Ac4341 Fin32 THE Metropolitan Borough of Finsbury ANNUAL REPORT on the Public Health of Finsbury for the Year 1951 By— C. O. S. BLYTH BROOKE, M.B., B.S., D.P.H. Barrister-at-Law. Medical Officer of Health. Finsbury Health Centre, Pine Street, London, E.C.i. Printed by Vail & Co., ltd. (t.u.), Finsbury, b.c. 1952 THE Metropolitan Borough of Finsbury ANNUAL REPORT on the Public Health of Finsbury for the Year 1951 By— C. O. S. BLYTH BROOKE, M.B., B.S., D.P.H. Barrister-at-Law. Medical Officer of Health. Finsbury Health Centre, Pine Street, London, E.C.i. Printed by Vail & Co., ltd. (t.u.), Finsbury, e.c. 1952 2 HEALTH COMMITTEE Chairman : Councillor Mrs. M. BENJAFIELD Vice-Chairman: Councillor J. CROSSLEY Alderman Mrs. V. M. HEAPS J. SCOTT Councillor J. T. BELLAMY R. A. J. BENNETT Mrs. E. B. BROMFIELD C. S. BROWN Miss A. T. CALLAGHAN W. J. DAVIES H. DUNGER A. E. HAYNES S. G. A. JEFFREYS W. O'LEARY J. W. TOZER Medical Officer of Health: C. O. S. Blyth Brooke, M.B., B.S., D.P.H., Barrister-at-Law. Deputy Medical Officer of Health: G. K. Lim, D.P.H., M.B., B.S., D.C.H., D.T., M, & H. (Resigned 28.3.51) M. Scott Stevenson, M.B., Ch.B., D.P.H. (From 1.8.51) Public Analyst: C. Harcourt Wordsworth, B.Sc. Sanitary Inspectors: H. J. Newdick, M.S.I.A. (Senior S.I.) R. E. Lay, M.S.I.A. A. J. Truslove, M.S.I.A. J. Lewis, M.R.San.I. E. Ditchburn D. M. Warner, M.R.San.I. (Resigned 30.9.51) S. C, Metcalf, M.S.I.A. (From 23.4.51) 3 Meat Inspector: T. Penman, M.B.E., M.S.I.A. (Seconded to Ministry of Food) (Retired 30.9.51) R. S. Barber, M.S.I.A., Barrister-at-Law Administrative and Clerical Staff: A. G. Holmes (Chief Clerk) J. T. Lindsay Miss J. L. Faulkner Mrs. A. H. Bradford R. Robertson (Returned from H.M. Forces 28.5.51) A. Phillips (With H.M. Forces from 1.11.51) Cleansing Station Nurse and Visitor to the Aged: Mrs. D. I. M. Lloyd, S.R.N. Infectious Disease Visitor: Mrs. R. Pepper, S.R.N. Resident Engineer and Health Centre Keeper: F. W. Battle 4 To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Finsbury. Mr. Mayor, Ladies and Gentlemen, I have the honour to present my Annual Report for 1951 of the work of the Public Health Department. This report is prepared in an abbreviated form in accordance with instructions given by the Ministry of Health. I am glad to be able to report that the general health of the community as in recent years has remained good, and that there was no serious outbreak of any infectious disease. The Birth Rate was 17.9 and shows little change from preceding years. The Infant Mortality Rate was 24.4 and the Still Birth Rate 1.9. Although the record low rates for 1950 were not quite maintained, yet these rates are lower than those for 1949 and below those for England and Wales and those for London as a whole. It is also satisfactory to note that the death rate among illegitimate infants was only very slightly higher than among others. It is with regret that it is my duty to call attention to a rise in the general death rate to 14.3, whereas the corresponding rates for London and the whole country rose to only a lesser extent, namely to 13.1 and 12.5 respectively. This rise is more than could be accounted for by the higher proportion of those of the higher age groups in Finsbury than elsewhere. The increase is due to a slightly larger number of deaths in every age group above 25, and mainly in deaths from vascular lesions of the nervous system, coronary disease, Bronchitis and Pneumonia. The incidence of measles, whooping cough and dysentery was high during the year as shown in the Section dealing with Infectious Diseases. It will be seen that the rates for these and certain other diseases were materially higher than those for the County of London. I am satisfied, however, that this is largely, if not entirely, due to 5 the excellent diagnostic facilities available in our laboratory and the care and attention given in the visitation to the follow-up of cases and contacts. These have led to a very close and friendly relation between both the Public, the local practitioners and this department, resulting in the notification of nearly all the cases which have occurred. Although, therefore, at first sight we may regret the apparent unduly high incidence which may, of course, be partly due to the overcrowded nature of the Borough, yet I am of opinion that in the main it reflects the high standard and value of our Preventive Services. There was little change in the general environmental conditions prevailing throughout the Borough during the year, and indeed there has been little during the past few years. Apart from the problem of vacant sites to which I have previously referred, the sanitary conditions have remained generally satisfactory, and only in exceptional instances have they constituted a direct threat to Health. I am glad to be able to report that Finsbury remains in the forefront in providing services to preserve the Health of the Aged. The additional arrangements made by or in conjunction with the Council during the year are set out on another page, and here I will only call attention to the inauguration of an experimental Part-time Employment Scheme which already by the end of the year had proved of great value. Many Health and Welfare Schemes organised by central and local government agencies are now available, but I believe there is ample scope for personal service and gifts in money or in kind from the charitably minded, and perhaps in no field is the scope greater than among the elderly. During the year I was offered, and gladly accepted, the post of Honorary Secretary of the Old People's Welfare Committee which represents all the major voluntary societies. I hope, that by occupation of this post, to effect that close co-ordination between statutory and voluntary efforts which is so desirable in the interests of efficiency and economy. Housing conditions, however, remain a serious menace to Physical as well as to Mental Health. Apart from the dilapidated 6 condition of much of the property and the extent of overcrowding, the survival of so many old blocks of flats and high houses without lifts, is a grave problem in relation to the increasing number of elderly people, and those with heart disease who are obliged to occupy accommodation approached only by many stairs. Hearts tired by disease or years of hard work are worn out by the repeated effort of climbing, or it may be that to avoid such effort persons may become housebound even to the extent of going short of necessary supplies, and at any rate to the detriment of their wellbeing. I gladly take this opportunity of thanking the Chairman, Vice-Chairman and members of the Health Committee as well as other Committees of the Council, most sincerely for their continued and generous support, and I also wish to place on record my thanks to my staff for their full co-operation and loyal assistance. I have the honour to be Your obedient Servant, C.O. S. BLYTH BROOKE, Medical Officer of Health. 7 SECTION A. Vital Statistics. Area. The area of the Borough is 587 acres. Population. Census 1951. Preliminary Report 35,347 The Registrar-General's mid-year estimate is: Home Population 35,620 Population Density. Number of Persons per Acre 61 Marriages Registered 328 Rateable Value. £956,228. Product of a Penny Rate £3,859. General Rate for the year 19s. 6d. in the pound. Area Comparability Factor. Births 0.96 Deaths 1.01 Live Births. The total number of live births belonging to the Borough was 639 including 41 illegitimate births and consisting of 336 males and 303 females, giving a rate of 17.9 per 1,000 civilian population. The birth rate for England and Wales was 15.5 per 1,000 home population and 17.8 per 1,000 home population for the Administrative County of London. Stillbirths. The total number of stillbirths allocated to the Borough during the year was 12. This figure represents 1.9 per cent. of the total births. Expressed as a proportion of the population the figures are 0.34 per 1,000 civilian population for Finsbury as against 0.37 for the Administrative County of London and 0.36 for England and Wales (total population). They were distributed by sex and legitimacy as follows:— Legitimate Illegitimate Total Males 5 — 5 Females 7 — 7 12 — 12 8 Deaths. The total number ot deaths belonging to the Borough registered during 1951 was 509, consisting of 296 males and 213 females, giving a general death rate of 14.3 per thousand of the civilian population. The corresponding rate in the Administrative County of London was 13.1 and of the total population of England and Wales was 12.5. Comparative Statistics, 1945-1951. 1945 1946 1947 1948 | 1949 1950 1951 Population 27,990 33,400 35,120 35,640 36,010 35,810 35,620 Birthrate (per 1,000 population) 16.9 20.6 22.2 18.9 18.6 17.3 17.9 Death rate (do.) 17.1 15.6 14.9 11.9 13.7 11.7 14.3 Maternal mortality (per 1,000 live births) 4.2 1.5 1.3 0.0 3.0 0.0 0.0 Death rate, infants under 1 (do.) 55.0 54.0 32.0 32.6 25.3 19.4 21.9 Death rate of illegitimate infants under 1 (per 1,000 illegitimate live births) 53.6 118.0 47.6 60.0 76.9 27.02 24.4 Still-births (percentage of total births) 2.7 3.6 1.6 2.3 2.3 1.6 1.9 T.B. death rate (per 1,000 inhabitants (all forms) 1.07 0.96 1.25 0.72 0.56 0.39 0.59 Illegitimate births 56 68 42 50 52 37 41 9 Causes of Death — 1951. 0—1 1— 2 5 15— 25— 45 65- -74 75 Total M. F. M. F. Bl. Tuberculosis, respiratory - - - - 2 6 6 3 - 2 - 19 B2. Tuberculosis, other - - - - - - 1 1 - - 2 B3. Syphilitic disease - - - - - - - - - - - - B8. Diphtheria - - - - - - 1 - - - - 1 B9. Whooping Cough - - - - - - - - - - - - B1O. Meningococcal infections - - - - - - - - - - - - B12. Acute poliomyelitis - - - - - - - - - - - - B14. Measles - - - - - - - - - - - - B4-7, 11, 13, 15-17. Other infective and parasitic diseases - - - - - - - - - - - - B18. A46 Malignant neoplasm —stomach - - - - - - 5 2 2 4 1 14 A50 Malignant neoplasm —lung, bronchus - - - - - 1 13 5 - 2 - 21 A51 Malignant neoplasm —breast - - - - - - 4 - 1 - - 5 A52/53 Malignant neoplasm—uterus - - - - - 2 - - - - - 2 A44/67 Other malignant and lymphatic neoplasms - 1 - - - 3 12 12 8 5 9 50 A58 Leukaemia, aleukae- mia - - - - - - 1 - - - - 1 B20. Diabetes - - - - - - - - 1 - - 1 B22. Vascular lesions of nervous system - - - - - 2 7 7 8 10 12 46 B26pt. Coronary disease, angina - - - - - 1 17 12 7 12 9 58 B28. Hypertension with heart disease - - - - - - 3 7 4 3 0 19 B25, 26pt., 27. Other heart disease - - - - 1 1 13 10 5 16 20 66 B29, 46pt. Other circulatory disease - - - - - 1 - 3 4 2 10 20 B30. Influenza - - - - - - 1 1 1 3 1 7 B31. Pneumonia 2 - - 1 - 2 6 4 - 8 12 35 B32. Bronchitis - - - 1 - - 10 15 3 14 10 53 B46pt. 10  0—1 1— 2 5— 15— 25— 45— 65- -74 75 Total M. F. M. F. Other diseases of respiratory system — — — — — — 1 2 — 1 — 1 B33. Ulcer of Stomach and duodenum — — — — — — 2 2 1 — 1 6 B36, 43pt. Gastritis, enteritis and diarrhoea — — — — — 1 1 — — — — 2 B38. Nephritis and nephrosis — — — — 3 — — 1 1 5 B39. Hyperplasia of prostate — — — — 2 — 3 — 5 B40. Pregnancy, childbirth, abortion — — — — — — — — — — — — B41. Congenital malformations 2 3 — — — — — — — — — 5 B19, 21, 23, 24, 34, 35, 37, 42, 43pt, 44, 45, 46pt. Other defined and illdefined diseases 9 1 — — — 2 10 2 7 3 5 39 BE47. Motor vehicle accidents — 1 — 1 — 1 — 2 — — — 5 BE48. All other accidents 1 1 — — — 1 3 2 1 — 5 14 BE49. Suicide —. — — — — 2 1 1 — — 4 BE50. Homicide and operations of war — — — — — — — — — — — — Totals 14 7 — 3 3 26 121 94 54 89 98 509 "B" categories refer to the Abbreviated List of 50 causes for Tabulation of Mortality contained in the Manual of the International Statistical Classification of Diseases, Injuries and Causes of Death, Volume 1. There are no special features revealed by the causes of death statistics to which it is desired to draw attention, apart from the observations which are made on this subject in the introduction. Maternal Mortality. There were no maternal deaths during the year. 11 Inquests. Inquests were held on 25 residents during the year. The causes of death found were:— Natural causes: (Male 53 years and Female 53 years) 2 Road Accidents:— (Males 3, 27, 66 and 69 years and Female 10 years) 5 Misadventure: (Male 1 year) 1 Accidental Falls: (Males 74, 71, 62 and 47 years and Females 89, 85, 80, 75 (2), 74 and 61 years) 11 Found Drowned: (Male 36 years) 1 Suicide: (Males 39, 62 and 69 years and Female 38 years) 4 Asphyxia: (Male 4 weeks) 1 25 It is unfortunate that accidents have taken an even greater toll of life than in previous years, and it should be noted that there were: (1) Five deaths involving 2 elderly persons and 2 children from Road Accidents. (2) Eleven deaths, mostly elderly persons, from falls. (3) One death in a child from misadventure through scalding from a fall into a bowl of hot water. Infant Mortality. There were 14 deaths amongst infants under one year of age and the Infant Mortality rate based on 1,000 live births was 21.9. Of these deaths 10 occurred in the neonatal period. The neonatal mortality rate was 15.65. The comparative infant mortality rates for London and England and Wales were 26.4 and 29.6 respectively. 12 Infant Mortality, 1951—Causes of Death. Cause of Death 0-1 wk. 1-2 wks. 2-3 wks. 3-4 wks. Total under 4wks. 1-3 mths. 3-6 mths. 6-9 mths. 9-12 mths. Total under 1 yr. Measles - - - - - - - - - Whooping Cough - - - - - - - - - - Diphtheria - - - - - - - - - - Pneumonia - - - - - 1 - 1 2 Diarrhoea and Enteritis - - - - - - - - - - Congenital malformation - 1 - - 1 1 - - - 2 Birth Injury and other diseases of early infancy 3 - - - 3 - - - - 3 Premature Birth 5 - - - 5 - - - - 5 Other defined causes 1 - - - 1 1 - - - 2 9 1 - - 10 2 1 - 1 14 13 SECTION B General Provision of Health Services Health Centre. The Council continued to maintain the Health Centre for the administration of the Public Health Services, and arrangements continued in force for the use by the Regional Hospital Board and by the London County Council of those portions of the building which were occupied by services transferred to those bodies under the National Health Service Act, 1946. The Council also continued to act as an agent for the Regional Hospital Board in respect of certain services controlled by them. Laboratory. The Laboratory serves the needs of the Public Health Department in the control of Infectious Disease and the bacterial cleanliness of foodstuffs, and for this purpose was particularly valuable, especially in the diagnosis and control of Whooping Cough. The work was carried out by the laboratory technician who was transferred to the Regional Hospital Board, and has operated in close association with the Central Public Health Laboratory service at Colindale. It has also undertaken work on behalf of the Regional Hospital Board. The arrangements continued to operate whereby in some cases special examination may be carried out by the Archway Group Laboratories, but no use was made of this service in 1951. Work of the Public Health Department Number positive Total Number Examined Total 1950 1951 1950 1951 1951 (1950) Throat and Nose Swabs for Diphtheria - - 616 185 - - Sputums for Tubercle Bacilli 97 86 455 460 Post nasal swabs and/or cough Plates for H. Pertussis 38 68 75 178 White Cell counts — — 48 88 Faeces and Rectal Swabs for Salmonella, etc. 1ll 270 732 2683 Urine Examination for Typhoid 2 - 71 - 3,594 (1997) 14  Number Unsatisfactory Number Poor Total Number Examined Total 1950 1951 1950 1951 1950 1951 1951 (1950) Milk- Pasteurised 5 1 - - 173 133 Tuberculin Tested Pasteurised - - - - 35 29 Sterilised - - - - 55 51 Ice-Cream 26 6 5 4 111 58 271 (374) Other foods — — — — 28 26 Water— Wells - - - - - - Tanks - - - - 41 - Swimming Baths - - - - 16 15 Various - - - - 10 41 (95) Totals 3,906 (2,466) Work of the Regional Hospital Board For General Practitioners For Various Clinics Totals 1950 1951 1950 1951 1950 1951 Blood Counts 61 114 148 75 209 189 Blood Sedimentation Rate estimations 1 3 11 41 12 44 Urine Examinations 10 21 47 24 57 45 Various 11 9 6 — 17 9 Total 295 287 It will be seen from the comparative figures given in the above tables that there has been a very great increase in the amount of work performed in the laboratory during the past year. Blood Transfusion. The Council continued to co-operate with the North London Blood Supply Depot of the National Blood Transfusion Service, by arranging Blood Donation Sessions at the Health Centre. Four sessions were held during the year at which 306 donors gave blood. 15 International Certificates of Vaccination and Inoculation. Arrangements continued during the year for the authentication by the Medical Officer of Health of Certificates of Vaccination and Inoculation in the International form. These certificates are required by passengers proceeding abroad from this country and the purpose of the authentication is to provide proof to health authorities abroad that the signature of the person issuing the certificate is that of a registered medical practitioner. Burial or Cremation of the Dead. It is provided under the provisions of Section 50 of the National Assistance Act, 1948, that the Local Authority shall arrange burial or cremation in the case of any person who has died or been found dead in the Borough, in any case where it appears to the authority that no suitable funeral arrangements have been or are being made. During the year six persons were buried or cremated under these provisions. Health Education. Health Education was continued during the year by the exhibition of Public Posters and by the distribution of literature from suitable centres. A joint meeting was convened early in the year at the Health Centre, of headmasters, education officers, and the school medical officers to discuss Health Education in the Schools with a view to ascertaining if, and in what ways, the Borough Council could further the ends of Health Propaganda in Schools as part of their programme for the rest of the community. A Health talk accompanied by the showing of a film was given by the Medical Officer on four occasions to groups of "school leavers" (boys and girls). These talks were very well received and were considered by all to have been well worth while. The Council continued to co-operate in the health publicity programme organised by the London County Council Health Division III, 16 It may also be said that the character of the Health Centre building which houses the Public Health Department was designed to inspire the conception of Health among the many members of the public who use it for one purpose or another. Aged Persons. The Council continued to take an active interest in the welfare of old people during 1951. A full description of the services available to the men over 65 and women over 60 years was given in the last report, but there have been several additions. The Part-time Employment Scheme was inaugurated with the appointment of an Organiser. The work was at first carried on in the hall of the Health Centre, but in September, 1951, it was transferred to other premises considered more suitable for this purpose, at 352, St. John Street. Many firms, both within and without the Borough, have co-operated generously by lending machines and giving orders for the finished articles. These included such things as covered coat hangers, stuffed toys, aprons, nightdresses, etc., which proved very popular as Christmas presents. A total of 50 men and women have been employed during the year, each worker receiving a small sum to augment his old age pension. Ten others were found employment in firms outside, either in part- or full-time employment. The Part-time Employment Scheme has attracted the interest of many people concerned with the welfare of the aged and may well serve either as an example or precedent to other voluntary and statutory bodies. A Laundry Service is now available for the chronic sick and for those aged persons who, for other reasons, are unable to cope with their own washing. This service is free and is especially appreciated by old gentlemen living alone. Any mending or darning of socks that is found to be necessary is undertaken by workers in the Part-time Employment Scheme. Assisted bathing facilities are provided at the Health Centre for those aged persons who are unable by reason of senility or chronic illness to avail themselves of the public baths. 17 During the summer months 253 elderly people were able to benefit from a stay of two weeks in the country or at the seaside, in holiday homes at which accommodation had been reserved by the Council. As before, the Council granted £770 to the voluntary organisations providing meals and recreation for the aged of Finsbury. The Nurse/Visitor was available for consultation by the aged persons about their various problems, and all those known to the department were visited regularly during the year. Every effort was made to give them help and encouragement in looking after themselves. 18 SECTION C. Sanitary Circumstances. Water. The Borough is freely supplied with water by the Metropolitan Water Board. No samples of drinking water for bacteriological or chemical tests were taken during 1951 by the Sanitary Inspectors. Swimming Baths. There are 4 indoor swimming baths in the Borough, 3 of which belong to the Council all of which maintain regular chlorination of the water. Bacteriological examination has shown an almost complete freedom from contamination. Sanitary Conditions. The Sanitary conditions of the Borough were subject to routine inspection and investigations were made into the circumstances of all complaints made. The work undertaken apart from that detailed elsewhere in this report is summarized in the following table:— Sanitary Conditions. The following is a summary of work undertaken by the Sanitary Inspectors during 1951. Houses, damp, dirty or dilapidated, remedied 565 Doors, windows, floors, walls, ceilings, sashcords repaired 665 Water closet defects remedied 188 Water closets erected 151 Urinal defects remedied 22 Urinals erected 20 Soil pipe and ventilating shaft defects remedied 24 Soil pipe and ventilating shafts erected 72 Yard defects remedied 29 Waste pipe defects remedied 63 Waste pipes erected 47 Water cistern defects remedied 60 Accumulations of rubbish or manure removed 87 19 Sanitary Conditions—continued Dung or dust receptacles repaired or renewed 28 Drains relaid, amended or sealed 160 Drains cleared or tested 77 Rain water pipes cleared, repaired or renewed 23 Water supply to houses reinstated 6 Roofs and gutters repaired 414 Area defects remedied 23 Wash-house defects remedied 29 Animal nuisances abated 2 Stables cleansed or repaired 0 Water supply laid on to upper storeys of house 4 Miscellaneous nuisances abated 90 First visits (complaints, casual visits) 5,003 Re-visits 5,971 Intimation Notices served 774 Nuisance Notices served 102 House inspections 1,758 Complaints received 1,973 Nuisance Notices were served in all instances where necessary, but in most cases co-operation with owners by informal approach and the service of Intimation Notices, secured the abatement of nuisances and in addition on many occasions other improvements in living conditions. In a number of cases time, additional to that provided for in notices, had to be allowed owing to such circumstances as shortage of material and of labour. It was frequently found that landlords were willing to comply with requirements but experienced delay in securing builders to execute the necessary works. Legal proceedings instituted under the Public Health (London) Act, 1936, for non-compliance with Nuisance Notices only occurred in the cases set out in the following table:— 20 Date Premises Offence Result 15.2.51 23, Shene Street Appeal against an abatement order and fine Appeal dismissed. Fine increased to £15. Costs £5 5s. 14.2.51 1, James' Gardens Failing to abate nuisance. Order to do the work within 7 days. 6.4.51 16, Cynthia Street Failing to abate nuisance. Costs £2 2s. Order to do the work within 7 days. 6.4.51 1, James' Gardens Failingtocomply with Court Order. Both defendants fined 40s. and £2 2s. Costs each. Order to do work within 7 days. 11.4.51 23. Shene Street Failingtocomply with abatement Order. Fined £5. Costs £22s. Order complied with. 27.4.51 12, Calshot Street Failing to abate nuisances. Costs £2 2s. Order to do the work within 7 days. 6.6.51 8, Wynford Place Failing to abate nuisance. Order to do work within 28 days. 6.8.51 31, Granville Square Failing to abate nuisance. Adjourned until 14.9.51. 14.9.51 31, Granville Square Failing to abate nuisance. Adjourned until 21.9.51. 21.9.51 31, Granville Square Failing to abate nuisance. Costs £3 3s. Order to do the work within 28 days. 26.11.51 31, Granville Square Failing to abate nuisance. Adjourned 14 days. 26.11.51 140, Farringdon Road Failing to abate nuisances. Order to abate nuisance within 14 days. 10.12.51 31, Granville Square Failingtocomply with Court Order. Abatement orde complied with. 19.12.51 162, Central Street Failing to abate nuisance. Costs £3 3s. Order to do the work within 14 days. The dreary and desolate character of many parts of the Borough was enhanced by the frequent deposit of rubble and rubbish on vacant sites which was difficult to control. The presence of harmless rubbish on vacant ground apart from being unsightly leads to the dumping thereon of vegetable and other refuse which may well constitute a danger to health, especially for children who play there. When such deposits were recognised as likely to be injurious to health they were removed by the Council, 21 Common Lodging Houses. The only common Lodging House is that situated at 88, Old Street, which is licensed for 313 beds. Twenty-one visits of inspection were made. Canal Boats. Canal boats do not normally halt during their passage along the short stretch of canal in the Borough. No inspections were made. Shops. The number of inspections made under the Shops Act, 1934, during 1951 was 48, and one Notice was served for contravention. Rag and Bone Dealers. There are 7 premises within the Borough in which this type of business is conducted. Nine visits were made to these premises. Rag Flock. The Rag Flock and Other Filling Materials Act, 1951, came into operation on November 1st, 1951. It repeals the Rag Flock Acts of 1911 and 1928. The purpose of the new Act is to secure the use of clean filling materials in upholstered articles and other articles which are stuffed or lined. The Act makes it an offence to use the filling materials mentioned in the Act in any specified activity except on premises registered by the local authority. Premises where Rag Flock is manufactured or stored must be licensed by the local authority, and occupier must keep suitable records of his transactions. There is also provision in the Act for the taking of samples of the various materials used and submitting them to a prescribed analyst for examination. Regulations have been made by the Minister under the Act relating to the standard of cleanliness for each kind of material to which the Rag Flock and Other Filling Materials Act, 1951, applies. Offensive Trades. The following premises were licensed for the purpose of carrying on offensive trades:— 22 (a) Messrs. J. L. Henson, 137, Whitecross Street, E.C.i. (b) Messrs. F. & W. Warman, Ltd., 5, Eagle Court, E.C.i. (c) Messrs. T. Kendon & Sons, Charterhouse Mews, E.Ci.. No offensive trade was carried out by Messrs. J. L. Henson or T. Kendon & Sons, but the premises of Messrs. F. & W. Warman, Ltd., were regularly used as such and were frequently visited. Factories. A register of Factories is maintained which indicates which are designated " Power " and which " Non-Power " Factories. Power: Number added to the Register during 1951 33 Number removed from the Register during 1951 73 Number on Register at end of 1951 1,372 Number Employed—13,064 men, 14,109 women—27,173 Persons. Non-Power: Number added to the Register during 1951 3 Number removed from the Register during 1951 62 Number on Register at end of 1951 763 Number Employed—1,060 men, 738 women,—1,798 Persons. Total Number on Register at end of 1951 2,135 Total Number Employed—14,124 men, 14,847 women—28,971 Persons. These factories were visited and inspected when first registered as regards those matters which are the responsibility of the Borough Council. They have been further inspected on receipt of complaints and as far as possible at regular intervals. It has not been possible to visit each factory every year. The general standard of Hygiene and compliance with legal requirements was found to be very good and only occasionally were defects, as set out below, discovered. In such cases notices were served. Number of Inspections—Power Factories 948 —Non-Power Factories 289 —Total 1,237 23 Number of complaints received from H.M. Inspector of Factories 12 Number of complaints received from others 2 Number of Defects discovered:— Want of cleanliness 4 Unreasonable temperature — In relation to Sanitary Conveniences 35 Various 31 Total 70 Number of Notices served 42 No prosecutions were instituted during the year. Number of notices sent to H.M. Inspector of Factories 25 (The information given here is exclusive of Bakeries and certain other premises which are referred to elsewhere in this report.) Outworkers. Number of firms in the Borough who employ outworkers 223 Number of notifications received of:— 1. Finsbury outworkers employed by Finsbury Firms 410 2. Outworkers in other districts employed by bury Firms 4,151 3. Finsbury outworkers employed by Firms in other districts 93 Total number of notifications received in respect of:— 1. Finsbury outworkers employed by: (a) Finsbury Firms 546 (b) Firms outside Finsbury 172 718 2. Outworkers employed by Finsbury Firms 4,697 Outworkers who are sub-contractors are normally occupiers of Premises registered as Factories and inspected as such. Domestic outworkers are visited in their homes to ensure that work is not carried out in unsuitable surroundings. 24 Number of visits to Domestic outworkers 164 Number of notices served in respect of unsatisfactory conditions Nil Smoke Abatement. Two complaints were received and 89 observations made during the year in regard to smoke emission. No notices were served. Generally speaking I am of opinion that there has been some diminution of atmospheric pollution in recent years. Verminous Premises and Articles. During the year 361 premises were found to be verminous, and disinfestation measures were carried out. Similar measures have been carried out on certain other occasions on request. In all disinfestation measures were carried out in 426 premises. The measures adopted have been the spraying of the room thoroughly with a D.D.T. Solution on one occasion, and the steam disinfection of the bedding in most cases and whenever considered necessary. As a routine measure for the control of vermin, disinfestation is carried out in the case of tenants moving into the Council's Housing Estates (other than Post-War Estates), or requisitioned property. The normal routine is for old accommodation of the prospective tenant to be sprayed with a D.D.T. Solution some days before the removal, and at the same time for the proposed new accommodation to be treated in the same way. On the day of removal bedding is collected from the old address, steam disinfected in the Council's ovens, and then removed to the new premises. In the case of Post-War Estates the Council has entered into arrangements for the furniture and effects to be treated with hydrogen cyanide gas before removal to the Estate. Verminous Persons. The Borough Council continued the operation of the Cleansing Station in the Health Centre for the treatment of verminous conditions, including Scabies, and the arrangements whereby school children 25 were treated on behalf of the London County Council under the supervision of a nurse appointed by them. At other times the work was carried out under the supervision of the nurse appointed by the Borough, who also undertook the Home Visiting. Arrangements were also continued during the year by which cases were treated on behalf of the Shoreditch Borough Council. The Service has worked very satisfactorily, but owing to the very small incidence of these conditions, the total numbers have, therefore, been small. Total number of treatments given to Finsbury cases (other than school children) 129 Total number of treatments given to Shoreditch cases (other than school children) 9 Total number of treatments given to School children 1,097 Total number of Home Visits paid 12 Rodent Control. The Prevention of Damage by Pests Act, 1949,* came into operation on March 31st, 1950. The Council employs five rodent operatives under the supervision of the Senior Sanitary Inspector who is designated Rodent Officer. Treatment for the eradication of rats and mice is provided free for private dwelling houses, but otherwise a charge is made to cover the cost. The maintenance treatment of the sewers was carried out during May and December in conjunction with the Borough Engineer's department. I feel that the rat and mice infestation in the Borough is certainly much less than it was some years ago, but without constant attention it would rapidly grow into a serious problem again. Number of complaints and requests for treatment received 682 Number of additional premises found infested 563 Number of houses treated 2,800 Number of other premises treated 1,069 Number of visits made to houses 14.776 Number of visits made to other premises 5,606 Number of treatments of sewers carried out 2 26 Reception House. The portion of the Health Centre which had in the past been maintained by the Council as a Reception House (for persons who could not remain in their own rooms whilst these were being cleansed after infectious disease, or who had no alternative accommodation in which to reside during housing repairs) continued to be used, by agreement with the North East Metropolitan Regional Hospital Board, for the purpose of accommodating the administrative side of the Mass Radiography Unit. The Islington Borough Council have kindly agreed to provide accommodation for Finsbury residents at their Reception House as and when the occasion should arise. Disinfection. Disinfection is carried out in all cases after infectious disease has occurred when this is considered necessary, and in other cases on request generally after advice has been given that it would be advisable for it to be carried out. During the year it was carried out in the following instances for the reasons set out:— Suspected Diphtheria 3 Suspected Scarlet Fever 58 Poliomyelitis 6 Dysentery and Gastro-enteritis 57 Suspected Measles 70 Suspected Whooping Cough 27 Tuberculosis 19 Scabies 2 On behalf of St. Marks and other Hospitals 22 Miscellaneous S3 Bedding and clothing were brought to the Disinfecting Station in the Health Centre in these cases, and disinfected with steam. In all, including the cases where this was carried out for the control of vermin, 13,791 articles were treated. Goods, mostly clothing, were also disinfected on behalf of certain export firms as follows:— 27 Number of articles 11,151,443 Number of times disinfecting plant charged 808 Nuisance from Pigeons. Authority was given previously for the catching of pigeons in the streets and open spaces in the Borough. This work has been carried on satisfactorily throughout the year. It must be appreciated that if the number of these birds is not kept under control, they would soon become a public health nuisance. Mortuary. The mortuary attached to the Health Centre remained available for the reception of bodies throughout the year. This mortuary is primarily intended for the isolation of the bodies of those dying from infectious disease and the early removal from overcrowded rooms of bodies of those dying from other conditions when this cannot otherwise be effected. At the present time other facilities are usually made available by undertakers and there have been no deaths from any serious infectious disease. It is, however, of great value to have this provision for use in an emergency. 28 SECTION D. Housing. General. It is estimated that there are 8,065 dwellings in the Borough. Unfortunately a very considerable proportion are dilapidated and outworn, and incapable at a reasonable expense of being reconditioned to comply with modern standards. Deterioration is proceeding almost as rapidly as temporary improvements can be effected. Again much of the property was built many years ago and is unsuitable for conversion into the type of accommodation that it is desired to provide at the present time. Until such time as demolition and rebuilding can be carried out on an extensive scale, it is clear that every effort must be exercised to preserve houses wherever possible and prevent the falling off of even those amenities that are available to residents. Most of the work to secure this has been undertaken under the Public Health Act by informal action. Proceedings under the Housing Act. No representations were made and no notices served under Section 9 and 10 of the Housing Act, 1936 requiring notices to be served. 44 House to House inspections were carried out. 18 representations were made during the year under Section 11 that premises were unfit for habitation and could not at a reasonable expense be made fit. Fourteen new representations were made in respect of Closing Orders during the year, one being a flat in a block of tenements and the rest basement rooms. Both the flat and the basement rooms are unoccupied and not used for human habitation. Four new Demolition Orders were made during the year in respect of 20 houses. One other Demolition Order in respect of a dwelling was made early in 1950 and was not included in the last report. 29 Of the two representations made under Section 11 in 1949 and mentioned in the last report, one of the houses is still occupied, but the 60 tenements have been demolished. Tabular Statement prepared in accordance with the Housing Consolidated Regulations, 1932. • Number of Houses considered on inspection to be unfit for human habitation 21 Number of Houses wherein defects were remedied by informal action Nil. Number of Representations made with a view to : (a) serving notices requiring the execution of works Nil. (b) making demolition or closing orders 20 Number of Notices served requiring the execution of repairs Nil. Number of Houses rendered fit after service of notices Nil. Number of demolition or closing orders made 20 Number of Houses in respect of which undertakings were accepted Nil. Number of Houses Demolished 1 Houses let in Lodgings. The register constructed in 1935 was maintained and at the end of the year contained entries in relation to 456 houses. No action was taken during the year under the Byelaws applicable to them. Housing. A list of the new properties which have been completed since the war was given in the last report. During the year the following new flats were completed :— Farringdon Road 8 flats Wilmington Square 8 flats 30 Priory Green Estate. Redington House 94 flats Tornay House 20 flats Paveley House 20 flats Grendon House 20 flats Foliot House 20 flats Kendal House 35 flats Total 225 flats Also under construction were 24 flats in Percival Street. Slum Clearance. Further attention was given during the year to the possibility of initiating small schemes for the clearance of the most unhealthy areas in the Borough although the sites might not be of any value for Rehousing. A suggested 5-year Plan was submitted by the London County Council which provided for the demolition of 395 premises. Discussions took place on the basis of this plan and these were still proceeding at the end of the year. It was, however, agreed that the programme for this year should comprise— (a) Bastwick Street—17 houses. These were already being dealt with as individual properties. (b) James' Gardens Area. A representation of James' Gardens, Frye's Buildings and certain adjoining derelict premises and outbuildings as a Clearance Area was made towards the end of the year, and the Council gave formal notice to the London County Council under Section 33 of the Housing Act, 1936, that they proposed to consider the designation of this Area as a Clearance Area. Rehousing. Applications for rehousing by the Borough Council are made to the Housing Department and these are assessed according to their need according to a points scheme. When accompanied by medical certificates to support the application on medical grounds these are 31 referred to the Medical Officer of Health. Enquiries are then made by the Nurse/Visitor into the detailed nature of the family health and the apparent bearing of the accommodation in use on this, and when desirable, an inspection is carried out by the Sanitary Inspector. These reports are then correlated with the medical certificates, and a degree of medical priority is then allotted according to the scheme. A large number of applications were dealt with in this manner. Applications for rehousing by the London County Council are made to that body. Reports are then frequently asked for and supplied in regard to existing overcrowding and sanitary defects. If accompanied by medical certificates, further information is given, on request, to the Divisional Medical Officer of the London County Council, who is responsible for allocating priorities on medical grounds. During the year 481 families were rehoused as follows Rehoused in Council Flats 198 Rehoused in requisitioned property 87 Rehoused by London County Council 114 Found own accommodation 82 481 Rent and Mortgage Restriction Act. No certificates of unfitness were issued during the year. Three old certificates were still in operation at the end of the year. 32 SECTION E. Food Food Hygiene. The Food Inspector comments and gives advice to traders and their employees during his visits to the various food premises, as do the Inspectors visiting factories where the canteens are included in their inspections. The local office of the Ministry of Food continues to co-operate by insisting that new retail food premises that require a Food Office Licence are constructed and equipped to the satisfaction of this department before granting a licence. Adulteration of Food. The Public Analyst reported 11 samples as being "Not Genuine," out of the 750 samples submitted to him during the year. Sixty-four samples were formal samples and 686 informal. The following is a summary of the samples taken :— Foods No. of Samples Taken Number Adulterated Milk 196 4 Ice-Cream 19 0 Meat Products 76 2 Butter 12 Margarine, Cooking fat, etc. 24 Jams, etc. 11 Cheese 10 Flours, etc. 11 Cereals 10 Coffee, Tea, Extracts 23 2 Sauces, Vinegar, etc. 28 Herbs, Spices and Condiments 61 Powders, (baking, etc.) 22 Canned Vegetables and Fruits 32 Non-alcoholic Drinks 14 Various 95 33 Foods Drugs. No. of Samples Taken Number Adulterated  Simple Medicines 32 Powders 18 Tablets 31 3 Saccharine 1 Ointments 24 Total 750 11 Adulterated Samples were :— 1. Milk.—Of the 4 samples reported as adulterated, one was an informal sample. When a corresponding delivery was sampled formally the milk was satisfactory. 2 samples were very slightlv deficient in fat, and warning letters were sent to the vendors. In the case of the fourth adulterated sample, proceedings were commenced but were subsequently withdrawn after legal argument on technical points raised by the defence. 2. Meat Products.—Two informal samples of sausages were adversely reported upon, both containing preservatives. The amount in each instance was well within the limits prescribed by the Public Health (Preservatives in Food) Regulations, but at the time of purchase the sausages were not labelled and the prescribed Notice was not seen in the shops. When visited by the Inspector both shops were found to have notices which were not as conspicuous as they might be. This was remedied immediately by the vendors. No formal action was considered necessary. 3.—An informal and a formal sample of synthetic cherries for use in cakes, etc., were reported as containing preservatives. This commodity does not appear in the list of foods which may contain preservatives, and the matter was referred to the Ministry of Food, but it was not considered necessary to take further action. 4. Drugs.—Informal and formal samples of Camphorated Chalk were found to be almost devoid of Camphor. The vendor was prosecuted at Clerkenwell Magistrates' Court and fined £5 with £5 5s. od. costs. 34 An informal sample of Iodine was found to be deficient in iodine. It had not been possible to obtain a formal sample of the particular brand by the end of the year, the vendor having no further supplies Compared with 1950 figures there was a considerable increase in the number of adulterated samples, but on examination of the above table, it will be seen to be wholly due to Milk samples, 4 of which were adulterated, compared with none in 1950. Milk. The trend towards ready bottled milk continued, and by the end of the year none of the dairymen in the Borough were regularly bottling milk, though 3 did so on occasions. Twelve premises remained on the Register of Dairies at the end of the year, one having been removed as it ceased to be used as a dairy. The only milk, other than bottled milk delivered by retailers in the borough, is that supplied to some restaurants and canteens, many of which prefer to have their supplies in bulk. These supplies are invariably delivered before normal office hours, so the Food Inspector/Sampling Officer made frequent early morning visits to obtain samples of this milk for both chemical and bacteriological examination. Detailed instructions are given in the Special Designations (Pasteurised and Sterilised) Milk Regulations, 1949, as to the manner in which bacteriological samples are to be taken. The equipment necessary to conform to these requirements makes some form of transport necessary, so it is the practice for one of the disinfector/ drivers to accompany the Inspector with one of the new vans on these early morning forays. The 4 samples of milk referred to as adulterated were all early morning samples. It is considered that all were due to carelessness, not deliberate intent. During the year the Minister of Food, in exercise of his powers under Section 21 Food and Drugs (Milk, Dairies and Artificial Cream) Act, 1950, declared the Metropolitan area and certain other districts " Specified Area No. 1 " within which only Designated Milks may be sold, 35 All milk now sold for consumption in Finsbury is milk that bears one or other of the permitted Designations, that is, Tuberculin Tested, Pasteurised or Sterilised. 1. Dairies : No. on register at end of 1951 12 2. Distributors : No. on register on 1st January, 1951 112 No. of Transfers approved during 1951 5 No. of new applications received and approved 9 The only cancellations were those resulting from transfers. 3- Designated Milk : No. of licences issued :— Dealers in T.T. Milk 50 supplementary 18 Dealers in Pasteurised Milk 71 supplementary 19 Dealers in Sterilised Milk 79 supplementary 20 4- Quality of Milk : No. of samples submitted to Public Analyst 196 No. of these reported as adulterated 4 The average fat content of the milk samples was 3.4 per cent. The average non-fatty solids content was 8.78 per cent. 5- The total number of visits paid to milk premises was 315 Ice-Cream. Number of premises registered for manufacture 24 Number of premises registered for storage and sale 93 The number of premises for the manufacture of Ice-Cream is one less than in 1950. This one was removed as the premises concerned had been converted for the use of an entirely different trade. 11 additional premises were registered during the year for storage and sale of ice-cream. The Food Standards (Ice-Cream) Order, 1951, came into operation in March, prescribing for the first time minimum standards of composition for Ice-Cream. Ice-Cream must now contain not less than 5 per cent, fat, 10 per cent, sugar, and 7½ per cent, milk solids other than fat, with slight variations for ice-cream containing fruit and for Kosha ice-cream. 36 Nineteen samples of ice-cream were submitted to the Public Analyst and all complied with the standard prescribed. Details of samples submitted for bacteriological examination are as follows:— No. of samples submitted 58 No. of samples satisfactory 48 No. of samples poor 4 No. of samples unsatisfactory 6 The vendors or manufacturers of all "Poor" and "Unsatisfactory" samples were visited, possible causes examined and advice given. Subsequent samples in every case were satisfactory. Total number of visits to Ice-Cream premises 113 Meat Inspection. There is in the vicinity of the Smithfield Meat Market a considerable number of wholesale butchers and offal shops, bacon factories, wholesale provision warehouses and public cold air stores, all of which are regularly inspected by the Meat Inspector. A systematic examination of all imported frozen carcases of mutton and lamb was carried out for Caseous Lymphadenitis. Over 58,000 carcases of mutton were examined during the year by the Meat Inspector and 2,252 carcases were found to be affected with the disease including 130 whole carcases of mutton which were condemned. Thousands of tons of Continental and Scandinavian offals were imported into the Borough under licence from the Ministry of Food. In several cases condemnation of these took place, mostly due to decomposition through lack of proper salting in the country of origin. Large consignments of tinned hams and shoulders from the continent arrived in the Borough and thousands of these tins were condemned, principally owing to faulty sterilization of the tins in the process of canning. On April 1st, Mr. W. Tuvey, "Lynn Regis" Piggeries, Colliers Row, Romford, Essex, took over the collection of the condemned meat and other foods from the Smithfield Animal Products Co., Stanwell, Middlesex, who had given notice to terminate their contract with the Council, 37 During the course of the year 2,524 visits were made to the retail butchers' shops and stalls. Sixty-six certificates for the export of meat essence, bovril, etc., were issued, mostly to U.S.A., Egypt and Canada. In December a case of food poisoning was notified, the suspected article being sausage meat manufactured by a butcher in Finsbury. The matter was fully investigated and no further action found necessary. Bakehouses. There were 19 bakehouses in use at the end of the year, 15 being basement bakehouses. Registered Food Premises. There were no alterations in the register during the year. Other Food Premises. There are approximately 500 premises where meals are prepared and sold in the borough—restaurants, cafes and canteens. All new premises were inspected and also those where alterations were being made. All food premises were liable to inspection, and 1,580 visits were made by the Food Inspector. Street Markets. Much food is handled in the Street Markets and the appropriate Department issued licences for 268 stalls during the year. In each case any storage accommodation used for foodstuffs was inspected throughout the year. Licensed Premises and Public Houses. There were 136 licensed premises in the Borough, 126 of which were Public Houses. 100 inspections were carried out. Listed Sellers of Poisons. Forty-five applicants were approved by the Council in accordance with the Pharmacy and Poisons Act, 1933, each of whom were visited. Unsound Food. Considerable quantities of unsound foodstuffs were confiscated or surrendered during the year as the following summary shows :— 38 Meat—diseased 40,880 lbs. Meat—unsound 23,486 „ Meat—products 437 „ Bacon 7,505 „ Offals—diseased and unsound 73,492 „ Poultry 7,498 „ Game 2,711 „ Rabbits 2,997 „ Cereals 1,854 „ Cheese 894 „ Dried Fruit 535 „ Tinned foodstuffs 93.874 „ Other foodstuffs 9,172 „ Total 265,335 lbs —118,45 Tons. Food Poisoning. Eleven cases of Food Poisoning were notified during the year. There were no deaths. There was one outbreak of Food Poisoning due to an identified cause during the year. This incident, which was domestic, occurred in August and comprised two cases (man and wife). The cases were originally notified as para-typhoid, but laboratory diagnosis after admission to hospital proved infection to be food poisoning due to salmonella typhi-murium. Two outbreaks due to unidentified causes occurred as under :— (a) Domestic 4 cases None notified (August) (b) Domestic 2 cases Notified (October) Suspected cause : Chicken cooked at home. Suspected cause : Beef eaten for lunch. Apart from the outbreaks detailed above, the following individual cases were investigated : 1. A case notified in January. The individual concerned had severe abdominal pain about five hours after eating fish, followed by vomiting and diarrhoea. 39 2. A case notified in February. The individual concerned had abdominal pain, diarrhoea and vomiting. No other member of the family complained of any illness. The probable cause was considered to be a meal taken at home. 3. A case notified in February. The information regarding this case was received from a hospital, where the individual concerned was an in-patient. Investigations were carried out at the hospital. No other member of the family complained of any illness. The probable cause was considered to be whelks. 4. A case notified in February. The child concerned had diarrhoea, but no vomiting or pain. No other member of the family complained of any illness. The probable cause was considered to be Corned Beef Pie. 5. Three cases notified in September. In each case (one of which was a child) the individuals concerned had abdominal pain, vomiting and diarrhoea. The probable cause in each case was uncertain. 40 SECTION F. Infectious Diseases. General. The incidence of infectious disease of all kinds has remained low throughout the year. There was, however, a considerable increase in cases of measles in young children and of dysentery of the some type. All cases notified were visited by the Infectious Diseases Nurse/Visitor and energetic measures taken wherever indicated to ensure adequate minimization of danger of infection to others. Number of visits by Infectious Disease Visitor 2,516 The following table shows the cases of notifiable diseases of which information by notification or otherwise was received in the several age periods set out:— All Ages Under 1 year 1-4 yrs. 5-14 yrs. 15-24 yrs. 25-44 yrs. 45-64 yrs. 65 + Cases treated in Hosp. Acute Influenzal Pneumonia 7 1 2 3 1 3 Acute Primary Pneumonia 26 5 6 2 1 3 3 6 25 Dysentery 163 14 78' 30 9 26 4 2 60 Erysipelas 3 — — — 1 — — 2 — Food Poisoning 15 — 1 1 — 10 0 1 4 Gastro enteritis (under 2 yrs.) 10 5 5 — — — — — 10 Measles 901 57 603 237 — 4 - - 66 Ophthalmia Neonatorum 2 2 — — — — — 1 Puerperal Pyrexia 8 — — — 3 5 — — 8 Poliomyelitis (Non-paralytic) 1 — — 1 — — — — 1 Scabies 22 — 7 4 2 3 2 4 - Scarlet Fever 54 1 27 26 — _ 45 Tuberculosis (Pulmonary) 86 — 9 4 20 29 18 6 Tuberculosis (Non-Pulmonary) 16 — 2 2 3 4 3 2 — Whooping Cough 192 22 119 50 — 1 — — 32 1,506 106 857 357 40 87 35 24 255 Incidence Rates. The rates per thousand of the population are set out below, together with the corresponding rates for England and Wales, the larger towns, the smaller towns, and London as a whole for comparison:— 41 (Notification Rates (Comparative Table) per 1,000 population.) Finsbury England and Wales 126 C.B's. and great towns including London 148 smaller towns, Res. population 25,000 to 50,000 at 1931 census London Adm. County Typhoid Fever 0.00 0.00 0.00 0.00 0.01 Paratyphoid Fever 0.00 0.02 0.03 0.02 0.01 Meningococcal infection 0.00 0.03 0.04 0.03 0.03 Scarlet Fever 1.52 1.11 1.20 1.20 1.10 Whooping Cough 5.39 3.87 3.62 4.00 3.11 Diphtheria 0.00 0.02 0.02 0.03 0.01 Erysipelas 0.08 0.14 0.15 0.12 0.15 Smallpox 0.00 0.00 0.00 0.00 — Measles 25.29 14.07 13.93 14.82 14.64 Pneumonia 0.93 0.99 1.04 0.96 0.72 Acute poliomyelitis ing polioencephalitis)— Paralytic 0.00 0.03 0.03 0.03 0.02 Non-paralytic 0.03 0.02 0.02 0.03 0.02 Food Poisoning 0.42 0.13 0.15 0.08 0.23 Diphtheria. For the third year in succession there has been no case of diphtheria in the Borough. This happy state of affairs is an indication of the success of the campaign to secure immunisation of all infants before their first birthday. The one death reported as due to diphtheria was from a complication of the disease which had occurred 53 years ago. Meningococcal Infection. There were no cases of meningococcal meningitis during the year. Typhoid and Paratyphoid. No cases of either typhoid or paratyphoid were reported this year. Poliomyelitis. One case of poliomyelitis of the non-paralytic type occurred during the year. The information was received only when the child was discharged from hospital. 42 Acute Influenzal Pneumonia. Seven cases of influenzal pneumonia were notified; three of these were removed to hospital on account of their home conditions. One death occurred in a patient of 72 years old. Acute Primary Pneumonia. Twenty-six cases were notified and of these 25 were removed to hospital, either because of the severity of illness, or unsuitable home conditions. Two deaths occurred, both in aged persons. Erysipelas. Three cases were notified during the year, they were mild and recovered. Measles. There was a considerable increase in the number of cases of measles notified during the year. The majority, however, were of a mild type. Out of a total of 901 cases (including 4 unnotified), 47 were recorded as severe, 281 moderate and 573 mild cases. Sixty-four patients were removed to hospital, thirty-three with bronchitis, and eleven with broncho-pneumonia as a complication. Only four of the cases were in adults, the remainder being in children up to the age of 14 years, with a majority between 1—4 years. Ophthalmia Neonatorum. Two cases of ophthalmia neonatorum were notified, both did well and no blindness resulted. Puerperal Pyrexia. Eight cases were notified. They were all in hospital and there were no deaths. Scarlet Fever. There were 54 cases during the year. All these were in young children. Two cases were of moderate severity, and one other developed the complication of mastoiditis. There were no deaths from this disease. 43 Whooping Cough. There was again a considerable incidence of Whooping Cough throughout 1951, but fortunately no deaths occurred. The majority of the cases were in the age-group 1—5 years but one adult, a nurse, developed the disease. Out of a total of 192 cases, 16 were classified as severe, 75 as moderate, and 101 as mild. Thirty-two patients were removed to hospital because of unsuitable home conditions, but there were no complications. Fifty-two of the cases of Whooping Cough were diagnosed or confirmed, as a result of tests carried out in the Laboratory. Food Poisoning. In all, 15 cases of food poisoning were notified. The first occurred in January, 3 in February, 6 in August, 3 in September, and 2 in October. They have been dealt with fully elsewhere. Smallpox. No cases occurred in the Borough. Two smallpox contacts were supervised during the period of possible incubation but there were no developments. One contact was a girl who had visited Brighton during the epidemic there, and the other a wine steward from an infected ship. Typhus. In October, two seamen arrived from a typhus infected port. They were kept under supervision and there were no further developments. Dysentery. The total number of cases of dysentery (sonne type) during 1951 was 163. Of these, 89 occurred in children in the 4 Day Nurseries in the Borough. Thirty adults were notified and they were probably infected by their children. In only 35 cases were the symptoms severe and there were no deaths. Sixty cases were removed to hospital for treatment and four were already in-patients when they developed the disease. 44 Pathological examinations were made as far as possible of all home contacts. There continued to be friendly co-operation between the families concerned and the Health Department staff, who were able to give help and advice. Gastro-enteritis. Gastro-enteritis in those under 2 years is a notifiable disease in Finsbury, and during 1951 ten such cases occurred. All were removed to hospital and there were no deaths. Five cases were notified occurring after the age of 2 (one was subsequently withdrawn). Scabies. Twenty-two cases were notified. Tuberculosis. The total number of new cases entered into the register during the year was 102. The distribution by sex and age, and according as to whether the case was of Pulmonary or Non-Pulmonary Tuberculosis, was :— 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65+ Total Males Pulmonary 0 6 1 1 2 7 7 7 7 10 4 52 Females Pulmonary 0 3 2 0 2 9 11 4 0 1 2 34 Males Non-pulmonary 0 0 1 1 2 1 0 0 0 1 1 7 Females Non-pulmonary 0 2 0 0 0 0 2 2 0 2 1 9 Total 0 11 4 2 6 17 20 13 7 14 8 102 The Non-Pulmonary cases include :— 1, Right Hip Joint; 5, Glands of Neck; 1, Right Femur; 1, Spine; 1, Miliary; 1, Pelvis; 1, Peritoneum; 2, Kidney and Bladder; 2, Wrist; 1, Meningitis. The numbers are higher than last year (when there were 86 notifications) and are equivalent to a notification rate of 28.64 Per 10,000. Too much significance must not, however, be attached to this figure as it varies from year to year according to the clinical standards accepted for diagnosis. The average figure in Finsbury from 1931 to 1938 was 18.5, and in London for 1948 was 17.9. The distribution as shown in the table is somewhat similar to that in recent years. 45 The total number of cases remaining on the register after adjustments for deaths and transfers was on the 31st December, Males Females Total Pulmonary 162 110 272 Non-Pulmonary 11 17 28 Total 173 127 300 The full details of each case obtained by the Tuberculosis Visitor were, by kind co-operation of the London County Council, made available to and any preventive measures possible co-ordinated with those of the Borough Council. Each case was visited with a view to tracing the source of infection, the conditions which may have influenced its development, the actual spread which may already have taken place, and the means that could be adopted or advised to prevent further danger of spread as well as to give help and advice. Disinfection was carried out whenever thought advisable and on request. Nineteen deaths occurred from Pulmonary Tuberculosis as set out:— 0- 15- 45- 65+ All ages Male 0 3 5 5 13 Female 0 5 1 0 6 Total 0 8 6 5 19 There were two deaths from Non-Pulmonary Tuberculosis, both females aged 56 and 68 years. The Tuberculosis Death-rate from all forms was 0.59 per thousand. In only three cases did death take place where the cases had not previously been notified, and most cases had been notified several years before. This rate though higher than that in 1950, is about the same as that in 1949. Unfortunately the rise is due to more deaths in the Age Group 15—45. 46 Mass Radiography Unit 6D. (Information kindly provided by Dr. W. D. R. Thompson, Medical Director). The Mass Radiography Unit 6D has continued to give good service throughout 1951. During the year it carried out 48,055 miniature chest X-ray examinations which comprised 26,468 males and 21,587 females representing 1,699 firms. For a large portion of the year the Unit was operating at the Mass Radiography Centre, 20, Golden Lane, London E.C.i. At the beginning of 1951 the Unit^was responsible for the examination of workers and residents in the City of London and the Metropolitan Boroughs of Finsbury, Hackney, Shoreditch and Stoke Newington, but this was reviewed by the North East Metropolitan Regional Hospital Board (under which authority the Unit operates) in September, 1951, when it was decided to transfer the Boroughs of Hackney and Stoke Newington to another Unit and return to Unit 6D the Borough of Stepney. While operating at the Mass Radiography Centre which adjoins the Borough of Finsbury, the Unit examined over eighty Finsbury firms and a large number of individuals. This was largely the result of a circulation of firms by the Medical Officer of Health for Finsbury, and this helpful co-operation is greatly appreciated. During the period that the Unit was mobile it carried out Surveys at firms within its zone. The Mass Radiography Service which is free, speedy, reliable and confidential, enables groups of people to have a chest X-ray with a minimum amount of inconvenience. Its purpose is to discover tuberculosis and other chest ailments in their early stages when they are more easily curable. Firms and individuals who wish to avail themselves of this Service or to obtain further information should communicate with the Organising Secretary, Mass Radiography Unit 6D, Finsbury Health Centre, Pine Street, London, E.C.i. (Tel. Nos. TERminus 2121, Ext. 92 or TERminus 6184). A notification of the result of the examination is sent to all examinees who bring to the Unit a stamped envelope bearing their name and private address.