REPORT OF THE MEDICAL OFFICER OF HEALTH OF THE ♦ * CITY. OF LONDON For the Year 1938. LONDON. Printed by Drake, Driver & Leaver, Ltd., Rosebery Avenue, E.C.I. 1939. INDEX. A. page. annual rateable value 8 appendices 80-88 artificial cream act, 1929 7 artizans dwellings, STONEY LANE 57, 58 agricultural PRODUCE (GRADING AND MARKING) ACT, 1928 & 1931 48 B. bacteriological EXAMINATIONS 18 BED BUGS, ERADICATION OF 63 births 8 infant WELFARE 12, 13 NOTIFICATION 12, 13 BUTTER FACTORIES 51 c. CEREBRO-SPINAL FEVER 17 CLEANSING OF PERSONS ACT, 1897 74 CLEANSING OF SCHOOL CHILDREN 74 cremation 30.31 COMMON LODGING HOUSES 60 CONGRESSES—PUBLIC HEALTH SERVICES 32 ,, —ROYAL INSTITUTE OF PUBLIC HEALTH 32 ,, —ROYAL SANITARY INSTITUTE 32 ,, —SANITARY INSPECTORS ASSOCIATION 32 ,, —NATIONAL ASSOCIATION FOR PREVENTION OF TUBERCULOSIS 32 ,, —NATIONAL VETERINARY MEDICAL ASSOCIATION 32 ,, —NATIONAL SMOKE ABATEMENT SOCIETY 32 D. deaths—causes of 10 density 8 dentures FOR MOTHERS AND EXPECTANT MOTHERS 14 DIPHTHERIA—ANTI-TOXIN 18 disinfectants, supply of 75 DISINFECTION—INFECTIOUS DISEASES 74 DISINFECTION OF SECOND-HAND CLOTHING 74 DRAINAGE PLANS 62 E. EXHUMATION AND REINTERMENT OF BODIES AT CITY OF LONDON CEMETERY 68 „ ,, HUMAN REMAINS DISCOVERED DURING EXCAVATION 66 F. FACTORIES ACT, 1937, AND PUBLIC HEALTH (LONDON) ACT, 1936—ABOVEGROUND BAKEHOUSES 67 ,, ,, ,, „ „ ,, —FACTORIES, WORKSHOPS AND WORKPLACES 66 ,, ,, ,, ,, „ ,, —OUTWORKERS 67,69, 72 ,, ,, ,, „ ,, „ —SUMMARY OF INSPECTIONS 68-71 ,, ,, ,, „ „ „ —UNDERGROUND BAKEHOUSES 67 FERTILISERS AND FEEDING STUFFS ACT, 1926 48 FISH SUPPLIES AND SEIZURES 42 FOOD—ITINERANT VENDORS 43 food AT RIVERSIDE WHARVES, INSPECTION AND CONDEMNATION 44-47 FOOD AND DRUGS—ADMINISTRATIVE ACTION REGARDING ADULTERATION, &c52,53 ,, ,, —PROSECUTIONS 56 ,, ,, —SUMMARY OF ARTICLES EXAMINED 54, 55 ,, „ —SUPERVISION OF 48 G. gullies, street 63 H. hospital accommodation FOR SCARLET FEVER, MEASLES, &c 17 houses let in lodgings 61 HOUSE, TRADE AND OTHER REFUSE REMOVAL 62 HOUSING 61 housing act, 1936 64 human REMAINS—EXHUMATION AND REINTERMENT AT CITY OF LONDON CEMETERY 66 DISCOVERED DURING EXCAVATION—REINTERMENT 66 I. ice cream 43 infantile mortality 9 • infant welfare 12,13 infectious disease 15,16 ,, ,, —bacteriological AND PATHOLOGICAL EXAMINATIONS 18 ,, ,, —diphtheria ANTI-TOXIN 18 ,, ,, -NOTIFICATION OF 16 ,, ,, —NURSING PROVISION—MEASLES, ENCEPHALITIS LETHARGICA, CEREBRO SPINAL FEVER AND INFLUENZA 18 ,, ,, -SMALLPOX 18 INFLUENZA—ANTI-INFLUENZA VACCINE 18 INQUESTS 74 insulin, PROVISION OF 18 introduction 7 itinerant VENDORS OF FOOD 43 INDEX (continued). L. page. limewashing of courts 63 lodging houses, common—116, middlesex street 61 registered 60 M. margarine, registration of dealers in margarine and margarine cheese 51 maternity and child welfare 12, 13 measles and whooping cough—notification of 17 meat inspection 32-41 ,, „ —caseous lymphadenitis 38 ,, ,, —delivery at central markets 41 ,, ,, —demonstrations and instruction 41 ,, ,, —export of meat 41 ,, ,, —home killed meat seized 35 ,, „ —leadenhall market and city shops 38 ,, „ —livestock imported 32 ,, „ —prosecutions 40 ,, „ —public health (meat) regulations, 1924 42 ,, „ —seizures of imported meat 39 ,, ,, —supplies 33 ,, „ —unsound meat removed from cold stores 38 medical examinations 77 merchandise marks act, 1926 48 midwives act, 1930 13 milk—bacteriological and chemical examinations for tuberculosis and dirt (railway stations) 56, 57 ,, —chemical examination of 49 ,, —public health (condensed milk) regulations, 1923 & 1927 51 ,, —public health (dried milk) regulations, 1923 & 1927 51 „ —milk and dairies (amendment) act, 1922 50 ,, —milk and dairies order, 1926 50 milk in schools scheme 50 milk—for school children 14 mortality 9 ,, —infantile 9 ,, —violence 9 „ —phthisis 9 ,, —zymotics 9 ,, —maternal 13 mortuary—disinfection of clothing for export, inquests, &c. 74 ,, —preservation of bodies of unknown dead 75 N. nursing homes—registration 13 nursing provisions 18 o. offices, inspection of 74 outworkers 67, 69,72 P. pharmacy and poisons act, 1933 47 pigeons—l.c.c. (general powers) act, 1927 65 population 8 post graduate nursing course 14 preserved meat, &c., preparation of 43 public health—(condensed milk) regulations, 1823 & 1927 51 ,, ,, —(dried milk) regulations, 1923 & 1927 51 ,, „ —(meat) regulations, 1824 42 ,, ,, —prevention of tuberculosis) regulations, 1925 18 „ „ —(tuberculosis) regulations, 1930 29 R. railway stations—samples of milk 58,57 rateable value 8 rat repression 75-77 refuse—collection and disposal 62 s. sanitary defects and infectious disease 82 sanitary inspections 59 scabies and impetigo 18 school children, milk for 14 sewer, defective connections 62 shops act, 1934 73 smallpox 18 staff 5 streets and gullies—cleansing of 63 swimming baths 63 T. tuberculosis 22-29 ,, —artifical i neumothorax treatment 23,29 ,, —public health (prevention of tuberculosis) regulations, 1925 18 ,, —public health (tuberculosis) regulations, 1930 29 ,, —training of health visitors 29 V. vaccination 11 venereal diseases 19,20, 21 vermin, disinfestation of premises 63 vital statistics 11 w. water closet bye laws 63 wharvf.s—inspection of food at 44-47 STAFF. MEDICAL OFFICER OF HEALTH. Date of Appointment White, Charles Francis, M.D., Ch.B., D.P.H., D.T.M Dec., 1937 CLERICAL STAFF. Lowe, George Principal Assistant and Vaccination Officer Nov., 1902 Gray, Charles M 1st Class Assistant March, 1911 Blunt, Harold F. 2nd Class Assistant May, 1924 Stout, James Erl July, 1930 Threadgold, Arthur W. 3rd Class Assistants Nov., 1923 Stevens, F. W Nov., 1937 Tunbridge, Mrs. Jan., 1917 Peters, E. unclassified NoV., 1935 Wilson, C. Unclassified Jan., 1936 Clements, K. N. H. Nov., 1930 SANITARY INSPECTORS. Robinson, Ernest S. Feb., 1913 Fowler, George Henry Oct., 1920 McGrath, William Richard Mar., 1922 Harrington. George Edwin Senior Inspectors Dec., 1925 Sillet, David Ernest April, 1926 Neale, William G. C. July, 1928 Thorpe, Robert C. March, 1930 Webber, G. A. (Rat Officer) July, 1932 Hudson, Leslie A April, 1934 Aldhous, H. J. Junior Inspectors April, 1935 Holloway, A. B. May, 1937 Cox. C. R. Oct., 1938 Scott, A. E. R Oct., 1938 MEAT INSPECTION STAFF. Grace, L. B. A., M.R.C.V.S., Veterinary Officer and Chief Meat Inspector June, 1934 Mitchener, William E., Senior Inspector Dec., 1910 Matson, William S. Dec., 1910 Jones, John April, 1914 Slatter, Charles Senior Inspectors May, 1908 Murray, Samuel B. Sept., 1911 Mellish, Cyril E. Jan., 1912 Thompson, Frank E. July, 1924 Perris, G. A. Dec., 1923 Cann, S. W. May, 1927 Peyton, H. R. Sept., 1932 Lee, W. R. July, 1930 Bernhardt, D. R. Probationary Meat Inspectors May, 1931 Seymour, K. D July, 1935 WOMAN SANITARY INSPECTOR. Wilkinson, Miss Annie M. July, 1909 TUBERCULOSIS SISTER AND HEALTH VISITOR. Backhouse, Miss S. A. June, 1931 TUBERCULOSIS NURSE AND ASST. HEALTH VISITOR. Scott, Miss J. F. April, 1938 KEEPER OF THE MORTUARY. Steggles, T. Dec., 1918 DISINFECTOR. McDonnell, R. J. April, 1903 MESSENGERS. Tierrney, T. E. (Temporary) Dec., 1926 Betts, Charles April, 1926 LABOURERS. Hastings, T. (General Duties at Mortuary) June, 1920 Burton, John Henry (Do. do.) March, 1936 Lawrence, F. H. (Do. do.) May, 1936 Ludgate, G. (General Duties at Smithfield Market) Oct., 1906 Strong, S. R. (Do. do.) March, 1914 Morris, W. F. (Do. do.) .... March, 1925 Prevost, A. C (Do. do.) Feb., 1926 Mann, Ernest V. (Do. do.) Jan., 1928 Lawrence. Charles J. (Do, do.) Feb., 1928 Graham, Mrs. (Bath Attendant and Cleaner) June, 1927 b annual report of the medical officer of health for the year 1938. To the Right Honourable The Lord Mayor, Aldermen and Commons of the Corporation of London. Public Health Department, Guildhall, E.C. July, 1939. My Lord Mayor and Gentlemen, I have the honour to present my Annual Report of the work of my Department for the year 1938. Throughout the year efforts to organise the Casualty Services under the Corporation's A.R.P. Scheme have absorbed a great deal of the time of your Medical Officer and other members of your staff. The problem is particularly difficult in the City, by reason of the enormous day population and the small resident population. It is certain that in the event of war the day population would be very greatly reduced, but the work of the City could not cease nor could it all be transferred to other and less vulnerable areas. The preparation of a scheme for dealing with casualties is therefore complicated by many uncertainties and anxieties, and it is no doubt difficult for those who have no direct responsibility, and who only hear and see what is, and what is not, achieved, to appreciate the amount of work which has been added to the normal duties of your staff. Nevertheless, I think this Report will show that the proper functions of this Department have been efficiently carried out during the year, and I should like to pay a tribute to the manner in which all the members of your staff have responded to the many additional calls upon their time and energy. During the year there were several changes in your staff. Dr. H. J. Sequira, who had been the Public Vaccinator for the City of London for over 40 years, resigned as from September 3rd, and has been succeeded by Dr. John Brock Bishop. Mr. E. A. Johnson, M.B.E., who for eight years acted as Inspector and Official Sampler under the Fertilisers and Feeding Stuffs Act, as an Officer under the Agricultural Produce (Grading and Marking) Act and the Merchandise Marks Act, died after a long illness. Both Dr. Sequira and Mr. Johnson gave good service to your Worshipful Committee and were, in addition, pleasant colleagues who are greatly missed by your staff. Mr. C. R. Cox and Mr. A. E. R. Scott joined your staff as Sanitary Inspectors in October, and Miss J. F. Scott was, in April, appointed Tuberculosis Nurse and Assistant Health Visitor in succession to Miss M. H. Cook, who resigned on appointment as Health Visitor in another district. The many and varied activities of this Department are detailed in the following pages, but I would direct attention of your Worshipful Committee particularly to the sections dealing with Maternity and Child Welfare, Infectious Diseases, (Cerebro-spinal Fever), Cremation, the Inspection of Food and Drugs, and the Administration of the Housing Act, 1936. STATISTICAL INFORMATION. Area.—The City of London (excluding The Temple) comprises an area of 66l 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. b2 8 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 £61,631,382, on April 6th, 1938, whilst on the same date the corresponding rateable value of property in the City of London was £8,251,092, or about one-seventh of the whole County, The annual sum receivable from a penny rate is £33,240. Population.—The undermentioned figures are extracted from the Report of the Registrar-General on the Census of England and Wales, 1921:— Area, Inhabited Houses. Population. Private Statute Families. Acres. 1911. 1921. 1911. 1921. 1921. City of London (Not including the Temple) 661 2,784 2,398 19,657 13,709 3,174 These figures represent the population on the nights of the 3rd April, 1911, and the 19th June, 1921. The following table shows the progressive decline which has taken place since 1861 in the number of inhabitants who reside within the City boundaries, and the progressive increase in the number of workers who are daily employed in the City:— Year. Imperial Census. Night Population. City Census, Day Population. 1861 112,063 - 1866 — 170,133 1871 75,983 — 1881 51,405 261,061 1891 37,705 301,384 1901 26,923 — 1911 19,657 364,061 1921 13,709 436,721 (Imperial 1931 10,808 — (Census.) There is only one registration district in the City. The estimated population of the City, for the year 1938, is 8,780, and consists principally of members of the working classes. There is very little poverty or unemployment amongst the residents. The day population of some half-a-million persons is mainly engaged in such industries as Banking, Insurance, Shipping, Textile, and Wholesale and Retail Trades. 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 1938, 541 live births were registered in the City, 518 of which, however, did not belong thereto. To the remaining 15 must be added the births of 43 children born to citizens temporarily residing outside the City boundary. The number of births, therefore, on which the rate should be calculated is 58. There was one still birth. The annual birth-rate was 6.6 per 1,000 persons of all ages, compared with a quinquennial mean rate of 7.3 per 1,000. In the Metropolis the birth-rate in 1938 was 13.4 per 1,000. *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. 9 Mortality.—During the year under review; 538 deaths were registered in the District, including 501 persons dying in the City, but not belonging thereto. Deducting these latter, 37 deaths remain, to which must be added those of 57 persons who died in outside districts, where they were registered; the total, therefore, on which the City death-rate is calculated is 94. See table, p. 10, for details. The death-rate for 1938 was 10.7 per 1,000 per annum of the population (the previous year being 11.2), whilst that for the whole of the Metropolis was 11.4. Deaths from Violence.—Of the City deaths, 3.2 per cent. were caused by injuries or violence, as compared with 6.7 in 1936 and 3.0 in 1937. This is 2.4 below the average for the previous five years. PERCENTAGE OF REGISTERED DEATHS FROM VIOLENCE. Year. City of London, Per cent. Metropolis, Per cent. 1933 4.6 4.7 1934 3.9 5.6 1935 9.7 4.5 1936 6.7 4.2 1937 30 0.5 Average previous five years 5.6 3.9 1938 3.2 0.9 DEATH RATES; PER 1,000 PER ANNUM. Year. City of London. 136 Great Towns of England and Wales. Metropolis. 1933 10.9 12.2 12.2 1934 10.5 11.8 11.9 1935 11.0 11.8 11.4 1936 11.4 12.3 12.5 1937 11.2 12.5 12.3 Average previous five years 11.0 12.1 12.1 1938 10.7 11.7 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 0.7 per 1,000 of the population. Infantile Mortality.—The deaths of children under one year of age were at the rate of 52 per 1,000 births, as against 57 for the whole of London. 10 CAUSES OF, AND AGES AT, DEATH DURING THE YEAR 1938. Causes of Death. Nett Deaths at the subjoined ages of '" Residents " whether occurring within or without the district. Total Deaths whether of "Residents" or ".NonResidents" in Institutions in the District. All Ages. Jnder year. 1 and under 2 years. 2 and under 5 years. 6 and under 16 years. 15 and under 25 years. 25 and under 35 years. 35 and under 45 years. 45 and under 55 years. 65 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. 94 3 - l - 2 l 3 14 24 23 23 462 1. Typhoid and Paratyphoid Fevers - - - - - - - - - - - - - 2. Measles - - - - - - - - - - - - - 3. Scarlet Fever - - - - - - - - - - - - - 4. Whooping Cough - - - - - - - - - - - - - 5. Diphtheria - - - - - - - - - - - - 4 6. Influenza 1 - - - - - - - - - 1 - - 7. Encephalitis Lethargica - - - - - - - - - - - - - 8. Cerebro-spinal Fever 1 - - - - - - - 1 - - - 1 9. Tuberculosis of Respiratory System 7 - - - - - l - 2 2 1 1 8 10. Other Tuberculous Diseases - - - - - - - - - - - - 13 11. Syphilis - - - - - - - - - - - - - 12. General Paralysis of the Insane, Tabes Dorsalis 1 - - - - - - - - - 1 - - 13. Cancer, Malignant Disease 11 - - - - - - 1 2 3 3 2 92 14. Diabetes 3 — - - - - - - 2 - 1 - 12 15. Cerebral Haemorrhage, &c. 3 - - - - - - - - 1 - 2 21 16. Heart Disease 33 - - - - - - - 3 6 11 13 42 17. Aneurysm 1 - - - - - - - - 1 - - 4 18. Other Circulatory Diseases 3 - - - - - - - - 1 1 1 8 19. Bronchitis - - - - - - - - - - - - - 20. Pneumonia (all forms) 3 l - - - - - - 1 1 - - 33 21. Other Respiratory Diseases - - - - - - - - - - - - 13 22. Peptic Ulcer 1 - - - - - - - - 1 - - 25 23. Diarrhoea, &c - - - - - - - - - - - - 13 24. Appendicitis 1 - - - - - - - - 1 - - 8 25. Cirrhosis of Liver - - - - - - - - - - - — 3 26. Other Diseases of Liver, &c - - - - - - - - - - - - 3 27. Other Digestive Diseases 4 - - - - - - - 1 2 - 1 28. Acute and Chronic Nephritis 6 .... ■#. .... .... .... .... .... 2 2 1 1 26 29. Puerperal Sepsis - - - - - - - - - - - - - 30. Other Puerperal Causes - - - - - - - - - - - - 31. Congenital Debility, Premature Birth, Malformations, &c 1 l - - - - - - - - - - 14 32. Senility 1 - - - - - - - - - - 1 - 33. Suicide 1 - - - - 1 - - - - - - 6 34. Other Violence 2 1 - - - - - 1 - - - 28 35. Other Defined Causes 10 - - l - 1 - 1 - 3 3 1 84 36. Causes ill-defined or unknown - - - - - - - - - - - - 1 Totals 94 3 - l - 2 l 3 14 24 23 23 462 11 VITAL STATISTICS OF WHOLE DISTRICT DURING 1938 AND PREVIOUS FIVE YEARS. Name of District: CITY OF LONDON. Births. Total Deaths Registered in the District. Transferable Deaths. Nett Deaths belonging to the District. Year. Population estimated to Middle of each Year. Uncorrected number. Nett. of Nonresidents registered in the District. of Residents not registered in the District. Under 1 Year of Age. At all Ages. Number. Rate. Number. Rate. Number. Rate per 1,000 nett Births. Number. Rate. 1 2 3 4 5 6 7 8 9 10 11 12 13 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 1935 9,360 378 71 7.6 572 61.11 525 56 8 113 103 11.0 1936 9,100 417 68 7.5 546 60.00 501 59 10 147 104 11.4 1937 8,980 377 55 6.1 551 61.35 506 56 2 36 101 11.2 Average previous years 9,386 390 69 7.3 582 62.00 536 57 7 95 103 11.0 1938 8,780 541 58 6.6 538 61.27 501 57 3 52 94 10.7 VACCINATION STATISTICS IN THE CITY OF LONDON. Year. Number of Births notified to Vaccination Officer. Successfully Vaccinated. Insusceptible. Had Small-pox. Died before Vaccination. Vaccination postponed. Cases pending or removed at the end of the year. Conscientious objections. • 1933 396 per cent. 36.7 per cent. 0.7 per cent. Nil. per cent. 4.5 per cent. 0.2 per cent. 35.4 per cent. 22.5 1934 371 31.5 Nil. - 4.0 1.1 41.6 21.8 1935 370 36.9 - - 4.5 0.2 36.5 21.9 1936 398 27.2 0.4 - 4.9 Nil. 43.7 23.8 1937 398 32.9 0.2 - 5.3 - 37.9 23.7 Average previous 5 years 388 33.0 0.3 - 4.6 0.3 39.1 22.7 1938 361 33.3 0.5 - 5.5 0.2 35.2 25.3 Area of City of London in acres Total population at all ages 13,709 (land and inland water) 661 Number of inhabited houses 2,922 Average number of persons per house 4.6 At Census 1921. Vaccination.—Of the 361 births notified to the Vaccination Officer during 1937, 120 had been successfully vaccinated by the end of 1938, 20 had died before the age for vaccination and 2 were reported as insusceptible. Vaccination was postponed by medical certificate in 1 case, and 127 had removed into other districts. No case was pending. There were 91 instances of conscientious objection. The Public Vaccinator performed 5 re-vaccinations during the year, and in addition to the 120 successful vaccinations referred to above, 5 adult persons were vaccinated for the first time. 12 MATERNITY AND CHILD WELFARE. Six hundred and forty-one notifications of births, including 28 still births, made in accordance with the requirements of the Public Health (London) Act, 1936, were received. Of these, 50 only referred to City births, and the balance were transferred to the appropriate authorities. There was 1 still birth to City parents. Fifty initial visits were made as a consequence of these notifications, and 1,357 subsequent visits in connection with infant welfare and ante-natal work. Four visits were necessary in connection with cases which came within the scope of the Children Act, 1908, or in respect of a nurse child. Supplies of milk (2,831 galls.) and 315 lbs. of 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. Two home helps were provided during 1938. There were no notifications of verminous school children under the London County Council (General Powers) Act, 1904. There were two cases of Ophthalmia, both of which recovered. 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 not utilized during 1938. /THE CITY OF LONDON WELFARE CENTRE. HELD AT ST. BARTHOLOMEW'S HOSPITAL. The City of London Infant Welfare Centre continued actively during 1938. Two sessions are held weekly at 2.30 p.m., on Wednesdays and Thursdays. There were 100 sessions held of the Welfare Centre, 12 special sessions for the immunisation of children against diphtheria, and 5 for Schick tests. One thousand three hundred and fifty-seven home visits were paid by the Health Visitors. It will be seen that, with an annual birth registration of about 50, this activity effectively covers the babies and young children living in the City and provides a satisfactory health service. I hope, however, to develop an ante- and post-natal service at no distant date. An agreement has been entered into with the Governors of St. Bartholomew's Hospital which will provide, as from the 1st April, 1939, convalescent home accommodation at the Zachery Merton Convalescent Home, at Rustington, Sussex, for such of the City mothers and their babies as the Medical Officer in charge of the Infant Welfare Clinic thinks need it and whose financial condition justifies the provision. During this year the immunisation of children against diphtheria has continued. Altogether, 40 have been immunised in 1938, which may be counted a very satisfactory figure. It has proved necessary to hold special sessions for purposes of immunisation and for Schick testing; 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 opportunity is taken to impress on mothers the importance of suitable diet both for themselves and their babies. It has been possible to arrange that toddlers attending the Centre receive dental treatment at Eastman's Dental Clinic, in Gray's Inn Road. Sunlight treatment, when recommended by the Medical Officer in charge of the clinic, is available through the kind offices of the Skin Department of St. Bartholomew's Hospital. Both these arrangements are informal, and the assistance rendered by the two institutions in question is gratefully acknowledged. Through the kind offices of the Lady Almoner at St. Bartholomew's Hospital, four of the children attending the Infant Welfare Clinic and three mothers were accommodated in the Convalescent Home. 13 During the year, it was found necessary to provide a certain amount of Clerical Assistance in connection with Infant Welfare work. This was not sufficient to justify the appointment of a whole-time clerk, and the difficulty has been met through the co-operation of St. Bartholomew's. Hospital. The following is a tabulated statement of the work carried out by the Health Visiting Staff in the above connection:— MATERNITY AND CHILD WELFARE, 1938. Birth Notifications received, 50. (1 stillborn.) Infant Welfare Centre, 100 Sessions:— (There were also 12 Sessions for Diphtheria Immunisation and 5 for Schick testing.) Attendances Under 1 year 813 Over 1 year 843 Total 1797 Diphtheria Immunisation 40 Schick Testing 31 Mothers attending during year 106 „ left City „ „ 52 No. Children becoming 5 during year 36 No. of Children on Register at end of year:— Under 1 year of age 34 45 „ „ „ (Did not wish to be visited) 14 (Diphtheria Over 1 year of age 96 (immunised. „ „ „ (Did not wish to be visited) 4 Total visits, 1,362:— Under 1 year 456 Over 1 to 5 years 742 Ante-Natal 149 Ophthalmia 2 Deaths under 1 year 4 Still Births 1 Infant Life Protection 4 Scabies 4 MIDWIVES ACT, 1936. CONSULTANT SERVICES AND EMERGENCY UNIT. In connection with the scheme under the above-mentioned Act for the provision of skilled midwifery service for all lying-in women, arrangements have been made for the services of an obstetric consultant to be available when necessary, and also for an emergency unit to be on call for emergency cases requiring blood and saline transfusion. For the purposes of administration of the Act, London has been divided into areas, and the City is in Area B, which comprises, in addition to the City, the Boroughs of Holborn, Finsbury, St. Pancras and Islington. A list of obstetric consultants has been prepared for the whole area, and an agreement has been entered into between the Authorities comprising Area B and St. Bartholomew's and University College Hospitals for the provision of emergency services. REGISTRATION OF NURSING HOMES. There are no nursing homes situate in the City of London, and consequently no action has been necessary under Sections 240-249 of the Public Health (London) Act, 1936. MATERNAL MORTALITY. The enquiries into maternal deaths, which the Ministry of Health has required to be conducted, have not called for any particular organisation in my Department. With a small City resident population, few deaths in this category are reported. Where such cases do occur, investigations are conducted by me. No case was reported during 1938. It may be of interest to note that, from 1900 to 1938 inclusive, only 17 maternal deaths have occurred amongst City residents. c 14 PROVISION OF DENTURES FOR MOTHERS AND EXPECTANT MOTHERS. In 1935 it was felt that the Maternity and Child Welfare activities of the Corporation were somewhat stultified by the fact that some of the City mothers in urgent need of dental treatment were not in the position to meet the cost, and the Public Health Committee decided to make free provision in such cases as the Medical Officer in charge thought necessary and where the financial conditions justified it. Some contribution is obtained when possible. , It was not necessary to use this provision during 1938. 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 Authority's 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, 1936. 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 course organised by the College of Nursing during the early part of the summer. These courses are particularly valuable to officers in the public health nursing service, as it enables them to keep in touch with modern developments in their profession. INFECTIOUS DISEASES. Eighty cases of infectious disease were notified during the year 1938. An examination is made of the sanitary condition of the premises where the cases occurred, and a summary of defects found by the District Inspectors is given on p. 62. In the following tables will be found particulars relating to cases of infectious diseases and information as to the removal of patients to hospital. 15 STATISTICS OF NOTIFICATIONS AND REMOVALS TO HOSPITAL. NAME OF DISEASE. Number of Notifications received. Treated at Home Removed to the L.C.C. Special Hospitals. Removed to the London Fever Hospital. Treated at other Hospitals and Institutions. Duplicate Certificates received. Diagnosis subsequently found to be incorrect. Net nutnbrr of Cases. Small-pox .... .... .... .... .... .... .... .... Diphtheria 12 .... 12 .... .... .... 6 6 Scarlet Fever 9 .... 8 .... l .... 1 8 Enteric Fever (including Para-typhoid) 1 .... .... .... l .... .... 1 Puerperal Fever .... .... .... .... .... .... .... .... Puerperal Pyrexia .... .... .... .... .... .... .... .... Erysipelas 3 .... 2 .... .... l .... 2 Cerebro-spinal Meningitis 1 .... 1 .... .... .... .... 1 Acute Polio-myelitis .... .... .... .... .... .... .... .... Ophthalmia Neonatorum 2 l .... .... l .... .... 2 Malaria contracted abroad .... .... .... .... .... .... .... .... Acute Primary Pneumonia 3 2 1 .... .... .... .... 3 Acute Influenzal Pneumonia 1 .... 1 .... .... .... .... 1 Encephalitis Lethargira 1 .... .... .... l .... .... 1 Food poisoning or suspected food poisoning 2 1 .... .... .... 1 .... 1 Dysentery 5 .... 3 .... 2 .... 1 4 Measles 49 37 10 2 .... .... .... 49 Whooping Cough 1 1 .... .... .... .... .... 1 Totals 90 42 38 2 6 2 8 80 The following is a return of infectious diseases which have occurred in the City of London, exclusive of Tuberculosis, Measles, Whooping Cough, Pneumonia and Food Poisoning, with the percentages of such cases removed to hospitals for treatment or nursed at home during 1938 compared with the figures for the previous five years:— In no case was it necessary to apply for an order for compulsory removal to hospital. Year. Number of actual cases. Per cent. of actual cases reported. Removed to Hospital. Treated at home. 1933 56 87.5 12.3 1934 61 90.2 9.8 1935 52 90.3 9.7 1936 35 97.1 2.9 1937 21 85.7 14.3 Average for the five years 45 90.2 9.8 1938 25 96.0 4.0 c 2 16 cases of, infectious disease (exclusive of tuberculosis) notified during the year 1938. NUMBER OF ACTUAL CASES NOTIFIED. DISEASES. At Ages—Years. No. of Cases Removed toHospital. 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 6 years. 5 years and under 10 yeas. 10 years and under 15 years. 10 years and under 20 years. 20 years and under 35 years. 35 years and under 45 years. 45 years and under 65 years. 65 years and over. Small-pox .... .... .... .... .... .... .... .... .... .... .... .... .... .... Cholera .... .... .... .... .... .... .... .... .... .... .... .... .... .... Plague .... .... .... .... .... .... .... .... .... .... .... .... .... .... Diphtheria 6 .... .... .... .... 2 3 .... l .... .... .... 6 Erysipelas 2 .... .... .... .... .... .... .... .... .... .... 2 .... 2 Scarlet Fever 8 .... .... .... .... 2 2 .... .... 4 .... .... .... 8 Typhus „ .... .... .... .... .... .... .... .... .... .... .... .... .... Enteric „ (including Para-typhoid) 1 .... .... .... .... .... .... .... .... .... .... 1 .... 1 Relapsing „ .... .... .... .... .... .... .... .... .... .... .... .... .... .... Continued „ .... .... .... .... .... .... .... .... .... .... .... .... .... .... Puerperal „ .... .... .... .... .... .... .... .... .... .... .... .... .... .... Puerperal Pyrexia .... .... .... .... .... .... .... .... .... .... .... .... .... .... Polio-myelitis .... .... .... .... .... .... .... .... .... .... .... .... .... .... Cerebro spinal Meningitis 1 .... .... .... .... .... .... .... .... .... .... 1 .... 1 Ophthalmia Neonatorum 2 2 .... .... .... .... .... .... .... .... .... .... .... 1 Measles 49 2 2 1 3 4 29 3 2 2 1 .... .... 12 Whooping Cough 1 .... 1 .... .... .... .... .... .... .... .... .... .... .... Malaria (contracted abroad) .... .... .... .... .... .... .... .... .... .... .... .... .... .... Acute Primary Pneumonia 3 .... .... .... .... .... .... 1 1 .... .... 1 .... 1 Acute Influenzal Pneumonia 1 .... .... .... .... .... .... .... 1 .... .... .... 1 Encephalitis Lethargica 1 .... .... .... .... .... .... .... .... .... .... .... 1 1 Dysentery 4 .... .... .... .... .... .... .... .... 2 .... 2 .... 4 Food Poisoning 1 .... .... .... .... .... .... .... .... .... 1 .... .... .... Totals 80 4 3 1 3 8 34 4 3 10 2 7 1 38 * L.C.C. Hospitals, St. Bartholomew's Hospital. City Police Hospital. &c 17 NOTIFICATION OF MEASLES AND WHOOPING COUGH. The County of London (Measles and Whooping Cough) Regulations, 1938, which came into operation on the 1st October, provide that cases of measles and whooping cough must be notified to the local medical officer of health by the medical practitioner in attendance, unless a previous case of the disease has occurred in the same house and has been notified within the preceding two months. In accordance with the instructions contained in the Order, the provisions were suitably advertised within the City, and a copy of the Regulations themselves, together with a covering letter, was forwarded to every medical man practising in the area. HOSPITAL ACCOMMODATION FOR SCARLET FEVER, MEASLES, &c. In view of the difficulties which were experienced in obtaining nurses, the London County Council had to restrict the admission of cases of scarlet fever, dysentery, measles, whooping cough, chicken-pox, german measles and mumps, to their Hospitals to cases in which hospital treatment was essential owing to severity of the case and unfavourable home conditions, and in the case of measles to children under two years of age. The restriction operated from the early part of the year until the middle of May, 1938, and so far as the City of London was concerned was not attended with any-difficulty. CEREBRO-SPINAL FEVER. Early in May the secretary of a firm in the City telephoned to say that a member of his staff had been reported to be suffering from Cerebro-Spinal Fever and to ask if it was necessary to take any stef>s to prevent the spread of infection. The offices of the firm, which were high up in a large modern building, were visited, and it was found that they were well lighted, there was provision for good ventilation and there was no crowding. Disinfection of the patient's desk and of articles used by him was carried out, but no other action was taken. On May 16th, a second case was reported from the same office, and as the staff was not very large, it was decided to try to find a carrier. It was ascertained that, in the second case, the infecting organism had been typed * and had proved to be Meningococcus, Group I. Unfortunately, the first case, which had been admitted to a different hospital, was not typed. Your Bacteriologist, Dr. Garrod, visited the office of the firm on May 16th, and obtained post-nasal swabs, from which cultures were made forthwith, from all the occupants of the two rooms in which the cases had occurred. The number of persons swabbed was 49, and Dr. Garrod reported that an unduly high proportion of them were suffering from pharyngeal or post-nasal catarrh. In 11 cases cultures yielded a profuse growth of meningococci, the majority being nearly pure cultures, and in 12 others there was an almost pure growth of. pneumococci, no less than seven of which were of the " mucosus " type. Dr. Garrod Remarked that these facts indicated that upper respiratory tract infections had been spreading freely from person to person in the office. By the kindness of Dr. Scott, of the Ministry of Health, the serological type of the meningococci was ascertained. With'one exception, they were of Group II. In one case, L. C., the meningococci were of Group I, the epidemic type, and the type known to have been responsible for the second case. L. C. lived at Wimbledon, and the Medical Officer of Health was informed of the circumstances. As his home conditions were not suitable for isolation, L. C. was admitted to the Wimbledon Infectious Diseases Hospital. Post-nasal swabs were taken on May 31st, June 7th and June 15th, and cultured by Dr. Garrod. On each occasion the swabs yielded a profuse growth of meningococci. Dr. Garrod deemed it advisable to have the meningococcus examined serologically again, and accordingly sent the culture of June 15th to Dr. Scott. Dr. Scott reported that the organism had lost type specificity and virulence. L. C. was therefore discharged from hospital, and after a holiday in the country, returned to his work on July 4th, seven weeks after he had been detected as a carrier. No further cases occurred. The investigation and the isolation of the carrier were greatly facilitated by the sympathetic co-operation of the principals of the firms concerned. 18 TREATMENT OF SCABIES. Some consideration was given during the year to the provision of treatment for persons suffering with scabies. Apparently certain local authorities provide no facilities for treatment of this infection, and it has been urged that the Ministry of Health should request such authorities to provide adequate treatment. The City Corporation has for many years now given treatment to any person suffering from scabies. The facility is not confined to residents or workers in the City, as it has been felt that to refuse an application might result in the patient, in an endeavour to seek treatment elsewhere, using public conveyances, with consequent possibility of the spread of the condition. SMALL-POX. No case of Small-pox occurred during the year in persons resident or employed in the City. DISTRIBUTION OF DIPHTHERIA ANTI-TOXIN AND ANTI-INFLUENZA VACCINE. Provision was made some years ago for the distribution of Diphtheria anti-toxin free of charge to medical practitioners who apply for it. No application was received during 1938. Similar provision is made in regard to anti-Influenza vaccine but again no application was received during the year. PUBLIC HEALTH (PREVENTION OF TUBERCULOSIS) REGULATIONS, 1925. It has not been necessary during the year to take any action in regard to the abovementioned Regulations, which provide for the exercise of some control over persons suffering from Tuberculous affections and engaged in certain occupations associated with the milk trade. PROVISION OF INSULIN. Under the powers provided by Section 227 of the Public Health (London) Act, 1936, the Corporation have, at the request of the authorities of the University College Hospital, supplied, at regular intervals, insulin to one patient resident in the City and in attendance at that hospital. This is the first patient, so far as I am aware, in regard to whom such powers have been put into operation in the City, and the provision has been continuous since 1930. NURSING PROVISIONS. MEASLES, ENCEPHALITIS LETHARGICA, CEREBRO-SPINAL FEVER AND INFLUENZA. No application has been received during 1938 in connection with the scheme which has been approved in connection with the provision of nursing accommodation for the above-mentioned affections. An expenditure of £25 per annum in connection with complicated cases of measles, encephalitis lethargica and cerebro-spinal fever, and of £30 per annum on provision of medical assistance and nursing attendance in necessitous cases of influenza, has been approved by the Corporation. EXAMINATION OF PATHOGENIC BACTERIA. Arrangements have been made for free bacteriological examination by Professor L: P. Garrod, who is in charge of the Bacteriological Department at St. Bartholomew's Hospital, at the request of medical practitioners, in cases of suspected infectious disease or food poisoning occurring amongst patients residing in the City. City practitioners have been informed of these facilities, and the. result is communicated to them immediately it has been ascertained. During the year 40 specimens were dealt with, and it will be seeij, that positive results were obtained in 14 per cent. of these cases. Specimens. Disease Suspected. Result. Positive. Negative. 19 Sputa Tuberculosis 3 16 19 Swabbings from Throats Diphtheria 2 17 2 Blood Typhoid Fever — 2 19 VENEREAL DISEASES. The Special Centre for the Treatment of Venereal Diseases, which, in accordance with the powers under the Public Health (Venereal Diseases) Regulations, 1916, the City Corporation established at 20/21, Golden Lane—previously occupied as a shelter, and specially altered to meet the requirements—was transferred to St. Bartholomew's Hospital on the 17th February, 1930. This step was deemed expedient for economic and other reasons, and it is satisfactory to note that the number of persons availing themselves of the opportunity afforded has since that date shown steady average increase, the total number of new cases in the year being 1,073, as compared with 1,060 in the previous year. The following is a brief summary of the work carried out during 1938. At the beginning of the year 476 males and 176 females were registered on the books as being under treatment or observation, which compares with 452 males and 194 females at the beginning of the previous year. Of these patients, 293 males and 156 females were under treatment for syphilis, 181 males and 15 females-for gonorrhoea, and 2 males and no females for soft chancre. No males and 5 females were under treatment for conditions other than venereal disease. The total attendances were 29,598. Unfortunately, 281 cases discharged themselves before completion of treatment, and 129, although completing treatment, failed to submit themselves to final test. Forty-five males and 25 females were transferred to other centres or care of private practitioners after treatment, whilst 544 males and 92 females were discharged after completion of treatment and observation. « There were 10 in-patients. The total number of attendances is made up as follows:— Syphilis. Soft Chancre. Gonorrhoea. Non-Venereal Conditions. Total Attendances. Male. Female. Male. Female. Male. Female. Male. Female. Male. Female. 13,225 7,360 9 — 7,340 * 939 581 144 21,155 8,443 In the laboratories associated with the Centre, 14,395 specimens were examined, 21 for the detection of spirochetes, 2,113 for gonococci, 11,476 examinations for the Wassermann or Serum test, and 651 for other examinations. The following tabulation indicates the number of patients coming under treatment for the first time from the Counties stated, and also the examinations which were made for the detection of Spirochetes, of Gonococci, and for the Wassermann or Serum test in respect of these patients:- For Syphilis. No. of patients treated. For Non-Venereal Conditions. For Soft Chancre. For Gonorrhœa. London 184 4 274 429 Essex 4 — 6 8 Surrey 7 — 4 12 Kent 4 — 4 9 Herts. — — 1 2 Bucks. — — 2 — Totals 199 4 291 460 The following summary shows the work carried out during each year that the Centre has been in operation. Year. New Patients. Total. Total Attendances. "606." Bismuth. Mercury. In-Pts. Path.Ex Men. Women. 1917 207 87 294 2,340 1,193 .... 339 22 372 1918 304 176 480 8,353 1,406 .... 1,391 71 421 1919 606 201 807 15,269 1,763 .... 1,782 45 2,485 1920 799 254 1,053 21,689 3,690 .... 2,800 41 6,005 1921 570 188 758 18,216 3,584 .... 2,859 52 5,241 1922 469 117 586 16,702 2,637 .... 2,851 23 4,774 1923 367 98 465 14,710 2,049 .... 2,130 9 6,832 1924 301 116 417 10,890 1,510 1,368 1,503 1 7,040 1925 314 88 402 10,541 1,782 1,198 1,192 1 5,835 1926 399 86 485 11,656 1,869 1,539 764 3 6,351 1927 340 80 420 12,501 1,723 2,124 362 2 6,266 1928 395 81 476 13,051 1,785 2,781 2 0 6,932 1929 396 102 498 14,095 1,580 3,042 .... 0 6,822 1930 816 257 1,073 20,694 2,601 5,509 .... 11 8,212 1931 853 209 1,062 26,378 4,175 6,860 .... 24 8,555 1932 785 196 981 26,069 4,916 7,021 .... 5 8,282 1933 845 178 1,023 30,377 4,155 8,532 .... 6 8,314 1934 866 207 1,073 32,130 3,997 9,314 .... 5 8,764 1935 725 202 927 31,214 2,967 6,448 3,229 6 8,709 1936 868 192 1,060 31,565 3,132 6,264 1,501 8 11,256 1937 840 235 1,075 32,880 3,419 6,964 520 8 12,557 1938 896 353 1,073 29,598 4,195 9,430 666 10 14,395 Totals 11,951 3,703 15,478 430,918 61,128 76,394 23,873 353 164,420 20 RETURN RELATING TO ALL PERSONS WHO WERE TREATED AT THE TREATMENT CENTRE AT ST. BARTHOLOMEW'S HOSPITAL DURING THE YEAR ENDED THE 31st DECEMBER, 1938. Syphilis. Soft Chancrc. 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 293 156 2 .... 181 15 .... 5 476 176 652 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 32 31 .... .... 44 5 .... .... 76 36 112 3. Number of cases dealt with for the first time during the year under report (exclusive of cases under Item 4) suffering from:— Syphilis, primary 25 1 .... .... .... .... .... .... 25 1 26 „ secondary 29 17 .... .... .... .... .... .... 29 17 46 „ latent in 1st year of infection .... 5 .... .... .... .... .... .... .... 5 5 „ all later stages 70 30 .... .... .... .... .... .... 70 30 100 ,, congenital 15 7 .... .... .... .... .... .... 15 7 22 Soft Chancre .... .... 4 .... .... .... .... .... 4 .... 4 Gonorrhœa, 1st year of infection .... .... .... .... 229 20 .... .... 229 20 249 „ later .... .... .... .... 42 .... .... .... 42 .... 42 Conditions other than venereal .... .... .... .... .... .... 399 61 399 61 460 4. Number of cases dealt with for the first time during the year under report known to have received treatment for the same infection, or to have been under observation, at other Centres 2 .... .... .... 5 .... .... .... 7 .... 7 Totals of Items 1, 2, 3 and 4 466 247 6 .... 501 40 399 66 1,372 353 1,725 5. Number of cases discharged after completion of treatment and final tests of cure or after diagnosis as non-venereal 13 6 2 .... 130 20 399 66 544 92 636 6. Number of cases which ceased to attend before completion of treatment and were, on first attendance, suffering from:— Syphilis, primary 20 .... .... .... .... .... .... .... 20 .... 20 „ secondary 31 13 .... .... .... .... .... .... 31 13 44 „ latent in 1st year of infection .... 2 .... .... .... .... .... .... .... 2 2 „ all later stages 41 11 .... .... .... .... .... .... 41 11 52 ,, congenital 10 6 .... .... .... .... .... .... 10 6 16 Soft Chancre .... .... .... .... .... .... .... .... .... .... .... Gonorrhœa, 1st year of infection .... .... .... .... 104 1 .... .... 104 1 105 ' ,, later .... .... .... .... 42 .... .... .... 42 .... 42 7. Number of cases which ceased to attend after completion of treatment but before final tests of cure 50 22 3 .... 54 .... .... .... 107 22 129 8. Number of cases transferred to other Centres or to institutions, or to care of private practitioners 5 20 .... .... 40 5 .... .... 45 25 70 9. Number of cases remaining under treatment or observation on 31st December 296 167 1 .... 131 14 .... .... 428 181 609 Totals of Items 5, 6, 7, 8 and 9 (These totals should agree with those of Items 1, 2, 3 and 4.) 466 247 6 .... 501 40 399 66 1,372 353 1,725 10. Number of cases in the following stages of syphilis included in Item 6 which failed to complete one course o treatment:— Syphilis, primary 13 .... .... .... .... .... .... .... 13 .... 13 ,, secondary 13 10 .... .... .... .... .... .... 13 l0 23 „ latent in 1st year of infection .... 1 .... .... .... .... .... .... .... 1 1 „ all later stages 22 6 .... .... .... .... .... .... 22 6 28 ,, congenital 3 5 .... .... .... .... .... .... 3 5 8 11. Number of attendances:— (a) for individual attention of the medical officer (s) 13,225 7,360 9 .... 3,548 487 581 144 17,363 7,991 25,354 (b) for intermediate treatment, e.g., irrigation, dressing .... .... .... .... 3,792 452 .... .... 3,792 452 4,244 Total Attendances 13,225 7,360 9 .... 7,340 939 581 144 21,155 8,443 29,598 12. In-patients:— (a) Total number of persons admitted for treatment during the year .... .... .... .... 10 .... .... .... 10 .... 10 (b) Aggregate number of "inpatient days "of treatment given .... .... .... .... 360 .... .... .... 360 .... 3610 21 Return relating to all persons who were treated at the Treatment Centre at St. Bartholomew's Hospital during'the year ended the 31st December, 1938.—continued. Under 1 year. 1 and under 6 years. 6 and under 16 years. 1ft years and over. Totals. M. F M. F M. F M. F M. F. 13. Number of cases of congenital syphilis in Item 3 above classified according to age periods 1 1 2 .... 6 5 6 .... 15 7 Arsenical. Mercury. Bismuth. Approved Arsenobenrene Compounds. Others. 14. Chief preparations used in treatment of Syphilis:— (a) Names of preparations Neosalvarsan. Neokharsavan. Novarsenobillon. Silver salvarsan. Collosal Mercury Sulp. & Oxychloride &Collosal Metal. (b) Total number of injections given (out-patients and in-patients) 4,195 666 9,430 15. Pathological Work:— Microscopical Cultural for Gonorrhœa. Serum Cerebro- spinal fluid. Others for diagnosis of Venereal Disease. for Syphilis. for Gonorrhœa. for rphilis. for Gonorrhœa. (a) Number of specimens examined at, and by the medical officer of, the Treatment Centre 21 .... .... .... .... .... .... (b) Number of specimens from patients attending at the Treatment Centre sent for examination to an approved laboratory .... 1,590 65 1,550 523 .... .... 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. Herts. Essex. Surrey. Kent. Bucks. Total. a. Number of cases from each area included under the following headings in Item 3:— Syphilis 184 .... 4 7 4 .... .... .... 199 Soft Chancre 4 .... .... .... .... .... .... .... 4 Gonorrhœa 274 1 6 4 4 2 .... .... 291 Conditions other than venereal 429 2 8 12 9 .... .... .... 460 Total 891 3 18 23 17 2 .... .... 954 B. Total number of attendances of all patients residing in each area 28,774 37 232 248 286 21 .... .... 29,598 C. Aggregate number of "In-patient days of all patients residing in each area 360 .... .... .... .... .... .... .... 360 24th Jan., 1939. (Signed) KENNETH M. WALKER, Medical Officer of the Treatment Centre D 22 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, 250 sessions have been held. New Patients.—The number of new patients examined was 265, as compared with 303 last year:— Patients Referred to the Hospital.—The following is the summary of patients referred to the various departments of St. Bartholomew's Hospital for help in diagnosis or treatment:— Resident. Non- Resident. Total. Referred.to X-ray Department 184 591 775 „ Dental „ 0 0 0 „ Throat „ 3 11 14 „ Other „ 4 13 17 191 615 806 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 3 non-resident patients were admitted for this and other purposes. Examination of Sputum.-The following is a summary:— City Residents. Non-Residents. Total. Positive 7 21 28 Negative 33 61 94 122 Residential Treatment.—The number of patients for whom residential treatment was arranged was 28. Admitted to L.C.C. Institutions. Other Institutions. St. Columhas Hospital. Corpa. Expense. St. Joseph's Hospice. Corpa. Expense. Brompton Corpn. Expense. Total. Patients resident in the City 12 3 - - l 16 Patients non-resident 3 9 - - — 12 15 12 - - l 28 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 trfeated at the Dispensary. The total number of cases so treated was 55. In addition, 35 contacts were kept under observation. (ii.) Patients non-resident in the City. (a) Who work in the City. On diagnosis, these patients are informed that they can be treated and advised at the Dispensary or transferred to the Tuberculosis Officer of their own Borough. (b) Who do not work in. the City. On diagnosis, these patients are usually transferred to the Tuberculosis Officer of their own Borough. The total number of cases so transferred was 128. Total Attendances:— Residents 336 Non-Residents 907 1,243 23 In view of the fact that the cases in the last stages of the disease are extremely infectious, cspccially in crowded houses, the Corporation have made arrangements to pay for the maintenance of selected City cases at St. Columba's Hospital, Swiss Cottage, and at St. Joseph's Hospice, Hackney. No case was admitted in 1938 to these institutions. 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. One patient was so admitted during the year. Iilood Examinations.—During recent years a new method of examination by means of the estimation of the Red Cell Sedimentation Rate has become a routine at the Dispensary. This examination has been performed on 172 occasions. Sixty-eight were performed on patients resident in the City. The examinations were extremely helpful in estimating the activity and progress of the disease. Artificial Pneumothorax.—This method of treatment is being increasingly employed, and its value is beyond doubt. The conduct of the cases should be controlled accurately by floroscopic examinations made prior to the introduction of air into the patient's chest. Many failures which have occurred when this treatment has been used are due to lack of floroscopic, control. At the City Dispensary this examination has been carried out on every occasion prior to a refill.' During the year 443 refills were performed on 24 cases— 5 resident in the City and 19 non-resident. A number of patients who are not resident in tjie City have been treated on behalf Qf other Local Authorities and payment made to the City Corporation for the work done. 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. Thirty-six homes have been visited, and' 293 visits made in connection with after-care and following up, and four in connection with City deaths. The Clerical work in connection with the Dispensary, which is increasing every year, is carried out by these Officials. It has been necessary, however, to give them some assistance in this connection, and that has been arranged through part-time help by one of the staff of St. Bartholomew's Hospital. A somewhat complicated system of records has to be kept to provide material for the detailed returns furnished for the Ministry of Health at the end of each year. Reports are furnished each month to the City Medical Officer of Health, and progress reports of all patients who have been treated in a London County Council Institution are sent annually. Great care has been taken that a full detailed clinical report is sent to every doctor who sends up cases to the Dispensary. To facilitate this work, arrangements have been made by the City Corporation with St. Bartholomew's Hospital, by which a small office has been provided adjacent to the Dispensary. 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. D 2 24 (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, 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 £he necessary visits of the Sanitary Inspectors, the Tuberculosis Nurse visits the homes of City residents periodically for the same purpose, and arranges for the attendance of the contacts at the Dispensary at times convenient to them. The supervision of these contacts and the re-examination of suspects among them is secured by the home visits periodically made by the Sister or Nurse. (vi.) Every patient attending the Dispensary'as a new case has had an X-ray taken, and all patients who attend for further treatment have at least one additional film taken during the year. The usual methods of treatment have been continued in the Dispensary. Five City and 19 non-City cases of pulmonary tuberculosis attended for the continuation of their treatment by artificial pneumothorax. Collapse therapy, by means of Artificial Pneumothorax intra and extra pleural, Thoracoplasty and Phrenic interruption have been used on an increasing scale. (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. (No patient was so provided during 1938.) (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 £30 has been expended. (x.) Patients suffering from Non-Pulmonary Tuberculosis receive advice and treatment from the Surgeons of St. Bartholomew's Hospital, to whom they are referred from the Dispensary. Treatment in residential institutions is provided for, as 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 sub, committee of the Public Health Committee, on which two ladies are co-opted as members.† It receives detailed reports on all cases of Tuberculosis occurring among City residents. (xii.) No local arrangements exist for providing employment for patients. (xiii.) No opportunity has arisen for the use of a shelter, but arrangements would be made for any suitable case if a site were available. (xiv.) No special points have been noted as to the incidence of Tuberculosis; the records do not show that the disease is specially prevalent among any class of workers in the City. (xv.) The usual method for preventing the spread of infection is adopted, and pocket sputum flasks are provided free of cost. (xvi.) The principal difficulty encountered occurs on the discharge of a patient from a sanatorium with the disease quiescent. The home environment to which he returns is often unsatisfactory; suitable occupation near his home may be practically unobtainable, even when remuneration is not the main consideration, and the very considerable benefit gained is in some cases soon lost and the treatment in the sanatorium largely wasted. (xvii.) Difficulties also arise with regard to advanced cases. These are usually very infectious and do not care to go to the Infirmary. This has been largely remedied by the arrangement made by the Corporation already referred to. Screening.—A floroscopic screening examination is made on every patient prior to the Artificial Pneumothorax refills. Until recently the method used in dealing with adult "contacts" of cases of pulmonary tuberculosis 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 † The present lady members of the Committee are Miss Crosby, M.D.E. (Vacant). 25 was seen periodically as long as contact was maintained 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. Further, 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 seemed possible that a considerable amount of psychological damage was being done by the system in operation. A new system was adopted in 1937, and this provides for the examination of 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 E. 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. 26 PULMONARY SUPPLEMENTARY ANNUAL RETURN SHOWING IN SUMMARY FORM (A) THE CONDITION AT THE END OF 1938 OF ALL PATIENTS THE TABLE IS ARRANGED ACCORDING TO THE YEARS IN WHICH THE PATIENTS WERE FIRST ENTERED ON THE Condition at the time of the last record made during the year to which the Return relates. Previous to 1928. 1828. 1928. 1930. 1931. Class T.B. minus. Class T.B. plus. Class T.B. minus. Class T.B. plus. Class T.B. minus. Class T.B. plus. 1 Class T.B. minus. Class T.B. plus. Class T.B. minus. 1 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) Remaininc on Dispensary Register on 31st Decrmber. Disease Arrested. Adults. M .... .... 1 .... 1 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... F .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Children. .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Disease not Arrested. Adults. M .... .... 1 .... 1 1 .... .... .... .... .... .... .... .... .... .... .... .... 1 1 .... .... .... .... .... F 1 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1 .... 1 Children. .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Condition not ascertained during the year .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1 .... .... .... .... Total on Dispensary Register at 31st December 2 .... 2 .... 2 1 .... .... .... .... .... .... .... .... .... 1 .... .... 1 1 1 .... 1 .... 1 (6) Not now on Dispensary Roister 1 and reasons (or remov.il therefrom. Discharged as Recovered. Adults. M 2 .... 1 .... 1 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... F 1 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Children. .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Lost sight of, or otherwise removed from Dispensary Register 30 3 22 8 33 8 1 .... 1 2 3 3 3 .... 6 4 1 3 2 6 5 1 1 3 5 Dead. Adults. M 2 1 4 13 18 1 .... 1 2 3 1 .... .... 1 1 .... .... .... 1 1 .... .... 1 2 3 F .... .... 1 5 6 .... .... .... 1 1 .... .... .... .... .... .... .... .... 1 1 .... .... .... 1 1 Children. 1 .... .... 1 1 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Total written off Dispensary Register 36 4 28 27 59 9 1 1 4 6 4 3 3 1 7 4 1 3 4 8 5 1 2 6 9 Grand Totals 38 4 30 127 61 10 1 1 1 4 1 6 1 4 1 3 3 1 7 5 1 3 5 9 6 1 3 6 10 NON-PULMONARY SUPPLEMENTARY ANNUAL RETURN SHOWING IN SUMMARY FORM (A) THE CONDITION AT THE END OF 1938 OF ALL PATIENTS Condition at the time of the last record made during the year to which the Return relates. Previous to 1028. 1928. 1929. 1930. 1931. 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. 1 Abdominal. Other Organs. Peripheral Glands. Total. (a) Remaining on Dispensary Register on 31st December. Disease Arrested. Adults. M .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... F .... .... .... 1 1 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Children. .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Disease not Arrested. Adults. M .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... F .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Children. .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Condition not ascertained during the year .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Total on Dispensary Register at 31st December .... .... .... 1 1 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Transferred to Pulmonary. .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... (b) Not now on Dispensary Register and reasons lor removal therefrom. Discharged as Recovered. Adults. M .... .... .... .... 1 .... .... .... .... .... 1 .... .... .... 1 .... .... .... .... .... .... .... .... .... .... F .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Children. 1 .... .... .... 1 .... .... .... .... .... .... .... .... .... .... .... .... .... .... ... .... .... .... .... .... Lost sight of, or otherwise removed from Dispensary Register 9 1 1 4 15 .... .... .... .... .... .... .... .... 1 1 2 .... .... .... 2 .... .... .... .... .... Dead. Adults. M .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... F .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Children. .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1 .... 1 .... .... .... .... .... Total written off Dispensary Register 12 1 1 4 18 .... .... .... .... .... .... .... .... 1 2 2 .... 1 .... 3 .... .... .... .... .... Grand Totals of (a) and (b) (excluding those transferred to Pulmonary. 12 1 1 5 19 .... .... .... .... .... 1 .... .... .... 2 2 .... 1 .... 3 .... .... .... .... .... 27 TUBERCULOSIS. REMAINING ON THE DISPENSARY REGISTER ; AND (B) THE REASONS FOR THE REMOVAL OF ALL CASES WRITTEN OFF THE REGISTER. DISPENSARY REGISTER AS DEFINITE CASES OF PULMONARY TUBERCULOSIS, AND THEIR CLASSIFICATION AT THAT TIME.. 1932. 1933. 1934. 1935. 1936. 1937. 1938. 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 I. 1 Group 2. Group 3. Total (Class T.B. plus). Group 1. Group 2. Group 3. Total (Class T.B. plus). Group 1. Group 2. Group 3. Total (Class T.B. plus). Group 1. Group 2. Group 3. Total (Class T.B. plus). Group 1. Group 2. Group 3. Total (Class T.B. plus). Group 1. Group 2. Group 3. Total (Class T.B. plus). Group 1. Group 2. Group 3. Total (Class T.B. plus). .... .... .... .... .... .... 1 .... .... 1 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1 .... .... 1 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1 2 .... 2 .... .... .... .... .... .... .... .... 1 1 .... 2 .... 2 4 1 .... .... 1 1 .... 1 .... 4 5 .... 1 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1 1 .... .... .... .... .... .... .... .... .... 1 2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... l .... .... l .... 3 .... .... 4 2 .... .... .... .... 2 .... .... 2 2 .... 2 .... 2 4 1 .... .... 1 2 2 1 .... 4 5 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 2 .... 2 4 5 1 2 1 4 6 3 1 .... 4 3 .... .... 1 1 4 .... 1 .... 1 4 .... .... .... .... .... 1 1 1 3 1 .... 1 2 3 .... .... .... .... 1 .... .... .... .... .... 1 .... .... 1 1 1 .... .... 3 3 .... .... .... .... .... .... .... 1 .... 1 1 .... .... .... .... .... .... .... 2 2 .... 1 .... 2 3 .... .... .... 1 1 .... .... .... .... .... .... .... .... .... .... .... .... .... 1 1 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 7 2 1 4 7 5 1 2 4 7 0 4 1 2 7 4 .... .... 3 3 5 .... .... 3 4 4 .... .... .... .... .... 1 2 2 5 7 3 1 4 8 5 4 3 4 1 8 4 1 2 7 6 .... .... 5 5 5 2 .... 5 8 5 l 1 2 2 2 2 6 10 TUBERCULOSIS. REMAINING ON THE DISPENSARY REGISTER; AND (B) THE REASONS FOR THE REMOVAL OF ALL CASES WRITTEN OFF THE REGISTER. 1933. 1933. 1934. 1935. 1936. 1937. 1938. Bones and Joints. Abdominal. Other Organs. Peripheral Glands. Total. Bones and Joints. Abdominal. Other Organs. Peripheral Glands. Total. Bones and Joints. 1 Abdominal. Other Organs. Peripheral Glands. Total. Bones and Joints. Abdominal. Other Organs. Peripheral Glands. Total. Bones and Joint. Abdominal. Other Organs. Peripheral Glands. Total. Bones and Joints, Abdominal. Other Organs. Peripheral Glands. Total. Bones and Joints.| Abdominal. Other Organs. Peripheral Glands. Total. .... .... 1 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... ... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1 1 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1 .... .... .... 1 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... ... .... .... .... ... .... .... .... .... .... 1 1 .... .... .... 1 1 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... ... ... ... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1 .... 1 .... .... .... 1 1 .... .... .... .... .... 1 .... .... .... 1 .... .... .... .... .... .... .... .... 1 1 .... .... .... 1 1 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... ... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1 1 .... .... .... 2 2 .... .... .... .... .... .... .... .... 1 1 .... .... .... 1 1 .... .... .... .... 1 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... ... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1 1 .... .... .... 2 2 .... .... .... .... .... .... .... .... 1 1 .... .... .... 1 1 .... .... 1 .... 1 .... .... .... .... .... .... .... 1 1 2 .... .... .... 3 3 .... .... .... .... .... 1 .... .... 1 2 .... .... .... 1 1 .... .... 1 1 2 .... .... .... 1 1 (Signed) CHARLES F. WHITE, Chief Tuberculosis Officer. 28 return showing the work of the dispensary during the year 1938. 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 7 5 .... .... .... .... .... l 7 5 .... 1 13 22 (b) Diagnosis not completed .... .... .... .... .... .... .... .... .... .... .... .... .... (c) Non-tuberculous .... .... .... .... .... .... .... .... 4 5 .... .... 9 B,—CONTACTS examined during the year:— (a) Definitely tuberculous .... .... .... .... .... .... .... .... .... .... .... .... .... (b) Diagnosis not completed .... .... .... .... .... .... .... .... .... .... .... .... .... (c)Non-tuberculous .... .... .... .... .... .... .... .... 4 8 2 1 15 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 13 2 1 24 D.—NUMBER OF CASES on Dispensary Register on December 31st:— (a) Definitely tuberculous 22 11 1 .... 2 1 1 2 24 12 2 2 40 1. Number of cases on Dispensary 2. Number of cases transferred from other Register on January 1st 41 areas and cases returned after charge under Head 3 in previous years 1 3. Number of cases transferred to 4. Cases written off during the year as other areas, cases not desiring Dead (all causes) 4 further assistance under the tuberculosis scheme, and cases "lost sight of" 11 Artificial Pneumothorax Refills 83 5. Number of attendances at the 6. Number of Insured Persons under Dispensary (including Contacts) 336 Domiciliary Treatment on the 31st December 32 7. Number of consultations with 8. Number of visits by Tuberculosis medical practitioners:— Officers to homes (including personal (a) Personal 1 consultations) (b) Other 10 9 Number of visits by Nurses or 10. Number of:— Health Visitors to homes for Erythrocyte-Sedimentation rates estiDispensary purposes 293 mated 118 (а) Specimens of sputum, etc., examined 40 (b) X-ray examinations made 184 in connection with Dispensary work. 11. Number of " Recovered " cases 12. Number of "T.B. plus" cases on Dis- restored to Dispensary Regispensary Register on December 31st 22 ter, and included in A (a) and A (b) above 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 65 44 2 7 2 .... 1 65 51 4 1 121 228 (b) Doubtfully tuberculous .... .... .... .... .... .... .... .... 4 .... .... .... 4 (c) Non-tuberculous .... .... .... .... .... .... .... .... 49 50 2 2 103 B.—Number of Tuberculous City workers attending Dispensary for treatment on Dec. 31st, 1938 28 C.—Number of Non-Resident and Non-Workers attending Dispensary for treatment on Dec. 31st, 1938 56 D.—Number of cases transferred to other areas or lost sight of 128 E.—Number of attendances at the Dispensary 907 F.—Number of consultations with Medical Practitioner 212 G.—Number of:—(a) Specimens of sputum, &c., examined 82 (b) X-ray examinations made 591 29 TUBERCULOSIS DISPENSARY. training of health visitors. The Corporation have placed at the disposal of the College of Nursing the facilities available at their Tuberculosis Dispensary, 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. Appreciation has been expressed on every occasion when advantage has been taken of these opportunities, although during 1938 the facilities were not used. artificial pneumothorax treatment. At the request of the Authorities of two of the Home Counties, artificial pneumothorax has been administered to patients under their control, and an appropriate fee charged. public health (tuberculosis) regulations, 1930. part 1. Summary of Notifications during the period from the 1st January, 1938, to the 31st December, 1938. Age Periods Formal Notifications. Number of Primary Notifications of new cases of Tuberculosis. Total Notifications. 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65- Total (all ages). Pulmonary Males .... .... .... .... 1 2 2 2 2 3 3 15 20 „ Females l .... .... .... .... .... 3 1 1 .... .... 6 10 Non-Pulmonary Males .... .... .... .... .... .... .... .... .... .... .... .... „ „ Females .... .... .... .... .... .... .... .... .... .... .... .... .... 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 .... .... .... .... .... .... .... .... 2 .... 1 3 Females .... .... .... .... .... .... .... .... .... .... 1 1 Non-Pulmonary Males .... .... .... .... .... .... .... .... .... .... .... .... Females .... .... .... .... .... .... .... .... .... .... .... .... The source or sources from which information as to the above-mentioned cases was obtained should be stated below:— Source of Information. No. of Cases. Pulmonary. NonPulmonary. Death Returns from local Registrars 3 .... transferable deaths from Registrar General .... .... Posthumous notifications .... .... "Transfers" from other areas (other than transferable deaths) 1 .... Other sources, if any (specify) .... .... PART Ml. notification register. Pulmonary. Non-Pulmonary. Total Cases. Males. Females. Total. Males. Females Total. Number of cases of Tuberculosis remaining at the 31st December, 1938, on the Registers of Notifications kept By District Medical Officers of Health in the County The Medical Officer of Health of the County Borough or Metropolitan Borough 36 19 55 3 4 7 62 Number of cases removed from the Register(s) during the year by reason of:— I. Withdrawal of notification .... .... .... .... .... .... .... 2. Recovery from the disease .... .... .... .... .... .... .... 3. Death (all causes) 5 3 8 .... .... .... 8 4. Otherwise 1 .... 1 1 .... 1 2 e 30 CREMATIONS IN THE UNITED YEAR. Woking. Manchester. Glasgow. Liverpool. Hull. Darlington. Leicester. Colders Green. Birmingham. (Perry Bar). Leeds. City of London. Sheffield. Bradford. W. Norwood. Hendon Park. Pontypridd. Bristol. Ipswich. Edinburgh. Brighton. 1885 3 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1886 10 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1887 13 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1888 28 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1889 46 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1890 54 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1891 99 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1892 104 3 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1893 101 30 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1894 125 47 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1895 150 58 1 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1896 137 52 10 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1897 173 51 16 10 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1898 240 62 12 27 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1899 240 88 16 23 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1900 301 83 20 40 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1901 273 96 18 40 17 1 .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1902 275 81 20 54 13 2 1 5 .... .... .... .... .... .... .... .... .... .... .... .... 1903 143 92 24 35 18 1 6 158 1 .... .... .... .... .... .... .... .... .... .... .... 1904 138 98 19 40 20 7 8 220 19 .... .... .... .... .... .... .... .... .... .... .... 1905 95 97 35 35 15 4 16 252 22 16 9 7 1 .... .... .... .... .... .... .... 1906 140 90 44 46 17 13 12 298 25 15 23 6 14 .... .... .... .... .... .... .... 1907 108 98 30 34 29 8 12 290 33 16 18 18 13 .... .... .... .... .... .... .... 1908 119 116 28 32 37 6 14 364 18 24 19 12 6 .... .... .... .... .... .... .... 1909 105 106 30 46 15 9 19 421 30 19 24 18 13 .... .... .... .... .... .... .... 1910 106 114 28 37 21 9 16 415 38 12 22 8 14 .... .... .... .... .... .... .... 1911 114 124 39 50 25 12 13 542 44 17 20 10 13 .... .... .... .... .... .... .... 1912 125 149 44 52 27 15 14 591 40 24 32 12 9 .... .... .... .... .... .... .... 1913 128 172 49 66 23 11 11 602 59 16 21 15 15 .... .... .... .... .... .... .... 1914 124 184 57 48 16 11 † 7 671 53 28 42 20 18 .... .... .... .... .... .... .... 1915 153 165 63 54 34 16 22 730 45 20 45 21 12 30 .... .... .... .... .... .... 1916 125 179 71 58 25 10 23 633 63 22 43 14 11 89 .... .... .... .... .... .... 1917 129 178 67 62 24 15 34 719 49 17 68 25 10 118 .... .... .... .... .... .... 1918 142 197 74 69 43 17 42 820 64 34 70 50 20 153 .... .... .... .... .... .... 1919 181 235 84 89 46 26 36 919 76 30 68 41 31 169 .... .... .... .... .... .... 1920 149 203 80 69 30 18 32 851 72 26 58 32 20 156 .... .... .... .... .... .... 1921 159 228 87 75 43 20 36 893 78 31 57 29 24 162 .... .... .... .... .... .... 1922 193 189 75 74 45 17 23 939 98 31 70 38 25 186 6 .... .... .... .... .... 1923 170 227 90 62 45 21 36 920 75 27 69 37 23 178 6 .... .... .... .... .... 1924 235 251 82 74 47 28 40 1,114 97 47 68 32 24 240 7 4 .... .... .... .... 1925 271 287 116 75 41 32 57 1,214 126 48 66 48 32 266 7 14 .... .... .... .... 1926 305 303 98 96 55 33 70 1,270 128 40 84 43 32 299 8 13 .... .... .... .... 1927 320 357 129 101 70 38 68 1,459 150 59 95 57 50 279 11 22 .... .... .... .... 1928 344 367 141 103 72 39 61 1,483 157 60 103 51 . 45 306 11 20 71 2 .... .... 1929 426 443 185 103 97 55 124 1,797 205 66 99 81 47 410 14 28 116 37 20 .... 1930 446 442 121 160 84 52 119 1,787 180 73 112 59 49 390 12 40 143 55 125 78 1931 476 508 158 163 128 62 89 1,866 257 109 112 87 77 415 13 43 177 68 169 144 1932 446 626 165 171 126 77 94 2,245 307 116 158 84 123 480 13 51 237 94 266 263 1033 447 674 202 247 148 119 122 2,396 395 153 192 108 101 624 10 84 300 120 359 300 1934 430 717 255 240 183 100 129 2.553 386 165 237 120 135 653 11 105 329 132 474 348 1935 464 790 307 207 194 74 149 2,855 459 200 215 129 158 726 13 95 312 167 541 449 1936 480 892 341 222 195 86 198 3,126 486 206 295 146 188 680 15 139 . 350 201 730 516 1937 556 1,075 430 286 249 106 214 3,467 607 226 364 155 216 455 17 194 475 175 899 601 1938 CM 1,224 467 316 301 112 234 3,421 555 273 451 218 270 333 93 204 466 182 1,085 694 9 Totals 11,418 12,848 4,413 3.893 2,619 1,285 2,197 44,306 5,497 2,266 3,430 1,831 1,837 7,798 269 1,056 2,976 1,233 4,668 3,393 * "Viscount Cross in the year 187a forbade the practice of cremation there (Woking) under the threat of passing an Act to make it illegal But in 1884 "coroner, determined cremation to be a legal act, provided no nu»ance be caused thereby to others"—Extract from speech made by the late Sir Henry †Closed for reconstruction from August, 1913y, 1914. CREMATION. Cremation, as a method of disposal of the dead, continues to make progress in this country. The progress is not as rapid as many of us would wish, but it is gratifying to know that more and more municipal authorities are meeting the demand by the installation of crematoria in their own areas.' There now exist in this country 47 different crematoria, and during 1938 the total cremations carried out reached the figure of 10,312. At the Crematorium established at Little Ilford by the Burial Board of the City of London, 451 cremations took place, as compared with 304 in 1937, and constitutes the highest figure since the opening of the Crematorium in 1905. 31 KINGDOM. 54 YEARS—1885-1938. Guernsey Nottingham. Reading. Southampton. Birkenhead Newcastle-onTyne. Plymouth. Stockport. Blackpool. Dundee. Kent County. (Charing). S. London. (Streatham). Harrogate. Norwich. Croydon. Birmingham. (Lodge Hill). Islington. St. Marylebone. Cheltenham. Aberdeen. Bournemouth Wandsworth. Leeds (Cottingley Hall) Enfield. Paisley. Rochdale. Cambridge. No. of Cremations each year. .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 3 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 10 .... .... .... .... .... .... .... .... .... .... .... .... ..... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 13 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 28 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 46 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 54 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 99 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 107 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 131 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 172 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 209 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 201 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 250 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 341 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 367 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 444 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 445 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 451 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 477 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 569 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 604 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 743 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 707 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 795 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 855 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 840 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1,023 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1,134 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1,188 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1.279 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1,410 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1,366 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1,515 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1,795 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 2,031 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1,796 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1,922 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 2,009 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1,986 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 2,390 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 2,700 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 2,877 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 3,265 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 3,436 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 4,353 6 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 4,533 4 70 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 5.195 6 74 13 77 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 6,315 20 90 67 193 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 7,480 15 130 81 299 120 26 10 48 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 8,337 20 125 95 359 78 188 122 94 29 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 9,614 17 184 118 416 112 270 153 109 110 13 104 191 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 11,289 25 230 162 493 125 377 251 149 212 134 238 686 50 59 110 42 7 3 .... .... .... .... .... .... .... .... .... 14,129 32 273 202 411 171 488 259 170 246 136 329 811 65 101 287 192 65 91 121 63 229 48 15 20 6 21 2 16,312 148 1101 738 2,248 506 1349 795 570 568 283 671 1688 115 160 397 234 72 94 121 63 229 48 15 20 6 21 2 131,619 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 Thompson at the opening of Golden Green Crematorium, 22nd November, 1902. Vide "Transactions of Creamtion Society of England, 1903." p. 31. Now that facilities are being provided in increasing numbers, doubtless the economic and social advantages of cremation will be more and more appreciated. It is many years since legislation affecting cremation has been the subject of any revision, and this aspect is now, I believe, receiving consideration by the Federation of Cremation Authorities. Any alteration, however, in the investigation which now takes place preparatory to the question of the cremation of any body must receive the most careful consideration, as although one would naturally desire to remove what to many, I know, appears to be unnecessary restriction, one must not overlook the necessity for the preservation of the fullest control, in order that criminal advantage may not be taken of this method of disposal of the dead. E2 32 4' CONGRESSES. The Royal Sanitary Institute Congress, at Portsmouth, from 11th to 16th July; the Royal Institute of Public Health Congress, at Blackpool, from 21st May to 4th June; the National Association for the Prevention of Tuberculosis Congress, in London, from 30th June to 2nd July; the National Veterinary Medical Association Congress, in Glasgow, from 5th to 9th September; the Public Health Services Congress, in London, from 14th to 19th November; and the National Smoke, Abatement Society, in London, on the 25th February, were all attended by representatives of the City Corporation, and each provided the usual facilities for the ihterchange of views and experience in the spheres of public health activity covered by the respective organisations. congress of the sanitary inspectors association. In accordance with the usual practice, one of the Sanitary Inspectors attended the Congress of the Sanitary Inspectors Association, held at Edinburgh, from 5th to 10th September last. The Conference afforded a valuable opportunity for an enlightening interchange of views in connection with the work of a sanitary inspector. MEAT INSPECTION. According to the Board of Trade returns, the imports of fresh meat and bacon for the twelve months, 1938, were:— BEEF AND VEAL. Cwts. MUTTON AND LAMB. Cwts. PORK. Cwts. BACON. Cwts. 1938. 1937. 1938. 1937. 1938. 1937. 1938. 1937. Argentina 7,078,053 7,124,885 893,633 889,932 238,829 194,001 — — Australia 2,192,312 2,190,301 1,899,112 1,882,962 284,131 233,892 — — Brazil 554,468 527,844 — — — — — — Canada — — — — — — 1,275,573 1,387,006 Chile — — 195,793 210,390 — — — — Denmark — — — — — — 3,389,192 3,429,427 Eire 5,423 4,223 24,047 15,620 36,089 54,010 536,764 509,809 Lithuania — — — — — — 190,050 187,949 Netherlands — — — — —. — 514,438 481,067 New Zealand 904,396 830,21-9 3,675,822 3,603,036 577,480 592,648 — — Poland — — — — — — 456,224 442,382 Sweden — — — — — — 251,048 250,046 United States — — —— — 62,002 21,706 42,821 6,969 Uruguay 644,643 654,994 171,346 164,961 — — — — Other Countries British 136,025 280,473 9,917 51,633 8,236 15,634 355 153,128 Foreign 138 — 44,373 — 10,162 — 132,673 — Totals 11,515,458 11,612,939 6,914,043 6,818,534. 1,217,649 1,111,891 6,868,467 8,925,385 Live stock for twelve months, 1938:— Cattle. Sheep. Pigs. Canada 26,450 — — Eire 620,230 298,432 48,186 646,680 298,432 48,186 Value of Live Stock:— Canada £502,035 — — Eire £872,615 £484,599 £224,746 £8,374,650 £484,599 £224,746 33 LONDON CENTRAL MARKET8. Analysis and Comparison of Supplies In Tons. Description and Country of Origin. Twelve Month. Difference. Beef and Veal: 1938. 1937. England and Wales 19,954 22,719 — 2,765 Scotland 16,226 16,768 — 542 Ireland 1,729 1,419 + 310 Australia 27,166 24,083 + 3,083 New Zealand 13,105 13,478 — 373 Canada 2,308 1,481 + 827 Union of South Africa 732 1,082 — 350 S. Rhodesia 2,030 2,928 — 898 U.S. of America 1,305 1,281 + 24 Argentina 141,177 149,946 — 8,769 Uruguay 7,057 6,408 + 649 Brazil, etc. 8,179 7,227 + 952 Netherlands — — — Denmark — — — Other Countries 2 — + 2 Totals : Beef and Veal 240,970 248,820 — 7850 Mutton and Lamb: England and Wales 11,853 10,654 + 1,199 Scotland 21,418 17,009 + 4,409 Ireland 1,942 1,285 + 657 Australia 26,553 26,948 — 395 New Zealand 61,902 62,234 — 332 Canada 9 33 — 24 Union of South Africa 81 56 + 25 U.S. of America 83 65 + 18 Argentina 16,001 17,240 — 1,239 Uruguay 1,034 833 + 201 Chile, etc 124 605 — 481 S. Rhodesia 1 — + 1 Denmark — — — Other Countries *451 *424 + 27 Totals : Mutton and Lamb 141,452 137,386 + 4,066 Pork and Bacon: England and Wales 26,799 28,276 — 1,477 Scotland 32 53 — 21 Ireland 3,298 3,887 — 589 Australia 2,176 2,540 — 364 New Zealand 7,181 7,213 — 32 Canada 927 1,025 — 98 Union of South Africa 24 — + 24 U.S. of America 515 536 — 21 Argentina 935 728 + 207 Uruguay 24 2 + 22 Brazil, etc. 108 136 — 28 Netherlands Bacon *903 *636 + 267 Denmark *442 *290 + 152 Other Countries *729 *516 + 213 Totals : Pork and Bacon 44,093 45,838 — 1,745 Poultry and Game: England and Wales 10,539 10,934 — 395 Scotland 1,053 1,016 + 37 Ireland 2,460 2,465 — 5 Australia 23 36 —13 New Zealand 13 43 — 30 Canada 211 969 — 758 Union of South Africa — — — U.S. of America 4 5 — 1 Argentina 311 273 + 38 Uruguay 10 17 — 7 Brazil, etc — — — Netherlands 1,001 599 + 402 Denmark 9 23 — 14 Other Countries 6,971 8,314 — 1,343 Totals: Poultry and Game 22,605 24,694 — 2,089 Totals: Carried forward Tons 449,120 456,738 — 7,618 34 Description and Country of Origin. Twelve Months. Difference. 19S8. 1937. Totals: Brought forward Tons 449,120 456,738 7,618 Rabbits: * England and Wales 3,045 3,077 — 32 Scotland 77 114 — 37 Ireland 1,688 2,930 — 1,242 Australia 2,739 1,965 4 774 New Zealand 238 102 4 136 Canada — — — Union of South Africa — — — U.S. of America — — — Argentina — — — Uruguay — — — Brazil, etc — — — Netherlands 20 15 +5 Denmark 11 — + 11 Other Countries 450 561 — 111 Totals: Rabbits 8,268 8,764 — 496 Eggs : England and Wales 1,284 1,380 — 96 Scotland 2 — + 2 Ireland 105 129 — 24 Australia 29 62 — 33 New Zealand 2 1 4 1 Canada — — — Union of South Africa 14 29 — 15 U.S. of America — — — 1 Argentina 15 46 — 31 Uruguay 2 — + 2 Brazil, etc. — — — Netherlands 602 497 + 105 Denmark 67 117 — 50 Other Countries 599 386 +213 Totals: Eggs 2,721 2,648 + 73 Butter and Cheese: England and Wales 420 251 + 169 Scotland — — — Ireland 3 — +3 Australia 46 129 — 83 New Zealand 174 246 — 72 Canada 3 8 — 5 Union of South Africa 3 4 — 1 U.S. of America — — — Argentina 15 65 — 50 Uruguay — — Brazil, etc. — — — Netherlands 6 5 + 1 Denmark 4 2 + 2 Other countries 3 27 — 24 Total: Butter and Cheese Tons 677 737 60 Sundries : England and Wales 891 794 + 97 Scotland — — — ireland —1 — + 1 Australia — 14 — 14 New Zealand 2 4 2 Canada 3 15 — 12 Union of south africa — — — U.S. America 10 3 + '7 Argentina — — — Uruguay — — — Brazil, etc — — — Netherlands 22 18 4. 4 Denmark 51 54 — 3 Other Countries 190 127 + 63 Totals: Sundries 1,171 1,030 4 141 Grand Totals Tons 461,957 469,917 — 7,960 % 35 The following table shows the amount of British diseased meat discovered in the Markets:— Disease. GREAT BRITAIN.—1938. Beef. Mutton. Pork. Veal. Goat. Mesenterlee Plucks. Heads. Carcases. Quarters. Carcases. Quarters. Carcases. Quarters. Carcases. Quarters. Carcases. Tongues. Lungs. Actinomycosis — — — — 1 — — — — 27 — — — — Abscess — 2 16 — 46 — 3 — — — — — — — Adenitis — — — — 1 — — — — — — — — — Anaemia — — — — 2 — — — — — — — — — Black-quarter — '— — — — — 3 — — — — — — — Caseous Lymphadenitis — — 12 — — — — — — — — — — — Cutaneous Rash — — — — 22 — — — — — — — — — Cysticercus Bovis 1 — — — — — — — — — — — — — Cysticercus Ovis — — 7 — — — — — — — — — — — Emaciation 2 — 168 — 51 — 20 — — — — — — — Fevered Condition — — — — 44 — — — — — — — — — Functional Derangement — — — — 2 — — — — — — — — — Hemorrhagic — — — — 61 — — — — — — — — — Hydraemia — — 10 — 1 — 1 — — — — — — — Immature — — — — — — 32 — — — — — — — In Extremis 1 — 24 — 19 — 10 — — — — — — — Injuries — — 2 — 3 — — — — — — — — — Jaundice — — — — 11 — 22 — — —. — — — — joint-ill — — — — — 5 — — — — — — — Leukaemia — — — — 1 — — — — — — — — — Lymphadenitis — — 2 — 1 — — — — — — — — — Melanosis — — — — — — 1 — — — — — — — Nephritis 1 — — — 8 — 5 1 — — — — — — Œdema — — 2 — 1 — — — — — — — — — Osteomalacia — — — — 2 — 3 — — — — — — — Pyaemia — — — — 3 — — — — — — — — — Pleurisy and Peritonitis — — 28 — 158 — 7 4 — — — — — — Rachitis — — 1 — 30 — — — — — — — — — Rheumatoid Arthritis — — 9 — 45 — — — — — — — — — Sarcosporidia — — — — 1 — — — — — — — — — Tuberculosis (Bovine) 7 38 — — — — 16 — — 9 3 — 4 11 Tuberculosis (Porcine) — — — — 302 — — — — — 281 4 283 2,527 Uraemia — — — V 3 — 1 — — — — — — — Urticaria — — — — 3 — — — — — — — — — Totals for 1938 12 40 282 — 822 — 129 5 — 36 2 84 4 287 2,538 Totals for 1937 15 26 812 1 1,512 — 151 6 1 57 4 54 8 425 4,260 IRELAND. The consignments of food, in tons, received from this country compared with those of 1937 were as follows:— Beef and Veal. Mutton and Lamb. Pork and Bacon. Poultry and Game. Rabbits. Eggs. Butter and Cheese Sundries. 1938 1,729 1,942 3,298 2,460 1,688 105 3 1 1937 1,419 1,285 3,887 2,465 2,930 129 — — The amount of unsound food surrendered is shown in tables Nos. 15 and 16:— Mutton Carcases. Pork Carcases. Abscess — 7 Emaciation — 3 Hemorrhagic — 1 In Extremis 3 — Jaundice — 1 Nephritis — 1 Osteomalacia — 1 Pleurisy and Peritonitis 1 15 Rachitis — 4 Rheumatoid Arthritis — 4 Tuberculosis — 22 Totals for 1938 4 59 Totals for 1937 22 79 36 ARGENTINE. During the year this country sent the following amounts of food, in tons, compared with those of 1937 :— Beef and Veal. Mutton and Lamb. Pork and Bacon. Poultry and Game. Eggs. Butter. Sundries. 1938 141,177 16,001 935 311 15 15 l 1937 149,946 17,240 728 273 46 65 l The amounts of diseased meat surrendered from this year's consignments are shown in the following table, and the amount of unsound food surrendered on pages 39 and 40. Beet Quarters. Lamb and Mutton Carcases. Lamb and Mutton Pieces. Pork Carcases. 1938. 1937. 1938. 1937. 1938. 1937. 1938. 1937. Abscess 27 21 6 13 3 — 28 3 Caseous Lymphadenitis — — 80 84 28 380 — — Cysticercus Bovis 30 25 — — — — — — Cysticercus Ovis — — 83 51 5 — — — Tuberculosis 57 58 — — — — — — Tumour 1 1 — — — — — — Totals 115 105 169 148 36 380 28 3 AUSTRALIA. This country sent the following amounts of food, in tons, to the markets during the year, compared with those for 1937:— Beef and Veal. Mutton and Lamb. Pork. Poultry and Game. Rabbits. Eggs. Butter. Sundries. 1938 .... 27,166 26,553 2,176 23 2,739 29 46 1937 ..... 24,083 26,948 2,540 36 1,965 62 129 14 Beef Carcases. Mutton Carcases. Mutton Pieces. Pork Carcases. 1938. 1937. 1938. 1937. 1938. 1937. 1038. 1937. Abscess 15 11 17 47 2 — 24 20 Actinobacillosis 1 — — — — — — Caseous Lymphadenitis 115 143 29 42 — — Cysticercus Bovis 3 — — — — — — Cysticercus Ovis — 138 109 37 — — — Hæmorrhagic — — — — — 3 — Tuberculosis 3 7 — — — — — — Totals 22 18 270 299 68 42 27 20 The amount of diseased meat surrendered from this year's consignments are shown in the above, and the amount of unsound food surrendered on pages 39 and 40. NEW ZEALAND. The total amount of food, in tons, for 1938 which was deposited in the markets, compared with those of 1937, is shown as follows :— Butter and cheese. Beef and Veal. Mutton and Lamb. Pork. Poultry and Game. Rabbits. Eggs. Sundries. 1938 13,105 61,902 7,181 13 238 2 147 2 1937 13,478 62,234 7,213 43 102 1 246 4 The amount of unsound food discovered in these consignments is given in tables on pages 39 and 40, and the diseased meat figures in the following table :— Beef Quarters. Mutton Carcases. Mutton Pieces. Pork Carcases. 1938. 1937. 1938. 1937. 1938. 1937. 1938. 1937. Abscess l 3 20 34 — — 149 59 Caseous Lymphadenitis — — 115 137 18 20 — — Cysticercus Ovis — — 189 119 19 — — — Tuberculosis l 4 — — — — 2 Totals 2 7 324 290 37 20 149 61 37 BRAZIL. The following table shows the amount of diseased meat surrendered from the consignments from this country during the year 1938 :— Beef Quarters. Mutton Carcases. Mutton Pieces. 1038. 1937. 1938. 1937. 1938. 1937. Abscess 4 8 — 1 — — Cysticercus Bovis 1 1 — — — — Caseous Lymphadenitis — — 3 24 — 50 Totals 5 9 3 25 — 50 SOUTH AFRICA AND SOUTHERN RHODESIA. The consignments for the year 1938 were made up as follows :— Beef and Veal. Mutton and Lamb. Pork and Bacon. Eggs. Butter. 2,762 82 24 14 3 The following tables show the amounts of diseased meat from the respective countries:— SOUTH AFRICA. SOUTHERN RHODESIA. Hindquarters Beef. Hindquarters Beef. 1938. 1937. 1938. 1937. Abscess 3 8 Abscess 8 16 Tuberculosis 1 2 Tuberculosis 2 2 Totals 4 10 Totals 10 18 URUGUAY. This country sent the following amount of food, in tons, during the year 1938:— Beef and Veal. Mutton and Lamb. Pork. Poultry and Game. Eggs. 1938 7,057 1,034 24 10 2 The amount of unsound food is shown in tables on pages 39 and 40, and the diseased is shown in the following table:— Beef Quarters. Mutton and Lamb Carcases. 1938. 1937. 1938. 1997. Abscess 3 — l 3 Caseous Lymphadenitis — — 3 5 Cysticercus Bovis — — 2 1 Tuberculosis 1 1 — — Totals 4 1 6 9 » CHILE. This country sends only Mutton and Lamb to the markets, and the amounts of diseased meat are given herewith :— Mutton and Lamb Carcases. Mutton and Lamb Pieces. 1938. 1937. 1938. 1837. Abscess 2 1 - - Caseous Lymphadenitis 8 14 6 133 Cysticercus Bovis 15 6 10 Totals 25 21 16 133 OTHER COUNTRIES. The following table .shows the amounts of food surrendered due to disease :— Bacon Sides. Belgium.-Abscess 2 Bulgaria.-Abscess 1 Denmark.—Abscess 5 Holland.—Abscess 1 Hungary.—Abscess 1 Lithuania.—Abscess 1 38 CASEOUS LYMPHADENITIS. The following table shows the amount of mutton taken on account of Caseous Lymphadenitis during the past three years :— Carcases. Pieces. Country. 1938. 1937. 1936. 1938. 1937. 1936. Argentine 80 84 104 28 380 92 Australia 115 143 103 29 42 18 Brazil 3 24 — — 50 — Chile 8 14 12 6 133 32 New Zealand 115 113 147 18 18 4 Uruguay 3 5 2 — — 1 Totals 324 383 368 81 623 147 LEADENHALL MARKET AND CITY SHOPS. The Leadenhall Market and City Shops have been systematically inspected during the year, and the following table shows the amount and variety of unsound food dealt with :— Bacon (Pieces) 47 Mutton (Carcases) 4 Beef (Livers) 30 „ (Pieces) 19 „ (Pieces) 28 Partridges 1,029 „ (Tongues) 45 Pheasants 699 „ (Melts) 10 Pigeons 555 „ (Stirk) 1 Plover 129 Chickens and Poussins 2,030 Pork (Pieces) 8 Curlew 3 „ (Heads and Collars) 12 Ducks 341 Plucks 30 Eggs 707 Ptarmigan 49 Fish (Tins) 6 Quail 67 Fowls 9,931 Rabbits 7,690 Fruit (Tins) 1,666 Sausages (Tins) 44 Game (Black) 2 Snipe 108 „ (Unclassified) 11 Teal 49 Geese 41 Turkeys 486 Grouse 72 Veal (Carcases) 8 Guinea Fowls 91 „ (Heads) 10 Hares 230 „ (Pieces) 18 Hazelhens 8 Widgeon 105 Meat (Tins) 20 Woodcock 24 Milk (Tins) 422 Tons. Cwts. Qrs Lbs. Totals for 1937 38 15 0 15 " 1938 39 5 0 21 Increase 0 10 0 6 UNSOUND MEAT, ETC., REMOVED FROM THE COLD STORES. Article. No. How Packed. Origin. Cause of Destruction. Tons. Cwts. Qrs. Lbs. Beef (Briskets) 1 Pack. Australia Decomposed 0 1 2 21 „ (Breads) 1 Box Argentine Mould Fungi 0 0 2 0 ,, (Kidneys) 5 Bags S. Africa „ 0 1 0 20 „ 2 Boxes Argentine Decomposed 0 0 1 14 „ (Livers) „ 5 Bags Australia Brine Stain 0 2 2 0 3 „ Argentine Decomposed 0 1 0 8 „ (Pieces) „ Australia Mould Fungi 0 1 0 13 Argentine Decomposed 0 0 1 25 „ Australia Brine Stain 0 1 2 6 „(Tails) 1 Bag „ „ 0 0 2 0 „ 1 „ Argentine Decomposed 0 0 1 22 „ (Tongues) 1 „ „ „ 0 0 2 0 Cheese 5¼ Boxes „ „ 0 0 5 10 Ducks 5 United Kingdom. „ 0 0 0 10 „ Eggs 1 Tin China „ Carried forward 0 13 1 9 39 Unsound Meat, Etc., Removed from the Cold Stores.—continued. Article. No. How Packed. Origin* Cause of Destruction. Tons. Cwts. Qrs. Lbs. - Brought forward 0 13 1 9 Glands 33 Boxes Argentine „ Store Damage 0 4 1 26 „ 1 „ Decomposed 0 0 0 5 „ 14 Cases Australia „ 0 4 2 8 „ 10 Tins „ „ 0 0 0 20 Fish (Oysters) 2 Boxes „ „ 0 0 0 26 Mutton (Brains) 334 „ Argentine „ 0 17 1 0 „ (Carcases) 11 .... „ C. L. A. 0 4 2 21 „ 5 .... Australia C. L. A. 0 5 1 6 „ „ 4 .... New Zealand C. L. A. 0 1 2 11 „ „ 3 .... Chile C. L. A. 0 1 2 10 „ „ 189 .... Argentine Vermin Damage 4 3 0 25 „ „ 5 .... Australia Emaciated 0 1 1 19 „ „ 1 .... New Zealand Mould Fungi 0 0 1 5 „ „ 4 .... Argentine .... Brine Stain 0 1 1 19 „ „ 1 .... Australia „ 0 0 0 27 „ „ 4 .... Chile „ 0 1 1 6 „ (Breasts) 2 .... New Zealand Abnormal Odour 0 0 0 4 „ (Legs) 6 .... Australia C. L. A. 0 0 1 10 „ „ 12 .... Argentine C. L. A. 0 0 0 12* „ „ 4 .... Brine Stain 0 0 3 21 „ „ 24 .... „ Ex. Glands 0 1 2 6 „ „ 2 .... New Zealand C. L. A. 0 0 0 22 „ (Pieces) ... .... Argentine Vermin Damage 8 7 2 4 „ (Shoulders) 12 .... C. L. A. 0* 0 2 12 „ „ 5 .... Australia C. L. A. 0 0 0 25 „ „ 24 .... „ Brine Stain 0 1 0 0 „ (Sides) 1 .... Argentine C. L. A. 0 0 0 18 Offal ... .... United Kingdom. Decomposed 0 1 1 10 Pork (Pieces) ... .... Argentine Vermin Damage 0 0 3 16 „ (Legs) 1 Bag United Store Damage 0 0 3 23 Kingdom. 0 26 „ (Kidneys) 16 Boxes Argentine Decomposed 6 3 Rabbits 15 Cases Australia „ 0 10 0 4 Veal (Sides) 12 .... New Zealand Brine Stain 0 0 3 0 „ (Boneless) 8 Sides „ Immature 0 0 1 23 „ „ 1 Bag „ Brine Stain 0 1 0 23 Total for 1938 16 16 1 24 SHOWING THE AMOUNT OF VARIOUS FOOD PRODUCTS SURRENDERED TO OR SEIZED BY MEAT INSPECTORS IN THE CITY OF LONDON FOR UNSOUND CONDITIONS, 1938. Country. Beef in lbs. Mutton & Lamb in lbs. Pork in lbs. Veal in lbs. Venison in lbs. Goat in lbs. Bacon in lbs. Offal in lbs. Furred Game. Feathered Game. Tinned Milk. Tinned Meat. Fish in lbs. Cheese in lbs. Argentine 304,901 55,713 2,576 80 18 13,385 104 63 11 4,880 — — Australia 186,920 20,024 2,860 118 — — 261 9,042 5,448 61 6 1,641 — Austria 79 — — — — — 116 24 —• — — — Belgium — — — — — — 62 80 2,868 17 — 521 — — Brazil 7,062 84 — — — — — 233 — — — 12 50 90 Bulgaria 26,880 48,341 58,591 13, 05 4 937 37 1,534 56,973 95,652 38,786 1,226 3,120 Bulgaria Canada — — — — — — — — — — — — 104 532 — 29 — 21 8 287 — — — Chile 327 4,364 — — — — — 112 — — — — —1 — China Czechoslavakia — — — — — — — — 25 33 — 60 62 — — Denmark — _ — — ' — — 1,446 — 17 — —- — — Egypt — — — — — — — — — 21 — — — — Finland — — — — — — — — — 6 — — — — France — — — — — — — — — 1,006 — — — — Germany — — — — — — — — — 14 — 1,454 — — Holland — — — — — — 941 — 55 520 235 1962 — — Hungary — — — — — — — — — 5,075 — — — — Iceland — 253 — — — — — — — 7,331 — — — — Eire 156 732 8,167 53 — — 103 47,531 45,142 — — — — Japan — — — — — — — — — 6 — — — — Lithuania — — _ — — — — 1,281 72 — — — — New Zealand 64,558 57,923 5,971 455 — — 92 30,368 8,593 352 113 953 — — Norway Poland — — — — — — — 15 101 — 67 — 6,647 808 — 648 — — Rumania — — — — — — — 40 — — — — Russia — — — — — — 388 — 11 — — — — South Africa 7,388 — — — — — — — — — — — — S. Rhodesia 9,028 — — — — — — — — — — — — — Sweden — — — — — — — 682 — — 65 26 — — Uruguay .... U.S. A 6,659 10 176 — 160 115 — — — — — — 396 813 — — — 16 40 — Yugoslavia Various 42 — — — — — — — — — — — 3,286 — 4 737 — 52 28 Totals for 1938 613,931 187,689 78,440 13,760 937 37 5,209 15,417 166,605 57,581 1,061 16,462 260 804 Totals for 1937 779,874 179,952 91,925 15,570 1,189 57 10,095 220,335 109,145 68,555 1,901 13,746 508 452 F2 SHOWING THE AMOUNT OF VARIOUS FOOD PRODUCTS SURRENDERED TO OR SEIZED BY MEAT INSPECTORS IN THE CITY OF LONDON FOR DISEASED CONDITIONS, 1938. Country. Beef in lbs. Mutton and Lamb in lbs. Pork in lbs. Veal in lbs. Bacon in lbs. Offal in lbs. Furred Game in lbs. Poultry and Feathered Game in lbs. Argentine 24,868 8,196 5,151 7 17 1,601 — 10 Australia 3.980 11,227 1,840 — — 211 6 — Belgium — — — 59 — 162 — Brazil 814 39 — — — 90 — — Britain 13,136 33,036 160,691 9,840 214 83,852 2,494 104,237 Bulgaria — — — — 60 — — — Canada — — — — 122 — — — Chile — 1,141 — — — — — — Denmark — — — — 299 — — — Finland — — — — — — — 3 France — — — — — — — 15 Holland — — — 177 — 14 16 Hungary — — — — 105 — — 159 Iceland — 33 — — — — — — Eire — 614 4,334 29 — 6,712 35 33,300 Japan — — — — — — — 16 Lithuania — — — — 14 — — — New Zealand 679 14,300 12,004 — 98 316 20 — Poland — — — — — 24 14 South Africa 1,476 — — — — — — — Southern Rhodesia 1,298 — — — — — — — Sweden — — — — — 8 40 — Uruguay 270 138 — — — — — — Totals for 1938 46,521 68,724. 184,320 9,876 1,191 92,790 2,795 137,770 Totals for 1937 55,199 69,787 214,130 12,572 2,173 72,298 6,749 25,971 PROSECUTIONS UNDER SEC. 180 (2), PUBLIC HEALTH (LONDON) ACT, 1936 Serial No. Date. Business. Where heard. Before whom. Offence. Result. l 15/3/38 Farmer & Slaughterman. Guildhall Sir F. J. C. Pollitzer. Being the owner and consignor of one pig's carcase, four pigs' heads and collars, seven pigs' plucks and four mesenteric fats, which were unfit for the food of man. Fined £10. Costs, £5 5s. 0d. Fined £20. Costs, £5 5s. 0d 2 2/5/38 Farmer & Slaughterman. „ Being the owner and consignor of five pigs minus heads, two pigs, two mesenteric fats, one sheep, one leg of mutton and one pig's head and collar, which were unfit for the food of man. Fined £10. Costs, £5 5s. 0d. Fined £30. Costs, £5 5s. 0d. ; or six weeks' imprisonment and 31 days in connection with previous fine unpaid. Table showing Weight of Meat delivered to the market and to the contractors during each month for the years 1937 and 1938 :— Month. Meat delivered at the Market, 1937. Unsound Meat delivered to Contractors, 1937. Meat delivered at the Market, 1938. Unsound Meat delivered to Contractors, 1933. Tons. cwts. qrs. Tons. cwts .qrs. Tons. cwts. qrs. Tons. cwts. qrs. January 41,216 0 0 58 8 0 40,632 0 0 49 7 1 February 37,668 0 0 61 18 2 36,490 0 0 46 18 1 March 41,496 0 0 66 16 1 39,346 0 0 71 4 2 April 41,810 0 0 84 1 2 36,967 0 0 43 7 1 May 36,561 0 0 71 0 0 38,417 0 0 68 12 0 June 36,192 0 0 93 12 3 35,517 0 0 68 8 3 July 36,049 0 0 85 16 2 36,309 0 0 52 11 1 August 34,468 0 0 69 17 2 36,380 0 0 91 5 0 September 39,621 0 0 140 6 1 38,436 0 0 123 8 0 October 39,424 0 0 91 18 0 40,868 0 0 128 3 3 November 41,689 0 0 66 12 3 40,286 0 0 157 5 2 December 43,731 0 0 74 1 0 42,309 0 0 66 19 0 Totals 469,925 0 0 964 9 0 461,957 0 0 967 10 2 41 SUMMARY OF UNSOUND FOOD DESTROYED. Tons. Cwts. Qrs. Lbs. Central Markets (Smithfield) 911 8 3 11 Leadenhall Markets 39 5 0 21 Cold Stores 16 16 1 24 Total for the year 1938 967 10 2 0 Total for the year 1937 964 9 0 0 Increase 3 1 2 0 EXPORT OF MEAT. One hundred and seventy-six certificates were issued during the year. DEMONSTRATIONS AND INSTRUCTIONS IN MEAT INSPECTION. Two hundred and sixty-two persons from various training centres received instruction. At the request of the Admiralty, the course of instruction in elementary Meat Inspection, which has been given at Smithfield Market for many years past, the officers of H.M. Navy, has been extended to include visits to cold-air store, in order that methods of stowing could be studied. Thirteen naval officers Teceived this training during 1938. One ton in every 477 tons of meat paying toll in the Central Markets, Smithfield, was condemned last vear, as compared with one ton in 487 in 1937. Table showing the average deliveries at the Central Meat Market, and other details for successive quinquennial periods during the past 66 years :— Annual Average General Supply. Seizure by Inspectors. % of Unsound Meat. Quinquennium. 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 2 •422 1919-1923 403,364 10 0 1,849 19 0 •459 1924-1928 477,405 0 0 1,210 2 0 •253 1929-1933 464,847 0 0 946 6 0 •203 1934-1938 468,555 0 0 925 17 2 •191 The following figures supplied by the Superintendent of the Market are of interest :— 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. Australian and New Zealand. South African and South Rhodesian. U.S.A. Argentine, etc. Continental. Year. Country Killed. Town Killed. Canadian. 1934 22.3 3.0 1.0 29.4 0.5 0.9 40.0 2.9 1935 24.5 3.4 0.5 28.8 0.8 0.6 38.9 2.5 1936 24.4 3.9 0.8 28.1 0.6 0.4 39.5 2.3 1937 22.8 3.8 0.8 29.6 0.8 0.4 39.1 2.7 1938 24.1 2.9 0.8 30.6 0.6 0.4 37.9 2.7 1934. 1935. 1936. 1937. 1938. Tons. Tons. Tons. Tons. Tons. Average daily delivery into the Markets 1,514 1,558 1,528 1,536 1,504 Minimum delivery on any one day 544 191 84 129 150 Maximum delivery on any one day 3,704 3,386 4,554 4,034 4,012 The heaviest weight previously recorded on any one day (20th December, 1926) was— 5,259 tons. 42 FISH SUPPLIES. 187,288 tons of fish, of which 185,023 were land-borne and 2,265 water-borne, were received at or near Billingsgate Market during the year. This was a decrease of 16,922 tons in the land deliveries and an increase of 407 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 1938. 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 17,289 9 2 92 12 2 17,382 2 0 28 8 3 •163% or 1 ton in 611.238 tons. February 15,583 14 2 112 10 2 15,696 5 0 20 9 2 •130% „ „ 766.605 „ March 16,928 10 3 86 8 2 17,014 19 1 118 6 2 •695% „ 143.798 ,, April 15,354 2 3 31 18 0 15,386 0 3 41 2 1 •267% „ „ 228.623 ., May 15,407 4 0 115 0 0 15,522 4 0 54 16 3 •353% „ „ 283.058 June 14,621 3 1 104 15 1 14,725 18 2 90 4 1 •612% „ „163.235 ., July 15,832 5 3 88 12 1 15,920 18 0 99 6 1 •623% „ „160.311 .. August 14,513 17 2 221 3 0 14,735 0 2 79 15 2 •541% „ „ 184.707 „ September 15,550 3 3 367 14 2 15,017 18 1 102 5 2 •642% „ „ 155.638 „ October 14,312 7 1 378 7 0 14,690 14 1 51 6 0 . •349% „ „ 286.368 ., November 15,328 6 0 419 6 2 15,747 12 2 83 3 2 •528% „ „ 189.331 „ December 14,301 17 0 247 4 0 14,549 1 0 35 16 3 •246% „ „ 405.972 „ Totals 185,023 2 0 2,265 12 0 187,288 14 0 805 1 2 429% „ „ 233.401 „ *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. Weight of Fish Delivered, Fish Seized as Unsound, and percentage of Fish Condemned to that Delivered, at or near Billingsgate Market during 1938 and the five years 1933—1937. 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. cwt. qrs; 1933 181,888 14,999 196,887 1,168 6 2 1 ton in 155.726 tons or 0.642% 1934 186,775 13,186 199,961 1,030 5 0 1 „ 194.137 „ 0.515% 1935 193,719 12,341 206,060 965 0 3 1 ,. 213.533 „ 0.467% 1936 201,770 2,976 204,746 1,027 6 1 1 „ 199.363 „ 0.501% 1937 201,945 1,858 203,803 867 3 0 1 „ 235.055 „ 0.425% Average (5 years) 193,219 9,072 202,291 1,011 12 3 1 ton in 200.090 tons or 0.499% 1938 185,023 2,265 187,288 805 1 2 1 ton in 233.401 tons or 0.429% PUBLIC HEALTH (MEAT) REGULATIONS, 1924. Much improvement is reported, and the number of persons who knowingly evade the Regulations is now negligible. The market carriers and private butchers know the Regulations, and the advantage of maintaining their vehicles in clean and proper condition. They are always willing to put right any unsatisfactory condition brought to their notice. The market porters generally also carry out the Regulations, although certain difficulty is experienced from time to time with some of the employees about the market in regard to the wearing of washable head-coverings. The number of private cars used for the conveyance of meat is increasing, but the owners are always willing to take such precautions as are reasonably necessary to avoid contamination when using this class of vehicle for the transport of meat. Many of them have fitted an adjustable boxed inner lining, which is easily detached and cleansed, and others have all meat adequately wrapped in clean jute cloths. I have, therefore, no justification in attempting to stop this practice. 43 During the year 1938 it has not been necessary to take any prosecutions. The 264 contraventions recorded were of a minor character, and the forwarding of cautionary letters, where necessary, produced the desired improvement. It is gratifying to note that the . number of contraventions has fallen by 182 on last year's figures. Butchers' shops and depots used as distributive centres by multiple restaurants are the subject of constant supervision, and whilst the standard of cleanliness in these premises is generally good, many improvements have been made. The premises used for the manufacture of sausages and meat products within the City are conducted in a satisfactory manner, and the installation of modern machinery and equipment show a genuine effort to bring their, in many cases, old-fashioned premises upto-date, and a desire to produce these foods in as hygienic and cleanly a manner as possible. The general improvements during the year are the result of co-operation between the meat traders and transporters and the officers of my department. PUBLIC HEALTH (LONDON) ACT, 1936.—SECTION 187. ICE CREAM AND PRESERVED FOOD. Summary of Types of Premises Registered during 1938. Sausages and Cooked Meat 2 Pickling of Meat 1 Boiling of Hams 1 Sorting and Testing Sausage Casings 1 Manufacture of Ice Cream 1 Sale and Storage of Ice Cream 17 Summary of Types of Premises Removed during 1938. Sausages and Cooked Meat 2 Pickling of Meat 2 Smoking of Bacon 1 Boiling of Shellfish 2 Pickling of Vegetables 1 Manufacture of Ice Cream 1 Sale and Storage of Ice Cream 7 Note.—Some of these premises are registered for more than one of the above processes. The action taken under this Act has improved the standard of cleanliness in many businesses. Before premises are registered, a schedule of alterations and improvements is submitted, where necessary, to the applicant. When the improvements have been carried out, a standard capable of maintenance results. The number of premises registered during 1938 is 21, and 13 premises were removed from the register, the occupiers having removed or discontinued in business. One premises was considered unsuitable for satisfactorily conducting the type of business for which application for registration was made. There is now a total of 135 premises on the register. SUPERVISION OF THE ICE CREAM TRADE. During the summer season, 98 inspections have been made in connection with the manufacture or sale of ice cream at the 67 premises now registered in the City, and 44 inspections have been made of the barrows or stalls of itinerant vendors, who this season numbered 19. In all instances where lack of cleanliness or other breach of the requirements of the Act were observed, the issue of a caution has resulted in appropriate steps being taken to remedy the defect. ITINERANT VENDORS OF FOOD. (Other than Ice Creaam). The new Bye-laws for the protection of food, made under Section 183, of the Public Health (London) Act, 1936, and which came into force on the 1st of February of this year, have given increased powers to enforce the sanitary and cleanly conditions of food exposed for sale, and as a consequence many improvements have been made. During the year 58 inspections have been made of the barrows, etc., of itinerant vendors of fruit and confectionery, and where unsatisfactory conditions existed, the issue of cautions resulted in the necessary improvements being made. 44 INSPECTION OF FOOD AT RIVERSIDE WHARVES. The following is a summary of the chief products coming under the observation of the Inspector charged with the supervision of foods delivered at City wharves :— SUMMARY OF FOOD DISCHARGED AT CITY WHARVES. Description of Packages. General Range of Weight of Packages. Article. Where from. Quantity. Butter Packages Holland 6 lbs.—1 cwt. 293,345 Bacon Bags, Cases „ 1 cwt. 2 qrs.—3 cwts 49,356 Cheese (Loose) Single „ 1 lb.—8 lbs. 160,962 Cheese Packages „ 28 lbs.—1 cwt. 360,127 Eggs (Fresh) Cases „ 84 lbs.—1 cwt. 2 qrs. 734,106 Eggs (Frozen) Packages Holland and China 45 lbs. 7,217 Eggs (Dried) „ China 25—100 lbs. 200 Egg Yolk Casks China and Holland 56 lbs.—4 cwts. 2,855 Lard Packages „ Canada and America 28 lbs.—4 cwts. 84,857 Margarine Holland 12 lbs.—56 lbs 159,578 Cereals— Barley Bags „ 100 lbs.- cwt. 2qrs. 2,478 Beans „ Holland, Japan and India. 1 cwt.—2 cwts. 6,692 Lentils „ Holland 1 cwt.—2 cwts. 13 Peas „ Holland, Roumania and Japan. 1 cwt.—1 cwt. 3 qrs. 29,559 Rice „ Holland, Italy and Japan. 1 cwt.—1 cwt. 2 qrs. 3,311 Sago „ Holland 1 cwt.—1 cwt. 2 qrs. 60 Tapioca „ Holland and Ceylon 1 cwt.—1 cwt. 2 qrs. 2,429 Cocoa Bags, Packages Holland, Ceylon, E. 28 lbs.—2 cwts. 16,515 Africa and Brazil. Coffee Bags Dutch E. Indies, Ceylon, E. Africa and Costa Rica. 1 cwt. 2 qrs. 84,165 Fruit (Soft)— Apples Packages - 28 lbs.—1 cwt. 2 qrs. 30,140 Cranberries „ Holland 28 lbs. 4,118 Gooseberries „ „ 40 lbs.—100 lbs. 582 Peaches „ „ 17 lbs.—32 lbs 16 Loganberries „ „ 7 lbs. 3 Rhubarb „ „ 6 lbs.—28 lbs. 853 Strawberries „ „ 7 lbs.—28 lbs. 404 Fruit (Dried)— Apricots „ America, Canada, S. Africa and Australia. 24 lbs. 67,670 Bananas „ W. Africa 32 lbs. 1,507 Currants „ Greece, Turkey and S. Africa. 28 lbs.—56 lbs. 166,885 Dates „ Egypt, Turkey and Persia. 3 qrs. 74,366 Evaporated Apples „ America, Canada, Australia and S. Africa. 56 lbs. 12,462 Figs „ Greece, Turkey, Spain and Italy. 28 lbs.—4 cwts. 36,397 Fruit Salad „ America 28 lbs.—56 lbs. 5,265 Nectarines „ America and Canada 24 lbs.—56 lbs. 849 Peaches „ America, Canada, Australia and S. Africa. 24 lbs.—56 lbs. 21,885 Pears „ America, Canada and Australia. 24 lbs.—56 lbs. 29,852 Plums „ America 24 lbs.—1 cwt. 210,960 Preserved Fruit „ Holland 10 lbs.—56 lbs. 2 Raisins „ America, Spain, Greece and Turkey. 6 lbs.—56 lbs. 132,889 Sultanas „ America, Spain, Greece, Turkey and Persia. 24 lbs.—56 lbs. 205,778 Fruit (Green)— Grape Fruit „ Trinidad, Jaffa and Florida. 56 lbs.—1 cwt.. 129,269 Grapes „ Spain, Holland, Turkey and Cyprus. 12 lbs.—1 cwt. 99,560 Lemons „ Italy, Spain, Cyprus, Trinidad and Jaffa. 1 cwt. 50,786 Mandarines „ Spain and Egypt 3 qrs.—1 cwt. 1 qr. 630 45 Article. Description of Packages. Where from. General Range of Weight of Packages. Quantity. Fruit (Green)—continued. Melons Packages Holland, Spain and Jaffa. 12 lbs.—1 cwt. 1 qr. 95,693 Oranges „ Spain, Cyprus, Egypt, Brazil, America and Jaffa. 3 qrs.—1 cwt. 1 qr. 351,521 Pomegranates „ Spain 28 lbs.—1 cwt. 1 qr. 1,794 Vegetables— Beans „ Holland 40 lbs. 40,678 Beetroots „ „ 1 cwt. 10,448 Cabbages „ „ 1 cwt. 3,220 Carrots „ „ 40 lbs.—1 cwt. 1 qr. 483,858 Cauliflower „ „ 12 lbs.—40 lbs. 36,170 Cucumbers „ „ 12 lbs.—40 lbs. 11,551 Gherkins „ „ 12 lbs.—40 lbs. 1,225 Lettuce „ „ 12 lbs.—40 lbs. 362,029 Onions „ Holland, Spain, Cyprus, Egypt, Czecho-Slovakia and Brazil. 1 cwt. 1 qr.: 346,855 Parsnips „ Holland 1 cwt. 7,366 Peas „ „ 40 lbs. 880 Potatoes „ Holland, St. Malo, prus and Palestine. 56 lbs.—1 cwt. 1 qr. 97,393 Radishes „ Holland 28 lbs.—1 cwt. 19,330 Spinach „ „ 14 lbs.—56 lbs. 155 Sprouts „ „ 100 lbs. 8,041 Tomatoes „ Holland, Cyprus and Jaffa. 12 lbs.—56 lbs. 909,853 Sugar Bags, Cases Holland 1 cwt.—2 cwts. 1,883 Tea Packages India, Ceylon, China and Java. 1 cwt. 100,237 Tinned Goods— Anchovies Cases Portugal and Spain 1 cwt., 5,906 Apples „ America and Canada 50 lbs.—1 cwt. 42,481 Apricots „ America, Canada and Australia. 48 lbs. 32,730 Asparagus „ America and Canada 56 lbs.—1 cwt. 1,730 Beans „ Italy, America and Canada. 1 cwt. 1,100 Black Currants „ Latvia and France 1 cwt. 704 Cherries „ Canada and Italy 28 lbs.—48 lbs. 41,189 Condensed Milk „ Holland 48 lbs. 878,928 Corned Beef „ South America and Australia. 72 lbs. 66,776 Fruit Pulp „ America, Spain, Holland and Latvia. 72 lbs.—100 lbs. 10,549 Eggs (Frozen) „ China 45 lbs. 30 Fruit Salad „ America — 23,206 Fruit Syrup „ Canada 60 lbs. 655 Grape Fruit „ Florida 50 lbs. 59,447 Grapes „ Portugal 48 lbs.—96 lbs. 508 Figs „ America and Italy 1 cwt. 1,265 Hams „ Holland, Denmark and Poland. 20 lbs.—1 cwt. 1 qr. 1,963 Fish „ Holland, Norway, America, Spain and Portugal. 1 cwt. 33,680 Loganberries „ America 56 lbs.—1 cwt. 14,619 Lobster „ „ 50 lbs. 2,859 Peaches „ America, Canada and Australia. 48 lbs. 177,144 Jam „ Australia 14 lbs.—1 cwt. 4,139 Peas „ America and Belgium 48 lbs. 18,673 Meat „ Australia, New Zealand, S. America and Canada. 56 lbs.—1 cwt. 48,857 Pears „ America, Canada and Australia. 48 lbs. 98,190 Oranges „ Japan 56 lbs.—1 cwt. 82,117 Pines „ Singapore, Hawaii, S. Africa and Australia. 60 lbs. 207,067 g 46 Article. Description of Packages. Where from General Range of Weight of Packages. Quantity. Tinned Goods—continued. Plums Cases Canada and America 60 lbs. 900 Meat Essence „ South America 1 cwt. 1,394 Pork and Beans „ America and Canada 60 lbs. 3,250 Prawns „ America 56 lbs. 550 Salmon „ America, Canada and Japan. 56 lbs.—1 cwt. 64,612 Sardines „ Portugal and Morocco 56 lbs.—1 cwt. 51,009 Sugar Corn „ Canada and America 56 lbs. 10,717 Sausages „ Holland 56 lbs.—1 cwt. 1,843 Soup „ Canada 56 lbs. 711 Sterilised Cream „ Holland 48 lbs. 3,261 Strawberries „ America 48 lbs. 134 Tomatoes „ Italy, Spain, Hungary, Bulgaria and Canada. 56 lbs;—1 cwt. 134,981 Tomato Juice „ Canada 56 lbs. 125 Tongues „ Holland, South America and New Zealand. 48 lbs.—1 cwt. 16,760 „ Veal „ Holland and New Zealand. 36 lbs.—100 lbs. 2,562 Vegetables „ Holland, Spain, Italy and Belgium. 50 lbs.—100 lbs. 27,088 Macaroni Packages Canada, Italy and Belgium. 40 lbs. 28,760 Milk Powder „ Holland, Canada, America and Australia. 50 lbs.—1 cwt. 102,281 Nuts (Various) Packages, Bags Spain, China, America, Italy, Persia and Ceylon. 50 lbs.—1 cwt. 1 qr. 44,257 Vegetables in Brine Casks Holland 3 cwts.—5 cwts. 7,205 Vegetables (Dried) Packages „ 3 qrs. 403 Ginger (Preserved) Cases, Casks China 30 lbs.—3 cwts. 13,400 Anchovies in Brine Casks Spain 1 cwt. 2 qrs. 328 Miscellaneous— Albumen — China 1 cwt. 3 qrs. 697 Biscuits Packages Holland 1 cwt.—1 cwt. 1 qr. 356 Block Condensed „ „ 56 lbs. 1,373 Milk. Carraway Seeds Bags „ 1 cwt. 1 qr. 853 Chocolate Packages „ 50 lbs.—1 cwt. 1 qr. 92 Chutney — India -1 cwt.—3 cwt. 188 Citrons in Brine Casks Italy 4 cwts. 50 Cocoa Butter Packages Holland and America 1 cwt.—2 cwts. 11,411 Curry — India 1 cwt. 21 Condensed Milk Casks Holland 4 cwts.—5 cwts. 4,267 Cornflakes — Canada 18 lbs. 10,050 Confectionery Packages Holland 28 lbs.—1 cwt. 1 qr. 270 Desiccated Cocoanut — Ceylon 28 lbs.—1 cwt. 18 lbs 8,815 Fruit and Lemon Casks Spain, Italy and America. 3 cwts.—15 cwts. 2,415 Juice. Fruit Pulp „ Holland, Spain, Italy and Latvia. 4 cwts.—6 cwts. 8,328 Hams (Salted) Holland 2 cwts. 91 Honey Casks Holland and Bulgaria 1 cwt.—2 cwts. 207 Liquorice Packages Italy and America 1 cwt.—2 cwts. 1,076 Pepper „ Dutch E. Indies and Sarawak. 1 cwt. 1 qr.—1 cwt. 2 qrs. 16 lbs. 846 Poultry — Holland 12 lbs.—56 lbs. 1,286 Peel in Brine Casks — 138 Shellfish — Holland 1 cwt. 4,460 Sugar Candy Packages „ 28 lbs.—56 lbs. 150 Olives — Spain and Greece 1 cwt. 220 Casings Casks and Cases Holland and America 56 lbs.—4 cwts. 1,155 Spaghetti — Italy and Canada 40 lbs. 875 Rabbits Cases Holland 1 cwt. 220 Tongues (Salted) Casks „ 6 cwts. 438 Vegetable Powder and Extract. — „ 56 lbs.—1 cwt. 2 qrs. 3,194 Yeast - „ 28 lbs—56 lbs. 7,645 47 UNSOUND FOOD. Removed by Cleansing Department. Article. . Tons. cwts. qrs. lbs. Casks Fruit Pulp 1 3 0 0 Dried Fruit 17 10 2 0 Tinned Condensed Milk 4 1 2 0 „ Egg Yolk 7 1 0 0 ,, Fruit Pulp 3 4 3 10 „ Vegetables and Fish 54 19 2 23 „ Meat 0 12 3 12 Fruit and Vegetables 3 12 1 0 Miscellaneous 14 0 1 7 Total 106 5 3 24 Unsound Food Removed by Private Contractors under Supervision. Date. Article. Reason for Destruction. Tons. cwts. qrs. lbs. April 8 46 Boxes Oranges Decomposed (Result of Garbling) 2 6 0 0 " 12 223 Bags Onions „ „ „ 11 3 0 0 " 13 347 „ „ „ 14 7 0 0 14 518 „ „ „ „ 25 18 0 0 July 26 372 „ „ „ „ „ 18 12 0 0 Aug. 25 133 „ „ „ „ 6 13 0 0 Sept. 11 130½ „ „ „ „ „ 3 5 0 0 Dec. 4 4 Stalks Bananas „ „ „ 0 1 0 0 Total 82 5 0 0 Unsound Food Destroyed at Wharf under Supervision. Date. Article. Reason for Destruction. Tons. cwts. qrs. lbs. June 23 4 Boxes Lemons Mouldy and decomposed (Result of 0 3 0 0 (Garbling) „ 23 1 Tin Cucumbers Mouldy (Customs ten unclaimed) 0 0 0 10 Total 0 3 0 10 Unsound Food Removed by Smithfield Animal Products. Date. Article. Reason for Destruction. Tons. cwts. qrs. lbs. Nov. 38 Barrels Casings Decomposed 1 18 0 0 Food Released for the Purposes Stated. Date. Article. Reason for Destruction. Tons. cwts. qrs. lbs. April 22 7 Casks Butter Stained and dirty (Used for Soap- 0 7 0 0 making). „ 28 3 „ „ Stained and dirty (Used for Soap- 0 3 0 0 making). May 3 5 „ „ Stained and dirty (Used for Soap- 0 5 0 0 making). July 6 1 Cask Sinews Not officially certificated (Re-exported) 0 4 0 0 Sept. 10 37 Casks Raspberry Pulp Excessive Preservative (Returned to 9 5 0 0 Dutch Manufacturers). Total 10 4 0 0 PHARMACY AND POISONS ACT, 1933. This Act came into operation on the 1st May, 1936. The greater part of the Act concerns the Pharmaceutical Society, members of which alone may sell poisons detailed in Part 1 of the Poisons List. Part 2 of the list is a concern of the Common Council of the City of London as Registering Authority for persons selling the poisons there listed in the City. g2 48 The duties of the Authority are to list these persons, to inspect their premises and to secure compliance with the provisions of Part 2 of the Act. A shopkeeper may not sell listed poisons unless he is on the Local Authority's list, and the application to be listed must be on a schedule form. Provision is made for a charge of 7s. 6d. for first listing, ls. for any subsequent alteration of address, and 5s. for annual renewal. In regard to multiple premises, the fee is 7s. 6d. for each of the listed premises and 5s. for each year of renewal. Appropriate forms of application for listing have been prepared, and have been circulated by me to grocers, ironmongers, oilmen, garage keepers, seedsmen, etc., likely to be affected by the Act. At the 31st December, 1938, 95 persons were registered, of whom five were new registrations during the year. FERTILISERS AND FEEDING STUFFS ACT, 1926. The work in connection with the above Act has been carried on as usual and, when necessary, special enquiries on behalf of other Authorities in connection with delivering samples and obtaining statutory statements from registers, were made. ' The quarterly returns to the Ministry of Agriculture and Fisheries have been made at the end of each quarter. MERCHANDISE MARKS ACT, 1926. 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. Three new orders were issued under the Agricultural Produce (Grading and Marking) Act, 1928 and 1931. SUPERVISION OF FOOD AND DRUGS. During the year 1938, 1,012 samples of food and drugs were submitted to the Public Analyst for examination, 777 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 follow:- 6 of Sausages, out of 45 samples. 3 of Canned Fish, out of 35. 2 of Butter (on bread), out of 22. 2 of Vinegar, out of 19., 1 of Jam, out of 10. 1 of Crushed Linseed, out of 1. 1 of Boric Ointment, out of 5. Of the formal samples, 7 out of 235 were reported against, as follow:— 3 of Sausages, out of 4 samples. 2 of Milk, out of 194. 1 of Butter, out of 6. 1 of Whisky, out of 25. The above-mentioned samples, with the exception of Milk and Whisky, were taken as a result of informal samples having been reported against. 49 General Observations.—The percentage rate of adulteration of all food and drugs sampled in the City was 2.2, as compared with 2.4 in 1937. Butter, Cream and Cheese.—Twenty-two samples of butter (on or with bread) were taken and two were reported against as containing margarine. Formal samples were taken in connection with these, one of which proved genuine, but the other was certified to contain 20 per cent. of margarine. The vendor, a proprietor of a small cafe, was fined £2, with £5 5s. costs. None of the 11 samples of cream nor the 32 samples of cheese taken was reported against. Sausages.—Six of the 45 samples of sausages taken informally were certified to contain sulphur dioxide, the only preservative permitted to be used in sausages, but no declaration of its presence was made by the vendors, contrary to the requirements of the Public Health (Preservatives, etc., in Food) Regulations. In no case did the amount of preservative exceed the permissible limit. Visits were paid to the shops where these purchases had been made, with a view to procuring formal samples of the sausages sold, and in three cases legal proceedings were taken successfully as a result. In the remaining instances notices were found to be exhibited, as required. Spirits.—Of the 30 samples of spirits taken, one, of whisky, was found to be below the legal limit of 35 degrees under proof, and the licensee of the premises was prosecuted. A fine of £1 was imposed, with £1 ls. costs. Canned Goods.—Three samples of canned fish were reported against, benzoic acid, tin and lead respectively being found to be, present in small amounts. The small balance of unsold stock was surrendered for destruction. Drugs.-Only two of the 113 samples of various drugs were reported against, and no legal action was found to be necessary. Vinegar.—It was held, in an important case in 1937, before the Chairman of the County of London Sessions, that the substance Sold as vinegar or table vinegar without any qualification or explanation as to its origin being given by the seller to the purchaser implies that the substance sold is produced by a process of fermentation. Following this decision, suppliers and vendors consequently generally took steps to give notice to the purchaser by label or otherwise when a non-brewed vinegar was being supplied. Nineteen samples of vinegar were purchased during the year, and two were certified to be artificial vinegar, though no notice was given to the purchaser. The vendors were communicated with in both cases. EXAMINATION OF MILK. Chemical.—Two of the 194 samples of milk—all of which were taken formally—were certified as being below the legal limits which presume adulteration, equal to a percentage figure of 1.0, as compared with 5.5 in 1937. One of these samples was found to be deficient in milk fat to the extent of 38 per cent., and had been served from a vessel fitted with a milk pump. Apparently the milk had remained in the container for some hours and the cream consequently rose to the surface. The plunging apparatus fitted to the piston rod of the pump presumably did not function satisfactorily, as the first quantity of milk pumped from the bottom of the receptacle showed this deficiency in milk fat. The proprietor of the shop was summoned and fined £2, with £2 2s. costs.' In the other instance the deficiency was small and the vendor was communicated with. As usual, considerable attention was paid to purveyors of milk in the streets, and 61 samples were taken. 50 The following table shows the percentage fat-content in each of the 194 samples, the average fat-content being 3.7 per cent.:- Percentage of Fat. No. of Samples. Percentage of Fat. No. of Samples. 1.9 1 4.1 5 2.7 1 4.3 2 3.0 1 4.4 2 3.1 6 4.5 1 3.2 6 4.6 2 3.3 12 4.8 1 3.4 21 5.0 1 3.5 26 5.1 2 3.6 26 5.5 1 3.7 34 5.9 2 3.8 18 6.2 1 3.9 13 7.1 1 4.0 8 - Total 194 In the above table it will be noticed that seven samples had a fat-content exceeding 5 per cent. Five of these were taken at a railway terminus from churns containing milk from Jersey cows. Two others were samples from counter pans in shops where plungers were not in use, and the attention of the proprietors was directed to the duty devolving upon them to keep the milk well plunged, so that its consistency remains uniform and each portion served has its proper proportion of cream. Seven purveyors of milk from whom samples had been taken availed themselves of the provisions of the Food and Drugs (Adulteration) Act, 1928, and served notice upon the Authority requesting samples of milk to be procured in course of delivery from their suppliers. MILK-IN-SCHOOLS SCHEME. The practice of taking samples both for chemical and bacteriological examinations quarterly from each of the contractors supplying milk under this scheme, upon delivery to the schools, has been continued. Milk that has been pasteurised in accordance with the requirements of the Milk (Special Designations) Order, 1936, only is supplied, and this Order requires that, on a sample being taken, it shall not contain more than 100,000 bacteria per millilitre. All the samples taken for chemical analysis were certified genuine, but one of the bacteriological samples exceeded the limit mentioned. The contractor was communicated with and the circumstances investigated. An early repeat sample proved satisfactory, and the Medical Officer of Health of the London County Council was informed. / THE MILK AND DAIRIES ORDER, 1926, AND THE MILK AND DAIRIES (AMENDMENT) ACT, 1922. Seventeen new applications for registration as purveyors of milk within the City were received and granted. Additional to these applications, a wholesaler, who had no business premises of his own, withdrew an application on being informed that registration could not be recommended on account of the unsatisfactory method in collection of milk from his suppliers. Incidentally, an adjoining Authority also refused to register him. Refusal of such applications in the future will be facilitated by the new Food and Drugs Act, which comes into force on the 1st October, 1939, the provisions of the Section dealing with registration applying also in relation to dairymen who are not retail purveyors of milk as they apply in relation to dairymen who are such purveyors. 51 Registration Statistics. New Applications for Registration received 17 New Applications granted 17 New Applications refused Nil Number of Retail Purveyors of Milk (with City premises) on the Register at end of 1938 119 Number of Retail Purveyors of Milk (without City premises) on the Register at end of 1938 42 Number of Milk Sellers (other than Retail Purveyors of Milk) on the Register at end of 1938 30 Licences issued under Milk (Special Designations) Order 14 During the year 121 inspections were made in connection with the sale of milk in order to see that statutory requirements were complied with. Observations have been made from time to time with regard to milk distribution from barrows and vehicles. One roundsman, who was seen to fill a bottle with milk in the street, a contravention of the Milk and Dairies Order, which requires a person who delivers milk in bottles to cause every such bottle to be filled and closed on registered premises, was prosecuted and fined £1. THE PUBLIC HEALTH (CONDENSED MILK) REGULATIONS, 1923 AND 1927. THE PUBLIC HEALTH (DRIED MILK) REGULATIONS, 1923 AND 1927. Thirteen samples of different brands of condensed milk were purchased for analysis and all found to conform to the requirements of the regulations in all respects. REGISTERED PREMISES. Butter Factories.-Samples taken at these premises were all certified to be genuine. Two factories are now on the register, one additional application having been approved during the year. Wholesale Dealers in Margarine and Margarine Cheese.—Four new applications for registration were received during the year. Artificial Cream Act, 1929.—No additions have been made to the register. . 52 ADMINISTRATIVE ACTION REGARDING Serial No. Article. Whether Formal ' or Informal. Nature of Adulteration or Irregularity. 34 Black Currant Jam Informal Excess Sulphur Dioxide, 35 parts per million. 186 Milk Formal Fat deficient, 9%. 194 Margarine Informal Not delivered to the purchaser in a properly printed wrapper. 196. Vinegar Informal Acetic Acid Vinegar, 100%. 201 Crushed Linseed Informal Linseed Oil deficient, 70%. 211 Chipolata Sausages Informal • Sulphur Dioxide preservative, 400 parts per million, without declaration. 238 Chipolata Sausages Formal Sulphur Dioxide preservative, 390 parts per million, without declaration. 342 • Canned Silver Herrings Informal Benzoic Acid, 195 parts per million. 343 Canned Sild Informal Tin, 4.7 grains per pound. 357 Sardines Informal Lead, 12 parts per million. 421 Butter (on bread) Informal Margarine, 100%. 434 Butter (with scone) Informal Margarine, 100%. 437 Sausages Informal Sulphur Dioxide preservative, 330 parts per million, without declaration. 451 Pork Sausages Informal Sulphur Dioxide preservative, 110 parts per million, without declaration. 469 Butter (with scone) Formal Margarine, 20%. 492 Pork Sausages Informal Sulphur Dioxide preservative, 170 parts per million, without declaration. 508 Pork Sausages Formal Sulphur Dioxide preservative, 240 parts per million, without declaration. 539 Chipolata Sausages Informal Sulphur Dioxide preservative, 360 parts per million, without declaration. 598 Whisky Formal Proof Spirit, 4 degrees deficient. 606 Boric Acid Eye Ointment Informal Boric Ointment, 100%. 645 Beef Sausages Informal Sulphur Dioxide preservative, 395 parts per million, without declaration. 648 Vinegar Informal Artificial Vinegar, 100%. 660 Beef Sausages Formal Sulphur Dioxide preservative, 420 parts per million, without declaration. 736 Margarine Informal Not delivered to the purchaser in a properly printed wrapper. 784 Milk Formal Fat deficient, 38%. 63 ADULTERATION OR OTHER IRREGULARITY. Observations. Results of Proceedings or other Action taken. Re-sampled formally—genuine Plynger in counter-pan defective Vendor communicated with. Proper wrappers provided not used Vendor communicated with. Vendor communicated with. Formal sample unable to be procured—stock sold out. Re-sampled formally—No. 238 Taken in connection with sample No. 211 Vendor prosecuted. Fined, £1, with £2 2s. 2d. Costs. Small balance of unsold stock surrendered for destruction. Small balance of unsold stock surrendered for destruction. Further samples taken of stock showed age lead content to be so small that further action was not justified. Re-sampled formally—genuine Additional informal samples proved genuine. Re-sampled formally—No. 469 Notice regarding preservatives exhibited in shop on subsequent visit. Re-sampled formally—genuine Taken in connection with sample No. 434 Vendor prosecuted. Fined £2, with £5 5s. 0d. Costs. Re-sampled formally—No. 508 Taken in connection with sample No.492 Vendor prosecuted. Summons dismissed under Probation of Offenders Act, with £3 3s. 0d. Costs. Notice regarding preservatives exhibited in shop on subsequent visit. Vendor prosecuted. Fined £1, with £1 is. 0d. Costs. Vendor communicated with. Explanation submitted. Re-sampled formally—No. 660 Vendor communicated with. Taken in connection with sample No. 645 Vendor prosecuted. Fined £2, with £2 2s. Od. Costs. Proper wrappers provided not used Vendor communicated with. Vendors prosecuted. One partner fined £2, with £2 2s. 0d. Costs. Summons against another partner dismissed under the Probation , of Offenders Act. H 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. 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 6 7 13 1 - 1 16.6 - 7.6 Butter (on bread) — 22 22 — 2 2 — 9.0 9.0 Cheese — 32 32 - - - - - - Cocoa — 5 5 - - - - - - Coffee — 3 3 - - - - - - Confectionery — 81 81 - - - - - - Jam and Marmalade 1 10 11 — 1 1 — 10.0 9.0 Cream — 11 11 - - - - - - Lard — 4 4 — — — — '— — Margarine — 9 9 - - - - - - Milk 194 — 194 2 — 2 1.0 — 1.0 Milk, Condensed — 13 13 - - - - - - Mustard — 4 4 - - - - - - Sugar — 10 10 - - - - - — Tea — 12 12 - - - - - - Vinegar — 19 19 — 2 2 — 10.5 10.5 Spirits 30 — 30 1 — 1 3.3 — 3.3 Drugs — 113 113 — 2 2 — 1.7 1.7 Other Articles 4 422 426 3 9 12 75.0 2.1 2.8 Totals 235 777 1,012 7 16 23 2.9 2.0 2.2 Spirits— Brandy 5 — 5 - - - - - - Whisky 25 - 25 1 - 1 4.0 - 4.0 Totals 30 — 30 1 — 1 3.3 — 3.3 Drugs— Camphorated Oil — 3 3 - - - - - - Cascara Sagrada — 4 4 - - - - - - Citrate, Iron and Quinine —• 2 2 - - - - - - Easton's Syrup — 1 1 - - - - - - Friar's Balsam — 1 1 - - - - - - Glucose — 1 1 - - - - - - Glycerine — 3 3 - - - - - - Glycerine of Borax — 4 4 - - - - - - Glycerine of Phenol — 1 1 - - - - - - Glycerine of Thymol — 4 4 - - - - - - Ground Ginger — 10 10 - - - - - - Hydrogen Peroxide — 1 1 - - - - — — Hypophosphites — 1 1 - - - - - - Linseed, Crushed — 1 1 - 1 1 - 100.0 100.0 Lotion, Eve — 1 1 - - - - - - Lozenges and Tablets — 14 14 - - - - - - Oil, Almond — 2 2 - - - - - - Oil, Castor — 2 2 - - - - - - Oil, Cod Liver — 5 5 - - - - - - Oil, Eucalyptus — 2 2 - - - - - - Oil, Halibut Liver — 2 2 - - - - - - Ointment, Boric — 5 5 - 1 1 - 20.0 20.0 Ointment, Mercury — 1 1 - - - - - - Ointment, Mercuric Nitrate — 2 2 - - - - - - Ointment, Zinc — 5 5 - - - - - - Paraffin, Liquid — 5 5 - - - - - - Carried forward — 83 83 - 2 2 - 1.7 1.7 55 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 - 83 83 - 2 2 — 1.7 1.7 Parrish's Food - 4 4 - - - - - - Powder, Gregory's - 4 4 - - - - - - Powder, Liquorice - 7 7 - - - - - - Powder, Seidlitz - 4 4 - - - - - - Sal Volatile - 3 3 - - - - - - Solution of Iodine - 4 4 - - - - - - Tincture, Nux Vomica - 1 1 - - - - - - Tincture, Quinine - 2 2 - - - - - - Turpentine, Liniment — 1 1 - - - - - - Totals — 113 113 — 2 2 - 1.7 1.7 Other Articles— Arrowroot - 3 3 - - - - - - Baking Powder - 4 4 - — — - — — Barley - 3 3 - - - - - - Beverages, etc. - 13 1.3 - - - - - - Cake and Biscuits - 11 11 — — - — — Chocolate Powder - 1 - - - - - - - Coffee Mixtures, etc - 5 5 - - - - - - Cornflour - 2 2 - - - - - - Dripping - 6 6 - - - - - - Cooking Fat - 3 3 - - - - - - Fish — 5 5 - - - - - - Fish, Canned - 35 35 - 3 3 - 8.5 8.5 Fish Paste - 12 12 - - - - - - Fruit, Canned - 14 14 - - - - - - Fruit, Dried - 49 49 - - - - - - Honey - 4 4 - — — — — — Ice Cream - 2 2 - - - - - - Jellies - 9 9 - - - - - - Lemonade Powder, etc - 8 8 - - - - - - Lemon Curd - 1 1 - - - - - - Meat - 25 25 - - - - - - Meat, Canned - 3 3 - - - - - - Meat Extract — 1 1 - - - - - - Meat Pies — 8 8 - - - - - - Mincemeat — 9 9 - - - - - - Olive Oil — 7 7 - - - - - — Pea Flour — 1 1 - - - - - - Pepper — 8 8 - — — - - — Pickles and Sauces — 13 13 - — — — — - Powder, Custard — 3 3 - - - - - - Preserved Vegetables — 15 15 - — — - — — Rice — 6 6 - — — - — — Sago - 4 4 - — — — — — Sausages, etc 4 45 49 3 6 9 750 13.3 18.3 Soups — 8 8 — — — - - - Spices and Condiments - 62 62 - - - - - - Suet — 6 6 — — — - - - Tapioca — . 2 2 — — '— - - - Treacle and Syrup — 1 1 — — — - - - Wheat Preparations — 4 4 - - - - - - Wines, Non-alcoholic — 1 1 — — - - - - Totals 4 422 426 3 9 12 75.0 2.1 2.8 H2 56 THE FOOD AND DRUGS (ADULTERATION) ACT, 1928, THE PUBLIC HEALTH (PRESERVATIVES, ETC., IN FOOD) REGULATIONS, THE PUBLIC HEALTH (CONDENSED MILK) REGULATIONS, 1923 AND 1927, THE PUBLIC HEALTH (DRIED MILK) REGULATIONS, 1923 AND 1927, AND THE ARTIFICIAL CREAM ACT, 1929. RESULTS OF PROSECUTIONS. Sample. Nature and extent of Adulteration. Result. 238 Chipolata Sausages 390 parts per million Sulphur Dioxide £1, with £2 2s. 0d. Costs. Preservative, without declaration. 469 Butter (with scone) 20% Margarine £2, with £5 5s. 0d. Costs. 508 Pork Sausages 240 parts per million Sulphur Dioxide Summons dismissed under Preservative, without declaration. Probation of Offenders Act, with £3 3s. Od. Costs. 598 Whisky 4 degrees deficient in Proof Spirit £1, with £1 ls. Od. Costs. 660 Beef Sausages 420 parts per million Sulphur Dioxide £2, with £2 2s. 0d. Costs. Preservative without declaration. 784 Milk 38% deficient in milk fat £2, with £2 2s. 0d. Costs. Summons against Partner dismissed under Probation of Offenders Act. SUMMARY. Total Fines £8 0 0 Total Costs £15 15 0 BACTERIOLOGICAL AND CHEMICAL EXAMINATION OF MILK ON ARRIVAL FROM THE COUNTRY INTO THE CITY. Since 1904, when the practice was first instituted, series of samples of milk arriving in the City of London from the country have been collected at the several termini within the City and have been the subject of report. In March and April, 1937, in continuation of this practice, 24 samples were collected at Liverpool Street on arrival by train. These samples were submitted to Dr. Garrod, the City Bacteriologist, for bacteriological examination and investigation as to the presence of dirt, and a duplicate of each sample was submitted to Mr. A. J. C. Lickorish, the Public Analyst for chemical examination. The samples were sent from different farms situate in the following counties :— Suffolk 12 Essex .... .... .... .... .... 3 Hertfordshire : 9 The following is a copy of a report which Dr. Garrod has submitted on the results of his investigations :— » • No. Date. Dirt. Result of Guinea Pig Inoculation. 1 24th March Small trace Negative. 2 24th March Trace Negative. 3 24th March Trace Negative. 4 24th March Clean Negative. 5 24th March Clean • ... Negative. 6 24th March .... Small trace .... Negative. 7 28th March .... Clean Negative. 8 28th March . Small trace . Negative. 9 28th March Trace' Doubtful (died 11 /4/38). 10 28th March Small trace Negative. 11 28th March . Clean Negative. 12 28th March Large trace Negative. 13 31st March Trace Negative. 1 14 31st March Trace Negative. 15 31st March ..." Small trace Negative. 16 31st March .... Trace Negative. 17 31st March .... Small trace Negative. • 18 31st March .... Small trace Negative. • 19 4th April .... Clean Negative. 20 4th April .... Small trace Negative. 21 4th April Small trace Doubtful (died 18 /4/38). 22 4th April .... Small trace .... Negative. 23 4th April .... Clean Negative. 24 4th April ... Small trace .... Negative. 57 For the purposes of comparison, the following summary of results since 1904 is here inserted:- Percentage showing Percentage showing Year. Tuberculous Infection. Year. Tuberculous Infection. 1904 7.7% 1923 2.6% 1905 9.1% 1924 12.8% 1906 8.0% 1925 2.4% 1st Series. 1907 8.3% 2.4% 2nd Series. 1909 12.5% 1st Series 1927 4.88% 4.7% 2nd Series. 1928 8.3% 1910 6.25% 1929 5.1% 1912 6.6% 1930 4.2% 1913 10.4% 1931 9.5% 1914 10.2% 1932 9.1% 1915 8.5% 1933 11.1% 1917 4.2% 1934 8.3% 1919 14.8% 1935 0.0% 1921 24.2% 1st Series. 1936 8.3% 26.3% 2nd Series. 1937 4.2% 12.5% 3rd Series. 1938 0.0% 1922 9.5% From the foregoing it will be seen that each sample of milk collected has produced negative results so far as the presence of tubercle bacilli is concerned. This is only the second occasion on which examination has indicated the absence of this bacillus. So far as the presence of dirt was concerned the samples proved satisfactory. The chemical examination undertaken by the Public Analyst showed that every sample conformed to the required standard. 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 512 persons, compared with 557 in 1937. 90 per cent. are adults and 10 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 1938, 100 persons, as compared with 90 in 1937 (92 per cent. adults and 8 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 1938, 66 persons, as compared with 69 in 1937 (82 per cent. adults and 18 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 678. The number of births was 7, viz.:4 males and 3 females. The birth-rate was 10 3 per 1,000. 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 1938 was 14.8 per 1,000 per annum. For the purposes of comparison of birth and death rates, the population in the whole of these dwellings has been included in the calculation, as probably representing a class homogeneity. 58 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 1938. Name of Block. Births. Mortality from all Causes at subjoined ages. Males. Females. At all ages. Under 1 year. 1 and under 5 5 and under 15 15 and under 25 25 and under 65 65 and upwards. NORTH BLOCK 1 - - - - - - - - SOUTH — — 4 - - — — 1 3 KING'S l — 2 1 - - - 1 — QUEEN'S 2 l 2 - - - - - 2 PRINCE'S — — 1 — - — — 1 — BEARSTED HOUSE — 1 - - - - - - - DUTTON — 1 1 - - - - 1 - Totals 4 3 10 1 — — - 4 5 The baths, provided for the use of tenants of these Buildings, which were opened in May, 1904, continue to be extensively used, the number of persons bathing during 1938 being 14,923, of whom 5,987 were males and 8,936 were females. The accompanying table is compiled from the monthly records of attendances at the baths:— record of attendances at the baths, artizans' dwellings. Month. Sex. Total. Males. Females. Children. Adults. Children. Adults. January 98 347 120 535 1,100 February 97 323 134 513 1,067 March 135 380 133 604 1,252 April 134 413 146 642 1,335 May 107 394 133 667 1,301 June 131 168 135 711 1,145 July 103 464 121 777 1,465 August 88 473 79 586 1,226 September 145 443 139 615 1,342 October 112 380 131 577 1,200 November 97 428 109 608 1,242 December 105 422 117 604 1,248 Totals 1,352 4,635 1,497 7,439 14,923 59 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 180 - 5 10 February 148 - 3 13 March 147 6 1 8 April 134 - 21 9 May 189 - - 4 June 149 - - 10 July 129 - 3 10 August 160 - - 7 September 176 - - 7 October 167 2 3 8 November 157 — - 13 December 121 — 2 15 Totals 1,857 8 38 114 MIDDLE DISTRICT—Inspector G. H. Fowler. Month. Premises Inspected. Orders issued. Notices served. Improvements effected. January 180 1 1 12 February 172 4 3 18 March 141 4 4 20 April 186 3 4 16 May 146 1 2 19 June 164 1 2 12 July 123 1 1 8 August 62 - - 13 September 155 - - 18 October 147 - - 12 November 153 1 1 18 December 178 - 2 13 Totals 1,807 16 20 179 EAST DISTRICT—Inspector G. E. Harrington. Month. Premises Inspected. Orders issued. Notices served. Improvements effected. January 185 4 4 10 February 175 3 3 11 March 149 1 17 14 April 195 12 2 12 May 178 1 1 15 June 190 — 1 5 July 166 — 2 11 August 203 2 3 13 September 120 1 2 10 October 144 2 2 7 November 141 2 3 6 December 160 — 3 12 Totals 2,006 28 43 126 THE FOREGOING ARE SUMMARISED AS UNDER District. Number of Inspections made. Orders issued. Notices served. Improvements effected. West 1,857 8 38 114 Middle 1,807 16 20 179 East 2,006 28 43 126 Totals 5,670 52 101 419 60 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, was 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 ccompanying table:— District. Number of Houses on Register. Number of Lodgers. Number of Tenements. Average Number of persons per Tenement. Cleansing Notices Served. West 23 148 83 1.8 21 Middle — — — — — East 16 111 65 1.7 16 Total 39 259 148 1.7 37 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 37 notices during 1938. In addition to the foregoing, there are twelve blocks of Dwellings let out in tenements, but not placed on the Register for the reason that each holding is "self-contained," it having been decided in a Court of Law that in these circumstances they are not subject to the Byelaws for houses let in lodgings, or occupied by members of more than one family:— Name and situation of Artizans' Block Dwellings. No. of Tenements. No. of Inhabitants. One Room. Two Rooms. Three Rooms. Four Rooms. Five Rooms or over. WEST DISTRICT. Albion Buildings, No. 21, Bartholomew Close .... 10 .... .... .... 16 Albion Buildings, No. 22, Bartholomew Close.... 10 .... .... .... 13 Bartholomew House, Bartholomew Close 20 .... .... .... .... 15 Dean Street Blocks, Fetter Lane— Block A 5 2 1 .... .... 13 „ B 2 3 .... 1 .... 15 „ C 4 4 .... .... .... 10 „ D 4 4 .... .... .... 14 „ E 6 3 .... .... .... 10 „ F 6 2 1 .... .... 17 St. Ann's Chambers, Ludgate Hill 3 8 1 1 1 26 Bloomfield House, Snow Hill .... 16 .... 1 1 53 Total (Six " Blocks ") 50 62 3 3 2 202 MIDDLE DISTRICT. Bridgewater House, Fann Street .... 9 .... .... 1 13 City Buildings, Moor Lane 2 20 11 .... .... 59 Total (Two "Blocks ") 2 29 11 .... 1 72 EAST DISTRICT. Harrow Place and Stoney Lane— North Block .... 48 8 .... .... 140 South „ 5 22 13 .... .... 73 Prince's „ 5 50 .... .... .... 114 Queen's „ 5 40 5 .... .... 109 King's ,, 8 16 16 .... .... 66 Barker's Buildings, Catherine Wheel Alley, Bishopsgate .... 1 2 2 .... 14 Bearsted House, Hutchison Street .... .... 3 16 .... 100 Dutton House, New Street .... .... 9 2 1 66 Total (Four " Blocks ") 23 177 56 20 1 668 These twelve blocks contain 440 tenements, and are inhabited by 944 persons—an average of 2.2 persons to each tenement. 61 The following table is included in this Report in accordance with the request contained in the letter from the Ministry of Health, dated 25th October, 1938, 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) 232 (b) Number of inspections made for the purpose 450 (2) (a) Number of dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 48 (b) Number of inspections made for the purpose 62 (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 65 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 68 3. Action under Statutory Powers during the Year:— A.—Proceedings under sections 9, 10 and 16 of the Housing Act, 1936 (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 46 (2) Number of dwelling-houses in which defects were remedied after service of formal notices:— (a) By owners 8 (b) By Local Authority in default of owners Nil. C.—Proceedings under sections 11 and 13 of the Housing Act, 1936: (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 12 of the Housing Act, 1936 : (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. 4. Housing Act, 1936.—Part IV.—Overcrowding: A.— (i) Number of dwellings overcrowded at the end of the year 29 (ii) Number of families dwelling therein 29 (iii) Number of persons dwelling therein 139 B.—Number of new cases of overcrowding reported during the year. 2 C.— (i) Number of cases of overcrowding relieved during the year 21 (ii) Number of persons concerned in such cases 87 D.— Particulars of any cases in which dwelling-houses have again become overcrowded after the Local Authority have taken steps for the abatement of overcrowding — E.— Any other particulars with respect to overcrowding conditions upon which the Medical Officer of Health may consider it desirable to report Common Lodging House, 116, Middlesex Street.—Opened on the 7th February, 1906, and known as the "Salvation Army Working Men's Hotel and Shelter," this is now the only common lodging house in the City. Periodical inspections have been made and such remedial works as required executed. The premises are well conducted and maintained in a generally satisfactory condition, and are registered in the name of the Salvation Army Trustee Co. I 62 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 235 plans were submitted with regard to proposed reconstruction of water-closets or drains in the City. . . Of these, 192 were approved, 33 revised and approved, and 10 not approved. /Street Gullies.—The gradual substitution of properly trapped gullies for those formerly existing has greatly reduced the number of complaints received of offensive smells arising from these appliances, especially in warm weather. In some cases this nuisance was doubtless due to want of flushing, but in the majority faulty construction was the cause of the trouble. The City Engineer has given special attention to this matter for several years past, and his action in replacing the old pattern gullies with those of a more up-to-date design will, I hope, eventually lead to a complete abatement of the evil. 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 88 cases investigated in 1938, defects were found in five instances. Legal Proceedings.—During the year, 52 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 and Smithfield Market, 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 nature of the trade carried on, especially during hot weather. Defective Conditions to Sewer.—During the year, 12 reports were received from the City Engineer respecting the condition of connections between the drains of certain City houses and the public sewer. Investigations showed that it was necessary to reconstruct all of these connections. As a result of the inspection of the internal drainage system of these premises, reconstruction or alteration was found, necessary in five 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. A. J. Eager, the Director of Public Cleansing:— Collection and Disposal of Refuse. House and Trade Refuse in the principal streets is collected by 9 a.m., and in certain other main streets by 10 a.m. (from receptacles placed on the kerb), in accordance with the Regulations of the Ministry of Transport. After 10 a.m. refuse is collected from the interior of premises in the remainder of the City. All refuse is conveyed by motor waggons or horse-drawn vans to Lett's Wharf. The Transport of the Cleansing Department is gradually being mechanised, and it is anticipated that the whole of the refuse collection will be carried out by motor waggons in the near future. The refuse is tipped into the contractors' barges at 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 are 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 the fixing of fire hose. 63 No rats have been seen at the tip for several 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 any time. During the year ended 31st December, 1938, the tonnage of refuse collected was as follows:— House, trade and market refuse 41,264 Street and gully refuse 11,989 Total tons 53,253 Forty-seven per cent. of the refuse was collected by horse vans and 53 per cent. by motor waggons. It is estimated that the above total tonnage is equal to over 200,000 cubic yards. 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 or flushed, as required. During the year 1938,65,211 gullies were cleansed and 26,712,576 gallons of water used for cleansing streets, courts and gullies. 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 smoke-laden atmosphere. These are cleansed or limewashed twice a year under the direction of the Director of Public Cleansing. Of the places so dealt with during 1938, 19 were situated in the East District, 24 in the Middle District, and 17 in the West District. bye-laws in regard to water closets, etc. The Bye-laws in regard to Water Closets, etc., which have been made under the City of London (Various Powers) Act, 1900, have been in operation since 1909. The passage of time has rendered these Bye-laws out of date, and a new set, made under the City of London (Various Powers) Act, 1926, was confirmed by the Ministry of Health in April, 1938. eradication of bed bugs. (1) There were no Council houses infested with bed bugs. Of private houses, 12 were found to be infested, and these 12 were disinfested. (2) Fumigation with SO2, combined with loosening of skirtings, etc., and the use of a blow lamp where necessary and practicable, were the methods employed for freeing infested houses. (3) Disinfestation of the belbngings of tenants before removal to other property is carried out on request. (4) Disinfestation is carried out by the Local Authority. (5) Instruction and advice is given by the responsible inspector in the hope of preventing infestation or re-infestation after cleansing. swimming baths. There is only one swimming bath in the City of London and that is under the control of St. Bride's Foundation. It is always conducted in a satisfactory manner and the purification of the water has been secured by the installation of the Royles system. 12 64 HOUSING ACT, 1936. PART 4. OVERCROWDING. During 1938 the overcrowding survey, under Part 4 of the Housing Act, 1936, was completed, with the exception of a number of licensed premises. Two hundred and twenty-three letters were addressed to landlords and employers of resident housekeepers in the City, pointing out their responsibilities under Section 62 of the Housing Act, 1936. In addition, 69 visits were made to houses where landlords had failed to apply for the "Permitted Number of Persons." This resulted in applications being received from landlords asking for the "Permitted Number of Persons "in respect of 333 dwellings. The Act required that a Local Authority, upon the application of the landlord or the occupier of a dwelling-house, shall inform them in writing of the "Permitted Number of Persons" in relation to the house. In order to obtain these particulars, it was necessary to measure 208 dwellings. It is apparent that information with regard to occupiers and their families change from time to time, and in order to trace additional cases of overcrowding, and to keep the office records to date, 383 visits have been made to check the number of occupants. Twelve visits were made to dwellings on notification of change of occupier. Section 62 (1) lays down that the landlord of a dwelling shall enter a summary in the rent book of the "Permitted Number of Persons" in relation to the house. In order to ascertain whether this part of the Act was being carried out, 20 visits were made to dwellings, when the rent books were inspected. Ninety-eight re-visits were made to overcrowded dwellings and, as a result, 21 cases of overcrowding were found to have been abated by reason of vacation of dwelling, additional rooms being provided, size of families in occupation diminishing. Two additional cases of overcrowding occurred by reason of children attaining the age of ten years and consequently requiring the accommodation for a whole unit. Section 61 of the Housing Act, 1936, gives power to a Local Authority, in exceptional circumstances, to issue a licence to the occupier of a dwelling, authorising him to permit such number of persons in excess of the " Permitted Number of Persons," as may be specified in the licence, to sleep in the house. During the period under review, four such licences were issued. Two of these licences were withdrawn on the overcrowding being abated. It was thought necessary to make an inspection of the 430 Licensed Premises in the City, to ascertain the conditions under which the staffs lived. To date 33 premises have been inspected and, with the exception of one case of overcrowding, the living conditions are satisfactory. All the rooms used for the purpose of human habitation have been measured and the " Permitted Number of Persons " recorded in the office records. Ninety-five miscellaneous visits have been carried out and four Special Reports made to the Worshipful The Public Health Committee. SECTION 12. UNDERGROUND ROOMS. The above Section of the Housing Act, 1936, deals with the closure or reconstruction of underground rooms, which are unfit for human habitation. During 1938 inspection of the City was made to discover underground rooms used for the purpose of human habitation. As a result of these inspections, 58 underground rooms were found. Eleven underground dwellings were re-visited and plans of the 16 unfit rooms were . prepared. As a result of these inspections, it was found that 11 of the rooms were capable of reconstruction which, if carried out, would render the rooms fit for human habitation by complying with the standards of the Housing Act, 1936. Consequently the owners were interviewed, and as a result five of the rooms have been reconstructed and are now being used for the purpose of human habitation. In the case of the remaining six rooms, the owners decided to close them for the purpose of human habitation. The occupants have vacated the premises, which are at present being used as offices. The reconstruction and/or closure of the 11 underground rooms mentioned above enabled five cases of overcrowding to be abated. One hundred and twenty-five visits were made in connection with the above work. Five Special Reports have been made to the Worshipful The Public Health Committee. 65 UNFIT DWELLINGS. During the period under review 32 visits were made to seven unfit dwellings in the City. The owners of these dwellings are willing to close the dwellings for the purpose of human habitation on alternative accommodation being provided for the occupants. The unfit dwellings provide accommodation for seven families, with a total number of occupants of 15. PROVISION OF ALTERNATIVE ACCOMMODATION. The abatement of overcrowding and the closure of unfit dwellings in the City is dependent upon the provision of suitable alternative accommodation for the occupants. The question of re-housing all the overcrowded and insanitarily housed families in a proposed block of flats in or near the City b6undary was investigated. A site sufficient to meet the re-housing requirements of the City was found on the eastern boundary of the City, but certain difficulties therewith prevented development. It was then decided to utilize, as they become vacant, all City Corporation dwellings situated inside and outside 'the City. At the present time these dwellings are being offered to overcrowded and insanitarily-housed families. PIGEONS. The Public Health Committee of the City Corporation have frequently urged upon me the necessity for increasing the efforts which are made to combat the nuisance caused by the congregation of pigeons in the City area, and have criticised the fewness of the birds which have been caught by the agents appointed under the powers granted by the Public Health (London) Act, 1936. Personally, I have felt that the number reported as caught has not contributed materially towards a minimization of the nuisance, and I have come to the conclusion that the problem is one which cannot be satisfactorily solved by the existing arrangements. City activity in this matter dates so far back as 1903, when the then Medical Officer of Health caused an investigation to be undertaken into the nuisance which was caused by these birds, and after satisfying himself that they were a very real nuisance, he gave thought as to what steps should be taken to combat the trouble. He found that it was impossible for the Corporation to take action as ownership of the birds could not be ascertained, and although they appeared, to belong to nobody in particular, they might be protected by the Larceny Act of 1861, which imposes a penalty for unlawful killing of any house dove or pigeon. Subsequently an Act of Parliament was passed in 1927, which empowered the Corporation, among other Metropolitan Authorities, to reduce the numbers, but in order to obtain its satisfactory progress through Parliament, undertakings had to be given that ringed or homing pigeons should not be destroyed, but when caught, returned to the Homing Union. To this course there could not be any objection, but a further and very important condition was imposed, and that was that the birds should not bp shot or killed in the public street, but should be caught and subsequently killed painlessly. These conditions practically restricted the catching of these birds to two methods—i.e., either hand catching or trapping. At first a certain amount of success attended the efforts of the professional pigeon catcher, but, unfortunately, publicity resulted in interference by well-intentioned but misguided persons, and such interference has now reached such a degree of intensity that the professional finds very considerable difficulty in catching any birds at all. In the hope of accelerating destruction, certain members of the Corporation staff have been allotted to this duty, but here, again, opposition has rendered their efforts of very little avail. There are four factors of material importance in connection with this matter of reduction of the pigeon population in the City. One is the nesting facilities provided by certain buildings, such as the belfries of City churches, and this I have attempted to deal with by an approach to the responsible parties, with the suggestion that pigeon proofing by the introduction of wire netting be attempted; secondly, feeding and interference by visitors and others; thirdly, the lack of uniformity and co-operative effort throughout not only Metropolitan London, but Greater London; and, fourthly, the restriction imposed by the promise given not to use shooting. In regard to the first, as I have already said, an attempt has been made-by this Department to impress upon the responsible persons the desirability of proofing, but this, unfortunately, has not met with the ready acceptance which I had hoped, and as at the moment, there is no power to demand these steps, no further action in this direction seems possible. 66 As regards the second, I fear that there is little prospect of securing legislation forbidding this practice. As far as the third point is concerned, the City Corporation have approached the local authorities concerned and directed their attention to the desirability of concerted and cooperative action. In regard to shooting, I am given to understand that shooting with a special type of gun, which, I am assured, is harrpless to human beings and will not damage property or break glass, has been found to be remarkably effective. Unfortunately, the promise already referred to prevents the use of this method. The principal places of congregation of these birds in the City are such places as St. Paul's Cathedral, Guildhall Yard, Royal Exchange, Bank of England, Carpenters' Hall, the several railway stations, markets, etc. It will be seen, therefore, that the City is generally infested. The contractor reports that he has caught 226 birds and, in addition, 769 have been caught by your own Officers, a total of 995 birds. EXHUMATION AND RE-INTERMENT OF BODIES AT THE CITY OF LONDON CEMETERY. When any application for the exhumation of any body interred at the City of London Cemetery, at Ilford, is received by the Home Office, permission has, in the past, invariably been accompanied by the provision that the exhumation, and subsequent re-interment, if in the same cemetery, shall be carried out under the supervision of your Medical Officer of Health. During the year three such exhumations and re-interments were effected, and each was carried out in the early hours of the morning, in the presence of relatives and under my supervision. A recent decision of the Home Office will, except in special circumstances, relieve your Medical Officer of this obligation in future exhumations. DISCOVERY OF HUMAN REMAINS. Byron House, Fleet Street and Salisbury Court ; St. Martin's-le-Grand ; 69, Old Broad Street ; News Chronicle Offices, Bouverie Street. As so frequently happens in the City of London, excavation preparatory to the erection of large blocks of buildings has resulted in the exhumation of human remains. In each of the above-mentioned four cases these remains were very small in number and consisted mainly of broken pieces of bone which had obviously been disturbed at some previous date. They were all old and, with the approval of the Coroner and the City Police, and in accordance with the usual practice, they were re-interred on the respective sites with due reverence. FACTORIES ACT, 1937, AND PUBLIC HEALTH (LONDON) ACT, 1936 (SECTION 181). Factories and Workplaces.—The premises upon the Register number 4,037, in which are included 8,506 workrooms, &c. There were served 1,366 notices during the year for varioils purposes under the Acts. The number of Factories and Workplaces at present Registered is as follows :— Registered Places. Workrooms, &c., in Registered Places. FACTORIES (With Power) 1,698 4,124 „ (Without Power) 1,108 1,545 WORKPLACES Kitchens of Restaurants and Tea Rooms 732 1,612 Kitchens of Licensed Premises 286 854 Stables 6 63 Other places 207 308 4,037 8,506 The following is a Summary of Inspections of separate workrooms, &c., during the year:— Workshop Inspectors Woman Inspector. Totals. FACTORIES (With Power) 1,049 1,049 „ (Without Power) 359 359 WORKPLACES 936 390 1,326 67 The following is a Summary of Inspections of separate workrooms since 1929:— FACTORIES (With Power). Factories Inspectors. Woman Inspector. Totals. 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 1936 1,119 - 1,119 1937 1,100 - 1,100 1938 1,049 - 1,049 FACTORIES (Without Power). Factories Inspectors. Woman Inspector. Totals. 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 1936 402 - 402 1937 321 - 321 1938 359 - 359 WORKPLACES. Factories Inspectors. Woman Inspector. Totals. 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 1936 808 812 1,620 1937 897 496 1,393 1938 936 390 1,326 Bakehouses.—The following is a list of Bakehouses registered in the City:— ABOVEGROUND BAKEHOUSES. † 15/19, Artillery Lane. †*85, Middlesex Street. †*280, Bishopsgate. † 12 and 13, Widegate Street. UNDERGROUND BAKEHOUSES. † 188, Aldersgate Street. †*122, Middlesex Street. 8, Copthall Avenue. †*51, Stoney Lane. †*67, Farringdon Street. † 68, St. Mary Axe. †*Great Eastern Railway Hotel. SUMMARY. Aboveground Bakehouses 4 Underground Bakehouses 7 — 11 * These have been established at least 50 years. † 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 City firms were duly received without the necessity for legal proceedings. In 31 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. 68 SUMMARY OF WORK DONE UNDER THE FACTORIES' ACT, 1937, AND THE PUBLIC HEALTH (LONDON) ACT, 1936, &.C. INSPECTIONS. East District. Middle District. West District. Totals. Factories (With Power) Initial Inspections (Tenancies) 9 71 57 137 Do. Initial Inspections (Workrooms) 10 103 103 216 Do. Periodical Inspections (Tenancies) 12 195 176 383 Do. Periodical Inspections (Workrooms) 16 287 499 802 Do. Re-inspections (Sanitary Works, &c., in hand) 34 258 108 400 Factories (Without Power) Initial Inspections (Tenancies) 8 35 34 77 Do. Initial Inspections (Workrooms) 8 43 54 105 Do. Periodical Inspections (Tenancies) 5 62 118 185 Do. Periodical Inspections (Workrooms) 7 89 156 252 Do. Re-inspections (Sanitary Works, &c., in hand) 15 77 66 158 Workplaces, Initial Inspections (Tenancies) — — — - Do. Initial Inspections (Workrooms) — — — — Do. Periodical Inspections (Tenancies) — — 11 11 Do. Periodical Inspections (Workrooms) — — 14 14 Do. Re-inspections (Sanitary Works, &c., in hand) — 1 2 3 Bakehouses, Periodical Inspections (Tenancies) 16 5 4 25 Do. Periodical Inspections (Workrooms) 23 6 4 33 Do. Re-inspections (Sanitary Works, &c., in hand) 24 14 6 44 Kitchens of Restaurants, See.— Initial Inspections (Tenancies) 4 12 7 23 Initial Inspections (Workrooms) 7 25 12 44 Periodical Inspections (Tenancies) 69 100 75 244 Periodical Inspections (Workrooms) 162 218 137 517 Re-inspections (Sanitary Works, &c., in hand) 95 172 97 364 Kitchens of Licensed Premises— Initial Inspections (Tenancies) 1 1 1 3 Initial Inspections (Workrooms) 2 3 2 7 Periodical Inspections (Tenancies) 30 42 41 113 Periodical Inspections (Workrooms) 111 141 102 354 Re-inspections (Sanitary Works, &c., in hand) 28 49 66 143 Factories notified by H.M. Inspector 3 14 8 25 General complaints received 8 12 10 30 Miscellaneous visits 16 104 129 249 FACTORIES, WORKPLACES. KITCHENS OF RESTAURANTS, &C KITCHENS OF LICENSED PREMISES. Totals. DEFECTS FOUND. East District. Middle District. West District. East District. Middle District. West District. East District. Middle District. West District. Want of Cleanliness 24 71 85 56 45 56 24 14 49 424 Want of Ventilation - 2 1 3 2 — 1 1 — 10 Overcrowding - - 1 - - - - - - 1 Unreasonable Temperature - - - - - - - - - - Want of Drainage of Floors - - - - - - - - - - Want of Lavatory Accommodation - - - - - - - - - - Food improperly stored — — — 2 2 — — — — 4 Storage Cistern defective 1 19 17 3 2 1 2 2 3 50 Accommodation for Refuse 3 17 6 8 11 5 2 1 — 53 Accumulation of Refuse 6 22 1 13 13 9 2 1 5 72 Sanitary Accommodation. Insufficient (Tenancies) 1 2 2 — — 2 — — 1 8 Unsuitable (Do.) 2 11 13 1 1 2 — — 1 31 Defective (Do.) 5 96 12 5 9 3 1 5 2 138 Do. (No. of Conveniences)* 5 96 12 5 9 3 1 5 2 138 Not separate for Sexes (Tenancies) 1 4 - 2 1 — — — — 8 Other Nuisances 3 14 23 14 11 18 14 5 31 133 Total Defects found 46 258 161 107 97 96 46 29 92 932 * Figures not included in total defects found or remedied. 69 FACTORIES, WORKPLACES. KITCHENS OF RESTAURANTS, &c. KITCHENS OF LICENSED PREMISES. DEFECTS REMEDIED. East District. Middle District. West District. East District. Middle District. West District. East District. Middle District. West District. Totals. Want of Cleanliness 21 79 82 43 52 69 19 12 44 421 Want of Ventilation — 2 1 — 2 — — 2 1 8 Overcrowding - - - - - - - - - - Unreasonable Temperature - - - - - - - - - - Want of Drainage of Floors - - - - - - - - - - Want of Lavatory Accommodation - - - - - - - - - - Food improperly stored — — — 2 2 — — — — 4 Storage Cistern defective — 20 18 3 2 — 2 2 2 49 Accommodation for Refuse 2 15 6 7 7 5 2 1 — 45 Accumulation of Refuse 5 18 5 11 13 10 1 1 3 67 Sanitary tion. Insufficient (Tenancies) 1 2 2 — — 2 — — 1 8 Unsuitable (Do.) 2 20 14 — 2 3 — — 1 42 Defective (Do.) 2 76 13 2 6 — 1 2 3 105 Do. (No. of Conveniences)* 2 76 13 2 6 — 1 2 3 105 Not separate for Sexes (Tenancies) 1 6 — 2 2 — — — 1 12 Other Nuisances 3 15 25 9 12 29 6 5 28 132 Total Defects remedied 37 253 166 79 100 118 31 25 84 893 ACTION TAKEN. East District. Middle District. West District. Totals. Matters referred to H.M. Inspector— Nuisances remediable by H.M. Inspector — 2 — 2 Failure to affix Abstract 2 17 2 21 Matters referred by H.M. Inspector— Notified by H.M. Inspector 6 5 1 12 Reports sent to H.M. Inspector 6 5 1 12 Notices served- Factories—(With Power) Intimation 11 54 5 70 Statutory 1 6 - 7 Factories—(Without Power) Intimation 2 8 10 20 Statutory — 1 1 Workplaces, &c.—Intimation — — - — Statutory ' — — — — Kitchens of Restaurants— Intimation 19 13 6 38 Statutory — 1 - 1 Kitchens of Licensed Premises— Intimation 1 2 4 7 Statutory — — 1 1 Prders required from Sanitary Committee 2 12 - 14 Certificates for Cleansing issued by Medical Officer of Health — 1 - 1 Matters referred to District Inspectors 2 7 4 13 Matters referred to Women Inspectors — — — — Matters referred to Factories Inspectors — — - — Cases reported for Legal Proceedings — - - — Legal Proceedings taken — — - — OUTWORK, AND THE INSPECTION OF OUTWORKERS' PREMISES, &c. Lists received from City Firms - — — 1,112 Names and Addresses, &c., received from other Authorities - — — 545 Names and Addresses transmitted to other Authorities - — — 7,630 Notices served on Employers - — — 1,221 Letters written, &c. - — — 31 Firms visited 13 29 16 58 Outworkers' Lists not kept 2 13 5 20 Do. not sent 2 13 6 21 Infectious Disease occurring in Outworkers' Premises — — — — Registered Factories and Workshops at which Outwork is received— Inspections 4 55 29 88 Defects found 2 32 10 44 Defects remedied 2 32 10 44 "Places from which work is given out "— Inspections 7 49 46 102 Defects found 7 27 6 40 Defects remedied 7 27 6 40 * Figures not included in total defects found or remedied. K 70 WOMAN INSPECTOR. Premises at which Outwork is received Inspections Total. l Defects reported and appropriate action taken — Premises which do not receive Outwork Inspections l Defects reported and appropriate action taken — Premises receiving Outwork (not registerable as Factories). Inspections 4 Defects reported and appropriate action taken - Underground Conveniences for Women Inspections 89 Defects reported and appropriate action taken 1 Railway Stations (Ladies' Rooms) (Inspections 26 Defects reported and appropriate action taken — Kitchens of Restaurants, &c. Initial Inspections (Tenancies) 3 Initial Inspections (Workrooms) 11 Periodical Inspections (Tenancies) 177 Periodical Inspections (Workrooms) 379 Re-inspections (Sanitary Works, &c., in hand) 152 Defects found 137 Notices Intimation (Verbal) 68 Statutory - Matters referred to District Inspectors 11 Matters referred to Factories 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. N umber 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 1936 1,140 1,294 8,551 9,845 1937 1,113 1,254 8,187 9,441 1938 1,069 1,222 7,622 8,844 71 FACTORIES ACT, 1937. FACTORIES, WORKPLACES AND HOMEWORK. 1.—Inspection of Factories and Workplaces. Including Inspections made by Sanitary Inspectors. Premises. Number of (1) Inspections. (2) Written Notices. (3) Occupiers Prosecuted. (4) Factories (With Power) 543 77 - Workshops (Without Power) 264 21 - Workplaces (other than Outworkers' premises) 11 — - Total 818 98 - 2.—Defects Found in Factories and Workplaces. Particulars. Number of Delects. Number of offences in respect of which Prose cutions were instituted. (5) (1) Found. (2) Remedied. (3) Referred to H.M. Inspectors. (4) Want of cleanliness 180 182 2 - Overcrowding 1 — — — Unreasonable temperature — — — — Inadequate ventilation 3 3 — - Ineffective drainage of floors — — — - Sanitary accommodation insufficient 5 5 — - unsuitable or defective 139 127 - — not separate for sexes 5 7 — — Other offences (not including offences relating to home work or offences under the Sections mentioned in the Schedule to the Ministry of Health (Factories and Workshops Transfer of Powers) Order, 1921, and re-enacted in the Third Schedule to the Factories Act, 1937) - - - - Total 333 324 2 — No instance of outwork in unwholesome premises under Section 111 of the Factories Act was reported. k2 72 3.—Home Work. NATURE OF WORK.* (1) OUTWORKERS' LISTS, SECTION 110. OUTWORK IN UNWHOLESOME PREMISES, SECTION 111. OUT-WORK IN INFECTED PREMISES, SECTIONS 109 AND 110 OF THIRD SCHEDULE. Lists received from Employers. Notices served on occu piers as to keeping of sending Lists. Prosecutions. Instances. (11) Notices served. (12) Prosecutions. (13) Instances. (14) Orders made (S. 110). (15) Prosecutions (Sections 109, 110). (16) Sending twice in the year. Sending once in the year. Failing to keep or permit inspection of lists. (9) Failing to send lists. (10) Lists. † (2) Outworkers.† Lists. (5) Outworkers. Contractors. (3) Workmen. (4) Contractors. (6) Workmen. (7) (8) Wearing Apparel— making, &c. 902 3,115 4,219 22 63 68 1,221 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) 80 228 190 4 16 1 Cables and Chains Anchors and Grapnels Cart Gear Locks, Latches and Keys Umbrellas, &c. 36 15 185 — — — Artificial Flowers 12 — 82 1 — 13 Nets, other than Wire Nets Tents Sacks Racquet and Tennis Balls Paper, &c., Boxes, Paper Bags 2 — 6 — — — Brush making 2 — 26 — — — Pea picking Feather sorting Carding, &c., of Buttons, &c. 4 — 51 — — — Stuffed Toys 2 — 17 - - - Basket making Chocolates and sweetmeats Cosaques, Christmas Crackers, Christmas Stockings, &c. 2 - 4 - - - Textile Weaving Lampshades Total 1,042 3,358 4,780 27 79 82 1,221 Nil. Nil. Nil. Nil. Nil. Nil. Nil. Nil. * If an occupier out work of more than one of the classcs specified in column 1, and subdivides his list in such a way as to show the number of workers in each class of work, the list should be included among those in column 2 (or 5 as The case may be) against the principal class only, but the outworkers should be assigned in columns 3 and 4 (or C and 7) into their respective classcs. A footnote should be added to show that this has been done. † The figures required in columns 2, 3 and 1 are the total number of the lists received from those employers who comply strictly with the statutory duty of sending two lists each year and of the entries of names of outworkers in those lists The entries in column 2 must necessarily be even numbers as there will be two lists for each employer—in some previous returns odd numbers have been inserted. The figures in columns 3 and 4 will usually be (approximately) double of the number of individual outworkers whose names are given, since in the February and August lists of the same employer the same outworker's name will often be repeated. 4.—Registered Factories. Factories on the Register (S. 8) at the end of the year, (1) Number. (2) Factories 2,795 Bakehouses 11 Total number of Factories on Register *2,806 73 * There were found to be 3,669 Workrooms, &c., in places Registered. 5.—Other Matters. Class. N umber. (1) (2) Matters notified to H.M. Inspector of Factories:— Failure to affix Abstract of the Factories Act, 1937 (S. 128) 21 Action taken in matters referred by H.M. Inspector (S. 9). Notified by H.M. Inspector 12 Reports (of action taken) sent to H.M. Inspector 12 Other — Underground Bakehouses (S. 54):— Certificates granted during the year 1 In use at the end of the year 7 Date, 31st December, 1938. (Signature) C. F. WHITE, Medical Officer of Health. Note.—The Factories Act, 1937 (S. 128), requires the Medical Officer of Health in his Annual Report to the District Council to report specifically on the administration of that Act in factories 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, workplaces, or homework. The duties of Local Authorities and the Medical Officer of Health under the Act of 1937 are detailed in the Home Office Memorandum of June, 1938. SHOPS ACTS, 1934. During the year 654 shops and warehouses were inspected and re-inspected, and defects found have been or are in course of being 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 registered 997 882 509 2,388 Number of shops inspected 184 154 11 349 Number of shops re-inspected 266 34 5 305 Number of shops re-visited 209 248 32 489 Number of defects found 178 123 22 323 Number of defects remedied 141 131 14 286 Number of intimations served 13 28 6 47 Number of statutory notices served 1 5 0 6 Number of complaints received 3 8 2 13 74 SYSTEMATIC INSPECTION OF OFFICES. Whenever possible, attention is given to the conditions under which office workers carry out their duties, but there still exist no powers which enable Corporation officers to conduct systematic inspection in the same way as they are empowered to do in factories and workshops. When information is received of undesirable conditions existing in offices, action can usually be taken under the Public Health (London) Act, 1936, but I am of opinion that the time has arrived when direct statutory powers should be given in this connection. I understand that the London County Council propose introducing legislation dealing with this matter at the first convenient opportunity. CITY MORTUARY. Bodies Received.—Post-Mortems and Inquests:— Bodies received at the Mortuary to await burial 69 Post-Mortem examinations made 19 Inquests held on bodies 60 Inquests held on fires 0 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. 1933 233,821 114 71 77 2 1934 243,939 121 81 69 2 1935 248,031 111 74 65 4 1936 170,726 103 62 55 3 1937 283,626 75 65 20 2 Average for previous 5 years 236,029 105 72 59 3 1938 173,375 69 60 19 0 Disinfection.—Trade.—In accordance with the requirements of the South African Government, the disinfection of second-hand clothing, prior to export to that country, has been carried on as usual. The following table gives the details of the work of disinfection carried out at the Disinfecting Station during the year in connection with the export trade:— Number of Certificates issued. Number of articles disinfected. Fees received by the Corporation. 449 165,499 £322 Other disinfection and cleansing work carried out during the year is as follows:— Disinfection.—Infectious Disease :— Articles disinfected after cases of infectious disease, &c. 1,917 Library Books, Papers, &c., disinfected 422 Public Vehicles—Electric Ambulance 1 Cells at Police Stations 0 Premises disinfected (including offices) 170 Lockers disinfected at request of General Post Office Authorities 116 Horsehair and Bristles (cases) 53 Cleansing of Persons Act, 1897:— Number of verminous persons bathed 150 Number of articles of clothing disinfected 1,845 Cleansing of School Children:— Total number of children cleansed 1,172 Number of articles of clothing disinfected 3,693 Books, &c., destroyed at request of owners 0 Beds, &c., destroyed at request of owners 16 Pigeons destroyed 995 75 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 1938 five bodies were placed in the apparatus, all of which were subsequently identified. disinfectants. The disinfectants and other chemicals in use in the Public Health Department and in other branches of the Corporation's service have, as in the past, been supplied under a contract prepared by your Medical Officer of Health. They are used for deodorising and denaturising unsound meat, disinfecting public conveniences, street gulleys, premises after infectious diseases, etc. Special attention was given to the thoroughfares in the vicinity of the Billingsgate and Smithfield Markets, the former of which presents certain difficulties in the matter of deodorisation in the summer months. Very few complaints were, however, received of offensive odours necessarily associated with the fish trade. In the interests of economy the practice of using a disinfectant fluid in conjunction with general street watering has been discontinued. RAT REPRESSION. Inspections under the Rats and Mice (Destruction) Act, 1919, have been carried out by Mr. G. A. Webber, one of the Sanitary Inspectors specially appointed to act as Rat Officer. It is not possible to give any indication of the number of rats caught in the City during any given period, although it may be said that, during the course of a year, the number would run into many thousands. The Black Rat type continues to provide the major problem in this area. Instances of Brown Sewer Rat infestation are comparatively rare. The majority of buildings in the City provide ample harbourage for the Black Rat type, and the enormous quantity of waste food and refuse accumulated during the course of each day, and its improper collection and storage by many tenants of buildings, offers a continuous supply of food. In many instances where complaint has been made to this Department, it has been found that the complainants themselves are to blame for the severity of the rat infestation of their properties because of their inattention to these important details. The powers given to a local authority by the Rats and Mice (Destruction) Act, 1919, are not sufficiently far-reaching, so far as the City is concerned. It is still the practice of this Department to recommend the employment of skilled rat-catchers, together with the introduction of all practicable incidental and structural rat-proofing, and although it is not possible to demand the introduction of these measures as a matter of routine by the exercise of our powers under the Act,, the acceptance of advice on these lines by harrassed tenants and owners of property has resulted in the successful disinfestation of many City buildings. 76 RATS AND MICE (DESTRUCTION) ACT, 1919. Details of Work Carried Out under the above Act for the Year. 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. Rat Catcher Employed. Poison Used. Traps. By City Engineer's Department. By M.O.H. Department. January 52 50 38 12 20 7 35 130 February 43 41 34 7 10 18 27 March 50 48 40 8 15 22 14 April 34 32 30 2 16 4 15 May 46 44 43 1 21 6 17 June 58 52 47 5 15 14 25 July 63 63 58 5 31 12 22 August September 44 38 35 3 16 6 18 October 52 49 45 4 20 9 27 November 48 44 42 2 15 10 18 December 35 35 34 1 12 4 19 Totals 525 496 446 50 191 112 237 130 77 The following figures have been supplied to me by the City Engineer:— Brick sewers reconstructed and in course of reconstructing 5 Disused sewers filled in and abolished 2 Brick sewers reinverted, pointed and repaired 24 Pipe sewers constructed, reconstructed and repaired 2 Miscellaneous repairs to sewers, drains, &c. 23 House drains constructed in connection with new buildings 20 Drains of existing buildings reconstructed 18 House drains partially reconstructed in connection with the part reconstruction and re- inverting of certain sewers 69 Gullies reconstructed 38 Gully drains reconstructed 93 Gully and house drains repaired 41 Disused gully and house drains bricked off 16 Number of rats destroyed by sewermen during year 635 Fifty-six pounds of rat poison were used in the sewers. A large number of dead rats were, doubtle'ss, carried away by the flow of water in the various sewers. 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, 105 persons were examined by your Medical Officer of Health during 1938. One hundred and two of these persons were reported as physically fit for office. Nineteen officers were also medically examined with a view to their retirement. With three exceptions, all were reported to be unfit for duty. I have the honour to be, Gentlemen, Your obedient Servant, CHARLES F. WHITE, Medical Officer of Health for the City of London. Public Health Department, Guildhall, E.C. APPENDICES. page Appendix A—Street Lists of Mortality 80 „ B— „ „ Infectious Diseases 84 „ C—Register of Houses let in lodgings or occupied by members of more than one 86 family „ D—List of Adoptive Acts, Orders, Bye-laws and Regulations in operation in the City 87 „ E—Tuberculosis Dispensary, St. Bartholomew's Hospital, E.C. P. (Leaflet) 88 * t l2 80 APPENDIX A.—STREET LISTS OF MORTALITY. STREET OR PLACE. No. of House Sex. Age. Date of Death. Cause of Death. Remarks. Albion Buildings 22 F 85 3rd Sept. la. Senile Myocardial degeneration b. Arterio-sclerosis Died in St. Peter's Hospital. " 22 F 63 10th Dec. la. Heart failure b. Myocardial degeneration c. Carcinoma of Rectum Aldersgate Street, Tube Tunnel. — M 61 20th Jan. Multiple injuries. Fall from train and injured by passing train. P.M. Inq. Resided at Ealing. Aldersgate Street. 180 M 86 27th Jan. la. Uræmia b. Chronic Nephritis c. Arterio-sclerosis Artillery Lane 5 F 68 24th Nov. Myocardial degeneration Died in St. Peter's Hospital. Barker's Buildings 24 M 66 6th Aug. 1a. Myocardial degeneration Died in St. Peter's Hospital. Died in Stone House, Basinghall Street, M 70' 29th Mar. b. Paralysis Agitans G.P.I. City of London Court. Basinghall Street. 36 M 4 16th Jan. Shock. Ethyl chloride anaesthesia. Operation for middle ear disease. P.M. Misadventure Dartford. Died in Children's Hospital, Gt. Ormond St. ,, 55/6 M 85 9th Nov. Myocardial degeneration Died at Northampton. Bartholomew House, Cloth Fair. 17 F 68 5th Jan. la. Hyperstatic Pneumonia b. Carcinoma of Lungs c. Carcinoma of left Breast (incised) Bishopsgate 164 M 64 25th April Lobar Pneumonia. Lymphadenoma. Died in the London Hospital. Bread Street 10/ 12 F 67 18th Nov. Leukaemia Carcinoma Cervix Died in Dulwich Hospital. Bridewell Place 2 F 40 23rd Dec. 1a. Carcinoma of Liver b. Carcinoma of Rectum Brushfield Street 12 F 65 4th Mar. la. Abdominal Carcinomatosis Died in Royal Northern Hospital. b. Carcinoma of Ovaries 10 F 79 30th July 1a. Cerebral Arterio-sclerosis Died in St. Peter's Hospital. 2. Strangulated Umbilical Hernia Ruptured Aortic Aneurism Budge Row 20 M 57 16th Sept. Died in St. Bartholomew's Hospital. „ 3 F 67 10th Dec. la. Unæmia Died in Royal Chest Hospital. b. Chronic Nephritis 2. Congestive Heart failure Bury Street 15 M 89 14th Sept. la. Myocardial degeneration Died in Tooting Bee Hospital. Cheapside 92 M 60 25th Oct. Syncope. Coronary disease. P.M. Natural Died in Charing Cross Hospital. 106 F 83 10th Jan. la. General (Edema b. Myocarditis 147 F 55 11th Mar. la. Intestinal obstruction. Post-operative shock Died in St. Bartholomew's Hospital. Coleman Street 12 M 79 26th Oct. b. Adhesions from old Appendectomy Syncope. Valvular disease of Heart. Atheroma of Aortic Valves. Chronic Nephritis. P.M. Natural Resided at Hampstead. Copthall Avenue 31 M 71 11th Jan. Syncope. Valvular disease of Heart. Fatty Heart. Bronchitis Resided at Finchley. 42 M 55 30th Dec., 1937 Syncope. Valvular disease of Heart. Myocardial degeneration. P.M. Resided at Ilford. Cornhill 62 M 46 30th Nov. 1a. Uraemia. Coma Died in St. Bartholomew's Hospital. b. Intestinal Acidosis c. Paralytic Ilans 2. Acute Bronchitis Dean's Court, Old Bailey 31 F 65 4th May 1a. Broncho-pneumonia Died at Stone House. Dartford. b. Cardio-vascular degeneration Dowgate Hill 5 I M 42 8th June Syncope. Enlarged Heart. Arteriosclerosis of Coronary Arteries. P.M. Resided at Chingford. Dutton House, New Street 7 M 56 21st July 1a. Cerebral Hemorrhage b. Subarachnoid Hæmorrhage c. Hyperpiesis and recurrent attacks of Gout Evangelist Court 2 M 92 23rd Feb. 1a. Myocardial degeneration Died in St. Peter's Hospital. b. Senility Fenchurch Street 45 M 63 2nd Sept. 1a. Uræmia Died in University College Hospital. b. Heart failure c. Hypertension 2. Ulcerative Colitis Optrans Colon „ 48 F 50 23rd Feb. 1a. Myocarditis and Cerebral Thrombosis Died in St. Peter's Hospital. b. Hypertension and Chronic Nephritis 81 street lists of mortality—continued. STREET OR PLACE. No. of House Sex. Age. Date of Death. Cause of Death. Remarks. Fenchurch Street 51 M 75 4th Oct. Cardial Thrombosis Died in St. Bartholomew's Hospital. „ Station - M 59 24th Oct. la. Coronary Thrombosis b. Hyperpiesis c. Aortic disease Resided at Upminster. Fetter Lane 108 M 49 30th Jan. la. Pulmonary Tuberculosis Died in Mile End Hospital. Freeman's Court 2 M 60 31st Aug. la. Coronary Thrombosis b. Hyperpiesis 2. Diabetes Resided at Kennington. Goodman's Yard 2 F 79 10th Dec. la. Cardiac failure b. Œdema 2. Nephritis Great New Street 11 F 72 2nd April la. Hyperstatic Pneumonia b. Influenza 2. Aortic Valvular disease 1 " 14 F 66 29th June la. Coronary Thrombosis b. Arterio-sclerosis 2. Gastritis Died in St. Peter's Hospital. " 23 M 67 17th Mar. la. Myocardial degeneration b. High Blood Pressure c. Arterio-sclerosis Died in Guy's Hospital. Gresham Street 71 F 71 1st Aug. la. Cerebral Thrombosis b. Arterio-sclerosis Died in St. Peter's Hospital. Gunpowder Alley 11 F 26 1st Mar. la. Pulmonary Tuberculosis Died in Bethnal Green Hospital. Holborn Bars (near) - M 39 1st July Syncope. Myocardial degeneration. Hypertrophy of Heart failure. P.M. Natural Resided at Iver, Bucks. Idol Lane 10 F 72 10th Aug. la. Cardiac failure b. Ascites c. Valvular disease of Heart 2. Chronic Myocarditis King's Block, Stoney Lane 18 M 1 day 28th Dec. Tentorial Tears. Difficult delivery. P.M. without Inquest " 29 M 53 16th Aug. Carcinoma of Pancreas (operation Laparotomy) Died in Royal Northern Hospital. King William Street 14/ 20 M 72 16th Mar. la. Cardiac failure b. Broncho-pneumonia c. Chronic Bronchitis 2. Chronic Myocarditis " 40 M 70 26th Mar. la. Cardiac failure b. Acute Bronchitis 2. Chronic Pulmonary Tuberculosis Died in St. Peter's Hospital. " 86 M 64 30th Oct. la. Broncho-pneumonia b. Chronic Bronchitis Died in St. Peter's Hospital. Lime Street 48 F 59 23rd Mar. la. V.D.H. Aortic Regurgitation b. Cardio-vascular degeneration Died in Stone House, Dartford. Liverpool Street. G.E. Hotel. - M 58 13th June Coronary Thrombosis Resided at Camberley. " - M 65 29tfi Jan. la. Haematemesis b. Duodenal Ulcer " - M 78 13th Feb. la. Toxæmia b. Carcinoma of Tongue c. Secondary involvement of Spine Lloyds Avenue 1 M 58 23rd May la. Myocardial degeneration b. Hypertension London Street 2 M 22 4th May Fractured Skull. Laceration of Brain and other injuries. Fall from window to pavement. P.M. Suicide. Unsound mind Died in ambulance on way to Hospital. Love Lane 5 M 52 2nd July la. Staphylococcal Septicæmia b. Carbuncle of Neck 2. Diabetes Mellitus Died in St. Peter's Hospital. Middlesex Street 116 M 83 19th Jan. la. Myocardial degeneration b. Arterio-sclerosis Died in St. Clement's, Poplar. " 116 M 77 13th Jan. la. Myocardial degeneration b. Senility Died in Poplar. « " 116 M 45 16th Jan. la. Meningococcal Meningitis Died in Park Hospital, Lewisham. " 16 M 63 27th Jan. la. Toxæmia b. Senile Gangrene of both Legs c. Arterio-sclerosis 2. Left Leg amputated i Died in St. Peter's Hospital. " 116 M 48 15th Feb. Asphyxia from Haemoptysis from Chronic Tuberculosis of Lungs Died in St. Bartholomew's Hospital. 82 street lists of mortality—continued. STREET OR PLACE. No. of House Sex j Age. Date of Death. Cause of Death. Remarks. Middlesex Street 116 M 55 26th Feb. la. Anaemia b. Secondary Carcinoma c. Carcinoma of Lung. P.M. Died in St. Peter's Hospital. " 116 M 46 22nd Mar. la. Uraemia b. Chronic Nephritis 2. Chronic Rheumatic Carditis Died in Queen Mary's Hospital. " 116 M 54 6th April la. Cerebral Thrombosis b. Chronic Myocarditis Died in St. Clement's Hospital. " 116 M 49 18th April la. Broncho-pneumonia Died in St. Peter's Hospital. " 116 M 73 18th April la. Myocardial degeneration 2. Senility Died in St. Peter's Hospital. " 116 M 67 26th April Syncope. Arterio-sclerosis. Coronary disease. P.M. Natural " 116 M 62 14th May la. Pulmonary Tuberculosis Died in Mile End Hospital. " 116 M 73 7th June Hypertrophic degeneration of Heart Addison's disease. P.M. Natural Died in St. Peter's Hospital. " 116 M 60 13th July la. Uræmia b. Chronic Nephritis Died in St. Peter's Hospital. " 116 M 85 19th July la. Myocardial degeneration b. Senility Died in St. Peter's Hospital. " 116 M 76 9th July Toxaemia from Septic Arthritis of Knee of unknown Traumatic origin. P.M. Died in St. Peter's Hospital. " 116 M 69 4th Oct. Accidental Advanced Myocardial degeneration. Died in Poplar. " 116 M 64 30th Oct. Arterio-sclerosis la. Auricular Fibrillation Died in Poplar. " 116 M 75 23rd Nov. Senile Ischæmic Myocarditis Died in St. Peter's Hospital. Minories 41 F 62 16th Aug. la. Carcinoma of Colon Died in St. Peter's Hospital. Mitre Court Chambers, Fleet Street. 6 M 60 1st Aug. la. Hypostatic Pneumonia b. Cerebral Haemorrhage Died in Guy's Hospital. Moor Lane Chambers 18 M 59 27th May Chronic Pulmonary Tuberculosis Died in St. Peter's Hospital. Moorgate 25 M 62 17th Oct. la. Cerebral Haemorrhage b. High Blood Pressure and Arteriosclerosis Resided in Chelsfield, Kent. Nevill's Court 12 F 84 4th Feb. la. Myocardial degeneration b. Senility Died in Poplar. " 12 M 58* 15th Mar. la. Myocardial degeneration 2. Subacute Bronchitis Newgate Streey 41 M 63 21st Oct. la. Syncope b. Myocarditis c. Chronic Nephritis Prince's Block, Stoney Lane. 15 M 63 26th June I t * la. Uraemia b. Hydronephrosis and Pyelonephritis 2. Enlarged Prostate Died in St. Bartholomew's Hospital. Queen Street Place, Vintry House. — M 62 10th Jan. la. Coronary Thrombosis b. Arterio-sclerosis Resided at Chesham, Bucks. Queen Victoria Street, College of Arms. — M 80 8th Oct. la. Cachexia b. Carcinoma of Rectum Died in St. Peter's Hospital. Queen's Block, Stoney Lane. 5 F 85 25th July la. Myocardial degeneration 2. Chronic Bronchitis Died in Poplar. " 17 F 85 6th Nov. la. Cardiac failure b. Mitral Stenosis Kiver Thames — M New born. 14 th May Syncope. Inattention at birth. P.M. Inquest Name unknown. " - M 4 11th Aug. Asphyxiation by drowning when fell into Thames. P.M. Inq. Resided in Lambeth. St. Bartholomew's Hospital. — F 23 1st Mar. la. Uræmia and Basal Meningitis b. Mastoiditis. Otitis Media. P.M. Hospital Nurse. St. Nicholas Cole Abbey Rectory. — F 90 17th Mar. la. Senile decay Shoe Lane 35 F 51 1st May la. Pontine Haemorrhage b. Hypertension South Block. 18 F 78 29th Oct. 2. Mild Diabetes la. Myocardial degeneration Stoney Lane. 19 M 66 29th April b. Arterio-sclerosis la. Coronary Thrombosis b. Angina Pectoris " 27 F 54 22nd Feb. la. Cerebral Embolus b. Myocardial degeneration " 34 F 75 23rd Jan. la. Cerebral Haemorrhage b. Hyperpiesis 83 STREET LISTS OF MORTALITY—continued. STREET OR PLACE. No. of House Sex. Age. Date of Death. Cause of Death. Remarks. Swan Lane 12 M 71 2nd July la. Gangrene of Foot b. Diabetes Mellitis « Died in St. Peter's Hospital. Telegraph Street, Butler's Head. — M 48 19th Sept. Syncope. Myocardial degeneration. Coronary disease. P.M. Natural Resided at Bexley, Kent. Temple Chambers, Temple Avenue. — M 40 21st Aug. Ingestion of a slightly corrosive metallic poison. P.M. Died in St. Bartholomew's Hospital. Tower Hill 3 M 71 28th Mar. la. Symphatic Leukaemia Died in St. Peter's Hospital. West Smithfield 57 F 77 3rd April la. Cerebella Haemorrhage b. Cardiac Vascular degeneration Died in Stone House, Dartford. Whitefriars Street 25 F 37 8th June Non-malignant Tumour. Glioma Died in National Hospital, Queen's Square, Holborn. Widegate Street 14 F 49 7 th Dec. la. Carcinoma of Ovary b. Cardiac failure Resided at Dulwich. " 22 F 75 24th June la. Cachexia b. Diabetes and Senile Pulmonary Tuberculosis Died in Metropolitan Hospital, Hackney. " 24 F 59 3rd Sept. Syncope. Valvular disease of Heart. Atheroma of Coronary Artery. P.M. Inq. Wren's View, St. Paul's Churchyard. 21 M 60 16th April la. Cardiac failure b. Toxaemia c. Uraemia " " 23 M 68 29th Nov. la. Heart failure b. Uraemia c. Coronary Thrombosis 84 APPENDIX B.—LIST OF CASES OF INFECTIOUS DISEASE OTHER THAN TUBERCULOSIS, 1938. STREET LISTS.—COMPILED FROM NOTIFICATIONS RECEIVED. Street or Place. No. of House. Sex. Age. Disease. Date of Notification. Aldersgate Street 03 M 8 Measles 13th May. Aldgate High Street 53 F 7 Diphtheria 21st December. Amen Court 8 F 48 Paratyphoid B. 4th January. Artillery Lane 58 M 1 7/12 Measles 13th May. Austin Friars 24 M 6 Ditto 19th February. Basinghall Street 70a F 8 Diphtheria 10th November. Bloomfield House 6 F 4 Measles 11th April. Ditto 6 M 3 Ditto 21st April. Ditto 16 M 1 3/12 Whooping Cough 20th October. Brackley Street 5 M 20 Measles 5th February. Ditto 5 F 15 Ditto 12th February. Ditto 5 M 17 Acute Primary Pneumonia. 7th April. Botolph Alley 2 F 7 Measles 4th February. Bouverie Street 11 M 7 Ditto 18th February. Ditto 11 M 7 Ditto 8th February. Budge Row 26 M 6 Ditto 19th February. Cannon Street 83 M 6 Ditto 6th February. Clothier Street 4 M 2½ Ditto 28th March. Ditto 4 F 4¾ Ditto 30th March. Copthall Avenue 4 F 9 Ditto 27th May. Crescent, The, Minories 8 M 6 Ditto 11th February. Crown, Court, Warwick Lane 5 M 18 Ditto 4th April. Ditto 5 F 66 Encephalitis Lethargica 26th April. Dean's Court - F 28 Scarlet Fever 12th March. Dean Street, Fetter Lane 8b M -9/12 Measles 28th March. Eastcheap 33 F 6 Ditto 18th February. Fenchurch Street 9/10 F 6 Ditto 11th February. Fetter Lane 108 F 50 Acute Primary Pneumonia. 24th December. Fish Street Hill 13 F 6 Measles 18th February. Fleet Street 3 F 45 Measles 28th August. Goldsmith Buildings, Temple - M 28 Diphtheria 19th March. Gracechurch Street 58 F 10 Acute Primary Pneumonia. 25th July. Gt. Tower Street 74 M 6 Measles 18th February. Holborn 5 F 4 Ditto 13th March. Ironmonger Lane 11 M 12 Ditto 9th April. Laurence Pountney Lane 5 F 7 Ditto 8th February. Lime Street 34 F 6 Ditto 8th February. Long Lane 64 F 7 Scarlet Fever 25th January. Lothbury 5 M 5 Ditto 21st May. Lower Thames Street 56 M 7 Measles 23rd February. Ditto 56 F 5 Ditto 23rd February. Ditto 116 F 9 Ditto 12th January. Ditto - F 8 Ditto 23rd February. Ludgate Hill 11 M 21 Acute Primary Pneumonia. 18th March. 85 LIST OF CASES OF INFECTIOUS DISEASE OTHER THAN TUBEPCULOSIS, 1938. STREET LISTS.—COMPILED FROM NOTIFICATIONS RECEIVE D—continued. Street or Place. No. of House. Sex. Age. Disease. Date of Notification. Mansell Street 20 F 4 Scarlet Fever 2nd September. Middlesex Street 99 F 4 Ditto 2nd February. Ditto 108 F 6 Measles 18th February. Ditto 116 M 27 Ditto 10th February. Ditto 116 M 45 Mening. Meningitis 14th January. Ditto 116 M 55 Sonne Dysentery 9th May. Minories 97 F 4 Measles 15th March. Ditto 98 F 8 Ditto 8th March. Ditto 99 M 3 Ditto 3rd February. Ditto 149 M 8 Ditto 8th February. New Broad Street 53 F 5 Ditto 19th February. Ditto 39 M 9 Ditto 12th January. New Street, Bishopsgate 12a F 43 Food Poisoning 9th November. Oxford Court, Cannon Street 2 F 5 Measles 8th February. Queen Victoria Street - M l 3/12 Ditto 1st March. Ditto - M 11 Ditto 23rd February. St. Bartholomew's Hospital - F 23 Sonne Dysentery 18th February. Ditto — F 21 Scarlet Fever 27th May. Ditto — F 23 Ditto 20th July. Ditto — F 26 Sonne Dysentery 16th January. Ditto — M 24 Scarlet Fever 10th May. St. Dunstan's Alley 4 F 11 Measles 18th February. St. Helen's Place 7 F 5 Ditto 8th February. Ditto 7 M 8 Ditto 19th February. Shoe Lane 110 F 54 Sonne Dysentery 2nd February. Stoney Lane, Dutton House 2 M 48 Erysipelas 10th October. Ditto King's Block 16 M 4 Diphtheria 8th November. Ditto Prince's Block 22 F 10/12 Measles 27th March. Ditto Ditto 30 M 4 Diphtheria 8th August. Ditto Queen's Block 46 F 3/52 Ophth. Neonatorum 9th November. Ditto South Block 45 F 45 Erysipelas 27th May. Ditto ditto 29 F 5 Diphtheria 5th April. Ditto ditto 29 F 5 Measles 5th April. Victoria Embankment — M 7 Ditto 8th February. Widegate Street 17 F 8 days Ophth. Neonatorum 29th March. Ditto 17 M 3 Measles 6th April. M 86 APPENDIX C.—REGISTER OF HOUSES LET IN LODGINGS OR OCCUPIED"BY MEMBERS OF MORE THAN ONE FAMILY. WEST DISTRICT. Situation of Premises. Name and Address of Owner or Tenant. Tenements. Lodgers. 43, Cloth Fair Messrs. J. Seeley & P. Paget, 41, Cloth Fair, E.C. (o) 2 2 *10, East Harding Street Goldsmiths' Company, Goldsmiths' Hall (o) 2 7 12, do Do. do. (o) 5 11 93, Fetter Lane Friern Manor Dairy Co., 3, Charles Street, Hatton Garden (o) 3 5 29, Fleet Lane Messrs. Watney, Combe & Reid, Stag Brewery, Pimlico (o) 5 13 30, do Do. do. do. (o) 2 7 31, do Do. do. do. (o) 3 4 11, Great New Street M. Quilty, 11, Great New Street (t) 4 6 13, do F. Wilson, 39, Holmedene Avenue, Heme Hill(o) 11 14 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) 4 8 25, do Do. do. (o) 7 9 27, do Do. do. (t) 6 8 7a, Gunpowder Alley Brookes (Cannon) & Odgers, Norfolk House, Norfolk Street, Strand, W.C. 2 (o) 1 2 8, do. Brookes (Cannon) & Odgers, Norfolk House, Norfolk Street, Strand, W 2 (o) 2 7 4 & 5, Middle Street J. Hull & Sons, Bartholoir lose (o) 5 7 11, do Goldsmiths' Company, Goldsmiths' Hall (o) 2 14 12, do Do. do. (o) 1 3 *14, Wine Office Court Messrs. Reynolds & Easo, 192, Bishopsgate (o) 2 2 *16, do Do. do. (o) 2 2 * 2, Pemberton Row Mr. J. O'Shea, 2, Pemberton Row (t) 1 4 23 Total 83 148 Average number of lodgers to each occupied tenement: 1.8 Houses demolished or closed as dwelling-houses 1 Tenement houses on Register 23 Cleansing Notices served 21 • 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) 4 8 7, do. Do. do. (o) 4 7 9, do. I. J. & J. Mendes, Ltd., 113, Golding Street, E. 1 (o) 3 4 21, do. Clerk to Bishopsgate Institute, Bishopsgate (o) 2 5 10, Brushfield Street Reynolds & Eason, 192, Bishopsgate (o) 5 6 12, do. N. J. Bliss & Son, 164, Bethnal Green Road, E.(o) 3 5 14, do. Clerk to Bishopsgate Institute, Bishopsgate (o) 7 7 3, The Circus, Minories H. Lewis, 3, Circus, Minories (t) 6 8 4, do. T. Davis, 4, do. (t) 4 11 5, do. T. Groves 5, do. (t) 9 9 3, Three Crown Court, Jewry Street. Mr. Martin, 14, Seething Lane (o) 3 3 18, Widegate Street S. Sonenfeld, 26, White Lion Street (o) 2 9 21, do A. & A. Field, 95, Whitechapel Road (o) 5 6 24, do. W. I. Crane, 25, Widegate Street (t) 3 4 25, do. Do. do. (t) 2 6 2, Goodman's Yard Charrington, Brewers, Mile End Road (o) 3 3 Total 65 111 Average number of persons to each occupied tenement: 1.7 Houses demolished or closed as dwelling-houses - Tenement houses on Register 16 Cleansing Notices served 16 (0) Owner. (T) Tenant. 87 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 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 Feb., 1938. 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. M2 88 APPENDIX E. Corporation of London. PUBLIC HEALTH DEPARTMENT. TUBERCULOSIS DISPENSARY, ST. BARTHOLOMEWS HOSPITAL, E.C.I. 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 cover 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