REPORT of the MEDICAL OFFICER OF HEALTH for the CITY OF LONDON for the year 1956. Printed by the Authority of Common Council 17th December 1953. 68615 STAFF. MEDICAL OFFICER OF HEALTH Appointment Wilson, John Greenwood, M.D., F.R.C.P., M.R.C.S., D.P.H April 1956 White, Charles Francis, O.B.E., M.D., Ch.B., D.P.H., D.T.M. Dec 1937 (Retired March, 1956) CLERICAL STAFF Blunt, Harold F. Chief Clerk May 1924 Gray, Charles M. Chief Clerk March 1911 (Retired Stout, James Erl. 1st Assistant Clerk July 1930 1956) Betts, Charles W.R. 2nd Assistant Clerk April 1926 Threadgold, Arthur W. Senior Clerk, Meat Inspector's Office Nov. 1923 Peters, E.J., General Grade Clerk, Meat Inspector's Office Nov. 1935 Cash, J.E. General Grade Clerk, Meat Inspector's Office March 1954 GurneY, Miss M.L. Clerical Assistant May, 1939 West Mrs. I.R. Clerical Assistant Sep. 1956 PUBLIC HEALTH INSPECTORS McGrath, William Richard March, 1922 Harrington, George Edwin Dec. 1925 Sillett, David Ernest April 1926 Neale, William G.C. July 1928 Thorpe, Robert C. March 1930 Hudson, Leslie A April 1934 Campbell, J.W Sep. 1946 Thompson, E. Sep. 1948 Flynn, J July 1951 MEAT INSPECTION STAFF Thompson, Frank, E. Chief Meat Inspector July 1924 Mellish, Cyril, E. Chief Meat Inspector Jan. 1912 (Retired Lee, W.R. Deputy Chief Meat Inspector July 1930 May, 1956) Garrard, S.S. Meat Inspector Sep. 1946 Morris, W.L. Meat Inspector Sep. 1946 Seymour, K.S. Meat Inspector July 1935 Wilson, J.C. Meat Inspector Jan. 1936 Leach, R.A. Meat Inspector Sep. 1952 Cox, J.T. Meat Inspector Aug. 1954 Field, H. Meat Inspector Aug. 1954 Gingell, G. Meat Inspector Aug. 1954 Giles, H.W. Meat Inspector Aug. 1956 Bernhardt, D.R. 'Authorised Officer' under Food Hygiene Regulations, 1955 May 1931 RODENT OFFICER Carter, J Sep. 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, J.G. Nov. 1951 KEEPER OF THE MORTUARY Lawrence, F.H May 1936 DISINFECTING APPARATUS ATTENDANT Burton, J.H. March 1936 MESSENGERS Bourne, A.W. March 1956 Powell, W.F. Dec. 1947 (Resigned March, 1956) SENIOR PORTER AT SMITHFIELD MARKET Prevost, A.E. Feb. 1926 PUBLIC ANALYST Lickorish, A.J.C., F.I.C April 1930 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 Wright, T.W. (General Duties at Smithfield Market) Oct. 1956 Lawrence, E.E. (General Duties at Mortuary) Aug. 1954 Jollie, Mrs. F.G. (Bath Attendant and Cleaner) Sept. 1955 Beach, Mrs. E. (Office Cleaner) Feb. 1945 Nathan, Mrs. A. (Office Cleaner) Sept. 1940 1. REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE CITY OF LONDON FOR THE YEAR 1956, To the Right Honourable The Lord Mayor, Aldermen and Commoners of the Corporation of London. 55/61, Moorgate, London, E.G.'2. October, 1'957. My Lord Mayor and Gentlemen, I have the honour to submit the following report on the work of ray Department during the year 1956. Vital Statistics The resident population of the City according to the Registrar General's estimate to mid-year 1956 was 5,180. The birth rate rose to 7.56 per 1,000 and the death rate rose to 13.19 per 1,000. There were 44 live births during the year, 2 of which were premature births; in neither case did the infant die within 28 days of birth. There were 3 deaths under one year of age, in 2 of which cases the infant died in a few minutes and the third in two days. There were no deaths attributable to pregnancy or childbirth. The number of deaths was 67 of which only the three infant deaths occurred in the age groups 1-25 years; 5 were between 25 and 45 years; 26 between 45 and 65; 19 between 65 and 75; and 14 over 75 years. Twenty-two deaths were due to disease of the heart or blood vessels, 17 were due to cancer of which 6 were cancer of the lung. There were 2 deaths due to respiratory tuberculosis, 4 to pneumonia, 4 to bronchitis and 2 to diabetes. Infectious Diseases The incidence of infectious diseases remained low. There were no cases of poliomyelitis. Cases of Puerperal Fever and Tuberculosis were 13 and 5 respectively compared with 2 and 11 in the previous year. Mass Radiography The Mass Radiography Unit of the \orth East Metropolitan Hospital Board continued to operate during the year from your premises at 20, Golden Lane. The total number of examinees was 54,112, in addition to 4,244 City workers when the Unit was mobile, i.e. when operating at the premises of large City firms, where employees were X-rayed at their place of work. The Unit is also available to the boroughs of Finsbury, Stepney and Shoreditch, although the majority of examinees are employed in the City. The following is an extract from the Annual Report for 1956 of the Medical Director of the Unit:— "During 1956 the Unit examined 37,264 males and 27,916 females making a total of 65,180, which shows an increase of about 3,400 on the 1955 figures. Sixty-two active cases of tuberculosis have been discovered, which gives a rate of almost one per thousand examined — with male examinees showing a slightly higher rate than females. All clinics have recorded their sputum findings, and twenty cases with a positive sputum have been reported, of which thirteen were male and seven female. "The Unit operated at the Mass Radiography Centre, 20, Golden Lane, London, E.C.I, from the 1st January to the 30th April and from the 8th August to the 31st December. The majority of examinees attending the Centre were employed in the City of London, although firms operating in the Metropolitan Boroughs of Finsbury and Shoreditch also sent their staffs, as well as Health and Teaching staffs of the London County Council. "At the commencement of the year under review the new scheme, detailed in our previous Report, for the examination of school teachers, came into operation, and has worked quite smoothly even if the response has not been so great as was contemplated. Altogether the Unit X-rayed 535 teachers, — representing ninety-three schools. A similar procedure has been adopted for Health Staffs in Divisions 3, 4 and 5. The normal Consent Form has been dispensed with; the examinee receiving the result of his (or her) examination. The upper portion of the form is sent to the Divisional Medical Officer, who will thus know who attended for examination. For convenience, a copy of the teachers' form, of which the Unit holds a supply provided by the London County Council, is attached.The Health Staffs' form is issued by the appropriate Health Division, and follows similar lines to the teachers' form. 2. "During the mobile period the Unit visited several firms in the City of London and carried out a special Survey in Finsbury, when the Unit operated in the Finsbury Health f.entre, rine Street, London, E.C.I, by kind permission of the Public Health Committee of the Borough of Finsbury. About 250 firms participated in this Survey, which took place from the 14th June to the 6th July. Particular emphasis was laid on firms operating in the northern sector of the Borough, as those in the southern area are conveniently situated to the Mass Radiography Centre at Golden Lane. Also in this Survey were included firms in the Ludgate Circus area, as there is direct transport facilities to the Health Centre. "During the Finsbury Survey some Public Sessions were held at which no appointments were necessary. The usual publicity, e.g. posters, handbills, etc., was used, but the attendances at these Sessions were disappointing. At the request of the Medical Officer of Health for Finsbury (Dr. C.O.S. Blyth Brooke) special sessions were set aside for the examination of elderly folk. "We would like to take this opportunity of recording our grateful appreciation to the Medical Officer of Health and his staff for their helpfulness during this Survey. "The attendance at the Public Sessions amounted to 542 with 4,299 at the Planned Sessions. Eight cases of active tuberculosis and 11 cases of inactive tuberculosis were discovered, as well as 2 cases of carcinoma of the lung. "As this Unit does not have the usual X-ray van and trailer, it is necessary for our apparatus to be installed within a firm's premises, and so every endeavour is made during the mobile period to X-ray either firms in the vicinity of a particular site or firms associated with the Company in which the apparatus has been installed. One case in point during 1956 was the Union International Company, when we X-rayed the staffs of 20 associated firms. "Of the firms examined during 1956 a high proportion were small or new firms. Of the total number X-rayed about 42% had not been X-rayed before or been examined for three years or more. "No Public Sessions, that is sessions without appointment, were arranged while the Unit operated at the Mass Radiography Centre, but a large number of the general public have been X-rayed there, as well as doctors' cases. "ZONE OF UNIT The zone of Unit 6D remains the same, viz., the City of London and the Metropolitan Boroughs of Finsbury and Shoreditch, with the administrative offices at the Finsbury Health Centre, Pine Street, London, E.C.I. Owing to the intensive day population there is a great demand for the services of the Unit, not only from new firms which are constantly being discovered as a result of our circulations, but also old firms requiring repeat examinations which are carried out at approximntely two yearly intervals. "METHOD OF OPERATION The Unit has continued its normal procedure while operating at the Mass Radiography Centre of holding miniature sessions on Mondays, Wednesdays and Fridays, from 9.15 a.m. to 12.30 p.m. and 2.00 p.m. to 4.30 p.m. Separate sessions have been arranged for men and women, and there has again been a predominance of men. Tuesdays and Thursdays have been allocated for reading miniature films, taking and reading large films and interviews by the Medical Director, and for the dispatch of results to examinees, who provide the stamped (2½d.) addresse envelope. Examinees receive their results within a week. "During the mobile period the sessions may have had to be slightly varied depending upon circumstances. Whenever possible, a firm's internal postal system is used for the circulation of examination results, as this provides a saving in time for recalls for large films. Also during the mobile period, miniature films are read almost daily, so that there is no unnecessary delay over the taking of large films. "Except for large films, examinees are X-rayed over their clothes; ladies being advised what to avoid wearing on the day of examination. "The Unit has emphasised the importance of newly appointed staff being X-rayed, and this is being adopted by a large number of City firms. The results of such examinations are, of course, sent direct to examinees. "PROPAGANDA This item of expenditure continues to be very low for this Unit and is only incurred when circumstances warrant it, as, for example, when the Unit pays its periodical visits to Finsbury or Shoreditch. "STAFF During the year under review, notwithstanding sundry changes in both technical and clerical staff, all members have provided an efficient and courteous service which has been fully appreciated by those attending the Unit. "MEDICAL PROCEDURE Abnormal cases have an interview with the Medical Director and are referred through the examinee's own doctor to the appropriate Chest Clinic; the ultimate diagnosis being secured from the latter. We express our grateful thanks to the many Chest Clinics, to which we have referred cases, for their helpful co-operation. "The Unit classifies its abnormal miniatures, and appropriate notification is passed to the examinee. Where an investigation is outside the purview of a Chest Clinic, the co-operation of St. Bartholomew's Hospital is secured. The help rendered by Dr. N.C. Oswald and his colleagues is herewith gratefully acknowledged. 3. "CONDITIONS OF INTEREST OTHER THAN TUBERCULOSIS The following cases of interest, other than tuberculosis, have been found during 1956. 1. Cardio-vascular lesions (a) Congenital (b) Acquired Patent Ductus Arteriosus 6 Thyro Toxicosis with auricular fibrillation Dextro-cardia 6 Calcified Pericardium Ventricular Septal Defect 3 Bundle Branch Block Atrial Septal Defect 3 Aortic Aneurysm 2 Dilated Pulmonary Artery 2 2. Abnormalities of Diaphragm Developmental abnormality of Diaphragm (Right) Diaphragmatic Hiatus Hernia 3. Pulmonary Conditions Virus Pneumonia 18 Adenoma Bronchi 2 Hydatid Cyst Substernal Thyroid 3 Histoplasmosis Neuro-fibroma 2 Pericardial Cyst 2 Sarcoidosis 7 An examinee, age 24, attended this Unit for a routine film in October 1953, and nothing abnormal was found. In March 1956, an opaque mass was found in the right side of the chest. On April the 30th, 1956, he was operated upon by Mr. N.R. Barrett, and a large dermoid was removed. Histologically it was a benign cystic teratoma. "The interesting feature of this case is the rapid growth of a presumably congenital tumour during two and a half years of adult life. This case was reported in "The Lancet", June 1957, by Dr. R.F. Guymer, Chief Medical Officer, Lloyds Bank, to whom I am indebted for the details. "CONCLUSION Since the Unit commenced operating in May 1950, it has examined (up to the end of 1956) 208,373 males and 152,274 females, making a grand total of 360,647. "The friendliest relationship has existed between the Unit and Dr. J. Greenwood Wilson, Medical Officer of Health for the City of London, and with the Medical Officers of Health for the Boroughs of Finsbury and Shoreditch, all of whom have been most helpful. Our grateful thanks must also be accorded to the London County Cpuncil and the Divisional Medical Officers, in Health Divisions 3, 4 and 5. To the Centred Group Hospital Management Committee and to the Regional Hospital Board, we have much pleasure in recording our gratitude for the many services they have rendered to this Unit during 1956." Food Poisoning Only one formal notification was received during the year. This was a case of suspected food poisoning which was not confirmed. Eight outbreaks of food poisoning were reported and were investigated. These 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 1. A small outbreak of what appeared to be mild food poisoning in a refreshment club in the City was received on 20th January. The suspected meal was luncheon served on 17th January. None of the food served at the meal was available for examination, but the probable vehicle of infection was stewed steak, which was cooked on the 16th January, allowed to cool, put in the refrigerator overnight, and served on 17th January. Thirteen persons were affected with abdominal pain, and diarrhoea coming on some 7 to 10 hours after the meal, and continuing from 12 to 36 hours, It appears probable that the infecting organism was a heat-resistant strain of Clostridium welchii. The kitchen was generally satisfactory, but several improvements were suggested, including the provision of a lavatory basin in addition to the sinks, of separate towels instead of a common towel for the staff, and the overhaul of the refrigerator. INCIDENT 2. On 8th February, a report was received of an outbreak of food poisoning at a business house in the City, which appeared to be connected with the mid-day meal served in their canteen on 6th February. The circumstances of the outbreak were investigated by a Public Health Inspector, and the staff of the firm, including the kitchen staff, were most co-operative. 4. Forty-one persons were affected with abdominal pain and diarrhoea. The time between the eating of the meal and the onset of symptoms varied considerably, but averaged 10 hours. The duration of illness likewise varied but averaged 20 hours. The meal comprised a number of items, but the one factor common to all the sufferers was what was described as"minced chicken" but which was in fact not minced but chopped up chicken. The history of this dish is as follows. The chickens were delivered on Thursday, 2nd February, boiled the same day and stored in a refrigerator till Monday, 8th February. On Monday the meat was stripped from the carcases, chopped up, heated and served with a sauce made from the chicken stock. A total of 102 portions of this chicken dish was served, and 41 of the persons who ate it complained of symptoms. None of the chicken was available for examination on 8th February, but it was decided to try to get samples of faeces from some of those who had suffered and also from the kitchen staff. Eleven such samples were obtained and submitted for bacteriological examination. The bacteriologist reported that 10 of the samples showed no pathogenic organisms but that from one heat-resistant Clostridium Welchii were isolated. This organism has in the last few years been recognised as the cause of a mild type of food poisoning, similar as regards symptoms to those described in this incident. It is of particular interest that the sample of faeces from which heat-resistant Clostridium Welchii were isolated was from the very member of the kitchen staff who had prepared the chickens, including stripping the carcases and chopping up the meat. He had not complained of illness, and I am not prepared to say definitely whether he infected the chicken or the chicken infected him, but I suspect the former. All practicable steps have been taken to prevent such an occurrence in the future, and the kitchen has been inspected in great detail and a considerable number of recommendations have been made which I feel sure will receive prompt attention, since the firm concerned have been so co-operative throughout the investigations. INCIDENT 3 On the 9th March, the Secretary of the refreshment club in a large Government establishment reported an outbreak of illness following upon a meal eaten the previous day. The canteen of the club is open day and night and in each 24 hours about 3,000 meals are served. Inquiry ascertained that 82 persons were affected, of whom 8 were prevented from attendance at work and 1 collapsed and was admitted to Hospital. The menu was a varied one, but investigation revealed that the item which was probably the cause of the illness was steak and onion pudding. 400 puddings were served and all the persons known to be affected ate them. The puddings were made from two forequarters of beef obtained from a reputable firm on the 6th March and stored in a refrigerator. On the 7th March the meat was cut up, cooked, and again placed in the refrigerator until the following morning, when it was re-heated for about an hour and served about 1 p.m. The onset of the illness occurred about 10 hours after eating the puddings. It was characterised by abdominal pains and severe diarrhoea, the latter recurring at intervals during the night. No sickness or fever was reported by any of the cases. Three of the puddings and a specimen of faeces were bacteriologically examined. Although the history of the illness and the clinical symptoms were typical of an infection by CI. Welchii neither this nor any other pathogenic organisms were found in any of the specimens submitted for examination. Scrapings of material were then obtained from the surfaces of tables etc. on which the food was prepared, but no pathogens were found. Enquiries were also made of the hospital to which one of the cases had been admitted, but the results of the examination of material from the patient were also negative. INCIDENT 4. On the 26th April, the Medical Officer of Health for West Ham reported that a resident of that area had been notified as a case of food poisoning. The patient was employed as a waitress at a well known City Club. As a result of investigation at the Club, it was ascertained that the number of meals served varies between 250 and 300 daily. Of this number 16 persons suffered from an illness which was characterised by severe abdominal pains and diarrhoea. There was no nausea, sickness or fever. The suspected food was boiled mutton, but the notification came too late to obtain any remains of this for bacteriological examination. Specimens of faeces of the patient were taken, but although the history and clinical examinations were typical of an infection by CI. Welchii, neither this nor any other pathogenic organisms were found. 5. Apart from the use of common towels and the absence of hot water over the lavatory basins in the staff water-closet compartments, the large old-fashioned type kitchen was found to be in a reasonably clean condition. Attention was drawn to these two defects for immediate remedy. INCIDENT 5. On the 18th July, it was reported by a firm in the City that a number of their employees were affected with symptoms usually associated with food poisoning. The outbreak was restricted to those using the Company's canteen. Enquiry revealed that in all probability the consumption of steak pie was the cause of the outbreak. The steak had been purchased from a reputable butcher. A contributary feature was the preparation of the steak. The meat was cooked on the 16th July; stored in the open kitchen overnight; re-heated on the 17th July and then served. The number of consumers at risk was 140 of whom 27 were affected. No portion of the steak pie was available for examination but in the endeavour to identify the agent causing the outbreak, a specimen of the faeces of one of the complainants was obtained. Cultures from this yielded a profuse growth of heat resistant CI. Welchii. Since several of those affected had eaten a proprietary cream in addition to the steak pie, a sample of this was also examined but with negative results. There is little doubt that if the steak had been cooked and eaten the same day instead of being cooked the day before, stored overnight and re-heated and served the next day, the outbreak would not have occurred. The caterers were warned of the danger of storing cooked meat foods in the open kitchen overnight. If it is not to be served the same day it must be placed in the refrigerator to prevent the growth and multiplication of any sporing organisms such as Clostridium Welchii which survive the cooking. The Kitchen, its equipment and the dining room are maintained in a very cleanly condition. INCIDENT 6 On Friday, 28th September, a telephone message was received from the manager of a restaurant in the City, stating that a number of the service staff had complained of feeling unwell after having their lunch on the previous day. There is an extensive menu available at this restaurant and the staff have a freedom of choice from the menu for their mid-day meal. The staff affected were 7 members of the service staff, i.e. staff who take the food from the kitchen to waitresses1. If they are carrying out their job efficiently they should have little or no contact with the food. The course of the illness appears to have been mild, all of them suffering from abdominal pain and diarrhoea to a certain extent. From enquiries made, the staff erave the impression that they were not unduly distressed. The average time from consuming the meal to the onset of symptoms was 8.2 hours, and the duration varied from 12 hours upwards. The meal in question was corned beef salad, and the only item in common was the corned beef. This is brought about by some people removing beetroot or tomato or some other part of the salad to which they had a particular dislike. 350 portions of corned beef salad were made up and served during Thursday. 5 tins of corned beef were used, and the remaining slice of the fifth tin was sent to the bacteriologist for examination. The tins are alleged to have been opened at approximately 8.30 a.m. on Thursday, and kept at a normal room temperature for the 3 — 4 hours that elapsed to lunch time. There appears to be very little possibility of a tin remaining in stock for any length of time as they have weekly deliveries of 2 — 3 cases. The chef was interviewed about the procedure of preparation, but there do not appear to be any points over which we could take exception. On the contrary, the salad preparation is allocated more or less permanently to one person, and this should have the effect of limiting any trouble — always provided, of course, that the person is free from infection. The report from the bacteriologist on the portion of corned beef indicates that there were no organisms associated with food poisoning in this specimen. INCIDENT 7. On Tuesday, 18th December 45 of 81 persons who lunched in the canteen of a Society in the City became ill with abdominal pains and diarrhoea. The menu was a plain one of roast beef, Yorkshire pudding, vegetables, tinned fruit and custard. 6. The food suspected was the topside of beef which had been purchased from a reputable local butcher. The remains of the beef together with specimens of faeces from two of the persons affected were submitted for bacteriological examination. Both the faeces and the beef yielded a profuse growth of heat resistant CI. Welchii which confirmed the nature of the outbreak. The responsibility for the illness was clearly due to the meat having been cooked two days before its consumption. It had then been stored in a refrigerator which, however, being in frequent use, had not had its temperature retained constantly at a low level. The desirability of food being cooked and eaten the same day was emphasised, and it was pointed out that if this is not possible then the greatest care should be taken to ensure that the temperature of the refrigerator remains constantly at a sufficiently low level to prevent multiplication of the organisms which cause food poisoning. Certain defects in the hygienic arrangements in the kitchen were noted and are being attended to. INCIDENT 8. On the evening of the 21st December, an outbreak of illness was reported amongst the staff numbering 700, who participated in a City firm's Christmas dinner. 124 persons were affected with either abdominal pains, diarrhoea, sickness, abnormal temperature or a combination of these symptoms. The illness was not characteristic of any specific form of food poisoning, both the incubation periods and symptoms having varied considerably. The remains of the following items on the menu were, sent for bacteriological examination:— turkey, sausage meat (cooked and uncooked), sausage, mince-pie, and Christmas pudding. In addition specimens of faeces from two of the sufferers were examined. The Chef had a history of diarrhoeal illness a few days before the service of the meal and a specimen of faeces from him was also examined. All the materials for the meal were obtained from the central meat and provisions depot of the caterers which is situate outside the City area. From the commencement of the outbreak, the Medical Officer of Health of the district concerned was kept fully informed of the investigations made in the City. He reported that no other notification had been received by him of illness which could be attributed to food supplied from this depot. The City Bacteriologist reported that cultures were made from the material sent to him on McConkey's medium for Salmonella, on salt agar for Staphylococci, and in meat broth for Clostridia Welchii. No organisms of any of these three types were isolated from any of the materials. The only suspicious item was the raw sausage meat. This showed numerous Grampositive bacilli in a direct film. These are apparently not Clostridia but Bacilli, since a growth of such organisms had only been obtained in aerobic culture. It is possible that some degree of non-specific decomposition produced by these organisms could account for the symptoms produced. It seems probable that the illness was caused by the practice of cooking meat products on a day previous to its re-heating and service. The caterers were informed of the result of the investigations and were strongly recommended to instal another refrigerator to ensure that the appropriate temperature is constantly maintained for the storage of pre-cooked foods. Food and Meat 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 423,968 tons of which 657 tons were found to be diseased or unsound and were voluntarily surrendered. At Leadenhall Market and in City shops 9 tons and at Cold Stores 4 tons were condemned. Of other foodstuffs in Markets and Shops 8 tons, and at Riverside Wharves 146 tons were condemned. The total amount of foodstuffs found by your Inspectors to be unfit for human consumption was therefore 824 tons. This is 142 tons more than in the previous year, but this is explained by larger deliveries of food. Food Hygiene Regulations, 1955 (Catering Establishments) Messrs. Thompson and Flynn, the two public health inspectors who specialise in the hygiene of catering establishments, report as follows:— "The provision of a midday meal and of other refreshments to the City's immense day time population is a major industry, and it is probable that with the increasing use of luncheon vouchers, more main meals are now consumed in the City than ever before. 7. "The various restaurants, cafes, snackbars, public houses and staff canteens number approximately 1,000, and the supervision of these premises represents one of the main activities of my Department. Two Inspectors have continued to devote the major part of their time to this task, and it is encouraging to be able to report that the steady improvement in conditions generally which it has been possible to achieve over the last few years has been maintained during the year 1956. "In reviewing the work on restaurants, etc., for the year 1956, it is of interest initially to consider the effect of the new legislation which became available to Local Authorities during that year. "The 1st January, 1956, was the date of commencement for part of the new Food & Drugs Regulations, and on the 1st July, 1956 the Regulations became fully operative. During this time there has been ample opportunity to see if they were to be of practical value in our day to day dealings with the catering trade. It can be said with some justification that the present position is still not without its difficulties. The lack of registration power still leads to untold troubles, especially in connection with the establishment of new businesses. It is agreed that those in existence at the present time have every right to continue, provided they maintain a minimum standard in hygiene, etc., and any registration or licensing should be theirs by reason of this fact alone but it is also undoubtedly true that no new businesses should be commenced without the sanction of the local authority. As things stand at the moment, a person is not compelled to seek the permission of the local authority before starting a catering business except with regard to Town Planning, and drainage works which are incidental to commencement of any business. Floor space in the City is at a premium, and many proposals are being made to this department for opening catering businesses in quite undesirable premises. Most people are prepared to accept guidance in these matters, but there have been cases, and doubtless there will be cases in the future, where businesses have started up in premises which are not satisfactory, as regards height, light, ventilation, and as regards the space available to conduct a business that complies to a reasonable extent with the views of the public health department. "The Regulations have undoubtedly assisted in bringing to people's attention the obvious things which are the minimum necessary to carry on a business. By having a written code there is a tendency for a too literal interpretation to be placed on some of the items, but it does help as a basis on which to commence negotiation. "Another point which should be made is that in spite of years of persistent propaganda, and by propaganda we do not mean the word in the derogatory sense in which it is bandied about these days, but straightforward factual, appealing and guiding announcements from many quarters; in far too many of the premises visited there is still a shoddy careless approach to the whole matter of hygiene. No one, management or employee, after such appeals, can honestly declare that they have no knowledlge of statutory requirements and the principles of elementary hygiene. This being so, the people concerned must appreciate that they are knowingly committing offences under the Regulations, and are continuing to do so while they allow unsatisfactory conditions and practices to continue. It should not be necessary for a Corporation official to apply pressure before they put their businesses in order. From this it follows that any deficiencies found, either personal or in the cleanliness of premises, are liable to be treated with some severity because they are now quite inexcusable. "It has been observed, since the Regulations became operative, that some members of the catering trade are showing real concern about making improvements in their premises, but they are also perturbed about the final outcome of this type of legislation. They require some definite assurances that after they have successfully met the present standards, they will not be called upon again in the near future to carry out radical alterations. It would seem, therefore, that local authorities must arrive at a standard — not necessarily an idealistic one, to which people can work with some confidence and with some sense of security. "This brings us to the crucial question which must be answered. Do public health workers know where they are going in this direction and have they an end in sight? While we are being cluttered up with so many technicalities and details, and while we search for the perfect answer to all our problems, there is the risk of nothing effective being done. "Although public health can never remain static and there must of necessity be a constant critical examination of our objectives, nevertheless there should be available an assurance for the catering industry on the lines they seek. "As in previous years we have willingly taken the opportunity to participate in food hygiene lectures and discussions which progressive members of the trade have thought desirable for the guidance of the staff employed by them. In one instance nearly 150 people attended lectures organised in the City. These lectures or discussions were based on a film produced by a well known firm on "Clean Food", which is admirably suited to its purpose. We would add our appreciation for the whole-hearted co-operation of this firm in helping us in this direction. It has always been a source of difficulty to arrange lectures in the City, where many part-time people are employed in the catering trade ant' where the bulk of the work is often telescoped into the late morning and early afternoon hours'. Nevertheless, where firms can arrange for their staff to be available we will endeavour to meet their requirements. "As a result of the gradual reconstruction and erection of new buildings in the City area, more catering facilities are becoming available by way of staff canteens, etc. Quite a fair portion of the time is being spent in endeavour to establish these on a sound basis, and in co-ordinating our requirements with those of Mr. City Engineer and of Mr. City Surveyor. The standards now being achieved, we believe, are as high as any that can be secured under the existing legislation, and in many instances the trade have gone to great lengths to establish the business on the best standards possible. "There still remain, however, a few kitchens which are inherently poor as regards situation and construction and which must of necessity cause concern both to their proprietors and this Department. While we must pursue our objectives it is also realised that hardship must inevitably result if effective action is not taken on the part of the owners of the businesses. Of these, eight ere known to have been voluntarily closed during the year, following official representations by ray Department, and others have Been completely reconstructed internally. The bringing up to an acceptable standard of these unsuitable premises is a very slow and difficult job, and with all the goodwill in the world cannot be carried out quickly. Some of the improvements which have taken place have been on such a scale that building work has continued for nearly a whole year. "The general experience has been that City caterers are not unwilling to co-operate with the officers of my Department in securing any necessary improvements, either in structure or equipment, but it is felt that full advantage has not been gained in many cases from the very heavy capital expenditure undertaken by the industry, because of the inferior calibre of the staff employed. As pointed out in previous annual reports and it is still operative today, some of the staff are either disinterested or incompetent, and because of the state of the labour market, discipline is at a low level. In one instance a letter was addressed to the chef in charge of a kitchen as well as to the proprietor of the restaurant regarding the unsatisfactory standard of cleanliness maintained. It was subsequently found that this official representation had a beneficial result, and the restaurant proprietor in question was grateful for the action taken, as it had enabled him to effect greater control over his staff. "During the year proceedings were instituted against the proprietor of a City catering establishment for the deplorable conditions in the premises. In the case which followed, fines totalling £140 were imposed and 5 guineas costs were awarded to the City Corporation. In addition, the owners of the restaurant were disqualified from carrying on their business in the premises in question for a period of twelve months. It is understood that this action taken under Section 14 of the Food and Drugs Acts, 1955, was the first case of its kind in the country, and undoubtedly it will have a salutory effect upon the moreindifferentroembers of the trade generally." Transport and Handling of Meat The Food Hygiene Regulations as from the 1st July, 1956 replaced the Sections of the Public Health (Meat) Regulations, 1924, which enforced hygienic transport and handling of meat. In addition, they prohibit spitting, smoking, or the use of snuff, by persons engaged in the handling of open food. They also stipulate that any cuts or abrasions on an exposed part of a food handler's body should be covered with a suitable waterproof dressing. Very little difficulty was experienced in the enforcement of these Regulations in this connection, the no doubt irksome requirement in regard to smoking being accepted philosophically in the shops and markets by employees, but it is hard on thera to see customers setting them such a bad example in so many instances, especially as the customers are not liable to prosecution under the regulations. THE FOOD AND DRUGS ACT, 1955, AND FOOD REGULATIONS The Food and Drugs Act, 1955, received the Royal Assent on 22nd November, 1955 and came into operation on 1st January, 1956. It repeals the Food and Drugs Act, 1938; the Food and Drugs (Milk, Dairies and Artificial Cream) Act, 1950, and the Food and Drugs (Amendment) Act, 1954, but with certain modifications and amendments and incorporating some additional provisions, it re-enacts these Measures in consolidated form. The following are briefly, some of the most important amendments and additions:— The Minister of Agriculture, Fisheries and Food and the Minister of Health acting jointly (referred to as the Ministers) are given powers to make Regulations on many important matters. The powers given by Section 13 of the Act, (to make Regulations as to food hygiene) were quickly exercised and The Food Hygiene Regulations, 1955 came into operation on 1st January, 1956. These Regulations supersede Section 13 of the Food and Drugs Act, 1938 and are wider in scope and power. Section 14 contains quite new provisions. On the application of a prosecuting local authority, where a person is convicted, the court is empowered, having regard to the gravity of the offence, to previous convictions or the unsatisfactory state of the premises, to make an order disqualifying that person from using the premises as catering premises for such period not exceeding two years as may be specified in the order. In like manner the powers given by Section 4 (to make Regulations as to composition of food etc.) have been exercised by the issue or.:— 9. (a) The Food Standards (Batter and Margarine) Regulations 1955 which also came into operation on 1st January, 1956. These Regulations lay down standards for butter and margarine and supersede Section 32 of the Food and Drugs Act, 1938. (b) The Food Standards (Curry Powder) (Amendment) Regulations, 1956 came into operation on 2nd August, 1956 and raised the tolerance of lead which may be present in curry powder from 10 parts per million to 20 parts per million. (c) The Food Standards (Tomato Ketchup) (Amendment) Regulations, 1956 also came into operation on 2nd August, 1956 and substituted for the limit of 50 parts of copper per million of the dried tomato solids in tomato ketchup, catsup, sauce or relish, a limit of 20 parts of copper per million parts of the tomato ketchup, catsup, sauce or relish as a whole, as the case may be. (d) The Flour (Composition) Regulations, 1956 came into operation on 30th September, 1956, contemporaneously with the abolition of the bread subsidy. The Regulations prescribe compositional requirements as respects certain nutrients in all flour and as respect creta praeparata in all flour other than flour containing the whole of the products derived from the milling of wheat For the purpose of enabling them to exercise their functions under Section 4 of the Act, the Ministers are empowered (Sec. 5) to obtain particulars (by order) of certain food ingredients .This entirely new provision is to be enforced by the Minister of Agriculture, Fisheries and Food. By Section 7 of the Food and Drugs Act, 1955, the Ministers are empowered to make Regulations as to the labelling and description of food and accordingly the following Regulations have been made:— (e) The Labelling of Food (Amendment) Regulations, 1955. These Regulations came into operation in parts progressively during the months of January to April, 1956. They amend the Labelling of Food Order, 1953 to re-enact with modifications certain requirements of the repealed Sections 32(2) and 33 of the Food and Drugs Act, 1938 relating to the labelling, marking and advertising of margarine and margarine cheese. They include a provision prohibiting, otherwise than in a manner prescribed, claims that margarine contains or is made with cream or milk. A further provision substitutes the description "imitation cream" for "synthetic cream" in the Schedule of the 1953 Order relating to the exemption or partial exemption of certain requirements for the labelling of pre-packed food for sale by retail. Section 1 of the Food and Drugs Act, 1955 replaces Sections 1 and 2 of the 1938 Act and is more comprehensive inasmuch as further to prohibiting the addition of any substance to any food as to render it injurious to health or to any drug as to affect injuriously its quality or potency, it prohibits the use of any substance as an ingredient in the preparation of food, the abstraction of any constituent from food or the subjection of the food to any other process or treatment, as to render it injurious to health. The Section further prohibits the abstraction of any constituent from a drug as to affect injuriously the quality, constitution or potency of the drug. The sale, exposure for sale, offering or advertising for sale of food or drugs so rendered injurious or adulterated is an offence under the Act. In determining whether an article of food is injurious to health regard is to be had not only to the probable effect of that article on the health of the person consuming it but also to the probable cumulative effect of articles of substantially the same composition on the health of the person consuming such articles in ordinary quantities. Section 47 of the Act contains new provisions in relating to cream and cream substitutes. Whereas under the Food and Drugs (Milk, Dairies and Artificial Cream) Act, 1950 it was an offence to sell for human consumption under the description or designation including the word, "cream" any substance purporting to be cream, unless it was cream, or to sell artificial cream as defined unless the word "cream" was immediately preceded by the word "artificial"; in the Food and Drugs Act, 1955 it is prohibited to sell under a description or designation which includes the word "cream" any substance which resembles cream in appearance but which is not cream and any article of food containing such a substance. This however, does not apply to the sale of any substance being reconstituted or imitation cream as defined, or any article containing such a substance, so described or designated. The definition in the Act of "reconstituted" cream is largely that of the definition of "artificial" cream given in the 1950 Act. "Imitation" cream as defined can be considered as a synthetic product resembling cream in appearance. It is noted that the description or designation under which the substance or article is sold shall be deemed to include the word "cream" if it includes any other word (composite or others wise) which is calculated to lead a purchaser to suppose that the substance is, or the article contains, cream. Section 97 is a new provision allowing that where a sample is procured of a food,drug or substance contained in unopened containers and the division thereof into parts is not reasonably practicable or might affect the composition, or impede the proper analysis of the contents, it shall suffice if the person procuring the sample divides the containers into the requisite number of lots and deals with each lot as if it were a part. 10. Section 108 amends Section 80 of the 1938 Act to extend the period of the time limit for the institution of proceedings from the date of procuring the sample to two months in respect of samples other than milk (for which samples the period remains at twenty-eight days). Section 109 — Under this Section, in the institution of any proceedings under Section 6 (false labelling or advertisement) so far as it relates to food or where provided for by regulations made by the Ministers under Section 7 (labelling and description of food), the council is required to give at least fourteen days notice to the Minister of Agriculture, Fisheries and Food, of their intention to institute such proceedings, together with a summary of the facts upon which the charges are founded. Section 16 of the Food and Drugs Act, 1955, provides for the registration of premises for the sale, manufacture or storage of ice cream intended for sale, and the preparation ormanufacture of sausages, potted, pressed, pickled or preserved food intended for sale. At the end of the year 130 premises were registered. 232 inspections were made in connection therewith. The types of business carried out at these premises were as follows, some premises being registered for more than one activity:— Bacon 1 Meat — cooked 10 Dripping and fat rendering 7 Meat — canning 2 Hams 9 Sausages 12 Ice Cream (sale) 69 Sausage casings 8 Jerlied Eels 5 Shellfish 9 Meat Brining 24 V egetables 1 Mr. G.E. Harrington, Sampling Officer under the Food and Drugs Act, reports as follows:— "Three hundred and eighty samples have been submitted to the Public Analyst, twenty-four of these were formal and three hundred and fifty-six were informal samples. Adverse reports were received on sixteen samples; in one case legal proceedings were instituted and in the other instances, appropriate cautions were administered. Milk The average composition of genuine milk samples taken during the year was:— milk fat: 3.63 per cent.; solids (not fat): 8.88 per cent.; total solids 12.51 per cent. Twenty-four samples of pasteurised milk were examined by the phosphatase and methylene blue tests, five of which were also submitted to general bacteriological examination. 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 quality which bears relation to cleanliness and care in handling. One sample of pasteurised milk was submitted for general bacteriological examination only and one sample of sterilised milk was examined by the turbidity test which in the case of this particular milk is also a check on the efficiency of heat treatment. Adverse reports were received on two of the samples 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. Milk is sold however, for consumption on the premises in a considerable number of milk-bars, snack-bars and restaurants. Eighty-six Supplementary Licences in respect of twenty-five firms and individuals and thirtythree Dealers Licences in respect of fifteen 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 1949/53. Three Firms with premises outside the City were registered under the Milk and Dairies Regulations, 1949 as distributors of milk within the City. Condensed Milk The attention of this Department was drawn to a breach of the Public Health (Condensed Milk) Regulations, 1923/1953 in relation to the labelling of a particular brand of condensed milk. The matter was taken up with the importers who submitted for consideration the labels of certain other brands. These also did not comply in every respect with the requirements of the Regulations and the importers were notified accordingly. They undertook to make alterations to existing labels and to take the matter up with their shippers to ensure compliance in the future. Daily Cream All the samples of cream submitted to the Public Analyst complied with the standards laid down by the Food Standards (Cream Order) 1951. Two samples of single, nine of double and one of sterilised cream were submitted to the Bacteriologist. Of the doable exsam samples, seven supplied from the same source outside London were found to be unsatisfactory and full details were communicated to the Medical Officer of Health for the district where the cream was prepared and packed. 11. Ice Cream The standard of this product has been steadily maintained and none of the samples submitted to the Public Analyst failed to comply with the requirements of the Food Standards (Ice Cream) Order, 1953. The average composition of the samples taken was fat: 11.4 per cent.; milk solids (not fat) 10.7 per cent; sucrose 15.6 per cent. Adverse reports were received from the Bacteriologist on his examination of two of the samples which came from the same source and the Medical Officer of Health for the district where the cream was manufactured was notified accordingly. Food Labelling With the exception of the question of the labelling of condensed milk, 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 as amended. Administration Generally Details of the formal and informal samples taken and submitted for analysis and of action taken with regard to adulteration or other irregularities, appear later in this Report. IMPORTED EGG PRODUCTS In 1955 it was found by the Central Public Health Laboratory that much of the Chinese crystalised albumen imported into this country was infected with organisms of the Salmonella group capable of causing food poisoning, and occasionally, the organisms of para-typhoid fever were present. Considerable quantities of egg products in crystalline, powdered or frozen liquid form are imported from China, Australia, New Zealand and South Africa, for use in the bakery and confectionery trades. This product is valuable and in keen demand. Upon arrival at City Wharves or Cold Stores consignments of all egg products are immediately placed under stop pending sampling for bacteriological examination. All crystal albumen is released subject to undergoing a sterilizing heat treatment at an approved centre before use, whether sampling discloses Salmonella organisms or not. Chinese crystal albumen is subjected to 1% — 2% sampling for record purposes. Powdered egg products are subjected to an initial 5% sampling of each batch or code. Should any sample be found to contain Salmonella organisms of a pathogenic type, a further 5% — 10% sampling of the positive batch or range is drawn, on the results of which decision is made as to disposal. There are a number of technical processes unconnected with food in which egg albumen is used. Consignments are freely released for this purpose under proper supervision. During the year, 3,871 cases of imported Chinese hen egg products, albumen crystals, whole egg powder, flaked whole egg powder and spray dried whole egg powder, were placed under stop at City Wharves pending bacteriological examination. 226 samples were taken for examination by the Central Public Health Laboratory at Colindale. 197 of these were reported negative and 29 were reported as containing pathogenic Salmonella organisms — 14.7%. Considerable quantities of frozen liquid whole egg are imported from Australia, New Zealand and South Africa. This is subjected to a 1% — 2% examination from batches or 'codes', batches from which positive samples have been taken undergoing a further 5% examination, the results of which determine decision as to detention or release. 143 samples, all of which were reported negative, were taken from shipments from Australia totalling 17,203 cartons, and 75 samples , 70 of which gave negative results and 5 positive results, were taken from South African shipments totalling 5,748 cartons. Whilst the results relating to Commonwealth imports may be accepted as fairly satisfactory, since this report was written experience has shown that the amount of contamination has increased. HYGIENE IN HAIRDRESSERS' AND BARBERS' SHOPS In accordance with Section 18 of the London County Council (General Powers) Act, 1954, the Corporation made Bye-laws for securing the cleanliness of premises registered under this Section also of instruments used and persons employed therein, which are based on the model Byelaws quoted in my last Annual Report. 77 hairdressers' establishments are now registered in the City. 12 of the 89 which were operating at the end of last year have closed voluntarily. Inspections throughout the year have shown that the standards required by the Byelaws are being maintained. 12. 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:— 5 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. During the year, 102 families were rehoused leaving a total number of 750 families for whom accommodation was required in December 1956. It is likely that this number will be reduced substantially when the Golden Lane Extension is completed as this estate will provide accommodation for 584 families. In addition to this a small estate of 57 flats and houses at Sydenham Hill will soon be completed. The modernisation of the flats at Dron House, Stepney is in progress and it is anticipated that improvement schemes will be carried out at the remainder of the pre-war housing estates administered by the Corporation as a Local Authority. Isleden House continues to stimulate interest amongst those who are concerned with the housing and welfare of the elderly. Many of the elderly residents would be unable to maintain a flat if they had to prepare their own meals and if they were required to do all the work of a normal householder and it is evident that the provision of a mid-day meal and of the other services assist the old people to remain in their homes and retain their independence. The Sick Bay under the supervision of an understanding Matron and her sympathetic Assistant has continued to work smoothly. Over three hundred patients from St. Bartholomew's Hospital have been admitted since 1954 and this has made a very useful contribution to reduce the waiting list for beds at the hospital. Patients from the Corporation's housing estates have also been admitted for short periods and the results have been most satisfactory. The following example of this may be of interest:— An elderly couple were in great distress when the husband aged 85 was suddenly seized with acute arthritis and became immobile. Until the attack the man had been in regular employment and in fact had carried out most of the household chores as his wife aged 86 was "not too good on her feet". The man was admitted to hospital but was discharged after a short period with his physical condition unchanged and his morale low as he had been informed that his condition could not improve. The couple were popular on the estate and the neighbours were most helpful but the major portion of the work fell on the wife who did her best. A special chair was made for the patient as it was impossible for him to rest in bed. After six months the wife had to be sent away for a holiday and the man was admitted to Isleden House Sick Bay. He was carried to his bed and told matron he couldn't move. Matron, however, took the matter in hand and within a few days the patient was walking and when the wife called to see him after her 2 weeks rest he went out unaided to the front door to greet her. They returned to their flat together happily and the following week he astonished everyone when he started work on his garden plot of which he was was most proud and for which he has since won a prize. Improvements are being carried out at the City of London Freemens' Houses and the provision of further amenities and communal services are being considered. The City of London Old People's Welfare Association continues to look after the 1,350 over—60's for whom the City as a Housing Authority has a responsibility. No effort is spared to ensure that these old people have the services they require. A Mid-day Meals Service has been established at the Three Score Club and it is hoped that a similar service will be provided within Corporation estates where accommodation has been allocated to elderly people. 13. RODENT CONTROL To comply with the provisions of the Prevention of Damage by Pests Act, 1949, it is the duty of every Local Authority to take such steps as may be necessary to secure so far as practicable that their district is kept free from rats and mice and in particular— (a) from time to time to carry out such inspections as may be necessary for the purpose aforesaid; (b) to destroy rats and mice on land of which they are the occupier and otherwise to keep such land so far as practicable free from rats and mice; (c) to enforce the duties of owners and occupiers of land under the provisions of Part 1 of this Act, and to carry out such operations as are authorised by those provisions; (d) to keep such records and make such reports relating to their functions under this Part of this Act as may be required by any directions given by the Minister of Agriculture, Fisheries and Food. In implementing these provisions, organisation and procedure of the Hodent Control Section during the year were similar to that of previous years, comprising inspection of properties to ascertain the presence of rats and mice, treatment of any such properties found to be infected, 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 necessitating statutory action to resolve the problem. A major proportion of the work comprised inspection of defined areas for the purpose of instituting collective action. In instances of individual notification of infestation, or request for assistance in control measures, the properties adjoining were also inspected and, if necessary, combined action taken. In respect of this side of the work, 3,784 occupancies and properties were inspected, these properties ranging from new buildings in varying stages of construction, blocks of offices, riverside food warehouses, catering establishments, factories and all types of shops, to domestic dwellings. A total of 661 infestations of rats or mice were the subject of control measures and of this number, 388 infestations were notified by owners or occupiers of properties, and 280 infestations were found on inspection. This total comprised 7 major and 141 minor infestations of rats, and 124 major and 389 minor infestations of mice. Treatment of these infestations entailed 5,837 visits for operational purposes. In the process of control measures for rats, 4,033 initial baiting points were selected, 10,519 pre-baits and 823 poison baits were laid. This resulted in a minimum estimated kill of 782 rats, and of this number, 459 bodies were recovered. In addition 63 rats were destroyed by means of trapping. The use of "Warfarin" anti-coagulant rodenticide for the control of mice resulted in 1,644 bodies being f ound. As in the past, the rat infestations were principally of Ship (Hack) rat character, and minor infestations of this nature often entail greater assiduity in respect of inspection and control measures than major infestations distributed over a similar area. Infestations of mice have been constant in relation to the previous year and, of the total number of treatments carried out, 513 were for infestations of this nature. In 31 instances structural rat proofing was carried out by owners or occupiers and in three instances defective drainage resulting in common rat infestation was remedied. Incidental rat and mouse proofing in the nature of removal of accumulations has received detailed attention and in this respect the assistance of the Director of Public Cleansing and his Inspectors has been invaluable. The downward trend of rat infestation in surface properties has continued and a further decline in the number of infestations treated, and the numerical quantity of the same has been manifest. There is a 30% reduction in major infestations (20 rats or over) and 7% reduction in the minor classification. In summarising the position of rat infestation in surface premises and the steady decline in recent years, there are several contributory factors. Occupiers and owners have become rat and mouse conscious, and generally welcome advice and treatment of infestations that at one time would have been accepted as inevitable. In the field of catering premises, of which there are approximately 1,000 in the City, the continued improvement of structural conditions and general hygiene is in the main due to the efforts of Mr. Thompson and Mr. Flynn, Public Health Inspectors, and this contribution as an adjunct to rodent control has been of great assistance. In reviewing the present situation, a wide perspective is necessary, the City having Iboundaries with five Metropolitan Boroughs, and a considerable riverside frontage of warehouses. 14. In this respect, the Port Health Authority by exercise of its functions relating to control of rat infestation in ships and lighters, make a contribution of primary importance by minimising the problem of re-infestation of Ship (Black) rats from vessels and lighters discharging cargo to riverside wharves, Likewise, by their efforts the Rodent Control organisations of contiguous Local Authorities have similarly contributed to the general overall plan of Rodent Control; and to this must be added the contribution of the commercial servicing undertakings. Infestation of Common (Sewer) rat character in surface properties was again on a minor scale, and this is, in no small measure, due to the systematic periodical maintenance control measures applied in the City sewers. It is the purpose of these treatments to check the build-up of the Common rat population in the sewers and thereby assist in preventing infestation of surface properties from this source via defective drainage. Following the initial sewer treatment in December, 1943, it was the practice in accordance with the legislation, and in conjunction with contiguous Metropolitan Boroughs to carry out sixmonthly controls. These measures comprised a two-day pre-bait, followed by poison baiting in all entrances where pre-bait acceptance was recorded, and examining the result on the fourth day. The poisons used were Zinc Phosphide, Arsenious Oxide, and Alpha-Napthyl-Thio-Urea. The recorded result of the initial treatment was 355 pre-bait "takes" of which 185 were complete "takes", this result indicating the numerical quality and distribution of the rat population of the sewers at that time. Continued six-monthly maintenance controls from January 1945, resulted in a gradual reduction of the pre-bait "takes", and the recorded result in May, 1948, was 118 "takes" of which 63 were complete. From then onwards an upward trend of pre-bait "takes" was experienced, with a proportional increase in complete "takes", until in December, 1950, the pre-bait "takes" were 225, of which 185 were complete, thus equalling the number of complete "takes" obtained in the initial control in December, 1943. Little was known scientifically of the movement of rats in sewers, but the position obtaining at the time of the December, 1950, control appeared to indicate that a wider distribution had developed, due to the breeding build-up during the intervening period of six months between controls. It was considered that in view of the time and effort expended on the maintenance controls, further action was necessary to effect a drastic reduction of the residual rat population and to this end discussions were held with the Technical Officers of the Ministry of Agriculture, Fisheries and Food. The utmost co-operation was received from the Ministry Officers and it was agreed that as from May, 1951, a series of treatments comprising "Direct" poisoning with Sodium Fluoroacetate, technically known as "1080", be carried out at three-monthly intervals. As mentioned in previous reports, this poison is extremely toxic and its use should be controlled by a responsible person, both in dispensing and distribution. In applying the "direct" poison method the time per treatment was halved by reason of the elimination of the two days required for pre-baiting, so that four treatments annually involved approximately the same number of man hours, as was needed by the six-monthly controls. A total of 17 treatments at quarterly intervals in four stages have been applied since May, 1951, the final control of the series being carried out in June, 1956. During the period September, 1954, and June, 1955, in agreement with the Ministry, Zinc Phosphide at a 10% concentration was substituted for "1080". The first stage of the series comprised five treatments during the period May, 1951 — May, 1952. In the first control in May, 1951, 150 poison "takes" (3 complete, 12 x 32 x ½ and 103 x ¼ or less) were recorded, each bait being 4 ozs. The second control in September, 1951, produced 142 poison "takes" (6 x ¾, 25 x ½ and 111 x ¼ or less). In the third treatment in December, 1951, 89 "takes" (1 complete, 2 x ¾, 7 x ½ and 79 x ¼ or less) wsre recorded. The fourth treatment in March, 1952, showed a continued reduction in the poison "takes", which were (1 complete, 2 x 6 x ½ and 44 x ¼ or less) a total of 53. In the fifth control in May, 1952, 424 sewer entrances were baited as against 306 in the previous controls, thus including 118 entrances not treated for 18 months. The result of this treatment was 20 "takes" only (3 x ½ and 17 x ¼ or less). A feature of this control was that only three "takes" were obtained from the additional 118 entrances baited. The decline in the number of poison "takes" was very satisfactory, but the possibility of poison prejudice was visualized, and in order to be reasonably satisfied on this point, and at the same time confirm the results which the "1080" controls had apparently obtained, a non-poison test baiting of all available sewer entrances after a lapse of three weeks was applied. A total of 417 entrances were treated and the baits left down for two days, and the recorded result on. examination was 35 "takes" (7 complete, 3 x ¾, 10 x ½ and 15 x ¼ or less). Altogether 104 lbs. of test bait was put down, and the estimated amount taken was 72 ozs + . This is a great reduction on the final pre-bait recording of December, 1950, when 225 "takes" (185 complete, 29 x ½ and 11 x ¼)ere obtained and the estimated amount then taken was 67 lbs+. 15. The second stage of the series comprised four treatments during the period September, 1952, and June, 1953. The number of entrances baited in each instance was approximately 315, and the poison "takes" were consistently low. They were 13, 14, 16 and 11 respectively, and with one exception Were in the ½ and ¼ category. Following the fourth control and after a lapse of three weeks, 413 sewer entrances were again test baited, and the recorded result was 23 "takes", the estimated amount taken being 71 ozs+. The third stage comprised four treatments during the period September, 1953, and June, 1954, and as in the previous year the "takes" were low, the recorded results being 21, 4, 5 and 4 respectively. The annual test baiting result, three weeks after the final poison control, was 26 "takes" out of 405 entrances baited. In this instance 101 lbs. of test bait was putdownand approximately 82 ozs. + was taken. So far, thirteen controls with "1080" had been applied, during the course of which 262 bodies were recovered from the base of the sewer shafts or in shallow flows close to the base. This number does not include those found subsequently by the sewermen during their routine duties along the lengths of sewers or in dead ends, and no doubt many bodies were washed away in rapid flows. From an analysis of the detailed records collated before and during these controls it did appear that the combination of quarterly controls and sodium Fluoroacetate had produced the results it was considered could be obtained, thereby justifying the use of this highly toxic poison and the labour and care taken in its dispensing and application. In view of the low level of infestation believed to have been obtained, it appeared to be an excellent opportunity to ascertain, as far as possible, if this level could be maintained by "direct" poisoning with Zinc Phosphide at a concentration of 10%. Four such controls were applied during the period September, 1954, and June, 1955, and the poison bait "takes" were 7, 22, 15 and 3 respectively. A similar test baiting to that applied after the "1080" controls was carried out, and a total of 405 entrances were baited for three days. The recorded result was 63 "takes" (33 complete, 5 x 19 x Vi and 6 x \ or less). The test bait "take" subsequent to the final "1080" control was 26 "takes" (15 complete, 5 x 3 x Vi and 3 x \ or less). In this series of controls 35 bodies were recovered. Analysis of the sector recordings and the overall result indicated that the previous low level achieved had not been maintained. The upward trend and distribution indicated by the acceptance of the non-poison test baits coincided with the observations of the sewermen, who had noticed an increase in the number of rats seen during their routine duties in the sewers, between controls, and in particular the last quarter. The low poison acceptance and increase in test "takes" plus the visual evidence indicated the possibility that poisons prejudice had been produced by the continued use of Zinc Phosphide at a 10% concentration. Following this result, it was considered that a return to Sodium Fluoroacetate was desirable, and during the period September, 1955 and June, 1956, three controls were "direct" poisoning and the fourth a pre-bait control. In the September control 397 entrances were poison baited, and after three days 38 "takes" (1 complete, 9x !i and 28 x \ or less) were recorded, and 52 bodies were recovered. In the two subsequent "direct" controls the "takes" were 12 and 10 respectively, and with two exceptions these were in the '4 or less category. These controls produced 21 bodies. For the final "1080" control it was decided to apply a pre-bait treatment on the 1—3 — 5 system, the final pre-bait acceptance result substituting for the annual test baiting. Thunderstorms and prolonged rain made recording difficult. The pre-bait result was 49 "takes" (36 complete, 9 x and 4 x 14). Some of the "takes" recorded as complete were doubtful and could have been washed away by charged up flows. The poison result was 25 "takes" (2 x Vi and 23 x '» or less) and 10 bodies were recovered. Having now carried out 21 treatments over a period of five years principally with "1080", it was suggested that Fluoracetamide, technically known as "1081" might prove advantageous as an alternative to "1080", and after discussion with Dr. E.F. Turtle and Dr. F.W. Hentley, Scientific Officers, Ministry of Agriculture, Fisheries and Food, it was decided that four direct controls be applied in a similar manner to the "1080" treatments, and the manufacturers kindly undertook to supply the required quantity. Chemically this poison is similar to "1080" but unlike the latter, which is an extremely fine powder, is in crystal form, which increases the safety factor in dispensing. It is readily soluble in water, odourless and said to be tasteless. The median lethal dose (LD50) for Common rat is about 15 MG/LG of bodyweight as against 1 MG/KG for "1080" and is therefore about 15 times less lethal to rats. After a lethal dose the speed of onset of warning symptoms is slower than Zinc Phosphide for which the LD50 is 40 MG/KG. 16. It was considered desirable to obtain by overall test baiting a basis upon which the effectiveness of "1081" could be judged after four "direct" controls, and this was carried out during the period 10th - 13th September, 1956, three months after the pre-bait and final "1080" control being repeated 19th - 22nd November, 1956, ten weeks later, and three weeks prior to the first "1081" control. For the first test baiting, 402 sewer entrances were baited and the baits, each 4 ounces, were left down for three days, and on examination 103 "takes" (84 complete, 6 x ¾, 8 X ½ and 5 x ¼) were recorded. The weather, an important factor in sewer control, was favourable and the 299 test baits recorded as no "takes" were in good condition after three days. For the purpose of the second overall test baiting, 19th - 23rd November, 403 sewer entrances were baited and the recorded result was 174 "takes" (165 complete and 9 x ½). The weather was again favourable, and no rain being experienced during the work or the previous three weeks, the sewer entrances were dry and in ideal condition for the test. The significant feature of the test result was the formidable increase in the number and quality of the test bait "takes", indicating the rapid build-up and distribution in the period of nine months between the last overall "direct" poisoning with "1080", for as previously mentioned only 49 entrances were subject of poison bait in the June control. The first "1081" "direct" control was applied in December, 1956, the procedure being similar to the "1080" treatments, in dispensing and distribution. The recorded result of the examination of the 394 entrances baited was 87 "takes" (8 complete, 7 x ¾, 39 x ½ and 33 x ¼ or less) and 51 bodies were recovered, the majority of which were in the flows, a considerable distance from the baits. The weather during this control was adverse, and heavy rain at times made examination of the baits difficult and only definite "takes" were recorded. To complete this record of sewer control up to the time of writing, the second treatment of this series was carried out in March, 1957. In this instance the recorded result of 401 entrances baited was 60 "takes" (11 complete, 7 x 18 x ½, and 24 x ¼ or less) each bait, with the exception of eight being4 ozs each. Fight entrances where complete"takes"were recorded in the December control were given 8 ozs. baits, and of these 4 x ¼ "takes" were obtained. A total of 34 bodies were found, all of which were in shallow and slow flows. From close observation of these treatments and analysis of the sector recordings, the initial introduction of Fluoracetamide as a rodenticide for sewer treatments is, so far, promising, but a comprehensive picture of its properties will be reflected on completion of the series in September, 1957, after which overall tests will be applied. ATMOSPHERIC POLLUTION During 1956 the Public Health Committee received a report relative to sulphur oxides in the neighbourhood of St. Paul's Cathedral. It was indicated there 'would be little prospect at the present time of securing legislation or control by regulation to deal with sulphur emissions. A contribution to the problem would be to ask developers to consider first the use of an "authorised" fuel under the City of London (Various Powers) Act, 1954. The Improvements and Town Planning Committee agreed to the Resolution of the Public Health Committee that when recommending the grant of planning permissions it should be indicated to the developers that advice should be sought from the Medical Officer of Health, in the case of alterations to old buildings, and from the City Engineer, in the case of new developments, with reference to the heating installations to be provided in connection with such developments. The Clean Air Act, 1956, with its comprehensive proposals to deal with the smoke pollution of the atmosphere, received the Royal Assent during the year. Certain provisions of the Act became operative on the 31st December, 1956, and for record purposes the joint report of the Medical Officer of Health and the City Engineer to the Port and City of London Health Committee is reproduced below. The recommendations appended to the report have been adopted. CLEAN AIR ACT, 1956 The Clean Air Act, 1956 (Appointed Day) Order, 1956 The Smoke Control Areas (Authorised Fuels) Regns. 1956 Model Building Byelaw under Section 24 in regard to heating and cooking appliances in new buildings. The Minister of Housing and Local Government appointed the 31st December, 1956 as the date on which certain provisions of the Clean Air Act, 1956 came into operation. The Act gives local authorities new powers and duties for the prevention of air pollution, and the provisions now in force deal with the installation of new furnaces; the height of chimneys; smoke control areas; pollution from colliery spoilbanks; research and publicity; and the making of building byelaws. The Minister has also issued the Smoke Control Areas (Authorised Fuels) Regulations, 1956, and a Model Building Byelaw in regard to heating and cooking appliances in new buildings. The Minister intends, at a later date, to make an Order fixing a date in the earlier part of 1958 as the appointed day for the remaining provisions of the Act. 17. By Sections 31 and 32 of the Clean Air Act, 1956, various general provisions of the Public Health Act, 1936 and the Public Health (London) Act, 1936 are applied with suitable modifications as if the Clean Air Act were a part of those Acts. The Act therefore forms part of the public health code. The authorities which are local authorities for public health purposes become local authorities under the Clean AirAct,and their functions are in consequence extended. Hence, under Section 29, it is the duty of the Court of Common Council, as the Port Health Authority of the Port of London and the local sanitary authority for the City of London, to administer the provisions of the Act in the Port and City of London, but as regards the Port Health Authority, it should be noted that under an Order of the Local Government Board giving assignment of powers dated 30th June, 1898, the powers of the Port Health Authority extend "as well in and over the whole of any wharf and of the area within the gates of any dock and the buildings thereon respectively, forming part of or abutting upon the Port of London as in and over all waters within the limits of the said Port". Under the City's own local legislation — The City of London (Various powers) Act, 1954, Part II - Smoke Abatement - Section 4 (and subject to the other provisions of this section) - the emission of smoke from any premises in the City is prohibited. This legislation does not apply to the Port of London. The 'other provisions' referred to above provide certain defences in any proceedings, e.g. any emission of smoke by the burning of an authorised fuel; by burning any other type of fuel because the authorised fuel was not available; and by the burning of any fuel which has been approved by the Court of Common Council for the particular appliance, and burnt in accordance with the conditions of approval already agreed by the Public Health Committee. In addition, the Court of Common Council may exempt any premises from the provisions of Section 4 and under sub-section (9) of Section 4 the Various Powers Act does not apply to smoke emitted from a railway locomotive. Section 35 (4) of the Clean Air Act empowers the Minister after consultation with the Corporation to repeal by Order any provision in the local legislation which appears to him to be unnecessary having regard to the provisions of the Clean Air Act, but this power may be exercised only with the consent of the Corporation. Having regard to the smoke abatement provisions of the City of London (Various Powers) Act, 1954, the effect of the (Appointed Day) Order under the Clean Air Act, 1956, may be summarised as follows:— Installation of new furnaces. Section 3 of the Clean Air Act, 1956 applies to all new furnaces installed after the 31st December, 1956 in buildings or in boilers and industrial plant except furnaces designed solely or mainly for domestic use with a heating capacity of less than 55,000 British thermal units per hour. In short, the section covers industrial furnaces and other large furnaces such as may be found in hotels and blocks of flats, but not small domestic appliances in houses, offices and shops. This section requires the person proposing to install the furnace to give notice of intention to the local authority. It is not necessary to submit plans or specifications when giving notice. The purpose of notification is solely to enable local authorities to know when and where new furnaces are being installed, and they are not required on receiving notice either to give or to withhold their approval. Where, however, a person proposing to install a new furnace chooses to submit plans and specifications, and where he subsequently installs the furnace in accordance with approved plans, the furnace is deemed to comply with the requirements of section 3, i.e. to be capable, so far as practicable, of continuous operation without emitting smoke when burning fuel of a type for which it was designed. Approval will not be a bar to proceedings for a contravention of any other provisions of the Act, e.g. the emission of dark smoke following the improper use of the furnace. Recommendations relative to this section are appended. In the application of section 3 of the Clean Air Act to the Port reference should be made to the Order of 1889 giving assignment of powers as quoted in an earlier part of this report. It should be noted that the area within the five great dock groups administered by the Port of I.ondon Authority, an area over which the Port Health Authority also has powers of sanitary administration, amounts to more than 3,000 acres, approximately five times as much as the area of the City of London itself. In this large area there are very many buildings, although probably not much prospect of new buildings being erected to any great extent because the area is already built up for the most part. Nevertheless we think that the same principle should apply here as in the City, namely that notice should be given in respect of replacement of obsolete furnaces and plant conversions in existing buildings to the Medical Officer of Health, and in respect of the installation of apparatus in new buildings to the City Engineer, both Officers, being advisers to the Corporation of London, which in one of its capacities acts as Port Health Authority of the Port of London and in another, as local sanitary authority for the City of London. Smoke control areas. Sections 11-15 inclusive provide for the declaration of smoke control areas, the adaptation of fireplaces in private dwellings, Exchequer contributions, and the power of a local authority to make grants towards the adaptations to fireplaces in churches, chapels, buildings used by charities, &c. In general, the smoke abatement provisions of the City of London (Various Powers) Act, 1954, cover the smoke control area requirements of the Clean Air \ct, with the exception that, in the City, expenditure incurred on the adaptation of fireplaces does not rank for Exchequer contribution. 18. The Port of London is outside the provisions of the Various Powers Act, but having regard to the complexities of smoke nuisance which are peculiar to the 70 mile long district covered by the Port Health Authority, it is not suggested that consideration should be given to declaring the area a Smoke Control Area. Section 31 (2) of the Clean Air Act (as applied by section 32) ensures that the Port Health Authority will assume the powers and functions of a local authority. On the second appointed day, i.e. in the earlier part of 1958, section 20 will come into operation and vessels will become subject to the provisions of sections 1 and 2 which prohibit the emission of dark smoke. Smoke from railway engines and vessels. Smoke from railway engines cannot be dealt with under the Corporation's own powers for smoke abatement, but by Section 19 of the Clean Air Act, 1956, they will be prohibited from emitting dark smoke. Under Section 20 of the Clean Air Act, 1956, as already mentioned, the same will apply to smoke from vessels. Unfortunately the act does not prohibit the emission of grit from either railway engines or vessels, although during the course of the Bill's transition through Parliament, Mr. Remembrancer, in consultation with your Medical Officer, made persistent efforts to get the prohibition of grit emission from vessels inserted in the Bill. This was because vessels are apt to cause a nuisance when tied up at Riverside Wharves as well as in the Docks by blowing their boiler tubes. This may be a serious nuisance particularly at the riverside. It is a nuisance which can be reduced by intelligent control of ships furnaces, and it is a constant endeavour of your Worshipful Committee's Port Health staffs to persuade masters of ships as to the undesirability of the practice which can be reduced by care, e.g. the tubes could be blown while the vessel is still at the mouth of the Thames and before it ties up at a riverside .vharf. With regard to railway engines, it will be noted that there are a number of these in the various dock groups owned by the Port of London Authority, and in the City, of course, there is the problem of the termini of the Eastern, London Midland, and Southern Railway Regions. Research and publicity. Under Section 25 a local authority may:— (a) undertake or contribute towards the cost of investigations and research relevant to the problem of pollution of the air; (b) arrange for the publication within their area of information; (c) arrange for the delivery of lectures and addresses and the holding of discussions; (d) arrange for the display of pictures, cinematograph films or models or the holding of exhibitions; and (e) prepare or join in or contribute to the cost of the preparation of pictures, films, models or exhibitions to be displayed or held in connection with the problem as aforesaid. With regard to publicity a good deal has already been done. Thus in the Port, conferences have been held both with the Association of Master Lightermen and Barge Owners, the principal tug owners, and with the Port of London Authority, who themselves own a fleet of vessels on the Thames. The help of the Fuel Research Station was obtained, and as reported to the Port of London Health Committee, their advice on the spot in practical experiments was much appreciated. The Port of London Authority have been reminded of their responsibilities in regard to railway engines in their dock areas, as well as for their fleet of vessels on the river, and with regard to railway engines in the City, numbers of conferences and representations have been made at various levels, with a view to reducing smoke nuisance from this source. The Chairman of the Public Health Committee has been particularly active in this sphere, and arrangements are now being made for the showing of films and lectures to be given to railway staffs by Mr. W.R. McGrath, your City Public Health Inspector. Pamphlets will also be issued. The Smoke Control Areas (Authorised Fuels) Regulations, 1956 The regulations declare the following fuels to be authorised fuels for the purposes of the Clean Air Act:— anthracite, briquetted fuels carbonised in the process of manufacture; coke; electricity; gas; low temperature carbonisation fuels; and low volatile steam coals. Electricity, gas, and briquetted fuels carbonised in the process of manufacture, are not included in the list of fuels authorised by the Court of Common Council for the purpose of the City of London (Various Powers) Act, 1954. It will also be observed that instead of the designation "Welsh Dry Steam Coal" in the City's list of authorised fuels, the Regulations refer to "low volatile steam coals". The latter designation is preferable since not all Welsh Dry Steam Coal has a low volatile content. The recommendation set out below is designed to bring the list of authorised fuels under the Various Powers Act into conformity with those named in the Authorised Fuels Regulations. Summary The new legislation supplements the City's own powers to promote clean air in the City, particularly by giving powers which will come into force in 1958 for taking action in respect of smoke from railway engines. The Clean Air Act, 1956 gives power which was lacking in the City's own act to pursue smoke offenders outside the City boundaries if such smoke affects any part of the City. 19. Railway engines in the dock areas like those in the City will be subject to smoke control under the new Act. By powers given under the Public Health (London) Act, 1936 smoke from vessels in the Port could be accounted a 'nuisance', but it is anticipated that the power to be given under the new Act to prosecute for the emission of dark smoke for longer than a fixed period will prove much more effective. Under the new Act both in the dock areas and in the City, notice of intention to install or to vary the installation of heating appliances (except for domestic purposes) must be given to the City Corporation. The new regulations as to 'authorised fuels' supplement and vary to advantage the City's pre-existing powers in these matters. Recommendations (1) That notices of intention to install new furnaces in the City of London under Section 3 of the Clean Air Act, 1956 in existing buildings be sent to the Medical Officer of Health, and in new buildings to the City Engineer; in the Port all notices (for new and old) be sent to the M.O.H. (2) That it be recommended to the Court of Common Council — (a) to add the following smokeless fuels to the list of approved authorised fuels for the purposes of the City of London (Various Powers) Act, 1954:— electricity; gas; briquetted fuels carbonised in the process of manufacture, and (b) that the designation "low volatile steam coals" be substituted for "Welsh Dry Steam Coal" in the approved list of authorised fuels. (3) That Mr. Town Clerk be requested to give appropriate publicity to the subject matter of recommendations 1 and 2 above. MEASUREMENT OF ATMOSPHERIC POLLUTION The period covered by the results of the measurement of atmospheric pollution, as set out in the Tables, coincides with the first complete year of the coming into operation of the smoke abatement provisions of the City of London (General Powers) Act, 1954, and Mr. McGrath reports as follows :— Deposit gauge at Golden Lane. This general purpose instrument is effective for sampling ash and other particles which fall rapidly or are washed down by rain. The month to month fluctuations in the results are primarily due to meteriological conditions, but another factor influencing the results is the deposit of wind blown grit and dust. With the re-development of war damaged sites in 1956 in the neighbourhood of the gauge at Golden Lane, demolition and rebuilding must have been reflected in the results obtained. The results of the measurements set out in Table I may be summarised as follows :— (a) The monthly rainfall average for 1956 — 44 millimetres — was the same as the average for the five years 1951-1955. This is equivalent to approximately 1.7 inches of rain. (b) The average monthly total of solids deposited — 21.08 tons per square mile — was less than was less than in the two previous years, and less than the average for the previous five years. (c) Whilst the undissolved matter (tarry matter, ash, &c.) — equivalent to 13.31 tons per square mile — was less than that recorded in 1955, the monthly average was in excess of the average for the previous five years, i.e. 12.13 tons per square mile. (d) A marked improvement will be noted in the figures for dissolved matter (calcium, chloride and sulphates) — 7.80 tons per square mile. This result was the lowest recorded in the previous six years and was well below the monthly averages for the five years 1951-1955, i.e. 9.93 tons per square mile. Sulphur dioxide measurement by the lead peroxide method. The Corporation maintains two stations for measuring sulphur pollution by this method — one at Golden Lane and the other in Finsbury Circus Gardens. It will be seen that at both stations there is a slight improvement when the results are compared with 1955 and with the average of the previous 5 years. Volumetric estimation of smoke and sulphur dioxide. Tables II and III are the results obtained at the four stations maintained in the City. This method recognizes the distinction to be drawn between relatively coarse particles of pollution deposited by their own weight — as measured by the deposit gauge — and fine particles which remain suspended in the air. A description of this method of measuring the concentrations of smoke and sulphur has been given in a previous annual report. It is too early to draw any reliable conclusions from the results obtained from the instruments at Tishopsgate, Cloak Lane and Snow Hill since observations only commenced in April, 1955. At Golden Lane the results for 1956 show that there has been a slight improvement in the concentrations when compared witii 1955 and the average of the five years 1951-1955. 20. TABLE I. —Results obtained in 1956 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 68 2.69 13.47 9.56 23.03 4.06 3.83 February 5 0.18 3.05 3.85 6.90 4.06 3.22 March 22 0.85 23.50 9.92 33.42 4.17 3.33 April 25 0.98 12.51 9.79 22.30 3.38 2.80 May 6 0.25 12.15 4.71 16.86 1.44 1.35 June 56 2.22 6.90 7.90 14.80 1.10 0.99 July 114 4.49 17.03 12.78 29.80 1.40 1.30 August 78 3.06 10.33 5.87 16.10 0.87 1.32 September 50 1.96 16.83 8.23 25.06 2.12 1.69 October 42 1.64 12.65 6.90 19.55 2.49 2.74 November 8 0.32 9.32 5.48 14.80 3.66 3.23 December 56 2.22 21.77 8.60 30.37 3.48 3.29 Averages: 1956 44. 1.74 13.31 7.80 21.08 2.69 2.42 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 1951-1955 44 1.70 12.13 9.93 22.04 2.56 2.48 TABLE 11. —Results obtained in 1956 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 Hishopsgate Cloak Lane Sno w 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 68 2.69 32 (a) 96 50 205 28 160 28 120 February 5 0.18 26 64 42 115 28 105 22 64 March 22 0.85 15 40 27 43 21 43 16 42 April 25 0.98 13 26 — — 17 28 11 18 May 6 0.25 7 22 — — 8 22 5 11 June 56 2.22 5 14 — — 5 9 4 12 July 114 4 49 6 11 15 34 3 5 4 8 August 78 3.06 5 9 18 34 4 9 6 12 September 50 1.96 6 14 16 29 5 13 6 17 October 42 1.64 14 38 24 47 17 44 13 29 November 8 0.32 17 35 32 51 23 45 16 31 December 56 2.22 16 34 29 89 23 56 15 32 Averages: 1956 44 1.74 14 21b) 15 12 1955 43 1.71 14 — 25(b) — 10(b) — 11(b) 1954 47 1.80 14 — — — — — — 1953 36 1.40 13 — — — — — — 1952 40 1.50 12 — — — — — — 1951 54 2.10 10 — — — — — — 1951-1955 44 1.70 13 — — — — — — (a) Includes the mean of 27 short period measurements taken between the 4th-ltth January (inclus.) during a persistent fog warning. (b) Measurements for 9 months of the year. 21. TABLE III.-Results obtained in 1956 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 68 2.69 19 (a) 43 23 70 20 85 25 64 February 5 0.18 14 50 17 58 19 55 19 50 March 22 0.85 13 45 17 35 17 32 17 35 April 25 0.98 10 22 — — 15 27 14 19 May 6 0.25 5 15 — — 7 13 8 14 June 56 2.22 3 10 — — 4 7 6 9 July 114 4.49 4 9 7 14 5 8 6 11 August 78 3.06 4 7 9 14 5 10 6 9 September 50 1.96 6 12 9 21 9 27 8 28 October 42 1.64 10 26 14 26 13 30 14 23 November 8 0.32 13 27 18 27 17 32 18 26 December 56 2.22 15 36 18 30 15 51 16 22 Averages: 1956 44 1.74 10 — 15(b) — 12 — 13 — 1955 43 1.71 10 — 13(b) — 10(b) — 12(b) — 1954 47 1.80 11 — — — — — — — 1953 36 1.40 11 — — — — — — — 1952 40 1.50 13 — — — — — — — 1951 54 2.10 10 — — — — — — — 1951-1955 44 1.70 11 — — — — — — — (a) Includes the mean of 27 short period measurements taken between the 4th-8th January (inclus.) during a persistent fog warning. (b) Measurements for 9 months of the year. Or. Charles F. White concluded his Annual Report for the year 1955 on a personal note in which he took farewell of the Corporation and expressed his appreciation for the happiness he had had in their service for the previous 28 years, first as Medical Officer of Health of the Port of London and then as Medical Officer of Health of the City. I succeeded him in Apri1, 1956 so that for the first three months of the year 1956 the work recorded in this Annual Report was carried out under his supervision. I am glad to have this opportunity of saying how much I appreciate the honour of succeeding so distinguished a Medical Officer of Health as Dr. Charles F. White. On the 17th December, 1953 the Court of Common Council approved the recommendation of the Officers' and Clerks' Committee that the person appointed to the position of Medical Officer of Health of the Port of London on the retirement of Dr. M.T. Morgan on the 31st March, 1954, be appointed to become Medical Officer of Health for the City of London as well upon the retirement of Dr. Charles F. White. It is now my privilege as the first holder of the combined appointrnentto present my first Annual Report as Medical Officer of Health of the City of London concurrently with my third Annual Report as Medical Officer of Health of the Port of London. I should like to express my thanks to the Chairman and members of the Public Health Committee for the warm welcome they gave me when I succeeded Dr. White, and for the kindness they showed me during the remainder of the year 1956 following his retirement. I have the honour to be, Your obedient Servant, J. GREENWOOD WILSON, Medical Officer of Health, Port and City of London. 22. 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, 1956, £13,968,300. Annual Sum received from Penny General Rate.—£56,500. Births:— Total. M. F. Legitimate 40 21 19 Live Birth, Illegitimate 4 3 1 Birth Rate per 1,000 resident population, 1956 7.56 Still Births — — — Rate per 1,000 total (live and still) births — Deaths:— Deaths, Infants under 4 weeks of age Legitimate 3 2 1 Illegitimate — — — Deaths under 1 year Legitimate 3 2 1 Illegitimate — — — Death Rate per 1,000 res idem population 13.19 Deaths (all ages) 67 50 17 Death Rate of Infants under one year of age:— All Infants per 1,000 live births 70.00 Legitimate Infants per 1,000 legitimate live births 76.50 Illegitimate Infants per 1,000 illegitimate live births — INFECTIOUS DISEASE. Notifications received:— Total cases notified Sonne Dysentery 6 Acute Pneumonia 1 Erysipelas 1 Puerperal Pyrexia 13 Measles 13 Whooping Cough 4 Tuberculosis 5 Food Poisoning (suspected) 1 Scarlet Fever 3 10 contacts of a case of Typhoid Fever were landed from a ship arriving from Alexandria and were kept under observation until the incubation period expired. No further case developed. ANALYTICAL EXAMINATIONS. (Other than under Food and Drugs Act). Advocaat 1 Pineapples, Tinned 1 Atmospheric Pollution 24 Pork, Chopped 1 Blackcurrant Pressings 1 Powder, (on carton of raisins) 1 Bread, slice of 1 Rainwater 12 Bun, Currant 1 Saithe in Edible Oil 1 Coffee 1 Salad Cream 1 Corned Beef 1 Salmon Salad in Mayonnaise 1 Deposit, fatty (on milk churn lid) 1 Sandwich (Corned Beef) 1 Fertilizer, Compound 1 Sandwich (Egg & Tomato) 1 Ginger 1 Sandwich (Ham) 1 Grapefruit, Segments 1 Sandwich (Sausage) 1 Honey Cake 1 Sulphate of Ammonia 1 Jellied Eels 1 Sultanas 2 Lunch Meat 2 Veal & Pork, Pressed 1 Pineapple Pieces 3 Water from well 5 Pineapple Slices 1 BACTERIOLOGICAL EXAMINATIONS. The following specimens were examined during the year:— Beef 2 Sausage, Frankfurter 1 Corned Beef 1 Sausage Meat, cooked 1 Cream, Vita 1 — do. — uncooked 1 Deposit, fatty on milk churn lid 1 Scrapings from food table 1 Egg Albumen (crystal & powder) 226 Steak puddings 3 Egg (frozen liquid) 179 Turkey, cooked portion 1 Faeces 23 Veal & Pork, pressed 2 Ham roll 2 Water, fresh (from ship) 1 Ham, tinned 1 Water, storage tank 3 Mincemeat 1 Water, from well 3 Saithe, tinned 1 Xmas Pudding 1 23. CAUSES OF, AND AGES AT, DEATH DURING THE YEAR 1956. 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 All Causes 67 3 — — — 5 26 19 14 1. Tuberculosis, respiratory M 2 — — — — — — 1 1 F — — — — — — — — — 2. Tuberculosis, other forms M — — — — — — — — — F — — — — — — — — — 3. Syphilitic disease M 1 — — — — — — 1 — 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 1 — — — — — 1 — — F — — — — — — — — — 10. Malignant neoplasm-stomach M — — — — — — — — — F — — — — — — — — — 11. Malignant neoplasm-lung, Bronchus M 6 — — — — — 4 1 1 F — — — — — — — — — 12. Malignant neoplasm-breast M — — — — — — — — — F — — — — — — — — — 13. Malignant neoplasm-uterus F — — — — — — — — — 14. Other malignant and lymphatic neoplasms M 7 — — — — 1 3 2 1 F 4 — — — — — 3 1 — 15. Leukaemia, aleukæmia M — — — — — — — — — F — — — — — — — — — 16. Diabetes M — — — — — — — — — F 2 — — — — — — 1 1 17. Vascular lesions of nervous system M F 1 — — — — — — 1 — 18. Coronary disease, angina M 3 — — — — — 2 1 — F 4 — — — — — 2 1 1 19. Hypertension with heart disease M 1 — — — — — 1 — — F 1 — — — — — — 1 — 20. Other heart disease M 3 — — — — — 2 1 — F 2 — — — — — — — 2 21. Other circulatory disease M 7 — — — — — 3 1 3 F 1 — — — — — — 1 — 22. Influenza M — — — — — — — — — F — — — — — — — — — 23. Pneumonia M 4 — — — — — — 3 1 F — — — — — — — — — 24. Bronchitis M 4 — — — — — 4 — — F — — — — — — — — — 25. Other diseases of respiratory system M 1 — — — — 1 — — — F — — — — — — — — — 26. Ulcer of Stomach and duodenum M 1 — — — — — — 1 — F — — — — — — — — — 27. Gastritis, enteritis and diarrhoea M — — — — — — — — — F — — — — — — — — — 28. Nephritis and nephrosis M 1 — — — — — — 1 — F — — — — — — — — — 29. Hyperplasia of prostate M — — — — — — — — — F — — — — — — — — — 30. Pregnancy, childbirth, abortion F — — — — — — — — — 31. Congenital malformations M — — — — — — — — — F — — — — — — — — — Carried forward M 42 — — — — 2 20 13 7 F 15 — — — — — 5 6 4 CAUSES OF AND AGES AT DEATH DURING THE YEAR 1956.-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 F 42 — — — — 2 20 13 7 15 — — — — — 5 6 4 32. Other defined and ill-defined diseases ... M 4 2 — — — — — — 2 33. Motor vehicle accidents F 2 1 — — — — — — 1 M — — — — — — — — — F — — — — — — — — — 34. All other accidents M 2 — — — — 2 — — — F — — — — — — — — — 35. Suicide M 2 — — — — 1 1 — — F — — — — — — — — — 36. Homicide and operations of war M — — — — — — — — — F — — — — — — — — — M 50 2 — — — 5 21 13 9 F 17 1 — — — — 5 6 5 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 Centre. 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 33 1—5 years of age 16 Total No. of children who attended during the year, and who were born in:— 1956 47 1955 40 1954-1951 50 Total attendances by children— Under 1 year of age 655 1—5 years of age 553 Health Visitors No. of infants under 1 year of age visited for first time 40 Total visits to infants under 1 year of age 150 Total visits to children aged 1 year but under 2 years 74 Total visits to children aged 2 years but under 5 years 166 No. of expectant mothers visited 15 Total visits to expectant mothers 33 Care of Premature Infants No. of premature births during the year 2 No. of deaths under 1 month — Diphtheria Immunisation No. of children who completed a full course of primary immunisation— Under 5 years of age 54 5—14 years of age 7 25. No. of children who were given a secondary or reinforcing injection 30 Vaccination No. of children successfully vaccinated or revaccinated 42 MEAT INSPECTION Tons. Cwts. Qrs. Lbs. Meat, &c., delivered at Smithfield Market 423,968 0 0 0 Meat, &c., seized by Inspectors at Smithfield Market 656 15 2 18 Meat, &c., seized by Inspectors at Leadenhall Market and City shops 8 12 1 11 Meat, &c., seized by Inspectors at Cold Stores 3 13 2 0 Various commodities seized by Inspectors and sent to Lett's Wharf 8 1 1 21 Number of demonstrations and lectures given, 92 Number of Students attending, 201. 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. 145 tons 18 cwts. 2 qrs. 19 lbs. were condemned as unfit for human consumption. 8 tons 15 cwts. 1 qr. 27 lbs. of this food were utilised for stock feeding, fertilizing or manufacturing purposes. The remainder, consisting of 137 tons 3 cwts. 0 qrs. 20 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. 11 tons 0 cwts. 3 qrs. 10 lbs. 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 4,151 inspections have been made. As a consequence of these inspections, it was necessary to serve 15 Intimation Notices. 6 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 1 OF THE ACT. 1 .—INSPECTIONS for purpses 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 1,156 (including 987 kitchens) 2,114 (including 2,049 kitchens) 274 (including 265 kitchens) — (ii) Factories not included in (1) in which Section 7 is enforced by the Local Authority 95 117 15 — (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) — — — — TOTAL 1,251 2,231 289 — 26. PART 1 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.) 679 609 — — — Overcrowding (S.2.) 1 2 — — — Unreasonable temperature (S.3.) — 1 — — — Inadequate ventilation (S.4.) 84 61 — — — Ineffective drainage of floors (S.6) 8 2 — — — Sanitary Conveniences (S.7.) (a) insufficient 4 6 — — — (b) Unsuitable or defective 167 123 — 4 — (c) Not separate for sexes 5 5 — — — Other offences against the Act (not including offences relating to Outwork) 586 449 — — — TOTAL 1,534 1,258 — 4 — OUTWORK AND THE INSPECTION OF OUTWORKERS' PREMISES, ETC. Lists received from City Firms 94 Names and Addresses, etc., received from other Authorities 129 Names and Addresses transmitted to other Authorities 572 No case of infectious disease was reported in connection with outworkers' premises in the City. SHOPS ACT, 1950. 98 inspections of shops and warehouses have been carried out. Defects found have been remedied after the service of 5 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 1956, 110 inspections were made in this connection and reports forwarded to the City Food Controller in regard to the 74 cases so referred. PHARMACY AND POISONS ACT, 1933. 66 firms were registered under this Act, 63 of which were re-registrations. One infringement was noted. 109 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. 20 inspections were made and no contravention came under the notice of the Inspector. FERTILISERS AND FEEDING STUFFS ACT, 1926. The provisions of the above Act were carried out without recourse to legal proceedings and without special difficulty. 56 inspections were made; one contravention was discovered. 27. FOOD AND DRUGS ACT, 1955, AMD FOOD REGULATIONS. Informal and Formal Samples submitted for Analysis Article Informal Formal Article Informal Formal FOOD Brought forward Almonds (ground) 5 — Pudding Mixtures 2 — Almond Essence 1 — Raisins 1 — Aspic Jelly Powder 1 — Rice (ground) 1 — Baking Powder 1 — Salad Cream 2 — Biscuits 1 — Sauces 5 — Bread 2 — Sausages 24 — Butter 11 — Sausage (breakfast) 1 — Butter (on rolls) 1 1 Sausage Meat 1 — Cake Decorations 1 — Sausage Rolls 9 — Cakes 3 — Savoury 1 — Caraway Seed 1 — Soft Drinks 2 — Cheese (processed) 3 — Soya Flour 1 — Christmas Pudding 2 — Spices 4 — Cinnamon (ground) 2 — Spreads 3 — Cloves 2 — Stewed Steak (tinned) 2 — Coffee 8 1 Stuffing 2 — Coffee & Chicory Mixture 2 — Suet 4 — Coffee Essence 4 — Sugar 7 — Colouring 2 — Sultanas 1 — Cooking Fat 1 — Sweets 15 1 Cornflour 1 — Tea 12 — Currants 2 — Tomatoes (tinned) 1 — Curry Powder 7 — Tomato Chutney 1 — Cream Powder (synthetic) 1 — Tomato Juice 1 — Custard Powder 2 — Tomato Paste (conc.) 1 — Dairy Cream 12 — Turmerric 1 — Desiccated Coconut 5 2 Vinegar 6 — Dessert Powder 6 — DRUGS Dripping 2 — Fish 8 — Fish Paste 7 — Ammoniated Tincture of Quinine 2 — Flavourings 7 — Almond Oil 2 — Flour 2 — Arrowroot (ground) 1 — Fruit (tinned) 4 — Bronchial Syrup 1 — Gelatin 1 — Calamine Lotion 3 — Ginger (ground) 5 — Camphorated Oil 2 — Glace Cherries 1 — Castor Oil 3 — Grape Juice 1 — Cascara Sagrada 1 — Gravy Browning 1 — Cod Liver Oil Capsules 1 — Herbs (mixed) 1 — Cough Linctus 4 — Honey 1 — Embrocation 1 — Ice Cream 6 — Eucalyptus Oil 3 — Ice Cream Powder 2 — Friars Balsam 1 — Iced Lolly 1 — Glaubers Salts 1 — Icing 1 — Glycerin of Thymol 1 — Jellies 2 — Lanolin 1 — Lard 3 — Liniment 1 — Lemon Curd 1 — Liniment of Turpentine 1 — Lemon Juice 1 — Liquid Paraffin 2 — Lemonade Powder 4 — Liquorice Powder 1 — Marzipan 2 — Lung Tonic 1 — Margarine 9 — Medicated Tablets 2 — Mayonnaise 1 — Olive Oil 1 — Milk — 19 Oil of Juniper 1 — Milk (condensed) 4 — Ointments 4 — Mincemeat 2 — Quinine, Belladonna & Camphor Compound 1 — Mint (dried) 4 — Mustard 2 — Rose Hip Syrup 1 — Nutmeg 2 — Tincture of Arnica 1 — Pastry Mix 2 — Tincture of Myrrh 1 — Peel (cut mixed) 1 — Tincture of Myrrh with Borax 1 — Pepper 5 — Witch Hazel 3 — Pepper Compound 1 — Pies 8 — Carried forward 195 23 TOTALS 356 24 28. ADMINISTRATIVE ACTION REGARDING ADULTERATION OR OTHER IRREGULARITY Article Informal or Formal Sample. Nature of adulteration or irregularity. Action. Butter (on rolls) Formal 100% margarine Prosecution. Milk (half pint bottle) Informal Contained piece of metal. Written caution. Milk (half pint bottle) Informal Contained splintered glass. Written caution by City Solicitor. Milk (from churn) Formal Unsatisfactory to Methylene Blue Test. Roundsman contravened Regulations by transferring milk from one container to another on other than registered premises. Written caution. Milk (from churn) Scrapings from churn lid Informal , Informal Bacteriologist's Reports adverse. Inner side of lid of churn contaminated. Written caution. Desiccated Coconut Informal & Formal Contained sulphite preservative equivalent to 165 and 135 parts per million sulphur dioxide respectively. Written caution to wholesalers who have communicated with shippers and suppliers abroad. PROSECUTION. Food and Drugs Act, 1955. Offence Result section 2. Selling margarine on rolls when "buttered rolls" Summons dismissed. No costs allowed, were asked for. 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 these 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 1956 458 pigeons were destroyed by this means. CITY MORTUARY. Bodies received 169 Post Mortem Examinations made 168 Inquest on bodies 36 Inquests held at Holloway Prison 1 Inquest on fires — DISINFECTION AND CLEANSING OF VERMINOUS PERSONS, ETC. Export of Clothing, &c. No. of articles disinfected 1,230,661 Cases of horsehair 395 Clothing by weight 3 Tons. 5 cwt. 2 qrs. Fees received £4,515 General Disinfection. Infectious Diseases, &c. Articles of bedding disinfected 187 Premises disinfected after cases of infectious disease 4 Lockers at Post Offices disinfected 17 Verminous premises disinfected 12 Ambulances, vans, &c., disinfected — Police Cells disinfected — Cleansing of Persons No. of verminous persons bathed 461 No. of Scabious Persons bathed 2 No. of verminous articles disinfected 4,155 Cleansing of Schoolchildren No. of children cleansed 188 No. of articles disinfected 1,466 No. of children treated for Minor ailments 2,369 29.