AC 434 Lon 81 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE CITY OF LONDON FOR THE YEAR 1955 Printed by the Authority of Common Council 17th December 1953. STAFF. Date of MEDICAL OFFICER OF HEALTH. Appointment. White, Charles Francis, O.B.E., M.D., Ch.B., D.P.H., D.T.M. Dec., 1937 CLERICAL STAFF. Gray, Charles M. Chief Clerk Mar., 1911 Blunt, Harold F. 1st Assistant Clerk May, 1924 Stout, James Erl 2nd „ „ July, 1930 Threadgold, Arthur W. Senior Clerk, Meat Inspector's Office Nov., 1923 Betts. C. Peters, E. J. Gurney, Miss M. L. General Grade Clerks Nov., 1935 Clerical Assistant May, 1939 SANITARY INSPECTORS. McGrath, William Richard Mar., 1922 Harrington, George Edwin Dec., 1925 Sillett, David Ernest April, 1926 Neale, William G. C. July, 1928 Thorpe, Robert C. Mar., 1930 Hudson, Leslie A. April, 1934 Campbell, J. W. Sept., 1946 Thompson, E. Sept., 1948 Flynn, J. July, 1951 MEAT INSPECTION STAFF. Mellish, Cyril E. Chief Meat Inspector Jan., 1912 Thompson, Frank E. Deputy Chief Meat Inspector July, 1924 Lee, W. R. Garrard, S. S. Morris, W. L. Seymour, K. D. Wilson, J. C. Leach, R. A. Cox, J. T. Field, H. Gingell, G. Bernhardt, D. R. July, 1930 Sept., 1946 Sept., 1946 July, 1935 Meat Inspectors Jan., 1935 Sept., 1952 Aug., 1954 Aug., 1954 Aug., 1954 Probationary Meat Inspector May, 1931 RO. ENT OFFICER. Carter, J. Sept., 1944 Rodent Operatives. Cooper, J. S. (Senior Rodent Operative). Aug., 1943 Tremayne, L. R. Nov., 1943 Mason, G. A. Dec., 1946 Cardy, E. G. June, 1950 Brown, G. J. Aug., 1950 Clayton, G. Nov., 1951 KEEPER OF THE MORTUARY. Lawrence, F. H. May, 1936 DISINFECTING APPARATUS ATTENDANT. Burton, John H. Mar., 1936 MESSENGERS. Powell, W. F. Dec., 1947 SENIOR PORTER AT SMITHFIELD MARKET Prevost, A. E. Feb. 1926 MANUAL WORKERS. Carmody, J. (General Duties at Mortuary) Feb., 1950 Sunnick, J. W. T. (General Duties at Mortuary) May, 1950 Mann, Ernest V. (General Duties at Smithfield Market) Jan., 1928 Lawrence, Charles J. (General Duties at Smithfield Market) Feb., 1928 Portbury, T. (General Duties at Smithfield Market) July, 1953 Wright, J. (General Duties at Smithfield Market) Oct., 1953 Cash, J. E. (General Duties at Smithfield Market) Mar., 1954 Lawrence, E. E. (General Duties at Mortuary) Aug., 1954 Rowe, Mrs. L. E. (Bath Attendant and Cleaner) June, 1951 Jollie, Mrs. F. G. (Bath Attendant and Cleaner) Sept. 1955 (Resigned Aug., 1950) 3 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE CITY OF LONDON FOR THE YEAR 1955. To the Right Honourable The Lord Mayor, Aldermen and Commoners of the Corporation of London. 55/61, Moorgate, London, E.C.2. September, 1956. My Lord Mayor and Gentlemen, I have the honour to submit the following report on the work of my Department during the year 1955. Vital Statistics. The resident population of the City according to the Registrar General's estimate to mid-year 1955 was 5,180. The birth rate rose to 5.33 per 1,000 and the death rate fell to 10.00 per 1,000. There were 31 live births during the year, no premature births and one death of an infant under one year of age. There were no deaths attributable to pregnancy or childbirth. The number of deaths was 54 of which none occurred in the age groups 1-25 years; 4 between 25 and 45 years; 21 between 45 and 65; 16 between 65 and 75; and 12 over 75 years. Thirteen deaths were due to disease of the heart or blood vessels, 16 were due to cancer of which 7 were cancer of the lung. There were 3 deaths due to tuberculosis, 4 to pneumonia and 1 to bronchitis. Infectious Diseases. The incidence of infectious diseases remained low. There were only 3 cases of poliomyelitis, 2 paralytic and 1 non-paralytic. Cases of Puerperal Fever and Tuberculosis were 2 and 11 respectively compared with 2 and 19 in the previous year. Mass Radiography. The Mass Radiography Unit of the North East Metropolitan Regional Hospital Board continued to operate during the year from your premises at 20, Golden Lane. The total number of examinees was 52,981, plus 9,324 City workers when the Unit was "mobile", i.e. when operating at the premises of large firms where employees were X-rayed at their place of work. The Unit is also available to the Boroughs of Finsbury, Stepney and Shoreditch, though the majority of examineees are persons employed in the City. Each year I give a summary of the annual report of the Medical Director of the Mass Radiography Unit referring to the previous year, in this case 1954, because the current report is not usually available to me at the time this report goes to press. 1 have, however, received the Medical Director's Report for 1955, and comparable figures for 1955 and 1954 respectively, are given. The Unit examined a total of 61,779 (61,671) persons, 37,776 (36,239) males and 24,003 (25,432) females. Amongst the males, 47 (51) cases of active pulmonary tuberculosis were detected, and amongst the females 28 (46) such cases, a total of 75 (97) or 1.2 (1.6) per 1,000 of the persons examined. Of these 75 (97) active cases, 35 (21) were reported to have tubercle bacilli in the sputum. The Medical Director estimates that about 10 (10) per cent. of the City's day population were examined, and that on the basis of the above results there are 350 (210) people every day in the City expectorating live, virulent tubercle bacilli. In his 1955 Report he then makes the following observations— "These undetected people who are habitually travelling in crowded trains and 'buses, eating in congested restaurants and perhaps working in overcrowded offices, are not aware of the peril to which they are subjecting themselves, their families and the general public. It should be borne in mind that the density of the daytime population which are exposed to such risks, is estimated at 1,200 persons per acre." "It will be seen from these figures that the incidence of pulmonary tuberculosis in the City of London is not unduly high in view of the congested area, and this may be due to an acquired immunity possessed by the average Londoner. However, there is no room for complacency, and the area must be considered a vulnerable spot by virtue of its intense density of daytime population. There is no doubt that the undetected case of pulmonary tuberculosis with a positive sputum constitutes a real danger to the community and is responsible for fresh cases in the area. The major role of Mass Miniature Radiography is to seek and discover such cases at the earliest opportunity." 4 Food Poisoning. Only one formal notification of a case of food-poisoning was received during the year but five outbreaks of mild food-poisoning were reported and were investigated. The incidents were all reported to the Public Health Committee at the time of their occurrence. The reports are repeated here in order that they may be readily available for reference at any time in the future. Incident No. 1. On Tuesday, 8th March, I was informed that a number of cases of illness had occurred amongst the staff of a firm in the City, and it appeared that the cause was a luncheon meal eaten in a canteen the previous day. On enquiry it was ascertained that 36 persons were affected. The symptoms were abdominal pain and diarrhoea, with vomiting in six cases. The average period between the eating of the meal and the onset of symptoms was 12 hours, and the average duration of symptoms was 14 hours. The luncheon menu on Monday, 7th March, comprised a variety of dishes, but the only one eaten by all those who developed symptoms was Beef and Tongue Patty. None of the actual patty was available for examination, nor was there any residue of the beef from which it was made. There still remained some of the tongue and this was submitted for bacteriological examination. The beef in the patty was from either 53 lbs. delivered on Thursday, 3rd March, or a similar quantity delivered on 4th March, or perhaps from both. The beef was in each case cooked on the day of delivery and stored in a refrigerator and served on Friday, 4th March, and Monday, 7th March. The tongue was from a tin opened for a special meal on Tuesday, 1st March, and not all used on that occasion. It had been kept in a refrigerator in the meantime. The Bacteriologist reported on his examination of all the five items from the luncheon menu which were available and submitted to him. These were, parsley butter, tomato juice, custard powder, grape fruit juice and tongue. No pathogenic organisms nor any abnormal number of non-pathogenic organisms were found in any of the samples. The bacteriologist's conclusion was:—"Nothing has been found in any of the materials which would account for symptoms of food poisoning." "It is possible that the beef used in making the beef and tongue patty was at fault, or that some change took place in this dish after it was made up." All except one of the persons affected had returned to work by Wednesday morning, 9th March. The exception was a boy of 16 who lives in Islington and who was notified as a case of food poisoning by his doctor. The Medical Officer of Health of Islington kindly arranged for the bacteriological examination of a sample of faeces from this case, but no pathogenic organisms were isolated. A thorough inspection was made of the kitchen of the restaurant, which was being used as a canteen for the employees of this particular firm. A number of unsatisfactory conditions were discovered. The restaurant has just changed hands and the new owners have undertaken to remedy the defects. The opportunity was also taken to instruct the staff in the importance of hygiene in the storage and preparation of food, and in their individual responsibility in this respect. Though, as so often happens, we were not able to identify with certainty the particular food responsible because none remained by the time we became aware of the outbreak, there can be little doubt that the beef and tongue patty was at fault. Incident No. 2. On 20th April I received a message that a number of people had been taken ill after a meal at a staff canteen on 19th April. On enquiry, it was ascertained that of 80 persons who took lunch in the canteen, 25 had subsequently been ill. The symptoms were abdominal pain and diarrhoea, without nausea or vomiting, coming on ten to fifteen hours after the suspected meal, which comprised roast beef and Yorkshire pudding, or stewed steak, or cold ham; boiled or baked potatoes; tinned peas or cabbage, gravy made with Oxo; bread and butter pudding, or jelly and custard. It appeared that the roast beef or the gravy was the article of diet responsible for the illness. The beef, a chuck-roast weighing 14 lbs., was cooked on 18th April, kept overnight in a refrigerator, and reheated and served on 19th April. Some beef and gravy was still available and was sent to the City Bacteriologist for examination. Five persons were still away from work. Their addresses were obtained, and the medical officers of health of the districts in which they lived were communicated with by telephone and asked to have samples of faces examined. All the medical officers readily consented to co-operate in the investigation. The City Bacteriologist reported that films and cultures from the gravy showed no bacteria, but the beef showed numerous Clostridia in films, and in anærobic plate cultures a profuse growth of three types of Clostridia, one of which formed a spreading growth obscuring the others. This latter type appeared to be Clostridium welchii and included a few haemolytic and many nonhæmolytic colonies. 5 In none of the specimens of faeces examined from the five persons who had not returned to work on 20th April were Clostridium welchii or other intestinal pathogens obtained. From the clinical symptoms and the bacteriological report on the roast beef, this appears to be a typical outbreak of mild food-poisoning due to a heat-resistant strain of Clostridium welchii, and I have little doubt that if the beef had been cooked and eaten the same day, instead of being cooked the day before, stored overnight and warmed up and served the next day, the outbreak would not have occurred. These large pieces of meat take a long time to cool, and therefore there is a considerable period during which the temperature is favourable for the growth and multiplication of any sporing organisms, such as Clostridium welchii, which survive the cooking. There is probably further multiplication next morning when the meat is cut up and kept warm till it is served. The kitchen of this canteen was inspected and found to be satisfactory. No illness had occurred amongst the canteen staff previous to the outbreak, though one member was ill after eating the beef. A sample of feces in her case was reported free from Clostridium welchii or other pathogenic organisms. Incident No. 3. On 27th April, I was informed that eight persons had developed symptoms of food-poisoning, vomiting and diarrhoea, some three to five hours after eating lunch at a staff canteen. Altogether 1,300 lunches had been served on that day. The menu comprised grilled fillet of sole, fish cakes, roast lamb, liver and bacon, braised lamb, beef and ham pasty, cheese and tomato on toast, hors dœuvres, sultana roll and custard, semolina pudding, trifle with mock cream, jelly, ice-cream, biscuits and cheese. No single item of diet was common to all sufferers, nevertheless specimens of roast lamb, jelly crystals, mock cream and custard powder, being available, were sent for bacteriological examination. Specimens of feces were obtained from 6 cases and bacteriologically examined. The clinical symptoms and the period between the meal and the onset of illness were suggestive of poisoning by the toxins of staphylococci, and it was thought that the mock cream might be the vehicle of infection, but no organisms associated with food-poisoning were recovered from the samples of food or of feces submitted. The cause of this very limited outbreak, only 8 persons out of 1,300 at risk, remains a mystery. Incident No. 4. On 12th August a report was received that about 20 people had been taken ill after a luncheon meal in a commercial canteen in the City. The symptoms were abdominal pain and diarrhoea, but no vomiting, coming on from 7 to 14 hours (average 10½ hours) after the meal and persisting for 8 to 24 hours. The menu included grilled halibut, chicken and ham vol-au-vent and gravy, braised ox tail and gravy, bacon, tomato and mushroom pancakes, egg salad, beans, onions, potatoes, rhubarb charlotte, peach condé, milk-pudding, mousse, ice-cream, custard, jelly, biscuits and cheese. The only food available for bacteriological examination were some vol-au-vent and fish. The report on these was negative. About 1,200 lunches were served on the day in question and it is remarkable that only 18 persons were affected. Ten of these were engaged in the preparation or service of food, and it was decided to have bacteriological examination of samples of feces from as many of the canteen staff as would consent. The Company concerned has a medical department who were most cooperative, and 53 fecal specimens were submitted for bacteriological examination. Heat-resistant Clostridium welchii were isolated from 5 specimens. In three cases the donors had not been ill and in two they had. Further examination of these organisms at the Central Public Health Laboratory revealed that in the two cases who had had symptoms the organisms were food-poisoning strains of Clostridium welchii, in the other three they were not. It appears, therefore, that this was another mild outbreak of food-poisoning due to heatresistant Clostridium welchii. What the vehicle of infection was is uncertain, but may have been the gravy served with both the vol-au-vent and the braised ox tail. It is not possible to suggest any reason why only 18 out of 1,200 persons should have been affected. I thought perhaps that those who were taken ill might have been those who took the meal late when there had been time for incubation of any organisms introduced during preparation of the food, but I found that times varied from 11.30 a.m. to 2.15 p.m. The canteen is well equipped and maintained, except that the refrigerated storage space is barely adequate. This is being remedied; also a continuous roller towel by the lavatory basin in the kitchen is being replaced by paper towels. Incident No. 5. On 8th September, a telephone message was received from a City firm that a number of members of their staff had been indisposed and that they suspected the water supply. Some internal work had been carried out on the service main to the canteen on the previous day, 7th September. The Metropolitan Water Board were notified and took samples of the water which on bacteriological chemical examination proved to be of the usual high standard of the Metropolitan Water Board supply. 6 Meanwhile enquiries were carried out as to the possibility of the illness being due to the luncheon meal served in the canteen on 7th September. Two hundred and ten meals were served to the members, of whom 67 subsequently complained of abdominal pain, diarrhoea, and five complained of vomiting also. There were a number of items on the menu including mixed grill, roast lamb, grilled gammon, fried haddock, blackberry tart, coconut meringue, bread and butter pudding and custard. There was no residue of the meal available for examination, and amongst 67 persons questioned there was no single item that had been eaten by all of them. Moreover four persons alleged that they had had no lunch and had taken only tea and coffee. Six persons volunteered to submit samples of fasces. From four of these specimens heatresistant Clostridium welchii were recovered, but none yielded intestinal pathogens. The cause of the outbreak remains a mystery. It may have been due to Clostridium welchii in some article of food, but in view of the fact that four sufferers had only had tea or coffee it appears possible that there may have been a temporary contamination of the water supply resulting from the work on the service main to the canteen. Food Inspection. There are no slaughterhouses in the City of London. The Metropolitan Cattle Market in Islington is owned and administered by the Corporation of the City but the Medical Officer of Health of the City is not responsible for meat inspection at the abattoir. The meat arriving at Smithfield Meat Market has presumably been inspected at the time of slaughter in this country or abroad. Evidence of disease which has escaped notice at the primary inspection is nevertheless found; in some cases it has been overlooked, in others it has only become apparent when the carcase is cut up. Condemnations of meat at Smithfield are to a considerable extent due not to disease but to deterioration during transport, decomposition, bone-taint, brine-staining, etc. The total amount of meat delivered at Smithfield Market was 386,046 tons of which 470 tonswere found to be diseased or unsound and were voluntarily surrendered. At Leadenhall Market and in City shops 7 tons and at Cold Stores 6 tons were condemned. Of other foodstuffs in Markets and Shops 5 tons, and at Riverside Wharves 194 tons 6 cwts., were condemned. The total amount of foodstuffs found by your Inspectors to be unfit for human consumption was therefore 682 tons. This is 109 tons more than in the previous year, but this is explained partly by larger deliveries of food and partly by a fire at Custom House Quay in which large quantities of food were damaged by fire and water. In only one instance were legal proceedings instituted and this was in relation to 61 wild rabbits delivered at Smithfield Market which were infected with myxomatosis. It appeared that whoever paunched the rabbits must have observed that they were diseased even if he did not know the signs of myxomatosis, so it was decided to prosecute the consignor. In the proceedings the consignor explained that he collected rabbits from a number of farms and delivered them direct to the market and it was not possible for him to say from which source the diseased rabbits were collected. The case was therefore dismissed on payment of 8 guineas costs. Food Hygiene and the Hygiene of Catering Establishments. I have asked your two inspectors, Mr. Thompson and Mr. Flynn, who devote their whole time to the hygiene of catering establishments in the City and both of whom are enthusiasts, but at the same time are essentially practical in their approach to the many problems with which they are confronted, to express their opinions on the progress achieved in the last 10 years, and they report as follows:— "It will be recalled that the first comprehensive measure covering the field of hygiene in food premises was the Food & Drugs Act, 1938, which unfortunately did not come into operation until after the outbreak of war, and was therefore, to a greater or less degree, put into 'cold storage' until the end of hostilities. However, during this time rationing came into being, and while no one welcomed such an event, it had perhaps one good feature. The Ministry of Food realized that to hand out food permits for new catering premises was likely to result in food being prepared in some very undesirable premises, and referred each application, as far as the City was concerned, to the Department of the Medical Officer of Health, asking whether or not the premises in question were satisfactory. Permits were not issued until the Medical Officer of Health was satisfied that as high a standard had been achieved in the premises as the circumstances allowed. This liaison lasted until the issue of catering licences was finally discontinued. It was impracticable, however, at that time, to effect any substantial amelioration of unsatisfactory structural conditions in the old dilapidated and badly designed restaurants and cafés which existed in various parts of the City. Even after the war, because of the acute shortage of labour and materials and the restriction of building activity by means of licences, it was for a long time difficult to secure major improvements in catering premises. Outbreaks of food poisoning were made notifiable by the 1938 Act, and consequent upon this and the fact that communal feeding had become established as part of our way of life, it became evident that food poisoning was probably on the increase and was giving rise to serious concern among health authorities. As a result the Ministry of Food set up a working party in 1949 to investigate the many facets of this problem. i The deliberations of this working party resulted in recommendations which were not unanimous, and the powers of registration for catering premises which public health workers have sought for so long were effectively denied them by the powerfully represented sections of the trade. In certain areas voluntary clean food guilds were established and undoubtedly raised the standard of food hygiene locally. Careful consideration was given to these schemes, but the conclusion was reached that they were not practicable under the conditions prevailing in the City. Eventually the Food & Drugs Amendment Act, 1954, was passed, and subsequently replaced by a Consolidation Act, the Food & Drugs Act, 1955. New Food Hygiene Regulations which came into operation on the 1st January, 1956, have been made under the latter enactment, and these Regulations are intended to replace and to extend the provisions contained in the 1938 Act, but it remains to be seen whether these new detailed requirements will be more effective than the broader and rather more comprehensive legislation which allowed discretion in interpretation, but contained no exemption clauses as do the new regulations. So far as the City is concerned, we think it is true to say that the statutory powers existing until 1st January, 1956, were not inadequate from our point of view. On the contrary, experience has shown that it has been possible in the normal course of administration to secure all necessary improvements both in structure, design and equipment. The restricting factor has not been the shortcomings or ineffectiveness of statutory provisions but the usual difficulties which anyone contemplating improvements in the City has to contend with, namely: inadequate floor area of kitchens, lack of space for the provision of proper food stores, the ever increasing problem of finding suitable outlets for the exhaust of mechanical ventilating plant, the expense and difficulty of installing additional sinks, and other similar technical problems. These technical problems and difficulties remain, no matter what additional powers may be given to the Local Authority or what increased requirements may be imposed by statutory regulation. In reviewing the advance made in the improvement of food hygiene it is convenient to assess the progress from two different angles. First of all, improvements in structure, equipment, essential facilities and design, and secondly, improvements in methods and practice. The first is the easier to judge accurately. The latter is the imponderable, and it is almost impossible to determine the extent of any real progress in this direction. So far as structural repairs and improvements are concerned, there is no doubt whatsoever that substantial and definite progress has been effected. In many cases complete reconstruction, re-design and re-equipment has been carried out, often at very high capital cost. Having regard to the difficulty of executing works of this magnitude and at the same time keeping a business In operation, it is not surprising that the rate of progress is very slow,— sometimes irritatingly so. As, for example, in one instance, a Notice in respect of unsatisfactory conditions at a large public house with an extensive catering trade was originally served in July, 1951, but it was not until November, 1955, that all the work was completed to the satisfaction of this department, and there have been many similar cases. During the last few years, as a matter of policy, the Sanitary Inspectors responsible for the hygiene of catering establishments have encouraged caterers to carry out such works of improvement as the following:— 1. The laying of suitable impervious floors in kitchens and ancillary rooms. 2. The tiling of kitchen walls, or at least, the provision of smooth easily cleansed painted surfaces. 3. The installation of additional sinks so that washing-up can be carried out easily and efficiently, and food washed in separate sinks which are not used for any other purpose. 4. The provision of adequate and efficient arrangements for the supply of hot water. 5. The installation of mechanical ventilating plants without which it is impossible to provide even tolerable working conditions in basement kitchens. 6. The provision of necessary staff amenities including sanitary accommodation, personal washing facilities and changing room space separate from the kitchen. Apart from these points, special emphasis has been placed upon the advantages to be derived from good planning which facilitates both the maintenance of cleanly conditions and the smooth running of the kitchen. Advice has also been given on the ways in which the risks of potential food poisoning may be reduced, particularly by avoiding the unnecessary handling of food, and so far as possible by preparing and cooking food the same day on which it is to be consumed. It has been found, however, that a problem which appears insoluble is the practice of displaying meat foods such as cooked hams, brawn, jellied veal and large meat pies on so-called "Snackbars" or "Cold Counters" usually in public houses. These snackbars seem to be increasing in popularity, and in order to do good business and tempt the customer, the display of food seems to be necessary. The possibilities of contamination in such cases are obvious but it is useless recommending a caterer to refrain from displaying these foodstuffs when it is known that this would result in financial loss. This is an example where the public could very well help themselves by refusing to patronise premises where foods, liable to contamination, are on display more or less throughout the day. As indicated in previous reports, the provision of adequate washing-up facilities has presented a particularly difficult problem and heavy capital investment on washing-up machines has not always produced an improvement comparable with the expenditure involved. In this connection there appears to be an unfortunate presumption that a washing-up machine will function by means of some spontaneous magical force, whereas in actual practice the common-sense and 8 skill of the operator is the vital factor. Quite insufficient attention seems to be paid to theproper training of operatives and very little, if any, regard paid to the importance of adequatesupervision of staff. The supervision of staff generally leaves much to be desired, doubtless due in some degree to the continued shortage of labour. Invariably on inspecting catering premises, especially during the lunch hour rush, one finds the Manager or Manageress pre-occupied in the execution of some routine task such as serving at an off-sales counter or helping on the self-service counter instead of leaving themselves free to exercise general supervisory duties. Whilst it has been found that, with few exceptions, the catering industry has been co-operative in carrying out the requirements and recommendations of this Department, it is felt that in some sections of the industry much time, energy and money is wasted by the absence of any clear realisation of what they themselves require, and very often they tend to proceed by trial and error, which in practice may become very expensive and quite discouraging. During the year under review it has been necessary to resort to legal proceedings on one occasion only. In this instance, notwithstanding several written intimations, the proprietor of a small snackbar failed to remedy various dirty and defective conditions until summonses had actually been served upon him. Although the requisite works had been completed to the satisfaction of this department before the date on which the summonses were returnable, nevertheless the Magistrate took a sufficiently serious view of the case as to impose fines totalling £24 and to award the City Corporation three guineas costs. It has always been felt that the only way of effecting a permanent improvement in the handling of food and of the conditions under which food is prepared is by securing the co-operation of the City caterers, and much time and energy of the officers of this department have been devoted to the consideration of the best means of resolving the problems of the individual caterer rather than resorting to the ' strong arm of the law.' Nevertheless, in spite of the continued efforts made since the war and notwithstanding the substantial improvements effected in many premises, there remains a hard core of unsatisfactory premises, and it would seem that in order to redress this state of affairs, consideration may have to be given in the immediate future to the institution of legal proceedings against the recalcitrant few, who either cannot or will not provide conditions under which their business may be conducted without positive danger to their customers. In conclusion we would say that in spite of many difficulties there is no doubt that progress has been made in securing improvements in the hygienic handling of food in the City catering establishments. Improvements are not a steady uninterrupted progression but are usually obtained by seizing an opportunity and using it to the best advantage. Much more remains tobe done, but with the continued co-operation and goodwill of all engaged in the catering industry, higher standards will be achieved in the future. Structural improvements and the provision of more efficient equipment necessarily involve the caterer in additional expenditure, sometimes heavy expenditure, and this must be reflected in the price charged for meals. The only improvement which need not involve additional expense is improvement in the personal standards of hygiene of the food handlers themselves and since, in these days, such improvements cannot be imposed but must be voluntary, it presents particular difficulties in initiation, maintenance and assessment." FOOD & DRUGS ACT, 1938. Mr. Harrington, Sampling Officer under the Food & Drugs Act, reports as follows: — "Three hundred and fifty-two samples have been submitted to the Public Analyst, 23 of these were formal and 329 were informal samples. Fifteen samples were reported against; in two cases legal proceedings were instituted and in other instances cautions were administered. Milk. Fifteen samples of pasteurised milk were examined by both the Phosphatase and the Methylene Blue Tests, one of which was also examined bacteriologically. The Phosphatase Test is a check on the efficiency of the heat treatment applied to the milk and the Methylene Blue Test on its keeping qualities which bears relation to cleanliness and care in handling. A strawberry flavoured full cream milk drink was also examined by the Turbidity Test. An adverse report was received on the sample examined bacteriologically and the suppliers were cautioned. There are now in the City, seven dairies within the meaning of the Milk and Dairies Regulations, 1949. There are however, also a number of milk-bars and snack-bars, where milk is sold for consumption on the premises only. The average composition of genuine milk samples taken during the year was:—milk fat: 3.55 per cent.; solids (not fat): 8.82 per cent.; total solids: 12.37 per cent. Eighty-six Supplementary Licences in respect of 25 firms and individuals and 33 Dealers Licences in respect of 15 firms and individuals were issued under the Milk (Special Designation) (Raw Milk) Regulations 1949/50 and the Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 1949/1953. Two new registrations were effected under Section 34(l)(b) of the Food & Drugs Act, 1938, for carrying on the business of a wholesale dealer in margarine. 9 Cream. One sample of clotted cream, seven samples of double and one of single and one sample of sterilised, cream were submitted to the Phosphatase Test and general bacteriological examination. In the case of the clotted cream and in one sample of double cream it was noted that although sold as such, the containers bore no labels at all. In addition, adverse reports were received on these samples from the Bacteriologist. Full details were communicated to the Medical Officers of Health for the districts wherein the cream was prepared and packed. Ice Cream. The improvement effected in this product over a number of years has been steadily maintained. The average composition of the samples taken was:—fat: 10.5 per cent; milk solids (not fat): 10.7 per cent.; sucrose: 10.9 per cent. An adverse report on his examination of one of the ice cream samples was received from the Bacteriologist and the Medical Officers of Health for the Districts of the place of manufacture and of the depot from where the cream was sent out in vans, were notified. The conditions of sale at the City premises were in order and additional samples taken there of iced lollies and of ice cream of other manufacture were reported as satisfactory. There is only one manufacturer of ice cream within the City of London: his premises have been kept under survey and his product found satisfactory. Eight new registrations of premises for the sale and storage of ice cream were granted during the year. Food Labelling. With the exception of the two dairy cream samples mentioned above, no administrative action has been required. Enquiries however, continue to be received from time to time and advice and assistance have been given wherever possible to assist compliance with the requirements of the Labelling of Food Order, 1953. Administration Generally. Details of the formal and informal samples taken and submitted for analysis and of action taken with regard to adulteration or other irregularity appear later in this Report." DRIED EGG ALBUMEN. Large quanities of dried egg albumen in crystalline and powdered form are imported from China and used in the bakery and confectionery trade. It has been found by the Central Public Health Laboratories that much of this Chinese egg albumen is infected with organisms of the Salmonella group capable of causing food-poisoning, and occasionally the organisms of para-typhoid fever are present. It may be that some of the hitherto unexplained outbreaks of food-poisoning or even paratyphoid fever are due to the use of this material in the preparation of foodstuffs. The dried egg albumen coming into the Port of London is mainly discharged at riverside Wharves in the City and therefore comes under your jurisdiction, not that of the Port Health Committee. During the year the control of this material has involved the taking of large numbers of samples under sterile conditions, and their submission for bacteriological examination. The tins, containing 100 lbs. or more, of albumen, have to be carefully opened, and then a sample is removed with a sterile spoon and placed in a sterile jar. Administratively it has been very difficult to deal with this material in such a way as to safeguard the public health and yet not be unnecessarily severe on the trade. The product is valuable and in keen demand. We have put all consignments under stop and have carried out a sampling of 5% of cases. If any of the samples are positive for Salmonella, the consignment is held under stop pending the discovery of some method of sterilising the material without impairing its chemical and physical qualities. The Bakery Research Station at Chorley Wood is engaged on experiments to this end. If all samples are negative, a second 5% of the consignment is sampled, because it has been found that on further sampling positive results are sometimes obtained. Negative results do not give confidence that the whole consignment is clear. On the other hand, we are not entitled to hold on to consignments without evidence that they are infected, so if the second samples are also all negative the consignment is released, but only on condition that if the material is used in the manufacture of foodstuffs it is only used in products which are, in the course of manufacture, raised to a sufficient temperature to destroy any pathogenic organisms. There are a number of technical processes unconnected with food in which egg albumen is used. Consignments are freely released for these purposes. 10 DISINFECTION OF BRISTLES. The disinfection of second-hand clothing, horsehair, bristles, etc., prior to export, is regularly carried out at your Disinfecting Station at 20, Golden Lane, on behalf of exporters in the City. The purpose of the disinfection of bristles has always been the destruction of the spores of the bacillus of Anthrax, which are particularly resistant. I have always been satisfied that the special procedure we carried out in the disinfection of bristles was quit efficient in this respect, and the City Bacteriologist has assured me that it gives an ample margin of safety. At the same time anthrax was not specifically mentioned on the certificates given, but the details of the method of disinfection were fully stated on the back of the certificates, so that health authorities in the countries to which the bristles were exported could decide for themselves whether the disinfection met their requirements. However, I was recently informed that the Egyptian authorities required certificates of disinfection of bristles to include the following words "the bristles are guaranteed after thorough examination as completely free from Anthrax Spores or any other contagious animal disease of infectious nature." It would be, in my opinion, quite useless to take samples of the bristles before and after treatment, because there might well be no anthrax spores in the consignment, and even if there were, the samples we took, either before or after treatment, might not include any infected bristles. It would be pure chance if we happened to hit on the infected ones in a large consignment. The only rational way is to adopt a method which has been proved to destroy spores known to be even more resistant to heat than anthrax spores are. In order to meet the Egyptian requirement I therefore arranged with the City Bacteriologist to make up packages, some containing anthrax spores and some containing more resistant spores, and to insert these packages in various parts of the consignment of bristles before disinfection. This was done, and after disinfection the packages were returned to the bacteriologist for examination. It was found that not only the anthrax spores but also the more resistant spores were destroyed. I therefore informed the firm who submitted bristles for disinfection for export to Egypt that I was prepared to issue a certificate in the special form required by the Egyptian Authorities. HYGIENE IN HAIRDRESSERS AND BARBERS SHOPS. In 1952 the Southwark Borough Council made representations to the Metropolitan Boroughs Standing Joint Committee that the necessary powers should be sought, by way of a clause in a London County Council (General Powers) Bill, to enable Metropolitan Boroughs to register and control barbers shops and to make bye-laws regulating the hygiene of such premises and of the operations therein. It is interesting to note that in 1904 the Corporation of the City instituted a scheme of voluntary registration of hairdressers shops and in consultation with the Incorporated Guild of Hairdressers, Wigmakers and Perfumers, laid down a code of practice which was to be followed as a condition of registration and the issue of a certificate which could be displayed in the shop. The number of registrations reached 32 in 1908 but after the first world war rapidly declined and there have been no registrations since 1932. To continue the story of the Southwark Borough Council's proposal, the Metropolitan Boroughs Standing Joint Committee took the opinion of the City and the Metropolitan Boroughs and decided to ask the London County Council to include a clause in a General Powers Bill that was then in preparation. The London County Council agreed and the clause is now Section 18 of the London County Council (General Powers) Act, 1954. The section provides that, as from the appointed day, no person shall carry on the business of a hairdresser or barber on any premises in a borough unless he and those premises are registered by the borough council. The borough council may make bve-laws for the purpose of securing— (a) the cleanliness of premises registered under this section and of the instruments, towels, materials and equipment used therein; and (b) the cleanliness of persons employed in such premises in regard to both themselves and their clothing. Sub-section 12 of Section 18 states that this Section shall apply to the City. Draft model bye-laws have now been agreed after discussions in which the Ministry of Housing and Local Government, the Metropolitan Boroughs Standing Joint Committee, the National Hairdressers Federation and the Incorporated Guild of Hairdressers, Wigmakers and Perfumers took part. The draft model bye-laws are as follows: — Bye-laws as to hairdressers and barbers made by the Metropolitan Borough Council under Section 18(4) of the London County Council (General Powers) Act, 1954. 1.—(1) In these bye-laws, unless the context otherwise requires—"hairdresser or barber" means any person carrying on the business of a hairdresser or barber on premises registered under Section 18 (1) of the London County Council (General Powers) Act, 1954; "day" means a day on which business is carried on. (2) The Interpretation Act, 1889, applies to the interpretation of these bye-laws as it applies to the Interpretation of an Act of Parliament. 11 2. For the purpose of securing the cleanliness of the premises, a hairdresser or barber shall comply with the following provisions: — (a) all internal walls, partitions and ceilings shall be painted, distempered, whitewashed, papered, decorated, furnished or otherwise treated and shall be capable of being kept clean, kept in good repair and cleansed as necessary; (b) the floor and any coverings shall be kept in good repair, and shall be cleansed at least once a day and swept as necessary to prevent the accumulation of hair clippings, neck wool or other litter; (c) all such sweepings and all other litter shall be placed in suitable covered receptacles, which shall be emptied as necessary and at least once a day, and kept clean; (d) every chair or seat shall be cleansed as necessary; (e) every shelf, table, cabinet, washbasin and other fitting shall be kept clean. 4. For the purpose of securing the cleanliness of persons employed in the premises, in regard to both themselves and their clothing, a hairdresser or barber shall— (a) cause every such person to keep his hands and clothes in a clean condition; (b) provide and maintain suitable and sufficient washing facilities for the use of such persons; (c) cause any overalls worn to be clean; (d) cause every such person who has an open boil or sore on an exposed part of the body to keep such open boil or sore effectively covered by an impermeable dressing while attending to any customer. There are 89 hairdressers shops in the City. They are not at present subject to any special inspection by the Sanitary Inspectors. The Corporation resolved to bring Section 18 of the London County Council (General Powers) Act, 1954, into operation on 1st December, 1955, but it is too early to report on the result of inspections under the Section. HOUSING. Housing Consolidation Regulations, 1925, No. 866, Part IV. Inspection of District: — 1. Number of houses which on inspection were considered to be unfit for human habitation: — None. 2. Number of houses in which the defects were remedied in consequence of informal action by the Local Authority or their Officers: — 2 3. Number of representations made to the Local Authority with a view to (a) the serving of notices requiring the execution of works or (b) the making of demolition or closing orders:— (a) none. (b) none. 4. Number of notices served during the execution of works: — None. 5. Number of houses which were rendered fit after service of formal notices: — None. 6. Number of demolition or closing orders made: — None. 7. Number of houses in respect of which an undertaking was accepted under subsection (2) of section 19 of the Housing Act, 1930: — None. 8. Number of houses demolished: — None. Only one application was received for a Certificate of Disrepair under the Housing Repairs & Rent Act, 1954. This was in relation to the 1st, 2nd and 3rd floors of No. 8, Brushfield Street. The certificate was issued and was not contested. During the year 38 families were re-housed. The number of housing applications outstanding on 31st December, 1955, was 699 representing 1,652 persons. The number on the register has increased more rapidly than in previous years possibly due to the fact that part of the new Estate at Golden Lane is occupied and is therefore causing interest. The Golden Lane Estate has 48 maisonettes occupied and it is hoped that many more than that will be occupied in the near future. Sydenham Hill Estate is progressing satisfactorilv and should be completed by the end of 1956. Forty-seven flats at Blake House, Lambeth, have been modernised. The small block of flats at Dron Buildings, Stepney, is rebuilt and occupied—the modernisation of the remaining 76 flats is about to commence. 12 Though the resident population within the City is small the Corporation has taken very seriously its responsibilities as a Housing Authority, and there is now so much work in connection with its new housing projects and the modernisation of its existing housing estates outside the City boundaries, that in my opinion it is desirable that the responsibilities, which the Public Health Committee has hitherto carried in this respect, should be transferred to a Housing Committee which can devote its whole attention to the many and difficult problems, not only of policy but of day-to-day administration. The Medical Officer of Health should, of course, attend such a Committee and should at all times be available for consultation, but in relation to the Corporation's housing estates outside the City he must not usurp the responsibility of the medical officers of health of the districts in which such estates are situated. The medical officers of health of the Metropolitan Boroughs and of the City are accustomed to the discussion of problems of mutual interest, not only in the Borough Medical Officers Committee of the Metropolitan Branch of the Society of Medical Officers of Health, but through friendly personal communication at any time, and no difficulty has arisen in the past nor should arise in the future. WELFARE OF OLD PEOPLE. The City of London Old Peoples' Welfare Association under the Presidency of the Lord Mayor and the Chairmanship of Sir Frederick Rowland is continuing to provide a service for the over 60's who are the responsibility of the Corporation even though they live beyond the square mile. The number on the register now totals, 1,312 not all of whom require assistance, but an amazing number seek help of one kind or another. The requests for Daily Home Help Service, Relief Night Help and for the provision of commodes, bed rests and wheel chairs have increased as more and more of the old people living alone survive to 80 years of age and over. Entertainments, outings, convalescent holidays all continue to be provided and enjoyed. The provision of wireless sets causes difficulty sometimes but at the crucial moment a set seems to appear ! The over 60's at the Three Score Club are very happy and active. They are anxious to help others and it is indeed a sight to see these folk out on a Flag Day for some charitable cause, each one out to beat a record in order to prove his or her appreciation of the services provided for them by the City of London Old Peoples' Welfare Association. Isleden House. This model accommodation for old people, built by the City of London Parochial Foundation and now owned and administered by the Corporation, provides ideal conditions for those who have lived all their lives in London and who would probably find a rural setting uncongenial because unfamiliar. The scheme under which vacant beds in the Sick Bay have been made available to suitable cases from St. Bartholomew's Hospital has continued to work smoothly to the mutual advantage of the Hospital and of Isleden House. The patients are very happy there and the old people benefit from the constantly changing contacts with younger people from the outside world. The Public Health Committee have now taken over responsibility for the City of London Freemens' Houses which are Almshouses, and consideration is being given to their modernisation, both structurally and in the provision of amenities for the old people housed therein. NATIONAL ASSISTANCE ACT, 1948 AND (AMENDMENT) ACT, 1951 Removal of Persons in need of care and attention It was found necessary to apply for a Magistrate's Order, under the above Acts, for the removal of a City resident, aged 67, residing at Princes Flats, Stoney Lane, E.l, to Luxborough Lodge, Marylebone. She had had a stroke in 1943 which left her partially paralysed. She was suffering from Parkinson's Disease (Paralysis Agitans), and had been a source of some anxiety to me since 1947, when she was living alone under very unsatisfactory conditions in Widegate Street. She was re-housed in Artizan's Dwellings in 1951, where at first we were able to give her such help as she then needed, but her physical condition deteriorated and she was constantly falling and unable to rise unaided. In addition it was impossible to keep her room clean, and offensive conditions developed there and in the toilet, used in common with other tenants. Every day a meal was sent in to her but nevertheless she appeared feeble and undernourished. I repeatedly tried to persuade her to enter voluntarily, a home where she would be constantly looked after, but she always refused. She fell so frequently that I was afraid that she might suffer serious or even fatal injury. An Order was made by Judge Block of the Mayor's and City of London Court, on 26th July, and arrangements were made with the L.C.C. for her removal to Luxborough Lodge, Marylebone, but on the arrival of the ambulance she was found to be comatose having accidently taken an over-dose of some sedative tablets which she had obtained on her doctor's prescription. She was accordingly removed to the London Hospital where she remained for about a month, and was then removed to St. Anne's Hostel, Tottenham, which is administered by the Little Sisters of the Poor. RODENT CONTROL Under the direction of your Chief Rodent Officer, Mr. Carter, the rat population of the City, both in sewers and in premises in the City, has been reduced to a minimum since the War. Mr. Carter's annual report suggests that this reduction in the number of rats has left the field clear for mice which have consequently increased in number. 13 In regard to the treatment of sewers, Mr. Carter's report indicates that Sodium Fluoroacetate is much more effective than Zinc Phosphide and that the very low level of infestation obtained while the former poison was used cannot be maintained by the latter. It was expected that this would prove to be the case but the experiment of going back to Zinc Phosphide for twelve months was worth trying because it is a much less dangerous poison to handle. Mr. Carter reports as follows: — "Organisation and procedure during the year were similar to that of previous years, and in compliance with the provisions of the Prevention of Damage by Pests Act, 1949, comprised inspection of properties to ascertain the presence of rats and mice, treatment of any such properties found to be infested, and periodical maintenance control measures for the destruction of rats in the City sewers. It has always been the policy to seek the co-operation of occupiers and owners of properties, and the response to this approach has been satisfactory. No difficulty has arisen in which it has been necessary to resort to statutory action to resolve the problem. A major proportion of the work consisted of inspecting defined areas for the purpose of instituting collective action. In instances of individual notification of infestation, or request for assistance in control measures, the property adjoining was also inspected and combined action taken where necessary. On the survey side of the work, 4,282 occupancies and properties were inspected, the varying types of properties ranging from blocks of offices, riverside food warehouses, catering establishments, factories and shops, to domestic dwellings. The time expended in block inspection is very considerable, and although often with negative result, it is necessary for the success of collective action. A total of 682 infestations of rats or mice were treated, and of this number 332 infestations were notified by owners or occupiers, and 350 infestations were found as the result of inspection. This total comprised 10 major and 169 minor infestations of rats, and 139 major and 364 minor infestations of mice. The rat infestations were mainly of Ship rat (Black) nature. Treatment of these infestations entailed 7,202 visits for operational purposes. A minimum of 1,070 rats was destroyed as the result of poison control measures and 595 bodies were recovered. Trapping resulted in the destruction of 60 rats. The use of "Warfarin" anti-coagulant rodenticide for the control of mice resulted in 1,540 bodies being found. No records are available of the results obtained by Pest Control firms servicing premises periodically. The downward trend of rat infestation manifest in recent years has continued and a further decline in the number of infestations treated and numerical density of the same has been experienced. There is a 50% reduction in major infestations (20 rats or over) and 27% reduction in the minor classification. Infestation of common rat character in surface properties was again on a minor scale and only five infestations were found and treated. The gradual increase and wider distribution of mice infestation apparent in recent years has continued, and as previously mentioned, 503 infestations were treated during the year, as against 20 infestations in 1944. In reviewing this problem, the relationship of the reduction of the rat population must be taken into consideration. It might well be that the balance of nature has been upset and the absence of rats has provided the necessary facilities, and full scope for the build-up of mice infestation. In many instances, premises treated several years ago for rats have remained free of that type of infestation, but have since been subject to mice infestation in varying degree. By reason of their small size and feeding capacity as compared to rats, plus their smaller range of activity from their nesting quarters, harbourage, both structural and incidental which would not be conducive to the well being of rats, is often quite acceptable to mice. In addition, the thoughtless disposal of food scraps, wrappers and fruit parings, by occupants of buildings provide the necessary sustenance to support a colony of mice. To illustrate further the decrease in rat infestation and relative rise in mice infestation, the following summary is included as a useful record. The estimation of the number of rats killed is based on the amount of poison bait consumed. The calculation is, however, based on common rat extermination and as 90% of surface infestations controlled were of Ship (Black) rat character, the total estimate is conservative and could reasonably be increased by 25%, as this species, being much smaller and finer built, consequently consumes less food, and a smaller quantity of poison bait constitutes a lethal dose. The total in the bodies found column is the sum of those taken from premises by the operators and does not include any subsequently found by occupiers consequent on the elimination of structural harbourage or removal of incidental harbourage. SURFACE PROPERTIES. Year Infestations Treated Rats Mice found Initial baiting points Prebaits laid Poison Baits laid Mice Warfarin Baits Traps No. Mice Estd. kill Bodies found Major Minor Major Minor 1944 320 261 39 13 7 11,388 2,558 423 95 12,784 62,336 8,542 1945 417 241 158 6 12 10,038 2,410 217 164 11,321 60,444 7,926 1946 373 232 101 12 28 8,658 2,767 480 207 14,991 63,244 8,672 1947 705 313 330 19 43 6,969 2,081 454 311 18,226 88,980 11,123 1948 751 260 438 22 31 5,637 1,822 552 263 18,720 98,506 12,066 1949 631 149 395 30 57 5,046 2,113 761 557 23,684 91,792 16,242 1950 846 186 391 109 160 4,369 1,632 605 710 23,737 129,295 17,719 1951 651 82 266 182 121 3.436 1,308 775 833 33,712 124,789 25,291 7,012 1952 616 50 278 152 136 2,877 1,237 514 852 11,320 48,783 5,149 16,800 1953 647 25 238 111 273 1,527 725 241 853 16,045 28,672 2,313 11,634 1954 675 20 219 116 320 1,630 955 91 1,181 16,508 25,339 1,982 16,508 1955 677 10 169 139 359 1,070 595 60 1,540 16,407 19,024 1,222 12,706 7,309 1,829 3,032 911 1,547 62,645 20,203 5,473 7,566 227,460 841,204 122,257 64,660 14 Periodical maintenance for the control of rats in the City sewers continues at quarterly intervals. The March and June controls were the completion of a series of four treatments started in September, 1954, comprising direct poisoning with Zinc Phosphide at a concentration of 10% by weight. These control measures were applied with the object of ascertaining, as far as possible, if the low level of infestation achieved by direct poisoning with Sodium Fluoroacetate at quarterly intervals during the three years 1951-1954 could be maintained with Zinc Phosphide, which is far less toxic, and consequently much safer to dispense and apply. In the September, 1954 control, 402 sewer entrances were baited, each bait comprising damp sausage rusk evenly mixed with Zinc Phosphide. The baits were left down for three days and then picked up and destroyed. Examination showed 7 "takes" (1 x ¾, 2 x ½ and 4 x ¼ or less). Of a total of 102 lbs. put down approximately 8 ozs. only was "taken." Heavy rain during the treatment resulted in 16 baits being washed away. For the second control in December, 1954, 400 entrances were baited and 22 "takes" (2 x ¾, 7 x ½ and 13 x ¼ or less) were recorded and approximately 33 ozs. was taken. In the third control, March, 1955, 414 entrances were baited, and the recorded result was 15 "takes" (1 full, 4 x ½ and 10 x ¼ or less) and the total weight taken was approximately 22 ozs. The final control of the series was applied in June, and 405 entrances were baited, and only 3 "takes" (2 x ½ and 1 x ¼) were obtained, the weight being about 5 ozs. In these treatments 28 bodies were recovered from the base of the shafts or nearly in the flow at the time of examination. Subsequent to the final control, the annual test baiting of all available entrances was applied after a lapse of three weeks, as during the Sodium Fluoroacetate series of controls. A total of 405 entrances was test baited, each bait being 4 ozs., comprising damp bread rusk, and left down for three days. The recorded result was 63 "takes" (33 full, 5 x ¾, 19 x ½ and 6 x ¼ or less), and in this instance 101 lbs. of test-bait was put down, and approximately 181 ozs. plus was taken. The test bait "take" subsequent to the final Sodium Fluoroacetate control was 26 "takes" (15 full, 5 x ¾, 3 x ½ and 3 x ¼ or less) approximately 82 ozs. plus. Analysis of the sector recordings and the overall result indicated that the low level of infestation previously achieved had not been maintained. The upward trend and distribution indicated by the acceptance of the non-poison test baits, while not startling, was significant, and coincided with the observations of the sewermen, who had noticed an increase in the number of rats during their routine duties in the sewers. The increase may be due to several factors, and foremost is poison prejudice produced by the continued use of Zinc Phosphide at a 10% concentration. In addition, the vast re-building operations now widespread in the City may be contributary by reason of disturbance of old drainage, which might tend to scatter the residual rat population into the active lengths of the sewers. Following on the results obtained in the Zinc Phosphide series, it was decided that a return to Sodium Fluoroacetate was desirable, and the September and December controls were applied on the pattern of the 1951-1954 series. In the September control 397 sewer entrances were baited. Each bait was 4 ozs. and comprised bread rusk and water in equal parts by weight evenly mixed with Sodium Fluoroacetate at a concentration of 1% by weight. A total of 397 entrances were baited and the baits left down for three days. On examination, 38 "takes" were recorded (1 full, 9 x ½ and 28 x ¼ or less) and 52 bodies were recovered from the base of the shafts. This number compares favourably with the Zinc Phosphide series when the total number found was 28 bodies. As in the previous controls no doubt others were carried away by the flows. The poison acceptance and number of bodies recovered does in some measure confirm the sewermens' observations. The December control result was 12 "takes" of 398 entrances baited (2 x ½ and 10 x ¼ or less) and 13 bodies were recovered. As far as can be ascertained at this juncture, it appears that the present control measures are again producing the desired result, and two further controls will be applied in March and September, 1956. In conclusion, the graph illustrates the progress made, and the result obtained, in this phase of Rodent Control." h-l Ox 17 SMOKE ABATEMENT. In my last annual report I gave a short account of the history of the Corporation's efforts to make the City a smokeless zone and printed in full the provisions of Sec. 4 of the City of London (Various Powers) Act, 1954, which received the Royal Assent on 5th July, 1954. Sec. 4 was brought into operation at the earliest date permitted under the Act., viz. 2nd October, 1955. I awaited "zero hour" with some trepidation, fearing that we should not only observe many smoking chimneys ourselves, but that we should be inundated with reports from members of the general public who had been made well aware by the Press and by the B.B.C. that the City was to be a smokeless zone from the beginning of October. I was delighted to find that the. owners and occupiers of premises in the City had been quietly making arrangements to comply with the Act by the appointed day. We observed a few smoking chimneys and we had a score or so of complaints within the next week or two. These were investigated and in all cases those responsible were co-operative. It is too early to expect that the measurements of atmospheric pollution as recorded at the five recording stations now operating in the City will prove that there has been definite improvement, for not only are we surrounded by densely built up areas emitting smoke but atmospheric pollution is much influenced by climatic conditions, which are so variable that reliable deductions cannot be made from comparison of the measurements over a short period of time.. I hope that "the wish is not farther to the thought", but it has appeared to me that the sky has been clearer over the City than over other districts in the vicinity, than it was even in the City in previous years in the months of October, November and December. Certainly the occasional emission of smoke from an individual chimney has attracted one's attention as it never did before, and the volumes of smoke emitted from railway engines at certain times of the day, particularly at Moorgate Station, have been painfully obvious. Being no longer Medical Officer of Health and having retired to the country, I shall only occasionally have the opportunity of observing atmospheric conditions in the City, but the contrast with the clean air in which I now spend most of my days will make me a very severe critic, and I shall hope that my impression of obvious improvement will be confirmed not only by my own occasional observation, but by the reports of regular observers and ultimately by the records of the actual measurements of atmospheric pollution. At least I can say with confidence that the City has made a stout effort in the campaign for clean air, and I desire to express my thanks to the owners and occupiers of premises; to those responsible for the operation and maintenance of fuel burning appliances; and to those who supply various types of fuel in the City, for their ready co-operation. I should also like to thank the Press for their invaluable support, and last but not least Mr. McGrath of my department, who has studied the subject of atmospheric pollution with such diligence and has carried out most of the field work with admirable persuasiveness, tact and patience. MEASUREMENT OF ATMOSPHERIC POLLUTION Mr. McGrath reports as follows: — "The measurement of smoke and sulphur pollution undertaken in co-operation with the Department of Scientific & Industrial Research continued during the year. The Public Health Committee authorised the establishment of three more stations to measure the concentrations of smoke and sulphur dioxide by the volumetric method. The additional apparatus has been placed in the Police Stations at Bishopsgate, Cloak Lane and Snow Hill. Observations commenced on the 1st April. Deposit Gauge. In such a district as the City of London, situated as it is in the centre of an enormous area of mixed, commercial, industrial and residential development, the measurements of atmospheric pollution vary not only with the volume and type of emission from chimneys, but also with meteorological conditions such as rainfall and the direction and strength of the wind. Because of this a long period of observations, sufficient for these meteorological factors to average out, is necessary before significant conclusions can be drawn as to the trend of atmospheric pollution. Table I shows that during the year the average monthly deposit was 21.71 tons per square mile. The highest monthly deposit occurred in May when it amounted to 44.80 tons. This coincided with the heaviest monthly rainfall of 4.16 inches. The average for the year of 7.99 tons per square mile of water-soluble deposits compares with the average of 11.73 for the previous five years. The average of undissolved matter, i.e. "tarry matter", ash, and combustible matter other than tar, was 13.73 tons per square mile, compared with 11.42 for the previous five years. Extensive building operations in the immediate vicinity of the gauge will have contributed to the increase. The gauge is sited on the northern boundary of the City and, with winds from a direction other than southerly, collects matter from the areas outside the City. In 1955 fresh winds prevailed on 187 days—109 from a northerly and 78 from a southerly direction. A "fresh" wind has a velocity of 10 miles or more per hour. This is of a strength sufficient to extend a light flag. Since the deposit gauge is most valuable for measuring deposits of ash, grit and particles which fall quickly, consideration might be given to the provision of another gauge placed at a more central point in the City, thus providing a truer index of the smokeless zone provisions. 18 Sulphur dioxide by the lead peroxide method. The difference between the deposit gauge and the lead peroxide instrument is that the former collects sulphur dioxide which is washed out of the air by rain or deposited in any other way, whilst the other collects it by a chemical process. Table I gives the results obtained during the year at Golden Lane and Finsbury Circus. At Golden Lane there is an increase of 0.32 mg./lOO sq.cm./day compared with the average of the previous five years, whilst at Finsbury Circus there is a decrease of 0.14. Volumetric estimation of smoke and sulphur dioxide—-Tables 11 and III. The average daily concentrations of smoke and sulphur dioxide are conveniently measured with this apparatus. A description of the instrument was published in a previous annual report. Smoke. At Golden Lane the average for the year was 14 parts per 100 million parts of air. The figure has remained constant for the past three years, although it slightly exceeds the average for the previous five years. The results for Cloak Lane and Snow Hill follow a pattern similar to that of Golden Lane, but those recorded at Bishopsgate have been influenced by the proximity of the railway termini at Liverpool Street. The concentrations at Bishopsgate are much in excess of those recorded at the other three stations. Sulphur dioxide. The concentration of sulphur dioxide is slightly below the average of the previous five years at Golden Lane. Similar results have been obtained at Cloak Lane and Snow Hill, but at Bishopsgate the figures for nine months are considerably in excess of those at Golden Lane which covered a period of 12 months." TABLE I.—Results obtained in 1955 of the monthly observations of rainfall and deposited matter by means of the deposit gauge, and the monthly observations of sulphur by the lead peroxide method- Month. Rainfall collected in deposit gauge. Deposit Gauge. Lead Peroxide Method. Golden Lane. Golden Lane Finsbury Circus Insoluble Deposit Soluble Deposit Total Solids Equivalent to Tons per square mile. Mgs. (S.0.3) per day per 100 sq. cm. Millimetres. inches of rain. January 60 2.38 19.35 15.37 34.72 4.81 4.26 February 33 1.30 9.96 6.24 16.20 4.30 3.67 March 20 0.78 14.04 8.36 22.40 3.30 3.60 April 5 0.19 11.10 6.40 17.50 2.30 2.30 May 105 4.16 26.50 18.30 44.80 2.00 1.80 June 63 2.48 15,90 8.00 23.80 1.80 1.70 July 33 1.30 7.00 3.40 10.40 1.50 1.20 August 22 0.88 10.50 5.10 15.60 1.50 1.30 September 55 2.18 13.80 5.50 19.30 1.80 1.70 October 70 2.74 11.60 7.60 19.20 3.10 2.40 November 12 0.49 9.15 4.88 14.03 3.85 3.58 December 40 1.59 15.90 6.70 22.60 3.90 3.30 Average: 1955 43 1.71 13.73 7.99 21.71 2.85 2.57 1954 47 1.80 12.40 9.04 21.35 2.54 2.60 1953 36 1.40 11.99 8.22 20.21 2.30 2.47 1952 40 1.50 11.02 9.17 20.19 2.26 2.19 1951 54 2.10 11.50 15.25 26.75 2.84 2.56 1950 38 1.50 10.19 16.96 27.15 2.66 2.32 1950-54 43 1.66 11.42 11.73 23.13 2.52 2.43 19 TABLE II.—Results obtained in 1955 of the daily observations of the concentrations of SMOKE by the volumetric method. MONTH Rainfall collected in deposit gauge at Golden Lane Golden Lane POLICE STATIONS Bishopsgate Cloak Lane Snow Hill Monthly average Highest daily Monthly average Highest daily Monthly average Highest daily Monthly average Highest daily Equivalent to Millimetres inches of rain Milligrams per 100 cubic metres Milligrams per 100 cubic metres Milligrams per 100 cubic metres Milligrams per 100 cubic metres January 60 2.38 36(a) 194 (a) Observations first commenced on the 1st April, 1955. February 33 1.30 15 30 March 20 0.78 15 41 April 5 0.19 7 20 25 58 10 25 13 28 May 105 4.16 6 15 19 35 6 9 8 13 June 63 2.48 5 11 16 29 4 9 5 8 July 33 1.30 5 10 14 33 4 8 3 7 August 22 0.88 4 9 18 44 4 .9 4 9 September 55 2.18 7 33 23 43 6 11 6 18 October 70 2.74 16 39 31 48 14 39 15 36 November 12 0.49 24 65 41 87 19 53 20 70 December 40 1.59 30 (b) 111 (6) 42 77 19 58 21 55 Average: 1955 43 1.71 14 — 25 (c) — 10(c) — 11 (c) — 1954 47 1.80 14 — — — — — — — 1953 36 1.40 14 — — — — — — — 1952 40 1.50 13 — — — — — — — 1951 54 2.10 12 — — — — — — 1950 38 1.50 10 — — — — — — 1950-54 43 1.66 12 — — — — — — — (a) These figure reflect the result of heavy fogs on the 12th and 20th of the month. (b) Includes the average of 8 short period measurements taken between 11.0 a.m. on the 30th November and 2.0 p.m. on the 1st December because of persistent fog warning. (c) Results for nine months of the year. TABLE III.—Results obtained in 1955 of the daily observations of concentrations of SULPHUR DIOXIDE by the volumetric method. MONTH Rainfall collected in deposit gauge at Golden Lane Golden Lane POLICE STATIONS Bishopsgate Cloak Lane Snow Hill Monthly average Highest daily Monthly average Highest daily Monthly average Highest daily Monthly average Highest daily Equivalent to Millimetres inches of rain Parts per 100 million parts of air Parts per 100 million parts of air Parts per 100 million parts of air Parts per 100 million parts of air January 60 2.38 17 (a) 69 (a) Obervations first commenced on the 1st April, 1955. February 33 1.30 13 35 March 20 0.78 13 29 April 5 0.19 8 18 13 21 12 23 12 21 May 105 4.16 5 10 11 19 7 11 9 17 June 63 2.48 6 13 9 15 6 15 8 17 July 33 1.30 4 9 6 14 5 11 6 13 Auguest 22 0.88 5 10 9 18 6 15 7 17 September 55 2.18 6 16 13 23 16 9 19 October 70 2.74 12 28 18 32 13 31 16 30 November 12 0.49 14 37 18 37 17 45 18 44 December Average: 40 1.59 15 (6) 35 (6) 21 43 17 36 21 45 1955 43 1.71 10 — 13 (c) — 10(c) — 12 (c) — 1954 47 1.80 10 - — — — - - - 1953 36 1.40 11 — — — — — — — 1952 40 1.50 11 - — — — — — — 1951 54 2.10 13 - — — — — - - 1950 38 1.50 10 — — — — — — 1950-54 43 1.66 11 - - - - - - - (а) These figures reflect the result of heavy fogs on the 12th and 20th of the month. (b) Includes the average of 8 short period measurements taken between 11.0 a.m. on the 30th November and 2.0 p.m. on the 1st December. (c) Results for nine months of the year. MEDICAL EXAMINATIONS Your Medical Officer carries out the medical examination of all new entrants to the staff of the Corporation; of those who appear to be medically unfit to continue in employment and of those who have had prolonged or repeated absence on account of illness. In connection with the last two mentioned categories, it is frequently necessary to correspond with medical and surgical specialists on the staff of hospitals, and with general medical practitioners, and I have pleasure in recording that I have always received from them the greatest assistance and courtesy. The total number of medical examinations during the year was 219. 20 This is the last occasion on which I shall be responsible for the submission of an annual report as Medical Officer of Health of the City of London. It has been a privilege to serve the Corporation of the City from 1928 to 1956, first as Medical Officer of Health of the Port of London and then as Medical Officer of Health of the City. During the last illness of my predecessor, Dr. W. M. Willoughby, and for about a year after his death, I took charge of the health work in both the City and the Port. 1 was unwilling to leave the Port Health Department, in which I was very happy and with the work of which I was thoroughly familiar, having previously served in the Port of Liverpool for nearly 8 years. It was then my impression that there would be definite advantages in combining the two appointments, but those were more spacious days, and the Corporation would not have been prepared to consider such a proposition even if I had suggested it, which I obviously could not do. At the time they were right and I was wrong, because war was looming ahead and Civil Defence duties were soon to throw heavy additional responsibilities on the Medical Officer of Health of the City, and subsequently post-war conditions maintained the strain. In the meantime two senior appointments, those of Comptroller and City Solicitor, were amalgamated and a precedent thereby established. On the retirement of Dr. Morgan as Medical Officer of Health of the Port of London, it was decided to amalgamate the two Medical Officer of Health appointments. I felt that I was then too old to take up Port Health duties again after nearly 20 years, particularly as the offices of the two departments were geographically widely separated, and the Corporation kindly postponed the amalgamation until my retirement. I am confident that Dr. Greenwood Wilson, with his long experience in the City and Port of Cardiff, will successfully take charge of the health work of both the City and the Port of London. The administration will be much easier when the new Guildhall offices are available, and the Medical Officer of Health will have an office with the City staff on one side and the Port staff on the other. I wish Dr. Greenwood Wilson well, and hope that he will be as happy in the combined appointments as I have been in each successively. For I have been very happy indeed throughout my time in the service of the Corporation. I have always had a loyal and efficient staff with whom it has been a pleasure to work, and I tender to them all, past and present, my sincere thanks for their help and their good fellowship. I cannot adequately express my gratitude to the members of the Corporation of London, particularly the Chairmen and members of the Public Health and Port Health Committees, over the past 28 years, for their unvarying kindness and consideration. I have always felt that it was an honour to serve the Corporation of the City of London and that, in my limited sphere, I must do everything in my power to maintain the high standard of local government for which the City has for centuries been renowned. But quite apart from such considerations, I could not have done less than my best in return for such kindness and friendship as I have enjoyed from all the members of the Court of Aldermen and the Court of Common Council. My Lord Mayor and Gentlemen, though I am glad, at my age, to lay down the responsibilities of office, I am sad to have come to the end of the very happy associations and the many privileges I have enjoyed in your service. I thank you all for them most gratefully and I pray that the City of London will prosper and the Corporation will stand even higher in the esteem of all men of goodwill throughout the world. I have the honour to be, Your obedient Servant, CHAS. F. WHITE, Medical Officer of Health.. 21 STATISTICAL INFORMATION. Area — 678 acres (including the Temple and foreshore). Population.—Census 1951, 5,268. Estimated mid-year 5,180 Annual Rateable Value.—As at 1st April, 1955, £13,968,300. Annual Sum received from Penny General Rate.—Estimated £55,700. Births:— Total. M. F. Legitimate 29 17 12 Live Births, Illegitimate 2 1 1 Still Births — — Birth Rate per 1,000 resident population, 1955 533 Rate per 1,000 total (live and still) births — Deaths:— Deaths, Infants under 4 weeks of age Legitimate 1 1 — Illegitimate — — — Deaths under 1 year Legitimate 1 1 — Illegitimate — — — Deaths (all ages) 54 39 15 Death Rate per 1,000 resident population 1000 Death Rate of Infants under one year of age:— All Infants per 1,000 live births 32.26 Legitimate Infants per 1,000 legitimate live births 34.48 Illegitimate Infants per 1,000 illegitimate live births — INFECTIOUS DISEASE. Notifications received:— Total cases notified. Acute Primary Pneumonia 4 Measles 20 Puerperal Pyrexia 2 Scarlet Fever 2 Tuberculosis 11 Acute Poliomyelitis (Paralytic) 2 Acute Poliomyelitis (Non-Paralytic) 1 ANALYTICAL EXAMINATIONS. (Other than under Food and Drugs Act). Atmospheric Pollution 24 Crab Meat 1 Egg Albumen 1 Fertiliser 2 Grapefruit (Tinned) 1 Ham (Tinned) 3 Meat (Tinned) 4 Melba Frosty Mints 1 Milk (Tinned) 8 Monosodium Glutinate 1 Rainwater 12 Raisins, Seedless 5 Strawberry Pressings 1 Tomato Paste 1 Well Water 1 BACTERIOLOGICAL EXAMINATIONS. The following specimens were examined during the year:— Braised Kidneys (Tinned) 2 Crab Meat 1 Custard Powder 2 Faeces 75 Grape Fruit Juice 1 Chicken and Ham Vol au Vent 1 Ham (Tinned) 4 Jellied Veal (Tinned) 1 Jelly Crystals 1 Milk (Tinned) 1 Mock Cream 1 Parsley Butter 1 Pork Sausages 4 Roast Beef and Gravy 1 Roast Lamb 1 Salmon (Tinned) 5 Stewed Steak 1 Tomato Juice 1 Tongue 1 Well Water 1 DIPHTHERIA ANTI-TOXIN. Quantity provided to private practitioners Nil. 22 CAUSES OF, AND AGES AT, DEATH DURING THE YEAR 1955. Nett Deaths at the subjoined ages of Residents whether occurring within or without the district. Causes or Death All Ages Under 1 year 1 and under 5 years 5 and under 15 years 15 and under 25 years 25 and under 45 years 45 and 65 and under under 65 75 years years 75 and upwards 1 2 3 4 5 6 7 8 9 10 All Causes ... 54 1 — — — 4 21 16 12 1. Tuberculosis, respiratory M 1 — — — — 1 — — — F 1 — — — — — — — 1 — — — 2. Tuberculosis, other forms M — — — — — — F 1 — — — — — 1 — — 3. Syphilitic disease M — — — — — — — — — F — — — — — — — — — 4. Diphtheria M F — — — — — — — — — — — — — — — — — — 5. Whooping Cough M — — — — — — — — — F — — — — — — — — — 6. Meningococcal infections M — — — — — — — — — F — — — — — — — — — 7. Acute poliomyelitis M — — — — — — — — — F — — — — — — — — — 8. Measles M — — — — — — — — — F — — — — — — — — — 9. Other infective and parasitic disease M — — — — — — — — — F — — — — — — — — — 10. Malignant neoplasm-stomach M 1 — — — — — — — 1 F — — — — — — — — — 11. Malignant neoplasm-lung, Bronchus M 5 — — — — — 4 1 — F 2 — — — — — 1 1 — 12. Malignant neoplasm-breast M — — — — — — — — — F 2 — — — — — 1 1 — 13. Malignant neoplasm-uterus F 1 — — — — — 1 — — 14. Other malignant and lymphatic neoplasms M 4 — — — — — 1 2 1 F 1 — — — — — 1 — — 15. Leukaemia, aleuksemia M 1 — — — — 1 — — — F — — — — — — — — — 16. Diabetes M — — — — — — — — — F — — — — — — — — — 17. Vascular lesions of nervous system M 1 — — — — — 1 — — F 1 — — — — — — 1 — 18. Coronary disease, angina M 5 — — — — — 3 2 — F 2 — — — — — — 1 1 19. Hypertension with heart disease M — — — — — — — — — F — — — — — — — — — 20. Other heart disease M 4 — — — — — — 1 3 F — — — — — — — — — 21. Other circulatory disease M — — — — — — — — — F 2 — — — — — — — 2 22. Influenza M — — — — — — — — — F — — — — — — — — — 23. Pneumonia M 4 — — — — — 2 1 1 F — — — — — — — — — 24. Bronchitis M 1 — — — — — — 1 — F — — — — — — — — — 25. Other diseases of respiratory system M 1 — — — — — — 1 — F — — — — — — — — — 26. Ulcer of Stomach and duodenum M 2 — — — — — — — 2 F — — — — — — — — — 27. Gastritis, enteritis and diarrhoea M — — — — — — — — — F — — — — — — — — — 28. Nephritis and nephrosis M — — — — — — — — — F — — — — — — — — — 29. Hyperplasia of prostate M 1 — — — — — 1 1 —— F — — — — — — — — — 30. Pregnancy, childbirth, abortion F — — — — — — — — — 31. Congenital malformations M 1 1 — — — — — — — F — — — — — — — — — Carried forward M 32 1 — — — 2 12 9 8 F 13 — — — — — 6 4 3 23 CAUSES OF, AND AGES AT, DEATH DURING THE YEAR 1955—continued. Causes of Death Nett Deaths at the subjoined ages of Residents whether occurring within or without the district. All Ages Under 1 year 1 and under 5 years 5 and under 15 years 15 and under 25 years 25 and under 45 years 45 and under 65 years 65 and under 75 years 75 and upwards 1 2 3 4 5 6 7 8 9 10 Brought forward M 32 1 — — — 2 12 9 8 F 13 — — — — — 6 4 3 32. Other defined and ill-defined diseases M 2 — — — — 1 — 1 — F 2 — — — — — — 2 — 33. Motor vehicle accidents M 1 — — — — — 1 — — F — — — — — — — — — 34. All other accidents M 3 — — — — 1 1 — 1 F — — — — — — — — — 35. Suicide M 1 — — — — — 1 — — F — — — — — — — — — 36. Homicide and operations of war M — — — — — — — — — F — — — — — — — — — M 39 1 — — — 4 15 10 9 F 15 — — — — — 6 6 3 MATERNITY AND CHILD WELFARE. The following details have been received from the Divisional Medical Officer of the London County Council with regard to work carried out in connection with Maternity and Child Welfare in the City. Infant Welfare Centres. Total No. of children who first attended during the year and who on the date of their first attendance were— Under 1 year of age 38 1-5 years of age 8 Total No. of children who attended during the year, and who were born in:— 1955 30 1954 26 1953-50 43 Total attendances by children— Under 1 year of age 533 1-5 years of age 375 Health Visitors. No. of infants under 1 year of age visited for first time 28 Total visits to infants under 1 year of age 75 Total visits to children aged 1 year but under 2 years 37 Total visits to children aged 2 years but under 5 years 112 No. of expectant mothers visited 14 Total visits to expectant mothers 21 Care of Premature Infants. No. of premature births during the year 2 No. of deaths under 1 month 1 Diphtheria Immunisation. No. of children who completed a full course of primary immunisation— Under 5 years of age 13 5-14 years of age 3 No. of children who were given a secondary or reinforcing injection 35 Vaccination. No. of children successfully vaccinated or revaccinated 17 24 MEAT INSPECTION. Tons. Cwts. Qrs. Lbs. Meat, &c., delivered at Smithfield Market 386,046 0 0 0 Meat, &c., seized by Inspectors at Smithfield Market 470 13 1 23 Meat, &c., seized by Inspectors at Leadenhall Market and City shops 7 0 2 26 Meat, &c., seized by Inspectors at Cold Stores 6 0 3 20 Various commodities seized by Inspectors and sent to Lett's Wharf 4 19 2 14 Number of eggs seized by Inspectors and sent to Lett's Wharf, 6,954 Number of demonstrations and lectures given, 46. Number of Students attending, 447. PUBLIC HEALTH (MEAT) REGULATIONS, 1924-1948. The improvement in carriage of meat noted in past reports has been maintained, although, of course, the quantities carried are still less than in pre-war years. 76 infringements were noted, the fault being remedied on each occasion on instructions given. PREMISES WHERE FOOD IS PREPARED AND OFFERED FOR SALE. All these premises are subject to regular inspection. Without exception all criticisms have received immediate attention. ITINERANT FOOD VENDORS. Constant inspections of barrows and of itinerant food vendors have been maintained and no difficulty has been experienced in connection with this class of trade. FOOD INSPECTION. The food delivered at riverside wharves and premises in the City has consisted of the customary varieties, and has been the subject of constant inspection. 194 tons 6 cwts. 3 qrs. 21 lbs. were condemned as unfit for human consumption. 95 tons 9 cwts. 0 qrs. 16 lbs. of this food were utilised for stock feeding, fertilizing or manufacturing purposes. The remainder, consisting of 98 tons 17 cwts. 3 qrs. 5 lbs. was destroyed either by the Cleansing Department of the City Corporation, being useless for stock feeding purposes, or else on the sites on which it was condemned. 24 tons 14 cwts. 2 qrs. 1 lb. of food were placed under stop and subsequently released to be dealt with under the supervision of other local authorities. SANITARY CIRCUMSTANCES. The general sanitary supervision has been maintained and in this connection 4,014 inspections have been made. As a consequence of these inspections, it was necessary to serve 15 Intimation Notices. Nine Statutory Orders were served. No Legal proceedings were necessary. Tenement Houses were inspected and the only common lodging house in the City was kept under regular supervision. FACTORIES ACTS, 1937 and 1948 Factory premises have been under such supervision as is necessary, and the following gives details of the work carried out:— PART I OF THE ACT. 1.—INSPECTIONS for purposes of provisions as to health. Premises Number on Register Number of Inspections Written notices Occupiers prosecuted (i) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 800 (including 718 kitchens) 1,767 (including 1,704 kitchens) 236 (including 222 kitchens) — (ii) Factories not included in (1) in which Section 7 is enforced by the Local Authority 90 117 9 — (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) TOTAL 890 1,884 245 — 25 PART I OF THE ACT—continued 2.—CASES IN WHICH DEFECTS WERE FOUND. (If defects are discovered at the premises on two, three or more separate occasions they are reckoned as two, three or more " cases ") Particulars Number of cases in which defects were found Number of cases in which prosecutions were instituted Found Remedied Referred To H.M. Inspector By H.M. Inspector Want of cleanliness (S.l.) 487 530 — — — Overcrowding (S.2) — 2 — — — Unreasonable temperature (S.3) — — — — — Inadequate ventilation (S.4) 61 56 — — — Ineffective drainage of floors (S.6) 11 7 — — — Sanitary Conveniences (S.7) (a) insufficient 14 3 — — — (6) Unsuitable or defective 168 104 — 6 — (c) Not separate for sexes 5 5 — 1 — Other offences against the Act (not including offences relating to Outwork) 305 442 — — — TOTAL 1,051 1,149 — 7 — OUTWORK AND THE INSPECTION OF OUTWORKERS' PREMISES, ETC. Lists received from City Firms 105 Names and Addresses, etc., received from other Authorities 105 Names and Addresses transmitted to other Authorities 640 No case of infectious disease was reported in connection with outworkers' premises in the City. SHOPS ACT, 1950. 86 inspections of shops and warehouses have been carried out. Defects found have been remedied after the service of 8 Intimation Notices and without recourse to legal proceedings. CATERING LICENCES. Before issuing licences for the establishment of catering businesses, the Local Food Control Officer refers cases to your Medical Officer of Health in order that licences may only be issued in respect of premises which are suitable from a public health point of view. During 1955, 141 inspections were made in this connection and reports forwarded to the City Food Controller in regard to the 37 cases so referred. PHARMACY AND POISONS ACT, 1933. 68 firms were registered under this Act, 66 of which were re-registrations. No infringement was noted. 83 inspections were made in connection with the administration of the Act. PHARMACY AND MEDICINES ACT, 1941. The provisions of the above Act were carried out without recourse to legal proceedings and without special difficulty. 23 inspections were made and no contravention came under the notice of the Inspector. FERTILIZERS AND FEEDING STUFFS ACT, 1926. The provisions of the above Act were carried out without recourse to legal proceedings and without special difficulty. 42 inspections were made ; no contravention was discovered. FOOD AND DRUGS ACT, 1938, AND FOOD REGULATIONS. Informal and Formal Samples submitted for Analysis. Article Informal Formal Article Informal Formal FOOD. Brought forward ... 51 3 Almonds (ground) 6 - Crab (dressed) 1 - Apricots (dried) 1 - Curry Powder ... 10 — Baking Powder 2 - Custard Powder 1 — Butter 9 - Dairy Cream 11 — Butter (on rolls, etc.) 5 3 Dessert Powder 6 — Cake 1 — Dripping 6 1 Celery Seed 1 — Essence 1 — Cheese (processed) 6 — Fish 3 — Christmas Pudding 1 — Fish Cakes 3 — Cinnamon (ground) 3 — Fish Paste 4 — Cloves 1 — Flavourings 6 — Coconut (desiccated) 4 — Flour 4 — Coffee 9 — Frying Oil 1 — Condensed Milk 1 — Gelatin 3 — Corned Beef 1 — Ginger (ground) 6 — Carried forward 51 3 Carried forward 117 4 26 FOOD AND DRUGS ACT, 1938, AND FOOD REGULATIONS—continued Informal and Formal Samples submitted for Analysis. Article Informal Formal Article Informal Formal Brought forward 117 4 Brought forward ... 245 20 Ginger (crystallised) 2 — Stuffing 1 — Gravy Powder 1 — Suet 4 — Herbs 2 — Sultanas 2 — Honey 3 — Sweets 6 2 Horseradish Relish 1 — Tea 14 — Ice Cream 6 — Vinegar 4 — Ice Cream Powder 1 — Welsh Rarebit 1 — Jellies 2 — Jelly Crystals 2 — Ketchup 1 — DRUGS. Lard 9 — Almond Oil 1 — Lemonade Crystals 3 — Ammoniated Tincture of Quinine 3 Lemon Curd 1 — Luncheon Meat 2 — Alum 2 - Mace (ground) 2 — Calamine Lotion 1 - Margarine ... ... 9 — Camphorated Oil 1 — Marzipan 1 — Cascara Sagrada 2 — Milk 1 15 Castor Oil 1 — Mincemeat 1 — Epsom Salts 1 — Minced Pork 1 — Eucalyptus Oil 4 — Mint (dried) 6 — Friars Balsam 2 — Mustard 2 — Fullers Earth ... 1 — Nutmeg (ground) 7 — Gregory's Powder 1 — Pastry Flake 2 — Halibut Liver Oil 1 — Patent Food 1 — Hypophosphites, Compound Syrup of 2 Peanut Butter 1 — Peas (tinned) 1 — Juniper, Oil of 3 — Peel (mixed) 2 — Linctus 2 — Pepper 4 — Liquorice Powder 1 — Pudding Powder 1 — Lotions 2 — Raisins 1 — Milk of Magnesia 1 — Rennet (essence of) 1 — Myrhh, Tincture of 1 — Rice 3 — Olive Oil 2 — Rum Butter 1 1 Ointments 6 — Salad Cream 1 — Paraffin (liquid) 2 — Sauces 7 — Peppermints 1 — Sausages 25 — Powders, Medicated 2 1 Soft Drink 1 — Rose Hip Syrup 1 — Soups (tinned) 2 — Saccharin Tablets 1 — Soya Flour 1 — Turpentine, Liniment of 1 — Spice (mixed) 4 — Witch Hazel Jelly 1 — Spreads 2 — Yeast Tablets 1 — Stewed Steak (tinned) 1 — Zinc & Castor Oil Cream 1 — Carried forward 245 20 Totals 329 23 ADMINISTRATIVE ACTION REGARDING ADULTERATION OR OTHER IRREGULARITY. Article. Informal or Formal Sample. Nature of adulteration or irregularity. Action. Glass of Hot Milk. Formal. Extraneous water 1.3%. Hot water added at time of service. Verbal caution. Butter (on rolls). Formal. 100% margarine. Prosecution (see page 27). Butter (on rolls). Formal. 30% margarine. Written caution by City Solicitor. Butter (on rolls). Formal. 100% margarine. Prosecution (see page 27). Rum Butter Informal. Foreign fat 13.5%—small rum content 0.8%. Formal sample taken. ditto Formal. Bum equivalent to proof spirit 0.35%. Written caution. Dripping. Informal. Excess acidity—oleic acid 3.59%. Formal sample taken but certified genuine. Letter to manufacturers. Butter Sweets. Informal. Fat 2.2%. Formal sample taken but certified as genuine. Butter Sweets. Informal. Fat 3.5%. Formal sample taken. ditto Formal. Butter Fat 3.7%. Written caution. Milk (J pint bottle). — Contained piece of metal. Suppliers cautioned. Milk (pint bottle). — Contained dried milk skin. ditto. Mixed Fruit Boll. — Contained a nail. Prosecution (see page 27). Acne Treatment Powder. Informal. Deficient in the amount of sulphur declared on the packet. Formal sample taken. ditto Formal. ditto. Written caution to manufac turers. 27 PROSECUTIONS. Food and Drugs Act, 1938. A rticle. Offence. Result. Butter (on rolls). Selling 100% margarine on rolls when "Buttered Bolls" were asked for. Plea of guilty. Fined Three Pounds with Two Guineas costs. Butter (on rolls). ditto. ditto. Mixed Fruit Boll. Sold for human consumption and found to contain nail. Plea of guilty. Absolute discharge. Two Guineas costs. MERCHANDISE MARKS ACT, 1926. AGRICULTURAL PRODUCE (GRADING AND MARKING) ACTS, 1928-1931. No difficulty was experienced during the year in regard to the administration of the above Acts PIGEON NUISANCE. The Corporation, in exercise of their powers under Sec. 121 of the Public Health (London) Act, 1936, from time to time cause the number of pigeons in the City to be reduced when it appears to them either that their number is excessive, or that complaints of their congregation in certain areas are justified. Certain pigeon-catchers are authorised by the Corporation to carry out the necessary trapping, and during 1955, 1,000 pigeons were destroyed by this means. CITY MORTUARY. Bodies received 132 Post Mortem Examinations made 131 Inquest on bodies 34 Inquests held at Holloway Prison 1 Inquest on fires — DISINFECTION AND CLEANSING OF VERMINOUS PERSONS, ETC. Export of Clothing, &c. :— No. of articles disinfected 1,058,259 Cases of horsehair 304 Clothing by weight 4 Tons 15 cwt. 2 qrs. Fees received £4,178 General Disinfection. Infectious Diseases, &c. :— Articles of bedding disinfected 354 Rooms disinfected after cases of infectious disease 3 Lockers at Post Offices disinfected 13 Verminous rooms disinfected 30 Ambulances, vans, &c., disinfected — Police Cells disinfected 1 Cleansing of Persons:— No. of verminous persons bathed 480 No. of Scabious Persons bathed 1 No. of verminous articles disinfected 4,803 Cleansing of Schoolchildren:— No. of children cleansed 148 No. of articles disinfected 1,569 No. of children treated for Minor ailments 2,683 LONDON: Printed by Drake, Driver & Leaver Ltd., London, W.C. 1 1956. 350—10/58—A7948.