made in Special Cases when the need for this is known to the Medical Officer of Health. The sooner you send word of the existence of measles in the home, the sooner will the Medical Officer of Health know and the sooner will help be forthcoming. Do not wait until bronchitis or pneumonia develops—it may then be too late. W. M. WILLOUGHBY, Medical Officer of Health.