Ac 4344 Wes 59 library Public Health Dept. City of Westminister COPY REPORT of the MEDICAL OFFICER OF HEALTH FOR THE YEAR 1949 ANDREW J. SHINNIE, M.D., D.P.H. (Lond.). Medical Officer of Health. LONDON: HARRISON AND SONS, LTD. PRINTERS TO HIS majesty THE KING, ST. MARTIN's LANE, vv.0.2. CITY OF WESTMINSTER. The Medical Officer of Health forwards the enclosed Report with bis compliments, and regrets that circumstances over which he has no control have prevented the Report being forwarded earlier. 3 CONTENTS Page Aged and Infirm, care of 26 Atmospheric Pollution 44,45 Bacteriological Examinations 24 Basement Bakehouses 36 Births 19 Burial or Cremation of the Dead 50 Catering Establishments 35,37,38,39,40 Common Lodging Houses 34 Coroner's Court and Mortuary 8,50, 51 Deaths, Analysis of, and ages at 21, 22, 23 Deaths, Causes of 21, 22, 23 Deaths, Statistics 19 Disinfecting Staff 8 Disinfection 48 Dwelling Houses 29, 30 Factories 32, 33, 34 Food, Inspection and Supervision of 35, 36, 37, 40, 41 Food, Legal Proceedings 46 Food, Poisoning 49 Food Shops 36 Food, Unsound 43 House to House Inspection 32 Housing Defects 30 Ice Cream 41, 42 Infantile Mortality 20 Infectious Diseases 20 International Certificates of Vaccination and Inoculation 25 Introduction 9 Legal Proceedings 46, 47 Medical Inspection of Aliens 27 Milk and Dairies 42,43 Mobile Meal Service 26 (807li) * 2 4 Page Noise Nuisances 46 Notices 29, 30, 32, 33, 34, 35, 37, 39 Outworkers 33 Overcrowding 30 Pears contaminated with Arsenic 43 Persons rendered Homeless by Flooding 49 Pharmacy and Poisons Act 43 Pigeons 44 Poliomyelitis 25 Population 11, 19 Premature Infants 20,21 Premises 28, 29, 30, 31, 32, 33 Preserved Meat Premises 36 Private Deep Wells 48 Public Health Committee 5 Public Health Services, 1900-1950 14 Rat and Mice Repression 44 Rodent Staff 8 Sanitary Circumstances 28 Smallpox 24 Smoke Abatement 46 Staff of the Public Health Department 6, 7 Starlings 48 Statistics and Social Conditions 19 Tuberculosis 24 Underground Rooms 31 Unfit Premises 31 Unsound Food 43 Water 47 Westminster Old People's Welfare Association 27 Workplaces, Shops, etc. 28,32,33,34 5 PUBLIC HEALTH COMMITTEE. The Mayor (ex-officio): Councillor Col. James Allan Mulholland, M.C. The Deputy Mayor (ex-officio): Councillor Hal Gutteridge, M.I.Mech.E., M.I.E.I. Chairman : Councillor C. R. Purnell. Vice-Chairman: Councillor Lt.-Col. H. Norman Edwards, M.B.E. Members: Alderman H. V. Day. to Nov. 1949 „ G. F. Jerdein, D.L. Councillor J. C. R. Durran, J.P. „ J. G. Elsworthy, F.R.I.C.S., F.A.I., M.R.San.I. „ R. L. Everest, F.R.I.C.S., F.I.Arb. „ D. E. Havinden. „ W. Charles Norton, M.B.E., M.C. „ Miss P. C. Paton Walsh. ,, Dr. G. Rewcastle, O.B.E. „ Mrs. Arthur Rye. „ A. Sciver, B.Sc., F.R.I.C. „ Mrs. Francis Storrs. „ The Countess Winterton. 6 STAFF OF THE PUBLIC HEALTH DEPARTMENT Medical Officer of Health: Andrew J. Shinnie, M.D., D.P.H., &c. Public Analysts: (Part time) F. W. Edwards, F.I.C. T. McLachlan, A.C.G.F.C., F.I.C. Chief Sanitary Inspector: H. E. White. Chief Clerk: W. D. Sambrook. Sanitary Inspectors: Theatres, Cinemas and other places of Amusement: W. G. J. Sutton. District: S. G. Bennett (Inspector for Rodent Control). J. M. Burbridge. W. J. Davies. W. L. French (Inspector for Disinfection, Disinfestation, etc.) D. W. Saunders. F. E. Siddle. R. F. Stubbs. Housing: C. F. Brockett (Inspector in Charge). A. G. Bates (Appointed 1st October). J. W. Baxter. J. J. Coveney. J. E. Drake. Food: P. A. Lloyd. H. D. Luke. Catering Establishments: J. H. Brownlee. M. J. Flynn. 7 Atmospheric Pollution: C. Ratcliff (Seconded to Civil Defence, 1st June). R. Roper. Women's Factories: Miss C. Hughesdon. Clerical Staff: J. W. Anderson. D. Levitton. A. G. Bates (to 30.9.49). G. Lyness (temporary). R. L. Booker. L. J. Nunn. C. E. Clark. J. M. Shotbolt. A. H. Cole. W. E. F. Simmons. A. R. Cook. W. H. Smith. P. Cox (temporary). E. A. Taylor. Miss P. M. Illman. B. S. Weaver. W. F. C. King. L. Yates (to 20.6.49). 8 Coroner's Court and Mortuary Superintendent: A. W. Nicholls. Morticians : S. King (to 26.11.49). C. H. Lorraine. A. E. Mould. M. J. Marchant. L. M, Swanston. P. O'Brien. Miss E. S. Dunford Mrs. E. Williamson (Nurse Attendant). (Cleaner) Disinfecting Staff: N. Heathcote (Foreman). 6. Lawrence. L. C. Clarke. J. A. Lovelock. C. J. Daniels. J. Shillingford. J. R. Doyle (Motor Driver). Miss H. McWilliam (State Registered Nurse). Miss I. M. Newman (Woman Attendant). Rodent Staff. Rodent Officer: J. W. Brown. B. C. Bennett. A. Howell. D. G. Cadlock. G. Murray. J. Carter. F. C. Smellie. A. C. Dale. J. Vidal. H. J. Felstead. H. Wise. Assistants in the Department: A MiirkLrT (Assistants to Sanitary Inspectors). J. W^Spooner} (Messengers.) 9 To the Right Worshipful the Mayor, Aldermen and Councillors of the City of Westminster. Ladies and Gentlemen, I beg to present my report on the public health and sanitary conditions of the City for the year 1949. This is the twenty-fifth annual report prepared by me and 1950 is the year of the Jubilee of the Metropolitan Boroughs. The report as laid down by the Ministry of Health in Circular 2/50 and directed by the City Council follows on the lines of that for 1948 and the other post-war reports. It may, however, be of some interest to touch on some of the changes observed during the half century. At the 1891 census the population figure of Westminster was 201,969, so that unless the next census of 1951 varies much from the Registrar General's estimate, it would seem that the population will have been halved in 60 years. Fifty years ago there were traffic problems, but life ran at a more leisurely tempo. Looking back the smell of horse traffic was perhaps more pleasant than the fumes of a traffic block in the Piccadilly of today. The gaily-coloured buses and the jingling hansoms surging into Trafalgar Square from the Strand was a cavalcade to be remembered. Both sides of Long Acre were then lined with the showrooms of the horse carriage makers. These gave place to the motor car salesrooms, which in turn were engulfed by the ever expanding Covent Garden fruit trade. There were still two or three mansions in Piccadilly, and Grosvenor Crescent presented a solid fa9ade of the homes of the well-to-do. Except for a few Embassies, neither administration nor commerce had invaded the beautifully planned streets and squares of Mayfair and Belgravia. Today few of the stately mansions remain in the occupation of private families. The war deprived many Londoners of their homes and quite a number of families from devastated areas outside Westminster are housed in some of the streets of Belgravia where the City Council has requisitioned and adapted a number of houses for occupation by three or more households. Overcrowding in the City fifty years ago was acute and prevalent to a degree quite startling when compared with conditions today. St. Anne's Ward with an acreage of 53.4 and population of 11,493 in 1901 had a density of 215.2. In 1931 with a population of 5,405, the density was 100-1. The great Strand improvement scheme of 1900 out of which Kingsway and Aldwych emerged, changed an area of dilapidation and overcrowding to one of order and dignity. The population of the Strand Ward in 1901 was 11,030; in 1931, it had fallen to 2,052. In Soho the buildings, mostly of late 17th and early 18th century, were more than fully occupied by foreign tailors rearing large families and following their trade in rooms which fulfilled the dual purpose of workshop and dwelling. 10 While some of the characteristic restaurants remain, the scene has altered, the film and other industries have invaded Soho and only about half of the tailoring families remain. In Soho Square itself once the resort of the quality, no private residences are now left. In St. John's Ward, Tufton Street, even thirty-five 'years ago, presented some of the most ill-conditioned tenements that could be imagined. In this area the transformation has been as pronounced as anywhere in the City. Along Millbank handsome office buildings have replaced the derelict 18th-century houses. The new Westminster Hospital, a vast repair shop for human machines where kindness vies with skill in returning them reconditioned for the road, is now surrounded with office buildings, lofty blocks of flats replacing the old-fashioned streets of cottages which had made this little old Westminster a hamlet of its own clustering on both sides of Marsham Street (its " High " Street). The Minister in Circular 2/50 asks for detailed information of any action taken under Section 47 of the National Assistance Act. This Section deals with the compulsory removal from their homes of persons in need of care and attention. As last year, no occasion for putting into operation these compulsory powers arose, but that does not mean that there were no cases in need of institutional treatment. The difficulty was not their refusal to go into an institution but that of finding suitable accommodation. The Hospital Authorities plead that there is a grave shortage of beds for those acutely ill. With the exercise of much persuasiveness, in some cases fortified with the utmost pertinacity, your officers have succeeded in obtaining hospital accommodation for those most in need of care and attention and suffering from grave chronic illness. It has been noted that the number of such cases coming to the notice of the Public Health Department has been increasing year by year. The figures are as follows:— 65 in 1945; 94 in 1946; 132 in 1947; 221 in 1948; .267 in 1949. One often hears the facile statement that these old people should be looked after in their own homes, that they are happier in their own homes and that medical, nursing and home help services should be capable of securing a reasonable degree of comfort and treatment. For most of the cases in Westminster this does not hold good. Very few have any known relative. They live in single rooms and the occasional or even daily visit of a district nurse and home help, however welcome, does not meet their needs and sometimes their distress. The Minister's next special mention is that of water supplies: All dwellings in the City are supplied by the Metropolitan Water Board except those blocks of flats with their own deep wells. Ninety-six premises have their own deep wells. Bacteriological and chemical analysis of the water from these various wells are made periodically and are duly reported to this department. On meat and other foods, the Minister inquires in detail as to the practice in slaughter houses relating to disease found in carcases, including tuberculosis. Although there are no slaughter houses in Westminster, 11 the food premises number some 5,000 which include shops, stalls and vehicles and those where food is prepared, especially restaurant and hotel kitchens and food factories. Ice cream and its manufacture in relation to the Heat Treatment Regulations, 1947, are also to be the subject of comment. Details of any outbreaks of food poisoning must be supplied. All these points relating to food receive special mention in this report. The population of the City estimated by the Registrar General for 1949 is 102,160 compared with an estimate of 100,900 for 1948. Next year by the census of 1951 exact figures will be available. The war-time census of 1939 obviously reflected abnormal conditions and it will be interesting to study the changes which have occurred during the twenty years that will have passed since the census of 1931. The birth rate of 12.2 reveals another fall from 13-8 in 1948,15.4 in 1947 and 15.1 in 1946. The general death rate is again lower than the previous year 10.9 and is below the rate for London and also that of England and Wales. The number of infants dying before the end of the first year of life was 42; last year it was 53. This gives an infantile mortality rate of 33.7, the lowest rate ever recorded in Westminster. The tuberculosis death rate was .5 per 1,000. By way of contrast the general death rate of 15.6, infantile mortality rate of 126 and tuberculosis death rate of 1.83 in 1900 indicate the very great advances in the health and welfare of the inhabitants of this City and reflect the improvements in nutrition, sobriety and knowledge of healthy living in which the health services of the City coupled with the spread of education have played a considerable part. There were two maternal deaths. In both cases death followed illegal interference with a pregnancy in women who had previously had healthy children. Diseases of the heart and blood vessels accounted for 412 deaths out of a total of 1,113. Of the deaths from this cause, no fewer than 279 were of persons 65 years and over, while 106 were of the age groups 45 to 65. This gives some indication of the ageing of the population and the effect of the passage of years on the mechanics of the body. Deaths from malignant disease were 218, more than half of them in persons over 65 years of age. Respiratory diseases, including tuberculosis of the lungs, caused 233 deaths, most of them above middle age. There were no deaths from diphtheria. Two cases were notified, one in a man aged 25 years with no evidence of having been immunised. The second case also occurred in an adult, a woman aged 22 years living in a hostel (no information as to immunisation). Measles notifications numbered 635, the largest number since 1938. Only 65 of these required removal to hospital. The epidemic was mild and no deaths were recorded. There were notably fewer cases of whooping cough but with one death. Poliomyelitis and polioencephalitis accounted for one death among 29 cases notified. This is a higher incidence than in 1947, the year of the widespread epidemic, which seems to indicate that the infection is likely to remain in the community. Gastro-enteritis, (8076) a 4 12 though not officially notifiable, is revealed by the number of cases removed to hospital. There were 54 cases and 3 deaths; in 1948 35 cases and 14 deaths. The improvement may be due to new methods of treatment in combating this very serious infection among infants. This is the first complete year since the various personal health services were transferred to the London County Council and to the Regional Hospital Board. In the report for 1948 these services were recorded for the first six months of that year up to 5th July, 1948, when the City Council ceased all responsibility for them. In the preface to my report of last year an assessment was made of the effects of the changes created by the operation of the National Health Service Act by which such services as maternity and child welfare, day nurseries, tuberculosis (dispensary, home visiting and after care) home help service and care of foster children, had been transferred to the London County Council. The centralisation of what are essentially local services may have certain advantages in some areas of the country. It would be difficult to discern any advantages in Westminster so far. That the transferred service has been working smoothly is in large measure due to the co-operative attitude of the Officers of the London County Council, those transferred to the London County Council from the staff of the City Council in 1948 and to the assistance given by Mr. W. D. Sambrook, the Chief Clerk of the Public Health Department of the City Council, whose wide knowledge and experience have been much appreciated by the Divisional Staff of the London County Council. In housing the Council may justly be proud of its efi'ort to provide homes for those to quote the official phrase inadequately housed." The great new Pimlico scheme of 1,621 fiats is now being developed. Some 59 flats are already occupied. The whole scheme when completed will be an outstanding architectural feature of London. The main blocks, of 9 storeys at right angles to the river, will provide a dignified and handsome aspect to this region of the riverside. The cost of buildings in this post-war era, together with land is vastly greater than that of the Council's pre-war estates and to this must be added the cost of the amenities, constant hot water supplies, central heating, space for refrigerators and lifts, etc. It should be noted that whereas under the pre-war Housing Acts, local authorities were empowered to provide housing accommodation for the working classes at rents prevailing in the district for similar accommodation, under the Housing Act, 1949, the term "working classes" has been eliminated. Provision has now to be made for those without homes of their own or otherwise inadequately housed. In the early part of this year the Council completed the Russell House scheme of 74 flats. It is situate on what was a bombed site between Cambridge and Alderney Streets and is a well-planned and imposing building of nine storeys supplied with all the amenities provided for the Pimlico-Scheme, At present the hot water supply and space heating are derived from a central boiler for the whole block. Later the boiler may be dispensed with and the system linked up with the district heating of the Pimlico Scheme. By this latter scheme, the first 13 of its kind in London, hot water from the Battersea Power Station is carried under the Thames, stored in a specially built tower for the purpose of supplying hot water and space heating to the 1,621 flats of the Pimlico Scheme. No solid fuel can be burnt in the flats and this should save some 10,000 tons of coal per annum as well as making a notable contribution to smoke abatement. The Westminster Housing trust operating with the City Council and receiving considerable financial assistance from the latter has completed 100 new flats up to the present time. These, like the Council s new dwellings, are also supplied with lifts. As has often been said a high proportion of old people is characteristic of our population today, especially so in Westminster, and it follows that the number of applications for ground floor and first floors is increasing. Heart weakness, high blood pressure, asthma, and other embarrassments of the circulation and lungs render high buildings rather distressing to old people. To them, the provision of lifts now universal in these postwar schemes, has given immeasurable relief. The City Council is considering the building of flats on two other bombed sites in the neighbourhood of the Southern Railway not far from Ebury Bridge. The proposed scheme would provide for 280 families. When all the new schemes are completed 2.152 flats will be in occupation. Added to the pre-war dwellings of the Council (1,557) and to accommodation adapted by the Council in requisitioned houses, Westminster will have provided accommodation for 6,075 family units. House-to-house routine inspections to secure improved standards of habitation continued throughout the year. This work is in the charge of a Housing Inspector with four others who devote all their time to housing. Through their operations. 778 dwellings came under review involving 3.654 re-inspections. As a result 53 underground dwellings and other parts of buildings were represented for closure, while 329 Notices were served to ensure repairs of various defects. Food poisoning: The Minister asks for details relating to outbreaks during the year.Eight investigations were made compared with 18 in 1948. It by no means follows that all cases, including those of mild or transient illness, have sought medical advice. In any given outbreak, there are almost always cases so mild, that, were it not for others of pronounced illness, would pass entirely umioticed. Therefore although two cases were notified in 1948 and eight in 1949, there were fewer outbreaks in 1949. The total persons reported known to be affected were 114 in 1948 and 105 in 1949. In last year's report the point was made that in Westminster with its 3,000 catering establishments, the incidence of food poisoning was relatively insignificant. In relation to the meals served in them, over one million per day, the number of persons affected throughout the year, even with minor food poisoning, was, so far as is known, 105. The matter of food poisoning to which so much publicity has been given, should be viewed in its proper perspective and at the same time let the improvements in structure, equipment, and methods in catering establishments, well under way, continue,—for considerable improvement after the war years was certainly due. (8076) a 5 14 While it is true that the incidence of cases of food poisoning seems to be increasing throughout the country, it must be remembered that through notifications and the services of bacteriologists, cases of all degrees of illness come to light many of which ten years or so ago would have passed unnoticed. I wish to thank my present Chairman, C. R. Purnell, Esq., and Vice-Chairman, Lt. Col. Norman Edwards, for their support and kind understanding and to express in retrospect appreciation of the consideration shown me by the Chairmen and members of the Council with whom I have worked during the past twenty-five years. During that period, there have been changes in the staff but the sense of service to the Council has never been higher in spite of the difficulties of the times in which we live. In concluding the foreword, I feel it would be of interest to append the following note prepared by Mr. H. E. White, the Chief Sanitary Inspector. It indicates some contrasts in the sanitary conditions of fifty years ago with those of today. 1900—1950. Public Health Services. During the past 50 years the methods employed by public health officers to safeguard the public health have not varied greatly but have increased vastly in scope and complexity. For example, in 1900 the inspection of dwelling houses and the remedying of defective conditions was a feature of the work, and there were very few notices served which did not include some reference to the presence of a degree of dirty and other conditions of nuisance rarely experienced today. Housing inspection in 1950 remains an important duty and the standard of good habitable conditions has been steadily improved by the introduction of some legislative codes dealing with the subject. Local Authorities have been given opportunities of abolishing slums by means of clearance and closure of unfit houses. The advent of two major wars in the period, however, has unfortunately been the cause of serious breaks in continuity. Cellar dwellings was a term often used in 1900 and efforts , were constantly being made to prevent their occupation as bedrooms. Today the City Council continue to make closing orders in regard to basements which do not comply with statutory requirements but such rooms bear little resemblance to the old cellar dwellings of the past situated under shops with little or no light or ventilation and serving as accommodition for large families of young children. In the northern part of the City many still remain but are used only for storage purposes and it requires little imagination to visualize the menace such dwellings presented to the health of their occupants 50 years ago. In 1900 there were 16 Common Lodging Houses including three for women only and one for women and married couples. They provided lodging of a very poor order viewed by the standards of the three lodging houses which exist today. All those sixteen have disappeared. From the nature of their inmates, many of whom were vagrants, the spread of 15 infectious disease such as smallpox gave constant concern, and tuberculosis was rife among them. One report of those days stated there was room for improvement in most of these houses, together with a recommendation that the rooms should be painted in lighter colours. It is a matter of surmise if this recommendation was made primarily on seSthetic grounds, as bed bugs are more easily discernible on a light background. Today there remain three Common Lodging Houses in the City, two for men and one for women, all well ordered and administered. The number and type of the majority of our City's workshops appear to have varied little during the past 50 years, by far the greater number of workers being engaged in the making and mending of wearing apparel for both sexes. Some changes in working conditions have occurred. It is rare today to find a tailor and his family occupying one or two rooms used jointly for their habitation and workshop; some still have their workshops in the same house in which they reside but they are apart from the living quarters, whilst many live in the suburbs and travel to and fro daily. Although it is still important that their workshops should be handy to the large businesses from which they derive their work the telephone and quick easy transport do not make it quite so vital that they themselves should be obliged to live on the doorstep as was certainly the case at the beginning of the century. A casual glance at the reports reveal for example that laundries appear to have given way to the business of dry cleaners: Lice makers have disappeared but hairdressers, particularly those catering for the fair sex, have multiplied. Mention of hairdressers recalls the fact that in the early 1900's it was necessary to call their attention to the danger of allowing petroleum spirit, used to shampoo their male customers, to enter the drains of their premises. The prevention and control of infectious disease is a duty which has never been relaxed and the effect of the steps taken to combat and control infectious disease in the last half century could fill a volume by itself. The following examples are, however, indicative of some great differences. In 1901 102 cases of smallpox. 475 scarlet fever, 253 diphtheria and 104 enteric fever were notified in Westminster. In 1949 there were only 2 cases of diphtheria, 48 scarlet fever, 1 enteric fever and no cases of smallpox during the year. Disinfection was and still remains as a preventive measure against the spread of infection. Advances in method have been noteworthy and have for example advanced from the cumbersome use of burning sulphur in a room sealed by old newspapers to the lethal power of cyanide gas in specially constructed chambers for certain purposes. In 1900 the abatement of smoke was one of the responsibilities of the Medical Officer of Health, who then reported he considered the smoke from the chimneys of private dwellings was a major cause of air pollution . in the City and commented on the fact that preventive measures could not be taken because such chimneys were exempt from the provisions of the smoke abatement clauses in the Public Health Act—unfortunately this exemption still applies to private dwellings today. Great importance, (8076) a 6 16 however, is still attached to the necessity of reducing atmospheric pollution and considerable advance has been made in this direction in recent years, interrupted inevitably by the dislocation caused through war. In fact to assist the defence of London against air attack owners of fuel consuming appliances were officially requested to produce as much smoke as possible. Many premises in Westminster are now using modern plant with scientific aids to smoke detection and prevention, and others are being encouraged to follow their example. Thus when suitable fuel becomes universally obtainable there appears to be no justifiable reason why the sky over the City will not be the invariable azure to be seen on a summer's day over our rural areas. Nuisances, a general term meaning anything that annoys, or irritates, but which to a public health department implies something more definite in its effect on health have varied in character in some ways over the years. In 1900 very many notices served requesting the abatement of nuisance arose from the improper keeping of animals, defective drainage and paving of stables, absence of proper dung receptacles and offensive accumulations. Motor cars have taken the place of horses and the stables in the numerous mews ways have become garages, nay, even the biiou residences of the elite. Few citizens now keep animals other than dogs and cats but since the end of the second world war the problem of offensive accumulations has again become prominent owing to the many tempting and free dumping grounds created by the activities of the German air force. Due largely to an excellent code of byelaws, together with more suitable materials and expert craftsmanship, comparatively few nuisances arise from defective drainage today but in the early days of the century defective apparatus and breakdowns in system called for the service of very many notices. The sanitary inspector of those days must have spent many anxious hours brooding over defective drainage systems (no less than 4.891 drains, etc., constructed, repaired or cleansed in 1901) for, with the much greater prevalence of enteric fever, nothing could have been a greater potential danger to health. Possibly this may account for so many people still associating the name of this class of public health officer with drains and nothing but drains. Possibly the inspection of food and food premises is one of the most publicised duties of the department today, but in 1900 it was more the tracking down of adulterated food which called for special attention judging by the number of our citizens who offended against accepted food standards. Within the precincts of the City at that period existed three cowsheds, two slaughterhouses, two tripe boilers and a tallow melter in addition to 97 underground bakehouses, 108 ice cream makers, 368 catering establishments and of course Covent Garden Market. The cows and slaughterhouses have disappeared long since whilst tripe is a commodity which does not find popular favour in the City judging by its rare appearance in the butchers' shops of today; tallow candles and flares play no part in the illumination of our homes and 17 streets in this age of electricity and brilliant neon lighting. Underground bakehouses are becoming a thing of the past and the few that do remain have been so modernised and improved as to render them suitable for use as such. In the old days most of the ice cream was made by the actual purveyor in the yard or back room attached to the shop—one vendor was severely reprimanded for making ice cream in his bedroom. In the City today we have 11 ice cream factories producing large quantities of this popular commodity, prepared and packed by modern methods, untouched bv hand and in hygienic surroundings. .Much is now sold in a prepacked form and the attractiveness of the wrapper has no doubt done much to increase sales. The number of catering establishments has increased nearly tenfold, and they include some of the largest restaurants in the world and the smallest of mobile snack bars. A national from almost any country in the world can come to Westminster and feed in a restaurant which prepares the dishes to which he is accustomed. In Soho alone can be found restaurants specially catering for Americans, French, Indians, Turks, Chinese, Greeks, Spanish, Italians, Russians and natives of the Balkans. Food shops in the City are of like variety. One food service still functions in much the same manner as it did 50 years ago—Covent Garden Market—-although it has sprawled beyond the confines of the original Charter Market and has invaded the adjacent streets. The market still calls for regular inspection as it always has done and apart from some differences in the range of its produce little change has taken place. Adulteration of milk by the addition of water appeared to be a habit in 1900 for out of 402 samples taken no less than 35 vendors were convicted of selling adulterated milk. Of 218 samples of butter taken during 1900, 18 vendors were prosecuted, some for selling margarine as butter and others who had enthusiastically patted a considerable quantity of excess water into their butter. In 1949 there were no cases of adulterated butter and only 7 samples of milk out of 685 samples purchased proved to be below standard. Although it is rare to find milk adulterated today liquids of a different kind have called for constant investigation since the war. During the past few years convictions, with heavy fines, have been imposed for offences in relation to the gross adulteration of scotch whisky, sherry, port and other wines and liqueurs. An examination of the list of food condemned as unfit for human consumption in 1900 indicates the changing taste of the population, for instance, in that year 2½ cwts. of bear hams, 800 lbs. caviare, numerous coconuts, lychees, mangoes, pomegranates and pineapples were condemned and destroyed. Today the list includes canned food, cereals, confectionery and foremost amongst the fruit and vegetables are tomatoes, pears and green vegetables. (8076) a 7 18 Many other interesting comparisons could be drawn if time and space, permitted but in this year of grace 1950—the tempo of official life is. considerably higher than it was in those more leisurely days 50 years back. h. e. w. Andrew J. Shinnie. Medical Officer of Health. Auyust, 1950. 19 STATISTICS AND SOCIAL CONDITIONS. Area (acres) 2,502.7 Population (Registrar General's Estimate, mid-year, 1949) 102,160 „ „ „ at 31st December, 1949 102.800 Number of inhabited houses (Census, 1931) 22.536 Rateable Value, March, 1950 £10,699.200 Births. Live Births (registered)- Total. Males. Females Legitimate 1,110 567 543 Illegitimate 136 76 60 1,246 643 603 Births Notified-1,246. Birth rate per 1,000 of the estimated resident population (Rate for London, 18.5; for England and Wales, 16.7) 12.2 Number of stillbirths (males, 18; females, 6) 24 Rate of stillbirths per 1,000 (live and still) births 18.9 Deaths. Net deaths (males, 563 ; females, 550) 1,113 Death-rate per 1,000 of the estimated resident population (Rate for London, 12.2; for England and Wales, 11.7) 10.9 Deaths from puerperal causes 2 Rate per 1,000 total (live and still) births 1.6 Deaths of infants under 1 year (males, 20; females, 22) 42 Death-rate of infants under 1 year:— All infants per 1,000 live births 33.7 Legitimate infants per 1,000 legitimate live births 33.3 Illegitimate infants per 1,000 illegitimate live births 36.8 Rate for London for infants under 1 year 29 Deaths (all ages) from measles — „ ,, whooping cough ... 1 „ ,, diarrhoea and enteritis 5 „ „ cancer 218 20 Infantile Mortality. Causes of Death. Total. Legitimate. Illegitimate. Meningitis and convulsions 1 1 — Diarrhoea and Enteritis 3 3 — Congenital malformation, prematurity and other neo-natal causes 16 14 2 Want of attention 1 — 1 Broncho-pneumonia 11 10 1 Bronchitis 3 3 — Accident 2 2 — Other causes 5 5 — 42 38 4 Infectious Disease. Notifications. Removed to Hospital. Deaths. Polio-encephalitis 1 1 1 Polio-myelitis 28 28 1 Diphtheria 2 2 — Erysipelas 6 1 — Scarlet Fever 48 32 1 Enteric Fever 1 1 — Paratyphoid 1 1 — Puerperal Pyrexia 4 4 — Cerebro-spinal Meningitis 1 1 — Ophthalmia Neonatorum 1 1 — Measles 635 66 — Pneumonia 15 2 21* Dysentery 16 10 • — Whooping Cough 91 24 , 1 Malaria 1 1 •— Scabies 21 1 — Food Poisoning 8 2 — * Includes deaths of unnotified cases. Corrected Diagnosis:— Whooping Cough, 1; Measles, 2; Polio-myelitis, 2.; Non-notifiable diseases—Removed to hospital:— German Measles 3 Chickenpox 9 Mumps 11 Gastro-enteritis 54 Lobar Pneumonia 1 Tonsillitis 12 21 Causes of Death (at all Ages). Males. Females. Total. Influenza 2 5 7 Meningitis and convulsions — — — Diarrhoea 2 3 5 Septic Diseases 1 4 5 Syphilis — — — Diabetes 1 2 3 Tuberculosis of the lungs 34 13 47 Non-pulmonary Tuberculosis 3 1 4 Malignant Growths; 100 118 218 Congenital Debility; Malformation, Prematurity, etc. 10 9 19 Old Age 18 40 58 Locomotor Ataxia and General Paralysis 1 1 2 Diseases of Nervous System — — — Circulatory Diseases 222 190 412 Bronchitis 34 28 62 Broncho-pneumonia 39 64 103 Pneumonia 9 12 21 Other Respiratory Diseases — 1 1 Alcoholism — 1 1 Appendicitis 1 1 2 Digestive Diseases 14 16 30 Bright's Disease, Nephritis, etc. 25 17 42 Cystitis 1 — 1 Accidents and negligence 16 8 24 Suicide and Murder 20 8 28 Other violent causes — — — Other Defined Diseases 3 2 5 Puerperal Causes other than Sepsis — 2 2 Diphtheria — — — Cirrhosis 4 3 7 Whooping Cough 1 — 1 Scarlet Fever — 1 1 Polio-myelitis and Encephalitis 2 — 2 563 550 1,113 22 Among the causes of death, those of the heart and blood vessels hold the highest place ; a long way behind comes malignant disease. There were two maternal deaths during the year. There were no deaths from diphtheria during the year. Deaths, 1949. Causes of Death at Different Periods of Life in the City. Causes of Deaths. Years of Age. Sex. All Ages. 0-1 1-2 2-5 5-15; 1525 2545 4565 65† All Causes M. 563 20 1 3 3 4 47 184 301 F. 550 22 — — 2 6 29 113 378 Grand Totals 1,113 42 1 3 5 10 76 297 679 Influenza M. 2 — — — — — — 1 1 F. 5 1 — — — — — — 4 Meningitis and Convulsions M. — — — — — — — — — F. — — — — — — — — — Diarrhoea and Enteritis M. 2 2 — — — — — — — F. 3 1 —- — — — — 2 Septic Diseases M. 1 — — — — — — — 1 F. 4 — — — — — — — 4 Syphilis M. — — — — — — — — — F. — — — — — — — — — Diabetes M. 1 — — — — — — — 1 F. 2 — — — — — — — 2 Tuberculo is of Lungs M. 34 — — — — 1 8 19 6 F. 13 — — — — 1 5 3 4 Non-pulmonary Tuberculosis M. 3 — — 1 — — — — 2 F. 1 — — — — 1 — — — Malignant Growths M. 100 — — — — 1 9 41 49 F. 118 — — — — — 6 39 73 Congenital Debility, &c., Malformation, Prematurity M. 10 10 — — — — — — — F. 9 9 — — — — — — — Old Age M. 18 — — — — — — — 18 F. 40 — — — — — — — 40 Locomotor Ataxia M. 1 — — — — — — 1 — F. 1 — — — — — — 1 — Diseases of the Nervous System M. — — — — — — — — — F. — — — — — — — — — Circulatory Diseases M. 222 2 — 1 — 1 14 75 129 F. 190 1 — — — — 8 31 150 23 Deaths, 1949—continued. Causes of Death at Different Periods of Life in the City-continued. Causes of Deaths. Sex. All Ages Years of Age. 0-1 1-2 2-5 5-15 1525 2545 4565 65† Bronchitis M. 34 1 — — — — — 8 25 F. 28 2 — — — — — 6 20 Broncho-pneumonia M. 39 3 — — — — — 10 26 F. 64 8 — — — 1 2 11 42 Pneumonia M. 9 — — — 1 — — 1 7 F. 12 — — — — — — 4 8 Respiratory Diseases M. — — — — — — — — — F. 1 — — — — — — 1 — Alcoholism M. — — — — — — — — — F. 1 — — — — — — 1 — Appendicitis M. 1 — — — — — — — 1 F. 1 — — — — — — — 1 Digestive Diseases M. 14 — 1 — — — 1 5 7 F. 16 — — — — 1 2 6 7 Bright's Disease, Nephritis, &c M. 25 — — — — — 1 6 18 F. 17 — — — 1 — 1 3 12 Cystitis M. 1 — — — — — — — 1 F. — — — — — — — — — Accidents and Negligence M. 16 1 — — 2 1 4 4 4 F. 8 — — — — — — 3 5 Suicide and Murder M. 20 — — — — — 7 12 1 F. 8 — — — — — 4 2 2 Puerperal Causes F. 2 — — — — 2 — — — Other Defined Diseases M. 3 — — — — — 2 — 1 F. 2 — — — — — 1 — 1 Diphtheria M. — — — — — — — — — F. — — — — — — — — — Cirrhosis M. 4 — — — — — — 1 3 F. 3 — — — — — — 2 1 Whooping Cough M. 1 1 — — — — — — — F. — — — — — — — — — Scarlet Fever M. — — — — — — — — — F. 1 — — — 1 — — — — Polio-myelitis and Polioencephalitis M. 2 — — 1 — — 1 — — F. — — — — — — — — — 24 Bacteriological Examinations. Diphtheria—Negative 159, positive Nil. Tuberculosis—Negative 166, positive 66. Tuberculosis. New Cases and Deaths. Age Periods. New Cases. Deaths. Pulmonary. NonPulmonary. Pulmonary. NonPulmonary. M. F. M. F. M. F. M. F. Under 1 year — — — 1 — — — — 1 to 2 years 4 — — — — — — — 2 to 5 „ 4 4 1 — — — 1 — 5 to 10 „ 2 — 1 2 — — — — 10 to 15 „ 2 2 — 1 — —- — — 15 to 20 „ 10 6 — — — — — — 20 to 25 „ 11 19 — 3 1 1 — 1 25 to 35 „ 36 28 1 2 4 3 — — 35 to 45 „ 18 12 1 1 4 2 — — 45 to 55 „ 32 5 — — 12 3 — — 55 to 65 ,, 12 1 — — 7 — — — 65 to 75 „ 5 2 2 — 5 2 2 — 75 and upwards 2 2 — — 1 2 — 138 81 6 10 34 13 3 1 New Cases. Pulmonary—219 new cases, including 31 transfers and 11 non-notified deaths. Non-Pulmonary—16 new cases, including 3 transfers and 1 non-notified death. (1948—Pulmonary, 199 new cases ; Non-Pulmonary, 27 new cases.) Deaths from Tuberculosis. Pulmonary—47 (34 males, 13 females). Non-Pulmonary—(3 males, 1 female). Smallpox. On the 2nd April, 1949, the s.s. "Mooltan" arrived in the Port of London and it was reported that a fatal case of smallpox had occurred on board the vessel during her voyage from Australia, the patient having died at sea on the 1st April. Some 64 contacts had given addresses in the City of Westminster. In addition the Medical Officer of Health received from day to day 25 information regarding other passengers who had visited the City and spent some part of their time in shops, restaurants, places of interest, etc. Fortunately none of the passengers who became resident in the City contracted the disease, but, although in 5 instances smallpox developed in passengers from the ship who had visited the City, no incidence of smallpox arose among the persons with whom they had been in contact in Westminster. Poliomyelitis. During the year the City experienced in common with the rest of the country an epidemic of poliomyelitis which, if fortunately not so severe as that of 1947, resulted in some 28 confirmed cases of the disease. The epidemic occurred between the months of June and October and reached its peak period during August and September. The major proportion of the confirmed cases in the City occurred in children under 5 years of age, one of whom died in hospital, the only other death from the disease being that of a man aged 34 years. In all these cases the usual routine of inspection and disinfection was carried out and any possible sources of infection investigated by the sanitary inspectors. Contacts were also instructed upon the advisability of seeking early medical advice should they become unwell. Certain precautionary measures were at the instance of the Medical Officer of Health brought into operation at the Council's Public Baths during the period of the incidence of the disease. Table showing period of incidence of cases of Poliomyelitis and ages. Notification. 1949 Number. Ages. June 1 23 years. August 8 One 3 months, three 1—2 years, three 4—5 years, one 7½ years. September 10 One 11 months, four 1—2 years, two 3 years and 12 years, one 19 years, one 26 years, one 29 years. October 10 Three 1—2 years, three 5—6 years, one 22 years, one 23 years, one 29 and 34 years. International Certificates of Vaccination and Inoculation. Arrangements continued during the year for the authentication by the Medical Officer of Health of International Certificates of Vaccination and Inoculation completed by medical practitioners in Westminster. These certificates are required by passengers proceeding abroad from this country and the purpose of the authentication is to provide proof to those health authorities abroad who desire it that the signature of the person issuing the certificate is that of a registered medical practitioner. Some 1,282 certificates were authenticated during the year. 26 Care of the Aged and Infirm. It was reported last year that the problem of the aged and infirm living on their own had been causing increasing concern to the Department. 1949 has proved no exception and no less than 93 further cases have been brought to the notice of the Department during the year. Altogether. 267 cases of old people living on their own with involved problems of some sort or other, have been the subject of visits by the Sanitary Inspectors. It has not been necessary however to invoke the provisions of the National Assistance Act in regard to compulsory removal. Oneaspect of this problem has proved easier than has been the case in recent years, and that is the removal of some of the aged folk able to look after themselves to the Homes for the Aged provided by the London County Council, who have been successful in removing in many respects the old institutional atmosphere. The Home Help service of the London Comity Council has rendered valuable service, even carrying out work for these lonely aged people after normal working hours and during week-ends and. the District Nurses have likewise sacrificed their leisure where and when they were needed. The Inspectors have found it advantageous to these old people to enlist the help of other tenants in the house, and in many instances found that it was invariably given with a marked degree of unselfishness. In some cases it has been possible to trace relatives or old friends who on being informed of the circumstances often endeavour to do their best to help. The problem however still remains, and even when suitable homes can be made available to all, it is extremely doubtful if many of the independent type of old person would be prepared to avail themselves of the opportunity of passing their last years away from the room and its furniture to which they have become so accustomed for many years. Mobile Meals Service. The Westminster Division of the British Red Cross Society continued to operate a meals delivery service for aged people and others in the City who are unable to provide themselves with hot mid-day meals. The meals are purchased by the British Red Cross Society from a Londoners' Meal Service Centre at a special price of 8d. per meal for aged people, and ls. 2d. for others, and delivered in a mobile van to the homes. The cost of the meal is recovered by the British Red Cross Society from the recipients. The names and addresses of those requiring the delivery of hot meals are submitted to the Society by the Medical Officer of Health weekly. Some 230 hot meals per week were being delivered by the Societv under this arrangement at the end of the year, by which time the Societv was using two vans. During the year the British Red Cross Society intimated that, in view of the steadily increasing demand for these meals, it would be necessary to increase the service by the provision of a third van. The City Council under the powers conferred by Section 31 of the National 27 Assistance Act, 1948, made a grant of £473 to cover the cost of a third van and equipment, and in addition made a grant of 75 per cent, of the running expenses of the three vans. It is hoped that the third van will be in use early in 1950. Westminster Old People's Welfare Association. Valuable work has been performed during the year by the Westminster Old People's Welfare Association in ministering to the needs and comfort of elderly people living in Westminster. Their work for the elderly includes the running of Darby and Joan Clubs in different parts of the City, the provision of mobile library facilities through the City Librarian, the visiting of old people in their homes and the organising of Christmas parties and outings. The City Council, under powers conferred by Section 31 of the National Assistance Act, 1948, and Ministry of Health Circular 51/1949, made a grant of £1,000 for the year towards the expenses of the Association. Medical Inspection of Aliens. By agreement with the Minister of Health, the City Council continued during the year the arrangements for the medical inspection of aliens arriving at Victoria Station by through sleeping car service from Paris. The actual inspection is carried out by medical staff from Westminster Hospital under the supervision of the Medical Officer of Health, and necessitates daily attendance at Victoria Station to inspect aliens arriving by the ferry train and to carry out medical examinations where necessary. The Government reimburse the Council the cost of this service. During 1949, 9,181 aliens were inspected, 23 were medically examined. 28 SANITARY CIRCUMSTANCES. Duties Performed by the Sanitary Inspectors. The following statistics show the work of the Sanitary Inspectors during the year. These figures are divided under the headings. Housing, Factories and Workplaces, Catering and Food. Summary of Inspections of all Types of Premises. Primary Re. inspection. Dwellings 4,950 9,367 Factories, workplaces and shops (other than food), &c. 2,252 3,495 Catering establishments and food premises 1,919 3,551 9,121 16,413 Number of Visits. Sampling of food 651 Inspection of food 1,278 Smoke and noise 805 Rat and mice repression 1,757 4,491 Drainage plans submitted 671 Combined Drainage Orders made 47 29 Summary of Notices Served. Factories, • Dwellings. Workplaces. &c. Food. Catering. Totals. Public Health (L) Act, 1936 839 89 6 106 1,040 Food and Drugs Act, 1938 — — 62 279 341 Shops Act, 1934 — 3 5 5 13 Factories Act, 1937 — 137 — 5 142 London County Council (Drainage) Byelaws, 1934 20 7 4 6 37 London County Council (Watercloset) Byelaws, 1930 2 4 10 4 20 Ice Cream (Heat Treatment) Regulations, 1947 — 4 4 Milk and Dairies Regulations, 1949 _ 13 — 13 London County Council Houses Let in Lodgings Byelaws, 1937 4 — — — 4 Sanitary Accommodation Regulations, 1938 — 1 — — 1 Totals 865 241 104 405 1,615 Total Notices served under the above Acts 1,615 Statutory Notices 134 Dwelling Houses. Analysis of Inspections— Primary. Re-inspection. Complaint 1,867 687 House to house 409 802 Routine 252 182 Infectious disease 324 71 Underground rooms 238 404 Housing applications 498 308 Building licences and permits 88 55 Drainage—Voluntary 569 1,699 Drainage under notice — 109 Sanitary defects—Voluntary 41 80 Sanitary defects Under notice — 3.594 Aged and infirm 93 264 Common Lodging Houses 31 14 Other reasons 540 1,098 4,950 9,367 Included in the above totalsRequisitioned properties 176 216 Houses let in lodgings 661 4,578 30 Notices served. Public Health (London) Act, 1936 839 London County Council (Drainage) Byelaws, 1934 20 London County Council (Watercloset) Byelaws, 1930 2 London County Council Houses Let in Lodgings Byelaws. 1938 4 865 Statutory Notices 96 Defects found. Defective, dirty internally 550 Damp 294 Inadequate underfloor ventilation 4 Defective drainage 251 „ roofs 243 „ area paving, &c 9 „ exteriors 37 Waterclosets—insufficient ventilation and light 10 „ defective 139 „ direct approach 4 Water supply insufficient 6 „ absence of, in upper floors 2 „ cisterns dirty, uncovered 7 Absence of food storage accommodation 2 Staircase lighting, tenements 7 Ventilation 9 Smells 9 Rubbish 54 Other nuisances 14 Overcrowding (Housing Act, 1936, Section IV). Cases coming to the notice of the Public Health Department during the year 135 Cases in which overcrowded families have been rehoused during 1949. Westminster City Council 14 ; London County Council 52 66 Water Supply in Tenement Houses. Under the powers of the Public 'Health (London) Act, 1936,8 additional water supplies were provided to working class tenement houses during the year. 31 Housing Acts, 1936 to 1949. A.-Individual Houses Unfit for Human Habitation. Number of houses represented for demolition Nil Number of Demolition Orders made Nil B.—Parts of Buildings Unfit for Human Habitation. (a) Number of underground rooms represented for closure 50 Number of Closing Orders made in respect of underground rooms 52 (b) Number of other parts of buildings represented for closure 3 Number of Closing Orders made in respect of other parts of buildings 3 (c) Number of specifications submitted and approved 10 (d) Number of Closing Orders determined in respect of underground rooms 3 Number of Closing Orders determined in respect of other parts of buildings 3 (e) Number of applications made for modification of Closing Orders to permit approved use 24 Number of applications approved 19 C.—Informal Action in Respect of Parts of Buildings Unfit for Human Habitation. Number of instances of informal action taken to secure requirements of the Housing Act and Regulations made thereunder:— (a) in respect of underground rooms 51 (b) in respect of other parts of buildings 1 Number of instances of such informal action taken included in (a) and (b) above:— (a) as a result of applications for Building Licences 19 (b) on the initiative of the owner 24 (c) at the suggestion of the Medical Officer of Health 9 D.—Contraventions of Closing Orders. Number of contraventions of Closing Orders reported 4 Number of legal proceedings instituted 1 Public Health (London) Act, 1936. A.—Illegal Separate Occupation of Underground Rooms. Number of instances of formal action taken to secure compliance with Section 132 1 Number of instances of informal action taken to secure compliance with Section 132 22 32 House-to-House Inspection. During the year 533 properties, involving 778 dwellings, were inspected. Of these properties 263 were residential, 63 part residential, 163 business premises and 44 bombed, derelict, etc., buildings. Inspections. Primary inspections 533 Re-inspections 3,654 Notices served. Public Health (London) Act, 1936 325 London County Council (Drainage) Byelaws, 1934 4 Defects found. Defective roofs 83 Dampness 101 Dirty, defective, dilapidated internally 226 Defective drainage 105 Verminous 5 Insufficient water supply 3 Families overcrowded 21 Factories, Workplaces, Shops and other Premises (other than Food Premises). Summary of Inspections. Primary. Re-inspections. Factories—Power 440 374 Factories—Non-power 387 549 Workplaces, &c. 1,296 2,308 Shops (other than food) 129 264 2,252 3,495 Analysis of Inspection. Complaint 488 236 Routine 945 556 Infectious disease 154 21 Building licences and permits 11 3 Drainage—Voluntary 475 1,800 Drainage—Under notice ■— 15 Sanitary defects —Voluntary 1 3 Sanitary defects—Under notice 2 652 Other reasons 176 209 2,252 3,495 33 Types of Premises Inspected. Laundries 10 Boot and shoe trades 32 Carpentry 4 Woodworkers (various) 19 Cigar and cigarette manufacturers 2 Dress and milliners 326 Furriers 61 Shirt makers 12 Hairdressers 69 Garages 50 Dry Cleaners 22 Metalworkers (excluding gold and silver) 20 Printers and publishers 77 Packers 8 Cinemas, concert halls 61 Shops (other than food) 393 Dance halls 8 Leather goods 24 Cabinet makers 2 Upholstery and carpets 11 Corset makers 6 Embroiderers 14 Lingerie 5 Tailors 756 Film renters, &c. 4 Warehouses 56 Jewellers and silversmiths 59 Opticians 5 Photographers 73 Florists, &c. 5 Offices 2,157 Theatres and music halls 154 Stables and mews 34 Hat and cap makers 5 Various 1,203 Outworkers. Inspections 358 Number of outworkers (includes workers living in areas outside the City) 3,805 Notices—Summary. Intimation. Statutory. Factories—Power 79 1 Factories—Non-power 111 1 Workplaces, shops (other than food) 51 3 241 5 34 Abstracts. Reports were made to the Factory Inspector of 99 instances for failure to display the appropriate abstracts of the Factories Act, 1937. Notices—Analysis. Factories. Power. Factories. Non-Power. Workplaces. Shops, &o. Public Health (London) Act, 1936 10 35 44 Shops Act, 1934 — — 3 Factories Act, 1937 65 72 — London County Council (Drainage] Bylaws, 1934 1 2 3 2 London Comity Council (Watercloset) Bylaws, 1930 1 1 1 2 Sanitary Accommodation Regulations 1938 1 — — 79 111 51 Total 241 Defects found. Factories. Power. Factories. Non-Power. Workplaces. Shops, &6c. Dirty, defective internally — 39 9 Dampness 1 1 3 Drainage defective 1 4 13 Roofs defective —• — 2 Waterclosets insufficient 4 — 1 „ insufficient ventilation and light 24 13 5 „ defective 30 18 6 „ direct approach 15 6 3 ,, not separate for sexes 17 10 2 „ unsuitable 4 8 1 Overcrowding — 8 3 Smells — — 2 Rubbish 1 1 31 Other nuisances — 1 5 Temperature .— 2 — Ventilation, want of . 6 6 Failure to fix abstracts 57 42 — Common Lodging Houses. There are three common lodging houses in the City, two for men and one for women. Forty-five visits were made during the year. 35 Catering Establishments and other Food Premises. Summary of Inspections. Primary. Re-inspection. Catering establishments 1,207 2,666 Food shops and other food premises 712 885 1,919 3,551 Analysis of Inspections. Primary. Re-inspect ion. Complaint 376 134 Routine 925 256 Infectious disease 39 10 Building licences and permits 12 3 Drainage—Voluntary 125 384 Drainage—Under notice 4 32 Sanitary defects—Voluntary work 4 35 Sanitary defects—Under notice 67 2,262 Food licences 4 4 Food licence transfers 1 — Catering licences 287 373 Catering licences transfers 30 28 Other reasons 45 30 1,919 3,551 Summary of Notices Served. Food Shops and Other Food Premises. Catering Establishments. Food and Drugs Act, 1938 62 279 Shops Act, 1934 5 5 Public Health (London) Act, 1936 6 106 London County Council (Drainage) Bylaws, 1934 4 6 London County Council (Watercloset) Bylaws, 1930 10 4 Ice Cream (Heat Treatment) Regulations, 1947 4 — Milk and Dairies Regulations, 1949 13 — Factories Act, 1937 — 5 104 405 36 Food Shops and Other Food Premises (other than Catering Establishments). Primary. Re-inspection. Bakehouses 62 122 Dairies and Milkshops 275 141 Fried fish shops 5 22 Ice cream premises—Sale 55 48 Ice cream premises—Manufacture 30 29 Meat shops 41 136 Other meat shops (preserved food, &c.) 1 1 Stalls 14 14 Confectioners 18 31 Fruit and greengrocery 58 45 Provision shops 73 144 Other food premises 68 57 Fish and poultry 12 95 712 885 Included in the above totals are visits in connection with the sale of horseflesh and inquiries into food poisoning outbreaks. Other Food Premises. Under this heading are included:— (1) Off-licences. (2) Food factories. (3) Bonded warehouses. (4) Chemists' shops. (5) Visits made in connection with applications for entry on the Lists of Persons entitled to sell Poisons included in Part II of the Poisons List. (6) Visits to various offices in connection with inquiries regarding adulterated samples. Basement Bakehouses. In accordance with the provisions of the Factories Act, 1937, Section 54, the quinquennial review of basement bakehouses was undertaken during the year. As a result of this review, the following action has been taken by the City Council:— (a) Number of basement bakehouses discontinued and Certificate of Suitability withdrawn 8 (b) Number of Certificates of Suitability continued after requisite reconstruction and repairs had been carried out 8 (c) Number of basement bakehouses in regard to which decision has been deferred pending reconstruction or the removal to other premises 3 37 In 4 instances appeals were lodged against the decision of the Council to discontinue the Certificate of Suitability. In 3 cases they were withdrawn following the construction of 2 new bakehouses above ground, and 1 complete reconstruction of the basement bakehouse, and in the other case the appeal was dismissed by the Court. Visits for the Purpose of Obtaining Samples and Inspecting Foodstuffs. Sampling Inspection of Food. Bakehouses ... 1 1 Dairies and milkshops 240 27 Ice cream premises—Sale 46 11 Ice cream premises Manufacture 34 5 Meat shops 3 185 Other meat shops — 1 Stalls — 4 Confectioners 1 8 Fruit and greengrocery 6 342 Provision shops 155 325 Other food premises 13 41 Staff canteens 4 20 Hotels, restaurants, clubs 17 117 Cafes, teashops, etc 2 8 Public houses 122 23 Fish and poultry 7 160 651 1,278 Food Shops and Other Food Premises. Notices served. Food and Drugs Act, 1938 62 Shops Act, 1934 5 Public Health (London) Act, 1936; 6 London County Council (Drainage) Bylaws, 1934 4 London County Council (Watercloset) Bylaws, 1930 10 Ice Cream (Heat Treatment) Regulations, 1947 4 Milk and Dairies Regulations, 1949 13 104 Statutory Notices 2 38 Defects found. Dirty and dilapidated internally 43. Defective internally 38 „ externally 5 „ drainage 6 „ area paving, &c. 2 „ floors 12 Preparation tables and equipment—Worn and insanitary 7 Food storage accommodation inadequate, unsuitable, &c. 5 Vegetable preparation and washing up facilities— Insufficient 5 Worn, insanitary 4 Ventilation insufficient 19 Washing facilities for staff, insufficient, unsuitable 18 Staff changing rooms insufficient, unsuitable 1 Rubbish, fuel and other extraneous materials in food preparation rooms 6 Arrangements in premises unsuitable (redesigning and resiting of equipment) , &c., necessary 8 Vermin— Cockroaches 1 Rats 2 Waterclosets— Insufficient 2 Insufficient ventilation and light 3 Defective 8 Dirty and dilapidated 21 Direct approach ... 2 Not separate for sexes 1 Unsuitable 1 Catering Establishments. During 1949, two Sanitary Inspectors continued to devote the whole of their time to the inspection of restaurants, snack bars, public houses, staff canteens and similar premises used for the preparation of food. Further progress was made in the improvement of structural conditions and amenities, and dining the year under review 1,207 primary inspections were made of this type of premises. 405 notices were served under various Statutes, principally the Food and Drugs Act, 1938. The enforcement of the execution of the extensive works necessary to comply with these notices involved 2,666 re-inspections. Hitherto, the determining factor in the extent of improvements effected has been the amount of building licences which could be obtained, but the decline in the prosperity of the catering industry has rendered it much more difficult to persuade restaurant proprietors to undertake the heavy capital expenditure which is so often necessary to put many existing premises into satisfactory condition. 39 Normally the trade, both large undertakings and small cafe proprietors, have co-operated willingly with this Department and in the majority of cases have endeavoured faithfully to carry out the recommendations of the Sanitary Inspectors. In regard to five establishments only was it necessary to resort to legal proceedings, in three of which conditions were considered to be so unsatisfactory as to warrant the institution of proceedings immediately, without the service of the usual informal notice. Two of these unsatisfactory premises eventually closed down. The City Council were successful in these proceedings. It has been found that an increasing proportion of the Inspectors' time has been taken up with the inspection of premises in respect of which application has been made for a catering licence, and in the supervision of the works necessary to properly adapt premises which were being put into commission for the first time for use as a restaurant, snack bar, or staff canteen, etc. During the year 287 premises were inspected and schedules of work prepared and forwarded to applicants for catering licences. It has been considered that the supervision of all new works in premises should take priority of the Inspectors' time but this work has of necessity reduced the number of routine inspections of existing premises. Analysis of Inspections. Primary. Re-inspection Hotels, restaurants, clubs 652 1,307 Cafes, teashops, &c 345 746 Staff canteens 130 228 Public houses 80 385 1,207 2,666 Notices served. Public Health (London) Act, 1936 106 Food and Drugs Act, 1938 279 Shops Act, 1934 5 London County Council (Drainage) Bylaws, 1934 6 London County Council (Watercloset) Bylaws, 1930 4 Factories Act, 1937 5 405 Defects found. Dirty and dilapidated internally 226 Defective internally 187 „ externally 5 ,, drainage 53 ,, area paving, &c. 6 „ floors 81 Preparation tables and equipment, worn and insanitary 92 Food storage, inadequate, unsuitable 41 40 Vegetable preparation and washing up facilities— Worn and insanitary 65 Insufficient 67 Ventilation insufficient 105 Staff: washing facilities, insufficient, unsuitable 81 Staff changing rooms, insufficient, unsuitable 25 Fuel, rubbish and other extraneous materials in food preparation rooms 68 Accommodation unsuitable (re-designing and resiting of equipment necessary), &c. 47 Vermin— Cockroaches 36 Rats 5 Fuel storage accommodation insufficient 3 Waterclosets— Insufficient 11 Insufficient ventilation and light 17 Defective 52 Dirty and dilapidated 37 Direct approach 14 Not separate for the sexes 7 Unsuitable 5 41 Samples Purchased under the Food and Drugs Act, 1938, Showing Results of Analysis for the Year 1949. Article of Food. Number of Samples Purchased. Adulterated. Genuine. Baking powder 21 — 21 Butter 7 — 7 Cake and pudding mixtures 80 2 78 Cereals 31 4 27 Cheese 11 1 10 Cocoa 1 — 1 Coffee preparations and essences 33 1 32 Condiments and spices 56 6 50 Confectionery 39 2 37 Cooking fat 21 3 18 Cream, synthetic 1 — 1 Culinary flavours 46 — 46 Dried fruit 5 — 5 Drugs 40 3 37 Eggs, dried 1 — 1 Fish preparations 52 9 43 Fruit (canned and preserved) 19 2 17 Gelatine 20 1 19 Jams and preserves 32 — 32 Margarine 10 — 10 Milk 685 7 678 Milk, condensed and evaporated 15 3 12 Milk, dried — — — Pickles and sauces 33 5 28 Meat and meat preparations 40 12 28 Salad oils and dressings 49 4 45 Sandwich spreads 8 1 7 Sausages 20 3 17 Soft drinks; cordials, etc 27 2 25 Soup 18 — 18 Spirits 203 27 176 Suet 3 — 3 Sugar 2 — 2 Tea 6 — 6 Vegetables, canned and preserved 46 4 42 Vinegar 25 — 25 Wines 3 — 3 Ice cream 86 1 85 Totals 1,795 103 1,692 42 Registration of Premises used in Connection with the Manufacture, Sale or Storage of Ice Cream. On 1st January, 1949, 118 premises were registered for the sale and storage of ice cream. During the course of the year applications were received in respect of 33 further premises and these were duly registered, making a total of 151 registered premises at the end of the year. At the commencement of the year 8 premises were registered for the manufacture of ice cream. During the year 3 further premises were registered for the manufacture of ice cream, making a total number at the end of the year of 11. Ice Cream (Heat Treatment, etc.) Regulations, 1947. During the year 111 samples of ice cream were submitted for examination by the methylene blue test. The samples were classified in the provisional grades, as follows:— Grade 1 36 Grade 2 25 Grade 3 25 Grade 4 25 The above grading is based upon the method of examination recommended by the Ministry of Health. In this test the grading is consequent upon the time taken for a measured volume of the ice cream to reduce the colour of a measured volume of methylene blue dye." Grade 1 Over 4£ hours. Grade % Between 2 and 4½ hours. Grade 3 Between ½ and 2 hours. Grade 4 Under ½ hour. Bacteriological Examination of Ice Cream. Five samples of ice cream were submitted to the Bacteriologist for a plate count and coliform test. The results obtained were as follows:— Standard "A" 3 Standard "B" 2 Unsatisfactory nil Standard "A" is the standard to aim for in assessing the purity of ice cream and samples falling within this category may be considered good. Ice creams which satisfy Standard "B" may be accepted although they cannot be considered very satisfactory. Milk and Dairies Regulations, 1949. At the 31st December, 1949, the following were entered in the City Council's Registers of Dairies and Distributors of Milk:— Premises used as dairies 64 Distributors of milk (premises in Westminster) 50 Distributors of milk (premises outside Westminster) 34 43 Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 1949. Milk (Special Designation) (Raw Milk) Regulations, 1949. The following are particulars of licences granted during 1949 to dealers in respect of the sale of milk under prescribed or special designations: Principal. Licence. Supplementary. Licence. Tuberculin tested 14 6 Pasteurised 3 12 Sterilised 40 14 Pharmacy and Poitons Act, 1933. At the end of the year the number entered on the List of Persons entitled to sell poisons included in Part 11 of the Poisons List was 174. During the year 8 persons had been removed from the List, because they were no longer in business or had moved out of the City, and 4 new applications had been duly entered on the List. Unsound Food. The following table shows the amount, and method of disposal, of food condemned by the Inspectors as unfit for human consumption during the year 1949:- Articles. Amount Amount Tons. Cwt. Lb. Tons. Cwt. Lb. Tons. Cwt. Lb. Destroyed. Salvaged. Total. Canned food 5 18 31 — — — 5 18 31 Meat 2 12 63 1 4 99 3 17 50 Fats — — — — 4 25 — 4 25 Fish 6 17 82 —. — — 6 17 82 Fruit and; vegetables 114 3 21 — — — 114 3 21 Cereals — 12 0 — 4 92 — 16 92 Confectionery — 2 95 — — — — 2 95 Miscellaneous 4 15 52 — — — 4 15 52 Total 135 2 8 1 13 104 136 16 0 Pears Contaminated with Arsenic. In August, 1949, intimation was received from the Ministry of Food that large consignments of pears were arriving in this country from Italy and that of had been found that some of the fruit was contaminated with a coating of arsenic through having been treated in the growing stage with insecticides containing copper and arsenic. 44 The pears as they arrived in Covent Garden Market were examined by the Council's Sanitary Inspectors and samples were submitted to the Public Analyst, who confirmed the presence of arsenic. It was therefore necessary to examine all the pears arriving at the Market from this source and this claimed the attention of all the Council's Inspectors. As a result some 6,000 cases were condemned and destroyed whilst large quantities were saved after approved treatment by the traders. Eat and Mice Repression. Complaints received 1,437 Visits made 11,789 Inspections by the Rodent Officer 1,757 Inspections by Sanitary Inspectors 195 Notices served 333 Rodents Destroyed. Black rats 5,623 Brown rats 1,411 Mice 3,997 11,031 333 Notices were served on owners or occupiers under the provisions of the Eats and Mice (Destruction) Act, 1919. Pigeons. Under the provisions of Section 121 of the Public Health (London Act, 1936, the City Council as a Sanitary Authority is empowered for the purpose of abating or mitigating any nuisance, annoyance, or damage caused by the congregation of pigeons in the City, having no owner, or for preventing or minimising any such nuisance, annoyance, or damage to reduce the number of such pigeons. The following action was taken during the year in this connection:— Premises visited 18 Visits made 211 Pigeons destroyed (mostly aged or infirm birds) 630 Atmospheric Pollution. Investigation of pollution of the atmosphere in the City area was continued throughout the year and the following table gives the results of the monthly analyses of the impurities collected in the rain deposit gauges at Pimlico and Mayfair. 45 Atmospheric Pollution Analyses of Deposited Impurities (tons per sq. mile). 1949 Mayfair. Pimlico. Total Solids. Sulphates. Total Solids. Sulphates. January 16.00 1.71 27.40 2.32 February 23.46 2.10 23.62 2.62 March 14.35 1.79 18.64 1.95 April 25.25 2.78 32.35 3.16 May 21.42 2.30 23.38 2.71 June 8.88 0.28 9.66 0.44 July 16.97 1.95 23.70 2.27 August 9.19 1.54 22.03 1.78 September 10.54 1.29 16.49 1.60 October 34.25 3.19 38.57 6.86 November 22.55 1.61 32.71 2.94 December 15.68 1.79 19.22 1.92 Estimation of Sulphur Activity by the Lead Peroxide Method. These lead peroxide cylinders for the estimation of sulphur activity are in use at — 1. Farm Street Depot, Mayfair. 2. Alhambra House, Charing Cross Road. 3. Bessborough Street Clinic, Pimlico. The following table indicates the daily absorption of sulphur due to active sulphurous gases in the air. Measurement of Sulphur Activity by the Lead Peroxide Method. (S02 in milligrammes per 100 sq. cms. per day.) 1949 Mayfair. Charing Cross. Pimlico. January 4.72 4.96 5.22 February 4.34 5.09 5.14 March 3.63 4.68 4.28 April 2.61 3.06 3.25 May 2.09 2.52 2.52 June 1.64 1.62 2.07 July 1.71 2.01 1.96 August 1.44 2.18 1.80 September 1.73 2.46 2.45 October 2.91 3.31 3.83 November 3.05 2.23 4.35 December 2.97 3.45 3.68 Owens Automatic Filter. An hourly record made of suspected impurities in the air was continued by the Owens method at Alhambra House, Charing Cross Road, AV.C.2. Estimation of Sulphur Dioxide by the Hydrogen Peroxide Method. A weekly estimation of the sulphur as S02 in the atmosphere was carried out by the Hydrogen Peroxide Method at Alhambra House, 46 Smoke Abatement. Smoke observations were continued throughout the year, the following table summarising the measures taken in mitigation:— Complaints 80 Observations made (including South Bank observations) 720 Notices issued 4 Complaints were received during the year of smoke nuisance in Westminster arising from premises outside the City on the south bank of the Thames. Many observations were made and a conference between the London County Council and the local authorities concerned was held at County Hall. Following this conference communications passed between the London County Council and the various interests and occupiers of certain premises on the south bank with the object of securing that every step was being taken to prevent pollution of the atmosphere from those sources. At the end of the year the position continued to engage the attention of the Council's officers and was under constant review by the Public Health Committee. Noise Nuisances. Complaints were received in respect of 57 nuisances. They varied from noise emanating from the use of pneumatic drills at night, patrons leaving night clubs, and power plant, to noisy radio sets. 85 investigations were made and in all but 4 instances the co-operation of the persons concerned was secured and the nuisance abated. In the 4 cases mentioned intimation notices were served and the nuisances were then abated. Legal Proceedings. Prosecutions instituted 55 Convictions 29 Cases withdrawn 8 Cases withdrawn on payment of costs by defendant 2 Cases dismissed on payment of costs by defendant 16 Cases dismissed 0 Analysis of Legal Proceedings. Catering. Failing to take precautions against the contamination of food Fines. Costs. £ s. d. £ s. d. 6 convictions 205 0 0 31 3 0 47 Food. Fines. Costs. £ s. d. £ s. d. Food unfit for human consumption:— 1 conviction 25 0 0 5 5 0 Misleading labels and false advertisements:— 6 convictions 1,290 0 0 262 10 0 1 case withdrawn. Adulterated whisky, gin and rum :—- 8 convictions 21 0 0 59 2 0 10 cases dismissed on payment of costs. 7 cases withdrawn. 2 cases withdrawn on payment of costs. Sale of milk deficient in fat and milk solids:— 2 convictions 5 0 0 21 0 0 6 cases dismissed on payment of costs. Failure to take precautions against the contamination of ice cream:— 1 conviction 2 0 0 2 2 0 Dwellings. Public Health (London) Act, 1936 (Nuisances):— 2 convictions (Abatement Orders made) 7 2 0 Public Health (London) Act, 1936 and London County Council (Watercloset) Bylaws:— 1 conviction 5 0 0 5 5 0 Pubhc Health (London) Act, 1936. Failing to comply with Order to abate a nuisance:— 1 conviction 25 0 0 15 15 0 Factories. Factories Act, 1937. Failing to provide separate sanitary accommodation for the sexes and insufficient ventilation to sanitary accommodation :— 1 conviction 5 0 0 4 0 0 £1,583 0 0 £413 4 0 Water. Water for drinking and commercial purposes is supplied by the Metropolitan Water Board and has proved throughout the year to be satisfactory in quality and quantity. Four complaints of contaminated drinking water were received, all of which were traced to dirty storage cisterns. In two cases, the water service system has been modified to a mains supply, and in the other two cases the tanks have been cleansed and their lids refitted. 48 The resident population (estimated at 102,160) in 22,536 houses receive water from the Metropolitan Water Board's mains or from deep wells. There are some 96 deep wells still actively used and 18 reports were received on the supplies drawn from these sources. In all but 3 of these 96, the water is used for domestic purposes, in those 3— 1 supply is used for cooling purposes. 1 for supplying boilers, and 1 is a standby in case of fire. Disinfection and Disinfestation. Rooms. Articles. Articles. Destroyed. Articles. Washed. Vehicles. Books. Disinfection 636 10,441 495 — 50 429 Disinfestation 1,398 2,279 5,224 — 3 — Laundry towels — — — 5,875 — — 2,034; 12,720 5,719 5,875 53 429 Treatments. Men. Women. Children (under school age). Children. (School). Articles. Scabies 45 78 82 227 4,333 Head lice — 18 1 320 311 Body lice 190 43 — — 4,063 235 139 83 547 8,707 Starlings. During the present year, reference was made by the Public Health Committee to the large numbers of starlings roosting in the City, particularly in the vicinity of Trafalgar Square and Whitehall. Furthermore, owners of buildings in this area protested about the nuisance caused by the guano deposited by these birds. They referred to the deleterious effects on stonework and the subsequent expense of cleaning the buildings. A reliable authority has estimated that some 20,000 starlings roost each night from October to March in this area, and accordingly the Public Health Department made investigations to ascertain what methods might be employed to reduce the number of starlings. Guidance was sought from the Ministry of Agriculture, and Fisheries but it was apparent from their reply that although such known methods as trapping, shooting or poisoning were effective in country areas in reducing the numbers of these birds, such methods would be impracticable to apply to an urban area such as Westminster. 49 Food Poisoning. During the year 8 outbreaks of food poisoning occurred in the City. In 5 of the cases, only one or two people were affected but nevertheless thorough investigations as to the cause were made in each case. The other 3 cases affected larger numbers of people and are reported here in some detail. In one of the three cases 15 people were affected after consuming lunch at a staff canteen in the City. It was estimated that 236 people were users of this canteen and were exposed to the risk of food poisoning. Samples of the suspected food were taken for bacteriological examination but no causal agent was identified. The degree of the illness was generally not severe. The second case involved some 35 persons who were participating in a staff outing from a firm in the City to Clacton. Ham sandwiches were eaten en route and were suspected of causing the outbreak but no causal agent was identified after samples had been bacteriologically examined. Laboratory investigation of serum and faeces from sufferers and swabs of food handlers proved negative. As in the previous case, the course of the illness was not severe. The third and largest case involved some 45 people who had consumed food in a staff canteen in the City. Samples of ham and rice, the suspected foods, were submitted for bacteriological examination the results of which were negative. Specimens of urine and faeces of the sufferers and food handlers were also examined but no pathogens were isolated. As in the other cases the food causing the outbreak and the causal agent are unknown. The estimated number of consumers risking infection in this canteen was 235. Particular attention was given to the hygienic condition of the canteen and this was reported as satisfactory. Again, the course of the illness was not severe and the duration of the symptoms lasted for 2-3 days. Persons Rendered Homeless by Flooding. It is the duty of the London County Council, under the provisions of the National Assistance Act, 1948, and Ministry of Health Circular 87/48, to provide temporary accommodation for persons rendered temporarily homeless through flooding. In certain metropolitan boroughs, including the City of Westminster, there is a recurrent danger from flooding from the River Thames, and, at the invitation of the County Council, the City Council has approved a joint scheme with the County Council to provide (a) temporary rest centres for persons who may be rendered homeless by flooding, (6) staff for opening and taking charge of these rest centres, (c) the transportation of food and equipment (provided by the County Council) and (d) the responsibility for general clearing and salvage in the flooded area. 50 The St. Gabriel's Church Hall, Glasgow Terrace, S.W.I, and St. Barnabas Church Hall, Ranelagh Grove, S.W.I, have been earmarked, for use as temporary rest centres, by courtesy of the respective Vicars of these Parishes, and the staff of the centres will be provided by City Council Officers and members of the Westminster. Wardens' Association. Bubial or Cremation of the Dead. Under the provisions of Section 50 of the National Assistance Act, 1948, it is the duty of the City Council as a sanitary authority to cause to be buried or cremated the body of any person who has died or is found dead in the area, where no other arrangements have been made for the disposal of the body. The Council is empowered to recover the cost of burial from the estate of the deceased, and as from the 5th July, 1949, is eligible to receive payments in respect of the cost of such burial from death grants payable under the provisions of the National Insurance Act, 1946. Some 75 per cent. of the cost of all burials carried out during the year has been recovered from these sources. Where persons without known relatives die in the City, it is frequently necessary not only to arrange for their burial, but to dispose of the contents of their homes. This course is necessary to enable the proceeds to be applied towards the cost of burial and also to avoid rent accruing and to release the accommodation for housing Purposes as early as possible. During the year 46 burials were undertaken by the City Council in its Cemetery at Hanwell, the requests for such burials being received from the following sources:— H.M. Coroner's Officer 20 Relatives of the Deceased 14 Hospitals in the City 11 General Practitioners, etc 1 46 Coroner's Court and Mortuary. In all, 342 bodies were received in the Mortuary on Coroner's warrants by Police or Undertakers. There were 10 cases admitted "to await burial." Number of Cases. Inquest cases 110 Non-inquest cases 232 Post-mortem examinations held 307 Causes of death in the foregoing were as under:— Accidental drowning 6 Found drowned 9 Suicide by drowning 2 „ by other means 32 51 Accidents— Street 10 Domestic 7 Others 18 Natural causes 239 Misadventure 9 Murder — Miscellaneous causes 10 , ^OOL ^ LIBRARY <£> 126 MAY 1970 f