Ac 434 M LON 60 REPORT of the MEDICAL OFFICER OF HEALTH OF THE CITY OF LONDON for the year 1934 LONDON Printed by Drake, Driver & Leaver, Ltd, Rosebery Avenue, EC 1 1935 REPORT OF THE MEDICAL OFFICER OF HEALTH OF THE CITY OF LONDON For the Year 1934 LONDON Printed by Drake, Driver & Leaver, Ltd, Rosebery Avenue, ECI 1935 INDEX A PAGE ANNUAL RATEABLE VALUE 7 APPENDICES 79-88 AREA 7 ARTIFICIAL CREAM ACT, 1929 51 ARTIZANS' DWELLINGS, STONEY LANE 59, 60 ATMOSPHERIC POLLUTION AND SMOKE 28 AGRICULTURAL PRODUCE (GRADING AND MARKING) ACT, 1923 & 1931 47 B BACTERIOLOGICAL EXAMINATIONS 17 BED BUG 66 BIRTHS 8 INFANT WELFARE 11, 12 NOTIFICATION 12 BLIND, WELFARE OF THE 13 BUTTER FACTORIES 51 c CLEANSING OF PERSONS ACT, 1897 75 CLEANSING OF SCHOOL CHILDREN 75 COURTS, SUMMER FLUSHING OF 65 LIMEWASHING OF 64 CREMATION 29, 30 COMMON LODGING HOUSES 63 CONGRESSES—ROYAL INSTITUTE OF PUBLIC HEALTH 29 —ROYAL SANITARY INSTITUTE 29 —SANITARY INSPECTORS' ASSOCIATION 29 D DEATHS—CAUSES OF 9 DENSITY 7 DEPARTMENTAL COMMITTEE ON THE COMPOSITION AND DESCRIPTION OF FOOD 48 DIPHTHERIA—ANTI-TOXIN 17 DISINFECTANTS, SUPPLY OF 75 DISINFECTION—INFECTIOUS DISEASES 75 DISINFECTION OF SECOND-HAND CLOTHING 75 DRAINAGE PLANS 63 E EXHUMATION AND REINTERMENT OF BODIES AT CITY OF LONDON CEMETERY 65 „ „ „ MITRE STREET, ALDGATE, AND BOW LANE 65 F FACTORY AND WORKSHOP ACT, 1901—ABOVEGROUND BAKEHOUSES 68 „ —FACTORIES, WORKSHOPS AND WORKPLACES 67 „ —OUTWORKERS 69-74 „ —SUMMARY OF INSPECTIONS 67, 68 „ —SUMMARY OF WORK DONE 72 „ —UNDERGROUND BAKEHOUSES 68 FERTILISERS AND FEEDING STUFFS ACT, 192C 47 FISH SUPPLIES AND SEIZURES 42 FLATLETS—HOUSES CONVERTED INTO 65 FOOD—DEPARTMENTAL COMMITTEE ON THE COMPOSITION AND DESCRIPTION OF 48 FOOD AT RIVERSIDE WHARVES, INSPECTION AND CONDEMNATION 44-47 FOOD AND DRUGS—ADMINISTRATIVE ACTION 52-55 ,, —PROSECUTIONS 59 „ —SUMMARY OF ARTICLES EXAMINED 56, 57 „ —SUPERVISION OF 49 G GULLIES, STREET 63 H HOUSES LET IN LODGINGS 62 HOUSE, TRADE AND OTHER REFUSE REMOVAL 64 HOUSES CONVERTED INTO FLATLETS 65 HOUSING 63 HOUSING—SLUM CLEARANCE 66 HUMAN REMAINS—EXHUMATION AND REINTERMENT AT CITY OF LONDON CEMETERY 65 „ „ „ MITRE STREET ALDGATE, AND BOW LANE 65 I ICE CREAM 74 INFANTILE MORTALITY 8 INFANT WELFARE 11 INFECTIOUS DISEASE 14 „ „ —BACTERIOLOGICAL AND PATHOLOGICAL EXAMINATIONS 17 „ „ —DIPHTHERIA ANTI-TOXIN 17 „ „ —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. pag1 LEGAL PROCEEDINGS—SANITARY 64 LIMEWASHING OF COURTS 64 L.C.C. (G.P.) ACT, 1932—PREPARATION OF PRESERVED MEAT, &c. 44 LODGING HOUSES, COMMON—116, MIDDLESEX STREET 63 REGISTERED 62 M. MARGARINE, REGISTRATION OF DEALERS IN MARGARINE AND MARGARINE CHEESE 51 MATERNITY AND CHILD WELFARE 11, 12 MEASLES 17 MEAT INSPECTION 31-41 „ „ —CASEOUS LYMPHADENITIS 37 „ „ —DELIVERY AT CENTRAL MARKETS 41 „ „ —DEMONSTRATIONS AND INSTRUCTION 40 „ „ —EXPORT OF MEAT 40 „ „ -HOME-KILLED MEAT SEIZED 34 „ „ —(IMPORTED FOOD) REGULATIONS. 1925-1933 40 „ „ -LEADENHALL MARKET AND CITY SHOPS 37 „ „ —LIVESTOCK IMPORTED 31 „ „ —PROSECUTIONS 40 „ „ —PUBLIC HEALTH (MEAT) REGULATIONS, 1924 42, 43 „ „ —SEIZURES OF IMPORTED MEAT 39 „ „ —UNSOUND MEAT REMOVED FROM COLD STORES 37 MEDICAL EXAMINATIONS 78 MILK—BACTERIOLOGICAL AND CHEMICAL EXAMINATIONS FOR TUBERCULOSIS AND DIRT (RAILWAY STATIONS) 58,59 „ —CHEMICAL EXAMINATION OF 49 „ —PUBLIC HEALTH (CONDENSED MILK) REGULATIONS, 1923 & 1927 51 „ —PUBLIC HEALTH (DRIED MILK) REGULATIONS, 1923 & 1927 51 „ —MILK AND DAIRIES (AMENDMENT) ACT, 1922 50 „ —MILK AND DAIRIES ORDER, 1926 50 MORTALITY 8 „ —INFANTILE 8 „ —MATERNAL 12 „ —VIOLENCE 8 „ —PHTHISIS 8 „ —ZYMOTICS 8 MORTUARY—DISINFECTION OF CLOTHING FOR EXPORT, INQUESTS, Etc 75 —PRESERVATION OF BODIES OF UNKNOWN DEAD 75 N. NOTIFICATION OF BIRTHS ACT, 1907, AND INFANT WELFARE WORK 11, 12 NURSING PROVISION 17 NUTRITION 12 O. OUTWORKERS 68, 71, 73 OVERCROWDING 64 P. PIGEONS—L.C.C. (GENERAL POWERS) ACT, 1927 65 POPULATION 7 POST-GRADUATE NURSING COURSE 17 PRESERVED MEAT, &c., PREPARATION OF—L.C.C. (G.P.) ACT, 1932 44 PUBLIC HEALTH—(CONDENSED MILK) REGULATIONS, 1923 & 1927 51 „ „ —(DRIED MILK) REGULATIONS, 1923 & 1927 51 „ „ —(IMPORTED FOOD) REGULATIONS, 1925-1933 40 „ „ —(MEAT) REGULATIONS, 1924 42, 43 „ „ —(PREVENTION OF TUBERCULOSIS) REGULATIONS, 1925 17 „ „ —(TREATMENT OF INFECTIOUS DISEASE) REGULATIONS, 1934 17 „ „ —(TUBERCULOSIS) REGULATIONS, 1930 27 R. RAILWAY STATIONS—SAMPLES OF MILK 58, 59 RATEABLE VALUE 7 RAT REPRESSION 76-78 REFUSE—COLLECTION AND DISPOSAL 64 REFUSE REMOVAL FROM EATING HOUSES 74 s. SANITARY DEFECTS AND INFECTIOUS DISEASE 64 SANITARY INSPECTIONS 61 SEWER, DEFECTIVE CONNECTIONS 64 SHOPS ACT, 1934 31 SLUM CLEARANCE 66 SMALLPOX 17 SMOKE AND ATMOSPHERIC POLLUTION 28 STAFF 5 STREET CLEANSING 65 STREET GULLIES 63 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 Lee, Wm, J. Pettit, Richard G. 3rd Class Assistants July, 1930 Oct., 1915 Jan., 1934 Threadgold, Arthur W. Lee, W. R. Tunbridge, Mrs. Holdrup, F. A. Unclassified Nov., 1923 June, 1930 Jan., 1917 March, 1932 SANITARY INSPECTORS. Robinson, Ernest S. Fowler, George Henry McGrath, William Richare Harrington, George Edwin Sillet. David Ernest Grade I. Feb., 1913 Oct., 1920 Mar., 1922 Dec., 1925 April, 1926 Fisher, Stanley G. Neale, William G. C. Tyler, Albert Thorpe, Robert C. Webber, G. A. (Rat Officer) Hudson, Leslie A. Grade II. July, 1928 July, 1928 July, 1928 March, 1930 July, 1932 April, 1934 Johnson, E. A., M.B.E., 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. Grace, L. B. A., M.R.C.V.S., Veterinary Surgeon June, 1934 Sharp, J. Owen, Senior Inspector May, 1892 Matson, William S. Mitchener, William E. Jones, John Slatter, Charles Murray. Samuel B. Grade I. Inspector Dec., 1910 Dec., 1910 April, 1914 May, 1908 Sept., 1911 Mellish, Cyril E. Thompson, Frank E. Perris, G. A. Grade II. Inspector Jan., 1912 July, 1924 Dec., 1923 Cann, S. W. Cole, E. Peyton, H. R. Bernhardt, D. R. Grade III. Inspector May, 1927 May, 1924 Sept., 1932 May, 1931 WOMAN SANITARY INSPECTOR. Wilkinson, Miss Annie M. July, 1909 TUBERCULOSIS SISTER AND HEALTH VISITOR. Backhouse, Miss S. A. June, 1931 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 Graham, Mrs. (Bath Attendant and Cleaner) June, 1927 b annual report of the medical officer of health for the year 1934 To the Right Honourable The Lord Mayor, Aldermen and Commons of the Corporation of London Public Health Department, Guildhall, EC May] 1935 My Lord Mayor and Gentlemen, I have the honour to present my eighth Annual Report on the work of the Medical Officer of Health for the City of London During the year Mr. T. Dunlop Young, OBE, MRCVS, DVSM, retired from the service, and I should like to place on record my appreciation of the assistance which I have received from him, and to say that his services as Veterinary Surgeon will be missed I should like to express my great appreciation of the valuable assistance which is rendered by St Bartholomew's Hospital to the Corporation in connection with (1) Venereal Disease; (2) Tuberculosis; (3) Maternity and Child Welfare The efficiency, combined with economy and ease of working, is productive of the maximum benefit to all concerned If, in the future, prevention is to take the place of treatment, here is being laid the foundation at a place and in an atmosphere where and in which transition would properly be effected 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 persons to an acre; Registration London, at night, 59.5 persons to an acre Annual Rateable Value—The rateable value of property within the administrative county of London (including the City) was £60,870,113, on April 6th, 1934, whilst on the same date the corresponding rateable value of property in the City of London was £8,933,634, or about one-seventh of the whole County The annual sum receivable from a penny rate is £36,602 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 *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 following table shows the progressive decline which has taken place since 1861 in the number of inhabitants who reside within the City boundaries, and the progressive increase in the number of workers who are daily employed in the City:— Year Imperial Census Night Population City Census Day Population 1861 112,063 - 1866 — 170,133 1871 75,983 — 1881 51,405 261,061 1891 37,705 301,384 1901 26,923 — 1911 19,657 364,061 1921 13,709 436,721 (Imperial 1931 10,808 — Census) There is only one registration district in the City The estimated population of the City, for the year 1934, is 9,660 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 1934, 382 live births were registered in the City, 350 of which, however, did not belong thereto To the remaining 32 must be added the births of 34 children born to citizens temporarily residing outside the City boundary The number of births, therefore, on which the rate should be calculated is 66 There were five still births The annual birth-rate was 6.8 per 1,000 persons of all ages, compared with a quinquennial mean rate of 7.2 per 1,000 In the Metropolis the birth-rate in 1934 was 13.2 per 1,000 Mortality—During the year under review, 670 deaths were registered in the District, including 628 persons dying in the City, but not belonging thereto Deducting these latter, 42 deaths remain, to which must be added those of 59 persons who died in outside districts, where they were registered; the total, therefore, on which the City death-rate is calculated is 101 See table, p 10 for details The death-rate for 1934 was 10.5 per 1,000 per annum of the population (the previous year being 10.9), whilst that for the whole of the Metropolis was 11.9 Deaths from Violence—Of the City deaths, 3.9 per cent. were caused by injuries or violence, as compared with 10.2 in 1932 and 4.6 in 1933 This is 2.5 below the average for the previous five years PERCENTAGE OF REGISTERED DEATHS FROM VIOLENCE Year City of London Per cent Metropolis Per cent 1929 2.7 5.6 1930 8.5 5.5 1931 5.9 5.7 1932 10.2 4.6 1933 4.6 4.7 Average previous five years 6.4 5.2 1934 3.9 5.6 DEATH RATES, PER 1,000 PER ANNUM Year City of London 121 Great Towns of England and Wales Metropolis 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 1933 10.9 12.2 12.2 Average previous five years 12.4 12.4 12.4 1934 10.5 11.8 11.9 The death-rate from zymotic disease per 1,000 of the population was 0.2 The deaths from Phthisis correspond to a rate of 0.8 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 121 per 1,000 births, as against 67 for the whole of London 9 CAUSES OF, AND AGES AT, DEATH DURING THE YEAR 1934 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 Cause* 101 8 ... 1 1 3 6 4 13 20 28 17 568 l Typhoid and Paratyphoid Fevers ... ... ... ... ... ... ... ... ... ... ... ... ... 2 Measles ... ... ... ... ... ... ... ... ... ... ... ... ... 3 Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... ... ... 4 Whooping Cough ... ... ... ... ... ... ... ... ... ... ... ... ... 5 Diphtheria ... ... ... ... ... ... ... ... ... ... ... ... 1 6 Influenza ... ... ... ... ... ... ... ... ... ... ... ... 1 7 Encephalitis Lethargica ... ... ... ... ... ... ... ... ... ... ... ... ... 8 Cerebro-spinal Fever ... ... ... ... ... ... ... ... ... ... ... ... 2 9 Tuberculosis of Respiratory System 8 ... ... ... 1 1 3 1 ... 2 ... ... 12 10 Other Tuberculous Diseases 2 ... ... ... ... ... ... ... ... ... 2 ... 10 11 Syphilis ... ... ... ... ... ... ... ... ... ... ... ... ... 12 General Paralysis of the Insane, Tabes Dorsalis 1 ... ... ... ... ... ... ... ... ... 1 ... ... 13 Cancer, Malignant Disease 15 ... ... ... ... ... ... ... 1 4 5 5 116 14 Diabetes ... ... ... ... ... ... ... ... ... ... ... ... 10 15 Cerebral Haemorrhage, &c. 4 ... ... ... ... ... ... 1 ... ... 2 1 18 16 Heart Disease 22 ... ... ... ... ... ... 2 3 9 3 5 26 17 Aneurysm ... ... ... ... ... ... ... ... ... ... ... ... 1 18 Other Circulatory Diseases 5 ... ... ... ... ... ... ... 1 ... 1 3 14 19 Bronchitis 2 ... ... ... ... ... ... ... ... 1 1 ... 3 20 Pneumonia (all forms) 12 ... ... ... ... ... ... ... 2 1 4 1 57 21 Other Respiratory Diseases 1 ... ... ... ... ... ... ... ... ... 1 ... 16 22 Peptic Ulcer 4 ... ... ... ... ... ... ... 2 1 1 ... 25 23 Diarrhoea, &c. 2 ... ... ... ... ... ... ... ... ... ... ... 13 24 Appendicitis 2 ... ... ... ... ... 1 ... 1 ... ... ... 14 25 Cirrhosis of Liver 1 ... ... ... ... ... ... ... 1 ... ... ... 6 26 Other Diseases of Liver, &c. ... ... ... ... ... ... ... ... ... ... ... ... 5 27 Other Digestive Diseases 1 ... ... ... ... ... ... ... ... ... 1 ... 5 28 Acute and Chronic Nephritis 2 ... ... ... ... ... ... ... ... ... 1 1 48 29 Puerperal Sepsis ... ... ... ... ... ... ... ... ... ... ... ... ... 30 Other Puerperal Causes ... ... ... ... ... ... ... ... ... ... ... ... ... 31 Congenital Debility, Premature Birth, Malformations, &c. 3 3 ... ... ... ... ... ... ... ... ... ... 13 32 Senility 1 ... ... ... ... ... ... ... ... ... ... 1 1 33 Suicide ... ... ... ... ... ... ... ... ... ... ... ... 3 34 Other Violence 4 1 ... ... ... ... ... ... ... ... 3 ... 32 35 Other Defined Causes 8 ... ... ... ... 2 ... ... 2 2 2 ... 111 36 Causes ill-defined or unknown 1 1 ... ... ... ... ... ... ... ... ... ... 5 Totals 101 8 ... 1 1 3 6 4 13 20 28 17 568 10 VITAL STATISTICS OF WHOLE DISTRICT DURING 1934 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 Number Rate of Nonresidents registered in the District of Residents not registered in the District Under 1 Year of Age At all Ages Number Rate Number Rate per 1,000 nett Births Number Rate 1 2 3 4 5 6 7 8 9 10 11 12 13 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 1933 9,830 396 83 8.4 572 58.18 521 57 5 60 108 10.9 Average previous 5 years 10,405 413 75 7.2 658 63.17 597 67 4 67 131 12.4 1934 9,660 382 66 6.8 670 69.36 628 59 8 121 101 10.5 Area of City of London in acres (land and inland water) 661 Total population at all ages 13,709 At Census 1921 Number of inhabited houses 2,922 Average number of persons per house 4.6 ) Vaccination—Of the 371 births notified to the Vaccination Officer during 1934, 117 had been successfully vaccinated by the end of the year, 15 had died before the age for vaccination and 0 were reported as insusceptible Vaccination was postponed by medical certificate in 4 cases, 154 had removed into other districts, or the vaccinations were pending at the end of the year There were 81 instances of conscientious objection The Public Vaccinator performed 13 re-vaccinations during the year, and in addition to the 117 successful vaccinations referred to above, 10 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 per cent per cent per cent per cent per cent per cent per cent 1929 427 25.5 Nil Nil 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 1933 396 36.7 0.7 „ 4.5 0.2 35.4 22.5 Average previous 5 years 417 30.1 0.3 „ 3.1 0.4 42.1 24.0 1934 371 31.5 Nil „ 4.0 1.1 41.6 21.8 11 MATERNITY AND CHILD WELFARE Three hundred and ninety notifications of births, including 24 still births, made in accordance with the requirements of the Notification of Births Act, were received Of these, 58 only referred to City births, and the balance were transferred to the appropriate authorities Fifty-eight initial visits were made as a consequence of these notifications, and 1,119 subsequent visits in connection with infant welfare and ante-natal work No visit was necessary in connection with a case which came within the scope of the Children Act, 1908, or 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 One home help was necessary during 1934 There were 14 notifications of verminous school children under the London County Council (General Powers) Act, 1904 Five visits were made in connection with infant life protection and none in connection with cases of Ophthalmia It was not necessary to utilise 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, during 1934 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 1934:— THE CITY OF LONDON WELFARE CENTRE, HELD AT ST BARTHOLOMEW'S HOSPITAL The City of London Infant Welfare Centre has continued actively during 1934 It will be recalled that an additional session each week was started at the beginning of 1934 This step has proved to be fully justified Not only were the total attendances higher than 1933 by 350, but the number of families attending was increased by 25 This, at first sight, may appear a small increase on a total of 2,150 attendances, but it must be remembered that the single session a week had become much too lengthy an affair Mothers and children were kept waiting until very late in the afternoon Now, with two sessions, it is possible for them to be seen without too long a delay at the clinic, and the fact that over 300 more attendances were made shows that the delay was no longer a serious obstacle to the mothers attending During the year 1934 there were some minor changes in the personnel of the clinic Dr Franklin, who, up to September, 1934, had been doing the actual medical work in the clinic, went to the United States in that month His work, as far as the City of London is concerned, has been continued during his absence by Dr C H Stuart Harris, the temporary Chief Assistant to the Children's Department of St Bartholomew's Hospital Dr Franklin will return during 1935, and it is hoped that he will then be able to resume his work In addition, Miss Backhouse's work has been made more manageable by the addition of another Health Visitor One would like to emphasise again at this point how much the success of this Welfare Centre has followed on the energy and skill that Miss Backhouse has put into the work It is a very reasonable step that she should have an assistant The relations with the Hospital have been very cordial, and the close association between the Corporation's Welfare Centre and the Hospital Children's Department has made it possible that those infants attending the Centre, who fall ill, have been able to get Hospital attention at a very early stage of their illness (Signed) CHARLES F HARRIS, MD, FRCP, 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, 1934. Birth Notifications received 58. Infant Welfare Centre. 98 Sessions:— Under 1 year 1,128 Total 2,149 attendances. Over 1 year 1,021 Mothers attended during year 192 „ left City „ 43 No. Children becoming over 5 during year 37 Total visits 1,119:— Under 1 year 333 Over 1 to 5 years 644 Ante-Natal 114 Ophthalmia 0 Deaths under 1 year 7 Still Births 2 Infant Life Protection 5 L.C.C. Reports for schools 9 Scabies 5 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 No case was reported during 1934 It may be of interest to note that, from 1900 to 1934 inclusive, only 16 maternal deaths have occurred amongst City residents NUTRITION A report of a conference between representatives of the Advisory Committee on Nutrition of the Ministry of Health and the representatives of a Committee appointed by the British Medical Association was issued during 1934 It will be remembered that a mountain was made of a molehill in that there appeared, to the uninformed, to be a difference of opinion between experts on nutrition on a matter of fact—of fact easily ascertained and, indeed, already long common knowledge among those whose business it is to know This difference could not exist in reality, and cross purposes which could give rise to its apparent existence are set out in the report The Advisory Committee was giving an average " man value " of energy used at 3,000 units per diem The British Medical Association was giving a " man value " applying to a man in active work of 3,400 units The average " man value " implies difference in physique, personal habits, likes and dislikes, variation in muscular effort involved in different occupations, clothing, climate, and every other factor varying that output of energy and intake of food which can be exactly balanced for the individual man Moreover, the figure is intended as a rough guide to institutional officers The British Medical Association Committee was determining the minimum weekly expenditure on foodstuffs which must be incurred by families of varying size if health and working capacity are to be maintained, and was constructing specimen diets Roughly, the one implies the figure for an average man, and the other for a man at work of a moderately strenuous nature The Committees are in full agreement on a sliding scale—from 4,000 calories for heavy work to 2,600 for light work in a man, 3,000 to 2,600 similarly for a woman, and so on for various ages down the scale Also that the all-round average requirements of the entire population, or of large mixed groups of people, are about 3,000 calories per diem The report, which is of extreme interest, is not of immediate practical use to the Public Health Committee in the absence of institutional supervision 13 WELFARE OF THE BLIND 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—ie, 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, 1920 For registration the person must be " so blind as to be unable o perform any work for which eyesight is essential," ie, not his ordinary or any particula work, but any work It is recognised in this stringency, however, that a person with a 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 Valuation Committee, report for the year 1933-1934 that the City of London blind number only 14, of whom in 6 blindness occurred below the age of 50, in 4 below 30, and in 2 below 20 No one of the City blind is now below age 30 It seems probable that the services of an ophthalmologist will be but rarely required The Authorities of St Bartholomew's Hospital were asked and agreed to entertain an arrangement by which examination and certification on the prescribed form be made by any one of the specially qualified Hospital Ophthalmolgists at a fee of £2 2s 14 INFECTIOUS DISEASES One hundred and eighty-eight cases of infectious disease were notified or reported during the year 1934 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, 1935 Appropriate notice to interested parties was given, a copy of which is reproduced in Appendix E of this Report Twenty-two of the cases reported were Diphtheria, compared with 15 in 1933 The number of Scarlet Fever cases was 42, compared with 39 in 1933 There were 9 cases of Erysipelas Measles and German Measles are not notifiable diseases, but 58 cases of the former illness were brought to my notice by medical practitioners and through the medium of the school medical service Fifty-two cases of Chicken-pox were notified, 1 of Polio-myelitis, 1 of Cerebro-spinal Meningitis, 2 of Acute Primary Pneumonia and 1 of Acute Influenzal Pneumonia 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 64 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 LCC Special Hospitals Removed to the London Fever Hospital Treated at other Hospitals and Institutions Duplicate Certificates received Diagnosis subsequently found to be incorrect Net number of Cases Small-pox ... ... ... ... ... ... ... ... Diphtheria 22 ... 13 4 ... 5 2 15 Scarlet Fever 42 4 32 4 ... 2 2 38 Enteric Fever (including Para-typhoid) ... ... ... ... ... ... ... ... Puerperal Fever ... ... ... ... ... ... ... ... Puerperal Pyrexia ... ... ... ... ... ... ... ... Erysipelas 9 2 ... ... 5 2 1 6 Cerebro-spinal Meningitis 1 ... ... ... l ... ... 1 Acute Polio-myelitis 1 ... ... ... l ... ... 1 Ophthalmia Neonatorum ... ... ... ... ... ... ... ... Malaria contracted abroad ... ... ... ... ... ... ... ... Acute Primary Pneumonia 2 ... l ... l ... ... 2 Acute Influenzal Pneumonia 1 ... ... ... l ... ... 1 Encephalitis Lethargica ... ... ... ... ... ... ... ... Food poisoning or suspected food poisoning ... ... ... ... ... ... ... ... Amoebic Dysentery ... ... ... ... ... ... ... ... Chicken-pox 52 50 l 1 ... ... ... 52 Totals 130 56 40 9 9 9 5 116 Measles 58 37 18 3 ... ... ... 58 Totals 188 93 58 12 9 9 5 174 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 1934 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 1929 60 90 0 10.0 1930 58 93.1 6.9 1931 38 94.7 5.3 1932 57 91.2 8.8 1933 56 87.5 12.3 Average for the five years 53.8 91.3 8.7 1934 61 90.2 9.8 C2 16 CASES OF INFECTIOUS DISEASE AND TUBERCULOSIS NOTIFIED DURING THE YEAR 1934 NUMBER OF ACTUAL CASES NOTIFIED DISEASES At Ages—Years No of Cases Removed to Hospital * At all ages Under 1 year l year and under 2 years 2 years and under 3 years 3 years and under 4 years 4 years and under 5 years 6 years and under 10 years 10 years and under 15 years 16 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 15 ... 1 ... 1 ... 4 ... l 6 l l ... 15 Erysipelas 6 ... ... ... ... ... ... ... ... ... 3 3 ... 4 Scarlet Fever 38 l 1 2 2 l ... 10 4 4 13 ... ... 34 Typhus „ ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric „ (including Para-typhoid) ... ... ... ... ... ... ... ... ... ... ... ... ... ... Relapsing „ ... ... ... ... ... ... ... ... ... ... ... ... ... ... Continued „ ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal „ ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Pyrexia ... ... ... ... ... ... ... ... ... ... ... ... ... ... Polio-myelitis 1 ... ... ... ... l ... ... ... ... ... ... ... 1 Cerebro-spinal Meningitis 1 ... ... ... ... ... ... ... 1 ... ... ... ... 1 Pulmonary Tuberculosis 25 ... ... ... ... ... ... l 4 13 3 3 l 25 Other forms of Tuberculosis ... ... ... ... ... ... ... ... ... ... ... ... ... ... Ophthalmia Neonatorum ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 58 2 2 1 6 2 31 3 7 3 1 ... ... 21 Rubella ... ... ... ... ... ... ... ... ... ... ... ... ... ... Chicken-pox 52 2 1 2 2 4 25 12 2 1 1 ... ... 2 Malaria (contracted abroad) ... ... ... ... ... ... ... ... ... ... ... ... ... ... Acute Primary Pneumonia 2 ... ... ... ... ... ... ... 1 1 ... ... ... 2 Acute Influenzal Pneumonia 1 ... ... ... ... ... ... ... ... ... 1 ... ... 1 Encephalitis Lethargica ... ... ... ... ... ... ... ... ... ... ... ... ... ... Amoebic Dysentery ... ... ... ... ... ... ... ... ... ... ... ... ... ... Food Poisoning ... ... ... ... ... ... ... ... ... ... ... ... ... ... Totals 199 5 5 5 11 8 60 26 20 28 23 7 1 106 * LCC Hospitals, London Fever Hospital, St Bartholomew's Hospital, City Police Hospital, Sanatoria, &c. 17 SMALL-POX Four cases of Small-pox occurred during the year in persons not resident but employed in the City Sixty-six contacts were kept under observation, including those who had been in contact with cases not resident or employed in the City The customary disinfection, where necessary, was carried out 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 1934 DISTRIBUTION OF DIPHTHERIA ANTI-TOXIN AND ANTI-INFLUENZA VACCINE Although City medical practitioners are well aware of the facilities available, only two applications for supplies of diphtheria anti-toxin were received during 1934 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 13.5 per cent. of these cases Specimens Disease Suspected Result Positive Negative 35 Swabbings from throats Diphtheria 4 31 2 Sputa Tuberculosis 1 1 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 facility is of considerable value in the training of health visitors and is much appreciated During 1934, 20 students attended for demonstrations 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 PUBLIC HEALTH (TREATMENT OF INFECTIOUS DISEASE) REGULATIONS, 1934 These Regulations came into force on the 1st July and give to county councils and the council of every borough or urban or rural district council and every joint hospital board constituted under the Public Health Act, 1875, having the powers of Section 131 of that Act, the same powers and duties in relation to the provision of hospitals or temporary places for the use of persons who are for the time being within their county borough or district, as the case may be, and are suffering from an infectious disease, as they have for the use of the inhabitants of that county borough or district The Ministry of Health points out in this connection that the primary purposes of these Regulations is prevention of spread, and the responsible body in any district, having provided proper treatment for the inhabitants in and of that district, should logically be enabled to deal with infectious disease in persons who are in but not of the district, and the Regulations constitute a very desirable addition to the public health powers 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 1,073. The following is a brief summary of the work carried out during 1934 : At the beginning of the year 524 males and 203 females were registered on the books as being under treatment or observation, which compares with 489 males and 187 females at the beginning of the previous year. Of these patients, 334 males and 177 females were under treatment for syphilis, and 177 males and 24 females for gonorrhoea. Thirteen males and 2 females were under treatment for conditions other than venereal disease. New patients admitted totalled 1,073, as compared with 1,023 in the previous year, the total attendances were 32,130. Unfortunately, 294 cases discharged themselves before completion of treatment, and 90, although completing treatment, failed to submit themselves to final test. Forty-four males and 13 females were transferred to other centres after treatment, whilst 524 males and 100 females were discharged after completion of treatment and observation. There were 5 in-patients. The total number of attendances is made up as follows:— Syphilis. Soft Chancre. Gonorrhoea. Non-Venereal Conditions. Total Attendances. Male. Female. Male. Female. Male. Female. Male. Female. Male. Female. 13,896 6,558 20 - 9,176 1,397 644 439 23,736 8,394 In the laboratories associated with the Centre, 8,764 specimens were examined, 23 for the detection of spirochetes, 1,744 for gonococci, 6,745 examinations for the Wassermann or Serum test, and 252 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 patient:- No. of patients treated. Examinations. For Syphilis. For Soft Chancre. For Gonorrhoea. For Non-Venereal Conditions. For Spirochetes. For Gonococci. For Wassermann or Serum Test Reactions. London 216 4 304 456 23 1,655 2,462 Essex — — 4 7 - 30 - Herts. 1 — - 1 - - 3 Surrey 3 — 3 1 - 24 9 Kent 1 — 4 3 - 19 3 Middlesex - - - - - - - Sussex - - - 1 - - - Bucks. — — 3 1 - 16 - Totals 221 4 318 476 23 1,744 2,477 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 1934 866 207 1,073 32,130 3,997 9,314 ... 5 8,764 Totals 9,632 2/721 12,353 305,661 47,415 49,288 17,975 321 107,503 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, 1934. Syphilis. Soft Chancre. Gonorrhoea. Conditions other than venereal. Totals. m. f. m. F. m. f. m. f. m. f. Totals. 1. Number of cases on 1st January under treatment or observation 334 177 ... ... 177 24 13 2 524 203 727 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 4 10 ... ... 40 ... ... ... 44 10 54 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 19 2 ... ... ... ... ... ... 19 2 21 „ secondary 40 34 ... ... ... ... ... ... 40 34 74 latent in 1st year of infection ... ... ... ... ... ... ... ... ... ... ... „ all later stages 82 18 ... ... ... ... ... ... 82 18 100 congenital 11 9 ... ... ... ... ... ... 11 9 20 Soft Chancre ... ... 4 ... ... ... ... ... 4 ... 4 Gonorrhoea, 1st year of infection ... ... ... ... 205 33 ... ... 205 33 238 later ... ... ... ... 68 ... ... ... 68 ... 68 Conditions other than venereal ... ... ... ... ... ... 376 100 376 100 476 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 6 ... ... ... 11 1 ... ... 17 1 18 Total of Items 1, 2, 3 and 4 496 250 4 ... 501 58 389 102 1,390 410 1,800 5. Number of cases discharged after completion of treatment and final tests of cure (see Item 15) 15 1 3 ... 117 7 389 92 524 100 624 6. Number of cases which ceased to attend before completion of treatment and were, on first attendance, suffering from :— Syphilis, primary 11 2 ... ... ... ... ... ... 11 2 13 „ secondary 29 14 ... ... ... ... ... ... 29 14 43 „ latent in 1st year of infection 26 6 ... ... ... ... ... ... 26 6 32 „ all later stages 23 8 ... ... ... ... ... ... 23 8 31 ,, congenital 3 18 ... ... ... ... ... ... 3 18 21 Soft Chancre ... ... ... ... ... ... ... ... ... ... ...... Gonorrhoea, 1st year of infection ... ... ... ... 105 10 ... ... 105 10 115 „ later ... ... ... ... 39 ... ... ... 39 ... 39 7. Number of cases which ceased to attend after completion of treatment but before final tests of cure (see Item 15) 8 26 ... ... 44 12 ... ... 52 38 90 8. Number of cases transferred to other centres or to institutions, or to care of private practitioners:— 22 3 ... ... 22 10 ... ... 44 13 57 9. Number of cases remaining under treatment or observation on 31st December 359 172 1 ... 174 19 ... 10 534 201 735 Totals of Items 5 6, 7, 8 and 9 (These totals should agree with those of Items 1, 2, 3 and 4.) 496 250 ... ... 501 58 389 102 1,390 410 1,800 10. Number of cases in the following stages of syphilis included in Item 6 which failed to complete one course of treatment:— Syphilis, primary ... 2 ... ... ... ... ... ... 4 2 6 „ secondary 10 3 ... ... ... ... ... ... 10 3 13 „ latent in 1st year of infection 12 8 ... ... ... ... ... ... 12 8 20 ,, all later stages 4 ... ... ... ... ... ... ... 4 ... 4 „ congenital ... 7 ... ... ... ... ... ... ... 7 7 11. Number of attendances:— (a) for individual attention of the medical officers 13,896 6,558 20 ... 4,187 978 644 439 18,747 7,975 26,722 (6) for intermediate treatment, e.g., irrigation, dressing ... ... ... ... 4,989 419 ... ... 4,989 419 5,408 Total Attendances 13,896 6,558 20 ... 9,176 1,397 644 436 23,736 8,394 32.130 12. In-patients :— (a) Total number of persons admitted for treatment during the year ... 2 ... ... 3 ... ... ... 3 2 5 (6) Aggregate number of "inpatient days" of treatment given ... 99 ... ... 158 ... ... ... 99 158 257 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, 1934—continued Under 1 year 1 and under 5 years 5 and under 15 years 15 years and over Totals M. F. M. F. M. F. M. F. M. F. 13 Number of cases of congenital syphilis in Item 3 above classified according to age periods 3 2 1 ... 6 3 1 4 11 9 14 Chief preparations used in treatment of Syphilis:— Arsenobenzene Compounds Mercury Bismuth (a) Names of preparations Neosalvarsan Sil Salvarsan Neokharsavan Novarsenobil ... Bis Oxychloride 5% Collosal Metal Bismuth (b) Total number of injections given (out-patients and in-patients) 3,997 ... 9,314 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 gonorrhoea? Yes If not, in what way are they modified ? — 16 Pathological Work:— (a) Number of specimens examined at and by the medical officer of the treatment centre Microscopical Serum Tests for Spirochetes for Gonococci Wassermann Others for Syphilis for Gonorrhoea 23 ... ... ... ... (b) Number of specimens from patients attending at the centre sent for examination to an approved laboratory ... 1,744 1,111 1,061 53 These numbers do not include any specimens for practitioners sent to the Pathological laboratory for examination 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 Surrey Essex Kent Bucks Herts Sussex Total A. Number of cases in Items 3 and 4 from each area found to be suffering from:— Syphilis 216 3 ... 1 ... 1 ... ... 221 Soft Chancre 4 ... ... ... ... ... ... ... 4 Gonorrhœa 304 3 4 4 3 ... ... ... 318 Conditions other than venereal 456 ... 7 3 1 1 1 ... 476 Total 980 13 11 8 4 2 1 ... 1,019 B. Total number of attendances of all patients residing in each area 31,850 130 85 42 14 6 3 ... 32,130 C. Aggregate number of " In-patient days " of all patients residing in each area 257 ... ... ... ... ... ... ... 257 D. Number of doses of arsenobenzene compounds given in the out-patient Clinic and In-patient Department to patients residing in each area 3,965 32 ... ... ... ... ... ... 3,997 25th Jan, 1935 (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 1230 pm—230 pm 230 pm—430 pm For the Artificial Pneumothorax Clinic 50 pm—70 pm Fridays 1230 pm (New cases only) 330 pm—430 pm In all, 249 sessions have been held New Patients—The number of new patients examined was 291, as compared with 312 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 76 180 256 ,, Surgical ,, 1 4 5 ,, Dental ,, 7 13 20 „ Throat „ 22 46 68 „ Pathological „ 1 2 3 „ Other „ 1 3 4 108 248 356 Patients Admitted to the Hospital for Diagnosis—The wards of the Hospital are available for the reception of cases presenting difficulties of diagnosis, which can only be overcome by observation as In-patients No resident and four non-resident patients were admitted for this and other purposes Examination of Sputum—The following is a summary:— City Residents Non-Residents Total Positive 4 6 10 Negative 16 39 55 Residential Treatment.—The number of patients for whom residential treatment was arranged was 79. 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 13 4 2 l 2 22 Patients non-resident 41 3 13 — — 57 54 7 15 l 2 79 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 58 In addition, 40 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 140 Total Attendances:— Residents 413 Non-Residents 816 1,229 D 22 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 1934 During past years a certain amount of difficulty has arisen in connection with the residential treatment of cases who were residing at the place at which they were employed, when diagnosed as having pulmonary tuberculosis In order to meet this, the Corporation have made an arrangement with the Brompton Hospital whereby urgent cases can be admitted within 48 hours under Dr Young's personal care, under a Certificate from the Medical Officer of Health Two 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 23 City and 275 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 Sixty homes have been visited, and 184 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 4 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 OBE ; 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, 4 City and 24 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 23 (ix) Nursing in their own homes of patients resident in the City is one of the duties of the Tuberculosis Sister, and 4 homes were visited in this connection Milk has been provided for necessitous persons requiring extra nourishment and in this connection the sum of about £40 has been expended (x) Patients suffering from Non-Pulmonary Tuberculosis receive advice and treatment from the Surgeons of St Bartholomew's Hospital, to whom they are referred from the Dispensary Treatment in residential institutions is provided for as 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 present lady members of the Committee are Miss Crosby, and Lady Smith; JP D2 24 25 SUPPLEMENTARY ANNUAL RETURN SHOWING IN SUMMARY FORM (A) THE CONDITION AT THE END OF 1934 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. 1934. 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. Class T.B. minus. Class T.B. plus. Class T.B. minus. Class T.B. plus. Group 1. Group 2. Group 3. Total (Class T.B. plus). Group 1. Group 2. Group 3. Total (Class T.B. plus). Group 1. Group 2. Group 3. Total (Class T.B. plus). Group 1. Group 2. Group 3. Total (Class T.B. plus). Group 1. Group 2. Group 3. Total (Class T.B. plus). Group 1. Group 2. Group 3. Total (Class T.B. plus). Group 1. Group 2. Group 3. Total (Class T.B. plus). Group 1. Group 2. Group 3. Total (Class T.B. plus). Group 1. Group 2. Group 3. Total (Class T.B. plus). Group 1. Group 2. Group 3. Total (Class T.B. plus). (a) Remaining on Dispensary Register on 31st December. Disease arrested. Adults. M 1 1 1 1 3 1 ... ... ... ... 1 ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... F ... ... 2 ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Children. ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Disease not arrested. Adults. M ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... 1 1 ... ... ... 1 1 ... 1 ... ... 1 1 3 2 ... 5 3 ... ... ... ... F ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... .... ... ... ... ... 1 ... ... 1 1 ... ... 1 ... 1 ... 1 ... ... 1 1 1 ... ... 1 3 3 ... 1 4 Children. 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Condition not ascertained during the year 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Total on Dispensary Register at 31st December 5 1 3 1 5 2 ... ... ... ... 2 ... ... ... ... 1 ... ... ... ... ... ... 1 ... 1 1 ... ... 2 2 2 ... 1 1 2 ... 2 ... ... 2 2 4 2 ... 6 6 3 ... 1 4 (b) Not now on Dispensary Register and reasons for removal therefrom. Discharged as Recovered Adults. M 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... F ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Children. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Lost sight of, or otherwise removed from Dispensary Register 21 2 16 3 21 4 ... 2 3 5 1 ... 3 2 5 8 1 ... 1 2 3 3 2 ... 5 3 1 3 1 5 4 1 1 2 4 5 1 ... 2 3 3 ... 1 1 2 3 1 1 ... 2 Dead. Adults. M 1 1 2 6 9 ... ... 1 3 4 ... ... 1 3 4 1 ... 1 2 3 1 ... ... 1 1 ... ... ... 1 1 ... ... 1 2 3 1 ... 1 2 3 ... ... ... 1 1 ... ... ... ... ... F ... ... ... 3 3 ... ... ... ... ... ... ... ... 2 2 ... ... ... 1 1 ... ... ... ... ... ... ... ... 1 1 ... ... ... 1 1 1 ... ... ... ... ... ... ... 2 2 ... ... ... ... ... Children. 1 ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Total written off Dispensary Register 24 3 18 12 33 4 ... 3 7 10 1 ... 5 7 12 9 1 1 4 6 4 3 2 1 0 3 1 3 3 7 4 1 2 5 8 7 1 1 4 6 3 1 4 5 3 1 1 ... 2 Grand Totals 29 4 21 13 38 6 ... 3 7 10 3 ... 5 7 12 10 1 1 4 6 4 3 3 1 7 4 1 3 5 9 6 1 3 10 7 3 1 4 8 5 4 3 4 11 9 4 1 1 6 SUPPLEMENTARY ANNUAL RETURN SHOWING IN SUMMARY FORM (A) THE CONDITION AT THE END OF 1934 OF ALL PATIENTS REMAININC B.—NON-PULMONARY ON THE DISPENSARY REGISTER; AND (B) THE REASONS FOR THE REMOVAL OF ALL CASES WRITTEN OFF THE REGISTER. TUBERCULOSIS. Previous to 1926. 1926. 1927. 1928. 1929. 1930. 1931. 1932. 1933. 1934. Condition at the time of the last record made during the year to which the Return relates. Bones and Joints. Abdominal. Other Organs. Peripheral Glauds. Total. Bones and Joints. Abdominal. Other Organs. Peripheral Glands. Total. Bones and Joints. Abdominal. Other Organs. Peripheral Glands. Totals. 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 ... ... ... ... ... ... .... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... Children. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... Disease not arrested. Adults. M ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... F ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Children ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Condition not ascertained during the year ... ... ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Total on Dispensary Register at 31st December ... ... .... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 1 ... ... ... 1 ... ... ... ... ... ... ... 1 ... 1 ... ... ... 2 2 ... ... ... ... ... Transferred to Pulmonary ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (b) Not now on Dispensary Register and reasons for removal therefrom. Discharged as Recovered Adults. M ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 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 ... ... ... ... ... ... ... ... 1 1 ... ... ... 1 1 ... ... ... ... ... Dead. Adults. M ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... F ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Children. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Total written off Dispensary Register 7 1 1 2 11 2 ... ... ... 2 3 ... ... 1 4 ... ... ... ... ... ... ... ... 1 1 1 ... 1 ... 2 ... ... ... ... ... ... ... ... 1 1 ... ... ... 1 1 ... ... ... ... ... 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 ... ... ... ... ... (Signed) W. M. WILLOUGHBY, Chief Tuberculosis Officer. 26 return showing the work of the dispensary during the year 1934, 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 vear (excluding contacts):— (a) Definitely tuberculous 6 8 .... .... .... .... .... .... 6 8 14 21 (b) Diagnosis not completed .... 1 .... .... .... .... .... .... 1 .... 1 (c) Non-tuberculous .... 6 .... .... .... .... .... .... .... 6 6 B.—CONTACTS examined during the year:— (a) Definitely tuberculous .... 1 .... .... .... .... .... .... 1 1 40 (b) Diagnosis not completed 1 1 .... .... .... .... .... .... 1 1 2 (c) Non-tuberculous 7 17 5 8 7 17 5 8 37 C.—CASE written off the Dispensary Register as— (a) Recovered 1 1 .... .... .... .... .... .... 1 1 .... .... 2 45 (b) Non-tuberculous (including any such cases previously diagnosed and entered on the Dispensary Register as tuberculous) .... .... .... .... .... .... 7 23 5 8 43 D.—NUMBER OF CASES on Dispensary Register on December 31st:— 52 (a) Definitely tuberculous 24 17 1 1 3 1 2 27 18 1 3 49 (b) Diagnosis not completed 1 2 .... .... .... .... .... .... .... .... .... .... 3 1. Number of cases on Dispensary Register on January 1st, 1934:— 58 2. Number of cases transferred from other areas and cases returned after discharge under Head 3 in previous years 1 3. Number of cases transferred toother areas, cases not desiring further assistance under the scheme, and cases "lost sight of " 18 4. Cases written off during the year as Dead (ah causes) 5 5. Number of attendances at the Dispensary (including Contacts) 413 6. Number of Insured Persons under Domiciliary Treatment on the 31st December 38 7. Number of consultations with medical practitioners:— 8. Number of visits by Tuberculosis Officers to homes (including personal consultations) 1 (a) Personal 12 (b) Other - 9. Number of visits by Nurses or Health Visitors to Homes for Dispensary purposes 184 10. dumber of (a) Specimens of sputum, etc., examined 20 (b) X-ray examinations made in connection with Dispensary work 76 11. Number of "Recovered" cases restored to Dispensary Register, and included in A (a) and A(b) above - 12. Number of "T.B. plus" cases on Dispensary Register on December 31st 21 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 92 50 2 3 6 6 3 1 98 56 5 4 163 256 (b) Doubtfully tuberculous .... .... .... .... .... .... .... .... 6 3 .... .... 9 (c) Non-tuberculous .... .... .... .... .... .... .... .... 35 42 2 5 84 B.—Number of Tuberculous City workers attending Dispensary for treatment on Dec. 31st, 1934 58 C —Number of Non-Resident and Non-Workers attending Dispensary for treatment on Dec. 31st, 1934 38 352 27 public health (tuberculosis) regulations, 1930. part 1. Summary of Notifications during the period from the 1st January, 1934, to the 31st December, 1934. Age Periods Formal Notifications. Number of Primary Notifications of new cases of Tuberculosis. Total Notifications. 0- 1- s- 10- 15- 20- 25- 35- 45- 55- 65- Total (all ages) Pulmonary Males .... .... .... .... .... 5 4 .... 1 .... 1 11 17 ,, Females .... .... .... .... 3 3 2 2 1 1 .... 12 17 Non-Pulmonarv Males .... .... .... .... .... .... .... .... .... .... .... .... .... „ „ Females .... .... .... .... .... .... .... .... .... .... .... .... .... Col. (1) (2) (3) (4) (6) (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- l- 5- 10- 15- 20- 25- 35- 45- 55- 65- Total Pulmonary Males .... .... .... .... .... .... .... .... 1 1 .... 2 ,, Females .... .... .... 1 .... .... .... .... .... .... .... 1 Non-Pulmonarv 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) 1 .... 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, 1934, on the Register of Notifications 39 23 62 3 3 6 68 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 6 3 9 .... .... .... 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 cases coming to knowledge through the Death Returns, as well as of cases notified posthumously, are required by Article 10(2) of the Regulations to be entered in the Notification Register. It follows that such cases will also be duly included in the number of cases removed from the Register during the year by reason of "death " (cf. Head 3 of the second section of Part III. of the Form overleaf). (d) No case should be included both in the Summary of Notifications and in the Supplemental Return for the same year. (e) In Counties, the particulars for the purposes of this Return should be obtained by the procedure suggested in paragraph 2 of Part II. of Circular 549. PART III. In Counties, the information should be compiled from the quarterly statements for the year 1934, which are required to be furnished to the County Medical Ofticer of Health by the Medical Officer of Health of each District in the County, in pursuance of Article 10 («) 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-four complaints of smoke nuisance or annoyance from chimneys were dealt with during the year, and in connection with these 304 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 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 1934, 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. SUMMARY OF MONTHLY OBSERVATIONS AND REPORTS DURING THE YEAR 1934. Month of the Year 1934. Place. 3 5 6 8 9 10 11 1Z Rainfall mm. Metric tons per square kilometre. Insoluble matter. Soluble matter. Included in soluble matter. Tar. Carbonaceous other than tar. Ash. Loss on ignition. Ash. Total solids. Sulphates (S03). Chlorine (CI). A mmonia (NH,), January Meteorological Office 31 0.34 1.65 310 1.85 3.20 10.14 1.59 0.76 0.06 Golden Lane 32 0.81 6.38 12.43 40.88 29.33 89.84 20.78 4.45 0.14 Victoria Park 31 0.23 3.70 6.13 2.12 3.25 15.43 1.22 0.52 0.07 Meteorological Office 6 0.25 1.47 1.95 113 1.13 5.93 0.52 0.42 0.05 February Golden Lane 4 0.37 0.87 2.64 1.41 2.12 7.41 0.80 0.61 0.04 Victoria Park 3 0.07 0.24 0.40 0.34 0.71 1.76 0.36 013 0.02 Meteorological Office 43 0.14 1.37 2.27 0.68 2.29 6.75 0.99 0.43 0.02 March Golden Lane 50 0.48 3. 03 5.30 8.12 11.25 28.19 6.73 0.14 0.19 Victoria Park 50 0.24 2.91 619 1.09 2.18 12.61 0.72 0.47 0.08 Meteorological Office 45 015 1.53 3.43 0.72 2.25 8.08 0.80 0.45 0.04 April Golden Lane 43 0.21 1.62 3.98 2.14 1.54 9.49 1.06 0.66 0.12 Victoria Park 49 0.11 4.21 3.01 1.27 1.95 10.55 0.94 0.35 0.09 Meteorological Office 12 014 0.86 1.23 0.42 1.62 4.27 0.53 0.22 0.01 May Golden Lane 7 0.37 0.70 2.47 3.09 3.53 10.16 2.30 0.45 0.07 Victoria Park 10 0.23 2. 03 5.44 0.30 0.85 8.85 0.35 0.11 0.04 Meteorological Office 25 0.08 0.50 0.99 0.50 1.92 3.99 0.64 0.24 0.02 June Golden Lane 20 0.25 0.48 1.72 1.14 1.74 5.33 0.66 0.34 0.06 Victoria Park 43 0.11 1.49 3.80 0.26 1.89 7.55 0.94 0.23 0.07 Meteorological Office 65 0.13 0.73 2.34 1.16 2.96 7.32 0.93 0.29 0.06 July Golden Lane 18 0.59 0.12 0.70 0.75 0.99 3.15 0.21 0.37 0.01 Victoria Park 24 0.07 1.07 2.97 0.61 1.14 5.86 0.55 0.15 0.11 Meteorological Office 54 0.08 0.24 0.38 1.51 1.94 4.15 0.66 0.22 0.02 August Golden Lane 35 0.47 2.24 5.26 2.01 2.93 12.92 1.05 0.55 0.01 Victoria Park 41 0.03 0.44 0.81 0.41 2.37 4.06 0.70 0.21 0.07 Meteorological Office 33 0.13 0.47 1.18 0.86 2.39 5.04 0.93 0.16 0.03 September Golden Lane 32 0.19 0.72 1.86 2.13 3.61 8.51 0.52 0.39 0.03 Victoria Park 31 0.06 0.91 1.83 0.19 2.10 5.09 0.68 0.11 0.04 Meteorological Office 22 0.14 1.36 1.83 0.76 2.28 6.37 0.81 0.44 0.02 October Golden Lane 25 0.22 0.92 2.38 1.52 2.13 7.17 0.66 0.59 0.01 Victoria Park 26 006 0.60 0.86 0.41 1.51 3.44 0.68 0.24 0.06 Meteorological Office 41 0.30 1.92 2.14 0.91 2.22 7.49 0.85 0.61 0.07 November Golden Lane 43 0.30 4.46 3.22 2.33 3.00 13.32 1.35 0.83 0.43 Victoria Park 46 005 0.78 1 .67 0.28 1.47 4.25 0.82 0.26 0.06 Meteorological Office* 126 0.21 3.13 4.19 4.80 12.38 24.71 3.73 4.07 2.34 December Golden Lane 112 0.61 3.06 4 .46 2.01 3.59 13.73 1.39 0.95 0.10 Victoria Park 114 0.13 2.85 5.79 1.14 4.09 14.00 1.64 0.19 0.09 •These figures are abnormal; the appearance of the sample was unusual, being very opalescent. 29 CONGRESSES. The Congress of the Royal Institute of Public Health, at Norwich, from 14th to 19th May ; the Congress of the Royal Sanitary Institute, at Bristol, from 9th to 14th July ; and the Congress of the National Association for the Prevention of Tuberculosis, in London, on 14th and 15th June, were all attended by representatives of the City Corporation, and again provided ample evidence of the value of these assemblies. One of my staff also attended the Congress of the Sanitary Inspectors' Association, held at Southport, from the 3rd to the 8th September. CREMATION. The publicity which the Public Health Committee of the City Corporation, acting as the Burial Board to the City of London, gave in 1933 to the Crematorium which they had established at the City of London Cemetery, at Little Ilford, was productive of such excellent results that it was felt desirable to adopt similar measures during 1934, and, accordingly, I communicated with the medical officers of health of the areas which might be regarded as within reasonable distance of Ilford Cemetery, asking them whether they would be good enough to circularise again the medical practitioners in their districts with copies of the Corporation brochure, " Garden of Rest," and to refer to the facilities available for cremation at Ilford, in their annual reports for 1933. I am glad to be able to record that the majority of the medical officers of health with whom I communicated were heartily in sympathy with the objects in view, and it is satisfactory to note that the number of cremations which took place during 1934—i.e., 237— is an increase of 23 per cent, over the previous highest of 192 during 1933. Reference to the following table will show that the total number of cremations which took place in the several crematoria existing in Great Britain during 1934 increased from the 1933 figure of 7,471 to 8,337. One cannot feel, however, that there will ever be a really appreciable increase in cremation until there has been an increase in the number of crematoria, and the consequent facilities available. At the present moment—although cremation is, contrary to the general belief, not an expensive matter—there are the practical difficulties in the way of the relatives carrying out either their own views, or even the expressed wishes of the deceased, associated with the journey from the place of decease to the nearest crematorium. I feel convinced that, with the establishment of a crematorium in every large town, one would see a marked increase in the figures. On the Continent, where facilities are more readily available, considerable expansion of the movement has been experienced, especially in Czecho-Slovakia and Germany. 30 CREMATIONS IN THE UNITED KINGDOM. 50 YEARS—1885-1934. YEAR. Working. 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. Southampton. Birkenhead. (Opened 18th Oct., 1934.) Newcastle-on- Tyne. (Opened 22nd Oct., 1934.) Plymouth. (Opened 19th Oct., 1934.) Stockport. ( Opened 27th March, 1934.) 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 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1,623 1912 125 149 44 52 27 15 14 591 40 24 32 12 9 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1,134 1913 128 172 49 66 23 11 11 602 59 16 21 15 15 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1,188 1914 124 184 57 48 16 11 7† 671 53 28 42 20 18 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1,279 1915 153 165 63 54 34 16 22 730 45 20 45 21 12 30 .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1,410 1916 125 179 71 58 25 10 23 633 63 22 43 14 11 89 .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1,366 1917 129 178 67 62 24 15 34 719 49 17 68 25 10 118 .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1,515 1918 142 197 74 69 43 17 42 820 64 34 70 50 20 153 .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1,795 1919 181 235 84 89 46 26 36 919 76 30 68 41 31 169 .... .... .... .... .... .... .... .... .... .... .... .... .... .... 2,031 1920 149 203 80 69 30 18 32 851 72 26 58 32 20 156 .... .... .... .... .... .... .... .... .... .... .... .... .... 1,796 1921 159 228 87 75 43 20 36 893 78 31 57 29 24 162 .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1,922 1922 193 189 75 74 45 17 23 939 98 31 70 38 25 186 6 .... .... .... .... .... .... .... .... .... .... .... .... .... 2,009 1923 170 227 90 62 45 21 36 920 75 27 69 37 23 178 6 .... .... .... .... .... .... .... .... .... .... .... .... .... 1,986 1924 235 251 82 74 47 28 40 1,114 97 47 68 32 24 240 7 4 .... .... .... .... .... .... .... .... .... .... .... .... 2,390 1925 271 287 116 75 41 32 57 1,214 126 48 66 48 32 266 7 14 .... .... .... .... .... .... .... .... .... .... .... .... 2,700 1926 305 303 98 96 55 33 70 1,270 128 40 84 43 32 299 8 13 .... .... .... .... .... .... .... .... .... .... .... .... 2,877 1927 320 357 129 101 70 38 68 1,459 150 59 95 57 50 279 11 22 .... .... .... .... .... .... .... .... .... .... .... .... 3,265 1928 344 367 141 103 72 39 61 1,483 157 60 103 51 45 306 11 20 71 2 .... .... .... .... .... .... .... .... .... .... 3,436 1929 426 443 185 103 97 55 124 1,797 205 66 99 81 47 410 14 28 116 37 20 .... .... .... .... .... .... .... .... .... 4,353 1930 446 442 121 160 84 52 119 1,787 180 73 112 59 49 390 12 40 143 55 125 78 6 .... .... .... .... .... .... .... 4,533 1931 476 508 158 163 128 62 89 1,866 257 109 112 87 77 415 13 43 177 68 169 144 4 70 .... .... .... .... .... .... 5,195 1932 446 626 165 171 126 77 94 2,245 307 116 158 84 123 480 13 51 237 94 266 263 9 74 13 77 .... .... .... .... 6,315 1933 447 674 202 247 148 119 122 2,396 395 153 192 108 101 624 10 84 300 120 359 300 20 90 67 193 .... .... .... .... 7,480 1934 430 717 255 240 183 100 129 2,553 386 165 237 120 135 653 11 105 329 132 474 348 15 136 81 299 20 26 10 48 8,337 Totals 9,364 8,867 2,868 2,862 1,680 907 1,402 31,437 3,390 1,361 2,105 1,183 1,005 5,604 131 424, 1,373 508 1,413 1,133 54 370 161 569 20 26 10 48 80,275 * " Viscount Cross in the vcar 1879 forbade the practice of cremation there (Woking) under the threat of passing an Act to make it illegal .... But in 1884 appeared the well-known judgment of Mr. Justice Stephen, which, in the case of a child's " body having been burned by its father contrary to the order of the coroner, determined cremation to be a legal act, provided no nuisance be caused thereby 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. t Closed for reconstruction from August, 1913, to July, 1914. 31 shops acts, 1934. The above-mentioned Act is based on certain recommendations of a Select Committee on Shop Assistants, which reported in 1931, and before which I had the honour of submitting evidence. So far as the Public Health Committee of the City Corporation is concerned, the responsibilities under the Act are confined to the arrangements for the health and comfort of shop workers, and Section 10 of the Act requires in every part of a shop in which persons are employed the provision and maintenance of— (a) suitable and sufficient ventilation ; (b) suitable and reasonable temperature ; (c) suitable and sufficient sanitary accommodation ; (d) suitable and sufficient lighting ; (e) suitable and sufficient washing facilities. In view of the fact that it was not possible to estimate what additional staff, if any, would be necessary to enable the provisions of this Act to be enforced, three inspectors engaged on factory and workshop inspection were relieved temporarily of such work as might be eased during the initial period of operation of the Act, and detailed for work under its provisions. At some later date, it may be necessary for recommendations to be made in regard to additional assistance in this matter. MEAT INSPECTION. According to the Board of Trade Returns the imports of fresh meat and bacon for the twelve months, 1934, were:— BEEF. Cwts. MUTTON. Cwts. PORK. Cwts. BACON. Cwts. 1934. 1933. 1934. 1933. 1934. 1933. 1934. 1933. Argentina 7,072,927 7,645,174 921,632 1,146,601 277,044 166,356 — — Australia 1,516,360 1,164,035 1,627,885 1,306,666 82,424 — — — Brazil 533,253 517,022 — — — — — — Canada — — — — — — 894,643 506,113 Chile — — 206,325 — — — 389,549 — Denmark — — — — — — 4,287,830 5,524,497 Irish Free State 4,667 — 12,882 — 143,783 194,695 367,803 204,303 Lithuania — — — — — — 251,572 415,526 Netherlands — — — — — — 607,728 871,950 New Zealand 1,003,955 706,750 3,554,511 3,734,462 414,352 278,082 — — Poland — — — — — — 463,397 783,758 Sweden — — — — — — 296,641 402,634 United States — 50,130 — — 290,070 83,322 39,759 62,931 Uruguay 612,292 673,471 138,386 171,958 — — — — Other Countries 354,629 361,916 30,778 338,756 40,829 95,369 — 313,221 Totals 11,098,083 11,118,498 6,492,399 6,698,443 1,248,503 817,824 7,598,922 9,084,933 Live Stock for the twelve months, 1934:— Cattle. Sheep. Pigs. Canada 51,373 — — Irish Free State 3,559,464 436,598 384,774 Average prices were given as follows:— Cattle. Sheep. Pigs. Canada £16 8 5 — — Irish Free State (including stores) £7 15 4 £1 4 0 £2 17 5 e2 32 LONDON CENTRAL MARKETS. Analysis and Comparison of Supplies in Tons. Twelve Months. Difference. Description and Country of Origin. 1934. 1933. Beef and Veal: England and Wales 20,717 19,999 + 718 Scotland 14,932 14,521 + 411 Ireland 1,652 2,557 905 Australia 20,370 11,607 + 8,763 New Zealand 10,834 3,525 + 7,309 Canada 4,147 2,945 + 1,202 Un. of South Africa 216 3,325 — 904 Southern Rhodesia 2,205 U.S. of America 2,258 1,901 + 357 Argentina 151,891 154,577 — 2,686 Uruguay 6,814 6,508 + 306 Brazil, etc. 6,885 7,593 — 708 Netherlands — — — Denmark — — — Other Countries — — — Totals: Beef and Veal 242,921 229,058 + 13,863 Mutton and Lamb: England and Wales 11,379 13,447 — 2,068 Scotland 19,400 18,366 + 1,034 Ireland 708 2,331 — 1,623 Australia 22,883 19,281 + 3,602 New Zealand 66,868 72,234 — 5,366 Canada 13 19 — 6 Un. of South Africa — 6 — 6 U.S. of America 35 36 — 1 Argentina 16,297 19,357 — 3,060 Uruguay 908 672 + 236 Brazil, etc. 460 369 + 91 Netherlands — — — Denmark — — — Other Countries 250 320 — 70 Totals: Mutton and Lamb 139,201 146,438 — 7,237 Pork and Bacon : England and Wales 23,098 24,370 — 1,272 Scotland 25 40 — 15 Ireland 6,763 6,471 + 292 Australia 2,962 2,596 + 366 New Zealand 6,135 4,200 + 1,935 Canada 495 283 + 212 Un. of South Africa — — — U.S. of America 1,544 536 + 1,008 Argentina 1,925 762 + 1,163 Uruguay 7 — + 7 Brazil, etc. 167 90 + 77 Netherlands *845 *844 + 1 Denmark *Bacon *524 *872 — 348 Other Countries *2,388 *3,059 — 671 Totals: Pork and Bacon 46,878 44,123 + 2,755 Poultrv and Game: England and Wales .... 11,421 9,703 + 1,718 Scotland .... S04 650 + 154 Ireland .... 2,403 1,717 + 686 Australia .... 103 87 + 16 New Zealand .... 5 12 — 7 Canada .... 256 153 + 103 Un. of South Africa .... 3 7 — 4 U.S. of America .... 126 180 — 54 Argentina .... 384 377 + 7 Uruguay .... 19 — + 19 Brazil, etc. .... 28 — + 28 Netherlands .... 607 1,339 — 732 Denmark .... 47 25 + 22 Other Countries .... 6,392 9,431 3,039 Totals: Poultry and Game Tons 22,598 23,681 — 1,083 Totals: Carried forward Tons 451,598 443,300 + 8,298 33 Twelve Months. Description and Country of Origin. 1934. 1933. Difference. Totals: Brought forward Tons 451,598 443,300 + 8,298 Rabbits: England and Wales .... 1,515 1,025 + 490 Scotland .... 9 32 — 23 Ireland .... — 1 — 1 Australia .... 5,030 6,363 — 1,333 New Zealand .... 715 330 + 385 Canada .... — — — Un. of South Africa .... — — — U.S. of America .... — — — Argentina .... 2 — + 2 Uruguay .... — — — Brazil, etc. .... — — — Netherlands .... 91 108 — 17 Denmark .... 1 2 — 1 Other Countries .... 374 382 — 8 Totals: Rabbits Tons 7,737 8,243 — 506 Eees: England and Wales .... 1,947 1,568 + 379 Scotland .... 3 — + 3 Ireland .... 126 177 — 51 Australia .... 127 115 + 12 New Zealand .... 3 3 — Canada .... 4 8 — 4 Un. of South Africa .... 39 189 — 150 U.S. of America .... 1 2 — 1 Argentina .... 8 11 — 3 Uruguay .... — 1 - 1 Brazil, etc. .... — — — Netherlands .... 62 95 - 33 Denmark .... 60 50 + 10 Other Countries .... 502 311 + 191 Totals: Eggs Tons 2,882 2,530 + 352 Butter and Cheese: England and Wales .... 176 264 — 88 Scotland .... — — — Ireland .... 3 8 — 5 Australia .... 150 164 — 14 New Zealand .... 323 270 + 53 Canada .... 16 2 + 14 Un. of South Africa .... — — — U.S. of America .... — 6 — 6 Argentina .... 61 70 — 9 Uruguay .... — 1 — 1 Brazil, etc. .... — — - Netherlands .... 29 117 — 88 Denmark .... 1 — + 1 Other Countries .... 455 93 + 362 Totals: Butter and Cheese Tons 1,214 995 + 219 Sundries: England and Wales .... 503 530 — 27 Scotland .... — — — Ireland .... 3 3 — Australia .... 1 6 — 5 New Zealand .... 5 12 — 7 Canada .... 1 7 — 6 Un. of South Africa .... 5 3 + 2 U.S. of America .... 39 41 — 2 Argentina .... 1 1 — Uruguay .... — - — Brazil, etc. .... — - — Netherlands .... 45 63 — 18 Denmark .... 85 94 — 9 Other Countries .... 629 585 + 44 Totals: Sundries Tons 1,317 1,345 — 28 Grand Totals Tons 464,748 456,413 + 8,335 34 Beef and Veal.—The figures show an increase of home supplies in England, Scotland and Wales, but a decrease in consignments from Ireland. Mutton and Lamb.—There was a decrease in this class of food, received at the Central Markets, from England and Wales, but an increase from Scotland. Pork and Bacon.—There was a decrease in supplies from England, Scotland and Wales. Poultry, Game, Rabbits, Eggs, Butter, Cheese and Sundries.-—On the whole, there was a slight decrease in these supplies compared with those of 1933. Supplies of meat, poultry, etc., for the year 1934 aggregated 464,748 tons. Empire produce consisted of 56 -3 per cent., and Foreign 43.7 per cent. GREAT BRITAIN.—1934. Beef. Mutton. Pork. Veal. Goat. Tongues. Lungs. Mesenteries. Plucks. Heads. Carcases. Quarters. Carcases. Quarters. Carcases. Quarters. Carcases. Quarters. Carcases. Abscess — — 25 2 32 2 2 — — — — — 2 l Arthritis — — 21 — 19 — 2 — — — — — 1 — Black Quarter — — — — — — 1 — — — — — — — Distomatosis — — 73 — — — — — — — — — — — Dropsy 4 — 103 — 4 — 3 — — — — — — — Emaciation 1 — 488 2 46 — 90 — 1 1 — 1 8 6 Hæmorrhagic Musculature — — 2 — 137 4 1 — — — — — 1 — Injury 1 — — — 3 — — — — — — — — — Jaundice — — 5 — 13 — 12 — — — — — 4 1 Joint Ill — — — — — — 2 — — — — — — — Killed in Extremis — — 20 6 10 — 13 — — — — — 1 1 Lymphadenoma — — — — — — 1 — — — — — — — Melanosis — — 1 — — — 2 — — — — — 1 — Myositis — — — — — — 1 — — — — — 1 1 Nephritis — — 3 — 2 4 6 — — — — 1 1 1 Osteomalacia — — — — — — 3 — — — — — — — Parasitic Disease — — 3 — — — — — — — — — 2 — Pleurisy and Peritonitis — — 186 — 249 8 8 2 — — — 1 5 — Pyaemia — — 3 — 1 — — — — — — — — — Rachitis — — — — 13 — — — — — — — — — Tuberculosis (Bovine) 13 14 — — — — 9 — — 51 41 2 28 32 Tuberculosis (Porcine) — — — — 421 58 — — — 1 322 98 458 4,057 Totals for 1934 19 14 933 10 950 76 156 2 1 53 363 103 513 4,100 Totals for 1933 22 18 1,000 2 1,082 34 123 5 3 31 58 152 829 3,767 Ireland [Southern).—The consignments of food, in tons, received from this country, compared with those of 1933 were as follows:— Beef and Veal. Mutton and Lamb. Pork and Bacon. Poultry and Game. Rabbits. Butter and Cheese. Eggs. Sundries. 1934 1,652 708 6,763 2,403 — 3 126 3 1933 2,557 2,331 6,471 1,717 l 8 177 3 The amount of unsound food surrendered is shown in Tables on page 39. Beef. Mutton. Pork. Sides. Quarters. Carcases. Quarters. Carcases. Sides Abscess — — — — l l Arthritis — — — — 2 — Decomposition — — — — 1 — Hæmorrhagic — — — — 5 — Killed in Extremis — — — — 1 — Malignant Growth — — — — 1 — Pleurisy and Peritonitis — — — — 19 — Tuberculosis — — — — 11 10 Totals for 1934 — — — — 41 11 Totals for 1933 2 3 8 2 32 35 35 Argentina.—The following table shows the amount of food in tons received from this country, compared with the amount for 1933:— Beef and Veal. Mutton and Lamb. Pork and Bacon. Poultry and Game. Rabbits. Eggs. Butter. Sundries. 1934 151,891 16,297 1,925 384 2 8 61 l 1933 154,577 19,357 762 377 — 11 70 l The amounts of diseased meat surrendered from this year's consignments are shown in the following table, and the amount of unsound food surrendered in tables on page 39. Beef. Quarters. Mutton. Carcases. Mutton. Quarters. Mutton. Pieces. Pork. Carcases. 1933. 1934. 1933. 1934. 1933. 1934. 1933. 1934. 1933. 1934. Abscess 38 40 34 32 5 — 1 — 3 23 Caseous Lymphadenitis — — 161 74 12 — 11 — — — Cysticercus Bovis 6 3 — — — — — — — — Emaciation — — — 1 — — — — — — Fibrous Growth — 1 — — — — — — — — Leukaemia 1 — — — — — — — — — Melanotic Tumour 1 — — — — — — — — — Osteomalacia 1 — — — — — — — — — Parasitic Disease — 7 — 25 — — — — — — Tuberculosis (Hinds) 45 72 — — — — — — — — „ (Fores) 9 8 — — — — — — — — (Pork) — — — — — — — — 1 1 Totals 101 131 195 132 17 — 12 — 4 24 Australia.—During the year this country sent the following amounts of food, in tons, to the markets, compared with those for 1933:— Beef and Veal. Mutton and Lamb. Pork. Poultry and Game. Rabbits. Eggs. Butter. Sundries. 1934 20,370 22,883 2,962 103 5,030 127 150 l 1933 11,607 19,281 2,596 87 6,363 115 164 6 The following table shows the amounts of meat surrendered as diseased and the quantities of unsound food are shown in tables on page 39. Beef. Quarters. Mutton. Carcases. Mutton. Quarters. Mutton. Pieces. Pork. Carcases. 1933. 1934. 1933. 1934. 1933. 1934. 1933. 1934. 1933. 1934. Abscess 4 9 19 39 — — 1 — 3 2 Caseous Lymphadenitis — — 122 91 41 — 9 — — 1 Parasitic Disease — — — 28 — — — — — — Tuberculosis 3 12 — — — — — — — — Totals 7 21 141 158 41 — 10 — 3 3 New Zealand.—The total amounts of food, in tons, deposited in the markets during the year 1934 from this country, compared with those for 1933, are shown in the following table:— Beef and Veal. Mutton and Lamb. Pork. Poultry and Game. Rabbits. Eggs. Butter and Cheese. Sundries. 1934 10,834 66,868 6,135 5 715 3 323 5 1933 3,525 72,234 4,200 12 330 3 270 12 The amount of unsound food discovered in those consignments is given in tables on page 39, and the amount of diseased meat in the following table:— Beef. Quarters. Mutton. Carcases. Mutton. Quarters. Mutton. Pieces. Pork. Carcases. 1933. 1934. 1933. 1934. 1933. 1934. 1933. 1934. 1933. 1934. Abscess 3 2 34 14 8 — 2 — 55 24 Caseous Lymphadenitis — — 103 73 41 — 13 — — — Cystic — — — 1 — — — — — — Hsemorrhagic — — — — — — — — — 1 Injury and Pleurisy — — — — — — — — — 1 Nephritis — — — — — — — — 1 — Parasitic Disease — 1 — 18 — — — — — — Pleurisy — — . 1 — — — — — 2 — Septic Injury — — — 1 — — — — — — Tuberculosis 1 1 — — — — — — — 10 Totals 4 4 138 107 49 — 15 — 58 36 Uruguay.—The amount of food, in tons, sent to the markets from this country in 1934 Was :- Beef and Veal. Mutton and Lamb. Pork. Poultry and Game. 6,814 908 7 19 The quantity of diseased meat surrendered is given herewith, and the amount of unsound food is shown in tables on page 39. Beef. Quarters. Mutton. Carcases. Mutton. Pieces. 1933. 1934. 1933. 1934. 1933. 1934. Abscess 5 3 — l — — Caseous Lymphadenitis — — 7 2 1 — Cysticercus Bovis 1 — — — — — Parasitic Disease — — — 1 — — Totals 6 3 7 4 1 — 36 Chile.—This country sends mutton and lamb only. The following table shows the amount of diseased meat surrendered, viz.:— Mutton. Carcases. Mutton. Quarters. Mutton. Pieces. 1933. 1934. 1933. 1934. 1933. 1934. Abscess 7 1 — — — — Caseous Lymphadenitis 29 1 4 — 2 — — — — — — — Totals 36 2 4 — 2 — Brazil.—The total amounts of food, in tons, deposited in the markets during 1934 was as follows:— Beef and Veal. Mutton and Lamb. Pork and Bacon. Pork and Game. 6,885 460 167 28 Beef. Quarters. Mutton. Carcases. Mutton. Pieces. Pork. Carcases. 1933. 1934. 1933. 1934. 1933. 1934. 1933. 1934. Abscess 3 8 — 3 — — 21 10 Parasitic Disease — 1 — — — — — 1 Tuberculosis 8 5 — — — — — — — — — — — — — — Totals 11 14 — 3 — — 21 11 South Africa, including Southern Rhodesia.—The consignments sent during 1934 were made up as follows:— Beef and Veal. Poultry and Game. Eggs. Sundries. 2,421 3 39 5 South Africa. Southern Rhodesia. Beef. Quarters. Beef. Quarters. 1933. 1934. 1933. 1934. Abscess 6 1 Abscess 14 10 Hæmorrhagic 1 — Tuberculosis 16 6 Tuberculosis 3 2 Totals 10 3 Totals 30 16 Other Countries.—The tables for the following countries show the amount of meat surrendered due to disease:— United States of America. Pork. Carcases. Sides. Bacon. 1933. 1934. 1933. 1934. Abscess l 5 Emaciated — 1 Pleurisy — 2 — — Totals l 8 Lithuania. 1934. Bacon. Pieces. Sides. Abscess — 4 Canada. Abscess 1 — 2 Denmark. Abscess — 4 Holland. Abscess — 3 Poland. Abscess — 4 Norway. Abscess — 1 Hungary. Abscess — 3 Austria. Abscess — 1 Iceland. Caseous Lymphadenitis 1 — — 37 CASEOUS LYMPHADENITIS. The following table shows the amount of mutton taken on account of Caseous Lymphadenitis during the past three years:— Countries. Carcases. Sides. Quarters. Pieces. 1932. 1933. 1934. 1932. 1933. 1934. 1932. 1933. 1934. 1932. 1933. 1934. Argentina 483 238 77 4 3 — 36 — — 47 3 66 Australia 187 132 123 — — — 101 30 — 111 86 396 Chile 105 36 10 169 85 — 79 7 — 284 93 46 New Zealand 246 154 113 — 19 — 18 12 — 393 27 139 Uruguay 3 22 2 — — — — — — — 32 — Totals 1,024 582 325 173 107 — 234 49 — 835 241 647 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) 41 Milk (Tins) 53 Beef (Feet) 64 Mutton (Carcases) 5 „ (Heads) 20 „ (Pieces) 12 ,, (Livers) 255 „ (Pluck) 1 ,, (Pieces) 32 Offal (lbs.) 550 (Tails) 18 Partridges 5,168 „ (Tongues) 1 Pheasants 2,881 Butter (cwts.) 4 Pigeons 1,641 Capercailzies 1 Plover 300 Chickens and Poussins 2,429 Pork (Head) 1 Cheese (Cases) 144 „ (Pieces) 6 Cream (Tins) 1,941 Ptarmigan 83 Curlew 9 Quail 2,805 Ducks 870 Rabbits 18,863 Eggs (Hens) 624 Salmon (Tins) 40 Fish (Tins) 65 Sausages (lbs.) 2 Fowls 6,381 Snipe 243 Fruit (Tins) 901 Soup (Tins) 122 Game (Black) 143 Teal 85 „ (Unclassified) 311 Turkeys 1,821 Geese 280 Veal (Carcases) 7 Goat (Carcases) 2 ,, (Feet) 297 Grouse 1,566 „ (Pieces) 1 Guinea Fowls 856 „ (Plucks) 19 Hares 2,896 Venison (Pieces) 19 Hazelhens 148 Widgeon 8 Meat (Tins) 19 Woodcock 47 Tons. Cwts. Qrs. Lbs. Total for 1934 52 1 3 10 „ 1933 42 15 2 0 Increase 9 6 1 10 UNSOUND MEAT, ETC., REMOVED FROM COLD STORES. Article. No. How Packed. Origin. Cause for Destruction. Tons. Cwts. Qrs. Lbs. Bacon (Sides) 4 .... New Zealand Decomposed 0 2 0 0 ,, ,, 10 .... United Kingdom. „ 0 3 1 26 Beef (Pieces) .... .... Australia „ & Brine Stained. 0 3 2 25 „ (Tongues) 2 .... ,, Decomposed 0 0 0 18 ,, ,, 22 .... Argentina ,, 0 1 0 3 „ (Fores) 42 .... ,, Fire Damage 3 6 3 22 „ (Pieces) .... .... ,, Decomposed & Brine Stained. 0 2 3 11 „ (Kidneys) .... .... Various Decomposed 0 0 1 26 „ (Livers) .... .... ,, ,, 0 0 0 10 „ (Tails) .... .... ,, „ 0 3 3 17 Fish (Various) .... .... ,, ,, 3 19 3 8 Carried forward 8 4 1 26 F 38 Unsound Meat, Etc., Removed from Cold Stores.—continued. Article. No. How Packed. Origin. Cause for Destruction. Tons. Cwts. Qrs. Lbs. Brought forward 8 4 l 26 Geese 1 Case Argentina Mould Fungi 0 0 3 23 Glands 2 ,, ,, Decomposed 0 0 2 0 Hares 97 .... United Kingdom. „ 0 4 0 11 Kidneys .... Argentina & ,, Vermin Damage. 0 4 3 21 ,, .... Australia Decomposed 0 0 1 2 „ .... New Zealand ,, 0 8 3 23 Livers .... Argentina ,, 4 4 4 11 ,, .... Australia ,, 0 0 0 18 ,, .... New Zealand ,, 5 3 1 15 Lard 4 Boxes United Kingdom. ,, 0 0 3 23 Mellons 225 Casks .... ,, 0 0 0 0 Mutton (Carcases) 3 .... Argentina *C.L.A 0 1 0 27 ,, 1 .... ,, Mould Fungi 6 0 1 12 ,, 2 .... ,, Decomposed 0 1 0 10 „ (Sides) 1 .... ,, *C.L.A 0 0 0 27 (Quarters) 2 .... ,, ,, 0 0 0 22 „ (Shoulders) 2 .... ,, ,, 0 0 0 8 (Legs) 168 .... ,, ,, 0 13 2 22 „ (Pieces) .... ,, ,, 0 0 2 21 ,, .... ,, Brine Stained & Perished. 0 3 2 15 „ (Hearts) 4 Bags ,, Mould Fungi 0 1 0 8 „ (Carcases) 32 .... Australia *C.L.A 0 11 3 24 ,, ,, 2 .... ,, Brine Stained 0 1 0 10 ,, ,, 2 .... ,, Decomposed 0 0 2 13 ,, ,, 22 .... ,, Store Damage 0 13 2 14 „ (Sides) 3 .... ,, *C.L.A 0 0 2 16 „ (Quarters) 157 .... ,, ,, 0 18 3 5 ,, ,, 30 .... ,, Decomposed 0 4 2 20 „ (Shoulders) 136 .... ,, *C.L.A 0 6 2 23 (Legs) 53 .... ,, ,, 0 3 3 0 ,, ,, 10 .... ,, Brine Stained 0 0 1 11 „ (Pieces) .... ,, *C.L.A 0 19 2 4 ,, ,, .... ,, Mould Fungi & Decomposed. 1 9 2 25 ,, ,, .... ,, Brine Stained 0 14 0 19 „ (Carcases) 8 .... Chile *C.L.A 0 5 0 0 ,, ,, 1 .... ,, Decomposed 0 0 2 5 „ (Shoulders) 6 .... ,, *C.L.A 0 0 0 23 (Legs) 68 .... ,, ,, 0 2 0 0 „ (Pieces) .... ,, Brine Stained 0 0 1 4 „ (Sides) 47 .... ,, *C.L. 0 12 0 17 „ (Hearts) 3 Bags ,, Decomposed 0 0 3 23 „ (Carcases) 5 .... New Zealand Brine Stained 0 2 2 13 Mutton (Carcases) 1 .... ,, Bruised 0 0 1 20 ,, ,, 40 .... ,, *C.L.A 1 0 0 26 ,, ,, 8 .... ,, Mould Fungi 0 2 3 26 ,, ,, 120 .... ,, SmokeDamage 0 0 0 0 ,, ,, 1 .... ,, Transit Damage. 0 0 1 27 ,, (Sides) 1 .... ,, *C.L.A 0 0 1 1 „ (Quarters) 2 .... ,, ,, 0 0 0 25 „ (Shoulders) 1 .... ,, ,, 0 0 0 3 (Legs) 129 .... ,, ,, 0 9 2 5 „ (Pieces) .... ,, ,, 2 17 0 0 (Quarters) 2 .... ,, Mould Fungi 0 0 0 12 „ (Pieces) .... .... ,, Brine Stained 0 2 2 13 ,, ,, .... .... ,, Mould Fungi 0 18 1 21 ,, ,, .... .... ,, Perished 0 4 3 11 Carried forward 33 2 2 20 * 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 33 2 2 20 Mutton (Pieces) .... .... Various Decomposed 0 14 3 22 Offal 3 Bags United Kingdom. 0 0 2 20 ,, 1 Box Argentina Mould Fungi 0 0 2 4 Pork (Legs) 2 .... ,, Abscess 0 0 0 17 „ (Pieces) .... .... ,, Decomposed 0 2 0 24 ,, ,, .... .... Australia ,, 0 0 0 4 ,, ,, 8 Boxes. Canada ,, 0 1 0 20 ,, (Carcases) 1 .... U.S.A Tuberculosis 0 0 2 19 Poultry (Mixed) .... .... United Kingdom. Decomposed 0 10 2 6 Rabbits 2 Cases New Zealand ,, 0 1 0 12 Sweetbreads 1 Case Argentina ,, 0 0 0 24 ,, 3 Boxes Australia ,, 0 0 1 1 ,, .... .... Various ,, 0 1 1 20 Tails .... .... Australia ,, 0 0 2 8 Tongues .... .... ,, Brine Stained 0 0 1 2 ,, .... .... New Zealand Decomposed 0 0 1 19 Tripe .... .... Australia ,, 0 0 3 3 Puffins 6 Casks Tasmania ,, 0 0 0 0 Total for 1934 34 18 2 21 SHOWING THE AMOUNT OF VARIOUS FOOD PRODUCTS SURRENDERED TO OR SEIZED BY MEAT INSPECTORS IN THE CITY OF LONDON FOR UNSOUND CONDITIONS, 1934. Countries. Beef in lbs. Lamb 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. Argentina 366,513 38,208 2,400 1,200 — — — 31,780 — — 9,540 107 — — Australia 22,097 26,572 3,205 — — — — 2,727 6,254 7,827 3,820 — — — Austria — — — — — — — — — 2,482 — — — — Belgium — — — — — — 512 — 10,727 587 — — — — Brazil 3,200 — 363 — 150 — — — — — 2,540 — — — Britain 19,533 27,416 70,407 11,140 607 138 1,427 51,232 36,772 51,982 3,005 2,296 4,610 1,654 Canada 3,901 — — — — — — — — — — — 4,785 — Chile — 5,225 — — — — — — — — — — — — Denmark — — — — — — 6,205 — — 170 7,234 1,020 — 519 France — — — — — — — — 5,117 3,072 — — — — Germany — — — — — — — — — 1,474 623 — — — Holland — — — — — — 6,576 — 28,584 30,005 3,781 972 — — Hungary — — — — — — — — 762 2,407 — 1,784 — — Ireland 1,497 14,768 13,271 278 95 — — 116,224 1,280 5,272 — — — — Italy — — — — — — — — 6,971 6,587 — — — 154 New Zealand 24,025 206,237 6,525 506 — — 274 5,071 6,809 3,074 242 — — 600 Poland — — — — — — 1,254 — — 528 1,452 — — — Uruguay 5,454 5,020 1,420 127 — — — 1,742 — — — — — U.S.A. 684 — — — — — — 30,274 — — 2,259 682 — — Russia — — — — — — — — 680 8,540 — — — — South Africa 8,079 — — — — — — — — — — — 250 — S. Rhodesia 7,543 — — — — — — — — — — — — — Siberia — — — — — — — — 600 — — — — — Syria — — — — — — — — — 5,027 — — — — Totals for 1934 462,526 323,446 97,591 13,251 852 138 16,248 239,050 104,556 129,034 34,496 6,861 9,645 2,927 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 1,532 633 SHOWING THE AMOUNT OF VARIOUS FOOD PRODUCTS SURRENDERED TO OR SEIZED BY MEAT INSPECTORS IN THE CITY OF LONDON FOR DISEASED CONDITIONS, 1934. 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 33,005 32,852 5,298 571 — — 4,271 — — Australia 4,251 24,075 4,002 — — — 2,870 — 1,782 Brazil 1,894 2,382 157 371 — — — — — Britain 24,681 17,362 102,343 4,183 232 1,586 68,207 8,203 9,995 Chile — 2,054 — — — — — — — Denmark — — 578 — — 897 — — — Holland — — — — — 342 — — — Hungary — — — — — — — 742 — Ireland 420 682 6,243 427 — 889 52,310 378 1,127 New Zealand 4,872 22,093 4,077 742 — 276 827 — 884 Poland — — 172 — — 542 — 1,420 — South Africa 3,955 — — — — 112 — — — Southern Rhodesia 3,740 — — — — — — — — Uruguay 872 2,042 62 127 — — — — — U.S.A — — 387 — — 156 549 — 754 Totals for 1934 77,690 103,542 123,319 6,421 232 4,800 129,034 10,743 14,542 Totals for 1933 71,676 100,700 117,283 6,389 376 2,783 136,844 8,029 9,637 F 2 40 SUMMARY CF UNSOUND FOOD DESTROYED. Tons. Cwts. Qrs. Lbs. Central Markets (Smithfield) 766 2 3 7 Cold Stores 34 18 2 21 Leadenhall Market and City Shops 52 1 3 10 Total for the year 1934 853 3 1 10 Total for the year 1933 878 5 2 7 Decrease 25 2 0 25 EXPORT OF MEAT, ETC. Fifty-four certificates were issued during the year. DEMONSTRATIONS AND INSTRUCTION IN MEAT INSPECTION. One hundred and eighty-seven persons from various training centres received instruction. Sixteen 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. 6 28/2/34 Dealer Guildhall Aid. Sir P. Neal. Under the City of London (Various Powers) Act, 1911, Sec. 39, being person who deposited for sale on Smithfield Market one calf carcase which was diseased. Fined £5 Costs, £2 2s. 0d. 6 28 /2 /34 Small Holder. ,, ,, Being the owner of one calf carcase which was diseased. Fined £5 Costs, £2 2s. 0d. GENERAL REMARKS. THE PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1925-33. From a meat inspector's point of view, these regulations are not easily read. This has lead to certain difficulties. Considerable quantities of meat are seen, in increasing volume, inspection of which is completely valueless. This is chiefly boneless beef and a variety of small joints and pieces of meat. An example of each category will suffice to indicate what is meant and, at the same time, illustrate the impracticability of examination. (a) Boneless Beef. In the removal of bones important lymphatic glands and portions of serous membranes are frequently removed. A typical specimen of boned-out beef, known as a " mid-cut," is imported in large quantities, and consists, as a rule, of loin, rump and thin flank. Apart from the absence of certain glands and portions of serous membranes, this particular cut presents a further difficulty in that, before one can attempt to examine it, it is necessary to defrost, in order to expose the various parts which have been folded over before freezing. (b) Small Joints. Portions of loins of mutton have been imported, inspection of which is of little value, particularly as in many cases the regional lymphatic glands are absent. (c) Pieces. Small pieces of muscle from various parts of the carcase are seen from time to time, but their inspection can be of no assistance in indicating their origin as being from a healthy carcase. An example of this is a cut described as a " flank steak," which consists merely of a circular portion of abdominal muscle. Obviously no inspector can pass an opinion of any value upon such a cut. Chilled Beef. A satisfactory aspect in connection with imported meat is the development of the trade in chilled beef from the Colonies. Whereas, until within the last few years, the chilled beef trade was almost a South American monopoly, many successful shipments have arrived during the course of the year from the Colonies. As a result of scientific investigation and research into the prolonged storage of chilled beef, a great expansion in this trade may be anticipated. 41 Table showing Weight of Meat delivered, and Meat delivered to Contractors as unsound, during each Month of the Years 1933 and 1934. Month. Meat delivered at the Market, 1933. Unsound Meat delivered to Contractors, 1933. Meat delivered at the Market, 1934. Unsound Meat delivered to Contractors, 1934. Tons. cwts. qrs. Tons. cwts. qrs. Tons. cwts. qrs. Tons. cwts. qrs. January 41,911 0 0 51 9 3 43,434 0 0 77 6 3 February 35,287 0 0 50 11 3 35,871 0 0 65 17 3 March 40,054 0 0 75 9 3 39,948 0 0 52 2 2 April 36,463 0 0 52 9 3 37,467 0 0 49 9 0 May 39,328 0 0 75 0 3 39,714 0 0 65 9 2 June 35,037 0 0 70 2 0 34,624 0 0 54 8 0 July 35,065 0 0 94 16 0 35,349 0 0 82 13 1 August 35,013 0 0 141 19 1 35,611 0 0 75 3 1 September 36,603 0 0 98 18 0 35,946 0 0 97 0 2 October 41,061 0 0 107 19 2 43,697 0 0 145 10 3 November 40,645 0 0 76 18 3 41,866 0 0 71 0 2 December 39,945 0 0 58 8 3 41,218 0 0 98 10 2 Totals 456,412 0 0 954 4 0 464,745 0 0 934 12 1 One ton in every 486 tons of meat paying toll in the Central Markets, Smithfield, was condemned last year, as compared with one ton in 478 in 1933. *Table showing the average deliveries at the Central Meat Market, and other details for successive quinquennial periods during the past 60 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 .253 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 1929-1934 464,847 0 0 946 6 0 .203 * 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 and New Zealand Per cent. South Africa. Per cent Country Killed. Per cent. Town Killed. Per cent † Foreign Killed. Per cent Home Killed. Per cent. American Killed.‡ Per cent. 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 1934 22.3 3.0 2.9 0.4 41.5 29.4 0.5 The following figures supplied by the Superintendent of the Market are of interest:— 1930. 1931. 1932. 1933. 1934. Tons. Tons. Tons. Tons. Tons. Average daily delivery into the Markets 1,502 1,554 1,511 1,491 1,514 **Minimum delivery on any one day 208 523 368 627 544 Maximum delivery on any one day 3,694 4,524 3,877 4,061 3,704 The heaviest weight previously recorded on any one day (20th December, 1926) was— 5,259 tons. •I am indebted to the Clerk and Superintendent of the Central Markets for the figures relating to the market supplies, sources of origin, &c. ** The minimum deliveries relate to Saturdays when practically no wholesale business at the Market is carried out. + Includes " General Foreign Meat and Produce." t Includes South American Imports. 42 FISH SUPPLIES. 199,961 tons of fish, of which 186,775 were land-borne and 13,186 water-borne, were received at or near Billingsgate Market during the year. This was an increase of 4,887 tons in the land deliveries and a decrease of 1,813 tons in deliveries bv 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 1934. 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 10,171 15 3 770 15 1 16,942 11 0 41 12 3 1 ton in 400.906 tons, or 0.245% February 16,035 15 0 686 5 2 10,722 0 2 48 0 0 ,, 348.375 „ „ 0.287% March 17,099 19 3 1,155 2 1 18,855 2 0 80 9 3 ,, 234.261 „ ,, 0.426% April 13,888 2 1 1,117 19 0 15,000 1 1 61 7 2 ,, 244.497 „ ,, 0.409% May 15,186 11 3 1,018 13 0 10,205 4 3 74 2 1 ,, 218.657 „ „ 0.457% June 15,775 12 0 1,117 10 1 16,893 2 1 131 15 1 ,, 128.208 „ ,, 0.779% July 18,548 13 0 1,166 17 0 16,715 10 0 124 7 0 ,, 134.422 „ „ 0.743% August 10.388 11 3 1,384 19 3 17,773 11 2 93 15 0 ,, 189.584 ,, ,, 0.527% September 15,281 17 2 1,299 17 2 10,581 15 0 128 9 2 ,, 129.065 ,, ,, 0.774% October 14,229 9 2 1,219 18 2 15,549 8 0 09 14 2 ,, 221.576 „ „ 0.451% November 16,013 4 1 1,233 13 2 17,246 17 3 95 9 0 ,, 180.690 „ „ 0.553% December 14,455 15 3 1,014 16 1 15,470 12 0 81 2 2 ,, 190.700 ,, ,, 0.524% Totals 180,775 8 1 13,186 7 3 199,961 16 0 1,030 5 0 ,, 194.137 ,, ,, 0.515% Weight of Fish Delivered, Fish Seized as Unsound, and percentage of Fish Condemned to that Delivered, at or near Billingsgate Market during 1934 and the five years 1929 —1933. 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. 1929 216,936 22,396 239,332 1,587 6 1 1 ton in 150.778 tons or 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% 1933 181,888 14,999 196,887 1,168 6 2 1 „ 155.726 „ 0.642% Average (5 years) 195,252 18,335 213,587 1,601 9 3 1 ton in 133.408 tons or 0.749% 1934 186,775 13,186 199,961 1,030 5 0 1 ton in 194.137 tons or 0.515% * Compiled from the Monthly Returns received from the Fishmongers' Company. PUBLIC HEALTH (MEAT) REGULATIONS, 1924. The improvement reported last year has been maintained, but there is still a number of persons to whom the Regulations are unknown or who evade them. Butchers who visit the markets about twice a week irregularly as to time are particularly difficult of supervision. The market carriers know the Regulations and the advantage of maintaining their vehicles fit within and without. The market porters also carry out the Regulations in spirit and letter ; the few contraventions noted have no intention behind them. Private Cars used for the conveyance of meat are increasing in number, and often no attempt is made to protect the meat from the gross contamination met with under these circumstances. In seven cases legal proceedings were instituted. Dissatisfaction has been expressed by those persons who are carrying out the Regulations, that the users of Private Cars are contravening practically all the requirements of Clause 21 of the Regulations. Details of cases heard are as follows:— 1932. 1933. 1934. No. of Cases 15 6 11 No. of Summonses issued 50 20 32 Total Fines £116 13 3 £17 10 0 £13 5 0 Total Costs £3 3 0 - - Six hundred and twenty-three cautionary letters were issued in 1934. The high standard of cleanliness with regard to butchers' shops reported last year has been maintained. The Depots used as distribution centres by certain multiple restaurants are the subject of constant supervision and owing to their limited space, the standard aimed at has not yet been reached. The premises used for the manufacture of sausages and meat products within the City show a general state of cleanliness. The general improvements noted during the past year are the result of cordial cooperation between persons and associations responsible for the carrying out of the Regulations and the Officers of my Department. 43 summary of summonses and offences.—public health (meat) regulations, 1924. Section of Regulations. OFFENCES. Market Carriers. Market Porters. Multiple Butchers. Small Butchers. Street Butchers. Private Cars. Hotel and Restaurant Proprietors. Part VI, Clause 21, Section (1) (a). Dirty Vehicle 1932 1933 1934 1932 1933 1931 1932 1933 1934 1932 1933 1934 1932 1933 1934 1932 1933 1934 1932 1933 1934 6 3 5 — — — 4 — — 11 3 2 — 1 — 1 — 3 — — — Part VI, Clause 21, Section (1) (b). Meat in contact with other commodities (furred rabbits, poultry, spare tyres). 1 — — — — — — — — — — 1 — — — — — — — — — Part VI, Clause 21, Section (2) (a). Meat in contact with ground — — — — — — — — — 1 — — — — — — — — — — — Part VI, Clause 21, Section (3). Head covering Offence 1 5 3 — — — 2 — — 1 2 1 — 1 — — — 3 — — — Part VI, Clause 21, Section (3). Overall Offence 1 — — — — — 1 — — 6 — 1 — — — — — 2 — — — Part VI, Clause 21, Section (2) (b). Meat in contact with floor mat of Private Car. — — — — — — — — — — — — — — — — — 2 — — — Part VI, Clause 21, Section (2) (b). Meat contaminated with visible dirt — — — — — — — — — 1 — — — — — — — — — — — Part VI, Clause 21, Section (2) (b.) Dirty and stinking cloths used for protection of the meat. 3 1 2 — — — 2 — — 7 1 1 — — — — — 5 — — — Part VI, Clause 21, Section (1) (b). Meat being conveyed uncovered — — — — — — — — — — — — — — — 1 — 1 — — — Totals 12 9 10 — — — 9 — — 27 6 6 — 2 — 2 — 16 — — — 44 LONDON COUNTY COUNCIL (GENERAL POWERS) ACT, 1932. PART II SUMMARY OF TYPES OF PREMISES REGISTERED DURING 1934. Sausage and Cooked Meat Manufacturers 3 Ham Boilers 4 Shellfish Boilers 4 Pickling of Meats 6 Preserving of Vegetables 1 Preparation of Sausage Casings 2 Manufacture of Ice Cream 1 Sale of Ice Cream 16 Note.—Some premises are registered for more than one of the above processes. This Act, in spite of its limitations, has improved the standard of cleanliness in many businesses. Before premises are registered, a schedule of alterations and improvements is submitted to the applicants When the improvements have been carried out, a standard capable of maintainance results. The number of premises registered in the City since the inception of the above Act is 84. In five cases the premises were considered unfit for the satisfactory conducting of the type of business for which application for registration was made. 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 Citv 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 200,381 Bacon Bags, Cases ,, 1 cwt. 2 qrs.—3 cwts 57,284 Cheese (Loose) Single ,, 1 lb.—8 lbs 107,773 Cheese Packages „ 24 lbs.—1 cwt 303,693 Eggs (Fresh) Cases ,, 84 lbs.—1 cwt. 2 qrs 71,060 Egg Yolk Casks ,, 56 lbs.—4 cwts. 245 Lard Packages .... Holland and South America. 28 lbs.—56 lbs 39,973 Margarine ,, 12 lbs.—56 lbs 9,072 Cereals— Barley Bags Holland 100 lbs.—1 cwt. 2 qrs 547 Beans ,, Holland and Madagascar. 1 cwt.—2 cwts 3,140 Peas ,, Holland 1 cwt.—1 cwt. 3 qrs 26,477 Rice ,, Holland and Italy 1 cwt.—1 cwt. 2 qrs 1,107 Tapioca ,, Holland 1 cwt.—1 cwt. 2 qrs 562 Lentils ,, ,, 1 cwt.—1 cwt. 3 qrs 43 Ground Rice ,, 1 cwt.—1 cwt. 2 qrs 24 Cocoa Bags, Packages Holland, Colombo and E. Africa. 28 lbs.—2 cwts. 11,161 Coffee Bags Holland, E. Africa, Ceylon and Costa Rica. 1 cwt. 2 qrs 49,614 Fruit (Soft)— Apples Packages Holland, Australia, New Zealand and Russia. 28 lbs.—1 cwt. 2 qrs 20,835 Bananas ,, Holland 1 cwt. 1 qr 1,500 Cherries ,, ,, 12 lbs.—40 lbs 497 Citrons ,, Spain 56 lbs. 16 Cranberries ,, Holland 28 lbs. 3,174 Juniper Berries ,, ,, 56 lbs. 84 Peaches ,, ,, 10 lbs.—14 lbs 52 Pears ,, Holland and Russia 6 lbs.—28 lbs 3,801 Plums ,, ,, 7 lbs.—28 lbs 521 Strawberries ,, ,, 6 lbs—14 lbs 6,604 Fruit (Dried)— Apricots ,, America and Australia 28 lbs.—56 lbs 44,344 Currants ,, Greece, Turkey and South Africa. 28 lbs.—56 lbs 252,985 Dates ,, Mesopotamia, Turkey and Egypt. 3 qrs. 10,551 Evaporated Apples Canada, America and 56 lbs. 8,364 Australia. 45 Article. Description of Packages. Where from General Range of Weight of Packages. Quantity. Fruit (Dried)—(continued). Figs Packages Turkey, Spain and Greece. 28 lbs.—4 cwts. 73,034 Fruit Salad ,, Canada, America and Australia. 28 lbs.—56 lbs. 2,550 Nectarines ,, Australia 56 lbs. 518 Peaches ,, Australia and America 24 lbs.—56 lbs. 2,624 Pears ,, Canada, America and Australia. 24 lbs.—56 lbs. 7,693 Plums ,, Australia, America and South Africa. 24 lbs.—1 cwt. 260,047 Preserved Fruit ,, Holland 10 lbs.—56 lbs. 153 Raisins ,, America, Turkey Greece, Spain and South Africa. 6 lbs.—56 lbs. 133,593 Sultanas ,, America, Turkey, Greece, South Africa and Persia. 24 lbs.—56 lbs. 277,800 Fruit (Green)— Grape Fruit ,, Florida and Jaffa 56 lbs.—I cwt. 1,616 Grapes ,, Holland, Spain and Russia. 12 lbs.—1 cwt. 110,709 Lemons ,, Italy and Spain 1 cwt. 257,194 Melons ,, Spain and Holland 12 lbs.—1 cwt. 1 qr. 84,351 Oranges ,, Holland, Spain, Brazil and Egypt. 3 qrs.—1 cwt. 1 qr. 47,175 Pineapples ,, St. Michaels 1 qr. 16 lbs.—2 qrs. 18 lbs. 22,424 Pomegranates ,, Spain 28 lbs.—1 cwt. 1 qr. 4,170 Vegetables— Asparagus ,, Holland 28 lbs. 50 Beans ,, ,, 40 lbs. 1,479 Beetroots ,, ,, 1 cwt. 80 Cabbages ,, ,, 1 cwt. 8,095 Carrots ,, ,, 40 lbs.—1 cwt. 1 qr. 41,224 Cauliflowers ,, ,, 24 lbs.—40 lbs. 5,733 Cucumbers ,, ,, 12 lbs.—40 lbs. 18,663 Lettuce ,, ,, 12 lbs.—28 lbs. 271,579 Onions ,, Holland and Spain 1 cwt. 1 qr. 102,412 Parsnips ,, Holland 1 cwt. 5,643 Peas ,, ,, 56 lbs.—1 cwt. 3,790 Potatoes ,, Holland, Spain and 56 lbs.—1 cwt. 1 qr. 120,260 ,, St. Malo. Radishes ,, Holland 28 lbs.—1 cwt. 17,986 Spinach ,, ,, 14 lbs.—56 lbs. 70 Sprouts ,, ,, 100 lbs. 3 Tomatoes ,, ,, 12 lbs.—56 lbs. 441,209 Sugar Bags, Cases ,, 1 cwt.—2 cwts. 42,290 Tea Chests India, Ceylon, China and Java. 1 cwt. 107,817 Tinned Goods— Anchovies Cases Holland and Portugal 2 cwts.—3 cwts. 1,012 Apples ,, Canada, Australia and 50 lbs.—1 cwt. 15,490 ,, America. Apricots ,, ,, 48 lbs. 24,704 Asparagus ,, Canada and America 56 lbs.—1 cwt. 2,393 Beans ,, 1 cwt. 850 Beef Brisket ,, South America 90 lbs. 425 Beef Powder ,, „ 1 cwt.—1 cwt. 2 qrs. 413 Black Currants ,, France 1 cwt. 150 Boiled Mutton ,, South America 56 lbs.—1 cwt. 250 Brawn ,, Holland 36 lbs. 3,863 Cherries ,, Canada and Italy 28 lbs.—48 lbs. 23,027 Condensed Milk ,, Holland 48 lbs. 1,104,512 Corned Beef ,, South America 72 lbs. 20,232 Crab ,, America 56 lbs. 436 Crayfish ,, ,, 56 lbs. 339 Figs ,, ,, 1 cwt. 535 Fish ,, Portugal 1 cwt. 735 Fruit Pulp ,, America and Spain 72 lbs.—100 lbs. 13,468 Fruit Salad ,, America, Australia and Canada. 56 lbs.—100 lbs. 14,379 g 46 Article. Description of Packages. Where from. General Range of Weight of Packages. Quantity. Tinned Goods—(continued). Grape Fruit Cases Florida and Texas 50 lbs. 18,202 Grape Fruit Juice ,, ,, ,, 50 lbs. 936 Hams ,, Holland and Denmark 20 lbs.—1 cwt. 1 qr. 11,000 Jam ,, Australia 56 lbs. 51 Kidneys ,, Holland 56 lbs. 7 Liver ,, ,, 56 lbs. 5 Loganberries ,, America 56 lbs.—1 cwt. 3,452 Lobster ,, ,, 50 lbs. 12,871 Olives ,, Spain 56 lbs.—1 cwt. 23 Orange Juice ,, ,, 56 lbs.—1 cwt. 400 Meat ,, Holland 36 lbs. 446 Oranges ,, Spain and Japan 56 lbs.—1 cwt. 16,011 Peache ,, Australia and America 48 lbs. 66,765 Peas ,, Holland and Italy 48 lbs. 14,658 Pears ,, Canada, Australia and America. 48 lbs. 63,257 Pines ,, Singapore and Hawaii 60 lbs. 42,519 Pilchards ,, America 60 lbs. 6,595 Plums ,, ,, 60 lbs. 1,250 Pork and Beans ,, America and Canada 60 lbs. 2,750 Prawns ,, America 56 lbs. 1,450 Raisins ,, ,, 56 lbs. 20 Rhubarb ,, Holland 1 cwt. 87 Salmon ,, Canada and America 56 lbs.—1 cwt. 27,447 Sardines ,, Portugal and Spain 56 lbs.—I cwt. 41,182 Sausages ,, Holland 56 lbs.—1 cwt. 468 Soup ,, Canada 56 lbs. . 2,400 Sterilized Cream ,, Holland 14 lbs.—56 lbs. 1,651 Strawberries ,, America 48 lbs. 111 Sugar Corn ,, Canada and America 56 lbs. 2,935 Tomatoes ,, Italy 56 lbs. 52,468 Tongues ,, Holland and South 48 lbs.—1 cwt. 8,353 America. Veal ,, Holland 56 lbs.—100 lbs. 24,674 Vegetables ,, Holland, Spain and Italy. 50 lbs.—100 lbs. 3,036 Macaroni Packages Canada and Italy 28 lbs. 10,662 Milk Powder ,, Holland 50 lbs.—1 cwt. 37,090 Nuts (Various) Bags Spain, Italy, China and Russia. 50 lbs.—1 cwt. 1 qr. 38,138 Vegetables (in Brine). Casks Spain and Holland 3 cwts.—4 cwts. 8,834 Vegetables (Dried) Packages Holland 56 lbs. 280 Ginger (Preserved) Cases, Casks China 30 lbs.—3 cwts. 7,656 Miscellaneous— Biscuits Packages Holland 1 cwt.—1 cwt. 1 qr. 93 Block Milk ,, ,, 56 lbs. 172 Carraway Seeds Bags ,, 1 cwt. 1 qr. 1,845 Cherries (in Brine) Casks Italy 2 cwts.—3 cwts. 998 Chocolate Packages Holland 50 lbs.—1 cwt. 1 qr. 419 Chutney ,, India 1 cwt.—3 cwts. 10 Citrons (in Brine) Casks Spain 4 cwts. 16 Cocoa Butter Packages Holland 1 cwt.—2 cwts. 5,433 Condensed Milk Casks ,, 4 cwts.—5 cwts. 3,712 Confectionery Packages ,, 28 lbs.—1 cwt. 512 Crispbread ,, Sweden 56 lbs. 847 Curry Powder ,, India 50 lbs. 4 Sterilized Cream Drums Holland 56 lbs. 2,643 Fruit and Lemon Juice. Casks Spain and Italy 3 cwts.—4 cwts. 3,232 Fruit Pulp ,, Holland, Spain and Italy. 4 cwts. 8,971 Glands ,, Holland 1 cwt.—3 cwts. 35 Honey ,, ,, 1 cwt.—2 cwts 30 Liquorice Packages Italy 1 cwt.—2 cwts 360 Liquorice Juice Casks ,, 2 cwts.—3 cwts. 481 Orange Skins Packages ,, 56 lbs. 10 Peel (in Brine) Casks Spain and Italy 4 cwts.—5 cwts. 150 Poultry Packages Holland 24 lbs.—56 lbs 3,728 47 Article. Description of Packages. Where from. General Range of Weight of Packages. Quantity. Miscellaneous—(continued). Pepper Packages Holland, Singapore and Java. 680 Sugar Candy ,, Holland 28 lbs.—56 lbs. 500 Casings Casks Holland, America and Persia. 56 lbs.—3 cwts. 300 Rabbits Packages Holland 1 cwt. 496 Tongues Casks ,, 2 cwts.—3 cwts. 6 Vegetable Powder Packages ,, 1 cwt. 2 qrs. 1,643 Yeast ,, ,, 28 lbs.—56 lbs. 5,738 Tomato Sauce ,, Italy 56 lbs.—1 cwt. 2,381 Candied Citrons ,, Spain 56 lbs. 50 Desiccated Cocoanut. Bags Ceylon 28 lbs.—1 cwt. 18 lbs 1,825 UNSOUND FOOD SURRENDERED AT RIVERSIDE WHARVES AND WAREHOUSES. As a result of the daily inspection of City Wharves, 77 loads of unsound food were removed from these places during the year by the Cleansing Department. The material so disposed of comprised :— Tons. Cwts. Qrs. Lbs. Condensed Milk 2 16 0 0 Coffee 1 10 1 0 Dried Fruit 3 13 2 0 Fresh Fruit 9 19 0 0 Fruit Pulp 27 14 2 0 Tinned Fruit, Vegetables and Fish 41 4 2 21 Vegetables 9 10 3 0 Miscellaneous 2 13 3 20½ Total 99 2 2 13½ In addition to the above, 76 cases and 3 tins Jellied Veal were removed from wharves by condemned meat van, and a large amount of fruit and vegetables were destroyed at the wharves under supervision, and a quantity of unsound food was released for manufacturing and cattle feeding, with proper guarantees and under supervision of local authorities concerned. AGRICULTURAL PRODUCE (GRADING AND MARKING) ACTS, 1928 AND 1931. The above-mentioned Acts have been administered during the year with little real difficulty, beyond that of persuading affected parties to conform to the requirements. This is readily understandable in areas like the City of London, where there are so many casual street vendors with little or no knowledge of the requirements of the law. Those regularly engaged in the work associated with these Acts of Parliament, having once been acquainted by the Inspector of their obligations, readily remedy any omission ; defect is almost invariably due to the failure of assistants to carry out the instructions of the proprietor. During the year, 2,648 shops and stores and 790 street traders were interviewed. There were in all 25 minor offences. There was one offence against the law relating to marking which is, at the time of writing this report, the subject of legal proceedings. Twenty-three new orders were issued under the Agricultural Produce (Grading and Marking) Acts, 1928 and 1931, and 4 new orders under the Merchandise Marks (Imported Goods) Act, 1926. There has been a marked improvement in the packing and grading of produce. FERTILISERS AND FEEDING STUFFS ACT, 1928. The work in connection with the above-mentioned Act has been carried on as usual, and 146 visits to firms dealing with material controlled by the Act made by your officer. Twenty-six special enquiries instituted in connection with reports by other authorities of neglect to comply with the requirements have been instituted, and such technical errors as have been discovered have been rectified by the responsible persons immediately their attention was directed to them. As in the past, such offences have 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 points of difficulty has been appreciated. The quarterly returns to the Ministry of Agriculture and Fisheries have been made in the usual way. G2 48 REPORT OF THE DEPARTMENTAL COMMITTEE ON THE COMPOSITION AND DESCRIPTION OF FOOD. This Departmental Committee was originally appointed in 1931, but in the interests of economy, operations were suspended and re-started in July, 1933, on the following terms of reference :— " To consider whether it is desirable that the law relating to the composition and description of articles of food should be altered so as to enable definitions or standards to be prescribed, or declarations of composition to be required, for articles of food other than liquid milk ; and if so, to recommend what alterations of the law are required." The conclusions and recommendations of the Committee are as follows :— The law should be altered so that standards should be prescribed and declarations of composition required. The enabling power should be vested in the Minister of Health. In some foods, standards or declarations are unnecessary, but in important articles of food it is desirable that the public should know what they are getting. Standards or declarations should only be fixed or made where analysis or other examination can be a check. The guiding consideration should be that the same term should always mean the same thing. The terms of reference did not cover a consideration of particular articles of food, but sausages, meat pastes, potted meats, infants' and invalids' food, jam, cream, confectionery and other articles were considered for the purpose of hearing the views of witnesses on the general question. Almost all witnesses urged that infants' and invalids' food should bear on the label of the package a declaration of their contents. Purchasers of toffee were getting what they wanted, whether toffee be made with butter or nut fat. It might be desirable to prohibit certain ingredients in sweetmeats, but definitions were not needed. The limits or standards as to arsenic, tin, lead or other contaminating impurity, and also additions to food for the purpose of carriage or consumption should also come under review. Complaints as to misleading advertisements and labelling are well founded. It is agreed in principle that, for purposes of evidence as to the nature, quality, and substance demanded, claims made in advertisement should be part of the package label. The retailer of a pre-packed article needs the protection of an alteration of the law in cases where samples are found not to be genuine. The responsibility should be transferred to the packer if the retailer can show that the article was sold as received. A label or invoice should constitute a warranty. The packer should have the option of fixing a time limit, beyond which he is safeguarded against deterioration in condition. If a Food and Drugs Authority finds a pre-packed article on sale and contravening legal requirements, action should be taken at the premises where the article is packed. If the premises are in the district of another Authority, this other Authority should be required to cause samples to be taken from the despatch department of the packer's premises, and should be empowered to take proceedings if the packer's samples are reported against. This entails extension of powers of entry and sampling to which no serious objection on the part of manufacturers or wholesalers is anticipated. No new permanent advisory committee or other tribunal for the purpose of setting standards and definitions is contemplated. The Ministry of Health has an efficient Foods Department. The power to fix standards and definitions should be exercised by means of an Order, a draft of the Order to be published and ample time allowed to interested persons to state their objections. Some articles would probably be agreed by interested parties after informal conversations and would form the subject of the first Order. Subsequent orders would or would not be made on consideration by the Minister of reports made to him and after consultations with the various interests involved, especially where there is divergence of opinion. Importations which contravene the orders would be provided against. There would be no material alteration in expense to Local Authorities ; but, perhaps, a reduction if the law were altered so as not to require an analysis of foods whose nature might be otherwise determined. The time is ripe for consolidation of the Statutes dealing with the composition of food. With these conclusions, I am in full agreement. 49 SUPERVISION OF FOOD AND DRUGS. During the year 1934, 982 samples of food and drugs were submitted to the Public Analyst for examination, 796 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. 7 Sausages 43 3 Spices 43 2 Liniment of Turpentine 3 1 Vinegar 33 1 Canned Fish 5 1 Meat Products 18 1 Canned Vegetables 46 1 Soup 4 17 Of the formal samples, 22 out of 186 were reported against, as follows:— Samples. 4 Milk 154 5 Sausages 7 2 Spices 4 1 Meat Products 2 22 The above-mentioned samples, with the exception of milk, 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 3-9, as compared with 3 - 7 in 1933. Butter, Cream and, Cheese.—None of the 56 samples of these important articles of dairy produce was reported against. Spices, etc.—Five samples of curry powder were reported against as containing lead and lead compounds in amounts varying from 44 to 160 parts per million. Where there was any remaining stock unsold, this was surrendered for destruction. It was found that the material sampled had been in stock for some considerable time, and it was not possible to trace the source of contamination. Sausages.—Of the 50 samples of sausages taken, 12 were reported against. Four of the samples were found to contain preservative, although no statutory declaration had been made of its presence. In these cases the vendors were cautioned. The remaining eight samples contained preservative in excess of the maximum amount permitted by the Public Health (Preservatives, etc., in Food) Regulations, although its presence was declared. On investigation it was found that in each case the sausages had been supplied by one and the same manufacturer. The attention of this Company was directed to the breach and the matter was immediately remedied. Spirits.—It is interesting to note that no one of the 18 samples of spirits procured was certified as adulterated. Drugs.—Only two of the 113 samples of drugs which were taken informally were certified by the Public Analyst to be not in accordance with the requirements of the British Pharmacopoeia. In one case it was not possible to procure a formal sample, as the vendor had no remaining stock ; in the other instance, the formal sample proved genuine. EXAMINATION OF., MILK Chemical.—Fourteen of the 154 samples of milk, which were all taken formally, were certified to be below the limits laid down which presume adulteration; this gives a percentage figure of 9.0, compared with 6.6 in 1933. Legal proceedings were instituted with regard to eight of the samples, and convictions registered in respect to four of these. In one case the 50 vendor absconded and no further action was possible. The other vendors or consignors were communicated with. The following table shows the percentage fat-content in each of the 154 samples of milk procured in the City during the year, the average fat-content being 3.5 per cent., only 10 samples falling below the standard figure of 3 per cent.:— Percentage of Fat. No. of Samples. Percentage of Fat. No. of Samples. 2.5 l 3.6 19 2.6 2 3.7 5 2.7 3 3.8 13 2.8 2 3.9 12 2.9 2 4.0 5 3.0 3 4.1 5 3.1 10 4.2 4 3.2 5 4.3 3 3.3 15 4.4 2 3.4 16 4.7 1 3.5 26 Total 54 Four purveyors of milk, from whom samples had been taken, availed themselves of the provisions of the Food and Drugs (Adulteration) Act, 1928, and served notices upon the Authority requesting samples of milk to be procured in course of delivery from their suppliers. Twenty-three samples of milk were taken at Liverpool Street Station in course of delivery upon the request of two other Local Authorities, as provided by this Act, for which services charges were made. the milk and dairies order, 1926, and the milk and dairies (amendment) act, 1922. Eight new applications for registration as retail purveyors of milk were received during the year, and none was refused. Three of these were from persons who have no City premises, but purvey milk within the area. Before registration, enquiries were made from the appropriate Authority within whose district the dairy was situated, to ensure that the premises were registered in that area. Registration Statistics. Number of Retail Purveyors of Milk on the Register at end of 1933* 291 New Applications for Registration received 8 New Applications granted 8 New Applications refused — Names of Retailers removed from Register 8 Number of Retail Purveyors of Milk on the Register at end of 1934 291 Number of Milk Sellers (other than Retail Purveyors of Milk) on the Register at end of 1934 26 Licenses issued under the Milk (Special Designations) Order, 1923 22 * This register contains a number of names which, in my opinion, should not be included, and it is now in process of revision. Inspection of Premises where Milk is Retailed.—During the year, 121 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 with regard to the distribution of milk. One roundsman was observed to fill 21 bottles with milk from a churn, and although a summons was issued against the dairyman for failing to cause such bottles to be filled and closed on registered premises, it was not possible to serve it, the dairyman having absconded. 51 the public health (condensed milk) regulations, 1923 and 1927. the public health (dried milk) regulations, 1923 and 1927. Ten 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. Another butter factory, which was opened during the year, became vacated before the close of the year. Samples taken at various times at these premises were all certified to be genuine. Wholesale Dealers in Margarine and Margarine Cheese.—There were 26 new applications for registration received during the year. Artificial Cream Act, 1929.—No additions have been made to the register. 52 53 administrative action regarding adulteration or other irregularity. Serial No. Article. Whether Formal or Informal. Nature of Adulterati6n or Irregularity. Observations. Results of Proceedings or other Action taken. 34 Curry Powder Informal Lead, 50 parts per million. Re-sampled formally—genuine 36 Curry Powder Formal Lead. 44 parts per million. Taken in connection with sample No. 1,010 (1933). Retailer and Wholesaler surrendered unsold stocks for destruction. 53 Curry Powder Informal Lead, 92 parts per million. Re-sampled formally—No. 92 90 Curry Powder Informal Lead, 68 parts per million. Re-sampled formally—genuine 92 Curry Powder Formal Lead, 160 parts per million. Taken in connection with sample No. 53 Old stock, exhausted; source of supply not ascertainable. Ministry of Health communicated with regarding samples of Curry Powder. 114 Desiccated Soup Informal Sulphur Dioxide, 70 parts per million. Discovered to be old stock, which was the subject of previous correspondence with the manufacturers. 184 Pork Sausages Informal Sulphur Dioxide, 190 parts per million. Re-sampled formally—No. 212. 205 Beef Sausages Informal Sulphur Dioxide, 400 parts per million. Re-sampled formally, when notice declaring preservative to be used was exhibited. 212 Pork Sausages Formal Sulphur Dioxide, 180 parts per million. Taken in connection with sample No. 184. Vendor cautioned. 267 Milk Formal Milk fat deficient, 9%. Further samples not procurable. Consignor ceased delivering. 268 Milk Formal Milk fat deficient, 10%. Consignor prosecuted. Fined £1, with £1 8s. 0d. Costs. 376 Tripe Informal Boric Acid, 32.97 grains per pound. Re-sampled formally—No. 457 381 Milk Formal Milk fat deficient, 9%. Consignor prosecuted. Fined £1 on each of three summonses, with £15 15s. 0d. Costs. Samples sent to Government Analyst, at direction of Court, on application of Defendant. 382 Milk Formal Milk fat deficient, 18%. 383 Milk Formal Milk fat deficient, 15%. 388 Milk Formal Extraneous water, 3.3%. Consignor prosecuted. Summons dismissed. 394 Milk Formal Milk fat deficient, 2%. Consignor prosecuted. Summons dismissed. 399 Milk Formal Milk fat deficient, 6%. Consignor prosecuted. Summons dismissed. 453 Milk Formal Milk fat deficient, 8%. Vendor cantioned. 457 Tripe Formal Boric Acid, 76.37 grains per pound. Taken in connection with sample No. 376 Explanation submitted by Vendor. Local Authority, in whose area the preservative powder which had been used was manufactured, communicated with. 469 Milk Formal Milk fat deficient, 2%. Taken in course of delivery from Wholesaler, in connection with sample No. 453. Wholesaler communicated with. 497 Milk Formal Milk fat deficient, 14%. Vendor absconded. 566 Beef Sausages Informal Sulphur Dioxide, 300 parts per million. Vendor cautioned. 581 Beef Sausages (Preserved). Informal Excess Sulphur Dioxide, 200 parts per million. Re-sampled formally—No. 625 591 Pork Sausages (Preserved). Informal Excess Sulphur Dioxide, 180 parts per million. Re-sampled formally—No. 637 h 54 55 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. 594 Pork Sausages (Preserved). Informal Excess Sulphur Dioxide, 150 parts per million. Re-sampled formally—genuine 595 Beef Sausages (Preserved). Informal Excess Sulphur Dioxide, 200 parts per million. Re-sampled formally—No. 636 603 Canned Sardines Informal Lead, 30 parts per million. Subject of investigation with the trade. 623 Beef Sausages (Preserved). Formal Excess Sulphur Dioxide, 215 parts per million. Manufacturer of samples Nos. 581, 591, 594, 595, 625, 636, and 637. Manufacturer cautioned. 625 Beef Sausages (Preserved). Formal Excess Sulphur Dioxide, 265 parts per million. Taken in connection with sample No. 581 Manufacturer cautioned. 636 Beef Sausages (Preserved). Formal Excess Sulphur Dioxide, 250 parts per million. Taken in connection with sample No. 595 Manufacturer cautioned. 637 Pork Sausages (Preserved). Formal Excess Sulphur Dioxide, 200 parts per million. Taken in connection with sample No. 591 Manufacturer cautioned. 669 Liniment of Turpentine Informal Oil of Turpentine, 92.5% ; Resins, etc., 7.5%. (Not genuine Liniment of Turpentine, B.P.) Re-sampled formally—genuine 680 Macedoine de Legumes Informal 0.21 grains of Crystallised Copper Sulphate per pound. Importers and Local Authority concerned communicated with. Unsold stock permitted to be returned to Importers for re-export. 692 Vinegar Informal Acetic Acid deficient, 12%. Vendor cautioned. 724 Liniment of Turpentine Informal Oil of Turpentine deficient, 38.4%. Stock sold out, consequently formal sample not procurable. 781 Milk Formal Extraneous water, 3.3%. Re-sampled—genuine 786 Milk Formal Extraneous water, 2.1%. Re-sampled—genuine 813 Milk Formal Extraneous water, 2.1%. Re-sampled—genuine h2 56 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. Bread — 3 3 — — — — — — Butter — 23 23 — — — — — — Butter (on bread) — 14 14 — — — — — — Cheese — 14 14 — — — — — — Cocoa — 5 5 — — — — — — Coffee — 4 4 — — — — — — Confectionery — 24 24 — — — — — — Cream — 19 19 — — — — — — Flour — 1 1 — — — — — — Flour (Self-raising) — 3 3 — — — — — — Jam and Marmalade — 8 8 — — — — — — Lard — 14 14 — — — — — — Margarine — 12 12 — — — — — — Milk 154 — 154 14 — 14 9.0 — 9.0 Milk, Condensed — 10 10 — — — — — — Mustard — 9 9 — — — — — — Sugar — 12 12 — — — — — — Tea — 21 21 — — — — — — Vinegar — 33 33 — l 1 — 30 30 Wine — 1 1 — — — — — — Spirits 18 — 18 — — — — — — Drugs 1 112 113 — 2 2 — 1.7 1.7 Other Articles 13 454 467 8 14 22 61.5 3.0 4.7 Totals 186 796 982 22 17 39 11.8 2.1 3.9 Spirits— Brandy 4 — 4 — — — — — — Gin 10 — 10 — — — — — — Whisky 4 — 4 — — — — — — Totals 18 — 18 — — — — — — Drugs— Borax — 1 1 — — — — — — Camphorated Oil — 7 7 — — — — — — Cascara Extract — 2 2 — — — — — — Easton's Syrup — 3 3 — — — — — — Friar's Balsam — 1 1 — — — — — — Glycerine — 3 3 — — — — — — Glycerine of Thymol — 1 1 — — — — — — Ground Ginger — 6 6 — — — — — — Hypophosphites, Syrup of — 1 1 — — — — — — Iron and Ammonium Citrate — 1 1 — — — — — — Iron and Quinine Citrate — 5 5 — — — — — — Liniment of Turpentine 1 3 4 — 2 2 — 66.6 50.0 Lozenges and Tablets — 21 21 — — — — — — Magnesium Citrate — 1 1 — — — — — — Oil, Almond — 3 3 — — — — — — Oil, Castor — 6 6 — — — — — — Oil, Cod Liver — 3 3 — — — — — — Oil, Eucalyptus — 4 4 — — — — — — Oil, Linseed — 1 1 — — — — — — Ointment, Boric — 2 2 — — — — — — Ointment, Calomel — 1 1 — — — — — — Ointment, Paraffin — 1 1 — — — — — — Ointment, Vapour rubbing — 1 1 — — — — — — Ointment, White Precipitate — 2 2 — — — — — — Ointment, Zinc — 6 6 — — — — — — Paraffin, Liquid — 6 6 — — — — — — Parrish's Chemical Food — 2 2 — — — — — — Powder, Gregory's — 1 1 — — — — — — Carried forward 1 95 96 — 2 2 — 2.1 2.1 57 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 1 95 96 — 2 2 — 2 2.1 Powder, Compound Liquorice — 1 1 — — — — — — Sal Volatile — 6 6 — — — — — — Slimming Salts — 1 1 — — — — — — Sulphur and Preparations — 6 6 — — — — — — Tincture, Iodine — 1 1 — — — — — — Tincture, Quinine — 1 1 — — — — — — Tincture, Rhubarb — 1 1 — — — — — — Totals 1 112 113 — 2 2 — 1.7 1.7 Other Articles— Arrowroot — 3 3 — — — — — — Baking Powder — 3 3 — — — — — — Barley — 20 20 — — — — — — Beverages, etc. — 25 25 — — — — — — Cake and Biscuits — 8 8 — — — — — — Coffee Mixtures — 8 8 — — — — — — Cornflour — 1 1 — — — — — — Dripping — 8 8 — — — — — — Fish — 6 6 — — — — — — Fish, Canned — 5 5 — 1 1 — 20.0 20.0 Fish, Potted — 17 17 — — — — — — Fruit, Bottled and Canned — 12 12 — — — — — — Fruit, Dried — 63 63 — — — — — — Honey — 6 6 — — — — — — Ice Cream — 8 8 — — — — — — Jellies — 4 4 — — — — — — Lemon Curd, etc. — 5 5 — — — — — — Lemonade Powder — 9 9 — — — — — — Meat 2 18 20 1 1 2 50.0 5.5 10.0 Meat, Canned — 3 3 — — — — — — Meat, Potted — 5 5 — — — — — — Meat Rolls and Pies — 6 6 — — — — — — Milk Preparations — 2 2 — — — — — — Milk, Dried — 1 1 — — — — — — Mincemeat — 6 6 — — — — — — Oatmeal — 1 1 — — — — — — Oil, Frying — 2 2 — — — — — — Olive Oil — 9 9 — — — — — — Pea Flour, etc. — 1 1 — — — — — — Pepper — 21 21 — — — — — — Pickles and Sauces — 17 17 — — — — — — Powder, Custard — 1 1 — — — — — — Powder, Preservative — 1 1 — — — — — — Preserved Vegetables — 46 46 — 1 1 — 21 21 Rice — 4 4 — — — — — — Sago — 1 1 — — — — — — Sausages 7 43 50 5 7 12 71.4 16.2 24.0 Semolina — 2 2 — — — — — — Soups — 4 4 — 1 1 — 25.0 25.0 Spices, etc. 4 43 47 2 3 5 50 0 6.9 10.6 Tapioca — 1 1 — — — — — — Water, Aerated — 1 1 — — — — — — Wines (Non-alcoholic) — 4 4 — — — — — — Totals 13 454 467 8 14 22 61.5 3.0 4.7 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. results of prosecutions. Sample. Nature and extent of Adulteration. Result. 268 Milk 10% deficient in milk fat £1 and £1 8s. 0d. Costs. 381 Milk 9% deficient in milk fat £1 and £15 15s. 0d. Costs. 382 Milk 18% deficient in milk fat £1 383 Milk 15% deficient in milk fat £1 388 Milk 3.3% extraneous water Summons dismissed. 394 Milk 2% deficient in milk fat Summons dismissed. 399 Milk 6% deficient in milk fat Summons dismissed. SUMMARY. Total Fines £4. Total Costs £17 3s. 0d. bacteriological and chemical examination of milk. samples collected at railway stations. Since 1904, when the practice was first instituted, series of samples of milk arriving in the City of London from the country have been collected at the several termini within the City, and have been the subject of report. In March, 1934, in continuation of this practice, 24 samples of milk were collected at Liverpool Street Station and submitted to Dr. R. G. Canti, the City Bacteriologist, for bacteriological examination and investigation as to the presence of dirt. A duplicate of each sample was also taken and submitted to Mr. A. J. C. Lickorish, F.I.C., the Public Analyst, for chemical examination. The samples were sent from different farms situate in the following counties :— Norfolk 10 Suffolk 10 Essex 4 The following is a copy of the report which Dr. Canti has submitted on the results of his investigations:— bacteriological report on samples of milk received in 1934. No. of Sample Date of inoculation of Guinea Pig. Dirt. Date of Death. Post Mortem Findings. Result qua Tubercle. l 8th March Nil 25th April Normal Negative. 2 8th March Nil 25th April Normal Negative. 3 8th March Nil 25th April Normal Negative. 4 8th March Nil 25th April Normal Negative. 5 8th March Trace 25th April Normal Negative. 6 8th March Nil 25th April Normal Negative. 7 13th March Nil 27th April Normal Negative. 8 13th March Nil 27th April Normal Negative. 9 13th March Nil 27th April Normal Negative. 10 13th March Trace 27th April Normal Negative. 11 13th March Trace 27th April Normal Negative. 12 13th March Trace 27th April Normal Negative. 13 16th March Nil 7th May Normal Negative. 14 16th March Nil 7th May Tuberculous right inguinal glands and lumbar glands. Early tuberculosis of spleen; tubercle bacilli demonstrated in glands. Positive. 15 16th March Nil 7th May Normal Negative. 16 16th March Nil 7 th May Normal Negative. 17 16th March Nil 29th April Tuberculous right inguinal, left axiliary gland and retrosternal glands. Tuberculous spleen. Tubercle bacilli demonstrated in inguinal glands. Positive. 18 16th March Nil 7th May Normal Negative. 19 20th March Trace 23rd April Pericarditis, perihepatitis, general peritonitis, perisplenitis. Acute infection. No evidence of tuberculosis. 20 20th March Nil 15th June Normal Negative. 59 No. Sample. Date of inoculation of Guinea Pig, Dirt. Date of Death. Post Mortem Findings. Result qua Tubercle. 21 20th March Nil 10th April Small non-caseous right inguinal and right lumbar glands. Nil liver, nil spleen. Emulsion of glands to guineapig 21a. 21a 12th April 30th May Normal Negative. 22 20th March Trace 30th May Normal Negative. 23 20th March Nil 30th May Normal Negative. 24 20th March Nil 30th May Normal Negative. Dirt.—Out of 24 samples, six contained a trace or more of dirt, and one of these was a repetition from the previous year, which had also been noted as unsatisfactory from this point of view. Tuberculosis.—Four samples—Nos. 6, 14, 15, and 18 were repetitions of last year, all of which were negative. One, No. 14, was found to be positive. This was also the case with No. 17. Case of 21.—The doubtful result obtained—with an enlarged gland as evidence, but the emulsion from this gland failed to produce tuberculosis in another animal, so this may now be counted as negative. The details in connection with samples from which the guinea-pigs found to be infected with tuberculosis were inoculated were forwarded to the appropriate medical officers of health for such action as they considered desirable, and in regard to No. 17, I have received a report from which the following is an extract:— "I arranged for this case to be investigated. As a result, one cow has been killed, and the post-mortem examination shows evidence that the animal was suffering from tuberculosis." With regard to No. 14, I am informed by the County Medical Officer that arrangements have been made for inspection of the herd at the farm. For purposes of comparison, the following summary of results obtained since 1904 is here inserted : Year. Percentage showing Tuberculous Infection. Year. Percentage showing Tuberculous Infection. 1904 7.7% 1921 12.5% 3rd Series. 1905 9.1% 1922 9.5% 1906 8.0% 1923 2.6% 1907 8.3% 1924 12.8% 1909 12.5% 1st Series. 4.7% 2nd Series. 1925 2.4% 1st Series. 2.4% 2nd Series. 1910 6.25% 1927 4.88% 1912 6.6% 1928 8.3% 1913 10.4% 1929 5.1% 1914 10.2% 1930 4.2% 1915 8.5% 1931 9.5% 1917 4.2% 1932 9.1% 1919 14.8% 1933 11.1% 1921 24.2% 1st Series. 26.3% 2nd Series. 1934 8.3% The chemical examination showed that two samples, Nos. 15 and 16, were deficient in milk fat to the extent of 9% and 10% respectively. It was not possible to re-sample No. 15, as the consignor had ceased to send milk to Liverpool Street Station. With regard to No. 16, the consignor was prosecuted and fined £1, with £1 8s. Od. Costs. GENERAL SANITARY WORK. Artizans' Dwellings, Stoney Lane, Houndsditch.—These Buildings, erected by the late Commissioners of Sewers and opened in January, 1885, stand upon ground formerly the site of several courts and alleys in the Ward of Portsoken. There are five "blocks" of Dwellings, severally named King's, Queen's, Prince's, North, and South, designed for occupation by persons of the artizan class, some of the ground floors being let as shops. The Buildings contain 501 rooms, arranged in 241 tenements, and are occupied by 635 persons, compared with 656 in 1933. 87 per cent. are adults and 13 per cent. children (under 14 years). In addition to these Artizans' Dwellings, the Corporation, in connection with a slum clearance scheme, erected in the City:— (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 1934 100 persons (94 per cent. adults and 6 per cent. children). 60 (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 1934, 62 persons (73 per cent. adults and 27 per cent, children). I here 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 797. The number of births was 3,* viz. : 1 male and 2 females. The birth-rate was 3.7 per 1,000, which is 1.6 per 1,000 below 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 1934 was 6.2 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 1934. Name op Block. Births. Mortality from all Causes at subjoined ages. Males. Females. At all ages. Under 1 year. 1 ancj under 5 5 and under 15 15 and under 25 25 and under 65 66 and upwards. NORTH BLOCK .... .... l .... .... .... .... l .... SOUTH .... l .... .... .... .... .... .... KING'S „ .... .... 2 .... .... .... .... 1 l QUEEN'S „ .... l 1 .... .... .... .... .... l PRINCE'S „ l .... 1 .... .... .... .... 1 .... BEARSTED HOUSE .... .... .... .... .... .... .... .... .... DUTTON „ .... .... .... .... .... .... .... .... .... Totals l 2 5 .... .... .... .... 3 2 The baths, provided for the use of tenants of these Buildings, which were opened in May, 1904, continue to be extensively used, the number of persons bathing during 1934 being 12,769, of whom 5,076 were males and 7,693 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 60 335 49 535 979 February 56 337 49 501 943 March 72 479 70 551 1,172 April 52 333 54 512 951 May 74 381 83 602 1,140 June 83 353 95 649 1,180 July 73 381 92 660 1,206 August 77 343 84 616 1,120 September 71 361 80 614 1,126 October 66 321 84 504 975 November 66 332 75 562 1,035 December 57 313 69 503 942 Totals 807 4,269 884 6,809 12,769 * No still births. 61 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 196 2 12 February 173 13 March 209 1 1 10 April 131 6 30 11 May 190 2 14 June 203 6 21 July 227 1 12 August 114 1 3 14 September 156 1 4 21 October 172 1 2 15 November 160 10 December 141 11 Totals 2,072 10 51 164 MIDDLE DISTRICT—Inspector G. H. Fowler. Month. Premises Inspected. Orders issued. Notices served. Improvements effected. January 166 4 5 20 February 185 5 6 15 March 125 2 6 19 April 190 2 2 9 May 217 3 4 16 June 188 3 5 18 July 207 1 1 15 August 89 .... 1 6 September 184 1 1 20 October 203 2 2 18 November 191 2 4 22 December 154 1 1 18 Totals 2,099 26 38 196 EAST DISTRICT—Inspector G. E. Harrington. Month. Premises Inspected. Orders issued. Notices served. Improvements effected. January 175 .... 3 15 February 172 .... 2 14 March 161 1 17 11 April 170 .... 1 12 May 195 9 2 18 June 152 2 2 12 July 192 .... 1 17 August 193 1 .... 18 September 172 2 3 17 October 191 2 2 15 November 195 1 1 22 December 180 .... 2 18 Totals 2,148 18 36 189 THE FOREGOING ARE SUMMARISED AS UNDER District. Number of Inspections made. Orders issued. Notices served. Improvements effected. West 2,072 10 51 164 Middle 2,099 28 38 196 East 2,148 18 36 189 Totals 6,319 56 125 549 I 62 registered lodging houses. Public Health (London) Act, 1891, Sec. 94; and Housing Act, 1925, Sec. 6. The Corporation, as the Sanitary Authority in the City, are required under the provisions of Sec. 94 of the Public Health (London) Act, 1891, and Section 6 of the Housing Act, 1925, to make and enforce Bye-laws with respect to houses intended or used for occupation by the working classes and let in lodgings or occupied by members of more than one family for the following purposes:— For regulating the number of persons and separation of the sexes. For the registration and inspection of such houses. For enforcing drainage and promoting cleanliness and ventilation. For requiring adequate and accessible and, where necessary, separate provision of closet accommodation, washing accommodation, and accommodation for the storage, preparation and cooking of food. For the keeping in repair and adequate lighting of any common staircase. For the cleansing and redecorating of the premises, and for the paving of the courts and courtyards. For the provision of handrails for staircases. For securing adequate lighting. For the taking of precautions in any case of infectious disease. Particulars relating to the registered Lodging-houses in the City now on the Register are given in the accompanying table:— District. Number of Houses on Register. Number of Lodgers. Number of Tenements. Average Number of persons per Tenement. Cleansing Notices Served. West 30 237 117 2.0 36 Middle — — — — — East 16 122 68 1.7 18 Total 46 359 175 2.0 54 These houses are periodically inspected, and in April of each year the owners or tenants are called upon to carry out a thorough cleansing of them, in accordance with the provisions of the Bye-laws. This necessitated the service of 54 notices during 1934. 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 .... 5 .... .... .... 14 „ B 3 3 l .... .... 13 „ C 4 4 .... .... .... 13 „ D 2 3 .... l .... 20 „ E 7 1 l .... .... 13 „ F 2 5 .... .... .... 17 St. Ann's Chambers, Ludgate HilL 1 13 l .... .... 33 Bloomfield House, Snow Hill .... 17 .... l 1 48 Total (Six "Blocks") 35 72 3 2 l 241 MIDDLE DISTRICT. Bridgewater House, Fann Street .... 9 .... .... l 15 City Buildings, Moor Lane 2 20 11 .... .... 64 Total (Two "Blocks") 2 29 11 .... l 79 EAST DISTRICT. Harrow Place and Stoney Lane— North Block .... 52 8 .... .... 165 South „ 5 22 13 .... .... 122 Prince's „ 5 50 .... .... .... 128 Queen's ,, 5 40 5 .... .... 119 King's „ 8 18 16 .... .... 101 Barker's Buildings, Catherine Wheel Alley, Bishopsgate 3 3 1 2 .... 21 Bearsted House, Hutchison Street .... .... 8 16 .... 100 Dutton House, New Street .... .... 13 2 l 62 Total (Four "Blocks") 26 185 64 20 l 818 These twelve blocks contain 452 tenements, and are inhabited by 1,138 persons—an average of 2.5 persons to each tenement. 63 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) 355 (b) Number of inspections made for the purpose 625 (2) (a) Number of dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 179 (b) Number of inspections made for the purpose 456 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 3 (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 8 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 125 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 21 (2) Number of dwelling-houses in which defects were remedied after service of formal notices:— (a) By owners 21 (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. Common Lodging House, 116, Middlesex Street.—This is the only common lodging house in the City and is known as the "Salvation Army Working Men's Hotel and Shelter." It was opened on the 7th February, 1906. Periodical inspections are made. The requirements of this Authority are always complied with, and the premises are well kept and maintained in a generally satisfactory condition. Neglect to comply with Water-closet Bye-laws.—No instance of neglect in this respect has occurred during the year under review. Drainage Plans.—In the course of the year 186 plans were submitted with regard to proposed reconstruction of water-closets or drains in the City. Of these, 172 were approved, 13 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. 12 64 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 seven 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 185 cases investigated in 1934, defects were found in 36 instances. Legal Proceedings.—During the year, 56 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. 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 1934, 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, nine 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 nine 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 six 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. collection and disposal of refuse and cleansing of streets, courts and gullies. The following observations are included in this Report by the courtesy of Mr. W. J. Heavey, the Director of Public Cleansing:— Collection and Disposal of Refuse. House and trade refuse is collected by 10 a.m. from receptacles placed on the kerb in streets scheduled by the Ministry of Transport, and after 10 a.m. from the interior of premises in other streets. Special arrangements are made for the collection of large quantities of trade refuse in scheduled streets. The contents of street orderly bins and market refuse are collected at any time during the day or night. All refuse is conveyed by horse-drawn vans or motor waggons to Lett's Wharf. It is there shot into the contractors' barges ; house, trade and market refuse being taken down the river to Hornchurch, where it is deposited on land belonging to the Corporation. Manure and contents of street orderly bins is separately barged where required by the contractors. At Hornchurch, the refuse is disposed of under the system of controlled tipping, as recommended by the Ministry of Health—i.e., the crude refuse is sealed off from the air by layers of earth excavated from the maiden ground of the tip and from other sources. Fires at the tip occur but seldom, and, as a precaution, iron water pipes are laid across the top of the tip, with joints at intervals to allow for the fixing of fire hose. No rats have been seen at the tip for over 18 months, and this result may reasonably be attributed to the system of controlled tipping. Arrangements have been made for dealing with these vermin should their presence be suspected at any time. During the year ended 31st December, 1934, the tonnage of refuse collected was as follows:— House, trade and market refuse 41,707 Street and gully refuse 16,440 Total tons 58,147 Seventy-three per cent. of the refuse was collected by horse vans and 27 per cent. by motor waggons. It is estimated that the above total tonnage is equal to over 200,000 cubic yards. 65 Cleansing of Streets, Courts and Gullies. The major part of the work of street cleansing is done during the night, when the whole of the City is cleansed either by motor brooms, motor water waggons or jet and hose. The condition of the centres of the carriageways in main thoroughfares during dry weather, except in market areas, is clean enough to render a nightly washing of the whole surface unnecessary, and such carriageways are therefore completely washed once a week only. On the other five nights of the week the channels are washed. In wet weather, however, the whole of the carriageways are washed every night if necessary. Certain secondary streets, including those in the vicinity of Billingsgate and Leadenhall Markets, are washed every night, and streets in the vicinity of Smithfield Market three times per week. Most of the street gullies are emptied as often as required by mechanical means, two machines being employed for this purpose every night. After the gullies have been emptied, they are re-sealed with clean water from the machines and the contents of the gullies removed to Lett's Wharf. Gullies in courts and narrow thoroughfares, which are inaccessible to the machines, are emptied by hand periodically or flushed fortnightly. During the year 1934, 66,531 gullies were cleansed and 20,741,000 gallons of water used for cleansing streets, courts and gullies. pigeons. Although complaints of the nuisance and damage caused by the congregation of pigeons in the City have not been so numerous as in past years, it is still essential that continual attention should be paid in order that the number of these birds may be kept within reasonable limits. The practice of feeding adopted by so many visitors to the City, together with the ideal nesting facilities readily available in the belfries of the several City churches, renders the problem of adequate reduction difficult. During the year some three hundred birds have been caught by the expert engaged by the Corporation and all destroyed under my supervision. Had there been any ringed birds, which there were not, they would have been forwarded to the Homing Union, in accordance with the undertaking given when the Act of Parliament under which action is permitted was placed on the Statute Book. I should add 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 10 persons buried in the City of London Cemetery, at Little Ilford, were exhumed and subsequently re-interred in other graves in the same cemetery. These exhumations were carried out at the request of members of the deceaseds' families, under special licence issued by the Home Secretary, and one of the conditions attached thereto is that the work of removal and re-interment shall be supervised by your Medical Officer of Health. The greatest care is exercised by the Cemetery staff and other responsible persons to ensure that the operations are carried out with due reverence. discovery of human remains at (1) 7, Mitre Street, Aldgate. (2) 1, Bow Lane. During the course of alterations in connection with sanitary accommodation at both of the above-mentioned premises, small quantities of human bones were unearthed. The remains were very old, and the customary notification to the Coroner and City Police was made, and they were subsequently decently and reverently re-interred on the sites. conversion of houses into one room flatlets. The desirability of local authorities having powers to make byelaws in regard to houses converted into one-room flatlets has been the subject of consideration during the year. The principal point of interest to the public health authority is that associated with ventilation in general, ventilation in regard to gas cooking, the provision of refuse bins, the situation of sanitary conveniences and facilities for washing up of feeding utensils and proper provision for food storage. It is felt that the lines of such byelaws should follow the lines of the byelaws in regard to houses let in lodgings, and although, so far as experience in the City is concerned in connection with the recent conversion of houses into flatlets, every consideration has been given to the principles above set out, compulsory powers would ensure that flats would be initiated on a standard which would be regarded as satisfactory. 66 housing—slum clearance. The question of slum clearance has been one of continuous consideration during 1934. There is no single area of houses for the working classes remaining; the Hutchison and Vine Street demolitions removed the last housing areas. There is, however, a number of dwellings dotted here and there which, were they aggregated, would constitute an area approximating to slum. By Section 62 of the Housing Act of 1930, sanitary defect in a house includes lack of air space or of ventilation, darkness, dampness, absence of ready accessibility of water supply or sanitary accommodation or of other conveniences and inadequate paving or drainage of courts, yards or passages. Part II of the Act deals with the repair or demolition of insanitary houses and requires action where the dwelling-house is in any respect unfit for human habitation, and lays down that, in determining whether a dwelling-house can be rendered fit at a reasonable expense, regard shall be had to the relative cost of rendering it fit and of the value of the house on completion of the work. In recommending to the Public Health Committee that Part II of the Act is the proper one on which to proceed, the question whether Section 17 (as to houses which can be rendered fit) or Section 19 (as to houses which are not capable of being rendered fit at reasonable expense) should be applied, arises, and naturally divides the houses into two classes ; those for demolition or an undertaking as to user from the owner under Section 19, and those for re-conditioning under Section 17. Decision on the unfitness of a house for habitation is difficult, especially as to degree of unfitness, whether one glaring defect overbears the presence of minor amenities, or whether a number of lesser defects constitute the unfitness. The scattered units dealt with present a great variety in type and user. As to preliminary procedure; in the case of unfit houses, incapable of being rendered fit at a reasonable expense, if the Public Health Committee is satisfied of the fact, notice is served on the interested parties, stating the time and place at which the condition of the house, any offer with respect to the carrying out of works, or the future user of the house, will be considered by the Local Authority. The Authority may accept undertakings by the owners in regard to these matters. In the case of dwelling-houses in any respect unfit for human habitation and capable of being rendered fit at reasonable expense, if the Public Health Committee is satisfied of the fact, notice is served requiring the execution of the works specified within a reasonable time, stating that those works will render the house fit for habitation. It appears that many persons, if displaced, would find the rents of new quarters a difficulty unless adjusted to circumstances, since in many of the inferior tenancies very low rents obtain ; it would be bad health policy to re-house at the expense of adequate food, the latter having the first claim on a small income. the bed bug. During 1934, a Memorandum on the Bed Bug and how to deal with it was issued by the Ministry of Health, and summarises our present knowledge in this matter. As to life, appearance and habits, bed bugs feed only on blood and seldom more than once a week, and are capable of fasting for six months, being then thin and transparent. They possibly travel from one house to the next in search of food. They can live for four years, and feed on mice, rats, sparrows, as well as on the human being. The eggs are by collared and lidded, and are cemented to the surface on which they are laid. Two to three eggs a day are laid during the lifetime of the adult female, and normally hatch in one to three weeks from the time of laying. The young can live without food for two or three months, but feed at once on hatching out, if food is available. On an average, ten weeks elapse before the young becomes adult, but circumstances, such as scarcity of food, can prolong this period of five moultings to a year or more. The presence of bugs in numbers can be detected by smell. The sites of infestation are all crevices or folds in walls, woodwork, paper, plaster, upholstery, picture frames, beds, chairs, curtains, bunks and boxes. 67 The bug is introduced to a house in infested furniture, etc., and by migration from room to room or house to house. As to methods of extermination, repeated "spring cleaning" and inculcation of the habit of cleanliness under supervision against half measures is a necessity. Discard of useless articles, steam disinfection of bedding, fumigation of heavily-upholstered furniture, detachment and cleansing of loose woodwork, repair of loose plaster-work and wall paper, use of the steam jet or blow lamp in chinks or crevices, with the requisite knowledge and perseverance, will prove successful. The sanitary officer's scope lies in knowledge, personality and tact ; the process of continuous cleansing is for the tenants. Soap and water used often and in plenty cannot be replaced as effective agents in destruction of bugs. An atomised spray, containing paraffin as a base, is a useful supplement to the organised scheme of cleansing. Hydrocyanic acid fumigation requires a trained and responsible person for its use. Furniture in transit might be thus treated in a van. Bedding and upholstery would require long airing to free them from cyanide fumes. The method is too dangerous to be applied in houses unless they are quite detached. Sulphur fumigation (5 lbs. burned in 1,000 cubic feet of space) is sometimes effective if repeated after three weeks against hatchments of unsterilised eggs. Before a tenant moves to new premises, the present house should be thoroughly searched, and if found infected, the tenants instructed, encouraged and helped to undertake a systematic cleansing of their effects, as above. Infested furniture moved from house to house is the most important channel of dissemination. Thus the difficulties to be overcome in the case of the bed bug arise from the following considerations:— The customary hiding up and laying of eggs in more or less inaccessible crevices. The feeding during the sleep of the host and return on engorgement to the fastnesses. The long period during which the bed bug normally and abnormally abstains from food, whether as young or adult. The meticulous cleansing and persistence therein to be exercised in case of infestation. The necessity for removal of woodwork and for repairs, which are beyond the province of the tenant to effect, but not to cause. The low level of cleanliness obtaining in many persons from age, infirmity, illness, poverty or mere acquiescence in squalor. factory and workshop act, 1901, &c. Factories, Workshops and Workplaces.—The premises upon the Register number 3,755, in which are included 8,256 workrooms, &c. There were served 1,708 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 1,472 3,756 WORKSHOPS 1,054 1,549 WORKPLACES Kitchens of Restaurants and Tea Rooms 705 1,568 Kitchens of Licensed Premises 269 859 Stables 3 40 Other places 252 484 3,755 8,256 The following is a Summary of Inspections of separate workrooms, &c., during the year:— Workshop Inspectors. Woman Inspector. Totals. FACTORIES 2,965 - 2,965 WORKSHOPS 1,194 - 1,194 WORKPLACES 2,109 885 2,994 68 Bakehouses.—Bakehouses are scheduled as Workshops (Part 2, Sixth Schedule), and are required to be registered by the Local Authority (Section 131). The following is a list of Bakehouses registered in the City:— ABOVEGROUND BAKEHOUSES. † 15 /19, Artillery Lane. †*85, Middlesex Street, † 280, Bishopsgate. † 12 and 13, Widegate Street, † Great Eastern Railway Hotel. UNDERGROUND BAKEHOUSES, † 188, Aldersgate Street. † * 122, Middlesex Street. 262, Bishopsgate. † 3, Pancras Lane 8, Copthall Avenue. † 21, Stoney Lane. † *67, Farringdon Street. † 68, St. Mary Axe. 48, Knightrider Street. 194, Upper Thames Street. SUMMARY. Aboveground Bakehouses 5 Underground Bakehouses 10 15 * These have been established at least 48 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 55 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. The following is a Summary of Inspections of separate workrooms, since 1925:— FACTORIES. Workshop Inspectors. Woman Inspector. Totals. 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 1934 2,965 — 2,965 WORKSHOPS. Workshop Inspectors. Woman Inspector. Totals. 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 1934 1,194 — 1,194 WORKPLACES. Workshop Inspectors. Woman Inspector. Totals. 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 1934 2,109 885 2,994 69 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) 58 165 63 286 Do. Initial Inspections (Workrooms) 78 211 137 426 Do. Periodical Inspections (Tenancies) 277 311 424 1,012 Do. Periodical Inspections (Workrooms) 607 603 1,318 2,528 Do. Re-inspections (Sanitary Works, &c., in hand) 176 349 244 769 Workshops, Initial Inspections (Tenancies) 32 40 48 120 Do. Initial Inspections (Workrooms) 39 44 62 145 Do. Periodical Inspections (Tenancies) 246 197 297 740 Do. Periodical Inspections (Workrooms) 337 272 440 1,049 Do. Re-inspections (Sanitary Works, &c., in hand) 149 145 97 391 Workplaces, Initial Inspections (Tenancies) 18 13 6 37 Do. Initial Inspections (Workrooms) 37 17 8 62 Do. Periodical Inspections (Tenancies) 75 24 67 166 Do. Periodical Inspections (Workrooms) 164 32 99 295 Do. Re-inspections (Sanitary Works, &c., in hand) 64 27 12 103 Bakehouses, Periodical Inspections (Tenancies) 13 9 4 26 Do. Periodical Inspections (Workrooms) 23 9 4 36 Do. Re-inspections (Sanitary Works. &c., in hand) 43 11 8 62 Kitchens of Restaurants, &c.— Initial Inspections (Tenancies) 27 27 11 65 Initial Inspections (Workrooms) 54 68 18 140 Periodical Inspections (Tenancies) 142 94 167 403 Periodical Inspections (Workrooms) 343 221 329 893 Re-inspections (Sanitary Works, &c., in hand) 139 199 185 523 Kitchens of Licensed Premises— Initial Inspections (Tenancies) 9 4 1 14 Initial Inspections (Workrooms) 33 22 2 57 Periodical Inspections (Tenancies) 71 54 83 208 Periodical Inspections (Workrooms) 244 178 200 622 Re-inspections (Sanitary Works, &c., in hand) 72 97 84 253 Workshops notified by H.M. Inspector 1 12 3 16 General complaints received 6 11 8 25 Miscellaneous visits 147 200 74 421 DEFECTS FOUND. FACTORIES, WORKSHOPS, WORKPLACES. KITCHENS OF RESTAURANTS, &c. KITCHENS OF LICENSED PREMISES. Totals. East District. Middle District. West District. East District. Middle District. West District. East District. Middle District. West District. Want of Cleanliness 124 179 8 43 46 25 27 19 13 484 Want of Ventilation 1 4 1 1 2 1 — — — 10 Overcrowding — — — — — — — — — — Want of Drainage of Floors 12 — — 5 — — 2 — — 19 Want of Lavatory Accommodation 1 — — — — — — — — 1 Food improperly stored 1 — — 1 8 2 2 2 — 16 Storage Cistern defective 4 41 34 4 2 10 3 2 24 124 Accommodation for Refuse 6 6 — 13 10 4 8 4 — 51 Accumulation of Refuse 23 5 12 6 7 5 — 1 5 64 Sanitary Accommodation. Insufficient (Tenancies) 3 2 — 1 1 — 1 — — 8 Unsuitable (Do.) 22 14 6 1 1 1 2 2 — 49 Defective (Do.) 139 92 161 27 27 18 10 5 3 482 Do. (No. of Conveniences)* 139 92 161 27 27 18 10 5 3 482 Not separate for Sexes (Tenancies) 4 6 4 2 1 1 1 — — 19 Other Nuisances 19 26 40 18 30 32 21 14 9 209 Total Defects found 359 375 266 122 135 99 77 49 54 1,536 * Figures not included in total defects found or remedied. K 70 DEFECTS REMEDIED. FACTORIES, WORKSHOPS, WORKPLACES. KITCHENS OF RESTAURANTS, Btc. KITCHENS OF LICENSED PREMISES. Totals. East District. Middle District. West District. East District. Middle District. West District. East District. Middle District. West District. Want of Cleanliness 122 173 9 37 49 29 26 23 9 477 Want of Ventilation 1 4 1 1 2 1 — l — 11 Overcrowding — — — — — — — — — — Want of Drainage of Floors 12 — — 3 — — 2 — — 17 Want of Lavatory Accommodation 1 — — — — — — — — 1 Food improperly stored 1 — — 1 8 2 2 3 — 17 Storage Cistern defective 4 43 27 4 1 14 3 3 25 124 Accommodation for Refuse 7 5 — 12 9 3 8 4 — 48 Accumulation of Refuse 27 4 15 6 6 5 — 1 3 67 Sanitary tion. Insufficient (Tenancies) 3 2 — 1 1 — 1 — — 8 Unsuitable (Do.) 21 11 8 1 1 2 2 2 — 48 Defective (Do.) 140 87 164 26 25 18 9 6 3 478 Do. (No. of Conveniences)* 140 87 164 26 25 18 9 6 3 478 Not separate for Sexes (Tenancies) 4 6 6 2 1 2 1 1 — 23 Other Nuisances 21 28 42 18 31 32 23 11 7 213 Total Defects remedied 364 363 272 112 134 108 77 55 47 1,532 ACTION TAKEN. East District. Middle District. West District. Totals. Matters referred to H.M. Inspector— Nuisances remediable by H.M. Inspector 2 13 — 15 Failure to affix Abstract 12 40 16 68 Matters referred by H.M. Inspector— Notified by H.M. Inspector 2 3 1 6 Reports sent to H.M. Inspector 2 3 1 6 Notices served— Factories—Intimation 16 47 16 79 Statutory — 1 2 3 Workshops—Intimation 20 21 7 48 Statutory 2 1 — 3 Workplaces, &c.—Intimation 3 3 — 6 Statutory — — — — Kitchens of Restaurants— Intimation 11 14 1 26 Statutory — — — — Kitchens of Licensed Premises— Intimation 7 3 5 15 Statutory — — — — Orders required from Sanitary Committee 6 4 1 11 Certificates for Cleansing issued by Medical Officer of Health — — — — Matters referred to District Inspectors 25 7 5 37 Matters referred to Women Inspectors — 1 — 1 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 — — — 1,248 Names and Addresses, &c., received from other Authorities — — — 472 Names and Addresses transmitted to other Authorities — — — 8,697 Notices served on Employers — — — 1,528 Letters written, &c. — — — 53 Firms visited 24 69 23 116 Outworkers' Lists not kept 3 45 7 55 Do. not sent 3 45 7 55 Infectious Disease occurring in Outworkers' Premises — — — — Registered Factories and Workshops at which Outwork is received— Inspections 124 131 55 310 Defects found 42 50 14 106 Defects remedied 42 50 14 106 "Places from which work is given out"— Inspections 31 87 27 145 Defects found 7 37 — 44 Defects remedied 7 37 — 44 *Figures not included in total defects found or remedied. 71 WOMAN INSPECTOR.  Domestic Workshops at which Outwork is received Inspections 2 Defects reported and appropriate action taken — Domestic Workshops which do not receive Outwork Inspections 1 Defects reported and appropriate action taken — Domestic Premises receiving Outwork (not registerable as Workshops). Inspections 10 Defects reported and appropriate action taken — Underground Conveniences for Women Inspections 152 Defects reported and appropriate action taken 5 Railway Stations (Ladies' Rooms) Inspections 83 Defects reported and appropriate action taken 10 Kitchens of Restaurants, &c. Initial Inspections (Tenancies) 53 Initial Inspections (Workrooms) 163 Periodical Inspections (Tenancies) 435 Periodical Inspections (Workrooms) 725 Re-inspections (Sanitary Works, &c., in hand) 67 Defects found 295 Notices | Intimation (Verbal) 121 Statutory — Matters referred to District Inspectors 47 Matters referred to Workshop Inspectors — 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 1934 1,182 1,196 8,702 9,898 K2 72 factories, workshops, workplaces and homework. 1.—Inspection of Factories, Workshops and Workplaces. Including Inspections made by Sanitary Inspectors. Premises. (1) Number of Inspections. (2) Written Notices. (3) Occupiers Prosecuted. (4) Factories (including Factory Laundries) 1,316 82 — Workshops (including Workshop Laundries) 868 51 — Workplaces (other than Outworkers' premises) 1,387 47 — Total 3,571 180 — 2.—Defects Found in Factories, Workshops and Workplaces. Particulars. (1) Number of Defects. Number of offences in respect of which Prosecutions were instituted. (5) Found. (2) Remedied. (3) Referred to H.M. Inspectors. (4) Nuisances under the Public Health Acts:—* Want of cleanliness 499 489 13 — Want of ventilation 26 25 1 — Overcrowding — — — — Want of drainage of floors 19 17 — — Other nuisances 646 623 1 — Sanitary accommodation insufficient 8 8 — — unsuitable or defective 614 609 — — not separate for sexes 19 23 — — 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 1,831 1,794 15 — •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. 73 3.—Home Work. NATURE OF WORK.* OUTWORKERS' LISTS, SECTION 107. OUTWORK IN UNWHOLESOME PREMISES, SECTION 108. OUTWORK IN INFECTED PREMISES, SECTIONS 109, 110. Lists received from Employers. Notices served on occupiers as to keeping or sending Lists. Prosecutions. Instances. Notices served. Prosecutions. Instances. Orders made (S. 110). Prosecutions (Sections 109, 110). Sending twice in the year. Sending once in the year. Failing to keep or permit inspection of lists. Failing to send lists. Lists.† Outworkers.† Lists. Outworkers. Contractors. Workmen. Contractors. Workmen. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) Wearing ADDarel— making, &c. 996 3,467 4,930 44 128 175 1,528 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) 86 263 195 7 14 5 Cables and Chains Anchors and Grapnels Cart Gear Locks, Latches and Keys Umbrellas, &c 36 15 159 — — — Artificial Flowers 6 — 15 — — — Nets, other than Wire Nets Tents Sacks Racquet and Tennis Balls Paper, &c., Boxes, Paper Bags 2 — 4 — — — Brush making 2 — 37 1 — 6 Pea picking Feather sorting Carding, &c., of Buttons, &c. Stuffed Toys 2 1 12 — — — Basket making Chocolates and sweetmeats Cosaques, Christmas Crackers, Christmas Stockings, &c Textile Weaving Total 1,130 3,746 5,352 52 142 186 1,528 Nil. Nil. Nil. Nil. Nil. Nil. Nil. Nil. * If an occupier gives out work of more than one of the classes specified in column 1, and subdivides his list in such a way as to show the number of workers in each class of work, the list should be included among those in column 2 (or 5 as the case may be) against the principal class only, but the outworkers should be assigned in columns 3 and 4 (or G and 7) into their respective classes. A footnote should be added to show that this has been done. † The figures required in columns 2, 3 and 4 are the total number of the lists received from those employers who comply strictly with the statutory duty of sending two lists each year and of the entries of names of outworkers in those lists. The entries in column 2 must necessarily be even numbers as there will be two lists for each employer—in some previous returns odd numbers have been inserted. The figures in columns 3 and 4 will usually be (approximately) double of the number of individual outworkers whose names are given, since in the February and August lists of the same employer the same outworker's name will often be repeated. 74 4.—Registered Workshops. Workshops on the Register (S. 131) at the end of the year. (1) Number. (2) Important classes of workshops, such as workshop bakehouses, may be enumerated here. General Workshops 1,050 Bakehouses (including Factory Bakehouses) 15 Total number of Workshops on Register *1,065 * These were found to be 1,566 Workrooms, &c., in places Registered. 5.—Other Matters. Class. (a) Number. (2) Matters notified to H.M. Inspector of Factories:— Failure to affix Abstract of the Factory and Workshop Act (S. 133, 1901) 68 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 6 Reports (of action taken) sent to H.M. Inspector 6 OtheR — Underground Bakehouses (S. 101):— Certificates granted during the year Nil. In use at the end of the year 10 Date, 31 st December, 1934. (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. Seventeen 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. removal of refuse from eating houses. Occasional complaints have been received of removal of refuse from restaurants by carts through City streets at hours when offices and business premises are open. The matter of refuse collection is regulated by the Statutory Rules and Orders of the Ministry of Transport, under the London Traffic Act, 1934. By Clause 2 of the London Traffic (Collection of Refuse) Regulations, the streets of the Metropolis, including the City, are divided into two categories, with 9 a.m. and 10 a.m. respectively as the times after which refuse shall not be collected from them, and 7 p.m. as the latest time at which either category can be legally kept clear of refuse carts. The Police are the authorities responsible for the administration of these Regulations, and complaints received by this Department are accordingly transferred to that Authority. 75 city mortuary. Bodies Received.—Post-Mortems and Inquests:— Bodies received at the Mortuary to await burial 121 Post-Mortem examinations made 81 Inquests held on bodies 69 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. 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 1933 233,821 114 71 77 2 Average for previous 5 years 262,519 142 117 81 2 1934 243,939 121 81 69 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. 458 Number of articles disinfected. 240,313 Fees received by the Corporation. £389 2s. Other disinfection and cleansing work carried out during the year is as follows:— Disinfection.—Infectious Disease:— Articles disinfected after cases of infectious disease 142 Library Books disinfected 34 Public Vehicles—Electric Ambulance and Police Litters 1 Cells at Police Stations 0 Premises disinfected (including offices) 273 Lockers disinfected at request of General Post Office Authorities 99 Horsehair (cases) 10 Cleansing of Persons Act, 1897 Number of verminous persons bathed 107 Number of articles of clothing disinfected 1,087 Cleansing of School Children:— Total number of children cleansed 1,154 Number of articles of clothing disinfected 2,352 63 articles of clothing were destroyed at request of owners. 3,701 other articles were also 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 1934 one body was placed in the apparatus. 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. 76 RAT REPRESSION. Rat repression work in the City has been carried on since June, 1934, by a Sanitary Inspector specially appointed for the purpose. Complaints continue to be received from tenants of many City buildings, although it is apparent from the inspections made that many more buildings are infested than are indicated by the complaints received. No legal responsibility rests-—under the Rats and Mice (Destruction) Act, 1919— upon the owner of occupied property, the necessity for action devolving upon the occupier. Herein lies one of the greatest difficulties for dealing with the problem. Rat proofing is and has been found to be one of the greatest factors for good in rat extermination. This work in many cases calls for alterations and additions to the structure of a building, work which cannot reasonably be asked of an occupier. It must be stated, however, that in many instances the owners, on being approached, have shown themselves willing to help in every way. Indeed, in a number of instances, it has been found that owners of properties have accepted a moral responsibility to deal with rat extermination entirely in their properties. Many of the empty properties in the City undoubtedly offer harbourage to rats, and wherever it is considered likely that an empty building has some bearing on the source of rat infestation in a certain area, the owner is communicated with and methods of disinfestation advised. (Legal responsibility rests with the owner in the case of unoccupied property.) It is not possible to give any indication of the total number of rats caught or killed in the City during 1934. Messrs. William Dalton & Sons, one of the firms principally engaged in this work in the City of London, inform me that they were responsible for the destruction of 14,969 rats during the year. Many of the big catering firms in the City employ their own rat catchers and exterminators. One of these firms has kept a record of their catch since August, 1934, and up to the 31st December, 1934, the total number caught was 1,964. In those cases where infestation is found to be severe, the employment of a rat catcher is recommended. In many instances requests are made to my Department for the recommendation of a rat catcher. In nine instances of such a recommendation being made, a total of 472 rats was caught. It must be said that rat infestation in the City of London is of a severe nature. It is apparent that no action is taken in many cases until the rats have obtained a firm hold on a building. It does not appear generally to be known that my Department is willing and anxious to offer advice to, and co-operate with, any firm whose premises are infested, no matter in what degree. It is often found that persons are spending considerable sums of money in tackling their problem in the wrong way. The value of rat proofing is certainly not appreciated to its full extent. It is not realised that tenants themselves are largely to blame for their occupancies becoming infested, owing to their carelessness with waste food, water supply, and accumulations of refuse, which provide the rat with its essential requirements. These are the first details which should receive attention in attacking the problem. The dilapidated dustbin and its contents are a great attraction to the rat. Trapping, poisoning, even rat catching, is largely a waste of time, effort and money, if these other matters are left unattended. Again, the lack of co-operation between tenants considerably lessens the success which would attend any united effort. Since it has been the task of my Department to concentrate upon this problem in the City of London, it has become increasingly evident that the action and methods taken against this pest have not resulted in a success proportionate to the great amount of money spent. It will be readily appreciated that a problem which has beset the City of London generally for a great many years cannot be completely solved in a short space of time. It is felt, however, that more co-operation between tenants, these exercising a more definite and logical means of exterminating the pest, with the advice and assistance which can be offered by my Department, would greatly reduce the infestation at present existing. 77 RATS AND MICE (DESTRUCTION) ACT, 1919. Summary, showing Investigations and Inspections Made and Details of Work Carried Out under the Above Act for the Year ended December 31st, 1934. 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. 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. Complaints or Applications for Advice. January 9 3.0 12 12 — 5 3 9 — — 1 17 289 236 16 — 8 February 6 2.3 6 6 1 3 2 5 2 - 1 13 10 — 6 March 6 1.8 6 6 — 2 1 3 4 — 2 12 10 — 5 April 5 2.5 5 5 — 2 — 3 1 — — 15 10 — 4 May 10 1.9 10 17 — 3 1 5 — — 1 20 18 — 7 June 23 1.0 23 23 2 6 1 5 — - — 22 8 — 10 July 34 2.7 37 107 7 6 11 17 8 - 9 36 26 - 28 August September 64 2.4 38 157 4 7 5 13 9 - 4 65 18 — 18 October 32 2.7 75 89 14 4 6 12 8 — — 70 — — 15 November 49 2.8 73 140 8 14 8 13 8 - 2 82 — — 26 December Totals 238 2.3 285 562 36 52 38 85 40 - 20 352 289 116 — 127 78 The following figures have been supplied to me by the City Engineer:— Brick sewers in course of reconstruction, 31st December, 1934 2 Brick sewers reinverted, pointed and repaired 19 Disused sewers filled in and abolished 4 Miscellaneous repairs to sewers, drains, etc. 40 House drains constructed in connection with new buildings 18 Drains of existing buildings reconstructed 14 New gullies and drains constructed 1 Gullies reconstructed 8 Gullies repaired 4 Gully drains reconstructed 44 Gully and house drains repaired 83 Disused gully and house drains bricked off 52 Number of rats destioyed by sewermen during the year, exclusive of those which died from poisoning 922 Thirty-five lbs. of rat poison was used in the sewers during the year. The number of drainage reconstructions carried out under the supervision of inspectors of this Department is set out on page 77. MEDICAL EXAMINATIONS. In accordance with the Standing Order of the Court that no person shall enter the employ of the Corporation or of any of its Committees without previously passing a medical examination to the satisfaction of the Committee having cognizance of the appointment, 80 persons were examined by the Medical Officer of Health during 1934. Two of these persons were reported as physically unfit for office. Seventeen officers were also medically examined with a view to their retirement. With two exceptions, all were reported to be unfit for duty. I have the honour to be, Gentlemen, Your obedient Servant, W. M. WILLOUGHBY, Medical Officer of Health for the City of London. Public Health Department, Guildhall, E.C. APPENDICES. PAGE Appendix A—Street Lists of Mortality 80 „ B— „ „ Infectious Diseases 84 „ C—Register of Houses let in lodgings or occupied by members of more than one family 87 „ D—List of Adoptive Acts, Orders, Bye-laws and Regulations in operation in the City 88 „ E—Compulsory Notification of Chicken-pox. Form of Notice 88 l2 80 APPENDIX A.—STREET LISTS OF MORTALITY. STREET OR PLACE. No. of House Sex. Age. Date of Death. Cause of Death. Remarks. Albion Buildings, Flat 11 — F 37 11th Aug. Syncope. Fatty degeneration of the heart, accelerated by alcohol. P.M. Aldgate 25/ 26 M 58 16th Feb. la. Cardiac failure Died in St. Peter's Hospital. b. Chr. Bronchitis c. Emphysema Aldgate Station, Met. Rly. — F Newly born. 28th Dec. 1933. Suffocation. Inattention at birth. No evidence as to how caused Aldersgate Street, Manchester Hotel. M 56 4 th Oct. Syncope. Haemorrhage due to ruptured vessel in right apex of lung, following tuberculosis. P.M. Natural causes. Resided at Wembley. Aldersgate Street 130 M 77 6th Oct. Myocardial failure, following Coronary Artery disease. P.M. Natural causes „ 187 M 86 9th May la. Broncho-pneumonia b. Chronic Nephritis „ 187 M 52 18th Aug. la. Uræmia b. Cerebral Hæmorrhage c. Cirrhosis Arthur Street 17/ 19 F 29 2nd Jan. la. Lobar Pneumonia Died in St. Peter's Hospital. Austin Friars 25 F 69 13th Mar. la. Cardiac failure b. Bronchial Asthma Bank Station, Central London Line. M 38 11th Dec. Shock and Hæmorrhage. Multiple injuries. Fall in front of train. P.M. Inquest. Misadventure Resided at Chingford. Bartholomew House 6 F 78 6th July "Syncope," due to ruptured Aorta. P.M. Natural death Basinghall Street 17 M 72 6th Jan. la. Heart failure Died in Italian Hospital, Holborn. b. Pneumonia 2. Myocarditis Elephantiasis „ 22 F 47 19th Oct. Hypostatic Pneumonia. Cerebral Embolism. Auricular fibrillation Died in St. Peter's Hospital. „ Girdlers' Hall. M 62 2nd Aug. la. Syncope Resided at Bayswater. b. Cerebral Hæmorrhage c. Arterio-sclerosis 2. Diabetic Mellitis Broad Street Station, L. M. & S. Rly. — F Newly born. 17th Aug. Cause of death not ascertainable by P.M. Inq. Found dead. Bucklersbury 1/2 F 68 23rd Mar. Broncho-pneumonia Died in St. Peter's Hospital. Cannon Street 21 M 63 10th Mar. la. Auricular fibrillation b. Myocardial degeneration 2. Gastric Hæmorrhage „ 87 F 62 9th Oct. la. Malignant Ovarian Cyst (Carcinoma) Died in Shoreditch. 2. Peritonitis and drainage by operation „ 135 F 60 18th Sept. la. Asthenia Died in St. Peter's Hospital. b. Secondary deposits c. Carcinoma of breast Cannon St. Rly. Station — M 41 5th Sept. Shock. Hæmorrhage and multiple injuries. Run over by an engine. Inq. Resided in Bermondsey. Camomile Street 36 M 63 23rd Mar. Pulmonary Tuberculosis Cloth Fair 43 M 68 20th Dec. Tub. Pericarditis. Coroner. P.M. Died in St. Peter's Hospital. Clothier Street 4 M 36 10th Jan. la. Myocardial disease Coleman Street 19 F 85 1st Oct. Senile decay Died in Hackney. „ 81 M 62 8th Jan. Syncope (Heart failure). Coronary thrombosis. Myocardial degeneration. P.M. Resided at Walthamstow. College Street, Innholders' Hall. — M 34 13th Mar. Tubercle of Lungs Died at Lewisham. Crown Place 7 F 73 1st June Hypostatic Pneumonia. Senility—fractured neck of right femur. Fall on stairs. P.M. Inq. Accidental Died in St. Peter's Hospital, Stepney. Dean Street, B Block 3a F 73 17th Apr. la. Cardiac failure Died in St. Peter's Hospital, Stepney. b. Auricular fibrillation Duke Street 18 F 52 5th Mar. la. Lobar Pneumonia. (Left apex and right base) Dyers' Buildings 4 M 62 19th Sept. Syncope due to occlusion of left Coronary Artery, following marked Atheroma of Aorta and Coronary Arteries. P.M. Resided at Islington. East Harding Street 14 F 71 30th Dec., 1933. la. Broncho-pneumonia Died in Royal Free Hosital. b. Bronchiectasis c. Bronchitis Fann Street, Chapel House — F 78 3rd Jan. la. Broncho-pneumonia Died in Archway Hospital. Fenchurch Buildings 1 F 64 21st Feb. la. Valvular disease of Heart (Aortic) Fenchurch Street 22 M 54 14th Sept. Syncope from fatty degeneration of heart. P.M. Natural causes Resided at Enfield. „ 65 M 53 29th Apr. la. Myocardial failure Died in London Hospital. b. Hyperpiesia „ 135 F 85 21st Jan. la. Broncho-pneumonia b. Cerebral Thrombosis c. Old age—Atheroma of Cerebral vessels 81 STREET LISTS OF MORTAL ITY—continued. STREET OR PLACE. No. of House Sex. Age. Date of Death. Cause of Death. Remarks. Founders' Court, Lothbury. — M 11 mos. 14th July la. Gastro-enteritis Died in St. Bartholomew's Hospital. Godliman Street 16 F 93 25th Jan. Myocardial degeneration Died in St. Peter's Hospital. Goodman's Yard 2 F 71 27th Apr. la. Asthenia b. Cerebral Hæmorrhage Great New Street 8 M 60 9th Aug. Syncope following ruptured Ulcers in the stomach. P.M. „ 13 F 68 4th June la. General Peritonitis Died in St. Peter's Hospital, Stepney. b. Perforation Ileum c. Intestinal obstruction 2. Divertianlitis Great Tower Street 92 M 70 19 th Mar. Carcinoma of stomach Died in St. Peter's Hospital, Stepney. Gutter Lane 17 F 72 23rd Oct. la. Cerebral Hæmorrhage Died in St. Peter's Hospital, Stepney. b. Atheroma generalised Holborn Viaduct — F 48 1st Jan. Hæmorrhage in the pons and medulla of the brain Resided at Wickford, Essex. „ 53 F 83 3rd May la. Hæmorrhage Died in St. Peter's Hospital. b. Carcinoma of Bladder Hosier Lane 21 M 27 20th July la. Lobar Pneumonia Died in St. Bartholomew's Hospital. 2. Calcification of suprarenals Houndsditch 149 M 74 6th May la. Broncho-pneumonia b. Cardio-vascular degeneration c. Thrombosis of Cerebral Arteries 2. Hemiplegia (right side). Cardiac failure Hutchison Avenue 22 M 71 20th Oct. la. Amyotrophic lateral Sclerosis Died in Jewish Hospital, Tottenham. 2. Myocardiac degeneration King's Bench Walk, Temple. 9 M 73 4th Nov. Syncope due to heart disease. Hypertrophy of heart. Myocardial degeneration. P.M. Natural Resided at West Norwood. King's Block, Stoney Lane 6 F 86 12th Sept. la. Pulmonary Neoplasm „ 21 M 37 3rd Mar. la. Cerebral Embolism Died in London Hospital. b. Infective Endocarditis King William Street, Regis House. — M 66 29th Oct. Syncope. Myocardial degeneration. Disease of Coronary Arteries. P.M. Resided outside City. Leadenhall Street 122 F 5 hrs. 31st Mar. la. Cardiac failure Died in Middlesex Hospital Annexe, St. Pan- b. Prematurity „ 122 M 57 5th Nov. Syncope. Valvular heart disease, much hypertrophy of the heart. P.M. Natural causes Resided at Earls Court Lime Street 14 M 71 25th Feb. la. Acute Gastric Dilatation Died in Metropolitan Hospital. b. following operation two days previously 2. For excision of Gastric Ulcer „ 50 M 63 21st Dec. Myocardial failure and Chronic Nephritis. Coronary vessels almost occluded. Inq. Natural Resided at Bromley,Kent. Little Britain 48 M 52 18th Nov. Syncope. Internal Hæmorrhage from Gastric Ulcer. P.M. Liverpool Street, Gt. Eastern Hotel. M 60 28th Apr. Syncope due to strangulation by necktie hung on door hook. P.M. Inq. Suicide —unsound mind Resided in Lancashire. Liverpool Street Station, L.& N.E.R. — M 64 8th Feb. Syncope and shock. Hæmorrhage from cut throat. P.M. Inquest. Suicide. Resided at Hammersmith. „ „ F 76 5th Mar. Atheroma and Thrombosis of the left Coronary Artery and rupture of the left ventricle of the heart Resided at Walthamstow. „ (In train) — M 47 12th Nov. Syncope. Atheroma and Thrombosis of the left Coronary Artery. P.M. Natural Resided in Holland. Lloyds Avenue 4 M 65 13th Sept. Syncope from Coronary Thrombosis. Natural causes. P.M. Resided at Finchley. London Street 2 M 49 4th Jan. Acute Primary Pneumonia Coronary. P.M. Died in Royal Northern Hospital. London Wall Buildings 2 M 52 13th Dec. Occlusion of left Coronary Artery. Myocardial degeneration. P.M. Resided at Sutton. Long Lane 76 F 63 2nd Mar. la. Acute Bronchitis Died in St. Peter's Hospital. 2. Myocardial degeneration Lower Thames Street 73 M 68 16th July la. Cachexia b. Carcinoma of cardiac end of stomach „ 73 F 25 16th Aug. Syncope while suffering from Tuberculosis of lungs and kidneys. P.M. Ludgate Hill 56 F 27 4th Feb. la. Tuberculosis Enteritis Died in St. Colomba's Hospital. b. Tuberculosis pulmonary „ 72 M 4 30th Jan. Acute Bronchitis and Chronic Pneumonia Died in North-Western Hospital. Mark Lane 61 M 44 2nd July la. Cerebral Hæmorrhage Mark Lane Railway Station. M 60 21st Feb. Syncope and shock. Multiple injuries. Run over by motor train after falling on line. P.M. Inq. Accidental Resided at Sutton. Middle Street 5 F 63 12th Feb. Carcinoma (rectum) Died in St. Luke's Hospital, Paddington. 82 STREET LISTS OF MORTALITY—continued. STREET OR PLACE. No. of House Sex. Age. Date of Death. Cause of Death. Remarks. Middlesex Street 116 M 56 1st Jan. la. Broncho-pneumonia Died in St. Peter's Hospital. „ 116 M 71 9th Jan. 1a. Myocardial degeneration Died in St. Peter's Hospital. 2. Tabes Dorsalis „ 116 M 76 24th Jan. 1 a. Myocardial degeneration Died in City of London Infirmary, Bow Road. b. Chronic Bronchitis „ 116 M 65 1st Mar. la. Broncho-pneumonia Died in St. Peter's Hospital. „ 116 M 68 19th Mar. la. Cerebral Hæmorrhage Died at Islington. „ 116 M 71 30th Mar. la. Cardiac failure Died in St. Peter's Hospital. b. Chronic Bronchitis „1 118/ 122 M 24 24th Aug. la. Rt. Empyema Died in Stepney. b. Lobar Pneumonia 2. Operation. Pul. Tub. Minories 150 M 65 23rd July la. Epithelioma of face Died in St. Peter's Hospital. „ 155 M 47 29th Dec., 1933. la. Acute Cardiac dilatation Resided at Tooting. b. Morbis Cordis Moor Lane 3 M 42 11th Feb. la. Miliary Tuberculosis Died in Brompton Hospital. b. Pulmonary Tuberculosis 2. T.B. Laryngitis „ 6 F 61 14th Aug. la. Toxæmia Died in St. Peter's Hospital. b. Osteomyelitis Nevill's Court 9 M 68 12th July la. Asthenia—1. cardiac failure Died in St. Peter's Hospital. b. Carcinoma of Cæcum „ 9 M 73 22nd Nov. Hypostatic Pneumonia. Fractured femur. Fall at home. Inq. P.M. Accidental Died in St. Peter's Hospital. „ 11 F 4 mos. 5th Oct. la. Gastro-Enteritis Died in St. Bartholomew's Hospital. 2. Nævus on left shoulder. Ulceration New Broad Street 46/ 7 M 47 3rd Dec. Syncope due to severe Hæmorrhage from left lung. Extensive Pulmonary Tuberculosis of both lungs of some years' duration. P.M. Resided at Purley Oaks. New Court, Temple M 37 14th June la. Cerebral Hæmorrhage Died in St. Bartholomew's Hospital. b. Arterio-sclerosis c. Chronic Nephritis 2. Cirrhosis Hepatis New Street Hill 11 M 77 5th Sept. la. Carcinoma of the bladder b. Uræmia and suppression of urine Newbury Street 15 M 73 26th July Syncope. Myocardial degeneration. Atheroma of Aorta Died in St. Bartholomew's Hospital. North Block, Stoney Lane. 50 F 53 21st Aug. la. Secondary Metastasis b. Carcinoma Vulva Old Broad Street, Winchester House. — M 56 2nd Nov. 2. Diabetes Mellitus Carcinoma of bladder Died in Hornsey. Paternoster Row 47 M 20 23rd May la. Acute Toxic Scarlet Fever Died in South-Eastern Hospital. Philpot Lane 16 M 63 29th Aug. la. Heart block Resided at Southgate. b. Chronic Myocardial disease Pleydell Court 3 M 1 day 9th May la. Heart failure Died in St. Bartholomew's Hospital. b. Congenital abnormality of heart Plowden Buildings, Temple. 3 M 67 8th Apr. la. Lobar Pneumonia Died in Southwark. 2. Fibrosis of lung Plum Tree Court, City Temple House. F 59 27th Jan. Syncope. Pulmonary Embolism following injury to leg due to fall in street. P.M. Inq. Resided at Gorleston. Prince's Block, Stoney Lane. 21 M 51 27th Mar. la. Toxæmia Died in St. Peter's Hospital. b. Gangrenous Perinephritis c. Urethral Stricture Puddle Dock, Upper Thames Street. M 70 28th July Asphyxiation by drowning. Fall in River Thames. P.M. Inq. Misadventure Resided at New Kent Road. Queen Street Place 9 F 54 17th June la. Cardiac failure Died in Farnborough Hospital. b. Operation c. Perityphlitis Queen Victoria Street 14 M 60 10th Feb. 2. Chronic Interstitial Nephritis Lymphatic Leukaemia, accelerated by fracture of neck of femur, due to a fall. P.M. Accidental Died in Archway Hospital. „ 44 M 64 18th Dec. la. Cardiac failure Died in St. Bartholomew's Hospital. b. Enlarged Prostate „ 70 F 30 30th Oct. 2. Prostatectomy Shock and Syncope. Hæmorrhage from bullet in head. P.M. Inq. Suicide Resided at Croydon. Queen's Block, Stoney Lane. 8 M 75 10th Dec. la. Cachexia b. Carcinoma of Ascending Colon 2. Icterus—Secondaries in liver River Thames — M 39 24th Apr. Asphyxiation by drowning. P.M. Inq. Suicide unsound mind Resided at Muswell Hill. „ M 75 19th May Asphyxia by drowning. Inq. P.M. No evidence as to whether by accident or otherwise Resided at Sidcup. 83 STREET LISTS OF MORT ALITY—continued. STREET OR PLACE. No. of House Sex. Age. Date of Death. Cause of Death. Remarks. River Thames — M 27 10th Aug. Shock and immersion. Fell in river. Accelerated by fracture of Skull and Hæmorrhage. P.M. Misadventure Resided in Hackney. Rose Alley 51 M 10 mos. 3rd June la. Meningitis pneumococcal Died in St. Bartholomew's Hospital. 2. Broncho-pneumonia Salisbury Court 4/7 M 62 15th Oct. Syncope, due to ruptured heart from Myocardial degeneration and disease of Coronary Arteries Resided at Hove. St. Bartholomew's Hospital, Smithfield Gate. M 57 7th Jan. Syncope due to Coronary obstruction, due to Atheroma. Associated cause, old Rheumatic Carditis St. Mary Axe 68 M 45 16th Apr. la. Broncho-pneumonia Died in St. Bartholomew's Hospital. b. Operation for Duodenal Ulcer c. General Peritonitis St. Paul's Churchyard (Nicholson's). M 64 17th Nov. la. Cardiac failure Died at St. Bartholomew's Hospital. b. Myocardial degeneration c. Arterio-sclerosis 2. Oedema of Lungs. P.M. Serjeants' Inn 16 F 93 26th Mar. la. Arterio-sclerosis Died in Shoreditch. Stoney Lane 43 M 81 17th Jan. la. Cardiac Syncope b. Cerebral Embolism 2. Senility Temple Avenue, Temple Chambers. — F 3 wks. 8th Mar. la. Pulmonary Congestion Died at Bancroft Lodge, Stepney. 2. Marasmus Temple Lane 3 M 58 11th Apr. Broncho-pneumonia Myocardial degeneration Died in St. Peter's Hospital. Thavies Inn 17 M 65 14th Dec. Syncope. Myocardial degeneration (Fatty Heart). Chronic Bronchitis. Chronic Nephritis. P.M. Throgmorton Street 28 M 59 21st Dec., 1933. la. Hypostatic Pneumonia Died in St. Peter's Hospital. b. Chr. Bronchitis and Cardiac failure c. Myocardial degeneration Tokenhouse Buildings 4 F 73 16th May la. Cachexia b. Carcinoma of left Parotid Gland Trump Street 10 M 55 31st Oct. la. Broncho-pneumonia b. Tuberculosis both lungs Union Court 14 F 76 14th Oct. la. Carcinoma of Uterus, with secondary growth Died in City of London Infirmary, Bow Road. Upper Thames Street 19/ 21 F 60 21st Feb. Myocardial degeneration Hypostatic Congestion of lung Died in St. Peter's Hospital. „ 29 M 45 23rd Oct. Myocardial failure Coronary Occlusion. P.M. Died in ambulance on way to hospital. „ M 38 18th Dec. Fractured Skull and multiple injuries. Resided at Chadwell Sunlight Wharf. Fall from sill of window on to barge in Thames. P.M. Inquest. Misadventure Heath. Vine Street 2 M 74 23rd June la. Myocardial degeneration Died in City of London Infirmary, Bow Road. b. Tuberculous Caries of dorsal vertebrae (30 years) Walbrook 27 M 18 21st Sept. Drowning, caused by falling in river whilst suffering from a fit. Inq. Misadventure Died in Chiswick Warwick Lane 7 M 70 12th Mar. Syncope, due to Myocardial degeneration, following Atheroma of the Coronary Arteries Resided at Balham. Well Court, Queen Street M 83 19th Oct. la. Myocardial degeneration Resided at Sidcup. b. Arterio-sclerosis c. Senility Whitefriars Street 25 F 11 16th Aug. la. Heart failure Died in Italian Hospital, Queen Square. b. Pulmonary Tuberculosis Wine Office Court 17 F 82 11th June la. Congestive heart failure Died in St. Peter's Hospital. b. Myocardial degeneration and Chr. Bronchitis 84 APPENDIX B.—LIST OF CASES OF INFECTIOUS DISEASE OTHER THAN TUBERCULOSIS, 1934. STREET LISTS.—COMPILED FROM NOTIFICATIONS RECEIVED. Street or Place. No. of House. Sex. Age. Disease. Date of Notification. Albion Buildings, Flat 6 21 M 8 Chickenpox 28th February. Ditto do 21 M - Ditto 20th March. Ditto do 21 M 6 Measles 20th April. Ditto do 21 F 4 Ditto 20th April. Ditto do 21 M 8 Ditto 20th April. Aldersgate Street 27 F 3 Diphtheria 16th May. Ditto 40 F 11/12 Measles 18th April. Ditto 181 F 3 Ditto 9th May. Aldgate High Street 7 F 6 1/12 Ditto 1st February. Ditto 41 F 16 Diphtheria 4th September. Ditto 78 M 5 Chickenpox 30th May. Artillery Lane 20 F 6 1/2 Scarlet Fever 29th November. Barnet Mansions, Stoney Lane 2 F 40 Acute Primary Pneumonia 7th April. Ditto do. 3 M 22 Diphtheria 6th October. Basinghall Street 65 M 8 Scarlet Fever 25th April. Bearsted House 7 M 47 Erysipelas 28th March. Ditto 24 F 8 Measles 18th March. Ditto 24 M 40 Erysipelas 19th January. Bevis Marks 17 M 5 Measles 17th November. Billiter Square 10 M 5 Ditto 8th February. Bishopsgate 15 M 4 Chickenpox 4th September. Ditto 10 M 7 Ditto 5th December. Bloomfield House, King Street 18 M 14 Ditto 3rd May. Ditto 19 F 7 1/2 Ditto 22nd November. Botolph Lane 42 F 5 Measles 22nd February. Brackley Street 5 M 22 Chickenpox 8th November. Bride Lane, Ludgate Circus 19 F 5 Ditto 11th April. Bridgewater House 2 M 7 Ditto 9th February. Broad Street, Station Restaurant — F 42 Diphtheria 27th November. Ditto — F 5 Ditto 23rd November. Brushfield Street 12 M 6 Chickenpox 10th January. Byward Street 16 F 5 Ditto 18th June. Camomile Street 26 F 33 Diphtheria 15th December. Cannon Street 110 M 7 Chickenpox 5th December. Carter Lane 61 M 1 7/12 Ditto 4th January. Cloak Lane Police Station — M 2 Scarlet Fever 14th June. Ditto — M 5 Ditto 14th June. Ditto — F 7 Ditto 14th June. Cloth Fair 38 M 14 Measles 18th April. Coleman Street 52 M 5½ Ditto 6th March. Ditto 52 M 6½ Diphtheria 4th October. Creechurch Lane 41 M 6 Measles 3rd February. Crown Court, Warwick Lane — M 20 Scarlet Fever 5th February. Ditto — M 17 Ditto 12th February. Ditto — M 20 Ditto 23rd May. Ditto — M 24 Ditto 12th February. Ditto — M 18 Ditto 12th February. Ditto — M 18 Measles 23rd April. Ditto — M 20 Ditto 23rd April. Ditto — M 23 Ditto 23rd May. Crown Place 5 F 6 Scarlet Fever 3rd September. Dean Street 5f M 31 11/12 Measles 10th April. Ditto 8b M 12 Chickenpox 17th May. Devonshire Square 2 F 9 Measles 19th March. Dutton House 9 M 5½ Ditto 16th January. Ditto 9 F 3½ Ditto 16th January. Eastcheap 19 M 6 Ditto 2nd January. Farringdon Street 75 F 20 Scarlet Fever 27th June. Finch Lane, Cornhill 3 M 14 Ditto 9th June. Fleet Street 72 F 10 Chickenpox 24th February. Ditto 107 M 11 Ditto 5th December. 85 LIST OF CASES OF INFECTIOUS DISEASE OTHER THAN TUBERCULOSIS, 1934. STREET LISTS.—COMPILED FROM NOTIFICATIONS RECEIVED—continued. Street or Place. No. of House. Sex. Age. Disease. Date of Notification. Fleet Street 107 M 35 Chickenpox 22nd December. Ditto 176 F 11 Ditto 22nd December. Ditto 177b F 3 Scarlet Fever 5th February. Ditto Anderton's Hotel — F 40 Measles 16th April. Fenchurch Avenue 9-11 M 7 Chickenpox 5th December. Ditto 13 M 8 Ditto 7 th September. Fenchurch Buildings, Fenchurch Street 9/13 M 6 Ditto 15th May. Ditto 9/13 M 6 Scarlet Fever 18th June. Fenchurch Street 133 F 5 Measles 22nd February. Fetter Lane 83 M 1¾ Ditto 28th April. Gracechurch Street 19 M 40 Erysipelas 1st January. Ditto 94 M 8 Measles 18th February. Great New Street 21 M 4 Chickenpox 21st February. Ditto 21 M 2 Ditto 21st February. Ditto 21 M 6 Ditto 21st February. Ditto 21 F 13 Ditto 22nd February. Gunpowder Alley 8 F 13 Ditto 22nd February. Ditto 8 M 7 Ditto 22nd February. Ditto 8 F 2 Ditto 22nd February. Holborn Viaduct 53 M 13 Scarlet Fever 21st December. Ironmonger Lane 11 M 6 Ditto 27th February. John Street, Minories, " Ye Old Crutched Friars." — M 3½ Measles 7th May. Lambeth Hill, St. Nicholas's Rectory — M 19 Ditto 18th June. Leadenhall Street 44 M 13 Chickenpox 12th January. Lime Street 23a M 7 Measles 8th February. London Street, "Railway Tavern" — M 55 Acute Influenzal Pneumonia. 2nd January. Lower Thames Street, "Yarmouth Arms Hotel." — M 6 Measles 5th February. Ditto ditto — F 3 Ditto 16th February. Ludgate Hill 72 M 4 Scarlet Fever 31st January. Middle Street 1 F 7 Ditto 3rd August. Ditto 2 M 8 Measles 22nd January. Middlesex Street 116 M 24 Acute Primary Pneumonia 3rd January. Ditto 116 M 21 Cerebro-spinal Fever 28th March. Ditto 116 M 60 Erysipelas 25th July. Milk Street Buildings 2 F 3 Scarlet Fever 23rd February. Mincing Lane 41 M 4 4/12 Acute Poliomyelitis 28th September. Minories 54 M 19 Scarlet Fever 13th December. Ditto 76 M 4 Measles 6th April. Ditto 76 F 1 Ditto 17th April. Ditto 81 M 5-10 Ditto 22nd April. Ditto 81 F 10 Ditto 22nd April. Ditto 81 F 5 Ditto 22nd April. Ditto 136 M 6 Ditto 15th February. Ditto 136 M 7 Ditto 21st February. Ditto 136 M 6 Chickenpox 27th February. Montague Court 1 M 4 Ditto 30th January. Ditto 5 F 4 Ditto 30th July. Ditto 2 F 3 Ditto 30th January. Moorgate, Basildon House - F 6 Measles 1st February. Ditto - F 7 Diphtheria 16th October. Ditto 48 M 1 Measles 6th January. Ditto 83 M 6 10/12 Chickenpox 20th June. Moor Lane Chambers 16 F 5 Measles 22nd February. Nevill's Court 11 F 8 Chickenpox 21st February. Ditto 11 F 5 Ditto 10th April. Ditto 12 M 2 Scarlet Fever 19th June. New Broad Street 36 M 8 Chickenpox 5th December. Ditto 36 F 3 11/12 Ditto 14th December. New London Street 3 F 11½ Measles 28th February. North Block 47 F 1 9/12 Diphtheria 24th January. Old Broad Street 70 F 11 10/12 Chickenpox 27th February. m 86 LIST OF CASES OF INFECTIOUS DISEASES OTHER THAN TUBERCULOSIS, 1934. STREET LISTS.—COMPILED FROM NOTIFICATIONS RECEIVE D—conti nued. Street or Place. No. of House. Sex. Age. Disease. Date of Notification. Paternoster Row 23 M 29 Measles 8th May. Ditto 23 M 19 Ditto 10th May. Ditto 23 M 21 Ditto 11th May. Ditto 23 M 17 Ditto 15th May. 28, Prince's Block 28 M 59 Erysipelas 19th September. Prince's Block, Stoney Lane 41 F 5 Scarlet Fever 3rd May. Queen Street Place 9 F 53 Diphtheria 26th March. Queen Victoria Street 148 F 5 Chickenpox 6th March. Queen's Block 15 F 11 Scarlet Fever 15th November. Ditto 37 F 1 5/12 Ditto 21st November. Red Bull Wharf 2 F 10/12 Ditto 20th December. Ditto 2 M 2 11/12 Ditto 17th December. Red Cross Street (L.C.C. Fire Brigade) - F 9 Ditto 17th April. Ditto 53 M 5½ Chickenpox 27th July. Ditto 53 M 11 Ditto 16th July. Police Buildings, Bishopsgate 17 F 14½ Scarlet Fever 15th October. Rose Alley 11 M 7 Chickenpox 3rd December. Ditto 20 F 5 Measles 6th February. Ditto 22 M 5 Ditto 6th February. Ditto 29 F 7 Chickenpox 5th May. Ditto 29 M 15 Ditto 19th May. Ditto 33 F 8 Measles 2nd March. Ditto 51 F 6 3/12 Diphtheria 22nd February. Ditto 51 M 3 Measles 5th February. Ditto 51 M 2 Ditto 5th February. Ditto 51/52 F 6 3/12 Ditto 16th January. Ditto 51 F 8 Ditto 23rd January. Ditto 58 F 5 Ditto 5th February. St. Bartholomew's Hospital, Nurses' Home. - F 21 2/12 Scarlet Fever 20th January. Ditto ditto - F 21 10/12 Ditto 17th February. Ditto ditto — F 24 Ditto 4th March. Ditto ditto — F 23 Diphtheria 2nd April. Ditto ditto — F 24 Ditto 18th April. Ditto ditto — F 22½ Scarlet Fever 28th May. Ditto ditto — F 20½ Diphtheria 11th July. Ditto ditto — F 22 Scarlet Fever 5th July. Ditto ditto — F 21 9/12 Ditto 30th July. Ditto ditto — F 20 2/12 Ditto 31st August. Ditto ditto — F 28 Diphtheria 28th September. Ditto ditto — F 21 8/12 Ditto 30th July. Ditto ditto — M 34 Scarlet Fever 27th November. Ditto ditto — F 24 Ditto 5th December. St. Dunstan's Alley 4 F 18 Measles 27th April. St. Mary Axe 31 F 58 Erysipelas 31st May. St. Swithin's Lane 30 M 14 Chickenpox 14th April. South Block 5 M 25 Scarlet Fever 10th December. Ditto 15 F 41 Erysipelas 14th February. Ditto 17 M 6 Measles 6th March. Throgmorton Avenue 8 F 23 Diphtheria 26th October. Tudor Street 6 F 19 Measles 10th April. Upper Thames Street 6 & 8 M 13 Chickenpox 4th April. Ditto 6 & 8 M 5 Ditto 10th April. Ditto 6 & 8 F 5 Ditto 16th April. Ditto 6 & 8 M 4/12 Ditto 27th April. Ditto 135 M 5 Measles 21st February. Wood Street 47 M 17 Chickenpox 24th September. Ditto 47 M 17 Scarlet Fever 17th September. 87 APPENDIX C.—REGISTER OF HOUSES LET IN LODGINGS OR OCCUPIED BY MEMBERS OF MORE THAN ONE FAMILY. WEST DISTRICT. Situation of Premises. Name and Address of Owner or Tenant. Tenements. Lodgers. 43, Cloth Fair Messrs. J. Seeley & P. Paget, 41, Cloth Fair, E.C. (o) 2 3 10, East Harding Street Goldsmiths' Company, Goldsmiths' Hall (o) 2 7 12, do. Do. do. (o) 4 6 93, Fetter Lane Friern Manor Dairy Co., 3, Charles Street, Hatton Garden (o) 3 4 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) 12 17 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) 4 12 23, do. Mrs. J. Barnsley, 27, Great New Street (o) 3 13 25, do. Do. do. (o) 5 11 27, do Do. do. (t) 4 8 7a, 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) 5 7 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 (o) 2 8 8, Nevill's Court Moravian Mission, 32, Fetter Lane (o) 4 7 9, do.Do. do. (o) 8 11 10, do. Do. do. (o) 6 10 11, do. Goldsmiths' Company, Goldsmiths' Hall (o) 7 18 12, do. Do. do. (o) 4 9 14, Newbury Street Page & Steward, 2, Ironmonger Row (o) 2 6 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) 3 6 30 TOTAL 117 237 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 36 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 9 7, do. Do. do. (o) 4 12 9, do. I. J. & J. Mendes, Ltd., 113-125, Grove Street, E.l (o) 3 8 21, do. Clerk to Bishopsgate Institute, Bishopsgate (o) 2 4 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 H. Lewis, 3, Circus, Minories (t) 6 7 4, do. T. Davis, 4, do. (t) 6 14 5, do. T. Groves, 5, do. (t) 6 8 3, Three Crown Court, Mr. Martin, 14, Seething Lane (o) 3 3 Jewry Place. 18, Widegate Street S. Franks, 18, Widegate Street (t) 2 6 21, do. A. & A. Field, 95, Whitechapel Road (o) 5 7 24, do. W. I. Crane, 25, Widegate Street (t) 4 8 25, do. Do. do. (t) 3 8 2, Goodman's Yard Charrington, Brewers, Mile End Road (o) 3 3 Total 68 122 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 18 (O) Owner. (T) Tenant. 88 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. 6Sept., 1926. Demolition of Buildings City of London (Public Health) Act, 1902, Sec. 5 July, 1904. Ash Pits City of London (Various Powers) Act, 1900, Sec. 54 June, 1925. Business of Slaughterer of Poultry Public Health (London) Act, 1891 July, 1925. Rag and Bone Dealer London County Council (General Powers) Act, 1908, Sec. 9 Jan., 1927. REGULATIONS. Soda Water . Agreed regulations to control trade .1908. Kitchens of Restaurants and above- ground Bakehouses ditto ditto ditto Jan., 1904. Common Lodging Houses City of London Sewers Act, 1851 & 1897 Oct., 1902. House Drainage Regulations adopted by the CorporationSept., 1898. APPENDIX E. Corporation of Honbon. PUBLIC HEALTH DEPARTMENT. THE PUBLIC HEALTH (LONDON) ACT, 1891. Compulsory Notification of Chicken-pox. XTOTICE 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, 1934, Chicken-pox shall be a compulsorily notifiable disease within the City of London. BELL. Guildhall, London, E.C.2. 1st March, 1934.