Ac 434 Lon 61 REPORT OF THE MEDICAL OFFICER OF HEALTH OF THE CITY OF LONDON FOR THF. YEAR 1935 LONDON. Printed by Drake, Driver & Leaver, Ltd., Rosebery Avenue, E.C.I. 1936. REPORT OF THE MEDICAL OFFICER OF HEALTH OF THE CITY OF LONDON For the Year 1935. LONDON. Printed by Drake, Driver & Leaver, Ltd., Rosebery Avenue, E.C.I. 1936. . INDEX. A. page. ANNUAL RATEABLE VALUE 7 APPENDICES 77.86 AREA 7 ARTIFICIAL CREAM ACT, 1929 49 ARTIZANS' DWELLINGS, STONEY LANE 55, 56 ATMOSPHERIC POLLUTION AND SMOKE 2 AGRICULTURAL PRODUCE (GRADING AND MARKING) ACT, 1928 & 1931 47 B. BACTERIOLOGICAL EXAMINATIONS 16 BIRTHS 8 INFANT WELFARE 11,12 NOTIFICATION 11, 12 BLIND, WELFARE OF THE 13 BUTTER FACTORIES 49 c CLEANSING OF PERSONS ACT, 1897 71 CLEANSING OF SCHOOL CHILDREN 71 CREMATION 29, 30 COMMON LODGING HOUSES 59 CONGRESSES—ROYAL INSTITUTE OF PUBLIC HEALTH 29 —ROYAL SANITARY INSTITUTE 29 „ —SANITARY INSPECTORS' ASSOCIATION 2y D. DEATHS—CAUSES OF 9 DENSITY 7 DENTURES FOR MOTHERS AND EXPECTANT MOTHERS 12 DIPHTHERIA—ANTI.TOXIN 16 DISINFECTANTS, SUPPLY OF 71 DISINFECTION—INFECTIOUS DISEASES 71 DISINFECTION OF SECOND HAND CLOTHING 70 DRAINAGE PLANS 59 E. EXHUMATION AND REINTERMENT OF BODIES AT CITY OF LONDON CEMETERY 61 67/9, CHARTERHOUSE STREET 61 F. FACTORY AND WORKSHOP ACT, 1901—ABOVBGROUND BAKEHOUSES 63 ,, —FACTORIES, WORKSHOPS AND WORKPLACES 62 ,, —OUTWORKERS 63,66, 68 ,, —SUMMARY OF INSPECTIONS 64.66 ,, —SUMMARY OF WORK DONE 67 „ —UNDERGROUND BAKEHOUSES 63 FERTILISERS AND FEEDING STUFFS ACT, 1926 47 FISH SUPPLIES AND SEIZURES 41 FOOD AT RIVERSIDE WHARVES, INSPECTION AND CONDEMNATION 43.46 FOOD AND DRUGS—ADMINISTRATIVE ACTION REGARDING ADULTERATION, &c. 50, 51 ,, —PROSECUTIONS 54 „ —SUMMARY OF ARTICLES EXAMINED 52, 53 „ —SUPERVISION OF 48 G. GULLIES, STREET 60 H. HEALTH SERVICE SURVEY 70 HOUSES LET IN LODGINGS 58 HOUSE, TRADE AND OTHER REFUSE REMOVAL 60 HOUSING 59, 61.2 HUMAN REMAINS—EXHUMATION AND REINTERMENT AT CITY OF LONDON CEMETERY 61 „ 57/9, CHARTERHOUSE STREET 61 I. ICE CREAM 70 INFANTILE MORTALITY 8 INFANT WELFARE 11 INFECTIOUS DISEASE 13.15 —BACTERIOLOGICAL AND PATHOLOGICAL EXAMINATIONS 16 —DIPHTHERIA ANTI.TOXIN 13.15 —NOTIFICATION OF 14, 15 —NURSING PROVISION—MEASLES, ENCEPHALITIS LETHARGICA, CEREBROSPINAL FEVER AND INFLUENZA 16 „ —SMALLPOX . . 16 INQUESTS •.... 70 INSULIN, PROVISION OF 16 INTRODUCTION 7 INDEX (continued). L. PAGE. LEGAL PROCEEDINGS—SANITARY 60 LIMEWASHING OF COURTS 60 L.C.C. (G.P.) ACT, 1932—PREPARATION OF PRESERVED MEAT, &c 43 LODGING HOUSES, COMMON—116, MIDDLESEX STREET 59 „ ,, REGISTERED 58 M. MARGARINE, REGISTRATION OF DEALERS IN MARGARINE AND MARGARINE CHEESE 49 MATERNITY AND CHILD WELFARE 11, 12 MEAT INSPECTION 31.41 ,, „ —CASEOUS LYMPHADENITIS 38 „ „ —DELIVERY AT CENTRAL MARKETS 40 —DEMONSTRATIONS AND INSTRUCTION 39 „ —EXPORT OF MEAT 39 „ .HOME.KILLED MEAT SEIZED 33 —LEADENHALL MARKET AND CITY SHOPS 37 —LIVESTOCK IMPORTED 31 „ —PROSECUTIONS 39 ,, —PUBLIC HEALTH (MEAT) REGULATIONS, 1924 42 —SEIZURES OF IMPORTED MEAT 38,39 „ —UNSOUND MEAT REMOVED FROM COLD STORES 37 MEDICAL EXAMINATIONS 75 MERCHANDISE MARKS (IMPORTED GOODS), No. 7. ORDER AND EXEMPTION DIRECTION, No. 1, 1935 47 MIDWIVES—SERVICE OF SALARIED MIDWIVES 12 MILK—BACTERIOLOGICAL AND CHEMICAL EXAMINATIONS FOR TUBERCULOSIS AND DIRT (RAILWAY STATIONS) 54, 55 ,, —CHEMICAL EXAMINATION OF 49 „ —PUBLIC HEALTH (CONDENSED MILK) REGULATIONS, 1923 4 1927 49 „ —PUBLIC HEALTH (DRIED MILK) REGULATIONS, 1923 4 1927 49 „ —MILK AND DAIRIES (AMENDMENT) ACT, 1922 49 „ —MILK AND DAIRIES ORDER, 1926 49 ,, —(SPECIAL DESIGNATIONS) ORDER, 1923 54 MORTALITY 8 —INFANTILE 8 —MATERNAL 12 „ —VIOLENCE 8 ,, —PHTHISIS 8 „ —ZYMOTICS 8 MORTUARY—DISINFECTION OF CLOTHING FOR EXPORT, INQUESTS, 4c. 70 —PRESERVATION OF BODIES OF UNKNOWN DEAD 71 N. NOTIFICATION OF BIRTHS ACT, 1907, AND INFANT WELFARE WORK 11, 12 NURSING PROVISIONS 16 O. OUTWORKERS 83, 88, 68 OVERCROWDING 60 P. PIGEONS—L.C.C. (GENERAL POWERS) ACT, 1927 61 POPULATION 7 POST.GRADUATE NURSING COURSE 16 PRESERVED MEAT, 4c., PREPARATION OF—L.C.C. (G.P.) ACT, 1932 43 PUBLIC HEALTH—(CONDENSED MILK) REGULATIONS, 1923 & 1927 49 —(DRIED MILK) REGULATIONS, 1923 4 1927 49 —(LONDON) BILL 70 ,, —(MEAT) REGULATIONS, 1924 42 —(PREVENTION OF TUBERCULOSIS) REGULATIONS, 1925 16 „ ,, —(TUBERCULOSIS) REGULATIONS, 1930 27 R. RAILWAY STATIONS—SAMPLES OF MILK 54, 55 RATEABLE VALUE 7 RAT REPRESSION 71.74 REFUSE—COLLECTION AND DISPOSAL 60 s. SANITARY DEFECTS AND INFECTIOUS DISEASES SANITARY INSPECTIONS 57 SCHOOL CHILDREN, MILK FOR 12 SEWER, DEFECTIVE CONNECTIONS 60 SHOPS ACT, 1934 69 SMALLPOX 16 SMOKE AND ATMOSPHERIC POLLUTION 28 SMOKE EMISSION AND HOUSING 29 STAFF 5 STREET CLEANSING 61 STREET GULLIES 81 SWIMMING BATHS 29 T. TUBERCULOSIS 20.27 —PUBLIC HEALTH (PREVENTION OF TUBERCULOSIS) REGULATIONS, 1925 16 —PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1930 27 —TRAINING OF HEALTH VISITORS 16 V. VACCINATION 10 VENEREAL DISEASES 17.19 VIOLENT DEATHS 8 VITAL STATISTICS 10 w. WHARVES—INSPECTION OF FOOD AT 43.46 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 Office r Nov., 1902 Gray, Charles M 1st Class Assistant Marrh, 1911 Blunt, Harold F 2nd Class Assistant May, 1924 Stout, James Erl July, 1930 Threadgold, Arthur W. 3rd Class Assistants Nov., 1923 Pettit, Richard G Jan., 1934 Tunbridge, Mrs. Jan., 1917 Seymour, K. D Peters, E. Unclassified July, 1935 Nov., 1935 Wilson, C. Jan., 1936 SANITARY INSPECTORS. Robinson, Ernest S Feb., 1913 Fowler, George Henry Oct., 1920 McGrath, William Richard Grade I. Mar., 1922 Harrington, George Edwin Dec., 1925 Sillet, David Ernest April, 1926 Neale, William G.C. July, 1928 Thorpe, Robert C March, 1930 Webber, G. A. (Rat Officer) Grade II July, 1932 Hudson, Leslie A VJlQUC AX. April, 1934 Aldhous, H. J April, 1935 (One vacant) — 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 Dec., 1910 Mitchener, William E. Dec., 1910 Jones, John Grade I. Inspector April, 1914 Slatter, Charles May, 1908 Murray, Samuel B Sept., 1911 Mellish, Cyril E Jan., 1912 Thompson, Frank E Grade II. Inspector July, 1924 Perris, G. A Dec., 1923 Cann, S. W May, 1927 Peyton, H. R Sept., 1932 Bernhardt, D. R Grade III. Inspector May, 1931 Lee, W. R July, 1930 WOMAN SANITARY INSPECIOR. Wilkinson, Miss Annie M July, 1909 TUBERCULOSIS SISTER AND HEALTH VISITOR. Backhouse, Miss S. A June, 1931 TUBERCULOSIS NURSE AND ASST. HEALTH VISITOR. Cook, Miss M. H. April, 1935 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 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 1935. To the Right Honourable The Lord Mayor, Aldermen and Commons of the Corporation of London. Public Health Department, Guildhall, E.C. May, 1936. My Lord Mayor and Gentlemen, I have the honour to present my ninth Annual Report on the work of the Medical Officer of Health for the City of London. 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.—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 £61,336,166, on April 6th, 1935, whilst on the same date the corresponding rateable value of property in the City of London was £8,946,725, or about one.seventh of the whole County. The annual sum receivable from a penny rate is £34,250. Population.—The undermentioned figures are extracted from the Report of the Registrar.General on the Census of England and Wales, 1921:— Statute Acres. Inhabited Houses. Population. Private Families. 1921. 1911. 1931. 1911. 1931. 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. b2 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 — Census.) 1931 10,808 There is only one registration district in the City. The estimated population of the City, for the year 1935, is 9,360. 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 1935, 378 live births were registered in the City, 345 of which, however, did not belong thereto. To the remaining 33 must be added the births of 38 children born to citizens temporarily residing outside the City boundary. The number of births, therefore, on which the rate should be calculated is 71. There were two still births. The annual birth-rate was 7.6 per 1,000 persons of all ages, compared with a quinquennial mean rate of 7.1 per 1,000. In the Metropolis the birth-rate in 1935 was 13 -3 per 1,000. Mortality.—During the year under review, 572 deaths were registered in the District, including 525 persons dying in the City, but not belonging thereto. Deducting these latter, 47 deaths remain, to which must be added those of 56 persons who died in outside districts, where they were registered; the total, therefore, on which the City death-rate is calculated is 103. See table, p. 10, for details. The death-rate for 1935 was 11.0 per 1,000 per annum of the population (the previous year being 10.5), whilst that for the whole of the Metropolis was 11.4. Deaths from Violence.—Of the City deaths, 9.7 per cent, were caused by injuries or violence, as compared with 4.6 in 1933 and 3.9 in 1934. This is 3.1 above the average for the previous five years. percentage of registered deaths from violence. Year. City of London. Per cent. Metropolis. Per cent. 1930 8.5 5.5 1931 5.9 5.7 1932 10.2 4.6 1933 4.6 4.7 1934 3.9 5.6 Average previous five years 6.6 5.2 1935 9.7 4.5 death rates, per 1,000 per annum. Year. City of London. 121 Great Towns of England and Wales. Metropolis. 1930 120 11.5 11.4 1931 12.5 12.3 12.4 1932 12.8 12.2 12.3 1932 10.9 12.2 12.2 1934 10.5 11.8 11.9 Average previous five years 11.8 120 12.0 1935 110 11.8 11.4 The death.rate from zymotic disease per 1,000 of the population was 0.1. The deaths from Phthisis correspond to a rate of 0.8 per 1,000 of the population, as compared with 0 .68 in the Metropolis. Infantile Mortality.—The deaths of children under one year of age were at the rate of 113 per 1,000 births, as against 58 for the whole of London. 9 causes of, and ages at, death during the year 1935. Causes of Death. Nbtt 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 Jnder 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'45 and under under 45 55 years, years. 55 and under 65 years. 65 and under 75 years. 75 and upwards. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. All Causes. 103 8 .... .... 2 3 3 4 20 18 22 23 472 l. Typhoid and Paratyphoid Fevers .... .... .... .... .... .... .... .... .... .... .... .... .... 2. Measles .... .... .... .... .... .... .... .... .... .... .... .... .... 3. Scarlet Fever .... .... .... .... .... .... .... .... .... .... .... .... 1 4. Whooping Cough .... .... .... .... .... .... .... .... .... .... .... .... .... 5. Diphtheria .... .... .... .... .... .... .... .... .... .... .... .... 1 6. Influenza 1 .... .... .... .... .... .... .... .... .... 1 .... 1 7. Encephalitis Lethargica .... .... .... .... .... .... .... .... .... .... .... .... .... 8. Cerebro.spinal Fever 1 .... .... .... 1 .... .... .... .... .... .... .... 2 9. Tuberculosis of Respiratory System 8 .... .... .... .... 1 .... 2 3 2 .... .... 9 10. Other Tuberculous Diseases 2 .... .... .... .... 1 .... .... 1 .... .... .... 8 11. Syphilis 1 .... .... .... .... .... .... .... .... 1 .... .... .... 12. General Paralysis of the Insane, Tabes Dorsalis .... .... .... .... .... .... .... .... .... .... .... .... ....« 13. Cancer, Malignant Disease 19 .... .... .... .... .... .... 2 5 4 5 3 83 14. Diabetes 1 .... .... .... .... .... .... .... .... .... 1 .... 9 15. Cerebral Haemorrhage, &c. 4 .... .... .... .... .... .... .... 1 .... 2 1 11 16. Heart Disease 24 .... .... .... .... 1 1 .... 3 1 6 12 33 17. Aneurysm 2 .... .... .... .... .... .... .... 1 1 .... .... 1 18. Other Circulatory Diseases 4 .... .... .... .... .... .... .... 1 .... 2 1 9 19. Bronchitis 4 .... .... .... .... .... .... .... .... 1 .... 3 3 20. Pneumonia (all forms) 5 .... .... .... .... .... .... .... 2 1 1 1 36 21. Other Respiratory Diseases .... .... .... .... .... .... .... .... .... .... .... .... 7 22. Peptic Ulcer .... .... .... .... .... .... .... .... .... .... .... .... 22 23. Diarrhoea, &c. 1 1 .... .... .... .... .... .... .... .... .... .... 8 24. Appendicitis .... .... .... .... .... .... .... .... .... .... .... .... 11 25. Cirrhosis of Liver 1 .... .... .... .... .... .... .... 1 .... .... .... 5 26. Other Diseases of Liver, &c. 1 .... .... .... .... .... .... .... .... .... 1 .... 3 27. Other Digestive Diseases .... .... .... .... .... .... .... .... .... .... .... .... 1 28. Acute and Chronic Nephritis 2 .... .... .... .... .... .... .... .... 1 .... 1 38 29. Puerperal Sepsis 1 .... .... .... .... .... 1 .... .... .... .... .... 2 30. Other Puerperal Causes .... .... .... .... .... .... .... .... .... .... .... .... .... 31. Congenital Debility, Premature Birth, Malformations, &c. 3 3 .... .... .... .... .... .... .... .... .... .... 16 32. Senility .... .... .... .... .... .... .... .... .... .... .... .... 1 33. Suicide 2 .... .... .... .... .... .... .... 2 .... .... .... 2 34. Other Violence 8 3 .... .... 1 .... 1 .... .... 3 .... .... 36 35. Other Defined Causes 8 1 .... .... .... .... .... .... .... 3 3 1 113 36. Causes ill.defined or unknown .... .... .... .... .... .... .... .... .... .... .... .... .... Totals 103 8 .... .... 2 3 3 4 20 18 22 23 472 10 vital statistics of whole district during 1935 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. Under 1 Year of Age. At all Ages. of Nonresidents registered in the District. of Residents not registered in the District. Number. Rate. Number. Rate per 1,000 nett Births. Number. Rate. 1 2 3 4 5 6 7 8 9 10 11 12 13 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 1934 9,660 382 66 6.8 670 69.36 628 59 8 121 101 10 5 Average previous 5 years 10,196 405 73 7.1 648 63.77 592 62 5 79 121 11.7 1935 9,360 378 71 7.6 572 61.11 525 56 8 113 103 11.0 Area of City of London in acres (land and inland water) 661 Total population at all ages 13,709 Number of inhabited houses 2,922 Average number of persons per house 4.6 j At Census 1921. Vaccination.—Of the 370 births notified to the Vaccination Officer during 1934, 136 had been successfully vaccinated by the end of 1935, 17 had died before the age for vaccination and 0 were reported as insusceptible. Vaccination was postponed by medical certificate in 1 case, 135 had removed into other districts. There were 81 instances of conscientious objection. The Public Vaccinator performed 12 re.vaccinations during the year, and in addition to the 136 successful vaccinations referred to above, 6 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 removed at the end of the year. Conscientious objections 1930 436 per cent. 22.1 per cent. Nil. per cent. Nil. per cent. 2.3 per cent. 0.5 per cent. 48.9 per cent. 26.2 1931 413 24.7 )) l» 2.6 0.2 53.1 19.4 1932 413 41.7 0.7 ft 3.4 0.3 33.1 21.3 1933 396 36.7 0.7 » 4.5 0.2 35.4 22.5 1934 371 315 Nil. " 4.0 1.1 416 21*8 Average previous 5 years. 406 31.3 0.3 ft 3.4 0.5 42.4 22.2 1935 370 36.9 Nil. ft 4.5 02 36.5 21.9 11 MATERNITY AND CHILD WELFARE. Four hundred and twenty.five notifications of births, including 16 still births, made in accordance with the requirements of the Notification of Births Act, were received. Of these, 63 only referred to City births, and the balance were transferred to the appropriate authorities. There were two still births. Fifty.four initial visits were made as a consequence of these notifications, and 1,513 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 1935. There were no notifications of verminous school children under the London County Council (General Powers) Act, 1904. No visit was made in connection with infant life protection and two in connection with cases of Ophthalmia. The lying.in accommodation provided by the City Corporation at St. Bartholomew's Hospital, in accordance with the provisions of the Local Government Act, 1929, was utilized in connection with only one birth during 1935. 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 continued actively during 1935. There were 97 sessions held of the Welfare Centre and four special sessions for the immunisation of children against diphtheria. The attendances totalled 1,782. In addition to this, 1,367 home visits were paid by the Health Visitors. It will be seen that, with an annual birth registration of about 63, this activity effectively covers the babies and young children living in the City and provides a very satisfactory health service. Dr. Franklin returned from America during 1935 and resumed his work in the Welfare Centre. During this year, also, the immunisation of children against diphtheria has started. Altogether, 26 have been immunised, which may be counted a fairly satisfactory figure as a start—the majority of parents waiting to see the effect of the immunisation on other children before agreeing to have their own done. It has proved necessary to hold extra sessions for purposes of immunisation; the technique cannot be satisfactorily carried out and the cases properly supervised at the regular sessions without causing much waiting and delay for the mothers normally attending. The success of the clinic has depended on the energy and enthusiasm that has been shown by the Health Visitor, Miss Backhouse, and the Assistant Health Visitor, Miss Cook; their work must be very strongly commended. Besides the home visits, weekly talks are given to the mothers on Mothercraft and on various subjects connected with the prevention of disease in their children. Owing to the energy of the Health Visitors and the co.ordination of the Welfare Centre with the work of the Hospital, the undertaking may be regarded as a very effective weapon in the prevention of disease. 12 The following is a tabulated statement of the work carried out by the Health Visiting Staff in the above connection:— maternity and child welfare, 1935. Birth Notifications received 63. Infant Welfare Centre. 97 Sessions:— Under 1 year 674 Total 1,782 Over 1 year 1,108 attendances. Mothers attended during year 109 „ left City ,, ,, 37 No. Children becoming over 5 during year 35 Total visits 1,525:— Under 1 year 462 Over 1 to 5 years 905 Ante.Natal 146 Ophthalmia 2 Deaths under 1 year 7 Still Births 3 Infant Life Protection 0 L.C.C. Reports for schools 0 Scabies 0 MATERNAL MORTALITY. The enquiries into maternal deaths, which the Ministry of Health has required to be conducted, has not called for any particular organisation in my Department. With a small City resident population, few deaths in this category are reported. Where such cases do occur, investigations are conducted by me. One case was reported during 1935. It may be of interest to note that, from 1900 to 1935 inclusive, only 17 maternal deaths have occurred amongst City residents. a service of salaried midwives. The institution of a service of salaried midwives has been the subject of consideration during the year, and although in the City of London, I do not think that such an appointment will be necessary, in more thickly.populated areas they would fill a very useful vacancy in social service work. The question as to whether these should be under the control of the County Council or the authority charged with the administration of the Maternity and Child Welfare Acts is one which is the subject of controversy. maternity and child welfare. Provision of Dentures for Mothers and Expectant Mothers. For some time past I have felt that work in connection with the Corporation maternity and child welfare responsibilities has been to some extent handicapped by the fact that some of the City mothers in urgent need of dental treatment have not been in a position to meet the necessary cost, and after consideration of the circumstances, the Public Health Committee decided to make this provision, which is authorised under Section 1 of the Maternity and Child Welfare Act, 1918, in cases where I am satisfied that it is essential in the interests of the mother and that the financial circumstances of the individual justifies it. provision of milk for school children. The Milk Act, 1934, authorised a scheme for the provision of milk for school children and has as its object the increase in the demand for milk in schools by lowering the price to scholars who are young children and young persons attending schools or courses for unemployed boys or girls recognised for grant by the Board of Education. The special price to these consumers is ½d. per⅓ pint and the milk is supplied in ⅓-pint bottles. Free milk is also provided in cases where children are unable to pay and where necessity is certified by the Education Authorities' Medical Officer. A scheme for the detailed and administrative control has been put into operation and, so far as London is concerned, it has been agreed that milk supplied under the scheme shall be pasteurised milk and comply with the Milk (Special Designations) Order, 1923. Fifteen samples for bacteriological examination have been taken from time to time by your officers of these milks as delivered to the various schools in the City where the scheme is in operation with, in every case, satisfactory results. At the same time, duplicate samples were taken for chemical analysis, and these proved to be genuine. I understand that the scheme has met with an encouraging reception. The scheme follows the good results of controlled experiments in schools, which indicate that children on milk are better in health, brighter in mind and grow faster than comparable children having no milk. It has also been shown that milk, if acting only as an additional nutriment, has an advantage over other experimental nutriment, and one would expect that the general effect of the scheme will be improvement in the well.being of those on whose behalf the scheme has been introduced. 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—i.e., a medical practitioner in charge of the ophthalmic department of a General Hospital, or one holding a recognised diploma in ophthalmology, or one who, by reason of special experience in the practice of ophthalmology, is fully competent to secure a correct and just certification. (3) A form of certification designed to be at once a certificate and a record for compilation of statistics of scientific value, which should be used in every case of blindness placed upon the register. The Minister and Board of Education have authorised the Prevention of Blindness Committee to collate and tabulate the statistics for the use of local authorities. An appendix to the circular gives intimate technical directions for the use of the certifying ophthalmologist and a definition of blindness for the purposes of the Blind Persons Act, 1920. For registration the person must be "so blind as to be unable to perform any work for which eyesight is essential," i.e., not his ordinary or any particular work, but any work. It is recognised in this stringency, however, that a person with 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 of the Valuation Committee as regards blind persons in the City of London, report that, for the year 1935, the number of blind persons was 13. Of these, 9 are males and four females, two being between the ages of 21 and 40, two between 40 and 50, four between 50 and 65, one between 65 and 70, and four over 70. Blindness occurred in five cases after the age of 50 and in eight cases below 50. In four of the latter cases it took place below 30, and in three cases below 20. Two of the blind persons in the City are employed, one as a masseur and one as a telephone operator. The remainder are unemployable. The Authorities of St. Bartholomew's Hospital have been asked and have agreed to entertain an arrangement by which examination and certification on the prescribed form be made by any one of the specially qualified Hospital Ophthalmologists at a fee of £2 2s. It seems probable that the services of an ophthalmologist will be but rarely required. No action has been necessary during 1935. INFECTIOUS DISEASES. Sixty.eight cases of infectious disease were notified or reported during the year 1935. 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 again been extended to 18th day of March, 1936. Appropriate notice to interested parties was given, a copy of which is reproduced in Appendix of this Report. In each instance of notified disease a detailed examination is made of the sanitary condition of the premises where the case occurred and a summary of defects found by the District Inspector is given on page 60. In the following tables will be found particulars relating to cases of infectious disease, and information as to the removal of patients to hospitals. c 14 statistics of notifications and removals to hospital. NAME OF DISEASE. Number of Notifications received. Treated at Home. Removed to the L.C.C. Special Hospitals. Removed to the London Fever Hospital. Treated at other Hospitals and Institutions. Duplicate Certificates received. Diagnosis subsequently found to be incorrect. Net number of Cases. Small.pox .... .... .... .... .... .... .... .... Diphtheria 20 .... 18 1 .... 1 4 15 Scarlet Fever 30 1 26 2 .... 1 1 28 Enteric Fever (including Para.typhoid) Puerperal Fever 2 .... 1 .... 1 .... 1 1 Puerperal Pyrexia 1 .... .... .... 1 .... .... 1 Erysipelas 5 2 .... .... 2 1 .... 4 Cerebro.spinal Meningitis 1 .... .... .... 1 .... .... 1 Acute Polio.myelitis .... .... .... .... .... .... .... .... Ophthalmia Neonatorum 2 2 .... .... .... .... .... 2 Malaria contracted abroad .... .... .... .... .... .... .... .... Acute Primary Pneumonia 2 .... .... .... 2 .... .... 2 Acute Influenzal Pneumonia .... .... .... .... .... .... .... .... Encephalitis Lethargica .... .... .... .... .... .... .... .... Food poisoning or suspected food poisoning Amoebic Dysentery .... .... .... .... .... .... .... .... Chicken.pox 14 14 .... .... .... .... .... 14 Totals 77 19 45 3 7 3 6 68 Measles .... .... .... .... .... .... .... .... Totals 77 19 45 3 7 3 6 68 15 cases of infectious disease and tuberculosis notified during the year 1935. NUMBER OF ACTUAL CASES NOTIFIED. DISEASES. At Ages—Years. No. ot Cases Removed toHos pital. At all ages. Under 1 year. 1 year and under 2 years. 2 years and under 3 years. 3 years and under 4 years. 4 years and under 5 years. t years and under 10 years. 10 years and under 15 years. 15 years and under 20 years. 20 years and under 35 years. 35 years and under 45 years. 45 years and under 65 years. 65 years and over. Small.pox .... .... .... .... .... .... .... .... .... .... .... .... .... .... Cholera .... .... .... .... .... .... .... .... .... .... .... .... .... .... Plague .... .... .... .... .... .... .... ... .... .... .... .... .... .... Diphthria 15 .... .... .... .... l 3 2 2 5 l l .... 15 Erysipelas 4 l .... .... .... .... .... .... .... .... .... 2 .... 2 Scarlet Fever 28 .... l l 2 .... 2 2 6 14 .... .... .... 27 Typhus „ .... .... .... .... .... .... .... .... .... .... .... .... .... .... Enteric „ (including Para.typhoid) 1 .... .... .... .... .... .... .... .... 1 .... .... .... 1 Relapsing „ .... .... .... .... .... .... .... .... .... .... .... .... .... .... Continued ,, .... .... .... .... .... .... .... .... .... .... .... .... .... .... Puerperal „ .... .... .... .... .... .... .... .... .... .... .... .... .... .... Puerperal Pyrexia 1 .... .... .... .... .... .... .... .... 1 .... .... .... 1 Polio.myelitis .... .... .... .... .... .... .... .... .... .... .... .... .... .... Cerebro.spinal Meningitis 1 .... .... .... .... .... .... 1 .... .... .... .... .... 1 Pulmonary Tuberculosis 19 .... .... .... .... .... .... .... 1 7 4 7 .... 14 Other forms of Tuberculosis 7 .... .... .... .... 2 .... .... .... 3 .... 2 .... 6 Ophthalmia Neonatorum 2 2 .... .... .... .... .... .... .... .... .... .... .... .... Measles .... .... .... .... .... .... .... .... .... .... .... .... .... .... Rubella .... .... .... .... .... .... .... .... .... .... .... .... .... .... Chicken.pox 14 .... 1 .... .... 1 4 6 2 .... .... .... .... .... Malaria (contracted abroad) .... .... .... .... .... .... .... .... .... .... .... .... .... .... Acute Primary Pneumonia 2 .... .... .... .... .... .... .... .... .... .... 2 .... 2 Acute Influenzal Pneumonia .... .... .... .... .... .... .... .... .... .... .... .... .... .... Encephalitis Lethargica .... .... .... .... .... .... .... .... .... .... .... .... .... .... Amoebic Dysentery .... .... .... .... .... .... .... .... .... .... .... .... .... .... Food Poisoning .... .... .... .... .... .... .... .... .... .... .... .... .... .... Totals 94 3 2 1 2 4 9 11 11 31 5 14 1 69 * L.C.C. Hospitals, London Fever Hospital, St. Bartholomew's Hospital, City Police Hospital, Sanatoria, &c. 16 small.pox. No case of Small.pox occurred during the year in persons resident or employed in the City. Thirteen passengers from two ships reported to have had Small.pox on board were notified as proceeding to addresses in the City. The usual enquiry was made and, where necessary, the passengers were kept under observation. 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 1935. 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 1935. 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 10.3 per cent, of these cases. Specimens. Disease Suspected. Result. Positive. Negative. 32 Swabbines from throats Diphtheria 3 29 7 Sputa Tuberculosis 1 6 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 above. mentioned Regulations, which provide for the exercise of some control over persons suffering from Tuberculous affections and 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. post.graduate nursing course. With the approval of the Public Health Committee, the Tuberculosis Sister and Health Visitor, and the Assistant Health Visitor, attended a special post.graduate nursing course, organised by the College of Nursing, during the early part of the summer. 17 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 927. The following is a brief summary of the work carried out during 1935:— At the beginning of the year 534 males and 201 females were registered on the books as being under treatment or observation, which compares with 524 males and 203 females at the beginning of the previous year. Of these patients, 359 males and 172 females were under treatment for syphilis, 174 males and 19 females for gonorrhoea, and 1 male and no females for soft chancre. No males and 10 females were under treatment for conditions other than venereal disease. New patients admitted totalled 927, as compared with 1,073 in the previous year, the total attendances were 31,214. Unfortunately, 225 cases discharged themselves before completion of treatment, and 172, although completing treatment, failed to submit themselves to final test. Fifty.seven males and 33 females were transferred to other centres after treatment, whilst 428 males and 119 females were discharged after completion of treatment and observation. There were 6 in.patients. I he total number ot attendances is made up as lollows:— Syphilis. Soft Chancre. Gonorrhoea. Non.Venereal Conditions. Total Attendances. Male. Female. Male. Female. Male. Female. Male. Female. Male. Female. 13,572 8,215 30 7,430 1,104 586 267 21,628 9,586 In the laboratories associated with the Centre, 8,709 specimens were examined, 23 for the detection of spirochetes, 1,465 for gonococci, 6,114 examinations for the Wassermann or Serum test, and 307 for other examinations. Ihe following tabulation indicates the number ot patients coming under treatment lor the first time from the Counties stated, and also the examinations which were made for the detection of Spirochetes, of Gonococci, and for the Wassermann or Serum test in respect of these patients:— No. of patients treated. For Examinations. For Syphilis. Soft Chancre. ror Gonorrhoea. or Non.Venereal Conditions. or Spirochetes. For Gonococci. •or Wassermann or Serum Test Reactions. London Essex Herts. Surrey Kent Totals 158 3 1 4 2 168 17 17 263 7 1 7 4 282 365 11 1 10 4 391 23 23 1,429 9 2 19 6 1,465 1,994 3 1 111 3 2,112 The following summary shows the work carried out during each year that the Centre has been in operation. New Patients. Year. Men. Women. Total. Total Attendances. " 606." Bismuth. Mercury. In.Pts. Path. Ex. 1917 207 87 294 2,340 1,193 .... 339 22 372 1918 304 176 480 8,353 1,406 .... 1,391 71 421 1919 606 201 807 15,269 1,763 .... 1,782 45 2,485 1920 799 254 1,053 21,689 3,690 .... 2,800 41 6,005 1921 570 188 758 18,216 3,584 .... 2,859 52 5,241 1922 469 117 586 16,702 2,637 .... 2,851 23 4,774 1923 367 98 465 14,710 2,049 .... 2,130 9 6,832 1924 301 116 417 10,890 1,510 1,368 1,503 1 7,040 1925 314 88 402 10,541 1,782 1,198 1,192 1 5,835 1926 399 86 485 11,656 1,869 1,539 764 3 6,351 1927 340 80 420 12,501 1,723 2,124 362 2 6,266 1928 395 81 476 13,051 1,785 2,781 2 0 6,932 1929 396 102 498 14,095 1,580 3,042 .... 0 6,822 1930 816 257 1,073 20,694 2,601 5,509 .... 11 8,212 1931 853 209 1,062 26,378 4,175 6,860 .... 24 8,555 1932 785 196 981 26,069 4,916 7,021 .... 5 8,282 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 1935 725 202 *927 31,214 2,967 6,448 3,229 6 8,709 Totals 9,347 2,923 4,330 336,875 50,382 55,736 21,186 327 126,212 18 RETURN RELATING TO ALL PERSONS WHO WERE TREATED AT THE TREATMENT CENTRE AT ST. BARTHOLOMEW'S HOSPITAL DURING THE YEAR ENDED THE 31st DECEMBER, 1935. Syphilis. Soft Chancre. Gonorrhoea. Conditions other than venereal. Totals. m. F. | m. 1 F- | m. F. m. F. m. F- Totals. 1. Number of cases on 1st January under treatment or observation 359 172 1 .... 174 19 .... 10 534 201 735 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 18 12 .... .... 34 5 .... .... 52 17 69 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 14 2 .... .... .... .... .... .... 14 2 16 „ secondary 22 19 .... .... .... .... .... .... 22 19 41 „ latent in 1st year of infection .... .... .... .... .... .... .... .... .... .... .... „ all later stages 61 33 .... .... .... .... .... .... 61 33 94 „ congenital 8 6 .... .... .... .... .... .... 8 6 14 Soft Chancre .... .... 17 .... .... .... .... .... 17 17 Gonorrhoea, 1st year of infection .... .... .... .... 204 32 .... .... 204 32 236 ,, later .... .... .... .... 43 .... .... .... 43 .... 43 Conditions other than venereal .... .... .... .... .... .... 300 91 300 91 391 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 1 2 .... .... 3 .... .... .... .... 2 6 Totals of Items 1, 2, 3 and 4 483 246 18 .... 458 56 300 101 1,259 403 1,662 6. Number of cases discharged after completion of treatment and final tests of cure (see Item 15) 37 12 13 .... 78 16 300 91 428 119 547 6. Number of cases which ceased to attend before completion of treatment and were, on first attendance, suffering from :— Syphilis, primary 10 .... .... .... .... .... .... .... 10 .... 10 ,, secondary 24 9 .... .... .... .... .... .... 24 9 33 ,, latent in 1st year of infection .... .... .... .... .... .... .... .... .... .... .... „ all later stages 57 9 .... .... .... .... .... .... 57 9 66 ,, congenital 2 4 .... .... .... .... .... .... 2 4 6 Soft Chancre .... .... .... .... .... .... .... .... .... .... .... Gonorrhoea, 1st year of infection .... .... .... .... 52 8 .... .... 52 8 60 „ later .... .... .... .... 50 .... .... .... 50 .... 50 7. Number of cases which ceased to attend after completion of treatment but before final tests of cure (see Item 15) 30 18 1 .... 112 11 .... .... 143 29 172 8. Number of cases transferred to other Centres or to institutions, or to care of private practitioners:— 45 23 .... .... 12 10 .... .... 57 33 90 9. Number of cases remaining under treatment or observation on 31st December 278 171 4 .... 154 11 .... 10 436 192 628 Totals of Items 5, 6, 7, 8 and 9 (These totals should agree with those of Items 1, 2, 3 and 4.) 483 246 18 .... 458 56 300 101 1,259 403 1,662 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 .... .... .... .... .... .... .... 2 .... 2 „ secondary 8 7 .... .... .... .... .... .... 8 7 15 „ latent in 1st year of infection .... .... .... .... .... .... .... .... .... .... „ all later stages 29 8 .... .... .... .... .... .... 29 8 37 „ congenital 2 5 .... .... .... .... .... .... 2 5 7 11. Number of attendances:— (a) for individual attention of the medical officers 13,572 8,215 30 .... 3,189 553 586 267 17,377 9,035 26,412 (6) for intermediate treatment, e.g., irrigation, dressing .... .... .... .... 4,251 551 .... .... 4,251 551 4,802 Total Attendances 13,572 8,215 30 .... 7,440 1,104 586 267 21,628 9,586 31,214 12. In-patients:— (a) Total number of persons admitted for treatment during the year 2 1 .... .... 3 .... .... .... 5 1 6 (6) Aggregate number of "inpatient days " of treatment given 10 16 .... .... 53 .... .... .... 63 16 79 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, 1935.—continued. Under 1 year. 1 and under 5 yeare. 5 and under 15 years. 15 years and over. Totals. m. m. F. m. F. m. F. m. F. 13. Number of cases of congenital syphilis in Item 3 above classified according to age periods 1 1 2 3 5 2 2 8 8 Approved Arsenobenzene Compounds. Mercury. Bismuth. 14. Chief preparations used in treatment of Syphilis:— (a) Names of preparations Neovalvarsan. Sil. Salvarsan. Neokharsavan. Neovarsenobil. Collosal Mercury Sulp. Bis. Oxychloride & Collosal Metal. (b) Total number of injections given (out.patients and in.patients) 2,967 3,229 6,448 15. Are the tests recommended in Memo. Vai as amended by Memo. V31» followed in deciding as to the discharge of the patient after treatment and observation for syphilis and gonorrhoea? Yes. If not. in what way are they modified ? — Microscopical Serum Tests 16. Pathological Work:— for Spirochetes. for Gonococci. Wassermann. Others for Syphilis. for Gonorrhoea. (a) Number of specimens examined at, and by the medical officer of, the treatment centre. .... .... .... .... .... (b) Number of specimens from patients attending at the Treatment Centre sent for examination to an approved laboratory 23 1,465 1,088 865 159 Statement Showing the Services rendered at the Treatment Centre during the year, classified according to the areas in which the patients resided. Name of County or County Borough (or Country in the case of persons residing elsewhere than in England and Wales) to be inserted in these headings. London. Essex. Herts. Surrey. Kent. Total. a. Number of cases in Items 3 and 4 from each area found to be suffering from:— Syphilis 158 3 1 4 2 .... .... .... 168 Soft Chancre 17 .... .... .... .... .... .... .... 17 Gonorrhoea 263 7 1 7 4 .... .... .... 282 Conditions other than venereal 365 11 1 10 4 .... .... .... 391 Total 803 21 3 21 10 .... .... .... 858 B. Total number of attendances of all patients residing in each area 30,677 187 91 184 75 .... .... .... 31,214 C. Aggregate number of "In.patient days" of all patients residing in each area 79 .... .... .... .... .... .... .... 79 d. Number of doses of approved arsenobenzene compounds given in the outpatient Clinic and in.patient Department to patients residing in each area 2,940 .... .... 24 3 .... .... .... 2,967 27th Jan., 1936. (Signed) KENNETH M. WALKER, Medical Officer of the Treatment Centre. 20 TUBERCULOSIS. The hours at which the Dispensary was open for diagnosis and treatment of Tuberculosis were :— Tuesdays 12.30 p.m.—2.30 p.m. 2.30 p.m.—4.30 p.m. For the Artificial Pneumothorax Clinic. 5.0 p.m.—7.0 p.m. Fridays 12.30 p.m. (New cases only.) 3.30 p.m.—4.30 p.m. In all, 253 sessions have been held. New Patients.—The number of new patients examined was 312, as compared with 291 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:— Referred to X.ray Department Resident. Non.Resident. Total. 49 298 347 Surgical „ 1 3 4 „ Dental „ 3 5 8 „ Throat „ 3 21 24 „ Pathological „ 2 4 6 „ Other „ 10 — 10 68 331 409 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. One resident and no non.resident patients were admitted for this and other purposes. Examination of Sputum.—The following is a summary:— City Residents. Non.Residents. Total.  Positive 3 6 9 Negative 10 83 93 Residential Treatment.—The number of patients for whom residential treatment was arranged was 116. Admitted to L.C.C. Institutions. Hospitals of Local Authorities. n.,ar St. Columbas Institution, .Co»nOS|£nse. Brompton Corpn. Expense. Total. Patients resident in the City5 19 3 3 30 Patients non.resident 62 10 14 — 86 67 29 17 3 116 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 52. In addition, 20 contacts were kept under observation. (ii.) Patients non.resident in the City. (a) Who work in the City. 21 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 116. Total Attendances:— Residents 340 Non.Residents 1,242 1,582 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. No case was admitted in 1935. 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. Three cases have been admitted under this scheme during the year. Artificial Pneumothorax.—Artificial pneumothorax treatment has been used again during the year. Artificial pneumothorax refills were done on 27 City and 225 non.City patients, in connection with the Dispensary. The Tuberculosis Sister and Nurse.—As an adjunct to the work at the Tuberculosis Clinic, the outside work of the Tuberculosis Sister and Nurse has been continued on the same lines as former years. Forty.five homes have been visited, and 180 visits made in connection with after.care and following up, and three in connection with City deaths. General.—The following information is supplied in accordance with the requirements of the Ministry of Health:— (i.) The Tuberculosis Dispensary is at St. Bartholomew's Hospital; the Tuberculosis Officer is Dr. F. H. Young, O.B.E.; one Tuberculosis Sister and one Tuberculosis Nurse are 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 doctors, 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 D 22 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 or Nurse. (vi.) Considerable use is made of X.rays from the point of view of diagnosis and decision as to method of treatment to be recommended. The usual methods of treatment have been continued in the Dispensary. Tuberculin has been used in a few cases. In addition, 3 City and 22 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, and the operations of thoracoplasty and phrenic evulsion have been performed. (vii.) Experience shows that when the disease is active, residence in an institution more quickly and certainly brings about arrest than when the treatment is attempted at home on sanatorium lines, and that the lessons learnt in the sanatorium are sometimes put into practice by the patient on his return home to his permanent advantage. (viii.) Dental treatment is provided by the Dental Department of St. Bartholomew's Hospital, and the Corporation defrays the whole or part of the cost of artificial dentures for necessitous cases. (ix.) Nursing in their own homes of patients resident in the City is one of the duties of the Tuberculosis Sister, but this year no visits in this connection were necessary. 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 Public Health Committee, on which two ladies are co.opted as members.f 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. For some time past the Tuberculosis Officer has been dissatisfied with the method in use in dealing with adult "contacts" of cases of pulmonary tuberculosis, and a new scheme has been used. The method previously used has been to examine each contact fully with X.rays at the time when the original case was discovered; if no evidence of tuberculous disease was discovered, the contact was seen periodically as long as contact was maintained † The present lady members of the Committee are Miss Crosby, and Lady Smith, J.P. 23 with the original case and for two years after this had ceased. The objection to this system was mainly psychological ; either the contact attended regularly and worried about the possibility of contracting tuberculous disease, or failed to attend after the first time owing to carelessness or fear that something would be discovered. In addition, there is a considerable change of population in and out of the City, and contacts who left the City were completely unprotected. Probably, owing to the fact that they had been examined and told originally that there was no evidence of tuberculosis, they were likely to be more negligent about symptoms than they normally would be. The number of people who subsequently develop pulmonary tuberculosis as a result of contact during adult life, provided they show no evidence of heavy tuberculous infection when they are X-rayed, is very small, and it seems possible that a considerable amount of psychological damage is being done by the present system. The new system is to examine each contact case thoroughly at the time when the original case is discovered. If no evidence of tuberculous disease or heavy tuberculous infection is discovered, they are informed of this and given a pamphlet telling them that there is no need to worry unless they develop any of the common symptoms which occur as a result of the onset of tuberculosis, and advising them of the course to take if symptoms do develop. The pamphlet which is given to them is shown in Appendix F. The method of dealing with non-adult contacts has not been changed, as most of the considerations noted above do not apply. Of course, this alteration of method does not mean that any abatement has been allowed in the hygienic measures which are applied to infectious cases. D2 24 25 SUPPLEMENTARY ANNUAL RETURN SHOWING IN SUMMARY FORM (A) THE CONDITION AT THE END OF 1935 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. 1935. 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. 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).1 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 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... f ... ... 1 ... 1 ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Children. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Disease not arrested. Adults. m ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 1 ... ... 1 1 ... 1 ... ... 1 1 3 1 ... 4 1 ... ... ... ... ... ... ... 2 2 f 1 1 ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... 1 ... ... 1 ... 1 ... ... 1 2 3 ... 2 5 3 ... ... 2 2 Children. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Condition not ascertained during the year 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... .... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... .... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Total on Dispensary Register at 31st December 4 2 2 1 5 ... ... ... ... ... 2 ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... ... 2 2 2 ... 1 1 2 ... 2 ... ... 2 1 4 1 ... 5 3 3 ... 2 5 4 ... ... 4 4 (b) Not now on Dispensary Register and reasons for removal there from. Discharged as Recovered Adults. m 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... F ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Children. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Lost sight of, or otherwise removed from Dispensary Register 22 2 16 3 21 5 ... 2 3 5 1 ... 3 2 5 8 1 ... 1 2 3 3 3 ... 6 3 1 3 1 5 4 1 1 2 4 5 1 ... 2 3 4 ... 2 1 3 5 1 1 ... 2 ... ... ... ... ... Dead. Adults m 1 1 2 6 9 1 ... 1 3 4 ... ... 1 3 4 1 ... 1 9 3 1 ... ... 1 1 ... ... ... 1 1 ... ... 1 9 3 1 ... 1 2 3 ... ... ... 1 1 ... ... ... ... ... 1 ... ... 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 25 3 18 12 33 6 ... 3 7 10 1 ... 5 7 12 9 1 1 4 6 4 3 3 1 7 3 1 3 3 7 4 1 2 5 8 7 1 1 4 6 4 ... 2 4 6 5 1 1 ... 2 1 ... ... 1 1 Grand Totals 29 5 20 13 38 6 ... 3 7 10 3 ... 5 7 12 10 1 1 4 6 4 3 3 1 7 4 1 3 5 9 6 1 3 6 10 7 3 1 4 8 5 4 3 4 11 8 4 1 2 7 5 ... ... 5 5 SUPPLEMENTARY ANNUAL RETURN SHOWING IN SUMMARY FORM (A) THE CONDITION AT THE END OF 1935 OF ALL PATIENTS REMAINING ON THE DISPENSARY REGISTER; AND (B) THE REASONS FOR THE REMOVAL OF ALL CASES WRITTEN OFF THE REGISTER. B.—NON-PULMONARY TUBERCULOSIS. Condition at the time of the last record made during the year to which the Return relates. Previous to 1926. 1926. 1927. 1928. 1929. 1930. 1931. 1932. 1933. 1934. 1935. Bones and Joints. Abdominal. Other Organs. Peripheral Glands. Total. Bones and Joints. Abdominal. Other Organs. Peripheral Glands. Total. Bones and Joints. Abdominal. Other Organs. Peripheral Glands. Total. Bones and Joints. Abdominal. Other Organs. Peripheral Glands. Total. Bones and Joints. Abdominal. Other Organs. Peripheral Glands. Total. Bones and Joints. | Abdominal. Other Organs. Peripheral Glands. Total. Bones and Joints. Abdominal. Other Organs. Peripheral Glands. Total. Bones and Joints. Abdominal. Other Organs. Peripheral Glands. Total. Bones and Joints. Abdominal. Other Organs. Peripheral Glands. Total. Bones and Joints. Abdominal. Other Organs. Peripheral Glands. Total. Bones and Joints. Abdominal. Other Organs. Peripheral Glands. | Total. (a) Remaining on Dispensary Register on 31st December. Disease arrested. Adults. M ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... F ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Children. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... ... ... Disease not arrested. Adults, M ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 F ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... ... ... Children ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 Condition not ascertained during the year ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Total on Dispensary Register at 31st December ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 1 ... ... ... 1 ... ... ... ... ... ... ... 1 ... 1 ... ... ... 2 2 ... ... ... ... ... 1 ... ... 1 2 Transferred to Pulmonary ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (b) Not now on Dispensary Register and reasons for removal therefrom. Discharged as Recovered Adults. M ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... F ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Children. 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Lost sight of or otherwise removed from Dispensary Register 6 1 1 3 11 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 3 12 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 ... ... ... ... ... 1 ... ... 1 2 (Signed) W. M. WILLOUGHBY, Chief Tuberculosis Officer. 26 RETURN SHOWING THE WORK OF THE DISPENSARY DURING THE YEAR 1935. CITY RESIDENTS. Diagnosis. Pulmonary. Non-Pulmonary. Total. Grand Total. Adults. Children. Adults. Children. Adults. Children. M. F. M. F. M. F. M. F. M. F. M. F. A.—NEW CASES examined during the year (excluding contacts):— (a) Definitely tuberculous 5 4 .... l ... ... ... 6 4 .... ... 10 18 (b) Diagnosis not completed .... .... .... .... .... .... .... .... .... .... .... .... .... (c) Non-tuberculous 3 5 8 B.—CONTACTS examined during the year:— (a) Definitely tuberculous .... .... .... .... .... .... .... l .... .... .... 1 1 20 (b) Diagnosis not completed .... .... .... .... .... .... .... .... .... .... .... .... .... (c) Non-tuberculous .... .... .... .... .... .... .... .... 5 10 3 1 19 C.—CASES written off the Dispensary Register as— .... .... .... .... .... .... .... .... .... .... .... .... .... .... (a) Recovered .... .... .... .... .... .... .... .... .... .... .... .... .... .... (b) Non-tuberculous (including any such cases previously diagnosed and entered on the Dispensary Register as tuberculous) .... .... .... .... .... .... .... .... 8 17 3 l 29 29 D.—NUMBER OF CASES on DisDensarv Register on December 31st:— (a) Definitely tuberculous 21 21 l .... 4 1 .... 2 25 22 1 2 50 50 (b) Diagnosis not completed .... .... .... .... .... .... .... .... .... .... .... .... .... 1. Number of cases on Dispensary Register on January 1st, 1935:— 52 2. Number of cases transferred from other areas and cases returned after discharge under Head 3 in previous years 3. Number of cases transferred toother areas, cases not desiring further assistance under the scheme, and cases "lost sight of" 8 4. Cases written off during the year as Dead (all causes) 3 5. Number of attendances at the Dispensary (including Contacts) 340 6. Number of Insured Persons under Domiciliary Treatment on the 31st December 28 7. Number of consultations with medical practitioners:— (a) Personal (b) Other 10 8. Number of visits by Tuberculosis Officers to homes (including personal consultations) — 9. Number of visits by Nurses or Health Visitors to Homes for Dispensary purposes 180 10. Number of (a) Specimens of sputum, etc., examined 13 (b) X-ray examinations made in connection with Dispensary work 60 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 25 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 80 46 4 1 2 4 .... 1 82 50 4 2 138 .... (b) Doubtfully tuberculous .... .... .... .... .... .... .... 6 6 .... 1 13 275 (c) Non-tuberculous .... .... .... .... .... .... .... 93 28 1 2 124 B.—Number of Tuberculous City workers attending Dispensary for treatment on Dec.31st, 1935 24 C - Number of Non-Resident and Non-Workers attending Dispensary for treatment on Dec. 31st, 1935 38 D.—Number of cases transferred to other areas or lost sight of 108 E.—Number of attendances at the Dispensary 1,242 F.—Number of consultations with Medical Practitioner 200 G.—Number of:—(a) Specimens of sputum, &c., examined 89 (6) X-Ray examinations made 287 27 public health (tuberculosis) regulations, 1930. part I. Summary of Notifications during the period from the 1st January, 1935, to the 31st December, 1935. Age Periods Formal Notifications. Total Notifications. Number of Primary Notifications of new cases of Tuberculosis. 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65- Total (all ages) Pulmonary Males Females ... ... ... ... 1 2 3 2 2 1 4 1 1 11 6 20 9 Non-Pulmonary Males l 2 1 1 5 5 ,, „ Females l 1 1 Col. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) PART II. SUPPLEMENTAL RETURN. New cases of Tuberculosis coming to the knowledge of the Medical Officer of Health during the above-mentioned period otherwise than by formal notification. Age Periods 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65- Total Pulmonary Males ... ... ... ... ... ... ... 1 ... ... ... 1 ,, Females Non-Pulmonary Males ... ... ... ... ... ... 1 .... 1 ... ... 2 ,, 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 l 2 transferable deaths from Registrar General ... ... Posthumous notifications ... ... " Transfers " from other areas (other than transferable deaths) ... ... Other sources, if any (specify) ... ... part iii. notification register. Pulmonary. N on - Pulmon a ry. Total Cases. Males Females Total Males Females Total Number of cases of Tuberculosis remaining at the 31st December, 1935, on the Register of Notifications 38 22 60 6 4 10 70 Number of cases removed from the Register(s) during the year by reason inter alia of :— 1. Withdrawal of notification ... ... ... ... ... ... ... 2. Recovery from the disease ... l 1 ... ... ... 1 3. Death 8 l 9 2 2 11 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-pulmonarv 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 11. (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 Summarv of Notifications and in the Supplemental Return for the same year. (e) In Counties, the particulars for theipurposes 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 1035, which are required to be furnished to the County Medical Officer of Health by the Medical Officer of Health of each District in the County, in pursuance of Article 10 (8) of the Regulations, and should represent the sum of the figures relating to each District in the County. If any of these quarterly statements has not been duly received by the County Medical Officer of Health, the Ministry should be furnished with particulars, including the name of the District caucrned. 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. Nineteen complaints of smoke nuisance or annoyance from chimneys were dealt with during the year, and 432 observations were made. Many of the offences were of a temporary character and did not recur. One intimation notice was served. 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 1935, 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 1935. Month ot the Year 1935. Place. 3 4 5 6 7 8 8 10 u 12 Rainfall mm. Metric tons per square kilometre. Insoluble matter. Soluble matter. Total solids. Included in soluble matter. Tar. Carbonaceous other than tar. Ash. Loss on ignition. Ash. Sulphates (S03). Chlorine (CI). Ammonia (NH,). January Meteorological Office 24.3 0.33 5.45 7.43 1.31 2.44 16.96 1.09 0.73 0.08 Golden Lane 138.04 0.56 5.67 7.76 36.80 48.25 99.103 27.65 8.61 0.85 Victoria Park 26.5 006 0.91 1.51 0.69 1.70 4.87 0.09 0.31 0.035 February Meteorological Office 51.3 017 1.45 2.49 0.51 2.36 6.98 0.70 0.53 0.02 Golden Lane 50.674 0.33 2.74 5.43 1.42 8.32 18.231 1.39 0.98 001 Victoria Park 44.5 0.25 3.77 8.19 0.45 2.31 14.97 1.07 0.44 0.06 March Meteorological Office 7.6 0.16 1.50 2 20 0.76 1.72 6.34 0.52 0.44 0.008 Golden Lane 11.705 0.12 1 96 0.78 1 .62 4.49 8.978 0.92 0.65 0.06 Victoria Park 7.8 0.09 1.43 1.41 0.44 1.03 4.40 0.48 0.20 0.04 April Meteorological Office 74.2 0.12 1.06 1.41 1.19 2.67 6.45 1 .12 0.55 0.01 Golden Lane 67.748 0.26 2.92 3.88 1.76 2.30 11.126 1.02 0.77 0.10 Victoria Park 49.9 0.14 2.17 4.07 0.60 2.60 9.58 1.23 0.32 0.07 May Meteorological Office 33.2 0.18 2.19 3.12 1.06 2.06 8.61 0.68 0.37 0.01 GoldenLane* 18.452 0.21 0.83 0.77 1.23 2.19 1.22 0.57 0.35 0.04 Victoria Park 33.3 005 0.92 1.69 040 1.46 4.52 0.60 0.27 0.05 June Meteorological Office 100.0 0.16 1 .16 1.25 1.80 3.80 8.17 1.54 0.38 0.02 Golden Lane 78.489 0.17 1.62 2.04 2.19 2.20 8.22 0.96 0.44 0.14 Victoria Park 66.6 0.06 107 2.38 0.53 2.40 6.44 0.96 0.24 0.07 July Meteorological Office 13.3 0.09 0.87 1.46 0.80 1.73 4.95 0.50 0.20 0.027 Golden Lane 12.118 0.16 0.03 0.11 1.73 0.89 1.928 0.30 0.22 0.03 Victoria Park 15.3 0.01 0.12 0.37 0.15 0.95 1.60 0.39 0.08 0.03 August Meteorological Office 51.1 0.11 0.96 1.51 0.61 1.53 4.72 0.66 0.07 0.02 Golden Lane 45.028 0.15 0.55 1.36 1.43 1.45 4.943 0.67 0 • .'2 0.06 Victoria Park 49.4 0.07 1.52 3.43 1 .19 3.30 9.57 1.25 0.32 0.035 September Meteorological Office 77.8 0.11 0.50 0.59 2.18 3.26 6.64 1.28 0.72 0.02 Golden Lane 61.965 0.25 1.47 2.82 2.11 1.98 8.634 1.20 0.80 0.01 Victoria Park 50.7 0.11 1.70 3.08 0.61 2.53 7.98 1.08 0.40 0.11 October Meteorological Office 63.8 0.12 0.88 1.06 1 .15 1.66 4.87 0.75 0.39 0.016 Golden Lane 78.214 0.28 2.70 4.24 2.82 7.97 18.011 3.48 1 .12 0.01 Victoria Park 67.3 0.10 1.43 3.14 0.54 1.75 6.96 0.79 0.22 0.04 November Meteorological Office 107.9 0.14 1.62 2.43 1 62 2.70 8.51 1.55 0.65 0.02 Golden Lane 84.686 1.27 0.27 4.60 2.88 1.35 10.369 0.76 0.78 0.27 Victoria Park ... ... ... ... ... ... ... ... ... ... December Meteorological Office 67.1 0.29 4.14 8.24 0.81 2.68 16.16 1.11 0.61 0.011 Golden Lane 61.965 0.34 1.25 419 3.34 3.72 12.847 1 .57 1 06 0.21 Victoria Park 52.3 0.10 2.06 3 35 1.05 2.09 8.65 1 .15 0.39 0.06 ♦Bottle overflowed. 29 SMOKE EMISSION AND HOUSING. At the request of the National Smoke Abatement Society, support was given to the following resolutions passed at the Annual General Meeting of that Society, and the Ministry of Health informed accordingly. Grit Emission.—" Resolved that this Conference of the National Smoke Abatement Society recommends that the Government set up a Committee to investigate and report upon measures to be employed to abate nuisances arising from the use of pulverised fuel, and that special consideration be given to the abatement of nuisances arising in connection with generating stations or other statutory undertakings. " That all Local Authorities be circulated, asking them to pass a resolution on similar lines, and that such resolution be sent to the Minister of Health and their respective Members of Parliament." House Fires.—" Resolved that this Conference views with grave concern the slow progress made towards the solution of the domestic smoke problem, and urges the Government, in any new housing legislation, to insist, as a condition of subsidy, that the heating arrangements in all houses to be erected under such legislation shall be of such design as will obviate atmospheric pollution." During the discussion reference was made to the use of electricity and gas for heating purposes and also the desirability of retaining the open fire grate of the type which will burn smokeless solid fuels without difficulty. CONGRESSES. The Congress of the Royal Institute of Public Health, at Harrogate, from the 4th to the 9th June ; the Congress of the Royal Sanitary Institute, at Bournemouth, from the 15th to the 20th July ; the Congress of the British Social Hygiene Council, in London, from the 8th to the 12th July ; the Congress of the National Association for the Prevention of Infant Mortality, in London, from the 1st to the 3rd July ; the Congress of the National Association for the Prevention of Tuberculosis, at Southport, from the 27th to the 29th June, were all attended by representatives of the City Corporation, and again provided evidence of the value of these meetings. One of my staff also attended, by permission of the Public Health Committee, the Congress of the Sanitary Inspectors' Association, held at Weymouth, from the 2nd to the 7th September. SWIMMING BATHS. In accordance with the suggestion of the Ministry of Health, that the winter months would form a fitting opportunity for local authorities to ensure an appropriate standard of cleanliness and purity of water in swimming baths, a special inspection was made of the only baths situate in the City—that is St. Bride's Bath. It was found that the purification system in this bath is identical with that suggested in the report of the Ministry of Health, " The Purification of the Water in Swimming Baths." This purification system is regarded as a model, and is visited by borough engineers prior to the construction of improved baths in their own areas. CREMATION. Cremation as a means of disposal of the dead is making slow but steady progress. This is clearly indicated by the regular increase in the numbers of persons cremated year by year. The total of 9,614 cremations which took place during 1935 in all the crematoria established throughout the country shows an increase of 1,277 over that for 1934. Two hundred and fifteen of these cremations took place at the Corporation's Crematorium, at Ilford. During the year one new crematorium was established in Blackpool, and four others are, at the time of writing this Report, in process of construction. They will, in all probability, become operative during 1936. An attempt to popularise cremation amongst working classes is indicated by the establishment of a cremation insurance scheme, much on the same lines as the burial insurance which has been in operation for many years past. During 1933-1934 I communicated with medical officers of health of areas which might be regarded as within reasonable distance of the City of London Cemetery, at Ilford, asking them whether they would be good enough in one way or another to direct attention to the facilities available for cremation at Ilford, and as a consequence, some of these gentlemen made reference to the matter in their annual reports. I know that the Corporation would very much appreciate any similar reference which might be made should this paragraph be noted by any of my medical colleagues. The following is a summary of the cremations carried out in Great Britain to the end of 1935, since the date of the erection of the first cremation at Woking, in 1885. E 30 CREMATIONS IN THE UNITED KINGDOM. 51 YEARS—1885-1935. YEAR. Woking.* Manchester. Glasgow. Liverpool. Hull. Darlington. Leicester. Golder's Green. Birmingham. Leeds. City of London. Sheffield. Bradford. W. Norwood. Hendon Park. Pontypridd. Bristol. Ipswich. Edinburgh. Brighton. Guernsey. Nottingham. Reading. Southampton. Birkenhead. Newcastle-onTyne. Plymouth. Stockport. Blackpool. (Opened 25th Sept., 1935.) No of Cremations each year. > 1885 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 1886 10 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 10 1887 13 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 13 1888 28 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 28 1889 46 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 46 1890 54 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 54 1891 99 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 99 1892 104 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 107 1893 101 30 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 131 1894 125 47 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 172 1895 150 58 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 209 1896 137 52 10 2 ... ... ... ... ... ... ...... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 201 1897 173 51 16 10 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 250 1898 240 62 12 27 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 341 1899 240 88 16 23 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 367 1900 301 83 20 40 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 444 1901 273 96 18 40 17 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 445 1902 275 81 20 54 13 2 1 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 451 1903 143 92 24 35 18 1 5 158 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 477 1904 138 98 19 40 20 7 8 220 19 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 569 1905 95 97 35 35 15 4 16 252 22 16 9 7 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 604 1906 140 90 44 46 17 13 12 298 25 15 23 6 14 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 743 1907 108 98 30 34 29 8 12 290 33 16 18 18 13 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 707 1908 119 116 28 32 37 6 14 364 18 24 19 12 6 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 795 1909 105 106 30 46 15 9 19 421 30 19 24 18 13 ... ... ... ... ... ... ... ... ... ... ... ... ... 855 1910 106 114 28 37 21 9 16 415 38 12 22 8 14 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 840 1911 114 124 39 50 25 12 13 542 44 17 20 10 13 1,023 1912 125 149 44 52 27 15 14 591 40 24 32 12 9 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1,134 1913 128 172 49 66 23 11 11 602 59 16 21 15 15 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1,188 1914 124 184 57 48 16 11 7 671 53 28 42 20 18 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1,279 1915 153 165 63 54 34 16 22 730 45 20 45 21 12 30 ... ... ...... ... ... ... ... ... ... 1,410 1916 125 179 71 58 25 10 23 633 63 22 43 14 11 89 1,366 1917 129 178 67 62 24 15 34 719 49 17 68 25 10 118 1,515 1918 142 197 74 69 43 17 42 820 64 34 70 50 20 153 1,795 1919 181 235 84 89 46 26 36 919 76 30 68 41 31 169 2.031 1920 149 203 80 69 30 18 32 851 72 26 58 32 20 156 1,796 1921 159 228 87 75 43 20 36 893 78 31 57 29 24 162 1,922 1922 193 189 75 74 45 17 23 939 98 31 70 38 25 186 6 2,009 1923 170 227 90 62 45 21 36 920 75 27 69 37 23 178 6 1,986 1924 235 251 82 74 47 28 40 1,114 97 47 68 32 24 240 7 4 2,390 1925 271 287 116 75 41 32 57 1,214 126 48 66 48 32 266 7 14 2,700 1926 305 303 98 96 55 33 70 1,270 128 40 84 43 32 299 8 13 2,877 1927 320 357 129 101 70 38 68 1,459 150 59 95 57 50 279 11 22 3,265 1928 344 367 141 103 72 39 61 1,483 157 60 103 51 45 306 11 20 71 2 3,436 1929 426 443 185 103 97 55 124 1,797 205 66 99 81 47 410 14 28 116 37 20 4,353 1930 446 442 121 160 84 52 119 1,787 180 73 112 59 49 390 12 40 143 55 125 78 6 4,533 1931 476 508 158 163 128 62 89 1,866 257 109 112 87 77 415 13 43 177 68 169 144 4 70 5,195 1932 446 626 165 171 126 77 94 2,245 307 116 158 84 123 480 13 51 237 94 266 263 9 74 13 77 6,315 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 1935 464 790 307 207 194 74 149 2,855 459 200 215 129 158 726 13 95 312 167 541 449 20 125 95 359 78 188 122 94 29 9,614 Totals 9,828 9.657 3,175 3,069 1,874 981 1,551 34,292 3,849 1,561 2,320 1,312 1,163 6,330 144 519 1,685 675 1,954 1,582 74 495 256 928 98 214 132 142 29 89,889 " Viscount Cross in the year 1879 forbade the practice of cremation there (Woking) under the threat of passing an Act to make it illegal .... But in 1884 appeared the well-known judgment of Mr. Justice Stephen, which, in the case of a child's " body having been burned by its father contrary to the order of the coroner, determined cremation to be a legal act, provided no nuisance be caused thereby to others."—Extract from speech made by the late Sir Henry Thompson at the opening of " Golder's Green Crematorium. 2?nd November, 1902. Vide " Transactions of Cremation Society of England, 1903." p. 31. t Closed for reconstruction from August, 1913, to July, 1914. 31 MEAT INSPECTION. According to the Board of Trade Returns the imports of fresh meat and bacon for the twelve months, 1935, were :— BEEF AND VEAL. Cwts. MUTTON AND LAMB. Cwts. PORK. Cwts. BACON. Cwts. 1935. 1934. 1935. 1934. 1935. 1934. 1935. 1934. Argentina 7,057,757 7,072,927 905,258 921,632 186,841 277,044 Australia 1,342,383 1,516,360 1,785,232 1,627,885 146,732 82,424 Brazil 536,122 533,253 — — — — Canada — — — — — — 917,883 894,643 Chile — — 207,880 206,325 — — — 389,549 Denmark — — — — — — 3,826,386 4,287,830 Irish Free State 2,291 4,667 53,347 12,882 142,841 143,783 458,423 367,803 Lithuania .... — — — — — — 165,318 251,572 Netherlands — — — — — — 508,669 607,728 New Zealand 783,719 1,003,955 3,632,933 3,554,511 490,327 414,352 — — Poland — — — — — — 430,456 463,397 Sweden — — — — — — 257,409 296,641 United States — — — — 77,079 290,070 20,011 39,759 Uruguay .... 611,346 612,292 136,407 138,386 — — — — Other Countries 653,397 354,629 31,449 30,778 14,240 40,829 341,099 — Totals 10,987,015 11,098,083 6,752,506 6,492,399 1,058,0601,248,503 6,925,654 7,598,922 Live Stock for twelve months, 1935 :— Cattle. Sheep. Pigs. Canada 6,478 - - Irish Free State 592,632 278,969 127,990 Average prices were given as follows :— Cattle. Sheep. Pigs. Canada £16 4 8 - - Irish Free State (including stores) £7 12 9 £15 7 £3 13 10 LONDON CENTRAL MARKETS. Analysis and Comparison of Supplies in Tons. Twelve Months. Description and Country of Origin. 1935. 1934. Difference. Beef and Veal: England and Wales 25,552 20,717 + 4,835 Scotland 17,854 14,932 + 2,922 Ireland 2,449 1,652 + 797 Australia 18,004 20,370 — 2,366 New Zealand 10,512 10,834 — 322 Canada 1,344 4,147 — 2,803 Un. of South Africa 812 216 + 596 Southern Rhodesia 3,032 2,205 + 827 U.S. of America 1,664 2,258 — 594 Argentina 153,184 151,891 + 1,293 Uruguay 6,610 6,814 — 204 Brazil, etc. 7,252 6,885 + 367 Netherlands — — — Denmark — — — Other Countries — — Totals : Beef and Veal Tons 248,269 242,921 + 5,348 Mutton and Lamb : England and Wales 10,772 11,379 — 607 Scotland 19,527 19,400 + 127 Ireland 1,763 708 + 1,055 Australia 25,064 22,883 + 2,181 New Zealand 68,747 66,868 + 1,879 Canada 5 13 — 8 Un. of South Africa — — — U.S. of America 58 35 + 23 Argentina 15,413 16,297 — 884 Uruguay 671 908 — 237 Chile, etc. 592 460 + 132 Netherlands - — — Denmark - — — Other Countries 234 250 16 Totals : Mutton and Lamb Tons 142,846 139,201 + 3,645 Totals : Carried forward Tons 391,115 382,122 + 8,993 E2 32 Description and Country of Origin. Twelve Months. 1935. 1934. Difference. 391,115 382,122 + 8,993 Pork and Bacon : England and Wales 26,365 23,098 + 3,267 Scotland 63 25 + 38 Ireland 9,013 6,763 + 2,250 Australia 1,821 2,962 1,141 New Zealand 7,952 6,135 + 1,817 Canada 648 495 + 153 Un. of South Africa — — — U.S. of America 852 1,544 692 Argentina 1,066 1,925 859 Uruguay 16 7 + 9 Brazil, etc. 101 167 — 66 Netherlands *656 *845 — 189 Denmark Bacon *436 *524 — 88 Other Countries *1,284 *2,388 — 1,104 Totals : Pork and Bacon Tons 50,273 46,878 + 3,395 Poultry and Game : England and Wales 12,445 11,421 + 1,024 Scotland 877 804 + 73 Ireland 2,101 2,403 — 302 Australia 66 103 — 37 New Zealand 40 5 + 35 Canada 300 256 + 44 Un. of South Africa — 3 — 3 U.S. of America 49 126 — 77 Argentina 344 384 — 40 Uruguay 6 19 — 13 Brazil, etc. — 28 — 28 Netherlands 371 607 — 236 Denmark 30 47 — 17 Other Countries 6,683 6,392 + 291 Totals : Poultry and Game Tons 23,312 22,598 + 714 Rabbits : England and Wales 2,283 1,515 + 768 Scotland 17 9 + 8 Ireland 8 — + 8 Australia 4,240 5,030 — 790 New Zealand 284 715 — 431 Canada — — — Un. of South Africa — — — U.S. of America — — — Argentina — 2 — 2 Uruguay — — — Brazil, etc. — — — Netherlands 100 91 + 9 Denmark 2 1 + 1 Other Countries 438 374 + 64 Totals: Rabbits Tons 7,372 7,737 — 365 Eggs: England and Wales 1,493 1,947 454 Scotland 2 3 — 1 Ireland 130 126 + 4 Australia 108 127 — 19 New Zealand 3 3 — Canada 5 4 + 1 Un. of South Africa 49 39 + 10 U.S. of America — 1 — 1 Argentina 3 8 — 5 Uruguay — — + — Brazil, etc. 2 — 2 Netherlands 269 62 + 207 Denmark 50 60 — 10 Other Countries 516 502 + 14 Totals: Eggs Tons 2,630 2,882 — 252 Totals: Carried forward Tons 474,702 462,2170 + 12,485 33 Twelve Months. Description and Country of Origin. 1935. 1934. Difference. Totals : Brought forward Tons 474,702 462,217 + 12,485 Butter and Cheese: England and Wales 235 176 + 59 Scotland — — — Ireland 4 3 + 1 Australia 179 150 + 29 New Zealand 277 323 46 Canada 15 16 — 1 Un. of South Africa — — — U.S. of America — — — Argentina 56 61 — 5 Uruguay — — — Brazil, etc. — — — Netherlands 46 29 + 17 Denmark — 1 — 1 Other Countries 62 455 — 393 Totals : Butter and Cheese Tons 874 1,214 — 340 Sundries : England and Wales 544 503 + 41 Scotland — — — Ireland 1 3 — 2 Australia 2 1 + 1 New Zealand 4 5 — 1 Canada 1 1 — Un. of South Africa — 5 — 5 U.S. of America 16 39 — 23 Argentina 3 1 + 2 Uruguay — — — Brazil, etc. — — — Netherlands 11 45 — 34 Denmark 45 85 — 40 Other Countries 574 629 — 55 Totals: Sundries Tons 1,201 1,317 — 116 Grand Totals Tons 476,777 464,748 + 12,029 GREAT BRITAIN.—1935. Beef. Mutton. Pork. Veal. Goat. Carcases. Quarters. Carcases. Quarters. Carcases. Quarters. Carcases. Quarters. Carcases. Tongues. Lungs. Mesenteries. Plucks. Heads. Abnormal Odour - 1 5 - l - — - - - - - — - Abscess - 2 56 2 60 - 3 - - - - - - - Anaemia - - 1 - - - - - - - - - - - Congestion - — 2 — — - — - - - - - — - Cutaneous Rash - - - - 14 - - - - - - - - - Cysticercus Bovis 1 — - - - - - - - - - - - - Cysticercus Senuicollis - — 3 — — — - - - - - — - Distomatosis - - 3 - - - - - - - - - - - Emaciation 3 — 706 4 57 - 89 1 7 1 - - 7 5 Fevered — — — — 7 - — - — - - - — — Hæmorrhagic 1 — 4 — 287 - — - — - - - 2 — Hydræmia — — 3 — — - 1 - — - - - — — Immature — — 3 — — - 54 - — - - - 6 5 Injury - 5 - - - 2 - - - - - - 1 Jaundice — — 1 — 11 - 26 - — - - - 3 Joint 111 — — — — — - 15 - — - - - 1 — Killed in Extremis 1 — 104 2 23 - 40 - - - - - 5 2 Leukaemia - - - - 2 - - - - - - - - Melanosis - - - 2 - - 1 - - - - - - - Myositis - - - - 1 - 1 - - - - - - - Nephritis — — 5 — 11 - 24 4 — - - - 2 — Osteomyelitis - - - - - - 5 - - - - - - - Parasitic Disease - - 1 - - - - - - - - - - - Pericarditis - - - - 1 - - - - - - - - - Purulent Nephritis - - - 1 - - - - - - - - - Pleurisy and Peritonitis — — 100 — 379 - 29 — — - - - 4 — Purulent Condition - - - - 1 - - - - - - - - Pyaemia — — 2 — 2 - 3 — — - - - 1 — Rachitis — — 18 — 20 - — — — - - - — — Rheumatoid Arthritis — — 96 — 56 - — — — - - - — — Tuberculosis (Bovine) 15 21 — — — - 11 4 — 1ll 270 - 43 186 Tuberculosis (Porcine) — — — — 640 6 — — — - — 130 1,117 3,560 Tumour 1 — 1 - - - - - - - - - - Uraemia — — 1 — 2 — — — - - — — — — Totals for 1935 22 24 1,120 10 1,576 6 304 9 7 112 270 130 1,191 3,759 Totals for 1934 19 14 933 10 950 76 156 2 1 53 363 103 513 4,100 34 Ireland.—The consignments of food, in tons, received from this country, compared with those of 1934, were as follows :— Beef and Veal. Mutton and Lamb. Pork and Bacon. Poultry and Game. Rabbits. Butter and Cheese. Eggs. Sundries. 1935 2,449 1,763 9,013 2,101 8 4 130 1 1934 1,652 708 6,763 2,403 — 3 126 3 The amount of unsound food surrendered is shown in tables Nos. 14 and 15. Mutton. Pork. Carcases. Quarters. Carcases. Sides. Abscess 1 - 11 Congestion - - l 2 Echinococcus - - l Emaciated - - l Haemorrhagic - - 9 2 Killed in Extremis - - 10 2 Leukaemia - - 1 - Osteomyelitis - - 1 - Pleurisy 1 - 23 - Pyelonephritis - - 2 - Rachitis 1 - 2 2 Rheumatoid Arthritis - - 5 Sarcosporidia 1 - — - Tuberculosis - - 14 18 Tumour - - 1 — Totals for 1935 4 — 82 26 Totals for 1934 41 11 Argentina.—During the year, this country sent the following amounts of food, in tons, compared with those for 1934 :— Beef and Veal. Mutton and Lamb. Pork and Bacon. Poultry and Game. Rabbits. Eggs. Butter. Sundries.[/##3] 1935 153,184 15,413 1,066 344 - 3 56 3 1934 151,891 16,297 1,925 384 2 8 61 1 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 Nos. 14 and 15. Beef. Quarters. Mutton. Carcases. Mutton. Quarters. Mutton. Pieces. Pork. 1934. 1935. 1934. 1935. 1934. 1935. 1934. 1935. 1934. 1935. Abscess 40 33 32 62 5 - 1 - 23 11 Actinomycosis — 1 — — — - - - — - Caseous Lymphadenitis — — 74 107 12 - 11 95 — - Cysticercus Bovis 3 9 — — — - — — - Emaciation — — 1 2 - - - - - - Emphysema — 1 - - - - - - - - Fibrous Growth 1 - - - - - - - — Leukaemia — 1 - - - - - - Lymphadenitis — — — 1 — — - — — - Pleurisy - - - - - - - - - - Parasitic Disease 7 4 25 7 — - - — — Purulent Condition — 2 — — — - - — Tuberculosis (Hinds) 72 47 - - - - - - - - „ (Fores) 8 7 - - - - - - -— - (Pork) - - - - - - - - 1 Tumour — 1 - - - - - - - - -Ulceration - - - - - - - - - - Totals 131 106 132 181 17 - 12 95 24 11 Australia.—This country sent the following amounts of food, in tons, to the markets during the year, compared with those for 1934 :— Beef and Veal. Mutton and Lamb. Pork. Poultry and Game. Rabbits. Eggs. Butter. Sundries. 1935 18,004 25,064 1,821 66 4,240 108 179 2 1934 20.370 22,883 2,962 103 5,030 127 150 1 35 The following table shows the amounts of meat surrendered as diseased and the quantities of unsound food are shown in tables Nos. 14 and 15. Beef. Quarters. Mutton. Carcases. Mutton. Quarters. Mutton. Pieces. Pork. Carcases. 1934. 1935. 1934. 1935. 1934. 1935. 1934. 1935. 1934. 1935. Abscess 9 6 39 59 - - - - 2 8 Caseous Lymphadenitis — — 91 101 - - - 144 — - Parasitic Disease — — 28 7 - - - - - - Pleurisy - - - - - - - - - 2 Tuberculosis 12 3 - - - - - - - 1 Ulcerated - - - 1 - - - - - - Totals 21 9 158 168 144 3 11 New Zealand,.—The total amount of food, in tons, for 1935, which was deposited in the markets, compared with that for 1934, is shown as follows :— Beef and Veal. Mutton and Lamb. Pork. Poultry and Game. Rabbits. Eggs. Butter and Cheese. Sundries. 1935 10,512 68,747 7,952 40 284 3 277 4 1934 10,834 66,868 6,135 5 715 3 323 5 The amount of unsound food discovered in these consignments is given in tables Nos. L and 15 and the diseased meat figures in the following table :— Beef. Mutton. Mutton. Mutton. Pork. Carcases. Pork Sides minus head 1934. 1935. 1934. 1935. 1934. 1935. 1934. 1935. 1934. 1935. 1935. Abscess 2 2 15 46 - - - - 24 60 3 Adenitis — — — 1 - - - - — — — Caseous Lymphadenitis — — 73 127 - — — 3 — — — Fatty Condition - - - - - - - - - 5 — Tumour - - - 1 - - - - - - Hæmorrhagic - - - - - - - - 1 1 — Injury and Pleurisy - - - - - - - - 1 — — Nephritis - - - - - - - - - 2 — Parasitic Disease 1 — 18 12 - - - - - - - Pleurisy — — — 1 - - - — — 22 34 Septic Injury - - 1 - - - - - - - Transit Damage - - - - - - - - 1 Tuberculosis 1 6 10 48 57 Uraemia — — — 2 — — — — Totals 4 8 107 190 3 36 139 94 Uruguay.—This country sent the following amounts of food, in tons, during the year 1935:- Beef and Veal. Mutton and Lamb. Pork. Poultry and Game. 1935 6,610 671 16 6 The amounts of unsound food is shown in tables Nos. 14 and 15 and the diseased is shown in the following table :- Beef. Quarters. Mutton. Carcases. Mutton. Pieces. 1934. 1935. 1934. 1935. 1934. 1935. Abscess 3 2 l 2 - - Caseous Lymphadenitis Tumour — 1 2 1 - - Parasitic Disease — — 1 — - - Tuberculosis — 1 — — - — Totals 3 4 4 3 - — Chile.—This country sends only mutton and lamb to the markets and the amount of diseased meat is given herewith:— Mutton. Carcases. Mutton. Quarters. Mutton. Pieces. 1934. 1935. 1934. 1935. 1934. 1935. Abscess 1 4 - - - - Caseous Lymphadenitis 1 15 - - - - Totals 2 19 - - - - 36 Brazil.—The following table shows the amount of diseased meat surrendered from the consignments from this country during the year 1935:— Beef. Quarters. Mutton. Carcases. Mutton. Pieces. Pork. Carcases. 1934. 1935. 1934. 1935. 1934. 1935. 1934. 1936. Abscess 8 12 3 - - - 10 1 Caseous Lymphadenitis — — — 1 - - — - Cysticercus Bovis — 4 Parasitic Disease 1 1 — - - - l - Tuberculosis 5 - - - - - - - Totals 14 17 3 1 11 1 South Africa, including Southern Rhodesia.—The consignments for the year 1935 were made up as follows :— Beef and Veal. Poultry and Game. Eggs. Sundries. 1935 3,844 3 49 - The following tables show the amounts of diseased meat for the respective countries :— Beef. Quarters. Beef. Quarters. 1934. 1935. 1934. 1935. Abscess - 2 Abscess 10 11 Tuberculosis 2 — Peritonitis — 1 Tuberculosis 6 4 Totals 2 2 Totals 16 16 Other Countries.—The following table shows the amounts of food surrendered due to disease :— Belgium. Abscess Beef. Hindquarters. Bacon. Sides. Bacon. Pieces. Pork. Carcases. 1934. 1936. 1934. 1935. 1934. 1935. 1934. 1935. 5 l Canada. Abscess - 1 2 4 - 2 1 - Denmark. Abscess - - 4 5 - 1 - - Injury Germany. - - - 1 - - - - Abscess Holland. - - - 1 - - - - Abscess - - 3 — — 1 - - Lithuania. Abscess - - 4 7 - - - - Poland. Abscess - - 4 3 - 3 - - Russia. Abscess - 3 - - - - United States of America. Abscess - - - 3 - 1 5 - Emaciated - - - - - - 1 - Pleurisy - — — — — 2 - 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. 1933. 1934. 1935. 1933. 1934. 1935. 1933. 1934. 1935. 1933. 1934. 1935. Argentina 238 77 107 3 - - - - - 3 66 95 Australia 132 123 101 — - - 30 - - 86 396 144 Brazil — 1 - - — - - — — Chile 36 10 15 85 - - 7 - - 93 46 — New Zealand 154 113 127 19 - - 12 - - 27 139 3 Uruguay 22 2 1 — - - — - - 32 — — Totals 582 325 352 107 49 - - 241 647 242 37 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 :— [###n (Pieces) 103 Mutton (Carcases) 5 Beef (Hearts) 24 ,, (Kidneys) 40 „ (Livers) 63 „ (Livers) 1 „ (Pieces of Liver) 25 „ (Pieces) 28 „ (Lungs) 1 „ (Pluck) 3 „ (Pieces) 80 Offal (lbs.) 510 „ (Pieces of Suet) 1 Partridges 2,760 „ (Tails) 22 Pheasants 1,589 „ (Tongues) 1 Pigeons 2,162 Brains (Various) 5 Plover 477 Breads (Various) 9 Pork (Carcases) 2 Capercailzies 3 „ (Livers) 15 Chickens and Poussins 1,325 „ (Pieces) 1 Cheese (lbs.) 1,788 „ (Plucks) 6 Cream (Tins) 1,374 Ptarmigan 199 Curlew 3 Quail 286 Ducks 1,077 Rabbits 15,974 Eggs 39 Sausages (lbs.) 7 „ (Cases) 6 Snipe 167 „ (Gills of Liquid) 272 Spleens (Various) 32 Fish (Tins) 192 Teal 94 Fowls 6,881 Turkeys 255 Fruit (Tins) 1,016 Veal (Carcases) 7 Game (Black) 34 „ (Jellied, c /s. of) 2 „ (Unclassified) 82 ,, (Kidneys) 2 Geese 176 „ (Liver) 1 Grouse 1,337 „ (Pieces) 45 Guinea Fowls 346 „ (Plucks) 64 Hares 1,138 Vegetables (Tinned) 184 Hazelhens 56 Venison (Pieces) 16 Horse Flesh 1 Widgeon 31 Meat (Tins) 5 Woodcock 31 Total for 1934 Tons. Cwts. Qrs. Lbs 42 15 2 0 1935 40 6 0 14 Decrease 2 9 1 14 UNSOUND MEAT, ETC., REMOVED FROM COLD STORES. Article. No. How Packed. Origin. Cause of Destruction. Tons. Cwts. Qrs. Lbs. Beef (Pieces) Argentine Injury and 0 3 3 4 composition. „ „ ... ... New Zealand Injury 0 0 2 7 „ (Tongues) Tin Argentine Decomposition 0 0 0 6 „ (Fores) 1 New Zealand Mould Fungi 0 1 2 6 „ (Kidneys) Cases Argentine Decomposition 0 0 1 26 „ (Sausages) Boxes United ,, 0 1 0 4 Kingdom. „ (Shins) Bag New Zealand Brine Stain 0 0 3 7 „ (Tinned) Argentine .... Decomposition 0 0 0 6 Brains Boxes United 0 0 3 23 Kingdom. Eggs Case Chile .... Fish Box Paraguay Decomposition 0 0 1 4 Glands Cases Australia Perished 0 2 2 22 Lettuce ,, Jersey Meat Bags Australia Perished 0 10 0 11 Mutton (Carcases) 14 Argentine C.L.A 0 5 2 4 " " 2 ,, Brine Stain 0 0 3 15 " " 5 ,, Store Damage 0 1 0 10 " " 2 ,, Minus Glands 0 0 3 0 " " 6 ,, Mould Fungi 0 1 1 17 ,, Carried forward 1 12 0 4 38 Unsound Meat, Etc., Removed from Cold Stores.—continued. Article. No. How Packed. Origin. Cause of Destruction. Tons. Cwts. Qrs. Lbs. Brought forward l 12 0 4 Mutton (Sides) 1 Argentine C.L.A 0 0 0 23 1 Minus Glands 0 0 0 23 (Legs) 81 ,, C.L.A 0 4 5 17 (Pieces) ,, Brine Stain 0 0 2 25 „ (Livers) Case ,, Decomposition 0 0 1 23 Tin ,, ,, 0 0 0 10 (Kidneys) Cases ,, ,, 0 5 0 7 ,, (Carcases) 25 Australia C.L.A 0 9 3 11 13 ,, Brine Stain 0 4 1 22 „ (Quarters) 36 ,, C.L.A 0 3 1 24 ,, (Shoulders) 2 ,, ,, 0 0 0 11 (Legs) 9 .... ,, ,, 0 0 2 4 „ (Pieces) ,, ,, 0 7 0 13 „ (Livers) Tin ,, Decomposition 0 0 0 9 „ (Carcases) 43 New Zealand C.L.A 0 19 3 5 4 ,, Brine Stain 0 3 1 2 ,, 3 ,, Transit Damage 0 1 1 12 ,, 31 ,, Mould Fungi 0 10 2 0 (Legs) 4 ,, C.L.A 0 0 3 2 2 ,, Injury 0 0 0 6 „ (Pieces) ,, C.L.A 0 3 2 26 ,, Brine Stain 0 0 0 6 „ (Livers) . ,, Decomposition 0 18 0 26 (Kidneys) ,, Mould Fungi 8 0 0 3 „ (Carcases) 19 Chile C.L.A 0 8 0 24 (Pieces) ,, Mould Fungi 0 3 1 2 Offal Argentine Brine Stain 0 5 0 5 Pigeons Boxes France Decomposition 0 0 0 16 Pork (Pieces) Bags United Brine Stain 0 2 0 3 Kingdom. ,, ,, ,, Decomposition 0 4 0 5 ,, ,, Argentine Brine Stain 0 0 2 5 (Legs) 2 ,, Injury 0 0 0 24 ,, (Livers) Cases ,, Brine Stain 0 2 2 1 Australia ,, Perished 0 0 1 23 ,, (Plucks) New Zealand Decomposition 0 0 3 18 Poultry Hamper United Perished 0 1 3 4 Kingdom Rabbits Australia Decomposition 1 8 3 5 Veal Bags United Kingdom. ,, 0 2 1 10 Bag Argentine Mould Fungi 0 0 1 22 ,, (Livers) New Zealand „ 0 15 0 26 Total for year 1935 ... ... ... 18 3 2 3 SHOWING THE AMOUNT OF VARIOUS FOOD PRODUCTS SURRENDERED TO OR SEIZED BY MEAT INSPECTORS IN THE CITY OF LONDON FOR DISEASED CONDITIONS, 1935. 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 33,661 16,143 3,415 551 - 18 3,398 29 Australia 3.886 12,424 5,096 99 1,092 1,872 Belgium 492 174 1,122 Brazil 704 200 23 Britain 23,198 20,765 146,544 7,485 54 951 48,297 21,582 7,415 Canada — — — — — 139 47 20 Chile Denmark 394 1,442 870 — — 1,421 - 59 :so France - - - - - - - 149 Holland - - - 260 110 225 1,008 Hungary — — — — — - 31 33 - Ireland 128 1,920 8,593 628 — 368 22,096 2,054 91 Italy — - 207 - Lithuania 181 - 60 30 New Zealand 8,154 45,965 20,823 200 — 62 2,537 335 2,004 Poland — — — — — 61 - - South Africa 158 — - - Southern Rhodesia 1,282 — — — — - - Syria — - - - - 66 - Russia — — 63 - - - Uruguay 570 64 21 - - - Various — — — — - — 12 — Totals for 1935 72,135 98,723 185,341 9,184 54 4,016 77,631 25,005 13,572 Totals for 1934. 77.690 103,542 123,319 6,421 232 4,800 129,034 10,743 14,542 39 SHOWING THE AMOUNT OF VARIOUS FOOD PRODUCTS SURRENDERED TO OR SEIZED BY MEAT INSPECTORS IN THE CITY OF LONDON FOR UNSOUND CONDITIONS, 1935. Countries. Beef in lbs. Mutton in lbs. Pork in lbs. Veal in lbs. Venison in lbs. Goat in lbs. Bacon in lbs. Offal in lbs. Furred Game. Feathered Game. Tinned Meat. Tinned Milk. Fish in lbs. Cheese in lbs. Alaska - - - - - 50 - 12 - Argentina 293,576 29,016 18,300 2,697 — — 312 43,999 631 185 4,170 391 — — Australia 16,531 24,376 6,573 164 — — — 10,870 4,295 959 381 — — — Belgium - - - 1,024 — 8,296 4 185 263 — 56 Brazil 4,074 37 1,003 576 - - — 168 — Britain 69,652 43,820 81,019 10,063 4,113 — 3,416 103,511 68,660 65,609 5,183 730 71 818 Canada 127 — — — — — 954 388 4 — — — 5 — Chile 278 2,981 59 - Denmark — — 555 — — — 3,323 710 1,111 354 1,840 827 — 31 France — — — — — — — — — 29 121 — — — Germany — — — — — — 16 290 — 127 2,696 — 1 — Holland - - - - - - 1,167 1,788 2,932 542 671 2,423 1 Hungary - - - - _ - - - 2,651 - - - - Ireland 909 14,810 14,979 959 - - 1,143 99,985 513 3,646 - 100 - - Italy - — — — — — 2,284 1,300 — — — — Lithuania 8 — — — — — — — 1,807 — — — — — New Zealand 28,790 151,565 12,305 373 — — 609 29,717 15,403 433 625 72 — 112 Poland 139 — — — — — 663 — 150 58 1,130 95 1 — Uruguay 12,799 41 — 496 - - - - - - - - - - U.S.A 336 — 72 — — — 8 545 — — 530 88 65 — South Africa 1,692 — — — — - — — 17 — — — — 52 S. Rhodesia 14,214 — — — — — 52 26 — — — — — — Sweden — — — — 12 — 114 — — — — — Syria — — — — — — — — — 262 — — — — Various — — — — — — 61 — 27 18 1,006 459 180 — Totals for 1935 443,125 266,646 134,865 15,328 4,113 12,760 292,047 106,244 76,177 18,538 5,448 336 1,069 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 SUMMARY OF UNSOUND FOOD DESTROYED. Tons. Cwts. Qrs. Lbs. Central Markets (Smithfield) 771 12 0 0 Cold Stores 19 10 0 7 Leadenhall Market and City Shops 40 6 0 14 Total for the year 1935 831 8 0 21 Total for the year 1934 853 3 1 10 Decrease 21 15 0 17 EXPORT OF MEAT. Thirty-two certificates were issued during the year. DEMONSTRATIONS AND INSTRUCTION IN MEAT INSPECTION. One hundred and ninety-one persons from various training centres received instruction. Fourteen naval officers received training in meat inspection at Central Markets, Smithfield. PUBLIC HEALTH (LONDON) ACT, 1891—UNSOUND M EAT—PROSECUTIONS. Serial No. Date. Business. Where heard. Before whom. Offence. Result. 3 13/6/35 Farmer Guildhall Ald. Sir G. Collins. Being the owner of 5 pairs hind-quarters and loins of pork and one head and two pieces of pork. Costs, £5 5s. 0d. 3 13 /6 /35 Licensed Slaughterman. " " Being the slaughterman and sender of the above pieces of pork. Fined £20. 3 13/6/35 Farm Labourer & Licensed Slaughterhouse Proprietor. " " Being the person who assisted in the slaughtering and sending of the above pieces of pork. Fined £10, 2 17 /6 /35 Wholesale Butcher & Grazier. " Ald. F.J. C. Pollitzer. Being the owner of two sides of pork minus head, which were diseased and unfit for human consumption, and deposited for sale on ' the 28 /3 /35 at Smithfield Market. Fined £15. F2 40 Serial No. Date. Business. Where heard. Before whom. Offence. Result. 2 17/6/35 Wholesale Butcher & Grazier. Guildhall Ald. F.J. C. Pollitzer. Being the owner of one pig carcase, which was diseased and unfit for human consumption and deposited for sale on the 29 /3 /35, at Smithfield Market. Fined £15. Costs, £5 5s. 0d. 4 31/12/35 Butcher tt " Being the owner of three pieces of boned-out beef, which were diseased and unfit for human consumption. Fined £20. Costs, £10. 4 31/12/35 Slaughterman. " Being the slaughterman and sender of three pieces of boned-out beef, which were diseased and unfit for human consumption. Fined £40. 5 2/1/36 Master Butcher. Being the owner and consignor of one pig carcase, which was diseased and unfit for human consumption. Fined £20. Costs, £5 5s. 0d. Table showing Weight of Meat delivered, and Meat delivered to Contractors as unsound, during each Month for the Years 1934 and 1935. Month. Meat delivered at the Market, 1934. Unsound Meat delivered to Contractors, 1934. Meat delivered at the Market, 1935. Unsound Meat delivered to Contractors, 1935. Tons. cwts. qrs. Tons. cwts. qrs. Tons. cwts. qrs. Tons. cwts. qrs. January 43,434 0 0 77 6 3 44,104 0 0 63 1 0 February 35,871 0 0 65 17 3 37,496 0 0 60 14 0 March 39,948 0 0 52 2 2 37,288 0 0 74 10 0 April 37,467 0 0 49 9 0 40,515 0 0 57 3 3 May 39,714 0 0 65 9 2 41,593 0 0 64 11 0 June 34,624 0 0 54 8 0 34,445 0 0 73 4 0 July 35,349 0 0 82 13 1 38,710 0 0 104 4 1 August 35,611 0 0 75 3 1 35,532 0 0 99 13 1 September 35,946 0 0 97 0 2 38,160 0 0 94 8 1 October 43,697 0 0 145 10 3 44,931 0 0 107 16 3 November 41,866 0 0 71 0 2 40,463 0 0 69 18 3 December 41,218 0 0 98 10 2 43,628 0 0 62 16 3 Totals 464,745 0 0 934 12 1 476,865 0 0 932 1 3 One ton in every 511 tons of meat paying toll in the Central Markets, Smithfield, was condemned last year, as compared with one ton in 486 in 1934. *Table showing the average deliveries at the Central Meat Market, and other details tor 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 .263 1904-1908 414,906 11 1 1,584 19 3 .382 1909-1913 427,146 0 0 1,520 2 3 .356 1914-1918 324/715 0 0 1,370 11 9 .422 1919-1923 403,364 10 0 1,849 19 0 .459 1924-1928 477,405 0 0 1,210 2 0 .253 1929-1933 464,847 0 0 946 6 0 .203 1934-1935 470,780 0 0 933 6 0 .198 * I am indebted to the Clerk and Superintendent of the Central Markets for the figures relating to the market supplies, sources of origin, &c. 41 *The sources of origin of the Central Markets Supplies during the past five years are here expressed in terms per cent, of the total annual deliveries. British. American. Country Killed. Per cent. Town Killed. Per cent. †Foreign Killed. Per cent. Home Killed. Per cent. American Killed.‡ Per cent. Australian and New Zealand. Per cent. South Africa. Per cent. 1931 21.1 3.8 4.9 0.3 46.6 23.2 0.1 1932 22.9 3.6 4.4 01 43.5 25.4 0.1 1933 22.3 3.5 3.8 0.3 42.8 26.5 0.8 1934 22.3 30 2.9 0.4 41.5 29.4 0.5 1935 24.5 3.4 2.5 — 400 28.8 0.8 The following figures supplied by the Superintendent of the Market are of interest:— 1931. 1932. 1933. 1934. 1935. Tons. Tons. Tons. Tons. Tons. Average daily delivery into the Markets 1,554 1,511 1,491 1,514 1,558 **Minimum delivery on any one day 523 368 627 544 191 Maximum delivery on any one day 4,524 3,877 4,061 3,704 3,386 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 Foreien Meat and Produce." ‡ Includes South American Imports. FISH SUPPLIES. 206,060 tons of fish, of which 193,719 were land-borne and 12,341 water-borne, were received at or near Billingsgate Market during the year. This was an increase of 6,944 tons in the land deliveries and a decrease of 845 tons in deliveries by water. MONTHLY FISH RETURNS. * Table showing Weight of Fish Delivered, Fish seized as Unsound, and Percentage of Fish Condemned to that delivered, at or near Billingsgate Market, and on board boats lying off that place, during each month of the year 1935. Month. Weight of Fish Delivered. Total. Weight of Fish Condemned. Ratio of Fish Condemned to that Delivered. By Land. By Water. Tons. cwts. qrs. Tons. cwts. qrs. Tons. cwts. qrs. Tons. cwts. qrs. January 17,823 11 1 991 19 0 18,815 10 1 116 1 2 1 ton in 162 097 tons, or 0 616% February 15,700 17 1 875 8 1 16,576 5 2 50 5 3 „ 329 630 „ „ 0.303% March 14,523 14 1 891 3 0 15,414 17 1 71 5 0 „ 217-323 ,. „ 0.464% April 16,207 4 0 1,150 3 0 17,357 7 0 105 0 0 „ 162-543 „ „ 0.613% May 15,875 2 2 910 14 1 16,785 16 3 91 4 3 „ 183-979 „ „ 0.543% June 14,133 11 3 889 4 1 15,022 16 0 69 10 0 „ 216 155 0.462% July 16,208 9 2 1,153 3 3 17,361 13 1 106 0 0 „ 163-789 „ „ 0.610% August 17,011 3 3 1.251 8 2 18.262 12 1 129 15 3 „ 140-711 „ „ 0.710% September 14,633 14 1 990 4 2 15,623 18 3 42 1 0 „ 371556 „ „ 0.269% October 18,183 13 0 1,156 11 1 19,340 4 1 70 19 2 „ 272-493 „ „ 0.366% November 17,633 17 3 1,030 10 2 18,664 8 1 64 6 1 „ 290-214 „ „ 0.344% December 15,784 5 3 1,050 4 0 16,834 9 3 48 11 1 ,, 346 656 ,, „ 0.288% Totals 193,719 5 0 12,340 14 1 206,059 19 1 965 0 3 „ 213 533 „ „ 0.467% Weight of Fish Delivered, Fish Seized as Unsound, and percentage of Fish Condemned to that Delivered, at or near Billingsgate Market during 1935 and the five years 1930—1934. 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. 1930 207,121 21,586 228,707 2,111 15 0 1 ton in 140-902 tons or 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 0 1 „ 155-726 „ 0.642% 1934 186,775 13,186 199,961 1,030 5 0 1 „ 194.137 „ 0.515% Average (5 years) 189,199 16,553 195,752 1,490 1 2 1 ton in 131.377 tons or 0.761% 1935 193,719 12,341 206,060 965 0 3 1 ton in 213.533 tons or 0.467% 42 PUBLIC HEALTH (SHELLFISH) REGULATIONS, 1935. The above-mentioned Regulations, which came into operation on the 1st January, 1935, authorised the Medical Officer of Health for a local authority, who is in possession of information that any person is suffering or has recently suffered from infectious or other disease attributable to the consumption of shellfish, or has reason to believe that the consumption of shellfish exposed for sale within the district is likely to cause danger to public health, to make such enquiries and take all such steps as are practicable to ascertain the layings from which such shellfish were derived. For this purpose, the local authority may require any fishmonger supplying shellfish in the district to furnish to the Medical Officer of Health a list of all layings from which his supply has been derived during any period not exceeding six weeks immediately preceding the date of requisition, together with any other information which will assist the Medical Officer of Health in ascertaining the layings from which the suspected shellfish were derived. Provision is made for dealing with such special circumstances as operate in the City of London, where there are, of course, no layings, by Article 4 (4), which provides that a copy of any report made by the Medical Officer of Health in connection with this matter shall be forwarded to the local authority within whose district the laying is situate. Power is given to the authority of that area to make an order prohibiting the distribution for sale for human consumption of shellfish taken from such a laying, either absolutely or subject to such exceptions and conditions as the authority may think proper. So far as the City is concerned, therefore, these Regulations mean that, in appropriate cases, the authority where layings from which suspected shellfish have been received will receive a copy of any report which your Medical Officer may make on the matter, and will then exercise their discretion after investigation as to the making of an order, but Section 8 will authorise the City to appeal to the Minister of Health if the outside authority fails to make an order at all or within a reasonable time, or does not provide adequate safeguards for the public health. The measure in question is a very useful one. 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 market about twice a week and at irregular times are particularly difficult to supervise. The market carriers know the Regulations and the advantage of maintaining their vehicles in a fit and proper condition. The market porters, generally, also carry out the Regulations, although a number appear to object to the wearing of a washable head-covering. Private cars are still used for the conveyance of meat, but many of these have been fitted with an adjustable boxed inner lining, which is easily detached and cleansed, thus avoiding the serious contamination which must occur unless very special precautions are taken in the use of these vehicles for this purpose. During the year 1935 no prosecutions were taken, but 775 contraventions of the Regulations have been recorded, mostly of a minor kind, and cautionary letters have been forwarded where necessary. The high standard of cleanliness with regard to the butchers' shops reported last year has been maintained. The depots used as distribution centres by multiple restaurants are the subject of constant supervision, and improvements have been made in many of these premises. 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 co-operation between persons and associations responsible for the carrying out of the Regulations and the officers of my department. 43 LONDON COUNTY COUNCIL GENERAL POWERS ACT, 1932. Summary of types of premises registered during 1935. Sausages and Cooked Meat 4 Shellfish Boilers 3 Pickling of Meat 4 Manufacture of Ice Cream 1 Sale of Ice Cream 10 Note.—Some of these 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 applicant. When the improvements have been carried out, a standard capable of maintenance results. The number of premises registered in the City since the inception of the Act is 105. In five cases the premises were considered unsuitable for satisfactorily conducting 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 City Wharves :— SUMMARY OF FOOD DISCHARGED AT CITY WHARVES. Article. Description of Packages. Where from. General Range of Weight of Packages. Quantity. Butter Packages Holland 6 lbs.—1 cwt. 230,926 Bacon Bags, Cases ,, 1 cwt. 2 qrs.—3 cwts. 53,418 Cheese (Loose) Single ,, 1 lb.—8 lbs. 117,480 Cheese Packages ,, 24 lbs.—1 cwt. 502,049 Dripping ,, South America 28 lbs.—56 lbs. 1,193 Eggs (Fresh) Cases Holland and Belgium 84 lbs.—1 cwt. 2 qrs. 210,460 Eggs (Frozen) ,, Holland 28 lbs. 657 Eggs (Gulls') Packages ,, 28 lbs. 110 Egg Yolk Casks China 56 lbs.—4 cwts. 232 Lard Packages Holland, Canada and S. America. 28 lbs.—56 lbs. 110,939 Margarine ,, Holland 12 lbs.—56 lbs. 8,088 Cereals— „ ,, Barley Bags ,, 100 lbs.—1 cwt. 2 qrs. 251 Beans „ ,, 1 cwt.—2 cwts. 2,192 Ground Rice „ ,, 1 cwt.—2 cwts. 32 Peas „ ,, 1 cwt.—1 cwt. 3 qrs. 23,064 Rice „ Italy 1 cwt.—1 cwt. 2 qrs. 440 Tapioca „ Holland 1 cwt.—1 cwt. 2 qrs. 1,094 Cocoa Bags, Packages Holland, Ceylon and Africa. 28 lbs.—2 cwts. 9,622 Coffee Bags Holland, Ceylon, E. Africa and Costa Rica. 1 cwt. 2 qrs. 47,698 Fruit (Soft)— Apples Packages Holland, America, Canada and Australia. 28 lbs.—1 cwt. 2 qrs. 104,294 Bananas „ Jamaica 1 cwt. 1 qr. 1,300 Blackberries „ Holland 12 lbs. 3,956 Black Currants „ ,, 12 lbs. 3,956 Cherries „ ,, 12 lbs.—40 lbs. 467 Cranberries „ ,, 28 lbs. 12,035 Gooseberries „ ,, 40 lbs.—100 lbs. 201 Greengages „ ,, 14 lbs.—28 lbs 143 Juniper Berries „ ,, 56 lbs. 312 Peaches , „ America 10 lbs.—14 lbs 106 Pears „ Holland and America 6 lbs.—28 lbs 12,297 Plums „ Holland 6 lbs.—28 lbs 9,176 Red Currants „ ,, 6 lbs.—12 lbs 1,641 Strawberries „ ,, 7 lbs.—28 lbs 82 44 Article. Description of Packages. Where from. General Range of Weight of Packages. Quantity. Fruit (Dried)— Apricots Packages America, Canada and S. Africa. 28 lbs.—56 lbs. 19,977 Bananas ,, Africa 100 Currants ,, Greece and Turkey 28 ibs.—56 lbs. 299,253 Dates ,, Egypt 3 qrs. 15,928 Evaporated Apples ,, America, Canada and S. Africa 56 lbs. 19,394 Figs ,, Greece and Turkey 28 lbs.—4 cwts. 75,531 Fruit Salad ,, America 28 lbs.—56 lbs. 2,600 Peaches ,, America and S. Africa 24 lbs.—56 lbs. 3,082 Pears ,, America 24 lbs.—56 lbs. 10,399 Plums ,, America and Australia 24 lbs.—1 cwt. 246,138 Preserved Fruit ,, Holland 10 lbs.—56 lbs. 384 Raisins ,, America, Spain, Greece and Turkey. 6 lbs.—56 lbs. 351,997 Sultanas ,, America, Greece, Turkey and Persia. 24 lbs.—56 lbs. 343,520 Fruit (Green)— ,, Bananas ,, Brazil 56 lbs. 1,600 Citrons ,, Spain 56 lbs.—1 cwt. 35 Grape Fruit ,, Trinidad, Florida, Italy and Jaffa. 56 lbs.—1 cwt. 10,055 Grapes ,, Spain 12 lbs.—I cwt. 127,786 Lemons ,, Italy and Spain 1 cwt. . 179,083 Limes ,, Trinidad 14 lbs.—24 lbs. 9 Mandarines ,, Spain 3 qrs.—1 cwt. 1 qr. 14,282 Melons ,, Holland and Spain 12 lbs.—1 cwt. I qr. 93,976 Oranges ,, Spain, Brazil and Jaffa 3 qrs.—I cwt. 1 qr. 122,477 Pomegranates ,, Spain 28 lbs.—1 cwt. 1 qr. 1,450 Pineapples ,, St. Michaels 1 qr. 16 lbs.—2 qrs. 18 lb 3. 4,246 Vegetables— ,, Beans ,, Holland 40 lbs. 48,212 Beetroots ,, 1 cwt. 781 Cabbages ,, 1 cwt. 3,312 Carrots ,, 40 lbs.—1 cwt. 1 qr. 43,134 Cauliflower ,, 24 lbs.—40 lbs. 13,916 Cucumbers ,, 12 lbs.—40 lbs. 9,563 Lettuce ,, 12 lbs.—40 lbs. 300,809 Marrows ,, 1 cwt. 70 Onions ,, Holland and Spain 1 cwt. I qr. 306,293 Parsnips ,, Holland 1 cwt. 350 Potatoes ,, 56 lbs.—1 cwt. 1 qr. 157,405 Radishes ,, 28 lbs.—1 cwt. 11,820 Spinach ,, ,, 14 lbs.—56 lbs. 20 Sprouts ,, ,, 100 lbs. 474 Tomatoes ,, ,, 12 lbs.—56 lbs. 848,747 Sugar— Bags, Cases ,, 1 cwt.—2 cwts. 21,628 Tea Packages India, China, Ceylon and Java. 1 cwt. 82,493 Tinned Goods—Anchovies Cases Portugal & Holland 1 cwt.—2 cwts. 1,628 Apples ,, America and Canada 50 lbs.—1 cwt. 19,080 Apricots ,, America, Canada and 48 lbs. 37,751 ,, Australia. Artichokes ,, Canada 40 lbs.—60 lbs. 50 Asparagus ,, America and Canada 56 lbs.—1 cwt. 3,172 Beans ,, America 1 cwt. 1,204 Beef Brisket ,, S. America 90 lbs. 4,124 Black Currants ,, France 1 cwt. 400 Boiled Beef ,, S. America — 13,487 Boiled Mutton ,, ,, 56 lbs.—1 cwt. 620 Brawn ,, ,, 36 lbs. 1,207 Cherries ,, Italy and Canada 28 lbs.—48 lbs. 44,978 Chicken ,, Holland and America 36 lbs. 292 Condensed Milk ,, Holland 48 lbs. 1,010,955 Corned Beef ,, ,, S. America 72 lbs. 152,311 Crab ,, America and Japan 56 lbs. 3,123 Crayfish ,, S. America 56 lbs. 300 Cucumber ,, Holland 20 lbs. 10 Egg Yolk ,, ,, 2 cwts. 56 45 Article. Description of Packages. Where from. General Range of Weight of Packages. Quantity. Tinned Goods—(continued). Figs Cases America 1 cwt. 2,264 Fish ,, Holland, Sweden and 1 cwt. 1,628 Portugal. Fruit Pulp ,, America 72 lbs.—100 lbs. 18,560 Fruit Salad 50 lbs.—100 lbs. 19,399 Grape Fruit ,, ,, 50 lbs. 56,519 Hams ,, ,, 20 lbs.—1 cwt. 1 qr. 2,295 Kidneys ,, S. America 56 lbs. 30 Loganberries ,, America 56 lbs.—1 cwt. 11,141 Lobster ,, ,, 50 lbs. 10,061 Meat Extract ,, S. America 56 lbs.—1 cwt. 1,980 Meat Roll ,, Holland 56 lbs.—1 cwt. 24 Oranges ,, Japan 56 lbs.—1 cwt. 23,077 Orange Juice ,, America 56 lbs.—1 cwt. 200 Ox-tails ,, ,, 40 lbs. 11 Ox Tripe ,, Holland 40 lbs. 50 Peaches ,, Canada, America and 48 lbs. 115,030 ,, Australia. Pears ,, Canada, America and 48 lbs. 84,673 Peas ,, Australia. America 48 lbs. 3,138 Pines ,, Singapore, Hawaii, and Australia. 60 lbs. 144,530 Pilchards ,, America 60 lbs. 9,702 Plums ,, Canada 60 lbs. 22,593 Pork ,, Holland 56 lbs.—2 cwts, 250 Pork and Beans ,, America 60 lbs. 4,976 Prawns ,, ,, 56 lbs. 1916 Pressed Beef ,, ,, 40 lbs.—90 lbs. 3,209 Salmon ,, Canada, America and Japan. 56 lbs.—1 cwt. 94,670 Sardines ,, Portugal and Spain 56 lbs.—1 cwt. 70,286 Sausages ,, Holland 56 lbs.—1 cwt. 394 Shrimps ,, America 40 lbs. 50 Soup ,, Canada 56 lbs. 291 Strawberries ,, America 48 lbs. 462 Sugar Corn ,, America and Canada 56 lbs. 7,220 Tomatoes ,, Canada and Italy 56 lbs. 108,009 Tomato Juice Tongues ,, Italy Holland, South America 56 lbs. 48 lbs.—1 cwt. 50 39,655 Tripe ,, and New Zealand. South America 56 lbs. 10 Veal ,, Holland, New Zealand and Australia. 56 lbs.—100 lbs. 29,032 Vegetables ,, Holland and Spain 50 lbs.—100 lbs. 5,061 Vegetable Soup ,, 56 lbs. 200 Cocoanuts Holland 1 cwt. 1 qr. 100 Ginger (Preserved) Cases, Casks China 30 lbs.—3 cwts. 13,511 Macaroni Packages Canada 40 lbs. 4,993 Milk Powder ,, Canada and Holland 50 lbs.—1 cwt. 26,082 Nuts (Various) ,, Spain, China and India 50 lbs.—1 cwt. 1 qr. 40,463 Vegetables (in Brine). Casks Holland and Spain 3 cwts.—4 cwts. 7,968 Vegetables (Dried) Packages Holland 56 lbs. 120 Miscellaneous— Anchovies (in Brine). Casks Holland 1 cwt. 2 Biscuits Packages ,, 1 cwt.—1 cwt. 1 qr. 64 Block Condensed Milk. ,, ,, 56 lbs. 1,020 Carraway Seeds Bags ,, 1 cwt. 1 qr. 1,526 Casings Casks, Cases ,, 56 lbs.—3 cwts. 909 Cherries (in Brine) Casks Italy 2 cwts.—3 cwts. 1,713 Chocolate Packages Holland 50 lbs.—1 cwt. 1 qr. 381 Chutney ,, India 1 cwt.—3 cwts. 216 Citrons (in Brine) Casks Spain 4 cwts. 735 Cloves Bags Zanzibar and Holland 1 cwt. 400 Cocoa Beans ,, Africa and Brazil 2 cwts. 94 G 46 Article. Description of Packages. Where from. General Range of Weight of Packages. Quantity. Miscellaneous—(continued). Cocoa Butter Packages Holland and America 1 cwt.—2 cwts. 10,238 Condensed Milk Casks Holland 4 cwts.—5 cwts. 7,411 Confectionery Packages ,, 28 lbs.—1 cwt. 385 Curry Powder — India 1 cwt. 5 Desiccated Cocoanut. Bags Ceylon 28 lbs.—1 cwt. 18 lbs. 5,930 Drained Cherries Packages Italy 2S lbs.—1 cwt. 286 Frozen Ducks Cases America 1 cwt.—2 cwts. 10 Frozen Fish Packages ,, 1 cwt.—3 cwts. 349 Fruit and Lemon Casks Spain, Italy and 3 cwts.—4 cwts. 2,182 Juice. America. Fruit Pulp ,, Holland and Spain 4 cwts. 16,198 Glands Casks Holland 1 cwt.—3 cwts. 2 Honey Casks, Cases America 1 cwt.—2 cwts. 239 Jam Cases Australia 1 cwt.—2 cwts. 15 Lemon Juice — Italy 1 cwt. 13 Powder. Liquorice Packages Italy 1 cwt.—2 cwts. 1,644 Milk Sugar ,, Holland 4 cwts.—5 cwts. 105 Olives (in Brine) Casks Spain 1 cwt.—2 cwts. 60 Orange Peel — ,, 14 lbs. 14 Peel (in Brine) Casks ,, 4 cwts.—5 cwts. 42 Pepper — ,, 1 cwt. 2 qrs. 16 lbs. 60 Poultry — Holland 24 lbs.—56 lbs 4,483 Rabbits Cases ,, 1 cwt. 406 Salmon Casks America 4 cwts.—5 cwts. 10 Sugar Candy Packages Holland 28 lbs.—56 lbs. 400 Vegetable Powder ,, „ 1 cwt. 2 qrs. 1,591 Yeast ,, ,, 28 lbs.—56 lbs. 5,440 UNSOUND FOOD SURRENDERED AT RIVERSIDE WHARVES AND WAREHOUSES. As a result of the daily inspection of City Wharves, 63½ loads of unsound food were removed from these places during the year by the Cleansing Department. The material so disposeu of cumprised .— Tons. Cwts. Qrs. Lbs. Condensed Milk 3 4 3 0 Dried Fruit 3 7 2 0 Fresh Fruit 6 18 3 0 Fruit Juice 7 15 2 0 Tinned Fruit Pulp 7 9 2 0 Tinned Fruit, Vegetables and Fish 41 13 3 22 Nuts 0 8 2 0 Vegetables 5 13 0 0 Miscellaneous 2 18 0 9 Total 79 9 2 3 The following were released for animal feeding and manufacturing purposes under guarantee :— Tons. Cwts. Qrs. Lbs. 1 Cask Full Cream Condensed Milk 0 6 0 0 92 Cases Full Cream Condensed Milk 2 6 0 0 228 Cases Skimmed Condensed Milk 3 1 1 0 12 Bags Nutmegs 0 9 0 0 166 Boxes Dried Apricots 2 0 0 0 Total 8 2 1 0 The following were destroyed at the wharves or by private contractors under proper supervision :- 2,592 Boxes Prunes Tons. Cwts. Qrs. Lbs. 21 0 0 0 31 Boxes Grape Fruit 1 11 0 0 98 Boxes Lemons 2 12 2 0 184 Boxes Oranges 5 15 0 0 117 Boxes Pears 3 2 2 20 10 Crates Lettuce 0 2 0 0 2 Casks Fruit Juice 0 10 0 0 69 Casks Condensed Milk 25 14 0 0 1 tin Cucumbers 0 0 0 14 1,230 Cases Tinned Meats 36 4 1 16 Total 96 11 2 22 Grand Total 184 3 l 25 47 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 3,287 shops and stores and 801 street traders were interviewed. There were, in all, 30 minor offences. There was one offence against the law which necessitated the institution of legal proceedings, and in this case the defendants were fined. Thirteen new orders were issued under the Agricultural Produce (Grading and Marking) Acts, 1928 and 1931, and one new order under the Merchandise Marks (Imported Goods) Act, 1926. FERTILISERS AND FEEDING STUFFS ACT, 1926. The work in connection with the above Act has been carried on as usual, and 105 visits to firms dealing with material controlled by the Act made by your officer. Twenty-seven special enquiries instituted on behalf of other authorities in connection with delivering samples and obtaining statutory statements from registers, and only small technical errors have been occasionally discovered, and rectified immediately. The quarterly returns to the Ministry of Agriculture and Fisheries have been made in the usual way. MERCHANDISE MARKS (IMPORTED GOODS) No. 7 ORDER. MERCHANDISE MARKS (IMPORTED GOODS) EXEMPTION DIRECTION No. 1, 1935. On the 28th February, 1935, the marking of overseas meat for sale and for exposure for sale became compulsory and general under the Merchandise Marks Imported Goods No. 7 Order. On importation, indication of origin must now be borne by all foreign meat, branded, stamped, stencilled or stained conspicuously and durably in letters of \ in. in height, unless otherwise specifically stated. The indication for complete carcases of chilled beef, frozen mutton or lamb and frozen pork is depicted in the Order. Each portion of such carcase shall bear its respective portion of the required ribbon mark or marks. Boneless beef and veal, salted beef and pork and edible offals must be marked on the container or package. The indications for sale or exposure for sale, whether by wholesale or retail, are as follows :— For chilled beef, frozen mutton, lamb, or pork, where the joint or cut would in preparation avoid the prescribed importation marks, a ticket or label is required for each cut and so for boneless meat, salted meat or offals, a ticket or label must be placed on each piece or on each package or container. Frozen beef and frozen veal must be similarly indicated. There are, however, important provisos. In case of a tray, slab or rail containing joints of boneless meat, salted meat or offals, which are of Empire origin only or oi foreign origin only, a ticket conveying the origin or adequately identifying the meat on the tray, slab or rail suffices. In case a shop deals solely in Empire or solely in foreign meat, two 2-foot square notices, bearing the words " All meat in this shop is imported meat of (Empire), (Foreign), as the case may be, origin in 2 ins. high letters is regarded as an adequate indication. Further, in shops dealing solely in Empire or solely in foreign meat, indication of origin may be given on sale or on an invoice note, and where a portion of meat is duly marked on exposure for sale, a purchaser in the shop needs no further indication. The Merchandise Marks (Imported Goods) Exemption Direction No. 1, 1935, later issued on representations from the South African Union, prescribes that the marking of meat from South Africa shall not bear the words " Empire " or " Foreign," but " Union South Africa " in ribbon form. The Sale of Food Order, 1921, which traversed the above-mentioned Orders, has been revoked. From experience gained during the year one may say that the prescribed indications of origin are not difficult of application, nor are the provisions of the Orders difficult of execution. G2 48 SUPERVISION OF FOOD AND DRUGS. Daring the year 1935, 1,032 samples of food and drugs were submitted to the Public Analyst for examination, 771 of which were taken as informal or test samples without the formalities of the Food and Drugs (Adulteration) Act, 1928, being observed. Sixteen of these informal samples were reported against, as follows :— Samples. 3 Canned Vegetables 25 3 Sausages 41 2 Canned Fish 9 2 Fish Paste 18 2 Iodine Ointment 6 1 Calomel Ointment 3 1 Phenol Ointment 1 1 Canned Fruit 12 1 Vinegar 25 16 Of the formal samples, 11 out of 261 were reported against, as follows :— Samples. 6 Milk 221 2 Whisky 21 1 Vinegar 1 1 Iodine Ointment 3 1 Canned Vegetables 1 11 The above-mentioned samples, with the exception of milk and whisky, were taken as the result of informal samples having been reported against. General Observation.—The percentage rate of adulteration of all food and drugs sampled in the City was 2 -6, as compared with 3 -9 in 1934. Butter, Cream and Cheese.—None of the 89 samples of these important articles of dairy produce was reported against. Canned Goods.—Forty-eight samples of canned goods were taken and seven of them found to contain tin in excess of 2 grains per lb. Five of these samples were procured from one vendor, who surrendered five bushels of unsold stock for destruction. Two samples of canned fish were also found to contain tin in excess, and the importers were communicated with, who immediately instituted enquiries to remedy the matter. Sausages.—Of the 41 samples of sausages taken, three were reported against as containing sulphur dioxide, though no declaration had been made of its presence by label or notice, as required. In no case did the amount of preservative found exceed the permissible limit. In each case the vendors were cautioned. Fish Pastes.—Two of the 18 samples of fish pastes were found to contain lead. The manufacturers were immediately communicated with, the source of the contamination ascertained and eliminated. Spirits.—Two of the 30 samples of spirits were found to be below the legal limit of 35 degrees under proof and legal proceedings were instituted in each case. One vendor was fined £2, with £3 3s. od. costs, and one summons was dismissed under the Probation of Offenders Act. Drugs.—Of the 107 samples procured, five were reported against, three of them being iodine ointment, the vendors in each case being cautioned. 49 examination of milk. Chemical.—Six of the 221 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 2.7, compared with 9.0 in 1934. Legal proceedings were taken in respect of three of the samples and convictions recorded in respect of two of these. One consignor was communicated with with regard to milk fat deficiency, and further samples taken in respect of another sample reported against proved genuine. The following table shows the percentage fat.content in each of the 221 samples of milk procured in the City during the year, the average fat.content being 3.5 per cent., only four samples falling below the standard figure of 3 per cent.:— Percentage of Fat. No. of Samples. Percentage of Fat. No. ot Samples. 2.8 l 3.9 10 2.9 3 4.0 9 3.0 4 4.1 4 3.1 6 4.2 2 3.2 13 4.3 2 3.3 23 4.4 1 3.4 35 4.5 1 3.5 30 4.6 3 3.6 26 4.7 2 3.7 37 5.0 1 3.8 8 Total 221 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. the milk and dairies order, 1926, and the milk and dairies (amendment) act, 1922. The number of retail purveyors of milk on the register at the end of 1934 was 291, but this number has been reduced as a consequence of the revision of the register referred to in my Annual Report for 1934. Registration Statistics. New Applications for Registration received 13 New Applications granted 13 New Applications refused — Number of Retail Purveyors of Milk (with City premises) on the Register at end of 1935 90 Number of Retail Purveyors of Milk (without City premises) on the Register at end of 1935 36 Number of Milk Sellers (other than Retail Purveyors of Milk) on the Register at end of 1935 27 Licenses issued under the Milk (Special Designations) Order, 1923 17 During the year, 129 inspections were made in connection with the sale of milk and, generally, the statutory requirements were found to be complied with. Observations have been made as to the distribution of milk, but no action has been necessary in connection with offences such as the bottling of milk in the street or off dairy premises. the public health (condensed milk) regulations, 1923 and 1927. the public health (dried milk) regulations, 1923 and 1927. Nine 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. registered premises. Butter Factories.—One butter factory is registered in the City, and samples taken at various times at these premises were all certified to be genuine. Wholesale Dealers in Margarine and Margarine Cheese.—There was one new application for registration received during the year. Artificial Cream Act, 1929.—No additions have been made to the register 50 51 administrative action regarding adulteration or other irregularity. Serial No. Article. Whether Formal or Informal. Nature of Adulteration or Irregularity. Observations. Results of Proceedings or other Action taken. 14 Canned Spinach Informal Tin, 3.04 grains per pound. Re-sampled formally—No. 37 ... 21 Phenol Ointment Informal Phenol deficient, 62%. Small quantity of unsold stock destroyed Vendor cautioned. 37 Canned Spinach Formal Tin, 4.75 grains per pound. Taken in connection with sample No. 14 5 bushels of unsold stock surrendered for destruction. 38 Canned Celery Informal Tin, 3.35 grains per pound. ... 39 Canned Haricot Verts Informal Tin, 2.21 grains per pound. ... 40 Canned Apricots Informal Tin, 4.9 grains per pound. ... 50 Iodine Ointment Informal Iodine deficient, 97%. Potassium Iodide deficient, 100%. Re-sampled formally—No. 124 ... 94 Iodine Ointment Informal Iodine deficient, 98.5%. Potassium Iodide deficient, 100%. Re-sampled formally—No. 124 ... 124 Iodine Ointment Formal Iodine deficient, 98.75%. Potassium Iodide deficient, 100%. Taken in connection with samples Nos. 50 and 94. Vendor cautioned. 247 Malt Vinegar Informal Artificial Vinegar, 100%. Re-sampled formally—No. 386 ... 297 Milk Formal Extraneous Water, 8%. ... Vendor prosecuted. Summons withdrawn. Consignor prosecuted re samples Nos. 306 and 329. 306 Milk Formal Extraneous Water, 3%. Consignor to Vendor of sample No. 297 Consignor prosecuted. Fined 10s. on each of two summonses, with £4 Costs. 329 Milk Formal Extraneous Water, 5.3%. 333 Milk Formal Extraneous Water, 4.7%. 386 Malt Vinegar Formal Artificial Vinegar, 100%. Taken in connection with sample No. 247 Vendor prosecuted. Fined 5s., with 25s. Costs. 414 Milk Formal Milk fat deficient, 8%. Samples from four other churns of the consignment satisfactory. Consignor communicated with. 441 Sardine and Tomato Paste. Informal Lead, 30 parts per million. ... Manufacturers communicated with. 483 Sardine and Tomato Paste. Informal Lead, 55 parts per million. ... Manufacturers communicated with. 543 Milk Formal Extraneous water, 3%. Re-sampled—genuine ... 573 Sausages Informal Sulphur Dioxide, 100 parts per million. ... Vendor cautioned. 580 Sausages Informal Sulphur Dioxide, 100 parts per million. ... Vendor cautioned. 591 Sausages Informal Sulphur Dioxide, 210 parts per million. ... Vendor cautioned. 726 Whisky Formal Proof Spirit, 7.1 degrees deficient. ... Vendor prosecuted. Summons dismissed under Probation of Offenders' Act. 742 Canned Norwegian Sild Informal 3.4 grains of Tin per pound. ... Wholesalers communicated with. 745 Canned Sild Informal 3.2 grains of Tin per pound. ... Wholesalers communicated with. 752 Calomel Ointment Informal 100% Compound Mercury Ointment. Re-sampled formally—genuine Vendor cautioned. 801 Whisky Formal Proof Spirit, 9.5 degrees deficient. ... Vendor prosecuted. Fined £2, with £3 3s. Costs. 52 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. Butter 4 11 15 — — — — — — Butter (on bread) — 25 25 — — — — — — Cheese — 31 31 — — — — — — Cocoa — 6 6 — — — — — — Coffee — 9 9 — — — — — — Confectionery — 42 42 — — — — — — Cream — 18 18 — — — — — — Flour (Self-raising) — 2 2 — — — — — — Jam and Marmalade — 5 5 — — — — — — I.ard — 5 5 — — — — — — Margarine — 5 5 — — — — — — Milk 221 — 221 6 — 6 2.7 — 2.7 Milk, Condensed — 9 9 — — — — — — Mustard — 6 6 — — — — — — Sugar — 25 25 — — — — — — Tea — 10 10 — — — — — — Vinegar 1 25 26 1 1 2 100.0 4.0 7.6 Wine — 2 2 — — — — — — Spirits 30 — 30 2 — 2 6.6 — 6.6 Drugs 4 103 107 1 4 5 25.0 3.8 4.6 Other Articles 1 432 433 1 11 12 100.0 2.5 2.7 Totals 261 771 1,032 11 16 27 4.2 2.0 2.6 Spirits— — — — — — — — — — Gin 4 — 4 — — — — — — Rum 5 — 5 — — — — — — Whisky 21 — 21 2 — 2 9.5 — 9.5 Totals 30 — 30 2 — 2 6.6 — 6.6 Drugs— Borax. — I 1 — — — — — — Borax and Honey — 4 4 — — — — — — Camphorated Oil — 6 6 — — — — — — Cascara Sagrada — 2 2 — — — — — — Easton's Syrup — 1 1 — — — — — — Friar's Balsam — 1 1 — — — — — — Ginger, Ground — 2 2 — — — — — — Glycerine — 1 1 — — — — — — Glycerine of Borax — 5 5 — — — — — — Glycerine, Lemon and Ipecachuana — 1 1 — — — — — — Iron and Quinine Citrate — 3 3 — — — — — — Linseed, Crushed — 1 1 — — — — — — Lozenges and Tablets — 13 13 — — — — — — Oil, Almond — 5 5 — — — — — — Oil, Castor — 2 2 — — — — — — Oil, Cloves — 3 3 — — — — — — Oil, Cod Liver — 1 1 — — — — — — Oil, Eucalyptus — 2 2 — — — — — — Ointment, Boric — 1 1 — — — — — — Ointment, Calomel 1 3 4 — 1 1 — 33.3 25.0 Ointment, Iodine 3 6 9 1 2 3 33.3 33.3 33.3 Ointment, Mercury — 2 2 — — — — — — Ointment, Phenol — 1 1 — 1 1 — 100.0 100.0 Ointment, White Precipitate — 2 2 — — — — — — Ointment, Zinc — 11 11 — — — — — — Carried forward 4 80 84 1 4 5 25.0 5.0 6.1 53 the food and drugs (adulteration) act, 1928, the public health (preservatives, etc., in food) regulations, the public health (condensed milk) regulations, 1923 and 1927, the public health (dried milk) regulations, 1923 and 1927, and the artificial cream act, 1929— Continued. Formal and Informal Samples Submitted for Analysis. Article. Number Examined. Number Adulterated, etc. Percentage of Adulteration. Formal. Informal. Total. Formal. Informal. Total. Formal. Informal. Total. Drugs (continued)— Brought forward 4 80 84 1 4 5 25.0 5.0 6.1 Paraffin, Liquid — 5 5 — — — — — — Parrish's Chemical Food — 4 4 — — — — — — Powder, Gregory's — 2 2 — — — — — — Powder, Liquorice — 2 2 — — — — — — Sal Volatile — 3 3 — — — — — — Sulphur — 1 1 — — — — — — Tincture, Iodine — 1 1 — — — — — — Tincture, Quinine — 3 — — — — — — Turpentine, Liniment — 1 1 — — — — — — Vaseline, Capsicum 1 1 — — — — — — Totals 4 103 107 1 4 5 25.0 3.8 4.6 Other Articles— Arrowroot — 2 2 — — — — Baking Powder — 3 3 — — — — — — Beverages, etc. — 13 13 — — — — — — Cake and Biscuits — 13 13 — — — — — — Chocolate Powder — 4 4 — — — — — — Cornflour — 1 1 — — — — — — Dripping — 4 4 — — — — — — Egg Powder Substitute — 1 1 — — — — — — Fish 3 3 — — — — — — Fish, Canned — 9 9 — 2 2 — 22.2 22.2 Fish, Potted and Paste — 18 18 — 2 2 — 11.1 11.1 Fruit, Canned — 12 12 — 1 1 — 8.3 8.3 Fruit, Dried — 74 74 — — — — — — Honey — 11 11 — — — — — — Ice Cream — 15 15 — — — — — — Jellies — 10 10 — — — — — — Lemonade Powder — 11 11 — — — — — — Lemon Curd — 3 3 — — — — — — Meat — 31 31 — — — — — — Meat, Canned — 1 1 — — — — — — Meat, Potted — 3 3 — — — — — — Meat Pies, etc. — 13 13 — — — — — — Milk Preparations — 6 6 — — — — — — Mincemeat — 7 7 — — — — — — Oatmeal — 1 1 — — — — — — Olive Oil — 5 5 — — — — — — Pepper — 7 7 — — — — — — Pickles and Sauces — 16 16 — — — — — — Powder, Custard — 2 2 — — — — — — Preserved Vegetables 1 25 26 1 3 4 100.0 12.0 15.3 Rice — 12 12 — — — — — — Sago — 3 3 — — — — — — Sausages, etc — 41 41 — 3 3 — 7.3 7.3 Semolina — 1 1 — — — — — — Soups — 7 7 — — — — — — Spices, etc — 35 35 — — — — — — Suet — 4 4 — — — — — — Tapioca — 2 2 — — — — — Treacle and Syrup — 1 1 — — — — — — Wines (Non—alcoholic) 2 2 — — — — — — Totals 1 432 433 1 11 12 1000 2.5 2.7 54 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. 297 Milk 8% extraneous water Summons withdrawn. Consignor prosecuted. See samples Nos. 306 and 329. 306 Milk 3% extraneous water and £4 Costs. 329 Milk. 5.3% extraneous water 386 Malt Vinegar 100% Artificial Vinegar 5s. and 25s. Costs. 726 Whisky 7.1 degrees deficient in Proof Spirit Summons dismissed under Probation of Offenders'Act. 801 Whisky 9.5 degrees deficient in Proof Spirit SUMMARY. £2 and £3 3s. 0d. Costs. Total Fines £3 5s. 0d. Total Co: 5ts .£8 8s. 0 d. milk (special designations) order, 1923. During the year 17 applications were received from nine retailers under the Milk (Special Designations) Order, 1923, for licences to sell specified grades of milk. Six of these were granted for the purpose of authorising the dealer to sell the milks from shops situate within the City, and 11 were supplementary licences in respect of milk delivered by roundsmen in the City from shops situate outside. The following table shows the number of licences issued in respect of each particular grade :— Grade. Dealers' Licences. Supplementary Licences. Grade A (T.T.) 4 3 Certified — 2 Pasteurised 2 5 Grade A Pasteurised — 1 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 May, 1935, in continuation of this practice, 27 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 :— Herts 9 Essex 8 Suffolk 8 Norfolk 2 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 1935. No. of Sample. Date of inoculation of Guinea Pig. Dirt. Date of Death. Post Mortem Findings. Result. l 3rd May Nil 16th June Normal Negative. 2 3rd May Nil 11th May No post mortem (died) Frustrate. 3 3rd May Nil 17th June Normal Negative. 4 3rd May Nil 16th May No post mortem (died) Frustrate. 5 3rd May Nil 17th June Normal Negative. 6 3rd May Nil 17th June Normal Negative. 7 10th May Nil 21st June Normal Negative. 8 10th May Nil 21st June Normal Negative. 9 10th May Nil 21st June Normal Negative. 10 10th May Nil 21st June Normal Negative. 11 10th May Trace 21st June Normal Negative. 12 10th May Trace 21st June Normal Negative. 13 14th May Nil 26th June Normal Negative. 55 No. of Sample. Date ot inoculation of Guinea Pig. Dirt. Date of Death. Post Mortem Findings. Result 14 14th May Nil 26th June Normal Negative. 15 14th May Nil 26th June Normal Negative. 16 14th May Nil 26th June Normal Negative. 17 14th May Trace 26th June Normal Negative. 18 17th May Nil 26th June Normal Negative. 19 17th May Nil 28th June Normal Negative. 20 17th May Nil 28th June Normal Negative. 21 17th May Nil 28th June Normal Negative. 22 21st May Nil 2nd July Normal Negative. 23 21st May Nil 2nd July Normal Negative. 24 21st May Trace 2nd July Normal Negative. 25 21st May Nil 2nd July Normal Negative. 26 21st May Nil 15th June Normal (25 days, died) Frustrate. 27 21st May Nil 15th June Normal (25 days, died) Frustrate. It will be observed that in no case was evidence of tuberculosis found and that in only. four were there any traces of dirt. So far as the results themselves are concerned, this series is one of the most satisfactory since sampling at railway stations first commenced. 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. 1934 8.3% 26.3% 2nd Series. 1935 0.0% Chemical examination showed that one sample only was sophisticated, and that to the extent of 8 per cent, deficiency in milk fat. The vendor was cautioned. 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 621 persons, compared with 635 in 1934. 88 per cent, are adults and 12 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 1935 97 persons (95 per cent, adults and 5 per cent, children). (2) In January, 1929, a similar block of buildings, Dutton House, in New Street, containing 52 rooms, arranged in 16 tenements, and housing at the end of 1935, 65 persons (78 per cent, adults and 22 per cent, children). There are 7 shops, each with a large and well.lighted basement, in Bearsted House, and 8 shops, similarly provided with a basement, in Dutton House. The total population of these dwellings is 783. h2 56 The number of births was 10,* viz. : 4 male and 6 females. The birth-rate was 12.7 per 1,000, which is 2.8 per 1,000 above the average for the previous five years. The birth-rate in these Dwellings reached a maximum of 46.9 per 1,000 in 1896, and has since been falling irregularly, but almost progressively. The death rate for 1935 was 19.2 per 1,000 per annum. For the purposes of comparison of births 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 1935. Name or Block. Births. Mortality from all Causes at subjoined ages. Males. Females. At aU ages. Under 1 year. 1 and under 5 5 and under 15 15 and under 25 25 and under 65 65 and upwards. north block 1 .... .... .... .... .... .... .... .... south 2 3 2 1 .... .... .... .... 1 king's 1 .... 2 .... .... .... .... 1 1 queen's .... 2 3 2 .... .... .... .... 1 prince's .... 1 3 .... .... .... .... .... 3 bearsted house .... .... 4 1 .... .... .... 1 2 dutton „ .... .... 1 .... .... .... .... 1 .... Totals 4 6 15 4 .... .... .... 3 8 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 1935 being 15,169, of whom 6,176 were males and 8,993 were females. The accompanying table is compiled from the monthly records of attendances at the baths:— record of attendances at the baths, artizans' dwellings. Month. Sex. Males. Females. Total. Children. Adults. Children. Adults. January 128 648 146 998 1,920 February 56 313 59 491 919 March 81 402 74 620 1,177 April 64 347 70 505 986 May 73 448 109 637 1,267 June 71 417 129 652 1,269 July 89 451 139 660 1,339 August 103 448 116 716 1,383 September 104 381 104 614 1,203 October 110 420 120 603 1,253 November 119 439 133 619 1,310 December 90 374 126 553 1,143 Totals 1,088 5,088 1,325 7,668 15,169 † No still births. 57 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 W. G. C. Neale. Month. Premises Inspected. Orders issued. Notices served. Improvements effected. January 192 .... 1 16 February 232 .... .... 21 March 167 .... 1 17 April 109 .... 27 11 May 112 4 .... 9 Tune 130 .... 1 10 July 146 .... .... 6 August 190 .... .... 8 September 152 .... 1 8 October 152 .... 2 5 November 196 .... .... 12 December 165 .... .... 10 Totals 1,943 4 33 133 MIDDLE DISTRICT—Inspector G. H. Fowler. Month. Premises Inspected. Orders issued. Notices served. Improvements effected. January 201 l 5 20 February 171 .... 2 14 March 156 .... 1 18 April 165 l 1 15 May 171 .... 9 19 June 181 10 10 12 July 193 .... .... 21 August 96 .... .... 8 September 192 .... 4 16 October 170 16 19 20 November 176 l 5 16 December 125 l 2 18 Totals 1,997 30 58 197 EAST DISTRICT—Inspector G. E. Harrington. Month. Premises Inspected. Orders issued Notices served. Improvements effected. January 183 .... 1 14 February 184 2 2 10 March 186 2 15 13 April 208 5 2 18 May 158 2 3 17 Tune 172 1 4 13 July 198 1 1 11 August 147 .... 1 12 September 183 1 2 16 October 148 1 1 13 November 197 .... 2 18 December 164 4 3 16 Totals 2,128 19 37 173 THE FOREGOING ARE SUMMARISED AS UNDER District. Number of Inspections made. Orders issued. Notices served. Improvements effected. West 1,943 4 33 133 Middle .... .... .... .... 1,997 30 58 197 East 2,128 19 37 173 Totals 6,068 53 128 503 58 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 24 177 96 1.8 27 Middle — — — — — East 16 129 71 1-8 17 Total 40 306 167 1.8 44 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 44 notices during 1935. 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, j Two ! Rooms. Three Rooms. Four Rooms. Five Rooms or over. WEST DISTRICT. Albion Buildings, No. 21, Bartholomew Close .... 10 .... .... .... 16 Albion Buildings, No. 22, Bartholomew Close .... 10 .... .... .... 13 Bartholomew House, Bartholomew Close 18 1 .... .... .... 27 Dean Street Blocks, Fetter Lane— Block A 6 .... .... .... 12 B 3 3 l .... .... 15 c 2 5 .... .... .... 9 „ D 2 3 .... l .... 18 „ E 4 4 .... .... .... 13 „ F 3 5 .... .... 17 St. Ann's Chambers, Ludgate Hill 3 8 l l l 21 Bloomfield House, Snow Hill .... 17 .... .... l 47 Total (Six " Blocks ") 35 72 2 2 2 208 MIDDLE DISTRICT. Bridgewater House, Fann Street .... 9 .... .... 1 11 City Buildings, Moor Lane 2 20 11 .... .... 61 72 Total (Two " Blocks ") 2 29 11 .... 1 EAST DISTRICT. Harrow Place and Stoney Lane— North Block .... 52 8 .... .... 164 South „ 5 22 13 .... .... 125 Prince's „ 5 50 .... .... .... 120 Queen's ,, 5 40 5 .... .... 117 King's ,, 8 18 16 .... .... 95 Barker's Buildings, Catherine Wheel Alley, Bishopsgate 1 4 1 1 .... 18 Bearsted House, Hutchison Street .... .... 7 15 1 97 Dutton House, New Street .... .... 13 2 1 65 Total (Four " Blocks ") 24 186 63 18 2 801 These twelve blocks contain 449 tenements, and are inhabited by 1,081 persons—an average of 2.4 persons to each tenement. 59 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) 206 (b) Number of inspections made for the purpose 493 (2) (a) Number of dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 104 (b) Number of inspections made for the purpose 297 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation Nil. (4) Number of dwelling-houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation Nil. 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 46 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 14 (2) Number of dwelling-houses in which defects were remedied after service of formal notices :— (a) By owners 14 (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. It was opened on the 7th February, 1906, and is known as the " Salvation Army Working Men's Hotel and Shelter." Periodical inspections were made during the year and, following representation from this Authority, entire reconstruction of the basement washhouse, together with the provision of new sanitary fittings, was undertaken and completed by the owners, the Salvation Army. The change in the generalship of the Army from General Edward J. Higgins to General Evangeline Booth necessitated, during the year, an alteration in the name under which the above-mentioned common lodging house is registered, and at the request of the Industrial Secretary of the Salvation Army, these premises are now registered in the name of the Salvation Army Trustee Co., and an appropriate certificate was issued on the 31st January, 1935. 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 253 plans were submitted with regard to proposed reconstruction of water-closets or drains in the City. Of these, 211 were approved, 25 revised and approved, and 14 not approved. 60 Street Gullies.—The gradual substitution of properly trapped gullies for those formerly existing has greatly reduced the number of complaints received of offensive smells arising from these appliances, especially in warm weather. In some cases this nuisance was doubtless due to want of flushing, but in the majority faulty construction was the cause of the trouble. The City Engineer has given special attention to this matter for several years past, and his action in replacing the old pattern gullies with those of a more up-to-date design will, I hope, eventually lead to a complete abatement of the evil. Overcrowding.—Overcrowding is a nuisance to be dealt with summarily under Section 2, Sub-section 1 (e) of the Public Health (London) Act, 1891, and is the subject of special observations elsewhere in this Report. 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 99 cases investigated in 1935, defects were found in 20 instances. Legal Proceedings.—During the year, 53 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 1935, 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, six 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 six 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 four instances. 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 2½ years, 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 anv time. During the year ended 31st December, 1935, the tonnage of refuse collected was as follows :— House, trade and market refuse 42,851 Street and gully refuse 15,121 Total tons 57,972 Seventy-four per cent, of the refuse was collected by horse vans and 26 per cent, by motor waggons. It is estimated that the above total tonnage is equal to over 200,000 cubic yards. 61 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 1935, 63,328 gullies were cleansed and 24,115,000 gallons of water used for cleansing streets, courts and gullies. pigeons. The congregation of pigeons within the City area continues to be a source of nuisance and damage, and it is essential that continual efforts be directed in order that the number of these birds may be kept within reasonable limits. This is not easy, because the City churches and other ornate structures afford such safe nesting places, and the easy acquisition of food. The work of destruction is in the hands of a contractor who, during 1935, destroyed 554 pigeons. As in the past, any ringed birds which have been caught have been sent to the Homing Union, in accordance with an undertaking given when the Act of Parliament under which action is permitted was placed on the Statute Book. Only one ringed bird was caught during 1935. There is considerable antagonism to the activities of the persons engaged in catching these birds, but I would assure these well-meaning people that every care is taken to ensure that the trapping is not attended by any element of cruelty. The birds, after being caught, are brought to the Corporation depot in Golden Lane and destroyed under my supervision. exhumation and re-interment of bodies. City of London Cemetery. During the year the bodies of four persons buried at the City of London Cemetery, at Ilford, have been exhumed and subsequently re-interred in the same cemetery. In accordance with the terms of the licences issued by the Home Secretary in respect of these cases, the work of removal and re-interment was carried out in the early morning and under the supervision of your Medical Officer of Health. discovery of human remains. 57 /59, Charterhouse Street. During excavation work at 57 /59, Charterhouse Street, a small quantity of human remains was discovered. These remains, which were very old, were not found in any orderly state, and had in all probability been disturbed at some previous excavation. I communicated with the City Police and the City Coroner and, with their approval, the remains, which totalled only one small bagful, were duly re-interred on the site with every decency and precaution. housing. Under the 1930 Housing Act a survey of every working-class house was made forthwith, and I felt that, were an extreme view of necessities under the Act taken, many of the comparatively few working-class private houses in the City would fail, in some respect, to come up to the standard set. Without a housing act many of the houses, and these the least conformable, would have been demolished long since but for the Rent Restriction Act, and even in presence of that Act, demolition of the worst houses has already taken place on normal evolution. Meanwhile, other houses have been brought to habitable state under the Housing Act within the existing limitations imposed by the City Byelaws. On the whole, from the very nature of the City's population and buildings, housing difficulties, as contemplated by the 1930 Act, did and do not exist in a critical form. I 62 On the passing of the 1935 Act, a full survey was immediately undertaken for the purposes of this Act and enquiry made in a manner which was substantially that necessary for the full particulars of the Form B later issued by the Minister of Health. The district sanitary inspectors were utilised for this purpose and the staff was not increased. At the end of 1935 it was apparent that the survey could be completed within a reasonable time with some pressure on the staff, which was relieved by a consideration of their other duties in relation to the necessity of this completion. In no case was the law invoked, but was an effective background to negotiation. Houses demolished 10 Houses no longer used as dwellings 16 Houses rendered reasonably fit for inhabitation 15 Unfit tenements not now occupied separately 2 Tenement houses improved 14 factory and workshop act, 1901, &c. Factories, Workshops and Workplaces.—The premises upon the Register number 3,908, in which are included 8,570 workrooms, &c. There were served 1,683 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 1,549 3,918 WORKSHOPS 1,102 1,605 WORKPLACES Kitchens of Restaurants and Tea Rooms 729 1,655 Kitchens of Licensed Premises 275 877 Stables 7 74 Other places 246 441 3,908 8,570 The following is a Summary of Inspections of separate workrooms, &c., during the year :— Workshop Inspectors. Woman Inspector. Totals. FACTORIES 1,825 1,825 WORKSHOPS 733 733 WORKPLACES 1,237 802 2,039 The following is a Summary of Inspections of separate workrooms, since 1926 :— FACTORIES. Workshop Inspectors. Woman Inspector. Totals. 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 1935 1,825 — 1,825 63 WORKSHOPS. Workshop Inspectors. Woman Inspector. Totals. 1926 1,242 7 1,249 1927 1,259 — 1,259 1928 1,093 l 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 1935 733 — 733 WORKPLACES. Workshop Inspectors. Woman Inspector. Totals. 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 1935 1,237 802 2,039 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, †280, Bishopsgate. † Great Eastern Railway Hotel. † *85, Middlesex Street, †12 and 13, Widegate Street. UNDERGROUND BAKEHOUSES. † 188, Aldersgate Street. 262, Bishopsgate. 8, Copthall Avenue. †*67, Farringdon Street. 48, Knightrider Street. †*122, Middlesex Street, †3, Pancras Lane †21, Stoney Lane, † 68, St. Mary Axe. 194, Upper Thames Street. SUMMARY. Aboveground Bakehouses 5 Underground Bakehouses 10 15 * These have been established at least 49 years. t 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 41 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. 12 64 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. s. Factories, Initial Inspections (Tenancies) 74 92 61 227 Do. Initial Inspections (Workrooms) 118 126 103 347 Do. Periodical Inspections (Tenancies) 141 183 283 607 Do. Periodical Inspections (Workrooms) 259 284 924 1,467 Do. Re-inspections (Sanitary Works, &c.. in hand) 79 182 158 419 Workshops, Initial Inspections (Tenancies) 75 32 38 145 Do. Initial Inspections (Workrooms) 93 36 55 184 Do. Periodical Inspections (Tenancies) 113 92 192 397 Do. Periodical Inspections (Workrooms) 155 121 269 545 Do. Re-inspections (Sanitary Works, &c., in hand) 71 94 46 211 Workplaces, Initial Inspections (Tenancies) 13 6 11 30 Do. Initial Inspections (Workrooms) 32 7 17 56 Do. Periodical Inspections (Tenancies) 18 14 27 59 Do. Periodical Inspections (Workrooms) 39 19 58 116 Do. Re-inspections (Sanitary Works, &c., in hand) 3 8 20 31 Bakehouses, Periodical Inspections (Tenancies) 16 10 4 30 Do. Periodical Inspections (Workrooms) 33 10 4 47 Do Re-inspections (Sanitary Works, &c., in hand) 20 9 7 36 Kitchens of Restaurants, &c.— Initial Inspections (Tenancies) 16 18 10 44 Initial Inspections (Workrooms) 36 37 17 90 Periodical Inspections (Tenancies) 61 81 103 245 Periodical Inspections (Workrooms) 150 204 214 568 Re-inspections (Sanitary Works, &c., in hand) 90 215 131 436 Kitchens of Licensed Premises— Initial Inspections (Tenancies) 15 3 3 21 Initial Inspections (Workrooms) 50 9 4 63 Periodical Inspections (Tenancies) 23 46 46 115 Periodical Inspections (Workrooms) 84 152 108 344 Re-inspections (Sanitary Works, &c., in hand) 66 61 46 173 Workshops notified by H.M. Inspector 7 15 10 32 General complaints received 15 21 15 51 Miscellaneous visits 158 135 122 415 FACTORIES, WORKSHOPS, WORKPLACES. KITCHENS OF RESTAURANTS, &c. KITCHENS OF LICENSED PREMISES. DEFECTS FOUND. East District. Middle District. West District. East District. Middle District. West District. East District. Middle District. West District. Totals. Want of Cleanliness 30 31 9 12 42 20 31 19 15 209 Want of Ventilation 7 5 — 3 5 2 3 — — 25 Overcrowding — — — — — — — — — — Want of Drainage of Floors — — — 2 — — 3 — — 5 Want of Lavatory Accommodation — — 1 — — — — — — 1 Food improperly stored 1 8 2 1 12 Storage Cistern defective 9 23 7 4 4 4 5 1 8 65 Accommodation for Refuse 4 3 3 3 3 1 — — — 17 Accumulation of Refuse 5 4 3 5 2 4 — — — 23 Sanitary Accommodation. Insufficient (Tenancies) 8 2 1 — — 1 — — 12 Unsuitable (Do.) 13 5 9 1 2 3 — 2 — 35 Defective (Do.) 71 121 114 10 23 9 11 11 7 377 Do. (No. of Conveniences)* 71 121 114 10 23 9 11 11 7 377 Not separate for Sexes (Tenancies) 3 4 4 1 1 2 2 — — 17 Other Nuisances 20 12 13 14 18 19 18 8 11 133 Total Defects found 170 208 165 57 108 66 74 41 42 931 * Figures not included in total defects found or remedied. 65 DEFECTS REMEDIED. FACTORIES, WORKSHOPS, WORKPLACES. KITCHENS OF RESTAURANTS, &c. KITCHENS OF LICENSED PREMISES. East District. Middle District. West District. East District. Middle District. West District. East District. Middle District. West District. Totals Want of Cleanliness 34 41 6 14 40 21 32 18 15 221 Want of Ventilation 7 3 — 1 3 2 3 — — 19 Overcrowding — — — — — — — — — — Want of Drainage of Floors — — — 4 — — 3 — — 7 Want of Lavatory Accommodation — — 1 — — — — — — 1 Food improperly stored — — 1 1 6 1 — — 1 10 Storage Cistern defective 8 25 14 4 3 4 5 1 8 72 Accommodation for Refuse 4 2 3 4 4 1 — — — 18 Accumulation of Refuse 5 5 3 4 2 3 — — 1 23 Insufficient (Tenancies) 6 — 2 1 — — 1 — — 10 Sanitary Accommodation. Unsuitable (Do.) 13 4 7 1 2 3 — 1 — 31 Defective (Do.) 69 103 112 10 24 14 13 9 5 359 Do. (No. of Conveniences)* 69 103 112 10 24 14 13 9 5 359 Not separate for Sexes (Tenancies) 3 4 4 1 1 2 2 — — 17 Other Nuisances 20 10 16 14 16 27 18 10 9 140 Total Defects remedied 169 197 169 59 101 78 77 39 39 928 ACTION TAKEN. East District. Middle District. West District. Totals. Matters referred to H.M. Inspector— Nuisances remediable by H.M. Inspector 5 10 l 16 Failure to affix Abstract 16 32 11 59 Matters referred by H.M. Inspector— Notified by H.M. Inspector 3 7 7 17 Reports sent to H.M. Inspector 3 7 7 17 Notices served— Factories—Intimation 24 36 10 70 Statutory 3 3 — 6 Workshops—Intimation 22 19 5 46 Statutory — 1 — 1 Workplaces, &c.—Intimation 1 1 — 2 Statutory — — — — Kitchens of Restaurants— Intimation 7 13 7 27 Statutory 2 — 1 3 Kitchens of Licensed Premises— Intimation 11 2 — 13 Statutory — — — — Orders required from Sanitary Committee 7 4 1 12 Certificates for Cleansing issued by Medical Officer of Health 3 — — 3 Matters referred to District Inspectors 10 7 5 22 Matters referred to Women Inspectors — — — — Matters referred to Workshop Inspectors — — — — Cases reported for Legal Proceedings — — — — Legal Proceedings taken — — — — OUTWORK, AND THE INSPECTION OF OUTWORKERS' PREMISES, &c. Lists received from City Firms — — — 1,233 Names and Addresses, &c., received from other Authorities — — — 518 Names and Addresses transmitted to other Authorities — — — 8,975 Notices served on Employers — — — 1,515 Letters written, &c — — — 32 Firms visited 40 77 14 131 Outworkers' Lists not kept 22 11 8 41 Do. not sent 22 11 8 41 Infectious Disease occurring in Outworkers' Premises — — — — Registered Factories and Workshops at which Outwork is received— Inspections 74 78 29 181 Defects found 28 32 4 64 Defects remedied 28 32 4 64 Places from which work is given out "— Inspections 70 44 37 151 Defects found 19 21 0 45 Defects remedied 19 21 5 45 *Figures not included in total defects found or remedied. 66 WOMAN INSPECTOR. Total. Domestic Workshops at which Outwork is received Inspections l Defects reported and appropriate action taken 2 Domestic Workshops which do not receive Outwork Inspections 2 Defects reported and appropriate action taken — Domestic Premises receiving Outwork (not registerable as Workshops). Inspections 4 Defects reported and appropriate action taken — Underground Conveniences for Women Inspections 142 Defects reported and appropriate action taken 6 Railway Stations (Ladies' Rooms) Inspections 61 Defects reported and appropriate action taken 7 Kitchens of Restaurants, &c. Initial Inspections (Tenancies) 12 Initial Inspections (Workrooms) 50 Periodical Inspections (Tenancies) 411 Periodical Inspections (Workrooms) 752 Re-inspections (Sanitary Works, &c., in hand) 69 Defects found 192 Intimation (Verbal) 102 (Notices Statutory — Matters referred to District Inspectors 25 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 1935 1,171 1,246 8,975 10,221 67 factories, workshops, workplaces and homework. 1.—Inspection of Factories, Workshops and, Workplaces. Including Inspections made by Sanitary Inspectors. Premises. Number of Inspections. Written Notices. Occupiers Prosecuted. (1) (2) (3) (4) Factories (including Factory Laundries) 856 76 — Workshops (including Workshop Laundries) 550 47 — Workplaces (other than Outworkers' premises) 937 45 — Total 2,343 168 — 2.—Defects Found in Factories, Workshops and Workplaces. Particulars. Number of Defects. Number of offences in respect of which Prosecutions were instituted. Found. Remedied. Referred to H.M. Inspectors. (1) (2) (3) (4) (5) Nuisances under the Public Health Acts :—-* Want of cleanliness 227 239 10 — Want of ventilation 32 24 3 — Overcrowding — — 1 — Want of drainage of floors 5 7 — — Other nuisances 357 387 2 — Sanitary accommodation insufficient 12 10 — — unsuitable or defective 473 449 — — not separate for sexes 17 17 — 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 1,123 1,133 16 — *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. 68 3.—Home Work. NATURE OF WORK.* OUTWORKERS' LISTS, SECTION 107. OUTWORK IN UNWHOLESOME PREMISES, SECTION 10S. 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.t Outworkers.f Lists. Outworkers. Contractors. Workmen. Contractors. Workmen. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) Wearing Apparel— 1,515 making, &c 998 3,720 4,945 34 171 151 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) 90 278 164 3 — 13 Cables'and Chains Anchors and Grapnels Cart Gear Locks, Latches and Keys Umbrellas, &c 34 9 180 1 — 1 Artificial Flowers ? 6 — 18 1 — 4 Nets, other than Wire Nets Tents Sacks Racquet and Tennis Balls Paper, &c., Boxes, Paper Bags 2 — 4 — — — Brush making — — 31 — — — Pea picking Feather sorting Carding, &c., of Buttons, &c Stuffed Toys 2 — 14 — — — Basket making Chocolates and sweetmeats Cosaques, Christmas Crackers, Christmas Stockings, &c Textile Weaving Total 1,132 4,007 5,356 39 171 169 1,515 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 - (or 5 as the case may be) against the principal class only, but the outworkers should be assigned in columns 3 and 4 (or 6 and 7) into their respective classes. A footnote should be added to show that this has been done. f 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; douDieoi tne num e of individual outworkers whose names are Riven, since in the February and August lists of the same employer the same outworker's name will often be repeated. 69 4.—Registered Workshops. Workshops on the Register (S. 131) at the end of the year. Number. (1) (2) Important classes of workshops, such as workshop bakehouses, may be enumerated here. / General Workshops 1,098 Bakehouses (including Factory Bakehouses) 15 Total number of Workshops on Register *1,113 * These were found to be 1,618 Workrooms, &c., in plaoet Registered. Date, 31 st December, 1935. (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. shops acts, 1934. The provisions of the above-mentioned Act have been carried out, and it has not been necessary to appoint any additional members to my inspectorial staff in connection therewith. As a consequence, however, of a memorandum which was issued by the Minister of Health dealing with this Act in general, each of my existing inspectors has been formally appointed and provided with a certificate of such appointment, in order that it may be produced to any appropriately responsible person on request. During the year 1,041 shops and warehouses were inspected and 232 defects found, all of which were remedied without recourse to legal proceedings. Applications for exemption certificates were received, and as satisfactory alternative accommodation was available in each case, all were granted. The following is a summary of the work done :— WEST. MIDDLE. EAST. TOTALS. Number of shops inspected 321 293 427 1,041 Number of shops re-visited 144 182 203 529 Number of defects found 41 104 87 232 Number of defects remedied 29 79 86 194 Number of intimations served 7 15 16 38 K 5.—Other Matters. Class. Number. (1) (2) Matters notified to H.M. Inspector of Factories :— Failure to affix Abstract of the Factory and Workshop Act (S. 133, 1901) 59 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 17 Reports (of action taken) sent to H.M. Inspector 17 Other — Underground Bakehouses (S. 101) :— Certificates granted during the year Nil. In use at the end of the year 10 70 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. Ten additional premises were registered during the year in accordance with the requirements of the London County Council (General Powers) Act, 1932. health service survey. During the year the Minister of Health conducted a survey of the public health services administered by the City Corporation, and the report subsequently issued indicated that a satisfactory standard of efficiency and progress is being maintained by the Corporation in discharge of their functions relating to public health, and appreciation was expressed of the fact that certain of the services maintained are of great importance and value to a much larger population than that resident or working in the City. Appreciation was also expressed of the close co-operation which exists between the Corporation and the Authorities of St. Bartholomew's Hospital, whereby valuable services are rendered by that Hospital in the provision of the necessary clinics and the Hospital's special resources of all kinds for diagnosis and treatment are placed at the disposal of the Corporation. One or two minor suggestions on matters of detail made by the Minister have received appropriate consideration. public health (london) bill. The draft Bill comprises 316 clauses and six schedules, and its object is the consolidation into one act of a large number of existing acts which at present constitute the law relating to public health in London. If and when this Bill is placed on the Statute Book, it will be the subject of further reference in a subsequent Annual Report. city mortuary. Bodies Received.—Post-Mortems and Inquests :— Bodies received at the Mortuary to await burial 111 Post-Mortem examinations made 65 Inquests held on bodies 74 Inquests held on fires 4 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. 1930 203,909 145 135 73 l 1931 155,324 133 127 77 l 1932 234,170 142 90 91 2 1933 233,821 114 71 77 2 1934 243,939 121 81 69 2 Average for previous 5 years 214,253 135 101 77 2 1935 248,031 111 74 65 4 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. 240,286 Fees received by the Corporation. £393 71 Other disinfection and cleansing work carried out during the year is as follows :— Disinfection.—Infectious Disease :— Articles disinfected after cases of infectious disease 2,245 Library Books disinfected 120 Public Vehicles—Electric Ambulance and Police Litters 3 Cells at Police Stations 0 Premises disinfected (including offices) 174 Lockers disinfected at request of General Post Office Authorities 129 Horsehair (cases) 29 Cleansing of Persons Act, 1897 :— Number of verminous persons bathed. 81 Number of articles of clothing disinfected 739 Cleansing of School Children :— Total number of children cleansed 1,249 Number of articles of clothing disinfected 4,612 70 articles of clothing were destroyed at request of owners. 96 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 1935 two bodies were 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. RAT REPRESSION. Inspections under the Rats and Mice (Destruction) Act, 1919, have been carried out by Mr. Webber, one of the Sanitary Inspectors, specially appointed to act as Rat Officer. I am able to report that many satisfactory results have been achieved through the co-operation of tenants of City Buildings and this Department. Nevertheless, the inadequacy of the present law, in the light of the chief problem, the Black Rat, and the many unsatisfactory methods of repression which are in existence, greatly increase the difficulties of the work. Two species of rat infest the City of London—the Black Rat and the Brown Rat. The respective names of these species often create a wrong impression, and must not be taken to illustrate the colouring of the rats. It is in their appearance and habits that they differ. The tail of the Black Rat, turned back over its head, reaches beyond the head ; the ears are large and thin. The tail of the Brown Rat reaches to about the eyes, and the ears are thicker and smaller. Determination of the species is important in deciding the method of disinfestation. It is unusual, but not unknown, for the two species to infest the same property at the same time. In the absence of a trapped or killed rat, the determination of the species may be decided by an examination of the " droppings." K2 72 Occupiers of City buildings, the persons legally responsible under existing legislation, would do well to seek the advice of this Department, particularly if the infestation is severe and has extended over a period. Of 284 serial instances, 261 were proved Black Rat infestation and 23 Brown Rat. The Black Rat nests in City buildings. Floors, ceilings, roofs, match-lined walls, provide the safe homes ; but they will, if necessary, nest in closer relation to man—-e.g., in coal bins constantly in use, disused fittings, between series of exposed ventilating shafts, in accumulations (not necessarily waste accumulations). It is not possible to give any indication of the total number of rats caught in the City during any given period. Messrs. William Dalton & Sons, professional rat catchers, say that their catch, during 1935, in the City of London, was 16,553, the large majority being Black Rats. A firm of caterers, with many branches in the City, give their catch during 1935 as 3,901, again the majority being Black Rats. The application of the methods used by this Authority differ according to the degree of infestation and the locus, i.e. :— Severe infestation Professional rat catching and rat proofing at and about the point of attraction. Moderate infestation Trapping and rat proofing. The prevention of feeding, watering, and nesting attractions is the aim. Whilst it is felt that rat catching is indispensable in dealing with severe infestation, rat proofing is undoubtedly the greatest factor in prevention. The term " rat proofing " is a wide one, and often calls for extensive repair work and even structural alteration, and there may be some doubt whether such work can be held to be " steps necessary and reasonably practicable," so that the occupier may be saddled with it. To rat proof a building is not impossible, but requires meticulous care, perseverance and work. The work is important, and, to achieve a successful result, should be in the hands of workmen knowing the habits and agility of the rat, particularly the Black Rat. Certainly every window capable of being opened, in a restaurant kitchen or even in the entire restaurant, requires to be adequately protected. Little notice can be taken of an assurance that windows are closed at night. Successful instance can be given of complete elimination of rat infestation in buildings. It must, however, be insisted upon that the majority of these successful results are attained, not by application of the law, so much as by advising a harrassed occupier or helpful owner, or both, to take certain action in catching and proofing after much money has been spent by them in tackling their problem in other ways which, though feeble in result, might have been held to comply with the law. The successful termination of cases of severe infestation have been brought about by the responsible persons employing a rat catcher recommended by, and working in co-operation with, the Rat Officer, rat proofing being simultaneously undertaken and carried out under the supervision of this Department. These rat catchers work at night and use no poison. Large numbers of their catch are taken alive. Little can be said of their method, except that it appears highly satisfactory and the result of knowledge acquired by many years at the work. Poisoning is rarely advised by this Department. Instances where poison has been used have not been successful. In the case of occasional infestation by one or two marauding rats, poisoning might be of use, but in infested premises it is not desirable. The Black Rat lives on the premises and, if poisoned, becomes an expensive nuisance. Complaints are usually received by this Department that " the premises are overrun." The following is a brief summary of the action taken following such a complaint. It will be seen that one marauding rat was responsible. Complaint—rat infestation—office—some weeks—inspected. Three rooms—few droppings, foot and tail marks—Black Rat. Space between door and floor only means of access. At end of corridor, enamel bowl, used tea cups, wiping-up cloths—evidence here emphatic—dirty tea cups left in bowl overnight—window adjoining broken—hole 2 ins. diameter—replacement of pane—done— morning inspection rat had chewed away new putty outside—still unable to obtain access. Breakback trap set on sill. Following morning rat dead in trap. No further trouble, of course. " It took a man to do that." 73 Then the complaint as to severity may be literally correct. Different action is necessary, as here instanced:— Complaint—rat infestation—restaurant—continuous—severe—Brown (Sewer) Rat. Drainage chemically tested—negative result—nesting in building—professional rat catching—rat proofing— advised—done. Trouble overcome. Complaint—rat infestation—factories—continuous—severe—Black Rat. Nesting in building— professional rat catching—rat proofing—advised—done. Trouble overcome. The pipe casings found in all buildings provide access for rats to all floors, sometimes the only access, as here:— Complaint—rat infestation—continuous—furriers' showroom. Defective pipe casing only access —rat proofing. Trouble overcome. Again, numbers of rats may enter and leave a building each night. It was so in this case :— Complaint—rat infestation—factories—showrooms—Black Rat. Evidence suggested rat entering building each night—rat proofing floors—ceilings—removal of food, water, nesting attractions. No further trouble. Sometimes the withholding of vital information on the part of an occupier may check success. Here is a case :— Complaint—rat infestation—factories—Black Rat—severe—continuous. Nesting in building— professional rat catching—rat proofing—removal of large accumulations. Trouble overcome on five out of six floors. Infestation confined to one room on second floor—disturbance of all material in room—rat proofing checked—apparently sound—infestation continued—occupier then stated that whilst windows remained closed during day, one was opened at night. This practice discontinued. No further trouble. The Rats and Mice (Destruction) Act, 1919, is inadequate, and appears to have been framed with the Brown (Sewer) Rat in mind, and, as such, is unsuitable in this and probably many other areas. It is desirable that an Authority should have power to stipulate a particular method of prevention. The owner of property should have some responsibility in the matter of rat proofing where this term implies structural alterations or repairs to a building. In dealing with the Sewer rat, it is possible for an Authority to require the owner to deal with a defective drain (the probable source of the infestation) under the Public Health Acts. This is really the only form of rat proofing which can be enforced under the Public Health and other associated Acts. It is practically impossible to hold the occupier responsible for the roof, internal pipe and cable casings, wainscottings, passages, staircases, lift gear, etc. There is little doubt that an occupier, knowing his responsibility under the Act, hesitates to report the true state of affairs to his local Authority. It is felt that, until the owner is made responsible in some part for such details as these, very little progress can be made. Instances continue to come to my notice of firms spending large sums of money in an endeavour to overcome rat infestation, with no result. It seems that this position will continue until the rat catcher employed is responsible in some way to local Authorities in whose area he works. The Department is making every endeavour to deal with the problem in a satisfactory manner, but there can be little doubt that the time is ripe for increased and amended legislation, together with the application of different and more logical measures for combating the rat. 74 RATS AND MICE (DESTRUCTION) ACT, 1019. Details of Work Carried Out under the Above Act for the Year Ended 31st December, 1935. Month. Initial Inspections. Number of Buildings found to be Infested. Number of cases of Black Rat Infestation. Number of cases of Brown Rat Infestation. Methods Employed to Destroy Rats. Drainage and Sewerage carried out during the year. Special Observations. Complaints or Applications for Advice. Rat Catcher Employed. Poison Used. Traps. i By City Engineer's Department. By M.O.H. Department. January 31 31 31 6 16 20 11 February 18 18 17 1 4 9 14 18 March 44 30 27 4 16 11 21 17 April 20 19 18 5 10 2 8 20 May 39 36 34 2 14 6 15 39 June 18 17 14 3 5 3 11 18 July 90 August 84 66 59 8 26 21 28 84 September October 37 33 33 — 6 5 22 37 November December 32 28 28 6 4 26 32 Totals 323 278 261 23 93 77 165 — 276 75 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, 91 persons were examined by the Medical Officer of Health during 1935. All of these persons were reported as physically fit for office. Ten officers were also medically examined with a view to their retirement. With one exception, all were reported to be unfit for duty. Three others were examined after illness and passed as fit 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 78 ,, B— „ „ Infectious Diseases 82 C—Register of Houses let in lodgings or occupied by members of more than one family 84 „ D—List of Adoptive Acts, Orders, Bye-laws and Regulations in operation in the City 85 „ E—Compulsory Notification of Chicken-pox. Form of Notice 86 „ F—Tuberculosis Dispensary, St. Bartholomew's Hospital, E.C. 1 (Leaflet) 86 l 78 APPENDIX A.—STREET LISTS OF MORTALITY. STREET OR PLACE. No. of House Sex. Age. Date of Death. Cause of Death. Remarks. Albion Buildings, Flat 22 19 M 82 26th June la. Bronchial Catarrh b. Cardiac failure Flat 13 21 F 47 10th July la. Cerebral Haemorrhage b. Arterio-sclerosis Died in St. Peter's Hospital. Flat 19 22 F 68 21st Aug. c. Arterial hypertensions la. Uraemia b. Pyonephrosis c. Renal Calculus Died in St. Bartholomew's Hospital. Aldgate, Three Nuns Hotel. — M 59 4th Dec. 2. Neophrectomy on opposite side la. Cardiac failure b. Acute Pulmonary Congestion Resident of Spain. America Square 15/ 16 M 65 12th Feb. 2. Chronic Bronchitis Cerebral Haemorrhage 34 hours. Haemiplegia—exhaustion Angel Court 1 M 45 22nd April la. Septicaemia b. Septic Broncho-pneumonia Died in Charing Cross Hospital. Arthur Street 10 F 63 23rd May Gangrenous Pneumonia, supervening on intrascapular fracture of right femur. Died in Guy's Hospital. Artillery Lane 23 M 78 3rd Dec. Fall down steps. P.M. Accidental la Cardiac failure b. Cerebral Thrombosis Died in St. Peter's Hospital. Bank of England — M 20 27th Feb. Shock—laceration of brain. Passage of bullet discharged by deceased. Inq. Soldier at Chelsea Barracks. Barley Mow Passage 65 F 62 6th Nov. Suicide—unsound mind la. Aplastic Anaemia b. Congenital Syphilis Died in Metropolitan Hospital, Caterham. Bartholomew House 15 M 47 22nd Oct. la. Exhaustion b. Phthisis Basinghall Street 70a M 22 17th Feb. Tuberculous Meningitis Died in Bancroft Lodge, Stepney. Bearsted House, New St. 6 M 4 mos. 18th Jan. la. Acute Gastro-enteritis 2. Bronchitis Died in Stepney. " 17 M 78 9th April la. Broncho-pneumonia b. Chronic Nephritis c. Arterio-sclerosis 2. Old age „ 17 M 54 2nd June la. Pulmonary Neoplasm ,, 20 F 83 5th Mar. la. Cardiac failure b. Chronic Cardiac Valvular Disease Beer Lane 13 F 65 19th June la. Asthenia b. Broncho-pneumonia c. Debility following 2. Cerebral Thrombosis Billingsgate Market, The Residence. — F 56 4th Aug. la. Heart failure b. Progressive Muscular Atrophy Bishopsgate, Police Hospital. — M 41 19th May Exhaustion. Lymphadenoma and Anaemia Resided in Camberwell. Bishopsgate 154 M 74 19th May Carcinoma of Stomach Died in St. Peter's Hospital. 213 F 3 days 2nd Nov. Prematurity Died in Hackney. Bloomfield House, Snow Hill. 9 F 30 8th Feb. Anaerobic Septicaemia from incomplete abortion Died in City of London Infirmary, Bow Road. Bolt Court, Fleet Street 6 F 49 28th Dec., 1934. la. Confusional Psychosis b. Anaemia Died at City of London Mental Hospital, Dartford. Brewers Lane, The Cottage. — M 9 25th July Asphyxia due to drowning, due to fall in River Thames. P.M. Inq. Broad Street Avenue 59/ 60 M 57 1st May Aortic Atheroma. Coronary disease. P.M. without Inquest Resided in Barnet. Budge Row 28 F 90 24th Aug. la. Morbus Cordis b. Senility Died in Islington. Cannon Street 102 M 64 31st Oct. Shock and multiple injuries. Crush by iron column P.M. Inq. Misadventure. Resided at East Ham. Cheapside, Sadlers' Hall — F 72 20th Feb. la. Myocardial degeneration b. Apoplexy Cloth Fair 45 M 67 5th Dec. la. Cerebral Haemorrhage b. Arterio-sclerosis Died in St. Peter's Hospital. Coleman Street 12 M 47 20th June Strangulation with handkerchief, due to suspension from boot rack P.M. Suicide—unsound mind Died in City of London Mental Hospital, Dartford. Crosby Square 2 3 M 52 5th Mar. Heart failure (Syncope). Hypertrophy of the heart, with Myocardial degeneration Resident of California, U.S.A. Cross Lane 3 M 71 18th Sept. la. Haemateuresis b. Carcinoma of Stomach Died in Guy's Hospital. Dean Street 6a F 93 15th Sept. la. Myocardial degeneration b. Arterio-sclerosis Died in City of London Institution, Bow Road. Dorset Street 16 M 18 20th Dec. Multiple fractures. Laceration of the brain. Fall down lift shaft. P.M. Inq. Misadventure Resided at Tottenham. Dutton House, New St. 1 F 60 27th Nov. la Cerebral Thrombosis b. Cardio Vascular Degeneration 2. Previous Thrombosis (Cerebral) Died in London Jewish Hospital, Stepney Green. 79 STREET LISTS OF MORTALITY—continued. STREET OR PLACE. No. of House Sex. Age. Date of Death. Cause of Death. Remarks. Eastcheap 19 F 15 6th April 1 a. Pneumonia b. Valvular disease of Heart, from acute rheumatism Essex Court, Temple 3 F 39 23rd July la. Sarcoma of Peritoneum b. Sarcoma of Ovary (proved by microscope) Fenchurch Street 153 F 70 29th Jan. Influenza ,, 153 M 73 4th Nov. la. Cerebral Thrombosis b. Arterio-sclerosis Died in St. Peter's Hospital. Fetter Lane 88 M 63 3rd Jan. Acute Heart failure, due to occlusion of Coronary Arteries caused by Arteriosclerosis and collification Resided at Burnt Oak. Fleet Lane 29 M 68 11th July la. Carcinoma of Stomach b. Secondary deposits (liver) Died in St. Peter's Hospital. Fleet Street 80 F 61 11th Feb. la. Carcinoma Mediastinum and Brain b. Carcinoma of Breast Freeman's Court 1 F 66 19th Oct. la. Carcinoma of Peritoneum b. Carcinoma of Breast Died in St. Colomba's Hospital. Furnival Street 19 M 74 19th Aug. Cardiac failure Secondary to Angina Pectoris Died at Lowestoft. Goodman's Yard 3 F 41 17th Dec. Pulmonary Tuberculosis Died in Stepney. Gravel Lane 118 M 70 1st April la. Uraemia b. Enlarged Prostate Died in South Grove Hospital, Stepney. Great New Street, " Three Tuns " » M 45 21st Oct. Delirium Tremens. Pneumonia. Cirrhosis of liver. Chr. Alcoholism Died in St. Bartholomew's Hospital. ,, 27 M 79 14th June 1. Malignant disease (Urinary bladder) Gt. Tower Street 34 M 62 3rd Aug. Severe injuries sustained by being knocked down by train while walking along the line Accident. No P.M. Inq. Died in Sheppey. Holborn Viaduct 26 M 57 24th Jan. Syncope. Myocardial degeneration— Valvular disease of Heart Resided at Harrow. ,, 53 M 34 15th Mar. Syncope. Myocardial degeneration (fatty heart). Disease of left Coronary Artery Resided at Twickenham. Hutchison Avenue 9 F 84 15th Aug. la. Cerebral Thrombosis b. Cardio Vase, degeneration 2. Carcinoma of Breast Died in Wandsworth. Jewry Street 12 M 50 27th June la. Chronic Myocarditis Arrhythmia 2. Progressive Perineal Muscular Atrophy John Street 3 M 69 14th Jan. la. Auricular fibrillation b. Myocarditis c Endocarditis 2. Chronic Colitis Resided in Camberwell. King's Bench Walk, Temple. 3 F 38 28th Feb. la. Sepsis and exhaustion b. November, 1934, operation for Cardiospasm under Eripan anaesthesia followed Died in St. Bartholomew's Hospital. ,, ,, 12 M 72 24th Aug. la. Hypostatic Pneumonia b. Peripheral Neuritis 2. Arterio-sclerosis King's Block, Stoney Lane 2 M 85 14th Nov. la. Heart failure b. Myocardial degeneration ,, ,, 39 M 53 22nd Jan. la. Chronic Pulmonary Tuberculosis Died in Stepney. Laurence Pountney Hill, Suffolk House. — F 51 25th Sept. la. Broncho-pneumonia b. Oesophago Tracheal Fistula Died in St. Bartholomew's Hospital. Leadenhall Street 53 M 64 25th Nov. Angina Pectoris, due to diseased condition of left Coronary Artery Resided at Wandsworth. P.M. Natural. Little Britain 22 M 47 19th June Asphyxia. Coal gas poisonong. P.M. Inq. Suicide—unsound mind Little Trinity Lane, Buxton House. — M 47 16th Jan. Syncope. Rupture of Aortic Aneurism. P.M. Natural Liverpool Street, Gt. Eastern Hotel. M 26 10th Dec. Heart failure due to Myocardial Degeneration through small ness of Coronary Arteries Resided at Leyton. Liverpool Street 21 M 57 29th Aug. In. Hodgkins' disease Liverpool St. Station, L.N.E.R. — M 57 22nd July Multiple injuries. Run over by train. P.M. Inq. Misadventure Resided in Stepney. Lloyds Avenue 4 M 44 11th June la. Angina Pectoris Resided at Catford. Long Lane 76 M 52 31st Mar. la. Tuberculous Peritonitis Died in St. Bartholomew's Hospital. Lower Thames Street 81 M 60 11th Mar. la. Cerebral Haemorrhage b. Arterio-sclerosis 2. Interstitial Nephritis „ H.M. Customs Office. M 53 9th May Syncope. Valvular Heart disease. Hypertrophy of Heart Muscle. Disease of Coronary Arteries Resided at Upminster. Ludgate Hill 19 F 54 20th June la. Carcinoma of Liver and Lung b. Carcinoma of left Breast „ (on Railway Bridge). — M 58 6th Dec. Multiple injuries. Knocked down by railway engine. Inq. Misadventure Resided at Penge. Middlesex Street 116 M 83 22nd Feb. Carcinoma of Pancreas Died in Tooting Bee Hospital. 116 M 57 27th Feb. Carcinoma of Stomach Died in St. Peter's Hospital. L2 80 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 26th Feb. 1 a. Broncho-pneumonia b. Carcinoma of Bronchus Died in St. Peter's Hospital. ,, 116 M 38 8th Mar. 1 a. Acute Lobar Pneumonia 2. Pulmonary Tuberculosis Died in Coulsdon and Purley Hospital. ,, 116 M 72 13th Mar. la. Hyperstatic Pneumonia b. Chronic Myocarditis c. Arterio-sclerosis Died in St. Peter's Hospital. ,, 116 M 51 20th Mar. la. Lobar Pneumonia Died in St. Peter's Hospital. ,, 116 M 78 25th April la. Cardio-vascular degeneration Died in Shoreditch. ,, 116 M 81 14th May la. Myocardial degeneration b. Chronic Bronchitis Died in City of London Infirmary, Bow Road. ,, 116 M 78 19th Sept. la. Pulmonary Œdema b. Cardiac failure c. Hyperpiesis 2. Senility Died in St. Peter's Hospital. ,, 116 M 62 31st Oct. la. Cardiac failure b. Lobar Pneumonia Died in St. Peter's Hospital. ,, 111 M 74 1st Dec. la. Myocardial degeneration Arterio-sclerosis Died in City of London Institution, Bow Road. ,, 116 M 55 12th Dec. la. Chronic Pulmonary Tuberculosis Died at Bancroft Lodge, Stepney. ,, 116 M 61 28th Nov. la. Uraemia b. Pyelonephritis Died in St. Peter's Hospital. Mincing Lane 41 F 86 6th Mar. la. Cardiac failure b. Overloaded Stomach 2. Chronic Gastric Ulcer Resided at Watford. Minories 76 M 79 19th Sept. la. Myocardial degeneration b. Arterio-sclerosis Died in City of London Infirmary, Bow Road. ,, 95 M 67 2nd Jan. la. Myocardial degeneration 2. Diabetes Mellitus Died in Stepney. Milton Street 24 F 34 9th May la. Chronic Endocarditis b. Hypostatic Congestion of Lungs Died in City of London Hospital, Bow Road. Mitre Court 3 F 59 13th Nov. la. Haemoptysis b. Tuberculous Phthisis, with cavity formation Mitre Court Chambers, Fleet Street. 93 M 81 24th Jan. la. Myocardial degeneration 2. Paralysis Agitans Montague Court 4 F 90 26th Jan. la. Myocardial degeneration b. Senility Died in St. Peter's Hospital. Monument Street 11/ 15 F 53 10th Mar. la. Carcinoma of Uterus Moor Lane 18 F 86 21st Oct. la. Chr. Bronchitis. Cardiac failure b. Senility Died in St. Peter's Hospital. Moor Lane Chambers 29 M 65 3rd Jan. Cerebral Apoplexy. P.M. Natural Moorgate 24/ 28 F 50 19th Aug. la. Myocardial degeneration Died in St. Thomas's Hospital. ,, 159 M 57 25th Oct. Syncope. Myocardial degeneration. Disease of the Coronary Arteries Resided at Rickmansworth. P.M. Natural. Nevill's Court 11 F 75 18th Oct. la. Chronic Bronchitis and Cardiac failure Died in St. Peter's Hospital. New Broad Street 39 M 19 27th July Syncope and shock Fracture of skull. Fall from window. P.M. Inq. Suicide —unsound mind Resided at East Ham. New Street 24 M 60 19th Aug. la. Carcinoma of (Esophagus Died in Leavesden Mental Hospital. Northumberland Alley 6 F 48 22nd June Cerebral Apoplexy P.M. Inq. Old Broad Street, Winchester House. M 58 12th Jan. la. Cardiac Hypertrophy b. Valvular (Mitral) disease of Heart Resided at Lewisham. ,, — M 58 13th June la. Arterio-sclerosis of Coronary Arteries b. Hyperitestor Resided at Hampstead. Prince's Block, Stoney Lane. 5 F 72 26th Oct. la. Post-operative shock b. Cholecystectomy c. Cholecystitis and Gall Stones Died in St. Peter's Hospital. 29 M 84 18th Aug. la. Cardiac failure b. Generalised Arterio-sclerosis and Chronic Valvular Disease of Heart c. Senile Gangrene of left foot ,, 38 F 77 17th Aug. Heart failure, d ue to Coronary Atheroma and Myocardial degeneration Died in Guy's Hospital. Queen's Block, Stoney Lane. 21 M 5 hrs. 13th Jan. la. Prematurity Died in London Hospital. „ 31 M 69 16th July la. Carcinoma of Stomach ,, 37 F 1 mo. 21st April la. Cellulitis of Face Died in Bancroft Lodge, Stepney. Red Bull Wharf i) F 85 1st May la. Cardio-vascular degeneration Died in City of London Mental Hospital. River Thames M 26 21st April Fractured base of skull. Struck head on stone platform while diving into Thames to rescue children Resided at Norbiton. ,, — M 23 1st July Asphyxia by drowning. P.M. Inq. Insufficient evidence as to whether accident or not Resided at Islington. ,, — M 25 /30 26th Sept. Asphyxiation by drowning. No evidence as to how he came into water P.M. Inq. Name and address unknown. 81 STREET LISTS OF MORTALITY—conttnuid. STREET OR PLACE. No. of House Sex. Age. Date of Death. Cause of Death. Remarks. St. Bride Street 30 M 17 22nd July Multiple injuries. Fall down lift shaft. Inq. Misadventure Resided at Camden Town. St. Paul's Churchyard (Hitchcock, Williams) — M 19 7th May la. Tub. Meningitis b. Pulmonary Tuberculosis Died at Chislehurst. South Block, Stoney Lane 2 F 79 6th Dec. la. Coronary Thrombosis b. Chronic Valvular Disease of Heart and Hyperpiesis ,, 25 M 16 hrs. 17th Nov. (a) Prematurity (30 weeks) Died at 102, City Road. Snow Hill, Saracen's Head Chmbrs. M 14 3rd Dec. Shock and Syncope. Fractured skull and laceration of brain. Squeezed between lift and shaft P.M. Inq. Swan Street 1 M 54 14th April la. Pulmonary Tuberculosis Died in Archway Hospital. Temple Chambers 233 F 53 8th July Peritonitis. Rupture of Colon due to cancer Temple Gardens 2 M 74 1st April la. Angina Pectoris b. Atheroma of Coronary Arteries 2. Arterio-sclerosis Tudor Street, Northcliffe House. — M 63 23rd Aug. Syncope. Rupture of Aorta. P.M. Coroner Resided at Walthamstow. Upper Thames Street, St. Paul's Wharf. M Few hours. 31st Dec. Syncope. Inattention at birth. No evidence to determine whether intentional or otherwise. P.M. Inq. Name unknown. ,, 79 M 65 17th July Asphyxia. Acute Bronchitis. Hypertrophy of heart. Valvular disease Resided at Wood Green. ,, 98 M 59 10th June la. Purulent Broncho-pneumonia b. Aneurism of Aortic arch Died in St. Bartholomew's Hospital. Water Lane, Gt. Tower Street. 19 M 66 9th Aug. Myocardial degeneration, following narrowing of Coronary Arteries. P.M. Wine Office Court 14 M 76 29th Dec. la Pneumonia (Lobar) 2. Arterio-sclerosis and Hyperpiesis Wood Street 118 M 55 18th May la. Myocardial degeneration b. Hyperpiesia 2. Cirrhosis of liver. Chronic Interstitial Nephritis Resided at Putney. 82 APPENDIX B.—LIST OF CASES OF INFECTIOUS DISEASE OTHER THAN TUBERCULOSIS, 1935. STREET LISTS.—COMPILED FROM NOTIFICATIONS RECEIVED. Street or Place. No. of House. Sex. Age. Disease. Date of Notification. Aldgate High Street 41 F 17 Diphtheria 3rd April. Ditto 41 M 6 Chickenpox 24th July. Artillery Lane 7 M 2 Ditto 1st April. Bloomfield House 9 F 3 Scarlet Fever 24th September. Brackley Street 5 M 18 Ditto 16th May. Ditto 5 M 17 Diphtheria 17th October. Ditto 5 M 20 Scarlet Fever 21st November. Ditto 5 M 18 Ditto 8th December. Brushfield Street 12 F 3 Ditto 16th October. Ditto 12 F 3 Chickenpox 16th November. Carter Lane (Choir House) M 12 Diphtheria 23rd May. Copthall Avenue 10 M 17 Scarlet Fever 25th May. Crown Court, Warwick Lane — M 18 Ditto 8th April. Ditto — M 21 Ditto 1st May. Dean Street 4e F 4 Diphtheria 19th January. Ditto 5c F 6 Ditto 16th February. Dutton House 7 F 8 Ditto 20th September. East India Buildings 3 M 13 Scarlet Fever 13th October. Fleet Lane 29 M 3 wks. Ophth. Neonatorum 16th July. Gresham Street 64 M 15 Scarlet Fever 6th December. Gunpowder Alley 8 M 6 Ditto 26th August. Houndsditch — F 24 Puer. Pyrexia 28th May. King Street, Cheapside 33 M 2 Scarlet Fever 13th August. Liverpool Street F 47 Erysipelas 14th January. Ditto – F 26 Scarlet Fever 2nd December. Lower Thames Street 55 F 10 Chickenpox 12th November. Ditto 55 M 7 Ditto 3rd November. Mansell Street 30 M 3 Scarlet Fever 28th April. Middlesex Street 116 M 62 Ac. Prim. Pneu 1st November. Ditto 116 M 51 Ditto 21st March. Minories 27 M 10 Chickenpox 6th November. Ditto 81 M 10 Ditto 5th November. Ditto 81 F 16 Ditto 5th November. Ditto 81 F 17 Ditto 6th November. Ditto 81 F 13 Ditto 13th November. Ditto 96 F 65 Erysipelas 19th January. Ditto 152 M 9 Chickenpox 14th November. Montague Court, Little Britain 3 M 8 Diphtheria 15th June. Ditto 6 M 39 Ditto 20th March. Moor Lane Chambers 25 M 1 day Ophth. Neonatorum 9th May. Old Broad Street 10 M 12 Chickenpox 4th January. Ditto 10 M 11 Ditto 19th January. Old Change 40 F 32 Diphtheria 15th June. Prince's Block 28 M 60 Erysipelas 5th March. Queen Victoria Street 181 M 8 Scarlet Fever 20th November. Queen's Block 37 F 7 wks Erysipelas 16th April. 83 LIST OF CASES OF INFECTIOUS DISEASE OTHER THAN TUBERCULOSIS, 1935. STREET LISTS.—COMPILED FROM NOTIFICATIONS RECEIVED—continued. Street or Place. No. of House. Sex. Age. Disease. Date of Notification. St. Bartholomew's Hospital Nurses' Home. — F 46 Diphtheria 13th February. Ditto ditto — F 23 Scarlet Fever 8th May. Ditto ditto — F 23 Ditto 17 th May. Ditto ditto — F 23 Ditto 23rd May. Ditto ditto — F 27 Ditto 7th June. Ditto ditto — F 23 Ditto 7th June. Ditto ditto — F 21 Ditto 24th June. Ditto ditto — F 21 Paratyphoid Fever 2nd August. Ditto ditto — F 20 Diphtheria 13th August. Ditto ditto — F 25 Ditto 17th August. Ditto ditto — F 22 Scarlet Fever 22nd August. Ditto ditto — F 23 Ditto 2nd November. Ditto ditto — F 20 Ditto 2nd November. Ditto ditto — F 20 Ditto 6th November. Ditto ditto — F 22 Ditto 10th November. Ditto ditto — F 24 Ditto 16th November. Snow Hill (City Police) — M 26 Diphtheria 6th November. South Block 25 F 8 Chickenpox 2nd October. Swan Street (School House) — M 11 Diphtheria 29th November. Upper Thames Street 129 M 10 Scarlet Fever 8th December. Victoria Embankment (Sion College) — F 12 Meningococcal Meningitis. 13th March. Widegate Street 24 F 31 Diphtheria 12th August. 84 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. rs. 43, Cloth Fair Messrs. J. Seeley & P. Paget, 41, Cloth Fair, E.C. (o) 2 2 *10, East Harding Street Goldsmiths' Company, Goldsmiths' Hall (o) 2 7 12, do Do. do. (o) 5 7 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 13 30, do Do. do. do. (o) 2 6 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 Empty 23 do Mrs. J. Barnsley, 27, Great New Street (o) 3 13 25, do Do. do. (o) 5 9 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 10, Nevill's Court Moravian Mission, 32, Fetter Lane (o) 6 9 11, do Goldsmiths' Company, Goldsmiths' Hall (o) 7 17 12, do Do. do. (o) 4 9 *14, Wine Office Court Messrs. Reynolds & Eason, 192, Bishopsgate (o) 2 2 *16, do Do. do. (o) 2 2 * 2, Pemberton Row Mr. J. O'Shea, 2, Pemberton Row (t) 3 6 24 Total 96 177 Average number of lodgers to each occupied tenement: 1-8 Houses demolished or closed as dwelling-houses 6 Tenement houses on Register 24 Cleansing Notices served 27 * Retained on Register though temporarily not subject to the Bye-laws. MIDDLE DISTRICT. Nil. EAST DISTRICT. Situation of Premises. Name and Address of Owner or Tenant. Tenements. Lodgers. 5, Artillery Lane Clerk to Bishopsgate Institute, Bishopsgate (o) 5 8 7, do. Do. do. (o) 4 12 9, do. I. J. & J. Mendes, Ltd., 113-125, Grove Street, E.l(o) 3 14 21, do. Clerk to Bishopsgate Institute, Bishopsgate (o) 2 5 10, Brushfield Street Reynolds & Eason, 192, Bishopsgate (o) 6 7 12, do. Luke Cohen, 12, Brushfield Street (t) 3 9 14, do. Clerk to Bishopsgate Institute, Bishopsgate (o) 7 6 3, The Circus, Minories H. Lewis, 3, Circus, Minories (t) 6 8 4, do. T. Davis, 4, do. (t) 6 16 5, do. T. Groves, 5, do. (t) 10 9 3, Three Crown Court, Jewry Place. Mr. Martin, 14, Seething Lane (o) 3 3 18, Widegate Street S. Franks, 18, Widegate Street (t) 2 8 21, do. A. & A. Field, 95, Whitechapel Road (o) 4 5 24, do. W. I. Crane, 25, Widegate Street (t) 5 8 25, do. Do. do. (t) 2 8 2, Goodman's Yard Charrington, Brewers, Mile End Road (o) 3 3 Total 71 129 Average number of persons to each occupied tenement: 1.8 Houses demolished or closed as dwelling-houses — Tenement houses on Register 16 Cleansing Notices served 17 (O) Owner. (T) Tenant. 85 APPENDIX D.—LIST OF ADOPTIVE ACTS, LOCAL BYE-LAWS AND REGULATIONS, RELATING TO PUBLIC HEALTH, IN FORCE IN THE CITY OF LONDON. ADOPTIVE ACTS.—Nil. ADOPTIVE ORDERS. Subject. Date adopted. Sanitary Accommodation Sanitary Accommodation Order, 1903 Sept., 1904. BYE-LAWS. Vendors of Fried Fish London County Council (General Powers) Act, 1908, Sec. 9 Jan., 1914. Fish Curers ditto ditto ditto. Slaughtering of Cattle Public Health (London) Act, 1891, Sec. 19 May, 1911. Prevention of Nuisances arising from Snow, Ice, Salt, Dust, Ashes, Rubbish, Offal, Carrion, Fish or Filth, or other matter or thing in any street City of London Sewers Act, 1897 ; Public Health (London) Act, 1891, Sec. 16 Feb., 1894. Prevention of nuisance arising from offensive matters running out of any manufactories, brewers, slaughterhouses, knackers' yard, butchers' or fishmongers' shop, or dunghill ditto ditto ditto. Prevention of keeping of animals on any premises in such a manner as to be a nuisance ditto ditto ditto. As to the paving of yards or open spaces in connection with dwelling houses ditto ditto ditto. Keeping W.C.'s supplied with a sufficient supply of water ditto ditto Sec. 39 Feb., 1894. Cleansing of Cisterns ditto ditto Sec. 50 ditto. Water Closet, Earth Closet, &c. City of London (Various Powers) Act, 1900 Sept., 1909. Houses Let in Lodgings Public Health (London) Act, 1891, Sec. 94 and Housing Act, 1925, Sec. 6 Sept., 1926. Demolition of Buildings City of London (Public Health) Act, 1902, Sec. 5 July, 1904. Ash Pits City of London (Various Powers) Act, 1900, Sec. 54 June, 1925. Business of Slaughterer of Poultry Public Health (London) Act, 1891 July, 1925. Rag and Bone Dealer London County Council (General Powers) Act, 1908, Sec. 9 Jan, 1927. REGULATIONS. Soda Water Agreed regulations to control trade 1908. Kitchens of Restaurants and aboveground Bakehouses ditto ditto ditto Jan., 1904. Common Lodging Houses City of London Sewers Act, 1851 and 1897 Oct., 1902. House Drainage Regulations adopted by the Corporation Sept., 1898. 86 APPENDIX E. Corporation of London. PUBLIC HEALTH DEPARTMENT. THE PUBLIC HEALTH (LONDON) ACT, 1891. Compulsory Notification of Chicken-pox. NOTICE IS HEREBY GIVEN that the Mayor and Commonalty and Citizens of the City of London, as the Sanitary Authority for the City of London, Do hereby by virtue of the powers vested in them by Section 56 of the Public Health (London) Act, 1891, and with the approval of the Minister of Health, Order that the provisions of the said Act, with respect to infectious disease, shall apply in the City of London to the disease known as Chicken-pox, in addition to the diseases specifically mentioned in Section 55 of the said Act (or any Order extending or amending the same) and that for a period of twelve months from the 18th day of March, 1935, Chicken-pox shall be a compulsorily notifiable disease within the City of London. BELL. Guildhall, London, 1st March, 1935. APPENDIX F. Corporation of London. PUBLIC HEALTH DEPARTMENT. TUBERCULOSIS DISPENSARY, ST. BARTHOLOMEW'S HOSPITAL, E.C. 1. When you were examined here to-day, there was no evidence that you were suffering from Tuberculosis Disease of the Lungs. You need not worry any further about yourself from this point of view UNLESS 1. You have more than one attack of flu in three months, or have 'flu when there is no epidemic, or from which you do not recover in three weeks. 2. You feel tired for no apparent reason for one month. 3. You lose weight persistently. 4. You develop a cough which does not clear in six weeks. 5. You bring up blood in the mouth. 6. Your doctor tells you that you have pleurisy. If you develop any of these symptoms it does not mean that you have Tuberculosis, but it does mean that you should seek advice from a doctor. If he cannot find any definite cause you should arrange through him to consult a Lung Specialist privately, or your local Tuberculosis Officer. Date R6/63